| behavioral |
| Psychoses | MS-DRG | 885 | 10 | — | — | $15,756 | $16,465 | 1.3× | $43,032 |
| imaging |
| EKG interpretation only | CPT | 93010 | 1 | — | — | $5.65 | $11.3 | 0.62× | $16.95 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 10 | — | — | $22,150 | $23,146 | 1.1× | $60,733 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 10 | — | — | $11,425 | $11,939 | 1.1× | $31,129 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 10 | — | — | $7,800.09 | $8,151.09 | 1.1× | $21,058 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $18,039 | $18,850 | 1.2× | $49,441 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $12,595 | $13,162 | 1.2× | $34,181 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $9,684.12 | $10,120 | 1.1× | $26,246 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $7,346.74 | $7,677.35 | 1.1× | $19,837 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $9,252.8 | $9,669.18 | 1.1× | $25,026 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $7,076.5 | $7,394.94 | 1.1× | $18,922 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $18,313 | $19,137 | 1.2× | $50,051 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $10,376 | $10,843 | 1.1× | $28,077 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $8,206.01 | $8,575.28 | 1.1× | $22,279 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $14,600 | $15,257 | 1.2× | $39,675 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $9,707.28 | $10,144 | 1.1× | $26,246 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $6,260.24 | $6,541.95 | 1.1× | $16,785 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $13,509 | $14,117 | 1.2× | $36,928 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $8,362.65 | $8,738.97 | 1.1× | $22,584 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $6,379.36 | $6,666.43 | 1.1× | $17,091 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $11,083 | $11,581 | 1.2× | $30,214 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $7,230.91 | $7,556.31 | 1.1× | $19,532 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $8,814.91 | $9,211.59 | 1.1× | $23,805 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 10 | — | — | $17,028 | $17,795 | 1.2× | $46,389 |
| Kidney/UTI w MCC | MS-DRG | 689 | 10 | — | — | $13,117 | $13,707 | 1.2× | $35,707 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 10 | — | — | $9,060.89 | $9,468.63 | 1.1× | $24,415 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 10 | — | — | $21,851 | $22,834 | 1.2× | $59,817 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 10 | — | — | $11,580 | $12,101 | 1.2× | $31,435 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 10 | — | — | $561.95 | $1,198.23 | 1.3× | $3,254.41 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 10 | — | — | $561.95 | $1,198.23 | 1.2× | $3,254.41 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | — | — | $551.13 | $1,165.19 | 1.4× | $3,164.68 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 10 | — | — | $551.13 | $1,165.19 | 1.3× | $3,164.68 |
| Colonoscopy diagnostic | CPT | 45378 | 10 | — | — | $551.13 | $1,165.19 | 1.3× | $3,164.68 |
| Colonoscopy with biopsy | CPT | 45380 | 10 | — | — | $720.16 | $1,506.9 | 1.2× | $4,092.77 |
| Colonoscopy with polyp removal | CPT | 45385 | 10 | — | — | $720.16 | $1,506.9 | 1.3× | $4,092.77 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 10 | — | — | $8,563.44 | $23,503 | 5.7× | $63,835 |
| Total hip replacement | CPT | 27130 | 10 | — | — | $8,563.44 | $16,444 | 3.8× | $44,663 |
| Total knee replacement | CPT | 27447 | 10 | — | — | $8,563.44 | $16,444 | 3.9× | $44,663 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 1 | — | — | $120.01 | $240.02 | 0.73× | $360.03 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 10 | — | — | $4,349.99 | $9,129.89 | 2.8× | $24,797 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | — | — | $1,966.75 | $4,146.7 | 2.0× | $11,263 |
| ACL reconstruction | CPT | 29888 | 10 | — | — | $4,349.99 | $9,129.89 | 2.7× | $24,797 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $50,859 | $53,148 | 1.2× | $140,082 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $26,281 | $27,463 | 1.2× | $72,025 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $18,419 | $19,248 | 1.2× | $50,356 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $18,501 | $19,333 | 1.2× | $50,662 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $14,742 | $15,405 | 1.1× | $40,285 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $39,140 | $40,901 | 1.3× | $107,732 |
| Open appendectomy | CPT | 44950 | 10 | — | — | $2,209.56 | $7,679.22 | 6.8× | $21,659 |
| Laparoscopic appendectomy | CPT | 44970 | 10 | — | — | $3,514.03 | $7,456.48 | 4.8× | $20,252 |
| Major joint replacement w MCC | MS-DRG | 469 | 10 | — | — | $36,263 | $37,895 | 1.3× | $99,797 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 10 | — | — | $21,006 | $21,951 | 1.2× | $57,681 |
| Laparoscopic cholecystectomy | CPT | 47562 | 10 | — | — | $3,514.03 | $7,456.48 | 4.2× | $20,252 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 10 | — | — | $3,514.03 | $7,456.48 | 4.0× | $20,252 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $32,649 | $34,118 | 1.2× | $89,726 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $23,095 | $24,134 | 1.2× | $63,174 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $17,707 | $18,503 | 1.2× | $48,525 |
| Lap inguinal hernia repair | CPT | 49650 | 10 | — | — | $3,514.03 | $7,456.48 | 6.6× | $20,252 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 10 | — | — | $6,185.59 | $13,306 | 6.0× | $36,139 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | — | — | $3,514.03 | $7,456.48 | 3.7× | $20,252 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 10 | — | — | $23,100 | $31,040 | 1.1× | $66,372 |
| OR procedure for obesity w CC | MS-DRG | 620 | 10 | — | — | $17,824 | $18,447 | 1.1× | $42,691 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 10 | — | — | $16,332 | $17,067 | 1.1× | $42,691 |
| Complex cataract surgery | CPT | 66982 | 10 | — | — | $1,442.18 | $2,914.83 | 1.3× | $7,916.74 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $1,442.18 | $2,914.83 | 1.3× | $7,916.74 |
| Intravitreal injection | CPT | 67028 | 10 | — | — | $221.44 | $423.91 | 1.2× | $1,151.35 |
| Vitrectomy mechanical | CPT | 67042 | 10 | — | — | $2,719.72 | $5,141.33 | 2.0× | $13,964 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 10 | — | — | $13,430 | $14,034 | 1.1× | $36,623 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 10 | — | — | $21,761 | $22,741 | 1.2× | $59,512 |
| PCI single major coronary artery | CPT | 92920 | 10 | — | — | $3,442.09 | $7,286.71 | 1.3× | $19,791 |
| PCI with drug-eluting stent | CPT | 92928 | 10 | — | — | $6,975.77 | $14,494 | 1.4× | $39,365 |
| PCI bypass graft | CPT | 92937 | 10 | — | — | $6,975.77 | $14,494 | 1.3× | $39,365 |
| Coronary angiography with cath | CPT | 93455 | 10 | — | — | $2,013.83 | $4,110.66 | 1.3× | $11,165 |
| Coronary angiography with bypass cath | CPT | 93458 | 10 | — | — | $2,013.83 | $4,110.66 | 1.3× | $11,165 |