| behavioral |
| Psychoses | MS-DRG | 885 | 7 | — | — | $2,778 | $14,619 | 1.1× | $19,452 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $2,778 | $22,219 | 1.1× | $27,740 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $2,778 | $11,275 | 1.1× | $14,076 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $2,778 | $7,626.44 | 1.0× | $9,521 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $2,778 | $18,678 | 1.2× | $23,493 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $2,778 | $12,224 | 1.1× | $15,497 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $2,778 | $9,417.96 | 1.1× | $11,856 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $2,778 | $7,119.49 | 1.0× | $8,931.36 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $2,778 | $9,120.66 | 1.1× | $11,387 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $2,778 | $6,939.78 | 1.0× | $8,664 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $14,124 | $18,823 | 1.2× | $26,466 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $7,932.09 | $10,571 | 1.1× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $6,239.49 | $8,315.24 | 1.1× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $2,778 | $14,242 | 1.1× | $18,006 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $2,778 | $9,501.15 | 1.1× | $11,885 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $2,778 | $6,228.72 | 1.0× | $7,776 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $2,778 | $13,336 | 1.1× | $16,649 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $2,778 | $8,260.96 | 1.1× | $10,313 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $2,778 | $6,134.43 | 0.99× | $7,721.1 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $2,778 | $10,913 | 1.1× | $13,625 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $2,778 | $7,024.09 | 1.0× | $8,786.46 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $2,778 | $5,783.74 | 0.72× | $10,880 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 8 | — | — | $2,778 | $17,792 | 1.2× | $22,593 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | — | — | $2,778 | $13,028 | 1.1× | $16,264 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | — | — | $2,778 | $8,950.94 | 1.1× | $11,175 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | — | — | $2,778 | $21,993 | 1.2× | $27,457 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | — | — | $2,778 | $11,425 | 1.1× | $14,263 |
| 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 | 5 | — | — | $1,163.16 | $1,414.66 | 1.5× | $3,500 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | — | — | $1,163.16 | $1,414.66 | 1.5× | $4,025 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 4 | — | — | $215.25 | $255.25 | 0.30× | $3,500 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 4 | — | — | $1,130.54 | $1,340.61 | 1.5× | $3,500 |
| Colonoscopy diagnostic | CPT | 45378 | 5 | — | — | $1,130.54 | $1,374.98 | 1.6× | $4,025 |
| Colonoscopy with biopsy | CPT | 45380 | 5 | — | — | $1,486.25 | $1,807.6 | 1.5× | $4,025 |
| Colonoscopy with polyp removal | CPT | 45385 | 5 | — | — | $1,486.25 | $1,807.6 | 1.5× | $4,025 |
| surgery |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | — | — | $4,051.43 | $4,681.04 | 2.3× | $11,621 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $6,182 | $50,105 | 1.2× | $63,368 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $6,182 | $26,314 | 1.1× | $32,851 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $6,182 | $18,548 | 1.1× | $23,156 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $6,182 | $18,134 | 1.1× | $22,886 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $6,182 | $14,567 | 1.1× | $18,187 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $6,182 | $35,506 | 1.1× | $48,707 |
| Open appendectomy | CPT | 44950 | 4 | — | — | $4,376 | $4,974.95 | 4.4× | $10,200 |
| Laparoscopic appendectomy | CPT | 44970 | 4 | — | — | $5,132 | $7,153.89 | 4.6× | $8,700.68 |
| 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 | 9 | — | — | $28,127 | $36,937 | 1.2× | $61,515 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $16,225 | $24,184 | 1.3× | $36,028 |
| Laparoscopic cholecystectomy | CPT | 47562 | 4 | — | — | $6,759 | $7,733.94 | 4.4× | $12,483 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 4 | — | — | $6,759 | $7,733.94 | 4.1× | $12,483 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $9,144 | $32,712 | 1.2× | $40,839 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $9,144 | $23,017 | 1.1× | $28,735 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $9,144 | $17,620 | 1.1× | $21,998 |
| Lap inguinal hernia repair | CPT | 49650 | 5 | — | — | $5,132 | $7,153.89 | 6.4× | $11,526 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $1,552.14 | $1,840.54 | 1.9× | $15,605 |
| Vaginal hysterectomy | CPT | 58260 | 4 | — | — | $4,376 | $6,834.46 | 3.8× | $12,483 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 4 | — | — | $5,645 | $12,451 | 5.6× | $15,605 |
| Lap salpingo-oophorectomy | CPT | 58661 | 5 | — | — | $5,645 | $7,153.89 | 3.5× | $12,483 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $6,182 | $28,714 | 1.1× | $37,626 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $6,182 | $17,995 | 1.1× | $28,880 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $6,182 | $16,831 | 1.1× | $28,880 |
| Complex cataract surgery | CPT | 66982 | 5 | — | — | $2,992.35 | $3,457.38 | 1.6× | $12,483 |
| Cataract surgery with lens implant | CPT | 66984 | 5 | — | — | $2,992.35 | $3,457.38 | 1.6× | $12,483 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | — | — | $6,182 | $12,890 | 1.0× | $16,542 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | — | — | $6,182 | $20,881 | 1.1× | $26,965 |