| behavioral |
| Psychoses | MS-DRG | 885 | 16 | — | — | $1,337 | $26,032 | 2.0× | $31,011 |
| emergency |
| ED visit level 1 | CPT | 99281 | 18 | $400 | $200 | $75 | $300 | 2.1× | $2,200 |
| ED visit level 2 | CPT | 99282 | 18 | $515 | $257.5 | $255 | $411 | 1.7× | $2,200 |
| ED visit level 3 | CPT | 99283 | 18 | $870 | $435 | $381 | $735.01 | 1.8× | $2,200 |
| ED visit level 4 | CPT | 99284 | 18 | $1,500 | $750 | $456 | $1,609.5 | 2.4× | $3,627 |
| ED visit level 5 | CPT | 99285 | 18 | $1,940 | $970 | $534 | $1,795.62 | 1.7× | $3,627 |
| Critical care, first hour | CPT | 99291 | 7 | $2,810 | $1,405 | $1,686 | $2,200 | 2.1× | $3,899 |
| imaging |
| CT head without contrast | CPT | 70450 | 18 | $2,940 | $1,470 | $475 | $1,014 | 4.9× | $2,487.24 |
| CT head with contrast | CPT | 70460 | 18 | $3,140 | $1,570 | $475 | $1,014 | 4.3× | $2,656.44 |
| CT head with and without contrast | CPT | 70470 | 18 | $4,610 | $2,305 | $475 | $1,014 | 3.8× | $3,900.06 |
| CT neck with contrast | CPT | 70491 | 18 | $3,140 | $1,570 | $475 | $1,014 | 3.7× | $2,656.44 |
| MRI brain without contrast | CPT | 70551 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.3× | $3,570.12 |
| MRI brain with contrast | CPT | 70552 | 18 | $4,420 | $2,210 | $650 | $1,350 | 2.8× | $3,739.32 |
| MRI brain with and without contrast | CPT | 70553 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.3× | $5,524.38 |
| Chest X-ray single view | CPT | 71045 | 18 | $565 | $282.5 | $200 | $339 | 3.6× | $477.99 |
| Chest X-ray 2 views | CPT | 71046 | 18 | $680 | $340 | $200 | $339 | 3.4× | $575.28 |
| Chest X-ray 3 views | CPT | 71047 | 18 | $845 | $422.5 | $200 | $339 | 3.5× | $714.87 |
| CT chest without contrast | CPT | 71250 | 18 | $2,940 | $1,470 | $475 | $1,014 | 4.7× | $2,487.24 |
| CT chest with contrast | CPT | 71260 | 18 | $3,140 | $1,570 | $475 | $1,014 | 3.6× | $2,656.44 |
| CT chest with and without contrast | CPT | 71270 | 18 | $4,610 | $2,305 | $475 | $1,014 | 3.5× | $3,900.06 |
| MRI chest without contrast | CPT | 71550 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.1× | $3,570.12 |
| MRI chest with contrast | CPT | 71551 | 18 | $4,420 | $2,210 | $650 | $1,350 | 1.7× | $3,739.32 |
| MRI chest with and without contrast | CPT | 71552 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.2× | $5,524.38 |
| Lumbosacral spine X-ray | CPT | 72100 | 18 | $850 | $425 | $200 | $339 | 3.3× | $719.1 |
| CT cervical spine without contrast | CPT | 72125 | 18 | $2,940 | $1,470 | $475 | $1,014 | 5.0× | $2,487.24 |
| CT thoracic spine without contrast | CPT | 72128 | 18 | $2,940 | $1,470 | $475 | $1,014 | 5.1× | $2,487.24 |
| CT lumbar spine without contrast | CPT | 72131 | 18 | $2,940 | $1,470 | $475 | $1,014 | 5.0× | $2,487.24 |
| MRI cervical spine without contrast | CPT | 72141 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.4× | $3,570.12 |
| MRI thoracic spine without contrast | CPT | 72146 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.6× | $3,570.12 |
| MRI lumbar spine without contrast | CPT | 72148 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.6× | $3,570.12 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 18 | $4,420 | $2,210 | $650 | $1,350 | 3.0× | $3,739.32 |
| MRI cervical spine with and without contrast | CPT | 72156 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.5× | $5,524.38 |
| MRI lumbar spine with contrast | CPT | 72158 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.5× | $5,524.38 |
| CT pelvis without contrast | CPT | 72192 | 18 | $2,940 | $1,470 | $475 | $1,014 | 5.1× | $2,487.24 |
| CT pelvis with contrast | CPT | 72193 | 18 | $3,140 | $1,570 | $475 | $1,014 | 3.6× | $2,656.44 |
| Shoulder X-ray | CPT | 73030 | 18 | $1,400 | $700 | $200 | $420 | 4.5× | $1,184.4 |
| Humerus X-ray | CPT | 73060 | 18 | $1,180 | $590 | $200 | $405 | 4.5× | $998.28 |
| Hand X-ray 3 views | CPT | 73130 | 18 | $1,270 | $635 | $200 | $405 | 4.4× | $1,074.42 |
| MRI upper extremity joint without contrast | CPT | 73221 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.2× | $3,570.12 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.2× | $5,524.38 |
| Knee X-ray 1-2 views | CPT | 73560 | 18 | $1,160 | $580 | $200 | $403 | 4.3× | $981.36 |
| Ankle X-ray 3 views | CPT | 73610 | 18 | $1,260 | $630 | $200 | $405 | 4.4× | $1,065.96 |
| MRI lower extremity joint without contrast | CPT | 73721 | 18 | $4,220 | $2,110 | $650 | $1,350 | 2.9× | $3,570.12 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.1× | $5,524.38 |
| CT abdomen without contrast | CPT | 74150 | 18 | $2,940 | $1,470 | $475 | $1,014 | 5.4× | $2,487.24 |
| CT abdomen with contrast | CPT | 74160 | 18 | $3,140 | $1,570 | $475 | $1,014 | 3.5× | $2,656.44 |
| CT abdomen with and without contrast | CPT | 74170 | 18 | $4,610 | $2,305 | $475 | $1,014 | 3.0× | $3,900.06 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 18 | $5,880 | $2,940 | $475 | $1,014 | 2.8× | $4,974.48 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 18 | $6,280 | $3,140 | $475 | $1,014 | 1.8× | $5,312.88 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 18 | $9,220 | $4,610 | $475 | $1,014 | 1.8× | $7,800.12 |
| MRI abdomen without contrast | CPT | 74181 | 18 | $4,220 | $2,110 | $650 | $1,350 | 3.5× | $3,570.12 |
| MRI abdomen with and without contrast | CPT | 74183 | 18 | $6,530 | $3,265 | $650 | $1,350 | 2.4× | $5,524.38 |
| Abdominal ultrasound complete | CPT | 76700 | 18 | $1,840 | $920 | $300 | $525 | 3.5× | $1,556.64 |
| Abdominal ultrasound limited | CPT | 76705 | 18 | $1,380 | $690 | $300 | $525 | 3.6× | $1,167.48 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 18 | $1,950 | $975 | $300 | $525 | 3.7× | $1,649.7 |
| Obstetric ultrasound first trimester | CPT | 76801 | 18 | $1,070 | $535 | $300 | $525 | 3.7× | $905.22 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 18 | $1,320 | $660 | $300 | $525 | 3.4× | $1,116.72 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 18 | $1,070 | $535 | $300 | $525 | 2.2× | $905.22 |
| Transvaginal ultrasound | CPT | 76830 | 18 | $1,340 | $670 | $300 | $525 | 3.6× | $1,133.64 |
| Pelvic ultrasound complete | CPT | 76856 | 18 | $1,650 | $825 | $300 | $525 | 3.7× | $1,395.9 |
| Scrotal ultrasound | CPT | 76870 | 18 | $1,190 | $595 | $300 | $525 | 4.0× | $1,006.74 |
| Diagnostic mammography unilateral | CPT | 77065 | 18 | $825 | $412.5 | $200 | $330 | 2.2× | $697.95 |
| Diagnostic mammography bilateral | CPT | 77066 | 18 | $565 | $282.5 | $200 | $306 | 1.6× | $477.99 |
| Screening mammography bilateral | CPT | 77067 | 18 | $445 | $222.5 | $200 | $303.25 | 1.9× | $376.47 |
| EKG tracing only | CPT | 93005 | 18 | $240 | $120 | $120 | $202.08 | 1.7× | $310 |
| Transthoracic echocardiogram complete | CPT | 93306 | 18 | $3,250 | $1,625 | $1,520 | $2,135 | 3.6× | $2,749.5 |
| Transthoracic echocardiogram | CPT | 93307 | 18 | $2,240 | $1,120 | $1,065 | $1,568 | 6.3× | $2,415 |
| Stress echocardiogram | CPT | 93350 | 18 | $4,060 | $2,030 | $361 | $1,725.64 | 3.4× | $3,434.76 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 16 | — | — | $23,536 | $36,737 | 1.8× | $43,762 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 16 | — | — | $12,032 | $18,780 | 1.8× | $22,372 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 16 | — | — | $8,143.97 | $12,712 | 1.7× | $15,143 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 16 | — | — | $19,126 | $29,854 | 1.9× | $35,563 |
| COPD w MCC | MS-DRG | 190 | 16 | — | — | $13,287 | $20,740 | 1.8× | $24,706 |
| COPD w CC | MS-DRG | 191 | 16 | — | — | $10,165 | $15,866 | 1.8× | $18,900 |
| COPD w/o CC/MCC | MS-DRG | 192 | 16 | — | — | $7,657.67 | $11,952 | 1.7× | $14,238 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 16 | — | — | $9,702.24 | $15,144 | 1.8× | $18,040 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 16 | — | — | $7,367.79 | $11,500 | 1.7× | $13,699 |
| AMI discharged alive w MCC | MS-DRG | 280 | 16 | — | — | $19,421 | $30,313 | 1.9× | $36,111 |
| AMI discharged alive w CC | MS-DRG | 281 | 16 | — | — | $10,907 | $17,024 | 1.8× | $20,280 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 16 | — | — | $8,579.38 | $13,391 | 1.7× | $15,952 |
| Heart failure & shock w MCC | MS-DRG | 291 | 16 | — | — | $15,438 | $24,097 | 1.9× | $28,706 |
| Heart failure & shock w CC | MS-DRG | 292 | 16 | — | — | $10,190 | $15,905 | 1.8× | $18,946 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 16 | — | — | $6,492.22 | $10,133 | 1.6× | $12,071 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 16 | — | — | $14,268 | $22,271 | 1.8× | $26,530 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 16 | — | — | $8,747.4 | $13,653 | 1.8× | $16,265 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 16 | — | — | $6,620 | $10,333 | 1.7× | $12,309 |
| GI hemorrhage w CC | MS-DRG | 378 | 16 | — | — | $11,665 | $18,208 | 1.8× | $21,690 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 16 | — | — | $7,533.43 | $11,759 | 1.7× | $14,007 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 16 | — | — | $9,232.51 | $14,411 | 1.8× | $17,167 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 16 | — | — | $18,043 | $28,162 | 1.9× | $33,548 |
| Kidney/UTI w MCC | MS-DRG | 689 | 16 | — | — | $13,847 | $21,613 | 1.9× | $25,747 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 16 | — | — | $9,496.36 | $14,822 | 1.8× | $17,657 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 16 | — | — | $23,216 | $36,236 | 1.9× | $43,166 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 16 | — | — | $12,199 | $19,041 | 1.8× | $22,682 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 18 | $235 | $117.5 | $6.77 | $24.66 | 0.76× | $198.81 |
| General health panel | CPT | 80050 | 18 | $560 | $280 | $37.82 | $336 | 3.1× | $473.76 |
| Electrolyte panel | CPT | 80051 | 18 | $115 | $57.5 | $5.61 | $37.8 | 1.6× | $97.29 |
| Comprehensive metabolic panel | CPT | 80053 | 18 | $315 | $157.5 | $8.45 | $30.62 | 0.69× | $266.49 |
| Lipid panel | CPT | 80061 | 18 | $250 | $125 | $10.71 | $79 | 2.1× | $211.5 |
| Renal function panel | CPT | 80069 | 18 | $285 | $142.5 | $6.94 | $25.62 | 0.94× | $241.11 |
| Hepatic function panel | CPT | 80076 | 18 | $280 | $140 | $6.54 | $23.88 | 0.90× | $236.88 |
| Urinalysis non-automated | CPT | 81002 | 18 | $30 | $15 | $2.78 | $10.09 | 1.4× | $25.38 |
| Urinalysis automated | CPT | 81003 | 18 | $50 | $25 | $1.8 | $6.64 | 0.48× | $42.3 |
| Glucose quantitative | CPT | 82947 | 18 | $55 | $27.5 | $3.14 | $20.4 | 1.2× | $46.53 |
| Hemoglobin A1c | CPT | 83036 | 18 | $165 | $82.5 | $7.77 | $28.65 | 1.1× | $139.59 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 18 | $210 | $105 | $13.44 | $39.73 | 0.84× | $177.66 |
| Complete blood count with automated differential | CPT | 85025 | 18 | $140 | $70 | $6.22 | $22.94 | 0.87× | $118.44 |
| Complete blood count without differential | CPT | 85027 | 18 | $100 | $50 | $5.18 | $19.08 | 0.88× | $84.6 |
| Urine culture bacterial | CPT | 87086 | 18 | $160 | $80 | $6.46 | $23.82 | 1.0× | $135.36 |
| Urine culture identification | CPT | 87088 | 18 | $160 | $80 | $6.47 | $60.7 | 2.7× | $135.36 |
| Tissue exam by pathologist level IV | CPT | 88305 | 18 | $615 | $307.5 | $57.17 | $369 | 3.6× | $520.29 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 18 | $550 | $275 | $132.5 | $330 | 1.8× | $14,482 |
| Routine obstetric care including vaginal delivery | CPT | 59400 | 13 | — | — | $3,672 | $10,200 | 4.4× | $14,482 |
| Vaginal delivery only | CPT | 59409 | 14 | — | — | $1,894 | $7,640 | 3.4× | $10,200 |
| Vaginal delivery with postpartum | CPT | 59410 | 13 | — | — | $1,894 | $10,057 | 9.5× | $14,038 |
| Routine obstetric care with C-section | CPT | 59510 | 13 | — | — | $3,672 | $15,818 | 6.3× | $19,887 |
| C-section delivery only | CPT | 59514 | 13 | — | — | $3,672 | $17,830 | 18.6× | $25,737 |
| C-section with postpartum | CPT | 59515 | 13 | — | — | $3,672 | $15,818 | 12.5× | $19,887 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 18 | $325 | $162.5 | $65 | $95 | 1.1× | $274.95 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 18 | $450 | $225 | $65 | $90 | 0.74× | $380.7 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 18 | $650 | $325 | $65 | $90 | 0.52× | $549.9 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 18 | $730 | $365 | $65 | $90 | 0.41× | $617.58 |
| Office visit, established patient, 5 min | CPT | 99211 | 18 | $265 | $132.5 | $60 | $84.6 | 1.3× | $224.19 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 18 | $325 | $162.5 | $65 | $90 | 1.1× | $274.95 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 18 | $450 | $225 | $65 | $90 | 0.79× | $380.7 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 18 | $650 | $325 | $65 | $90 | 0.59× | $549.9 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 18 | $730 | $365 | $65 | $90 | 0.48× | $617.58 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $1,894 | $2,965.5 | 3.2× | $5,100 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $2,020 | $2,976 | 3.1× | $6,800 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | — | — | $1,291 | $2,126.5 | 2.5× | $3,500 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 15 | — | — | $1,291 | $2,126.5 | 2.4× | $3,500 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $2,020 | $2,976 | 3.4× | $6,800 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | — | $2,020 | $2,976 | 2.5× | $6,800 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $2,020 | $2,976 | 2.5× | $6,800 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 14 | — | — | $6,793 | $17,955 | 4.3× | $25,737 |
| Hip hemiarthroplasty | CPT | 27125 | 13 | — | — | $9,580 | $17,588 | 14.1× | $25,737 |
| Total hip replacement | CPT | 27130 | 14 | — | — | $6,793 | $17,955 | 4.1× | $25,737 |
| Total knee replacement | CPT | 27447 | 14 | — | — | $8,129 | $17,955 | 4.3× | $26,520 |
| Knee revision arthroplasty single component | CPT | 27486 | 13 | — | — | $9,580 | $18,759 | 11.2× | $25,737 |
| Knee revision arthroplasty all components | CPT | 27487 | 13 | — | — | $9,580 | $18,759 | 9.4× | $25,737 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 15 | — | — | $1,291 | $1,958.5 | 6.0× | $21,930 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | — | — | $5,651 | $13,401 | 4.1× | $21,930 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | — | — | $4,223 | $9,917.5 | 4.8× | $13,500 |
| ACL reconstruction | CPT | 29888 | 15 | — | — | $5,651 | $12,997 | 3.9× | $21,930 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 16 | — | — | $54,331 | $84,803 | 2.0× | $101,022 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 16 | — | — | $27,967 | $43,653 | 1.9× | $52,001 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 16 | — | — | $19,535 | $30,491 | 1.9× | $36,322 |
| CABG single arterial graft | CPT | 33533 | 14 | — | — | $8,129 | $17,830 | 9.5× | $26,520 |
| CABG 2 arterial grafts | CPT | 33534 | 14 | — | — | $8,129 | $17,830 | 8.3× | $26,520 |
| CABG 3 arterial grafts | CPT | 33535 | 14 | — | — | $8,129 | $17,830 | 7.8× | $26,520 |
| CABG 4+ arterial grafts | CPT | 33536 | 14 | — | — | $8,129 | $17,830 | 7.3× | $26,520 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 16 | — | — | $19,622 | $30,627 | 1.9× | $36,485 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 16 | — | — | $15,590 | $24,333 | 1.8× | $28,987 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 16 | — | — | $41,761 | $65,183 | 2.0× | $77,649 |
| Open appendectomy | CPT | 44950 | 14 | — | — | $4,916 | $9,882 | 8.7× | $18,870 |
| Laparoscopic appendectomy | CPT | 44970 | 15 | — | — | $5,651 | $13,275 | 8.5× | $21,930 |
| Major joint replacement w MCC | MS-DRG | 469 | 16 | — | — | $38,675 | $53,751 | 1.8× | $71,911 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 16 | — | — | $22,309 | $31,005 | 1.6× | $41,481 |
| Laparoscopic cholecystectomy | CPT | 47562 | 15 | — | — | $5,651 | $13,401 | 7.6× | $21,930 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 15 | — | — | $5,651 | $13,401 | 7.1× | $21,930 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 16 | — | — | $34,798 | $54,314 | 1.9× | $64,702 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 16 | — | — | $24,550 | $38,319 | 1.9× | $45,648 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 16 | — | — | $18,770 | $29,298 | 1.8× | $34,901 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | — | — | $5,651 | $13,275 | 11.8× | $21,930 |
| Total abdominal hysterectomy | CPT | 58150 | 14 | — | — | $5,651 | $17,346 | 17.8× | $25,737 |
| Vaginal hysterectomy | CPT | 58260 | 15 | — | — | $4,223 | $11,450 | 6.3× | $19,000 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 15 | — | — | $5,651 | $13,401 | 9.1× | $21,930 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 15 | — | — | $5,651 | $13,401 | 6.0× | $21,930 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | — | — | $5,651 | $13,401 | 6.6× | $21,930 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 16 | — | — | $32,260 | $50,157 | 1.8× | $59,983 |
| OR procedure for obesity w CC | MS-DRG | 620 | 16 | — | — | $18,896 | $29,378 | 1.8× | $35,134 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 16 | — | — | $17,296 | $26,891 | 1.8× | $32,160 |
| Complex cataract surgery | CPT | 66982 | 15 | — | — | $2,789 | $3,351.5 | 1.5× | $17,500 |
| Cataract surgery with lens implant | CPT | 66984 | 15 | — | — | $2,789 | $3,351.5 | 1.5× | $21,930 |
| Intravitreal injection | CPT | 67028 | 15 | — | — | $1,291 | $1,807 | 5.3× | $3,500 |
| Vitrectomy mechanical | CPT | 67042 | 15 | — | — | $4,916 | $11,205 | 4.4× | $19,000 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 16 | — | — | $14,183 | $22,138 | 1.8× | $26,371 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 16 | — | — | $23,120 | $36,086 | 1.9× | $42,988 |
| PCI single major coronary artery | CPT | 92920 | 14 | — | — | $5,651 | $13,050 | 2.3× | $21,930 |
| PCI with drug-eluting stent | CPT | 92928 | 14 | — | — | $5,651 | $15,600 | 1.6× | $21,930 |
| PCI bypass graft | CPT | 92937 | 14 | — | — | $5,651 | $15,600 | 1.4× | $21,930 |
| Left heart catheterization | CPT | 93452 | 14 | — | — | $4,916 | $10,170 | 3.3× | $18,870 |
| Coronary angiography with cath | CPT | 93455 | 14 | — | — | $4,916 | $10,170 | 3.2× | $18,870 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | — | — | $4,916 | $10,170 | 3.3× | $18,870 |