UPMC Northwest (Acute Care) — Pricing
863 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 863 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.
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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Showing all 863 procedures
Procedures with negotiated rates only
These 863 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 |
|---|---|---|---|
| 001 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC | $3,704 – $238,160 · median $211,922 | 10 plans |
| 002 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC | — | 10 plans |
| 003 | ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES | $3,704 – $259,102 · median $165,181 | 10 plans |
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES | $3,704 – $172,376 · median $107,941 | 10 plans |
| 005 | LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT | — | 10 plans |
| 006 | LIVER TRANSPLANT WITHOUT MCC | $3,704 – $39,787 · median $35,404 | 10 plans |
| 007 | LUNG TRANSPLANT | — | 10 plans |
| 008 | SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT | $3,704 – $47,995 · median $42,707 | 10 plans |
| 010 | PANCREAS TRANSPLANT | $3,704 – $61,321 · median $53,526 | 10 plans |
| 011 | TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC | $3,704 – $72,512 · median $42,755 | 10 plans |
| 012 | TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC | $3,704 – $58,957 · median $33,144 | 10 plans |
| 013 | TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC | $3,704 – $35,024 · median $22,787 | 10 plans |
| 014 | ALLOGENEIC BONE MARROW TRANSPLANT | — | 10 plans |
| 016 | AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC | — | 10 plans |
| 017 | AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC | $3,704 – $46,533 · median $41,074 | 10 plans |
| 018 | CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES | — | 10 plans |
| 019 | SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS | $3,704 – $60,973 · median $54,255 | 10 plans |
| 020 | INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC | $3,704 – $133,326 · median $61,500 | 10 plans |
| 021 | INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC | $3,704 – $100,819 · median $41,511 | 10 plans |
| 022 | INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC | $3,704 – $70,932 · median $25,082 | 10 plans |
| 023 | CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR | $3,704 – $74,282 · median $44,899 | 10 plans |
| 024 | CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC | $3,704 – $52,796 · median $30,783 | 10 plans |
| 025 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | $3,704 – $54,393 · median $35,711 | 10 plans |
| 026 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC | $3,704 – $37,367 · median $24,552 | 10 plans |
| 027 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC | $3,704 – $32,212 · median $20,001 | 10 plans |
| 028 | SPINAL PROCEDURES WITH MCC | $3,704 – $70,898 · median $47,057 | 10 plans |
| 029 | SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS | $3,704 – $41,133 · median $26,900 | 10 plans |
| 030 | SPINAL PROCEDURES WITHOUT CC/MCC | $3,704 – $23,760 · median $17,457 | 10 plans |
| 031 | VENTRICULAR SHUNT PROCEDURES WITH MCC | $3,704 – $47,815 · median $35,197 | 10 plans |
| 032 | VENTRICULAR SHUNT PROCEDURES WITH CC | $3,704 – $25,877 · median $16,959 | 10 plans |
| 033 | VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC | $3,704 – $21,642 · median $13,325 | 10 plans |
| 034 | CAROTID ARTERY STENT PROCEDURES WITH MCC | $3,704 – $68,051 · median $30,464 | 10 plans |
| 035 | CAROTID ARTERY STENT PROCEDURES WITH CC | $3,704 – $31,900 · median $18,973 | 10 plans |
| 036 | CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC | $3,704 – $22,979 · median $15,498 | 10 plans |
| 037 | EXTRACRANIAL PROCEDURES WITH MCC | $3,704 – $49,099 · median $25,972 | 10 plans |
| 038 | EXTRACRANIAL PROCEDURES WITH CC | $3,704 – $26,450 · median $13,012 | 10 plans |
| 039 | EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | $3,704 – $17,616 · median $9,542 | 10 plans |
| 040 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC | $3,704 – $44,621 · median $30,390 | 10 plans |
| 041 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR | $3,704 – $31,674 · median $17,484 | 10 plans |
| 042 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC | $3,704 – $20,202 · median $13,828 | 10 plans |
| 052 | SPINAL DISORDERS AND INJURIES WITH CC/MCC | $3,704 – $33,028 · median $14,477 | 10 plans |
| 053 | SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC | $3,704 – $17,269 · median $8,019 | 10 plans |
| 054 | NERVOUS SYSTEM NEOPLASMS WITH MCC | $3,704 – $15,134 · median $12,269 | 10 plans |
| 055 | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC | $3,704 – $13,225 · median $8,332 | 10 plans |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $3,704 – $30,251 · median $18,450 | 10 plans |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $3,704 – $19,247 · median $10,474 | 10 plans |
| 058 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC | $3,704 – $28,550 · median $13,687 | 10 plans |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $3,704 – $14,908 · median $10,049 | 10 plans |
| 060 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC | $3,704 – $13,260 · median $7,557 | 10 plans |
| 061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC | $3,704 – $40,213 · median $21,819 | 10 plans |
| 062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC | $3,704 – $29,904 · median $14,057 | 10 plans |
| 063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC | $3,704 – $28,029 · median $11,314 | 10 plans |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $3,704 – $24,367 · median $16,027 | 10 plans |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $3,704 – $15,308 · median $8,260 | 10 plans |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $3,704 – $11,958 · median $5,730 | 10 plans |
| 067 | PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC | $3,704 – $24,801 · median $11,818 | 10 plans |
| 068 | PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC | $3,704 – $13,190 · median $7,127 | 10 plans |
| 069 | TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | $3,704 – $11,871 · median $6,618 | 10 plans |
| 070 | OTHER CEREBROVASCULAR DISORDERS WITH MCC | $3,704 – $27,040 · median $13,340 | 10 plans |
| 071 | OTHER CEREBROVASCULAR DISORDERS WITH CC | $3,704 – $14,856 · median $8,382 | 10 plans |
| 072 | OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC | $3,704 – $11,489 · median $6,287 | 10 plans |
| 073 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC | $3,704 – $21,191 · median $12,870 | 10 plans |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $3,704 – $13,728 · median $8,419 | 10 plans |
| 075 | VIRAL MENINGITIS WITH CC/MCC | $3,704 – $19,837 · median $15,302 | 10 plans |
| 076 | VIRAL MENINGITIS WITHOUT CC/MCC | $3,704 – $10,552 · median $6,822 | 10 plans |
| 080 | NONTRAUMATIC STUPOR AND COMA WITH MCC | $3,704 – $36,204 · median $14,467 | 10 plans |
| 081 | NONTRAUMATIC STUPOR AND COMA WITHOUT MCC | $3,704 – $11,403 · median $7,370 | 10 plans |
| 082 | TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | $3,704 – $30,338 · median $18,159 | 10 plans |
| 083 | TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC | $3,704 – $19,056 · median $11,252 | 10 plans |
| 084 | TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC | $3,704 – $11,889 · median $7,837 | 10 plans |
| 085 | TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC | $3,704 – $24,454 · median $18,053 | 10 plans |
| 086 | TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | $3,704 – $15,186 · median $10,529 | 10 plans |
| 087 | TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC | $3,704 – $9,945 · median $7,518 | 10 plans |
| 088 | CONCUSSION WITH MCC | $3,704 – $22,337 · median $10,910 | 10 plans |
| 089 | CONCUSSION WITH CC | $3,704 – $12,600 · median $8,946 | 10 plans |
| 090 | CONCUSSION WITHOUT CC/MCC | $3,704 – $10,222 · median $6,807 | 10 plans |
| 091 | OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | $3,704 – $21,938 · median $14,049 | 10 plans |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $3,704 – $15,603 · median $8,359 | 10 plans |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $3,704 – $11,923 · median $6,599 | 10 plans |
| 094 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC | $3,704 – $49,377 · median $27,737 | 10 plans |
| 095 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC | $3,704 – $38,425 · median $20,438 | 10 plans |
| 096 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC | $3,704 – $35,371 · median $20,438 | 10 plans |
| 097 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC | $3,704 – $53,594 · median $28,454 | 10 plans |
| 098 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC | $3,704 – $28,706 · median $18,231 | 10 plans |
| 099 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC | $3,704 – $16,106 · median $10,992 | 10 plans |
| 100 | SEIZURES WITH MCC | $3,704 – $21,330 · median $15,451 | 10 plans |
| 101 | SEIZURES WITHOUT MCC | $3,704 – $9,459 · median $7,424 | 10 plans |
| 102 | HEADACHES WITH MCC | $3,704 – $15,568 · median $9,119 | 10 plans |
| 103 | HEADACHES WITHOUT MCC | $3,704 – $11,212 · median $6,909 | 10 plans |
| 113 | ORBITAL PROCEDURES WITH CC/MCC | $3,704 – $40,543 · median $18,667 | 10 plans |
| 114 | ORBITAL PROCEDURES WITHOUT CC/MCC | $3,704 – $21,903 · median $10,919 | 10 plans |
| 115 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT | $3,704 – $26,415 · median $12,332 | 10 plans |
| 116 | INTRAOCULAR PROCEDURES WITH CC/MCC | $3,704 – $31,344 · median $14,452 | 10 plans |
| 117 | INTRAOCULAR PROCEDURES WITHOUT CC/MCC | $3,704 – $19,091 · median $8,839 | 10 plans |
| 121 | ACUTE MAJOR EYE INFECTIONS WITH CC/MCC | $3,704 – $18,414 · median $9,447 | 10 plans |
| 122 | ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC | $3,704 – $10,587 · median $6,517 | 10 plans |
| 123 | NEUROLOGICAL EYE DISORDERS | $3,704 – $12,409 · median $6,616 | 10 plans |
| 124 | OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT | $3,704 – $23,343 · median $10,687 | 10 plans |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | $3,704 – $10,084 · median $6,377 | 10 plans |
| 135 | SINUS AND MASTOID PROCEDURES WITH CC/MCC | $3,704 – $42,764 · median $17,262 | 10 plans |
| 136 | SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC | $3,704 – $18,848 · median $8,299 | 10 plans |
| 137 | MOUTH PROCEDURES WITH CC/MCC | $3,704 – $13,711 · median $11,675 | 10 plans |
| 138 | MOUTH PROCEDURES WITHOUT CC/MCC | $3,704 – $10,344 · median $7,297 | 10 plans |
| 139 | SALIVARY GLAND PROCEDURES | $3,704 – $21,729 · median $10,009 | 10 plans |
| 140 | MAJOR HEAD AND NECK PROCEDURES WITH MCC | $3,704 – $69,422 · median $33,527 | 10 plans |
| 141 | MAJOR HEAD AND NECK PROCEDURES WITH CC | $3,704 – $32,056 · median $17,348 | 10 plans |
| 142 | MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC | $3,704 – $27,300 · median $12,809 | 10 plans |
| 143 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC | $3,704 – $41,740 · median $29,500 | 10 plans |
| 144 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC | $3,704 – $21,122 · median $13,869 | 10 plans |
| 145 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $15,447 · median $9,750 | 10 plans |
| 146 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC | $3,704 – $36,724 · median $16,853 | 10 plans |
| 147 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC | $3,704 – $21,087 · median $10,287 | 10 plans |
| 148 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC | $3,704 – $14,457 · median $6,605 | 10 plans |
| 149 | DYSEQUILIBRIUM | $3,704 – $10,118 · median $6,252 | 10 plans |
| 150 | EPISTAXIS WITH MCC | $3,704 – $23,361 · median $10,753 | 10 plans |
| 151 | EPISTAXIS WITHOUT MCC | $3,704 – $10,170 · median $6,115 | 10 plans |
| 152 | OTITIS MEDIA AND URI WITH MCC | $3,704 – $13,763 · median $9,594 | 10 plans |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $3,704 – $9,224 · median $6,147 | 10 plans |
| 154 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC | $3,704 – $26,606 · median $12,554 | 10 plans |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $3,704 – $10,413 · median $7,532 | 10 plans |
| 156 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC | $3,704 – $9,224 · median $5,782 | 10 plans |
| 157 | DENTAL AND ORAL DISEASES WITH MCC | $3,704 – $24,142 · median $13,744 | 10 plans |
| 158 | DENTAL AND ORAL DISEASES WITH CC | $3,704 – $10,708 · median $7,480 | 10 plans |
| 159 | DENTAL AND ORAL DISEASES WITHOUT CC/MCC | $3,704 – $9,224 · median $5,917 | 10 plans |
| 163 | MAJOR CHEST PROCEDURES WITH MCC | $3,704 – $56,979 · median $35,207 | 10 plans |
| 164 | MAJOR CHEST PROCEDURES WITH CC | $3,704 – $34,538 · median $20,010 | 10 plans |
| 165 | MAJOR CHEST PROCEDURES WITHOUT CC/MCC | $3,704 – $25,009 · median $15,276 | 10 plans |
| 166 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC | $3,704 – $45,871 · median $29,431 | 10 plans |
| 167 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC | $3,704 – $23,742 · median $14,416 | 10 plans |
| 168 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $18,345 · median $11,024 | 10 plans |
| 173 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM | $3,704 – $46,149 · median $23,521 | 10 plans |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $3,704 – $17,113 · median $11,079 | 10 plans |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $3,704 – $10,604 · median $6,666 | 10 plans |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $3,704 – $18,779 · median $12,547 | 10 plans |
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | $3,704 – $12,930 · median $7,994 | 10 plans |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $3,704 – $9,684 · median $6,278 | 10 plans |
| 180 | RESPIRATORY NEOPLASMS WITH MCC | $3,704 – $23,066 · median $14,125 | 10 plans |
| 181 | RESPIRATORY NEOPLASMS WITH CC | $3,704 – $15,950 · median $8,731 | 10 plans |
| 182 | RESPIRATORY NEOPLASMS WITHOUT CC/MCC | $3,704 – $13,694 · median $6,269 | 10 plans |
| 183 | MAJOR CHEST TRAUMA WITH MCC | $3,704 – $18,310 · median $12,293 | 10 plans |
| 184 | MAJOR CHEST TRAUMA WITH CC | $3,704 – $13,277 · median $8,678 | 10 plans |
| 185 | MAJOR CHEST TRAUMA WITHOUT CC/MCC | $3,704 – $10,379 · median $6,523 | 10 plans |
| 186 | PLEURAL EFFUSION WITH MCC | $3,704 – $18,223 · median $12,515 | 10 plans |
| 187 | PLEURAL EFFUSION WITH CC | $3,704 – $13,312 · median $8,095 | 10 plans |
| 188 | PLEURAL EFFUSION WITHOUT CC/MCC | $3,704 – $10,344 · median $5,985 | 10 plans |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $3,704 – $15,325 · median $10,007 | 10 plans |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $3,704 – $12,670 · median $9,016 | 10 plans |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $3,704 – $11,194 · median $6,961 | 10 plans |
| 192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC | $3,704 – $9,224 · median $5,401 | 10 plans |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $3,704 – $14,943 · median $10,620 | 10 plans |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $3,704 – $10,604 · median $6,673 | 10 plans |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $3,704 – $9,224 · median $5,296 | 10 plans |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $3,704 – $24,454 · median $15,066 | 10 plans |
| 197 | INTERSTITIAL LUNG DISEASE WITH CC | $3,704 – $14,249 · median $7,785 | 10 plans |
| 198 | INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC | $3,704 – $10,951 · median $5,977 | 10 plans |
| 199 | PNEUMOTHORAX WITH MCC | $3,704 – $18,189 · median $14,111 | 10 plans |
| 200 | PNEUMOTHORAX WITH CC | $3,704 – $12,409 · median $8,951 | 10 plans |
| 201 | PNEUMOTHORAX WITHOUT CC/MCC | $3,704 – $9,224 · median $5,968 | 10 plans |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $3,704 – $11,316 · median $7,956 | 10 plans |
| 203 | BRONCHITIS AND ASTHMA WITHOUT CC/MCC | $3,704 – $9,224 · median $5,618 | 10 plans |
| 204 | RESPIRATORY SIGNS AND SYMPTOMS | $3,704 – $10,170 · median $6,685 | 10 plans |
| 205 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC | $3,704 – $19,542 · median $14,630 | 10 plans |
| 206 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | $3,704 – $10,986 · median $7,723 | 10 plans |
| 207 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | $3,704 – $98,163 · median $50,367 | 10 plans |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $3,704 – $33,930 · median $21,754 | 10 plans |
| 209 | COMPLEX AORTIC ARCH PROCEDURES | — | 10 plans |
| 212 | CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES | $3,704 – $187,475 · median $84,829 | 10 plans |
| 213 | ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES | $3,704 – $48,862 · median $43,479 | 10 plans |
| 215 | OTHER HEART ASSIST SYSTEM IMPLANT | $3,704 – $92,853 · median $75,558 | 10 plans |
| 216 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC | $3,704 – $119,025 · median $76,357 | 10 plans |
| 217 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC | $3,704 – $78,083 · median $51,459 | 10 plans |
| 218 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC | $3,704 – $70,915 · median $51,459 | 10 plans |
| 219 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC | $3,704 – $82,248 · median $60,021 | 10 plans |
| 220 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC | $3,704 – $64,615 · median $41,813 | 10 plans |
| 221 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC | $3,704 – $51,355 · median $39,542 | 10 plans |
| 228 | OTHER CARDIOTHORACIC PROCEDURES WITH MCC | $3,704 – $88,913 · median $38,822 | 10 plans |
| 229 | OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC | $3,704 – $47,468 · median $24,865 | 10 plans |
| 231 | CORONARY BYPASS WITH PTCA WITH MCC | $3,704 – $122,913 · median $65,855 | 10 plans |
| 232 | CORONARY BYPASS WITH PTCA WITHOUT MCC | $3,704 – $82,786 · median $47,479 | 10 plans |
| 233 | CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | $3,704 – $84,869 · median $59,764 | 10 plans |
| 234 | CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC | $3,704 – $66,212 · median $42,822 | 10 plans |
| 235 | CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC | $3,704 – $64,858 · median $45,973 | 10 plans |
| 236 | CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | $3,704 – $50,835 · median $32,933 | 10 plans |
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | $3,704 – $55,347 · median $38,622 | 10 plans |
| 240 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC | $3,704 – $34,572 · median $22,544 | 10 plans |
| 241 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC | $3,704 – $25,790 · median $11,163 | 10 plans |
| 242 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | $3,704 – $45,767 · median $25,201 | 10 plans |
| 243 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | $3,704 – $33,826 · median $16,958 | 10 plans |
| 244 | PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | $3,704 – $29,574 · median $14,448 | 10 plans |
| 245 | AICD GENERATOR PROCEDURES | $3,704 – $83,567 · median $35,833 | 10 plans |
| 250 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC | $3,704 – $31,657 · median $17,359 | 10 plans |
| 251 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC | $3,704 – $25,669 · median $12,018 | 10 plans |
| 252 | OTHER VASCULAR PROCEDURES WITH MCC | $3,704 – $51,182 · median $27,495 | 10 plans |
| 253 | OTHER VASCULAR PROCEDURES WITH CC | $3,704 – $36,412 · median $20,565 | 10 plans |
| 254 | OTHER VASCULAR PROCEDURES WITHOUT CC/MCC | $3,704 – $25,200 · median $14,247 | 10 plans |
| 255 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC | $3,704 – $32,594 · median $21,356 | 10 plans |
| 256 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC | $3,704 – $17,304 · median $13,597 | 10 plans |
| 257 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC | $3,704 – $12,704 · median $8,896 | 10 plans |
| 258 | CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC | $3,704 – $49,325 · median $24,808 | 10 plans |
| 259 | CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC | $3,704 – $33,080 · median $16,113 | 10 plans |
| 260 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC | $3,704 – $50,227 · median $25,667 | 10 plans |
| 261 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC | $3,704 – $26,658 · median $15,092 | 10 plans |
| 262 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC | $3,704 – $23,690 · median $13,069 | 10 plans |
| 263 | VEIN LIGATION AND STRIPPING | $3,704 – $46,617 · median $24,150 | 10 plans |
| 264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $3,704 – $31,986 · median $25,964 | 10 plans |
| 265 | AICD LEAD PROCEDURES | $3,704 – $60,276 · median $28,504 | 10 plans |
| 266 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | $3,704 – $77,215 · median $47,989 | 10 plans |
| 267 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | $3,704 – $69,544 · median $37,373 | 10 plans |
| 268 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC | $3,704 – $95,577 · median $53,808 | 10 plans |
| 269 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | $3,704 – $50,783 · median $33,200 | 10 plans |
| 270 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | $3,704 – $61,769 · median $41,375 | 10 plans |
| 271 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | $3,704 – $50,123 · median $28,023 | 10 plans |
| 272 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC | $3,704 – $36,499 · median $20,235 | 10 plans |
| 273 | PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC | $3,704 – $63,643 · median $32,442 | 10 plans |
| 274 | PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | $3,704 – $44,326 · median $25,969 | 10 plans |
| 275 | CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC | $3,704 – $107,466 · median $55,768 | 10 plans |
| 276 | CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR | $3,704 – $92,610 · median $47,044 | 10 plans |
| 277 | CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC | $3,704 – $71,470 · median $36,269 | 10 plans |
| 278 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC | $3,704 – $79,766 · median $43,625 | 10 plans |
| 279 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC | $3,704 – $55,573 · median $28,412 | 10 plans |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $3,704 – $19,022 · median $12,869 | 10 plans |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $3,704 – $13,121 · median $7,552 | 10 plans |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $3,704 – $11,837 · median $6,030 | 10 plans |
| 283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC | $3,704 – $27,005 · median $15,793 | 10 plans |
| 284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC | $3,704 – $12,808 · median $5,790 | 10 plans |
| 285 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC | $3,704 – $9,224 · median $5,066 | 10 plans |
| 286 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | $3,704 – $24,385 · median $17,594 | 10 plans |
| 287 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | $3,704 – $14,874 · median $8,724 | 10 plans |
| 288 | ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC | $3,704 – $36,655 · median $21,424 | 10 plans |
| 289 | ACUTE AND SUBACUTE ENDOCARDITIS WITH CC | $3,704 – $18,067 · median $13,667 | 10 plans |
| 290 | ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC | $3,704 – $17,512 · median $7,634 | 10 plans |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $3,704 – $14,700 · median $10,382 | 10 plans |
| 292 | HEART FAILURE AND SHOCK WITH CC | $3,704 – $10,032 · median $7,008 | 10 plans |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $3,704 – $9,224 · median $4,810 | 10 plans |
| 296 | CARDIAC ARREST, UNEXPLAINED WITH MCC | $3,704 – $25,808 · median $12,541 | 10 plans |
| 297 | CARDIAC ARREST, UNEXPLAINED WITH CC | $3,704 – $12,149 · median $5,338 | 10 plans |
| 298 | CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC | $3,573 – $9,224 · median $3,949 | 10 plans |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $3,704 – $15,273 · median $12,728 | 10 plans |
| 300 | PERIPHERAL VASCULAR DISORDERS WITH CC | $3,704 – $12,253 · median $8,704 | 10 plans |
| 301 | PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC | $3,704 – $9,224 · median $6,004 | 10 plans |
| 302 | ATHEROSCLEROSIS WITH MCC | $3,704 – $19,924 · median $9,705 | 10 plans |
| 303 | ATHEROSCLEROSIS WITHOUT MCC | $3,704 – $9,224 · median $5,643 | 10 plans |
| 304 | HYPERTENSION WITH MCC | $3,704 – $14,023 · median $9,654 | 10 plans |
| 305 | HYPERTENSION WITHOUT MCC | $3,704 – $9,997 · median $6,279 | 10 plans |
| 306 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | $3,704 – $25,114 · median $12,649 | 10 plans |
| 307 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC | $3,704 – $15,481 · median $7,506 | 10 plans |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $3,704 – $13,642 · median $9,763 | 10 plans |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $3,704 – $9,224 · median $6,128 | 10 plans |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $3,704 – $9,224 · median $4,811 | 10 plans |
| 311 | ANGINA PECTORIS | $3,704 – $9,224 · median $5,866 | 10 plans |
| 312 | SYNCOPE AND COLLAPSE | $3,704 – $11,212 · median $7,183 | 10 plans |
| 313 | CHEST PAIN | $3,704 – $9,224 · median $6,006 | 10 plans |
| 314 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | $3,704 – $25,218 · median $16,603 | 10 plans |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $3,704 – $13,121 · median $7,895 | 10 plans |
| 316 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC | $3,704 – $11,472 · median $5,712 | 10 plans |
| 317 | CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION | — | 10 plans |
| 318 | PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE | $3,704 – $21,001 · median $18,687 | 10 plans |
| 319 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC | $3,704 – $75,341 · median $35,061 | 10 plans |
| 320 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC | $3,704 – $40,387 · median $19,088 | 10 plans |
| 321 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES | $3,704 – $42,816 · median $21,537 | 10 plans |
| 322 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | $3,704 – $31,761 · median $14,102 | 10 plans |
| 323 | CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC | $3,704 – $67,756 · median $34,009 | 10 plans |
| 324 | CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC | $3,704 – $52,483 · median $24,877 | 10 plans |
| 325 | CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE | $3,704 – $46,843 · median $25,338 | 10 plans |
| 326 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC | $3,704 – $63,435 · median $39,132 | 10 plans |
| 327 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | $3,704 – $34,243 · median $19,390 | 10 plans |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $3,704 – $21,226 · median $12,855 | 10 plans |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $3,704 – $49,984 · median $36,098 | 10 plans |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $3,704 – $30,737 · median $19,025 | 10 plans |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $3,704 – $23,100 · median $13,480 | 10 plans |
| 332 | RECTAL RESECTION WITH MCC | $3,704 – $65,240 · median $28,523 | 10 plans |
| 333 | RECTAL RESECTION WITH CC | $3,704 – $36,464 · median $18,598 | 10 plans |
| 334 | RECTAL RESECTION WITHOUT CC/MCC | $3,704 – $21,521 · median $13,131 | 10 plans |
| 335 | PERITONEAL ADHESIOLYSIS WITH MCC | $3,704 – $39,033 · median $28,136 | 10 plans |
| 336 | PERITONEAL ADHESIOLYSIS WITH CC | $3,704 – $25,929 · median $16,786 | 10 plans |
| 337 | PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | $3,704 – $19,942 · median $12,332 | 10 plans |
| 344 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $3,704 – $47,294 · median $20,466 | 10 plans |
| 345 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $3,704 – $19,768 · median $12,097 | 10 plans |
| 346 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $3,704 – $16,748 · median $9,625 | 10 plans |
| 347 | ANAL AND STOMAL PROCEDURES WITH MCC | $3,704 – $43,215 · median $18,237 | 10 plans |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $3,704 – $16,627 · median $10,576 | 10 plans |
| 349 | ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC | $3,704 – $12,722 · median $7,175 | 10 plans |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $3,704 – $41,775 · median $19,760 | 10 plans |
| 351 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC | $3,704 – $24,905 · median $12,251 | 10 plans |
| 352 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC | $3,704 – $14,926 · median $9,482 | 10 plans |
| 353 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC | $3,704 – $39,467 · median $22,944 | 10 plans |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $3,704 – $21,295 · median $13,477 | 10 plans |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $3,704 – $17,790 · median $10,857 | 10 plans |
| 356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC | $3,704 – $48,440 · median $34,516 | 10 plans |
| 357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC | $3,704 – $24,593 · median $18,469 | 10 plans |
| 358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $18,206 · median $11,268 | 10 plans |
| 359 | PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC | $3,704 – $29,622 · median $26,359 | 10 plans |
| 360 | PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC | $3,704 – $20,934 · median $18,628 | 10 plans |
| 368 | MAJOR ESOPHAGEAL DISORDERS WITH MCC | $3,704 – $21,070 · median $12,774 | 10 plans |
| 369 | MAJOR ESOPHAGEAL DISORDERS WITH CC | $3,704 – $13,971 · median $8,182 | 10 plans |
| 370 | MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC | $3,704 – $11,941 · median $5,857 | 10 plans |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $3,704 – $21,486 · median $14,181 | 10 plans |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $3,704 – $12,513 · median $8,343 | 10 plans |
| 373 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC | $3,704 – $9,251 · median $6,064 | 10 plans |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $3,704 – $26,381 · median $17,019 | 10 plans |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $3,704 – $15,585 · median $9,806 | 10 plans |
| 376 | DIGESTIVE MALIGNANCY WITHOUT CC/MCC | $3,704 – $12,999 · median $7,592 | 10 plans |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $3,704 – $23,257 · median $14,607 | 10 plans |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $3,704 – $13,364 · median $8,030 | 10 plans |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $3,704 – $9,424 · median $5,311 | 10 plans |
| 380 | COMPLICATED PEPTIC ULCER WITH MCC | $3,704 – $23,795 · median $15,649 | 10 plans |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $3,704 – $13,190 · median $8,828 | 10 plans |
| 382 | COMPLICATED PEPTIC ULCER WITHOUT CC/MCC | $3,704 – $10,431 · median $6,632 | 10 plans |
| 383 | UNCOMPLICATED PEPTIC ULCER WITH MCC | $3,704 – $23,309 · median $11,135 | 10 plans |
| 384 | UNCOMPLICATED PEPTIC ULCER WITHOUT MCC | $3,704 – $11,038 · median $7,053 | 10 plans |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $3,704 – $18,449 · median $12,699 | 10 plans |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $3,704 – $12,878 · median $7,996 | 10 plans |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $3,704 – $9,251 · median $5,706 | 10 plans |
| 388 | GASTROINTESTINAL OBSTRUCTION WITH MCC | $3,704 – $15,880 · median $11,881 | 10 plans |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $3,704 – $9,224 · median $6,548 | 10 plans |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $3,704 – $9,224 · median $4,640 | 10 plans |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $3,704 – $15,169 · median $10,262 | 10 plans |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $3,704 – $9,224 · median $6,469 | 10 plans |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $3,704 – $21,382 · median $12,831 | 10 plans |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $3,704 – $11,489 · median $7,681 | 10 plans |
| 395 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $3,704 – $9,389 · median $5,455 | 10 plans |
| 397 | APPENDIX PROCEDURES WITH MCC | $3,704 – $24,124 · median $19,007 | 10 plans |
| 398 | APPENDIX PROCEDURES WITH CC | $3,704 – $21,452 · median $12,166 | 10 plans |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $3,704 – $15,412 · median $9,303 | 10 plans |
| 402 | SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL | $3,704 – $45,749 · median $31,626 | 10 plans |
| 405 | PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC | $3,704 – $75,202 · median $42,882 | 10 plans |
| 406 | PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC | $3,704 – $39,397 · median $22,930 | 10 plans |
| 407 | PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC | $3,704 – $29,991 · median $17,647 | 10 plans |
| 408 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC | $3,704 – $59,044 · median $28,095 | 10 plans |
| 409 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC | $3,704 – $30,581 · median $17,318 | 10 plans |
| 410 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC | $3,704 – $25,530 · median $12,741 | 10 plans |
| 411 | CHOLECYSTECTOMY WITH C.D.E. WITH MCC | $3,704 – $54,913 · median $26,059 | 10 plans |
| 412 | CHOLECYSTECTOMY WITH C.D.E. WITH CC | $3,704 – $37,662 · median $16,738 | 10 plans |
| 413 | CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC | $3,704 – $27,890 · median $13,307 | 10 plans |
| 414 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC | $3,704 – $53,837 · median $28,072 | 10 plans |
| 415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC | $3,704 – $26,519 · median $16,460 | 10 plans |
| 416 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC | $3,704 – $20,098 · median $10,999 | 10 plans |
| 417 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | $3,704 – $27,196 · median $18,941 | 10 plans |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $3,704 – $22,146 · median $13,548 | 10 plans |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $3,704 – $18,414 · median $11,019 | 10 plans |
| 420 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC | $3,704 – $58,002 · median $26,865 | 10 plans |
| 421 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC | $3,704 – $29,157 · median $13,904 | 10 plans |
| 422 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC | $3,704 – $24,714 · median $11,280 | 10 plans |
| 423 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC | $3,704 – $60,762 · median $32,655 | 10 plans |
| 424 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC | $3,704 – $36,881 · median $17,401 | 10 plans |
| 425 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $26,780 · median $12,063 | 10 plans |
| 426 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE | $3,704 – $93,940 · median $83,590 | 10 plans |
| 427 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC | $3,704 – $69,874 · median $56,452 | 10 plans |
| 428 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC | — | 10 plans |
| 429 | COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC | — | 10 plans |
| 430 | COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC | — | 10 plans |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $3,704 – $25,391 · median $15,695 | 10 plans |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $3,704 – $13,832 · median $8,616 | 10 plans |
| 434 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $3,704 – $11,698 · median $5,948 | 10 plans |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $3,704 – $22,198 · median $14,674 | 10 plans |
| 436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | $3,704 – $14,544 · median $9,198 | 10 plans |
| 437 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC | $3,704 – $13,780 · median $7,041 | 10 plans |
| 438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | $3,704 – $24,003 · median $13,071 | 10 plans |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $3,704 – $11,351 · median $6,947 | 10 plans |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $3,704 – $9,224 · median $5,241 | 10 plans |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $3,704 – $26,294 · median $14,348 | 10 plans |
| 442 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | $3,704 – $13,485 · median $7,911 | 10 plans |
| 443 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $3,704 – $11,142 · median $5,849 | 10 plans |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $3,704 – $20,723 · median $13,387 | 10 plans |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $3,704 – $14,388 · median $8,913 | 10 plans |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $3,704 – $12,218 · median $6,839 | 10 plans |
| 447 | MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE | — | 10 plans |
| 448 | MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $3,704 – $46,166 · median $33,337 | 10 plans |
| 450 | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE | — | 10 plans |
| 451 | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $3,704 – $35,423 · median $25,493 | 10 plans |
| 456 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC | $3,704 – $118,296 · median $65,650 | 10 plans |
| 457 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC | $3,704 – $86,032 · median $46,706 | 10 plans |
| 458 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC | $3,704 – $77,771 · median $32,807 | 10 plans |
| 461 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC | $3,704 – $110,868 · median $43,290 | 10 plans |
| 462 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC | $3,704 – $33,115 · median $21,065 | 10 plans |
| 463 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC | $3,704 – $63,331 · median $44,660 | 10 plans |
| 464 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC | $3,704 – $36,551 · median $24,595 | 10 plans |
| 465 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $3,704 – $24,159 · median $14,573 | 10 plans |
| 466 | REVISION OF HIP OR KNEE REPLACEMENT WITH MCC | $3,704 – $55,937 · median $40,824 | 10 plans |
| 467 | REVISION OF HIP OR KNEE REPLACEMENT WITH CC | $3,704 – $36,950 · median $27,792 | 10 plans |
| 468 | REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | $3,704 – $30,008 · median $21,748 | 10 plans |
| 469 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT | $3,704 – $38,547 · median $23,962 | 10 plans |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | $3,704 – $20,931 · median $15,390 | 10 plans |
| 471 | CERVICAL SPINAL FUSION WITH MCC | $3,704 – $51,928 · median $37,900 | 10 plans |
| 472 | CERVICAL SPINAL FUSION WITH CC | $3,704 – $33,340 · median $23,286 | 10 plans |
| 473 | CERVICAL SPINAL FUSION WITHOUT CC/MCC | $3,704 – $26,936 · median $19,368 | 10 plans |
| 474 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC | $3,704 – $49,620 · median $33,741 | 10 plans |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $3,704 – $27,109 · median $18,082 | 10 plans |
| 476 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $3,704 – $20,462 · median $9,578 | 10 plans |
| 477 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $3,704 – $42,348 · median $27,234 | 10 plans |
| 478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $3,704 – $28,133 · median $19,507 | 10 plans |
| 479 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $3,704 – $21,747 · median $14,847 | 10 plans |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $3,704 – $44,239 · median $23,024 | 10 plans |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $3,704 – $31,032 · median $16,676 | 10 plans |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $3,704 – $22,476 · median $13,078 | 10 plans |
| 483 | MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | $3,704 – $25,634 · median $21,327 | 10 plans |
| 485 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC | $3,704 – $56,979 · median $25,468 | 10 plans |
| 486 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC | $3,704 – $24,454 · median $16,649 | 10 plans |
| 487 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC | $3,704 – $18,397 · median $12,575 | 10 plans |
| 488 | KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC | $3,704 – $32,143 · median $13,756 | 10 plans |
| 489 | KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC | $3,704 – $19,056 · median $9,087 | 10 plans |
| 492 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC | $3,704 – $40,334 · median $28,918 | 10 plans |
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | $3,704 – $32,819 · median $20,104 | 10 plans |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $3,704 – $23,066 · median $15,992 | 10 plans |
| 495 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC | $3,704 – $62,064 · median $28,562 | 10 plans |
| 496 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC | $3,704 – $23,135 · median $14,420 | 9 plans |
| 497 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC | $3,704 – $18,380 · median $9,787 | 9 plans |
| 498 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC | $3,704 – $44,448 · median $23,836 | 9 plans |
| 499 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC | $3,704 – $21,590 · median $16,058 | 9 plans |
| 500 | SOFT TISSUE PROCEDURES WITH MCC | $3,704 – $37,037 · median $24,985 | 9 plans |
| 501 | SOFT TISSUE PROCEDURES WITH CC | $3,704 – $22,528 · median $13,987 | 9 plans |
| 502 | SOFT TISSUE PROCEDURES WITHOUT CC/MCC | $3,704 – $16,852 · median $10,865 | 9 plans |
| 503 | FOOT PROCEDURES WITH MCC | $3,704 – $41,862 · median $22,084 | 9 plans |
| 504 | FOOT PROCEDURES WITH CC | $3,704 – $21,313 · median $14,927 | 9 plans |
| 505 | FOOT PROCEDURES WITHOUT CC/MCC | $3,704 – $19,855 · median $14,334 | 9 plans |
| 506 | MAJOR THUMB OR JOINT PROCEDURES | $3,704 – $25,252 · median $10,739 | 9 plans |
| 507 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC | $3,704 – $34,972 · median $14,440 | 9 plans |
| 508 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC | $3,704 – $24,367 · median $12,173 | 9 plans |
| 510 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC | $3,704 – $48,387 · median $23,865 | 9 plans |
| 511 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC | $3,704 – $25,808 · median $16,559 | 9 plans |
| 512 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC | $3,704 – $18,866 · median $13,268 | 9 plans |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $3,704 – $16,193 · median $12,638 | 9 plans |
| 514 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC | $3,704 – $12,652 · median $8,353 | 9 plans |
| 515 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC | $3,704 – $43,823 · median $25,157 | 9 plans |
| 516 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | $3,704 – $28,758 · median $16,549 | 9 plans |
| 517 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $18,241 · median $12,346 | 9 plans |
| 518 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR | $3,704 – $36,603 · median $29,429 | 9 plans |
| 519 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | $3,704 – $23,881 · median $15,944 | 9 plans |
| 520 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC | $3,704 – $16,332 · median $12,014 | 9 plans |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $3,704 – $46,374 · median $22,698 | 9 plans |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $3,704 – $28,741 · median $16,856 | 9 plans |
| 533 | FRACTURES OF FEMUR WITH MCC | $3,704 – $26,519 · median $12,587 | 9 plans |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $3,704 – $12,305 · median $6,674 | 9 plans |
| 535 | FRACTURES OF HIP AND PELVIS WITH MCC | $3,704 – $20,011 · median $10,369 | 9 plans |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $3,704 – $10,431 · median $6,686 | 9 plans |
| 537 | SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC | $3,704 – $16,557 · median $7,825 | 9 plans |
| 538 | SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC | $3,704 – $12,149 · median $6,008 | 9 plans |
| 539 | OSTEOMYELITIS WITH MCC | $3,704 – $20,376 · median $15,707 | 9 plans |
| 540 | OSTEOMYELITIS WITH CC | $3,704 – $13,694 · median $10,480 | 9 plans |
| 541 | OSTEOMYELITIS WITHOUT CC/MCC | $3,704 – $9,719 · median $6,529 | 9 plans |
| 542 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | $3,704 – $26,311 · median $14,130 | 9 plans |
| 543 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | $3,704 – $16,575 · median $8,397 | 9 plans |
| 544 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC | $3,704 – $13,329 · median $6,275 | 9 plans |
| 545 | CONNECTIVE TISSUE DISORDERS WITH MCC | $3,704 – $41,463 · median $19,682 | 9 plans |
| 546 | CONNECTIVE TISSUE DISORDERS WITH CC | $3,704 – $16,974 · median $9,371 | 9 plans |
| 547 | CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $3,704 – $14,162 · median $6,908 | 9 plans |
| 548 | SEPTIC ARTHRITIS WITH MCC | $3,704 – $33,167 · median $15,406 | 9 plans |
| 549 | SEPTIC ARTHRITIS WITH CC | $3,704 – $15,585 · median $9,788 | 9 plans |
| 550 | SEPTIC ARTHRITIS WITHOUT CC/MCC | $3,704 – $13,346 · median $7,202 | 9 plans |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $3,704 – $21,347 · median $13,428 | 9 plans |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $3,704 – $10,969 · median $7,879 | 9 plans |
| 553 | BONE DISEASES AND ARTHROPATHIES WITH MCC | $3,704 – $22,927 · median $10,480 | 9 plans |
| 554 | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | $3,704 – $10,518 · median $6,861 | 9 plans |
| 555 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $3,704 – $23,690 · median $10,678 | 9 plans |
| 556 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC | $3,704 – $11,455 · median $6,865 | 9 plans |
| 557 | TENDONITIS, MYOSITIS AND BURSITIS WITH MCC | $3,704 – $16,766 · median $11,959 | 9 plans |
| 558 | TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | $3,704 – $8,036 · median $7,248 | 9 plans |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $3,704 – $24,541 · median $14,894 | 9 plans |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $3,704 – $14,284 · median $9,159 | 9 plans |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $3,704 – $11,507 · median $6,657 | 9 plans |
| 562 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC | $3,704 – $20,636 · median $11,477 | 9 plans |
| 563 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | $3,704 – $10,622 · median $7,368 | 9 plans |
| 564 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC | $3,704 – $24,905 · median $12,400 | 9 plans |
| 565 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | $3,704 – $12,774 · median $7,981 | 9 plans |
| 566 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC | $3,704 – $11,229 · median $6,233 | 9 plans |
| 570 | SKIN DEBRIDEMENT WITH MCC | $3,704 – $34,034 · median $23,248 | 9 plans |
| 571 | SKIN DEBRIDEMENT WITH CC | $3,704 – $17,512 · median $13,532 | 9 plans |
| 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | $3,704 – $15,030 · median $9,315 | 9 plans |
| 573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC | $3,704 – $101,635 · median $51,275 | 9 plans |
| 574 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC | $3,704 – $56,493 · median $27,365 | 9 plans |
| 575 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | $3,704 – $32,646 · median $14,167 | 9 plans |
| 576 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC | $3,704 – $94,987 · median $38,465 | 9 plans |
| 577 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC | $3,704 – $40,439 · median $20,994 | 9 plans |
| 578 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | $3,704 – $28,220 · median $12,887 | 9 plans |
| 579 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC | $3,704 – $31,796 · median $25,557 | 9 plans |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $3,704 – $23,204 · median $13,831 | 9 plans |
| 581 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC | $3,704 – $19,456 · median $11,619 | 9 plans |
| 582 | MASTECTOMY FOR MALIGNANCY WITH CC/MCC | $3,704 – $36,482 · median $15,373 | 9 plans |
| 583 | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC | $3,704 – $32,941 · median $13,803 | 9 plans |
| 584 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC | $3,704 – $39,744 · median $17,035 | 9 plans |
| 585 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC | $3,704 – $34,659 · median $15,392 | 9 plans |
| 592 | SKIN ULCERS WITH MCC | $3,704 – $19,438 · median $15,440 | 9 plans |
| 593 | SKIN ULCERS WITH CC | $3,704 – $11,871 · median $9,626 | 9 plans |
| 594 | SKIN ULCERS WITHOUT CC/MCC | $3,704 – $8,070 · median $7,046 | 9 plans |
| 595 | MAJOR SKIN DISORDERS WITH MCC | $3,704 – $36,881 · median $16,880 | 9 plans |
| 596 | MAJOR SKIN DISORDERS WITHOUT MCC | $3,704 – $10,899 · median $8,820 | 9 plans |
| 597 | MALIGNANT BREAST DISORDERS WITH MCC | $3,704 – $28,654 · median $13,358 | 9 plans |
| 598 | MALIGNANT BREAST DISORDERS WITH CC | $3,704 – $14,822 · median $9,199 | 9 plans |
| 599 | MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $3,704 – $12,774 · median $6,307 | 9 plans |
| 600 | NON-MALIGNANT BREAST DISORDERS WITH CC/MCC | $3,704 – $11,056 · median $8,503 | 9 plans |
| 601 | NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $3,704 – $6,161 · median $5,057 | 9 plans |
| 602 | CELLULITIS WITH MCC | $3,704 – $18,709 · median $11,450 | 9 plans |
| 603 | CELLULITIS WITHOUT MCC | $3,704 – $8,539 · median $7,078 | 9 plans |
| 604 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC | $3,704 – $25,409 · median $11,845 | 9 plans |
| 605 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | $3,704 – $10,344 · median $7,528 | 9 plans |
| 606 | MINOR SKIN DISORDERS WITH MCC | $3,704 – $24,732 · median $12,164 | 9 plans |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $3,704 – $9,112 · median $7,424 | 9 plans |
| 614 | ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC | $3,704 – $32,021 · median $17,432 | 9 plans |
| 615 | ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC | $3,704 – $23,777 · median $11,279 | 9 plans |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $3,704 – $39,692 · median $27,489 | 9 plans |
| 617 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $3,704 – $20,115 · median $14,936 | 9 plans |
| 618 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC | $3,704 – $12,687 · median $11,268 | 9 plans |
| 619 | O.R. PROCEDURES FOR OBESITY WITH MCC | $3,704 – $37,974 · median $22,832 | 9 plans |
| 620 | O.R. PROCEDURES FOR OBESITY WITH CC | $3,704 – $22,163 · median $12,840 | 9 plans |
| 621 | O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC | $3,704 – $17,894 · median $12,126 | 9 plans |
| 622 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC | $3,704 – $34,867 · median $28,047 | 9 plans |
| 623 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | $3,704 – $19,803 · median $14,343 | 9 plans |
| 624 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC | $3,704 – $15,082 · median $10,135 | 9 plans |
| 625 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC | $3,704 – $50,054 · median $23,862 | 9 plans |
| 626 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC | $3,704 – $22,892 · median $12,057 | 9 plans |
| 627 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC | $3,704 – $16,470 · median $10,728 | 9 plans |
| 628 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC | $3,704 – $39,623 · median $29,348 | 9 plans |
| 629 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC | $3,704 – $22,927 · median $17,331 | 9 plans |
| 630 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $14,891 · median $11,747 | 9 plans |
| 637 | DIABETES WITH MCC | $3,704 – $15,394 · median $11,570 | 9 plans |
| 638 | DIABETES WITH CC | $3,704 – $9,511 · median $7,374 | 9 plans |
| 639 | DIABETES WITHOUT CC/MCC | $3,704 – $7,341 · median $5,239 | 9 plans |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | $3,704 – $16,766 · median $10,785 | 9 plans |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | $3,704 – $9,216 · median $6,458 | 9 plans |
| 642 | INBORN AND OTHER DISORDERS OF METABOLISM | $3,704 – $13,381 · median $11,297 | 9 plans |
| 643 | ENDOCRINE DISORDERS WITH MCC | $3,704 – $20,341 · median $13,195 | 9 plans |
| 644 | ENDOCRINE DISORDERS WITH CC | $3,704 – $11,750 · median $8,374 | 9 plans |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $3,704 – $8,053 · median $6,381 | 9 plans |
| 650 | KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC | $3,704 – $40,334 · median $36,401 | 9 plans |
| 651 | KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC | $3,704 – $31,889 · median $28,780 | 9 plans |
| 652 | KIDNEY TRANSPLANT | $3,704 – $27,849 · median $25,133 | 9 plans |
| 653 | MAJOR BLADDER PROCEDURES WITH MCC | $3,704 – $95,074 · median $40,756 | 9 plans |
| 654 | MAJOR BLADDER PROCEDURES WITH CC | $3,704 – $37,332 · median $22,148 | 9 plans |
| 655 | MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | $3,704 – $30,737 · median $16,848 | 9 plans |
| 656 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC | $3,704 – $41,966 · median $25,133 | 9 plans |
| 657 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC | $3,704 – $24,819 · median $14,623 | 9 plans |
| 658 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC | $3,704 – $21,399 · median $12,463 | 9 plans |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $3,704 – $27,595 · median $20,142 | 9 plans |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $3,704 – $15,308 · median $10,677 | 9 plans |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $3,704 – $12,531 · median $8,454 | 9 plans |
| 662 | MINOR BLADDER PROCEDURES WITH MCC | $3,704 – $52,622 · median $24,183 | 9 plans |
| 663 | MINOR BLADDER PROCEDURES WITH CC | $3,704 – $26,276 · median $12,218 | 9 plans |
| 664 | MINOR BLADDER PROCEDURES WITHOUT CC/MCC | $3,704 – $19,109 · median $8,544 | 9 plans |
| 665 | PROSTATECTOMY WITH MCC | $3,704 – $54,878 · median $24,647 | 9 plans |
| 666 | PROSTATECTOMY WITH CC | $3,704 – $29,609 · median $13,996 | 9 plans |
| 667 | PROSTATECTOMY WITHOUT CC/MCC | $3,704 – $17,737 · median $9,004 | 9 plans |
| 668 | TRANSURETHRAL PROCEDURES WITH MCC | $3,704 – $43,458 · median $23,085 | 9 plans |
| 669 | TRANSURETHRAL PROCEDURES WITH CC | $3,704 – $17,234 · median $12,465 | 9 plans |
| 670 | TRANSURETHRAL PROCEDURES WITHOUT CC/MCC | $3,704 – $14,023 · median $8,003 | 9 plans |
| 671 | URETHRAL PROCEDURES WITH CC/MCC | $3,704 – $30,338 · median $14,351 | 9 plans |
| 672 | URETHRAL PROCEDURES WITHOUT CC/MCC | $3,704 – $17,894 · median $8,797 | 9 plans |
| 673 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | $3,704 – $42,105 · median $33,034 | 9 plans |
| 674 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC | $3,704 – $27,838 · median $18,571 | 9 plans |
| 675 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC | $3,704 – $25,860 · median $13,159 | 9 plans |
| 682 | RENAL FAILURE WITH MCC | $3,704 – $15,429 · median $11,914 | 9 plans |
| 683 | RENAL FAILURE WITH CC | $3,704 – $8,834 · median $7,193 | 9 plans |
| 684 | RENAL FAILURE WITHOUT CC/MCC | $3,704 – $6,578 · median $5,077 | 9 plans |
| 686 | KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC | $3,704 – $26,676 · median $14,419 | 9 plans |
| 687 | KIDNEY AND URINARY TRACT NEOPLASMS WITH CC | $3,704 – $13,954 · median $8,551 | 9 plans |
| 688 | KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC | $3,704 – $10,726 · median $6,552 | 9 plans |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $3,704 – $15,828 · median $9,424 | 9 plans |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $3,704 – $8,660 · median $6,701 | 9 plans |
| 693 | URINARY STONES WITH MCC | $3,704 – $24,489 · median $10,854 | 9 plans |
| 694 | URINARY STONES WITHOUT MCC | $3,704 – $8,209 · median $6,485 | 9 plans |
| 695 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC | $3,704 – $20,150 · median $9,296 | 9 plans |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $3,704 – $8,591 · median $5,765 | 9 plans |
| 697 | URETHRAL STRICTURE | $3,704 – $18,050 · median $8,784 | 9 plans |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $3,704 – $21,035 · median $13,260 | 9 plans |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $3,704 – $12,322 · median $8,296 | 9 plans |
| 700 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC | $3,704 – $10,865 · median $5,772 | 9 plans |
| 707 | MAJOR MALE PELVIC PROCEDURES WITH CC/MCC | $3,704 – $25,339 · median $15,945 | 9 plans |
| 708 | MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | $3,704 – $23,413 · median $12,327 | 9 plans |
| 709 | PENIS PROCEDURES WITH CC/MCC | $3,704 – $39,224 · median $18,482 | 9 plans |
| 710 | PENIS PROCEDURES WITHOUT CC/MCC | $3,704 – $24,836 · median $11,294 | 9 plans |
| 711 | TESTES PROCEDURES WITH CC/MCC | $3,704 – $35,701 · median $16,593 | 9 plans |
| 712 | TESTES PROCEDURES WITHOUT CC/MCC | $3,704 – $19,855 · median $8,954 | 9 plans |
| 713 | TRANSURETHRAL PROSTATECTOMY WITH CC/MCC | $3,704 – $20,705 · median $12,088 | 9 plans |
| 714 | TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC | $3,704 – $14,475 · median $8,625 | 9 plans |
| 715 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC | $3,704 – $38,130 · median $17,785 | 9 plans |
| 716 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC | $3,704 – $23,968 · median $11,836 | 9 plans |
| 717 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC | $3,704 – $19,907 · median $15,093 | 9 plans |
| 718 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC | $3,704 – $13,364 · median $10,843 | 9 plans |
| 722 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC | $3,704 – $30,824 · median $14,465 | 9 plans |
| 723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC | $3,704 – $19,438 · median $9,287 | 9 plans |
| 724 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $3,704 – $13,051 · median $5,430 | 9 plans |
| 725 | BENIGN PROSTATIC HYPERTROPHY WITH MCC | $3,704 – $21,799 · median $9,501 | 9 plans |
| 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | $3,704 – $12,930 · median $6,022 | 9 plans |
| 727 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC | $3,704 – $26,224 · median $11,928 | 9 plans |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $3,704 – $9,372 · median $6,714 | 9 plans |
| 729 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC | $3,704 – $18,154 · median $8,635 | 9 plans |
| 730 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $3,704 – $10,726 · median $5,633 | 9 plans |
| 734 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC | $3,704 – $25,617 · median $16,952 | 9 plans |
| 735 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC | $3,704 – $20,636 · median $10,862 | 9 plans |
| 736 | UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC | $3,704 – $69,961 · median $28,166 | 9 plans |
| 737 | UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC | $3,704 – $26,294 · median $16,413 | 9 plans |
| 738 | UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC | $3,704 – $19,143 · median $11,817 | 9 plans |
| 739 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC | $3,704 – $65,813 · median $28,230 | 9 plans |
| 740 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC | $3,704 – $25,704 · median $14,465 | 9 plans |
| 741 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC | $3,704 – $18,015 · median $11,487 | 9 plans |
| 742 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC | $3,704 – $21,660 · median $14,660 | 9 plans |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $3,704 – $15,151 · median $10,048 | 9 plans |
| 744 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC | $3,704 – $17,836 · median $16,097 | 9 plans |
| 745 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC | $3,704 – $11,802 · median $9,247 | 9 plans |
| 746 | VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC | $3,704 – $17,963 · median $13,902 | 9 plans |
| 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | $3,704 – $12,808 · median $7,090 | 9 plans |
| 748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | $3,704 – $23,395 · median $11,186 | 9 plans |
| 749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC | $3,704 – $28,619 · median $20,349 | 9 plans |
| 750 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $23,673 · median $11,873 | 9 plans |
| 754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $3,704 – $22,285 · median $14,714 | 9 plans |
| 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | $3,704 – $13,381 · median $8,861 | 9 plans |
| 756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $3,704 – $11,784 · median $7,873 | 9 plans |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $3,704 – $25,218 · median $11,532 | 9 plans |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $3,704 – $10,813 · median $8,017 | 9 plans |
| 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $3,704 – $8,504 · median $5,568 | 9 plans |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $3,704 – $10,379 · median $8,238 | 9 plans |
| 761 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC | $3,704 – $7,741 · median $4,840 | 9 plans |
| 768 | VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C | $2,820 – $9,545 · median $8,493 | 9 plans |
| 769 | POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES | $3,704 – $18,518 · median $13,535 | 9 plans |
| 770 | ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | $3,704 – $9,684 · median $8,087 | 9 plans |
| 776 | POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES | $3,704 – $6,009 · median $5,423 | 9 plans |
| 779 | ABORTION WITHOUT D&C | $3,704 – $7,591 · median $6,530 | 9 plans |
| 783 | CESAREAN SECTION WITH STERILIZATION WITH MCC | $2,820 – $21,280 · median $18,575 | 9 plans |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $2,820 – $12,618 · median $8,646 | 9 plans |
| 785 | CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC | $2,820 – $10,535 · median $7,852 | 9 plans |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $2,820 – $14,447 · median $12,855 | 9 plans |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $2,820 – $12,531 · median $9,086 | 9 plans |
| 788 | CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC | $2,820 – $10,518 · median $7,859 | 9 plans |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $3,704 – $19,785 · median $14,407 | 9 plans |
| 790 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | $3,704 – $113,245 · median $46,556 | 9 plans |
| 791 | PREMATURITY WITH MAJOR PROBLEMS | $3,704 – $34,885 · median $31,483 | 9 plans |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $3,704 – $21,230 · median $18,711 | 9 plans |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $3,704 – $35,823 · median $31,573 | 9 plans |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $3,198 – $12,974 · median $11,435 | 9 plans |
| 795 | NORMAL NEWBORN | $1,696 – $3,704 · median $1,968 | 9 plans |
| 796 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC | $2,820 – $20,306 · median $9,476 | 9 plans |
| 797 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC | $2,820 – $13,381 · median $8,182 | 9 plans |
| 798 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC | $2,820 – $11,385 · median $7,846 | 9 plans |
| 799 | SPLENIC PROCEDURES WITH MCC | $3,704 – $52,431 · median $35,575 | 9 plans |
| 800 | SPLENIC PROCEDURES WITH CC | $3,704 – $38,547 · median $22,226 | 9 plans |
| 801 | SPLENIC PROCEDURES WITHOUT CC/MCC | $3,704 – $27,908 · median $15,235 | 9 plans |
| 802 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC | $3,704 – $61,960 · median $31,345 | 9 plans |
| 803 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC | $3,704 – $26,919 · median $14,847 | 9 plans |
| 804 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC | $3,704 – $18,293 · median $10,943 | 9 plans |
| 805 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC | $2,820 – $9,609 · median $8,551 | 9 plans |
| 806 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC | $2,820 – $8,105 · median $6,270 | 9 plans |
| 807 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | $2,820 – $6,908 · median $5,607 | 9 plans |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC | $3,704 – $28,099 · median $17,557 | 9 plans |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC | $3,704 – $15,082 · median $10,244 | 9 plans |
| 810 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC | $3,704 – $12,479 · median $8,541 | 9 plans |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $3,704 – $17,876 · median $11,318 | 9 plans |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $3,704 – $12,392 · median $7,545 | 9 plans |
| 813 | COAGULATION DISORDERS | $3,704 – $23,760 · median $12,258 | 9 plans |
| 814 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC | $3,704 – $23,690 · median $16,926 | 9 plans |
| 815 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC | $3,704 – $12,982 · median $8,288 | 9 plans |
| 816 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC | $3,704 – $9,754 · median $5,323 | 9 plans |
| 817 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC | $3,704 – $20,636 · median $17,458 | 9 plans |
| 818 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC | $3,704 – $13,850 · median $9,285 | 9 plans |
| 819 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $9,285 · median $7,092 | 9 plans |
| 820 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC | $3,704 – $82,613 · median $45,945 | 9 plans |
| 821 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC | $3,704 – $36,117 · median $17,795 | 9 plans |
| 822 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $20,601 · median $9,763 | 9 plans |
| 823 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC | $3,704 – $62,203 · median $36,009 | 9 plans |
| 824 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC | $3,704 – $34,781 · median $18,005 | 9 plans |
| 825 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC | $3,704 – $21,157 · median $10,892 | 9 plans |
| 826 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC | $3,704 – $83,845 · median $36,731 | 9 plans |
| 827 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC | $3,704 – $36,377 · median $18,359 | 9 plans |
| 828 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $24,246 · median $13,643 | 9 plans |
| 829 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC | $3,704 – $27,908 · median $24,601 | 9 plans |
| 830 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC | $3,704 – $23,690 · median $12,100 | 9 plans |
| 831 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC | $3,704 – $10,778 · median $9,616 | 9 plans |
| 832 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC | $3,704 – $7,029 · median $5,935 | 9 plans |
| 833 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $4,998 · median $4,395 | 9 plans |
| 834 | ACUTE LEUKEMIA WITH MCC | $3,704 – $118,174 · median $43,035 | 9 plans |
| 835 | ACUTE LEUKEMIA WITH CC | $3,704 – $45,194 · median $16,609 | 9 plans |
| 836 | ACUTE LEUKEMIA WITHOUT CC/MCC | $3,704 – $27,873 · median $9,884 | 9 plans |
| 837 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC | $3,704 – $54,740 · median $37,713 | 9 plans |
| 838 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT | $3,704 – $18,189 · median $16,390 | 9 plans |
| 839 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC | $3,704 – $14,700 · median $11,626 | 9 plans |
| 840 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | $3,704 – $54,340 · median $25,529 | 9 plans |
| 841 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | $3,704 – $27,300 · median $13,081 | 9 plans |
| 842 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC | $3,704 – $18,605 · median $8,260 | 9 plans |
| 843 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC | $3,704 – $30,754 · median $15,902 | 9 plans |
| 844 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC | $3,704 – $17,425 · median $9,867 | 9 plans |
| 845 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC | $3,704 – $14,804 · median $7,028 | 9 plans |
| 846 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC | $3,704 – $26,415 · median $20,542 | 9 plans |
| 847 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | $3,704 – $12,895 · median $10,520 | 9 plans |
| 848 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC | $3,704 – $8,261 · median $6,913 | 9 plans |
| 849 | RADIOTHERAPY | $3,704 – $44,430 · median $21,451 | 9 plans |
| 850 | ACUTE LEUKEMIA WITH OTHER PROCEDURES | — | 9 plans |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $3,704 – $58,870 · median $38,755 | 9 plans |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | $3,704 – $24,142 · median $15,928 | 9 plans |
| 855 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $19,091 · median $12,039 | 9 plans |
| 856 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC | $3,704 – $47,641 · median $35,728 | 9 plans |
| 857 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | $3,704 – $22,354 · median $17,041 | 9 plans |
| 858 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC | $3,704 – $15,880 · median $11,230 | 9 plans |
| 862 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | $3,704 – $17,321 · median $14,372 | 9 plans |
| 863 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | $3,704 – $11,038 · median $8,163 | 9 plans |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $3,704 – $10,951 · median $7,308 | 9 plans |
| 865 | VIRAL ILLNESS WITH MCC | $3,704 – $16,523 · median $12,048 | 9 plans |
| 866 | VIRAL ILLNESS WITHOUT MCC | $3,704 – $9,303 · median $7,167 | 9 plans |
| 867 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC | $3,704 – $28,671 · median $16,666 | 9 plans |
| 868 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC | $3,704 – $13,156 · median $8,421 | 9 plans |
| 869 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC | $3,704 – $10,604 · median $6,081 | 9 plans |
| 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | $3,704 – $90,249 · median $54,073 | 9 plans |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $3,704 – $24,333 · median $15,496 | 9 plans |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $3,704 – $12,427 · median $8,361 | 9 plans |
| 876 | O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS | $3,704 – $62,567 · median $30,420 | 9 plans |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $3,704 – $10,205 · median $7,871 | 9 plans |
| 881 | DEPRESSIVE NEUROSES | $3,704 – $8,436 · median $7,435 | 9 plans |
| 882 | NEUROSES EXCEPT DEPRESSIVE | $3,704 – $9,563 · median $8,429 | 9 plans |
| 883 | DISORDERS OF PERSONALITY AND IMPULSE CONTROL | $3,704 – $17,460 · median $15,463 | 9 plans |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $3,704 – $14,102 · median $12,429 | 9 plans |
| 885 | PSYCHOSES | $3,704 – $12,303 · median $10,843 | 9 plans |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $3,704 – $21,365 · median $16,527 | 9 plans |
| 887 | OTHER MENTAL DISORDER DIAGNOSES | $3,704 – $17,911 · median $8,730 | 9 plans |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $3,704 – $5,918 · median $5,133 | 9 plans |
| 895 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | $3,704 – $25,929 · median $11,406 | 9 plans |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $3,704 – $19,716 · median $13,964 | 9 plans |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $3,704 – $8,626 · median $7,169 | 9 plans |
| 901 | WOUND DEBRIDEMENTS FOR INJURIES WITH MCC | $3,704 – $55,659 · median $32,995 | 9 plans |
| 902 | WOUND DEBRIDEMENTS FOR INJURIES WITH CC | $3,704 – $20,705 · median $15,279 | 9 plans |
| 903 | WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC | $3,704 – $13,832 · median $9,496 | 9 plans |
| 904 | SKIN GRAFTS FOR INJURIES WITH CC/MCC | $3,704 – $50,713 · median $28,931 | 9 plans |
| 905 | SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC | $3,704 – $27,890 · median $11,932 | 9 plans |
| 906 | HAND PROCEDURES FOR INJURIES | $3,704 – $22,441 · median $15,448 | 9 plans |
| 907 | OTHER O.R. PROCEDURES FOR INJURIES WITH MCC | $3,704 – $47,676 · median $30,221 | 9 plans |
| 908 | OTHER O.R. PROCEDURES FOR INJURIES WITH CC | $3,704 – $24,437 · median $15,905 | 9 plans |
| 909 | OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC | $3,704 – $16,627 · median $10,607 | 9 plans |
| 913 | TRAUMATIC INJURY WITH MCC | $3,704 – $26,849 · median $13,106 | 9 plans |
| 914 | TRAUMATIC INJURY WITHOUT MCC | $3,704 – $10,396 · median $7,291 | 9 plans |
| 915 | ALLERGIC REACTIONS WITH MCC | $3,704 – $18,154 · median $13,471 | 9 plans |
| 916 | ALLERGIC REACTIONS WITHOUT MCC | $3,704 – $7,932 · median $5,589 | 9 plans |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $3,704 – $17,217 · median $12,592 | 9 plans |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $3,704 – $8,556 · median $7,008 | 9 plans |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $3,704 – $19,247 · median $14,629 | 9 plans |
| 920 | COMPLICATIONS OF TREATMENT WITH CC | $3,704 – $11,837 · median $8,198 | 9 plans |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $3,704 – $8,487 · median $5,761 | 9 plans |
| 922 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC | $3,704 – $25,808 · median $13,997 | 9 plans |
| 923 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC | $3,704 – $9,632 · median $8,202 | 9 plans |
| 927 | EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT | $3,704 – $376,548 · median $163,854 | 9 plans |
| 928 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC | $3,704 – $61,296 · median $54,023 | 9 plans |
| 929 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC | $3,704 – $27,775 · median $24,479 | 9 plans |
| 933 | EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT | $3,704 – $56,406 · median $30,647 | 9 plans |
| 934 | FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY | $3,704 – $35,041 · median $17,578 | 9 plans |
| 935 | NON-EXTENSIVE BURNS | $3,704 – $17,929 · median $15,801 | 9 plans |
| 939 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC | $3,704 – $55,868 · median $28,585 | 9 plans |
| 940 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC | $3,704 – $29,748 · median $18,558 | 9 plans |
| 941 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC | $3,704 – $19,924 · median $16,158 | 9 plans |
| 945 | REHABILITATION WITH CC/MCC | $3,704 – $26,120 · median $12,438 | 9 plans |
| 946 | REHABILITATION WITHOUT CC/MCC | $3,704 – $18,675 · median $9,319 | 9 plans |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $3,704 – $15,481 · median $10,271 | 9 plans |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $3,704 – $10,518 · median $6,631 | 9 plans |
| 949 | AFTERCARE WITH CC/MCC | $3,704 – $18,119 · median $9,652 | 9 plans |
| 950 | AFTERCARE WITHOUT CC/MCC | $3,704 – $11,333 · median $5,289 | 9 plans |
| 951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $3,704 – $5,831 · median $4,726 | 9 plans |
| 955 | CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA | $3,704 – $103,821 · median $52,670 | 9 plans |
| 956 | LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA | $3,704 – $82,578 · median $29,629 | 9 plans |
| 957 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC | $3,704 – $99,569 · median $59,570 | 9 plans |
| 958 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC | $3,704 – $57,534 · median $33,129 | 9 plans |
| 959 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC | $3,704 – $45,073 · median $23,272 | 9 plans |
| 963 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC | $3,704 – $41,775 · median $21,639 | 9 plans |
| 964 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC | $3,704 – $19,091 · median $12,314 | 9 plans |
| 965 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC | $3,704 – $13,121 · median $7,718 | 9 plans |
| 969 | HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC | $3,704 – $114,669 · median $47,937 | 9 plans |
| 970 | HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC | $3,704 – $49,168 · median $20,891 | 9 plans |
| 974 | HIV WITH MAJOR RELATED CONDITION WITH MCC | $3,704 – $44,587 · median $22,821 | 9 plans |
| 975 | HIV WITH MAJOR RELATED CONDITION WITH CC | $3,704 – $23,395 · median $10,470 | 9 plans |
| 976 | HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC | $3,704 – $15,811 · median $7,424 | 9 plans |
| 977 | HIV WITH OR WITHOUT OTHER RELATED CONDITION | $3,704 – $23,916 · median $10,491 | 9 plans |
| 981 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $3,704 – $68,034 · median $36,839 | 9 plans |
| 982 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $3,704 – $34,243 · median $19,502 | 9 plans |
| 983 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $3,704 – $21,278 · median $13,722 | 9 plans |
| 987 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $3,704 – $44,830 · median $27,031 | 9 plans |
| 988 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $3,704 – $20,914 · median $13,176 | 9 plans |
| 989 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $3,704 – $16,106 · median $9,726 | 9 plans |
| 077 | HYPERTENSIVE ENCEPHALOPATHY WITH MCC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 078 | HYPERTENSIVE ENCEPHALOPATHY WITH CC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 079 | HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 294 | DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 295 | DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 453 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC | — | 2 plans |
| 454 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | — | 2 plans |
| 455 | COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 459 | SPINAL FUSION EXCEPT CERVICAL WITH MCC | $3,704 – $9,224 | 2 plans |
| 460 | SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $3,704 – $9,224 · median $6,464 | 2 plans |
| 009 | DRG Grouper 12 (10/1/1994): DRG 9: SPINAL DISORDERS & INJURIES | $9,224 – $9,224 · median $9,224 | 1 plans |
| 015 | DRG Grouper 12 (10/1/1994): DRG 15: TRANSIENT ISCHEMIC ATTACK & | $9,224 – $9,224 · median $9,224 | 1 plans |
| 043 | DRG Grouper 12 (10/1/1994): DRG 43: HYPHEMA | $9,224 – $9,224 · median $9,224 | 1 plans |
| 044 | DRG Grouper 12 (10/1/1994): DRG 44: ACUTE MAJOR EYE INFECTIONS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 045 | DRG Grouper 12 (10/1/1994): DRG 45: NEUROLOGICAL EYE DISORDERS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 046 | DRG Grouper 12 (10/1/1994): DRG 46: OTHER DISORDERS OF THE EYE AGE >17 | $9,224 – $9,224 · median $9,224 | 1 plans |
| 047 | DRG Grouper 12 (10/1/1994): DRG 47: OTHER DISORDERS OF THE EYE AGE >17 | $9,224 – $9,224 · median $9,224 | 1 plans |
| 048 | DRG Grouper 12 (10/1/1994): DRG 48: *OTHER DISORDERS OF THE EYE AGE 0- | $9,224 – $9,224 · median $9,224 | 1 plans |
| 049 | DRG Grouper 12 (10/1/1994): DRG 49: MAJOR HEAD & NECK PROCEDURES | $9,224 – $9,224 · median $9,224 | 1 plans |
| 050 | DRG Grouper 12 (10/1/1994): DRG 50: SIALOADENECTOMY | $9,224 – $9,224 · median $9,224 | 1 plans |
| 051 | DRG Grouper 12 (10/1/1994): DRG 51: SALIVARY GLAND PROCEDURES EXCEPT | $9,224 – $9,224 · median $9,224 | 1 plans |
| 104 | DRG Grouper 12 (10/1/1994): DRG 104: CARDIAC VALVE PROCEDURES W CARDIAC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 105 | DRG Grouper 12 (10/1/1994): DRG 105: CARDIAC VALVE PROCEDURES W/O | $9,224 – $9,224 · median $9,224 | 1 plans |
| 106 | DRG Grouper 12 (10/1/1994): DRG 106: CORONARY BYPASS W CARDIAC CATH | $9,224 – $9,224 · median $9,224 | 1 plans |
| 107 | DRG Grouper 12 (10/1/1994): DRG 107: CORONARY BYPASS W/O CARDIAC CATH | $9,224 – $9,224 · median $9,224 | 1 plans |
| 108 | DRG Grouper 12 (10/1/1994): DRG 108: OTHER CARDIOTHORACIC PROCEDURES | $9,224 – $9,224 · median $9,224 | 1 plans |
| 109 | DRG Grouper 12 (10/1/1994): DRG 109: NO LONGER VALID | $9,224 – $9,224 · median $9,224 | 1 plans |
| 110 | DRG Grouper 12 (10/1/1994): DRG 110: MAJOR CARDIOVASCULAR PROCEDURES W | $9,224 – $9,224 · median $9,224 | 1 plans |
| 111 | DRG Grouper 12 (10/1/1994): DRG 111: MAJOR CARDIOVASCULAR PROCEDURES W/ | $9,224 – $9,224 · median $9,224 | 1 plans |
| 112 | DRG Grouper 12 (10/1/1994): DRG 112: PERCUTANEOUS CARDIOVASCULAR | $9,224 – $9,224 · median $9,224 | 1 plans |
| 118 | DRG Grouper 12 (10/1/1994): DRG 118: CARDIAC PACEMAKER DEVICE | $9,224 – $9,224 · median $9,224 | 1 plans |
| 119 | DRG Grouper 12 (10/1/1994): DRG 119: VEIN LIGATION & STRIPPING | $9,224 – $9,224 · median $9,224 | 1 plans |
| 120 | DRG Grouper 12 (10/1/1994): DRG 120: OTHER CIRCULATORY SYSTEM O.R. | $9,224 – $9,224 · median $9,224 | 1 plans |
| 126 | DRG Grouper 12 (10/1/1994): DRG 126: ACUTE & SUBACUTE ENDOCARDITIS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 127 | DRG Grouper 12 (10/1/1994): DRG 127: HEART FAILURE & SHOCK | $9,224 – $9,224 · median $9,224 | 1 plans |
| 128 | DRG Grouper 12 (10/1/1994): DRG 128: DEEP VEIN THROMBOPHLEBITIS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 129 | DRG Grouper 12 (10/1/1994): DRG 129: CARDIAC ARREST, UNEXPLAINED | $9,224 – $9,224 · median $9,224 | 1 plans |
| 130 | DRG Grouper 12 (10/1/1994): DRG 130: PERIPHERAL VASCULAR DISORDERS W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 131 | DRG Grouper 12 (10/1/1994): DRG 131: PERIPHERAL VASCULAR DISORDERS W/O | $9,224 – $9,224 · median $9,224 | 1 plans |
| 132 | DRG Grouper 12 (10/1/1994): DRG 132: ATHEROSCLEROSIS W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 133 | DRG Grouper 12 (10/1/1994): DRG 133: ATHEROSCLEROSIS W/O CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 134 | DRG Grouper 12 (10/1/1994): DRG 134: HYPERTENSION | $9,224 – $9,224 · median $9,224 | 1 plans |
| 160 | DRG Grouper 12 (10/1/1994): DRG 160: HERNIA PROCEDURES EXCEPT INGUINAL | $9,224 – $9,224 · median $9,224 | 1 plans |
| 161 | DRG Grouper 12 (10/1/1994): DRG 161: INGUINAL & FEMORAL HERNIA | $9,224 – $9,224 · median $9,224 | 1 plans |
| 162 | DRG Grouper 12 (10/1/1994): DRG 162: INGUINAL & FEMORAL HERNIA | $9,224 – $9,224 · median $9,224 | 1 plans |
| 169 | DRG Grouper 12 (10/1/1994): DRG 169: MOUTH PROCEDURES W/O CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 170 | DRG Grouper 12 (10/1/1994): DRG 170: OTHER DIGESTIVE SYSTEM O.R. | $9,224 – $9,224 · median $9,224 | 1 plans |
| 171 | DRG Grouper 12 (10/1/1994): DRG 171: OTHER DIGESTIVE SYSTEM O.R. | $9,224 – $9,224 · median $9,224 | 1 plans |
| 172 | DRG Grouper 12 (10/1/1994): DRG 172: DIGESTIVE MALIGNANCY W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 174 | DRG Grouper 12 (10/1/1994): DRG 174: G.I. HEMORRHAGE W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 210 | DRG Grouper 12 (10/1/1994): DRG 210: HIP & FEMUR PROCEDURES EXCEPT | $9,224 – $9,224 · median $9,224 | 1 plans |
| 211 | DRG Grouper 12 (10/1/1994): DRG 211: HIP & FEMUR PROCEDURES EXCEPT | $9,224 – $9,224 · median $9,224 | 1 plans |
| 214 | DRG Grouper 12 (10/1/1994): DRG 214: BACK & NECK PROCEDURES W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 222 | DRG Grouper 12 (10/1/1994): DRG 222: KNEE PROCEDURES W/O CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 223 | DRG Grouper 12 (10/1/1994): DRG 223: MAJOR SHOULDER/ELBOW PROC, OR | $9,224 – $9,224 · median $9,224 | 1 plans |
| 224 | DRG Grouper 12 (10/1/1994): DRG 224: SHOULDER, ELBOW OR FOREARM PROC, | $9,224 – $9,224 · median $9,224 | 1 plans |
| 225 | DRG Grouper 12 (10/1/1994): DRG 225: FOOT PROCEDURES | $9,224 – $9,224 · median $9,224 | 1 plans |
| 226 | DRG Grouper 12 (10/1/1994): DRG 226: SOFT TISSUE PROCEDURES W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 227 | DRG Grouper 12 (10/1/1994): DRG 227: SOFT TISSUE PROCEDURES W/O CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 230 | DRG Grouper 12 (10/1/1994): DRG 230: LOCAL EXCISION & REMOVAL OF INT | $9,224 – $9,224 · median $9,224 | 1 plans |
| 237 | DRG Grouper 12 (10/1/1994): DRG 237: SPRAINS, STRAINS, & DISLOCATIONS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 238 | DRG Grouper 12 (10/1/1994): DRG 238: OSTEOMYELITIS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 246 | DRG Grouper 12 (10/1/1994): DRG 246: NON-SPECIFIC ARTHROPATHIES | $9,224 – $9,224 · median $9,224 | 1 plans |
| 247 | DRG Grouper 12 (10/1/1994): DRG 247: SIGNS & SYMPTOMS OF | $9,224 – $9,224 · median $9,224 | 1 plans |
| 248 | DRG Grouper 12 (10/1/1994): DRG 248: TENDONITIS, MYOSITIS & BURSITIS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 249 | DRG Grouper 12 (10/1/1994): DRG 249: AFTERCARE, MUSCULOSKELETAL SYSTEM | $9,224 – $9,224 · median $9,224 | 1 plans |
| 338 | DRG Grouper 12 (10/1/1994): DRG 338: TESTES PROCEDURES, FOR MALIGNANCY | $9,224 – $9,224 · median $9,224 | 1 plans |
| 339 | DRG Grouper 12 (10/1/1994): DRG 339: TESTES PROCEDURES, NON-MALIGNANCY | $9,224 – $9,224 · median $9,224 | 1 plans |
| 340 | DRG Grouper 12 (10/1/1994): DRG 340: *TESTES PROCEDURES, NON-MALIGNANCY | $9,224 – $9,224 · median $9,224 | 1 plans |
| 341 | DRG Grouper 12 (10/1/1994): DRG 341: PENIS PROCEDURES | $9,224 – $9,224 · median $9,224 | 1 plans |
| 342 | DRG Grouper 12 (10/1/1994): DRG 342: CIRCUMCISION AGE >17 | $9,224 – $9,224 · median $9,224 | 1 plans |
| 343 | DRG Grouper 12 (10/1/1994): DRG 343: *CIRCUMCISION AGE 0-17 | $9,224 – $9,224 · median $9,224 | 1 plans |
| 361 | DRG Grouper 12 (10/1/1994): DRG 361: LAPAROSCOPY & INCISIONAL TUBAL | $9,224 – $9,224 · median $9,224 | 1 plans |
| 362 | DRG Grouper 12 (10/1/1994): DRG 362: *ENDOSCOPIC TUBAL INTERRUPTION | $9,224 – $9,224 · median $9,224 | 1 plans |
| 363 | DRG Grouper 12 (10/1/1994): DRG 363: D&C, CONIZATION & RADIO-IMPLANT, | $9,224 – $9,224 · median $9,224 | 1 plans |
| 364 | DRG Grouper 12 (10/1/1994): DRG 364: D&C, CONIZATION EXCEPT FOR | $9,224 – $9,224 · median $9,224 | 1 plans |
| 365 | DRG Grouper 12 (10/1/1994): DRG 365: OTHER FEMALE REPRODUCTIVE SYSTEM | $9,224 – $9,224 · median $9,224 | 1 plans |
| 366 | DRG Grouper 12 (10/1/1994): DRG 366: MALIGNANCY, FEMALE REPRODUCTIVE | $9,224 – $9,224 · median $9,224 | 1 plans |
| 367 | DRG Grouper 12 (10/1/1994): DRG 367: MALIGNANCY, FEMALE REPRODUCTIVE | $9,224 – $9,224 · median $9,224 | 1 plans |
| 396 | DRG Grouper 12 (10/1/1994): DRG 396: RED BLOOD CELL DISORDERS AGE 0-17 | $9,224 – $9,224 · median $9,224 | 1 plans |
| 400 | DRG Grouper 12 (10/1/1994): DRG 400: LYMPHOMA & LEUKEMIA W MAJOR O.R. | $9,224 – $9,224 · median $9,224 | 1 plans |
| 401 | DRG Grouper 12 (10/1/1994): DRG 401: LYMPHOMA & NON-ACUTE LEUKEMIA W | $9,224 – $9,224 · median $9,224 | 1 plans |
| 403 | DRG Grouper 12 (10/1/1994): DRG 403: LYMPHOMA & NON-ACUTE LEUKEMIA W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 404 | DRG Grouper 12 (10/1/1994): DRG 404: LYMPHOMA & NON-ACUTE LEUKEMIA W/O | $9,224 – $9,224 · median $9,224 | 1 plans |
| 431 | DRG Grouper 12 (10/1/1994): DRG 431: CHILDHOOD MENTAL DISORDERS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 449 | DRG Grouper 12 (10/1/1994): DRG 449: POISONING & TOXIC EFFECTS OF DRUGS | $9,224 – $9,224 · median $9,224 | 1 plans |
| 452 | DRG Grouper 12 (10/1/1994): DRG 452: COMPLICATIONS OF TREATMENT W CC | $9,224 – $9,224 · median $9,224 | 1 plans |
| 484 | DRG Grouper 12 (10/1/1994): DRG 484: CRANIOTOMY FOR MULTIPLE | $9,224 – $9,224 · median $9,224 | 1 plans |
| 490 | DRG Grouper 12 (10/1/1994): DRG 490: HIV W OR W/O OTHER RELATED | $9,224 – $9,224 · median $9,224 | 1 plans |
| 491 | DRG Grouper 12 (10/1/1994): DRG 491: MAJOR JOINT & LIMB REATTACHMENT | $9,224 – $9,224 · median $9,224 | 1 plans |
| 509 | ARTHROSCOPY | $3,704 – $3,704 · median $3,704 | 1 plans |
| 998 | PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS | $3,704 – $3,704 · median $3,704 | 1 plans |
| 999 | UNGROUPABLE | $3,704 – $3,704 · median $3,704 | 1 plans |
No procedures match that keyword.