| MRI brain without contrast | CPT | 70551 | 15 | $223.98 |
| CT head without contrast | CPT | 70450 | 15 | $98.14 |
| CT head with contrast | CPT | 70460 | 15 | $164.66 |
| CT head with and without contrast | CPT | 70470 | 15 | $164.66 |
| CT neck with contrast | CPT | 70491 | 15 | $164.66 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 15 | $17,798 |
| Major joint replacement w MCC | MS-DRG | 469 | 15 | $27,987 |
| Heart failure & shock w MCC | MS-DRG | 291 | 15 | $11,845 |
| Heart failure & shock w CC | MS-DRG | 292 | 15 | $7,833.59 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 15 | $5,222.39 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 15 | $7,193.25 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 15 | $7,469.13 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 15 | $11,109 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 15 | $6,788.19 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 15 | $5,223.31 |
| AMI discharged alive w MCC | MS-DRG | 280 | 15 | $14,801 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 15 | $6,671.93 |
| COPD w MCC | MS-DRG | 190 | 15 | $10,221 |
| COPD w CC | MS-DRG | 191 | 15 | $7,778.23 |
| COPD w/o CC/MCC | MS-DRG | 192 | 15 | $5,923.63 |
| GI hemorrhage w CC | MS-DRG | 378 | 15 | $9,048.77 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 15 | $5,816.6 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 15 | $15,049 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 15 | $14,465 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 15 | $13,918 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 15 | $22,119 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 15 | $15,528 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 15 | $15,608 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 15 | $12,602 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 15 | $31,437 |