| behavioral |
| Psychoses | MS-DRG | 885 | 18 | — | — | $1,458 | $12,440 | 0.97× | $30,024 |
| imaging |
| EKG tracing only | CPT | 93005 | 14 | — | — | $53.31 | $58.93 | 0.50× | $892 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 18 | — | — | $2,778 | $18,692 | 0.93× | $42,370 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 18 | — | — | $2,778 | $9,773.7 | 0.91× | $21,660 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 18 | — | — | $2,778 | $6,681.63 | 0.88× | $14,661 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 18 | — | — | $2,778 | $15,433 | 1.00× | $34,431 |
| COPD w MCC | MS-DRG | 190 | 18 | — | — | $2,778 | $10,597 | 0.94× | $23,920 |
| COPD w CC | MS-DRG | 191 | 18 | — | — | $2,778 | $8,163.98 | 0.93× | $18,299 |
| COPD w/o CC/MCC | MS-DRG | 192 | 18 | — | — | $2,778 | $6,353.55 | 0.91× | $13,785 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 18 | — | — | $2,778 | $7,906.28 | 0.93× | $17,466 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 18 | — | — | $2,778 | $6,157.99 | 0.92× | $13,264 |
| AMI discharged alive w MCC | MS-DRG | 280 | 19 | — | — | $12,261 | $16,240 | 1.0× | $34,962 |
| AMI discharged alive w CC | MS-DRG | 281 | 19 | — | — | $6,885.67 | $9,326.48 | 0.96× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 19 | — | — | $5,416.36 | $7,403.97 | 0.95× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 18 | — | — | $2,778 | $12,346 | 0.97× | $27,792 |
| Heart failure & shock w CC | MS-DRG | 292 | 18 | — | — | $2,778 | $8,236.1 | 0.92× | $18,344 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 18 | — | — | $2,778 | $5,567.25 | 0.90× | $11,983 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 18 | — | — | $2,778 | $11,560 | 0.96× | $25,686 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 18 | — | — | $2,778 | $7,161.04 | 0.92× | $15,747 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 18 | — | — | $2,778 | $5,653.44 | 0.91× | $12,168 |
| GI hemorrhage w CC | MS-DRG | 378 | 18 | — | — | $2,778 | $9,460.22 | 0.94× | $21,000 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 18 | — | — | $2,778 | $6,269.73 | 0.92× | $13,562 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 18 | — | — | $2,778 | $7,554.33 | 0.94× | $16,620 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 18 | — | — | $2,778 | $14,632 | 0.96× | $32,480 |
| Kidney/UTI w MCC | MS-DRG | 689 | 18 | — | — | $2,778 | $11,293 | 0.97× | $24,927 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 18 | — | — | $2,778 | $7,759.15 | 0.93× | $17,095 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 18 | — | — | $2,778 | $18,455 | 0.99× | $41,793 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 18 | — | — | $2,778 | $9,903.52 | 0.95× | $21,960 |
| lab |
| Comprehensive metabolic panel | CPT | 80053 | 14 | — | — | $10.03 | $11.09 | 0.25× | $51.64 |
| Complete blood count with automated differential | CPT | 85025 | 14 | — | — | $7.38 | $8.16 | 0.31× | $38 |
| Tissue exam by pathologist level IV | CPT | 88305 | 14 | — | — | $47.23 | $52.21 | 0.51× | $241.91 |
| maternity |
| C-section delivery only | CPT | 59514 | 2 | — | — | $1,518.26 | $3,046 | 3.2× | $7,702 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 17 | — | — | $334.95 | $956.41 | 1.0× | $4,042 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 17 | — | — | $334.95 | $956.41 | 0.99× | $5,016 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 16 | — | — | $130.67 | $879.44 | 1.0× | $4,042 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 16 | — | — | $328.5 | $922.38 | 1.0× | $4,042 |
| Colonoscopy diagnostic | CPT | 45378 | 17 | — | — | $328.5 | $964.3 | 1.1× | $5,016 |
| Colonoscopy with biopsy | CPT | 45380 | 17 | — | — | $429.26 | $1,245.07 | 1.0× | $5,016 |
| Colonoscopy with polyp removal | CPT | 45385 | 17 | — | — | $429.26 | $1,245.07 | 1.0× | $5,016 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 15 | — | — | $2,417.79 | $17,098 | 4.1× | $35,393 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | — | — | $1,886.14 | $6,546 | 5.2× | $16,721 |
| Total hip replacement | CPT | 27130 | 15 | — | — | $6,546 | $13,282 | 3.1× | $40,224 |
| Total knee replacement | CPT | 27447 | 15 | — | — | $6,546 | $13,282 | 3.2× | $40,224 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | — | — | $2,337.65 | $6,546 | 3.9× | $16,721 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | — | — | $2,925.22 | $6,546 | 3.3× | $16,721 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 17 | — | — | $2,398.52 | $6,891.76 | 2.1× | $20,219 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 18 | — | — | $6,182 | $41,447 | 0.96× | $97,807 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 18 | — | — | $6,182 | $21,966 | 0.95× | $50,347 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 18 | — | — | $6,182 | $15,735 | 0.96× | $35,166 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 18 | — | — | $6,182 | $15,719 | 0.95× | $35,324 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 18 | — | — | $6,182 | $12,628 | 0.93× | $28,065 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 18 | — | — | $6,182 | $31,017 | 0.96× | $75,178 |
| Laparoscopic appendectomy | CPT | 44970 | 15 | — | — | $5,029.05 | $6,293.75 | 4.0× | $16,338 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 6 | — | — | $35,308 | $68,382 | 1.4× | $103,364 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 6 | — | — | $35,174 | $37,715 | 1.1× | $57,008 |
| Major joint replacement w MCC | MS-DRG | 469 | 19 | — | — | $24,417 | $32,313 | 1.1× | $69,623 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 19 | — | — | $14,084 | $18,984 | 1.0× | $40,161 |
| Laparoscopic cholecystectomy | CPT | 47562 | 16 | — | — | $1,888.85 | $5,823.12 | 3.3× | $16,338 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 16 | — | — | $1,888.85 | $5,823.12 | 3.1× | $16,338 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 19 | — | — | $9,144 | $26,430 | 0.94× | $62,643 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 19 | — | — | $9,144 | $18,838 | 0.93× | $44,195 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 19 | — | — | $9,144 | $14,556 | 0.91× | $33,790 |
| Lap inguinal hernia repair | CPT | 49650 | 17 | — | — | $1,888.85 | $6,087.8 | 5.4× | $16,338 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $1,677.98 | $5,369 | 5.5× | $16,163 |
| Vaginal hysterectomy | CPT | 58260 | 16 | — | — | $1,526.99 | $5,019.71 | 2.8× | $15,605 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 17 | — | — | $1,888.85 | $6,087.8 | 4.1× | $16,721 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 16 | — | — | $3,110.01 | $9,904.96 | 4.4× | $28,436 |
| Lap salpingo-oophorectomy | CPT | 58661 | 17 | — | — | $1,888.85 | $6,087.8 | 3.0× | $16,338 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 19 | — | — | $6,182 | $25,685 | 0.95× | $58,074 |
| OR procedure for obesity w CC | MS-DRG | 620 | 19 | — | — | $6,182 | $15,763 | 0.97× | $34,016 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 19 | — | — | $6,182 | $14,595 | 0.96× | $31,136 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 18 | — | — | $6,182 | $11,174 | 0.91× | $25,532 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 18 | — | — | $6,182 | $18,101 | 0.95× | $41,620 |