| behavioral |
| Psychoses | MS-DRG | 885 | 15 | — | — | $2,778 | $11,513 | 0.90× | $26,286 |
| inpatient |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 16 | — | — | $2,778 | $17,174 | 0.85× | $37,095 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 16 | — | — | $2,778 | $8,779.44 | 0.82× | $18,963 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 16 | — | — | $2,778 | $5,942.45 | 0.78× | $12,835 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 16 | — | — | $2,778 | $13,956 | 0.90× | $30,144 |
| COPD w MCC | MS-DRG | 190 | 16 | — | — | $2,778 | $9,695.45 | 0.86× | $20,942 |
| COPD w CC | MS-DRG | 191 | 16 | — | — | $2,778 | $7,417.06 | 0.84× | $16,021 |
| COPD w/o CC/MCC | MS-DRG | 192 | 16 | — | — | $2,778 | $5,587.61 | 0.80× | $12,069 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 16 | — | — | $2,778 | $7,079.5 | 0.83× | $15,291 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 16 | — | — | $2,778 | $5,376.11 | 0.80× | $11,612 |
| AMI discharged alive w MCC | MS-DRG | 280 | 17 | — | — | $10,839 | $15,219 | 0.97× | $30,609 |
| AMI discharged alive w CC | MS-DRG | 281 | 17 | — | — | $6,087.33 | $8,546.72 | 0.88× | $26,466 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 17 | — | — | $4,788.37 | $6,722.97 | 0.86× | $19,849 |
| Heart failure & shock w MCC | MS-DRG | 291 | 16 | — | — | $2,778 | $11,265 | 0.88× | $24,332 |
| Heart failure & shock w CC | MS-DRG | 292 | 16 | — | — | $2,778 | $7,435.2 | 0.83× | $16,060 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 16 | — | — | $2,778 | $4,737.21 | 0.76× | $10,232 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 16 | — | — | $2,778 | $10,411 | 0.86× | $22,488 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 16 | — | — | $2,778 | $6,382.76 | 0.82× | $13,786 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 16 | — | — | $2,778 | $4,830.45 | 0.78× | $10,434 |
| GI hemorrhage w CC | MS-DRG | 378 | 16 | — | — | $2,778 | $8,511.8 | 0.85× | $18,385 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 16 | — | — | $2,778 | $5,496.97 | 0.80× | $11,873 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 16 | — | — | $2,778 | $5,695.32 | 0.71× | $14,551 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 16 | — | — | $2,778 | $13,165 | 0.87× | $28,436 |
| Kidney/UTI w MCC | MS-DRG | 689 | 16 | — | — | $2,778 | $10,104 | 0.87× | $21,824 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 16 | — | — | $2,778 | $6,929.25 | 0.83× | $14,967 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 16 | — | — | $2,778 | $16,940 | 0.91× | $36,589 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 16 | — | — | $2,778 | $8,901.15 | 0.86× | $19,226 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | — | $334.95 | $1,163.16 | 1.3× | $4,419 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | — | $334.95 | $1,163.16 | 1.2× | $4,958 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 14 | — | — | $130.67 | $857.42 | 1.0× | $4,419 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 14 | — | — | $328.5 | $1,078.27 | 1.2× | $4,419 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | — | $328.5 | $1,130.54 | 1.3× | $4,958 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | — | $429.26 | $1,486.25 | 1.2× | $4,958 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | — | $429.26 | $1,486.25 | 1.2× | $4,958 |
| surgery |
| Total shoulder arthroplasty | CPT | 23472 | 14 | — | — | $2,236.46 | $16,670 | 4.0× | $27,505 |
| Total hip replacement | CPT | 27130 | 14 | — | — | $5,388 | $13,933 | 3.2× | $21,421 |
| Total knee replacement | CPT | 27447 | 14 | — | — | $5,388 | $13,933 | 3.3× | $21,421 |
| Knee revision arthroplasty single component | CPT | 27486 | 5 | — | — | $2,162.32 | $2,629.85 | 1.6× | $17,086 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $2,866 | $5,460 | 16.7× | $11,621 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 15 | — | — | $2,398.52 | $7,679 | 2.3× | $12,483 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 15 | — | — | $1,088.27 | $4,051.43 | 2.0× | $11,621 |
| ACL reconstruction | CPT | 29888 | 15 | — | — | $3,300.05 | $7,359.05 | 2.2× | $11,621 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 16 | — | — | $6,182 | $39,644 | 0.92× | $85,630 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 16 | — | — | $6,182 | $20,407 | 0.88× | $44,078 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 16 | — | — | $6,182 | $14,254 | 0.87× | $30,788 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 16 | — | — | $6,182 | $14,318 | 0.87× | $30,926 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 16 | — | — | $6,182 | $11,376 | 0.84× | $24,571 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 16 | — | — | $6,182 | $30,472 | 0.94× | $65,818 |
| Laparoscopic appendectomy | CPT | 44970 | 14 | — | — | $4,903.08 | $6,193.37 | 4.0× | $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 | 17 | — | — | $21,586 | $33,496 | 1.1× | $61,515 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 17 | — | — | $12,451 | $19,119 | 1.0× | $36,028 |
| Laparoscopic cholecystectomy | CPT | 47562 | 14 | — | — | $1,888.85 | $6,815.56 | 3.8× | $14,887 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 14 | — | — | $1,888.85 | $6,815.56 | 3.6× | $14,887 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 17 | — | — | $9,144 | $25,349 | 0.91× | $54,844 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 17 | — | — | $9,144 | $17,884 | 0.88× | $38,693 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 17 | — | — | $9,144 | $13,674 | 0.86× | $29,583 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | — | — | $1,888.85 | $6,193.37 | 5.5× | $11,526 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 15 | — | — | $1,888.85 | $6,595 | 4.5× | $13,933 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 14 | — | — | $3,110.01 | $10,128 | 4.5× | $15,605 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | — | — | $1,888.85 | $6,477.23 | 3.2× | $12,483 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 17 | — | — | $6,182 | $23,884 | 0.88× | $50,844 |
| OR procedure for obesity w CC | MS-DRG | 620 | 17 | — | — | $6,182 | $13,990 | 0.86× | $29,781 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 17 | — | — | $6,182 | $12,805 | 0.84× | $28,880 |
| Complex cataract surgery | CPT | 66982 | 15 | — | — | $849.94 | $2,992.35 | 1.3× | $12,483 |
| Cataract surgery with lens implant | CPT | 66984 | 15 | — | — | $849.94 | $2,992.35 | 1.4× | $12,483 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 16 | — | — | $6,182 | $10,349 | 0.84× | $22,353 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 16 | — | — | $6,182 | $16,870 | 0.88× | $36,438 |