Erlanger Medical Center — Pricing

771 procedures published in this hospital's Machine-Readable File (MRF) — 477 with a comparable price, 294 with per-payer negotiated rates only. Prices shown are pre-insurance; actual cost depends on your plan, Medicare/Medicaid coverage, or cash-pay discounts.

Procedures published 771
Lowest published price $574
Average published price $19,075
Highest published price $369,990

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

Showing all 771 procedures

Published charges

Showing all 477 procedures with a comparable published price (gross, cash, or insurance-negotiated median), sorted highest to lowest. Green = this hospital prices below the median; amber = above. Cash-pay prices not published for this hospital.

Across 114 procedures, this hospital's negotiated rates average ≈123% of what Medicare pays.

DRG Description Published price vs. TN median vs. National median vs Medicare
212 Concomitant Aortic and Mitral Valve Procedures $369,990 $256,471 +44% $171,338 +116% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $228,809 $193,242 +18% $121,714 +88% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $223,430 $123,949 +80% $71,551 +212% ≈114% of Medicare
028 SPINAL PROCEDURES WITH MCC $153,120 $117,425 +30% $95,858 +60% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $146,096 $62,801 +133% $90,331 +62% —
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $144,504 $240,349 −40% $371,366 −61% ≈130% of Medicare
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $139,861 $76,747 +82% $64,776 +116% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $119,543 $98,068 +22% $83,441 +43% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $91,444 $186,275 −51% $175,437 −48% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $89,061 $83,233 +7% $107,355 −17% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $79,952 $80,775 −1% $134,914 −41% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $77,514 $92,918 −17% $88,691 −13% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $74,777 $78,984 −5% $117,280 −36% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $63,396 $63,396 +0% $86,953 −27% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $63,053 $98,140 −36% $68,399 −8% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $62,052 $96,337 −36% $151,029 −59% —
790 Extreme immaturity or respiratory distress syndrome, neonate $58,644 $45,845 +28% $80,018 −27% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $57,431 $102,814 −44% $143,242 −60% ≈100% of Medicare
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $55,497 $108,721 −49% $120,587 −54% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC $53,540 $103,817 −48% $138,868 −61% ≈120% of Medicare
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $51,684 $161,432 −68% $138,008 −63% ≈151% of Medicare
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $49,092 $49,092 +0% $37,080 +32% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $48,748 $89,636 −46% $131,961 −63% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $48,591 $161,832 −70% $245,241 −80% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $46,100 $69,684 −34% $108,472 −58% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $45,699 $88,410 −48% $71,755 −36% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $45,428 $144,853 −69% $116,058 −61% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $43,845 $31,079 +41% $34,900 +26% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $42,773 $50,178 −15% $68,659 −38% —
955 Craniotomy for multiple significant trauma $42,495 $58,201 −27% $105,612 −60% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $42,112 $64,108 −34% $76,583 −45% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $42,036 $87,632 −52% $96,192 −56% —
653 MAJOR BLADDER PROCEDURES WITH MCC $40,534 $63,523 −36% $97,046 −58% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $39,630 $51,793 −23% $45,817 −14% ≈121% of Medicare
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR $39,534 $76,970 −49% $106,778 −63% ≈114% of Medicare
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $36,730 $71,776 −49% $102,177 −64% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $36,535 $82,017 −55% $99,423 −63% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $35,656 $58,773 −39% $80,747 −56% ≈116% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $35,537 $74,482 −52% $96,905 −63% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $35,462 $34,907 +2% $24,432 +45% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $35,028 $107,454 −67% $87,018 −60% ≈111% of Medicare
471 CERVICAL SPINAL FUSION WITH MCC $34,744 $88,694 −61% $92,515 −62% —
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $34,712 $79,247 −56% $112,062 −69% ≈133% of Medicare
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $34,706 $71,243 −51% $94,927 −63% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC $34,318 $64,248 −47% $92,217 −63% ≈109% of Medicare
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $34,241 $34,241 +0% $33,694 +2% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $33,852 $57,204 −41% $87,565 −61% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $33,423 $44,971 −26% $45,622 −27% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $33,416 $50,743 −34% $49,631 −33% —
163 MAJOR CHEST PROCEDURES WITH MCC $33,381 $75,425 −56% $88,341 −62% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $33,099 $73,103 −55% $78,582 −58% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $32,570 $32,587 −0% $37,064 −12% ≈119% of Medicare
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $32,107 $45,362 −29% $74,257 −57% —
215 Other heart assist system implant $32,074 $133,515 −76% $191,314 −83% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $31,882 $67,339 −53% $80,885 −61% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $31,819 $30,294 +5% $39,018 −18% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $31,805 $64,714 −51% $72,945 −56% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $31,436 $63,356 −50% $88,307 −64% ≈113% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $31,354 $64,565 −51% $72,859 −57% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $30,690 $77,850 −61% $76,954 −60% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $30,393 $62,021 −51% $82,561 −63% ≈113% of Medicare
539 OSTEOMYELITIS WITH MCC $29,736 $29,736 +0% $33,746 −12% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $29,701 $48,469 −39% $83,065 −64% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $29,615 $137,121 −78% $88,049 −66% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $29,602 $30,003 −1% $46,066 −36% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $29,508 $51,906 −43% $41,380 −29% —
570 SKIN DEBRIDEMENT WITH MCC $28,911 $42,263 −32% $52,435 −45% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $28,830 $47,594 −39% $66,853 −57% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $28,652 $92,635 −69% $68,006 −58% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $28,098 $46,680 −40% $72,011 −61% —
273 PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC $27,993 $37,242 −25% $78,852 −64% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $27,797 $49,285 −44% $70,540 −61% ≈129% of Medicare
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $27,734 $52,805 −47% $75,103 −63% ≈77% of Medicare
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $27,191 $45,790 −41% $74,755 −64% —
252 OTHER VASCULAR PROCEDURES WITH MCC $26,942 $39,884 −32% $68,508 −61% ≈116% of Medicare
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $26,856 $31,410 −14% $46,659 −42% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $26,834 $76,944 −65% $71,701 −63% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $26,767 $33,189 −19% $36,097 −26% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $26,705 $68,514 −61% $64,956 −59% —
313 Chest pain $26,528 $19,674 +35% $15,962 +66% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $26,436 $37,840 −30% $44,973 −41% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $26,362 $94,614 −72% $88,050 −70% ≈131% of Medicare
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $26,357 $43,787 −40% $70,132 −62% —
501 SOFT TISSUE PROCEDURES WITH CC $26,157 $60,321 −57% $37,975 −31% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $25,725 $27,073 −5% $32,839 −22% —
264 Other circulatory system O.R. procedures $25,498 $39,035 −35% $51,953 −51% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $25,260 $105,341 −76% $68,880 −63% ≈115% of Medicare
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $24,954 $45,724 −45% $61,832 −60% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $24,905 $53,660 −54% $64,152 −61% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $24,648 $53,806 −54% $65,325 −62% ≈119% of Medicare
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $24,579 $30,459 −19% $38,878 −37% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC $24,460 $72,075 −66% $102,573 −76% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $24,381 $45,570 −46% $53,555 −54% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $24,251 $79,847 −70% $71,014 −66% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $24,080 $30,023 −20% $35,114 −31% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $24,072 $25,345 −5% $40,065 −40% —
037 EXTRACRANIAL PROCEDURES WITH MCC $23,883 $45,525 −48% $64,749 −63% —
662 MINOR BLADDER PROCEDURES WITH MCC $23,414 $36,161 −35% $54,483 −57% —
652 Kidney transplant $23,297 $31,097 −25% $54,720 −57% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $23,020 $29,092 −21% $30,940 −26% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $22,855 $60,860 −62% $64,465 −65% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $22,147 $56,565 −61% $82,247 −73% ≈116% of Medicare
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $22,091 $65,814 −66% $54,313 −59% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $21,942 $114,261 −81% $67,764 −68% ≈117% of Medicare
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $21,836 $104,470 −79% $66,819 −67% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $21,798 $52,820 −59% $54,475 −60% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $21,796 $34,348 −37% $57,963 −62% —
472 CERVICAL SPINAL FUSION WITH CC $21,701 $45,802 −53% $59,537 −64% ≈111% of Medicare
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $21,683 $57,222 −62% $44,839 −52% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $21,606 $42,739 −49% $47,583 −55% —
510 Shoulder,elbow or forearm proc,exc major joint proc w MCC $21,457 $40,289 −47% $49,055 −56% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $21,418 $18,536 +16% $19,598 +9% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $21,405 $19,806 +8% $18,478 +16% —
321 Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices $21,356 $108,590 −80% $74,274 −71% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $21,177 $26,046 −19% $40,232 −47% —
654 MAJOR BLADDER PROCEDURES WITH CC $21,175 $32,991 −36% $53,868 −61% ≈116% of Medicare
462 Bilateral or multiple major joint procs of lower extremity w/o MCC $21,031 $112,168 −81% $56,758 −63% ≈120% of Medicare
800 SPLENIC PROCEDURES WITH CC $20,873 $33,970 −39% $49,184 −58% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $20,423 $42,892 −52% $40,548 −50% —
253 OTHER VASCULAR PROCEDURES WITH CC $20,358 $36,329 −44% $53,746 −62% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $20,319 $34,586 −41% $46,591 −56% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $20,230 $38,454 −47% $43,491 −53% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $20,214 $18,879 +7% $24,544 −18% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $20,104 $24,846 −19% $30,930 −35% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $20,095 $72,374 −72% $52,405 −62% ≈121% of Medicare
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $19,943 $115,471 −83% $63,984 −69% ≈119% of Medicare
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $19,871 $31,535 −37% $45,432 −56% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $19,864 $71,381 −72% $54,929 −64% ≈125% of Medicare
500 SOFT TISSUE PROCEDURES WITH MCC $19,834 $44,088 −55% $57,479 −65% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $19,710 $25,498 −23% $35,542 −45% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $19,529 $52,634 −63% $39,747 −51% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $19,385 $21,552 −10% $35,528 −45% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $19,214 $34,391 −44% $50,139 −62% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $18,963 $24,201 −22% $40,277 −53% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $18,872 $42,293 −55% $36,334 −48% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $18,681 $79,992 −77% $51,985 −64% —
887 OTHER MENTAL DISORDER DIAGNOSES $18,659 $21,939 −15% $20,602 −9% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $18,645 $64,235 −71% $54,824 −66% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $18,625 $12,453 +50% $15,607 +19% —
906 Hand procedures for injuries $18,620 $38,001 −51% $31,520 −41% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $18,601 $44,704 −58% $48,682 −62% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $18,576 $28,296 −34% $46,430 −60% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $18,251 $35,990 −49% $39,657 −54% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $18,172 $38,473 −53% $50,624 −64% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $17,995 $51,655 −65% $39,409 −54% ≈142% of Medicare
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $17,930 $43,149 −58% $44,553 −60% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $17,807 $33,619 −47% $58,043 −69% —
164 MAJOR CHEST PROCEDURES WITH CC $17,714 $51,761 −66% $53,141 −67% —
333 RECTAL RESECTION WITH CC $17,704 $47,425 −63% $34,352 −48% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $17,593 $27,149 −35% $43,586 −60% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $17,557 $75,583 −77% $52,313 −66% ≈135% of Medicare
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $17,543 $80,468 −78% $57,149 −69% ≈120% of Medicare
113 ORBITAL PROCEDURES WITH CC/MCC $17,472 $23,961 −27% $35,642 −51% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $17,447 $21,677 −20% $31,812 −45% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $17,346 $21,338 −19% $36,850 −53% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $17,299 $28,778 −40% $41,651 −58% —
374 DIGESTIVE MALIGNANCY WITH MCC $17,236 $55,381 −69% $38,885 −56% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $17,228 $36,779 −53% $36,237 −52% ≈106% of Medicare
336 PERITONEAL ADHESIOLYSIS WITH CC $17,208 $75,525 −77% $49,470 −65% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $17,206 $32,433 −47% $50,011 −66% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $17,085 $58,459 −71% $62,269 −73% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $17,047 $57,662 −70% $65,383 −74% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $17,000 $22,925 −26% $30,006 −43% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $16,919 $27,797 −39% $31,758 −47% —
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $16,872 $10,918 +55% $22,557 −25% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $16,833 $37,463 −55% $52,332 −68% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $16,769 $26,800 −37% $38,998 −57% —
274 PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC $16,737 $30,971 −46% $65,573 −74% ≈112% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $16,730 $28,993 −42% $35,139 −52% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $16,680 $40,660 −59% $63,475 −74% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $16,416 $49,227 −67% $44,600 −63% ≈129% of Medicare
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,371 $61,503 −73% $42,881 −62% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $16,303 $53,407 −69% $41,900 −61% ≈123% of Medicare
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $16,145 $60,182 −73% $56,519 −71% ≈121% of Medicare
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $16,144 $47,128 −66% $41,520 −61% ≈119% of Medicare
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $15,807 $69,740 −77% $43,524 −64% ≈132% of Medicare
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $15,760 $27,256 −42% $22,698 −31% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $15,751 $27,515 −43% $29,374 −46% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $15,649 $24,512 −36% $29,826 −48% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $15,594 $34,411 −55% $37,902 −59% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $15,585 $25,121 −38% $29,409 −47% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $15,568 $59,684 −74% $55,162 −72% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $15,549 $29,553 −47% $36,280 −57% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $15,471 $39,961 −61% $35,714 −57% ≈125% of Medicare
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $15,419 $49,311 −69% $41,660 −63% ≈114% of Medicare
549 SEPTIC ARTHRITIS WITH CC $15,372 $26,872 −43% $20,938 −27% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $15,270 $31,382 −51% $35,014 −56% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $15,219 $23,565 −35% $43,080 −65% —
380 COMPLICATED PEPTIC ULCER WITH MCC $15,108 $34,745 −57% $36,641 −59% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $15,078 $33,001 −54% $38,836 −61% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $15,006 $38,192 −61% $30,766 −51% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $14,945 $15,039 −1% $17,585 −15% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $14,809 $21,084 −30% $32,483 −54% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $14,699 $27,369 −46% $35,459 −59% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $14,627 $31,129 −53% $48,680 −70% ≈114% of Medicare
470 Major joint replacement or reattachment of lower extremity w/o MCC $14,614 $61,781 −76% $49,197 −70% ≈122% of Medicare
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $14,601 $27,823 −48% $42,126 −65% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $14,596 $50,449 −71% $40,563 −64% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $14,453 $42,903 −66% $41,380 −65% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $14,429 $40,100 −64% $30,974 −53% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $14,422 $49,829 −71% $38,094 −62% —
919 COMPLICATIONS OF TREATMENT WITH MCC $14,416 $26,862 −46% $29,031 −50% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $14,415 $24,448 −41% $36,333 −60% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $14,390 $45,114 −68% $56,394 −74% ≈122% of Medicare
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $14,365 $37,783 −62% $40,583 −65% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $14,363 $19,790 −27% $24,316 −41% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $14,341 $111,391 −87% $58,832 −76% ≈121% of Medicare
666 PROSTATECTOMY WITH CC $14,320 $20,493 −30% $30,016 −52% —
180 RESPIRATORY NEOPLASMS WITH MCC $14,090 $44,651 −68% $36,658 −62% —
663 MINOR BLADDER PROCEDURES WITH CC $14,087 $23,018 −39% $29,924 −53% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $14,038 $23,137 −39% $35,584 −61% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $13,999 $27,569 −49% $39,093 −64% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $13,966 $40,317 −65% $32,689 −57% —
199 PNEUMOTHORAX WITH MCC $13,950 $27,737 −50% $31,491 −56% ≈107% of Medicare
915 ALLERGIC REACTIONS WITH MCC $13,923 $29,587 −53% $30,944 −55% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $13,802 $43,100 −68% $25,208 −45% ≈119% of Medicare
551 MEDICAL BACK PROBLEMS WITH MCC $13,791 $29,913 −54% $31,086 −56% ≈147% of Medicare
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $13,758 $64,310 −79% $43,266 −68% —
334 RECTAL RESECTION WITHOUT CC/MCC $13,740 $29,048 −53% $32,213 −57% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $13,688 $42,629 −68% $37,842 −64% ≈114% of Medicare
399 APPENDIX PROCEDURES WITHOUT CC/MCC $13,685 $46,658 −71% $30,314 −55% —
038 EXTRACRANIAL PROCEDURES WITH CC $13,653 $32,231 −58% $35,770 −62% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $13,600 $31,712 −57% $28,252 −52% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $13,585 $15,547 −13% $18,428 −26% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $13,526 $25,301 −47% $37,950 −64% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $13,502 $27,058 −50% $30,394 −56% ≈129% of Medicare
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,481 $23,241 −42% $25,731 −48% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $13,422 $11,356 +18% $13,303 +1% —
115 Extraocular procedures except orbit $13,329 $19,007 −30% $24,879 −46% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $13,320 $47,626 −72% $44,989 −70% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $13,284 $56,252 −76% $44,117 −70% ≈127% of Medicare
511 Shoulder,elbow or forearm proc,exc major joint proc w CC $13,284 $37,011 −64% $43,538 −69% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $13,251 $30,002 −56% $32,502 −59% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $13,169 $33,129 −60% $33,607 −61% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $12,927 $23,921 −46% $35,453 −64% —
592 SKIN ULCERS WITH MCC $12,768 $41,533 −69% $32,662 −61% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $12,766 $24,969 −49% $30,910 −59% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $12,763 $50,533 −75% $42,119 −70% ≈121% of Medicare
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $12,739 $37,363 −66% $28,967 −56% ≈123% of Medicare
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $12,736 $34,137 −63% $24,036 −47% —
541 OSTEOMYELITIS WITHOUT CC/MCC $12,729 $14,549 −13% $14,549 −13% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $12,717 $22,670 −44% $32,490 −61% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $12,620 $36,397 −65% $31,059 −59% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $12,612 $77,741 −84% $54,772 −77% ≈132% of Medicare
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $12,496 $42,525 −71% $24,561 −49% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $12,484 $27,614 −55% $32,399 −61% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $12,382 $49,766 −75% $31,978 −61% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $12,378 $52,603 −76% $33,137 −63% —
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $12,263 $23,788 −48% $29,476 −58% —
602 CELLULITIS WITH MCC $12,258 $43,477 −72% $29,347 −58% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $12,242 $13,032 −6% $13,822 −11% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $12,201 $22,167 −45% $32,451 −62% —
562 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC $12,194 $41,545 −71% $29,211 −58% —
398 Appendix Procedures without MCC/CC $12,186 $60,324 −80% $39,107 −69% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $12,154 $32,463 −63% $25,854 −53% ≈125% of Medicare
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $12,150 $36,791 −67% $41,703 −71% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $12,091 $46,734 −74% $36,239 −67% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $12,065 $18,187 −34% $32,911 −63% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $12,038 $22,047 −45% $33,424 −64% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $11,937 $21,240 −44% $24,118 −51% ≈130% of Medicare
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $11,892 $31,747 −63% $38,357 −69% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $11,829 $38,853 −70% $33,792 −65% —
512 Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC $11,806 $35,650 −67% $35,692 −67% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $11,705 $29,661 −61% $36,242 −68% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $11,677 $34,912 −67% $46,402 −75% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $11,643 $28,555 −59% $33,050 −65% —
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $11,601 $22,077 −47% $24,941 −53% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $11,540 $56,937 −80% $38,420 −70% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $11,530 $39,605 −71% $29,757 −61% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $11,390 $35,724 −68% $43,775 −74% ≈122% of Medicare
914 TRAUMATIC INJURY WITHOUT MCC $11,267 $22,335 −50% $15,593 −28% —
885 PSYCHOSES $11,238 $27,090 −59% $21,489 −48% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $11,184 $24,253 −54% $29,524 −62% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $11,162 $37,212 −70% $28,156 −60% —
075 VIRAL MENINGITIS WITH CC/MCC $11,148 $25,549 −56% $29,853 −63% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $11,122 $35,091 −68% $25,243 −56% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $11,074 $31,264 −65% $30,358 −64% ≈119% of Medicare
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $10,989 $43,753 −75% $31,840 −65% ≈125% of Medicare
593 SKIN ULCERS WITH CC $10,942 $13,902 −21% $20,470 −47% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $10,867 $31,730 −66% $24,202 −55% —
375 DIGESTIVE MALIGNANCY WITH CC $10,860 $31,330 −65% $27,219 −60% ≈136% of Medicare
348 ANAL AND STOMAL PROCEDURES WITH CC $10,811 $36,019 −70% $27,947 −61% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $10,776 $42,835 −75% $30,814 −65% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $10,679 $25,107 −57% $19,091 −44% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $10,669 $13,791 −23% $17,928 −40% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $10,664 $24,631 −57% $24,017 −56% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $10,574 $17,251 −39% $20,080 −47% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $10,529 $14,883 −29% $20,421 −48% —
381 COMPLICATED PEPTIC ULCER WITH CC $10,408 $23,199 −55% $24,177 −57% —
540 OSTEOMYELITIS WITH CC $10,360 $29,718 −65% $23,494 −56% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $10,306 $24,408 −58% $32,204 −68% —
504 FOOT PROCEDURES WITH CC $10,289 $46,447 −78% $36,598 −72% —
304 HYPERTENSION WITH MCC $10,268 $49,998 −79% $24,185 −58% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $10,226 $22,207 −54% $30,972 −67% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $10,216 $18,572 −45% $20,842 −51% —
740 Uterine,adnexa proc for non-ovarian/adnexal malig w CC $10,186 $26,794 −62% $36,597 −72% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $10,173 $30,984 −67% $26,488 −62% ≈116% of Medicare
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $10,154 $24,617 −59% $24,136 −58% ≈125% of Medicare
181 RESPIRATORY NEOPLASMS WITH CC $10,134 $25,877 −61% $22,431 −55% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $10,081 $47,112 −79% $35,375 −72% ≈119% of Medicare
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $10,073 $16,245 −38% $18,459 −45% —
672 URETHRAL PROCEDURES WITHOUT CC/MCC $10,053 $17,398 −42% $17,398 −42% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $9,961 $12,294 −19% $19,854 −50% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,930 $18,191 −45% $25,307 −61% —
813 COAGULATION DISORDERS $9,704 $38,908 −75% $30,128 −68% —
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $9,688 $24,468 −60% $19,305 −50% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $9,654 $22,219 −57% $15,600 −38% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $9,585 $67,532 −86% $40,552 −76% —
158 DENTAL AND ORAL DISEASES WITH CC $9,499 $15,886 −40% $17,700 −46% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $9,476 $36,851 −74% $24,190 −61% ≈124% of Medicare
445 DISORDERS OF THE BILIARY TRACT WITH CC $9,432 $34,507 −73% $21,806 −57% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $9,429 $15,637 −40% $22,275 −58% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $9,425 $21,964 −57% $12,797 −26% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $9,406 $44,293 −79% $35,237 −73% ≈121% of Medicare
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $9,376 $16,402 −43% $23,115 −59% ≈128% of Medicare
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $9,342 $42,951 −78% $30,058 −69% ≈130% of Medicare
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $9,335 $87,201 −89% $86,390 −89% ≈121% of Medicare
644 ENDOCRINE DISORDERS WITH CC $9,325 $38,114 −76% $22,941 −59% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $9,292 $17,544 −47% $18,017 −48% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $9,290 $29,131 −68% $24,022 −61% ≈130% of Medicare
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $9,290 $31,052 −70% $28,375 −67% —
089 CONCUSSION WITH CC $9,051 $17,574 −48% $18,293 −51% —
563 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC $8,986 $28,871 −69% $18,803 −52% ≈127% of Medicare
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $8,958 $32,182 −72% $26,322 −66% —
748 Female reproductive system reconstructive procedures $8,922 $20,875 −57% $24,980 −64% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $8,910 $54,667 −84% $36,375 −76% ≈129% of Medicare
303 ATHEROSCLEROSIS WITHOUT MCC $8,827 $28,471 −69% $14,927 −41% —
102 HEADACHES WITH MCC $8,784 $18,941 −54% $22,544 −61% —
811 RED BLOOD CELL DISORDERS WITH MCC $8,731 $30,781 −72% $27,934 −69% ≈117% of Medicare
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $8,717 $35,708 −76% $31,190 −72% ≈128% of Medicare
552 MEDICAL BACK PROBLEMS WITHOUT MCC $8,648 $22,335 −61% $21,213 −59% ≈128% of Medicare
682 RENAL FAILURE WITH MCC $8,552 $30,514 −72% $27,854 −69% ≈132% of Medicare
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $8,532 $15,960 −47% $17,700 −52% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $8,529 $26,241 −67% $21,449 −60% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $8,407 $18,937 −56% $18,918 −56% ≈123% of Medicare
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $8,402 $30,973 −73% $27,244 −69% ≈117% of Medicare
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $8,399 $26,634 −68% $18,002 −53% ≈124% of Medicare
444 DISORDERS OF THE BILIARY TRACT WITH MCC $8,394 $28,389 −70% $31,128 −73% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $8,354 $13,389 −38% $15,608 −46% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $8,345 $18,493 −55% $19,569 −57% —
607 MINOR SKIN DISORDERS WITHOUT MCC $8,344 $17,880 −53% $15,284 −45% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $8,313 $19,928 −58% $14,166 −41% —
152 OTITIS MEDIA AND URI WITH MCC $8,307 $33,331 −75% $19,795 −58% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $8,283 $27,922 −70% $18,608 −55% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $8,276 $21,596 −62% $17,731 −53% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $8,235 $40,184 −80% $20,463 −60% ≈124% of Medicare
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $8,172 $32,872 −75% $23,749 −66% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $8,157 $15,986 −49% $18,282 −55% —
640 Nutritional & misc metabolic disorders w MCC $8,126 $32,235 −75% $24,480 −67% ≈121% of Medicare
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $8,126 $17,159 −53% $17,943 −55% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $8,113 $12,609 −36% $16,104 −50% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $8,085 $26,866 −70% $19,326 −58% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $8,076 $33,592 −76% $27,118 −70% —
200 PNEUMOTHORAX WITH CC $7,916 $20,643 −62% $20,573 −62% ≈145% of Medicare
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $7,882 $27,585 −71% $31,816 −75% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $7,840 $19,169 −59% $27,321 −71% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $7,792 $25,856 −70% $18,623 −58% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $7,788 $26,671 −71% $23,141 −66% ≈115% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $7,757 $9,402 −17% $20,309 −62% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $7,656 $22,795 −66% $15,858 −52% —
204 RESPIRATORY SIGNS AND SYMPTOMS $7,644 $24,479 −69% $16,866 −55% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $7,623 $34,308 −78% $22,560 −66% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $7,611 $14,733 −48% $16,418 −54% —
176 PULMONARY EMBOLISM WITHOUT MCC $7,602 $29,267 −74% $18,081 −58% ≈124% of Medicare
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $7,599 $11,755 −35% $13,368 −43% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $7,598 $33,452 −77% $20,777 −63% ≈114% of Medicare
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $7,568 $38,715 −80% $22,982 −67% ≈126% of Medicare
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $7,552 $52,324 −86% $36,933 −80% ≈133% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $7,544 $14,001 −46% $19,001 −60% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $7,496 $21,964 −66% $17,388 −57% ≈124% of Medicare
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $7,496 $56,900 −87% $27,369 −73% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $7,476 $19,056 −61% $18,253 −59% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $7,456 $29,836 −75% $19,815 −62% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $7,451 $18,133 −59% $18,133 −59% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $7,410 $42,864 −83% $22,024 −66% ≈129% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $7,355 $61,418 −88% $34,887 −79% —
291 HEART FAILURE AND SHOCK WITH MCC $7,318 $32,556 −78% $25,020 −71% ≈125% of Medicare
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $7,263 $14,937 −51% $15,077 −52% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $7,244 $27,644 −74% $19,483 −63% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $7,220 $28,675 −75% $21,886 −67% ≈123% of Medicare
300 PERIPHERAL VASCULAR DISORDERS WITH CC $7,182 $28,060 −74% $19,579 −63% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $7,176 $21,451 −67% $17,367 −59% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $7,049 $26,253 −73% $28,134 −75% ≈98% of Medicare
100 SEIZURES WITH MCC $7,034 $31,536 −78% $35,194 −80% ≈119% of Medicare
385 INFLAMMATORY BOWEL DISEASE WITH MCC $7,001 $39,158 −82% $26,020 −73% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $6,968 $27,432 −75% $23,571 −70% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $6,919 $9,061 −24% $11,997 −42% —
896 Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC $6,817 $40,042 −83% $30,275 −77% —
866 VIRAL ILLNESS WITHOUT MCC $6,682 $23,059 −71% $16,391 −59% —
201 PNEUMOTHORAX WITHOUT CC/MCC $6,674 $10,073 −34% $13,081 −49% —
642 Inborn errors of metabolism $6,619 $16,306 −59% $20,727 −68% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $6,496 $13,497 −52% $13,198 −51% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $6,485 $20,932 −69% $14,128 −54% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $6,438 $16,750 −62% $17,226 −63% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $6,400 $16,553 −61% $22,850 −72% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $6,332 $24,471 −74% $20,732 −69% ≈133% of Medicare
694 URINARY STONES WITHOUT MCC $6,321 $27,794 −77% $16,531 −62% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $6,234 $33,894 −82% $23,469 −73% ≈125% of Medicare
684 RENAL FAILURE WITHOUT CC/MCC $6,231 $13,542 −54% $13,623 −54% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $6,230 $25,655 −76% $20,084 −69% —
916 ALLERGIC REACTIONS WITHOUT MCC $6,224 $14,241 −56% $13,890 −55% —
183 MAJOR CHEST TRAUMA WITH MCC $6,198 $31,295 −80% $28,924 −79% ≈121% of Medicare
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $6,111 $36,068 −83% $22,032 −72% —
153 OTITIS MEDIA AND URI WITHOUT MCC $6,093 $19,529 −69% $14,473 −58% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $6,079 $31,958 −81% $18,238 −67% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $6,045 $14,323 −58% $17,193 −65% —
637 DIABETES WITH MCC $6,010 $25,374 −76% $28,819 −79% ≈123% of Medicare
103 HEADACHES WITHOUT MCC $6,004 $23,348 −74% $20,111 −70% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $5,912 $17,781 −67% $16,865 −65% ≈125% of Medicare
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $5,859 $16,683 −65% $14,880 −61% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $5,761 $8,789 −34% $18,191 −68% ≈129% of Medicare
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $5,752 $30,890 −81% $20,278 −72% ≈131% of Medicare
683 RENAL FAILURE WITH CC $5,752 $20,344 −72% $18,620 −69% ≈124% of Medicare
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $5,662 $10,145 −44% $15,636 −64% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $5,517 $37,718 −85% $25,426 −78% ≈134% of Medicare
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $5,484 $17,011 −68% $17,522 −69% —
864 FEVER AND INFLAMMATORY CONDITIONS $5,458 $21,175 −74% $17,412 −69% —
312 SYNCOPE AND COLLAPSE $5,398 $25,349 −79% $19,342 −72% ≈122% of Medicare
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $5,322 $17,464 −70% $18,291 −71% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $5,318 $12,120 −56% $14,012 −62% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $5,315 $21,217 −75% $14,337 −63% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $5,279 $28,118 −81% $15,876 −67% —
882 Neuroses except depressive $5,248 $15,680 −67% $15,680 −67% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $5,216 $14,942 −65% $16,571 −69% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $5,194 $30,263 −83% $19,096 −73% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $5,105 $30,787 −83% $20,968 −76% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $5,096 $23,912 −79% $22,781 −78% ≈126% of Medicare
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $5,054 $25,965 −81% $22,713 −78% —
151 EPISTAXIS WITHOUT MCC $5,046 $7,098 −29% $13,032 −61% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $5,026 $21,003 −76% $17,727 −72% ≈135% of Medicare
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $4,971 $10,768 −54% $12,895 −61% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $4,962 $28,510 −83% $23,396 −79% ≈127% of Medicare
639 DIABETES WITHOUT CC/MCC $4,878 $19,580 −75% $13,910 −65% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $4,756 $17,318 −73% $20,007 −76% —
184 MAJOR CHEST TRAUMA WITH CC $4,718 $28,035 −83% $20,842 −77% ≈123% of Medicare
292 HEART FAILURE AND SHOCK WITH CC $4,694 $27,604 −83% $16,212 −71% —
149 Dysequilibrium $4,638 $17,710 −74% $17,203 −73% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $4,628 $19,810 −77% $27,492 −83% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $4,598 $17,245 −73% $17,103 −73% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $4,598 $16,607 −72% $15,370 −70% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $4,598 $13,303 −65% $13,090 −65% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $4,432 $18,383 −76% $22,231 −80% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $4,291 $21,109 −80% $13,384 −68% ≈126% of Medicare
789 Neonates, died or transferred to another acute care facility $4,274 $7,590 −44% $14,284 −70% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $4,247 $12,776 −67% $12,044 −65% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $4,229 $14,990 −72% $14,444 −71% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $4,191 $19,928 −79% $15,869 −74% —
638 DIABETES WITH CC $4,054 $24,216 −83% $18,821 −78% ≈132% of Medicare
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $3,975 $12,454 −68% $12,381 −68% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $3,929 $18,669 −79% $15,045 −74% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $3,884 $72,305 −95% $45,963 −92% ≈121% of Medicare
123 Neurological eye disorders $3,672 $17,547 −79% $17,831 −79% —
101 SEIZURES WITHOUT MCC $3,621 $25,441 −86% $19,954 −82% ≈126% of Medicare
202 BRONCHITIS AND ASTHMA WITH CC/MCC $3,593 $27,454 −87% $17,273 −79% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $3,545 $14,351 −75% $16,719 −79% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $3,540 $28,584 −88% $25,704 −86% ≈126% of Medicare
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $3,516 $32,279 −89% $18,204 −81% ≈131% of Medicare
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $3,492 $21,266 −84% $13,318 −74% ≈130% of Medicare
792 PREMATURITY WITHOUT MAJOR PROBLEMS $3,459 $6,687 −48% $11,633 −70% —
897 Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC $3,430 $23,674 −86% $16,049 −79% —
920 COMPLICATIONS OF TREATMENT WITH CC $3,407 $27,148 −87% $21,181 −84% ≈115% of Medicare
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $3,383 $24,968 −86% $15,070 −78% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $3,341 $17,531 −81% $14,368 −77% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $3,322 $10,866 −69% $9,076 −63% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $3,292 $14,659 −78% $11,421 −71% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $3,111 $29,414 −89% $20,488 −85% —
779 ABORTION WITHOUT D&C $3,040 $15,715 −81% $15,327 −80% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $3,000 $16,930 −82% $13,824 −78% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $3,000 $23,997 −87% $44,363 −93% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $2,971 $28,774 −90% $17,466 −83% ≈130% of Medicare
305 HYPERTENSION WITHOUT MCC $2,871 $29,441 −90% $17,144 −83% —
894 Alcohol/drug abuse or dependence, left AMA $2,444 $13,471 −82% $12,013 −80% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $2,407 $32,168 −93% $44,053 −95% —
791 PREMATURITY WITH MAJOR PROBLEMS $2,306 $15,379 −85% $39,563 −94% —
311 Angina pectoris $1,300 $18,322 −93% $15,165 −91% —
795 Normal newborn $980 $4,569 −79% $4,530 −78% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $574 $5,589 −90% $7,961 −93% —

Procedures with negotiated rates only

These 294 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 $104,342 – $434,060 · median $228,906 19 plans
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $40,820 – $198,792 · median $94,087 19 plans
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $39,448 – $168,793 · median $86,541 19 plans
006 LIVER TRANSPLANT WITHOUT MCC $17,963 – $81,475 · median $40,077 19 plans
007 Lung transplant $48,410 – $199,145 · median $106,202 19 plans
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $20,155 – $88,203 · median $44,807 19 plans
010 Pancreas transplant $29,534 – $104,064 · median $62,952 19 plans
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $15,201 – $68,298 · median $34,120 19 plans
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $9,816 – $47,404 · median $22,906 19 plans
014 ALLOGENEIC BONE MARROW TRANSPLANT $48,532 – $186,387 · median $106,470 19 plans
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $22,358 – $102,700 · median $50,039 19 plans
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $22,358 – $102,700 · median $50,039 19 plans
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $139,697 – $588,389 · median $306,468 19 plans
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $29,365 – $131,470 · median $64,894 19 plans
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC $20,474 – $102,136 · median $47,779 19 plans
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $13,077 – $59,932 · median $29,539 19 plans
030 SPINAL PROCEDURES WITHOUT CC/MCC $8,243 – $41,596 · median $19,881 19 plans
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $5,910 – $30,571 · median $14,811 19 plans
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $14,405 – $66,658 · median $32,402 19 plans
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $6,790 – $33,506 · median $16,569 19 plans
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $4,216 – $22,939 · median $11,113 19 plans
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $5,553 – $28,205 · median $14,032 19 plans
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $4,041 – $21,865 · median $10,676 19 plans
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $6,838 – $32,234 · median $16,666 19 plans
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $3,306 – $19,080 · median $9,153 19 plans
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $2,779 – $17,269 · median $7,874 19 plans
076 VIRAL MENINGITIS WITHOUT CC/MCC $3,396 – $19,478 · median $9,374 19 plans
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $3,696 – $20,973 · median $10,112 19 plans
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $2,470 – $16,600 · median $6,997 19 plans
088 CONCUSSION WITH MCC $5,226 – $29,160 · median $13,373 19 plans
090 CONCUSSION WITHOUT CC/MCC $3,176 – $19,673 · median $8,848 19 plans
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $13,516 – $62,244 · median $30,485 19 plans
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $13,278 – $62,469 · median $30,116 19 plans
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $5,161 – $25,777 · median $13,173 19 plans
116 INTRAOCULAR PROCEDURES WITH CC/MCC $6,181 – $33,864 · median $15,589 19 plans
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $4,830 – $25,804 · median $12,434 19 plans
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $3,623 – $19,741 · median $9,787 19 plans
137 MOUTH PROCEDURES WITH CC/MCC $5,181 – $28,699 · median $13,259 19 plans
138 MOUTH PROCEDURES WITHOUT CC/MCC $3,013 – $18,578 · median $8,460 19 plans
139 Salivary gland procedures $5,086 – $23,678 · median $13,000 19 plans
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $15,666 – $64,706 · median $35,123 19 plans
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $5,825 – $29,337 · median $14,589 19 plans
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $12,231 – $57,539 · median $27,844 19 plans
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $6,507 – $32,275 · median $15,988 19 plans
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $4,611 – $24,440 · median $11,876 19 plans
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $2,966 – $18,959 · median $8,347 19 plans
150 EPISTAXIS WITH MCC $5,120 – $25,687 · median $13,079 19 plans
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $6,024 – $29,230 · median $14,998 19 plans
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $3,458 – $19,860 · median $9,547 19 plans
157 DENTAL AND ORAL DISEASES WITH MCC $6,066 – $31,903 · median $15,294 19 plans
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $14,262 – $69,136 · median $32,796 19 plans
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $5,015 – $26,339 · median $12,835 19 plans
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $3,102 – $16,888 · median $8,569 19 plans
186 PLEURAL EFFUSION WITH MCC $5,853 – $29,450 · median $14,647 19 plans
187 PLEURAL EFFUSION WITH CC $3,719 – $20,647 · median $10,056 19 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC $2,720 – $16,690 · median $7,706 19 plans
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $3,182 – $18,314 · median $8,818 19 plans
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $4,881 – $25,878 · median $12,518 19 plans
197 INTERSTITIAL LUNG DISEASE WITH CC $3,667 – $20,666 · median $10,008 19 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $2,594 – $17,193 · median $7,351 19 plans
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $2,580 – $15,873 · median $7,311 19 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $22,038 – $95,093 · median $48,867 19 plans
231 CORONARY BYPASS WITH PTCA WITH MCC $31,389 – $133,397 · median $69,040 19 plans
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $22,628 – $99,082 · median $50,141 19 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $5,593 – $26,879 · median $14,114 19 plans
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $6,685 – $33,843 · median $16,401 19 plans
245 AICD generator procedures $18,102 – $76,636 · median $40,378 19 plans
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $8,566 – $42,100 · median $20,336 19 plans
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $9,692 – $48,381 · median $23,014 19 plans
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $6,274 – $30,837 · median $15,510 19 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $3,304 – $20,563 · median $9,178 19 plans
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $10,392 – $47,767 · median $23,954 19 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $6,511 – $34,431 · median $16,350 19 plans
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $12,617 – $57,374 · median $28,547 19 plans
263 VEIN LIGATION AND STRIPPING $9,935 – $49,613 · median $23,563 19 plans
265 AICD lead procedures $13,214 – $60,841 · median $29,833 19 plans
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC $22,191 – $103,794 · median $50,115 19 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $24,698 – $113,433 · median $55,272 19 plans
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $17,232 – $80,612 · median $38,919 19 plans
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $18,533 – $75,512 · median $41,308 19 plans
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $11,870 – $55,559 · median $26,994 19 plans
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $2,745 – $16,583 · median $7,777 19 plans
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $2,080 – $12,607 · median $5,892 19 plans
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $10,118 – $45,936 · median $23,392 19 plans
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $5,840 – $28,271 · median $14,621 19 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $3,626 – $21,105 · median $9,947 19 plans
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $2,033 – $13,760 · median $5,759 19 plans
294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC $4,549 – $22,190 · median $11,734 19 plans
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC $2,926 – $14,869 · median $8,131 19 plans
297 CARDIAC ARREST, UNEXPLAINED WITH CC $2,609 – $16,407 · median $7,393 19 plans
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $1,636 – $11,819 · median $4,636 19 plans
302 ATHEROSCLEROSIS WITH MCC $4,309 – $22,623 · median $11,184 19 plans
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $5,547 – $29,207 · median $14,107 19 plans
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $16,272 – $73,952 · median $36,430 19 plans
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $8,575 – $40,123 · median $20,227 19 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $10,602 – $46,748 · median $24,383 19 plans
332 RECTAL RESECTION WITH MCC $12,849 – $62,322 · median $29,638 19 plans
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $5,514 – $29,268 · median $14,051 19 plans
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $4,613 – $25,264 · median $11,989 19 plans
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $4,084 – $22,432 · median $10,857 19 plans
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $10,865 – $51,183 · median $24,922 19 plans
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $2,586 – $16,646 · median $7,326 19 plans
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $2,358 – $14,896 · median $6,683 19 plans
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $2,776 – $16,858 · median $7,864 19 plans
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $4,683 – $27,012 · median $12,131 19 plans
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $5,445 – $27,888 · median $13,810 19 plans
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $2,890 – $17,310 · median $8,167 19 plans
397 APPENDIX PROCEDURES WITH MCC $9,178 – $40,449 · median $21,465 19 plans
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $12,970 – $63,820 · median $30,124 19 plans
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $5,746 – $29,657 · median $14,427 19 plans
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $10,136 – $50,489 · median $23,982 19 plans
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $7,896 – $37,264 · median $18,836 19 plans
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $6,158 – $28,777 · median $15,273 19 plans
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $7,327 – $36,160 · median $17,670 19 plans
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $5,076 – $26,078 · median $12,976 19 plans
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $13,074 – $55,562 · median $29,532 19 plans
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $5,443 – $27,215 · median $13,807 19 plans
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $8,458 – $37,926 · median $19,988 19 plans
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $5,726 – $30,238 · median $14,539 19 plans
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $2,580 – $15,471 · median $7,310 19 plans
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $2,909 – $18,030 · median $8,210 19 plans
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $18,872 – $87,014 · median $42,315 19 plans
469 Major joint replacement or reattachment of lower extremity w MCC $12,108 – $57,605 · median $27,734 19 plans
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $4,308 – $23,507 · median $11,343 19 plans
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $6,578 – $34,390 · median $16,423 19 plans
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $7,686 – $37,730 · median $18,405 19 plans
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $7,856 – $36,675 · median $18,754 19 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $5,853 – $29,336 · median $14,648 19 plans
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $13,041 – $61,587 · median $29,658 19 plans
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $7,308 – $36,346 · median $17,648 19 plans
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $4,973 – $27,475 · median $12,768 19 plans
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $4,300 – $25,295 · median $11,353 19 plans
503 FOOT PROCEDURES WITH MCC $9,804 – $47,344 · median $22,878 19 plans
505 FOOT PROCEDURES WITHOUT CC/MCC $6,501 – $31,882 · median $15,976 19 plans
506 Major thumb or joint procedures $5,553 – $28,032 · median $14,032 19 plans
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $7,180 – $38,630 · median $17,893 19 plans
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $4,781 – $27,579 · median $12,330 19 plans
509 Arthroscopy $6,507 – $25,872 · median $15,988 19 plans
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $11,455 – $54,940 · median $26,416 19 plans
533 FRACTURES OF FEMUR WITH MCC $5,649 – $30,706 · median $14,361 19 plans
534 FRACTURES OF FEMUR WITHOUT MCC $3,015 – $17,696 · median $8,465 19 plans
535 FRACTURES OF HIP AND PELVIS WITH MCC $4,926 – $25,405 · median $12,607 19 plans
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $3,404 – $20,183 · median $9,418 19 plans
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $2,487 – $16,098 · median $7,048 19 plans
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $3,930 – $22,142 · median $10,602 19 plans
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $2,799 – $17,023 · median $7,932 19 plans
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $2,764 – $17,750 · median $7,832 19 plans
548 SEPTIC ARTHRITIS WITH MCC $7,463 – $35,749 · median $17,947 19 plans
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $3,193 – $19,451 · median $8,890 19 plans
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $4,838 – $26,273 · median $12,456 19 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $4,988 – $27,025 · median $12,803 19 plans
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $3,025 – $17,924 · median $8,487 19 plans
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $5,740 – $29,524 · median $14,416 19 plans
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $4,218 – $22,798 · median $11,080 19 plans
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $3,029 – $17,224 · median $8,403 19 plans
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $5,813 – $29,605 · median $14,564 19 plans
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $3,777 – $20,696 · median $10,127 19 plans
571 SKIN DEBRIDEMENT WITH CC $6,202 – $31,664 · median $15,376 19 plans
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $22,811 – $103,351 · median $50,707 19 plans
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $12,835 – $58,809 · median $29,016 19 plans
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $7,396 – $37,272 · median $17,963 19 plans
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $19,985 – $94,877 · median $45,472 19 plans
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $6,262 – $30,375 · median $15,485 19 plans
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $12,074 – $57,802 · median $27,746 19 plans
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $6,487 – $31,271 · median $15,947 19 plans
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $6,085 – $28,971 · median $15,123 19 plans
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $7,584 – $35,888 · median $18,196 19 plans
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $7,353 – $31,539 · median $17,723 19 plans
594 SKIN ULCERS WITHOUT CC/MCC $3,144 – $17,338 · median $8,667 19 plans
595 MAJOR SKIN DISORDERS WITH MCC $7,835 – $39,315 · median $18,909 19 plans
597 MALIGNANT BREAST DISORDERS WITH MCC $6,507 – $30,216 · median $15,988 19 plans
598 MALIGNANT BREAST DISORDERS WITH CC $3,996 – $23,854 · median $10,737 19 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $3,167 – $14,709 · median $8,721 19 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $2,221 – $14,728 · median $6,292 19 plans
603 CELLULITIS WITHOUT MCC $3,263 – $18,879 · median $9,045 19 plans
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $5,503 – $28,723 · median $13,945 19 plans
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $3,422 – $19,261 · median $9,356 19 plans
606 MINOR SKIN DISORDERS WITH MCC $5,965 – $29,983 · median $14,877 19 plans
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $14,317 – $67,550 · median $32,474 19 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $4,612 – $23,263 · median $11,879 19 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $13,861 – $65,458 · median $31,455 19 plans
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $7,085 – $34,348 · median $17,174 19 plans
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $3,716 – $22,519 · median $10,160 19 plans
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $10,620 – $51,134 · median $24,636 19 plans
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $5,591 – $28,496 · median $14,110 19 plans
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $4,693 – $24,443 · median $12,064 19 plans
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $8,331 – $40,706 · median $19,756 19 plans
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $5,191 – $26,982 · median $13,241 19 plans
641 Nutritional & misc metabolic disorders w/o MCC $2,894 – $17,243 · median $8,176 19 plans
643 ENDOCRINE DISORDERS WITH MCC $6,139 – $30,923 · median $15,234 19 plans
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $12,863 – $59,642 · median $29,077 19 plans
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $9,573 – $45,871 · median $22,284 19 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $4,000 – $21,681 · median $10,590 19 plans
665 PROSTATECTOMY WITH MCC $12,719 – $53,793 · median $28,766 19 plans
667 PROSTATECTOMY WITHOUT CC/MCC $3,807 – $21,491 · median $10,349 19 plans
668 TRANSURETHRAL PROCEDURES WITH MCC $10,803 – $49,499 · median $24,795 19 plans
669 TRANSURETHRAL PROCEDURES WITH CC $5,732 – $29,173 · median $14,400 19 plans
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $3,540 – $20,113 · median $9,725 19 plans
671 URETHRAL PROCEDURES WITH CC/MCC $6,385 – $31,981 · median $15,738 19 plans
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $6,985 – $34,000 · median $16,968 19 plans
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $2,683 – $17,235 · median $7,601 19 plans
693 URINARY STONES WITH MCC $5,447 – $27,299 · median $13,814 19 plans
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $4,178 – $23,810 · median $11,105 19 plans
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $2,563 – $15,829 · median $7,261 19 plans
697 URETHRAL STRICTURE $3,711 – $22,497 · median $10,149 19 plans
709 PENIS PROCEDURES WITH CC/MCC $8,324 – $38,444 · median $19,713 19 plans
710 PENIS PROCEDURES WITHOUT CC/MCC $5,562 – $24,416 · median $14,050 19 plans
711 TESTES PROCEDURES WITH CC/MCC $7,077 – $38,490 · median $17,657 19 plans
712 TESTES PROCEDURES WITHOUT CC/MCC $3,962 – $23,689 · median $10,667 19 plans
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $5,356 – $27,844 · median $13,621 19 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $3,481 – $20,048 · median $9,600 19 plans
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $5,257 – $27,392 · median $13,394 19 plans
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $6,873 – $33,593 · median $16,739 19 plans
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $4,563 – $23,490 · median $11,767 19 plans
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $4,159 – $22,516 · median $10,953 19 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $2,699 – $17,688 · median $7,647 19 plans
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $4,677 – $24,521 · median $12,028 19 plans
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $2,757 – $16,443 · median $7,813 19 plans
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $5,443 – $30,541 · median $13,887 19 plans
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $3,027 – $17,539 · median $8,478 19 plans
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $4,078 – $20,767 · median $10,692 19 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $2,248 – $14,712 · median $6,370 19 plans
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $7,789 – $39,293 · median $18,856 19 plans
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $4,497 – $24,827 · median $11,753 19 plans
739 Uterine,adnexa proc for non-ovarian/adnexal malig w MCC $14,746 – $62,143 · median $33,139 19 plans
741 Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC $5,088 – $25,446 · median $13,005 19 plans
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $3,796 – $21,274 · median $10,286 19 plans
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $6,203 – $31,414 · median $15,365 19 plans
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $4,777 – $26,407 · median $12,321 19 plans
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $3,538 – $20,542 · median $9,736 19 plans
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $5,243 – $28,492 · median $13,417 19 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $2,371 – $15,102 · median $6,717 19 plans
799 SPLENIC PROCEDURES WITH MCC $17,613 – $83,339 · median $40,008 19 plans
801 SPLENIC PROCEDURES WITHOUT CC/MCC $6,081 – $33,213 · median $15,359 19 plans
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $13,279 – $58,564 · median $29,974 19 plans
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $6,594 – $34,298 · median $16,417 19 plans
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $2,443 – $16,116 · median $6,921 19 plans
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $4,237 – $24,488 · median $11,225 19 plans
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $8,147 – $40,232 · median $19,452 19 plans
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $8,742 – $41,568 · median $20,569 19 plans
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $11,423 – $54,818 · median $26,354 19 plans
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $5,417 – $29,911 · median $13,828 19 plans
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $7,912 – $40,274 · median $19,220 19 plans
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC $4,707 – $23,830 · median $12,096 19 plans
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $18,548 – $80,203 · median $41,340 19 plans
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $7,513 – $35,790 · median $18,050 19 plans
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $5,076 – $25,506 · median $12,978 19 plans
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $11,813 – $54,365 · median $26,866 19 plans
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $3,896 – $21,757 · median $10,504 19 plans
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $3,100 – $18,566 · median $8,666 19 plans
849 Radiotherapy $9,894 – $47,494 · median $23,008 19 plans
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $6,076 – $31,821 · median $15,378 19 plans
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $4,773 – $25,194 · median $12,247 19 plans
865 VIRAL ILLNESS WITH MCC $5,467 – $30,840 · median $13,942 19 plans
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $2,666 – $15,807 · median $7,553 19 plans
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $14,556 – $63,967 · median $32,729 19 plans
881 Depressive neuroses $3,386 – $19,225 · median $9,298 19 plans
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $6,655 – $31,502 · median $16,291 19 plans
895 Alcohol/drug abuse or dependence w rehabilitation therapy $5,363 – $30,348 · median $13,703 19 plans
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $16,412 – $73,412 · median $36,732 19 plans
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $4,516 – $24,530 · median $11,792 19 plans
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $14,302 – $56,440 · median $32,182 19 plans
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $6,105 – $29,950 · median $15,164 19 plans
913 TRAUMATIC INJURY WITH MCC $5,995 – $28,537 · median $14,937 19 plans
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $88,671 – $422,341 · median $187,474 19 plans
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $24,964 – $114,463 · median $53,626 19 plans
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $11,781 – $55,795 · median $26,614 19 plans
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $16,173 – $52,889 · median $35,338 19 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $7,949 – $38,009 · median $18,529 19 plans
935 Non-extensive burns $8,136 – $37,195 · median $18,773 19 plans
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $11,757 – $55,792 · median $26,934 19 plans
945 REHABILITATION WITH CC/MCC $5,655 – $28,775 · median $14,240 19 plans
946 REHABILITATION WITHOUT CC/MCC $4,136 – $20,907 · median $10,807 19 plans
947 SIGNS AND SYMPTOMS WITH MCC $4,764 – $24,690 · median $12,228 19 plans
949 AFTERCARE WITH CC/MCC $3,997 – $21,277 · median $10,530 19 plans
950 AFTERCARE WITHOUT CC/MCC $2,171 – $14,817 · median $6,151 19 plans
951 Other factors influencing health status $2,100 – $14,212 · median $5,951 19 plans
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $23,427 – $113,717 · median $53,908 19 plans
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $9,828 – $42,949 · median $22,798 19 plans
975 HIV WITH MAJOR RELATED CONDITION WITH CC $5,265 – $26,459 · median $13,412 19 plans
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $3,715 – $18,255 · median $9,970 19 plans
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $5,341 – $27,296 · median $13,587 19 plans
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $68,632 – $80,745 · median $72,672 1 plans
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL $43,402 – $51,062 · median $45,957 1 plans
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $116,214 – $136,725 · median $123,055 1 plans
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC $78,797 – $92,704 · median $83,435 1 plans
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC $61,062 – $71,840 · median $64,657 1 plans
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC $92,531 – $108,862 · median $97,977 1 plans
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC $60,690 – $71,401 · median $64,262 1 plans
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $74,382 – $87,510 · median $78,760 1 plans
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $45,302 – $53,298 · median $47,969 1 plans
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE $57,135 – $67,219 · median $60,498 1 plans
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $34,236 – $40,278 · median $36,251 1 plans
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES $102,197 – $120,234 · median $108,212 1 plans
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