| behavioral |
| Psychoses | MS-DRG | 885 | 10 | — | — | $12,695 | $12,695 | 0.99× | $43,797 |
| emergency |
| ED visit level 1 | CPT | 99281 | 15 | $1,413 | $989.1 | $21.77 | $476.98 | 3.4× | $3,726 |
| ED visit level 2 | CPT | 99282 | 15 | $1,869 | $1,308.3 | $34.97 | $632.32 | 2.7× | $3,726 |
| ED visit level 3 | CPT | 99283 | 15 | $3,157 | $2,209.9 | $63.97 | $1,114.03 | 2.8× | $7,311 |
| ED visit level 4 | CPT | 99284 | 15 | $5,681 | $3,976.7 | $98.04 | $1,751.17 | 2.6× | $14,484 |
| ED visit level 5 | CPT | 99285 | 15 | $11,993 | $8,395.1 | $155.03 | $2,513.58 | 2.4× | $18,826 |
| Critical care, first hour | CPT | 99291 | 14 | $14,244 | $9,970.8 | $324.06 | $6,649 | 6.2× | $18,826 |
| imaging |
| CT head without contrast | CPT | 70450 | 15 | $4,646 | $3,252.2 | $145.43 | $245.18 | 1.2× | $3,819.02 |
| CT head with contrast | CPT | 70460 | 15 | $5,573 | $3,901.1 | $205.27 | $274.74 | 1.2× | $4,581.01 |
| CT head with and without contrast | CPT | 70470 | 15 | $6,727 | $4,708.9 | $242.06 | $293.82 | 1.1× | $5,529.6 |
| CT neck with contrast | CPT | 70491 | 15 | $7,137 | $4,995.9 | $257.32 | $303.3 | 1.1× | $5,866.62 |
| MRI brain without contrast | CPT | 70551 | 15 | $8,838 | $6,186.6 | $277.63 | $517.79 | 1.3× | $7,264.84 |
| MRI brain with contrast | CPT | 70552 | 15 | $9,746 | $6,822.2 | $389.09 | $828.27 | 1.7× | $8,011.22 |
| MRI brain with and without contrast | CPT | 70553 | 15 | $10,646 | $7,452.2 | $457.73 | $828.27 | 1.4× | $8,751.02 |
| Chest X-ray single view | CPT | 71045 | 15 | $917 | $641.9 | $17.67 | $144.76 | 1.5× | $753.78 |
| Chest X-ray 2 views | CPT | 71046 | 15 | $805 | $563.5 | $27.48 | $156.33 | 1.6× | $661.71 |
| Chest X-ray 3 views | CPT | 71047 | 15 | $940 | $658 | $35.27 | $156.33 | 1.6× | $772.68 |
| CT chest without contrast | CPT | 71250 | 15 | $6,256 | $4,379.2 | $167.44 | $206.77 | 0.96× | $5,142.44 |
| CT chest with contrast | CPT | 71260 | 15 | $6,556 | $4,589.2 | $233.29 | $401.74 | 1.4× | $5,389.04 |
| CT chest with and without contrast | CPT | 71270 | 15 | $7,173 | $5,021.1 | $274.72 | $315.37 | 1.1× | $5,896.21 |
| MRI chest without contrast | CPT | 71550 | 15 | $8,491 | $5,943.7 | $353.89 | $516.49 | 1.2× | $6,979.61 |
| MRI chest with contrast | CPT | 71551 | 15 | $9,384 | $6,568.8 | $395.33 | $1,100.37 | 1.4× | $7,713.65 |
| MRI chest with and without contrast | CPT | 71552 | 15 | $10,287 | $7,200.9 | $501.11 | $611.36 | 1.0× | $8,455.92 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | $1,285 | $899.5 | $43.45 | $204.54 | 2.0× | $1,056.27 |
| CT cervical spine without contrast | CPT | 72125 | 15 | $7,083 | $4,958.1 | $167.44 | $245.18 | 1.2× | $5,822.23 |
| CT thoracic spine without contrast | CPT | 72128 | 15 | $7,083 | $4,958.1 | $167.44 | $202.54 | 1.0× | $5,822.23 |
| CT lumbar spine without contrast | CPT | 72131 | 15 | $7,083 | $4,958.1 | $167.44 | $245.18 | 1.2× | $5,822.23 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | $8,755 | $6,128.5 | $271.44 | $517.79 | 1.3× | $7,196.61 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | $8,755 | $6,128.5 | $271.44 | $517.79 | 1.4× | $7,196.61 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | $8,755 | $6,128.5 | $271.91 | $517.79 | 1.4× | $7,196.61 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 15 | $9,870 | $6,909 | $392.33 | $828.27 | 1.8× | $8,113.14 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | $11,228 | $7,859.6 | $462.36 | $828.27 | 1.5× | $9,229.42 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | $11,228 | $7,859.6 | $461.44 | $828.27 | 1.5× | $9,229.42 |
| CT pelvis without contrast | CPT | 72192 | 15 | $6,256 | $4,379.2 | $167.44 | $245.18 | 1.2× | $5,142.44 |
| CT pelvis with contrast | CPT | 72193 | 15 | $6,556 | $4,589.2 | $274.72 | $401.74 | 1.4× | $5,389.04 |
| Shoulder X-ray | CPT | 73030 | 15 | $1,393 | $975.1 | $37.09 | $223.92 | 2.4× | $1,145.05 |
| Humerus X-ray | CPT | 73060 | 15 | $971 | $679.7 | $29.81 | $223.92 | 2.5× | $798.17 |
| Hand X-ray 3 views | CPT | 73130 | 15 | $1,453 | $1,017.1 | $36.06 | $223.92 | 2.4× | $1,194.37 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | $16,941 | $11,859 | $289.9 | $517.79 | 1.2× | $13,926 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $15,972 | $11,180 | $408.36 | $828.27 | 1.4× | $13,129 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | $1,870 | $1,309 | $27.28 | $362.68 | 3.9× | $1,537.14 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | $1,534 | $1,073.8 | $36.06 | $223.92 | 2.4× | $1,260.95 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | $9,401 | $6,580.7 | $288.98 | $517.79 | 1.1× | $7,727.63 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | $10,646 | $7,452.2 | $407.06 | $828.27 | 1.3× | $8,751.02 |
| CT abdomen without contrast | CPT | 74150 | 15 | $6,256 | $4,379.2 | $167.44 | $245.18 | 1.3× | $5,142.44 |
| CT abdomen with contrast | CPT | 74160 | 15 | $6,556 | $4,589.2 | $274.72 | $346.25 | 1.2× | $5,389.04 |
| CT abdomen with and without contrast | CPT | 74170 | 15 | $7,173 | $5,021.1 | $274.72 | $386.64 | 1.2× | $5,896.21 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | $12,512 | $8,758.4 | $178.43 | $353.91 | 0.97× | $10,285 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 15 | $13,111 | $9,177.7 | $281.8 | $566.38 | 1.0× | $10,777 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | $14,347 | $10,043 | $319.24 | $566.38 | 0.98× | $11,793 |
| MRI abdomen without contrast | CPT | 74181 | 15 | $9,258 | $6,480.6 | $281.36 | $1,212.12 | 3.1× | $7,610.08 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | $11,049 | $7,734.3 | $351.25 | $828.27 | 1.5× | $9,082.28 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $2,864 | $2,004.8 | $119.34 | $167.45 | 1.1× | $2,354.21 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $1,515 | $1,060.5 | $87.13 | $167.45 | 1.1× | $1,245.33 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $2,031 | $1,421.7 | $115.78 | $167.45 | 1.2× | $1,669.49 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $2,307 | $1,614.9 | $78.42 | $167.45 | 1.2× | $1,896.36 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $2,639 | $1,847.3 | $135.29 | $175.82 | 1.2× | $2,169.26 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $1,611 | $1,127.7 | $97.04 | $167.45 | 1.1× | $1,324.25 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $2,287 | $1,600.9 | $97.04 | $167.45 | 1.2× | $1,879.92 |
| Scrotal ultrasound | CPT | 76870 | 15 | $2,031 | $1,421.7 | $85.75 | $167.45 | 1.3× | $1,669.49 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $772 | $540.4 | $117.89 | $377.69 | 2.5× | $772 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $939 | $657.3 | $149.36 | $472.91 | 2.5× | $939 |
| Screening mammography bilateral | CPT | 77067 | 10 | $939 | $657.3 | $120.94 | $551.56 | 3.5× | $939 |
| EKG tracing only | CPT | 93005 | 15 | $1,072 | $750.4 | $8.51 | $85.61 | 0.73× | $1,072 |
| Transthoracic echocardiogram complete | CPT | 93306 | 15 | $5,352 | $3,746.4 | $239.76 | $743.17 | 1.2× | $5,352 |
| Transthoracic echocardiogram | CPT | 93307 | 15 | $2,261 | $1,582.7 | $185.32 | $353.91 | 1.4× | $2,261 |
| Stress echocardiogram | CPT | 93350 | 15 | $4,447 | $3,112.9 | $137.87 | $743.17 | 1.5× | $4,447 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $18,940 | $18,940 | 1.2× | $65,342 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $11,524 | $11,524 | 1.0× | $39,758 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $9,057.64 | $9,057.64 | 1.0× | $31,249 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $7,124.84 | $7,124.84 | 1.0× | $24,581 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $8,848.68 | $8,848.68 | 1.0× | $30,528 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $6,819.6 | $6,819.6 | 1.0× | $23,528 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $16,459 | $16,459 | 1.1× | $56,784 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $9,531.87 | $9,531.87 | 0.99× | $32,885 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $7,437.24 | $7,437.24 | 0.95× | $25,658 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $12,991 | $12,991 | 1.0× | $44,818 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $8,844.59 | $8,844.59 | 0.99× | $30,514 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $6,042.18 | $6,042.18 | 0.97× | $20,846 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $12,300 | $12,300 | 1.0× | $42,437 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $7,687.16 | $7,687.16 | 0.99× | $26,521 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $5,727.73 | $5,727.73 | 0.92× | $19,761 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $10,176 | $10,176 | 1.0× | $35,108 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $6,526.66 | $6,526.66 | 0.95× | $22,517 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $7,843.87 | $7,843.87 | 0.98× | $27,061 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 10 | — | — | $14,506 | $14,506 | 0.95× | $50,045 |
| Kidney/UTI w MCC | MS-DRG | 689 | 10 | — | — | $11,412 | $11,412 | 0.98× | $39,373 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 10 | — | — | $8,132.72 | $8,132.72 | 0.98× | $28,058 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | — | — | $19,176 | $19,176 | 1.0× | $66,159 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 10 | — | — | $10,512 | $10,512 | 1.0× | $36,267 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | $468 | $327.6 | $8.46 | $15.75 | 0.49× | $384.7 |
| General health panel | CPT | 80050 | 9 | $1,160 | $812 | $54.43 | $344.96 | 3.2× | $953.52 |
| Electrolyte panel | CPT | 80051 | 15 | $1,363 | $954.1 | $7.01 | $9.88 | 0.42× | $1,120.39 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | $681 | $476.7 | $10.49 | $19.57 | 0.44× | $559.79 |
| Lipid panel | CPT | 80061 | 15 | $1,120 | $784 | $3.14 | $16.07 | 0.42× | $920.64 |
| Renal function panel | CPT | 80069 | 15 | $612 | $428.4 | $8.68 | $12.24 | 0.45× | $503.07 |
| Hepatic function panel | CPT | 80076 | 15 | $526 | $368.2 | $8.03 | $15.06 | 0.57× | $432.38 |
| Urinalysis automated | CPT | 81003 | 15 | $439 | $307.3 | $2.25 | $3.17 | 0.23× | $360.86 |
| Glucose quantitative | CPT | 82947 | 15 | $623 | $436.1 | $3.93 | $27.69 | 1.6× | $512.11 |
| Hemoglobin A1c | CPT | 83036 | 15 | $853 | $597.1 | $9.59 | $17.95 | 0.67× | $701.17 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | $677 | $473.9 | $1.79 | $15.4 | 0.33× | $556.5 |
| Complete blood count with automated differential | CPT | 85025 | 15 | $797 | $557.9 | $7.77 | $10.96 | 0.41× | $655.14 |
| Complete blood count without differential | CPT | 85027 | 15 | $696 | $487.2 | $6.47 | $9.13 | 0.42× | $572.12 |
| Urine culture bacterial | CPT | 87086 | 15 | $986 | $690.2 | $8.07 | $11.38 | 0.49× | $810.5 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | $171 | $119.7 | $22.12 | $74.81 | 0.73× | $239.23 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 15 | $836 | $585.2 | $32.7 | $477.4 | 2.5× | $11,860 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 6 | — | — | $1,994.02 | $3,783.57 | 1.6× | $16,353 |
| Vaginal delivery only | CPT | 59409 | 12 | — | — | $780.72 | $4,035.36 | 1.8× | $16,353 |
| Vaginal delivery with postpartum | CPT | 59410 | 5 | — | — | $1,144.68 | $5,906.77 | 5.6× | $16,353 |
| Routine obstetric care with C-section | CPT | 59510 | 6 | — | — | $1,995.21 | $4,259.95 | 1.7× | $16,353 |
| C-section delivery only | CPT | 59514 | 6 | — | — | $781.35 | $3,290.15 | 3.4× | $16,353 |
| C-section with postpartum | CPT | 59515 | 5 | — | — | $1,401.51 | $7,343.43 | 5.8× | $16,353 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 8 | $1,708 | $1,195.6 | $49.2 | $376.76 | 4.4× | $1,708 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 8 | $2,406 | $1,684.2 | $82.05 | $461.27 | 3.8× | $2,406 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 8 | $5,750 | $4,025 | $98.83 | $863.54 | 5.0× | $5,750 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 8 | $4,548 | $3,183.6 | $118.62 | $853.89 | 3.9× | $4,548 |
| Office visit, established patient, 5 min | CPT | 99211 | 8 | $1,708 | $1,195.6 | $17.21 | $234.08 | 3.6× | $1,708 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 8 | $1,607 | $1,124.9 | $16.37 | $297.29 | 3.7× | $1,607 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 8 | $2,406 | $1,684.2 | $34.43 | $418.19 | 3.7× | $2,406 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 8 | $5,750 | $4,025 | $53.79 | $838.64 | 5.5× | $5,750 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 8 | $4,548 | $3,183.6 | $82.05 | $790.19 | 4.2× | $4,548 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 12 | — | — | $388.13 | $1,244.53 | 1.4× | $10,333 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 12 | — | — | $423.61 | $1,244.53 | 1.3× | $10,333 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 12 | — | — | $99 | $1,220.57 | 1.4× | $7,377 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 12 | — | — | $130.65 | $1,220.57 | 1.4× | $7,377 |
| Colonoscopy diagnostic | CPT | 45378 | 12 | — | — | $433.27 | $1,220.57 | 1.4× | $7,377 |
| Colonoscopy with biopsy | CPT | 45380 | 12 | — | — | $569.45 | $1,594.92 | 1.3× | $7,377 |
| Colonoscopy with polyp removal | CPT | 45385 | 12 | — | — | $579.62 | $1,594.92 | 1.3× | $7,377 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 11 | — | — | $1,654.98 | $18,965 | 4.6× | $59,359 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 10 | — | — | $32,001 | $32,001 | 1.2× | $110,405 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 10 | — | — | $20,211 | $20,211 | 1.1× | $69,728 |
| Hip hemiarthroplasty | CPT | 27125 | 8 | — | — | $1,300.85 | $5,906.77 | 4.7× | $19,899 |
| Total hip replacement | CPT | 27130 | 12 | — | — | $1,466.66 | $12,168 | 2.8× | $59,359 |
| Total knee replacement | CPT | 27447 | 12 | — | — | $1,464.95 | $17,923 | 4.3× | $59,359 |
| Knee revision arthroplasty single component | CPT | 27486 | 6 | — | — | $1,606.64 | $10,283 | 6.1× | $19,191 |
| Knee revision arthroplasty all components | CPT | 27487 | 8 | — | — | $1,993.9 | $8,347.35 | 4.2× | $19,191 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 8 | — | — | $192.66 | $4,086.5 | 12.5× | $19,191 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 12 | — | — | $623.03 | $9,633.83 | 2.9× | $30,153 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 12 | — | — | $639.76 | $4,355.72 | 2.1× | $17,720 |
| ACL reconstruction | CPT | 29888 | 12 | — | — | $1,129.6 | $9,633.83 | 2.9× | $30,153 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $50,048 | $50,048 | 1.2× | $172,665 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $26,112 | $26,112 | 1.1× | $90,086 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $17,520 | $17,520 | 1.1× | $60,445 |
| CABG single arterial graft | CPT | 33533 | 7 | — | — | $2,005.05 | $8,591 | 4.6× | $24,364 |
| CABG 2 arterial grafts | CPT | 33534 | 7 | — | — | $2,350.36 | $8,591 | 4.0× | $33,907 |
| CABG 3 arterial grafts | CPT | 33535 | 7 | — | — | $2,613.41 | $8,591 | 3.8× | $33,907 |
| CABG 4+ arterial grafts | CPT | 33536 | 7 | — | — | $2,810.22 | $8,591 | 3.5× | $33,907 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $17,300 | $17,300 | 1.0× | $59,685 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $13,472 | $13,472 | 1.00× | $46,479 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $36,019 | $36,019 | 1.1× | $124,264 |
| Open appendectomy | CPT | 44950 | 12 | — | — | $712.83 | $4,893.46 | 4.3× | $19,191 |
| Laparoscopic appendectomy | CPT | 44970 | 12 | — | — | $494.31 | $7,782.44 | 5.0× | $24,358 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 10 | — | — | $68,969 | $68,969 | 1.4× | $237,944 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 10 | — | — | $40,261 | $40,261 | 1.2× | $138,901 |
| Major joint replacement w MCC | MS-DRG | 469 | 10 | — | — | $31,608 | $31,608 | 1.1× | $109,048 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | — | $19,464 | $19,464 | 1.0× | $67,152 |
| Laparoscopic cholecystectomy | CPT | 47562 | 12 | — | — | $737.17 | $7,782.44 | 4.4× | $33,907 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | — | — | $801.45 | $7,782.44 | 4.1× | $33,907 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $30,992 | $30,992 | 1.1× | $106,924 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $21,470 | $21,470 | 1.1× | $74,071 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $16,857 | $16,857 | 1.1× | $58,158 |
| Open umbilical hernia repair | CPT | 49560 | 12 | — | — | $822.25 | $4,893.46 | 2.6× | $17,720 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 12 | — | — | $509.08 | $4,893.46 | 3.7× | $17,720 |
| Lap inguinal hernia repair | CPT | 49650 | 12 | — | — | $379.7 | $7,782.44 | 6.9× | $24,358 |
| Lap incisional hernia repair | CPT | 49652 | 12 | — | — | $524.57 | $7,782.44 | 2.9× | $24,358 |
| Total abdominal hysterectomy | CPT | 58150 | 8 | — | — | $1,144.74 | $4,413.84 | 4.5× | $24,364 |
| Vaginal hysterectomy | CPT | 58260 | 12 | — | — | $955.37 | $6,782.17 | 3.7× | $24,364 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | — | — | $838.74 | $7,782.44 | 5.3× | $24,364 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | — | — | $616.65 | $13,699 | 6.2× | $42,876 |
| Lap salpingo-oophorectomy | CPT | 58661 | 12 | — | — | $701.38 | $7,782.44 | 3.8× | $24,358 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 10 | — | — | $31,360 | $31,360 | 1.2× | $108,192 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | — | $18,055 | $18,055 | 1.1× | $62,289 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 10 | — | — | $16,359 | $16,359 | 1.1× | $56,437 |
| Complex cataract surgery | CPT | 66982 | 12 | — | — | $885.33 | $3,193.97 | 1.4× | $22,884 |
| Cataract surgery with lens implant | CPT | 66984 | 12 | — | — | $647.78 | $3,193.97 | 1.5× | $22,884 |
| Intravitreal injection | CPT | 67028 | 12 | — | — | $137.03 | $796.94 | 2.3× | $7,377 |
| Vitrectomy mechanical | CPT | 67042 | 12 | — | — | $1,186.9 | $6,023.3 | 2.4× | $18,852 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 10 | — | — | $11,603 | $11,603 | 0.94× | $40,030 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 10 | — | — | $18,390 | $18,390 | 0.96× | $63,445 |
| PCI single major coronary artery | CPT | 92920 | 15 | $22,317 | $15,622 | $435.12 | $7,948.46 | 1.4× | $33,907 |
| PCI with drug-eluting stent | CPT | 92928 | 15 | $32,105 | $22,474 | $483.05 | $15,449 | 1.5× | $48,354 |
| PCI bypass graft | CPT | 92937 | 15 | $32,105 | $22,474 | $482.46 | $15,449 | 1.4× | $48,354 |
| Left heart catheterization | CPT | 93452 | 15 | $14,871 | $10,410 | $967.53 | $5,523.89 | 1.8× | $24,364 |
| Coronary angiography with cath | CPT | 93455 | 15 | $23,266 | $16,286 | $1,166.18 | $6,355.33 | 2.0× | $33,907 |
| Coronary angiography with bypass cath | CPT | 93458 | 15 | $31,131 | $21,792 | $1,204.89 | $6,355.33 | 2.0× | $33,907 |