| behavioral |
| Psychoses | MS-DRG | 885 | 17 | — | — | $1,458 | $10,049 | 0.78× | $30,024 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 17 | — | — | $2,778 | $17,033 | 0.84× | $42,370 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 17 | — | — | $2,778 | $8,707.63 | 0.81× | $21,660 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 17 | — | — | $2,778 | $5,893.85 | 0.77× | $14,661 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 17 | — | — | $2,778 | $13,842 | 0.90× | $34,431 |
| COPD w MCC | MS-DRG | 190 | 17 | — | — | $2,778 | $9,616.16 | 0.86× | $23,920 |
| COPD w CC | MS-DRG | 191 | 17 | — | — | $2,778 | $7,356.41 | 0.83× | $18,299 |
| COPD w/o CC/MCC | MS-DRG | 192 | 17 | — | — | $2,778 | $5,541.92 | 0.79× | $13,785 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 17 | — | — | $2,778 | $7,021.59 | 0.83× | $17,466 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 17 | — | — | $2,778 | $5,332.13 | 0.80× | $13,264 |
| AMI discharged alive w MCC | MS-DRG | 280 | 18 | — | — | $10,587 | $15,256 | 0.97× | $34,962 |
| AMI discharged alive w CC | MS-DRG | 281 | 18 | — | — | $5,945.64 | $8,779.41 | 0.91× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 18 | — | — | $4,676.92 | $6,905.25 | 0.89× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 17 | — | — | $2,778 | $11,173 | 0.87× | $27,792 |
| Heart failure & shock w CC | MS-DRG | 292 | 17 | — | — | $2,778 | $7,374.39 | 0.82× | $18,344 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 17 | — | — | $2,778 | $4,698.48 | 0.76× | $11,687 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 17 | — | — | $2,778 | $10,326 | 0.85× | $25,686 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 17 | — | — | $2,778 | $6,330.57 | 0.81× | $15,747 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 17 | — | — | $2,778 | $4,790.95 | 0.77× | $11,917 |
| GI hemorrhage w CC | MS-DRG | 378 | 17 | — | — | $2,778 | $8,442.18 | 0.84× | $21,000 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 17 | — | — | $2,778 | $5,452 | 0.80× | $13,562 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 17 | — | — | $2,778 | $6,681.65 | 0.83× | $16,620 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 17 | — | — | $2,778 | $13,058 | 0.86× | $32,480 |
| Kidney/UTI w MCC | MS-DRG | 689 | 17 | — | — | $2,778 | $10,021 | 0.86× | $24,927 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 17 | — | — | $2,778 | $6,872.6 | 0.83× | $17,095 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 17 | — | — | $2,778 | $16,801 | 0.90× | $41,793 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 17 | — | — | $2,778 | $8,828.36 | 0.85× | $21,960 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $334.95 | $1,020.86 | 1.1× | $4,042 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $334.95 | $1,020.86 | 1.1× | $5,016 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 14 | — | — | $130.67 | $880.45 | 1.0× | $4,042 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 14 | — | — | $328.5 | $1,006.22 | 1.1× | $4,042 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $328.5 | $1,029.28 | 1.2× | $5,016 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | — | $429.26 | $1,328.98 | 1.1× | $5,016 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $429.26 | $1,328.98 | 1.1× | $5,016 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 14 | — | — | $2,417.79 | $17,098 | 4.1× | $35,393 |
| Total hip replacement | CPT | 27130 | 14 | — | — | $6,546 | $13,886 | 3.2× | $40,224 |
| Total knee replacement | CPT | 27447 | 14 | — | — | $6,546 | $13,886 | 3.3× | $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 decompression | CPT | 29826 | 4 | — | — | $1,772 | $5,668 | 17.3× | $11,704 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | — | — | $2,398.52 | $7,712.21 | 2.3× | $20,219 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | — | — | $1,088.27 | $3,645.27 | 1.8× | $13,821 |
| ACL reconstruction | CPT | 29888 | 15 | — | — | $3,300.05 | $7,219.94 | 2.2× | $20,219 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 17 | — | — | $6,182 | $39,320 | 0.91× | $97,807 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 17 | — | — | $6,182 | $20,240 | 0.87× | $50,347 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 17 | — | — | $6,182 | $14,137 | 0.86× | $35,166 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 17 | — | — | $6,182 | $14,201 | 0.86× | $35,324 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 17 | — | — | $6,182 | $11,282 | 0.83× | $28,065 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 17 | — | — | $6,182 | $30,223 | 0.93× | $75,178 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | — | — | $5,029.05 | $6,352.49 | 4.1× | $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 | 18 | — | — | $21,083 | $32,019 | 1.1× | $69,623 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 18 | — | — | $12,162 | $18,094 | 0.96× | $40,161 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | — | — | $1,888.85 | $6,352.49 | 3.6× | $16,338 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $1,888.85 | $6,352.49 | 3.4× | $16,338 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 18 | — | — | $9,144 | $25,060 | 0.90× | $62,643 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 18 | — | — | $9,144 | $17,680 | 0.87× | $44,195 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 18 | — | — | $9,144 | $13,517 | 0.85× | $33,790 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | — | — | $1,888.85 | $6,293.75 | 5.6× | $16,338 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $1,677.98 | $5,369 | 5.5× | $16,163 |
| Vaginal hysterectomy | CPT | 58260 | 14 | — | — | $1,526.99 | $5,369 | 3.0× | $15,605 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 15 | — | — | $1,888.85 | $6,473.75 | 4.4× | $16,721 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 14 | — | — | $3,110.01 | $9,916.29 | 4.5× | $28,436 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | — | — | $1,888.85 | $6,498.07 | 3.2× | $16,338 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 18 | — | — | $6,182 | $23,961 | 0.88× | $58,074 |
| OR procedure for obesity w CC | MS-DRG | 620 | 18 | — | — | $6,182 | $14,034 | 0.87× | $34,016 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 18 | — | — | $6,182 | $12,846 | 0.85× | $31,136 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 17 | — | — | $6,182 | $10,264 | 0.84× | $25,532 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 17 | — | — | $6,182 | $16,732 | 0.87× | $41,620 |