| behavioral |
| Psychoses | MS-DRG | 885 | 1 | — | — | $21,044 | $24,291 | 1.9× | $27,539 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 18 | $740 | $740 | $60.38 | $228.6 | 1.3× | $744.3 |
| Psychiatric eval with medical services | CPT | 90792 | 18 | $825 | $825 | $95 | $228.6 | 1.3× | $843.69 |
| Psychotherapy 30 minutes | CPT | 90832 | 18 | $345 | $345 | $25.21 | $172.36 | 1.2× | $363.89 |
| Psychotherapy 45 minutes | CPT | 90834 | 18 | $460 | $460 | $37.79 | $198.12 | 1.2× | $485.18 |
| Psychotherapy 60 minutes | CPT | 90837 | 18 | $635 | $635 | $57.05 | $209.42 | 1.1× | $657.02 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 18 | $720 | $720 | $89 | $215.82 | 1.4× | $695.32 |
| emergency |
| ED visit level 1 | CPT | 99281 | 18 | $135 | $135 | $8.04 | $65.32 | 0.47× | $134.3 |
| ED visit level 2 | CPT | 99282 | 18 | $255 | $255 | $15.11 | $166.84 | 0.70× | $257.2 |
| ED visit level 3 | CPT | 99283 | 18 | $380 | $380 | $24.41 | $254.45 | 0.63× | $383.47 |
| ED visit level 4 | CPT | 99284 | 18 | $715 | $715 | $45.02 | $461.22 | 0.69× | $708.27 |
| ED visit level 5 | CPT | 99285 | 18 | $1,015 | $1,015 | $67.19 | $667.65 | 0.64× | $1,029.25 |
| Critical care, first hour | CPT | 99291 | 18 | $8,179 | $8,179 | $84.68 | $1,174 | 1.1× | $7,361.1 |
| imaging |
| CT head without contrast | CPT | 70450 | 18 | $2,454 | $2,454 | $35.18 | $460.76 | 2.2× | $2,208.6 |
| CT head with contrast | CPT | 70460 | 18 | $2,874 | $2,874 | $47.11 | $516.17 | 2.2× | $2,586.6 |
| CT head with and without contrast | CPT | 70470 | 18 | $3,068 | $3,068 | $53.08 | $523.48 | 2.0× | $2,761.2 |
| CT neck with contrast | CPT | 70491 | 18 | $2,874 | $2,874 | $57.44 | $523.48 | 1.9× | $2,586.6 |
| MRI brain without contrast | CPT | 70551 | 18 | $6,467 | $6,467 | $61.65 | $641.04 | 1.6× | $6,836 |
| MRI brain with contrast | CPT | 70552 | 18 | $7,279 | $7,279 | $74.02 | $948.04 | 2.0× | $6,836 |
| MRI brain with and without contrast | CPT | 70553 | 18 | $7,589 | $7,589 | $95.08 | $966.83 | 1.6× | $6,836 |
| Chest X-ray single view | CPT | 71045 | 18 | $482 | $482 | $7.41 | $51.04 | 0.54× | $1,198 |
| Chest X-ray 2 views | CPT | 71046 | 18 | $647 | $647 | $9.17 | $53.91 | 0.55× | $1,198 |
| Chest X-ray 3 views | CPT | 71047 | 18 | $695 | $695 | $11.51 | $64 | 0.67× | $1,198 |
| CT chest without contrast | CPT | 71250 | 18 | $2,454 | $2,454 | $45.07 | $438.02 | 2.0× | $2,208.6 |
| CT chest with contrast | CPT | 71260 | 18 | $2,874 | $2,874 | $48.58 | $523.48 | 1.9× | $2,586.6 |
| CT chest with and without contrast | CPT | 71270 | 18 | $3,068 | $3,068 | $51.76 | $523.48 | 1.8× | $2,761.2 |
| MRI chest without contrast | CPT | 71550 | 18 | $6,467 | $6,467 | $60.77 | $669.24 | 1.6× | $6,836 |
| MRI chest with contrast | CPT | 71551 | 18 | $7,279 | $7,279 | $71.98 | $966.83 | 1.2× | $6,836 |
| MRI chest with and without contrast | CPT | 71552 | 18 | $7,589 | $7,589 | $93.92 | $1,009.36 | 1.7× | $6,836 |
| Lumbosacral spine X-ray | CPT | 72100 | 18 | $1,028 | $1,028 | $9.47 | $53.91 | 0.52× | $1,198 |
| CT cervical spine without contrast | CPT | 72125 | 18 | $2,454 | $2,454 | $41.43 | $438.02 | 2.2× | $2,208.6 |
| CT thoracic spine without contrast | CPT | 72128 | 18 | $2,454 | $2,454 | $41.43 | $438.02 | 2.2× | $2,208.6 |
| CT lumbar spine without contrast | CPT | 72131 | 18 | $2,540 | $2,540 | $41.43 | $438.02 | 2.2× | $2,286 |
| MRI cervical spine without contrast | CPT | 72141 | 18 | $5,492 | $5,492 | $30.82 | $601.3 | 1.5× | $6,836 |
| MRI thoracic spine without contrast | CPT | 72146 | 18 | $5,492 | $5,492 | $61.65 | $641.04 | 1.7× | $6,836 |
| MRI lumbar spine without contrast | CPT | 72148 | 18 | $6,444 | $6,444 | $61.96 | $641.04 | 1.7× | $6,836 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 18 | $7,266 | $7,266 | $74.46 | $947.94 | 2.1× | $6,836 |
| MRI cervical spine with and without contrast | CPT | 72156 | 18 | $6,450 | $6,450 | $47.7 | $906.9 | 1.7× | $6,836 |
| MRI lumbar spine with contrast | CPT | 72158 | 18 | $6,444 | $6,444 | $95.39 | $966.83 | 1.8× | $6,836 |
| CT pelvis without contrast | CPT | 72192 | 18 | $1,993 | $1,993 | $45.36 | $438.02 | 2.2× | $2,168 |
| CT pelvis with contrast | CPT | 72193 | 18 | $2,258 | $2,258 | $48.27 | $523.48 | 1.9× | $2,168 |
| Shoulder X-ray | CPT | 73030 | 18 | $1,558 | $1,558 | $8.03 | $81.66 | 0.88× | $1,402.2 |
| Humerus X-ray | CPT | 73060 | 18 | $1,150 | $1,150 | $3.42 | $49.42 | 0.55× | $1,198 |
| Hand X-ray 3 views | CPT | 73130 | 18 | $1,233 | $1,233 | $7.43 | $62.24 | 0.67× | $1,198 |
| MRI upper extremity joint without contrast | CPT | 73221 | 18 | $5,492 | $5,492 | $56.59 | $572.13 | 1.4× | $6,836 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 18 | $6,444 | $6,444 | $89.74 | $889.25 | 1.5× | $6,836 |
| Knee X-ray 1-2 views | CPT | 73560 | 18 | $1,495 | $1,495 | $7.15 | $60 | 0.64× | $1,345.5 |
| Ankle X-ray 3 views | CPT | 73610 | 18 | $1,346 | $1,346 | $7.43 | $62.24 | 0.68× | $1,211.4 |
| MRI lower extremity joint without contrast | CPT | 73721 | 18 | $10,360 | $10,360 | $56.59 | $794.63 | 1.7× | $9,324 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 18 | $12,156 | $12,156 | $89.42 | $1,006.65 | 1.6× | $10,940 |
| CT abdomen without contrast | CPT | 74150 | 18 | $1,993 | $1,993 | $49.44 | $438.02 | 2.3× | $2,168 |
| CT abdomen with contrast | CPT | 74160 | 18 | $2,258 | $2,258 | $53.08 | $523.48 | 1.8× | $2,168 |
| CT abdomen with and without contrast | CPT | 74170 | 18 | $2,359 | $2,359 | $58.01 | $546.51 | 1.6× | $2,168 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 18 | $4,513 | $4,513 | $72.26 | $528.82 | 1.5× | $4,061.7 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 18 | $4,513 | $4,513 | $75.46 | $552.88 | 1.0× | $4,061.7 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 18 | $4,654 | $4,654 | $83.15 | $552.88 | 0.96× | $4,188.6 |
| MRI abdomen without contrast | CPT | 74181 | 18 | $5,492 | $5,492 | $60.77 | $641.04 | 1.6× | $6,836 |
| MRI abdomen with and without contrast | CPT | 74183 | 18 | $6,444 | $6,444 | $91.15 | $966.83 | 1.7× | $6,836 |
| Abdominal ultrasound complete | CPT | 76700 | 18 | $1,774 | $1,774 | $33.43 | $521.93 | 3.5× | $2,047.28 |
| Abdominal ultrasound limited | CPT | 76705 | 18 | $1,668 | $1,668 | $24.26 | $277.3 | 1.9× | $1,501.2 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 18 | $1,784 | $1,784 | $30.82 | $563.08 | 3.9× | $2,047.28 |
| Transvaginal ultrasound | CPT | 76830 | 18 | $1,780 | $1,780 | $28.66 | $209.77 | 1.4× | $1,602 |
| Pelvic ultrasound complete | CPT | 76856 | 18 | $1,778 | $1,778 | $28.34 | $489 | 3.4× | $2,047.28 |
| Scrotal ultrasound | CPT | 76870 | 18 | $1,778 | $1,778 | $26.3 | $203.24 | 1.5× | $1,600.2 |
| Diagnostic mammography unilateral | CPT | 77065 | 18 | $795 | $795 | $33.74 | $192.45 | 1.3× | $880.85 |
| Diagnostic mammography bilateral | CPT | 77066 | 18 | $1,405 | $1,405 | $41.43 | $236 | 1.2× | $1,880 |
| Screening mammography bilateral | CPT | 77067 | 18 | $827 | $827 | $15.85 | $208.89 | 1.3× | $1,880 |
| EKG tracing only | CPT | 93005 | 18 | $512 | $512 | $45.19 | $122.01 | 1.0× | $460.8 |
| EKG interpretation only | CPT | 93010 | 18 | $50 | $50 | $7.13 | $25.47 | 1.4× | $45 |
| Transthoracic echocardiogram complete | CPT | 93306 | 18 | $5,092 | $5,092 | $59.45 | $453.72 | 0.76× | $4,582.8 |
| Transthoracic echocardiogram | CPT | 93307 | 18 | $372 | $372 | $37.35 | $223.2 | 0.90× | $1,037.01 |
| Stress echocardiogram | CPT | 93350 | 18 | $882 | $882 | $327 | $573.3 | 1.1× | $1,109.74 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 3 | — | — | $21,044 | $38,471 | 2.5× | $66,834 |
| COPD w MCC | MS-DRG | 190 | 3 | — | — | $21,044 | $28,320 | 2.5× | $47,374 |
| COPD w CC | MS-DRG | 191 | 3 | — | — | $18,220 | $22,461 | 2.5× | $36,053 |
| COPD w/o CC/MCC | MS-DRG | 192 | 1 | — | — | $21,044 | $24,291 | 3.5× | $27,539 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 3 | — | — | $17,418 | $21,472 | 2.5× | $34,467 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 1 | — | — | $21,044 | $24,291 | 3.6× | $27,539 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | — | — | $21,044 | $39,490 | 2.5× | $68,604 |
| AMI discharged alive w CC | MS-DRG | 281 | 3 | — | — | $19,865 | $24,489 | 2.5× | $39,308 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 1 | — | — | $21,044 | $24,291 | 3.1× | $27,539 |
| Heart failure & shock w MCC | MS-DRG | 291 | 3 | — | — | $21,044 | $31,605 | 2.5× | $54,906 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | — | — | $18,349 | $22,621 | 2.5× | $36,310 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 1 | — | — | $21,044 | $24,291 | 3.9× | $27,539 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | — | — | $21,044 | $29,640 | 2.5× | $51,493 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | — | — | $15,901 | $20,460 | 2.6× | $31,464 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 3 | — | — | $12,235 | $15,909 | 2.6× | $27,539 |
| GI hemorrhage w CC | MS-DRG | 378 | 3 | — | — | $21,044 | $26,130 | 2.6× | $41,943 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 1 | — | — | $21,044 | $24,291 | 3.6× | $27,539 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 3 | — | — | $16,849 | $21,053 | 2.6× | $33,342 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 1 | — | — | $21,044 | $24,291 | 1.6× | $27,539 |
| Kidney/UTI w MCC | MS-DRG | 689 | 3 | — | — | $21,044 | $29,011 | 2.5× | $49,624 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 3 | — | — | $17,496 | $21,568 | 2.6× | $34,621 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 3 | — | — | $21,044 | $47,820 | 2.6× | $83,077 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 3 | — | — | $21,044 | $27,211 | 2.6× | $43,764 |
| Initial hospital care, low complexity | CPT | 99221 | 18 | $620 | $620 | $35.25 | $370.8 | 4.0× | $606.38 |
| Initial hospital care, moderate complexity | CPT | 99222 | 18 | $830 | $830 | $48.55 | $542.1 | 3.2× | $814.31 |
| Initial hospital care, high complexity | CPT | 99223 | 18 | $1,210 | $1,210 | $71.33 | $754.44 | 3.4× | $1,189.6 |
| Hospital discharge, <30 min | CPT | 99238 | 18 | $425 | $425 | $27.01 | $283.82 | 3.3× | $430.74 |
| Hospital discharge, >30 min | CPT | 99239 | 18 | $625 | $625 | $38.71 | $414.8 | 3.4× | $629.53 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 18 | $261 | $261 | $29.59 | $71.69 | 2.2× | $234.9 |
| Electrolyte panel | CPT | 80051 | 18 | $237 | $237 | $24.86 | $70.1 | 2.9× | $213.3 |
| Comprehensive metabolic panel | CPT | 80053 | 18 | $381 | $381 | $31.86 | $76.4 | 1.7× | $342.9 |
| Lipid panel | CPT | 80061 | 18 | $378 | $378 | $31.86 | $78.86 | 2.1× | $340.2 |
| Hepatic function panel | CPT | 80076 | 18 | $261 | $261 | $28.41 | $70.36 | 2.6× | $234.9 |
| Urinalysis automated | CPT | 81003 | 18 | $69 | $69 | $8.29 | $29.25 | 2.1× | $62.1 |
| Glucose quantitative | CPT | 82947 | 18 | $81 | $81 | $8.24 | $21.74 | 1.2× | $72.9 |
| Hemoglobin A1c | CPT | 83036 | 18 | $233 | $233 | $8.24 | $38.84 | 1.4× | $209.7 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 18 | $404 | $404 | $31.13 | $84.06 | 1.8× | $363.6 |
| Complete blood count with automated differential | CPT | 85025 | 18 | $158 | $158 | $13.65 | $43.9 | 1.7× | $142.2 |
| Complete blood count without differential | CPT | 85027 | 18 | $111 | $111 | $13.65 | $35.99 | 1.7× | $99.9 |
| Urine culture identification | CPT | 87088 | 18 | $213 | $213 | $11.93 | $33.87 | 1.5× | $191.7 |
| Tissue exam by pathologist level IV | CPT | 88305 | 18 | $841 | $841 | $31.65 | $162 | 1.6× | $756.9 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 2 | — | — | $6,373 | $8,530 | 45.4× | $9,831 |
| Vaginal delivery only | CPT | 59409 | 4 | — | — | $5,509.88 | $8,337 | 3.8× | $10,588 |
| Vaginal delivery with postpartum | CPT | 59410 | 1 | — | — | $5,509.88 | $5,815.69 | 5.5× | $6,121.5 |
| C-section delivery only | CPT | 59514 | 1 | — | — | $9,290 | $9,290 | 9.7× | $9,290 |
| C-section with postpartum | CPT | 59515 | 1 | — | — | $8,276.48 | $8,735.99 | 6.9× | $9,195.5 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 18 | $465 | $465 | $50.87 | $238.96 | 2.8× | $457.26 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 18 | $655 | $655 | $89.71 | $370.5 | 3.0× | $645.11 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 18 | $1,000 | $1,000 | $145.8 | $596.46 | 3.4× | $981.57 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 18 | $1,260 | $1,260 | $195.47 | $796.99 | 3.6× | $1,237.95 |
| Office visit, established patient, 5 min | CPT | 99211 | 10 | $1,946 | $1,946 | $778.4 | $1,373.88 | 21.3× | $1,751.4 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 18 | $4,909 | $4,909 | $38.11 | $802.2 | 10.0× | $4,418.1 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 18 | $460 | $460 | $71.64 | $288.19 | 2.5× | $448.47 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 18 | $660 | $660 | $105.48 | $419.9 | 2.8× | $647.31 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 18 | $3,729 | $3,729 | $155.98 | $756.06 | 4.0× | $3,356.1 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 18 | $2,527 | $2,527 | $80.8 | $1,009.36 | 1.1× | $10,588 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 18 | $3,152 | $3,152 | $101 | $1,010.1 | 1.0× | $10,588 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 18 | $4,569 | $4,569 | $29.69 | $936.22 | 1.1× | $9,831 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 18 | $3,468 | $3,468 | $35.69 | $1,000.56 | 1.1× | $9,831 |
| Colonoscopy diagnostic | CPT | 45378 | 18 | $4,926 | $4,926 | $83.13 | $986.47 | 1.1× | $10,588 |
| Colonoscopy with biopsy | CPT | 45380 | 18 | $3,472 | $3,472 | $161.6 | $1,274.26 | 1.0× | $10,588 |
| Colonoscopy with polyp removal | CPT | 45385 | 18 | $3,647 | $3,647 | $146.87 | $1,445.53 | 1.2× | $10,588 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 12 | $11,450 | $11,450 | $730.45 | $6,757.98 | 1.6× | $21,179 |
| Hip hemiarthroplasty | CPT | 27125 | 18 | $9,805 | $9,805 | $540.25 | $5,114.19 | 4.1× | $18,153 |
| Total hip replacement | CPT | 27130 | 18 | $12,950 | $12,950 | $697.27 | $5,711.91 | 1.3× | $21,179 |
| Total knee replacement | CPT | 27447 | 18 | $11,645 | $11,645 | $749.09 | $5,878.93 | 1.4× | $21,179 |
| Knee revision arthroplasty single component | CPT | 27486 | 18 | $10,950 | $10,950 | $683.36 | $6,359.38 | 3.8× | $21,179 |
| Knee revision arthroplasty all components | CPT | 27487 | 18 | $16,950 | $16,950 | $861.73 | $7,953.51 | 4.0× | $21,179 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $6,373 | $7,576.75 | 23.2× | $9,831 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | — | — | $7,803 | $14,115 | 4.3× | $18,153 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | — | $6,838 | $7,969.94 | 3.9× | $10,588 |
| ACL reconstruction | CPT | 29888 | 5 | — | — | $6,504 | $14,115 | 4.2× | $18,153 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 3 | — | — | $21,044 | $113,157 | 2.6× | $196,583 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 3 | — | — | $21,044 | $59,014 | 2.5× | $102,523 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 3 | — | — | $21,044 | $41,430 | 2.5× | $71,974 |
| CABG single arterial graft | CPT | 33533 | 4 | — | — | $9,290 | $16,079 | 8.6× | $21,179 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | — | — | $9,290 | $16,079 | 7.5× | $21,179 |
| CABG 3 arterial grafts | CPT | 33535 | 4 | — | — | $9,290 | $16,079 | 7.1× | $21,179 |
| CABG 4+ arterial grafts | CPT | 33536 | 4 | — | — | $9,290 | $16,079 | 6.6× | $21,179 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 3 | — | — | $21,044 | $41,644 | 2.5× | $72,346 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 3 | — | — | $21,044 | $33,623 | 2.5× | $58,413 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 1 | — | — | $21,044 | $24,291 | 0.75× | $27,539 |
| Open appendectomy | CPT | 44950 | 12 | $4,585 | $4,585 | $291.96 | $3,052.45 | 2.7× | $10,588 |
| Laparoscopic appendectomy | CPT | 44970 | 18 | $4,280 | $4,280 | $267.83 | $2,793.74 | 1.8× | $21,142 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $21,044 | $24,291 | 0.49× | $27,539 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $21,044 | $24,291 | 0.72× | $27,539 |
| Major joint replacement w MCC | MS-DRG | 469 | 3 | — | — | $21,044 | $74,671 | 2.5× | $129,724 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 3 | — | — | $21,044 | $47,486 | 2.5× | $82,495 |
| Laparoscopic cholecystectomy | CPT | 47562 | 18 | $5,700 | $5,700 | $333.58 | $3,066.32 | 1.7× | $21,142 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 12 | $5,700 | $5,700 | $343.71 | $3,408.82 | 1.8× | $18,153 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 3 | — | — | $21,044 | $71,695 | 2.6× | $124,553 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 3 | — | — | $21,044 | $51,562 | 2.5× | $89,578 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 3 | — | — | $21,044 | $40,152 | 2.5× | $69,755 |
| Open umbilical hernia repair | CPT | 49560 | 3 | — | — | $6,838 | $7,743.5 | 4.1× | $10,256 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 3 | — | — | $6,838 | $7,743.5 | 5.9× | $10,256 |
| Lap inguinal hernia repair | CPT | 49650 | 18 | $3,175 | $3,175 | $193.57 | $2,018.8 | 1.8× | $21,142 |
| Lap incisional hernia repair | CPT | 49652 | 3 | — | — | $9,230.48 | $10,455 | 3.9× | $13,656 |
| Total abdominal hysterectomy | CPT | 58150 | 18 | $7,860 | $7,860 | $476.06 | $4,513 | 4.6× | $11,518 |
| Vaginal hysterectomy | CPT | 58260 | 12 | $5,890 | $5,890 | $399.81 | $3,849.1 | 2.1× | $13,656 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 12 | $6,295 | $6,295 | $428.77 | $4,071.36 | 2.8× | $18,153 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 12 | $7,875 | $7,875 | $471.98 | $4,538.46 | 2.0× | $18,153 |
| Lap salpingo-oophorectomy | CPT | 58661 | 18 | $9,457.5 | $9,457.5 | $313.65 | $2,957.52 | 1.5× | $21,142 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 1 | — | — | $21,044 | $24,291 | 0.89× | $27,539 |
| OR procedure for obesity w CC | MS-DRG | 620 | 1 | — | — | $21,044 | $24,291 | 1.5× | $27,539 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 1 | — | — | $21,044 | $24,291 | 1.6× | $27,539 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $5,685 | $8,306.74 | 3.7× | $13,656 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | — | $5,685 | $8,306.74 | 3.8× | $13,656 |
| Intravitreal injection | CPT | 67028 | 18 | $2,264 | $2,264 | $81.71 | $541.96 | 1.6× | $9,831 |
| Vitrectomy mechanical | CPT | 67042 | 5 | — | — | $7,844 | $9,363.5 | 3.7× | $13,656 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 3 | — | — | $21,044 | $30,544 | 2.5× | $53,062 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 3 | — | — | $21,044 | $50,445 | 2.6× | $87,636 |
| PCI single major coronary artery | CPT | 92920 | 3 | — | — | $11,538 | $13,574 | 2.4× | $18,153 |
| PCI with drug-eluting stent | CPT | 92928 | 3 | — | — | $11,767 | $15,485 | 1.5× | $18,153 |
| PCI bypass graft | CPT | 92937 | 3 | — | — | $11,767 | $15,485 | 1.4× | $18,153 |
| Left heart catheterization | CPT | 93452 | 4 | — | — | $6,838 | $9,526 | 3.1× | $12,103 |
| Coronary angiography with cath | CPT | 93455 | 4 | — | — | $6,838 | $9,526 | 3.0× | $12,103 |
| Coronary angiography with bypass cath | CPT | 93458 | 4 | — | — | $6,838 | $9,526 | 3.1× | $12,103 |