| behavioral |
| Psychoses | MS-DRG | 885 | 8 | — | $14,951 | $3,404.58 | $7,238.1 | 0.56× | $14,951 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 8 | — | $262.99 | $101.01 | $133.04 | 0.75× | $262.99 |
| Psychiatric eval with medical services | CPT | 90792 | 8 | — | $262.99 | $101.01 | $133.04 | 0.77× | $262.99 |
| Psychotherapy 30 minutes | CPT | 90832 | 8 | — | $262.99 | $75.97 | $133.04 | 0.90× | $262.99 |
| Psychotherapy 45 minutes | CPT | 90834 | 8 | — | $262.99 | $101.01 | $133.04 | 0.83× | $262.99 |
| Psychotherapy 60 minutes | CPT | 90837 | 8 | — | $262.99 | $101.01 | $133.04 | 0.70× | $262.99 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 8 | — | $262.99 | $101.01 | $133.04 | 0.84× | $262.99 |
| emergency |
| ED visit level 1 | CPT | 99281 | 20 | $280 | $120 | $51.57 | $124.95 | 0.89× | $261.8 |
| ED visit level 2 | CPT | 99282 | 20 | $452 | $220 | $85.21 | $305.1 | 1.3× | $422.62 |
| imaging |
| CT head without contrast | CPT | 70450 | 20 | $2,272 | $213.99 | $108.26 | $1,590.4 | 7.7× | $2,124.32 |
| CT head with contrast | CPT | 70460 | 20 | $3,124 | $351.09 | $177.62 | $2,186.8 | 9.3× | $2,920.94 |
| CT head with and without contrast | CPT | 70470 | 20 | $3,124 | $351.09 | $177.62 | $2,186.8 | 8.2× | $2,920.94 |
| CT neck with contrast | CPT | 70491 | 20 | $3,124 | $351.09 | $177.62 | $2,186.8 | 8.0× | $2,920.94 |
| MRI brain without contrast | CPT | 70551 | 20 | $2,840 | $452.26 | $228.8 | $1,988 | 4.9× | $2,655.4 |
| MRI brain with contrast | CPT | 70552 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 5.8× | $3,717.56 |
| MRI brain with and without contrast | CPT | 70553 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 4.7× | $3,717.56 |
| Chest X-ray single view | CPT | 71045 | 7 | — | $158.99 | $52.46 | $80.43 | 0.85× | $158.99 |
| Chest X-ray 2 views | CPT | 71046 | 19 | $286 | $158.99 | $52.46 | $200.2 | 2.0× | $267.41 |
| Chest X-ray 3 views | CPT | 71047 | 19 | $320 | $158.99 | $52.46 | $224 | 2.3× | $299.2 |
| CT chest without contrast | CPT | 71250 | 20 | $2,556 | $213.99 | $106.87 | $1,704 | 7.9× | $2,389.86 |
| CT chest with contrast | CPT | 71260 | 20 | $3,408 | $351.09 | $177.62 | $2,343 | 8.3× | $3,186.48 |
| CT chest with and without contrast | CPT | 71270 | 20 | $3,408 | $351.09 | $177.62 | $2,343 | 8.0× | $3,186.48 |
| MRI chest without contrast | CPT | 71550 | 20 | $2,840 | $452.26 | $228.8 | $1,988 | 4.6× | $2,655.4 |
| MRI chest with contrast | CPT | 71551 | 8 | — | $1,406.19 | $408.81 | $711.39 | 0.87× | $1,406.19 |
| MRI chest with and without contrast | CPT | 71552 | 8 | — | $723.78 | $366.16 | $519.36 | 0.86× | $950 |
| Lumbosacral spine X-ray | CPT | 72100 | 20 | $538 | $213.99 | $52.46 | $376.6 | 3.6× | $503.03 |
| CT cervical spine without contrast | CPT | 72125 | 20 | $2,272 | $213.99 | $106.87 | $1,590.4 | 7.9× | $2,124.32 |
| CT thoracic spine without contrast | CPT | 72128 | 20 | $2,272 | $213.99 | $106.87 | $1,590.4 | 8.0× | $2,124.32 |
| CT lumbar spine without contrast | CPT | 72131 | 20 | $2,272 | $213.99 | $106.87 | $1,590.4 | 7.8× | $2,124.32 |
| MRI cervical spine without contrast | CPT | 72141 | 20 | $2,840 | $452.26 | $228.8 | $1,988 | 5.0× | $2,655.4 |
| MRI thoracic spine without contrast | CPT | 72146 | 20 | $2,840 | $452.26 | $228.8 | $1,988 | 5.3× | $2,655.4 |
| MRI lumbar spine without contrast | CPT | 72148 | 20 | $2,840 | $452.26 | $228.8 | $1,988 | 5.3× | $2,655.4 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 6.1× | $3,717.56 |
| MRI cervical spine with and without contrast | CPT | 72156 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 5.2× | $3,717.56 |
| MRI lumbar spine with contrast | CPT | 72158 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 5.1× | $3,717.56 |
| CT pelvis without contrast | CPT | 72192 | 20 | $2,272 | $213.99 | $106.87 | $1,590.4 | 8.0× | $2,124.32 |
| CT pelvis with contrast | CPT | 72193 | 20 | $3,124 | $351.09 | $177.62 | $2,186.8 | 7.8× | $2,920.94 |
| Shoulder X-ray | CPT | 73030 | 20 | $572 | $158.99 | $52.46 | $228.8 | 2.5× | $534.82 |
| Humerus X-ray | CPT | 73060 | 20 | $572 | $158.99 | $52.46 | $228.8 | 2.6× | $534.82 |
| Hand X-ray 3 views | CPT | 73130 | 20 | $1,855 | $158.99 | $52.46 | $228.8 | 2.5× | $1,734.43 |
| MRI upper extremity joint without contrast | CPT | 73221 | 20 | $5,679 | $452.26 | $228.8 | $2,272 | 5.5× | $5,309.87 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 4.6× | $3,717.56 |
| Knee X-ray 1-2 views | CPT | 73560 | 20 | $410 | $158.99 | $52.46 | $221.65 | 2.4× | $383.35 |
| Ankle X-ray 3 views | CPT | 73610 | 20 | $572 | $158.99 | $52.46 | $228.8 | 2.5× | $534.82 |
| MRI lower extremity joint without contrast | CPT | 73721 | 20 | $5,679 | $452.26 | $228.8 | $2,272 | 4.9× | $5,309.87 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 20 | $3,976 | $723.78 | $366.16 | $2,783.2 | 4.4× | $3,717.56 |
| CT abdomen without contrast | CPT | 74150 | 20 | $2,272 | $213.99 | $106.87 | $1,590.4 | 8.5× | $2,124.32 |
| CT abdomen with contrast | CPT | 74160 | 20 | $3,124 | $351.09 | $177.62 | $2,186.8 | 7.6× | $2,920.94 |
| CT abdomen with and without contrast | CPT | 74170 | 20 | $3,124 | $351.09 | $177.62 | $2,186.8 | 6.5× | $2,920.94 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 20 | $2,556 | $452.26 | $184.02 | $1,789.2 | 4.9× | $2,389.86 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 20 | $3,408 | $723.78 | $284.61 | $2,385.6 | 4.3× | $3,186.48 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 20 | $3,408 | $723.78 | $289.54 | $2,385.6 | 4.1× | $3,186.48 |
| MRI abdomen without contrast | CPT | 74181 | 8 | — | $452.26 | $228.8 | $339.04 | 0.87× | $950 |
| MRI abdomen with and without contrast | CPT | 74183 | 8 | — | $723.78 | $366.16 | $519.36 | 0.92× | $950 |
| Abdominal ultrasound complete | CPT | 76700 | 20 | $597 | $213.99 | $94.37 | $417.9 | 2.8× | $558.2 |
| Abdominal ultrasound limited | CPT | 76705 | 20 | $597 | $213.99 | $94.37 | $417.9 | 2.9× | $558.2 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 20 | $597 | $213.99 | $94.37 | $417.9 | 2.9× | $558.2 |
| Obstetric ultrasound first trimester | CPT | 76801 | 20 | $597 | $213.99 | $93.15 | $417.9 | 3.0× | $558.2 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 20 | $597 | $213.99 | $93.15 | $417.9 | 2.7× | $558.2 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 8 | — | $452.26 | $93.15 | $228.8 | 0.97× | $452.26 |
| Transvaginal ultrasound | CPT | 76830 | 20 | $597 | $213.99 | $94.37 | $417.9 | 2.8× | $558.2 |
| Pelvic ultrasound complete | CPT | 76856 | 20 | $597 | $213.99 | $94.37 | $417.9 | 2.9× | $558.2 |
| Scrotal ultrasound | CPT | 76870 | 20 | $597 | $213.99 | $94.37 | $417.9 | 3.2× | $558.2 |
| Diagnostic mammography unilateral | CPT | 77065 | 1 | — | — | $46.4 | $46.4 | 0.31× | $46.4 |
| Diagnostic mammography bilateral | CPT | 77066 | 1 | — | — | $46.4 | $46.4 | 0.24× | $46.4 |
| Screening mammography bilateral | CPT | 77067 | 1 | — | — | $46.4 | $46.4 | 0.29× | $46.4 |
| EKG tracing only | CPT | 93005 | 20 | $153 | $109.41 | $24.16 | $107.1 | 0.91× | $143.06 |
| Transthoracic echocardiogram complete | CPT | 93306 | 8 | — | $949.71 | $425.17 | $480.46 | 0.80× | $949.71 |
| Transthoracic echocardiogram | CPT | 93307 | 8 | — | $452.26 | $228.8 | $256.46 | 1.0× | $452.26 |
| Stress echocardiogram | CPT | 93350 | 8 | — | $949.71 | $425.17 | $480.46 | 0.95× | $949.71 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | $23,010 | $7,696.69 | $10,799 | 0.70× | $23,010 |
| COPD w MCC | MS-DRG | 190 | 9 | — | $14,884 | $21.91 | $6,056.37 | 0.54× | $14,884 |
| COPD w CC | MS-DRG | 191 | 8 | — | $11,424 | $3,680.81 | $5,164.31 | 0.59× | $11,424 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | $9,051.25 | $21.91 | $3,717.98 | 0.53× | $9,051.25 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | $11,253 | $3,595.9 | $5,045.18 | 0.60× | $11,253 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | $8,585 | $2,503.43 | $3,888.27 | 0.58× | $8,585 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | $20,714 | $6,688.56 | $10,300 | 0.66× | $20,714 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | $12,245 | $3,873.53 | $5,977.48 | 0.62× | $12,245 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | $9,362.5 | $3,022.32 | $4,670.45 | 0.60× | $9,362.5 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | $16,818 | $5,279.17 | $7,406.87 | 0.58× | $16,818 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | $11,498 | $3,594.23 | $5,042.84 | 0.56× | $11,498 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | $8,320 | $2,393.79 | $3,445.02 | 0.55× | $8,320 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | $15,045 | $4,708.05 | $7,013.26 | 0.58× | $15,045 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | $9,543.75 | $3,123.88 | $4,382.92 | 0.56× | $9,543.75 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | $7,028.75 | $2,223.62 | $3,265.73 | 0.53× | $7,028.75 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | $12,379 | $3,130.61 | $5,802.04 | 0.58× | $12,379 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | $8,165 | $2,245.55 | $3,721.25 | 0.54× | $8,165 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | $9,442.5 | $2,118.07 | $4,472.27 | 0.56× | $9,442.5 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | $19,131 | $5,894.79 | $8,270.61 | 0.54× | $19,131 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | $13,895 | $4,551.03 | $6,506.93 | 0.56× | $13,895 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | $9,926.25 | $2,612.79 | $4,636.96 | 0.56× | $9,926.25 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | $23,205 | $7,217.62 | $10,934 | 0.59× | $23,205 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | $13,161 | $21.91 | $5,485.58 | 0.53× | $13,161 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $94.94 | $94.94 | 1.1× | $94.94 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $94.94 | $94.94 | 0.78× | $94.94 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 20 | $109 | — | $7.58 | $73.58 | 2.3× | $101.92 |
| General health panel | CPT | 80050 | 3 | — | — | $7.58 | $38.24 | 0.36× | $38.24 |
| Electrolyte panel | CPT | 80051 | 20 | $82 | — | $6.31 | $55.35 | 2.3× | $76.67 |
| Comprehensive metabolic panel | CPT | 80053 | 20 | $131 | — | $7.58 | $88.43 | 2.0× | $122.49 |
| Lipid panel | CPT | 80061 | 20 | $134 | — | $7.58 | $90.45 | 2.4× | $125.29 |
| Renal function panel | CPT | 80069 | 20 | $101 | — | $7.58 | $68.18 | 2.5× | $94.44 |
| Hepatic function panel | CPT | 80076 | 20 | $103 | — | $7.35 | $69.53 | 2.6× | $96.31 |
| Urinalysis non-automated | CPT | 81002 | 20 | $42 | — | $2.52 | $28.35 | 4.1× | $39.27 |
| Urinalysis automated | CPT | 81003 | 20 | $27 | — | $2.02 | $18.23 | 1.3× | $25.25 |
| Glucose quantitative | CPT | 82947 | 20 | $26 | — | $3.54 | $17.55 | 1.00× | $24.31 |
| Hemoglobin A1c | CPT | 83036 | 20 | $134 | — | $4.47 | $90.45 | 3.4× | $125.29 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 20 | $200 | — | $11.53 | $135 | 2.9× | $187 |
| Complete blood count with automated differential | CPT | 85025 | 20 | $89 | — | $5.17 | $60.08 | 2.3× | $83.22 |
| Complete blood count without differential | CPT | 85027 | 20 | $65 | — | $5.17 | $43.88 | 2.0× | $60.78 |
| Urine culture bacterial | CPT | 87086 | 9 | — | — | $6.6 | $7.94 | 0.34× | $14.09 |
| Urine culture identification | CPT | 87088 | 20 | $95 | — | $5.13 | $64.13 | 2.9× | $88.83 |
| Tissue exam by pathologist level IV | CPT | 88305 | 21 | $254 | $97.67 | $29.8 | $165.1 | 1.6× | $237.49 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 10 | — | $334.85 | $99.89 | $169.4 | 0.90× | $500 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 1 | — | — | $1,988.89 | $1,988.89 | 0.87× | $1,988.89 |
| Vaginal delivery only | CPT | 59409 | 10 | — | $5,156.87 | $1,310.63 | $2,608.84 | 1.2× | $5,156.87 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $1,988.89 | $1,988.89 | 1.9× | $1,988.89 |
| Routine obstetric care with C-section | CPT | 59510 | 1 | — | — | $2,388.8 | $2,388.8 | 0.95× | $2,388.8 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $2,388.8 | $2,388.8 | 2.5× | $2,388.8 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $2,388.8 | $2,388.8 | 1.9× | $2,388.8 |
| office |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 14 | $415 | — | $203.35 | $311.25 | 2.5× | $388.03 |
| Office visit, established patient, 5 min | CPT | 99211 | 14 | $213 | — | $104.37 | $159.75 | 2.5× | $199.16 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 14 | $229 | — | $112.21 | $171.75 | 1.5× | $214.12 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | — | $1,590.4 | $488 | $840.48 | 0.92× | $3,000 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | — | $1,590.4 | $488 | $840.48 | 0.87× | $3,000 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | — | $1,559.78 | $377.57 | $889.46 | 1.1× | $1,559.78 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | — | $1,559.78 | $377.57 | $889.46 | 1.00× | $1,559.78 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | — | $1,559.78 | $466 | $839.28 | 0.96× | $3,000 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | — | $2,038.19 | $595.33 | $1,031.11 | 0.85× | $3,000 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | — | $2,038.19 | $595.33 | $1,031.11 | 0.86× | $3,000 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 9 | — | $24,236 | $8,541.6 | $20,242 | 4.9× | $24,236 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 8 | — | $40,485 | $13,005 | $19,998 | 0.72× | $40,485 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 8 | — | $25,964 | $8,213.25 | $12,641 | 0.69× | $28,935 |
| Hip hemiarthroplasty | CPT | 27125 | 3 | — | — | $1,000 | $1,000 | 0.80× | $3,181.68 |
| Total hip replacement | CPT | 27130 | 9 | — | $23,760 | $8,541.6 | $20,242 | 4.7× | $23,760 |
| Total knee replacement | CPT | 27447 | 9 | — | $23,760 | $8,541.6 | $20,000 | 4.8× | $23,760 |
| Knee revision arthroplasty single component | CPT | 27486 | 3 | — | — | $8,541.6 | $20,000 | 11.9× | $20,000 |
| Knee revision arthroplasty all components | CPT | 27487 | 3 | — | — | $8,541.6 | $20,000 | 10.0× | $20,000 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $500 | $2,048.16 | 6.3× | $3,191.88 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 11 | — | $11,940 | $3,191.88 | $6,228.23 | 1.9× | $11,940 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 11 | — | $5,470 | $1,611 | $2,815.95 | 1.4× | $5,500 |
| ACL reconstruction | CPT | 29888 | 11 | — | $11,940 | $3,426 | $6,228.23 | 1.9× | $11,940 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | $62,409 | $13,760 | $28,535 | 0.66× | $62,409 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | $31,541 | $10,611 | $14,888 | 0.64× | $31,541 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | $21,184 | $7,119.79 | $9,989.32 | 0.61× | $21,184 |
| CABG single arterial graft | CPT | 33533 | 3 | — | — | $1,000 | $1,000 | 0.53× | $19,783 |
| CABG 2 arterial grafts | CPT | 33534 | 3 | — | — | $1,000 | $1,000 | 0.47× | $19,783 |
| CABG 3 arterial grafts | CPT | 33535 | 3 | — | — | $1,000 | $1,000 | 0.44× | $19,783 |
| CABG 4+ arterial grafts | CPT | 33536 | 3 | — | — | $1,000 | $1,000 | 0.41× | $19,783 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | $20,803 | $4,879.97 | $9,863.76 | 0.60× | $20,803 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | $16,303 | $4,448.99 | $7,681.35 | 0.57× | $16,303 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | $43,970 | $13,462 | $20,536 | 0.63× | $43,970 |
| Open appendectomy | CPT | 44950 | 10 | — | $6,253.43 | $1,777.5 | $4,623.36 | 4.1× | $6,253.43 |
| Laparoscopic appendectomy | CPT | 44970 | 10 | — | $9,945.31 | $3,062.58 | $5,031.31 | 3.2× | $10,000 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 9 | — | $79,810 | $14,735 | $40,630 | 0.82× | $79,810 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 9 | — | $50,469 | $12,525 | $23,727 | 0.71× | $50,469 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | $39,678 | $12,845 | $18,853 | 0.64× | $39,678 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | $22,136 | $21.91 | $11,994 | 0.63× | $22,136 |
| Laparoscopic cholecystectomy | CPT | 47562 | 11 | — | $9,945.31 | $2,538 | $5,031.31 | 2.8× | $10,000 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 11 | — | $9,945.31 | $2,538 | $5,031.31 | 2.7× | $10,000 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | $37,880 | $12,172 | $17,671 | 0.63× | $37,880 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | $25,779 | $8,724.81 | $12,241 | 0.60× | $25,779 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | $20,806 | $6,850.48 | $9,611.47 | 0.60× | $20,806 |
| Open umbilical hernia repair | CPT | 49560 | 11 | — | $6,253.43 | $1,678 | $3,631.58 | 1.9× | $6,253.43 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 11 | — | $6,253.43 | $1,678 | $3,186.35 | 2.4× | $6,253.43 |
| Lap inguinal hernia repair | CPT | 49650 | 11 | — | $9,945.31 | $2,538 | $5,031.31 | 4.5× | $10,000 |
| Lap incisional hernia repair | CPT | 49652 | 11 | — | $9,945.31 | $2,538 | $5,031.31 | 1.9× | $10,000 |
| Total abdominal hysterectomy | CPT | 58150 | 3 | — | — | $1,000 | $1,000 | 1.0× | $5,471.78 |
| Vaginal hysterectomy | CPT | 58260 | 11 | — | $8,667.03 | $2,305.86 | $4,384.64 | 2.4× | $8,667.03 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 11 | — | $9,945.31 | $2,741 | $5,251.55 | 3.6× | $10,000 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 11 | — | $17,506 | $3,062.58 | $8,851.51 | 4.0× | $17,506 |
| Lap salpingo-oophorectomy | CPT | 58661 | 11 | — | $9,945.31 | $2,741 | $5,031.31 | 2.5× | $10,000 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | $36,509 | $12,482 | $17,880 | 0.66× | $36,509 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | $22,620 | $21.91 | $10,294 | 0.63× | $22,620 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | $19,729 | $5,838.72 | $9,636.02 | 0.64× | $19,729 |
| Complex cataract surgery | CPT | 66982 | 10 | — | $4,040 | $1,579.44 | $2,064.89 | 0.93× | $4,040 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | $4,040 | $1,579.44 | $2,064.89 | 0.94× | $4,040 |
| Intravitreal injection | CPT | 67028 | 10 | — | $626.7 | $288.74 | $317.05 | 0.93× | $626.7 |
| Vitrectomy mechanical | CPT | 67042 | 10 | — | $7,697.28 | $2,613.02 | $3,894.04 | 1.5× | $8,300 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | $13,945 | $3,630.3 | $6,834.68 | 0.56× | $13,945 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | $21,129 | $3,822.11 | $10,485 | 0.55× | $21,129 |
| PCI single major coronary artery | CPT | 92920 | 10 | — | $9,741.69 | $3,688.56 | $7,879.29 | 1.4× | $10,000 |
| PCI with drug-eluting stent | CPT | 92928 | 10 | — | $19,743 | $5,602.4 | $9,978.28 | 0.99× | $19,743 |
| PCI bypass graft | CPT | 92937 | 10 | — | $19,743 | $5,602.4 | $9,978.28 | 0.92× | $19,743 |
| Left heart catheterization | CPT | 93452 | 10 | — | $5,699.48 | $2,156.81 | $2,883.36 | 0.93× | $8,300 |
| Coronary angiography with cath | CPT | 93455 | 10 | — | $5,699.48 | $2,156.81 | $2,883.36 | 0.92× | $8,300 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | — | $5,699.48 | $2,156.81 | $2,883.36 | 0.93× | $8,300 |