| Knee arthroscopy with meniscectomy | CPT | 29881 | 5 | $4,208.34 |
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | $1,166.53 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | $1,166.53 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 5 | $9,332.7 |
| ACL reconstruction | CPT | 29888 | 5 | $9,332.7 |
| Heart failure & shock w MCC | MS-DRG | 291 | 5 | $15,099 |
| Heart failure & shock w CC | MS-DRG | 292 | 5 | $10,311 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 5 | $7,195.16 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 5 | $9,547.08 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 5 | $14,220 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 5 | $9,063.7 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 5 | $7,196.27 |
| AMI discharged alive w MCC | MS-DRG | 280 | 5 | $18,626 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | $11,083 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 5 | $23,106 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 5 | $12,087 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 5 | $8,498.85 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 5 | $9,836.64 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 5 | $7,883.34 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 5 | $18,170 |
| COPD w MCC | MS-DRG | 190 | 5 | $13,160 |
| COPD w CC | MS-DRG | 191 | 5 | $10,245 |
| COPD w/o CC/MCC | MS-DRG | 192 | 5 | $8,031.99 |
| GI hemorrhage w CC | MS-DRG | 378 | 5 | $11,761 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 5 | $7,904.25 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 5 | $51,574 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 5 | $27,358 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 5 | $19,493 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 5 | $19,589 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 5 | $16,002 |
