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Metro Health – University of Michigan Health Pricing by DRG

Please Note: These prices are for hospital services only and do not include fees from physicians, such as your emergency room physician, surgeon, radiologist or anesthesiologist. The prices listed are average prices. Actual prices may vary based on the complexity of your service. Our prices reflect the amount charged for services.  Patient responsibility varies based on health insurance benefits coverage.  For patient specific estimates of out of pocket cost, please contact (616) 252-7110.

DRGDRG DescriptionAverage Price
3 ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE MOUTH NECK W MAJ O.R. 245,708.43
4 TRACH W MV >96 HRS OR PDX EXC FACE MOUTH NECK W/O MAJ O.R. 175,864.85
5 LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT 157,149.00
11 TRACHEOSTOMY FOR FACE, MOUTH & NECK DIAGNOSES OR LARYNGECTOMY W MCC 125,408.00
20 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC 156,217.44
21 INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC 95,135.13
23 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT 136,732.45
24 CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC 96,787.41
25 CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC 95,011.90
26 CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W CC 70,556.62
27 CRANIOTOMY ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC 68,267.90
28 SPINAL PROCEDURES W MCC 130,991.50
29 SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS 54,393.57
30 SPINAL PROCEDURES W/O CC/MCC 26,303.33
32 VENTRICULAR SHUNT PROCEDURES W CC 36,479.29
33 VENTRICULAR SHUNT PROCEDURES W/O CC/MCC 31,439.38
35 CAROTID ARTERY STENT PROCEDURE W CC 35,805.40
36 CAROTID ARTERY STENT PROCEDURE W/O CC/MCC 50,371.33
37 EXTRACRANIAL PROCEDURES W MCC 90,847.00
38 EXTRACRANIAL PROCEDURES W CC 48,804.80
39 EXTRACRANIAL PROCEDURES W/O CC/MCC 31,139.50
40 PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W MCC 48,581.50
41 PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM 50,518.40
42 PERIPH/CRANIAL NERVE OTHER NERV SYST PROC W/O CC/MCC 43,202.00
52 SPINAL DISORDERS INJURIES W CC/MCC 29,983.20
53 SPINAL DISORDERS INJURIES W/O CC/MCC 17,740.70
54 NERVOUS SYSTEM NEOPLASMS W MCC 18,511.45
55 NERVOUS SYSTEM NEOPLASMS W/O MCC 17,556.88
56 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC 18,422.50
57 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC 21,847.67
58 MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W MCC 26,009.40
59 MULTIPLE SCLEROSIS CEREBELLAR ATAXIA W CC 25,774.00
61 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC 76,857.50
62 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC 41,828.35
63 ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC 31,686.86
64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 30,005.02
65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS 22,662.46
66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 20,629.91
68 NONSPECIFIC CVA PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC 24,602.00
69 TRANSIENT ISCHEMIA 17,615.67
70 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC 33,698.50
71 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 26,330.79
72 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC 16,501.00
73 CRANIAL PERIPHERAL NERVE DISORDERS W MCC 15,287.33
74 CRANIAL PERIPHERAL NERVE DISORDERS W/O MCC 28,050.00
76 VIRAL MENINGITIS W/O CC/MCC 15,735.80
77 HYPERTENSIVE ENCEPHALOPATHY W MCC 34,653.00
78 HYPERTENSIVE ENCEPHALOPATHY W CC 15,246.00
79 HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC 20,273.00
80 NONTRAUMATIC STUPOR COMA W MCC 22,434.00
81 NONTRAUMATIC STUPOR COMA W/O MCC 20,980.00
82 TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC 46,500.57
83 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC 28,036.00
84 TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC 17,235.50
85 TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC 41,551.50
86 TRAUMATIC STUPOR & COMA, COMA <1 HR W CC 22,076.67
87 TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC 16,909.27
89 CONCUSSION W CC 69,146.00
91 OTHER DISORDERS OF NERVOUS SYSTEM W MCC 32,473.69
92 OTHER DISORDERS OF NERVOUS SYSTEM W CC 23,237.31
93 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC 24,654.33
95 BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC 70,628.50
96 BACTERIAL TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC 73,990.00
97 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC 116,589.00
98 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC 32,169.33
99 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC 18,917.50
100 SEIZURES W MCC 26,364.53
101 SEIZURES W/O MCC 14,704.46
103 HEADACHES W/O MCC 23,765.00
113 ORBITAL PROCEDURES W CC/MCC 15,453.40
115 EXTRAOCULAR PROCEDURES EXCEPT ORBIT 26,778.00
121 ACUTE MAJOR EYE INFECTIONS W CC/MCC 53,404.00
123 NEUROLOGICAL EYE DISORDERS 14,262.00
124 OTHER DISORDERS OF THE EYE W MCC 14,203.00
129 MAJOR HEAD NECK PROCEDURES W CC/MCC OR MAJOR DEVICE 48,056.00
130 MAJOR HEAD NECK PROCEDURES W/O CC/MCC 78,424.00
131 CRANIAL/FACIAL PROCEDURES W CC/MCC 84,702.67
133 OTHER EAR NOSE MOUTH THROAT O.R. PROCEDURES W CC/MCC 27,006.08
134 OTHER EAR NOSE MOUTH THROAT O.R. PROCEDURES W/O CC/MCC 22,759.13
135 SINUS MASTOID PROCEDURES W CC/MCC 37,480.00
136 SINUS MASTOID PROCEDURES W/O CC/MCC 53,162.00
137 MOUTH PROCEDURES W CC/MCC 30,277.00
138 MOUTH PROCEDURES W/O CC/MCC 7,251.00
139 SALIVARY GLAND PROCEDURES 14,919.00
146 EAR NOSE MOUTH THROAT MALIGNANCY W MCC 18,379.00
149 DYSEQUILIBRIUM 17,236.00
152 OTITIS MEDIA URI W MCC 11,044.50
153 OTITIS MEDIA URI W/O MCC 20,116.00
154 OTHER EAR NOSE MOUTH THROAT DIAGNOSES W MCC 18,245.00
155 OTHER EAR NOSE MOUTH THROAT DIAGNOSES W CC 33,793.00
158 DENTAL ORAL DISEASES W CC 15,788.00
159 DENTAL ORAL DISEASES W/O CC/MCC 15,065.50
163 MAJOR CHEST PROCEDURES W MCC 97,100.00
164 MAJOR CHEST PROCEDURES W CC 45,051.67
165 MAJOR CHEST PROCEDURES W/O CC/MCC 27,212.33
166 OTHER RESP SYSTEM O.R. PROCEDURES W MCC 52,952.00
167 OTHER RESP SYSTEM O.R. PROCEDURES W CC 33,378.50
168 OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC 27,096.00
175 PULMONARY EMBOLISM W MCC 38,768.06
176 PULMONARY EMBOLISM W/O MCC 16,425.95
177 RESPIRATORY INFECTIONS INFLAMMATIONS W MCC 23,659.35
178 RESPIRATORY INFECTIONS INFLAMMATIONS W CC 20,833.11
180 RESPIRATORY NEOPLASMS W MCC 27,315.64
181 RESPIRATORY NEOPLASMS W CC 117,632.80
182 RESPIRATORY NEOPLASMS W/O CC/MCC 99,010.50
183 MAJOR CHEST TRAUMA W MCC 24,978.75
184 MAJOR CHEST TRAUMA W CC 25,596.07
185 MAJOR CHEST TRAUMA W/O CC/MCC 23,494.75
186 PLEURAL EFFUSION W MCC 42,860.57
187 PLEURAL EFFUSION W CC 13,909.75
188 PLEURAL EFFUSION W/O CC/MCC 11,591.00
189 PULMONARY EDEMA RESPIRATORY FAILURE 20,552.01
190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC 17,267.60
191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC 14,442.88
192 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 23,207.58
193 SIMPLE PNEUMONIA PLEURISY W MCC 20,895.28
194 SIMPLE PNEUMONIA PLEURISY W CC 16,790.26
195 SIMPLE PNEUMONIA PLEURISY W/O CC/MCC 10,411.10
196 INTERSTITIAL LUNG DISEASE W MCC 38,703.00
197 INTERSTITIAL LUNG DISEASE W CC 24,339.83
198 INTERSTITIAL LUNG DISEASE W/O CC/MCC 11,188.00
199 PNEUMOTHORAX W MCC 30,223.18
200 PNEUMOTHORAX W CC 16,999.00
201 PNEUMOTHORAX W/O CC/MCC 7,581.43
202 BRONCHITIS ASTHMA W CC/MCC 15,760.00
203 BRONCHITIS ASTHMA W/O CC/MCC 12,441.75
204 RESPIRATORY SIGNS SYMPTOMS 14,319.60
205 OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC 21,815.75
206 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC 17,889.63
207 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS 25,363.00
208 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS 47,179.97
215 OTHER HEART ASSIST SYSTEM IMPLANT 163,216.25
220 CARDIAC VALVE OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC 72,294.33
222 CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC 228,550.00
224 CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC 145,769.89
225 CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC 143,515.00
226 CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC 187,672.00
227 CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC 97,507.00
228 OTHER CARDIOTHORACIC PROCEDURES W MCC 36,234.50
229 OTHER CARDIOTHORACIC PROCEDURES W/O MCC 26,557.33
231 CORONARY BYPASS W PTCA W MCC 37,788.38
233 CORONARY BYPASS W CARDIAC CATH W MCC 22,666.00
239 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W MCC 49,319.00
240 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W CC 38,490.00
241 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB TOE W/O CC/MCC 16,616.18
242 PERMANENT CARDIAC PACEMAKER IMPLANT W MCC 69,722.77
243 PERMANENT CARDIAC PACEMAKER IMPLANT W CC 50,601.56
244 PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC 45,139.67
245 AICD GENERATOR PROCEDURES 30,677.50
246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS 69,386.47
247 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC 51,372.18
248 PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS 32,732.33
249 PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC 30,922.58
250 PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC 57,745.50
251 PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC 45,287.00
252 OTHER VASCULAR PROCEDURES W MCC 72,229.42
253 OTHER VASCULAR PROCEDURES W CC 54,028.75
254 OTHER VASCULAR PROCEDURES W/O CC/MCC 34,526.92
256 UPPER LIMB TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC 17,706.00
260 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC 95,558.33
263 VEIN LIGATION STRIPPING 27,345.73
264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES 33,361.33
268 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC 135,252.50
270 OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC 129,265.10
271 OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC 113,599.22
272 OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC 72,040.50
280 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC 28,853.42
281 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W CC 18,866.98
282 ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W/O CC/MCC 17,236.05
283 ACUTE MYOCARDIAL INFARCTION EXPIRED W MCC 26,525.25
284 ACUTE MYOCARDIAL INFARCTION EXPIRED W CC 45,988.00
286 CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W MCC 34,825.44
287 CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCC 25,317.52
291 HEART FAILURE SHOCK W MCC 21,578.09
292 HEART FAILURE SHOCK W CC 15,757.64
293 HEART FAILURE SHOCK W/O CC/MCC 9,065.20
296 CARDIAC ARREST UNEXPLAINED W MCC 30,887.00
299 PERIPHERAL VASCULAR DISORDERS W MCC 36,077.79
300 PERIPHERAL VASCULAR DISORDERS W CC 24,192.75
301 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC 35,854.17
302 ATHEROSCLEROSIS W MCC 43,135.97
303 ATHEROSCLEROSIS W/O MCC 10,655.00
304 HYPERTENSION W MCC 81,855.86
305 HYPERTENSION W/O MCC 23,303.67
306 CARDIAC CONGENITAL VALVULAR DISORDERS W MCC 10,937.00
308 CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W MCC 26,842.67
309 CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W CC 13,659.65
310 CARDIAC ARRHYTHMIA CONDUCTION DISORDERS W/O CC/MCC 16,447.08
312 SYNCOPE COLLAPSE 18,623.09
313 CHEST PAIN 24,082.30
314 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC 33,127.08
315 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC 20,417.00
326 STOMACH ESOPHAGEAL DUODENAL PROC W MCC 159,235.25
327 STOMACH ESOPHAGEAL DUODENAL PROC W CC 61,440.75
328 STOMACH ESOPHAGEAL DUODENAL PROC W/O CC/MCC 42,607.25
329 MAJOR SMALL LARGE BOWEL PROCEDURES W MCC 91,144.92
330 MAJOR SMALL LARGE BOWEL PROCEDURES W CC 46,685.66
331 MAJOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC 35,165.07
333 RECTAL RESECTION W CC 45,249.00
335 PERITONEAL ADHESIOLYSIS W MCC 49,851.40
336 PERITONEAL ADHESIOLYSIS W CC 55,271.50
337 PERITONEAL ADHESIOLYSIS W/O CC/MCC 20,826.00
338 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC 62,909.00
339 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC 37,364.75
340 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC 29,628.30
341 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC 24,970.00
344 MINOR SMALL LARGE BOWEL PROCEDURES W MCC 19,558.75
345 MINOR SMALL LARGE BOWEL PROCEDURES W CC 42,020.00
346 MINOR SMALL LARGE BOWEL PROCEDURES W/O CC/MCC 14,204.00
347 ANAL STOMAL PROCEDURES W MCC 22,185.67
348 ANAL STOMAL PROCEDURES W CC 11,494.00
349 ANAL STOMAL PROCEDURES W/O CC/MCC 10,685.00
350 INGUINAL FEMORAL HERNIA PROCEDURES W MCC 46,183.00
351 INGUINAL FEMORAL HERNIA PROCEDURES W CC 17,293.71
352 INGUINAL FEMORAL HERNIA PROCEDURES W/O CC/MCC 15,500.50
353 HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W MCC 76,104.00
354 HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W CC 46,197.50
355 HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL W/O CC/MCC 28,684.50
356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC 96,967.50
357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC 76,072.50
358 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC 22,821.00
368 MAJOR ESOPHAGEAL DISORDERS W MCC 28,256.00
369 MAJOR ESOPHAGEAL DISORDERS W CC 14,515.00
370 MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC 10,850.50
371 MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W MCC 30,806.56
372 MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W CC 19,301.07
373 MAJOR GASTROINTESTINAL DISORDERS PERITONEAL INFECTIONS W/O CC/MCC 21,488.00
374 DIGESTIVE MALIGNANCY W MCC 23,247.67
375 DIGESTIVE MALIGNANCY W CC 35,163.80
377 G.I. HEMORRHAGE W MCC 39,243.96
378 G.I. HEMORRHAGE W CC 16,789.14
379 G.I. HEMORRHAGE W/O CC/MCC 10,011.80
380 COMPLICATED PEPTIC ULCER W MCC 35,734.71
381 COMPLICATED PEPTIC ULCER W CC 19,208.14
382 COMPLICATED PEPTIC ULCER W/O CC/MCC 18,717.00
383 UNCOMPLICATED PEPTIC ULCER W MCC 18,477.31
384 UNCOMPLICATED PEPTIC ULCER W/O MCC 11,377.00
385 INFLAMMATORY BOWEL DISEASE W MCC 18,027.00
386 INFLAMMATORY BOWEL DISEASE W CC 14,711.00
387 INFLAMMATORY BOWEL DISEASE W/O CC/MCC 14,922.00
388 G.I. OBSTRUCTION W MCC 36,466.67
389 G.I. OBSTRUCTION W CC 17,734.92
390 G.I. OBSTRUCTION W/O CC/MCC 14,523.48
391 ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W MCC 22,815.78
392 ESOPHAGITIS GASTROENT MISC DIGEST DISORDERS W/O MCC 16,763.36
393 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC 26,377.40
394 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC 16,409.76
395 OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC 10,831.29
405 PANCREAS LIVER SHUNT PROCEDURES W MCC 129,424.00
406 PANCREAS LIVER SHUNT PROCEDURES W CC 67,134.88
407 PANCREAS LIVER SHUNT PROCEDURES W/O CC/MCC 52,860.60
408 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC 83,399.00
409 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 30,970.00
411 CHOLECYSTECTOMY W C.D.E. W MCC 35,431.50
413 CHOLECYSTECTOMY W C.D.E. W/O CC/MCC 31,212.00
414 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC 36,264.67
415 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 77,025.00
417 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC 44,825.55
418 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 31,733.66
419 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 25,200.91
420 HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC 21,881.22
422 HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC 30,330.00
423 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC 56,671.67
425 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC 16,022.83
432 CIRRHOSIS ALCOHOLIC HEPATITIS W MCC 26,431.14
433 CIRRHOSIS ALCOHOLIC HEPATITIS W CC 15,859.86
434 CIRRHOSIS ALCOHOLIC HEPATITIS W/O CC/MCC 10,409.00
435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC 38,848.71
436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC 21,616.40
437 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC 12,864.00
438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC 40,789.90
439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 16,280.32
440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 15,189.29
441 DISORDERS OF LIVER EXCEPT MALIGCIRRALC HEPA W MCC 32,220.07
442 DISORDERS OF LIVER EXCEPT MALIGCIRRALC HEPA W CC 19,852.08
443 DISORDERS OF LIVER EXCEPT MALIGCIRRALC HEPA W/O CC/MCC 19,970.25
444 DISORDERS OF THE BILIARY TRACT W MCC 41,188.55
445 DISORDERS OF THE BILIARY TRACT W CC 22,649.36
446 DISORDERS OF THE BILIARY TRACT W/O CC/MCC 13,821.67
453 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC 145,926.09
454 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC 120,491.21
455 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC 105,774.31
457 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC 109,336.00
459 SPINAL FUSION EXCEPT CERVICAL W MCC 105,578.71
460 SPINAL FUSION EXCEPT CERVICAL W/O MCC 78,087.77
462 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 63,709.50
463 WND DEBRID SKN GRFT EXC HAND FOR MUSCULO-CONN TISS DIS W MCC 57,769.00
464 WND DEBRID SKN GRFT EXC HAND FOR MUSCULO-CONN TISS DIS W CC 51,080.33
465 WND DEBRID SKN GRFT EXC HAND FOR MUSCULO-CONN TISS DIS W/O CC/MCC 32,515.60
466 REVISION OF HIP OR KNEE REPLACEMENT W MCC 104,916.29
467 REVISION OF HIP OR KNEE REPLACEMENT W CC 74,211.36
468 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC 77,628.61
469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT 59,912.68
470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 36,925.12
471 CERVICAL SPINAL FUSION W MCC 66,801.00
472 CERVICAL SPINAL FUSION W CC 57,736.09
473 CERVICAL SPINAL FUSION W/O CC/MCC 50,450.60
474 AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W MCC 31,779.00
475 AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W CC 27,664.00
476 AMPUTATION FOR MUSCULOSKELETAL SYS CONN TISSUE DIS W/O CC/MCC 12,927.00
477 BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC 160,463.00
478 BIOPSIES OF MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC 22,760.80
480 HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC 52,313.44
481 HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC 37,569.74
482 HIP FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC 33,183.76
483 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES 52,749.23
485 KNEE PROCEDURES W PDX OF INFECTION W MCC 56,694.67
486 KNEE PROCEDURES W PDX OF INFECTION W CC 28,606.00
487 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC 15,672.00
488 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC 40,416.00
489 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC 23,245.93
492 LOWER EXTREM HUMER PROC EXCEPT HIPFOOTFEMUR W MCC 52,765.43
493 LOWER EXTREM HUMER PROC EXCEPT HIPFOOTFEMUR W CC 40,131.92
494 LOWER EXTREM HUMER PROC EXCEPT HIPFOOTFEMUR W/O CC/MCC 34,356.42
496 LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W CC 41,695.00
497 LOCAL EXCISION REMOVAL INT FIX DEVICES EXC HIP FEMUR W/O CC/MCC 23,779.67
498 LOCAL EXCISION REMOVAL INT FIX DEVICES OF HIP FEMUR W CC/MCC 21,492.00
500 SOFT TISSUE PROCEDURES W MCC 89,059.00
501 SOFT TISSUE PROCEDURES W CC 28,774.00
502 SOFT TISSUE PROCEDURES W/O CC/MCC 19,798.25
503 FOOT PROCEDURES W MCC 54,239.00
504 FOOT PROCEDURES W CC 36,000.00
505 FOOT PROCEDURES W/O CC/MCC 16,044.33
506 MAJOR THUMB OR JOINT PROCEDURES 18,920.50
511 SHOULDERELBOW OR FOREARM PROCEXC MAJOR JOINT PROC W CC 33,769.40
512 SHOULDERELBOW OR FOREARM PROCEXC MAJOR JOINT PROC W/O CC/MCC 31,016.00
513 HAND OR WRIST PROC EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 22,789.00
514 HAND OR WRIST PROC EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 9,990.00
515 OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W MCC 75,614.00
516 OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W CC 37,011.19
517 OTHER MUSCULOSKELET SYS CONN TISS O.R. PROC W/O CC/MCC 21,551.20
518 BACK NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM 49,659.40
519 BACK NECK PROC EXC SPINAL FUSION W CC 33,797.17
520 BACK NECK PROC EXC SPINAL FUSION W/O CC/MCC 23,511.08
534 FRACTURES OF FEMUR W/O MCC 15,737.50
535 FRACTURES OF HIP PELVIS W MCC 52,988.83
536 FRACTURES OF HIP PELVIS W/O MCC 15,299.88
540 OSTEOMYELITIS W CC 15,107.18
541 OSTEOMYELITIS W/O CC/MCC 11,606.20
542 PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W MCC 13,646.17
543 PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W CC 39,624.00
544 PATHOLOGICAL FRACTURES MUSCULOSKELET CONN TISS MALIG W/O CC/MCC 15,055.00
545 CONNECTIVE TISSUE DISORDERS W MCC 31,915.33
546 CONNECTIVE TISSUE DISORDERS W CC 31,500.67
550 SEPTIC ARTHRITIS W/O CC/MCC 14,866.00
551 MEDICAL BACK PROBLEMS W MCC 21,879.67
552 MEDICAL BACK PROBLEMS W/O MCC 22,002.95
554 BONE DISEASES ARTHROPATHIES W/O MCC 24,878.00
555 SIGNS SYMPTOMS OF MUSCULOSKELETAL SYSTEM CONN TISSUE W MCC 31,592.00
557 TENDONITIS MYOSITIS BURSITIS W MCC 16,971.00
558 TENDONITIS MYOSITIS BURSITIS W/O MCC 16,522.67
559 AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W MCC 22,718.00
560 AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W CC 10,306.64
561 AFTERCARE MUSCULOSKELETAL SYSTEM CONNECTIVE TISSUE W/O CC/MCC 18,402.29
562 FX SPRN STRN DISL EXCEPT FEMUR HIP PELVIS THIGH W MCC 26,994.60
563 FX SPRN STRN DISL EXCEPT FEMUR HIP PELVIS THIGH W/O MCC 15,965.74
564 OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W MCC 31,080.20
565 OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W CC 28,000.00
566 OTHER MUSCULOSKELETAL SYS CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 8,982.82
570 SKIN DEBRIDEMENT W MCC 33,161.67
571 SKIN DEBRIDEMENT W CC 17,486.75
572 SKIN DEBRIDEMENT W/O CC/MCC 25,138.00
576 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC 169,405.00
577 SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC 35,833.00
579 OTHER SKIN SUBCUT TISS BREAST PROC W MCC 34,539.00
580 OTHER SKIN SUBCUT TISS BREAST PROC W CC 24,138.50
581 OTHER SKIN SUBCUT TISS BREAST PROC W/O CC/MCC 16,198.56
582 MASTECTOMY FOR MALIGNANCY W CC/MCC 48,363.00
592 SKIN ULCERS W MCC 11,784.00
593 SKIN ULCERS W CC 665
596 MAJOR SKIN DISORDERS W/O MCC 16,908.00
598 MALIGNANT BREAST DISORDERS W CC 16,223.00
600 NON-MALIGNANT BREAST DISORDERS W CC/MCC 18,992.00
602 CELLULITIS W MCC 21,248.64
603 CELLULITIS W/O MCC 10,526.36
605 TRAUMA TO THE SKIN SUBCUT TISS BREAST W/O MCC 23,723.00
606 MINOR SKIN DISORDERS W MCC 19,142.00
607 MINOR SKIN DISORDERS W/O MCC 14,896.60
614 ADRENAL PITUITARY PROCEDURES W CC/MCC 40,117.82
615 ADRENAL PITUITARY PROCEDURES W/O CC/MCC 49,127.50
616 AMPUTAT OF LOWER LIMB FOR ENDOCRINENUTRIT METABOL DIS W MCC 75,901.75
617 AMPUTAT OF LOWER LIMB FOR ENDOCRINENUTRIT METABOL DIS W CC 39,304.80
619 O.R. PROCEDURES FOR OBESITY W MCC 48,620.67
620 O.R. PROCEDURES FOR OBESITY W CC 30,836.46
621 O.R. PROCEDURES FOR OBESITY W/O CC/MCC 29,841.60
622 SKIN GRAFTS WOUND DEBRID FOR ENDOC NUTRIT METAB DIS W MCC 41,712.00
623 SKIN GRAFTS WOUND DEBRID FOR ENDOC NUTRIT METAB DIS W CC 27,277.67
625 THYROID PARATHYROID THYROGLOSSAL PROCEDURES W MCC 8,947.00
626 THYROID PARATHYROID THYROGLOSSAL PROCEDURES W CC 5,635.41
627 THYROID PARATHYROID THYROGLOSSAL PROCEDURES W/O CC/MCC 34,908.00
628 OTHER ENDOCRINE NUTRIT METAB O.R. PROC W MCC 58,802.00
629 OTHER ENDOCRINE NUTRIT METAB O.R. PROC W CC 26,620.20
637 DIABETES W MCC 33,384.75
638 DIABETES W CC 13,235.44
639 DIABETES W/O CC/MCC 8,405.42
640 MISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W MCC 3,416.70
641 MISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W/O MCC 13,909.00
643 ENDOCRINE DISORDERS W MCC 20,590.78
644 ENDOCRINE DISORDERS W CC 16,154.86
645 ENDOCRINE DISORDERS W/O CC/MCC 13,085.33
653 MAJOR BLADDER PROCEDURES W MCC 97,492.67
654 MAJOR BLADDER PROCEDURES W CC 80,855.29
655 MAJOR BLADDER PROCEDURES W/O CC/MCC 62,086.50
656 KIDNEY URETER PROCEDURES FOR NEOPLASM W MCC 57,174.00
657 KIDNEY URETER PROCEDURES FOR NEOPLASM W CC 47,040.44
658 KIDNEY URETER PROCEDURES FOR NEOPLASM W/O CC/MCC 38,069.50
659 KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W MCC 38,910.67
660 KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W CC 31,003.22
661 KIDNEY URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC 25,341.50
662 MINOR BLADDER PROCEDURES W MCC 47,996.00
663 MINOR BLADDER PROCEDURES W CC 17,630.57
668 TRANSURETHRAL PROCEDURES W MCC 54,522.00
669 TRANSURETHRAL PROCEDURES W CC 25,540.22
670 TRANSURETHRAL PROCEDURES W/O CC/MCC 16,513.00
672 URETHRAL PROCEDURES W/O CC/MCC 21,940.00
673 OTHER KIDNEY URINARY TRACT PROCEDURES W MCC 57,656.57
674 OTHER KIDNEY URINARY TRACT PROCEDURES W CC 48,980.33
682 RENAL FAILURE W MCC 26,133.31
683 RENAL FAILURE W CC 16,240.23
684 RENAL FAILURE W/O CC/MCC 9,319.54
686 KIDNEY URINARY TRACT NEOPLASMS W MCC 13,000.00
689 KIDNEY URINARY TRACT INFECTIONS W MCC 18,153.67
690 KIDNEY URINARY TRACT INFECTIONS W/O MCC 20,164.79
691 URINARY STONES W ESW LITHOTRIPSY W CC/MCC 26,708.67
693 URINARY STONES W/O ESW LITHOTRIPSY W MCC 25,280.00
694 URINARY STONES W/O ESW LITHOTRIPSY W/O MCC 17,089.00
695 KIDNEY URINARY TRACT SIGNS SYMPTOMS W MCC 152,423.00
696 KIDNEY URINARY TRACT SIGNS SYMPTOMS W/O MCC 23,186.20
697 URETHRAL STRICTURE 24,855.00
698 OTHER KIDNEY URINARY TRACT DIAGNOSES W MCC 28,838.60
699 OTHER KIDNEY URINARY TRACT DIAGNOSES W CC 17,420.92
700 OTHER KIDNEY URINARY TRACT DIAGNOSES W/O CC/MCC 13,569.00
707 MAJOR MALE PELVIC PROCEDURES W CC/MCC 38,000.64
708 MAJOR MALE PELVIC PROCEDURES W/O CC/MCC 33,336.91
710 PENIS PROCEDURES W/O CC/MCC 83,180.00
711 TESTES PROCEDURES W CC/MCC 45,788.00
714 TRANSURETHRAL PROSTATECTOMY W/O CC/MCC 27,622.50
727 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC 24,334.00
728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC 11,813.80
742 UTERINE ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC 23,205.00
743 UTERINE ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC 21,880.70
744 DC CONIZATION LAPAROSCOPY TUBAL INTERRUPTION W CC/MCC 20,353.00
746 VAGINA CERVIX VULVA PROCEDURES W CC/MCC 32,576.00
754 MALIGNANCY FEMALE REPRODUCTIVE SYSTEM W MCC 24,725.00
755 MALIGNANCY FEMALE REPRODUCTIVE SYSTEM W CC 13,604.00
758 INFECTIONS FEMALE REPRODUCTIVE SYSTEM W CC 7,828.00
759 INFECTIONS FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC 16,761.00
765 CESAREAN SECTION W CC/MCC 16,623.87
766 CESAREAN SECTION W/O CC/MCC 13,443.29
767 VAGINAL DELIVERY W STERILIZATION /OR DC 12,568.26
768 VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL /OR DC 12,729.56
769 POSTPARTUM POST ABORTION DIAGNOSES W O.R. PROCEDURE 20,067.00
770 ABORTION W DC ASPIRATION CURETTAGE OR HYSTEROTOMY 10,726.27
774 VAGINAL DELIVERY W COMPLICATING DIAGNOSES 11,568.87
775 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES 10,030.56
776 POSTPARTUM POST ABORTION DIAGNOSES W/O O.R. PROCEDURE 12,964.17
778 THREATENED ABORTION 11,276.50
779 ABORTION W/O DC 3,384.00
781 OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS 7,826.32
782 OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS 5,232.25
784 CESAREAN SECTION W STERILIZATION W CC 18,472.60
785 CESAREAN SECTION W STERILIZATION W/O CC/MCC 13,693.22
786 CESAREAN SECTION W/O STERILIZATION W MCC 18,483.40
787 CESAREAN SECTION W/O STERILIZATION W CC 18,637.71
788 CESAREAN SECTION W/O STERILIZATION W/O CC/MCC 13,523.67
789 NEONATES DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY 5,341.94
790 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME NEONATE 14,945.00
791 PREMATURITY W MAJOR PROBLEMS 5,538.24
792 PREMATURITY W/O MAJOR PROBLEMS 13,223.26
793 FULL TERM NEONATE W MAJOR PROBLEMS 5,128.36
794 NEONATE W OTHER SIGNIFICANT PROBLEMS 2,418.30
795 NORMAL NEWBORN 1,835.74
800 SPLENECTOMY W CC 24,230.00
801 SPLENECTOMY W/O CC/MCC 28,148.00
802 OTHER O.R. PROC OF THE BLOOD BLOOD FORMING ORGANS W MCC 40,706.00
805 VAGINAL DELIVERY W/O STERILIZATION/DC W MCC 17,425.75
806 VAGINAL DELIVERY W/O STERILIZATION/DC W CC 11,794.13
807 VAGINAL DELIVERY W/O STERILIZATION/DC W/O CC/MCC 10,032.68
808 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W MCC 30,724.00
809 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W CC 22,489.27
810 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS COAGUL W/O CC/MCC 11,233.25
811 RED BLOOD CELL DISORDERS W MCC 16,946.77
812 RED BLOOD CELL DISORDERS W/O MCC 17,546.12
813 COAGULATION DISORDERS 25,687.50
814 RETICULOENDOTHELIAL IMMUNITY DISORDERS W MCC 24,097.00
815 RETICULOENDOTHELIAL IMMUNITY DISORDERS W CC 37,241.00
816 RETICULOENDOTHELIAL IMMUNITY DISORDERS W/O CC/MCC 28,028.25
817 OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCC 11,597.33
820 LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W MCC 145,247.50
822 LYMPHOMA LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC 42,475.00
824 LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W CC 33,412.67
825 LYMPHOMA NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC 36,896.00
827 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC 62,151.00
829 MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC 36,657.00
831 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W MCC 13,112.50
832 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC 3,593.50
833 OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC 7,918.50
834 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC 17,517.50
835 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC 13,062.00
837 CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC 179,285.50
840 LYMPHOMA NON-ACUTE LEUKEMIA W MCC 37,781.00
841 LYMPHOMA NON-ACUTE LEUKEMIA W CC 45,242.50
843 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC 17,873.00
844 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC 23,386.00
847 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC 59,711.50
853 INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W MCC 91,293.62
854 INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W CC 45,256.96
855 INFECTIOUS PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC 34,426.00
856 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC 45,878.00
857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC 32,880.24
858 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC 29,762.00
862 POSTOPERATIVE POST-TRAUMATIC INFECTIONS W MCC 28,788.19
863 POSTOPERATIVE POST-TRAUMATIC INFECTIONS W/O MCC 15,914.33
864 FEVER AND INFLAMMATORY CONDITIONS 13,808.67
865 VIRAL ILLNESS W MCC 38,906.33
866 VIRAL ILLNESS W/O MCC 11,828.33
867 OTHER INFECTIOUS PARASITIC DISEASES DIAGNOSES W MCC 72,317.00
870 SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS 110,539.20
871 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC 29,170.74
872 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC 17,926.14
876 O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS 58,956.00
880 ACUTE ADJUSTMENT REACTION PSYCHOSOCIAL DYSFUNCTION 11,685.00
884 ORGANIC DISTURBANCES INTELLECTUAL DISABILITY 13,074.00
887 OTHER MENTAL DISORDER DIAGNOSES 20,960.00
894 ALCOHOL/DRUG ABUSE OR DEPENDENCE LEFT AMA 7,540.00
896 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC 29,377.50
897 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC 15,476.35
901 WOUND DEBRIDEMENTS FOR INJURIES W MCC 39,790.00
902 WOUND DEBRIDEMENTS FOR INJURIES W CC 30,327.10
903 WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC 21,187.50
907 OTHER O.R. PROCEDURES FOR INJURIES W MCC 94,357.86
908 OTHER O.R. PROCEDURES FOR INJURIES W CC 33,386.75
909 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC 29,390.20
913 TRAUMATIC INJURY W MCC 14,787.00
915 ALLERGIC REACTIONS W MCC 81,057.00
916 ALLERGIC REACTIONS W/O MCC 24,579.00
917 POISONING TOXIC EFFECTS OF DRUGS W MCC 32,045.18
918 POISONING TOXIC EFFECTS OF DRUGS W/O MCC 13,055.24
919 COMPLICATIONS OF TREATMENT W MCC 29,123.20
920 COMPLICATIONS OF TREATMENT W CC 19,148.18
921 COMPLICATIONS OF TREATMENT W/O CC/MCC 15,042.25
922 OTHER INJURY POISONING TOXIC EFFECT DIAG W MCC 43,181.67
923 OTHER INJURY POISONING TOXIC EFFECT DIAG W/O MCC 13,870.00
940 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC 15,629.00
941 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC 138,412.00
947 SIGNS SYMPTOMS W MCC 13,528.00
948 SIGNS SYMPTOMS W/O MCC 18,354.20
950 AFTERCARE W/O CC/MCC 50,390.20
951 OTHER FACTORS INFLUENCING HEALTH STATUS 5,694.67
955 CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA 149,755.33
956 LIMB REATTACHMENT HIP FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA 80,405.20
957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC 165,575.50
958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC 76,047.33
959 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC 45,904.67
963 OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC 40,293.33
964 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC 35,370.25
965 OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC 19,031.67
969 HIV W EXTENSIVE O.R. PROCEDURE W MCC 71,551.00
970 HIV W EXTENSIVE O.R. PROCEDURE W/O MCC 80,196.00
974 HIV W MAJOR RELATED CONDITION W MCC 135,816.00
975 HIV W MAJOR RELATED CONDITION W CC 16,868.50
977 HIV W OR W/O OTHER RELATED CONDITION 29,077.00
981 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC 54,189.82
982 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC 58,508.69
983 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC 39,538.50
987 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC 64,789.60
988 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC 21,708.00
989 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC 44,414.00