| behavioral |
| Psychoses | MS-DRG | 885 | 15 | — | — | $2,778 | $15,034 | 1.2× | $24,001 |
| imaging |
| EKG tracing only | CPT | 93005 | 12 | — | — | $53.16 | $69.5 | 0.59× | $892 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 15 | — | — | $2,778 | $21,422 | 1.1× | $33,870 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 15 | — | — | $2,778 | $11,275 | 1.1× | $17,601 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 15 | — | — | $2,778 | $7,626.44 | 1.0× | $13,057 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 15 | — | — | $2,778 | $17,773 | 1.2× | $27,524 |
| COPD w MCC | MS-DRG | 190 | 15 | — | — | $2,778 | $12,224 | 1.1× | $19,121 |
| COPD w CC | MS-DRG | 191 | 15 | — | — | $2,778 | $9,417.96 | 1.1× | $15,419 |
| COPD w/o CC/MCC | MS-DRG | 192 | 15 | — | — | $2,778 | $7,284.78 | 1.0× | $12,488 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 15 | — | — | $2,778 | $9,120.66 | 1.1× | $14,878 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 15 | — | — | $2,778 | $7,087.15 | 1.1× | $12,149 |
| AMI discharged alive w MCC | MS-DRG | 280 | 16 | — | — | $13,847 | $17,823 | 1.1× | $27,948 |
| AMI discharged alive w CC | MS-DRG | 281 | 16 | — | — | $7,932.09 | $10,488 | 1.1× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 16 | — | — | $6,239.49 | $8,491.04 | 1.1× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 15 | — | — | $2,778 | $14,242 | 1.1× | $22,217 |
| Heart failure & shock w CC | MS-DRG | 292 | 15 | — | — | $2,778 | $9,501.15 | 1.1× | $15,448 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 15 | — | — | $2,778 | $6,490.21 | 1.0× | $11,126 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 15 | — | — | $2,778 | $13,336 | 1.1× | $20,533 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 15 | — | — | $2,778 | $8,260.96 | 1.1× | $13,762 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 15 | — | — | $2,778 | $6,577.32 | 1.1× | $11,275 |
| GI hemorrhage w CC | MS-DRG | 378 | 15 | — | — | $2,778 | $10,913 | 1.1× | $17,172 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 15 | — | — | $2,778 | $7,200.09 | 1.1× | $12,343 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 15 | — | — | $2,778 | $8,358.47 | 1.0× | $14,329 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 15 | — | — | $2,778 | $16,939 | 1.1× | $25,964 |
| Kidney/UTI w MCC | MS-DRG | 689 | 15 | — | — | $2,778 | $13,028 | 1.1× | $19,927 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 15 | — | — | $2,778 | $8,950.94 | 1.1× | $14,637 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 15 | — | — | $2,778 | $21,163 | 1.1× | $33,409 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 15 | — | — | $2,778 | $11,425 | 1.1× | $17,796 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 11 | — | — | $8.04 | $10.33 | 0.32× | $50.08 |
| Tissue exam by pathologist level IV | CPT | 88305 | 11 | — | — | $47.1 | $60.54 | 0.59× | $292.86 |
| maternity |
| Routine obstetric care with C-section | CPT | 59510 | 2 | — | — | $3,573.64 | $3,597.78 | 1.4× | $7,006 |
| office |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 1 | — | — | $227.23 | $228.43 | 1.5× | $276.83 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $334.95 | $1,163.16 | 1.3× | $3,704 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $334.95 | $1,163.16 | 1.2× | $4,958 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 14 | — | — | $130.67 | $877.98 | 1.0× | $3,500 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 14 | — | — | $328.5 | $1,130.54 | 1.3× | $3,500 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $328.5 | $1,130.54 | 1.3× | $4,958 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | — | $429.26 | $1,486.25 | 1.2× | $4,958 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $429.26 | $1,486.25 | 1.2× | $4,958 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 13 | — | — | $2,236.46 | $16,197 | 3.9× | $28,132 |
| Hip hemiarthroplasty | CPT | 27125 | 5 | — | — | $1,744.68 | $5,388 | 4.3× | $13,933 |
| Total hip replacement | CPT | 27130 | 13 | — | — | $5,388 | $13,847 | 3.2× | $21,421 |
| Total knee replacement | CPT | 27447 | 13 | — | — | $5,388 | $13,847 | 3.3× | $21,421 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | — | $2,162.32 | $5,388 | 3.2× | $13,933 |
| Knee revision arthroplasty all components | CPT | 27487 | 5 | — | — | $2,705.82 | $5,388 | 2.7× | $13,933 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $959 | $4,856.5 | 14.9× | $11,621 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | — | — | $2,398.52 | $8,129.11 | 2.5× | $12,483 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | — | — | $1,088.27 | $4,051.43 | 2.0× | $11,621 |
| ACL reconstruction | CPT | 29888 | 15 | — | — | $3,300.05 | $8,129.11 | 2.4× | $11,621 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 15 | — | — | $6,182 | $46,257 | 1.1× | $78,186 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 15 | — | — | $6,182 | $24,996 | 1.1× | $40,247 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 15 | — | — | $6,182 | $18,153 | 1.1× | $28,112 |
| CABG single arterial graft | CPT | 33533 | 5 | — | — | $2,885.04 | $3,223 | 1.7× | $12,595 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 15 | — | — | $6,182 | $18,134 | 1.1× | $28,238 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 15 | — | — | $6,182 | $14,506 | 1.1× | $22,435 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 15 | — | — | $6,182 | $35,506 | 1.1× | $60,097 |
| Open appendectomy | CPT | 44950 | 13 | — | — | $4,601.82 | $6,921.66 | 6.1× | $14,887 |
| Laparoscopic appendectomy | CPT | 44970 | 13 | — | — | $5,014.95 | $6,625.02 | 4.2× | $14,887 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 5 | — | — | $35,308 | $73,572 | 1.5× | $91,851 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 5 | — | — | $35,308 | $40,577 | 1.2× | $50,658 |
| Major joint replacement w MCC | MS-DRG | 469 | 16 | — | — | $25,724 | $35,348 | 1.2× | $61,515 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 16 | — | — | $15,629 | $20,874 | 1.1× | $36,028 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | — | — | $1,888.85 | $7,153.89 | 4.0× | $14,887 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $1,888.85 | $7,153.89 | 3.8× | $14,887 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 16 | — | — | $9,144 | $30,504 | 1.1× | $50,076 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 16 | — | — | $9,144 | $21,892 | 1.1× | $35,329 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 16 | — | — | $9,144 | $17,213 | 1.1× | $27,012 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | — | — | $1,888.85 | $6,625.02 | 5.9× | $11,526 |
| Total abdominal hysterectomy | CPT | 58150 | 5 | — | — | $1,552.14 | $5,180 | 5.3× | $15,605 |
| Vaginal hysterectomy | CPT | 58260 | 14 | — | — | $1,526.99 | $5,681.4 | 3.1× | $14,887 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 15 | — | — | $1,888.85 | $7,153.89 | 4.8× | $13,933 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 14 | — | — | $3,110.01 | $10,359 | 4.7× | $15,605 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | — | — | $1,888.85 | $6,641 | 3.3× | $12,483 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 16 | — | — | $6,182 | $28,457 | 1.0× | $46,424 |
| OR procedure for obesity w CC | MS-DRG | 620 | 16 | — | — | $6,182 | $17,680 | 1.1× | $28,880 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 16 | — | — | $6,182 | $16,390 | 1.1× | $28,880 |
| Complex cataract surgery | CPT | 66982 | 15 | — | — | $849.94 | $2,992.35 | 1.3× | $12,483 |
| Cataract surgery with lens implant | CPT | 66984 | 15 | — | — | $849.94 | $2,992.35 | 1.4× | $12,483 |
| Vitrectomy mechanical | CPT | 67042 | 14 | — | — | $1,533.49 | $5,606.12 | 2.2× | $14,887 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 15 | — | — | $6,182 | $12,890 | 1.0× | $20,410 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 15 | — | — | $6,182 | $20,881 | 1.1× | $33,271 |