| behavioral |
| Psychoses | MS-DRG | 885 | 8 | — | — | $13,861 | $21,471 | 1.7× | $30,160 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 11 | $620 | $310 | $242.85 | $486.7 | 2.7× | $1,556 |
| Psychiatric eval with medical services | CPT | 90792 | 5 | — | — | $242.85 | $321.57 | 1.9× | $979.42 |
| Psychotherapy 30 minutes | CPT | 90832 | 11 | $285 | $142.5 | $99.47 | $223.73 | 1.5× | $411.65 |
| Psychotherapy 45 minutes | CPT | 90834 | 11 | $380 | $190 | $132.62 | $251.02 | 1.6× | $596.16 |
| Psychotherapy 60 minutes | CPT | 90837 | 11 | $480 | $240 | $167.52 | $301.44 | 1.6× | $875.33 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 11 | $480 | $240 | $167.52 | $301.44 | 1.9× | $402.24 |
| emergency |
| ED visit level 1 | CPT | 99281 | 11 | $390 | $195 | $49.25 | $207.81 | 1.5× | $796 |
| ED visit level 2 | CPT | 99282 | 11 | $475 | $237.5 | $187.15 | $378.1 | 1.6× | $1,214 |
| ED visit level 3 | CPT | 99283 | 11 | $930 | $465 | $366.42 | $740.28 | 1.8× | $2,071 |
| ED visit level 4 | CPT | 99284 | 11 | $1,610 | $805 | $634.34 | $1,281.56 | 1.9× | $3,426 |
| ED visit level 5 | CPT | 99285 | 11 | $2,460 | $1,230 | $926.71 | $1,931.1 | 1.9× | $4,020 |
| Critical care, first hour | CPT | 99291 | 11 | $2,810 | $1,405 | $1,107.14 | $1,601.92 | 1.5× | $11,010 |
| imaging |
| CT head without contrast | CPT | 70450 | 11 | $1,600 | $800 | $160.73 | $864 | 4.2× | $1,280 |
| CT head with contrast | CPT | 70460 | 11 | $1,810 | $905 | $269.08 | $941 | 4.0× | $1,497.75 |
| CT head with and without contrast | CPT | 70470 | 11 | $2,610 | $1,305 | $269.08 | $1,140.57 | 4.3× | $2,088 |
| CT neck with contrast | CPT | 70491 | 11 | $1,810 | $905 | $269.08 | $941 | 3.4× | $1,497.75 |
| MRI brain without contrast | CPT | 70551 | 11 | $2,850 | $1,425 | $365.36 | $1,539 | 3.8× | $2,280 |
| MRI brain with contrast | CPT | 70552 | 11 | $3,050 | $1,525 | $539.81 | $1,613 | 3.4× | $2,496.26 |
| MRI brain with and without contrast | CPT | 70553 | 11 | $4,480 | $2,240 | $539.81 | $1,957.76 | 3.3× | $3,584 |
| Chest X-ray single view | CPT | 71045 | 11 | $470 | $235 | $78.83 | $220 | 2.3× | $634 |
| Chest X-ray 2 views | CPT | 71046 | 11 | $560 | $280 | $105.62 | $244.72 | 2.5× | $634 |
| Chest X-ray 3 views | CPT | 71047 | 11 | $750 | $375 | $132.4 | $298.09 | 3.1× | $634 |
| CT chest without contrast | CPT | 71250 | 11 | $1,600 | $800 | $160.73 | $864 | 4.0× | $1,280 |
| CT chest with contrast | CPT | 71260 | 11 | $1,810 | $905 | $269.08 | $941 | 3.3× | $1,497.75 |
| CT chest with and without contrast | CPT | 71270 | 11 | $2,610 | $1,305 | $269.08 | $1,140.57 | 3.9× | $2,088 |
| MRI chest without contrast | CPT | 71550 | 11 | $2,850 | $1,425 | $365.36 | $1,539 | 3.6× | $2,280 |
| MRI chest with contrast | CPT | 71551 | 11 | $3,050 | $1,525 | $1,096 | $1,613 | 2.0× | $2,496.26 |
| MRI chest with and without contrast | CPT | 71552 | 11 | $4,480 | $2,240 | $539.81 | $1,957.76 | 3.3× | $3,584 |
| Lumbosacral spine X-ray | CPT | 72100 | 11 | $670 | $335 | $130.42 | $263.98 | 2.6× | $634 |
| CT cervical spine without contrast | CPT | 72125 | 11 | $1,600 | $800 | $160.73 | $864 | 4.3× | $1,280 |
| CT thoracic spine without contrast | CPT | 72128 | 11 | $1,600 | $800 | $160.73 | $864 | 4.3× | $1,280 |
| CT lumbar spine without contrast | CPT | 72131 | 11 | $1,600 | $800 | $160.73 | $864 | 4.3× | $1,280 |
| MRI cervical spine without contrast | CPT | 72141 | 11 | $2,850 | $1,425 | $365.36 | $1,539 | 3.9× | $2,280 |
| MRI thoracic spine without contrast | CPT | 72146 | 11 | $2,850 | $1,425 | $365.36 | $1,539 | 4.1× | $2,280 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $2,850 | $1,425 | $365.36 | $1,539 | 4.1× | $2,280 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 11 | $3,050 | $1,525 | $539.81 | $1,613 | 3.6× | $2,496.26 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $4,480 | $2,240 | $539.81 | $1,957.76 | 3.6× | $3,584 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $4,480 | $2,240 | $539.81 | $1,957.76 | 3.6× | $3,584 |
| CT pelvis without contrast | CPT | 72192 | 11 | $1,600 | $800 | $160.73 | $864 | 4.3× | $1,280 |
| CT pelvis with contrast | CPT | 72193 | 11 | $1,810 | $905 | $269.08 | $941 | 3.3× | $1,497.75 |
| Shoulder X-ray | CPT | 73030 | 11 | $610 | $305 | $107.66 | $267.3 | 2.9× | $634 |
| Humerus X-ray | CPT | 73060 | 11 | $620 | $310 | $107.66 | $270.94 | 3.0× | $634 |
| Hand X-ray 3 views | CPT | 73130 | 11 | $580 | $290 | $100.21 | $253.8 | 2.7× | $634 |
| MRI upper extremity joint without contrast | CPT | 73221 | 11 | $3,560 | $1,780 | $365.36 | $1,613 | 3.9× | $2,848 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 11 | $4,480 | $2,240 | $539.81 | $1,957.76 | 3.2× | $3,584 |
| Hip X-ray 2 views | CPT | 73510 | 1 | — | — | $216.18 | $233.67 | 3.1× | $246.03 |
| Knee X-ray 1-2 views | CPT | 73560 | 11 | $460 | $230 | $96.72 | $220 | 2.4× | $634 |
| Ankle X-ray 3 views | CPT | 73610 | 11 | $580 | $290 | $101.97 | $253.8 | 2.8× | $634 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $3,560 | $1,780 | $365.36 | $1,613 | 3.4× | $2,848 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 11 | $5,600 | $2,800 | $539.81 | $2,419.2 | 3.8× | $4,480 |
| CT abdomen without contrast | CPT | 74150 | 11 | $1,600 | $800 | $160.73 | $864 | 4.6× | $1,280 |
| CT abdomen with contrast | CPT | 74160 | 11 | $1,810 | $905 | $269.08 | $941 | 3.3× | $1,497.75 |
| CT abdomen with and without contrast | CPT | 74170 | 11 | $2,610 | $1,305 | $269.08 | $1,140.57 | 3.4× | $2,088 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $3,200 | $1,600 | $365.36 | $1,016.06 | 2.8× | $2,560 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 11 | $3,620 | $1,810 | $539.81 | $1,422.49 | 2.6× | $2,896 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $5,220 | $2,610 | $539.81 | $1,016.06 | 1.8× | $4,176 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $2,850 | $1,425 | $365.36 | $1,539 | 3.9× | $2,280 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $4,480 | $2,240 | $539.81 | $1,957.76 | 3.5× | $3,584 |
| Abdominal ultrasound complete | CPT | 76700 | 11 | $1,220 | $610 | $160.73 | $533.14 | 3.6× | $976 |
| Abdominal ultrasound limited | CPT | 76705 | 11 | $915 | $457.5 | $160.73 | $444 | 3.0× | $732 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 11 | $1,200 | $600 | $160.73 | $524.4 | 3.7× | $960 |
| Obstetric ultrasound first trimester | CPT | 76801 | 11 | $1,090 | $545 | $160.73 | $476.33 | 3.4× | $884.79 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 11 | $1,250 | $625 | $160.73 | $537 | 3.5× | $1,000 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 11 | $2,010 | $1,005 | $214 | $791.94 | 3.4× | $1,608 |
| Transvaginal ultrasound | CPT | 76830 | 10 | $1,100 | $550 | $160.73 | $508.85 | 3.4× | $880 |
| Pelvic ultrasound complete | CPT | 76856 | 11 | $1,240 | $620 | $160.73 | $541.88 | 3.8× | $992 |
| Scrotal ultrasound | CPT | 76870 | 11 | $1,060 | $530 | $160.73 | $463.22 | 3.5× | $848 |
| Diagnostic mammography unilateral | CPT | 77065 | 11 | $565 | $282.5 | $127.12 | $306.05 | 2.0× | $524 |
| Diagnostic mammography bilateral | CPT | 77066 | 11 | $565 | $282.5 | $161.67 | $306.05 | 1.6× | $524 |
| Screening mammography bilateral | CPT | 77067 | 11 | $475 | $237.5 | $133.37 | $285.5 | 1.8× | $524 |
| EKG complete | CPT | 93000 | 1 | — | — | $137.2 | $148.3 | 6.1× | $156.14 |
| EKG tracing only | CPT | 93005 | 11 | $370 | $185 | $78.98 | $193.2 | 1.6× | $330 |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $58.2 | $62.91 | 3.5× | $66.24 |
| Transthoracic echocardiogram complete | CPT | 93306 | 11 | $2,150 | $1,075 | $698 | $1,221.8 | 2.0× | $1,977.77 |
| Transthoracic echocardiogram | CPT | 93307 | 11 | $1,600 | $800 | $365.36 | $951.8 | 3.8× | $1,877 |
| Stress echocardiogram | CPT | 93350 | 5 | — | — | $828.76 | $1,097.39 | 2.2× | $1,537.73 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $19,560 | $30,299 | 1.5× | $42,561 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $9,999.18 | $16,177 | 1.5× | $21,758 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $6,768.05 | $11,388 | 1.5× | $15,079 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $15,895 | $24,623 | 1.6× | $34,587 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $11,042 | $17,597 | 1.6× | $24,028 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $8,447.53 | $13,919 | 1.6× | $18,381 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $6,363.92 | $10,856 | 1.6× | $14,375 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $8,063.06 | $13,286 | 1.6× | $17,545 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $6,123.01 | $10,540 | 1.6× | $13,956 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $16,140 | $25,002 | 1.6× | $35,119 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $9,064.06 | $14,905 | 1.5× | $19,723 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $7,129.91 | $11,864 | 1.5× | $15,709 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $12,830 | $20,029 | 1.6× | $27,918 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $8,468.18 | $13,953 | 1.6× | $18,426 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $5,395.37 | $9,582.46 | 1.5× | $12,688 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $11,858 | $18,706 | 1.5× | $25,801 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $7,269.54 | $12,048 | 1.6× | $15,953 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $5,501.56 | $9,722.15 | 1.6× | $12,873 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $9,694.35 | $15,762 | 1.6× | $21,094 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $6,260.67 | $10,721 | 1.6× | $14,196 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $7,672.69 | $12,642 | 1.6× | $16,695 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $14,994 | $23,227 | 1.5× | $32,627 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $11,508 | $18,229 | 1.6× | $25,040 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $7,891.97 | $13,004 | 1.6× | $17,172 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $19,293 | $29,887 | 1.6× | $41,981 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $10,138 | $16,366 | 1.6× | $22,059 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $440.69 | $476.33 | 5.1× | $501.54 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $602.83 | $651.59 | 3.9× | $686.07 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $885.54 | $957.16 | 4.3× | $1,007.81 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $328.44 | $355 | 4.1× | $373.78 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $473.96 | $512.29 | 4.2× | $539.4 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | $150 | $75 | $8.46 | $81 | 2.5× | $164.04 |
| General health panel | CPT | 80050 | 4 | — | — | $47.28 | $184.08 | 1.7× | $331.2 |
| Electrolyte panel | CPT | 80051 | 11 | $100 | $50 | $7.01 | $39.4 | 1.7× | $80 |
| Comprehensive metabolic panel | CPT | 80053 | 11 | $215 | $107.5 | $10.56 | $93.96 | 2.1× | $213.96 |
| Lipid panel | CPT | 80061 | 11 | $165 | $82.5 | $13.39 | $72.62 | 1.9× | $132 |
| Renal function panel | CPT | 80069 | 11 | $165 | $82.5 | $8.68 | $47.07 | 1.7× | $132 |
| Hepatic function panel | CPT | 80076 | 11 | $160 | $80 | $8.17 | $69.92 | 2.6× | $156.91 |
| Urinalysis non-automated | CPT | 81002 | 11 | $50 | $25 | $3.48 | $14.19 | 2.0× | $40 |
| Urinalysis automated | CPT | 81003 | 11 | $65 | $32.5 | $2.25 | $19.8 | 1.4× | $52 |
| Glucose quantitative | CPT | 82947 | 11 | $80 | $40 | $3.93 | $31.52 | 1.8× | $64 |
| Hemoglobin A1c | CPT | 83036 | 11 | $140 | $70 | $9.71 | $58.41 | 2.2× | $112 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 11 | $220 | $110 | $16.8 | $40 | 0.85× | $176 |
| Complete blood count with automated differential | CPT | 85025 | 11 | $85 | $42.5 | $7.77 | $42.11 | 1.6× | $83.94 |
| Complete blood count without differential | CPT | 85027 | 11 | $55 | $27.5 | $6.47 | $29.76 | 1.4× | $44 |
| Urine culture bacterial | CPT | 87086 | 11 | $115 | $57.5 | $8.07 | $45.74 | 2.0× | $92 |
| Urine culture identification | CPT | 87088 | 11 | $95 | $47.5 | $8.09 | $43.88 | 2.0× | $76 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | $475 | $237.5 | $49.47 | $256.5 | 2.5× | $449.49 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 11 | $900 | $450 | $304.07 | $511.2 | 2.7× | $754.2 |
| Vaginal delivery only | CPT | 59409 | 10 | $2,780 | $1,390 | $1,095.32 | $2,212.88 | 1.00× | $6,363.66 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 7 | $230 | $115 | $80.27 | $124.15 | 1.4× | $184 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 7 | $295 | $147.5 | $84 | $148.7 | 1.2× | $236 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 7 | $355 | $177.5 | $84 | $160.57 | 0.92× | $284 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 7 | $415 | $207.5 | $84 | $174.51 | 0.79× | $332 |
| Office visit, established patient, 5 min | CPT | 99211 | 7 | $180 | $90 | $62.82 | $109.5 | 1.7× | $166 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 7 | $240 | $120 | $83.76 | $128.22 | 1.6× | $192 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 7 | $295 | $147.5 | $84 | $148.7 | 1.3× | $236 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 7 | $355 | $177.5 | $84 | $160.57 | 1.1× | $284 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 7 | $415 | $207.5 | $84 | $174.51 | 0.93× | $332 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | — | — | $1,417.13 | $2,501.24 | 2.7× | $6,181 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | — | — | $1,417.13 | $2,501.24 | 2.6× | $6,181 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 5 | — | — | $1,378.06 | $2,447.37 | 2.9× | $6,071 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 5 | — | — | $1,378.06 | $2,447.37 | 2.7× | $6,071 |
| Colonoscopy diagnostic | CPT | 45378 | 7 | — | — | $1,378.06 | $1,890 | 2.2× | $6,181 |
| Colonoscopy with biopsy | CPT | 45380 | 5 | — | — | $1,782.19 | $2,742.94 | 2.3× | $6,181 |
| Colonoscopy with polyp removal | CPT | 45385 | 5 | — | — | $1,782.19 | $2,742.94 | 2.3× | $6,181 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 5 | — | — | $24,003 | $28,284 | 6.8× | $47,462 |
| Hip hemiarthroplasty | CPT | 27125 | 1 | — | — | $12,700 | $18,206 | 14.5× | $25,111 |
| Total hip replacement | CPT | 27130 | 5 | — | — | $19,448 | $24,878 | 5.7× | $47,462 |
| Total knee replacement | CPT | 27447 | 5 | — | — | $19,448 | $24,878 | 6.0× | $47,462 |
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $24,003 | $34,410 | 20.6× | $47,462 |
| Knee revision arthroplasty all components | CPT | 27487 | 1 | — | — | $24,003 | $34,410 | 17.2× | $47,462 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $3,181 | $4,561.5 | 14.0× | $6,291 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | — | $10,798 | $13,499 | 4.1× | $25,111 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | — | $4,904.26 | $7,657.46 | 3.7× | $17,439 |
| ACL reconstruction | CPT | 29888 | 5 | — | — | $10,798 | $13,499 | 4.0× | $25,111 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $45,152 | $69,944 | 1.6× | $98,248 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $23,242 | $36,004 | 1.6× | $50,574 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $16,234 | $25,148 | 1.5× | $35,325 |
| CABG single arterial graft | CPT | 33533 | 1 | — | — | $3,181 | $4,561.5 | 2.4× | $6,291 |
| CABG 2 arterial grafts | CPT | 33534 | 1 | — | — | $3,181 | $4,561.5 | 2.1× | $6,291 |
| CABG 3 arterial grafts | CPT | 33535 | 1 | — | — | $3,181 | $4,561.5 | 2.0× | $6,291 |
| CABG 4+ arterial grafts | CPT | 33536 | 1 | — | — | $3,181 | $4,561.5 | 1.9× | $6,291 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $16,307 | $25,261 | 1.5× | $35,483 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $12,956 | $20,200 | 1.5× | $28,191 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $34,706 | $53,761 | 1.7× | $75,517 |
| Open appendectomy | CPT | 44950 | 5 | — | — | $8,821 | $9,987.83 | 8.8× | $17,439 |
| Laparoscopic appendectomy | CPT | 44970 | 5 | — | — | $8,818.69 | $12,189 | 7.8× | $25,111 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $32,141 | $49,789 | 1.7× | $69,937 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $18,540 | $28,720 | 1.5× | $40,342 |
| Laparoscopic cholecystectomy | CPT | 47562 | 5 | — | — | $8,818.69 | $12,189 | 6.9× | $25,111 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 5 | — | — | $8,818.69 | $12,189 | 6.5× | $25,111 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $28,919 | $44,797 | 1.6× | $62,926 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $20,402 | $31,605 | 1.6× | $44,395 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $15,599 | $24,164 | 1.5× | $33,943 |
| Lap inguinal hernia repair | CPT | 49650 | 5 | — | — | $8,818.69 | $12,189 | 10.8× | $25,111 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $8,821 | $12,644 | 13.0× | $17,439 |
| Vaginal hysterectomy | CPT | 58260 | 5 | — | — | $7,461.49 | $9,350.52 | 5.2× | $17,439 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 5 | — | — | $8,818.69 | $12,189 | 8.3× | $25,111 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 5 | — | — | $12,700 | $16,008 | 7.2× | $25,111 |
| Lap salpingo-oophorectomy | CPT | 58661 | 5 | — | — | $8,818.69 | $12,189 | 6.0× | $25,111 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $13,685 | $37,749 | 1.4× | $58,336 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $13,685 | $23,140 | 1.4× | $34,169 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $13,685 | $22,130 | 1.5× | $31,277 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $3,447.34 | $5,430.38 | 2.4× | $12,362 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | — | $3,447.34 | $5,430.38 | 2.5× | $12,362 |
| Intravitreal injection | CPT | 67028 | 5 | — | — | $501.35 | $1,922.43 | 5.6× | $6,291 |
| Vitrectomy mechanical | CPT | 67042 | 5 | — | — | $6,080.59 | $8,603.27 | 3.4× | $18,102 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $11,787 | $18,609 | 1.5× | $25,647 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $19,214 | $29,763 | 1.6× | $41,808 |
| PCI single major coronary artery | CPT | 92920 | 11 | $13,180 | $6,590 | $5,192.92 | $9,143.03 | 1.6× | $25,111 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $37,860 | $18,930 | $10,165 | $19,687 | 2.0× | $30,629 |
| PCI bypass graft | CPT | 92937 | 11 | $25,200 | $12,600 | $9,928.8 | $17,141 | 1.6× | $25,111 |
| Left heart catheterization | CPT | 93452 | 11 | $7,960 | $3,980 | $3,136.24 | $5,344.42 | 1.7× | $18,102 |
| Coronary angiography with cath | CPT | 93455 | 11 | $8,780 | $4,390 | $3,459.32 | $5,860.65 | 1.9× | $18,102 |
| Coronary angiography with bypass cath | CPT | 93458 | 11 | $9,610 | $4,805 | $3,786.34 | $6,217.06 | 2.0× | $18,102 |