| behavioral |
| Psychoses | MS-DRG | 885 | 18 | — | $13,541 | $6,301.33 | $13,542 | 1.1× | $26,114 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 19 | $577.6 | $227 | $128.08 | $227.16 | 1.3× | $352.1 |
| Psychiatric eval with medical services | CPT | 90792 | 19 | $577.6 | $227 | $103.25 | $227.16 | 1.3× | $352.1 |
| Psychotherapy 30 minutes | CPT | 90832 | 19 | $849.49 | $227 | $18.98 | $227.16 | 1.5× | $352.1 |
| Psychotherapy 45 minutes | CPT | 90834 | 19 | $849.49 | $227 | $67.16 | $227.16 | 1.4× | $352.1 |
| Psychotherapy 60 minutes | CPT | 90837 | 19 | $577.6 | $227 | $38.01 | $227.16 | 1.2× | $352.1 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 19 | $577.6 | $227 | $38.01 | $227.16 | 1.4× | $352.1 |
| emergency |
| ED visit level 1 | CPT | 99281 | 19 | $832.13 | $107 | $21.77 | $107.92 | 0.77× | $167.28 |
| ED visit level 2 | CPT | 99282 | 19 | $1,403.06 | $196 | $34.97 | $196.51 | 0.83× | $304.59 |
| ED visit level 3 | CPT | 99283 | 19 | $2,399.11 | $349 | $51 | $349.37 | 0.86× | $541.52 |
| ED visit level 4 | CPT | 99284 | 20 | $3,573.47 | $534 | $51 | $534.03 | 0.80× | $827.75 |
| ED visit level 5 | CPT | 99285 | 19 | $5,161.88 | $762 | $51 | $762.2 | 0.73× | $1,181.41 |
| Critical care, first hour | CPT | 99291 | 19 | $7,235.81 | $1,057 | $51 | $1,057.2 | 0.99× | $1,638.66 |
| imaging |
| CT head without contrast | CPT | 70450 | 19 | $5,370 | $133 | $51 | $133.8 | 0.65× | $207.39 |
| CT head with contrast | CPT | 70460 | 19 | $4,043.42 | $224 | $137.27 | $224.48 | 0.96× | $347.94 |
| CT head with and without contrast | CPT | 70470 | 19 | $5,656.4 | $224 | $163.9 | $224.48 | 0.84× | $347.94 |
| CT neck with contrast | CPT | 70491 | 19 | $4,923.45 | $224 | $184.4 | $224.48 | 0.82× | $347.94 |
| MRI brain without contrast | CPT | 70551 | 19 | $6,099.97 | $305 | $188.21 | $305.38 | 0.76× | $473.34 |
| MRI brain with contrast | CPT | 70552 | 19 | $5,743.16 | $446 | $276.68 | $446.5 | 0.93× | $692.08 |
| MRI brain with and without contrast | CPT | 70553 | 19 | $9,097.01 | $446 | $316.79 | $446.5 | 0.76× | $692.08 |
| Chest X-ray single view | CPT | 71045 | 19 | $678.28 | $111 | $9.71 | $111.37 | 1.2× | $172.62 |
| Chest X-ray 2 views | CPT | 71046 | 20 | $879.3 | $111 | $18.13 | $111.37 | 1.1× | $172.62 |
| Chest X-ray 3 views | CPT | 71047 | 19 | $395.28 | $111 | $22.92 | $111.37 | 1.2× | $172.62 |
| CT chest without contrast | CPT | 71250 | 19 | $4,488.53 | $133 | $133.32 | $133.8 | 0.62× | $207.39 |
| CT chest with contrast | CPT | 71260 | 19 | $5,560.76 | $224 | $170.83 | $224.48 | 0.80× | $347.94 |
| CT chest with and without contrast | CPT | 71270 | 19 | $6,224.59 | $224 | $208.88 | $224.48 | 0.77× | $347.94 |
| MRI chest without contrast | CPT | 71550 | 19 | $4,471.68 | $305 | $305.38 | $308.43 | 0.72× | $473.34 |
| MRI chest with contrast | CPT | 71551 | 19 | $4,200.12 | $1,003 | $306.79 | $1,003.31 | 1.2× | $1,555.13 |
| MRI chest with and without contrast | CPT | 71552 | 19 | $6,094 | $446 | $387.38 | $446.5 | 0.74× | $692.08 |
| Lumbosacral spine X-ray | CPT | 72100 | 19 | $1,091.25 | $133 | $29.98 | $133.8 | 1.3× | $207.39 |
| CT cervical spine without contrast | CPT | 72125 | 19 | $5,497.09 | $133 | $129.09 | $133.8 | 0.66× | $207.39 |
| CT thoracic spine without contrast | CPT | 72128 | 19 | $4,923.45 | $133 | $132.34 | $133.8 | 0.67× | $207.39 |
| CT lumbar spine without contrast | CPT | 72131 | 19 | $4,913.34 | $133 | $131.98 | $133.8 | 0.66× | $207.39 |
| MRI cervical spine without contrast | CPT | 72141 | 19 | $6,140.76 | $305 | $181.08 | $305.38 | 0.77× | $473.34 |
| MRI thoracic spine without contrast | CPT | 72146 | 19 | $6,180.38 | $305 | $183.45 | $305.38 | 0.82× | $473.34 |
| MRI lumbar spine without contrast | CPT | 72148 | 19 | $6,212.5 | $305 | $181.42 | $305.38 | 0.81× | $473.34 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 19 | $5,670.53 | $446 | $281.85 | $446.5 | 0.98× | $692.08 |
| MRI cervical spine with and without contrast | CPT | 72156 | 19 | $7,070 | $446 | $319.01 | $446.5 | 0.83× | $692.08 |
| MRI lumbar spine with contrast | CPT | 72158 | 19 | $8,752.5 | $446 | $318.04 | $446.5 | 0.82× | $692.08 |
| CT pelvis without contrast | CPT | 72192 | 19 | $5,110.51 | $133 | $117.13 | $133.8 | 0.67× | $207.39 |
| CT pelvis with contrast | CPT | 72193 | 19 | $5,082.28 | $224 | $222.88 | $224.48 | 0.80× | $347.94 |
| Shoulder X-ray | CPT | 73030 | 21 | $1,051.89 | $111 | $25.59 | $111.37 | 1.2× | $172.62 |
| Humerus X-ray | CPT | 73060 | 19 | $846.05 | $111 | $21.46 | $111.37 | 1.2× | $172.62 |
| Hand X-ray 3 views | CPT | 73130 | 19 | $1,017.13 | $111 | $26.32 | $111.37 | 1.2× | $172.62 |
| MRI upper extremity joint without contrast | CPT | 73221 | 19 | $5,785.73 | $305 | $206.55 | $305.38 | 0.73× | $473.34 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 19 | $7,171 | $446 | $301.18 | $446.5 | 0.73× | $692.08 |
| Knee X-ray 1-2 views | CPT | 73560 | 19 | $863.81 | $111 | $20.19 | $111.37 | 1.2× | $172.62 |
| Ankle X-ray 3 views | CPT | 73610 | 19 | $1,016.88 | $111 | $26.32 | $111.37 | 1.2× | $172.62 |
| MRI lower extremity joint without contrast | CPT | 73721 | 19 | $6,090.54 | $305 | $206.2 | $305.38 | 0.65× | $473.34 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 19 | $6,867 | $446 | $300.2 | $446.5 | 0.70× | $692.08 |
| CT abdomen without contrast | CPT | 74150 | 19 | $4,484.59 | $133 | $116.66 | $133.8 | 0.71× | $207.39 |
| CT abdomen with contrast | CPT | 74160 | 19 | $4,676.52 | $224 | $221.59 | $224.48 | 0.78× | $347.94 |
| CT abdomen with and without contrast | CPT | 74170 | 19 | $6,865.49 | $224 | $224.48 | $226.72 | 0.68× | $347.94 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 19 | $7,681.25 | $305 | $101.1 | $305.38 | 0.84× | $473.34 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 19 | $9,123.98 | $446 | $202.9 | $446.5 | 0.81× | $692.08 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 19 | $10,644 | $446 | $233.05 | $446.5 | 0.78× | $692.08 |
| MRI abdomen without contrast | CPT | 74181 | 19 | $6,293.45 | $305 | $216.39 | $305.38 | 0.78× | $473.34 |
| MRI abdomen with and without contrast | CPT | 74183 | 19 | $6,936 | $446 | $263.48 | $446.5 | 0.79× | $692.08 |
| Abdominal ultrasound complete | CPT | 76700 | 19 | $2,441.38 | $133 | $82.35 | $133.8 | 0.90× | $207.39 |
| Abdominal ultrasound limited | CPT | 76705 | 19 | $1,918.21 | $133 | $60.12 | $133.8 | 0.91× | $207.39 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 19 | $2,062.9 | $133 | $79.89 | $133.8 | 0.93× | $207.39 |
| Obstetric ultrasound first trimester | CPT | 76801 | 19 | $1,333.67 | $133 | $47.84 | $133.8 | 0.95× | $207.39 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 19 | $1,553 | $133 | $90.65 | $133.8 | 0.88× | $207.39 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 19 | $1,700.01 | $305 | $77.75 | $305.38 | 1.3× | $473.34 |
| Transvaginal ultrasound | CPT | 76830 | 19 | $1,709.31 | $133 | $70.84 | $133.8 | 0.91× | $207.39 |
| Pelvic ultrasound complete | CPT | 76856 | 19 | $2,116.25 | $133 | $67.93 | $133.8 | 0.93× | $207.39 |
| Scrotal ultrasound | CPT | 76870 | 19 | $1,609.31 | $133 | $47.16 | $133.8 | 1.0× | $207.39 |
| Diagnostic mammography unilateral | CPT | 77065 | 19 | $743.8 | $101 | $84.3 | $101.77 | 0.68× | $157.74 |
| Diagnostic mammography bilateral | CPT | 77066 | 19 | $906.9 | $130 | $108.06 | $130.44 | 0.68× | $202.18 |
| Screening mammography bilateral | CPT | 77067 | 19 | $506.25 | $107 | $88.39 | $107.7 | 0.68× | $166.94 |
| EKG tracing only | CPT | 93005 | 20 | $720 | $75 | $23.52 | $75.5 | 0.64× | $117.03 |
| Transthoracic echocardiogram complete | CPT | 93306 | 19 | $5,766.25 | $699 | $177.42 | $699.34 | 1.2× | $1,083.98 |
| Transthoracic echocardiogram | CPT | 93307 | 19 | $3,128.92 | $305 | $129.18 | $305.38 | 1.2× | $473.34 |
| Stress echocardiogram | CPT | 93350 | 19 | $2,280.96 | $699 | $68.94 | $699.34 | 1.4× | $1,083.98 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 18 | — | $19,307 | $19,308 | $19,404 | 0.96× | $36,851 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 18 | — | $9,913 | $9,913.36 | $9,962.93 | 0.93× | $18,839 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 18 | — | $6,853 | $6,853.95 | $6,888.22 | 0.90× | $12,751 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 18 | — | $15,099 | $15,089 | $15,099 | 0.98× | $29,947 |
| COPD w MCC | MS-DRG | 190 | 18 | — | $10,827 | $10,696 | $10,828 | 0.96× | $20,804 |
| COPD w CC | MS-DRG | 191 | 18 | — | $8,342 | $8,342.82 | $8,384.54 | 0.95× | $15,915 |
| COPD w/o CC/MCC | MS-DRG | 192 | 18 | — | $6,455 | $5,930.6 | $6,455.92 | 0.92× | $11,990 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 18 | — | $7,994 | $7,994.54 | $8,034.52 | 0.95× | $15,191 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 18 | — | $6,329 | $6,329.19 | $6,360.84 | 0.95× | $11,536 |
| AMI discharged alive w MCC | MS-DRG | 280 | 18 | — | $15,487 | $15,488 | $15,565 | 0.99× | $30,408 |
| AMI discharged alive w CC | MS-DRG | 281 | 18 | — | $9,057 | $9,057.22 | $9,102.51 | 0.94× | $17,077 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 18 | — | $7,217 | $7,217.25 | $7,253.34 | 0.93× | $13,433 |
| Heart failure & shock w MCC | MS-DRG | 291 | 18 | — | $12,480 | $12,481 | $12,543 | 0.98× | $24,172 |
| Heart failure & shock w CC | MS-DRG | 292 | 18 | — | $8,399 | $8,399.15 | $8,441.15 | 0.94× | $15,954 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 18 | — | $5,742 | $5,742.46 | $5,771.17 | 0.93× | $10,405 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 18 | — | $11,731 | $11,360 | $11,732 | 0.97× | $22,340 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 18 | — | $7,335 | $6,288.3 | $7,335.54 | 0.94× | $13,696 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 18 | — | $5,743 | $5,341.92 | $5,743.4 | 0.93× | $10,407 |
| GI hemorrhage w CC | MS-DRG | 378 | 18 | — | $9,635 | $9,635.49 | $9,683.67 | 0.97× | $18,264 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 18 | — | $6,347 | $6,347.02 | $6,378.76 | 0.93× | $11,795 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 18 | — | $7,747 | $7,638.59 | $7,747.65 | 0.96× | $14,456 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 18 | — | $15,146 | $15,146 | $15,222 | 1.0× | $28,250 |
| Kidney/UTI w MCC | MS-DRG | 689 | 18 | — | $11,321 | $11,322 | $11,378 | 0.98× | $21,681 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 18 | — | $8,028 | $7,447.89 | $8,028.34 | 0.97× | $14,869 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 18 | — | $18,664 | $18,664 | $18,758 | 1.0× | $36,349 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 18 | — | $10,035 | $8,911.88 | $10,035 | 0.97× | $19,100 |
| Hospital discharge, <30 min | CPT | 99238 | 5 | $188.32 | — | $53.93 | $55.82 | 0.65× | $188.32 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 20 | $714.15 | $8 | $8.34 | $8.46 | 0.26× | $30 |
| Electrolyte panel | CPT | 80051 | 19 | $297.5 | $7 | $7.01 | $7.08 | 0.30× | $10.87 |
| Comprehensive metabolic panel | CPT | 80053 | 19 | $1,248.75 | $10 | $10.55 | $10.56 | 0.24× | $16.37 |
| Lipid panel | CPT | 80061 | 19 | $869.4 | $13 | $13.24 | $13.39 | 0.35× | $20.75 |
| Renal function panel | CPT | 80069 | 19 | $416.09 | $8 | $8.68 | $8.72 | 0.32× | $13.45 |
| Hepatic function panel | CPT | 80076 | 19 | $643.8 | $8 | $7.32 | $8.17 | 0.31× | $12.66 |
| Urinalysis non-automated | CPT | 81002 | 19 | $96.12 | $3 | $2.47 | $3.48 | 0.50× | $5.39 |
| Urinalysis automated | CPT | 81003 | 19 | $140.11 | $2 | $2.25 | $2.25 | 0.16× | $3.49 |
| Glucose quantitative | CPT | 82947 | 19 | $158.16 | $3 | $3.79 | $3.93 | 0.22× | $6.09 |
| Hemoglobin A1c | CPT | 83036 | 19 | $293.93 | $9 | $9.71 | $9.8 | 0.36× | $15.05 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 19 | $423.95 | $16 | $16.8 | $16.94 | 0.36× | $26.04 |
| Complete blood count with automated differential | CPT | 85025 | 20 | $467.5 | $7 | $7.75 | $7.77 | 0.29× | $30 |
| Complete blood count without differential | CPT | 85027 | 19 | $360 | $6 | $6.47 | $6.53 | 0.30× | $10.03 |
| Urine culture bacterial | CPT | 87086 | 19 | $502.91 | $8 | $6.48 | $8.07 | 0.35× | $12.51 |
| Urine culture identification | CPT | 87088 | 19 | $266.88 | $8 | $6.98 | $8.09 | 0.36× | $12.54 |
| Tissue exam by pathologist level IV | CPT | 88305 | 19 | $830.82 | $66 | $11.76 | $66.69 | 0.65× | $103.37 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 4 | $405.35 | — | $19.62 | $19.62 | 0.10× | $20.99 |
| Vaginal delivery only | CPT | 59409 | 19 | $16,485 | $4,143 | $780.72 | $4,143.08 | 1.9× | $6,421.77 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 6 | $421.05 | — | $49.2 | $50.92 | 0.59× | $421.05 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 5 | $558.8 | — | $82.05 | $82.05 | 0.67× | $558.8 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 5 | $720.05 | — | $98.83 | $98.83 | 0.57× | $720.05 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 5 | $946.65 | — | $118.62 | $118.62 | 0.54× | $946.65 |
| Office visit, established patient, 5 min | CPT | 99211 | 6 | $338 | — | $9.85 | $17.21 | 0.27× | $338 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 6 | $376.28 | — | $16.37 | $16.95 | 0.21× | $376.28 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 6 | $522 | — | $34.43 | $35.64 | 0.31× | $522 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 6 | $643.49 | — | $53.79 | $55.68 | 0.36× | $643.49 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 6 | $846 | — | $82.05 | $84.92 | 0.45× | $846 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 19 | $6,196.8 | $1,160 | $321.48 | $1,160.81 | 1.3× | $1,799.26 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 19 | $6,016.31 | $1,160 | $335.91 | $1,160.81 | 1.2× | $1,799.26 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 19 | $4,845.3 | $1,190 | $78.5 | $1,190.22 | 1.4× | $1,844.84 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 19 | $4,845.3 | $1,190 | $103.61 | $1,190.22 | 1.3× | $1,844.84 |
| Colonoscopy diagnostic | CPT | 45378 | 19 | $6,238.32 | $1,190 | $423.48 | $1,190.22 | 1.4× | $1,844.84 |
| Colonoscopy with biopsy | CPT | 45380 | 19 | $7,892.25 | $1,531 | $473.68 | $1,531.54 | 1.3× | $2,373.89 |
| Colonoscopy with polyp removal | CPT | 45385 | 19 | $7,892.25 | $1,531 | $574.08 | $1,531.54 | 1.3× | $2,373.89 |
| surgery |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 19 | $8,373.22 | $4,187 | $790.35 | $4,187.71 | 2.0× | $6,490.95 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 18 | — | $43,579 | $43,579 | $43,797 | 1.0× | $85,068 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 18 | — | $22,932 | $22,933 | $23,048 | 0.99× | $43,789 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 18 | — | $16,227 | $16,227 | $16,309 | 0.99× | $30,586 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 18 | — | $16,309 | $16,309 | $16,391 | 0.99× | $30,723 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 18 | — | $13,250 | $13,251 | $13,317 | 0.98× | $24,409 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 18 | — | $32,413 | $32,414 | $32,576 | 1.0× | $67,826 |
| Laparoscopic appendectomy | CPT | 44970 | 19 | $13,125 | $7,737 | $391.98 | $7,737.45 | 5.0× | $11,993 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $95,128 | $95,128 | 1.9× | $95,128 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $52,466 | $52,466 | 1.6× | $52,466 |
| Major joint replacement w MCC | MS-DRG | 469 | 18 | — | $28,903 | $28,903 | $29,048 | 0.98× | $60,555 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 18 | — | $18,536 | $18,537 | $18,629 | 0.99× | $34,930 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 19 | $17,250 | $7,737 | $769.53 | $7,737.45 | 4.1× | $11,993 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 18 | — | $27,768 | $27,769 | $27,907 | 1.00× | $54,484 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 18 | — | $20,091 | $20,091 | $20,192 | 0.99× | $38,439 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 18 | — | $15,740 | $15,740 | $15,819 | 0.99× | $29,389 |
| Lap salpingo-oophorectomy | CPT | 58661 | 19 | $24,600 | $7,737 | $701.38 | $7,737.45 | 3.8× | $11,993 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 18 | — | $27,534 | $27,535 | $27,672 | 1.0× | $50,510 |
| OR procedure for obesity w CC | MS-DRG | 620 | 18 | — | $15,452 | $15,452 | $15,529 | 0.96× | $29,585 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 18 | — | $14,589 | $14,589 | $14,662 | 0.97× | $27,081 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 18 | — | $12,076 | $12,076 | $12,137 | 0.99× | $22,207 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 18 | — | $19,665 | $18,056 | $19,665 | 1.0× | $36,199 |
| PCI single major coronary artery | CPT | 92920 | 19 | $30,408 | $7,284 | $435.12 | $7,284.43 | 1.3× | $11,291 |
| PCI with drug-eluting stent | CPT | 92928 | 19 | $61,892 | $14,775 | $483.05 | $14,775 | 1.5× | $22,901 |
| PCI bypass graft | CPT | 92937 | 19 | $61,892 | $14,775 | $482.46 | $14,775 | 1.4× | $22,901 |
| Left heart catheterization | CPT | 93452 | 19 | $15,282 | $4,149 | $549.26 | $4,149.23 | 1.3× | $6,431.31 |
| Coronary angiography with cath | CPT | 93455 | 19 | $15,282 | $4,149 | $671.23 | $4,149.23 | 1.3× | $6,431.31 |
| Coronary angiography with bypass cath | CPT | 93458 | 19 | $25,380 | $4,149 | $693.51 | $4,149.23 | 1.3× | $6,431.31 |