| Knee arthroscopy with meniscectomy | CPT | 29881 | 21 | $3,211.94 |
| Total hip replacement | CPT | 27130 | 21 | $12,598 |
| Total knee replacement | CPT | 27447 | 21 | $12,598 |
| Total shoulder arthroplasty | CPT | 23472 | 21 | $17,204 |
| Hip hemiarthroplasty | CPT | 27125 | 21 | $12,598 |
| Knee revision arthroplasty single component | CPT | 27486 | 21 | $12,598 |
| Knee revision arthroplasty all components | CPT | 27487 | 21 | $17,204 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 21 | $7,120.79 |
| ACL reconstruction | CPT | 29888 | 21 | $7,120.79 |
| Heart failure & shock w MCC | MS-DRG | 291 | 21 | $11,601 |
| Heart failure & shock w CC | MS-DRG | 292 | 21 | $7,724.45 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 21 | $5,201.42 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 21 | $7,105.73 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 21 | $10,889 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 21 | $6,714.35 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 21 | $5,202.31 |
| AMI discharged alive w MCC | MS-DRG | 280 | 21 | $14,456 |
| AMI discharged alive w CC | MS-DRG | 281 | 21 | $8,349.41 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 21 | $6,602.01 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 21 | $7,340.2 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 21 | $5,758.62 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 21 | $14,087 |
| COPD w MCC | MS-DRG | 190 | 21 | $10,031 |
| COPD w CC | MS-DRG | 191 | 21 | $7,670.96 |
| COPD w/o CC/MCC | MS-DRG | 192 | 21 | $5,878.98 |
| GI hemorrhage w CC | MS-DRG | 378 | 21 | $8,898.6 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 21 | $5,775.56 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 21 | $41,135 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 21 | $21,527 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 21 | $15,159 |
