| Psychoses | MS-DRG 885 | $14,878 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG 064 | $21,871 |
| Intracranial hemorrhage/CVA w CC | MS-DRG 065 | $11,275 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG 066 | $7,953.87 |
| Respiratory infections & inflammations w MCC | MS-DRG 177 | $17,773 |
| COPD w MCC | MS-DRG 190 | $12,224 |
| COPD w CC | MS-DRG 191 | $9,460.33 |
| COPD w/o CC/MCC | MS-DRG 192 | $7,596.6 |
| Simple pneumonia & pleurisy w CC | MS-DRG 194 | $9,120.66 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG 195 | $7,383.61 |
| AMI discharged alive w MCC | MS-DRG 280 | $17,937 |
| AMI discharged alive w CC | MS-DRG 281 | $10,353 |
| AMI discharged alive w/o CC/MCC | MS-DRG 282 | $8,304 |
| Heart failure & shock w MCC | MS-DRG 291 | $14,242 |
| Heart failure & shock w CC | MS-DRG 292 | $9,501.15 |
| Heart failure & shock w/o CC/MCC | MS-DRG 293 | $6,740.3 |
| Cardiac arrhythmia w MCC | MS-DRG 308 | $13,336 |
| Cardiac arrhythmia w CC | MS-DRG 309 | $8,416.49 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG 310 | $6,834.2 |
| GI hemorrhage w CC | MS-DRG 378 | $10,913 |
| GI hemorrhage w/o CC/MCC | MS-DRG 379 | $7,505.31 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG 392 | $8,753.66 |
| Fractures of femur w/o MCC | MS-DRG 533 | $16,939 |
| Kidney/UTI w MCC | MS-DRG 689 | $13,028 |
| Kidney/UTI w/o MCC | MS-DRG 690 | $8,968.04 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG 871 | $21,573 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG 872 | $11,425 |
| Tissue exam by pathologist level IV | CPT 88305 | $61.37 |
| Fetal non-stress test | CPT 59025 | $194.05 |
| Routine obstetric care with C-section | CPT 59510 | $3,597.78 |
| Office visit, established patient, 30-39 minutes | CPT 99214 | $227.23 |
| Upper GI endoscopy diagnostic | CPT 43235 | $1,163.16 |
| Upper GI endoscopy with biopsy | CPT 43239 | $1,163.16 |
| Sigmoidoscopy diagnostic | CPT 45330 | $890.04 |
| Sigmoidoscopy with biopsy | CPT 45331 | $1,130.54 |
| Colonoscopy diagnostic | CPT 45378 | $1,130.54 |
| Colonoscopy with biopsy | CPT 45380 | $1,486.25 |
| Colonoscopy with polyp removal | CPT 45385 | $1,486.25 |
| Total shoulder arthroplasty | CPT 23472 | $17,284 |
| Hip hemiarthroplasty | CPT 27125 | $5,388 |
| Total hip replacement | CPT 27130 | $14,887 |
| Total knee replacement | CPT 27447 | $14,887 |
| Knee revision arthroplasty single component | CPT 27486 | $5,388 |
| Knee revision arthroplasty all components | CPT 27487 | $5,388 |
| Shoulder arthroscopy with decompression | CPT 29826 | $4,856.5 |
| Shoulder arthroscopy with rotator cuff repair | CPT 29827 | $8,240.86 |
| Knee arthroscopy with meniscectomy | CPT 29881 | $4,051.43 |
| ACL reconstruction | CPT 29888 | $8,240.86 |
| Major small/large bowel procedures w MCC | MS-DRG 329 | $47,983 |
| Major small/large bowel procedures w CC | MS-DRG 330 | $25,795 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG 331 | $18,153 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG 418 | $18,134 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG 419 | $14,567 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG 420 | $35,506 |
| Open appendectomy | CPT 44950 | $7,016.81 |
| Laparoscopic appendectomy | CPT 44970 | $6,716.08 |
| Spinal fusion (non-cervical) w MCC | MS-DRG 459 | $73,572 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG 460 | $40,577 |
| Major joint replacement w MCC | MS-DRG 469 | $36,025 |
| Major joint replacement w/o MCC | MS-DRG 470 | $21,696 |
| Laparoscopic cholecystectomy | CPT 47562 | $7,153.89 |
| Lap cholecystectomy with cholangiography | CPT 47563 | $7,153.89 |
| Hip & femur procedures except major joint w MCC | MS-DRG 480 | $31,081 |
| Hip & femur procedures except major joint w CC | MS-DRG 481 | $22,389 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG 482 | $17,372 |
| Lap inguinal hernia repair | CPT 49650 | $6,716.08 |
| Total abdominal hysterectomy | CPT 58150 | $5,388 |
| Vaginal hysterectomy | CPT 58260 | $5,759.5 |
| Lap-assisted vaginal hysterectomy | CPT 58550 | $7,153.89 |
| Lap-assisted vaginal hysterectomy >250g | CPT 58552 | $10,430 |
| Lap salpingo-oophorectomy | CPT 58661 | $6,716.08 |
| OR procedure for obesity w MCC | MS-DRG 619 | $28,714 |
| OR procedure for obesity w CC | MS-DRG 620 | $17,995 |
| OR procedure for obesity w/o CC/MCC | MS-DRG 621 | $16,764 |
| Complex cataract surgery | CPT 66982 | $2,992.35 |
| Cataract surgery with lens implant | CPT 66984 | $2,992.35 |
| Intravitreal injection | CPT 67028 | $329.81 |
| Vitrectomy mechanical | CPT 67042 | $5,637.54 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG 743 | $12,890 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG 744 | $20,881 |
| PCI with drug-eluting stent | CPT 92928 | $12,672 |
