004TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R.$84,075.24$1,169,776.63
023CRANIOTOMY W MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PDX W MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY W NEUROSTIMULATOR$61,860.23$312,775.96
025CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC$43,710.90$330,406.95
026CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC$30,761.86$90,813.42
027CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC$36,311.41$58,636.39
029SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS$38,636.40$76,237.52
030SPINAL PROCEDURES W/O CC/MCC$26,038.95$70,125.46
031VENTRICULAR SHUNT PROCEDURES W MCC$41,491.11$48,691.72
032VENTRICULAR SHUNT PROCEDURES W CC$32,366.51$87,056.79
033VENTRICULAR SHUNT PROCEDURES W/O CC/MCC$32,775.40$32,775.40
034CAROTID ARTERY STENT PROCEDURE W MCC$83,914.28$83,914.28
035CAROTID ARTERY STENT PROCEDURE W CC$53,728.44$53,728.44
036CAROTID ARTERY STENT PROCEDURE W/O CC/MCC$25,741.92$50,122.18
037EXTRACRANIAL PROCEDURES W MCC$39,740.79$55,250.71
038EXTRACRANIAL PROCEDURES W CC$32,369.17$188,119.04
039EXTRACRANIAL PROCEDURES W/O CC/MCC$18,100.29$58,152.71
040PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC$352,830.69$352,830.69
041PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM$36,888.11$59,132.73
054NERVOUS SYSTEM NEOPLASMS W MCC$13,751.84$56,170.95
055NERVOUS SYSTEM NEOPLASMS W/O MCC$16,577.24$52,559.66
056DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC$21,613.27$166,749.50
057DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC$10,675.11$91,088.45
058MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC$21,036.02$21,036.02
060MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC$16,558.88$16,558.88
061ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W MCC$26,831.14$151,253.26
062ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W CC$34,498.86$57,676.84
063ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC AGENT W/O CC/MCC$42,137.87$46,312.22
064INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC$7,856.40$273,082.52
065INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS$6,660.04$82,180.48
066INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC$5,836.04$38,459.39
069TRANSIENT ISCHEMIA W/O THROMBOLYTIC$7,190.66$56,368.31
070NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC$9,152.63$61,951.46
071NONSPECIFIC CEREBROVASCULAR DISORDERS W CC$12,674.36$62,338.51
072NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC$16,043.81$34,276.16
073CRANIAL & PERIPHERAL NERVE DISORDERS W MCC$55,087.90$55,087.90
074CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC$13,658.75$19,887.91
079HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC$13,551.26$13,551.26
082TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC$35,377.21$35,377.21
083TRAUMATIC STUPOR & COMA, COMA >1 HR W CC$19,633.19$83,000.84
084TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC$19,033.75$24,663.27
085TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC$32,332.18$154,286.16
086TRAUMATIC STUPOR & COMA, COMA <1 HR W CC$8,525.77$60,138.04
087TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC$9,740.29$42,966.27
091OTHER DISORDERS OF NERVOUS SYSTEM W MCC$11,438.36$49,582.30
092OTHER DISORDERS OF NERVOUS SYSTEM W CC$9,839.83$40,658.03
093OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC$11,765.39$58,510.79
094BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC$49,126.98$75,535.63
095BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC$73,184.88$91,347.02
097NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC$49,445.67$49,445.67
098NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC$18,314.47$83,068.54
099NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC$44,198.98$44,198.98
100SEIZURES W MCC$8,601.81$253,467.42
101SEIZURES W/O MCC$7,401.58$49,516.36
103HEADACHES W/O MCC$9,291.91$36,431.42
123NEUROLOGICAL EYE DISORDERS$19,134.25$19,134.25
125OTHER DISORDERS OF THE EYE W/O MCC$14,148.12$14,148.12
134OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC$26,552.62$26,552.62
139SALIVARY GLAND PROCEDURES$26,874.32$26,874.32
149DYSEQUILIBRIUM$12,399.84$23,735.39
151EPISTAXIS W/O MCC$15,112.78$15,112.78
152OTITIS MEDIA & URI W MCC$22,073.17$24,001.78
153OTITIS MEDIA & URI W/O MCC$13,846.03$13,846.03
157DENTAL & ORAL DISEASES W MCC$13,590.88$13,590.88
158DENTAL & ORAL DISEASES W CC$19,267.98$24,891.07
163MAJOR CHEST PROCEDURES W MCC$118,208.29$485,828.83
164MAJOR CHEST PROCEDURES W CC$39,747.71$90,926.29
165MAJOR CHEST PROCEDURES W/O CC/MCC$30,310.25$68,169.43
166OTHER RESP SYSTEM O.R. PROCEDURES W MCC$21,250.41$274,633.83
167OTHER RESP SYSTEM O.R. PROCEDURES W CC$20,481.42$55,599.45
168OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC$20,625.14$45,798.12
175PULMONARY EMBOLISM W MCC OR ACUTE COR PULMONALE$14,238.18$134,411.57
176PULMONARY EMBOLISM W/O MCC$8,644.93$59,993.88
177RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC$5,858.81$262,691.77
178RESPIRATORY INFECTIONS & INFLAMMATIONS W CC$7,765.67$46,300.63
179RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC$22,268.57$30,143.13
180RESPIRATORY NEOPLASMS W MCC$17,958.47$82,349.14
181RESPIRATORY NEOPLASMS W CC$18,864.78$22,640.91
182RESPIRATORY NEOPLASMS W/O CC/MCC$46,070.15$46,070.15
183MAJOR CHEST TRAUMA W MCC$22,681.74$80,564.00
184MAJOR CHEST TRAUMA W CC$16,417.98$51,346.88
185MAJOR CHEST TRAUMA W/O CC/MCC$18,575.57$23,635.05
186PLEURAL EFFUSION W MCC$17,768.71$29,025.15
187PLEURAL EFFUSION W CC$11,319.58$29,094.32
188PLEURAL EFFUSION W/O CC/MCC$24,250.97$25,859.54
189PULMONARY EDEMA & RESPIRATORY FAILURE$8,158.70$116,586.89
190CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC$14,834.96$86,767.18
191CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC$11,970.73$65,265.79
192CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC$11,294.68$40,476.98
193SIMPLE PNEUMONIA & PLEURISY W MCC$11,919.73$99,032.16
194SIMPLE PNEUMONIA & PLEURISY W CC$9,174.51$55,400.24
195SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC$8,782.09$37,311.48
196INTERSTITIAL LUNG DISEASE W MCC$19,433.16$121,449.19
199PNEUMOTHORAX W MCC$21,634.26$351,232.95
200PNEUMOTHORAX W CC$17,594.09$52,390.99
201PNEUMOTHORAX W/O CC/MCC$13,121.41$59,525.79
202BRONCHITIS & ASTHMA W CC/MCC$9,253.25$38,976.30
203BRONCHITIS & ASTHMA W/O CC/MCC$8,710.63$36,635.96
204RESPIRATORY SIGNS & SYMPTOMS$8,776.36$35,046.80
205OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC$15,288.59$110,329.26
206OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC$14,407.65$31,090.92
207RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS$61,432.84$285,238.13
208RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS$7,686.45$152,271.08
239AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC$52,855.28$75,650.59
240AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC$29,444.90$75,892.70
242PERMANENT CARDIAC PACEMAKER IMPLANT W MCC$73,614.25$95,014.98
243PERMANENT CARDIAC PACEMAKER IMPLANT W CC$29,597.45$73,568.15
244PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC$45,600.75$68,713.69
245AICD GENERATOR PROCEDURES$93,232.47$93,232.47
246PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS$44,301.37$105,335.49
247PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC$40,892.84$70,742.72
252OTHER VASCULAR PROCEDURES W MCC$33,303.61$71,381.82
253OTHER VASCULAR PROCEDURES W CC$15,917.23$74,253.10
254OTHER VASCULAR PROCEDURES W/O CC/MCC$25,150.21$107,121.95
255UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC$41,101.19$67,157.54
256UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC$25,241.28$80,447.82
260CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC$12,483.06$77,301.23
264OTHER CIRCULATORY SYSTEM O.R. PROCEDURES$50,043.20$220,634.26
268AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC$68,546.23$68,546.23
269AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC$49,010.62$107,369.54
270OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC$23,461.41$315,848.33
271OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC$20,623.69$84,334.44
272OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC$44,406.88$72,145.46
280ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC$10,398.62$209,519.30
281ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC$9,544.89$49,259.36
282ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC$8,829.25$38,309.52
283ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC$14,216.76$32,747.64
284ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC$7,512.98$7,512.98
286CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC$12,618.87$113,547.39
287CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC$13,792.22$49,579.25
289ACUTE & SUBACUTE ENDOCARDITIS W CC$13,387.66$21,860.74
291HEART FAILURE & SHOCK W MCC$8,688.75$189,985.91
292HEART FAILURE & SHOCK W CC$10,907.10$68,958.37
293HEART FAILURE & SHOCK W/O CC/MCC$9,219.75$26,619.60
294DEEP VEIN THROMBOPHLEBITIS W CC/MCC$11,814.08$20,522.53
296CARDIAC ARREST, UNEXPLAINED W MCC$7,761.10$26,734.73
297CARDIAC ARREST, UNEXPLAINED W CC$8,367.96$8,367.96
299PERIPHERAL VASCULAR DISORDERS W MCC$8,306.12$50,357.70
300PERIPHERAL VASCULAR DISORDERS W CC$6,992.47$29,224.87
301PERIPHERAL VASCULAR DISORDERS W/O CC/MCC$9,098.74$24,661.77
302ATHEROSCLEROSIS W MCC$8,985.71$103,203.21
303ATHEROSCLEROSIS W/O MCC$11,485.82$30,897.48
304HYPERTENSION W MCC$13,573.11$65,445.35
305HYPERTENSION W/O MCC$9,108.11$35,475.35
306CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC$19,130.57$33,560.77
307CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC$11,009.62$40,729.92
308CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC$7,461.10$89,052.79
309CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC$7,654.24$57,345.43
310CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC$7,519.73$87,452.30
311ANGINA PECTORIS$10,033.63$23,854.14
312SYNCOPE & COLLAPSE$8,923.54$51,566.18
313CHEST PAIN$6,602.72$40,364.44
314OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC$8,435.07$103,557.26
315OTHER CIRCULATORY SYSTEM DIAGNOSES W CC$9,080.47$47,015.87
316OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC$15,133.35$15,133.35
326STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC$43,223.29$148,695.39
327STOMACH, ESOPHAGEAL & DUODENAL PROC W CC$41,069.18$268,580.25
328STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC$26,274.37$62,956.55
329MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC$25,493.13$529,619.12
330MAJOR SMALL & LARGE BOWEL PROCEDURES W CC$22,454.65$139,980.01
331MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC$22,570.33$49,938.54
333RECTAL RESECTION W CC$41,404.34$41,404.34
334RECTAL RESECTION W/O CC/MCC$15,918.89$15,918.89
335PERITONEAL ADHESIOLYSIS W MCC$48,621.28$149,381.71
336PERITONEAL ADHESIOLYSIS W CC$32,468.89$108,037.75
337PERITONEAL ADHESIOLYSIS W/O CC/MCC$39,042.89$75,962.29
340APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC$34,607.59$34,607.59
343APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC$23,237.27$35,059.27
345MINOR SMALL & LARGE BOWEL PROCEDURES W CC$9,141.54$13,587.48
346MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC$48,761.47$48,761.47
347ANAL & STOMAL PROCEDURES W MCC$147,665.61$148,927.26
348ANAL & STOMAL PROCEDURES W CC$28,811.64$51,018.26
349ANAL & STOMAL PROCEDURES W/O CC/MCC$22,898.35$22,898.35
350INGUINAL & FEMORAL HERNIA PROCEDURES W MCC$46,419.20$46,419.20
351INGUINAL & FEMORAL HERNIA PROCEDURES W CC$57,889.84$57,889.84
352INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC$20,028.93$38,459.26
353HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC$64,041.60$162,925.99
354HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC$21,571.73$68,180.37
355HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC$23,027.58$30,998.32
356OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC$92,630.98$376,022.69
357OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC$23,572.63$91,816.88
368MAJOR ESOPHAGEAL DISORDERS W MCC$21,142.15$109,807.00
369MAJOR ESOPHAGEAL DISORDERS W CC$19,258.65$38,605.53
371MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC$15,707.50$68,933.10
372MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC$15,459.05$73,360.76
373MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC$48,516.53$48,516.53
374DIGESTIVE MALIGNANCY W MCC$22,221.37$167,002.71
375DIGESTIVE MALIGNANCY W CC$9,544.73$63,708.20
377G.I. HEMORRHAGE W MCC$10,615.57$154,474.01
378G.I. HEMORRHAGE W CC$7,680.17$84,530.36
379G.I. HEMORRHAGE W/O CC/MCC$7,649.76$27,799.57
380COMPLICATED PEPTIC ULCER W MCC$52,576.85$66,476.34
381COMPLICATED PEPTIC ULCER W CC$20,490.92$88,632.11
382COMPLICATED PEPTIC ULCER W/O CC/MCC$16,851.77$20,269.01
384UNCOMPLICATED PEPTIC ULCER W/O MCC$13,955.97$23,773.05
385INFLAMMATORY BOWEL DISEASE W MCC$52,059.40$52,059.40
386INFLAMMATORY BOWEL DISEASE W CC$12,056.42$50,929.85
387INFLAMMATORY BOWEL DISEASE W/O CC/MCC$16,225.74$17,776.20
388G.I. OBSTRUCTION W MCC$17,618.34$110,874.36
389G.I. OBSTRUCTION W CC$11,884.85$61,597.64
390G.I. OBSTRUCTION W/O CC/MCC$12,310.66$59,659.57
391ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC$11,235.53$160,663.12
392ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC$7,488.26$61,979.95
393OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC$7,739.07$102,896.45
394OTHER DIGESTIVE SYSTEM DIAGNOSES W CC$12,296.55$96,978.54
395OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC$113.52$55,219.58
405PANCREAS, LIVER & SHUNT PROCEDURES W MCC$88,956.41$88,956.41
406PANCREAS, LIVER & SHUNT PROCEDURES W CC$74,696.40$107,748.67
407PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC$31,043.45$92,432.27
409BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC$78,250.80$78,250.80
414CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC$50,916.76$79,534.45
415CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC$32,603.10$128,332.70
416CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC$28,979.90$28,979.90
417LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC$28,436.91$109,919.36
418LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC$33,972.30$85,013.95
419LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC$22,986.17$58,412.76
423OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC$116,181.55$116,181.55
424OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC$53,667.55$53,667.55
432CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC$27,662.94$41,843.53
433CIRRHOSIS & ALCOHOLIC HEPATITIS W CC$10,903.68$51,026.40
435MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC$26,717.72$64,586.34
436MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC$22,484.58$101,605.63
438DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC$17,043.52$34,760.99
439DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC$8,978.20$62,482.97
440DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC$9,673.14$21,570.52
441DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC$11,801.20$88,061.96
442DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W CC$13,459.79$52,728.82
443DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W/O CC/MCC$7,391.40$30,212.40
444DISORDERS OF THE BILIARY TRACT W MCC$33,238.23$195,986.03
445DISORDERS OF THE BILIARY TRACT W CC$11,982.50$66,696.00
446DISORDERS OF THE BILIARY TRACT W/O CC/MCC$8,752.15$57,863.67
453COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC$201,556.12$393,940.70
454COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC$61,495.69$150,306.73
455COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC$63,529.54$134,380.86
457SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC$124,093.79$124,093.79
458SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC$81,233.11$81,233.11
459SPINAL FUSION EXCEPT CERVICAL W MCC$119,446.64$435,650.20
460SPINAL FUSION EXCEPT CERVICAL W/O MCC$54,309.39$260,884.03
463WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC$69,798.68$69,798.68
465WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC$67,444.91$67,444.91
466REVISION OF HIP OR KNEE REPLACEMENT W MCC$102,116.98$102,116.98
467REVISION OF HIP OR KNEE REPLACEMENT W CC$39,435.51$82,137.77
468REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC$87,081.57$87,081.57
469MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC OR TOTAL ANKLE REPLACEMENT$42,202.30$98,287.39
470MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC$29,357.42$76,774.04
472CERVICAL SPINAL FUSION W CC$52,036.56$150,737.56
473CERVICAL SPINAL FUSION W/O CC/MCC$44,850.90$94,452.51
475AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC$44,451.59$44,451.59
477BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC$82,323.97$82,323.97
478BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC$51,744.50$72,374.29
479BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC$36,357.96$76,134.04
480HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC$29,988.56$115,189.39
481HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC$26,939.26$79,870.42
482HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC$32,406.83$64,173.11
483MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES$61,703.95$61,703.95
486KNEE PROCEDURES W PDX OF INFECTION W CC$36,316.73$53,569.78
492LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W MCC$45,517.92$125,093.85
493LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W CC$20,010.31$65,412.09
494LOWER EXTREM & HUMER PROC EXCEPT HIP, FOOT, FEMUR W/O CC/MCC$23,387.97$47,784.28
496LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC$45,682.33$45,682.33
500SOFT TISSUE PROCEDURES W MCC$70,090.47$72,864.12
501SOFT TISSUE PROCEDURES W CC$29,783.00$48,513.87
502SOFT TISSUE PROCEDURES W/O CC/MCC$24,437.75$24,437.75
504FOOT PROCEDURES W CC$30,891.02$30,891.02
505FOOT PROCEDURES W/O CC/MCC$31,428.45$42,713.10
507MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC$41,571.98$41,571.98
511SHOULDER, ELBOW OR FOREARM PROC, EXC MAJOR JOINT PROC W CC$30,710.42$30,710.42
512SHOULDER, ELBOW OR FOREARM PROC, EXC MAJOR JOINT PROC W/O CC/MCC$16,341.16$34,810.07
514HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC$23,365.97$23,365.97
515OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC$28,994.01$68,745.45
516OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC$29,537.90$89,037.00
517OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC$33,150.84$63,074.98
518BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM$56,135.64$56,135.64
519BACK & NECK PROC EXC SPINAL FUSION W CC$46,583.84$162,057.54
520BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC$21,539.49$25,788.92
534FRACTURES OF FEMUR W/O MCC$22,726.06$30,945.09
535FRACTURES OF HIP & PELVIS W MCC$20,167.75$59,867.47
536FRACTURES OF HIP & PELVIS W/O MCC$7,962.98$51,222.96
538SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC$21,228.52$21,228.52
539OSTEOMYELITIS W MCC$26,836.76$50,214.12
540OSTEOMYELITIS W CC$53,077.17$53,077.17
541OSTEOMYELITIS W/O CC/MCC$33,695.60$33,695.60
542PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC$14,032.53$73,998.13
543PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC$20,586.97$84,786.91
545CONNECTIVE TISSUE DISORDERS W MCC$26,394.34$197,727.57
547CONNECTIVE TISSUE DISORDERS W/O CC/MCC$33,449.77$33,449.77
548SEPTIC ARTHRITIS W MCC$19,452.97$19,452.97
551MEDICAL BACK PROBLEMS W MCC$23,802.65$55,445.46
552MEDICAL BACK PROBLEMS W/O MCC$6,853.44$60,749.62
553BONE DISEASES & ARTHROPATHIES W MCC$16,296.61$49,387.20
554BONE DISEASES & ARTHROPATHIES W/O MCC$11,747.90$25,920.39
556SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC$13,833.75$30,011.76
557TENDONITIS, MYOSITIS & BURSITIS W MCC$27,692.18$80,053.78
558TENDONITIS, MYOSITIS & BURSITIS W/O MCC$15,610.75$51,849.57
559AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC$35,699.88$35,699.88
561AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC$22,199.94$22,199.94
562FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC$16,410.39$33,195.18
563FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC$10,244.02$25,722.18
564OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC$28,856.33$41,139.42
565OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC$18,858.25$38,625.71
566OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC$19,496.98$27,516.34
570SKIN DEBRIDEMENT W MCC$19,326.37$52,202.50
571SKIN DEBRIDEMENT W CC$20,784.33$44,359.06
572SKIN DEBRIDEMENT W/O CC/MCC$18,221.75$39,590.03
573SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC$27,849.44$75,203.84
574SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC$32,683.82$60,419.02
579OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC$143,288.51$143,288.51
580OTHER SKIN, SUBCUT TISS & BREAST PROC W CC$11,039.62$75,460.64
581OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC$6,655.28$31,792.97
582MASTECTOMY FOR MALIGNANCY W CC/MCC$49,306.73$49,306.73
583MASTECTOMY FOR MALIGNANCY W/O CC/MCC$74,956.68$74,956.68
584BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC$36,132.02$36,132.02
585BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC$43,190.08$43,190.08
593SKIN ULCERS W CC$14,382.02$14,382.02
594SKIN ULCERS W/O CC/MCC$6,497.39$6,497.39
595MAJOR SKIN DISORDERS W MCC$49,962.00$49,962.00
596MAJOR SKIN DISORDERS W/O MCC$14,088.37$28,946.47
597MALIGNANT BREAST DISORDERS W MCC$23,361.99$104,166.65
602CELLULITIS W MCC$17,360.24$48,667.09
603CELLULITIS W/O MCC$7,338.26$46,388.74
604TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC$31,799.49$31,799.49
605TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC$19,699.14$24,752.39
606MINOR SKIN DISORDERS W MCC$21,546.54$21,546.54
607MINOR SKIN DISORDERS W/O MCC$12,614.93$12,614.93
614ADRENAL & PITUITARY PROCEDURES W CC/MCC$60,751.14$65,647.81
616AMPUTAT OF LOWER LIMB FOR ENDOCRINE, NUTRIT, & METABOL DIS W MCC$30,167.21$86,336.71
617AMPUTAT OF LOWER LIMB FOR ENDOCRINE, NUTRIT, & METABOL DIS W CC$13,859.28$109,946.60
623SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC$29,132.39$61,240.42
625THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W MCC$54,652.13$54,652.13
629OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC$19,966.23$49,946.64
637DIABETES W MCC$15,203.58$288,783.99
638DIABETES W CC$8,228.98$79,519.91
639DIABETES W/O CC/MCC$9,869.66$19,810.75
640MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W MCC$10,936.72$201,309.87
641MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC$7,552.66$118,232.16
642INBORN AND OTHER DISORDERS OF METABOLISM$6,025.29$10,978.27
643ENDOCRINE DISORDERS W MCC$22,158.66$92,749.52
644ENDOCRINE DISORDERS W CC$14,659.09$77,348.80
645ENDOCRINE DISORDERS W/O CC/MCC$12,426.45$40,813.70
653MAJOR BLADDER PROCEDURES W MCC$99,495.28$99,495.28
654MAJOR BLADDER PROCEDURES W CC$46,805.87$123,950.57
655MAJOR BLADDER PROCEDURES W/O CC/MCC$43,904.55$70,720.03
656KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC$59,303.41$59,303.41
657KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC$29,364.64$122,011.09
658KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC$26,420.49$66,834.46
659KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC$20,275.61$64,324.54
660KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC$19,182.44$95,133.18
661KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC$18,133.60$56,565.26
662MINOR BLADDER PROCEDURES W MCC$86,610.20$86,768.88
663MINOR BLADDER PROCEDURES W CC$15,818.11$15,818.11
666PROSTATECTOMY W CC$27,681.74$34,013.20
667PROSTATECTOMY W/O CC/MCC$29,574.35$29,574.35
668TRANSURETHRAL PROCEDURES W MCC$37,568.90$100,074.07
669TRANSURETHRAL PROCEDURES W CC$26,780.28$69,669.31
670TRANSURETHRAL PROCEDURES W/O CC/MCC$26,416.11$34,275.42
671URETHRAL PROCEDURES W CC/MCC$40,130.70$40,130.70
673OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC$39,711.78$262,015.25
674OTHER KIDNEY & URINARY TRACT PROCEDURES W CC$8,439.38$81,294.77
675OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC$46,558.11$46,558.11
682RENAL FAILURE W MCC$8,747.31$347,337.30
683RENAL FAILURE W CC$7,239.60$84,129.48
684RENAL FAILURE W/O CC/MCC$7,362.46$48,205.25
686KIDNEY & URINARY TRACT NEOPLASMS W MCC$165,604.50$165,604.50
687KIDNEY & URINARY TRACT NEOPLASMS W CC$15,554.32$40,961.37
688KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC$43,909.92$49,063.83
689KIDNEY & URINARY TRACT INFECTIONS W MCC$9,108.34$162,155.17
690KIDNEY & URINARY TRACT INFECTIONS W/O MCC$8,712.67$40,009.01
694URINARY STONES W/O MCC$10,444.18$31,031.87
696KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC$10,031.44$26,969.66
698OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC$15,111.74$104,630.77
699OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC$18,822.00$51,946.37
707MAJOR MALE PELVIC PROCEDURES W CC/MCC$41,309.95$41,311.65
708MAJOR MALE PELVIC PROCEDURES W/O CC/MCC$33,062.68$57,676.10
709PENIS PROCEDURES W CC/MCC$38,852.79$38,852.79
713TRANSURETHRAL PROSTATECTOMY W CC/MCC$26,543.07$56,243.04
728INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC$15,542.47$54,726.92
736UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC$55,241.77$268,386.08
737UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC$45,255.00$91,873.65
738UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC$33,143.90$33,143.90
740UTERINE, ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC$47,975.34$47,975.34
741UTERINE, ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC$54,484.73$54,484.73
742UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC$29,690.13$38,572.63
743UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC$35,222.90$35,222.90
746VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC$31,948.29$41,809.64
747VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC$24,374.48$66,500.18
748FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES$21,839.00$21,839.00
754MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC$31,531.32$109,276.35
755MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC$10,642.35$45,456.52
760MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC$31,346.78$31,346.78
787CESAREAN SECTION W/O STERILIZATION W CC$17,291.14$28,673.02
788CESAREAN SECTION W/O STERILIZATION W/O CC/MCC$20,370.65$27,140.51
806VAGINAL DELIVERY W/O STERILIZATION/D&C W CC$13,070.35$13,158.44
807VAGINAL DELIVERY W/O STERILIZATION/D&C W/O CC/MCC$8,491.04$15,495.36
808MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC$35,178.33$104,005.73
809MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC$11,294.26$83,440.88
810MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC$15,513.19$48,293.90
811RED BLOOD CELL DISORDERS W MCC$8,223.93$52,176.93
812RED BLOOD CELL DISORDERS W/O MCC$8,159.08$61,884.88
813COAGULATION DISORDERS$13,213.91$263,604.75
815RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC$32,349.01$32,349.01
821LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC$113,577.72$113,577.72
823LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W MCC$205,792.56$205,792.56
824LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W CC$19,546.53$31,500.56
826MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC$63,867.60$63,867.60
827MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC$39,467.69$110,894.69
828MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC$77,786.98$77,786.98
829MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS W OTHER PROCEDURE W CC/MCC$43,682.21$80,801.84
834ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC$17,477.19$151,198.70
837CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC$137,816.17$137,816.17
838CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT$23,005.47$23,005.47
840LYMPHOMA & NON-ACUTE LEUKEMIA W MCC$24,175.03$310,216.81
841LYMPHOMA & NON-ACUTE LEUKEMIA W CC$20,714.24$123,646.66
842LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC$26,991.51$26,991.51
847CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC$36,063.04$60,800.82
853INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC$15,487.76$538,642.16
854INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC$19,934.29$208,943.69
856POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC$28,299.03$299,821.36
857POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC$25,477.18$59,215.11
858POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC$35,391.53$35,391.53
862POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC$21,441.84$68,899.20
863POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC$13,358.52$13,358.52
864FEVER AND INFLAMMATORY CONDITIONS$7,143.84$20,422.39
865VIRAL ILLNESS W MCC$16,489.59$101,124.17
866VIRAL ILLNESS W/O MCC$17,599.44$25,233.14
867OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC$6,326.50$136,694.22
868OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC$36,646.51$36,646.51
869OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC$23,134.18$23,134.18
870SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS$72,374.89$493,698.64
871SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC$5,291.98$372,937.75
872SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC$7,607.70$107,992.05
876O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS$27,329.55$27,329.55
880ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION$15,522.76$23,694.18
881DEPRESSIVE NEUROSES$5,747.19$26,117.74
883DISORDERS OF PERSONALITY & IMPULSE CONTROL$25,913.95$25,913.95
884ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY$11,961.01$21,467.69
885PSYCHOSES$5,557.95$203,371.03
894ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA$9,746.23$25,277.83
896ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC$23,534.85$64,776.28
897ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC$7,261.20$58,496.37
901WOUND DEBRIDEMENTS FOR INJURIES W MCC$25,142.85$25,142.85
904SKIN GRAFTS FOR INJURIES W CC/MCC$24,707.45$24,707.45
905SKIN GRAFTS FOR INJURIES W/O CC/MCC$25,584.92$25,584.92
907OTHER O.R. PROCEDURES FOR INJURIES W MCC$67,320.06$206,561.00
908OTHER O.R. PROCEDURES FOR INJURIES W CC$18,879.06$41,126.92
913TRAUMATIC INJURY W MCC$42,162.41$42,162.41
914TRAUMATIC INJURY W/O MCC$18,364.15$37,531.94
916ALLERGIC REACTIONS W/O MCC$8,861.97$10,142.91
917POISONING & TOXIC EFFECTS OF DRUGS W MCC$9,499.43$72,055.49
918POISONING & TOXIC EFFECTS OF DRUGS W/O MCC$9,341.56$35,468.87
919COMPLICATIONS OF TREATMENT W MCC$22,145.72$119,049.57
920COMPLICATIONS OF TREATMENT W CC$7,968.22$27,762.17
921COMPLICATIONS OF TREATMENT W/O CC/MCC$7,532.19$27,173.98
947SIGNS & SYMPTOMS W MCC$16,050.79$57,324.87
948SIGNS & SYMPTOMS W/O MCC$7,823.32$38,338.96
951OTHER FACTORS INFLUENCING HEALTH STATUS$10,945.38$10,945.38
955CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA$74,525.39$74,525.39
956LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA$44,322.08$44,322.08
957OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC$366,437.13$366,437.13
963OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC$47,511.96$89,679.98
969HIV W EXTENSIVE O.R. PROCEDURE W MCC$42,465.44$42,465.44
974HIV W MAJOR RELATED CONDITION W MCC$13,628.42$39,126.71
975HIV W MAJOR RELATED CONDITION W CC$20,930.69$33,949.83
977HIV W OR W/O OTHER RELATED CONDITION$28,941.81$28,941.81
981EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC$20,891.70$155,308.52
982EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC$33,410.64$129,190.55
983EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC$24,163.77$26,220.74
987NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC$21,797.72$89,665.64
988NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC$19,526.37$56,790.06