| emergency |
| Critical care, first hour | CPT | 99291 | 9 | $4,466.63 | $4,466.63 | $3,126.64 | $3,349.97 | 3.1× | $3,796.64 |
| imaging |
| CT head without contrast | CPT | 70450 | 9 | $2,335.95 | $2,335.95 | $1,635.17 | $1,751.96 | 8.5× | $1,985.56 |
| CT head with contrast | CPT | 70460 | 9 | $2,009.88 | $2,009.88 | $1,406.92 | $1,507.41 | 6.4× | $1,708.4 |
| CT head with and without contrast | CPT | 70470 | 9 | $2,690.5 | $2,690.5 | $1,883.35 | $2,017.88 | 7.6× | $2,286.93 |
| CT neck with contrast | CPT | 70491 | 9 | $923.4 | $923.4 | $646.38 | $692.55 | 2.5× | $784.89 |
| Chest X-ray single view | CPT | 71045 | 9 | $141.48 | $141.48 | $99.04 | $106.11 | 1.1× | $120.26 |
| Chest X-ray 2 views | CPT | 71046 | 9 | $97.2 | $97.2 | $68.04 | $72.9 | 0.74× | $82.62 |
| Chest X-ray 3 views | CPT | 71047 | 9 | $964.44 | $964.44 | $675.11 | $723.33 | 7.6× | $819.77 |
| CT chest without contrast | CPT | 71250 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 6.1× | $1,483.49 |
| CT chest with contrast | CPT | 71260 | 9 | $2,009.88 | $2,009.88 | $1,406.92 | $1,507.41 | 5.4× | $1,708.4 |
| CT chest with and without contrast | CPT | 71270 | 9 | $2,096.28 | $2,096.28 | $1,467.4 | $1,572.21 | 5.4× | $1,781.84 |
| MRI chest without contrast | CPT | 71550 | 9 | $2,118.96 | $2,118.96 | $1,483.27 | $1,589.22 | 3.7× | $1,801.12 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $210.6 | $210.6 | $147.42 | $157.95 | 1.5× | $179.01 |
| CT cervical spine without contrast | CPT | 72125 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 6.5× | $1,483.49 |
| CT thoracic spine without contrast | CPT | 72128 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 6.6× | $1,483.49 |
| CT lumbar spine without contrast | CPT | 72131 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 6.4× | $1,483.49 |
| MRI thoracic spine without contrast | CPT | 72146 | 9 | $7,324 | $7,324 | $5,126.8 | $5,493 | 14.7× | $6,225.4 |
| MRI lumbar spine without contrast | CPT | 72148 | 9 | $7,324 | $7,324 | $5,126.8 | $5,493 | 14.6× | $6,225.4 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 9 | $7,324 | $7,324 | $5,126.8 | $5,493 | 12.1× | $6,225.4 |
| MRI cervical spine with and without contrast | CPT | 72156 | 9 | $11,377 | $11,377 | $7,964.01 | $8,532.86 | 15.8× | $9,670.58 |
| MRI lumbar spine with contrast | CPT | 72158 | 9 | $11,377 | $11,377 | $7,964.01 | $8,532.86 | 15.6× | $9,670.58 |
| CT pelvis without contrast | CPT | 72192 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 6.5× | $1,483.49 |
| CT pelvis with contrast | CPT | 72193 | 9 | $2,009.88 | $2,009.88 | $1,406.92 | $1,507.41 | 5.4× | $1,708.4 |
| Shoulder X-ray | CPT | 73030 | 9 | $194.4 | $194.4 | $103.57 | $130.93 | 1.4× | $165.24 |
| Humerus X-ray | CPT | 73060 | 9 | $89.64 | $89.64 | $62.75 | $67.23 | 0.75× | $76.19 |
| Hand X-ray 3 views | CPT | 73130 | 9 | $270 | $270 | $189 | $202.5 | 2.2× | $229.5 |
| Knee X-ray 1-2 views | CPT | 73560 | 9 | $147.96 | $147.96 | $103.57 | $110.97 | 1.2× | $125.77 |
| Ankle X-ray 3 views | CPT | 73610 | 9 | $139.32 | $139.32 | $97.52 | $104.49 | 1.1× | $118.42 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 9 | $1,746.94 | $1,746.94 | $1,222.86 | $1,310.21 | 2.1× | $1,484.9 |
| CT abdomen without contrast | CPT | 74150 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 7.0× | $1,483.49 |
| CT abdomen with contrast | CPT | 74160 | 9 | $2,009.88 | $2,009.88 | $1,406.92 | $1,507.41 | 5.3× | $1,708.4 |
| CT abdomen with and without contrast | CPT | 74170 | 9 | $1,358.64 | $1,358.64 | $951.05 | $1,018.98 | 3.0× | $1,154.84 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 9 | $1,745.28 | $1,745.28 | $1,221.7 | $1,308.96 | 3.6× | $1,483.49 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 9 | $2,009.88 | $2,009.88 | $1,406.92 | $1,507.41 | 2.7× | $1,708.4 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 9 | $2,096.28 | $2,096.28 | $1,467.4 | $1,572.21 | 2.7× | $1,781.84 |
| MRI abdomen without contrast | CPT | 74181 | 9 | $7,324 | $7,324 | $5,126.8 | $5,493 | 14.1× | $6,225.4 |
| Abdominal ultrasound complete | CPT | 76700 | 9 | $308.88 | $308.88 | $216.22 | $231.66 | 1.6× | $262.55 |
| Abdominal ultrasound limited | CPT | 76705 | 9 | $1,137.05 | $1,137.05 | $167.83 | $499.87 | 3.4× | $966.49 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 9 | $1,415.51 | $1,415.51 | $167.83 | $597.33 | 4.2× | $1,203.18 |
| Transvaginal ultrasound | CPT | 76830 | 9 | $462 | $462 | $323.4 | $346.5 | 2.3× | $392.7 |
| Pelvic ultrasound complete | CPT | 76856 | 9 | $239.76 | $239.76 | $167.83 | $179.82 | 1.3× | $203.8 |
| Scrotal ultrasound | CPT | 76870 | 9 | $476.28 | $476.28 | $333.4 | $357.21 | 2.7× | $404.84 |
| EKG tracing only | CPT | 93005 | 9 | $125.28 | $125.28 | $87.7 | $93.96 | 0.80× | $106.49 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $1,005.48 | $1,005.48 | $703.84 | $754.11 | 1.3× | $854.66 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $875.88 | $875.88 | $613.12 | $656.91 | 2.7× | $744.5 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 10 | — | — | $59,475 | $61,315 | 3.0× | $91,972 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 10 | — | — | $31,160 | $32,123 | 3.0× | $48,185 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 10 | — | — | $21,855 | $22,531 | 3.0× | $33,797 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $37,062 | $38,209 | 2.5× | $57,313 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $29,879 | $30,804 | 2.7× | $46,205 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $29,879 | $30,804 | 3.5× | $46,205 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $29,879 | $30,804 | 4.4× | $46,205 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $24,388 | $25,143 | 3.0× | $37,714 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $21,855 | $22,531 | 3.4× | $33,797 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $37,488 | $38,647 | 2.5× | $57,971 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $29,203 | $30,106 | 3.1× | $45,159 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $21,855 | $22,531 | 2.9× | $33,797 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $35,183 | $36,271 | 2.8× | $54,407 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $24,983 | $25,755 | 2.9× | $38,633 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $21,855 | $22,531 | 3.6× | $33,797 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $38,279 | $39,463 | 3.3× | $59,194 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $21,855 | $22,531 | 2.9× | $33,797 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $21,855 | $22,531 | 3.6× | $33,797 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $29,203 | $30,106 | 3.0× | $45,159 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $29,203 | $30,106 | 4.4× | $45,159 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $28,640 | $29,526 | 3.7× | $44,289 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 10 | — | — | $33,167 | $34,193 | 2.2× | $51,289 |
| Kidney/UTI w MCC | MS-DRG | 689 | 10 | — | — | $28,887 | $29,781 | 2.6× | $44,671 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 10 | — | — | $21,489 | $22,154 | 2.7× | $33,231 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | — | — | $38,814 | $40,014 | 2.1× | $60,021 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 10 | — | — | $26,007 | $26,811 | 2.6× | $40,217 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 9 | $107.72 | $107.72 | $75.4 | $80.79 | 2.5× | $91.56 |
| Comprehensive metabolic panel | CPT | 80053 | 9 | $229.58 | $229.58 | $160.71 | $172.19 | 3.9× | $195.14 |
| Lipid panel | CPT | 80061 | 9 | $107.57 | $107.57 | $75.3 | $80.68 | 2.1× | $91.43 |
| Renal function panel | CPT | 80069 | 9 | $215.15 | $215.15 | $150.61 | $161.36 | 5.9× | $182.88 |
| Hepatic function panel | CPT | 80076 | 9 | $154.22 | $154.22 | $107.95 | $115.67 | 4.3× | $131.09 |
| Urinalysis automated | CPT | 81003 | 9 | $82.75 | $82.75 | $57.93 | $62.06 | 4.5× | $70.34 |
| Glucose quantitative | CPT | 82947 | 9 | $12.96 | $12.96 | $9.07 | $9.72 | 0.55× | $11.02 |
| Hemoglobin A1c | CPT | 83036 | 9 | $68.69 | $68.69 | $48.08 | $51.52 | 1.9× | $58.39 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 9 | $90.72 | $90.72 | $63.5 | $68.04 | 1.4× | $77.11 |
| Complete blood count with automated differential | CPT | 85025 | 9 | $32.4 | $32.4 | $22.68 | $24.3 | 0.92× | $27.54 |
| Complete blood count without differential | CPT | 85027 | 9 | $29.81 | $29.81 | $20.87 | $22.36 | 1.0× | $25.34 |
| Urine culture bacterial | CPT | 87086 | 9 | $55.73 | $55.73 | $39.01 | $41.8 | 1.8× | $47.37 |
| Urine culture identification | CPT | 87088 | 9 | $34.99 | $34.99 | $24.49 | $26.24 | 1.2× | $29.74 |
| Tissue exam by pathologist level IV | CPT | 88305 | 9 | $319.2 | $319.2 | $223.44 | $239.4 | 2.3× | $271.32 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | $3,116.88 | $3,116.88 | $2,181.82 | $2,337.66 | 2.6× | $2,649.35 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | $3,116.88 | $3,116.88 | $2,181.82 | $2,337.66 | 2.4× | $2,649.35 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | $2,034.72 | $2,034.72 | $1,424.3 | $1,526.04 | 1.8× | $1,729.51 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | $2,034.72 | $2,034.72 | $1,424.3 | $1,526.04 | 1.7× | $1,729.51 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | $1,609.2 | $1,609.2 | $1,126.44 | $1,206.9 | 1.4× | $1,367.82 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | $3,278.88 | $3,278.88 | $2,295.22 | $2,459.16 | 2.0× | $2,787.05 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | $1,609.2 | $1,609.2 | $1,126.44 | $1,206.9 | 1.0× | $1,367.82 |
| surgery |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $57,715 | $59,500 | 1.4× | $89,250 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $29,203 | $30,106 | 1.3× | $45,159 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $29,203 | $30,106 | 1.8× | $45,159 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $33,167 | $34,193 | 2.1× | $51,289 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $33,167 | $34,193 | 2.5× | $51,289 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $32,879 | $33,896 | 1.0× | $50,844 |
| Major joint replacement w MCC | MS-DRG | 469 | 10 | — | — | $57,715 | $59,500 | 2.0× | $89,250 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | — | $31,160 | $32,123 | 1.7× | $48,185 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $31,160 | $32,123 | 1.1× | $48,185 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $31,160 | $32,123 | 1.6× | $48,185 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $31,160 | $32,123 | 2.0× | $48,185 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 10 | — | — | $59,786 | $61,635 | 2.3× | $92,453 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | — | $43,377 | $44,718 | 2.8× | $67,077 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 10 | — | — | $31,160 | $32,123 | 2.1× | $48,185 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 10 | — | — | $57,715 | $59,500 | 4.8× | $89,250 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 10 | — | — | $57,715 | $59,500 | 3.1× | $89,250 |