Cleveland Clinic Indian River Hospital
1000 36th St, Vero Beach, FL 32960 · (772) 567-4311
The money
$23what care cost the hospital for every $100 it billed
−$45.8Mnet income, all sources
−15.8%margin on patient care alone
$18.0Mcost of charity care (4.1% of costs)
$16.6Munpaid bills written off (bad debt)
310beds
From the hospital's Medicare cost report for the year ending December 2024. Non-profit hospitals must have a financial assistance (charity care) policy; ask for it if a bill is hard to pay.
Hospital stays
Medicare figures are 2024 averages for this hospital; the bars show how much of the bill was actually paid. Cash and insurer prices are from the hospital's own price file; insurer prices are commercial plans only.
Billed (list price)Actually paid (Medicare + patient)
| Stay | Medicare stays | Billed | Paid | Insurers (median) | |
|---|---|---|---|---|---|
| Sepsis, with major complications 871 | 592 | $52,450 | $13,459 | $20,733$15,863–$30,117 · 18 plans | |
| Heart failure, with major complications 291 | 202 | $31,596 | $9,152 | $13,703$10,644–$19,904 · 18 plans | |
| Heart attack, with major complications 280 | 192 | $41,575 | $11,381 | $17,121$13,182–$24,870 · 18 plans | |
| Lung infection, with major complications 177 | 114 | $41,817 | $11,448 | $16,679$12,854–$24,228 · 18 plans | |
| Pneumonia, with major complications 193 | 111 | $40,681 | $9,410 | $14,029$10,887–$20,379 · 18 plans | |
| Sepsis 872 | 102 | $32,078 | $7,550 | $10,922$8,580–$15,865 · 18 plans | |
| Heart procedure through a catheter (e.g. ablation, valve clip) 274 | 95 | $57,276 | $22,597 | $35,134$26,552–$51,812 · 18 plans | |
| Stomach or intestinal bleeding, with complications 378 | 91 | $32,408 | $7,230 | $10,468$8,243–$15,205 · 18 plans | |
| Other kidney and urinary problems, with major complications 698 | 85 | $42,127 | $11,021 | $17,658$13,580–$25,650 · 18 plans | |
| Stroke, with major complications 064 | 79 | $51,948 | $13,056 | $21,464$16,405–$31,179 · 18 plans | |
| Urinary tract infection, with major complications 689 | 77 | $29,000 | $8,266 | $12,384$9,666–$17,989 · 18 plans | |
| COPD, with major complications 190 | 75 | $35,656 | $7,955 | $11,823$9,249–$17,174 · 18 plans | |
| Hip or thigh bone surgery (not replacement), with complications 481 | 72 | $60,803 | $13,762 | $22,356$17,067–$39,291 · 18 plans | |
| Infection needing surgery, with major complications 853 | 66 | $129,231 | $36,127 | $52,712$39,600–$76,569 · 18 plans | |
| Stroke, with complications or clot-busting drug 065 | 58 | $31,075 | $7,292 | $10,783$8,477–$15,664 · 18 plans | |
| Stomach or intestinal bleeding, with major complications 377 | 57 | $47,965 | $12,561 | $19,511$14,956–$28,342 · 18 plans | |
| Stomach and digestive disorders 392 | 57 | $21,721 | $5,991 | $8,321$6,650–$12,087 · 18 plans | |
| Irregular heartbeat, with complications 309 | 56 | $24,798 | $5,625 | $7,853$6,302–$11,406 · 18 plans | |
| Skin infection (cellulitis) 603 | 54 | $22,170 | $6,472 | $9,296$7,373–$13,503 · 18 plans | |
| Kidney failure, with major complications 682 | 54 | $33,535 | $10,197 | $15,807$12,206–$22,962 · 18 plans | |
| Heart attack, with complications 281 | 51 | $27,382 | $6,712 | $9,810$7,755–$14,250 · 18 plans | |
| Heart stent 322 | 50 | $85,541 | $13,008 | $18,817$14,441–$27,334 · 18 plans | |
| Urinary tract infection 690 | 49 | $23,414 | $5,966 | $8,640$6,886–$12,551 · 18 plans | |
| Bowel obstruction, with complications 389 | 45 | $19,922 | $6,070 | $8,430$6,730–$12,245 · 18 plans | |
| Dehydration and electrolyte problems, with major complications 640 | 45 | $30,147 | $9,097 | $14,256$11,054–$20,707 · 18 plans | |
| Bowel surgery, with complications 330 | 43 | $73,296 | $17,184 | $25,627$19,465–$36,708 · 18 plans | |
| Hip replacement after a hip fracture 522 | 40 | $60,085 | $14,366 | $22,603$17,251–$39,589 · 18 plans | |
| Bowel surgery, with major complications 329 | 39 | $110,395 | $29,674 | $47,017$34,350–$64,351 · 18 plans | |
| Back problems (no surgery) 552 | 38 | $28,452 | $7,084 | $10,260$8,089–$14,904 · 18 plans | |
| Heart valve replacement through a catheter (TAVR) 267 | 36 | $184,352 | $33,715 | $50,814$38,191–$73,812 · 18 plans | |
| Permanent Cardiac Pacemaker Implant with Cc 243 | 35 | $79,742 | $16,508 | $22,744$17,355–$33,541 · 18 plans | |
| Irregular heartbeat, with major complications 308 | 35 | $32,591 | $8,853 | $12,851$10,012–$18,667 · 18 plans | |
| Hip or thigh bone surgery (not replacement), with major complications 480 | 34 | $72,037 | $19,278 | $31,084$23,546–$45,840 · 18 plans | |
| Psychoses 885 | 34 | $20,565 | $9,896 | $14,909$11,539–$21,656 · 18 plans | |
| Extracranial Procedures Without Cc/Mcc 039 | 33 | $47,248 | $8,299 | $12,547$9,786–$18,225 · 18 plans | |
| Kidney failure, with complications 683 | 33 | $27,398 | $6,702 | $9,348$7,412–$13,579 · 18 plans | |
| Heart valve replacement through a catheter (TAVR), with major complications 266 | 32 | $188,736 | $43,164 | $65,411$49,026–$95,015 · 18 plans | |
| Mini-stroke (TIA) 069 | 31 | $39,313 | $6,212 | $8,526$6,802–$12,385 · 18 plans | |
| Pulmonary Embolism with Mcc or Acute Cor Pulmonale 175 | 31 | $36,004 | $9,717 | $14,661$11,356–$21,296 · 18 plans | |
| Respiratory failure 189 | 30 | $41,018 | $8,959 | $13,186$10,261–$19,154 · 18 plans | |
| Dehydration and electrolyte problems 641 | 30 | $24,184 | $5,818 | $8,306$6,638–$12,065 · 18 plans | |
| Extracranial Procedures with Cc 038 | 29 | $46,250 | $11,596 | $17,319$13,328–$25,157 · 18 plans | |
| Stomach and digestive disorders, with major complications 391 | 29 | $33,026 | $9,332 | $13,537$10,521–$19,664 · 18 plans | |
| Anemia and blood disorders 812 | 27 | $24,988 | $6,962 | $9,800$7,748–$14,236 · 18 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm with Cc 660 | 26 | $42,285 | $9,561 | $14,107$10,944–$20,492 · 18 plans | |
| Other kidney and urinary problems, with complications 699 | 26 | $30,552 | $7,315 | $10,834$8,514–$15,737 · 18 plans | |
| Craniotomy and Endovascular Intracranial Procedures with Mcc 025 | 25 | $134,666 | $31,356 | $48,529$36,495–$70,492 · 18 plans | |
| Permanent Cardiac Pacemaker Implant with Mcc 242 | 25 | $87,303 | $22,530 | $33,350$25,768–$45,945 · 18 plans | |
| Heart catheterization 287 | 25 | $45,521 | $8,174 | $11,422$8,951–$21,197 · 18 plans | |
| Other digestive problems, with complications 394 | 25 | $26,420 | $6,974 | $9,987$7,886–$14,507 · 18 plans | |
| Pneumonia, with complications 194 | 24 | $25,461 | $6,123 | $8,602$6,858–$12,495 · 18 plans | |
| Gastrointestinal Obstruction with Mcc 388 | 24 | $27,137 | $10,114 | $15,763$12,173–$22,896 · 18 plans | |
| Anemia and blood disorders, with major complications 811 | 24 | $30,803 | $10,160 | $14,989$11,599–$21,772 · 18 plans | |
| Irregular heartbeat 310 | 23 | $20,643 | $4,393 | $6,042$4,958–$8,777 · 18 plans | |
| Heart stent, with major complications or 4+ stents 321 | 23 | $101,242 | $21,500 | $28,420$22,029–$40,356 · 18 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. with Cc 418 | 23 | $64,225 | $12,173 | $18,055$13,875–$26,227 · 18 plans | |
| Cellulitis with Mcc 602 | 22 | $38,540 | $11,601 | $15,170$11,733–$22,036 · 18 plans | |
| Infectious and Parasitic Diseases with O.r. Procedures with Cc 854 | 22 | $71,518 | $14,506 | $21,327$16,303–$30,979 · 18 plans | |
| Major Chest Procedures with Mcc 163 | 21 | $104,500 | $31,936 | $47,837$35,981–$69,486 · 18 plans | |
| Fainting 312 | 21 | $25,278 | $6,440 | $9,303$7,378–$13,513 · 18 plans | |
| Other Vascular Procedures with Cc 253 | 20 | $79,181 | $18,101 | $27,704$21,037–$40,242 · 18 plans | |
| Revision of Hip or Knee Replacement with Cc 467 | 20 | $97,062 | $21,868 | $37,641$28,413–$55,509 · 18 plans | |
| Degenerative Nervous System Disorders with Mcc 056 | 19 | $96,088 | $24,136 | $24,796$18,878–$36,018 · 18 plans | |
| Other circulation problems, with major complications 314 | 19 | $46,230 | $14,143 | $22,256$16,993–$32,329 · 18 plans | |
| Malignancy of Hepatobiliary System or Pancreas with Mcc 435 | 19 | $43,370 | $13,025 | $19,604$15,025–$28,476 · 18 plans | |
| Diabetes, with major complications 637 | 19 | $41,307 | $10,258 | $15,335$11,855–$22,275 · 18 plans | |
| Diabetes, with complications 638 | 19 | $23,387 | $6,715 | $9,566$7,573–$13,895 · 18 plans | |
| Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy with Mcc 896 | 19 | $35,740 | $12,620 | $18,626$14,299–$27,056 · 18 plans | |
| Nervous System Neoplasms with Mcc 054 | 18 | $37,440 | $9,652 | $16,297$12,570–$23,673 · 18 plans | |
| Major Chest Procedures with Cc 164 | 18 | $70,686 | $17,058 | $26,940$20,470–$39,132 · 18 plans | |
| Breathing problem needing a ventilator (up to 4 days) 208 | 18 | $69,600 | $18,449 | $29,338$22,250–$42,616 · 18 plans | |
| Coronary Bypass Without Cardiac Catheterization with Mcc 235 | 18 | $197,250 | $36,322 | $62,639$46,968–$90,987 · 18 plans | |
| Aortic and Heart Assist Procedures Except Pulsation Balloon Without Mcc 269 | 18 | $119,426 | $29,384 | $45,076$33,932–$65,477 · 18 plans | |
| Heart catheterization, with major complications 286 | 18 | $61,401 | $15,624 | $23,618$18,004–$34,258 · 18 plans | |
| Other Kidney and Urinary Tract Procedures with Mcc 673 | 18 | $83,710 | $30,183 | $44,846$33,761–$65,142 · 18 plans | |
| Seizures with Mcc 100 | 17 | $37,683 | $13,327 | $20,672$15,818–$30,028 · 18 plans | |
| Peripheral Vascular Disorders with Cc 300 | 17 | $36,720 | $8,517 | $11,394$8,930–$16,551 · 18 plans | |
| Hip and Femur Procedures Except Major Joint Without Cc/Mcc 482 | 17 | $53,878 | $11,303 | $17,408$13,395–$33,345 · 18 plans | |
| Hip Replacement with Principal Diagnosis of Hip Fracture with Mcc 521 | 17 | $66,967 | $19,362 | $30,635$23,213–$45,178 · 18 plans | |
| Degenerative nerve disorders (e.g. Parkinson's, dementia) 057 | 16 | $27,421 | $9,138 | $13,829$10,738–$20,087 · 18 plans | |
| Intracranial Hemorrhage or Cerebral Infarction Without Cc/Mcc 066 | 16 | $34,593 | $5,257 | $7,305$5,895–$10,611 · 18 plans | |
| Other Cerebrovascular Disorders with Cc 071 | 16 | $38,999 | $8,483 | $10,951$8,602–$15,907 · 18 plans | |
| Pneumothorax with Mcc 199 | 16 | $40,138 | $12,565 | $18,829$14,449–$27,351 · 18 plans | |
| Delirium and other mental confusion 884 | 16 | $24,712 | $10,122 | $17,173$13,220–$24,945 · 18 plans | |
| High blood pressure 305 | 15 | $22,593 | $5,669 | $8,060$6,455–$11,707 · 18 plans | |
| Hip or knee replacement 470 | 15 | $68,432 | $13,350 | $25,083$19,489–$45,604 · 18 plans | |
| Lung infection, with complications 178 | 14 | $29,482 | $7,104 | $10,417$8,206–$15,132 · 18 plans | |
| Other Cardiothoracic Procedures Without Mcc 229 | 14 | $92,448 | $23,374 | $33,616$25,425–$48,830 · 18 plans | |
| Other Vascular Procedures with Mcc 252 | 14 | $96,708 | $23,443 | $37,232$28,110–$54,083 · 18 plans | |
| Gastrointestinal Obstruction Without Cc/Mcc 390 | 14 | $14,760 | $4,510 | $5,806$4,783–$8,434 · 18 plans | |
| Cirrhosis and Alcoholic Hepatitis with Cc 433 | 14 | $34,140 | $7,716 | $11,273$8,841–$16,375 · 18 plans | |
| Fracture or sprain (not hip or thigh) 563 | 14 | $16,471 | $6,471 | $9,558$7,568–$13,884 · 18 plans | |
| Complications of Treatment with Mcc 919 | 14 | $39,478 | $12,921 | $19,541$14,978–$28,385 · 18 plans | |
| Other Cerebrovascular Disorders with Mcc 070 | 13 | $36,382 | $12,243 | $17,769$13,663–$25,811 · 18 plans | |
| Other Disorders of Nervous System with Cc 092 | 13 | $30,766 | $7,370 | $10,919$8,578–$15,861 · 18 plans | |
| Pleural Effusion with Mcc 186 | 13 | $48,247 | $11,410 | $16,635$12,820–$24,163 · 18 plans | |
| Bronchitis and Asthma with Cc/Mcc 202 | 13 | $32,302 | $7,159 | $10,366$8,167–$15,058 · 18 plans | |
| Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 282 | 13 | $29,876 | $5,462 | $7,718$6,202–$11,211 · 18 plans | |
| Other Digestive System Diagnoses with Mcc 393 | 13 | $50,268 | $11,798 | $17,070$13,144–$24,796 · 18 plans | |
| Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Mcc 441 | 13 | $44,948 | $12,894 | $19,156$14,692–$27,825 · 18 plans | |
| Poisoning and Toxic Effects of Drugs with Mcc 917 | 13 | $25,733 | $10,659 | $16,740$12,899–$24,317 · 18 plans | |
| Peritoneal Adhesiolysis with Cc 336 | 12 | $61,897 | $14,542 | $22,507$17,179–$32,694 · 18 plans | |
| Cirrhosis and Alcoholic Hepatitis with Mcc 432 | 12 | $46,516 | $13,533 | $21,008$16,066–$30,515 · 18 plans | |
| Disorders of the Biliary Tract with Mcc 444 | 12 | $41,717 | $11,856 | $17,834$13,711–$25,906 · 18 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Cc 543 | 12 | $32,233 | $7,620 | $10,972$8,617–$15,938 · 18 plans | |
| Medical Back Problems with Mcc 551 | 12 | $35,209 | $10,975 | $17,890$13,752–$25,986 · 18 plans | |
| Postoperative and Post-Traumatic Infections Without Mcc 863 | 12 | $26,998 | $7,557 | $10,651$8,379–$15,472 · 18 plans | |
| Septicemia or Severe Sepsis with Mv >96 Hours 870 | 12 | $170,021 | $43,252 | $73,773$55,233–$107,161 · 18 plans | |
| Traumatic Stupor and Coma >1 Hour with Mcc 082 | 11 | $43,688 | $16,612 | $24,395$18,581–$35,436 · 18 plans | |
| Traumatic Stupor and Coma >1 Hour with Cc 083 | 11 | $37,317 | $9,998 | $14,898$11,531–$21,641 · 18 plans | |
| Other Respiratory System O.r. Procedures with Mcc 166 | 11 | $97,593 | $25,642 | $39,894$30,085–$57,950 · 18 plans | |
| Respiratory Neoplasms with Mcc 180 | 11 | $52,439 | $12,684 | $18,849$14,464–$27,380 · 18 plans | |
| Coronary Bypass with Cardiac Catheterization or Open Ablation with Mcc 233 | 11 | $271,169 | $52,299 | $79,858$61,043–$107,718 · 18 plans | |
| Other Major Cardiovascular Procedures with Mcc 270 | 11 | $118,333 | $35,921 | $56,317$42,275–$81,804 · 18 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures with Cc 516 | 11 | $59,079 | $13,800 | $21,707$16,937–$31,126 · 18 plans | |
| Fractures of Hip and Pelvis Without Mcc 536 | 11 | $17,420 | $5,515 | $8,620$6,871–$12,521 · 18 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Mcc 542 | 11 | $36,371 | $11,350 | $18,855$14,468–$27,388 · 18 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm with Mcc 659 | 11 | $56,574 | $15,581 | $27,120$20,604–$39,394 · 18 plans | |
| Urinary Stones Without Mcc 694 | 11 | $24,129 | $5,899 | $8,343$6,666–$12,120 · 18 plans | |
| Heart Transplant or Implant of Heart Assist System with Mcc 001 | – | – | – | $314,302$222,496–$411,532 · 18 plans | |
| Ms-Drg 002 002 | – | – | – | $127,092$90,251–$400,000 · 18 plans | |
| Ecmo or Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Nec 003 | – | – | – | $226,547$168,632–$329,078 · 18 plans | |
| Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Neck Withou 004 | – | – | – | $147,843$110,213–$214,753 · 18 plans | |
| Liver Transplant with Mcc or Intestinal Transplant 005 | – | – | – | $129,309$96,258–$235,000 · 18 plans | |
| Liver Transplant Without Mcc 006 | – | – | – | $58,155$43,402–$235,000 · 18 plans | |
| Lung Transplant 007 | – | – | – | $138,224$103,073–$200,781 · 18 plans | |
| Ms-Drg 008 008 | – | – | – | $59,821$44,876–$86,894 · 18 plans | |
| Ms-Drg 010 010 | – | – | – | $76,590$57,323–$111,253 · 18 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Mcc 011 | – | – | – | $58,214$43,684–$84,561 · 18 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Cc 012 | – | – | – | $44,999$33,875–$65,365 · 18 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy Without Cc/Mcc 013 | – | – | – | $30,759$23,304–$44,680 · 18 plans | |
| Allogeneic Bone Marrow Transplant 014 | – | – | – | $128,273$95,686–$186,327 · 18 plans | |
| Autologous Bone Marrow Transplant with Cc/Mcc 016 | – | – | – | $63,291$47,452–$91,935 · 18 plans | |
| Ms-Drg 017 017 | – | – | – | $57,982$43,511–$84,223 · 18 plans | |
| Chimeric Antigen Receptor (car) T-Cell and Other Immunotherapies 018 | – | – | – | $460,912$342,594–$669,510 · 18 plans | |
| Ms-Drg 019 019 | – | – | – | $76,151$56,998–$110,616 · 18 plans | |
| Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Mcc 020 | – | – | – | $83,988$62,815–$121,999 · 18 plans | |
| Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Cc 021 | – | – | – | $56,503$42,414–$82,076 · 18 plans | |
| Ms-Drg 022 022 | – | – | – | $33,914$25,646–$49,263 · 18 plans | |
| Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis with Mcc O 023 | – | – | – | $61,162$45,872–$88,843 · 18 plans | |
| Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis Without Mc 024 | – | – | – | $41,754$31,466–$60,650 · 18 plans | |
| Craniotomy and Endovascular Intracranial Procedures with Cc 026 | – | – | – | $33,186$25,106–$48,205 · 18 plans | |
| Craniotomy and Endovascular Intracranial Procedures Without Cc/Mcc 027 | – | – | – | $26,928$20,461–$39,115 · 18 plans | |
| Spinal Procedures with Mcc 028 | – | – | – | $64,130$48,075–$93,153 · 18 plans | |
| Spinal Procedures with Cc or Spinal Neurostimulators 029 | – | – | – | $36,414$27,502–$52,894 · 18 plans | |
| Spinal Procedures Without Cc/Mcc 030 | – | – | – | $23,430$17,865–$34,035 · 18 plans | |
| Ventricular Shunt Procedures with Mcc 031 | – | – | – | $47,823$35,970–$69,466 · 18 plans | |
| Ventricular Shunt Procedures with Cc 032 | – | – | – | $22,745$17,356–$33,039 · 18 plans | |
| Ventricular Shunt Procedures Without Cc/Mcc 033 | – | – | – | $17,749$13,648–$25,782 · 18 plans | |
| Carotid Artery Stent Procedures with Mcc 034 | – | – | – | $39,593$26,918–$54,189 · 18 plans | |
| Carotid Artery Stent Procedures with Cc 035 | – | – | – | $24,452$17,864–$33,467 · 18 plans | |
| Carotid Artery Stent Procedures Without Cc/Mcc 036 | – | – | – | $20,293$14,519–$27,199 · 18 plans | |
| Extracranial Procedures with Mcc 037 | – | – | – | $35,138$26,555–$51,041 · 18 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures with Mcc 040 | – | – | – | $41,213$31,064–$59,864 · 18 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures with Cc or Peripheral Neur 041 | – | – | – | $23,468$17,893–$34,089 · 18 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures Without Cc/Mcc 042 | – | – | – | $18,441$14,161–$26,786 · 18 plans | |
| Ms-Drg 052 052 | – | – | – | $19,333$14,823–$28,083 · 18 plans | |
| Ms-Drg 053 053 | – | – | – | $10,452$8,231–$15,182 · 18 plans | |
| Nervous System Neoplasms Without Mcc 055 | – | – | – | $10,883$8,551–$15,808 · 18 plans | |
| Ms-Drg 058 058 | – | – | – | $18,246$14,017–$26,504 · 18 plans | |
| Ms-Drg 059 059 | – | – | – | $13,245$10,304–$19,239 · 18 plans | |
| Ms-Drg 060 060 | – | – | – | $9,817$7,760–$14,261 · 18 plans | |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 061 | – | – | – | $29,428$22,317–$42,746 · 18 plans | |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 062 | – | – | – | $18,755$14,395–$27,244 · 18 plans | |
| Ms-Drg 063 063 | – | – | – | $14,983$11,595–$21,765 · 18 plans | |
| Ms-Drg 067 067 | – | – | – | $15,676$12,109–$22,771 · 18 plans | |
| Precerebral Occlusion Without Infarction Without Mcc 068 | – | – | – | $9,226$7,321–$13,402 · 18 plans | |
| Other Cerebrovascular Disorders Without Cc/Mcc 072 | – | – | – | $8,071$6,464–$11,724 · 18 plans | |
| Cranial and Peripheral Nerve Disorders with Mcc 073 | – | – | – | $17,124$13,183–$24,873 · 18 plans | |
| Cranial and Peripheral Nerve Disorders Without Mcc 074 | – | – | – | $11,002$8,640–$15,982 · 18 plans | |
| Ms-Drg 075 075 | – | – | – | $20,466$15,665–$29,729 · 18 plans | |
| Ms-Drg 076 076 | – | – | – | $8,808$7,011–$12,794 · 18 plans | |
| Nontraumatic Stupor and Coma with Mcc 080 | – | – | – | $19,319$14,813–$28,062 · 18 plans | |
| Ms-Drg 081 081 | – | – | – | $9,559$7,569–$13,885 · 18 plans | |
| Traumatic Stupor and Coma >1 Hour Without Cc/Mcc 084 | – | – | – | $10,202$8,045–$14,819 · 18 plans | |
| Traumatic Stupor and Coma <1 Hour with Mcc 085 | – | – | – | $24,249$18,472–$35,224 · 18 plans | |
| Traumatic Stupor and Coma <1 Hour with Cc 086 | – | – | – | $13,904$10,794–$20,197 · 18 plans | |
| Traumatic Stupor and Coma <1 Hour Without Cc/Mcc 087 | – | – | – | $9,763$7,720–$14,182 · 18 plans | |
| Concussion with Mcc 088 | – | – | – | $14,428$11,183–$20,958 · 18 plans | |
| Concussion with Cc 089 | – | – | – | $11,726$9,177–$17,033 · 18 plans | |
| Concussion Without Cc/Mcc 090 | – | – | – | $8,786$6,995–$12,763 · 18 plans | |
| Other Disorders of Nervous System with Mcc 091 | – | – | – | $18,745$14,387–$27,228 · 18 plans | |
| Other Disorders of Nervous System Without Cc/Mcc 093 | – | – | – | $8,499$6,782–$12,346 · 18 plans | |
| Bacterial and Tuberculous Infections of Nervous System with Mcc 094 | – | – | – | $37,564$28,356–$54,565 · 18 plans | |
| Ms-Drg 095 095 | – | – | – | $27,529$20,907–$39,988 · 18 plans | |
| Ms-Drg 096 096 | – | – | – | $27,529$20,907–$39,988 · 18 plans | |
| Non-Bacterial Infection of Nervous System Except Viral Meningitis with Mcc 097 | – | – | – | $38,551$29,088–$55,998 · 18 plans | |
| Ms-Drg 098 098 | – | – | – | $24,495$18,655–$35,580 · 18 plans | |
| Ms-Drg 099 099 | – | – | – | $14,542$11,267–$21,123 · 18 plans | |
| Seizures 101 | – | – | – | $9,634$7,624–$13,994 · 18 plans | |
| Headaches with Mcc 102 | – | – | – | $11,964$9,353–$17,379 · 18 plans | |
| Headaches Without Mcc 103 | – | – | – | $8,926$7,099–$12,966 · 18 plans | |
| Orbital Procedures with Cc/Mcc 113 | – | – | – | $25,094$19,100–$36,452 · 18 plans | |
| Ms-Drg 114 114 | – | – | – | $14,441$11,192–$20,977 · 18 plans | |
| Extraocular Procedures Except Orbit 115 | – | – | – | $16,383$12,633–$23,797 · 18 plans | |
| Intraocular Procedures with Cc/Mcc 116 | – | – | – | $19,299$14,798–$28,033 · 18 plans | |
| Ms-Drg 117 117 | – | – | – | $11,580$9,068–$16,820 · 18 plans | |
| Acute Major Eye Infections with Cc/Mcc 121 | – | – | – | $12,416$9,689–$18,036 · 18 plans | |
| Ms-Drg 122 122 | – | – | – | $8,387$6,699–$12,183 · 18 plans | |
| Neurological Eye Disorders 123 | – | – | – | $8,524$6,800–$12,382 · 18 plans | |
| Other Disorders of the Eye with Mcc or Thrombolytic Agent 124 | – | – | – | $14,122$10,955–$20,513 · 18 plans | |
| Other Disorders of the Eye Without Mcc 125 | – | – | – | $8,195$6,556–$11,904 · 18 plans | |
| Ms-Drg 135 135 | – | – | – | $23,162$17,665–$33,644 · 18 plans | |
| Ms-Drg 136 136 | – | – | – | $10,837$8,517–$15,741 · 18 plans | |
| Ms-Drg 137 137 | – | – | – | $15,938$12,303–$23,151 · 18 plans | |
| Ms-Drg 138 138 | – | – | – | $9,459$7,494–$13,740 · 18 plans | |
| Ms-Drg 139 139 | – | – | – | $13,189$10,263–$19,158 · 18 plans | |
| Ms-Drg 140 140 | – | – | – | $45,526$34,265–$66,130 · 18 plans | |
| Major Head and Neck Procedures with Cc 141 | – | – | – | $23,280$17,753–$33,816 · 18 plans | |
| Major Head and Neck Procedures Without Cc/Mcc 142 | – | – | – | $17,039$13,121–$24,751 · 18 plans | |
| Ms-Drg 143 143 | – | – | – | $39,989$30,156–$58,088 · 18 plans | |
| Other Ear, Nose, Mouth and Throat O.r. Procedures with Cc 144 | – | – | – | $18,496$14,202–$26,867 · 18 plans | |
| Other Ear, Nose, Mouth and Throat O.r. Procedures Without Cc/Mcc 145 | – | – | – | $12,833$9,998–$18,641 · 18 plans | |
| Ear, Nose, Mouth and Throat Malignancy with Mcc 146 | – | – | – | $22,600$17,248–$32,828 · 18 plans | |
| Ear, Nose, Mouth and Throat Malignancy with Cc 147 | – | – | – | $13,571$10,547–$19,713 · 18 plans | |
| Ms-Drg 148 148 | – | – | – | $8,508$6,788–$12,358 · 18 plans | |
| Dysequilibrium 149 | – | – | – | $8,022$6,428–$11,653 · 18 plans | |
| Ms-Drg 150 150 | – | – | – | $14,212$11,022–$20,644 · 18 plans | |
| Epistaxis Without Mcc 151 | – | – | – | $7,834$6,288–$11,380 · 18 plans | |
| Otitis Media and Uri with Mcc 152 | – | – | – | $12,618$9,839–$18,329 · 18 plans | |
| Otitis Media and Uri Without Mcc 153 | – | – | – | $7,879$6,322–$11,445 · 18 plans | |
| Other Ear, Nose, Mouth and Throat Diagnoses with Mcc 154 | – | – | – | $16,688$12,860–$24,241 · 18 plans | |
| Other Ear, Nose, Mouth and Throat Diagnoses with Cc 155 | – | – | – | $9,782$7,734–$14,210 · 18 plans | |
| Ms-Drg 156 156 | – | – | – | $7,376$5,948–$10,715 · 18 plans | |
| Dental and Oral Diseases with Mcc 157 | – | – | – | $18,324$14,075–$26,617 · 18 plans | |
| Dental and Oral Diseases with Cc 158 | – | – | – | $9,711$7,681–$14,106 · 18 plans | |
| Ms-Drg 159 159 | – | – | – | $7,562$6,086–$10,985 · 18 plans | |
| Major Chest Procedures Without Cc/Mcc 165 | – | – | – | $20,431$15,639–$29,678 · 18 plans | |
| Other Respiratory System O.r. Procedures with Cc 167 | – | – | – | $19,249$14,761–$27,960 · 18 plans | |
| Other Respiratory System O.r. Procedures Without Cc/Mcc 168 | – | – | – | $14,584$11,299–$21,185 · 18 plans | |
| Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolis 173 | – | – | – | $31,769$24,054–$46,146 · 18 plans | |
| Pulmonary Embolism Without Mcc 176 | – | – | – | $8,592$6,851–$12,481 · 18 plans | |
| Respiratory Infections and Inflammations Without Cc/Mcc 179 | – | – | – | $8,059$6,455–$11,706 · 18 plans | |
| Respiratory Neoplasms with Cc 181 | – | – | – | $11,431$8,958–$16,605 · 18 plans | |
| Ms-Drg 182 182 | – | – | – | $8,046$6,445–$11,687 · 18 plans | |
| Major Chest Trauma with Mcc 183 | – | – | – | $16,329$12,594–$23,720 · 18 plans | |
| Major Chest Trauma with Cc 184 | – | – | – | $11,358$8,903–$16,498 · 18 plans | |
| Major Chest Trauma Without Cc/Mcc 185 | – | – | – | $8,395$6,704–$12,194 · 18 plans | |
| Pleural Effusion with Cc 187 | – | – | – | $10,557$8,309–$15,335 · 18 plans | |
| Ms-Drg 188 188 | – | – | – | $7,655$6,155–$11,120 · 18 plans | |
| Chronic Obstructive Pulmonary Disease with Cc 191 | – | – | – | $8,998$7,152–$13,070 · 18 plans | |
| Chronic Obstructive Pulmonary Disease Without Cc/Mcc 192 | – | – | – | $6,852$5,559–$9,954 · 18 plans | |
| Simple Pneumonia and Pleurisy Without Cc/Mcc 195 | – | – | – | $6,708$5,452–$9,744 · 18 plans | |
| Interstitial Lung Disease with Mcc 196 | – | – | – | $20,143$15,425–$29,259 · 18 plans | |
| Interstitial Lung Disease with Cc 197 | – | – | – | $10,130$7,992–$14,715 · 18 plans | |
| Ms-Drg 198 198 | – | – | – | $7,644$6,147–$11,104 · 18 plans | |
| Pneumothorax with Cc 200 | – | – | – | $11,733$9,182–$17,044 · 18 plans | |
| Ms-Drg 201 201 | – | – | – | $7,633$6,138–$11,087 · 18 plans | |
| Bronchitis and Asthma Without Cc/Mcc 203 | – | – | – | $7,151$5,781–$10,388 · 18 plans | |
| Respiratory Signs and Symptoms 204 | – | – | – | $8,618$6,870–$12,518 · 18 plans | |
| Other Respiratory System Diagnoses with Mcc 205 | – | – | – | $19,543$14,979–$28,388 · 18 plans | |
| Other Respiratory System Diagnoses Without Mcc 206 | – | – | – | $10,045$7,929–$14,591 · 18 plans | |
| Respiratory System Diagnosis with Ventilator Support >96 Hours 207 | – | – | – | $68,681$51,453–$99,764 · 18 plans | |
| Ms-Drg 209 209 | – | – | – | $113,277$84,585–$156,504 · 10 plans | |
| Concomitant Aortic and Mitral Valve Procedures 212 | – | – | – | $116,065$86,624–$168,593 · 18 plans | |
| Ms-Drg 213 213 | – | – | – | $57,114$42,648–$78,909 · 10 plans | |
| Other Heart Assist System Implant 215 | – | – | – | $106,276$79,359–$154,374 · 18 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 216 | – | – | – | $102,186$73,107–$136,958 · 18 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 217 | – | – | – | $68,682$52,567–$99,129 · 18 plans | |
| Ms-Drg 218 218 | – | – | – | $68,682$52,567–$99,129 · 18 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 219 | – | – | – | $80,203$61,305–$107,863 · 18 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 220 | – | – | – | $56,920$42,723–$83,939 · 18 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 221 | – | – | – | $53,797$40,405–$79,334 · 18 plans | |
| Other Cardiothoracic Procedures with Mcc 228 | – | – | – | $52,806$39,669–$76,705 · 18 plans | |
| Coronary Bypass with Ptca with Mcc 231 | – | – | – | $88,054$65,792–$118,018 · 18 plans | |
| Ms-Drg 232 232 | – | – | – | $64,709$48,505–$93,878 · 18 plans | |
| Coronary Bypass with Cardiac Catheterization or Open Ablation Without Mcc 234 | – | – | – | $58,306$43,752–$85,984 · 18 plans | |
| Coronary Bypass Without Cardiac Catheterization Without Mcc 236 | – | – | – | $44,709$33,659–$64,944 · 18 plans | |
| Amputation for Circulatory System Disorders Except Upper Limb and Toe with Mcc 239 | – | – | – | $52,532$39,466–$76,307 · 18 plans | |
| Amputation for Circulatory System Disorders Except Upper Limb and Toe with Cc 240 | – | – | – | $30,425$23,056–$44,194 · 18 plans | |
| Ms-Drg 241 241 | – | – | – | $14,776$11,441–$21,464 · 18 plans | |
| Permanent Cardiac Pacemaker Implant Without Cc/Mcc 244 | – | – | – | $19,292$14,793–$30,509 · 18 plans | |
| Ms-Drg 245 245 | – | – | – | $46,668$34,095–$63,873 · 18 plans | |
| Percutaneous Cardiovascular Procedures Without Intraluminal Device with Mcc 250 | – | – | – | $23,295$17,764–$41,726 · 18 plans | |
| Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 251 | – | – | – | $15,952$12,313–$32,900 · 18 plans | |
| Other Vascular Procedures Without Cc/Mcc 254 | – | – | – | $19,017$14,589–$27,624 · 18 plans | |
| Ms-Drg 255 255 | – | – | – | $28,791$21,844–$41,821 · 18 plans | |
| Ms-Drg 256 256 | – | – | – | $18,123$13,925–$26,324 · 18 plans | |
| Ms-Drg 257 257 | – | – | – | $11,658$9,126–$16,934 · 18 plans | |
| Ms-Drg 258 258 | – | – | – | $32,140$23,481–$43,989 · 18 plans | |
| Ms-Drg 259 259 | – | – | – | $21,122$16,493–$28,868 · 18 plans | |
| Cardiac Pacemaker Revision Except Device Replacement with Mcc 260 | – | – | – | $33,272$23,993–$45,539 · 18 plans | |
| Cardiac Pacemaker Revision Except Device Replacement with Cc 261 | – | – | – | $19,747$14,533–$26,467 · 18 plans | |
| Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 262 | – | – | – | $17,025$13,386–$23,434 · 18 plans | |
| Ms-Drg 263 263 | – | – | – | $32,633$24,696–$47,402 · 18 plans | |
| Other Circulatory System O.r. Procedures 264 | – | – | – | $35,656$26,939–$51,793 · 18 plans | |
| Ms-Drg 265 265 | – | – | – | $38,619$29,139–$56,097 · 18 plans | |
| Aortic and Heart Assist Procedures Except Pulsation Balloon with Mcc 268 | – | – | – | $73,411$54,964–$106,636 · 18 plans | |
| Other Major Cardiovascular Procedures with Cc 271 | – | – | – | $37,958$28,648–$55,137 · 18 plans | |
| Other Major Cardiovascular Procedures Without Cc/Mcc 272 | – | – | – | $27,249$20,699–$39,582 · 18 plans | |
| Percutaneous and Other Intracardiac Procedures with Mcc 273 | – | – | – | $44,034$33,158–$63,563 · 18 plans | |
| Cardiac Defibrillator Implant with Cardiac Catheterization and Mcc 275 | – | – | – | $74,480$56,965–$104,883 · 18 plans | |
| Cardiac Defibrillator Implant with Mcc or Carotid Sinus Neurostimulator 276 | – | – | – | $62,742$48,061–$89,859 · 18 plans | |
| Cardiac Defibrillator Implant Without Mcc 277 | – | – | – | $49,296$37,064–$71,606 · 18 plans | |
| Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with Mcc 278 | – | – | – | $59,411$44,572–$86,299 · 18 plans | |
| Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures Without 279 | – | – | – | $38,493$29,045–$55,914 · 18 plans | |
| Acute Myocardial Infarction, Expired with Mcc 283 | – | – | – | $21,142$16,166–$30,711 · 18 plans | |
| Ms-Drg 284 284 | – | – | – | $7,388$5,957–$10,732 · 18 plans | |
| Ms-Drg 285 285 | – | – | – | $6,392$5,218–$9,285 · 18 plans | |
| Ms-Drg 288 288 | – | – | – | $28,885$21,913–$41,957 · 18 plans | |
| Ms-Drg 289 289 | – | – | – | $18,219$13,996–$26,464 · 18 plans | |
| Ms-Drg 290 290 | – | – | – | $9,923$7,839–$14,414 · 18 plans | |
| Heart Failure and Shock with Cc 292 | – | – | – | $9,062$7,199–$13,163 · 18 plans | |
| Heart Failure and Shock Without Cc/Mcc 293 | – | – | – | $6,041$4,957–$8,775 · 18 plans | |
| Cardiac Arrest, Unexplained with Mcc 296 | – | – | – | $16,671$12,847–$24,216 · 18 plans | |
| Ms-Drg 297 297 | – | – | – | $6,767$5,496–$9,830 · 18 plans | |
| Ms-Drg 298 298 | – | – | – | $4,858$4,079–$7,056 · 18 plans | |
| Peripheral Vascular Disorders with Mcc 299 | – | – | – | $17,427$13,408–$25,314 · 18 plans | |
| Peripheral Vascular Disorders Without Cc/Mcc 301 | – | – | – | $7,682$6,175–$11,158 · 18 plans | |
| Atherosclerosis with Mcc 302 | – | – | – | $12,772$9,953–$18,552 · 18 plans | |
| Atherosclerosis Without Mcc 303 | – | – | – | $7,185$5,807–$10,437 · 18 plans | |
| Hypertension with Mcc 304 | – | – | – | $12,701$9,901–$18,450 · 18 plans | |
| Cardiac Congenital and Valvular Disorders with Mcc 306 | – | – | – | $16,819$12,957–$24,431 · 18 plans | |
| Cardiac Congenital and Valvular Disorders Without Mcc 307 | – | – | – | $9,747$7,708–$14,158 · 18 plans | |
| Angina Pectoris 311 | – | – | – | $7,492$6,034–$10,882 · 18 plans | |
| Chest pain 313 | – | – | – | $7,685$6,177–$11,163 · 18 plans | |
| Other Circulatory System Diagnoses with Cc 315 | – | – | – | $10,282$8,105–$14,935 · 18 plans | |
| Other Circulatory System Diagnoses Without Cc/Mcc 316 | – | – | – | $7,280$5,877–$10,575 · 18 plans | |
| Concomitant Left Atrial Appendage Closure and Cardiac Ablation 317 | – | – | – | $71,238$51,956–$107,084 · 15 plans | |
| Ms-Drg 318 318 | – | – | – | $24,241$18,101–$33,492 · 10 plans | |
| Other Endovascular Cardiac Valve Procedures with Mcc 319 | – | – | – | $47,635$35,831–$69,193 · 18 plans | |
| Other Endovascular Cardiac Valve Procedures Without Mcc 320 | – | – | – | $25,673$19,529–$37,292 · 18 plans | |
| Coronary Intravascular Lithotripsy with Intraluminal Device with Mcc 323 | – | – | – | $44,264$32,339–$60,583 · 18 plans | |
| Coronary Intravascular Lithotripsy with Intraluminal Device Without Mcc 324 | – | – | – | $33,632$25,437–$48,853 · 18 plans | |
| Ms-Drg 325 325 | – | – | – | $34,266$25,908–$49,774 · 18 plans | |
| Stomach, Esophageal and Duodenal Procedures with Mcc 326 | – | – | – | $53,233$39,986–$77,325 · 18 plans | |
| Stomach, Esophageal and Duodenal Procedures with Cc 327 | – | – | – | $26,088$19,838–$37,895 · 18 plans | |
| Stomach, Esophageal and Duodenal Procedures Without Cc/Mcc 328 | – | – | – | $17,102$13,167–$24,842 · 18 plans | |
| Major Small and Large Bowel Procedures Without Cc/Mcc 331 | – | – | – | $20,212$13,806–$28,893 · 18 plans | |
| Ms-Drg 332 332 | – | – | – | $38,646$29,158–$56,136 · 18 plans | |
| Ms-Drg 333 333 | – | – | – | $24,999$19,029–$36,314 · 18 plans | |
| Ms-Drg 334 334 | – | – | – | $17,482$13,449–$25,394 · 18 plans | |
| Peritoneal Adhesiolysis with Mcc 335 | – | – | – | $38,114$28,764–$55,364 · 18 plans | |
| Peritoneal Adhesiolysis Without Cc/Mcc 337 | – | – | – | $16,384$12,634–$23,799 · 18 plans | |
| Ms-Drg 344 344 | – | – | – | $27,568$20,936–$40,044 · 18 plans | |
| Ms-Drg 345 345 | – | – | – | $16,060$12,394–$23,329 · 18 plans | |
| Ms-Drg 346 346 | – | – | – | $12,661$9,871–$18,391 · 18 plans | |
| Anal and Stomal Procedures with Mcc 347 | – | – | – | $24,502$18,660–$35,591 · 18 plans | |
| Ms-Drg 348 348 | – | – | – | $13,969$10,842–$20,292 · 18 plans | |
| Ms-Drg 349 349 | – | – | – | $9,292$7,370–$13,498 · 18 plans | |
| Inguinal and Femoral Hernia Procedures with Mcc 350 | – | – | – | $26,597$20,215–$38,635 · 18 plans | |
| Inguinal and Femoral Hernia Procedures with Cc 351 | – | – | – | $16,272$12,551–$23,636 · 18 plans | |
| Inguinal and Femoral Hernia Procedures Without Cc/Mcc 352 | – | – | – | $12,465$9,725–$18,106 · 18 plans | |
| Hernia Procedures Except Inguinal and Femoral with Mcc 353 | – | – | – | $30,975$23,464–$44,993 · 18 plans | |
| Hernia Procedures Except Inguinal and Femoral with Cc 354 | – | – | – | $17,957$13,802–$26,084 · 18 plans | |
| Hernia Procedures Except Inguinal and Femoral Without Cc/Mcc 355 | – | – | – | $14,356$11,129–$20,853 · 18 plans | |
| Other Digestive System O.r. Procedures with Mcc 356 | – | – | – | $46,887$35,276–$68,106 · 18 plans | |
| Other Digestive System O.r. Procedures with Cc 357 | – | – | – | $24,821$18,897–$36,055 · 18 plans | |
| Ms-Drg 358 358 | – | – | – | $14,920$11,548–$21,673 · 18 plans | |
| Ms-Drg 359 359 | – | – | – | $34,413$25,697–$47,545 · 10 plans | |
| Ms-Drg 360 360 | – | – | – | $24,162$18,042–$33,382 · 10 plans | |
| Major Esophageal Disorders with Mcc 368 | – | – | – | $16,991$13,085–$24,681 · 18 plans | |
| Major Esophageal Disorders with Cc 369 | – | – | – | $10,676$8,397–$15,507 · 18 plans | |
| Ms-Drg 370 370 | – | – | – | $7,480$6,025–$10,865 · 18 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections with Mcc 371 | – | – | – | $18,925$14,521–$27,490 · 18 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections with Cc 372 | – | – | – | $10,898$8,562–$15,830 · 18 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections Without Cc/Mcc 373 | – | – | – | $7,764$6,236–$11,278 · 18 plans | |
| Digestive Malignancy with Mcc 374 | – | – | – | $22,827$17,417–$33,159 · 18 plans | |
| Digestive Malignancy with Cc 375 | – | – | – | $12,911$10,056–$18,754 · 18 plans | |
| Ms-Drg 376 376 | – | – | – | $9,866$7,796–$14,330 · 18 plans | |
| Gastrointestinal Hemorrhage Without Cc/Mcc 379 | – | – | – | $6,729$5,467–$9,774 · 18 plans | |
| Complicated Peptic Ulcer with Mcc 380 | – | – | – | $20,944$16,019–$30,422 · 18 plans | |
| Complicated Peptic Ulcer with Cc 381 | – | – | – | $11,565$9,057–$16,799 · 18 plans | |
| Ms-Drg 382 382 | – | – | – | $8,545$6,816–$12,413 · 18 plans | |
| Ms-Drg 383 383 | – | – | – | $14,737$11,412–$21,407 · 18 plans | |
| Uncomplicated Peptic Ulcer Without Mcc 384 | – | – | – | $9,124$7,245–$13,253 · 18 plans | |
| Inflammatory Bowel Disease with Mcc 385 | – | – | – | $16,889$13,009–$24,532 · 18 plans | |
| Inflammatory Bowel Disease with Cc 386 | – | – | – | $10,421$8,208–$15,137 · 18 plans | |
| Ms-Drg 387 387 | – | – | – | $7,272$5,871–$10,563 · 18 plans | |
| Other Digestive System Diagnoses Without Cc/Mcc 395 | – | – | – | $6,927$5,615–$10,062 · 18 plans | |
| Ms-Drg 397 397 | – | – | – | $25,562$19,447–$37,131 · 18 plans | |
| Appendix Procedures with Cc 398 | – | – | – | $16,155$12,465–$23,467 · 18 plans | |
| Appendix Procedures Without Cc/Mcc 399 | – | – | – | $12,218$9,542–$17,748 · 18 plans | |
| Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical 402 | – | – | – | $41,158$30,054–$55,197 · 15 plans | |
| Pancreas, Liver and Shunt Procedures with Mcc 405 | – | – | – | $58,389$43,814–$84,815 · 18 plans | |
| Pancreas, Liver and Shunt Procedures with Cc 406 | – | – | – | $30,955$23,450–$44,965 · 18 plans | |
| Pancreas, Liver and Shunt Procedures Without Cc/Mcc 407 | – | – | – | $23,691$18,058–$34,413 · 18 plans | |
| Ms-Drg 408 408 | – | – | – | $38,057$28,722–$55,281 · 18 plans | |
| Ms-Drg 409 409 | – | – | – | $23,239$17,723–$33,757 · 18 plans | |
| Ms-Drg 410 410 | – | – | – | $16,946$13,052–$24,616 · 18 plans | |
| Cholecystectomy with C.d.e. with Mcc 411 | – | – | – | $35,258$26,644–$51,215 · 18 plans | |
| Ms-Drg 412 412 | – | – | – | $22,441$17,130–$32,597 · 18 plans | |
| Ms-Drg 413 413 | – | – | – | $17,723$13,629–$25,745 · 18 plans | |
| Ms-Drg 414 414 | – | – | – | $38,025$28,698–$55,235 · 18 plans | |
| Cholecystectomy Except by Laparoscope Without C.d.e. with Cc 415 | – | – | – | $22,059$16,847–$32,042 · 18 plans | |
| Ms-Drg 416 416 | – | – | – | $14,551$11,274–$21,137 · 18 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. with Mcc 417 | – | – | – | $25,471$19,380–$36,999 · 18 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 419 | – | – | – | $14,578$11,294–$21,176 · 18 plans | |
| Hepatobiliary Diagnostic Procedures with Mcc 420 | – | – | – | $36,366$27,466–$52,824 · 18 plans | |
| Ms-Drg 421 421 | – | – | – | $18,545$14,239–$26,938 · 18 plans | |
| Ms-Drg 422 422 | – | – | – | $14,938$11,561–$21,698 · 18 plans | |
| Other Hepatobiliary or Pancreas O.r. Procedures with Mcc 423 | – | – | – | $44,327$33,376–$64,389 · 18 plans | |
| Ms-Drg 424 424 | – | – | – | $23,353$17,807–$33,921 · 18 plans | |
| Ms-Drg 425 425 | – | – | – | $16,013$12,359–$23,261 · 18 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Mcc or 426 | – | – | – | $112,644$60,946–$151,310 · 15 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Cc 427 | – | – | – | $73,779$49,579–$99,104 · 15 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical Without Cc/ 428 | – | – | – | $57,461$42,013–$77,184 · 15 plans | |
| Ms-Drg 429 429 | – | – | – | $92,085$54,933–$123,693 · 15 plans | |
| Combined Anterior and Posterior Cervical Spinal Fusion Without Mcc 430 | – | – | – | $58,944$43,098–$79,177 · 15 plans | |
| Ms-Drg 434 434 | – | – | – | $7,605$6,118–$11,047 · 18 plans | |
| Malignancy of Hepatobiliary System or Pancreas with Cc 436 | – | – | – | $12,073$9,434–$17,537 · 18 plans | |
| Ms-Drg 437 437 | – | – | – | $9,108$7,233–$13,230 · 18 plans | |
| Disorders of Pancreas Except Malignancy with Mcc 438 | – | – | – | $17,400$13,388–$25,275 · 18 plans | |
| Disorders of Pancreas Except Malignancy with Cc 439 | – | – | – | $8,979$7,138–$13,042 · 18 plans | |
| Disorders of Pancreas Except Malignancy Without Cc/Mcc 440 | – | – | – | $6,633$5,396–$9,634 · 18 plans | |
| Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Cc 442 | – | – | – | $10,303$8,121–$14,966 · 18 plans | |
| Ms-Drg 443 443 | – | – | – | $7,468$6,016–$10,848 · 18 plans | |
| Disorders of the Biliary Tract with Cc 445 | – | – | – | $11,681$9,144–$16,968 · 18 plans | |
| Disorders of the Biliary Tract Without Cc/Mcc 446 | – | – | – | $8,830$7,027–$12,827 · 18 plans | |
| Ms-Drg 447 447 | – | – | – | $68,291$33,412–$91,732 · 15 plans | |
| Multiple Level Spinal Fusion Except Cervical Without Mcc 448 | – | – | – | $43,344$26,116–$58,222 · 15 plans | |
| Ms-Drg 450 450 | – | – | – | $54,472$29,371–$73,170 · 15 plans | |
| Single Level Spinal Fusion Except Cervical Without Mcc 451 | – | – | – | $33,017$23,096–$44,350 · 15 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 456 | – | – | – | $89,694$67,050–$130,287 · 18 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 457 | – | – | – | $63,647$47,716–$92,453 · 18 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 458 | – | – | – | $44,536$33,531–$64,692 · 18 plans | |
| Ms-Drg 461 461 | – | – | – | $58,950$44,230–$85,629 · 18 plans | |
| Bilateral or Multiple Major Joint Procedures of Lower Extremity Without Mcc 462 | – | – | – | $28,392$21,547–$41,241 · 18 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 463 | – | – | – | $60,834$45,628–$88,366 · 18 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 464 | – | – | – | $33,245$25,150–$48,291 · 18 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 465 | – | – | – | $19,465$14,922–$28,275 · 18 plans | |
| Revision of Hip or Knee Replacement with Mcc 466 | – | – | – | $54,373$40,656–$72,875 · 18 plans | |
| Revision of Hip or Knee Replacement Without Cc/Mcc 468 | – | – | – | $29,331$22,244–$44,094 · 18 plans | |
| Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with Mcc or Tota 469 | – | – | – | $39,554$30,647–$63,265 · 18 plans | |
| Cervical Spinal Fusion with Mcc 471 | – | – | – | $49,392$31,979–$67,601 · 18 plans | |
| Cervical Spinal Fusion with Cc 472 | – | – | – | $32,809$23,929–$46,372 · 18 plans | |
| Cervical Spinal Fusion Without Cc/Mcc 473 | – | – | – | $26,345$21,826–$38,068 · 18 plans | |
| Amputation for Musculoskeletal System and Connective Tissue Disorders with Mcc 474 | – | – | – | $45,820$34,484–$66,558 · 18 plans | |
| Amputation for Musculoskeletal System and Connective Tissue Disorders with Cc 475 | – | – | – | $24,290$18,503–$35,283 · 18 plans | |
| Ms-Drg 476 476 | – | – | – | $12,597$9,823–$18,298 · 18 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue with Mcc 477 | – | – | – | $36,873$27,843–$53,560 · 18 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue with Cc 478 | – | – | – | $26,248$19,956–$38,128 · 18 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue Without Cc/Mcc 479 | – | – | – | $19,841$15,200–$28,821 · 18 plans | |
| Major Joint or Limb Reattachment Procedures of Upper Extremities 483 | – | – | – | $31,088$28,007–$46,530 · 18 plans | |
| Knee Procedures with Principal Diagnosis of Infection with Mcc 485 | – | – | – | $34,444$26,040–$50,795 · 18 plans | |
| Knee Procedures with Principal Diagnosis of Infection with Cc 486 | – | – | – | $22,319$17,040–$39,247 · 18 plans | |
| Knee Procedures with Principal Diagnosis of Infection Without Cc/Mcc 487 | – | – | – | $16,717$12,881–$32,514 · 18 plans | |
| Knee Procedures Without Principal Diagnosis of Infection with Cc/Mcc 488 | – | – | – | $18,880$14,487–$35,114 · 18 plans | |
| Knee Procedures Without Principal Diagnosis of Infection Without Cc/Mcc 489 | – | – | – | $11,920$9,321–$26,749 · 18 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Mcc 492 | – | – | – | $39,189$29,562–$56,925 · 18 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Cc 493 | – | – | – | $27,069$20,566–$39,320 · 18 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur Without Cc/Mcc 494 | – | – | – | $21,416$16,370–$31,109 · 18 plans | |
| Ms-Drg 495 495 | – | – | – | $38,699$29,198–$56,213 · 18 plans | |
| Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with Cc 496 | – | – | – | $19,254$14,765–$27,968 · 18 plans | |
| Local Excision and Removal of Internal Fixation Devices Except Hip and Femur Without Cc/ 497 | – | – | – | $12,897$10,046–$18,734 · 18 plans | |
| Ms-Drg 498 498 | – | – | – | $32,200$24,374–$46,773 · 18 plans | |
| Ms-Drg 499 499 | – | – | – | $21,505$16,436–$31,238 · 18 plans | |
| Soft Tissue Procedures with Mcc 500 | – | – | – | $33,780$25,547–$49,067 · 18 plans | |
| Soft Tissue Procedures with Cc 501 | – | – | – | $18,658$14,323–$27,103 · 18 plans | |
| Soft Tissue Procedures Without Cc/Mcc 502 | – | – | – | $14,365$11,136–$20,867 · 18 plans | |
| Ms-Drg 503 503 | – | – | – | $29,791$22,586–$43,274 · 18 plans | |
| Foot Procedures with Cc 504 | – | – | – | $19,951$15,282–$28,980 · 18 plans | |
| Ms-Drg 505 505 | – | – | – | $19,135$14,677–$27,796 · 18 plans | |
| Ms-Drg 506 506 | – | – | – | $14,401$11,162–$20,918 · 18 plans | |
| Ms-Drg 507 507 | – | – | – | $19,281$14,784–$28,007 · 18 plans | |
| Ms-Drg 508 508 | – | – | – | $16,164$12,471–$23,479 · 18 plans | |
| Ms-Drg 510 510 | – | – | – | $32,239$24,403–$46,830 · 18 plans | |
| Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Cc 511 | – | – | – | $22,194$16,947–$32,239 · 18 plans | |
| Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc 512 | – | – | – | $17,669$13,588–$25,665 · 18 plans | |
| Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with Cc/Mcc 513 | – | – | – | $16,803$12,946–$24,408 · 18 plans | |
| Ms-Drg 514 514 | – | – | – | $10,912$8,572–$15,850 · 18 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures with Mcc 515 | – | – | – | $32,714$23,816–$44,616 · 18 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures Without Cc/Mcc 517 | – | – | – | $16,402$12,648–$24,188 · 18 plans | |
| Back and Neck Procedures Except Spinal Fusion with Mcc or Disc Device or Neurostimulator 518 | – | – | – | $38,228$23,470–$52,322 · 18 plans | |
| Back and Neck Procedures Except Spinal Fusion with Cc 519 | – | – | – | $20,460$14,383–$28,003 · 18 plans | |
| Back and Neck Procedures Except Spinal Fusion Without Cc/Mcc 520 | – | – | – | $15,281$11,164–$20,914 · 18 plans | |
| Ms-Drg 533 533 | – | – | – | $16,733$12,893–$24,306 · 18 plans | |
| Ms-Drg 534 534 | – | – | – | $8,604$6,859–$12,498 · 18 plans | |
| Fractures of Hip and Pelvis with Mcc 535 | – | – | – | $13,683$10,630–$19,876 · 18 plans | |
| Ms-Drg 537 537 | – | – | – | $10,186$8,034–$14,796 · 18 plans | |
| Ms-Drg 538 538 | – | – | – | $7,688$6,180–$11,168 · 18 plans | |
| Osteomyelitis with Mcc 539 | – | – | – | $21,024$16,078–$30,538 · 18 plans | |
| Osteomyelitis with Cc 540 | – | – | – | $13,836$10,743–$20,098 · 18 plans | |
| Ms-Drg 541 541 | – | – | – | $8,404$6,711–$12,208 · 18 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy Without Cc/M 544 | – | – | – | $8,054$6,451–$11,699 · 18 plans | |
| Connective Tissue Disorders with Mcc 545 | – | – | – | $26,488$20,135–$38,477 · 18 plans | |
| Connective Tissue Disorders with Cc 546 | – | – | – | $12,311$9,611–$17,882 · 18 plans | |
| Connective Tissue Disorders Without Cc/Mcc 547 | – | – | – | $8,925$7,098–$12,965 · 18 plans | |
| Ms-Drg 548 548 | – | – | – | $20,609$15,771–$29,937 · 18 plans | |
| Ms-Drg 549 549 | – | – | – | $12,885$10,037–$18,717 · 18 plans | |
| Ms-Drg 550 550 | – | – | – | $9,330$7,398–$13,552 · 18 plans | |
| Bone Diseases and Arthropathies with Mcc 553 | – | – | – | $13,836$10,743–$20,098 · 18 plans | |
| Bone Diseases and Arthropathies Without Mcc 554 | – | – | – | $8,860$7,050–$12,870 · 18 plans | |
| Signs and Symptoms of Musculoskeletal System and Connective Tissue with Mcc 555 | – | – | – | $14,108$10,945–$20,493 · 18 plans | |
| Signs and Symptoms of Musculoskeletal System and Connective Tissue Without Mcc 556 | – | – | – | $8,865$7,054–$12,878 · 18 plans | |
| Tendonitis, Myositis and Bursitis with Mcc 557 | – | – | – | $15,870$12,253–$23,053 · 18 plans | |
| Tendonitis, Myositis and Bursitis Without Mcc 558 | – | – | – | $9,534$7,550–$13,848 · 18 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue with Mcc 559 | – | – | – | $19,905$15,248–$28,914 · 18 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue with Cc 560 | – | – | – | $12,019$9,395–$17,459 · 18 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue Without Cc/Mcc 561 | – | – | – | $8,580$6,842–$12,464 · 18 plans | |
| Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with Mcc 562 | – | – | – | $15,208$11,761–$22,090 · 18 plans | |
| Other Musculoskeletal System and Connective Tissue Diagnoses with Mcc 564 | – | – | – | $16,476$12,702–$23,932 · 18 plans | |
| Other Musculoskeletal System and Connective Tissue Diagnoses with Cc 565 | – | – | – | $10,400$8,193–$15,107 · 18 plans | |
| Ms-Drg 566 566 | – | – | – | $7,998$6,409–$11,617 · 18 plans | |
| Skin Debridement with Mcc 570 | – | – | – | $31,392$23,774–$45,599 · 18 plans | |
| Skin Debridement with Cc 571 | – | – | – | $18,033$13,858–$26,194 · 18 plans | |
| Ms-Drg 572 572 | – | – | – | $12,235$9,555–$17,772 · 18 plans | |
| Skin Graft for Skin Ulcer or Cellulitis with Mcc 573 | – | – | – | $69,926$52,377–$101,574 · 18 plans | |
| Skin Graft for Skin Ulcer or Cellulitis with Cc 574 | – | – | – | $37,052$27,976–$53,821 · 18 plans | |
| Ms-Drg 575 575 | – | – | – | $19,180$14,710–$27,861 · 18 plans | |
| Ms-Drg 576 576 | – | – | – | $52,313$39,303–$75,989 · 18 plans | |
| Skin Graft Except for Skin Ulcer or Cellulitis with Cc 577 | – | – | – | $28,292$21,474–$41,097 · 18 plans | |
| Ms-Drg 578 578 | – | – | – | $17,146$13,200–$24,906 · 18 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures with Mcc 579 | – | – | – | $34,566$26,130–$50,210 · 18 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures with Cc 580 | – | – | – | $18,444$14,163–$26,791 · 18 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures Without Cc/Mcc 581 | – | – | – | $15,403$11,906–$22,374 · 18 plans | |
| Ms-Drg 582 582 | – | – | – | $20,564$15,737–$29,870 · 18 plans | |
| Ms-Drg 583 583 | – | – | – | $18,405$14,135–$26,735 · 18 plans | |
| Ms-Drg 584 584 | – | – | – | $22,849$17,433–$33,190 · 18 plans | |
| Breast Biopsy, Local Excision and Other Breast Procedures Without Cc/Mcc 585 | – | – | – | $20,590$15,757–$29,909 · 18 plans | |
| Skin Ulcers with Mcc 592 | – | – | – | $20,656$15,806–$30,005 · 18 plans | |
| Skin Ulcers with Cc 593 | – | – | – | $12,662$9,872–$18,393 · 18 plans | |
| Ms-Drg 594 594 | – | – | – | $9,252$7,340–$13,439 · 18 plans | |
| Ms-Drg 595 595 | – | – | – | $22,635$17,275–$32,880 · 18 plans | |
| Major Skin Disorders Without Mcc 596 | – | – | – | $11,554$9,049–$16,783 · 18 plans | |
| Malignant Breast Disorders with Mcc 597 | – | – | – | $17,794$13,681–$25,847 · 18 plans | |
| Ms-Drg 598 598 | – | – | – | $12,075$9,436–$17,540 · 18 plans | |
| Ms-Drg 599 599 | – | – | – | $8,212$6,569–$11,929 · 18 plans | |
| Ms-Drg 600 600 | – | – | – | $11,118$8,725–$16,149 · 18 plans | |
| Ms-Drg 601 601 | – | – | – | $6,457$5,266–$9,380 · 18 plans | |
| Trauma to the Skin, Subcutaneous Tissue and Breast with Mcc 604 | – | – | – | $15,712$12,136–$22,824 · 18 plans | |
| Trauma to the Skin, Subcutaneous Tissue and Breast Without Mcc 605 | – | – | – | $9,777$7,730–$14,202 · 18 plans | |
| Minor Skin Disorders with Mcc 606 | – | – | – | $16,151$12,462–$23,461 · 18 plans | |
| Minor Skin Disorders Without Mcc 607 | – | – | – | $9,674$7,654–$14,053 · 18 plans | |
| Adrenal and Pituitary Procedures with Cc/Mcc 614 | – | – | – | $23,394$17,838–$33,982 · 18 plans | |
| Adrenal and Pituitary Procedures Without Cc/Mcc 615 | – | – | – | $14,935$11,559–$21,695 · 18 plans | |
| Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Mcc 616 | – | – | – | $37,223$28,102–$54,069 · 18 plans | |
| Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Cc 617 | – | – | – | $19,963$15,291–$28,997 · 18 plans | |
| Ms-Drg 618 618 | – | – | – | $15,138$11,710–$21,989 · 18 plans | |
| Ms-Drg 619 619 | – | – | – | $28,972$20,320–$40,423 · 18 plans | |
| O.r. Procedures for Obesity with Cc 620 | – | – | – | $17,997$13,152–$25,189 · 18 plans | |
| O.r. Procedures for Obesity Without Cc/Mcc 621 | – | – | – | $17,505$12,424–$23,743 · 18 plans | |
| Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 622 | – | – | – | $37,989$28,671–$55,182 · 18 plans | |
| Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 623 | – | – | – | $19,147$14,685–$27,813 · 18 plans | |
| Ms-Drg 624 624 | – | – | – | $13,362$10,391–$19,410 · 18 plans | |
| Ms-Drg 625 625 | – | – | – | $32,235$24,400–$46,824 · 18 plans | |
| Thyroid, Parathyroid and Thyroglossal Procedures with Cc 626 | – | – | – | $16,004$12,352–$23,247 · 18 plans | |
| Thyroid, Parathyroid and Thyroglossal Procedures Without Cc/Mcc 627 | – | – | – | $14,178$10,997–$20,594 · 18 plans | |
| Other Endocrine, Nutritional and Metabolic O.r. Procedures with Mcc 628 | – | – | – | $39,778$29,999–$57,781 · 18 plans | |
| Other Endocrine, Nutritional and Metabolic O.r. Procedures with Cc 629 | – | – | – | $23,255$17,735–$33,780 · 18 plans | |
| Ms-Drg 630 630 | – | – | – | $15,578$12,036–$22,628 · 18 plans | |
| Diabetes Without Cc/Mcc 639 | – | – | – | $6,630$5,395–$9,631 · 18 plans | |
| Inborn and Other Disorders of Metabolism 642 | – | – | – | $15,179$11,740–$22,048 · 18 plans | |
| Endocrine Disorders with Mcc 643 | – | – | – | $17,570$13,514–$25,521 · 18 plans | |
| Endocrine Disorders with Cc 644 | – | – | – | $10,940$8,594–$15,892 · 18 plans | |
| Endocrine Disorders Without Cc/Mcc 645 | – | – | – | $8,200$6,560–$11,912 · 18 plans | |
| Kidney Transplant with Hemodialysis with Mcc 650 | – | – | – | $52,077$28,172–$103,600 · 19 plans | |
| Kidney Transplant with Hemodialysis Without Mcc 651 | – | – | – | $41,049$22,220–$103,600 · 19 plans | |
| Kidney Transplant 652 | – | – | – | $35,773$19,373–$103,600 · 19 plans | |
| Major Bladder Procedures with Mcc 653 | – | – | – | $55,464$41,642–$80,566 · 18 plans | |
| Major Bladder Procedures with Cc 654 | – | – | – | $29,878$22,651–$43,401 · 18 plans | |
| Major Bladder Procedures Without Cc/Mcc 655 | – | – | – | $22,592$17,242–$32,816 · 18 plans | |
| Kidney and Ureter Procedures for Neoplasm with Mcc 656 | – | – | – | $33,982$25,697–$49,362 · 18 plans | |
| Kidney and Ureter Procedures for Neoplasm with Cc 657 | – | – | – | $19,533$14,971–$28,373 · 18 plans | |
| Kidney and Ureter Procedures for Neoplasm Without Cc/Mcc 658 | – | – | – | $16,563$12,767–$24,059 · 18 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm Without Cc/Mcc 661 | – | – | – | $11,051$8,676–$16,053 · 18 plans | |
| Ms-Drg 662 662 | – | – | – | $32,677$24,728–$47,466 · 18 plans | |
| Minor Bladder Procedures with Cc 663 | – | – | – | $16,226$12,517–$23,569 · 18 plans | |
| Ms-Drg 664 664 | – | – | – | $11,174$8,767–$16,231 · 18 plans | |
| Prostatectomy with Mcc 665 | – | – | – | $33,314$25,201–$48,391 · 18 plans | |
| Ms-Drg 666 666 | – | – | – | $18,671$14,332–$27,121 · 18 plans | |
| Ms-Drg 667 667 | – | – | – | $11,807$9,237–$17,151 · 18 plans | |
| Transurethral Procedures with Mcc 668 | – | – | – | $31,167$23,607–$45,272 · 18 plans | |
| Transurethral Procedures with Cc 669 | – | – | – | $16,565$12,769–$24,062 · 18 plans | |
| Ms-Drg 670 670 | – | – | – | $10,431$8,216–$15,152 · 18 plans | |
| Ms-Drg 671 671 | – | – | – | $19,159$14,694–$27,830 · 18 plans | |
| Ms-Drg 672 672 | – | – | – | $11,522$9,026–$16,737 · 18 plans | |
| Other Kidney and Urinary Tract Procedures with Cc 674 | – | – | – | $24,961$19,001–$36,258 · 18 plans | |
| Ms-Drg 675 675 | – | – | – | $17,519$13,477–$25,448 · 18 plans | |
| Renal Failure Without Cc/Mcc 684 | – | – | – | $6,407$5,229–$9,307 · 18 plans | |
| Kidney and Urinary Tract Neoplasms with Mcc 686 | – | – | – | $19,252$14,763–$27,965 · 18 plans | |
| Kidney and Urinary Tract Neoplasms with Cc 687 | – | – | – | $11,184$8,774–$16,245 · 18 plans | |
| Ms-Drg 688 688 | – | – | – | $8,435$6,734–$12,253 · 18 plans | |
| Ms-Drg 693 693 | – | – | – | $14,351$11,125–$20,845 · 18 plans | |
| Ms-Drg 695 695 | – | – | – | $12,208$9,535–$17,734 · 18 plans | |
| Kidney and Urinary Tract Signs and Symptoms Without Mcc 696 | – | – | – | $7,354$5,932–$10,682 · 18 plans | |
| Ms-Drg 697 697 | – | – | – | $11,504$9,012–$16,710 · 18 plans | |
| Other Kidney and Urinary Tract Diagnoses Without Cc/Mcc 700 | – | – | – | $7,364$5,939–$10,696 · 18 plans | |
| Major Male Pelvic Procedures with Cc/Mcc 707 | – | – | – | $21,350$16,321–$31,013 · 18 plans | |
| Major Male Pelvic Procedures Without Cc/Mcc 708 | – | – | – | $16,375$12,628–$23,786 · 18 plans | |
| Ms-Drg 709 709 | – | – | – | $24,838$18,910–$36,080 · 18 plans | |
| Ms-Drg 710 710 | – | – | – | $14,956$11,574–$21,724 · 18 plans | |
| Ms-Drg 711 711 | – | – | – | $22,241$16,982–$32,307 · 18 plans | |
| Ms-Drg 712 712 | – | – | – | $11,738$9,186–$17,050 · 18 plans | |
| Transurethral Prostatectomy with Cc/Mcc 713 | – | – | – | $16,047$12,384–$23,309 · 18 plans | |
| Transurethral Prostatectomy Without Cc/Mcc 714 | – | – | – | $11,286$8,850–$16,394 · 18 plans | |
| Ms-Drg 715 715 | – | – | – | $23,880$18,198–$34,687 · 18 plans | |
| Ms-Drg 716 716 | – | – | – | $15,701$12,127–$22,807 · 18 plans | |
| Other Male Reproductive System O.r. Procedures Except Malignancy with Cc/Mcc 717 | – | – | – | $20,178$15,451–$29,311 · 18 plans | |
| Ms-Drg 718 718 | – | – | – | $14,336$11,114–$20,824 · 18 plans | |
| Malignancy, Male Reproductive System with Mcc 722 | – | – | – | $19,316$14,811–$28,058 · 18 plans | |
| Ms-Drg 723 723 | – | – | – | $12,197$9,526–$17,717 · 18 plans | |
| Ms-Drg 724 724 | – | – | – | $6,999$5,668–$10,166 · 18 plans | |
| Ms-Drg 725 725 | – | – | – | $12,490$9,744–$18,143 · 18 plans | |
| Benign Prostatic Hypertrophy Without Mcc 726 | – | – | – | $7,706$6,193–$11,194 · 18 plans | |
| Ms-Drg 727 727 | – | – | – | $15,828$12,221–$22,991 · 18 plans | |
| Inflammation of the Male Reproductive System Without Mcc 728 | – | – | – | $8,658$6,900–$12,577 · 18 plans | |
| Ms-Drg 729 729 | – | – | – | $11,300$8,861–$16,414 · 18 plans | |
| Ms-Drg 730 730 | – | – | – | $7,173$5,797–$10,419 · 18 plans | |
| Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy with Cc/Mcc 734 | – | – | – | $21,787$14,267–$29,820 · 18 plans | |
| Ms-Drg 735 735 | – | – | – | $13,763$10,055–$18,837 · 18 plans | |
| Ms-Drg 736 736 | – | – | – | $36,563$25,419–$50,043 · 18 plans | |
| Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with Cc 737 | – | – | – | $21,078$13,904–$28,848 · 18 plans | |
| Ms-Drg 738 738 | – | – | – | $15,021$10,807–$20,559 · 18 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Mcc 739 | – | – | – | $36,648$21,867–$50,159 · 18 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Cc 740 | – | – | – | $18,510$12,591–$25,334 · 18 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy Without Cc/Mcc 741 | – | – | – | $14,587$10,585–$19,965 · 18 plans | |
| Uterine and Adnexa Procedures for Non-Malignancy with Cc/Mcc 742 | – | – | – | $18,768$12,723–$25,687 · 18 plans | |
| Uterine and Adnexa Procedures for Non-Malignancy Without Cc/Mcc 743 | – | – | – | $12,691$9,272–$17,370 · 18 plans | |
| D&c, Conization, Laparoscopy and Tubal Interruption with Cc/Mcc 744 | – | – | – | $21,871$16,707–$31,769 · 18 plans | |
| Ms-Drg 745 745 | – | – | – | $12,141$9,485–$17,636 · 18 plans | |
| Vagina, Cervix and Vulva Procedures with Cc/Mcc 746 | – | – | – | $18,541$14,235–$26,932 · 18 plans | |
| Vagina, Cervix and Vulva Procedures Without Cc/Mcc 747 | – | – | – | $9,176$7,284–$13,329 · 18 plans | |
| Female Reproductive System Reconstructive Procedures 748 | – | – | – | $14,190$10,367–$19,422 · 18 plans | |
| Ms-Drg 749 749 | – | – | – | $27,405$20,815–$39,808 · 18 plans | |
| Ms-Drg 750 750 | – | – | – | $15,752$12,165–$22,881 · 18 plans | |
| Malignancy, Female Reproductive System with Mcc 754 | – | – | – | $19,657$15,064–$28,554 · 18 plans | |
| Malignancy, Female Reproductive System with Cc 755 | – | – | – | $11,611$9,091–$16,865 · 18 plans | |
| Ms-Drg 756 756 | – | – | – | $10,252$8,083–$14,892 · 18 plans | |
| Ms-Drg 757 757 | – | – | – | $15,283$11,817–$22,200 · 18 plans | |
| Ms-Drg 758 758 | – | – | – | $10,449$8,229–$15,179 · 18 plans | |
| Ms-Drg 759 759 | – | – | – | $7,083$5,730–$10,289 · 18 plans | |
| Ms-Drg 760 760 | – | – | – | $10,754$8,455–$15,620 · 18 plans | |
| Ms-Drg 761 761 | – | – | – | $6,089$4,993–$8,845 · 18 plans | |
| Ms-Drg 768 768 | – | – | – | $10,736$6,470–$16,614 · 18 plans | |
| Ms-Drg 769 769 | – | – | – | $18,036$13,861–$26,199 · 18 plans | |
| Ms-Drg 770 770 | – | – | – | $10,702$8,417–$15,546 · 18 plans | |
| Ms-Drg 776 776 | – | – | – | $6,988$5,660–$10,151 · 18 plans | |
| Ms-Drg 779 779 | – | – | – | $8,980$7,138–$13,044 · 18 plans | |
| Ms-Drg 783 783 | – | – | – | $24,048$8,945–$38,064 · 18 plans | |
| Ms-Drg 784 784 | – | – | – | $10,637$7,721–$16,436 · 18 plans | |
| Ms-Drg 785 785 | – | – | – | $9,738$7,158–$14,850 · 18 plans | |
| C-section, with major complications 786 | – | – | – | $16,157$8,945–$25,574 · 18 plans | |
| C-section, with complications 787 | – | – | – | $11,206$8,017–$17,315 · 18 plans | |
| C-section 788 | – | – | – | $9,743$7,165–$14,865 · 18 plans | |
| Ms-Drg 789 789 | – | – | – | $19,236$14,751–$27,941 · 18 plans | |
| Ms-Drg 790 790 | – | – | – | $63,438$47,561–$92,149 · 18 plans | |
| Ms-Drg 791 791 | – | – | – | $43,324$32,631–$62,931 · 18 plans | |
| Ms-Drg 792 792 | – | – | – | $26,142$19,877–$37,973 · 18 plans | |
| Ms-Drg 793 793 | – | – | – | $44,504$33,507–$64,646 · 18 plans | |
| Ms-Drg 794 794 | – | – | – | $15,753$12,166–$22,883 · 18 plans | |
| Newborn care (healthy baby) 795 | – | – | – | $2,175$1,818–$3,098 · 18 plans | |
| Ms-Drg 796 796 | – | – | – | $11,431$6,470–$18,093 · 18 plans | |
| Ms-Drg 797 797 | – | – | – | $10,038$6,216–$15,510 · 18 plans | |
| Ms-Drg 798 798 | – | – | – | $9,604$5,989–$14,839 · 18 plans | |
| Ms-Drg 799 799 | – | – | – | $48,339$36,354–$70,217 · 18 plans | |
| Ms-Drg 800 800 | – | – | – | $29,986$22,731–$43,557 · 18 plans | |
| Ms-Drg 801 801 | – | – | – | $20,375$15,597–$29,596 · 18 plans | |
| Ms-Drg 802 802 | – | – | – | $42,524$32,038–$61,770 · 18 plans | |
| Ms-Drg 803 803 | – | – | – | $19,841$15,200–$28,821 · 18 plans | |
| Ms-Drg 804 804 | – | – | – | $14,473$11,216–$21,024 · 18 plans | |
| Vaginal birth, with major complications 805 | – | – | – | $10,774$6,470–$16,732 · 18 plans | |
| Vaginal birth, with complications 806 | – | – | – | $7,779$4,927–$11,690 · 18 plans | |
| Vaginal birth 807 | – | – | – | $7,055$4,509–$11,204 · 18 plans | |
| Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 808 | – | – | – | $23,566$17,965–$34,232 · 18 plans | |
| Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 809 | – | – | – | $13,512$10,502–$19,627 · 18 plans | |
| Ms-Drg 810 810 | – | – | – | $11,171$8,765–$16,227 · 18 plans | |
| Coagulation Disorders 813 | – | – | – | $16,280$12,557–$23,648 · 18 plans | |
| Reticuloendothelial and Immunity Disorders with Mcc 814 | – | – | – | $22,699$17,322–$32,973 · 18 plans | |
| Reticuloendothelial and Immunity Disorders with Cc 815 | – | – | – | $10,823$8,507–$15,721 · 18 plans | |
| Ms-Drg 816 816 | – | – | – | $6,746$5,480–$9,799 · 18 plans | |
| Ms-Drg 817 817 | – | – | – | $24,353$18,549–$35,374 · 18 plans | |
| Ms-Drg 818 818 | – | – | – | $12,373$9,657–$17,972 · 18 plans | |
| Ms-Drg 819 819 | – | – | – | $9,178$7,286–$13,332 · 18 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures with Mcc 820 | – | – | – | $62,598$46,938–$90,928 · 18 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures with Cc 821 | – | – | – | $23,894$18,209–$34,707 · 18 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures Without Cc/Mcc 822 | – | – | – | $12,851$10,012–$18,667 · 18 plans | |
| Lymphoma and Non-Acute Leukemia with Other Procedures with Mcc 823 | – | – | – | $48,936$36,797–$71,083 · 18 plans | |
| Lymphoma and Non-Acute Leukemia with Other Procedures with Cc 824 | – | – | – | $24,182$18,423–$35,126 · 18 plans | |
| Ms-Drg 825 825 | – | – | – | $14,403$11,164–$20,921 · 18 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 826 | – | – | – | $49,929$37,534–$72,525 · 18 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 827 | – | – | – | $24,669$18,784–$35,833 · 18 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 828 | – | – | – | $18,186$13,972–$26,416 · 18 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures Wi 829 | – | – | – | $33,728$25,509–$48,993 · 18 plans | |
| Ms-Drg 830 830 | – | – | – | $16,064$12,397–$23,334 · 18 plans | |
| Ms-Drg 831 831 | – | – | – | $12,835$10,000–$18,644 · 18 plans | |
| Ms-Drg 832 832 | – | – | – | $7,702$6,190–$11,188 · 18 plans | |
| Ms-Drg 833 833 | – | – | – | $5,581$4,616–$8,107 · 18 plans | |
| Acute Leukemia with Mcc 834 | – | – | – | $58,596$43,967–$85,116 · 18 plans | |
| Acute Leukemia with Cc 835 | – | – | – | $22,263$16,998–$32,338 · 18 plans | |
| Ms-Drg 836 836 | – | – | – | $13,016$10,135–$18,907 · 18 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis or with High Dose Chemotherapy a 837 | – | – | – | $51,279$38,536–$74,486 · 18 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis with Cc or High Dose Chemotherap 838 | – | – | – | $22,280$17,011–$32,363 · 18 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis Without Cc/Mcc 839 | – | – | – | $15,411$11,913–$22,386 · 18 plans | |
| Lymphoma and Non-Acute Leukemia with Mcc 840 | – | – | – | $34,528$26,102–$50,154 · 18 plans | |
| Lymphoma and Non-Acute Leukemia with Cc 841 | – | – | – | $17,413$13,398–$25,293 · 18 plans | |
| Lymphoma and Non-Acute Leukemia Without Cc/Mcc 842 | – | – | – | $10,785$8,478–$15,665 · 18 plans | |
| Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with Mc 843 | – | – | – | $21,292$16,277–$30,928 · 18 plans | |
| Ms-Drg 844 844 | – | – | – | $12,994$10,118–$18,875 · 18 plans | |
| Ms-Drg 845 845 | – | – | – | $9,090$7,220–$13,203 · 18 plans | |
| Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Mcc 846 | – | – | – | $27,671$21,012–$40,194 · 18 plans | |
| Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Cc 847 | – | – | – | $13,963$10,837–$20,282 · 18 plans | |
| Ms-Drg 848 848 | – | – | – | $9,066$7,203–$13,169 · 18 plans | |
| Radiotherapy 849 | – | – | – | $28,920$21,939–$42,008 · 18 plans | |
| Ms-Drg 850 850 | – | – | – | $92,258$67,208–$138,682 · 15 plans | |
| Ms-Drg 855 855 | – | – | – | $15,980$12,335–$23,213 · 18 plans | |
| Postoperative or Post-Traumatic Infections with O.r. Procedures with Mcc 856 | – | – | – | $48,551$36,511–$70,524 · 18 plans | |
| Postoperative or Post-Traumatic Infections with O.r. Procedures with Cc 857 | – | – | – | $22,857$17,439–$33,202 · 18 plans | |
| Ms-Drg 858 858 | – | – | – | $14,867$11,508–$21,596 · 18 plans | |
| Postoperative and Post-Traumatic Infections with Mcc 862 | – | – | – | $19,465$14,922–$28,275 · 18 plans | |
| Fever and Inflammatory Conditions 864 | – | – | – | $9,475$7,506–$13,763 · 18 plans | |
| Viral Illness with Mcc 865 | – | – | – | $15,992$12,344–$23,230 · 18 plans | |
| Viral Illness Without Mcc 866 | – | – | – | $9,282$7,363–$13,482 · 18 plans | |
| Other Infectious and Parasitic Diseases Diagnoses with Mcc 867 | – | – | – | $22,342$17,057–$32,453 · 18 plans | |
| Other Infectious and Parasitic Diseases Diagnoses with Cc 868 | – | – | – | $11,005$8,642–$15,986 · 18 plans | |
| Ms-Drg 869 869 | – | – | – | $7,788$6,254–$11,313 · 18 plans | |
| O.r. Procedures with Principal Diagnosis of Mental Illness 876 | – | – | – | $41,252$31,093–$59,922 · 18 plans | |
| Acute Adjustment Reaction and Psychosocial Dysfunction 880 | – | – | – | $10,249$8,080–$14,887 · 18 plans | |
| Depressive Neuroses 881 | – | – | – | $10,043$7,927–$14,588 · 18 plans | |
| Neuroses Except Depressive 882 | – | – | – | $11,461$8,980–$16,648 · 18 plans | |
| Disorders of Personality and Impulse Control 883 | – | – | – | $20,987$16,051–$30,486 · 18 plans | |
| Ms-Drg 886 886 | – | – | – | $22,151$16,915–$32,176 · 18 plans | |
| Ms-Drg 887 887 | – | – | – | $11,430$8,957–$16,603 · 18 plans | |
| Alcohol, Drug Abuse or Dependence, Left Ama 894 | – | – | – | $6,584$5,360–$9,564 · 18 plans | |
| Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy 895 | – | – | – | $15,109$11,688–$21,948 · 18 plans | |
| Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy Without Mcc 897 | – | – | – | $9,423$7,467–$13,687 · 18 plans | |
| Ms-Drg 901 901 | – | – | – | $44,792$33,721–$65,065 · 18 plans | |
| Wound Debridements for Injuries with Cc 902 | – | – | – | $20,434$15,641–$29,683 · 18 plans | |
| Ms-Drg 903 903 | – | – | – | $12,484$9,739–$18,134 · 18 plans | |
| Skin Grafts for Injuries with Cc/Mcc 904 | – | – | – | $39,205$29,574–$56,948 · 18 plans | |
| Ms-Drg 905 905 | – | – | – | $15,833$12,225–$22,999 · 18 plans | |
| Ms-Drg 906 906 | – | – | – | $20,966$16,035–$30,455 · 18 plans | |
| Other O.r. Procedures for Injuries with Mcc 907 | – | – | – | $40,979$30,890–$59,525 · 18 plans | |
| Other O.r. Procedures for Injuries with Cc 908 | – | – | – | $21,296$16,280–$30,934 · 18 plans | |
| Other O.r. Procedures for Injuries Without Cc/Mcc 909 | – | – | – | $14,011$10,873–$20,352 · 18 plans | |
| Traumatic Injury with Mcc 913 | – | – | – | $17,447$13,423–$25,343 · 18 plans | |
| Traumatic Injury Without Mcc 914 | – | – | – | $9,451$7,489–$13,729 · 18 plans | |
| Ms-Drg 915 915 | – | – | – | $17,949$13,796–$26,072 · 18 plans | |
| Allergic Reactions Without Mcc 916 | – | – | – | $7,112$5,752–$10,330 · 18 plans | |
| Poisoning and Toxic Effects of Drugs Without Mcc 918 | – | – | – | $9,148$7,264–$13,289 · 18 plans | |
| Complications of Treatment with Cc 920 | – | – | – | $10,698$8,414–$15,540 · 18 plans | |
| Complications of Treatment Without Cc/Mcc 921 | – | – | – | $7,348$5,927–$10,673 · 18 plans | |
| Other Injury, Poisoning and Toxic Effect Diagnoses with Mcc 922 | – | – | – | $18,672$14,333–$27,123 · 18 plans | |
| Other Injury, Poisoning and Toxic Effect Diagnoses Without Mcc 923 | – | – | – | $10,862$8,536–$15,779 · 18 plans | |
| Ms-Drg 927 927 | – | – | – | $227,885$169,625–$331,020 · 18 plans | |
| Full Thickness Burn with Skin Graft or Inhalation Injury with Cc/Mcc 928 | – | – | – | $76,558$57,300–$111,206 · 18 plans | |
| Ms-Drg 929 929 | – | – | – | $34,377$25,990–$49,936 · 18 plans | |
| Ms-Drg 933 933 | – | – | – | $41,565$31,325–$60,376 · 18 plans | |
| Full Thickness Burn Without Skin Graft or Inhalation Injury 934 | – | – | – | $23,595$17,987–$34,273 · 18 plans | |
| Non-Extensive Burns 935 | – | – | – | $21,987$16,794–$31,938 · 18 plans | |
| Ms-Drg 939 939 | – | – | – | $38,729$29,220–$56,257 · 18 plans | |
| O.r. Procedures with Diagnoses of Other Contact with Health Services with Cc 940 | – | – | – | $24,943$18,987–$36,232 · 18 plans | |
| O.r. Procedures with Diagnoses of Other Contact with Health Services Without Cc/Mcc 941 | – | – | – | $21,643$16,538–$31,438 · 18 plans | |
| Rehabilitation with Cc/Mcc 945 | – | – | – | $16,529$12,742–$24,010 · 18 plans | |
| Rehabilitation Without Cc/Mcc 946 | – | – | – | $12,240$9,559–$17,780 · 18 plans | |
| Signs and Symptoms with Mcc 947 | – | – | – | $13,549$10,530–$19,681 · 18 plans | |
| Signs and Symptoms Without Mcc 948 | – | – | – | $8,544$6,815–$12,411 · 18 plans | |
| Aftercare with Cc/Mcc 949 | – | – | – | $12,698$9,899–$18,445 · 18 plans | |
| Aftercare Without Cc/Mcc 950 | – | – | – | $6,700$5,446–$9,732 · 18 plans | |
| Other Factors Influencing Health Status 951 | – | – | – | $5,934$4,878–$8,620 · 18 plans | |
| Ms-Drg 955 955 | – | – | – | $71,844$53,801–$104,360 · 18 plans | |
| Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma 956 | – | – | – | $40,164$30,286–$58,342 · 18 plans | |
| Other O.r. Procedures for Multiple Significant Trauma with Mcc 957 | – | – | – | $81,331$60,843–$118,140 · 18 plans | |
| Other O.r. Procedures for Multiple Significant Trauma with Cc 958 | – | – | – | $44,977$33,858–$65,333 · 18 plans | |
| Ms-Drg 959 959 | – | – | – | $31,424$23,798–$45,646 · 18 plans | |
| Other Multiple Significant Trauma with Mcc 963 | – | – | – | $29,179$22,132–$42,385 · 18 plans | |
| Other Multiple Significant Trauma with Cc 964 | – | – | – | $16,358$12,615–$23,762 · 18 plans | |
| Ms-Drg 965 965 | – | – | – | $10,038$7,924–$14,582 · 18 plans | |
| Ms-Drg 969 969 | – | – | – | $65,336$48,970–$94,905 · 18 plans | |
| Ms-Drg 970 970 | – | – | – | $28,150$21,368–$40,891 · 18 plans | |
| Hiv with Major Related Condition with Mcc 974 | – | – | – | $30,804$23,338–$44,745 · 18 plans | |
| Hiv with Major Related Condition with Cc 975 | – | – | – | $13,822$10,733–$20,078 · 18 plans | |
| Ms-Drg 976 976 | – | – | – | $9,635$7,625–$13,996 · 18 plans | |
| Ms-Drg 977 977 | – | – | – | $13,851$10,754–$20,120 · 18 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 981 | – | – | – | $50,078$37,644–$72,742 · 18 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 982 | – | – | – | $26,241$19,951–$38,117 · 18 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis Without Cc/Mcc 983 | – | – | – | $18,294$14,052–$26,574 · 18 plans | |
| Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 987 | – | – | – | $36,593$27,635–$53,154 · 18 plans | |
| Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 988 | – | – | – | $17,543$13,495–$25,483 · 18 plans | |
| Ms-Drg 989 989 | – | – | – | $12,800$9,974–$18,593 · 18 plans |
Outpatient procedures and tests
The hospital's facility charge only; doctors usually bill separately.
| Procedure | List price | Cash price | Insurers (median) |
|---|---|---|---|
| Cataract surgery CPT 66984 | – | – | $4,029$3,681–$5,000 · 3 plans |
| Colonoscopy CPT 45378 | $5,243 | $3,408 | $3,146$1,506–$5,154 · 25 plans |
| Colonoscopy with biopsy CPT 45380 | – | – | $3,314$2,016–$5,804 · 8 plans |
| Complete blood count (CBC) CPT 85025 | $154 | $100 | $55$18–$120 · 15 plans |
| Comprehensive metabolic panel (blood test) CPT 80053 | $306 | $199 | $109$24–$239 · 15 plans |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $3,080 | $2,002 | $830$464–$2,279 · 22 plans |
| Emergency room visit, highest level CPT 99285 | $5,288 | $3,437 | $1,639$860–$3,754 · 25 plans |
| Gallbladder removal (laparoscopic) CPT 47562 | $33,548 | $21,806 | $12,702$8,518–$25,496 · 19 plans |
| Hip replacement CPT 27130 | – | – | $19,319$13,128–$26,154 · 6 plans |
| Knee arthroscopy (meniscus) CPT 29881 | – | – | $5,732$5,237–$7,113 · 3 plans |
| Knee replacement CPT 27447 | – | – | $20,277$13,816–$26,838 · 5 plans |
| MRI of the brain, with and without contrast CPT 70553 | $3,080 | $2,002 | $888$616–$2,279 · 22 plans |
| MRI of the knee, without contrast CPT 73721 | $2,085 | $1,355 | $680$438–$1,658 · 22 plans |
Price file: Cleveland Clinic, read November 9, 2026.