New York Community Hospital of Brooklyn, Inc. — Pricing

396 procedures published in this hospital's Machine-Readable File (MRF) — 387 with a comparable price, 9 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 396
Lowest published price $1,910
Average published price $14,482
Highest published price $162,037

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 396 procedures

Published charges

Showing all 387 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 68 procedures, this hospital's negotiated rates average ≈98% of what Medicare pays.

DRG Description Published price Cash price vs. NY median vs. National median vs Medicare
003 ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. $162,037 $162,037 $389,239 −58% $371,366 −56% —
004 TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. $113,523 $113,523 $256,977 −56% $245,241 −54% ≈100% of Medicare
686 KIDNEY & URINARY TRACT NEOPLASMS W MCC $83,857 $83,857 $41,587 +102% $32,981 +154% —
335 PERITONEAL ADHESIOLYSIS W MCC $64,305 $64,305 $82,458 −22% $71,755 −10% —
334 RECTAL RESECTION W/O CC/MCC $61,650 $61,650 $47,039 +31% $32,213 +91% —
870 SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS $55,167 $55,167 $176,606 −69% $138,008 −60% ≈100% of Medicare
239 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC $52,654 $52,654 $91,116 −42% $87,565 −40% —
654 MAJOR BLADDER PROCEDURES W CC $49,629 $49,629 $50,400 −2% $53,868 −8% —
463 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC $47,857 $47,857 $73,103 −35% $78,582 −39% —
207 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS $46,196 $46,196 $114,669 −60% $116,058 −60% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC $45,810 $45,810 $49,908 −8% $68,399 −33% —
254 OTHER VASCULAR PROCEDURES W/O CC/MCC $44,712 $44,712 $47,265 −5% $38,836 +15% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC $41,396 $41,396 $46,501 −11% $55,162 −25% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC $39,971 $39,971 $89,159 −55% $82,561 −52% —
329 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC $37,702 $37,702 $75,766 −50% $88,050 −57% ≈93% of Medicare
853 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC $36,855 $36,855 $92,416 −60% $87,018 −58% ≈95% of Medicare
642 INBORN AND OTHER DISORDERS OF METABOLISM $36,437 $36,437 $19,302 +89% $20,727 +76% —
956 LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA $36,341 $36,341 $55,689 −35% $75,103 −52% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC $35,845 $35,845 $83,715 −57% $67,901 −47% —
622 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC $35,556 $35,556 $51,761 −31% $60,861 −42% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC $35,130 $35,130 $115,907 −70% $99,423 −65% —
969 HIV W EXTENSIVE O.R. PROCEDURE W MCC $33,375 $33,375 $87,759 −62% $109,331 −69% —
088 CONCUSSION W MCC $32,988 $32,988 $21,503 +53% $24,402 +35% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT W MCC $32,616 $32,616 $69,584 −53% $70,132 −53% —
628 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC $32,247 $32,247 $61,206 −47% $68,006 −53% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC $32,086 $32,086 $68,489 −53% $71,014 −55% —
981 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $31,950 $31,950 $110,658 −71% $86,390 −63% ≈81% of Medicare
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC $31,505 $31,505 $38,036 −17% $50,139 −37% —
037 EXTRACRANIAL PROCEDURES W MCC $31,291 $31,291 $89,423 −65% $64,749 −52% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACE $31,168 $31,168 $48,438 −36% $65,254 −52% —
674 OTHER KIDNEY & URINARY TRACT PROCEDURES W CC $31,161 $31,161 $42,884 −27% $49,631 −37% —
252 OTHER VASCULAR PROCEDURES W MCC $30,652 $30,652 $75,832 −60% $68,508 −55% —
982 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC $30,464 $30,464 $58,553 −48% $51,985 −41% —
673 OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC $30,421 $30,421 $77,589 −61% $72,945 −58% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $30,290 $30,290 $48,557 −38% $51,953 −42% —
500 SOFT TISSUE PROCEDURES W MCC $30,223 $30,223 $53,498 −44% $57,479 −47% —
166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC $28,601 $28,601 $67,154 −57% $72,782 −61% —
417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC $28,288 $28,288 $41,196 −31% $52,313 −46% —
464 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC $28,115 $28,115 $56,193 −50% $54,313 −48% —
653 MAJOR BLADDER PROCEDURES W MCC $27,593 $27,593 $84,904 −68% $97,046 −72% —
987 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $27,577 $27,577 $69,526 −60% $65,383 −58% —
629 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC $26,686 $26,686 $46,757 −43% $45,059 −41% —
840 LYMPHOMA & NON-ACUTE LEUKEMIA W MCC $26,406 $26,406 $44,584 −41% $49,710 −47% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC $26,249 $26,249 $76,169 −66% $62,269 −58% —
579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC $26,201 $26,201 $52,030 −50% $54,129 −52% —
344 MINOR SMALL & LARGE BOWEL PROCEDURES W MCC $23,894 $23,894 $38,706 −38% $44,839 −47% —
253 OTHER VASCULAR PROCEDURES W CC $23,498 $23,498 $56,289 −58% $53,746 −56% —
465 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC $23,295 $23,295 $27,614 −16% $32,839 −29% —
027 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC $22,827 $22,827 $57,419 −60% $52,332 −56% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC $22,827 $22,827 $63,580 −64% $72,859 −69% —
208 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS $22,216 $22,216 $54,297 −59% $52,405 −58% ≈94% of Medicare
347 ANAL & STOMAL PROCEDURES W MCC $21,998 $21,998 $49,639 −56% $40,548 −46% —
908 OTHER O.R. PROCEDURES FOR INJURIES W CC $21,563 $21,563 $40,387 −47% $41,660 −48% —
082 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC $21,317 $21,317 $33,308 −36% $36,237 −41% —
196 INTERSTITIAL LUNG DISEASE W MCC $21,125 $21,125 $31,341 −33% $30,766 −31% —
337 PERITONEAL ADHESIOLYSIS W/O CC/MCC $20,996 $20,996 $32,884 −36% $36,239 −42% —
659 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC $20,938 $20,938 $43,429 −52% $48,094 −56% —
503 FOOT PROCEDURES W MCC $20,926 $20,926 $58,830 −64% $43,901 −52% —
808 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC $20,815 $20,815 $32,919 −37% $36,334 −43% —
080 NONTRAUMATIC STUPOR & COMA W MCC $20,672 $20,672 $28,993 −29% $35,139 −41% —
570 SKIN DEBRIDEMENT W MCC $20,512 $20,512 $42,263 −51% $52,435 −61% —
709 PENIS PROCEDURES W CC/MCC $20,321 $20,321 $32,359 −37% $34,535 −41% —
480 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC $20,122 $20,122 $64,529 −69% $63,984 −69% —
330 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC $20,081 $20,081 $55,088 −64% $58,832 −66% —
493 LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W CC $20,028 $20,028 $54,832 −63% $56,394 −64% —
481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC $19,912 $19,912 $53,106 −63% $51,172 −61% ≈115% of Medicare
243 PERMANENT CARDIAC PACEMAKER IMPLANT W CC $19,783 $19,783 $50,655 −61% $50,011 −60% —
616 AMPUTAT OF LOWER LIMB FOR ENDOCRINE, NUTRIT, & METABOL DIS W MCC $19,765 $19,765 $53,357 −63% $62,961 −69% —
571 SKIN DEBRIDEMENT W CC $19,502 $19,502 $37,246 −48% $34,901 −44% —
580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC $19,434 $19,434 $34,662 −44% $36,242 −46% —
668 TRANSURETHRAL PROCEDURES W MCC $19,432 $19,432 $49,739 −61% $47,277 −59% —
940 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC $19,226 $19,226 $35,473 −46% $38,420 −50% —
522 Anesth Chest Lining Biopsy $19,212 $19,212 $52,634 −63% $56,519 −66% ≈104% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROC, EXC MAJOR JOINT PROC W CC $18,745 $18,745 $39,545 −53% $43,538 −57% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC $18,589 $18,589 $41,480 −55% $35,714 −48% ≈109% of Medicare
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC $18,529 $18,529 $42,202 −56% $39,409 −53% ≈101% of Medicare
041 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM $18,495 $18,495 $33,306 −44% $44,989 −59% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC $18,491 $18,491 $28,470 −35% $25,786 −28% —
432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC $18,467 $18,467 $49,473 −63% $36,933 −50% —
617 AMPUTAT OF LOWER LIMB FOR ENDOCRINE, NUTRIT, & METABOL DIS W CC $18,322 $18,322 $38,934 −53% $42,881 −57% —
042 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC $18,218 $18,218 $50,041 −64% $39,018 −53% —
368 MAJOR ESOPHAGEAL DISORDERS W MCC $18,108 $18,108 $32,526 −44% $33,607 −46% —
380 COMPLICATED PEPTIC ULCER W MCC $18,083 $18,083 $33,696 −46% $36,641 −51% —
535 FRACTURES OF HIP & PELVIS W MCC $18,022 $18,022 $25,858 −30% $23,350 −23% —
862 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC $18,008 $18,008 $32,602 −45% $30,394 −41% —
742 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC $17,789 $17,789 $27,369 −35% $40,552 −56% —
326 STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC $17,784 $17,784 $80,701 −78% $80,747 −78% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC $17,536 $17,536 $34,822 −50% $37,950 −54% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC $17,532 $17,532 $43,498 −60% $35,673 −51% —
598 MALIGNANT BREAST DISORDERS W CC $17,484 $17,484 $20,485 −15% $19,073 −8% —
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC $17,398 $17,398 $35,135 −50% $29,476 −41% —
592 SKIN ULCERS W MCC $17,396 $17,396 $29,882 −42% $32,662 −47% —
657 KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC $17,354 $17,354 $39,277 −56% $40,583 −57% —
623 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC $17,328 $17,328 $28,893 −40% $33,165 −48% —
355 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC $17,302 $17,302 $28,482 −39% $31,978 −46% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC $17,217 $17,217 $44,198 −61% $40,063 −57% —
882 NEUROSES EXCEPT DEPRESSIVE $16,970 $16,970 $15,680 +8% $15,680 +8% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC $16,834 $16,834 $44,442 −62% $42,126 −60% —
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC $16,803 $16,803 $35,115 −52% $35,237 −52% ≈96% of Medicare
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $16,749 $16,749 $51,101 −67% $57,149 −71% —
915 ALLERGIC REACTIONS W MCC $16,687 $16,687 $25,750 −35% $30,944 −46% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC $16,657 $16,657 $25,633 −35% $29,826 −44% —
100 SEIZURES W MCC $16,456 $16,456 $31,211 −47% $35,194 −53% —
350 INGUINAL & FEMORAL HERNIA PROCEDURES W MCC $16,367 $16,367 $66,902 −76% $46,591 −65% —
470 Major joint replacement or reattachment of lower extremity without major complication or comorbidity $16,363 $16,363 $45,967 −64% $49,197 −67% —
186 PLEURAL EFFUSION W MCC $16,211 $16,211 $30,373 −47% $32,468 −50% —
671 URETHRAL PROCEDURES W CC/MCC $16,123 $16,123 $26,412 −39% $27,233 −41% —
157 DENTAL & ORAL DISEASES W MCC $16,045 $16,045 $27,457 −42% $27,457 −42% —
711 TESTES PROCEDURES W CC/MCC $16,040 $16,040 $46,485 −65% $34,852 −54% —
441 DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC $16,036 $16,036 $27,729 −42% $32,399 −51% —
516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC $16,026 $16,026 $46,090 −65% $45,817 −65% —
546 CONNECTIVE TISSUE DISORDERS W CC $15,930 $15,930 $31,617 −50% $24,202 −34% —
286 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC $15,798 $15,798 $44,619 −65% $44,600 −65% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC $15,565 $15,565 $43,479 −64% $33,694 −54% —
256 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC $15,451 $15,451 $26,332 −41% $29,729 −48% —
513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC $15,277 $15,277 $27,447 −44% $33,424 −54% —
666 PROSTATECTOMY W CC $15,154 $15,154 $33,815 −55% $30,016 −50% —
091 OTHER DISORDERS OF NERVOUS SYSTEM W MCC $15,095 $15,095 $32,429 −53% $36,375 −59% —
177 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC $14,903 $14,903 $34,944 −57% $31,840 −53% ≈105% of Medicare
922 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC $14,798 $14,798 $28,798 −49% $29,409 −50% —
517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC $14,757 $14,757 $31,148 −53% $33,137 −55% —
385 INFLAMMATORY BOWEL DISEASE W MCC $14,742 $14,742 $24,282 −39% $26,020 −43% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC $14,660 $14,660 $31,582 −54% $35,014 −58% —
854 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC $14,564 $14,564 $38,023 −62% $43,524 −67% —
345 MINOR SMALL & LARGE BOWEL PROCEDURES W CC $14,530 $14,530 $31,758 −54% $31,062 −53% —
988 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC $14,529 $14,529 $46,235 −69% $38,094 −62% —
482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC $14,356 $14,356 $39,285 −63% $39,747 −64% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC $14,352 $14,352 $30,510 −53% $32,689 −56% ≈101% of Medicare
070 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC $14,284 $14,284 $25,761 −45% $30,814 −54% ≈92% of Medicare
504 FOOT PROCEDURES W CC $14,284 $14,284 $29,220 −51% $36,598 −61% —
698 OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC $14,246 $14,246 $30,494 −53% $30,058 −53% ≈99% of Medicare
919 COMPLICATIONS OF TREATMENT W MCC $14,223 $14,223 $26,862 −47% $29,031 −51% —
811 RED BLOOD CELL DISORDERS W MCC $14,098 $14,098 $28,682 −51% $27,934 −50% ≈117% of Medicare
913 TRAUMATIC INJURY W MCC $14,054 $14,054 $36,618 −62% $24,198 −42% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC $13,953 $13,953 $30,390 −54% $28,967 −52% ≈109% of Medicare
884 ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY $13,841 $13,841 $23,378 −41% $25,208 −45% ≈96% of Medicare
180 RESPIRATORY NEOPLASMS W MCC $13,832 $13,832 $40,315 −66% $36,658 −62% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC $13,814 $13,814 $33,498 −59% $38,357 −64% ≈78% of Medicare
377 G.I. HEMORRHAGE W MCC $13,764 $13,764 $38,268 −64% $37,842 −64% ≈93% of Medicare
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC $13,733 $13,733 $17,560 −22% $19,091 −28% —
643 ENDOCRINE DISORDERS W MCC $13,684 $13,684 $27,741 −51% $32,996 −59% —
299 PERIPHERAL VASCULAR DISORDERS W MCC $13,653 $13,653 $36,771 −63% $25,731 −47% ≈98% of Medicare
669 TRANSURETHRAL PROCEDURES W CC $13,611 $13,611 $47,653 −71% $34,354 −60% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC $13,548 $13,548 $24,997 −46% $25,854 −48% —
520 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC $13,529 $13,529 $27,584 −51% $31,816 −57% —
374 DIGESTIVE MALIGNANCY W MCC $13,528 $13,528 $38,075 −64% $38,885 −65% —
512 SHOULDER, ELBOW OR FOREARM PROC, EXC MAJOR JOINT PROC W/O CC/MCC $13,527 $13,527 $41,155 −67% $35,692 −62% —
693 URINARY STONES W MCC $13,375 $13,375 $23,355 −43% $22,525 −41% —
604 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC $13,330 $13,330 $26,971 −51% $28,140 −53% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC $13,287 $13,287 $27,695 −52% $32,204 −59% —
444 DISORDERS OF THE BILIARY TRACT W MCC $13,182 $13,182 $34,124 −61% $31,128 −58% —
241 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC $13,090 $13,090 $23,738 −45% $24,229 −46% —
909 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC $13,041 $13,041 $31,734 −59% $28,156 −54% —
637 DIABETES W MCC $13,019 $13,019 $26,438 −51% $28,819 −55% ≈104% of Medicare
602 CELLULITIS W MCC $12,916 $12,916 $27,789 −54% $29,347 −56% ≈109% of Medicare
545 CONNECTIVE TISSUE DISORDERS W MCC $12,902 $12,902 $43,431 −70% $39,657 −67% —
606 MINOR SKIN DISORDERS W MCC $12,881 $12,881 $38,677 −67% $25,434 −49% —
885 PSYCHOSES $12,867 $12,867 $21,489 −40% $21,489 −40% —
542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC $12,697 $12,697 $34,886 −64% $35,114 −64% —
289 ACUTE & SUBACUTE ENDOCARDITIS W CC $12,658 $12,658 $23,658 −46% $29,371 −57% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC $12,531 $12,531 $48,180 −74% $35,542 −65% —
124 OTHER DISORDERS OF THE EYE W MCC $12,497 $12,497 $22,519 −45% $21,029 −41% —
086 TRAUMATIC STUPOR & COMA, COMA <1 HR W CC $12,419 $12,419 $23,278 −47% $23,115 −46% —
089 CONCUSSION W CC $12,281 $12,281 $17,109 −28% $18,293 −33% —
551 MEDICAL BACK PROBLEMS W MCC $12,069 $12,069 $33,102 −64% $31,086 −61% —
193 SIMPLE PNEUMONIA & PLEURISY W MCC $11,996 $11,996 $24,801 −52% $26,158 −54% ≈110% of Medicare
348 ANAL & STOMAL PROCEDURES W CC $11,958 $11,958 $32,613 −63% $27,947 −57% —
640 MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W MCC $11,915 $11,915 $24,142 −51% $24,480 −51% ≈108% of Medicare
682 RENAL FAILURE W MCC $11,852 $11,852 $24,994 −53% $27,854 −57% ≈92% of Medicare
371 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC $11,830 $11,830 $36,341 −67% $31,758 −63% —
073 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC $11,715 $11,715 $29,289 −60% $28,252 −59% —
391 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC $11,650 $11,650 $27,007 −57% $27,244 −57% ≈104% of Medicare
712 TESTES PROCEDURES W/O CC/MCC $11,555 $11,555 $17,076 −32% $18,898 −39% —
291 HEART FAILURE & SHOCK W MCC $11,424 $11,424 $26,231 −56% $25,020 −54% ≈95% of Medicare
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC $11,360 $11,360 $25,581 −56% $32,502 −65% —
296 CARDIAC ARREST, UNEXPLAINED W MCC $11,305 $11,305 $27,987 −60% $30,910 −63% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC $11,286 $11,286 $19,367 −42% $18,623 −39% —
433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC $11,269 $11,269 $24,089 −53% $23,749 −53% —
621 O.R. PROCEDURES FOR OBESITY W/O CC/MCC $11,148 $11,148 $36,535 −69% $32,451 −66% —
083 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC $11,142 $11,142 $23,875 −53% $24,118 −54% —
593 SKIN ULCERS W CC $11,104 $11,104 $24,087 −54% $20,470 −46% —
189 PULMONARY EDEMA & RESPIRATORY FAILURE $11,059 $11,059 $24,336 −55% $25,704 −57% ≈102% of Medicare
562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC $11,040 $11,040 $26,717 −59% $29,211 −62% —
695 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC $11,035 $11,035 $21,583 −49% $20,741 −47% —
644 ENDOCRINE DISORDERS W CC $10,948 $10,948 $24,428 −55% $22,941 −52% —
346 MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC $10,868 $10,868 $19,357 −44% $26,146 −58% —
197 INTERSTITIAL LUNG DISEASE W CC $10,822 $10,822 $25,701 −58% $20,106 −46% —
388 G.I. OBSTRUCTION W MCC $10,819 $10,819 $27,615 −61% $28,780 −62% —
769 POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE $10,814 $10,814 $21,228 −49% $24,561 −56% —
300 PERIPHERAL VASCULAR DISORDERS W CC $10,758 $10,758 $22,925 −53% $19,579 −45% ≈121% of Medicare
240 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC $10,755 $10,755 $54,475 −80% $54,475 −80% —
725 BENIGN PROSTATIC HYPERTROPHY W MCC $10,748 $10,748 $19,581 −45% $19,894 −46% —
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC $10,658 $10,658 $22,084 −52% $20,147 −47% —
844 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC $10,637 $10,637 $18,707 −43% $20,421 −48% —
553 BONE DISEASES & ARTHROPATHIES W MCC $10,603 $10,603 $27,100 −61% $23,956 −56% —
917 POISONING & TOXIC EFFECTS OF DRUGS W MCC $10,590 $10,590 $30,645 −65% $28,134 −62% —
887 OTHER MENTAL DISORDER DIAGNOSES $10,553 $10,553 $18,631 −43% $20,602 −49% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC $10,534 $10,534 $19,179 −45% $19,317 −45% —
872 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC $10,517 $10,517 $18,541 −43% $22,781 −54% ≈108% of Medicare
092 OTHER DISORDERS OF NERVOUS SYSTEM W CC $10,447 $10,447 $27,612 −62% $24,136 −57% —
697 URETHRAL STRICTURE $10,387 $10,387 $21,435 −52% $17,705 −41% —
813 COAGULATION DISORDERS $10,383 $10,383 $32,291 −68% $30,128 −66% —
039 EXTRACRANIAL PROCEDURES W/O CC/MCC $10,377 $10,377 $31,640 −67% $25,267 −59% —
354 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC $10,322 $10,322 $40,400 −74% $43,266 −76% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC $10,267 $10,267 $21,186 −52% $18,459 −44% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC $10,231 $10,231 $29,561 −65% $25,426 −60% ≈95% of Medicare
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC $10,216 $10,216 $28,020 −64% $29,374 −65% —
304 HYPERTENSION W MCC $10,175 $10,175 $30,162 −66% $24,185 −58% —
533 FRACTURES OF FEMUR W MCC $10,098 $10,098 $28,442 −64% $25,945 −61% —
947 SIGNS & SYMPTOMS W MCC $10,035 $10,035 $30,911 −68% $25,474 −61% —
760 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC $10,030 $10,030 $21,346 −53% $18,282 −45% —
817 OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCC $9,992 $9,992 $31,159 −68% $36,097 −72% —
372 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC $9,991 $9,991 $20,158 −50% $22,850 −56% —
336 PERITONEAL ADHESIOLYSIS W CC $9,935 $9,935 $44,395 −78% $49,470 −80% —
167 OTHER RESP SYSTEM O.R. PROCEDURES W CC $9,916 $9,916 $41,820 −76% $40,563 −76% —
687 KIDNEY & URINARY TRACT NEOPLASMS W CC $9,907 $9,907 $16,903 −41% $18,478 −46% —
419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC $9,853 $9,853 $30,820 −68% $34,887 −72% —
054 NERVOUS SYSTEM NEOPLASMS W MCC $9,802 $9,802 $28,195 −65% $29,484 −67% —
375 DIGESTIVE MALIGNANCY W CC $9,770 $9,770 $27,902 −65% $27,219 −64% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC $9,746 $9,746 $25,085 −61% $17,483 −44% —
600 NON-MALIGNANT BREAST DISORDERS W CC/MCC $9,740 $9,740 $21,992 −56% $16,418 −41% —
660 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC $9,721 $9,721 $24,370 −60% $30,358 −68% ≈85% of Medicare
302 ATHEROSCLEROSIS W MCC $9,665 $9,665 $23,828 −59% $20,844 −54% —
306 CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC $9,620 $9,620 $28,689 −66% $24,450 −61% —
557 TENDONITIS, MYOSITIS & BURSITIS W MCC $9,594 $9,594 $26,780 −64% $28,646 −67% —
810 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC $9,545 $9,545 $22,446 −57% $18,428 −48% —
664 MINOR BLADDER PROCEDURES W/O CC/MCC $9,530 $9,530 $24,070 −60% $18,126 −47% —
418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC $9,360 $9,360 $32,818 −71% $42,119 −78% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC $9,289 $9,289 $32,506 −71% $43,398 −79% —
154 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC $9,282 $9,282 $27,330 −66% $24,465 −62% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC $9,275 $9,275 $21,554 −57% $24,190 −62% —
201 PNEUMOTHORAX W/O CC/MCC $9,259 $9,259 $13,089 −29% $13,081 −29% —
204 RESPIRATORY SIGNS & SYMPTOMS $9,257 $9,257 $22,926 −60% $16,866 −45% —
351 INGUINAL & FEMORAL HERNIA PROCEDURES W CC $9,144 $9,144 $37,278 −75% $33,792 −73% —
920 COMPLICATIONS OF TREATMENT W CC $9,104 $9,104 $23,173 −61% $21,181 −57% —
178 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC $9,077 $9,077 $20,666 −56% $22,024 −59% ≈117% of Medicare
689 KIDNEY & URINARY TRACT INFECTIONS W MCC $9,069 $9,069 $20,718 −56% $22,982 −61% ≈91% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC $9,016 $9,016 $22,831 −61% $20,777 −57% —
152 OTITIS MEDIA & URI W MCC $8,976 $8,976 $21,226 −58% $19,795 −55% —
564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC $8,956 $8,956 $30,064 −70% $32,936 −73% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC $8,931 $8,931 $19,449 −54% $17,731 −50% —
090 CONCUSSION W/O CC/MCC $8,897 $8,897 $25,638 −65% $14,873 −40% —
540 OSTEOMYELITIS W CC $8,719 $8,719 $19,990 −56% $23,494 −63% —
373 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC $8,710 $8,710 $16,767 −48% $16,104 −46% —
184 MAJOR CHEST TRAUMA W CC $8,692 $8,692 $18,219 −52% $20,842 −58% —
699 OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC $8,683 $8,683 $19,401 −55% $20,732 −58% ≈99% of Medicare
081 NONTRAUMATIC STUPOR & COMA W/O MCC $8,629 $8,629 $16,935 −49% $15,077 −43% —
745 D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC $8,606 $8,606 $16,495 −48% $16,495 −48% —
308 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC $8,553 $8,553 $24,934 −66% $26,488 −68% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS $8,544 $8,544 $28,079 −70% $23,469 −64% ≈114% of Medicare
316 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC $8,471 $8,471 $18,090 −53% $12,797 −34% —
863 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC $8,444 $8,444 $19,304 −56% $20,007 −58% —
445 DISORDERS OF THE BILIARY TRACT W CC $8,434 $8,434 $21,478 −61% $21,806 −61% ≈89% of Medicare
713 TRANSURETHRAL PROSTATECTOMY W CC/MCC $8,400 $8,400 $28,811 −71% $29,663 −72% ≈66% of Medicare
087 TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC $8,384 $8,384 $16,456 −49% $15,869 −47% —
603 CELLULITIS W/O MCC $8,370 $8,370 $16,168 −48% $18,530 −55% ≈123% of Medicare
442 DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W CC $8,330 $8,330 $20,528 −59% $21,449 −61% —
809 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC $8,327 $8,327 $22,707 −63% $22,032 −62% —
434 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC $8,308 $8,308 $13,676 −39% $12,405 −33% —
386 INFLAMMATORY BOWEL DISEASE W CC $8,308 $8,308 $19,528 −57% $20,968 −60% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC $8,280 $8,280 $21,138 −61% $23,396 −65% ≈97% of Medicare
202 BRONCHITIS & ASTHMA W CC/MCC $8,242 $8,242 $15,954 −48% $17,273 −52% —
683 RENAL FAILURE W CC $8,086 $8,086 $20,765 −61% $18,620 −57% ≈115% of Medicare
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC $8,069 $8,069 $17,067 −53% $19,096 −58% —
378 G.I. HEMORRHAGE W CC $8,056 $8,056 $24,838 −68% $21,886 −63% ≈98% of Medicare
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC $8,000 $8,000 $22,530 −64% $19,483 −59% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC $7,971 $7,971 $21,786 −63% $24,017 −67% —
384 UNCOMPLICATED PEPTIC ULCER W/O MCC $7,904 $7,904 $17,796 −56% $19,305 −59% —
989 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC $7,848 $7,848 $26,556 −70% $25,307 −69% —
543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC $7,817 $7,817 $17,733 −56% $23,496 −67% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC $7,760 $7,760 $53,594 −86% $48,680 −84% —
594 SKIN ULCERS W/O CC/MCC $7,720 $7,720 $14,209 −46% $14,209 −46% —
194 SIMPLE PNEUMONIA & PLEURISY W CC $7,718 $7,718 $17,292 −55% $18,204 −58% ≈122% of Medicare
534 FRACTURES OF FEMUR W/O MCC $7,704 $7,704 $21,585 −64% $17,195 −55% —
181 RESPIRATORY NEOPLASMS W CC $7,703 $7,703 $27,871 −72% $22,431 −66% —
547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC $7,686 $7,686 $19,855 −61% $14,861 −48% —
125 OTHER DISORDERS OF THE EYE W/O MCC $7,620 $7,620 $18,154 −58% $15,876 −52% —
605 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC $7,594 $7,594 $17,652 −57% $19,287 −61% —
597 MALIGNANT BREAST DISORDERS W MCC $7,527 $7,527 $35,093 −79% $31,846 −76% —
158 DENTAL & ORAL DISEASES W CC $7,464 $7,464 $18,988 −61% $17,700 −58% —
389 G.I. OBSTRUCTION W CC $7,442 $7,442 $18,664 −60% $17,388 −57% ≈122% of Medicare
198 INTERSTITIAL LUNG DISEASE W/O CC/MCC $7,440 $7,440 $13,654 −46% $13,654 −46% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC $7,428 $7,428 $15,474 −52% $15,070 −51% —
881 DEPRESSIVE NEUROSES $7,424 $7,424 $15,058 −51% $15,058 −51% —
175 PULMONARY EMBOLISM W MCC OR ACUTE COR PULMONALE $7,402 $7,402 $33,894 −78% $29,757 −75% ≈61% of Medicare
544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC $7,379 $7,379 $16,795 −56% $16,776 −56% —
151 EPISTAXIS W/O MCC $7,371 $7,371 $15,397 −52% $13,032 −43% —
382 COMPLICATED PEPTIC ULCER W/O CC/MCC $7,357 $7,357 $15,817 −53% $16,634 −56% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC $7,335 $7,335 $24,971 −71% $20,463 −64% —
349 ANAL & STOMAL PROCEDURES W/O CC/MCC $7,320 $7,320 $24,016 −70% $19,854 −63% —
726 BENIGN PROSTATIC HYPERTROPHY W/O MCC $7,314 $7,314 $12,855 −43% $13,892 −47% —
596 MAJOR SKIN DISORDERS W/O MCC $7,305 $7,305 $17,226 −58% $17,226 −58% —
896 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC $7,270 $7,270 $26,307 −72% $30,275 −76% —
182 RESPIRATORY NEOPLASMS W/O CC/MCC $7,264 $7,264 $14,064 −48% $14,064 −48% —
074 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC $7,257 $7,257 $25,890 −72% $23,141 −69% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC $7,213 $7,213 $18,712 −61% $18,278 −61% ≈105% of Medicare
975 HIV W MAJOR RELATED CONDITION W CC $7,204 $7,204 $25,117 −71% $25,010 −71% —
918 POISONING & TOXIC EFFECTS OF DRUGS W/O MCC $7,196 $7,196 $14,675 −51% $15,045 −52% —
842 LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC $7,182 $7,182 $24,574 −71% $17,550 −59% —
443 DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W/O CC/MCC $7,163 $7,163 $18,925 −62% $15,600 −54% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC $7,135 $7,135 $20,595 −65% $18,918 −62% ≈95% of Medicare
581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC $7,114 $7,114 $24,215 −71% $25,243 −72% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC $7,050 $7,050 $13,735 −49% $13,282 −47% —
068 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC $6,972 $6,972 $21,569 −68% $19,569 −64% —
195 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC $6,924 $6,924 $14,132 −51% $13,824 −50% ≈128% of Medicare
638 DIABETES W CC $6,910 $6,910 $20,074 −66% $18,821 −63% ≈101% of Medicare
203 BRONCHITIS & ASTHMA W/O CC/MCC $6,906 $6,906 $13,119 −47% $12,279 −44% —
381 COMPLICATED PEPTIC ULCER W CC $6,825 $6,825 $23,283 −71% $24,177 −72% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC $6,794 $6,794 $11,454 −41% $14,128 −52% —
187 PLEURAL EFFUSION W CC $6,788 $6,788 $20,494 −67% $21,467 −68% —
179 RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC $6,774 $6,774 $13,598 −50% $14,444 −53% ≈110% of Medicare
868 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC $6,762 $6,762 $18,889 −64% $22,231 −70% —
645 ENDOCRINE DISORDERS W/O CC/MCC $6,719 $6,719 $20,616 −67% $14,166 −53% —
343 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC $6,699 $6,699 $12,397 −46% $13,735 −51% —
880 ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION $6,682 $6,682 $19,792 −66% $15,636 −57% —
690 KIDNEY & URINARY TRACT INFECTIONS W/O MCC $6,678 $6,678 $18,046 −63% $17,466 −62% ≈91% of Medicare
199 PNEUMOTHORAX W MCC $6,620 $6,620 $29,170 −77% $31,491 −79% —
536 FRACTURES OF HIP & PELVIS W/O MCC $6,563 $6,563 $18,887 −65% $18,002 −64% ≈106% of Medicare
101 SEIZURES W/O MCC $6,552 $6,552 $17,204 −62% $19,954 −67% ≈90% of Medicare
352 INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC $6,529 $6,529 $30,251 −78% $25,162 −74% —
390 G.I. OBSTRUCTION W/O CC/MCC $6,525 $6,525 $13,471 −52% $13,318 −51% ≈152% of Medicare
153 OTITIS MEDIA & URI W/O MCC $6,518 $6,518 $13,277 −51% $14,473 −55% —
812 RED BLOOD CELL DISORDERS W/O MCC $6,499 $6,499 $19,481 −67% $20,488 −68% ≈87% of Medicare
312 SYNCOPE & COLLAPSE $6,494 $6,494 $23,545 −72% $19,342 −66% ≈97% of Medicare
303 ATHEROSCLEROSIS W/O MCC $6,489 $6,489 $18,920 −66% $14,927 −57% —
379 G.I. HEMORRHAGE W/O CC/MCC $6,454 $6,454 $20,210 −68% $14,134 −54% —
684 RENAL FAILURE W/O CC/MCC $6,352 $6,352 $12,049 −47% $13,623 −53% —
156 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC $6,246 $6,246 $11,921 −48% $13,198 −53% —
639 DIABETES W/O CC/MCC $6,240 $6,240 $16,811 −63% $13,910 −55% —
072 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC $6,236 $6,236 $23,908 −74% $16,654 −63% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC $6,210 $6,210 $19,164 −68% $14,368 −57% —
607 MINOR SKIN DISORDERS W/O MCC $6,205 $6,205 $19,884 −69% $15,284 −59% —
670 TRANSURETHRAL PROCEDURES W/O CC/MCC $6,197 $6,197 $18,223 −66% $20,371 −70% —
923 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC $6,102 $6,102 $17,649 −65% $16,571 −63% —
641 MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC $6,084 $6,084 $16,822 −64% $16,745 −64% ≈100% of Medicare
696 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC $6,082 $6,082 $13,500 −55% $14,441 −58% —
563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC $6,080 $6,080 $18,854 −68% $18,803 −68% —
060 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC $5,972 $5,972 $18,043 −67% $21,261 −72% —
067 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC $5,968 $5,968 $42,416 −86% $24,941 −76% —
392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC $5,939 $5,939 $14,681 −60% $17,322 −66% ≈72% of Medicare
446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC $5,930 $5,930 $19,221 −69% $17,700 −66% —
078 HYPERTENSIVE ENCEPHALOPATHY W CC $5,902 $5,902 $31,817 −81% $17,434 −66% —
103 HEADACHES W/O MCC $5,857 $5,857 $21,111 −72% $20,111 −71% —
552 MEDICAL BACK PROBLEMS W/O MCC $5,847 $5,847 $21,141 −72% $21,213 −72% ≈55% of Medicare
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC $5,832 $5,832 $35,183 −83% $32,538 −82% —
661 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC $5,799 $5,799 $20,291 −71% $24,022 −76% —
554 BONE DISEASES & ARTHROPATHIES W/O MCC $5,790 $5,790 $18,143 −68% $18,253 −68% —
948 SIGNS & SYMPTOMS W/O MCC $5,756 $5,756 $21,819 −74% $17,727 −68% ≈88% of Medicare
311 ANGINA PECTORIS $5,735 $5,735 $15,425 −63% $15,165 −62% —
565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC $5,652 $5,652 $22,525 −75% $21,545 −74% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC $5,605 $5,605 $13,799 −59% $16,837 −67% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC $5,578 $5,578 $19,521 −71% $18,150 −69% —
558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC $5,506 $5,506 $20,995 −74% $17,367 −68% —
069 TRANSIENT ISCHEMIA W/O THROMBOLYTIC $5,478 $5,478 $24,940 −78% $20,278 −73% ≈97% of Medicare
122 ACUTE MAJOR EYE INFECTIONS W/O CC/MCC $5,459 $5,459 $11,997 −55% $11,997 −55% —
305 HYPERTENSION W/O MCC $5,452 $5,452 $24,338 −78% $17,144 −68% —
297 CARDIAC ARREST, UNEXPLAINED W CC $5,379 $5,379 $12,336 −56% $12,336 −56% —
309 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC $5,336 $5,336 $22,237 −76% $16,865 −68% ≈94% of Medicare
292 HEART FAILURE & SHOCK W CC $5,278 $5,278 $19,303 −73% $16,212 −67% —
301 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC $5,210 $5,210 $19,031 −73% $15,607 −67% —
866 VIRAL ILLNESS W/O MCC $4,969 $4,969 $19,085 −74% $16,391 −70% —
093 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC $4,942 $4,942 $19,993 −75% $17,522 −72% —
897 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC $4,909 $4,909 $15,819 −69% $16,049 −69% —
894 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA $4,853 $4,853 $12,685 −62% $12,013 −60% —
287 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC $4,836 $4,836 $30,745 −84% $31,190 −84% —
176 PULMONARY EMBOLISM W/O MCC $4,814 $4,814 $21,913 −78% $18,081 −73% ≈72% of Medicare
815 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC $4,776 $4,776 $19,264 −75% $18,017 −73% —
149 DYSEQUILIBRIUM $4,726 $4,726 $23,926 −80% $17,203 −73% ≈87% of Medicare
369 MAJOR ESOPHAGEAL DISORDERS W CC $4,681 $4,681 $26,899 −83% $22,713 −79% —
556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC $4,647 $4,647 $17,696 −74% $17,715 −74% ≈72% of Medicare
832 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC $4,563 $4,563 $12,895 −65% $12,895 −65% —
155 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC $4,233 $4,233 $16,642 −75% $16,642 −75% —
307 CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC $4,147 $4,147 $18,323 −77% $18,608 −78% —
667 PROSTATECTOMY W/O CC/MCC $3,909 $3,909 $16,534 −76% $16,703 −77% —
313 CHEST PAIN $3,801 $3,801 $20,854 −82% $15,962 −76% ≈69% of Medicare
494 LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W/O CC/MCC $3,678 $3,678 $38,192 −90% $45,963 −92% —
694 URINARY STONES W/O MCC $3,653 $3,653 $14,472 −75% $16,531 −78% —
663 MINOR BLADDER PROCEDURES W CC $3,631 $3,631 $29,153 −88% $29,924 −88% —
310 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC $3,606 $3,606 $12,915 −72% $13,384 −73% ≈89% of Medicare
293 HEART FAILURE & SHOCK W/O CC/MCC $3,507 $3,507 $12,530 −72% $11,955 −71% —
059 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC $3,374 $3,374 $22,337 −85% $26,322 −87% —
700 OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC $3,368 $3,368 $12,551 −73% $13,303 −75% —
188 PLEURAL EFFUSION W/O CC/MCC $3,116 $3,116 $20,711 −85% $14,110 −78% —
999 UNGROUPABLE $2,879 $2,879 $13,627 −79% $28,822 −90% —
916 ALLERGIC REACTIONS W/O MCC $2,796 $2,796 $15,531 −82% $13,890 −80% —
779 ABORTION W/O D&C $2,180 $2,180 $15,408 −86% $15,327 −86% —
761 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC $1,910 $1,910 $11,421 −83% $11,421 −83% —

Procedures with negotiated rates only

These 9 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
833 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC — 13 plans
117 INTRAOCULAR PROCEDURES W/O CC/MCC — 12 plans
502 SOFT TISSUE PROCEDURES W/O CC/MCC — 12 plans
555 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC — 12 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC — 12 plans
864 FEVER AND INFLAMMATORY CONDITIONS — 12 plans
714 TRANSURETHRAL PROSTATECTOMY W/O CC/MCC — 11 plans
566 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC — 9 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC — 9 plans
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