| Office visit, established patient, 20-29 minutes | CPT | 99213 | 6 | $230.04 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 6 | $237.17 |
| MRI brain with contrast | CPT | 70552 | 5 | $1,924.06 |
| CT head without contrast | CPT | 70450 | 5 | $1,784.18 |
| CT head with contrast | CPT | 70460 | 5 | $2,851.85 |
| CT head with and without contrast | CPT | 70470 | 5 | $2,606.7 |
| CT neck with contrast | CPT | 70491 | 5 | $2,189.62 |
| CT chest without contrast | CPT | 71250 | 5 | $2,214.22 |
| CT chest with contrast | CPT | 71260 | 5 | $2,642.02 |
| CT chest with and without contrast | CPT | 71270 | 5 | $2,940.47 |
| Chest X-ray single view | CPT | 71045 | 5 | $328.92 |
| Chest X-ray 2 views | CPT | 71046 | 5 | $298.25 |
| Upper GI endoscopy diagnostic | CPT | 43235 | 5 | $1,656.33 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 5 | $1,398.23 |
| Heart failure & shock w MCC | MS-DRG | 291 | 5 | $4,764.02 |
| Heart failure & shock w CC | MS-DRG | 292 | 5 | $3,198.51 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 5 | $1,412.34 |
| Kidney/UTI w MCC | MS-DRG | 689 | 5 | $3,957.74 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 5 | $4,266.76 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 5 | $2,686.86 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 5 | $2,016.12 |
| AMI discharged alive w MCC | MS-DRG | 280 | 5 | $5,765.9 |
| AMI discharged alive w CC | MS-DRG | 281 | 5 | $3,328.44 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 5 | $2,602.93 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 5 | $3,085.78 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 5 | $6,535.31 |
| COPD w MCC | MS-DRG | 190 | 5 | $4,001.98 |
| MRI brain without contrast | CPT | 70551 | 5 | $1,167.58 |
| GI hemorrhage w CC | MS-DRG | 378 | 5 | $3,543.01 |
| MRI brain with and without contrast | CPT | 70553 | 5 | $1,797.23 |
