| behavioral |
| Psychoses | MS-DRG | 885 | 8 | — | — | $1,947 | $14,891 | 1.2× | $24,633 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 23 | — | — | $158.05 | $164.51 | 0.93× | $415.13 |
| Psychiatric eval with medical services | CPT | 90792 | 23 | — | — | $158.05 | $164.51 | 0.95× | $468.65 |
| Psychotherapy 30 minutes | CPT | 90832 | 23 | — | — | $158.05 | $164.51 | 1.1× | $362.88 |
| Psychotherapy 45 minutes | CPT | 90834 | 23 | — | — | $158.05 | $164.51 | 1.0× | $362.88 |
| Psychotherapy 60 minutes | CPT | 90837 | 23 | — | — | $158.05 | $164.51 | 0.86× | $383.6 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 23 | — | — | $158.05 | $164.51 | 1.0× | $369.8 |
| emergency |
| ED visit level 1 | CPT | 99281 | 23 | $572.25 | $211.73 | $28.33 | $136.99 | 0.98× | $2,291 |
| ED visit level 2 | CPT | 99282 | 23 | $1,327.5 | $491.18 | $103.8 | $222.54 | 0.94× | $2,767 |
| ED visit level 3 | CPT | 99283 | 23 | $3,565 | $1,319.05 | $174.98 | $389.12 | 0.96× | $4,456.25 |
| ED visit level 4 | CPT | 99284 | 23 | $3,588 | $1,327.56 | $299.3 | $598.4 | 0.90× | $4,508 |
| ED visit level 5 | CPT | 99285 | 23 | $3,771.5 | $1,395.46 | $434.53 | $861.59 | 0.83× | $5,592 |
| Critical care, first hour | CPT | 99291 | 23 | $4,147.75 | $1,534.67 | $664.65 | $1,184.12 | 1.1× | $5,978 |
| imaging |
| CT head without contrast | CPT | 70450 | 23 | $1,828.5 | $676.55 | $104.61 | $109.94 | 0.53× | $783 |
| CT head with contrast | CPT | 70460 | 23 | $1,952.5 | $722.43 | $175.12 | $184.05 | 0.79× | $783 |
| CT head with and without contrast | CPT | 70470 | 23 | $2,076.5 | $768.31 | $175.12 | $184.05 | 0.69× | $783 |
| CT neck with contrast | CPT | 70491 | 23 | $1,749.5 | $647.32 | $175.12 | $184.05 | 0.67× | $783 |
| MRI brain without contrast | CPT | 70551 | 23 | $3,046 | $1,127.02 | $237.78 | $294.8 | 0.73× | $1,127.02 |
| MRI brain with contrast | CPT | 70552 | 23 | $1,595 | $590.15 | $319 | $365.65 | 0.76× | $1,111 |
| MRI brain with and without contrast | CPT | 70553 | 23 | $2,402.5 | $888.93 | $336.35 | $369.23 | 0.63× | $1,111 |
| Chest X-ray single view | CPT | 71045 | 23 | $442.5 | $163.73 | $47.93 | $90.15 | 0.95× | $198.85 |
| Chest X-ray 2 views | CPT | 71046 | 23 | $479.5 | $177.42 | $63.39 | $90.59 | 0.92× | $198.85 |
| Chest X-ray 3 views | CPT | 71047 | 23 | $529 | $195.73 | $79.88 | $90.59 | 0.95× | $198.85 |
| CT chest without contrast | CPT | 71250 | 23 | $1,749.5 | $647.32 | $104.61 | $109.94 | 0.51× | $783 |
| CT chest with contrast | CPT | 71260 | 23 | $1,873.25 | $693.1 | $175.12 | $184.05 | 0.65× | $783 |
| CT chest with and without contrast | CPT | 71270 | 23 | $1,997.25 | $738.98 | $175.12 | $184.05 | 0.63× | $783 |
| MRI chest without contrast | CPT | 71550 | 23 | $2,278.5 | $843.05 | $237.78 | $284.46 | 0.66× | $843.04 |
| MRI chest with contrast | CPT | 71551 | 23 | — | — | $777.19 | $808.91 | 0.99× | $1,784.36 |
| MRI chest with and without contrast | CPT | 71552 | 23 | $2,526.5 | $934.81 | $351.31 | $369.23 | 0.61× | $1,092.34 |
| Lumbosacral spine X-ray | CPT | 72100 | 23 | $884.5 | $327.27 | $77.83 | $109.94 | 1.1× | $327.26 |
| CT cervical spine without contrast | CPT | 72125 | 23 | $1,749.5 | $647.32 | $104.61 | $109.94 | 0.55× | $783 |
| CT thoracic spine without contrast | CPT | 72128 | 23 | $1,563.25 | $578.4 | $104.61 | $109.94 | 0.55× | $783 |
| CT lumbar spine without contrast | CPT | 72131 | 23 | $1,625.5 | $601.44 | $104.61 | $109.94 | 0.54× | $783 |
| MRI cervical spine without contrast | CPT | 72141 | 23 | $2,154.5 | $797.17 | $237.78 | $275.78 | 0.69× | $797.16 |
| MRI thoracic spine without contrast | CPT | 72146 | 23 | $2,154.5 | $797.17 | $237.78 | $275.78 | 0.74× | $797.16 |
| MRI lumbar spine without contrast | CPT | 72148 | 23 | $3,071 | $1,136.27 | $237.78 | $294.8 | 0.78× | $1,136.27 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 23 | $2,402.5 | $888.93 | $336.35 | $369.23 | 0.81× | $888.92 |
| MRI cervical spine with and without contrast | CPT | 72156 | 23 | $2,340.5 | $865.99 | $327.65 | $369.23 | 0.68× | $865.99 |
| MRI lumbar spine with contrast | CPT | 72158 | 23 | $2,526.5 | $934.81 | $351.31 | $369.23 | 0.67× | $934.8 |
| CT pelvis without contrast | CPT | 72192 | 23 | $1,687.25 | $624.28 | $104.61 | $109.94 | 0.55× | $783 |
| CT pelvis with contrast | CPT | 72193 | 23 | $1,811.25 | $670.16 | $175.12 | $184.05 | 0.65× | $783 |
| Shoulder X-ray | CPT | 73030 | 23 | $712.5 | $263.63 | $68.56 | $91.03 | 0.98× | $263.63 |
| Humerus X-ray | CPT | 73060 | 23 | $532.25 | $196.93 | $66.47 | $90.59 | 1.0× | $198.85 |
| Hand X-ray 3 views | CPT | 73130 | 23 | $672.75 | $248.92 | $75.77 | $91.03 | 0.98× | $248.92 |
| MRI upper extremity joint without contrast | CPT | 73221 | 23 | $3,071 | $1,136.27 | $237.78 | $294.8 | 0.71× | $1,136.27 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 23 | $2,526.5 | $934.81 | $351.31 | $369.23 | 0.60× | $999.04 |
| Knee X-ray 1-2 views | CPT | 73560 | 23 | $711.5 | $263.26 | $72.66 | $91.03 | 0.98× | $263.25 |
| Ankle X-ray 3 views | CPT | 73610 | 23 | $698.75 | $258.54 | $75.77 | $91.03 | 0.99× | $258.54 |
| MRI lower extremity joint without contrast | CPT | 73721 | 23 | $2,278.5 | $843.05 | $237.78 | $284.46 | 0.61× | $843.04 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 23 | $2,526.5 | $934.81 | $351.31 | $369.23 | 0.58× | $996.97 |
| CT abdomen without contrast | CPT | 74150 | 23 | $1,625.5 | $601.44 | $104.61 | $109.94 | 0.58× | $783 |
| CT abdomen with contrast | CPT | 74160 | 23 | $1,749.5 | $647.32 | $175.12 | $184.05 | 0.64× | $783 |
| CT abdomen with and without contrast | CPT | 74170 | 23 | $1,873.25 | $693.1 | $175.12 | $184.05 | 0.55× | $783 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 23 | $1,749.5 | $647.32 | $237.78 | $249.91 | 0.69× | $783 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 23 | $1,873.25 | $693.1 | $351.31 | $369.23 | 0.67× | $824.45 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 23 | $1,997.25 | $738.98 | $351.31 | $369.23 | 0.64× | $824.45 |
| MRI abdomen without contrast | CPT | 74181 | 23 | $2,154.5 | $797.17 | $237.78 | $275.78 | 0.71× | $797.16 |
| MRI abdomen with and without contrast | CPT | 74183 | 23 | $2,402.5 | $888.93 | $336.35 | $369.23 | 0.65× | $888.92 |
| Abdominal ultrasound complete | CPT | 76700 | 23 | $2,424.5 | $897.07 | $104.61 | $149.44 | 1.0× | $897.07 |
| Abdominal ultrasound limited | CPT | 76705 | 23 | $2,366.75 | $875.7 | $104.61 | $129.69 | 0.89× | $875.7 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 23 | $1,528 | $565.36 | $104.61 | $129.69 | 0.90× | $565.36 |
| Obstetric ultrasound first trimester | CPT | 76801 | 23 | $1,465.75 | $542.33 | $104.61 | $129.69 | 0.92× | $542.33 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 23 | $921.5 | $340.96 | $104.61 | $129.69 | 0.85× | $340.95 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 23 | — | — | $237.78 | $247.48 | 1.1× | $545.92 |
| Transvaginal ultrasound | CPT | 76830 | 23 | $1,919.75 | $710.31 | $104.61 | $129.69 | 0.88× | $710.31 |
| Pelvic ultrasound complete | CPT | 76856 | 23 | $2,061.5 | $762.76 | $104.61 | $129.69 | 0.91× | $762.75 |
| Scrotal ultrasound | CPT | 76870 | 23 | $1,709.75 | $632.61 | $104.61 | $129.69 | 0.99× | $632.61 |
| Diagnostic mammography unilateral | CPT | 77065 | 23 | $815 | $301.55 | $78.7 | $97.58 | 0.65× | $301.55 |
| Diagnostic mammography bilateral | CPT | 77066 | 23 | $821.5 | $303.96 | $100.16 | $121.09 | 0.64× | $344.86 |
| Screening mammography bilateral | CPT | 77067 | 23 | $776 | $287.12 | $82.7 | $123.75 | 0.78× | $287.12 |
| EKG complete | CPT | 93000 | 2 | — | — | $34.38 | $34.38 | 1.4× | $1,636 |
| EKG tracing only | CPT | 93005 | 23 | $336 | $124.32 | $14.88 | $60.81 | 0.52× | $1,636 |
| EKG interpretation only | CPT | 93010 | 2 | — | — | $19.5 | $19.5 | 1.1× | $1,636 |
| Transthoracic echocardiogram complete | CPT | 93306 | 23 | $5,795 | $2,144.15 | $289.38 | $561.38 | 0.94× | $7,243.75 |
| Transthoracic echocardiogram | CPT | 93307 | 23 | $3,227.5 | $1,194.18 | $211.4 | $247.48 | 1.0× | $4,034.38 |
| Stress echocardiogram | CPT | 93350 | 23 | — | — | $263.13 | $561.38 | 1.1× | $1,636 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $1,947 | $14,891 | 0.96× | $24,633 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $1,947 | $14,891 | 1.3× | $24,633 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $1,947 | $14,891 | 1.7× | $24,633 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $1,947 | $14,891 | 2.1× | $24,633 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $1,947 | $14,891 | 1.8× | $24,633 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $1,947 | $14,891 | 2.2× | $24,633 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $1,947 | $14,891 | 0.95× | $24,633 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $1,947 | $14,891 | 1.5× | $24,633 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $1,947 | $14,891 | 1.9× | $24,633 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $1,947 | $14,891 | 1.2× | $24,633 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $1,947 | $14,891 | 1.7× | $24,633 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $1,947 | $14,891 | 2.4× | $24,633 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $1,947 | $14,891 | 1.2× | $24,633 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $1,947 | $14,891 | 1.9× | $24,633 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $1,947 | $14,891 | 2.4× | $24,633 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $1,947 | $14,891 | 1.5× | $24,633 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $1,947 | $14,891 | 2.2× | $24,633 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $1,947 | $14,891 | 1.9× | $24,633 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $1,947 | $14,891 | 0.98× | $24,633 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $1,947 | $14,891 | 1.3× | $24,633 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $1,947 | $14,891 | 1.8× | $24,633 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $1,947 | $14,891 | 0.80× | $24,633 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $1,947 | $14,891 | 1.4× | $24,633 |
| Initial hospital care, low complexity | CPT | 99221 | 1 | — | — | $202.15 | $202.15 | 2.2× | $202.15 |
| Initial hospital care, moderate complexity | CPT | 99222 | 1 | — | — | $316.93 | $316.93 | 1.9× | $316.93 |
| Initial hospital care, high complexity | CPT | 99223 | 1 | — | — | $421.9 | $421.9 | 1.9× | $421.9 |
| Hospital discharge, <30 min | CPT | 99238 | 1 | — | — | $196.35 | $196.35 | 2.3× | $196.35 |
| Hospital discharge, >30 min | CPT | 99239 | 1 | — | — | $277.23 | $277.23 | 2.3× | $277.23 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 23 | $193.25 | $71.5 | $7.45 | $8.67 | 0.27× | $193.25 |
| General health panel | CPT | 80050 | 4 | $402 | $148.74 | $47.28 | $91.98 | 0.86× | $402 |
| Electrolyte panel | CPT | 80051 | 23 | $104 | $38.48 | $6.17 | $7.19 | 0.30× | $104 |
| Comprehensive metabolic panel | CPT | 80053 | 23 | $330.75 | $122.38 | $9.29 | $10.83 | 0.24× | $330.75 |
| Lipid panel | CPT | 80061 | 23 | $424.25 | $156.97 | $11.78 | $13.73 | 0.36× | $424.25 |
| Renal function panel | CPT | 80069 | 23 | $210 | $77.7 | $7.64 | $8.9 | 0.33× | $210 |
| Hepatic function panel | CPT | 80076 | 23 | $135.5 | $50.14 | $7.19 | $8.38 | 0.31× | $135.5 |
| Urinalysis non-automated | CPT | 81002 | 23 | $13.25 | $4.9 | $2.65 | $3.55 | 0.51× | $13.25 |
| Urinalysis automated | CPT | 81003 | 23 | $28.25 | $10.45 | $1.98 | $2.31 | 0.17× | $28.25 |
| Glucose quantitative | CPT | 82947 | 23 | $18.5 | $6.85 | $3.46 | $4.01 | 0.23× | $18.5 |
| Hemoglobin A1c | CPT | 83036 | 23 | $30.75 | $11.38 | $1.8 | $9.9 | 0.37× | $30.75 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 23 | $97.75 | $36.17 | $1.48 | $17.14 | 0.36× | $97.75 |
| Complete blood count with automated differential | CPT | 85025 | 23 | $138.5 | $51.25 | $6.84 | $7.97 | 0.30× | $138.5 |
| Complete blood count without differential | CPT | 85027 | 23 | $126 | $46.62 | $5.69 | $6.63 | 0.31× | $126 |
| Urine culture bacterial | CPT | 87086 | 23 | $216.25 | $80.01 | $7.1 | $8.27 | 0.35× | $216.25 |
| Urine culture identification | CPT | 87088 | 23 | $48.25 | $17.85 | $7.12 | $8.29 | 0.37× | $48.25 |
| Tissue exam by pathologist level IV | CPT | 88305 | 23 | $116.5 | $43.11 | $12.95 | $54.7 | 0.53× | $167.93 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 23 | — | — | $197.89 | $205.97 | 1.1× | $454.34 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 2 | $282.5 | $104.53 | $171.68 | $171.68 | 2.0× | $353.13 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 2 | $366.75 | $135.7 | $270.75 | $270.75 | 2.2× | $458.44 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 2 | $503 | $186.11 | $406.73 | $406.73 | 2.3× | $628.75 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 2 | $847.75 | $313.67 | $538.48 | $538.48 | 2.4× | $1,059.69 |
| Office visit, established patient, 5 min | CPT | 99211 | 2 | $164.5 | $60.87 | $54.5 | $54.5 | 0.85× | $205.63 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 2 | $219 | $81.03 | $134.75 | $134.75 | 1.7× | $273.75 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 2 | $314 | $116.18 | $219.6 | $219.6 | 1.9× | $392.5 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 2 | $317 | $117.29 | $309.88 | $309.88 | 2.0× | $396.25 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 2 | $710 | $262.7 | $435.3 | $435.3 | 2.3× | $887.5 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 23 | — | — | $922.28 | $959.92 | 1.0× | $11,236 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 23 | — | — | $922.28 | $959.92 | 0.99× | $11,236 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 23 | — | — | $896.86 | $933.46 | 1.1× | $11,236 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 23 | — | — | $896.86 | $933.46 | 1.0× | $11,236 |
| Colonoscopy diagnostic | CPT | 45378 | 23 | — | — | $896.86 | $933.46 | 1.1× | $11,236 |
| Colonoscopy with biopsy | CPT | 45380 | 1 | — | — | $5,618 | $8,427 | 6.9× | $11,236 |
| Colonoscopy with polyp removal | CPT | 45385 | 1 | — | — | $5,618 | $8,427 | 7.0× | $11,236 |
| surgery |
| Total hip replacement | CPT | 27130 | 2 | — | — | $26,877 | $32,093 | 7.4× | $32,093 |
| Total knee replacement | CPT | 27447 | 2 | — | — | $26,877 | $32,093 | 7.7× | $32,093 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $13,544 | $27,040 | 82.7× | $27,040 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 1 | — | — | $13,544 | $27,040 | 8.2× | $27,040 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 1 | — | — | $13,544 | $27,040 | 13.2× | $27,040 |
| ACL reconstruction | CPT | 29888 | 1 | — | — | $13,544 | $27,040 | 8.1× | $27,040 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $4,562 | $16,012 | 0.37× | $25,895 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $4,562 | $14,891 | 0.64× | $24,633 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $4,562 | $14,891 | 0.91× | $24,633 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $4,562 | $14,891 | 0.90× | $24,633 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $4,562 | $14,891 | 1.1× | $24,633 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $9,559 | $16,012 | 0.49× | $24,633 |
| Open appendectomy | CPT | 44950 | 1 | — | — | $5,618 | $8,427 | 7.4× | $11,236 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $7,840 | $15,296 | 0.52× | $54,850 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $7,840 | $22,887 | 1.2× | $54,850 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $4,562 | $16,012 | 0.57× | $24,633 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $4,562 | $14,891 | 0.73× | $24,633 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $4,562 | $14,891 | 0.93× | $24,633 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 8 | — | — | $4,562 | $14,891 | 0.55× | $40,833 |
| OR procedure for obesity w CC | MS-DRG | 620 | 8 | — | — | $4,562 | $14,891 | 0.92× | $40,833 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 8 | — | — | $4,562 | $14,891 | 0.98× | $40,833 |
| Intravitreal injection | CPT | 67028 | 23 | — | — | $326.28 | $339.6 | 0.99× | $749.12 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $4,562 | $14,891 | 1.2× | $24,633 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $4,562 | $14,891 | 0.78× | $24,633 |
| PCI single major coronary artery | CPT | 92920 | 4 | — | — | $1,319.85 | $27,140 | 4.8× | $38,010 |
| PCI with drug-eluting stent | CPT | 92928 | 4 | — | — | $1,465.8 | $27,140 | 2.7× | $38,010 |
| PCI bypass graft | CPT | 92937 | 4 | — | — | $1,464.98 | $27,140 | 2.5× | $38,010 |
| Left heart catheterization | CPT | 93452 | 2 | — | — | $1,428.48 | $2,009.43 | 0.65× | $15,191 |
| Coronary angiography with cath | CPT | 93455 | 2 | — | — | $1,576.73 | $2,263 | 0.72× | $15,191 |
| Coronary angiography with bypass cath | CPT | 93458 | 2 | — | — | $1,612.88 | $2,336.58 | 0.75× | $15,191 |