| behavioral |
| Psychoses | MS-DRG | 885 | 19 | — | — | $1,458 | $14,129 | 1.1× | $30,480 |
| imaging |
| EKG tracing only | CPT | 93005 | 15 | — | — | $53.14 | $58.74 | 0.50× | $892 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 19 | — | — | $2,778 | $19,084 | 0.95× | $42,370 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 19 | — | — | $2,778 | $10,946 | 1.0× | $23,559 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 19 | — | — | $2,778 | $8,255.23 | 1.1× | $17,768 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 19 | — | — | $2,778 | $16,000 | 1.0× | $34,431 |
| COPD w MCC | MS-DRG | 190 | 19 | — | — | $2,778 | $11,814 | 1.1× | $25,429 |
| COPD w CC | MS-DRG | 191 | 19 | — | — | $2,778 | $9,653.69 | 1.1× | $20,778 |
| COPD w/o CC/MCC | MS-DRG | 192 | 19 | — | — | $2,778 | $7,918.72 | 1.1× | $17,044 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 19 | — | — | $2,778 | $9,333.54 | 1.1× | $20,089 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 19 | — | — | $2,778 | $7,718.11 | 1.2× | $16,612 |
| AMI discharged alive w MCC | MS-DRG | 280 | 20 | — | — | $12,261 | $16,394 | 1.0× | $34,962 |
| AMI discharged alive w CC | MS-DRG | 281 | 20 | — | — | $6,885.67 | $10,167 | 1.1× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 20 | — | — | $5,416.36 | $8,556.52 | 1.1× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 19 | — | — | $2,778 | $13,303 | 1.0× | $28,633 |
| Heart failure & shock w CC | MS-DRG | 292 | 19 | — | — | $2,778 | $9,670.87 | 1.1× | $20,815 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 19 | — | — | $2,778 | $7,112.23 | 1.1× | $15,308 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 19 | — | — | $2,778 | $12,493 | 1.0× | $26,890 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 19 | — | — | $2,778 | $8,672.79 | 1.1× | $18,667 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 19 | — | — | $2,778 | $7,200.65 | 1.2× | $15,499 |
| GI hemorrhage w CC | MS-DRG | 378 | 19 | — | — | $2,778 | $10,692 | 1.1× | $23,013 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 19 | — | — | $2,778 | $7,832.75 | 1.1× | $16,859 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 19 | — | — | $2,778 | $9,008.51 | 1.1× | $19,390 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 19 | — | — | $2,778 | $15,168 | 1.00× | $32,512 |
| Kidney/UTI w MCC | MS-DRG | 689 | 19 | — | — | $2,778 | $12,202 | 1.1× | $26,263 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 19 | — | — | $2,778 | $9,191.09 | 1.1× | $19,783 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 19 | — | — | $2,778 | $18,875 | 1.0× | $41,793 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 19 | — | — | $2,778 | $11,061 | 1.1× | $23,808 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | — | — | $8.04 | $8.88 | 0.27× | $41.37 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | — | — | $47.08 | $52.04 | 0.51× | $241.91 |
| maternity |
| Vaginal delivery with postpartum | CPT | 59410 | 2 | — | — | $1,726.42 | $3,371.91 | 3.2× | $3,901 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 17 | — | — | $334.95 | $974.1 | 1.1× | $4,042 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 17 | — | — | $334.95 | $974.1 | 1.0× | $5,016 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 16 | — | — | $130.67 | $877.65 | 1.0× | $4,042 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 16 | — | — | $328.5 | $961.24 | 1.1× | $4,042 |
| Colonoscopy diagnostic | CPT | 45378 | 17 | — | — | $328.5 | $982.14 | 1.1× | $5,016 |
| Colonoscopy with biopsy | CPT | 45380 | 17 | — | — | $429.26 | $1,268.1 | 1.0× | $5,016 |
| Colonoscopy with polyp removal | CPT | 45385 | 17 | — | — | $429.26 | $1,268.1 | 1.1× | $5,016 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 16 | — | — | $2,417.79 | $17,044 | 4.1× | $35,280 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | — | — | $1,886.14 | $6,546 | 5.2× | $16,721 |
| Total hip replacement | CPT | 27130 | 17 | — | — | $6,546 | $13,842 | 3.2× | $40,224 |
| Total knee replacement | CPT | 27447 | 17 | — | — | $6,546 | $13,842 | 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 | 5 | — | — | $2,925.22 | $7,702 | 3.8× | $29,741 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | — | — | $1,772 | $5,668 | 17.3× | $11,704 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 18 | — | — | $2,398.52 | $7,687.7 | 2.3× | $20,219 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 18 | — | — | $1,088.27 | $3,633.7 | 1.8× | $13,821 |
| ACL reconstruction | CPT | 29888 | 18 | — | — | $3,300.05 | $7,197 | 2.2× | $20,219 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 19 | — | — | $6,182 | $41,894 | 0.97× | $97,807 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 19 | — | — | $6,182 | $22,392 | 0.96× | $50,347 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 19 | — | — | $6,182 | $16,138 | 0.98× | $35,166 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 19 | — | — | $6,182 | $16,198 | 0.98× | $35,324 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 19 | — | — | $6,182 | $13,408 | 0.99× | $28,859 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 19 | — | — | $6,182 | $31,518 | 0.97× | $75,178 |
| Open appendectomy | CPT | 44950 | 16 | — | — | $4,974.94 | $7,265.01 | 6.4× | $14,322 |
| Laparoscopic appendectomy | CPT | 44970 | 16 | — | — | $5,013.07 | $6,235 | 4.0× | $16,338 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 7 | — | — | $35,308 | $80,553 | 1.6× | $103,364 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 7 | — | — | $35,174 | $44,427 | 1.3× | $62,455 |
| Major joint replacement w MCC | MS-DRG | 469 | 21 | — | — | $24,417 | $34,770 | 1.2× | $69,623 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 21 | — | — | $14,084 | $20,637 | 1.1× | $40,161 |
| Laparoscopic cholecystectomy | CPT | 47562 | 16 | — | — | $1,888.85 | $6,068.46 | 3.4× | $16,338 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 16 | — | — | $1,888.85 | $6,068.46 | 3.2× | $16,338 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 20 | — | — | $9,144 | $26,700 | 0.95× | $62,643 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 20 | — | — | $9,144 | $19,608 | 0.97× | $44,195 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 20 | — | — | $9,144 | $15,609 | 0.98× | $33,790 |
| Lap inguinal hernia repair | CPT | 49650 | 17 | — | — | $1,888.85 | $6,151.73 | 5.5× | $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 | $5,231.2 | 2.9× | $15,605 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 17 | — | — | $1,888.85 | $6,200.38 | 4.2× | $16,721 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 16 | — | — | $3,110.01 | $9,884.78 | 4.4× | $28,436 |
| Lap salpingo-oophorectomy | CPT | 58661 | 17 | — | — | $1,888.85 | $6,200.38 | 3.1× | $16,338 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 20 | — | — | $6,182 | $26,491 | 0.98× | $58,074 |
| OR procedure for obesity w CC | MS-DRG | 620 | 20 | — | — | $6,182 | $15,951 | 0.98× | $34,016 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 20 | — | — | $6,182 | $14,600 | 0.96× | $31,400 |
| Vitrectomy mechanical | CPT | 67042 | 16 | — | — | $1,533.49 | $4,276.16 | 1.7× | $15,605 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 19 | — | — | $6,182 | $12,434 | 1.0× | $26,763 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 19 | — | — | $6,182 | $18,618 | 0.97× | $41,620 |