| behavioral |
| Psychoses | MS-DRG | 885 | 8 | — | — | $9,152.97 | $16,091 | 1.3× | $28,498 |
| emergency |
| ED visit level 1 | CPT | 99281 | 11 | $575 | $402.5 | $55.9 | $368 | 2.6× | $1,433 |
| ED visit level 2 | CPT | 99282 | 11 | $876 | $613.2 | $91.09 | $512.46 | 2.2× | $1,686 |
| ED visit level 3 | CPT | 99283 | 11 | $1,388 | $971.6 | $141.7 | $822.65 | 2.0× | $1,961 |
| ED visit level 4 | CPT | 99284 | 11 | $2,383 | $1,668.1 | $226.71 | $1,394.11 | 2.1× | $2,709 |
| ED visit level 5 | CPT | 99285 | 11 | $3,750 | $2,625 | $340.71 | $2,326.5 | 2.2× | $4,131 |
| Critical care, first hour | CPT | 99291 | 10 | $7,590 | $5,313 | $514.74 | $1,989.55 | 1.9× | $6,117.54 |
| imaging |
| CT head without contrast | CPT | 70450 | 10 | $2,836 | $1,985.2 | $80.98 | $112.78 | 0.54× | $2,285.82 |
| CT head with contrast | CPT | 70460 | 10 | $3,800 | $2,660 | $132.69 | $185.05 | 0.79× | $3,062.8 |
| CT head with and without contrast | CPT | 70470 | 10 | $4,481 | $3,136.7 | $132.69 | $185.05 | 0.69× | $3,611.69 |
| CT neck with contrast | CPT | 70491 | 10 | $3,725 | $2,607.5 | $132.69 | $185.05 | 0.68× | $3,002.35 |
| MRI brain without contrast | CPT | 70551 | 10 | $2,811 | $1,967.7 | $171.01 | $238.37 | 0.59× | $2,265.67 |
| MRI brain with contrast | CPT | 70552 | 10 | $5,020 | $3,514 | $247.87 | $839.42 | 1.8× | $4,046.12 |
| MRI brain with and without contrast | CPT | 70553 | 10 | $5,020 | $3,514 | $273.56 | $839.42 | 1.4× | $4,046.12 |
| Chest X-ray single view | CPT | 71045 | 10 | $376 | $263.2 | $42.89 | $86.49 | 0.91× | $376 |
| Chest X-ray 2 views | CPT | 71046 | 10 | $376 | $263.2 | $58.7 | $86.49 | 0.88× | $376 |
| Chest X-ray 3 views | CPT | 71047 | 10 | $376 | $263.2 | $60.12 | $94.24 | 0.98× | $376 |
| CT chest without contrast | CPT | 71250 | 10 | $2,099 | $1,469.3 | $80.98 | $112.78 | 0.52× | $1,691.8 |
| CT chest with contrast | CPT | 71260 | 10 | $3,479 | $2,435.3 | $132.69 | $185.05 | 0.66× | $2,804.08 |
| CT chest with and without contrast | CPT | 71270 | 10 | $3,896 | $2,727.2 | $132.69 | $185.05 | 0.63× | $3,140.18 |
| MRI chest without contrast | CPT | 71550 | 10 | $2,241 | $1,568.7 | $171.01 | $238.37 | 0.55× | $2,178.5 |
| MRI chest with contrast | CPT | 71551 | 10 | $3,362 | $2,353.4 | $531.47 | $735.01 | 0.90× | $2,709.78 |
| MRI chest with and without contrast | CPT | 71552 | 10 | $3,735 | $2,614.5 | $273.56 | $381.49 | 0.63× | $3,010.41 |
| Lumbosacral spine X-ray | CPT | 72100 | 10 | $741 | $518.7 | $73.59 | $112.78 | 1.1× | $741 |
| CT cervical spine without contrast | CPT | 72125 | 10 | $3,190 | $2,233 | $80.98 | $112.78 | 0.56× | $2,571.14 |
| CT thoracic spine without contrast | CPT | 72128 | 10 | $3,190 | $2,233 | $80.98 | $112.78 | 0.57× | $2,571.14 |
| CT lumbar spine without contrast | CPT | 72131 | 10 | $3,520 | $2,464 | $80.98 | $112.78 | 0.56× | $2,837.12 |
| MRI cervical spine without contrast | CPT | 72141 | 10 | $2,943 | $2,060.1 | $171.01 | $238.37 | 0.60× | $2,372.06 |
| MRI thoracic spine without contrast | CPT | 72146 | 10 | $3,334 | $2,333.8 | $171.01 | $238.37 | 0.64× | $2,687.21 |
| MRI lumbar spine without contrast | CPT | 72148 | 10 | $2,933 | $2,053.1 | $171.01 | $238.37 | 0.63× | $2,364 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 10 | $4,050 | $2,835 | $273.56 | $381.49 | 0.84× | $3,264.3 |
| MRI cervical spine with and without contrast | CPT | 72156 | 10 | $4,747 | $3,322.9 | $273.56 | $381.49 | 0.71× | $3,826.09 |
| MRI lumbar spine with contrast | CPT | 72158 | 10 | $4,655 | $3,258.5 | $273.56 | $381.49 | 0.70× | $3,751.93 |
| CT pelvis without contrast | CPT | 72192 | 10 | $3,205 | $2,243.5 | $80.98 | $112.78 | 0.56× | $2,583.23 |
| CT pelvis with contrast | CPT | 72193 | 10 | $3,718 | $2,602.6 | $132.69 | $185.05 | 0.66× | $2,996.71 |
| Shoulder X-ray | CPT | 73030 | 10 | $648 | $453.6 | $60.12 | $85.27 | 0.92× | $648 |
| Humerus X-ray | CPT | 73060 | 10 | $654 | $457.8 | $60.12 | $122.36 | 1.4× | $654 |
| Hand X-ray 3 views | CPT | 73130 | 10 | $666 | $466.2 | $60.12 | $89.17 | 0.96× | $666 |
| MRI upper extremity joint without contrast | CPT | 73221 | 10 | $3,113 | $2,179.1 | $171.01 | $238.37 | 0.57× | $2,509.08 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 10 | $3,673 | $2,571.1 | $273.56 | $381.49 | 0.62× | $2,960.44 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $660 | $462 | $60.12 | $88.79 | 0.95× | $660 |
| Ankle X-ray 3 views | CPT | 73610 | 10 | $720 | $504 | $60.12 | $89.17 | 0.97× | $720 |
| MRI lower extremity joint without contrast | CPT | 73721 | 10 | $3,676 | $2,573.2 | $171.01 | $238.37 | 0.51× | $2,962.86 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 10 | $4,999 | $3,499.3 | $273.56 | $381.49 | 0.60× | $4,029.2 |
| CT abdomen without contrast | CPT | 74150 | 10 | $2,180 | $1,526 | $80.98 | $112.78 | 0.60× | $1,757.08 |
| CT abdomen with contrast | CPT | 74160 | 10 | $3,374 | $2,361.8 | $132.69 | $185.05 | 0.65× | $2,719.45 |
| CT abdomen with and without contrast | CPT | 74170 | 10 | $3,893 | $2,725.1 | $132.69 | $185.05 | 0.55× | $3,137.76 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 10 | $3,278 | $2,294.6 | $171.01 | $238.37 | 0.65× | $2,642.07 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 10 | $5,190 | $3,633 | $247.87 | $381.49 | 0.70× | $4,183.14 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 10 | $6,020 | $4,214 | $247.87 | $381.49 | 0.66× | $4,852.12 |
| MRI abdomen without contrast | CPT | 74181 | 10 | $3,243 | $2,270.1 | $171.01 | $238.37 | 0.61× | $2,613.86 |
| MRI abdomen with and without contrast | CPT | 74183 | 10 | $5,230 | $3,661 | $273.56 | $381.49 | 0.67× | $4,215.38 |
| Abdominal ultrasound complete | CPT | 76700 | 10 | $1,586 | $1,110.2 | $80.98 | $125.21 | 0.84× | $1,586 |
| Abdominal ultrasound limited | CPT | 76705 | 10 | $1,249 | $874.3 | $80.98 | $125.21 | 0.86× | $1,249 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 10 | $857 | $599.9 | $80.98 | $125.21 | 0.87× | $857 |
| Obstetric ultrasound first trimester | CPT | 76801 | 10 | $1,397 | $977.9 | $80.98 | $258.98 | 1.8× | $1,397 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 10 | $1,034 | $723.8 | $80.98 | $276.22 | 1.8× | $1,034 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 10 | $982 | $687.4 | $171.01 | $238.37 | 1.0× | $982 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $1,206 | $844.2 | $80.98 | $125.21 | 0.85× | $1,206 |
| Pelvic ultrasound complete | CPT | 76856 | 10 | $1,225 | $857.5 | $80.98 | $125.21 | 0.87× | $1,225 |
| Scrotal ultrasound | CPT | 76870 | 10 | $1,228 | $859.6 | $80.98 | $314.57 | 2.4× | $1,228 |
| EKG tracing only | CPT | 93005 | 10 | $565 | $395.5 | $26.25 | $81.28 | 0.69× | $455.39 |
| Transthoracic echocardiogram complete | CPT | 93306 | 10 | $3,026 | $2,118.2 | $358.85 | $538 | 0.90× | $2,438.96 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $13,656 | $26,289 | 1.7× | $55,560 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $8,308.87 | $14,941 | 1.3× | $31,077 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $6,530.57 | $12,572 | 1.4× | $26,241 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $5,137.01 | $9,889.35 | 1.4× | $22,725 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $6,379.9 | $12,043 | 1.4× | $25,049 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $4,916.94 | $9,465.68 | 1.4× | $20,554 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $11,867 | $22,845 | 1.5× | $53,756 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $6,872.48 | $13,230 | 1.4× | $40,569 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $5,362.25 | $10,323 | 1.3× | $32,816 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $9,366.41 | $16,466 | 1.3× | $33,709 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $6,376.96 | $12,276 | 1.4× | $27,143 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $4,356.42 | $8,386.62 | 1.3× | $23,475 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $8,868.66 | $15,591 | 1.3× | $30,152 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $5,542.44 | $10,670 | 1.4× | $22,900 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $4,129.69 | $7,950.15 | 1.3× | $17,908 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $7,337 | $13,200 | 1.3× | $27,455 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $4,705.73 | $9,059.08 | 1.3× | $22,822 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $5,655.44 | $9,942.38 | 1.2× | $18,143 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $10,459 | $18,387 | 1.2× | $32,563 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $8,228.38 | $14,466 | 1.2× | $26,682 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $5,863.69 | $10,309 | 1.2× | $20,163 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $13,826 | $24,307 | 1.3× | $47,567 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $7,579.23 | $14,591 | 1.4× | $37,500 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 10 | $250 | $175 | $4.83 | $39.9 | 1.2× | $250 |
| Electrolyte panel | CPT | 80051 | 10 | $143 | $100.1 | $4.01 | $27.17 | 1.1× | $143 |
| Comprehensive metabolic panel | CPT | 80053 | 10 | $275 | $192.5 | $6.04 | $47.5 | 1.1× | $275 |
| Lipid panel | CPT | 80061 | 10 | $394 | $275.8 | $7.65 | $63.15 | 1.7× | $394 |
| Renal function panel | CPT | 80069 | 10 | $312 | $218.4 | $4.96 | $40.95 | 1.5× | $312 |
| Hepatic function panel | CPT | 80076 | 10 | $230 | $161 | $4.67 | $38.53 | 1.4× | $230 |
| Urinalysis automated | CPT | 81003 | 10 | $93 | $65.1 | $1.29 | $10.58 | 0.76× | $93 |
| Glucose quantitative | CPT | 82947 | 10 | $158 | $110.6 | $2.24 | $10.59 | 0.60× | $158 |
| Hemoglobin A1c | CPT | 83036 | 10 | $221 | $154.7 | $5.55 | $41.99 | 1.6× | $221 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 10 | $393 | $275.1 | $9.61 | $74.67 | 1.6× | $393 |
| Complete blood count with automated differential | CPT | 85025 | 10 | $238 | $166.6 | $4.44 | $36.64 | 1.4× | $238 |
| Complete blood count without differential | CPT | 85027 | 10 | $182 | $127.4 | $3.7 | $30.5 | 1.4× | $182 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 10 | — | — | $64.37 | $185.5 | 0.99× | $2,298 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 3 | — | — | $2,298 | $4,573.57 | 2.0× | $9,514.14 |
| Vaginal delivery only | CPT | 59409 | 8 | — | — | $1,949.38 | $2,583.39 | 1.2× | $9,514.14 |
| Vaginal delivery with postpartum | CPT | 59410 | 4 | — | — | $1,954 | $3,435.79 | 3.2× | $9,514.14 |
| Routine obstetric care with C-section | CPT | 59510 | 3 | — | — | $2,298 | $4,573.57 | 1.8× | $9,514.14 |
| C-section delivery only | CPT | 59514 | 2 | — | — | $2,018 | $3,029.5 | 3.2× | $5,042 |
| C-section with postpartum | CPT | 59515 | 3 | — | — | $2,018 | $2,298 | 1.8× | $4,109 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 6 | $403 | $282.1 | $55.9 | $257.92 | 3.0× | $403 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 6 | $536 | $375.2 | $55.9 | $343.04 | 2.8× | $536 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 6 | $679 | $475.3 | $55.9 | $434.56 | 2.5× | $679 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 6 | $823 | $576.1 | $55.9 | $526.72 | 2.4× | $823 |
| Office visit, established patient, 5 min | CPT | 99211 | 6 | $277 | $193.9 | $52.63 | $177.28 | 2.8× | $277 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 6 | $350 | $245 | $55.9 | $224 | 2.8× | $350 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 6 | $473 | $331.1 | $55.9 | $302.72 | 2.6× | $473 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 6 | $627 | $438.9 | $55.9 | $401.28 | 2.6× | $627 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 6 | $753 | $527.1 | $55.9 | $481.92 | 2.6× | $753 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 10 | — | — | $601.63 | $1,496.73 | 1.6× | $3,183.72 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 10 | — | — | $601.63 | $1,852.76 | 1.9× | $4,263.47 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | — | — | $350.82 | $1,496.73 | 1.8× | $3,183.72 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | — | — | $589.79 | $1,496.73 | 1.7× | $3,183.72 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | — | — | $589.79 | $1,852.76 | 2.1× | $4,263.47 |
| Colonoscopy with biopsy | CPT | 45380 | 10 | — | — | $770.6 | $1,852.76 | 1.5× | $4,263.47 |
| Colonoscopy with polyp removal | CPT | 45385 | 10 | — | — | $770.6 | $1,852.76 | 1.5× | $4,263.47 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 8 | — | — | $2,298 | $6,465.88 | 1.6× | $13,451 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 8 | — | — | $23,073 | $44,418 | 1.6× | $112,937 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 8 | — | — | $14,572 | $28,053 | 1.5× | $93,340 |
| Hip hemiarthroplasty | CPT | 27125 | 8 | — | — | $2,298 | $7,116 | 5.7× | $12,803 |
| Total hip replacement | CPT | 27130 | 8 | — | — | $2,298 | $10,640 | 2.5× | $25,606 |
| Total knee replacement | CPT | 27447 | 8 | — | — | $2,298 | $10,640 | 2.6× | $25,606 |
| Knee revision arthroplasty single component | CPT | 27486 | 8 | — | — | $2,298 | $6,154.45 | 3.7× | $12,803 |
| Knee revision arthroplasty all components | CPT | 27487 | 8 | — | — | $2,298 | $6,195 | 3.1× | $12,803 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $1,174.54 | $2,659 | 8.1× | $8,180 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 10 | — | — | $2,614 | $5,890.93 | 1.8× | $8,349.33 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | — | — | $2,103.34 | $3,141.09 | 1.5× | $8,180 |
| ACL reconstruction | CPT | 29888 | 10 | — | — | $1,848 | $6,169.85 | 1.8× | $11,987 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $36,085 | $63,438 | 1.5× | $122,369 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $18,827 | $36,243 | 1.6× | $78,580 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $12,632 | $24,044 | 1.5× | $50,011 |
| CABG single arterial graft | CPT | 33533 | 6 | — | — | $2,298 | $4,081.5 | 2.2× | $12,803 |
| CABG 2 arterial grafts | CPT | 33534 | 6 | — | — | $2,298 | $4,081.5 | 1.9× | $12,803 |
| CABG 3 arterial grafts | CPT | 33535 | 6 | — | — | $2,298 | $4,629.5 | 2.0× | $12,803 |
| CABG 4+ arterial grafts | CPT | 33536 | 6 | — | — | $2,298 | $4,629.5 | 1.9× | $12,803 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $12,473 | $21,928 | 1.3× | $39,179 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $9,713.5 | $17,077 | 1.3× | $30,243 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $25,969 | $47,461 | 1.5× | $98,715 |
| Open appendectomy | CPT | 44950 | 8 | — | — | $2,018 | $3,135.09 | 2.8× | $12,803 |
| Laparoscopic appendectomy | CPT | 44970 | 8 | — | — | $2,241 | $4,983.62 | 3.2× | $9,514.14 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 8 | — | — | $49,727 | $87,421 | 1.8× | $154,823 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 8 | — | — | $29,028 | $51,032 | 1.5× | $98,788 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $22,789 | $40,685 | 1.4× | $84,621 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $14,034 | $27,017 | 1.4× | $68,521 |
| Laparoscopic cholecystectomy | CPT | 47562 | 10 | — | — | $3,760.54 | $5,133.13 | 2.9× | $12,803 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 10 | — | — | $3,760.54 | $5,133.13 | 2.7× | $12,803 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $22,346 | $39,284 | 1.4× | $76,886 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $15,480 | $28,440 | 1.4× | $59,153 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $12,154 | $23,398 | 1.5× | $50,061 |
| Open umbilical hernia repair | CPT | 49560 | 10 | — | — | $2,241 | $3,135.09 | 1.6× | $6,028.09 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 10 | — | — | $2,241 | $3,135.09 | 2.4× | $6,028.09 |
| Lap inguinal hernia repair | CPT | 49650 | 10 | — | — | $2,241 | $4,983.62 | 4.4× | $7,232.76 |
| Lap incisional hernia repair | CPT | 49652 | 10 | — | — | $2,897.78 | $5,046.81 | 1.9× | $10,408 |
| Total abdominal hysterectomy | CPT | 58150 | 6 | — | — | $2,018 | $3,989 | 4.1× | $12,803 |
| Vaginal hysterectomy | CPT | 58260 | 8 | — | — | $2,018 | $4,342.6 | 2.4× | $12,803 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 10 | — | — | $3,760.54 | $5,266.58 | 3.6× | $12,803 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | — | — | $2,614 | $7,232.76 | 3.2× | $12,803 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | — | — | $2,614 | $4,983.62 | 2.5× | $7,232.76 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $22,611 | $39,866 | 1.5× | $82,919 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $13,018 | $25,060 | 1.5× | $57,911 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $11,795 | $22,706 | 1.5× | $50,655 |
| Complex cataract surgery | CPT | 66982 | 10 | — | — | $1,545.07 | $2,993 | 1.3× | $9,304.36 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $1,545.07 | $2,993 | 1.4× | $9,304.36 |
| Intravitreal injection | CPT | 67028 | 10 | — | — | $169.1 | $1,372.5 | 4.0× | $3,183.72 |
| Vitrectomy mechanical | CPT | 67042 | 10 | — | — | $2,911.37 | $4,561.48 | 1.8× | $9,855 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $8,365.74 | $14,707 | 1.2× | $26,356 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $13,259 | $21,982 | 1.1× | $41,282 |