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 $374,499 −57% $371,366 −56% —
004 TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. $113,523 $113,523 $227,105 −50% $248,521 −54% ≈100% of Medicare
686 KIDNEY & URINARY TRACT NEOPLASMS W MCC $83,857 $83,857 $30,841 +172% $37,844 +122% —
335 PERITONEAL ADHESIOLYSIS W MCC $64,305 $64,305 $56,742 +13% $71,755 −10% —
334 RECTAL RESECTION W/O CC/MCC $61,650 $61,650 $24,721 +149% $36,820 +67% —
870 SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS $55,167 $55,167 $175,904 −69% $148,832 −63% ≈100% of Medicare
239 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC $52,654 $52,654 $68,473 −23% $93,390 −44% —
654 MAJOR BLADDER PROCEDURES W CC $49,629 $49,629 $39,822 +25% $58,274 −15% —
463 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC $47,857 $47,857 $74,690 −36% $89,207 −46% —
207 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS $46,196 $46,196 $100,570 −54% $116,058 −60% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC $45,810 $45,810 $48,670 −6% $69,743 −34% —
254 OTHER VASCULAR PROCEDURES W/O CC/MCC $44,712 $44,712 $43,831 +2% $38,836 +15% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC $41,396 $41,396 $42,404 −2% $55,162 −25% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC $39,971 $39,971 $108,198 −63% $82,561 −52% —
329 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC $37,702 $37,702 $69,268 −46% $88,050 −57% ≈93% of Medicare
853 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC $36,855 $36,855 $96,196 −62% $93,172 −60% ≈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 $61,356 −41% $75,103 −52% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC $35,845 $35,845 $78,755 −54% $70,371 −49% —
622 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC $35,556 $35,556 $51,761 −31% $61,470 −42% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC $35,130 $35,130 $111,594 −69% $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 $62,843 −48% $70,132 −53% —
628 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC $32,247 $32,247 $68,006 −53% $71,795 −55% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC $32,086 $32,086 $81,781 −61% $71,014 −55% —
981 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $31,950 $31,950 $105,908 −70% $90,775 −65% ≈81% of Medicare
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC $31,505 $31,505 $36,172 −13% $50,139 −37% —
037 EXTRACRANIAL PROCEDURES W MCC $31,291 $31,291 $89,423 −65% $66,666 −53% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACE $31,168 $31,168 $45,618 −32% $65,788 −53% —
674 OTHER KIDNEY & URINARY TRACT PROCEDURES W CC $31,161 $31,161 $41,721 −25% $50,394 −38% —
252 OTHER VASCULAR PROCEDURES W MCC $30,652 $30,652 $72,690 −58% $68,508 −55% —
982 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC $30,464 $30,464 $34,970 −13% $51,985 −41% —
673 OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC $30,421 $30,421 $68,137 −55% $77,990 −61% —
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 $45,424 −33% $61,872 −51% —
166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC $28,601 $28,601 $65,839 −57% $75,573 −62% —
417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC $28,288 $28,288 $42,068 −33% $53,451 −47% —
464 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC $28,115 $28,115 $56,193 −50% $58,228 −52% —
653 MAJOR BLADDER PROCEDURES W MCC $27,593 $27,593 $94,497 −71% $104,583 −74% —
987 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC $27,577 $27,577 $59,880 −54% $66,068 −58% —
629 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC $26,686 $26,686 $49,188 −46% $47,737 −44% —
840 LYMPHOMA & NON-ACUTE LEUKEMIA W MCC $26,406 $26,406 $51,930 −49% $49,710 −47% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC $26,249 $26,249 $74,502 −65% $68,653 −62% —
579 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC $26,201 $26,201 $45,498 −42% $58,745 −55% —
344 MINOR SMALL & LARGE BOWEL PROCEDURES W MCC $23,894 $23,894 $38,166 −37% $44,546 −46% —
253 OTHER VASCULAR PROCEDURES W CC $23,498 $23,498 $40,302 −42% $57,454 −59% —
465 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC $23,295 $23,295 $25,727 −9% $32,443 −28% —
027 CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC $22,827 $22,827 $71,258 −68% $54,583 −58% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC $22,827 $22,827 $61,750 −63% $76,001 −70% —
208 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS $22,216 $22,216 $59,696 −63% $52,405 −58% ≈94% of Medicare
347 ANAL & STOMAL PROCEDURES W MCC $21,998 $21,998 $33,912 −35% $40,548 −46% —
908 OTHER O.R. PROCEDURES FOR INJURIES W CC $21,563 $21,563 $38,919 −45% $42,914 −50% —
082 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC $21,317 $21,317 $33,308 −36% $36,489 −42% —
196 INTERSTITIAL LUNG DISEASE W MCC $21,125 $21,125 $31,016 −32% $32,637 −35% —
337 PERITONEAL ADHESIOLYSIS W/O CC/MCC $20,996 $20,996 $32,469 −35% $39,211 −46% —
659 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC $20,938 $20,938 $44,554 −53% $52,178 −60% —
503 FOOT PROCEDURES W MCC $20,926 $20,926 $39,757 −47% $47,540 −56% —
808 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC $20,815 $20,815 $36,743 −43% $39,181 −47% —
080 NONTRAUMATIC STUPOR & COMA W MCC $20,672 $20,672 $28,993 −29% $36,249 −43% —
570 SKIN DEBRIDEMENT W MCC $20,512 $20,512 $42,044 −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 $72,286 −72% $65,653 −69% —
330 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC $20,081 $20,081 $50,487 −60% $59,500 −66% —
493 LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W CC $20,028 $20,028 $61,840 −68% $59,651 −66% —
481 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC $19,912 $19,912 $50,338 −60% $52,751 −62% ≈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 $54,631 −64% $66,685 −70% —
571 SKIN DEBRIDEMENT W CC $19,502 $19,502 $37,317 −48% $37,169 −48% —
580 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC $19,434 $19,434 $26,907 −28% $38,101 −49% —
668 TRANSURETHRAL PROCEDURES W MCC $19,432 $19,432 $41,045 −53% $51,608 −62% —
940 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC $19,226 $19,226 $36,660 −48% $43,650 −56% —
522 Anesth Chest Lining Biopsy $19,212 $19,212 $50,107 −62% $58,280 −67% ≈104% of Medicare
511 SHOULDER, ELBOW OR FOREARM PROC, EXC MAJOR JOINT PROC W CC $18,745 $18,745 $36,710 −49% $43,538 −57% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC $18,589 $18,589 $42,071 −56% $39,106 −52% ≈109% of Medicare
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC $18,529 $18,529 $38,791 −52% $39,973 −54% ≈101% of Medicare
041 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM $18,495 $18,495 $32,503 −43% $49,418 −63% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC $18,491 $18,491 $25,171 −27% $26,463 −30% —
432 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC $18,467 $18,467 $48,837 −62% $40,213 −54% —
617 AMPUTAT OF LOWER LIMB FOR ENDOCRINE, NUTRIT, & METABOL DIS W CC $18,322 $18,322 $41,821 −56% $42,881 −57% —
042 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC $18,218 $18,218 $26,578 −31% $39,018 −53% —
368 MAJOR ESOPHAGEAL DISORDERS W MCC $18,108 $18,108 $32,526 −44% $33,876 −47% —
380 COMPLICATED PEPTIC ULCER W MCC $18,083 $18,083 $33,696 −46% $39,627 −54% —
535 FRACTURES OF HIP & PELVIS W MCC $18,022 $18,022 $25,858 −30% $24,552 −27% —
862 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC $18,008 $18,008 $33,224 −46% $32,859 −45% —
742 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC $17,789 $17,789 $34,049 −48% $40,552 −56% —
326 STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC $17,784 $17,784 $69,008 −74% $80,793 −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 $32,289 −46% $39,020 −55% —
598 MALIGNANT BREAST DISORDERS W CC $17,484 $17,484 $18,578 −6% $19,073 −8% —
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC $17,398 $17,398 $26,677 −35% $32,433 −46% —
592 SKIN ULCERS W MCC $17,396 $17,396 $29,882 −42% $33,246 −48% —
657 KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC $17,354 $17,354 $39,277 −56% $43,298 −60% —
623 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC $17,328 $17,328 $28,020 −38% $34,459 −50% —
355 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC $17,302 $17,302 $24,594 −30% $32,841 −47% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC $17,217 $17,217 $44,198 −61% $41,591 −59% —
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 $34,861 −52% $42,126 −60% —
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC $16,803 $16,803 $36,465 −54% $35,628 −53% ≈96% of Medicare
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $16,749 $16,749 $47,785 −65% $58,707 −71% —
915 ALLERGIC REACTIONS W MCC $16,687 $16,687 $25,750 −35% $32,645 −49% —
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 $30,087 −45% $35,481 −54% —
350 INGUINAL & FEMORAL HERNIA PROCEDURES W MCC $16,367 $16,367 $46,352 −65% $50,046 −67% —
470 Major joint replacement or reattachment of lower extremity without major complication or comorbidity $16,363 $16,363 $43,106 −62% $50,607 −68% —
186 PLEURAL EFFUSION W MCC $16,211 $16,211 $35,284 −54% $33,834 −52% —
671 URETHRAL PROCEDURES W CC/MCC $16,123 $16,123 $25,566 −37% $27,233 −41% —
157 DENTAL & ORAL DISEASES W MCC $16,045 $16,045 $24,447 −34% $31,300 −49% —
711 TESTES PROCEDURES W CC/MCC $16,040 $16,040 $46,485 −65% $38,343 −58% —
441 DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC $16,036 $16,036 $24,768 −35% $33,985 −53% —
516 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC $16,026 $16,026 $40,849 −61% $46,090 −65% —
546 CONNECTIVE TISSUE DISORDERS W CC $15,930 $15,930 $32,794 −51% $25,700 −38% —
286 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC $15,798 $15,798 $44,619 −65% $46,283 −66% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC $15,565 $15,565 $26,273 −41% $33,694 −54% —
256 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC $15,451 $15,451 $25,176 −39% $32,944 −53% —
513 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC $15,277 $15,277 $22,744 −33% $33,424 −54% —
666 PROSTATECTOMY W CC $15,154 $15,154 $29,763 −49% $31,906 −53% —
091 OTHER DISORDERS OF NERVOUS SYSTEM W MCC $15,095 $15,095 $32,465 −54% $37,387 −60% —
177 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC $14,903 $14,903 $33,707 −56% $33,707 −56% ≈105% of Medicare
922 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC $14,798 $14,798 $32,757 −55% $31,563 −53% —
517 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC $14,757 $14,757 $31,148 −53% $33,393 −56% —
385 INFLAMMATORY BOWEL DISEASE W MCC $14,742 $14,742 $24,282 −39% $27,617 −47% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC $14,660 $14,660 $39,782 −63% $39,955 −63% —
854 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC $14,564 $14,564 $32,044 −55% $43,943 −67% —
345 MINOR SMALL & LARGE BOWEL PROCEDURES W CC $14,530 $14,530 $37,473 −61% $33,048 −56% —
988 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC $14,529 $14,529 $27,009 −46% $38,094 −62% —
482 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC $14,356 $14,356 $39,675 −64% $41,955 −66% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC $14,352 $14,352 $30,510 −53% $34,192 −58% ≈101% of Medicare
070 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC $14,284 $14,284 $25,761 −45% $31,951 −55% ≈92% of Medicare
504 FOOT PROCEDURES W CC $14,284 $14,284 $29,220 −51% $38,960 −63% —
698 OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC $14,246 $14,246 $30,494 −53% $32,496 −56% ≈99% of Medicare
919 COMPLICATIONS OF TREATMENT W MCC $14,223 $14,223 $26,862 −47% $31,105 −54% —
811 RED BLOOD CELL DISORDERS W MCC $14,098 $14,098 $24,954 −44% $28,226 −50% ≈117% of Medicare
913 TRAUMATIC INJURY W MCC $14,054 $14,054 $24,198 −42% $24,198 −42% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC $13,953 $13,953 $30,500 −54% $30,828 −55% ≈109% of Medicare
884 ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY $13,841 $13,841 $24,125 −43% $26,682 −48% ≈96% of Medicare
180 RESPIRATORY NEOPLASMS W MCC $13,832 $13,832 $33,385 −59% $36,658 −62% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC $13,814 $13,814 $33,498 −59% $38,666 −64% ≈78% of Medicare
377 G.I. HEMORRHAGE W MCC $13,764 $13,764 $38,041 −64% $37,842 −64% ≈93% of Medicare
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC $13,733 $13,733 $16,992 −19% $20,901 −34% —
643 ENDOCRINE DISORDERS W MCC $13,684 $13,684 $25,825 −47% $33,563 −59% —
299 PERIPHERAL VASCULAR DISORDERS W MCC $13,653 $13,653 $30,993 −56% $27,316 −50% ≈98% of Medicare
669 TRANSURETHRAL PROCEDURES W CC $13,611 $13,611 $36,359 −63% $34,354 −60% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC $13,548 $13,548 $34,139 −60% $27,394 −51% —
520 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC $13,529 $13,529 $23,681 −43% $35,465 −62% —
374 DIGESTIVE MALIGNANCY W MCC $13,528 $13,528 $34,183 −60% $39,958 −66% —
512 SHOULDER, ELBOW OR FOREARM PROC, EXC MAJOR JOINT PROC W/O CC/MCC $13,527 $13,527 $34,657 −61% $35,692 −62% —
693 URINARY STONES W MCC $13,375 $13,375 $22,278 −40% $23,892 −44% —
604 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC $13,330 $13,330 $22,477 −41% $28,140 −53% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC $13,287 $13,287 $28,430 −53% $33,255 −60% —
444 DISORDERS OF THE BILIARY TRACT W MCC $13,182 $13,182 $33,595 −61% $34,273 −62% —
241 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC $13,090 $13,090 $22,791 −43% $30,770 −57% —
909 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC $13,041 $13,041 $28,736 −55% $28,156 −54% —
637 DIABETES W MCC $13,019 $13,019 $29,918 −56% $30,100 −57% ≈104% of Medicare
602 CELLULITIS W MCC $12,916 $12,916 $26,232 −51% $30,598 −58% ≈109% of Medicare
545 CONNECTIVE TISSUE DISORDERS W MCC $12,902 $12,902 $38,759 −67% $40,362 −68% —
606 MINOR SKIN DISORDERS W MCC $12,881 $12,881 $30,798 −58% $27,975 −54% —
885 PSYCHOSES $12,867 $12,867 $23,973 −46% $21,729 −41% —
542 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC $12,697 $12,697 $34,886 −64% $36,792 −65% —
289 ACUTE & SUBACUTE ENDOCARDITIS W CC $12,658 $12,658 $23,658 −46% $32,697 −61% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC $12,531 $12,531 $46,269 −73% $39,887 −69% —
124 OTHER DISORDERS OF THE EYE W MCC $12,497 $12,497 $21,894 −43% $21,894 −43% —
086 TRAUMATIC STUPOR & COMA, COMA <1 HR W CC $12,419 $12,419 $23,278 −47% $27,043 −54% —
089 CONCUSSION W CC $12,281 $12,281 $17,109 −28% $18,821 −35% —
551 MEDICAL BACK PROBLEMS W MCC $12,069 $12,069 $33,108 −64% $34,017 −65% —
193 SIMPLE PNEUMONIA & PLEURISY W MCC $11,996 $11,996 $28,415 −58% $27,275 −56% ≈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 $23,010 −48% $25,463 −53% ≈108% of Medicare
682 RENAL FAILURE W MCC $11,852 $11,852 $27,301 −57% $29,064 −59% ≈92% of Medicare
371 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC $11,830 $11,830 $29,997 −61% $33,555 −65% —
073 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC $11,715 $11,715 $28,480 −59% $30,010 −61% —
391 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC $11,650 $11,650 $19,865 −41% $28,050 −58% ≈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 $27,424 −58% $26,776 −57% ≈95% of Medicare
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC $11,360 $11,360 $21,375 −47% $32,628 −65% —
296 CARDIAC ARREST, UNEXPLAINED W MCC $11,305 $11,305 $29,888 −62% $33,661 −66% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC $11,286 $11,286 $18,651 −39% $19,227 −41% —
433 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC $11,269 $11,269 $21,094 −47% $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 $28,798 −61% $27,285 −59% —
593 SKIN ULCERS W CC $11,104 $11,104 $23,101 −52% $22,886 −51% —
189 PULMONARY EDEMA & RESPIRATORY FAILURE $11,059 $11,059 $24,603 −55% $26,580 −58% ≈102% of Medicare
562 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC $11,040 $11,040 $23,984 −54% $29,743 −63% —
695 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC $11,035 $11,035 $28,352 −61% $24,566 −55% —
644 ENDOCRINE DISORDERS W CC $10,948 $10,948 $23,815 −54% $23,198 −53% —
346 MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC $10,868 $10,868 $19,263 −44% $27,297 −60% —
197 INTERSTITIAL LUNG DISEASE W CC $10,822 $10,822 $17,431 −38% $21,941 −51% —
388 G.I. OBSTRUCTION W MCC $10,819 $10,819 $22,272 −51% $30,571 −65% —
769 POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE $10,814 $10,814 $21,228 −49% $25,094 −57% —
300 PERIPHERAL VASCULAR DISORDERS W CC $10,758 $10,758 $22,956 −53% $20,422 −47% ≈121% of Medicare
240 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC $10,755 $10,755 $54,475 −80% $59,790 −82% —
725 BENIGN PROSTATIC HYPERTROPHY W MCC $10,748 $10,748 $27,823 −61% $22,320 −52% —
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC $10,658 $10,658 $19,183 −44% $19,270 −45% —
844 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC $10,637 $10,637 $18,707 −43% $21,847 −51% —
553 BONE DISEASES & ARTHROPATHIES W MCC $10,603 $10,603 $26,469 −60% $26,051 −59% —
917 POISONING & TOXIC EFFECTS OF DRUGS W MCC $10,590 $10,590 $26,798 −60% $30,235 −65% —
887 OTHER MENTAL DISORDER DIAGNOSES $10,553 $10,553 $18,631 −43% $20,616 −49% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC $10,534 $10,534 $17,768 −41% $19,815 −47% —
872 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC $10,517 $10,517 $18,180 −42% $22,888 −54% ≈108% of Medicare
092 OTHER DISORDERS OF NERVOUS SYSTEM W CC $10,447 $10,447 $22,889 −54% $24,914 −58% —
697 URETHRAL STRICTURE $10,387 $10,387 $17,701 −41% $18,428 −44% —
813 COAGULATION DISORDERS $10,383 $10,383 $32,291 −68% $33,296 −69% —
039 EXTRACRANIAL PROCEDURES W/O CC/MCC $10,377 $10,377 $31,640 −67% $26,618 −61% —
354 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC $10,322 $10,322 $39,779 −74% $43,477 −76% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC $10,267 $10,267 $17,602 −42% $18,459 −44% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC $10,231 $10,231 $29,561 −65% $27,543 −63% ≈95% of Medicare
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC $10,216 $10,216 $28,020 −64% $30,083 −66% —
304 HYPERTENSION W MCC $10,175 $10,175 $24,714 −59% $26,080 −61% —
533 FRACTURES OF FEMUR W MCC $10,098 $10,098 $22,986 −56% $25,945 −61% —
947 SIGNS & SYMPTOMS W MCC $10,035 $10,035 $23,898 −58% $27,401 −63% —
760 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC $10,030 $10,030 $15,986 −37% $20,895 −52% —
817 OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCC $9,992 $9,992 $30,225 −67% $39,173 −74% —
372 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC $9,991 $9,991 $19,320 −48% $22,850 −56% —
336 PERITONEAL ADHESIOLYSIS W CC $9,935 $9,935 $44,395 −78% $50,463 −80% —
167 OTHER RESP SYSTEM O.R. PROCEDURES W CC $9,916 $9,916 $41,640 −76% $40,642 −76% —
687 KIDNEY & URINARY TRACT NEOPLASMS W CC $9,907 $9,907 $16,857 −41% $20,232 −51% —
419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC $9,853 $9,853 $36,603 −73% $36,937 −73% —
054 NERVOUS SYSTEM NEOPLASMS W MCC $9,802 $9,802 $22,682 −57% $30,502 −68% —
375 DIGESTIVE MALIGNANCY W CC $9,770 $9,770 $30,392 −68% $27,277 −64% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC $9,746 $9,746 $17,483 −44% $17,483 −44% —
600 NON-MALIGNANT BREAST DISORDERS W CC/MCC $9,740 $9,740 $16,461 −41% $16,700 −42% —
660 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC $9,721 $9,721 $26,769 −64% $31,264 −69% ≈85% of Medicare
302 ATHEROSCLEROSIS W MCC $9,665 $9,665 $21,279 −55% $22,446 −57% —
306 CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC $9,620 $9,620 $35,088 −73% $24,586 −61% —
557 TENDONITIS, MYOSITIS & BURSITIS W MCC $9,594 $9,594 $33,619 −71% $32,877 −71% —
810 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC $9,545 $9,545 $21,101 −55% $18,316 −48% —
664 MINOR BLADDER PROCEDURES W/O CC/MCC $9,530 $9,530 $19,882 −52% $22,314 −57% —
418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC $9,360 $9,360 $33,278 −72% $44,606 −79% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC $9,289 $9,289 $32,506 −71% $43,913 −79% —
154 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC $9,282 $9,282 $27,330 −66% $27,633 −66% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC $9,275 $9,275 $19,690 −53% $24,386 −62% —
201 PNEUMOTHORAX W/O CC/MCC $9,259 $9,259 $13,089 −29% $14,053 −34% —
204 RESPIRATORY SIGNS & SYMPTOMS $9,257 $9,257 $22,720 −59% $18,004 −49% —
351 INGUINAL & FEMORAL HERNIA PROCEDURES W CC $9,144 $9,144 $28,985 −68% $36,505 −75% —
920 COMPLICATIONS OF TREATMENT W CC $9,104 $9,104 $23,878 −62% $22,468 −59% —
178 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC $9,077 $9,077 $20,753 −56% $22,024 −59% ≈117% of Medicare
689 KIDNEY & URINARY TRACT INFECTIONS W MCC $9,069 $9,069 $18,916 −52% $23,617 −62% ≈91% of Medicare
315 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC $9,016 $9,016 $20,236 −55% $21,363 −58% —
152 OTITIS MEDIA & URI W MCC $8,976 $8,976 $17,922 −50% $20,247 −56% —
564 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC $8,956 $8,956 $33,452 −73% $33,653 −73% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC $8,931 $8,931 $16,722 −47% $18,488 −52% —
090 CONCUSSION W/O CC/MCC $8,897 $8,897 $25,638 −65% $15,412 −42% —
540 OSTEOMYELITIS W CC $8,719 $8,719 $19,990 −56% $26,676 −67% —
373 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC $8,710 $8,710 $14,912 −42% $16,767 −48% —
184 MAJOR CHEST TRAUMA W CC $8,692 $8,692 $19,872 −56% $22,432 −61% —
699 OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC $8,683 $8,683 $20,153 −57% $21,275 −59% ≈99% of Medicare
081 NONTRAUMATIC STUPOR & COMA W/O MCC $8,629 $8,629 $14,937 −42% $16,552 −48% —
745 D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC $8,606 $8,606 $16,495 −48% $18,348 −53% —
308 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC $8,553 $8,553 $24,743 −65% $26,770 −68% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS $8,544 $8,544 $26,059 −67% $23,940 −64% ≈114% of Medicare
316 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC $8,471 $8,471 $15,788 −46% $13,651 −38% —
863 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC $8,444 $8,444 $19,304 −56% $20,957 −60% —
445 DISORDERS OF THE BILIARY TRACT W CC $8,434 $8,434 $20,142 −58% $23,319 −64% ≈89% of Medicare
713 TRANSURETHRAL PROSTATECTOMY W CC/MCC $8,400 $8,400 $28,808 −71% $32,100 −74% ≈66% of Medicare
087 TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC $8,384 $8,384 $14,668 −43% $16,520 −49% —
603 CELLULITIS W/O MCC $8,370 $8,370 $14,803 −43% $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 $19,268 −57% $22,458 −63% —
434 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC $8,308 $8,308 $14,866 −44% $12,460 −33% —
386 INFLAMMATORY BOWEL DISEASE W CC $8,308 $8,308 $17,764 −53% $22,033 −62% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC $8,280 $8,280 $16,872 −51% $23,488 −65% ≈97% of Medicare
202 BRONCHITIS & ASTHMA W CC/MCC $8,242 $8,242 $16,255 −49% $17,724 −54% —
683 RENAL FAILURE W CC $8,086 $8,086 $15,913 −49% $19,130 −58% ≈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 $25,803 −69% $22,098 −64% ≈98% of Medicare
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC $8,000 $8,000 $20,781 −62% $20,781 −62% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC $7,971 $7,971 $20,166 −60% $25,034 −68% —
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 $24,926 −69% $25,652 −69% —
543 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC $7,817 $7,817 $18,503 −58% $23,551 −67% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC $7,760 $7,760 $51,445 −85% $52,075 −85% —
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 $16,173 −52% $18,204 −58% ≈122% of Medicare
534 FRACTURES OF FEMUR W/O MCC $7,704 $7,704 $16,748 −54% $17,559 −56% —
181 RESPIRATORY NEOPLASMS W CC $7,703 $7,703 $30,260 −75% $23,573 −67% —
547 CONNECTIVE TISSUE DISORDERS W/O CC/MCC $7,686 $7,686 $19,855 −61% $16,565 −54% —
125 OTHER DISORDERS OF THE EYE W/O MCC $7,620 $7,620 $18,154 −58% $17,298 −56% —
605 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC $7,594 $7,594 $21,754 −65% $20,506 −63% —
597 MALIGNANT BREAST DISORDERS W MCC $7,527 $7,527 $25,994 −71% $33,386 −77% —
158 DENTAL & ORAL DISEASES W CC $7,464 $7,464 $20,087 −63% $18,466 −60% —
389 G.I. OBSTRUCTION W CC $7,442 $7,442 $16,234 −54% $17,578 −58% ≈122% of Medicare
198 INTERSTITIAL LUNG DISEASE W/O CC/MCC $7,440 $7,440 $12,284 −39% $15,549 −52% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC $7,428 $7,428 $12,703 −42% $15,183 −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 $28,499 −74% $30,959 −76% ≈61% of Medicare
544 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC $7,379 $7,379 $13,002 −43% $16,776 −56% —
151 EPISTAXIS W/O MCC $7,371 $7,371 $13,032 −43% $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 $24,435 −70% $20,463 −64% —
349 ANAL & STOMAL PROCEDURES W/O CC/MCC $7,320 $7,320 $18,669 −61% $19,854 −63% —
726 BENIGN PROSTATIC HYPERTROPHY W/O MCC $7,314 $7,314 $13,602 −46% $15,019 −51% —
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 $22,819 −68% $31,159 −77% —
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 $16,950 −57% $23,141 −69% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC $7,213 $7,213 $14,338 −50% $18,807 −62% ≈105% of Medicare
975 HIV W MAJOR RELATED CONDITION W CC $7,204 $7,204 $25,319 −72% $27,808 −74% —
918 POISONING & TOXIC EFFECTS OF DRUGS W/O MCC $7,196 $7,196 $12,276 −41% $15,452 −53% —
842 LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC $7,182 $7,182 $20,494 −65% $19,657 −63% —
443 DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W/O CC/MCC $7,163 $7,163 $21,770 −67% $15,600 −54% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC $7,135 $7,135 $18,918 −62% $20,181 −65% ≈95% of Medicare
581 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC $7,114 $7,114 $22,149 −68% $26,932 −74% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC $7,050 $7,050 $15,776 −55% $16,450 −57% —
068 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC $6,972 $6,972 $20,241 −66% $19,569 −64% —
195 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC $6,924 $6,924 $13,910 −50% $13,824 −50% ≈128% of Medicare
638 DIABETES W CC $6,910 $6,910 $18,494 −63% $19,661 −65% ≈101% of Medicare
203 BRONCHITIS & ASTHMA W/O CC/MCC $6,906 $6,906 $14,098 −51% $12,252 −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 $16,504 −59% $14,128 −52% —
187 PLEURAL EFFUSION W CC $6,788 $6,788 $20,440 −67% $21,789 −69% —
179 RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC $6,774 $6,774 $14,596 −54% $14,648 −54% ≈110% of Medicare
868 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC $6,762 $6,762 $17,504 −61% $22,763 −70% —
645 ENDOCRINE DISORDERS W/O CC/MCC $6,719 $6,719 $17,762 −62% $15,428 −56% —
343 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC $6,699 $6,699 $12,397 −46% $12,397 −46% —
880 ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION $6,682 $6,682 $20,399 −67% $17,733 −62% —
690 KIDNEY & URINARY TRACT INFECTIONS W/O MCC $6,678 $6,678 $16,665 −60% $17,674 −62% ≈91% of Medicare
199 PNEUMOTHORAX W MCC $6,620 $6,620 $33,787 −80% $33,787 −80% —
536 FRACTURES OF HIP & PELVIS W/O MCC $6,563 $6,563 $13,719 −52% $18,002 −64% ≈106% of Medicare
101 SEIZURES W/O MCC $6,552 $6,552 $15,777 −58% $20,461 −68% ≈90% of Medicare
352 INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC $6,529 $6,529 $29,044 −78% $27,843 −77% —
390 G.I. OBSTRUCTION W/O CC/MCC $6,525 $6,525 $10,472 −38% $13,361 −51% ≈152% of Medicare
153 OTITIS MEDIA & URI W/O MCC $6,518 $6,518 $13,931 −53% $14,583 −55% —
812 RED BLOOD CELL DISORDERS W/O MCC $6,499 $6,499 $16,909 −62% $20,488 −68% ≈87% of Medicare
312 SYNCOPE & COLLAPSE $6,494 $6,494 $17,340 −63% $19,342 −66% ≈97% of Medicare
303 ATHEROSCLEROSIS W/O MCC $6,489 $6,489 $19,063 −66% $14,927 −57% —
379 G.I. HEMORRHAGE W/O CC/MCC $6,454 $6,454 $20,210 −68% $15,038 −57% —
684 RENAL FAILURE W/O CC/MCC $6,352 $6,352 $11,276 −44% $13,642 −53% —
156 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC $6,246 $6,246 $11,921 −48% $14,549 −57% —
639 DIABETES W/O CC/MCC $6,240 $6,240 $15,601 −60% $13,910 −55% —
072 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC $6,236 $6,236 $24,325 −74% $19,037 −67% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC $6,210 $6,210 $16,076 −61% $14,368 −57% —
607 MINOR SKIN DISORDERS W/O MCC $6,205 $6,205 $15,276 −59% $15,889 −61% —
670 TRANSURETHRAL PROCEDURES W/O CC/MCC $6,197 $6,197 $21,685 −71% $20,911 −70% —
923 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC $6,102 $6,102 $16,813 −64% $17,601 −65% —
641 MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC $6,084 $6,084 $15,817 −62% $17,038 −64% ≈100% of Medicare
696 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC $6,082 $6,082 $12,411 −51% $14,689 −59% —
563 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC $6,080 $6,080 $18,854 −68% $19,842 −69% —
060 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC $5,972 $5,972 $18,799 −68% $22,148 −73% —
067 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC $5,968 $5,968 $24,511 −76% $24,941 −76% —
392 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC $5,939 $5,939 $13,321 −55% $17,322 −66% ≈72% of Medicare
446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC $5,930 $5,930 $16,731 −65% $17,700 −66% —
078 HYPERTENSIVE ENCEPHALOPATHY W CC $5,902 $5,902 $21,190 −72% $17,698 −67% —
103 HEADACHES W/O MCC $5,857 $5,857 $23,367 −75% $21,280 −72% —
552 MEDICAL BACK PROBLEMS W/O MCC $5,847 $5,847 $21,141 −72% $21,396 −73% ≈55% of Medicare
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC $5,832 $5,832 $31,516 −81% $36,670 −84% —
661 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC $5,799 $5,799 $18,935 −69% $25,970 −78% —
554 BONE DISEASES & ARTHROPATHIES W/O MCC $5,790 $5,790 $19,424 −70% $18,528 −69% —
948 SIGNS & SYMPTOMS W/O MCC $5,756 $5,756 $21,742 −74% $17,921 −68% ≈88% of Medicare
311 ANGINA PECTORIS $5,735 $5,735 $14,117 −59% $15,502 −63% —
565 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC $5,652 $5,652 $24,135 −77% $22,506 −75% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC $5,605 $5,605 $13,799 −59% $17,118 −67% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC $5,578 $5,578 $14,554 −62% $18,150 −69% —
558 TENDONITIS, MYOSITIS & BURSITIS W/O MCC $5,506 $5,506 $19,672 −72% $18,602 −70% —
069 TRANSIENT ISCHEMIA W/O THROMBOLYTIC $5,478 $5,478 $16,890 −68% $21,056 −74% ≈97% of Medicare
122 ACUTE MAJOR EYE INFECTIONS W/O CC/MCC $5,459 $5,459 $11,072 −51% $11,997 −55% —
305 HYPERTENSION W/O MCC $5,452 $5,452 $19,959 −73% $18,086 −70% —
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 $19,628 −73% $17,303 −69% ≈94% of Medicare
292 HEART FAILURE & SHOCK W CC $5,278 $5,278 $15,779 −67% $16,371 −68% —
301 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC $5,210 $5,210 $12,453 −58% $15,837 −67% —
866 VIRAL ILLNESS W/O MCC $4,969 $4,969 $16,845 −71% $17,081 −71% —
093 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC $4,942 $4,942 $17,811 −72% $17,620 −72% —
897 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC $4,909 $4,909 $14,644 −66% $16,699 −71% —
894 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA $4,853 $4,853 $11,294 −57% $12,324 −61% —
287 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC $4,836 $4,836 $27,854 −83% $32,021 −85% —
176 PULMONARY EMBOLISM W/O MCC $4,814 $4,814 $17,685 −73% $18,081 −73% ≈72% of Medicare
815 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC $4,776 $4,776 $19,264 −75% $19,264 −75% —
149 DYSEQUILIBRIUM $4,726 $4,726 $23,926 −80% $18,096 −74% ≈87% of Medicare
369 MAJOR ESOPHAGEAL DISORDERS W CC $4,681 $4,681 $28,508 −84% $25,303 −81% —
556 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC $4,647 $4,647 $17,051 −73% $18,126 −74% ≈72% of Medicare
832 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC $4,563 $4,563 $12,595 −64% $12,895 −65% —
155 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC $4,233 $4,233 $15,869 −73% $16,968 −75% —
307 CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC $4,147 $4,147 $22,213 −81% $20,566 −80% —
667 PROSTATECTOMY W/O CC/MCC $3,909 $3,909 $16,534 −76% $16,703 −77% —
313 CHEST PAIN $3,801 $3,801 $15,639 −76% $16,440 −77% ≈69% of Medicare
494 LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W/O CC/MCC $3,678 $3,678 $41,301 −91% $47,711 −92% —
694 URINARY STONES W/O MCC $3,653 $3,653 $13,336 −73% $17,345 −79% —
663 MINOR BLADDER PROCEDURES W CC $3,631 $3,631 $23,673 −85% $33,103 −89% —
310 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC $3,606 $3,606 $12,015 −70% $13,384 −73% ≈89% of Medicare
293 HEART FAILURE & SHOCK W/O CC/MCC $3,507 $3,507 $10,316 −66% $12,999 −73% —
059 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC $3,374 $3,374 $20,927 −84% $27,163 −88% —
700 OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC $3,368 $3,368 $16,196 −79% $14,797 −77% —
188 PLEURAL EFFUSION W/O CC/MCC $3,116 $3,116 $12,723 −76% $14,514 −79% —
999 UNGROUPABLE $2,879 $2,879 $13,627 −79% $29,674 −90% —
916 ALLERGIC REACTIONS W/O MCC $2,796 $2,796 $13,750 −80% $13,942 −80% —
779 ABORTION W/O D&C $2,180 $2,180 $11,302 −81% $15,327 −86% —
761 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC $1,910 $1,910 $9,852 −81% $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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