Ohio State University State Health System — Pricing

770 procedures published in this hospital's Machine-Readable File (MRF) — 730 with a comparable price, 40 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 770
Lowest published price $3,375
Average published price $120,827
Highest published price $2,079,414

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

Showing all 770 procedures

Published charges

Showing all 730 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. Cash-pay prices not published for this hospital.

Across 191 procedures, this hospital's negotiated rates average ≈87% of what Medicare pays.

DRG Description Published price vs. OH median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $2,079,414 $483,987 +330% $498,715 +317% —
209 COMPLEX AORTIC ARCH PROCEDURES $1,287,296 $163,638 +687% $183,292 +602% —
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $1,222,292 $362,617 +237% $431,073 +184% —
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $1,109,215 $306,087 +262% $306,087 +262% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $932,415 $298,601 +212% $371,366 +151% ≈76% of Medicare
007 LUNG TRANSPLANT $767,663 $170,608 +350% $170,608 +350% —
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $634,337 $139,842 +354% $159,181 +299% ≈87% of Medicare
014 ALLOGENEIC BONE MARROW TRANSPLANT $618,788 $171,028 +262% $182,314 +239% —
006 LIVER TRANSPLANT WITHOUT MCC $589,304 $84,407 +598% $84,407 +598% —
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $542,290 $86,459 +527% $86,459 +527% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $529,134 $105,228 +403% $105,228 +403% —
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $505,541 $142,952 +254% $171,338 +195% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $501,287 $184,103 +172% $245,241 +104% ≈84% of Medicare
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $492,986 $137,630 +258% $142,326 +246% —
010 PANCREAS TRANSPLANT $467,825 $99,940 +368% $99,940 +368% —
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $465,922 $40,363 +1054% $56,758 +721% —
263 VEIN LIGATION AND STRIPPING $448,789 $38,005 +1081% $44,938 +899% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE MALIGNANCY INFECTION OR EXTENSIVE FUSIONS WITH MCC $448,400 $112,424 +299% $151,029 +197% —
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $447,308 $110,483 +305% $120,174 +272% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $420,552 $179,930 +134% $175,437 +140% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $418,547 $78,460 +433% $96,192 +335% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $398,957 $91,253 +337% $105,612 +278% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $392,009 $83,516 +369% $71,551 +448% ≈91% of Medicare
231 CORONARY BYPASS WITH PTCA WITH MCC $380,255 $112,178 +239% $146,474 +160% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $372,647 $123,733 +201% $143,242 +160% ≈86% of Medicare
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $367,766 $121,563 +203% $121,563 +203% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $360,701 $106,929 +237% $134,914 +167% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $356,957 $103,817 +244% $138,868 +157% ≈76% of Medicare
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $352,810 $99,339 +255% $120,587 +193% —
956 LIMB REATTACHMENT HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $349,921 $52,805 +563% $75,103 +366% ≈77% of Medicare
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $344,347 $81,176 +324% $98,260 +250% —
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $335,634 $89,209 +276% $118,589 +183% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $333,742 $82,102 +306% $106,238 +214% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $332,541 $119,815 +178% $138,008 +141% ≈81% of Medicare
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $331,951 $73,030 +355% $82,527 +302% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP FOOT AND FEMUR WITH MCC $331,648 $49,285 +573% $70,540 +370% ≈75% of Medicare
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $329,764 $94,288 +250% $131,961 +150% ≈92% of Medicare
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $329,342 $56,242 +486% $56,242 +486% —
215 OTHER HEART ASSIST SYSTEM IMPLANT $328,819 $153,273 +115% $191,314 +72% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $328,492 $112,466 +192% $112,062 +193% ≈85% of Medicare
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $320,355 $105,110 +205% $121,728 +163% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $314,917 $48,780 +546% $78,582 +301% ≈82% of Medicare
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $313,117 $73,048 +329% $102,177 +206% ≈79% of Medicare
652 KIDNEY TRANSPLANT $306,985 $54,720 +461% $54,720 +461% ≈90% of Medicare
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $306,357 $68,473 +347% $87,565 +250% ≈79% of Medicare
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $304,710 $80,958 +276% $102,573 +197% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE MALIGNANCY INFECTION OR EXTENSIVE FUSIONS WITH CC $303,716 $92,271 +229% $107,355 +183% ≈80% of Medicare
011 TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $300,299 $73,038 +311% $86,953 +245% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $298,444 $81,365 +267% $87,018 +243% ≈84% of Medicare
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $296,556 $84,844 +250% $109,331 +171% —
405 PANCREAS LIVER AND SHUNT PROCEDURES WITH MCC $289,426 $73,455 +294% $94,927 +205% —
012 TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $289,217 $62,325 +364% $73,029 +296% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $288,721 $48,637 +494% $59,207 +388% —
653 MAJOR BLADDER PROCEDURES WITH MCC $286,140 $75,310 +280% $97,046 +195% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $284,820 $60,697 +369% $68,847 +314% —
028 SPINAL PROCEDURES WITH MCC $284,695 $81,731 +248% $95,858 +197% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $280,055 $69,206 +305% $96,222 +191% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $278,485 $86,661 +221% $116,058 +140% ≈75% of Medicare
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $276,879 $70,780 +291% $82,247 +237% ≈87% of Medicare
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $271,092 $65,149 +316% $88,691 +206% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $270,000 $89,353 +202% $89,353 +202% ≈84% of Medicare
585 BREAST BIOPSY LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $268,015 $23,246 +1053% $29,633 +804% —
584 BREAST BIOPSY LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $263,068 $29,894 +780% $34,089 +672% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $261,609 $56,535 +363% $66,853 +291% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $261,413 $69,695 +275% $99,423 +163% ≈67% of Medicare
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $256,386 $25,923 +889% $34,264 +648% —
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $255,614 $89,681 +185% $114,914 +122% —
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $254,696 $69,912 +264% $79,944 +219% —
662 MINOR BLADDER PROCEDURES WITH MCC $254,263 $43,683 +482% $54,483 +367% —
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $253,798 $73,986 +243% $93,783 +171% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $250,220 $49,721 +403% $59,425 +321% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $250,009 $58,558 +327% $82,561 +203% —
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $248,144 $76,970 +222% $106,778 +132% ≈89% of Medicare
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $246,128 $49,711 +395% $64,776 +280% —
654 MAJOR BLADDER PROCEDURES WITH CC $239,126 $39,822 +500% $53,868 +344% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $239,062 $83,192 +187% $117,280 +104% ≈81% of Medicare
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $238,469 $24,514 +873% $31,566 +655% —
711 TESTES PROCEDURES WITH CC/MCC $237,480 $28,965 +720% $34,852 +581% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $236,370 $87,969 +169% $88,050 +168% ≈87% of Medicare
326 STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $234,521 $69,008 +240% $80,747 +190% ≈79% of Medicare
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $232,264 $54,862 +323% $57,521 +304% —
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $230,506 $81,401 +183% $81,998 +181% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $230,470 $63,928 +261% $80,885 +185% —
471 CERVICAL SPINAL FUSION WITH MCC $229,307 $93,070 +146% $92,515 +148% —
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $229,061 $82,731 +177% $98,912 +132% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $224,960 $116,302 +93% $88,307 +155% ≈83% of Medicare
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $224,706 $41,464 +442% $54,313 +314% ≈93% of Medicare
834 ACUTE LEUKEMIA WITH MCC $223,126 $74,709 +199% $76,583 +191% —
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $222,725 $87,201 +155% $105,899 +110% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $219,607 $86,542 +154% $121,714 +80% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $218,821 $61,750 +254% $72,859 +200% ≈89% of Medicare
500 SOFT TISSUE PROCEDURES WITH MCC $217,127 $44,320 +390% $57,479 +278% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $216,800 $47,403 +357% $67,901 +219% —
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $214,941 $70,464 +205% $86,390 +149% ≈69% of Medicare
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $213,607 $68,045 +214% $84,861 +152% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $213,282 $48,557 +339% $51,953 +311% —
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $210,927 $74,709 +182% $101,235 +108% —
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $209,062 $67,791 +208% $96,905 +116% ≈104% of Medicare
252 OTHER VASCULAR PROCEDURES WITH MCC $208,950 $47,717 +338% $68,508 +205% ≈71% of Medicare
335 PERITONEAL ADHESIOLYSIS WITH MCC $208,575 $50,222 +315% $71,755 +191% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $208,141 $34,586 +502% $46,591 +347% —
625 THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $207,998 $40,406 +415% $58,968 +253% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $207,926 $80,366 +159% $68,659 +203% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $207,891 $55,985 +271% $72,011 +189% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $207,868 $80,603 +158% $113,855 +83% ≈79% of Medicare
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $207,460 $37,754 +449% $45,432 +357% —
013 TRACHEOSTOMY FOR FACE MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $207,396 $39,475 +425% $45,290 +358% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $206,073 $68,095 +203% $70,735 +191% —
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $204,985 $83,090 +147% $94,988 +116% —
799 SPLENIC PROCEDURES WITH MCC $203,477 $64,885 +214% $78,821 +158% —
332 RECTAL RESECTION WITH MCC $203,270 $48,214 +322% $58,125 +250% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $201,571 $43,021 +369% $53,555 +276% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $198,555 $28,381 +600% $43,080 +361% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $198,515 $40,157 +394% $57,855 +243% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $197,107 $61,401 +221% $76,954 +156% —
245 AICD GENERATOR PROCEDURES $196,963 $66,564 +196% $72,076 +173% —
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $195,858 $41,261 +375% $60,140 +226% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $195,692 $37,153 +427% $43,697 +348% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $195,056 $30,155 +547% $41,651 +368% —
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $194,084 $53,307 +264% $55,097 +252% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $194,019 $20,619 +841% $29,805 +551% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $193,830 $53,167 +265% $72,782 +166% —
037 EXTRACRANIAL PROCEDURES WITH MCC $192,969 $46,296 +317% $64,749 +198% —
040 PERIPHERAL CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $190,953 $52,152 +266% $74,257 +157% —
163 MAJOR CHEST PROCEDURES WITH MCC $190,664 $63,017 +203% $88,341 +116% ≈81% of Medicare
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $189,863 $35,964 +428% $46,659 +307% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $188,546 $28,559 +560% $29,524 +539% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $187,237 $67,682 +177% $91,329 +105% ≈83% of Medicare
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $185,579 $38,166 +386% $44,839 +314% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $185,250 $54,196 +242% $54,196 +242% —
213 ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES $184,327 $113,290 — $119,631 +54% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $183,620 $57,196 +221% $83,065 +121% ≈74% of Medicare
595 MAJOR SKIN DISORDERS WITH MCC $182,863 $30,646 +497% $31,785 +475% —
581 OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $182,819 $21,873 +736% $25,243 +624% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $182,155 $38,646 +371% $45,497 +300% —
406 PANCREAS LIVER AND SHUNT PROCEDURES WITH CC $179,922 $39,644 +354% $58,043 +210% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $177,633 $48,350 +267% $64,465 +176% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE MALIGNANCY INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $177,604 $68,852 +158% $83,441 +113% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $177,066 $50,550 +250% $62,524 +183% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $176,945 $41,365 +328% $63,984 +177% ≈91% of Medicare
407 PANCREAS LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $176,563 $30,914 +471% $40,232 +339% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $176,447 $58,085 +204% $60,098 +194% —
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $176,257 $51,761 +241% $60,861 +190% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $175,754 $48,887 +260% $56,964 +209% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $175,425 $53,357 +229% $62,961 +179% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $174,768 $41,952 +317% $46,402 +277% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $172,273 $20,980 +721% $20,980 +721% —
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $171,894 $71,617 +140% $65,216 +164% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $170,390 $62,801 +171% $90,331 +89% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $170,035 $27,849 +511% $32,839 +418% —
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $169,365 $78,716 +115% $75,492 +124% —
113 ORBITAL PROCEDURES WITH CC/MCC $167,883 $32,482 +417% $35,642 +371% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $167,675 $37,072 +352% $47,546 +253% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $165,643 $41,516 +299% $54,475 +204% ≈96% of Medicare
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $164,574 $47,828 +244% $62,269 +164% —
253 OTHER VASCULAR PROCEDURES WITH CC $163,777 $38,674 +323% $53,746 +205% ≈89% of Medicare
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $162,765 $36,735 +343% $48,094 +238% ≈77% of Medicare
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $162,636 $45,618 +257% $65,254 +149% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $162,507 $48,655 +234% $65,383 +149% ≈98% of Medicare
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $162,167 $41,024 +295% $67,764 +139% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $161,602 $44,783 +261% $57,277 +182% —
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $161,164 $53,945 +199% $78,852 +104% ≈81% of Medicare
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $160,838 $47,899 +236% $71,014 +126% ≈79% of Medicare
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $160,762 $31,193 +415% $44,553 +261% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $159,170 $44,389 +259% $51,142 +211% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP FOOT AND FEMUR WITH CC $158,803 $65,770 +141% $56,394 +182% ≈87% of Medicare
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $157,308 $57,570 +173% $72,945 +116% ≈79% of Medicare
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $156,218 $46,760 +234% $64,152 +144% ≈87% of Medicare
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $154,799 $31,079 +398% $34,900 +344% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $154,602 $54,898 +182% $71,701 +116% ≈70% of Medicare
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $154,271 $24,910 +519% $30,006 +414% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $154,025 $34,039 +353% $52,313 +194% ≈75% of Medicare
347 ANAL AND STOMAL PROCEDURES WITH MCC $153,801 $33,912 +354% $40,548 +279% —
800 SPLENIC PROCEDURES WITH CC $153,793 $41,012 +275% $49,184 +213% —
334 RECTAL RESECTION WITHOUT CC/MCC $152,280 $24,721 +516% $32,213 +373% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $151,744 $44,584 +240% $49,710 +205% —
397 APPENDIX PROCEDURES WITH MCC $151,655 $35,353 +329% $52,319 +190% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $150,950 $20,875 +623% $24,980 +504% —
666 PROSTATECTOMY WITH CC $150,485 $24,574 +512% $30,016 +401% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $149,351 $19,169 +679% $27,321 +447% —
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $149,117 $52,536 +184% $74,755 +99% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $149,041 $34,307 +334% $47,583 +213% —
327 STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $148,964 $35,941 +314% $54,824 +172% ≈85% of Medicare
472 CERVICAL SPINAL FUSION WITH CC $148,359 $63,839 +132% $59,537 +149% ≈99% of Medicare
501 SOFT TISSUE PROCEDURES WITH CC $148,204 $34,828 +326% $37,975 +290% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $147,589 $58,476 +152% $88,049 +68% —
143 OTHER EAR NOSE MOUTH AND THROAT O.R. PROCEDURES WITH MCC $146,503 $46,049 +218% $52,908 +177% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $146,494 $32,773 +347% $43,586 +236% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $145,710 $47,649 +206% $68,880 +112% ≈89% of Medicare
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $145,145 $64,248 +126% $92,217 +57% ≈84% of Medicare
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $144,979 $56,561 +156% $63,475 +128% ≈88% of Medicare
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $144,097 $22,435 +542% $32,911 +338% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $143,162 $43,218 +231% $53,817 +166% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $142,801 $25,133 +468% $28,578 +400% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $142,088 $43,330 +228% $62,821 +126% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $141,787 $22,208 +538% $25,666 +452% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $139,987 $30,860 +354% $37,654 +272% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $139,280 $47,751 +192% $50,624 +175% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $138,857 $39,827 +249% $50,919 +173% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $138,796 $54,300 +156% $61,832 +124% —
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $138,617 $36,267 +282% $57,149 +143% ≈98% of Medicare
512 SHOULDER ELBOW OR FOREARM PROCEDURES EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $138,191 $24,061 +474% $35,692 +287% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $137,032 $44,977 +205% $64,956 +111% —
145 OTHER EAR NOSE MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $136,734 $18,572 +636% $20,842 +556% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $135,955 $32,168 +323% $44,053 +209% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $135,727 $47,218 +187% $70,132 +94% ≈88% of Medicare
164 MAJOR CHEST PROCEDURES WITH CC $135,688 $39,462 +244% $53,141 +155% ≈87% of Medicare
571 SKIN DEBRIDEMENT WITH CC $135,553 $24,925 +444% $34,901 +288% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $135,512 $31,740 +327% $38,382 +253% —
061 ISCHEMIC STROKE PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $135,200 $39,820 +240% $57,963 +133% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $134,688 $23,602 +471% $34,906 +286% —
580 OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $133,742 $26,206 +410% $36,242 +269% —
042 PERIPHERAL CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $133,477 $29,085 +359% $39,018 +242% —
906 HAND PROCEDURES FOR INJURIES $133,285 $31,520 +323% $31,520 +323% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $132,958 $18,290 +627% $21,062 +531% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $132,477 $30,598 +333% $38,420 +245% —
333 RECTAL RESECTION WITH CC $131,500 $30,778 +327% $34,352 +283% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $131,105 $53,665 +144% $72,908 +80% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $130,641 $47,789 +173% $58,832 +122% ≈94% of Medicare
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $130,388 $45,278 +188% $56,519 +131% ≈88% of Medicare
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $130,123 $46,319 +181% $65,325 +99% —
628 OTHER ENDOCRINE NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $129,943 $54,405 +139% $68,006 +91% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $129,524 $27,823 +366% $35,459 +265% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $128,801 $35,670 +261% $55,162 +133% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $128,422 $43,334 +196% $51,172 +151% ≈92% of Medicare
038 EXTRACRANIAL PROCEDURES WITH CC $127,020 $24,107 +427% $35,770 +255% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $126,997 $28,787 +341% $43,775 +190% ≈93% of Medicare
545 CONNECTIVE TISSUE DISORDERS WITH MCC $125,054 $35,990 +247% $39,657 +215% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $124,173 $23,326 +432% $34,434 +261% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $122,429 $26,296 +366% $33,564 +265% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $122,329 $38,213 +220% $54,929 +123% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $122,173 $23,998 +409% $35,584 +243% —
579 OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $121,884 $45,498 +168% $54,129 +125% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $121,722 $26,794 +354% $36,597 +233% —
668 TRANSURETHRAL PROCEDURES WITH MCC $121,098 $41,045 +195% $47,277 +156% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $119,486 $19,357 +517% $26,146 +357% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $118,929 $29,131 +308% $44,363 +168% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $118,224 $26,921 +339% $40,583 +191% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $117,527 $18,021 +552% $24,432 +381% —
336 PERITONEAL ADHESIOLYSIS WITH CC $117,316 $30,609 +283% $49,470 +137% ≈87% of Medicare
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $117,278 $27,387 +328% $41,380 +183% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $117,182 $38,027 +208% $52,405 +124% ≈90% of Medicare
359 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC $116,807 $126,132 −7% $110,732 +5% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $116,472 $48,317 +141% $45,817 +154% ≈92% of Medicare
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $116,306 $38,454 +202% $43,491 +167% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $116,220 $23,257 +400% $25,484 +356% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $116,071 $36,791 +215% $41,703 +178% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $115,788 $48,165 +140% $49,065 +136% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $115,693 $32,464 +256% $38,878 +198% —
144 OTHER EAR NOSE MOUTH AND THROAT O.R. PROCEDURES WITH CC $115,572 $25,683 +350% $29,558 +291% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $115,351 $41,415 +179% $31,816 +263% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $115,056 $28,868 +299% $43,398 +165% —
813 COAGULATION DISORDERS $114,935 $23,285 +394% $30,128 +281% ≈73% of Medicare
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $114,716 $27,401 +319% $35,114 +227% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $114,665 $32,604 +252% $37,064 +209% —
570 SKIN DEBRIDEMENT WITH MCC $114,193 $42,263 +170% $52,435 +118% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $113,600 $21,793 +421% $31,812 +257% —
510 SHOULDER ELBOW OR FOREARM PROCEDURES EXCEPT MAJOR JOINT PROCEDURES WITH MCC $113,555 $40,289 +182% $49,055 +131% —
041 PERIPHERAL CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $113,445 $34,736 +227% $44,989 +152% ≈95% of Medicare
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $112,678 $55,495 +103% $62,404 +81% —
286 CIRCULATORY DISORDERS EXCEPT AMI WITH CARDIAC CATHETERIZATION WITH MCC $112,650 $43,288 +160% $44,600 +153% ≈84% of Medicare
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $112,155 $20,978 +435% $30,418 +269% —
548 SEPTIC ARTHRITIS WITH MCC $111,327 $29,341 +279% $31,019 +259% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $110,950 $44,521 +149% $33,137 +235% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $110,369 $26,903 +310% $40,552 +172% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $110,289 $49,623 +122% $74,274 +48% ≈79% of Medicare
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $109,976 $35,224 +212% $52,332 +110% ≈91% of Medicare
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $109,956 $35,943 +206% $46,477 +137% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $109,779 $31,349 +250% $37,902 +190% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $109,519 $27,668 +296% $32,981 +232% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $109,276 $38,077 +187% $51,985 +110% ≈81% of Medicare
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $109,247 $22,714 +381% $35,528 +207% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $108,985 $31,474 +246% $41,900 +160% ≈62% of Medicare
626 THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $107,681 $22,783 +373% $27,279 +295% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $107,397 $26,167 +310% $32,538 +230% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $107,274 $26,242 +309% $31,909 +236% —
283 ACUTE MYOCARDIAL INFARCTION EXPIRED WITH MCC $107,217 $25,478 +321% $35,014 +206% ≈73% of Medicare
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $107,215 $34,993 +206% $42,119 +155% ≈90% of Medicare
722 MALIGNANCY MALE REPRODUCTIVE SYSTEM WITH MCC $107,093 $25,633 +318% $29,826 +259% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $105,822 $45,132 +134% $43,524 +143% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $105,562 $36,097 +192% $36,097 +192% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $105,397 $17,967 +487% $25,267 +317% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $104,805 $32,680 +221% $45,818 +129% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $104,415 $33,546 +211% $50,139 +108% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $104,275 $28,801 +262% $43,800 +138% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $104,175 $31,025 +236% $36,850 +183% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $104,080 $28,350 +267% $36,202 +187% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $103,877 $21,670 +379% $30,930 +236% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $103,788 $27,767 +274% $36,280 +186% —
734 PELVIC EVISCERATION RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $102,918 $30,486 +238% $35,686 +188% —
709 PENIS PROCEDURES WITH CC/MCC $102,389 $32,359 +216% $34,535 +196% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $102,319 $17,830 +474% $24,017 +326% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $102,254 $20,480 +399% $25,152 +307% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $102,082 $39,606 +158% $48,907 +109% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $101,713 $22,882 +345% $30,972 +228% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $101,194 $38,581 +162% $44,973 +125% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $101,078 $22,498 +349% $25,307 +299% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP FOOT AND FEMUR WITHOUT CC/MCC $100,944 $33,792 +199% $45,963 +120% —
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $100,893 $43,701 +131% $65,573 +54% ≈90% of Medicare
063 ISCHEMIC STROKE PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $100,789 $28,751 +251% $35,542 +184% —
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $100,617 $22,175 +354% $25,149 +300% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $100,545 $29,518 +241% $30,661 +228% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $100,091 $27,820 +260% $49,197 +103% ≈96% of Medicare
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $99,970 $26,545 +277% $32,483 +208% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $99,685 $21,022 +374% $29,050 +243% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $99,677 $18,038 +453% $25,390 +293% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $98,661 $34,487 +186% $40,065 +146% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $98,317 $29,462 +234% $36,375 +170% ≈81% of Medicare
374 DIGESTIVE MALIGNANCY WITH MCC $97,805 $28,612 +242% $38,885 +152% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $97,573 $28,660 +240% $35,237 +177% ≈82% of Medicare
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $97,569 $44,472 +119% $44,472 +119% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $96,966 $40,662 +138% $44,117 +120% ≈91% of Medicare
265 AICD LEAD PROCEDURES $96,949 $49,492 +96% $56,695 +71% —
506 MAJOR THUMB OR JOINT PROCEDURES $96,604 $22,651 +326% $28,983 +233% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $96,586 $32,829 +194% $39,253 +146% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $96,561 $35,456 +172% $39,747 +143% —
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $96,520 $14,624 +560% $21,029 +359% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $96,382 $30,404 +217% $46,066 +109% —
328 STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $96,048 $28,203 +241% $35,375 +172% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $95,765 $18,260 +424% $22,532 +325% —
627 THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $95,705 $19,637 +387% $25,623 +274% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $95,642 $26,875 +256% $37,950 +152% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $95,595 $23,118 +314% $36,239 +164% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $95,380 $25,272 +277% $43,266 +120% ≈96% of Medicare
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $95,315 $34,307 +178% $39,093 +144% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $95,134 $20,497 +364% $31,978 +198% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $94,607 $33,308 +184% $36,237 +161% ≈84% of Medicare
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $94,463 $26,909 +251% $40,563 +133% —
629 OTHER ENDOCRINE NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $94,354 $32,385 +191% $45,059 +109% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $94,303 $44,663 +111% $66,819 +41% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $93,933 $27,647 +240% $30,766 +205% ≈96% of Medicare
180 RESPIRATORY NEOPLASMS WITH MCC $93,359 $25,879 +261% $36,658 +155% —
062 ISCHEMIC STROKE PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $93,345 $26,308 +255% $48,680 +92% —
504 FOOT PROCEDURES WITH CC $92,863 $25,972 +258% $36,598 +154% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $92,768 $25,899 +258% $38,836 +139% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $92,605 $48,670 +90% $68,399 +35% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $92,299 $24,189 +282% $25,731 +259% ≈74% of Medicare
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $92,207 $31,619 +192% $48,682 +89% —
665 PROSTATECTOMY WITH MCC $92,078 $47,758 +93% $54,072 +70% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $90,860 $36,646 +148% $35,714 +154% ≈86% of Medicare
503 FOOT PROCEDURES WITH MCC $90,761 $37,544 +142% $43,901 +107% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $90,636 $33,209 +173% $51,339 +77% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $90,193 $22,628 +299% $24,450 +269% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $89,891 $27,823 +223% $42,126 +113% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $89,662 $20,374 +340% $27,369 +228% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $89,001 $19,686 +352% $22,275 +300% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $88,775 $16,823 +428% $22,231 +299% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $88,723 $36,386 +144% $38,357 +131% ≈88% of Medicare
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $88,347 $33,734 +162% $41,660 +112% ≈93% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $88,215 $30,159 +193% $34,887 +153% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $88,095 $30,912 +185% $45,622 +93% ≈94% of Medicare
444 DISORDERS OF THE BILIARY TRACT WITH MCC $87,863 $25,056 +251% $31,128 +182% ≈86% of Medicare
663 MINOR BLADDER PROCEDURES WITH CC $87,475 $23,018 +280% $29,924 +192% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $87,305 $16,518 +429% $24,022 +263% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS WITH CC $87,031 $28,020 +211% $33,165 +162% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $87,009 $19,267 +352% $27,492 +216% —
604 TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE AND BREAST WITH MCC $86,752 $22,477 +286% $28,140 +208% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $86,729 $32,433 +167% $50,011 +73% ≈81% of Medicare
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $86,652 $24,869 +248% $33,607 +158% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $86,512 $30,076 +188% $36,933 +134% ≈83% of Medicare
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $86,210 $20,586 +319% $30,358 +184% ≈82% of Medicare
945 REHABILITATION WITH CC/MCC $85,567 $23,834 +259% $23,834 +259% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $85,482 $24,687 +246% $32,689 +162% ≈78% of Medicare
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $85,354 $59,352 +44% $59,352 +44% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $85,275 $28,703 +197% $41,520 +105% —
669 TRANSURETHRAL PROCEDURES WITH CC $84,044 $23,279 +261% $34,354 +145% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $83,299 $20,702 +302% $27,118 +207% —
511 SHOULDER ELBOW OR FOREARM PROCEDURES EXCEPT MAJOR JOINT PROCEDURES WITH CC $83,094 $35,265 +136% $43,538 +91% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $83,052 $33,155 +150% $49,631 +67% ≈84% of Medicare
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $82,489 $22,803 +262% $28,375 +191% —
735 PELVIC EVISCERATION RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $82,200 $18,949 +334% $23,297 +253% —
183 MAJOR CHEST TRAUMA WITH MCC $82,102 $23,796 +245% $28,924 +184% —
398 APPENDIX PROCEDURES WITH CC $81,985 $22,834 +259% $39,107 +110% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $81,870 $23,921 +242% $35,453 +131% —
154 OTHER EAR NOSE MOUTH AND THROAT DIAGNOSES WITH MCC $81,393 $23,634 +244% $24,465 +233% —
919 COMPLICATIONS OF TREATMENT WITH MCC $81,282 $26,862 +203% $29,031 +180% ≈87% of Medicare
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $81,066 $19,911 +307% $24,316 +233% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $80,931 $27,058 +199% $30,394 +166% ≈81% of Medicare
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $80,842 $23,902 +238% $33,984 +138% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $80,439 $33,237 +142% $36,080 +123% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $79,862 $27,729 +188% $32,399 +146% ≈75% of Medicare
754 MALIGNANCY FEMALE REPRODUCTIVE SYSTEM WITH MCC $79,647 $26,677 +199% $29,476 +170% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $79,503 $24,448 +225% $36,333 +119% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $79,440 $12,879 +517% $14,861 +435% —
146 EAR NOSE MOUTH AND THROAT MALIGNANCY WITH MCC $79,358 $32,969 +141% $37,080 +114% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $78,922 $24,851 +218% $28,103 +181% ≈87% of Medicare
671 URETHRAL PROCEDURES WITH CC/MCC $78,459 $25,566 +207% $27,233 +188% —
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC $78,327 $25,761 +204% $30,814 +154% ≈87% of Medicare
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $77,993 $32,919 +137% $36,334 +115% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $77,455 $22,721 +241% $33,792 +129% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $77,412 $25,466 +204% $38,094 +103% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $77,404 $27,567 +181% $30,940 +150% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $77,401 $24,279 +219% $31,840 +143% ≈82% of Medicare
139 SALIVARY GLAND PROCEDURES $77,222 $21,014 +267% $21,014 +267% —
360 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC $76,870 $70,047 +10% $93,769 −18% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $76,284 $38,709 +97% $48,358 +58% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $76,261 $15,890 +380% $15,890 +380% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $75,986 $23,510 +223% $32,490 +134% —
280 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE WITH MCC $75,695 $24,497 +209% $28,967 +161% ≈81% of Medicare
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $75,673 $20,766 +264% $28,527 +165% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $75,449 $35,694 +111% $39,409 +91% ≈84% of Medicare
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $74,716 $20,145 +271% $23,956 +212% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $74,339 $22,167 +235% $32,451 +129% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $73,927 $22,664 +226% $25,854 +186% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $73,866 $60,208 +23% $75,585 −2% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $73,729 $23,545 +213% $31,059 +137% —
835 ACUTE LEUKEMIA WITH CC $73,651 $30,915 +138% $35,569 +107% —
630 OTHER ENDOCRINE NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $73,062 $21,381 +242% $24,452 +199% —
514 HAND OR WRIST PROCEDURES EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $72,875 $16,427 +344% $20,080 +263% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $72,553 $19,655 +269% $28,156 +158% —
865 VIRAL ILLNESS WITH MCC $72,394 $22,350 +224% $26,088 +177% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS WITH CC $71,726 $28,264 +154% $42,881 +67% ≈92% of Medicare
849 RADIOTHERAPY $71,600 $37,862 +89% $37,862 +89% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $71,541 $14,950 +379% $17,731 +303% ≈80% of Medicare
712 TESTES PROCEDURES WITHOUT CC/MCC $71,485 $17,076 +319% $18,898 +278% —
746 VAGINA CERVIX AND VULVA PROCEDURES WITH CC/MCC $70,561 $24,928 +183% $29,916 +136% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $69,666 $32,719 +113% $46,430 +50% ≈94% of Medicare
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $69,373 $17,505 +296% $25,162 +176% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $69,329 $23,475 +195% $41,380 +68% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $69,038 $24,871 +178% $25,208 +174% ≈81% of Medicare
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $68,753 $29,416 +134% $54,772 +26% ≈92% of Medicare
157 DENTAL AND ORAL DISEASES WITH MCC $68,240 $24,447 +179% $27,457 +149% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $68,092 $26,792 +154% $37,842 +80% ≈88% of Medicare
643 ENDOCRINE DISORDERS WITH MCC $68,061 $24,704 +176% $32,996 +106% ≈92% of Medicare
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $67,629 $23,065 +193% $24,879 +172% —
539 OSTEOMYELITIS WITH MCC $67,385 $29,216 +131% $33,746 +100% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $67,220 $17,544 +283% $24,544 +174% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $66,651 $25,166 +165% $28,252 +136% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $66,082 $24,475 +170% $28,134 +135% ≈80% of Medicare
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $64,958 $27,695 +135% $32,204 +102% ≈92% of Medicare
100 SEIZURES WITH MCC $64,781 $30,016 +116% $35,194 +84% ≈83% of Medicare
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $64,522 $19,916 +224% $23,924 +170% —
597 MALIGNANT BREAST DISORDERS WITH MCC $64,503 $25,994 +148% $31,846 +103% —
513 HAND OR WRIST PROCEDURES EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $64,305 $22,735 +183% $33,424 +92% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $64,126 $24,086 +166% $30,314 +112% —
682 RENAL FAILURE WITH MCC $63,960 $22,687 +182% $27,854 +130% ≈77% of Medicare
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $63,946 $25,881 +147% $31,758 +101% ≈108% of Medicare
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $63,692 $21,228 +200% $24,561 +159% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $63,622 $21,961 +190% $29,663 +114% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $63,574 $20,782 +206% $29,374 +116% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $63,199 $26,510 +138% $24,836 +154% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $63,083 $15,808 +299% $22,560 +180% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $62,434 $26,617 +135% $40,063 +56% ≈87% of Medicare
642 INBORN AND OTHER DISORDERS OF METABOLISM $62,292 $19,302 +223% $20,727 +201% —
380 COMPLICATED PEPTIC ULCER WITH MCC $62,114 $28,169 +121% $36,641 +70% —
551 MEDICAL BACK PROBLEMS WITH MCC $62,059 $25,341 +145% $31,086 +100% ≈85% of Medicare
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $61,674 $19,075 +223% $26,322 +134% —
949 AFTERCARE WITH CC/MCC $61,456 $17,198 +257% $23,953 +157% —
186 PLEURAL EFFUSION WITH MCC $60,801 $25,923 +135% $32,468 +87% ≈95% of Medicare
557 TENDONITIS MYOSITIS AND BURSITIS WITH MCC $60,430 $22,624 +167% $28,646 +111% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $60,379 $24,787 +144% $32,502 +86% ≈86% of Medicare
606 MINOR SKIN DISORDERS WITH MCC $60,250 $23,644 +155% $25,434 +137% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $59,524 $24,142 +147% $29,484 +102% —
811 RED BLOOD CELL DISORDERS WITH MCC $59,494 $21,454 +177% $27,934 +113% ≈82% of Medicare
836 ACUTE LEUKEMIA WITHOUT CC/MCC $59,007 $19,686 +200% $19,686 +200% —
592 SKIN ULCERS WITH MCC $58,899 $29,882 +97% $32,662 +80% —
559 AFTERCARE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $58,762 $18,543 +217% $30,974 +90% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $58,678 $15,613 +276% $23,571 +149% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $58,567 $25,358 +131% $24,118 +143% ≈90% of Medicare
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $58,464 $26,986 +117% $40,694 +44% —
148 EAR NOSE MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $57,760 $13,586 +325% $13,586 +325% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $57,734 $19,440 +197% $24,202 +139% ≈85% of Medicare
975 HIV WITH MAJOR RELATED CONDITION WITH CC $57,506 $21,642 +166% $25,010 +130% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $57,374 $22,516 +155% $31,062 +85% —
747 VAGINA CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $56,941 $15,591 +265% $19,326 +195% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $56,816 $25,010 +127% $30,058 +89% ≈87% of Medicare
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $56,764 $18,707 +203% $20,421 +178% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $56,642 $17,947 +216% $23,350 +143% —
561 AFTERCARE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $56,581 $13,806 +310% $18,150 +212% —
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $56,502 $16,434 +244% $22,557 +150% —
533 FRACTURES OF FEMUR WITH MCC $56,184 $22,986 +144% $25,945 +117% —
744 D&C CONIZATION LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $56,106 $28,555 +96% $33,050 +70% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $55,931 $19,254 +190% $25,704 +118% ≈87% of Medicare
199 PNEUMOTHORAX WITH MCC $55,428 $26,943 +106% $31,491 +76% —
296 CARDIAC ARREST UNEXPLAINED WITH MCC $55,394 $24,108 +130% $30,910 +79% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $55,118 $20,513 +169% $25,426 +117% ≈89% of Medicare
181 RESPIRATORY NEOPLASMS WITH CC $54,972 $17,604 +212% $22,431 +145% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $54,841 $32,504 +69% $38,998 +41% —
693 URINARY STONES WITH MCC $54,777 $22,278 +146% $22,525 +143% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $54,707 $23,467 +133% $23,141 +136% ≈98% of Medicare
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $54,324 $21,908 +148% $22,525 +141% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $53,879 $28,903 +86% $29,757 +81% ≈86% of Medicare
935 NON-EXTENSIVE BURNS $53,830 $31,701 +70% $29,458 +83% ≈82% of Medicare
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $53,595 $19,930 +169% $23,920 +124% —
534 FRACTURES OF FEMUR WITHOUT MCC $53,565 $13,759 +289% $17,195 +212% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $53,557 $16,847 +218% $17,550 +205% —
602 CELLULITIS WITH MCC $53,419 $22,262 +140% $29,347 +82% ≈78% of Medicare
291 HEART FAILURE AND SHOCK WITH MCC $53,378 $20,129 +165% $25,020 +113% ≈82% of Medicare
640 MISCELLANEOUS DISORDERS OF NUTRITION METABOLISM FLUIDS AND ELECTROLYTES WITH MCC $53,140 $20,430 +160% $24,480 +117% ≈89% of Medicare
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $52,412 $14,171 +270% $20,084 +161% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $52,163 $15,598 +234% $20,371 +156% —
292 HEART FAILURE AND SHOCK WITH CC $51,793 $14,372 +260% $16,212 +219% ≈86% of Medicare
913 TRAUMATIC INJURY WITH MCC $51,514 $24,198 +113% $24,198 +113% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $51,405 $20,646 +149% $32,936 +56% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $51,364 $19,268 +167% $22,032 +133% —
562 FRACTURE SPRAIN STRAIN AND DISLOCATION EXCEPT FEMUR HIP PELVIS AND THIGH WITH MCC $51,293 $22,189 +131% $29,211 +76% ≈96% of Medicare
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $51,212 $19,017 +169% $23,588 +117% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $51,130 $16,382 +212% $18,017 +184% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $51,082 $20,217 +153% $23,115 +121% ≈89% of Medicare
560 AFTERCARE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $51,018 $17,043 +199% $24,452 +109% ≈98% of Medicare
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $50,887 $20,296 +151% $26,158 +95% ≈90% of Medicare
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $50,548 $13,884 +264% $19,815 +155% —
637 DIABETES WITH MCC $50,497 $22,095 +129% $28,819 +75% ≈96% of Medicare
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $50,396 $19,077 +164% $26,488 +90% ≈88% of Medicare
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $50,025 $12,593 +297% $12,593 +297% —
947 SIGNS AND SYMPTOMS WITH MCC $49,612 $19,887 +149% $25,474 +95% —
896 ALCOHOL DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $49,603 $21,995 +126% $30,275 +64% ≈80% of Medicare
348 ANAL AND STOMAL PROCEDURES WITH CC $49,281 $19,533 +152% $27,947 +76% —
287 CIRCULATORY DISORDERS EXCEPT AMI WITH CARDIAC CATHETERIZATION WITHOUT MCC $49,274 $17,337 +184% $31,190 +58% ≈93% of Medicare
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $49,271 $13,288 +271% $15,858 +211% —
137 MOUTH PROCEDURES WITH CC/MCC $49,095 $21,346 +130% $24,348 +102% —
710 PENIS PROCEDURES WITHOUT CC/MCC $49,094 $22,681 +116% $23,814 +106% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $49,035 $18,291 +168% $18,291 +168% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $49,020 $18,383 +167% $22,982 +113% ≈89% of Medicare
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $48,988 $22,272 +120% $28,780 +70% ≈90% of Medicare
385 INFLAMMATORY BOWEL DISEASE WITH MCC $48,773 $20,139 +142% $26,020 +87% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $48,717 $16,857 +189% $18,478 +164% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $48,703 $23,658 +106% $29,371 +66% —
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $48,631 $24,586 +98% $25,197 +93% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $48,435 $11,997 +304% $11,997 +304% —
184 MAJOR CHEST TRAUMA WITH CC $48,294 $17,057 +183% $20,842 +132% ≈93% of Medicare
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $47,804 $17,193 +178% $17,193 +178% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $47,743 $16,122 +196% $17,483 +173% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $47,619 $22,893 +108% $33,694 +41% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $46,816 $25,150 +86% $23,496 +99% ≈83% of Medicare
302 ATHEROSCLEROSIS WITH MCC $46,610 $18,292 +155% $20,844 +124% —
152 OTITIS MEDIA AND URI WITH MCC $46,541 $17,922 +160% $19,795 +135% —
866 VIRAL ILLNESS WITHOUT MCC $46,157 $14,678 +214% $16,391 +182% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $46,032 $16,392 +181% $23,469 +96% ≈88% of Medicare
123 NEUROLOGICAL EYE DISORDERS $46,002 $13,618 +238% $17,831 +158% —
375 DIGESTIVE MALIGNANCY WITH CC $45,940 $19,141 +140% $27,219 +69% —
088 CONCUSSION WITH MCC $45,916 $21,503 +114% $24,402 +88% —
950 AFTERCARE WITHOUT CC/MCC $45,885 $10,801 +325% $13,527 +239% —
922 OTHER INJURY POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $45,841 $25,121 +82% $29,409 +56% —
391 ESOPHAGITIS GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $45,823 $20,473 +124% $27,244 +68% ≈75% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $45,725 $28,993 +58% $35,139 +30% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $45,648 $22,265 +105% $25,786 +77% —
304 HYPERTENSION WITH MCC $45,634 $23,368 +95% $24,185 +89% ≈88% of Medicare
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $45,262 $16,429 +176% $21,545 +110% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $45,086 $14,776 +205% $21,261 +112% —
923 OTHER INJURY POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $44,837 $16,431 +173% $16,571 +171% —
885 PSYCHOSES $44,823 $18,995 +136% $21,489 +109% ≈84% of Medicare
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $44,512 $14,064 +216% $14,064 +216% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $44,192 $14,668 +201% $15,869 +178% —
723 MALIGNANCY MALE REPRODUCTIVE SYSTEM WITH CC $43,998 $17,768 +148% $19,317 +128% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $43,834 $27,152 +61% $29,609 +48% —
563 FRACTURE SPRAIN STRAIN AND DISLOCATION EXCEPT FEMUR HIP PELVIS AND THIGH WITHOUT MCC $43,444 $14,795 +194% $18,803 +131% ≈95% of Medicare
915 ALLERGIC REACTIONS WITH MCC $43,382 $25,750 +68% $30,944 +40% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $43,264 $17,770 +143% $24,190 +79% ≈91% of Medicare
552 MEDICAL BACK PROBLEMS WITHOUT MCC $42,767 $15,703 +172% $21,213 +102% ≈96% of Medicare
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $42,731 $26,328 +62% $31,044 +38% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $42,664 $13,385 +219% $13,385 +219% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $42,267 $13,542 +212% $17,700 +139% —
158 DENTAL AND ORAL DISEASES WITH CC $42,228 $15,402 +174% $17,700 +139% ≈85% of Medicare
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $42,025 $13,791 +205% $17,928 +134% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $42,013 $17,269 +143% $21,806 +93% ≈90% of Medicare
071 OTHER CEREBROVASCULAR DISORDERS WITH CC $41,939 $26,383 +59% $23,396 +79% ≈87% of Medicare
138 MOUTH PROCEDURES WITHOUT CC/MCC $41,244 $13,752 +200% $17,383 +137% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $41,241 $12,284 +236% $13,654 +202% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $41,222 $15,242 +170% $18,133 +127% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $41,197 $18,536 +122% $19,598 +110% —
697 URETHRAL STRICTURE $40,984 $16,196 +153% $17,705 +131% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $40,797 $18,846 +116% $26,634 +53% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $40,557 $21,623 +88% $24,136 +68% ≈95% of Medicare
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $40,518 $16,070 +152% $22,024 +84% ≈92% of Medicare
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $40,313 $13,822 +192% $13,822 +192% —
946 REHABILITATION WITHOUT CC/MCC $40,227 $17,685 +127% $17,685 +127% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $40,155 $15,684 +156% $20,777 +93% ≈96% of Medicare
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $40,089 $14,226 +182% $17,715 +126% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $39,750 $17,089 +133% $19,579 +103% ≈90% of Medicare
755 MALIGNANCY FEMALE REPRODUCTIVE SYSTEM WITH CC $39,530 $17,555 +125% $18,459 +114% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $39,522 $15,734 +151% $21,449 +84% ≈87% of Medicare
067 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $39,472 $22,077 +79% $24,941 +58% —
197 INTERSTITIAL LUNG DISEASE WITH CC $39,393 $16,043 +146% $20,106 +96% —
312 SYNCOPE AND COLLAPSE $38,957 $18,111 +115% $19,342 +101% ≈90% of Medicare
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $38,873 $13,002 +199% $16,776 +132% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $38,591 $17,354 +122% $19,868 +94% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $38,573 $13,602 +184% $18,238 +111% —
187 PLEURAL EFFUSION WITH CC $38,533 $22,534 +71% $21,467 +80% —
920 COMPLICATIONS OF TREATMENT WITH CC $38,329 $16,379 +134% $21,181 +81% ≈83% of Medicare
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $38,255 $15,603 +145% $18,191 +110% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $38,167 $17,600 +117% $22,698 +68% —
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $38,128 $17,079 +123% $23,749 +61% ≈88% of Medicare
381 COMPLICATED PEPTIC ULCER WITH CC $38,117 $17,329 +120% $24,177 +58% —
914 TRAUMATIC INJURY WITHOUT MCC $37,950 $15,088 +152% $15,593 +143% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $37,937 $20,766 +83% $20,732 +83% ≈91% of Medicare
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $37,874 $12,919 +193% $16,634 +128% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $37,770 $17,565 +115% $21,886 +73% ≈86% of Medicare
147 EAR NOSE MOUTH AND THROAT MALIGNANCY WITH CC $37,552 $19,350 +94% $21,860 +72% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $37,513 $14,344 +162% $18,278 +105% ≈94% of Medicare
103 HEADACHES WITHOUT MCC $36,971 $14,229 +160% $20,111 +84% ≈117% of Medicare
281 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE WITH CC $36,907 $15,158 +143% $20,463 +80% ≈100% of Medicare
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $36,715 $19,183 +91% $20,147 +82% —
149 DYSEQUILIBRIUM $36,517 $16,163 +126% $17,203 +112% ≈93% of Medicare
102 HEADACHES WITH MCC $36,361 $17,476 +108% $22,544 +61% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $36,273 $16,575 +119% $22,781 +59% ≈89% of Medicare
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $36,263 $12,453 +191% $15,607 +132% —
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $36,039 $13,602 +165% $19,001 +90% —
605 TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $35,690 $15,183 +135% $19,287 +85% —
540 OSTEOMYELITIS WITH CC $35,607 $19,990 +78% $23,494 +52% —
204 RESPIRATORY SIGNS AND SYMPTOMS $35,362 $13,720 +158% $16,866 +110% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $35,346 $25,176 +40% $29,729 +19% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $35,149 $14,464 +143% $18,253 +93% ≈92% of Medicare
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $35,138 $15,547 +126% $18,428 +91% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $34,831 $13,911 +150% $15,876 +119% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $34,792 $13,506 +158% $17,727 +96% ≈90% of Medicare
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $34,654 $11,755 +195% $13,368 +159% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $34,620 $15,897 +118% $20,488 +69% ≈96% of Medicare
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $34,485 $15,411 +124% $18,918 +82% ≈90% of Medicare
202 BRONCHITIS AND ASTHMA WITH CC/MCC $34,395 $13,648 +152% $17,273 +99% ≈86% of Medicare
386 INFLAMMATORY BOWEL DISEASE WITH CC $34,374 $16,076 +114% $20,968 +64% ≈97% of Medicare
607 MINOR SKIN DISORDERS WITHOUT MCC $34,308 $14,410 +138% $15,284 +124% ≈104% of Medicare
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $34,259 $16,553 +107% $22,850 +50% ≈99% of Medicare
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $34,069 $14,627 +133% $19,854 +72% —
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $33,971 $14,635 +132% $19,569 +74% —
644 ENDOCRINE DISORDERS WITH CC $33,814 $22,494 +50% $22,941 +47% —
155 OTHER EAR NOSE MOUTH AND THROAT DIAGNOSES WITH CC $33,796 $15,311 +121% $16,642 +103% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $33,399 $12,314 +171% $15,600 +114% —
593 SKIN ULCERS WITH CC $33,270 $19,063 +75% $20,470 +63% —
864 FEVER AND INFLAMMATORY CONDITIONS $32,529 $22,978 +42% $17,412 +87% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $32,262 $13,579 +138% $20,278 +59% ≈94% of Medicare
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $32,035 $14,480 +121% $19,305 +66% —
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $31,881 $16,990 +88% $20,309 +57% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $31,815 $12,474 +155% $15,636 +103% ≈83% of Medicare
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $31,810 $15,986 +99% $18,282 +74% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $31,699 $13,719 +131% $18,002 +76% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $31,686 $20,672 +53% $23,723 +34% —
200 PNEUMOTHORAX WITH CC $31,595 $17,568 +80% $20,573 +54% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $31,510 $15,519 +103% $18,204 +73% ≈90% of Medicare
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $31,483 $11,894 +165% $14,880 +112% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $31,479 $16,402 +92% $22,713 +39% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $31,334 $16,798 +87% $20,007 +57% ≈103% of Medicare
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $31,290 $16,212 +93% $16,212 +93% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $31,277 $14,675 +113% $15,045 +108% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $31,228 $11,454 +173% $14,128 +121% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $30,993 $14,358 +116% $19,096 +62% —
683 RENAL FAILURE WITH CC $30,883 $18,011 +71% $18,620 +66% ≈91% of Medicare
641 MISCELLANEOUS DISORDERS OF NUTRITION METABOLISM FLUIDS AND ELECTROLYTES WITHOUT MCC $30,846 $15,148 +104% $16,745 +84% ≈84% of Medicare
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $30,486 $13,813 +121% $19,483 +56% ≈89% of Medicare
638 DIABETES WITH CC $30,220 $15,709 +92% $18,821 +61% ≈87% of Medicare
694 URINARY STONES WITHOUT MCC $30,008 $13,336 +125% $16,531 +82% —
598 MALIGNANT BREAST DISORDERS WITH CC $29,961 $17,197 +74% $19,073 +57% —
075 VIRAL MENINGITIS WITH CC/MCC $29,531 $25,549 +16% $29,853 −1% —
558 TENDONITIS MYOSITIS AND BURSITIS WITHOUT MCC $29,415 $14,405 +104% $17,367 +69% —
153 OTITIS MEDIA AND URI WITHOUT MCC $29,346 $12,431 +136% $14,473 +103% ≈91% of Medicare
201 PNEUMOTHORAX WITHOUT CC/MCC $29,268 $11,982 +144% $13,081 +124% —
603 CELLULITIS WITHOUT MCC $29,214 $14,626 +100% $18,530 +58% ≈92% of Medicare
101 SEIZURES WITHOUT MCC $29,136 $15,526 +88% $19,954 +46% ≈93% of Medicare
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $28,534 $18,935 +51% $17,522 +63% —
549 SEPTIC ARTHRITIS WITH CC $28,340 $18,835 +50% $20,938 +35% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $28,247 $12,505 +126% $12,895 +119% —
882 NEUROSES EXCEPT DEPRESSIVE $28,217 $13,211 +114% $15,680 +80% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $28,145 $11,752 +139% $13,485 +109% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $28,116 $14,654 +92% $15,608 +80% —
770 ABORTION WITH D&C ASPIRATION CURETTAGE OR HYSTEROTOMY $28,029 $17,159 +63% $17,943 +56% —
176 PULMONARY EMBOLISM WITHOUT MCC $27,893 $13,765 +103% $18,081 +54% ≈87% of Medicare
537 SPRAINS STRAINS AND DISLOCATIONS OF HIP PELVIS AND THIGH WITH CC/MCC $27,823 $15,121 +84% $16,352 +70% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $27,811 $12,609 +121% $16,104 +73% —
392 ESOPHAGITIS GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $27,805 $13,747 +102% $17,322 +61% ≈88% of Medicare
881 DEPRESSIVE NEUROSES $27,737 $14,686 +89% $15,058 +84% —
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $27,287 $12,931 +111% $16,654 +64% —
305 HYPERTENSION WITHOUT MCC $27,159 $20,359 +33% $17,144 +58% ≈95% of Medicare
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $27,011 $15,039 +80% $17,585 +54% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $26,748 $13,611 +97% $17,466 +53% ≈92% of Medicare
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $26,655 $15,610 +71% $16,418 +62% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $26,284 $10,773 +144% $12,381 +112% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $26,125 $13,799 +89% $16,837 +55% —
089 CONCUSSION WITH CC $25,928 $17,109 +52% $18,293 +42% —
282 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE WITHOUT CC/MCC $25,628 $12,605 +103% $18,623 +38% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $25,496 $16,067 +59% $17,388 +47% ≈90% of Medicare
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $25,225 $12,534 +101% $12,537 +101% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $25,149 $14,778 +70% $17,103 +47% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $24,893 $14,081 +77% $17,226 +45% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $24,719 $12,055 +105% $12,797 +93% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $23,860 $16,633 +43% $16,865 +41% ≈94% of Medicare
303 ATHEROSCLEROSIS WITHOUT MCC $23,353 $11,921 +96% $14,927 +56% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $23,055 $15,217 +52% $18,608 +24% —
759 INFECTIONS FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $22,917 $11,501 +99% $14,208 +61% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $22,659 $14,937 +52% $15,077 +50% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $22,633 $13,876 +63% $15,370 +47% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $22,028 $13,300 +66% $14,166 +55% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $21,839 $19,581 +12% $19,894 +10% —
758 INFECTIONS FEMALE REPRODUCTIVE SYSTEM WITH CC $21,753 $17,603 +24% $19,091 +14% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $21,496 $12,903 +67% $14,337 +50% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $21,472 $12,120 +77% $14,012 +53% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $21,399 $14,055 +52% $14,055 +52% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $21,350 $14,383 +48% $16,156 +32% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $21,245 $11,458 +85% $14,134 +50% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $20,714 $11,177 +85% $15,070 +37% —
897 ALCOHOL DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $20,546 $14,180 +45% $16,049 +28% ≈88% of Medicare
313 CHEST PAIN $20,252 $13,168 +54% $15,962 +27% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $20,080 $12,204 +65% $13,303 +51% —
076 VIRAL MENINGITIS WITHOUT CC/MCC $20,026 $19,275 +4% $15,474 +29% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $19,868 $12,173 +63% $14,441 +38% —
639 DIABETES WITHOUT CC/MCC $19,573 $14,668 +33% $13,910 +41% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $19,407 $12,235 +59% $12,279 +58% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $18,996 $11,355 +67% $13,090 +45% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $18,953 $12,253 +55% $15,072 +26% —
311 ANGINA PECTORIS $18,946 $12,257 +55% $15,165 +25% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $18,476 $10,456 +77% $13,384 +38% ≈106% of Medicare
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $18,299 $11,071 +65% $11,071 +65% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $18,240 $7,192 +154% $9,076 +101% —
156 OTHER EAR NOSE MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $17,973 $11,921 +51% $13,198 +36% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $17,459 $17,832 −2% $20,741 −16% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $17,412 $12,855 +35% $13,892 +25% —
151 EPISTAXIS WITHOUT MCC $16,876 $13,032 +29% $13,032 +29% —
684 RENAL FAILURE WITHOUT CC/MCC $16,683 $11,077 +51% $13,623 +22% —
916 ALLERGIC REACTIONS WITHOUT MCC $16,368 $13,100 +25% $13,890 +18% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $16,209 $11,276 +44% $13,824 +17% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $15,881 $10,563 +50% $12,044 +32% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $15,770 $14,343 +10% $13,318 +18% —
894 ALCOHOL DRUG ABUSE OR DEPENDENCE LEFT AMA $15,318 $11,294 +36% $12,013 +28% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $15,293 $13,184 +16% $14,444 +6% —
756 MALIGNANCY FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $14,376 $14,994 −4% $15,589 −8% —
757 INFECTIONS FEMALE REPRODUCTIVE SYSTEM WITH MCC $13,690 $21,563 −37% $23,734 −42% —
724 MALIGNANCY MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $13,364 $12,650 +6% $12,650 +6% —
779 ABORTION WITHOUT D&C $12,831 $12,637 +2% $15,327 −16% —
895 ALCOHOL DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $12,376 $12,472 −1% $21,986 −44% —
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $12,110 $10,316 +17% $11,955 +1% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $11,947 $10,553 +13% $9,385 +27% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $11,123 $11,510 −3% $14,368 −23% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $10,565 $10,337 +2% $11,633 −9% —
791 PREMATURITY WITH MAJOR PROBLEMS $10,289 $28,338 −64% $39,563 −74% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE $9,307 $53,277 −83% $80,018 −88% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $9,091 $9,238 −2% $16,719 −46% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $9,071 $7,548 +20% $7,961 +14% —
795 NORMAL NEWBORN $7,797 $4,526 +72% $4,530 +72% —
789 NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $5,744 $12,793 −55% $14,284 −60% —
541 OSTEOMYELITIS WITHOUT CC/MCC $5,278 $13,738 −62% $14,549 −64% —
745 D&C CONIZATION LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $3,375 $16,495 −80% $16,495 −80% —

Procedures with negotiated rates only

These 40 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
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $71,211 – $403,864 · median $80,803 29 plans
090 CONCUSSION WITHOUT CC/MCC $5,173 – $18,830 · median $5,671 26 plans
150 EPISTAXIS WITH MCC $8,367 – $30,457 · median $9,172 26 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC $4,507 – $16,405 · median $4,941 26 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $41,320 – $150,403 · median $45,296 26 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $8,700 – $31,667 · median $9,537 26 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $6,864 – $24,983 · median $7,524 26 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $12,707 – $46,254 · median $13,930 26 plans
284 ACUTE MYOCARDIAL INFARCTION EXPIRED WITH CC $4,350 – $15,833 · median $4,768 26 plans
285 ACUTE MYOCARDIAL INFARCTION EXPIRED WITHOUT CC/MCC $3,764 – $13,699 · median $4,126 26 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $5,842 – $21,266 · median $6,405 26 plans
297 CARDIAC ARREST UNEXPLAINED WITH CC $3,984 – $14,502 · median $4,368 26 plans
298 CARDIAC ARREST UNEXPLAINED WITHOUT CC/MCC $2,860 – $10,410 · median $3,135 26 plans
318 PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE $15,221 – $55,405 · median $16,686 26 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $20,175 – $73,435 · median $22,116 26 plans
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $10,435 – $37,982 · median $11,439 26 plans
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $4,477 – $16,298 · median $4,908 26 plans
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $34,707 – $126,333 · median $38,047 26 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $9,842 – $35,825 · median $10,789 26 plans
505 FOOT PROCEDURES WITHOUT CC/MCC $11,266 – $41,009 · median $12,350 26 plans
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $9,517 – $34,640 · median $10,432 26 plans
538 SPRAINS STRAINS AND DISLOCATIONS OF HIP PELVIS AND THIGH WITHOUT CC/MCC $4,526 – $16,476 · median $4,962 26 plans
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $11,293 – $41,105 · median $12,379 26 plans
594 SKIN ULCERS WITHOUT CC/MCC $5,447 – $19,827 · median $5,971 26 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $4,835 – $17,599 · median $5,300 26 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $3,802 – $13,839 · median $4,168 26 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $8,913 – $32,442 · median $9,770 26 plans
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $7,867 – $28,636 · median $8,624 26 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $6,579 – $23,947 · median $7,212 26 plans
667 PROSTATECTOMY WITHOUT CC/MCC $6,952 – $25,303 · median $7,620 26 plans
672 URETHRAL PROCEDURES WITHOUT CC/MCC $6,784 – $24,692 · median $7,437 26 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $6,645 – $24,187 · median $7,284 26 plans
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $9,244 – $33,648 · median $10,133 26 plans
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $3,585 – $13,050 · median $3,930 26 plans
801 SPLENIC PROCEDURES WITHOUT CC/MCC $11,996 – $43,664 · median $13,150 26 plans
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $9,409 – $34,247 · median $10,314 26 plans
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $18,501 – $67,343 · median $20,281 26 plans
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $16,574 – $60,328 · median $18,169 26 plans
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $34,137 – $120,488 · median $35,844 23 plans
887 OTHER MENTAL DISORDER DIAGNOSES $6,730 – $11,239 · median $7,066 19 plans
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