| Psychoses | MS-DRG 885 | $12,440 |
| EKG tracing only | CPT 93005 | $58.93 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG 064 | $18,692 |
| Intracranial hemorrhage/CVA w CC | MS-DRG 065 | $9,773.7 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG 066 | $6,681.63 |
| Respiratory infections & inflammations w MCC | MS-DRG 177 | $15,433 |
| COPD w MCC | MS-DRG 190 | $10,597 |
| COPD w CC | MS-DRG 191 | $8,163.98 |
| COPD w/o CC/MCC | MS-DRG 192 | $6,353.55 |
| Simple pneumonia & pleurisy w CC | MS-DRG 194 | $7,906.28 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG 195 | $6,157.99 |
| AMI discharged alive w MCC | MS-DRG 280 | $16,240 |
| AMI discharged alive w CC | MS-DRG 281 | $9,326.48 |
| AMI discharged alive w/o CC/MCC | MS-DRG 282 | $7,403.97 |
| Heart failure & shock w MCC | MS-DRG 291 | $12,346 |
| Heart failure & shock w CC | MS-DRG 292 | $8,236.1 |
| Heart failure & shock w/o CC/MCC | MS-DRG 293 | $5,567.25 |
| Cardiac arrhythmia w MCC | MS-DRG 308 | $11,560 |
| Cardiac arrhythmia w CC | MS-DRG 309 | $7,161.04 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG 310 | $5,653.44 |
| GI hemorrhage w CC | MS-DRG 378 | $9,460.22 |
| GI hemorrhage w/o CC/MCC | MS-DRG 379 | $6,269.73 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG 392 | $7,554.33 |
| Fractures of femur w/o MCC | MS-DRG 533 | $14,632 |
| Kidney/UTI w MCC | MS-DRG 689 | $11,293 |
| Kidney/UTI w/o MCC | MS-DRG 690 | $7,759.15 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG 871 | $18,455 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG 872 | $9,903.52 |
| Comprehensive metabolic panel | CPT 80053 | $11.09 |
| Complete blood count with automated differential | CPT 85025 | $8.16 |
| Tissue exam by pathologist level IV | CPT 88305 | $52.21 |
| C-section delivery only | CPT 59514 | $3,046 |
| Upper GI endoscopy diagnostic | CPT 43235 | $956.41 |
| Upper GI endoscopy with biopsy | CPT 43239 | $956.41 |
| Sigmoidoscopy diagnostic | CPT 45330 | $879.44 |
| Sigmoidoscopy with biopsy | CPT 45331 | $922.38 |
| Colonoscopy diagnostic | CPT 45378 | $964.3 |
| Colonoscopy with biopsy | CPT 45380 | $1,245.07 |
| Colonoscopy with polyp removal | CPT 45385 | $1,245.07 |
| Total shoulder arthroplasty | CPT 23472 | $17,098 |
| Hip hemiarthroplasty | CPT 27125 | $6,546 |
| Total hip replacement | CPT 27130 | $13,282 |
| Total knee replacement | CPT 27447 | $13,282 |
| Knee revision arthroplasty single component | CPT 27486 | $6,546 |
| Knee revision arthroplasty all components | CPT 27487 | $6,546 |
| Shoulder arthroscopy with rotator cuff repair | CPT 29827 | $6,891.76 |
| Major small/large bowel procedures w MCC | MS-DRG 329 | $41,447 |
| Major small/large bowel procedures w CC | MS-DRG 330 | $21,966 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG 331 | $15,735 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG 418 | $15,719 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG 419 | $12,628 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG 420 | $31,017 |
| Laparoscopic appendectomy | CPT 44970 | $6,293.75 |
| Spinal fusion (non-cervical) w MCC | MS-DRG 459 | $68,382 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG 460 | $37,715 |
| Major joint replacement w MCC | MS-DRG 469 | $32,313 |
| Major joint replacement w/o MCC | MS-DRG 470 | $18,984 |
| Laparoscopic cholecystectomy | CPT 47562 | $5,823.12 |
| Lap cholecystectomy with cholangiography | CPT 47563 | $5,823.12 |
| Hip & femur procedures except major joint w MCC | MS-DRG 480 | $26,430 |
| Hip & femur procedures except major joint w CC | MS-DRG 481 | $18,838 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG 482 | $14,556 |
| Lap inguinal hernia repair | CPT 49650 | $6,087.8 |
| Total abdominal hysterectomy | CPT 58150 | $5,369 |
| Vaginal hysterectomy | CPT 58260 | $5,019.71 |
| Lap-assisted vaginal hysterectomy | CPT 58550 | $6,087.8 |
| Lap-assisted vaginal hysterectomy >250g | CPT 58552 | $9,904.96 |
| Lap salpingo-oophorectomy | CPT 58661 | $6,087.8 |
| OR procedure for obesity w MCC | MS-DRG 619 | $25,138 |
| OR procedure for obesity w CC | MS-DRG 620 | $15,599 |
| OR procedure for obesity w/o CC/MCC | MS-DRG 621 | $14,590 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG 743 | $11,174 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG 744 | $18,101 |
