Baylor University Medical Center, part of Baylor Scott & White Health (Sunnyvale) — Pricing

766 procedures published in this hospital's Machine-Readable File (MRF) — 737 with a comparable price, 29 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 766
Lowest published price $3,279
Average published price $11,535
Highest published price $210,657

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 766 procedures

Published charges

Showing all 737 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 17 procedures, this hospital's negotiated rates average ≈110% of what Medicare pays.

DRG Description Published price vs. TX median vs. National median vs Medicare
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY $210,657 $483,987 −56% $498,715 −58% —
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC $135,625 $196,712 −31% $143,242 −5% —
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $70,248 $143,467 −51% $169,977 −59% —
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES $65,980 $230,527 −71% $245,241 −73% —
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS $61,581 $226,137 −73% $138,008 −55% —
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC $60,770 $91,449 −34% $109,331 −44% —
454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC $58,373 $69,101 −16% $69,101 −16% —
232 CORONARY BYPASS WITH PTCA WITHOUT MCC $55,971 $198,564 −72% $106,238 −47% —
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $53,507 $78,460 −32% $96,192 −44% —
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $50,674 $122,950 −59% $120,587 −58% —
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $50,450 $106,929 −53% $134,914 −63% —
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC $48,232 $89,353 −46% $89,353 −46% —
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $46,724 $149,897 −69% $138,868 −66% —
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $46,623 $86,459 −46% $86,459 −46% —
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $45,998 $105,228 −56% $105,228 −56% —
010 PANCREAS TRANSPLANT $45,131 $99,940 −55% $99,940 −55% —
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $43,371 $210,247 −79% $116,058 −63% —
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC $43,083 $99,711 −57% $90,331 −52% —
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $41,535 $56,565 −27% $82,247 −49% —
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC $38,726 $77,406 −50% $107,355 −64% —
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC $38,537 $209,912 −82% $121,714 −68% —
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC $37,651 $83,192 −55% $117,280 −68% —
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC $36,043 $98,765 −64% $72,782 −50% —
500 SOFT TISSUE PROCEDURES WITH MCC $34,448 $44,320 −22% $57,479 −40% —
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $34,318 $47,649 −28% $68,880 −50% —
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $34,186 $49,718 −31% $57,855 −41% —
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC $33,978 $58,314 −42% $70,132 −52% —
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC $33,643 $84,256 −60% $102,573 −67% —
252 OTHER VASCULAR PROCEDURES WITH MCC $33,541 $48,030 −30% $68,508 −51% —
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS $33,186 $54,196 −39% $54,196 −39% —
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC $32,879 $57,570 −43% $72,945 −55% —
335 PERITONEAL ADHESIOLYSIS WITH MCC $31,797 $117,803 −73% $71,755 −56% —
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC $30,368 $70,888 −57% $54,313 −44% —
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC $29,782 $46,133 −35% $54,129 −45% —
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC $29,628 $91,266 −68% $92,238 −68% —
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC $29,592 $95,604 −69% $63,984 −54% —
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $29,577 $53,584 −45% $52,908 −44% —
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC $29,522 $59,237 −50% $83,441 −65% —
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC $29,283 $70,782 −59% $58,968 −50% —
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $29,143 $48,557 −40% $51,953 −44% —
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC $28,689 $40,363 −29% $56,758 −49% —
799 SPLENECTOMY WITH MCC $28,613 $99,427 −71% $78,821 −64% —
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC $28,507 $49,003 −42% $50,919 −44% —
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $28,244 $80,603 −65% $113,855 −75% —
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC $28,086 $48,636 −42% $53,817 −48% —
006 LIVER TRANSPLANT WITHOUT MCC $27,961 $84,407 −67% $84,407 −67% —
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $27,699 $77,461 −64% $91,329 −70% —
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC $27,483 $86,484 −68% $70,735 −61% —
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM $27,374 $80,266 −66% $53,555 −49% —
163 MAJOR CHEST PROCEDURES WITH MCC $27,237 $142,222 −81% $88,341 −69% —
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $27,212 $76,015 −64% $50,139 −46% —
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC $26,769 $105,340 −75% $99,423 −73% —
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $26,264 $90,791 −71% $75,103 −65% —
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $26,048 $63,928 −59% $80,885 −68% —
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC $25,614 $37,070 −31% $40,065 −36% —
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $25,609 $108,235 −76% $72,859 −65% —
834 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC $25,348 $74,709 −66% $76,583 −67% —
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $25,248 $73,345 −66% $56,394 −55% —
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC $25,063 $74,518 −66% $54,475 −54% —
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC $24,520 $75,038 −67% $75,585 −68% —
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $24,377 $38,454 −37% $43,491 −44% —
545 CONNECTIVE TISSUE DISORDERS WITH MCC $24,216 $41,070 −41% $39,657 −39% —
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $23,735 $115,433 −79% $70,540 −66% —
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC $23,600 $60,574 −61% $51,339 −54% —
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC $23,323 $115,941 −80% $76,954 −70% —
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC $23,211 $133,390 −83% $73,029 −68% —
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $23,126 $43,248 −47% $48,094 −52% —
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $23,027 $118,231 −81% $80,747 −71% —
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC $22,930 $74,599 −69% $64,956 −65% —
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC $22,689 $31,221 −27% $43,800 −48% —
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC $22,405 $38,564 −42% $36,202 −38% —
113 ORBITAL PROCEDURES WITH CC/MCC $22,401 $32,482 −31% $35,642 −37% —
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $22,330 $106,284 −79% $74,257 −70% —
935 NON-EXTENSIVE BURNS $22,236 $31,701 −30% $29,458 −25% —
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $21,841 $66,292 −67% $51,172 −57% —
037 EXTRACRANIAL PROCEDURES WITH MCC $21,471 $107,947 −80% $64,749 −67% —
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $21,391 $65,401 −67% $48,907 −56% —
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC $21,211 $132,154 −84% $88,049 −76% —
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT $21,148 $69,973 −70% $65,254 −68% —
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC $21,127 $70,613 −70% $67,901 −69% —
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $20,993 $149,263 −86% $88,050 −76% —
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC $20,799 $58,221 −64% $47,546 −56% —
035 CAROTID ARTERY STENT PROCEDURES WITH CC $20,644 $32,719 −37% $46,430 −56% —
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC $20,539 $92,740 −78% $66,819 −69% —
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC $20,110 $73,266 −73% $68,847 −71% —
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC $20,083 $58,809 −66% $54,772 −63% —
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC $20,047 $91,417 −78% $88,307 −77% —
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $19,764 $68,425 −71% $38,998 −49% —
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC $19,633 $71,969 −73% $65,383 −70% —
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $19,602 $51,569 −62% $39,747 −51% —
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $19,588 $26,990 −27% $16,719 +17% —
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC $19,517 $37,991 −49% $36,333 −46% —
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC $19,454 $138,656 −86% $82,561 −76% —
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $19,405 $37,784 −49% $38,420 −49% —
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $19,364 $79,695 −76% $83,065 −77% —
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $19,298 $31,349 −38% $37,902 −49% —
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $19,267 $45,049 −57% $40,232 −52% —
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC $19,247 $49,397 −61% $44,600 −57% —
504 FOOT PROCEDURES WITH CC $19,236 $39,139 −51% $36,598 −47% —
711 TESTES PROCEDURES WITH CC/MCC $19,001 $62,108 −69% $34,852 −45% —
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC $18,916 $32,969 −43% $37,080 −49% —
503 FOOT PROCEDURES WITH MCC $18,902 $44,309 −57% $43,901 −57% —
501 SOFT TISSUE PROCEDURES WITH CC $18,858 $57,633 −67% $37,975 −50% —
592 SKIN ULCERS WITH MCC $18,732 $32,263 −42% $32,662 −43% —
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $18,635 $58,702 −68% $62,269 −70% —
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC $18,488 $100,268 −82% $62,961 −71% —
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $18,477 $47,693 −61% $30,974 −40% —
620 O.R. PROCEDURES FOR OBESITY WITH CC $18,393 $44,265 −58% $35,453 −48% —
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC $18,359 $67,278 −73% $37,654 −51% —
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC $18,319 $52,262 −65% $35,692 −49% —
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $18,275 $63,641 −71% $43,524 −58% —
506 MAJOR THUMB OR JOINT PROCEDURES $18,200 $25,946 −30% $28,983 −37% —
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $18,116 $54,300 −67% $61,832 −71% —
665 PROSTATECTOMY WITH MCC $17,991 $68,365 −74% $54,072 −67% —
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $17,849 $42,680 −58% $33,424 −47% —
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $17,782 $83,214 −79% $63,475 −72% —
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC $17,771 $74,112 −76% $49,055 −64% —
034 CAROTID ARTERY STENT PROCEDURES WITH MCC $17,769 $53,665 −67% $72,908 −76% —
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS $17,724 $68,604 −74% $52,405 −66% —
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $17,585 $63,080 −72% $43,080 −59% —
546 CONNECTIVE TISSUE DISORDERS WITH CC $17,392 $32,249 −46% $24,202 −28% —
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC $17,369 $48,637 −64% $59,207 −71% —
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $16,925 $30,041 −44% $33,050 −49% —
652 KIDNEY TRANSPLANT $16,889 $54,720 −69% $54,720 −69% —
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC $16,813 $39,644 −58% $58,043 −71% —
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC $16,700 $27,713 −40% $33,564 −50% —
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $16,569 $33,998 −51% $40,583 −59% —
116 INTRAOCULAR PROCEDURES WITH CC/MCC $16,471 $21,347 −23% $28,103 −41% —
668 TRANSURETHRAL PROCEDURES WITH MCC $16,437 $51,424 −68% $47,277 −65% —
919 COMPLICATIONS OF TREATMENT WITH MCC $16,398 $47,893 −66% $29,031 −44% —
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC $16,357 $87,874 −81% $57,963 −72% —
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $16,351 $17,621 −7% $14,284 +14% —
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC $16,315 $26,161 −38% $24,450 −33% —
570 SKIN DEBRIDEMENT WITH MCC $16,126 $47,727 −66% $52,435 −69% —
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS $16,068 $59,774 −73% $64,152 −75% —
654 MAJOR BLADDER PROCEDURES WITH CC $15,977 $39,822 −60% $53,868 −70% —
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC $15,887 $94,746 −83% $67,764 −77% —
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $15,782 $24,871 −37% $25,208 −37% —
180 RESPIRATORY NEOPLASMS WITH MCC $15,637 $58,269 −73% $36,658 −57% —
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $15,619 $29,558 −47% $29,558 −47% —
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $15,617 $47,335 −67% $29,609 −47% —
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC $15,537 $49,651 −69% $49,065 −68% —
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC $15,526 $38,751 −60% $46,659 −67% —
253 OTHER VASCULAR PROCEDURES WITH CC $15,363 $69,497 −78% $53,746 −71% —
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $15,317 $32,009 −52% $27,168 −44% —
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $15,265 $41,021 −63% $32,839 −54% —
849 RADIOTHERAPY $15,175 $41,538 −63% $37,862 −60% —
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC $15,026 $63,849 −76% $51,142 −71% —
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $14,959 $71,589 −79% $50,624 −70% —
637 DIABETES WITH MCC $14,949 $39,978 −63% $28,819 −48% —
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC $14,759 $36,879 −60% $36,080 −59% —
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $14,628 $46,747 −69% $35,673 −59% —
189 PULMONARY EDEMA AND RESPIRATORY FAILURE $14,493 $40,228 −64% $25,704 −44% ≈138% of Medicare
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC $14,306 $34,857 −59% $25,149 −43% —
606 MINOR SKIN DISORDERS WITH MCC $14,304 $27,528 −48% $25,434 −44% —
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $14,279 $34,683 −59% $25,426 −44% —
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC $14,263 $55,658 −74% $45,963 −69% —
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $14,234 $32,141 −56% $31,909 −55% —
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $14,213 $24,189 −41% $25,731 −45% —
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC $14,196 $43,611 −67% $31,059 −54% —
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC $14,116 $50,419 −72% $34,434 −59% —
974 HIV WITH MAJOR RELATED CONDITION WITH MCC $13,719 $41,952 −67% $46,402 −70% —
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC $13,704 $76,642 −82% $54,824 −75% —
077 HYPERTENSIVE ENCEPHALOPATHY WITH MCC $13,677 $23,263 −41% $24,036 −43% —
398 APPENDIX PROCEDURES WITH CC $13,667 $49,193 −72% $39,107 −65% —
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC $13,657 $26,548 −49% $28,252 −52% —
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC $13,608 $58,326 −77% $35,237 −61% ≈76% of Medicare
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $13,607 $39,406 −65% $27,548 −51% —
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $13,308 $22,592 −41% $31,812 −58% —
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC $13,215 $32,773 −60% $43,586 −70% —
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES $13,186 $92,538 −86% $74,274 −82% —
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $13,094 $52,001 −75% $46,477 −72% —
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC $13,073 $32,168 −59% $44,053 −70% —
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $12,739 $30,486 −58% $35,686 −64% —
383 UNCOMPLICATED PEPTIC ULCER WITH MCC $12,647 $35,114 −64% $26,634 −53% —
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $12,598 $49,325 −74% $43,697 −71% —
709 PENIS PROCEDURES WITH CC/MCC $12,460 $32,777 −62% $34,535 −64% —
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $12,453 $39,072 −68% $32,502 −62% —
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $12,363 $37,764 −67% $41,651 −70% —
975 HIV WITH MAJOR RELATED CONDITION WITH CC $12,321 $21,642 −43% $25,010 −51% —
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $12,315 $31,044 −60% $31,044 −60% —
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC $12,279 $39,906 −69% $28,156 −56% —
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC $12,246 $29,949 −59% $20,309 −40% —
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC $12,228 $46,335 −74% $45,432 −73% —
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $12,216 $31,646 −61% $40,063 −70% —
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC $12,074 $51,010 −76% $32,936 −63% —
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $12,030 $21,210 −43% $29,109 −59% —
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $11,961 $25,579 −53% $25,666 −53% —
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $11,928 $52,032 −77% $45,497 −74% —
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC $11,900 $42,832 −72% $34,887 −66% —
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC $11,890 $27,641 −57% $20,080 −41% —
245 AICD GENERATOR PROCEDURES $11,861 $66,564 −82% $72,076 −84% —
472 CERVICAL SPINAL FUSION WITH CC $11,861 $51,075 −77% $59,537 −80% —
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC $11,861 $30,313 −61% $22,532 −47% —
642 INBORN AND OTHER DISORDERS OF METABOLISM $11,820 $40,345 −71% $20,727 −43% —
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $11,720 $36,333 −68% $51,985 −77% —
347 ANAL AND STOMAL PROCEDURES WITH MCC $11,712 $42,818 −73% $40,548 −71% —
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $11,684 $28,324 −59% $26,146 −55% —
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $11,679 $55,994 −79% $42,881 −73% —
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC $11,645 $35,632 −67% $23,924 −51% —
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC $11,610 $48,286 −76% $43,398 −73% —
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT $11,476 $26,492 −57% $30,661 −63% —
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC $11,450 $46,399 −75% $52,332 −78% —
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC $11,347 $37,631 −70% $40,947 −72% —
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC $11,301 $38,050 −70% $35,114 −68% —
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $11,269 $48,152 −77% $36,933 −69% —
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC $11,268 $89,410 −87% $56,964 −80% —
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC $11,250 $25,581 −56% $23,588 −52% —
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $11,224 $23,689 −53% $24,836 −55% —
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $11,213 $65,883 −83% $35,014 −68% —
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC $11,200 $41,744 −73% $43,775 −74% —
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $11,066 $75,392 −85% $46,591 −76% —
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $11,053 $25,633 −57% $29,826 −63% —
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC $11,042 $61,539 −82% $36,280 −70% —
030 SPINAL PROCEDURES WITHOUT CC/MCC $10,999 $59,227 −81% $45,818 −76% —
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC $10,996 $19,686 −44% $22,275 −51% —
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $10,992 $30,669 −64% $21,545 −49% —
088 CONCUSSION WITH MCC $10,958 $44,167 −75% $24,402 −55% —
836 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC $10,888 $31,874 −66% $19,686 −45% —
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $10,885 $32,258 −66% $30,940 −65% —
551 MEDICAL BACK PROBLEMS WITH MCC $10,857 $42,807 −75% $31,086 −65% —
139 SALIVARY GLAND PROCEDURES $10,796 $21,014 −49% $21,014 −49% —
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $10,758 $43,017 −75% $40,563 −73% —
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC $10,685 $35,004 −69% $32,204 −67% —
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC $10,679 $50,793 −79% $41,380 −74% —
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $10,653 $31,143 −66% $40,694 −74% —
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $10,619 $31,343 −66% $22,557 −53% —
199 PNEUMOTHORAX WITH MCC $10,485 $56,291 −81% $31,491 −67% —
304 HYPERTENSION WITH MCC $10,456 $33,511 −69% $24,185 −57% —
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $10,445 $38,356 −73% $28,375 −63% —
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $10,284 $35,486 −71% $28,134 −63% —
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $10,282 $36,428 −72% $39,018 −74% —
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $10,233 $19,570 −48% $14,861 −31% —
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC $10,212 $30,692 −67% $22,811 −55% —
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $10,201 $44,354 −77% $31,816 −68% —
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $10,189 $32,502 −69% $23,723 −57% —
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC $10,182 $32,168 −68% $29,805 −66% —
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC $10,168 $61,278 −83% $36,334 −72% —
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC $10,085 $35,839 −72% $25,162 −60% —
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $10,084 $43,520 −77% $32,483 −69% —
595 MAJOR SKIN DISORDERS WITH MCC $10,062 $42,247 −76% $31,785 −68% —
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC $10,058 $51,021 −80% $38,836 −74% —
455 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC $10,058 $61,694 −84% $54,320 −81% —
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC $10,058 $39,954 −75% $30,006 −66% —
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC $10,058 $39,653 −75% $43,538 −77% —
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC $9,948 $44,483 −78% $29,211 −66% —
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $9,919 $43,019 −77% $38,357 −74% —
553 BONE DISEASES AND ARTHROPATHIES WITH MCC $9,918 $30,239 −67% $23,956 −59% —
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC $9,833 $35,420 −72% $31,190 −68% —
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC $9,802 $30,058 −67% $30,058 −67% ≈110% of Medicare
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $9,756 $28,547 −66% $19,001 −49% —
071 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC $9,696 $34,256 −72% $23,396 −59% —
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC $9,694 $35,101 −72% $18,126 −47% —
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $9,685 $35,273 −73% $30,930 −69% —
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $9,682 $68,532 −86% $56,519 −83% —
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $9,682 $38,609 −75% $32,451 −70% —
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC $9,676 $24,566 −61% $16,776 −42% —
535 FRACTURES OF HIP AND PELVIS WITH MCC $9,605 $39,831 −76% $23,350 −59% —
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC $9,590 $73,103 −87% $78,582 −88% —
667 PROSTATECTOMY WITHOUT CC/MCC $9,589 $16,534 −42% $16,703 −43% —
459 SPINAL FUSION EXCEPT CERVICAL WITH MCC $9,525 $78,699 −88% $75,251 −87% —
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $9,525 $51,780 −82% $44,553 −79% —
505 FOOT PROCEDURES WITHOUT CC/MCC $9,525 $26,653 −64% $31,716 −70% —
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR $9,525 $60,017 −84% $64,776 −85% —
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $9,486 $62,477 −85% $35,714 −73% —
949 AFTERCARE WITH CC/MCC $9,470 $35,072 −73% $23,953 −60% —
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC $9,454 $49,043 −81% $28,967 −67% ≈88% of Medicare
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $9,442 $16,495 −43% $16,495 −43% —
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $9,397 $23,297 −60% $23,297 −60% —
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $9,375 $34,419 −73% $24,136 −61% —
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $9,343 $18,069 −48% $13,090 −29% —
183 MAJOR CHEST TRAUMA WITH MCC $9,339 $37,213 −75% $28,924 −68% —
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC $9,309 $33,151 −72% $20,732 −55% —
078 HYPERTENSIVE ENCEPHALOPATHY WITH CC $9,294 $16,146 −42% $17,434 −47% —
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC $9,293 $59,086 −84% $49,631 −81% —
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $9,293 $56,535 −84% $66,853 −86% —
946 REHABILITATION WITHOUT CC/MCC $9,257 $14,074 −34% $17,685 −48% —
813 COAGULATION DISORDERS $9,236 $44,051 −79% $30,128 −69% —
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $9,228 $40,079 −77% $35,375 −74% —
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $9,228 $51,365 −82% $33,490 −72% —
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $9,228 $39,148 −76% $45,817 −80% —
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC $9,228 $63,316 −85% $45,059 −80% —
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC $9,213 $26,360 −65% $18,002 −49% —
100 SEIZURES WITH MCC $9,210 $28,961 −68% $35,194 −74% —
231 CORONARY BYPASS WITH PTCA WITH MCC $9,172 $128,088 −93% $146,474 −94% —
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC $9,172 $125,987 −93% $84,861 −89% —
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $9,172 $29,425 −69% $27,492 −67% —
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $9,172 $24,506 −63% $28,646 −68% —
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $9,172 $59,215 −85% $40,277 −77% —
075 VIRAL MENINGITIS WITH CC/MCC $9,147 $30,536 −70% $29,853 −69% —
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC $9,132 $24,302 −62% $24,465 −63% —
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $9,061 $31,637 −71% $19,091 −53% —
200 PNEUMOTHORAX WITH CC $9,054 $35,999 −75% $20,573 −56% —
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC $9,010 $35,336 −75% $19,894 −55% —
445 DISORDERS OF THE BILIARY TRACT WITH CC $9,004 $34,380 −74% $21,806 −59% —
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $8,992 $46,575 −81% $25,854 −65% —
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $8,952 $25,515 −65% $19,854 −55% —
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $8,949 $38,950 −77% $28,140 −68% —
597 MALIGNANT BREAST DISORDERS WITH MCC $8,932 $48,535 −82% $31,846 −72% —
791 PREMATURITY WITH MAJOR PROBLEMS $8,873 $34,685 −74% $39,563 −78% —
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC $8,858 $53,102 −83% $33,165 −73% —
768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C $8,858 $22,506 −61% $17,103 −48% —
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $8,817 $32,249 −73% $29,476 −70% —
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $8,803 $24,315 −64% $14,337 −39% —
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC $8,758 $57,163 −85% $32,981 −73% —
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC $8,731 $27,131 −68% $18,253 −52% —
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC $8,726 $48,189 −82% $32,911 −73% —
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $8,582 $30,298 −72% $30,394 −72% —
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $8,533 $58,714 −85% $32,399 −74% —
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $8,514 $58,617 −85% $37,842 −78% —
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC $8,485 $34,027 −75% $30,275 −72% —
915 ALLERGIC REACTIONS WITH MCC $8,466 $47,831 −82% $30,944 −73% —
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC $8,440 $15,167 −44% $12,279 −31% —
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $8,439 $31,077 −73% $18,191 −54% —
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC $8,435 $45,663 −82% $35,542 −76% —
693 URINARY STONES WITH MCC $8,416 $22,278 −62% $22,525 −63% —
811 RED BLOOD CELL DISORDERS WITH MCC $8,363 $39,626 −79% $27,934 −70% —
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC $8,339 $35,990 −77% $36,375 −77% —
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $8,335 $81,319 −90% $56,242 −85% —
101 SEIZURES WITHOUT MCC $8,331 $20,289 −59% $19,954 −58% —
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $8,330 $42,949 −81% $36,597 −77% —
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC $8,326 $52,248 −84% $29,409 −72% —
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $8,289 $15,335 −46% $18,238 −55% —
812 RED BLOOD CELL DISORDERS WITHOUT MCC $8,280 $29,514 −72% $20,488 −60% —
471 CERVICAL SPINAL FUSION WITH MCC $8,255 $66,842 −88% $92,515 −91% —
509 ARTHROSCOPY $8,255 $25,994 −68% $25,994 −68% —
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA $8,255 $91,253 −91% $105,612 −92% —
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $8,245 $85,313 −90% $59,425 −86% —
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $8,222 $58,041 −86% $32,538 −75% —
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC $8,183 $10,073 −19% $13,586 −40% —
265 AICD LEAD PROCEDURES $8,180 $49,492 −83% $56,695 −86% —
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $8,176 $67,791 −88% $96,905 −92% —
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $8,176 $59,712 −86% $65,325 −87% —
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC $8,176 $45,698 −82% $33,137 −75% —
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC $8,161 $24,389 −67% $19,326 −58% —
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $8,156 $49,708 −84% $36,242 −77% —
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC $8,154 $29,160 −72% $31,758 −74% —
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC $8,138 $95,906 −92% $62,404 −87% —
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC $8,134 $175,396 −95% $86,953 −91% —
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC $8,134 $139,926 −94% $102,177 −92% —
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $8,134 $31,821 −74% $34,146 −76% —
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC $8,134 $36,115 −77% $33,694 −76% —
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $8,134 $39,682 −80% $29,633 −73% —
638 DIABETES WITH CC $8,134 $27,005 −70% $18,821 −57% —
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES $8,134 $13,068 −38% $12,381 −34% —
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $8,114 $13,257 −39% $23,920 −66% —
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $8,104 $47,454 −83% $31,840 −75% ≈65% of Medicare
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC $8,096 $30,579 −74% $20,463 −60% —
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $8,096 $34,890 −77% $41,520 −81% —
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $8,087 $33,413 −76% $38,094 −79% —
540 OSTEOMYELITIS WITH CC $8,087 $19,990 −60% $23,494 −66% —
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $8,066 $26,192 −69% $18,623 −57% —
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC $8,035 $44,541 −82% $30,418 −74% —
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC $8,034 $43,556 −82% $30,358 −74% —
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC $8,011 $24,928 −68% $29,916 −73% —
157 DENTAL AND ORAL DISEASES WITH MCC $7,980 $42,077 −81% $27,457 −71% —
312 SYNCOPE AND COLLAPSE $7,952 $28,324 −72% $19,342 −59% ≈154% of Medicare
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC $7,947 $79,247 −90% $112,062 −93% —
460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $7,947 $83,613 −90% $50,815 −84% —
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $7,947 $44,566 −82% $54,929 −86% —
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $7,947 $22,625 −65% $21,062 −62% —
619 O.R. PROCEDURES FOR OBESITY WITH MCC $7,947 $51,746 −85% $44,973 −82% —
552 MEDICAL BACK PROBLEMS WITHOUT MCC $7,912 $31,330 −75% $21,213 −63% —
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC $7,908 $43,894 −82% $33,607 −76% —
124 OTHER DISORDERS OF THE EYE WITH MCC $7,904 $20,117 −61% $21,029 −62% —
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $7,903 $15,538 −49% $15,045 −47% —
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $7,884 $27,241 −71% $29,729 −73% —
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $7,872 $27,856 −72% $19,096 −59% —
865 VIRAL ILLNESS WITH MCC $7,846 $29,325 −73% $26,088 −70% —
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC $7,838 $61,292 −87% $49,197 −84% —
533 FRACTURES OF FEMUR WITH MCC $7,838 $49,567 −84% $25,945 −70% —
539 OSTEOMYELITIS WITH MCC $7,838 $46,459 −83% $33,746 −77% —
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $7,838 $23,928 −67% $20,741 −62% —
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $7,802 $37,057 −79% $34,264 −77% —
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $7,768 $38,514 −80% $33,984 −77% —
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $7,765 $29,643 −74% $18,150 −57% —
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $7,714 $43,744 −82% $35,584 −78% —
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $7,707 $43,330 −82% $62,821 −88% —
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $7,690 $55,298 −86% $43,266 −82% —
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $7,666 $17,903 −57% $12,044 −36% —
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $7,653 $38,140 −80% $27,244 −72% —
444 DISORDERS OF THE BILIARY TRACT WITH MCC $7,650 $40,821 −81% $31,128 −75% —
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC $7,642 $21,239 −64% $16,745 −54% ≈187% of Medicare
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $7,633 $51,898 −85% $57,149 −87% —
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE $7,541 $93,036 −92% $53,551 −86% —
453 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH MCC $7,541 $103,861 −93% $103,861 −93% —
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $7,541 $22,948 −67% $17,367 −57% —
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC $7,541 $24,482 −69% $18,803 −60% —
334 RECTAL RESECTION WITHOUT CC/MCC $7,517 $27,809 −73% $32,213 −77% —
947 SIGNS AND SYMPTOMS WITH MCC $7,503 $32,843 −77% $25,474 −71% —
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC $7,452 $11,909 −37% $11,909 −37% —
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC $7,433 $57,889 −87% $48,680 −85% —
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $7,414 $21,228 −65% $24,561 −70% —
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $7,393 $23,602 −69% $34,906 −79% —
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $7,387 $68,262 −89% $60,140 −88% —
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $7,375 $17,159 −57% $17,943 −59% —
114 ORBITAL PROCEDURES WITHOUT CC/MCC $7,363 $25,952 −72% $19,598 −62% —
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT $7,336 $25,262 −71% $24,879 −71% —
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC $7,318 $82,870 −91% $96,222 −92% —
945 REHABILITATION WITH CC/MCC $7,289 $23,834 −69% $23,834 −69% —
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $7,287 $16,156 −55% $16,156 −55% —
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC $7,268 $17,544 −59% $24,544 −70% —
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $7,261 $49,899 −85% $36,239 −80% —
694 URINARY STONES WITHOUT MCC $7,242 $22,050 −67% $16,531 −56% —
137 MOUTH PROCEDURES WITH CC/MCC $7,228 $29,348 −75% $24,348 −70% —
682 RENAL FAILURE WITH MCC $7,217 $38,760 −81% $27,854 −74% ≈66% of Medicare
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC $7,214 $48,230 −85% $34,089 −79% —
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC $7,196 $18,873 −62% $19,868 −64% —
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $7,195 $53,393 −87% $31,566 −77% —
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC $7,195 $18,649 −61% $13,654 −47% —
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $7,172 $17,193 −58% $17,193 −58% —
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC $7,137 $27,927 −74% $18,278 −61% —
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $7,087 $27,480 −74% $17,715 −60% —
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC $7,043 $40,042 −82% $20,147 −65% —
663 MINOR BLADDER PROCEDURES WITH CC $7,026 $39,409 −82% $29,924 −77% —
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $6,989 $21,962 −68% $19,354 −64% —
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC $6,964 $38,849 −82% $20,421 −66% —
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $6,899 $20,838 −67% $15,072 −54% —
089 CONCUSSION WITH CC $6,896 $17,109 −60% $18,293 −62% —
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $6,858 $21,615 −68% $21,615 −68% —
548 SEPTIC ARTHRITIS WITH MCC $6,849 $43,438 −84% $31,019 −78% —
067 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC $6,834 $34,298 −80% $24,941 −73% —
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC $6,831 $48,914 −86% $33,792 −80% —
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $6,823 $31,755 −79% $22,525 −70% —
388 GASTROINTESTINAL OBSTRUCTION WITH MCC $6,821 $34,816 −80% $28,780 −76% —
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC $6,819 $19,537 −65% $12,895 −47% —
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $6,790 $73,229 −91% $50,011 −86% —
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $6,740 $34,326 −80% $24,452 −72% —
697 URETHRAL STRICTURE $6,712 $16,196 −59% $17,705 −62% —
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC $6,637 $22,840 −71% $15,600 −57% —
181 RESPIRATORY NEOPLASMS WITH CC $6,617 $20,728 −68% $22,431 −71% —
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $6,604 $17,778 −63% $13,485 −51% —
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC $6,603 $17,727 −63% $20,371 −68% —
054 NERVOUS SYSTEM NEOPLASMS WITH MCC $6,578 $46,151 −86% $29,484 −78% —
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $6,561 $22,563 −71% $13,303 −51% —
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC $6,523 $27,057 −76% $18,459 −65% —
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC $6,517 $33,422 −81% $23,496 −72% —
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC $6,506 $32,980 −80% $25,243 −74% —
311 ANGINA PECTORIS $6,491 $15,034 −57% $15,165 −57% —
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC $6,490 $104,160 −94% $57,277 −89% —
541 OSTEOMYELITIS WITHOUT CC/MCC $6,419 $21,919 −71% $14,549 −56% —
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC $6,419 $24,106 −73% $24,452 −74% —
644 ENDOCRINE DISORDERS WITH CC $6,392 $33,596 −81% $22,941 −72% —
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $6,353 $37,000 −83% $25,267 −75% —
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $6,353 $28,993 −78% $15,764 −60% —
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC $6,353 $16,953 −63% $16,418 −61% —
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC $6,353 $16,847 −62% $17,550 −64% —
348 ANAL AND STOMAL PROCEDURES WITH CC $6,348 $29,376 −78% $27,947 −77% —
032 VENTRICULAR SHUNT PROCEDURES WITH CC $6,339 $35,340 −82% $45,622 −86% —
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $6,331 $23,796 −73% $15,869 −60% —
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC $6,321 $16,444 −62% $16,104 −61% —
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $6,321 $31,822 −80% $27,279 −77% —
710 PENIS PROCEDURES WITHOUT CC/MCC $6,321 $23,485 −73% $23,814 −73% —
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $6,307 $20,980 −70% $20,980 −70% —
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC $6,302 $26,012 −76% $20,278 −69% —
138 MOUTH PROCEDURES WITHOUT CC/MCC $6,302 $26,445 −76% $17,383 −64% —
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $6,302 $32,387 −81% $28,527 −78% —
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC $6,289 $22,375 −72% $19,483 −68% —
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC $6,289 $35,255 −82% $20,842 −70% —
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC $6,289 $21,977 −71% $15,858 −60% —
201 PNEUMOTHORAX WITHOUT CC/MCC $6,289 $22,004 −71% $13,081 −52% —
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $6,289 $64,248 −90% $92,217 −93% —
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC $6,289 $19,044 −67% $15,608 −60% —
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $6,289 $26,184 −76% $19,305 −67% —
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $6,289 $64,932 −90% $52,313 −88% —
598 MALIGNANT BREAST DISORDERS WITH CC $6,289 $19,410 −68% $19,073 −67% —
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC $6,289 $11,421 −45% $11,421 −45% —
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $6,289 $29,419 −79% $20,084 −69% —
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $6,289 $31,025 −80% $36,850 −83% —
920 COMPLICATIONS OF TREATMENT WITH CC $6,289 $33,021 −81% $21,181 −70% —
948 SIGNS AND SYMPTOMS WITHOUT MCC $6,289 $25,630 −75% $17,727 −65% —
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $6,282 $36,543 −83% $26,322 −76% —
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $6,282 $30,961 −80% $23,141 −73% —
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC $6,282 $14,937 −58% $15,077 −58% —
090 CONCUSSION WITHOUT CC/MCC $6,282 $27,428 −77% $14,873 −58% —
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC $6,282 $50,472 −88% $47,583 −87% —
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC $6,282 $15,890 −60% $15,890 −60% —
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $6,282 $32,081 −80% $22,024 −71% —
227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $6,282 $56,960 −89% $56,960 −89% —
295 DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC $6,282 $13,445 −53% $13,445 −53% —
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $6,282 $49,765 −87% $30,910 −80% —
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $6,282 $22,189 −72% $12,797 −51% —
339 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $6,282 $18,474 −66% $18,474 −66% —
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC $6,282 $43,335 −86% $31,978 −80% —
381 COMPLICATED PEPTIC ULCER WITH CC $6,282 $36,066 −83% $24,177 −74% —
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC $6,282 $47,763 −87% $25,152 −75% —
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $6,282 $39,849 −84% $39,253 −84% —
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $6,282 $23,257 −73% $25,484 −75% —
671 URETHRAL PROCEDURES WITH CC/MCC $6,282 $25,566 −75% $27,233 −77% —
684 RENAL FAILURE WITHOUT CC/MCC $6,282 $18,804 −67% $13,623 −54% —
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $6,282 $32,060 −80% $25,390 −75% —
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC $6,282 $15,436 −59% $25,197 −75% —
038 EXTRACRANIAL PROCEDURES WITH CC $6,263 $52,372 −88% $35,770 −82% —
158 DENTAL AND ORAL DISEASES WITH CC $6,263 $30,573 −80% $17,700 −65% —
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $6,263 $8,927 −30% $8,927 −30% —
341 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $6,263 $25,628 −76% $25,628 −76% —
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $6,263 $17,785 −65% $13,318 −53% —
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC $6,263 $17,892 −65% $15,070 −58% —
593 SKIN ULCERS WITH CC $6,263 $27,293 −77% $20,470 −69% —
666 PROSTATECTOMY WITH CC $6,263 $53,546 −88% $30,016 −79% —
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $6,263 $29,131 −79% $44,363 −86% —
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,263 $17,100 −63% $15,589 −60% —
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,263 $19,950 −69% $14,208 −56% —
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $6,263 $23,388 −73% $18,017 −65% —
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC $6,202 $21,022 −70% $29,050 −79% —
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $6,187 $44,047 −86% $29,374 −79% —
549 SEPTIC ARTHRITIS WITH CC $6,177 $27,124 −77% $20,938 −70% —
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $6,134 $33,060 −81% $23,469 −74% —
338 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITH MCC $6,109 $23,532 −74% $30,138 −80% —
378 GASTROINTESTINAL HEMORRHAGE WITH CC $6,099 $32,061 −81% $21,886 −72% ≈153% of Medicare
672 URETHRAL PROCEDURES WITHOUT CC/MCC $6,099 $17,398 −65% $17,398 −65% —
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $6,079 $19,287 −68% $19,287 −68% —
197 INTERSTITIAL LUNG DISEASE WITH CC $6,067 $22,609 −73% $20,106 −70% —
225 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC $6,067 $49,712 −88% $57,380 −89% —
864 FEVER AND INFLAMMATORY CONDITIONS $6,067 $14,849 −59% $17,412 −65% —
779 ABORTION WITHOUT D&C $6,060 $17,738 −66% $15,327 −60% —
866 VIRAL ILLNESS WITHOUT MCC $6,060 $24,453 −75% $16,391 −63% —
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $6,056 $49,536 −88% $41,900 −86% —
222 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITH MCC $6,040 $86,864 −93% $86,864 −93% —
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC $6,040 $31,282 −81% $20,777 −71% —
343 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $6,040 $12,397 −51% $13,735 −56% —
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC $6,040 $28,002 −78% $18,918 −68% —
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $6,035 $34,217 −82% $18,478 −67% —
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC $6,035 $22,265 −73% $25,786 −77% —
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC $6,035 $30,937 −80% $18,428 −67% —
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC $6,035 $36,339 −83% $38,878 −84% —
076 VIRAL MENINGITIS WITHOUT CC/MCC $6,025 $18,601 −68% $15,474 −61% —
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC $6,025 $37,976 −84% $21,860 −72% —
196 INTERSTITIAL LUNG DISEASE WITH MCC $6,025 $43,199 −86% $30,766 −80% —
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC $6,025 $33,833 −82% $24,480 −75% ≈104% of Medicare
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC $6,025 $33,892 −82% $29,524 −80% —
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $6,008 $35,694 −83% $39,409 −85% —
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE $6,005 $45,806 −87% $29,757 −80% —
303 ATHEROSCLEROSIS WITHOUT MCC $6,005 $22,255 −73% $14,927 −60% —
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC $6,005 $35,895 −83% $46,066 −87% —
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $6,005 $17,277 −65% $14,166 −58% —
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC $6,005 $50,184 −88% $32,490 −82% —
080 NONTRAUMATIC STUPOR AND COMA WITH MCC $5,993 $44,679 −87% $35,139 −83% —
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $5,993 $33,308 −82% $36,237 −83% —
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $5,993 $11,997 −50% $11,997 −50% —
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $5,993 $18,755 −68% $13,198 −55% —
249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC $5,993 $20,610 −71% $20,610 −71% —
386 INFLAMMATORY BOWEL DISEASE WITH CC $5,993 $29,842 −80% $20,968 −71% —
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $5,993 $21,623 −72% $17,322 −65% ≈187% of Medicare
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $5,993 $32,129 −81% $23,749 −75% —
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $5,993 $25,521 −77% $13,385 −55% —
639 DIABETES WITHOUT CC/MCC $5,993 $19,891 −70% $13,910 −57% —
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR $5,986 $52,027 −88% $44,989 −87% —
068 NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC $5,986 $21,624 −72% $19,569 −69% —
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $5,986 $31,933 −81% $24,118 −75% —
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $5,986 $58,037 −90% $39,093 −85% —
151 EPISTAXIS WITHOUT MCC $5,986 $13,119 −54% $13,032 −54% —
152 OTITIS MEDIA AND URI WITH MCC $5,986 $36,209 −83% $19,795 −70% —
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS $5,986 $33,983 −82% $33,983 −82% —
291 HEART FAILURE AND SHOCK WITH MCC $5,986 $32,698 −82% $25,020 −76% ≈51% of Medicare
297 CARDIAC ARREST, UNEXPLAINED WITH CC $5,986 $12,336 −51% $12,336 −51% —
336 PERITONEAL ADHESIOLYSIS WITH CC $5,986 $68,668 −91% $49,470 −88% —
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $5,986 $24,358 −75% $16,634 −64% —
399 APPENDIX PROCEDURES WITHOUT CC/MCC $5,986 $36,541 −84% $30,314 −80% —
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC $5,986 $73,455 −92% $94,927 −94% —
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC $5,986 $29,922 −80% $22,982 −74% —
712 TESTES PROCEDURES WITHOUT CC/MCC $5,986 $17,076 −65% $18,898 −68% —
784 CESAREAN SECTION WITH STERILIZATION WITH CC $5,986 $35,205 −83% $22,560 −73% —
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC $5,986 $10,795 −45% $9,076 −34% —
950 AFTERCARE WITHOUT CC/MCC $5,986 $11,329 −47% $13,527 −56% —
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $5,986 $26,342 −77% $17,585 −66% —
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $5,966 $32,604 −82% $37,064 −84% —
123 NEUROLOGICAL EYE DISORDERS $5,966 $24,612 −76% $17,831 −67% —
153 OTITIS MEDIA AND URI WITHOUT MCC $5,966 $21,412 −72% $14,473 −59% —
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC $5,966 $26,656 −78% $18,204 −67% ≈138% of Medicare
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $5,966 $53,945 −89% $78,852 −92% —
300 PERIPHERAL VASCULAR DISORDERS WITH CC $5,966 $21,345 −72% $19,579 −70% —
333 RECTAL RESECTION WITH CC $5,966 $61,029 −90% $34,352 −83% —
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $5,966 $11,562 −48% $11,071 −46% —
916 ALLERGIC REACTIONS WITHOUT MCC $5,966 $14,486 −59% $13,890 −57% —
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC $5,966 $22,352 −73% $14,012 −57% —
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $5,966 $33,151 −82% $16,571 −64% —
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $5,966 $32,602 −82% $16,212 −63% —
534 FRACTURES OF FEMUR WITHOUT MCC $5,920 $26,458 −78% $17,195 −66% —
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $5,798 $51,792 −89% $44,117 −87% —
571 SKIN DEBRIDEMENT WITH CC $5,798 $37,792 −85% $34,901 −83% —
223 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITH AMI, HF OR SHOCK WITHOUT MCC $5,760 $59,206 −90% $59,206 −90% —
305 HYPERTENSION WITHOUT MCC $5,760 $24,403 −76% $17,144 −66% —
800 SPLENECTOMY WITH CC $5,760 $94,713 −94% $49,184 −88% —
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $5,760 $37,559 −85% $25,307 −77% —
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC $5,738 $48,888 −88% $35,528 −84% —
102 HEADACHES WITH MCC $5,738 $25,386 −77% $22,544 −75% —
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC $5,729 $39,491 −85% $22,032 −74% —
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $5,728 $59,066 −90% $60,098 −90% —
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC $5,728 $37,079 −85% $27,369 −79% —
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC $5,728 $24,781 −77% $17,928 −68% —
913 TRAUMATIC INJURY WITH MCC $5,728 $35,934 −84% $24,198 −76% —
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC $5,713 $21,306 −73% $24,316 −77% —
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC $5,709 $86,138 −93% $45,290 −87% —
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $5,709 $33,079 −83% $22,713 −75% —
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC $5,709 $43,152 −87% $48,358 −88% —
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC $5,709 $37,241 −85% $23,734 −76% —
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $5,709 $20,528 −72% $18,282 −69% —
998 PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS $5,709 $26,211 −78% $15,655 −64% —
375 DIGESTIVE MALIGNANCY WITH CC $5,701 $33,697 −83% $27,219 −79% —
070 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC $5,696 $46,828 −88% $30,814 −82% —
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $5,696 $36,697 −84% $23,115 −75% —
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $5,696 $37,809 −85% $18,291 −69% —
340 APPENDECTOMY WITH COMPLICATED PRINCIPAL DIAGNOSIS WITHOUT CC/MCC $5,696 $13,613 −58% $16,240 −65% —
342 APPENDECTOMY WITHOUT COMPLICATED PRINCIPAL DIAGNOSIS WITH CC $5,696 $16,487 −65% $19,454 −71% —
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC $5,696 $42,406 −87% $37,950 −85% —
176 PULMONARY EMBOLISM WITHOUT MCC $5,689 $26,477 −79% $18,081 −69% —
186 PLEURAL EFFUSION WITH MCC $5,689 $51,361 −89% $32,468 −82% —
188 PLEURAL EFFUSION WITHOUT CC/MCC $5,689 $13,879 −59% $14,110 −60% —
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $5,689 $54,107 −89% $55,162 −90% —
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC $5,689 $53,785 −89% $44,839 −87% —
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $5,689 $20,694 −73% $14,134 −60% —
603 CELLULITIS WITHOUT MCC $5,689 $26,407 −78% $18,530 −69% —
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $5,689 $100,025 −94% $64,465 −91% —
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $5,689 $27,571 −79% $19,815 −71% —
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC $5,689 $47,944 −88% $36,097 −84% —
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $5,689 $58,561 −90% $49,710 −89% —
149 DYSEQUILIBRIUM $5,670 $23,899 −76% $17,203 −67% —
374 DIGESTIVE MALIGNANCY WITH MCC $5,670 $41,900 −86% $38,885 −85% —
596 MAJOR SKIN DISORDERS WITHOUT MCC $5,670 $17,226 −67% $17,226 −67% —
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $5,670 $59,378 −90% $40,552 −86% —
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $5,670 $16,636 −66% $13,822 −59% —
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $5,540 $35,346 −84% $24,432 −77% —
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC $5,494 $18,918 −71% $17,078 −68% —
302 ATHEROSCLEROSIS WITH MCC $5,455 $18,292 −70% $20,844 −74% —
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $5,382 $36,655 −85% $24,017 −78% —
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC $5,328 $14,520 −63% $11,955 −55% —
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC $5,162 $34,116 −85% $23,571 −78% —
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $5,149 $14,064 −63% $14,064 −63% —
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC $5,131 $12,534 −59% $12,537 −59% —
079 HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC $5,035 $13,841 −64% $11,847 −57% —
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC $5,032 $33,372 −85% $24,022 −79% —
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $5,020 $33,283 −85% $22,781 −78% ≈133% of Medicare
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $5,008 $19,271 −74% $14,444 −65% —
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $5,005 $32,046 −84% $22,850 −78% —
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $5,004 $19,875 −75% $13,368 −63% —
141 MAJOR HEAD AND NECK PROCEDURES WITH CC $4,987 $47,416 −89% $34,900 −86% —
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $4,987 $13,949 −64% $22,698 −78% —
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC $4,984 $18,684 −73% $12,405 −60% —
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $4,977 $76,837 −94% $58,832 −92% —
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $4,977 $25,622 −81% $17,700 −72% —
125 OTHER DISORDERS OF THE EYE WITHOUT MCC $4,974 $15,300 −67% $15,876 −69% —
669 TRANSURETHRAL PROCEDURES WITH CC $4,957 $50,305 −90% $34,354 −86% —
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC $4,957 $17,483 −72% $17,483 −72% —
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC $4,947 $18,133 −73% $18,133 −73% —
385 INFLAMMATORY BOWEL DISEASE WITH MCC $4,945 $24,282 −80% $26,020 −81% —
594 SKIN ULCERS WITHOUT CC/MCC $4,945 $15,334 −68% $14,209 −65% —
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $4,945 $14,944 −67% $12,013 −59% —
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $4,938 $48,410 −90% $31,062 −84% —
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC $4,938 $48,444 −90% $48,682 −90% —
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC $4,938 $20,688 −76% $14,128 −65% —
397 APPENDIX PROCEDURES WITH MCC $4,938 $49,342 −90% $52,319 −91% —
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC $4,938 $38,044 −87% $25,623 −81% —
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC $4,938 $15,278 −68% $13,892 −64% —
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC $4,918 $20,246 −76% $13,824 −64% —
263 VEIN LIGATION AND STRIPPING $4,918 $60,391 −92% $44,938 −89% —
792 PREMATURITY WITHOUT MAJOR PROBLEMS $4,918 $9,520 −48% $11,633 −58% —
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $4,918 $15,636 −69% $15,636 −69% —
906 HAND PROCEDURES FOR INJURIES $4,918 $49,938 −90% $31,520 −84% —
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $4,772 $21,855 −78% $17,522 −73% —
202 BRONCHITIS AND ASTHMA WITH CC/MCC $4,665 $19,597 −76% $17,273 −73% —
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $4,658 $21,986 −79% $21,986 −79% —
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $4,649 $18,018 −74% $10,039 −54% —
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $4,645 $18,214 −74% $10,975 −58% —
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $4,645 $8,330 −44% $7,961 −42% —
150 EPISTAXIS WITH MCC $4,638 $21,133 −78% $21,133 −78% —
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC $4,638 $18,250 −75% $13,282 −65% —
294 DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC $4,638 $18,573 −75% $19,132 −76% —
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $4,638 $24,033 −81% $16,865 −72% —
313 CHEST PAIN $4,638 $20,378 −77% $15,962 −71% —
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $4,638 $44,413 −90% $32,689 −86% —
643 ENDOCRINE DISORDERS WITH MCC $4,638 $44,725 −90% $32,996 −86% —
801 SPLENECTOMY WITHOUT CC/MCC $4,638 $28,886 −84% $28,634 −84% —
914 TRAUMATIC INJURY WITHOUT MCC $4,638 $21,714 −79% $15,593 −70% —
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC $4,619 $35,026 −87% $26,158 −82% —
292 HEART FAILURE AND SHOCK WITH CC $4,619 $23,340 −80% $16,212 −72% —
389 GASTROINTESTINAL OBSTRUCTION WITH CC $4,619 $26,061 −82% $17,388 −73% —
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC $4,619 $53,913 −91% $42,119 −89% —
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC $4,619 $17,209 −73% $17,108 −73% —
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES $4,619 $41,513 −89% $24,980 −82% —
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC $4,619 $16,204 −71% $14,055 −67% —
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT $4,619 $59,352 −92% $59,352 −92% —
835 ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC $4,550 $31,659 −86% $35,569 −87% —
380 COMPLICATED PEPTIC ULCER WITH MCC $4,550 $43,397 −90% $36,641 −88% —
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC $4,526 $20,900 −78% $17,731 −74% —
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC $4,518 $30,727 −85% $27,321 −83% —
103 HEADACHES WITHOUT MCC $4,486 $27,638 −84% $20,111 −78% —
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $4,486 $39,204 −89% $26,488 −83% ≈97% of Medicare
602 CELLULITIS WITH MCC $4,486 $41,052 −89% $29,347 −85% —
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC $4,486 $47,002 −90% $29,663 −85% —
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC $4,479 $75,197 −94% $62,524 −93% —
226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC $4,479 $72,618 −94% $72,618 −94% —
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $4,479 $80,018 −94% $80,018 −94% —
885 PSYCHOSES $4,479 $22,469 −80% $21,489 −79% —
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $4,460 $12,650 −65% $12,650 −65% —
887 OTHER MENTAL DISORDER DIAGNOSES $4,460 $18,631 −76% $20,602 −78% —
999 UNGROUPABLE $4,460 $62,821 −93% $28,822 −85% —
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC $4,433 $29,009 −85% $21,261 −79% —
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $4,419 $12,593 −65% $12,593 −65% —
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC $4,407 $61,679 −93% $42,126 −90% —
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC $4,407 $29,871 −85% $16,352 −73% —
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC $4,407 $19,845 −78% $22,231 −80% —
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC $4,407 $17,768 −75% $19,317 −77% —
882 NEUROSES EXCEPT DEPRESSIVE $4,407 $15,680 −72% $15,680 −72% —
184 MAJOR CHEST TRAUMA WITH CC $4,400 $22,961 −81% $20,842 −79% —
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $4,400 $36,515 −88% $24,190 −82% ≈77% of Medicare
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $4,400 $31,408 −86% $21,449 −79% —
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC $4,400 $17,587 −75% $14,290 −69% —
164 MAJOR CHEST PROCEDURES WITH CC $4,380 $58,838 −93% $53,141 −92% —
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $4,380 $21,634 −80% $15,607 −72% —
951 OTHER FACTORS INFLUENCING HEALTH STATUS $4,332 $5,751 −25% $9,385 −54% —
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $4,325 $43,221 −90% $41,380 −90% —
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC $4,325 $24,260 −82% $24,229 −82% —
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $4,325 $43,181 −90% $41,660 −90% —
072 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $4,306 $24,384 −82% $16,654 −74% —
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC $4,306 $20,543 −79% $16,642 −74% —
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC $4,269 $18,461 −77% $16,049 −73% —
204 RESPIRATORY SIGNS AND SYMPTOMS $4,151 $22,897 −82% $16,866 −75% —
187 PLEURAL EFFUSION WITH CC $4,139 $21,455 −81% $21,467 −81% —
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $4,107 $23,658 −83% $29,371 −86% —
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC $4,107 $18,188 −77% $13,384 −69% —
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $4,081 $23,926 −83% $17,466 −77% ≈134% of Medicare
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $4,075 $15,901 −74% $15,901 −74% —
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC $4,068 $25,975 −84% $18,608 −78% —
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $4,068 $27,823 −85% $35,459 −89% —
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $4,049 $25,133 −84% $28,578 −86% —
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC $4,030 $17,388 −77% $14,441 −72% —
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $4,022 $21,459 −81% $14,368 −72% —
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $3,946 $23,808 −83% $16,837 −77% —
881 DEPRESSIVE NEUROSES $3,946 $15,058 −74% $15,058 −74% —
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $3,502 $36,791 −90% $41,703 −92% —
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $3,491 $15,323 −77% $14,880 −77% —
683 RENAL FAILURE WITH CC $3,491 $26,850 −87% $18,620 −81% —
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $3,431 $34,876 −90% $27,118 −87% —
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $3,431 $31,740 −89% $38,382 −91% —
795 NORMAL NEWBORN $3,412 $4,862 −30% $4,530 −25% —
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC $3,279 $73,695 −96% $71,014 −95% —

Procedures with negotiated rates only

These 29 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
653 MAJOR BLADDER PROCEDURES WITH MCC — 11 plans
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC — 11 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC — 10 plans
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC — 8 plans
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC — 7 plans
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC — 7 plans
212 CONCOMITANT AORTIC AND MITRAL VALVE�PROCEDURES — 7 plans
332 RECTAL RESECTION WITH MCC — 7 plans
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES — 6 plans
031 VENTRICULAR SHUNT PROCEDURES WITH MCC — 6 plans
215 OTHER HEART ASSIST SYSTEM IMPLANT — 6 plans
224 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC $703 – $8,255 6 plans
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC — 6 plans
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC — 6 plans
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC — 5 plans
662 MINOR BLADDER PROCEDURES WITH MCC — 5 plans
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC — 5 plans
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC — 4 plans
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC — 4 plans
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT — 4 plans
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR — 3 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC — 3 plans
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT — 2 plans
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC — 2 plans
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC — 2 plans
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC — 2 plans
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC — 2 plans
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC — 1 plans
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC — 1 plans
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