Umass Memorial Medical Center/University Campus
55 Lake Avenue North, Worcester, MA 01655 · (508) 334-1000
The money
$33what care cost the hospital for every $100 it billed
$77.2Mnet income, all sources
−2.0%margin on patient care alone
$35.2Mcost of charity care (1.3% of costs)
$36.1Munpaid bills written off (bad debt)
700beds
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 | Cash price | Insurers (median) | |
|---|---|---|---|---|---|---|
| Sepsis, with major complications 871 | 762 | $80,122 | $26,281 | $68,590 | $19,629$7,584–$24,483 · 20 plans | |
| Heart failure, with major complications 291 | 379 | $53,316 | $17,494 | $45,280 | $13,092$7,584–$16,364 · 20 plans | |
| Pneumonia, with major complications 193 | 221 | $44,045 | $17,211 | $38,082 | $13,387$7,584–$16,713 · 20 plans | |
| Lung infection, with major complications 177 | 210 | $61,160 | $21,505 | $51,689 | $15,931$7,584–$19,826 · 20 plans | |
| Respiratory failure 189 | 139 | $55,370 | $16,714 | $40,816 | $12,745$7,584–$15,744 · 20 plans | |
| COPD, with major complications 190 | 134 | $41,045 | $15,125 | $35,695 | $11,502$7,584–$14,199 · 20 plans | |
| Stomach and digestive disorders 392 | 134 | $33,709 | $11,054 | $27,636 | $8,386$7,654–$11,083 · 21 plans | |
| Heart procedure through a catheter (e.g. ablation, valve clip) 274 | 128 | $94,575 | $37,291 | $95,110 | $33,072$7,654–$71,539 · 21 plans | |
| Other kidney and urinary problems, with major complications 698 | 121 | $61,121 | $21,090 | $56,565 | $16,824$7,584–$20,910 · 20 plans | |
| Infection needing surgery, with major complications 853 | 121 | $192,626 | $64,212 | $170,533 | $48,335$7,515–$62,280 · 19 plans | |
| Stomach or intestinal bleeding, with complications 378 | 120 | $48,025 | $13,507 | $40,161 | $10,266$7,584–$12,629 · 20 plans | |
| Kidney failure, with complications 683 | 120 | $33,465 | $12,075 | $32,788 | $9,244$7,584–$11,355 · 20 plans | |
| Sepsis 872 | 117 | $43,282 | $13,926 | $39,179 | $10,781$7,654–$14,643 · 21 plans | |
| Urinary tract infection 690 | 109 | $33,967 | $10,876 | $25,935 | $8,599$7,584–$10,515 · 20 plans | |
| Hip or thigh bone surgery (not replacement), with complications 481 | 108 | $93,037 | $25,711 | $101,109 | $20,909$7,515–$26,594 · 19 plans | |
| Dehydration and electrolyte problems, with major complications 640 | 108 | $54,290 | $18,082 | $49,140 | $13,721$7,584–$16,957 · 20 plans | |
| Kidney failure, with major complications 682 | 106 | $71,000 | $22,450 | $48,362 | $15,136$7,584–$18,779 · 20 plans | |
| Urinary tract infection, with major complications 689 | 103 | $57,608 | $16,876 | $37,540 | $12,014$7,584–$14,835 · 20 plans | |
| Heart attack, with major complications 280 | 96 | $80,309 | $22,250 | $74,047 | $16,180$7,515–$20,643 · 19 plans | |
| Fainting 312 | 90 | $36,844 | $11,497 | $38,223 | $9,204$7,584–$11,285 · 20 plans | |
| Septicemia or Severe Sepsis with Mv >96 Hours 870 | 84 | $236,603 | $78,951 | $240,888 | $68,646$65,498–$89,819 · 17 plans | |
| Heart stent 322 | 81 | $137,969 | $24,710 | $146,606 | $18,303$17,398–$45,253 · 20 plans | |
| Irregular heartbeat, with complications 309 | 80 | $30,746 | $10,021 | $28,602 | $7,955$7,435–$10,500 · 21 plans | |
| Back problems (no surgery) 552 | 80 | $38,799 | $12,766 | $34,501 | $10,077$7,584–$12,387 · 20 plans | |
| Heart stent, with major complications or 4+ stents 321 | 76 | $192,080 | $41,224 | $191,637 | $27,462$26,202–$36,219 · 17 plans | |
| Stroke, with major complications 064 | 75 | $105,531 | $28,467 | $65,510 | $20,104$7,584–$25,209 · 20 plans | |
| Skin infection (cellulitis) 603 | 74 | $40,604 | $12,249 | $28,475 | $9,110$7,654–$12,510 · 21 plans | |
| Hip or knee replacement 470 | 73 | $89,894 | $23,151 | $78,252 | $19,680$8,728–$40,407 · 22 plans | |
| Stroke, with complications or clot-busting drug 065 | 70 | $43,106 | $12,667 | $38,108 | $10,952$10,303–$25,976 · 21 plans | |
| Stomach or intestinal bleeding, with major complications 377 | 70 | $85,194 | $23,652 | $63,443 | $18,689$7,654–$25,824 · 21 plans | |
| Dehydration and electrolyte problems 641 | 69 | $33,485 | $10,992 | $24,255 | $8,294$7,584–$10,146 · 20 plans | |
| Bowel surgery, with complications 330 | 68 | $76,757 | $29,857 | $79,756 | $23,828$7,515–$30,328 · 19 plans | |
| Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy Without Mcc 897 | 68 | $42,088 | $11,620 | $29,104 | $9,225$6,958–$11,298 · 21 plans | |
| Major Chest Trauma with Cc 184 | 65 | $45,602 | $14,158 | $38,077 | $10,973$7,515–$13,480 · 19 plans | |
| Heart valve replacement through a catheter (TAVR) 267 | 65 | $169,724 | $57,590 | $188,482 | $47,508$45,330–$61,500 · 17 plans | |
| Other kidney and urinary problems, with complications 699 | 61 | $44,080 | $13,175 | $39,350 | $10,700$7,654–$14,486 · 21 plans | |
| Major Chest Trauma with Mcc 183 | 59 | $76,552 | $20,891 | $54,001 | $15,465$7,515–$19,083 · 19 plans | |
| Stomach and digestive disorders, with major complications 391 | 59 | $61,781 | $17,809 | $45,892 | $13,065$7,584–$16,167 · 20 plans | |
| Pneumonia, with complications 194 | 57 | $32,804 | $11,073 | $28,968 | $8,564$7,584–$10,501 · 20 plans | |
| Heart attack, with complications 281 | 56 | $57,346 | $12,346 | $66,924 | $9,666$7,584–$13,780 · 20 plans | |
| Heart catheterization, with major complications 286 | 55 | $111,234 | $30,193 | $103,622 | $22,470$8,989–$31,671 · 22 plans | |
| Irregular heartbeat, with major complications 308 | 54 | $71,867 | $18,368 | $50,197 | $12,322$7,654–$15,163 · 21 plans | |
| Major Chest Procedures with Cc 164 | 52 | $123,597 | $32,085 | $124,667 | $25,051$7,515–$31,984 · 19 plans | |
| Degenerative nerve disorders (e.g. Parkinson's, dementia) 057 | 51 | $62,161 | $19,133 | $43,166 | $13,205$6,338–$16,533 · 20 plans | |
| Other circulation problems, with major complications 314 | 51 | $104,813 | $29,552 | $66,937 | $21,018$7,584–$26,348 · 20 plans | |
| Hip replacement after a hip fracture 522 | 51 | $92,229 | $25,678 | $91,835 | $21,536$7,654–$44,691 · 21 plans | |
| Anemia and blood disorders 812 | 49 | $36,624 | $11,873 | $34,032 | $9,748$7,654–$13,108 · 21 plans | |
| Pulmonary Embolism with Mcc or Acute Cor Pulmonale 175 | 48 | $44,980 | $17,861 | $43,906 | $14,423$13,710–$30,396 · 20 plans | |
| Lung infection, with complications 178 | 48 | $51,120 | $14,915 | $39,785 | $10,220$7,584–$12,587 · 20 plans | |
| Other digestive problems, with complications 394 | 48 | $40,542 | $12,802 | $33,602 | $9,920$7,654–$13,369 · 21 plans | |
| Diabetes, with complications 638 | 47 | $40,467 | $12,179 | $37,991 | $9,443$7,584–$11,616 · 20 plans | |
| Heart catheterization 287 | 46 | $82,807 | $15,350 | $79,703 | $11,241$7,654–$23,256 · 21 plans | |
| Hip or thigh bone surgery (not replacement), with major complications 480 | 46 | $123,730 | $36,761 | $107,257 | $29,344$7,654–$42,767 · 21 plans | |
| Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis with Mcc O 023 | 44 | $205,150 | $69,389 | $241,682 | $57,036$54,420–$74,181 · 17 plans | |
| Breathing problem needing a ventilator (up to 4 days) 208 | 43 | $117,852 | $34,375 | $87,361 | $27,477$7,584–$40,280 · 20 plans | |
| Craniotomy and Endovascular Intracranial Procedures with Mcc 025 | 42 | $173,869 | $57,745 | $161,039 | $45,405$43,471–$74,108 · 18 plans | |
| Anemia and blood disorders, with major complications 811 | 42 | $58,039 | $18,172 | $49,848 | $14,389$7,584–$17,813 · 20 plans | |
| Poisoning and Toxic Effects of Drugs with Mcc 917 | 41 | $89,358 | $26,860 | $52,967 | $15,987$7,584–$19,921 · 20 plans | |
| Heart valve replacement through a catheter (TAVR), with major complications 266 | 40 | $193,266 | $72,608 | $199,343 | $60,948$58,153–$78,678 · 17 plans | |
| Cervical Spinal Fusion with Cc 472 | 40 | $132,190 | $36,027 | $106,198 | $29,399$7,584–$43,203 · 20 plans | |
| Bowel surgery, with major complications 329 | 39 | $135,276 | $54,710 | $143,783 | $45,894$43,789–$59,673 · 17 plans | |
| Diabetes, with major complications 637 | 39 | $67,581 | $20,195 | $58,111 | $14,705$7,584–$18,234 · 20 plans | |
| Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy with Mcc 896 | 39 | $81,000 | $26,434 | $51,581 | $17,540$6,338–$22,034 · 20 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 981 | 39 | $204,553 | $59,966 | $179,477 | $46,830$44,683–$61,281 · 17 plans | |
| Bowel obstruction, with complications 389 | 38 | $38,906 | $11,029 | $27,021 | $8,407$7,584–$10,300 · 20 plans | |
| Seizures 101 | 37 | $36,344 | $12,336 | $28,754 | $9,505$7,584–$11,692 · 20 plans | |
| Respiratory System Diagnosis with Ventilator Support >96 Hours 207 | 37 | $393,375 | $90,093 | $284,345 | $63,957$61,025–$83,595 · 17 plans | |
| Delirium and other mental confusion 884 | 37 | $124,673 | $34,332 | $72,807 | $16,227$5,718–$20,771 · 19 plans | |
| Traumatic Stupor and Coma <1 Hour with Cc 086 | 36 | $51,121 | $16,187 | $48,559 | $13,274$7,584–$16,578 · 20 plans | |
| Other Disorders of Nervous System with Cc 092 | 36 | $49,619 | $13,760 | $39,144 | $10,677$7,584–$13,190 · 20 plans | |
| Endocrine Disorders with Cc 644 | 36 | $33,798 | $13,721 | $33,126 | $10,697$7,584–$13,176 · 20 plans | |
| Other Vascular Procedures with Mcc 252 | 35 | $142,017 | $42,406 | $135,889 | $35,004$33,399–$45,075 · 17 plans | |
| Other Major Cardiovascular Procedures with Mcc 270 | 35 | $250,310 | $70,711 | $244,209 | $52,574$50,506–$93,579 · 19 plans | |
| Disorders of Pancreas Except Malignancy with Cc 439 | 35 | $37,168 | $11,516 | $29,278 | $8,992$7,654–$12,217 · 21 plans | |
| Coagulation Disorders 813 | 35 | $76,942 | $21,565 | $59,119 | $15,420$7,584–$19,324 · 20 plans | |
| Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Cc 442 | 34 | $44,120 | $12,881 | $38,962 | $10,211$7,654–$13,723 · 21 plans | |
| Other Factors Influencing Health Status 951 | 34 | $24,831 | $7,830 | $14,443 | $6,276$5,965–$8,136 · 20 plans | |
| Other Vascular Procedures with Cc 253 | 33 | $111,914 | $29,236 | $101,505 | $25,741$7,515–$32,775 · 19 plans | |
| Medical Back Problems with Mcc 551 | 32 | $73,167 | $20,493 | $49,177 | $17,035$7,584–$21,182 · 20 plans | |
| Mini-stroke (TIA) 069 | 31 | $32,188 | $10,903 | $29,587 | $8,495$7,584–$10,395 · 20 plans | |
| Traumatic Stupor and Coma <1 Hour with Mcc 085 | 31 | $90,569 | $28,158 | $79,163 | $22,620$7,515–$28,845 · 19 plans | |
| Bronchitis and Asthma with Cc/Mcc 202 | 31 | $40,277 | $12,723 | $27,680 | $10,077$7,584–$12,499 · 20 plans | |
| Cirrhosis and Alcoholic Hepatitis with Mcc 432 | 31 | $79,653 | $26,094 | $66,020 | $19,879$7,584–$24,765 · 20 plans | |
| Hip Replacement with Principal Diagnosis of Hip Fracture with Mcc 521 | 31 | $102,783 | $34,896 | $110,696 | $28,930$7,654–$44,691 · 21 plans | |
| Fracture or sprain (not hip or thigh) 563 | 31 | $31,617 | $11,224 | $32,142 | $9,347$7,654–$12,695 · 21 plans | |
| Chronic Obstructive Pulmonary Disease with Cc 191 | 30 | $35,930 | $11,767 | $30,670 | $8,925$7,584–$10,958 · 20 plans | |
| Other Digestive System Diagnoses with Mcc 393 | 30 | $115,662 | $30,860 | $59,893 | $16,288$7,584–$20,278 · 20 plans | |
| Disorders of the Biliary Tract with Cc 445 | 30 | $76,549 | $15,882 | $52,696 | $11,373$7,584–$14,000 · 20 plans | |
| Aortic and Heart Assist Procedures Except Pulsation Balloon Without Mcc 269 | 29 | $234,547 | $50,774 | $261,527 | $42,226$40,565–$71,744 · 19 plans | |
| Major Small and Large Bowel Procedures Without Cc/Mcc 331 | 28 | $57,333 | $22,367 | $70,472 | $16,940$7,515–$21,429 · 19 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections with Cc 372 | 28 | $35,805 | $13,455 | $39,710 | $10,658$7,584–$13,127 · 20 plans | |
| Traumatic Stupor and Coma >1 Hour with Mcc 082 | 27 | $114,934 | $34,055 | $67,659 | $23,185$22,122–$30,086 · 17 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 220 | 27 | $207,225 | $64,020 | $214,584 | $53,129$51,040–$119,952 · 19 plans | |
| Peripheral Vascular Disorders with Cc 300 | 27 | $39,456 | $13,662 | $31,848 | $11,111$7,584–$13,689 · 20 plans | |
| Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Mcc 441 | 27 | $121,852 | $34,778 | $53,096 | $18,190$7,584–$22,730 · 20 plans | |
| Degenerative Nervous System Disorders with Mcc 056 | 26 | $76,767 | $30,099 | $72,161 | $23,554$7,654–$32,242 · 21 plans | |
| Coronary Bypass with Cardiac Catheterization or Open Ablation Without Mcc 234 | 26 | $193,204 | $64,467 | $218,837 | $55,931$52,621–$104,405 · 21 plans | |
| High blood pressure 305 | 26 | $27,256 | $9,899 | $35,448 | $8,146$7,613–$10,662 · 21 plans | |
| Digestive Malignancy with Mcc 374 | 26 | $103,258 | $28,399 | $77,369 | $21,539$7,584–$31,637 · 20 plans | |
| Endocrine Disorders with Mcc 643 | 26 | $74,911 | $24,041 | $58,298 | $16,901$7,654–$23,538 · 21 plans | |
| Signs and Symptoms Without Mcc 948 | 26 | $36,450 | $10,035 | $33,879 | $8,511$7,584–$10,406 · 20 plans | |
| Other Cerebrovascular Disorders with Cc 071 | 25 | $47,947 | $14,168 | $51,072 | $10,707$7,584–$13,216 · 20 plans | |
| Traumatic Stupor and Coma >1 Hour with Cc 083 | 25 | $49,483 | $17,307 | $45,825 | $14,172$7,584–$17,698 · 20 plans | |
| Seizures with Mcc 100 | 25 | $115,556 | $30,695 | $83,465 | $19,389$7,515–$24,822 · 19 plans | |
| Respiratory Neoplasms with Mcc 180 | 25 | $69,945 | $23,205 | $64,808 | $18,079$7,654–$24,824 · 21 plans | |
| Permanent Cardiac Pacemaker Implant with Cc 243 | 25 | $90,244 | $27,288 | $109,682 | $24,293$20,984–$47,779 · 22 plans | |
| Postoperative and Post-Traumatic Infections with Mcc 862 | 25 | $110,365 | $33,833 | $58,768 | $18,472$7,584–$22,980 · 20 plans | |
| Chest pain 313 | 24 | $29,212 | $9,573 | $32,024 | $7,728$7,257–$9,419 · 20 plans | |
| Other Circulatory System Diagnoses with Cc 315 | 24 | $52,022 | $12,908 | $36,772 | $10,096$7,584–$12,407 · 20 plans | |
| Disorders of Pancreas Except Malignancy with Mcc 438 | 24 | $93,649 | $25,569 | $54,929 | $16,588$7,584–$20,624 · 20 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Cc 493 | 24 | $114,179 | $30,585 | $105,415 | $25,168$7,515–$31,771 · 19 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm with Mcc 659 | 24 | $110,217 | $35,416 | $85,507 | $25,214$7,515–$32,338 · 19 plans | |
| Complications of Treatment with Mcc 919 | 24 | $55,543 | $22,965 | $84,516 | $18,541$7,584–$27,289 · 20 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 982 | 24 | $79,409 | $29,427 | $108,294 | $24,419$7,515–$31,158 · 19 plans | |
| Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis Without Mc 024 | 23 | $110,273 | $42,343 | $126,770 | $38,435$7,515–$48,991 · 19 plans | |
| Other Cardiothoracic Procedures Without Mcc 229 | 23 | $113,904 | $38,813 | $144,340 | $31,675$30,222–$40,788 · 17 plans | |
| Kidney Transplant 652 | 23 | $305,958 | $42,513 | $324,548 | $39,530$31,854–$116,050 · 22 plans | |
| Other Kidney and Urinary Tract Procedures with Mcc 673 | 23 | $179,681 | $52,462 | $156,091 | $41,228$7,515–$52,881 · 19 plans | |
| Ecmo or Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Nec 003 | 22 | $654,597 | $242,090 | $702,677 | $207,343$199,022–$256,026 · 16 plans | |
| Craniotomy and Endovascular Intracranial Procedures with Cc 026 | 22 | $134,593 | $35,083 | $150,194 | $30,986$29,742–$38,083 · 16 plans | |
| Nervous System Neoplasms with Mcc 054 | 22 | $62,282 | $20,389 | $67,196 | $15,583$7,584–$22,481 · 20 plans | |
| Other Cerebrovascular Disorders with Mcc 070 | 22 | $103,346 | $28,284 | $58,236 | $16,925$7,584–$21,105 · 20 plans | |
| Peripheral Vascular Disorders with Mcc 299 | 22 | $71,628 | $24,103 | $57,713 | $16,613$7,584–$20,586 · 20 plans | |
| Infectious and Parasitic Diseases with O.r. Procedures with Cc 854 | 22 | $69,243 | $24,483 | $59,404 | $20,170$7,584–$25,155 · 20 plans | |
| Psychoses 885 | 22 | $112,319 | $30,388 | $59,237 | $1,770$743–$17,482 · 21 plans | |
| Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma 956 | 22 | $140,993 | $45,906 | $120,878 | $36,999$7,445–$45,948 · 18 plans | |
| Extracranial Procedures with Cc 038 | 21 | $64,029 | $21,861 | $54,364 | $16,670$7,654–$22,885 · 21 plans | |
| Other Cardiothoracic Procedures with Mcc 228 | 21 | $179,461 | $63,696 | $187,912 | $49,342$47,080–$64,429 · 17 plans | |
| Coronary Bypass with Cardiac Catheterization or Open Ablation with Mcc 233 | 21 | $278,819 | $89,901 | $275,665 | $75,853$72,870–$138,752 · 19 plans | |
| Gastrointestinal Obstruction with Mcc 388 | 21 | $48,896 | $18,547 | $50,412 | $15,095$7,584–$18,688 · 20 plans | |
| Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Cc 617 | 21 | $90,465 | $26,193 | $98,872 | $18,747$7,515–$24,030 · 19 plans | |
| Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Cc 847 | 21 | $51,067 | $16,746 | $38,744 | $13,454$7,584–$16,579 · 20 plans | |
| Poisoning and Toxic Effects of Drugs Without Mcc 918 | 21 | $35,003 | $11,725 | $21,660 | $8,977$7,584–$11,147 · 20 plans | |
| Complications of Treatment with Cc 920 | 21 | $36,472 | $13,246 | $31,438 | $10,476$7,584–$12,905 · 20 plans | |
| Other Multiple Significant Trauma with Cc 964 | 21 | $65,842 | $19,042 | $56,283 | $15,491$7,515–$19,116 · 19 plans | |
| Craniotomy and Endovascular Intracranial Procedures Without Cc/Mcc 027 | 20 | $131,281 | $27,791 | $132,809 | $25,279$24,264–$31,030 · 16 plans | |
| Extracranial Procedures Without Cc/Mcc 039 | 20 | $63,169 | $14,966 | $53,972 | $12,047$7,584–$14,954 · 20 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections with Mcc 371 | 20 | $66,879 | $23,554 | $61,515 | $18,149$7,654–$24,827 · 21 plans | |
| Malignancy of Hepatobiliary System or Pancreas with Mcc 435 | 20 | $89,621 | $23,633 | $72,879 | $18,423$7,515–$23,402 · 19 plans | |
| Spinal fusion (lower or mid back) 460 | 20 | $144,856 | $44,374 | – | – | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Cc 543 | 20 | $46,846 | $13,938 | $42,784 | $10,827$7,654–$15,068 · 21 plans | |
| Heart Failure and Shock with Cc 292 | 19 | $45,638 | $12,603 | $31,685 | $8,984$7,584–$11,026 · 20 plans | |
| Disorders of the Biliary Tract with Mcc 444 | 19 | $91,819 | $22,730 | $90,479 | $16,824$7,515–$21,408 · 19 plans | |
| Other Musculoskeletal System and Connective Tissue Diagnoses with Cc 565 | 19 | $42,508 | $13,484 | $40,615 | $10,204$7,584–$12,609 · 20 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm with Cc 660 | 19 | $52,375 | $16,840 | $52,494 | $13,585$7,584–$16,824 · 20 plans | |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 062 | 18 | $87,013 | $22,699 | $85,288 | $17,657$7,515–$22,513 · 19 plans | |
| Cranial and Peripheral Nerve Disorders Without Mcc 074 | 18 | $33,947 | $13,605 | $34,433 | $10,855$7,654–$14,805 · 21 plans | |
| Pulmonary Embolism Without Mcc 176 | 18 | $33,312 | $12,234 | $29,906 | $8,757$8,324–$20,533 · 20 plans | |
| Other Respiratory System Diagnoses with Mcc 205 | 18 | $54,959 | $23,000 | $44,794 | $18,543$7,584–$23,132 · 20 plans | |
| Coronary Bypass Without Cardiac Catheterization Without Mcc 236 | 18 | $132,377 | $51,185 | $129,874 | $41,888$40,240–$80,175 · 19 plans | |
| Atherosclerosis Without Mcc 303 | 18 | $24,521 | $10,847 | $26,283 | $7,341$6,948–$8,854 · 20 plans | |
| Other O.r. Procedures for Injuries with Mcc 907 | 18 | $140,921 | $41,437 | $116,225 | $37,734$7,515–$48,809 · 19 plans | |
| Other Disorders of Nervous System with Mcc 091 | 17 | $89,736 | $29,725 | $55,118 | $17,815$7,584–$22,214 · 20 plans | |
| Permanent Cardiac Pacemaker Implant with Mcc 242 | 17 | $156,542 | $43,898 | $128,823 | $32,100$30,628–$42,724 · 17 plans | |
| Irregular heartbeat 310 | 17 | $26,826 | $7,742 | $20,423 | $6,465$6,081–$7,947 · 21 plans | |
| Stomach, Esophageal and Duodenal Procedures with Mcc 326 | 17 | $142,346 | $62,727 | $112,110 | $49,270$7,584–$75,762 · 20 plans | |
| Combined Anterior and Posterior Spinal Fusion with Cc 454 | 17 | $215,251 | $71,039 | – | – | |
| Other O.r. Procedures for Injuries with Cc 908 | 17 | $101,730 | $25,535 | $49,328 | $20,332$7,654–$28,649 · 21 plans | |
| Other Multiple Significant Trauma with Mcc 963 | 17 | $163,891 | $41,414 | $78,396 | $27,074$7,515–$33,639 · 19 plans | |
| Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 282 | 16 | $51,050 | $9,492 | $56,772 | $7,758$7,283–$10,840 · 20 plans | |
| Inflammatory Bowel Disease with Cc 386 | 16 | $43,103 | $13,908 | $39,039 | $10,319$7,654–$14,096 · 21 plans | |
| Hip and Femur Procedures Except Major Joint Without Cc/Mcc 482 | 16 | $65,949 | $19,285 | $60,206 | $16,596$7,584–$20,523 · 20 plans | |
| Fractures of Hip and Pelvis Without Mcc 536 | 16 | $37,221 | $12,421 | $43,404 | $8,581$7,584–$10,506 · 20 plans | |
| Trauma to the Skin, Subcutaneous Tissue and Breast Without Mcc 605 | 16 | $34,649 | $11,571 | $38,105 | $9,636$7,584–$11,840 · 20 plans | |
| Kidney and Ureter Procedures for Neoplasm with Cc 657 | 16 | $111,018 | $29,073 | $97,210 | $18,534$7,584–$27,345 · 20 plans | |
| Lymphoma and Non-Acute Leukemia with Mcc 840 | 16 | $321,880 | $85,084 | $97,803 | $31,906$7,515–$40,735 · 19 plans | |
| Dysequilibrium 149 | 15 | $33,267 | $9,639 | $30,885 | $8,035$7,518–$9,810 · 20 plans | |
| Major Chest Procedures with Mcc 163 | 15 | $167,961 | $57,779 | $151,289 | $44,767$42,860–$75,046 · 18 plans | |
| Major Chest Procedures Without Cc/Mcc 165 | 15 | $111,504 | $24,531 | $101,576 | $19,353$7,584–$27,987 · 20 plans | |
| Amputation for Circulatory System Disorders Except Upper Limb and Toe with Cc 240 | 15 | $97,436 | $30,527 | $90,407 | $28,199$7,515–$36,249 · 19 plans | |
| Acute Myocardial Infarction, Expired with Mcc 283 | 15 | $86,203 | $25,174 | $91,137 | $19,813$7,515–$25,161 · 19 plans | |
| Other Digestive System O.r. Procedures with Mcc 356 | 15 | $205,351 | $60,587 | $187,012 | $43,892$41,880–$56,349 · 17 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. with Cc 418 | 15 | $63,288 | $21,293 | $76,990 | $17,024$7,515–$21,534 · 19 plans | |
| Major Joint or Limb Reattachment Procedures of Upper Extremities 483 | 15 | $127,699 | $32,324 | $124,590 | $27,964$7,654–$37,506 · 21 plans | |
| Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 808 | 15 | $102,220 | $28,974 | $87,391 | $22,003$7,515–$28,298 · 19 plans | |
| Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 809 | 15 | $145,467 | $37,582 | $49,324 | $13,042$7,584–$16,076 · 20 plans | |
| Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Neck Withou 004 | 14 | $498,427 | $147,980 | $440,684 | $135,560$130,119–$167,316 · 16 plans | |
| Pneumothorax with Cc 200 | 14 | $54,944 | $14,269 | $36,071 | $11,313$7,584–$14,086 · 20 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 219 | 14 | $269,650 | $96,470 | $267,394 | $76,178$73,182–$136,167 · 19 plans | |
| Other Major Cardiovascular Procedures with Cc 271 | 14 | $109,239 | $40,855 | $127,916 | $35,672$7,654–$71,744 · 21 plans | |
| Percutaneous and Other Intracardiac Procedures with Mcc 273 | 14 | $176,795 | $50,890 | $172,071 | $41,266$39,642–$90,443 · 19 plans | |
| Digestive Malignancy with Cc 375 | 14 | $36,077 | $14,318 | $52,040 | $12,494$7,584–$15,452 · 20 plans | |
| Cellulitis with Mcc 602 | 14 | $124,114 | $28,016 | $47,509 | $14,692$7,654–$20,867 · 21 plans | |
| Uterine and Adnexa Procedures for Non-Malignancy Without Cc/Mcc 743 | 14 | $48,096 | $14,100 | $49,978 | $12,676$6,958–$15,604 · 21 plans | |
| Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 987 | 14 | $119,881 | $46,589 | $121,759 | $33,772$7,515–$43,488 · 19 plans | |
| Liver Transplant with Mcc or Intestinal Transplant 005 | 13 | $531,433 | $138,072 | $474,026 | $124,717$100,136–$253,949 · 21 plans | |
| Intracranial Hemorrhage or Cerebral Infarction Without Cc/Mcc 066 | 13 | $32,281 | $9,124 | $29,822 | $7,660$7,205–$25,976 · 21 plans | |
| Hypertension with Mcc 304 | 13 | $52,398 | $16,644 | $60,977 | $12,187$7,515–$15,332 · 19 plans | |
| Stomach, Esophageal and Duodenal Procedures with Cc 327 | 13 | $75,494 | $30,032 | $85,618 | $24,281$7,515–$30,963 · 19 plans | |
| Gastrointestinal Obstruction Without Cc/Mcc 390 | 13 | $26,982 | $7,799 | $22,398 | $6,241$5,871–$7,772 · 21 plans | |
| Cirrhosis and Alcoholic Hepatitis with Cc 433 | 13 | $39,661 | $12,870 | $39,591 | $11,001$7,584–$13,565 · 20 plans | |
| Kidney Transplant with Hemodialysis with Mcc 650 | 13 | $333,836 | $66,347 | $332,373 | $46,925$44,773–$60,517 · 17 plans | |
| Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 988 | 13 | $77,674 | $22,177 | $55,717 | $16,877$7,654–$24,372 · 21 plans | |
| Other Ear, Nose, Mouth and Throat Diagnoses with Cc 155 | 12 | $32,058 | $13,160 | $35,528 | $9,732$7,654–$13,260 · 21 plans | |
| Pneumothorax with Mcc 199 | 12 | $67,723 | $22,728 | $56,460 | $17,892$7,584–$22,218 · 20 plans | |
| Other Circulatory System O.r. Procedures 264 | 12 | $179,570 | $49,736 | $97,050 | $32,925$7,515–$42,622 · 19 plans | |
| Peritoneal Adhesiolysis with Cc 336 | 12 | $66,014 | $25,735 | $60,698 | $21,046$7,654–$30,001 · 21 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur Without Cc/Mcc 494 | 12 | $89,065 | $22,847 | $70,366 | $20,061$7,515–$25,209 · 19 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures with Cc 516 | 12 | $56,558 | $24,548 | $69,523 | $20,949$7,584–$26,068 · 20 plans | |
| O.r. Procedures for Obesity with Cc 620 | 12 | $59,030 | $19,064 | $64,603 | $16,682$15,536–$24,332 · 24 plans | |
| Postoperative or Post-Traumatic Infections with O.r. Procedures with Mcc 856 | 12 | $154,412 | $58,808 | $137,941 | $44,575$7,515–$57,136 · 19 plans | |
| Signs and Symptoms with Mcc 947 | 12 | $62,810 | $15,985 | $37,566 | $13,076$7,584–$16,181 · 20 plans | |
| Hiv with Major Related Condition with Mcc 974 | 12 | $119,223 | $38,662 | $78,623 | $29,085$7,654–$42,413 · 21 plans | |
| Other Disorders of the Eye Without Mcc 125 | 11 | $45,440 | $11,162 | $31,493 | $8,270$7,654–$11,727 · 21 plans | |
| Other Respiratory System O.r. Procedures with Mcc 166 | 11 | $107,690 | $41,508 | $136,935 | $37,455$35,737–$49,261 · 17 plans | |
| Cardiac Defibrillator Implant with Cardiac Catheterization and Mcc 275 | 11 | $258,020 | $89,027 | $290,036 | $70,794$67,548–$92,025 · 17 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 464 | 11 | $181,654 | $55,266 | $106,841 | $30,747$6,338–$38,522 · 20 plans | |
| Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with Mcc 562 | 11 | $66,352 | $17,771 | $46,713 | $14,589$7,584–$18,116 · 20 plans | |
| Other Musculoskeletal System and Connective Tissue Diagnoses with Mcc 564 | 11 | $80,080 | $20,727 | $52,308 | $15,745$7,584–$19,552 · 20 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures with Cc 580 | 11 | $80,010 | $21,731 | $56,662 | $17,375$7,584–$21,838 · 20 plans | |
| Acute Adjustment Reaction and Psychosocial Dysfunction 880 | 11 | $80,164 | $17,670 | $37,360 | $9,971$6,338–$12,368 · 20 plans | |
| Alcohol, Drug Abuse or Dependence, Left Ama 894 | 11 | $27,272 | $7,890 | $25,788 | $6,788$6,344–$8,100 · 21 plans | |
| Heart Transplant or Implant of Heart Assist System with Mcc 001 | – | – | – | $831,840 | $279,979$266,154–$482,523 · 20 plans | |
| Liver Transplant Without Mcc 006 | – | – | – | $329,690 | $56,463$45,427–$253,542 · 22 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Mcc 011 | – | – | – | $284,230 | $53,814$51,653–$66,293 · 16 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Cc 012 | – | – | – | $230,569 | $41,761$40,084–$51,398 · 16 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy Without Cc/Mcc 013 | – | – | – | $144,829 | $28,773$27,617–$35,347 · 16 plans | |
| Allogeneic Bone Marrow Transplant 014 | – | – | – | $616,386 | $122,153$116,266–$229,001 · 19 plans | |
| Autologous Bone Marrow Transplant with Cc/Mcc 016 | – | – | – | $282,521 | $60,649$57,726–$135,141 · 19 plans | |
| Chimeric Antigen Receptor (car) T-Cell and Other Immunotherapies 018 | – | – | – | $3,361,507 | $421,098$404,198–$520,184 · 16 plans | |
| Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Mcc 020 | – | – | – | $598,946 | $77,321$74,217–$95,343 · 16 plans | |
| Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Cc 021 | – | – | – | $448,768 | $52,253$50,156–$64,365 · 16 plans | |
| Ms-Drg 022 022 | – | – | – | $93,844 | $31,352$7,515–$38,968 · 19 plans | |
| Spinal Procedures with Mcc 028 | – | – | – | $245,343 | $59,767$57,027–$78,315 · 17 plans | |
| Spinal Procedures with Cc or Spinal Neurostimulators 029 | – | – | – | $119,918 | $33,610$7,515–$42,912 · 19 plans | |
| Spinal Procedures Without Cc/Mcc 030 | – | – | – | $80,311 | $21,880$7,515–$27,991 · 19 plans | |
| Ventricular Shunt Procedures with Mcc 031 | – | – | – | $122,424 | $43,918$7,515–$55,568 · 19 plans | |
| Ventricular Shunt Procedures with Cc 032 | – | – | – | $91,636 | $21,261$7,515–$27,118 · 19 plans | |
| Ventricular Shunt Procedures Without Cc/Mcc 033 | – | – | – | $88,478 | $16,747$7,515–$21,079 · 19 plans | |
| Carotid Artery Stent Procedures with Mcc 034 | – | – | – | $129,173 | $38,762$36,984–$50,439 · 17 plans | |
| Carotid Artery Stent Procedures with Cc 035 | – | – | – | $111,369 | $23,764$7,515–$30,011 · 19 plans | |
| Carotid Artery Stent Procedures Without Cc/Mcc 036 | – | – | – | $90,174 | $19,446$7,515–$24,448 · 19 plans | |
| Extracranial Procedures with Mcc 037 | – | – | – | $67,736 | $32,767$7,584–$41,486 · 20 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures with Mcc 040 | – | – | – | $103,337 | $37,946$7,515–$48,419 · 19 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures with Cc or Peripheral Neur 041 | – | – | – | $83,907 | $22,123$7,584–$33,644 · 20 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures Without Cc/Mcc 042 | – | – | – | $67,962 | $17,372$7,515–$22,163 · 19 plans | |
| Ms-Drg 052 052 | – | – | – | $63,338 | $18,351$7,584–$23,089 · 20 plans | |
| Ms-Drg 053 053 | – | – | – | $100,905 | $10,154$7,515–$12,584 · 19 plans | |
| Nervous System Neoplasms Without Mcc 055 | – | – | – | $61,482 | $10,544$6,908–$13,199 · 20 plans | |
| Ms-Drg 058 058 | – | – | – | $105,020 | $17,360$7,584–$26,425 · 20 plans | |
| Ms-Drg 059 059 | – | – | – | $40,127 | $12,799$7,584–$15,784 · 20 plans | |
| Ms-Drg 060 060 | – | – | – | $52,251 | $9,764$7,654–$12,675 · 21 plans | |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 061 | – | – | – | $117,057 | $27,299$7,515–$34,757 · 19 plans | |
| Ms-Drg 063 063 | – | – | – | $86,988 | $14,249$7,515–$18,043 · 19 plans | |
| Ms-Drg 067 067 | – | – | – | $19,453 | $14,875$7,654–$20,664 · 21 plans | |
| Precerebral Occlusion Without Infarction Without Mcc 068 | – | – | – | $28,270 | $9,134$7,584–$11,221 · 20 plans | |
| Other Cerebrovascular Disorders Without Cc/Mcc 072 | – | – | – | $26,816 | $8,080$7,556–$9,863 · 20 plans | |
| Cranial and Peripheral Nerve Disorders with Mcc 073 | – | – | – | $51,198 | $16,336$7,584–$20,176 · 20 plans | |
| Ms-Drg 075 075 | – | – | – | $23,281 | $19,202$7,654–$23,746 · 21 plans | |
| Ms-Drg 076 076 | – | – | – | $13,109 | $8,834$7,654–$13,023 · 21 plans | |
| Nontraumatic Stupor and Coma with Mcc 080 | – | – | – | $67,418 | $18,166$6,338–$23,012 · 20 plans | |
| Ms-Drg 081 081 | – | – | – | $22,715 | $9,348$6,396–$11,452 · 21 plans | |
| Traumatic Stupor and Coma >1 Hour Without Cc/Mcc 084 | – | – | – | $30,515 | $9,929$7,654–$13,579 · 21 plans | |
| Traumatic Stupor and Coma <1 Hour Without Cc/Mcc 087 | – | – | – | $27,599 | $9,532$7,584–$11,770 · 20 plans | |
| Concussion with Mcc 088 | – | – | – | $82,744 | $13,747$6,620–$17,250 · 20 plans | |
| Concussion with Cc 089 | – | – | – | $50,377 | $11,306$6,958–$15,227 · 21 plans | |
| Concussion Without Cc/Mcc 090 | – | – | – | $37,211 | $8,732$7,584–$10,741 · 20 plans | |
| Other Disorders of Nervous System Without Cc/Mcc 093 | – | – | – | $28,508 | $8,550$7,654–$11,210 · 21 plans | |
| Bacterial and Tuberculous Infections of Nervous System with Mcc 094 | – | – | – | $175,951 | $35,310$33,690–$46,540 · 17 plans | |
| Ms-Drg 095 095 | – | – | – | $133,741 | $25,583$7,515–$32,175 · 19 plans | |
| Ms-Drg 096 096 | – | – | – | $161,112 | $26,071$24,875–$32,643 · 17 plans | |
| Non-Bacterial Infection of Nervous System Except Viral Meningitis with Mcc 097 | – | – | – | $78,607 | $36,218$7,654–$47,055 · 21 plans | |
| Ms-Drg 098 098 | – | – | – | $108,013 | $23,059$7,584–$32,717 · 20 plans | |
| Ms-Drg 099 099 | – | – | – | $49,745 | $14,113$7,654–$18,825 · 21 plans | |
| Headaches with Mcc 102 | – | – | – | $27,976 | $11,740$7,654–$16,468 · 21 plans | |
| Headaches Without Mcc 103 | – | – | – | $31,374 | $8,884$7,654–$12,075 · 21 plans | |
| Orbital Procedures with Cc/Mcc 113 | – | – | – | $636,804 | $23,606$22,658–$28,963 · 16 plans | |
| Extraocular Procedures Except Orbit 115 | – | – | – | $36,066 | $15,808$7,654–$21,745 · 21 plans | |
| Intraocular Procedures with Cc/Mcc 116 | – | – | – | $86,777 | $18,148$7,515–$22,684 · 19 plans | |
| Ms-Drg 117 117 | – | – | – | $65,464 | $11,174$7,028–$14,312 · 22 plans | |
| Acute Major Eye Infections with Cc/Mcc 121 | – | – | – | $30,073 | $12,043$7,584–$14,858 · 20 plans | |
| Ms-Drg 122 122 | – | – | – | $28,523 | $8,368$7,584–$10,131 · 20 plans | |
| Neurological Eye Disorders 123 | – | – | – | $38,892 | $8,493$7,584–$10,398 · 20 plans | |
| Other Disorders of the Eye with Mcc or Thrombolytic Agent 124 | – | – | – | $41,493 | $13,727$7,654–$18,519 · 21 plans | |
| Ms-Drg 135 135 | – | – | – | $111,000 | $21,637$7,515–$28,276 · 19 plans | |
| Ms-Drg 136 136 | – | – | – | $35,491 | $10,502$7,654–$13,893 · 21 plans | |
| Ms-Drg 137 137 | – | – | – | $65,056 | $15,111$7,515–$18,886 · 19 plans | |
| Ms-Drg 138 138 | – | – | – | $13,411 | $9,346$7,584–$12,325 · 20 plans | |
| Ms-Drg 140 140 | – | – | – | $202,618 | $42,639$40,684–$55,222 · 17 plans | |
| Major Head and Neck Procedures with Cc 141 | – | – | – | $83,496 | $21,951$7,584–$32,204 · 20 plans | |
| Major Head and Neck Procedures Without Cc/Mcc 142 | – | – | – | $67,124 | $16,106$7,515–$20,373 · 19 plans | |
| Ms-Drg 143 143 | – | – | – | $193,738 | $36,841$7,515–$45,980 · 19 plans | |
| Other Ear, Nose, Mouth and Throat O.r. Procedures with Cc 144 | – | – | – | $72,506 | $17,588$7,584–$26,221 · 20 plans | |
| Other Ear, Nose, Mouth and Throat O.r. Procedures Without Cc/Mcc 145 | – | – | – | $40,038 | $12,306$7,654–$16,828 · 21 plans | |
| Ear, Nose, Mouth and Throat Malignancy with Mcc 146 | – | – | – | $126,419 | $21,331$7,584–$33,134 · 20 plans | |
| Ear, Nose, Mouth and Throat Malignancy with Cc 147 | – | – | – | $96,354 | $13,097$7,584–$18,675 · 20 plans | |
| Ms-Drg 150 150 | – | – | – | $125,922 | $13,552$7,515–$17,283 · 19 plans | |
| Epistaxis Without Mcc 151 | – | – | – | $36,813 | $7,938$7,419–$10,766 · 21 plans | |
| Otitis Media and Uri with Mcc 152 | – | – | – | $22,602 | $12,227$7,584–$15,022 · 20 plans | |
| Otitis Media and Uri Without Mcc 153 | – | – | – | $16,550 | $7,905$7,408–$9,614 · 20 plans | |
| Other Ear, Nose, Mouth and Throat Diagnoses with Mcc 154 | – | – | – | $54,394 | $15,939$7,584–$19,849 · 20 plans | |
| Ms-Drg 156 156 | – | – | – | $15,506 | $7,517$7,025–$9,550 · 21 plans | |
| Dental and Oral Diseases with Mcc 157 | – | – | – | $53,615 | $17,432$7,584–$21,524 · 20 plans | |
| Dental and Oral Diseases with Cc 158 | – | – | – | $27,725 | $9,575$7,584–$11,797 · 20 plans | |
| Ms-Drg 159 159 | – | – | – | $22,394 | $7,671$7,162–$9,218 · 20 plans | |
| Other Respiratory System O.r. Procedures with Cc 167 | – | – | – | $75,610 | $18,102$7,515–$23,089 · 19 plans | |
| Other Respiratory System O.r. Procedures Without Cc/Mcc 168 | – | – | – | $84,753 | $13,888$7,515–$17,539 · 19 plans | |
| Respiratory Infections and Inflammations Without Cc/Mcc 179 | – | – | – | $32,388 | $8,069$7,546–$9,878 · 20 plans | |
| Respiratory Neoplasms with Cc 181 | – | – | – | $51,038 | $11,145$7,584–$13,783 · 20 plans | |
| Major Chest Trauma Without Cc/Mcc 185 | – | – | – | $26,181 | $10,973$7,515–$13,480 · 19 plans | |
| Pleural Effusion with Mcc 186 | – | – | – | $30,196 | $15,741$7,654–$22,441 · 21 plans | |
| Pleural Effusion with Cc 187 | – | – | – | $44,012 | $10,347$7,584–$12,746 · 20 plans | |
| Ms-Drg 188 188 | – | – | – | $25,887 | $7,773$7,265–$10,428 · 21 plans | |
| Chronic Obstructive Pulmonary Disease Without Cc/Mcc 192 | – | – | – | $21,776 | $7,034$6,780–$8,481 · 20 plans | |
| Simple Pneumonia and Pleurisy Without Cc/Mcc 195 | – | – | – | $20,468 | $6,930$6,652–$8,300 · 20 plans | |
| Interstitial Lung Disease with Mcc 196 | – | – | – | $41,412 | $19,270$7,654–$26,760 · 21 plans | |
| Interstitial Lung Disease with Cc 197 | – | – | – | $28,515 | $9,958$7,584–$12,293 · 20 plans | |
| Ms-Drg 198 198 | – | – | – | $27,202 | $7,709$7,226–$9,321 · 20 plans | |
| Ms-Drg 201 201 | – | – | – | $31,846 | $7,753$7,245–$9,617 · 21 plans | |
| Bronchitis and Asthma Without Cc/Mcc 203 | – | – | – | $12,044 | $7,309$6,945–$8,854 · 20 plans | |
| Respiratory Signs and Symptoms 204 | – | – | – | $30,194 | $8,579$7,584–$10,504 · 20 plans | |
| Other Respiratory System Diagnoses Without Mcc 206 | – | – | – | $24,476 | $9,880$7,584–$12,086 · 20 plans | |
| Concomitant Aortic and Mitral Valve Procedures 212 | – | – | – | $281,445 | $107,582$102,650–$140,789 · 17 plans | |
| Ms-Drg 213 213 | – | – | – | $210,454 | $56,275$54,016–$69,334 · 16 plans | |
| Other Heart Assist System Implant 215 | – | – | – | $622,502 | $97,649$93,729–$120,465 · 16 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 216 | – | – | – | $438,303 | $98,216$93,365–$186,781 · 20 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 217 | – | – | – | $293,976 | $65,339$62,769–$151,597 · 19 plans | |
| Ms-Drg 218 218 | – | – | – | $409,840 | $65,339$62,556–$115,062 · 18 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 221 | – | – | – | $166,706 | $51,663$48,605–$109,539 · 21 plans | |
| Coronary Bypass with Ptca with Mcc 231 | – | – | – | $352,083 | $84,735$80,550–$151,490 · 20 plans | |
| Ms-Drg 232 232 | – | – | – | $334,636 | $61,146$58,126–$133,732 · 20 plans | |
| Coronary Bypass Without Cardiac Catheterization with Mcc 235 | – | – | – | $146,250 | $58,395$56,098–$112,962 · 19 plans | |
| Amputation for Circulatory System Disorders Except Upper Limb and Toe with Mcc 239 | – | – | – | $130,491 | $48,172$7,515–$62,218 · 19 plans | |
| Ms-Drg 241 241 | – | – | – | $28,631 | $14,196$7,584–$17,744 · 20 plans | |
| Permanent Cardiac Pacemaker Implant Without Cc/Mcc 244 | – | – | – | $85,620 | $18,487$7,654–$39,282 · 21 plans | |
| Ms-Drg 245 245 | – | – | – | $145,110 | $45,559$43,767–$58,334 · 19 plans | |
| Percutaneous Cardiovascular Procedures Without Intraluminal Device with Mcc 250 | – | – | – | $147,640 | $22,172$21,155–$29,299 · 17 plans | |
| Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 251 | – | – | – | $128,342 | $15,123$7,515–$19,365 · 19 plans | |
| Other Vascular Procedures Without Cc/Mcc 254 | – | – | – | $73,875 | $17,893$7,515–$22,659 · 19 plans | |
| Ms-Drg 255 255 | – | – | – | $114,755 | $26,978$7,584–$39,308 · 20 plans | |
| Ms-Drg 256 256 | – | – | – | $40,978 | $17,248$7,584–$21,400 · 20 plans | |
| Ms-Drg 258 258 | – | – | – | $89,195 | $31,011$7,515–$38,752 · 19 plans | |
| Ms-Drg 259 259 | – | – | – | $75,672 | $20,211$7,515–$25,005 · 19 plans | |
| Cardiac Pacemaker Revision Except Device Replacement with Mcc 260 | – | – | – | $133,907 | $32,690$31,191–$43,237 · 17 plans | |
| Cardiac Pacemaker Revision Except Device Replacement with Cc 261 | – | – | – | $72,943 | $18,942$7,515–$24,127 · 19 plans | |
| Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 262 | – | – | – | $47,504 | $16,586$7,584–$20,413 · 20 plans | |
| Ms-Drg 263 263 | – | – | – | $102,437 | $30,195$7,515–$37,587 · 19 plans | |
| Ms-Drg 265 265 | – | – | – | $160,529 | $36,280$34,853–$62,087 · 19 plans | |
| Aortic and Heart Assist Procedures Except Pulsation Balloon with Mcc 268 | – | – | – | $257,046 | $68,313$65,626–$93,803 · 19 plans | |
| Other Major Cardiovascular Procedures Without Cc/Mcc 272 | – | – | – | $102,538 | $25,813$7,654–$55,484 · 21 plans | |
| Cardiac Defibrillator Implant with Mcc or Carotid Sinus Neurostimulator 276 | – | – | – | $206,009 | $59,751$57,011–$78,955 · 17 plans | |
| Cardiac Defibrillator Implant Without Mcc 277 | – | – | – | $173,955 | $46,110$43,996–$60,172 · 17 plans | |
| Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with Mcc 278 | – | – | – | $134,580 | $55,423$52,882–$69,010 · 17 plans | |
| Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures Without 279 | – | – | – | $68,422 | $35,489$7,584–$44,209 · 20 plans | |
| Ms-Drg 284 284 | – | – | – | $47,659 | $7,528$7,027–$9,157 · 20 plans | |
| Ms-Drg 288 288 | – | – | – | $65,258 | $26,808$7,584–$33,791 · 20 plans | |
| Ms-Drg 289 289 | – | – | – | $30,979 | $17,172$7,041–$21,213 · 21 plans | |
| Heart Failure and Shock Without Cc/Mcc 293 | – | – | – | $14,426 | $6,376$6,060–$7,902 · 20 plans | |
| Cardiac Arrest, Unexplained with Mcc 296 | – | – | – | $51,752 | $15,924$7,584–$19,848 · 20 plans | |
| Ms-Drg 297 297 | – | – | – | $12,932 | $8,294$7,584–$10,146 · 20 plans | |
| Peripheral Vascular Disorders Without Cc/Mcc 301 | – | – | – | $19,161 | $7,798$7,288–$10,132 · 21 plans | |
| Atherosclerosis with Mcc 302 | – | – | – | $13,583 | $12,659$12,033–$28,001 · 20 plans | |
| Cardiac Congenital and Valvular Disorders with Mcc 306 | – | – | – | $54,609 | $16,059$7,584–$19,799 · 20 plans | |
| Cardiac Congenital and Valvular Disorders Without Mcc 307 | – | – | – | $24,933 | $9,609$7,584–$11,814 · 20 plans | |
| Angina Pectoris 311 | – | – | – | $24,102 | $7,623$7,124–$9,918 · 21 plans | |
| Other Circulatory System Diagnoses Without Cc/Mcc 316 | – | – | – | $38,632 | $7,428$6,956–$8,965 · 20 plans | |
| Concomitant Left Atrial Appendage Closure and Cardiac Ablation 317 | – | – | – | $244,818 | $66,432$63,386–$83,818 · 17 plans | |
| Ms-Drg 318 318 | – | – | – | $104,688 | $24,069$7,445–$29,818 · 18 plans | |
| Other Endovascular Cardiac Valve Procedures with Mcc 319 | – | – | – | $238,988 | $44,581$42,828–$98,268 · 19 plans | |
| Other Endovascular Cardiac Valve Procedures Without Mcc 320 | – | – | – | $49,190 | $24,134$7,777–$50,335 · 22 plans | |
| Coronary Intravascular Lithotripsy with Intraluminal Device with Mcc 323 | – | – | – | $280,962 | $43,250$41,266–$55,841 · 17 plans | |
| Coronary Intravascular Lithotripsy with Intraluminal Device Without Mcc 324 | – | – | – | $236,675 | $31,689$30,236–$41,303 · 17 plans | |
| Ms-Drg 325 325 | – | – | – | $111,185 | $32,726$31,109–$42,280 · 20 plans | |
| Stomach, Esophageal and Duodenal Procedures Without Cc/Mcc 328 | – | – | – | $56,798 | $16,163$7,584–$20,222 · 20 plans | |
| Ms-Drg 332 332 | – | – | – | $38,379 | $35,966$7,584–$45,366 · 20 plans | |
| Ms-Drg 333 333 | – | – | – | $65,424 | $23,520$7,584–$29,179 · 20 plans | |
| Ms-Drg 334 334 | – | – | – | $46,783 | $16,663$7,584–$20,700 · 20 plans | |
| Peritoneal Adhesiolysis with Mcc 335 | – | – | – | $91,232 | $35,146$7,515–$45,202 · 19 plans | |
| Peritoneal Adhesiolysis Without Cc/Mcc 337 | – | – | – | $54,273 | $15,662$7,584–$19,411 · 20 plans | |
| Ms-Drg 344 344 | – | – | – | $114,636 | $25,618$7,515–$33,054 · 19 plans | |
| Ms-Drg 345 345 | – | – | – | $57,013 | $15,367$7,584–$19,017 · 20 plans | |
| Ms-Drg 346 346 | – | – | – | $56,056 | $12,382$7,654–$17,687 · 21 plans | |
| Anal and Stomal Procedures with Mcc 347 | – | – | – | $21,735 | $22,848$7,584–$28,827 · 20 plans | |
| Ms-Drg 348 348 | – | – | – | $38,791 | $13,587$7,654–$17,880 · 21 plans | |
| Ms-Drg 349 349 | – | – | – | $31,942 | $9,194$7,584–$11,288 · 20 plans | |
| Inguinal and Femoral Hernia Procedures with Mcc 350 | – | – | – | $67,566 | $24,977$7,584–$31,267 · 20 plans | |
| Inguinal and Femoral Hernia Procedures with Cc 351 | – | – | – | $48,057 | $15,560$7,584–$19,253 · 20 plans | |
| Inguinal and Femoral Hernia Procedures Without Cc/Mcc 352 | – | – | – | $35,591 | $11,973$7,584–$14,820 · 20 plans | |
| Hernia Procedures Except Inguinal and Femoral with Mcc 353 | – | – | – | $85,093 | $28,969$7,584–$43,764 · 20 plans | |
| Hernia Procedures Except Inguinal and Femoral with Cc 354 | – | – | – | $67,578 | $16,935$7,515–$21,566 · 19 plans | |
| Hernia Procedures Except Inguinal and Femoral Without Cc/Mcc 355 | – | – | – | $58,886 | $13,682$7,654–$18,935 · 21 plans | |
| Other Digestive System O.r. Procedures with Cc 357 | – | – | – | $76,056 | $23,137$7,515–$29,321 · 19 plans | |
| Ms-Drg 358 358 | – | – | – | $45,153 | $14,192$7,654–$19,246 · 21 plans | |
| Ms-Drg 359 359 | – | – | – | $250,016 | $34,193$32,820–$42,046 · 16 plans | |
| Ms-Drg 360 360 | – | – | – | $186,833 | $24,222$23,249–$29,723 · 16 plans | |
| Major Esophageal Disorders with Mcc 368 | – | – | – | $63,535 | $16,216$7,584–$20,218 · 20 plans | |
| Major Esophageal Disorders with Cc 369 | – | – | – | $47,339 | $10,456$7,584–$12,885 · 20 plans | |
| Ms-Drg 370 370 | – | – | – | $27,866 | $7,612$7,114–$9,914 · 21 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections Without Cc/Mcc 373 | – | – | – | $26,811 | $7,873$7,358–$10,303 · 21 plans | |
| Ms-Drg 376 376 | – | – | – | $56,107 | $9,625$7,515–$11,946 · 19 plans | |
| Gastrointestinal Hemorrhage Without Cc/Mcc 379 | – | – | – | $15,047 | $6,939$6,670–$8,340 · 20 plans | |
| Complicated Peptic Ulcer with Mcc 380 | – | – | – | $64,363 | $19,820$7,584–$24,649 · 20 plans | |
| Complicated Peptic Ulcer with Cc 381 | – | – | – | $40,213 | $11,373$7,654–$15,468 · 21 plans | |
| Ms-Drg 382 382 | – | – | – | $27,897 | $8,593$7,654–$10,642 · 21 plans | |
| Ms-Drg 383 383 | – | – | – | $14,280 | $14,026$7,584–$17,355 · 20 plans | |
| Uncomplicated Peptic Ulcer Without Mcc 384 | – | – | – | $39,085 | $8,955$7,654–$12,351 · 21 plans | |
| Inflammatory Bowel Disease with Mcc 385 | – | – | – | $41,724 | $16,122$7,584–$20,050 · 20 plans | |
| Ms-Drg 387 387 | – | – | – | $34,313 | $7,420$6,958–$9,520 · 21 plans | |
| Other Digestive System Diagnoses Without Cc/Mcc 395 | – | – | – | $26,200 | $7,103$6,846–$8,541 · 20 plans | |
| Ms-Drg 397 397 | – | – | – | $47,988 | $24,033$7,584–$30,268 · 20 plans | |
| Appendix Procedures with Cc 398 | – | – | – | $60,512 | $15,453$7,584–$19,148 · 20 plans | |
| Appendix Procedures Without Cc/Mcc 399 | – | – | – | $46,015 | $11,750$7,584–$14,600 · 20 plans | |
| Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical 402 | – | – | – | $145,270 | $40,234$38,389–$51,654 · 17 plans | |
| Pancreas, Liver and Shunt Procedures with Mcc 405 | – | – | – | $249,076 | $54,483$51,984–$70,736 · 17 plans | |
| Pancreas, Liver and Shunt Procedures with Cc 406 | – | – | – | $117,770 | $28,952$7,584–$42,037 · 20 plans | |
| Pancreas, Liver and Shunt Procedures Without Cc/Mcc 407 | – | – | – | $91,985 | $22,116$7,515–$27,971 · 19 plans | |
| Ms-Drg 408 408 | – | – | – | $127,216 | $35,095$7,515–$44,805 · 19 plans | |
| Ms-Drg 409 409 | – | – | – | $75,433 | $21,708$7,515–$27,453 · 19 plans | |
| Cholecystectomy with C.d.e. with Mcc 411 | – | – | – | $86,199 | $32,566$7,515–$40,418 · 19 plans | |
| Ms-Drg 413 413 | – | – | – | $58,041 | $17,043$7,654–$23,612 · 21 plans | |
| Ms-Drg 414 414 | – | – | – | $144,820 | $35,066$7,515–$44,783 · 19 plans | |
| Cholecystectomy Except by Laparoscope Without C.d.e. with Cc 415 | – | – | – | $116,549 | $20,641$7,515–$26,052 · 19 plans | |
| Ms-Drg 416 416 | – | – | – | $106,378 | $13,990$7,584–$20,478 · 20 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. with Mcc 417 | – | – | – | $63,794 | $23,950$7,584–$30,029 · 20 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 419 | – | – | – | $57,297 | $14,147$7,654–$18,714 · 21 plans | |
| Hepatobiliary Diagnostic Procedures with Mcc 420 | – | – | – | $78,386 | $34,206$7,654–$50,129 · 21 plans | |
| Ms-Drg 421 421 | – | – | – | $67,772 | $17,633$7,584–$21,749 · 20 plans | |
| Other Hepatobiliary or Pancreas O.r. Procedures with Mcc 423 | – | – | – | $146,667 | $41,536$39,631–$53,492 · 17 plans | |
| Ms-Drg 424 424 | – | – | – | $79,248 | $21,810$7,515–$28,085 · 19 plans | |
| Ms-Drg 425 425 | – | – | – | $119,769 | $15,324$7,584–$23,020 · 20 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Mcc or 426 | – | – | – | $391,597 | $109,028$104,029–$139,473 · 17 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Cc 427 | – | – | – | $218,211 | $71,661$68,375–$92,864 · 17 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical Without Cc/ 428 | – | – | – | $206,504 | $55,971$53,405–$72,257 · 17 plans | |
| Ms-Drg 429 429 | – | – | – | $503,405 | $88,426$84,877–$109,067 · 16 plans | |
| Combined Anterior and Posterior Cervical Spinal Fusion Without Mcc 430 | – | – | – | $274,313 | $57,397$54,765–$73,114 · 17 plans | |
| Ms-Drg 434 434 | – | – | – | $31,448 | $7,691$7,195–$9,314 · 20 plans | |
| Malignancy of Hepatobiliary System or Pancreas with Cc 436 | – | – | – | $45,749 | $11,730$7,584–$14,459 · 20 plans | |
| Ms-Drg 437 437 | – | – | – | $25,660 | $9,025$7,584–$10,964 · 20 plans | |
| Disorders of Pancreas Except Malignancy Without Cc/Mcc 440 | – | – | – | $21,167 | $6,958$6,607–$8,736 · 21 plans | |
| Ms-Drg 443 443 | – | – | – | $28,439 | $7,601$7,104–$9,980 · 21 plans | |
| Disorders of the Biliary Tract Without Cc/Mcc 446 | – | – | – | $24,189 | $8,772$7,584–$10,700 · 20 plans | |
| Ms-Drg 447 447 | – | – | – | $274,902 | $66,384$63,340–$86,727 · 17 plans | |
| Multiple Level Spinal Fusion Except Cervical Without Mcc 448 | – | – | – | $151,628 | $42,399$40,454–$54,217 · 17 plans | |
| Ms-Drg 450 450 | – | – | – | $214,400 | $52,602$50,490–$64,795 · 16 plans | |
| Single Level Spinal Fusion Except Cervical Without Mcc 451 | – | – | – | $144,079 | $32,166$30,875–$39,541 · 16 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 456 | – | – | – | $273,727 | $81,746$75,971–$101,774 · 17 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 457 | – | – | – | $257,057 | $58,214$50,797–$72,416 · 17 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 458 | – | – | – | $81,668 | $41,338$7,584–$55,672 · 20 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 463 | – | – | – | $116,509 | $55,672$7,515–$70,738 · 19 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 465 | – | – | – | $79,918 | $18,472$7,584–$23,540 · 20 plans | |
| Revision of Hip or Knee Replacement with Mcc 466 | – | – | – | $132,570 | $51,877$49,837–$65,112 · 19 plans | |
| Revision of Hip or Knee Replacement with Cc 467 | – | – | – | $132,096 | $35,380$33,989–$56,956 · 19 plans | |
| Revision of Hip or Knee Replacement Without Cc/Mcc 468 | – | – | – | $101,563 | $27,729$7,654–$56,956 · 21 plans | |
| Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with Mcc or Tota 469 | – | – | – | $106,958 | $30,532$7,654–$44,691 · 21 plans | |
| Cervical Spinal Fusion with Mcc 471 | – | – | – | $203,901 | $48,176$45,967–$62,857 · 17 plans | |
| Cervical Spinal Fusion Without Cc/Mcc 473 | – | – | – | $68,526 | $24,253$7,584–$30,405 · 20 plans | |
| Amputation for Musculoskeletal System and Connective Tissue Disorders with Mcc 474 | – | – | – | $105,512 | $42,510$7,584–$63,961 · 20 plans | |
| Amputation for Musculoskeletal System and Connective Tissue Disorders with Cc 475 | – | – | – | $81,094 | $22,872$7,584–$32,522 · 20 plans | |
| Ms-Drg 476 476 | – | – | – | $34,713 | $12,093$7,584–$15,041 · 20 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue with Mcc 477 | – | – | – | $135,114 | $34,673$33,083–$44,880 · 17 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue with Cc 478 | – | – | – | $81,278 | $24,426$7,515–$30,854 · 19 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue Without Cc/Mcc 479 | – | – | – | $77,776 | $18,637$7,515–$23,477 · 19 plans | |
| Knee Procedures with Principal Diagnosis of Infection with Mcc 485 | – | – | – | $112,902 | $31,831$7,515–$40,746 · 19 plans | |
| Knee Procedures with Principal Diagnosis of Infection with Cc 486 | – | – | – | $65,418 | $21,075$7,584–$26,368 · 20 plans | |
| Knee Procedures with Principal Diagnosis of Infection Without Cc/Mcc 487 | – | – | – | $30,903 | $15,965$7,584–$19,812 · 20 plans | |
| Knee Procedures Without Principal Diagnosis of Infection with Cc/Mcc 488 | – | – | – | $171,506 | $18,108$17,277–$24,341 · 17 plans | |
| Knee Procedures Without Principal Diagnosis of Infection Without Cc/Mcc 489 | – | – | – | $34,336 | $11,591$7,584–$14,461 · 20 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Mcc 492 | – | – | – | $162,470 | $36,805$35,117–$47,084 · 17 plans | |
| Ms-Drg 495 495 | – | – | – | $129,729 | $36,354$34,687–$46,579 · 17 plans | |
| Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with Cc 496 | – | – | – | $122,779 | $18,107$7,515–$23,508 · 19 plans | |
| Local Excision and Removal of Internal Fixation Devices Except Hip and Femur Without Cc/ 497 | – | – | – | $59,148 | $12,481$7,584–$15,600 · 20 plans | |
| Ms-Drg 498 498 | – | – | – | $105,090 | $29,803$7,515–$36,971 · 19 plans | |
| Soft Tissue Procedures with Mcc 500 | – | – | – | $181,353 | $31,230$7,515–$40,002 · 19 plans | |
| Soft Tissue Procedures with Cc 501 | – | – | – | $72,697 | $17,569$7,515–$22,436 · 19 plans | |
| Soft Tissue Procedures Without Cc/Mcc 502 | – | – | – | $45,297 | $13,821$7,584–$17,167 · 20 plans | |
| Ms-Drg 503 503 | – | – | – | $113,013 | $27,627$7,515–$34,923 · 19 plans | |
| Foot Procedures with Cc 504 | – | – | – | $71,000 | $18,737$7,515–$23,517 · 19 plans | |
| Ms-Drg 506 506 | – | – | – | $33,340 | $13,853$7,584–$17,348 · 20 plans | |
| Ms-Drg 507 507 | – | – | – | $48,187 | $18,304$7,584–$22,928 · 20 plans | |
| Ms-Drg 508 508 | – | – | – | $118,515 | $15,315$7,515–$18,897 · 19 plans | |
| Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Cc 511 | – | – | – | $78,275 | $20,764$7,515–$26,126 · 19 plans | |
| Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc 512 | – | – | – | $62,393 | $16,834$7,584–$20,817 · 20 plans | |
| Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with Cc/Mcc 513 | – | – | – | $162,902 | $16,044$7,584–$22,667 · 20 plans | |
| Ms-Drg 514 514 | – | – | – | $52,396 | $10,771$7,654–$14,481 · 21 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures with Mcc 515 | – | – | – | $129,391 | $31,443$7,515–$39,998 · 19 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures Without Cc/Mcc 517 | – | – | – | $56,643 | $15,678$7,584–$19,369 · 20 plans | |
| Back and Neck Procedures Except Spinal Fusion with Mcc or Disc Device or Neurostimulator 518 | – | – | – | $79,081 | $36,751$7,654–$46,380 · 21 plans | |
| Back and Neck Procedures Except Spinal Fusion with Cc 519 | – | – | – | $65,185 | $20,381$7,654–$28,007 · 21 plans | |
| Back and Neck Procedures Except Spinal Fusion Without Cc/Mcc 520 | – | – | – | $50,769 | $15,406$7,654–$20,356 · 21 plans | |
| Ms-Drg 533 533 | – | – | – | $55,263 | $15,980$7,584–$19,750 · 20 plans | |
| Ms-Drg 534 534 | – | – | – | $13,957 | $8,647$7,654–$11,561 · 21 plans | |
| Fractures of Hip and Pelvis with Mcc 535 | – | – | – | $28,163 | $13,074$6,908–$16,380 · 20 plans | |
| Ms-Drg 537 537 | – | – | – | $53,764 | $10,009$7,584–$12,248 · 20 plans | |
| Osteomyelitis with Mcc 539 | – | – | – | $58,371 | $19,706$6,908–$24,809 · 20 plans | |
| Osteomyelitis with Cc 540 | – | – | – | $49,080 | $13,464$12,890–$16,905 · 18 plans | |
| Ms-Drg 541 541 | – | – | – | $27,645 | $8,463$7,654–$12,426 · 21 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Mcc 542 | – | – | – | $61,866 | $18,084$17,314–$23,298 · 18 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy Without Cc/M 544 | – | – | – | $29,552 | $8,065$7,543–$9,854 · 20 plans | |
| Connective Tissue Disorders with Mcc 545 | – | – | – | $95,028 | $24,878$7,584–$36,482 · 20 plans | |
| Connective Tissue Disorders with Cc 546 | – | – | – | $40,281 | $12,060$7,654–$16,443 · 21 plans | |
| Connective Tissue Disorders Without Cc/Mcc 547 | – | – | – | $44,209 | $8,943$7,654–$10,738 · 21 plans | |
| Ms-Drg 548 548 | – | – | – | $116,982 | $19,332$7,515–$24,849 · 19 plans | |
| Ms-Drg 549 549 | – | – | – | $38,215 | $12,471$7,584–$15,393 · 20 plans | |
| Ms-Drg 550 550 | – | – | – | $62,100 | $9,228$7,584–$12,920 · 20 plans | |
| Bone Diseases and Arthropathies with Mcc 553 | – | – | – | $77,133 | $13,212$7,515–$16,728 · 19 plans | |
| Bone Diseases and Arthropathies Without Mcc 554 | – | – | – | $24,584 | $8,800$7,584–$10,783 · 20 plans | |
| Signs and Symptoms of Musculoskeletal System and Connective Tissue with Mcc 555 | – | – | – | $93,046 | $13,458$7,515–$17,089 · 19 plans | |
| Signs and Symptoms of Musculoskeletal System and Connective Tissue Without Mcc 556 | – | – | – | $25,145 | $8,888$7,654–$11,597 · 21 plans | |
| Tendonitis, Myositis and Bursitis with Mcc 557 | – | – | – | $63,020 | $15,337$7,654–$22,010 · 21 plans | |
| Tendonitis, Myositis and Bursitis Without Mcc 558 | – | – | – | $24,191 | $9,414$7,584–$11,508 · 20 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue with Mcc 559 | – | – | – | $57,322 | $18,873$7,584–$23,466 · 20 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue with Cc 560 | – | – | – | $33,845 | $11,791$11,288–$14,810 · 18 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue Without Cc/Mcc 561 | – | – | – | $26,259 | $8,545$7,584–$10,476 · 20 plans | |
| Ms-Drg 566 566 | – | – | – | $15,388 | $8,013$7,018–$10,532 · 22 plans | |
| Skin Debridement with Mcc 570 | – | – | – | $64,493 | $29,350$7,584–$37,125 · 20 plans | |
| Skin Debridement with Cc 571 | – | – | – | $42,181 | $17,004$7,654–$23,780 · 21 plans | |
| Ms-Drg 572 572 | – | – | – | $127,258 | $11,878$7,584–$17,094 · 20 plans | |
| Skin Graft for Skin Ulcer or Cellulitis with Mcc 573 | – | – | – | $313,160 | $65,104$62,119–$82,682 · 17 plans | |
| Skin Graft for Skin Ulcer or Cellulitis with Cc 574 | – | – | – | $89,250 | $34,187$7,515–$43,795 · 19 plans | |
| Ms-Drg 575 575 | – | – | – | $38,350 | $18,212$7,584–$22,907 · 20 plans | |
| Ms-Drg 576 576 | – | – | – | $207,157 | $48,888$46,646–$66,436 · 17 plans | |
| Skin Graft Except for Skin Ulcer or Cellulitis with Cc 577 | – | – | – | $65,346 | $26,273$7,654–$37,820 · 21 plans | |
| Ms-Drg 578 578 | – | – | – | $44,092 | $16,511$7,654–$23,306 · 21 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures with Mcc 579 | – | – | – | $95,337 | $32,245$7,584–$48,300 · 20 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures Without Cc/Mcc 581 | – | – | – | $71,671 | $14,628$7,515–$18,519 · 19 plans | |
| Ms-Drg 582 582 | – | – | – | $27,784 | $19,474$7,584–$24,005 · 20 plans | |
| Ms-Drg 584 584 | – | – | – | $65,929 | $21,762$7,654–$29,079 · 21 plans | |
| Breast Biopsy, Local Excision and Other Breast Procedures Without Cc/Mcc 585 | – | – | – | $65,080 | $19,314$7,654–$28,194 · 21 plans | |
| Skin Ulcers with Mcc 592 | – | – | – | $21,132 | $19,559$7,584–$24,536 · 20 plans | |
| Skin Ulcers with Cc 593 | – | – | – | $16,732 | $12,267$7,584–$15,191 · 20 plans | |
| Ms-Drg 595 595 | – | – | – | $125,684 | $21,162$7,515–$26,961 · 19 plans | |
| Major Skin Disorders Without Mcc 596 | – | – | – | $18,502 | $11,350$7,654–$13,701 · 21 plans | |
| Ms-Drg 598 598 | – | – | – | $43,068 | $11,842$7,654–$15,066 · 21 plans | |
| Ms-Drg 600 600 | – | – | – | $48,556 | $10,859$7,584–$13,247 · 20 plans | |
| Ms-Drg 601 601 | – | – | – | $18,746 | $6,858$6,451–$8,515 · 21 plans | |
| Trauma to the Skin, Subcutaneous Tissue and Breast with Mcc 604 | – | – | – | $71,525 | $14,907$7,515–$18,931 · 19 plans | |
| Minor Skin Disorders with Mcc 606 | – | – | – | $23,207 | $15,304$7,584–$19,281 · 20 plans | |
| Minor Skin Disorders Without Mcc 607 | – | – | – | $31,067 | $9,632$7,654–$11,582 · 21 plans | |
| Adrenal and Pituitary Procedures with Cc/Mcc 614 | – | – | – | $56,314 | $22,264$7,654–$32,368 · 21 plans | |
| Adrenal and Pituitary Procedures Without Cc/Mcc 615 | – | – | – | $52,747 | $14,341$7,584–$17,796 · 20 plans | |
| Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Mcc 616 | – | – | – | $123,459 | $34,341$7,515–$45,085 · 19 plans | |
| Ms-Drg 619 619 | – | – | – | $77,123 | $28,555$9,403–$35,749 · 23 plans | |
| O.r. Procedures for Obesity Without Cc/Mcc 621 | – | – | – | $64,411 | $15,548$9,029–$21,731 · 23 plans | |
| Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 622 | – | – | – | $93,349 | $35,033$7,515–$45,427 · 19 plans | |
| Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 623 | – | – | – | $60,840 | $18,182$7,584–$22,753 · 20 plans | |
| Ms-Drg 624 624 | – | – | – | $13,001 | $12,784$7,584–$15,739 · 20 plans | |
| Ms-Drg 625 625 | – | – | – | $80,365 | $30,119$7,584–$37,804 · 20 plans | |
| Thyroid, Parathyroid and Thyroglossal Procedures with Cc 626 | – | – | – | $60,300 | $15,171$7,584–$18,988 · 20 plans | |
| Thyroid, Parathyroid and Thyroglossal Procedures Without Cc/Mcc 627 | – | – | – | $76,566 | $13,650$7,584–$18,340 · 20 plans | |
| Other Endocrine, Nutritional and Metabolic O.r. Procedures with Mcc 628 | – | – | – | $131,081 | $36,650$7,515–$47,618 · 19 plans | |
| Other Endocrine, Nutritional and Metabolic O.r. Procedures with Cc 629 | – | – | – | $89,324 | $21,722$7,515–$27,901 · 19 plans | |
| Ms-Drg 630 630 | – | – | – | $78,991 | $14,786$7,515–$18,570 · 19 plans | |
| Diabetes Without Cc/Mcc 639 | – | – | – | $29,313 | $6,958$6,605–$8,900 · 21 plans | |
| Inborn and Other Disorders of Metabolism 642 | – | – | – | $32,812 | $14,563$7,584–$17,786 · 20 plans | |
| Endocrine Disorders Without Cc/Mcc 645 | – | – | – | $28,559 | $8,198$7,584–$10,035 · 20 plans | |
| Kidney Transplant with Hemodialysis Without Mcc 651 | – | – | – | $360,646 | $37,141$35,680–$96,680 · 19 plans | |
| Major Bladder Procedures with Mcc 653 | – | – | – | $289,489 | $51,789$49,414–$69,586 · 17 plans | |
| Major Bladder Procedures with Cc 654 | – | – | – | $118,587 | $27,706$7,515–$35,500 · 19 plans | |
| Major Bladder Procedures Without Cc/Mcc 655 | – | – | – | $113,388 | $21,122$7,515–$26,814 · 19 plans | |
| Kidney and Ureter Procedures for Neoplasm with Mcc 656 | – | – | – | $178,705 | $32,012$30,544–$41,897 · 17 plans | |
| Kidney and Ureter Procedures for Neoplasm Without Cc/Mcc 658 | – | – | – | $85,173 | $15,676$7,515–$19,750 · 19 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm Without Cc/Mcc 661 | – | – | – | $37,254 | $10,900$7,654–$14,581 · 21 plans | |
| Ms-Drg 662 662 | – | – | – | $41,435 | $30,810$7,654–$37,993 · 21 plans | |
| Minor Bladder Procedures with Cc 663 | – | – | – | $115,255 | $15,518$7,584–$22,828 · 20 plans | |
| Ms-Drg 664 664 | – | – | – | $64,193 | $10,807$7,515–$13,685 · 19 plans | |
| Prostatectomy with Mcc 665 | – | – | – | $230,557 | $31,397$29,957–$42,443 · 17 plans | |
| Ms-Drg 666 666 | – | – | – | $35,201 | $17,580$7,584–$21,890 · 20 plans | |
| Transurethral Procedures with Mcc 668 | – | – | – | $51,675 | $29,145$7,584–$36,755 · 20 plans | |
| Transurethral Procedures with Cc 669 | – | – | – | $58,196 | $15,827$7,584–$19,612 · 20 plans | |
| Ms-Drg 670 670 | – | – | – | $55,365 | $10,329$7,654–$13,574 · 21 plans | |
| Ms-Drg 671 671 | – | – | – | $29,530 | $18,021$7,654–$22,273 · 21 plans | |
| Other Kidney and Urinary Tract Procedures with Cc 674 | – | – | – | $82,947 | $23,263$7,515–$29,607 · 19 plans | |
| Ms-Drg 675 675 | – | – | – | $54,069 | $16,698$7,584–$20,605 · 20 plans | |
| Renal Failure Without Cc/Mcc 684 | – | – | – | $27,342 | $6,717$6,385–$7,973 · 20 plans | |
| Kidney and Urinary Tract Neoplasms with Mcc 686 | – | – | – | $100,842 | $18,105$7,515–$23,258 · 19 plans | |
| Kidney and Urinary Tract Neoplasms with Cc 687 | – | – | – | $46,678 | $10,919$7,584–$13,450 · 20 plans | |
| Ms-Drg 688 688 | – | – | – | $11,299 | $8,412$7,584–$10,196 · 20 plans | |
| Ms-Drg 693 693 | – | – | – | $46,701 | $13,807$7,584–$17,256 · 20 plans | |
| Urinary Stones Without Mcc 694 | – | – | – | $28,561 | $13,457$7,584–$16,824 · 20 plans | |
| Kidney and Urinary Tract Signs and Symptoms Without Mcc 696 | – | – | – | $22,924 | $7,496$7,006–$9,826 · 21 plans | |
| Ms-Drg 697 697 | – | – | – | $42,129 | $11,317$7,654–$13,817 · 21 plans | |
| Other Kidney and Urinary Tract Diagnoses Without Cc/Mcc 700 | – | – | – | $23,809 | $7,505$7,014–$9,860 · 21 plans | |
| Major Male Pelvic Procedures with Cc/Mcc 707 | – | – | – | $79,378 | $20,001$7,515–$25,306 · 19 plans | |
| Major Male Pelvic Procedures Without Cc/Mcc 708 | – | – | – | $68,949 | $15,506$7,515–$19,519 · 19 plans | |
| Ms-Drg 709 709 | – | – | – | $42,412 | $23,373$7,584–$29,183 · 20 plans | |
| Ms-Drg 710 710 | – | – | – | $46,657 | $14,224$7,654–$18,216 · 21 plans | |
| Ms-Drg 711 711 | – | – | – | $116,669 | $20,806$7,515–$26,016 · 19 plans | |
| Ms-Drg 712 712 | – | – | – | $48,868 | $11,532$7,654–$13,908 · 21 plans | |
| Transurethral Prostatectomy with Cc/Mcc 713 | – | – | – | $38,003 | $15,354$7,584–$18,942 · 20 plans | |
| Transurethral Prostatectomy Without Cc/Mcc 714 | – | – | – | $32,804 | $10,908$7,584–$13,399 · 20 plans | |
| Ms-Drg 715 715 | – | – | – | $133,199 | $22,286$7,515–$28,490 · 19 plans | |
| Other Male Reproductive System O.r. Procedures Except Malignancy with Cc/Mcc 717 | – | – | – | $82,605 | $18,942$7,515–$24,008 · 19 plans | |
| Ms-Drg 718 718 | – | – | – | $50,197 | $13,924$7,654–$17,497 · 21 plans | |
| Malignancy, Male Reproductive System with Mcc 722 | – | – | – | $52,710 | $18,336$7,584–$22,668 · 20 plans | |
| Ms-Drg 723 723 | – | – | – | $40,486 | $11,843$7,584–$14,577 · 20 plans | |
| Ms-Drg 724 724 | – | – | – | $47,719 | $7,169$6,909–$8,929 · 20 plans | |
| Ms-Drg 725 725 | – | – | – | $30,094 | $12,225$7,654–$17,933 · 21 plans | |
| Benign Prostatic Hypertrophy Without Mcc 726 | – | – | – | $26,611 | $7,747$7,274–$9,485 · 20 plans | |
| Ms-Drg 727 727 | – | – | – | $39,510 | $15,155$7,584–$18,753 · 20 plans | |
| Inflammation of the Male Reproductive System Without Mcc 728 | – | – | – | $29,227 | $8,616$7,584–$10,554 · 20 plans | |
| Ms-Drg 730 730 | – | – | – | $11,965 | $7,329$6,958–$8,884 · 21 plans | |
| Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy with Cc/Mcc 734 | – | – | – | $68,404 | $21,454$7,584–$26,777 · 20 plans | |
| Ms-Drg 735 735 | – | – | – | $65,367 | $13,687$7,515–$16,940 · 19 plans | |
| Ms-Drg 736 736 | – | – | – | $98,776 | $35,181$7,515–$46,130 · 19 plans | |
| Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with Cc 737 | – | – | – | $89,328 | $20,582$7,515–$26,051 · 19 plans | |
| Ms-Drg 738 738 | – | – | – | $77,978 | $20,582$7,515–$26,051 · 19 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Mcc 739 | – | – | – | $228,656 | $35,933$34,285–$48,884 · 17 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Cc 740 | – | – | – | $73,368 | $18,162$6,475–$22,786 · 20 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy Without Cc/Mcc 741 | – | – | – | $67,531 | $14,602$7,584–$20,658 · 20 plans | |
| Uterine and Adnexa Procedures for Non-Malignancy with Cc/Mcc 742 | – | – | – | $60,275 | $18,405$6,958–$22,770 · 21 plans | |
| D&c, Conization, Laparoscopy and Tubal Interruption with Cc/Mcc 744 | – | – | – | $42,188 | $20,471$6,958–$25,429 · 21 plans | |
| Ms-Drg 745 745 | – | – | – | $36,291 | $11,681$7,654–$14,555 · 21 plans | |
| Vagina, Cervix and Vulva Procedures with Cc/Mcc 746 | – | – | – | $31,280 | $17,463$6,958–$21,576 · 21 plans | |
| Vagina, Cervix and Vulva Procedures Without Cc/Mcc 747 | – | – | – | $28,513 | $9,002$6,958–$11,021 · 21 plans | |
| Female Reproductive System Reconstructive Procedures 748 | – | – | – | $31,617 | $14,090$6,958–$17,368 · 21 plans | |
| Ms-Drg 749 749 | – | – | – | $113,680 | $25,471$6,475–$32,087 · 20 plans | |
| Ms-Drg 750 750 | – | – | – | $28,864 | $14,943$7,654–$18,432 · 21 plans | |
| Malignancy, Female Reproductive System with Mcc 754 | – | – | – | $50,348 | $18,472$6,958–$22,856 · 21 plans | |
| Malignancy, Female Reproductive System with Cc 755 | – | – | – | $50,712 | $11,202$6,958–$13,765 · 21 plans | |
| Ms-Drg 756 756 | – | – | – | $19,682 | $9,974$6,958–$12,233 · 21 plans | |
| Ms-Drg 757 757 | – | – | – | $30,833 | $14,520$6,958–$17,904 · 21 plans | |
| Ms-Drg 758 758 | – | – | – | $25,603 | $10,346$7,654–$14,477 · 21 plans | |
| Ms-Drg 759 759 | – | – | – | $23,179 | $7,246$6,791–$9,069 · 22 plans | |
| Ms-Drg 760 760 | – | – | – | $45,783 | $10,626$7,654–$13,998 · 21 plans | |
| Ms-Drg 761 761 | – | – | – | $10,815 | $6,509$6,123–$9,003 · 21 plans | |
| Ms-Drg 768 768 | – | – | – | $37,509 | $11,256$10,812–$13,728 · 19 plans | |
| Ms-Drg 769 769 | – | – | – | $72,939 | $17,007$7,515–$21,007 · 19 plans | |
| Ms-Drg 770 770 | – | – | – | $32,426 | $10,480$7,584–$12,995 · 20 plans | |
| Ms-Drg 776 776 | – | – | – | $15,834 | $7,159$6,923–$8,554 · 21 plans | |
| Ms-Drg 779 779 | – | – | – | $24,087 | $8,825$7,654–$10,799 · 21 plans | |
| Ms-Drg 783 783 | – | – | – | $55,721 | $24,619$7,584–$30,239 · 20 plans | |
| Ms-Drg 784 784 | – | – | – | $44,250 | $11,039$7,584–$13,626 · 20 plans | |
| Ms-Drg 785 785 | – | – | – | $43,390 | $9,948$6,966–$12,201 · 20 plans | |
| C-section, with major complications 786 | – | – | – | $57,581 | $16,935$16,268–$23,950 · 19 plans | |
| C-section, with complications 787 | – | – | – | $49,656 | $11,700$11,239–$15,822 · 19 plans | |
| C-section 788 | – | – | – | $46,017 | $10,147$9,747–$13,369 · 19 plans | |
| Ms-Drg 789 789 | – | – | – | $50,388 | $18,091$5,106–$25,602 · 21 plans | |
| Ms-Drg 790 790 | – | – | – | $353,532 | $59,131$56,419–$77,082 · 17 plans | |
| Ms-Drg 791 791 | – | – | – | $126,231 | $40,233$5,060–$58,415 · 20 plans | |
| Ms-Drg 792 792 | – | – | – | $21,765 | $24,793$20,824–$31,274 · 19 plans | |
| Ms-Drg 793 793 | – | – | – | $23,214 | $41,699$36,048–$53,242 · 19 plans | |
| Ms-Drg 794 794 | – | – | – | $13,817 | $15,229$12,205–$18,940 · 19 plans | |
| Newborn care (healthy baby) 795 | – | – | – | $11,480 | $2,689$2,506–$3,082 · 19 plans | |
| Ms-Drg 796 796 | – | – | – | $48,304 | $12,193$11,713–$15,254 · 19 plans | |
| Ms-Drg 797 797 | – | – | – | $43,109 | $10,556$10,140–$14,200 · 19 plans | |
| Ms-Drg 798 798 | – | – | – | $43,132 | $10,131$9,731–$13,876 · 19 plans | |
| Ms-Drg 799 799 | – | – | – | $110,450 | $44,807$7,584–$56,399 · 20 plans | |
| Ms-Drg 800 800 | – | – | – | $171,364 | $28,333$27,033–$37,239 · 17 plans | |
| Ms-Drg 801 801 | – | – | – | $106,017 | $19,302$7,584–$24,974 · 20 plans | |
| Ms-Drg 802 802 | – | – | – | $86,282 | $39,503$7,584–$49,590 · 20 plans | |
| Ms-Drg 803 803 | – | – | – | $36,584 | $18,815$7,584–$23,290 · 20 plans | |
| Ms-Drg 804 804 | – | – | – | $59,388 | $13,919$7,584–$18,096 · 20 plans | |
| Vaginal birth, with major complications 805 | – | – | – | $34,581 | $11,330$10,884–$14,431 · 19 plans | |
| Vaginal birth, with complications 806 | – | – | – | $30,912 | $8,135$7,814–$10,312 · 19 plans | |
| Vaginal birth 807 | – | – | – | $27,545 | $7,351$7,061–$9,071 · 19 plans | |
| Ms-Drg 810 810 | – | – | – | $20,681 | $10,804$7,119–$13,269 · 21 plans | |
| Reticuloendothelial and Immunity Disorders with Mcc 814 | – | – | – | $60,743 | $21,422$7,584–$26,722 · 20 plans | |
| Reticuloendothelial and Immunity Disorders with Cc 815 | – | – | – | $43,303 | $10,490$7,028–$14,276 · 22 plans | |
| Ms-Drg 816 816 | – | – | – | $26,505 | $6,958$6,707–$9,365 · 21 plans | |
| Ms-Drg 817 817 | – | – | – | $62,299 | $22,713$7,584–$28,419 · 20 plans | |
| Ms-Drg 818 818 | – | – | – | $53,911 | $11,890$7,654–$14,624 · 21 plans | |
| Ms-Drg 819 819 | – | – | – | $32,454 | $9,090$7,584–$11,023 · 20 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures with Mcc 820 | – | – | – | $276,782 | $57,266$7,515–$73,526 · 19 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures with Cc 821 | – | – | – | $112,070 | $22,511$7,584–$32,765 · 20 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures Without Cc/Mcc 822 | – | – | – | $93,885 | $12,439$7,584–$17,236 · 20 plans | |
| Lymphoma and Non-Acute Leukemia with Other Procedures with Mcc 823 | – | – | – | $268,807 | $45,779$43,680–$60,086 · 17 plans | |
| Lymphoma and Non-Acute Leukemia with Other Procedures with Cc 824 | – | – | – | $113,338 | $22,559$7,515–$28,595 · 19 plans | |
| Ms-Drg 825 825 | – | – | – | $57,605 | $13,986$7,654–$17,481 · 21 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 826 | – | – | – | $164,547 | $46,693$44,552–$61,303 · 17 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 827 | – | – | – | $93,767 | $22,999$7,515–$29,490 · 19 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 828 | – | – | – | $58,835 | $17,468$7,654–$22,766 · 21 plans | |
| Ms-Drg 830 830 | – | – | – | $99,043 | $15,370$7,584–$21,965 · 20 plans | |
| Ms-Drg 831 831 | – | – | – | $33,064 | $12,542$7,654–$16,348 · 21 plans | |
| Ms-Drg 832 832 | – | – | – | $20,747 | $7,816$7,305–$10,615 · 21 plans | |
| Ms-Drg 833 833 | – | – | – | $14,995 | $6,028$5,670–$8,203 · 21 plans | |
| Acute Leukemia with Mcc 834 | – | – | – | $296,592 | $54,673$52,166–$71,436 · 17 plans | |
| Acute Leukemia with Cc 835 | – | – | – | $102,147 | $20,825$7,515–$26,684 · 19 plans | |
| Ms-Drg 836 836 | – | – | – | $102,212 | $12,472$7,515–$15,808 · 19 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis or with High Dose Chemotherapy a 837 | – | – | – | $112,278 | $47,040$7,515–$61,004 · 19 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis with Cc or High Dose Chemotherap 838 | – | – | – | $49,772 | $21,039$7,584–$26,195 · 20 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis Without Cc/Mcc 839 | – | – | – | $23,187 | $14,775$7,584–$18,190 · 20 plans | |
| Lymphoma and Non-Acute Leukemia with Cc 841 | – | – | – | $76,280 | $16,444$7,515–$20,698 · 19 plans | |
| Lymphoma and Non-Acute Leukemia Without Cc/Mcc 842 | – | – | – | $92,891 | $10,455$7,515–$13,255 · 19 plans | |
| Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with Mc 843 | – | – | – | $127,802 | $19,948$7,515–$25,119 · 19 plans | |
| Ms-Drg 844 844 | – | – | – | $90,272 | $12,570$7,584–$17,575 · 20 plans | |
| Ms-Drg 845 845 | – | – | – | $23,392 | $9,009$7,584–$11,019 · 20 plans | |
| Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Mcc 846 | – | – | – | $46,892 | $25,956$7,584–$32,583 · 20 plans | |
| Ms-Drg 848 848 | – | – | – | $40,804 | $8,987$7,584–$10,970 · 20 plans | |
| Radiotherapy 849 | – | – | – | $56,424 | $27,095$7,584–$34,056 · 20 plans | |
| Ms-Drg 850 850 | – | – | – | $405,774 | $85,018$81,605–$104,855 · 16 plans | |
| Ms-Drg 855 855 | – | – | – | $31,079 | $15,149$7,654–$23,088 · 21 plans | |
| Postoperative or Post-Traumatic Infections with O.r. Procedures with Cc 857 | – | – | – | $64,478 | $21,769$7,654–$30,947 · 21 plans | |
| Ms-Drg 858 858 | – | – | – | $40,132 | $14,413$7,654–$18,299 · 21 plans | |
| Postoperative and Post-Traumatic Infections Without Mcc 863 | – | – | – | $25,825 | $10,532$7,654–$14,201 · 21 plans | |
| Fever and Inflammatory Conditions 864 | – | – | – | $22,687 | $9,360$7,584–$11,497 · 20 plans | |
| Viral Illness with Mcc 865 | – | – | – | $34,864 | $15,449$7,654–$20,601 · 21 plans | |
| Viral Illness Without Mcc 866 | – | – | – | $18,382 | $9,271$7,654–$11,140 · 21 plans | |
| Other Infectious and Parasitic Diseases Diagnoses with Mcc 867 | – | – | – | $66,889 | $21,096$7,584–$26,424 · 20 plans | |
| Other Infectious and Parasitic Diseases Diagnoses with Cc 868 | – | – | – | $42,309 | $10,858$7,654–$14,914 · 21 plans | |
| Ms-Drg 869 869 | – | – | – | $44,378 | $7,896$7,379–$10,220 · 21 plans | |
| O.r. Procedures with Principal Diagnosis of Mental Illness 876 | – | – | – | $83,682 | $37,981$6,958–$47,963 · 21 plans | |
| Depressive Neuroses 881 | – | – | – | $33,045 | $1,770$788–$11,997 · 21 plans | |
| Neuroses Except Depressive 882 | – | – | – | $28,335 | $1,770$758–$13,596 · 21 plans | |
| Disorders of Personality and Impulse Control 883 | – | – | – | $27,494 | $19,673$6,958–$24,402 · 21 plans | |
| Ms-Drg 887 887 | – | – | – | $17,090 | $11,039$6,958–$13,561 · 21 plans | |
| Ms-Drg 901 901 | – | – | – | $152,619 | $41,964$40,040–$55,869 · 17 plans | |
| Wound Debridements for Injuries with Cc 902 | – | – | – | $70,057 | $19,173$7,515–$24,358 · 19 plans | |
| Ms-Drg 903 903 | – | – | – | $40,645 | $12,105$7,584–$15,005 · 20 plans | |
| Skin Grafts for Injuries with Cc/Mcc 904 | – | – | – | $97,615 | $36,476$7,584–$56,352 · 20 plans | |
| Ms-Drg 905 905 | – | – | – | $96,531 | $15,159$7,584–$24,292 · 20 plans | |
| Ms-Drg 906 906 | – | – | – | $108,182 | $19,654$7,515–$25,647 · 19 plans | |
| Other O.r. Procedures for Injuries Without Cc/Mcc 909 | – | – | – | $64,505 | $13,370$7,515–$16,779 · 19 plans | |
| Traumatic Injury with Mcc 913 | – | – | – | $46,481 | $16,474$7,515–$20,343 · 19 plans | |
| Traumatic Injury Without Mcc 914 | – | – | – | $32,554 | $9,251$7,515–$11,331 · 19 plans | |
| Ms-Drg 915 915 | – | – | – | $30,307 | $17,089$7,584–$21,286 · 20 plans | |
| Allergic Reactions Without Mcc 916 | – | – | – | $19,604 | $7,273$6,958–$9,432 · 21 plans | |
| Complications of Treatment Without Cc/Mcc 921 | – | – | – | $31,903 | $7,490$7,000–$9,767 · 21 plans | |
| Other Injury, Poisoning and Toxic Effect Diagnoses with Mcc 922 | – | – | – | $62,097 | $17,916$7,654–$23,994 · 21 plans | |
| Other Injury, Poisoning and Toxic Effect Diagnoses Without Mcc 923 | – | – | – | $22,079 | $10,526$7,654–$14,486 · 21 plans | |
| Full Thickness Burn with Skin Graft or Inhalation Injury with Cc/Mcc 928 | – | – | – | $40,323 | $69,879$7,515–$87,377 · 19 plans | |
| Ms-Drg 929 929 | – | – | – | $29,945 | $31,770$7,584–$40,000 · 20 plans | |
| Ms-Drg 933 933 | – | – | – | $24,636 | $38,264$6,857–$47,527 · 19 plans | |
| Full Thickness Burn Without Skin Graft or Inhalation Injury 934 | – | – | – | $23,483 | $22,029$7,515–$27,272 · 19 plans | |
| Non-Extensive Burns 935 | – | – | – | $24,248 | $20,773$7,584–$25,856 · 20 plans | |
| Ms-Drg 939 939 | – | – | – | $151,467 | $36,382$34,713–$44,630 · 17 plans | |
| O.r. Procedures with Diagnoses of Other Contact with Health Services with Cc 940 | – | – | – | $128,478 | $23,247$7,584–$28,911 · 20 plans | |
| Aftercare with Cc/Mcc 949 | – | – | – | $70,487 | $12,300$7,584–$15,531 · 20 plans | |
| Aftercare Without Cc/Mcc 950 | – | – | – | $14,130 | $6,926$6,644–$8,380 · 20 plans | |
| Ms-Drg 955 955 | – | – | – | $349,239 | $66,870$65,620–$81,656 · 11 plans | |
| Other O.r. Procedures for Multiple Significant Trauma with Mcc 957 | – | – | – | $235,905 | $74,897$71,891–$92,348 · 16 plans | |
| Other O.r. Procedures for Multiple Significant Trauma with Cc 958 | – | – | – | $133,332 | $41,741$40,065–$51,373 · 16 plans | |
| Ms-Drg 965 965 | – | – | – | $22,984 | $9,874$7,584–$12,089 · 20 plans | |
| Ms-Drg 969 969 | – | – | – | $98,903 | $60,309$7,028–$88,438 · 22 plans | |
| Hiv with Major Related Condition with Cc 975 | – | – | – | $29,588 | $13,325$7,584–$16,650 · 20 plans | |
| Ms-Drg 976 976 | – | – | – | $21,915 | $9,417$6,958–$14,246 · 21 plans | |
| Ms-Drg 977 977 | – | – | – | $74,813 | $13,226$7,515–$17,128 · 19 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis Without Cc/Mcc 983 | – | – | – | $61,993 | $17,568$7,654–$23,693 · 21 plans | |
| Ms-Drg 989 989 | – | – | – | $31,887 | $12,393$7,584–$15,236 · 20 plans | |
| Ms-Drg 998 998 | – | – | – | $24,098 | $712$678–$752 · 16 plans | |
| Ms-Drg 999 999 | – | – | – | $36,006 | $712$678–$3,580 · 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 | $27,678 | $27,678 | $4,954$1,027–$5,936 · 30 plans |
| Colonoscopy CPT 45378 | $7,401 | $7,401 | $1,558$827–$3,455 · 47 plans |
| Colonoscopy with biopsy CPT 45380 | $11,026 | $11,026 | $1,535$957–$3,455 · 50 plans |
| Complete blood count (CBC) CPT 85025 | $164 | $164 | $25$8–$164 · 51 plans |
| Comprehensive metabolic panel (blood test) CPT 80053 | $158 | $158 | $43$11–$158 · 49 plans |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $5,472 | $5,472 | $1,178$418–$4,796 · 45 plans |
| Emergency room visit, highest level CPT 99285 | $4,226 | $4,226 | $1,798$714–$4,226 · 48 plans |
| Gallbladder removal (laparoscopic) CPT 47562 | $25,750 | $25,750 | $7,608$4,136–$14,352 · 49 plans |
| Hip replacement CPT 27130 | $67,725 | $67,725 | $15,897$8,408–$26,693 · 29 plans |
| Knee arthroscopy (meniscus) CPT 29881 | $37,935 | $37,935 | $6,309$1,229–$6,735 · 30 plans |
| Knee replacement CPT 27447 | $60,439 | $60,439 | $15,897$8,876–$25,598 · 29 plans |
| MRI of the brain, with and without contrast CPT 70553 | $5,423 | $5,423 | $1,178$423–$5,423 · 43 plans |
| MRI of the knee, without contrast CPT 73721 | $3,763 | $3,763 | $770$289–$3,763 · 43 plans |
Price file: Umass Memorial Medical Center/University Campus, read November 9, 2026.