| Knee arthroscopy with meniscectomy | CPT | 29881 | 3 | $1,137 |
| Total hip replacement | CPT | 27130 | 3 | $2,710 |
| Total knee replacement | CPT | 27447 | 3 | $2,674 |
| Total shoulder arthroplasty | CPT | 23472 | 3 | $3,169 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 3 | $2,255 |
| ACL reconstruction | CPT | 29888 | 3 | $2,054 |
| Heart failure & shock w MCC | MS-DRG | 291 | 3 | $9,795.34 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | $6,465.17 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 3 | $4,119.18 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 3 | $5,857.84 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | $9,052.88 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | $5,550.04 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 3 | $4,200.26 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | $12,322 |
| AMI discharged alive w CC | MS-DRG | 281 | 3 | $6,920.1 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 3 | $5,443.44 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 3 | $14,933 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 3 | $7,634.03 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 3 | $5,167.18 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 3 | $6,155.87 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 3 | $4,674.71 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 3 | $12,135 |
| COPD w MCC | MS-DRG | 190 | 3 | $8,430.54 |
| COPD w CC | MS-DRG | 191 | 3 | $6,449.4 |
| COPD w/o CC/MCC | MS-DRG | 192 | 3 | $4,858.63 |
| GI hemorrhage w CC | MS-DRG | 378 | 3 | $7,401.31 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 3 | $4,779.81 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 3 | $34,472 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 3 | $17,745 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 3 | $12,394 |
