| behavioral |
| Psychoses | MS-DRG | 885 | 8 | — | — | $7,705.65 | $13,614 | 1.1× | $14,023 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 13 | $1,242 | $869.4 | $155.25 | $326.5 | 1.8× | $1,242 |
| Psychiatric eval with medical services | CPT | 90792 | 13 | $1,242 | $869.4 | $130.95 | $310.5 | 1.8× | $1,242 |
| Psychotherapy 30 minutes | CPT | 90832 | 13 | $1,237 | $865.9 | $67.05 | $188.94 | 1.3× | $1,031.79 |
| Psychotherapy 45 minutes | CPT | 90834 | 13 | $663 | $464.1 | $85.18 | $188.94 | 1.2× | $553.01 |
| Psychotherapy 60 minutes | CPT | 90837 | 13 | $990 | $693 | $124.32 | $214.64 | 1.1× | $825.76 |
| emergency |
| ED visit level 1 | CPT | 99281 | 16 | $491 | $343.7 | $21.77 | $331.18 | 2.4× | $5,570 |
| ED visit level 2 | CPT | 99282 | 16 | $1,224 | $856.8 | $34.97 | $908.15 | 3.8× | $5,711 |
| ED visit level 3 | CPT | 99283 | 16 | $2,268 | $1,587.6 | $63.97 | $1,271.58 | 3.1× | $11,936 |
| ED visit level 4 | CPT | 99284 | 16 | $18,542 | $12,979 | $98.04 | $2,593.77 | 3.9× | $22,845 |
| ED visit level 5 | CPT | 99285 | 16 | $34,425 | $24,098 | $155.03 | $4,291.2 | 4.1× | $34,566 |
| Critical care, first hour | CPT | 99291 | 16 | $48,238 | $33,767 | $293 | $6,952.18 | 6.5× | $48,436 |
| imaging |
| CT head without contrast | CPT | 70450 | 13 | $4,465 | $3,125.5 | $144.97 | $257.46 | 1.2× | $4,465 |
| CT head with contrast | CPT | 70460 | 13 | $6,697 | $4,687.9 | $209.04 | $390.05 | 1.7× | $6,697 |
| CT head with and without contrast | CPT | 70470 | 13 | $6,697 | $4,687.9 | $237.85 | $424.62 | 1.6× | $6,697 |
| CT neck with contrast | CPT | 70491 | 13 | $6,697 | $4,687.9 | $237.85 | $438.8 | 1.6× | $6,697 |
| MRI brain without contrast | CPT | 70551 | 13 | $5,092 | $3,564.4 | $283.78 | $513.64 | 1.3× | $5,930 |
| MRI brain with contrast | CPT | 70552 | 13 | $7,800 | $5,460 | $396.44 | $717.56 | 1.5× | $7,800 |
| MRI brain with and without contrast | CPT | 70553 | 13 | $7,800 | $5,460 | $467.23 | $828.27 | 1.4× | $7,800 |
| Chest X-ray single view | CPT | 71045 | 15 | $1,054 | $737.8 | $17.67 | $117.65 | 1.2× | $1,054 |
| Chest X-ray 2 views | CPT | 71046 | 15 | $1,054 | $737.8 | $27.48 | $117.65 | 1.2× | $1,054 |
| Chest X-ray 3 views | CPT | 71047 | 15 | $1,054 | $737.8 | $35.27 | $117.65 | 1.2× | $1,054 |
| CT chest without contrast | CPT | 71250 | 13 | $4,465 | $3,125.5 | $144.97 | $291.94 | 1.4× | $4,465 |
| CT chest with contrast | CPT | 71260 | 13 | $6,697 | $4,687.9 | $237.85 | $416.28 | 1.5× | $6,697 |
| CT chest with and without contrast | CPT | 71270 | 13 | $6,697 | $4,687.9 | $237.85 | $456.85 | 1.6× | $6,697 |
| MRI chest without contrast | CPT | 71550 | 13 | $5,092 | $3,564.4 | $306.4 | $566.7 | 1.3× | $5,930 |
| MRI chest with contrast | CPT | 71551 | 13 | $8,000 | $5,600 | $395.33 | $1,010.24 | 1.2× | $8,000 |
| MRI chest with and without contrast | CPT | 71552 | 13 | $7,800 | $5,460 | $490.35 | $828.27 | 1.4× | $7,800 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | $1,175 | $822.5 | $43.45 | $158.34 | 1.5× | $1,175 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $4,465 | $3,125.5 | $144.97 | $288.91 | 1.4× | $4,465 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $4,465 | $3,125.5 | $144.97 | $288.47 | 1.4× | $4,465 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $4,465 | $3,125.5 | $144.97 | $288.06 | 1.4× | $4,465 |
| MRI cervical spine without contrast | CPT | 72141 | 13 | $5,092 | $3,564.4 | $277.53 | $502.33 | 1.3× | $5,930 |
| MRI thoracic spine without contrast | CPT | 72146 | 13 | $5,092 | $3,564.4 | $277.53 | $502.33 | 1.3× | $5,930 |
| MRI lumbar spine without contrast | CPT | 72148 | 13 | $5,092 | $3,564.4 | $277.97 | $510.46 | 1.4× | $5,930 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 13 | $7,800 | $5,460 | $399.67 | $723.4 | 1.6× | $7,800 |
| MRI cervical spine with and without contrast | CPT | 72156 | 13 | $7,800 | $5,460 | $471.83 | $828.27 | 1.5× | $7,800 |
| MRI lumbar spine with contrast | CPT | 72158 | 13 | $7,800 | $5,460 | $470.9 | $828.27 | 1.5× | $7,800 |
| CT pelvis without contrast | CPT | 72192 | 13 | $4,465 | $3,125.5 | $144.97 | $292.28 | 1.5× | $4,465 |
| CT pelvis with contrast | CPT | 72193 | 13 | $6,697 | $4,687.9 | $237.85 | $466.27 | 1.7× | $6,697 |
| Shoulder X-ray | CPT | 73030 | 15 | $1,054 | $737.8 | $37.09 | $117.65 | 1.3× | $1,054 |
| Humerus X-ray | CPT | 73060 | 15 | $1,054 | $737.8 | $29.81 | $117.65 | 1.3× | $1,054 |
| Hand X-ray 3 views | CPT | 73130 | 15 | $1,054 | $737.8 | $36.06 | $117.65 | 1.3× | $1,054 |
| MRI upper extremity joint without contrast | CPT | 73221 | 13 | $5,092 | $3,564.4 | $295.44 | $526.27 | 1.3× | $5,930 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 13 | $7,800 | $5,460 | $408.36 | $739.13 | 1.2× | $7,800 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | $1,054 | $737.8 | $27.28 | $117.65 | 1.3× | $1,054 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | $1,054 | $737.8 | $36.06 | $117.65 | 1.3× | $1,054 |
| MRI lower extremity joint without contrast | CPT | 73721 | 13 | $7,091 | $4,963.7 | $294.53 | $900.68 | 1.9× | $7,091 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 13 | $7,800 | $5,460 | $407.06 | $736.78 | 1.2× | $7,800 |
| CT abdomen without contrast | CPT | 74150 | 13 | $4,465 | $3,125.5 | $144.97 | $296.51 | 1.6× | $4,465 |
| CT abdomen with contrast | CPT | 74160 | 13 | $6,697 | $4,687.9 | $237.85 | $471.87 | 1.6× | $6,697 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $6,697 | $4,687.9 | $237.85 | $509.36 | 1.5× | $6,697 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $5,921 | $4,144.7 | $178.43 | $337.43 | 0.93× | $5,921 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $8,837 | $6,185.9 | $281.8 | $535.51 | 0.98× | $8,837 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $8,837 | $6,185.9 | $319.24 | $592.19 | 1.0× | $8,837 |
| MRI abdomen without contrast | CPT | 74181 | 13 | $5,092 | $3,564.4 | $287.28 | $517.79 | 1.3× | $5,930 |
| MRI abdomen with and without contrast | CPT | 74183 | 13 | $7,800 | $5,460 | $351.25 | $635.76 | 1.1× | $7,800 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | $1,874 | $1,311.8 | $119.34 | $245.18 | 1.6× | $1,874 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | $1,874 | $1,311.8 | $87.13 | $245.18 | 1.7× | $1,874 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | $1,874 | $1,311.8 | $115.78 | $245.18 | 1.7× | $1,874 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | $1,874 | $1,311.8 | $78.42 | $245.18 | 1.7× | $1,874 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | $1,250 | $875 | $135.29 | $271.93 | 1.8× | $1,250 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 15 | $2,793 | $1,955.1 | $159.03 | $334.67 | 1.4× | $2,793 |
| Transvaginal ultrasound | CPT | 76830 | 15 | $1,874 | $1,311.8 | $97.04 | $245.18 | 1.7× | $1,874 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | $1,874 | $1,311.8 | $97.04 | $245.18 | 1.7× | $1,874 |
| Scrotal ultrasound | CPT | 76870 | 15 | $1,874 | $1,311.8 | $85.75 | $245.18 | 1.9× | $1,874 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $557 | $389.9 | $117.89 | $434.16 | 2.9× | $557 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $716 | $501.2 | $149.36 | $558.09 | 2.9× | $716 |
| EKG complete | CPT | 93000 | 7 | $505 | $353.5 | $52.21 | $378.75 | 15.5× | $505 |
| EKG tracing only | CPT | 93005 | 13 | $529 | $370.3 | $29.84 | $135 | 1.1× | $529 |
| Transthoracic echocardiogram complete | CPT | 93306 | 13 | $3,050 | $2,135 | $239.76 | $2,085 | 3.5× | $3,050 |
| Transthoracic echocardiogram | CPT | 93307 | 13 | $1,068 | $747.6 | $215.3 | $399.38 | 1.6× | $1,068 |
| Stress echocardiogram | CPT | 93350 | 13 | $4,164 | $2,914.8 | $137.87 | $682.3 | 1.3× | $4,164 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $11,990 | $20,048 | 1.3× | $20,649 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $7,252.96 | $12,408 | 1.1× | $12,781 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $5,660.36 | $9,867.46 | 1.1× | $10,163 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $4,496.34 | $7,876.4 | 1.1× | $8,112.69 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $5,633.73 | $9,652.21 | 1.1× | $9,941.78 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $4,324.51 | $7,561.97 | 1.1× | $7,788.83 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $10,340 | $17,492 | 1.1× | $18,017 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $6,141.57 | $10,356 | 1.1× | $10,667 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $4,678.3 | $8,198.22 | 1.1× | $9,285 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $8,532.38 | $13,919 | 1.1× | $14,337 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $5,740.88 | $9,647.99 | 1.1× | $9,937.43 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $4,154.61 | $6,761.11 | 1.1× | $6,963.94 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $7,530.03 | $13,208 | 1.1× | $13,604 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $4,794.94 | $8,455.68 | 1.1× | $8,709.35 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $3,545.96 | $6,437.18 | 1.0× | $6,630.3 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $6,264.55 | $11,020 | 1.1× | $11,350 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $4,093.74 | $7,260.2 | 1.1× | $7,478.01 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $4,827.92 | $8,617.12 | 1.1× | $8,875.63 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $9,252.6 | $15,480 | 1.0× | $15,944 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $7,091.92 | $12,293 | 1.1× | $12,662 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $5,013.67 | $8,914.67 | 1.1× | $9,182.11 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $11,832 | $20,291 | 1.1× | $20,900 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $6,589.17 | $11,366 | 1.1× | $11,707 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | $479 | $335.3 | $7.98 | $22.55 | 0.70× | $399.54 |
| General health panel | CPT | 80050 | 11 | $481 | $336.7 | $54.43 | $322.54 | 3.0× | $481 |
| Electrolyte panel | CPT | 80051 | 15 | $371 | $259.7 | $6.61 | $18.7 | 0.79× | $309.46 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | $953 | $667.1 | $9.96 | $28.13 | 0.63× | $794.9 |
| Lipid panel | CPT | 80061 | 15 | $325 | $227.5 | $3.02 | $11.63 | 0.30× | $325 |
| Renal function panel | CPT | 80069 | 15 | $248 | $173.6 | $8.19 | $23.12 | 0.85× | $242.59 |
| Hepatic function panel | CPT | 80076 | 15 | $234 | $163.8 | $7.7 | $21.77 | 0.82× | $228.47 |
| Urinalysis non-automated | CPT | 81002 | 15 | $39 | $27.3 | $3.08 | $9.27 | 1.3× | $39 |
| Urinalysis automated | CPT | 81003 | 15 | $90 | $63 | $2.12 | $39.86 | 2.9× | $75.07 |
| Glucose quantitative | CPT | 82947 | 15 | $130 | $91 | $3.71 | $19.95 | 1.1× | $109.91 |
| Hemoglobin A1c | CPT | 83036 | 15 | $544 | $380.8 | $9.16 | $146.36 | 5.4× | $453.76 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | $231 | $161.7 | $15.84 | $44.77 | 0.95× | $231 |
| Complete blood count with automated differential | CPT | 85025 | 15 | $185 | $129.5 | $7.33 | $20.71 | 0.78× | $185 |
| Complete blood count without differential | CPT | 85027 | 15 | $148 | $103.6 | $6.1 | $17.26 | 0.80× | $148 |
| Urine culture bacterial | CPT | 87086 | 15 | $143 | $100.1 | $7.61 | $21.53 | 0.92× | $143 |
| Urine culture identification | CPT | 87088 | 15 | $147 | $102.9 | $7.63 | $41.25 | 1.9× | $147 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | $620 | $434 | $24.95 | $65.43 | 0.64× | $620 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 16 | $861 | $602.7 | $32.7 | $442.4 | 2.4× | $23,269 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 7 | — | — | $1,994.02 | $8,783.55 | 3.8× | $23,269 |
| Vaginal delivery only | CPT | 59409 | 11 | — | — | $780.72 | $5,364.05 | 2.4× | $23,269 |
| Vaginal delivery with postpartum | CPT | 59410 | 6 | — | — | $4,982 | $10,275 | 9.7× | $23,269 |
| Routine obstetric care with C-section | CPT | 59510 | 7 | — | — | $1,995.21 | $9,380 | 3.7× | $23,269 |
| C-section delivery only | CPT | 59514 | 7 | — | — | $781.35 | $9,380 | 9.8× | $23,269 |
| C-section with postpartum | CPT | 59515 | 6 | — | — | $6,130.34 | $10,958 | 8.7× | $23,269 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 10 | $1,856 | $1,299.2 | $49.2 | $314 | 3.6× | $1,856 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 10 | $397 | $277.9 | $82.05 | $277.45 | 2.3× | $397 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 10 | $3,410 | $2,387 | $98.83 | $346.4 | 2.0× | $3,410 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 10 | $505 | $353.5 | $118.62 | $374.87 | 1.7× | $505 |
| Office visit, established patient, 5 min | CPT | 99211 | 10 | $1,856 | $1,299.2 | $17.21 | $226.8 | 3.5× | $1,856 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 10 | $316 | $221.2 | $16.37 | $203 | 2.5× | $316 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 10 | $358 | $250.6 | $34.43 | $203 | 1.8× | $358 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 10 | $3,410 | $2,387 | $53.79 | $322 | 2.1× | $3,410 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 10 | $486 | $340.2 | $82.05 | $335.85 | 1.8× | $486 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | — | — | $405.42 | $4,530 | 4.9× | $11,836 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | — | — | $423.61 | $4,530 | 4.7× | $11,836 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | — | — | $99 | $2,979 | 3.5× | $9,864 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 11 | — | — | $130.65 | $2,979 | 3.3× | $9,864 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | — | — | $534.04 | $2,979 | 3.4× | $11,836 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | — | — | $597.36 | $2,979 | 2.5× | $11,836 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | — | — | $723.96 | $2,979 | 2.5× | $11,836 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 10 | — | — | $2,359.38 | $17,361 | 4.2× | $33,533 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 8 | — | — | $20,116 | $33,503 | 1.2× | $34,508 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 8 | — | — | $12,900 | $21,357 | 1.2× | $21,998 |
| Hip hemiarthroplasty | CPT | 27125 | 8 | — | — | $1,885.66 | $10,653 | 8.5× | $29,588 |
| Total hip replacement | CPT | 27130 | 11 | — | — | $2,693.8 | $16,419 | 3.8× | $33,533 |
| Total knee replacement | CPT | 27447 | 11 | — | — | $2,693.8 | $17,310 | 4.2× | $36,067 |
| Knee revision arthroplasty single component | CPT | 27486 | 7 | — | — | $2,608.21 | $13,379 | 8.0× | $33,533 |
| Knee revision arthroplasty all components | CPT | 27487 | 8 | — | — | $2,584.03 | $13,107 | 6.5× | $33,533 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 8 | — | — | $605.06 | $7,751 | 23.7× | $17,794 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 11 | — | — | $623.03 | $9,110.03 | 2.8× | $29,588 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 11 | — | — | $790.35 | $7,580.4 | 3.7× | $19,095 |
| ACL reconstruction | CPT | 29888 | 11 | — | — | $1,220.29 | $8,793.26 | 2.6× | $29,588 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $31,112 | $52,093 | 1.2× | $53,656 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $16,020 | $27,436 | 1.2× | $28,259 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $10,710 | $18,585 | 1.1× | $19,143 |
| CABG single arterial graft | CPT | 33533 | 7 | — | — | $3,386.12 | $17,452 | 9.3× | $29,408 |
| CABG 2 arterial grafts | CPT | 33534 | 7 | — | — | $3,807.69 | $18,163 | 8.5× | $36,067 |
| CABG 3 arterial grafts | CPT | 33535 | 7 | — | — | $4,228.6 | $18,163 | 8.0× | $36,067 |
| CABG 4+ arterial grafts | CPT | 33536 | 7 | — | — | $4,650.86 | $18,163 | 7.4× | $36,067 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $10,581 | $18,358 | 1.1× | $18,909 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $8,285.12 | $14,415 | 1.1× | $14,848 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $21,777 | $37,641 | 1.2× | $38,770 |
| Open appendectomy | CPT | 44950 | 11 | — | — | $724.63 | $5,014 | 4.4× | $23,269 |
| Laparoscopic appendectomy | CPT | 44970 | 11 | — | — | $494.31 | $7,157 | 4.6× | $29,588 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 8 | — | — | $43,442 | $71,585 | 1.4× | $73,733 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 8 | — | — | $25,109 | $42,011 | 1.3× | $43,272 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $19,907 | $33,098 | 1.1× | $34,090 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $12,480 | $20,588 | 1.1× | $21,205 |
| Laparoscopic cholecystectomy | CPT | 47562 | 11 | — | — | $843.15 | $11,966 | 6.7× | $36,067 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 11 | — | — | $970.44 | $11,966 | 6.4× | $36,067 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $19,137 | $32,463 | 1.2× | $33,437 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $13,237 | $22,654 | 1.1× | $23,333 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $10,431 | $17,902 | 1.1× | $18,439 |
| Open umbilical hernia repair | CPT | 49560 | 11 | — | — | $839.12 | $7,580.4 | 4.0× | $19,095 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 11 | — | — | $534.04 | $7,580.4 | 5.8× | $19,095 |
| Lap inguinal hernia repair | CPT | 49650 | 11 | — | — | $379.7 | $7,580.4 | 6.7× | $29,588 |
| Lap incisional hernia repair | CPT | 49652 | 11 | — | — | $524.57 | $9,079 | 3.4× | $29,588 |
| Total abdominal hysterectomy | CPT | 58150 | 8 | — | — | $1,162.9 | $11,366 | 11.7× | $29,408 |
| Vaginal hysterectomy | CPT | 58260 | 11 | — | — | $1,162.9 | $6,226.62 | 3.4× | $29,408 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 11 | — | — | $838.74 | $13,946 | 9.4× | $32,455 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 11 | — | — | $616.65 | $12,577 | 5.6× | $32,455 |
| Lap salpingo-oophorectomy | CPT | 58661 | 11 | — | — | $701.38 | $8,617.85 | 4.2× | $29,588 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $19,518 | $32,842 | 1.2× | $33,827 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $11,378 | $19,136 | 1.2× | $19,710 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $9,966.49 | $17,389 | 1.1× | $17,910 |
| Complex cataract surgery | CPT | 66982 | 11 | — | — | $1,272.35 | $11,659 | 5.3× | $23,498 |
| Cataract surgery with lens implant | CPT | 66984 | 11 | — | — | $1,818.32 | $11,659 | 5.3× | $23,498 |
| Intravitreal injection | CPT | 67028 | 11 | — | — | $424.58 | $2,979 | 8.7× | $8,864 |
| Vitrectomy mechanical | CPT | 67042 | 11 | — | — | $1,186.9 | $7,668.46 | 3.0× | $23,671 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $7,281.5 | $12,490 | 1.0× | $12,864 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $11,035 | $19,481 | 1.0× | $20,065 |
| PCI single major coronary artery | CPT | 92920 | 13 | $17,500 | $12,250 | $435.12 | $10,780 | 1.9× | $36,067 |
| PCI with drug-eluting stent | CPT | 92928 | 13 | $36,094 | $25,266 | $483.05 | $14,184 | 1.4× | $36,067 |
| PCI bypass graft | CPT | 92937 | 13 | $36,094 | $25,266 | $482.46 | $14,184 | 1.3× | $36,067 |
| Left heart catheterization | CPT | 93452 | 13 | $36,933 | $25,853 | $967.53 | $14,968 | 4.8× | $30,806 |
| Coronary angiography with cath | CPT | 93455 | 13 | $34,066 | $23,846 | $1,166.18 | $14,968 | 4.8× | $36,067 |
| Coronary angiography with bypass cath | CPT | 93458 | 13 | $41,919 | $29,343 | $1,204.89 | $14,968 | 4.8× | $36,067 |