Heritage Valley Sewickley — 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.

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 24 procedures, this hospital's negotiated rates average ≈166% 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% —
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% —
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% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $30,706 $14,416 $39,528 −22% $35,237 −13% ≈163% 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% ≈152% of Medicare
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% ≈160% 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% ≈166% 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% ≈165% 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% ≈153% 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% ≈147% 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% ≈173% 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% ≈166% 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% ≈201% 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% —
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% ≈169% 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% ≈163% 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% ≈160% of Medicare
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% —
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% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $15,278 $8,956 $34,893 −56% $22,982 −34% ≈180% of Medicare
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $15,264 $6,541 $26,493 −42% $18,204 −16% ≈188% 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% ≈165% 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% ≈196% 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% ≈179% of Medicare
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% ≈166% of Medicare
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% ≈189% 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% ≈183% 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% ≈187% 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% —
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% ≈192% 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
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