Good Samaritan Hospital — Pricing

633 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 633 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 633
Lowest published price —
Average published price —
Highest published price —

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 633 procedures

Procedures with negotiated rates only

These 633 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
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC — 68 plans
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC — 68 plans
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC — 68 plans
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC — 68 plans
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC — 67 plans
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC — 67 plans
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC — 67 plans
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR — 67 plans
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC — 67 plans
028 SPINAL PROCEDURES WITH MCC — 67 plans
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS — 67 plans
030 SPINAL PROCEDURES WITHOUT CC/MCC — 67 plans
034 CAROTID ARTERY STENT PROCEDURES WITH MCC — 67 plans
035 CAROTID ARTERY STENT PROCEDURES WITH CC — 67 plans
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC — 67 plans
037 EXTRACRANIAL PROCEDURES WITH MCC — 67 plans
038 EXTRACRANIAL PROCEDURES WITH CC — 67 plans
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC — 67 plans
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC — 67 plans
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR — 67 plans
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC — 67 plans
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC — 67 plans
054 NERVOUS SYSTEM NEOPLASMS WITH MCC — 67 plans
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC — 67 plans
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC — 67 plans
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC — 67 plans
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC — 67 plans
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC — 67 plans
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC — 67 plans
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC — 67 plans
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC — 67 plans
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC — 67 plans
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS — 67 plans
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC — 67 plans
067 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC — 67 plans
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC — 67 plans
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC — 67 plans
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC — 67 plans
071 OTHER CEREBROVASCULAR DISORDERS WITH CC — 67 plans
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC — 67 plans
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC — 67 plans
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC — 67 plans
075 VIRAL MENINGITIS WITH CC/MCC — 67 plans
080 NONTRAUMATIC STUPOR AND COMA WITH MCC — 67 plans
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC — 67 plans
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC — 67 plans
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC — 67 plans
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC — 67 plans
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC — 67 plans
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC — 67 plans
088 CONCUSSION WITH MCC — 67 plans
089 CONCUSSION WITH CC — 67 plans
090 CONCUSSION WITHOUT CC/MCC — 67 plans
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC — 67 plans
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC — 67 plans
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC — 67 plans
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC — 67 plans
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC — 67 plans
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC — 67 plans
100 SEIZURES WITH MCC — 67 plans
101 SEIZURES WITHOUT MCC — 67 plans
103 HEADACHES WITHOUT MCC — 67 plans
113 ORBITAL PROCEDURES WITH CC/MCC — 67 plans
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT — 67 plans
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC — 67 plans
123 NEUROLOGICAL EYE DISORDERS — 67 plans
125 OTHER DISORDERS OF THE EYE WITHOUT MCC — 67 plans
137 MOUTH PROCEDURES WITH CC/MCC — 67 plans
138 MOUTH PROCEDURES WITHOUT CC/MCC — 67 plans
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $450 – $89,456 · median $68,002 67 plans
141 MAJOR HEAD AND NECK PROCEDURES WITH CC — 67 plans
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC — 67 plans
149 DYSEQUILIBRIUM — 67 plans
150 EPISTAXIS WITH MCC — 67 plans
151 EPISTAXIS WITHOUT MCC — 67 plans
152 OTITIS MEDIA AND URI WITH MCC — 67 plans
153 OTITIS MEDIA AND URI WITHOUT MCC — 67 plans
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC — 67 plans
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC — 67 plans
157 DENTAL AND ORAL DISEASES WITH MCC — 67 plans
163 MAJOR CHEST PROCEDURES WITH MCC — 67 plans
164 MAJOR CHEST PROCEDURES WITH CC — 67 plans
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC — 67 plans
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC — 67 plans
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC — 67 plans
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM — 67 plans
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE — 67 plans
176 PULMONARY EMBOLISM WITHOUT MCC — 67 plans
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC — 67 plans
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC — 67 plans
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC — 67 plans
180 RESPIRATORY NEOPLASMS WITH MCC — 67 plans
181 RESPIRATORY NEOPLASMS WITH CC — 67 plans
183 MAJOR CHEST TRAUMA WITH MCC — 67 plans
184 MAJOR CHEST TRAUMA WITH CC — 67 plans
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC — 67 plans
186 PLEURAL EFFUSION WITH MCC — 67 plans
187 PLEURAL EFFUSION WITH CC — 67 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC — 67 plans
189 PULMONARY EDEMA AND RESPIRATORY FAILURE — 67 plans
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC — 67 plans
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC — 67 plans
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC — 67 plans
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC — 67 plans
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC — 67 plans
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC — 67 plans
196 INTERSTITIAL LUNG DISEASE WITH MCC — 67 plans
197 INTERSTITIAL LUNG DISEASE WITH CC — 67 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC — 67 plans
199 PNEUMOTHORAX WITH MCC — 67 plans
200 PNEUMOTHORAX WITH CC — 67 plans
201 PNEUMOTHORAX WITHOUT CC/MCC — 67 plans
202 BRONCHITIS AND ASTHMA WITH CC/MCC — 67 plans
204 RESPIRATORY SIGNS AND SYMPTOMS — 67 plans
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC — 67 plans
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC — 67 plans
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS — 67 plans
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC — 67 plans
231 CORONARY BYPASS WITH PTCA WITH MCC — 67 plans
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC — 67 plans
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC — 67 plans
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC — 67 plans
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC — 67 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC — 67 plans
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC — 67 plans
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC — 67 plans
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC — 67 plans
245 AICD GENERATOR PROCEDURES — 67 plans
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC — 67 plans
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC — 67 plans
252 OTHER VASCULAR PROCEDURES WITH MCC — 67 plans
253 OTHER VASCULAR PROCEDURES WITH CC — 67 plans
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC — 67 plans
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC — 67 plans
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC — 67 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC — 67 plans
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC — 67 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC — 67 plans
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC — 67 plans
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC — 67 plans
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES — 67 plans
265 AICD LEAD PROCEDURES — 67 plans
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC — 67 plans
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC — 67 plans
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC — 67 plans
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC — 67 plans
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC — 67 plans
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC — 67 plans
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR — 67 plans
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC — 67 plans
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC — 67 plans
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC — 67 plans
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC — 67 plans
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC — 67 plans
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC — 67 plans
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC — 67 plans
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC — 67 plans
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC — 67 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC — 67 plans
291 HEART FAILURE AND SHOCK WITH MCC — 67 plans
292 HEART FAILURE AND SHOCK WITH CC — 67 plans
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC — 67 plans
296 CARDIAC ARREST, UNEXPLAINED WITH MCC — 67 plans
297 CARDIAC ARREST, UNEXPLAINED WITH CC — 67 plans
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $450 – $10,403 · median $7,256 67 plans
299 PERIPHERAL VASCULAR DISORDERS WITH MCC — 67 plans
300 PERIPHERAL VASCULAR DISORDERS WITH CC — 67 plans
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC — 67 plans
302 ATHEROSCLEROSIS WITH MCC — 67 plans
303 ATHEROSCLEROSIS WITHOUT MCC — 67 plans
304 HYPERTENSION WITH MCC — 67 plans
305 HYPERTENSION WITHOUT MCC — 67 plans
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC — 67 plans
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC — 67 plans
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC — 67 plans
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC — 67 plans
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC — 67 plans
311 ANGINA PECTORIS — 67 plans
312 SYNCOPE AND COLLAPSE — 67 plans
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC — 67 plans
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC — 67 plans
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC — 67 plans
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC — 67 plans
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES — 67 plans
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC — 67 plans
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC — 67 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE — 67 plans
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC — 67 plans
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC — 67 plans
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC — 67 plans
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC — 67 plans
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC — 67 plans
333 RECTAL RESECTION WITH CC — 67 plans
335 PERITONEAL ADHESIOLYSIS WITH MCC — 67 plans
336 PERITONEAL ADHESIOLYSIS WITH CC — 67 plans
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC — 67 plans
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC — 67 plans
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC — 67 plans
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC — 67 plans
347 ANAL AND STOMAL PROCEDURES WITH MCC — 67 plans
348 ANAL AND STOMAL PROCEDURES WITH CC — 67 plans
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC — 67 plans
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC — 67 plans
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC — 67 plans
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC — 67 plans
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC — 67 plans
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC — 67 plans
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC — 67 plans
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC — 67 plans
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC — 67 plans
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC — 67 plans
369 MAJOR ESOPHAGEAL DISORDERS WITH CC — 67 plans
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC — 67 plans
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC — 67 plans
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC — 67 plans
374 DIGESTIVE MALIGNANCY WITH MCC — 67 plans
375 DIGESTIVE MALIGNANCY WITH CC — 67 plans
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC — 67 plans
377 GASTROINTESTINAL HEMORRHAGE WITH MCC — 67 plans
378 GASTROINTESTINAL HEMORRHAGE WITH CC — 67 plans
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC — 67 plans
380 COMPLICATED PEPTIC ULCER WITH MCC — 67 plans
381 COMPLICATED PEPTIC ULCER WITH CC — 67 plans
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC — 67 plans
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC — 67 plans
385 INFLAMMATORY BOWEL DISEASE WITH MCC — 67 plans
386 INFLAMMATORY BOWEL DISEASE WITH CC — 67 plans
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC — 67 plans
388 GASTROINTESTINAL OBSTRUCTION WITH MCC — 67 plans
389 GASTROINTESTINAL OBSTRUCTION WITH CC — 67 plans
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $450 – $11,409 · median $8,673 67 plans
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC — 67 plans
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC — 67 plans
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC — 67 plans
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC — 67 plans
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC — 67 plans
397 APPENDIX PROCEDURES WITH MCC — 67 plans
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL — 67 plans
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC — 67 plans
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC — 67 plans
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC — 67 plans
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC — 67 plans
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC — 67 plans
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC — 67 plans
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC — 67 plans
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC — 67 plans
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC — 67 plans
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC — 67 plans
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE — 67 plans
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC — 67 plans
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC — 67 plans
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC — 67 plans
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC — 67 plans
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC — 67 plans
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC — 67 plans
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC — 67 plans
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC — 67 plans
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC — 67 plans
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC — 67 plans
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC — 67 plans
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC — 67 plans
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC — 67 plans
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC — 67 plans
444 DISORDERS OF THE BILIARY TRACT WITH MCC — 67 plans
445 DISORDERS OF THE BILIARY TRACT WITH CC — 67 plans
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC — 67 plans
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE — 67 plans
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC — 67 plans
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE — 67 plans
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC — 67 plans
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC — 67 plans
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC — 67 plans
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC — 67 plans
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC — 67 plans
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC — 67 plans
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC — 67 plans
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC — 67 plans
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC — 67 plans
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT — 67 plans
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC — 67 plans
471 CERVICAL SPINAL FUSION WITH MCC — 67 plans
472 CERVICAL SPINAL FUSION WITH CC — 67 plans
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC — 67 plans
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC — 67 plans
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC — 67 plans
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC — 67 plans
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC — 67 plans
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC — 67 plans
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC — 67 plans
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC — 67 plans
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC — 67 plans
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES — 67 plans
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC — 67 plans
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC — 67 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC — 67 plans
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC — 67 plans
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC — 67 plans
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC — 67 plans
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC — 67 plans
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC — 67 plans
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC — 67 plans
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC — 67 plans
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC — 67 plans
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC — 67 plans
500 SOFT TISSUE PROCEDURES WITH MCC — 67 plans
501 SOFT TISSUE PROCEDURES WITH CC — 67 plans
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC — 67 plans
503 FOOT PROCEDURES WITH MCC — 67 plans
504 FOOT PROCEDURES WITH CC — 67 plans
505 FOOT PROCEDURES WITHOUT CC/MCC — 67 plans
506 MAJOR THUMB OR JOINT PROCEDURES — 67 plans
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC — 67 plans
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC — 67 plans
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC — 67 plans
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC — 67 plans
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC — 67 plans
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC — 67 plans
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC — 67 plans
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC — 67 plans
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC — 67 plans
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC — 67 plans
533 FRACTURES OF FEMUR WITH MCC — 67 plans
534 FRACTURES OF FEMUR WITHOUT MCC — 67 plans
535 FRACTURES OF HIP AND PELVIS WITH MCC — 67 plans
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC — 67 plans
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC — 67 plans
539 OSTEOMYELITIS WITH MCC — 67 plans
540 OSTEOMYELITIS WITH CC — 67 plans
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC — 67 plans
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC — 67 plans
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC — 67 plans
545 CONNECTIVE TISSUE DISORDERS WITH MCC — 67 plans
546 CONNECTIVE TISSUE DISORDERS WITH CC — 67 plans
548 SEPTIC ARTHRITIS WITH MCC — 67 plans
549 SEPTIC ARTHRITIS WITH CC — 67 plans
551 MEDICAL BACK PROBLEMS WITH MCC — 67 plans
552 MEDICAL BACK PROBLEMS WITHOUT MCC — 67 plans
553 BONE DISEASES AND ARTHROPATHIES WITH MCC — 67 plans
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC — 67 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC — 67 plans
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC — 67 plans
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC — 67 plans
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC — 67 plans
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC — 67 plans
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC — 67 plans
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC — 67 plans
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC — 67 plans
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC — 67 plans
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC — 67 plans
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC — 67 plans
570 SKIN DEBRIDEMENT WITH MCC — 67 plans
571 SKIN DEBRIDEMENT WITH CC — 67 plans
572 SKIN DEBRIDEMENT WITHOUT CC/MCC — 67 plans
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC — 67 plans
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC — 67 plans
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC — 67 plans
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC — 67 plans
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC — 67 plans
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC — 67 plans
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC — 67 plans
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC — 67 plans
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC — 67 plans
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC — 67 plans
592 SKIN ULCERS WITH MCC — 67 plans
593 SKIN ULCERS WITH CC — 67 plans
595 MAJOR SKIN DISORDERS WITH MCC — 67 plans
596 MAJOR SKIN DISORDERS WITHOUT MCC — 67 plans
597 MALIGNANT BREAST DISORDERS WITH MCC — 67 plans
598 MALIGNANT BREAST DISORDERS WITH CC — 67 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC — 67 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC — 67 plans
602 CELLULITIS WITH MCC — 67 plans
603 CELLULITIS WITHOUT MCC — 67 plans
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC — 67 plans
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC — 67 plans
606 MINOR SKIN DISORDERS WITH MCC — 67 plans
607 MINOR SKIN DISORDERS WITHOUT MCC — 67 plans
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC — 67 plans
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC — 67 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC — 67 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC — 67 plans
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC — 67 plans
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC — 67 plans
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC — 67 plans
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC — 67 plans
637 DIABETES WITH MCC — 67 plans
638 DIABETES WITH CC — 67 plans
639 DIABETES WITHOUT CC/MCC — 67 plans
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC — 67 plans
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC — 67 plans
643 ENDOCRINE DISORDERS WITH MCC — 67 plans
644 ENDOCRINE DISORDERS WITH CC — 67 plans
645 ENDOCRINE DISORDERS WITHOUT CC/MCC — 67 plans
653 MAJOR BLADDER PROCEDURES WITH MCC — 67 plans
654 MAJOR BLADDER PROCEDURES WITH CC — 67 plans
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC — 67 plans
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC — 67 plans
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC — 67 plans
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC — 67 plans
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC — 67 plans
662 MINOR BLADDER PROCEDURES WITH MCC — 67 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC — 67 plans
665 PROSTATECTOMY WITH MCC — 67 plans
666 PROSTATECTOMY WITH CC — 67 plans
667 PROSTATECTOMY WITHOUT CC/MCC — 67 plans
668 TRANSURETHRAL PROCEDURES WITH MCC — 67 plans
669 TRANSURETHRAL PROCEDURES WITH CC — 67 plans
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC — 67 plans
671 URETHRAL PROCEDURES WITH CC/MCC — 67 plans
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC — 67 plans
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC — 67 plans
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC — 67 plans
682 RENAL FAILURE WITH MCC — 67 plans
683 RENAL FAILURE WITH CC — 67 plans
684 RENAL FAILURE WITHOUT CC/MCC — 67 plans
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC — 67 plans
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC — 67 plans
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC — 67 plans
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC — 67 plans
693 URINARY STONES WITH MCC — 67 plans
694 URINARY STONES WITHOUT MCC — 67 plans
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC — 67 plans
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC — 67 plans
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC — 67 plans
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC — 67 plans
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC — 67 plans
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC — 67 plans
709 PENIS PROCEDURES WITH CC/MCC — 67 plans
710 PENIS PROCEDURES WITHOUT CC/MCC — 67 plans
711 TESTES PROCEDURES WITH CC/MCC — 67 plans
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC — 67 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC — 67 plans
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC — 67 plans
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC — 67 plans
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC — 67 plans
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC — 67 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC — 67 plans
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC — 67 plans
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC — 67 plans
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC — 67 plans
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC — 67 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC — 67 plans
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC — 67 plans
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC — 67 plans
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC — 67 plans
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC — 67 plans
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC — 67 plans
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC — 67 plans
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC — 67 plans
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC — 67 plans
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC — 67 plans
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC — 67 plans
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC — 67 plans
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC — 67 plans
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC — 67 plans
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC — 67 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC — 67 plans
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC — 67 plans
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES — 67 plans
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY — 67 plans
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES — 67 plans
779 ABORTION WITHOUT D&C — 67 plans
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $450 – $37,798 · median $4,878 67 plans
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $450 – $124,653 · median $5,003 67 plans
791 PREMATURITY WITH MAJOR PROBLEMS $450 – $85,129 · median $3,885 67 plans
792 PREMATURITY WITHOUT MAJOR PROBLEMS $450 – $51,367 · median $3,536 67 plans
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $450 – $87,449 · median $3,935 67 plans
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $450 – $30,954 · median $3,321 67 plans
799 SPLENIC PROCEDURES WITH MCC — 67 plans
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC — 67 plans
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC — 67 plans
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC — 67 plans
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC — 67 plans
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC — 67 plans
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC — 67 plans
811 RED BLOOD CELL DISORDERS WITH MCC — 67 plans
812 RED BLOOD CELL DISORDERS WITHOUT MCC — 67 plans
813 COAGULATION DISORDERS — 67 plans
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC — 67 plans
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC — 67 plans
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC — 67 plans
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC — 67 plans
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC — 67 plans
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC — 67 plans
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC — 67 plans
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC — 67 plans
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC — 67 plans
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $450 – $10,967 · median $8,337 67 plans
834 ACUTE LEUKEMIA WITH MCC — 67 plans
835 ACUTE LEUKEMIA WITH CC — 67 plans
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC — 67 plans
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC — 67 plans
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC — 67 plans
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC — 67 plans
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC — 67 plans
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC — 67 plans
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC — 67 plans
849 RADIOTHERAPY — 67 plans
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC — 67 plans
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC — 67 plans
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC — 67 plans
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC — 67 plans
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC — 67 plans
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC — 67 plans
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC — 67 plans
864 FEVER AND INFLAMMATORY CONDITIONS — 67 plans
865 VIRAL ILLNESS WITH MCC — 67 plans
866 VIRAL ILLNESS WITHOUT MCC — 67 plans
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC — 67 plans
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC — 67 plans
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $450 – $144,961 · median $110,195 67 plans
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC — 67 plans
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC — 67 plans
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $450 – $19,000 · median $2,650 67 plans
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $450 – $31,837 · median $2,650 67 plans
885 PSYCHOSES $450 – $27,640 · median $2,650 67 plans
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $450 – $12,207 · median $2,650 67 plans
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $450 – $31,110 · median $2,584 67 plans
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC — 67 plans
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC — 67 plans
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC — 67 plans
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC — 67 plans
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC — 67 plans
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC — 67 plans
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC — 67 plans
913 TRAUMATIC INJURY WITH MCC — 67 plans
914 TRAUMATIC INJURY WITHOUT MCC — 67 plans
915 ALLERGIC REACTIONS WITH MCC — 67 plans
916 ALLERGIC REACTIONS WITHOUT MCC — 67 plans
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC — 67 plans
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC — 67 plans
919 COMPLICATIONS OF TREATMENT WITH MCC — 67 plans
920 COMPLICATIONS OF TREATMENT WITH CC — 67 plans
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC — 67 plans
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC — 67 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY — 67 plans
935 NON-EXTENSIVE BURNS — 67 plans
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC — 67 plans
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC — 67 plans
947 SIGNS AND SYMPTOMS WITH MCC — 67 plans
949 AFTERCARE WITH CC/MCC — 67 plans
951 OTHER FACTORS INFLUENCING HEALTH STATUS — 67 plans
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA — 67 plans
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC — 67 plans
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC — 67 plans
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC — 67 plans
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC — 67 plans
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC — 67 plans
975 HIV WITH MAJOR RELATED CONDITION WITH CC — 67 plans
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC — 67 plans
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC — 67 plans
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC — 67 plans
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC — 67 plans
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC — 67 plans
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC — 67 plans
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $10,250 – $37,988 · median $28,311 66 plans
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $4,020 – $16,701 · median $12,446 66 plans
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $7,097 – $28,574 · median $21,295 66 plans
102 HEADACHES WITH MCC $5,906 – $23,509 · median $17,520 66 plans
139 SALIVARY GLAND PROCEDURES $6,993 – $25,916 · median $19,314 66 plans
158 DENTAL AND ORAL DISEASES WITH CC $4,791 – $19,081 · median $14,221 66 plans
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $3,774 – $14,518 · median $10,819 66 plans
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $3,555 – $14,698 · median $10,954 66 plans
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $6,439 – $28,957 · median $21,581 66 plans
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $4,164 – $16,006 · median $12,507 66 plans
663 MINOR BLADDER PROCEDURES WITH CC $7,780 – $31,883 · median $23,761 66 plans
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $6,568 – $30,952 · median $23,067 66 plans
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $3,229 – $11,965 · median $9,241 66 plans
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $3,359 – $13,255 · median $10,237 66 plans
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $10,403 – $47,852 · median $35,662 66 plans
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $5,013 – $25,220 · median $18,796 66 plans
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $1,660 – $43,525 · median $32,438 66 plans
950 AFTERCARE WITHOUT CC/MCC $2,985 – $18,006 · median $10,365 66 plans
795 NORMAL NEWBORN $450 – $4,190 · median $2,808 65 plans
076 VIRAL MENINGITIS WITHOUT CC/MCC — 64 plans
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC — 64 plans
398 APPENDIX PROCEDURES WITH CC — 64 plans
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $450 – $17,469 · median $2,584 64 plans
948 SIGNS AND SYMPTOMS WITHOUT MCC — 64 plans
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC — 63 plans
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $450 – $398,100 · median $317,699 63 plans
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $450 – $259,797 · median $207,328 63 plans
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC — 63 plans
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC — 63 plans
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $450 – $120,689 · median $96,315 63 plans
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $450 – $203,955 · median $162,764 63 plans
215 OTHER HEART ASSIST SYSTEM IMPLANT — 63 plans
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC — 63 plans
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC — 63 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC — 63 plans
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC — 63 plans
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC — 63 plans
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC — 63 plans
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC — 63 plans
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC — 63 plans
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC — 63 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC — 63 plans
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC — 63 plans
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC — 63 plans
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC — 63 plans
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC — 63 plans
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION — 63 plans
318 PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE — 63 plans
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC — 63 plans
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC — 63 plans
360 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC — 63 plans
399 APPENDIX PROCEDURES WITHOUT CC/MCC $5,724 – $24,008 · median $18,250 63 plans
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC — 63 plans
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC — 63 plans
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $5,229 – $21,715 · median $16,507 63 plans
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC — 63 plans
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC — 63 plans
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $450 – $22,475 · median $10,573 61 plans
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $450 – $51,491 · median $12,287 61 plans
784 CESAREAN SECTION WITH STERILIZATION WITH CC — 61 plans
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC — 61 plans
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC — 61 plans
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC — 61 plans
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $450 – $20,981 · median $10,628 61 plans
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $450 – $22,634 · median $10,573 61 plans
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $450 – $15,814 · median $10,573 61 plans
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $450 – $14,140 · median $10,021 61 plans
359 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC — 59 plans
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC — 58 plans
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $450 – $20,073 · median $11,431 58 plans
313 CHEST PAIN $7,983 – $10,403 · median $8,870 8 plans
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $7,983 – $8,870 · median $8,427 3 plans
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