| Fetal non-stress test | CPT | 59025 | 2 | $241.14 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 2 | $19,791 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | $17,702 |
| Heart failure & shock w MCC | MS-DRG | 291 | 2 | $16,417 |
| Heart failure & shock w CC | MS-DRG | 292 | 2 | $8,057.78 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 2 | $7,016.69 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 2 | $9,896.18 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 2 | $15,188 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 2 | $9,386.42 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 2 | $7,150.97 |
| AMI discharged alive w MCC | MS-DRG | 280 | 2 | $14,454 |
| AMI discharged alive w CC | MS-DRG | 281 | 2 | $8,991.68 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 2 | $7,730.87 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 2 | $17,262 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 2 | $12,838 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 2 | $7,137.14 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 2 | $7,778.39 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 2 | $7,936.73 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 2 | $14,026 |
| COPD w MCC | MS-DRG | 190 | 2 | $18,235 |
| COPD w CC | MS-DRG | 191 | 2 | $10,876 |
| GI hemorrhage w CC | MS-DRG | 378 | 2 | $9,252.51 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | $12,247 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 2 | $10,106 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 2 | $14,595 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 2 | $36,908 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 2 | $20,263 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 2 | $20,722 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 2 | $20,814 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 2 | $16,576 |