Montefiore St. Luke's Cornwall — Pricing

770 procedures published in this hospital's Machine-Readable File (MRF) — 757 with a comparable price, 13 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 770
Lowest published price $1,606
Average published price $18,164
Highest published price $293,431

Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.

Showing all 770 procedures

Published charges

Showing all 757 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.

Across 52 procedures, this hospital's negotiated rates average ≈121% of what Medicare pays.

DRG Description Published price Cash price vs. NY median vs. National median vs Medicare
018 Chimeric antigen receptor CAR T cell and other immunotherapies $293,431 $293,431 $483,987 −39% $498,715 −41% —
001 Heart transplant or implant of heart assist system with MCC $215,825 $215,825 $562,528 −62% $431,073 −50% —
927 Extensive burns or full thickness burns w MV 96 hours w skin graft $209,932 $209,932 $306,087 −31% $306,087 −31% —
003 ECMO or trach w MV 96 hrs or PDX exc face mouth neck w maj O R $169,804 $169,804 $389,239 −56% $371,366 −54% —
004 Trach w MV 96 hrs or PDX exc face mouth neck w o maj O R $117,077 $117,077 $256,977 −54% $245,241 −52% —
007 Lung transplant $97,695 $97,695 $170,608 −43% $170,608 −43% —
002 Heart transplant or implant of heart assist system without MCC $97,517 $97,517 $155,461 −37% $169,977 −43% —
014 Allogeneic bone marrow transplant $91,279 $91,279 $171,028 −47% $182,314 −50% —
212 Concomitant aortic and mitral valve procedures $85,782 $85,782 $312,843 −73% $171,338 −50% —
005 Liver transplant with MCC or intestinal transplant $82,432 $82,432 $139,842 −41% $159,181 −48% —
215 Other heart assist system implant $81,355 $81,355 $201,916 −60% $191,314 −57% —
216 Cardiac valve oth maj cardiothoracic proc w cardiac cath w MCC $77,297 $77,297 $247,059 −69% $175,437 −56% —
020 Intracranial vascular procedures with PDX hemorrhage w MCC $67,318 $67,318 $112,518 −40% $134,914 −50% —
456 Spinal fusion exc cerv w spinal curv malig infec ext fusion w MCC $67,135 $67,135 $112,119 −40% $151,029 −56% —
231 Coronary bypass with PTCA with MCC $64,633 $64,633 $156,608 −59% $146,474 −56% —
019 Simultaneous pancreas and kidney transplant with hemodialysis $63,664 $63,664 $105,228 −39% $105,228 −39% —
233 Coronary bypass with cardiac cath or open ablation with MCC $62,119 $62,119 $175,329 −65% $138,868 −55% —
219 Cardiac valve oth maj cardiothoracic proc w o cardiac cath w MCC $61,415 $61,415 $238,993 −74% $143,242 −57% —
957 Other O R procedures for multiple significant trauma with MCC $57,603 $57,603 $108,019 −47% $120,587 −52% —
275 Cardiac defibrillator implant with cardiac catheterization and MCC $56,036 $56,036 $197,899 −72% $131,961 −58% —
870 Septicemia or severe sepsis with MV 96 hours $55,471 $55,471 $176,606 −69% $138,008 −60% —
928 Full thickness burn w skin graft or inhalation injury w CC MCC $55,111 $55,111 $89,353 −38% $89,353 −38% —
207 Respiratory system diagnosis with ventilator support 96 hours $55,018 $55,018 $114,669 −52% $116,058 −53% —
969 HIV with extensive O R procedures with MCC $54,736 $54,736 $87,759 −38% $109,331 −50% —
268 Aortic and heart assist procedures except pulsation balloon w MCC $54,594 $54,594 $177,288 −69% $118,589 −54% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $54,305 $54,305 $143,991 −62% $108,472 −50% —
217 Cardiac valve oth maj cardiothoracic proc w cardiac cath w CC $50,696 $50,696 $192,933 −74% $121,714 −58% —
266 Endovascular cardiac valve replacement supplement procedure w MCC $49,747 $49,747 $165,478 −70% $113,855 −56% —
573 Skin graft for skin ulcer or cellulitis with MCC $49,524 $49,524 $93,310 −47% $98,912 −50% —
276 Cardiac defibrillator implant with MCC or carotid sinus neurostimulators $49,461 $49,461 $122,027 −59% $117,280 −58% —
016 Autologous bone marrow transplant with CC MCC $49,196 $49,196 $81,176 −39% $98,260 −50% —
017 Autologous bone marrow transplant without CC MCC $49,196 $49,196 $81,176 −39% $81,176 −39% —
021 Intracranial vascular procedures with PDX hemorrhage w CC $48,913 $48,913 $122,881 −60% $101,235 −52% —
955 Craniotomy for multiple significant trauma $48,505 $48,505 $91,253 −47% $105,612 −54% —
457 Spinal fusion exc cerv w spinal curv malig infec ext fusion w CC $48,386 $48,386 $115,045 −58% $107,355 −55% —
820 Lymphoma and leukemia with major O R procedures with MCC $48,158 $48,158 $111,682 −57% $96,192 −50% —
028 Spinal procedures with MCC $47,994 $47,994 $125,606 −62% $95,858 −50% —
790 Extreme immaturity or respiratory distress syndrome neonate $47,787 $47,787 $80,018 −40% $80,018 −40% —
232 Coronary bypass with PTCA without MCC $47,377 $47,377 $173,445 −73% $106,238 −55% —
235 Coronary bypass without cardiac catheterization with MCC $46,836 $46,836 $142,880 −67% $112,062 −58% —
218 Cardiac valve oth maj cardiothoracic proc w card cath w o CC MCC $45,371 $45,371 $152,440 −70% $92,238 −51% —
576 Skin graft except for skin ulcer or cellulitis with MCC $45,263 $45,263 $115,701 −61% $82,527 −45% —
023 Craniot w maj dev impl acute CNS PDX w MCC or chemo epilep w neuros $45,149 $45,149 $135,515 −67% $106,778 −58% —
463 Wnd debride skn grft exc hand for musculoskel conn tis dis w MCC $45,108 $45,108 $73,103 −38% $78,582 −43% —
834 Acute leukemia with MCC $44,593 $44,593 $74,709 −40% $76,583 −42% —
405 Pancreas liver and shunt procedures with MCC $43,846 $43,846 $94,162 −53% $94,927 −54% —
653 Major bladder procedures with MCC $43,116 $43,116 $84,904 −49% $97,046 −56% —
008 Simultaneous pancreas and kidney transplant $41,906 $41,906 $86,459 −52% $86,459 −52% —
220 Cardiac valve oth maj cardiothoracic proc w o cardiac cath w CC $41,770 $41,770 $124,741 −67% $102,177 −59% —
234 Coronary bypass with cardiac cath or open ablation without MCC $41,398 $41,398 $160,266 −74% $102,573 −60% —
466 Revision of hip or knee replacement with MCC $41,308 $41,308 $94,394 −56% $96,222 −57% —
011 Tracheostomy for face mouth neck diagnoses or laryngectomy w MCC $41,067 $41,067 $73,038 −44% $86,953 −53% —
326 Stomach esophageal and duodenal procedures with MCC $40,451 $40,451 $80,701 −50% $80,747 −50% —
270 Other major cardiovascular procedures with MCC $40,275 $40,275 $115,907 −65% $99,423 −59% —
228 Other cardiothoracic procedures with MCC $40,130 $40,130 $111,145 −64% $96,905 −59% —
853 Infectious and parasitic diseases with O R procedures with MCC $39,817 $39,817 $92,416 −57% $87,018 −54% ≈114% of Medicare
799 Splenic procedures with MCC $39,461 $39,461 $76,574 −48% $78,821 −50% —
471 Cervical spinal fusion with MCC $39,177 $39,177 $80,569 −51% $92,515 −58% —
267 Endovascular cardiac valve replace supplement procedure w o MCC $38,868 $38,868 $142,453 −73% $92,217 −58% —
837 Chemo w acute leukemia as SDX or w high dose chemo agent w MCC $38,580 $38,580 $68,095 −43% $70,735 −45% —
006 Liver transplant without MCC $38,523 $38,523 $84,407 −54% $84,407 −54% —
010 Pancreas transplant $38,338 $38,338 $99,940 −62% $99,940 −62% —
239 Amputation for circulatory sys disorders exc upper limb toe w MCC $38,283 $38,283 $91,116 −58% $87,565 −56% —
277 Cardiac defibrillator implant without MCC $38,089 $38,089 $102,350 −63% $91,329 −58% —
981 Extensive O R procedures unrelated to principal diagnosis w MCC $37,755 $37,755 $110,658 −66% $86,390 −56% —
163 Major chest procedures with MCC $37,541 $37,541 $90,851 −59% $88,341 −58% —
221 Cardiac valve oth maj cardiothorac proc w o card cath w o CC MCC $37,023 $37,023 $81,713 −55% $90,331 −59% —
826 Myeloprolif disord or poorly diff neopl w maj O R proc w MCC $36,857 $36,857 $82,674 −55% $88,691 −58% —
245 AICD generator procedures $36,090 $36,090 $66,564 −46% $72,076 −50% —
458 Spinal fus exc cerv w spinal curv malig infec ext fusion w o CC MCC $36,087 $36,087 $135,307 −73% $83,441 −57% —
329 Major small and large bowel procedures with MCC $35,974 $35,974 $75,766 −53% $88,050 −59% —
823 Lymphoma and non acute leukemia with other procedures with MCC $35,855 $35,855 $89,295 −60% $80,885 −56% —
650 Kidney transplant with hemodialysis with MCC $35,820 $35,820 $62,992 −43% $71,551 −50% —
278 US accelerated other thrombolysis of peripheral vasc structures w MCC $35,525 $35,525 $102,309 −65% $84,861 −58% —
856 Postoperative or post traumatic infections w O R procedures w MCC $35,270 $35,270 $63,580 −45% $72,859 −52% —
025 Craniotomy and endovascular intracranial procedures with MCC $35,171 $35,171 $97,799 −64% $88,307 −60% —
319 Other endovascular cardiac valve procedures with MCC $34,740 $34,740 $87,760 −60% $75,585 −54% —
901 Wound debridements for injuries with MCC $34,468 $34,468 $60,697 −43% $68,847 −50% —
474 Amputation for musculoskeletal syst connective tissue dis w MCC $34,269 $34,269 $86,544 −60% $76,954 −55% —
356 Other digestive system O R procedures with MCC $34,077 $34,077 $89,159 −62% $82,561 −59% —
793 Full term neonate with major problems $33,525 $33,525 $22,283 +50% $16,719 +101% —
269 Aortic and heart assist procedures except pulsation balloon w o MCC $33,121 $33,121 $109,299 −70% $83,065 −60% —
323 Coronary intravascular lithotripsy with intraluminal device with MCC $32,973 $32,973 $112,108 −71% $88,049 −63% —
031 Ventricular shunt procedures with MCC $32,786 $32,786 $113,929 −71% $68,659 −52% —
791 Prematurity with major problems $32,636 $32,636 $49,057 −33% $39,563 −18% —
166 Other respiratory system O R procedures with MCC $32,318 $32,318 $67,154 −52% $72,782 −56% —
958 Other O R procedures for multiple significant trauma with CC $32,214 $32,214 $58,656 −45% $66,853 −52% —
236 Coronary bypass without cardiac catheterization without MCC $32,186 $32,186 $104,981 −69% $82,247 −61% —
628 Other endocrine nutritional and metabolic O R procedures with MCC $31,973 $31,973 $61,206 −48% $68,006 −53% —
012 Tracheostomy for face mouth neck diagnoses or laryngectomy w CC $31,897 $31,897 $73,029 −56% $73,029 −56% —
616 Amputation lower limb for endocrine nutrit metabolic disord w MCC $31,521 $31,521 $53,357 −41% $62,961 −50% —
022 Intracranial vascular procedures with PDX hemorrhage w o CC MCC $31,242 $31,242 $49,015 −36% $62,404 −50% —
423 Other hepatobiliary or pancreas O R procedures with MCC $31,148 $31,148 $92,292 −66% $72,011 −57% —
034 Carotid artery stent procedures with MCC $31,072 $31,072 $95,318 −67% $72,908 −57% —
273 Percutaneous and other intracardiac procedures with MCC $31,037 $31,037 $104,086 −70% $78,852 −61% —
736 Uterine adnexa procedures for ovarian or adnexal malignancy w MCC $30,959 $30,959 $54,300 −43% $61,832 −50% —
956 Limb reattachment hip femur proc for multiple significant trauma $30,888 $30,888 $55,689 −45% $75,103 −59% —
040 Peripheral cranial nerve and other nervous system procedures w MCC $30,667 $30,667 $84,121 −64% $74,257 −59% —
622 Skin grafts wound debride for endocrine nutrit metab disord w MCC $30,469 $30,469 $51,761 −41% $60,861 −50% —
024 Craniotomy w major device implant or acute complex CNS PDX w o MCC $30,176 $30,176 $85,781 −65% $74,755 −60% —
140 Major head and neck procedures with MCC $30,090 $30,090 $58,085 −48% $60,098 −50% —
876 O R procedures with principal diagnosis of mental illness $29,719 $29,719 $52,861 −44% $54,196 −45% —
408 Biliary tract proc except only cholecystect w or w o C D E w MCC $29,645 $29,645 $72,552 −59% $59,207 −50% —
907 Other O R procedures for injuries with MCC $29,624 $29,624 $75,408 −61% $71,701 −59% —
673 Other kidney and urinary tract procedures with MCC $29,452 $29,452 $77,589 −62% $72,945 −60% —
332 Rectal resection with MCC $29,104 $29,104 $58,213 −50% $58,125 −50% —
518 Back neck proc exc spinal fusion w MCC or disc device neurostim $29,084 $29,084 $49,711 −41% $64,776 −55% —
097 Non bacterial infect of nervous syst except viral meningitis w MCC $28,966 $28,966 $49,718 −42% $57,855 −50% —
094 Bacterial and tuberculous infections of nervous system with MCC $28,853 $28,853 $50,550 −43% $62,524 −54% —
739 Uterine adnexa proc for non ovarian non adnexal malignancy w MCC $28,802 $28,802 $54,862 −48% $57,521 −50% —
495 Local excision removal inter fixation dev exc hip femur w MCC $28,522 $28,522 $48,887 −42% $56,964 −50% —
335 Peritoneal adhesiolysis with MCC $28,473 $28,473 $82,458 −65% $71,755 −60% —
265 AICD lead procedures $28,147 $28,147 $83,892 −66% $56,695 −50% —
414 Cholecystectomy except by laparoscope without C D E with MCC $28,076 $28,076 $49,908 −44% $68,399 −59% —
467 Revision of hip or knee replacement with CC $27,766 $27,766 $73,275 −62% $68,880 −60% —
492 Lower extremity humerus procedures exc hip foot and femur w MCC $27,574 $27,574 $78,651 −65% $70,540 −61% —
651 Kidney transplant with hemodialysis without MCC $27,544 $27,544 $56,242 −51% $56,242 −51% —
271 Other major cardiovascular procedures with CC $27,527 $27,527 $68,489 −60% $71,014 −61% —
242 Permanent cardiac pacemaker implant with MCC $27,518 $27,518 $69,584 −60% $70,132 −61% —
802 Other O R procedures of the blood and blood forming organs w MCC $27,324 $27,324 $72,168 −62% $59,425 −54% —
029 Spinal procedures with CC or spinal neurostimulators $27,304 $27,304 $60,497 −55% $64,152 −57% —
574 Skin graft for skin ulcer or cellulitis with CC $27,125 $27,125 $48,165 −44% $49,065 −45% —
987 Non extensive O R proc unrelated to principal diagnosis w MCC $26,893 $26,893 $69,526 −61% $65,383 −59% —
037 Extracranial procedures with MCC $26,885 $26,885 $89,423 −70% $64,749 −58% —
477 Biopsies of musculoskeletal system and connective tissue with MCC $26,832 $26,832 $76,169 −65% $62,269 −57% —
252 Other vascular procedures with MCC $26,711 $26,711 $75,832 −65% $68,508 −61% —
579 Other skin subcutaneous tissue and breast procedures with MCC $26,619 $26,619 $52,030 −49% $54,129 −51% —
469 Maj hip knee jnt replace reattach low extrem w MCC or tot ank repl $26,520 $26,520 $48,438 −45% $65,254 −59% —
143 Other ear nose mouth and throat O R procedures with MCC $26,486 $26,486 $46,049 −42% $52,908 −50% —
260 Cardiac pacemaker revision except device replacement with MCC $26,404 $26,404 $83,715 −68% $67,901 −61% —
485 Knee procedures with principal diagnosis of infection with MCC $26,235 $26,235 $83,932 −69% $64,956 −60% —
264 Other circulatory system O R procedures $26,012 $26,012 $48,557 −46% $51,953 −50% —
904 Skin grafts for injuries with CC MCC $25,934 $25,934 $89,065 −71% $55,097 −53% —
500 Soft tissue procedures with MCC $25,827 $25,827 $53,498 −52% $57,479 −55% —
274 Percutaneous and other intracardiac procedures without MCC $25,811 $25,811 $87,436 −70% $65,573 −61% —
929 Full thickness burn w skin graft or inhalation injury w o CC MCC $25,610 $25,610 $44,472 −42% $44,472 −42% —
939 O R procedure w diagnoses of other contact w health services w MCC $25,608 $25,608 $44,389 −42% $51,142 −50% —
420 Hepatobiliary diagnostic procedures with MCC $25,493 $25,493 $49,003 −48% $50,919 −50% —
279 US accelerated other thrombolysis of peripheral vasc structures w o MCC $25,491 $25,491 $65,588 −61% $57,277 −55% —
229 Other cardiothoracic procedures without MCC $25,324 $25,324 $79,460 −68% $65,325 −61% —
515 Other musculoskeletal system connective tissue O R proc w MCC $25,180 $25,180 $51,311 −51% $62,821 −60% —
829 Myeloprolif disord or poorly diff neopl w oth proc w CC MCC $25,118 $25,118 $43,218 −42% $53,817 −53% —
656 Kidney and ureter procedures for neoplasm with MCC $24,989 $24,989 $64,465 −61% $64,465 −61% —
840 Lymphoma and non acute leukemia with MCC $24,890 $24,890 $44,584 −44% $49,710 −50% —
665 Prostatectomy with MCC $24,603 $24,603 $50,174 −51% $54,072 −54% —
173 Ultrasound accelerated and oth thrombolysis with PDX pulmonary embolism $24,491 $24,491 $67,085 −63% $53,555 −54% —
411 Cholecystectomy with C D E with MCC $24,215 $24,215 $67,831 −64% $48,358 −50% —
933 Extensive burns or full thick burns w MV 96 hours w o skin graft $24,148 $24,148 $59,352 −59% $59,352 −59% —
652 Kidney transplant $23,928 $23,928 $54,720 −56% $54,720 −56% —
464 Wnd debride skn grft exc hand for musculoskel conn tis dis w CC $23,904 $23,904 $56,193 −57% $54,313 −56% —
662 Minor bladder procedures with MCC $23,867 $23,867 $55,854 −57% $54,483 −56% —
521 Hip replacement with principal diagnosis of hip fracture with MCC $23,847 $23,847 $63,485 −62% $67,764 −65% —
324 Coronary intravascular lithotripsy with intraluminal device without MCC $23,643 $23,643 $91,834 −74% $66,819 −65% —
472 Cervical spinal fusion with CC $23,538 $23,538 $59,171 −60% $59,537 −60% —
026 Craniotomy and endovascular intracranial procedures with CC $23,520 $23,520 $61,575 −62% $63,475 −63% —
480 Hip and femur procedures except major joint with MCC $23,486 $23,486 $64,529 −64% $63,984 −63% —
353 Hernia procedures except inguinal and femoral with MCC $23,290 $23,290 $51,577 −55% $60,140 −61% —
570 Skin debridement with MCC $23,274 $23,274 $42,263 −45% $52,435 −56% —
625 Thyroid parathyroid and thyroglossal procedures with MCC $23,266 $23,266 $40,406 −42% $58,968 −61% —
974 HIV with major related condition with MCC $23,228 $23,228 $46,103 −50% $46,402 −50% —
406 Pancreas liver and shunt procedures with CC $22,996 $22,996 $47,220 −51% $58,043 −60% —
321 Perc CV proc with intralum device with MCC or 4 arteries intralum dev $22,895 $22,895 $76,734 −70% $74,274 −69% ≈111% of Medicare
462 Bilateral or multiple major joint procs of lower extremity w o MCC $22,669 $22,669 $59,254 −62% $56,758 −60% —
263 Vein ligation and stripping $22,501 $22,501 $38,005 −41% $44,938 −50% —
668 Transurethral procedures with MCC $22,444 $22,444 $49,739 −55% $47,277 −53% —
800 Splenic procedures with CC $22,441 $22,441 $41,012 −45% $49,184 −54% —
817 Other antepartum diagnoses with O R procedures with MCC $22,434 $22,434 $31,159 −28% $36,097 −38% —
240 Amputation for circulatory sys disorders exc upper limb toe w CC $22,374 $22,374 $54,475 −59% $54,475 −59% —
061 Ischemic stroke precereb occl trans ischemia w thrombolyt agt w MCC $22,323 $22,323 $66,547 −66% $57,963 −61% —
970 HIV with extensive O R procedures without MCC $22,138 $22,138 $37,631 −41% $40,947 −46% —
255 Upper limb toe amputation for circulatory system disorders w MCC $21,881 $21,881 $37,153 −41% $43,697 −50% —
344 Minor small and large bowel procedures with MCC $21,826 $21,826 $38,706 −44% $44,839 −51% —
654 Major bladder procedures with CC $21,803 $21,803 $50,400 −57% $53,868 −60% —
963 Other multiple significant trauma with MCC $21,777 $21,777 $38,454 −43% $43,491 −50% —
510 Shoulder elbow or forearm procedures exc major joint proc w MCC $21,668 $21,668 $53,604 −60% $49,055 −56% —
258 Cardiac pacemaker device replacement with MCC $21,572 $21,572 $39,606 −46% $48,907 −56% —
208 Respiratory system diagnosis with ventilator support 96 hours $21,534 $21,534 $54,297 −60% $52,405 −59% —
849 Radiotherapy $21,435 $21,435 $37,862 −43% $37,862 −43% —
013 Tracheostomy for face mouth neck diag or laryngectomy w o CC MCC $21,390 $21,390 $84,844 −75% $45,290 −53% —
503 Foot procedures with MCC $21,360 $21,360 $58,830 −64% $43,901 −51% —
468 Revision of hip or knee replacement without CC MCC $21,262 $21,262 $49,222 −57% $54,929 −61% —
135 Sinus and mastoid procedures with CC MCC $21,122 $21,122 $29,979 −30% $40,065 −47% —
577 Skin graft except for skin ulcer or cellulitis with CC $21,099 $21,099 $37,754 −44% $45,432 −54% —
325 Coronary intravascular lithotripsy without intraluminal device $21,060 $21,060 $72,297 −71% $53,551 −61% —
498 Local excision removal inter fixation dev hip femur w CC MCC $20,795 $20,795 $36,842 −44% $46,659 −55% —
619 O R procedures for obesity with MCC $20,727 $20,727 $38,581 −46% $44,973 −54% —
288 Acute and subacute endocarditis with MCC $20,652 $20,652 $45,238 −54% $45,497 −55% —
659 Kidney and ureter procedures for non neoplasm with MCC $20,619 $20,619 $43,429 −53% $48,094 −57% —
253 Other vascular procedures with CC $20,318 $20,318 $56,289 −64% $53,746 −62% —
164 Major chest procedures with CC $20,312 $20,312 $67,197 −70% $53,141 −62% —
347 Anal and stomal procedures with MCC $20,302 $20,302 $49,639 −59% $40,548 −50% —
959 Other O R procedures for multiple significant trauma w o CC MCC $20,169 $20,169 $46,181 −56% $40,277 −50% —
749 Other female reproductive system O R procedures with CC MCC $20,048 $20,048 $42,815 −53% $41,703 −52% —
113 Orbital procedures with CC MCC $19,969 $19,969 $57,860 −65% $35,642 −44% —
327 Stomach esophageal and duodenal procedures with CC $19,890 $19,890 $49,647 −60% $54,824 −64% —
545 Connective tissue disorders with MCC $19,857 $19,857 $43,431 −54% $39,657 −50% —
483 Major joint or limb reattachment procedures of upper extremities $19,785 $19,785 $51,101 −61% $57,149 −65% —
792 Prematurity without major problems $19,692 $19,692 $22,087 −11% $11,633 +69% —
473 Cervical spinal fusion without CC MCC $19,597 $19,597 $58,276 −66% $50,624 −61% —
846 Chemotherapy without acute leukemia as secondary diagnosis with MCC $19,465 $19,465 $36,339 −46% $38,878 −50% —
272 Other major cardiovascular procedures without CC MCC $19,429 $19,429 $46,501 −58% $55,162 −65% —
027 Craniotomy and endovascular intracranial procedures without CC MCC $19,377 $19,377 $57,419 −66% $52,332 −63% —
493 Lower extremity humerus procedures exc hip foot and femur w CC $19,128 $19,128 $54,832 −65% $56,394 −66% —
350 Inguinal and femoral hernia procedures with MCC $19,115 $19,115 $66,902 −71% $46,591 −59% —
056 Degenerative nervous system disorders with MCC $19,067 $19,067 $42,202 −55% $39,409 −52% —
095 Bacterial and tuberculous infections of nervous system with CC $18,989 $18,989 $59,209 −68% $47,583 −60% —
478 Biopsies of musculoskeletal system and connective tissue with CC $18,985 $18,985 $38,036 −50% $50,139 −62% —
674 Other kidney and urinary tract procedures with CC $18,973 $18,973 $42,884 −56% $49,631 −62% —
330 Major small and large bowel procedures with CC $18,892 $18,892 $55,088 −66% $58,832 −68% —
250 Percutaneous cardiovascular proc w o intraluminal device with MCC $18,723 $18,723 $55,306 −66% $51,339 −64% —
030 Spinal procedures without CC MCC $18,469 $18,469 $38,567 −52% $45,818 −60% —
417 Laparoscopic cholecystectomy without C D E with MCC $18,460 $18,460 $41,196 −55% $52,313 −65% —
827 Myeloprolif disord or poorly diff neopl w maj O R proc w CC $18,455 $18,455 $73,532 −75% $47,546 −61% —
035 Carotid artery stent procedures with CC $18,314 $18,314 $61,008 −70% $46,430 −61% —
082 Traumatic stupor and coma 1 hour with MCC $18,145 $18,145 $33,308 −46% $36,237 −50% —
243 Permanent cardiac pacemaker implant with CC $18,140 $18,140 $50,655 −64% $50,011 −64% —
085 Traumatic stupor and coma 1 hour with MCC $18,102 $18,102 $47,618 −62% $37,064 −51% —
629 Other endocrine nutritional and metabolic O R procedures with CC $18,022 $18,022 $46,757 −61% $45,059 −60% —
614 Adrenal and pituitary procedures with CC MCC $17,939 $17,939 $46,130 −61% $43,586 −59% —
397 Appendix procedures with MCC $17,893 $17,893 $52,457 −66% $52,319 −66% —
835 Acute leukemia with CC $17,804 $17,804 $41,313 −57% $35,569 −50% —
824 Lymphoma and non acute leukemia with other procedures with CC $17,784 $17,784 $45,690 −61% $38,382 −54% —
821 Lymphoma and leukemia with major O R procedures with CC $17,777 $17,777 $71,300 −75% $44,053 −60% —
041 Periph cranial nerve other nerv syst proc w CC or periph neurost $17,766 $17,766 $33,306 −47% $44,989 −61% —
320 Other endovascular cardiac valve procedures without MCC $17,729 $17,729 $57,963 −69% $36,080 −51% —
080 Nontraumatic stupor and coma with MCC $17,591 $17,591 $28,993 −39% $35,139 −50% —
715 Other male reproductive system O R proc for malignancy w CC MCC $17,581 $17,581 $32,504 −46% $38,998 −55% —
357 Other digestive system O R procedures with CC $17,496 $17,496 $62,284 −72% $48,682 −64% —
808 Major hematol immun diag exc sickle cell crisis coagul dis w MCC $17,443 $17,443 $32,919 −47% $36,334 −52% —
096 Bacterial and tuberculous infections of nervous system w o CC MCC $17,360 $17,360 $34,307 −49% $39,093 −56% —
595 Major skin disorders with MCC $17,323 $17,323 $37,345 −54% $31,785 −46% —
734 Pelvic evisceration rad hysterectomy and rad vulvectomy w CC MCC $17,311 $17,311 $37,410 −54% $35,686 −51% —
709 Penis procedures with CC MCC $17,289 $17,289 $32,359 −47% $34,535 −50% —
940 O R procedure w diagnoses of other contact w health services w CC $17,256 $17,256 $35,473 −51% $38,420 −55% —
286 Circulatory disorders except AMI w cardiac catheterization w MCC $17,168 $17,168 $44,619 −62% $44,600 −62% ≈113% of Medicare
098 Non bacterial infect of nervous system except viral meningitis w CC $17,159 $17,159 $39,489 −57% $37,902 −55% —
032 Ventricular shunt procedures with CC $17,154 $17,154 $43,988 −61% $45,622 −62% —
407 Pancreas liver and shunt procedures without CC MCC $17,131 $17,131 $66,230 −74% $40,232 −57% —
475 Amputation for musculoskeletal syst connective tissue dis w CC $17,081 $17,081 $39,369 −57% $44,553 −62% —
857 Postoperative or post traumatic infections w O R procedures w CC $17,010 $17,010 $42,315 −60% $41,900 −59% —
424 Other hepatobiliary or pancreas O R procedures with CC $16,978 $16,978 $44,472 −62% $39,253 −57% —
507 Major shoulder or elbow joint procedures with CC MCC $16,978 $16,978 $36,202 −53% $36,202 −53% —
814 Reticuloendothelial and immunity disorders with MCC $16,949 $16,949 $35,509 −52% $32,483 −48% —
711 Testes procedures with CC MCC $16,908 $16,908 $46,485 −64% $34,852 −51% —
522 Hip replacement with principal diagnosis of hip fracture w o MCC $16,822 $16,822 $52,634 −68% $56,519 −70% ≈116% of Medicare
146 Ear nose mouth and throat malignancy with MCC $16,813 $16,813 $47,803 −65% $37,080 −55% —
655 Major bladder procedures without CC MCC $16,787 $16,787 $45,797 −63% $41,651 −60% —
488 Knee procedures without principal diagnosis of infection w CC MCC $16,778 $16,778 $44,644 −62% $41,520 −60% —
336 Peritoneal adhesiolysis with CC $16,767 $16,767 $44,395 −62% $49,470 −66% —
374 Digestive malignancy with MCC $16,717 $16,717 $38,075 −56% $38,885 −57% —
314 Other circulatory system diagnoses with MCC $16,674 $16,674 $33,498 −50% $38,357 −57% —
934 Full thickness burn without skin graft or inhalation injury $16,666 $16,666 $31,044 −46% $31,044 −46% —
867 Other infectious and parasitic diseases diagnoses with MCC $16,664 $16,664 $37,707 −56% $36,850 −55% —
592 Skin ulcers with MCC $16,646 $16,646 $29,882 −44% $32,662 −49% —
333 Rectal resection with CC $16,562 $16,562 $31,951 −48% $34,352 −52% —
481 Hip and femur procedures except major joint with CC $16,525 $16,525 $53,106 −69% $51,172 −68% ≈115% of Medicare
141 Major head and neck procedures with CC $16,500 $16,500 $38,653 −57% $34,900 −53% —
412 Cholecystectomy with C D E with CC $16,455 $16,455 $57,394 −71% $37,654 −56% —
575 Skin graft for skin ulcer or cellulitis without CC MCC $16,295 $16,295 $29,109 −44% $29,109 −44% —
935 Non extensive burns $16,256 $16,256 $31,701 −49% $29,458 −45% —
516 Other musculoskeletal system connective tissue O R proc w CC $16,254 $16,254 $46,090 −65% $45,817 −65% —
854 Infectious and parasitic diseases with O R procedures with CC $16,233 $16,233 $38,023 −57% $43,524 −63% —
486 Knee procedures with principal diagnosis of infection with CC $15,995 $15,995 $49,467 −68% $46,477 −66% —
908 Other O R procedures for injuries with CC $15,961 $15,961 $40,387 −60% $41,660 −62% —
064 Intracranial hemorrhage or cerebral infarction with MCC $15,953 $15,953 $41,480 −62% $35,714 −55% ≈121% of Medicare
838 Chemo w acute leukemia as SDX w CC or high dose chemo agent $15,942 $15,942 $29,518 −46% $30,661 −48% —
511 Shoulder elbow or forearm procedures exc major joint proc w CC $15,879 $15,879 $39,545 −60% $43,538 −64% —
496 Local excision removal inter fixation dev exc hip femur w CC $15,829 $15,829 $52,219 −70% $43,800 −64% —
617 Amputation lower limb for endocrine nutrit metabolic disord w CC $15,805 $15,805 $38,934 −59% $42,881 −63% —
539 Osteomyelitis with MCC $15,805 $15,805 $45,071 −65% $33,746 −53% —
871 Septicemia or severe sepsis without MV 96 hours with MCC $15,790 $15,790 $35,115 −55% $35,237 −55% ≈113% of Medicare
100 Seizures with MCC $15,789 $15,789 $31,211 −49% $35,194 −55% ≈106% of Medicare
415 Cholecystectomy except by laparoscope without C D E with CC $15,736 $15,736 $32,506 −52% $43,398 −64% —
737 Uterine adnexa procedures for ovarian or adnexal malignancy w CC $15,720 $15,720 $47,968 −67% $44,363 −65% —
283 Acute myocardial infarction expired with MCC $15,701 $15,701 $31,582 −50% $35,014 −55% —
519 Back neck procedures except spinal fusion with CC $15,679 $15,679 $36,815 −57% $43,775 −64% —
707 Major male pelvic procedures with CC MCC $15,625 $15,625 $49,323 −68% $43,080 −64% —
584 Breast biopsy local excision and other breast procedures w CC MCC $15,599 $15,599 $39,826 −61% $34,089 −54% —
409 Biliary tract proc except only cholecystectomy w or w o C D E w CC $15,589 $15,589 $48,770 −68% $46,066 −66% —
548 Septic arthritis with MCC $15,529 $15,529 $34,947 −56% $31,019 −50% —
380 Complicated peptic ulcer with MCC $15,519 $15,519 $33,696 −54% $36,641 −58% —
052 Spinal disorders and injuries with CC MCC $15,487 $15,487 $29,314 −47% $30,940 −50% —
432 Cirrhosis and alcoholic hepatitis with MCC $15,260 $15,260 $49,473 −69% $36,933 −59% —
075 Viral meningitis with CC MCC $15,242 $15,242 $29,084 −48% $29,853 −49% —
196 Interstitial lung disease with MCC $15,096 $15,096 $31,341 −52% $30,766 −51% —
902 Wound debridements for injuries with CC $15,011 $15,011 $41,665 −64% $35,459 −58% —
744 D C conization laparoscopy and tubal interruption with CC MCC $14,992 $14,992 $31,344 −52% $33,050 −55% —
261 Cardiac pacemaker revision except device replacement with CC $14,987 $14,987 $44,442 −66% $42,126 −64% —
470 Major hip knee joint replace or reattach lower extremity w o MCC $14,987 $14,987 $45,967 −67% $49,197 −70% —
906 Hand procedures for injuries $14,986 $14,986 $31,792 −53% $31,520 −52% —
165 Major chest procedures without CC MCC $14,944 $14,944 $57,095 −74% $41,380 −64% —
883 Disorders of personality and impulse control $14,936 $14,936 $27,256 −45% $22,698 −34% —
722 Malignancy male reproductive system with MCC $14,932 $14,932 $25,633 −42% $29,826 −50% —
062 Ischemic stroke precereb occl trans ischemia w thrombolyt agt w CC $14,907 $14,907 $53,594 −72% $48,680 −69% —
465 Wnd debride skn grft exc hand for musculo conn tis dis w o CC MCC $14,900 $14,900 $27,614 −46% $32,839 −55% —
494 Lower extremity humerus proc exc hip foot and femur w o CC MCC $14,887 $14,887 $38,192 −61% $45,963 −68% —
259 Cardiac pacemaker device replacement without MCC $14,866 $14,866 $43,498 −66% $35,673 −58% —
479 Biopsies of musculoskeletal system and connective tissue w o CC MCC $14,846 $14,846 $43,492 −66% $31,909 −53% —
623 Skin grafts wound debride for endocrine nutrit metab disord w CC $14,825 $14,825 $28,893 −49% $33,165 −55% —
843 Other myeloprolif disord or poorly diff neoplastic diagnoses w MCC $14,819 $14,819 $34,120 −57% $36,280 −59% —
803 Other O R procedures of the blood and blood forming organs w CC $14,799 $14,799 $46,694 −68% $33,564 −56% —
941 O R proc w diagnoses of other contact w health services w o CC MCC $14,782 $14,782 $35,817 −59% $29,524 −50% —
754 Malignancy female reproductive system with MCC $14,754 $14,754 $35,135 −58% $29,476 −50% —
559 Aftercare musculoskeletal system and connective tissue with MCC $14,738 $14,738 $29,800 −51% $30,974 −52% —
657 Kidney and ureter procedures for neoplasm with CC $14,688 $14,688 $39,277 −63% $40,583 −64% —
862 Postoperative and post traumatic infections with MCC $14,670 $14,670 $32,602 −55% $30,394 −52% —
686 Kidney and urinary tract neoplasms with MCC $14,650 $14,650 $41,587 −65% $32,981 −56% —
116 Intraocular procedures with CC MCC $14,581 $14,581 $24,851 −41% $28,103 −48% —
244 Permanent cardiac pacemaker implant without CC MCC $14,571 $14,571 $44,198 −67% $40,063 −64% —
441 Disorders of liver exc malignancy cirrhosis or alc hepatitis w MCC $14,561 $14,561 $27,729 −47% $32,399 −55% —
919 Complications of treatment with MCC $14,533 $14,533 $26,862 −46% $29,031 −50% —
542 Pathological fractures musculoskeletal conn tissue malig w MCC $14,525 $14,525 $34,886 −58% $35,114 −59% —
322 Perc CV procedures with intraluminal device without MCC $14,522 $14,522 $59,784 −76% $54,772 −73% ≈118% of Medicare
167 Other respiratory system O R procedures with CC $14,494 $14,494 $41,820 −65% $40,563 −64% —
789 Neonates died or transferred to another acute care facility $14,490 $14,490 $26,590 −46% $14,284 +1% —
717 Other male reproductive system O R proc except malignancy w CC MCC $14,445 $14,445 $35,183 −59% $32,538 −56% —
205 Other respiratory system diagnoses with MCC $14,418 $14,418 $27,695 −48% $32,204 −55% —
036 Carotid artery stent procedures without CC MCC $14,401 $14,401 $55,123 −74% $40,694 −65% —
377 Gastrointestinal hemorrhage with MCC $14,259 $14,259 $38,268 −63% $37,842 −62% ≈116% of Medicare
801 Splenic procedures without CC MCC $14,254 $14,254 $41,456 −66% $28,634 −50% —
070 Nonspecific cerebrovascular disorders with MCC $14,252 $14,252 $25,761 −45% $30,814 −54% ≈120% of Medicare
091 Other disorders of nervous system with MCC $14,250 $14,250 $32,429 −56% $36,375 −61% —
740 Uterine adnexa proc for non ovarian non adnexal malignancy w CC $14,232 $14,232 $48,949 −71% $36,597 −61% —
742 Uterine and adnexa procedures for non malignancy with CC MCC $14,192 $14,192 $27,369 −48% $40,552 −65% —
896 Alcohol drug abuse or dependence w o rehabilitation therapy w MCC $14,162 $14,162 $26,307 −46% $30,275 −53% —
199 Pneumothorax with MCC $14,130 $14,130 $29,170 −52% $31,491 −55% —
915 Allergic reactions with MCC $14,129 $14,129 $25,750 −45% $30,944 −54% —
783 Cesarean section with sterilization with MCC $14,111 $14,111 $25,515 −45% $28,375 −50% —
435 Malignancy of hepatobiliary system or pancreas with MCC $14,017 $14,017 $34,822 −60% $37,950 −63% —
884 Organic disturbances and intellectual disability $13,993 $13,993 $23,378 −40% $25,208 −44% ≈110% of Medicare
786 Cesarean section without sterilization with MCC $13,934 $13,934 $25,044 −44% $27,118 −49% —
371 Major gastrointestinal disorders and peritoneal infections with MCC $13,919 $13,919 $36,341 −62% $31,758 −56% —
580 Other skin subcutaneous tissue and breast procedures with CC $13,911 $13,911 $34,662 −60% $36,242 −62% —
922 Other injury poisoning and toxic effect diagnoses with MCC $13,897 $13,897 $28,798 −52% $29,409 −53% —
582 Mastectomy for malignancy with CC MCC $13,868 $13,868 $30,024 −54% $34,264 −60% —
042 Peripheral cranial nerve other nervous system proc w o CC MCC $13,857 $13,857 $50,041 −72% $39,018 −64% —
180 Respiratory neoplasms with MCC $13,844 $13,844 $40,315 −66% $36,658 −62% —
501 Soft tissue procedures with CC $13,824 $13,824 $45,517 −70% $37,975 −64% —
254 Other vascular procedures without CC MCC $13,819 $13,819 $47,265 −71% $38,836 −64% —
144 Other ear nose mouth and throat O R procedures with CC $13,782 $13,782 $33,575 −59% $29,558 −53% —
058 Multiple sclerosis and cerebellar ataxia with MCC $13,762 $13,762 $27,853 −51% $29,609 −54% —
504 Foot procedures with CC $13,755 $13,755 $29,220 −53% $36,598 −62% —
354 Hernia procedures except inguinal and femoral with CC $13,681 $13,681 $40,400 −66% $43,266 −68% —
666 Prostatectomy with CC $13,678 $13,678 $33,815 −60% $30,016 −54% —
671 Urethral procedures with CC MCC $13,634 $13,634 $26,412 −48% $27,233 −50% —
421 Hepatobiliary diagnostic procedures with CC $13,616 $13,616 $54,499 −75% $36,333 −63% —
157 Dental and oral diseases with MCC $13,595 $13,595 $27,457 −50% $27,457 −50% —
505 Foot procedures without CC MCC $13,585 $13,585 $25,972 −48% $31,716 −57% —
551 Medical back problems with MCC $13,555 $13,555 $33,102 −59% $31,086 −56% —
855 Infectious and parasitic diseases with O R procedures w o CC MCC $13,554 $13,554 $24,292 −44% $27,168 −50% —
177 Respiratory infections and inflammations with MCC $13,511 $13,511 $34,944 −61% $31,840 −58% ≈118% of Medicare
571 Skin debridement with CC $13,475 $13,475 $37,246 −64% $34,901 −61% —
585 Breast biopsy local excision other breast procedures w o CC MCC $13,412 $13,412 $28,958 −54% $29,633 −55% —
886 Behavioral and developmental disorders $13,394 $13,394 $24,172 −45% $24,836 −46% —
746 Vagina cervix and vulva procedures with CC MCC $13,349 $13,349 $28,382 −53% $29,916 −55% —
331 Major small and large bowel procedures without CC MCC $13,317 $13,317 $42,815 −69% $44,117 −70% —
438 Disorders of pancreas except malignancy with MCC $13,291 $13,291 $25,581 −48% $32,502 −59% —
698 Other kidney and urinary tract diagnoses with MCC $13,176 $13,176 $30,494 −57% $30,058 −56% ≈123% of Medicare
368 Major esophageal disorders with MCC $13,157 $13,157 $32,526 −60% $33,607 −61% —
262 Cardiac pacemaker revision except device replacement without CC MCC $13,104 $13,104 $43,479 −70% $33,694 −61% —
643 Endocrine disorders with MCC $13,102 $13,102 $27,741 −53% $32,996 −60% —
828 Myeloprolif disord or poorly diff neopl w maj O R proc w o CC MCC $13,065 $13,065 $45,989 −72% $35,584 −63% —
865 Viral illness with MCC $13,061 $13,061 $22,350 −42% $26,088 −50% —
256 Upper limb toe amputation for circulatory system disorders w CC $13,059 $13,059 $26,332 −50% $29,729 −56% —
983 Extensive O R proc unrelated to principal diagnosis w o CC MCC $13,023 $13,023 $36,561 −64% $30,930 −58% —
418 Laparoscopic cholecystectomy without C D E with CC $13,019 $13,019 $32,818 −60% $42,119 −69% —
444 Disorders of the biliary tract with MCC $13,007 $13,007 $34,124 −62% $31,128 −58% —
533 Fractures of femur with MCC $12,993 $12,993 $28,442 −54% $25,945 −50% —
033 Ventricular shunt procedures without CC MCC $12,925 $12,925 $34,211 −62% $33,984 −62% —
620 O R procedures for obesity with CC $12,920 $12,920 $37,027 −65% $35,453 −64% —
513 Hand or wrist procedures exc major thumb or joint proc w CC MCC $12,910 $12,910 $27,447 −53% $33,424 −61% —
727 Inflammation of the male reproductive system with MCC $12,910 $12,910 $28,470 −55% $25,786 −50% —
393 Other digestive system diagnoses with MCC $12,899 $12,899 $30,510 −58% $32,689 −61% —
512 Shoulder elbow or forearm proc exc major joint proc w o CC MCC $12,853 $12,853 $41,155 −69% $35,692 −64% —
578 Skin graft except for skin ulcer or cellulitis without CC MCC $12,827 $12,827 $26,167 −51% $28,578 −55% —
895 Alcohol drug abuse or dependence with rehabilitation therapy $12,813 $12,813 $34,171 −63% $21,986 −42% —
334 Rectal resection without CC MCC $12,784 $12,784 $47,039 −73% $32,213 −60% —
296 Cardiac arrest unexplained with MCC $12,769 $12,769 $27,987 −54% $30,910 −59% —
425 Other hepatobiliary or pancreas O R procedures without CC MCC $12,758 $12,758 $26,477 −52% $25,484 −50% —
597 Malignant breast disorders with MCC $12,747 $12,747 $35,093 −64% $31,846 −60% —
038 Extracranial procedures with CC $12,742 $12,742 $39,339 −68% $35,770 −64% —
328 Stomach esophageal and duodenal procedures without CC MCC $12,722 $12,722 $46,229 −72% $35,375 −64% —
917 Poisoning and toxic effects of drugs with MCC $12,710 $12,710 $30,645 −59% $28,134 −55% —
482 Hip and femur procedures except major joint without CC MCC $12,651 $12,651 $39,285 −68% $39,747 −68% —
251 Percutaneous cardiovascular proc w o intraluminal device without MCC $12,639 $12,639 $42,413 −70% $41,380 −69% —
280 Acute myocardial infarction discharged alive with MCC $12,636 $12,636 $30,390 −58% $28,967 −56% ≈125% of Medicare
675 Other kidney and urinary tract procedures without CC MCC $12,636 $12,636 $38,708 −67% $32,490 −61% —
606 Minor skin disorders with MCC $12,630 $12,630 $38,677 −67% $25,434 −50% —
905 Skin grafts for injuries without CC MCC $12,613 $12,613 $32,783 −62% $25,197 −50% —
830 Myeloprolif disord or poorly diff neopl w oth proc w o CC MCC $12,593 $12,593 $48,696 −74% $25,149 −50% —
299 Peripheral vascular disorders with MCC $12,554 $12,554 $36,771 −66% $25,731 −51% —
183 Major chest trauma with MCC $12,540 $12,540 $23,796 −47% $28,924 −57% —
841 Lymphoma and non acute leukemia with CC $12,532 $12,532 $30,877 −59% $31,059 −60% —
385 Inflammatory bowel disease with MCC $12,479 $12,479 $24,282 −49% $26,020 −52% —
410 Biliary tract proc except only cholecyst w or w o C D E w o CC MCC $12,466 $12,466 $47,908 −74% $34,434 −64% —
115 Extraocular procedures except orbit $12,460 $12,460 $23,065 −46% $24,879 −50% —
564 Other musculoskeletal system and connective tissue diagnoses w MCC $12,440 $12,440 $30,064 −59% $32,936 −62% —
813 Coagulation disorders $12,425 $12,425 $32,291 −62% $30,128 −59% ≈208% of Medicare
557 Tendonitis myositis and bursitis with MCC $12,399 $12,399 $26,780 −54% $28,646 −57% —
186 Pleural effusion with MCC $12,362 $12,362 $30,373 −59% $32,468 −62% —
142 Major head and neck procedures without CC MCC $12,305 $12,305 $40,799 −70% $34,906 −65% —
487 Knee procedures with principal diagnosis of infection w o CC MCC $12,304 $12,304 $52,596 −77% $33,490 −63% —
769 Postpartum and post abortion diagnoses with O R procedures $12,296 $12,296 $21,228 −42% $24,561 −50% —
345 Minor small and large bowel procedures with CC $12,270 $12,270 $31,758 −61% $31,062 −60% —
154 Other ear nose mouth and throat diagnoses with MCC $12,251 $12,251 $27,330 −55% $24,465 −50% —
306 Cardiac congenital and valvular disorders with MCC $12,240 $12,240 $28,689 −57% $24,450 −50% —
669 Transurethral procedures with CC $12,222 $12,222 $47,653 −74% $34,354 −64% —
088 Concussion with MCC $12,216 $12,216 $21,503 −43% $24,402 −50% —
583 Mastectomy for malignancy without CC MCC $12,121 $12,121 $28,688 −58% $31,566 −62% —
562 Fracture sprain strain disloc exc femur hip pelvis thigh w MCC $12,111 $12,111 $26,717 −55% $29,211 −59% —
621 O R procedures for obesity without CC MCC $12,084 $12,084 $36,535 −67% $32,451 −63% —
398 Appendix procedures with CC $12,053 $12,053 $40,924 −71% $39,107 −69% —
073 Cranial and peripheral nerve disorders with MCC $12,050 $12,050 $29,289 −59% $28,252 −57% —
077 Hypertensive encephalopathy with MCC $12,033 $12,033 $35,852 −66% $24,036 −50% —
413 Cholecystectomy with C D E without CC MCC $12,023 $12,023 $39,618 −70% $27,548 −56% —
945 Rehabilitation with CC MCC $12,022 $12,022 $23,834 −50% $23,834 −50% —
604 Trauma to the skin subcutaneous tissue and breast with MCC $11,996 $11,996 $26,971 −56% $28,140 −57% —
137 Mouth procedures with CC MCC $11,984 $11,984 $34,700 −65% $24,348 −51% —
964 Other multiple significant trauma with CC $11,955 $11,955 $24,997 −52% $25,854 −54% —
682 Renal failure with MCC $11,953 $11,953 $24,994 −52% $27,854 −57% ≈128% of Medicare
337 Peritoneal adhesiolysis without CC MCC $11,918 $11,918 $32,884 −64% $36,239 −67% —
913 Traumatic injury with MCC $11,903 $11,903 $36,618 −67% $24,198 −51% —
517 Other musculoskeletal system conn tissue O R proc w o CC MCC $11,902 $11,902 $31,148 −62% $33,137 −64% —
626 Thyroid parathyroid and thyroglossal procedures with CC $11,882 $11,882 $24,888 −52% $27,279 −56% —
757 Infections female reproductive system with MCC $11,880 $11,880 $21,563 −45% $23,734 −50% —
794 Neonate with other significant problems $11,866 $11,866 $9,053 +31% $7,961 +49% —
602 Cellulitis with MCC $11,847 $11,847 $27,789 −57% $29,347 −60% —
063 Ischemic stroke precereb occ trans ischemia w thromb agt w o CC MCC $11,842 $11,842 $48,180 −75% $35,542 −67% —
658 Kidney and ureter procedures for neoplasm without CC MCC $11,791 $11,791 $38,106 −69% $35,528 −67% —
289 Acute and subacute endocarditis with CC $11,769 $11,769 $23,658 −50% $29,371 −60% —
054 Nervous system neoplasms with MCC $11,736 $11,736 $28,195 −58% $29,484 −60% —
615 Adrenal and pituitary procedures without CC MCC $11,716 $11,716 $43,042 −73% $31,812 −63% —
506 Major thumb or joint procedures $11,649 $11,649 $47,364 −75% $28,983 −60% —
663 Minor bladder procedures with CC $11,620 $11,620 $29,153 −60% $29,924 −61% —
708 Major male pelvic procedures without CC MCC $11,616 $11,616 $33,198 −65% $32,911 −65% —
351 Inguinal and femoral hernia procedures with CC $11,593 $11,593 $37,278 −69% $33,792 −66% —
388 Gastrointestinal obstruction with MCC $11,576 $11,576 $27,615 −58% $28,780 −60% —
713 Transurethral prostatectomy with CC MCC $11,554 $11,554 $28,811 −60% $29,663 −61% —
637 Diabetes with MCC $11,543 $11,543 $26,438 −56% $28,819 −60% ≈124% of Medicare
508 Major shoulder or elbow joint procedures without CC MCC $11,421 $11,421 $19,945 −43% $22,811 −50% —
520 Back neck procedures except spinal fusion without CC MCC $11,401 $11,401 $27,584 −59% $31,816 −64% —
818 Other antepartum diagnoses with O R procedures with CC $11,398 $11,398 $31,637 −64% $24,316 −53% —
497 Local excision removl int fixation dev exc hip femur w o CC MCC $11,368 $11,368 $28,768 −60% $29,805 −62% —
716 Other male reproductive system O R proc for malignancy w o CC MCC $11,327 $11,327 $21,615 −48% $21,615 −48% —
796 Vaginal delivery with sterilization and or D C with MCC $11,297 $11,297 $24,581 −54% $22,557 −50% —
067 Nonspecific CVA and precerebral occlusion without infarction w MCC $11,285 $11,285 $42,416 −73% $24,941 −55% —
693 Urinary stones with MCC $11,280 $11,280 $23,355 −52% $22,525 −50% —
977 HIV with or without other related condition $11,278 $11,278 $21,908 −49% $22,525 −50% —
836 Acute leukemia without CC MCC $11,245 $11,245 $19,686 −43% $19,686 −43% —
422 Hepatobiliary diagnostic procedures without CC MCC $11,238 $11,238 $39,028 −71% $25,152 −55% —
748 Female reproductive system reconstructive procedures $11,189 $11,189 $35,261 −68% $24,980 −55% —
811 Red blood cell disorders with MCC $11,179 $11,179 $28,682 −61% $27,934 −60% —
175 Pulmonary embolism with MCC or acute cor pulmonale $11,174 $11,174 $33,894 −67% $29,757 −62% ≈119% of Medicare
555 Signs and symptoms of musculoskeletal system conn tissue w MCC $11,142 $11,142 $23,338 −52% $23,723 −53% —
383 Uncomplicated peptic ulcer with MCC $11,136 $11,136 $19,602 −43% $26,634 −58% —
630 Other endocrine nutritional metabolic O R procedures w o CC MCC $11,121 $11,121 $25,986 −57% $24,452 −55% —
241 Amputation for circ sys disorders exc upper limb toe w o CC MCC $11,102 $11,102 $23,738 −53% $24,229 −54% —
502 Soft tissue procedures without CC MCC $11,012 $11,012 $39,215 −72% $30,006 −63% —
885 Psychoses $10,883 $10,883 $21,489 −49% $21,489 −49% —
509 Arthroscopy $10,880 $10,880 $25,994 −58% $25,994 −58% —
738 Uterine adnexa proc for ovarian or adnexal malignancy w o CC MCC $10,868 $10,868 $35,950 −70% $30,972 −65% —
975 HIV with major related condition with CC $10,858 $10,858 $25,117 −57% $25,010 −57% —
057 Degenerative nervous system disorders without MCC $10,857 $10,857 $29,561 −63% $25,426 −57% ≈121% of Medicare
355 Hernia procedures except inguinal and femoral without CC MCC $10,852 $10,852 $28,482 −62% $31,978 −66% —
750 Other female reproductive system O R procedures without CC MCC $10,832 $10,832 $19,930 −46% $23,920 −55% —
083 Traumatic stupor and coma 1 hour with CC $10,803 $10,803 $23,875 −55% $24,118 −55% —
909 Other O R procedures for injuries without CC MCC $10,802 $10,802 $31,734 −66% $28,156 −62% —
168 Other respiratory system O R procedures without CC MCC $10,797 $10,797 $39,268 −73% $28,527 −62% —
553 Bone diseases and arthropathies with MCC $10,764 $10,764 $27,100 −60% $23,956 −55% —
581 Other skin subcutaneous tissue and breast procedures w o CC MCC $10,726 $10,726 $24,215 −56% $25,243 −58% —
660 Kidney and ureter procedures for non neoplasm with CC $10,719 $10,719 $24,370 −56% $30,358 −65% ≈120% of Medicare
416 Cholecystectomy except by laparoscope without C D E without CC MCC $10,666 $10,666 $34,473 −69% $30,418 −65% —
193 Simple pneumonia and pleurisy with MCC $10,566 $10,566 $24,801 −57% $26,158 −60% ≈115% of Medicare
124 Other disorders of the eye with MCC or thrombolytic agent $10,528 $10,528 $22,519 −53% $21,029 −50% —
099 Non bacterial infect of nervous sys exc viral meningitis w o CC MCC $10,515 $10,515 $36,948 −72% $25,666 −59% —
086 Traumatic stupor and coma 1 hour with CC $10,490 $10,490 $23,278 −55% $23,115 −55% —
640 Misc disorders of nutrition metabolism fluids electrolyte w MCC $10,475 $10,475 $24,142 −57% $24,480 −57% ≈113% of Medicare
150 Epistaxis with MCC $10,469 $10,469 $21,133 −50% $21,133 −50% —
419 Laparoscopic cholecystectomy without C D E without CC MCC $10,459 $10,459 $30,820 −66% $34,887 −70% —
642 Inborn and other disorders of metabolism $10,380 $10,380 $19,302 −46% $20,727 −50% —
839 Chemotherapy w acute leukemia as secondary DX without CC MCC $10,378 $10,378 $20,980 −51% $20,980 −51% —
348 Anal and stomal procedures with CC $10,365 $10,365 $32,613 −68% $27,947 −63% —
741 Uterine adnexa proc for non ovarian non adnexal malig w o CC MCC $10,348 $10,348 $31,294 −67% $29,050 −64% —
540 Osteomyelitis with CC $10,339 $10,339 $19,990 −48% $23,494 −56% —
710 Penis procedures without CC MCC $10,332 $10,332 $30,970 −67% $23,814 −57% —
535 Fractures of hip and pelvis with MCC $10,327 $10,327 $25,858 −60% $23,350 −56% —
887 Other mental disorder diagnoses $10,319 $10,319 $18,631 −45% $20,602 −50% —
825 Lymphoma and non acute leukemia with other procedures w o CC MCC $10,285 $10,285 $21,703 −53% $27,321 −62% —
499 Local excision removal inter fixation dev hip femur w o CC MCC $10,273 $10,273 $31,100 −67% $22,532 −54% —
346 Minor small and large bowel procedures without CC MCC $10,257 $10,257 $19,357 −47% $26,146 −61% —
291 Heart failure and shock with MCC $10,226 $10,226 $26,231 −61% $25,020 −59% ≈119% of Medicare
858 Postop or post traumatic infections w O R procedures w o CC MCC $10,222 $10,222 $29,484 −65% $23,924 −57% —
121 Acute major eye infections with CC MCC $10,204 $10,204 $18,291 −44% $18,291 −44% —
358 Other digestive system O R procedures without CC MCC $10,203 $10,203 $28,020 −64% $29,374 −65% —
391 Esophagitis gastroenteritis misc digestive disorders w MCC $10,160 $10,160 $27,007 −62% $27,244 −63% —
735 Pelvic evisceration rad hysterectomy and rad vulvectomy w o CC MCC $10,037 $10,037 $18,949 −47% $23,297 −57% —
947 Signs and symptoms with MCC $9,968 $9,968 $30,911 −68% $25,474 −61% —
903 Wound debridements for injuries without CC MCC $9,888 $9,888 $32,316 −69% $23,588 −58% —
725 Benign prostatic hypertrophy with MCC $9,883 $9,883 $19,581 −50% $19,894 −50% —
822 Lymphoma and leukemia with major O R procedures without CC MCC $9,866 $9,866 $38,130 −74% $25,390 −61% —
489 Knee procedures without principal diagnosis of infection w o CC MCC $9,858 $9,858 $36,311 −73% $27,492 −64% —
627 Thyroid parathyroid and thyroglossal procedures without CC MCC $9,844 $9,844 $24,888 −60% $25,623 −62% —
147 Ear nose mouth and throat malignancy with CC $9,842 $9,842 $32,900 −70% $21,860 −55% —
189 Pulmonary edema and respiratory failure $9,812 $9,812 $24,336 −60% $25,704 −62% ≈114% of Medicare
114 Orbital procedures without CC MCC $9,811 $9,811 $30,056 −67% $19,598 −50% —
145 Other ear nose mouth and throat O R procedures without CC MCC $9,725 $9,725 $19,101 −49% $20,842 −53% —
768 Vaginal delivery with O R procedures exc sterilization and or D C $9,701 $9,701 $15,777 −39% $17,103 −43% —
847 Chemotherapy without acute leukemia as secondary diagnosis with CC $9,658 $9,658 $21,831 −56% $22,275 −57% —
804 Other O R procedures of blood and blood forming organs w o CC MCC $9,640 $9,640 $32,471 −70% $24,544 −61% —
593 Skin ulcers with CC $9,636 $9,636 $24,087 −60% $20,470 −53% —
102 Headaches with MCC $9,610 $9,610 $25,440 −62% $22,544 −57% —
549 Septic arthritis with CC $9,607 $9,607 $27,777 −65% $20,938 −54% —
809 Major hematol immun diag exc sickle cell crisis coagulat dis w CC $9,592 $9,592 $22,707 −58% $22,032 −56% —
308 Cardiac arrhythmia and conduction disorders with MCC $9,575 $9,575 $24,934 −62% $26,488 −64% ≈118% of Medicare
546 Connective tissue disorders with CC $9,552 $9,552 $31,617 −70% $24,202 −61% —
598 Malignant breast disorders with CC $9,548 $9,548 $20,485 −53% $19,073 −50% —
117 Intraocular procedures without CC MCC $9,545 $9,545 $17,193 −44% $17,193 −44% —
375 Digestive malignancy with CC $9,544 $9,544 $27,902 −66% $27,219 −65% —
695 Kidney and urinary tract signs and symptoms with MCC $9,525 $9,525 $21,583 −56% $20,741 −54% —
712 Testes procedures without CC MCC $9,465 $9,465 $17,076 −45% $18,898 −50% —
152 Otitis media and URI with MCC $9,463 $9,463 $21,226 −55% $19,795 −52% —
139 Salivary gland procedures $9,459 $9,459 $25,144 −62% $21,014 −55% —
059 Multiple sclerosis and cerebellar ataxia with CC $9,455 $9,455 $22,337 −58% $26,322 −64% —
476 Amputation for musculoskeletal syst conn tissue dis w o CC MCC $9,373 $9,373 $23,274 −60% $21,062 −55% —
718 Other male reproductive system O R proc exc malignancy w o CC MCC $9,365 $9,365 $22,084 −58% $20,147 −54% —
689 Kidney and urinary tract infections with MCC $9,353 $9,353 $20,718 −55% $22,982 −59% ≈123% of Medicare
743 Uterine and adnexa procedures for non malignancy without CC MCC $9,255 $9,255 $27,377 −66% $27,369 −66% —
618 Amputation lower limb for endocrine nutrit metabolic dis w o CC MCC $9,251 $9,251 $19,354 −52% $19,354 −52% —
844 Other myeloprolif disord or poorly diff neoplastic diagnoses w CC $9,216 $9,216 $18,707 −51% $20,421 −55% —
089 Concussion with CC $9,158 $9,158 $17,109 −46% $18,293 −50% —
304 Hypertension with MCC $9,151 $9,151 $30,162 −70% $24,185 −62% —
039 Extracranial procedures without CC MCC $9,087 $9,087 $31,640 −71% $25,267 −64% —
572 Skin debridement without CC MCC $9,076 $9,076 $22,256 −59% $24,432 −63% —
560 Aftercare musculoskeletal system and connective tissue with CC $9,017 $9,017 $27,156 −67% $24,452 −63% —
302 Atherosclerosis with MCC $8,929 $8,929 $23,828 −63% $20,844 −57% —
624 Skin grafts wound debride for endocr nutrit metab dis w o CC MCC $8,876 $8,876 $17,137 −48% $17,078 −48% —
723 Malignancy male reproductive system with CC $8,875 $8,875 $19,179 −54% $19,317 −54% —
399 Appendix procedures without CC MCC $8,865 $8,865 $27,097 −67% $30,314 −71% —
697 Urethral stricture $8,865 $8,865 $21,435 −59% $17,705 −50% —
352 Inguinal and femoral hernia procedures without CC MCC $8,833 $8,833 $30,251 −71% $25,162 −65% —
190 Chronic obstructive pulmonary disease with MCC $8,777 $8,777 $21,554 −59% $24,190 −64% ≈123% of Medicare
181 Respiratory neoplasms with CC $8,770 $8,770 $27,871 −69% $22,431 −61% —
436 Malignancy of hepatobiliary system or pancreas with CC $8,766 $8,766 $21,786 −60% $24,017 −63% —
294 Deep vein thrombophlebitis with CC MCC $8,711 $8,711 $19,132 −54% $19,132 −54% —
543 Pathological fractures musculoskeletal conn tissue malig w CC $8,687 $8,687 $17,733 −51% $23,496 −63% —
445 Disorders of the biliary tract with CC $8,656 $8,656 $21,478 −60% $21,806 −60% —
868 Other infectious and parasitic diseases diagnoses with CC $8,645 $8,645 $18,889 −54% $22,231 −61% —
290 Acute and subacute endocarditis without CC MCC $8,642 $8,642 $28,129 −69% $15,901 −46% —
755 Malignancy female reproductive system with CC $8,639 $8,639 $21,186 −59% $18,459 −53% —
287 Circulatory disorders except AMI w cardiac catheterization w o MCC $8,614 $8,614 $30,745 −72% $31,190 −72% —
989 Non extensive O R proc unrelated to principal diagnosis w o CC MCC $8,604 $8,604 $26,556 −68% $25,307 −66% —
200 Pneumothorax with CC $8,578 $8,578 $25,705 −67% $20,573 −58% —
831 Other antepartum diagnoses without O R procedures with MCC $8,564 $8,564 $18,133 −53% $18,133 −53% —
055 Nervous system neoplasms without MCC $8,547 $8,547 $20,673 −59% $19,868 −57% —
381 Complicated peptic ulcer with CC $8,546 $8,546 $23,283 −63% $24,177 −65% —
949 Aftercare with CC MCC $8,544 $8,544 $21,946 −61% $23,953 −64% —
300 Peripheral vascular disorders with CC $8,498 $8,498 $22,925 −63% $19,579 −57% ≈121% of Medicare
842 Lymphoma and non acute leukemia without CC MCC $8,493 $8,493 $24,574 −65% $17,550 −52% —
071 Nonspecific cerebrovascular disorders with CC $8,457 $8,457 $21,138 −60% $23,396 −64% —
644 Endocrine disorders with CC $8,456 $8,456 $24,428 −65% $22,941 −63% —
664 Minor bladder procedures without CC MCC $8,455 $8,455 $24,070 −65% $18,126 −53% —
184 Major chest trauma with CC $8,378 $8,378 $18,219 −54% $20,842 −60% —
787 Cesarean section without sterilization with CC $8,371 $8,371 $24,974 −66% $23,571 −64% —
667 Prostatectomy without CC MCC $8,359 $8,359 $16,534 −49% $16,703 −50% —
661 Kidney and ureter procedures for non neoplasm without CC MCC $8,350 $8,350 $20,291 −59% $24,022 −65% —
687 Kidney and urinary tract neoplasms with CC $8,325 $8,325 $16,903 −51% $18,478 −55% —
136 Sinus and mastoid procedures without CC MCC $8,317 $8,317 $22,597 −63% $15,890 −48% —
372 Major gastrointestinal disorders and peritoneal infections with CC $8,301 $8,301 $20,158 −59% $22,850 −64% ≈115% of Medicare
514 Hand or wrist procedures exc major thumb or joint proc w o CC MCC $8,295 $8,295 $18,052 −54% $20,080 −59% —
745 D C conization laparoscopy and tubal interruption without CC MCC $8,250 $8,250 $16,495 −50% $16,495 −50% —
920 Complications of treatment with CC $8,234 $8,234 $23,173 −64% $21,181 −61% —
433 Cirrhosis and alcoholic hepatitis with CC $8,211 $8,211 $24,089 −66% $23,749 −65% —
872 Septicemia or severe sepsis without MV 96 hours without MCC $8,203 $8,203 $18,541 −56% $22,781 −64% ≈124% of Medicare
074 Cranial and peripheral nerve disorders without MCC $8,173 $8,173 $25,890 −68% $23,141 −65% —
092 Other disorders of nervous system with CC $8,172 $8,172 $27,612 −70% $24,136 −66% —
600 Non malignant breast disorders with CC MCC $8,168 $8,168 $21,992 −63% $16,418 −50% —
784 Cesarean section with sterilization with CC $8,156 $8,156 $21,782 −63% $22,560 −64% —
699 Other kidney and urinary tract diagnoses with CC $8,130 $8,130 $19,401 −58% $20,732 −61% —
078 Hypertensive encephalopathy with CC $8,099 $8,099 $31,817 −75% $17,434 −54% —
065 Intracranial hemorrhage or cerebral infarction w CC or tPA in 24 hr $8,095 $8,095 $28,079 −71% $23,469 −66% ≈125% of Medicare
946 Rehabilitation without CC MCC $8,066 $8,066 $17,685 −54% $17,685 −54% —
923 Other injury poisoning and toxic effect diagnoses without MCC $8,055 $8,055 $17,649 −54% $16,571 −51% —
596 Major skin disorders without MCC $8,036 $8,036 $17,226 −53% $17,226 −53% —
805 Vaginal delivery without sterilization OR D C with MCC $8,030 $8,030 $15,319 −48% $15,370 −48% —
863 Postoperative and post traumatic infections without MCC $8,008 $8,008 $19,304 −59% $20,007 −60% —
810 Major hematol immun diag exc sickle cell crisis coagul w o CC MCC $8,000 $8,000 $22,446 −64% $18,428 −57% —
729 Other male reproductive system diagnoses with CC MCC $7,995 $7,995 $25,085 −68% $17,483 −54% —
565 Other musculoskeletal system and connective tissue diagnoses w CC $7,960 $7,960 $22,525 −65% $21,545 −63% —
197 Interstitial lung disease with CC $7,945 $7,945 $25,701 −69% $20,106 −60% —
187 Pleural effusion with CC $7,935 $7,935 $20,494 −61% $21,467 −63% —
797 Vaginal delivery with sterilization and or D C with CC $7,932 $7,932 $21,046 −62% $19,001 −58% —
760 Menstrual and other female reproductive system disorders w CC MCC $7,928 $7,928 $21,346 −63% $18,282 −57% —
815 Reticuloendothelial and immunity disorders with CC $7,918 $7,918 $19,264 −59% $18,017 −56% —
758 Infections female reproductive system with CC $7,905 $7,905 $17,560 −55% $19,091 −59% —
257 Upper limb toe amputation for circ sys disorders w o CC MCC $7,893 $7,893 $23,771 −67% $15,764 −50% —
756 Malignancy female reproductive system without CC MCC $7,882 $7,882 $15,589 −49% $15,589 −49% —
779 Abortion without D C $7,878 $7,878 $15,408 −49% $15,327 −49% —
369 Major esophageal disorders with CC $7,871 $7,871 $26,899 −71% $22,713 −65% —
178 Respiratory infections and inflammations with CC $7,858 $7,858 $20,666 −62% $22,024 −64% ≈122% of Medicare
053 Spinal disorders and injuries without CC MCC $7,835 $7,835 $15,286 −49% $20,309 −61% —
378 Gastrointestinal hemorrhage with CC $7,835 $7,835 $24,838 −68% $21,886 −64% ≈127% of Medicare
349 Anal and stomal procedures without CC MCC $7,772 $7,772 $24,016 −68% $19,854 −61% —
386 Inflammatory bowel disease with CC $7,738 $7,738 $19,528 −60% $20,968 −63% —
315 Other circulatory system diagnoses with CC $7,704 $7,704 $22,831 −66% $20,777 −63% —
537 Sprains strains dislocations of hip pelvis and thigh w CC MCC $7,702 $7,702 $24,565 −69% $16,352 −53% —
552 Medical back problems without MCC $7,696 $7,696 $21,141 −64% $21,213 −64% ≈118% of Medicare
670 Transurethral procedures without CC MCC $7,667 $7,667 $18,223 −58% $20,371 −62% —
714 Transurethral prostatectomy without CC MCC $7,634 $7,634 $23,601 −68% $17,108 −55% —
202 Bronchitis and asthma with CC MCC $7,626 $7,626 $15,954 −52% $17,273 −56% ≈122% of Medicare
965 Other multiple significant trauma without CC MCC $7,613 $7,613 $15,039 −49% $17,585 −57% —
880 Acute adjustment reaction and psychosocial dysfunction $7,603 $7,603 $19,792 −62% $15,636 −51% —
442 Disorders of liver exc malignancy cirrhosis or alc hepatitis w CC $7,578 $7,578 $20,528 −63% $21,449 −65% —
155 Other ear nose mouth and throat diagnoses with CC $7,539 $7,539 $16,642 −55% $16,642 −55% —
550 Septic arthritis without CC MCC $7,514 $7,514 $26,032 −71% $16,156 −53% —
307 Cardiac congenital and valvular disorders without MCC $7,507 $7,507 $18,323 −59% $18,608 −60% —
882 Neuroses except depressive $7,481 $7,481 $15,680 −52% $15,680 −52% —
158 Dental and oral diseases with CC $7,475 $7,475 $18,988 −61% $17,700 −58% —
672 Urethral procedures without CC MCC $7,467 $7,467 $17,398 −57% $17,398 −57% —
394 Other digestive system diagnoses with CC $7,462 $7,462 $20,595 −64% $18,918 −61% —
090 Concussion without CC MCC $7,445 $7,445 $25,638 −71% $14,873 −50% —
076 Viral meningitis without CC MCC $7,347 $7,347 $18,152 −60% $15,474 −53% —
084 Traumatic stupor and coma 1 hour without CC MCC $7,325 $7,325 $23,422 −69% $18,191 −60% —
866 Viral illness without MCC $7,309 $7,309 $19,085 −62% $16,391 −55% —
206 Other respiratory system diagnoses without MCC $7,276 $7,276 $19,449 −63% $17,731 −59% —
281 Acute myocardial infarction discharged alive with CC $7,272 $7,272 $24,971 −71% $20,463 −64% ≈122% of Medicare
101 Seizures without MCC $7,244 $7,244 $17,204 −58% $19,954 −64% ≈117% of Medicare
081 Nontraumatic stupor and coma without MCC $7,244 $7,244 $16,935 −57% $15,077 −52% —
605 Trauma to the skin subcutaneous tissue and breast without MCC $7,238 $7,238 $17,652 −59% $19,287 −62% —
914 Traumatic injury without MCC $7,229 $7,229 $16,946 −57% $15,593 −54% —
819 Other antepartum diagnoses with O R procedures without CC MCC $7,225 $7,225 $22,448 −68% $17,928 −60% —
881 Depressive neuroses $7,220 $7,220 $15,058 −52% $15,058 −52% —
683 Renal failure with CC $7,174 $7,174 $20,765 −65% $18,620 −61% ≈117% of Medicare
812 Red blood cell disorders without MCC $7,174 $7,174 $19,481 −63% $20,488 −65% ≈230% of Medicare
638 Diabetes with CC $7,163 $7,163 $20,074 −64% $18,821 −62% ≈131% of Medicare
060 Multiple sclerosis and cerebellar ataxia without CC MCC $7,147 $7,147 $18,043 −60% $21,261 −66% —
563 Fracture sprain strain dislo exc femur hip pelvis thigh w o MCC $7,133 $7,133 $18,854 −62% $18,803 −62% —
607 Minor skin disorders without MCC $7,116 $7,116 $19,884 −64% $15,284 −53% —
376 Digestive malignancy without CC MCC $7,099 $7,099 $23,883 −70% $15,608 −55% —
148 Ear nose mouth and throat malignancy without CC MCC $7,086 $7,086 $24,592 −71% $13,586 −48% —
747 Vagina cervix and vulva procedures without CC MCC $7,066 $7,066 $18,522 −62% $19,326 −63% —
087 Traumatic stupor and coma 1 hour without CC MCC $7,058 $7,058 $16,456 −57% $15,869 −56% —
603 Cellulitis without MCC $7,046 $7,046 $16,168 −56% $18,530 −62% ≈129% of Medicare
864 Fever and inflammatory conditions $7,031 $7,031 $24,489 −71% $17,412 −60% —
558 Tendonitis myositis and bursitis without MCC $6,996 $6,996 $20,995 −67% $17,367 −60% —
384 Uncomplicated peptic ulcer without MCC $6,974 $6,974 $17,796 −61% $19,305 −64% —
068 Nonspecific CVA and precerebral occlusion w o infarction w o MCC $6,937 $6,937 $21,569 −68% $19,569 −65% —
785 Cesarean section with sterilization without CC MCC $6,900 $6,900 $19,783 −65% $19,815 −65% —
138 Mouth procedures without CC MCC $6,895 $6,895 $13,752 −50% $17,383 −60% —
845 Other myeloprolif disord or poorly diff neoplastic diag w o CC MCC $6,888 $6,888 $14,055 −51% $14,055 −51% —
312 Syncope and collapse $6,877 $6,877 $23,545 −71% $19,342 −64% ≈123% of Medicare
918 Poisoning and toxic effects of drugs without MCC $6,857 $6,857 $14,675 −53% $15,045 −54% —
541 Osteomyelitis without CC MCC $6,833 $6,833 $15,754 −57% $14,549 −53% —
292 Heart failure and shock with CC $6,822 $6,822 $19,303 −65% $16,212 −58% —
897 Alcohol drug abuse or dependence w o rehabilitation thrpy w o MCC $6,814 $6,814 $15,819 −57% $16,049 −58% —
439 Disorders of pancreas except malignancy with CC $6,811 $6,811 $17,067 −60% $19,096 −64% —
788 Cesarean section without sterilization without CC MCC $6,810 $6,810 $22,795 −70% $20,084 −66% —
191 Chronic obstructive pulmonary disease with CC $6,762 $6,762 $18,712 −64% $18,278 −63% ≈122% of Medicare
976 HIV with major related condition without CC MCC $6,732 $6,732 $18,228 −63% $16,212 −58% —
103 Headaches without MCC $6,709 $6,709 $21,111 −68% $20,111 −67% —
848 Chemotherapy w o acute leukemia as secondary diagnosis w o CC MCC $6,660 $6,660 $13,822 −52% $13,822 −52% —
798 Vaginal delivery with sterilization and or D C without CC MCC $6,651 $6,651 $13,737 −52% $18,238 −64% —
437 Malignancy of hepatobiliary system or pancreas without CC MCC $6,619 $6,619 $16,336 −59% $13,385 −51% —
556 Signs and symptoms of musculoskeletal system conn tissue w o MCC $6,566 $6,566 $17,696 −63% $17,715 −63% —
547 Connective tissue disorders without CC MCC $6,557 $6,557 $19,855 −67% $14,861 −56% —
204 Respiratory signs and symptoms $6,554 $6,554 $22,926 −71% $16,866 −61% —
194 Simple pneumonia and pleurisy with CC $6,548 $6,548 $17,292 −62% $18,204 −64% ≈120% of Medicare
554 Bone diseases and arthropathies without MCC $6,545 $6,545 $18,143 −64% $18,253 −64% —
176 Pulmonary embolism without MCC $6,496 $6,496 $21,913 −70% $18,081 −64% ≈115% of Medicare
534 Fractures of femur without MCC $6,451 $6,451 $21,585 −70% $17,195 −62% —
724 Malignancy male reproductive system without CC MCC $6,447 $6,447 $15,546 −59% $12,650 −49% —
690 Kidney and urinary tract infections without MCC $6,426 $6,426 $18,046 −64% $17,466 −63% ≈129% of Medicare
123 Neurological eye disorders $6,403 $6,403 $24,443 −74% $17,831 −64% —
446 Disorders of the biliary tract without CC MCC $6,383 $6,383 $19,221 −67% $17,700 −64% —
948 Signs and symptoms without MCC $6,380 $6,380 $21,819 −71% $17,727 −64% —
728 Inflammation of the male reproductive system without MCC $6,372 $6,372 $13,799 −54% $16,837 −62% —
182 Respiratory neoplasms without CC MCC $6,362 $6,362 $14,064 −55% $14,064 −55% —
069 Transient ischemia without thrombolytic $6,361 $6,361 $24,940 −74% $20,278 −69% ≈128% of Medicare
770 Abortion with D C aspiration curettage or hysterotomy $6,361 $6,361 $17,159 −63% $17,943 −65% —
125 Other disorders of the eye without MCC $6,352 $6,352 $18,154 −65% $15,876 −60% —
295 Deep vein thrombophlebitis without CC MCC $6,348 $6,348 $19,889 −68% $13,445 −53% —
389 Gastrointestinal obstruction with CC $6,343 $6,343 $18,664 −66% $17,388 −64% ≈127% of Medicare
594 Skin ulcers without CC MCC $6,271 $6,271 $14,209 −56% $14,209 −56% —
536 Fractures of hip and pelvis without MCC $6,269 $6,269 $18,887 −67% $18,002 −65% —
392 Esophagitis gastroenteritis misc digestive disorders w o MCC $6,257 $6,257 $14,681 −57% $17,322 −64% ≈138% of Medicare
072 Nonspecific cerebrovascular disorders without CC MCC $6,236 $6,236 $23,908 −74% $16,654 −63% —
694 Urinary stones without MCC $6,234 $6,234 $14,472 −57% $16,531 −62% —
641 Misc disorder of nutrition metabolism fluid electrolyte w o MCC $6,223 $6,223 $16,822 −63% $16,745 −63% ≈126% of Medicare
688 Kidney and urinary tract neoplasms without CC MCC $6,219 $6,219 $18,232 −66% $12,593 −51% —
561 Aftercare musculoskeletal system and connective tissue w o CC MCC $6,214 $6,214 $19,521 −68% $18,150 −66% —
198 Interstitial lung disease without CC MCC $6,198 $6,198 $13,654 −55% $13,654 −55% —
093 Other disorders of nervous system without CC MCC $6,168 $6,168 $19,993 −69% $17,522 −65% —
151 Epistaxis without MCC $6,138 $6,138 $15,397 −60% $13,032 −53% —
544 Pathological fractures musculoskel conn tiss malig w o CC MCC $6,113 $6,113 $16,795 −64% $16,776 −64% —
179 Respiratory infections and inflammations without CC MCC $6,079 $6,079 $13,598 −55% $14,444 −58% —
645 Endocrine disorders without CC MCC $6,060 $6,060 $20,616 −71% $14,166 −57% —
382 Complicated peptic ulcer without CC MCC $6,030 $6,030 $15,817 −62% $16,634 −64% —
185 Major chest trauma without CC MCC $6,019 $6,019 $16,609 −64% $15,858 −62% —
305 Hypertension without MCC $6,001 $6,001 $24,338 −75% $17,144 −65% —
566 Other musculoskeletal system connective tiss diagnoses w o CC MCC $5,977 $5,977 $16,445 −64% $14,337 −58% —
806 Vaginal delivery without sterilization OR D C with CC $5,947 $5,947 $13,651 −56% $13,090 −55% —
188 Pleural effusion without CC MCC $5,945 $5,945 $20,711 −71% $14,110 −58% —
149 Dysequilibrium $5,931 $5,931 $23,926 −75% $17,203 −66% —
309 Cardiac arrhythmia and conduction disorders with CC $5,931 $5,931 $22,237 −73% $16,865 −65% ≈133% of Medicare
122 Acute major eye infections without CC MCC $5,930 $5,930 $11,997 −51% $11,997 −51% —
370 Major esophageal disorders without CC MCC $5,923 $5,923 $23,345 −75% $15,072 −61% —
079 Hypertensive encephalopathy without CC MCC $5,900 $5,900 $13,350 −56% $11,847 −50% —
284 Acute myocardial infarction expired with CC $5,891 $5,891 $13,735 −57% $13,282 −56% —
832 Other antepartum diagnoses without O R procedures with CC $5,875 $5,875 $12,895 −54% $12,895 −54% —
153 Otitis media and URI without MCC $5,852 $5,852 $13,277 −56% $14,473 −60% —
726 Benign prostatic hypertrophy without MCC $5,821 $5,821 $12,855 −55% $13,892 −58% —
297 Cardiac arrest unexplained with CC $5,803 $5,803 $12,336 −53% $12,336 −53% —
313 Chest pain $5,763 $5,763 $20,854 −72% $15,962 −64% —
282 Acute myocardial infarction discharged alive without CC MCC $5,719 $5,719 $19,367 −70% $18,623 −69% —
776 Postpartum and post abortion diagnoses without O R procedures $5,708 $5,708 $12,381 −54% $12,381 −54% —
373 Major gastrointestinal disorders peritoneal infections w o CC MCC $5,707 $5,707 $16,767 −66% $16,104 −65% —
443 Disorders of liver exc malignancy cirr or alc hepatitis w o CC MCC $5,692 $5,692 $18,925 −70% $15,600 −64% —
816 Reticuloendothelial and immunity disorders without CC MCC $5,656 $5,656 $12,745 −56% $13,485 −58% —
301 Peripheral vascular disorders without CC MCC $5,653 $5,653 $19,031 −70% $15,607 −64% —
538 Sprains strains dislocations of hip pelvis thigh w o CC MCC $5,648 $5,648 $21,957 −74% $11,909 −53% —
700 Other kidney and urinary tract diagnoses without CC MCC $5,641 $5,641 $12,551 −55% $13,303 −58% —
201 Pneumothorax without CC MCC $5,624 $5,624 $13,089 −57% $13,081 −57% —
311 Angina pectoris $5,560 $5,560 $15,425 −64% $15,165 −63% —
921 Complications of treatment without CC MCC $5,558 $5,558 $14,264 −61% $14,012 −60% —
203 Bronchitis and asthma without CC MCC $5,534 $5,534 $13,119 −58% $12,279 −55% —
316 Other circulatory system diagnoses without CC MCC $5,517 $5,517 $18,090 −70% $12,797 −57% —
696 Kidney and urinary tract signs and symptoms without MCC $5,512 $5,512 $13,500 −59% $14,441 −62% —
869 Other infectious and parasitic diseases diagnoses without CC MCC $5,501 $5,501 $24,076 −77% $12,537 −56% —
066 Intracranial hemorrhage or cerebral infarction without CC MCC $5,476 $5,476 $22,530 −76% $19,483 −72% —
387 Inflammatory bowel disease without CC MCC $5,448 $5,448 $15,055 −64% $14,880 −63% —
159 Dental and oral diseases without CC MCC $5,378 $5,378 $11,755 −54% $13,368 −60% —
599 Malignant breast disorders without CC MCC $5,358 $5,358 $18,080 −70% $14,290 −63% —
434 Cirrhosis and alcoholic hepatitis without CC MCC $5,332 $5,332 $13,676 −61% $12,405 −57% —
916 Allergic reactions without MCC $5,247 $5,247 $15,531 −66% $13,890 −62% —
303 Atherosclerosis without MCC $5,241 $5,241 $18,920 −72% $14,927 −65% —
156 Other ear nose mouth and throat diagnoses without CC MCC $5,221 $5,221 $11,921 −56% $13,198 −60% —
807 Vaginal delivery without sterilization OR D C without CC MCC $5,211 $5,211 $13,696 −62% $12,044 −57% —
395 Other digestive system diagnoses without CC MCC $5,157 $5,157 $11,454 −55% $14,128 −63% —
759 Infections female reproductive system without CC MCC $5,147 $5,147 $12,883 −60% $14,208 −64% —
192 Chronic obstructive pulmonary disease without CC MCC $5,112 $5,112 $19,164 −73% $14,368 −64% —
950 Aftercare without CC MCC $5,086 $5,086 $18,599 −73% $13,527 −62% —
601 Non malignant breast disorders without CC MCC $5,045 $5,045 $12,415 −59% $10,975 −54% —
379 Gastrointestinal hemorrhage without CC MCC $5,043 $5,043 $20,210 −75% $14,134 −64% —
195 Simple pneumonia and pleurisy without CC MCC $4,983 $4,983 $14,132 −65% $13,824 −64% —
639 Diabetes without CC MCC $4,958 $4,958 $16,811 −71% $13,910 −64% —
730 Other male reproductive system diagnoses without CC MCC $4,951 $4,951 $11,071 −55% $11,071 −55% —
440 Disorders of pancreas except malignancy without CC MCC $4,903 $4,903 $15,474 −68% $15,070 −67% —
684 Renal failure without CC MCC $4,846 $4,846 $12,049 −60% $13,623 −64% —
761 Menstrual and other female reproductive system disorders w o CC MCC $4,823 $4,823 $11,421 −58% $11,421 −58% —
951 Other factors influencing health status $4,699 $4,699 $10,553 −55% $9,385 −50% —
894 Alcohol drug abuse or dependence left AMA $4,576 $4,576 $12,685 −64% $12,013 −62% —
293 Heart failure and shock without CC MCC $4,472 $4,472 $12,530 −64% $11,955 −63% —
390 Gastrointestinal obstruction without CC MCC $4,452 $4,452 $13,471 −67% $13,318 −67% —
310 Cardiac arrhythmia and conduction disorders without CC MCC $4,404 $4,404 $12,915 −66% $13,384 −67% —
833 Other antepartum diagnoses without O R procedures without CC MCC $4,076 $4,076 $9,295 −56% $9,076 −55% —
285 Acute myocardial infarction expired without CC MCC $3,892 $3,892 $10,480 −63% $10,039 −61% —
298 Cardiac arrest unexplained without CC MCC $3,502 $3,502 $8,927 −61% $8,927 −61% —
795 Normal newborn $1,606 $1,606 $5,442 −70% $4,530 −65% —

Procedures with negotiated rates only

These 13 procedures have published per-payer insurance agreements but no single comparable dollar amount in the MRF — typically because the agreement is expressed as a percentage of charge, a fee schedule reference, or a contract algorithm. The number of payers indicates how many insurance plans have a negotiated rate on file.

DRG Description Insurance rate range Payers
317 Concomitant left atrial appendage closure and cardiac ablation $49,444 – $61,311 · median $50,927 6 plans
402 Single level combined anterior and posterior spinal fusion exc cervical $31,406 – $38,943 · median $32,348 6 plans
426 Mult lvl comb ant pst spin fsn exc cerv w MCC or cust anat des fus dev $83,778 – $103,885 · median $86,292 6 plans
427 Multiple level comb ant pst spinal fusion except cervical with CC $56,739 – $70,357 · median $58,441 6 plans
428 Multiple level comb ant pst spinal fusion except cervical w o CC MCC $44,002 – $54,563 · median $45,323 6 plans
429 Combine anterior and posterior cervical spinal fusion with MCC $66,661 – $82,659 · median $68,661 6 plans
430 combine anterior and posterior cervical spinal fusion without MCC $43,722 – $54,215 · median $45,034 6 plans
447 Mult lvl spin fus exc cerv w MCC or vust anatom des interbody fus dev $53,586 – $66,447 · median $55,194 6 plans
448 Multiple level spinal fusion except cervical without MCC $32,637 – $40,469 · median $33,616 6 plans
450 Sing lvl spin fus exc cerv w MCC or cust anatom design inter fus dev $41,161 – $51,040 · median $42,396 6 plans
451 Single level spinal fusion except cervical without MCC $24,664 – $30,584 · median $25,404 6 plans
850 Acute Leukemia with other procedures $73,625 – $91,295 · median $75,834 6 plans
982 Extensive O R procedures unrelated to principal diagnosis w CC $19,571 – $24,268 · median $20,158 6 plans
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