| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | $3,924.82 |
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | $1,343.94 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | $7,875.26 |
| ACL reconstruction | CPT | 29888 | 5 | $11,307 |
| Heart failure & shock w MCC | MS-DRG | 291 | 5 | $31,981 |
| Heart failure & shock w CC | MS-DRG | 292 | 5 | $21,426 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 5 | $15,439 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 5 | $47,845 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 5 | $75,321 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 5 | $18,428 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 5 | $28,910 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 5 | $18,065 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 5 | $13,461 |
| AMI discharged alive w MCC | MS-DRG | 280 | 5 | $39,102 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | $22,456 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 5 | $17,487 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 5 | $20,802 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 5 | $16,030 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 5 | $44,488 |
| COPD w MCC | MS-DRG | 190 | 5 | $27,091 |
| COPD w CC | MS-DRG | 191 | 5 | $21,288 |
| COPD w/o CC/MCC | MS-DRG | 192 | 5 | $16,750 |
| GI hemorrhage w CC | MS-DRG | 378 | 5 | $23,937 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 5 | $15,354 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 5 | $117,054 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 5 | $61,236 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 5 | $41,214 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 5 | $40,686 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 5 | $31,696 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 5 | $84,699 |
