Heritage Valley Beaver — Pricing
388 procedures published in this hospital's Machine-Readable File (MRF) — 387 with a comparable price, 1 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 388
Lowest published price $3,945
Average published price $27,878
Highest published price $384,339
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.
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Rates come from the hospital's own published price file and are medians across that insurer's plans. Your specific plan, network tier, and benefit design can differ — confirm with your insurer.
Showing all 388 procedures
Published charges
Showing all 387 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above.
Across 27 procedures, this hospital's negotiated rates average ≈147% of what Medicare pays.
| DRG | Description | Published price | Cash price | vs. PA median | vs. National median | vs Medicare | ||
|---|---|---|---|---|---|---|---|---|
| 003 | ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROC | $384,339 | $148,659 | $373,542 | +3% | $371,366 | +3% | — |
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURE | $211,478 | $98,314 | $219,105 | −3% | $245,241 | −14% | — |
| 823 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC | $143,727 | $33,152 | $143,727 | +0% | $80,885 | +78% | — |
| 981 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $136,972 | $33,665 | $140,076 | −2% | $86,390 | +59% | — |
| 356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC | $130,772 | $30,299 | $121,101 | +8% | $82,561 | +58% | — |
| 817 | INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE | $112,534 | $18,366 | $97,144 | +16% | $36,097 | +212% | — |
| 656 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC | $97,437 | $23,351 | $96,685 | +1% | $64,465 | +51% | — |
| 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | $87,741 | $48,852 | $138,008 | −36% | $138,008 | −36% | — |
| 462 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC | $86,983 | $20,633 | $86,983 | +0% | $56,758 | +53% | — |
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | $83,054 | $35,616 | $132,153 | −37% | $87,565 | −5% | — |
| 720 | SEPTICEMIA AND DISSEMINATED INFECTIONS | $82,717 | — | $82,717 | +0% | $47,150 | +75% | — |
| 539 | OSTEOMYELITIS WITH MCC | $77,251 | $14,831 | $54,560 | +42% | $33,746 | +129% | — |
| 668 | TRANSURETHRAL PROCEDURES WITH MCC | $73,806 | $20,995 | $73,806 | +0% | $47,277 | +56% | — |
| 816 | TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES | $72,498 | $5,433 | $18,512 | +292% | $13,485 | +438% | — |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $70,706 | $27,536 | $74,070 | −5% | $62,961 | +12% | — |
| 428 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC | $70,159 | $38,838 | $104,911 | −33% | $105,899 | −34% | — |
| 468 | REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | $69,396 | $18,975 | $81,138 | −14% | $54,929 | +26% | — |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $66,820 | $13,921 | $69,265 | −4% | $32,399 | +106% | — |
| 397 | APPENDIX PROCEDURES WITH MCC | $66,179 | $17,971 | $66,179 | +0% | $52,319 | +26% | — |
| 717 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC | $66,149 | $13,681 | $27,276 | +143% | $32,538 | +103% | — |
| 686 | KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC | $61,301 | $13,889 | $61,301 | +0% | $32,981 | +86% | — |
| 207 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | $60,849 | $45,478 | $139,264 | −56% | $116,058 | −48% | — |
| 061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC | $60,243 | $19,527 | $66,234 | −9% | $57,963 | +4% | — |
| 454 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | $58,772 | — | $63,936 | −8% | $69,101 | −15% | — |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $57,882 | $32,548 | $65,122 | −11% | $88,050 | −34% | — |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $55,344 | $19,392 | $68,094 | −19% | $52,405 | +6% | — |
| 448 | MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $54,864 | $29,043 | $193,669 | −72% | $81,998 | −33% | — |
| 657 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC | $54,592 | $13,492 | $77,958 | −30% | $40,583 | +35% | — |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $53,634 | $35,371 | $68,020 | −21% | $87,018 | −38% | ≈142% of Medicare |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $53,405 | $17,564 | $75,930 | −30% | $46,591 | +15% | — |
| 455 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | $53,268 | — | $53,794 | −1% | $54,320 | −2% | — |
| 409 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC | $50,628 | $15,342 | $128,626 | −61% | $46,066 | +10% | — |
| 463 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC | $50,322 | $38,127 | $99,014 | −49% | $78,582 | −36% | — |
| 244 | PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | $50,284 | $13,330 | $102,790 | −51% | $40,063 | +26% | — |
| 345 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $47,804 | $11,151 | $41,707 | +15% | $31,062 | +54% | — |
| 326 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC | $47,587 | $35,907 | $73,489 | −35% | $80,747 | −41% | — |
| 459 | SPINAL FUSION EXCEPT CERVICAL WITH MCC | $47,257 | — | $75,251 | −37% | $75,251 | −37% | — |
| 220 | MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES | $47,178 | $37,408 | $156,470 | −70% | $102,177 | −54% | — |
| 460 | SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $46,864 | — | $45,459 | +3% | $50,815 | −8% | — |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $46,538 | $17,185 | $99,021 | −53% | $58,832 | −21% | ≈137% of Medicare |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $46,424 | $20,984 | $99,634 | −53% | $67,764 | −31% | — |
| 304 | HYPERTENSION WITH MCC | $46,271 | $8,987 | $35,353 | +31% | $24,185 | +91% | — |
| 467 | REVISION OF HIP OR KNEE REPLACEMENT WITH CC | $46,025 | $24,504 | $122,711 | −62% | $68,880 | −33% | — |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $45,794 | $15,761 | $59,979 | −24% | $44,553 | +3% | — |
| 402 | SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL | $45,054 | $27,862 | $90,735 | −50% | $75,492 | −40% | — |
| 451 | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $44,944 | $22,165 | $74,887 | −40% | $65,216 | −31% | — |
| 505 | FOOT PROCEDURES WITHOUT CC/MCC | $44,816 | $12,988 | $50,588 | −11% | $31,716 | +41% | — |
| 497 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC | $44,366 | $10,144 | $29,456 | +51% | $29,805 | +49% | — |
| 137 | MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS | $44,326 | $10,530 | $59,510 | −26% | $24,348 | +82% | — |
| 030 | SPINAL PROCEDURES WITHOUT CC/MCC | $43,888 | $16,231 | $45,866 | −4% | $45,818 | −4% | — |
| 841 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | $43,529 | $11,698 | $36,255 | +20% | $31,059 | +40% | — |
| 876 | O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS | $43,474 | $27,982 | $51,515 | −16% | $54,196 | −20% | — |
| 062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC | $43,159 | $13,166 | $48,680 | −11% | $48,680 | −11% | — |
| 483 | MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | $42,878 | $18,457 | $74,137 | −42% | $57,149 | −25% | — |
| 336 | PERITONEAL ADHESIOLYSIS WITH CC | $42,865 | $15,451 | $78,344 | −45% | $49,470 | −13% | — |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $41,441 | $12,270 | $41,441 | +0% | $44,117 | −6% | — |
| 658 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC | $40,097 | $11,257 | $51,978 | −23% | $35,528 | +13% | — |
| 982 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $39,978 | $17,768 | $78,122 | −49% | $51,985 | −23% | — |
| 063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC | $39,887 | $10,573 | $66,511 | −40% | $35,542 | +12% | — |
| 180 | RESPIRATORY NEOPLASMS WITH MCC | $39,797 | $12,938 | $74,080 | −46% | $36,658 | +9% | — |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $39,697 | $18,706 | $36,735 | +8% | $48,094 | −17% | — |
| 963 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC | $39,426 | $19,619 | $58,674 | −33% | $43,491 | −9% | — |
| 289 | ACUTE AND SUBACUTE ENDOCARDITIS WITH CC | $38,675 | $11,758 | $63,265 | −39% | $29,371 | +32% | — |
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | $38,543 | $17,442 | $76,694 | −50% | $56,394 | −32% | — |
| 628 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC | $38,419 | $28,093 | $73,792 | −48% | $68,006 | −44% | — |
| 368 | MAJOR ESOPHAGEAL DISORDERS WITH MCC | $38,174 | $12,401 | $46,643 | −18% | $33,607 | +14% | — |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $38,162 | $13,887 | $76,396 | −50% | $49,197 | −22% | — |
| 052 | SPINAL DISORDERS AND INJURIES WITH CC/MCC | $37,862 | $14,763 | $74,308 | −49% | $30,940 | +22% | — |
| 941 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC | $37,743 | $14,362 | $37,743 | +0% | $29,524 | +28% | — |
| 824 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC | $37,474 | $16,052 | $81,864 | −54% | $38,382 | −2% | — |
| 335 | PERITONEAL ADHESIOLYSIS WITH MCC | $37,000 | $25,870 | $88,270 | −58% | $71,755 | −48% | — |
| 417 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | $36,639 | $17,273 | $62,838 | −42% | $52,313 | −30% | — |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $36,527 | $13,112 | $58,085 | −37% | $36,242 | +1% | — |
| 241 | PEPTIC ULCER AND GASTRITIS | $35,870 | $11,298 | $35,870 | +0% | $24,229 | +48% | — |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $35,861 | $13,887 | $65,542 | −45% | $45,963 | −22% | — |
| 242 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | $35,623 | $24,275 | $108,910 | −67% | $70,132 | −49% | — |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $35,151 | $12,090 | $35,151 | +0% | $26,020 | +35% | — |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $34,735 | $21,165 | $99,541 | −65% | $63,984 | −46% | — |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $34,716 | $12,321 | $54,572 | −36% | $42,119 | −18% | — |
| 983 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $34,607 | $12,389 | $87,143 | −60% | $30,930 | +12% | — |
| 364 | OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES | $34,536 | — | $34,536 | — | $46,852 | −26% | — |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | $34,023 | $14,664 | $37,921 | −10% | $43,524 | −22% | — |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $33,894 | $15,422 | $72,502 | −53% | $56,519 | −40% | — |
| 500 | SOFT TISSUE PROCEDURES WITH MCC | $33,736 | $22,735 | $90,626 | −63% | $57,479 | −41% | — |
| 410 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC | $33,092 | $11,582 | $130,375 | −75% | $34,434 | −4% | — |
| 167 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC | $32,891 | $13,485 | $39,935 | −18% | $40,563 | −19% | — |
| 713 | TRANSURETHRAL PROSTATECTOMY WITH CC/MCC | $32,508 | $10,857 | $34,106 | −5% | $29,663 | +10% | — |
| 472 | CERVICAL SPINAL FUSION WITH CC | $32,134 | $20,863 | $45,228 | −29% | $59,537 | −46% | — |
| 068 | NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC | $32,107 | $6,965 | $32,471 | −1% | $19,569 | +64% | — |
| 592 | SKIN ULCERS WITH MCC | $31,986 | $15,065 | $31,986 | +0% | $32,662 | −2% | — |
| 327 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | $31,801 | $17,629 | $78,640 | −60% | $54,824 | −42% | — |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $31,758 | $12,939 | $40,463 | −22% | $31,758 | +0% | — |
| 254 | OTHER DIGESTIVE SYSTEM DIAGNOSES | $31,752 | $12,949 | $66,959 | −53% | $38,836 | −18% | — |
| 486 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC | $31,626 | $15,510 | $59,923 | −47% | $46,477 | −32% | — |
| 288 | ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC | $31,442 | $19,721 | $54,941 | −43% | $45,497 | −31% | — |
| 620 | O.R. PROCEDURES FOR OBESITY WITH CC | $31,291 | $11,898 | $70,442 | −56% | $35,453 | −12% | — |
| 240 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC | $31,124 | $20,966 | $67,997 | −54% | $54,475 | −43% | — |
| 674 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC | $31,035 | $16,803 | $47,856 | −35% | $49,631 | −37% | — |
| 284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC | $30,988 | $5,996 | $42,616 | −27% | $13,282 | +133% | — |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $30,903 | $7,496 | $21,114 | +46% | $15,636 | +98% | — |
| 548 | SEPTIC ARTHRITIS WITH MCC | $30,800 | $14,778 | $26,119 | +18% | $31,019 | −1% | — |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $30,766 | $13,878 | $44,911 | −31% | $30,766 | +0% | — |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $30,732 | $15,193 | $67,860 | −55% | $51,172 | −40% | ≈150% of Medicare |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $30,706 | $14,416 | $39,528 | −22% | $35,237 | −13% | ≈147% of Medicare |
| 243 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | $30,588 | $16,420 | $53,331 | −43% | $50,011 | −39% | — |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $30,582 | $8,635 | $34,401 | −11% | $30,314 | +1% | — |
| 100 | SEIZURES WITH MCC | $30,507 | $14,575 | $37,837 | −19% | $35,194 | −13% | — |
| 357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC | $30,367 | $16,414 | $70,333 | −57% | $48,682 | −38% | — |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $30,300 | $10,603 | $38,853 | −22% | $29,757 | +2% | — |
| 186 | PLEURAL EFFUSION WITH MCC | $30,137 | $11,781 | $30,885 | −2% | $32,468 | −7% | — |
| 629 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC | $30,100 | $16,394 | $52,395 | −43% | $45,059 | −33% | — |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $30,083 | $18,153 | $40,359 | −25% | $39,409 | −24% | — |
| 070 | NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | $29,936 | $12,876 | $37,068 | −19% | $30,814 | −3% | — |
| 867 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC | $29,930 | $15,672 | $32,455 | −8% | $36,850 | −19% | — |
| 920 | COMPLICATIONS OF TREATMENT WITH CC | $29,522 | $7,891 | $30,061 | −2% | $21,181 | +39% | — |
| 337 | PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | $29,335 | $11,471 | $41,400 | −29% | $36,239 | −19% | — |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $29,321 | $13,423 | $49,365 | −41% | $37,842 | −23% | — |
| 443 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $29,170 | $5,732 | $29,170 | +0% | $15,600 | +87% | — |
| 673 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | $29,043 | $29,043 | $77,990 | −63% | $72,945 | −60% | — |
| 314 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | $28,917 | $15,735 | $38,640 | −25% | $38,357 | −25% | — |
| 621 | O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC | $28,771 | $10,966 | $65,100 | −56% | $32,451 | −11% | — |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $28,681 | $13,467 | $38,595 | −26% | $37,950 | −24% | — |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $28,502 | $10,079 | $48,171 | −41% | $31,978 | −11% | — |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $28,348 | $10,587 | $31,732 | −11% | $27,934 | +1% | — |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $28,181 | $10,126 | $30,980 | −9% | $30,358 | −7% | — |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $28,160 | $12,033 | $35,519 | −21% | $31,840 | −12% | ≈138% of Medicare |
| 511 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC | $28,147 | $14,409 | $71,163 | −60% | $43,538 | −35% | — |
| 230 | MAJOR SMALL BOWEL PROCEDURES | $27,996 | — | $34,343 | −18% | $88,720 | −68% | — |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $27,903 | $13,165 | $46,212 | −40% | $30,275 | −8% | — |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $27,876 | $12,193 | $42,094 | −34% | $28,134 | −1% | — |
| 215 | OTHER HEART ASSIST SYSTEM IMPLANT | $27,574 | $27,574 | $327,059 | −92% | $191,314 | −86% | — |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $27,549 | $11,825 | $51,915 | −47% | $39,747 | −31% | — |
| 840 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | $27,508 | $22,875 | $43,242 | −36% | $49,710 | −45% | — |
| 473 | CERVICAL SPINAL FUSION WITHOUT CC/MCC | $27,449 | $17,210 | $69,024 | −60% | $50,624 | −46% | — |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $27,343 | $9,972 | $39,169 | −30% | $34,887 | −22% | — |
| 398 | APPENDIX PROCEDURES WITH CC | $27,314 | $11,320 | $44,431 | −39% | $39,107 | −30% | — |
| 813 | COAGULATION DISORDERS | $27,306 | $11,560 | $40,699 | −33% | $30,128 | −9% | — |
| 297 | CARDIAC ARREST, UNEXPLAINED WITH CC | $27,137 | $5,744 | $19,234 | +41% | $12,336 | +120% | — |
| 637 | DIABETES WITH MCC | $26,939 | $10,928 | $34,156 | −21% | $28,819 | −7% | — |
| 263 | CHOLECYSTECTOMY | $26,804 | $19,380 | $71,990 | −63% | $44,938 | −40% | — |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $26,638 | $12,616 | $47,371 | −44% | $43,266 | −38% | — |
| 604 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC | $26,497 | $11,131 | $47,554 | −44% | $28,140 | −6% | — |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $26,439 | $12,501 | $44,023 | −40% | $31,128 | −15% | — |
| 602 | CELLULITIS WITH MCC | $26,385 | $11,017 | $35,442 | −26% | $29,347 | −10% | — |
| 700 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC | $26,155 | $5,673 | $19,012 | +38% | $13,303 | +97% | — |
| 123 | NEUROLOGICAL EYE DISORDERS | $26,106 | $6,425 | $15,376 | +70% | $17,831 | +46% | — |
| 103 | HEADACHES WITHOUT MCC | $26,087 | $6,749 | $29,873 | −13% | $20,111 | +30% | — |
| 626 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC | $26,076 | $11,293 | $55,562 | −53% | $27,279 | −4% | — |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $25,598 | $8,396 | $25,598 | +0% | $24,177 | +6% | — |
| 598 | MALIGNANT BREAST DISORDERS WITH CC | $25,501 | $8,326 | $31,404 | −19% | $19,073 | +34% | — |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $25,492 | $7,984 | $26,489 | −4% | $22,850 | +12% | — |
| 369 | MAJOR ESOPHAGEAL DISORDERS WITH CC | $25,428 | $7,903 | $35,613 | −29% | $22,713 | +12% | — |
| 438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | $25,379 | $12,358 | $44,066 | −42% | $32,502 | −22% | — |
| 205 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC | $25,216 | $13,903 | $36,177 | −30% | $32,204 | −22% | — |
| 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | $24,944 | $8,764 | $50,519 | −51% | $24,432 | +2% | — |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $24,854 | $16,678 | $42,070 | −41% | $36,334 | −32% | — |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $24,651 | $7,965 | $24,651 | +0% | $24,022 | +3% | — |
| 091 | OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | $24,552 | $13,456 | $48,725 | −50% | $36,375 | −33% | — |
| 464 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC | $24,477 | $21,217 | $52,059 | −53% | $54,313 | −55% | — |
| 373 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC | $24,451 | $5,888 | $21,817 | +12% | $16,104 | +52% | — |
| 643 | ENDOCRINE DISORDERS WITH MCC | $24,414 | $12,314 | $25,187 | −3% | $32,996 | −26% | — |
| 358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $24,049 | $10,230 | $39,000 | −38% | $29,374 | −18% | — |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $24,031 | $14,395 | $55,209 | −56% | $36,933 | −35% | — |
| 570 | SKIN DEBRIDEMENT WITH MCC | $24,014 | $21,642 | $39,384 | −39% | $52,435 | −54% | — |
| 496 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC | $23,933 | $14,491 | $63,521 | −62% | $43,800 | −45% | — |
| 750 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $23,920 | — | $64,704 | −63% | $23,920 | +0% | — |
| 296 | CARDIAC ARREST, UNEXPLAINED WITH MCC | $23,887 | $12,184 | $35,112 | −32% | $30,910 | −23% | — |
| 073 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC | $23,788 | $11,544 | $31,577 | −25% | $28,252 | −16% | — |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $23,777 | $14,602 | $37,867 | −37% | $35,714 | −33% | — |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $23,655 | $11,874 | $50,979 | −54% | $35,375 | −33% | — |
| 617 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $23,652 | $14,205 | $48,099 | −51% | $42,881 | −45% | — |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $23,587 | $8,263 | $27,603 | −15% | $23,749 | −1% | — |
| 352 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC | $23,581 | $8,489 | $34,604 | −32% | $25,162 | −6% | — |
| 197 | PERIPHERAL AND OTHER VASCULAR DISORDERS | $23,570 | $7,713 | $23,570 | +0% | $20,106 | +17% | — |
| 166 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC | $23,559 | $23,559 | $77,879 | −70% | $72,782 | −68% | — |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $23,537 | $12,305 | $24,687 | −5% | $32,689 | −28% | — |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $23,532 | $8,364 | $23,532 | +0% | $21,806 | +8% | — |
| 857 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | $23,404 | $15,910 | $55,773 | −58% | $41,900 | −44% | — |
| 519 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | $23,397 | $14,483 | $52,334 | −55% | $43,775 | −47% | — |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $23,209 | $9,567 | $35,108 | −34% | $27,947 | −17% | — |
| 201 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS | $23,208 | $5,555 | $14,485 | +60% | $13,081 | +77% | — |
| 814 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC | $23,206 | $15,301 | $40,048 | −42% | $32,483 | −29% | — |
| 988 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $22,798 | $12,719 | $46,875 | −51% | $38,094 | −40% | — |
| 442 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | $22,781 | $7,549 | $26,696 | −15% | $21,449 | +6% | — |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $22,772 | $9,972 | $25,058 | −9% | $26,158 | −13% | ≈144% of Medicare |
| 264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $22,685 | $22,685 | $50,532 | −55% | $51,953 | −56% | — |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $22,674 | $12,477 | $30,436 | −26% | $30,058 | −25% | — |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $22,622 | $11,268 | $30,729 | −26% | $33,424 | −32% | — |
| 517 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC | $22,560 | $11,179 | $31,976 | −29% | $33,137 | −32% | — |
| 154 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC | $22,227 | $12,100 | $33,651 | −34% | $24,465 | −9% | — |
| 255 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC | $22,019 | $18,928 | $49,447 | −55% | $43,697 | −50% | — |
| 562 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC | $21,966 | $10,978 | $41,055 | −46% | $29,211 | −25% | — |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $21,859 | $8,630 | $22,381 | −2% | $24,190 | −10% | ≈174% of Medicare |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $21,834 | $15,445 | $55,499 | −61% | $38,885 | −44% | — |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $21,815 | $12,652 | $36,807 | −41% | $31,086 | −30% | — |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $21,801 | $9,743 | $29,881 | −27% | $27,244 | −20% | — |
| 478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $21,777 | $17,012 | $67,316 | −68% | $50,139 | −57% | — |
| 512 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC | $21,593 | $11,973 | $73,367 | −71% | $35,692 | −40% | — |
| 071 | NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | $21,581 | $8,153 | $26,190 | −18% | $23,396 | −8% | — |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $21,152 | $1,020 | $22,557 | −6% | $18,282 | +16% | — |
| 256 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC | $21,030 | $12,565 | $37,833 | −44% | $29,729 | −29% | — |
| 863 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | $20,957 | $7,781 | $23,715 | −12% | $20,007 | +5% | — |
| 682 | RENAL FAILURE WITH MCC | $20,903 | $11,242 | $31,849 | −34% | $27,854 | −25% | ≈152% of Medicare |
| 060 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC | $20,507 | $7,040 | $36,145 | −43% | $21,261 | −4% | — |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $20,501 | $9,359 | $35,509 | −42% | $27,219 | −25% | — |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $20,487 | $9,324 | $26,819 | −24% | $26,322 | −22% | — |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC | $20,398 | $9,426 | $27,940 | −27% | $22,032 | −7% | — |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $20,361 | $12,040 | $22,503 | −10% | $25,731 | −21% | — |
| 181 | RESPIRATORY NEOPLASMS WITH CC | $20,219 | $8,542 | $26,398 | −23% | $22,431 | −10% | — |
| 245 | INFLAMMATORY BOWEL DISEASE | $20,110 | $20,110 | $50,191 | −60% | $72,076 | −72% | — |
| 564 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC | $19,901 | $11,706 | $30,882 | −36% | $32,936 | −40% | — |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $19,878 | $9,419 | $23,857 | −17% | $25,704 | −23% | ≈137% of Medicare |
| 502 | SOFT TISSUE PROCEDURES WITHOUT CC/MCC | $19,814 | $10,520 | $29,075 | −32% | $30,006 | −34% | — |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $19,724 | $6,384 | $26,886 | −27% | $17,700 | +11% | — |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $19,346 | $9,755 | $21,963 | −12% | $25,474 | −24% | — |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $19,335 | $5,508 | $20,716 | −7% | $14,880 | +30% | — |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $19,284 | $12,403 | $27,008 | −29% | $25,208 | −23% | — |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $18,749 | $9,883 | $27,270 | −31% | $25,020 | −25% | ≈140% of Medicare |
| 865 | VIRAL ILLNESS WITH MCC | $18,738 | $11,063 | $36,697 | −49% | $26,088 | −28% | — |
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | $18,716 | $7,727 | $21,730 | −14% | $22,024 | −15% | — |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $18,551 | $8,738 | $31,520 | −41% | $24,452 | −24% | — |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | $18,527 | $6,580 | $25,128 | −26% | $15,876 | +17% | — |
| 862 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | $18,472 | $13,565 | $28,004 | −34% | $30,394 | −39% | — |
| 815 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC | $18,461 | $7,893 | $29,841 | −38% | $18,017 | +2% | — |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $18,339 | $13,461 | $24,805 | −26% | $29,031 | −37% | — |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $18,152 | $7,685 | $31,625 | −43% | $21,886 | −17% | ≈131% of Medicare |
| 723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC | $18,129 | $8,629 | $25,069 | −28% | $19,317 | −6% | — |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $18,089 | $7,915 | $22,434 | −19% | $19,091 | −5% | — |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $18,016 | $7,898 | $30,957 | −42% | $23,469 | −23% | ≈160% of Medicare |
| 382 | COMPLICATED PEPTIC ULCER WITHOUT CC/MCC | $18,016 | $6,053 | $21,832 | −17% | $16,634 | +8% | — |
| 909 | OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC | $17,960 | $9,632 | $27,953 | −36% | $28,156 | −36% | — |
| 670 | TRANSURETHRAL PROCEDURES WITHOUT CC/MCC | $17,915 | $7,476 | $23,429 | −24% | $20,371 | −12% | — |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $17,870 | $6,329 | $19,998 | −11% | $17,522 | +2% | — |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $17,785 | $7,078 | $27,616 | −36% | $17,412 | +2% | — |
| 644 | ENDOCRINE DISORDERS WITH CC | $17,768 | $8,012 | $24,634 | −28% | $22,941 | −23% | — |
| 566 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC | $17,704 | $6,045 | $24,435 | −28% | $14,337 | +23% | — |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | $17,696 | $10,043 | $35,677 | −50% | $24,480 | −28% | ≈154% of Medicare |
| 504 | FOOT PROCEDURES WITH CC | $17,686 | $12,988 | $36,434 | −51% | $36,598 | −52% | — |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $17,595 | $7,996 | $22,608 | −22% | $22,781 | −23% | ≈141% of Medicare |
| 388 | GASTROINTESTINAL OBSTRUCTION WITH MCC | $17,554 | $11,022 | $36,099 | −51% | $28,780 | −39% | — |
| 199 | PNEUMOTHORAX WITH MCC | $17,479 | $13,059 | $23,929 | −27% | $31,491 | −44% | — |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $17,450 | $7,250 | $25,875 | −33% | $20,488 | −15% | — |
| 425 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC | $17,424 | $11,545 | $44,272 | −61% | $25,484 | −32% | — |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $17,389 | $6,810 | $18,190 | −4% | $18,278 | −5% | — |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $17,337 | $7,919 | $19,942 | −13% | $20,732 | −16% | — |
| 683 | RENAL FAILURE WITH CC | $17,333 | $7,016 | $23,801 | −27% | $18,620 | −7% | ≈146% of Medicare |
| 520 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC | $17,287 | $10,769 | $47,828 | −64% | $31,816 | −46% | — |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $17,282 | $10,087 | $29,540 | −41% | $25,426 | −32% | — |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $17,282 | $9,201 | $21,336 | −19% | $26,488 | −35% | ≈148% of Medicare |
| 940 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC | $17,265 | $15,445 | $35,948 | −52% | $38,420 | −55% | — |
| 053 | SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC | $17,221 | $7,240 | $57,278 | −70% | $20,309 | −15% | — |
| 546 | CONNECTIVE TISSUE DISORDERS WITH CC | $17,146 | $8,869 | $30,441 | −44% | $24,202 | −29% | — |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $17,094 | $6,818 | $24,102 | −29% | $19,096 | −10% | — |
| 501 | MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY | $16,948 | $13,192 | $37,750 | −55% | $37,975 | −55% | — |
| 206 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | $16,925 | $7,132 | $18,520 | −9% | $17,731 | −5% | — |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $16,707 | $6,256 | $19,007 | −12% | $14,166 | +18% | — |
| 557 | TENDONITIS, MYOSITIS AND BURSITIS WITH MCC | $16,612 | $11,572 | $37,392 | −56% | $28,646 | −42% | — |
| 666 | PROSTATECTOMY WITH CC | $16,607 | $12,245 | $26,335 | −37% | $30,016 | −45% | — |
| 565 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | $16,447 | $7,918 | $24,741 | −34% | $21,545 | −24% | — |
| 694 | URINARY STONES WITHOUT MCC | $16,303 | $6,275 | $18,170 | −10% | $16,531 | −1% | — |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $16,246 | $12,204 | $36,515 | −56% | $28,967 | −44% | — |
| 868 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC | $16,245 | $8,127 | $26,077 | −38% | $22,231 | −27% | — |
| 775 | ALCOHOL ABUSE AND DEPENDENCE | $16,183 | — | $16,183 | +0% | $3,242 | +399% | — |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $16,180 | $8,187 | $24,816 | −35% | $24,136 | −33% | — |
| 623 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $16,148 | $14,076 | $61,034 | −74% | $33,165 | −51% | — |
| 555 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $16,009 | $10,172 | $23,563 | −32% | $23,723 | −33% | — |
| 436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | $15,996 | $8,662 | $25,169 | −36% | $24,017 | −33% | — |
| 311 | ANGINA PECTORIS | $15,909 | $5,702 | $35,368 | −55% | $15,165 | +5% | — |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $15,900 | $7,377 | $24,794 | −36% | $18,918 | −16% | — |
| 866 | VIRAL ILLNESS WITHOUT MCC | $15,894 | $6,987 | $18,465 | −14% | $16,391 | −3% | — |
| 869 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC | $15,882 | $5,848 | $24,303 | −35% | $12,537 | +27% | — |
| 627 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC | $15,787 | $9,622 | $62,207 | −75% | $25,623 | −38% | — |
| 139 | OTHER PNEUMONIA | $15,776 | $10,354 | $51,345 | −69% | $21,014 | −25% | — |
| 306 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | $15,770 | $11,211 | $23,112 | −32% | $24,450 | −36% | — |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $15,767 | $7,552 | $20,065 | −21% | $17,273 | −9% | — |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $15,662 | $6,503 | $25,421 | −38% | $18,081 | −13% | — |
| 543 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | $15,661 | $8,202 | $25,997 | −40% | $23,496 | −33% | — |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $15,649 | $13,686 | $25,688 | −39% | $30,974 | −49% | — |
| 638 | DIABETES WITH CC | $15,638 | $7,211 | $19,661 | −20% | $18,821 | −17% | ≈148% of Medicare |
| 069 | TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | $15,543 | $6,403 | $27,214 | −43% | $20,278 | −23% | — |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $15,460 | $7,730 | $33,537 | −54% | $20,968 | −26% | — |
| 434 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $15,427 | $5,689 | $15,427 | +0% | $12,405 | +24% | — |
| 102 | HEADACHES WITH MCC | $15,417 | $8,882 | $35,629 | −57% | $22,544 | −32% | — |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $15,367 | $1,091 | $20,286 | −24% | $24,836 | −38% | — |
| 312 | SYNCOPE AND COLLAPSE | $15,359 | $6,894 | $25,336 | −39% | $19,342 | −21% | ≈133% of Medicare |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $15,278 | $8,956 | $34,893 | −56% | $22,982 | −34% | ≈153% of Medicare |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $15,264 | $6,541 | $26,493 | −42% | $18,204 | −16% | ≈157% of Medicare |
| 200 | PNEUMOTHORAX WITH CC | $15,255 | $8,523 | $27,413 | −44% | $20,573 | −26% | — |
| 553 | BONE DISEASES AND ARTHROPATHIES WITH MCC | $15,153 | $9,892 | $21,902 | −31% | $23,956 | −37% | — |
| 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | $15,137 | $1,020 | $17,602 | −14% | $18,459 | −18% | — |
| 835 | ACUTE LEUKEMIA WITH CC | $15,128 | $15,128 | $30,915 | −51% | $35,569 | −57% | — |
| 054 | MIGRAINE AND OTHER HEADACHES | $15,009 | $11,223 | $22,651 | −34% | $29,484 | −49% | — |
| 149 | DYSEQUILIBRIUM | $14,946 | $6,041 | $29,050 | −49% | $17,203 | −13% | — |
| 203 | BRONCHITIS AND ASTHMA WITHOUT CC/MCC | $14,744 | $5,690 | $14,744 | +0% | $12,279 | +20% | — |
| 558 | TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | $14,631 | $6,843 | $18,608 | −21% | $17,367 | −16% | — |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $14,609 | $6,267 | $21,322 | −31% | $17,322 | −16% | ≈143% of Medicare |
| 247 | INTESTINAL OBSTRUCTION | $14,516 | — | $14,516 | +0% | $21,663 | −33% | — |
| 951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $14,511 | $4,796 | $14,284 | +2% | $9,385 | +55% | — |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $14,444 | $6,194 | $14,865 | −3% | $14,444 | +0% | — |
| 184 | MAJOR CHEST TRAUMA WITH CC | $14,362 | $8,251 | $27,435 | −48% | $20,842 | −31% | — |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $14,323 | $6,421 | $16,819 | −15% | $17,466 | −18% | ≈155% of Medicare |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $14,322 | $6,414 | $19,855 | −28% | $17,388 | −18% | — |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $14,298 | $5,277 | $25,214 | −43% | $14,134 | +1% | — |
| 395 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $14,234 | $5,275 | $15,702 | −9% | $14,128 | +1% | — |
| 465 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MC | $14,227 | $12,857 | $40,731 | −65% | $32,839 | −57% | — |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $14,212 | $8,074 | $36,977 | −62% | $23,141 | −39% | — |
| 881 | DEPRESSIVE NEUROSES | $14,155 | $1,081 | $17,523 | −19% | $15,058 | −6% | — |
| 101 | SEIZURES WITHOUT MCC | $14,153 | $7,242 | $21,606 | −34% | $19,954 | −29% | — |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $14,120 | $7,532 | $23,602 | −40% | $21,213 | −33% | — |
| 313 | CHEST PAIN | $14,100 | $5,806 | $16,104 | −12% | $15,962 | −12% | — |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $14,086 | $7,522 | $20,351 | −31% | $20,777 | −32% | — |
| 305 | HYPERTENSION WITHOUT MCC | $13,980 | $6,063 | $18,521 | −25% | $17,144 | −18% | — |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $13,968 | $5,633 | $21,806 | −36% | $19,483 | −28% | — |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $13,964 | $5,886 | $28,478 | −51% | $18,623 | −25% | — |
| 192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC | $13,896 | $5,349 | $14,410 | −4% | $14,368 | −3% | — |
| 072 | NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC | $13,795 | $6,059 | $26,429 | −48% | $16,654 | −17% | — |
| 292 | HEART FAILURE AND SHOCK WITH CC | $13,647 | $6,825 | $13,647 | +0% | $16,212 | −16% | — |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $13,428 | $5,128 | $20,809 | −35% | $15,070 | −11% | — |
| 603 | CELLULITIS WITHOUT MCC | $13,335 | $6,960 | $16,191 | −18% | $18,530 | −28% | ≈139% of Medicare |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $13,249 | $6,521 | $15,542 | −15% | $16,837 | −21% | — |
| 376 | DIGESTIVE MALIGNANCY WITHOUT CC/MCC | $13,223 | $6,975 | $15,608 | −15% | $15,608 | −15% | — |
| 593 | SKIN ULCERS WITH CC | $13,118 | $9,317 | $29,687 | −56% | $20,470 | −36% | — |
| 770 | DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE | $13,061 | $8,306 | $32,570 | −60% | $17,943 | −27% | — |
| 140 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE | $12,961 | $12,961 | $212,612 | −94% | $60,098 | −78% | — |
| 283 | OTHER DISORDERS OF THE LIVER | $12,958 | $12,958 | $67,548 | −81% | $35,014 | −63% | — |
| 639 | DIABETES WITHOUT CC/MCC | $12,728 | $5,207 | $18,483 | −31% | $13,910 | −9% | — |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $12,609 | $6,970 | $16,602 | −24% | $16,049 | −21% | — |
| 554 | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | $12,608 | $6,641 | $24,528 | −49% | $18,253 | −31% | — |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $12,588 | $4,660 | $14,096 | −11% | $13,318 | −5% | — |
| 885 | PSYCHOSES | $12,535 | $10,606 | $21,489 | −42% | $21,489 | −42% | — |
| 605 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | $12,451 | $7,256 | $34,431 | −64% | $19,287 | −35% | — |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | $12,393 | $6,275 | $14,282 | −13% | $16,745 | −26% | ≈138% of Medicare |
| 756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $12,370 | $1,020 | $34,540 | −64% | $15,589 | −21% | — |
| 923 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC | $12,222 | $7,919 | $17,707 | −31% | $16,571 | −26% | — |
| 078 | HYPERTENSIVE ENCEPHALOPATHY WITH CC | $12,144 | $7,767 | $26,587 | −54% | $17,434 | −30% | — |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $12,113 | $6,499 | $55,274 | −78% | $17,195 | −30% | — |
| 300 | PERIPHERAL VASCULAR DISORDERS WITH CC | $11,934 | $8,269 | $33,374 | −64% | $19,579 | −39% | — |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $11,924 | $5,794 | $18,755 | −36% | $14,473 | −18% | — |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $11,886 | $6,478 | $28,389 | −58% | $18,002 | −34% | — |
| 370 | MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC | $11,820 | $5,699 | $14,787 | −20% | $15,072 | −22% | — |
| 753 | BIPOLAR DISORDERS | $11,740 | $1,020 | $11,740 | — | $34,651 | −66% | — |
| 949 | AFTERCARE WITH CC/MCC | $11,660 | $8,326 | $20,718 | −44% | $23,953 | −51% | — |
| 133 | RESPIRATORY FAILURE | $11,524 | — | $56,370 | −80% | $23,289 | −51% | — |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $11,519 | $5,984 | $15,153 | −24% | $16,865 | −32% | ≈155% of Medicare |
| 581 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC | $11,511 | $10,810 | $29,013 | −60% | $25,243 | −54% | — |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $11,296 | $5,657 | $17,493 | −35% | $14,441 | −22% | — |
| 563 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | $11,255 | $7,050 | $29,722 | −62% | $18,803 | −40% | — |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $11,227 | $6,365 | $19,939 | −44% | $17,727 | −37% | ≈155% of Medicare |
| 684 | RENAL FAILURE WITHOUT CC/MCC | $11,206 | $5,075 | $14,416 | −22% | $13,623 | −18% | — |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $11,185 | $5,628 | $16,800 | −33% | $14,012 | −20% | — |
| 667 | PROSTATECTOMY WITHOUT CC/MCC | $11,126 | $7,973 | $16,534 | −33% | $16,703 | −33% | — |
| 384 | UNCOMPLICATED PEPTIC ULCER WITHOUT MCC | $11,066 | $6,883 | $28,128 | −61% | $19,305 | −43% | — |
| 134 | OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC | $11,012 | — | $11,012 | +0% | $23,289 | −53% | — |
| 187 | PLEURAL EFFUSION WITH CC | $10,980 | $7,809 | $27,513 | −60% | $21,467 | −49% | — |
| 908 | OTHER O.R. PROCEDURES FOR INJURIES WITH CC | $10,796 | $10,796 | $56,468 | −81% | $41,660 | −74% | — |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $10,783 | $5,180 | $10,783 | +0% | $13,824 | −22% | — |
| 301 | PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC | $10,606 | $5,806 | $22,258 | −52% | $15,607 | −32% | — |
| 751 | MAJOR DEPRESSIVE DISORDERS AND OTHER/UNSPECIFIED PSYCHOSES | $10,462 | $1,020 | $10,462 | — | $33,812 | −69% | — |
| 252 | OTHER VASCULAR PROCEDURES WITH MCC | $10,303 | $10,303 | $72,090 | −86% | $68,508 | −85% | — |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $10,294 | — | $47,867 | −78% | $23,734 | −57% | — |
| 303 | ATHEROSCLEROSIS WITHOUT MCC | $10,273 | $5,523 | $15,800 | −35% | $14,927 | −31% | — |
| 669 | TRANSURETHRAL PROCEDURES WITH CC | $10,192 | $10,192 | $33,509 | −70% | $34,354 | −70% | — |
| 469 | ACUTE KIDNEY INJURY | $10,092 | $10,092 | $55,229 | −82% | $65,254 | −85% | — |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $9,849 | $6,845 | $19,551 | −50% | $15,284 | −36% | — |
| 754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $9,838 | — | $34,177 | −71% | $29,476 | −67% | — |
| 550 | SEPTIC ARTHRITIS WITHOUT CC/MCC | $9,672 | $6,831 | $12,242 | −21% | $16,156 | −40% | — |
| 541 | OSTEOMYELITIS WITHOUT CC/MCC | $9,668 | $6,919 | $14,335 | −33% | $14,549 | −34% | — |
| 556 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC | $9,593 | $6,517 | $35,526 | −73% | $17,715 | −46% | — |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $9,469 | $7,243 | $26,910 | −65% | $20,463 | −54% | — |
| 544 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC | $9,282 | $6,097 | $41,201 | −77% | $16,776 | −45% | — |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $9,174 | $4,670 | $20,643 | −56% | $11,955 | −23% | — |
| 903 | WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC | $9,134 | $9,134 | $72,800 | −87% | $23,588 | −61% | — |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $9,109 | $6,986 | $22,957 | −60% | $15,045 | −39% | — |
| 095 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC | $8,957 | $8,957 | $124,137 | −93% | $47,583 | −81% | — |
| 158 | DENTAL AND ORAL DISEASES WITH CC | $8,882 | $7,372 | $20,087 | −56% | $17,700 | −50% | — |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $8,703 | $4,745 | $14,635 | −41% | $13,384 | −35% | ≈155% of Medicare |
| 058 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC | $8,659 | $8,659 | $79,883 | −89% | $29,609 | −71% | — |
| 538 | SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC | $8,598 | $5,517 | $25,293 | −66% | $11,909 | −28% | — |
| 882 | NEUROSES EXCEPT DEPRESSIVE | $8,414 | $1,040 | $14,170 | −41% | $15,680 | −46% | — |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $8,333 | $6,524 | $13,806 | −40% | $18,150 | −54% | — |
| 845 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC | $8,148 | $6,657 | $8,148 | +0% | $14,055 | −42% | — |
| 188 | PLEURAL EFFUSION WITHOUT CC/MCC | $6,820 | $5,949 | $18,488 | −63% | $14,110 | −52% | — |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $6,806 | $6,806 | $23,092 | −71% | $16,642 | −59% | — |
| 883 | DISORDERS OF PERSONALITY AND IMPULSE CONTROL | $6,342 | $1,193 | $26,584 | −76% | $22,698 | −72% | — |
| 316 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC | $5,706 | $5,594 | $12,501 | −54% | $12,797 | −55% | — |
| 540 | OSTEOMYELITIS WITH CC | $5,238 | $5,238 | $17,786 | −71% | $23,494 | −78% | — |
| 916 | ALLERGIC REACTIONS WITHOUT MCC | $3,945 | $3,945 | $15,633 | −75% | $13,890 | −72% | — |
Procedures with negotiated rates only
These 1 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 |
|---|---|---|---|
| 516 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | $2,482 – $19,975 · median $2,482 | 4 plans |
No procedures match that keyword.