| Knee arthroscopy with meniscectomy | CPT | 29881 | 4 | $1,188.84 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | $1,358.55 |
| Total hip replacement | CPT | 27130 | 4 | $2,936.67 |
| Total knee replacement | CPT | 27447 | 4 | $3,189.55 |
| CABG single arterial graft | CPT | 33533 | 4 | $3,422.43 |
| CABG 2 arterial grafts | CPT | 33534 | 4 | $3,882.27 |
| Total shoulder arthroplasty | CPT | 23472 | 4 | $2,778.32 |
| Hip hemiarthroplasty | CPT | 27125 | 4 | $2,015.73 |
| Knee revision arthroplasty single component | CPT | 27486 | 4 | $2,660.62 |
| Knee revision arthroplasty all components | CPT | 27487 | 4 | $3,695.31 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 4 | $1,548.35 |
| ACL reconstruction | CPT | 29888 | 4 | $1,929.95 |
| Heart failure & shock w MCC | MS-DRG | 291 | 4 | $13,926 |
| Heart failure & shock w CC | MS-DRG | 292 | 4 | $9,520.59 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 4 | $6,889.44 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 4 | $12,458 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 4 | $7,902.77 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 4 | $5,820.21 |
| AMI discharged alive w MCC | MS-DRG | 280 | 4 | $17,152 |
| AMI discharged alive w CC | MS-DRG | 281 | 4 | $10,140 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 4 | $7,752.69 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 4 | $9,317.72 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 4 | $7,108.87 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 4 | $19,054 |
| COPD w MCC | MS-DRG | 190 | 4 | $12,325 |
| COPD w CC | MS-DRG | 191 | 4 | $9,459.52 |
| COPD w/o CC/MCC | MS-DRG | 192 | 4 | $7,494.96 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 4 | $51,678 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 4 | $26,118 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 4 | $17,541 |
