| behavioral |
| Psychoses | MS-DRG | 885 | 9 | — | — | $11,581 | $16,853 | 1.3× | $30,160 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 11 | $640 | $320 | $242.85 | $402.52 | 2.3× | $845 |
| Psychiatric eval with medical services | CPT | 90792 | 5 | — | — | $242.85 | $321.57 | 1.9× | $457.85 |
| Psychotherapy 30 minutes | CPT | 90832 | 5 | — | — | $169.18 | $242.85 | 1.6× | $321.57 |
| Psychotherapy 45 minutes | CPT | 90834 | 5 | — | — | $242.85 | $251.23 | 1.6× | $321.57 |
| Psychotherapy 60 minutes | CPT | 90837 | 5 | — | — | $242.85 | $321.57 | 1.7× | $409.19 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 11 | $480 | $240 | $146.88 | $252.48 | 1.6× | $432 |
| emergency |
| ED visit level 1 | CPT | 99281 | 11 | $390 | $195 | $49.25 | $176.23 | 1.3× | $724 |
| ED visit level 2 | CPT | 99282 | 11 | $410 | $205 | $161.54 | $239.36 | 1.0× | $1,042 |
| ED visit level 3 | CPT | 99283 | 11 | $785 | $392.5 | $309.29 | $432.95 | 1.1× | $1,948 |
| ED visit level 4 | CPT | 99284 | 11 | $1,390 | $695 | $547.66 | $749.17 | 1.1× | $3,263 |
| ED visit level 5 | CPT | 99285 | 11 | $2,800 | $1,400 | $926.71 | $1,397.2 | 1.3× | $2,520 |
| Critical care, first hour | CPT | 99291 | 11 | $6,510 | $3,255 | $610.59 | $3,248.49 | 3.0× | $6,291 |
| imaging |
| CT head without contrast | CPT | 70450 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 4.9× | $2,718 |
| CT head with contrast | CPT | 70460 | 11 | $3,220 | $1,610 | $269.08 | $1,314.94 | 5.6× | $2,898 |
| CT head with and without contrast | CPT | 70470 | 11 | $4,730 | $2,365 | $269.08 | $1,416.04 | 5.3× | $4,257 |
| CT neck with contrast | CPT | 70491 | 11 | $3,220 | $1,610 | $269.08 | $1,314.94 | 4.8× | $2,898 |
| MRI brain without contrast | CPT | 70551 | 11 | $3,580 | $1,790 | $365.36 | $1,588.73 | 3.9× | $3,222 |
| MRI brain with contrast | CPT | 70552 | 11 | $3,780 | $1,890 | $539.81 | $1,632.43 | 3.4× | $3,402 |
| MRI brain with and without contrast | CPT | 70553 | 11 | $5,570 | $2,785 | $539.81 | $2,231.63 | 3.8× | $5,013 |
| Chest X-ray single view | CPT | 71045 | 11 | $365 | $182.5 | $77.78 | $175.12 | 1.9× | $328.5 |
| Chest X-ray 2 views | CPT | 71046 | 11 | $440 | $220 | $85.56 | $184.26 | 1.9× | $396 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $585 | $292.5 | $122.51 | $194 | 2.0× | $526.5 |
| CT chest without contrast | CPT | 71250 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 4.7× | $2,718 |
| CT chest with contrast | CPT | 71260 | 11 | $3,220 | $1,610 | $269.08 | $1,314.94 | 4.7× | $2,898 |
| CT chest with and without contrast | CPT | 71270 | 11 | $4,730 | $2,365 | $269.08 | $1,416.04 | 4.9× | $4,257 |
| MRI chest without contrast | CPT | 71550 | 11 | $3,580 | $1,790 | $365.36 | $1,588.73 | 3.7× | $3,222 |
| MRI chest with contrast | CPT | 71551 | 6 | — | — | $1,194.18 | $1,678.92 | 2.1× | $2,580.48 |
| MRI chest with and without contrast | CPT | 71552 | 11 | $5,570 | $2,785 | $539.81 | $2,231.63 | 3.7× | $5,013 |
| Lumbosacral spine X-ray | CPT | 72100 | 11 | $620 | $310 | $103.07 | $194 | 1.9× | $558 |
| CT cervical spine without contrast | CPT | 72125 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 5.0× | $2,718 |
| CT thoracic spine without contrast | CPT | 72128 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 5.1× | $2,718 |
| CT lumbar spine without contrast | CPT | 72131 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 5.0× | $2,718 |
| MRI cervical spine without contrast | CPT | 72141 | 11 | $3,580 | $1,790 | $365.36 | $1,588.73 | 4.0× | $3,222 |
| MRI thoracic spine without contrast | CPT | 72146 | 11 | $3,580 | $1,790 | $365.36 | $1,588.73 | 4.3× | $3,222 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $3,580 | $1,790 | $365.36 | $1,588.73 | 4.2× | $3,222 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 11 | $3,780 | $1,890 | $539.81 | $1,632.43 | 3.6× | $3,402 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $5,570 | $2,785 | $539.81 | $2,231.63 | 4.1× | $5,013 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $5,570 | $2,785 | $539.81 | $2,231.63 | 4.1× | $5,013 |
| CT pelvis without contrast | CPT | 72192 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 5.1× | $2,718 |
| CT pelvis with contrast | CPT | 72193 | 11 | $3,220 | $1,610 | $269.08 | $1,314.94 | 4.7× | $2,898 |
| Shoulder X-ray | CPT | 73030 | 11 | $620 | $310 | $83.62 | $216.32 | 2.3× | $558 |
| Humerus X-ray | CPT | 73060 | 11 | $710 | $355 | $77.78 | $224.58 | 2.5× | $639 |
| Hand X-ray 3 views | CPT | 73130 | 11 | $450 | $225 | $79.73 | $193 | 2.1× | $405 |
| MRI upper extremity joint without contrast | CPT | 73221 | 11 | $4,460 | $2,230 | $365.36 | $1,757.24 | 4.2× | $4,014 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $6,940 | $3,470 | $539.81 | $2,580.48 | 4.2× | $6,246 |
| Hip X-ray 2 views | CPT | 73510 | 1 | — | — | $101.12 | $109.26 | 1.4× | $115.01 |
| Knee X-ray 1-2 views | CPT | 73560 | 11 | $400 | $200 | $73.9 | $176.23 | 1.9× | $360 |
| Ankle X-ray 3 views | CPT | 73610 | 11 | $450 | $225 | $79.73 | $193 | 2.1× | $405 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $4,460 | $2,230 | $365.36 | $1,757.24 | 3.8× | $4,014 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 11 | $6,940 | $3,470 | $539.81 | $2,580.48 | 4.1× | $6,246 |
| CT abdomen without contrast | CPT | 74150 | 11 | $3,020 | $1,510 | $160.73 | $1,011.46 | 5.4× | $2,718 |
| CT abdomen with contrast | CPT | 74160 | 11 | $3,220 | $1,610 | $269.08 | $1,314.94 | 4.6× | $2,898 |
| CT abdomen with and without contrast | CPT | 74170 | 11 | $4,730 | $2,365 | $269.08 | $1,416.04 | 4.2× | $4,257 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $6,030 | $3,015 | $365.36 | $1,011.46 | 2.8× | $5,427 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 11 | $6,450 | $3,225 | $539.81 | $1,416.04 | 2.6× | $5,805 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $9,460 | $4,730 | $539.81 | $1,011.46 | 1.8× | $8,514 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $3,580 | $1,790 | $365.36 | $1,588.73 | 4.1× | $3,222 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $5,570 | $2,785 | $539.81 | $2,231.63 | 3.9× | $5,013 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $1,950 | $975 | $160.73 | $390.72 | 2.6× | $1,755 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $1,470 | $735 | $160.73 | $285.24 | 1.9× | $1,323 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 11 | $1,790 | $895 | $160.73 | $360.08 | 2.5× | $1,611 |
| Obstetric ultrasound first trimester | CPT | 76801 | 11 | $935 | $467.5 | $160.73 | $366.01 | 2.6× | $841.5 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 11 | $1,070 | $535 | $160.73 | $412.05 | 2.7× | $963 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 11 | $1,730 | $865 | $192 | $639.25 | 2.7× | $1,557 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $710 | $355 | $160.73 | $310.27 | 2.1× | $639 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,260 | $630 | $160.73 | $347.94 | 2.4× | $1,134 |
| Scrotal ultrasound | CPT | 76870 | 11 | $1,250 | $625 | $160.73 | $326.77 | 2.5× | $1,125 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $565 | $282.5 | $127.12 | $246.91 | 1.7× | $508.5 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $565 | $282.5 | $161.67 | $246.91 | 1.3× | $508.5 |
| Screening mammography bilateral | CPT | 77067 | 11 | $475 | $237.5 | $133.37 | $238 | 1.5× | $442.37 |
| EKG complete | CPT | 93000 | 1 | — | — | $64.17 | $69.34 | 2.8× | $72.99 |
| EKG tracing only | CPT | 93005 | 11 | $500 | $250 | $36.94 | $166 | 1.4× | $450 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $27.22 | $29.41 | 1.6× | $30.96 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $2,850 | $1,425 | $812.84 | $1,446.5 | 2.4× | $2,565 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $2,170 | $1,085 | $365.36 | $1,117.8 | 4.5× | $1,953 |
| Stress echocardiogram | CPT | 93350 | 11 | $2,250 | $1,125 | $631.99 | $1,192.12 | 2.4× | $2,025 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 9 | — | — | $16,343 | $23,783 | 1.2× | $42,561 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 9 | — | — | $8,354.85 | $12,158 | 1.1× | $21,758 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 9 | — | — | $5,655.07 | $8,229.32 | 1.1× | $15,079 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $13,281 | $19,327 | 1.3× | $34,587 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $9,226.57 | $13,427 | 1.2× | $24,028 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $7,058.37 | $10,271 | 1.2× | $18,381 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $5,317.4 | $7,737.93 | 1.1× | $14,375 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $6,737.12 | $9,803.92 | 1.2× | $17,545 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $5,116.1 | $7,445 | 1.1× | $13,956 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $13,486 | $19,625 | 1.3× | $35,119 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $7,573.51 | $11,021 | 1.1× | $19,723 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $5,957.42 | $8,669.3 | 1.1× | $15,709 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $10,720 | $15,600 | 1.2× | $27,918 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $7,075.62 | $10,297 | 1.2× | $18,426 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $4,508.12 | $6,560.26 | 1.1× | $12,688 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $9,907.67 | $14,418 | 1.2× | $25,801 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $6,074.09 | $8,839.07 | 1.1× | $15,953 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $4,596.85 | $6,689.39 | 1.1× | $12,873 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $8,100.15 | $11,787 | 1.2× | $21,094 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $5,231.13 | $7,612.39 | 1.1× | $14,196 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $6,410.94 | $9,329.27 | 1.2× | $16,695 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $12,529 | $18,232 | 1.2× | $32,627 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $9,615.18 | $13,992 | 1.2× | $25,040 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $6,594.16 | $9,595.89 | 1.2× | $17,172 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $16,121 | $23,459 | 1.3× | $41,981 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $8,470.7 | $12,327 | 1.2× | $22,059 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $206.13 | $222.74 | 2.4× | $234.46 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $281.96 | $304.68 | 1.8× | $320.72 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $414.2 | $447.57 | 2.0× | $471.12 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $153.62 | $165.99 | 1.9× | $174.73 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $221.68 | $239.54 | 2.0× | $252.14 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $155 | $77.5 | $8.46 | $68.64 | 2.1× | $139.5 |
| General health panel | CPT | 80050 | 7 | $560 | $280 | $47.28 | $202.36 | 1.9× | $504 |
| Electrolyte panel | CPT | 80051 | 11 | $100 | $50 | $7.01 | $25.58 | 1.1× | $90 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $215 | $107.5 | $10.56 | $89.34 | 2.0× | $193.5 |
| Lipid panel | CPT | 80061 | 11 | $165 | $82.5 | $13.39 | $50.42 | 1.3× | $148.5 |
| Renal function panel | CPT | 80069 | 11 | $165 | $82.5 | $8.68 | $31.15 | 1.1× | $148.5 |
| Hepatic function panel | CPT | 80076 | 11 | $160 | $80 | $8.17 | $66.03 | 2.5× | $144 |
| Urinalysis non-automated | CPT | 81002 | 8 | — | — | $3.48 | $5.84 | 0.84× | $16.37 |
| Urinalysis automated | CPT | 81003 | 11 | $65 | $32.5 | $2.25 | $18.7 | 1.3× | $58.5 |
| Glucose quantitative | CPT | 82947 | 11 | $80 | $40 | $3.93 | $26.22 | 1.5× | $72 |
| Hemoglobin A1c | CPT | 83036 | 11 | $140 | $70 | $9.71 | $52.58 | 2.0× | $126 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $220 | $110 | $16.8 | $42.02 | 0.89× | $198 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $145 | $72.5 | $7.77 | $38.26 | 1.4× | $130.5 |
| Complete blood count without differential | CPT | 85027 | 11 | $115 | $57.5 | $6.47 | $24.83 | 1.1× | $103.5 |
| Urine culture bacterial | CPT | 87086 | 11 | $115 | $57.5 | $8.07 | $30.77 | 1.3× | $103.5 |
| Urine culture identification | CPT | 87088 | 11 | $95 | $47.5 | $8.09 | $30.77 | 1.4× | $85.5 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $475 | $237.5 | $49.47 | $193.39 | 1.9× | $427.5 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 11 | $900 | $450 | $275.4 | $468 | 2.5× | $810 |
| Vaginal delivery only | CPT | 59409 | 10 | $3,060 | $1,530 | $936.36 | $1,681.01 | 0.76× | $6,363.66 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $230 | $115 | $90.62 | $124.68 | 1.4× | $207 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $295 | $147.5 | $105 | $155.17 | 1.3× | $265.5 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $355 | $177.5 | $105 | $186.73 | 1.1× | $319.5 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | $415 | $207.5 | $105 | $218.29 | 0.99× | $373.5 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $180 | $90 | $55.83 | $102.96 | 1.6× | $162 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $240 | $120 | $94.56 | $129.6 | 1.6× | $216 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $295 | $147.5 | $105 | $155.17 | 1.4× | $265.5 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $355 | $177.5 | $105 | $186.73 | 1.2× | $319.5 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $415 | $207.5 | $105 | $218.29 | 1.2× | $373.5 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | — | — | $1,417.13 | $2,623.74 | 2.9× | $4,256 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | — | — | $1,417.13 | $2,623.74 | 2.7× | $4,256 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 5 | — | — | $1,378.06 | $2,597.87 | 3.1× | $4,256 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 5 | — | — | $1,378.06 | $2,597.87 | 2.9× | $4,256 |
| Colonoscopy diagnostic | CPT | 45378 | 7 | — | — | $1,378.06 | $1,954 | 2.2× | $4,256 |
| Colonoscopy with biopsy | CPT | 45380 | 5 | — | — | $1,782.19 | $2,865.44 | 2.4× | $4,256 |
| Colonoscopy with polyp removal | CPT | 45385 | 5 | — | — | $1,782.19 | $2,865.44 | 2.4× | $4,256 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | — | $15,472 | $23,667 | 5.7× | $36,807 |
| Hip hemiarthroplasty | CPT | 27125 | 1 | — | — | $11,146 | $12,497 | 10.0× | $14,074 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $15,472 | $19,448 | 4.5× | $25,752 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $15,472 | $19,448 | 4.7× | $25,752 |
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $15,472 | $17,349 | 10.4× | $19,537 |
| Knee revision arthroplasty all components | CPT | 27487 | 1 | — | — | $15,472 | $17,349 | 8.7× | $19,537 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $3,260 | $3,655.5 | 11.2× | $4,116 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | — | $10,798 | $11,749 | 3.6× | $14,298 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | — | $4,904.26 | $6,481.46 | 3.2× | $8,168 |
| ACL reconstruction | CPT | 29888 | 5 | — | — | $10,798 | $11,749 | 3.5× | $14,298 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $37,727 | $54,901 | 1.3× | $98,248 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $19,420 | $28,260 | 1.2× | $50,574 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $13,565 | $19,739 | 1.2× | $35,325 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $3,371 | $3,779 | 2.0× | $4,256 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $3,371 | $3,779 | 1.8× | $4,256 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $3,371 | $3,779 | 1.7× | $4,256 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $3,371 | $3,779 | 1.5× | $4,256 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $13,625 | $19,828 | 1.2× | $35,483 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $10,825 | $15,753 | 1.2× | $28,191 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $28,998 | $42,199 | 1.3× | $75,517 |
| Open appendectomy | CPT | 44950 | 5 | — | — | $6,469 | $8,799.72 | 7.7× | $12,489 |
| Laparoscopic appendectomy | CPT | 44970 | 5 | — | — | $8,818.69 | $11,412 | 7.3× | $14,074 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $26,856 | $39,081 | 1.3× | $69,937 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $15,491 | $22,543 | 1.2× | $40,342 |
| Laparoscopic cholecystectomy | CPT | 47562 | 5 | — | — | $8,818.69 | $11,412 | 6.4× | $14,074 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 5 | — | — | $8,818.69 | $11,412 | 6.1× | $14,074 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $24,163 | $35,163 | 1.3× | $62,926 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $17,047 | $24,808 | 1.2× | $44,395 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $13,034 | $18,967 | 1.2× | $33,943 |
| Lap inguinal hernia repair | CPT | 49650 | 5 | — | — | $8,818.69 | $11,412 | 10.1× | $14,074 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $6,469 | $7,252.5 | 7.4× | $8,168 |
| Vaginal hysterectomy | CPT | 58260 | 5 | — | — | $6,469 | $7,461.49 | 4.1× | $9,880.04 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 5 | — | — | $8,818.69 | $11,412 | 7.7× | $14,074 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 5 | — | — | $11,146 | $14,905 | 6.7× | $20,838 |
| Lap salpingo-oophorectomy | CPT | 58661 | 5 | — | — | $8,818.69 | $11,412 | 5.6× | $14,074 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $22,401 | $32,598 | 1.2× | $58,336 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $13,121 | $19,094 | 1.2× | $34,169 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $12,010 | $17,477 | 1.2× | $31,277 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $3,447.34 | $4,849.88 | 2.2× | $6,482 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | — | $3,447.34 | $4,849.88 | 2.2× | $6,482 |
| Intravitreal injection | CPT | 67028 | 5 | — | — | $501.35 | $1,961.93 | 5.7× | $4,116 |
| Vitrectomy mechanical | CPT | 67042 | 5 | — | — | $6,080.59 | $7,955.77 | 3.2× | $9,925 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $9,848.52 | $14,332 | 1.2× | $25,647 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $16,054 | $23,362 | 1.2× | $41,808 |
| PCI single major coronary artery | CPT | 92920 | 11 | $14,210 | $7,105 | $5,271.91 | $8,617.9 | 1.5× | $14,074 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $23,420 | $11,710 | $5,346.11 | $11,574 | 1.2× | $22,698 |
| PCI bypass graft | CPT | 92937 | 11 | $17,880 | $8,940 | $5,635.49 | $9,109.86 | 0.84× | $22,698 |
| Left heart catheterization | CPT | 93452 | 11 | $10,820 | $5,410 | $4,014.22 | $5,626.4 | 1.8× | $9,925 |
| Coronary angiography with cath | CPT | 93455 | 11 | $14,990 | $7,495 | $4,861.63 | $7,480.01 | 2.4× | $13,491 |
| Coronary angiography with bypass cath | CPT | 93458 | 11 | $17,120 | $8,560 | $4,861.63 | $8,388.8 | 2.7× | $15,408 |