Las Palmas Medical Center, A Campus of Las Palmas Del Sol Healthcare — Pricing
763 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 763 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 763
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Gross charges are the hospital's listed price — almost no one pays this amount. Your actual cost depends on your insurance plan. Use the cash price (when shown) as a guide for what uninsured patients are charged, and contact the hospital or your insurer for a personalized cost estimate.
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Showing all 763 procedures
Procedures with negotiated rates only
These 763 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 |
|---|---|---|---|
| 768 | VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C | $8,690 – $14,451 · median $11,952 | 10 plans |
| 783 | CESAREAN SECTION WITH STERILIZATION WITH MCC | $10,449 – $15,496 · median $14,535 | 10 plans |
| 784 | CESAREAN SECTION WITH STERILIZATION WITH CC | $10,449 – $15,496 · median $14,535 | 10 plans |
| 785 | CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC | $10,449 – $15,496 · median $13,635 | 10 plans |
| 786 | CESAREAN SECTION WITHOUT STERILIZATION WITH MCC | $10,449 – $15,496 · median $14,535 | 10 plans |
| 787 | CESAREAN SECTION WITHOUT STERILIZATION WITH CC | $10,449 – $15,496 · median $14,535 | 10 plans |
| 788 | CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC | $10,449 – $15,496 · median $13,635 | 10 plans |
| 796 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC | $8,690 – $14,451 · median $11,952 | 10 plans |
| 797 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC | $8,690 – $14,451 · median $11,952 | 10 plans |
| 798 | VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC | $8,690 – $12,651 · median $11,924 | 10 plans |
| 805 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC | $8,690 – $14,451 · median $11,952 | 10 plans |
| 806 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC | $8,690 – $12,651 · median $11,924 | 10 plans |
| 807 | VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC | $8,690 – $12,651 · median $11,924 | 10 plans |
| 209 | COMPLEX AORTIC ARCH PROCEDURES | $14,795 – $175,674 · median $17,449 | 7 plans |
| 212 | CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES | $11,387 – $168,970 · median $17,407 | 7 plans |
| 213 | ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES | $14,795 – $97,913 · median $17,449 | 7 plans |
| 216 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA | $14,795 – $164,997 · median $17,449 | 7 plans |
| 217 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA | $14,795 – $139,360 · median $17,449 | 7 plans |
| 218 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA | $14,795 – $118,560 · median $17,449 | 7 plans |
| 219 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER | $14,795 – $120,790 · median $17,449 | 7 plans |
| 220 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER | $14,795 – $85,429 · median $17,449 | 7 plans |
| 221 | CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER | $14,795 – $81,018 · median $17,449 | 7 plans |
| 228 | OTHER CARDIOTHORACIC PROCEDURES WITH MCC | $14,795 – $91,520 · median $17,449 | 7 plans |
| 229 | OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC | $14,795 – $62,400 · median $17,449 | 7 plans |
| 268 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC | $14,795 – $120,640 · median $17,449 | 7 plans |
| 269 | AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | $14,795 – $74,880 · median $17,449 | 7 plans |
| 619 | O.R. PROCEDURES FOR OBESITY WITH MCC | $24,035 – $48,562 · median $38,046 | 7 plans |
| 620 | O.R. PROCEDURES FOR OBESITY WITH CC | $24,035 – $44,875 · median $38,046 | 7 plans |
| 621 | O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC | $24,035 – $44,875 · median $38,046 | 7 plans |
| 650 | KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC | $100,000 – $397,568 · median $335,508 | 7 plans |
| 651 | KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC | $100,000 – $397,568 · median $335,508 | 7 plans |
| 652 | KIDNEY TRANSPLANT | $100,000 – $397,568 | 7 plans |
| 789 | NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY | $5,225 – $44,500 · median $44,500 | 7 plans |
| 790 | EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE | $6,270 – $99,000 · median $99,000 | 7 plans |
| 791 | PREMATURITY WITH MAJOR PROBLEMS | $6,270 – $66,226 · median $44,500 | 7 plans |
| 792 | PREMATURITY WITHOUT MAJOR PROBLEMS | $5,225 – $41,956 · median $27,033 | 7 plans |
| 793 | FULL TERM NEONATE WITH MAJOR PROBLEMS | $6,270 – $67,893 · median $27,033 | 7 plans |
| 794 | NEONATE WITH OTHER SIGNIFICANT PROBLEMS | $5,225 – $27,283 · median $10,730 | 7 plans |
| 871 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | $8,199 – $34,317 · median $30,898 | 7 plans |
| 872 | SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | $8,199 – $29,469 · median $13,111 | 7 plans |
| 193 | SIMPLE PNEUMONIA AND PLEURISY WITH MCC | $8,199 – $30,898 · median $27,873 | 6 plans |
| 194 | SIMPLE PNEUMONIA AND PLEURISY WITH CC | $8,199 – $30,898 · median $24,040 | 6 plans |
| 195 | SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | $8,199 – $30,898 · median $22,703 | 6 plans |
| 392 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | $8,199 – $16,785 · median $13,111 | 6 plans |
| 402 | SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL | $41,674 – $107,776 · median $89,648 | 6 plans |
| 426 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT | $107,776 – $187,327 · median $110,168 | 6 plans |
| 427 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT | $76,320 – $127,014 · median $107,776 | 6 plans |
| 429 | COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC | $89,621 – $149,151 · median $107,776 | 6 plans |
| 430 | COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC | $58,782 – $107,776 · median $102,802 | 6 plans |
| 447 | MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL | $72,043 – $119,896 · median $93,795 | 6 plans |
| 448 | MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $43,878 – $93,795 · median $83,410 | 6 plans |
| 450 | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY | $55,338 – $93,795 · median $92,946 | 6 plans |
| 451 | SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | $33,159 – $93,795 · median $74,491 | 6 plans |
| 456 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX | $70,184 – $131,722 · median $107,776 | 6 plans |
| 457 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX | $57,724 – $107,776 · median $101,354 | 6 plans |
| 458 | SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX | $58,247 – $107,776 · median $100,688 | 6 plans |
| 471 | CERVICAL SPINAL FUSION WITH MCC | $40,250 – $77,830 · median $42,065 | 6 plans |
| 472 | CERVICAL SPINAL FUSION WITH CC | $40,250 – $69,258 · median $41,875 | 6 plans |
| 473 | CERVICAL SPINAL FUSION WITHOUT CC/MCC | $40,250 – $70,720 · median $41,044 | 6 plans |
| 603 | CELLULITIS WITHOUT MCC | $8,199 – $18,162 · median $13,111 | 6 plans |
| 683 | RENAL FAILURE WITH CC | $8,199 – $18,236 · median $13,111 | 6 plans |
| 689 | KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | $8,199 – $30,898 · median $26,711 | 6 plans |
| 690 | KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | $8,199 – $17,236 · median $13,111 | 6 plans |
| 177 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | $42,480 – $44,602 · median $44,073 | 5 plans |
| 698 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | $17,838 – $27,789 · median $27,451 | 5 plans |
| 854 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | $42,480 – $44,602 · median $44,073 | 5 plans |
| 250 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC | $8,496 – $48,880 · median $34,062 | 4 plans |
| 251 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC | $8,496 – $43,296 · median $26,789 | 4 plans |
| 286 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | $7,286 – $38,392 · median $22,785 | 4 plans |
| 287 | CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | $7,286 – $24,536 · median $17,780 | 4 plans |
| 321 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A | $8,496 – $70,720 · median $44,648 | 4 plans |
| 322 | PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | $8,496 – $69,258 · median $37,717 | 4 plans |
| 323 | CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC | $8,496 – $70,272 · median $15,201 | 4 plans |
| 324 | CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC | $8,496 – $52,537 · median $15,201 | 4 plans |
| 325 | CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE | $8,496 – $53,432 · median $15,201 | 4 plans |
| 880 | ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION | $2,613 – $19,508 · median $10,470 | 4 plans |
| 881 | DEPRESSIVE NEUROSES | $2,613 – $19,217 · median $10,470 | 4 plans |
| 882 | NEUROSES EXCEPT DEPRESSIVE | $2,613 – $21,221 · median $10,470 | 4 plans |
| 883 | DISORDERS OF PERSONALITY AND IMPULSE CONTROL | $2,613 – $34,676 · median $10,470 | 4 plans |
| 884 | ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | $2,613 – $29,288 · median $10,470 | 4 plans |
| 885 | PSYCHOSES | $2,613 – $26,090 · median $10,470 | 4 plans |
| 886 | BEHAVIORAL AND DEVELOPMENTAL DISORDERS | $2,613 – $36,319 · median $10,470 | 4 plans |
| 887 | OTHER MENTAL DISORDER DIAGNOSES | $2,613 – $21,177 · median $10,470 | 4 plans |
| 894 | ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | $2,613 – $14,332 · median $10,470 | 4 plans |
| 895 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY | $2,613 – $26,374 · median $10,470 | 4 plans |
| 896 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC | $2,613 – $31,341 · median $10,470 | 4 plans |
| 897 | ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | $2,613 – $18,341 · median $10,470 | 4 plans |
| 011 | TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC | $11,387 – $87,258 · median $19,015 | 3 plans |
| 012 | TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC | $11,387 – $68,592 · median $19,015 | 3 plans |
| 013 | TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC | $11,387 – $48,478 · median $19,015 | 3 plans |
| 020 | INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC | $113,310 – $182,000 · median $123,662 | 3 plans |
| 021 | INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC | $74,973 – $120,640 · median $84,841 | 3 plans |
| 022 | INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ | $52,935 – $120,640 · median $74,973 | 3 plans |
| 023 | CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI | $75,203 – $120,640 · median $91,422 | 3 plans |
| 024 | CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI | $48,452 – $78,000 · median $64,008 | 3 plans |
| 025 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | $65,360 – $101,850 · median $73,578 | 3 plans |
| 026 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC | $45,281 – $72,800 · median $51,906 | 3 plans |
| 027 | CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC | $36,591 – $60,896 · median $43,067 | 3 plans |
| 028 | SPINAL PROCEDURES WITH MCC | $40,461 – $95,613 · median $62,400 | 3 plans |
| 029 | SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS | $21,495 – $56,465 · median $35,340 | 3 plans |
| 030 | SPINAL PROCEDURES WITHOUT CC/MCC | $20,228 – $38,127 · median $33,663 | 3 plans |
| 031 | VENTRICULAR SHUNT PROCEDURES WITH MCC | $31,175 – $72,580 · median $49,920 | 3 plans |
| 032 | VENTRICULAR SHUNT PROCEDURES WITH CC | $23,932 – $38,480 · median $37,159 | 3 plans |
| 033 | VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC | $23,932 – $38,480 · median $30,102 | 3 plans |
| 034 | CAROTID ARTERY STENT PROCEDURES WITH MCC | $26,628 – $63,387 · median $41,600 | 3 plans |
| 035 | CAROTID ARTERY STENT PROCEDURES WITH CC | $16,375 – $41,071 · median $27,040 | 3 plans |
| 036 | CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC | $11,218 – $34,322 · median $18,670 | 3 plans |
| 037 | EXTRACRANIAL PROCEDURES WITH MCC | $23,834 – $54,664 · median $39,666 | 3 plans |
| 038 | EXTRACRANIAL PROCEDURES WITH CC | $10,473 – $29,494 · median $17,429 | 3 plans |
| 039 | EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | $10,473 – $22,754 · median $17,429 | 3 plans |
| 040 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC | $33,611 – $63,243 · median $53,981 | 3 plans |
| 041 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHE | $33,904 – $55,120 · median $38,180 | 3 plans |
| 042 | PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC | $31,079 – $55,120 · median $33,904 | 3 plans |
| 052 | SPINAL DISORDERS AND INJURIES WITH CC/MCC | $8,199 – $32,339 · median $12,740 | 3 plans |
| 053 | SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC | $8,199 – $19,794 · median $12,740 | 3 plans |
| 054 | NERVOUS SYSTEM NEOPLASMS WITH MCC | $8,199 – $28,052 · median $12,740 | 3 plans |
| 055 | NERVOUS SYSTEM NEOPLASMS WITHOUT MCC | $8,199 – $20,404 · median $12,740 | 3 plans |
| 056 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | $8,199 – $40,055 · median $12,740 | 3 plans |
| 057 | DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | $8,199 – $24,565 · median $12,740 | 3 plans |
| 058 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC | $8,199 – $30,804 · median $12,740 | 3 plans |
| 059 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC | $8,199 – $23,740 · median $12,740 | 3 plans |
| 060 | MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC | $8,199 – $18,899 · median $12,740 | 3 plans |
| 061 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A | $8,199 – $46,598 · median $12,740 | 3 plans |
| 062 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A | $8,199 – $31,524 · median $12,740 | 3 plans |
| 063 | ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A | $8,199 – $26,196 · median $12,740 | 3 plans |
| 064 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | $8,199 – $35,350 · median $12,740 | 3 plans |
| 065 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | $8,199 – $20,263 · median $12,740 | 3 plans |
| 066 | INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | $8,199 – $15,350 · median $12,740 | 3 plans |
| 067 | PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC | $8,199 – $27,174 · median $12,740 | 3 plans |
| 068 | PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC | $8,199 – $18,064 · median $12,740 | 3 plans |
| 069 | TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | $8,199 – $17,075 · median $12,740 | 3 plans |
| 070 | OTHER CEREBROVASCULAR DISORDERS WITH MCC | $8,199 – $30,131 · median $12,740 | 3 plans |
| 071 | OTHER CEREBROVASCULAR DISORDERS WITH CC | $8,199 – $20,500 · median $12,740 | 3 plans |
| 072 | OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC | $8,199 – $16,433 · median $12,740 | 3 plans |
| 073 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC | $8,199 – $29,218 · median $12,740 | 3 plans |
| 074 | CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | $8,199 – $20,572 · median $12,740 | 3 plans |
| 075 | VIRAL MENINGITIS WITH CC/MCC | $8,199 – $33,940 · median $12,740 | 3 plans |
| 076 | VIRAL MENINGITIS WITHOUT CC/MCC | $8,199 – $17,473 · median $12,740 | 3 plans |
| 080 | NONTRAUMATIC STUPOR AND COMA WITH MCC | $8,199 – $32,320 · median $12,740 | 3 plans |
| 081 | NONTRAUMATIC STUPOR AND COMA WITHOUT MCC | $8,199 – $18,534 · median $12,740 | 3 plans |
| 082 | TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | $20,433 – $39,490 · median $33,280 | 3 plans |
| 083 | TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC | $17,536 – $28,080 · median $26,075 | 3 plans |
| 084 | TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC | $15,156 – $24,960 · median $19,442 | 3 plans |
| 085 | TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC | $16,022 – $39,283 · median $26,340 | 3 plans |
| 086 | TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | $14,244 – $24,672 · median $23,419 | 3 plans |
| 087 | TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC | $11,885 – $19,779 · median $18,822 | 3 plans |
| 088 | CONCUSSION WITH MCC | $8,199 – $25,412 · median $12,740 | 3 plans |
| 089 | CONCUSSION WITH CC | $8,199 – $21,595 · median $12,740 | 3 plans |
| 090 | CONCUSSION WITHOUT CC/MCC | $8,199 – $17,443 · median $12,740 | 3 plans |
| 091 | OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | $8,199 – $31,509 · median $12,740 | 3 plans |
| 092 | OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | $8,199 – $20,455 · median $12,740 | 3 plans |
| 093 | OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC | $8,199 – $17,037 · median $12,740 | 3 plans |
| 094 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC | $8,199 – $58,091 · median $12,740 | 3 plans |
| 095 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC | $8,199 – $43,916 · median $12,740 | 3 plans |
| 096 | BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC | $8,199 – $43,916 · median $12,740 | 3 plans |
| 097 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC | $8,199 – $59,484 · median $12,740 | 3 plans |
| 098 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC | $8,199 – $39,630 · median $12,740 | 3 plans |
| 099 | NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC | $8,199 – $25,572 · median $12,740 | 3 plans |
| 100 | SEIZURES WITH MCC | $8,199 – $34,231 · median $12,740 | 3 plans |
| 101 | SEIZURES WITHOUT MCC | $8,199 – $18,640 · median $12,740 | 3 plans |
| 102 | HEADACHES WITH MCC | $8,199 – $21,931 · median $12,740 | 3 plans |
| 103 | HEADACHES WITHOUT MCC | $8,199 – $17,640 · median $12,740 | 3 plans |
| 113 | ORBITAL PROCEDURES WITH CC/MCC | $11,387 – $40,477 · median $19,015 | 3 plans |
| 114 | ORBITAL PROCEDURES WITHOUT CC/MCC | $11,387 – $25,430 · median $19,015 | 3 plans |
| 115 | EXTRAOCULAR PROCEDURES EXCEPT ORBIT | $11,387 – $28,172 · median $19,015 | 3 plans |
| 116 | INTRAOCULAR PROCEDURES WITH CC/MCC | $11,387 – $32,291 · median $19,015 | 3 plans |
| 117 | INTRAOCULAR PROCEDURES WITHOUT CC/MCC | $11,387 – $21,388 · median $19,015 | 3 plans |
| 121 | ACUTE MAJOR EYE INFECTIONS WITH CC/MCC | $8,199 – $22,570 · median $12,740 | 3 plans |
| 122 | ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC | $8,199 – $16,879 · median $12,740 | 3 plans |
| 123 | NEUROLOGICAL EYE DISORDERS | $8,199 – $17,072 · median $12,740 | 3 plans |
| 124 | OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT | $8,199 – $24,979 · median $12,740 | 3 plans |
| 125 | OTHER DISORDERS OF THE EYE WITHOUT MCC | $8,199 – $16,607 · median $12,740 | 3 plans |
| 135 | SINUS AND MASTOID PROCEDURES WITH CC/MCC | $11,387 – $37,747 · median $19,015 | 3 plans |
| 136 | SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC | $11,387 – $20,339 · median $19,015 | 3 plans |
| 137 | MOUTH PROCEDURES WITH CC/MCC | $11,387 – $27,544 · median $19,015 | 3 plans |
| 138 | MOUTH PROCEDURES WITHOUT CC/MCC | $11,387 – $19,015 · median $18,392 | 3 plans |
| 139 | SALIVARY GLAND PROCEDURES | $11,387 – $23,661 · median $19,015 | 3 plans |
| 140 | MAJOR HEAD AND NECK PROCEDURES WITH MCC | $11,387 – $69,336 · median $19,015 | 3 plans |
| 141 | MAJOR HEAD AND NECK PROCEDURES WITH CC | $11,387 – $37,914 · median $19,015 | 3 plans |
| 142 | MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC | $11,387 – $29,099 · median $19,015 | 3 plans |
| 143 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC | $11,387 – $61,516 · median $19,015 | 3 plans |
| 144 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC | $11,387 – $31,157 · median $19,015 | 3 plans |
| 145 | OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $23,158 · median $19,015 | 3 plans |
| 146 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC | $8,199 – $36,954 · median $12,740 | 3 plans |
| 147 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC | $8,199 – $24,201 · median $12,740 | 3 plans |
| 148 | EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC | $8,199 – $17,049 · median $12,740 | 3 plans |
| 149 | DYSEQUILIBRIUM | $8,199 – $16,363 · median $12,740 | 3 plans |
| 150 | EPISTAXIS WITH MCC | $8,199 – $25,106 · median $12,740 | 3 plans |
| 151 | EPISTAXIS WITHOUT MCC | $8,199 – $16,098 · median $12,740 | 3 plans |
| 152 | OTITIS MEDIA AND URI WITH MCC | $8,199 – $22,855 · median $12,740 | 3 plans |
| 153 | OTITIS MEDIA AND URI WITHOUT MCC | $8,199 – $16,161 · median $12,740 | 3 plans |
| 154 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC | $8,199 – $28,603 · median $12,740 | 3 plans |
| 155 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC | $8,199 – $18,849 · median $12,740 | 3 plans |
| 156 | OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC | $8,199 – $15,451 · median $12,740 | 3 plans |
| 157 | DENTAL AND ORAL DISEASES WITH MCC | $8,199 – $30,915 · median $12,740 | 3 plans |
| 158 | DENTAL AND ORAL DISEASES WITH CC | $8,199 – $18,748 · median $12,740 | 3 plans |
| 159 | DENTAL AND ORAL DISEASES WITHOUT CC/MCC | $8,199 – $15,713 · median $12,740 | 3 plans |
| 163 | MAJOR CHEST PROCEDURES WITH MCC | $11,387 – $72,600 · median $19,015 | 3 plans |
| 164 | MAJOR CHEST PROCEDURES WITH CC | $11,387 – $43,084 · median $19,015 | 3 plans |
| 165 | MAJOR CHEST PROCEDURES WITHOUT CC/MCC | $11,387 – $33,891 · median $19,015 | 3 plans |
| 166 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC | $11,387 – $61,382 · median $19,015 | 3 plans |
| 167 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC | $11,387 – $32,220 · median $19,015 | 3 plans |
| 168 | OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $25,632 · median $19,015 | 3 plans |
| 173 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY | $11,387 – $49,904 · median $19,015 | 3 plans |
| 175 | PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | $8,199 – $25,740 · median $12,740 | 3 plans |
| 176 | PULMONARY EMBOLISM WITHOUT MCC | $8,199 – $17,168 · median $12,740 | 3 plans |
| 178 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | $8,199 – $19,746 · median $12,740 | 3 plans |
| 179 | RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC | $8,199 – $16,414 · median $12,740 | 3 plans |
| 180 | RESPIRATORY NEOPLASMS WITH MCC | $8,199 – $31,656 · median $12,740 | 3 plans |
| 181 | RESPIRATORY NEOPLASMS WITH CC | $8,199 – $21,178 · median $12,740 | 3 plans |
| 182 | RESPIRATORY NEOPLASMS WITHOUT CC/MCC | $8,199 – $16,396 · median $12,740 | 3 plans |
| 183 | MAJOR CHEST TRAUMA WITH MCC | $8,199 – $28,097 · median $12,740 | 3 plans |
| 184 | MAJOR CHEST TRAUMA WITH CC | $8,199 – $21,074 · median $12,740 | 3 plans |
| 185 | MAJOR CHEST TRAUMA WITHOUT CC/MCC | $8,199 – $16,889 · median $12,740 | 3 plans |
| 186 | PLEURAL EFFUSION WITH MCC | $8,199 – $28,528 · median $12,740 | 3 plans |
| 187 | PLEURAL EFFUSION WITH CC | $8,199 – $19,944 · median $12,740 | 3 plans |
| 188 | PLEURAL EFFUSION WITHOUT CC/MCC | $8,199 – $15,845 · median $12,740 | 3 plans |
| 189 | PULMONARY EDEMA AND RESPIRATORY FAILURE | $8,199 – $23,657 · median $12,740 | 3 plans |
| 190 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | $8,199 – $21,732 · median $12,740 | 3 plans |
| 191 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | $8,199 – $17,741 · median $12,740 | 3 plans |
| 192 | CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC | $8,199 – $14,711 · median $12,740 | 3 plans |
| 196 | INTERSTITIAL LUNG DISEASE WITH MCC | $8,199 – $33,483 · median $12,740 | 3 plans |
| 197 | INTERSTITIAL LUNG DISEASE WITH CC | $8,199 – $19,341 · median $12,740 | 3 plans |
| 198 | INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC | $8,199 – $15,829 · median $12,740 | 3 plans |
| 199 | PNEUMOTHORAX WITH MCC | $8,199 – $31,628 · median $12,740 | 3 plans |
| 200 | PNEUMOTHORAX WITH CC | $8,199 – $21,605 · median $12,740 | 3 plans |
| 201 | PNEUMOTHORAX WITHOUT CC/MCC | $8,199 – $15,813 · median $12,740 | 3 plans |
| 202 | BRONCHITIS AND ASTHMA WITH CC/MCC | $8,199 – $19,674 · median $12,740 | 3 plans |
| 203 | BRONCHITIS AND ASTHMA WITHOUT CC/MCC | $8,199 – $15,133 · median $12,740 | 3 plans |
| 204 | RESPIRATORY SIGNS AND SYMPTOMS | $8,199 – $17,204 · median $12,740 | 3 plans |
| 205 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC | $8,199 – $32,636 · median $12,740 | 3 plans |
| 206 | OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | $8,199 – $19,220 · median $12,740 | 3 plans |
| 207 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS | $8,199 – $102,042 · median $12,740 | 3 plans |
| 208 | RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | $8,199 – $46,471 · median $12,740 | 3 plans |
| 215 | OTHER HEART ASSIST SYSTEM IMPLANT | $145,843 – $234,000 · median $155,144 | 3 plans |
| 231 | CORONARY BYPASS WITH PTCA WITH MCC | $76,573 – $132,121 · median $127,435 | 3 plans |
| 232 | CORONARY BYPASS WITH PTCA WITHOUT MCC | $64,819 – $107,873 · median $96,432 | 3 plans |
| 233 | CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | $64,819 – $120,291 · median $107,873 | 3 plans |
| 234 | CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC | $70,339 – $112,035 · median $87,388 | 3 plans |
| 235 | CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC | $44,227 – $93,507 · median $71,760 | 3 plans |
| 236 | CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | $34,519 – $68,182 · median $56,160 | 3 plans |
| 239 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC | $11,387 – $79,232 · median $19,015 | 3 plans |
| 240 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC | $11,387 – $48,006 · median $19,015 | 3 plans |
| 241 | AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC | $11,387 – $25,903 · median $19,015 | 3 plans |
| 242 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | $46,708 – $74,880 · median $53,167 | 3 plans |
| 243 | PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | $36,418 – $59,280 · median $37,157 | 3 plans |
| 244 | PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | $32,282 – $67,600 · median $42,033 | 3 plans |
| 245 | AICD GENERATOR PROCEDURES | $46,708 – $74,880 · median $73,815 | 3 plans |
| 252 | OTHER VASCULAR PROCEDURES WITH MCC | $20,923 – $57,622 · median $34,820 | 3 plans |
| 253 | OTHER VASCULAR PROCEDURES WITH CC | $19,944 – $44,163 · median $33,193 | 3 plans |
| 254 | OTHER VASCULAR PROCEDURES WITHOUT CC/MCC | $22,110 – $36,798 · median $31,893 | 3 plans |
| 255 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC | $11,387 – $45,698 · median $19,015 | 3 plans |
| 256 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC | $11,387 – $30,630 · median $19,015 | 3 plans |
| 257 | UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC | $11,387 – $21,498 · median $19,015 | 3 plans |
| 258 | CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC | $21,820 – $52,402 · median $35,360 | 3 plans |
| 259 | CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC | $14,959 – $35,517 · median $24,960 | 3 plans |
| 260 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC | $26,824 – $54,071 · median $43,680 | 3 plans |
| 261 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC | $10,969 – $33,533 · median $18,256 | 3 plans |
| 262 | CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC | $10,969 – $29,604 · median $18,256 | 3 plans |
| 263 | VEIN LIGATION AND STRIPPING | $13,961 – $51,125 · median $23,235 | 3 plans |
| 264 | OTHER CIRCULATORY SYSTEM O.R. PROCEDURES | $19,945 – $55,395 · median $33,195 | 3 plans |
| 265 | AICD LEAD PROCEDURES | $31,814 – $59,580 · median $50,960 | 3 plans |
| 266 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | $92,165 – $147,680 · median $97,424 | 3 plans |
| 267 | ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | $69,204 – $112,320 · median $76,806 | 3 plans |
| 270 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC | $56,014 – $88,610 · median $84,578 | 3 plans |
| 271 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | $37,177 – $59,073 · median $58,647 | 3 plans |
| 272 | OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC | $26,707 – $43,680 · median $43,521 | 3 plans |
| 273 | PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC | $48,155 – $76,960 · median $67,228 | 3 plans |
| 274 | PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | $32,540 – $54,658 · median $50,925 | 3 plans |
| 275 | CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC | $70,761 – $113,360 · median $112,530 | 3 plans |
| 276 | CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR | $64,258 – $101,850 · median $95,588 | 3 plans |
| 277 | CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC | $73,232 – $117,520 · median $74,661 | 3 plans |
| 278 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES | $20,923 – $88,948 · median $34,820 | 3 plans |
| 279 | ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES | $31,287 – $59,402 · median $49,920 | 3 plans |
| 280 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | $16,438 – $29,215 · median $26,481 | 3 plans |
| 281 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | $14,830 – $24,382 · median $18,888 | 3 plans |
| 282 | ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | $11,083 – $18,219 · median $15,934 | 3 plans |
| 283 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC | $12,959 – $34,895 · median $21,569 | 3 plans |
| 284 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC | $8,766 – $15,468 · median $14,560 | 3 plans |
| 285 | ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC | $8,766 – $14,560 · median $14,061 | 3 plans |
| 288 | ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC | $15,054 – $45,831 · median $25,054 | 3 plans |
| 289 | ACUTE AND SUBACUTE ENDOCARDITIS WITH CC | $15,054 – $30,765 · median $25,054 | 3 plans |
| 290 | ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC | $15,054 – $25,054 · median $19,048 | 3 plans |
| 291 | HEART FAILURE AND SHOCK WITH MCC | $24,387 – $48,888 · median $30,537 | 3 plans |
| 292 | HEART FAILURE AND SHOCK WITH CC | $17,832 – $37,204 · median $22,355 | 3 plans |
| 293 | HEART FAILURE AND SHOCK WITHOUT CC/MCC | $13,565 – $36,871 · median $22,155 | 3 plans |
| 296 | CARDIAC ARREST, UNEXPLAINED WITH MCC | $8,199 – $28,579 · median $12,740 | 3 plans |
| 297 | CARDIAC ARREST, UNEXPLAINED WITH CC | $8,199 – $14,590 · median $12,740 | 3 plans |
| 298 | CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC | $8,199 – $12,740 · median $11,893 | 3 plans |
| 299 | PERIPHERAL VASCULAR DISORDERS WITH MCC | $7,644 – $29,647 · median $10,677 | 3 plans |
| 300 | PERIPHERAL VASCULAR DISORDERS WITH CC | $8,604 – $21,126 · median $10,988 | 3 plans |
| 301 | PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC | $7,578 – $15,882 · median $10,532 | 3 plans |
| 302 | ATHEROSCLEROSIS WITH MCC | $8,199 – $23,072 · median $12,740 | 3 plans |
| 303 | ATHEROSCLEROSIS WITHOUT MCC | $8,199 – $15,181 · median $12,740 | 3 plans |
| 304 | HYPERTENSION WITH MCC | $8,199 – $22,972 · median $12,740 | 3 plans |
| 305 | HYPERTENSION WITHOUT MCC | $8,199 – $16,416 · median $12,740 | 3 plans |
| 306 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC | $8,199 – $28,789 · median $12,740 | 3 plans |
| 307 | CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC | $8,199 – $18,799 · median $12,740 | 3 plans |
| 308 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | $8,199 – $23,184 · median $12,740 | 3 plans |
| 309 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | $8,199 – $16,123 · median $12,740 | 3 plans |
| 310 | CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | $8,199 – $13,567 · median $12,740 | 3 plans |
| 311 | ANGINA PECTORIS | $8,199 – $15,614 · median $12,740 | 3 plans |
| 312 | SYNCOPE AND COLLAPSE | $8,199 – $18,172 · median $12,740 | 3 plans |
| 313 | CHEST PAIN | $7,578 – $15,887 · median $15,278 | 3 plans |
| 314 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | $8,199 – $36,469 · median $12,740 | 3 plans |
| 315 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | $8,199 – $19,555 · median $12,740 | 3 plans |
| 316 | OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC | $8,199 – $15,315 · median $12,740 | 3 plans |
| 317 | CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION | $69,552 – $115,750 · median $105,838 | 3 plans |
| 318 | PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE | $41,549 – $70,633 · median $43,594 | 3 plans |
| 319 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC | $42,995 – $72,315 · median $68,640 | 3 plans |
| 320 | OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC | $24,615 – $41,294 · median $39,520 | 3 plans |
| 326 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC | $11,387 – $80,222 · median $19,015 | 3 plans |
| 327 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | $11,387 – $41,881 · median $19,015 | 3 plans |
| 328 | STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | $11,387 – $29,188 · median $19,015 | 3 plans |
| 329 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $11,387 – $74,329 · median $19,015 | 3 plans |
| 330 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $11,387 – $41,172 · median $19,015 | 3 plans |
| 331 | MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $11,387 – $30,403 · median $19,015 | 3 plans |
| 332 | RECTAL RESECTION WITH MCC | $11,387 – $59,618 · median $19,015 | 3 plans |
| 333 | RECTAL RESECTION WITH CC | $11,387 – $40,343 · median $19,015 | 3 plans |
| 334 | RECTAL RESECTION WITHOUT CC/MCC | $11,387 – $29,725 · median $19,015 | 3 plans |
| 335 | PERITONEAL ADHESIOLYSIS WITH MCC | $11,387 – $58,867 · median $19,015 | 3 plans |
| 336 | PERITONEAL ADHESIOLYSIS WITH CC | $11,387 – $36,823 · median $19,015 | 3 plans |
| 337 | PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC | $11,387 – $28,174 · median $19,015 | 3 plans |
| 344 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | $11,387 – $43,970 · median $19,015 | 3 plans |
| 345 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | $11,387 – $27,717 · median $19,015 | 3 plans |
| 346 | MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | $11,387 – $22,915 · median $19,015 | 3 plans |
| 347 | ANAL AND STOMAL PROCEDURES WITH MCC | $11,387 – $39,641 · median $19,015 | 3 plans |
| 348 | ANAL AND STOMAL PROCEDURES WITH CC | $11,387 – $24,764 · median $19,015 | 3 plans |
| 349 | ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC | $11,387 – $19,015 · median $18,157 | 3 plans |
| 350 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC | $11,387 – $42,600 · median $19,015 | 3 plans |
| 351 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC | $11,387 – $28,015 · median $19,015 | 3 plans |
| 352 | INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC | $11,387 – $22,638 · median $19,015 | 3 plans |
| 353 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC | $11,387 – $48,783 · median $19,015 | 3 plans |
| 354 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | $11,387 – $30,396 · median $19,015 | 3 plans |
| 355 | HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC | $11,387 – $25,309 · median $19,015 | 3 plans |
| 356 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC | $11,387 – $71,258 · median $19,015 | 3 plans |
| 357 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC | $11,387 – $40,091 · median $19,015 | 3 plans |
| 358 | OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $26,107 · median $19,015 | 3 plans |
| 359 | PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC | $43,822 – $70,720 · median $56,872 | 3 plans |
| 360 | PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC | $41,430 – $70,403 · median $43,451 | 3 plans |
| 368 | MAJOR ESOPHAGEAL DISORDERS WITH MCC | $8,199 – $29,032 · median $12,740 | 3 plans |
| 369 | MAJOR ESOPHAGEAL DISORDERS WITH CC | $8,199 – $20,111 · median $12,740 | 3 plans |
| 370 | MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC | $8,199 – $15,597 · median $12,740 | 3 plans |
| 371 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | $8,199 – $31,763 · median $12,740 | 3 plans |
| 372 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | $8,199 – $20,425 · median $12,740 | 3 plans |
| 373 | MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC | $8,199 – $15,998 · median $12,740 | 3 plans |
| 374 | DIGESTIVE MALIGNANCY WITH MCC | $8,199 – $37,275 · median $12,740 | 3 plans |
| 375 | DIGESTIVE MALIGNANCY WITH CC | $8,199 – $23,268 · median $12,740 | 3 plans |
| 376 | DIGESTIVE MALIGNANCY WITHOUT CC/MCC | $8,199 – $18,967 · median $12,740 | 3 plans |
| 377 | GASTROINTESTINAL HEMORRHAGE WITH MCC | $8,199 – $32,591 · median $12,740 | 3 plans |
| 378 | GASTROINTESTINAL HEMORRHAGE WITH CC | $8,199 – $19,817 · median $12,740 | 3 plans |
| 379 | GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC | $8,199 – $14,536 · median $12,740 | 3 plans |
| 380 | COMPLICATED PEPTIC ULCER WITH MCC | $8,199 – $34,614 · median $12,740 | 3 plans |
| 381 | COMPLICATED PEPTIC ULCER WITH CC | $8,199 – $21,367 · median $12,740 | 3 plans |
| 382 | COMPLICATED PEPTIC ULCER WITHOUT CC/MCC | $8,199 – $17,102 · median $12,740 | 3 plans |
| 383 | UNCOMPLICATED PEPTIC ULCER WITH MCC | $8,199 – $25,847 · median $12,740 | 3 plans |
| 384 | UNCOMPLICATED PEPTIC ULCER WITHOUT MCC | $8,199 – $17,919 · median $12,740 | 3 plans |
| 385 | INFLAMMATORY BOWEL DISEASE WITH MCC | $8,199 – $28,887 · median $12,740 | 3 plans |
| 386 | INFLAMMATORY BOWEL DISEASE WITH CC | $8,199 – $19,751 · median $12,740 | 3 plans |
| 387 | INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC | $8,199 – $15,303 · median $12,740 | 3 plans |
| 388 | GASTROINTESTINAL OBSTRUCTION WITH MCC | $8,199 – $27,296 · median $12,740 | 3 plans |
| 389 | GASTROINTESTINAL OBSTRUCTION WITH CC | $8,199 – $16,939 · median $12,740 | 3 plans |
| 390 | GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | $8,199 – $13,233 · median $12,740 | 3 plans |
| 391 | ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | $8,199 – $24,153 · median $12,740 | 3 plans |
| 393 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | $8,199 – $29,143 · median $12,740 | 3 plans |
| 394 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | $8,199 – $19,139 · median $12,740 | 3 plans |
| 395 | OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $8,199 – $14,816 · median $12,740 | 3 plans |
| 397 | APPENDIX PROCEDURES WITH MCC | $11,387 – $41,138 · median $19,015 | 3 plans |
| 398 | APPENDIX PROCEDURES WITH CC | $11,387 – $27,851 · median $19,015 | 3 plans |
| 399 | APPENDIX PROCEDURES WITHOUT CC/MCC | $11,387 – $22,290 · median $19,015 | 3 plans |
| 405 | PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC | $11,387 – $87,505 · median $19,015 | 3 plans |
| 406 | PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC | $11,387 – $48,755 · median $19,015 | 3 plans |
| 407 | PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC | $11,387 – $38,495 · median $19,015 | 3 plans |
| 408 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH | $11,387 – $58,787 · median $19,015 | 3 plans |
| 409 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH | $11,387 – $37,857 · median $19,015 | 3 plans |
| 410 | BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH | $11,387 – $28,968 · median $19,015 | 3 plans |
| 411 | CHOLECYSTECTOMY WITH C.D.E. WITH MCC | $11,387 – $54,833 · median $19,015 | 3 plans |
| 412 | CHOLECYSTECTOMY WITH C.D.E. WITH CC | $11,387 – $36,729 · median $19,015 | 3 plans |
| 413 | CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC | $11,387 – $30,066 · median $19,015 | 3 plans |
| 414 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC | $11,387 – $58,742 · median $19,015 | 3 plans |
| 415 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC | $11,387 – $36,190 · median $19,015 | 3 plans |
| 416 | CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC | $11,387 – $25,585 · median $19,015 | 3 plans |
| 417 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | $11,387 – $41,009 · median $19,015 | 3 plans |
| 418 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | $11,387 – $30,535 · median $19,015 | 3 plans |
| 419 | LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | $11,387 – $25,623 · median $19,015 | 3 plans |
| 420 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC | $11,387 – $56,397 · median $19,015 | 3 plans |
| 421 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC | $11,387 – $31,227 · median $19,015 | 3 plans |
| 422 | HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC | $11,387 – $26,131 · median $19,015 | 3 plans |
| 423 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC | $11,387 – $67,643 · median $19,015 | 3 plans |
| 424 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC | $11,387 – $38,017 · median $19,015 | 3 plans |
| 425 | OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $27,651 · median $19,015 | 3 plans |
| 428 | MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT | $58,631 – $96,392 · median $89,789 | 3 plans |
| 432 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC | $8,199 – $34,705 · median $12,740 | 3 plans |
| 433 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC | $8,199 – $20,955 · median $12,740 | 3 plans |
| 434 | CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC | $8,199 – $15,774 · median $12,740 | 3 plans |
| 435 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | $8,199 – $32,722 · median $12,740 | 3 plans |
| 436 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | $8,199 – $22,085 · median $12,740 | 3 plans |
| 437 | MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC | $8,199 – $17,896 · median $12,740 | 3 plans |
| 438 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC | $8,199 – $29,609 · median $12,740 | 3 plans |
| 439 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | $8,199 – $17,714 · median $12,740 | 3 plans |
| 440 | DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC | $8,199 – $14,400 · median $12,740 | 3 plans |
| 441 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | $8,199 – $32,089 · median $12,740 | 3 plans |
| 442 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | $8,199 – $19,585 · median $12,740 | 3 plans |
| 443 | DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C | $8,199 – $15,581 · median $12,740 | 3 plans |
| 444 | DISORDERS OF THE BILIARY TRACT WITH MCC | $8,199 – $30,223 · median $12,740 | 3 plans |
| 445 | DISORDERS OF THE BILIARY TRACT WITH CC | $8,199 – $21,531 · median $12,740 | 3 plans |
| 446 | DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC | $8,199 – $17,504 · median $12,740 | 3 plans |
| 461 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC | $38,697 – $88,297 · median $62,400 | 3 plans |
| 462 | BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC | $33,903 – $54,080 · median $45,134 | 3 plans |
| 463 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE | $52,352 – $90,958 · median $59,186 | 3 plans |
| 464 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE | $21,555 – $51,989 · median $34,494 | 3 plans |
| 465 | WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE | $17,577 – $32,526 · median $28,127 | 3 plans |
| 466 | REVISION OF HIP OR KNEE REPLACEMENT WITH MCC | $38,247 – $83,509 · median $60,320 | 3 plans |
| 467 | REVISION OF HIP OR KNEE REPLACEMENT WITH CC | $43,432 – $58,199 · median $50,185 | 3 plans |
| 468 | REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | $23,551 – $46,461 · median $37,685 | 3 plans |
| 469 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC | $37,603 – $50,761 · median $43,680 | 3 plans |
| 470 | MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT | $34,034 – $41,600 · median $34,112 | 3 plans |
| 474 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC | $11,387 – $69,752 · median $19,015 | 3 plans |
| 475 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC | $11,387 – $39,340 · median $19,015 | 3 plans |
| 476 | AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC | $11,387 – $22,825 · median $19,015 | 3 plans |
| 477 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $11,387 – $57,114 · median $19,015 | 3 plans |
| 478 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $11,387 – $42,107 · median $19,015 | 3 plans |
| 479 | BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $11,387 – $33,057 · median $19,015 | 3 plans |
| 480 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | $23,379 – $48,938 · median $37,440 | 3 plans |
| 481 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | $15,603 – $36,609 · median $25,967 | 3 plans |
| 482 | HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | $22,568 – $29,621 · median $28,921 | 3 plans |
| 483 | MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | $11,387 – $46,821 · median $19,015 | 3 plans |
| 485 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC | $24,455 – $53,684 · median $39,520 | 3 plans |
| 486 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC | $14,959 – $36,557 · median $24,897 | 3 plans |
| 487 | KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC | $14,959 – $28,644 · median $24,897 | 3 plans |
| 488 | KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC | $13,010 – $31,700 · median $21,424 | 3 plans |
| 489 | KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC | $11,088 – $21,869 · median $18,230 | 3 plans |
| 492 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC | $21,937 – $60,385 · median $35,360 | 3 plans |
| 493 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | $24,088 – $43,266 · median $36,079 | 3 plans |
| 494 | LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | $19,088 – $35,282 · median $31,200 | 3 plans |
| 495 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT | $21,674 – $59,693 · median $35,360 | 3 plans |
| 496 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT | $12,304 – $32,228 · median $20,474 | 3 plans |
| 497 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT | $8,996 – $23,248 · median $14,935 | 3 plans |
| 498 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC | $11,387 – $50,513 · median $19,015 | 3 plans |
| 499 | LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT | $11,387 – $35,407 · median $19,015 | 3 plans |
| 500 | SOFT TISSUE PROCEDURES WITH MCC | $11,387 – $52,745 · median $19,015 | 3 plans |
| 501 | SOFT TISSUE PROCEDURES WITH CC | $11,387 – $31,386 · median $19,015 | 3 plans |
| 502 | SOFT TISSUE PROCEDURES WITHOUT CC/MCC | $11,387 – $25,323 · median $19,015 | 3 plans |
| 503 | FOOT PROCEDURES WITH MCC | $17,235 – $47,111 · median $28,683 | 3 plans |
| 504 | FOOT PROCEDURES WITH CC | $11,750 – $33,212 · median $19,317 | 3 plans |
| 505 | FOOT PROCEDURES WITHOUT CC/MCC | $8,248 – $32,060 · median $13,694 | 3 plans |
| 506 | MAJOR THUMB OR JOINT PROCEDURES | $11,387 – $25,373 · median $19,015 | 3 plans |
| 507 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC | $14,139 – $32,265 · median $22,880 | 3 plans |
| 508 | MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC | $10,548 – $27,863 · median $17,552 | 3 plans |
| 510 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC | $16,258 – $50,569 · median $25,768 | 3 plans |
| 511 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC | $11,151 – $36,381 · median $18,557 | 3 plans |
| 512 | SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ | $10,192 – $29,989 · median $16,640 | 3 plans |
| 513 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC | $11,387 – $28,766 · median $19,015 | 3 plans |
| 514 | HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC | $11,387 – $20,444 · median $19,015 | 3 plans |
| 515 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC | $24,213 – $53,078 · median $39,520 | 3 plans |
| 516 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | $19,944 – $36,361 · median $33,193 | 3 plans |
| 517 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC | $19,944 – $33,193 · median $28,199 | 3 plans |
| 518 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST | $15,583 – $61,376 · median $17,903 | 3 plans |
| 519 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | $10,986 – $35,187 · median $18,281 | 3 plans |
| 520 | BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC | $11,866 – $27,554 · median $19,749 | 3 plans |
| 521 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | $37,603 – $48,303 · median $42,640 | 3 plans |
| 522 | HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | $34,034 – $40,560 · median $36,958 | 3 plans |
| 533 | FRACTURES OF FEMUR WITH MCC | $8,199 – $28,667 · median $12,740 | 3 plans |
| 534 | FRACTURES OF FEMUR WITHOUT MCC | $8,199 – $17,185 · median $12,740 | 3 plans |
| 535 | FRACTURES OF HIP AND PELVIS WITH MCC | $8,199 – $24,359 · median $12,740 | 3 plans |
| 536 | FRACTURES OF HIP AND PELVIS WITHOUT MCC | $8,199 – $17,207 · median $12,740 | 3 plans |
| 537 | SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC | $8,199 – $19,419 · median $12,740 | 3 plans |
| 538 | SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC | $8,199 – $15,891 · median $12,740 | 3 plans |
| 539 | OSTEOMYELITIS WITH MCC | $8,199 – $34,727 · median $12,740 | 3 plans |
| 540 | OSTEOMYELITIS WITH CC | $8,199 – $24,575 · median $12,740 | 3 plans |
| 541 | OSTEOMYELITIS WITHOUT CC/MCC | $8,199 – $16,903 · median $12,740 | 3 plans |
| 542 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH | $8,199 – $31,664 · median $12,740 | 3 plans |
| 543 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH | $8,199 – $20,530 · median $12,740 | 3 plans |
| 544 | PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH | $8,199 – $16,408 · median $12,740 | 3 plans |
| 545 | CONNECTIVE TISSUE DISORDERS WITH MCC | $8,199 – $42,446 · median $12,740 | 3 plans |
| 546 | CONNECTIVE TISSUE DISORDERS WITH CC | $8,199 – $22,421 · median $12,740 | 3 plans |
| 547 | CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC | $8,199 – $17,639 · median $12,740 | 3 plans |
| 548 | SEPTIC ARTHRITIS WITH MCC | $8,199 – $34,142 · median $12,740 | 3 plans |
| 549 | SEPTIC ARTHRITIS WITH CC | $8,199 – $23,232 · median $12,740 | 3 plans |
| 550 | SEPTIC ARTHRITIS WITHOUT CC/MCC | $8,199 – $18,210 · median $12,740 | 3 plans |
| 551 | MEDICAL BACK PROBLEMS WITH MCC | $10,192 – $30,301 · median $16,640 | 3 plans |
| 552 | MEDICAL BACK PROBLEMS WITHOUT MCC | $9,434 – $19,525 · median $16,296 | 3 plans |
| 553 | BONE DISEASES AND ARTHROPATHIES WITH MCC | $8,199 – $24,575 · median $12,740 | 3 plans |
| 554 | BONE DISEASES AND ARTHROPATHIES WITHOUT MCC | $8,199 – $17,547 · median $12,740 | 3 plans |
| 555 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $8,199 – $24,960 · median $12,740 | 3 plans |
| 556 | SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC | $8,199 – $17,554 · median $12,740 | 3 plans |
| 557 | TENDONITIS, MYOSITIS AND BURSITIS WITH MCC | $8,199 – $27,449 · median $12,740 | 3 plans |
| 558 | TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC | $8,199 – $18,498 · median $12,740 | 3 plans |
| 559 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC | $8,199 – $33,147 · median $12,740 | 3 plans |
| 560 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC | $8,199 – $22,009 · median $12,740 | 3 plans |
| 561 | AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC | $8,199 – $17,152 · median $12,740 | 3 plans |
| 562 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT | $8,199 – $26,512 · median $12,740 | 3 plans |
| 563 | FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT | $8,199 – $18,533 · median $12,740 | 3 plans |
| 564 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC | $8,199 – $28,303 · median $12,740 | 3 plans |
| 565 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC | $8,199 – $19,722 · median $12,740 | 3 plans |
| 566 | OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC | $8,199 – $16,329 · median $12,740 | 3 plans |
| 570 | SKIN DEBRIDEMENT WITH MCC | $11,387 – $49,372 · median $19,015 | 3 plans |
| 571 | SKIN DEBRIDEMENT WITH CC | $11,387 – $30,503 · median $19,015 | 3 plans |
| 572 | SKIN DEBRIDEMENT WITHOUT CC/MCC | $11,387 – $22,314 · median $19,015 | 3 plans |
| 573 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC | $11,387 – $103,801 · median $19,015 | 3 plans |
| 574 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC | $11,387 – $57,367 · median $19,015 | 3 plans |
| 575 | SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | $11,387 – $32,124 · median $19,015 | 3 plans |
| 576 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC | $11,387 – $78,923 · median $19,015 | 3 plans |
| 577 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC | $11,387 – $44,994 · median $19,015 | 3 plans |
| 578 | SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC | $11,387 – $29,250 · median $19,015 | 3 plans |
| 579 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC | $11,387 – $53,856 · median $19,015 | 3 plans |
| 580 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | $11,387 – $31,083 · median $19,015 | 3 plans |
| 581 | OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC | $11,387 – $26,788 · median $19,015 | 3 plans |
| 582 | MASTECTOMY FOR MALIGNANCY WITH CC/MCC | $11,387 – $34,077 · median $19,015 | 3 plans |
| 583 | MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC | $11,387 – $31,029 · median $19,015 | 3 plans |
| 584 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC | $11,387 – $37,305 · median $19,015 | 3 plans |
| 585 | BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC | $11,387 – $34,115 · median $19,015 | 3 plans |
| 592 | SKIN ULCERS WITH MCC | $8,199 – $34,209 · median $12,740 | 3 plans |
| 593 | SKIN ULCERS WITH CC | $8,199 – $22,917 · median $12,740 | 3 plans |
| 594 | SKIN ULCERS WITHOUT CC/MCC | $8,199 – $18,100 · median $12,740 | 3 plans |
| 595 | MAJOR SKIN DISORDERS WITH MCC | $8,199 – $37,004 · median $12,740 | 3 plans |
| 596 | MAJOR SKIN DISORDERS WITHOUT MCC | $8,199 – $21,352 · median $12,740 | 3 plans |
| 597 | MALIGNANT BREAST DISORDERS WITH MCC | $8,199 – $30,165 · median $12,740 | 3 plans |
| 598 | MALIGNANT BREAST DISORDERS WITH CC | $8,199 – $22,088 · median $12,740 | 3 plans |
| 599 | MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $8,199 – $16,632 · median $12,740 | 3 plans |
| 600 | NON-MALIGNANT BREAST DISORDERS WITH CC/MCC | $8,199 – $20,735 · median $12,740 | 3 plans |
| 601 | NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC | $8,199 – $14,153 · median $12,740 | 3 plans |
| 602 | CELLULITIS WITH MCC | $8,199 – $26,460 · median $12,740 | 3 plans |
| 604 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC | $10,192 – $27,225 · median $16,640 | 3 plans |
| 605 | TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | $7,556 – $18,842 · median $16,640 | 3 plans |
| 606 | MINOR SKIN DISORDERS WITH MCC | $8,199 – $27,845 · median $12,740 | 3 plans |
| 607 | MINOR SKIN DISORDERS WITHOUT MCC | $8,199 – $18,697 · median $12,740 | 3 plans |
| 614 | ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC | $11,387 – $38,076 · median $19,015 | 3 plans |
| 615 | ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC | $11,387 – $26,128 · median $19,015 | 3 plans |
| 616 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH | $11,387 – $57,608 · median $19,015 | 3 plans |
| 617 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH | $11,387 – $33,229 · median $19,015 | 3 plans |
| 618 | AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH | $11,387 – $26,414 · median $19,015 | 3 plans |
| 622 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR | $11,387 – $58,691 · median $19,015 | 3 plans |
| 623 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR | $11,387 – $32,077 · median $19,015 | 3 plans |
| 624 | SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR | $11,387 – $23,906 · median $19,015 | 3 plans |
| 625 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC | $11,387 – $50,563 · median $19,015 | 3 plans |
| 626 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC | $11,387 – $27,637 · median $19,015 | 3 plans |
| 627 | THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC | $11,387 – $25,058 · median $19,015 | 3 plans |
| 628 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC | $11,387 – $61,217 · median $19,015 | 3 plans |
| 629 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC | $11,387 – $37,880 · median $19,015 | 3 plans |
| 630 | OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $27,035 · median $19,015 | 3 plans |
| 637 | DIABETES WITH MCC | $8,199 – $26,692 · median $12,740 | 3 plans |
| 638 | DIABETES WITH CC | $8,199 – $18,543 · median $12,740 | 3 plans |
| 639 | DIABETES WITHOUT CC/MCC | $8,199 – $14,397 · median $12,740 | 3 plans |
| 640 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M | $8,199 – $25,168 · median $12,740 | 3 plans |
| 641 | MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU | $8,199 – $16,764 · median $12,740 | 3 plans |
| 642 | INBORN AND OTHER DISORDERS OF METABOLISM | $8,199 – $26,472 · median $12,740 | 3 plans |
| 643 | ENDOCRINE DISORDERS WITH MCC | $8,199 – $29,849 · median $12,740 | 3 plans |
| 644 | ENDOCRINE DISORDERS WITH CC | $8,199 – $20,485 · median $12,740 | 3 plans |
| 645 | ENDOCRINE DISORDERS WITHOUT CC/MCC | $8,199 – $16,615 · median $12,740 | 3 plans |
| 653 | MAJOR BLADDER PROCEDURES WITH MCC | $11,387 – $83,373 · median $19,015 | 3 plans |
| 654 | MAJOR BLADDER PROCEDURES WITH CC | $11,387 – $47,234 · median $19,015 | 3 plans |
| 655 | MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | $11,387 – $36,942 · median $19,015 | 3 plans |
| 656 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC | $11,387 – $53,031 · median $19,015 | 3 plans |
| 657 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC | $11,387 – $32,621 · median $19,015 | 3 plans |
| 658 | KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC | $16,787 – $28,427 · median $18,823 | 3 plans |
| 659 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | $25,004 – $43,339 · median $39,722 | 3 plans |
| 660 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | $13,651 – $24,958 · median $22,441 | 3 plans |
| 661 | KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | $9,872 – $20,642 · median $17,315 | 3 plans |
| 662 | MINOR BLADDER PROCEDURES WITH MCC | $11,387 – $51,187 · median $19,015 | 3 plans |
| 663 | MINOR BLADDER PROCEDURES WITH CC | $11,387 – $27,951 · median $19,015 | 3 plans |
| 664 | MINOR BLADDER PROCEDURES WITHOUT CC/MCC | $11,387 – $20,815 · median $19,015 | 3 plans |
| 665 | PROSTATECTOMY WITH MCC | $11,387 – $52,087 · median $19,015 | 3 plans |
| 666 | PROSTATECTOMY WITH CC | $11,387 – $31,405 · median $19,015 | 3 plans |
| 667 | PROSTATECTOMY WITHOUT CC/MCC | $11,387 – $21,709 · median $19,015 | 3 plans |
| 668 | TRANSURETHRAL PROCEDURES WITH MCC | $11,387 – $49,054 · median $19,015 | 3 plans |
| 669 | TRANSURETHRAL PROCEDURES WITH CC | $11,387 – $28,430 · median $19,015 | 3 plans |
| 670 | TRANSURETHRAL PROCEDURES WITHOUT CC/MCC | $11,387 – $19,766 · median $19,015 | 3 plans |
| 671 | URETHRAL PROCEDURES WITH CC/MCC | $11,387 – $32,093 · median $19,015 | 3 plans |
| 672 | URETHRAL PROCEDURES WITHOUT CC/MCC | $11,387 – $21,307 · median $19,015 | 3 plans |
| 673 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | $11,387 – $68,375 · median $19,015 | 3 plans |
| 674 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC | $11,387 – $40,289 · median $19,015 | 3 plans |
| 675 | OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC | $11,387 – $29,778 · median $19,015 | 3 plans |
| 682 | RENAL FAILURE WITH MCC | $8,199 – $27,360 · median $12,740 | 3 plans |
| 684 | RENAL FAILURE WITHOUT CC/MCC | $8,199 – $14,082 · median $12,740 | 3 plans |
| 686 | KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC | $8,199 – $32,225 · median $12,740 | 3 plans |
| 687 | KIDNEY AND URINARY TRACT NEOPLASMS WITH CC | $8,199 – $20,829 · median $12,740 | 3 plans |
| 688 | KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC | $8,199 – $16,947 · median $12,740 | 3 plans |
| 695 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC | $8,199 – $22,276 · median $12,740 | 3 plans |
| 696 | KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC | $8,199 – $15,419 · median $12,740 | 3 plans |
| 697 | URETHRAL STRICTURE | $8,199 – $21,281 · median $12,740 | 3 plans |
| 699 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | $8,199 – $20,334 · median $12,740 | 3 plans |
| 700 | OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC | $8,199 – $15,433 · median $12,740 | 3 plans |
| 707 | MAJOR MALE PELVIC PROCEDURES WITH CC/MCC | $13,331 – $35,189 · median $22,188 | 3 plans |
| 708 | MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | $10,104 – $28,162 · median $16,296 | 3 plans |
| 709 | PENIS PROCEDURES WITH CC/MCC | $11,387 – $40,115 · median $19,015 | 3 plans |
| 710 | PENIS PROCEDURES WITHOUT CC/MCC | $11,387 – $26,157 · median $19,015 | 3 plans |
| 711 | TESTES PROCEDURES WITH CC/MCC | $11,387 – $36,447 · median $19,015 | 3 plans |
| 712 | TESTES PROCEDURES WITHOUT CC/MCC | $11,387 – $21,611 · median $19,015 | 3 plans |
| 713 | TRANSURETHRAL PROSTATECTOMY WITH CC/MCC | $11,387 – $27,697 · median $19,015 | 3 plans |
| 714 | TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC | $11,387 – $20,973 · median $19,015 | 3 plans |
| 715 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC | $11,387 – $38,762 · median $19,015 | 3 plans |
| 716 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC | $11,387 – $27,209 · median $19,015 | 3 plans |
| 717 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC | $11,387 – $33,533 · median $19,015 | 3 plans |
| 718 | OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC | $11,387 – $25,281 · median $19,015 | 3 plans |
| 722 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC | $8,199 – $32,315 · median $12,740 | 3 plans |
| 723 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC | $8,199 – $22,259 · median $12,740 | 3 plans |
| 724 | MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $8,199 – $14,917 · median $12,740 | 3 plans |
| 725 | BENIGN PROSTATIC HYPERTROPHY WITH MCC | $8,199 – $22,674 · median $12,740 | 3 plans |
| 726 | BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC | $8,199 – $15,917 · median $12,740 | 3 plans |
| 727 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC | $8,199 – $27,388 · median $12,740 | 3 plans |
| 728 | INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC | $8,199 – $17,262 · median $12,740 | 3 plans |
| 729 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC | $8,199 – $20,993 · median $12,740 | 3 plans |
| 730 | OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC | $8,199 – $15,163 · median $12,740 | 3 plans |
| 734 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC | $11,387 – $37,144 · median $19,015 | 3 plans |
| 735 | PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC | $11,387 – $25,317 · median $19,015 | 3 plans |
| 736 | UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC | $11,387 – $58,921 · median $19,015 | 3 plans |
| 737 | UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC | $11,387 – $36,098 · median $19,015 | 3 plans |
| 738 | UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC | $11,387 – $27,171 · median $19,015 | 3 plans |
| 739 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC | $27,297 – $59,046 · median $41,427 | 3 plans |
| 740 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC | $12,562 – $32,314 · median $19,064 | 3 plans |
| 741 | UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT | $10,104 – $26,532 · median $16,105 | 3 plans |
| 742 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC | $16,717 – $32,693 · median $23,426 | 3 plans |
| 743 | UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | $11,847 – $23,737 · median $16,296 | 3 plans |
| 744 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC | $11,387 – $35,924 · median $19,015 | 3 plans |
| 745 | D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC | $11,387 – $22,181 · median $19,015 | 3 plans |
| 746 | VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC | $11,387 – $31,221 · median $19,015 | 3 plans |
| 747 | VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC | $11,387 – $19,015 · median $17,993 | 3 plans |
| 748 | FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | $8,796 – $25,947 · median $14,560 | 3 plans |
| 749 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC | $11,387 – $43,741 · median $19,015 | 3 plans |
| 750 | OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $27,281 · median $19,015 | 3 plans |
| 754 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $8,199 – $32,798 · median $12,740 | 3 plans |
| 755 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC | $8,199 – $21,432 · median $12,740 | 3 plans |
| 756 | MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $8,199 – $19,513 · median $12,740 | 3 plans |
| 757 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC | $8,199 – $26,619 · median $12,740 | 3 plans |
| 758 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC | $8,199 – $19,791 · median $12,740 | 3 plans |
| 759 | INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC | $8,199 – $15,036 · median $12,740 | 3 plans |
| 760 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC | $8,199 – $20,221 · median $12,740 | 3 plans |
| 761 | MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC | $8,199 – $13,633 · median $12,740 | 3 plans |
| 769 | POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES | $11,387 – $30,507 · median $19,015 | 3 plans |
| 770 | ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY | $11,387 – $20,149 · median $19,015 | 3 plans |
| 776 | POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES | $8,199 – $14,902 · median $12,740 | 3 plans |
| 779 | ABORTION WITHOUT D&C | $8,199 – $17,715 · median $12,740 | 3 plans |
| 799 | SPLENIC PROCEDURES WITH MCC | $11,387 – $73,310 · median $19,015 | 3 plans |
| 800 | SPLENIC PROCEDURES WITH CC | $11,387 – $47,387 · median $19,015 | 3 plans |
| 801 | SPLENIC PROCEDURES WITHOUT CC/MCC | $11,387 – $33,811 · median $19,015 | 3 plans |
| 802 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC | $11,387 – $65,096 · median $19,015 | 3 plans |
| 803 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC | $11,387 – $33,057 · median $19,015 | 3 plans |
| 804 | OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC | $11,387 – $25,475 · median $19,015 | 3 plans |
| 808 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO | $8,199 – $38,318 · median $12,740 | 3 plans |
| 809 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO | $8,199 – $24,117 · median $12,740 | 3 plans |
| 810 | MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO | $8,199 – $20,811 · median $12,740 | 3 plans |
| 811 | RED BLOOD CELL DISORDERS WITH MCC | $8,199 – $26,203 · median $12,740 | 3 plans |
| 812 | RED BLOOD CELL DISORDERS WITHOUT MCC | $8,199 – $18,875 · median $12,740 | 3 plans |
| 813 | COAGULATION DISORDERS | $8,199 – $28,027 · median $12,740 | 3 plans |
| 814 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC | $8,199 – $37,094 · median $12,740 | 3 plans |
| 815 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC | $8,199 – $20,319 · median $12,740 | 3 plans |
| 816 | RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC | $8,199 – $14,560 · median $12,740 | 3 plans |
| 820 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC | $11,387 – $93,450 · median $19,015 | 3 plans |
| 821 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC | $11,387 – $38,781 · median $19,015 | 3 plans |
| 822 | LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $23,184 · median $19,015 | 3 plans |
| 823 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC | $11,387 – $74,152 · median $19,015 | 3 plans |
| 824 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC | $11,387 – $39,188 · median $19,015 | 3 plans |
| 825 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC | $11,387 – $25,376 · median $19,015 | 3 plans |
| 826 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. | $11,387 – $75,555 · median $19,015 | 3 plans |
| 827 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. | $11,387 – $39,876 · median $19,015 | 3 plans |
| 828 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. | $11,387 – $30,719 · median $19,015 | 3 plans |
| 829 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE | $11,387 – $52,672 · median $19,015 | 3 plans |
| 830 | MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE | $11,387 – $27,721 · median $19,015 | 3 plans |
| 834 | ACUTE LEUKEMIA WITH MCC | $8,199 – $87,798 · median $12,740 | 3 plans |
| 835 | ACUTE LEUKEMIA WITH CC | $8,199 – $36,478 · median $12,740 | 3 plans |
| 836 | ACUTE LEUKEMIA WITHOUT CC/MCC | $8,199 – $23,417 · median $12,740 | 3 plans |
| 837 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT | $8,199 – $77,462 · median $12,740 | 3 plans |
| 838 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE | $8,199 – $36,502 · median $12,740 | 3 plans |
| 839 | CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC | $8,199 – $26,800 · median $12,740 | 3 plans |
| 840 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | $8,199 – $53,801 · median $12,740 | 3 plans |
| 841 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC | $8,199 – $29,627 · median $12,740 | 3 plans |
| 842 | LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC | $8,199 – $20,265 · median $12,740 | 3 plans |
| 843 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES | $8,199 – $35,106 · median $12,740 | 3 plans |
| 844 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES | $8,199 – $23,386 · median $12,740 | 3 plans |
| 845 | OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES | $8,199 – $17,871 · median $12,740 | 3 plans |
| 846 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC | $8,199 – $44,117 · median $12,740 | 3 plans |
| 847 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | $8,199 – $24,754 · median $12,740 | 3 plans |
| 848 | CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC | $8,199 – $17,838 · median $12,740 | 3 plans |
| 849 | RADIOTHERAPY | $8,199 – $45,880 · median $12,740 | 3 plans |
| 850 | ACUTE LEUKEMIA WITH OTHER PROCEDURES | $11,387 – $135,583 · median $19,015 | 3 plans |
| 853 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | $11,387 – $79,486 · median $19,015 | 3 plans |
| 855 | INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $27,604 · median $19,015 | 3 plans |
| 856 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC | $11,387 – $73,608 · median $19,015 | 3 plans |
| 857 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | $11,387 – $37,317 · median $19,015 | 3 plans |
| 858 | POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC | $11,387 – $26,031 · median $19,015 | 3 plans |
| 862 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC | $8,199 – $32,526 · median $12,740 | 3 plans |
| 863 | POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | $8,199 – $20,076 · median $12,740 | 3 plans |
| 864 | FEVER AND INFLAMMATORY CONDITIONS | $8,199 – $18,415 · median $12,740 | 3 plans |
| 865 | VIRAL ILLNESS WITH MCC | $8,199 – $27,620 · median $12,740 | 3 plans |
| 866 | VIRAL ILLNESS WITHOUT MCC | $8,199 – $18,142 · median $12,740 | 3 plans |
| 867 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC | $8,199 – $36,589 · median $12,740 | 3 plans |
| 868 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC | $8,199 – $20,577 · median $12,740 | 3 plans |
| 869 | OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC | $8,199 – $16,033 · median $12,740 | 3 plans |
| 870 | SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | $8,199 – $109,234 · median $12,740 | 3 plans |
| 876 | O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS | $11,387 – $63,299 · median $19,015 | 3 plans |
| 901 | WOUND DEBRIDEMENTS FOR INJURIES WITH MCC | $11,387 – $68,300 · median $19,015 | 3 plans |
| 902 | WOUND DEBRIDEMENTS FOR INJURIES WITH CC | $11,387 – $33,895 · median $19,015 | 3 plans |
| 903 | WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC | $11,387 – $22,665 · median $19,015 | 3 plans |
| 904 | SKIN GRAFTS FOR INJURIES WITH CC/MCC | $11,387 – $60,408 · median $19,015 | 3 plans |
| 905 | SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC | $11,387 – $27,396 · median $19,015 | 3 plans |
| 906 | HAND PROCEDURES FOR INJURIES | $11,387 – $34,646 · median $19,015 | 3 plans |
| 907 | OTHER O.R. PROCEDURES FOR INJURIES WITH MCC | $11,387 – $62,913 · median $19,015 | 3 plans |
| 908 | OTHER O.R. PROCEDURES FOR INJURIES WITH CC | $11,387 – $35,112 · median $19,015 | 3 plans |
| 909 | OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC | $11,387 – $24,822 · median $19,015 | 3 plans |
| 913 | TRAUMATIC INJURY WITH MCC | $8,199 – $29,675 · median $12,740 | 3 plans |
| 914 | TRAUMATIC INJURY WITHOUT MCC | $8,199 – $18,382 · median $12,740 | 3 plans |
| 915 | ALLERGIC REACTIONS WITH MCC | $8,199 – $30,384 · median $12,740 | 3 plans |
| 916 | ALLERGIC REACTIONS WITHOUT MCC | $8,199 – $15,077 · median $12,740 | 3 plans |
| 917 | POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | $8,199 – $28,677 · median $12,740 | 3 plans |
| 918 | POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC | $8,199 – $17,954 · median $12,740 | 3 plans |
| 919 | COMPLICATIONS OF TREATMENT WITH MCC | $8,199 – $32,633 · median $12,740 | 3 plans |
| 920 | COMPLICATIONS OF TREATMENT WITH CC | $8,199 – $20,143 · median $12,740 | 3 plans |
| 921 | COMPLICATIONS OF TREATMENT WITHOUT CC/MCC | $8,199 – $15,410 · median $12,740 | 3 plans |
| 922 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC | $8,199 – $31,406 · median $12,740 | 3 plans |
| 923 | OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC | $8,199 – $20,375 · median $12,740 | 3 plans |
| 927 | EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT | $11,387 – $326,912 | 3 plans |
| 928 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC | $11,387 – $113,168 · median $19,015 | 3 plans |
| 929 | FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC | $11,387 – $53,589 · median $19,015 | 3 plans |
| 933 | EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT | $8,199 – $63,741 · median $12,740 | 3 plans |
| 934 | FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY | $8,199 – $38,359 · median $12,740 | 3 plans |
| 935 | NON-EXTENSIVE BURNS | $8,199 – $36,089 · median $12,740 | 3 plans |
| 939 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC | $11,387 – $59,735 · median $19,015 | 3 plans |
| 940 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC | $11,387 – $40,263 · median $19,015 | 3 plans |
| 941 | O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ | $11,387 – $35,602 · median $19,015 | 3 plans |
| 947 | SIGNS AND SYMPTOMS WITH MCC | $8,199 – $24,170 · median $12,740 | 3 plans |
| 948 | SIGNS AND SYMPTOMS WITHOUT MCC | $8,199 – $17,100 · median $12,740 | 3 plans |
| 949 | AFTERCARE WITH CC/MCC | $8,199 – $22,968 · median $12,740 | 3 plans |
| 950 | AFTERCARE WITHOUT CC/MCC | $8,199 – $14,495 · median $12,740 | 3 plans |
| 951 | OTHER FACTORS INFLUENCING HEALTH STATUS | $8,199 – $13,414 · median $12,740 | 3 plans |
| 955 | CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA | $55,959 – $106,510 · median $89,440 | 3 plans |
| 956 | LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA | $39,590 – $63,147 · median $61,763 | 3 plans |
| 957 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC | $72,434 – $119,910 · median $116,480 | 3 plans |
| 958 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC | $59,843 – $96,720 · median $68,561 | 3 plans |
| 959 | OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC | $49,417 – $85,280 · median $53,161 | 3 plans |
| 963 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC | $17,146 – $46,247 · median $28,536 | 3 plans |
| 964 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC | $14,982 – $28,138 · median $24,932 | 3 plans |
| 965 | OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC | $13,378 – $22,262 · median $19,211 | 3 plans |
| 969 | HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC | $11,387 – $97,317 · median $19,015 | 3 plans |
| 970 | HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC | $11,387 – $44,793 · median $19,015 | 3 plans |
| 974 | HIV WITH MAJOR RELATED CONDITION WITH MCC | $8,199 – $48,541 · median $12,740 | 3 plans |
| 975 | HIV WITH MAJOR RELATED CONDITION WITH CC | $8,199 – $24,555 · median $12,740 | 3 plans |
| 976 | HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC | $8,199 – $18,641 · median $12,740 | 3 plans |
| 977 | HIV WITH OR WITHOUT OTHER RELATED CONDITION | $8,199 – $24,596 · median $12,740 | 3 plans |
| 981 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $11,387 – $75,766 · median $19,015 | 3 plans |
| 982 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $11,387 – $42,096 · median $19,015 | 3 plans |
| 983 | EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $11,387 – $30,872 · median $19,015 | 3 plans |
| 987 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | $11,387 – $56,719 · median $19,015 | 3 plans |
| 988 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | $11,387 – $29,811 · median $19,015 | 3 plans |
| 989 | NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC | $11,387 – $23,111 · median $19,015 | 3 plans |
| 001 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC | $147,532 – $237,120 · median $192,326 | 2 plans |
| 002 | HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC | $127,144 – $208,000 · median $167,572 | 2 plans |
| 003 | ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH | $113,340 – $174,180 · median $143,760 | 2 plans |
| 004 | TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC | $207,200 – $207,200 · median $207,200 | 2 plans |
| 693 | URINARY STONES WITH MCC | $12,208 – $20,315 · median $16,262 | 2 plans |
| 694 | URINARY STONES WITHOUT MCC | $8,474 – $14,068 · median $11,271 | 2 plans |
| 795 | NORMAL NEWBORN | $1,254 – $8,044 · median $4,649 | 2 plans |
| 005 | LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT | $125,000 – $125,000 · median $125,000 | 1 plans |
| 006 | LIVER TRANSPLANT WITHOUT MCC | $125,000 – $125,000 · median $125,000 | 1 plans |
| 010 | PANCREAS TRANSPLANT | $90,000 – $90,000 · median $90,000 | 1 plans |
| 817 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC | $39,429 – $39,429 · median $39,429 | 1 plans |
| 818 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC | $22,508 – $22,508 · median $22,508 | 1 plans |
| 819 | OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC | $17,996 – $17,996 · median $17,996 | 1 plans |
| 831 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC | $23,161 – $23,161 · median $23,161 | 1 plans |
| 832 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC | $15,911 – $15,911 · median $15,911 | 1 plans |
| 833 | OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC | $12,915 – $12,915 · median $12,915 | 1 plans |
| 945 | REHABILITATION WITH CC/MCC | — | 1 plans |
| 946 | REHABILITATION WITHOUT CC/MCC | $2,613 – $2,613 · median $2,613 | 1 plans |
No procedures match that keyword.