| emergency |
| Critical care, first hour | CPT | 99291 | 9 | $4,466.63 | $4,466.63 | $3,126.64 | $3,461.64 | 3.2× | $3,796.64 |
| imaging |
| CT head without contrast | CPT | 70450 | 9 | $10,568 | $10,568 | $7,397.26 | $8,189.82 | 39.6× | $8,982.38 |
| CT head with contrast | CPT | 70460 | 9 | $4,698 | $4,698 | $3,288.6 | $3,640.95 | 15.6× | $3,993.3 |
| CT head with and without contrast | CPT | 70470 | 9 | $10,613 | $10,613 | $7,429.21 | $8,225.2 | 30.8× | $9,021.19 |
| CT neck with contrast | CPT | 70491 | 9 | $10,044 | $10,044 | $7,030.8 | $7,784.1 | 28.5× | $8,537.4 |
| MRI brain without contrast | CPT | 70551 | 9 | $9,086.04 | $9,086.04 | $6,360.23 | $7,041.68 | 17.4× | $7,723.13 |
| MRI brain with contrast | CPT | 70552 | 9 | $9,677.88 | $9,677.88 | $6,774.52 | $7,500.36 | 15.7× | $8,226.2 |
| MRI brain with and without contrast | CPT | 70553 | 9 | $10,268 | $10,268 | $7,187.29 | $7,957.36 | 13.5× | $8,727.43 |
| Chest X-ray single view | CPT | 71045 | 9 | $1,882.44 | $1,882.44 | $1,317.71 | $1,458.89 | 15.4× | $1,600.07 |
| Chest X-ray 2 views | CPT | 71046 | 9 | $1,512 | $1,512 | $1,058.4 | $1,171.8 | 11.9× | $1,285.2 |
| Chest X-ray 3 views | CPT | 71047 | 9 | $1,620 | $1,620 | $1,134 | $1,255.5 | 13.1× | $1,377 |
| CT chest without contrast | CPT | 71250 | 9 | $10,787 | $10,787 | $7,550.93 | $8,359.96 | 38.9× | $9,168.98 |
| CT chest with contrast | CPT | 71260 | 9 | $12,206 | $12,206 | $8,544.31 | $9,459.78 | 33.6× | $10,375 |
| CT chest with and without contrast | CPT | 71270 | 9 | $9,136 | $9,136 | $6,395.2 | $7,080.4 | 24.3× | $7,765.6 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $2,256.74 | $2,256.74 | $1,579.72 | $1,748.98 | 16.9× | $1,918.23 |
| CT cervical spine without contrast | CPT | 72125 | 9 | $4,698 | $4,698 | $3,288.6 | $3,640.95 | 18.1× | $3,993.3 |
| CT thoracic spine without contrast | CPT | 72128 | 9 | $8,928.36 | $8,928.36 | $6,249.85 | $6,919.48 | 34.7× | $7,589.11 |
| CT lumbar spine without contrast | CPT | 72131 | 9 | $4,698 | $4,698 | $3,288.6 | $3,640.95 | 17.9× | $3,993.3 |
| MRI cervical spine without contrast | CPT | 72141 | 9 | $11,749 | $11,749 | $8,224.52 | $9,105.73 | 22.9× | $9,986.92 |
| MRI thoracic spine without contrast | CPT | 72146 | 9 | $10,779 | $10,779 | $7,545.64 | $8,354.1 | 22.4× | $9,162.56 |
| MRI lumbar spine without contrast | CPT | 72148 | 9 | $5,639.76 | $5,639.76 | $3,947.83 | $4,370.82 | 11.6× | $4,793.8 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 9 | $7,255 | $7,255 | $5,078.5 | $5,622.63 | 12.4× | $6,166.75 |
| MRI cervical spine with and without contrast | CPT | 72156 | 9 | $13,369 | $13,369 | $9,358.52 | $10,361 | 19.2× | $11,364 |
| MRI lumbar spine with contrast | CPT | 72158 | 9 | $14,565 | $14,565 | $10,195 | $11,288 | 20.6× | $12,380 |
| CT pelvis without contrast | CPT | 72192 | 9 | $10,787 | $10,787 | $7,550.93 | $8,359.96 | 41.8× | $9,168.98 |
| CT pelvis with contrast | CPT | 72193 | 9 | $11,687 | $11,687 | $8,180.68 | $9,057.18 | 32.2× | $9,933.68 |
| Shoulder X-ray | CPT | 73030 | 9 | $2,256.74 | $2,256.74 | $1,579.72 | $1,748.98 | 18.8× | $1,918.23 |
| Humerus X-ray | CPT | 73060 | 9 | $1,564.92 | $1,564.92 | $1,095.44 | $1,212.82 | 13.6× | $1,330.18 |
| Hand X-ray 3 views | CPT | 73130 | 9 | $1,564.92 | $1,564.92 | $1,095.44 | $1,212.82 | 13.0× | $1,330.18 |
| MRI upper extremity joint without contrast | CPT | 73221 | 9 | $5,222 | $5,222 | $3,655.4 | $4,047.05 | 9.7× | $4,438.7 |
| Knee X-ray 1-2 views | CPT | 73560 | 9 | $1,882.44 | $1,882.44 | $1,145.34 | $1,390.77 | 14.9× | $1,600.07 |
| Ankle X-ray 3 views | CPT | 73610 | 9 | $2,070.3 | $2,070.3 | $901.91 | $1,272.19 | 13.8× | $1,759.76 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 9 | $13,554 | $13,554 | $9,487.8 | $10,504 | 16.6× | $11,521 |
| CT abdomen without contrast | CPT | 74150 | 9 | $10,787 | $10,787 | $7,550.93 | $8,359.96 | 44.4× | $9,168.98 |
| CT abdomen with contrast | CPT | 74160 | 9 | $12,060 | $12,060 | $8,442.25 | $9,346.78 | 32.6× | $10,251 |
| CT abdomen with and without contrast | CPT | 74170 | 9 | $13,387 | $13,387 | $9,370.62 | $10,375 | 31.0× | $11,379 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 9 | $7,267.32 | $7,267.32 | $5,087.12 | $5,632.18 | 15.5× | $6,177.22 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 9 | $7,563.24 | $7,563.24 | $5,294.27 | $5,861.51 | 10.7× | $6,428.75 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 9 | $14,880 | $14,880 | $10,416 | $11,532 | 20.1× | $12,648 |
| MRI abdomen without contrast | CPT | 74181 | 9 | $10,779 | $10,779 | $5,126.8 | $6,885.52 | 17.6× | $9,162.56 |
| Abdominal ultrasound complete | CPT | 76700 | 9 | $4,338.68 | $4,338.68 | $3,037.08 | $3,362.48 | 22.5× | $3,687.88 |
| Abdominal ultrasound limited | CPT | 76705 | 9 | $4,135.41 | $4,135.41 | $795.94 | $1,930.64 | 13.2× | $3,515.1 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 9 | $5,221.7 | $5,221.7 | $990.86 | $2,429.19 | 16.9× | $4,438.45 |
| Pelvic ultrasound complete | CPT | 76856 | 9 | $4,402.12 | $4,402.12 | $3,081.48 | $3,411.65 | 23.8× | $3,741.8 |
| Scrotal ultrasound | CPT | 76870 | 9 | $1,974.24 | $1,974.24 | $1,381.97 | $1,530.04 | 11.7× | $1,678.1 |
| Screening mammography bilateral | CPT | 77067 | 9 | $1,628.79 | $1,628.79 | $1,140.15 | $1,262.31 | 8.0× | $1,384.47 |
| EKG tracing only | CPT | 93005 | 9 | $253.26 | $253.26 | $177.28 | $196.28 | 1.7× | $215.27 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $4,482.44 | $4,482.44 | $3,137.71 | $3,473.89 | 5.8× | $3,810.07 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $2,901 | $2,901 | $2,030.7 | $2,248.28 | 9.1× | $2,465.85 |
| Stress echocardiogram | CPT | 93350 | 9 | $4,179 | $4,179 | $2,925.3 | $3,238.73 | 6.4× | $3,552.15 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 9 | — | — | $54,246 | $57,101 | 2.8× | $68,522 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 9 | — | — | $28,420 | $29,916 | 2.8× | $35,899 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 9 | — | — | $19,934 | $20,983 | 2.8× | $25,179 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $33,804 | $35,583 | 2.3× | $42,700 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $27,252 | $28,687 | 2.6× | $34,424 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $27,252 | $28,687 | 3.3× | $34,424 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $27,252 | $28,687 | 4.1× | $34,424 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $22,244 | $23,415 | 2.8× | $28,098 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $19,934 | $20,983 | 3.1× | $25,179 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $34,192 | $35,991 | 2.3× | $43,190 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $26,635 | $28,037 | 2.9× | $33,645 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $19,934 | $20,983 | 2.7× | $25,179 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $32,090 | $33,779 | 2.6× | $40,535 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $22,786 | $23,985 | 2.7× | $28,782 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $19,934 | $20,983 | 3.4× | $25,179 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $34,913 | $36,751 | 3.0× | $44,101 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $19,934 | $20,983 | 2.7× | $25,179 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $19,934 | $20,983 | 3.4× | $25,179 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $26,635 | $28,037 | 2.8× | $33,645 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $26,635 | $28,037 | 4.1× | $33,645 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $26,122 | $27,497 | 3.4× | $32,997 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $30,251 | $31,843 | 2.1× | $38,212 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $26,348 | $27,734 | 2.4× | $33,281 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $19,600 | $20,632 | 2.5× | $24,758 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $35,401 | $37,264 | 2.0× | $44,717 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $23,720 | $24,969 | 2.4× | $29,962 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 9 | $551.12 | $551.12 | $385.78 | $427.12 | 13.2× | $468.45 |
| Electrolyte panel | CPT | 80051 | 9 | $456.84 | $456.84 | $319.79 | $354.05 | 14.9× | $388.31 |
| Comprehensive metabolic panel | CPT | 80053 | 9 | $547.62 | $547.62 | $383.33 | $424.41 | 9.6× | $465.48 |
| Lipid panel | CPT | 80061 | 9 | $1,491.16 | $1,491.16 | $1,043.81 | $1,155.65 | 30.3× | $1,267.49 |
| Renal function panel | CPT | 80069 | 9 | $597.22 | $597.22 | $418.05 | $462.85 | 17.0× | $507.64 |
| Hepatic function panel | CPT | 80076 | 9 | $1,572.88 | $1,572.88 | $1,101.02 | $1,218.98 | 45.8× | $1,336.95 |
| Urinalysis non-automated | CPT | 81002 | 9 | $34.8 | $34.8 | $24.36 | $26.97 | 3.9× | $29.58 |
| Urinalysis automated | CPT | 81003 | 9 | $59.49 | $59.49 | $41.64 | $46.11 | 3.3× | $50.57 |
| Glucose quantitative | CPT | 82947 | 9 | $516.75 | $516.75 | $361.73 | $400.48 | 22.8× | $439.24 |
| Hemoglobin A1c | CPT | 83036 | 9 | $731.75 | $731.75 | $512.23 | $567.11 | 21.1× | $621.99 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 9 | $1,460.98 | $1,460.98 | $1,022.69 | $1,132.26 | 23.9× | $1,241.83 |
| Complete blood count with automated differential | CPT | 85025 | 9 | $339.42 | $339.42 | $237.59 | $263.06 | 9.9× | $288.51 |
| Complete blood count without differential | CPT | 85027 | 9 | $339.42 | $339.42 | $237.59 | $263.06 | 12.2× | $288.51 |
| Urine culture bacterial | CPT | 87086 | 9 | $1,097.63 | $1,097.63 | $768.34 | $850.66 | 36.5× | $932.99 |
| Urine culture identification | CPT | 87088 | 9 | $476.52 | $476.52 | $333.56 | $369.31 | 16.6× | $405.04 |
| Tissue exam by pathologist level IV | CPT | 88305 | 9 | $2,016.72 | $2,016.72 | $1,411.7 | $1,562.96 | 15.3× | $1,714.21 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | $5,142.96 | $5,142.96 | $3,600.07 | $3,985.8 | 4.4× | $4,371.52 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | $2,462.4 | $2,462.4 | $1,723.68 | $1,908.36 | 2.0× | $2,093.04 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 9 | $1,694.52 | $1,694.52 | $1,186.16 | $1,313.26 | 1.6× | $1,440.34 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | $1,694.52 | $1,694.52 | $1,186.16 | $1,313.26 | 1.5× | $1,440.34 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | $2,741.04 | $2,741.04 | $1,918.73 | $2,124.31 | 2.4× | $2,329.88 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | $5,951.88 | $5,951.88 | $4,166.32 | $4,612.71 | 3.8× | $5,059.1 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | $5,951.88 | $5,951.88 | $4,166.32 | $4,612.71 | 3.8× | $5,059.1 |
| surgery |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $52,641 | $55,411 | 1.3× | $66,494 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $26,635 | $28,037 | 1.2× | $33,645 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $26,635 | $28,037 | 1.7× | $33,645 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $30,251 | $31,843 | 1.9× | $38,212 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $30,251 | $31,843 | 2.4× | $38,212 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $29,988 | $31,566 | 0.98× | $37,880 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $52,641 | $55,411 | 1.9× | $66,494 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $28,420 | $29,916 | 1.6× | $35,899 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $28,420 | $29,916 | 1.1× | $35,899 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $28,420 | $29,916 | 1.5× | $35,899 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $28,420 | $29,916 | 1.9× | $35,899 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $54,530 | $57,400 | 2.1× | $68,880 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $39,563 | $41,645 | 2.6× | $49,974 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $28,420 | $29,916 | 2.0× | $35,899 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $52,641 | $55,411 | 4.5× | $66,494 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $52,641 | $55,411 | 2.9× | $66,494 |