| behavioral |
| Psychoses | MS-DRG | 885 | 11 | — | — | $14,068 | $16,002 | 1.2× | $49,955 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 17 | $469 | $469 | $93.8 | $248.7 | 1.4× | $779.36 |
| Psychiatric eval with medical services | CPT | 90792 | 17 | $525 | $525 | $124 | $225.41 | 1.3× | $871.25 |
| Psychotherapy 30 minutes | CPT | 90832 | 17 | $213 | $213 | $32 | $128.37 | 0.86× | $337.05 |
| Psychotherapy 45 minutes | CPT | 90834 | 17 | $281 | $281 | $56.2 | $165.16 | 1.0× | $445.37 |
| Psychotherapy 60 minutes | CPT | 90837 | 17 | $414 | $414 | $80 | $213.65 | 1.1× | $655.79 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 17 | $398 | $398 | $83 | $202.47 | 1.3× | $628.52 |
| emergency |
| ED visit level 1 | CPT | 99281 | 17 | $399 | $399 | $7.98 | $88.74 | 0.63× | $2,833 |
| ED visit level 2 | CPT | 99282 | 17 | $851 | $851 | $29.4 | $159.6 | 0.67× | $2,833 |
| ED visit level 3 | CPT | 99283 | 17 | $1,285 | $1,285 | $49.72 | $279.05 | 0.69× | $6,062 |
| ED visit level 4 | CPT | 99284 | 17 | $2,022 | $2,022 | $84.74 | $429.14 | 0.64× | $6,062 |
| ED visit level 5 | CPT | 99285 | 17 | $3,161 | $3,161 | $122.87 | $617.88 | 0.59× | $9,286.49 |
| Critical care, first hour | CPT | 99291 | 17 | $4,154 | $4,154 | $168.76 | $849.18 | 0.79× | $4,089.2 |
| imaging |
| CT head without contrast | CPT | 70450 | 17 | $3,749 | $3,749 | $26.57 | $145.6 | 0.70× | $3,690.52 |
| CT head with contrast | CPT | 70460 | 17 | $3,498 | $3,498 | $35.22 | $197.35 | 0.84× | $3,443.43 |
| CT head with and without contrast | CPT | 70470 | 17 | $4,322 | $4,322 | $39.63 | $217.6 | 0.82× | $4,254.58 |
| CT neck with contrast | CPT | 70491 | 17 | $3,693 | $3,693 | $42.99 | $237.6 | 0.87× | $3,635.39 |
| MRI brain without contrast | CPT | 70551 | 17 | $5,279 | $5,279 | $32.96 | $528 | 1.3× | $5,196.65 |
| MRI brain with contrast | CPT | 70552 | 17 | $6,519 | $6,519 | $39.93 | $359.92 | 0.75× | $6,417.3 |
| MRI brain with and without contrast | CPT | 70553 | 17 | $7,767 | $7,767 | $52.69 | $416.5 | 0.71× | $7,645.83 |
| Chest X-ray single view | CPT | 71045 | 17 | $576 | $576 | $5.75 | $54.97 | 0.58× | $567.01 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $597 | $597 | $6.87 | $71.38 | 0.73× | $587.69 |
| Chest X-ray 3 views | CPT | 71047 | 17 | $597 | $597 | $8.65 | $88.74 | 0.93× | $587.69 |
| CT chest without contrast | CPT | 71250 | 17 | $3,186 | $3,186 | $33.56 | $181.17 | 0.84× | $3,136.3 |
| CT chest with contrast | CPT | 71260 | 17 | $4,890 | $4,890 | $36.34 | $200 | 0.71× | $4,813.72 |
| CT chest with and without contrast | CPT | 71270 | 17 | $3,100 | $3,100 | $38.97 | $219.43 | 0.75× | $3,051.64 |
| MRI chest without contrast | CPT | 71550 | 17 | $5,337 | $5,337 | $32.35 | $326.1 | 0.76× | $5,253.74 |
| MRI chest with contrast | CPT | 71551 | 17 | $9,587 | $9,587 | $38.41 | $796.22 | 0.98× | $9,437.44 |
| MRI chest with and without contrast | CPT | 71552 | 17 | $6,028 | $6,028 | $50.43 | $456.25 | 0.76× | $5,933.96 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $864 | $864 | $6.46 | $84.93 | 0.82× | $850.52 |
| CT cervical spine without contrast | CPT | 72125 | 17 | $3,644 | $3,644 | $31.04 | $170.4 | 0.85× | $3,587.15 |
| CT thoracic spine without contrast | CPT | 72128 | 17 | $3,364 | $3,364 | $31.04 | $170.4 | 0.85× | $3,311.52 |
| CT lumbar spine without contrast | CPT | 72131 | 17 | $3,442 | $3,442 | $31.04 | $170.4 | 0.84× | $3,388.3 |
| MRI cervical spine without contrast | CPT | 72141 | 17 | $5,569 | $5,569 | $35.83 | $267.97 | 0.67× | $5,482.12 |
| MRI thoracic spine without contrast | CPT | 72146 | 17 | $5,486 | $5,486 | $35.83 | $267.97 | 0.72× | $5,400.42 |
| MRI lumbar spine without contrast | CPT | 72148 | 17 | $5,367 | $5,367 | $33.24 | $267.97 | 0.71× | $5,283.27 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 17 | $3,835 | $3,835 | $39.93 | $359.92 | 0.79× | $3,775.17 |
| MRI cervical spine with and without contrast | CPT | 72156 | 17 | $7,902 | $7,902 | $57.54 | $416.5 | 0.77× | $7,778.73 |
| MRI lumbar spine with contrast | CPT | 72158 | 17 | $7,867 | $7,867 | $52.97 | $416.5 | 0.76× | $7,744.27 |
| CT pelvis without contrast | CPT | 72192 | 17 | $3,334 | $3,334 | $33.89 | $181.17 | 0.91× | $3,281.99 |
| CT pelvis with contrast | CPT | 72193 | 17 | $4,510 | $4,510 | $36.12 | $230.98 | 0.82× | $4,439.64 |
| Shoulder X-ray | CPT | 73030 | 17 | $789 | $789 | $5.53 | $73.51 | 0.79× | $776.69 |
| Humerus X-ray | CPT | 73060 | 17 | $674 | $674 | $4.82 | $68.51 | 0.77× | $663.49 |
| Hand X-ray 3 views | CPT | 73130 | 17 | $718 | $718 | $4.63 | $78.49 | 0.84× | $706.8 |
| MRI upper extremity joint without contrast | CPT | 73221 | 17 | $5,131 | $5,131 | $30.66 | $267.97 | 0.64× | $5,050.96 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 17 | $7,671 | $7,671 | $47.83 | $429.68 | 0.70× | $7,551.33 |
| Knee X-ray 1-2 views | CPT | 73560 | 17 | $649 | $649 | $5.16 | $72.79 | 0.78× | $638.88 |
| Ankle X-ray 3 views | CPT | 73610 | 17 | $741 | $741 | $4.63 | $78.49 | 0.85× | $729.44 |
| MRI lower extremity joint without contrast | CPT | 73721 | 17 | $5,028 | $5,028 | $30.5 | $267.97 | 0.57× | $4,949.56 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 17 | $7,356 | $7,356 | $47.83 | $428.24 | 0.68× | $7,241.25 |
| CT abdomen without contrast | CPT | 74150 | 17 | $3,367 | $3,367 | $37.02 | $195.58 | 1.0× | $3,314.47 |
| CT abdomen with contrast | CPT | 74160 | 17 | $4,298 | $4,298 | $39.63 | $253.27 | 0.88× | $4,230.95 |
| CT abdomen with and without contrast | CPT | 74170 | 17 | $5,120 | $5,120 | $43.44 | $277.6 | 0.83× | $5,040.13 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 17 | $6,220 | $6,220 | $54.26 | $287.21 | 0.79× | $6,122.97 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 17 | $6,553 | $6,553 | $57.05 | $363.01 | 0.66× | $6,450.77 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 17 | $9,799 | $9,799 | $62.64 | $386.1 | 0.67× | $9,646.14 |
| MRI abdomen without contrast | CPT | 74181 | 17 | $5,374 | $5,374 | $32.5 | $267.97 | 0.69× | $5,290.17 |
| MRI abdomen with and without contrast | CPT | 74183 | 17 | $6,410 | $6,410 | $50.12 | $398.65 | 0.70× | $6,310 |
| Abdominal ultrasound complete | CPT | 76700 | 17 | $1,883 | $1,883 | $21.84 | $138.4 | 0.93× | $1,853.63 |
| Abdominal ultrasound limited | CPT | 76705 | 17 | $1,147 | $1,147 | $15.92 | $113.4 | 0.77× | $1,129.11 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 17 | $1,245 | $1,245 | $19.98 | $125.6 | 0.87× | $1,225.58 |
| Obstetric ultrasound first trimester | CPT | 76801 | 17 | $1,000 | $1,000 | $31.03 | $161.37 | 1.1× | $984.4 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 17 | $1,226 | $1,226 | $31.24 | $164.78 | 1.1× | $1,206.87 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 17 | $1,322 | $1,322 | $59.37 | $303.03 | 1.3× | $1,301.38 |
| Transvaginal ultrasound | CPT | 76830 | 17 | $1,333 | $1,333 | $18.71 | $129.69 | 0.88× | $1,312.21 |
| Pelvic ultrasound complete | CPT | 76856 | 17 | $1,248 | $1,248 | $18.71 | $118.4 | 0.83× | $1,228.53 |
| Scrotal ultrasound | CPT | 76870 | 17 | $1,061 | $1,061 | $17.57 | $117.89 | 0.90× | $1,044.45 |
| Diagnostic mammography unilateral | CPT | 77065 | 17 | $574 | $574 | $25.24 | $160.67 | 1.1× | $568.58 |
| Diagnostic mammography bilateral | CPT | 77066 | 17 | $731 | $731 | $31.04 | $197.94 | 1.0× | $719.6 |
| Screening mammography bilateral | CPT | 77067 | 17 | $777 | $777 | $23.89 | $152.08 | 0.96× | $764.88 |
| EKG complete | CPT | 93000 | 17 | $105 | $105 | $9.34 | $15.57 | 0.64× | $94.5 |
| EKG tracing only | CPT | 93005 | 17 | $88 | $88 | $4.03 | $53.03 | 0.45× | $89.79 |
| EKG interpretation only | CPT | 93010 | 17 | $35 | $35 | $5.31 | $8.73 | 0.48× | $35.87 |
| Transthoracic echocardiogram complete | CPT | 93306 | 17 | $3,717 | $3,717 | $44.9 | $367.34 | 0.61× | $3,659.01 |
| Transthoracic echocardiogram | CPT | 93307 | 17 | $1,714 | $1,714 | $28.42 | $243.61 | 0.98× | $1,687.26 |
| Stress echocardiogram | CPT | 93350 | 17 | $779 | $779 | $44.9 | $178.32 | 0.35× | $838.8 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 11 | — | — | $19,852 | $22,582 | 1.1× | $70,495 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 11 | — | — | $10,149 | $11,544 | 1.1× | $36,038 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 11 | — | — | $6,869.26 | $7,813.79 | 1.0× | $24,393 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 11 | — | — | $16,133 | $18,351 | 1.2× | $57,287 |
| COPD w MCC | MS-DRG | 190 | 11 | — | — | $11,208 | $12,749 | 1.1× | $39,798 |
| COPD w CC | MS-DRG | 191 | 11 | — | — | $8,573.87 | $9,752.78 | 1.1× | $30,446 |
| COPD w/o CC/MCC | MS-DRG | 192 | 11 | — | — | $6,459.1 | $7,347.23 | 1.0× | $22,936 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 11 | — | — | $8,183.66 | $9,308.92 | 1.1× | $29,060 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 11 | — | — | $6,214.58 | $7,069.09 | 1.1× | $22,068 |
| AMI discharged alive w MCC | MS-DRG | 280 | 11 | — | — | $16,381 | $18,634 | 1.2× | $58,170 |
| AMI discharged alive w CC | MS-DRG | 281 | 11 | — | — | $9,199.6 | $10,465 | 1.1× | $32,668 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 11 | — | — | $7,236.53 | $8,231.55 | 1.1× | $25,697 |
| Heart failure & shock w MCC | MS-DRG | 291 | 11 | — | — | $13,022 | $14,812 | 1.2× | $46,241 |
| Heart failure & shock w CC | MS-DRG | 292 | 11 | — | — | $8,594.81 | $9,776.6 | 1.1× | $30,520 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 11 | — | — | $5,476.05 | $6,229.01 | 1.0× | $19,445 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 11 | — | — | $12,035 | $13,690 | 1.1× | $42,736 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 11 | — | — | $7,378.25 | $8,392.76 | 1.1× | $26,200 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 11 | — | — | $5,583.83 | $6,351.61 | 1.0× | $19,828 |
| GI hemorrhage w CC | MS-DRG | 378 | 11 | — | — | $9,839.34 | $11,192 | 1.1× | $34,939 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 11 | — | — | $6,354.3 | $7,228.02 | 1.1× | $22,564 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 11 | — | — | $7,787.44 | $8,858.22 | 1.1× | $27,653 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 11 | — | — | $15,219 | $17,311 | 1.1× | $54,041 |
| Kidney/UTI w MCC | MS-DRG | 689 | 11 | — | — | $11,680 | $13,286 | 1.1× | $41,474 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 11 | — | — | $8,010 | $9,111.38 | 1.1× | $28,443 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 11 | — | — | $19,582 | $22,274 | 1.2× | $69,535 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 11 | — | — | $10,289 | $11,704 | 1.1× | $36,538 |
| Initial hospital care, low complexity | CPT | 99221 | 17 | $244 | $244 | $34.9 | $102.54 | 1.1× | $241.53 |
| Initial hospital care, moderate complexity | CPT | 99222 | 17 | $385 | $385 | $48.07 | $155.33 | 0.92× | $380.85 |
| Initial hospital care, high complexity | CPT | 99223 | 17 | $514 | $514 | $70.62 | $210.8 | 0.94× | $509.04 |
| Hospital discharge, <30 min | CPT | 99238 | 17 | $240 | $240 | $26.74 | $97.19 | 1.1× | $237.63 |
| Hospital discharge, >30 min | CPT | 99239 | 17 | $340 | $340 | $38.33 | $137.55 | 1.1× | $336.42 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 17 | $105 | $105 | $5.08 | $29.33 | 0.91× | $105 |
| General health panel | CPT | 80050 | 13 | $312 | $312 | $62.4 | $249.6 | 2.3× | $312 |
| Electrolyte panel | CPT | 80051 | 17 | $48 | $48 | $4.21 | $21.65 | 0.91× | $48 |
| Comprehensive metabolic panel | CPT | 80053 | 17 | $123 | $123 | $6.34 | $35.4 | 0.80× | $123.4 |
| Lipid panel | CPT | 80061 | 17 | $103 | $103 | $7.79 | $42.45 | 1.1× | $103 |
| Renal function panel | CPT | 80069 | 17 | $187 | $187 | $5.21 | $31.2 | 1.1× | $187.2 |
| Hepatic function panel | CPT | 80076 | 17 | $117 | $117 | $4.9 | $29.05 | 1.1× | $117 |
| Urinalysis non-automated | CPT | 81002 | 17 | $16 | $16 | $2.44 | $4 | 0.57× | $15.66 |
| Urinalysis automated | CPT | 81003 | 17 | $38 | $38 | $1.58 | $7.85 | 0.56× | $38 |
| Glucose quantitative | CPT | 82947 | 17 | $30 | $30 | $2.75 | $12.5 | 0.71× | $30 |
| Hemoglobin A1c | CPT | 83036 | 17 | $93 | $93 | $1.94 | $11.17 | 0.41× | $93 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 17 | $130 | $130 | $10.08 | $53.06 | 1.1× | $130 |
| Complete blood count with automated differential | CPT | 85025 | 17 | $53 | $53 | $4.09 | $23.95 | 0.90× | $53.3 |
| Complete blood count without differential | CPT | 85027 | 17 | $50 | $50 | $3.88 | $20.33 | 0.94× | $50.4 |
| Urine culture bacterial | CPT | 87086 | 17 | $92 | $92 | $4.84 | $26.9 | 1.2× | $92.3 |
| Urine culture identification | CPT | 87088 | 17 | $74 | $74 | $4.85 | $25.7 | 1.2× | $74 |
| Tissue exam by pathologist level IV | CPT | 88305 | 17 | $302 | $302 | $18.6 | $75.7 | 0.74× | $271.8 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 17 | $728 | $728 | $18.67 | $102.6 | 0.55× | $716.64 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 17 | $9,623 | $9,623 | $1,720.75 | $2,521.71 | 1.1× | $10,265 |
| Vaginal delivery only | CPT | 59409 | 17 | $8,764 | $8,764 | $607.33 | $2,787.11 | 1.3× | $8,627.28 |
| Vaginal delivery with postpartum | CPT | 59410 | 17 | $4,247 | $4,247 | $823.79 | $1,114.53 | 1.0× | $4,491.99 |
| Routine obstetric care with C-section | CPT | 59510 | 17 | $10,623 | $10,623 | $1,948.09 | $2,781.28 | 1.1× | $11,281 |
| C-section delivery only | CPT | 59514 | 17 | $3,526 | $3,526 | $683.96 | $1,055.43 | 1.1× | $3,808.76 |
| C-section with postpartum | CPT | 59515 | 17 | $5,240 | $5,240 | $1,015.33 | $1,373.69 | 1.1× | $5,499.45 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 17 | $217 | $217 | $33.8 | $122.84 | 1.4× | $214.5 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 17 | $333 | $333 | $50.2 | $181.8 | 1.5× | $330.15 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 17 | $496 | $496 | $72.6 | $271.34 | 1.6× | $490.89 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 17 | $654 | $654 | $94.8 | $329.91 | 1.5× | $647.61 |
| Office visit, established patient, 5 min | CPT | 99211 | 17 | $70 | $70 | $8.24 | $39.96 | 0.62× | $287.25 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 17 | $169 | $169 | $26.6 | $83.05 | 1.0× | $298.74 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 17 | $270 | $270 | $40.8 | $134.57 | 1.2× | $276.19 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 17 | $382 | $382 | $57 | $189.13 | 1.2× | $378.27 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 17 | $535 | $535 | $78.2 | $277.21 | 1.5× | $529.83 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 17 | $4,202 | $4,202 | $96.53 | $1,007.56 | 1.1× | $4,136.45 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 17 | $4,190 | $4,190 | $108.61 | $1,232.45 | 1.3× | $4,124.64 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 17 | $2,950 | $2,950 | $45.15 | $881.15 | 1.0× | $2,903.98 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 17 | $3,241 | $3,241 | $57.38 | $950.1 | 1.1× | $3,190.44 |
| Colonoscopy diagnostic | CPT | 45378 | 17 | $4,293 | $4,293 | $144.63 | $1,162.43 | 1.3× | $4,226.03 |
| Colonoscopy with biopsy | CPT | 45380 | 17 | $4,918 | $4,918 | $157.27 | $1,414.57 | 1.2× | $4,841.28 |
| Colonoscopy with polyp removal | CPT | 45385 | 17 | $5,184 | $5,184 | $198.6 | $1,478.16 | 1.2× | $5,103.13 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 17 | $5,839 | $5,839 | $944.1 | $3,454.17 | 0.84× | $27,800 |
| Hip hemiarthroplasty | CPT | 27125 | 17 | $4,590 | $4,590 | $742 | $1,215.65 | 0.97× | $4,929.39 |
| Total hip replacement | CPT | 27130 | 17 | $5,184 | $5,184 | $839.55 | $3,605.29 | 0.83× | $19,451 |
| Total knee replacement | CPT | 27447 | 17 | $5,177 | $5,177 | $838.52 | $3,601.02 | 0.86× | $19,451 |
| Knee revision arthroplasty single component | CPT | 27486 | 17 | $5,674 | $5,674 | $918.64 | $1,503.08 | 0.90× | $6,096.87 |
| Knee revision arthroplasty all components | CPT | 27487 | 17 | $7,055 | $7,055 | $1,143.04 | $1,867.24 | 0.93× | $7,586.37 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 17 | $682 | $682 | $111.23 | $297.34 | 0.91× | $5,997 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 17 | $4,349 | $4,349 | $700.83 | $3,294.8 | 1.00× | $10,799 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 17 | $2,235 | $2,235 | $358.85 | $1,693.24 | 0.83× | $6,220.96 |
| ACL reconstruction | CPT | 29888 | 17 | $3,968 | $3,968 | $639.14 | $3,006.16 | 0.90× | $11,037 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 11 | — | — | $45,827 | $52,129 | 1.2× | $162,732 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 11 | — | — | $23,590 | $26,833 | 1.2× | $83,767 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 11 | — | — | $16,477 | $18,743 | 1.1× | $58,510 |
| CABG single arterial graft | CPT | 33533 | 17 | $7,241 | $7,241 | $1,188.05 | $1,910.13 | 1.0× | $7,815.92 |
| CABG 2 arterial grafts | CPT | 33534 | 17 | $8,499 | $8,499 | $1,395.58 | $2,242.93 | 1.0× | $9,173.61 |
| CABG 3 arterial grafts | CPT | 33535 | 17 | $9,442 | $9,442 | $1,550.76 | $2,491.59 | 1.1× | $10,199 |
| CABG 4+ arterial grafts | CPT | 33536 | 17 | $10,172 | $10,172 | $1,670.33 | $2,682.57 | 1.1× | $10,973 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 11 | — | — | $16,551 | $18,827 | 1.1× | $58,772 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 11 | — | — | $13,150 | $14,958 | 1.1× | $46,694 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 11 | — | — | $35,225 | $40,068 | 1.2× | $125,082 |
| Open appendectomy | CPT | 44950 | 17 | $2,554 | $2,554 | $416.91 | $1,698.29 | 1.5× | $9,432.63 |
| Laparoscopic appendectomy | CPT | 44970 | 17 | $2,410 | $2,410 | $392.57 | $1,825.82 | 1.2× | $8,819.81 |
| Major joint replacement w MCC | MS-DRG | 469 | 11 | — | — | $32,622 | $37,107 | 1.3× | $115,839 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 11 | — | — | $18,817 | $21,405 | 1.1× | $66,820 |
| Laparoscopic cholecystectomy | CPT | 47562 | 17 | $2,636 | $2,636 | $430.26 | $1,997.03 | 1.1× | $10,991 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 17 | $2,864 | $2,864 | $467.69 | $2,169.77 | 1.2× | $10,455 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 11 | — | — | $29,351 | $33,387 | 1.2× | $104,226 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 11 | — | — | $20,708 | $23,555 | 1.2× | $73,532 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 11 | — | — | $15,832 | $18,009 | 1.1× | $56,220 |
| Lap inguinal hernia repair | CPT | 49650 | 17 | $1,744 | $1,744 | $283.6 | $1,235.07 | 1.1× | $8,819.81 |
| Total abdominal hysterectomy | CPT | 58150 | 17 | $4,130 | $4,130 | $665.41 | $1,087.27 | 1.1× | $4,425.71 |
| Vaginal hysterectomy | CPT | 58260 | 17 | $3,416 | $3,416 | $547.62 | $2,103.87 | 1.2× | $7,462.43 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 17 | $3,587 | $3,587 | $576.73 | $942.31 | 0.64× | $3,856.55 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 17 | $3,983 | $3,983 | $641.17 | $2,736.93 | 1.2× | $15,739 |
| Lap salpingo-oophorectomy | CPT | 58661 | 17 | $2,647 | $2,647 | $425.96 | $2,038.19 | 1.0× | $9,690.66 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 11 | — | — | $18,950 | $27,823 | 1.0× | $96,624 |
| OR procedure for obesity w CC | MS-DRG | 620 | 11 | — | — | $15,938 | $17,643 | 1.1× | $56,596 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 11 | — | — | $14,589 | $16,595 | 1.1× | $51,805 |
| Complex cataract surgery | CPT | 66982 | 17 | $3,068 | $3,068 | $482.62 | $2,133.29 | 0.96× | $4,408.17 |
| Cataract surgery with lens implant | CPT | 66984 | 17 | $2,242 | $2,242 | $352.38 | $1,698.54 | 0.78× | $3,595.7 |
| Intravitreal injection | CPT | 67028 | 17 | $986 | $986 | $73.49 | $371.06 | 1.1× | $970.62 |
| Vitrectomy mechanical | CPT | 67042 | 17 | $4,688 | $4,688 | $738.47 | $2,796.67 | 1.1× | $6,081.36 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 11 | — | — | $11,963 | $13,608 | 1.1× | $42,481 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 11 | — | — | $19,501 | $22,182 | 1.2× | $69,248 |
| PCI single major coronary artery | CPT | 92920 | 17 | $15,921 | $15,921 | $333.31 | $5,101.94 | 0.90× | $15,673 |
| PCI with drug-eluting stent | CPT | 92928 | 17 | $25,095 | $25,095 | $370.43 | $9,227.82 | 0.92× | $24,704 |
| PCI bypass graft | CPT | 92937 | 17 | $25,095 | $25,095 | $370.2 | $9,227.82 | 0.85× | $24,704 |
| Left heart catheterization | CPT | 93452 | 17 | $9,102 | $9,102 | $149.17 | $1,607.47 | 0.52× | $8,960.01 |
| Coronary angiography with cath | CPT | 93455 | 17 | $15,280 | $15,280 | $175.89 | $1,805.53 | 0.58× | $15,042 |
| Coronary angiography with bypass cath | CPT | 93458 | 17 | $15,699 | $15,699 | $185.72 | $1,862.66 | 0.60× | $15,454 |