| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | $3,998.92 |
| Total hip replacement | CPT | 27130 | 5 | $17,412 |
| Total knee replacement | CPT | 27447 | 5 | $17,412 |
| Total shoulder arthroplasty | CPT | 23472 | 5 | $17,412 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | $8,844.69 |
| ACL reconstruction | CPT | 29888 | 5 | $8,844.69 |
| Heart failure & shock w MCC | MS-DRG | 291 | 5 | $13,012 |
| Heart failure & shock w CC | MS-DRG | 292 | 5 | $9,011.37 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 5 | $6,307.27 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 5 | $19,979 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 5 | $31,356 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 5 | $8,045.76 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 5 | $12,346 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 5 | $7,894.54 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 5 | $6,003.85 |
| AMI discharged alive w MCC | MS-DRG | 280 | 5 | $16,359 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | $9,674.54 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 5 | $7,653.39 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 5 | $9,015.32 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 5 | $7,057.42 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 5 | $18,752 |
| COPD w MCC | MS-DRG | 190 | 5 | $11,597 |
| COPD w CC | MS-DRG | 191 | 5 | $9,216.94 |
| COPD w/o CC/MCC | MS-DRG | 192 | 5 | $7,351.94 |
| GI hemorrhage w CC | MS-DRG | 378 | 5 | $10,296 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 5 | $6,774.75 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 5 | $48,769 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 5 | $25,673 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 5 | $17,383 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 5 | $17,170 |
