Saint Francis Medical Center

530 NE Glen Oak Ave, Peoria, IL 61637 · (309) 655-2000

General hospitalVoluntary non-profit - PrivateEmergency roomCMS rating ★★★★★

The money

$17what care cost the hospital for every $100 it billed

$310.0Mnet income, all sources

15.9%margin on patient care alone

$21.1Mcost of charity care (2.0% of costs)

$25.7Munpaid bills written off (bad debt)

642beds

From the hospital's Medicare cost report for the year ending September 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	643	$100,767	$21,291	$30,177$23,796–$42,216 · 11 plans
Heart failure, with major complications 291	323	$50,813	$12,085	$19,944$15,727–$27,901 · 11 plans
Infection needing surgery, with major complications 853	125	$231,447	$44,662	$76,721$60,498–$107,331 · 11 plans
Sepsis 872	125	$47,500	$11,801	$15,897$12,535–$22,239 · 11 plans
Lung infection, with major complications 177	121	$72,150	$19,397	$24,277$19,143–$33,962 · 11 plans
Stroke, with complications or clot-busting drug 065	119	$57,542	$11,662	$15,695$12,376–$21,957 · 11 plans
Heart valve replacement through a catheter (TAVR) 267	110	$255,109	$42,780	$73,959$58,320–$103,466 · 11 plans
Stomach or intestinal bleeding, with complications 378	103	$47,950	$10,871	$15,235$12,014–$21,314 · 11 plans
Back problems (no surgery) 552	100	$47,521	$9,450	$14,934$11,776–$20,892 · 11 plans
Other kidney and urinary problems, with major complications 698	97	$71,485	$16,824	$25,701$20,266–$35,955 · 11 plans
Stroke, with major complications 064	96	$103,361	$19,780	$31,241$24,635–$43,705 · 11 plans
Stomach and digestive disorders 392	95	$36,591	$9,447	$12,111$9,550–$16,943 · 11 plans
Fainting 312	86	$38,773	$8,289	$13,540$10,677–$18,942 · 11 plans
Hip or thigh bone surgery (not replacement), with complications 481	86	$115,161	$18,614	$32,538$25,658–$45,520 · 11 plans
Heart stent 322	82	$113,045	$17,168	$27,388$21,597–$38,315 · 11 plans
Pneumonia, with major complications 193	81	$62,344	$13,358	$20,419$16,101–$28,566 · 11 plans
Urinary tract infection, with major complications 689	80	$49,442	$11,080	$18,025$14,214–$25,217 · 11 plans
Heart attack, with major complications 280	79	$86,232	$14,881	$24,920$19,650–$34,862 · 11 plans
Urinary tract infection 690	78	$34,693	$8,120	$12,576$9,916–$17,593 · 11 plans
Craniotomy and Endovascular Intracranial Procedures with Mcc 025	74	$212,786	$42,698	$70,633$55,697–$98,813 · 11 plans
Skin infection (cellulitis) 603	74	$37,216	$9,390	$13,529$10,669–$18,927 · 11 plans
Heart catheterization 287	73	$56,827	$11,098	$16,624$13,109–$23,256 · 11 plans
Seizures 101	71	$44,870	$10,605	$14,022$11,057–$19,616 · 11 plans
Kidney failure, with complications 683	71	$31,899	$10,096	$13,606$10,729–$19,034 · 11 plans
Respiratory failure 189	66	$63,458	$14,275	$19,192$15,134–$26,849 · 11 plans
Degenerative nerve disorders (e.g. Parkinson's, dementia) 057	64	$51,127	$13,124	$20,127$15,871–$28,157 · 11 plans
Stomach or intestinal bleeding, with major complications 377	61	$81,223	$22,486	$28,398$22,393–$39,728 · 11 plans
Dehydration and electrolyte problems, with major complications 640	61	$56,682	$12,449	$20,749$16,361–$29,027 · 11 plans
Dehydration and electrolyte problems 641	61	$28,990	$7,495	$12,089$9,533–$16,913 · 11 plans
Heart catheterization, with major complications 286	57	$97,091	$20,273	$34,376$27,107–$48,091 · 11 plans
COPD, with major complications 190	56	$51,066	$11,862	$17,208$13,569–$24,074 · 11 plans
Other kidney and urinary problems, with complications 699	55	$60,158	$9,818	$15,768$12,434–$22,059 · 11 plans
Hip or knee replacement 470	54	$93,721	$18,174	$29,965$23,629–$41,921 · 11 plans
Kidney failure, with major complications 682	54	$67,347	$16,219	$23,007$18,142–$32,187 · 11 plans
Irregular heartbeat, with complications 309	51	$32,297	$7,354	$11,429$9,012–$15,989 · 11 plans
Bowel surgery, with complications 330	49	$147,661	$29,787	$37,241$29,366–$52,098 · 11 plans
Other Vascular Procedures with Mcc 252	46	$163,216	$32,377	$54,191$42,732–$75,811 · 11 plans
Breathing problem needing a ventilator (up to 4 days) 208	43	$156,817	$33,424	$42,701$33,672–$59,738 · 11 plans
Fracture or sprain (not hip or thigh) 563	42	$38,306	$8,761	$13,912$10,970–$19,462 · 11 plans
Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis with Mcc O 023	40	$298,266	$64,185	$89,020$70,196–$124,537 · 11 plans
Lung infection, with complications 178	40	$39,333	$10,025	$15,162$11,956–$21,211 · 11 plans
Other digestive problems, with complications 394	40	$49,297	$9,130	$14,536$11,462–$20,336 · 11 plans
Septicemia or Severe Sepsis with Mv >96 Hours 870	39	$365,576	$91,066	$107,375$84,670–$150,214 · 11 plans
Pneumonia, with complications 194	38	$26,883	$8,313	$12,520$9,872–$17,515 · 11 plans
Other circulation problems, with major complications 314	38	$71,472	$21,022	$32,394$25,544–$45,318 · 11 plans
Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 981	38	$234,843	$46,101	$72,887$57,475–$101,967 · 11 plans
Other Disorders of Nervous System with Cc 092	37	$45,355	$15,452	$15,892$12,532–$22,233 · 11 plans
Chronic Obstructive Pulmonary Disease with Cc 191	37	$30,992	$9,964	$13,096$10,327–$18,321 · 11 plans
Irregular heartbeat, with major complications 308	37	$55,003	$12,611	$18,704$14,749–$26,167 · 11 plans
High blood pressure 305	36	$37,293	$7,353	$11,730$9,250–$16,411 · 11 plans
Hip or thigh bone surgery (not replacement), with major complications 480	36	$165,137	$26,641	$45,243$35,676–$63,293 · 11 plans
Seizures with Mcc 100	35	$149,900	$20,868	$30,088$23,726–$42,092 · 11 plans
Other Major Cardiovascular Procedures with Mcc 270	35	$290,112	$43,785	$81,967$64,635–$114,670 · 11 plans
Other Major Cardiovascular Procedures with Cc 271	35	$209,445	$31,177	$55,247$43,565–$77,289 · 11 plans
Heart stent, with major complications or 4+ stents 321	35	$166,951	$25,650	$42,268$33,330–$59,131 · 11 plans
Disorders of the Biliary Tract with Cc 445	35	$73,073	$11,671	$17,002$13,406–$23,785 · 11 plans
Cervical Spinal Fusion with Cc 472	35	$183,256	$30,526	$45,768$36,090–$64,028 · 11 plans
Heart attack, with complications 281	34	$50,511	$8,660	$14,278$11,259–$19,975 · 11 plans
Other Vascular Procedures with Cc 253	33	$166,706	$30,260	$40,323$31,796–$56,410 · 11 plans
Bowel surgery, with major complications 329	33	$286,413	$55,546	$71,407$56,307–$99,896 · 11 plans
Medical Back Problems with Mcc 551	33	$101,286	$15,859	$26,038$20,532–$36,427 · 11 plans
Diabetes, with major complications 637	33	$76,206	$13,236	$22,319$17,600–$31,224 · 11 plans
Coagulation Disorders 813	33	$53,629	$14,504	$23,696$18,685–$33,149 · 11 plans
Pulmonary Embolism Without Mcc 176	32	$40,837	$7,765	$12,506$9,861–$17,495 · 11 plans
Stomach and digestive disorders, with major complications 391	32	$53,405	$12,101	$19,703$15,537–$27,564 · 11 plans
Other Digestive System Diagnoses with Mcc 393	32	$63,846	$18,488	$24,845$19,591–$34,758 · 11 plans
Kidney and Ureter Procedures for Non-Neoplasm with Cc 660	32	$61,195	$14,049	$20,533$16,191–$28,725 · 11 plans
Traumatic Stupor and Coma <1 Hour with Cc 086	31	$66,937	$14,719	$20,237$15,958–$28,312 · 11 plans
Signs and Symptoms Without Mcc 948	31	$42,110	$7,800	$12,436$9,806–$17,397 · 11 plans
Major Chest Procedures with Cc 164	30	$118,057	$37,906	$39,210$30,919–$54,854 · 11 plans
Coronary Bypass with Cardiac Catheterization or Open Ablation with Mcc 233	30	$391,965	$74,794	$118,768$93,654–$166,153 · 11 plans
Disorders of Pancreas Except Malignancy with Cc 439	30	$39,329	$9,803	$13,068$10,305–$18,282 · 11 plans
Combined Anterior and Posterior Spinal Fusion with Cc 454	30	$205,380	$53,203	$95,017$74,925–$132,926 · 11 plans
Major Chest Trauma with Cc 184	29	$74,993	$11,120	$16,531$13,035–$23,126 · 11 plans
Major Joint or Limb Reattachment Procedures of Upper Extremities 483	29	$98,003	$20,989	$43,061$33,956–$60,242 · 11 plans
Complications of Treatment with Mcc 919	29	$70,745	$18,357	$28,441$22,427–$39,789 · 11 plans
Anemia and blood disorders 812	28	$41,904	$11,214	$14,264$11,248–$19,955 · 11 plans
Traumatic Stupor and Coma >1 Hour with Cc 083	27	$58,781	$12,535	$21,684$17,099–$30,335 · 11 plans
Pulmonary Embolism with Mcc or Acute Cor Pulmonale 175	27	$63,791	$13,262	$21,339$16,827–$29,852 · 11 plans
Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 219	27	$391,026	$110,382	$119,282$94,059–$166,872 · 11 plans
Permanent Cardiac Pacemaker Implant with Cc 243	27	$134,650	$30,707	$33,104$26,104–$46,311 · 11 plans
Heart valve replacement through a catheter (TAVR), with major complications 266	27	$365,271	$54,095	$95,205$75,073–$133,189 · 11 plans
Malignancy of Hepatobiliary System or Pancreas with Mcc 435	27	$80,573	$18,851	$28,533$22,500–$39,917 · 11 plans
Revision of Hip or Knee Replacement with Cc 467	26	$151,691	$32,674	$54,786$43,201–$76,644 · 11 plans
Hip replacement after a hip fracture 522	26	$96,246	$18,945	$32,898$25,942–$46,024 · 11 plans
Major Gastrointestinal Disorders and Peritoneal Infections with Cc 372	25	$44,728	$10,102	$15,861$12,507–$22,189 · 11 plans
Laparoscopic Cholecystectomy Without C.d.e. with Cc 418	25	$111,746	$24,218	$26,279$20,722–$36,764 · 11 plans
Combined Anterior and Posterior Spinal Fusion Without Cc/Mcc 455	24	$197,383	$40,059	$71,548$56,419–$100,094 · 11 plans
Spinal fusion (lower or mid back) 460	24	$202,567	$48,545	$56,825$44,809–$79,497 · 11 plans
Ecmo or Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Nec 003	23	$777,860	$154,795	$329,733$260,009–$461,287 · 11 plans
Degenerative Nervous System Disorders with Mcc 056	23	$107,507	$21,021	$36,089$28,458–$50,488 · 11 plans
Cranial and Peripheral Nerve Disorders Without Mcc 074	23	$70,116	$10,383	$16,013$12,627–$22,402 · 11 plans
Other Circulatory System Diagnoses with Cc 315	23	$41,348	$10,329	$14,965$11,800–$20,935 · 11 plans
Traumatic Stupor and Coma >1 Hour with Mcc 082	22	$88,440	$20,321	$35,507$27,999–$49,673 · 11 plans
Traumatic Stupor and Coma <1 Hour with Mcc 085	22	$119,904	$27,068	$35,294$27,831–$49,375 · 11 plans
Major Chest Procedures Without Cc/Mcc 165	22	$122,230	$22,823	$29,737$23,449–$41,601 · 11 plans
Aortic and Heart Assist Procedures Except Pulsation Balloon Without Mcc 269	22	$188,524	$38,797	$65,607$51,734–$91,783 · 11 plans
Heart procedure through a catheter (e.g. ablation, valve clip) 274	22	$171,384	$40,574	$51,137$40,323–$71,539 · 11 plans
Digestive Malignancy with Mcc 374	22	$113,558	$19,692	$33,225$26,199–$46,480 · 11 plans
Kidney Transplant 652	22	$317,824	$31,493	$50,170$39,561–$70,187 · 11 plans
Hypertension with Mcc 304	21	$73,716	$14,894	$18,487$14,578–$25,862 · 11 plans
Coronary Intravascular Lithotripsy with Intraluminal Device Without Mcc 324	21	$164,120	$25,225	$48,951$38,600–$68,481 · 11 plans
Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Cc 493	21	$157,652	$22,256	$39,398$31,067–$55,117 · 11 plans
Kidney and Ureter Procedures for Non-Neoplasm with Mcc 659	21	$127,381	$31,265	$39,473$31,126–$55,221 · 11 plans
Intracranial Hemorrhage or Cerebral Infarction Without Cc/Mcc 066	20	$41,265	$15,885	$10,632$8,384–$14,874 · 11 plans
Traumatic Stupor and Coma <1 Hour Without Cc/Mcc 087	20	$36,349	$8,242	$14,210$11,205–$19,879 · 11 plans
Coronary Bypass Without Cardiac Catheterization with Mcc 235	20	$306,655	$57,814	$91,169$71,890–$127,542 · 11 plans
Postoperative and Post-Traumatic Infections with Mcc 862	20	$77,410	$15,963	$28,331$22,340–$39,634 · 11 plans
Peripheral, Cranial Nerve and Other Nervous System Procedures with Cc or Peripheral Neur 041	19	$119,441	$30,201	$34,157$26,934–$47,784 · 11 plans
Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 062	19	$110,746	$21,583	$27,298$21,526–$38,189 · 11 plans
Chest pain 313	19	$31,428	$6,833	$11,185$8,820–$15,648 · 11 plans
Major Small and Large Bowel Procedures Without Cc/Mcc 331	19	$105,383	$17,001	$26,144$20,616–$36,574 · 11 plans
Digestive Malignancy with Cc 375	19	$63,187	$10,576	$18,791$14,818–$26,288 · 11 plans
Cirrhosis and Alcoholic Hepatitis with Mcc 432	19	$136,878	$23,888	$30,576$24,110–$42,775 · 11 plans
Disorders of the Biliary Tract with Mcc 444	19	$84,688	$15,087	$25,957$20,469–$36,314 · 11 plans
Craniotomy and Endovascular Intracranial Procedures Without Cc/Mcc 027	18	$161,432	$27,219	$39,193$30,906–$54,830 · 11 plans
Respiratory Neoplasms with Mcc 180	18	$69,621	$16,524	$27,435$21,634–$38,380 · 11 plans
Pneumothorax with Cc 200	18	$80,160	$10,032	$17,078$13,466–$23,891 · 11 plans
Disorders of Pancreas Except Malignancy with Mcc 438	18	$75,191	$20,026	$25,325$19,970–$35,429 · 11 plans
Signs and Symptoms of Musculoskeletal System and Connective Tissue Without Mcc 556	18	$28,392	$7,946	$12,903$10,175–$18,051 · 11 plans
Anemia and blood disorders, with major complications 811	18	$81,449	$12,737	$21,816$17,203–$30,520 · 11 plans
Permanent Cardiac Pacemaker Implant with Mcc 242	17	$159,793	$30,215	$49,600$39,112–$69,389 · 11 plans
Peripheral Vascular Disorders with Mcc 299	17	$74,290	$16,296	$25,364$20,001–$35,483 · 11 plans
Major Gastrointestinal Disorders and Peritoneal Infections with Mcc 371	17	$88,783	$16,789	$27,545$21,720–$38,535 · 11 plans
Revision of Hip or Knee Replacement Without Cc/Mcc 468	17	$119,067	$22,401	$42,690$33,663–$59,722 · 11 plans
Back and Neck Procedures Except Spinal Fusion with Cc 519	17	$130,105	$25,212	$31,073$24,502–$43,470 · 11 plans
Diabetes, with complications 638	17	$41,457	$8,354	$13,922$10,978–$19,477 · 11 plans
Infectious and Parasitic Diseases with O.r. Procedures with Cc 854	17	$121,193	$19,508	$31,040$24,477–$43,425 · 11 plans
Other O.r. Procedures for Injuries with Mcc 907	17	$176,890	$49,509	$59,644$47,031–$83,440 · 11 plans
Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 987	17	$130,741	$30,059	$53,260$41,998–$74,509 · 11 plans
Mini-stroke (TIA) 069	16	$52,902	$7,726	$12,409$9,785–$17,360 · 11 plans
Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Cc 617	16	$106,781	$18,628	$29,055$22,911–$40,647 · 11 plans
Craniotomy and Endovascular Intracranial Procedures with Cc 026	15	$185,425	$33,644	$48,301$38,088–$67,572 · 11 plans
Other Cerebrovascular Disorders with Cc 071	15	$59,111	$10,374	$15,939$12,569–$22,298 · 11 plans
Other Disorders of Nervous System Without Cc/Mcc 093	15	$69,327	$9,484	$12,371$9,755–$17,306 · 11 plans
Dysequilibrium 149	15	$31,107	$7,048	$11,676$9,207–$16,335 · 11 plans
Interstitial Lung Disease with Mcc 196	15	$100,196	$20,722	$29,318$23,118–$41,015 · 11 plans
Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 282	15	$41,741	$10,860	$11,233$8,858–$15,715 · 11 plans
Stomach, Esophageal and Duodenal Procedures with Mcc 326	15	$279,329	$64,394	$77,479$61,096–$108,391 · 11 plans
Stomach, Esophageal and Duodenal Procedures with Cc 327	15	$104,444	$23,654	$37,971$29,941–$53,120 · 11 plans
Other Digestive System O.r. Procedures with Mcc 356	15	$250,091	$40,798	$68,242$53,812–$95,469 · 11 plans
Laparoscopic Cholecystectomy Without C.d.e. with Mcc 417	15	$108,012	$20,835	$37,073$29,233–$51,864 · 11 plans
Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 419	15	$91,692	$26,470	$21,218$16,731–$29,683 · 11 plans
Cellulitis with Mcc 602	15	$57,715	$14,441	$22,080$17,411–$30,889 · 11 plans
Trauma to the Skin, Subcutaneous Tissue and Breast Without Mcc 605	15	$38,238	$8,764	$14,230$11,221–$19,907 · 11 plans
Endocrine Disorders with Cc 644	15	$39,173	$9,558	$15,923$12,556–$22,276 · 11 plans
Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Cc 847	15	$132,245	$30,859	$20,323$16,025–$28,431 · 11 plans
Other O.r. Procedures for Injuries with Cc 908	15	$92,352	$17,224	$30,995$24,441–$43,362 · 11 plans
Complications of Treatment with Cc 920	15	$49,084	$11,720	$15,571$12,278–$21,783 · 11 plans
Other Disorders of Nervous System with Mcc 091	14	$101,637	$17,228	$27,283$21,513–$38,167 · 11 plans
Pneumothorax with Mcc 199	14	$95,895	$31,525	$27,405$21,610–$38,339 · 11 plans
Permanent Cardiac Pacemaker Implant Without Cc/Mcc 244	14	$115,572	$15,703	$28,080$22,142–$39,282 · 11 plans
Other Vascular Procedures Without Cc/Mcc 254	14	$138,473	$15,919	$27,679$21,826–$38,722 · 11 plans
Gastrointestinal Obstruction with Mcc 388	14	$62,846	$13,142	$22,942$18,091–$32,095 · 11 plans
Pancreas, Liver and Shunt Procedures with Cc 406	14	$144,788	$29,398	$45,055$35,527–$63,030 · 11 plans
Poisoning and Toxic Effects of Drugs with Mcc 917	14	$90,573	$25,715	$24,365$19,213–$34,086 · 11 plans
Carotid Artery Stent Procedures Without Cc/Mcc 036	13	$110,443	$15,447	$30,181$23,799–$42,223 · 11 plans
Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 061	13	$149,815	$37,048	$42,832$33,774–$59,920 · 11 plans
Other Cerebrovascular Disorders with Mcc 070	13	$137,337	$19,674	$25,863$20,394–$36,181 · 11 plans
Other Disorders of the Eye Without Mcc 125	13	$39,593	$7,707	$11,928$9,406–$16,687 · 11 plans
Major Chest Trauma with Mcc 183	13	$111,954	$15,141	$23,767$18,741–$33,249 · 11 plans
Bronchitis and Asthma with Cc/Mcc 202	13	$46,890	$10,691	$15,088$11,897–$21,107 · 11 plans
Respiratory System Diagnosis with Ventilator Support >96 Hours 207	13	$223,401	$53,439	$99,963$78,825–$139,845 · 11 plans
Irregular heartbeat 310	13	$23,467	$5,523	$8,794$6,935–$12,303 · 11 plans
Bowel obstruction, with complications 389	13	$40,552	$10,558	$12,270$9,675–$17,165 · 11 plans
Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Cc 442	13	$53,966	$8,413	$14,996$11,825–$20,979 · 11 plans
Cervical Spinal Fusion with Mcc 471	13	$234,263	$40,231	$75,014$59,152–$104,942 · 11 plans
Fractures of Hip and Pelvis Without Mcc 536	13	$39,015	$10,117	$12,546$9,893–$17,552 · 11 plans
Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Cc 543	13	$50,420	$10,505	$15,970$12,593–$22,342 · 11 plans
Endocrine Disorders with Mcc 643	13	$69,976	$14,436	$25,572$20,165–$35,775 · 11 plans
Postoperative or Post-Traumatic Infections with O.r. Procedures with Mcc 856	13	$258,177	$54,300	$70,664$55,722–$98,857 · 11 plans
Delirium and other mental confusion 884	13	$44,612	$16,261	$24,994$19,709–$34,966 · 11 plans
Other Multiple Significant Trauma with Mcc 963	13	$155,658	$26,316	$42,470$33,489–$59,414 · 11 plans
Extracranial Procedures with Cc 038	12	$146,613	$15,774	$25,207$19,877–$35,264 · 11 plans
Acute Myocardial Infarction, Expired with Mcc 283	12	$107,313	$20,008	$30,772$24,265–$43,049 · 11 plans
Cirrhosis and Alcoholic Hepatitis with Cc 433	12	$40,860	$9,747	$16,408$12,938–$22,954 · 11 plans
Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Mcc 441	12	$61,693	$20,457	$27,881$21,985–$39,004 · 11 plans
Bone Diseases and Arthropathies Without Mcc 554	12	$47,304	$8,868	$12,896$10,169–$18,041 · 11 plans
Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 808	12	$187,586	$36,875	$34,300$27,047–$47,984 · 11 plans
Lymphoma and Non-Acute Leukemia with Cc 841	12	$97,034	$18,885	$25,344$19,985–$35,455 · 11 plans
Postoperative or Post-Traumatic Infections with O.r. Procedures with Cc 857	12	$115,517	$20,088	$33,268$26,233–$46,541 · 11 plans
Ventricular Shunt Procedures with Cc 032	11	$105,539	$18,506	$33,105$26,105–$46,313 · 11 plans
Major Chest Procedures with Mcc 163	11	$141,025	$38,068	$69,625$54,902–$97,403 · 11 plans
Other Respiratory System Diagnoses with Mcc 205	11	$78,228	$18,833	$28,445$22,430–$39,793 · 11 plans
Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 220	11	$367,495	$47,036	$82,845$65,327–$115,898 · 11 plans
Coronary Bypass Without Cardiac Catheterization Without Mcc 236	11	$295,122	$36,545	$65,073$51,313–$91,035 · 11 plans
Peripheral Vascular Disorders with Cc 300	11	$64,883	$9,840	$16,584$13,077–$23,200 · 11 plans
Coronary Intravascular Lithotripsy with Intraluminal Device with Mcc 323	11	$205,876	$34,872	$67,226$53,011–$94,047 · 11 plans
Other Digestive System O.r. Procedures with Cc 357	11	$121,487	$21,466	$36,127$28,487–$50,540 · 11 plans
Other Musculoskeletal System and Connective Tissue O.r. Procedures with Mcc 515	11	$115,336	$27,842	$49,508$39,040–$69,261 · 11 plans
Aftercare, Musculoskeletal System and Connective Tissue with Cc 560	11	$42,192	$10,222	$17,494$13,795–$24,474 · 11 plans
Uterine and Adnexa Procedures for Non-Malignancy with Cc/Mcc 742	11	$119,936	$16,688	$28,504$22,476–$39,876 · 11 plans
Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma 956	11	$142,586	$32,429	$58,458$46,097–$81,781 · 11 plans
Heart Transplant or Implant of Heart Assist System with Mcc 001	–	–	–	$435,351$343,293–$609,043 · 11 plans
Ms-Drg 002 002	–	–	–	$176,040$138,815–$246,274 · 11 plans
Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Neck Withou 004	–	–	–	$215,182$169,680–$301,032 · 11 plans
Liver Transplant with Mcc or Intestinal Transplant 005	–	–	–	$160,174$126,304–$224,078 · 11 plans
Liver Transplant Without Mcc 006	–	–	–	$72,036$56,803–$100,776 · 11 plans
Lung Transplant 007	–	–	–	$201,181$158,640–$281,447 · 11 plans
Ms-Drg 008 008	–	–	–	$87,067$68,656–$121,805 · 11 plans
Ms-Drg 009 009	–	–	–	Not in dollars (22 plans)
Ms-Drg 010 010	–	–	–	$111,475$87,902–$155,949 · 11 plans
Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Mcc 011	–	–	–	$84,729$66,813–$118,534 · 11 plans
Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Cc 012	–	–	–	$65,496$51,646–$91,626 · 11 plans
Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy Without Cc/Mcc 013	–	–	–	$44,769$35,302–$62,630 · 11 plans
Allogeneic Bone Marrow Transplant 014	–	–	–	$186,698$147,219–$261,185 · 11 plans
Autologous Bone Marrow Transplant with Cc/Mcc 016	–	–	–	$92,118$72,639–$128,870 · 11 plans
Ms-Drg 017 017	–	–	–	$84,391$66,546–$118,060 · 11 plans
Chimeric Antigen Receptor (car) T-Cell and Other Immunotherapies 018	–	–	–	$670,845$528,989–$938,492 · 11 plans
Ms-Drg 019 019	–	–	–	$110,836$87,399–$155,056 · 11 plans
Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Mcc 020	–	–	–	$122,242$96,393–$171,013 · 11 plans
Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Cc 021	–	–	–	$82,239$64,849–$115,050 · 11 plans
Ms-Drg 022 022	–	–	–	$49,361$38,923–$69,054 · 11 plans
Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis Without Mc 024	–	–	–	$60,771$47,921–$85,017 · 11 plans
Spinal Procedures with Mcc 028	–	–	–	$93,339$73,602–$130,578 · 11 plans
Spinal Procedures with Cc or Spinal Neurostimulators 029	–	–	–	$52,999$41,792–$74,144 · 11 plans
Spinal Procedures Without Cc/Mcc 030	–	–	–	$34,102$26,891–$47,708 · 11 plans
Ventricular Shunt Procedures with Mcc 031	–	–	–	$69,605$54,886–$97,375 · 11 plans
Ventricular Shunt Procedures Without Cc/Mcc 033	–	–	–	$25,833$20,371–$36,140 · 11 plans
Carotid Artery Stent Procedures with Mcc 034	–	–	–	$60,131$47,416–$84,122 · 11 plans
Carotid Artery Stent Procedures with Cc 035	–	–	–	$37,136$29,284–$51,953 · 11 plans
Extracranial Procedures with Mcc 037	–	–	–	$51,143$40,328–$71,547 · 11 plans
Extracranial Procedures Without Cc/Mcc 039	–	–	–	$18,261$14,400–$25,547 · 11 plans
Peripheral, Cranial Nerve and Other Nervous System Procedures with Mcc 040	–	–	–	$59,984$47,300–$83,915 · 11 plans
Peripheral, Cranial Nerve and Other Nervous System Procedures Without Cc/Mcc 042	–	–	–	$26,840$21,164–$37,548 · 11 plans
Ms-Drg 043 043	–	–	–	Not in dollars (22 plans)
Ms-Drg 044 044	–	–	–	Not in dollars (22 plans)
Ms-Drg 045 045	–	–	–	Not in dollars (22 plans)
Ms-Drg 046 046	–	–	–	Not in dollars (22 plans)
Ms-Drg 047 047	–	–	–	Not in dollars (22 plans)
Ms-Drg 048 048	–	–	–	Not in dollars (22 plans)
Ms-Drg 049 049	–	–	–	Not in dollars (22 plans)
Ms-Drg 050 050	–	–	–	Not in dollars (22 plans)
Ms-Drg 051 051	–	–	–	Not in dollars (22 plans)
Ms-Drg 052 052	–	–	–	$28,139$22,188–$39,365 · 11 plans
Ms-Drg 053 053	–	–	–	$15,212$11,995–$21,281 · 11 plans
Nervous System Neoplasms with Mcc 054	–	–	–	$23,720$18,705–$33,184 · 11 plans
Nervous System Neoplasms Without Mcc 055	–	–	–	$15,839$12,490–$22,159 · 11 plans
Ms-Drg 058 058	–	–	–	$26,557$20,941–$37,153 · 11 plans
Ms-Drg 059 059	–	–	–	$19,277$15,201–$26,968 · 11 plans
Ms-Drg 060 060	–	–	–	$14,289$11,268–$19,990 · 11 plans
Ms-Drg 063 063	–	–	–	$21,808$17,197–$30,509 · 11 plans
Ms-Drg 067 067	–	–	–	$22,816$17,992–$31,919 · 11 plans
Precerebral Occlusion Without Infarction Without Mcc 068	–	–	–	$13,428$10,589–$18,786 · 11 plans
Other Cerebrovascular Disorders Without Cc/Mcc 072	–	–	–	$11,748$9,263–$16,434 · 11 plans
Cranial and Peripheral Nerve Disorders with Mcc 073	–	–	–	$24,923$19,653–$34,866 · 11 plans
Ms-Drg 075 075	–	–	–	$29,788$23,489–$41,673 · 11 plans
Ms-Drg 076 076	–	–	–	$12,819$10,109–$17,934 · 11 plans
Hypertensive Encephalopathy with Mcc 077	–	–	–	$24,020$18,941–$33,604 · 11 plans
Hypertensive Encephalopathy with Cc 078	–	–	–	$15,501$12,223–$21,685 · 11 plans
Ms-Drg 079 079	–	–	–	$10,357$8,167–$14,489 · 11 plans
Nontraumatic Stupor and Coma with Mcc 080	–	–	–	$28,118$22,173–$39,337 · 11 plans
Ms-Drg 081 081	–	–	–	$13,913$10,971–$19,464 · 11 plans
Traumatic Stupor and Coma >1 Hour Without Cc/Mcc 084	–	–	–	$14,848$11,709–$20,772 · 11 plans
Concussion with Mcc 088	–	–	–	$21,000$16,560–$29,379 · 11 plans
Concussion with Cc 089	–	–	–	$17,067$13,458–$23,876 · 11 plans
Concussion Without Cc/Mcc 090	–	–	–	$12,788$10,084–$17,891 · 11 plans
Bacterial and Tuberculous Infections of Nervous System with Mcc 094	–	–	–	$54,674$43,113–$76,487 · 11 plans
Ms-Drg 095 095	–	–	–	$40,068$31,595–$56,054 · 11 plans
Ms-Drg 096 096	–	–	–	$40,068$31,595–$56,054 · 11 plans
Non-Bacterial Infection of Nervous System Except Viral Meningitis with Mcc 097	–	–	–	$56,109$44,245–$78,495 · 11 plans
Ms-Drg 098 098	–	–	–	$35,651$28,113–$49,875 · 11 plans
Ms-Drg 099 099	–	–	–	$21,165$16,689–$29,609 · 11 plans
Headaches with Mcc 102	–	–	–	$17,413$13,731–$24,361 · 11 plans
Headaches Without Mcc 103	–	–	–	$12,992$10,245–$18,175 · 11 plans
Ms-Drg 104 104	–	–	–	Not in dollars (22 plans)
Ms-Drg 105 105	–	–	–	Not in dollars (22 plans)
Ms-Drg 106 106	–	–	–	Not in dollars (22 plans)
Ms-Drg 107 107	–	–	–	Not in dollars (22 plans)
Ms-Drg 108 108	–	–	–	Not in dollars (22 plans)
Ms-Drg 109 109	–	–	–	Not in dollars (22 plans)
Ms-Drg 110 110	–	–	–	Not in dollars (22 plans)
Ms-Drg 111 111	–	–	–	Not in dollars (22 plans)
Ms-Drg 112 112	–	–	–	Not in dollars (22 plans)
Orbital Procedures with Cc/Mcc 113	–	–	–	$36,524$28,801–$51,096 · 11 plans
Ms-Drg 114 114	–	–	–	$21,019$16,574–$29,405 · 11 plans
Extraocular Procedures Except Orbit 115	–	–	–	$23,845$18,803–$33,358 · 11 plans
Intraocular Procedures with Cc/Mcc 116	–	–	–	$28,089$22,149–$39,295 · 11 plans
Ms-Drg 117 117	–	–	–	$16,854$13,290–$23,578 · 11 plans
Ms-Drg 118 118	–	–	–	Not in dollars (22 plans)
Ms-Drg 119 119	–	–	–	Not in dollars (22 plans)
Ms-Drg 120 120	–	–	–	Not in dollars (22 plans)
Acute Major Eye Infections with Cc/Mcc 121	–	–	–	$18,072$14,250–$25,282 · 11 plans
Ms-Drg 122 122	–	–	–	$12,207$9,626–$17,078 · 11 plans
Neurological Eye Disorders 123	–	–	–	$12,406$9,783–$17,356 · 11 plans
Other Disorders of the Eye with Mcc or Thrombolytic Agent 124	–	–	–	$20,554$16,208–$28,755 · 11 plans
Ms-Drg 126 126	–	–	–	Not in dollars (22 plans)
Ms-Drg 127 127	–	–	–	Not in dollars (22 plans)
Ms-Drg 128 128	–	–	–	Not in dollars (22 plans)
Ms-Drg 129 129	–	–	–	Not in dollars (22 plans)
Ms-Drg 130 130	–	–	–	Not in dollars (22 plans)
Ms-Drg 131 131	–	–	–	Not in dollars (22 plans)
Ms-Drg 132 132	–	–	–	Not in dollars (22 plans)
Ms-Drg 133 133	–	–	–	Not in dollars (22 plans)
Ms-Drg 134 134	–	–	–	Not in dollars (22 plans)
Ms-Drg 135 135	–	–	–	$33,711$26,583–$47,161 · 11 plans
Ms-Drg 136 136	–	–	–	$15,773$12,437–$22,066 · 11 plans
Ms-Drg 137 137	–	–	–	$23,197$18,292–$32,452 · 11 plans
Ms-Drg 138 138	–	–	–	$13,767$10,856–$19,260 · 11 plans
Ms-Drg 139 139	–	–	–	$19,197$15,137–$26,855 · 11 plans
Ms-Drg 140 140	–	–	–	$66,261$52,250–$92,698 · 11 plans
Major Head and Neck Procedures with Cc 141	–	–	–	$33,883$26,718–$47,402 · 11 plans
Major Head and Neck Procedures Without Cc/Mcc 142	–	–	–	$24,800$19,556–$34,695 · 11 plans
Ms-Drg 143 143	–	–	–	$58,203$45,896–$81,425 · 11 plans
Other Ear, Nose, Mouth and Throat O.r. Procedures with Cc 144	–	–	–	$26,921$21,228–$37,661 · 11 plans
Other Ear, Nose, Mouth and Throat O.r. Procedures Without Cc/Mcc 145	–	–	–	$18,678$14,728–$26,130 · 11 plans
Ear, Nose, Mouth and Throat Malignancy with Mcc 146	–	–	–	$32,894$25,938–$46,017 · 11 plans
Ear, Nose, Mouth and Throat Malignancy with Cc 147	–	–	–	$19,753$15,576–$27,634 · 11 plans
Ms-Drg 148 148	–	–	–	$12,383$9,764–$17,323 · 11 plans
Ms-Drg 150 150	–	–	–	$20,685$16,311–$28,937 · 11 plans
Epistaxis Without Mcc 151	–	–	–	$11,403$8,992–$15,952 · 11 plans
Otitis Media and Uri with Mcc 152	–	–	–	$18,365$14,482–$25,693 · 11 plans
Otitis Media and Uri Without Mcc 153	–	–	–	$11,468$9,043–$16,043 · 11 plans
Other Ear, Nose, Mouth and Throat Diagnoses with Mcc 154	–	–	–	$24,289$19,153–$33,980 · 11 plans
Other Ear, Nose, Mouth and Throat Diagnoses with Cc 155	–	–	–	$14,238$11,227–$19,918 · 11 plans
Ms-Drg 156 156	–	–	–	$10,736$8,466–$15,020 · 11 plans
Dental and Oral Diseases with Mcc 157	–	–	–	$26,670$21,031–$37,311 · 11 plans
Dental and Oral Diseases with Cc 158	–	–	–	$14,134$11,145–$19,773 · 11 plans
Ms-Drg 159 159	–	–	–	$11,007$8,679–$15,398 · 11 plans
Ms-Drg 160 160	–	–	–	Not in dollars (22 plans)
Ms-Drg 161 161	–	–	–	Not in dollars (22 plans)
Ms-Drg 162 162	–	–	–	Not in dollars (22 plans)
Other Respiratory System O.r. Procedures with Mcc 166	–	–	–	$58,065$45,787–$81,231 · 11 plans
Other Respiratory System O.r. Procedures with Cc 167	–	–	–	$28,016$22,092–$39,193 · 11 plans
Other Respiratory System O.r. Procedures Without Cc/Mcc 168	–	–	–	$21,227$16,738–$29,696 · 11 plans
Ms-Drg 169 169	–	–	–	Not in dollars (22 plans)
Ms-Drg 171 171	–	–	–	Not in dollars (22 plans)
Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolis 173	–	–	–	$46,238$36,461–$64,686 · 11 plans
Ms-Drg 174 174	–	–	–	Not in dollars (22 plans)
Respiratory Infections and Inflammations Without Cc/Mcc 179	–	–	–	$11,729$9,249–$16,408 · 11 plans
Respiratory Neoplasms with Cc 181	–	–	–	$16,638$13,120–$23,276 · 11 plans
Ms-Drg 182 182	–	–	–	$11,710$9,234–$16,382 · 11 plans
Major Chest Trauma Without Cc/Mcc 185	–	–	–	$12,218$9,635–$17,093 · 11 plans
Pleural Effusion with Mcc 186	–	–	–	$24,211$19,092–$33,871 · 11 plans
Pleural Effusion with Cc 187	–	–	–	$15,366$12,116–$21,496 · 11 plans
Ms-Drg 188 188	–	–	–	$11,142$8,786–$15,587 · 11 plans
Chronic Obstructive Pulmonary Disease Without Cc/Mcc 192	–	–	–	$9,973$7,865–$13,953 · 11 plans
Simple Pneumonia and Pleurisy Without Cc/Mcc 195	–	–	–	$9,764$7,699–$13,659 · 11 plans
Interstitial Lung Disease with Cc 197	–	–	–	$14,744$11,626–$20,627 · 11 plans
Ms-Drg 198 198	–	–	–	$11,126$8,773–$15,565 · 11 plans
Ms-Drg 201 201	–	–	–	$11,109$8,760–$15,541 · 11 plans
Bronchitis and Asthma Without Cc/Mcc 203	–	–	–	$10,408$8,208–$14,561 · 11 plans
Respiratory Signs and Symptoms 204	–	–	–	$12,543$9,891–$17,547 · 11 plans
Other Respiratory System Diagnoses Without Mcc 206	–	–	–	$14,620$11,528–$20,453 · 11 plans
Ms-Drg 209 209	–	–	–	$175,838$138,655–$245,991 · 11 plans
Ms-Drg 210 210	–	–	–	Not in dollars (22 plans)
Ms-Drg 211 211	–	–	–	Not in dollars (22 plans)
Concomitant Aortic and Mitral Valve Procedures 212	–	–	–	$168,929$133,208–$236,327 · 11 plans
Ms-Drg 213 213	–	–	–	$88,657$69,910–$124,028 · 11 plans
Ms-Drg 214 214	–	–	–	Not in dollars (22 plans)
Other Heart Assist System Implant 215	–	–	–	$154,682$121,973–$216,395 · 11 plans
Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 216	–	–	–	$151,976$119,839–$212,610 · 11 plans
Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 217	–	–	–	$102,147$80,547–$142,901 · 11 plans
Ms-Drg 218 218	–	–	–	$102,147$80,547–$142,901 · 11 plans
Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 221	–	–	–	$78,300$61,742–$109,539 · 11 plans
Ms-Drg 222 222	–	–	–	$118,945$93,793–$166,401 · 11 plans
Ms-Drg 223 223	–	–	–	$81,073$63,929–$113,418 · 11 plans
Ms-Drg 224 224	–	–	–	$110,131$86,843–$154,070 · 11 plans
Ms-Drg 225 225	–	–	–	$78,571$61,957–$109,919 · 11 plans
Ms-Drg 226 226	–	–	–	$99,438$78,411–$139,111 · 11 plans
Ms-Drg 227 227	–	–	–	$77,997$61,504–$109,115 · 11 plans
Other Cardiothoracic Procedures with Mcc 228	–	–	–	$76,858$60,606–$107,522 · 11 plans
Other Cardiothoracic Procedures Without Mcc 229	–	–	–	$48,927$38,581–$68,448 · 11 plans
Ms-Drg 230 230	–	–	–	Not in dollars (22 plans)
Coronary Bypass with Ptca with Mcc 231	–	–	–	$130,959$103,266–$183,207 · 11 plans
Ms-Drg 232 232	–	–	–	$94,182$74,267–$131,758 · 11 plans
Coronary Bypass with Cardiac Catheterization or Open Ablation Without Mcc 234	–	–	–	$84,863$66,918–$118,721 · 11 plans
Ms-Drg 237 237	–	–	–	Not in dollars (22 plans)
Ms-Drg 238 238	–	–	–	Not in dollars (22 plans)
Amputation for Circulatory System Disorders Except Upper Limb and Toe with Mcc 239	–	–	–	$76,459$60,291–$106,963 · 11 plans
Amputation for Circulatory System Disorders Except Upper Limb and Toe with Cc 240	–	–	–	$44,283$34,919–$61,950 · 11 plans
Ms-Drg 241 241	–	–	–	$21,507$16,959–$30,087 · 11 plans
Ms-Drg 245 245	–	–	–	$70,877$55,889–$99,155 · 11 plans
Ms-Drg 246 246	–	–	–	$46,534$36,694–$65,099 · 11 plans
Ms-Drg 247 247	–	–	–	$29,664$23,391–$41,499 · 11 plans
Ms-Drg 248 248	–	–	–	$46,757$36,870–$65,412 · 11 plans
Ms-Drg 249 249	–	–	–	$28,222$22,255–$39,482 · 11 plans
Percutaneous Cardiovascular Procedures Without Intraluminal Device with Mcc 250	–	–	–	$33,905$26,736–$47,432 · 11 plans
Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 251	–	–	–	$23,217$18,308–$32,480 · 11 plans
Ms-Drg 255 255	–	–	–	$41,904$33,043–$58,623 · 11 plans
Ms-Drg 256 256	–	–	–	$26,377$20,799–$36,900 · 11 plans
Ms-Drg 257 257	–	–	–	$16,967$13,379–$23,737 · 11 plans
Ms-Drg 258 258	–	–	–	$48,813$38,491–$68,287 · 11 plans
Ms-Drg 259 259	–	–	–	$31,413$24,771–$43,946 · 11 plans
Cardiac Pacemaker Revision Except Device Replacement with Mcc 260	–	–	–	$50,532$39,847–$70,693 · 11 plans
Cardiac Pacemaker Revision Except Device Replacement with Cc 261	–	–	–	$29,369$23,159–$41,086 · 11 plans
Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 262	–	–	–	$25,321$19,966–$35,423 · 11 plans
Ms-Drg 263 263	–	–	–	$47,497$37,453–$66,446 · 11 plans
Other Circulatory System O.r. Procedures 264	–	–	–	$51,896$40,922–$72,601 · 11 plans
Ms-Drg 265 265	–	–	–	$56,209$44,323–$78,634 · 11 plans
Aortic and Heart Assist Procedures Except Pulsation Balloon with Mcc 268	–	–	–	$106,848$84,254–$149,477 · 11 plans
Other Major Cardiovascular Procedures Without Cc/Mcc 272	–	–	–	$39,661$31,274–$55,484 · 11 plans
Percutaneous and Other Intracardiac Procedures with Mcc 273	–	–	–	$64,090$50,537–$89,659 · 11 plans
Cardiac Defibrillator Implant with Cardiac Catheterization and Mcc 275	–	–	–	$110,771$87,347–$154,965 · 11 plans
Cardiac Defibrillator Implant with Mcc or Carotid Sinus Neurostimulator 276	–	–	–	$93,313$73,581–$130,541 · 11 plans
Cardiac Defibrillator Implant Without Mcc 277	–	–	–	$71,748$56,577–$100,374 · 11 plans
Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with Mcc 278	–	–	–	$86,471$68,186–$120,970 · 11 plans
Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures Without 279	–	–	–	$56,025$44,178–$78,378 · 11 plans
Ms-Drg 284 284	–	–	–	$10,753$8,479–$15,044 · 11 plans
Ms-Drg 285 285	–	–	–	$9,304$7,337–$13,016 · 11 plans
Ms-Drg 288 288	–	–	–	$42,041$33,151–$58,814 · 11 plans
Ms-Drg 289 289	–	–	–	$26,517$20,910–$37,096 · 11 plans
Ms-Drg 290 290	–	–	–	$14,443$11,389–$20,205 · 11 plans
Heart Failure and Shock with Cc 292	–	–	–	$13,189$10,400–$18,451 · 11 plans
Heart Failure and Shock Without Cc/Mcc 293	–	–	–	$8,793$6,934–$12,301 · 11 plans
Ms-Drg 294 294	–	–	–	$19,075$15,042–$26,686 · 11 plans
Ms-Drg 295 295	–	–	–	$12,270$9,675–$17,165 · 11 plans
Cardiac Arrest, Unexplained with Mcc 296	–	–	–	$24,264$19,133–$33,945 · 11 plans
Ms-Drg 297 297	–	–	–	$9,849$7,767–$13,779 · 11 plans
Ms-Drg 298 298	–	–	–	$7,070$5,575–$9,891 · 11 plans
Peripheral Vascular Disorders Without Cc/Mcc 301	–	–	–	$11,181$8,816–$15,641 · 11 plans
Atherosclerosis with Mcc 302	–	–	–	$18,589$14,658–$26,006 · 11 plans
Atherosclerosis Without Mcc 303	–	–	–	$10,458$8,247–$14,631 · 11 plans
Cardiac Congenital and Valvular Disorders with Mcc 306	–	–	–	$24,480$19,304–$34,247 · 11 plans
Cardiac Congenital and Valvular Disorders Without Mcc 307	–	–	–	$14,187$11,187–$19,847 · 11 plans
Angina Pectoris 311	–	–	–	$10,904$8,598–$15,254 · 11 plans
Other Circulatory System Diagnoses Without Cc/Mcc 316	–	–	–	$10,596$8,356–$14,824 · 11 plans
Concomitant Left Atrial Appendage Closure and Cardiac Ablation 317	–	–	–	$103,875$81,910–$145,318 · 11 plans
Ms-Drg 318 318	–	–	–	$37,629$29,672–$52,642 · 11 plans
Other Endovascular Cardiac Valve Procedures with Mcc 319	–	–	–	$69,331$54,671–$96,992 · 11 plans
Other Endovascular Cardiac Valve Procedures Without Mcc 320	–	–	–	$37,366$29,465–$52,274 · 11 plans
Ms-Drg 325 325	–	–	–	$49,874$39,327–$69,772 · 11 plans
Stomach, Esophageal and Duodenal Procedures Without Cc/Mcc 328	–	–	–	$24,892$19,628–$34,823 · 11 plans
Ms-Drg 332 332	–	–	–	$56,248$44,354–$78,689 · 11 plans
Ms-Drg 333 333	–	–	–	$36,386$28,692–$50,903 · 11 plans
Ms-Drg 334 334	–	–	–	$25,445$20,064–$35,596 · 11 plans
Peritoneal Adhesiolysis with Mcc 335	–	–	–	$55,474$43,744–$77,606 · 11 plans
Peritoneal Adhesiolysis with Cc 336	–	–	–	$32,759$25,832–$45,828 · 11 plans
Peritoneal Adhesiolysis Without Cc/Mcc 337	–	–	–	$23,846$18,804–$33,360 · 11 plans
Ms-Drg 338 338	–	–	–	$41,269$32,542–$57,734 · 11 plans
Ms-Drg 339 339	–	–	–	$25,297$19,948–$35,390 · 11 plans
Ms-Drg 340 340	–	–	–	$18,640$14,699–$26,077 · 11 plans
Ms-Drg 341 341	–	–	–	$35,094$27,673–$49,095 · 11 plans
Ms-Drg 342 342	–	–	–	$22,575$17,802–$31,582 · 11 plans
Ms-Drg 343 343	–	–	–	$16,975$13,386–$23,748 · 11 plans
Ms-Drg 344 344	–	–	–	$40,124$31,639–$56,132 · 11 plans
Ms-Drg 345 345	–	–	–	$23,376$18,433–$32,702 · 11 plans
Ms-Drg 346 346	–	–	–	$18,428$14,531–$25,780 · 11 plans
Anal and Stomal Procedures with Mcc 347	–	–	–	$35,662$28,121–$49,890 · 11 plans
Ms-Drg 348 348	–	–	–	$20,332$16,033–$28,444 · 11 plans
Ms-Drg 349 349	–	–	–	$13,525$10,665–$18,921 · 11 plans
Inguinal and Femoral Hernia Procedures with Mcc 350	–	–	–	$38,712$30,526–$54,156 · 11 plans
Inguinal and Femoral Hernia Procedures with Cc 351	–	–	–	$23,683$18,675–$33,132 · 11 plans
Inguinal and Femoral Hernia Procedures Without Cc/Mcc 352	–	–	–	$18,142$14,306–$25,380 · 11 plans
Hernia Procedures Except Inguinal and Femoral with Mcc 353	–	–	–	$45,083$35,550–$63,069 · 11 plans
Hernia Procedures Except Inguinal and Femoral with Cc 354	–	–	–	$26,136$20,609–$36,564 · 11 plans
Hernia Procedures Except Inguinal and Femoral Without Cc/Mcc 355	–	–	–	$20,895$16,476–$29,231 · 11 plans
Ms-Drg 358 358	–	–	–	$21,716$17,124–$30,381 · 11 plans
Ms-Drg 359 359	–	–	–	$53,419$42,123–$74,731 · 11 plans
Ms-Drg 360 360	–	–	–	$37,506$29,575–$52,470 · 11 plans
Ms-Drg 361 361	–	–	–	Not in dollars (22 plans)
Ms-Drg 362 362	–	–	–	Not in dollars (22 plans)
Ms-Drg 363 363	–	–	–	Not in dollars (22 plans)
Ms-Drg 364 364	–	–	–	Not in dollars (22 plans)
Ms-Drg 365 365	–	–	–	Not in dollars (22 plans)
Ms-Drg 366 366	–	–	–	Not in dollars (22 plans)
Ms-Drg 367 367	–	–	–	Not in dollars (22 plans)
Major Esophageal Disorders with Mcc 368	–	–	–	$24,730$19,501–$34,597 · 11 plans
Major Esophageal Disorders with Cc 369	–	–	–	$15,538$12,252–$21,737 · 11 plans
Ms-Drg 370 370	–	–	–	$10,887$8,585–$15,230 · 11 plans
Major Gastrointestinal Disorders and Peritoneal Infections Without Cc/Mcc 373	–	–	–	$11,300$8,911–$15,809 · 11 plans
Ms-Drg 376 376	–	–	–	$14,359$11,323–$20,088 · 11 plans
Gastrointestinal Hemorrhage Without Cc/Mcc 379	–	–	–	$9,793$7,722–$13,700 · 11 plans
Complicated Peptic Ulcer with Mcc 380	–	–	–	$30,483$24,037–$42,644 · 11 plans
Complicated Peptic Ulcer with Cc 381	–	–	–	$16,832$13,273–$23,548 · 11 plans
Ms-Drg 382 382	–	–	–	$12,437$9,807–$17,399 · 11 plans
Ms-Drg 383 383	–	–	–	$21,449$16,914–$30,007 · 11 plans
Uncomplicated Peptic Ulcer Without Mcc 384	–	–	–	$13,279$10,471–$18,577 · 11 plans
Inflammatory Bowel Disease with Mcc 385	–	–	–	$24,581$19,383–$34,388 · 11 plans
Inflammatory Bowel Disease with Cc 386	–	–	–	$15,167$11,960–$21,218 · 11 plans
Ms-Drg 387 387	–	–	–	$10,584$8,346–$14,807 · 11 plans
Gastrointestinal Obstruction Without Cc/Mcc 390	–	–	–	$8,451$6,664–$11,823 · 11 plans
Other Digestive System Diagnoses Without Cc/Mcc 395	–	–	–	$10,082$7,950–$14,105 · 11 plans
Ms-Drg 396 396	–	–	–	Not in dollars (22 plans)
Ms-Drg 397 397	–	–	–	$37,205$29,338–$52,048 · 11 plans
Appendix Procedures with Cc 398	–	–	–	$23,514$18,542–$32,895 · 11 plans
Appendix Procedures Without Cc/Mcc 399	–	–	–	$17,783$14,023–$24,878 · 11 plans
Ms-Drg 400 400	–	–	–	Not in dollars (22 plans)
Ms-Drg 401 401	–	–	–	Not in dollars (22 plans)
Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical 402	–	–	–	$62,458$49,251–$87,378 · 11 plans
Ms-Drg 403 403	–	–	–	Not in dollars (22 plans)
Ms-Drg 404 404	–	–	–	Not in dollars (22 plans)
Pancreas, Liver and Shunt Procedures with Mcc 405	–	–	–	$84,984$67,014–$118,890 · 11 plans
Pancreas, Liver and Shunt Procedures Without Cc/Mcc 407	–	–	–	$34,481$27,190–$48,239 · 11 plans
Ms-Drg 408 408	–	–	–	$55,392$43,679–$77,491 · 11 plans
Ms-Drg 409 409	–	–	–	$33,824$26,672–$47,319 · 11 plans
Ms-Drg 410 410	–	–	–	$24,665$19,449–$34,505 · 11 plans
Cholecystectomy with C.d.e. with Mcc 411	–	–	–	$51,317$40,465–$71,791 · 11 plans
Ms-Drg 412 412	–	–	–	$32,662$25,756–$45,694 · 11 plans
Ms-Drg 413 413	–	–	–	$25,796$20,341–$36,088 · 11 plans
Ms-Drg 414 414	–	–	–	$55,345$43,642–$77,426 · 11 plans
Cholecystectomy Except by Laparoscope Without C.d.e. with Cc 415	–	–	–	$32,106$25,317–$44,916 · 11 plans
Ms-Drg 416 416	–	–	–	$21,179$16,700–$29,629 · 11 plans
Hepatobiliary Diagnostic Procedures with Mcc 420	–	–	–	$52,929$41,737–$74,047 · 11 plans
Ms-Drg 421 421	–	–	–	$26,992$21,284–$37,761 · 11 plans
Ms-Drg 422 422	–	–	–	$21,741$17,144–$30,415 · 11 plans
Other Hepatobiliary or Pancreas O.r. Procedures with Mcc 423	–	–	–	$64,517$50,874–$90,257 · 11 plans
Ms-Drg 424 424	–	–	–	$33,989$26,802–$47,550 · 11 plans
Ms-Drg 425 425	–	–	–	$23,307$18,379–$32,606 · 11 plans
Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Mcc or 426	–	–	–	$171,214$135,010–$239,524 · 11 plans
Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Cc 427	–	–	–	$112,141$88,428–$156,882 · 11 plans
Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical Without Cc/ 428	–	–	–	$87,338$68,870–$122,183 · 11 plans
Ms-Drg 429 429	–	–	–	$139,964$110,368–$195,806 · 11 plans
Combined Anterior and Posterior Cervical Spinal Fusion Without Mcc 430	–	–	–	$89,592$70,647–$125,336 · 11 plans
Ms-Drg 431 431	–	–	–	Not in dollars (22 plans)
Ms-Drg 434 434	–	–	–	$11,069$8,728–$15,485 · 11 plans
Malignancy of Hepatobiliary System or Pancreas with Cc 436	–	–	–	$17,572$13,856–$24,582 · 11 plans
Ms-Drg 437 437	–	–	–	$13,256$10,453–$18,545 · 11 plans
Disorders of Pancreas Except Malignancy Without Cc/Mcc 440	–	–	–	$9,653$7,612–$13,505 · 11 plans
Ms-Drg 443 443	–	–	–	$10,870$8,571–$15,207 · 11 plans
Disorders of the Biliary Tract Without Cc/Mcc 446	–	–	–	$12,852$10,134–$17,980 · 11 plans
Ms-Drg 447 447	–	–	–	$103,799$81,850–$145,211 · 11 plans
Multiple Level Spinal Fusion Except Cervical Without Mcc 448	–	–	–	$65,881$51,950–$92,165 · 11 plans
Ms-Drg 449 449	–	–	–	Not in dollars (22 plans)
Ms-Drg 450 450	–	–	–	$82,795$65,288–$115,828 · 11 plans
Single Level Spinal Fusion Except Cervical Without Mcc 451	–	–	–	$50,184$39,572–$70,206 · 11 plans
Ms-Drg 452 452	–	–	–	Not in dollars (22 plans)
Combined Anterior and Posterior Spinal Fusion with Mcc 453	–	–	–	$137,662$108,552–$192,585 · 11 plans
Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 456	–	–	–	$130,547$102,942–$182,631 · 11 plans
Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 457	–	–	–	$92,637$73,048–$129,596 · 11 plans
Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 458	–	–	–	$64,821$51,114–$90,683 · 11 plans
Spinal Fusion Except Cervical with Mcc 459	–	–	–	$103,033$81,246–$144,140 · 11 plans
Ms-Drg 461 461	–	–	–	$85,800$67,657–$120,031 · 11 plans
Bilateral or Multiple Major Joint Procedures of Lower Extremity Without Mcc 462	–	–	–	$41,323$32,585–$57,810 · 11 plans
Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 463	–	–	–	$88,542$69,819–$123,867 · 11 plans
Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 464	–	–	–	$48,387$38,155–$67,692 · 11 plans
Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 465	–	–	–	$28,331$22,340–$39,634 · 11 plans
Revision of Hip or Knee Replacement with Mcc 466	–	–	–	$80,866$63,766–$113,129 · 11 plans
Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with Mcc or Tota 469	–	–	–	$47,121$37,157–$65,921 · 11 plans
Cervical Spinal Fusion Without Cc/Mcc 473	–	–	–	$37,926$29,906–$53,057 · 11 plans
Amputation for Musculoskeletal System and Connective Tissue Disorders with Mcc 474	–	–	–	$66,690$52,588–$93,298 · 11 plans
Amputation for Musculoskeletal System and Connective Tissue Disorders with Cc 475	–	–	–	$35,353$27,877–$49,458 · 11 plans
Ms-Drg 476 476	–	–	–	$18,334$14,457–$25,649 · 11 plans
Biopsies of Musculoskeletal System and Connective Tissue with Mcc 477	–	–	–	$53,667$42,319–$75,079 · 11 plans
Biopsies of Musculoskeletal System and Connective Tissue with Cc 478	–	–	–	$38,204$30,125–$53,446 · 11 plans
Biopsies of Musculoskeletal System and Connective Tissue Without Cc/Mcc 479	–	–	–	$28,878$22,772–$40,399 · 11 plans
Hip and Femur Procedures Except Major Joint Without Cc/Mcc 482	–	–	–	$25,338$19,980–$35,447 · 11 plans
Ms-Drg 484 484	–	–	–	Not in dollars (22 plans)
Knee Procedures with Principal Diagnosis of Infection with Mcc 485	–	–	–	$50,133$39,532–$70,135 · 11 plans
Knee Procedures with Principal Diagnosis of Infection with Cc 486	–	–	–	$32,485$25,616–$45,446 · 11 plans
Knee Procedures with Principal Diagnosis of Infection Without Cc/Mcc 487	–	–	–	$24,331$19,186–$34,038 · 11 plans
Knee Procedures Without Principal Diagnosis of Infection with Cc/Mcc 488	–	–	–	$27,480$21,669–$38,444 · 11 plans
Knee Procedures Without Principal Diagnosis of Infection Without Cc/Mcc 489	–	–	–	$17,349$13,681–$24,271 · 11 plans
Ms-Drg 490 490	–	–	–	Not in dollars (22 plans)
Ms-Drg 491 491	–	–	–	Not in dollars (22 plans)
Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Mcc 492	–	–	–	$57,038$44,977–$79,795 · 11 plans
Lower Extremity and Humerus Procedures Except Hip, Foot and Femur Without Cc/Mcc 494	–	–	–	$31,171$24,580–$43,607 · 11 plans
Ms-Drg 495 495	–	–	–	$56,325$44,415–$78,797 · 11 plans
Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with Cc 496	–	–	–	$28,024$22,098–$39,204 · 11 plans
Local Excision and Removal of Internal Fixation Devices Except Hip and Femur Without Cc/ 497	–	–	–	$18,771$14,802–$26,260 · 11 plans
Ms-Drg 498 498	–	–	–	$46,866$36,956–$65,564 · 11 plans
Ms-Drg 499 499	–	–	–	$31,300$24,681–$43,788 · 11 plans
Soft Tissue Procedures with Mcc 500	–	–	–	$49,165$38,769–$68,781 · 11 plans
Soft Tissue Procedures with Cc 501	–	–	–	$27,157$21,414–$37,991 · 11 plans
Soft Tissue Procedures Without Cc/Mcc 502	–	–	–	$20,909$16,487–$29,250 · 11 plans
Ms-Drg 503 503	–	–	–	$43,360$34,191–$60,659 · 11 plans
Foot Procedures with Cc 504	–	–	–	$29,038$22,898–$40,623 · 11 plans
Ms-Drg 505 505	–	–	–	$27,851$21,962–$38,963 · 11 plans
Ms-Drg 506 506	–	–	–	$20,960$16,528–$29,322 · 11 plans
Ms-Drg 507 507	–	–	–	$28,062$22,128–$39,258 · 11 plans
Ms-Drg 508 508	–	–	–	$23,526$18,551–$32,912 · 11 plans
Ms-Drg 509 509	–	–	–	$27,287$21,517–$38,174 · 11 plans
Ms-Drg 510 510	–	–	–	$46,923$37,001–$65,645 · 11 plans
Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Cc 511	–	–	–	$32,303$25,473–$45,192 · 11 plans
Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc 512	–	–	–	$25,717$20,279–$35,977 · 11 plans
Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with Cc/Mcc 513	–	–	–	$24,457$19,285–$34,214 · 11 plans
Ms-Drg 514 514	–	–	–	$15,881$12,523–$22,218 · 11 plans
Other Musculoskeletal System and Connective Tissue O.r. Procedures with Cc 516	–	–	–	$32,283$25,457–$45,163 · 11 plans
Other Musculoskeletal System and Connective Tissue O.r. Procedures Without Cc/Mcc 517	–	–	–	$23,873$18,825–$33,397 · 11 plans
Back and Neck Procedures Except Spinal Fusion with Mcc or Disc Device or Neurostimulator 518	–	–	–	$58,059$45,782–$81,223 · 11 plans
Back and Neck Procedures Except Spinal Fusion Without Cc/Mcc 520	–	–	–	$23,208$18,300–$32,467 · 11 plans
Hip Replacement with Principal Diagnosis of Hip Fracture with Mcc 521	–	–	–	$44,589$35,160–$62,378 · 11 plans
Ms-Drg 523 523	–	–	–	Not in dollars (22 plans)
Ms-Drg 524 524	–	–	–	Not in dollars (22 plans)
Ms-Drg 525 525	–	–	–	Not in dollars (22 plans)
Ms-Drg 526 526	–	–	–	Not in dollars (22 plans)
Ms-Drg 527 527	–	–	–	Not in dollars (22 plans)
Ms-Drg 528 528	–	–	–	Not in dollars (22 plans)
Ms-Drg 529 529	–	–	–	Not in dollars (22 plans)
Ms-Drg 530 530	–	–	–	Not in dollars (22 plans)
Ms-Drg 531 531	–	–	–	Not in dollars (22 plans)
Ms-Drg 532 532	–	–	–	Not in dollars (22 plans)
Ms-Drg 533 533	–	–	–	$24,354$19,204–$34,071 · 11 plans
Ms-Drg 534 534	–	–	–	$12,523$9,875–$17,519 · 11 plans
Fractures of Hip and Pelvis with Mcc 535	–	–	–	$19,916$15,705–$27,862 · 11 plans
Ms-Drg 537 537	–	–	–	$14,825$11,690–$20,740 · 11 plans
Ms-Drg 538 538	–	–	–	$11,190$8,824–$15,654 · 11 plans
Osteomyelitis with Mcc 539	–	–	–	$30,599$24,129–$42,807 · 11 plans
Osteomyelitis with Cc 540	–	–	–	$20,138$15,880–$28,172 · 11 plans
Ms-Drg 541 541	–	–	–	$12,232$9,646–$17,113 · 11 plans
Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Mcc 542	–	–	–	$27,443$21,640–$38,391 · 11 plans
Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy Without Cc/M 544	–	–	–	$11,723$9,244–$16,400 · 11 plans
Connective Tissue Disorders with Mcc 545	–	–	–	$38,553$30,401–$53,935 · 11 plans
Connective Tissue Disorders with Cc 546	–	–	–	$17,918$14,129–$25,067 · 11 plans
Connective Tissue Disorders Without Cc/Mcc 547	–	–	–	$12,990$10,243–$18,173 · 11 plans
Ms-Drg 548 548	–	–	–	$29,997$23,654–$41,964 · 11 plans
Ms-Drg 549 549	–	–	–	$18,754$14,788–$26,236 · 11 plans
Ms-Drg 550 550	–	–	–	$13,579$10,708–$18,997 · 11 plans
Bone Diseases and Arthropathies with Mcc 553	–	–	–	$20,138$15,880–$28,172 · 11 plans
Signs and Symptoms of Musculoskeletal System and Connective Tissue with Mcc 555	–	–	–	$20,534$16,192–$28,727 · 11 plans
Tendonitis, Myositis and Bursitis with Mcc 557	–	–	–	$23,099$18,215–$32,315 · 11 plans
Tendonitis, Myositis and Bursitis Without Mcc 558	–	–	–	$13,876$10,942–$19,412 · 11 plans
Aftercare, Musculoskeletal System and Connective Tissue with Mcc 559	–	–	–	$28,971$22,845–$40,530 · 11 plans
Aftercare, Musculoskeletal System and Connective Tissue Without Cc/Mcc 561	–	–	–	$12,489$9,848–$17,471 · 11 plans
Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with Mcc 562	–	–	–	$22,134$17,454–$30,965 · 11 plans
Other Musculoskeletal System and Connective Tissue Diagnoses with Mcc 564	–	–	–	$23,980$18,909–$33,547 · 11 plans
Other Musculoskeletal System and Connective Tissue Diagnoses with Cc 565	–	–	–	$15,137$11,936–$21,177 · 11 plans
Ms-Drg 566 566	–	–	–	$11,640$9,179–$16,285 · 11 plans
Ms-Drg 567 567	–	–	–	Not in dollars (22 plans)
Ms-Drg 568 568	–	–	–	Not in dollars (22 plans)
Ms-Drg 569 569	–	–	–	Not in dollars (22 plans)
Skin Debridement with Mcc 570	–	–	–	$45,690$36,028–$63,919 · 11 plans
Skin Debridement with Cc 571	–	–	–	$26,246$20,696–$36,718 · 11 plans
Ms-Drg 572 572	–	–	–	$17,808$14,042–$24,913 · 11 plans
Skin Graft for Skin Ulcer or Cellulitis with Mcc 573	–	–	–	$101,776$80,255–$142,382 · 11 plans
Skin Graft for Skin Ulcer or Cellulitis with Cc 574	–	–	–	$53,928$42,525–$75,444 · 11 plans
Ms-Drg 575 575	–	–	–	$27,916$22,013–$39,054 · 11 plans
Ms-Drg 576 576	–	–	–	$76,140$60,040–$106,518 · 11 plans
Skin Graft Except for Skin Ulcer or Cellulitis with Cc 577	–	–	–	$41,179$32,471–$57,608 · 11 plans
Ms-Drg 578 578	–	–	–	$24,955$19,678–$34,912 · 11 plans
Other Skin, Subcutaneous Tissue and Breast Procedures with Mcc 579	–	–	–	$50,310$39,672–$70,382 · 11 plans
Other Skin, Subcutaneous Tissue and Breast Procedures with Cc 580	–	–	–	$26,844$21,168–$37,555 · 11 plans
Other Skin, Subcutaneous Tissue and Breast Procedures Without Cc/Mcc 581	–	–	–	$22,419$17,678–$31,363 · 11 plans
Ms-Drg 582 582	–	–	–	$29,930$23,601–$41,871 · 11 plans
Ms-Drg 583 583	–	–	–	$26,789$21,124–$37,476 · 11 plans
Ms-Drg 584 584	–	–	–	$33,256$26,224–$46,524 · 11 plans
Breast Biopsy, Local Excision and Other Breast Procedures Without Cc/Mcc 585	–	–	–	$29,969$23,631–$41,925 · 11 plans
Skin Ulcers with Mcc 592	–	–	–	$30,065$23,707–$42,060 · 11 plans
Skin Ulcers with Cc 593	–	–	–	$18,429$14,532–$25,782 · 11 plans
Ms-Drg 594 594	–	–	–	$13,466$10,618–$18,838 · 11 plans
Ms-Drg 595 595	–	–	–	$32,945$25,979–$46,089 · 11 plans
Major Skin Disorders Without Mcc 596	–	–	–	$16,817$13,261–$23,526 · 11 plans
Malignant Breast Disorders with Mcc 597	–	–	–	$25,898$20,422–$36,231 · 11 plans
Ms-Drg 598 598	–	–	–	$17,575$13,858–$24,587 · 11 plans
Ms-Drg 599 599	–	–	–	$11,953$9,425–$16,721 · 11 plans
Ms-Drg 600 600	–	–	–	$16,181$12,760–$22,637 · 11 plans
Ms-Drg 601 601	–	–	–	$9,399$7,411–$13,148 · 11 plans
Trauma to the Skin, Subcutaneous Tissue and Breast with Mcc 604	–	–	–	$22,869$18,033–$31,993 · 11 plans
Minor Skin Disorders with Mcc 606	–	–	–	$23,508$18,537–$32,886 · 11 plans
Minor Skin Disorders Without Mcc 607	–	–	–	$14,081$11,103–$19,699 · 11 plans
Adrenal and Pituitary Procedures with Cc/Mcc 614	–	–	–	$34,050$26,850–$47,634 · 11 plans
Adrenal and Pituitary Procedures Without Cc/Mcc 615	–	–	–	$21,738$17,141–$30,411 · 11 plans
Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Mcc 616	–	–	–	$54,177$42,721–$75,792 · 11 plans
Ms-Drg 618 618	–	–	–	$22,033$17,374–$30,824 · 11 plans
Ms-Drg 619 619	–	–	–	$44,856$35,371–$62,752 · 11 plans
O.r. Procedures for Obesity with Cc 620	–	–	–	$24,861$19,604–$34,779 · 11 plans
O.r. Procedures for Obesity Without Cc/Mcc 621	–	–	–	$23,433$18,478–$32,782 · 11 plans
Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 622	–	–	–	$55,292$43,600–$77,352 · 11 plans
Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 623	–	–	–	$27,868$21,975–$38,987 · 11 plans
Ms-Drg 624 624	–	–	–	$19,448$15,336–$27,208 · 11 plans
Ms-Drg 625 625	–	–	–	$46,917$36,996–$65,636 · 11 plans
Thyroid, Parathyroid and Thyroglossal Procedures with Cc 626	–	–	–	$23,293$18,368–$32,586 · 11 plans
Thyroid, Parathyroid and Thyroglossal Procedures Without Cc/Mcc 627	–	–	–	$20,635$16,272–$28,868 · 11 plans
Other Endocrine, Nutritional and Metabolic O.r. Procedures with Mcc 628	–	–	–	$57,896$45,653–$80,995 · 11 plans
Other Endocrine, Nutritional and Metabolic O.r. Procedures with Cc 629	–	–	–	$33,848$26,690–$47,352 · 11 plans
Ms-Drg 630 630	–	–	–	$22,673$17,879–$31,719 · 11 plans
Diabetes Without Cc/Mcc 639	–	–	–	$9,650$7,610–$13,501 · 11 plans
Inborn and Other Disorders of Metabolism 642	–	–	–	$22,092$17,421–$30,907 · 11 plans
Endocrine Disorders Without Cc/Mcc 645	–	–	–	$11,936$9,412–$16,697 · 11 plans
Kidney Transplant with Hemodialysis with Mcc 650	–	–	–	$73,036$57,592–$102,176 · 11 plans
Kidney Transplant with Hemodialysis Without Mcc 651	–	–	–	$57,570$45,396–$80,538 · 11 plans
Major Bladder Procedures with Mcc 653	–	–	–	$80,726$63,656–$112,933 · 11 plans
Major Bladder Procedures with Cc 654	–	–	–	$43,487$34,291–$60,837 · 11 plans
Major Bladder Procedures Without Cc/Mcc 655	–	–	–	$32,881$25,928–$46,000 · 11 plans
Kidney and Ureter Procedures for Neoplasm with Mcc 656	–	–	–	$49,460$39,002–$69,194 · 11 plans
Kidney and Ureter Procedures for Neoplasm with Cc 657	–	–	–	$28,429$22,418–$39,771 · 11 plans
Kidney and Ureter Procedures for Neoplasm Without Cc/Mcc 658	–	–	–	$24,107$19,010–$33,725 · 11 plans
Kidney and Ureter Procedures for Non-Neoplasm Without Cc/Mcc 661	–	–	–	$16,085$12,684–$22,502 · 11 plans
Ms-Drg 662 662	–	–	–	$47,560$37,503–$66,536 · 11 plans
Minor Bladder Procedures with Cc 663	–	–	–	$23,616$18,622–$33,039 · 11 plans
Ms-Drg 664 664	–	–	–	$16,264$12,825–$22,752 · 11 plans
Prostatectomy with Mcc 665	–	–	–	$48,488$38,235–$67,833 · 11 plans
Ms-Drg 666 666	–	–	–	$27,175$21,429–$38,018 · 11 plans
Ms-Drg 667 667	–	–	–	$17,185$13,551–$24,041 · 11 plans
Transurethral Procedures with Mcc 668	–	–	–	$45,362$35,770–$63,460 · 11 plans
Transurethral Procedures with Cc 669	–	–	–	$24,110$19,012–$33,730 · 11 plans
Ms-Drg 670 670	–	–	–	$15,182$11,972–$21,240 · 11 plans
Ms-Drg 671 671	–	–	–	$27,885$21,989–$39,011 · 11 plans
Ms-Drg 672 672	–	–	–	$16,770$13,224–$23,461 · 11 plans
Other Kidney and Urinary Tract Procedures with Mcc 673	–	–	–	$65,272$51,470–$91,313 · 11 plans
Other Kidney and Urinary Tract Procedures with Cc 674	–	–	–	$36,330$28,648–$50,825 · 11 plans
Ms-Drg 675 675	–	–	–	$25,499$20,107–$35,673 · 11 plans
Renal Failure Without Cc/Mcc 684	–	–	–	$9,326$7,354–$13,046 · 11 plans
Ms-Drg 685 685	–	–	–	Not in dollars (22 plans)
Kidney and Urinary Tract Neoplasms with Mcc 686	–	–	–	$28,020$22,095–$39,200 · 11 plans
Kidney and Urinary Tract Neoplasms with Cc 687	–	–	–	$16,278$12,836–$22,772 · 11 plans
Ms-Drg 688 688	–	–	–	$12,277$9,681–$17,176 · 11 plans
Ms-Drg 691 691	–	–	–	Not in dollars (22 plans)
Ms-Drg 692 692	–	–	–	Not in dollars (22 plans)
Ms-Drg 693 693	–	–	–	$20,887$16,470–$29,220 · 11 plans
Urinary Stones Without Mcc 694	–	–	–	$12,144$9,576–$16,989 · 11 plans
Ms-Drg 695 695	–	–	–	$17,769$14,012–$24,858 · 11 plans
Kidney and Urinary Tract Signs and Symptoms Without Mcc 696	–	–	–	$10,704$8,440–$14,974 · 11 plans
Ms-Drg 697 697	–	–	–	$16,744$13,203–$23,424 · 11 plans
Other Kidney and Urinary Tract Diagnoses Without Cc/Mcc 700	–	–	–	$10,718$8,451–$14,994 · 11 plans
Major Male Pelvic Procedures with Cc/Mcc 707	–	–	–	$31,075$24,504–$43,473 · 11 plans
Major Male Pelvic Procedures Without Cc/Mcc 708	–	–	–	$23,834$18,794–$33,343 · 11 plans
Ms-Drg 709 709	–	–	–	$36,152$28,507–$50,575 · 11 plans
Ms-Drg 710 710	–	–	–	$21,768$17,165–$30,452 · 11 plans
Ms-Drg 711 711	–	–	–	$32,372$25,527–$45,287 · 11 plans
Ms-Drg 712 712	–	–	–	$17,084$13,471–$23,900 · 11 plans
Transurethral Prostatectomy with Cc/Mcc 713	–	–	–	$23,355$18,417–$32,673 · 11 plans
Transurethral Prostatectomy Without Cc/Mcc 714	–	–	–	$16,427$12,953–$22,980 · 11 plans
Ms-Drg 715 715	–	–	–	$34,756$27,407–$48,623 · 11 plans
Ms-Drg 716 716	–	–	–	$22,852$18,020–$31,969 · 11 plans
Other Male Reproductive System O.r. Procedures Except Malignancy with Cc/Mcc 717	–	–	–	$29,369$23,159–$41,086 · 11 plans
Ms-Drg 718 718	–	–	–	$20,865$16,453–$29,190 · 11 plans
Malignancy, Male Reproductive System with Mcc 722	–	–	–	$28,114$22,169–$39,330 · 11 plans
Ms-Drg 723 723	–	–	–	$17,752$13,998–$24,834 · 11 plans
Ms-Drg 724 724	–	–	–	$10,186$8,032–$14,250 · 11 plans
Ms-Drg 725 725	–	–	–	$18,179$14,335–$25,432 · 11 plans
Benign Prostatic Hypertrophy Without Mcc 726	–	–	–	$11,216$8,845–$15,691 · 11 plans
Ms-Drg 727 727	–	–	–	$23,037$18,166–$32,228 · 11 plans
Inflammation of the Male Reproductive System Without Mcc 728	–	–	–	$12,602$9,937–$17,630 · 11 plans
Ms-Drg 729 729	–	–	–	$16,447$12,969–$23,009 · 11 plans
Ms-Drg 730 730	–	–	–	$10,440$8,232–$14,605 · 11 plans
Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy with Cc/Mcc 734	–	–	–	$33,090$26,093–$46,291 · 11 plans
Ms-Drg 735 735	–	–	–	$20,902$16,482–$29,242 · 11 plans
Ms-Drg 736 736	–	–	–	$55,530$43,788–$77,685 · 11 plans
Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with Cc 737	–	–	–	$32,011$25,242–$44,783 · 11 plans
Ms-Drg 738 738	–	–	–	$22,813$17,989–$31,915 · 11 plans
Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Mcc 739	–	–	–	$55,659$43,889–$77,865 · 11 plans
Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Cc 740	–	–	–	$28,112$22,168–$39,328 · 11 plans
Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy Without Cc/Mcc 741	–	–	–	$22,154$17,470–$30,993 · 11 plans
Uterine and Adnexa Procedures for Non-Malignancy Without Cc/Mcc 743	–	–	–	$19,274$15,199–$26,964 · 11 plans
D&c, Conization, Laparoscopy and Tubal Interruption with Cc/Mcc 744	–	–	–	$31,833$25,101–$44,533 · 11 plans
Ms-Drg 745 745	–	–	–	$17,671$13,934–$24,721 · 11 plans
Vagina, Cervix and Vulva Procedures with Cc/Mcc 746	–	–	–	$26,986$21,279–$37,752 · 11 plans
Vagina, Cervix and Vulva Procedures Without Cc/Mcc 747	–	–	–	$13,355$10,531–$18,684 · 11 plans
Female Reproductive System Reconstructive Procedures 748	–	–	–	$21,552$16,994–$30,150 · 11 plans
Ms-Drg 749 749	–	–	–	$39,888$31,453–$55,802 · 11 plans
Ms-Drg 750 750	–	–	–	$22,927$18,079–$32,074 · 11 plans
Malignancy, Female Reproductive System with Mcc 754	–	–	–	$28,611$22,561–$40,026 · 11 plans
Malignancy, Female Reproductive System with Cc 755	–	–	–	$16,899$13,326–$23,641 · 11 plans
Ms-Drg 756 756	–	–	–	$14,921$11,766–$20,875 · 11 plans
Ms-Drg 757 757	–	–	–	$22,245$17,541–$31,119 · 11 plans
Ms-Drg 758 758	–	–	–	$15,209$11,993–$21,277 · 11 plans
Ms-Drg 759 759	–	–	–	$10,309$8,129–$14,422 · 11 plans
Ms-Drg 760 760	–	–	–	$15,652$12,342–$21,896 · 11 plans
Ms-Drg 761 761	–	–	–	$8,863$6,989–$12,399 · 11 plans
Ms-Drg 765 765	–	–	–	Not in dollars (22 plans)
Ms-Drg 766 766	–	–	–	Not in dollars (22 plans)
Ms-Drg 767 767	–	–	–	Not in dollars (22 plans)
Ms-Drg 768 768	–	–	–	$16,647$13,127–$23,289 · 11 plans
Ms-Drg 769 769	–	–	–	$26,251$20,700–$36,724 · 11 plans
Ms-Drg 770 770	–	–	–	$15,577$12,283–$21,792 · 11 plans
Ms-Drg 774 774	–	–	–	Not in dollars (22 plans)
Ms-Drg 775 775	–	–	–	Not in dollars (22 plans)
Ms-Drg 776 776	–	–	–	$10,171$8,020–$14,229 · 11 plans
Ms-Drg 777 777	–	–	–	Not in dollars (22 plans)
Ms-Drg 778 778	–	–	–	Not in dollars (22 plans)
Ms-Drg 779 779	–	–	–	$13,070$10,306–$18,284 · 11 plans
Ms-Drg 780 780	–	–	–	Not in dollars (22 plans)
Ms-Drg 781 781	–	–	–	Not in dollars (22 plans)
Ms-Drg 782 782	–	–	–	Not in dollars (22 plans)
Ms-Drg 783 783	–	–	–	$38,140$30,075–$53,357 · 11 plans
Ms-Drg 784 784	–	–	–	$16,469$12,986–$23,039 · 11 plans
Ms-Drg 785 785	–	–	–	$14,879$11,733–$20,816 · 11 plans
C-section, with major complications 786	–	–	–	$25,625$20,206–$35,849 · 11 plans
C-section, with complications 787	–	–	–	$17,349$13,681–$24,271 · 11 plans
C-section 788	–	–	–	$14,895$11,745–$20,838 · 11 plans
Ms-Drg 789 789	–	–	–	$27,997$22,077–$39,167 · 11 plans
Ms-Drg 790 790	–	–	–	$92,332$72,808–$129,170 · 11 plans
Ms-Drg 791 791	–	–	–	$63,057$49,723–$88,214 · 11 plans
Ms-Drg 792 792	–	–	–	$38,048$30,003–$53,228 · 11 plans
Ms-Drg 793 793	–	–	–	$64,775$51,078–$90,618 · 11 plans
Ms-Drg 794 794	–	–	–	$22,928$18,080–$32,076 · 11 plans
Newborn care (healthy baby) 795	–	–	–	$3,104$2,448–$4,342 · 11 plans
Ms-Drg 796 796	–	–	–	$18,129$14,296–$25,362 · 11 plans
Ms-Drg 797 797	–	–	–	$15,541$12,255–$21,742 · 11 plans
Ms-Drg 798 798	–	–	–	$14,869$11,724–$20,801 · 11 plans
Ms-Drg 799 799	–	–	–	$70,356$55,479–$98,427 · 11 plans
Ms-Drg 800 800	–	–	–	$43,644$34,415–$61,057 · 11 plans
Ms-Drg 801 801	–	–	–	$29,655$23,384–$41,486 · 11 plans
Ms-Drg 802 802	–	–	–	$61,893$48,805–$86,586 · 11 plans
Ms-Drg 803 803	–	–	–	$28,878$22,772–$40,399 · 11 plans
Ms-Drg 804 804	–	–	–	$21,065$16,611–$29,470 · 11 plans
Vaginal birth, with major complications 805	–	–	–	$16,765$13,220–$23,454 · 11 plans
Vaginal birth, with complications 806	–	–	–	$11,713$9,237–$16,387 · 11 plans
Vaginal birth 807	–	–	–	$10,474$8,259–$14,652 · 11 plans
Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 809	–	–	–	$19,666$15,507–$27,512 · 11 plans
Ms-Drg 810 810	–	–	–	$16,259$12,821–$22,746 · 11 plans
Reticuloendothelial and Immunity Disorders with Mcc 814	–	–	–	$33,038$26,052–$46,220 · 11 plans
Reticuloendothelial and Immunity Disorders with Cc 815	–	–	–	$15,752$12,422–$22,037 · 11 plans
Ms-Drg 816 816	–	–	–	$9,818$7,742–$13,735 · 11 plans
Ms-Drg 817 817	–	–	–	$35,445$27,950–$49,586 · 11 plans
Ms-Drg 818 818	–	–	–	$18,008$14,200–$25,193 · 11 plans
Ms-Drg 819 819	–	–	–	$13,359$10,534–$18,688 · 11 plans
Lymphoma and Leukemia with Major O.r. Procedures with Mcc 820	–	–	–	$91,110$71,844–$127,460 · 11 plans
Lymphoma and Leukemia with Major O.r. Procedures with Cc 821	–	–	–	$34,777$27,423–$48,651 · 11 plans
Lymphoma and Leukemia with Major O.r. Procedures Without Cc/Mcc 822	–	–	–	$18,704$14,749–$26,167 · 11 plans
Lymphoma and Non-Acute Leukemia with Other Procedures with Mcc 823	–	–	–	$71,225$56,164–$99,641 · 11 plans
Lymphoma and Non-Acute Leukemia with Other Procedures with Cc 824	–	–	–	$35,196$27,754–$49,238 · 11 plans
Ms-Drg 825 825	–	–	–	$20,963$16,530–$29,327 · 11 plans
Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 826	–	–	–	$72,670$57,303–$101,663 · 11 plans
Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 827	–	–	–	$35,904$28,312–$50,229 · 11 plans
Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 828	–	–	–	$26,469$20,872–$37,029 · 11 plans
Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures Wi 829	–	–	–	$49,091$38,710–$68,676 · 11 plans
Ms-Drg 830 830	–	–	–	$23,380$18,436–$32,708 · 11 plans
Ms-Drg 831 831	–	–	–	$18,681$14,731–$26,134 · 11 plans
Ms-Drg 832 832	–	–	–	$11,210$8,840–$15,683 · 11 plans
Ms-Drg 833 833	–	–	–	$8,123$6,406–$11,364 · 11 plans
Acute Leukemia with Mcc 834	–	–	–	$85,286$67,251–$119,312 · 11 plans
Acute Leukemia with Cc 835	–	–	–	$32,403$25,551–$45,331 · 11 plans
Ms-Drg 836 836	–	–	–	$18,945$14,939–$26,503 · 11 plans
Chemotherapy with Acute Leukemia As Secondary Diagnosis or with High Dose Chemotherapy a 837	–	–	–	$74,635$58,853–$104,412 · 11 plans
Chemotherapy with Acute Leukemia As Secondary Diagnosis with Cc or High Dose Chemotherap 838	–	–	–	$32,428$25,571–$45,365 · 11 plans
Chemotherapy with Acute Leukemia As Secondary Diagnosis Without Cc/Mcc 839	–	–	–	$22,431$17,688–$31,380 · 11 plans
Lymphoma and Non-Acute Leukemia with Mcc 840	–	–	–	$50,254$39,628–$70,304 · 11 plans
Lymphoma and Non-Acute Leukemia Without Cc/Mcc 842	–	–	–	$15,697$12,377–$21,959 · 11 plans
Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with Mc 843	–	–	–	$30,989$24,436–$43,353 · 11 plans
Ms-Drg 844 844	–	–	–	$18,912$14,913–$26,458 · 11 plans
Ms-Drg 845 845	–	–	–	$13,230$10,432–$18,508 · 11 plans
Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Mcc 846	–	–	–	$40,274$31,758–$56,343 · 11 plans
Ms-Drg 848 848	–	–	–	$13,195$10,405–$18,460 · 11 plans
Radiotherapy 849	–	–	–	$42,092$33,191–$58,886 · 11 plans
Ms-Drg 850 850	–	–	–	$134,525$106,079–$188,197 · 11 plans
Ms-Drg 855 855	–	–	–	$23,259$18,341–$32,539 · 11 plans
Ms-Drg 858 858	–	–	–	$21,639$17,063–$30,272 · 11 plans
Postoperative and Post-Traumatic Infections Without Mcc 863	–	–	–	$15,502$12,224–$21,687 · 11 plans
Fever and Inflammatory Conditions 864	–	–	–	$13,790$10,874–$19,292 · 11 plans
Viral Illness with Mcc 865	–	–	–	$23,276$18,354–$32,563 · 11 plans
Viral Illness Without Mcc 866	–	–	–	$13,509$10,653–$18,899 · 11 plans
Other Infectious and Parasitic Diseases Diagnoses with Mcc 867	–	–	–	$32,518$25,642–$45,492 · 11 plans
Other Infectious and Parasitic Diseases Diagnoses with Cc 868	–	–	–	$16,018$12,631–$22,409 · 11 plans
Ms-Drg 869 869	–	–	–	$11,336$8,939–$15,859 · 11 plans
O.r. Procedures with Principal Diagnosis of Mental Illness 876	–	–	–	$60,041$47,345–$83,996 · 11 plans
Acute Adjustment Reaction and Psychosocial Dysfunction 880	–	–	–	$14,917$11,762–$20,868 · 11 plans
Depressive Neuroses 881	–	–	–	$14,617$11,526–$20,449 · 11 plans
Neuroses Except Depressive 882	–	–	–	$16,681$13,154–$23,337 · 11 plans
Disorders of Personality and Impulse Control 883	–	–	–	$30,546$24,087–$42,734 · 11 plans
Psychoses 885	–	–	–	$21,699$17,111–$30,357 · 11 plans
Ms-Drg 886 886	–	–	–	$32,240$25,422–$45,102 · 11 plans
Ms-Drg 887 887	–	–	–	$16,636$13,119–$23,274 · 11 plans
Alcohol, Drug Abuse or Dependence, Left Ama 894	–	–	–	$9,584$7,557–$13,407 · 11 plans
Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy 895	–	–	–	$21,991$17,341–$30,765 · 11 plans
Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy with Mcc 896	–	–	–	$27,110$21,377–$37,926 · 11 plans
Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy Without Mcc 897	–	–	–	$13,714$10,814–$19,186 · 11 plans
Ms-Drg 901 901	–	–	–	$65,194$51,408–$91,205 · 11 plans
Wound Debridements for Injuries with Cc 902	–	–	–	$29,742$23,453–$41,608 · 11 plans
Ms-Drg 903 903	–	–	–	$18,170$14,328–$25,419 · 11 plans
Skin Grafts for Injuries with Cc/Mcc 904	–	–	–	$57,062$44,995–$79,827 · 11 plans
Ms-Drg 905 905	–	–	–	$23,045$18,172–$32,239 · 11 plans
Ms-Drg 906 906	–	–	–	$30,515$24,063–$42,690 · 11 plans
Other O.r. Procedures for Injuries Without Cc/Mcc 909	–	–	–	$20,393$16,081–$28,529 · 11 plans
Traumatic Injury with Mcc 913	–	–	–	$25,394$20,024–$35,525 · 11 plans
Traumatic Injury Without Mcc 914	–	–	–	$13,756$10,847–$19,245 · 11 plans
Ms-Drg 915 915	–	–	–	$26,124$20,600–$36,546 · 11 plans
Allergic Reactions Without Mcc 916	–	–	–	$10,351$8,162–$14,481 · 11 plans
Poisoning and Toxic Effects of Drugs Without Mcc 918	–	–	–	$13,315$10,499–$18,627 · 11 plans
Complications of Treatment Without Cc/Mcc 921	–	–	–	$10,694$8,433–$14,961 · 11 plans
Other Injury, Poisoning and Toxic Effect Diagnoses with Mcc 922	–	–	–	$27,177$21,430–$38,020 · 11 plans
Other Injury, Poisoning and Toxic Effect Diagnoses Without Mcc 923	–	–	–	$15,810$12,467–$22,118 · 11 plans
Ms-Drg 927 927	–	–	–	$331,680$261,544–$464,010 · 11 plans
Full Thickness Burn with Skin Graft or Inhalation Injury with Cc/Mcc 928	–	–	–	$111,428$87,866–$155,884 · 11 plans
Ms-Drg 929 929	–	–	–	$50,035$39,455–$69,998 · 11 plans
Ms-Drg 933 933	–	–	–	$60,496$47,704–$84,633 · 11 plans
Full Thickness Burn Without Skin Graft or Inhalation Injury 934	–	–	–	$34,342$27,080–$48,043 · 11 plans
Non-Extensive Burns 935	–	–	–	$32,002$25,235–$44,770 · 11 plans
Ms-Drg 939 939	–	–	–	$56,369$44,449–$78,858 · 11 plans
O.r. Procedures with Diagnoses of Other Contact with Health Services with Cc 940	–	–	–	$36,304$28,627–$50,788 · 11 plans
O.r. Procedures with Diagnoses of Other Contact with Health Services Without Cc/Mcc 941	–	–	–	$31,500$24,839–$44,068 · 11 plans
Rehabilitation with Cc/Mcc 945	–	–	–	$24,058$18,970–$33,656 · 11 plans
Rehabilitation Without Cc/Mcc 946	–	–	–	$17,816$14,048–$24,923 · 11 plans
Signs and Symptoms with Mcc 947	–	–	–	$19,720$15,550–$27,588 · 11 plans
Aftercare with Cc/Mcc 949	–	–	–	$18,482$14,574–$25,856 · 11 plans
Aftercare Without Cc/Mcc 950	–	–	–	$9,751$7,689–$13,642 · 11 plans
Other Factors Influencing Health Status 951	–	–	–	$8,637$6,811–$12,084 · 11 plans
Ms-Drg 955 955	–	–	–	$104,568$82,456–$146,287 · 11 plans
Other O.r. Procedures for Multiple Significant Trauma with Mcc 957	–	–	–	$118,375$93,344–$165,603 · 11 plans
Other O.r. Procedures for Multiple Significant Trauma with Cc 958	–	–	–	$65,463$51,620–$91,581 · 11 plans
Ms-Drg 959 959	–	–	–	$45,737$36,065–$63,984 · 11 plans
Other Multiple Significant Trauma with Cc 964	–	–	–	$23,809$18,774–$33,308 · 11 plans
Ms-Drg 965 965	–	–	–	$14,611$11,521–$20,440 · 11 plans
Ms-Drg 969 969	–	–	–	$95,094$74,986–$133,034 · 11 plans
Ms-Drg 970 970	–	–	–	$40,972$32,308–$57,319 · 11 plans
Hiv with Major Related Condition with Mcc 974	–	–	–	$44,834$35,354–$62,721 · 11 plans
Hiv with Major Related Condition with Cc 975	–	–	–	$20,118$15,864–$28,144 · 11 plans
Ms-Drg 976 976	–	–	–	$14,023$11,058–$19,618 · 11 plans
Ms-Drg 977 977	–	–	–	$20,160$15,897–$28,203 · 11 plans
Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 982	–	–	–	$38,193$30,117–$53,431 · 11 plans
Extensive O.r. Procedures Unrelated to Principal Diagnosis Without Cc/Mcc 983	–	–	–	$26,627$20,997–$37,250 · 11 plans
Ms-Drg 984 984	–	–	–	Not in dollars (22 plans)
Ms-Drg 985 985	–	–	–	Not in dollars (22 plans)
Ms-Drg 986 986	–	–	–	Not in dollars (22 plans)
Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 988	–	–	–	$25,533$20,134–$35,720 · 11 plans
Ms-Drg 989 989	–	–	–	$18,630$14,690–$26,062 · 11 plans
Ms-Drg 998 998	–	–	–	Not in dollars (22 plans)
Ms-Drg 999 999	–	–	–	Not in dollars (22 plans)

Outpatient procedures and tests

The hospital's facility charge only; doctors usually bill separately.

Procedure	List price	Cash price	Insurers (median)
C-section, with prenatal and postpartum care CPT 59510	–	–	$4,623only 2 plans
Cataract surgery CPT 66984	–	–	$6,975$5,214–$14,134 · 4 plans
Colonoscopy CPT 45378	$1,279	$767	$3,639$2,647–$4,077 · 4 plans
Colonoscopy with biopsy CPT 45380	–	–	$4,047$2,845–$4,299 · 4 plans
Complete blood count (CBC) CPT 85025	$147	$88	$9$9–$15 · 3 plans
Comprehensive metabolic panel (blood test) CPT 80053	$446	$267	$12$12–$20 · 3 plans
CT scan of the abdomen and pelvis, with contrast CPT 74177	$3,755	$2,253	$227$227–$1,062 · 3 plans
Emergency room visit, highest level CPT 99285	$3,272	$1,963	$2,586$2,253–$3,926 · 3 plans
Gallbladder removal (laparoscopic) CPT 47562	–	–	$14,495$6,287–$20,527 · 4 plans
Hip replacement CPT 27130	–	–	$13,283$3,742–$39,236 · 4 plans
Knee arthroscopy (meniscus) CPT 29881	–	–	$7,425$4,225–$10,932 · 4 plans
Knee replacement CPT 27447	–	–	$13,283$3,741–$39,236 · 4 plans
MRI of the brain, with and without contrast CPT 70553	$6,022	$3,613	$255$255–$1,068 · 3 plans
MRI of the knee, without contrast CPT 73721	$5,633	$3,380	$164$164–$728 · 3 plans
Vaginal delivery, with prenatal and postpartum care CPT 59400	–	–	$4,493only 2 plans

Price file: Saint Francis Medical Center, read November 9, 2026.