Medical City Alliance — Pricing

775 procedures published in this hospital's Machine-Readable File (MRF) — 0 with a comparable price, 775 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 775
Lowest published price —
Average published price —
Highest published price —

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

Showing all 775 procedures

Procedures with negotiated rates only

These 775 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 $649 – $14,519 · median $10,038 13 plans
783 CESAREAN SECTION WITH STERILIZATION WITH MCC $649 – $17,468 · median $12,044 12 plans
784 CESAREAN SECTION WITH STERILIZATION WITH CC — 12 plans
785 CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC $649 – $17,468 · median $11,598 12 plans
786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC $649 – $17,468 · median $12,044 12 plans
787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC — 12 plans
788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC $649 – $17,468 · median $11,598 12 plans
796 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC $649 – $14,519 · median $10,235 12 plans
797 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC $649 – $14,519 · median $10,235 12 plans
798 VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC $649 – $12,540 · median $10,235 12 plans
805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC $649 – $14,519 · median $10,235 12 plans
806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC $649 – $12,540 · median $10,235 12 plans
807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC $649 – $12,540 · median $10,235 12 plans
619 O.R. PROCEDURES FOR OBESITY WITH MCC $21,128 – $45,036 · median $24,035 7 plans
620 O.R. PROCEDURES FOR OBESITY WITH CC $18,215 – $45,036 · median $23,364 7 plans
621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC $17,169 – $45,036 · median $24,035 7 plans
215 OTHER HEART ASSIST SYSTEM IMPLANT Pediatric $57,612 – $371,637 · median $95,958 4 plans
216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA $57,612 – $201,813 · median $94,966 4 plans
217 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA $57,612 – $201,813 · median $76,713 4 plans
218 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZA $57,612 – $199,619 · median $76,713 4 plans
219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER $57,612 – $180,819 · median $82,990 4 plans
220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER $57,612 – $180,819 · median $69,641 4 plans
221 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETER $57,368 – $171,393 · median $68,099 4 plans
228 OTHER CARDIOTHORACIC PROCEDURES WITH MCC $56,311 – $92,551 · median $68,099 4 plans
229 OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC $35,848 – $88,765 · median $68,099 4 plans
231 CORONARY BYPASS WITH PTCA WITH MCC $57,612 – $120,526 · median $87,267 4 plans
232 CORONARY BYPASS WITH PTCA WITHOUT MCC Pediatric $57,612 – $119,217 · median $73,795 4 plans
235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC Pediatric $51,903 – $78,585 · median $62,204 4 plans
236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC $47,677 – $78,585 · median $53,456 4 plans
273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC $25,055 – $57,612 · median $46,547 4 plans
274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC $25,055 – $57,612 · median $35,581 4 plans
698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC Pediatric $6,075 – $29,469 · median $19,027 4 plans
854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC $12,121 – $31,873 · median $25,749 4 plans
871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC Pediatric $6,075 – $31,873 · median $21,917 4 plans
872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC $6,075 – $29,469 · median $13,527 4 plans
177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC $6,075 – $28,756 · median $17,787 3 plans
193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC Pediatric $6,075 – $15,771 · median $14,295 3 plans
194 SIMPLE PNEUMONIA AND PLEURISY WITH CC Pediatric $6,075 – $15,771 · median $14,295 3 plans
195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC Pediatric $6,075 – $15,771 · median $14,295 3 plans
209 COMPLEX AORTIC ARCH PROCEDURES $81,187 – $180,819 · median $128,831 3 plans
212 CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES $12,121 – $123,769 · median $78,585 3 plans
233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC $78,585 – $101,742 · median $87,018 3 plans
234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC Pediatric $62,176 – $101,742 · median $78,585 3 plans
244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC $20,573 – $77,234 · median $29,610 3 plans
245 AICD GENERATOR PROCEDURES $51,929 – $81,484 · median $57,612 3 plans
250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC $24,841 – $25,834 · median $25,055 3 plans
251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC Pediatric $17,010 – $25,055 · median $24,776 3 plans
258 CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC $29,610 – $35,763 · median $34,156 3 plans
259 CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC $23,016 – $29,610 · median $24,592 3 plans
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC Pediatric $29,610 – $38,370 · median $37,023 3 plans
261 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC Pediatric $21,518 – $29,610 · median $23,504 3 plans
262 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC Pediatric $18,552 – $29,610 · median $20,444 3 plans
265 AICD LEAD PROCEDURES Pediatric $41,182 – $82,712 · median $57,612 3 plans
266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC $69,753 – $276,492 · median $78,585 3 plans
267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC $54,187 – $207,606 · median $78,585 3 plans
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC $57,612 – $192,743 · median $78,284 3 plans
269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC $48,068 – $119,811 · median $57,612 3 plans
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC Pediatric $57,612 – $145,306 · median $60,055 3 plans
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC Pediatric $40,478 – $96,442 · median $57,612 3 plans
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC $29,058 – $69,074 · median $57,612 3 plans
275 CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC Pediatric $78,585 – $215,457 · median $81,158 3 plans
276 CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR Pediatric $68,367 – $102,263 · median $78,585 3 plans
277 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC $52,568 – $102,746 · median $78,585 3 plans
286 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC Pediatric $16,896 – $25,186 · median $17,074 3 plans
287 CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC Pediatric $12,180 – $17,074 · median $13,000 3 plans
318 PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE $25,883 – $42,508 · median $27,569 3 plans
321 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ A $25,055 – $44,698 · median $30,968 3 plans
322 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric $20,066 – $44,698 · median $25,055 3 plans
323 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC Pediatric $12,121 – $49,254 · median $25,055 3 plans
324 CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC Pediatric $12,121 – $35,865 · median $25,055 3 plans
325 CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE Pediatric $12,121 – $36,541 · median $25,055 3 plans
359 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC $25,883 – $44,698 · median $39,138 3 plans
360 PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC $25,883 – $42,369 · median $27,480 3 plans
392 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC $6,075 – $8,295 · median $7,818 3 plans
467 REVISION OF HIP OR KNEE REPLACEMENT WITH CC $40,140 – $101,900 · median $61,827 3 plans
468 REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC $31,278 – $98,225 · median $62,446 3 plans
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT $21,955 – $60,000 · median $36,151 3 plans
603 CELLULITIS WITHOUT MCC $6,075 – $8,295 · median $7,818 3 plans
683 RENAL FAILURE WITH CC $6,075 – $8,295 · median $7,818 3 plans
689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC Pediatric $6,075 – $15,771 · median $14,295 3 plans
690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC $6,075 – $8,295 · median $7,818 3 plans
789 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY $2,800 – $35,435 · median $5,225 3 plans
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE $3,080 – $69,005 · median $6,270 3 plans
791 PREMATURITY WITH MAJOR PROBLEMS $3,080 – $35,435 · median $6,270 3 plans
792 PREMATURITY WITHOUT MAJOR PROBLEMS $2,800 – $11,856 · median $5,225 3 plans
793 FULL TERM NEONATE WITH MAJOR PROBLEMS $3,080 – $11,856 · median $6,270 3 plans
794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS $2,800 – $5,225 · median $4,150 3 plans
880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION $2,613 – $10,929 · median $6,075 3 plans
881 DEPRESSIVE NEUROSES Pediatric $2,613 – $10,709 · median $6,075 3 plans
882 NEUROSES EXCEPT DEPRESSIVE Pediatric $2,613 – $12,222 · median $6,075 3 plans
883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL $2,613 – $22,380 · median $6,075 3 plans
884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY $2,613 – $18,313 · median $6,075 3 plans
885 PSYCHOSES Pediatric $2,613 – $15,898 · median $6,075 3 plans
886 BEHAVIORAL AND DEVELOPMENTAL DISORDERS $2,613 – $23,621 · median $6,075 3 plans
887 OTHER MENTAL DISORDER DIAGNOSES Pediatric $2,613 – $12,189 · median $6,075 3 plans
894 ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA $2,613 – $7,022 · median $6,075 3 plans
895 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY $2,613 – $16,112 · median $6,075 3 plans
896 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC Pediatric $2,613 – $19,863 · median $6,075 3 plans
897 ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC Pediatric $2,613 – $10,048 · median $6,075 3 plans
011 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC Pediatric $12,121 – $62,079 · median $37,100 2 plans
012 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC Pediatric $12,121 – $47,987 · median $30,054 2 plans
013 TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC Pediatric $12,121 – $32,801 · median $22,461 2 plans
020 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC $89,563 – $143,155 · median $116,359 2 plans
021 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC Pediatric $60,254 – $146,825 · median $103,540 2 plans
022 INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/ Pediatric $36,165 – $146,825 · median $91,495 2 plans
023 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI $65,222 – $146,100 · median $105,661 2 plans
024 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WI Pediatric $44,525 – $141,364 · median $92,945 2 plans
025 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC Pediatric $51,751 – $57,160 · median $54,455 2 plans
026 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC $35,389 – $57,160 · median $46,274 2 plans
027 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC Pediatric $28,716 – $57,431 · median $43,073 2 plans
028 SPINAL PROCEDURES WITH MCC Pediatric $39,620 – $68,386 · median $54,003 2 plans
029 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS Pediatric $31,175 – $38,831 · median $35,003 2 plans
030 SPINAL PROCEDURES WITHOUT CC/MCC $24,892 – $24,986 · median $24,939 2 plans
031 VENTRICULAR SHUNT PROCEDURES WITH MCC Pediatric $39,291 – $50,997 · median $45,144 2 plans
032 VENTRICULAR SHUNT PROCEDURES WITH CC Pediatric $24,255 – $35,431 · median $29,843 2 plans
033 VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC $18,927 – $35,764 · median $27,346 2 plans
034 CAROTID ARTERY STENT PROCEDURES WITH MCC Pediatric $42,705 – $44,056 · median $43,381 2 plans
035 CAROTID ARTERY STENT PROCEDURES WITH CC Pediatric $27,209 – $27,446 · median $27,327 2 plans
036 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC $22,113 – $22,293 · median $22,203 2 plans
037 EXTRACRANIAL PROCEDURES WITH MCC $18,242 – $37,471 · median $27,856 2 plans
038 EXTRACRANIAL PROCEDURES WITH CC Pediatric $18,468 – $21,694 · median $20,081 2 plans
039 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC $13,380 – $18,309 · median $15,844 2 plans
040 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC $43,948 – $86,041 · median $64,995 2 plans
041 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHE $25,026 – $82,156 · median $53,591 2 plans
042 PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC $19,665 – $82,156 · median $50,910 2 plans
052 SPINAL DISORDERS AND INJURIES WITH CC/MCC $6,075 – $20,616 · median $13,346 2 plans
053 SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC Pediatric $6,075 – $11,145 · median $8,610 2 plans
054 NERVOUS SYSTEM NEOPLASMS WITH MCC Pediatric $6,075 – $17,379 · median $11,727 2 plans
055 NERVOUS SYSTEM NEOPLASMS WITHOUT MCC Pediatric $6,075 – $11,605 · median $8,840 2 plans
056 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC $6,075 – $26,442 · median $16,258 2 plans
057 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC $6,075 – $14,747 · median $10,411 2 plans
058 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC $6,075 – $19,458 · median $12,766 2 plans
059 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC $6,075 – $14,124 · median $10,099 2 plans
060 MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC Pediatric $6,075 – $10,469 · median $8,272 2 plans
061 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric $6,075 – $31,381 · median $18,728 2 plans
062 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric $6,075 – $20,000 · median $13,038 2 plans
063 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC A Pediatric $6,075 – $15,978 · median $11,027 2 plans
064 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC $6,075 – $22,889 · median $14,482 2 plans
065 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS $6,075 – $11,499 · median $8,787 2 plans
066 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC Pediatric $6,075 – $7,790 · median $6,932 2 plans
067 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC Pediatric $6,075 – $16,717 · median $11,396 2 plans
068 PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC Pediatric $6,075 – $9,839 · median $7,957 2 plans
069 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC Pediatric $6,075 – $9,092 · median $7,583 2 plans
070 OTHER CEREBROVASCULAR DISORDERS WITH MCC Pediatric $6,075 – $18,949 · median $12,512 2 plans
071 OTHER CEREBROVASCULAR DISORDERS WITH CC Pediatric $6,075 – $11,678 · median $8,876 2 plans
072 OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC $6,075 – $8,607 · median $7,341 2 plans
073 CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC Pediatric $6,075 – $18,260 · median $12,168 2 plans
074 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC $6,075 – $11,733 · median $8,904 2 plans
075 VIRAL MENINGITIS WITH CC/MCC Pediatric $6,075 – $21,825 · median $13,950 2 plans
076 VIRAL MENINGITIS WITHOUT CC/MCC $6,075 – $9,392 · median $7,734 2 plans
080 NONTRAUMATIC STUPOR AND COMA WITH MCC Pediatric $6,075 – $20,601 · median $13,338 2 plans
081 NONTRAUMATIC STUPOR AND COMA WITHOUT MCC Pediatric $6,075 – $10,194 · median $8,134 2 plans
082 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC $26,015 – $27,064 · median $26,539 2 plans
083 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC $15,887 – $17,866 · median $16,877 2 plans
084 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC $10,879 – $12,250 · median $11,564 2 plans
085 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC $25,859 – $27,885 · median $26,872 2 plans
086 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC $14,827 – $17,711 · median $16,269 2 plans
087 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC $10,411 – $12,250 · median $11,331 2 plans
088 CONCUSSION WITH MCC Pediatric $6,075 – $15,386 · median $10,731 2 plans
089 CONCUSSION WITH CC $6,075 – $12,504 · median $9,290 2 plans
090 CONCUSSION WITHOUT CC/MCC Pediatric $6,075 – $9,370 · median $7,722 2 plans
091 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC Pediatric $6,075 – $19,989 · median $13,032 2 plans
092 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC $6,075 – $11,644 · median $8,859 2 plans
093 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC $6,075 – $9,063 · median $7,569 2 plans
094 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC Pediatric $6,075 – $40,058 · median $23,066 2 plans
095 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC Pediatric $6,075 – $29,356 · median $17,716 2 plans
096 BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC $6,075 – $29,356 · median $17,716 2 plans
097 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC $6,075 – $41,110 · median $23,592 2 plans
098 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC $6,075 – $26,121 · median $16,098 2 plans
099 NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC $6,075 – $15,507 · median $10,791 2 plans
100 SEIZURES WITH MCC $6,075 – $22,045 · median $14,060 2 plans
101 SEIZURES WITHOUT MCC Pediatric $6,075 – $10,273 · median $8,174 2 plans
102 HEADACHES WITH MCC $6,075 – $12,758 · median $9,417 2 plans
103 HEADACHES WITHOUT MCC Pediatric $6,075 – $9,519 · median $7,797 2 plans
113 ORBITAL PROCEDURES WITH CC/MCC Pediatric $12,121 – $26,760 · median $19,441 2 plans
114 ORBITAL PROCEDURES WITHOUT CC/MCC $12,121 – $15,400 · median $13,760 2 plans
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT Pediatric $12,121 – $17,470 · median $14,796 2 plans
116 INTRAOCULAR PROCEDURES WITH CC/MCC $12,121 – $20,580 · median $16,350 2 plans
117 INTRAOCULAR PROCEDURES WITHOUT CC/MCC $12,121 – $12,348 · median $12,235 2 plans
121 ACUTE MAJOR EYE INFECTIONS WITH CC/MCC $6,075 – $13,241 · median $9,658 2 plans
122 ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC $6,075 – $8,944 · median $7,509 2 plans
123 NEUROLOGICAL EYE DISORDERS $6,075 – $9,090 · median $7,582 2 plans
124 OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT $6,075 – $15,060 · median $10,567 2 plans
125 OTHER DISORDERS OF THE EYE WITHOUT MCC Pediatric $6,075 – $8,739 · median $7,407 2 plans
135 SINUS AND MASTOID PROCEDURES WITH CC/MCC Pediatric $12,121 – $24,699 · median $18,410 2 plans
136 SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC Pediatric $11,556 – $12,121 · median $11,839 2 plans
137 MOUTH PROCEDURES WITH CC/MCC Pediatric $12,121 – $16,996 · median $14,558 2 plans
138 MOUTH PROCEDURES WITHOUT CC/MCC $10,087 – $12,121 · median $11,104 2 plans
139 SALIVARY GLAND PROCEDURES $12,121 – $14,065 · median $13,093 2 plans
140 MAJOR HEAD AND NECK PROCEDURES WITH MCC $12,121 – $48,548 · median $30,334 2 plans
141 MAJOR HEAD AND NECK PROCEDURES WITH CC Pediatric $12,121 – $24,825 · median $18,473 2 plans
142 MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC $12,121 – $18,170 · median $15,146 2 plans
143 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC $12,121 – $42,644 · median $27,382 2 plans
144 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC $12,121 – $19,724 · median $15,922 2 plans
145 OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $13,685 · median $12,903 2 plans
146 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC Pediatric $6,075 – $24,100 · median $15,088 2 plans
147 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC Pediatric $6,075 – $14,472 · median $10,274 2 plans
148 EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC Pediatric $6,075 – $9,073 · median $7,574 2 plans
149 DYSEQUILIBRIUM $6,075 – $8,555 · median $7,315 2 plans
150 EPISTAXIS WITH MCC $6,075 – $15,155 · median $10,615 2 plans
151 EPISTAXIS WITHOUT MCC Pediatric $6,075 – $8,354 · median $7,215 2 plans
152 OTITIS MEDIA AND URI WITH MCC $6,075 – $13,456 · median $9,765 2 plans
153 OTITIS MEDIA AND URI WITHOUT MCC $6,075 – $8,402 · median $7,239 2 plans
154 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC Pediatric $6,075 – $17,796 · median $11,935 2 plans
155 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC Pediatric $6,075 – $10,432 · median $8,253 2 plans
156 OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC $6,075 – $7,866 · median $6,971 2 plans
157 DENTAL AND ORAL DISEASES WITH MCC $6,075 – $19,541 · median $12,808 2 plans
158 DENTAL AND ORAL DISEASES WITH CC $6,075 – $10,355 · median $8,215 2 plans
159 DENTAL AND ORAL DISEASES WITHOUT CC/MCC $6,075 – $8,064 · median $7,070 2 plans
163 MAJOR CHEST PROCEDURES WITH MCC Pediatric $12,121 – $51,012 · median $31,566 2 plans
164 MAJOR CHEST PROCEDURES WITH CC Pediatric $12,121 – $28,728 · median $20,425 2 plans
165 MAJOR CHEST PROCEDURES WITHOUT CC/MCC $12,121 – $21,787 · median $16,954 2 plans
166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC Pediatric $12,121 – $42,543 · median $27,332 2 plans
167 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC $12,121 – $20,526 · median $16,324 2 plans
168 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,552 · median $13,837 2 plans
173 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY Pediatric $12,121 – $33,877 · median $22,999 2 plans
175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE Pediatric $6,075 – $15,634 · median $10,855 2 plans
176 PULMONARY EMBOLISM WITHOUT MCC $6,075 – $9,163 · median $7,619 2 plans
178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC $6,075 – $11,109 · median $8,592 2 plans
179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC $6,075 – $8,593 · median $7,334 2 plans
180 RESPIRATORY NEOPLASMS WITH MCC Pediatric $6,075 – $20,101 · median $13,088 2 plans
181 RESPIRATORY NEOPLASMS WITH CC Pediatric $6,075 – $12,190 · median $9,133 2 plans
182 RESPIRATORY NEOPLASMS WITHOUT CC/MCC $6,075 – $8,580 · median $7,327 2 plans
183 MAJOR CHEST TRAUMA WITH MCC $6,075 – $17,413 · median $11,744 2 plans
184 MAJOR CHEST TRAUMA WITH CC $6,075 – $12,112 · median $9,093 2 plans
185 MAJOR CHEST TRAUMA WITHOUT CC/MCC Pediatric $6,075 – $8,952 · median $7,513 2 plans
186 PLEURAL EFFUSION WITH MCC Pediatric $6,075 – $17,739 · median $11,907 2 plans
187 PLEURAL EFFUSION WITH CC Pediatric $6,075 – $11,258 · median $8,666 2 plans
188 PLEURAL EFFUSION WITHOUT CC/MCC Pediatric $6,075 – $8,163 · median $7,119 2 plans
189 PULMONARY EDEMA AND RESPIRATORY FAILURE Pediatric $6,075 – $14,061 · median $10,068 2 plans
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC $6,075 – $12,608 · median $9,341 2 plans
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC Pediatric $6,075 – $9,595 · median $7,835 2 plans
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC $6,075 – $7,307 · median $6,691 2 plans
196 INTERSTITIAL LUNG DISEASE WITH MCC Pediatric $6,075 – $21,480 · median $13,778 2 plans
197 INTERSTITIAL LUNG DISEASE WITH CC Pediatric $6,075 – $10,803 · median $8,439 2 plans
198 INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC Pediatric $6,075 – $8,152 · median $7,113 2 plans
199 PNEUMOTHORAX WITH MCC Pediatric $6,075 – $20,079 · median $13,077 2 plans
200 PNEUMOTHORAX WITH CC $6,075 – $12,512 · median $9,294 2 plans
201 PNEUMOTHORAX WITHOUT CC/MCC Pediatric $6,075 – $8,139 · median $7,107 2 plans
202 BRONCHITIS AND ASTHMA WITH CC/MCC Pediatric $6,075 – $11,054 · median $8,565 2 plans
203 BRONCHITIS AND ASTHMA WITHOUT CC/MCC Pediatric $6,075 – $7,626 · median $6,850 2 plans
204 RESPIRATORY SIGNS AND SYMPTOMS Pediatric $6,075 – $9,190 · median $7,632 2 plans
205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC Pediatric $6,075 – $20,840 · median $13,458 2 plans
206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC Pediatric $6,075 – $10,712 · median $8,393 2 plans
207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS $6,075 – $73,240 · median $39,657 2 plans
208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS Pediatric $6,075 – $31,286 · median $18,680 2 plans
213 ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES $64,956 – $157,633 · median $111,294 2 plans
239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC Pediatric $12,121 – $56,019 · median $34,070 2 plans
240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC Pediatric $12,121 – $32,444 · median $22,283 2 plans
241 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC Pediatric $12,121 – $15,757 · median $13,939 2 plans
242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC Pediatric $36,340 – $81,484 · median $58,912 2 plans
243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC $24,254 – $81,484 · median $52,869 2 plans
252 OTHER VASCULAR PROCEDURES WITH MCC Pediatric $30,394 – $39,704 · median $35,049 2 plans
253 OTHER VASCULAR PROCEDURES WITH CC $24,896 – $29,543 · median $27,220 2 plans
254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC Pediatric $20,279 – $24,896 · median $22,588 2 plans
255 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC $12,121 – $30,702 · median $21,411 2 plans
256 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC $12,121 – $19,326 · median $15,723 2 plans
257 UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC $12,121 – $12,431 · median $12,276 2 plans
263 VEIN LIGATION AND STRIPPING $33,618 – $34,799 · median $34,209 2 plans
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES $14,000 – $38,023 · median $26,011 2 plans
278 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES Pediatric $34,041 – $63,354 · median $48,698 2 plans
279 ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES $33,394 – $41,048 · median $37,221 2 plans
280 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC Pediatric $18,258 – $23,645 · median $20,951 2 plans
281 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC Pediatric $10,461 – $23,645 · median $17,053 2 plans
282 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC $8,230 – $23,645 · median $15,938 2 plans
283 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC $22,545 – $30,202 · median $26,374 2 plans
284 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC Pediatric $7,879 – $23,645 · median $15,762 2 plans
285 ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC $6,817 – $22,412 · median $14,614 2 plans
288 ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC $29,062 – $30,802 · median $29,932 2 plans
289 ACUTE AND SUBACUTE ENDOCARDITIS WITH CC $18,373 – $19,428 · median $18,900 2 plans
290 ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC $10,582 – $14,029 · median $12,305 2 plans
291 HEART FAILURE AND SHOCK WITH MCC $13,000 – $14,612 · median $13,806 2 plans
292 HEART FAILURE AND SHOCK WITH CC $9,663 – $15,613 · median $12,638 2 plans
293 HEART FAILURE AND SHOCK WITHOUT CC/MCC Pediatric $6,442 – $14,000 · median $10,221 2 plans
296 CARDIAC ARREST, UNEXPLAINED WITH MCC $6,075 – $17,778 · median $11,926 2 plans
297 CARDIAC ARREST, UNEXPLAINED WITH CC $6,075 – $7,216 · median $6,646 2 plans
298 CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC $5,180 – $6,075 · median $5,627 2 plans
299 PERIPHERAL VASCULAR DISORDERS WITH MCC $13,000 – $18,583 · median $15,792 2 plans
300 PERIPHERAL VASCULAR DISORDERS WITH CC Pediatric $12,150 – $13,000 · median $12,575 2 plans
301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC $8,192 – $13,000 · median $10,596 2 plans
302 ATHEROSCLEROSIS WITH MCC $6,075 – $13,620 · median $9,847 2 plans
303 ATHEROSCLEROSIS WITHOUT MCC Pediatric $6,075 – $7,662 · median $6,869 2 plans
304 HYPERTENSION WITH MCC $6,075 – $13,545 · median $9,810 2 plans
305 HYPERTENSION WITHOUT MCC $6,075 – $8,595 · median $7,335 2 plans
306 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC Pediatric $6,075 – $17,936 · median $12,005 2 plans
307 CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC Pediatric $6,075 – $10,394 · median $8,235 2 plans
308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC $6,075 – $13,704 · median $9,889 2 plans
309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC $6,075 – $8,374 · median $7,224 2 plans
310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC Pediatric $6,075 – $6,443 · median $6,259 2 plans
311 ANGINA PECTORIS $6,075 – $7,989 · median $7,032 2 plans
312 SYNCOPE AND COLLAPSE $6,075 – $9,921 · median $7,998 2 plans
313 CHEST PAIN Pediatric $8,195 – $9,000 · median $8,598 2 plans
314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC $6,075 – $23,734 · median $14,904 2 plans
315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC Pediatric $6,075 – $10,964 · median $8,520 2 plans
316 OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC $6,075 – $7,764 · median $6,919 2 plans
317 CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION $66,637 – $76,106 · median $71,371 2 plans
319 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC Pediatric $50,797 – $98,646 · median $74,721 2 plans
320 OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC Pediatric $27,377 – $56,478 · median $41,928 2 plans
326 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC $12,121 – $56,767 · median $34,444 2 plans
327 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC Pediatric $12,121 – $27,820 · median $19,970 2 plans
328 STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC $12,121 – $18,237 · median $15,179 2 plans
329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric $12,121 – $52,317 · median $32,219 2 plans
330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $12,121 – $27,285 · median $19,703 2 plans
331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $19,155 · median $15,638 2 plans
332 RECTAL RESECTION WITH MCC $12,121 – $41,211 · median $26,666 2 plans
333 RECTAL RESECTION WITH CC $12,121 – $26,659 · median $19,390 2 plans
334 RECTAL RESECTION WITHOUT CC/MCC $12,121 – $18,643 · median $15,382 2 plans
335 PERITONEAL ADHESIOLYSIS WITH MCC $12,121 – $40,644 · median $26,382 2 plans
336 PERITONEAL ADHESIOLYSIS WITH CC Pediatric $12,121 – $24,001 · median $18,061 2 plans
337 PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC $12,121 – $17,471 · median $14,796 2 plans
344 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC Pediatric $12,121 – $29,397 · median $20,759 2 plans
345 MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC $12,121 – $17,127 · median $14,624 2 plans
346 MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC $12,121 – $13,501 · median $12,811 2 plans
347 ANAL AND STOMAL PROCEDURES WITH MCC Pediatric $12,121 – $26,129 · median $19,125 2 plans
348 ANAL AND STOMAL PROCEDURES WITH CC Pediatric $12,121 – $14,897 · median $13,509 2 plans
349 ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC $9,909 – $12,121 · median $11,015 2 plans
350 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC $12,121 – $28,363 · median $20,242 2 plans
351 INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC Pediatric $12,121 – $17,352 · median $14,736 2 plans
352 INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $13,292 · median $12,706 2 plans
353 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC $12,121 – $33,031 · median $22,576 2 plans
354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC $12,121 – $19,149 · median $15,635 2 plans
355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC Pediatric $12,121 – $15,309 · median $13,715 2 plans
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC Pediatric $12,121 – $49,999 · median $31,060 2 plans
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC Pediatric $12,121 – $26,469 · median $19,295 2 plans
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,911 · median $14,016 2 plans
368 MAJOR ESOPHAGEAL DISORDERS WITH MCC Pediatric $6,075 – $18,119 · median $12,097 2 plans
369 MAJOR ESOPHAGEAL DISORDERS WITH CC $6,075 – $11,384 · median $8,730 2 plans
370 MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC $6,075 – $7,977 · median $7,026 2 plans
371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC Pediatric $6,075 – $20,181 · median $13,128 2 plans
372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC $6,075 – $11,621 · median $8,848 2 plans
373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC Pediatric $6,075 – $8,279 · median $7,177 2 plans
374 DIGESTIVE MALIGNANCY WITH MCC $6,075 – $24,343 · median $15,209 2 plans
375 DIGESTIVE MALIGNANCY WITH CC Pediatric $6,075 – $13,768 · median $9,921 2 plans
376 DIGESTIVE MALIGNANCY WITHOUT CC/MCC Pediatric $6,075 – $10,520 · median $8,298 2 plans
377 GASTROINTESTINAL HEMORRHAGE WITH MCC $6,075 – $20,806 · median $13,441 2 plans
378 GASTROINTESTINAL HEMORRHAGE WITH CC Pediatric $6,075 – $11,162 · median $8,619 2 plans
379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC $6,075 – $7,175 · median $6,625 2 plans
380 COMPLICATED PEPTIC ULCER WITH MCC Pediatric $6,075 – $22,334 · median $14,204 2 plans
381 COMPLICATED PEPTIC ULCER WITH CC Pediatric $6,075 – $12,332 · median $9,204 2 plans
382 COMPLICATED PEPTIC ULCER WITHOUT CC/MCC $6,075 – $9,112 · median $7,594 2 plans
383 UNCOMPLICATED PEPTIC ULCER WITH MCC Pediatric $6,075 – $15,715 · median $10,895 2 plans
384 UNCOMPLICATED PEPTIC ULCER WITHOUT MCC $6,075 – $9,729 · median $7,902 2 plans
385 INFLAMMATORY BOWEL DISEASE WITH MCC $6,075 – $18,010 · median $12,042 2 plans
386 INFLAMMATORY BOWEL DISEASE WITH CC $6,075 – $11,112 · median $8,594 2 plans
387 INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC $6,075 – $7,755 · median $6,915 2 plans
388 GASTROINTESTINAL OBSTRUCTION WITH MCC Pediatric $6,075 – $16,809 · median $11,442 2 plans
389 GASTROINTESTINAL OBSTRUCTION WITH CC $6,075 – $8,990 · median $7,532 2 plans
390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC $6,075 – $6,192 · median $6,133 2 plans
391 ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC $6,075 – $14,436 · median $10,255 2 plans
393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC $6,075 – $18,203 · median $12,139 2 plans
394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC Pediatric $6,075 – $10,650 · median $8,363 2 plans
395 OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric $6,075 – $7,387 · median $6,731 2 plans
397 APPENDIX PROCEDURES WITH MCC Pediatric $12,121 – $27,259 · median $19,690 2 plans
398 APPENDIX PROCEDURES WITH CC $12,121 – $17,228 · median $14,674 2 plans
399 APPENDIX PROCEDURES WITHOUT CC/MCC $12,121 – $13,029 · median $12,575 2 plans
402 SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL Pediatric $60,607 – $108,999 · median $84,803 2 plans
405 PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC Pediatric $12,121 – $62,265 · median $37,193 2 plans
406 PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC Pediatric $12,121 – $33,010 · median $22,566 2 plans
407 PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC $12,121 – $25,263 · median $18,692 2 plans
408 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH Pediatric $12,121 – $40,584 · median $26,352 2 plans
409 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH $12,121 – $24,782 · median $18,452 2 plans
410 BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH $12,121 – $18,071 · median $15,096 2 plans
411 CHOLECYSTECTOMY WITH C.D.E. WITH MCC Pediatric $12,121 – $37,598 · median $24,860 2 plans
412 CHOLECYSTECTOMY WITH C.D.E. WITH CC Pediatric $12,121 – $23,931 · median $18,026 2 plans
413 CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC $12,121 – $18,900 · median $15,510 2 plans
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC Pediatric $12,121 – $40,550 · median $26,335 2 plans
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC Pediatric $12,121 – $23,523 · median $17,822 2 plans
416 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC Pediatric $12,121 – $15,517 · median $13,819 2 plans
417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC $12,121 – $27,162 · median $19,642 2 plans
418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC Pediatric $12,121 – $19,254 · median $15,687 2 plans
419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC Pediatric $12,121 – $15,546 · median $13,833 2 plans
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC Pediatric $12,121 – $38,780 · median $25,450 2 plans
421 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC Pediatric $12,121 – $19,776 · median $15,949 2 plans
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,929 · median $14,025 2 plans
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC Pediatric $12,121 – $47,269 · median $29,695 2 plans
424 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC $12,121 – $24,903 · median $18,512 2 plans
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC $12,121 – $17,076 · median $14,599 2 plans
426 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT $60,607 – $291,857 · median $176,232 2 plans
427 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT Pediatric $60,607 – $197,890 · median $129,249 2 plans
428 MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WIT $60,607 – $153,351 · median $106,979 2 plans
429 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC Pediatric $60,607 – $232,379 · median $146,493 2 plans
430 COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC Pediatric $60,607 – $152,415 · median $106,511 2 plans
432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC $6,075 – $22,402 · median $14,239 2 plans
433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC $6,075 – $12,022 · median $9,048 2 plans
434 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC Pediatric $6,075 – $8,110 · median $7,092 2 plans
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC Pediatric $6,075 – $20,905 · median $13,490 2 plans
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC $6,075 – $12,874 · median $9,475 2 plans
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC $6,075 – $9,712 · median $7,894 2 plans
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC $6,075 – $18,555 · median $12,315 2 plans
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC $6,075 – $9,575 · median $7,825 2 plans
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric $6,075 – $7,073 · median $6,574 2 plans
441 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC $6,075 – $20,427 · median $13,251 2 plans
442 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC $6,075 – $10,987 · median $8,531 2 plans
443 DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT C $6,075 – $7,964 · median $7,019 2 plans
444 DISORDERS OF THE BILIARY TRACT WITH MCC Pediatric $6,075 – $19,018 · median $12,547 2 plans
445 DISORDERS OF THE BILIARY TRACT WITH CC $6,075 – $12,456 · median $9,266 2 plans
446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC $6,075 – $9,416 · median $7,746 2 plans
447 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALL Pediatric $36,089 – $186,801 · median $111,445 2 plans
448 MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC Pediatric $36,089 – $113,771 · median $74,930 2 plans
450 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY Pediatric $36,089 – $143,488 · median $89,789 2 plans
451 SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC $36,089 – $85,980 · median $61,035 2 plans
456 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX $60,607 – $145,308 · median $102,958 2 plans
457 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX Pediatric $60,607 – $145,308 · median $102,958 2 plans
458 SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EX $60,607 – $143,946 · median $102,277 2 plans
461 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC $62,863 – $74,995 · median $68,929 2 plans
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC Pediatric $30,276 – $71,888 · median $51,082 2 plans
463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE Pediatric $34,767 – $64,872 · median $49,819 2 plans
464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE $18,976 – $35,452 · median $27,214 2 plans
465 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE $20,757 – $24,469 · median $22,613 2 plans
466 REVISION OF HIP OR KNEE REPLACEMENT WITH MCC Pediatric $59,248 – $85,317 · median $72,282 2 plans
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC $34,524 – $37,225 · median $35,874 2 plans
471 CERVICAL SPINAL FUSION WITH MCC Pediatric $28,952 – $48,663 · median $38,808 2 plans
472 CERVICAL SPINAL FUSION WITH CC $28,952 – $48,003 · median $38,478 2 plans
473 CERVICAL SPINAL FUSION WITHOUT CC/MCC $28,952 – $48,003 · median $38,478 2 plans
474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric $12,121 – $48,862 · median $30,491 2 plans
475 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC $12,121 – $25,902 · median $19,012 2 plans
476 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC $12,121 – $13,433 · median $12,777 2 plans
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric $12,121 – $39,320 · median $25,721 2 plans
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric $12,121 – $27,991 · median $20,056 2 plans
479 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC $12,121 – $21,158 · median $16,640 2 plans
480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC Pediatric $32,428 – $33,148 · median $32,788 2 plans
481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC $23,840 – $32,891 · median $28,365 2 plans
482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC $18,564 – $32,735 · median $25,650 2 plans
483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES $12,121 – $31,550 · median $21,835 2 plans
485 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC Pediatric $18,905 – $36,731 · median $27,818 2 plans
486 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC $18,321 – $23,801 · median $21,061 2 plans
487 KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC $14,000 – $17,826 · median $15,913 2 plans
488 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC $14,000 – $20,134 · median $17,067 2 plans
489 KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC Pediatric $12,711 – $18,550 · median $15,631 2 plans
492 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC $17,093 – $41,790 · median $29,442 2 plans
493 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC $20,287 – $28,866 · median $24,576 2 plans
494 LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC Pediatric $17,713 – $22,838 · median $20,275 2 plans
495 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT Pediatric $36,456 – $41,268 · median $38,862 2 plans
496 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT $14,000 – $20,532 · median $17,266 2 plans
497 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WIT $13,753 – $16,696 · median $15,224 2 plans
498 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC Pediatric $12,121 – $34,337 · median $23,229 2 plans
499 LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT Pediatric $12,121 – $22,932 · median $17,527 2 plans
500 SOFT TISSUE PROCEDURES WITH MCC Pediatric $12,121 – $36,022 · median $24,071 2 plans
501 SOFT TISSUE PROCEDURES WITH CC $12,121 – $19,897 · median $16,009 2 plans
502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,319 · median $13,720 2 plans
503 FOOT PROCEDURES WITH MCC Pediatric $28,588 – $31,768 · median $30,178 2 plans
504 FOOT PROCEDURES WITH CC Pediatric $19,521 – $21,275 · median $20,398 2 plans
505 FOOT PROCEDURES WITHOUT CC/MCC $17,063 – $20,406 · median $18,734 2 plans
506 MAJOR THUMB OR JOINT PROCEDURES Pediatric $12,121 – $15,357 · median $13,739 2 plans
507 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC Pediatric $20,560 – $22,470 · median $21,515 2 plans
508 MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC Pediatric $17,237 – $17,640 · median $17,438 2 plans
510 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC Pediatric $29,676 – $34,379 · median $32,028 2 plans
511 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC Pediatric $17,301 – $23,668 · median $20,484 2 plans
512 SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/ Pediatric $14,692 – $18,842 · median $16,767 2 plans
513 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC $12,121 – $17,919 · median $15,020 2 plans
514 HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC Pediatric $11,636 – $12,121 · median $11,878 2 plans
515 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC $36,074 – $36,273 · median $36,174 2 plans
516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC $23,653 – $36,074 · median $29,863 2 plans
517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MC Pediatric $17,491 – $36,434 · median $26,962 2 plans
518 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROST Pediatric $24,856 – $42,538 · median $33,697 2 plans
519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC Pediatric $20,320 – $22,766 · median $21,543 2 plans
520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC $13,451 – $17,004 · median $15,227 2 plans
521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC Pediatric $32,669 – $35,793 · median $34,231 2 plans
522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC $24,104 – $35,793 · median $29,948 2 plans
533 FRACTURES OF FEMUR WITH MCC Pediatric $6,075 – $17,844 · median $11,959 2 plans
534 FRACTURES OF FEMUR WITHOUT MCC $6,075 – $9,175 · median $7,625 2 plans
535 FRACTURES OF HIP AND PELVIS WITH MCC $6,075 – $14,592 · median $10,333 2 plans
536 FRACTURES OF HIP AND PELVIS WITHOUT MCC Pediatric $6,075 – $9,192 · median $7,634 2 plans
537 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC Pediatric $6,075 – $10,862 · median $8,468 2 plans
538 SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC Pediatric $6,075 – $8,198 · median $7,137 2 plans
539 OSTEOMYELITIS WITH MCC Pediatric $6,075 – $22,419 · median $14,247 2 plans
540 OSTEOMYELITIS WITH CC Pediatric $6,075 – $14,754 · median $10,415 2 plans
541 OSTEOMYELITIS WITHOUT CC/MCC $6,075 – $8,962 · median $7,519 2 plans
542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric $6,075 – $20,106 · median $13,091 2 plans
543 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH $6,075 – $11,701 · median $8,888 2 plans
544 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH Pediatric $6,075 – $8,589 · median $7,332 2 plans
545 CONNECTIVE TISSUE DISORDERS WITH MCC Pediatric $6,075 – $28,247 · median $17,161 2 plans
546 CONNECTIVE TISSUE DISORDERS WITH CC Pediatric $6,075 – $13,128 · median $9,602 2 plans
547 CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC $6,075 – $9,518 · median $7,796 2 plans
548 SEPTIC ARTHRITIS WITH MCC Pediatric $6,075 – $21,978 · median $14,026 2 plans
549 SEPTIC ARTHRITIS WITH CC Pediatric $6,075 – $13,740 · median $9,908 2 plans
550 SEPTIC ARTHRITIS WITHOUT CC/MCC $6,075 – $9,949 · median $8,012 2 plans
551 MEDICAL BACK PROBLEMS WITH MCC $19,077 – $21,414 · median $20,246 2 plans
552 MEDICAL BACK PROBLEMS WITHOUT MCC $10,942 – $12,250 · median $11,596 2 plans
553 BONE DISEASES AND ARTHROPATHIES WITH MCC Pediatric $6,075 – $14,754 · median $10,415 2 plans
554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC Pediatric $6,075 – $9,448 · median $7,762 2 plans
555 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC $6,075 – $15,045 · median $10,560 2 plans
556 SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC $6,075 – $9,454 · median $7,764 2 plans
557 TENDONITIS, MYOSITIS AND BURSITIS WITH MCC $6,075 – $16,924 · median $11,499 2 plans
558 TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC $6,075 – $10,166 · median $8,121 2 plans
559 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC Pediatric $6,075 – $21,226 · median $13,651 2 plans
560 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC Pediatric $6,075 – $12,817 · median $9,446 2 plans
561 AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC Pediatric $6,075 – $9,150 · median $7,612 2 plans
562 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric $6,075 – $16,217 · median $11,146 2 plans
563 FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WIT Pediatric $6,075 – $10,193 · median $8,134 2 plans
564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC Pediatric $6,075 – $17,569 · median $11,822 2 plans
565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC $6,075 – $11,091 · median $8,583 2 plans
566 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC $6,075 – $8,529 · median $7,302 2 plans
570 SKIN DEBRIDEMENT WITH MCC $12,121 – $33,476 · median $22,798 2 plans
571 SKIN DEBRIDEMENT WITH CC $12,121 – $19,230 · median $15,675 2 plans
572 SKIN DEBRIDEMENT WITHOUT CC/MCC $12,121 – $13,047 · median $12,584 2 plans
573 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC $12,121 – $74,568 · median $43,345 2 plans
574 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric $12,121 – $39,511 · median $25,816 2 plans
575 SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC Pediatric $12,121 – $20,453 · median $16,287 2 plans
576 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC $12,121 – $55,785 · median $33,953 2 plans
577 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC Pediatric $12,121 – $30,170 · median $21,146 2 plans
578 SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC $12,121 – $18,284 · median $15,203 2 plans
579 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC Pediatric $12,121 – $36,861 · median $24,491 2 plans
580 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC $12,121 – $19,668 · median $15,895 2 plans
581 OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $16,425 · median $14,273 2 plans
582 MASTECTOMY FOR MALIGNANCY WITH CC/MCC $12,121 – $21,929 · median $17,025 2 plans
583 MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC $12,121 – $19,627 · median $15,874 2 plans
584 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC Pediatric $12,121 – $24,365 · median $18,243 2 plans
585 BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC $12,121 – $21,957 · median $17,039 2 plans
592 SKIN ULCERS WITH MCC Pediatric $6,075 – $22,028 · median $14,051 2 plans
593 SKIN ULCERS WITH CC $6,075 – $13,502 · median $9,789 2 plans
594 SKIN ULCERS WITHOUT CC/MCC $6,075 – $9,866 · median $7,970 2 plans
595 MAJOR SKIN DISORDERS WITH MCC $6,075 – $24,138 · median $15,106 2 plans
596 MAJOR SKIN DISORDERS WITHOUT MCC $6,075 – $12,321 · median $9,198 2 plans
597 MALIGNANT BREAST DISORDERS WITH MCC Pediatric $6,075 – $18,975 · median $12,525 2 plans
598 MALIGNANT BREAST DISORDERS WITH CC $6,075 – $12,876 · median $9,476 2 plans
599 MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric $6,075 – $8,757 · median $7,416 2 plans
600 NON-MALIGNANT BREAST DISORDERS WITH CC/MCC Pediatric $6,075 – $11,855 · median $8,965 2 plans
601 NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC Pediatric $6,075 – $6,886 · median $6,481 2 plans
602 CELLULITIS WITH MCC Pediatric $6,075 – $16,177 · median $11,126 2 plans
604 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC $16,755 – $19,368 · median $18,062 2 plans
605 TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC $10,426 – $12,250 · median $11,338 2 plans
606 MINOR SKIN DISORDERS WITH MCC $6,075 – $17,223 · median $11,649 2 plans
607 MINOR SKIN DISORDERS WITHOUT MCC Pediatric $6,075 – $10,317 · median $8,196 2 plans
614 ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC Pediatric $12,121 – $24,947 · median $18,534 2 plans
615 ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC $12,121 – $15,927 · median $14,024 2 plans
616 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH $12,121 – $39,694 · median $25,907 2 plans
617 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH Pediatric $12,121 – $21,288 · median $16,704 2 plans
618 AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH $12,121 – $16,143 · median $14,132 2 plans
622 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR $12,121 – $40,511 · median $26,316 2 plans
623 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR Pediatric $12,121 – $20,418 · median $16,270 2 plans
624 SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISOR $12,121 – $14,249 · median $13,185 2 plans
625 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC Pediatric $12,121 – $34,375 · median $23,248 2 plans
626 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC $12,121 – $17,066 · median $14,594 2 plans
627 THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,119 · median $13,620 2 plans
628 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC $12,121 – $42,418 · median $27,270 2 plans
629 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC Pediatric $12,121 – $24,799 · median $18,460 2 plans
630 OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC $12,121 – $16,612 · median $14,367 2 plans
637 DIABETES WITH MCC $6,075 – $16,353 · median $11,214 2 plans
638 DIABETES WITH CC Pediatric $6,075 – $10,201 · median $8,138 2 plans
639 DIABETES WITHOUT CC/MCC Pediatric $6,075 – $7,071 · median $6,573 2 plans
640 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH M Pediatric $6,075 – $15,202 · median $10,638 2 plans
641 MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOU $6,075 – $8,857 · median $7,466 2 plans
642 INBORN AND OTHER DISORDERS OF METABOLISM Pediatric $6,075 – $16,186 · median $11,131 2 plans
643 ENDOCRINE DISORDERS WITH MCC Pediatric $6,075 – $18,736 · median $12,405 2 plans
644 ENDOCRINE DISORDERS WITH CC Pediatric $6,075 – $11,667 · median $8,871 2 plans
645 ENDOCRINE DISORDERS WITHOUT CC/MCC $6,075 – $8,745 · median $7,410 2 plans
650 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC $53,511 – $184,455 · median $118,983 2 plans
651 KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC $42,179 – $184,455 · median $113,317 2 plans
652 KIDNEY TRANSPLANT $36,758 – $184,455 · median $110,606 2 plans
653 MAJOR BLADDER PROCEDURES WITH MCC $12,121 – $59,145 · median $35,633 2 plans
654 MAJOR BLADDER PROCEDURES WITH CC $12,121 – $31,862 · median $21,991 2 plans
655 MAJOR BLADDER PROCEDURES WITHOUT CC/MCC $12,121 – $24,091 · median $18,106 2 plans
656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC $12,121 – $36,238 · median $24,180 2 plans
657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC $12,121 – $20,829 · median $16,475 2 plans
658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC Pediatric $17,382 – $17,663 · median $17,522 2 plans
659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC $28,921 – $36,738 · median $32,829 2 plans
660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC Pediatric $15,044 – $19,997 · median $17,520 2 plans
661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC Pediatric $11,785 – $14,000 · median $12,892 2 plans
662 MINOR BLADDER PROCEDURES WITH MCC $12,121 – $34,846 · median $23,483 2 plans
663 MINOR BLADDER PROCEDURES WITH CC $12,121 – $17,303 · median $14,712 2 plans
664 MINOR BLADDER PROCEDURES WITHOUT CC/MCC Pediatric $11,916 – $12,121 · median $12,018 2 plans
665 PROSTATECTOMY WITH MCC $12,121 – $35,526 · median $23,823 2 plans
666 PROSTATECTOMY WITH CC Pediatric $12,121 – $19,911 · median $16,016 2 plans
667 PROSTATECTOMY WITHOUT CC/MCC $12,121 – $12,591 · median $12,356 2 plans
668 TRANSURETHRAL PROCEDURES WITH MCC $12,121 – $33,235 · median $22,678 2 plans
669 TRANSURETHRAL PROCEDURES WITH CC Pediatric $12,121 – $17,665 · median $14,893 2 plans
670 TRANSURETHRAL PROCEDURES WITHOUT CC/MCC Pediatric $11,124 – $12,121 · median $11,622 2 plans
671 URETHRAL PROCEDURES WITH CC/MCC Pediatric $12,121 – $20,431 · median $16,276 2 plans
672 URETHRAL PROCEDURES WITHOUT CC/MCC $12,121 – $12,287 · median $12,204 2 plans
673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC Pediatric $12,121 – $47,823 · median $29,972 2 plans
674 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC Pediatric $12,121 – $26,618 · median $19,369 2 plans
675 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $18,682 · median $15,402 2 plans
682 RENAL FAILURE WITH MCC $6,075 – $16,857 · median $11,466 2 plans
684 RENAL FAILURE WITHOUT CC/MCC Pediatric $6,075 – $6,833 · median $6,454 2 plans
686 KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC Pediatric $6,075 – $20,530 · median $13,302 2 plans
687 KIDNEY AND URINARY TRACT NEOPLASMS WITH CC $6,075 – $11,926 · median $9,001 2 plans
688 KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC $6,075 – $8,995 · median $7,535 2 plans
693 URINARY STONES WITH MCC $15,303 – $15,684 · median $15,494 2 plans
694 URINARY STONES WITHOUT MCC $8,897 – $13,990 · median $11,444 2 plans
695 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC $6,075 – $13,019 · median $9,547 2 plans
696 KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC Pediatric $6,075 – $7,842 · median $6,959 2 plans
697 URETHRAL STRICTURE Pediatric $6,075 – $12,268 · median $9,171 2 plans
699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC Pediatric $6,075 – $11,553 · median $8,814 2 plans
700 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC $6,075 – $7,852 · median $6,964 2 plans
707 MAJOR MALE PELVIC PROCEDURES WITH CC/MCC $19,449 – $22,767 · median $21,108 2 plans
708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC Pediatric $17,462 – $19,626 · median $18,544 2 plans
709 PENIS PROCEDURES WITH CC/MCC Pediatric $12,121 – $26,487 · median $19,304 2 plans
710 PENIS PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,948 · median $14,035 2 plans
711 TESTES PROCEDURES WITH CC/MCC Pediatric $12,121 – $23,718 · median $17,919 2 plans
712 TESTES PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $12,517 · median $12,319 2 plans
713 TRANSURETHRAL PROSTATECTOMY WITH CC/MCC Pediatric $12,121 – $17,112 · median $14,616 2 plans
714 TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC Pediatric $12,035 – $12,121 · median $12,078 2 plans
715 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC $12,121 – $25,465 · median $18,793 2 plans
716 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC $12,121 – $16,743 · median $14,432 2 plans
717 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC $12,121 – $21,518 · median $16,819 2 plans
718 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC Pediatric $12,121 – $15,287 · median $13,704 2 plans
722 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC $6,075 – $20,598 · median $13,337 2 plans
723 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC Pediatric $6,075 – $13,006 · median $9,541 2 plans
724 MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC Pediatric $6,075 – $7,463 · median $6,769 2 plans
725 BENIGN PROSTATIC HYPERTROPHY WITH MCC Pediatric $6,075 – $13,319 · median $9,697 2 plans
726 BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC Pediatric $6,075 – $8,218 · median $7,146 2 plans
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC Pediatric $6,075 – $16,878 · median $11,477 2 plans
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC $6,075 – $9,233 · median $7,654 2 plans
729 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC Pediatric $6,075 – $12,050 · median $9,063 2 plans
730 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC Pediatric $6,075 – $7,649 · median $6,862 2 plans
734 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC $12,121 – $24,244 · median $18,182 2 plans
735 PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC $12,121 – $15,314 · median $13,718 2 plans
736 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC $12,121 – $40,685 · median $26,403 2 plans
737 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC $12,121 – $23,454 · median $17,787 2 plans
738 UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC $12,121 – $16,714 · median $14,418 2 plans
739 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MC $40,779 – $44,366 · median $42,573 2 plans
740 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC $16,485 – $20,597 · median $18,541 2 plans
741 UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT $13,554 – $16,232 · median $14,893 2 plans
742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC $16,109 – $20,884 · median $18,496 2 plans
743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC Pediatric $14,000 – $14,122 · median $14,061 2 plans
744 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC $12,121 – $23,323 · median $17,722 2 plans
745 D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC $12,121 – $12,947 · median $12,534 2 plans
746 VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC Pediatric $12,121 – $19,772 · median $15,946 2 plans
747 VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC Pediatric $9,785 – $12,121 · median $10,953 2 plans
748 FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES Pediatric $14,000 – $15,790 · median $14,895 2 plans
749 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC $12,121 – $29,224 · median $20,673 2 plans
750 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC $12,121 – $16,798 · median $14,459 2 plans
754 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC $6,075 – $20,962 · median $13,519 2 plans
755 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC Pediatric $6,075 – $12,381 · median $9,228 2 plans
756 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,075 – $10,932 · median $8,504 2 plans
757 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC Pediatric $6,075 – $16,298 · median $11,186 2 plans
758 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC $6,075 – $11,143 · median $8,609 2 plans
759 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC $6,075 – $7,553 · median $6,814 2 plans
760 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC $6,075 – $11,467 · median $8,771 2 plans
761 MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC Pediatric $6,075 – $6,493 · median $6,284 2 plans
769 POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES $12,121 – $19,233 · median $15,677 2 plans
770 ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY $11,413 – $12,121 · median $11,767 2 plans
776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES Pediatric $6,075 – $7,452 · median $6,763 2 plans
779 ABORTION WITHOUT D&C Pediatric $6,075 – $9,576 · median $7,825 2 plans
799 SPLENIC PROCEDURES WITH MCC Pediatric $12,121 – $51,548 · median $31,834 2 plans
800 SPLENIC PROCEDURES WITH CC $12,121 – $31,977 · median $22,049 2 plans
801 SPLENIC PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $21,727 · median $16,924 2 plans
802 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC $12,121 – $45,347 · median $28,734 2 plans
803 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC Pediatric $12,121 – $21,158 · median $16,640 2 plans
804 OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC Pediatric $12,121 – $15,434 · median $13,777 2 plans
808 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric $6,075 – $25,130 · median $15,603 2 plans
809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO $6,075 – $14,408 · median $10,242 2 plans
810 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND CO Pediatric $6,075 – $11,912 · median $8,994 2 plans
811 RED BLOOD CELL DISORDERS WITH MCC $6,075 – $15,984 · median $11,029 2 plans
812 RED BLOOD CELL DISORDERS WITHOUT MCC Pediatric $6,075 – $10,451 · median $8,263 2 plans
813 COAGULATION DISORDERS Pediatric $6,075 – $17,361 · median $11,718 2 plans
814 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC $6,075 – $24,206 · median $15,141 2 plans
815 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC $6,075 – $11,541 · median $8,808 2 plans
816 RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC $6,075 – $7,193 · median $6,634 2 plans
820 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC $12,121 – $66,753 · median $39,437 2 plans
821 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC Pediatric $12,121 – $25,480 · median $18,800 2 plans
822 LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC $12,121 – $13,704 · median $12,912 2 plans
823 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC $12,121 – $52,184 · median $32,153 2 plans
824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC $12,121 – $25,787 · median $18,954 2 plans
825 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,359 · median $13,740 2 plans
826 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric $12,121 – $53,243 · median $32,682 2 plans
827 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. Pediatric $12,121 – $26,306 · median $19,214 2 plans
828 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. $12,121 – $19,393 · median $15,757 2 plans
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric $12,121 – $35,967 · median $24,044 2 plans
830 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCE Pediatric $12,121 – $17,130 · median $14,625 2 plans
834 ACUTE LEUKEMIA WITH MCC $6,075 – $62,486 · median $34,281 2 plans
835 ACUTE LEUKEMIA WITH CC $6,075 – $23,741 · median $14,908 2 plans
836 ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric $6,075 – $13,880 · median $9,978 2 plans
837 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOT Pediatric $6,075 – $54,683 · median $30,379 2 plans
838 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHE Pediatric $6,075 – $23,759 · median $14,917 2 plans
839 CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC Pediatric $6,075 – $16,434 · median $11,255 2 plans
840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC $6,075 – $36,820 · median $21,447 2 plans
841 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC Pediatric $6,075 – $18,569 · median $12,322 2 plans
842 LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC Pediatric $6,075 – $11,500 · median $8,788 2 plans
843 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric $6,075 – $22,705 · median $14,390 2 plans
844 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES $6,075 – $13,856 · median $9,966 2 plans
845 OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES Pediatric $6,075 – $9,693 · median $7,884 2 plans
846 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC Pediatric $6,075 – $29,508 · median $17,791 2 plans
847 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC Pediatric $6,075 – $14,890 · median $10,482 2 plans
848 CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC $6,075 – $9,668 · median $7,871 2 plans
849 RADIOTHERAPY $6,075 – $30,840 · median $18,457 2 plans
850 ACUTE LEUKEMIA WITH OTHER PROCEDURES Pediatric $12,121 – $98,562 · median $55,342 2 plans
853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC $12,121 – $56,211 · median $34,166 2 plans
855 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC $12,121 – $17,041 · median $14,581 2 plans
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC $12,121 – $51,773 · median $31,947 2 plans
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC $12,121 – $24,375 · median $18,248 2 plans
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric $12,121 – $15,854 · median $13,987 2 plans
862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC $6,075 – $20,757 · median $13,416 2 plans
863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC $6,075 – $11,358 · median $8,717 2 plans
864 FEVER AND INFLAMMATORY CONDITIONS Pediatric $6,075 – $10,104 · median $8,089 2 plans
865 VIRAL ILLNESS WITH MCC $6,075 – $17,054 · median $11,564 2 plans
866 VIRAL ILLNESS WITHOUT MCC $6,075 – $9,898 · median $7,986 2 plans
867 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC $6,075 – $23,825 · median $14,950 2 plans
868 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC Pediatric $6,075 – $11,736 · median $8,905 2 plans
869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC Pediatric $6,075 – $8,305 · median $7,190 2 plans
870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS Pediatric $6,075 – $78,670 · median $42,373 2 plans
876 O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS Pediatric $12,121 – $43,990 · median $28,056 2 plans
901 WOUND DEBRIDEMENTS FOR INJURIES WITH MCC Pediatric $12,121 – $47,766 · median $29,943 2 plans
902 WOUND DEBRIDEMENTS FOR INJURIES WITH CC $12,121 – $21,791 · median $16,956 2 plans
903 WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC Pediatric $12,121 – $13,312 · median $12,717 2 plans
904 SKIN GRAFTS FOR INJURIES WITH CC/MCC $12,121 – $41,807 · median $26,964 2 plans
905 SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC Pediatric $12,121 – $16,884 · median $14,503 2 plans
906 HAND PROCEDURES FOR INJURIES $12,121 – $22,358 · median $17,239 2 plans
907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC Pediatric $12,121 – $43,699 · median $27,910 2 plans
908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC $12,121 – $22,709 · median $17,415 2 plans
909 OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC Pediatric $12,121 – $14,941 · median $13,531 2 plans
913 TRAUMATIC INJURY WITH MCC $6,075 – $18,605 · median $12,340 2 plans
914 TRAUMATIC INJURY WITHOUT MCC $6,075 – $10,079 · median $8,077 2 plans
915 ALLERGIC REACTIONS WITH MCC Pediatric $6,075 – $19,140 · median $12,607 2 plans
916 ALLERGIC REACTIONS WITHOUT MCC Pediatric $6,075 – $7,584 · median $6,829 2 plans
917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC $6,075 – $17,852 · median $11,963 2 plans
918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC $6,075 – $9,756 · median $7,915 2 plans
919 COMPLICATIONS OF TREATMENT WITH MCC Pediatric $6,075 – $20,838 · median $13,457 2 plans
920 COMPLICATIONS OF TREATMENT WITH CC Pediatric $6,075 – $11,408 · median $8,742 2 plans
921 COMPLICATIONS OF TREATMENT WITHOUT CC/MCC Pediatric $6,075 – $7,835 · median $6,955 2 plans
922 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC Pediatric $6,075 – $19,912 · median $12,993 2 plans
923 OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC $6,075 – $11,583 · median $8,829 2 plans
939 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC Pediatric $12,121 – $41,300 · median $26,710 2 plans
940 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC $12,121 – $26,599 · median $19,360 2 plans
941 O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/ $12,121 – $23,079 · median $17,600 2 plans
947 SIGNS AND SYMPTOMS WITH MCC Pediatric $6,075 – $14,448 · median $10,262 2 plans
948 SIGNS AND SYMPTOMS WITHOUT MCC $6,075 – $9,111 · median $7,593 2 plans
949 AFTERCARE WITH CC/MCC $6,075 – $13,541 · median $9,808 2 plans
950 AFTERCARE WITHOUT CC/MCC $6,075 – $7,144 · median $6,610 2 plans
951 OTHER FACTORS INFLUENCING HEALTH STATUS Pediatric $6,075 – $6,328 · median $6,202 2 plans
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA Pediatric $76,613 – $119,847 · median $98,230 2 plans
956 LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA $42,830 – $79,373 · median $61,102 2 plans
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC $78,687 – $86,730 · median $82,708 2 plans
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC $47,963 – $61,634 · median $54,798 2 plans
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $33,510 – $37,962 · median $35,736 2 plans
963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC $31,116 – $31,689 · median $31,403 2 plans
964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC $17,444 – $19,651 · median $18,548 2 plans
965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC $10,705 – $14,000 · median $12,352 2 plans
969 HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC Pediatric $12,121 – $69,673 · median $40,897 2 plans
970 HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC Pediatric $12,121 – $30,019 · median $21,070 2 plans
974 HIV WITH MAJOR RELATED CONDITION WITH MCC Pediatric $6,075 – $32,848 · median $19,462 2 plans
975 HIV WITH MAJOR RELATED CONDITION WITH CC Pediatric $6,075 – $14,740 · median $10,407 2 plans
976 HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC $6,075 – $10,275 · median $8,175 2 plans
977 HIV WITH OR WITHOUT OTHER RELATED CONDITION $6,075 – $14,770 · median $10,423 2 plans
981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric $12,121 – $53,402 · median $32,762 2 plans
982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $12,121 – $27,983 · median $20,052 2 plans
983 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric $12,121 – $19,509 · median $15,815 2 plans
987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC Pediatric $12,121 – $39,022 · median $25,572 2 plans
988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC $12,121 – $18,707 · median $15,414 2 plans
989 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC Pediatric $12,121 – $13,649 · median $12,885 2 plans
001 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC $363,230 – $363,230 · median $363,230 1 plans
002 HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC $363,230 – $363,230 · median $363,230 1 plans
003 ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH $206,553 – $206,553 · median $206,553 1 plans
004 TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC $206,553 – $206,553 · median $206,553 1 plans
005 LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT $117,354 – $117,354 · median $117,354 1 plans
006 LIVER TRANSPLANT WITHOUT MCC $52,778 – $52,778 · median $52,778 1 plans
007 LUNG TRANSPLANT $147,399 – $147,399 · median $147,399 1 plans
008 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT $63,792 – $63,792 · median $63,792 1 plans
010 PANCREAS TRANSPLANT $81,674 – $81,674 · median $81,674 1 plans
014 ALLOGENEIC BONE MARROW TRANSPLANT $136,788 – $136,788 · median $136,788 1 plans
016 AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC $67,492 – $67,492 · median $67,492 1 plans
017 AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC $61,830 – $61,830 · median $61,830 1 plans
018 CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES $491,507 – $491,507 · median $491,507 1 plans
019 SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS $81,206 – $81,206 · median $81,206 1 plans
765 CESAREAN SECTION W CC/MCC $8,182 – $8,182 · median $8,182 1 plans
766 CESAREAN SECTION W/O CC/MCC $8,182 – $8,182 · median $8,182 1 plans
767 VAGINAL DELIVERY W STERILIZATION &/OR D&C $5,536 – $5,536 · median $5,536 1 plans
774 VAGINAL DELIVERY W COMPLICATING DIAGNOSES $5,536 – $5,536 · median $5,536 1 plans
775 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES $5,536 – $5,536 · median $5,536 1 plans
795 NORMAL NEWBORN $1,254 – $1,254 · median $1,254 1 plans
817 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC Pediatric $25,969 – $25,969 · median $25,969 1 plans
818 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC Pediatric $13,194 – $13,194 · median $13,194 1 plans
819 OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC Pediatric $9,787 – $9,787 · median $9,787 1 plans
831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC Pediatric $13,687 – $13,687 · median $13,687 1 plans
832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC Pediatric $8,213 – $8,213 · median $8,213 1 plans
833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC Pediatric $5,952 – $5,952 · median $5,952 1 plans
927 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT Pediatric — 1 plans
928 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC Pediatric — 1 plans
929 FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC $12,121 – $12,121 · median $12,121 1 plans
933 EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT — 1 plans
934 FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY $6,075 – $6,075 · median $6,075 1 plans
935 NON-EXTENSIVE BURNS Pediatric $6,075 – $6,075 · median $6,075 1 plans
945 REHABILITATION WITH CC/MCC — 1 plans
946 REHABILITATION WITHOUT CC/MCC $2,613 – $2,613 · median $2,613 1 plans
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