| Psychoses | MS-DRG 885 | $11,501 |
| Hand X-ray 3 views | CPT 73130 | $85.34 |
| Knee X-ray 1-2 views | CPT 73560 | $85.34 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG 064 | $16,231 |
| Intracranial hemorrhage/CVA w CC | MS-DRG 065 | $8,297.23 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG 066 | $5,616.07 |
| Respiratory infections & inflammations w MCC | MS-DRG 177 | $13,190 |
| COPD w MCC | MS-DRG 190 | $9,162.94 |
| COPD w CC | MS-DRG 191 | $7,009.69 |
| COPD w/o CC/MCC | MS-DRG 192 | $5,280.71 |
| Simple pneumonia & pleurisy w CC | MS-DRG 194 | $6,690.68 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG 195 | $5,080.83 |
| AMI discharged alive w MCC | MS-DRG 280 | $13,393 |
| AMI discharged alive w CC | MS-DRG 281 | $7,521.3 |
| AMI discharged alive w/o CC/MCC | MS-DRG 282 | $5,916.33 |
| Heart failure & shock w MCC | MS-DRG 291 | $10,646 |
| Heart failure & shock w CC | MS-DRG 292 | $7,026.84 |
| Heart failure & shock w/o CC/MCC | MS-DRG 293 | $4,477.03 |
| Cardiac arrhythmia w MCC | MS-DRG 308 | $9,839.34 |
| Cardiac arrhythmia w CC | MS-DRG 309 | $6,032.21 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG 310 | $4,565.15 |
| GI hemorrhage w CC | MS-DRG 378 | $8,044.29 |
| GI hemorrhage w/o CC/MCC | MS-DRG 379 | $5,195.04 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG 392 | $6,366.74 |
| Fractures of femur w/o MCC | MS-DRG 533 | $12,442 |
| Kidney/UTI w MCC | MS-DRG 689 | $9,548.87 |
| Kidney/UTI w/o MCC | MS-DRG 690 | $6,548.68 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG 871 | $16,009 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG 872 | $8,412.26 |
| Tissue exam by pathologist level IV | CPT 88305 | $50.89 |
| Upper GI endoscopy diagnostic | CPT 43235 | $851.37 |
| Upper GI endoscopy with biopsy | CPT 43239 | $851.37 |
| Sigmoidoscopy diagnostic | CPT 45330 | $858.4 |
| Sigmoidoscopy with biopsy | CPT 45331 | $858.4 |
| Colonoscopy diagnostic | CPT 45378 | $858.4 |
| Colonoscopy with biopsy | CPT 45380 | $1,108.33 |
| Colonoscopy with polyp removal | CPT 45385 | $1,108.33 |
| Total shoulder arthroplasty | CPT 23472 | $17,503 |
| Total hip replacement | CPT 27130 | $12,361 |
| Total knee replacement | CPT 27447 | $12,361 |
| Shoulder arthroscopy with rotator cuff repair | CPT 29827 | $6,719.13 |
| Knee arthroscopy with meniscectomy | CPT 29881 | $3,040.05 |
| ACL reconstruction | CPT 29888 | $6,719.13 |
| Major small/large bowel procedures w MCC | MS-DRG 329 | $37,467 |
| Major small/large bowel procedures w CC | MS-DRG 330 | $19,286 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG 331 | $13,471 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG 418 | $13,531 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG 419 | $10,751 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG 420 | $28,798 |
| Laparoscopic appendectomy | CPT 44970 | $5,419.2 |
| Major joint replacement w MCC | MS-DRG 469 | $26,670 |
| Major joint replacement w/o MCC | MS-DRG 470 | $15,384 |
| Laparoscopic cholecystectomy | CPT 47562 | $5,419.2 |
| Lap cholecystectomy with cholangiography | CPT 47563 | $5,419.2 |
| Hip & femur procedures except major joint w MCC | MS-DRG 480 | $23,997 |
| Hip & femur procedures except major joint w CC | MS-DRG 481 | $16,930 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG 482 | $12,944 |
| Lap inguinal hernia repair | CPT 49650 | $5,419.2 |
| Vaginal hysterectomy | CPT 58260 | $4,671.52 |
| Lap-assisted vaginal hysterectomy >250g | CPT 58552 | $9,667.91 |
| Lap salpingo-oophorectomy | CPT 58661 | $5,419.2 |
| OR procedure for obesity w MCC | MS-DRG 619 | $22,246 |
| OR procedure for obesity w CC | MS-DRG 620 | $13,030 |
| OR procedure for obesity w/o CC/MCC | MS-DRG 621 | $11,927 |
| Complex cataract surgery | CPT 66982 | $2,188.68 |
| Cataract surgery with lens implant | CPT 66984 | $2,188.68 |
| Vitrectomy mechanical | CPT 67042 | $3,818.66 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG 743 | $9,780.6 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG 744 | $15,943 |
