Baylor Scott and White Surgical Hospital - Fort Worth — Pricing

782 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 782 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 782
Lowest published price —
Average published price —
Highest published price —

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 782 procedures

Procedures with negotiated rates only

These 782 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
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC — 15 plans
619 O.R. PROCEDURES FOR OBESITY WITH MCC $2,500 – $45,527 · median $16,221 15 plans
620 O.R. PROCEDURES FOR OBESITY WITH CC $2,500 – $28,531 · median $16,221 15 plans
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $2,500 – $27,505 · median $16,221 15 plans
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $2,500 – $69,351 · median $41,850 14 plans
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR — 14 plans
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $2,500 – $43,898 · median $21,001 14 plans
028 SPINAL PROCEDURES WITH MCC — 14 plans
030 SPINAL PROCEDURES WITHOUT CC/MCC $2,500 – $34,472 · median $10,744 14 plans
031 VENTRICULAR SHUNT PROCEDURES WITH MCC $2,500 – $61,193 · median $17,895 14 plans
032 VENTRICULAR SHUNT PROCEDURES WITH CC $2,500 – $69,351 · median $21,190 14 plans
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $2,500 – $57,994 · median $10,744 14 plans
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $2,500 – $17,598 · median $10,744 14 plans
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $2,500 – $57,238 · median $17,895 14 plans
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $2,500 – $34,696 · median $8,873 14 plans
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $2,500 – $14,624 · median $7,642 14 plans
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $2,500 – $21,904 · median $7,642 14 plans
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $2,500 – $15,953 · median $7,642 14 plans
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $2,500 – $35,587 · median $7,642 14 plans
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $2,500 – $20,264 · median $7,642 14 plans
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $2,500 – $32,919 · median $9,924 14 plans
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC $2,500 – $144,269 · median $44,272 14 plans
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $2,500 – $94,620 · median $45,494 14 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $2,500 – $85,816 · median $45,494 14 plans
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $2,500 – $114,627 · median $49,645 14 plans
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $2,500 – $81,840 · median $45,494 14 plans
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $2,500 – $76,599 · median $45,494 14 plans
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $2,500 – $80,029 · median $45,494 14 plans
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $2,500 – $69,351 · median $44,272 14 plans
231 CORONARY BYPASS WITH PTCA WITH MCC $2,500 – $120,632 · median $45,494 14 plans
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $2,500 – $88,426 · median $45,494 14 plans
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $2,500 – $115,941 · median $49,645 14 plans
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $2,500 – $81,429 · median $45,494 14 plans
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $2,500 – $87,433 · median $45,494 14 plans
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $2,500 – $71,257 · median $45,334 14 plans
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $2,500 – $51,360 · median $21,580 14 plans
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $2,500 – $34,317 · median $21,580 14 plans
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $2,500 – $32,783 · median $21,005 14 plans
245 AICD GENERATOR PROCEDURES — 14 plans
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC $2,500 – $34,945 · median $14,165 14 plans
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC $2,500 – $23,589 · median $14,165 14 plans
252 OTHER VASCULAR PROCEDURES WITH MCC $2,500 – $49,854 · median $11,178 14 plans
253 OTHER VASCULAR PROCEDURES WITH CC $2,500 – $37,922 · median $11,178 14 plans
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $2,500 – $25,792 · median $11,178 14 plans
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $2,500 – $40,263 · median $21,580 14 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $2,500 – $30,703 · median $21,217 14 plans
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $2,500 – $49,280 · median $21,580 14 plans
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $2,500 – $30,837 · median $21,304 14 plans
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $2,500 – $28,757 · median $21,001 14 plans
265 AICD LEAD PROCEDURES $2,500 – $52,534 · median $21,580 14 plans
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC $2,500 – $104,587 · median $27,342 14 plans
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $2,500 – $92,315 · median $9,924 14 plans
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC — 14 plans
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $2,500 – $66,304 · median $9,924 14 plans
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $2,500 – $47,577 · median $9,924 14 plans
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $2,500 – $25,380 · median $14,557 14 plans
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $2,500 – $22,189 · median $13,826 14 plans
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $2,500 – $18,521 · median $10,675 14 plans
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $2,500 – $32,043 · median $10,744 14 plans
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $2,500 – $17,140 · median $10,744 14 plans
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $2,500 – $69,351 · median $20,539 14 plans
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $2,500 – $27,105 · median $9,924 14 plans
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $2,500 – $61,541 · median $9,924 14 plans
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $2,500 – $52,836 · median $9,924 14 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $2,500 – $52,836 · median $9,924 14 plans
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $2,500 – $101,357 · median $8,378 14 plans
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $2,500 – $42,310 · median $8,378 14 plans
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $2,500 – $84,191 · median $8,378 14 plans
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $2,500 – $44,616 · median $8,378 14 plans
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $2,500 – $27,809 · median $8,378 14 plans
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC — 14 plans
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $2,500 – $51,824 · median $23,662 14 plans
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $2,500 – $40,898 · median $23,662 14 plans
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $2,500 – $49,497 · median $23,662 14 plans
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $2,500 – $33,969 · median $23,027 14 plans
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $2,500 – $63,961 · median $8,378 14 plans
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $2,500 – $31,881 · median $8,378 14 plans
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $2,500 – $17,495 · median $8,378 14 plans
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $2,500 – $50,080 · median $8,378 14 plans
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $2,500 – $35,434 · median $8,378 14 plans
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $2,500 – $27,708 · median $8,378 14 plans
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $2,500 – $43,835 · median $8,378 14 plans
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $2,500 – $30,843 · median $8,378 14 plans
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $2,500 – $23,612 · median $8,378 14 plans
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $2,500 – $36,928 · median $8,378 14 plans
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $2,500 – $48,965 · median $8,378 14 plans
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $2,500 – $29,853 · median $8,378 14 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $2,500 – $22,965 · median $8,378 14 plans
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $2,500 – $31,315 · median $8,378 14 plans
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $2,500 – $18,398 · median $8,378 14 plans
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $2,500 – $51,464 · median $8,378 14 plans
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $2,500 – $35,701 · median $8,378 14 plans
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $2,500 – $27,786 · median $8,378 14 plans
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $2,500 – $53,235 · median $8,378 14 plans
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $2,500 – $29,544 · median $8,378 14 plans
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $2,500 – $21,218 · median $8,378 14 plans
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $2,500 – $38,813 · median $8,378 14 plans
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $2,500 – $19,173 · median $8,378 14 plans
500 SOFT TISSUE PROCEDURES WITH MCC $2,500 – $48,204 · median $8,378 14 plans
501 SOFT TISSUE PROCEDURES WITH CC $2,500 – $25,801 · median $8,378 14 plans
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $2,500 – $20,554 · median $8,378 14 plans
503 FOOT PROCEDURES WITH MCC $2,500 – $39,866 · median $8,378 14 plans
504 FOOT PROCEDURES WITH CC $2,500 – $25,673 · median $8,378 14 plans
505 FOOT PROCEDURES WITHOUT CC/MCC $2,500 – $25,355 · median $8,378 14 plans
506 MAJOR THUMB OR JOINT PROCEDURES $2,500 – $21,742 · median $8,378 14 plans
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $2,500 – $31,688 · median $8,378 14 plans
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $2,500 – $21,316 · median $8,378 14 plans
509 ARTHROSCOPY $2,500 – $19,714 · median $8,378 14 plans
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $2,500 – $40,442 · median $8,378 14 plans
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $2,500 – $29,638 · median $8,378 14 plans
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $2,500 – $23,989 · median $8,378 14 plans
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $2,500 – $24,096 · median $8,378 14 plans
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $2,500 – $15,482 · median $8,378 14 plans
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $2,500 – $46,996 · median $8,378 14 plans
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $2,500 – $30,336 · median $8,378 14 plans
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $22,214 · median $8,378 14 plans
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $2,500 – $44,509 · median $9,924 14 plans
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $2,500 – $35,996 · median $9,924 14 plans
533 FRACTURES OF FEMUR WITH MCC $2,500 – $24,251 · median $7,642 14 plans
534 FRACTURES OF FEMUR WITHOUT MCC $2,500 – $12,041 · median $7,642 14 plans
535 FRACTURES OF HIP AND PELVIS WITH MCC $2,500 – $19,275 · median $7,642 14 plans
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $2,500 – $11,700 · median $7,642 14 plans
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $2,500 – $14,374 · median $7,642 14 plans
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 14 plans
539 OSTEOMYELITIS WITH MCC $2,500 – $29,498 · median $7,642 14 plans
540 OSTEOMYELITIS WITH CC $2,500 – $19,298 · median $7,642 14 plans
541 OSTEOMYELITIS WITHOUT CC/MCC $2,500 – $12,753 · median $7,642 14 plans
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $2,500 – $27,109 · median $7,642 14 plans
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $2,500 – $16,213 · median $7,642 14 plans
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $2,500 – $11,409 · median $7,642 14 plans
545 CONNECTIVE TISSUE DISORDERS WITH MCC $2,500 – $37,061 · median $7,642 14 plans
546 CONNECTIVE TISSUE DISORDERS WITH CC $2,500 – $17,828 · median $7,642 14 plans
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $2,500 – $12,091 · median $7,642 14 plans
548 SEPTIC ARTHRITIS WITH MCC $2,500 – $28,984 · median $7,642 14 plans
549 SEPTIC ARTHRITIS WITH CC $2,500 – $17,930 · median $7,642 14 plans
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $2,500 – $13,688 · median $7,642 14 plans
551 MEDICAL BACK PROBLEMS WITH MCC $2,500 – $25,299 · median $7,642 14 plans
552 MEDICAL BACK PROBLEMS WITHOUT MCC $2,500 – $14,364 · median $7,642 14 plans
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $2,500 – $20,090 · median $7,642 14 plans
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $2,500 – $12,216 · median $7,642 14 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $2,500 – $20,796 · median $7,642 14 plans
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $2,500 – $12,255 · median $7,642 14 plans
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $2,500 – $23,142 · median $7,642 14 plans
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $2,500 – $13,057 · median $7,642 14 plans
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $2,500 – $27,508 · median $7,642 14 plans
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $2,500 – $16,829 · median $7,642 14 plans
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $2,500 – $11,598 · median $7,642 14 plans
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $2,500 – $22,605 · median $7,642 14 plans
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $2,500 – $13,313 · median $7,642 14 plans
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $2,500 – $23,218 · median $7,642 14 plans
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $2,500 – $14,856 · median $7,642 14 plans
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $2,500 – $11,156 · median $7,642 14 plans
570 SKIN DEBRIDEMENT WITH MCC $2,500 – $43,439 · median $7,642 14 plans
571 SKIN DEBRIDEMENT WITH CC $2,500 – $25,150 · median $7,642 14 plans
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $2,500 – $18,107 · median $7,642 14 plans
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $2,500 – $21,085 · median $7,642 14 plans
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $2,500 – $14,804 · median $7,642 14 plans
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $2,500 – $12,058 · median $7,642 14 plans
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $2,500 – $14,987 · median $7,642 14 plans
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $2,500 – $11,100 · median $7,642 14 plans
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $2,500 – $10,675 · median $7,329 14 plans
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $2,500 – $90,531 · median $8,378 14 plans
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $2,500 – $57,649 · median $8,378 14 plans
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $2,500 – $107,511 · median $8,378 14 plans
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC — 14 plans
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $2,500 – $37,644 · median $8,378 14 plans
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT — 13 plans
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC — 13 plans
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $2,500 – $27,035 · median $8,929 13 plans
453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC $2,500 – $131,725 · median $19,209 13 plans
454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC $2,500 – $90,919 · median $19,438 13 plans
455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC $2,500 – $68,462 · median $19,438 13 plans
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC — 13 plans
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC — 13 plans
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC — 13 plans
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $2,500 – $98,589 · median $20,276 13 plans
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC — 13 plans
471 CERVICAL SPINAL FUSION WITH MCC — 13 plans
472 CERVICAL SPINAL FUSION WITH CC $2,500 – $43,932 · median $19,438 13 plans
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $2,500 – $39,235 · median $19,438 13 plans
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $2,500 – $54,284 · median $9,172 13 plans
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $2,500 – $34,908 · median $9,172 13 plans
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $2,500 – $33,435 · median $9,172 13 plans
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC — 12 plans
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC — 12 plans
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES $2,500 – $316,926 12 plans
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $2,500 – $218,516 12 plans
006 LIVER TRANSPLANT WITHOUT MCC — 12 plans
007 LUNG TRANSPLANT — 12 plans
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT — 12 plans
010 PANCREAS TRANSPLANT $2,500 – $71,554 · median $8,335 12 plans
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $2,500 – $76,648 · median $8,335 12 plans
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $2,500 – $59,533 · median $8,335 12 plans
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $2,500 – $39,923 · median $8,335 12 plans
014 ALLOGENEIC BONE MARROW TRANSPLANT — 12 plans
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC — 12 plans
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $2,500 – $91,821 · median $8,335 12 plans
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY — 12 plans
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS — 12 plans
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $2,500 – $125,645 · median $8,335 12 plans
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC — 12 plans
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC $2,500 – $56,321 · median $8,634 12 plans
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $2,500 – $44,535 · median $9,924 12 plans
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $2,500 – $50,960 · median $8,634 12 plans
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $2,500 – $24,124 · median $8,634 12 plans
035 CAROTID ARTERY STENT PROCEDURES WITH CC $2,500 – $34,182 · median $8,634 12 plans
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $2,500 – $26,879 · median $8,634 12 plans
037 EXTRACRANIAL PROCEDURES WITH MCC $2,500 – $50,178 · median $8,634 12 plans
038 EXTRACRANIAL PROCEDURES WITH CC $2,500 – $23,783 · median $8,634 12 plans
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $2,500 – $33,159 · median $8,634 12 plans
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $2,500 – $25,862 · median $8,634 12 plans
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $2,500 – $25,685 · median $8,335 12 plans
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $2,500 – $17,648 · median $8,335 12 plans
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $2,500 – $13,340 · median $8,176 12 plans
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $2,500 – $41,664 · median $8,335 12 plans
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $2,500 – $22,101 · median $8,335 12 plans
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $2,500 – $29,775 · median $8,335 12 plans
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $2,500 – $15,109 · median $8,335 12 plans
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $2,500 – $10,675 · median $7,972 12 plans
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $2,500 – $21,062 · median $8,335 12 plans
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $2,500 – $12,947 · median $8,176 12 plans
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $2,500 – $11,873 · median $8,335 12 plans
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $2,500 – $26,601 · median $8,335 12 plans
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $2,500 – $15,784 · median $8,335 12 plans
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $2,500 – $11,639 · median $8,335 12 plans
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $2,500 – $22,491 · median $8,335 12 plans
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $2,500 – $15,254 · median $8,335 12 plans
075 VIRAL MENINGITIS WITH CC/MCC $2,500 – $28,449 · median $8,335 12 plans
076 VIRAL MENINGITIS WITHOUT CC/MCC $2,500 – $13,713 · median $8,176 12 plans
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $2,500 – $22,460 · median $8,335 12 plans
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $2,500 – $15,116 · median $8,335 12 plans
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $2,500 – $11,268 · median $8,276 12 plans
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $2,500 – $32,832 · median $8,335 12 plans
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $2,500 – $13,520 · median $8,176 12 plans
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $2,500 – $33,867 · median $8,335 12 plans
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $2,500 – $20,163 · median $8,335 12 plans
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $2,500 – $13,671 · median $8,176 12 plans
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $2,500 – $33,785 · median $8,335 12 plans
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $2,500 – $19,579 · median $8,335 12 plans
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $2,500 – $13,173 · median $8,176 12 plans
088 CONCUSSION WITH MCC $2,500 – $22,800 · median $8,335 12 plans
089 CONCUSSION WITH CC $2,500 – $17,093 · median $8,335 12 plans
090 CONCUSSION WITHOUT CC/MCC $2,500 – $13,896 · median $8,221 12 plans
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $2,500 – $26,596 · median $8,335 12 plans
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $2,500 – $15,253 · median $8,335 12 plans
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $2,500 – $11,511 · median $8,335 12 plans
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $2,500 – $53,851 · median $8,335 12 plans
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $2,500 – $35,441 · median $8,335 12 plans
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $2,500 – $32,401 · median $8,335 12 plans
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $2,500 – $54,063 · median $8,335 12 plans
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $2,500 – $32,027 · median $8,335 12 plans
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $2,500 – $19,625 · median $8,335 12 plans
100 SEIZURES WITH MCC $2,500 – $29,470 · median $8,335 12 plans
101 SEIZURES WITHOUT MCC $2,500 – $13,521 · median $8,176 12 plans
102 HEADACHES WITH MCC $2,500 – $17,936 · median $8,335 12 plans
103 HEADACHES WITHOUT MCC $2,500 – $12,522 · median $8,176 12 plans
113 ORBITAL PROCEDURES WITH CC/MCC $2,500 – $37,271 · median $8,335 12 plans
114 ORBITAL PROCEDURES WITHOUT CC/MCC $2,500 – $18,311 · median $8,335 12 plans
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $2,500 – $23,255 · median $8,335 12 plans
116 INTRAOCULAR PROCEDURES WITH CC/MCC $2,500 – $27,215 · median $8,335 12 plans
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $2,500 – $17,814 · median $8,335 12 plans
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $2,500 – $19,045 · median $8,335 12 plans
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $2,500 – $11,067 · median $8,298 12 plans
123 NEUROLOGICAL EYE DISORDERS $2,500 – $11,951 · median $8,176 12 plans
124 OTHER DISORDERS OF THE EYE WITH MCC $2,500 – $19,650 · median $8,335 12 plans
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $2,500 – $11,855 · median $8,335 12 plans
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $2,500 – $39,423 · median $8,335 12 plans
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $2,500 – $13,960 · median $8,241 12 plans
137 MOUTH PROCEDURES WITH CC/MCC $2,500 – $22,367 · median $8,335 12 plans
138 MOUTH PROCEDURES WITHOUT CC/MCC $2,500 – $12,869 · median $8,176 12 plans
139 SALIVARY GLAND PROCEDURES $2,500 – $17,655 · median $8,335 12 plans
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $2,500 – $56,161 · median $8,335 12 plans
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $2,500 – $30,796 · median $8,335 12 plans
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $2,500 – $22,966 · median $8,335 12 plans
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $2,500 – $49,435 · median $8,335 12 plans
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $2,500 – $25,724 · median $8,335 12 plans
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $18,152 · median $8,335 12 plans
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $2,500 – $31,380 · median $8,335 12 plans
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $2,500 – $18,370 · median $8,335 12 plans
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $2,500 – $13,225 · median $8,176 12 plans
149 DYSEQUILIBRIUM $2,500 – $11,070 · median $8,299 12 plans
150 EPISTAXIS WITH MCC $2,500 – $19,540 · median $8,335 12 plans
151 EPISTAXIS WITHOUT MCC $2,500 – $11,456 · median $8,335 12 plans
152 OTITIS MEDIA AND URI WITH MCC $2,500 – $17,663 · median $8,335 12 plans
153 OTITIS MEDIA AND URI WITHOUT MCC $2,500 – $10,923 · median $8,242 12 plans
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $2,500 – $22,865 · median $8,335 12 plans
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $2,500 – $14,071 · median $8,274 12 plans
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $2,500 – $10,675 · median $7,790 12 plans
157 DENTAL AND ORAL DISEASES WITH MCC $2,500 – $25,375 · median $8,335 12 plans
158 DENTAL AND ORAL DISEASES WITH CC $2,500 – $13,951 · median $8,238 12 plans
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $2,500 – $10,675 · median $7,902 12 plans
163 MAJOR CHEST PROCEDURES WITH MCC $2,500 – $70,068 · median $8,335 12 plans
164 MAJOR CHEST PROCEDURES WITH CC $2,500 – $37,912 · median $8,335 12 plans
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $2,500 – $27,893 · median $8,335 12 plans
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $2,500 – $60,319 · median $8,335 12 plans
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $2,500 – $27,051 · median $8,335 12 plans
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $20,152 · median $8,335 12 plans
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $2,500 – $45,710 · median $8,335 12 plans
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $2,500 – $20,856 · median $8,335 12 plans
176 PULMONARY EMBOLISM WITHOUT MCC $2,500 – $12,124 · median $8,176 12 plans
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $2,500 – $25,217 · median $8,335 12 plans
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $2,500 – $14,667 · median $8,335 12 plans
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $2,500 – $11,346 · median $8,335 12 plans
180 RESPIRATORY NEOPLASMS WITH MCC $2,500 – $25,838 · median $8,335 12 plans
181 RESPIRATORY NEOPLASMS WITH CC $2,500 – $16,368 · median $8,335 12 plans
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $2,500 – $11,283 · median $8,335 12 plans
183 MAJOR CHEST TRAUMA WITH MCC $2,500 – $23,405 · median $8,335 12 plans
184 MAJOR CHEST TRAUMA WITH CC $2,500 – $15,636 · median $8,335 12 plans
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $2,500 – $11,233 · median $8,335 12 plans
186 PLEURAL EFFUSION WITH MCC $2,500 – $23,072 · median $8,335 12 plans
187 PLEURAL EFFUSION WITH CC $2,500 – $14,810 · median $8,335 12 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC $2,500 – $11,097 · median $8,309 12 plans
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $2,500 – $18,314 · median $8,335 12 plans
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $2,500 – $16,381 · median $8,335 12 plans
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $2,500 – $12,620 · median $8,176 12 plans
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $2,500 – $10,675 · median $7,711 12 plans
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $2,500 – $19,720 · median $8,335 12 plans
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $2,500 – $12,222 · median $8,176 12 plans
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
196 INTERSTITIAL LUNG DISEASE WITH MCC $2,500 – $28,175 · median $8,335 12 plans
197 INTERSTITIAL LUNG DISEASE WITH CC $2,500 – $14,828 · median $8,335 12 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $2,500 – $11,568 · median $8,335 12 plans
199 PNEUMOTHORAX WITH MCC $2,500 – $26,372 · median $8,335 12 plans
200 PNEUMOTHORAX WITH CC $2,500 – $16,010 · median $8,335 12 plans
201 PNEUMOTHORAX WITHOUT CC/MCC $2,500 – $10,675 · median $8,078 12 plans
202 BRONCHITIS AND ASTHMA WITH CC/MCC $2,500 – $14,233 · median $8,323 12 plans
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $2,500 – $10,675 · median $8,014 12 plans
204 RESPIRATORY SIGNS AND SYMPTOMS $2,500 – $12,232 · median $8,176 12 plans
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $2,500 – $26,910 · median $8,335 12 plans
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $2,500 – $13,579 · median $8,176 12 plans
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $2,500 – $102,687 · median $8,335 12 plans
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $2,500 – $40,192 · median $8,335 12 plans
212 CONCOMITANT AORTIC AND MITRAL VALVE�PROCEDURES $2,500 – $160,106 12 plans
215 OTHER HEART ASSIST SYSTEM IMPLANT $2,500 – $151,843 12 plans
222 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC $2,500 – $71,438 · median $11,046 12 plans
223 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC $2,500 – $71,438 · median $11,046 12 plans
224 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC $2,500 – $71,438 · median $11,046 12 plans
225 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC $2,500 – $71,438 · median $11,046 12 plans
226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC $2,500 – $71,438 · median $11,046 12 plans
227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $2,500 – $71,438 · median $11,046 12 plans
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC $2,500 – $71,453 · median $8,335 12 plans
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $2,500 – $41,759 · median $8,335 12 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $2,500 – $20,659 · median $8,335 12 plans
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $2,500 – $21,435 · median $8,513 12 plans
247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC $2,500 – $21,435 · median $8,513 12 plans
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $2,500 – $21,435 · median $8,513 12 plans
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $2,500 – $40,840 · median $8,335 12 plans
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $2,500 – $24,374 · median $8,335 12 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $2,500 – $14,731 · median $8,335 12 plans
263 VEIN LIGATION AND STRIPPING $2,500 – $41,997 · median $8,335 12 plans
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $2,500 – $48,549 · median $8,335 12 plans
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC — 12 plans
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $2,500 – $78,635 · median $27,605 12 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $2,500 – $101,895 · median $9,624 12 plans
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $2,500 – $61,818 · median $8,873 12 plans
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $2,500 – $75,171 · median $8,873 12 plans
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $2,500 – $51,376 · median $8,873 12 plans
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $2,500 – $44,535 · median $8,873 12 plans
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $2,500 – $57,929 · median $8,873 12 plans
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $2,500 – $48,174 · median $8,873 12 plans
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $2,500 – $29,305 · median $8,335 12 plans
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $2,500 – $10,996 · median $8,270 12 plans
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $2,500 – $10,675 · median $7,226 12 plans
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $2,500 – $38,545 · median $8,335 12 plans
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $2,500 – $21,966 · median $8,335 12 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $2,500 – $15,240 · median $8,335 12 plans
291 HEART FAILURE AND SHOCK WITH MCC $2,500 – $19,085 · median $8,335 12 plans
292 HEART FAILURE AND SHOCK WITH CC $2,500 – $12,732 · median $8,176 12 plans
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $2,500 – $10,675 · median $7,603 12 plans
294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC $2,500 – $16,258 · median $8,335 12 plans
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC $2,500 – $10,675 · median $7,653 12 plans
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $2,500 – $23,832 · median $8,335 12 plans
297 CARDIAC ARREST, UNEXPLAINED WITH CC $2,500 – $10,831 · median $8,207 12 plans
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $2,500 – $10,675 · median $7,006 12 plans
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $2,500 – $23,430 · median $8,335 12 plans
300 PERIPHERAL VASCULAR DISORDERS WITH CC $2,500 – $15,861 · median $8,335 12 plans
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $2,500 – $10,675 · median $8,100 12 plans
302 ATHEROSCLEROSIS WITH MCC $2,500 – $16,665 · median $8,335 12 plans
303 ATHEROSCLEROSIS WITHOUT MCC $2,500 – $10,675 · median $7,804 12 plans
304 HYPERTENSION WITH MCC $2,500 – $17,080 · median $8,335 12 plans
305 HYPERTENSION WITHOUT MCC $2,500 – $11,201 · median $8,335 12 plans
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $2,500 – $22,845 · median $8,335 12 plans
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $2,500 – $14,012 · median $8,256 12 plans
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $2,500 – $17,871 · median $8,335 12 plans
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $2,500 – $11,070 · median $8,299 12 plans
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $2,500 – $10,675 · median $7,565 12 plans
311 ANGINA PECTORIS $2,500 – $10,675 · median $8,033 12 plans
312 SYNCOPE AND COLLAPSE $2,500 – $12,836 · median $8,176 12 plans
313 CHEST PAIN $2,500 – $10,756 · median $8,178 12 plans
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $2,500 – $31,120 · median $8,335 12 plans
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $2,500 – $14,379 · median $8,335 12 plans
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $2,500 – $10,675 · median $8,002 12 plans
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $2,500 – $42,732 · median $8,873 12 plans
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $2,500 – $75,499 · median $8,335 12 plans
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $2,500 – $37,124 · median $8,335 12 plans
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $2,500 – $23,744 · median $8,335 12 plans
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $2,500 – $67,142 · median $8,335 12 plans
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $2,500 – $35,261 · median $8,335 12 plans
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $2,500 – $24,854 · median $8,335 12 plans
332 RECTAL RESECTION WITH MCC $2,500 – $53,924 · median $8,335 12 plans
333 RECTAL RESECTION WITH CC $2,500 – $30,912 · median $8,335 12 plans
334 RECTAL RESECTION WITHOUT CC/MCC $2,500 – $23,860 · median $8,335 12 plans
335 PERITONEAL ADHESIOLYSIS WITH MCC $2,500 – $53,142 · median $8,335 12 plans
336 PERITONEAL ADHESIOLYSIS WITH CC $2,500 – $31,295 · median $8,335 12 plans
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $2,500 – $22,244 · median $8,335 12 plans
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $2,500 – $40,736 · median $8,335 12 plans
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $2,500 – $22,901 · median $8,335 12 plans
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $2,500 – $19,143 · median $8,335 12 plans
347 ANAL AND STOMAL PROCEDURES WITH MCC $2,500 – $37,892 · median $8,335 12 plans
348 ANAL AND STOMAL PROCEDURES WITH CC $2,500 – $19,345 · median $8,335 12 plans
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $2,500 – $14,505 · median $8,335 12 plans
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $2,500 – $35,676 · median $8,335 12 plans
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $2,500 – $21,637 · median $8,335 12 plans
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $2,500 – $16,485 · median $8,335 12 plans
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $2,500 – $43,470 · median $8,335 12 plans
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $2,500 – $25,535 · median $8,335 12 plans
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $2,500 – $20,255 · median $8,335 12 plans
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $2,500 – $63,603 · median $8,335 12 plans
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $2,500 – $32,655 · median $8,335 12 plans
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $19,044 · median $8,335 12 plans
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $2,500 – $24,557 · median $8,335 12 plans
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $2,500 – $14,691 · median $8,335 12 plans
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $2,500 – $11,055 · median $8,293 12 plans
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $2,500 – $25,980 · median $8,335 12 plans
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $2,500 – $15,494 · median $8,335 12 plans
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $2,500 – $10,675 · median $8,138 12 plans
374 DIGESTIVE MALIGNANCY WITH MCC $2,500 – $31,202 · median $8,335 12 plans
375 DIGESTIVE MALIGNANCY WITH CC $2,500 – $17,813 · median $8,335 12 plans
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $2,500 – $13,251 · median $8,176 12 plans
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $2,500 – $26,613 · median $8,335 12 plans
378 GASTROINTESTINAL HEMORRHAGE WITH CC $2,500 – $14,624 · median $8,335 12 plans
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $2,500 – $10,675 · median $7,662 12 plans
380 COMPLICATED PEPTIC ULCER WITH MCC $2,500 – $28,964 · median $8,335 12 plans
381 COMPLICATED PEPTIC ULCER WITH CC $2,500 – $15,950 · median $8,335 12 plans
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $2,500 – $11,254 · median $8,335 12 plans
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $2,500 – $20,784 · median $8,335 12 plans
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $2,500 – $13,017 · median $8,176 12 plans
385 INFLAMMATORY BOWEL DISEASE WITH MCC $2,500 – $23,292 · median $8,335 12 plans
386 INFLAMMATORY BOWEL DISEASE WITH CC $2,500 – $14,443 · median $8,335 12 plans
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $2,500 – $10,675 · median $7,953 12 plans
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $2,500 – $21,606 · median $8,335 12 plans
389 GASTROINTESTINAL OBSTRUCTION WITH CC $2,500 – $11,838 · median $8,335 12 plans
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $2,500 – $10,675 · median $7,592 12 plans
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $2,500 – $18,963 · median $8,335 12 plans
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $2,500 – $11,678 · median $8,335 12 plans
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $2,500 – $24,075 · median $8,335 12 plans
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $2,500 – $13,927 · median $8,231 12 plans
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $2,500 – $10,675 · median $7,744 12 plans
397 APPENDIX PROCEDURES WITH MCC $2,500 – $33,396 · median $8,335 12 plans
398 APPENDIX PROCEDURES WITH CC $2,500 – $22,495 · median $8,335 12 plans
399 APPENDIX PROCEDURES WITHOUT CC/MCC $2,500 – $16,546 · median $8,335 12 plans
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $2,500 – $81,835 · median $8,335 12 plans
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $2,500 – $42,921 · median $8,335 12 plans
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $2,500 – $31,975 · median $8,335 12 plans
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $2,500 – $55,331 · median $8,335 12 plans
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $2,500 – $29,095 · median $8,335 12 plans
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $2,500 – $23,267 · median $8,335 12 plans
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $2,500 – $42,819 · median $8,335 12 plans
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $2,500 – $30,406 · median $8,335 12 plans
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $2,500 – $22,440 · median $8,335 12 plans
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC $2,500 – $52,402 · median $8,335 12 plans
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $2,500 – $29,370 · median $8,335 12 plans
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $2,500 – $19,907 · median $8,335 12 plans
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $2,500 – $34,454 · median $8,335 12 plans
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $2,500 – $24,300 · median $8,335 12 plans
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $2,500 – $19,521 · median $8,335 12 plans
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $2,500 – $47,580 · median $8,335 12 plans
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $2,500 – $25,413 · median $8,335 12 plans
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $2,500 – $20,975 · median $8,335 12 plans
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC $2,500 – $58,136 · median $8,335 12 plans
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $2,500 – $31,028 · median $8,335 12 plans
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $23,812 · median $8,335 12 plans
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $2,500 – $28,481 · median $8,335 12 plans
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $2,500 – $15,326 · median $8,335 12 plans
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $2,500 – $10,675 · median $7,870 12 plans
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $2,500 – $26,161 · median $8,335 12 plans
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $2,500 – $16,362 · median $8,335 12 plans
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $2,500 – $12,354 · median $8,176 12 plans
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $2,500 – $24,807 · median $8,335 12 plans
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $2,500 – $12,713 · median $8,176 12 plans
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $2,500 – $27,176 · median $8,335 12 plans
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $2,500 – $14,144 · median $8,296 12 plans
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $2,500 – $10,675 · median $8,128 12 plans
444 DISORDERS OF THE BILIARY TRACT WITH MCC $2,500 – $24,278 · median $8,335 12 plans
445 DISORDERS OF THE BILIARY TRACT WITH CC $2,500 – $16,155 · median $8,335 12 plans
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $2,500 – $11,914 · median $8,335 12 plans
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $2,500 – $16,940 · median $8,335 12 plans
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $2,500 – $92,432 · median $8,335 12 plans
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $2,500 – $50,627 · median $8,335 12 plans
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $2,500 – $30,414 · median $8,335 12 plans
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $2,500 – $84,479 · median $8,335 12 plans
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $2,500 – $39,379 · median $8,335 12 plans
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $2,500 – $23,940 · median $8,335 12 plans
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $2,500 – $49,682 · median $8,335 12 plans
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $2,500 – $25,963 · median $8,335 12 plans
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $2,500 – $20,019 · median $8,335 12 plans
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $2,500 – $24,781 · median $8,335 12 plans
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $2,500 – $22,623 · median $8,335 12 plans
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $2,500 – $29,115 · median $8,335 12 plans
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $2,500 – $25,033 · median $8,335 12 plans
592 SKIN ULCERS WITH MCC $2,500 – $31,069 · median $8,335 12 plans
593 SKIN ULCERS WITH CC $2,500 – $17,985 · median $8,335 12 plans
594 SKIN ULCERS WITHOUT CC/MCC $2,500 – $11,705 · median $8,335 12 plans
595 MAJOR SKIN DISORDERS WITH MCC $2,500 – $32,331 · median $8,335 12 plans
596 MAJOR SKIN DISORDERS WITHOUT MCC $2,500 – $14,999 · median $8,335 12 plans
597 MALIGNANT BREAST DISORDERS WITH MCC $2,500 – $23,791 · median $8,335 12 plans
598 MALIGNANT BREAST DISORDERS WITH CC $2,500 – $17,820 · median $8,335 12 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $2,500 – $15,244 · median $8,335 12 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
602 CELLULITIS WITH MCC $2,500 – $22,112 · median $8,335 12 plans
603 CELLULITIS WITHOUT MCC $2,500 – $13,151 · median $8,176 12 plans
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $2,500 – $22,390 · median $8,335 12 plans
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $2,500 – $13,509 · median $8,176 12 plans
606 MINOR SKIN DISORDERS WITH MCC $2,500 – $23,573 · median $8,335 12 plans
607 MINOR SKIN DISORDERS WITHOUT MCC $2,500 – $13,282 · median $8,176 12 plans
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $2,500 – $33,482 · median $8,335 12 plans
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $2,500 – $21,868 · median $8,335 12 plans
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $2,500 – $58,831 · median $8,335 12 plans
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $2,500 – $29,500 · median $8,335 12 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $2,500 – $17,266 · median $8,335 12 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $2,500 – $56,868 · median $8,335 12 plans
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $2,500 – $27,670 · median $8,335 12 plans
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $2,500 – $16,567 · median $8,335 12 plans
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $2,500 – $43,424 · median $8,335 12 plans
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $2,500 – $22,177 · median $8,335 12 plans
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $2,500 – $18,373 · median $8,335 12 plans
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $2,500 – $59,676 · median $8,335 12 plans
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $2,500 – $33,637 · median $8,335 12 plans
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $20,756 · median $8,335 12 plans
637 DIABETES WITH MCC $2,500 – $21,544 · median $8,335 12 plans
638 DIABETES WITH CC $2,500 – $13,370 · median $8,176 12 plans
639 DIABETES WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $2,500 – $19,550 · median $8,335 12 plans
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $2,500 – $11,616 · median $8,335 12 plans
642 INBORN AND OTHER DISORDERS OF METABOLISM $2,500 – $19,374 · median $8,335 12 plans
643 ENDOCRINE DISORDERS WITH MCC $2,500 – $24,454 · median $8,335 12 plans
644 ENDOCRINE DISORDERS WITH CC $2,500 – $15,782 · median $8,335 12 plans
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $2,500 – $11,311 · median $8,335 12 plans
653 MAJOR BLADDER PROCEDURES WITH MCC — 12 plans
654 MAJOR BLADDER PROCEDURES WITH CC $2,500 – $40,693 · median $8,335 12 plans
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $2,500 – $31,332 · median $8,335 12 plans
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $2,500 – $46,640 · median $8,335 12 plans
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $2,500 – $27,414 · median $8,335 12 plans
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $2,500 – $22,006 · median $8,335 12 plans
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $2,500 – $38,484 · median $8,335 12 plans
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $2,500 – $20,007 · median $8,335 12 plans
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $2,500 – $15,584 · median $8,335 12 plans
662 MINOR BLADDER PROCEDURES WITH MCC $2,500 – $44,546 · median $8,335 12 plans
663 MINOR BLADDER PROCEDURES WITH CC $2,500 – $21,688 · median $8,335 12 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $2,500 – $15,781 · median $8,335 12 plans
665 PROSTATECTOMY WITH MCC $2,500 – $45,919 · median $8,335 12 plans
666 PROSTATECTOMY WITH CC $2,500 – $25,529 · median $8,335 12 plans
667 PROSTATECTOMY WITHOUT CC/MCC $2,500 – $15,602 · median $8,335 12 plans
668 TRANSURETHRAL PROCEDURES WITH MCC $2,500 – $41,890 · median $8,335 12 plans
669 TRANSURETHRAL PROCEDURES WITH CC $2,500 – $22,812 · median $8,335 12 plans
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $2,500 – $14,309 · median $8,335 12 plans
671 URETHRAL PROCEDURES WITH CC/MCC $2,500 – $25,447 · median $8,335 12 plans
672 URETHRAL PROCEDURES WITHOUT CC/MCC $2,500 – $13,716 · median $8,176 12 plans
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $2,500 – $54,971 · median $8,335 12 plans
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $2,500 – $35,411 · median $8,335 12 plans
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $2,500 – $23,583 · median $8,335 12 plans
682 RENAL FAILURE WITH MCC $2,500 – $22,309 · median $8,335 12 plans
683 RENAL FAILURE WITH CC $2,500 – $13,390 · median $8,176 12 plans
684 RENAL FAILURE WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $2,500 – $27,343 · median $8,335 12 plans
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $2,500 – $15,538 · median $8,335 12 plans
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $2,500 – $11,608 · median $8,335 12 plans
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $2,500 – $17,457 · median $8,335 12 plans
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $2,500 – $11,995 · median $8,176 12 plans
693 URINARY STONES WITH MCC $2,500 – $21,053 · median $8,335 12 plans
694 URINARY STONES WITHOUT MCC $2,500 – $11,635 · median $8,335 12 plans
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $2,500 – $17,779 · median $8,335 12 plans
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $2,500 – $10,675 · median $7,999 12 plans
697 URETHRAL STRICTURE $2,500 – $16,546 · median $8,335 12 plans
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $2,500 – $24,593 · median $8,335 12 plans
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $2,500 – $15,174 · median $8,335 12 plans
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $2,500 – $10,675 · median $8,091 12 plans
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $2,500 – $29,164 · median $8,335 12 plans
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $2,500 – $21,681 · median $8,335 12 plans
709 PENIS PROCEDURES WITH CC/MCC $2,500 – $31,514 · median $8,335 12 plans
710 PENIS PROCEDURES WITHOUT CC/MCC $2,500 – $18,348 · median $8,335 12 plans
711 TESTES PROCEDURES WITH CC/MCC $2,500 – $31,557 · median $8,335 12 plans
712 TESTES PROCEDURES WITHOUT CC/MCC $2,500 – $17,666 · median $8,335 12 plans
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $2,500 – $21,565 · median $8,335 12 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $2,500 – $14,248 · median $8,327 12 plans
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $2,500 – $32,814 · median $8,335 12 plans
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $2,500 – $21,141 · median $8,335 12 plans
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $2,500 – $26,961 · median $8,335 12 plans
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $2,500 – $17,478 · median $8,335 12 plans
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $2,500 – $27,869 · median $8,335 12 plans
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $2,500 – $16,564 · median $8,335 12 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $2,500 – $12,033 · median $8,176 12 plans
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $2,500 – $18,446 · median $8,335 12 plans
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $2,500 – $10,865 · median $8,220 12 plans
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $2,500 – $24,096 · median $8,335 12 plans
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $2,500 – $11,893 · median $8,335 12 plans
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $2,500 – $14,923 · median $8,335 12 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $2,500 – $32,311 · median $8,335 12 plans
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $2,500 – $18,733 · median $8,335 12 plans
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $2,500 – $57,783 · median $8,335 12 plans
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $2,500 – $29,341 · median $8,335 12 plans
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $2,500 – $20,285 · median $8,335 12 plans
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC $2,500 – $53,756 · median $8,335 12 plans
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $2,500 – $26,564 · median $8,335 12 plans
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $2,500 – $19,314 · median $8,335 12 plans
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $2,500 – $26,488 · median $8,335 12 plans
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $2,500 – $17,273 · median $8,335 12 plans
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $2,500 – $27,982 · median $8,335 12 plans
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $2,500 – $15,399 · median $8,335 12 plans
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $2,500 – $24,915 · median $8,335 12 plans
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $2,500 – $13,188 · median $8,176 12 plans
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $2,500 – $20,884 · median $8,335 12 plans
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $2,500 – $37,418 · median $8,335 12 plans
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $20,216 · median $8,335 12 plans
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $2,500 – $27,537 · median $8,335 12 plans
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $2,500 – $16,124 · median $8,335 12 plans
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $2,500 – $14,712 · median $8,335 12 plans
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $2,500 – $22,173 · median $8,335 12 plans
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $2,500 – $14,755 · median $8,335 12 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $2,500 – $10,675 · median $7,737 12 plans
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $2,500 – $14,797 · median $8,335 12 plans
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $2,500 – $22,950 · median $8,335 12 plans
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $2,500 – $11,873 · median $8,335 12 plans
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $2,500 – $10,675 · median $8,139 12 plans
779 ABORTION WITHOUT D&C $2,500 – $14,704 · median $8,335 12 plans
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $2,500 – $26,338 · median $8,335 12 plans
784 CESAREAN SECTION WITH STERILIZATION WITH CC $2,500 – $15,223 · median $8,335 12 plans
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $2,500 – $12,878 · median $8,176 12 plans
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $2,500 – $26,006 · median $8,335 12 plans
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $2,500 – $15,625 · median $8,335 12 plans
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $2,500 – $12,710 · median $8,176 12 plans
799 SPLENECTOMY WITH MCC $2,500 – $73,650 · median $8,335 12 plans
800 SPLENECTOMY WITH CC $2,500 – $41,885 · median $8,335 12 plans
801 SPLENECTOMY WITHOUT CC/MCC $2,500 – $26,604 · median $8,335 12 plans
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $2,500 – $50,397 · median $8,335 12 plans
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $2,500 – $27,622 · median $8,335 12 plans
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $2,500 – $17,993 · median $8,335 12 plans
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $2,500 – $32,556 · median $8,335 12 plans
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $2,500 – $17,903 · median $8,335 12 plans
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $2,500 – $14,932 · median $8,335 12 plans
811 RED BLOOD CELL DISORDERS WITH MCC $2,500 – $20,865 · median $8,335 12 plans
812 RED BLOOD CELL DISORDERS WITHOUT MCC $2,500 – $13,389 · median $8,176 12 plans
813 COAGULATION DISORDERS $2,500 – $23,189 · median $8,335 12 plans
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $2,500 – $31,634 · median $8,335 12 plans
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $2,500 – $14,779 · median $8,335 12 plans
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $2,500 – $10,675 · median $8,102 12 plans
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $2,500 – $33,521 · median $8,335 12 plans
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $2,500 – $17,438 · median $8,335 12 plans
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $13,486 · median $8,176 12 plans
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC — 12 plans
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $2,500 – $33,180 · median $8,335 12 plans
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $18,415 · median $8,335 12 plans
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC — 12 plans
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $2,500 – $33,192 · median $8,335 12 plans
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $2,500 – $19,197 · median $8,335 12 plans
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC $2,500 – $65,240 · median $8,335 12 plans
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $2,500 – $34,445 · median $8,335 12 plans
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $24,385 · median $8,335 12 plans
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $2,500 – $46,881 · median $8,335 12 plans
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $2,500 – $23,505 · median $8,335 12 plans
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $2,500 – $15,011 · median $8,335 12 plans
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $2,500 – $10,966 · median $8,259 12 plans
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $10,675 · median $7,384 12 plans
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $2,500 – $83,229 · median $8,335 12 plans
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $2,500 – $33,231 · median $8,335 12 plans
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $17,798 · median $8,335 12 plans
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $2,500 – $70,707 · median $8,335 12 plans
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $2,500 – $29,022 · median $8,335 12 plans
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $2,500 – $19,371 · median $8,335 12 plans
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $2,500 – $46,456 · median $8,335 12 plans
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $2,500 – $23,390 · median $8,335 12 plans
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $2,500 – $15,852 · median $8,335 12 plans
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $2,500 – $27,658 · median $8,335 12 plans
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $2,500 – $17,202 · median $8,335 12 plans
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $2,500 – $12,857 · median $8,176 12 plans
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $2,500 – $36,330 · median $8,335 12 plans
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $2,500 – $18,025 · median $8,335 12 plans
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $2,500 – $11,290 · median $8,335 12 plans
849 RADIOTHERAPY $2,500 – $40,008 · median $8,335 12 plans
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $2,500 – $74,315 · median $8,335 12 plans
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $2,500 – $30,298 · median $8,335 12 plans
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $25,297 · median $8,335 12 plans
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $2,500 – $65,828 · median $8,335 12 plans
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $2,500 – $31,747 · median $8,335 12 plans
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $2,500 – $19,078 · median $8,335 12 plans
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $2,500 – $27,381 · median $8,335 12 plans
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $2,500 – $14,947 · median $8,335 12 plans
864 FEVER AND INFLAMMATORY CONDITIONS $2,500 – $13,123 · median $8,176 12 plans
865 VIRAL ILLNESS WITH MCC $2,500 – $24,377 · median $8,335 12 plans
866 VIRAL ILLNESS WITHOUT MCC $2,500 – $13,642 · median $8,176 12 plans
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $2,500 – $31,102 · median $8,335 12 plans
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $2,500 – $16,136 · median $8,335 12 plans
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $2,500 – $10,675 · median $7,991 12 plans
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $2,500 – $103,533 · median $8,335 12 plans
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $2,500 – $29,471 · median $8,335 12 plans
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $2,500 – $15,309 · median $8,335 12 plans
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC — 12 plans
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $2,500 – $28,016 · median $8,335 12 plans
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $2,500 – $18,455 · median $8,335 12 plans
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $2,500 – $48,403 · median $8,335 12 plans
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $2,500 – $23,542 · median $8,335 12 plans
906 HAND PROCEDURES FOR INJURIES $2,500 – $27,970 · median $8,335 12 plans
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC $2,500 – $55,290 · median $8,335 12 plans
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $2,500 – $29,791 · median $8,335 12 plans
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $2,500 – $20,161 · median $8,335 12 plans
913 TRAUMATIC INJURY WITH MCC $2,500 – $22,216 · median $8,335 12 plans
914 TRAUMATIC INJURY WITHOUT MCC $2,500 – $13,493 · median $8,176 12 plans
915 ALLERGIC REACTIONS WITH MCC $2,500 – $26,371 · median $8,335 12 plans
916 ALLERGIC REACTIONS WITHOUT MCC $2,500 – $10,675 · median $7,808 12 plans
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $2,500 – $23,723 · median $8,335 12 plans
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $2,500 – $12,797 · median $8,176 12 plans
919 COMPLICATIONS OF TREATMENT WITH MCC $2,500 – $27,124 · median $8,335 12 plans
920 COMPLICATIONS OF TREATMENT WITH CC $2,500 – $15,367 · median $8,335 12 plans
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $2,500 – $10,675 · median $8,031 12 plans
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $2,500 – $25,938 · median $8,335 12 plans
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $2,500 – $15,034 · median $8,335 12 plans
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $2,500 – $47,795 · median $8,335 12 plans
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $2,500 – $32,207 · median $8,335 12 plans
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $2,500 – $27,589 · median $8,335 12 plans
947 SIGNS AND SYMPTOMS WITH MCC $2,500 – $18,605 · median $8,335 12 plans
948 SIGNS AND SYMPTOMS WITHOUT MCC $2,500 – $11,907 · median $8,335 12 plans
949 AFTERCARE WITH CC/MCC $2,500 – $15,402 · median $8,335 12 plans
950 AFTERCARE WITHOUT CC/MCC $2,500 – $10,675 · median $7,642 12 plans
951 OTHER FACTORS INFLUENCING HEALTH STATUS $2,500 – $10,675 · median $7,642 12 plans
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $2,500 – $40,645 · median $8,335 12 plans
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $2,500 – $22,312 · median $8,335 12 plans
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $2,500 – $14,209 · median $8,316 12 plans
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $2,500 – $102,161 · median $8,335 12 plans
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $2,500 – $35,741 · median $8,335 12 plans
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $2,500 – $43,354 · median $8,335 12 plans
975 HIV WITH MAJOR RELATED CONDITION WITH CC $2,500 – $20,265 · median $8,335 12 plans
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $2,500 – $12,565 · median $8,176 12 plans
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $2,500 – $21,050 · median $8,335 12 plans
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $2,500 – $70,466 · median $8,335 12 plans
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $2,500 – $36,954 · median $8,335 12 plans
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $2,500 – $24,307 · median $8,335 12 plans
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $2,500 – $50,195 · median $8,335 12 plans
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $2,500 – $25,226 · median $8,335 12 plans
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $2,500 – $16,059 · median $8,335 12 plans
338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $2,500 – $11,416 · median $7,188 11 plans
339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $2,500 – $11,416 · median $7,188 11 plans
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $2,500 – $11,416 · median $7,188 11 plans
341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $2,500 – $11,416 · median $7,188 11 plans
342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $2,500 – $11,416 · median $7,188 11 plans
343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $2,500 – $11,416 · median $7,188 11 plans
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $2,500 – $55,469 · median $8,096 11 plans
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $2,500 – $14,190 · median $8,096 11 plans
881 DEPRESSIVE NEUROSES $2,500 – $13,475 · median $8,096 11 plans
882 NEUROSES EXCEPT DEPRESSIVE $2,500 – $13,963 · median $8,096 11 plans
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $2,500 – $27,878 · median $8,096 11 plans
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $2,500 – $26,116 · median $8,096 11 plans
885 PSYCHOSES $2,500 – $20,312 · median $8,096 11 plans
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $2,500 – $24,998 · median $8,096 11 plans
887 OTHER MENTAL DISORDER DIAGNOSES $2,500 – $19,259 · median $8,096 11 plans
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $2,500 – $8,573 · median $7,188 11 plans
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $2,500 – $23,915 · median $8,096 11 plans
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $2,500 – $26,431 · median $8,096 11 plans
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $2,500 – $12,718 · median $8,096 11 plans
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT $2,500 – $391,822 11 plans
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $2,500 – $102,861 · median $8,096 11 plans
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $2,500 – $47,798 · median $8,096 11 plans
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $2,500 – $45,071 · median $8,096 11 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $2,500 – $31,105 · median $8,096 11 plans
935 NON-EXTENSIVE BURNS $2,500 – $30,341 · median $8,096 11 plans
998 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS $2,500 – $11,416 · median $7,188 11 plans
999 UNGROUPABLE $2,500 – $11,416 · median $7,188 11 plans
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $2,500 – $27,045 · median $7,642 10 plans
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $2,500 – $89,191 · median $7,642 10 plans
791 PREMATURITY WITH MAJOR PROBLEMS $2,500 – $60,912 · median $7,642 10 plans
792 PREMATURITY WITHOUT MAJOR PROBLEMS $2,500 – $36,754 · median $7,642 10 plans
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $2,500 – $62,571 · median $7,642 10 plans
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $2,500 – $22,147 · median $7,642 10 plans
945 REHABILITATION WITH CC/MCC $2,500 – $22,439 · median $7,642 10 plans
946 REHABILITATION WITHOUT CC/MCC $2,500 – $15,054 · median $7,642 10 plans
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC — 9 plans
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $2,500 – $51,409 · median $7,188 9 plans
795 NORMAL NEWBORN $2,500 – $8,573 · median $5,960 9 plans
652 KIDNEY TRANSPLANT $2,500 – $44,660 · median $7,073 7 plans
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