| Knee arthroscopy with meniscectomy | CPT | 29881 | 3 | $3,164.95 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 3 | $30 |
| Total hip replacement | CPT | 27130 | 3 | $12,419 |
| Total knee replacement | CPT | 27447 | 3 | $12,419 |
| CABG single arterial graft | CPT | 33533 | 3 | $30 |
| CABG 2 arterial grafts | CPT | 33534 | 3 | $30 |
| Total shoulder arthroplasty | CPT | 23472 | 3 | $16,960 |
| Hip hemiarthroplasty | CPT | 27125 | 3 | $12,419 |
| Knee revision arthroplasty single component | CPT | 27486 | 3 | $12,419 |
| Knee revision arthroplasty all components | CPT | 27487 | 3 | $16,960 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 3 | $7,018.79 |
| ACL reconstruction | CPT | 29888 | 3 | $7,018.79 |
| Heart failure & shock w MCC | MS-DRG | 291 | 3 | $10,692 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | $7,070.94 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 3 | $4,713.96 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | $10,028 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | $6,127.32 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 3 | $4,714.8 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | $13,360 |
| AMI discharged alive w CC | MS-DRG | 281 | 3 | $7,654.78 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 3 | $6,022.38 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 3 | $6,711.98 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 3 | $5,234.49 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 3 | $13,015 |
| COPD w MCC | MS-DRG | 190 | 3 | $9,225.54 |
| COPD w CC | MS-DRG | 191 | 3 | $7,020.97 |
| COPD w/o CC/MCC | MS-DRG | 192 | 3 | $5,346.93 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 3 | $38,282 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 3 | $19,965 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 3 | $14,016 |
