Erlanger Medical Center — Pricing

771 procedures published in this hospital's Machine-Readable File (MRF) — 476 with a comparable price, 295 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 $19,112
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 476 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 $142,952 +159% $196,346 +88% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $228,809 $386,137 −41% $123,995 +85% —
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $223,430 $62,992 +255% $71,551 +212% ≈114% of Medicare
028 SPINAL PROCEDURES WITH MCC $153,120 $218,956 −30% $113,077 +35% —
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 $527,787 −73% $371,366 −61% ≈130% of Medicare
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $139,861 $103,783 +35% $71,092 +97% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $119,543 $121,376 −2% $83,441 +43% —
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $91,444 $466,934 −80% $188,171 −51% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $89,061 $178,670 −50% $107,355 −17% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $79,952 $106,929 −25% $148,686 −46% —
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $77,514 $71,331 +9% $90,724 −15% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR $74,777 $268,292 −72% $117,280 −36% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $63,396 $73,038 −13% $101,576 −38% —
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $63,053 $96,882 −35% $69,743 −10% —
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC $62,052 $112,119 −45% $153,282 −60% —
790 Extreme immaturity or respiratory distress syndrome, neonate $58,644 $20,715 +183% $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 $118,104 −53% $120,573 −54% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC $53,540 $103,817 −48% $144,569 −63% ≈120% of Medicare
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $51,684 $201,416 −74% $148,832 −65% ≈151% of Medicare
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $49,092 $32,969 +49% $40,108 +22% —
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $48,748 $94,288 −48% $131,961 −63% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $48,591 $324,510 −85% $248,521 −80% —
461 Bilateral or multiple major joint procs of lower extremity w MCC $46,100 $76,071 −39% $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 $174,196 −74% $116,058 −61% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $43,845 $23,368 +88% $37,267 +18% —
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $42,773 $57,584 −26% $72,962 −41% —
955 Craniotomy for multiple significant trauma $42,495 $38,091 +12% $102,600 −59% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $42,112 $85,566 −51% $85,566 −51% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $42,036 $55,735 −25% $96,192 −56% —
653 MAJOR BLADDER PROCEDURES WITH MCC $40,534 $151,686 −73% $104,583 −61% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $39,630 $82,861 −52% $46,090 −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 $212,510 −81% $106,778 −63% ≈114% of Medicare
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $36,730 $71,776 −49% $111,320 −67% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $36,535 $153,649 −76% $99,423 −63% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $35,656 $125,958 −72% $80,793 −56% ≈116% of Medicare
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $35,537 $200,802 −82% $96,905 −63% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $35,462 $45,474 −22% $24,944 +42% —
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $35,028 $127,657 −73% $93,172 −62% ≈111% of Medicare
471 CERVICAL SPINAL FUSION WITH MCC $34,744 $212,889 −84% $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 $73,455 −53% $102,128 −66% —
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 $73,182 −53% $33,694 +2% —
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $33,852 $148,353 −77% $93,390 −64% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $33,423 $82,687 −60% $46,724 −28% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $33,416 $95,995 −65% $50,394 −34% —
163 MAJOR CHEST PROCEDURES WITH MCC $33,381 $160,879 −79% $90,195 −63% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $33,099 $143,848 −77% $89,207 −63% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $32,570 $66,170 −51% $41,892 −22% ≈119% of Medicare
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $32,107 $128,201 −75% $74,257 −57% —
215 Other heart assist system implant $32,074 $475,995 −93% $208,939 −85% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $31,882 $87,761 −64% $87,761 −64% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $31,819 $28,768 +11% $39,018 −18% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $31,805 $111,707 −72% $77,990 −59% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $31,436 $195,030 −84% $88,307 −64% ≈113% of Medicare
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $31,354 $82,674 −62% $76,001 −59% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $30,690 $109,914 −72% $84,692 −64% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $30,393 $95,866 −68% $82,561 −63% ≈113% of Medicare
539 OSTEOMYELITIS WITH MCC $29,736 $50,351 −41% $37,609 −21% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $29,701 $172,120 −83% $85,159 −65% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $29,615 $177,398 −83% $101,510 −71% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $29,602 $30,404 −3% $46,066 −36% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC $29,508 $82,429 −64% $46,295 −36% —
570 SKIN DEBRIDEMENT WITH MCC $28,911 $45,372 −36% $52,435 −45% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $28,830 $56,535 −49% $73,120 −61% —
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $28,652 $123,106 −77% $71,795 −60% —
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $28,098 $55,985 −50% $79,225 −65% —
273 PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC $27,993 $53,945 −48% $78,852 −64% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $27,797 $59,017 −53% $70,564 −61% ≈129% of Medicare
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $27,734 $122,800 −77% $75,103 −63% ≈77% of Medicare
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $27,191 $46,088 −41% $74,755 −64% —
252 OTHER VASCULAR PROCEDURES WITH MCC $26,942 $114,667 −77% $68,508 −61% ≈116% of Medicare
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $26,856 $69,764 −62% $49,423 −46% —
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $26,834 $98,989 −73% $77,817 −66% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $26,767 $35,750 −25% $39,173 −32% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $26,705 $97,161 −73% $72,424 −63% —
313 Chest pain $26,528 $21,819 +22% $16,440 +61% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $26,436 $38,581 −31% $51,746 −49% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $26,362 $137,306 −81% $88,050 −70% ≈131% of Medicare
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $26,357 $155,075 −83% $70,132 −62% —
501 SOFT TISSUE PROCEDURES WITH CC $26,157 $74,943 −65% $39,619 −34% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $25,725 $31,915 −19% $32,443 −21% —
264 Other circulatory system O.R. procedures $25,498 $93,232 −73% $51,953 −51% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $25,260 $140,647 −82% $70,847 −64% ≈115% of Medicare
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $24,954 $54,300 −54% $61,832 −60% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $24,905 $173,990 −86% $67,268 −63% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $24,648 $162,153 −85% $65,325 −62% ≈119% of Medicare
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $24,579 $36,339 −32% $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 $112,838 −78% $60,407 −60% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $24,251 $123,776 −80% $71,014 −66% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $24,080 $53,719 −55% $36,792 −35% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $24,072 $21,783 +11% $42,186 −43% —
037 EXTRACRANIAL PROCEDURES WITH MCC $23,883 $46,296 −48% $66,666 −64% —
662 MINOR BLADDER PROCEDURES WITH MCC $23,414 $43,683 −46% $54,562 −57% —
652 Kidney transplant $23,297 $54,720 −57% $54,720 −57% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $23,020 $26,865 −14% $32,031 −28% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $22,855 $45,479 −50% $65,608 −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 $73,014 −70% $58,228 −62% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $21,942 $125,800 −83% $70,467 −69% ≈117% of Medicare
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $21,836 $145,049 −85% $71,464 −69% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $21,798 $77,863 −72% $59,790 −64% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $21,796 $112,488 −81% $62,264 −65% —
472 CERVICAL SPINAL FUSION WITH CC $21,701 $127,116 −83% $59,537 −64% ≈111% of Medicare
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $21,683 $38,166 −43% $44,546 −51% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $21,606 $112,338 −81% $47,583 −55% —
510 Shoulder,elbow or forearm proc,exc major joint proc w MCC $21,457 $40,289 −47% $49,839 −57% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $21,418 $18,536 +16% $19,598 +9% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $21,405 $22,793 −6% $20,232 +6% —
321 Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices $21,356 $137,354 −84% $81,706 −74% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $21,177 $30,914 −31% $46,727 −55% —
654 MAJOR BLADDER PROCEDURES WITH CC $21,175 $65,422 −68% $58,274 −64% ≈116% of Medicare
462 Bilateral or multiple major joint procs of lower extremity w/o MCC $21,031 $84,701 −75% $58,975 −64% ≈120% of Medicare
800 SPLENIC PROCEDURES WITH CC $20,873 $41,012 −49% $49,184 −58% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $20,423 $51,872 −61% $40,548 −50% —
253 OTHER VASCULAR PROCEDURES WITH CC $20,358 $114,254 −82% $57,454 −65% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $20,319 $54,164 −62% $50,046 −59% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $20,230 $169,637 −88% $43,491 −53% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $20,214 $17,544 +15% $24,544 −18% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $20,104 $49,595 −59% $34,607 −42% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $20,095 $83,023 −76% $52,405 −62% ≈121% of Medicare
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $19,943 $128,144 −84% $65,653 −70% ≈119% of Medicare
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $19,871 $37,754 −47% $47,945 −59% —
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 $102,052 −81% $61,872 −68% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $19,710 $78,474 −75% $39,887 −51% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $19,529 $62,575 −69% $41,955 −53% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $19,385 $22,714 −15% $36,253 −47% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $19,214 $90,581 −79% $50,139 −62% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $18,963 $30,866 −39% $41,422 −54% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $18,872 $42,293 −55% $39,181 −52% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $18,681 $91,676 −80% $51,985 −64% —
887 OTHER MENTAL DISORDER DIAGNOSES $18,659 $33,684 −45% $20,616 −9% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $18,645 $94,139 −80% $59,421 −69% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $18,625 $18,704 −0% $15,837 +18% —
906 Hand procedures for injuries $18,620 $44,481 −58% $32,065 −42% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $18,601 $75,345 −75% $48,682 −62% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $18,576 $32,719 −43% $49,066 −62% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $18,251 $35,990 −49% $40,362 −55% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $18,172 $124,159 −85% $50,624 −64% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $17,995 $51,655 −65% $39,973 −55% ≈142% of Medicare
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $17,930 $51,069 −65% $45,877 −61% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $17,807 $39,644 −55% $58,043 −69% —
164 MAJOR CHEST PROCEDURES WITH CC $17,714 $137,471 −87% $56,755 −69% —
333 RECTAL RESECTION WITH CC $17,704 $47,559 −63% $37,154 −52% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $17,593 $32,773 −46% $48,349 −64% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $17,557 $90,992 −81% $53,451 −67% ≈135% of Medicare
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES $17,543 $97,667 −82% $58,707 −70% ≈120% of Medicare
113 ORBITAL PROCEDURES WITH CC/MCC $17,472 $20,048 −13% $36,167 −52% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $17,447 $59,140 −70% $32,833 −47% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $17,346 $45,881 −62% $38,070 −54% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $17,299 $30,155 −43% $43,174 −60% —
374 DIGESTIVE MALIGNANCY WITH MCC $17,236 $55,854 −69% $39,958 −57% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $17,228 $80,453 −79% $36,489 −53% ≈106% of Medicare
336 PERITONEAL ADHESIOLYSIS WITH CC $17,208 $101,243 −83% $50,463 −66% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $17,206 $113,974 −85% $50,011 −66% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $17,085 $118,821 −86% $68,653 −75% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $17,047 $57,662 −70% $66,068 −74% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $17,000 $43,030 −60% $31,017 −45% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $16,919 $36,298 −53% $33,555 −50% —
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $16,872 $16,434 +3% $22,557 −25% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $16,833 $112,611 −85% $54,583 −69% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $16,769 $32,504 −48% $38,998 −57% —
274 PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC $16,737 $43,701 −62% $65,573 −74% ≈112% of Medicare
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $16,730 $49,024 −66% $36,249 −54% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $16,680 $158,118 −89% $64,523 −74% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $16,416 $79,846 −79% $46,283 −65% ≈129% of Medicare
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $16,371 $67,828 −76% $42,881 −62% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $16,303 $74,533 −78% $45,333 −64% ≈123% of Medicare
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $16,145 $90,228 −82% $58,280 −72% ≈121% of Medicare
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $16,144 $63,008 −74% $43,631 −63% ≈119% of Medicare
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $15,807 $69,740 −77% $43,943 −64% ≈132% of Medicare
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $15,760 $27,256 −42% $23,206 −32% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $15,751 $44,825 −65% $30,083 −48% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $15,649 $25,633 −39% $29,826 −48% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $15,594 $43,315 −64% $42,901 −64% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $15,585 $24,999 −38% $31,563 −51% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $15,568 $70,105 −78% $55,162 −72% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $15,549 $57,799 −73% $36,431 −57% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $15,471 $48,565 −68% $39,106 −60% ≈125% of Medicare
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $15,419 $63,523 −76% $42,914 −64% ≈114% of Medicare
549 SEPTIC ARTHRITIS WITH CC $15,372 $24,180 −36% $24,056 −36% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $15,270 $60,922 −75% $39,955 −62% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $15,219 $28,381 −46% $43,080 −65% —
380 COMPLICATED PEPTIC ULCER WITH MCC $15,108 $42,323 −64% $39,627 −62% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $15,078 $61,052 −75% $38,836 −61% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $15,006 $42,908 −65% $32,637 −54% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $14,945 $45,871 −67% $20,259 −26% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $14,809 $17,624 −16% $33,851 −56% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $14,699 $27,823 −47% $40,562 −64% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $14,627 $105,853 −86% $52,075 −72% ≈114% of Medicare
470 Major joint replacement or reattachment of lower extremity w/o MCC $14,614 $64,995 −78% $50,607 −71% ≈122% of Medicare
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $14,601 $69,604 −79% $42,126 −65% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $14,596 $63,524 −77% $40,642 −64% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $14,453 $127,726 −89% $46,340 −69% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $14,429 $44,280 −67% $33,047 −56% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $14,422 $58,994 −76% $38,094 −62% —
919 COMPLICATIONS OF TREATMENT WITH MCC $14,416 $55,624 −74% $31,105 −54% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $14,415 $24,448 −41% $36,354 −60% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $14,390 $64,245 −78% $59,651 −76% ≈122% of Medicare
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $14,365 $26,921 −47% $43,298 −67% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $14,363 $21,597 −33% $26,870 −47% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $14,341 $111,391 −87% $59,500 −76% ≈121% of Medicare
666 PROSTATECTOMY WITH CC $14,320 $24,574 −42% $31,906 −55% —
180 RESPIRATORY NEOPLASMS WITH MCC $14,090 $58,251 −76% $36,658 −62% —
663 MINOR BLADDER PROCEDURES WITH CC $14,087 $58,736 −76% $33,103 −57% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $14,038 $89,281 −84% $35,584 −61% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $13,999 $95,112 −85% $41,620 −66% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $13,966 $39,965 −65% $34,192 −59% —
199 PNEUMOTHORAX WITH MCC $13,950 $34,682 −60% $33,787 −59% ≈107% of Medicare
915 ALLERGIC REACTIONS WITH MCC $13,923 $41,180 −66% $32,645 −57% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $13,802 $43,100 −68% $26,682 −48% ≈119% of Medicare
551 MEDICAL BACK PROBLEMS WITH MCC $13,791 $56,708 −76% $34,017 −59% ≈147% of Medicare
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $13,758 $65,248 −79% $43,477 −68% —
334 RECTAL RESECTION WITHOUT CC/MCC $13,740 $82,520 −83% $36,820 −63% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $13,688 $45,009 −70% $37,842 −64% ≈114% of Medicare
399 APPENDIX PROCEDURES WITHOUT CC/MCC $13,685 $53,727 −75% $31,321 −56% —
038 EXTRACRANIAL PROCEDURES WITH CC $13,653 $58,337 −77% $35,770 −62% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $13,600 $44,855 −70% $30,010 −55% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $13,585 $11,913 +14% $18,316 −26% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $13,526 $35,163 −62% $37,950 −64% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $13,502 $64,628 −79% $32,859 −59% ≈129% of Medicare
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,481 $24,768 −46% $27,316 −51% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $13,422 $12,813 +5% $14,797 −9% —
115 Extraocular procedures except orbit $13,329 $23,065 −42% $25,703 −48% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $13,320 $91,463 −85% $49,418 −73% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $13,284 $72,134 −82% $44,117 −70% ≈127% of Medicare
511 Shoulder,elbow or forearm proc,exc major joint proc w CC $13,284 $56,507 −76% $43,538 −69% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $13,251 $49,064 −73% $32,628 −59% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $13,169 $33,129 −60% $33,876 −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% $33,246 −62% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $12,766 $50,512 −75% $33,661 −62% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $12,763 $62,676 −80% $44,606 −71% ≈121% of Medicare
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $12,739 $42,250 −70% $30,828 −59% ≈123% of Medicare
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $12,736 $23,263 −45% $24,550 −48% —
541 OSTEOMYELITIS WITHOUT CC/MCC $12,729 $29,513 −57% $15,215 −16% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $12,717 $71,281 −82% $34,749 −63% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $12,620 $56,824 −78% $33,633 −62% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $12,612 $94,411 −87% $58,809 −79% ≈132% of Medicare
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $12,496 $46,193 −73% $25,094 −50% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $12,484 $37,498 −67% $33,985 −63% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $12,382 $46,935 −74% $32,841 −62% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $12,378 $65,491 −81% $33,393 −63% —
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $12,263 $71,538 −83% $32,433 −62% —
602 CELLULITIS WITH MCC $12,258 $46,242 −73% $30,598 −60% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $12,242 $13,822 −11% $14,501 −16% —
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 $39,320 −69% $29,743 −59% —
398 Appendix Procedures without MCC/CC $12,186 $64,962 −81% $40,162 −70% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $12,154 $55,401 −78% $27,394 −56% ≈125% of Medicare
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $12,150 $54,529 −78% $45,167 −73% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $12,091 $60,837 −80% $39,211 −69% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $12,065 $22,435 −46% $36,988 −67% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $12,038 $33,965 −65% $33,424 −64% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $11,937 $47,333 −75% $27,285 −56% ≈130% of Medicare
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $11,892 $48,869 −76% $38,666 −69% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $11,829 $53,399 −78% $36,505 −68% —
512 Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC $11,806 $71,909 −84% $35,692 −67% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $11,705 $41,795 −72% $38,101 −69% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $11,677 $53,483 −78% $46,402 −75% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $11,643 $52,301 −78% $38,861 −70% —
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 $83,277 −86% $43,650 −74% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $11,530 $43,479 −73% $30,959 −63% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $11,390 $103,547 −89% $44,139 −74% ≈122% of Medicare
914 TRAUMATIC INJURY WITHOUT MCC $11,267 $24,833 −55% $15,855 −29% —
885 PSYCHOSES $11,238 $29,910 −62% $21,729 −48% —
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $11,184 $28,559 −61% $29,524 −62% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $11,162 $56,359 −80% $28,156 −60% —
075 VIRAL MENINGITIS WITH CC/MCC $11,148 $25,549 −56% $30,447 −63% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $11,122 $56,971 −80% $26,932 −59% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $11,074 $44,636 −75% $31,264 −65% ≈119% of Medicare
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $10,989 $43,753 −75% $33,707 −67% ≈125% of Medicare
593 SKIN ULCERS WITH CC $10,942 $19,063 −43% $22,886 −52% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $10,867 $33,391 −67% $25,700 −58% —
375 DIGESTIVE MALIGNANCY WITH CC $10,860 $32,044 −66% $27,277 −60% ≈136% of Medicare
348 ANAL AND STOMAL PROCEDURES WITH CC $10,811 $45,396 −76% $27,947 −61% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $10,776 $42,835 −75% $31,951 −66% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $10,679 $29,592 −64% $20,901 −49% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $10,669 $27,858 −62% $18,126 −41% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $10,664 $34,884 −69% $25,034 −57% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $10,574 $37,129 −72% $22,635 −53% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $10,529 $18,707 −44% $21,847 −52% —
381 COMPLICATED PEPTIC ULCER WITH CC $10,408 $30,250 −66% $24,177 −57% —
540 OSTEOMYELITIS WITH CC $10,360 $34,794 −70% $26,676 −61% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $10,306 $45,504 −77% $33,255 −69% —
504 FOOT PROCEDURES WITH CC $10,289 $65,518 −84% $38,960 −74% —
304 HYPERTENSION WITH MCC $10,268 $61,398 −83% $26,080 −61% —
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $10,226 $22,882 −55% $33,674 −70% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $10,216 $35,437 −71% $25,712 −60% —
740 Uterine,adnexa proc for non-ovarian/adnexal malig w CC $10,186 $82,704 −88% $40,365 −75% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $10,173 $39,202 −74% $26,770 −62% ≈116% of Medicare
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $10,154 $30,798 −67% $24,914 −59% ≈125% of Medicare
181 RESPIRATORY NEOPLASMS WITH CC $10,134 $44,379 −77% $23,573 −57% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $10,081 $69,184 −85% $39,006 −74% ≈119% of Medicare
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $10,073 $12,252 −18% $18,459 −45% —
672 URETHRAL PROCEDURES WITHOUT CC/MCC $10,053 $28,760 −65% $17,398 −42% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $9,961 $14,627 −32% $19,854 −50% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,930 $18,191 −45% $25,652 −61% —
813 COAGULATION DISORDERS $9,704 $40,340 −76% $33,296 −71% —
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 $66,524 −86% $40,552 −76% —
158 DENTAL AND ORAL DISEASES WITH CC $9,499 $24,004 −60% $18,466 −49% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $9,476 $50,457 −81% $24,386 −61% ≈124% of Medicare
445 DISORDERS OF THE BILIARY TRACT WITH CC $9,432 $38,290 −75% $23,319 −60% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $9,429 $19,686 −52% $23,498 −60% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $9,425 $21,964 −57% $13,651 −31% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $9,406 $44,293 −79% $35,628 −74% ≈121% of Medicare
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $9,376 $36,217 −74% $27,043 −65% ≈128% of Medicare
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $9,342 $59,579 −84% $32,496 −71% ≈130% of Medicare
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $9,335 $104,125 −91% $90,775 −90% ≈121% of Medicare
644 ENDOCRINE DISORDERS WITH CC $9,325 $31,330 −70% $23,198 −60% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $9,292 $29,015 −68% $19,264 −52% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $9,290 $34,254 −73% $25,970 −64% ≈130% of Medicare
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $9,290 $31,052 −70% $29,221 −68% —
089 CONCUSSION WITH CC $9,051 $18,369 −51% $18,821 −52% —
563 Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC $8,986 $30,301 −70% $19,842 −55% ≈127% of Medicare
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $8,958 $28,523 −69% $27,163 −67% —
748 Female reproductive system reconstructive procedures $8,922 $20,875 −57% $30,242 −70% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $8,910 $65,828 −86% $37,387 −76% ≈129% of Medicare
303 ATHEROSCLEROSIS WITHOUT MCC $8,827 $22,945 −62% $14,927 −41% —
102 HEADACHES WITH MCC $8,784 $35,978 −76% $25,740 −66% —
811 RED BLOOD CELL DISORDERS WITH MCC $8,731 $37,560 −77% $28,226 −69% ≈117% of Medicare
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $8,717 $42,477 −79% $32,021 −73% ≈128% of Medicare
552 MEDICAL BACK PROBLEMS WITHOUT MCC $8,648 $27,370 −68% $21,396 −60% ≈128% of Medicare
682 RENAL FAILURE WITH MCC $8,552 $46,893 −82% $29,064 −71% ≈132% of Medicare
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $8,532 $21,743 −61% $17,700 −52% —
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $8,529 $27,046 −68% $21,449 −60% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $8,407 $29,126 −71% $20,181 −58% ≈123% of Medicare
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $8,402 $44,704 −81% $28,050 −70% ≈117% of Medicare
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $8,399 $27,102 −69% $18,002 −53% ≈124% of Medicare
444 DISORDERS OF THE BILIARY TRACT WITH MCC $8,394 $57,295 −85% $34,273 −76% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $8,354 $14,516 −42% $16,998 −51% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $8,345 $28,413 −71% $19,569 −57% —
607 MINOR SKIN DISORDERS WITHOUT MCC $8,344 $17,880 −53% $15,889 −47% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $8,313 $23,568 −65% $15,428 −46% —
152 OTITIS MEDIA AND URI WITH MCC $8,307 $45,505 −82% $20,247 −59% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $8,283 $39,692 −79% $20,566 −60% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $8,276 $21,596 −62% $18,488 −55% —
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $8,235 $43,996 −81% $20,463 −60% ≈124% of Medicare
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $8,172 $30,514 −73% $23,749 −66% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $8,157 $24,095 −66% $20,895 −61% —
640 Nutritional & misc metabolic disorders w MCC $8,126 $52,780 −85% $25,463 −68% ≈121% of Medicare
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $8,126 $24,378 −67% $18,956 −57% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $8,113 $20,073 −60% $16,767 −52% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $8,085 $15,591 −48% $19,594 −59% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $8,076 $43,649 −81% $27,152 −70% —
200 PNEUMOTHORAX WITH CC $7,916 $25,828 −69% $21,368 −63% ≈145% of Medicare
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $7,882 $55,276 −86% $35,465 −78% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $7,840 $19,169 −59% $27,323 −71% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $7,792 $32,403 −76% $19,227 −59% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $7,788 $33,138 −76% $23,141 −66% ≈115% of Medicare
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $7,757 $15,153 −49% $20,455 −62% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $7,656 $26,898 −72% $17,124 −55% —
204 RESPIRATORY SIGNS AND SYMPTOMS $7,644 $38,490 −80% $18,004 −58% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $7,623 $34,308 −78% $23,283 −67% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $7,611 $15,610 −51% $16,700 −54% —
176 PULMONARY EMBOLISM WITHOUT MCC $7,602 $29,171 −74% $18,081 −58% ≈124% of Medicare
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $7,599 $9,606 −21% $13,633 −44% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $7,598 $23,220 −67% $21,363 −64% ≈114% of Medicare
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $7,568 $38,715 −80% $23,617 −68% ≈126% of Medicare
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $7,552 $64,036 −88% $40,213 −81% ≈133% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $7,544 $13,602 −45% $19,962 −62% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $7,496 $23,474 −68% $17,578 −57% ≈124% of Medicare
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $7,496 $63,856 −88% $30,784 −76% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $7,476 $16,177 −54% $18,528 −60% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $7,456 $29,836 −75% $19,846 −62% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $7,451 $19,057 −61% $18,133 −59% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $7,410 $44,199 −83% $22,024 −66% ≈129% of Medicare
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $7,355 $61,418 −88% $36,937 −80% —
291 HEART FAILURE AND SHOCK WITH MCC $7,318 $40,123 −82% $26,776 −73% ≈125% of Medicare
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $7,263 $17,625 −59% $16,552 −56% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $7,244 $27,876 −74% $20,781 −65% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $7,220 $33,491 −78% $22,098 −67% ≈123% of Medicare
300 PERIPHERAL VASCULAR DISORDERS WITH CC $7,182 $39,619 −82% $20,422 −65% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $7,176 $21,587 −67% $18,602 −61% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $7,049 $30,777 −77% $30,235 −77% ≈98% of Medicare
100 SEIZURES WITH MCC $7,034 $47,409 −85% $35,481 −80% ≈119% of Medicare
385 INFLAMMATORY BOWEL DISEASE WITH MCC $7,001 $42,576 −84% $27,617 −75% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $6,968 $28,901 −76% $23,571 −70% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $6,919 $11,503 −40% $11,997 −42% —
896 Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC $6,817 $47,898 −86% $31,159 −78% —
866 VIRAL ILLNESS WITHOUT MCC $6,682 $31,738 −79% $17,081 −61% —
201 PNEUMOTHORAX WITHOUT CC/MCC $6,674 $13,904 −52% $14,053 −53% —
642 Inborn errors of metabolism $6,619 $19,302 −66% $20,727 −68% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $6,496 $13,497 −52% $14,549 −55% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $6,485 $24,375 −73% $14,128 −54% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $6,438 $27,174 −76% $17,226 −63% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $6,400 $22,922 −72% $22,850 −72% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $6,332 $34,781 −82% $21,275 −70% ≈133% of Medicare
694 URINARY STONES WITHOUT MCC $6,321 $27,794 −77% $17,345 −64% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $6,234 $36,938 −83% $23,940 −74% ≈125% of Medicare
684 RENAL FAILURE WITHOUT CC/MCC $6,231 $16,007 −61% $13,642 −54% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $6,230 $27,659 −77% $20,084 −69% —
916 ALLERGIC REACTIONS WITHOUT MCC $6,224 $17,472 −64% $13,942 −55% —
183 MAJOR CHEST TRAUMA WITH MCC $6,198 $36,218 −83% $29,933 −79% ≈121% of Medicare
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $6,111 $36,362 −83% $22,458 −73% —
153 OTITIS MEDIA AND URI WITHOUT MCC $6,093 $26,521 −77% $14,583 −58% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $6,079 $38,065 −84% $18,452 −67% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $6,045 $17,193 −65% $17,193 −65% —
637 DIABETES WITH MCC $6,010 $30,655 −80% $30,100 −80% ≈123% of Medicare
103 HEADACHES WITHOUT MCC $6,004 $30,163 −80% $21,280 −72% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $5,912 $26,087 −77% $17,303 −66% ≈125% of Medicare
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $5,859 $18,486 −68% $16,288 −64% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $5,761 $15,603 −63% $19,924 −71% ≈129% of Medicare
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $5,752 $30,760 −81% $21,056 −73% ≈131% of Medicare
683 RENAL FAILURE WITH CC $5,752 $24,421 −76% $19,130 −70% ≈124% of Medicare
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $5,662 $30,303 −81% $17,733 −68% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $5,517 $39,158 −86% $27,543 −80% ≈134% of Medicare
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $5,484 $26,055 −79% $17,620 −69% —
864 FEVER AND INFLAMMATORY CONDITIONS $5,458 $26,401 −79% $18,640 −71% —
312 SYNCOPE AND COLLAPSE $5,398 $26,853 −80% $19,342 −72% ≈122% of Medicare
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $5,322 $77,284 −93% $19,412 −73% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $5,318 $17,702 −70% $14,415 −63% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $5,315 $21,217 −75% $14,716 −64% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $5,279 $28,118 −81% $17,298 −69% —
882 Neuroses except depressive $5,248 $18,025 −71% $15,680 −67% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $5,216 $30,654 −83% $17,601 −70% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $5,194 $32,674 −84% $19,096 −73% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $5,105 $27,597 −82% $22,033 −77% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $5,096 $30,281 −83% $22,888 −78% ≈126% of Medicare
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $5,054 $29,934 −83% $25,303 −80% —
151 EPISTAXIS WITHOUT MCC $5,046 $6,972 −28% $13,032 −61% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $5,026 $24,486 −79% $17,921 −72% ≈135% of Medicare
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $4,971 $10,118 −51% $12,895 −61% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $4,962 $29,084 −83% $23,488 −79% ≈127% of Medicare
639 DIABETES WITHOUT CC/MCC $4,878 $19,699 −75% $13,910 −65% —
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $4,756 $21,106 −77% $20,957 −77% —
184 MAJOR CHEST TRAUMA WITH CC $4,718 $31,929 −85% $22,432 −79% ≈123% of Medicare
292 HEART FAILURE AND SHOCK WITH CC $4,694 $30,136 −84% $16,371 −71% —
149 Dysequilibrium $4,638 $22,523 −79% $18,096 −74% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $4,628 $51,552 −91% $28,320 −84% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $4,598 $26,155 −82% $16,846 −73% —
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $4,598 $16,841 −73% $15,370 −70% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $4,598 $14,454 −68% $13,275 −65% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $4,432 $26,067 −83% $22,763 −81% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $4,291 $19,711 −78% $13,384 −68% ≈126% of Medicare
789 Neonates, died or transferred to another acute care facility $4,274 $11,107 −62% $16,351 −74% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $4,247 $14,272 −70% $12,078 −65% —
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $4,229 $11,758 −64% $14,648 −71% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $4,191 $25,188 −83% $16,520 −75% —
638 DIABETES WITH CC $4,054 $24,658 −84% $19,661 −79% ≈132% of Medicare
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $3,975 $21,818 −82% $12,454 −68% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $3,929 $25,476 −85% $15,452 −75% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $3,884 $84,233 −95% $47,711 −92% ≈121% of Medicare
123 Neurological eye disorders $3,672 $33,346 −89% $19,745 −81% —
101 SEIZURES WITHOUT MCC $3,621 $25,796 −86% $20,461 −82% ≈126% of Medicare
202 BRONCHITIS AND ASTHMA WITH CC/MCC $3,593 $33,241 −89% $17,724 −80% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $3,545 $13,360 −73% $18,649 −81% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $3,540 $37,757 −91% $26,580 −87% ≈126% of Medicare
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $3,516 $33,175 −89% $18,204 −81% ≈131% of Medicare
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $3,492 $17,180 −80% $13,361 −74% ≈130% of Medicare
792 PREMATURITY WITHOUT MAJOR PROBLEMS $3,459 $11,361 −70% $12,229 −72% —
897 Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC $3,430 $24,811 −86% $16,699 −79% —
920 COMPLICATIONS OF TREATMENT WITH CC $3,407 $28,101 −88% $22,468 −85% ≈115% of Medicare
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $3,383 $21,274 −84% $15,183 −78% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $3,341 $18,699 −82% $14,368 −77% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $3,322 $11,173 −70% $9,940 −67% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $3,292 $8,604 −62% $11,421 −71% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $3,111 $28,035 −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 $27,187 −89% $13,824 −78% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $3,000 $29,131 −90% $44,363 −93% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $2,971 $28,774 −90% $17,674 −83% ≈130% of Medicare
305 HYPERTENSION WITHOUT MCC $2,871 $28,872 −90% $18,086 −84% —
894 Alcohol/drug abuse or dependence, left AMA $2,444 $16,529 −85% $12,324 −80% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $2,407 $32,168 −93% $47,789 −95% —
791 PREMATURITY WITH MAJOR PROBLEMS $2,306 $15,421 −85% $42,679 −95% —
795 Normal newborn $980 $5,787 −83% $4,720 −79% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $574 $10,849 −95% $8,445 −93% —

Procedures with negotiated rates only

These 295 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
311 Angina pectoris $2,587 – $15,924 · median $7,329 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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