| Fractures of femur w/o MCC | MS-DRG | 533 | 3 | $5,525 |
| COPD w/o CC/MCC | MS-DRG | 192 | 3 | $5,525 |
| GI hemorrhage w CC | MS-DRG | 378 | 3 | $5,525 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 3 | $5,525 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 3 | $5,525 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 3 | $5,525 |
| Heart failure & shock w MCC | MS-DRG | 291 | 3 | $5,525 |
| Heart failure & shock w CC | MS-DRG | 292 | 3 | $5,525 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 3 | $5,525 |
| Psychoses | MS-DRG | 885 | 3 | $5,525 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 3 | $5,525 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 3 | $5,525 |
| Kidney/UTI w MCC | MS-DRG | 689 | 3 | $5,525 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 3 | $5,525 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 3 | $5,525 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 3 | $5,525 |
| AMI discharged alive w MCC | MS-DRG | 280 | 3 | $5,525 |
| AMI discharged alive w CC | MS-DRG | 281 | 3 | $5,525 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 3 | $5,525 |
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 3 | $5,525 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 3 | $5,525 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 3 | $5,525 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 3 | $5,525 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 3 | $5,525 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 3 | $5,525 |
| COPD w MCC | MS-DRG | 190 | 3 | $5,525 |
| COPD w CC | MS-DRG | 191 | 3 | $5,525 |
| Major joint replacement w MCC | MS-DRG | 469 | 2 | $11,409 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 2 | $11,409 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 2 | $11,409 |
