| behavioral |
| Psychoses | MS-DRG | 885 | 17 | — | — | $2,778 | $13,155 | 1.0× | $24,001 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 17 | — | — | $2,778 | $19,390 | 0.96× | $33,870 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 17 | — | — | $2,778 | $10,553 | 0.98× | $17,315 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 17 | — | — | $2,778 | $7,510.58 | 0.98× | $12,875 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 17 | — | — | $2,778 | $16,155 | 1.0× | $27,524 |
| COPD w MCC | MS-DRG | 190 | 17 | — | — | $2,778 | $11,442 | 1.0× | $19,121 |
| COPD w CC | MS-DRG | 191 | 17 | — | — | $2,778 | $8,842.76 | 1.0× | $15,159 |
| COPD w/o CC/MCC | MS-DRG | 192 | 17 | — | — | $2,778 | $7,173.59 | 1.0× | $12,326 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 17 | — | — | $2,778 | $8,537.78 | 1.0× | $14,636 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 17 | — | — | $2,778 | $6,982.95 | 1.0× | $11,998 |
| AMI discharged alive w MCC | MS-DRG | 280 | 18 | — | — | $9,027.7 | $17,339 | 1.1× | $27,948 |
| AMI discharged alive w CC | MS-DRG | 281 | 18 | — | — | $5,069.9 | $10,128 | 1.0× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 18 | — | — | $3,988.05 | $7,965.88 | 1.0× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 17 | — | — | $2,778 | $13,331 | 1.0× | $22,217 |
| Heart failure & shock w CC | MS-DRG | 292 | 17 | — | — | $2,778 | $8,893.04 | 0.99× | $15,187 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 17 | — | — | $2,778 | $6,407.08 | 1.0× | $11,009 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 17 | — | — | $2,778 | $12,482 | 1.0× | $20,533 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 17 | — | — | $2,778 | $7,908.37 | 1.0× | $13,557 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 17 | — | — | $2,778 | $6,491.13 | 1.0× | $11,153 |
| GI hemorrhage w CC | MS-DRG | 378 | 17 | — | — | $2,778 | $10,215 | 1.0× | $16,854 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 17 | — | — | $2,778 | $7,091.89 | 1.0× | $12,185 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 17 | — | — | $2,778 | $8,209.32 | 1.0× | $14,105 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 17 | — | — | $2,778 | $15,372 | 1.0× | $25,964 |
| Kidney/UTI w MCC | MS-DRG | 689 | 17 | — | — | $2,778 | $12,194 | 1.1× | $19,927 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 17 | — | — | $2,778 | $8,402.06 | 1.0× | $14,404 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 17 | — | — | $2,778 | $19,126 | 1.0× | $33,409 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 17 | — | — | $2,778 | $10,693 | 1.0× | $17,555 |
| maternity |
| C-section with postpartum | CPT | 59515 | 3 | — | — | $1,941.49 | $2,098.91 | 1.7× | $12,483 |
| office |
| Office visit, established patient, 5 min | CPT | 99211 | 1 | — | — | $26.61 | $26.75 | 0.42× | $32.42 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $334.95 | $1,083.16 | 1.2× | $3,704 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $334.95 | $1,083.16 | 1.1× | $4,958 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 14 | — | — | $130.67 | $846.22 | 1.0× | $3,500 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 14 | — | — | $328.5 | $1,011.43 | 1.1× | $3,500 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $328.5 | $1,070.99 | 1.2× | $4,958 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | — | $429.26 | $1,396.09 | 1.2× | $4,958 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $429.26 | $1,396.09 | 1.2× | $4,958 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 14 | — | — | $2,236.46 | $16,433 | 4.0× | $27,115 |
| Total hip replacement | CPT | 27130 | 14 | — | — | $5,388 | $12,790 | 3.0× | $21,421 |
| Total knee replacement | CPT | 27447 | 14 | — | — | $5,388 | $12,790 | 3.1× | $21,421 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | — | $2,162.32 | $2,629.85 | 1.6× | $13,933 |
| Knee revision arthroplasty all components | CPT | 27487 | 5 | — | — | $2,705.82 | $3,290.87 | 1.6× | $13,933 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $1,444 | $5,460 | 16.7× | $11,621 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | — | — | $2,398.52 | $7,006.82 | 2.1× | $12,483 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | — | — | $1,088.27 | $3,816.73 | 1.9× | $11,621 |
| ACL reconstruction | CPT | 29888 | 15 | — | — | $3,300.05 | $6,691.4 | 2.0× | $11,621 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 17 | — | — | $6,182 | $43,379 | 1.0× | $78,186 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 17 | — | — | $6,182 | $23,040 | 0.99× | $40,247 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 17 | — | — | $6,182 | $16,450 | 1.0× | $28,112 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 17 | — | — | $6,182 | $16,513 | 1.0× | $28,238 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 17 | — | — | $6,182 | $13,602 | 1.0× | $22,435 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 17 | — | — | $6,182 | $33,234 | 1.0× | $60,097 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | — | — | $4,833.51 | $6,071.75 | 3.9× | $14,887 |
| 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 | 18 | — | — | $17,978 | $33,803 | 1.1× | $61,515 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 18 | — | — | $10,370 | $20,033 | 1.1× | $36,028 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | — | — | $1,888.85 | $6,385.33 | 3.6× | $14,887 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $1,888.85 | $6,385.33 | 3.4× | $14,887 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 18 | — | — | $9,144 | $28,075 | 1.0× | $50,076 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 18 | — | — | $9,144 | $20,148 | 0.99× | $35,329 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 18 | — | — | $8,725.2 | $15,681 | 0.98× | $27,012 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | — | — | $1,888.85 | $6,071.75 | 5.4× | $11,526 |
| Total abdominal hysterectomy | CPT | 58150 | 5 | — | — | $1,552.14 | $1,887.73 | 1.9× | $15,605 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 14 | — | — | $3,110.01 | $9,530.73 | 4.3× | $15,605 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | — | — | $1,888.85 | $6,245.41 | 3.1× | $12,483 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 18 | — | — | $6,182 | $26,814 | 0.99× | $46,424 |
| OR procedure for obesity w CC | MS-DRG | 620 | 18 | — | — | $6,182 | $16,763 | 1.0× | $28,880 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 18 | — | — | $6,182 | $15,616 | 1.0× | $28,880 |
| Complex cataract surgery | CPT | 66982 | 15 | — | — | $849.94 | $2,785.62 | 1.3× | $12,483 |
| Cataract surgery with lens implant | CPT | 66984 | 15 | — | — | $849.94 | $2,785.62 | 1.3× | $12,483 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 17 | — | — | $6,182 | $12,065 | 0.98× | $20,410 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 17 | — | — | $6,182 | $19,047 | 1.00× | $33,271 |