St Lukes Hospital
801 Ostrum Street, Bethlehem, PA 18015 · (484) 526-4000
St Lukes Hospital is a non-profit general hospital in Bethlehem, Pennsylvania (Northampton County), with 807 beds. It has an emergency room and holds 5 of 5 stars in CMS's overall quality rating. In CMS's patient survey it scores 4 of 5 stars, and 76% of patients said they would definitely recommend it. Medicare patients had 6,633 stays here in 2024, most often for sepsis, heart failure and heart valve replacement through a catheter (TAVR). It lists $10.47 for every $1 its care costs, more than the typical Pennsylvania hospital ($5.26). Its own cash prices and insurer rates are on this page.
On this page:QualityThe moneyHospital staysOutpatient pricesNearby hospitals
Compare with another hospital Best hospitals in Pennsylvania
★★★★★CMS overall quality rating
★★★★★patients' own rating (2,011 surveys)
$10.47listed for every $1 its care costs Pennsylvania typical $5.26
2 h 12 mintypical ER visit US typical 2 h 28 min
6,633Medicare stays in 2024
807beds
Quality and patient experience
What patients say
★★★★★4 of 5 · 2,011 surveys
76%would definitely recommend the hospital US typical 71%
75%rated the hospital 9 or 10 out of 10 US typical 72%
Rated by patients
- Nurses communicated well★★★★★
- Doctors communicated well★★★★★
- Staff explained medicines★★★★★
- Information for going home★★★★★
- Room was clean★★★★★
- Quiet at night★★★★★
Emergency room and urgent care
2 h 12 mintypical time in the ER before going home US typical 2 h 28 min
1%left the ER without being seen US typical 1%
85%of sepsis patients got the recommended care US typical 65%
ER volume: very high.
US typical hospital. Infection figures are a ratio: 1.00 means as many infections as expected for a hospital like this one. CMS adjusts these rates for how sick the patients are; a small gap from the typical hospital can be chance, so a verdict is shown only where CMS gives one.
Source: CMS Care Compare, measurement periods ending up to September 2025.
The money
$10what care cost the hospital for every $100 it billed
$347.3Mnet income, all sources
15.4%margin on patient care alone
$27.1Mcost of charity care (2.8% of costs)
$55.7Munpaid bills written off (bad debt)
5,136full-time staff (equivalent)
From the hospital's Medicare cost report for the year ending June 2025. 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 | 457 | $137,361 | $18,878 | $29,408$24,234–$34,978 · 7 plans | |
| Heart failure, with major complications 291 | 360 | $102,984 | $12,914 | $19,755$18,194–$25,327 · 7 plans | |
| Heart valve replacement through a catheter (TAVR) 267 | 158 | $463,112 | $46,229 | $78,581$72,698–$107,329 · 7 plans | |
| Infection needing surgery, with major complications 853 | 121 | $395,964 | $48,289 | $74,765$64,889–$95,839 · 7 plans | |
| Sepsis 872 | 112 | $79,507 | $11,041 | $15,492$14,114–$19,817 · 7 plans | |
| Back problems (no surgery) 552 | 95 | $70,369 | $9,817 | $14,553$12,221–$16,134 · 7 plans | |
| Kidney failure, with major complications 682 | 95 | $112,591 | $14,987 | $22,421$18,775–$28,845 · 7 plans | |
| Psychoses 885 | 92 | $200,947 | $15,834 | $18,499$13,104–$23,055 · 6 plans | |
| Stroke, with major complications 064 | 89 | $211,199 | $19,878 | $30,445$23,532–$35,853 · 7 plans | |
| Respiratory failure 189 | 89 | $85,190 | $12,589 | $18,703$16,448–$23,886 · 7 plans | |
| Lung infection, with major complications 177 | 85 | $116,657 | $15,365 | $24,592$22,540–$33,092 · 7 plans | |
| Stomach and digestive disorders 392 | 84 | $68,433 | $8,429 | $11,802$10,307–$13,511 · 7 plans | |
| Kidney failure, with complications 683 | 84 | $76,247 | $9,186 | $13,259$11,546–$18,438 · 7 plans | |
| Irregular heartbeat, with complications 309 | 83 | $57,306 | $8,210 | $11,138$10,221–$14,487 · 7 plans | |
| Hip or knee replacement 470 | 81 | $128,396 | $18,710 | $29,202$25,634–$36,446 · 7 plans | |
| Heart procedure through a catheter (e.g. ablation, valve clip) 274 | 80 | $265,602 | $30,299 | $47,747$36,436–$54,332 · 7 plans | |
| Permanent Cardiac Pacemaker Implant with Cc 243 | 79 | $138,835 | $20,943 | $35,172$33,530–$44,911 · 7 plans | |
| Stroke, with complications or clot-busting drug 065 | 72 | $95,831 | $10,154 | $16,676$14,015–$20,363 · 7 plans | |
| Urinary tract infection, with major complications 689 | 72 | $84,402 | $11,425 | $17,586$14,637–$22,117 · 7 plans | |
| Stomach or intestinal bleeding, with complications 378 | 70 | $81,905 | $9,828 | $14,848$13,230–$18,388 · 7 plans | |
| Urinary tract infection 690 | 69 | $61,656 | $8,329 | $12,255$10,426–$14,565 · 7 plans | |
| Heart stent 322 | 68 | $130,410 | $19,054 | $29,100$27,654–$36,609 · 5 plans | |
| Degenerative nerve disorders (e.g. Parkinson's, dementia) 057 | 67 | $87,129 | $13,329 | $19,614$15,357–$21,385 · 7 plans | |
| Heart valve replacement through a catheter (TAVR), with major complications 266 | 66 | $553,920 | $60,255 | $100,759$88,138–$140,094 · 7 plans | |
| Bowel surgery, with complications 330 | 66 | $195,544 | $24,541 | $36,291$32,571–$45,845 · 7 plans | |
| Other kidney and urinary problems, with major complications 698 | 64 | $115,544 | $15,337 | $25,046$21,201–$29,098 · 7 plans | |
| Hip or thigh bone surgery (not replacement), with complications 481 | 62 | $161,499 | $19,124 | $34,478$27,166–$36,443 · 7 plans | |
| Skin infection (cellulitis) 603 | 62 | $53,993 | $9,150 | $13,185$10,804–$15,559 · 7 plans | |
| Dehydration and electrolyte problems 641 | 62 | $60,296 | $8,089 | $11,781$10,298–$13,598 · 7 plans | |
| Other Disorders of Nervous System with Cc 092 | 60 | $66,439 | $10,587 | $16,885$12,798–$18,364 · 7 plans | |
| Dehydration and electrolyte problems, with major complications 640 | 60 | $84,315 | $12,715 | $20,220$15,839–$22,848 · 7 plans | |
| Stomach or intestinal bleeding, with major complications 377 | 58 | $172,040 | $18,444 | $27,674$22,828–$31,988 · 7 plans | |
| Fainting 312 | 55 | $63,902 | $9,503 | $13,195$10,987–$14,762 · 7 plans | |
| Pneumonia, with major complications 193 | 53 | $91,242 | $13,857 | $19,899$17,698–$25,393 · 7 plans | |
| Heart catheterization, with major complications 286 | 49 | $203,781 | $25,899 | $33,500$28,516–$38,991 · 7 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm with Cc 660 | 48 | $95,747 | $14,215 | $21,816$18,809–$30,650 · 7 plans | |
| Major Chest Procedures with Mcc 163 | 46 | $294,390 | $42,886 | $67,850$62,656–$87,557 · 7 plans | |
| Major Chest Procedures with Cc 164 | 45 | $201,252 | $24,681 | $38,373$33,974–$47,415 · 7 plans | |
| Heart catheterization 287 | 45 | $90,743 | $11,030 | $16,525$15,872–$19,454 · 7 plans | |
| Stomach and digestive disorders, with major complications 391 | 45 | $73,124 | $13,432 | $19,201$16,646–$21,938 · 7 plans | |
| Peripheral Vascular Disorders with Cc 300 | 44 | $61,697 | $10,518 | $16,161$13,756–$18,593 · 7 plans | |
| Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy Without Mcc 897 | 44 | $42,004 | $8,786 | $13,365$10,372–$14,571 · 7 plans | |
| Other Vascular Procedures with Cc 253 | 43 | $226,890 | $25,381 | $40,456$33,424–$45,180 · 7 plans | |
| Irregular heartbeat, with major complications 308 | 43 | $110,585 | $12,901 | $18,227$15,690–$23,147 · 7 plans | |
| Major Chest Trauma with Cc 184 | 42 | $85,529 | $11,776 | $16,109$13,807–$18,708 · 7 plans | |
| Craniotomy and Endovascular Intracranial Procedures with Mcc 025 | 39 | $336,268 | $47,249 | $68,832$56,285–$88,313 · 7 plans | |
| Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis with Mcc O 023 | 38 | $474,266 | $55,054 | $86,751$71,623–$100,445 · 7 plans | |
| Revision of Hip or Knee Replacement with Cc 467 | 38 | $267,554 | $32,301 | $53,389$42,893–$61,384 · 7 plans | |
| Infectious and Parasitic Diseases with O.r. Procedures with Cc 854 | 37 | $151,451 | $22,486 | $31,568$28,879–$44,987 · 7 plans | |
| Irregular heartbeat 310 | 36 | $44,224 | $7,381 | $8,570$7,765–$10,654 · 7 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Cc 543 | 36 | $76,740 | $10,346 | $16,968$14,643–$20,812 · 7 plans | |
| Anemia and blood disorders, with major complications 811 | 35 | $109,321 | $13,867 | $21,260$17,971–$24,924 · 7 plans | |
| Permanent Cardiac Pacemaker Implant with Mcc 242 | 34 | $175,849 | $31,888 | $48,530$48,248–$63,606 · 7 plans | |
| Other Vascular Procedures with Mcc 252 | 34 | $261,236 | $33,795 | $53,809$42,437–$60,072 · 7 plans | |
| Trauma to the Skin, Subcutaneous Tissue and Breast Without Mcc 605 | 34 | $57,767 | $8,811 | $13,867$11,572–$15,119 · 7 plans | |
| Other kidney and urinary problems, with complications 699 | 34 | $84,114 | $10,027 | $15,366$14,005–$18,453 · 7 plans | |
| Seizures 101 | 33 | $106,548 | $9,582 | $13,664$11,045–$15,519 · 7 plans | |
| Fracture or sprain (not hip or thigh) 563 | 33 | $69,614 | $8,515 | $13,557$11,336–$14,781 · 7 plans | |
| Pulmonary Embolism with Mcc or Acute Cor Pulmonale 175 | 32 | $110,784 | $13,725 | $20,795$19,396–$27,248 · 7 plans | |
| Lung infection, with complications 178 | 32 | $72,666 | $9,615 | $16,110$14,612–$23,397 · 7 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 219 | 32 | $511,761 | $66,258 | $116,242$93,921–$145,431 · 7 plans | |
| Seizures with Mcc 100 | 31 | $192,561 | $18,669 | $29,321$21,974–$32,198 · 7 plans | |
| Other Major Cardiovascular Procedures with Mcc 270 | 31 | $358,175 | $54,638 | $79,878$64,476–$89,908 · 7 plans | |
| Other Major Cardiovascular Procedures with Cc 271 | 31 | $273,472 | $31,885 | $53,839$44,376–$60,211 · 7 plans | |
| Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Cc 617 | 31 | $151,667 | $18,729 | $28,314$25,610–$36,691 · 7 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm Without Cc/Mcc 661 | 31 | $76,025 | $11,125 | $17,090$14,974–$22,536 · 7 plans | |
| COPD, with major complications 190 | 30 | $76,821 | $11,166 | $16,769$14,980–$22,226 · 7 plans | |
| Heart stent, with major complications or 4+ stents 321 | 30 | $236,592 | $27,867 | $44,909$42,678–$54,925 · 5 plans | |
| Bowel surgery, with major complications 329 | 30 | $309,345 | $40,270 | $69,586$59,490–$90,151 · 7 plans | |
| Major Small and Large Bowel Procedures Without Cc/Mcc 331 | 30 | $144,604 | $19,420 | $25,666$22,335–$30,681 · 7 plans | |
| Other Digestive System Diagnoses with Mcc 393 | 30 | $122,007 | $16,514 | $24,212$21,884–$29,149 · 7 plans | |
| Other digestive problems, with complications 394 | 30 | $87,221 | $9,688 | $14,166$12,834–$17,489 · 7 plans | |
| Pneumonia, with complications 194 | 29 | $62,402 | $9,016 | $12,751$12,033–$16,668 · 7 plans | |
| Coronary Bypass Without Cardiac Catheterization with Mcc 235 | 29 | $453,333 | $62,374 | $88,845$72,446–$107,108 · 7 plans | |
| Heart attack, with complications 281 | 29 | $94,064 | $9,949 | $14,578$13,417–$19,652 · 7 plans | |
| Other circulation problems, with major complications 314 | 29 | $109,755 | $21,601 | $31,568$25,980–$35,812 · 7 plans | |
| Spinal fusion (lower or mid back) 460 | 29 | $279,020 | $39,462 | $52,523only 2 plans | |
| Diabetes, with major complications 637 | 29 | $85,696 | $14,459 | $21,750$17,601–$25,973 · 7 plans | |
| Breathing problem needing a ventilator (up to 4 days) 208 | 28 | $210,049 | $24,945 | $41,613$31,266–$46,054 · 7 plans | |
| Diabetes, with complications 638 | 28 | $63,221 | $10,213 | $13,568$11,243–$15,928 · 7 plans | |
| Chronic Obstructive Pulmonary Disease with Cc 191 | 27 | $55,956 | $8,407 | $12,762$12,505–$16,777 · 7 plans | |
| Hip replacement after a hip fracture 522 | 27 | $176,855 | $20,675 | $34,954$31,983–$43,308 · 5 plans | |
| Traumatic Stupor and Coma <1 Hour with Cc 086 | 26 | $69,092 | $13,237 | $19,722$15,966–$23,329 · 7 plans | |
| Pulmonary Embolism Without Mcc 176 | 26 | $80,617 | $10,166 | $12,261$12,025–$17,226 · 7 plans | |
| Other Circulatory System Diagnoses with Cc 315 | 26 | $70,136 | $9,623 | $14,583$13,172–$18,123 · 7 plans | |
| Anemia and blood disorders 812 | 26 | $57,426 | $9,557 | $13,901$12,101–$15,684 · 7 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 981 | 26 | $280,479 | $38,651 | $71,526$56,329–$89,862 · 7 plans | |
| Other Disorders of Nervous System with Mcc 091 | 25 | $168,148 | $18,856 | $26,587$20,583–$30,995 · 7 plans | |
| Major Chest Trauma with Mcc 183 | 25 | $110,849 | $15,665 | $23,161$19,767–$28,407 · 7 plans | |
| Bronchitis and Asthma with Cc/Mcc 202 | 25 | $72,215 | $9,681 | $14,703$12,624–$16,664 · 7 plans | |
| Kidney and Ureter Procedures for Non-Neoplasm with Mcc 659 | 25 | $201,162 | $28,891 | $41,940$35,344–$55,661 · 7 plans | |
| Traumatic Stupor and Coma >1 Hour with Cc 083 | 24 | $82,444 | $13,738 | $21,173$16,925–$25,047 · 7 plans | |
| High blood pressure 305 | 24 | $69,502 | $7,606 | $11,431$9,633–$12,590 · 7 plans | |
| Bowel obstruction, with complications 389 | 24 | $56,946 | $8,262 | $11,957$10,999–$15,825 · 7 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 982 | 24 | $171,183 | $26,165 | $38,045$32,764–$50,939 · 7 plans | |
| Respiratory Neoplasms with Mcc 180 | 23 | $122,124 | $17,740 | $26,735$22,511–$32,131 · 7 plans | |
| Hip or thigh bone surgery (not replacement), with major complications 480 | 23 | $224,236 | $27,832 | $46,510$39,682–$53,891 · 7 plans | |
| Complications of Treatment with Cc 920 | 23 | $91,281 | $9,827 | $15,174$13,423–$17,903 · 7 plans | |
| Extracranial Procedures with Cc 038 | 22 | $149,086 | $15,699 | $26,782$20,940–$31,043 · 7 plans | |
| Cranial and Peripheral Nerve Disorders Without Mcc 074 | 22 | $74,367 | $10,947 | $15,605$13,013–$17,484 · 7 plans | |
| Stomach, Esophageal and Duodenal Procedures with Cc 327 | 22 | $229,528 | $26,803 | $38,045$28,019–$48,707 · 7 plans | |
| Pleural Effusion with Mcc 186 | 21 | $107,156 | $14,167 | $23,594$20,329–$29,473 · 7 plans | |
| Endocrine Disorders with Cc 644 | 21 | $88,925 | $10,624 | $15,517$13,408–$19,187 · 7 plans | |
| Delirium and other mental confusion 884 | 21 | $167,081 | $17,081 | $20,497$14,354–$26,556 · 6 plans | |
| Other Cerebrovascular Disorders with Mcc 070 | 20 | $128,249 | $19,743 | $27,479$21,984–$33,787 · 7 plans | |
| Disorders of the Biliary Tract with Mcc 444 | 20 | $136,574 | $17,461 | $25,296$21,353–$30,009 · 7 plans | |
| Disorders of the Biliary Tract with Cc 445 | 20 | $97,277 | $11,461 | $16,568$14,363–$19,813 · 7 plans | |
| Kidney and Ureter Procedures for Neoplasm with Cc 657 | 20 | $156,518 | $20,188 | $27,704$26,237–$34,213 · 7 plans | |
| Coagulation Disorders 813 | 20 | $74,967 | $14,900 | $25,176$23,048–$27,528 · 7 plans | |
| Carotid Artery Stent Procedures with Cc 035 | 19 | $192,162 | $25,061 | $36,190$29,459–$41,147 · 7 plans | |
| Extracranial Procedures Without Cc/Mcc 039 | 19 | $123,613 | $11,818 | $19,403$15,081–$20,386 · 7 plans | |
| Degenerative Nervous System Disorders with Mcc 056 | 19 | $237,916 | $26,182 | $35,169$25,403–$38,345 · 7 plans | |
| Major Chest Procedures Without Cc/Mcc 165 | 19 | $137,506 | $17,278 | $28,979$24,592–$34,537 · 7 plans | |
| Coronary Bypass with Cardiac Catheterization or Open Ablation with Mcc 233 | 19 | $535,247 | $67,283 | $115,741$92,979–$136,306 · 7 plans | |
| Permanent Cardiac Pacemaker Implant Without Cc/Mcc 244 | 19 | $136,845 | $18,053 | $29,834$27,937–$37,042 · 7 plans | |
| Percutaneous and Other Intracardiac Procedures with Mcc 273 | 19 | $272,831 | $37,060 | $66,910$46,899–$68,877 · 7 plans | |
| Medical Back Problems with Mcc 551 | 19 | $94,091 | $15,613 | $25,374$20,754–$29,835 · 7 plans | |
| Signs and Symptoms of Musculoskeletal System and Connective Tissue Without Mcc 556 | 19 | $66,449 | $8,813 | $12,574$10,761–$13,710 · 7 plans | |
| Traumatic Stupor and Coma >1 Hour with Mcc 082 | 18 | $166,558 | $20,738 | $34,602$28,502–$40,085 · 7 plans | |
| Other Cardiothoracic Procedures Without Mcc 229 | 18 | $275,612 | $29,135 | $51,985$49,015–$79,297 · 7 plans | |
| Coronary Bypass Without Cardiac Catheterization Without Mcc 236 | 18 | $339,460 | $39,912 | $63,414$50,831–$72,534 · 7 plans | |
| Aortic and Heart Assist Procedures Except Pulsation Balloon Without Mcc 269 | 18 | $377,234 | $37,495 | $63,935$53,959–$72,872 · 7 plans | |
| Peripheral Vascular Disorders with Mcc 299 | 18 | $79,617 | $14,746 | $24,717$18,140–$28,582 · 7 plans | |
| Stomach, Esophageal and Duodenal Procedures Without Cc/Mcc 328 | 18 | $131,659 | $16,229 | $24,257$20,123–$28,420 · 7 plans | |
| Malignancy of Hepatobiliary System or Pancreas with Mcc 435 | 18 | $155,350 | $17,355 | $27,806$22,263–$33,052 · 7 plans | |
| Endocrine Disorders with Mcc 643 | 18 | $124,294 | $15,656 | $24,920$21,246–$30,524 · 7 plans | |
| Traumatic Stupor and Coma <1 Hour with Mcc 085 | 17 | $132,028 | $19,782 | $34,394$27,136–$40,560 · 7 plans | |
| Amputation for Circulatory System Disorders Except Upper Limb and Toe with Mcc 239 | 17 | $403,839 | $48,180 | $74,510$59,673–$87,652 · 7 plans | |
| Cardiac Defibrillator Implant Without Mcc 277 | 17 | $353,055 | $46,454 | $76,232$72,007–$92,156 · 5 plans | |
| Signs and Symptoms Without Mcc 948 | 17 | $61,388 | $8,163 | $12,119$10,679–$13,543 · 7 plans | |
| Other Cerebrovascular Disorders with Cc 071 | 16 | $79,976 | $10,234 | $16,506$13,479–$19,975 · 7 plans | |
| Dysequilibrium 149 | 16 | $65,180 | $7,524 | $11,378$9,796–$12,721 · 7 plans | |
| Stomach, Esophageal and Duodenal Procedures with Mcc 326 | 16 | $334,434 | $44,794 | $75,504$59,400–$99,404 · 7 plans | |
| Bone Diseases and Arthropathies Without Mcc 554 | 16 | $60,111 | $8,407 | $12,567$10,408–$13,708 · 7 plans | |
| Other Musculoskeletal System and Connective Tissue Diagnoses with Cc 565 | 16 | $74,221 | $11,993 | $14,751$13,003–$17,322 · 7 plans | |
| Postoperative or Post-Traumatic Infections with O.r. Procedures with Mcc 856 | 16 | $268,813 | $39,752 | $68,863$54,928–$86,098 · 7 plans | |
| Mini-stroke (TIA) 069 | 15 | $74,577 | $8,236 | $13,185$10,414–$14,096 · 7 plans | |
| Other Respiratory System O.r. Procedures with Mcc 166 | 15 | $277,191 | $35,732 | $56,585$46,484–$68,901 · 7 plans | |
| Cardiac Congenital and Valvular Disorders with Mcc 306 | 15 | $86,754 | $18,176 | $26,010$18,287–$30,306 · 7 plans | |
| Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Mcc 441 | 15 | $184,232 | $18,601 | $29,214$24,143–$32,147 · 7 plans | |
| Major Joint or Limb Reattachment Procedures of Upper Extremities 483 | 15 | $191,372 | $25,761 | $41,964$30,608–$46,894 · 7 plans | |
| Other Disorders of Nervous System Without Cc/Mcc 093 | 14 | $69,587 | $8,031 | $13,144$10,116–$13,803 · 7 plans | |
| Heart attack, with major complications 280 | 14 | $132,328 | $15,441 | $24,284$21,715–$32,648 · 7 plans | |
| Gastrointestinal Obstruction with Mcc 388 | 14 | $97,513 | $15,607 | $22,357$19,282–$27,935 · 7 plans | |
| Fractures of Hip and Pelvis Without Mcc 536 | 14 | $58,950 | $7,860 | $12,226$10,445–$14,013 · 7 plans | |
| Cellulitis with Mcc 602 | 14 | $103,000 | $14,484 | $21,517$19,375–$26,198 · 7 plans | |
| Complications of Treatment with Mcc 919 | 14 | $153,293 | $18,552 | $27,716$22,535–$31,281 · 7 plans | |
| Nervous System Neoplasms with Mcc 054 | 13 | $195,649 | $17,905 | $23,116$17,333–$28,822 · 7 plans | |
| Headaches Without Mcc 103 | 13 | $80,068 | $9,263 | $12,661$10,383–$13,804 · 7 plans | |
| Other Cardiothoracic Procedures with Mcc 228 | 13 | $354,158 | $46,187 | $85,839$78,956–$123,345 · 7 plans | |
| Heart Failure and Shock with Cc 292 | 13 | $56,392 | $8,580 | $13,082$12,170–$17,106 · 7 plans | |
| Inflammatory Bowel Disease with Cc 386 | 13 | $82,939 | $10,882 | $14,780$13,122–$18,839 · 7 plans | |
| Cirrhosis and Alcoholic Hepatitis with Mcc 432 | 13 | $112,055 | $21,786 | $29,797$23,943–$33,996 · 7 plans | |
| Revision of Hip or Knee Replacement Without Cc/Mcc 468 | 13 | $194,155 | $28,042 | $41,602$35,574–$48,378 · 7 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Cc 493 | 13 | $175,931 | $30,445 | $38,051$29,147–$41,860 · 7 plans | |
| Transurethral Prostatectomy with Cc/Mcc 713 | 13 | $91,713 | $13,769 | $23,005$19,087–$24,815 · 7 plans | |
| Other O.r. Procedures for Injuries with Mcc 907 | 13 | $348,846 | $49,354 | $58,123$52,780–$69,815 · 7 plans | |
| Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma 956 | 13 | $234,558 | $30,035 | $62,111$51,125–$80,617 · 7 plans | |
| Interstitial Lung Disease with Mcc 196 | 12 | $113,229 | $19,455 | $28,570$21,311–$32,530 · 7 plans | |
| Amputation for Circulatory System Disorders Except Upper Limb and Toe with Cc 240 | 12 | $232,536 | $24,167 | $43,154$35,126–$51,271 · 7 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. with Cc 418 | 12 | $147,304 | $15,690 | $25,609$22,211–$31,012 · 7 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 464 | 12 | $167,678 | $24,071 | $47,153$37,409–$53,450 · 7 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures with Cc 516 | 12 | $160,744 | $30,134 | $31,952$24,996–$36,201 · 7 plans | |
| Postoperative and Post-Traumatic Infections with Mcc 862 | 12 | $105,208 | $16,389 | $27,609$22,314–$34,596 · 7 plans | |
| Acute Adjustment Reaction and Psychosocial Dysfunction 880 | 12 | $77,861 | $9,134 | $12,937$11,142–$15,849 · 6 plans | |
| Other O.r. Procedures for Injuries with Cc 908 | 12 | $127,769 | $19,961 | $30,205$26,847–$36,253 · 7 plans | |
| Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Neck Withou 004 | 11 | $881,002 | $115,936 | $209,696$143,526–$233,377 · 7 plans | |
| Craniotomy and Endovascular Intracranial Procedures Without Cc/Mcc 027 | 11 | $200,933 | $28,347 | $38,194$31,249–$43,151 · 7 plans | |
| Other Respiratory System Diagnoses with Mcc 205 | 11 | $80,881 | $16,379 | $26,698$19,976–$30,222 · 7 plans | |
| Other Circulatory System O.r. Procedures 264 | 11 | $130,775 | $28,863 | $50,573$39,556–$55,139 · 7 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections with Cc 372 | 11 | $88,663 | $10,393 | $15,457$14,186–$21,403 · 7 plans | |
| Pancreas, Liver and Shunt Procedures with Mcc 405 | 11 | $462,351 | $48,794 | $82,818$68,945–$102,901 · 7 plans | |
| Pancreas, Liver and Shunt Procedures with Cc 406 | 11 | $250,334 | $26,721 | $43,906$36,790–$52,786 · 7 plans | |
| Cirrhosis and Alcoholic Hepatitis with Cc 433 | 11 | $80,281 | $12,465 | $15,990$13,890–$18,575 · 7 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy with Mcc 542 | 11 | $84,691 | $15,667 | $29,158$24,072–$33,991 · 7 plans | |
| Transurethral Procedures with Cc 669 | 11 | $115,284 | $14,757 | $23,496$18,554–$25,763 · 7 plans | |
| Other Kidney and Urinary Tract Procedures with Mcc 673 | 11 | $236,664 | $34,367 | $59,828$45,420–$69,351 · 7 plans | |
| Lymphoma and Non-Acute Leukemia with Mcc 840 | 11 | $160,540 | $30,480 | $53,395$40,448–$56,495 · 7 plans | |
| Heart Transplant or Implant of Heart Assist System with Mcc 001 | – | – | – | $424,254$329,137–$462,558 · 5 plans | |
| Ms-Drg 002 002 | – | – | – | $187,041$177,748–$197,471 · 5 plans | |
| Ecmo or Tracheostomy with Mv >96 Hours or Principal Diagnosis Except Face, Mouth and Nec 003 | – | – | – | $321,328$228,164–$368,881 · 7 plans | |
| Liver Transplant with Mcc or Intestinal Transplant 005 | – | – | – | $156,091$135,430–$170,183 · 5 plans | |
| Liver Transplant Without Mcc 006 | – | – | – | $70,200$58,807–$76,538 · 5 plans | |
| Lung Transplant 007 | – | – | – | $196,053$127,082–$213,754 · 5 plans | |
| Ms-Drg 008 008 | – | – | – | $84,848$66,037–$92,509 · 5 plans | |
| Ms-Drg 010 010 | – | – | – | $50,671$48,154–$57,134 · 5 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Mcc 011 | – | – | – | $82,570$64,192–$96,198 · 7 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy with Cc 012 | – | – | – | $63,826$46,182–$69,589 · 7 plans | |
| Tracheostomy for Face, Mouth and Neck Diagnoses or Laryngectomy Without Cc/Mcc 013 | – | – | – | $40,958$31,795–$47,567 · 7 plans | |
| Allogeneic Bone Marrow Transplant 014 | – | – | – | $181,939$150,869–$198,365 · 5 plans | |
| Autologous Bone Marrow Transplant with Cc/Mcc 016 | – | – | – | $89,770$83,873–$97,875 · 5 plans | |
| Ms-Drg 017 017 | – | – | – | $73,247$59,145–$79,860 · 5 plans | |
| Chimeric Antigen Receptor (car) T-Cell and Other Immunotherapies 018 | – | – | – | $712,768$665,549–$712,768 · 3 plans | |
| Ms-Drg 019 019 | – | – | – | $109,387$102,141–$109,387 · 3 plans | |
| Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Mcc 020 | – | – | – | $129,881$125,502–$155,729 · 7 plans | |
| Intracranial Vascular Procedures with Principal Diagnosis Hemorrhage with Cc 021 | – | – | – | $97,969$84,484–$118,531 · 7 plans | |
| Ms-Drg 022 022 | – | – | – | $74,491$49,076–$80,623 · 7 plans | |
| Craniotomy with Major Device Implant or Acute Complex Cns Principal Diagnosis Without Mc 024 | – | – | – | $59,222$50,155–$68,627 · 7 plans | |
| Craniotomy and Endovascular Intracranial Procedures with Cc 026 | – | – | – | $47,070$39,346–$56,757 · 7 plans | |
| Spinal Procedures with Mcc 028 | – | – | – | $90,960$72,445–$104,352 · 7 plans | |
| Spinal Procedures with Cc or Spinal Neurostimulators 029 | – | – | – | $51,648$42,957–$57,924 · 7 plans | |
| Spinal Procedures Without Cc/Mcc 030 | – | – | – | $33,224$27,503–$36,234 · 7 plans | |
| Ventricular Shunt Procedures with Mcc 031 | – | – | – | $67,830$52,081–$82,260 · 7 plans | |
| Ventricular Shunt Procedures with Cc 032 | – | – | – | $32,261$28,166–$37,964 · 7 plans | |
| Ventricular Shunt Procedures Without Cc/Mcc 033 | – | – | – | $25,175$22,637–$27,948 · 7 plans | |
| Carotid Artery Stent Procedures with Mcc 034 | – | – | – | $63,889$52,225–$70,366 · 7 plans | |
| Carotid Artery Stent Procedures Without Cc/Mcc 036 | – | – | – | $29,412$23,468–$32,779 · 7 plans | |
| Extracranial Procedures with Mcc 037 | – | – | – | $51,619$41,605–$58,745 · 7 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures with Mcc 040 | – | – | – | $58,455$48,675–$72,485 · 7 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures with Cc or Peripheral Neur 041 | – | – | – | $35,191$30,792–$40,362 · 7 plans | |
| Peripheral, Cranial Nerve and Other Nervous System Procedures Without Cc/Mcc 042 | – | – | – | $26,156$24,197–$31,587 · 7 plans | |
| Ms-Drg 052 052 | – | – | – | $29,394$20,184–$35,690 · 7 plans | |
| Ms-Drg 053 053 | – | – | – | $16,163$12,753–$18,907 · 7 plans | |
| Nervous System Neoplasms Without Mcc 055 | – | – | – | $15,436$13,607–$19,451 · 7 plans | |
| Ms-Drg 058 058 | – | – | – | $28,217$21,851–$32,599 · 7 plans | |
| Ms-Drg 059 059 | – | – | – | $18,786$14,549–$20,482 · 7 plans | |
| Ms-Drg 060 060 | – | – | – | $14,732$11,611–$15,182 · 7 plans | |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 061 | – | – | – | $42,277$36,817–$52,111 · 7 plans | |
| Ischemic Stroke, Precerebral Occlusion or Transient Ischemia with Thrombolytic Agent Wit 062 | – | – | – | $29,004$25,643–$36,811 · 7 plans | |
| Ms-Drg 063 063 | – | – | – | $23,171$21,446–$31,766 · 7 plans | |
| Intracranial Hemorrhage or Cerebral Infarction Without Cc/Mcc 066 | – | – | – | $11,297$10,343–$15,261 · 7 plans | |
| Ms-Drg 067 067 | – | – | – | $24,242$18,946–$28,517 · 7 plans | |
| Precerebral Occlusion Without Infarction Without Mcc 068 | – | – | – | $14,268$12,270–$16,098 · 7 plans | |
| Other Cerebrovascular Disorders Without Cc/Mcc 072 | – | – | – | $12,482$10,519–$14,267 · 7 plans | |
| Cranial and Peripheral Nerve Disorders with Mcc 073 | – | – | – | $24,288$18,825–$27,189 · 7 plans | |
| Ms-Drg 075 075 | – | – | – | $29,029$22,006–$33,442 · 7 plans | |
| Ms-Drg 076 076 | – | – | – | $12,360$11,569–$15,295 · 7 plans | |
| Hypertensive Encephalopathy with Mcc 077 | – | – | – | $20,992$20,992–$27,878 · 3 plans | |
| Hypertensive Encephalopathy with Cc 078 | – | – | – | $13,526$13,526–$18,085 · 3 plans | |
| Ms-Drg 079 079 | – | – | – | $10,623$10,623–$13,232 · 3 plans | |
| Nontraumatic Stupor and Coma with Mcc 080 | – | – | – | $27,402$23,120–$34,015 · 7 plans | |
| Ms-Drg 081 081 | – | – | – | $13,558$10,463–$15,006 · 7 plans | |
| Traumatic Stupor and Coma >1 Hour Without Cc/Mcc 084 | – | – | – | $14,470$12,324–$17,027 · 7 plans | |
| Traumatic Stupor and Coma <1 Hour Without Cc/Mcc 087 | – | – | – | $13,848$11,287–$15,979 · 7 plans | |
| Concussion with Mcc 088 | – | – | – | $22,313$18,830–$28,564 · 7 plans | |
| Concussion with Cc 089 | – | – | – | $16,632$13,700–$18,815 · 7 plans | |
| Concussion Without Cc/Mcc 090 | – | – | – | $12,462$10,911–$13,984 · 7 plans | |
| Bacterial and Tuberculous Infections of Nervous System with Mcc 094 | – | – | – | $53,280$44,756–$63,796 · 7 plans | |
| Ms-Drg 095 095 | – | – | – | $40,398$31,054–$44,491 · 7 plans | |
| Ms-Drg 096 096 | – | – | – | $39,299$29,335–$42,572 · 7 plans | |
| Non-Bacterial Infection of Nervous System Except Viral Meningitis with Mcc 097 | – | – | – | $56,345$44,640–$63,475 · 7 plans | |
| Ms-Drg 098 098 | – | – | – | $34,742$24,888–$38,712 · 7 plans | |
| Ms-Drg 099 099 | – | – | – | $20,625$16,271–$24,371 · 7 plans | |
| Headaches with Mcc 102 | – | – | – | $17,297$14,402–$19,380 · 7 plans | |
| Orbital Procedures with Cc/Mcc 113 | – | – | – | $35,593$28,934–$40,334 · 7 plans | |
| Ms-Drg 114 114 | – | – | – | $20,483$17,243–$23,133 · 7 plans | |
| Extraocular Procedures Except Orbit 115 | – | – | – | $23,237$19,997–$26,940 · 7 plans | |
| Intraocular Procedures with Cc/Mcc 116 | – | – | – | $27,373$20,069–$31,837 · 7 plans | |
| Ms-Drg 117 117 | – | – | – | $16,424$13,617–$19,229 · 7 plans | |
| Acute Major Eye Infections with Cc/Mcc 121 | – | – | – | $19,201$13,437–$20,560 · 7 plans | |
| Ms-Drg 122 122 | – | – | – | $11,896$10,564–$13,093 · 7 plans | |
| Neurological Eye Disorders 123 | – | – | – | $13,182$10,373–$14,212 · 7 plans | |
| Other Disorders of the Eye with Mcc or Thrombolytic Agent 124 | – | – | – | $21,839$16,826–$24,163 · 7 plans | |
| Other Disorders of the Eye Without Mcc 125 | – | – | – | $11,624$10,674–$13,382 · 7 plans | |
| Ms-Drg 129 129 | – | – | – | $30,293only 2 plans | |
| Ms-Drg 130 130 | – | – | – | $19,265only 2 plans | |
| Ms-Drg 131 131 | – | – | – | $33,891only 2 plans | |
| Ms-Drg 132 132 | – | – | – | $20,784only 2 plans | |
| Ms-Drg 133 133 | – | – | – | $26,335only 2 plans | |
| Ms-Drg 134 134 | – | – | – | $15,688only 2 plans | |
| Ms-Drg 135 135 | – | – | – | $34,913$30,033–$39,793 · 7 plans | |
| Ms-Drg 136 136 | – | – | – | $17,470$16,203–$20,004 · 7 plans | |
| Ms-Drg 137 137 | – | – | – | $22,606$17,077–$25,688 · 7 plans | |
| Ms-Drg 138 138 | – | – | – | $13,416$11,724–$15,139 · 7 plans | |
| Ms-Drg 139 139 | – | – | – | $18,297$15,111–$21,626 · 7 plans | |
| Ms-Drg 140 140 | – | – | – | $70,402$64,592–$71,953 · 5 plans | |
| Major Head and Neck Procedures with Cc 141 | – | – | – | $35,836$34,058–$36,001 · 5 plans | |
| Major Head and Neck Procedures Without Cc/Mcc 142 | – | – | – | $26,350$24,948–$28,739 · 5 plans | |
| Ms-Drg 143 143 | – | – | – | $56,720$45,575–$61,841 · 5 plans | |
| Other Ear, Nose, Mouth and Throat O.r. Procedures with Cc 144 | – | – | – | $28,417$24,574–$28,603 · 5 plans | |
| Other Ear, Nose, Mouth and Throat O.r. Procedures Without Cc/Mcc 145 | – | – | – | $19,700$17,578–$19,845 · 5 plans | |
| Ear, Nose, Mouth and Throat Malignancy with Mcc 146 | – | – | – | $34,949$25,522–$40,850 · 7 plans | |
| Ear, Nose, Mouth and Throat Malignancy with Cc 147 | – | – | – | $20,987$16,846–$24,812 · 7 plans | |
| Ms-Drg 148 148 | – | – | – | $13,157$11,214–$16,726 · 7 plans | |
| Ms-Drg 150 150 | – | – | – | $21,978$17,780–$26,158 · 7 plans | |
| Epistaxis Without Mcc 151 | – | – | – | $11,300$10,154–$12,481 · 7 plans | |
| Otitis Media and Uri with Mcc 152 | – | – | – | $17,897$14,273–$19,513 · 7 plans | |
| Otitis Media and Uri Without Mcc 153 | – | – | – | $11,176$9,001–$12,471 · 7 plans | |
| Other Ear, Nose, Mouth and Throat Diagnoses with Mcc 154 | – | – | – | $25,807$19,457–$29,636 · 7 plans | |
| Other Ear, Nose, Mouth and Throat Diagnoses with Cc 155 | – | – | – | $13,875$12,002–$16,664 · 7 plans | |
| Ms-Drg 156 156 | – | – | – | $10,463$9,281–$12,297 · 7 plans | |
| Dental and Oral Diseases with Mcc 157 | – | – | – | $26,823$20,685–$29,740 · 7 plans | |
| Dental and Oral Diseases with Cc 158 | – | – | – | $13,773$12,064–$16,452 · 7 plans | |
| Ms-Drg 159 159 | – | – | – | $10,726$9,396–$12,170 · 7 plans | |
| Other Respiratory System O.r. Procedures with Cc 167 | – | – | – | $27,302$24,580–$35,364 · 7 plans | |
| Other Respiratory System O.r. Procedures Without Cc/Mcc 168 | – | – | – | $20,686$17,361–$25,136 · 7 plans | |
| Ultrasound Accelerated and Other Thrombolysis with Principal Diagnosis Pulmonary Embolis 173 | – | – | – | $49,128$46,443–$59,766 · 5 plans | |
| Respiratory Infections and Inflammations Without Cc/Mcc 179 | – | – | – | $12,462$11,162–$16,626 · 7 plans | |
| Respiratory Neoplasms with Cc 181 | – | – | – | $17,678$15,627–$21,271 · 7 plans | |
| Ms-Drg 182 182 | – | – | – | $12,280$11,472–$16,675 · 7 plans | |
| Major Chest Trauma Without Cc/Mcc 185 | – | – | – | $11,907$10,502–$13,673 · 7 plans | |
| Pleural Effusion with Cc 187 | – | – | – | $14,974$14,347–$19,247 · 7 plans | |
| Ms-Drg 188 188 | – | – | – | $11,493$10,956–$14,128 · 7 plans | |
| Chronic Obstructive Pulmonary Disease Without Cc/Mcc 192 | – | – | – | $10,084$9,846–$12,624 · 7 plans | |
| Simple Pneumonia and Pleurisy Without Cc/Mcc 195 | – | – | – | $9,870$9,249–$12,544 · 7 plans | |
| Interstitial Lung Disease with Cc 197 | – | – | – | $15,666$14,193–$18,994 · 7 plans | |
| Ms-Drg 198 198 | – | – | – | $11,821$10,805–$14,382 · 7 plans | |
| Pneumothorax with Mcc 199 | – | – | – | $26,707$22,497–$32,502 · 7 plans | |
| Pneumothorax with Cc 200 | – | – | – | $16,642$14,156–$19,617 · 7 plans | |
| Ms-Drg 201 201 | – | – | – | $10,826$9,665–$13,477 · 7 plans | |
| Bronchitis and Asthma Without Cc/Mcc 203 | – | – | – | $10,143$9,089–$11,780 · 7 plans | |
| Respiratory Signs and Symptoms 204 | – | – | – | $12,223$10,596–$13,652 · 7 plans | |
| Other Respiratory System Diagnoses Without Mcc 206 | – | – | – | $14,247$11,701–$15,617 · 7 plans | |
| Respiratory System Diagnosis with Ventilator Support >96 Hours 207 | – | – | – | $103,202$71,489–$107,828 · 7 plans | |
| Ms-Drg 209 209 | – | – | – | $186,826$175,997–$228,011 · 4 plans | |
| Concomitant Aortic and Mitral Valve Procedures 212 | – | – | – | $179,486$170,568–$216,929 · 5 plans | |
| Ms-Drg 213 213 | – | – | – | $94,197$88,737–$101,564 · 4 plans | |
| Other Heart Assist System Implant 215 | – | – | – | $164,349$129,491–$206,038 · 7 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 216 | – | – | – | $148,102$123,307–$184,080 · 7 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization Wit 217 | – | – | – | $99,543$81,793–$125,499 · 7 plans | |
| Ms-Drg 218 218 | – | – | – | $99,543$74,064–$111,947 · 7 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 220 | – | – | – | $80,733$67,047–$98,422 · 7 plans | |
| Cardiac Valve and Other Major Cardiothoracic Procedures Without Cardiac Catheterization 221 | – | – | – | $76,304$57,516–$87,810 · 7 plans | |
| Ms-Drg 222 222 | – | – | – | $110,215only 2 plans | |
| Ms-Drg 223 223 | – | – | – | $83,846only 2 plans | |
| Ms-Drg 224 224 | – | – | – | $95,450only 2 plans | |
| Ms-Drg 225 225 | – | – | – | $73,770only 2 plans | |
| Ms-Drg 226 226 | – | – | – | $88,432only 2 plans | |
| Ms-Drg 227 227 | – | – | – | $70,462only 2 plans | |
| Coronary Bypass with Ptca with Mcc 231 | – | – | – | $129,222$105,403–$149,514 · 7 plans | |
| Ms-Drg 232 232 | – | – | – | $91,782$76,082–$107,802 · 7 plans | |
| Coronary Bypass with Cardiac Catheterization or Open Ablation Without Mcc 234 | – | – | – | $82,700$65,967–$93,900 · 7 plans | |
| Ms-Drg 241 241 | – | – | – | $22,851$19,775–$30,774 · 7 plans | |
| Ms-Drg 245 245 | – | – | – | $75,306$70,273–$86,767 · 7 plans | |
| Ms-Drg 246 246 | – | – | – | $42,139only 2 plans | |
| Ms-Drg 247 247 | – | – | – | $28,011only 2 plans | |
| Ms-Drg 248 248 | – | – | – | $40,039only 2 plans | |
| Ms-Drg 249 249 | – | – | – | $25,960only 2 plans | |
| Percutaneous Cardiovascular Procedures Without Intraluminal Device with Mcc 250 | – | – | – | $35,172$33,045–$47,455 · 7 plans | |
| Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 251 | – | – | – | $24,668$22,166–$30,966 · 7 plans | |
| Other Vascular Procedures Without Cc/Mcc 254 | – | – | – | $27,999$24,102–$30,970 · 7 plans | |
| Ms-Drg 255 255 | – | – | – | $40,836$33,170–$47,540 · 7 plans | |
| Ms-Drg 256 256 | – | – | – | $25,705$21,612–$30,567 · 7 plans | |
| Ms-Drg 257 257 | – | – | – | $16,535$14,789–$19,677 · 7 plans | |
| Ms-Drg 258 258 | – | – | – | $51,857$40,475–$55,585 · 7 plans | |
| Ms-Drg 259 259 | – | – | – | $33,376$27,641–$36,598 · 7 plans | |
| Cardiac Pacemaker Revision Except Device Replacement with Mcc 260 | – | – | – | $52,805$47,007–$61,671 · 7 plans | |
| Cardiac Pacemaker Revision Except Device Replacement with Cc 261 | – | – | – | $29,619$25,720–$31,204 · 7 plans | |
| Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 262 | – | – | – | $24,675$21,979–$26,903 · 7 plans | |
| Ms-Drg 263 263 | – | – | – | $46,286$30,867–$50,465 · 7 plans | |
| Ms-Drg 265 265 | – | – | – | $54,776$43,785–$61,181 · 7 plans | |
| Aortic and Heart Assist Procedures Except Pulsation Balloon with Mcc 268 | – | – | – | $104,125$84,941–$118,063 · 7 plans | |
| Other Major Cardiovascular Procedures Without Cc/Mcc 272 | – | – | – | $38,650$32,376–$43,183 · 7 plans | |
| Cardiac Defibrillator Implant with Cardiac Catheterization and Mcc 275 | – | – | – | $117,693$109,961–$152,424 · 5 plans | |
| Cardiac Defibrillator Implant with Mcc or Carotid Sinus Neurostimulator 276 | – | – | – | $99,144$93,506–$124,032 · 5 plans | |
| Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with Mcc 278 | – | – | – | $84,267$83,067–$91,875 · 5 plans | |
| Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures Without 279 | – | – | – | $59,225$56,128–$59,527 · 5 plans | |
| Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 282 | – | – | – | $11,935$10,498–$15,402 · 7 plans | |
| Acute Myocardial Infarction, Expired with Mcc 283 | – | – | – | $30,004$23,386–$34,237 · 7 plans | |
| Ms-Drg 284 284 | – | – | – | $11,425$10,711–$16,409 · 7 plans | |
| Ms-Drg 285 285 | – | – | – | $9,885$7,849–$11,257 · 7 plans | |
| Ms-Drg 288 288 | – | – | – | $40,969$35,658–$53,440 · 7 plans | |
| Ms-Drg 289 289 | – | – | – | $25,841$21,576–$33,825 · 7 plans | |
| Ms-Drg 290 290 | – | – | – | $15,345$14,500–$24,169 · 7 plans | |
| Heart Failure and Shock Without Cc/Mcc 293 | – | – | – | $9,401$9,033–$12,218 · 7 plans | |
| Ms-Drg 294 294 | – | – | – | $13,888$13,888–$20,842 · 3 plans | |
| Ms-Drg 295 295 | – | – | – | $10,845$10,845–$14,958 · 3 plans | |
| Cardiac Arrest, Unexplained with Mcc 296 | – | – | – | $25,780$19,941–$26,949 · 7 plans | |
| Ms-Drg 297 297 | – | – | – | $10,291$9,186–$13,693 · 7 plans | |
| Ms-Drg 298 298 | – | – | – | $7,512$6,936–$9,152 · 7 plans | |
| Peripheral Vascular Disorders Without Cc/Mcc 301 | – | – | – | $10,896$10,066–$12,834 · 7 plans | |
| Atherosclerosis with Mcc 302 | – | – | – | $19,751$14,552–$22,174 · 7 plans | |
| Atherosclerosis Without Mcc 303 | – | – | – | $10,192$9,264–$11,563 · 7 plans | |
| Hypertension with Mcc 304 | – | – | – | $18,015$14,238–$21,170 · 7 plans | |
| Cardiac Congenital and Valvular Disorders Without Mcc 307 | – | – | – | $15,073$11,386–$16,601 · 7 plans | |
| Angina Pectoris 311 | – | – | – | $10,626$9,472–$11,585 · 7 plans | |
| Chest pain 313 | – | – | – | $10,900$9,458–$11,884 · 7 plans | |
| Other Circulatory System Diagnoses Without Cc/Mcc 316 | – | – | – | $11,259$10,259–$13,287 · 7 plans | |
| Concomitant Left Atrial Appendage Closure and Cardiac Ablation 317 | – | – | – | $110,366$104,883–$138,109 · 5 plans | |
| Ms-Drg 318 318 | – | – | – | $39,980$37,663–$54,467 · 4 plans | |
| Other Endovascular Cardiac Valve Procedures with Mcc 319 | – | – | – | $73,664$70,004–$85,595 · 5 plans | |
| Other Endovascular Cardiac Valve Procedures Without Mcc 320 | – | – | – | $39,701$37,729–$43,474 · 5 plans | |
| Coronary Intravascular Lithotripsy with Intraluminal Device with Mcc 323 | – | – | – | $71,427$67,801–$81,741 · 5 plans | |
| Coronary Intravascular Lithotripsy with Intraluminal Device Without Mcc 324 | – | – | – | $52,010$49,426–$58,692 · 5 plans | |
| Ms-Drg 325 325 | – | – | – | $52,990$48,860–$59,281 · 5 plans | |
| Ms-Drg 332 332 | – | – | – | $59,763$50,026–$80,235 · 7 plans | |
| Ms-Drg 333 333 | – | – | – | $38,336$26,422–$44,318 · 7 plans | |
| Ms-Drg 334 334 | – | – | – | $24,796$17,445–$30,233 · 7 plans | |
| Peritoneal Adhesiolysis with Mcc 335 | – | – | – | $54,060$48,539–$70,667 · 7 plans | |
| Peritoneal Adhesiolysis with Cc 336 | – | – | – | $31,924$30,065–$40,206 · 7 plans | |
| Peritoneal Adhesiolysis Without Cc/Mcc 337 | – | – | – | $23,238$21,592–$27,742 · 7 plans | |
| Ms-Drg 338 338 | – | – | – | $36,378only 2 plans | |
| Ms-Drg 339 339 | – | – | – | $22,713only 2 plans | |
| Ms-Drg 340 340 | – | – | – | $16,192only 2 plans | |
| Ms-Drg 341 341 | – | – | – | $32,817only 2 plans | |
| Ms-Drg 342 342 | – | – | – | $19,914only 2 plans | |
| Ms-Drg 343 343 | – | – | – | $14,332only 2 plans | |
| Ms-Drg 344 344 | – | – | – | $42,631$36,235–$56,328 · 7 plans | |
| Ms-Drg 345 345 | – | – | – | $22,780$20,858–$29,022 · 7 plans | |
| Ms-Drg 346 346 | – | – | – | $18,608$14,913–$22,011 · 7 plans | |
| Anal and Stomal Procedures with Mcc 347 | – | – | – | $37,891$34,645–$46,305 · 7 plans | |
| Ms-Drg 348 348 | – | – | – | $19,814$18,750–$24,090 · 7 plans | |
| Ms-Drg 349 349 | – | – | – | $14,134$13,555–$15,255 · 7 plans | |
| Inguinal and Femoral Hernia Procedures with Mcc 350 | – | – | – | $41,131$32,465–$45,881 · 7 plans | |
| Inguinal and Femoral Hernia Procedures with Cc 351 | – | – | – | $25,163$19,927–$27,391 · 7 plans | |
| Inguinal and Femoral Hernia Procedures Without Cc/Mcc 352 | – | – | – | $17,529$14,096–$19,276 · 7 plans | |
| Hernia Procedures Except Inguinal and Femoral with Mcc 353 | – | – | – | $43,933$39,553–$50,214 · 7 plans | |
| Hernia Procedures Except Inguinal and Femoral with Cc 354 | – | – | – | $25,470$22,955–$28,772 · 7 plans | |
| Hernia Procedures Except Inguinal and Femoral Without Cc/Mcc 355 | – | – | – | $20,362$17,751–$22,200 · 7 plans | |
| Other Digestive System O.r. Procedures with Mcc 356 | – | – | – | $66,503$49,828–$76,821 · 7 plans | |
| Other Digestive System O.r. Procedures with Cc 357 | – | – | – | $35,206$27,615–$41,783 · 7 plans | |
| Ms-Drg 358 358 | – | – | – | $21,163$18,886–$25,483 · 7 plans | |
| Ms-Drg 359 359 | – | – | – | $56,757$53,467–$69,056 · 4 plans | |
| Ms-Drg 360 360 | – | – | – | $39,850$37,540–$46,977 · 4 plans | |
| Major Esophageal Disorders with Mcc 368 | – | – | – | $24,418$23,824–$29,836 · 7 plans | |
| Major Esophageal Disorders with Cc 369 | – | – | – | $15,523$14,747–$19,161 · 7 plans | |
| Ms-Drg 370 370 | – | – | – | $11,567$10,348–$14,714 · 7 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections with Mcc 371 | – | – | – | $26,843$22,962–$34,090 · 7 plans | |
| Major Gastrointestinal Disorders and Peritoneal Infections Without Cc/Mcc 373 | – | – | – | $11,012$10,438–$14,705 · 7 plans | |
| Digestive Malignancy with Mcc 374 | – | – | – | $32,378$26,537–$37,658 · 7 plans | |
| Digestive Malignancy with Cc 375 | – | – | – | $18,312$16,643–$22,814 · 7 plans | |
| Ms-Drg 376 376 | – | – | – | $14,443$12,841–$16,773 · 7 plans | |
| Gastrointestinal Hemorrhage Without Cc/Mcc 379 | – | – | – | $10,405$9,027–$12,817 · 7 plans | |
| Complicated Peptic Ulcer with Mcc 380 | – | – | – | $29,706$25,187–$34,986 · 7 plans | |
| Complicated Peptic Ulcer with Cc 381 | – | – | – | $16,403$14,622–$20,351 · 7 plans | |
| Ms-Drg 382 382 | – | – | – | $12,120$11,074–$15,028 · 7 plans | |
| Ms-Drg 383 383 | – | – | – | $22,790$18,063–$25,576 · 7 plans | |
| Uncomplicated Peptic Ulcer Without Mcc 384 | – | – | – | $12,941$12,020–$15,236 · 7 plans | |
| Inflammatory Bowel Disease with Mcc 385 | – | – | – | $23,954$21,426–$31,710 · 7 plans | |
| Ms-Drg 387 387 | – | – | – | $10,314$10,191–$13,473 · 7 plans | |
| Gastrointestinal Obstruction Without Cc/Mcc 390 | – | – | – | $8,407$8,042–$10,874 · 7 plans | |
| Other Digestive System Diagnoses Without Cc/Mcc 395 | – | – | – | $10,432$9,414–$12,271 · 7 plans | |
| Ms-Drg 397 397 | – | – | – | $39,530$30,585–$47,129 · 5 plans | |
| Appendix Procedures with Cc 398 | – | – | – | $24,983$23,282–$30,007 · 5 plans | |
| Appendix Procedures Without Cc/Mcc 399 | – | – | – | $18,894$17,206–$20,893 · 5 plans | |
| Single Level Combined Anterior and Posterior Spinal Fusion Except Cervical 402 | – | – | – | $66,362$53,205–$83,727 · 5 plans | |
| Pancreas, Liver and Shunt Procedures Without Cc/Mcc 407 | – | – | – | $33,603$26,758–$37,866 · 7 plans | |
| Ms-Drg 408 408 | – | – | – | $58,853$51,645–$74,030 · 7 plans | |
| Ms-Drg 409 409 | – | – | – | $33,977$30,785–$43,719 · 7 plans | |
| Ms-Drg 410 410 | – | – | – | $26,206$23,013–$31,244 · 7 plans | |
| Cholecystectomy with C.d.e. with Mcc 411 | – | – | – | $54,524$43,276–$67,029 · 7 plans | |
| Ms-Drg 412 412 | – | – | – | $34,704$31,350–$44,178 · 7 plans | |
| Ms-Drg 413 413 | – | – | – | $27,408$22,473–$33,171 · 7 plans | |
| Ms-Drg 414 414 | – | – | – | $56,601$46,482–$66,120 · 7 plans | |
| Cholecystectomy Except by Laparoscope Without C.d.e. with Cc 415 | – | – | – | $31,288$26,790–$38,036 · 7 plans | |
| Ms-Drg 416 416 | – | – | – | $22,330$18,806–$24,981 · 7 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. with Mcc 417 | – | – | – | $36,128$31,027–$45,026 · 7 plans | |
| Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 419 | – | – | – | $20,677$17,552–$23,256 · 7 plans | |
| Hepatobiliary Diagnostic Procedures with Mcc 420 | – | – | – | $56,237$52,482–$72,079 · 7 plans | |
| Ms-Drg 421 421 | – | – | – | $28,679$25,020–$35,814 · 7 plans | |
| Ms-Drg 422 422 | – | – | – | $23,100$20,801–$26,900 · 7 plans | |
| Other Hepatobiliary or Pancreas O.r. Procedures with Mcc 423 | – | – | – | $63,881$49,582–$80,702 · 7 plans | |
| Ms-Drg 424 424 | – | – | – | $36,113$29,557–$45,022 · 7 plans | |
| Ms-Drg 425 425 | – | – | – | $24,764$21,393–$29,720 · 7 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Mcc or 426 | – | – | – | $181,914$123,198–$225,307 · 5 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with Cc 427 | – | – | – | $119,149$87,789–$150,969 · 5 plans | |
| Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical Without Cc/ 428 | – | – | – | $92,796$72,811–$117,237 · 5 plans | |
| Ms-Drg 429 429 | – | – | – | $148,711$141,322–$182,245 · 5 plans | |
| Combined Anterior and Posterior Cervical Spinal Fusion Without Mcc 430 | – | – | – | $95,191$76,054–$117,684 · 5 plans | |
| Ms-Drg 434 434 | – | – | – | $11,760$8,815–$13,456 · 7 plans | |
| Malignancy of Hepatobiliary System or Pancreas with Cc 436 | – | – | – | $17,124$15,361–$21,499 · 7 plans | |
| Ms-Drg 437 437 | – | – | – | $14,084$12,443–$17,419 · 7 plans | |
| Disorders of Pancreas Except Malignancy with Mcc 438 | – | – | – | $26,668$22,122–$30,841 · 7 plans | |
| Disorders of Pancreas Except Malignancy with Cc 439 | – | – | – | $12,735$11,989–$17,177 · 7 plans | |
| Disorders of Pancreas Except Malignancy Without Cc/Mcc 440 | – | – | – | $9,407$8,943–$12,181 · 7 plans | |
| Disorders of Liver Except Malignancy, Cirrhosis or Alcoholic Hepatitis with Cc 442 | – | – | – | $14,983$12,831–$18,051 · 7 plans | |
| Ms-Drg 443 443 | – | – | – | $11,549$9,467–$13,459 · 7 plans | |
| Disorders of the Biliary Tract Without Cc/Mcc 446 | – | – | – | $13,575$10,924–$14,439 · 7 plans | |
| Ms-Drg 447 447 | – | – | – | $110,285$86,661–$141,682 · 5 plans | |
| Multiple Level Spinal Fusion Except Cervical Without Mcc 448 | – | – | – | $69,998$54,802–$87,423 · 5 plans | |
| Ms-Drg 450 450 | – | – | – | $87,969$71,139–$95,137 · 5 plans | |
| Single Level Spinal Fusion Except Cervical Without Mcc 451 | – | – | – | $53,320$43,176–$60,249 · 5 plans | |
| Combined Anterior and Posterior Spinal Fusion with Mcc 453 | – | – | – | $126,424only 2 plans | |
| Combined Anterior and Posterior Spinal Fusion with Cc 454 | – | – | – | $84,554only 2 plans | |
| Combined Anterior and Posterior Spinal Fusion Without Cc/Mcc 455 | – | – | – | $66,246only 2 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 456 | – | – | – | $127,219$119,497–$156,570 · 7 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 457 | – | – | – | $90,448$88,547–$107,826 · 7 plans | |
| Spinal Fusion Except Cervical with Spinal Curvature, Malignancy, Infection or Extensive 458 | – | – | – | $69,956$66,591–$89,451 · 7 plans | |
| Spinal Fusion Except Cervical with Mcc 459 | – | – | – | $78,634only 2 plans | |
| Ms-Drg 461 461 | – | – | – | $88,481$63,849–$105,474 · 7 plans | |
| Bilateral or Multiple Major Joint Procedures of Lower Extremity Without Mcc 462 | – | – | – | $42,832$38,879–$53,500 · 7 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 463 | – | – | – | $86,285$65,457–$96,998 · 7 plans | |
| Wound Debridement and Skin Graft Except Hand for Musculoskeletal and Connective Tissue D 465 | – | – | – | $27,609$24,990–$30,989 · 7 plans | |
| Revision of Hip or Knee Replacement with Mcc 466 | – | – | – | $78,805$62,998–$90,796 · 7 plans | |
| Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity with Mcc or Tota 469 | – | – | – | $45,920$41,422–$58,460 · 7 plans | |
| Cervical Spinal Fusion with Mcc 471 | – | – | – | $73,102$60,350–$85,934 · 7 plans | |
| Cervical Spinal Fusion with Cc 472 | – | – | – | $44,601$37,337–$51,708 · 7 plans | |
| Cervical Spinal Fusion Without Cc/Mcc 473 | – | – | – | $36,959$30,140–$40,711 · 7 plans | |
| Amputation for Musculoskeletal System and Connective Tissue Disorders with Mcc 474 | – | – | – | $64,990$50,563–$72,309 · 7 plans | |
| Amputation for Musculoskeletal System and Connective Tissue Disorders with Cc 475 | – | – | – | $34,452$28,489–$39,630 · 7 plans | |
| Ms-Drg 476 476 | – | – | – | $19,480$15,783–$23,142 · 7 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue with Mcc 477 | – | – | – | $52,299$42,435–$62,529 · 7 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue with Cc 478 | – | – | – | $37,230$29,599–$42,690 · 7 plans | |
| Biopsies of Musculoskeletal System and Connective Tissue Without Cc/Mcc 479 | – | – | – | $28,142$23,508–$31,144 · 7 plans | |
| Hip and Femur Procedures Except Major Joint Without Cc/Mcc 482 | – | – | – | $24,971$22,250–$29,066 · 7 plans | |
| Knee Procedures with Principal Diagnosis of Infection with Mcc 485 | – | – | – | $53,266$42,695–$64,412 · 7 plans | |
| Knee Procedures with Principal Diagnosis of Infection with Cc 486 | – | – | – | $31,657$28,502–$39,361 · 7 plans | |
| Knee Procedures with Principal Diagnosis of Infection Without Cc/Mcc 487 | – | – | – | $23,711$21,451–$28,933 · 7 plans | |
| Knee Procedures Without Principal Diagnosis of Infection with Cc/Mcc 488 | – | – | – | $26,474$24,315–$35,944 · 7 plans | |
| Knee Procedures Without Principal Diagnosis of Infection Without Cc/Mcc 489 | – | – | – | $18,434$17,158–$22,725 · 7 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur with Mcc 492 | – | – | – | $55,584$42,946–$60,603 · 7 plans | |
| Lower Extremity and Humerus Procedures Except Hip, Foot and Femur Without Cc/Mcc 494 | – | – | – | $26,677$23,373–$33,119 · 7 plans | |
| Ms-Drg 495 495 | – | – | – | $59,845$39,581–$66,568 · 7 plans | |
| Local Excision and Removal of Internal Fixation Devices Except Hip and Femur with Cc 496 | – | – | – | $27,309$25,997–$33,173 · 7 plans | |
| Local Excision and Removal of Internal Fixation Devices Except Hip and Femur Without Cc/ 497 | – | – | – | $19,010$18,142–$21,969 · 7 plans | |
| Ms-Drg 498 498 | – | – | – | $45,671$32,056–$49,795 · 7 plans | |
| Ms-Drg 499 499 | – | – | – | $23,988$16,734–$33,256 · 7 plans | |
| Soft Tissue Procedures with Mcc 500 | – | – | – | $47,912$38,898–$55,888 · 7 plans | |
| Soft Tissue Procedures with Cc 501 | – | – | – | $26,464$22,509–$30,010 · 7 plans | |
| Soft Tissue Procedures Without Cc/Mcc 502 | – | – | – | $20,376$17,017–$22,215 · 7 plans | |
| Ms-Drg 503 503 | – | – | – | $44,011$32,811–$47,550 · 7 plans | |
| Foot Procedures with Cc 504 | – | – | – | $28,298$22,959–$31,206 · 7 plans | |
| Ms-Drg 505 505 | – | – | – | $22,060$20,392–$29,592 · 7 plans | |
| Ms-Drg 506 506 | – | – | – | $19,800$18,370–$24,487 · 7 plans | |
| Ms-Drg 507 507 | – | – | – | $29,816$24,933–$37,784 · 7 plans | |
| Ms-Drg 508 508 | – | – | – | $24,064$20,499–$25,827 · 7 plans | |
| Ms-Drg 509 509 | – | – | – | $24,352$24,352–$28,720 · 3 plans | |
| Ms-Drg 510 510 | – | – | – | $45,727$32,816–$50,262 · 7 plans | |
| Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures with Cc 511 | – | – | – | $28,921$23,757–$34,322 · 7 plans | |
| Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures Without Cc/Mcc 512 | – | – | – | $20,961$20,015–$27,324 · 7 plans | |
| Hand or Wrist Procedures, Except Major Thumb or Joint Procedures with Cc/Mcc 513 | – | – | – | $23,833$19,911–$26,762 · 7 plans | |
| Ms-Drg 514 514 | – | – | – | $15,477$13,861–$17,087 · 7 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures with Mcc 515 | – | – | – | $48,246$38,386–$58,054 · 7 plans | |
| Other Musculoskeletal System and Connective Tissue O.r. Procedures Without Cc/Mcc 517 | – | – | – | $23,264$19,242–$26,701 · 7 plans | |
| Back and Neck Procedures Except Spinal Fusion with Mcc or Disc Device or Neurostimulator 518 | – | – | – | $56,579$38,044–$61,687 · 7 plans | |
| Back and Neck Procedures Except Spinal Fusion with Cc 519 | – | – | – | $30,281$23,987–$33,015 · 7 plans | |
| Back and Neck Procedures Except Spinal Fusion Without Cc/Mcc 520 | – | – | – | $21,832$17,441–$24,658 · 7 plans | |
| Hip Replacement with Principal Diagnosis of Hip Fracture with Mcc 521 | – | – | – | $47,375$45,021–$60,541 · 5 plans | |
| Ms-Drg 533 533 | – | – | – | $25,876$19,266–$29,982 · 7 plans | |
| Ms-Drg 534 534 | – | – | – | $13,305$10,528–$14,542 · 7 plans | |
| Fractures of Hip and Pelvis with Mcc 535 | – | – | – | $21,160$16,928–$24,923 · 7 plans | |
| Ms-Drg 537 537 | – | – | – | $15,752$13,201–$18,746 · 7 plans | |
| Ms-Drg 538 538 | – | – | – | $11,889$9,440–$12,925 · 7 plans | |
| Osteomyelitis with Mcc 539 | – | – | – | $29,819$24,075–$37,031 · 7 plans | |
| Osteomyelitis with Cc 540 | – | – | – | $19,625$16,510–$24,483 · 7 plans | |
| Ms-Drg 541 541 | – | – | – | $12,734$11,327–$15,746 · 7 plans | |
| Pathological Fractures and Musculoskeletal and Connective Tissue Malignancy Without Cc/M 544 | – | – | – | $12,455$10,720–$15,535 · 7 plans | |
| Connective Tissue Disorders with Mcc 545 | – | – | – | $40,963$31,209–$46,453 · 7 plans | |
| Connective Tissue Disorders with Cc 546 | – | – | – | $18,859$15,250–$20,898 · 7 plans | |
| Connective Tissue Disorders Without Cc/Mcc 547 | – | – | – | $13,802$11,229–$15,663 · 7 plans | |
| Ms-Drg 548 548 | – | – | – | $31,871$27,015–$38,323 · 7 plans | |
| Ms-Drg 549 549 | – | – | – | $18,276$16,125–$21,991 · 7 plans | |
| Ms-Drg 550 550 | – | – | – | $14,428$12,331–$15,871 · 7 plans | |
| Bone Diseases and Arthropathies with Mcc 553 | – | – | – | $21,397$17,345–$24,530 · 7 plans | |
| Signs and Symptoms of Musculoskeletal System and Connective Tissue with Mcc 555 | – | – | – | $21,755$17,123–$23,619 · 7 plans | |
| Tendonitis, Myositis and Bursitis with Mcc 557 | – | – | – | $22,510$19,051–$27,074 · 7 plans | |
| Tendonitis, Myositis and Bursitis Without Mcc 558 | – | – | – | $13,522$10,629–$15,787 · 7 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue with Mcc 559 | – | – | – | $28,233$22,406–$33,201 · 7 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue with Cc 560 | – | – | – | $17,048$14,610–$19,406 · 7 plans | |
| Aftercare, Musculoskeletal System and Connective Tissue Without Cc/Mcc 561 | – | – | – | $12,536$10,530–$13,269 · 7 plans | |
| Fracture, Sprain, Strain and Dislocation Except Femur, Hip, Pelvis and Thigh with Mcc 562 | – | – | – | $22,927$18,542–$26,170 · 7 plans | |
| Other Musculoskeletal System and Connective Tissue Diagnoses with Mcc 564 | – | – | – | $25,478$19,589–$28,792 · 7 plans | |
| Ms-Drg 566 566 | – | – | – | $12,368$10,734–$13,268 · 7 plans | |
| Skin Debridement with Mcc 570 | – | – | – | $44,525$34,196–$57,770 · 7 plans | |
| Skin Debridement with Cc 571 | – | – | – | $25,577$20,819–$31,975 · 7 plans | |
| Ms-Drg 572 572 | – | – | – | $17,354$15,880–$20,422 · 7 plans | |
| Skin Graft for Skin Ulcer or Cellulitis with Mcc 573 | – | – | – | $99,182$53,150–$108,136 · 7 plans | |
| Skin Graft for Skin Ulcer or Cellulitis with Cc 574 | – | – | – | $52,554$38,901–$58,136 · 7 plans | |
| Ms-Drg 575 575 | – | – | – | $24,731$23,188–$30,687 · 7 plans | |
| Ms-Drg 576 576 | – | – | – | $74,253$59,208–$88,484 · 7 plans | |
| Skin Graft Except for Skin Ulcer or Cellulitis with Cc 577 | – | – | – | $40,129$32,230–$43,752 · 7 plans | |
| Ms-Drg 578 578 | – | – | – | $24,319$19,927–$28,451 · 7 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures with Mcc 579 | – | – | – | $49,028$35,045–$56,213 · 7 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures with Cc 580 | – | – | – | $26,160$20,787–$29,302 · 7 plans | |
| Other Skin, Subcutaneous Tissue and Breast Procedures Without Cc/Mcc 581 | – | – | – | $21,616$16,504–$23,820 · 7 plans | |
| Ms-Drg 582 582 | – | – | – | $29,167$19,835–$34,422 · 7 plans | |
| Ms-Drg 583 583 | – | – | – | $26,106$17,379–$31,717 · 7 plans | |
| Ms-Drg 584 584 | – | – | – | $32,408$24,658–$37,914 · 7 plans | |
| Breast Biopsy, Local Excision and Other Breast Procedures Without Cc/Mcc 585 | – | – | – | $29,205$19,695–$34,508 · 7 plans | |
| Skin Ulcers with Mcc 592 | – | – | – | $29,299$19,832–$34,296 · 7 plans | |
| Skin Ulcers with Cc 593 | – | – | – | $17,959$13,799–$21,320 · 7 plans | |
| Ms-Drg 594 594 | – | – | – | $13,122$9,884–$15,417 · 7 plans | |
| Ms-Drg 595 595 | – | – | – | $35,004$28,055–$38,991 · 7 plans | |
| Major Skin Disorders Without Mcc 596 | – | – | – | $16,388$12,850–$17,868 · 7 plans | |
| Malignant Breast Disorders with Mcc 597 | – | – | – | $27,517$23,981–$32,975 · 7 plans | |
| Ms-Drg 598 598 | – | – | – | $17,127$14,742–$20,540 · 7 plans | |
| Ms-Drg 599 599 | – | – | – | $12,102$11,628–$14,830 · 7 plans | |
| Ms-Drg 600 600 | – | – | – | $15,769$12,747–$18,509 · 7 plans | |
| Ms-Drg 601 601 | – | – | – | $9,159$8,035–$11,681 · 7 plans | |
| Trauma to the Skin, Subcutaneous Tissue and Breast with Mcc 604 | – | – | – | $24,298$18,666–$26,731 · 7 plans | |
| Minor Skin Disorders with Mcc 606 | – | – | – | $24,977$18,547–$27,133 · 7 plans | |
| Minor Skin Disorders Without Mcc 607 | – | – | – | $13,722$10,591–$14,961 · 7 plans | |
| Adrenal and Pituitary Procedures with Cc/Mcc 614 | – | – | – | $35,577$31,023–$43,288 · 7 plans | |
| Adrenal and Pituitary Procedures Without Cc/Mcc 615 | – | – | – | $23,097$19,742–$27,704 · 7 plans | |
| Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders with Mcc 616 | – | – | – | $52,886$48,369–$75,195 · 7 plans | |
| Ms-Drg 618 618 | – | – | – | $21,472$15,189–$25,563 · 7 plans | |
| Ms-Drg 619 619 | – | – | – | $43,712$40,530–$57,144 · 7 plans | |
| O.r. Procedures for Obesity with Cc 620 | – | – | – | $24,624$24,328–$31,951 · 7 plans | |
| O.r. Procedures for Obesity Without Cc/Mcc 621 | – | – | – | $22,836$20,632–$27,197 · 7 plans | |
| Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 622 | – | – | – | $53,883$43,886–$62,656 · 7 plans | |
| Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metabolic Disorders Wit 623 | – | – | – | $27,158$23,915–$34,073 · 7 plans | |
| Ms-Drg 624 624 | – | – | – | $18,953$16,054–$21,854 · 7 plans | |
| Ms-Drg 625 625 | – | – | – | $45,877$35,402–$50,959 · 7 plans | |
| Thyroid, Parathyroid and Thyroglossal Procedures with Cc 626 | – | – | – | $24,472$20,301–$25,023 · 7 plans | |
| Thyroid, Parathyroid and Thyroglossal Procedures Without Cc/Mcc 627 | – | – | – | $18,300$14,396–$21,925 · 7 plans | |
| Other Endocrine, Nutritional and Metabolic O.r. Procedures with Mcc 628 | – | – | – | $56,420$44,780–$65,129 · 7 plans | |
| Other Endocrine, Nutritional and Metabolic O.r. Procedures with Cc 629 | – | – | – | $32,985$28,545–$41,336 · 7 plans | |
| Ms-Drg 630 630 | – | – | – | $22,095$19,408–$27,476 · 7 plans | |
| Diabetes Without Cc/Mcc 639 | – | – | – | $9,404$8,532–$10,988 · 7 plans | |
| Inborn and Other Disorders of Metabolism 642 | – | – | – | $21,529$16,058–$23,473 · 7 plans | |
| Endocrine Disorders Without Cc/Mcc 645 | – | – | – | $11,631$9,724–$13,818 · 7 plans | |
| Kidney Transplant with Hemodialysis with Mcc 650 | – | – | – | $77,601$72,460–$77,601 · 3 plans | |
| Kidney Transplant with Hemodialysis Without Mcc 651 | – | – | – | $61,167$57,115–$61,167 · 3 plans | |
| Kidney Transplant 652 | – | – | – | $48,891$43,551–$53,306 · 5 plans | |
| Major Bladder Procedures with Mcc 653 | – | – | – | $85,771$72,076–$110,205 · 7 plans | |
| Major Bladder Procedures with Cc 654 | – | – | – | $42,379$36,490–$53,132 · 7 plans | |
| Major Bladder Procedures Without Cc/Mcc 655 | – | – | – | $34,150$27,159–$38,451 · 7 plans | |
| Kidney and Ureter Procedures for Neoplasm with Mcc 656 | – | – | – | $48,200$42,711–$59,848 · 7 plans | |
| Kidney and Ureter Procedures for Neoplasm Without Cc/Mcc 658 | – | – | – | $23,776$20,879–$27,259 · 7 plans | |
| Ms-Drg 662 662 | – | – | – | $50,533$40,013–$56,610 · 7 plans | |
| Minor Bladder Procedures with Cc 663 | – | – | – | $25,092$23,418–$29,981 · 7 plans | |
| Ms-Drg 664 664 | – | – | – | $17,314$16,708–$21,309 · 7 plans | |
| Prostatectomy with Mcc 665 | – | – | – | $51,518$41,016–$56,225 · 7 plans | |
| Ms-Drg 666 666 | – | – | – | $28,874$23,157–$33,158 · 7 plans | |
| Ms-Drg 667 667 | – | – | – | $17,786$13,499–$18,838 · 7 plans | |
| Transurethral Procedures with Mcc 668 | – | – | – | $45,689$34,714–$48,258 · 7 plans | |
| Ms-Drg 670 670 | – | – | – | $15,581$13,402–$16,315 · 7 plans | |
| Ms-Drg 671 671 | – | – | – | $29,628$20,510–$31,912 · 7 plans | |
| Ms-Drg 672 672 | – | – | – | $17,155$13,905–$18,643 · 7 plans | |
| Other Kidney and Urinary Tract Procedures with Cc 674 | – | – | – | $35,404$30,604–$41,807 · 7 plans | |
| Ms-Drg 675 675 | – | – | – | $27,093$21,881–$28,455 · 7 plans | |
| Renal Failure Without Cc/Mcc 684 | – | – | – | $9,088$8,214–$12,255 · 7 plans | |
| Ms-Drg 685 685 | – | – | – | $14,323only 2 plans | |
| Kidney and Urinary Tract Neoplasms with Mcc 686 | – | – | – | $29,638$23,002–$31,886 · 7 plans | |
| Kidney and Urinary Tract Neoplasms with Cc 687 | – | – | – | $15,863$14,886–$19,661 · 7 plans | |
| Ms-Drg 688 688 | – | – | – | $11,964$11,693–$13,720 · 7 plans | |
| Ms-Drg 691 691 | – | – | – | $21,334only 2 plans | |
| Ms-Drg 692 692 | – | – | – | $16,064only 2 plans | |
| Ms-Drg 693 693 | – | – | – | $22,192$19,127–$26,353 · 7 plans | |
| Urinary Stones Without Mcc 694 | – | – | – | $11,834$10,378–$13,413 · 7 plans | |
| Ms-Drg 695 695 | – | – | – | $18,879$15,811–$23,549 · 7 plans | |
| Kidney and Urinary Tract Signs and Symptoms Without Mcc 696 | – | – | – | $10,431$9,634–$12,285 · 7 plans | |
| Ms-Drg 697 697 | – | – | – | $16,317$13,994–$18,696 · 7 plans | |
| Other Kidney and Urinary Tract Diagnoses Without Cc/Mcc 700 | – | – | – | $11,387$10,615–$13,141 · 7 plans | |
| Major Male Pelvic Procedures with Cc/Mcc 707 | – | – | – | $30,283$23,965–$33,803 · 7 plans | |
| Major Male Pelvic Procedures Without Cc/Mcc 708 | – | – | – | $25,323$18,577–$25,666 · 7 plans | |
| Ms-Drg 709 709 | – | – | – | $38,411$30,196–$40,937 · 7 plans | |
| Ms-Drg 710 710 | – | – | – | $23,128$20,163–$27,261 · 7 plans | |
| Ms-Drg 711 711 | – | – | – | $34,395$26,775–$41,281 · 7 plans | |
| Ms-Drg 712 712 | – | – | – | $17,415$12,709–$19,715 · 7 plans | |
| Transurethral Prostatectomy Without Cc/Mcc 714 | – | – | – | $16,008$12,084–$17,453 · 7 plans | |
| Ms-Drg 715 715 | – | – | – | $36,868$28,783–$38,192 · 7 plans | |
| Ms-Drg 716 716 | – | – | – | $22,269$19,118–$25,220 · 7 plans | |
| Other Male Reproductive System O.r. Procedures Except Malignancy with Cc/Mcc 717 | – | – | – | $28,620$24,210–$34,346 · 7 plans | |
| Ms-Drg 718 718 | – | – | – | $16,864$16,014–$22,169 · 7 plans | |
| Malignancy, Male Reproductive System with Mcc 722 | – | – | – | $29,871$23,120–$34,023 · 7 plans | |
| Ms-Drg 723 723 | – | – | – | $18,861$15,188–$21,495 · 7 plans | |
| Ms-Drg 724 724 | – | – | – | $10,488$9,762–$13,537 · 7 plans | |
| Ms-Drg 725 725 | – | – | – | $19,315$17,146–$23,282 · 7 plans | |
| Benign Prostatic Hypertrophy Without Mcc 726 | – | – | – | $11,917$10,225–$14,404 · 7 plans | |
| Ms-Drg 727 727 | – | – | – | $24,477$19,421–$28,366 · 7 plans | |
| Inflammation of the Male Reproductive System Without Mcc 728 | – | – | – | $12,281$10,874–$14,032 · 7 plans | |
| Ms-Drg 729 729 | – | – | – | $17,475$14,331–$21,600 · 7 plans | |
| Ms-Drg 730 730 | – | – | – | $11,092$8,944–$12,305 · 7 plans | |
| Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy with Cc/Mcc 734 | – | – | – | $32,246$28,654–$41,370 · 7 plans | |
| Ms-Drg 735 735 | – | – | – | $22,209$17,591–$23,494 · 7 plans | |
| Ms-Drg 736 736 | – | – | – | $59,000$51,398–$80,224 · 7 plans | |
| Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy with Cc 737 | – | – | – | $31,195$25,999–$37,310 · 7 plans | |
| Ms-Drg 738 738 | – | – | – | $22,232$18,693–$24,539 · 7 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Mcc 739 | – | – | – | $58,205$46,411–$66,610 · 7 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy with Cc 740 | – | – | – | $28,558$22,924–$30,568 · 7 plans | |
| Uterine and Adnexa Procedures for Non-Ovarian and Non-Adnexal Malignancy Without Cc/Mcc 741 | – | – | – | $21,559$17,026–$23,539 · 7 plans | |
| Uterine and Adnexa Procedures for Non-Malignancy with Cc/Mcc 742 | – | – | – | $27,777$21,859–$30,285 · 7 plans | |
| Uterine and Adnexa Procedures for Non-Malignancy Without Cc/Mcc 743 | – | – | – | $18,220$14,575–$20,479 · 7 plans | |
| D&c, Conization, Laparoscopy and Tubal Interruption with Cc/Mcc 744 | – | – | – | $30,067$21,444–$33,822 · 7 plans | |
| Ms-Drg 745 745 | – | – | – | $16,084$13,878–$18,775 · 7 plans | |
| Vagina, Cervix and Vulva Procedures with Cc/Mcc 746 | – | – | – | $26,298$21,063–$28,672 · 7 plans | |
| Vagina, Cervix and Vulva Procedures Without Cc/Mcc 747 | – | – | – | $13,857$12,610–$15,769 · 7 plans | |
| Female Reproductive System Reconstructive Procedures 748 | – | – | – | $21,002$17,063–$24,136 · 7 plans | |
| Ms-Drg 749 749 | – | – | – | $38,871$33,099–$46,880 · 7 plans | |
| Ms-Drg 750 750 | – | – | – | $22,342$17,483–$25,136 · 7 plans | |
| Malignancy, Female Reproductive System with Mcc 754 | – | – | – | $27,882$23,816–$33,396 · 7 plans | |
| Malignancy, Female Reproductive System with Cc 755 | – | – | – | $16,468$14,871–$20,085 · 7 plans | |
| Ms-Drg 756 756 | – | – | – | $13,685$8,904–$15,854 · 7 plans | |
| Ms-Drg 757 757 | – | – | – | $23,635$19,621–$30,462 · 7 plans | |
| Ms-Drg 758 758 | – | – | – | $14,821$12,997–$18,887 · 7 plans | |
| Ms-Drg 759 759 | – | – | – | $10,046$9,745–$13,192 · 7 plans | |
| Ms-Drg 760 760 | – | – | – | $15,253$11,686–$16,831 · 7 plans | |
| Ms-Drg 761 761 | – | – | – | $9,000$8,614–$9,981 · 7 plans | |
| Ms-Drg 765 765 | – | – | – | $19,848only 2 plans | |
| Ms-Drg 766 766 | – | – | – | $19,848only 2 plans | |
| Ms-Drg 767 767 | – | – | – | $13,874only 2 plans | |
| Ms-Drg 768 768 | – | – | – | $12,171$7,852–$17,688 · 7 plans | |
| Ms-Drg 769 769 | – | – | – | $25,582$22,004–$27,892 · 7 plans | |
| Ms-Drg 770 770 | – | – | – | $14,311$10,829–$16,550 · 7 plans | |
| Ms-Drg 774 774 | – | – | – | $13,874only 2 plans | |
| Ms-Drg 775 775 | – | – | – | $13,874only 2 plans | |
| Ms-Drg 776 776 | – | – | – | $10,806$8,600–$12,045 · 7 plans | |
| Ms-Drg 777 777 | – | – | – | $12,040only 2 plans | |
| Ms-Drg 778 778 | – | – | – | $8,562only 2 plans | |
| Ms-Drg 779 779 | – | – | – | $10,627$8,471–$11,770 · 7 plans | |
| Ms-Drg 780 780 | – | – | – | $7,005only 2 plans | |
| Ms-Drg 781 781 | – | – | – | $11,826only 2 plans | |
| Ms-Drg 782 782 | – | – | – | $8,600only 2 plans | |
| Ms-Drg 783 783 | – | – | – | $12,171$9,007–$40,523 · 5 plans | |
| Ms-Drg 784 784 | – | – | – | $12,171$8,498–$17,498 · 5 plans | |
| Ms-Drg 785 785 | – | – | – | $12,171$7,662–$15,809 · 5 plans | |
| C-section, with major complications 786 | – | – | – | $12,171$8,937–$27,226 · 5 plans | |
| C-section, with complications 787 | – | – | – | $12,171$8,464–$18,434 · 5 plans | |
| C-section 788 | – | – | – | $12,171$7,655–$15,826 · 5 plans | |
| Ms-Drg 789 789 | – | – | – | $15,873$1,018–$36,729 · 7 plans | |
| Ms-Drg 790 790 | – | – | – | $47,201$1,018–$98,102 · 7 plans | |
| Ms-Drg 791 791 | – | – | – | $26,775$1,018–$66,997 · 7 plans | |
| Ms-Drg 792 792 | – | – | – | $8,897$1,018–$43,136 · 7 plans | |
| Ms-Drg 793 793 | – | – | – | $11,556$1,018–$68,823 · 7 plans | |
| Ms-Drg 794 794 | – | – | – | $4,421$1,018–$33,497 · 7 plans | |
| Newborn care (healthy baby) 795 | – | – | – | $3,298$1,018–$3,797 · 7 plans | |
| Ms-Drg 796 796 | – | – | – | $18,182$9,290–$19,262 · 5 plans | |
| Ms-Drg 797 797 | – | – | – | $12,171$9,214–$16,512 · 5 plans | |
| Ms-Drg 798 798 | – | – | – | $12,171$8,499–$15,798 · 5 plans | |
| Ms-Drg 799 799 | – | – | – | $68,563$60,238–$85,982 · 7 plans | |
| Ms-Drg 800 800 | – | – | – | $42,532$35,384–$49,957 · 7 plans | |
| Ms-Drg 801 801 | – | – | – | $31,007$22,684–$33,071 · 7 plans | |
| Ms-Drg 802 802 | – | – | – | $65,140$42,702–$69,006 · 7 plans | |
| Ms-Drg 803 803 | – | – | – | $29,908$24,716–$33,658 · 7 plans | |
| Ms-Drg 804 804 | – | – | – | $20,528$16,177–$22,522 · 7 plans | |
| Vaginal birth, with major complications 805 | – | – | – | $12,171$7,610–$17,813 · 5 plans | |
| Vaginal birth, with complications 806 | – | – | – | $12,171$7,302–$12,445 · 5 plans | |
| Vaginal birth 807 | – | – | – | $11,128$6,659–$11,754 · 5 plans | |
| Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 808 | – | – | – | $33,425$28,179–$39,044 · 7 plans | |
| Major Hematological and Immunological Diagnoses Except Sickle Cell Crisis and Coagulatio 809 | – | – | – | $19,164$16,148–$22,681 · 7 plans | |
| Ms-Drg 810 810 | – | – | – | $15,844$12,847–$18,122 · 7 plans | |
| Reticuloendothelial and Immunity Disorders with Mcc 814 | – | – | – | $32,196$23,357–$35,103 · 7 plans | |
| Reticuloendothelial and Immunity Disorders with Cc 815 | – | – | – | $15,351$13,638–$18,645 · 7 plans | |
| Ms-Drg 816 816 | – | – | – | $10,432$9,689–$12,544 · 7 plans | |
| Ms-Drg 817 817 | – | – | – | $27,862$23,978–$33,198 · 5 plans | |
| Ms-Drg 818 818 | – | – | – | $17,400$15,616–$18,794 · 5 plans | |
| Ms-Drg 819 819 | – | – | – | $13,018$11,062–$14,193 · 5 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures with Mcc 820 | – | – | – | $88,787$70,626–$106,726 · 7 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures with Cc 821 | – | – | – | $36,950$30,849–$43,525 · 7 plans | |
| Lymphoma and Leukemia with Major O.r. Procedures Without Cc/Mcc 822 | – | – | – | $19,873$16,712–$24,395 · 7 plans | |
| Lymphoma and Non-Acute Leukemia with Other Procedures with Mcc 823 | – | – | – | $69,409$56,365–$80,775 · 7 plans | |
| Lymphoma and Non-Acute Leukemia with Other Procedures with Cc 824 | – | – | – | $37,396$28,908–$42,014 · 7 plans | |
| Ms-Drg 825 825 | – | – | – | $22,273$17,305–$24,532 · 7 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 826 | – | – | – | $77,211$68,010–$92,643 · 7 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 827 | – | – | – | $38,148$31,270–$43,869 · 7 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.r. Procedur 828 | – | – | – | $26,938$21,623–$28,123 · 7 plans | |
| Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Other Procedures Wi 829 | – | – | – | $47,839$37,071–$56,284 · 7 plans | |
| Ms-Drg 830 830 | – | – | – | $23,319$17,214–$25,433 · 7 plans | |
| Ms-Drg 831 831 | – | – | – | $18,205$13,155–$19,848 · 5 plans | |
| Ms-Drg 832 832 | – | – | – | $10,924$8,860–$11,911 · 5 plans | |
| Ms-Drg 833 833 | – | – | – | $7,916$6,121–$8,631 · 5 plans | |
| Acute Leukemia with Mcc 834 | – | – | – | $90,615$71,610–$109,130 · 7 plans | |
| Acute Leukemia with Cc 835 | – | – | – | $34,428$27,989–$50,807 · 7 plans | |
| Ms-Drg 836 836 | – | – | – | $20,129$18,470–$28,088 · 7 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis or with High Dose Chemotherapy a 837 | – | – | – | $74,318$66,659–$102,668 · 7 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis with Cc or High Dose Chemotherap 838 | – | – | – | $31,601$26,721–$46,100 · 7 plans | |
| Chemotherapy with Acute Leukemia As Secondary Diagnosis Without Cc/Mcc 839 | – | – | – | $21,859$17,277–$26,526 · 7 plans | |
| Lymphoma and Non-Acute Leukemia with Cc 841 | – | – | – | $26,928$21,623–$31,614 · 7 plans | |
| Lymphoma and Non-Acute Leukemia Without Cc/Mcc 842 | – | – | – | $16,677$15,218–$21,264 · 7 plans | |
| Other Myeloproliferative Disorders or Poorly Differentiated Neoplastic Diagnoses with Mc 843 | – | – | – | $32,926$23,796–$36,249 · 7 plans | |
| Ms-Drg 844 844 | – | – | – | $19,360$16,284–$22,453 · 7 plans | |
| Ms-Drg 845 845 | – | – | – | $14,056$12,351–$16,978 · 7 plans | |
| Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Mcc 846 | – | – | – | $39,248$30,597–$44,050 · 7 plans | |
| Chemotherapy Without Acute Leukemia As Secondary Diagnosis with Cc 847 | – | – | – | $19,805$15,922–$21,593 · 7 plans | |
| Ms-Drg 848 848 | – | – | – | $12,859$11,313–$15,297 · 7 plans | |
| Radiotherapy 849 | – | – | – | $41,019$23,937–$45,518 · 7 plans | |
| Ms-Drg 850 850 | – | – | – | $142,932$135,831–$182,732 · 5 plans | |
| Ms-Drg 855 855 | – | – | – | $22,666$19,292–$30,497 · 7 plans | |
| Postoperative or Post-Traumatic Infections with O.r. Procedures with Cc 857 | – | – | – | $32,420$25,754–$38,936 · 7 plans | |
| Ms-Drg 858 858 | – | – | – | $21,087$17,927–$25,538 · 7 plans | |
| Postoperative and Post-Traumatic Infections Without Mcc 863 | – | – | – | $15,107$13,129–$18,180 · 7 plans | |
| Fever and Inflammatory Conditions 864 | – | – | – | $13,439$11,937–$15,924 · 7 plans | |
| Viral Illness with Mcc 865 | – | – | – | $22,683$19,394–$27,838 · 7 plans | |
| Viral Illness Without Mcc 866 | – | – | – | $13,165$10,758–$14,407 · 7 plans | |
| Other Infectious and Parasitic Diseases Diagnoses with Mcc 867 | – | – | – | $31,855$28,034–$40,979 · 7 plans | |
| Other Infectious and Parasitic Diseases Diagnoses with Cc 868 | – | – | – | $15,610$14,383–$19,529 · 7 plans | |
| Ms-Drg 869 869 | – | – | – | $11,782$10,885–$13,835 · 7 plans | |
| Septicemia or Severe Sepsis with Mv >96 Hours 870 | – | – | – | $104,638$79,298–$117,911 · 7 plans | |
| O.r. Procedures with Principal Diagnosis of Mental Illness 876 | – | – | – | $61,152$45,999–$64,786 · 6 plans | |
| Depressive Neuroses 881 | – | – | – | $12,288$8,695–$15,530 · 6 plans | |
| Neuroses Except Depressive 882 | – | – | – | $13,509$8,833–$17,724 · 6 plans | |
| Disorders of Personality and Impulse Control 883 | – | – | – | $24,583$15,895–$32,455 · 6 plans | |
| Ms-Drg 886 886 | – | – | – | $27,578$14,485–$34,255 · 6 plans | |
| Ms-Drg 887 887 | – | – | – | $16,944$14,569–$18,788 · 6 plans | |
| Alcohol, Drug Abuse or Dependence, Left Ama 894 | – | – | – | $7,474$5,092–$10,182 · 7 plans | |
| Alcohol, Drug Abuse or Dependence with Rehabilitation Therapy 895 | – | – | – | $21,431$11,873–$25,543 · 7 plans | |
| Alcohol, Drug Abuse or Dependence Without Rehabilitation Therapy with Mcc 896 | – | – | – | $26,419$21,818–$29,227 · 7 plans | |
| Ms-Drg 901 901 | – | – | – | $63,532$54,319–$76,017 · 7 plans | |
| Wound Debridements for Injuries with Cc 902 | – | – | – | $28,984$25,098–$33,650 · 7 plans | |
| Ms-Drg 903 903 | – | – | – | $17,707$16,234–$20,229 · 7 plans | |
| Skin Grafts for Injuries with Cc/Mcc 904 | – | – | – | $55,607$42,663–$61,665 · 7 plans | |
| Ms-Drg 905 905 | – | – | – | $23,633$19,575–$26,844 · 7 plans | |
| Ms-Drg 906 906 | – | – | – | $24,933$22,644–$29,090 · 7 plans | |
| Other O.r. Procedures for Injuries Without Cc/Mcc 909 | – | – | – | $19,873$18,708–$22,798 · 7 plans | |
| Traumatic Injury with Mcc 913 | – | – | – | $26,571$18,514–$28,121 · 7 plans | |
| Traumatic Injury Without Mcc 914 | – | – | – | $13,406$11,422–$14,616 · 7 plans | |
| Ms-Drg 915 915 | – | – | – | $25,458$21,020–$27,756 · 7 plans | |
| Allergic Reactions Without Mcc 916 | – | – | – | $9,552$8,454–$10,998 · 7 plans | |
| Poisoning and Toxic Effects of Drugs with Mcc 917 | – | – | – | $23,744$18,802–$27,760 · 7 plans | |
| Poisoning and Toxic Effects of Drugs Without Mcc 918 | – | – | – | $12,551$10,036–$14,147 · 7 plans | |
| Complications of Treatment Without Cc/Mcc 921 | – | – | – | $10,422$9,689–$12,095 · 7 plans | |
| Other Injury, Poisoning and Toxic Effect Diagnoses with Mcc 922 | – | – | – | $28,674$19,834–$29,049 · 7 plans | |
| Other Injury, Poisoning and Toxic Effect Diagnoses Without Mcc 923 | – | – | – | $13,296$11,029–$16,798 · 7 plans | |
| Ms-Drg 927 927 | – | – | – | $299,098$219,302–$340,874 · 7 plans | |
| Full Thickness Burn with Skin Graft or Inhalation Injury with Cc/Mcc 928 | – | – | – | $108,314$61,777–$118,391 · 7 plans | |
| Ms-Drg 929 929 | – | – | – | $46,309$29,651–$53,162 · 7 plans | |
| Ms-Drg 933 933 | – | – | – | $57,781$42,725–$62,998 · 7 plans | |
| Full Thickness Burn Without Skin Graft or Inhalation Injury 934 | – | – | – | $33,466$23,205–$37,466 · 7 plans | |
| Non-Extensive Burns 935 | – | – | – | $26,374$20,236–$34,002 · 7 plans | |
| Ms-Drg 939 939 | – | – | – | $57,379$45,647–$59,891 · 7 plans | |
| O.r. Procedures with Diagnoses of Other Contact with Health Services with Cc 940 | – | – | – | $35,313$30,945–$38,572 · 7 plans | |
| O.r. Procedures with Diagnoses of Other Contact with Health Services Without Cc/Mcc 941 | – | – | – | $24,688$22,759–$33,469 · 7 plans | |
| Rehabilitation with Cc/Mcc 945 | – | – | – | $23,444$11,281–$26,945 · 7 plans | |
| Rehabilitation Without Cc/Mcc 946 | – | – | – | $17,361$10,321–$19,657 · 7 plans | |
| Signs and Symptoms with Mcc 947 | – | – | – | $19,217$15,858–$21,706 · 7 plans | |
| Aftercare with Cc/Mcc 949 | – | – | – | $18,011$15,751–$19,835 · 7 plans | |
| Aftercare Without Cc/Mcc 950 | – | – | – | $11,089$10,018–$12,311 · 7 plans | |
| Other Factors Influencing Health Status 951 | – | – | – | $9,177$7,642–$13,142 · 7 plans | |
| Ms-Drg 955 955 | – | – | – | $109,151$78,532–$111,102 · 7 plans | |
| Other O.r. Procedures for Multiple Significant Trauma with Mcc 957 | – | – | – | $115,358$94,962–$127,210 · 7 plans | |
| Other O.r. Procedures for Multiple Significant Trauma with Cc 958 | – | – | – | $63,794$55,632–$72,660 · 7 plans | |
| Ms-Drg 959 959 | – | – | – | $47,386$35,484–$49,813 · 7 plans | |
| Other Multiple Significant Trauma with Mcc 963 | – | – | – | $43,919$35,276–$52,025 · 7 plans | |
| Other Multiple Significant Trauma with Cc 964 | – | – | – | $23,202$19,148–$29,098 · 7 plans | |
| Ms-Drg 965 965 | – | – | – | $14,578$13,528–$17,913 · 7 plans | |
| Ms-Drg 969 969 | – | – | – | $101,037$70,966–$117,965 · 7 plans | |
| Ms-Drg 970 970 | – | – | – | $43,532$33,868–$52,959 · 7 plans | |
| Hiv with Major Related Condition with Mcc 974 | – | – | – | $46,875$36,499–$50,744 · 7 plans | |
| Hiv with Major Related Condition with Cc 975 | – | – | – | $21,375$18,253–$27,354 · 7 plans | |
| Ms-Drg 976 976 | – | – | – | $14,764$13,573–$18,272 · 7 plans | |
| Ms-Drg 977 977 | – | – | – | $20,923$17,480–$24,822 · 7 plans | |
| Extensive O.r. Procedures Unrelated to Principal Diagnosis Without Cc/Mcc 983 | – | – | – | $25,948$21,945–$34,206 · 7 plans | |
| Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Mcc 987 | – | – | – | $51,903$42,473–$63,674 · 7 plans | |
| Non-Extensive O.r. Procedures Unrelated to Principal Diagnosis with Cc 988 | – | – | – | $24,882$22,782–$32,510 · 7 plans | |
| Ms-Drg 989 989 | – | – | – | $18,155$14,976–$21,386 · 7 plans | |
| Ms-Drg 998 998 | – | – | – | Not in dollars (1 plan) |
Outpatient procedures and tests
The hospital's facility charge only; doctors usually bill separately.
| Procedure | List price | Cash price | Insurers (median) |
|---|---|---|---|
| Doctor and ER visits | |||
| Child checkup, established patient, age 5 to 11 CPT 99393 | $259 | $215 | $82$71–$134 · 10 plans |
| Critical care, first hour CPT 99291 | $5,670 | $4,706 | $1,594$1,128–$2,799 · 11 plans |
| Emergency room visit, highest level CPT 99285 | $4,068 | $3,376 | $1,144$1,056–$2,037 · 11 plans |
| Emergency room visit, level 1 (minor) CPT 99281 | $586 | $486 | $157$123–$1,128 · 11 plans |
| Emergency room visit, level 2 CPT 99282 | $788 | $654 | $275$216–$1,128 · 11 plans |
| Emergency room visit, level 3 CPT 99283 | $1,645 | $1,365 | $574$450–$1,128 · 11 plans |
| Emergency room visit, level 4 CPT 99284 | $2,896 | $2,404 | $996$784–$1,647 · 11 plans |
| Office visit, established patient, level 1 (nurse visit) CPT 99211 | $184 | $153 | $58$50–$95 · 10 plans |
| Office visit, established patient, level 2 CPT 99212 | $218 | $181 | $69$59–$113 · 10 plans |
| Office visit, established patient, level 3 CPT 99213 | $322 | $267 | $102$88–$167 · 10 plans |
| Office visit, established patient, level 4 CPT 99214 | $535 | $444 | $169$146–$277 · 10 plans |
| Office visit, established patient, level 5 CPT 99215 | $857 | $711 | $271$233–$444 · 10 plans |
| Office visit, new patient, level 2 (short) CPT 99202 | $425 | $353 | $135$116–$220 · 10 plans |
| Office visit, new patient, level 3 CPT 99203 | $654 | $543 | $207$178–$339 · 10 plans |
| Office visit, new patient, level 4 CPT 99204 | $972 | $807 | $308$265–$503 · 10 plans |
| Office visit, new patient, level 5 (longest) CPT 99205 | $1,247 | $1,035 | $395$340–$646 · 10 plans |
| Teen checkup, established patient, age 12 to 17 CPT 99394 | $281 | $233 | $89$77–$145 · 10 plans |
| Yearly checkup, established patient, age 18 to 39 CPT 99395 | $281 | $233 | $89$77–$145 · 10 plans |
| Yearly checkup, established patient, age 40 to 64 CPT 99396 | $329 | $273 | $104$90–$170 · 10 plans |
| Yearly checkup, established patient, age 65 and over CPT 99397 | $344 | $286 | $109$94–$178 · 10 plans |
| Yearly checkup, new patient, age 18 to 39 CPT 99385 | $317 | $263 | $100$86–$164 · 10 plans |
| Yearly checkup, new patient, age 40 to 64 CPT 99386 | $352 | $292 | $111$96–$182 · 10 plans |
| Yearly checkup, new patient, age 65 and over CPT 99387 | $382 | $317 | $121$104–$198 · 10 plans |
| Scans and imaging | |||
| Barium swallow X-ray (esophagus) CPT 74220 | $1,252 | $1,039 | $352$228–$437 · 11 plans |
| Bone density scan (DEXA) CPT 77080 | $878 | $729 | $254$228–$353 · 11 plans |
| Bone scan, whole body CPT 78306 | $6,725 | $5,582 | $1,841$688–$2,313 · 11 plans |
| Breast ultrasound, complete CPT 76641 | $723 | $600 | $209$188–$353 · 11 plans |
| Breast ultrasound, limited CPT 76642 | $555 | $461 | $176$152–$292 · 11 plans |
| Chest X-ray, one view CPT 71045 | $637 | $529 | $174$88–$222 · 11 plans |
| Chest X-ray, two views CPT 71046 | $763 | $633 | $209$116–$266 · 11 plans |
| CT angiogram of the chest CPT 71275 | $6,274 | $5,207 | $1,718$1,025–$2,190 · 11 plans |
| CT angiogram of the heart CPT 75574 | $4,081 | $3,387 | $1,179$1,059–$1,424 · 11 plans |
| CT heart scan for calcium score CPT 75571 | $683 | $567 | $235$187–$699 · 11 plans |
| CT scan of the abdomen and pelvis, with and without contrast CPT 74178 | $13,832 | $11,481 | $3,786$1,186–$4,758 · 11 plans |
| CT scan of the abdomen and pelvis, with contrast CPT 74177 | $10,584 | $8,785 | $2,897$1,080–$3,641 · 11 plans |
| CT scan of the abdomen and pelvis, without contrast CPT 74176 | $7,456 | $6,188 | $2,041$803–$2,565 · 11 plans |
| CT scan of the abdomen, with contrast CPT 74160 | $5,694 | $4,726 | $1,559$820–$1,987 · 11 plans |
| CT scan of the abdomen, without contrast CPT 74150 | $4,038 | $3,352 | $1,105$696–$1,389 · 11 plans |
| CT scan of the chest, with contrast CPT 71260 | $5,906 | $4,902 | $1,617$838–$2,032 · 11 plans |
| CT scan of the chest, without contrast CPT 71250 | $4,249 | $3,527 | $1,163$717–$1,462 · 11 plans |
| CT scan of the head, without contrast CPT 70450 | $3,152 | $2,616 | $863$572–$1,100 · 11 plans |
| CT scan of the lower back, without contrast CPT 72131 | $4,249 | $3,527 | $1,163$717–$1,462 · 11 plans |
| CT scan of the neck spine, without contrast CPT 72125 | $4,249 | $3,527 | $1,163$717–$1,462 · 11 plans |
| CT scan of the pelvis, with contrast CPT 72193 | $4,889 | $4,058 | $1,338$805–$1,706 · 11 plans |
| CT scan of the sinuses, without contrast CPT 70486 | $4,592 | $3,811 | $1,257$603–$1,580 · 11 plans |
| Detailed pregnancy ultrasound (anatomy scan) CPT 76811 | $3,709 | $3,078 | $1,015$434–$1,276 · 11 plans |
| Diagnostic mammogram, both breasts CPT 77066 | $1,528 | $1,268 | $424$263–$565 · 10 plans |
| Diagnostic mammogram, one breast CPT 77065 | $1,251 | $1,038 | $347$206–$459 · 10 plans |
| Kidney ultrasound CPT 76770 | $2,366 | $1,964 | $648$353–$814 · 11 plans |
| Low-dose CT lung cancer screening CPT 71271 | $2,447 | $2,031 | $687$635–$854 · 11 plans |
| MRI of the abdomen, with and without contrast CPT 74183 | $15,070 | $12,508 | $4,125$1,992–$5,184 · 11 plans |
| MRI of the abdomen, without contrast CPT 74181 | $6,871 | $5,703 | $1,881$1,229–$2,398 · 11 plans |
| MRI of the brain, with and without contrast CPT 70553 | $15,374 | $12,760 | $4,208$1,992–$5,289 · 11 plans |
| MRI of the brain, without contrast CPT 70551 | $6,926 | $5,749 | $1,896$1,229–$2,417 · 11 plans |
| MRI of the knee, without contrast CPT 73721 | $6,849 | $5,685 | $1,875$1,229–$2,390 · 11 plans |
| MRI of the lower back, with and without contrast CPT 72158 | $15,374 | $12,760 | $4,208$1,992–$5,289 · 11 plans |
| MRI of the lower back, without contrast CPT 72148 | $7,684 | $6,378 | $2,104$1,229–$2,643 · 11 plans |
| MRI of the mid-back, without contrast CPT 72146 | $7,684 | $6,378 | $2,104$1,229–$2,643 · 11 plans |
| MRI of the neck spine, without contrast CPT 72141 | $6,926 | $5,749 | $1,896$1,229–$2,417 · 11 plans |
| MRI of the pelvis, with and without contrast CPT 72197 | $15,070 | $12,508 | $4,125$1,992–$5,184 · 11 plans |
| MRI of the shoulder, without contrast CPT 73221 | $6,849 | $5,685 | $1,875$1,229–$2,390 · 11 plans |
| Nuclear heart stress test CPT 78452 | $6,504 | $5,398 | $1,829$1,688–$2,270 · 11 plans |
| Pelvic ultrasound CPT 76856 | $1,832 | $1,521 | $502$317–$630 · 11 plans |
| PET/CT scan, skull to thigh CPT 78815 | $22,449 | $18,633 | $6,145$4,845–$7,722 · 11 plans |
| Pregnancy ultrasound, after the first trimester CPT 76805 | $2,142 | $1,778 | $586$341–$737 · 11 plans |
| Pregnancy ultrasound, first trimester CPT 76801 | $1,094 | $908 | $316$284–$382 · 11 plans |
| Pregnancy ultrasound, limited CPT 76815 | $1,319 | $1,095 | $361$293–$454 · 11 plans |
| Pregnancy ultrasound, transvaginal CPT 76817 | $1,510 | $1,253 | $413$341–$519 · 11 plans |
| Screening mammogram CPT 77067 | $828 | $687 | $230$200–$330 · 10 plans |
| Scrotal ultrasound CPT 76870 | $1,832 | $1,521 | $502$307–$630 · 11 plans |
| Transvaginal ultrasound CPT 76830 | $1,015 | $842 | $293$263–$354 · 11 plans |
| Ultrasound of a joint or limb, limited CPT 76882 | $427 | $354 | $123$111–$283 · 11 plans |
| Ultrasound of the abdomen, complete CPT 76700 | $2,366 | $1,964 | $648$353–$814 · 11 plans |
| Ultrasound of the abdomen, limited CPT 76705 | $1,759 | $1,460 | $482$283–$605 · 11 plans |
| Ultrasound of the leg veins, both legs CPT 93970 | $7,875 | $6,536 | $2,156$803–$2,748 · 11 plans |
| Ultrasound of the leg veins, one leg CPT 93971 | $3,938 | $3,269 | $1,078$531–$1,374 · 11 plans |
| Ultrasound of the neck arteries (carotid) CPT 93880 | $5,483 | $4,551 | $1,501$803–$1,914 · 11 plans |
| Ultrasound of the neck or thyroid CPT 76536 | $1,712 | $1,421 | $469$279–$589 · 11 plans |
| X-ray of the abdomen CPT 74018 | $800 | $664 | $219$112–$279 · 11 plans |
| X-ray of the ankle CPT 73610 | $1,000 | $830 | $274$99–$344 · 11 plans |
| X-ray of the foot CPT 73630 | $918 | $762 | $251$99–$316 · 11 plans |
| X-ray of the hand CPT 73130 | $958 | $795 | $262$99–$330 · 11 plans |
| X-ray of the knee, 1 or 2 views CPT 73560 | $873 | $725 | $239$92–$300 · 11 plans |
| X-ray of the knee, 3 views CPT 73562 | $966 | $802 | $264$106–$332 · 11 plans |
| X-ray of the knee, 4 or more views CPT 73564 | $1,125 | $934 | $308$119–$387 · 11 plans |
| X-ray of the lower back, 2 or 3 views CPT 72100 | $936 | $777 | $256$126–$327 · 11 plans |
| X-ray of the lower back, 4 or more views CPT 72110 | $1,755 | $1,457 | $480$170–$604 · 11 plans |
| X-ray of the lower leg CPT 73590 | $847 | $703 | $232$99–$292 · 11 plans |
| X-ray of the neck spine CPT 72040 | $936 | $777 | $256$116–$322 · 11 plans |
| X-ray of the shoulder CPT 73030 | $873 | $725 | $239$106–$300 · 11 plans |
| X-ray of the wrist CPT 73110 | $919 | $763 | $252$99–$316 · 11 plans |
| Lab tests | |||
| Acute hepatitis panel CPT 80074 | $875 | $726 | $225$167–$246 · 11 plans |
| ANA (autoimmune) test CPT 86038 | $493 | $409 | $64$42–$135 · 11 plans |
| Antibody screen (blood bank) CPT 86850 | $100 | $83 | $28$26–$39 · 11 plans |
| Basic metabolic panel (blood test) CPT 80048 | $156 | $129 | $40$30–$44 · 11 plans |
| Blood count (CBC) without differential CPT 85027 | $132 | $110 | $34$23–$37 · 11 plans |
| Blood culture CPT 87040 | $380 | $315 | $55$36–$104 · 11 plans |
| Blood draw CPT 36415 | $30 | $25 | $8$3–$30 · 11 plans |
| Blood type (ABO) CPT 86900 | $626 | $520 | $16$10–$171 · 11 plans |
| Blood type (Rh) CPT 86901 | $324 | $269 | $18$10–$89 · 11 plans |
| BNP (heart failure blood test) CPT 83880 | $625 | $519 | $162$127–$176 · 11 plans |
| BUN (kidney blood test) CPT 84520 | $117 | $97 | $16$6–$32 · 11 plans |
| C-reactive protein (CRP) test CPT 86140 | $147 | $122 | $28$18–$40 · 11 plans |
| Chlamydia test CPT 87491 | $632 | $525 | $164$123–$178 · 11 plans |
| CK (muscle enzyme) test CPT 82550 | $187 | $155 | $26$6–$51 · 11 plans |
| Complete blood count (CBC) CPT 85025 | $188 | $156 | $37$27–$53 · 11 plans |
| Comprehensive metabolic panel (blood test) CPT 80053 | $192 | $159 | $50$37–$54 · 11 plans |
| COVID-19 PCR test CPT 87635 | $293 | $243 | $82$70–$240 · 11 plans |
| Creatinine blood test CPT 82565 | $131 | $109 | $20$6–$37 · 11 plans |
| Drug screen CPT 80307 | $715 | $593 | $201$115–$247 · 11 plans |
| Ferritin (iron stores) test CPT 82728 | $466 | $387 | $73$48–$128 · 11 plans |
| Free T4 (thyroid test) CPT 84439 | $165 | $137 | $43$32–$47 · 11 plans |
| Glucose (blood sugar) test CPT 82947 | $44 | $37 | $12$6–$16 · 11 plans |
| Glucose tolerance test CPT 82951 | $296 | $246 | $68$45–$83 · 11 plans |
| Gonorrhea test CPT 87591 | $632 | $525 | $164$123–$178 · 11 plans |
| Hemoglobin A1c (diabetes test) CPT 83036 | $324 | $269 | $50$34–$89 · 11 plans |
| Hemoglobin test CPT 85018 | $62 | $51 | $10$8–$17 · 11 plans |
| Hepatitis B antibody test CPT 86706 | $196 | $163 | $50$38–$55 · 11 plans |
| Hepatitis B antigen test CPT 87340 | $189 | $157 | $49$36–$53 · 11 plans |
| Hepatitis C antibody test CPT 86803 | $250 | $208 | $65$50–$70 · 11 plans |
| High-sensitivity CRP (heart risk) test CPT 86141 | $232 | $193 | $60$45–$65 · 11 plans |
| HIV test (antigen and antibody) CPT 87389 | $431 | $358 | $96$78–$121 · 11 plans |
| HPV test CPT 87624 | $632 | $525 | $140$89–$178 · 11 plans |
| Iron binding capacity test CPT 83550 | $160 | $133 | $42$31–$46 · 11 plans |
| Iron test CPT 83540 | $171 | $142 | $34$23–$48 · 11 plans |
| Kidney function panel CPT 80069 | $260 | $216 | $41$30–$71 · 11 plans |
| Lipase (pancreas) test CPT 83690 | $195 | $162 | $37$24–$53 · 11 plans |
| Lipid panel (cholesterol test) CPT 80061 | $246 | $204 | $64$47–$69 · 11 plans |
| Liver function panel CPT 80076 | $343 | $285 | $39$29–$94 · 11 plans |
| Magnesium test CPT 83735 | $184 | $153 | $36$23–$51 · 11 plans |
| Obstetric (pregnancy) blood panel CPT 80055 | $1,134 | $941 | $190$91–$319 · 11 plans |
| Pap test CPT 88142 | $319 | $265 | $84$71–$111 · 11 plans |
| Phosphorus test CPT 84100 | $125 | $104 | $19$6–$35 · 11 plans |
| Potassium test CPT 84132 | $86 | $71 | $19$6–$24 · 11 plans |
| Pregnancy blood test (hCG) CPT 84703 | $137 | $114 | $36$26–$40 · 11 plans |
| Pregnancy blood test (hCG), quantitative CPT 84702 | $265 | $220 | $65$49–$75 · 11 plans |
| Prothrombin time (PT/INR) clotting test CPT 85610 | $73 | $61 | $19$14–$21 · 11 plans |
| PSA (prostate screening test) CPT 84153 | $170 | $141 | $64$47–$89 · 11 plans |
| PTT clotting test CPT 85730 | $192 | $159 | $32$21–$53 · 11 plans |
| Rapid flu test CPT 87804 | $208 | $173 | $57$52–$66 · 11 plans |
| Rapid strep test CPT 87880 | $180 | $149 | $52$47–$66 · 11 plans |
| Rheumatoid factor test CPT 86431 | $494 | $410 | $30$20–$135 · 11 plans |
| Rubella antibody test CPT 86762 | $264 | $219 | $69$50–$74 · 11 plans |
| Sed rate (ESR) inflammation test CPT 85652 | $123 | $102 | $13$9–$34 · 11 plans |
| Syphilis test (RPR) CPT 86592 | $136 | $113 | $23$15–$37 · 11 plans |
| TB blood test CPT 86480 | $1,138 | $945 | $295$217–$324 · 11 plans |
| TB skin test CPT 86580 | $65 | $54 | $18$11–$81 · 11 plans |
| Tissue exam by a pathologist (biopsy) CPT 88305 | $648 | $537 | $182$168–$304 · 11 plans |
| Troponin (heart attack blood test) CPT 84484 | $161 | $134 | $44$40–$50 · 11 plans |
| TSH (thyroid test) CPT 84443 | $311 | $258 | $81$59–$89 · 11 plans |
| Uric acid (gout) test CPT 84550 | $114 | $95 | $18$6–$32 · 11 plans |
| Urinalysis, automated CPT 81003 | $42 | $35 | $11$8–$12 · 11 plans |
| Urinalysis, automated, with microscope CPT 81001 | $114 | $95 | $15$11–$31 · 11 plans |
| Urinalysis, dipstick CPT 81002 | $42 | $35 | $12$11–$17 · 11 plans |
| Urine albumin (kidney screening) CPT 82043 | $106 | $88 | $28$20–$31 · 11 plans |
| Urine culture CPT 87086 | $149 | $124 | $39$28–$44 · 11 plans |
| Urine pregnancy test CPT 81025 | $105 | $87 | $30$27–$34 · 11 plans |
| Vitamin B12 test CPT 82607 | $274 | $227 | $71$53–$80 · 11 plans |
| Vitamin D test CPT 82306 | $555 | $461 | $144$104–$156 · 11 plans |
| Heart, lung and nerve tests | |||
| Ablation for atrial fibrillation CPT 93656 | $16,850 | $13,986 | $5,796$4,612–$52,917 · 11 plans |
| Breathing test (spirometry) CPT 94010 | $918 | $762 | $258$144–$348 · 11 plans |
| Breathing test before and after an inhaler CPT 94060 | $1,547 | $1,284 | $435$261–$587 · 11 plans |
| Breathing treatment (nebulizer) CPT 94640 | $483 | $401 | $136$85–$183 · 11 plans |
| Coronary stent placement CPT 92928 | $29,522 | $24,503 | $8,532$8,080–$37,672 · 11 plans |
| Echocardiogram (heart ultrasound), complete CPT 93306 | $4,736 | $3,931 | $1,369$1,229–$1,821 · 11 plans |
| EEG (brain wave test) CPT 95816 | $3,121 | $2,590 | $877$379–$1,089 · 11 plans |
| EEG with sleep CPT 95819 | $3,503 | $2,907 | $985$614–$1,223 · 11 plans |
| Electrocardiogram (ECG), tracing only CPT 93005 | $411 | $341 | $122$112–$160 · 11 plans |
| Heart catheterization (left heart) CPT 93452 | $29,753 | $24,695 | $8,599$8,089–$11,590 · 11 plans |
| Heart catheterization with coronary angiogram CPT 93458 | $37,222 | $30,894 | $10,685$9,659–$12,990 · 11 plans |
| Lung diffusion test CPT 94729 | $1,443 | $1,198 | $400$156–$508 · 10 plans |
| Lung volume test CPT 94726 | $1,401 | $1,163 | $394$144–$532 · 11 plans |
| Nerve conduction study CPT 95910 | $4,256 | $3,532 | $1,165$1,034–$1,485 · 11 plans |
| Sleep study in a sleep lab CPT 95810 | $17,390 | $14,434 | $4,761$2,891–$6,069 · 11 plans |
| Sleep study with CPAP CPT 95811 | $19,169 | $15,910 | $5,248$2,891–$6,690 · 11 plans |
| Stress echocardiogram CPT 93350 | $3,179 | $2,639 | $894$800–$1,821 · 11 plans |
| Treadmill stress test, tracing only CPT 93017 | $1,345 | $1,116 | $463$368–$1,034 · 11 plans |
| Scopes and biopsies | |||
| Bladder scope (cystoscopy) CPT 52000 | – | – | $1,597$771–$2,686 · 4 plans |
| Bone marrow biopsy CPT 38221 | $13,028 | $10,813 | $3,566$977–$4,547 · 11 plans |
| Breast biopsy with ultrasound CPT 19083 | $7,918 | $6,572 | $2,724$2,167–$5,082 · 11 plans |
| Breast biopsy, stereotactic CPT 19081 | $8,822 | $7,322 | $3,035$2,415–$5,082 · 11 plans |
| Colonoscopy CPT 45378 | – | – | $3,015$2,921–$3,918 · 4 plans |
| Colonoscopy with biopsy CPT 45380 | – | – | $3,459$2,921–$4,185 · 4 plans |
| Colonoscopy with polyp removal CPT 45385 | – | – | $3,459$2,921–$4,185 · 4 plans |
| Colposcopy with biopsy CPT 57454 | – | – | $994$771–$2,286 · 4 plans |
| ERCP (bile duct scope) CPT 43260 | – | – | $5,882$4,007–$10,851 · 4 plans |
| Fine needle biopsy with ultrasound CPT 10005 | $4,283 | $3,555 | $1,473$1,172–$2,345 · 11 plans |
| Kidney biopsy CPT 50200 | $12,143 | $10,079 | $3,547$3,324–$5,082 · 11 plans |
| Liver biopsy CPT 47000 | $2,025 | $1,681 | $697$554–$5,082 · 11 plans |
| Lung scope (bronchoscopy) CPT 31622 | – | – | $2,910$771–$5,463 · 4 plans |
| Prostate biopsy CPT 55700 | $13,878 | $11,519 | $4,011$3,601–$5,082 · 11 plans |
| Screening colonoscopy, average risk HCPCS G0121 | – | – | $3,015$2,921–$3,918 · 4 plans |
| Screening colonoscopy, high risk HCPCS G0105 | – | – | $3,015$2,921–$3,918 · 4 plans |
| Sigmoidoscopy CPT 45330 | – | – | $2,589$1,850–$2,970 · 4 plans |
| Skin biopsy CPT 11102 | $682 | $566 | $235$187–$977 · 11 plans |
| Skin punch biopsy CPT 11104 | $682 | $566 | $235$187–$1,327 · 11 plans |
| Throat scope (laryngoscopy) CPT 31575 | $1,758 | $1,459 | $605$481–$3,001 · 11 plans |
| Upper endoscopy (EGD) CPT 43235 | – | – | $2,616$1,850–$3,046 · 4 plans |
| Upper endoscopy with biopsy CPT 43239 | – | – | $3,058$2,921–$3,944 · 4 plans |
| Upper endoscopy with esophagus dilation CPT 43249 | – | – | $3,650$2,921–$5,701 · 4 plans |
| Surgery | |||
| Abdominal hernia repair, small CPT 49591 | – | – | $8,989$4,932–$12,777 · 4 plans |
| ACL reconstruction CPT 29888 | – | – | $12,087$8,631–$20,580 · 4 plans |
| Appendix removal (laparoscopic) CPT 44970 | – | – | $10,719$6,473–$17,535 · 4 plans |
| Breast lump removal CPT 19120 | – | – | $5,882$4,007–$10,909 · 4 plans |
| Carpal tunnel release CPT 64721 | – | – | $5,784$4,007–$6,623 · 4 plans |
| Cataract surgery CPT 66984 | – | – | $7,917$7,595–$10,120 · 4 plans |
| Cataract surgery, complex CPT 66982 | – | – | $7,917$7,595–$10,120 · 4 plans |
| Chemo port placement CPT 36561 | $3,768 | $3,127 | $1,296$1,031–$8,195 · 11 plans |
| Draining a skin abscess CPT 10060 | $1,329 | $1,103 | $457$364–$977 · 11 plans |
| Draining fluid from the belly (paracentesis) CPT 49083 | $1,197 | $994 | $412$328–$3,114 · 11 plans |
| Draining fluid from the chest (thoracentesis) CPT 32555 | $3,269 | $2,713 | $1,125$895–$3,001 · 11 plans |
| Ear tubes, under general anesthesia CPT 69436 | – | – | $3,594$1,850–$4,897 · 4 plans |
| Gallbladder removal (laparoscopic) CPT 47562 | – | – | $13,568$10,763–$17,739 · 4 plans |
| Gastric bypass (laparoscopic) CPT 43644 | – | – | $9,381$7,115–$26,995 · 3 plans |
| Hip replacement CPT 27130 | – | – | $25,434$18,882–$39,339 · 4 plans |
| Inguinal hernia repair (laparoscopic) CPT 49650 | – | – | $10,719$6,473–$17,535 · 4 plans |
| Inguinal hernia repair (open) CPT 49505 | – | – | $7,811$5,857–$10,665 · 4 plans |
| Joint injection, large joint (knee, shoulder) CPT 20610 | $564 | $468 | $194$154–$981 · 11 plans |
| Joint injection, large joint, with ultrasound CPT 20611 | $677 | $562 | $233$185–$981 · 11 plans |
| Kidney stone removal with laser (ureteroscopy) CPT 52356 | – | – | $10,719$6,473–$15,790 · 4 plans |
| Kidney stone shock wave treatment CPT 50590 | – | – | $12,343$10,515–$14,110 · 4 plans |
| Knee arthroscopy (both menisci) CPT 29880 | – | – | $8,202$6,469–$10,007 · 4 plans |
| Knee arthroscopy (meniscus) CPT 29881 | – | – | $8,202$6,469–$10,007 · 4 plans |
| Knee replacement CPT 27447 | – | – | $25,434$18,882–$39,339 · 4 plans |
| Lower back disc surgery (discectomy) CPT 63030 | – | – | $9,742$4,932–$20,580 · 4 plans |
| Lower back epidural steroid injection CPT 62323 | $4,660 | $3,868 | $1,603$1,275–$2,345 · 11 plans |
| Lower back facet joint injection CPT 64493 | $759 | $630 | $261$208–$2,887 · 11 plans |
| Lower back laminectomy CPT 63047 | – | – | $12,087$8,631–$20,580 · 4 plans |
| Lower back nerve ablation (radiofrequency) CPT 64635 | $1,752 | $1,454 | $603$480–$4,843 · 11 plans |
| Lower back nerve root injection CPT 64483 | $1,263 | $1,048 | $434$346–$2,887 · 11 plans |
| Lower back spine fusion CPT 22612 | – | – | $10,328$5,857–$46,732 · 4 plans |
| Lumpectomy (partial mastectomy) CPT 19301 | – | – | $6,468$4,932–$10,909 · 4 plans |
| Mastectomy CPT 19303 | – | – | $7,225$4,932–$17,623 · 4 plans |
| Neck epidural steroid injection CPT 62321 | $4,660 | $3,868 | $1,603$1,275–$2,345 · 11 plans |
| Neck spine fusion (ACDF) CPT 22551 | – | – | $19,412$5,857–$39,339 · 4 plans |
| Pacemaker insertion CPT 33208 | $10,336 | $8,579 | $3,556$2,829–$22,423 · 11 plans |
| PICC line placement CPT 36573 | $4,059 | $3,369 | $1,396$1,111–$4,843 · 11 plans |
| Prostate removal (laparoscopic or robotic) CPT 55866 | – | – | $18,826$4,932–$33,629 · 4 plans |
| Prostate surgery (TURP) CPT 52601 | – | – | $7,225$4,932–$14,280 · 4 plans |
| Rotator cuff repair (arthroscopic) CPT 29827 | – | – | $10,719$6,473–$20,580 · 4 plans |
| Sacroiliac joint injection CPT 27096 | – | – | $830only 2 plans |
| Septoplasty (nose) CPT 30520 | – | – | $7,225$4,932–$10,000 · 4 plans |
| Shoulder replacement CPT 23472 | – | – | $25,434$18,882–$52,182 · 4 plans |
| Sinus surgery CPT 31255 | – | – | $9,570$7,806–$19,380 · 4 plans |
| Sleeve gastrectomy CPT 43775 | – | – | $6,254$4,743–$26,369 · 3 plans |
| Spinal tap (lumbar puncture) CPT 62270 | $736 | $611 | $253$201–$2,300 · 11 plans |
| Stitches for a cut, 2.6 to 7.5 cm CPT 12002 | $767 | $637 | $264$210–$977 · 11 plans |
| Stitches for a small cut (up to 2.5 cm) CPT 12001 | $620 | $515 | $213$170–$977 · 11 plans |
| Tonsillectomy, age 12 and over CPT 42826 | – | – | $7,811$5,857–$10,000 · 4 plans |
| Tonsils and adenoids removal, age 12 and over CPT 42821 | – | – | $7,811$5,857–$10,000 · 4 plans |
| Tonsils and adenoids removal, under age 12 CPT 42820 | – | – | $7,811$5,857–$16,214 · 4 plans |
| Trigger finger release CPT 26055 | – | – | $4,571$3,391–$5,174 · 4 plans |
| Ureteral stent placement CPT 52332 | – | – | $6,326$3,514–$10,478 · 4 plans |
| Vasectomy CPT 55250 | – | – | $3,830$771–$6,768 · 4 plans |
| Vein ablation (varicose veins) CPT 36475 | – | – | $7,769$4,007–$12,397 · 4 plans |
| Wound debridement CPT 11042 | $855 | $710 | $294$234–$3,001 · 11 plans |
| Childbirth and women's health | |||
| D&C (dilation and curettage) CPT 58120 | – | – | $5,491$3,391–$9,398 · 4 plans |
| Fetal non-stress test CPT 59025 | $1,112 | $923 | $321$304–$668 · 11 plans |
| Hysterectomy (abdominal) CPT 58150 | – | – | $10,945$8,300–$27,307 · 3 plans |
| Hysterectomy (laparoscopic) CPT 58571 | – | – | $11,830$8,225–$28,178 · 4 plans |
| Hysteroscopy with biopsy CPT 58558 | – | – | $5,882$4,007–$9,398 · 4 plans |
| IUD insertion CPT 58300 | – | – | $830only 2 plans |
| IUD removal CPT 58301 | – | – | $1,486$1,108–$2,133 · 4 plans |
| Miscarriage care, surgical (first trimester) CPT 59820 | – | – | $5,491$3,391–$9,398 · 4 plans |
| Removal of ovaries or tubes (laparoscopic) CPT 58661 | – | – | $10,719$6,473–$17,535 · 4 plans |
| Tubal ligation (laparoscopic) CPT 58670 | – | – | $9,742$4,932–$17,535 · 4 plans |
| Therapy and mental health | |||
| Balance and coordination therapy, 15 minutes CPT 97112 | $365 | $303 | $103$82–$347 · 11 plans |
| Cardiac rehab session CPT 93798 | $523 | $434 | $147$136–$199 · 11 plans |
| Electroconvulsive therapy (ECT) CPT 90870 | $1,924 | $1,597 | $662$527–$1,426 · 11 plans |
| Family therapy, with the patient CPT 90847 | $672 | $558 | $231$184–$498 · 11 plans |
| Family therapy, without the patient CPT 90846 | $571 | $474 | $196$156–$423 · 11 plans |
| Group therapy CPT 90853 | $180 | $149 | $62$49–$133 · 11 plans |
| Hearing test CPT 92557 | $540 | $448 | $186$148–$265 · 11 plans |
| Manual therapy, 15 minutes CPT 97140 | $376 | $312 | $106$68–$347 · 11 plans |
| Nutrition counseling, 15 minutes CPT 97802 | $110 | $91 | $35$30–$153 · 10 plans |
| Occupational therapy evaluation, low complexity CPT 97165 | $650 | $540 | $182$166–$239 · 10 plans |
| Occupational therapy evaluation, moderate complexity CPT 97166 | $682 | $566 | $194$181–$249 · 10 plans |
| Physical therapy evaluation, high complexity CPT 97163 | $716 | $594 | $217$196–$347 · 11 plans |
| Physical therapy evaluation, low complexity CPT 97161 | $650 | $540 | $183$169–$347 · 11 plans |
| Physical therapy evaluation, moderate complexity CPT 97162 | $682 | $566 | $197$181–$347 · 11 plans |
| Physical therapy exercises, 15 minutes CPT 97110 | $375 | $311 | $109$103–$347 · 11 plans |
| Physical therapy re-evaluation CPT 97164 | $376 | $312 | $109$98–$347 · 11 plans |
| Psychiatric evaluation CPT 90791 | $853 | $708 | $293$233–$534 · 11 plans |
| Psychiatric evaluation with medical services CPT 90792 | $854 | $709 | $294$234–$534 · 11 plans |
| Psychotherapy, 30 minutes CPT 90832 | $362 | $300 | $125$99–$268 · 11 plans |
| Psychotherapy, 45 minutes CPT 90834 | $542 | $450 | $186$148–$402 · 11 plans |
| Psychotherapy, 60 minutes CPT 90837 | $816 | $677 | $281$223–$534 · 11 plans |
| Self-care training, 15 minutes CPT 97535 | $334 | $277 | $94$68–$347 · 11 plans |
| Speech and language evaluation CPT 92523 | $1,398 | $1,160 | $383$250–$482 · 10 plans |
| Speech therapy session CPT 92507 | $730 | $606 | $208$189–$264 · 10 plans |
| Therapeutic activities, 15 minutes CPT 97530 | $381 | $316 | $107$77–$347 · 11 plans |
| Walking (gait) training, 15 minutes CPT 97116 | $339 | $281 | $95$68–$347 · 11 plans |
| Infusions, shots and treatments | |||
| Blood transfusion CPT 36430 | $2,340 | $1,942 | $658$458–$1,452 · 11 plans |
| Chemotherapy infusion, first hour CPT 96413 | $2,340 | $1,942 | $658$144–$888 · 11 plans |
| Chemotherapy shot CPT 96401 | $943 | $783 | $258$27–$329 · 11 plans |
| Dialysis session CPT 90935 | $5,010 | $4,158 | $1,371$354–$1,902 · 11 plans |
| Flu vaccine CPT 90686 | $100 | $83 | $27$26–$34 · 10 plans |
| IV drug infusion, first hour CPT 96365 | $1,074 | $891 | $369$294–$700 · 11 plans |
| IV fluids (hydration), first hour CPT 96360 | $881 | $731 | $303$241–$653 · 11 plans |
| IV push injection CPT 96374 | $843 | $700 | $290$231–$625 · 11 plans |
| Pneumonia vaccine (PCV20) CPT 90677 | $1,258 | $1,044 | $344$282–$433 · 10 plans |
| Radiation therapy session (IMRT) CPT 77385 | $15,329 | $12,723 | $4,196$1,581–$5,350 · 11 plans |
| Shot (injection) under the skin or into a muscle CPT 96372 | $122 | $101 | $42$33–$90 · 11 plans |
| Tdap vaccine CPT 90715 | $227 | $188 | $62$55–$78 · 10 plans |
| Vaccine given (administration) CPT 90471 | $100 | $83 | $29$27–$78 · 9 plans |
| Wound care (debridement), first 20 sq cm CPT 97597 | $321 | $266 | $93$88–$347 · 11 plans |
Price file: St Luke's Hospital - Monroe Campus, read November 12, 2026.
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