Service Type DRG CPT/HCPCS CPT / DRG Description Gross or Average Charge Self Pay Cash Price Min Negotiated Rate Max Negotiated Rate Aetna Better Health MA Aetna Comm Aetna Medicare Aetna Signature Administrators AmeriHealth MA CBC Comm CBC Medicare Cigna Gateway MA Gateway Medicare Geisinger Comm Geisinger MA Geisinger Medicare Highmark Choice Blue Highmark Comm Highmark Medicare Humana Medicare Medicare Multiplan PA Health & Wellness PAMA UHC Comm UHC MA UHC MA CHIP UPMC Comm UPMC MA UPMC MA CHIP Vibra Medicare Outpatient 0238T Trluml perip athrc iliac art " 84,336.00 " " 31,170.59 " - " 67,468.80 " - " 58,276.18 " " 16,751.22 " " 58,276.18 " - " 46,595.64 " " 16,432.15 " " 55,661.76 " - - " 55,822.00 " " 14,358.19 " " 15,953.54 " " 4,088.01 " " 5,110.01 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " - " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 10005 Fna bx w/us gdn 1st les " 3,265.00 " " 1,206.74 " 543.97 " 2,612.00 " 892.40 " 2,256.12 " 649.06 " 2,256.12 " 907.92 " 1,803.91 " 636.69 " 1,775.00 " 869.12 808.05 " 2,161.10 " 556.34 618.15 703.12 878.90 633.60 636.69 618.15 " 2,612.00 " 565.61 776.00 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 10030 Guide cathet fluid drainage " 3,265.00 " " 1,206.74 " 125.28 " 2,612.00 " 144.07 " 1,718.00 " 649.06 " 1,718.00 " 146.58 " 1,803.91 " 636.69 845.00 140.31 130.45 " 2,161.10 " 556.34 618.15 " 1,647.30 " " 2,059.12 " 633.60 636.69 618.15 " 2,612.00 " 565.61 125.28 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 10060 Drainage of skin abscess 943.00 348.53 156.97 " 1,469.00 " 711.85 " 1,469.00 " 187.30 " 1,469.00 " 724.23 521.01 183.73 845.00 693.28 644.56 624.17 160.54 178.38 393.78 492.23 182.84 183.73 178.38 754.40 163.22 619.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 10061 Drainage of skin abscess " 1,816.00 " 671.19 302.14 " 1,775.00 " 690.00 " 1,469.00 " 360.51 " 1,469.00 " 702.00 " 1,003.34 " 353.64 " 1,775.00 " 672.00 624.78 " 1,202.01 " 309.01 343.34 " 1,012.58 " " 1,265.72 " 351.92 353.64 343.34 " 1,452.80 " 314.16 600.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 10080 Drainage of pilonidal cyst " 3,265.00 " " 1,206.74 " 393.78 " 2,612.00 " 892.40 " 1,469.00 " 649.06 " 1,469.00 " 907.92 " 1,803.91 " 636.69 845.00 869.12 808.05 " 2,161.10 " 556.34 618.15 393.78 492.23 633.60 636.69 618.15 " 2,612.00 " 565.61 776.00 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 10120 Remove foreign body " 1,816.00 " 671.19 302.14 " 1,469.00 " 893.55 " 1,469.00 " 360.51 " 1,469.00 " 909.09 " 1,003.34 " 353.64 845.00 870.24 809.09 " 1,202.01 " 309.01 343.34 393.78 492.23 351.92 353.64 343.34 " 1,452.80 " 314.16 777.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 10140 Drainage of hematoma/fluid " 7,387.00 " " 2,730.24 " 618.80 " 5,909.60 " 711.85 " 1,469.00 " " 1,467.55 " " 1,469.00 " 724.23 " 4,081.32 " " 1,439.60 " 845.00 693.28 644.56 " 4,889.46 " " 1,257.90 " " 1,397.67 " 618.80 773.50 " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 619.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 10160 Puncture drainage of lesion " 1,816.00 " 671.19 302.14 " 1,469.00 " 892.40 " 1,469.00 " 360.51 " 1,469.00 " 907.92 " 1,003.34 " 353.64 845.00 869.12 808.05 " 1,202.01 " 309.01 343.34 393.78 492.23 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 10180 Complex drainage wound " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 1,718.00 " " 2,473.07 " " 1,718.00 " 907.92 " 6,874.76 " " 2,425.96 " " 2,820.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,208.66 " " 2,760.83 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 11012 Deb skin bone at fx site " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 1,718.00 " " 2,473.07 " " 1,718.00 " 907.92 " 6,874.76 " " 2,425.96 " " 2,820.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,376.02 " " 2,970.02 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 11042 Deb subq tissue 20 sq cm/< " 1,816.00 " 671.19 302.14 " 2,820.00 " 696.90 " 1,718.00 " 360.51 " 1,718.00 " 709.02 " 1,003.34 " 353.64 " 2,820.00 " 678.72 631.03 " 1,202.01 " 309.01 343.34 " 2,208.66 " " 2,760.83 " 351.92 353.64 343.34 " 1,452.80 " 314.16 606.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 11043 Deb musc/fascia 20 sq cm/< " 2,752.00 " " 1,017.14 " 457.83 " 2,820.00 " 696.90 " 1,718.00 " 546.27 " 1,718.00 " 709.02 " 1,520.48 " 535.87 " 2,820.00 " 678.72 631.03 " 1,821.55 " 468.23 520.26 " 2,208.66 " " 2,760.83 " 533.27 535.87 520.26 " 2,201.60 " 476.04 606.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 11044 Deb bone 20 sq cm/< " 7,387.00 " " 2,730.24 " 606.00 " 5,909.60 " 696.90 " 1,718.00 " " 1,467.55 " " 1,718.00 " 709.02 " 4,081.32 " " 1,439.60 " " 2,820.00 " 678.72 631.03 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,208.66 " " 2,760.83 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 606.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11200 Removal of skin tags <w/15 943.00 348.53 156.97 " 1,469.00 " 892.40 " 1,469.00 " 187.30 " 1,469.00 " 907.92 521.01 183.73 845.00 869.12 808.05 624.17 160.54 178.38 618.80 773.50 182.84 183.73 178.38 754.40 163.22 776.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 11401 Exc tr-ext b9+marg 0.6-1 cm " 1,816.00 " 671.19 302.14 " 2,061.86 " 662.40 " 1,469.00 " 360.51 " 1,469.00 " 673.92 " 1,003.34 " 353.64 " 1,775.00 " 645.12 599.79 " 1,202.01 " 309.01 343.34 " 1,649.49 " " 2,061.86 " 351.92 353.64 343.34 " 1,452.80 " 314.16 576.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 11402 Exc tr-ext b9+marg 1.1-2 cm " 3,265.00 " " 1,206.74 " 543.97 " 2,612.00 " 784.30 " 1,469.00 " 649.06 " 1,469.00 " 797.94 " 1,803.91 " 636.69 " 1,775.00 " 763.84 710.17 " 2,161.10 " 556.34 618.15 " 1,649.49 " " 2,061.86 " 633.60 636.69 618.15 " 2,612.00 " 565.61 682.00 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 11403 Exc tr-ext b9+marg 2.1-3cm " 3,265.00 " " 1,206.74 " 543.97 " 2,612.00 " 673.90 " 1,469.00 " 649.06 " 1,469.00 " 685.62 " 1,803.91 " 636.69 " 1,775.00 " 656.32 610.20 " 2,161.10 " 556.34 618.15 " 1,649.49 " " 2,061.86 " 633.60 636.69 618.15 " 2,612.00 " 565.61 586.00 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 11404 Exc tr-ext b9+marg 3.1-4 cm " 7,387.00 " " 2,730.24 " " 1,229.95 " " 5,909.60 " " 1,819.30 " " 1,469.00 " " 1,467.55 " " 1,469.00 " " 1,850.94 " " 4,081.32 " " 1,439.60 " " 1,775.00 " " 1,771.84 " " 1,647.34 " " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " " 1,582.00 " " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11406 Exc tr-ext b9+marg >4.0 cm " 7,387.00 " " 2,730.24 " 837.00 " 5,909.60 " 962.55 " 1,718.00 " " 1,467.55 " " 1,718.00 " 979.29 " 4,081.32 " " 1,439.60 " " 2,820.00 " 937.44 871.57 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,208.66 " " 2,760.83 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 837.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11420 Exc h-f-nk-sp b9+marg 0.5/< " 7,387.00 " " 2,730.24 " 572.00 " 5,909.60 " 657.80 " 1,718.00 " " 1,467.55 " " 1,718.00 " 669.24 " 4,081.32 " " 1,439.60 " " 1,775.00 " 640.64 595.62 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 572.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11421 Exc h-f-nk-sp b9+marg 0.6-1 " 3,265.00 " " 1,206.74 " 543.97 " 2,612.00 " 779.70 " 1,718.00 " 649.06 " 1,718.00 " 793.26 " 1,803.91 " 636.69 " 1,775.00 " 759.36 706.00 " 2,161.10 " 556.34 618.15 " 1,649.49 " " 2,061.86 " 633.60 636.69 618.15 " 2,612.00 " 565.61 678.00 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 11422 Exc h-f-nk-sp b9+marg 1.1-2 " 7,387.00 " " 2,730.24 " 741.00 " 5,909.60 " 852.15 " 1,469.00 " " 1,467.55 " " 1,469.00 " 866.97 " 4,081.32 " " 1,439.60 " " 1,775.00 " 829.92 771.60 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 741.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11423 Exc h-f-nk-sp b9+marg 2.1-3 " 7,387.00 " " 2,730.24 " 691.00 " 5,909.60 " 794.65 " 1,469.00 " " 1,467.55 " " 1,469.00 " 808.47 " 4,081.32 " " 1,439.60 " " 1,775.00 " 773.92 719.54 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 691.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11426 Exc h-f-nk-sp b9+marg >4 cm " 12,443.00 " " 4,598.93 " 846.00 " 9,954.40 " 972.90 " 1,718.00 " " 2,473.07 " " 1,718.00 " 989.82 " 6,874.76 " " 2,425.96 " " 2,820.00 " 947.52 880.94 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,208.66 " " 2,760.83 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 846.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 11606 Exc tr-ext mal+marg >4 cm " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,718.00 " " 1,467.55 " " 1,718.00 " 907.92 " 4,081.32 " " 1,439.60 " " 2,820.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,208.66 " " 2,760.83 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 11730 Removal of nail plate 943.00 348.53 25.75 " 1,469.00 " 29.61 " 1,469.00 " 187.30 " 1,469.00 " 30.13 521.01 183.73 845.00 28.84 26.81 624.17 160.54 178.38 393.78 492.23 182.84 183.73 178.38 754.40 163.22 25.75 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 11740 Drain blood from under nail 588.00 217.32 98.57 " 1,469.00 " 892.40 " 1,469.00 " 117.61 " 1,469.00 " 907.92 324.87 115.37 845.00 869.12 808.05 389.20 100.81 112.01 281.27 351.59 114.81 115.37 112.01 470.40 102.49 776.00 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 11750 Removal of nail bed " 1,816.00 " 671.19 302.14 " 1,775.00 " 892.40 " 1,469.00 " 360.51 " 1,469.00 " 907.92 " 1,003.34 " 353.64 " 1,775.00 " 869.12 808.05 " 1,202.01 " 309.01 343.34 " 1,012.58 " " 1,265.72 " 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 11771 Remove pilonidal cyst exten " 12,443.00 " " 4,598.93 " 838.00 " 9,954.40 " 963.70 " 2,773.00 " " 2,473.07 " " 2,773.00 " 980.46 " 6,874.76 " " 2,425.96 " " 3,545.00 " 938.56 872.61 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,532.97 " " 3,166.21 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 838.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 11772 Remove pilonidal cyst compl " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 2,773.00 " " 2,473.07 " " 2,773.00 " 907.92 " 6,874.76 " " 2,425.96 " " 3,545.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,532.97 " " 3,166.21 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 11970 Rplcmt tiss xpndr perm implt " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 12001 Rpr s/n/ax/gen/trnk 2.5cm/< 943.00 348.53 156.97 " 1,469.00 " 604.90 " 1,469.00 " 187.30 " 1,469.00 " 615.42 521.01 183.73 845.00 589.12 547.72 624.17 160.54 178.38 393.78 492.23 182.84 183.73 178.38 754.40 163.22 526.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12002 Rpr s/n/ax/gen/trnk2.6-7.5cm 943.00 348.53 156.97 907.92 892.40 651.61 187.30 651.61 907.92 521.01 183.73 845.00 869.12 808.05 624.17 160.54 178.38 393.78 492.23 182.84 183.73 178.38 754.40 163.22 776.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12004 Rpr s/n/ax/gen/trk7.6-12.5cm 943.00 348.53 156.97 " 1,469.00 " 848.70 " 1,469.00 " 187.30 " 1,469.00 " 863.46 521.01 183.73 845.00 826.56 768.48 624.17 160.54 178.38 618.80 773.50 182.84 183.73 178.38 754.40 163.22 738.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12005 Rpr s/n/a/gen/trk12.6-20.0cm " 1,816.00 " 671.19 302.14 " 2,820.00 " 892.40 " 1,718.00 " 360.51 " 1,718.00 " 907.92 " 1,003.34 " 353.64 " 2,820.00 " 869.12 808.05 " 1,202.01 " 309.01 343.34 " 2,208.66 " " 2,760.83 " 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12011 Rpr f/e/e/n/l/m 2.5 cm/< 943.00 348.53 156.97 845.00 566.95 651.61 187.30 651.61 576.81 521.01 183.73 845.00 552.16 513.36 624.17 160.54 178.38 393.78 492.23 182.84 183.73 178.38 754.40 163.22 493.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12013 Rpr f/e/e/n/l/m 2.6-5.0 cm 943.00 348.53 156.97 907.92 892.40 651.61 187.30 651.61 907.92 521.01 183.73 845.00 869.12 808.05 624.17 160.54 178.38 393.78 492.23 182.84 183.73 178.38 754.40 163.22 776.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12014 Rpr f/e/e/n/l/m 5.1-7.5 cm 943.00 348.53 156.97 " 1,469.00 " 892.40 " 1,469.00 " 187.30 " 1,469.00 " 907.92 521.01 183.73 845.00 869.12 808.05 624.17 160.54 178.38 618.80 773.50 182.84 183.73 178.38 754.40 163.22 776.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12015 Rpr f/e/e/n/l/m 7.6-12.5 cm 943.00 348.53 156.97 " 1,469.00 " 631.35 " 1,469.00 " 187.30 " 1,469.00 " 642.33 521.01 183.73 845.00 614.88 571.67 624.17 160.54 178.38 618.80 773.50 182.84 183.73 178.38 754.40 163.22 549.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 12020 Closure of split wound " 2,752.00 " " 1,017.14 " 457.83 " 2,201.60 " 892.40 " 1,469.00 " 546.27 " 1,469.00 " 907.92 " 1,520.48 " 535.87 " 1,775.00 " 869.12 808.05 " 1,821.55 " 468.23 520.26 " 1,649.49 " " 2,061.86 " 533.27 535.87 520.26 " 2,201.60 " 476.04 776.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 12031 Intmd rpr s/a/t/ext 2.5 cm/< " 1,816.00 " 671.19 302.14 " 1,469.00 " 604.90 " 1,469.00 " 360.51 " 1,469.00 " 615.42 " 1,003.34 " 353.64 845.00 589.12 547.72 " 1,202.01 " 309.01 343.34 393.78 492.23 351.92 353.64 343.34 " 1,452.80 " 314.16 526.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12032 Intmd rpr s/a/t/ext 2.6-7.5 " 1,816.00 " 671.19 302.14 " 1,469.00 " 892.40 " 1,469.00 " 360.51 " 1,469.00 " 907.92 " 1,003.34 " 353.64 845.00 869.12 808.05 " 1,202.01 " 309.01 343.34 618.80 773.50 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12034 Intmd rpr s/tr/ext 7.6-12.5 " 1,816.00 " 671.19 302.14 " 2,820.00 " 892.40 " 1,718.00 " 360.51 " 1,718.00 " 907.92 " 1,003.34 " 353.64 " 2,820.00 " 869.12 808.05 " 1,202.01 " 309.01 343.34 " 2,208.66 " " 2,760.83 " 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12041 Intmd rpr n-hf/genit 2.5cm/< " 1,816.00 " 671.19 302.14 " 1,469.00 " 604.90 " 1,469.00 " 360.51 " 1,469.00 " 615.42 " 1,003.34 " 353.64 845.00 589.12 547.72 " 1,202.01 " 309.01 343.34 393.78 492.23 351.92 353.64 343.34 " 1,452.80 " 314.16 526.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12042 Intmd rpr n-hf/genit2.6-7.5 " 1,816.00 " 671.19 302.14 " 1,469.00 " 892.40 " 1,469.00 " 360.51 " 1,469.00 " 907.92 " 1,003.34 " 353.64 845.00 869.12 808.05 " 1,202.01 " 309.01 343.34 618.80 773.50 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12044 Intmd rpr n-hf/genit7.6-12.5 " 2,752.00 " " 1,017.14 " 457.83 " 2,820.00 " 848.70 " 1,718.00 " 546.27 " 1,718.00 " 863.46 " 1,520.48 " 535.87 " 2,820.00 " 826.56 768.48 " 1,821.55 " 468.23 520.26 " 2,208.66 " " 2,760.83 " 533.27 535.87 520.26 " 2,201.60 " 476.04 738.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 12051 Intmd rpr face/mm 2.5 cm/< " 1,816.00 " 671.19 302.14 " 1,469.00 " 566.95 " 1,469.00 " 360.51 " 1,469.00 " 576.81 " 1,003.34 " 353.64 845.00 552.16 513.36 " 1,202.01 " 309.01 343.34 393.78 492.23 351.92 353.64 343.34 " 1,452.80 " 314.16 493.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 12052 Intmd rpr face/mm 2.6-5.0 cm " 1,816.00 " 671.19 302.14 " 1,469.00 " 892.40 " 1,469.00 " 360.51 " 1,469.00 " 907.92 " 1,003.34 " 353.64 845.00 869.12 808.05 " 1,202.01 " 309.01 343.34 393.78 492.23 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 13101 Cmplx rpr trunk 2.6-7.5 cm " 2,752.00 " " 1,017.14 " 457.83 " 3,545.00 " 892.40 " 2,773.00 " 546.27 " 2,773.00 " 907.92 " 1,520.48 " 535.87 " 3,545.00 " 869.12 808.05 " 1,821.55 " 468.23 520.26 " 2,532.97 " " 3,166.21 " 533.27 535.87 520.26 " 2,201.60 " 476.04 776.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 13121 Cmplx rpr s/a/l 2.6-7.5 cm " 2,752.00 " " 1,017.14 " 457.83 " 3,545.00 " 892.40 " 2,773.00 " 546.27 " 2,773.00 " 907.92 " 1,520.48 " 535.87 " 3,545.00 " 869.12 808.05 " 1,821.55 " 468.23 520.26 " 2,532.97 " " 3,166.21 " 533.27 535.87 520.26 " 2,201.60 " 476.04 776.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 13131 Cmplx rpr f/c/c/m/n/ax/g/h/f " 1,816.00 " 671.19 302.14 " 2,820.00 " 892.40 " 1,718.00 " 360.51 " 1,718.00 " 907.92 " 1,003.34 " 353.64 " 2,820.00 " 869.12 808.05 " 1,202.01 " 309.01 343.34 " 2,208.66 " " 2,760.83 " 351.92 353.64 343.34 " 1,452.80 " 314.16 776.00 " 1,216.72 " 302.14 742.74 " 1,362.00 " 690.26 812.30 355.36 Outpatient 13132 Cmplx rpr f/c/c/m/n/ax/g/h/f " 2,752.00 " " 1,017.14 " 457.83 " 3,545.00 " 892.40 " 2,773.00 " 546.27 " 2,773.00 " 907.92 " 1,520.48 " 535.87 " 3,545.00 " 869.12 808.05 " 1,821.55 " 468.23 520.26 " 2,532.97 " " 3,166.21 " 533.27 535.87 520.26 " 2,201.60 " 476.04 776.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 13152 Cmplx rpr e/n/e/l 2.6-7.5 cm " 2,752.00 " " 1,017.14 " 457.83 " 3,545.00 " 892.40 " 2,773.00 " 546.27 " 2,773.00 " 907.92 " 1,520.48 " 535.87 " 3,545.00 " 869.12 808.05 " 1,821.55 " 468.23 520.26 " 2,532.97 " " 3,166.21 " 533.27 535.87 520.26 " 2,201.60 " 476.04 776.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 14001 Tis trnfr trunk 10.1-30sqcm " 9,006.00 " " 3,328.62 " 776.00 " 7,204.80 " 892.40 " 2,773.00 " " 1,786.47 " " 2,773.00 " 907.92 " 4,975.82 " " 1,752.44 " " 3,545.00 " 869.12 808.05 " 5,961.07 " " 1,531.26 " " 1,701.40 " " 2,532.97 " " 3,166.21 " " 1,743.94 " " 1,752.44 " " 1,701.40 " " 7,204.80 " " 1,556.78 " 776.00 " 6,034.02 " " 1,497.23 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,760.95 " Outpatient 14301 Tis trnfr any 30.1-60 sq cm " 18,491.00 " " 6,834.27 " 776.00 " 14,792.80 " 892.40 " 2,773.00 " " 3,672.72 " " 2,773.00 " 907.92 " 10,216.28 " " 3,602.76 " " 6,576.00 " 869.12 808.05 " 12,239.19 " " 3,148.05 " " 3,497.83 " " 5,573.80 " " 6,967.25 " " 3,585.28 " " 3,602.76 " " 3,497.83 " " 14,792.80 " " 3,200.51 " 776.00 " 12,388.97 " " 3,078.09 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,620.25 " Outpatient 15002 Wound prep trk/arm/leg " 9,006.00 " " 3,328.62 " 776.00 " 7,204.80 " 892.40 " 1,718.00 " " 1,786.47 " " 1,718.00 " 907.92 " 4,975.82 " " 1,752.44 " " 2,820.00 " 869.12 808.05 " 5,961.07 " " 1,531.26 " " 1,701.40 " " 2,368.76 " " 2,960.95 " " 1,743.94 " " 1,752.44 " " 1,701.40 " " 7,204.80 " " 1,556.78 " 776.00 " 6,034.02 " " 1,497.23 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,760.95 " Outpatient 15004 Wound prep f/n/hf/g " 2,752.00 " " 1,017.14 " 457.83 " 2,960.95 " 892.40 " 1,718.00 " 546.27 " 1,718.00 " 907.92 " 1,520.48 " 535.87 " 2,820.00 " 869.12 808.05 " 1,821.55 " 468.23 520.26 " 2,368.76 " " 2,960.95 " 533.27 535.87 520.26 " 2,201.60 " 476.04 776.00 " 1,843.84 " 457.83 " 1,125.57 " " 2,064.00 " " 1,046.04 " " 1,230.97 " 538.47 Outpatient 15100 Skin splt grft trnk/arm/leg " 9,006.00 " " 3,328.62 " 571.00 " 7,204.80 " 656.65 " 1,718.00 " " 1,786.47 " " 1,718.00 " 668.07 " 4,975.82 " " 1,752.44 " " 2,820.00 " 639.52 594.58 " 5,961.07 " " 1,531.26 " " 1,701.40 " " 2,208.66 " " 2,760.83 " " 1,743.94 " " 1,752.44 " " 1,701.40 " " 7,204.80 " " 1,556.78 " 571.00 " 6,034.02 " " 1,497.23 " " 3,683.45 " " 6,754.50 " " 3,423.18 " " 4,028.38 " " 1,760.95 " Outpatient 15733 Musc myoq/fscq flp h&n pedcl " 18,491.00 " " 6,834.27 " 776.00 " 14,792.80 " 892.40 " 12,777.28 " " 3,672.72 " " 12,777.28 " 907.92 " 10,216.28 " " 3,602.76 " " 6,576.00 " 869.12 808.05 " 12,239.19 " " 3,148.05 " " 3,497.83 " " 2,532.97 " " 3,166.21 " " 3,585.28 " " 3,602.76 " " 3,497.83 " " 14,792.80 " " 3,200.51 " 776.00 " 12,388.97 " " 3,078.09 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,620.25 " Outpatient 15771 Grfg autol fat lipo 50 cc/< " 18,491.00 " " 6,834.27 " 776.00 " 14,792.80 " 892.40 " 12,777.28 " " 3,672.72 " " 12,777.28 " 907.92 " 10,216.28 " " 3,602.76 " " 6,576.00 " 869.12 808.05 " 12,239.19 " " 3,148.05 " " 3,497.83 " " 3,239.74 " " 4,049.68 " " 3,585.28 " " 3,602.76 " " 3,497.83 " " 14,792.80 " " 3,200.51 " 776.00 " 12,388.97 " " 3,078.09 " " 7,562.82 " " 13,868.25 " " 7,028.43 " " 8,271.02 " " 3,620.25 " Outpatient 15830 Exc skin abd " 29,053.00 " " 10,737.99 " 776.00 " 23,242.40 " 892.40 " 2,773.00 " " 5,772.33 " " 2,773.00 " 907.92 " 16,051.78 " " 5,662.38 " " 3,545.00 " 869.12 808.05 " 19,230.18 " " 4,947.71 " " 5,497.46 " " 2,708.70 " " 3,385.88 " " 5,634.90 " " 5,662.38 " " 5,497.46 " " 23,242.40 " " 5,030.18 " 776.00 " 19,465.51 " " 4,837.76 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,689.87 " Outpatient 16020 Dress/debrid p-thick burn s 943.00 348.53 20.00 " 1,775.00 " 23.00 " 1,469.00 " 187.30 " 1,469.00 " 23.40 521.01 183.73 " 1,775.00 " 22.40 20.83 624.17 160.54 178.38 281.27 351.59 182.84 183.73 178.38 754.40 163.22 20.00 631.81 156.97 385.69 707.25 358.43 421.80 184.62 Outpatient 19110 Nipple exploration " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 1,718.00 " " 3,293.60 " " 1,718.00 " 907.92 " 9,159.35 " " 3,230.86 " " 2,820.00 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,208.66 " " 2,760.83 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 19120 Removal of breast lesion " 16,578.00 " " 6,127.23 " 833.00 " 13,262.40 " 957.95 " 2,773.00 " " 3,293.60 " " 2,773.00 " 974.61 " 9,159.35 " " 3,230.86 " " 3,545.00 " 932.96 867.40 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,532.97 " " 3,166.21 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 833.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 19125 Excision breast lesion " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 2,773.00 " " 3,293.60 " " 2,773.00 " 907.92 " 9,159.35 " " 3,230.86 " " 3,545.00 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,532.97 " " 3,166.21 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 19300 Removal of breast tissue " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 3,326.00 " " 3,293.60 " " 3,326.00 " 907.92 " 9,159.35 " " 3,230.86 " " 4,860.00 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 3,346.06 " " 4,182.58 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 19301 Partial mastectomy " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 2,773.00 " " 3,293.60 " " 2,773.00 " 907.92 " 9,159.35 " " 3,230.86 " " 3,545.00 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,708.70 " " 3,385.88 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 19303 Mast simple complete " 29,053.00 " " 10,737.99 " 776.00 " 23,242.40 " 892.40 " 3,326.00 " " 5,772.33 " " 3,326.00 " 907.92 " 16,051.78 " " 5,662.38 " " 4,860.00 " 869.12 808.05 " 19,230.18 " " 4,947.71 " " 5,497.46 " " 3,346.06 " " 4,182.58 " " 5,634.90 " " 5,662.38 " " 5,497.46 " " 23,242.40 " " 5,030.18 " 776.00 " 19,465.51 " " 4,837.76 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,689.87 " Outpatient 19307 Mast mod rad " 29,053.00 " " 10,737.99 " 776.00 " 23,242.40 " 892.40 " 3,604.00 " " 5,772.33 " " 3,604.00 " 907.92 " 16,051.78 " " 5,662.38 " " 6,576.00 " 869.12 808.05 " 19,230.18 " " 4,947.71 " " 5,497.46 " " 5,408.30 " " 6,760.37 " " 5,634.90 " " 5,662.38 " " 5,497.46 " " 23,242.40 " " 5,030.18 " 776.00 " 19,465.51 " " 4,837.76 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,689.87 " Outpatient 19316 Suspension of breast " 29,053.00 " " 10,737.99 " - " 23,242.40 " - " 3,326.00 " " 5,772.33 " " 3,326.00 " - " 16,051.78 " " 5,662.38 " " 4,860.00 " - - " 19,230.18 " " 4,947.71 " " 5,497.46 " " 2,208.66 " " 2,760.83 " " 5,634.90 " " 5,662.38 " " 5,497.46 " " 23,242.40 " " 5,030.18 " - " 19,465.51 " " 4,837.76 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,689.87 " Outpatient 19318 Breast reduction " 29,053.00 " " 10,737.99 " 776.00 " 23,242.40 " 892.40 " 3,326.00 " " 5,772.33 " " 3,326.00 " 907.92 " 16,051.78 " " 5,662.38 " " 4,860.00 " 869.12 808.05 " 19,230.18 " " 4,947.71 " " 5,497.46 " " 3,120.10 " " 3,900.12 " " 5,634.90 " " 5,662.38 " " 5,497.46 " " 23,242.40 " " 5,030.18 " 776.00 " 19,465.51 " " 4,837.76 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,689.87 " Outpatient 19342 Insj/rplcmt brst implt sep d " 46,830.00 " " 17,308.37 " 776.00 " 37,464.00 " 892.40 " 2,773.00 " " 9,300.12 " " 2,773.00 " 907.92 " 25,873.58 " " 9,122.98 " " 3,545.00 " 869.12 808.05 " 30,996.78 " " 7,971.53 " " 8,857.26 " " 2,532.97 " " 3,166.21 " " 9,078.69 " " 9,122.98 " " 8,857.26 " " 37,464.00 " " 8,104.39 " 776.00 " 31,376.10 " " 7,794.39 " " 19,153.47 " " 35,122.50 " " 17,800.08 " " 20,947.06 " " 9,167.26 " Outpatient 19357 Tiss xpndr plmt brst rcnstj " 78,376.00 " " 28,967.77 " 776.00 " 62,700.80 " 892.40 " 3,604.00 " " 15,561.86 " " 3,604.00 " 907.92 " 43,302.74 " " 15,265.44 " " 4,445.00 " 869.12 808.05 " 51,877.07 " " 13,338.74 " " 14,820.82 " " 3,730.57 " " 4,663.21 " " 15,191.34 " " 15,265.44 " " 14,820.82 " " 62,700.80 " " 13,561.05 " 776.00 " 52,511.92 " " 13,042.32 " " 32,055.78 " " 58,782.00 " " 29,790.72 " " 35,057.58 " " 15,339.55 " Outpatient 19371 Peri-implt capslc brst compl " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 3,326.00 " " 3,293.60 " " 3,326.00 " 907.92 " 9,159.35 " " 3,230.86 " " 4,860.00 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 3,120.10 " " 3,900.12 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 19380 Revj reconstructed breast " 29,053.00 " " 10,737.99 " 776.00 " 23,242.40 " 892.40 " 3,604.00 " " 5,772.33 " " 3,604.00 " 907.92 " 16,051.78 " " 5,662.38 " " 4,445.00 " 869.12 808.05 " 19,230.18 " " 4,947.71 " " 5,497.46 " " 3,730.57 " " 4,663.21 " " 5,634.90 " " 5,662.38 " " 5,497.46 " " 23,242.40 " " 5,030.18 " 776.00 " 19,465.51 " " 4,837.76 " " 11,882.68 " " 21,789.75 " " 11,043.05 " " 12,995.41 " " 5,689.87 " Outpatient 19499 Breast surgery procedure " 16,578.00 " " 6,127.23 " - " 13,262.40 " - " 1,469.00 " " 3,293.60 " " 1,469.00 " - " 9,159.35 " " 3,230.86 " " 10,941.48 " - - " 10,972.98 " " 2,823.08 " " 3,136.76 " 56.26 70.32 " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " - " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 20206 Needle biopsy muscle " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,469.00 " " 1,467.55 " " 1,469.00 " 907.92 " 4,081.32 " " 1,439.60 " " 1,775.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 20220 Bone biopsy trocar/needle " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,469.00 " " 1,467.55 " " 1,469.00 " 907.92 " 4,081.32 " " 1,439.60 " " 1,775.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 20225 Bone biopsy trocar/needle " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,718.00 " " 1,467.55 " " 1,718.00 " 907.92 " 4,081.32 " " 1,439.60 " " 2,820.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,208.66 " " 2,760.83 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 20610 Drain/inj joint/bursa w/o us " 1,371.00 " 506.72 56.26 " 1,775.00 " 892.40 " 1,469.00 " 272.51 " 1,469.00 " 907.92 757.48 267.32 " 1,775.00 " 869.12 808.05 907.46 233.58 259.53 56.26 70.32 266.02 267.32 259.53 " 1,096.80 " 237.47 776.00 918.57 228.39 560.74 " 1,028.25 " 521.12 613.25 268.61 Outpatient 20680 Removal of support implant " 12,443.00 " " 4,598.93 " 720.00 " 9,954.40 " 828.00 " 2,773.00 " " 2,473.07 " " 2,773.00 " 842.40 " 6,874.76 " " 2,425.96 " " 3,545.00 " 806.40 749.74 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,532.97 " " 3,166.21 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 720.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 21235 Ear cartilage graft " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 6,540.00 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 21337 Closed tx septal&nose fx " 14,366.00 " " 5,309.67 " 776.00 " 11,492.80 " 892.40 " 1,718.00 " " 2,853.42 " " 1,718.00 " 907.92 " 7,937.22 " " 2,799.07 " " 2,820.00 " 869.12 808.05 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 2,208.66 " " 2,760.83 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 776.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 21552 Exc neck les sc 3 cm/> " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 2,773.00 " " 2,473.07 " " 2,773.00 " 907.92 " 6,874.76 " " 2,425.96 " " 6,576.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,397.90 " " 2,997.38 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 21931 Exc back les sc 3 cm/> " 7,387.00 " " 2,730.24 " 776.00 " 6,576.00 " 892.40 " 2,773.00 " " 1,467.55 " " 2,773.00 " 907.92 " 4,081.32 " " 1,439.60 " " 6,576.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,513.45 " " 3,141.81 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 21933 Exc back tum deep 5 cm/> " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 2,773.00 " " 2,473.07 " " 2,773.00 " 907.92 " 6,874.76 " " 2,425.96 " " 6,576.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 3,984.73 " " 4,980.91 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 22513 Perq vertebral augmentation " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 21,708.06 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 14,228.31 " " 17,785.39 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 22514 Perq vertebral augmentation " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 21,708.06 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 14,149.56 " " 17,686.95 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 22551 Arthrd ant ntrbdy cervical " 64,652.00 " " 23,895.38 " 776.00 " 51,721.60 " 892.40 " 3,686.00 " " 12,861.18 " " 3,686.00 " 907.92 " 35,720.23 " " 12,616.20 " " 42,670.32 " 869.12 808.05 " 42,793.16 " " 11,023.87 " " 12,248.74 " " 9,771.56 " " 12,214.45 " " 12,554.96 " " 12,616.20 " " 12,248.74 " " 51,721.60 " " 11,207.60 " 776.00 " 43,316.84 " " 10,778.89 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,677.45 " Outpatient 22612 Arthrd pst tq 1ntrspc lumbar " 64,652.00 " " 23,895.38 " 776.00 " 51,721.60 " 892.40 " 3,686.00 " " 12,861.18 " " 3,686.00 " 907.92 " 35,720.23 " " 12,616.20 " " 42,670.32 " 869.12 808.05 " 42,793.16 " " 11,023.87 " " 12,248.74 " " 7,992.79 " " 9,990.99 " " 12,554.96 " " 12,616.20 " " 12,248.74 " " 51,721.60 " " 11,207.60 " 776.00 " 43,316.84 " " 10,778.89 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,677.45 " Outpatient 22856 Tot disc arthrp ant 1ntrspc " 83,308.00 " " 30,790.64 " - " 66,646.40 " - " 3,686.00 " " 16,864.63 " " 3,686.00 " - " 46,027.67 " " 16,543.40 " " 54,983.28 " - - " 55,141.57 " " 14,455.40 " " 16,061.55 " " 8,639.66 " " 10,799.58 " " 16,463.09 " " 16,543.40 " " 16,061.55 " " 66,646.40 " " 14,696.32 " - " 55,816.36 " " 14,134.16 " " 34,072.97 " " 62,481.00 " " 31,665.37 " " 37,263.67 " " 16,623.70 " Outpatient 23120 Partial removal collar bone " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 3,604.00 " " 2,953.81 " " 3,604.00 " 907.92 " 8,210.15 " " 2,897.54 " " 4,445.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,730.57 " " 4,663.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 23430 Repair biceps tendon " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,326.00 " " 6,533.13 " " 3,326.00 " 907.92 " 18,172.28 " " 6,408.69 " " 4,860.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 3,120.10 " " 3,900.12 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 23515 Treat clavicle fracture " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 23650 Treat shoulder dislocation " 1,082.00 " 399.91 180.17 " 2,061.86 " 892.40 " 1,469.00 " 214.98 " 1,469.00 " 907.92 597.81 210.88 " 1,775.00 " 869.12 808.05 716.18 184.27 204.74 " 1,649.49 " " 2,061.86 " 209.86 210.88 204.74 865.60 187.34 776.00 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 23655 Treat shoulder dislocation " 7,310.00 " " 2,701.78 " 776.00 " 5,848.00 " 892.40 " 1,469.00 " " 1,452.77 " " 1,469.00 " 907.92 " 4,038.78 " " 1,425.10 " " 1,775.00 " 869.12 808.05 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 1,649.49 " " 2,061.86 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 776.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 24071 Exc arm/elbow les sc 3 cm/> " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 2,773.00 " " 2,473.07 " " 2,773.00 " 907.92 " 6,874.76 " " 2,425.96 " " 6,576.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " " 2,160.39 " " 2,700.49 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 24342 Repair of ruptured tendon " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 24640 Treat elbow dislocation " 1,082.00 " 399.91 180.17 " 1,775.00 " 892.40 747.66 214.98 747.66 907.92 597.81 210.88 " 1,775.00 " 869.12 808.05 716.18 184.27 204.74 281.27 351.59 209.86 210.88 204.74 865.60 187.34 776.00 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 25111 Remove wrist tendon lesion " 7,310.00 " " 2,701.78 " 854.00 " 5,848.00 " 982.10 " 2,773.00 " " 1,452.77 " " 2,773.00 " 999.18 " 4,038.78 " " 1,425.10 " " 3,545.00 " 956.48 889.27 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,532.97 " " 3,166.21 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 854.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 25112 Reremove wrist tendon lesion " 7,310.00 " " 2,701.78 " 854.00 " 5,848.00 " 982.10 " 3,326.00 " " 1,452.77 " " 3,326.00 " 999.18 " 4,038.78 " " 1,425.10 " " 4,860.00 " 956.48 889.27 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 3,120.10 " " 3,900.12 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 854.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 25447 Repair wrist joints " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 3,604.00 " " 2,953.81 " " 3,604.00 " 907.92 " 8,210.15 " " 2,897.54 " " 4,445.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,730.57 " " 4,663.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 25565 Treat fracture radius & ulna " 7,310.00 " " 2,701.78 " 688.00 " 5,848.00 " 791.20 " 1,718.00 " " 1,452.77 " " 1,718.00 " 804.96 " 4,038.78 " " 1,425.10 " " 2,820.00 " 770.56 716.41 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,208.66 " " 2,760.83 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 688.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 25600 Treat fracture radius/ulna " 1,082.00 " 399.91 180.17 " 1,469.00 " 892.40 " 1,469.00 " 214.98 " 1,469.00 " 907.92 597.81 210.88 845.00 869.12 808.05 716.18 184.27 204.74 393.78 492.23 209.86 210.88 204.74 865.60 187.34 776.00 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 25605 Treat fracture radius/ulna " 7,310.00 " " 2,701.78 " 994.00 " 5,848.00 " " 1,143.10 " " 2,773.00 " " 1,452.77 " " 2,773.00 " " 1,162.98 " " 4,038.78 " " 1,425.10 " " 3,545.00 " " 1,113.28 " " 1,035.05 " " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,532.97 " " 3,166.21 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 994.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 25607 Treat fx rad extra-articul " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,604.00 " " 6,533.13 " " 3,604.00 " 907.92 " 18,172.28 " " 6,408.69 " " 4,445.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 3,808.03 " " 4,760.04 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 25609 Treat fx radial 3+ frag " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,604.00 " " 6,533.13 " " 3,604.00 " 907.92 " 18,172.28 " " 6,408.69 " " 4,445.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 3,808.03 " " 4,760.04 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 26055 Incise finger tendon sheath " 7,310.00 " " 2,701.78 " 643.00 " 5,848.00 " 739.45 " 1,718.00 " " 1,452.77 " " 1,718.00 " 752.31 " 4,038.78 " " 1,425.10 " " 2,820.00 " 720.16 669.56 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,208.66 " " 2,760.83 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 643.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 26123 Release palm contracture " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 3,326.00 " " 2,953.81 " " 3,326.00 " 907.92 " 8,210.15 " " 2,897.54 " " 4,860.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 26160 Remove tendon sheath lesion " 7,310.00 " " 2,701.78 " 775.00 " 5,848.00 " 891.25 " 2,773.00 " " 1,452.77 " " 2,773.00 " 906.75 " 4,038.78 " " 1,425.10 " " 3,545.00 " 868.00 807.01 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,532.97 " " 3,166.21 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 775.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 26356 Repair finger/hand tendon " 14,860.00 " " 5,492.26 " 849.00 " 11,888.00 " 976.35 " 3,326.00 " " 2,953.81 " " 3,326.00 " 993.33 " 8,210.15 " " 2,897.54 " " 4,860.00 " 950.88 884.06 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 849.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 26418 Repair finger tendon " 7,310.00 " " 2,701.78 " 809.00 " 5,848.00 " 930.35 " 3,326.00 " " 1,452.77 " " 3,326.00 " 946.53 " 4,038.78 " " 1,425.10 " " 4,860.00 " 906.08 842.41 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 3,120.10 " " 3,900.12 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 809.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 26440 Release palm/finger tendon " 7,310.00 " " 2,701.78 " 744.00 " 5,848.00 " 855.60 " 2,773.00 " " 1,452.77 " " 2,773.00 " 870.48 " 4,038.78 " " 1,425.10 " " 3,545.00 " 833.28 774.73 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,532.97 " " 3,166.21 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 744.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 26615 Treat metacarpal fracture " 14,860.00 " " 5,492.26 " 873.00 " 11,888.00 " " 1,003.95 " " 3,326.00 " " 2,953.81 " " 3,326.00 " " 1,021.41 " " 8,210.15 " " 2,897.54 " " 4,860.00 " 977.76 909.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 873.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 26725 Treat finger fracture each " 1,082.00 " 399.91 180.17 " 1,718.00 " 840.65 " 1,718.00 " 214.98 " 1,718.00 " 855.27 597.81 210.88 845.00 818.72 761.19 716.18 184.27 204.74 393.78 492.23 209.86 210.88 204.74 865.60 187.34 731.00 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 26727 Treat finger fracture each " 14,860.00 " " 5,492.26 " 900.00 " 11,888.00 " " 1,035.00 " " 4,435.00 " " 2,953.81 " " 4,435.00 " " 1,053.00 " " 8,210.15 " " 2,897.54 " " 6,540.00 " " 1,008.00 " 937.17 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 4,937.34 " " 6,171.67 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 900.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 26735 Treat finger fracture each " 14,860.00 " " 5,492.26 " 900.00 " 11,888.00 " " 1,035.00 " " 3,326.00 " " 2,953.81 " " 3,326.00 " " 1,053.00 " " 8,210.15 " " 2,897.54 " " 4,860.00 " " 1,008.00 " 937.17 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 900.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 26755 Treat finger fracture each " 1,082.00 " 399.91 180.17 907.92 892.40 747.66 214.98 747.66 907.92 597.81 210.88 845.00 869.12 808.05 716.18 184.27 204.74 393.78 492.23 209.86 210.88 204.74 865.60 187.34 776.00 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 26756 Pin finger fracture each " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 1,718.00 " " 2,953.81 " " 1,718.00 " 907.92 " 8,210.15 " " 2,897.54 " " 2,820.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,208.66 " " 2,760.83 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 26770 Treat finger dislocation " 1,082.00 " 399.91 36.50 865.60 41.98 747.66 214.98 747.66 42.71 597.81 210.88 845.00 40.88 38.01 716.18 184.27 204.74 281.27 351.59 209.86 210.88 204.74 865.60 187.34 36.50 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 26951 Amputation of finger/thumb " 14,860.00 " " 5,492.26 " 526.00 " 11,888.00 " 604.90 " 1,718.00 " " 2,953.81 " " 1,718.00 " 615.42 " 8,210.15 " " 2,897.54 " " 2,820.00 " 589.12 547.72 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,208.66 " " 2,760.83 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 526.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 27130 Total hip arthroplasty " 64,652.00 " " 23,895.38 " 776.00 " 51,721.60 " 892.40 " 44,674.53 " " 12,861.18 " " 44,674.53 " 907.92 " 35,720.23 " " 12,616.20 " " 42,670.32 " 869.12 808.05 " 42,793.16 " " 11,023.87 " " 12,248.74 " " 7,473.06 " " 9,341.32 " " 12,554.96 " " 12,616.20 " " 12,248.74 " " 51,721.60 " " 11,207.60 " 776.00 " 43,316.84 " " 10,778.89 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,677.45 " Outpatient 27446 Revision of knee joint " 64,652.00 " " 23,895.38 " 776.00 " 51,721.60 " 892.40 " 3,604.00 " " 12,861.18 " " 3,604.00 " 907.92 " 35,720.23 " " 12,616.20 " " 42,670.32 " 869.12 808.05 " 42,793.16 " " 11,023.87 " " 12,248.74 " " 6,047.74 " " 7,559.68 " " 12,554.96 " " 12,616.20 " " 12,248.74 " " 51,721.60 " " 11,207.60 " 776.00 " 43,316.84 " " 10,778.89 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,677.45 " Outpatient 27447 Total knee arthroplasty " 64,652.00 " " 23,895.38 " 776.00 " 51,721.60 " 892.40 " 44,674.53 " " 12,861.18 " " 44,674.53 " 907.92 " 35,720.23 " " 12,616.20 " " 42,670.32 " 869.12 808.05 " 42,793.16 " " 11,023.87 " " 12,248.74 " " 8,066.71 " " 10,083.39 " " 12,554.96 " " 12,616.20 " " 12,248.74 " " 51,721.60 " " 11,207.60 " 776.00 " 43,316.84 " " 10,778.89 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,677.45 " Outpatient 27524 Treat kneecap fracture " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27654 Repair of achilles tendon " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27659 Repair of leg tendon each " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 1,718.00 " " 6,533.13 " " 1,718.00 " 907.92 " 18,172.28 " " 6,408.69 " " 2,820.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,208.66 " " 2,760.83 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27691 Revise lower leg tendon " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,326.00 " " 6,533.13 " " 3,326.00 " 907.92 " 18,172.28 " " 6,408.69 " " 4,860.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 3,120.10 " " 3,900.12 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27698 Repair of ankle ligament " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 1,718.00 " " 6,533.13 " " 1,718.00 " 907.92 " 18,172.28 " " 6,408.69 " " 2,820.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,208.66 " " 2,760.83 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27792 Treatment of ankle fracture " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27822 Treatment of ankle fracture " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 27829 Treat lower leg joint " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 1,718.00 " " 6,533.13 " " 1,718.00 " 907.92 " 18,172.28 " " 6,408.69 " " 2,820.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,208.66 " " 2,760.83 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 28008 Incision of foot fascia " 14,860.00 " " 5,492.26 " 888.00 " 11,888.00 " " 1,021.20 " " 2,773.00 " " 2,953.81 " " 2,773.00 " " 1,038.96 " " 8,210.15 " " 2,897.54 " " 3,545.00 " 994.56 924.67 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 888.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28035 Decompression of tibia nerve " 9,211.00 " " 3,404.39 " 776.00 " 7,368.80 " 892.40 " 3,326.00 " " 1,831.46 " " 3,326.00 " 907.92 " 5,089.08 " " 1,796.58 " " 4,860.00 " 869.12 808.05 " 6,096.76 " " 1,569.83 " " 1,744.25 " " 3,120.10 " " 3,900.12 " " 1,787.86 " " 1,796.58 " " 1,744.25 " " 7,368.80 " " 1,595.99 " 776.00 " 6,171.37 " " 1,534.94 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,805.30 " Outpatient 28060 Partial removal foot fascia " 14,860.00 " " 5,492.26 " 628.00 " 11,888.00 " 722.20 " 1,718.00 " " 2,953.81 " " 1,718.00 " 734.76 " 8,210.15 " " 2,897.54 " " 2,820.00 " 703.36 653.94 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,208.66 " " 2,760.83 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 628.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28080 Removal of foot lesion " 7,310.00 " " 2,701.78 " 779.00 " 5,848.00 " 895.85 " 2,773.00 " " 1,452.77 " " 2,773.00 " 911.43 " 4,038.78 " " 1,425.10 " " 3,545.00 " 872.48 811.17 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,532.97 " " 3,166.21 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 779.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 28090 Removal of foot lesion " 7,310.00 " " 2,701.78 " 886.00 " 5,848.00 " " 1,018.90 " " 2,773.00 " " 1,452.77 " " 2,773.00 " " 1,036.62 " " 4,038.78 " " 1,425.10 " " 3,545.00 " 992.32 922.59 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 2,532.97 " " 3,166.21 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 886.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 28118 Removal of heel bone " 14,860.00 " " 5,492.26 " 832.00 " 11,888.00 " 956.80 " 3,326.00 " " 2,953.81 " " 3,326.00 " 973.44 " 8,210.15 " " 2,897.54 " " 4,860.00 " 931.84 866.36 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 832.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28119 Removal of heel spur " 14,860.00 " " 5,492.26 " 832.00 " 11,888.00 " 956.80 " 3,326.00 " " 2,953.81 " " 3,326.00 " 973.44 " 8,210.15 " " 2,897.54 " " 4,860.00 " 931.84 866.36 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 832.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28122 Partial removal of foot bone " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 2,773.00 " " 2,953.81 " " 2,773.00 " 907.92 " 8,210.15 " " 2,897.54 " " 3,545.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28124 Partial removal of toe " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 1,718.00 " " 2,953.81 " " 1,718.00 " 907.92 " 8,210.15 " " 2,897.54 " " 3,545.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 4,937.34 " " 6,171.67 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28192 Removal of foot foreign body " 7,387.00 " " 2,730.24 " 720.00 " 5,909.60 " 828.00 " 1,718.00 " " 1,467.55 " " 1,718.00 " 842.40 " 4,081.32 " " 1,439.60 " " 2,820.00 " 806.40 749.74 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,208.66 " " 2,760.83 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 720.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 28238 Revision of foot tendon " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 28285 Repair of hammertoe " 14,860.00 " " 5,492.26 " 947.00 " 11,888.00 " " 1,089.05 " " 2,773.00 " " 2,953.81 " " 2,773.00 " " 1,107.99 " " 8,210.15 " " 2,897.54 " " 3,545.00 " " 1,060.64 " 986.11 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 947.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28289 Corrj halux rigdus w/o implt " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 2,773.00 " " 2,953.81 " " 2,773.00 " 907.92 " 8,210.15 " " 2,897.54 " " 3,545.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,717.03 " " 3,396.29 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28292 Correction hallux valgus " 14,860.00 " " 5,492.26 " " 1,236.00 " " 11,888.00 " " 1,421.40 " " 1,718.00 " " 2,953.81 " " 1,718.00 " " 1,446.12 " " 8,210.15 " " 2,897.54 " " 2,820.00 " " 1,384.32 " " 1,287.05 " " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,208.66 " " 2,760.83 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " " 1,236.00 " " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28296 Correction hallux valgus " 14,860.00 " " 5,492.26 " " 1,085.00 " " 11,888.00 " " 1,247.75 " " 2,773.00 " " 2,953.81 " " 2,773.00 " " 1,269.45 " " 8,210.15 " " 2,897.54 " " 3,545.00 " " 1,215.20 " " 1,129.81 " " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " " 1,085.00 " " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28298 Correction hallux valgus " 32,891.00 " " 12,156.51 " " 1,372.00 " " 26,312.80 " " 1,577.80 " " 2,773.00 " " 6,533.13 " " 2,773.00 " " 1,605.24 " " 18,172.28 " " 6,408.69 " " 3,545.00 " " 1,536.64 " " 1,428.66 " " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " " 1,372.00 " " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 28299 Correction hallux valgus " 32,891.00 " " 12,156.51 " " 1,085.00 " " 26,312.80 " " 1,247.75 " " 3,604.00 " " 6,533.13 " " 3,604.00 " " 1,269.45 " " 18,172.28 " " 6,408.69 " " 4,445.00 " " 1,215.20 " " 1,129.81 " " 21,770.55 " " 5,599.83 " " 6,222.03 " " 3,730.57 " " 4,663.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " " 1,085.00 " " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 28300 Incision of heel bone " 32,891.00 " " 12,156.51 " " 1,384.00 " " 26,312.80 " " 1,591.60 " " 1,718.00 " " 6,533.13 " " 1,718.00 " " 1,619.28 " " 18,172.28 " " 6,408.69 " " 2,820.00 " " 1,550.08 " " 1,441.16 " " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,208.66 " " 2,760.83 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " " 1,384.00 " " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 28308 Incision of metatarsal " 14,860.00 " " 5,492.26 " " 1,036.00 " " 11,888.00 " " 1,191.40 " " 1,718.00 " " 2,953.81 " " 1,718.00 " " 1,212.12 " " 8,210.15 " " 2,897.54 " " 2,820.00 " " 1,160.32 " " 1,078.79 " " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,208.66 " " 2,760.83 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " " 1,036.00 " " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28820 Amputation of toe " 14,860.00 " " 5,492.26 " 730.00 " 11,888.00 " 839.50 " 1,718.00 " " 2,953.81 " " 1,718.00 " 854.10 " 8,210.15 " " 2,897.54 " " 2,820.00 " 817.60 760.15 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,208.66 " " 2,760.83 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 730.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 28899 Foot/toes surgery procedure " 1,082.00 " 399.91 - " 1,469.00 " - " 1,469.00 " 214.98 " 1,469.00 " - 597.81 210.88 714.12 - - 716.18 184.27 204.74 56.26 70.32 209.86 210.88 204.74 865.60 187.34 - 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 29105 Apply long arm splint 741.00 273.87 123.50 907.92 892.40 512.03 147.36 512.03 907.92 409.40 144.55 845.00 869.12 808.05 490.47 126.31 140.34 393.78 492.23 143.85 144.55 140.34 592.80 128.41 776.00 496.47 123.50 303.07 555.75 281.65 331.45 145.25 Outpatient 29125 Apply forearm splint 588.00 217.32 26.00 845.00 29.90 406.31 117.61 406.31 30.42 324.87 115.37 845.00 29.12 27.07 389.20 100.81 112.01 281.27 351.59 114.81 115.37 112.01 470.40 102.49 26.00 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 29130 Application of finger splint 588.00 217.32 - 845.00 - 406.31 117.61 406.31 - 324.87 115.37 845.00 - - 389.20 100.81 112.01 168.76 210.95 114.81 115.37 112.01 470.40 102.49 - 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 29505 Application long leg splint 741.00 273.87 37.00 " 1,265.72 " 42.55 512.03 147.36 512.03 43.29 409.40 144.55 845.00 41.44 38.53 490.47 126.31 140.34 " 1,012.58 " " 1,265.72 " 143.85 144.55 140.34 592.80 128.41 37.00 496.47 123.50 303.07 555.75 281.65 331.45 145.25 Outpatient 29515 Application lower leg splint 741.00 273.87 35.00 845.00 40.25 512.03 147.36 512.03 40.95 409.40 144.55 845.00 39.20 36.45 490.47 126.31 140.34 393.78 492.23 143.85 144.55 140.34 592.80 128.41 35.00 496.47 123.50 303.07 555.75 281.65 331.45 145.25 Outpatient 29807 Sho arthrs srg rpr slap les " 32,891.00 " " 12,156.51 " 788.28 " 26,312.80 " 906.52 " 2,773.00 " " 6,533.13 " " 2,773.00 " 922.29 " 18,172.28 " " 6,408.69 " " 3,545.00 " 882.87 820.84 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,650.99 " " 3,313.74 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 788.28 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 29822 Sho arthrs srg lmtd dbrdmt " 14,860.00 " " 5,492.26 " 932.00 " 11,888.00 " " 1,071.80 " " 2,773.00 " " 2,953.81 " " 2,773.00 " " 1,090.44 " " 8,210.15 " " 2,897.54 " " 3,545.00 " " 1,043.84 " 970.49 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 932.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29823 Sho arthrs srg xtnsv dbrdmt " 14,860.00 " " 5,492.26 " 932.00 " 11,888.00 " " 1,071.80 " " 2,773.00 " " 2,953.81 " " 2,773.00 " " 1,090.44 " " 8,210.15 " " 2,897.54 " " 3,545.00 " " 1,043.84 " 970.49 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 932.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29824 Sho arthrs srg dstl claviclc " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 3,604.00 " " 2,953.81 " " 3,604.00 " 907.92 " 8,210.15 " " 2,897.54 " " 4,445.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,727.42 " " 4,659.27 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29827 Sho arthrs srg rt8tr cuf rpr " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,604.00 " " 6,533.13 " " 3,604.00 " 907.92 " 18,172.28 " " 6,408.69 " " 4,445.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 3,819.73 " " 4,774.66 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 29828 Sho arthrs srg bicp tenodsis " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 6,576.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 4,491.24 " " 5,614.05 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 29848 Wrist endoscopy/surgery " 7,310.00 " " 2,701.78 " 776.00 " 6,576.00 " 892.40 " 4,656.00 " " 1,452.77 " " 4,656.00 " 907.92 " 4,038.78 " " 1,425.10 " " 6,576.00 " 869.12 808.05 " 4,838.49 " " 1,245.23 " " 1,383.59 " " 4,937.34 " " 6,171.67 " " 1,418.18 " " 1,425.10 " " 1,383.59 " " 5,848.00 " " 1,265.98 " 776.00 " 4,897.70 " " 1,217.56 " " 2,989.79 " " 5,482.50 " " 2,778.53 " " 3,269.76 " " 1,432.02 " Outpatient 29877 Knee arthroscopy/surgery " 14,860.00 " " 5,492.26 " 932.00 " 11,888.00 " " 1,071.80 " " 3,326.00 " " 2,953.81 " " 3,326.00 " " 1,090.44 " " 8,210.15 " " 2,897.54 " " 4,860.00 " " 1,043.84 " 970.49 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 932.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29879 Knee arthroscopy/surgery " 14,860.00 " " 5,492.26 " 932.00 " 11,888.00 " " 1,071.80 " " 2,773.00 " " 2,953.81 " " 2,773.00 " " 1,090.44 " " 8,210.15 " " 2,897.54 " " 3,545.00 " " 1,043.84 " 970.49 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 2,532.97 " " 3,166.21 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 932.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29880 Knee arthroscopy/surgery " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 3,326.00 " " 2,953.81 " " 3,326.00 " 907.92 " 8,210.15 " " 2,897.54 " " 4,860.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29881 Knee arthroscopy/surgery " 14,860.00 " " 5,492.26 " 932.00 " 11,888.00 " " 1,071.80 " " 3,326.00 " " 2,953.81 " " 3,326.00 " " 1,090.44 " " 8,210.15 " " 2,897.54 " " 4,860.00 " " 1,043.84 " 970.49 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 3,120.10 " " 3,900.12 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 932.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29888 Knee arthroscopy/surgery " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 2,773.00 " " 6,533.13 " " 2,773.00 " 907.92 " 18,172.28 " " 6,408.69 " " 3,545.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 2,532.97 " " 3,166.21 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 29893 Scope plantar fasciotomy " 14,860.00 " " 5,492.26 " 776.00 " 11,888.00 " 892.40 " 4,656.00 " " 2,953.81 " " 4,656.00 " 907.92 " 8,210.15 " " 2,897.54 " " 6,576.00 " 869.12 808.05 " 9,835.83 " " 2,531.84 " " 2,813.15 " " 7,133.34 " " 8,916.67 " " 2,883.48 " " 2,897.54 " " 2,813.15 " " 11,888.00 " " 2,574.03 " 776.00 " 9,956.20 " " 2,475.57 " " 6,077.74 " " 11,145.00 " " 5,648.29 " " 6,646.88 " " 2,911.61 " Outpatient 29999 Arthroscopy of joint " 1,082.00 " 399.91 - " 1,469.00 " - " 1,469.00 " 214.98 " 1,469.00 " - 597.81 210.88 714.12 - - 716.18 184.27 204.74 - - 209.86 210.88 204.74 865.60 187.34 - 724.94 180.17 442.54 811.50 411.27 483.98 211.91 Outpatient 30140 Resect inferior turbinate " 14,366.00 " " 5,309.67 " 776.00 " 11,492.80 " 892.40 " 1,718.00 " " 2,853.42 " " 1,718.00 " 907.92 " 7,937.22 " " 2,799.07 " " 2,820.00 " 869.12 808.05 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 2,208.66 " " 2,760.83 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 776.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 30420 Reconstruction of nose " 26,702.00 " " 9,869.06 " - " 21,361.60 " - " 3,604.00 " " 5,304.76 " " 3,604.00 " - " 14,752.86 " " 5,203.71 " " 4,445.00 " - - " 17,674.05 " " 4,546.94 " " 5,052.15 " " 3,730.57 " " 4,663.21 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " - " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 30520 Repair of nasal septum " 14,366.00 " " 5,309.67 " 823.00 " 11,492.80 " 946.45 " 3,326.00 " " 2,853.42 " " 3,326.00 " 962.91 " 7,937.22 " " 2,799.07 " " 4,860.00 " 921.76 856.99 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 3,120.10 " " 3,900.12 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 823.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 30901 Control of nosebleed 588.00 217.32 98.57 " 1,469.00 " 892.40 " 1,469.00 " 117.61 " 1,469.00 " 907.92 324.87 115.37 845.00 869.12 808.05 389.20 100.81 112.01 393.78 492.23 114.81 115.37 112.01 470.40 102.49 776.00 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 31237 Nasal/sinus endoscopy surg " 7,856.00 " " 2,903.58 " 776.00 " 6,284.80 " 892.40 " 1,718.00 " " 1,560.50 " " 1,718.00 " 907.92 " 4,340.44 " " 1,530.78 " " 2,820.00 " 869.12 808.05 " 5,199.89 " " 1,337.57 " " 1,486.19 " " 2,208.66 " " 2,760.83 " " 1,523.34 " " 1,530.78 " " 1,486.19 " " 6,284.80 " " 1,359.86 " 776.00 " 5,263.52 " " 1,307.85 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,538.21 " Outpatient 31238 Nasal/sinus endoscopy surg " 7,856.00 " " 2,903.58 " 776.00 " 6,284.80 " 892.40 " 1,469.00 " " 1,560.50 " " 1,469.00 " 907.92 " 4,340.44 " " 1,530.78 " " 1,775.00 " 869.12 808.05 " 5,199.89 " " 1,337.57 " " 1,486.19 " " 1,649.49 " " 2,061.86 " " 1,523.34 " " 1,530.78 " " 1,486.19 " " 6,284.80 " " 1,359.86 " 776.00 " 5,263.52 " " 1,307.85 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,538.21 " Outpatient 31240 Nasal/sinus endoscopy surg " 7,856.00 " " 2,903.58 " 776.00 " 6,284.80 " 892.40 " 1,718.00 " " 1,560.50 " " 1,718.00 " 907.92 " 4,340.44 " " 1,530.78 " " 2,820.00 " 869.12 808.05 " 5,199.89 " " 1,337.57 " " 1,486.19 " " 2,208.66 " " 2,760.83 " " 1,523.34 " " 1,530.78 " " 1,486.19 " " 6,284.80 " " 1,359.86 " 776.00 " 5,263.52 " " 1,307.85 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,538.21 " Outpatient 31253 Nsl/sins ndsc total " 30,569.00 " " 11,298.30 " 776.00 " 24,455.20 " 892.40 " 21,123.18 " " 6,074.00 " " 21,123.18 " 907.92 " 16,889.37 " " 5,958.30 " " 6,576.00 " 869.12 808.05 " 20,233.62 " " 5,206.28 " " 5,784.76 " " 2,849.74 " " 3,562.17 " " 5,929.38 " " 5,958.30 " " 5,784.76 " " 24,455.20 " " 5,293.06 " 776.00 " 20,481.23 " " 5,090.59 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 5,987.23 " Outpatient 31254 Nsl/sins ndsc w/prtl ethmdct " 30,569.00 " " 11,298.30 " 776.00 " 24,455.20 " 892.40 " 2,773.00 " " 6,074.00 " " 2,773.00 " 907.92 " 16,889.37 " " 5,958.30 " " 3,545.00 " 869.12 808.05 " 20,233.62 " " 5,206.28 " " 5,784.76 " " 2,532.97 " " 3,166.21 " " 5,929.38 " " 5,958.30 " " 5,784.76 " " 24,455.20 " " 5,293.06 " 776.00 " 20,481.23 " " 5,090.59 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 5,987.23 " Outpatient 31255 Nsl/sins ndsc w/tot ethmdct " 30,569.00 " " 11,298.30 " 776.00 " 24,455.20 " 892.40 " 3,604.00 " " 6,074.00 " " 3,604.00 " 907.92 " 16,889.37 " " 5,958.30 " " 4,445.00 " 869.12 808.05 " 20,233.62 " " 5,206.28 " " 5,784.76 " " 3,730.57 " " 4,663.21 " " 5,929.38 " " 5,958.30 " " 5,784.76 " " 24,455.20 " " 5,293.06 " 776.00 " 20,481.23 " " 5,090.59 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 5,987.23 " Outpatient 31256 Exploration maxillary sinus " 16,265.00 " " 6,011.54 " 776.00 " 13,012.00 " 892.40 " 2,773.00 " " 3,230.87 " " 2,773.00 " 907.92 " 8,986.41 " " 3,169.33 " " 3,545.00 " 869.12 808.05 " 10,765.80 " " 2,769.32 " " 3,077.02 " " 2,532.97 " " 3,166.21 " " 3,153.95 " " 3,169.33 " " 3,077.02 " " 13,012.00 " " 2,815.47 " 776.00 " 10,897.55 " " 2,707.78 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,184.72 " Outpatient 31259 Nsl/sins ndsc sphn tiss rmvl " 30,569.00 " " 11,298.30 " 776.00 " 24,455.20 " 892.40 " 21,123.18 " " 6,074.00 " " 21,123.18 " 907.92 " 16,889.37 " " 5,958.30 " " 6,576.00 " 869.12 808.05 " 20,233.62 " " 5,206.28 " " 5,784.76 " " 2,688.90 " " 3,361.13 " " 5,929.38 " " 5,958.30 " " 5,784.76 " " 24,455.20 " " 5,293.06 " 776.00 " 20,481.23 " " 5,090.59 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 5,987.23 " Outpatient 31267 Endoscopy maxillary sinus " 30,569.00 " " 11,298.30 " 776.00 " 24,455.20 " 892.40 " 2,773.00 " " 6,074.00 " " 2,773.00 " 907.92 " 16,889.37 " " 5,958.30 " " 3,545.00 " 869.12 808.05 " 20,233.62 " " 5,206.28 " " 5,784.76 " " 2,532.97 " " 3,166.21 " " 5,929.38 " " 5,958.30 " " 5,784.76 " " 24,455.20 " " 5,293.06 " 776.00 " 20,481.23 " " 5,090.59 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 5,987.23 " Outpatient 31276 Nsl/sins ndsc frnt tiss rmvl " 30,569.00 " " 11,298.30 " 776.00 " 24,455.20 " 892.40 " 2,773.00 " " 6,074.00 " " 2,773.00 " 907.92 " 16,889.37 " " 5,958.30 " " 3,545.00 " 869.12 808.05 " 20,233.62 " " 5,206.28 " " 5,784.76 " " 2,532.97 " " 3,166.21 " " 5,929.38 " " 5,958.30 " " 5,784.76 " " 24,455.20 " " 5,293.06 " 776.00 " 20,481.23 " " 5,090.59 " " 12,502.72 " " 22,926.75 " " 11,619.28 " " 13,673.51 " " 5,987.23 " Outpatient 31500 Insert emergency airway " 1,111.00 " 410.63 184.94 " 2,061.86 " 892.40 " 1,469.00 " 220.67 " 1,469.00 " 907.92 613.83 216.46 " 1,775.00 " 869.12 808.05 735.37 189.14 210.16 " 1,649.49 " " 2,061.86 " 215.41 216.46 210.16 888.80 192.30 776.00 744.37 184.94 454.40 833.25 422.29 496.95 217.52 Outpatient 31541 Larynscop w/tumr exc + scope " 16,265.00 " " 6,011.54 " " 1,036.00 " " 13,012.00 " " 1,191.40 " " 3,326.00 " " 3,230.87 " " 3,326.00 " " 1,212.12 " " 8,986.41 " " 3,169.33 " " 4,860.00 " " 1,160.32 " " 1,078.79 " " 10,765.80 " " 2,769.32 " " 3,077.02 " " 3,120.10 " " 3,900.12 " " 3,153.95 " " 3,169.33 " " 3,077.02 " " 13,012.00 " " 2,815.47 " " 1,036.00 " " 10,897.55 " " 2,707.78 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,184.72 " Outpatient 31623 Dx bronchoscope/brush " 7,856.00 " " 2,903.58 " 776.00 " 6,284.80 " 892.40 " 1,718.00 " " 1,560.50 " " 1,718.00 " 907.92 " 4,340.44 " " 1,530.78 " " 2,820.00 " 869.12 808.05 " 5,199.89 " " 1,337.57 " " 1,486.19 " " 2,376.02 " " 2,970.02 " " 1,523.34 " " 1,530.78 " " 1,486.19 " " 6,284.80 " " 1,359.86 " 776.00 " 5,263.52 " " 1,307.85 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,538.21 " Outpatient 31624 Dx bronchoscope/lavage " 7,856.00 " " 2,903.58 " 776.00 " 6,284.80 " 892.40 " 1,718.00 " " 1,560.50 " " 1,718.00 " 907.92 " 4,340.44 " " 1,530.78 " " 2,820.00 " 869.12 808.05 " 5,199.89 " " 1,337.57 " " 1,486.19 " " 2,376.02 " " 2,970.02 " " 1,523.34 " " 1,530.78 " " 1,486.19 " " 6,284.80 " " 1,359.86 " 776.00 " 5,263.52 " " 1,307.85 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,538.21 " Outpatient 31625 Bronchoscopy w/biopsy(s) " 7,856.00 " " 2,903.58 " 664.00 " 6,284.80 " 763.60 " 1,718.00 " " 1,560.50 " " 1,718.00 " 776.88 " 4,340.44 " " 1,530.78 " " 2,820.00 " 743.68 691.42 " 5,199.89 " " 1,337.57 " " 1,486.19 " " 2,208.66 " " 2,760.83 " " 1,523.34 " " 1,530.78 " " 1,486.19 " " 6,284.80 " " 1,359.86 " 664.00 " 5,263.52 " " 1,307.85 " " 3,213.10 " " 5,892.00 " " 2,986.07 " " 3,513.99 " " 1,538.21 " Outpatient 31652 Bronch ebus samplng 1/2 node " 16,265.00 " " 6,011.54 " 776.00 " 13,012.00 " 892.40 " 11,239.12 " " 3,230.87 " " 11,239.12 " 907.92 " 8,986.41 " " 3,169.33 " " 6,576.00 " 869.12 808.05 " 10,765.80 " " 2,769.32 " " 3,077.02 " " 4,883.10 " " 6,103.88 " " 3,153.95 " " 3,169.33 " " 3,077.02 " " 13,012.00 " " 2,815.47 " 776.00 " 10,897.55 " " 2,707.78 " " 6,652.39 " " 12,198.75 " " 6,182.33 " " 7,275.33 " " 3,184.72 " Outpatient 32408 Core ndl bx lng/med perq " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 5,104.42 " " 1,467.55 " " 5,104.42 " 907.92 " 4,081.32 " " 1,439.60 " " 4,875.42 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 3,914.37 " " 4,893.15 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 32550 Insert pleural cath " 16,713.00 " " 6,177.12 " 776.00 " 13,370.40 " 892.40 " 1,718.00 " " 3,318.47 " " 1,718.00 " 907.92 " 9,233.93 " " 3,255.26 " " 6,576.00 " 869.12 808.05 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 4,291.87 " " 5,364.84 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 776.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 32555 Aspirate pleura w/ imaging " 2,844.00 " " 1,051.14 " 472.51 " 2,275.20 " 892.40 " 1,469.00 " 563.79 " 1,469.00 " 907.92 " 1,571.31 " 553.05 " 1,775.00 " 869.12 808.05 " 1,882.44 " 483.25 536.94 " 1,221.79 " " 1,527.24 " 550.36 553.05 536.94 " 2,275.20 " 491.30 776.00 " 1,905.48 " 472.51 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 555.73 Outpatient 33207 Insert heart pm ventricular " 54,601.00 " " 20,180.53 " 776.00 " 43,680.80 " 892.40 " 4,435.00 " " 10,845.22 " " 4,435.00 " 907.92 " 30,167.05 " " 10,638.64 " " 36,036.66 " 869.12 808.05 " 36,140.40 " " 9,295.90 " " 10,328.78 " " 2,726.76 " " 3,408.45 " " 10,587.00 " " 10,638.64 " " 10,328.78 " " 43,680.80 " " 9,450.83 " 776.00 " 36,582.67 " " 9,089.33 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,690.29 " Outpatient 33208 Insrt heart pm atrial & vent " 54,601.00 " " 20,180.53 " 776.00 " 43,680.80 " 892.40 " 4,435.00 " " 10,845.22 " " 4,435.00 " 907.92 " 30,167.05 " " 10,638.64 " " 36,036.66 " 869.12 808.05 " 36,140.40 " " 9,295.90 " " 10,328.78 " " 2,764.00 " " 3,455.00 " " 10,587.00 " " 10,638.64 " " 10,328.78 " " 43,680.80 " " 9,450.83 " 776.00 " 36,582.67 " " 9,089.33 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,690.29 " Outpatient 33228 Remv&replc pm gen dual lead " 54,601.00 " " 20,180.53 " 776.00 " 43,680.80 " 892.40 " 2,773.00 " " 10,845.22 " " 2,773.00 " 907.92 " 30,167.05 " " 10,638.64 " " 36,036.66 " 869.12 808.05 " 36,140.40 " " 9,295.90 " " 10,328.78 " " 1,355.62 " " 1,694.52 " " 10,587.00 " " 10,638.64 " " 10,328.78 " " 43,680.80 " " 9,450.83 " 776.00 " 36,582.67 " " 9,089.33 " " 22,331.81 " " 40,950.75 " " 20,753.84 " " 24,423.03 " " 10,690.29 " Outpatient 33249 Insj/rplcmt defib w/lead(s) " 172,404.00 " " 63,720.52 " 776.00 " 137,923.20 " 892.40 " 4,435.00 " " 34,260.64 " " 4,435.00 " 907.92 " 95,253.21 " " 33,608.06 " " 113,786.64 " 869.12 808.05 " 114,114.21 " " 29,366.26 " " 32,629.18 " " 4,804.63 " " 6,005.79 " " 33,444.91 " " 33,608.06 " " 32,629.18 " " 137,923.20 " " 29,855.70 " 776.00 " 115,510.68 " " 28,713.68 " " 70,513.24 " " 129,303.00 " " 65,530.76 " " 77,116.31 " " 33,771.20 " Outpatient 33263 Rmvl & rplcmt dfb gen 2 lead " 120,961.00 " " 44,707.19 " 776.00 " 96,768.80 " 892.40 " 2,773.00 " " 24,051.83 " " 2,773.00 " 907.92 " 66,830.95 " " 23,593.70 " " 79,834.26 " 869.12 808.05 " 80,064.09 " " 20,615.85 " " 22,906.50 " " 1,469.48 " " 1,836.85 " " 23,479.16 " " 23,593.70 " " 22,906.50 " " 96,768.80 " " 20,959.45 " 776.00 " 81,043.87 " " 20,157.72 " " 49,473.05 " " 90,720.75 " " 45,977.28 " " 54,105.86 " " 23,708.23 " Outpatient 33264 Rmvl & rplcmt dfb gen mlt ld " 172,404.00 " " 63,720.52 " 776.00 " 137,923.20 " 892.40 " 2,773.00 " " 34,260.64 " " 2,773.00 " 907.92 " 95,253.21 " " 33,608.06 " " 113,786.64 " 869.12 808.05 " 114,114.21 " " 29,366.26 " " 32,629.18 " " 1,525.73 " " 1,907.16 " " 33,444.91 " " 33,608.06 " " 32,629.18 " " 137,923.20 " " 29,855.70 " 776.00 " 115,510.68 " " 28,713.68 " " 70,513.24 " " 129,303.00 " " 65,530.76 " " 77,116.31 " " 33,771.20 " Outpatient 33285 Insj subq car rhythm mntr " 42,801.00 " " 15,819.25 " 776.00 " 34,681.61 " 892.40 " 29,575.49 " " 8,509.62 " " 29,575.49 " 907.92 " 23,647.55 " " 8,347.53 " " 28,248.66 " 869.12 808.05 " 28,329.98 " " 7,293.96 " " 8,104.40 " " 27,745.29 " " 34,681.61 " " 8,307.01 " " 8,347.53 " " 8,104.40 " " 34,240.80 " " 7,415.53 " 776.00 " 28,676.67 " " 7,131.87 " " 17,505.61 " " 32,100.75 " " 16,268.66 " " 19,144.89 " " 8,388.05 " Outpatient 33286 Rmvl subq car rhythm mntr " 3,265.00 " " 1,206.74 " 543.97 " 2,820.00 " 892.40 " 2,256.12 " 649.06 " 2,256.12 " 907.92 " 1,803.91 " 636.69 " 2,820.00 " 869.12 808.05 " 2,161.10 " 556.34 618.15 747.46 934.32 633.60 636.69 618.15 " 2,612.00 " 565.61 776.00 " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 36223 Place cath carotid/inom art " 25,044.00 " " 9,256.26 " 776.00 " 20,035.20 " 892.40 " 1,718.00 " " 4,973.85 " " 1,718.00 " 907.92 " 13,836.81 " " 4,879.11 " " 16,529.04 " 869.12 808.05 " 16,576.62 " " 4,263.30 " " 4,737.00 " " 3,787.10 " " 4,733.88 " " 4,855.43 " " 4,879.11 " " 4,737.00 " " 20,035.20 " " 4,334.36 " 776.00 " 16,779.48 " " 4,168.56 " " 10,243.00 " " 18,783.00 " " 9,519.22 " " 11,202.18 " " 4,902.80 " Outpatient 36225 Place cath subclavian art " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 1,718.00 " " 2,985.82 " " 1,718.00 " 907.92 " 8,300.76 " " 2,928.95 " " 9,915.84 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 3,759.65 " " 4,699.56 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36475 Endovenous rf 1st vein " 15,024.00 " " 5,552.87 " 776.00 " 14,414.70 " 892.40 " 4,656.00 " " 2,985.82 " " 4,656.00 " 907.92 " 8,300.76 " " 2,928.95 " " 6,576.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 11,531.76 " " 14,414.70 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36556 Insert non-tunnel cv cath " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 1,469.00 " " 2,985.82 " " 1,469.00 " 907.92 " 8,300.76 " " 2,928.95 " " 1,775.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 1,768.58 " " 2,210.73 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36558 Insert tunneled cv cath " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 1,718.00 " " 2,985.82 " " 1,718.00 " 907.92 " 8,300.76 " " 2,928.95 " " 2,820.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 2,368.76 " " 2,960.95 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36561 Insert tunneled cv cath " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 2,773.00 " " 2,985.82 " " 2,773.00 " 907.92 " 8,300.76 " " 2,928.95 " " 3,545.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 2,708.70 " " 3,385.88 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36573 Insj picc rs&i 5 yr+ " 7,382.00 " " 2,728.39 " 776.00 " 5,905.60 " 892.40 " 5,100.96 " " 1,466.71 " " 5,100.96 " 907.92 " 4,078.56 " " 1,438.78 " " 4,645.00 " 869.12 808.05 " 4,886.15 " " 1,257.18 " " 1,396.87 " " 2,150.94 " " 2,688.68 " " 1,431.79 " " 1,438.78 " " 1,396.87 " " 5,905.60 " " 1,278.14 " 776.00 " 4,945.94 " " 1,229.25 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,445.76 " Outpatient 36581 Replace tunneled cv cath " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 1,718.00 " " 2,985.82 " " 1,718.00 " 907.92 " 8,300.76 " " 2,928.95 " " 2,820.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 2,368.76 " " 2,960.95 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36589 Removal tunneled cv cath " 2,844.00 " " 1,051.14 " 472.51 " 2,275.20 " 892.40 " 1,469.00 " 563.79 " 1,469.00 " 907.92 " 1,571.31 " 553.05 " 1,775.00 " 869.12 808.05 " 1,882.44 " 483.25 536.94 " 1,768.58 " " 2,210.73 " 550.36 553.05 536.94 " 2,275.20 " 491.30 776.00 " 1,905.48 " 472.51 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 555.73 Outpatient 36590 Removal tunneled cv cath " 7,382.00 " " 2,728.39 " 776.00 " 5,905.60 " 892.40 " 1,469.00 " " 1,466.71 " " 1,469.00 " 907.92 " 4,078.56 " " 1,438.78 " " 1,775.00 " 869.12 808.05 " 4,886.15 " " 1,257.18 " " 1,396.87 " " 1,768.58 " " 2,210.73 " " 1,431.79 " " 1,438.78 " " 1,396.87 " " 5,905.60 " " 1,278.14 " 776.00 " 4,945.94 " " 1,229.25 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,445.76 " Outpatient 36598 Inj w/fluor eval cv device " 1,068.00 " 394.73 - " 1,775.00 " - " 1,718.00 " 213.37 " 1,718.00 " - 590.07 209.31 " 1,775.00 " - - 706.91 182.89 203.21 628.63 785.79 208.29 209.31 203.21 854.40 185.94 - 715.56 178.82 436.81 801.00 405.95 477.72 210.32 Outpatient 36821 Av fusion direct any site " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 2,773.00 " " 2,985.82 " " 2,773.00 " 907.92 " 8,300.76 " " 2,928.95 " " 3,545.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 2,532.97 " " 3,166.21 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 36830 Artery-vein nonautograft " 25,044.00 " " 9,256.26 " 776.00 " 20,035.20 " 892.40 " 3,326.00 " " 4,973.85 " " 3,326.00 " 907.92 " 13,836.81 " " 4,879.11 " " 4,860.00 " 869.12 808.05 " 16,576.62 " " 4,263.30 " " 4,737.00 " " 3,120.10 " " 3,900.12 " " 4,855.43 " " 4,879.11 " " 4,737.00 " " 20,035.20 " " 4,334.36 " 776.00 " 16,779.48 " " 4,168.56 " " 10,243.00 " " 18,783.00 " " 9,519.22 " " 11,202.18 " " 4,902.80 " Outpatient 36832 Av fistula revision open " 25,044.00 " " 9,256.26 " 776.00 " 20,035.20 " 892.40 " 3,326.00 " " 4,973.85 " " 3,326.00 " 907.92 " 13,836.81 " " 4,879.11 " " 4,860.00 " 869.12 808.05 " 16,576.62 " " 4,263.30 " " 4,737.00 " " 3,120.10 " " 3,900.12 " " 4,855.43 " " 4,879.11 " " 4,737.00 " " 20,035.20 " " 4,334.36 " 776.00 " 16,779.48 " " 4,168.56 " " 10,243.00 " " 18,783.00 " " 9,519.22 " " 11,202.18 " " 4,902.80 " Outpatient 36901 Intro cath dialysis circuit " 7,382.00 " " 2,728.39 " 776.00 " 5,905.60 " 892.40 " 5,100.96 " " 1,466.71 " " 5,100.96 " 907.92 " 4,078.56 " " 1,438.78 " 845.00 869.12 808.05 " 4,886.15 " " 1,257.18 " " 1,396.87 " " 3,093.15 " " 3,866.44 " " 1,431.79 " " 1,438.78 " " 1,396.87 " " 5,905.60 " " 1,278.14 " 776.00 " 4,945.94 " " 1,229.25 " " 3,019.24 " " 5,536.50 " " 2,805.90 " " 3,301.97 " " 1,445.76 " Outpatient 36902 Intro cath dialysis circuit " 26,023.00 " " 9,618.10 " 776.00 " 20,818.40 " 892.40 " 17,981.89 " " 5,169.57 " " 17,981.89 " 907.92 " 14,377.71 " " 5,071.10 " " 17,175.18 " 869.12 808.05 " 17,224.62 " " 4,431.06 " " 4,923.40 " " 6,549.82 " " 8,187.27 " " 5,046.49 " " 5,071.10 " " 4,923.40 " " 20,818.40 " " 4,504.91 " 776.00 " 17,435.41 " " 4,332.59 " " 10,643.41 " " 19,517.25 " " 9,891.34 " " 11,640.09 " " 5,095.72 " Outpatient 36903 Intro cath dialysis circuit " 52,725.00 " " 19,487.16 " 776.00 " 52,813.32 " 892.40 " 36,432.98 " " 10,476.71 " " 36,432.98 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 42,250.66 " " 52,813.32 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 36905 Thrmbc/nfs dialysis circuit " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 36,432.98 " " 10,476.71 " " 36,432.98 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 12,229.09 " " 15,286.36 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 36906 Thrmbc/nfs dialysis circuit " 84,336.00 " " 31,170.59 " 776.00 " 67,468.80 " 892.40 " 58,276.18 " " 16,751.22 " " 58,276.18 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 51,297.47 " " 64,121.84 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 37184 Prim art m-thrmbc 1st vsl " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 4,656.00 " " 10,476.71 " " 4,656.00 " 907.92 " 29,130.56 " " 10,277.15 " " 6,576.00 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 15,766.93 " " 19,708.66 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37191 Ins endovas vena cava filtr " 25,044.00 " " 9,256.26 " 776.00 " 20,035.20 " 892.40 " 2,773.00 " " 4,973.85 " " 2,773.00 " 907.92 " 13,836.81 " " 4,879.11 " " 16,529.04 " 869.12 808.05 " 16,576.62 " " 4,263.30 " " 4,737.00 " " 9,479.66 " " 11,849.57 " " 4,855.43 " " 4,879.11 " " 4,737.00 " " 20,035.20 " " 4,334.36 " 776.00 " 16,779.48 " " 4,168.56 " " 10,243.00 " " 18,783.00 " " 9,519.22 " " 11,202.18 " " 4,902.80 " Outpatient 37220 Iliac revasc " 26,023.00 " " 9,618.10 " 776.00 " 21,504.86 " 892.40 " 3,326.00 " " 5,169.57 " " 3,326.00 " 907.92 " 14,377.71 " " 5,071.10 " " 17,175.18 " 869.12 808.05 " 17,224.62 " " 4,431.06 " " 4,923.40 " " 17,203.89 " " 21,504.86 " " 5,046.49 " " 5,071.10 " " 4,923.40 " " 20,818.40 " " 4,504.91 " 776.00 " 17,435.41 " " 4,332.59 " " 10,643.41 " " 19,517.25 " " 9,891.34 " " 11,640.09 " " 5,095.72 " Outpatient 37221 Iliac revasc w/stent " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 3,326.00 " " 10,476.71 " " 3,326.00 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 25,387.55 " " 31,734.44 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37224 Fem/popl revas w/tla " 26,023.00 " " 9,618.10 " 776.00 " 25,821.12 " 892.40 " 3,326.00 " " 5,169.57 " " 3,326.00 " 907.92 " 14,377.71 " " 5,071.10 " " 17,175.18 " 869.12 808.05 " 17,224.62 " " 4,431.06 " " 4,923.40 " " 20,656.90 " " 25,821.12 " " 5,046.49 " " 5,071.10 " " 4,923.40 " " 20,818.40 " " 4,504.91 " 776.00 " 17,435.41 " " 4,332.59 " " 10,643.41 " " 19,517.25 " " 9,891.34 " " 11,640.09 " " 5,095.72 " Outpatient 37225 Fem/popl revas w/ather " 52,725.00 " " 19,487.16 " 776.00 " 72,672.46 " 892.40 " 3,326.00 " " 10,476.71 " " 3,326.00 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 58,137.97 " " 72,672.46 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37226 Fem/popl revasc w/stent " 52,725.00 " " 19,487.16 " 776.00 " 60,805.03 " 892.40 " 3,326.00 " " 10,476.71 " " 3,326.00 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 48,644.02 " " 60,805.03 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37227 Fem/popl revasc stnt & ather " 84,336.00 " " 31,170.59 " 776.00 " 98,217.58 " 892.40 " 3,326.00 " " 16,751.22 " " 3,326.00 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 78,574.06 " " 98,217.58 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 37228 Tib/per revasc w/tla " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 3,326.00 " " 10,476.71 " " 3,326.00 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 29,380.89 " " 36,726.11 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37229 Tib/per revasc w/ather " 84,336.00 " " 31,170.59 " 776.00 " 72,090.79 " 892.40 " 3,326.00 " " 16,751.22 " " 3,326.00 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 57,672.63 " " 72,090.79 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 37230 Tib/per revasc w/stent " 84,336.00 " " 31,170.59 " 776.00 " 67,468.80 " 892.40 " 3,326.00 " " 16,751.22 " " 3,326.00 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 45,341.22 " " 56,676.52 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 37231 Tib/per revasc stent & ather " 84,336.00 " " 31,170.59 " 776.00 " 90,820.27 " 892.40 " 3,326.00 " " 16,751.22 " " 3,326.00 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 72,656.22 " " 90,820.27 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 37236 Open/perq place stent 1st " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 2,773.00 " " 10,476.71 " " 2,773.00 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 5,959.59 " " 7,449.49 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37242 Vasc embolize/occlude artery " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 2,773.00 " " 10,476.71 " " 2,773.00 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 16,123.81 " " 20,154.76 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 37609 Temporal artery procedure " 7,387.00 " " 2,730.24 " 408.00 " 5,909.60 " 469.20 " 1,718.00 " " 1,467.55 " " 1,718.00 " 477.36 " 4,081.32 " " 1,439.60 " " 2,820.00 " 456.96 424.85 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 2,208.66 " " 2,760.83 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 408.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 37700 Revise leg vein " 15,024.00 " " 5,552.87 " 968.00 " 12,019.20 " " 1,113.20 " " 1,718.00 " " 2,985.82 " " 1,718.00 " " 1,132.56 " " 8,300.76 " " 2,928.95 " " 2,820.00 " " 1,084.16 " " 1,007.98 " " 9,944.39 " " 2,559.28 " " 2,843.64 " " 2,208.66 " " 2,760.83 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 968.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 37765 Stab phleb veins xtr 10-20 " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 2,773.00 " " 2,985.82 " " 2,773.00 " 907.92 " 8,300.76 " " 2,928.95 " " 3,545.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 2,549.50 " " 3,186.88 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 37799 Vascular surgery procedure " 2,844.00 " " 1,051.14 " - " 2,275.20 " - " 1,718.00 " 563.79 " 1,718.00 " - " 1,571.31 " 553.05 " 1,877.04 " - - " 1,882.44 " 483.25 536.94 56.26 70.32 550.36 553.05 536.94 " 2,275.20 " 491.30 - " 1,905.48 " 472.51 " 1,163.20 " " 2,133.00 " " 1,081.00 " " 1,272.12 " 555.73 Outpatient 38222 Dx bone marrow bx & aspir " 12,443.00 " " 4,598.93 " 776.00 " 9,954.40 " 892.40 " 8,598.11 " " 2,473.07 " " 8,598.11 " 907.92 " 6,874.76 " " 2,425.96 " " 1,775.00 " 869.12 808.05 " 8,236.02 " " 2,119.77 " " 2,355.30 " 935.18 " 1,168.97 " " 2,414.18 " " 2,425.96 " " 2,355.30 " " 9,954.40 " " 2,155.10 " 776.00 " 8,336.81 " " 2,072.66 " " 5,089.19 " " 9,332.25 " " 4,729.58 " " 5,565.75 " " 2,437.74 " Outpatient 38505 Needle biopsy lymph nodes " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,469.00 " " 1,467.55 " " 1,469.00 " 907.92 " 4,081.32 " " 1,439.60 " " 1,775.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 38510 Biopsy/removal lymph nodes " 16,578.00 " " 6,127.23 " 743.00 " 13,262.40 " 854.45 " 1,718.00 " " 3,293.60 " " 1,718.00 " 869.31 " 9,159.35 " " 3,230.86 " " 2,820.00 " 832.16 773.69 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,208.66 " " 2,760.83 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 743.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 38525 Biopsy/removal lymph nodes " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 1,718.00 " " 3,293.60 " " 1,718.00 " 907.92 " 9,159.35 " " 3,230.86 " " 2,820.00 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,208.66 " " 2,760.83 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 38531 Open bx/exc inguinofem nodes " 16,578.00 " " 6,127.23 " 776.00 " 13,262.40 " 892.40 " 11,455.40 " " 3,293.60 " " 11,455.40 " 907.92 " 9,159.35 " " 3,230.86 " " 10,941.48 " 869.12 808.05 " 10,972.98 " " 2,823.08 " " 3,136.76 " " 2,503.21 " " 3,129.01 " " 3,215.18 " " 3,230.86 " " 3,136.76 " " 13,262.40 " " 2,870.14 " 776.00 " 11,107.26 " " 2,760.35 " " 6,780.40 " " 12,433.50 " " 6,301.30 " " 7,415.34 " " 3,246.55 " Outpatient 38792 Ra tracer id of sentinl node " 1,980.00 " 731.81 - " 1,775.00 " - " 1,368.18 " 393.18 " 1,368.18 " - " 1,093.95 " 385.69 " 1,775.00 " - - " 1,310.56 " 337.01 374.46 207.07 258.84 383.82 385.69 374.46 " 1,584.00 " 342.63 - " 1,326.60 " 329.52 809.82 " 1,485.00 " 752.60 885.65 387.57 Outpatient 41800 Drainage of gum lesion 588.00 217.32 98.57 " 2,061.86 " 711.85 " 1,469.00 " 117.61 " 1,469.00 " 724.23 324.87 115.37 " 1,775.00 " 693.28 644.56 389.20 100.81 112.01 " 1,649.49 " " 2,061.86 " 114.81 115.37 112.01 470.40 102.49 619.00 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 42415 Excise parotid gland/lesion " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 6,540.00 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 42820 Remove tonsils and adenoids " 26,702.00 " " 9,869.06 " 694.00 " 21,361.60 " 798.10 " 2,773.00 " " 5,304.76 " " 2,773.00 " 811.98 " 14,752.86 " " 5,203.71 " " 3,545.00 " 777.28 722.66 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 694.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 42821 Remove tonsils and adenoids " 14,366.00 " " 5,309.67 " 700.00 " 11,492.80 " 805.00 " 3,604.00 " " 2,853.42 " " 3,604.00 " 819.00 " 7,937.22 " " 2,799.07 " " 4,445.00 " 784.00 728.91 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 3,730.57 " " 4,663.21 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 700.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 42826 Removal of tonsils " 14,366.00 " " 5,309.67 " 700.00 " 11,492.80 " 805.00 " 3,326.00 " " 2,853.42 " " 3,326.00 " 819.00 " 7,937.22 " " 2,799.07 " " 4,860.00 " 784.00 728.91 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 3,120.10 " " 3,900.12 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 700.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 42830 Removal of adenoids " 14,366.00 " " 5,309.67 " 620.00 " 11,492.80 " 713.00 " 3,326.00 " " 2,853.42 " " 3,326.00 " 725.40 " 7,937.22 " " 2,799.07 " " 4,860.00 " 694.40 645.61 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 3,730.57 " " 4,663.21 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 620.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 43235 Egd diagnostic brush wash " 4,250.00 " " 1,570.80 " 286.00 " 3,400.00 " 328.90 " 1,469.00 " 843.97 " 1,469.00 " 334.62 " 2,348.13 " 827.89 " 1,775.00 " 320.32 297.81 " 2,813.08 " 723.40 803.78 " 1,649.49 " " 2,061.86 " 823.87 827.89 803.78 " 3,400.00 " 735.46 286.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 43236 Uppr gi scope w/submuc inj " 4,250.00 " " 1,570.80 " 707.33 " 3,400.00 " 892.40 " 1,718.00 " 843.97 " 1,718.00 " 907.92 " 2,348.13 " 827.89 " 2,820.00 " 869.12 808.05 " 2,813.08 " 723.40 803.78 " 2,376.02 " " 2,970.02 " 823.87 827.89 803.78 " 3,400.00 " 735.46 776.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 43238 Egd us fine needle bx/aspir " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 1,718.00 " " 1,694.09 " " 1,718.00 " 907.92 " 4,713.38 " " 1,661.82 " " 2,820.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 1,528.60 " " 1,910.75 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43239 Egd biopsy single/multiple " 4,250.00 " " 1,570.80 " 281.00 " 3,400.00 " 323.15 " 1,718.00 " 843.97 " 1,718.00 " 328.77 " 2,348.13 " 827.89 " 2,820.00 " 314.72 292.61 " 2,813.08 " 723.40 803.78 " 2,208.66 " " 2,760.83 " 823.87 827.89 803.78 " 3,400.00 " 735.46 281.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 43245 Egd dilate stricture " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 1,718.00 " " 1,694.09 " " 1,718.00 " 907.92 " 4,713.38 " " 1,661.82 " " 2,820.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,208.66 " " 2,760.83 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43246 Egd place gastrostomy tube " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 1,718.00 " " 1,694.09 " " 1,718.00 " 907.92 " 4,713.38 " " 1,661.82 " " 2,820.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,208.66 " " 2,760.83 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43247 Egd remove foreign body " 4,250.00 " " 1,570.80 " 451.00 " 3,400.00 " 518.65 " 1,718.00 " 843.97 " 1,718.00 " 527.67 " 2,348.13 " 827.89 " 2,820.00 " 505.12 469.63 " 2,813.08 " 723.40 803.78 " 2,208.66 " " 2,760.83 " 823.87 827.89 803.78 " 3,400.00 " 735.46 451.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 43248 Egd guide wire insertion " 4,250.00 " " 1,570.80 " 707.33 " 3,400.00 " 892.40 " 1,718.00 " 843.97 " 1,718.00 " 907.92 " 2,348.13 " 827.89 " 2,820.00 " 869.12 808.05 " 2,813.08 " 723.40 803.78 " 2,208.66 " " 2,760.83 " 823.87 827.89 803.78 " 3,400.00 " 735.46 776.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 43249 Esoph egd dilation <30 mm " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 1,718.00 " " 1,694.09 " " 1,718.00 " 907.92 " 4,713.38 " " 1,661.82 " " 2,820.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,208.66 " " 2,760.83 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43251 Egd remove lesion snare " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 1,718.00 " " 1,694.09 " " 1,718.00 " 907.92 " 4,713.38 " " 1,661.82 " " 2,820.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,208.66 " " 2,760.83 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43255 Egd control bleeding any " 8,531.00 " " 3,153.06 " 356.00 " 6,824.80 " 409.40 " 1,718.00 " " 1,694.09 " " 1,718.00 " 416.52 " 4,713.38 " " 1,661.82 " " 2,820.00 " 398.72 370.70 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,208.66 " " 2,760.83 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 356.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43259 Egd us exam duodenum/jejunum " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 2,773.00 " " 1,694.09 " " 2,773.00 " 907.92 " 4,713.38 " " 1,661.82 " " 3,545.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,532.97 " " 3,166.21 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43262 Endo cholangiopancreatograph " 16,174.00 " " 5,977.91 " 144.00 " 12,939.20 " 165.60 " 1,718.00 " " 3,202.61 " " 1,718.00 " 168.48 " 8,936.14 " " 3,141.60 " " 2,820.00 " 161.28 149.95 " 10,705.57 " " 2,745.09 " " 3,050.10 " " 2,208.66 " " 2,760.83 " " 3,126.35 " " 3,141.60 " " 3,050.10 " " 12,939.20 " " 2,790.84 " 144.00 " 10,836.58 " " 2,684.09 " " 6,615.17 " " 12,130.50 " " 6,147.74 " " 7,234.63 " " 3,156.85 " Outpatient 43264 Ercp remove duct calculi " 16,174.00 " " 5,977.91 " 776.00 " 12,939.20 " 892.40 " 1,718.00 " " 3,202.61 " " 1,718.00 " 907.92 " 8,936.14 " " 3,141.60 " " 2,820.00 " 869.12 808.05 " 10,705.57 " " 2,745.09 " " 3,050.10 " " 2,208.66 " " 2,760.83 " " 3,126.35 " " 3,141.60 " " 3,050.10 " " 12,939.20 " " 2,790.84 " 776.00 " 10,836.58 " " 2,684.09 " " 6,615.17 " " 12,130.50 " " 6,147.74 " " 7,234.63 " " 3,156.85 " Outpatient 43270 Egd lesion ablation " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 2,773.00 " " 1,694.09 " " 2,773.00 " 907.92 " 4,713.38 " " 1,661.82 " " 4,445.00 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 2,532.97 " " 3,166.21 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 43280 Laparoscopy fundoplasty " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 3,604.00 " " 9,289.96 " " 3,604.00 " 907.92 " 25,837.66 " " 9,113.01 " " 4,445.00 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 5,477.43 " " 6,846.79 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 43281 Lap paraesophag hern repair " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 32,314.62 " " 9,289.96 " " 32,314.62 " 907.92 " 25,837.66 " " 9,113.01 " " 30,864.90 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 8,507.13 " " 10,633.91 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 43762 Rplc gtube no revj trc " 1,397.00 " 516.33 31.10 " 1,775.00 " 35.77 965.33 277.55 965.33 36.39 771.84 272.26 " 1,775.00 " 34.83 32.38 924.67 237.90 264.33 " 1,209.30 " " 1,511.63 " 270.94 272.26 264.33 " 1,117.60 " 241.86 31.10 935.99 232.61 571.37 " 1,047.75 " 531.00 624.88 273.58 Outpatient 44180 Lap enterolysis " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 2,773.00 " " 5,277.62 " " 2,773.00 " 907.92 " 14,678.27 " " 5,177.09 " " 4,445.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,593.96 " " 5,742.45 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 44970 Laparoscopy appendectomy " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 2,773.00 " " 5,277.62 " " 2,773.00 " 907.92 " 14,678.27 " " 5,177.09 " " 4,860.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,937.34 " " 6,171.67 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 45330 Diagnostic sigmoidoscopy " 4,167.00 " " 1,540.12 " 337.00 " 3,333.60 " 387.55 " 1,469.00 " 827.73 " 1,469.00 " 394.29 " 2,302.27 " 811.96 " 1,775.00 " 377.44 350.92 " 2,758.14 " 709.48 788.31 " 1,012.58 " " 1,265.72 " 808.02 811.96 788.31 " 3,333.60 " 721.30 337.00 " 2,791.89 " 693.71 " 1,704.30 " " 3,125.25 " " 1,583.88 " " 1,863.90 " 815.90 Outpatient 45331 Sigmoidoscopy and biopsy " 4,167.00 " " 1,540.12 " 227.00 " 3,333.60 " 261.05 " 1,469.00 " 827.73 " 1,469.00 " 265.59 " 2,302.27 " 811.96 " 1,775.00 " 254.24 236.38 " 2,758.14 " 709.48 788.31 " 1,649.49 " " 2,061.86 " 808.02 811.96 788.31 " 3,333.60 " 721.30 227.00 " 2,791.89 " 693.71 " 1,704.30 " " 3,125.25 " " 1,583.88 " " 1,863.90 " 815.90 Outpatient 45378 Diagnostic colonoscopy " 4,167.00 " " 1,540.12 " 443.00 " 3,333.60 " 509.45 " 1,718.00 " 827.73 " 1,718.00 " 518.31 " 2,302.27 " 811.96 " 2,820.00 " 496.16 461.30 " 2,758.14 " 709.48 788.31 " 2,208.66 " " 2,760.83 " 808.02 811.96 788.31 " 3,333.60 " 721.30 443.00 " 2,791.89 " 693.71 " 1,704.30 " " 3,125.25 " " 1,583.88 " " 1,863.90 " 815.90 Outpatient 45380 Colonoscopy and biopsy " 5,444.00 " " 2,012.10 " 320.00 " 4,355.20 " 368.00 " 1,718.00 " " 1,081.58 " " 1,718.00 " 374.40 " 3,007.81 " " 1,060.98 " " 2,820.00 " 358.40 333.22 " 3,603.38 " 927.07 " 1,030.08 " " 2,208.66 " " 2,760.83 " " 1,055.83 " " 1,060.98 " " 1,030.08 " " 4,355.20 " 942.52 320.00 " 3,647.48 " 906.47 " 2,226.60 " " 4,083.00 " " 2,069.26 " " 2,435.10 " " 1,066.13 " Outpatient 45381 Colonoscopy submucous njx " 5,444.00 " " 2,012.10 " 776.00 " 4,355.20 " 892.40 " 1,718.00 " " 1,081.58 " " 1,718.00 " 907.92 " 3,007.81 " " 1,060.98 " " 2,820.00 " 869.12 808.05 " 3,603.38 " 927.07 " 1,030.08 " " 2,376.02 " " 2,970.02 " " 1,055.83 " " 1,060.98 " " 1,030.08 " " 4,355.20 " 942.52 776.00 " 3,647.48 " 906.47 " 2,226.60 " " 4,083.00 " " 2,069.26 " " 2,435.10 " " 1,066.13 " Outpatient 45384 Colonoscopy w/lesion removal " 5,444.00 " " 2,012.10 " 776.00 " 4,355.20 " 892.40 " 1,718.00 " " 1,081.58 " " 1,718.00 " 907.92 " 3,007.81 " " 1,060.98 " " 2,820.00 " 869.12 808.05 " 3,603.38 " 927.07 " 1,030.08 " " 2,208.66 " " 2,760.83 " " 1,055.83 " " 1,060.98 " " 1,030.08 " " 4,355.20 " 942.52 776.00 " 3,647.48 " 906.47 " 2,226.60 " " 4,083.00 " " 2,069.26 " " 2,435.10 " " 1,066.13 " Outpatient 45385 Colonoscopy w/lesion removal " 5,444.00 " " 2,012.10 " 380.00 " 4,355.20 " 437.00 " 1,718.00 " " 1,081.58 " " 1,718.00 " 444.60 " 3,007.81 " " 1,060.98 " " 2,820.00 " 425.60 395.69 " 3,603.38 " 927.07 " 1,030.08 " " 2,208.66 " " 2,760.83 " " 1,055.83 " " 1,060.98 " " 1,030.08 " " 4,355.20 " 942.52 380.00 " 3,647.48 " 906.47 " 2,226.60 " " 4,083.00 " " 2,069.26 " " 2,435.10 " " 1,066.13 " Outpatient 45386 Colonoscopy w/balloon dilat " 5,444.00 " " 2,012.10 " 776.00 " 4,355.20 " 892.40 " 1,718.00 " " 1,081.58 " " 1,718.00 " 907.92 " 3,007.81 " " 1,060.98 " " 2,820.00 " 869.12 808.05 " 3,603.38 " 927.07 " 1,030.08 " " 2,376.02 " " 2,970.02 " " 1,055.83 " " 1,060.98 " " 1,030.08 " " 4,355.20 " 942.52 776.00 " 3,647.48 " 906.47 " 2,226.60 " " 4,083.00 " " 2,069.26 " " 2,435.10 " " 1,066.13 " Outpatient 46020 Placement of seton " 12,828.00 " " 4,741.23 " 776.00 " 10,262.40 " 892.40 " 2,773.00 " " 2,548.12 " " 2,773.00 " 907.92 " 7,087.47 " " 2,499.58 " " 3,545.00 " 869.12 808.05 " 8,490.85 " " 2,184.10 " " 2,426.78 " " 2,650.99 " " 3,313.74 " " 2,487.45 " " 2,499.58 " " 2,426.78 " " 10,262.40 " " 2,220.50 " 776.00 " 8,594.76 " " 2,135.57 " " 5,246.65 " " 9,621.00 " " 4,875.92 " " 5,737.96 " " 2,511.72 " Outpatient 46040 Incision of rectal abscess " 5,444.00 " " 2,012.10 " 776.00 " 4,355.20 " 892.40 " 2,773.00 " " 1,081.58 " " 2,773.00 " 907.92 " 3,007.81 " " 1,060.98 " " 3,545.00 " 869.12 808.05 " 3,603.38 " 927.07 " 1,030.08 " " 2,532.97 " " 3,166.21 " " 1,055.83 " " 1,060.98 " " 1,030.08 " " 4,355.20 " 942.52 776.00 " 3,647.48 " 906.47 " 2,226.60 " " 4,083.00 " " 2,069.26 " " 2,435.10 " " 1,066.13 " Outpatient 46230 Removal of anal tags " 12,828.00 " " 4,741.23 " 776.00 " 10,262.40 " 892.40 " 1,469.00 " " 2,548.12 " " 1,469.00 " 907.92 " 7,087.47 " " 2,499.58 " " 1,775.00 " 869.12 808.05 " 8,490.85 " " 2,184.10 " " 2,426.78 " " 1,649.49 " " 2,061.86 " " 2,487.45 " " 2,499.58 " " 2,426.78 " " 10,262.40 " " 2,220.50 " 776.00 " 8,594.76 " " 2,135.57 " " 5,246.65 " " 9,621.00 " " 4,875.92 " " 5,737.96 " " 2,511.72 " Outpatient 46260 Remove in/ex hem groups 2+ " 12,828.00 " " 4,741.23 " 776.00 " 10,262.40 " 892.40 " 2,773.00 " " 2,548.12 " " 2,773.00 " 907.92 " 7,087.47 " " 2,499.58 " " 3,545.00 " 869.12 808.05 " 8,490.85 " " 2,184.10 " " 2,426.78 " " 2,532.97 " " 3,166.21 " " 2,487.45 " " 2,499.58 " " 2,426.78 " " 10,262.40 " " 2,220.50 " 776.00 " 8,594.76 " " 2,135.57 " " 5,246.65 " " 9,621.00 " " 4,875.92 " " 5,737.96 " " 2,511.72 " Outpatient 46275 Remove anal fist inter " 12,828.00 " " 4,741.23 " 776.00 " 10,262.40 " 892.40 " 2,773.00 " " 2,548.12 " " 2,773.00 " 907.92 " 7,087.47 " " 2,499.58 " " 3,545.00 " 869.12 808.05 " 8,490.85 " " 2,184.10 " " 2,426.78 " " 2,532.97 " " 3,166.21 " " 2,487.45 " " 2,499.58 " " 2,426.78 " " 10,262.40 " " 2,220.50 " 776.00 " 8,594.76 " " 2,135.57 " " 5,246.65 " " 9,621.00 " " 4,875.92 " " 5,737.96 " " 2,511.72 " Outpatient 47000 Needle biopsy of liver " 7,387.00 " " 2,730.24 " 278.00 " 5,909.60 " 319.70 " 1,469.00 " " 1,467.55 " " 1,469.00 " 325.26 " 4,081.32 " " 1,439.60 " " 1,775.00 " 311.36 289.48 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 278.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 47536 Exchange biliary drg cath " 16,713.00 " " 6,177.12 " 776.00 " 13,370.40 " 892.40 " 11,548.68 " " 3,318.47 " " 11,548.68 " 907.92 " 9,233.93 " " 3,255.26 " " 6,576.00 " 869.12 808.05 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 4,385.26 " " 5,481.57 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 776.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 47562 Laparoscopic cholecystectomy " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,604.00 " " 5,277.62 " " 3,604.00 " 907.92 " 14,678.27 " " 5,177.09 " " 7,248.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,937.34 " " 6,171.67 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 47563 Laparo cholecystectomy/graph " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,604.00 " " 5,277.62 " " 3,604.00 " 907.92 " 14,678.27 " " 5,177.09 " " 7,248.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,937.34 " " 6,171.67 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 47564 Laparo cholecystectomy/explr " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 4,435.00 " " 5,277.62 " " 4,435.00 " 907.92 " 14,678.27 " " 5,177.09 " " 7,248.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,509.02 " " 5,636.27 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 49083 Abd paracentesis w/imaging " 4,250.00 " " 1,570.80 " 707.33 " 3,400.00 " 892.40 " 1,718.00 " 843.97 " 1,718.00 " 907.92 " 2,348.13 " 827.89 " 1,775.00 " 869.12 808.05 " 2,813.08 " 723.40 803.78 " 2,534.38 " " 3,167.97 " 823.87 827.89 803.78 " 3,400.00 " 735.46 776.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 49180 Biopsy abdominal mass " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,469.00 " " 1,467.55 " " 1,469.00 " 907.92 " 4,081.32 " " 1,439.60 " " 1,775.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 49185 Sclerotx fluid collection " 3,265.00 " " 1,206.74 " - " 6,657.64 " - " 2,256.12 " 649.06 " 2,256.12 " - " 1,803.91 " 636.69 " 6,540.00 " - - " 2,161.10 " 556.34 618.15 " 5,326.11 " " 6,657.64 " 633.60 636.69 618.15 " 2,612.00 " 565.61 - " 2,187.55 " 543.97 " 1,335.39 " " 2,448.75 " " 1,241.03 " " 1,460.43 " 639.79 Outpatient 49320 Diag laparo separate proc " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 2,773.00 " " 5,277.62 " " 2,773.00 " 907.92 " 14,678.27 " " 5,177.09 " " 3,545.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 2,532.97 " " 3,166.21 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 49324 Lap insert tunnel ip cath " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,326.00 " " 5,277.62 " " 3,326.00 " 907.92 " 14,678.27 " " 5,177.09 " " 6,576.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 1,865.46 " " 2,331.82 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 49325 Lap revision perm ip cath " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,326.00 " " 5,277.62 " " 3,326.00 " 907.92 " 14,678.27 " " 5,177.09 " " 6,576.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 2,008.39 " " 2,510.49 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 49418 Insert tun ip cath perc " 16,713.00 " " 6,177.12 " 776.00 " 13,370.40 " 892.40 " 1,718.00 " " 3,318.47 " " 1,718.00 " 907.92 " 9,233.93 " " 3,255.26 " " 6,576.00 " 869.12 808.05 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 8,237.62 " " 10,297.02 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 776.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 49422 Remove tunneled ip cath " 15,024.00 " " 5,552.87 " 776.00 " 12,019.20 " 892.40 " 1,469.00 " " 2,985.82 " " 1,469.00 " 907.92 " 8,300.76 " " 2,928.95 " " 1,775.00 " 869.12 808.05 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 1,774.04 " " 2,217.55 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 776.00 " 10,066.08 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 49423 Exchange drainage catheter " 8,531.00 " " 3,153.06 " 776.00 " 6,824.80 " 892.40 " 1,469.00 " " 1,694.09 " " 1,469.00 " 907.92 " 4,713.38 " " 1,661.82 " " 5,630.46 " 869.12 808.05 " 5,646.67 " " 1,452.08 " " 1,613.42 " " 3,074.36 " " 3,842.95 " " 1,653.76 " " 1,661.82 " " 1,613.42 " " 6,824.80 " " 1,476.28 " 776.00 " 5,715.77 " " 1,419.81 " " 3,489.18 " " 6,398.25 " " 3,242.63 " " 3,815.92 " " 1,669.89 " Outpatient 49452 Replace g-j tube perc " 4,250.00 " " 1,570.80 " 707.33 " 6,475.09 " 892.40 " 1,469.00 " 843.97 " 1,469.00 " 907.92 " 2,348.13 " 827.89 " 1,775.00 " 869.12 808.05 " 2,813.08 " 723.40 803.78 " 5,180.07 " " 6,475.09 " 823.87 827.89 803.78 " 3,400.00 " 735.46 776.00 " 2,847.50 " 707.33 " 1,738.25 " " 3,187.50 " " 1,615.43 " " 1,901.03 " 831.91 Outpatient 49505 Prp i/hern init reduc >5 yr " 16,713.00 " " 6,177.12 " 806.00 " 13,370.40 " 926.90 " 3,326.00 " " 3,318.47 " " 3,326.00 " 943.02 " 9,233.93 " " 3,255.26 " " 4,860.00 " 902.72 839.29 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 3,120.10 " " 3,900.12 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 806.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 49520 Rerepair ing hernia reduce " 16,713.00 " " 6,177.12 " 921.00 " 13,370.40 " " 1,059.15 " " 4,435.00 " " 3,318.47 " " 4,435.00 " " 1,077.57 " " 9,233.93 " " 3,255.26 " " 6,540.00 " " 1,031.52 " 959.04 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 4,937.34 " " 6,171.67 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 921.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 49560 Rpr ventral hern init reduc " 16,713.00 " " 6,177.12 " 790.00 " 13,370.40 " 908.50 " 3,326.00 " " 3,318.47 " " 3,326.00 " 924.30 " 9,233.93 " " 3,255.26 " " 4,860.00 " 884.80 822.63 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 3,120.10 " " 3,900.12 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 790.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 49585 Rpr umbil hern reduc > 5 yr " 16,713.00 " " 6,177.12 " 776.00 " 13,370.40 " 892.40 " 3,326.00 " " 3,318.47 " " 3,326.00 " 907.92 " 9,233.93 " " 3,255.26 " " 4,860.00 " 869.12 808.05 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 3,120.10 " " 3,900.12 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 776.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 49587 Rpr umbil hern block > 5 yr " 16,713.00 " " 6,177.12 " 776.00 " 13,370.40 " 892.40 " 4,656.00 " " 3,318.47 " " 4,656.00 " 907.92 " 9,233.93 " " 3,255.26 " " 6,576.00 " 869.12 808.05 " 11,062.33 " " 2,844.41 " " 3,160.45 " " 4,937.34 " " 6,171.67 " " 3,239.46 " " 3,255.26 " " 3,160.45 " " 13,370.40 " " 2,891.81 " 776.00 " 11,197.71 " " 2,781.20 " " 6,835.62 " " 12,534.75 " " 6,352.61 " " 7,475.72 " " 3,271.07 " Outpatient 49650 Lap ing hernia repair init " 26,567.00 " " 9,819.16 " 776.99 " 21,253.60 " 893.54 " 3,326.00 " " 5,277.62 " " 3,326.00 " 909.08 " 14,678.27 " " 5,177.09 " " 4,860.00 " 870.23 809.08 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 3,120.10 " " 3,900.12 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.99 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 49652 Lap vent/abd hernia repair " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,326.00 " " 5,277.62 " " 3,326.00 " 907.92 " 14,678.27 " " 5,177.09 " " 6,576.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 3,975.78 " " 4,969.72 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 49654 Lap inc hernia repair " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 3,326.00 " " 9,289.96 " " 3,326.00 " 907.92 " 25,837.66 " " 9,113.01 " " 6,576.00 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 4,564.37 " " 5,705.46 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 50080 Removal of kidney stone " 43,355.00 " " 16,024.01 " 776.00 " 34,684.00 " 892.40 " 3,326.00 " " 8,608.12 " " 3,326.00 " 907.92 " 23,953.64 " " 8,444.16 " " 28,614.30 " 869.12 808.05 " 28,696.67 " " 7,378.39 " " 8,198.21 " " 4,534.90 " " 5,668.62 " " 8,403.17 " " 8,444.16 " " 8,198.21 " " 34,684.00 " " 7,501.36 " 776.00 " 29,047.85 " " 7,214.42 " " 17,732.20 " " 32,516.25 " " 16,479.24 " " 19,392.69 " " 8,485.15 " Outpatient 50200 Renal biopsy perq " 7,387.00 " " 2,730.24 " 776.00 " 5,909.60 " 892.40 " 1,469.00 " " 1,467.55 " " 1,469.00 " 907.92 " 4,081.32 " " 1,439.60 " " 1,775.00 " 869.12 808.05 " 4,889.46 " " 1,257.90 " " 1,397.67 " " 1,649.49 " " 2,061.86 " " 1,432.61 " " 1,439.60 " " 1,397.67 " " 5,909.60 " " 1,278.87 " 776.00 " 4,949.29 " " 1,229.95 " " 3,021.28 " " 5,540.25 " " 2,807.80 " " 3,304.21 " " 1,446.59 " Outpatient 50387 Change nephroureteral cath " 9,413.00 " " 3,479.04 " 776.00 " 7,530.40 " 892.40 " 1,469.00 " " 1,867.55 " " 1,469.00 " 907.92 " 5,200.68 " " 1,831.98 " " 2,820.00 " 869.12 808.05 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 3,958.34 " " 4,947.93 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 776.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 50435 Exchange nephrostomy cath " 9,413.00 " " 3,479.04 " 776.00 " 7,530.40 " 892.40 " 6,504.38 " " 1,867.55 " " 6,504.38 " 907.92 " 5,200.68 " " 1,831.98 " " 3,545.00 " 869.12 808.05 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 2,540.84 " " 3,176.05 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 776.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 50590 Fragmenting of kidney stone " 16,151.00 " " 5,969.41 " 776.00 " 12,920.80 " 892.40 " 4,656.00 " " 3,206.84 " " 4,656.00 " 907.92 " 8,923.43 " " 3,145.75 " " 6,576.00 " 869.12 808.05 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 4,937.34 " " 6,171.67 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 776.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 50688 Change of ureter tube/stent " 9,413.00 " " 3,479.04 " - " 7,530.40 " - " 1,469.00 " " 1,867.55 " " 1,469.00 " - " 5,200.68 " " 1,831.98 " " 1,775.00 " - - " 6,230.46 " " 1,600.76 " " 1,778.62 " " 1,649.49 " " 2,061.86 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " - " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 51102 Drain bl w/cath insertion " 9,413.00 " " 3,479.04 " 776.00 " 7,530.40 " 892.40 " 1,469.00 " " 1,867.55 " " 1,469.00 " 907.92 " 5,200.68 " " 1,831.98 " " 2,820.00 " 869.12 808.05 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 1,792.10 " " 2,240.12 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 776.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 51702 Insert temp bladder cath 588.00 217.32 27.51 " 1,469.00 " 31.64 " 1,469.00 " 117.61 " 1,469.00 " 32.19 324.87 115.37 845.00 30.81 28.65 389.20 100.81 112.01 519.68 649.60 114.81 115.37 112.01 470.40 102.49 27.51 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 51705 Change of bladder tube " 1,397.00 " 516.33 28.00 " 1,775.00 " 32.20 " 1,469.00 " 277.55 " 1,469.00 " 32.76 771.84 272.26 " 1,775.00 " 31.36 29.16 924.67 237.90 264.33 168.76 210.95 270.94 272.26 264.33 " 1,117.60 " 241.86 28.00 935.99 232.61 571.37 " 1,047.75 " 531.00 624.88 273.58 Outpatient 52000 Cystoscopy " 3,018.00 " " 1,115.45 " 502.90 " 2,414.40 " 669.30 " 1,469.00 " 600.05 " 1,469.00 " 680.94 " 1,667.45 " 588.62 " 1,775.00 " 651.84 606.04 " 1,997.61 " 514.33 571.48 " 1,649.49 " " 2,061.86 " 585.77 588.62 571.48 " 2,414.40 " 522.90 582.00 " 2,022.06 " 502.90 " 1,234.36 " " 2,263.50 " " 1,147.14 " " 1,349.95 " 591.48 Outpatient 52005 Cystoscopy & ureter catheter " 9,413.00 " " 3,479.04 " 688.00 " 7,530.40 " 791.20 " 1,718.00 " " 1,867.55 " " 1,718.00 " 804.96 " 5,200.68 " " 1,831.98 " " 2,820.00 " 770.56 716.41 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 2,208.66 " " 2,760.83 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 688.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 52204 Cystoscopy w/biopsy(s) " 9,413.00 " " 3,479.04 " 698.00 " 7,530.40 " 802.70 " 1,718.00 " " 1,867.55 " " 1,718.00 " 816.66 " 5,200.68 " " 1,831.98 " " 2,820.00 " 781.76 726.83 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 2,208.66 " " 2,760.83 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 698.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 52224 Cystoscopy and treatment " 16,151.00 " " 5,969.41 " 545.00 " 12,920.80 " 626.75 " 1,718.00 " " 3,206.84 " " 1,718.00 " 637.65 " 8,923.43 " " 3,145.75 " " 2,820.00 " 610.40 567.51 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 2,208.66 " " 2,760.83 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 545.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 52234 Cystoscopy and treatment " 16,151.00 " " 5,969.41 " 701.00 " 12,920.80 " 806.15 " 1,718.00 " " 3,206.84 " " 1,718.00 " 820.17 " 8,923.43 " " 3,145.75 " " 2,820.00 " 785.12 729.95 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 2,208.66 " " 2,760.83 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 701.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 52235 Cystoscopy and treatment " 16,151.00 " " 5,969.41 " 597.00 " 12,920.80 " 686.55 " 2,773.00 " " 3,206.84 " " 2,773.00 " 698.49 " 8,923.43 " " 3,145.75 " " 3,545.00 " 668.64 621.66 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 2,532.97 " " 3,166.21 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 597.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 52240 Cystoscopy and treatment " 23,173.00 " " 8,564.74 " 776.00 " 18,538.40 " 892.40 " 2,773.00 " " 4,601.74 " " 2,773.00 " 907.92 " 12,803.08 " " 4,514.09 " " 3,545.00 " 869.12 808.05 " 15,338.21 " " 3,944.35 " " 4,382.61 " " 2,532.97 " " 3,166.21 " " 4,492.18 " " 4,514.09 " " 4,382.61 " " 18,538.40 " " 4,010.09 " 776.00 " 15,525.91 " " 3,856.70 " " 9,477.76 " " 17,379.75 " " 8,808.06 " " 10,365.28 " " 4,536.00 " Outpatient 52310 Cystoscopy and treatment " 9,413.00 " " 3,479.04 " 649.00 " 7,530.40 " 746.35 " 1,718.00 " " 1,867.55 " " 1,718.00 " 759.33 " 5,200.68 " " 1,831.98 " " 2,820.00 " 726.88 675.80 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 2,208.66 " " 2,760.83 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 649.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 52317 Remove bladder stone " 16,151.00 " " 5,969.41 " 776.00 " 12,920.80 " 892.40 " 1,469.00 " " 3,206.84 " " 1,469.00 " 907.92 " 8,923.43 " " 3,145.75 " " 1,775.00 " 869.12 808.05 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 1,649.49 " " 2,061.86 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 776.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 52332 Cystoscopy and treatment " 16,151.00 " " 5,969.41 " 776.00 " 12,920.80 " 892.40 " 1,718.00 " " 3,206.84 " " 1,718.00 " 907.92 " 8,923.43 " " 3,145.75 " " 2,820.00 " 869.12 808.05 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 2,208.66 " " 2,760.83 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 776.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 52352 Cystouretero w/stone remove " 16,151.00 " " 5,969.41 " 776.00 " 12,920.80 " 892.40 " 3,326.00 " " 3,206.84 " " 3,326.00 " 907.92 " 8,923.43 " " 3,145.75 " " 4,860.00 " 869.12 808.05 " 10,690.35 " " 2,748.72 " " 3,054.13 " " 3,356.30 " " 4,195.38 " " 3,130.48 " " 3,145.75 " " 3,054.13 " " 12,920.80 " " 2,794.53 " 776.00 " 10,821.17 " " 2,687.63 " " 6,605.76 " " 12,113.25 " " 6,139.00 " " 7,224.34 " " 3,161.02 " Outpatient 52353 Cystouretero w/lithotripsy " 23,173.00 " " 8,564.74 " 776.00 " 18,538.40 " 892.40 " 3,326.00 " " 4,601.74 " " 3,326.00 " 907.92 " 12,803.08 " " 4,514.09 " " 4,860.00 " 869.12 808.05 " 15,338.21 " " 3,944.35 " " 4,382.61 " " 3,356.30 " " 4,195.38 " " 4,492.18 " " 4,514.09 " " 4,382.61 " " 18,538.40 " " 4,010.09 " 776.00 " 15,525.91 " " 3,856.70 " " 9,477.76 " " 17,379.75 " " 8,808.06 " " 10,365.28 " " 4,536.00 " Outpatient 52356 Cysto/uretero w/lithotripsy " 23,173.00 " " 8,564.74 " 776.00 " 18,538.40 " 892.40 " 3,326.00 " " 4,601.74 " " 3,326.00 " 907.92 " 12,803.08 " " 4,514.09 " " 6,576.00 " 869.12 808.05 " 15,338.21 " " 3,944.35 " " 4,382.61 " 929.78 " 1,162.22 " " 4,492.18 " " 4,514.09 " " 4,382.61 " " 18,538.40 " " 4,010.09 " 776.00 " 15,525.91 " " 3,856.70 " " 9,477.76 " " 17,379.75 " " 8,808.06 " " 10,365.28 " " 4,536.00 " Outpatient 52601 Prostatectomy (turp) " 23,173.00 " " 8,564.74 " 776.00 " 18,538.40 " 892.40 " 3,326.00 " " 4,601.74 " " 3,326.00 " 907.92 " 12,803.08 " " 4,514.09 " " 4,860.00 " 869.12 808.05 " 15,338.21 " " 3,944.35 " " 4,382.61 " " 3,120.10 " " 3,900.12 " " 4,492.18 " " 4,514.09 " " 4,382.61 " " 18,538.40 " " 4,010.09 " 776.00 " 15,525.91 " " 3,856.70 " " 9,477.76 " " 17,379.75 " " 8,808.06 " " 10,365.28 " " 4,536.00 " Outpatient 52648 Laser surgery of prostate " 23,173.00 " " 8,564.74 " 776.00 " 18,538.40 " 892.40 " 4,656.00 " " 4,601.74 " " 4,656.00 " 907.92 " 12,803.08 " " 4,514.09 " " 6,576.00 " 869.12 808.05 " 15,338.21 " " 3,944.35 " " 4,382.61 " " 7,133.34 " " 8,916.67 " " 4,492.18 " " 4,514.09 " " 4,382.61 " " 18,538.40 " " 4,010.09 " 776.00 " 15,525.91 " " 3,856.70 " " 9,477.76 " " 17,379.75 " " 8,808.06 " " 10,365.28 " " 4,536.00 " Outpatient 54405 Insert multi-comp penis pros " 95,856.00 " " 35,428.38 " - " 76,684.80 " - " 2,773.00 " " 19,049.81 " " 2,773.00 " - " 52,960.44 " " 18,686.96 " " 3,545.00 " - - " 63,447.09 " " 16,328.41 " " 18,142.68 " " 2,717.03 " " 3,396.29 " " 18,596.25 " " 18,686.96 " " 18,142.68 " " 76,684.80 " " 16,600.55 " - " 64,223.52 " " 15,965.56 " " 39,205.10 " " 71,892.00 " " 36,434.87 " " 42,876.39 " " 18,777.67 " Outpatient 55700 Biopsy of prostate " 9,413.00 " " 3,479.04 " 776.00 " 7,530.40 " 892.40 " 1,718.00 " " 1,867.55 " " 1,718.00 " 907.92 " 5,200.68 " " 1,831.98 " " 2,820.00 " 869.12 808.05 " 6,230.46 " " 1,600.76 " " 1,778.62 " " 2,208.66 " " 2,760.83 " " 1,823.09 " " 1,831.98 " " 1,778.62 " " 7,530.40 " " 1,627.44 " 776.00 " 6,306.71 " " 1,565.19 " " 3,849.92 " " 7,059.75 " " 3,577.88 " " 4,210.43 " " 1,840.87 " Outpatient 56420 Drainage of gland abscess 894.00 330.42 148.92 " 2,061.86 " 776.25 " 1,469.00 " 177.69 " 1,469.00 " 789.75 493.94 174.31 " 1,775.00 " 756.00 702.88 591.74 152.31 169.23 " 1,649.49 " " 2,061.86 " 173.46 174.31 169.23 715.20 154.85 675.00 598.98 148.92 365.65 670.50 339.81 399.89 175.15 Outpatient 57120 Closure of vagina " 23,150.00 " " 8,556.24 " 776.00 " 18,520.00 " 892.40 " 15,996.65 " " 4,599.28 " " 15,996.65 " 907.92 " 12,790.38 " " 4,511.68 " " 15,279.00 " 869.12 808.05 " 15,322.99 " " 3,942.24 " " 4,380.27 " " 2,625.39 " " 3,281.74 " " 4,489.78 " " 4,511.68 " " 4,380.27 " " 18,520.00 " " 4,007.95 " 776.00 " 15,510.50 " " 3,854.64 " " 9,468.35 " " 17,362.50 " " 8,799.32 " " 10,355.00 " " 4,533.58 " Outpatient 57250 Repair rectum & vagina " 23,150.00 " " 8,556.24 " 776.00 " 18,520.00 " 892.40 " 3,604.00 " " 4,599.28 " " 3,604.00 " 907.92 " 12,790.38 " " 4,511.68 " " 4,445.00 " 869.12 808.05 " 15,322.99 " " 3,942.24 " " 4,380.27 " " 3,730.57 " " 4,663.21 " " 4,489.78 " " 4,511.68 " " 4,380.27 " " 18,520.00 " " 4,007.95 " 776.00 " 15,510.50 " " 3,854.64 " " 9,468.35 " " 17,362.50 " " 8,799.32 " " 10,355.00 " " 4,533.58 " Outpatient 57288 Repair bladder defect " 23,150.00 " " 8,556.24 " 776.00 " 18,520.00 " 892.40 " 3,604.00 " " 4,599.28 " " 3,604.00 " 907.92 " 12,790.38 " " 4,511.68 " " 4,445.00 " 869.12 808.05 " 15,322.99 " " 3,942.24 " " 4,380.27 " " 4,116.08 " " 5,145.10 " " 4,489.78 " " 4,511.68 " " 4,380.27 " " 18,520.00 " " 4,007.95 " 776.00 " 15,510.50 " " 3,854.64 " " 9,468.35 " " 17,362.50 " " 8,799.32 " " 10,355.00 " " 4,533.58 " Outpatient 57425 Laparoscopy surg colpopexy " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 3,604.00 " " 9,289.96 " " 3,604.00 " 907.92 " 25,837.66 " " 9,113.01 " " 30,864.90 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 4,947.18 " " 6,183.98 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 57522 Conization of cervix " 13,772.00 " " 5,090.13 " 776.00 " 11,017.60 " 892.40 " 1,718.00 " " 2,736.56 " " 1,718.00 " 907.92 " 7,609.03 " " 2,684.44 " " 2,820.00 " 869.12 808.05 " 9,115.69 " " 2,345.63 " " 2,606.25 " " 4,937.34 " " 6,171.67 " " 2,671.41 " " 2,684.44 " " 2,606.25 " " 11,017.60 " " 2,384.72 " 776.00 " 9,227.24 " " 2,293.50 " " 5,632.75 " " 10,329.00 " " 5,234.74 " " 6,160.22 " " 2,697.47 " Outpatient 58120 Dilation and curettage " 13,772.00 " " 5,090.13 " 726.00 " 11,017.60 " 834.90 " 1,718.00 " " 2,736.56 " " 1,718.00 " 849.42 " 7,609.03 " " 2,684.44 " " 2,820.00 " 813.12 755.98 " 9,115.69 " " 2,345.63 " " 2,606.25 " " 2,208.66 " " 2,760.83 " " 2,671.41 " " 2,684.44 " " 2,606.25 " " 11,017.60 " " 2,384.72 " 726.00 " 9,227.24 " " 2,293.50 " " 5,632.75 " " 10,329.00 " " 5,234.74 " " 6,160.22 " " 2,697.47 " Outpatient 58345 Reopen fallopian tube " 13,772.00 " " 5,090.13 " - " 11,017.60 " - " 1,469.00 " " 2,736.56 " " 1,469.00 " - " 7,609.03 " " 2,684.44 " " 9,089.52 " - - " 9,115.69 " " 2,345.63 " " 2,606.25 " " 2,208.66 " " 2,760.83 " " 2,671.41 " " 2,684.44 " " 2,606.25 " " 11,017.60 " " 2,384.72 " - " 9,227.24 " " 2,293.50 " " 5,632.75 " " 10,329.00 " " 5,234.74 " " 6,160.22 " " 2,697.47 " Outpatient 58545 Laparoscopic myomectomy " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 4,656.00 " " 5,277.62 " " 4,656.00 " 907.92 " 14,678.27 " " 5,177.09 " " 6,576.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 7,133.34 " " 8,916.67 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 58552 Laparo-vag hyst incl t/o " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 4,435.00 " " 9,289.96 " " 4,435.00 " 907.92 " 25,837.66 " " 9,113.01 " " 6,958.00 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 5,263.10 " " 6,578.88 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 58558 Hysteroscopy biopsy " 13,772.00 " " 5,090.13 " 776.00 " 11,017.60 " 892.40 " 2,773.00 " " 2,736.56 " " 2,773.00 " 907.92 " 7,609.03 " " 2,684.44 " " 3,545.00 " 869.12 808.05 " 9,115.69 " " 2,345.63 " " 2,606.25 " " 2,717.03 " " 3,396.29 " " 2,671.41 " " 2,684.44 " " 2,606.25 " " 11,017.60 " " 2,384.72 " 776.00 " 9,227.24 " " 2,293.50 " " 5,632.75 " " 10,329.00 " " 5,234.74 " " 6,160.22 " " 2,697.47 " Outpatient 58560 Hysteroscopy resect septum " 23,150.00 " " 8,556.24 " 337.82 " 18,520.00 " 388.49 " 2,773.00 " " 4,599.28 " " 2,773.00 " 395.25 " 12,790.38 " " 4,511.68 " " 3,545.00 " 378.36 351.77 " 15,322.99 " " 3,942.24 " " 4,380.27 " " 2,717.03 " " 3,396.29 " " 4,489.78 " " 4,511.68 " " 4,380.27 " " 18,520.00 " " 4,007.95 " 337.82 " 15,510.50 " " 3,854.64 " " 9,468.35 " " 17,362.50 " " 8,799.32 " " 10,355.00 " " 4,533.58 " Outpatient 58561 Hysteroscopy remove myoma " 23,150.00 " " 8,556.24 " 776.00 " 18,520.00 " 892.40 " 2,773.00 " " 4,599.28 " " 2,773.00 " 907.92 " 12,790.38 " " 4,511.68 " " 3,545.00 " 869.12 808.05 " 15,322.99 " " 3,942.24 " " 4,380.27 " " 2,532.97 " " 3,166.21 " " 4,489.78 " " 4,511.68 " " 4,380.27 " " 18,520.00 " " 4,007.95 " 776.00 " 15,510.50 " " 3,854.64 " " 9,468.35 " " 17,362.50 " " 8,799.32 " " 10,355.00 " " 4,533.58 " Outpatient 58563 Hysteroscopy ablation " 23,150.00 " " 8,556.24 " 776.00 " 18,520.00 " 892.40 " 4,656.00 " " 4,599.28 " " 4,656.00 " 907.92 " 12,790.38 " " 4,511.68 " " 6,576.00 " 869.12 808.05 " 15,322.99 " " 3,942.24 " " 4,380.27 " " 2,532.97 " " 3,166.21 " " 4,489.78 " " 4,511.68 " " 4,380.27 " " 18,520.00 " " 4,007.95 " 776.00 " 15,510.50 " " 3,854.64 " " 9,468.35 " " 17,362.50 " " 8,799.32 " " 10,355.00 " " 4,533.58 " Outpatient 58571 Tlh w/t/o 250 g or less " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 3,686.00 " " 9,289.96 " " 3,686.00 " 907.92 " 25,837.66 " " 9,113.01 " " 6,958.00 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 5,037.18 " " 6,296.48 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 58573 Tlh w/t/o uterus over 250 g " 46,765.00 " " 17,284.34 " 776.00 " 37,412.00 " 892.40 " 3,686.00 " " 9,289.96 " " 3,686.00 " 907.92 " 25,837.66 " " 9,113.01 " " 6,958.00 " 869.12 808.05 " 30,953.75 " " 7,962.82 " " 8,847.58 " " 6,443.66 " " 8,054.58 " " 9,068.77 " " 9,113.01 " " 8,847.58 " " 37,412.00 " " 8,095.54 " 776.00 " 31,332.55 " " 7,785.87 " " 19,126.89 " " 35,073.75 " " 17,775.38 " " 20,917.98 " " 9,157.25 " Outpatient 58578 Laparo proc uterus " 26,567.00 " " 9,819.16 " - " 21,253.60 " - " 2,773.00 " " 5,277.62 " " 2,773.00 " - " 14,678.27 " " 5,177.09 " " 17,534.22 " - - " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,937.34 " " 6,171.67 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " - " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 58661 Laparoscopy remove adnexa " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,604.00 " " 5,277.62 " " 3,604.00 " 907.92 " 14,678.27 " " 5,177.09 " " 4,445.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 3,730.57 " " 4,663.21 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 58662 Laparoscopy excise lesions " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,604.00 " " 5,277.62 " " 3,604.00 " 907.92 " 14,678.27 " " 5,177.09 " " 4,445.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 3,730.57 " " 4,663.21 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 58999 Genital surgery procedure 894.00 330.42 - " 1,469.00 " - " 1,469.00 " 177.69 " 1,469.00 " - 493.94 174.31 590.04 - - 591.74 152.31 169.23 56.26 70.32 173.46 174.31 169.23 715.20 154.85 - 598.98 148.92 365.65 670.50 339.81 399.89 175.15 Outpatient 59151 Treat ectopic pregnancy " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 3,326.00 " " 5,277.62 " " 3,326.00 " 907.92 " 14,678.27 " " 5,177.09 " " 17,534.22 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 4,937.34 " " 6,171.67 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 59812 Treatment of miscarriage " 13,772.00 " " 5,090.13 " 776.00 " 11,017.60 " 892.40 " 3,604.00 " " 2,736.56 " " 3,604.00 " 907.92 " 7,609.03 " " 2,684.44 " " 4,445.00 " 869.12 808.05 " 9,115.69 " " 2,345.63 " " 2,606.25 " " 4,081.82 " " 5,102.27 " " 2,671.41 " " 2,684.44 " " 2,606.25 " " 11,017.60 " " 2,384.72 " 776.00 " 9,227.24 " " 2,293.50 " " 5,632.75 " " 10,329.00 " " 5,234.74 " " 6,160.22 " " 2,697.47 " Outpatient 59820 Care of miscarriage " 13,772.00 " " 5,090.13 " 585.00 " 11,017.60 " 672.75 " 3,604.00 " " 2,736.56 " " 3,604.00 " 684.45 " 7,609.03 " " 2,684.44 " " 4,445.00 " 655.20 609.16 " 9,115.69 " " 2,345.63 " " 2,606.25 " " 4,081.82 " " 5,102.27 " " 2,671.41 " " 2,684.44 " " 2,606.25 " " 11,017.60 " " 2,384.72 " 585.00 " 9,227.24 " " 2,293.50 " " 5,632.75 " " 10,329.00 " " 5,234.74 " " 6,160.22 " " 2,697.47 " Outpatient 60220 Partial removal of thyroid " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 1,718.00 " " 5,277.62 " " 1,718.00 " 907.92 " 14,678.27 " " 5,177.09 " " 2,820.00 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 2,208.66 " " 2,760.83 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 60240 Removal of thyroid " 26,567.00 " " 9,819.16 " 776.00 " 21,253.60 " 892.40 " 4,435.00 " " 5,277.62 " " 4,435.00 " 907.92 " 14,678.27 " " 5,177.09 " " 17,534.22 " 869.12 808.05 " 17,584.70 " " 4,523.67 " " 5,026.30 " " 5,217.71 " " 6,522.14 " " 5,151.96 " " 5,177.09 " " 5,026.30 " " 21,253.60 " " 4,599.06 " 776.00 " 17,799.89 " " 4,423.14 " " 10,865.90 " " 19,925.25 " " 10,098.12 " " 11,883.42 " " 5,202.22 " Outpatient 60500 Explore parathyroid glands " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 17,623.32 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 5,244.54 " " 6,555.68 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 62230 Replace/revise brain shunt " 29,927.00 " " 11,061.02 " 776.00 " 23,941.60 " 892.40 " 1,718.00 " " 5,947.84 " " 1,718.00 " 907.92 " 16,534.67 " " 5,834.55 " " 2,820.00 " 869.12 808.05 " 19,808.68 " " 5,098.15 " " 5,664.61 " " 2,208.66 " " 2,760.83 " " 5,806.23 " " 5,834.55 " " 5,664.61 " " 23,941.60 " " 5,183.12 " 776.00 " 20,051.09 " " 4,984.86 " " 12,240.14 " " 22,445.25 " " 11,375.25 " " 13,386.35 " " 5,862.87 " Outpatient 62304 Myelography lumbar injection " 3,755.00 " " 1,387.85 " 445.42 " 4,860.00 " 892.40 " 1,469.00 " 746.21 " 1,469.00 " 907.92 " 2,074.64 " 732.00 " 4,860.00 " 869.12 808.05 " 2,485.43 " 639.61 710.68 445.42 556.77 728.45 732.00 710.68 " 3,004.00 " 650.27 776.00 " 2,515.85 " 625.40 " 1,535.80 " " 2,816.25 " " 1,427.28 " " 1,679.61 " 735.55 Outpatient 62328 Dx lmbr spi pnxr w/fluor/ct " 3,332.00 " " 1,231.51 " 555.09 " 2,665.60 " 892.40 " 2,302.41 " 662.32 " 2,302.41 " 907.92 " 1,840.93 " 649.70 " 1,775.00 " 869.12 808.05 " 2,205.45 " 567.70 630.78 " 1,430.94 " " 1,788.68 " 646.55 649.70 630.78 " 2,665.60 " 577.16 776.00 " 2,232.44 " 555.09 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 652.86 Outpatient 63030 Low back disk surgery " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,604.00 " " 6,533.13 " " 3,604.00 " 907.92 " 18,172.28 " " 6,408.69 " " 6,755.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 4,937.34 " " 6,171.67 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 63047 Lam facetec & foramot lumbar " 32,891.00 " " 12,156.51 " 776.00 " 26,312.80 " 892.40 " 3,604.00 " " 6,533.13 " " 3,604.00 " 907.92 " 18,172.28 " " 6,408.69 " " 6,755.00 " 869.12 808.05 " 21,770.55 " " 5,599.83 " " 6,222.03 " " 5,583.08 " " 6,978.85 " " 6,377.58 " " 6,408.69 " " 6,222.03 " " 26,312.80 " " 5,693.16 " 776.00 " 22,036.97 " " 5,475.39 " " 13,452.42 " " 24,668.25 " " 12,501.87 " " 14,712.14 " " 6,439.80 " Outpatient 63655 Implant neuroelectrodes " 107,519.00 " " 39,739.02 " 776.00 " 86,015.20 " 892.40 " 3,686.00 " " 21,357.40 " " 3,686.00 " 907.92 " 59,404.25 " " 20,950.59 " " 6,755.00 " 869.12 808.05 " 71,166.83 " " 18,306.34 " " 20,340.38 " " 3,935.34 " " 4,919.17 " " 20,848.89 " " 20,950.59 " " 20,340.38 " " 86,015.20 " " 18,611.45 " 776.00 " 72,037.73 " " 17,899.53 " " 43,975.27 " " 80,639.25 " " 40,867.97 " " 48,093.25 " " 21,052.29 " Outpatient 63685 Insrt/redo spine n generator " 154,584.00 " " 57,134.25 " 776.00 " 123,667.20 " 892.40 " 1,718.00 " " 30,702.99 " " 1,718.00 " 907.92 " 85,407.66 " " 30,118.17 " " 2,820.00 " 869.12 808.05 " 102,319.15 " " 26,316.85 " " 29,240.94 " " 2,208.66 " " 2,760.83 " " 29,971.96 " " 30,118.17 " " 29,240.94 " " 123,667.20 " " 26,755.46 " 776.00 " 103,571.28 " " 25,732.03 " " 63,224.86 " " 115,938.00 " " 58,757.38 " " 69,145.42 " " 30,264.37 " Outpatient 64400 Njx aa&/strd trigeminal nrv " 1,371.00 " 506.72 228.39 " 1,775.00 " 892.40 " 1,469.00 " 272.51 " 1,469.00 " 907.92 757.48 267.32 " 1,775.00 " 869.12 808.05 907.46 233.58 259.53 " 1,012.58 " " 1,265.72 " 266.02 267.32 259.53 " 1,096.80 " 237.47 776.00 918.57 228.39 560.74 " 1,028.25 " 521.12 613.25 268.61 Outpatient 64450 Njx aa&/strd other pn/branch " 3,332.00 " " 1,231.51 " 21.00 " 2,665.60 " 24.15 " 1,469.00 " 662.32 " 1,469.00 " 24.57 " 1,840.93 " 649.70 " 1,775.00 " 23.52 21.87 " 2,205.45 " 567.70 630.78 618.80 773.50 646.55 649.70 630.78 " 2,665.60 " 577.16 21.00 " 2,232.44 " 555.09 " 1,362.79 " " 2,499.00 " " 1,266.49 " " 1,490.40 " 652.86 Outpatient 64568 Opn impltj crnl nrv nea&pg " 154,584.00 " " 57,134.25 " 776.00 " 123,667.20 " 892.40 " 1,718.00 " " 30,702.99 " " 1,718.00 " 907.92 " 85,407.66 " " 30,118.17 " " 102,025.44 " 869.12 808.05 " 102,319.15 " " 26,316.85 " " 29,240.94 " " 3,565.23 " " 4,456.54 " " 29,971.96 " " 30,118.17 " " 29,240.94 " " 123,667.20 " " 26,755.46 " 776.00 " 103,571.28 " " 25,732.03 " " 63,224.86 " " 115,938.00 " " 58,757.38 " " 69,145.42 " " 30,264.37 " Outpatient 64640 Injection treatment of nerve " 4,318.00 " " 1,595.93 " 618.80 " 3,454.40 " 892.40 " 1,469.00 " 858.62 " 1,469.00 " 907.92 " 2,385.70 " 842.26 " 1,775.00 " 869.12 808.05 " 2,858.08 " 735.96 817.73 618.80 773.50 838.17 842.26 817.73 " 3,454.40 " 748.22 776.00 " 2,893.06 " 719.60 " 1,766.06 " " 3,238.50 " " 1,641.27 " " 1,931.44 " 846.35 Outpatient 64718 Revise ulnar nerve at elbow " 9,211.00 " " 3,404.39 " 776.00 " 7,368.80 " 892.40 " 1,718.00 " " 1,831.46 " " 1,718.00 " 907.92 " 5,089.08 " " 1,796.58 " " 2,820.00 " 869.12 808.05 " 6,096.76 " " 1,569.83 " " 1,744.25 " " 2,208.66 " " 2,760.83 " " 1,787.86 " " 1,796.58 " " 1,744.25 " " 7,368.80 " " 1,595.99 " 776.00 " 6,171.37 " " 1,534.94 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,805.30 " Outpatient 64721 Carpal tunnel surgery " 9,211.00 " " 3,404.39 " 664.00 " 7,368.80 " 763.60 " 1,718.00 " " 1,831.46 " " 1,718.00 " 776.88 " 5,089.08 " " 1,796.58 " " 2,820.00 " 743.68 691.42 " 6,096.76 " " 1,569.83 " " 1,744.25 " " 2,208.66 " " 2,760.83 " " 1,787.86 " " 1,796.58 " " 1,744.25 " " 7,368.80 " " 1,595.99 " 664.00 " 6,171.37 " " 1,534.94 " " 3,767.30 " " 6,908.25 " " 3,501.10 " " 4,120.08 " " 1,805.30 " Outpatient 65205 Remove foreign body from eye 588.00 217.32 98.57 907.92 892.40 406.31 117.61 406.31 907.92 324.87 115.37 845.00 869.12 808.05 389.20 100.81 112.01 168.76 210.95 114.81 115.37 112.01 470.40 102.49 776.00 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 65220 Remove foreign body from eye " 1,419.00 " 524.46 237.25 " 1,135.20 " 887.80 980.53 283.08 980.53 903.24 784.00 277.69 845.00 864.64 803.88 939.24 242.64 269.60 281.27 351.59 276.34 277.69 269.60 " 1,135.20 " 246.68 772.00 950.73 237.25 580.37 " 1,064.25 " 539.36 634.72 279.04 Outpatient 66852 Removal of lens material " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 3,326.00 " " 4,084.67 " " 3,326.00 " 907.92 " 11,363.82 " " 4,006.86 " " 4,860.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 3,120.10 " " 3,900.12 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67036 Removal of inner eye fluid " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 3,326.00 " " 4,084.67 " " 3,326.00 " 907.92 " 11,363.82 " " 4,006.86 " " 4,860.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 3,120.10 " " 3,900.12 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67039 Laser treatment of retina " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 4,435.00 " " 4,084.67 " " 4,435.00 " 907.92 " 11,363.82 " " 4,006.86 " " 6,540.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 4,937.34 " " 6,171.67 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67040 Laser treatment of retina " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 4,435.00 " " 4,084.67 " " 4,435.00 " 907.92 " 11,363.82 " " 4,006.86 " " 6,540.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 4,937.34 " " 6,171.67 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67041 Vit for macular pucker " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 3,604.00 " " 4,084.67 " " 3,604.00 " 907.92 " 11,363.82 " " 4,006.86 " " 6,576.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 5,788.07 " " 7,235.09 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67042 Vit for macular hole " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 3,604.00 " " 4,084.67 " " 3,604.00 " 907.92 " 11,363.82 " " 4,006.86 " " 6,576.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 6,626.94 " " 8,283.67 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67108 Repair detached retina " 20,568.00 " " 7,601.93 " " 1,000.00 " " 16,454.40 " " 1,150.00 " " 4,435.00 " " 4,084.67 " " 4,435.00 " " 1,170.00 " " 11,363.82 " " 4,006.86 " " 6,540.00 " " 1,120.00 " " 1,041.30 " " 13,613.96 " " 3,501.14 " " 3,890.16 " " 4,937.34 " " 6,171.67 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " " 1,000.00 " " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67113 Repair retinal detach cplx " 20,568.00 " " 7,601.93 " 776.00 " 16,454.40 " 892.40 " 3,604.00 " " 4,084.67 " " 3,604.00 " 907.92 " 11,363.82 " " 4,006.86 " " 6,576.00 " 869.12 808.05 " 13,613.96 " " 3,501.14 " " 3,890.16 " " 7,637.66 " " 9,547.07 " " 3,987.41 " " 4,006.86 " " 3,890.16 " " 16,454.40 " " 3,559.50 " 776.00 " 13,780.56 " " 3,423.34 " " 8,412.31 " " 15,426.00 " " 7,817.90 " " 9,200.07 " " 4,026.32 " Outpatient 67121 Remove eye implant material " 10,916.00 " " 4,034.55 " 776.00 " 8,732.80 " 892.40 " 1,718.00 " " 2,165.97 " " 1,718.00 " 907.92 " 6,031.09 " " 2,124.71 " " 2,820.00 " 869.12 808.05 " 7,225.30 " " 1,856.55 " " 2,062.83 " " 2,208.66 " " 2,760.83 " " 2,114.40 " " 2,124.71 " " 2,062.83 " " 8,732.80 " " 1,887.49 " 776.00 " 7,313.72 " " 1,815.29 " " 4,464.64 " " 8,187.00 " " 4,149.17 " " 4,882.73 " " 2,135.03 " Outpatient 67900 Repair brow defect " 10,512.00 " " 3,885.24 " - " 8,409.60 " - " 3,326.00 " " 2,087.17 " " 3,326.00 " - " 5,807.88 " " 2,047.41 " " 4,860.00 " - - " 6,957.89 " " 1,789.00 " " 1,987.78 " " 4,937.34 " " 6,171.67 " " 2,037.47 " " 2,047.41 " " 1,987.78 " " 8,409.60 " " 1,818.82 " - " 7,043.04 " " 1,749.25 " " 4,299.41 " " 7,884.00 " " 3,995.61 " " 4,702.02 " " 2,057.35 " Outpatient 69200 Clear outer ear canal 588.00 217.32 98.57 845.00 558.90 406.31 117.61 406.31 568.62 324.87 115.37 845.00 544.32 506.07 389.20 100.81 112.01 281.27 351.59 114.81 115.37 112.01 470.40 102.49 486.00 393.96 98.57 240.49 441.00 223.50 263.01 115.93 Outpatient 69209 Remove impacted ear wax uni 292.00 107.92 48.66 907.92 892.40 201.77 58.05 201.77 907.92 161.33 56.95 845.00 869.12 808.05 193.27 49.76 55.29 95.66 119.57 56.67 56.95 55.29 233.60 50.59 776.00 195.64 48.66 119.43 219.00 110.99 130.61 57.23 Outpatient 69424 Remove ventilating tube " 14,366.00 " " 5,309.67 " 544.00 " 11,492.80 " 625.60 " 1,469.00 " " 2,853.42 " " 1,469.00 " 636.48 " 7,937.22 " " 2,799.07 " " 1,775.00 " 609.28 566.47 " 9,508.86 " " 2,445.79 " " 2,717.54 " " 1,649.49 " " 2,061.86 " " 2,785.48 " " 2,799.07 " " 2,717.54 " " 11,492.80 " " 2,486.55 " 544.00 " 9,625.22 " " 2,391.44 " " 5,875.69 " " 10,774.50 " " 5,460.52 " " 6,425.91 " " 2,812.65 " Outpatient 69436 Create eardrum opening " 7,102.00 " " 2,624.90 " 514.00 " 5,681.60 " 591.10 " 2,773.00 " " 1,410.93 " " 2,773.00 " 601.38 " 3,923.86 " " 1,384.05 " " 3,545.00 " 575.68 535.23 " 4,700.81 " " 1,209.37 " " 1,343.74 " " 2,532.97 " " 3,166.21 " " 1,377.33 " " 1,384.05 " " 1,343.74 " " 5,681.60 " " 1,229.52 " 514.00 " 4,758.34 " " 1,182.49 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,390.77 " Outpatient 69610 Repair of eardrum " 7,102.00 " " 2,624.90 " 776.00 " 6,171.67 " 892.40 " 2,773.00 " " 1,410.93 " " 2,773.00 " 907.92 " 3,923.86 " " 1,384.05 " " 4,687.32 " 869.12 808.05 " 4,700.81 " " 1,209.37 " " 1,343.74 " " 4,937.34 " " 6,171.67 " " 1,377.33 " " 1,384.05 " " 1,343.74 " " 5,681.60 " " 1,229.52 " 776.00 " 4,758.34 " " 1,182.49 " " 2,904.72 " " 5,326.50 " " 2,699.47 " " 3,176.72 " " 1,390.77 " Outpatient 69631 Repair eardrum structures " 26,702.00 " " 9,869.06 " 924.00 " 21,361.60 " " 1,062.60 " " 3,604.00 " " 5,304.76 " " 3,604.00 " " 1,081.08 " " 14,752.86 " " 5,203.71 " " 4,445.00 " " 1,034.88 " 962.16 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 3,730.57 " " 4,663.21 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 924.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 69641 Revise middle ear & mastoid " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 6,540.00 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 69643 Revise middle ear & mastoid " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 6,540.00 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 69644 Revise middle ear & mastoid " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 6,540.00 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 69645 Revise middle ear & mastoid " 26,702.00 " " 9,869.06 " 776.00 " 21,361.60 " 892.40 " 4,435.00 " " 5,304.76 " " 4,435.00 " 907.92 " 14,752.86 " " 5,203.71 " " 6,540.00 " 869.12 808.05 " 17,674.05 " " 4,546.94 " " 5,052.15 " " 4,937.34 " " 6,171.67 " " 5,178.45 " " 5,203.71 " " 5,052.15 " " 21,361.60 " " 4,622.72 " 776.00 " 17,890.34 " " 4,445.89 " " 10,921.12 " " 20,026.50 " " 10,149.43 " " 11,943.80 " " 5,228.98 " Outpatient 69714 Impltj oi implt skl perq esp " 64,652.00 " " 23,895.38 " 776.00 " 51,721.60 " 892.40 " 4,656.00 " " 12,861.18 " " 4,656.00 " 907.92 " 35,720.23 " " 12,616.20 " " 42,670.32 " 869.12 808.05 " 42,793.16 " " 11,023.87 " " 12,248.74 " " 7,133.34 " " 8,916.67 " " 12,554.96 " " 12,616.20 " " 12,248.74 " " 51,721.60 " " 11,207.60 " 776.00 " 43,316.84 " " 10,778.89 " " 26,442.67 " " 48,489.00 " " 24,574.23 " " 28,918.84 " " 12,677.45 " Outpatient 69930 Implant cochlear device " 180,745.00 " " 66,803.35 " 776.00 " 144,596.00 " 892.40 " 4,435.00 " " 35,951.44 " " 4,435.00 " 907.92 " 99,861.61 " " 35,266.65 " " 6,540.00 " 869.12 808.05 " 119,635.12 " " 30,815.52 " " 34,239.47 " " 4,937.34 " " 6,171.67 " " 35,095.46 " " 35,266.65 " " 34,239.47 " " 144,596.00 " " 31,329.12 " 776.00 " 121,099.15 " " 30,130.73 " " 73,924.71 " " 135,558.75 " " 68,701.17 " " 80,847.24 " " 35,437.85 " Outpatient 74740 X-ray female genital tract " 1,208.00 " 446.48 26.50 966.40 30.48 834.73 240.00 834.73 31.01 667.42 235.43 797.28 29.68 26.50 799.58 205.71 228.57 223.18 278.98 234.28 235.43 228.57 966.40 209.14 26.50 602.94 201.14 494.07 906.00 459.16 540.34 236.57 Outpatient 75710 Artery x-rays arm/leg " 15,024.00 " " 5,552.87 " 37.50 " 12,019.20 " 43.13 " 10,381.58 " " 2,985.82 " " 10,381.58 " 43.88 " 8,300.76 " " 2,928.95 " " 9,915.84 " 42.00 37.50 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 1,701.89 " " 2,127.36 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 37.50 " 7,497.55 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 75716 Artery x-rays arms/legs " 15,024.00 " " 5,552.87 " 37.50 " 12,019.20 " 43.13 " 10,381.58 " " 2,985.82 " " 10,381.58 " 43.88 " 8,300.76 " " 2,928.95 " " 9,915.84 " 42.00 37.50 " 9,944.39 " " 2,559.28 " " 2,843.64 " " 1,732.13 " " 2,165.16 " " 2,914.73 " " 2,928.95 " " 2,843.64 " " 12,019.20 " " 2,601.93 " 37.50 " 7,497.55 " " 2,502.40 " " 6,144.82 " " 11,268.00 " " 5,710.62 " " 6,720.24 " " 2,943.17 " Outpatient 76080 X-ray exam of fistula " 2,535.00 " 936.94 27.50 " 2,028.00 " 31.63 " 1,751.69 " 503.98 " 1,751.69 " 32.18 " 1,400.59 " 494.38 " 1,673.10 " 30.80 27.50 " 1,677.92 " 431.98 479.98 223.02 278.78 491.98 494.38 479.98 " 2,028.00 " 439.18 27.50 " 1,265.17 " 422.38 " 1,036.82 " " 1,901.25 " 963.55 " 1,133.91 " 496.78 Outpatient 76604 Us exam chest 572.00 211.41 74.03 457.60 85.13 395.25 113.56 395.25 86.62 316.03 111.39 377.52 82.91 74.03 378.61 97.34 108.15 254.57 318.21 110.85 111.39 108.15 457.60 98.96 74.03 285.50 95.17 233.95 429.00 217.42 255.86 111.94 Outpatient 76705 Echo exam of abdomen 572.00 211.41 62.50 457.60 71.88 395.25 113.56 395.25 73.13 316.03 111.39 377.52 70.00 62.50 378.61 97.34 108.15 274.50 343.13 110.85 111.39 108.15 457.60 98.96 62.50 285.50 95.17 233.95 429.00 217.42 255.86 111.94 Outpatient 92920 Prq cardiac angioplast 1 art " 26,023.00 " " 9,618.10 " 776.00 " 20,818.40 " 892.40 " 17,981.89 " " 5,169.57 " " 17,981.89 " 907.92 " 14,377.71 " " 5,071.10 " " 17,175.18 " 869.12 808.05 " 17,224.62 " " 4,431.06 " " 4,923.40 " " 4,760.78 " " 5,950.98 " " 5,046.49 " " 5,071.10 " " 4,923.40 " " 20,818.40 " " 4,504.91 " 776.00 " 17,435.41 " " 4,332.59 " " 10,643.41 " " 19,517.25 " " 9,891.34 " " 11,640.09 " " 5,095.72 " Outpatient 92928 Prq card stent w/angio 1 vsl " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 36,432.98 " " 10,476.71 " " 36,432.98 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 11,279.02 " " 14,098.78 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 92933 Prq card stent/ath/angio " 84,336.00 " " 31,170.59 " 776.00 " 67,468.80 " 892.40 " 58,276.18 " " 16,751.22 " " 58,276.18 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 13,435.18 " " 16,793.98 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 92937 Prq revasc byp graft 1 vsl " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 36,432.98 " " 10,476.71 " " 36,432.98 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 2,200.09 " " 2,750.11 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 92943 Prq card revasc chronic 1vsl " 52,725.00 " " 19,487.16 " 776.00 " 42,180.00 " 892.40 " 36,432.98 " " 10,476.71 " " 36,432.98 " 907.92 " 29,130.56 " " 10,277.15 " " 34,798.50 " 869.12 808.05 " 34,898.68 " " 8,980.04 " " 9,977.82 " " 2,467.99 " " 3,084.99 " " 10,227.27 " " 10,277.15 " " 9,977.82 " " 42,180.00 " " 9,129.71 " 776.00 " 35,325.75 " " 8,780.48 " " 21,564.53 " " 39,543.75 " " 20,040.77 " " 23,583.89 " " 10,327.04 " Outpatient 92960 Cardioversion electric ext " 2,950.00 " " 1,090.32 " 491.07 " 2,360.00 " 892.40 " 2,038.45 " 585.93 " 2,038.45 " 907.92 " 1,629.88 " 574.77 " 1,947.00 " 869.12 808.05 " 1,952.61 " 502.23 558.03 " 1,481.34 " " 1,851.67 " 571.98 574.77 558.03 " 2,360.00 " 510.60 776.00 " 1,976.50 " 491.07 " 1,206.55 " " 2,212.50 " " 1,121.30 " " 1,319.54 " 577.56 Outpatient 93312 Echo transesophageal " 2,535.00 " 936.94 239.49 " 2,028.00 " 275.41 " 1,751.69 " 503.98 " 1,751.69 " 280.20 " 1,400.59 " 494.38 " 1,673.10 " 268.23 249.38 " 1,677.92 " 431.98 479.98 " 1,097.46 " " 1,371.82 " 491.98 494.38 479.98 " 2,028.00 " 439.18 239.49 " 1,698.45 " 422.38 " 1,036.82 " " 1,901.25 " 963.55 " 1,133.91 " 496.78 Outpatient 93454 Coronary artery angio s&i " 15,220.00 " " 5,625.31 " 776.00 " 12,176.00 " 892.40 " 4,435.00 " " 3,024.51 " " 4,435.00 " 907.92 " 8,409.05 " " 2,966.90 " " 10,045.20 " 869.12 808.05 " 10,074.12 " " 2,592.44 " " 2,880.49 " " 4,673.90 " " 5,842.37 " " 2,952.50 " " 2,966.90 " " 2,880.49 " " 12,176.00 " " 2,635.65 " 776.00 " 10,197.40 " " 2,534.83 " " 6,224.98 " " 11,415.00 " " 5,785.12 " " 6,807.91 " " 2,981.31 " Outpatient 93455 Coronary art/grft angio s&i " 15,220.00 " " 5,625.31 " 776.00 " 12,176.00 " 892.40 " 4,435.00 " " 3,024.51 " " 4,435.00 " 907.92 " 8,409.05 " " 2,966.90 " " 10,045.20 " 869.12 808.05 " 10,074.12 " " 2,592.44 " " 2,880.49 " " 5,478.58 " " 6,848.22 " " 2,952.50 " " 2,966.90 " " 2,880.49 " " 12,176.00 " " 2,635.65 " 776.00 " 10,197.40 " " 2,534.83 " " 6,224.98 " " 11,415.00 " " 5,785.12 " " 6,807.91 " " 2,981.31 " Outpatient 93458 L hrt artery/ventricle angio " 15,220.00 " " 5,625.31 " 776.00 " 12,176.00 " 892.40 " 4,435.00 " " 3,024.51 " " 4,435.00 " 907.92 " 8,409.05 " " 2,966.90 " " 10,045.20 " 869.12 808.05 " 10,074.12 " " 2,592.44 " " 2,880.49 " " 5,613.53 " " 7,016.91 " " 2,952.50 " " 2,966.90 " " 2,880.49 " " 12,176.00 " " 2,635.65 " 776.00 " 10,197.40 " " 2,534.83 " " 6,224.98 " " 11,415.00 " " 5,785.12 " " 6,807.91 " " 2,981.31 " Outpatient 93459 L hrt art/grft angio " 15,220.00 " " 5,625.31 " 776.00 " 12,176.00 " 892.40 " 4,435.00 " " 3,024.51 " " 4,435.00 " 907.92 " 8,409.05 " " 2,966.90 " " 10,045.20 " 869.12 808.05 " 10,074.12 " " 2,592.44 " " 2,880.49 " " 6,147.98 " " 7,684.98 " " 2,952.50 " " 2,966.90 " " 2,880.49 " " 12,176.00 " " 2,635.65 " 776.00 " 10,197.40 " " 2,534.83 " " 6,224.98 " " 11,415.00 " " 5,785.12 " " 6,807.91 " " 2,981.31 " Outpatient 93460 R&l hrt art/ventricle angio " 15,220.00 " " 5,625.31 " 776.00 " 12,176.00 " 892.40 " 4,435.00 " " 3,024.51 " " 4,435.00 " 907.92 " 8,409.05 " " 2,966.90 " " 10,045.20 " 869.12 808.05 " 10,074.12 " " 2,592.44 " " 2,880.49 " " 6,459.34 " " 8,074.17 " " 2,952.50 " " 2,966.90 " " 2,880.49 " " 12,176.00 " " 2,635.65 " 776.00 " 10,197.40 " " 2,534.83 " " 6,224.98 " " 11,415.00 " " 5,785.12 " " 6,807.91 " " 2,981.31 " Outpatient 93461 R&l hrt art/ventricle angio " 15,220.00 " " 5,625.31 " 776.00 " 12,176.00 " 892.40 " 4,435.00 " " 3,024.51 " " 4,435.00 " 907.92 " 8,409.05 " " 2,966.90 " " 10,045.20 " 869.12 808.05 " 10,074.12 " " 2,592.44 " " 2,880.49 " " 7,531.28 " " 9,414.10 " " 2,952.50 " " 2,966.90 " " 2,880.49 " " 12,176.00 " " 2,635.65 " 776.00 " 10,197.40 " " 2,534.83 " " 6,224.98 " " 11,415.00 " " 5,785.12 " " 6,807.91 " " 2,981.31 " Outpatient 93580 Transcath closure of asd " 84,336.00 " " 31,170.59 " 776.00 " 67,468.80 " 892.40 " 4,878.00 " " 16,751.22 " " 4,878.00 " 907.92 " 46,595.64 " " 16,432.15 " " 55,661.76 " 869.12 808.05 " 55,822.00 " " 14,358.19 " " 15,953.54 " " 5,487.00 " " 6,858.75 " " 16,352.38 " " 16,432.15 " " 15,953.54 " " 67,468.80 " " 14,597.49 " 776.00 " 56,505.12 " " 14,039.12 " " 34,493.42 " " 63,252.00 " " 32,056.11 " " 37,723.49 " " 16,511.91 " Outpatient 93620 Electrophysiology evaluation " 31,912.00 " " 11,794.68 " 776.00 " 25,529.60 " 892.40 " 4,435.00 " " 6,339.89 " " 4,435.00 " 907.92 " 17,631.38 " " 6,219.13 " " 21,061.92 " 869.12 808.05 " 21,122.55 " " 5,434.19 " " 6,037.99 " " 4,244.98 " " 5,306.22 " " 6,188.94 " " 6,219.13 " " 6,037.99 " " 25,529.60 " " 5,524.76 " 776.00 " 21,381.04 " " 5,313.43 " " 13,052.01 " " 23,934.00 " " 12,129.75 " " 14,274.24 " " 6,249.32 " Outpatient 93650 Ablate heart dysrhythm focus " 31,912.00 " " 11,794.68 " 776.00 " 25,529.60 " 892.40 " 4,435.00 " " 6,339.89 " " 4,435.00 " 907.92 " 17,631.38 " " 6,219.13 " " 21,061.92 " 869.12 808.05 " 21,122.55 " " 5,434.19 " " 6,037.99 " " 1,893.20 " " 2,366.50 " " 6,188.94 " " 6,219.13 " " 6,037.99 " " 25,529.60 " " 5,524.76 " 776.00 " 21,381.04 " " 5,313.43 " " 13,052.01 " " 23,934.00 " " 12,129.75 " " 14,274.24 " " 6,249.32 " Outpatient 93653 Compre ep eval tx svt " 112,688.00 " " 41,649.48 " 776.00 " 90,150.40 " 892.40 " 4,435.00 " " 22,381.77 " " 4,435.00 " 907.92 " 62,260.12 " " 21,955.45 " " 74,374.08 " 869.12 808.05 " 74,588.19 " " 19,184.37 " " 21,315.97 " " 2,994.16 " " 3,742.70 " " 21,848.87 " " 21,955.45 " " 21,315.97 " " 90,150.40 " " 19,504.11 " 776.00 " 75,500.96 " " 18,758.05 " " 46,089.39 " " 84,516.00 " " 42,832.71 " " 50,405.34 " " 22,062.03 " Outpatient 93654 Compre ep eval tx vt " 112,688.00 " " 41,649.48 " 776.00 " 90,150.40 " 892.40 " 4,435.00 " " 22,381.77 " " 4,435.00 " 907.92 " 62,260.12 " " 21,955.45 " " 74,374.08 " 869.12 808.05 " 74,588.19 " " 19,184.37 " " 21,315.97 " " 3,995.56 " " 4,994.45 " " 21,848.87 " " 21,955.45 " " 21,315.97 " " 90,150.40 " " 19,504.11 " 776.00 " 75,500.96 " " 18,758.05 " " 46,089.39 " " 84,516.00 " " 42,832.71 " " 50,405.34 " " 22,062.03 " Outpatient 93656 Compre ep eval abltj atr fib " 112,688.00 " " 41,649.48 " 776.00 " 90,150.40 " 892.40 " 4,435.00 " " 22,381.77 " " 4,435.00 " 907.92 " 62,260.12 " " 21,955.45 " " 74,374.08 " 869.12 808.05 " 74,588.19 " " 19,184.37 " " 21,315.97 " " 3,996.92 " " 4,996.15 " " 21,848.87 " " 21,955.45 " " 21,315.97 " " 90,150.40 " " 19,504.11 " 776.00 " 75,500.96 " " 18,758.05 " " 46,089.39 " " 84,516.00 " " 42,832.71 " " 50,405.34 " " 22,062.03 " Outpatient 93660 Tilt table evaluation " 2,561.00 " 946.55 - " 2,048.80 " - " 1,769.65 " 509.13 " 1,769.65 " - " 1,414.95 " 499.44 " 1,690.26 " - - " 1,695.13 " 436.40 484.89 " 1,580.42 " " 1,975.52 " 497.01 499.44 484.89 " 2,048.80 " 443.67 - " 1,715.87 " 426.70 " 1,047.45 " " 1,920.75 " 973.44 " 1,145.54 " 501.86 Outpatient G0104 Ca screen;flexi sigmoidscope " 4,167.00 " " 1,540.12 " - " 3,333.60 " - " 2,879.40 " 827.73 " 2,879.40 " - " 2,302.27 " 811.96 " 2,750.22 " - - " 2,758.14 " 709.48 788.31 381.42 476.77 808.02 811.96 788.31 " 3,333.60 " 721.30 - " 2,791.89 " 693.71 " 1,704.30 " " 3,125.25 " " 1,583.88 " " 1,863.90 " 815.90 Outpatient G0105 Colorectal scrn; hi risk ind " 4,167.00 " " 1,540.12 " - " 3,333.60 " - " 1,718.00 " 827.73 " 1,718.00 " - " 2,302.27 " 811.96 " 2,820.00 " - - " 2,758.14 " 709.48 788.31 " 2,376.02 " " 2,970.02 " 808.02 811.96 788.31 " 3,333.60 " 721.30 - " 2,791.89 " 693.71 " 1,704.30 " " 3,125.25 " " 1,583.88 " " 1,863.90 " 815.90 Outpatient G0121 Colon ca scrn not hi rsk ind " 4,167.00 " " 1,540.12 " - " 3,333.60 " - " 1,718.00 " 827.73 " 1,718.00 " - " 2,302.27 " 811.96 " 2,820.00 " - - " 2,758.14 " 709.48 788.31 " 1,878.00 " " 2,347.50 " 808.02 811.96 788.31 " 3,333.60 " 721.30 - " 2,791.89 " 693.71 " 1,704.30 " " 3,125.25 " " 1,583.88 " " 1,863.90 " 815.90 Inpatient 3 "ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES" " 518,030.52 " " 163,231.42 " " 124,610.32 " " 414,424.42 " " 287,021.93 " " 130,840.84 " " 287,021.93 " " 277,536.00 " " 128,348.63 " " 272,253.38 " " 124,610.32 " " 295,381.00 " " 124,610.32 " " 198,844.68 " " 248,555.82 " " 128,348.63 " " 128,348.63 " " 124,610.32 " " 414,424.42 " " 334,346.25 " " 388,522.89 " " 128,348.63 " Inpatient 4 "TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES" " 727,962.63 " " 229,381.02 " " 78,051.50 " " 582,370.10 " " 179,111.72 " " 81,954.08 " " 179,111.72 " " 170,760.00 " " 80,393.05 " " 169,895.63 " " 78,051.50 " " 415,084.29 " " 78,051.50 " " 134,557.52 " " 168,196.88 " " 80,393.05 " " 80,393.05 " " 78,051.50 " " 582,370.10 " " 208,643.75 " " 545,971.97 " " 80,393.05 " Inpatient 23 CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR " 251,153.48 " " 79,138.46 " " 37,536.31 " " 200,922.78 " " 85,208.95 " " 39,413.13 " " 85,208.95 " " 83,290.00 " " 38,662.40 " " 80,824.58 " " 37,536.31 " " 143,207.71 " " 37,536.31 " " 64,929.75 " " 81,162.18 " " 38,662.40 " " 38,662.40 " " 37,536.31 " " 200,922.78 " " 99,258.25 " " 188,365.11 " " 38,662.40 " Inpatient 25 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC " 196,783.27 " " 62,006.41 " " 29,923.42 " " 157,426.62 " " 67,564.44 " " 31,419.59 " " 67,564.44 " " 68,244.00 " " 30,821.12 " " 64,087.95 " " 29,923.42 " " 112,205.82 " " 29,923.42 " " 46,137.68 " " 57,672.09 " " 30,821.12 " " 30,821.12 " " 29,923.42 " " 157,426.62 " " 78,704.50 " " 147,587.45 " " 30,821.12 " Inpatient 26 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC " 90,144.79 " " 28,404.62 " " 20,619.44 " " 72,115.83 " " 46,000.43 " " 21,650.41 " " 46,000.43 " " 47,218.00 " " 21,238.02 " " 43,633.50 " " 20,619.44 " " 51,400.56 " " 20,619.44 " " 33,114.60 " " 41,393.25 " " 21,238.02 " " 21,238.02 " " 20,619.44 " " 72,115.83 " " 53,585.00 " " 67,608.59 " " 21,238.02 " Inpatient 27 CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC " 63,082.35 " " 19,877.25 " " 17,069.35 " " 50,465.88 " " 37,772.33 " " 17,922.82 " " 37,772.33 " " 35,911.00 " " 17,581.43 " " 35,828.78 " " 17,069.35 " " 35,969.56 " " 17,069.35 " " 30,847.72 " " 38,559.67 " " 17,581.43 " " 17,581.43 " " 17,069.35 " " 50,465.88 " " 44,000.25 " " 47,311.76 " " 17,581.43 " Inpatient 28 SPINAL PROCEDURES WITH MCC " 164,612.52 " " 51,869.41 " " 38,516.36 " " 131,690.02 " " 87,480.43 " " 40,442.18 " " 87,480.43 " " 84,910.00 " " 39,671.85 " " 82,979.18 " " 38,516.36 " " 93,862.06 " " 38,516.36 " " 59,631.99 " " 74,539.97 " " 39,671.85 " " 39,671.85 " " 38,516.36 " " 131,690.02 " " 101,904.25 " " 123,459.39 " " 39,671.85 " Inpatient 29 SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS " 161,418.14 " " 50,862.86 " " 22,141.36 " " 129,134.51 " " 49,527.83 " " 23,248.43 " " 49,527.83 " " 49,675.00 " " 22,805.60 " " 46,979.40 " " 22,141.36 " " 92,040.62 " " 22,141.36 " " 31,515.28 " " 39,394.09 " " 22,805.60 " " 22,805.60 " " 22,141.36 " " 129,134.51 " " 57,694.00 " " 121,063.61 " " 22,805.60 " Inpatient 30 SPINAL PROCEDURES WITHOUT CC/MCC " 88,409.26 " " 27,857.76 " " 16,048.47 " " 70,727.41 " " 35,406.21 " " 16,850.89 " " 35,406.21 " " 28,061.00 " " 16,529.92 " " 33,584.40 " " 16,048.47 " " 50,410.96 " " 16,048.47 " " 22,452.56 " " 28,065.71 " " 16,529.92 " " 16,529.92 " " 16,048.47 " " 70,727.41 " " 41,244.00 " " 66,306.95 " " 16,529.92 " Inpatient 35 CAROTID ARTERY STENT PROCEDURES WITH CC " 57,395.47 " " 18,085.31 " " 15,937.63 " " 45,916.38 " " 35,149.31 " " 16,734.51 " " 35,149.31 " " 34,785.00 " " 16,415.76 " " 33,340.73 " " 15,937.63 " " 32,726.90 " " 15,937.63 " " 29,815.99 " " 37,269.99 " " 16,415.76 " " 16,415.76 " " 15,937.63 " " 45,916.38 " " 40,944.75 " " 43,046.60 " " 16,415.76 " Inpatient 36 CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC " 48,124.27 " " 15,163.96 " " 12,778.39 " " 38,499.42 " " 27,827.10 " " 13,417.31 " " 27,827.10 " " 27,240.00 " " 13,161.74 " " 26,395.28 " " 12,778.39 " " 27,440.46 " " 12,778.39 " " 23,107.15 " " 28,883.96 " " 13,161.74 " " 13,161.74 " " 12,778.39 " " 38,499.42 " " 32,415.25 " " 36,093.20 " " 13,161.74 " Inpatient 38 EXTRACRANIAL PROCEDURES WITH CC " 58,620.04 " " 18,471.17 " " 11,524.16 " " 46,896.03 " " 24,920.15 " " 12,100.37 " " 24,920.15 " " 24,968.00 " " 11,869.88 " " 23,637.90 " " 11,524.16 " " 33,425.15 " " 11,524.16 " " 24,890.92 " " 31,113.67 " " 11,869.88 " " 11,869.88 " " 11,524.16 " " 46,896.03 " " 29,029.00 " " 43,965.03 " " 11,869.88 " Inpatient 39 EXTRACRANIAL PROCEDURES WITHOUT CC/MCC " 42,610.10 " " 13,426.44 " " 8,155.57 " " 34,088.08 " " 17,112.70 " " 8,563.35 " " 17,112.70 " " 16,648.00 " " 8,400.24 " " 16,232.18 " " 8,155.57 " " 24,296.28 " " 8,155.57 " " 17,166.72 " " 21,458.41 " " 8,400.24 " " 8,400.24 " " 8,155.57 " " 34,088.08 " " 19,934.25 " " 31,957.58 " " 8,400.24 " Inpatient 41 "PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR" " 70,898.12 " " 22,340.00 " " 16,002.44 " " 56,718.50 " " 35,299.54 " " 16,802.56 " " 35,299.54 " " 33,460.00 " " 16,482.51 " " 33,483.23 " " 16,002.44 " " 40,426.11 " " 16,002.44 " " 30,340.41 " " 37,925.54 " " 16,482.51 " " 16,482.51 " " 16,002.44 " " 56,718.50 " " 41,119.75 " " 53,173.59 " " 16,482.51 " Inpatient 54 NERVOUS SYSTEM NEOPLASMS WITH MCC " 56,602.52 " " 17,835.45 " " 9,641.20 " " 45,282.02 " " 20,555.97 " " 10,123.26 " " 20,555.97 " " 20,529.00 " " 9,930.44 " " 19,498.28 " " 9,641.20 " " 32,274.76 " " 9,641.20 " " 14,613.80 " " 18,267.26 " " 9,930.44 " " 9,930.44 " " 9,641.20 " " 45,282.02 " " 23,945.25 " " 42,451.89 " " 9,930.44 " Inpatient 56 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC " 87,587.70 " " 27,598.88 " " 15,001.65 " " 70,070.16 " " 32,979.99 " " 15,751.73 " " 32,979.99 " " 27,716.00 " " 15,451.70 " " 31,283.03 " " 15,001.65 " " 49,942.51 " " 15,001.65 " " 27,934.78 " " 34,918.49 " " 15,451.70 " " 15,451.70 " " 15,001.65 " " 70,070.16 " " 38,417.75 " " 65,690.78 " " 15,451.70 " Inpatient 57 DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC " 55,669.35 " " 17,541.41 " " 8,987.83 " " 44,535.48 " " 19,041.65 " " 9,437.22 " " 19,041.65 " " 15,889.00 " " 9,257.46 " " 18,061.88 " " 8,987.83 " " 31,742.66 " " 8,987.83 " " 17,003.07 " " 21,253.85 " " 9,257.46 " " 9,257.46 " " 8,987.83 " " 44,535.48 " " 22,181.25 " " 41,752.01 " " 9,257.46 " Inpatient 61 "ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC" " 147,357.04 " " 46,432.20 " " 19,512.34 " " 117,885.63 " " 43,434.50 " " 20,487.96 " " 43,434.50 " " 43,379.00 " " 20,097.71 " " 41,199.60 " " 19,512.34 " " 84,022.98 " " 19,512.34 " " 38,083.93 " " 47,604.91 " " 20,097.71 " " 20,097.71 " " 19,512.34 " " 117,885.63 " " 50,596.00 " " 110,517.78 " " 20,097.71 " Inpatient 62 "ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC" " 106,068.79 " " 33,422.28 " " 13,659.92 " " 84,855.03 " " 29,870.23 " " 14,342.92 " " 29,870.23 " " 29,194.00 " " 14,069.72 " " 28,333.28 " " 13,659.92 " " 60,480.42 " " 13,659.92 " " 32,042.36 " " 40,052.97 " " 14,069.72 " " 14,069.72 " " 13,659.92 " " 84,855.03 " " 34,795.25 " " 79,551.59 " " 14,069.72 " Inpatient 64 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC " 76,440.30 " " 24,086.34 " " 13,210.08 " " 61,152.24 " " 28,827.63 " " 13,870.58 " " 28,827.63 " " 27,345.00 " " 13,606.38 " " 27,344.33 " " 13,210.08 " " 43,586.26 " " 13,210.08 " " 25,643.70 " " 32,054.65 " " 13,606.38 " " 13,606.38 " " 13,210.08 " " 61,152.24 " " 33,580.75 " " 57,330.23 " " 13,606.38 " Inpatient 65 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS " 50,186.48 " " 15,813.76 " " 7,383.58 " " 40,149.18 " " 15,323.46 " " 7,752.76 " " 15,323.46 " " 16,745.00 " " 7,605.09 " " 14,535.00 " " 7,383.58 " " 28,616.33 " " 7,383.58 " " 16,135.73 " " 20,169.68 " " 7,605.09 " " 7,605.09 " " 7,383.58 " " 40,149.18 " " 17,850.00 " " 37,639.86 " " 7,605.09 " Inpatient 66 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC " 39,595.07 " " 12,476.41 " " 5,384.59 " " 31,676.06 " " 10,690.37 " " 5,653.82 " " 10,690.37 " " 11,846.00 " " 5,546.13 " " 10,140.30 " " 5,384.59 " " 22,577.11 " " 5,384.59 " " 13,190.06 " " 16,487.58 " " 5,546.13 " " 5,546.13 " " 5,384.59 " " 31,676.06 " " 12,453.00 " " 29,696.30 " " 5,546.13 " Inpatient 69 TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC " 49,426.21 " " 15,574.20 " " 5,873.97 " " 39,540.97 " " 11,824.60 " " 6,167.67 " " 11,824.60 " " 10,990.00 " " 6,050.19 " " 11,216.18 " " 5,873.97 " " 28,182.82 " " 5,873.97 " " 11,733.59 " " 14,667.00 " " 6,050.19 " " 6,050.19 " " 5,873.97 " " 39,540.97 " " 13,774.25 " " 37,069.66 " " 6,050.19 " Inpatient 70 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC " 85,244.86 " " 26,860.66 " " 11,658.98 " " 68,195.89 " " 25,232.63 " " 12,241.93 " " 25,232.63 " " 25,863.00 " " 12,008.75 " " 23,934.30 " " 11,658.98 " " 48,606.62 " " 11,658.98 " " 21,339.75 " " 26,674.70 " " 12,008.75 " " 12,008.75 " " 11,658.98 " " 68,195.89 " " 29,393.00 " " 63,933.65 " " 12,008.75 " Inpatient 71 NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC " 40,105.32 " " 12,637.19 " " 7,330.43 " " 32,084.26 " " 15,200.27 " " 7,696.95 " " 15,200.27 " " 15,337.00 " " 7,550.34 " " 14,418.15 " " 7,330.43 " " 22,868.05 " " 7,330.43 " " 14,450.15 " " 18,062.70 " " 7,550.34 " " 7,550.34 " " 7,330.43 " " 32,084.26 " " 17,706.50 " " 30,078.99 " " 7,550.34 " Inpatient 72 NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC " 41,478.37 " " 13,069.83 " " 5,774.15 " " 33,182.70 " " 11,593.25 " " 6,062.86 " " 11,593.25 " " 10,930.00 " " 5,947.37 " " 10,996.73 " " 5,774.15 " " 23,650.97 " " 5,774.15 " " 10,817.16 " " 13,521.46 " " 5,947.37 " " 5,947.37 " " 5,774.15 " " 33,182.70 " " 13,504.75 " " 31,108.78 " " 5,947.37 " Inpatient 74 CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC " 48,947.02 " " 15,423.21 " " 7,377.10 " " 39,157.62 " " 15,308.44 " " 7,745.96 " " 15,308.44 " " 13,919.00 " " 7,598.41 " " 14,520.75 " " 7,377.10 " " 27,909.59 " " 7,377.10 " " 12,584.56 " " 15,730.71 " " 7,598.41 " " 7,598.41 " " 7,377.10 " " 39,157.62 " " 17,832.50 " " 36,710.27 " " 7,598.41 " Inpatient 82 TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC " 107,423.49 " " 33,849.14 " " 15,446.31 " " 85,938.79 " " 34,010.57 " " 16,218.63 " " 34,010.57 " " 30,118.00 " " 15,909.70 " " 32,260.58 " " 15,446.31 " " 61,252.87 " " 15,446.31 " " 31,387.76 " " 39,234.72 " " 15,909.70 " " 15,909.70 " " 15,446.31 " " 85,938.79 " " 39,618.25 " " 80,567.62 " " 15,909.70 " Inpatient 83 TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC " 74,358.83 " " 23,430.47 " " 9,483.69 " " 59,487.06 " " 20,190.91 " " 9,957.87 " " 20,190.91 " " 19,511.00 " " 9,768.20 " " 19,152.00 " " 9,483.69 " " 42,399.40 " " 9,483.69 " " 18,934.12 " " 23,667.66 " " 9,768.20 " " 9,768.20 " " 9,483.69 " " 59,487.06 " " 23,520.00 " " 55,769.12 " " 9,768.20 " Inpatient 84 TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC " 43,879.71 " " 13,826.50 " " 6,642.07 " " 35,103.77 " " 13,604.83 " " 6,974.17 " " 13,604.83 " " 13,518.00 " " 6,841.33 " " 12,904.80 " " 6,642.07 " " 25,020.21 " " 6,642.07 " " 12,355.45 " " 15,444.33 " " 6,841.33 " " 6,841.33 " " 6,642.07 " " 35,103.77 " " 15,848.00 " " 32,909.78 " " 6,841.33 " Inpatient 85 TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC " 92,817.67 " " 29,246.85 " " 15,756.14 " " 74,254.14 " " 34,728.67 " " 16,543.95 " " 34,728.67 " " 31,104.00 " " 16,228.82 " " 32,941.73 " " 15,756.14 " " 52,924.64 " " 15,756.14 " " 25,938.27 " " 32,422.86 " " 16,228.82 " " 16,228.82 " " 15,756.14 " " 74,254.14 " " 40,454.75 " " 69,613.25 " " 16,228.82 " Inpatient 86 TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC " 53,980.82 " " 17,009.36 " " 9,033.20 " " 43,184.66 " " 19,146.81 " " 9,484.86 " " 19,146.81 " " 17,592.00 " " 9,304.20 " " 18,161.63 " " 9,033.20 " " 30,779.86 " " 9,033.20 " " 14,859.27 " " 18,574.10 " " 9,304.20 " " 9,304.20 " " 9,033.20 " " 43,184.66 " " 22,303.75 " " 40,485.62 " " 9,304.20 " Inpatient 87 TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC " 35,839.50 " " 11,293.03 " " 6,369.83 " " 28,671.60 " " 12,973.86 " " 6,688.32 " " 12,973.86 " " 11,737.00 " " 6,560.92 " " 12,306.30 " " 6,369.83 " " 20,435.68 " " 6,369.83 " " 10,048.01 " " 12,560.02 " " 6,560.92 " " 6,560.92 " " 6,369.83 " " 28,671.60 " " 15,113.00 " " 26,879.63 " " 6,560.92 " Inpatient 89 CONCUSSION WITH CC " 47,414.57 " " 14,940.33 " " 7,665.54 " " 37,931.66 " " 15,976.96 " " 8,048.82 " " 15,976.96 " " 15,084.00 " " 7,895.51 " " 15,154.88 " " 7,665.54 " " 27,035.79 " " 7,665.54 " " 13,059.14 " " 16,323.94 " " 7,895.51 " " 7,895.51 " " 7,665.54 " " 37,931.66 " " 18,611.25 " " 35,560.93 " " 7,895.51 " Inpatient 91 OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC " 95,063.16 " " 29,954.40 " " 11,472.31 " " 76,050.53 " " 24,799.97 " " 12,045.93 " " 24,799.97 " " 25,139.00 " " 11,816.48 " " 23,523.90 " " 11,472.31 " " 54,205.01 " " 11,472.31 " " 20,881.54 " " 26,101.93 " " 11,816.48 " " 11,816.48 " " 11,472.31 " " 76,050.53 " " 28,889.00 " " 71,297.37 " " 11,816.48 " Inpatient 92 OTHER DISORDERS OF NERVOUS SYSTEM WITH CC " 46,632.87 " " 14,694.02 " " 7,182.00 " " 37,306.30 " " 14,856.24 " " 7,541.10 " " 14,856.24 " " 14,143.00 " " 7,397.46 " " 14,091.83 " " 7,182.00 " " 26,590.06 " " 7,182.00 " " 14,973.83 " " 18,717.29 " " 7,397.46 " " 7,397.46 " " 7,182.00 " " 37,306.30 " " 17,305.75 " " 34,974.65 " " 7,397.46 " Inpatient 93 OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC " 38,719.88 " " 12,200.63 " " 5,842.21 " " 30,975.90 " " 11,750.99 " " 6,134.32 " " 11,750.99 " " 10,671.00 " " 6,017.48 " " 11,146.35 " " 5,842.21 " " 22,078.08 " " 5,842.21 " " 11,586.31 " " 14,482.89 " " 6,017.48 " " 6,017.48 " " 5,842.21 " " 30,975.90 " " 13,688.50 " " 29,039.91 " " 6,017.48 " Inpatient 100 SEIZURES WITH MCC " 82,383.76 " " 25,959.12 " " 12,934.60 " " 65,907.01 " " 28,189.16 " " 13,581.33 " " 28,189.16 " " 24,078.00 " " 13,322.64 " " 26,738.70 " " 12,934.60 " " 46,975.22 " " 12,934.60 " " 21,290.66 " " 26,613.33 " " 13,322.64 " " 13,322.64 " " 12,934.60 " " 65,907.01 " " 32,837.00 " " 61,787.82 " " 13,322.64 " Inpatient 101 SEIZURES WITHOUT MCC " 38,262.11 " " 12,056.39 " " 6,530.58 " " 30,609.69 " " 13,346.43 " " 6,857.11 " " 13,346.43 " " 11,905.00 " " 6,726.50 " " 12,659.70 " " 6,530.58 " " 21,817.06 " " 6,530.58 " " 9,491.61 " " 11,864.51 " " 6,726.50 " " 6,726.50 " " 6,530.58 " " 30,609.69 " " 15,547.00 " " 28,696.58 " " 6,726.50 " Inpatient 103 HEADACHES WITHOUT MCC " 32,281.45 " " 10,171.88 " " 6,148.80 " " 25,825.16 " " 12,461.58 " " 6,456.24 " " 12,461.58 " " 10,878.00 " " 6,333.26 " " 11,820.38 " " 6,148.80 " " 18,406.88 " " 6,148.80 " " 10,162.57 " " 12,703.21 " " 6,333.26 " " 6,333.26 " " 6,148.80 " " 25,825.16 " " 14,516.25 " " 24,211.09 " " 6,333.26 " Inpatient 125 OTHER DISORDERS OF THE EYE WITHOUT MCC " 44,673.32 " " 14,076.56 " " 6,197.41 " " 35,738.66 " " 12,574.25 " " 6,507.28 " " 12,574.25 " " 10,780.00 " " 6,383.33 " " 11,927.25 " " 6,197.41 " " 25,472.73 " " 6,197.41 " " 9,115.22 " " 11,394.03 " " 6,383.33 " " 6,383.33 " " 6,197.41 " " 35,738.66 " " 14,647.50 " " 33,504.99 " " 6,383.33 " Inpatient 149 DYSEQUILIBRIUM " 56,244.92 " " 17,722.77 " " 5,549.23 " " 44,995.94 " " 11,071.95 " " 5,826.69 " " 11,071.95 " " 9,979.00 " " 5,715.71 " " 10,502.25 " " 5,549.23 " " 32,070.85 " " 5,549.23 " " 9,737.08 " " 12,171.36 " " 5,715.71 " " 5,715.71 " " 5,549.23 " " 44,995.94 " " 12,897.50 " " 42,183.69 " " 5,715.71 " Inpatient 151 EPISTAXIS WITHOUT MCC " 24,163.94 " " 7,614.06 " " 5,558.31 " " 19,331.15 " " 11,092.98 " " 5,836.23 " " 11,092.98 " " 10,526.00 " " 5,725.06 " " 10,522.20 " " 5,558.31 " " 13,778.28 " " 5,558.31 " " 9,229.77 " " 11,537.22 " " 5,725.06 " " 5,725.06 " " 5,558.31 " " 19,331.15 " " 12,922.00 " " 18,122.96 " " 5,725.06 " Inpatient 153 OTITIS MEDIA AND URI WITHOUT MCC " 34,399.67 " " 10,839.34 " " 5,394.97 " " 27,519.74 " " 10,714.40 " " 5,664.72 " " 10,714.40 " " 10,831.00 " " 5,556.82 " " 10,163.10 " " 5,394.97 " " 19,614.69 " " 5,394.97 " " 6,316.83 " " 7,896.04 " " 5,556.82 " " 5,556.82 " " 5,394.97 " " 27,519.74 " " 12,481.00 " " 25,799.75 " " 5,556.82 " Inpatient 155 "OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC" " 51,533.20 " " 16,238.11 " " 6,667.34 " " 41,226.56 " " 13,663.42 " " 7,000.71 " " 13,663.42 " " 13,921.00 " " 6,867.36 " " 12,960.38 " " 6,667.34 " " 29,384.23 " " 6,667.34 " " 8,689.73 " " 10,862.17 " " 6,867.36 " " 6,867.36 " " 6,667.34 " " 41,226.56 " " 15,916.25 " " 38,649.90 " " 6,867.36 " Inpatient 156 "OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC" " 29,779.52 " " 9,383.53 " " 5,039.76 " " 23,823.62 " " 9,891.14 " " 5,291.75 " " 9,891.14 " " 10,252.00 " " 5,190.95 " " 9,382.20 " " 5,039.76 " " 16,980.28 " " 5,039.76 " " 7,282.35 " " 9,102.95 " " 5,190.95 " " 5,190.95 " " 5,039.76 " " 23,823.62 " " 11,522.00 " " 22,334.64 " " 5,190.95 " Inpatient 166 OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC " 107,594.13 " " 33,902.91 " " 24,907.15 " " 86,075.30 " " 55,938.14 " " 26,152.51 " " 55,938.14 " " 57,599.00 " " 25,654.36 " " 53,059.88 " " 24,907.15 " " 61,350.17 " " 24,907.15 " " 37,241.43 " " 46,551.78 " " 25,654.36 " " 25,654.36 " " 24,907.15 " " 86,075.30 " " 65,161.25 " " 80,695.60 " " 25,654.36 " Inpatient 175 PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE " 58,646.94 " " 18,479.65 " " 10,793.02 " " 46,917.55 " " 23,225.56 " " 11,332.67 " " 23,225.56 " " 24,027.00 " " 11,116.81 " " 22,030.50 " " 10,793.02 " " 33,440.49 " " 10,793.02 " " 17,935.86 " " 22,419.84 " " 11,116.81 " " 11,116.81 " " 10,793.02 " " 46,917.55 " " 27,055.00 " " 43,985.21 " " 11,116.81 " Inpatient 176 PULMONARY EMBOLISM WITHOUT MCC " 40,924.38 " " 12,895.27 " " 6,526.69 " " 32,739.50 " " 13,337.42 " " 6,853.02 " " 13,337.42 " " 15,215.00 " " 6,722.49 " " 12,651.15 " " 6,526.69 " " 23,335.08 " " 6,526.69 " " 10,604.42 " " 13,255.53 " " 6,722.49 " " 6,722.49 " " 6,526.69 " " 32,739.50 " " 15,536.50 " " 30,693.29 " " 6,722.49 " Inpatient 177 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC " 83,488.57 " " 26,307.25 " " 12,757.65 " " 66,790.86 " " 27,779.03 " " 13,395.53 " " 27,779.03 " " 30,668.00 " " 13,140.38 " " 26,349.68 " " 12,757.65 " " 47,605.18 " " 12,757.65 " " 21,028.82 " " 26,286.04 " " 13,140.38 " " 13,140.38 " " 12,757.65 " " 66,790.86 " " 32,359.25 " " 62,616.43 " " 13,140.38 " Inpatient 178 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC " 50,069.18 " " 15,776.80 " " 8,600.87 " " 40,055.34 " " 18,144.78 " " 9,030.91 " " 18,144.78 " " 21,883.00 " " 8,858.90 " " 17,211.15 " " 8,600.87 " " 28,549.45 " " 8,600.87 " " 16,135.73 " " 20,169.68 " " 8,858.90 " " 8,858.90 " " 8,600.87 " " 40,055.34 " " 21,136.50 " " 37,551.89 " " 8,858.90 " Inpatient 179 RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC " 36,387.38 " " 11,465.66 " " 6,428.81 " " 29,109.90 " " 13,110.57 " " 6,750.25 " " 13,110.57 " " 15,250.00 " " 6,621.67 " " 12,435.98 " " 6,428.81 " " 20,748.08 " " 6,428.81 " " 11,291.74 " " 14,114.68 " " 6,621.67 " " 6,621.67 " " 6,428.81 " " 29,109.90 " " 15,272.25 " " 27,290.54 " " 6,621.67 " Inpatient 180 RESPIRATORY NEOPLASMS WITH MCC " 66,731.52 " " 21,027.10 " " 12,049.84 " " 53,385.22 " " 26,138.52 " " 12,652.33 " " 26,138.52 " " 26,542.00 " " 12,411.34 " " 24,793.58 " " 12,049.84 " " 38,050.31 " " 12,049.84 " " 22,076.17 " " 27,595.22 " " 12,411.34 " " 12,411.34 " " 12,049.84 " " 53,385.22 " " 30,448.25 " " 50,048.64 " " 12,411.34 " Inpatient 183 MAJOR CHEST TRAUMA WITH MCC " 54,874.23 " " 17,290.87 " " 10,876.63 " " 43,899.38 " " 23,419.35 " " 11,420.46 " " 23,419.35 " " 23,760.00 " " 11,202.93 " " 22,214.33 " " 10,876.63 " " 31,289.29 " " 10,876.63 " " 18,639.55 " " 23,299.45 " " 11,202.93 " " 11,202.93 " " 10,876.63 " " 43,899.38 " " 27,280.75 " " 41,155.67 " " 11,202.93 " Inpatient 184 MAJOR CHEST TRAUMA WITH CC " 41,887.64 " " 13,198.80 " " 7,519.05 " " 33,510.11 " " 15,637.44 " " 7,895.00 " " 15,637.44 " " 15,558.00 " " 7,744.62 " " 14,832.83 " " 7,519.05 " " 23,884.33 " " 7,519.05 " " 13,746.47 " " 17,183.09 " " 7,744.62 " " 7,744.62 " " 7,519.05 " " 33,510.11 " " 18,215.75 " " 31,415.73 " " 7,744.62 " Inpatient 185 MAJOR CHEST TRAUMA WITHOUT CC/MCC " 38,138.96 " " 12,017.59 " " 5,794.89 " " 30,511.17 " " 11,641.32 " " 6,084.63 " " 11,641.32 " " 10,428.00 " " 5,968.74 " " 11,042.33 " " 5,794.89 " " 21,746.83 " " 5,794.89 " " 10,604.42 " " 13,255.53 " " 5,968.74 " " 5,968.74 " " 5,794.89 " " 30,511.17 " " 13,560.75 " " 28,604.22 " " 5,968.74 " Inpatient 187 PLEURAL EFFUSION WITH CC " 51,527.33 " " 16,236.26 " " 7,467.20 " " 41,221.86 " " 15,517.26 " " 7,840.56 " " 15,517.26 " " 16,819.00 " " 7,691.22 " " 14,718.83 " " 7,467.20 " " 29,380.88 " " 7,467.20 " " 13,861.02 " " 17,326.28 " " 7,691.22 " " 7,691.22 " " 7,467.20 " " 41,221.86 " " 18,075.75 " " 38,645.50 " " 7,691.22 " Inpatient 189 PULMONARY EDEMA AND RESPIRATORY FAILURE " 60,427.27 " " 19,040.63 " " 8,719.48 " " 48,341.82 " " 18,419.70 " " 9,155.45 " " 18,419.70 " " 19,094.00 " " 8,981.06 " " 17,471.93 " " 8,719.48 " " 34,455.63 " " 8,719.48 " " 14,777.45 " " 18,471.82 " " 8,981.06 " " 8,981.06 " " 8,719.48 " " 48,341.82 " " 21,456.75 " " 45,320.45 " " 8,981.06 " Inpatient 190 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC " 54,182.88 " " 17,073.03 " " 8,064.82 " " 43,346.30 " " 16,902.38 " " 8,468.06 " " 16,902.38 " " 18,476.00 " " 8,306.76 " " 16,032.68 " " 8,064.82 " " 30,895.08 " " 8,064.82 " " 13,010.05 " " 16,262.57 " " 8,306.76 " " 8,306.76 " " 8,064.82 " " 43,346.30 " " 19,689.25 " " 40,637.16 " " 8,306.76 " Inpatient 191 CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC " 36,663.89 " " 11,552.79 " " 6,504.00 " " 29,331.11 " " 13,284.84 " " 6,829.20 " " 13,284.84 " " 14,742.00 " " 6,699.12 " " 12,601.28 " " 6,504.00 " " 20,905.75 " " 6,504.00 " " 10,948.08 " " 13,685.10 " " 6,699.12 " " 6,699.12 " " 6,504.00 " " 29,331.11 " " 15,475.25 " " 27,497.92 " " 6,699.12 " Inpatient 193 SIMPLE PNEUMONIA AND PLEURISY WITH MCC " 48,528.99 " " 15,291.48 " " 9,276.27 " " 38,823.19 " " 19,710.18 " " 9,740.08 " " 19,710.18 " " 22,798.00 " " 9,554.56 " " 18,696.00 " " 9,276.27 " " 27,671.23 " " 9,276.27 " " 15,775.71 " " 19,719.64 " " 9,554.56 " " 9,554.56 " " 9,276.27 " " 38,823.19 " " 22,960.00 " " 36,396.74 " " 9,554.56 " Inpatient 194 SIMPLE PNEUMONIA AND PLEURISY WITH CC " 39,388.56 " " 12,411.34 " " 6,371.77 " " 31,510.85 " " 12,978.37 " " 6,690.36 " " 12,978.37 " " 15,243.00 " " 6,562.92 " " 12,310.58 " " 6,371.77 " " 22,459.36 " " 6,371.77 " " 10,195.30 " " 12,744.13 " " 6,562.92 " " 6,562.92 " " 6,371.77 " " 31,510.85 " " 15,118.25 " " 29,541.42 " " 6,562.92 " Inpatient 195 SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC " 31,515.62 " " 9,930.57 " " 5,087.73 " " 25,212.50 " " 10,002.31 " " 5,342.12 " " 10,002.31 " " 11,083.00 " " 5,240.36 " " 9,487.65 " " 5,087.73 " " 17,970.21 " " 5,087.73 " " 7,495.10 " " 9,368.88 " " 5,240.36 " " 5,240.36 " " 5,087.73 " " 25,212.50 " " 11,651.50 " " 23,636.72 " " 5,240.36 " Inpatient 199 PNEUMOTHORAX WITH MCC " 43,833.92 " " 13,812.07 " " 12,374.58 " " 35,067.14 " " 26,891.17 " " 12,993.31 " " 26,891.17 " " 28,862.00 " " 12,745.82 " " 25,507.50 " " 12,374.58 " " 24,994.10 " " 12,374.58 " " 18,361.35 " " 22,951.70 " " 12,745.82 " " 12,745.82 " " 12,374.58 " " 35,067.14 " " 31,325.00 " " 32,875.44 " " 12,745.82 " Inpatient 200 PNEUMOTHORAX WITH CC " 52,376.77 " " 16,503.92 " " 7,749.81 " " 41,901.42 " " 16,172.26 " " 8,137.30 " " 16,172.26 " " 15,865.00 " " 7,982.30 " " 15,340.13 " " 7,749.81 " " 29,865.23 " " 7,749.81 " " 12,764.58 " " 15,955.73 " " 7,982.30 " " 7,982.30 " " 7,749.81 " " 41,901.42 " " 18,838.75 " " 39,282.58 " " 7,982.30 " Inpatient 201 PNEUMOTHORAX WITHOUT CC/MCC " 28,299.97 " " 8,917.32 " " 5,371.63 " " 22,639.98 " " 10,660.32 " " 5,640.21 " " 10,660.32 " " 11,164.00 " " 5,532.78 " " 10,111.80 " " 5,371.63 " " 16,136.64 " " 5,371.63 " " 7,462.37 " " 9,327.96 " " 5,532.78 " " 5,532.78 " " 5,371.63 " " 22,639.98 " " 12,418.00 " " 21,224.98 " " 5,532.78 " Inpatient 202 BRONCHITIS AND ASTHMA WITH CC/MCC " 46,919.34 " " 14,784.28 " " 7,040.05 " " 37,535.47 " " 14,527.24 " " 7,392.05 " " 14,527.24 " " 13,807.00 " " 7,251.25 " " 13,779.75 " " 7,040.05 " " 26,753.41 " " 7,040.05 " " 10,244.39 " " 12,805.49 " " 7,251.25 " " 7,251.25 " " 7,040.05 " " 37,535.47 " " 16,922.50 " " 35,189.51 " " 7,251.25 " Inpatient 204 RESPIRATORY SIGNS AND SYMPTOMS " 39,561.17 " " 12,465.72 " " 5,916.10 " " 31,648.94 " " 11,922.25 " " 6,211.91 " " 11,922.25 " " 11,077.00 " " 6,093.58 " " 11,308.80 " " 5,916.10 " " 22,557.78 " " 5,916.10 " " 10,228.03 " " 12,785.04 " " 6,093.58 " " 6,093.58 " " 5,916.10 " " 31,648.94 " " 13,888.00 " " 29,670.88 " " 6,093.58 " Inpatient 205 OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC " 51,181.04 " " 16,127.15 " " 11,692.69 " " 40,944.83 " " 25,310.75 " " 12,277.32 " " 25,310.75 " " 22,025.00 " " 12,043.47 " " 24,008.40 " " 11,692.69 " " 29,183.43 " " 11,692.69 " " 18,083.15 " " 22,603.95 " " 12,043.47 " " 12,043.47 " " 11,692.69 " " 40,944.83 " " 29,484.00 " " 38,385.78 " " 12,043.47 " Inpatient 206 OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC " 45,123.78 " " 14,218.50 " " 6,515.02 " " 36,099.02 " " 13,310.38 " " 6,840.77 " " 13,310.38 " " 12,495.00 " " 6,710.47 " " 12,625.50 " " 6,515.02 " " 25,729.58 " " 6,515.02 " " 10,244.39 " " 12,805.49 " " 6,710.47 " " 6,710.47 " " 6,515.02 " " 36,099.02 " " 15,505.00 " " 33,842.84 " " 6,710.47 " Inpatient 207 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS " 403,581.21 " " 127,168.44 " " 37,952.44 " " 322,864.97 " " 86,173.43 " " 39,850.06 " " 86,173.43 " " 84,056.00 " " 39,091.01 " " 81,739.43 " " 37,952.44 " " 230,122.01 " " 37,952.44 " " 68,571.07 " " 85,713.83 " " 39,091.01 " " 39,091.01 " " 37,952.44 " " 322,864.97 " " 100,381.75 " " 302,685.91 " " 39,091.01 " Inpatient 208 RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS " 143,899.15 " " 45,342.62 " " 17,267.05 " " 115,119.32 " " 38,230.53 " " 18,130.40 " " 38,230.53 " " 36,140.00 " " 17,785.06 " " 36,263.40 " " 17,267.05 " " 82,051.30 " " 17,267.05 " " 30,258.59 " " 37,823.25 " " 17,785.06 " " 17,785.06 " " 17,267.05 " " 115,119.32 " " 44,534.00 " " 107,924.36 " " 17,785.06 " Inpatient 215 OTHER HEART ASSIST SYSTEM IMPLANT " 343,115.26 " " 108,115.62 " " 69,209.66 " " 274,492.21 " " 158,618.84 " " 72,670.14 " " 158,618.84 " " 242,842.00 " " 71,285.95 " " 150,457.20 " " 69,209.66 " " 195,644.32 " " 69,209.66 " " 107,711.70 " " 134,639.61 " " 71,285.95 " " 71,285.95 " " 69,209.66 " " 274,492.21 " " 184,772.00 " " 257,336.45 " " 71,285.95 " Inpatient 216 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC " 389,384.60 " " 122,695.09 " " 65,844.96 " " 311,507.68 " " 150,820.40 " " 69,137.21 " " 150,820.40 " " 149,840.00 " " 67,820.31 " " 143,060.03 " " 65,844.96 " " 222,027.10 " " 65,844.96 " " 96,887.70 " " 121,109.60 " " 67,820.31 " " 67,820.31 " " 65,844.96 " " 311,507.68 " " 175,687.75 " " 292,038.45 " " 67,820.31 " Inpatient 219 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC " 253,096.05 " " 79,750.57 " " 52,999.96 " " 202,476.84 " " 121,049.32 " " 55,649.96 " " 121,049.32 " " 121,254.00 " " 54,589.96 " " 114,820.80 " " 52,999.96 " " 144,315.37 " " 52,999.96 " " 74,525.70 " " 93,157.11 " " 54,589.96 " " 54,589.96 " " 52,999.96 " " 202,476.84 " " 141,008.00 " " 189,822.04 " " 54,589.96 " Inpatient 220 CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC " 214,250.05 " " 67,510.19 " " 35,808.26 " " 171,400.04 " " 81,203.82 " " 37,598.67 " " 81,203.82 " " 81,901.00 " " 36,882.51 " " 77,025.53 " " 35,808.26 " " 122,165.38 " " 35,808.26 " " 57,461.47 " " 71,826.83 " " 36,882.51 " " 36,882.51 " " 35,808.26 " " 171,400.04 " " 94,592.75 " " 160,687.54 " " 36,882.51 " Inpatient 224 "CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITH MCC" " 276,359.87 " " 87,081.00 " " 49,509.50 " " 221,087.90 " " 112,959.44 " " 51,984.98 " " 112,959.44 " " 120,727.00 " " 50,994.79 " " 107,147.18 " " 49,509.50 " " 157,580.40 " " 49,509.50 " " 91,218.66 " " 114,023.31 " " 50,994.79 " " 50,994.79 " " 49,509.50 " " 221,087.90 " " 131,584.25 " " 207,269.90 " " 50,994.79 " Inpatient 225 "CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION WITHOUT AMI, HF OR SHOCK WITHOUT MCC" " 158,850.65 " " 50,053.84 " " 37,185.64 " " 127,080.52 " " 84,396.21 " " 39,044.92 " " 84,396.21 " " 92,214.00 " " 38,301.21 " " 80,053.65 " " 37,185.64 " " 90,576.64 " " 37,185.64 " " 62,459.36 " " 78,074.19 " " 38,301.21 " " 38,301.21 " " 37,185.64 " " 127,080.52 " " 98,311.50 " " 119,137.99 " " 38,301.21 " Inpatient 226 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITH MCC " 289,018.98 " " 91,069.88 " " 43,325.21 " " 231,215.18 " " 98,626.00 " " 45,491.47 " " 98,626.00 " " 109,461.00 " " 44,624.97 " " 93,551.25 " " 43,325.21 " " 164,798.62 " " 43,325.21 " " 80,451.77 " " 100,564.70 " " 44,624.97 " " 44,624.97 " " 43,325.21 " " 231,215.18 " " 114,887.50 " " 216,764.24 " " 44,624.97 " Inpatient 227 CARDIAC DEFIBRILLATOR IMPLANT WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC " 259,390.81 " " 81,734.04 " " 34,555.97 " " 207,512.65 " " 78,301.38 " " 36,283.77 " " 78,301.38 " " 85,737.00 " " 35,592.65 " " 74,272.43 " " 34,555.97 " " 147,904.64 " " 34,555.97 " " 56,476.17 " " 70,595.21 " " 35,592.65 " " 35,592.65 " " 34,555.97 " " 207,512.65 " " 91,211.75 " " 194,543.11 " " 35,592.65 " Inpatient 233 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC " 287,200.65 " " 90,496.92 " " 52,122.97 " " 229,760.52 " " 119,016.71 " " 54,729.12 " " 119,016.71 " " 115,629.00 " " 53,686.66 " " 112,892.78 " " 52,122.97 " " 163,761.81 " " 52,122.97 " " 73,697.48 " " 92,121.84 " " 53,686.66 " " 53,686.66 " " 52,122.97 " " 229,760.52 " " 138,640.25 " " 215,400.49 " " 53,686.66 " Inpatient 234 CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC " 198,401.64 " " 62,516.36 " " 35,359.07 " " 158,721.31 " " 80,162.73 " " 37,127.02 " " 80,162.73 " " 76,804.00 " " 36,419.84 " " 76,038.00 " " 35,359.07 " " 113,128.62 " " 35,359.07 " " 57,547.15 " " 71,933.93 " " 36,419.84 " " 36,419.84 " " 35,359.07 " " 158,721.31 " " 93,380.00 " " 148,801.23 " " 36,419.84 " Inpatient 235 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC " 218,222.23 " " 68,761.82 " " 40,337.74 " " 174,577.78 " " 91,701.89 " " 42,354.63 " " 91,701.89 " " 89,822.00 " " 41,547.87 " " 86,983.43 " " 40,337.74 " " 124,430.32 " " 40,337.74 " " 55,933.55 " " 69,916.92 " " 41,547.87 " " 41,547.87 " " 40,337.74 " " 174,577.78 " " 106,821.75 " " 163,666.67 " " 41,547.87 " Inpatient 236 CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC " 175,430.39 " " 55,278.12 " " 27,328.11 " " 140,344.31 " " 61,549.23 " " 28,694.52 " " 61,549.23 " " 59,712.00 " " 28,147.95 " " 58,382.25 " " 27,328.11 " " 100,030.41 " " 27,328.11 " " 43,353.14 " " 54,191.42 " " 28,147.95 " " 28,147.95 " " 27,328.11 " " 140,344.31 " " 71,697.50 " " 131,572.79 " " 28,147.95 " Inpatient 239 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC " 137,286.78 " " 43,259.06 " " 31,988.53 " " 109,829.42 " " 72,350.77 " " 33,587.96 " " 72,350.77 " " 74,877.00 " " 32,948.19 " " 68,628.00 " " 31,988.53 " " 78,280.92 " " 31,988.53 " " 50,235.95 " " 62,794.93 " " 32,948.19 " " 32,948.19 " " 31,988.53 " " 109,829.42 " " 84,280.00 " " 102,965.09 " " 32,948.19 " Inpatient 240 AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC " 110,949.09 " " 34,960.06 " " 18,848.61 " " 88,759.27 " " 41,896.14 " " 19,791.04 " " 41,896.14 " " 43,416.00 " " 19,414.07 " " 39,740.40 " " 18,848.61 " " 63,263.17 " " 18,848.61 " " 32,304.19 " " 40,380.26 " " 19,414.07 " " 19,414.07 " " 18,848.61 " " 88,759.27 " " 48,804.00 " " 83,211.82 " " 19,414.07 " Inpatient 242 PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC " 101,170.77 " " 31,878.91 " " 24,933.73 " " 80,936.62 " " 55,999.73 " " 26,180.42 " " 55,999.73 " " 58,597.00 " " 25,681.74 " " 53,118.30 " " 24,933.73 " " 57,687.57 " " 24,933.73 " " 40,611.44 " " 50,764.29 " " 25,681.74 " " 25,681.74 " " 24,933.73 " " 80,936.62 " " 65,233.00 " " 75,878.08 " " 25,681.74 " Inpatient 243 PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC " 79,809.52 " " 25,147.98 " " 17,096.57 " " 63,847.62 " " 37,835.43 " " 17,951.40 " " 37,835.43 " " 42,001.00 " " 17,609.47 " " 35,888.63 " " 17,096.57 " " 45,507.39 " " 17,096.57 " " 29,501.84 " " 36,877.29 " " 17,609.47 " " 17,609.47 " " 17,096.57 " " 63,847.62 " " 44,073.75 " " 59,857.14 " " 17,609.47 " Inpatient 244 PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC " 76,835.12 " " 24,210.75 " " 14,146.05 " " 61,468.10 " " 30,996.96 " " 14,853.35 " " 30,996.96 " " 33,913.00 " " 14,570.43 " " 29,402.03 " " 14,146.05 " " 43,811.39 " " 14,146.05 " " 31,305.94 " " 39,132.44 " " 14,570.43 " " 14,570.43 " " 14,146.05 " " 61,468.10 " " 36,107.75 " " 57,626.34 " " 14,570.43 " Inpatient 246 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES OR STENTS " 100,474.66 " " 31,659.57 " " 21,023.25 " " 80,379.73 " " 46,936.36 " " 22,074.41 " " 46,936.36 " " 50,927.00 " " 21,653.95 " " 44,521.28 " " 21,023.25 " " 57,290.65 " " 21,023.25 " " 38,683.68 " " 48,354.59 " " 21,653.95 " " 21,653.95 " " 21,023.25 " " 80,379.73 " " 54,675.25 " " 75,356.00 " " 21,653.95 " Inpatient 247 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC " 72,767.30 " " 22,928.98 " " 13,562.04 " " 58,213.84 " " 29,643.38 " " 14,240.14 " " 29,643.38 " " 32,390.00 " " 13,968.90 " " 28,118.10 " " 13,562.04 " " 41,491.91 " " 13,562.04 " " 32,811.50 " " 41,014.40 " " 13,968.90 " " 13,968.90 " " 13,562.04 " " 58,213.84 " " 34,531.00 " " 54,575.48 " " 13,968.90 " Inpatient 249 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH NON-DRUG-ELUTING STENT WITHOUT MCC " 81,074.84 " " 25,546.68 " " 12,917.10 " " 64,859.87 " " 28,148.60 " " 13,562.96 " " 28,148.60 " " 29,591.00 " " 13,304.61 " " 26,700.23 " " 12,917.10 " " 46,228.87 " " 12,917.10 " " 31,453.22 " " 39,316.55 " " 13,304.61 " " 13,304.61 " " 12,917.10 " " 64,859.87 " " 32,789.75 " " 60,806.13 " " 13,304.61 " Inpatient 250 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITH MCC " 85,531.77 " " 26,951.06 " " 17,117.96 " " 68,425.42 " " 37,885.00 " " 17,973.86 " " 37,885.00 " " 47,019.00 " " 17,631.50 " " 35,935.65 " " 17,117.96 " " 48,770.22 " " 17,117.96 " " 32,058.72 " " 40,073.42 " " 17,631.50 " " 17,631.50 " " 17,117.96 " " 68,425.42 " " 44,131.50 " " 64,148.83 " " 17,631.50 " Inpatient 251 PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT CORONARY ARTERY STENT WITHOUT MCC " 63,662.03 " " 20,059.91 " " 11,521.57 " " 50,929.62 " " 24,914.14 " " 12,097.65 " " 24,914.14 " " 32,094.00 " " 11,867.22 " " 23,632.20 " " 11,521.57 " " 36,300.09 " " 11,521.57 " " 26,740.15 " " 33,425.20 " " 11,867.22 " " 11,867.22 " " 11,521.57 " " 50,929.62 " " 29,022.00 " " 47,746.52 " " 11,867.22 " Inpatient 252 OTHER VASCULAR PROCEDURES WITH MCC " 117,360.10 " " 36,980.17 " " 22,328.69 " " 93,888.08 " " 49,961.99 " " 23,445.12 " " 49,961.99 " " 51,364.00 " " 22,998.55 " " 47,391.23 " " 22,328.69 " " 66,918.73 " " 22,328.69 " " 45,695.01 " " 57,118.75 " " 22,998.55 " " 22,998.55 " " 22,328.69 " " 93,888.08 " " 58,199.75 " " 88,020.08 " " 22,998.55 " Inpatient 253 OTHER VASCULAR PROCEDURES WITH CC " 79,372.11 " " 25,010.15 " " 17,972.27 " " 63,497.69 " " 39,865.03 " " 18,870.88 " " 39,865.03 " " 40,170.00 " " 18,511.44 " " 37,813.80 " " 17,972.27 " " 45,257.98 " " 17,972.27 " " 31,872.27 " " 39,840.33 " " 18,511.44 " " 18,511.44 " " 17,972.27 " " 63,497.69 " " 46,438.00 " " 59,529.08 " " 18,511.44 " Inpatient 254 OTHER VASCULAR PROCEDURES WITHOUT CC/MCC " 50,905.58 " " 16,040.35 " " 12,542.46 " " 40,724.46 " " 27,280.27 " " 13,169.58 " " 27,280.27 " " 27,224.00 " " 12,918.73 " " 25,876.58 " " 12,542.46 " " 29,026.36 " " 12,542.46 " " 26,265.57 " " 32,831.98 " " 12,918.73 " " 12,918.73 " " 12,542.46 " " 40,724.46 " " 31,778.25 " " 38,179.19 " " 12,918.73 " Inpatient 264 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES " 90,850.77 " " 28,627.08 " " 21,861.35 " " 72,680.62 " " 48,878.83 " " 22,954.42 " " 48,878.83 " " 44,513.00 " " 22,517.19 " " 46,363.80 " " 21,861.35 " " 51,803.11 " " 21,861.35 " " 30,798.63 " " 38,498.30 " " 22,517.19 " " 22,517.19 " " 21,861.35 " " 72,680.62 " " 56,938.00 " " 68,138.08 " " 22,517.19 " Inpatient 266 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC " 240,898.84 " " 75,907.22 " " 46,455.28 " " 192,719.07 " " 105,880.60 " " 48,778.04 " " 105,880.60 " " 141,475.00 " " 47,848.94 " " 100,432.58 " " 46,455.28 " " 137,360.52 " " 46,455.28 " " 78,081.34 " " 97,601.67 " " 47,848.94 " " 47,848.94 " " 46,455.28 " " 192,719.07 " " 123,338.25 " " 180,674.13 " " 47,848.94 " Inpatient 267 ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC " 147,680.61 " " 46,534.16 " " 37,057.30 " " 118,144.49 " " 84,098.75 " " 38,910.17 " " 84,098.75 " " 106,226.00 " " 38,169.02 " " 79,771.50 " " 37,057.30 " " 84,207.48 " " 37,057.30 " " 63,501.78 " " 79,377.22 " " 38,169.02 " " 38,169.02 " " 37,057.30 " " 118,144.49 " " 97,965.00 " " 110,760.46 " " 38,169.02 " Inpatient 269 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC " 100,137.79 " " 31,553.42 " " 28,741.79 " " 80,110.23 " " 64,825.75 " " 30,178.88 " " 64,825.75 " " 61,426.00 " " 29,604.04 " " 61,490.18 " " 28,741.79 " " 57,098.57 " " 28,741.79 " " 42,353.56 " " 52,941.94 " " 29,604.04 " " 29,604.04 " " 28,741.79 " " 80,110.23 " " 75,514.25 " " 75,103.34 " " 29,604.04 " Inpatient 270 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC " 162,674.40 " " 51,258.70 " " 34,393.28 " " 130,139.52 " " 77,924.30 " " 36,112.94 " " 77,924.30 " " 74,495.00 " " 35,425.08 " " 73,914.75 " " 34,393.28 " " 92,756.94 " " 34,393.28 " " 52,392.18 " " 65,490.22 " " 35,425.08 " " 35,425.08 " " 34,393.28 " " 130,139.52 " " 90,772.50 " " 122,005.80 " " 35,425.08 " Inpatient 271 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC " 119,741.24 " " 37,730.46 " " 23,882.38 " " 95,792.99 " " 53,563.00 " " 25,076.50 " " 53,563.00 " " 49,444.00 " " 24,598.85 " " 50,806.95 " " 23,882.38 " " 68,276.46 " " 23,882.38 " " 42,096.53 " " 52,620.65 " " 24,598.85 " " 24,598.85 " " 23,882.38 " " 95,792.99 " " 62,394.50 " " 89,805.93 " " 24,598.85 " Inpatient 272 OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC " 77,666.52 " " 24,472.72 " " 18,197.18 " " 62,133.22 " " 40,386.33 " " 19,107.04 " " 40,386.33 " " 35,412.00 " " 18,743.10 " " 38,308.28 " " 18,197.18 " " 44,285.45 " " 18,197.18 " " 32,986.08 " " 41,232.60 " " 18,743.10 " " 18,743.10 " " 18,197.18 " " 62,133.22 " " 47,045.25 " " 58,249.89 " " 18,743.10 " Inpatient 273 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC " 102,937.07 " " 32,435.47 " " 25,576.08 " " 82,349.66 " " 57,488.51 " " 26,854.88 " " 57,488.51 " " 55,850.00 " " 26,343.36 " " 54,530.48 " " 25,576.08 " " 58,694.72 " " 25,576.08 " " 54,134.30 " " 67,667.87 " " 26,343.36 " " 26,343.36 " " 25,576.08 " " 82,349.66 " " 66,967.25 " " 77,202.80 " " 26,343.36 " Inpatient 274 PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC " 150,914.52 " " 47,553.17 " " 22,075.25 " " 120,731.62 " " 49,374.59 " " 23,179.01 " " 49,374.59 " " 38,071.00 " " 22,737.51 " " 46,834.05 " " 22,075.25 " " 86,051.46 " " 22,075.25 " " 38,940.71 " " 48,675.89 " " 22,737.51 " " 22,737.51 " " 22,075.25 " " 120,731.62 " " 57,515.50 " " 113,185.89 " " 22,737.51 " Inpatient 280 "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC" " 69,731.43 " " 21,972.37 " " 11,187.76 " " 55,785.14 " " 24,140.46 " " 11,747.15 " " 24,140.46 " " 27,201.00 " " 11,523.39 " " 22,898.33 " " 11,187.76 " " 39,760.86 " " 11,187.76 " " 20,292.40 " " 25,365.51 " " 11,523.39 " " 11,523.39 " " 11,187.76 " " 55,785.14 " " 28,120.75 " " 52,298.57 " " 11,523.39 " Inpatient 281 "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC" " 50,747.11 " " 15,990.41 " " 6,804.11 " " 40,597.69 " " 13,980.40 " " 7,144.32 " " 13,980.40 " " 16,120.00 " " 7,008.23 " " 13,261.05 " " 6,804.11 " " 28,936.00 " " 6,804.11 " " 13,435.53 " " 16,794.43 " " 7,008.23 " " 7,008.23 " " 6,804.11 " " 40,597.69 " " 16,285.50 " " 38,060.33 " " 7,008.23 " Inpatient 282 "ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC" " 27,030.33 " " 8,517.26 " " 5,478.58 " " 21,624.26 " " 10,908.20 " " 5,752.51 " " 10,908.20 " " 11,898.00 " " 5,642.94 " " 10,346.93 " " 5,478.58 " " 15,412.69 " " 5,478.58 " " 12,240.90 " " 15,301.13 " " 5,642.94 " " 5,642.94 " " 5,478.58 " " 21,624.26 " " 12,706.75 " " 20,272.75 " " 5,642.94 " Inpatient 283 "ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC" " 99,398.03 " " 31,320.32 " " 12,858.77 " " 79,518.42 " " 28,013.39 " " 13,501.71 " " 28,013.39 " " 26,358.00 " " 13,244.53 " " 26,571.98 " " 12,858.77 " " 56,676.76 " " 12,858.77 " " 32,500.57 " " 40,625.74 " " 13,244.53 " " 13,244.53 " " 12,858.77 " " 79,518.42 " " 32,632.25 " " 74,548.52 " " 13,244.53 " Inpatient 286 "CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC" " 61,356.18 " " 19,333.33 " " 14,619.23 " " 49,084.94 " " 32,093.63 " " 15,350.19 " " 32,093.63 " " 33,418.00 " " 15,057.81 " " 30,442.28 " " 14,619.23 " " 34,985.29 " " 14,619.23 " " 24,760.00 " " 30,950.02 " " 15,057.81 " " 15,057.81 " " 14,619.23 " " 49,084.94 " " 37,385.25 " " 46,017.14 " " 15,057.81 " Inpatient 287 "CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC" " 46,646.84 " " 14,698.42 " " 8,000.00 " " 37,317.47 " " 16,752.15 " " 8,400.00 " " 16,752.15 " " 17,763.00 " " 8,240.00 " " 15,890.18 " " 8,000.00 " " 26,598.03 " " 8,000.00 " " 15,432.04 " " 19,290.06 " " 8,240.00 " " 8,240.00 " " 8,000.00 " " 37,317.47 " " 19,514.25 " " 34,985.13 " " 8,240.00 " Inpatient 291 HEART FAILURE AND SHOCK WITH MCC " 55,700.25 " " 17,551.15 " " 8,993.02 " " 44,560.20 " " 19,053.67 " " 9,442.67 " " 19,053.67 " " 23,754.00 " " 9,262.81 " " 18,073.28 " " 8,993.02 " " 31,760.28 " " 8,993.02 " " 15,595.69 " " 19,494.63 " " 9,262.81 " " 9,262.81 " " 8,993.02 " " 44,560.20 " " 22,195.25 " " 41,775.19 " " 9,262.81 " Inpatient 292 HEART FAILURE AND SHOCK WITH CC " 44,634.06 " " 14,064.19 " " 6,369.18 " " 35,707.25 " " 12,972.36 " " 6,687.64 " " 12,972.36 " " 15,459.00 " " 6,560.26 " " 12,304.88 " " 6,369.18 " " 25,450.34 " " 6,369.18 " " 10,882.62 " " 13,603.28 " " 6,560.26 " " 6,560.26 " " 6,369.18 " " 35,707.25 " " 15,111.25 " " 33,475.55 " " 6,560.26 " Inpatient 293 HEART FAILURE AND SHOCK WITHOUT CC/MCC " 22,466.06 " " 7,079.06 " " 4,595.76 " " 17,972.85 " " 8,862.07 " " 4,825.55 " " 8,862.07 " " 10,637.00 " " 4,733.63 " " 8,406.08 " " 4,595.76 " " 12,810.15 " " 4,595.76 " " 8,509.72 " " 10,637.15 " " 4,733.63 " " 4,733.63 " " 4,595.76 " " 17,972.85 " " 10,323.25 " " 16,849.55 " " 4,733.63 " Inpatient 299 PERIPHERAL VASCULAR DISORDERS WITH MCC " 48,344.62 " " 15,233.39 " " 10,706.16 " " 38,675.70 " " 23,024.25 " " 11,241.47 " " 23,024.25 " " 22,176.00 " " 11,027.34 " " 21,839.55 " " 10,706.16 " " 27,566.10 " " 10,706.16 " " 14,941.10 " " 18,676.38 " " 11,027.34 " " 11,027.34 " " 10,706.16 " " 38,675.70 " " 26,820.50 " " 36,258.47 " " 11,027.34 " Inpatient 300 PERIPHERAL VASCULAR DISORDERS WITH CC " 40,224.94 " " 12,674.88 " " 7,537.85 " " 32,179.95 " " 15,681.01 " " 7,914.74 " " 15,681.01 " " 15,373.00 " " 7,763.99 " " 14,874.15 " " 7,537.85 " " 22,936.26 " " 7,537.85 " " 10,866.25 " " 13,582.82 " " 7,763.99 " " 7,763.99 " " 7,537.85 " " 32,179.95 " " 18,266.50 " " 30,168.71 " " 7,763.99 " Inpatient 301 PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC " 21,914.75 " " 6,905.34 " " 5,588.77 " " 17,531.80 " " 11,163.59 " " 5,868.21 " " 11,163.59 " " 10,660.00 " " 5,756.43 " " 10,589.18 " " 5,588.77 " " 12,495.79 " " 5,588.77 " " 8,002.41 " " 10,003.01 " " 5,756.43 " " 5,756.43 " " 5,588.77 " " 17,531.80 " " 13,004.25 " " 16,436.06 " " 5,756.43 " Inpatient 303 ATHEROSCLEROSIS WITHOUT MCC " 34,724.03 " " 10,941.54 " " 5,164.21 " " 27,779.22 " " 10,179.58 " " 5,422.42 " " 10,179.58 " " 9,598.00 " " 5,319.14 " " 9,655.80 " " 5,164.21 " " 19,799.64 " " 5,164.21 " " 9,982.55 " " 12,478.20 " " 5,319.14 " " 5,319.14 " " 5,164.21 " " 27,779.22 " " 11,858.00 " " 26,043.02 " " 5,319.14 " Inpatient 304 HYPERTENSION WITH MCC " 40,656.99 " " 12,811.02 " " 7,882.68 " " 32,525.59 " " 16,480.23 " " 8,276.81 " " 16,480.23 " " 15,758.00 " " 8,119.16 " " 15,632.25 " " 7,882.68 " " 23,182.62 " " 7,882.68 " " 14,515.61 " " 18,144.53 " " 8,119.16 " " 8,119.16 " " 7,882.68 " " 32,525.59 " " 19,197.50 " " 30,492.74 " " 8,119.16 " Inpatient 305 HYPERTENSION WITHOUT MCC " 44,460.91 " " 14,009.63 " " 5,568.03 " " 35,568.73 " " 11,115.52 " " 5,846.43 " " 11,115.52 " " 9,869.00 " " 5,735.07 " " 10,543.58 " " 5,568.03 " " 25,351.61 " " 5,568.03 " " 9,475.24 " " 11,844.06 " " 5,735.07 " " 5,735.07 " " 5,568.03 " " 35,568.73 " " 12,948.25 " " 33,345.68 " " 5,735.07 " Inpatient 308 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC " 49,725.95 " " 15,668.65 " " 8,556.14 " " 39,780.76 " " 18,041.12 " " 8,983.95 " " 18,041.12 " " 19,048.00 " " 8,812.82 " " 17,112.83 " " 8,556.14 " " 28,353.74 " " 8,556.14 " " 13,664.64 " " 17,080.81 " " 8,812.82 " " 8,812.82 " " 8,556.14 " " 39,780.76 " " 21,015.75 " " 37,294.46 " " 8,812.82 " Inpatient 309 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC " 32,934.90 " " 10,377.79 " " 5,636.74 " " 26,347.92 " " 11,274.76 " " 5,918.58 " " 11,274.76 " " 12,374.00 " " 5,805.84 " " 10,694.63 " " 5,636.74 " " 18,779.48 " " 5,636.74 " " 8,624.27 " " 10,780.34 " " 5,805.84 " " 5,805.84 " " 5,636.74 " " 26,347.92 " " 13,133.75 " " 24,701.18 " " 5,805.84 " Inpatient 310 CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC " 30,013.05 " " 9,457.11 " " 4,396.77 " " 24,010.44 " " 8,400.86 " " 4,616.61 " " 8,400.86 " " 8,642.00 " " 4,528.67 " " 7,968.60 " " 4,396.77 " " 17,113.44 " " 4,396.77 " " 6,971.42 " " 8,714.28 " " 4,528.67 " " 4,528.67 " " 4,396.77 " " 24,010.44 " " 9,786.00 " " 22,509.79 " " 4,528.67 " Inpatient 312 SYNCOPE AND COLLAPSE " 46,621.72 " " 14,690.50 " " 6,208.43 " " 37,297.38 " " 12,599.79 " " 6,518.85 " " 12,599.79 " " 11,679.00 " " 6,394.68 " " 11,951.48 " " 6,208.43 " " 26,583.70 " " 6,208.43 " " 9,786.17 " " 12,232.72 " " 6,394.68 " " 6,394.68 " " 6,208.43 " " 37,297.38 " " 14,677.25 " " 34,966.29 " " 6,394.68 " Inpatient 313 CHEST PAIN " 34,013.23 " " 10,717.57 " " 5,448.12 " " 27,210.58 " " 10,837.59 " " 5,720.53 " " 10,837.59 " " 9,656.00 " " 5,611.56 " " 10,279.95 " " 5,448.12 " " 19,394.34 " " 5,448.12 " " 9,131.58 " " 11,414.48 " " 5,611.56 " " 5,611.56 " " 5,448.12 " " 27,210.58 " " 12,624.50 " " 25,509.92 " " 5,611.56 " Inpatient 314 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC " 121,976.29 " " 38,434.73 " " 14,284.77 " " 97,581.03 " " 31,318.45 " " 14,999.01 " " 31,318.45 " " 30,202.00 " " 14,713.31 " " 29,706.98 " " 14,284.77 " " 69,550.88 " " 14,284.77 " " 24,825.46 " " 31,031.84 " " 14,713.31 " " 14,713.31 " " 14,284.77 " " 97,581.03 " " 36,482.25 " " 91,482.22 " " 14,713.31 " Inpatient 315 OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC " 62,512.16 " " 19,697.58 " " 7,081.53 " " 50,009.73 " " 14,623.39 " " 7,435.61 " " 14,623.39 " " 15,125.00 " " 7,293.98 " " 13,870.95 " " 7,081.53 " " 35,644.43 " " 7,081.53 " " 12,519.10 " " 15,648.89 " " 7,293.98 " " 7,293.98 " " 7,081.53 " " 50,009.73 " " 17,034.50 " " 46,884.12 " " 7,293.98 " Inpatient 326 "STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC" " 132,254.63 " " 41,673.43 " " 35,231.38 " " 105,803.70 " " 79,866.77 " " 36,992.95 " " 79,866.77 " " 84,719.00 " " 36,288.32 " " 75,757.28 " " 35,231.38 " " 75,411.59 " " 35,231.38 " " 56,133.46 " " 70,166.82 " " 36,288.32 " " 36,288.32 " " 35,231.38 " " 105,803.70 " " 93,035.25 " " 99,190.97 " " 36,288.32 " Inpatient 327 "STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC" " 60,645.16 " " 19,109.29 " " 17,396.03 " " 48,516.13 " " 38,529.49 " " 18,265.83 " " 38,529.49 " " 41,745.00 " " 17,917.91 " " 36,546.98 " " 17,396.03 " " 34,579.87 " " 17,396.03 " " 31,845.98 " " 39,807.49 " " 17,917.91 " " 17,917.91 " " 17,396.03 " " 48,516.13 " " 44,882.25 " " 45,483.87 " " 17,917.91 " Inpatient 329 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC " 124,407.13 " " 39,200.69 " " 32,443.55 " " 99,525.70 " " 73,405.38 " " 34,065.73 " " 73,405.38 " " 79,888.00 " " 33,416.86 " " 69,628.35 " " 32,443.55 " " 70,936.95 " " 32,443.55 " " 44,981.02 " " 56,226.27 " " 33,416.86 " " 33,416.86 " " 32,443.55 " " 99,525.70 " " 85,508.50 " " 93,305.35 " " 33,416.86 " Inpatient 330 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC " 80,186.53 " " 25,266.78 " " 17,296.21 " " 64,149.22 " " 38,298.13 " " 18,161.02 " " 38,298.13 " " 40,106.00 " " 17,815.10 " " 36,327.53 " " 17,296.21 " " 45,722.36 " " 17,296.21 " " 30,013.12 " " 37,516.41 " " 17,815.10 " " 17,815.10 " " 17,296.21 " " 64,149.22 " " 44,612.75 " " 60,139.90 " " 17,815.10 " Inpatient 331 MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC " 54,587.51 " " 17,200.52 " " 11,859.27 " " 43,670.01 " " 25,696.84 " " 12,452.23 " " 25,696.84 " " 26,087.00 " " 12,215.05 " " 24,374.63 " " 11,859.27 " " 31,125.80 " " 11,859.27 " " 22,354.37 " " 27,942.98 " " 12,215.05 " " 12,215.05 " " 11,859.27 " " 43,670.01 " " 29,933.75 " " 40,940.63 " " 12,215.05 " Inpatient 336 PERITONEAL ADHESIOLYSIS WITH CC " 84,020.23 " " 26,474.77 " " 15,623.91 " " 67,216.18 " " 34,422.20 " " 16,405.11 " " 34,422.20 " " 37,036.00 " " 16,092.63 " " 32,651.03 " " 15,623.91 " " 47,908.34 " " 15,623.91 " " 26,494.68 " " 33,118.36 " " 16,092.63 " " 16,092.63 " " 15,623.91 " " 67,216.18 " " 40,097.75 " " 63,015.17 " " 16,092.63 " Inpatient 354 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC " 60,910.36 " " 19,192.85 " " 12,340.87 " " 48,728.29 " " 26,813.05 " " 12,957.91 " " 26,813.05 " " 26,613.00 " " 12,711.10 " " 25,433.40 " " 12,340.87 " " 34,731.09 " " 12,340.87 " " 20,734.25 " " 25,917.83 " " 12,711.10 " " 12,711.10 " " 12,340.87 " " 48,728.29 " " 31,234.00 " " 45,682.77 " " 12,711.10 " Inpatient 355 HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC " 57,186.76 " " 18,019.55 " " 9,588.70 " " 45,749.41 " " 20,434.28 " " 10,068.14 " " 20,434.28 " " 19,701.00 " " 9,876.36 " " 19,382.85 " " 9,588.70 " " 32,607.89 " " 9,588.70 " " 17,657.66 " " 22,072.09 " " 9,876.36 " " 9,876.36 " " 9,588.70 " " 45,749.41 " " 23,803.50 " " 42,890.07 " " 9,876.36 " Inpatient 356 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC " 189,013.98 " " 59,558.31 " " 28,694.47 " " 151,211.18 " " 64,716.08 " " 30,129.19 " " 64,716.08 " " 60,688.00 " " 29,555.30 " " 61,386.15 " " 28,694.47 " " 107,775.77 " " 28,694.47 " " 41,596.74 " " 51,995.91 " " 29,555.30 " " 29,555.30 " " 28,694.47 " " 151,211.18 " " 75,386.50 " " 141,760.49 " " 29,555.30 " Inpatient 357 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC " 81,152.64 " " 25,571.20 " " 15,476.12 " " 64,922.11 " " 34,079.68 " " 16,249.93 " " 34,079.68 " " 33,153.00 " " 15,940.40 " " 32,326.13 " " 15,476.12 " " 46,273.24 " " 15,476.12 " " 24,285.42 " " 30,356.79 " " 15,940.40 " " 15,940.40 " " 15,476.12 " " 64,922.11 " " 39,698.75 " " 60,864.48 " " 15,940.40 " Inpatient 368 MAJOR ESOPHAGEAL DISORDERS WITH MCC " 143,210.37 " " 45,125.59 " " 13,405.83 " " 114,568.30 " " 29,281.33 " " 14,076.12 " " 29,281.33 " " 29,329.00 " " 13,808.00 " " 27,774.68 " " 13,405.83 " " 81,658.55 " " 13,405.83 " " 24,874.56 " " 31,093.21 " " 13,808.00 " " 13,808.00 " " 13,405.83 " " 114,568.30 " " 34,109.25 " " 107,407.78 " " 13,808.00 " Inpatient 369 MAJOR ESOPHAGEAL DISORDERS WITH CC " 59,990.54 " " 18,903.02 " " 7,754.34 " " 47,992.43 " " 16,182.78 " " 8,142.06 " " 16,182.78 " " 16,839.00 " " 7,986.97 " " 15,350.10 " " 7,754.34 " " 34,206.61 " " 7,754.34 " " 13,484.63 " " 16,855.79 " " 7,986.97 " " 7,986.97 " " 7,754.34 " " 47,992.43 " " 18,851.00 " " 44,992.91 " " 7,986.97 " Inpatient 371 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC " 60,989.33 " " 19,217.74 " " 11,993.45 " " 48,791.46 " " 26,007.82 " " 12,593.12 " " 26,007.82 " " 29,316.00 " " 12,353.25 " " 24,669.60 " " 11,993.45 " " 34,776.12 " " 11,993.45 " " 19,621.44 " " 24,526.82 " " 12,353.25 " " 12,353.25 " " 11,993.45 " " 48,791.46 " " 30,296.00 " " 45,742.00 " " 12,353.25 " Inpatient 372 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC " 40,895.83 " " 12,886.28 " " 7,443.87 " " 32,716.66 " " 15,463.17 " " 7,816.06 " " 15,463.17 " " 17,847.00 " " 7,667.19 " " 14,667.53 " " 7,443.87 " " 23,318.80 " " 7,443.87 " " 11,308.10 " " 14,135.14 " " 7,667.19 " " 7,667.19 " " 7,443.87 " " 32,716.66 " " 18,012.75 " " 30,671.87 " " 7,667.19 " Inpatient 373 MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC " 40,297.87 " " 12,697.86 " " 5,598.49 " " 32,238.30 " " 11,186.13 " " 5,878.41 " " 11,186.13 " " 12,605.00 " " 5,766.44 " " 10,610.55 " " 5,598.49 " " 22,977.85 " " 5,598.49 " " 9,295.23 " " 11,619.04 " " 5,766.44 " " 5,766.44 " " 5,598.49 " " 32,238.30 " " 13,030.50 " " 30,223.40 " " 5,766.44 " Inpatient 374 DIGESTIVE MALIGNANCY WITH MCC " 69,237.34 " " 21,816.69 " " 14,213.47 " " 55,389.87 " " 31,153.20 " " 14,924.14 " " 31,153.20 " " 31,752.00 " " 14,639.87 " " 29,550.23 " " 14,213.47 " " 39,479.13 " " 14,213.47 " " 23,663.56 " " 29,579.46 " " 14,639.87 " " 14,639.87 " " 14,213.47 " " 55,389.87 " " 36,289.75 " " 51,928.01 " " 14,639.87 " Inpatient 375 DIGESTIVE MALIGNANCY WITH CC " 69,348.07 " " 21,851.58 " " 8,599.57 " " 55,478.46 " " 18,141.77 " " 9,029.55 " " 18,141.77 " " 19,554.00 " " 8,857.56 " " 17,208.30 " " 8,599.57 " " 39,542.27 " " 8,599.57 " " 14,793.82 " " 18,492.28 " " 8,857.56 " " 8,857.56 " " 8,599.57 " " 55,478.46 " " 21,133.00 " " 52,011.05 " " 8,857.56 " Inpatient 377 GASTROINTESTINAL HEMORRHAGE WITH MCC " 75,273.35 " " 23,718.63 " " 12,447.17 " " 60,218.68 " " 27,059.43 " " 13,069.53 " " 27,059.43 " " 27,965.00 " " 12,820.59 " " 25,667.10 " " 12,447.17 " " 42,920.86 " " 12,447.17 " " 23,107.15 " " 28,883.96 " " 12,820.59 " " 12,820.59 " " 12,447.17 " " 60,218.68 " " 31,521.00 " " 56,455.01 " " 12,820.59 " Inpatient 378 GASTROINTESTINAL HEMORRHAGE WITH CC " 39,925.07 " " 12,580.39 " " 7,211.82 " " 31,940.06 " " 14,925.35 " " 7,572.41 " " 14,925.35 " " 15,765.00 " " 7,428.17 " " 14,157.38 " " 7,211.82 " " 22,765.27 " " 7,211.82 " " 12,797.30 " " 15,996.64 " " 7,428.17 " " 7,428.17 " " 7,211.82 " " 31,940.06 " " 17,386.25 " " 29,943.80 " " 7,428.17 " Inpatient 379 GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC " 20,173.20 " " 6,356.58 " " 4,902.35 " " 16,138.56 " " 9,572.66 " " 5,147.47 " " 9,572.66 " " 10,660.00 " " 5,049.42 " " 9,080.10 " " 4,902.35 " " 11,502.76 " " 4,902.35 " " 9,049.76 " " 11,312.20 " " 5,049.42 " " 5,049.42 " " 4,902.35 " " 16,138.56 " " 11,151.00 " " 15,129.90 " " 5,049.42 " Inpatient 380 COMPLICATED PEPTIC ULCER WITH MCC " 67,963.20 " " 21,415.20 " " 13,000.72 " " 54,370.56 " " 28,342.39 " " 13,650.76 " " 28,342.39 " " 30,311.00 " " 13,390.74 " " 26,884.05 " " 13,000.72 " " 38,752.62 " " 13,000.72 " " 23,025.33 " " 28,781.68 " " 13,390.74 " " 13,390.74 " " 13,000.72 " " 54,370.56 " " 33,015.50 " " 50,972.40 " " 13,390.74 " Inpatient 381 COMPLICATED PEPTIC ULCER WITH CC " 48,225.63 " " 15,195.90 " " 7,638.32 " " 38,580.50 " " 15,913.86 " " 8,020.24 " " 15,913.86 " " 17,110.00 " " 7,867.47 " " 15,095.03 " " 7,638.32 " " 27,498.25 " " 7,638.32 " " 12,780.94 " " 15,976.18 " " 7,867.47 " " 7,867.47 " " 7,638.32 " " 38,580.50 " " 18,537.75 " " 36,169.22 " " 7,867.47 " Inpatient 386 INFLAMMATORY BOWEL DISEASE WITH CC " 43,734.78 " " 13,780.83 " " 7,222.19 " " 34,987.82 " " 14,949.39 " " 7,583.30 " " 14,949.39 " " 15,797.00 " " 7,438.86 " " 14,180.18 " " 7,222.19 " " 24,937.57 " " 7,222.19 " " 11,520.85 " " 14,401.07 " " 7,438.86 " " 7,438.86 " " 7,222.19 " " 34,987.82 " " 17,414.25 " " 32,801.09 " " 7,438.86 " Inpatient 388 GASTROINTESTINAL OBSTRUCTION WITH MCC " 73,768.69 " " 23,244.51 " " 10,589.49 " " 59,014.95 " " 22,753.84 " " 11,118.96 " " 22,753.84 " " 25,332.00 " " 10,907.17 " " 21,583.05 " " 10,589.49 " " 42,062.91 " " 10,589.49 " " 15,170.21 " " 18,962.77 " " 10,907.17 " " 10,907.17 " " 10,589.49 " " 59,014.95 " " 26,505.50 " " 55,326.52 " " 10,907.17 " Inpatient 389 GASTROINTESTINAL OBSTRUCTION WITH CC " 31,005.66 " " 9,769.88 " " 6,107.96 " " 24,804.53 " " 12,366.93 " " 6,413.36 " " 12,366.93 " " 13,716.00 " " 6,291.20 " " 11,730.60 " " 6,107.96 " " 17,679.43 " " 6,107.96 " " 8,787.92 " " 10,984.90 " " 6,291.20 " " 6,291.20 " " 6,107.96 " " 24,804.53 " " 14,406.00 " " 23,254.25 " " 6,291.20 " Inpatient 390 GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC " 20,308.68 " " 6,399.27 " " 4,551.68 " " 16,246.94 " " 8,759.91 " " 4,779.26 " " 8,759.91 " " 9,494.00 " " 4,688.23 " " 8,309.18 " " 4,551.68 " " 11,580.01 " " 4,551.68 " " 6,955.06 " " 8,693.83 " " 4,688.23 " " 4,688.23 " " 4,551.68 " " 16,246.94 " " 10,204.25 " " 15,231.51 " " 4,688.23 " Inpatient 391 "ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC" " 46,563.72 " " 14,672.23 " " 8,869.21 " " 37,250.98 " " 18,766.73 " " 9,312.67 " " 18,766.73 " " 18,842.00 " " 9,135.29 " " 17,801.10 " " 8,869.21 " " 26,550.63 " " 8,869.21 " " 14,384.69 " " 17,980.88 " " 9,135.29 " " 9,135.29 " " 8,869.21 " " 37,250.98 " " 21,861.00 " " 34,922.79 " " 9,135.29 " Inpatient 392 "ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC" " 32,308.50 " " 10,180.41 " " 5,735.91 " " 25,846.80 " " 11,504.61 " " 6,022.71 " " 11,504.61 " " 11,623.00 " " 5,907.99 " " 10,912.65 " " 5,735.91 " " 18,422.31 " " 5,735.91 " " 8,837.01 " " 11,046.27 " " 5,907.99 " " 5,907.99 " " 5,735.91 " " 25,846.80 " " 13,401.50 " " 24,231.38 " " 5,907.99 " Inpatient 393 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC " 49,940.94 " " 15,736.39 " " 11,539.72 " " 39,952.75 " " 24,956.21 " " 12,116.71 " " 24,956.21 " " 26,577.00 " " 11,885.91 " " 23,672.10 " " 11,539.72 " " 28,476.32 " " 11,539.72 " " 18,950.48 " " 23,688.12 " " 11,885.91 " " 11,885.91 " " 11,539.72 " " 39,952.75 " " 29,071.00 " " 37,455.71 " " 11,885.91 " Inpatient 394 OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC " 39,320.76 " " 12,389.97 " " 6,870.87 " " 31,456.61 " " 14,135.14 " " 7,214.41 " " 14,135.14 " " 14,866.00 " " 7,077.00 " " 13,407.83 " " 6,870.87 " " 22,420.70 " " 6,870.87 " " 11,520.85 " " 14,401.07 " " 7,077.00 " " 7,077.00 " " 6,870.87 " " 31,456.61 " " 16,465.75 " " 29,490.57 " " 7,077.00 " Inpatient 417 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC " 78,563.88 " " 24,755.48 " " 16,485.99 " " 62,851.10 " " 36,420.26 " " 17,310.29 " " 36,420.26 " " 38,315.00 " " 16,980.57 " " 34,546.28 " " 16,485.99 " " 44,797.12 " " 16,485.99 " " 24,170.87 " " 30,213.60 " " 16,980.57 " " 16,980.57 " " 16,485.99 " " 62,851.10 " " 42,425.25 " " 58,922.91 " " 16,980.57 " Inpatient 418 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC " 57,697.68 " " 18,180.54 " " 11,719.91 " " 46,158.14 " " 25,373.85 " " 12,305.91 " " 25,373.85 " " 26,118.00 " " 12,071.51 " " 24,068.25 " " 11,719.91 " " 32,899.22 " " 11,719.91 " " 20,406.96 " " 25,508.71 " " 12,071.51 " " 12,071.51 " " 11,719.91 " " 46,158.14 " " 29,557.50 " " 43,273.26 " " 12,071.51 " Inpatient 419 LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC " 48,624.17 " " 15,321.48 " " 9,297.66 " " 38,899.34 " " 19,759.75 " " 9,762.54 " " 19,759.75 " " 19,378.00 " " 9,576.59 " " 18,743.03 " " 9,297.66 " " 27,725.50 " " 9,297.66 " " 17,363.10 " " 21,703.88 " " 9,576.59 " " 9,576.59 " " 9,297.66 " " 38,899.34 " " 23,017.75 " " 36,468.13 " " 9,576.59 " Inpatient 432 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC " 63,431.30 " " 19,987.20 " " 12,963.12 " " 50,745.04 " " 28,255.26 " " 13,611.28 " " 28,255.26 " " 26,290.00 " " 13,352.01 " " 26,801.40 " " 12,963.12 " " 36,168.53 " " 12,963.12 " " 23,483.55 " " 29,354.45 " " 13,352.01 " " 13,352.01 " " 12,963.12 " " 50,745.04 " " 32,914.00 " " 47,573.48 " " 13,352.01 " Inpatient 433 CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC " 53,092.57 " " 16,729.47 " " 7,447.75 " " 42,474.06 " " 15,472.19 " " 7,820.14 " " 15,472.19 " " 14,432.00 " " 7,671.18 " " 14,676.08 " " 7,447.75 " " 30,273.38 " " 7,447.75 " " 13,010.05 " " 16,262.57 " " 7,671.18 " " 7,671.18 " " 7,447.75 " " 42,474.06 " " 18,023.25 " " 39,819.43 " " 7,671.18 " Inpatient 435 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC " 60,888.60 " " 19,186.00 " " 12,137.34 " " 48,710.88 " " 26,341.33 " " 12,744.21 " " 26,341.33 " " 27,570.00 " " 12,501.46 " " 24,985.95 " " 12,137.34 " " 34,718.68 " " 12,137.34 " " 21,683.41 " " 27,104.28 " " 12,501.46 " " 12,501.46 " " 12,137.34 " " 48,710.88 " " 30,684.50 " " 45,666.45 " " 12,501.46 " Inpatient 436 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC " 34,967.37 " " 11,018.22 " " 8,041.49 " " 27,973.90 " " 16,848.29 " " 8,443.56 " " 16,848.29 " " 18,313.00 " " 8,282.73 " " 15,981.38 " " 8,041.49 " " 19,938.39 " " 8,041.49 " " 14,204.68 " " 17,755.86 " " 8,282.73 " " 8,282.73 " " 8,041.49 " " 27,973.90 " " 19,626.25 " " 26,225.53 " " 8,282.73 " Inpatient 438 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC " 57,082.49 " " 17,986.69 " " 11,128.77 " " 45,665.99 " " 24,003.75 " " 11,685.21 " " 24,003.75 " " 26,782.00 " " 11,462.63 " " 22,768.65 " " 11,128.77 " " 32,548.44 " " 11,128.77 " " 22,550.75 " " 28,188.45 " " 11,462.63 " " 11,462.63 " " 11,128.77 " " 45,665.99 " " 27,961.50 " " 42,811.87 " " 11,462.63 " Inpatient 439 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC " 28,368.08 " " 8,938.78 " " 6,250.56 " " 22,694.46 " " 12,697.44 " " 6,563.09 " " 12,697.44 " " 14,273.00 " " 6,438.08 " " 12,044.10 " " 6,250.56 " " 16,175.48 " " 6,250.56 " " 10,784.43 " " 13,480.54 " " 6,438.08 " " 6,438.08 " " 6,250.56 " " 22,694.46 " " 14,791.00 " " 21,276.06 " " 6,438.08 " Inpatient 440 DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC " 25,131.29 " " 7,918.87 " " 4,702.06 " " 20,105.03 " " 9,108.44 " " 4,937.16 " " 9,108.44 " " 10,106.00 " " 4,843.12 " " 8,639.78 " " 4,702.06 " " 14,329.86 " " 4,702.06 " " 8,116.96 " " 10,146.21 " " 4,843.12 " " 4,843.12 " " 4,702.06 " " 20,105.03 " " 10,610.25 " " 18,848.47 " " 4,843.12 " Inpatient 441 "DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC" " 71,649.77 " " 22,576.84 " " 12,954.70 " " 57,319.82 " " 28,235.73 " " 13,602.44 " " 28,235.73 " " 29,634.00 " " 13,343.34 " " 26,782.88 " " 12,954.70 " " 40,854.70 " " 12,954.70 " " 24,825.46 " " 31,031.84 " " 13,343.34 " " 13,343.34 " " 12,954.70 " " 57,319.82 " " 32,891.25 " " 53,737.33 " " 13,343.34 " Inpatient 442 "DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC" " 43,568.50 " " 13,728.43 " " 6,800.22 " " 34,854.80 " " 13,971.39 " " 7,140.23 " " 13,971.39 " " 14,579.00 " " 7,004.23 " " 13,252.50 " " 6,800.22 " " 24,842.76 " " 6,800.22 " " 12,044.52 " " 15,055.66 " " 7,004.23 " " 7,004.23 " " 6,800.22 " " 34,854.80 " " 16,275.00 " " 32,676.38 " " 7,004.23 " Inpatient 446 DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC " 35,103.92 " " 11,061.25 " " 6,065.18 " " 28,083.14 " " 12,267.78 " " 6,368.44 " " 12,267.78 " " 11,907.00 " " 6,247.14 " " 11,636.55 " " 6,065.18 " " 20,016.26 " " 6,065.18 " " 11,062.63 " " 13,828.30 " " 6,247.14 " " 6,247.14 " " 6,065.18 " " 28,083.14 " " 14,290.50 " " 26,327.94 " " 6,247.14 " Inpatient 454 COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC " 178,400.06 " " 56,213.86 " " 40,266.44 " " 142,720.05 " " 91,536.64 " " 42,279.76 " " 91,536.64 " " 126,157.00 " " 41,474.43 " " 86,826.68 " " 40,266.44 " " 101,723.71 " " 40,266.44 " " 63,344.70 " " 79,180.87 " " 41,474.43 " " 41,474.43 " " 40,266.44 " " 142,720.05 " " 106,629.25 " " 133,800.05 " " 41,474.43 " Inpatient 457 "SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC" " 163,136.79 " " 51,404.40 " " 42,877.32 " " 130,509.43 " " 97,587.91 " " 45,021.19 " " 97,587.91 " " 108,678.00 " " 44,163.64 " " 92,566.58 " " 42,877.32 " " 93,020.60 " " 42,877.32 " " 83,964.58 " " 104,955.71 " " 44,163.64 " " 44,163.64 " " 42,877.32 " " 130,509.43 " " 113,678.25 " " 122,352.59 " " 44,163.64 " Inpatient 460 SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC " 108,773.89 " " 34,274.65 " " 26,250.18 " " 87,019.11 " " 59,050.91 " " 27,562.69 " " 59,050.91 " " 62,930.00 " " 27,037.69 " " 56,012.48 " " 26,250.18 " " 62,022.87 " " 26,250.18 " " 34,242.70 " " 42,803.36 " " 27,037.69 " " 27,037.69 " " 26,250.18 " " 87,019.11 " " 68,787.25 " " 81,580.42 " " 27,037.69 " Inpatient 463 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC " 193,819.44 " " 61,072.51 " " 35,581.39 " " 155,055.55 " " 80,678.02 " " 37,360.46 " " 80,678.02 " " 83,928.00 " " 36,648.83 " " 76,526.78 " " 35,581.39 " " 110,515.84 " " 35,581.39 " " 51,292.65 " " 64,115.80 " " 36,648.83 " " 36,648.83 " " 35,581.39 " " 155,055.55 " " 93,980.25 " " 145,364.58 " " 36,648.83 " Inpatient 464 WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC " 92,554.71 " " 29,163.99 " " 20,061.35 " " 74,043.77 " " 44,706.95 " " 21,064.42 " " 44,706.95 " " 47,335.00 " " 20,663.19 " " 42,406.58 " " 20,061.35 " " 52,774.70 " " 20,061.35 " " 29,044.89 " " 36,306.11 " " 20,663.19 " " 20,663.19 " " 20,061.35 " " 74,043.77 " " 52,078.25 " " 69,416.03 " " 20,663.19 " Inpatient 469 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT " 104,426.96 " " 32,904.94 " " 20,774.35 " " 83,541.57 " " 46,359.48 " " 21,813.07 " " 46,359.48 " " 53,344.00 " " 21,397.58 " " 43,974.08 " " 20,774.35 " " 59,544.25 " " 20,774.35 " " 32,876.96 " " 41,096.22 " " 21,397.58 " " 21,397.58 " " 20,774.35 " " 83,541.57 " " 54,003.25 " " 78,320.22 " " 21,397.58 " Inpatient 470 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC " 58,996.40 " " 18,589.77 " " 13,089.52 " " 47,197.12 " " 28,548.21 " " 13,744.00 " " 28,548.21 " " 33,258.00 " " 13,482.21 " " 27,079.28 " " 13,089.52 " " 33,639.75 " " 13,089.52 " " 22,059.80 " " 27,574.77 " " 13,482.21 " " 13,482.21 " " 13,089.52 " " 47,197.12 " " 33,255.25 " " 44,247.30 " " 13,482.21 " Inpatient 472 CERVICAL SPINAL FUSION WITH CC " 108,967.49 " " 34,335.66 " " 20,565.64 " " 87,173.99 " " 45,875.74 " " 21,593.92 " " 45,875.74 " " 45,887.00 " " 21,182.61 " " 43,515.23 " " 20,565.64 " " 62,133.26 " " 20,565.64 " " 29,130.57 " " 36,413.20 " " 21,182.61 " " 21,182.61 " " 20,565.64 " " 87,173.99 " " 53,439.75 " " 81,725.62 " " 21,182.61 " Inpatient 473 CERVICAL SPINAL FUSION WITHOUT CC/MCC " 62,565.67 " " 19,714.44 " " 17,229.45 " " 50,052.54 " " 38,143.40 " " 18,090.92 " " 38,143.40 " " 35,643.00 " " 17,746.33 " " 36,180.75 " " 17,229.45 " " 35,674.95 " " 17,229.45 " " 26,167.38 " " 32,709.24 " " 17,746.33 " " 17,746.33 " " 17,229.45 " " 50,052.54 " " 44,432.50 " " 46,924.25 " " 17,746.33 " Inpatient 474 AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC " 167,334.16 " " 52,726.99 " " 27,192.64 " " 133,867.33 " " 61,235.25 " " 28,552.27 " " 61,235.25 " " 56,551.00 " " 28,008.42 " " 58,084.43 " " 27,192.64 " " 95,413.94 " " 27,192.64 " " 55,419.48 " " 69,274.34 " " 28,008.42 " " 28,008.42 " " 27,192.64 " " 133,867.33 " " 71,331.75 " " 125,500.62 " " 28,008.42 " Inpatient 478 BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC " 93,690.97 " " 29,522.02 " " 16,058.84 " " 74,952.78 " " 35,430.24 " " 16,861.78 " " 35,430.24 " " 35,308.00 " " 16,540.61 " " 33,607.20 " " 16,058.84 " " 53,422.59 " " 16,058.84 " " 29,047.59 " " 36,309.51 " " 16,540.61 " " 16,540.61 " " 16,058.84 " " 74,952.78 " " 41,272.00 " " 70,268.23 " " 16,540.61 " Inpatient 480 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC " 112,913.57 " " 35,579.07 " " 20,384.79 " " 90,330.86 " " 45,456.59 " " 21,404.03 " " 45,456.59 " " 47,283.00 " " 20,996.33 " " 43,117.65 " " 20,384.79 " " 64,383.32 " " 20,384.79 " " 38,026.81 " " 47,533.51 " " 20,996.33 " " 20,996.33 " " 20,384.79 " " 90,330.86 " " 52,951.50 " " 84,685.18 " " 20,996.33 " Inpatient 481 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC " 82,824.90 " " 26,098.13 " " 14,358.66 " " 66,259.92 " " 31,489.71 " " 15,076.59 " " 31,489.71 " " 31,115.00 " " 14,789.42 " " 29,869.43 " " 14,358.66 " " 47,226.76 " " 14,358.66 " " 29,473.08 " " 36,841.36 " " 14,789.42 " " 14,789.42 " " 14,358.66 " " 66,259.92 " " 36,681.75 " " 62,118.68 " " 14,789.42 " Inpatient 482 HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC " 70,721.88 " " 22,284.46 " " 11,439.90 " " 56,577.50 " " 24,724.85 " " 12,011.90 " " 24,724.85 " " 25,556.00 " " 11,783.10 " " 23,452.65 " " 11,439.90 " " 40,325.62 " " 11,439.90 " " 21,405.21 " " 26,756.53 " " 11,783.10 " " 11,783.10 " " 11,439.90 " " 56,577.50 " " 28,801.50 " " 53,041.41 " " 11,783.10 " Inpatient 483 MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES " 61,570.17 " " 19,400.76 " " 16,235.79 " " 49,256.14 " " 35,840.37 " " 17,047.58 " " 35,840.37 " " 38,082.00 " " 16,722.86 " " 33,996.23 " " 16,235.79 " " 35,107.31 " " 16,235.79 " " 27,443.84 " " 34,304.81 " " 16,722.86 " " 16,722.86 " " 16,235.79 " " 49,256.14 " " 41,749.75 " " 46,177.63 " " 16,722.86 " Inpatient 492 "LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC" " 102,838.65 " " 32,404.46 " " 23,264.01 " " 82,270.92 " " 52,129.81 " " 24,427.21 " " 52,129.81 " " 50,148.00 " " 23,961.93 " " 49,447.50 " " 23,264.01 " " 58,638.60 " " 23,264.01 " " 35,385.07 " " 44,231.33 " " 23,961.93 " " 23,961.93 " " 23,264.01 " " 82,270.92 " " 60,725.00 " " 77,128.99 " " 23,961.93 " Inpatient 493 "LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC" " 83,566.81 " " 26,331.90 " " 15,847.53 " " 66,853.45 " " 34,940.49 " " 16,639.91 " " 34,940.49 " " 32,023.00 " " 16,322.96 " " 33,142.65 " " 15,847.53 " " 47,649.80 " " 15,847.53 " " 30,160.40 " " 37,700.52 " " 16,322.96 " " 16,322.96 " " 15,847.53 " " 66,853.45 " " 40,701.50 " " 62,675.11 " " 16,322.96 " Inpatient 494 "LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC" " 71,619.82 " " 22,567.41 " " 12,774.50 " " 57,295.86 " " 27,818.09 " " 13,413.23 " " 27,818.09 " " 24,225.00 " " 13,157.74 " " 26,386.73 " " 12,774.50 " " 40,837.62 " " 12,774.50 " " 21,372.48 " " 26,715.61 " " 13,157.74 " " 13,157.74 " " 12,774.50 " " 57,295.86 " " 32,404.75 " " 53,714.87 " " 13,157.74 " Inpatient 502 SOFT TISSUE PROCEDURES WITHOUT CC/MCC " 48,936.31 " " 15,419.83 " " 9,411.09 " " 39,149.05 " " 20,022.65 " " 9,881.64 " " 20,022.65 " " 18,246.00 " " 9,693.42 " " 18,992.40 " " 9,411.09 " " 27,903.48 " " 9,411.09 " " 15,857.53 " " 19,821.92 " " 9,693.42 " " 9,693.42 " " 9,411.09 " " 39,149.05 " " 23,324.00 " " 36,702.23 " " 9,693.42 " Inpatient 505 FOOT PROCEDURES WITHOUT CC/MCC " 58,566.13 " " 18,454.19 " " 12,277.35 " " 46,852.90 " " 26,665.83 " " 12,891.22 " " 26,665.83 " " 19,627.00 " " 12,645.67 " " 25,293.75 " " 12,277.35 " " 33,394.41 " " 12,277.35 " " 20,456.05 " " 25,570.08 " " 12,645.67 " " 12,645.67 " " 12,277.35 " " 46,852.90 " " 31,062.50 " " 43,924.60 " " 12,645.67 " Inpatient 511 "SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC" " 88,130.35 " " 27,769.87 " " 13,524.45 " " 70,504.28 " " 29,556.25 " " 14,200.67 " " 29,556.25 " " 25,975.00 " " 13,930.18 " " 28,035.45 " " 13,524.45 " " 50,251.93 " " 13,524.45 " " 25,267.31 " " 31,584.16 " " 13,930.18 " " 13,930.18 " " 13,524.45 " " 70,504.28 " " 34,429.50 " " 66,097.76 " " 13,930.18 " Inpatient 513 "HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC" " 42,498.86 " " 13,391.39 " " 10,961.54 " " 33,999.09 " " 23,616.16 " " 11,509.62 " " 23,616.16 " " 22,753.00 " " 11,290.39 " " 22,401.00 " " 10,961.54 " " 24,232.85 " " 10,961.54 " " 17,870.41 " " 22,338.02 " " 11,290.39 " " 11,290.39 " " 10,961.54 " " 33,999.09 " " 27,510.00 " " 31,874.15 " " 11,290.39 " Inpatient 516 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC " 84,124.76 " " 26,507.71 " " 13,494.63 " " 67,299.81 " " 29,487.14 " " 14,169.36 " " 29,487.14 " " 32,150.00 " " 13,899.47 " " 27,969.90 " " 13,494.63 " " 47,967.94 " " 13,494.63 " " 27,116.54 " " 33,895.69 " " 13,899.47 " " 13,899.47 " " 13,494.63 " " 67,299.81 " " 34,349.00 " " 63,093.57 " " 13,899.47 " Inpatient 517 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC " 53,392.44 " " 16,823.96 " " 9,835.00 " " 42,713.95 " " 21,005.16 " " 10,326.75 " " 21,005.16 " " 27,143.00 " " 10,130.05 " " 19,924.35 " " 9,835.00 " " 30,444.37 " " 9,835.00 " " 17,084.89 " " 21,356.13 " " 10,130.05 " " 10,130.05 " " 9,835.00 " " 42,713.95 " " 24,468.50 " " 40,044.33 " " 10,130.05 " Inpatient 519 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC " 86,938.44 " " 27,394.30 " " 13,476.48 " " 69,550.75 " " 29,445.08 " " 14,150.30 " " 29,445.08 " " 25,908.00 " " 13,880.77 " " 27,930.00 " " 13,476.48 " " 49,572.30 " " 13,476.48 " " 21,323.39 " " 26,654.25 " " 13,880.77 " " 13,880.77 " " 13,476.48 " " 69,550.75 " " 34,300.00 " " 65,203.83 " " 13,880.77 " Inpatient 520 BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC " 44,768.75 " " 14,106.63 " " 9,965.29 " " 35,815.00 " " 21,307.12 " " 10,463.55 " " 21,307.12 " " 17,930.00 " " 10,264.25 " " 20,210.78 " " 9,965.29 " " 25,527.14 " " 9,965.29 " " 16,512.12 " " 20,640.16 " " 10,264.25 " " 10,264.25 " " 9,965.29 " " 35,815.00 " " 24,820.25 " " 33,576.56 " " 10,264.25 " Inpatient 521 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC " 118,364.34 " " 37,296.60 " " 20,646.66 " " 94,691.47 " " 46,063.52 " " 21,678.99 " " 46,063.52 " " 48,199.00 " " 21,266.06 " " 43,693.35 " " 20,646.66 " " 67,491.35 " " 20,646.66 " " 43,738.69 " " 54,673.36 " " 21,266.06 " " 21,266.06 " " 20,646.66 " " 94,691.47 " " 53,658.50 " " 88,773.26 " " 21,266.06 " Inpatient 522 HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC " 79,423.44 " " 25,026.33 " " 14,963.41 " " 63,538.75 " " 32,891.36 " " 15,711.58 " " 32,891.36 " " 34,443.00 " " 15,412.31 " " 31,198.95 " " 14,963.41 " " 45,287.25 " " 14,963.41 " " 27,836.59 " " 34,795.76 " " 15,412.31 " " 15,412.31 " " 14,963.41 " " 63,538.75 " " 38,314.50 " " 59,567.58 " " 15,412.31 " Inpatient 535 FRACTURES OF HIP AND PELVIS WITH MCC " 72,288.45 " " 22,778.09 " " 8,762.91 " " 57,830.76 " " 18,520.35 " " 9,201.06 " " 18,520.35 " " 19,525.00 " " 9,025.80 " " 17,567.40 " " 8,762.91 " " 41,218.87 " " 8,762.91 " " 20,161.48 " " 25,201.87 " " 9,025.80 " " 9,025.80 " " 8,762.91 " " 57,830.76 " " 21,574.00 " " 54,216.34 " " 9,025.80 " Inpatient 536 FRACTURES OF HIP AND PELVIS WITHOUT MCC " 41,066.25 " " 12,939.98 " " 5,774.15 " " 32,853.00 " " 11,593.25 " " 6,062.86 " " 11,593.25 " " 11,330.00 " " 5,947.37 " " 10,996.73 " " 5,774.15 " " 23,415.98 " " 5,774.15 " " 9,851.63 " " 12,314.55 " " 5,947.37 " " 5,947.37 " " 5,774.15 " " 32,853.00 " " 13,504.75 " " 30,799.69 " " 5,947.37 " Inpatient 540 OSTEOMYELITIS WITH CC " 45,500.43 " " 14,337.19 " " 9,208.86 " " 36,400.34 " " 19,553.94 " " 9,669.30 " " 19,553.94 " " 20,404.00 " " 9,485.13 " " 18,547.80 " " 9,208.86 " " 25,944.35 " " 9,208.86 " " 13,877.38 " " 17,346.74 " " 9,485.13 " " 9,485.13 " " 9,208.86 " " 36,400.34 " " 22,778.00 " " 34,125.32 " " 9,485.13 " Inpatient 542 PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC " 76,531.36 " " 24,115.03 " " 12,499.03 " " 61,225.09 " " 27,179.61 " " 13,123.98 " " 27,179.61 " " 30,635.00 " " 12,874.00 " " 25,781.10 " " 12,499.03 " " 43,638.18 " " 12,499.03 " " 26,429.22 " " 33,036.54 " " 12,874.00 " " 12,874.00 " " 12,499.03 " " 61,225.09 " " 31,661.00 " " 57,398.52 " " 12,874.00 " Inpatient 551 MEDICAL BACK PROBLEMS WITH MCC " 65,422.44 " " 20,614.61 " " 11,320.63 " " 52,337.95 " " 24,448.43 " " 11,886.66 " " 24,448.43 " " 24,475.00 " " 11,660.25 " " 23,190.45 " " 11,320.63 " " 37,303.88 " " 11,320.63 " " 17,739.49 " " 22,174.37 " " 11,660.25 " " 11,660.25 " " 11,320.63 " " 52,337.95 " " 28,479.50 " " 49,066.83 " " 11,660.25 " Inpatient 552 MEDICAL BACK PROBLEMS WITHOUT MCC " 39,922.56 " " 12,579.60 " " 6,887.08 " " 31,938.05 " " 14,172.70 " " 7,231.43 " " 14,172.70 " " 13,686.00 " " 7,093.69 " " 13,443.45 " " 6,887.08 " " 22,763.84 " " 6,887.08 " " 11,684.50 " " 14,605.63 " " 7,093.69 " " 7,093.69 " " 6,887.08 " " 31,938.05 " " 16,509.50 " " 29,941.92 " " 7,093.69 " Inpatient 554 BONE DISEASES AND ARTHROPATHIES WITHOUT MCC " 54,114.52 " " 17,051.49 " " 5,908.97 " " 43,291.62 " " 11,905.73 " " 6,204.42 " " 11,905.73 " " 11,444.00 " " 6,086.24 " " 11,293.13 " " 5,908.97 " " 30,856.10 " " 5,908.97 " " 12,240.90 " " 15,301.13 " " 6,086.24 " " 6,086.24 " " 5,908.97 " " 43,291.62 " " 13,868.75 " " 40,585.89 " " 6,086.24 " Inpatient 557 "TENDONITIS, MYOSITIS AND BURSITIS WITH MCC" " 59,284.61 " " 18,680.58 " " 9,840.84 " " 47,427.69 " " 21,018.68 " " 10,332.88 " " 21,018.68 " " 22,450.00 " " 10,136.07 " " 19,937.18 " " 9,840.84 " " 33,804.08 " " 9,840.84 " " 18,263.16 " " 22,828.96 " " 10,136.07 " " 10,136.07 " " 9,840.84 " " 47,427.69 " " 24,484.25 " " 44,463.46 " " 10,136.07 " Inpatient 558 "TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC" " 29,487.79 " " 9,291.60 " " 6,355.57 " " 23,590.23 " " 12,940.81 " " 6,673.35 " " 12,940.81 " " 13,408.00 " " 6,546.24 " " 12,274.95 " " 6,355.57 " " 16,813.94 " " 6,355.57 " " 7,576.92 " " 9,471.16 " " 6,546.24 " " 6,546.24 " " 6,355.57 " " 23,590.23 " " 15,074.50 " " 22,115.84 " " 6,546.24 " Inpatient 559 "AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC" " 77,948.86 " " 24,561.69 " " 12,862.66 " " 62,359.09 " " 28,022.40 " " 13,505.79 " " 28,022.40 " " 29,194.00 " " 13,248.54 " " 26,580.53 " " 12,862.66 " " 44,446.44 " " 12,862.66 " " 22,288.91 " " 27,861.15 " " 13,248.54 " " 13,248.54 " " 12,862.66 " " 62,359.09 " " 32,642.75 " " 58,461.65 " " 13,248.54 " Inpatient 562 "FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC" " 62,615.69 " " 19,730.20 " " 9,923.16 " " 50,092.55 " " 21,209.47 " " 10,419.32 " " 21,209.47 " " 21,565.00 " " 10,220.85 " " 20,118.15 " " 9,923.16 " " 35,703.47 " " 9,923.16 " " 19,719.63 " " 24,649.55 " " 10,220.85 " " 10,220.85 " " 9,923.16 " " 50,092.55 " " 24,706.50 " " 46,961.77 " " 10,220.85 " Inpatient 563 "FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC" " 37,660.76 " " 11,866.91 " " 6,425.57 " " 30,128.61 " " 13,103.06 " " 6,746.85 " " 13,103.06 " " 12,202.00 " " 6,618.34 " " 12,428.85 " " 6,425.57 " " 21,474.17 " " 6,425.57 " " 11,062.63 " " 13,828.30 " " 6,618.34 " " 6,618.34 " " 6,425.57 " " 30,128.61 " " 15,263.50 " " 28,245.57 " " 6,618.34 " Inpatient 564 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC " 61,613.06 " " 19,414.28 " " 10,647.82 " " 49,290.45 " " 22,889.04 " " 11,180.21 " " 22,889.04 " " 23,656.00 " " 10,967.25 " " 21,711.30 " " 10,647.82 " " 35,131.77 " " 10,647.82 " " 19,457.79 " " 24,322.26 " " 10,967.25 " " 10,967.25 " " 10,647.82 " " 49,290.45 " " 26,663.00 " " 46,209.80 " " 10,967.25 " Inpatient 565 OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC " 39,256.20 " " 12,369.63 " " 7,314.23 " " 31,404.96 " " 15,162.71 " " 7,679.94 " " 15,162.71 " " 14,787.00 " " 7,533.66 " " 14,382.53 " " 7,314.23 " " 22,383.89 " " 7,314.23 " " 11,880.87 " " 14,851.10 " " 7,533.66 " " 7,533.66 " " 7,314.23 " " 31,404.96 " " 17,662.75 " " 29,442.15 " " 7,533.66 " Inpatient 571 SKIN DEBRIDEMENT WITH CC " 56,925.77 " " 17,937.31 " " 11,372.49 " " 45,540.62 " " 24,568.61 " " 11,941.11 " " 24,568.61 " " 23,070.00 " " 11,713.66 " " 23,304.45 " " 11,372.49 " " 32,459.07 " " 11,372.49 " " 18,001.32 " " 22,501.67 " " 11,713.66 " " 11,713.66 " " 11,372.49 " " 45,540.62 " " 28,619.50 " " 42,694.33 " " 11,713.66 " Inpatient 579 "OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC" " 93,433.23 " " 29,440.81 " " 21,156.78 " " 74,746.58 " " 47,245.83 " " 22,214.62 " " 47,245.83 " " 42,893.00 " " 21,791.48 " " 44,814.83 " " 21,156.78 " " 53,275.63 " " 21,156.78 " " 29,187.69 " " 36,484.60 " " 21,791.48 " " 21,791.48 " " 21,156.78 " " 74,746.58 " " 55,035.75 " " 70,074.92 " " 21,791.48 " Inpatient 580 "OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC" " 57,529.43 " " 18,127.52 " " 11,977.89 " " 46,023.54 " " 25,971.76 " " 12,576.78 " " 25,971.76 " " 24,744.00 " " 12,337.23 " " 24,635.40 " " 11,977.89 " " 32,803.28 " " 11,977.89 " " 18,344.99 " " 22,931.24 " " 12,337.23 " " 12,337.23 " " 11,977.89 " " 46,023.54 " " 30,254.00 " " 43,147.07 " " 12,337.23 " Inpatient 581 "OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC" " 43,918.22 " " 13,838.63 " " 9,696.29 " " 35,134.58 " " 20,683.67 " " 10,181.10 " " 20,683.67 " " 17,839.00 " " 9,987.18 " " 19,619.40 " " 9,696.29 " " 25,042.17 " " 9,696.29 " " 14,777.45 " " 18,471.82 " " 9,987.18 " " 9,987.18 " " 9,696.29 " " 35,134.58 " " 24,094.00 " " 32,938.67 " " 9,987.18 " Inpatient 602 CELLULITIS WITH MCC " 61,085.54 " " 19,248.05 " " 10,170.76 " " 48,868.43 " " 21,783.35 " " 10,679.30 " " 21,783.35 " " 22,902.00 " " 10,475.88 " " 20,662.50 " " 10,170.76 " " 34,830.97 " " 10,170.76 " " 14,908.37 " " 18,635.47 " " 10,475.88 " " 10,475.88 " " 10,170.76 " " 48,868.43 " " 25,375.00 " " 45,814.16 " " 10,475.88 " Inpatient 603 CELLULITIS WITHOUT MCC " 32,426.71 " " 10,217.66 " " 6,305.01 " " 25,941.37 " " 12,823.63 " " 6,620.26 " " 12,823.63 " " 13,291.00 " " 6,494.16 " " 12,163.80 " " 6,305.01 " " 18,489.71 " " 6,305.01 " " 7,233.26 " " 9,041.58 " " 6,494.16 " " 6,494.16 " " 6,305.01 " " 25,941.37 " " 14,938.00 " " 24,320.03 " " 6,494.16 " Inpatient 605 "TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC" " 46,597.13 " " 14,682.76 " " 6,631.05 " " 37,277.70 " " 13,579.29 " " 6,962.60 " " 13,579.29 " " 12,058.00 " " 6,829.98 " " 12,880.58 " " 6,631.05 " " 26,569.68 " " 6,631.05 " " 10,228.03 " " 12,785.04 " " 6,829.98 " " 6,829.98 " " 6,631.05 " " 37,277.70 " " 15,818.25 " " 34,947.85 " " 6,829.98 " Inpatient 607 MINOR SKIN DISORDERS WITHOUT MCC " 39,730.13 " " 12,518.96 " " 6,140.37 " " 31,784.10 " " 12,442.05 " " 6,447.39 " " 12,442.05 " " 11,480.00 " " 6,324.58 " " 11,801.85 " " 6,140.37 " " 22,654.12 " " 6,140.37 " " 7,380.54 " " 9,225.68 " " 6,324.58 " " 6,324.58 " " 6,140.37 " " 31,784.10 " " 14,493.50 " " 29,797.60 " " 6,324.58 " Inpatient 616 "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC" " 158,855.62 " " 50,055.41 " " 26,480.29 " " 127,084.50 " " 59,584.22 " " 27,804.30 " " 59,584.22 " " 65,468.00 " " 27,274.70 " " 56,518.35 " " 26,480.29 " " 90,579.47 " " 26,480.29 " " 35,042.36 " " 43,802.94 " " 27,274.70 " " 27,274.70 " " 26,480.29 " " 127,084.50 " " 69,408.50 " " 119,141.72 " " 27,274.70 " Inpatient 617 "AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC" " 82,686.20 " " 26,054.42 " " 13,928.91 " " 66,148.96 " " 30,493.69 " " 14,625.36 " " 30,493.69 " " 31,399.00 " " 14,346.78 " " 28,924.65 " " 13,928.91 " " 47,147.67 " " 13,928.91 " " 20,914.27 " " 26,142.84 " " 14,346.78 " " 14,346.78 " " 13,928.91 " " 66,148.96 " " 35,521.50 " " 62,014.65 " " 14,346.78 " Inpatient 620 O.R. PROCEDURES FOR OBESITY WITH CC " 48,372.44 " " 15,242.16 " " 12,197.62 " " 38,697.95 " " 26,481.04 " " 12,807.50 " " 26,481.04 " " 29,060.00 " " 12,563.55 " " 25,118.48 " " 12,197.62 " " 27,581.97 " " 12,197.62 " " 20,750.62 " " 25,938.28 " " 12,563.55 " " 12,563.55 " " 12,197.62 " " 38,697.95 " " 30,847.25 " " 36,279.33 " " 12,563.55 " Inpatient 621 O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC " 36,688.16 " " 11,560.44 " " 11,124.24 " " 29,350.53 " " 23,993.23 " " 11,680.45 " " 23,993.23 " " 24,284.00 " " 11,457.97 " " 22,758.68 " " 11,124.24 " " 20,919.59 " " 11,124.24 " " 18,115.88 " " 22,644.86 " " 11,457.97 " " 11,457.97 " " 11,124.24 " " 29,350.53 " " 27,949.25 " " 27,516.12 " " 11,457.97 " Inpatient 623 "SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC" " 67,915.58 " " 21,400.20 " " 12,902.84 " " 54,332.46 " " 28,115.54 " " 13,547.98 " " 28,115.54 " " 28,803.00 " " 13,289.93 " " 26,668.88 " " 12,902.84 " " 38,725.46 " " 12,902.84 " " 19,686.90 " " 24,608.64 " " 13,289.93 " " 13,289.93 " " 12,902.84 " " 54,332.46 " " 32,751.25 " " 50,936.69 " " 13,289.93 " Inpatient 629 "OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC" " 81,598.02 " " 25,711.54 " " 15,973.92 " " 65,278.42 " " 35,233.44 " " 16,772.62 " " 35,233.44 " " 35,354.00 " " 16,453.14 " " 33,420.53 " " 15,973.92 " " 46,527.19 " " 15,973.92 " " 24,923.65 " " 31,154.58 " " 16,453.14 " " 16,453.14 " " 15,973.92 " " 65,278.42 " " 41,042.75 " " 61,198.52 " " 16,453.14 " Inpatient 637 DIABETES WITH MCC " 70,341.09 " " 22,164.48 " " 9,695.00 " " 56,272.87 " " 20,680.66 " " 10,179.75 " " 20,680.66 " " 21,940.00 " " 9,985.85 " " 19,616.55 " " 9,695.00 " " 40,108.49 " " 9,695.00 " " 16,348.48 " " 20,435.60 " " 9,985.85 " " 9,985.85 " " 9,695.00 " " 56,272.87 " " 24,090.50 " " 52,755.82 " " 9,985.85 " Inpatient 638 DIABETES WITH CC " 41,584.35 " " 13,103.23 " " 6,472.24 " " 33,267.48 " " 13,211.23 " " 6,795.85 " " 13,211.23 " " 12,998.00 " " 6,666.41 " " 12,531.45 " " 6,472.24 " " 23,711.40 " " 6,472.24 " " 9,164.31 " " 11,455.39 " " 6,666.41 " " 6,666.41 " " 6,472.24 " " 33,267.48 " " 15,389.50 " " 31,188.26 " " 6,666.41 " Inpatient 639 DIABETES WITHOUT CC/MCC " 26,429.85 " " 8,328.05 " " 4,723.45 " " 21,143.88 " " 9,158.02 " " 4,959.62 " " 9,158.02 " " 9,545.00 " " 4,865.15 " " 8,686.80 " " 4,723.45 " " 15,070.30 " " 4,723.45 " " 7,036.88 " " 8,796.11 " " 4,865.15 " " 4,865.15 " " 4,723.45 " " 21,143.88 " " 10,668.00 " " 19,822.39 " " 4,865.15 " Inpatient 640 "MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC" " 55,079.23 " " 17,355.47 " " 8,749.95 " " 44,063.38 " " 18,490.31 " " 9,187.45 " " 18,490.31 " " 17,376.00 " " 9,012.45 " " 17,538.90 " " 8,749.95 " " 31,406.18 " " 8,749.95 " " 15,202.94 " " 19,003.68 " " 9,012.45 " " 9,012.45 " " 8,749.95 " " 44,063.38 " " 21,539.00 " " 41,309.42 " " 9,012.45 " Inpatient 641 "MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC" " 38,660.60 " " 12,181.96 " " 5,660.72 " " 30,928.48 " " 11,330.35 " " 5,943.76 " " 11,330.35 " " 11,093.00 " " 5,830.54 " " 10,747.35 " " 5,660.72 " " 22,044.27 " " 5,660.72 " " 8,984.30 " " 11,230.38 " " 5,830.54 " " 5,830.54 " " 5,660.72 " " 30,928.48 " " 13,198.50 " " 28,995.45 " " 5,830.54 " Inpatient 643 ENDOCRINE DISORDERS WITH MCC " 52,270.50 " " 16,470.43 " " 11,581.85 " " 41,816.40 " " 25,053.86 " " 12,160.94 " " 25,053.86 " " 25,897.00 " " 11,929.31 " " 23,764.73 " " 11,581.85 " " 29,804.64 " " 11,581.85 " " 20,145.12 " " 25,181.41 " " 11,929.31 " " 11,929.31 " " 11,581.85 " " 41,816.40 " " 29,184.75 " " 39,202.88 " " 11,929.31 " Inpatient 644 ENDOCRINE DISORDERS WITH CC " 45,510.24 " " 14,340.28 " " 7,382.29 " " 36,408.19 " " 15,320.46 " " 7,751.40 " " 15,320.46 " " 16,046.00 " " 7,603.76 " " 14,532.15 " " 7,382.29 " " 25,949.94 " " 7,382.29 " " 12,322.72 " " 15,403.41 " " 7,603.76 " " 7,603.76 " " 7,382.29 " " 36,408.19 " " 17,846.50 " " 34,132.68 " " 7,603.76 " Inpatient 659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC " 82,912.37 " " 26,125.69 " " 18,055.23 " " 66,329.90 " " 40,057.33 " " 18,957.99 " " 40,057.33 " " 53,198.00 " " 18,596.89 " " 37,996.20 " " 18,055.23 " " 47,276.63 " " 18,055.23 " " 26,167.38 " " 32,709.24 " " 18,596.89 " " 18,596.89 " " 18,055.23 " " 66,329.90 " " 46,662.00 " " 62,184.28 " " 18,596.89 " Inpatient 660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC " 51,277.21 " " 16,157.45 " " 10,126.04 " " 41,021.77 " " 21,679.69 " " 10,632.34 " " 21,679.69 " " 29,717.00 " " 10,429.82 " " 20,564.18 " " 10,126.04 " " 29,238.27 " " 10,126.04 " " 15,906.62 " " 19,883.29 " " 10,429.82 " " 10,429.82 " " 10,126.04 " " 41,021.77 " " 25,254.25 " " 38,457.91 " " 10,429.82 " Inpatient 661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC " 37,832.55 " " 11,921.04 " " 7,666.84 " " 30,266.04 " " 15,979.97 " " 8,050.18 " " 15,979.97 " " 21,231.00 " " 7,896.85 " " 15,157.73 " " 7,666.84 " " 21,572.12 " " 7,666.84 " " 12,944.59 " " 16,180.74 " " 7,896.85 " " 7,896.85 " " 7,666.84 " " 30,266.04 " " 18,614.75 " " 28,374.41 " " 7,896.85 " Inpatient 669 TRANSURETHRAL PROCEDURES WITH CC " 50,773.94 " " 15,998.87 " " 10,906.45 " " 40,619.15 " " 23,488.46 " " 11,451.77 " " 23,488.46 " " 19,921.00 " " 11,233.64 " " 22,279.88 " " 10,906.45 " " 28,951.30 " " 10,906.45 " " 15,661.15 " " 19,576.45 " " 11,233.64 " " 11,233.64 " " 10,906.45 " " 40,619.15 " " 27,361.25 " " 38,080.46 " " 11,233.64 " Inpatient 673 OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC " 186,186.23 " " 58,667.28 " " 23,252.99 " " 148,948.98 " " 52,104.27 " " 24,415.64 " " 52,104.27 " " 55,103.00 " " 23,950.58 " " 49,423.28 " " 23,252.99 " " 106,163.39 " " 23,252.99 " " 34,985.24 " " 43,731.54 " " 23,950.58 " " 23,950.58 " " 23,252.99 " " 148,948.98 " " 60,695.25 " " 139,639.67 " " 23,950.58 " Inpatient 682 RENAL FAILURE WITH MCC " 64,293.03 " " 20,258.73 " " 10,317.90 " " 51,434.42 " " 22,124.37 " " 10,833.80 " " 22,124.37 " " 23,905.00 " " 10,627.44 " " 20,985.98 " " 10,317.90 " " 36,659.89 " " 10,317.90 " " 17,674.03 " " 22,092.54 " " 10,627.44 " " 10,627.44 " " 10,317.90 " " 51,434.42 " " 25,772.25 " " 48,219.77 " " 10,627.44 " Inpatient 683 RENAL FAILURE WITH CC " 35,206.77 " " 11,093.65 " " 6,471.59 " " 28,165.42 " " 13,209.72 " " 6,795.17 " " 13,209.72 " " 14,965.00 " " 6,665.74 " " 12,530.03 " " 6,471.59 " " 20,074.90 " " 6,471.59 " " 9,769.81 " " 12,212.27 " " 6,665.74 " " 6,665.74 " " 6,471.59 " " 28,165.42 " " 15,387.75 " " 26,405.08 " " 6,665.74 " Inpatient 684 RENAL FAILURE WITHOUT CC/MCC " 22,757.55 " " 7,170.90 " " 4,712.43 " " 18,206.04 " " 9,132.48 " " 4,948.05 " " 9,132.48 " " 9,574.00 " " 4,853.80 " " 8,662.58 " " 4,712.43 " " 12,976.36 " " 4,712.43 " " 6,922.33 " " 8,652.91 " " 4,853.80 " " 4,853.80 " " 4,712.43 " " 18,206.04 " " 10,638.25 " " 17,068.16 " " 4,853.80 " Inpatient 689 KIDNEY AND URINARY TRACT INFECTIONS WITH MCC " 52,056.30 " " 16,402.94 " " 7,994.17 " " 41,645.04 " " 16,738.63 " " 8,393.88 " " 16,738.63 " " 17,576.00 " " 8,234.00 " " 15,877.35 " " 7,994.17 " " 29,682.50 " " 7,994.17 " " 14,073.76 " " 17,592.21 " " 8,234.00 " " 8,234.00 " " 7,994.17 " " 41,645.04 " " 19,498.50 " " 39,042.23 " " 8,234.00 " Inpatient 690 KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC " 37,460.68 " " 11,803.86 " " 5,918.70 " " 29,968.54 " " 11,928.26 " " 6,214.64 " " 11,928.26 " " 12,262.00 " " 6,096.26 " " 11,314.50 " " 5,918.70 " " 21,360.08 " " 5,918.70 " " 7,855.12 " " 9,818.91 " " 6,096.26 " " 6,096.26 " " 5,918.70 " " 29,968.54 " " 13,895.00 " " 28,095.51 " " 6,096.26 " Inpatient 694 URINARY STONES WITHOUT MCC " 30,752.66 " " 9,690.16 " " 5,770.91 " " 24,602.13 " " 11,585.74 " " 6,059.46 " " 11,585.74 " " 10,791.00 " " 5,944.04 " " 10,989.60 " " 5,770.91 " " 17,535.17 " " 5,770.91 " " 7,576.92 " " 9,471.16 " " 5,944.04 " " 5,944.04 " " 5,770.91 " " 24,602.13 " " 13,496.00 " " 23,064.50 " " 5,944.04 " Inpatient 698 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC " 56,380.51 " " 17,765.50 " " 11,211.74 " " 45,104.41 " " 24,196.04 " " 11,772.33 " " 24,196.04 " " 24,584.00 " " 11,548.09 " " 22,951.05 " " 11,211.74 " " 32,148.17 " " 11,211.74 " " 19,212.32 " " 24,015.41 " " 11,548.09 " " 11,548.09 " " 11,211.74 " " 45,104.41 " " 28,185.50 " " 42,285.38 " " 11,548.09 " Inpatient 699 OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC " 34,573.17 " " 10,894.01 " " 7,428.96 " " 27,658.54 " " 15,428.62 " " 7,800.41 " " 15,428.62 " " 16,001.00 " " 7,651.83 " " 14,634.75 " " 7,428.96 " " 19,713.62 " " 7,428.96 " " 11,749.96 " " 14,687.45 " " 7,651.83 " " 7,651.83 " " 7,428.96 " " 27,658.54 " " 17,972.50 " " 25,929.88 " " 7,651.83 " Inpatient 708 MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC " 43,385.52 " " 13,670.78 " " 10,437.81 " " 34,708.42 " " 22,402.30 " " 10,959.70 " " 22,402.30 " " 20,867.00 " " 10,750.94 " " 21,249.60 " " 10,437.81 " " 24,738.42 " " 10,437.81 " " 20,292.40 " " 25,365.51 " " 10,750.94 " " 10,750.94 " " 10,437.81 " " 34,708.42 " " 26,096.00 " " 32,539.14 " " 10,750.94 " Inpatient 728 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC " 50,927.90 " " 16,047.38 " " 5,994.53 " " 40,742.32 " " 12,104.03 " " 6,294.26 " " 12,104.03 " " 12,596.00 " " 6,174.37 " " 11,481.23 " " 5,994.53 " " 29,039.09 " " 5,994.53 " " 8,231.51 " " 10,289.40 " " 6,174.37 " " 6,174.37 " " 5,994.53 " " 40,742.32 " " 14,099.75 " " 38,195.93 " " 6,174.37 " Inpatient 742 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC " 61,417.60 " " 19,352.69 " " 11,908.53 " " 49,134.08 " " 25,811.02 " " 12,503.96 " " 25,811.02 " " 24,286.00 " " 12,265.79 " " 24,482.93 " " 11,908.53 " " 35,020.32 " " 11,908.53 " " 20,079.66 " " 25,099.59 " " 12,265.79 " " 12,265.79 " " 11,908.53 " " 49,134.08 " " 30,066.75 " " 46,063.20 " " 12,265.79 " Inpatient 743 UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC " 37,621.60 " " 11,854.57 " " 8,114.73 " " 30,097.28 " " 17,018.05 " " 8,520.47 " " 17,018.05 " " 15,660.00 " " 8,358.17 " " 16,142.40 " " 8,114.73 " " 21,451.84 " " 8,114.73 " " 14,057.40 " " 17,571.76 " " 8,358.17 " " 8,358.17 " " 8,114.73 " " 30,097.28 " " 19,824.00 " " 28,216.20 " " 8,358.17 " Inpatient 744 "D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC" " 56,293.64 " " 17,738.13 " " 12,409.58 " " 45,034.91 " " 26,972.29 " " 13,030.06 " " 26,972.29 " " 27,507.00 " " 12,781.87 " " 25,584.45 " " 12,409.58 " " 32,098.63 " " 12,409.58 " " 16,577.58 " " 20,721.99 " " 12,781.87 " " 12,781.87 " " 12,409.58 " " 45,034.91 " " 31,419.50 " " 42,220.23 " " 12,781.87 " Inpatient 768 VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C " 14,904.77 " " 4,696.49 " " 7,567.85 " " 20,468.00 " " 17,570.90 " " 8,770.92 " " 17,570.90 " " 17,596.00 " " 8,603.86 " " 16,666.80 " " 8,353.26 " " 8,498.70 " " 8,353.26 " " 7,567.85 " " 9,459.82 " " 8,603.86 " " 8,603.86 " " 8,353.26 " " 11,923.82 " " 20,468.00 " " 11,178.58 " " 8,603.86 " Inpatient 776 POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES " 12,807.91 " " 4,035.77 " " 5,792.30 " " 13,553.75 " " 11,635.31 " " 6,081.92 " " 11,635.31 " " 12,771.00 " " 5,966.07 " " 11,036.63 " " 5,792.30 " " 7,303.07 " " 5,792.30 " " 6,480.48 " " 8,100.60 " " 5,966.07 " " 5,966.07 " " 5,792.30 " " 10,246.33 " " 13,553.75 " " 9,605.93 " " 5,966.07 " Inpatient 786 CESAREAN SECTION WITHOUT STERILIZATION WITH MCC " 39,520.51 " " 12,452.91 " " 9,985.15 " " 31,616.41 " " 23,952.67 " " 11,662.07 " " 23,952.67 " " 17,187.00 " " 11,439.93 " " 22,720.20 " " 11,106.73 " " 22,534.59 " " 11,106.73 " " 9,985.15 " " 12,481.43 " " 11,439.93 " " 11,439.93 " " 11,106.73 " " 31,616.41 " " 27,902.00 " " 29,640.38 " " 11,439.93 " Inpatient 787 CESAREAN SECTION WITHOUT STERILIZATION WITH CC " 31,650.04 " " 9,972.93 " " 7,671.38 " " 25,320.03 " " 15,990.48 " " 8,054.95 " " 15,990.48 " " 17,187.00 " " 7,901.52 " " 15,167.70 " " 7,671.38 " " 18,046.85 " " 7,671.38 " " 8,784.11 " " 10,980.13 " " 7,901.52 " " 7,901.52 " " 7,671.38 " " 25,320.03 " " 18,627.00 " " 23,737.53 " " 7,901.52 " Inpatient 788 CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC " 28,665.09 " " 9,032.37 " " 6,524.10 " " 22,932.07 " " 13,331.41 " " 6,850.31 " " 13,331.41 " " 11,898.00 " " 6,719.82 " " 12,645.45 " " 6,524.10 " " 16,344.83 " " 6,524.10 " " 7,736.14 " " 9,670.17 " " 6,719.82 " " 6,719.82 " " 6,524.10 " " 22,932.07 " " 15,529.50 " " 21,498.82 " " 6,719.82 " Inpatient 789 "NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY" " 30,195.25 " " 9,514.52 " " 11,920.85 " " 25,839.56 " " 25,839.56 " " 12,516.89 " " 25,839.56 " " 24,461.00 " " 12,278.48 " " 24,510.00 " " 11,920.85 " " 17,217.33 " " 11,920.85 " " 14,166.91 " " 17,708.69 " " 12,278.48 " " 12,278.48 " " 11,920.85 " " 24,156.20 " " 18,117.15 " " 22,646.44 " " 12,278.48 " Inpatient 790 "EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE" " 421,817.52 " " 132,914.70 " " 37,537.60 " " 337,454.02 " " 85,211.96 " " 39,414.48 " " 85,211.96 " " 80,661.00 " " 38,663.73 " " 80,827.43 " " 37,537.60 " " 240,520.35 " " 37,537.60 " " 85,161.38 " " 106,452.03 " " 38,663.73 " " 38,663.73 " " 37,537.60 " " 337,454.02 " " 253,090.51 " " 316,363.14 " " 38,663.73 " Inpatient 791 PREMATURITY WITH MAJOR PROBLEMS " 148,586.39 " " 46,819.57 " " 25,881.37 " " 118,869.11 " " 58,196.10 " " 27,175.44 " " 58,196.10 " " 55,090.00 " " 26,657.81 " " 55,201.65 " " 25,881.37 " " 84,723.96 " " 25,881.37 " " 29,919.77 " " 37,399.81 " " 26,657.81 " " 26,657.81 " " 25,881.37 " " 118,869.11 " " 89,151.83 " " 111,439.79 " " 26,657.81 " Inpatient 792 PREMATURITY WITHOUT MAJOR PROBLEMS " 24,374.70 " " 7,680.47 " " 9,009.25 " " 35,114.76 " " 35,114.76 " " 16,718.86 " " 35,114.76 " " 33,240.00 " " 16,400.40 " " 33,307.95 " " 15,922.72 " " 13,898.45 " " 15,922.72 " " 9,009.25 " " 11,261.59 " " 16,400.40 " " 16,400.40 " " 15,922.72 " " 19,499.76 " " 14,624.82 " " 18,281.03 " " 16,400.40 " Inpatient 793 FULL TERM NEONATE WITH MAJOR PROBLEMS " 22,854.82 " " 7,201.55 " " 10,955.03 " " 59,779.52 " " 59,779.52 " " 27,892.78 " " 59,779.52 " " 56,590.00 " " 27,361.49 " " 56,703.60 " " 26,564.55 " " 13,031.82 " " 26,564.55 " " 10,955.03 " " 13,693.83 " " 27,361.49 " " 27,361.49 " " 26,564.55 " " 18,283.86 " " 13,712.89 " " 17,141.12 " " 27,361.49 " Inpatient 794 NEONATE WITH OTHER SIGNIFICANT PROBLEMS " 4,307.54 " " 1,357.31 " " 2,456.16 " " 21,158.39 " " 21,158.39 " " 10,396.18 " " 21,158.39 " " 20,030.00 " " 10,198.15 " " 20,069.70 " " 9,901.12 " " 2,456.16 " " 9,901.12 " " 2,718.77 " " 3,398.47 " " 10,198.15 " " 10,198.15 " " 9,901.12 " " 3,446.03 " " 2,584.52 " " 3,230.66 " " 10,198.15 " Inpatient 795 NORMAL NEWBORN " 3,574.60 " " 1,126.36 " " 1,662.89 " " 3,337.25 " " 2,864.89 " " 2,108.63 " " 2,864.89 " " 2,711.00 " " 2,068.47 " " 2,717.48 " " 2,008.22 " " 2,038.24 " " 2,008.22 " " 1,662.89 " " 2,078.62 " " 2,068.47 " " 2,068.47 " " 2,008.22 " " 2,859.68 " " 3,337.25 " " 2,680.95 " " 2,068.47 " Inpatient 805 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC " 15,024.21 " " 4,734.13 " " 7,447.75 " " 18,023.25 " " 15,472.19 " " 7,820.14 " " 15,472.19 " " 11,277.00 " " 7,671.18 " " 14,676.08 " " 7,447.75 " " 8,566.80 " " 7,447.75 " " 8,113.28 " " 10,141.61 " " 7,671.18 " " 7,671.18 " " 7,447.75 " " 12,019.37 " " 18,023.25 " " 11,268.16 " " 7,671.18 " Inpatient 806 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC " 13,293.06 " " 4,188.64 " " 5,533.68 " " 12,855.50 " " 11,035.90 " " 5,810.36 " " 11,035.90 " " 11,277.00 " " 5,699.69 " " 10,468.05 " " 5,533.68 " " 7,579.70 " " 5,533.68 " " 6,763.34 " " 8,454.18 " " 5,699.69 " " 5,699.69 " " 5,533.68 " " 10,634.45 " " 12,855.50 " " 9,969.80 " " 5,699.69 " Inpatient 807 VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC " 11,744.79 " " 3,700.78 " " 4,935.41 " " 11,240.25 " " 9,649.27 " " 5,182.18 " " 9,649.27 " " 8,877.00 " " 5,083.47 " " 9,152.78 " " 4,935.41 " " 6,696.88 " " 4,935.41 " " 5,999.74 " " 7,499.68 " " 5,083.47 " " 5,083.47 " " 4,935.41 " " 9,395.83 " " 11,240.25 " " 8,808.59 " " 5,083.47 " Inpatient 809 MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC " 36,012.02 " " 11,347.39 " " 8,701.98 " " 28,809.62 " " 18,379.14 " " 9,137.08 " " 18,379.14 " " 18,937.00 " " 8,963.04 " " 17,433.45 " " 8,701.98 " " 20,534.05 " " 8,701.98 " " 14,515.61 " " 18,144.53 " " 8,963.04 " " 8,963.04 " " 8,701.98 " " 28,809.62 " " 21,409.50 " " 27,009.02 " " 8,963.04 " Inpatient 811 RED BLOOD CELL DISORDERS WITH MCC " 46,513.05 " " 14,656.26 " " 9,712.50 " " 37,210.44 " " 20,721.22 " " 10,198.13 " " 20,721.22 " " 20,184.00 " " 10,003.88 " " 19,655.03 " " 9,712.50 " " 26,521.74 " " 9,712.50 " " 17,624.93 " " 22,031.18 " " 10,003.88 " " 10,003.88 " " 9,712.50 " " 37,210.44 " " 24,137.75 " " 34,884.79 " " 10,003.88 " Inpatient 812 RED BLOOD CELL DISORDERS WITHOUT MCC " 38,725.26 " " 12,202.33 " " 6,478.08 " " 30,980.21 " " 13,224.75 " " 6,801.98 " " 13,224.75 " " 12,843.00 " " 6,672.42 " " 12,544.28 " " 6,478.08 " " 22,081.14 " " 6,478.08 " " 11,177.19 " " 13,971.49 " " 6,672.42 " " 6,672.42 " " 6,478.08 " " 30,980.21 " " 15,405.25 " " 29,043.95 " " 6,672.42 " Inpatient 813 COAGULATION DISORDERS " 48,171.75 " " 15,178.92 " " 10,787.18 " " 38,537.40 " " 23,212.04 " " 11,326.54 " " 23,212.04 " " 26,014.00 " " 11,110.80 " " 22,017.68 " " 10,787.18 " " 27,467.53 " " 10,787.18 " " 21,568.86 " " 26,961.09 " " 11,110.80 " " 11,110.80 " " 10,787.18 " " 38,537.40 " " 27,039.25 " " 36,128.81 " " 11,110.80 " Inpatient 824 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC " 63,956.18 " " 20,152.59 " " 16,097.73 " " 51,164.94 " " 35,520.38 " " 16,902.62 " " 35,520.38 " " 36,109.00 " " 16,580.66 " " 33,692.70 " " 16,097.73 " " 36,467.81 " " 16,097.73 " " 32,827.87 " " 41,034.86 " " 16,580.66 " " 16,580.66 " " 16,097.73 " " 51,164.94 " " 41,377.00 " " 47,967.14 " " 16,580.66 " Inpatient 831 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC " 38,595.87 " " 12,161.56 " " 8,043.43 " " 30,876.70 " " 16,852.80 " " 8,445.60 " " 16,852.80 " " 16,175.00 " " 8,284.73 " " 15,985.65 " " 8,043.43 " " 22,007.37 " " 8,043.43 " " 8,722.46 " " 10,903.08 " " 8,284.73 " " 8,284.73 " " 8,043.43 " " 30,876.70 " " 19,631.50 " " 28,946.90 " " 8,284.73 " Inpatient 832 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC " 20,249.29 " " 6,380.55 " " 5,816.93 " " 16,199.43 " " 11,692.40 " " 6,107.78 " " 11,692.40 " " 11,309.00 " " 5,991.44 " " 11,090.78 " " 5,816.93 " " 11,546.15 " " 5,816.93 " " 6,693.22 " " 8,366.53 " " 5,991.44 " " 5,991.44 " " 5,816.93 " " 16,199.43 " " 13,620.25 " " 15,186.97 " " 5,991.44 " Inpatient 833 OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC " 9,508.65 " " 2,996.18 " " 4,252.87 " " 9,397.50 " " 8,067.35 " " 4,465.51 " " 8,067.35 " " 7,557.00 " " 4,380.46 " " 7,652.25 " " 4,252.87 " " 5,421.83 " " 4,252.87 " " 5,089.47 " " 6,361.83 " " 4,380.46 " " 4,380.46 " " 4,252.87 " " 7,606.92 " " 9,397.50 " " 7,131.49 " " 4,380.46 " Inpatient 840 LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC " 89,634.36 " " 28,243.79 " " 21,646.80 " " 71,707.49 " " 48,381.57 " " 22,729.14 " " 48,381.57 " " 48,865.00 " " 22,296.20 " " 45,892.13 " " 21,646.80 " " 51,109.51 " " 21,646.80 " " 43,081.82 " " 53,852.27 " " 22,296.20 " " 22,296.20 " " 21,646.80 " " 71,707.49 " " 56,358.75 " " 67,225.77 " " 22,296.20 " Inpatient 853 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC " 199,810.47 " " 62,960.28 " " 32,972.47 " " 159,848.38 " " 74,631.26 " " 34,621.09 " " 74,631.26 " " 81,921.00 " " 33,961.64 " " 70,791.15 " " 32,972.47 " " 113,931.93 " " 32,972.47 " " 51,464.00 " " 64,329.99 " " 33,961.64 " " 33,961.64 " " 32,972.47 " " 159,848.38 " " 86,936.50 " " 149,857.85 " " 33,961.64 " Inpatient 854 INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC " 64,899.67 " " 20,449.89 " " 14,527.83 " " 51,919.74 " " 31,881.81 " " 15,254.22 " " 31,881.81 " " 37,566.00 " " 14,963.66 " " 30,241.35 " " 14,527.83 " " 37,005.79 " " 14,527.83 " " 24,367.25 " " 30,459.07 " " 14,963.66 " " 14,963.66 " " 14,527.83 " " 51,919.74 " " 37,138.50 " " 48,674.75 " " 14,963.66 " Inpatient 857 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC " 69,043.57 " " 21,755.63 " " 14,399.49 " " 55,234.86 " " 31,584.36 " " 15,119.46 " " 31,584.36 " " 32,255.00 " " 14,831.47 " " 29,959.20 " " 14,399.49 " " 39,368.64 " " 14,399.49 " " 21,879.79 " " 27,349.75 " " 14,831.47 " " 14,831.47 " " 14,399.49 " " 55,234.86 " " 36,792.00 " " 51,782.68 " " 14,831.47 " Inpatient 862 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC " 58,271.30 " " 18,361.29 " " 13,066.19 " " 46,617.04 " " 28,494.12 " " 13,719.50 " " 28,494.12 " " 29,116.00 " " 13,458.18 " " 27,027.98 " " 13,066.19 " " 33,226.30 " " 13,066.19 " " 15,202.94 " " 19,003.68 " " 13,458.18 " " 13,458.18 " " 13,066.19 " " 46,617.04 " " 33,192.25 " " 43,703.48 " " 13,458.18 " Inpatient 863 POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC " 42,308.23 " " 13,331.32 " " 7,327.84 " " 33,846.58 " " 15,194.26 " " 7,694.23 " " 15,194.26 " " 15,476.00 " " 7,547.68 " " 14,412.45 " " 7,327.84 " " 24,124.15 " " 7,327.84 " " 10,178.93 " " 12,723.67 " " 7,547.68 " " 7,547.68 " " 7,327.84 " " 33,846.58 " " 17,699.50 " " 31,731.17 " " 7,547.68 " Inpatient 864 FEVER AND INFLAMMATORY CONDITIONS " 46,738.86 " " 14,727.41 " " 6,453.44 " " 37,391.09 " " 13,167.66 " " 6,776.11 " " 13,167.66 " " 13,246.00 " " 6,647.04 " " 12,490.13 " " 6,453.44 " " 26,650.50 " " 6,453.44 " " 9,687.99 " " 12,109.99 " " 6,647.04 " " 6,647.04 " " 6,453.44 " " 37,391.09 " " 15,338.75 " " 35,054.15 " " 6,647.04 " Inpatient 866 VIRAL ILLNESS WITHOUT MCC " 53,436.00 " " 16,837.68 " " 6,210.38 " " 42,748.80 " " 12,604.30 " " 6,520.90 " " 12,604.30 " " 11,682.00 " " 6,396.69 " " 11,955.75 " " 6,210.38 " " 30,469.21 " " 6,210.38 " " 8,640.64 " " 10,800.80 " " 6,396.69 " " 6,396.69 " " 6,210.38 " " 42,748.80 " " 14,682.50 " " 40,077.00 " " 6,396.69 " Inpatient 869 OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC " 28,406.73 " " 8,950.96 " " 5,494.14 " " 22,725.38 " " 10,944.26 " " 5,768.85 " " 10,944.26 " " 10,821.00 " " 5,658.96 " " 10,381.13 " " 5,494.14 " " 16,197.52 " " 5,494.14 " " 9,442.51 " " 11,803.15 " " 5,658.96 " " 5,658.96 " " 5,494.14 " " 22,725.38 " " 12,748.75 " " 21,305.05 " " 5,658.96 " Inpatient 870 SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS " 391,747.69 " " 123,439.70 " " 42,508.50 " " 313,398.15 " " 96,733.10 " " 44,633.93 " " 96,733.10 " " 92,352.00 " " 43,783.76 " " 91,755.75 " " 42,508.50 " " 223,374.53 " " 42,508.50 " " 76,482.02 " " 95,602.51 " " 43,783.76 " " 43,783.76 " " 42,508.50 " " 313,398.15 " " 112,682.50 " " 293,810.77 " " 43,783.76 " Inpatient 871 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC " 93,689.84 " " 29,521.67 " " 12,907.38 " " 74,951.87 " " 28,126.06 " " 13,552.75 " " 28,126.06 " " 28,435.00 " " 13,294.60 " " 26,678.85 " " 12,907.38 " " 53,421.95 " " 12,907.38 " " 21,896.16 " " 27,370.21 " " 13,294.60 " " 13,294.60 " " 12,907.38 " " 74,951.87 " " 32,763.50 " " 70,267.38 " " 13,294.60 " Inpatient 872 SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC " 43,444.10 " " 13,689.24 " " 7,424.42 " " 34,755.28 " " 15,418.10 " " 7,795.64 " " 15,418.10 " " 16,565.00 " " 7,647.15 " " 14,624.78 " " 7,424.42 " " 24,771.83 " " 7,424.42 " " 11,569.94 " " 14,462.43 " " 7,647.15 " " 7,647.15 " " 7,424.42 " " 34,755.28 " " 17,960.25 " " 32,583.08 " " 7,647.15 " Inpatient 880 ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION " 24,586.02 " " 7,747.05 " - " 19,668.82 " " 12,987.38 " " 6,694.44 " " 12,987.38 " - " 6,566.93 " " 12,319.13 " " 6,375.66 " " 14,018.95 " " 6,375.66 " " 9,622.53 " " 12,028.16 " " 6,566.93 " " 6,566.93 " " 6,375.66 " " 19,668.82 " " 15,128.75 " " 18,439.52 " " 6,566.93 " Inpatient 881 DEPRESSIVE NEUROSES " 19,671.01 " " 6,198.34 " - " 15,736.81 " " 12,048.45 " " 6,269.08 " " 12,048.45 " - " 6,149.67 " " 11,428.50 " " 5,970.55 " " 11,216.41 " " 5,970.55 " " 5,580.41 " " 6,975.52 " " 6,149.67 " " 6,149.67 " " 5,970.55 " " 15,736.81 " " 14,035.00 " " 14,753.26 " " 6,149.67 " Inpatient 882 NEUROSES EXCEPT DEPRESSIVE " 22,910.85 " " 7,219.21 " - " 18,328.68 " " 12,372.94 " " 6,416.09 " " 12,372.94 " - " 6,293.88 " " 11,736.30 " " 6,110.56 " " 13,063.77 " " 6,110.56 " " 5,498.59 " " 6,873.24 " " 6,293.88 " " 6,293.88 " " 6,110.56 " " 18,328.68 " " 14,413.00 " " 17,183.14 " " 6,293.88 " Inpatient 883 DISORDERS OF PERSONALITY AND IMPULSE CONTROL " 29,416.78 " " 9,269.23 " - " 27,681.50 " " 23,763.38 " " 11,576.31 " " 23,763.38 " - " 11,355.81 " " 22,540.65 " " 11,025.06 " " 16,773.45 " " 11,025.06 " " 12,519.10 " " 15,648.89 " " 11,355.81 " " 11,355.81 " " 11,025.06 " " 23,533.42 " " 27,681.50 " " 22,062.59 " " 11,355.81 " Inpatient 884 ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY " 70,590.93 " " 22,243.20 " - " 56,472.74 " " 21,742.79 " " 10,660.92 " " 21,742.79 " - " 10,457.86 " " 20,624.03 " " 10,153.26 " " 40,250.95 " " 10,153.26 " " 9,131.58 " " 11,414.48 " " 10,457.86 " " 10,457.86 " " 10,153.26 " " 56,472.74 " " 25,327.75 " " 52,943.20 " " 10,457.86 " Inpatient 885 PSYCHOSES " 35,307.54 " " 11,125.41 " - " 28,246.03 " " 18,619.51 " " 9,245.97 " " 18,619.51 " - " 9,069.86 " " 17,661.45 " " 8,805.69 " " 20,132.36 " " 8,805.69 " " 7,560.56 " " 9,450.70 " " 9,069.86 " " 9,069.86 " " 8,805.69 " " 28,246.03 " " 21,689.50 " " 26,480.66 " " 9,069.86 " Inpatient 894 "ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA" " 32,089.99 " " 10,111.56 " " 4,330.65 " " 25,671.99 " " 8,247.63 " " 4,547.18 " " 8,247.63 " " 7,000.00 " " 4,460.57 " " 7,823.25 " " 4,330.65 " " 18,297.71 " " 4,330.65 " " 5,809.52 " " 7,261.90 " " 4,460.57 " " 4,460.57 " " 4,330.65 " " 25,671.99 " " 9,607.50 " " 24,067.49 " " 4,460.57 " Inpatient 896 "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC" " 74,735.06 " " 23,549.02 " " 12,311.70 " " 59,788.05 " " 26,745.45 " " 12,927.29 " " 26,745.45 " " 23,984.00 " " 12,681.05 " " 25,369.28 " " 12,311.70 " " 42,613.93 " " 12,311.70 " " 21,094.28 " " 26,367.86 " " 12,681.05 " " 12,681.05 " " 12,311.70 " " 59,788.05 " " 31,155.25 " " 56,051.30 " " 12,681.05 " Inpatient 897 "ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC" " 35,572.25 " " 11,208.82 " " 6,132.60 " " 28,457.80 " " 12,424.02 " " 6,439.23 " " 12,424.02 " " 10,864.00 " " 6,316.58 " " 11,784.75 " " 6,132.60 " " 20,283.30 " " 6,132.60 " " 7,855.12 " " 9,818.91 " " 6,316.58 " " 6,316.58 " " 6,132.60 " " 28,457.80 " " 14,472.50 " " 26,679.19 " " 6,316.58 " Inpatient 907 OTHER O.R. PROCEDURES FOR INJURIES WITH MCC " 221,822.43 " " 69,896.25 " " 26,363.61 " " 177,457.94 " " 59,313.81 " " 27,681.79 " " 59,313.81 " " 59,589.00 " " 27,154.52 " " 56,261.85 " " 26,363.61 " " 126,483.15 " " 26,363.61 " " 42,310.72 " " 52,888.39 " " 27,154.52 " " 27,154.52 " " 26,363.61 " " 177,457.94 " " 69,093.50 " " 166,366.82 " " 27,154.52 " Inpatient 908 OTHER O.R. PROCEDURES FOR INJURIES WITH CC " 71,316.80 " " 22,471.92 " " 14,062.44 " " 57,053.44 " " 30,803.16 " " 14,765.56 " " 30,803.16 " " 30,799.00 " " 14,484.31 " " 29,218.20 " " 14,062.44 " " 40,664.84 " " 14,062.44 " " 22,534.38 " " 28,167.99 " " 14,484.31 " " 14,484.31 " " 14,062.44 " " 57,053.44 " " 35,882.00 " " 53,487.60 " " 14,484.31 " Inpatient 917 POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC " 68,718.25 " " 21,653.12 " " 10,355.49 " " 54,974.60 " " 22,211.51 " " 10,873.26 " " 22,211.51 " " 22,106.00 " " 10,666.15 " " 21,068.63 " " 10,355.49 " " 39,183.15 " " 10,355.49 " " 16,544.85 " " 20,681.08 " " 10,666.15 " " 10,666.15 " " 10,355.49 " " 54,974.60 " " 25,873.75 " " 51,538.69 " " 10,666.15 " Inpatient 918 POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC " 35,794.01 " " 11,278.69 " " 5,903.14 " " 28,635.21 " " 11,892.21 " " 6,198.30 " " 11,892.21 " " 10,089.00 " " 6,080.23 " " 11,280.30 " " 5,903.14 " " 20,409.74 " " 5,903.14 " " 7,806.03 " " 9,757.54 " " 6,080.23 " " 6,080.23 " " 5,903.14 " " 28,635.21 " " 13,853.00 " " 26,845.51 " " 6,080.23 " Inpatient 919 COMPLICATIONS OF TREATMENT WITH MCC " 56,001.16 " " 17,645.97 " " 12,725.24 " " 44,800.93 " " 27,703.91 " " 13,361.50 " " 27,703.91 " " 26,354.00 " " 13,107.00 " " 26,278.43 " " 12,725.24 " " 31,931.86 " " 12,725.24 " " 19,768.73 " " 24,710.92 " " 13,107.00 " " 13,107.00 " " 12,725.24 " " 44,800.93 " " 32,271.75 " " 42,000.87 " " 13,107.00 " Inpatient 920 COMPLICATIONS OF TREATMENT WITH CC " 37,381.15 " " 11,778.80 " " 7,413.40 " " 29,904.92 " " 15,392.57 " " 7,784.07 " " 15,392.57 " " 15,498.00 " " 7,635.80 " " 14,600.55 " " 7,413.40 " " 21,314.73 " " 7,413.40 " " 12,126.35 " " 15,157.94 " " 7,635.80 " " 7,635.80 " " 7,413.40 " " 29,904.92 " " 17,930.50 " " 28,035.86 " " 7,635.80 " Inpatient 923 "OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC" " 32,388.51 " " 10,205.62 " " 6,863.74 " " 25,910.81 " " 14,118.62 " " 7,206.93 " " 14,118.62 " " 11,562.00 " " 7,069.65 " " 13,392.15 " " 6,863.74 " " 18,467.93 " " 6,863.74 " " 9,475.24 " " 11,844.06 " " 7,069.65 " " 7,069.65 " " 6,863.74 " " 25,910.81 " " 16,446.50 " " 24,291.38 " " 7,069.65 " Inpatient 947 SIGNS AND SYMPTOMS WITH MCC " 53,067.41 " " 16,721.54 " " 8,511.42 " " 42,453.93 " " 17,937.46 " " 8,936.99 " " 17,937.46 " " 17,885.00 " " 8,766.76 " " 17,014.50 " " 8,511.42 " " 30,259.04 " " 8,511.42 " " 14,319.24 " " 17,899.05 " " 8,766.76 " " 8,766.76 " " 8,511.42 " " 42,453.93 " " 20,895.00 " " 39,800.56 " " 8,766.76 " Inpatient 948 SIGNS AND SYMPTOMS WITHOUT MCC " 37,674.95 " " 11,871.38 " " 5,873.97 " " 30,139.96 " " 11,824.60 " " 6,167.67 " " 11,824.60 " " 11,220.00 " " 6,050.19 " " 11,216.18 " " 5,873.97 " " 21,482.26 " " 5,873.97 " " 10,260.75 " " 12,825.95 " " 6,050.19 " " 6,050.19 " " 5,873.97 " " 30,139.96 " " 13,774.25 " " 28,256.21 " " 6,050.19 " Inpatient 951 OTHER FACTORS INFLUENCING HEALTH STATUS " 8,947.89 " " 2,819.48 " " 4,399.36 " " 14,456.00 " " 8,406.87 " " 4,619.33 " " 8,406.87 " " 14,456.00 " " 4,531.34 " " 7,974.30 " " 4,399.36 " " 5,102.09 " " 4,399.36 " " 6,104.09 " " 7,630.11 " " 4,531.34 " " 4,531.34 " " 4,399.36 " " 7,158.31 " " 9,793.00 " " 6,710.92 " " 4,531.34 " Inpatient 956 "LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA" " 131,888.78 " " 41,558.15 " " 25,727.10 " " 105,511.02 " " 57,838.55 " " 27,013.46 " " 57,838.55 " " 57,729.00 " " 26,498.91 " " 54,862.50 " " 25,727.10 " " 75,202.98 " " 25,727.10 " " 64,929.75 " " 81,162.18 " " 26,498.91 " " 26,498.91 " " 25,727.10 " " 105,511.02 " " 67,375.00 " " 98,916.59 " " 26,498.91 " Inpatient 957 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC " 236,096.55 " " 74,394.02 " " 48,872.99 " " 188,877.24 " " 111,484.18 " " 51,316.64 " " 111,484.18 " " 107,701.00 " " 50,339.18 " " 105,747.83 " " 48,872.99 " " 134,622.25 " " 48,872.99 " " 94,817.14 " " 118,521.41 " " 50,339.18 " " 50,339.18 " " 48,872.99 " " 188,877.24 " " 129,865.75 " " 177,072.41 " " 50,339.18 " Inpatient 958 OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC " 145,149.62 " " 45,736.65 " " 28,032.68 " " 116,119.70 " " 63,182.23 " " 29,434.31 " " 63,182.23 " " 60,734.00 " " 28,873.66 " " 59,931.23 " " 28,032.68 " " 82,764.31 " " 28,032.68 " " 46,680.31 " " 58,350.38 " " 28,873.66 " " 28,873.66 " " 28,032.68 " " 116,119.70 " " 73,599.75 " " 108,862.22 " " 28,873.66 " Inpatient 963 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC " 80,426.79 " " 25,342.48 " " 18,466.83 " " 64,341.43 " " 41,011.29 " " 19,390.17 " " 41,011.29 " " 42,592.00 " " 19,020.83 " " 38,901.08 " " 18,466.83 " " 45,859.36 " " 18,466.83 " " 32,857.57 " " 41,071.95 " " 19,020.83 " " 19,020.83 " " 18,466.83 " " 64,341.43 " " 47,773.25 " " 60,320.09 " " 19,020.83 " Inpatient 964 OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC " 61,360.93 " " 19,334.83 " " 10,441.70 " " 49,088.74 " " 22,411.31 " " 10,963.79 " " 22,411.31 " " 23,236.00 " " 10,754.95 " " 21,258.15 " " 10,441.70 " " 34,988.00 " " 10,441.70 " " 18,672.28 " " 23,340.36 " " 10,754.95 " " 10,754.95 " " 10,441.70 " " 49,088.74 " " 26,106.50 " " 46,020.70 " " 10,754.95 " Inpatient 965 OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC " 46,149.73 " " 14,541.78 " " 6,686.79 " " 36,919.78 " " 13,708.49 " " 7,021.13 " " 13,708.49 " " 14,818.00 " " 6,887.39 " " 13,003.13 " " 6,686.79 " " 26,314.58 " " 6,686.79 " " 12,404.55 " " 15,505.69 " " 6,887.39 " " 6,887.39 " " 6,686.79 " " 36,919.78 " " 15,968.75 " " 34,612.30 " " 6,887.39 " Inpatient 974 HIV WITH MAJOR RELATED CONDITION WITH MCC " 118,314.06 " " 37,280.76 " " 18,211.44 " " 94,651.25 " " 40,419.38 " " 19,122.01 " " 40,419.38 " " 42,243.00 " " 18,757.78 " " 38,339.63 " " 18,211.44 " " 67,462.68 " " 18,211.44 " " 34,471.17 " " 43,088.96 " " 18,757.78 " " 18,757.78 " " 18,211.44 " " 94,651.25 " " 47,083.75 " " 88,735.55 " " 18,757.78 " Inpatient 981 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC " 142,970.99 " " 45,050.16 " " 30,682.44 " " 114,376.79 " " 69,323.63 " " 32,216.56 " " 69,323.63 " " 78,617.00 " " 31,602.91 " " 65,756.63 " " 30,682.44 " " 81,522.06 " " 30,682.44 " " 52,534.98 " " 65,668.72 " " 31,602.91 " " 31,602.91 " " 30,682.44 " " 114,376.79 " " 80,753.75 " " 107,228.24 " " 31,602.91 " Inpatient 982 EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC " 97,316.87 " " 30,664.55 " " 17,213.89 " " 77,853.50 " " 38,107.34 " " 18,074.58 " " 38,107.34 " " 44,290.00 " " 17,730.31 " " 36,146.55 " " 17,213.89 " " 55,490.08 " " 17,213.89 " " 30,062.21 " " 37,577.78 " " 17,730.31 " " 17,730.31 " " 17,213.89 " " 77,853.50 " " 44,390.50 " " 72,987.65 " " 17,730.31 " Inpatient 987 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC " 134,188.50 " " 42,282.80 " " 22,005.90 " " 107,350.80 " " 49,213.85 " " 23,106.20 " " 49,213.85 " " 51,932.00 " " 22,666.08 " " 46,681.58 " " 22,005.90 " " 76,514.28 " " 22,005.90 " " 35,813.46 " " 44,766.82 " " 22,666.08 " " 22,666.08 " " 22,005.90 " " 107,350.80 " " 57,328.25 " " 100,641.38 " " 22,666.08 " Inpatient 988 NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC " 70,062.82 " " 22,076.79 " " 11,832.70 " " 56,050.26 " " 25,635.25 " " 12,424.34 " " 25,635.25 " " 27,760.00 " " 12,187.68 " " 24,316.20 " " 11,832.70 " " 39,949.82 " " 11,832.70 " " 20,505.14 " " 25,631.44 " " 12,187.68 " " 12,187.68 " " 11,832.70 " " 56,050.26 " " 29,862.00 " " 52,547.12 " " 12,187.68 " Inpatient 20.4 OPEN CRANIOTOMY FOR TRAUMA " 653,471.84 " " 205,908.98 " - " 82,484.42 " " 57,517.63 " - " 47,543.02 " - " 57,247.10 " - " 45,852.70 " - - - " 48,833.13 " " 45,852.70 " " 45,852.70 " " 68,779.05 " " 82,484.42 " " 81,682.00 " Inpatient 21.1 OPEN CRANIOTOMY EXCEPT TRAUMA " 92,210.79 " " 29,055.62 " - " 29,102.73 " " 20,293.77 " - " 16,774.46 " - " 20,198.32 " - " 16,178.07 " - - - " 17,229.64 " " 16,178.07 " " 16,178.07 " " 24,267.11 " " 29,102.73 " " 28,819.61 " Inpatient 21.3 OPEN CRANIOTOMY EXCEPT TRAUMA " 346,234.50 " " 109,098.49 " - " 58,235.02 " " 40,608.15 " - " 33,565.96 " - " 40,417.15 " - " 32,372.57 " - - - " 34,476.79 " " 32,372.57 " " 32,372.57 " " 48,558.86 " " 58,235.02 " " 57,668.50 " Inpatient 21.4 OPEN CRANIOTOMY EXCEPT TRAUMA " 419,226.83 " " 132,098.37 " - " 97,086.29 " " 67,699.73 " - " 55,959.36 " - " 67,381.31 " - " 53,969.81 " - - - " 57,477.85 " " 53,969.81 " " 53,969.81 " " 80,954.72 " " 97,086.29 " " 96,141.82 " Inpatient 52.2 ALTERATION IN CONSCIOUSNESS " 41,806.41 " " 13,173.20 " - " 9,870.49 " " 6,882.84 " - " 5,689.23 " - " 6,850.47 " - " 5,486.96 " - - - " 5,843.61 " " 5,486.96 " " 5,486.96 " " 8,230.44 " " 9,870.49 " " 9,774.47 " Inpatient 52.3 ALTERATION IN CONSCIOUSNESS " 19,817.10 " " 6,244.37 " - " 12,954.94 " " 9,033.67 " - " 7,467.07 " - " 8,991.19 " - " 7,201.59 " - - - " 7,669.69 " " 7,201.59 " " 7,201.59 " " 10,802.39 " " 12,954.94 " " 12,828.91 " Inpatient 53.1 SEIZURE " 30,003.45 " " 9,454.09 " - " 7,660.62 " " 5,341.86 " - " 4,415.49 " - " 5,316.74 " - " 4,258.50 " - - - " 4,535.30 " " 4,258.50 " " 4,258.50 " " 6,387.75 " " 7,660.62 " " 7,586.09 " Inpatient 53.2 SEIZURE " 28,243.84 " " 8,899.63 " - " 9,622.89 " " 6,710.19 " - " 5,546.52 " - " 6,678.63 " - " 5,349.32 " - - - " 5,697.03 " " 5,349.32 " " 5,349.32 " " 8,023.98 " " 9,622.89 " " 9,529.28 " Inpatient 55.1 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE " 121,386.25 " " 38,248.81 " - " 9,989.98 " " 6,966.16 " - " 5,758.10 " - " 6,933.39 " - " 5,553.38 " - - - " 5,914.35 " " 5,553.38 " " 5,553.38 " " 8,330.07 " " 9,989.98 " " 9,892.79 " Inpatient 55.2 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE " 53,184.66 " " 16,758.49 " - " 13,695.26 " " 9,549.91 " - " 7,893.78 " - " 9,504.99 " - " 7,613.13 " - - - " 8,107.98 " " 7,613.13 " " 7,613.13 " " 11,419.70 " " 13,695.26 " " 13,562.03 " Inpatient 55.4 HEAD TRAUMA W COMA >1 HR OR HEMORRHAGE " 463,368.82 " " 146,007.52 " - " 41,574.79 " " 28,990.73 " - " 23,963.21 " - " 28,854.37 " - " 23,111.23 " - - - " 24,613.46 " " 23,111.23 " " 23,111.23 " " 34,666.85 " " 41,574.79 " " 41,170.35 " Inpatient 113.2 INFECTIONS OF UPPER RESPIRATORY TRACT " 30,456.64 " " 9,596.89 " - " 7,293.55 " " 5,085.90 " - " 4,203.91 " - " 5,061.98 " - " 4,054.45 " - - - " 4,317.99 " " 4,054.45 " " 4,054.45 " " 6,081.68 " " 7,293.55 " " 7,222.60 " Inpatient 114.2 DENTAL DISEASES & DISORDERS " 20,216.65 " " 6,370.27 " - " 8,887.50 " " 6,197.39 " - " 5,122.65 " - " 6,168.24 " - " 4,940.52 " - - - " 5,261.65 " " 4,940.52 " " 4,940.52 " " 7,410.78 " " 8,887.50 " " 8,801.04 " Inpatient 115.2 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES " " 39,008.04 " " 12,291.43 " - " 10,012.14 " " 6,981.61 " - " 5,770.88 " - " 6,948.78 " - " 5,565.70 " - - - " 5,927.47 " " 5,565.70 " " 5,565.70 " " 8,348.55 " " 10,012.14 " " 9,914.74 " Inpatient 115.3 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES " " 55,572.67 " " 17,510.95 " - " 16,055.40 " " 11,195.67 " - " 9,254.14 " - " 11,143.01 " - " 8,925.12 " - - - " 9,505.25 " " 8,925.12 " " 8,925.12 " " 13,387.68 " " 16,055.40 " " 15,899.21 " Inpatient 115.4 "OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES " " 53,755.42 " " 16,938.33 " - " 32,860.97 " " 22,914.45 " - " 18,940.67 " - " 22,806.67 " - " 18,267.26 " - - - " 19,454.63 " " 18,267.26 " " 18,267.26 " " 27,400.89 " " 32,860.97 " " 32,541.30 " Inpatient 121.2 OTHER RESPIRATORY & CHEST PROCEDURES " 86,404.89 " " 27,226.18 " - " 24,463.73 " " 17,058.92 " - " 14,100.60 " - " 16,978.69 " - " 13,599.27 " - - - " 14,483.22 " " 13,599.27 " " 13,599.27 " " 20,398.91 " " 24,463.73 " " 24,225.74 " Inpatient 121.4 OTHER RESPIRATORY & CHEST PROCEDURES " 115,159.32 " " 36,286.70 " - " 71,467.11 " " 49,835.09 " - " 41,192.78 " - " 49,600.70 " - " 39,728.23 " - - - " 42,310.56 " " 39,728.23 " " 39,728.23 " " 59,592.35 " " 71,467.11 " " 70,771.87 " Inpatient 130.3 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS " 586,248.51 " " 184,726.91 " - " 61,304.70 " " 42,748.69 " - " 35,335.28 " - " 42,547.62 " - " 34,078.99 " - - - " 36,294.12 " " 34,078.99 " " 34,078.99 " " 51,118.49 " " 61,304.70 " " 60,708.31 " Inpatient 130.4 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS " 452,638.53 " " 142,626.40 " - " 80,975.45 " " 56,465.40 " - " 46,673.27 " - " 56,199.82 " - " 45,013.87 " - - - " 47,939.77 " " 45,013.87 " " 45,013.87 " " 67,520.81 " " 80,975.45 " " 80,187.71 " Inpatient 133.2 RESPIRATORY FAILURE " 919,178.57 " " 289,633.17 " - " 10,775.86 " " 7,514.17 " - " 6,211.08 " - " 7,478.83 " - " 5,990.25 " - - - " 6,379.62 " " 5,990.25 " " 5,990.25 " " 8,985.38 " " 10,775.86 " " 10,671.03 " Inpatient 133.3 RESPIRATORY FAILURE " 68,930.04 " " 21,719.86 " - " 15,935.92 " " 11,112.35 " - " 9,185.27 " - " 11,060.09 " - " 8,858.70 " - - - " 9,434.52 " " 8,858.70 " " 8,858.70 " " 13,288.05 " " 15,935.92 " " 15,780.89 " Inpatient 133.4 RESPIRATORY FAILURE " 137,677.79 " " 43,382.27 " - " 26,864.54 " " 18,733.05 " - " 15,484.39 " - " 18,644.94 " - " 14,933.87 " - - - " 15,904.57 " " 14,933.87 " " 14,933.87 " " 22,400.81 " " 26,864.54 " " 26,603.20 " Inpatient 134.1 PULMONARY EMBOLISM " 61,054.24 " " 19,238.19 " - " 8,747.08 " " 6,099.47 " - " 5,041.71 " - " 6,070.78 " - " 4,862.46 " - - - " 5,178.52 " " 4,862.46 " " 4,862.46 " " 7,293.69 " " 8,747.08 " " 8,661.99 " Inpatient 134.2 PULMONARY EMBOLISM " 49,034.42 " " 15,450.75 " - " 11,564.23 " " 8,063.91 " - " 6,665.48 " - " 8,025.98 " - " 6,428.50 " - - - " 6,846.35 " " 6,428.50 " " 6,428.50 " " 9,642.75 " " 11,564.23 " " 11,451.73 " Inpatient 134.4 PULMONARY EMBOLISM " 60,638.44 " " 19,107.17 " - " 24,647.27 " " 17,186.91 " - " 14,206.39 " - " 17,106.07 " - " 13,701.30 " - - - " 14,591.88 " " 13,701.30 " " 13,701.30 " " 20,551.95 " " 24,647.27 " " 24,407.50 " Inpatient 135.1 MAJOR CHEST & RESPIRATORY TRAUMA " 38,210.41 " " 12,040.10 " - " 10,807.90 " " 7,536.51 " - " 6,229.54 " - " 7,501.06 " - " 6,008.06 " - - - " 6,398.58 " " 6,008.06 " " 6,008.06 " " 9,012.09 " " 10,807.90 " " 10,702.76 " Inpatient 135.2 MAJOR CHEST & RESPIRATORY TRAUMA " 54,284.43 " " 17,105.02 " - " 11,628.29 " " 8,108.58 " - " 6,702.40 " - " 8,070.44 " - " 6,464.11 " - - - " 6,884.28 " " 6,464.11 " " 6,464.11 " " 9,696.17 " " 11,628.29 " " 11,515.17 " Inpatient 135.3 MAJOR CHEST & RESPIRATORY TRAUMA " 42,385.38 " " 13,355.63 " - " 17,379.60 " " 12,119.06 " - " 10,017.39 " - " 12,062.06 " - " 9,661.24 " - - - " 10,289.22 " " 9,661.24 " " 9,661.24 " " 14,491.86 " " 17,379.60 " " 17,210.53 " Inpatient 135.4 MAJOR CHEST & RESPIRATORY TRAUMA " 38,355.54 " " 12,085.83 " - " 30,247.08 " " 21,091.75 " - " 17,434.05 " - " 20,992.54 " - " 16,814.21 " - - - " 17,907.13 " " 16,814.21 " " 16,814.21 " " 25,221.32 " " 30,247.08 " " 29,952.83 " Inpatient 136.3 RESPIRATORY MALIGNANCY " 40,760.09 " " 12,843.50 " - " 18,989.57 " " 13,241.71 " - " 10,945.36 " - " 13,179.43 " - " 10,556.21 " - - - " 11,242.36 " " 10,556.21 " " 10,556.21 " " 15,834.32 " " 18,989.57 " " 18,804.83 " Inpatient 136.4 RESPIRATORY MALIGNANCY " 180,525.83 " " 56,883.69 " - " 27,691.08 " " 19,309.41 " - " 15,960.80 " - " 19,218.58 " - " 15,393.34 " - - - " 16,393.91 " " 15,393.34 " " 15,393.34 " " 23,090.01 " " 27,691.08 " " 27,421.70 " Inpatient 137.1 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS " 143,857.35 " " 45,329.45 " - " 9,348.20 " " 6,518.64 " - " 5,388.19 " - " 6,487.98 " - " 5,196.62 " - - - " 5,534.40 " " 5,196.62 " " 5,196.62 " " 7,794.93 " " 9,348.20 " " 9,257.26 " Inpatient 137.2 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS " 45,729.36 " " 14,409.32 " - " 11,948.55 " " 8,331.90 " - " 6,887.00 " - " 8,292.71 " - " 6,642.14 " - - - " 7,073.88 " " 6,642.14 " " 6,642.14 " " 9,963.21 " " 11,948.55 " " 11,832.31 " Inpatient 137.3 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS " 84,701.77 " " 26,689.53 " - " 17,136.93 " " 11,949.84 " - " 9,877.52 " - " 11,893.64 " - " 9,526.34 " - - - " 10,145.55 " " 9,526.34 " " 9,526.34 " " 14,289.51 " " 17,136.93 " " 16,970.22 " Inpatient 137.4 MAJOR RESPIRATORY INFECTIONS & INFLAMMATIONS " 110,617.03 " " 34,855.43 " - " 25,148.62 " " 17,536.51 " - " 14,495.36 " - " 17,454.03 " - " 13,980.00 " - - - " 14,888.70 " " 13,980.00 " " 13,980.00 " " 20,970.00 " " 25,148.62 " " 24,903.97 " Inpatient 139.1 OTHER PNEUMONIA " 66,277.02 " " 20,883.89 " - " 6,517.50 " " 4,544.75 " - " 3,756.61 " - " 4,523.38 " - " 3,623.05 " - - - " 3,858.55 " " 3,623.05 " " 3,623.05 " " 5,434.58 " " 6,517.50 " " 6,454.10 " Inpatient 139.2 OTHER PNEUMONIA " 74,845.24 " " 23,583.74 " - " 9,020.55 " " 6,290.16 " - " 5,199.33 " - " 6,260.58 " - " 5,014.48 " - - - " 5,340.42 " " 5,014.48 " " 5,014.48 " " 7,521.72 " " 9,020.55 " " 8,932.79 " Inpatient 139.3 OTHER PNEUMONIA " 62,360.58 " " 19,649.82 " - " 13,392.23 " " 9,338.61 " - " 7,719.12 " - " 9,294.68 " - " 7,444.68 " - - - " 7,928.58 " " 7,444.68 " " 7,444.68 " " 11,167.02 " " 13,392.23 " " 13,261.95 " Inpatient 139.4 OTHER PNEUMONIA " 53,950.81 " " 16,999.90 " - " 21,285.66 " " 14,842.81 " - " 12,268.80 " - " 14,773.00 " - " 11,832.60 " - - - " 12,601.72 " " 11,832.60 " " 11,832.60 " " 17,748.90 " " 21,285.66 " " 21,078.59 " Inpatient 140.1 CHRONIC OBSTRUCTIVE PULMONARY DISEASE " 40,070.29 " " 12,626.15 " - " 7,573.17 " " 5,280.89 " - " 4,365.08 " - " 5,256.05 " - " 4,209.89 " - - - " 4,483.53 " " 4,209.89 " " 4,209.89 " " 6,314.84 " " 7,573.17 " " 7,499.50 " Inpatient 140.2 CHRONIC OBSTRUCTIVE PULMONARY DISEASE " 47,519.21 " " 14,973.30 " - " 9,514.49 " " 6,634.60 " - " 5,484.04 " - " 6,603.39 " - " 5,289.06 " - - - " 5,632.85 " " 5,289.06 " " 5,289.06 " " 7,933.59 " " 9,514.49 " " 9,421.93 " Inpatient 140.3 CHRONIC OBSTRUCTIVE PULMONARY DISEASE " 50,077.81 " " 15,779.52 " - " 11,868.48 " " 8,276.07 " - " 6,840.85 " - " 8,237.14 " - " 6,597.63 " - - - " 7,026.48 " " 6,597.63 " " 6,597.63 " " 9,896.45 " " 11,868.48 " " 11,753.02 " Inpatient 140.4 CHRONIC OBSTRUCTIVE PULMONARY DISEASE " 59,719.84 " " 18,817.72 " - " 18,435.25 " " 12,855.18 " - " 10,625.86 " - " 12,794.72 " - " 10,248.07 " - - - " 10,914.19 " " 10,248.07 " " 10,248.07 " " 15,372.11 " " 18,435.25 " " 18,255.91 " Inpatient 141.1 ASTHMA " 34,680.32 " " 10,927.77 " - " 5,828.92 " " 4,064.59 " - " 3,359.72 " - " 4,045.48 " - " 3,240.27 " - - - " 3,450.89 " " 3,240.27 " " 3,240.27 " " 4,860.41 " " 5,828.92 " " 5,772.22 " Inpatient 141.2 ASTHMA " 27,272.74 " " 8,593.64 " - " 8,398.47 " " 5,856.38 " - " 4,840.78 " - " 5,828.83 " - " 4,668.67 " - - - " 4,972.13 " " 4,668.67 " " 4,668.67 " " 7,003.01 " " 8,398.47 " " 8,316.77 " Inpatient 141.3 ASTHMA " 59,117.70 " " 18,627.99 " - " 11,973.19 " " 8,349.09 " - " 6,901.20 " - " 8,309.82 " - " 6,655.84 " - - - " 7,088.47 " " 6,655.84 " " 6,655.84 " " 9,983.76 " " 11,973.19 " " 11,856.71 " Inpatient 143.1 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DI " " 20,046.32 " " 6,316.60 " - " 7,312.02 " " 5,098.78 " - " 4,214.56 " - " 5,074.80 " - " 4,064.72 " - - - " 4,328.93 " " 4,064.72 " " 4,064.72 " " 6,097.08 " " 7,312.02 " " 7,240.89 " Inpatient 143.2 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DI " " 17,906.24 " " 5,642.26 " - " 10,422.34 " " 7,267.65 " - " 6,007.31 " - " 7,233.47 " - " 5,793.73 " - - - " 6,170.32 " " 5,793.73 " " 5,793.73 " " 8,690.60 " " 10,422.34 " " 10,320.95 " Inpatient 143.3 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DI " " 22,710.80 " " 7,156.17 " - " 15,815.21 " " 11,028.18 " - " 9,115.69 " - " 10,976.31 " - " 8,791.60 " - - - " 9,363.05 " " 8,791.60 " " 8,791.60 " " 13,187.40 " " 15,815.21 " " 15,661.36 " Inpatient 143.4 "OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS & MINOR DI " " 616,638.04 " " 194,302.65 " - " 24,819.73 " " 17,307.17 " - " 14,305.79 " - " 17,225.77 " - " 13,797.17 " - - - " 14,693.99 " " 13,797.17 " " 13,797.17 " " 20,695.76 " " 24,819.73 " " 24,578.28 " Inpatient 144.2 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES " " 73,716.84 " " 23,228.18 " - " 10,038.01 " " 6,999.65 " - " 5,785.79 " - " 6,966.73 " - " 5,580.08 " - - - " 5,942.79 " " 5,580.08 " " 5,580.08 " " 8,370.12 " " 10,038.01 " " 9,940.35 " Inpatient 144.3 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES " " 59,956.47 " " 18,892.28 " - " 14,621.59 " " 10,195.85 " - " 8,427.70 " - " 10,147.90 " - " 8,128.07 " - - - " 8,656.39 " " 8,128.07 " " 8,128.07 " " 12,192.11 " " 14,621.59 " " 14,479.34 " Inpatient 144.4 "RESPIRATORY SIGNS, SYMPTOMS & MINOR DIAGNOSES " " 191,510.49 " " 60,344.96 " - " 23,990.72 " " 16,729.09 " - " 13,827.96 " - " 16,650.41 " - " 13,336.33 " - - - " 14,203.19 " " 13,336.33 " " 13,336.33 " " 20,004.50 " " 23,990.72 " " 23,757.34 " Inpatient 145.1 ACUTE BRONCHITIS & RELATED SYMPTOMS " 31,110.09 " " 9,802.79 " - " 7,271.37 " " 5,070.44 " - " 4,191.13 " - " 5,046.59 " - " 4,042.12 " - - - " 4,304.86 " " 4,042.12 " " 4,042.12 " " 6,063.18 " " 7,271.37 " " 7,200.63 " Inpatient 145.2 ACUTE BRONCHITIS & RELATED SYMPTOMS " 55,068.13 " " 17,351.97 " - " 8,768.02 " " 6,114.07 " - " 5,053.78 " - " 6,085.31 " - " 4,874.10 " - - - " 5,190.92 " " 4,874.10 " " 4,874.10 " " 7,311.15 " " 8,768.02 " " 8,682.72 " Inpatient 163.2 CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX " 263,332.99 " " 82,976.23 " - " 59,351.04 " " 41,386.37 " - " 34,209.22 " - " 41,191.71 " - " 32,992.96 " - - - " 35,137.50 " " 32,992.96 " " 32,992.96 " " 49,489.44 " " 59,351.04 " " 58,773.66 " Inpatient 163.3 CARDIAC VALVE PROCEDURES W/O AMI OR COMPLEX PDX " 244,843.17 " " 77,150.08 " - " 77,607.69 " " 54,117.01 " - " 44,732.13 " - " 53,862.47 " - " 43,141.75 " - - - " 45,945.96 " " 43,141.75 " " 43,141.75 " " 64,712.63 " " 77,607.69 " " 76,852.71 " Inpatient 165.2 CORONARY BYPASS W AMI OR COMPLEX PDX " 207,249.66 " " 65,304.37 " - " 57,898.73 " " 40,373.65 " - " 33,372.13 " - " 40,183.76 " - " 32,185.63 " - - - " 34,277.70 " " 32,185.63 " " 32,185.63 " " 48,278.45 " " 57,898.73 " " 57,335.48 " Inpatient 165.4 CORONARY BYPASS W AMI OR COMPLEX PDX " 397,271.62 " " 125,180.29 " - " 108,656.67 " " 75,767.93 " - " 62,628.39 " - " 75,411.56 " - " 60,401.73 " - - - " 64,327.84 " " 60,401.73 " " 60,401.73 " " 90,602.60 " " 108,656.67 " " 107,599.64 " Inpatient 166.3 CORONARY BYPASS W/O AMI OR COMPLEX PDX " 218,985.14 " " 69,002.22 " - " 61,892.27 " " 43,158.41 " - " 35,673.95 " - " 42,955.42 " - " 34,405.62 " - - - " 36,641.99 " " 34,405.62 " " 34,405.62 " " 51,608.43 " " 61,892.27 " " 61,290.17 " Inpatient 174.1 PERCUTANEOUS CARDIAC INTERVENTION W AMI " 79,491.85 " " 25,047.88 " - " 26,403.84 " " 18,411.79 " - " 15,218.85 " - " 18,325.20 " - " 14,677.77 " - - - " 15,631.83 " " 14,677.77 " " 14,677.77 " " 22,016.66 " " 26,403.84 " " 26,146.98 " Inpatient 174.2 PERCUTANEOUS CARDIAC INTERVENTION W AMI " 87,055.28 " " 27,431.12 " - " 29,717.40 " " 20,722.39 " - " 17,128.75 " - " 20,624.92 " - " 16,519.76 " - - - " 17,593.54 " " 16,519.76 " " 16,519.76 " " 24,779.64 " " 29,717.40 " " 29,428.30 " Inpatient 174.3 PERCUTANEOUS CARDIAC INTERVENTION W AMI " 160,381.79 " " 50,536.30 " - " 38,287.10 " " 26,698.17 " - " 22,068.22 " - " 26,572.60 " - " 21,283.62 " - - - " 22,667.06 " " 21,283.62 " " 21,283.62 " " 31,925.43 " " 38,287.10 " " 37,914.64 " Inpatient 174.4 PERCUTANEOUS CARDIAC INTERVENTION W AMI " 106,680.34 " " 33,614.98 " - " 54,045.63 " " 37,686.83 " - " 31,151.25 " - " 37,509.57 " - " 30,043.71 " - - - " 31,996.55 " " 30,043.71 " " 30,043.71 " " 45,065.57 " " 54,045.63 " " 53,519.86 " Inpatient 175.1 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI " 64,273.07 " " 20,252.44 " - " 31,251.01 " " 21,791.80 " - " 18,012.70 " - " 21,689.30 " - " 17,372.29 " - - - " 18,501.49 " " 17,372.29 " " 17,372.29 " " 26,058.44 " " 31,251.01 " " 30,947.00 " Inpatient 175.2 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI " 74,508.03 " " 23,477.48 " - " 33,787.30 " " 23,560.39 " - " 19,474.59 " - " 23,449.58 " - " 18,782.20 " - - - " 20,003.04 " " 18,782.20 " " 18,782.20 " " 28,173.30 " " 33,787.30 " " 33,458.61 " Inpatient 175.3 PERCUTANEOUS CARDIAC INTERVENTION W/O AMI " 86,366.60 " " 27,214.12 " - " 41,664.72 " " 29,053.43 " - " 24,015.04 " - " 28,916.78 " - " 23,161.22 " - - - " 24,666.70 " " 23,161.22 " " 23,161.22 " " 34,741.83 " " 41,664.72 " " 41,259.40 " Inpatient 179.2 DEFIBRILLATOR IMPLANTS " 119,913.97 " " 37,784.89 " - " 60,739.28 " " 42,354.41 " - " 35,009.39 " - " 42,155.20 " - " 33,764.68 " - - - " 35,959.38 " " 33,764.68 " " 33,764.68 " " 50,647.02 " " 60,739.28 " " 60,148.40 " Inpatient 179.3 DEFIBRILLATOR IMPLANTS " 176,383.93 " " 55,578.58 " - " 72,158.16 " " 50,316.97 " - " 41,591.09 " - " 50,080.31 " - " 40,112.38 " - - - " 42,719.68 " " 40,112.38 " " 40,112.38 " " 60,168.57 " " 72,158.16 " " 71,456.19 " Inpatient 180.2 OTHER CIRCULATORY SYSTEM PROCEDURES " 58,847.50 " " 18,542.85 " - " 22,448.49 " " 15,653.67 " - " 12,939.04 " - " 15,580.04 " - " 12,479.01 " - - - " 13,290.15 " " 12,479.01 " " 12,479.01 " " 18,718.52 " " 22,448.49 " " 22,230.11 " Inpatient 180.3 OTHER CIRCULATORY SYSTEM PROCEDURES " 70,955.93 " " 22,358.21 " - " 32,147.76 " " 22,417.12 " - " 18,529.58 " - " 22,311.68 " - " 17,870.79 " - - - " 19,032.39 " " 17,870.79 " " 17,870.79 " " 26,806.19 " " 32,147.76 " " 31,835.03 " Inpatient 181.1 LOWER EXTREMITY ARTERIAL PROCEDURES " 66,441.68 " " 20,935.77 " - " 21,003.58 " " 14,646.11 " - " 12,106.21 " - " 14,577.22 " - " 11,675.79 " - - - " 12,434.72 " " 11,675.79 " " 11,675.79 " " 17,513.69 " " 21,003.58 " " 20,799.25 " Inpatient 181.2 LOWER EXTREMITY ARTERIAL PROCEDURES " 85,219.83 " " 26,852.77 " - " 29,558.50 " " 20,611.59 " - " 17,037.16 " - " 20,514.64 " - " 16,431.43 " - - - " 17,499.47 " " 16,431.43 " " 16,431.43 " " 24,647.15 " " 29,558.50 " " 29,270.95 " Inpatient 181.3 LOWER EXTREMITY ARTERIAL PROCEDURES " 115,419.69 " " 36,368.74 " - " 47,684.58 " " 33,251.17 " - " 27,484.81 " - " 33,094.78 " - " 26,507.63 " - - - " 28,230.63 " " 26,507.63 " " 26,507.63 " " 39,761.45 " " 47,684.58 " " 47,220.69 " Inpatient 182.1 OTHER PERIPHERAL VASCULAR PROCEDURES " 87,840.27 " " 27,678.47 " - " 34,703.77 " " 24,199.46 " - " 20,002.83 " - " 24,085.64 " - " 19,291.66 " - - - " 20,545.62 " " 19,291.66 " " 19,291.66 " " 28,937.49 " " 34,703.77 " " 34,366.16 " Inpatient 182.2 OTHER PERIPHERAL VASCULAR PROCEDURES " 79,257.12 " " 24,973.92 " - " 35,224.82 " " 24,562.80 " - " 20,303.16 " - " 24,447.27 " - " 19,581.31 " - - - " 20,854.10 " " 19,581.31 " " 19,581.31 " " 29,371.97 " " 35,224.82 " " 34,882.15 " Inpatient 182.3 OTHER PERIPHERAL VASCULAR PROCEDURES " 158,026.03 " " 49,794.00 " - " 39,900.77 " " 27,823.41 " - " 22,998.32 " - " 27,692.54 " - " 22,180.65 " - - - " 23,622.39 " " 22,180.65 " " 22,180.65 " " 33,270.98 " " 39,900.77 " " 39,512.61 " Inpatient 182.4 OTHER PERIPHERAL VASCULAR PROCEDURES " 167,777.75 " " 52,866.77 " - " 74,611.93 " " 52,028.02 " - " 43,005.41 " - " 51,783.31 " - " 41,476.42 " - - - " 44,172.39 " " 41,476.42 " " 41,476.42 " " 62,214.63 " " 74,611.93 " " 73,886.09 " Inpatient 190.1 ACUTE MYOCARDIAL INFARCTION " 58,784.75 " " 18,523.07 " - " 9,693.10 " " 6,759.15 " - " 5,586.99 " - " 6,727.35 " - " 5,388.35 " - - - " 5,738.59 " " 5,388.35 " " 5,388.35 " " 8,082.53 " " 9,693.10 " " 9,598.81 " Inpatient 190.2 ACUTE MYOCARDIAL INFARCTION " 28,141.59 " " 8,867.42 " - " 11,779.79 " " 8,214.23 " - " 6,789.73 " - " 8,175.59 " - " 6,548.33 " - - - " 6,973.97 " " 6,548.33 " " 6,548.33 " " 9,822.50 " " 11,779.79 " " 11,665.20 " Inpatient 190.3 ACUTE MYOCARDIAL INFARCTION " 81,490.76 " " 25,677.74 " - " 16,246.33 " " 11,328.81 " - " 9,364.19 " - " 11,275.53 " - " 9,031.26 " - - - " 9,618.29 " " 9,031.26 " " 9,031.26 " " 13,546.89 " " 16,246.33 " " 16,088.29 " Inpatient 190.4 ACUTE MYOCARDIAL INFARCTION " 64,224.05 " " 20,237.00 " - " 24,445.25 " " 17,046.04 " - " 14,089.95 " - " 16,965.87 " - " 13,589.00 " - - - " 14,472.29 " " 13,589.00 " " 13,589.00 " " 20,383.50 " " 24,445.25 " " 24,207.44 " Inpatient 192.1 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS " 62,687.68 " " 19,752.89 " - " 14,606.80 " " 10,185.54 " - " 8,419.18 " - " 10,137.63 " - " 8,119.85 " - - - " 8,647.64 " " 8,119.85 " " 8,119.85 " " 12,179.78 " " 14,606.80 " " 14,464.70 " Inpatient 192.2 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS " 58,518.11 " " 18,439.06 " - " 17,972.09 " " 12,532.21 " - " 10,358.90 " - " 12,473.26 " - " 9,990.60 " - - - " 10,639.99 " " 9,990.60 " " 9,990.60 " " 14,985.90 " " 17,972.09 " " 17,797.25 " Inpatient 192.3 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS " 65,319.73 " " 20,582.25 " - " 26,268.33 " " 18,317.30 " - " 15,140.75 " - " 18,231.15 " - " 14,602.44 " - - - " 15,551.60 " " 14,602.44 " " 14,602.44 " " 21,903.66 " " 26,268.33 " " 26,012.79 " Inpatient 192.4 CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS " 72,070.36 " " 22,709.37 " - " 43,023.41 " " 30,000.87 " - " 24,798.17 " - " 29,859.76 " - " 23,916.51 " - - - " 25,471.08 " " 23,916.51 " " 23,916.51 " " 35,874.77 " " 43,023.41 " " 42,604.87 " Inpatient 194.1 HEART FAILURE " 52,037.31 " " 16,396.96 " - " 7,328.04 " " 5,109.95 " - " 4,223.79 " - " 5,085.91 " - " 4,073.62 " - - - " 4,338.41 " " 4,073.62 " " 4,073.62 " " 6,110.43 " " 7,328.04 " " 7,256.75 " Inpatient 194.2 HEART FAILURE " 50,979.62 " " 16,063.68 " - " 9,685.71 " " 6,753.99 " - " 5,582.73 " - " 6,722.22 " - " 5,384.24 " - - - " 5,734.22 " " 5,384.24 " " 5,384.24 " " 8,076.36 " " 9,685.71 " " 9,591.49 " Inpatient 194.3 HEART FAILURE " 68,353.40 " " 21,538.16 " - " 14,010.61 " " 9,769.81 " - " 8,075.54 " - " 9,723.85 " - " 7,788.43 " - - - " 8,294.68 " " 7,788.43 " " 7,788.43 " " 11,682.65 " " 14,010.61 " " 13,874.31 " Inpatient 194.4 HEART FAILURE " 132,449.17 " " 41,734.73 " - " 22,917.81 " " 15,980.93 " - " 13,209.55 " - " 15,905.77 " - " 12,739.90 " - - - " 13,567.99 " " 12,739.90 " " 12,739.90 " " 19,109.85 " " 22,917.81 " " 22,694.86 " Inpatient 197.2 PERIPHERAL & OTHER VASCULAR DISORDERS " 42,588.89 " " 13,419.76 " - " 10,269.60 " " 7,161.14 " - " 5,919.27 " - " 7,127.46 " - " 5,708.82 " - - - " 6,079.89 " " 5,708.82 " " 5,708.82 " " 8,563.23 " " 10,269.60 " " 10,169.69 " Inpatient 197.3 PERIPHERAL & OTHER VASCULAR DISORDERS " 33,536.59 " " 10,567.38 " - " 14,254.50 " " 9,939.88 " - " 8,216.12 " - " 9,893.13 " - " 7,924.01 " - - - " 8,439.07 " " 7,924.01 " " 7,924.01 " " 11,886.02 " " 14,254.50 " " 14,115.83 " Inpatient 199.1 HYPERTENSION " 41,661.26 " " 13,127.46 " - " 7,480.78 " " 5,216.46 " - " 4,311.83 " - " 5,191.92 " - " 4,158.53 " - - - " 4,428.83 " " 4,158.53 " " 4,158.53 " " 6,237.80 " " 7,480.78 " " 7,408.01 " Inpatient 199.2 HYPERTENSION " 40,417.11 " " 12,735.43 " - " 8,657.15 " " 6,036.76 " - " 4,989.88 " - " 6,008.37 " - " 4,812.47 " - - - " 5,125.28 " " 4,812.47 " " 4,812.47 " " 7,218.71 " " 8,657.15 " " 8,572.93 " Inpatient 199.3 HYPERTENSION " 172,455.08 " " 54,340.60 " - " 11,487.85 " " 8,010.65 " - " 6,621.46 " - " 7,972.97 " - " 6,386.04 " - - - " 6,801.13 " " 6,386.04 " " 6,386.04 " " 9,579.06 " " 11,487.85 " " 11,376.09 " Inpatient 199.4 HYPERTENSION " 103,353.63 " " 32,566.73 " - " 20,597.08 " " 14,362.65 " - " 11,871.91 " - " 14,295.10 " - " 11,449.82 " - - - " 12,194.06 " " 11,449.82 " " 11,449.82 " " 17,174.73 " " 20,597.08 " " 20,396.71 " Inpatient 201.1 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS " 54,675.67 " " 17,228.30 " - " 6,607.43 " " 4,607.46 " - " 3,808.44 " - " 4,585.79 " - " 3,673.04 " - - - " 3,911.79 " " 3,673.04 " " 3,673.04 " " 5,509.56 " " 6,607.43 " " 6,543.15 " Inpatient 201.2 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS " 37,384.77 " " 11,779.94 " - " 8,653.46 " " 6,034.19 " - " 4,987.75 " - " 6,005.81 " - " 4,810.42 " - - - " 5,123.10 " " 4,810.42 " " 4,810.42 " " 7,215.63 " " 8,653.46 " " 8,569.28 " Inpatient 201.3 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS " 58,090.06 " " 18,304.18 " - " 12,767.71 " " 8,903.12 " - " 7,359.15 " - " 8,861.24 " - " 7,097.51 " - - - " 7,558.85 " " 7,097.51 " " 7,097.51 " " 10,646.27 " " 12,767.71 " " 12,643.50 " Inpatient 203.1 CHEST PAIN " 30,054.35 " " 9,470.13 " - " 8,221.10 " " 5,732.70 " - " 4,738.54 " - " 5,705.73 " - " 4,570.07 " - - - " 4,867.12 " " 4,570.07 " " 4,570.07 " " 6,855.11 " " 8,221.10 " " 8,141.12 " Inpatient 203.2 CHEST PAIN " 67,713.16 " " 21,336.42 " - " 8,960.18 " " 6,248.07 " - " 5,164.54 " - " 6,218.68 " - " 4,980.92 " - - - " 5,304.68 " " 4,980.92 " " 4,980.92 " " 7,471.38 " " 8,960.18 " " 8,873.01 " Inpatient 203.4 CHEST PAIN " 59,399.12 " " 18,716.66 " - " 16,503.77 " " 11,508.33 " - " 9,512.58 " - " 11,454.20 " - " 9,174.37 " - - - " 9,770.70 " " 9,174.37 " " 9,174.37 " " 13,761.56 " " 16,503.77 " " 16,343.22 " Inpatient 204.1 SYNCOPE & COLLAPSE " 27,445.38 " " 8,648.04 " - " 8,934.31 " " 6,230.03 " - " 5,149.63 " - " 6,200.73 " - " 4,966.54 " - - - " 5,289.37 " " 4,966.54 " " 4,966.54 " " 7,449.81 " " 8,934.31 " " 8,847.39 " Inpatient 204.2 SYNCOPE & COLLAPSE " 39,151.08 " " 12,336.51 " - " 9,847.09 " " 6,866.52 " - " 5,675.74 " - " 6,834.23 " - " 5,473.95 " - - - " 5,829.76 " " 5,473.95 " " 5,473.95 " " 8,210.93 " " 9,847.09 " " 9,751.29 " Inpatient 206.2 "MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR P " " 41,375.31 " " 13,037.36 " - " 11,289.54 " " 7,872.36 " - " 6,507.15 " - " 7,835.34 " - " 6,275.80 " - - - " 6,683.73 " " 6,275.80 " " 6,275.80 " " 9,413.70 " " 11,289.54 " " 11,179.71 " Inpatient 206.3 "MALFUNCTION,REACTION,COMPLICATION OF CARDIAC/VASC DEVICE OR P " " 107,653.42 " " 33,921.59 " - " 16,944.77 " " 11,815.85 " - " 9,766.76 " - " 11,760.27 " - " 9,419.52 " - - - " 10,031.79 " " 9,419.52 " " 9,419.52 " " 14,129.28 " " 16,944.77 " " 16,779.93 " Inpatient 222.2 "OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES " " 54,003.25 " " 17,016.42 " - " 17,931.45 " " 12,503.87 " - " 10,335.47 " - " 12,445.06 " - " 9,968.01 " - - - " 10,615.93 " " 9,968.01 " " 9,968.01 " " 14,952.02 " " 17,931.45 " " 17,757.01 " Inpatient 222.4 "OTHER STOMACH, ESOPHAGEAL & DUODENAL PROCEDURES " " 37,498.15 " " 11,815.67 " - " 60,278.58 " " 42,033.16 " - " 34,743.85 " - " 41,835.46 " - " 33,508.58 " - - - " 35,686.64 " " 33,508.58 " " 33,508.58 " " 50,262.87 " " 60,278.58 " " 59,692.18 " Inpatient 223.2 OTHER SMALL & LARGE BOWEL PROCEDURES " 53,525.62 " " 16,865.92 " - " 21,359.58 " " 14,894.36 " - " 12,311.40 " - " 14,824.30 " - " 11,873.69 " - - - " 12,645.48 " " 11,873.69 " " 11,873.69 " " 17,810.54 " " 21,359.58 " " 21,151.79 " Inpatient 227.1 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL " " 98,958.61 " " 31,181.86 " - " 16,248.80 " " 11,330.53 " - " 9,365.61 " - " 11,277.24 " - " 9,032.63 " - - - " 9,619.75 " " 9,032.63 " " 9,032.63 " " 13,548.95 " " 16,248.80 " " 16,090.73 " Inpatient 227.2 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL " " 100,625.40 " " 31,707.06 " - " 20,971.56 " " 14,623.78 " - " 12,087.75 " - " 14,555.00 " - " 11,657.99 " - - - " 12,415.76 " " 11,657.99 " " 11,657.99 " " 17,486.99 " " 20,971.56 " " 20,767.54 " Inpatient 227.4 "HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL & UMBILICAL " " 165,437.02 " " 52,129.21 " - " 60,782.40 " " 42,384.48 " - " 35,034.24 " - " 42,185.13 " - " 33,788.65 " - - - " 35,984.91 " " 33,788.65 " " 33,788.65 " " 50,682.98 " " 60,782.40 " " 60,191.10 " Inpatient 229.1 OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES " 46,393.08 " " 14,618.46 " - " 16,029.53 " " 11,177.63 " - " 9,239.23 " - " 11,125.06 " - " 8,910.74 " - - - " 9,489.94 " " 8,910.74 " " 8,910.74 " " 13,366.11 " " 16,029.53 " " 15,873.59 " Inpatient 229.2 OTHER DIGESTIVE SYSTEM & ABDOMINAL PROCEDURES " 41,784.52 " " 13,166.30 " - " 21,299.21 " " 14,852.26 " - " 12,276.61 " - " 14,782.40 " - " 11,840.13 " - - - " 12,609.74 " " 11,840.13 " " 11,840.13 " " 17,760.20 " " 21,299.21 " " 21,092.01 " Inpatient 230.1 MAJOR SMALL BOWEL PROCEDURES " 37,171.15 " " 11,712.63 " - " 19,176.81 " " 13,372.28 " - " 11,053.28 " - " 13,309.38 " - " 10,660.30 " - - - " 11,353.22 " " 10,660.30 " " 10,660.30 " " 15,990.45 " " 19,176.81 " " 18,990.26 " Inpatient 230.4 MAJOR SMALL BOWEL PROCEDURES " 138,405.12 " " 43,611.45 " - " 79,227.51 " " 55,246.54 " - " 45,665.78 " - " 54,986.69 " - " 44,042.20 " - - - " 46,904.94 " " 44,042.20 " " 44,042.20 " " 66,063.30 " " 79,227.51 " " 78,456.78 " Inpatient 231.1 MAJOR LARGE BOWEL PROCEDURES " 54,962.98 " " 17,318.83 " - " 19,450.26 " " 13,562.96 " - " 11,210.90 " - " 13,499.17 " - " 10,812.31 " - - - " 11,515.11 " " 10,812.31 " " 10,812.31 " " 16,218.47 " " 19,450.26 " " 19,261.05 " Inpatient 231.3 MAJOR LARGE BOWEL PROCEDURES " 127,773.78 " " 40,261.52 " - " 39,728.31 " " 27,703.15 " - " 22,898.92 " - " 27,572.85 " - " 22,084.78 " - - - " 23,520.29 " " 22,084.78 " " 22,084.78 " " 33,127.17 " " 39,728.31 " " 39,341.83 " Inpatient 231.4 MAJOR LARGE BOWEL PROCEDURES " 270,630.30 " " 85,275.61 " - " 68,014.36 " " 47,427.43 " - " 39,202.65 " - " 47,204.36 " - " 37,808.86 " - - - " 40,266.44 " " 37,808.86 " " 37,808.86 " " 56,713.29 " " 68,014.36 " " 67,352.70 " Inpatient 241.1 PEPTIC ULCER & GASTRITIS " 24,277.90 " " 7,649.97 " - " 9,082.12 " " 6,333.10 " - " 5,234.83 " - " 6,303.31 " - " 5,048.71 " - - - " 5,376.88 " " 5,048.71 " " 5,048.71 " " 7,573.07 " " 9,082.12 " " 8,993.77 " Inpatient 241.2 PEPTIC ULCER & GASTRITIS " 53,237.65 " " 16,775.18 " - " 11,310.48 " " 7,886.96 " - " 6,519.22 " - " 7,849.87 " - " 6,287.44 " - - - " 6,696.12 " " 6,287.44 " " 6,287.44 " " 9,431.16 " " 11,310.48 " " 11,200.45 " Inpatient 241.3 PEPTIC ULCER & GASTRITIS " 32,100.17 " " 10,114.76 " - " 16,772.31 " " 11,695.59 " - " 9,667.36 " - " 11,640.58 " - " 9,323.65 " - - - " 9,929.69 " " 9,323.65 " " 9,323.65 " " 13,985.48 " " 16,772.31 " " 16,609.15 " Inpatient 241.4 PEPTIC ULCER & GASTRITIS " 411,136.84 " " 129,549.22 " - " 35,639.93 " " 24,852.26 " - " 20,542.43 " - " 24,735.37 " - " 19,812.07 " - - - " 21,099.85 " " 19,812.07 " " 19,812.07 " " 29,718.11 " " 35,639.93 " " 35,293.22 " Inpatient 242.3 MAJOR ESOPHAGEAL DISORDERS " 51,646.82 " " 16,273.91 " - " 15,736.36 " " 10,973.20 " - " 9,070.25 " - " 10,921.59 " - " 8,747.77 " - - - " 9,316.38 " " 8,747.77 " " 8,747.77 " " 13,121.66 " " 15,736.36 " " 15,583.28 " Inpatient 242.4 MAJOR ESOPHAGEAL DISORDERS " 301,915.34 " " 95,133.52 " - " 34,500.51 " " 24,057.72 " - " 19,885.68 " - " 23,944.57 " - " 19,178.67 " - - - " 20,425.28 " " 19,178.67 " " 19,178.67 " " 28,768.01 " " 34,500.51 " " 34,164.88 " Inpatient 243.1 OTHER ESOPHAGEAL DISORDERS " 46,919.21 " " 14,784.24 " - " 7,897.14 " " 5,506.79 " - " 4,551.81 " - " 5,480.89 " - " 4,389.98 " - - - " 4,675.33 " " 4,389.98 " " 4,389.98 " " 6,584.97 " " 7,897.14 " " 7,820.31 " Inpatient 243.2 OTHER ESOPHAGEAL DISORDERS " 48,723.45 " " 15,352.76 " - " 10,094.67 " " 7,039.17 " - " 5,818.45 " - " 7,006.06 " - " 5,611.58 " - - - " 5,976.33 " " 5,611.58 " " 5,611.58 " " 8,417.37 " " 10,094.67 " " 9,996.47 " Inpatient 243.3 OTHER ESOPHAGEAL DISORDERS " 79,581.63 " " 25,076.17 " - " 15,106.91 " " 10,534.28 " - " 8,707.44 " - " 10,484.73 " - " 8,397.86 " - - - " 8,943.72 " " 8,397.86 " " 8,397.86 " " 12,596.79 " " 15,106.91 " " 14,959.95 " Inpatient 244.1 DIVERTICULITIS & DIVERTICULOSIS " 19,498.14 " " 6,143.86 " - " 7,292.31 " " 5,085.04 " - " 4,203.20 " - " 5,061.12 " - " 4,053.76 " - - - " 4,317.25 " " 4,053.76 " " 4,053.76 " " 6,080.64 " " 7,292.31 " " 7,221.37 " Inpatient 244.2 DIVERTICULITIS & DIVERTICULOSIS " 19,903.36 " " 6,271.55 " - " 9,847.09 " " 6,866.52 " - " 5,675.74 " - " 6,834.23 " - " 5,473.95 " - - - " 5,829.76 " " 5,473.95 " " 5,473.95 " " 8,210.93 " " 9,847.09 " " 9,751.29 " Inpatient 247.1 INTESTINAL OBSTRUCTION " 16,670.87 " " 5,252.99 " - " 6,851.33 " " 4,777.53 " - " 3,949.02 " - " 4,755.06 " - " 3,808.62 " - - - " 4,056.18 " " 3,808.62 " " 3,808.62 " " 5,712.93 " " 6,851.33 " " 6,784.68 " Inpatient 247.3 INTESTINAL OBSTRUCTION " 58,007.19 " " 18,278.07 " - " 14,895.04 " " 10,386.53 " - " 8,585.32 " - " 10,337.68 " - " 8,280.08 " - - - " 8,818.29 " " 8,280.08 " " 8,280.08 " " 12,420.12 " " 14,895.04 " " 14,750.13 " Inpatient 248.1 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS " 80,674.29 " " 25,420.47 " - " 7,671.71 " " 5,349.60 " - " 4,421.88 " - " 5,324.44 " - " 4,264.67 " - - - " 4,541.87 " " 4,264.67 " " 4,264.67 " " 6,397.01 " " 7,671.71 " " 7,597.08 " Inpatient 248.2 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS " 60,220.74 " " 18,975.56 " - " 10,658.84 " " 7,432.57 " - " 6,143.63 " - " 7,397.61 " - " 5,925.20 " - - - " 6,310.34 " " 5,925.20 " " 5,925.20 " " 8,887.80 " " 10,658.84 " " 10,555.15 " Inpatient 248.3 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS " 57,537.56 " " 18,130.09 " - " 15,788.10 " " 11,009.28 " - " 9,100.07 " - " 10,957.50 " - " 8,776.53 " - - - " 9,347.00 " " 8,776.53 " " 8,776.53 " " 13,164.80 " " 15,788.10 " " 15,634.51 " Inpatient 248.4 MAJOR GASTROINTESTINAL & PERITONEAL INFECTIONS " 141,000.04 " " 44,429.11 " - " 33,220.66 " " 23,165.27 " - " 19,147.99 " - " 23,056.31 " - " 18,467.21 " - - - " 19,667.58 " " 18,467.21 " " 18,467.21 " " 27,700.82 " " 33,220.66 " " 32,897.49 " Inpatient 249.1 "OTHER GASTROENTERITIS, NAUSEA & VOMITING " " 25,923.61 " " 8,168.53 " - " 6,638.23 " " 4,628.94 " - " 3,826.19 " - " 4,607.16 " - " 3,690.16 " - - - " 3,930.02 " " 3,690.16 " " 3,690.16 " " 5,535.24 " " 6,638.23 " " 6,573.65 " Inpatient 249.2 "OTHER GASTROENTERITIS, NAUSEA & VOMITING " " 36,816.60 " " 11,600.91 " - " 8,174.29 " " 5,700.06 " - " 4,711.56 " - " 5,673.25 " - " 4,544.05 " - - - " 4,839.41 " " 4,544.05 " " 4,544.05 " " 6,816.08 " " 8,174.29 " " 8,094.77 " Inpatient 249.3 "OTHER GASTROENTERITIS, NAUSEA & VOMITING " " 72,829.61 " " 22,948.61 " - " 12,430.18 " " 8,667.75 " - " 7,164.61 " - " 8,626.99 " - " 6,909.88 " - - - " 7,359.02 " " 6,909.88 " " 6,909.88 " " 10,364.82 " " 12,430.18 " " 12,309.26 " Inpatient 251.2 ABDOMINAL PAIN " 15,612.63 " " 4,919.54 " - " 9,391.32 " " 6,548.71 " - " 5,413.04 " - " 6,517.91 " - " 5,220.59 " - - - " 5,559.93 " " 5,220.59 " " 5,220.59 " " 7,830.89 " " 9,391.32 " " 9,299.96 " Inpatient 251.4 ABDOMINAL PAIN " 31,528.14 " " 9,934.52 " - " 23,246.70 " " 16,210.27 " - " 13,399.12 " - " 16,134.03 " - " 12,922.73 " - - - " 13,762.71 " " 12,922.73 " " 12,922.73 " " 19,384.10 " " 23,246.70 " " 23,020.55 " Inpatient 253.1 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE " 10,870.66 " " 3,425.34 " - " 8,389.85 " " 5,850.37 " - " 4,835.81 " - " 5,822.85 " - " 4,663.88 " - - - " 4,967.03 " " 4,663.88 " " 4,663.88 " " 6,995.82 " " 8,389.85 " " 8,308.24 " Inpatient 253.2 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE " 35,611.44 " " 11,221.16 " - " 10,827.60 " " 7,550.25 " - " 6,240.90 " - " 7,514.73 " - " 6,019.01 " - - - " 6,410.25 " " 6,019.01 " " 6,019.01 " " 9,028.52 " " 10,827.60 " " 10,722.26 " Inpatient 253.4 OTHER & UNSPECIFIED GASTROINTESTINAL HEMORRHAGE " 65,865.92 " " 20,754.35 " - " 29,148.30 " " 20,325.54 " - " 16,800.73 " - " 20,229.94 " - " 16,203.40 " - - - " 17,256.62 " " 16,203.40 " " 16,203.40 " " 24,305.10 " " 29,148.30 " " 28,864.74 " Inpatient 254.1 OTHER DIGESTIVE SYSTEM DIAGNOSES " 30,397.02 " " 9,578.10 " - " 7,573.17 " " 5,280.89 " - " 4,365.08 " - " 5,256.05 " - " 4,209.89 " - - - " 4,483.53 " " 4,209.89 " " 4,209.89 " " 6,314.84 " " 7,573.17 " " 7,499.50 " Inpatient 254.2 OTHER DIGESTIVE SYSTEM DIAGNOSES " 45,251.37 " " 14,258.71 " - " 10,127.93 " " 7,062.36 " - " 5,837.62 " - " 7,029.14 " - " 5,630.07 " - - - " 5,996.02 " " 5,630.07 " " 5,630.07 " " 8,445.11 " " 10,127.93 " " 10,029.41 " Inpatient 254.3 OTHER DIGESTIVE SYSTEM DIAGNOSES " 58,744.09 " " 18,510.26 " - " 15,366.82 " " 10,715.51 " - " 8,857.25 " - " 10,665.11 " - " 8,542.34 " - - - " 9,097.59 " " 8,542.34 " " 8,542.34 " " 12,813.51 " " 15,366.82 " " 15,217.32 " Inpatient 254.4 OTHER DIGESTIVE SYSTEM DIAGNOSES " 46,569.72 " " 14,674.12 " - " 30,614.17 " " 21,347.72 " - " 17,645.63 " - " 21,247.31 " - " 17,018.27 " - - - " 18,124.46 " " 17,018.27 " " 17,018.27 " " 25,527.41 " " 30,614.17 " " 30,316.35 " Inpatient 263.1 CHOLECYSTECTOMY " 60,734.20 " " 19,137.35 " - " 14,952.94 " " 10,426.91 " - " 8,618.69 " - " 10,377.87 " - " 8,312.27 " - - - " 8,852.57 " " 8,312.27 " " 8,312.27 " " 12,468.41 " " 14,952.94 " " 14,807.48 " Inpatient 263.2 CHOLECYSTECTOMY " 37,945.73 " " 11,956.70 " - " 19,563.60 " " 13,641.99 " - " 11,276.22 " - " 13,577.82 " - " 10,875.31 " - - - " 11,582.21 " " 10,875.31 " " 10,875.31 " " 16,312.97 " " 19,563.60 " " 19,373.28 " Inpatient 263.3 CHOLECYSTECTOMY " 64,861.23 " " 20,437.77 " - " 26,321.31 " " 18,354.24 " - " 15,171.28 " - " 18,267.91 " - " 14,631.89 " - - - " 15,582.96 " " 14,631.89 " " 14,631.89 " " 21,947.84 " " 26,321.31 " " 26,065.25 " Inpatient 279.2 HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS " 415,619.11 " " 130,961.58 " - " 9,651.22 " " 6,729.94 " - " 5,562.85 " - " 6,698.29 " - " 5,365.07 " - - - " 5,713.80 " " 5,365.07 " " 5,365.07 " " 8,047.61 " " 9,651.22 " " 9,557.34 " Inpatient 279.3 HEPATIC COMA & OTHER MAJOR ACUTE LIVER DISORDERS " 90,464.03 " " 28,505.22 " - " 14,785.41 " " 10,310.09 " - " 8,522.13 " - " 10,261.60 " - " 8,219.14 " - - - " 8,753.38 " " 8,219.14 " " 8,219.14 " " 12,328.71 " " 14,785.41 " " 14,641.58 " Inpatient 280.1 ALCOHOLIC LIVER DISEASE " 83,722.95 " " 26,381.10 " - " 7,151.89 " " 4,987.12 " - " 4,122.26 " - " 4,963.66 " - " 3,975.70 " - - - " 4,234.12 " " 3,975.70 " " 3,975.70 " " 5,963.55 " " 7,151.89 " " 7,082.31 " Inpatient 280.2 ALCOHOLIC LIVER DISEASE " 28,526.03 " " 8,988.55 " - " 9,210.24 " " 6,422.44 " - " 5,308.67 " - " 6,392.23 " - " 5,119.93 " - - - " 5,452.73 " " 5,119.93 " " 5,119.93 " " 7,679.90 " " 9,210.24 " " 9,120.64 " Inpatient 280.3 ALCOHOLIC LIVER DISEASE " 51,626.54 " " 16,267.52 " - " 14,185.51 " " 9,891.77 " - " 8,176.36 " - " 9,845.25 " - " 7,885.66 " - - - " 8,398.23 " " 7,885.66 " " 7,885.66 " " 11,828.49 " " 14,185.51 " " 14,047.51 " Inpatient 280.4 ALCOHOLIC LIVER DISEASE " 84,257.96 " " 26,549.68 " - " 31,956.83 " " 22,283.98 " - " 18,419.53 " - " 22,179.17 " - " 17,764.65 " - - - " 18,919.35 " " 17,764.65 " " 17,764.65 " " 26,646.98 " " 31,956.83 " " 31,645.95 " Inpatient 281.1 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS " 58,559.15 " " 18,451.99 " - " 10,405.09 " " 7,255.63 " - " 5,997.37 " - " 7,221.50 " - " 5,784.14 " - - - " 6,160.11 " " 5,784.14 " " 5,784.14 " " 8,676.21 " " 10,405.09 " " 10,303.87 " Inpatient 281.3 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS " 79,767.28 " " 25,134.67 " - " 17,308.15 " " 12,069.23 " - " 9,976.21 " - " 12,012.47 " - " 9,621.52 " - - - " 10,246.92 " " 9,621.52 " " 9,621.52 " " 14,432.28 " " 17,308.15 " " 17,139.78 " Inpatient 281.4 MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS " 57,980.92 " " 18,269.79 " - " 28,552.10 " " 19,909.81 " - " 16,457.09 " - " 19,816.17 " - " 15,871.98 " - - - " 16,903.66 " " 15,871.98 " " 15,871.98 " " 23,807.97 " " 28,552.10 " " 28,274.35 " Inpatient 282.1 DISORDERS OF PANCREAS EXCEPT MALIGNANCY " 20,559.08 " " 6,478.17 " - " 7,128.48 " " 4,970.80 " - " 4,108.77 " - " 4,947.42 " - " 3,962.69 " - - - " 4,220.26 " " 3,962.69 " " 3,962.69 " " 5,944.04 " " 7,128.48 " " 7,059.14 " Inpatient 282.2 DISORDERS OF PANCREAS EXCEPT MALIGNANCY " 23,236.51 " " 7,321.82 " - " 9,610.57 " " 6,701.59 " - " 5,539.42 " - " 6,670.07 " - " 5,342.47 " - - - " 5,689.73 " " 5,342.47 " " 5,342.47 " " 8,013.71 " " 9,610.57 " " 9,517.08 " Inpatient 282.3 DISORDERS OF PANCREAS EXCEPT MALIGNANCY " 41,353.87 " " 13,030.60 " - " 16,051.71 " " 11,193.10 " - " 9,252.01 " - " 11,140.45 " - " 8,923.07 " - - - " 9,503.07 " " 8,923.07 " " 8,923.07 " " 13,384.61 " " 16,051.71 " " 15,895.56 " Inpatient 283.2 OTHER DISORDERS OF THE LIVER " 44,659.51 " " 14,072.21 " - " 9,817.51 " " 6,845.90 " - " 5,658.70 " - " 6,813.70 " - " 5,457.51 " - - - " 5,812.25 " " 5,457.51 " " 5,457.51 " " 8,186.27 " " 9,817.51 " " 9,722.01 " Inpatient 283.3 OTHER DISORDERS OF THE LIVER " 67,633.85 " " 21,311.43 " - " 14,780.48 " " 10,306.65 " - " 8,519.29 " - " 10,258.18 " - " 8,216.40 " - - - " 8,750.47 " " 8,216.40 " " 8,216.40 " " 12,324.60 " " 14,780.48 " " 14,636.69 " Inpatient 283.4 OTHER DISORDERS OF THE LIVER " 143,635.63 " " 45,259.59 " - " 31,576.20 " " 22,018.56 " - " 18,200.14 " - " 21,915.00 " - " 17,553.06 " - - - " 18,694.01 " " 17,553.06 " " 17,553.06 " " 26,329.59 " " 31,576.20 " " 31,269.02 " Inpatient 284.1 DISORDERS OF GALLBLADDER & BILIARY TRACT " 48,084.18 " " 15,151.33 " - " 9,741.15 " " 6,792.65 " - " 5,614.68 " - " 6,760.70 " - " 5,415.06 " - - - " 5,767.04 " " 5,415.06 " " 5,415.06 " " 8,122.59 " " 9,741.15 " " 9,646.39 " Inpatient 284.2 DISORDERS OF GALLBLADDER & BILIARY TRACT " 107,681.03 " " 33,930.29 " - " 12,254.03 " " 8,544.92 " - " 7,063.08 " - " 8,504.73 " - " 6,811.96 " - - - " 7,254.74 " " 6,811.96 " " 6,811.96 " " 10,217.94 " " 12,254.03 " " 12,134.83 " Inpatient 284.3 DISORDERS OF GALLBLADDER & BILIARY TRACT " 33,510.96 " " 10,559.30 " - " 17,496.62 " " 12,200.66 " - " 10,084.84 " - " 12,143.27 " - " 9,726.29 " - - - " 10,358.50 " " 9,726.29 " " 9,726.29 " " 14,589.44 " " 17,496.62 " " 17,326.41 " Inpatient 301.1 HIP JOINT REPLACEMENT " 59,623.40 " " 18,787.33 " - " 21,603.48 " " 15,064.43 " - " 12,451.98 " - " 14,993.57 " - " 12,009.27 " - - - " 12,789.87 " " 12,009.27 " " 12,009.27 " " 18,013.91 " " 21,603.48 " " 21,393.31 " Inpatient 301.2 HIP JOINT REPLACEMENT " 73,360.06 " " 23,115.75 " - " 22,891.94 " " 15,962.89 " - " 13,194.64 " - " 15,887.81 " - " 12,725.52 " - - - " 13,552.68 " " 12,725.52 " " 12,725.52 " " 19,088.28 " " 22,891.94 " " 22,669.24 " Inpatient 302.1 KNEE JOINT REPLACEMENT " 41,395.07 " " 13,043.59 " - " 19,802.56 " " 13,808.62 " - " 11,413.96 " - " 13,743.68 " - " 11,008.15 " - - - " 11,723.68 " " 11,008.15 " " 11,008.15 " " 16,512.23 " " 19,802.56 " " 19,609.92 " Inpatient 302.2 KNEE JOINT REPLACEMENT " 100,639.38 " " 31,711.47 " - " 22,362.27 " " 15,593.55 " - " 12,889.34 " - " 15,520.20 " - " 12,431.08 " - - - " 13,239.10 " " 12,431.08 " " 12,431.08 " " 18,646.62 " " 22,362.27 " " 22,144.73 " Inpatient 304.1 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK " 75,182.85 " " 23,690.12 " - " 37,748.80 " " 26,322.81 " - " 21,757.95 " - " 26,199.00 " - " 20,984.38 " - - - " 22,348.36 " " 20,984.38 " " 20,984.38 " " 31,476.57 " " 37,748.80 " " 37,381.57 " Inpatient 304.2 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK " 104,504.48 " " 32,929.36 " - " 46,021.64 " " 32,091.58 " - " 26,526.31 " - " 31,940.64 " - " 25,583.21 " - - - " 27,246.12 " " 25,583.21 " " 25,583.21 " " 38,374.82 " " 46,021.64 " " 45,573.93 " Inpatient 304.3 DORSAL & LUMBAR FUSION PROC EXCEPT FOR CURVATURE OF BACK " 95,626.63 " " 30,131.95 " - " 71,680.21 " " 49,983.69 " - " 41,315.61 " - " 49,748.59 " - " 39,846.69 " - - - " 42,436.72 " " 39,846.69 " " 39,846.69 " " 59,770.04 " " 71,680.21 " " 70,982.89 " Inpatient 305.1 AMPUTATION OF LOWER LIMB EXCEPT TOES " 45,109.27 " " 14,213.93 " - " 13,717.42 " " 9,565.36 " - " 7,906.56 " - " 9,520.37 " - " 7,625.45 " - - - " 8,121.10 " " 7,625.45 " " 7,625.45 " " 11,438.18 " " 13,717.42 " " 13,583.98 " Inpatient 305.2 AMPUTATION OF LOWER LIMB EXCEPT TOES " 36,188.54 " " 11,403.01 " - " 19,578.38 " " 13,652.30 " - " 11,284.74 " - " 13,588.09 " - " 10,883.53 " - - - " 11,590.96 " " 10,883.53 " " 10,883.53 " " 16,325.30 " " 19,578.38 " " 19,387.92 " Inpatient 305.3 AMPUTATION OF LOWER LIMB EXCEPT TOES " 177,834.59 " " 56,035.68 " - " 31,715.40 " " 22,115.62 " - " 18,280.37 " - " 22,011.60 " - " 17,630.44 " - - - " 18,776.42 " " 17,630.44 " " 17,630.44 " " 26,445.66 " " 31,715.40 " " 31,406.87 " Inpatient 305.4 AMPUTATION OF LOWER LIMB EXCEPT TOES " 344,673.94 " " 108,606.76 " - " 64,630.57 " " 45,067.87 " - " 37,252.28 " - " 44,855.90 " - " 35,927.83 " - - - " 38,263.14 " " 35,927.83 " " 35,927.83 " " 53,891.75 " " 64,630.57 " " 64,001.84 " Inpatient 308.1 HIP & FEMUR FRACTURE REPAIR " 81,653.78 " " 25,729.11 " - " 18,353.96 " " 12,798.49 " - " 10,579.00 " - " 12,738.30 " - " 10,202.88 " - - - " 10,866.07 " " 10,202.88 " " 10,202.88 " " 15,304.32 " " 18,353.96 " " 18,175.41 " Inpatient 308.2 HIP & FEMUR FRACTURE REPAIR " 82,929.51 " " 26,131.09 " - " 21,695.87 " " 15,128.85 " - " 12,505.23 " - " 15,057.70 " - " 12,060.63 " - - - " 12,844.57 " " 12,060.63 " " 12,060.63 " " 18,090.95 " " 21,695.87 " " 21,484.81 " Inpatient 308.3 HIP & FEMUR FRACTURE REPAIR " 70,348.71 " " 22,166.88 " - " 28,462.20 " " 19,847.12 " - " 16,405.26 " - " 19,753.77 " - " 15,822.00 " - - - " 16,850.43 " " 15,822.00 " " 15,822.00 " " 23,733.00 " " 28,462.20 " " 28,185.31 " Inpatient 308.4 HIP & FEMUR FRACTURE REPAIR " 270,428.45 " " 85,212.00 " - " 44,003.92 " " 30,684.59 " - " 25,363.33 " - " 30,540.27 " - " 24,461.57 " - - - " 26,051.57 " " 24,461.57 " " 24,461.57 " " 36,692.36 " " 44,003.92 " " 43,575.84 " Inpatient 310.1 INTERVERTEBRAL DISC EXCISION & DECOMPRESSION " 39,816.35 " " 12,546.13 " - " 15,747.44 " " 10,980.93 " - " 9,076.64 " - " 10,929.28 " - " 8,753.93 " - - - " 9,322.94 " " 8,753.93 " " 8,753.93 " " 13,130.90 " " 15,747.44 " " 15,594.25 " Inpatient 310.2 INTERVERTEBRAL DISC EXCISION & DECOMPRESSION " 63,498.39 " " 20,008.34 " - " 20,125.30 " " 14,033.68 " - " 11,599.98 " - " 13,967.67 " - " 11,187.56 " - - - " 11,914.75 " " 11,187.56 " " 11,187.56 " " 16,781.34 " " 20,125.30 " " 19,929.52 " Inpatient 313.1 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT " 70,952.13 " " 22,357.02 " - " 16,593.70 " " 11,571.04 " - " 9,564.41 " - " 11,516.61 " - " 9,224.36 " - - - " 9,823.94 " " 9,224.36 " " 9,224.36 " " 13,836.54 " " 16,593.70 " " 16,432.27 " Inpatient 313.2 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT " 70,579.90 " " 22,239.73 " - " 22,363.49 " " 15,594.40 " - " 12,890.05 " - " 15,521.05 " - " 12,431.76 " - - - " 13,239.82 " " 12,431.76 " " 12,431.76 " " 18,647.64 " " 22,363.49 " " 22,145.94 " Inpatient 313.3 KNEE & LOWER LEG PROCEDURES EXCEPT FOOT " 113,329.77 " " 35,710.21 " - " 32,800.62 " " 22,872.37 " - " 18,905.88 " - " 22,764.79 " - " 18,233.71 " - - - " 19,418.90 " " 18,233.71 " " 18,233.71 " " 27,350.57 " " 32,800.62 " " 32,481.53 " Inpatient 314.2 FOOT & TOE PROCEDURES " 56,801.10 " " 17,898.03 " - " 16,169.97 " " 11,275.56 " - " 9,320.17 " - " 11,222.53 " - " 8,988.81 " - - - " 9,573.08 " " 8,988.81 " " 8,988.81 " " 13,483.22 " " 16,169.97 " " 16,012.67 " Inpatient 314.3 FOOT & TOE PROCEDURES " 87,289.27 " " 27,504.85 " - " 23,134.61 " " 16,132.11 " - " 13,334.51 " - " 16,056.23 " - " 12,860.42 " - - - " 13,696.35 " " 12,860.42 " " 12,860.42 " " 19,290.63 " " 23,134.61 " " 22,909.55 " Inpatient 314.4 FOOT & TOE PROCEDURES " 158,298.87 " " 49,879.97 " - " 45,410.66 " " 31,665.53 " - " 26,174.15 " - " 31,516.60 " - " 25,243.57 " - - - " 26,884.40 " " 25,243.57 " " 25,243.57 " " 37,865.36 " " 45,410.66 " " 44,968.90 " Inpatient 315.1 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLAC " " 68,188.15 " " 21,486.09 " - " 12,564.45 " " 8,761.38 " - " 7,242.00 " - " 8,720.17 " - " 6,984.52 " - - - " 7,438.51 " " 6,984.52 " " 6,984.52 " " 10,476.78 " " 12,564.45 " " 12,442.22 " Inpatient 315.2 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLAC " " 101,365.86 " " 31,940.38 " - " 20,315.00 " " 14,165.95 " - " 11,709.32 " - " 14,099.32 " - " 11,293.01 " - - - " 12,027.06 " " 11,293.01 " " 11,293.01 " " 16,939.52 " " 20,315.00 " " 20,117.37 " Inpatient 315.3 "SHOULDER, UPPER ARM & FOREARM PROCEDURES EXCEPT JOINT REPLAC " " 108,553.53 " " 34,205.22 " - " 29,641.03 " " 20,669.14 " - " 17,084.73 " - " 20,571.92 " - " 16,477.31 " - - - " 17,548.34 " " 16,477.31 " " 16,477.31 " " 24,715.97 " " 29,641.03 " " 29,352.68 " Inpatient 316.1 HAND & WRIST PROCEDURES " 10,340.29 " " 3,258.23 " - " 12,055.72 " " 8,406.64 " - " 6,948.77 " - " 8,367.10 " - " 6,701.72 " - - - " 7,137.33 " " 6,701.72 " " 6,701.72 " " 10,052.58 " " 12,055.72 " " 11,938.44 " Inpatient 316.2 HAND & WRIST PROCEDURES " 85,623.57 " " 26,979.99 " - " 15,863.24 " " 11,061.68 " - " 9,143.38 " - " 11,009.65 " - " 8,818.30 " - - - " 9,391.49 " " 8,818.30 " " 8,818.30 " " 13,227.45 " " 15,863.24 " " 15,708.92 " Inpatient 316.3 HAND & WRIST PROCEDURES " 31,320.64 " " 9,869.13 " - " 25,721.41 " " 17,935.93 " - " 14,825.51 " - " 17,851.56 " - " 14,298.41 " - - - " 15,227.81 " " 14,298.41 " " 14,298.41 " " 21,447.62 " " 25,721.41 " " 25,471.19 " Inpatient 317.1 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES " " 49,040.67 " " 15,452.72 " - " 13,663.22 " " 9,527.57 " - " 7,875.32 " - " 9,482.76 " - " 7,595.32 " - - - " 8,089.02 " " 7,595.32 " " 7,595.32 " " 11,392.98 " " 13,663.22 " " 13,530.30 " Inpatient 317.2 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES " " 56,103.24 " " 17,678.13 " - " 18,469.76 " " 12,879.24 " - " 10,645.74 " - " 12,818.66 " - " 10,267.25 " - - - " 10,934.62 " " 10,267.25 " " 10,267.25 " " 15,400.88 " " 18,469.76 " " 18,290.08 " Inpatient 317.4 "TENDON, MUSCLE & OTHER SOFT TISSUE PROCEDURES " " 148,826.99 " " 46,895.38 " - " 58,714.19 " " 40,942.29 " - " 33,842.15 " - " 40,749.72 " - " 32,638.94 " - - - " 34,760.47 " " 32,638.94 " " 32,638.94 " " 48,958.41 " " 58,714.19 " " 58,143.01 " Inpatient 320.1 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES " 83,723.81 " " 26,381.37 " - " 14,988.65 " " 10,451.81 " - " 8,639.28 " - " 10,402.65 " - " 8,332.12 " - - - " 8,873.71 " " 8,332.12 " " 8,332.12 " " 12,498.18 " " 14,988.65 " " 14,842.84 " Inpatient 320.3 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE PROCEDURES " 62,084.75 " " 19,562.90 " - " 32,349.78 " " 22,557.99 " - " 18,646.02 " - " 22,451.89 " - " 17,983.09 " - - - " 19,151.99 " " 17,983.09 " " 17,983.09 " " 26,974.64 " " 32,349.78 " " 32,035.08 " Inpatient 321.1 CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DEC " 56,943.83 " " 17,943.00 " - " 23,468.43 " " 16,364.89 " - " 13,526.92 " - " 16,287.92 " - " 13,045.99 " - - - " 13,893.98 " " 13,045.99 " " 13,045.99 " " 19,568.99 " " 23,468.43 " " 23,240.13 " Inpatient 321.2 CERVICAL SPINAL FUSION & OTHER BACK/NECK PROC EXC DISC EXCIS/DEC " 81,881.57 " " 25,800.88 " - " 29,491.98 " " 20,565.20 " - " 16,998.82 " - " 20,468.47 " - " 16,394.45 " - - - " 17,460.09 " " 16,394.45 " " 16,394.45 " " 24,591.68 " " 29,491.98 " " 29,205.07 " Inpatient 340.2 FRACTURE OF FEMUR " 89,885.79 " " 28,323.01 " - " 7,708.66 " " 5,375.37 " - " 4,443.18 " - " 5,350.08 " - " 4,285.21 " - - - " 4,563.75 " " 4,285.21 " " 4,285.21 " " 6,427.82 " " 7,708.66 " " 7,633.67 " Inpatient 341.2 FRACTURE OF PELVIS OR DISLOCATION OF HIP " 48,193.22 " " 15,185.68 " - " 8,634.99 " " 6,021.31 " - " 4,977.10 " - " 5,992.99 " - " 4,800.15 " - - - " 5,112.16 " " 4,800.15 " " 4,800.15 " " 7,200.23 " " 8,634.99 " " 8,550.99 " Inpatient 341.3 FRACTURE OF PELVIS OR DISLOCATION OF HIP " 48,820.70 " " 15,383.40 " - " 11,104.75 " " 7,743.51 " - " 6,400.65 " - " 7,707.09 " - " 6,173.08 " - - - " 6,574.33 " " 6,173.08 " " 6,173.08 " " 9,259.62 " " 11,104.75 " " 10,996.72 " Inpatient 342.1 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK " " 79,068.15 " " 24,914.37 " - " 7,734.53 " " 5,393.41 " - " 4,458.09 " - " 5,368.04 " - " 4,299.59 " - - - " 4,579.06 " " 4,299.59 " " 4,299.59 " " 6,449.39 " " 7,734.53 " " 7,659.29 " Inpatient 342.2 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK " " 35,539.04 " " 11,198.35 " - " 9,454.14 " " 6,592.51 " - " 5,449.25 " - " 6,561.50 " - " 5,255.51 " - - - " 5,597.12 " " 5,255.51 " " 5,255.51 " " 7,883.27 " " 9,454.14 " " 9,362.17 " Inpatient 342.3 "FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK " " 41,392.67 " " 13,042.83 " - " 13,468.60 " " 9,391.86 " - " 7,763.14 " - " 9,347.68 " - " 7,487.13 " - - - " 7,973.79 " " 7,487.13 " " 7,487.13 " " 11,230.70 " " 13,468.60 " " 13,337.57 " Inpatient 344.1 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIO " " 29,820.30 " " 9,396.38 " - " 9,842.16 " " 6,863.09 " - " 5,672.90 " - " 6,830.81 " - " 5,471.21 " - - - " 5,826.84 " " 5,471.21 " " 5,471.21 " " 8,206.82 " " 9,842.16 " " 9,746.41 " Inpatient 344.2 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIO " " 62,047.25 " " 19,551.09 " - " 12,366.14 " " 8,623.10 " - " 7,127.69 " - " 8,582.54 " - " 6,874.28 " - - - " 7,321.11 " " 6,874.28 " " 6,874.28 " " 10,311.42 " " 12,366.14 " " 12,245.84 " Inpatient 344.3 "OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIO " " 35,607.55 " " 11,219.94 " - " 17,837.84 " " 12,438.59 " - " 10,281.51 " - " 12,380.09 " - " 9,915.97 " - - - " 10,560.51 " " 9,915.97 " " 9,915.97 " " 14,873.96 " " 17,837.84 " " 17,664.31 " Inpatient 347.1 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES " " 41,280.75 " " 13,007.56 " - " 9,250.90 " " 6,450.79 " - " 5,332.10 " - " 6,420.45 " - " 5,142.53 " - - - " 5,476.79 " " 5,142.53 " " 5,142.53 " " 7,713.80 " " 9,250.90 " " 9,160.90 " Inpatient 347.2 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES " " 77,793.57 " " 24,512.75 " - " 11,030.85 " " 7,691.98 " - " 6,358.05 " - " 7,655.80 " - " 6,132.00 " - - - " 6,530.58 " " 6,132.00 " " 6,132.00 " " 9,198.00 " " 11,030.85 " " 10,923.54 " Inpatient 347.3 "OTHER BACK & NECK DISORDERS, FRACTURES & INJURIES " " 77,531.54 " " 24,430.19 " - " 14,819.90 " " 10,334.14 " - " 8,542.01 " - " 10,285.53 " - " 8,238.31 " - - - " 8,773.80 " " 8,238.31 " " 8,238.31 " " 12,357.47 " " 14,819.90 " " 14,675.73 " Inpatient 351.1 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES " 20,268.91 " " 6,386.73 " - " 7,656.93 " " 5,339.29 " - " 4,413.36 " - " 5,314.18 " - " 4,256.45 " - - - " 4,533.12 " " 4,256.45 " " 4,256.45 " " 6,384.68 " " 7,656.93 " " 7,582.44 " Inpatient 351.2 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES " 69,851.20 " " 22,010.11 " - " 9,019.31 " " 6,289.30 " - " 5,198.62 " - " 6,259.72 " - " 5,013.79 " - - - " 5,339.69 " " 5,013.79 " " 5,013.79 " " 7,520.69 " " 9,019.31 " " 8,931.57 " Inpatient 351.3 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES " 44,976.24 " " 14,172.01 " - " 15,073.65 " " 10,511.08 " - " 8,688.27 " - " 10,461.64 " - " 8,379.37 " - - - " 8,924.03 " " 8,379.37 " " 8,379.37 " " 12,569.06 " " 15,073.65 " " 14,927.01 " Inpatient 351.4 OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES " 189,340.98 " " 59,661.34 " - " 28,972.15 " " 20,202.71 " - " 16,699.20 " - " 20,107.69 " - " 16,105.48 " - - - " 17,152.34 " " 16,105.48 " " 16,105.48 " " 24,158.22 " " 28,972.15 " " 28,690.30 " Inpatient 361.1 SKIN GRAFT FOR SKIN & SUBCUTANEOUS TISSUE DIAGNOSES " 50,750.69 " " 15,991.54 " - " 16,012.30 " " 11,165.62 " - " 9,229.29 " - " 11,113.10 " - " 8,901.16 " - - - " 9,479.74 " " 8,901.16 " " 8,901.16 " " 13,351.74 " " 16,012.30 " " 15,856.53 " Inpatient 363.1 BREAST PROCEDURES EXCEPT MASTECTOMY " 30,368.78 " " 9,569.20 " - " 15,953.17 " " 11,124.38 " - " 9,195.21 " - " 11,072.06 " - " 8,868.29 " - - - " 9,444.73 " " 8,868.29 " " 8,868.29 " " 13,302.44 " " 15,953.17 " " 15,797.97 " Inpatient 363.2 BREAST PROCEDURES EXCEPT MASTECTOMY " 95,145.28 " " 29,980.28 " - " 21,759.91 " " 15,173.51 " - " 12,542.15 " - " 15,102.14 " - " 12,096.23 " - - - " 12,882.48 " " 12,096.23 " " 12,096.23 " " 18,144.35 " " 21,759.91 " " 21,548.22 " Inpatient 363.3 BREAST PROCEDURES EXCEPT MASTECTOMY " 61,045.54 " " 19,235.45 " - " 30,929.50 " " 21,567.60 " - " 17,827.39 " - " 21,466.16 " - " 17,193.56 " - - - " 18,311.14 " " 17,193.56 " " 17,193.56 " " 25,790.34 " " 30,929.50 " " 30,628.61 " Inpatient 364.1 "OTHER SKIN, SUBCUTANEOUS TISSUE & RELATED PROCEDURES " " 35,757.46 " " 11,267.18 " - " 10,621.89 " " 7,406.81 " - " 6,122.33 " - " 7,371.97 " - " 5,904.66 " - - - " 6,288.46 " " 5,904.66 " " 5,904.66 " " 8,856.99 " " 10,621.89 " " 10,518.56 " Inpatient 380.1 SKIN ULCERS " 18,882.48 " " 5,949.87 " - " 8,056.03 " " 5,617.59 " - " 4,643.40 " - " 5,591.17 " - " 4,478.31 " - - - " 4,769.40 " " 4,478.31 " " 4,478.31 " " 6,717.47 " " 8,056.03 " " 7,977.66 " Inpatient 380.2 SKIN ULCERS " 48,850.66 " " 15,392.84 " - " 10,141.48 " " 7,071.81 " - " 5,845.43 " - " 7,038.54 " - " 5,637.60 " - - - " 6,004.04 " " 5,637.60 " " 5,637.60 " " 8,456.40 " " 10,141.48 " " 10,042.82 " Inpatient 383.1 CELLULITIS & OTHER SKIN INFECTIONS " 33,830.94 " " 10,660.13 " - " 6,221.87 " " 4,338.61 " - " 3,586.21 " - " 4,318.20 " - " 3,458.71 " - - - " 3,683.53 " " 3,458.71 " " 3,458.71 " " 5,188.07 " " 6,221.87 " " 6,161.35 " Inpatient 383.2 CELLULITIS & OTHER SKIN INFECTIONS " 33,603.32 " " 10,588.41 " - " 8,637.45 " " 6,023.03 " - " 4,978.52 " - " 5,994.70 " - " 4,801.52 " - - - " 5,113.62 " " 4,801.52 " " 4,801.52 " " 7,202.28 " " 8,637.45 " " 8,553.43 " Inpatient 383.3 CELLULITIS & OTHER SKIN INFECTIONS " 108,793.07 " " 34,280.70 " - " 13,238.25 " " 9,231.23 " - " 7,630.37 " - " 9,187.81 " - " 7,359.08 " - - - " 7,837.42 " " 7,359.08 " " 7,359.08 " " 11,038.62 " " 13,238.25 " " 13,109.47 " Inpatient 384.1 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOU " " 27,954.00 " " 8,808.31 " - " 7,840.47 " " 5,467.28 " - " 4,519.15 " - " 5,441.56 " - " 4,358.48 " - - - " 4,641.78 " " 4,358.48 " " 4,358.48 " " 6,537.72 " " 7,840.47 " " 7,764.20 " Inpatient 384.2 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOU " " 51,819.35 " " 16,328.28 " - " 10,078.66 " " 7,028.00 " - " 5,809.22 " - " 6,994.95 " - " 5,602.68 " - - - " 5,966.85 " " 5,602.68 " " 5,602.68 " " 8,404.02 " " 10,078.66 " " 9,980.61 " Inpatient 384.4 "CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOU " " 76,572.05 " " 24,127.85 " - " 28,552.10 " " 19,909.81 " - " 16,457.09 " - " 19,816.17 " - " 15,871.98 " - - - " 16,903.66 " " 15,871.98 " " 15,871.98 " " 23,807.97 " " 28,552.10 " " 28,274.35 " Inpatient 385.1 "OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS " " 44,784.00 " " 14,111.44 " - " 6,214.48 " " 4,333.45 " - " 3,581.95 " - " 4,313.07 " - " 3,454.60 " - - - " 3,679.15 " " 3,454.60 " " 3,454.60 " " 5,181.90 " " 6,214.48 " " 6,154.02 " Inpatient 385.2 "OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DISORDERS " " 39,040.53 " " 12,301.67 " - " 8,644.83 " " 6,028.17 " - " 4,982.78 " - " 5,999.82 " - " 4,805.62 " - - - " 5,117.99 " " 4,805.62 " " 4,805.62 " " 7,208.43 " " 8,644.83 " " 8,560.73 " Inpatient 403.1 PROCEDURES FOR OBESITY " 35,985.63 " " 11,339.07 " - " 14,463.91 " " 10,085.90 " - " 8,336.82 " - " 10,038.46 " - " 8,040.42 " - - - " 8,563.05 " " 8,040.42 " " 8,040.42 " " 12,060.63 " " 14,463.91 " " 14,323.20 " Inpatient 403.2 PROCEDURES FOR OBESITY " 35,431.00 " " 11,164.31 " - " 17,650.59 " " 12,308.02 " - " 10,173.59 " - " 12,250.13 " - " 9,811.88 " - - - " 10,449.65 " " 9,811.88 " " 9,811.88 " " 14,717.82 " " 17,650.59 " " 17,478.88 " Inpatient 420.1 DIABETES " 35,590.71 " " 11,214.63 " - " 6,544.60 " " 4,563.65 " - " 3,772.23 " - " 4,542.18 " - " 3,638.11 " - - - " 3,874.59 " " 3,638.11 " " 3,638.11 " " 5,457.17 " " 6,544.60 " " 6,480.93 " Inpatient 420.2 DIABETES " 51,367.74 " " 16,185.97 " - " 7,892.21 " " 5,503.35 " - " 4,548.97 " - " 5,477.47 " - " 4,387.24 " - - - " 4,672.41 " " 4,387.24 " " 4,387.24 " " 6,580.86 " " 7,892.21 " " 7,815.43 " Inpatient 420.3 DIABETES " 49,823.55 " " 15,699.40 " - " 11,954.72 " " 8,336.20 " - " 6,890.55 " - " 8,296.99 " - " 6,645.57 " - - - " 7,077.53 " " 6,645.57 " " 6,645.57 " " 9,968.36 " " 11,954.72 " " 11,838.42 " Inpatient 420.4 DIABETES " 122,703.81 " " 38,663.97 " - " 25,838.43 " " 18,017.52 " - " 14,892.96 " - " 17,932.78 " - " 14,363.46 " - - - " 15,297.08 " " 14,363.46 " " 14,363.46 " " 21,545.19 " " 25,838.43 " " 25,587.07 " Inpatient 422.2 HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS " 47,757.06 " " 15,048.25 " - " 7,496.79 " " 5,227.62 " - " 4,321.06 " - " 5,203.04 " - " 4,167.43 " - - - " 4,438.31 " " 4,167.43 " " 4,167.43 " " 6,251.15 " " 7,496.79 " " 7,423.86 " Inpatient 422.3 HYPOVOLEMIA & RELATED ELECTROLYTE DISORDERS " 62,675.33 " " 19,749.00 " - " 11,251.35 " " 7,845.73 " - " 6,485.14 " - " 7,808.83 " - " 6,254.57 " - - - " 6,661.12 " " 6,254.57 " " 6,254.57 " " 9,381.86 " " 11,251.35 " " 11,141.89 " Inpatient 425.2 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS " 36,778.77 " " 11,588.99 " - " 8,372.60 " " 5,838.34 " - " 4,825.87 " - " 5,810.88 " - " 4,654.29 " - - - " 4,956.82 " " 4,654.29 " " 4,654.29 " " 6,981.44 " " 8,372.60 " " 8,291.15 " Inpatient 425.3 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS " 57,058.50 " " 17,979.13 " - " 11,671.39 " " 8,138.64 " - " 6,727.25 " - " 8,100.36 " - " 6,488.07 " - - - " 6,909.79 " " 6,488.07 " " 6,488.07 " " 9,732.11 " " 11,671.39 " " 11,557.85 " Inpatient 425.4 OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS " 122,672.07 " " 38,653.97 " - " 23,920.51 " " 16,680.13 " - " 13,787.49 " - " 16,601.68 " - " 13,297.30 " - - - " 14,161.62 " " 13,297.30 " " 13,297.30 " " 19,945.95 " " 23,920.51 " " 23,687.81 " Inpatient 426.1 NON-HYPOVOLEMIC SODIUM DISORDERS " 18,442.45 " " 5,811.22 " - " 7,027.47 " " 4,900.36 " - " 4,050.55 " - " 4,877.32 " - " 3,906.54 " - - - " 4,160.47 " " 3,906.54 " " 3,906.54 " " 5,859.81 " " 7,027.47 " " 6,959.11 " Inpatient 426.2 NON-HYPOVOLEMIC SODIUM DISORDERS " 48,757.75 " " 15,363.57 " - " 9,090.76 " " 6,339.12 " - " 5,239.80 " - " 6,309.31 " - " 5,053.51 " - - - " 5,381.99 " " 5,053.51 " " 5,053.51 " " 7,580.27 " " 9,090.76 " " 9,002.32 " Inpatient 426.3 NON-HYPOVOLEMIC SODIUM DISORDERS " 41,423.63 " " 13,052.59 " - " 13,549.91 " " 9,448.55 " - " 7,810.00 " - " 9,404.11 " - " 7,532.33 " - - - " 8,021.93 " " 7,532.33 " " 7,532.33 " " 11,298.50 " " 13,549.91 " " 13,418.09 " Inpatient 446.2 URETHRAL & TRANSURETHRAL PROCEDURES " 34,368.93 " " 10,829.65 " - " 15,302.77 " " 10,670.85 " - " 8,820.33 " - " 10,620.66 " - " 8,506.74 " - - - " 9,059.68 " " 8,506.74 " " 8,506.74 " " 12,760.11 " " 15,302.77 " " 15,153.91 " Inpatient 446.4 URETHRAL & TRANSURETHRAL PROCEDURES " 85,648.76 " " 26,987.92 " - " 46,849.40 " " 32,668.79 " - " 27,003.43 " - " 32,515.13 " - " 26,043.36 " - - - " 27,736.18 " " 26,043.36 " " 26,043.36 " " 39,065.04 " " 46,849.40 " " 46,393.64 " Inpatient 463.1 KIDNEY & URINARY TRACT INFECTIONS " 38,681.96 " " 12,188.69 " - " 7,027.47 " " 4,900.36 " - " 4,050.55 " - " 4,877.32 " - " 3,906.54 " - - - " 4,160.47 " " 3,906.54 " " 3,906.54 " " 5,859.81 " " 7,027.47 " " 6,959.11 " Inpatient 463.2 KIDNEY & URINARY TRACT INFECTIONS " 29,191.07 " " 9,198.11 " - " 8,589.41 " " 5,989.52 " - " 4,950.83 " - " 5,961.35 " - " 4,774.81 " - - - " 5,085.17 " " 4,774.81 " " 4,774.81 " " 7,162.22 " " 8,589.41 " " 8,505.85 " Inpatient 463.3 KIDNEY & URINARY TRACT INFECTIONS " 101,606.10 " " 32,016.08 " - " 11,811.81 " " 8,236.55 " - " 6,808.19 " - " 8,197.81 " - " 6,566.13 " - - - " 6,992.93 " " 6,566.13 " " 6,566.13 " " 9,849.20 " " 11,811.81 " " 11,696.90 " Inpatient 463.4 KIDNEY & URINARY TRACT INFECTIONS " 54,575.27 " " 17,196.67 " - " 22,218.14 " " 15,493.04 " - " 12,806.27 " - " 15,420.17 " - " 12,350.96 " - - - " 13,153.77 " " 12,350.96 " " 12,350.96 " " 18,526.44 " " 22,218.14 " " 22,002.00 " Inpatient 466.2 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PRO " " 37,151.92 " " 11,706.57 " - " 9,445.52 " " 6,586.50 " - " 5,444.28 " - " 6,555.52 " - " 5,250.72 " - - - " 5,592.02 " " 5,250.72 " " 5,250.72 " " 7,876.08 " " 9,445.52 " " 9,353.63 " Inpatient 466.3 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PRO " " 59,287.43 " " 18,681.47 " - " 14,600.63 " " 10,181.24 " - " 8,415.63 " - " 10,133.35 " - " 8,116.42 " - - - " 8,643.99 " " 8,116.42 " " 8,116.42 " " 12,174.63 " " 14,600.63 " " 14,458.59 " Inpatient 466.4 "MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PRO " " 33,612.52 " " 10,591.31 " - " 24,524.10 " " 17,101.02 " - " 14,135.39 " - " 17,020.59 " - " 13,632.83 " - - - " 14,518.96 " " 13,632.83 " " 13,632.83 " " 20,449.25 " " 24,524.10 " " 24,285.52 " Inpatient 468.2 "OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS " " 50,691.63 " " 15,972.93 " - " 9,733.76 " " 6,787.50 " - " 5,610.42 " - " 6,755.57 " - " 5,410.95 " - - - " 5,762.66 " " 5,410.95 " " 5,410.95 " " 8,116.43 " " 9,733.76 " " 9,639.07 " Inpatient 468.3 "OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS " " 55,013.21 " " 17,334.66 " - " 13,965.02 " " 9,738.02 " - " 8,049.27 " - " 9,692.22 " - " 7,763.09 " - - - " 8,267.69 " " 7,763.09 " " 7,763.09 " " 11,644.64 " " 13,965.02 " " 13,829.17 " Inpatient 469.1 ACUTE KIDNEY INJURY " 137,617.21 " " 43,363.18 " - " 6,866.11 " " 4,787.84 " - " 3,957.54 " - " 4,765.32 " - " 3,816.84 " - - - " 4,064.93 " " 3,816.84 " " 3,816.84 " " 5,725.26 " " 6,866.11 " " 6,799.32 " Inpatient 469.2 ACUTE KIDNEY INJURY " 22,519.79 " " 7,095.99 " - " 9,116.63 " " 6,357.16 " - " 5,254.71 " - " 6,327.26 " - " 5,067.89 " - - - " 5,397.30 " " 5,067.89 " " 5,067.89 " " 7,601.84 " " 9,116.63 " " 9,027.94 " Inpatient 469.3 ACUTE KIDNEY INJURY " 51,201.08 " " 16,133.46 " - " 14,492.24 " " 10,105.66 " - " 8,353.15 " - " 10,058.13 " - " 8,056.17 " - - - " 8,579.82 " " 8,056.17 " " 8,056.17 " " 12,084.26 " " 14,492.24 " " 14,351.26 " Inpatient 469.4 ACUTE KIDNEY INJURY " 259,405.82 " " 81,738.77 " - " 28,577.97 " " 19,927.85 " - " 16,472.00 " - " 19,834.12 " - " 15,886.36 " - - - " 16,918.97 " " 15,886.36 " " 15,886.36 " " 23,829.54 " " 28,577.97 " " 28,299.96 " Inpatient 501.1 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY " 26,945.13 " " 8,490.41 " - " 6,742.92 " " 4,701.94 " - " 3,886.54 " - " 4,679.83 " - " 3,748.36 " - - - " 3,992.00 " " 3,748.36 " " 3,748.36 " " 5,622.54 " " 6,742.92 " " 6,677.33 " Inpatient 501.3 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY " 46,781.24 " " 14,740.77 " - " 13,726.06 " " 9,571.39 " - " 7,911.53 " - " 9,526.37 " - " 7,630.25 " - - - " 8,126.22 " " 7,630.25 " " 7,630.25 " " 11,445.38 " " 13,726.06 " " 13,592.53 " Inpatient 501.4 MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY " 226,083.11 " " 71,238.79 " - " 28,982.01 " " 20,209.59 " - " 16,704.88 " - " 20,114.53 " - " 16,110.96 " - - - " 17,158.17 " " 16,110.96 " " 16,110.96 " " 24,166.44 " " 28,982.01 " " 28,700.06 " Inpatient 519.1 UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA " 31,026.35 " " 9,776.40 " - " 8,585.72 " " 5,986.95 " - " 4,948.70 " - " 5,958.79 " - " 4,772.76 " - - - " 5,082.99 " " 4,772.76 " " 4,772.76 " " 7,159.14 " " 8,585.72 " " 8,502.19 " Inpatient 519.2 UTERINE & ADNEXA PROCEDURES FOR LEIOMYOMA " 32,498.63 " " 10,240.32 " - " 11,067.80 " " 7,717.75 " - " 6,379.35 " - " 7,681.45 " - " 6,152.54 " - - - " 6,552.46 " " 6,152.54 " " 6,152.54 " " 9,228.81 " " 11,067.80 " " 10,960.13 " Inpatient 532.2 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS " 42,572.91 " " 13,414.72 " - " 7,776.41 " " 5,422.61 " - " 4,482.23 " - " 5,397.10 " - " 4,322.87 " - - - " 4,603.86 " " 4,322.87 " " 4,322.87 " " 6,484.31 " " 7,776.41 " " 7,700.76 " Inpatient 540.1 CESAREAN SECTION W/O STERILIZATION " 26,933.83 " " 8,486.85 " - " 6,686.26 " " 4,662.43 " - " 3,853.88 " - " 4,640.50 " - " 3,716.86 " - - - " 3,958.46 " " 3,716.86 " " 3,716.86 " " 5,575.29 " " 6,686.26 " " 6,621.21 " Inpatient 540.2 CESAREAN SECTION W/O STERILIZATION " 32,473.02 " " 10,232.25 " - " 7,897.14 " " 5,506.79 " - " 4,551.81 " - " 5,480.89 " - " 4,389.98 " - - - " 4,675.33 " " 4,389.98 " " 4,389.98 " " 6,584.97 " " 7,897.14 " " 7,820.31 " Inpatient 540.3 CESAREAN SECTION W/O STERILIZATION " 36,705.37 " " 11,565.86 " - " 11,561.76 " " 8,062.19 " - " 6,664.06 " - " 8,024.27 " - " 6,427.13 " - - - " 6,844.89 " " 6,427.13 " " 6,427.13 " " 9,640.70 " " 11,561.76 " " 11,449.29 " Inpatient 542.2 VAGINAL DELIVERY W O.R. PROCEDURE EXCEPT STERILIZATION &/OR D&C " 14,125.32 " " 4,450.89 " - " 5,674.95 " " 3,957.23 " - " 3,270.97 " - " 3,938.62 " - " 3,154.68 " - - - " 3,359.73 " " 3,154.68 " " 3,154.68 " " 4,732.02 " " 5,674.95 " " 5,619.75 " Inpatient 547.2 ANTEPARTUM W O.R. PROCEDURE " 121,145.09 " " 38,172.82 " - " 9,135.10 " " 6,370.04 " - " 5,265.36 " - " 6,340.08 " - " 5,078.16 " - - - " 5,408.24 " " 5,078.16 " " 5,078.16 " " 7,617.24 " " 9,135.10 " " 9,046.23 " Inpatient 560.1 VAGINAL DELIVERY " 10,743.84 " " 3,385.38 " - " 4,200.47 " " 2,929.05 " - " 2,421.10 " - " 2,915.27 " - " 2,335.02 " - - - " 2,486.80 " " 2,335.02 " " 2,335.02 " " 3,502.53 " " 4,200.47 " " 4,159.60 " Inpatient 560.2 VAGINAL DELIVERY " 13,289.88 " " 4,187.64 " - " 4,512.11 " " 3,146.36 " - " 2,600.73 " - " 3,131.56 " - " 2,508.26 " - - - " 2,671.30 " " 2,508.26 " " 2,508.26 " " 3,762.39 " " 4,512.11 " " 4,468.21 " Inpatient 560.3 VAGINAL DELIVERY " 15,467.63 " " 4,873.85 " - " 6,384.48 " " 4,451.99 " - " 3,679.93 " - " 4,431.05 " - " 3,549.10 " - - - " 3,779.79 " " 3,549.10 " " 3,549.10 " " 5,323.65 " " 6,384.48 " " 6,322.37 " Inpatient 560.4 VAGINAL DELIVERY " 17,011.07 " " 5,360.19 " - " 9,802.75 " " 6,835.60 " - " 5,650.18 " - " 6,803.45 " - " 5,449.30 " - - - " 5,803.50 " " 5,449.30 " " 5,449.30 " " 8,173.95 " " 9,802.75 " " 9,707.38 " Inpatient 561.1 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE " 21,091.02 " " 6,645.78 " - " 3,917.16 " " 2,731.49 " - " 2,257.80 " - " 2,718.65 " - " 2,177.53 " - - - " 2,319.07 " " 2,177.53 " " 2,177.53 " " 3,266.30 " " 3,917.16 " " 3,879.05 " Inpatient 561.2 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE " 17,746.87 " " 5,592.04 " - " 4,986.37 " " 3,477.07 " - " 2,874.08 " - " 3,460.72 " - " 2,771.90 " - - - " 2,952.07 " " 2,771.90 " " 2,771.90 " " 4,157.85 " " 4,986.37 " " 4,937.86 " Inpatient 561.3 POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE " 46,847.59 " " 14,761.68 " - " 7,963.64 " " 5,553.17 " - " 4,590.15 " - " 5,527.05 " - " 4,426.95 " - - - " 4,714.70 " " 4,426.95 " " 4,426.95 " " 6,640.43 " " 7,963.64 " " 7,886.17 " Inpatient 566.1 ANTEPARTUM W/O O.R. PROCEDURE " 7,203.51 " " 2,269.83 " - " 4,084.67 " " 2,848.30 " - " 2,354.36 " - " 2,834.91 " - " 2,270.65 " - - - " 2,418.24 " " 2,270.65 " " 2,270.65 " " 3,405.98 " " 4,084.67 " " 4,044.94 " Inpatient 566.2 ANTEPARTUM W/O O.R. PROCEDURE " 14,642.62 " " 4,613.89 " - " 5,167.45 " " 3,603.34 " - " 2,978.45 " - " 3,586.39 " - " 2,872.56 " - - - " 3,059.28 " " 2,872.56 " " 2,872.56 " " 4,308.84 " " 5,167.45 " " 5,117.18 " Inpatient 566.3 ANTEPARTUM W/O O.R. PROCEDURE " 33,273.09 " " 10,484.35 " - " 7,728.38 " " 5,389.12 " - " 4,454.54 " - " 5,363.77 " - " 4,296.17 " - - - " 4,575.42 " " 4,296.17 " " 4,296.17 " " 6,444.26 " " 7,728.38 " " 7,653.20 " Inpatient 566.4 ANTEPARTUM W/O O.R. PROCEDURE " 82,561.86 " " 26,015.24 " - " 15,587.32 " " 10,869.28 " - " 8,984.34 " - " 10,818.15 " - " 8,664.92 " - - - " 9,228.14 " " 8,664.92 " " 8,664.92 " " 12,997.38 " " 15,587.32 " " 15,435.69 " Inpatient 581.2 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE " " 26,345.80 " " 8,301.56 " - " 2,197.55 " " 1,532.39 " - " 1,266.64 " - " 1,525.18 " - " 1,221.61 " - - - " 1,301.01 " " 1,221.61 " " 1,221.61 " " 1,832.42 " " 2,197.55 " " 2,176.18 " Inpatient 581.3 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE " " 52,939.32 " " 16,681.18 " - " 3,954.11 " " 2,757.26 " - " 2,279.10 " - " 2,744.29 " - " 2,198.07 " - - - " 2,340.94 " " 2,198.07 " " 2,198.07 " " 3,297.11 " " 3,954.11 " " 3,915.64 " Inpatient 581.4 "NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE " " 24,312.45 " " 7,660.85 " - " 6,189.84 " " 4,316.26 " - " 3,567.75 " - " 4,295.96 " - " 3,440.90 " - - - " 3,664.56 " " 3,440.90 " " 3,440.90 " " 5,161.35 " " 6,189.84 " " 6,129.62 " Inpatient 607.3 NEONATE BWT 1250-1499G W RESP DIST SYND/OTH MAJ RESP OR MAJ AN " 606,832.80 " " 191,213.02 " - " 116,525.47 " " 81,254.96 " - " 67,163.87 " - " 80,872.79 " - " 64,775.96 " - - - " 68,986.40 " " 64,775.96 " " 64,775.96 " " 97,163.94 " " 116,525.47 " " 115,391.90 " Inpatient 614.1 NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION " 32,774.23 " " 10,327.16 " - " 24,625.11 " " 17,171.46 " - " 14,193.61 " - " 17,090.69 " - " 13,688.98 " - - - " 14,578.76 " " 13,688.98 " " 13,688.98 " " 20,533.47 " " 24,625.11 " " 24,385.55 " Inpatient 614.2 NEONATE BWT 1500-1999G W OR W/O OTHER SIGNIFICANT CONDITION " 214,985.87 " " 67,742.05 " - " 41,614.22 " " 29,018.22 " - " 23,985.93 " - " 28,881.74 " - " 23,133.15 " - - - " 24,636.80 " " 23,133.15 " " 23,133.15 " " 34,699.73 " " 41,614.22 " " 41,209.39 " Inpatient 625.1 NEONATE BWT 2000-2499G W OTHER SIGNIFICANT CONDITION " 66,700.90 " " 21,017.45 " - " 23,302.14 " " 16,248.93 " - " 13,431.07 " - " 16,172.51 " - " 12,953.55 " - - - " 13,795.53 " " 12,953.55 " " 12,953.55 " " 19,430.33 " " 23,302.14 " " 23,075.45 " Inpatient 626.1 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER " " 5,662.69 " " 1,784.31 " - " 2,796.21 " " 1,949.84 " - " 1,611.70 " - " 1,940.67 " - " 1,554.40 " - - - " 1,655.44 " " 1,554.40 " " 1,554.40 " " 2,331.60 " " 2,796.21 " " 2,769.01 " Inpatient 626.2 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER " " 5,967.38 " " 1,880.32 " - " 5,039.33 " " 3,514.00 " - " 2,904.61 " - " 3,497.47 " - " 2,801.34 " - - - " 2,983.43 " " 2,801.34 " " 2,801.34 " " 4,202.01 " " 5,039.33 " " 4,990.31 " Inpatient 626.3 "NEONATE BWT 2000-2499G, NORMAL NEWBORN OR NEONATE W OTHER " " 62,616.85 " " 19,730.57 " - " 14,088.21 " " 9,823.92 " - " 8,120.27 " - " 9,777.72 " - " 7,831.57 " - - - " 8,340.62 " " 7,831.57 " " 7,831.57 " " 11,747.36 " " 14,088.21 " " 13,951.16 " Inpatient 633.1 NEONATE BIRTHWT >2499G W MAJOR ANOMALY " 5,064.74 " " 1,595.90 " - " 7,464.77 " " 5,205.30 " - " 4,302.60 " - " 5,180.81 " - " 4,149.63 " - - - " 4,419.36 " " 4,149.63 " " 4,149.63 " " 6,224.45 " " 7,464.77 " " 7,392.15 " Inpatient 633.2 NEONATE BIRTHWT >2499G W MAJOR ANOMALY " 29,799.98 " " 9,389.97 " - " 23,489.37 " " 16,379.49 " - " 13,538.99 " - " 16,302.45 " - " 13,057.63 " - - - " 13,906.38 " " 13,057.63 " " 13,057.63 " " 19,586.45 " " 23,489.37 " " 23,260.86 " Inpatient 633.3 NEONATE BIRTHWT >2499G W MAJOR ANOMALY " 11,879.75 " " 3,743.31 " - " 52,997.37 " " 36,955.87 " - " 30,547.04 " - " 36,782.05 " - " 29,460.99 " - - - " 31,375.95 " " 29,460.99 " " 29,460.99 " " 44,191.49 " " 52,997.37 " " 52,481.81 " Inpatient 634.1 "NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND " " 125,595.49 " " 39,575.14 " - " 12,318.09 " " 8,589.59 " - " 7,100.00 " - " 8,549.19 " - " 6,847.57 " - - - " 7,292.66 " " 6,847.57 " " 6,847.57 " " 10,271.36 " " 12,318.09 " " 12,198.26 " Inpatient 634.2 "NEONATE, BIRTHWT >2499G W RESP DIST SYND/OTH MAJ RESP COND " " 34,857.42 " " 10,983.57 " - " 21,952.07 " " 15,307.51 " - " 12,652.91 " - " 15,235.51 " - " 12,203.05 " - - - " 12,996.25 " " 12,203.05 " " 12,203.05 " " 18,304.58 " " 21,952.07 " " 21,738.51 " Inpatient 639.1 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION " 75,966.25 " " 23,936.97 " - " 11,449.67 " " 7,984.03 " - " 6,599.45 " - " 7,946.48 " - " 6,364.82 " - - - " 6,778.53 " " 6,364.82 " " 6,364.82 " " 9,547.23 " " 11,449.67 " " 11,338.29 " Inpatient 639.2 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION " 58,328.65 " " 18,379.36 " - " 20,355.65 " " 14,194.30 " - " 11,732.75 " - " 14,127.54 " - " 11,315.61 " - - - " 12,051.12 " " 11,315.61 " " 11,315.61 " " 16,973.42 " " 20,355.65 " " 20,157.63 " Inpatient 639.3 NEONATE BIRTHWT >2499G W OTHER SIGNIFICANT CONDITION " 43,376.29 " " 13,667.87 " - " 32,165.00 " " 22,429.14 " - " 18,539.52 " - " 22,323.64 " - " 17,880.37 " - - - " 19,042.59 " " 17,880.37 " " 17,880.37 " " 26,820.56 " " 32,165.00 " " 31,852.09 " Inpatient 640.1 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER " " 4,137.48 " " 1,303.72 " - " 1,573.01 " " 1,096.88 " - 906.67 - " 1,091.73 " - 874.43 - - - 931.27 874.43 874.43 " 1,311.65 " " 1,573.01 " " 1,557.71 " Inpatient 640.2 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER " " 6,521.31 " " 2,054.86 " - " 2,487.02 " " 1,734.23 " - " 1,433.49 " - " 1,726.08 " - " 1,382.52 " - - - " 1,472.38 " " 1,382.52 " " 1,382.52 " " 2,073.78 " " 2,487.02 " " 2,462.82 " Inpatient 640.3 "NEONATE BIRTHWT >2499G, NORMAL NEWBORN OR NEONATE W OTHER " " 19,823.55 " " 6,246.40 " - " 6,186.15 " " 4,313.69 " - " 3,565.62 " - " 4,293.40 " - " 3,438.85 " - - - " 3,662.38 " " 3,438.85 " " 3,438.85 " " 5,158.28 " " 6,186.15 " " 6,125.97 " Inpatient 662.1 SICKLE CELL ANEMIA CRISIS " 22,867.51 " " 7,205.55 " - " 7,892.21 " " 5,503.35 " - " 4,548.97 " - " 5,477.47 " - " 4,387.24 " - - - " 4,672.41 " " 4,387.24 " " 4,387.24 " " 6,580.86 " " 7,892.21 " " 7,815.43 " Inpatient 663.1 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS " 30,983.34 " " 9,762.85 " - " 7,776.41 " " 5,422.61 " - " 4,482.23 " - " 5,397.10 " - " 4,322.87 " - - - " 4,603.86 " " 4,322.87 " " 4,322.87 " " 6,484.31 " " 7,776.41 " " 7,700.76 " Inpatient 663.2 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS " 40,639.81 " " 12,805.60 " - " 9,870.49 " " 6,882.84 " - " 5,689.23 " - " 6,850.47 " - " 5,486.96 " - - - " 5,843.61 " " 5,486.96 " " 5,486.96 " " 8,230.44 " " 9,870.49 " " 9,774.47 " Inpatient 663.4 OTHER ANEMIA & DISORDERS OF BLOOD & BLOOD-FORMING ORGANS " 35,903.10 " " 11,313.07 " - " 25,714.02 " " 17,930.77 " - " 14,821.25 " - " 17,846.43 " - " 14,294.30 " - - - " 15,223.43 " " 14,294.30 " " 14,294.30 " " 21,441.45 " " 25,714.02 " " 25,463.87 " Inpatient 710.2 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE " 83,981.50 " " 26,462.57 " - " 23,408.08 " " 16,322.80 " - " 13,492.13 " - " 16,246.03 " - " 13,012.44 " - - - " 13,858.25 " " 13,012.44 " " 13,012.44 " " 19,518.66 " " 23,408.08 " " 23,180.36 " Inpatient 710.3 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE " 273,655.25 " " 86,228.77 " - " 37,395.26 " " 26,076.28 " - " 21,554.18 " - " 25,953.63 " - " 20,787.85 " - - - " 22,139.06 " " 20,787.85 " " 20,787.85 " " 31,181.78 " " 37,395.26 " " 37,031.48 " Inpatient 710.4 INFECTIOUS & PARASITIC DISEASES INCLUDING HIV W O.R. PROCEDURE " 346,330.06 " " 109,128.60 " - " 71,309.44 " " 49,725.14 " - " 41,101.90 " - " 49,491.26 " - " 39,640.58 " - - - " 42,217.22 " " 39,640.58 " " 39,640.58 " " 59,460.87 " " 71,309.44 " " 70,615.73 " Inpatient 711.2 "POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE " " 53,028.29 " " 16,709.21 " - " 20,683.30 " " 14,422.78 " - " 11,921.61 " - " 14,354.94 " - " 11,497.75 " - - - " 12,245.10 " " 11,497.75 " " 11,497.75 " " 17,246.63 " " 20,683.30 " " 20,482.09 " Inpatient 711.3 "POST-OP, POST-TRAUMA, OTHER DEVICE INFECTIONS W O.R. PROCEDURE " " 56,864.00 " " 17,917.85 " - " 36,763.35 " " 25,635.63 " - " 21,189.95 " - " 25,515.06 " - " 20,436.57 " - - - " 21,764.95 " " 20,436.57 " " 20,436.57 " " 30,654.86 " " 36,763.35 " " 36,405.71 " Inpatient 720.1 SEPTICEMIA & DISSEMINATED INFECTIONS " 73,192.82 " " 23,063.06 " - " 8,102.84 " " 5,650.23 " - " 4,670.38 " - " 5,623.66 " - " 4,504.33 " - - - " 4,797.11 " " 4,504.33 " " 4,504.33 " " 6,756.50 " " 8,102.84 " " 8,024.01 " Inpatient 720.2 SEPTICEMIA & DISSEMINATED INFECTIONS " 40,586.91 " " 12,788.94 " - " 10,836.23 " " 7,556.27 " - " 6,245.87 " - " 7,520.73 " - " 6,023.81 " - - - " 6,415.36 " " 6,023.81 " " 6,023.81 " " 9,035.72 " " 10,836.23 " " 10,730.82 " Inpatient 720.3 SEPTICEMIA & DISSEMINATED INFECTIONS " 93,918.60 " " 29,593.75 " - " 16,766.16 " " 11,691.30 " - " 9,663.81 " - " 11,636.31 " - " 9,320.23 " - - - " 9,926.04 " " 9,320.23 " " 9,320.23 " " 13,980.35 " " 16,766.16 " " 16,603.06 " Inpatient 720.4 SEPTICEMIA & DISSEMINATED INFECTIONS " 176,214.82 " " 55,525.29 " - " 31,565.12 " " 22,010.83 " - " 18,193.75 " - " 21,907.30 " - " 17,546.90 " - - - " 18,687.45 " " 17,546.90 " " 17,546.90 " " 26,320.35 " " 31,565.12 " " 31,258.05 " Inpatient 721.1 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS " " 60,343.65 " " 19,014.28 " - " 8,181.69 " " 5,705.21 " - " 4,715.82 " - " 5,678.38 " - " 4,548.16 " - - - " 4,843.79 " " 4,548.16 " " 4,548.16 " " 6,822.24 " " 8,181.69 " " 8,102.09 " Inpatient 721.2 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS " " 28,032.07 " " 8,832.91 " - " 11,326.49 " " 7,898.13 " - " 6,528.45 " - " 7,860.98 " - " 6,296.34 " - - - " 6,705.60 " " 6,296.34 " " 6,296.34 " " 9,444.51 " " 11,326.49 " " 11,216.30 " Inpatient 721.3 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS " " 38,250.08 " " 12,052.60 " - " 18,814.66 " " 13,119.74 " - " 10,844.54 " - " 13,058.04 " - " 10,458.98 " - - - " 11,138.81 " " 10,458.98 " " 10,458.98 " " 15,688.47 " " 18,814.66 " " 18,631.63 " Inpatient 721.4 "POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS " " 280,049.27 " " 88,243.52 " - " 35,856.74 " " 25,003.44 " - " 20,667.39 " - " 24,885.84 " - " 19,932.59 " - - - " 21,228.21 " " 19,932.59 " " 19,932.59 " " 29,898.89 " " 35,856.74 " " 35,507.92 " Inpatient 724.1 OTHER INFECTIOUS & PARASITIC DISEASES " 31,411.58 " " 9,897.79 " - " 8,776.64 " " 6,120.08 " - " 5,058.75 " - " 6,091.29 " - " 4,878.89 " - - - " 5,196.02 " " 4,878.89 " " 4,878.89 " " 7,318.34 " " 8,776.64 " " 8,691.25 " Inpatient 724.3 OTHER INFECTIOUS & PARASITIC DISEASES " 26,932.31 " " 8,486.37 " - " 18,659.45 " " 13,011.51 " - " 10,755.08 " - " 12,950.32 " - " 10,372.70 " - - - " 11,046.93 " " 10,372.70 " " 10,372.70 " " 15,559.05 " " 18,659.45 " " 18,477.93 " Inpatient 724.4 OTHER INFECTIOUS & PARASITIC DISEASES " 144,211.52 " " 45,441.05 " - " 43,206.95 " " 30,128.86 " - " 24,903.96 " - " 29,987.15 " - " 24,018.54 " - - - " 25,579.75 " " 24,018.54 " " 24,018.54 " " 36,027.81 " " 43,206.95 " " 42,786.63 " Inpatient 740.1 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE " 22,170.64 " " 6,985.97 " - " 20,087.11 " " 14,007.04 " - " 11,577.97 " - " 13,941.16 " - " 11,166.33 " - - - " 11,892.14 " " 11,166.33 " " 11,166.33 " " 16,749.50 " " 20,087.11 " " 19,891.70 " Inpatient 740.2 MENTAL ILLNESS DIAGNOSIS W O.R. PROCEDURE " 43,230.84 " " 13,622.04 " - " 21,330.01 " " 14,873.73 " - " 12,294.36 " - " 14,803.78 " - " 11,857.25 " - - - " 12,627.97 " " 11,857.25 " " 11,857.25 " " 17,785.88 " " 21,330.01 " " 21,122.51 " Inpatient 750.1 SCHIZOPHRENIA " 71,846.06 " " 22,638.69 " - " 6,824.22 " " 4,758.63 " - " 3,933.40 " - " 4,736.25 " - " 3,793.55 " - - - " 4,040.13 " " 3,793.55 " " 3,793.55 " " 5,690.33 " " 6,824.22 " " 6,757.83 " Inpatient 750.2 SCHIZOPHRENIA " 58,506.85 " " 18,435.51 " - " 7,499.25 " " 5,229.34 " - " 4,322.48 " - " 5,204.75 " - " 4,168.80 " - - - " 4,439.77 " " 4,168.80 " " 4,168.80 " " 6,253.20 " " 7,499.25 " " 7,426.30 " Inpatient 750.3 SCHIZOPHRENIA " 69,016.14 " " 21,746.99 " - " 14,359.20 " " 10,012.88 " - " 8,276.47 " - " 9,965.79 " - " 7,982.21 " - - - " 8,501.05 " " 7,982.21 " " 7,982.21 " " 11,973.32 " " 14,359.20 " " 14,219.51 " Inpatient 751.1 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES " 30,785.60 " " 9,700.54 " - " 5,257.36 " " 3,666.03 " - " 3,030.28 " - " 3,648.79 " - " 2,922.54 " - - - " 3,112.51 " " 2,922.54 " " 2,922.54 " " 4,383.81 " " 5,257.36 " " 5,206.21 " Inpatient 751.2 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES " 34,324.97 " " 10,815.80 " - " 6,354.90 " " 4,431.37 " - " 3,662.89 " - " 4,410.53 " - " 3,532.66 " - - - " 3,762.28 " " 3,532.66 " " 3,532.66 " " 5,298.99 " " 6,354.90 " " 6,293.08 " Inpatient 751.3 MAJOR DEPRESSIVE DISORDERS & OTHER/UNSPECIFIED PSYCHOSES " 101,465.35 " " 31,971.73 " - " 12,853.93 " " 8,963.24 " - " 7,408.85 " - " 8,921.08 " - " 7,145.44 " - - - " 7,609.89 " " 7,145.44 " " 7,145.44 " " 10,718.16 " " 12,853.93 " " 12,728.89 " Inpatient 752.2 DISORDERS OF PERSONALITY & IMPULSE CONTROL " 21,289.31 " " 6,708.26 " - " 5,865.87 " " 4,090.36 " - " 3,381.02 " - " 4,071.12 " - " 3,260.81 " - - - " 3,472.76 " " 3,260.81 " " 3,260.81 " " 4,891.22 " " 5,865.87 " " 5,808.81 " Inpatient 752.3 DISORDERS OF PERSONALITY & IMPULSE CONTROL " 13,195.50 " " 4,157.90 " - " 12,771.40 " " 8,905.69 " - " 7,361.28 " - " 8,863.80 " - " 7,099.56 " - - - " 7,561.03 " " 7,099.56 " " 7,099.56 " " 10,649.34 " " 12,771.40 " " 12,647.16 " Inpatient 753.1 BIPOLAR DISORDERS " 35,050.20 " " 11,044.32 " - " 5,233.95 " " 3,649.71 " - " 3,016.79 " - " 3,632.55 " - " 2,909.53 " - - - " 3,098.65 " " 2,909.53 " " 2,909.53 " " 4,364.30 " " 5,233.95 " " 5,183.04 " Inpatient 753.2 BIPOLAR DISORDERS " 36,522.80 " " 11,508.33 " - " 6,155.35 " " 4,292.22 " - " 3,547.87 " - " 4,272.03 " - " 3,421.73 " - - - " 3,644.14 " " 3,421.73 " " 3,421.73 " " 5,132.60 " " 6,155.35 " " 6,095.47 " Inpatient 754.1 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER " 20,630.31 " " 6,500.61 " - " 4,672.25 " " 3,258.03 " - " 2,693.03 " - " 3,242.70 " - " 2,597.28 " - - - " 2,766.10 " " 2,597.28 " " 2,597.28 " " 3,895.92 " " 4,672.25 " " 4,626.79 " Inpatient 754.2 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER " 28,835.29 " " 9,086.00 " - " 5,634.30 " " 3,928.88 " - " 3,247.54 " - " 3,910.40 " - " 3,132.08 " - - - " 3,335.67 " " 3,132.08 " " 3,132.08 " " 4,698.12 " " 5,634.30 " " 5,579.49 " Inpatient 754.3 DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER " 7,964.88 " " 2,509.73 " - " 9,783.03 " " 6,821.85 " - " 5,638.82 " - " 6,789.77 " - " 5,438.34 " - - - " 5,791.83 " " 5,438.34 " " 5,438.34 " " 8,157.51 " " 9,783.03 " " 9,687.86 " Inpatient 755.1 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES " 15,326.15 " " 4,829.27 " - " 4,572.48 " " 3,188.46 " - " 2,635.52 " - " 3,173.46 " - " 2,541.82 " - - - " 2,707.04 " " 2,541.82 " " 2,541.82 " " 3,812.73 " " 4,572.48 " " 4,528.00 " Inpatient 755.2 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES " 49,517.24 " " 15,602.88 " - " 7,234.42 " " 5,044.67 " - " 4,169.83 " - " 5,020.94 " - " 4,021.58 " - - - " 4,282.98 " " 4,021.58 " " 4,021.58 " " 6,032.37 " " 7,234.42 " " 7,164.04 " Inpatient 755.3 ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES " 12,355.00 " " 3,893.06 " - " 10,068.80 " " 7,021.13 " - " 5,803.54 " - " 6,988.10 " - " 5,597.20 " - - - " 5,961.02 " " 5,597.20 " " 5,597.20 " " 8,395.80 " " 10,068.80 " " 9,970.85 " Inpatient 756.1 ACUTE ANXIETY & DELIRIUM STATES " 22,373.93 " " 7,050.03 " - " 7,135.88 " " 4,975.95 " - " 4,113.03 " - " 4,952.55 " - " 3,966.80 " - - - " 4,224.64 " " 3,966.80 " " 3,966.80 " " 5,950.20 " " 7,135.88 " " 7,066.46 " Inpatient 756.2 ACUTE ANXIETY & DELIRIUM STATES " 26,604.72 " " 8,383.15 " - " 8,591.87 " " 5,991.24 " - " 4,952.25 " - " 5,963.06 " - " 4,776.18 " - - - " 5,086.63 " " 4,776.18 " " 4,776.18 " " 7,164.27 " " 8,591.87 " " 8,508.29 " Inpatient 758.1 BEHAVIORAL DISORDERS " 16,027.00 " " 5,050.11 " - " 6,487.95 " " 4,524.14 " - " 3,739.57 " - " 4,502.87 " - " 3,606.62 " - - - " 3,841.05 " " 3,606.62 " " 3,606.62 " " 5,409.93 " " 6,487.95 " " 6,424.83 " Inpatient 760.1 OTHER MENTAL HEALTH DISORDERS " 43,714.75 " " 13,774.52 " - " 7,490.64 " " 5,223.33 " - " 4,317.51 " - " 5,198.77 " - " 4,164.01 " - - - " 4,434.67 " " 4,164.01 " " 4,164.01 " " 6,246.02 " " 7,490.64 " " 7,417.77 " Inpatient 770.1 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVI " " 20,603.47 " " 6,492.15 " - " 3,009.31 " " 2,098.44 " - " 1,734.53 " - " 2,088.57 " - " 1,672.86 " - - - " 1,781.60 " " 1,672.86 " " 1,672.86 " " 2,509.29 " " 3,009.31 " " 2,980.03 " Inpatient 770.2 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVI " " 38,446.49 " " 12,114.49 " - " 4,717.83 " " 3,289.81 " - " 2,719.30 " - " 3,274.34 " - " 2,622.62 " - - - " 2,793.09 " " 2,622.62 " " 2,622.62 " " 3,933.93 " " 4,717.83 " " 4,671.94 " Inpatient 770.3 "DRUG & ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVI " " 70,740.74 " " 22,290.41 " - " 8,655.93 " " 6,035.91 " - " 4,989.17 " - " 6,007.52 " - " 4,811.79 " - - - " 5,124.56 " " 4,811.79 " " 4,811.79 " " 7,217.69 " " 8,655.93 " " 8,571.72 " Inpatient 773.1 OPIOID ABUSE & DEPENDENCE " 39,359.14 " " 12,402.07 " - " 3,763.17 " " 2,624.12 " - " 2,169.05 " - " 2,611.77 " - " 2,091.93 " - - - " 2,227.91 " " 2,091.93 " " 2,091.93 " " 3,137.90 " " 3,763.17 " " 3,726.56 " Inpatient 773.2 OPIOID ABUSE & DEPENDENCE " 36,468.74 " " 11,491.30 " - " 5,498.81 " " 3,834.40 " - " 3,169.44 " - " 3,816.36 " - " 3,056.76 " - - - " 3,255.45 " " 3,056.76 " " 3,056.76 " " 4,585.14 " " 5,498.81 " " 5,445.31 " Inpatient 773.3 OPIOID ABUSE & DEPENDENCE " 14,391.35 " " 4,534.71 " - " 10,943.39 " " 7,630.99 " - " 6,307.64 " - " 7,595.10 " - " 6,083.38 " - - - " 6,478.80 " " 6,083.38 " " 6,083.38 " " 9,125.07 " " 10,943.39 " " 10,836.93 " Inpatient 773.4 OPIOID ABUSE & DEPENDENCE " 55,690.26 " " 17,548.00 " - " 28,265.09 " " 19,709.67 " - " 16,291.66 " - " 19,616.97 " - " 15,712.43 " - - - " 16,733.74 " " 15,712.43 " " 15,712.43 " " 23,568.65 " " 28,265.09 " " 27,990.12 " Inpatient 774.2 COCAINE ABUSE & DEPENDENCE " 30,004.74 " " 9,454.49 " - " 5,512.35 " " 3,843.85 " - " 3,177.25 " - " 3,825.77 " - " 3,064.29 " - - - " 3,263.47 " " 3,064.29 " " 3,064.29 " " 4,596.44 " " 5,512.35 " " 5,458.73 " Inpatient 774.4 COCAINE ABUSE & DEPENDENCE " 158,555.97 " " 49,960.99 " - " 28,539.78 " " 19,901.22 " - " 16,449.99 " - " 19,807.61 " - " 15,865.13 " - - - " 16,896.36 " " 15,865.13 " " 15,865.13 " " 23,797.70 " " 28,539.78 " " 28,262.14 " Inpatient 775.1 ALCOHOL ABUSE & DEPENDENCE " 37,059.54 " " 11,677.46 " - " 5,132.95 " " 3,579.28 " - " 2,958.57 " - " 3,562.44 " - " 2,853.38 " - - - " 3,038.85 " " 2,853.38 " " 2,853.38 " " 4,280.07 " " 5,132.95 " " 5,083.01 " Inpatient 775.2 ALCOHOL ABUSE & DEPENDENCE " 37,657.33 " " 11,865.82 " - " 7,309.56 " " 5,097.07 " - " 4,213.14 " - " 5,073.09 " - " 4,063.35 " - - - " 4,327.47 " " 4,063.35 " " 4,063.35 " " 6,095.03 " " 7,309.56 " " 7,238.45 " Inpatient 775.3 ALCOHOL ABUSE & DEPENDENCE " 62,459.35 " " 19,680.94 " - " 12,539.83 " " 8,744.21 " - " 7,227.80 " - " 8,703.08 " - " 6,970.83 " - - - " 7,423.93 " " 6,970.83 " " 6,970.83 " " 10,456.25 " " 12,539.83 " " 12,417.84 " Inpatient 775.4 ALCOHOL ABUSE & DEPENDENCE " 209,604.70 " " 66,046.44 " - " 32,472.95 " " 22,643.88 " - " 18,717.02 " - " 22,537.37 " - " 18,051.56 " - - - " 19,224.91 " " 18,051.56 " " 18,051.56 " " 27,077.34 " " 32,472.95 " " 32,157.05 " Inpatient 776.1 OTHER DRUG ABUSE & DEPENDENCE " 37,833.79 " " 11,921.43 " - " 6,643.14 " " 4,632.36 " - " 3,829.03 " - " 4,610.57 " - " 3,692.89 " - - - " 3,932.93 " " 3,692.89 " " 3,692.89 " " 5,539.34 " " 6,643.14 " " 6,578.51 " Inpatient 776.2 OTHER DRUG ABUSE & DEPENDENCE " 25,658.87 " " 8,085.11 " - " 7,926.69 " " 5,527.40 " - " 4,568.85 " - " 5,501.40 " - " 4,406.41 " - - - " 4,692.83 " " 4,406.41 " " 4,406.41 " " 6,609.62 " " 7,926.69 " " 7,849.58 " Inpatient 776.3 OTHER DRUG ABUSE & DEPENDENCE " 209,799.38 " " 66,107.78 " - " 13,628.74 " " 9,503.52 " - " 7,855.44 " - " 9,458.82 " - " 7,576.15 " - - - " 8,068.60 " " 7,576.15 " " 7,576.15 " " 11,364.23 " " 13,628.74 " " 13,496.15 " Inpatient 812.1 POISONING OF MEDICINAL AGENTS " 36,424.29 " " 11,477.29 " - " 5,500.03 " " 3,835.25 " - " 3,170.15 " - " 3,817.21 " - " 3,057.44 " - - - " 3,256.17 " " 3,057.44 " " 3,057.44 " " 4,586.16 " " 5,500.03 " " 5,446.52 " Inpatient 812.2 POISONING OF MEDICINAL AGENTS " 33,833.91 " " 10,661.07 " - " 7,817.07 " " 5,450.96 " - " 4,505.66 " - " 5,425.32 " - " 4,345.47 " - - - " 4,627.93 " " 4,345.47 " " 4,345.47 " " 6,518.21 " " 7,817.07 " " 7,741.02 " Inpatient 812.3 POISONING OF MEDICINAL AGENTS " 43,911.72 " " 13,836.58 " - " 11,442.28 " " 7,978.87 " - " 6,595.19 " - " 7,941.35 " - " 6,360.71 " - - - " 6,774.16 " " 6,360.71 " " 6,360.71 " " 9,541.07 " " 11,442.28 " " 11,330.97 " Inpatient 812.4 POISONING OF MEDICINAL AGENTS " 65,723.83 " " 20,709.58 " - " 21,536.95 " " 15,018.04 " - " 12,413.64 " - " 14,947.40 " - " 11,972.29 " - - - " 12,750.49 " " 11,972.29 " " 11,972.29 " " 17,958.44 " " 21,536.95 " " 21,327.44 " Inpatient 813.3 OTHER COMPLICATIONS OF TREATMENT " 121,449.21 " " 38,268.65 " - " 15,706.81 " " 10,952.59 " - " 9,053.21 " - " 10,901.08 " - " 8,731.34 " - - - " 9,298.88 " " 8,731.34 " " 8,731.34 " " 13,097.01 " " 15,706.81 " " 15,554.01 " Inpatient 815.2 "OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES " " 18,150.51 " " 5,719.23 " - " 8,971.28 " " 6,255.81 " - " 5,170.93 " - " 6,226.38 " - " 4,987.09 " - - - " 5,311.25 " " 4,987.09 " " 4,987.09 " " 7,480.64 " " 8,971.28 " " 8,884.00 " Inpatient 815.4 "OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES " " 104,406.83 " " 32,898.59 " - " 45,257.91 " " 31,559.02 " - " 26,086.11 " - " 31,410.59 " - " 25,158.66 " - - - " 26,793.97 " " 25,158.66 " " 25,158.66 " " 37,737.99 " " 45,257.91 " " 44,817.64 " Inpatient 816.1 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES " 55,235.71 " " 17,404.77 " - " 7,844.16 " " 5,469.85 " - " 4,521.28 " - " 5,444.12 " - " 4,360.53 " - - - " 4,643.96 " " 4,360.53 " " 4,360.53 " " 6,540.80 " " 7,844.16 " " 7,767.85 " Inpatient 816.3 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES " 196,177.10 " " 61,815.40 " - " 10,472.84 " " 7,302.87 " - " 6,036.42 " - " 7,268.52 " - " 5,821.80 " - - - " 6,200.22 " " 5,821.80 " " 5,821.80 " " 8,732.70 " " 10,472.84 " " 10,370.95 " Inpatient 816.4 TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES " 38,731.46 " " 12,204.28 " - " 20,667.29 " " 14,411.61 " - " 11,912.38 " - " 14,343.83 " - " 11,488.85 " - - - " 12,235.63 " " 11,488.85 " " 11,488.85 " " 17,233.28 " " 20,667.29 " " 20,466.24 " Inpatient 817.1 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE " 42,218.51 " " 13,303.05 " - " 5,391.63 " " 3,759.66 " - " 3,107.67 " - " 3,741.98 " - " 2,997.18 " - - - " 3,192.00 " " 2,997.18 " " 2,997.18 " " 4,495.77 " " 5,391.63 " " 5,339.18 " Inpatient 817.2 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE " 33,931.22 " " 10,691.73 " - " 7,001.61 " " 4,882.33 " - " 4,035.64 " - " 4,859.36 " - " 3,892.16 " - - - " 4,145.15 " " 3,892.16 " " 3,892.16 " " 5,838.24 " " 7,001.61 " " 6,933.49 " Inpatient 817.3 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE " 42,677.33 " " 13,447.63 " - " 11,899.27 " " 8,297.54 " - " 6,858.60 " - " 8,258.52 " - " 6,614.75 " - - - " 7,044.71 " " 6,614.75 " " 6,614.75 " " 9,922.13 " " 11,899.27 " " 11,783.52 " Inpatient 817.4 INTENTIONAL SELF-HARM & ATTEMPTED SUICIDE " 56,011.92 " " 17,649.36 " - " 24,122.53 " " 16,821.00 " - " 13,903.93 " - " 16,741.89 " - " 13,409.60 " - - - " 14,281.22 " " 13,409.60 " " 13,409.60 " " 20,114.40 " " 24,122.53 " " 23,887.86 " Inpatient 861.1 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS " " 28,918.84 " " 9,112.33 " - " 7,302.17 " " 5,091.91 " - " 4,208.88 " - " 5,067.96 " - " 4,059.24 " - - - " 4,323.09 " " 4,059.24 " " 4,059.24 " " 6,088.86 " " 7,302.17 " " 7,231.13 " Inpatient 861.2 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS " " 20,648.40 " " 6,506.31 " - " 8,820.98 " " 6,151.00 " - " 5,084.31 " - " 6,122.07 " - " 4,903.54 " - - - " 5,222.27 " " 4,903.54 " " 4,903.54 " " 7,355.31 " " 8,820.98 " " 8,735.17 " Inpatient 861.3 "SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS " " 53,484.55 " " 16,852.98 " - " 12,437.58 " " 8,672.91 " - " 7,168.87 " - " 8,632.12 " - " 6,913.99 " - - - " 7,363.40 " " 6,913.99 " " 6,913.99 " " 10,370.99 " " 12,437.58 " " 12,316.58 " Inpatient 862.2 OTHER AFTERCARE & CONVALESCENCE " 38,528.26 " " 12,140.25 " - " 9,734.98 " " 6,788.35 " - " 5,611.13 " - " 6,756.42 " - " 5,411.63 " - - - " 5,763.39 " " 5,411.63 " " 5,411.63 " " 8,117.45 " " 9,734.98 " " 9,640.28 " Inpatient 862.4 OTHER AFTERCARE & CONVALESCENCE " 5,281.16 " " 1,664.09 " - " 28,324.22 " " 19,750.90 " - " 16,325.74 " - " 19,658.01 " - " 15,745.30 " - - - " 16,768.74 " " 15,745.30 " " 15,745.30 " " 23,617.95 " " 28,324.22 " " 28,048.68 " Inpatient 890.3 HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS " 147,947.25 " " 46,618.18 " - " 18,278.82 " " 12,746.10 " - " 10,535.69 " - " 12,686.15 " - " 10,161.11 " - - - " 10,821.58 " " 10,161.11 " " 10,161.11 " " 15,241.67 " " 18,278.82 " " 18,101.00 " Inpatient 890.4 HIV W MULTIPLE MAJOR HIV RELATED CONDITIONS " 91,136.65 " " 28,717.16 " - " 39,552.16 " " 27,580.32 " - " 22,797.39 " - " 27,450.59 " - " 21,986.86 " - - - " 23,416.01 " " 21,986.86 " " 21,986.86 " " 32,980.29 " " 39,552.16 " " 39,167.39 " Inpatient 911.3 EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT " 98,275.86 " " 30,966.72 " - " 38,106.03 " " 26,571.91 " - " 21,963.85 " - " 26,446.93 " - " 21,182.96 " - - - " 22,559.85 " " 21,182.96 " " 21,182.96 " " 31,774.44 " " 38,106.03 " " 37,735.32 " Inpatient 911.4 EXTENSIVE ABDOMINAL/THORACIC PROCEDURES FOR MULT SIGNIFICANT " 331,697.90 " " 104,518.01 " - " 89,298.78 " " 62,269.38 " - " 51,470.74 " - " 61,976.50 " - " 49,640.77 " - - - " 52,867.42 " " 49,640.77 " " 49,640.77 " " 74,461.16 " " 89,298.78 " " 88,430.07 " Inpatient 912.1 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT T " 84,137.14 " " 26,511.61 " - " 24,685.46 " " 17,213.54 " - " 14,228.40 " - " 17,132.58 " - " 13,722.53 " - - - " 14,614.49 " " 13,722.53 " " 13,722.53 " " 20,583.80 " " 24,685.46 " " 24,445.31 " Inpatient 912.2 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT T " 101,182.46 " " 31,882.59 " - " 27,181.11 " " 18,953.80 " - " 15,666.86 " - " 18,864.65 " - " 15,109.85 " - - - " 16,091.99 " " 15,109.85 " " 15,109.85 " " 22,664.78 " " 27,181.11 " " 26,916.69 " Inpatient 912.3 MUSCULOSKELETAL & OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT T " 139,454.29 " " 43,942.05 " - " 43,865.96 " " 30,588.39 " - " 25,283.81 " - " 30,444.52 " - " 24,384.88 " - - - " 25,969.90 " " 24,384.88 " " 24,384.88 " " 36,577.32 " " 43,865.96 " " 43,439.23 " Inpatient 930.2 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE " 60,917.52 " " 19,195.11 " - " 13,358.97 " " 9,315.41 " - " 7,699.95 " - " 9,271.60 " - " 7,426.19 " - - - " 7,908.89 " " 7,426.19 " " 7,426.19 " " 11,139.29 " " 13,358.97 " " 13,229.01 " Inpatient 930.3 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE " 32,311.19 " " 10,181.26 " - " 21,363.27 " " 14,896.93 " - " 12,313.53 " - " 14,826.86 " - " 11,875.74 " - - - " 12,647.66 " " 11,875.74 " " 11,875.74 " " 17,813.61 " " 21,363.27 " " 21,155.44 " Inpatient 930.4 MULTIPLE SIGNIFICANT TRAUMA W/O O.R. PROCEDURE " 101,608.05 " " 32,016.70 " - " 46,414.57 " " 32,365.58 " - " 26,752.80 " - " 32,213.35 " - " 25,801.64 " - - - " 27,478.75 " " 25,801.64 " " 25,801.64 " " 38,702.46 " " 46,414.57 " " 45,963.04 " Inpatient 950.3 EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS " 184,027.71 " " 57,987.13 " - " 38,197.18 " " 26,635.47 " - " 22,016.39 " - " 26,510.19 " - " 21,233.63 " - - - " 22,613.82 " " 21,233.63 " " 21,233.63 " " 31,850.45 " " 38,197.18 " " 37,825.59 " Inpatient 950.4 EXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS " 601,298.64 " " 189,469.20 " - " 80,541.86 " " 56,163.05 " - " 46,423.35 " - " 55,898.89 " - " 44,772.84 " - - - " 47,683.07 " " 44,772.84 " " 44,772.84 " " 67,159.26 " " 80,541.86 " " 79,758.34 " Inpatient 952.2 NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS " 88,921.81 " " 28,019.26 " - " 19,143.55 " " 13,349.09 " - " 11,034.11 " - " 13,286.30 " - " 10,641.81 " - - - " 11,333.53 " " 10,641.81 " " 10,641.81 " " 15,962.72 " " 19,143.55 " " 18,957.32 " Inpatient 952.3 NONEXTENSIVE PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS " 97,345.36 " " 30,673.52 " - " 30,768.13 " " 21,455.08 " - " 17,734.38 " - " 21,354.17 " - " 17,103.86 " - - - " 18,215.61 " " 17,103.86 " " 17,103.86 " " 25,655.79 " " 30,768.13 " " 30,468.82 "