National Average Payment (Ver 30.0) Average Length of Stay (in days) Average Charge Per Stay. Average Charge Per Day.

Transcription

1 Per HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W MCC ,675 $223,519,640 1 $139, $1,011,401 $19, HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM W/O MCC 54 1,440 $31,764,923 2 $74, $588,239 $22, ECMO OR TRACH W MV 96+ HRS OR PDX EXC FACE MOUTH & NECK W MAJ O.R. 4, ,802 $2,735,386,433 3 $94, $640,606 $14, TRACH W MV 96+ HRS OR PDX EXC FACE MOUTH & NECK W/O MAJ O.R. 3, ,232 $1,443,791,223 4 $58, $395,668 $12, LIVER TRANSPLANT W MCC OR INTESTINAL TRANSPLANT 322 6,686 $147,439,028 5 $58, $457,885 $22, LIVER TRANSPLANT W/O MCC $22,097,385 6 $25, $256,946 $31, LUNG TRANSPLANT 85 1,883 $41,102,677 7 $51, $483,561 $21, SIMULTANEOUS PANCREAS/KIDNEY TRANSPLANT $18,048, $353,883 $30, PANCREAS TRANSPLANT 7 77 $1,429, $20, $204,213 $18, TRACHEOSTOMY FOR FACEMOUTH & NECK DIAGNOSES W MCC 346 4,456 $55,831, $25, $161,363 $12, TRACHEOSTOMY FOR FACEMOUTH & NECK DIAGNOSES W CC 407 3,627 $48,867, $120,067 $13, TRACHEOSTOMY FOR FACEMOUTH & NECK DIAGNOSES W/O CC/MCC 222 1,406 $20,864, $10, $93,984 $14, ALLOGENEIC BONE MARROW TRANSPLANT ,544 $169,433, $56, $460,418 $14, AUTOLOGOUS BONE MARROW TRANSPLANT W CC/MCC 512 9,862 $126,515, $32, $247,100 $12, AUTOLOGOUS BONE MARROW TRANSPLANT W/O CC/MCC $8,114, $24, $202,874 $12, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC 371 6,666 $125,718, $48, $338,865 $18, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC 198 2,784 $51,336, $35, $259,274 $18, INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC $14,919, $24, $181,947 $20, CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT 1,217 15,481 $253,224, $28, $208,073 $16, CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC 476 3,765 $67,621, $18, $142,062 $17, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC 3,420 36,150 $570,281, $24, $166,749 $15, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC 2,213 14,786 $262,140, $15, $118,455 $17, CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC 2,892 10,350 $252,158, $11, $87,192 $24, SPINAL PROCEDURES W MCC 450 6,401 $84,156, $29, $187,015 $13, SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS 1,014 6,877 $106,188, $15, $104,723 $15, SPINAL PROCEDURES W/O CC/MCC 1,039 3,749 $75,367, $9, $72,538 $20, VENTRICULAR SHUNT PROCEDURES W MCC 262 2,682 $32,147, $22, $122,701 $11, VENTRICULAR SHUNT PROCEDURES W CC 682 3,290 $46,512, $10, $68,200 $14, VENTRICULAR SHUNT PROCEDURES W/O CC/MCC 749 1,938 $39,577, $7, $52,841 $20, CAROTID ARTERY STENT PROCEDURE W MCC 137 1,175 $18,863, $19, $137,691 $16, CAROTID ARTERY STENT PROCEDURE W CC 301 1,225 $24,846, $11, $82,545 $20, CAROTID ARTERY STENT PROCEDURE W/O CC/MCC 579 1,009 $32,658, $8, $56,405 $32, EXTRACRANIAL PROCEDURES W MCC 665 6,162 $86,380, $17, $129,895 $14, EXTRACRANIAL PROCEDURES W CC 1,835 7,782 $139,135, $8, $75,823 $17, EXTRACRANIAL PROCEDURES W/O CC/MCC 5,207 9,391 $255,536, $5, $49,076 $27, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC ,223 $115,031, $20, $147,099 $10, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM 1,404 9,580 $108,105, $11, $76,999 $11, PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC 645 2,189 $40,400, $9, $62,637 $18, SPINAL DISORDERS & INJURIES W CC/MCC 192 1,201 $10,974, $7, $57,160 $9, SPINAL DISORDERS & INJURIES W/O CC/MCC $4,574, $4, $39,781 $13, NERVOUS SYSTEM NEOPLASMS W MCC 2,091 10,927 $98,081, $7, $46,906 $8, NERVOUS SYSTEM NEOPLASMS W/O MCC 1,865 7,284 $72,878, $5, $39,077 $10, DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC 1,585 11,939 $88,601, $9, $55,900 $7, DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC 5,613 28,319 $187,936, $5, $33,482 $6, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC 144 1,009 $9,937, $8, $69,013 $9, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC 749 3,429 $29,353, $5, $39,190 $8, MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC 1,111 3,884 $35,181, $4, $31,666 $9, ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC 619 5,050 $67,961, $15, $109,792 $13, ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC 1,128 5,927 $86,814, $10, $76,963 $14, ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC 451 1,576 $30,652, $8, $67,965 $19, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC 9,212 61,528 $640,538, $9, $69,533 $10, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC 15,056 69,774 $688,482, $6, $45,728 $9, INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC 10,368 31,217 $367,096, $4, $35,407 $11, NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC $8,239, $8, $58,027 $10, NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC 1,193 3,558 $45,213, $4, $37,899 $12, TRANSIENT ISCHEMIA 14,863 34,955 $461,443, $3, $31,046 $13, NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC 1,532 10,462 $89,403, $9, $58,358 $8, NONSPECIFIC CEREBROVASCULAR DISORDERS W CC 2,111 10,006 $82,065, $5, $38,875 $8, NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC 1,191 3,246 $35,122, $4, $29,490 $10, CRANIAL & PERIPHERAL NERVE DISORDERS W MCC 1,121 7,056 $59,689, $6, $53,247 $8, Page 1 of 13

2 Per CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC 7,154 26,068 $235,615, $4, $32,935 $9, VIRAL MENINGITIS W CC/MCC 578 3,022 $28,936, $9, $50,063 $9, VIRAL MENINGITIS W/O CC/MCC 1,162 3,613 $31,542, $4, $27,145 $8, HYPERTENSIVE ENCEPHALOPATHY W MCC 207 1,268 $11,926, $8, $57,614 $9, HYPERTENSIVE ENCEPHALOPATHY W CC 510 1,798 $19,419, $5, $38,077 $10, HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC $6,593, $3, $30,810 $11, NONTRAUMATIC STUPOR & COMA W MCC $6,335, $6, $45,253 $9, NONTRAUMATIC STUPOR & COMA W/O MCC 575 1,693 $14,366, $3, $24,985 $8, TRAUMATIC STUPOR & COMA COMA >1 HR W MCC 647 4,014 $50,366, $10, $77,846 $12, TRAUMATIC STUPOR & COMA COMA >1 HR W CC 607 2,764 $33,906, $7, $55,858 $12, TRAUMATIC STUPOR & COMA COMA >1 HR W/O CC/MCC 813 2,171 $30,451, $4, $37,456 $14, TRAUMATIC STUPOR & COMA COMA <1 HR W MCC 1,613 11,673 $119,258, $10, $73,936 $10, TRAUMATIC STUPOR & COMA COMA <1 HR W CC 2,714 11,524 $115,835, $6, $42,681 $10, TRAUMATIC STUPOR & COMA COMA <1 HR W/O CC/MCC 3,812 8,943 $108,403, $4, $28,437 $12, CONCUSSION W MCC 242 1,064 $17,681, $8, $73,063 $16, CONCUSSION W CC 714 2,164 $38,134, $5, $53,410 $17, CONCUSSION W/O CC/MCC 1,009 1,572 $39,189, $3, $38,840 $24, OTHER DISORDERS OF NERVOUS SYSTEM W MCC 1,747 12,472 $103,947, $8, $59,500 $8, OTHER DISORDERS OF NERVOUS SYSTEM W CC 3,413 12,678 $116,614, $4, $34,168 $9, OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC 3,201 7,888 $90,679, $3, $28,328 $11, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC 344 4,996 $44,953, $19, $130,678 $8, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC 342 3,525 $31,654, $13, $92,558 $8, BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC 243 1,626 $21,088, $10, $86,782 $12, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC 263 3,329 $40,639, $18, $154,524 $12, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC 275 2,156 $21,388, $9, $77,775 $9, NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC 279 1,323 $12,038, $6, $43,149 $9, SEIZURES W MCC 4,500 23,758 $242,556, $8, $53,902 $10, SEIZURES W/O MCC 18,035 47,723 $471,396, $4, $26,138 $9, HEADACHES W MCC 380 1,408 $14,357, $5, $37,782 $10, HEADACHES W/O MCC 6,567 16,455 $183,201, $3, $27,897 $11, ORBITAL PROCEDURES W CC/MCC 223 1,052 $15,614, $9, $70,020 $14, ORBITAL PROCEDURES W/O CC/MCC $7,802, $5, $45,896 $16, EXTRAOCULAR PROCEDURES EXCEPT ORBIT $9,644, $6, $44,443 $11, INTRAOCULAR PROCEDURES W CC/MCC $5,847, $8, $67,995 $12, INTRAOCULAR PROCEDURES W/O CC/MCC $3,790, $3, $40,756 $19, ACUTE MAJOR EYE INFECTIONS W CC/MCC 216 1,059 $7,086, $5, $32,808 $6, ACUTE MAJOR EYE INFECTIONS W/O CC/MCC 367 1,088 $6,975, $3, $19,006 $6, NEUROLOGICAL EYE DISORDERS 967 2,544 $30,176, $4, $31,206 $11, OTHER DISORDERS OF THE EYE W MCC $8,558, $6, $52,509 $9, OTHER DISORDERS OF THE EYE W/O MCC 1,716 4,652 $39,880, $3, $23,240 $8, MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE 292 1,282 $24,135, $11, $82,655 $18, MAJOR HEAD & NECK PROCEDURES W/O CC/MCC $14,465, $6, $64,007 $24, CRANIAL/FACIAL PROCEDURES W CC/MCC 721 3,545 $60,912, $12, $84,484 $17, CRANIAL/FACIAL PROCEDURES W/O CC/MCC 1,095 2,448 $63,763, $6, $58,232 $26, OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W CC/MCC 928 4,577 $55,935, $9, $60,276 $12, OTHER EAR NOSE MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC 2,249 4,419 $69,708, $4, $30,995 $15, SINUS & MASTOID PROCEDURES W CC/MCC $9,129, $10, $76,076 $12, SINUS & MASTOID PROCEDURES W/O CC/MCC $2,848, $46,698 $16, MOUTH PROCEDURES W CC/MCC 430 1,740 $18,402, $42,796 $10, MOUTH PROCEDURES W/O CC/MCC $9,768, $32,890 $12, SALIVARY GLAND PROCEDURES $7,777, $45,217 $20, EAR NOSE MOUTH & THROAT MALIGNANCY W MCC 182 1,540 $12,731, $69,952 $8, EAR NOSE MOUTH & THROAT MALIGNANCY W CC 340 2,051 $16,336, $48,047 $7, EAR NOSE MOUTH & THROAT MALIGNANCY W/O CC/MCC $6,605, $36,695 $7, DYSEQUILIBRIUM 5,895 12,417 $157,185, $26,664 $12, EPISTAXIS W MCC $5,283, $42,605 $9, EPISTAXIS W/O MCC 736 1,901 $15,861, $21,550 $8, OTITIS MEDIA & URI W MCC 945 4,012 $33,366, $35,308 $8, OTITIS MEDIA & URI W/O MCC 9,230 21,892 $170,553, $18,478 $7, OTHER EAR NOSE MOUTH & THROAT DIAGNOSES W MCC 358 1,895 $16,728, $46,727 $8, Page 2 of 13

3 Per OTHER EAR NOSE MOUTH & THROAT DIAGNOSES W CC 1,316 4,764 $41,822, $31,780 $8, OTHER EAR NOSE MOUTH & THROAT DIAGNOSES W/O CC/MCC 1,320 3,190 $27,957, $21,180 $8, DENTAL & ORAL DISEASES W MCC 320 1,936 $17,937, $56,056 $9, DENTAL & ORAL DISEASES W CC 1,372 4,598 $40,190, $29,294 $8, DENTAL & ORAL DISEASES W/O CC/MCC 1,094 2,467 $24,107, $22,036 $9, MAJOR CHEST PROCEDURES W MCC 2,251 32,504 $410,316, $182,282 $12, MAJOR CHEST PROCEDURES W CC 3,255 22,464 $319,910, $98,283 $14, MAJOR CHEST PROCEDURES W/O CC/MCC 1,917 8,584 $148,692, $77,565 $17, OTHER RESP SYSTEM O.R. PROCEDURES W MCC 3,642 57,224 $545,756, $149,851 $9, OTHER RESP SYSTEM O.R. PROCEDURES W CC 2,849 20,705 $214,692, $75,357 $10, OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC 728 3,331 $38,858, $53,377 $11, PULMONARY EMBOLISM W MCC 2,485 16,949 $149,217, $60,047 $8, PULMONARY EMBOLISM W/O MCC 7,096 31,846 $270,701, $38,149 $8, RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC 7,920 71,218 $569,926, $71,960 $8, RESPIRATORY INFECTIONS & INFLAMMATIONS W CC 6,412 45,291 $337,663, $52,661 $7, RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC 1,918 10,978 $73,642, $38,396 $6, RESPIRATORY NEOPLASMS W MCC 3,355 23,552 $209,381, $62,409 $8, RESPIRATORY NEOPLASMS W CC 3,750 19,096 $173,539, $46,277 $9, RESPIRATORY NEOPLASMS W/O CC/MCC 612 1,969 $19,011, $31,065 $9, MAJOR CHEST TRAUMA W MCC 390 2,294 $21,229, $54,434 $9, MAJOR CHEST TRAUMA W CC 1,087 4,125 $44,215, $40,677 $10, MAJOR CHEST TRAUMA W/O CC/MCC $11,092, $27,593 $11, PLEURAL EFFUSION W MCC 1,335 8,711 $73,006, $54,687 $8, PLEURAL EFFUSION W CC 1,680 7,321 $65,107, $38,755 $8, PLEURAL EFFUSION W/O CC/MCC 463 1,481 $13,999, $30,235 $9, PULMONARY EDEMA & RESPIRATORY FAILURE 14, ,371 $719,986, $50,163 $7, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC 21, ,316 $936,993, $42,946 $7, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC 23, ,638 $837,596, $5, $35,239 $7, CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC 21,847 71,140 $569,813, $26,082 $8, SIMPLE PNEUMONIA & PLEURISY W MCC 15, ,856 $833,349, $54,364 $8, SIMPLE PNEUMONIA & PLEURISY W CC 28, ,461 $961,695, $5, $34,250 $7, SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC 17,160 51,712 $405,293, $23,618 $7, INTERSTITIAL LUNG DISEASE W MCC 1,030 7,137 $57,485, $55,811 $8, INTERSTITIAL LUNG DISEASE W CC 946 4,657 $37,636, $39,785 $8, INTERSTITIAL LUNG DISEASE W/O CC/MCC 514 1,677 $14,708, $28,616 $8, PNEUMOTHORAX W MCC 708 5,241 $43,599, $61,581 $8, PNEUMOTHORAX W CC 1,973 8,569 $73,934, $37,473 $8, PNEUMOTHORAX W/O CC/MCC 1,174 3,764 $28,194, $24,016 $7, BRONCHITIS & ASTHMA W CC/MCC 12,154 44,095 $341,547, $28,102 $7, BRONCHITIS & ASTHMA W/O CC/MCC 18,564 43,752 $315,404, $16,990 $7, RESPIRATORY SIGNS & SYMPTOMS 4,187 10,299 $106,699, $25,484 $10, OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC 1,126 6,836 $60,647, $53,861 $8, OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC 3,638 9,910 $106,628, $29,310 $10, RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT 96+ HOURS 7, ,165 $1,488,053, $202,374 $9, RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <96 HOURS 11,825 81,727 $969,398, $81,979 $11, OTHER HEART ASSIST SYSTEM IMPLANT $10,839, $471,274 $29, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC 1,802 28,952 $635,798, $352,830 $21, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC 865 9,478 $219,371, $253,609 $23, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC 192 1,397 $38,919, $202,705 $27, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC 2,760 33,783 $756,258, $274,007 $22, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC 3,069 22,862 $577,152, $188,059 $25, CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC 930 5,023 $146,331, $157,346 $29, CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC 298 3,942 $83,825, $281,293 $21, CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W/O MCC 358 2,482 $71,403, $199,450 $28, CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC 422 4,352 $105,731, $250,550 $24, CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W/O MCC 551 2,796 $102,726, $186,436 $36, CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC 913 8,262 $182,116, $199,470 $22, CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC 2,804 11,219 $447,683, $159,659 $39, OTHER CARDIOTHORACIC PROCEDURES W MCC 485 8,179 $163,623, $337,368 $20, OTHER CARDIOTHORACIC PROCEDURES W CC 674 5,613 $125,499, $186,202 $22, Page 3 of 13

4 Per OTHER CARDIOTHORACIC PROCEDURES W/O CC/MCC $29,302, $133,192 $29, CORONARY BYPASS W PTCA W MCC 235 2,991 $74,717, $317,947 $24, CORONARY BYPASS W PTCA W/O MCC 244 2,182 $58,612, $240,213 $26, CORONARY BYPASS W CARDIAC CATH W MCC 2,356 30,204 $630,893, $267,781 $20, CORONARY BYPASS W CARDIAC CATH W/O MCC 3,636 31,348 $707,374, $194,547 $22, CORONARY BYPASS W/O CARDIAC CATH W MCC 1,435 14,944 $288,253, $200,873 $19, CORONARY BYPASS W/O CARDIAC CATH W/O MCC 2,911 19,996 $418,572, $143,790 $20, MAJOR CARDIOVASC PROCEDURES W MCC 3,236 35,277 $627,287, $193,847 $17, MAJOR CARDIOVASC PROCEDURES W/O MCC 6,047 26,372 $728,710, $120,508 $27, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC ,966 $170,349, $172,418 $10, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC 1,130 12,585 $125,065, $110,677 $9, AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC $8,329, $62,160 $9, PERMANENT CARDIAC PACEMAKER IMPLANT W MCC 2,095 16,496 $254,737, $121,593 $15, PERMANENT CARDIAC PACEMAKER IMPLANT W CC 4,356 20,665 $380,476, $87,345 $18, PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC 4,129 12,273 $300,735, $72,835 $24, AICD GENERATOR PROCEDURES 514 2,218 $66,234, $128,861 $29, PERC CARDIOVASC PROC W DRUG-ELUTING STENT W MCC OR 4+ VESSELS/STENTS 5,261 29,918 $687,724, $130,721 $22, PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC 22,714 59,151 $2,036,074, $10, $89,640 $34, PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W MCC OR 4+ VES/STENTS 1,695 11,247 $217,127, $128,099 $19, PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC 4,713 14,261 $407,152, $86,389 $28, PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC 1,542 10,954 $190,936, $123,824 $17, PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC 7,221 20,960 $664,838, $92,070 $31, OTHER VASCULAR PROCEDURES W MCC 4,928 42,746 $584,761, $118,661 $13, OTHER VASCULAR PROCEDURES W CC 6,239 40,391 $630,270, $101,021 $15, OTHER VASCULAR PROCEDURES W/O CC/MCC 4,076 12,162 $282,240, $69,244 $23, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC 262 2,828 $25,819, $98,547 $9, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC 466 3,599 $31,352, $67,280 $8, UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC $2,240, $43,085 $9, CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC $6,059, $83,012 $12, CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC 477 1,453 $28,265, $59,258 $19, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC 286 3,356 $40,937, $143,139 $12, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC 568 2,866 $39,618, $69,750 $13, CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC $17,439, $52,527 $18, VEIN LIGATION & STRIPPING $5,300, $75,722 $13, OTHER CIRCULATORY SYSTEM O.R. PROCEDURES 2,759 26,831 $279,343, $101,248 $10, AICD LEAD PROCEDURES $18,019, $90,096 $26, ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W MCC 7,908 49,664 $517,059, $65,384 $10, ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W CC 6,433 24,459 $288,017, $44,772 $11, ACUTE MYOCARDIAL INFARCTION DISCHARGED ALIVE W/O CC/MCC 4,995 11,338 $180,044, $36,045 $15, ACUTE MYOCARDIAL INFARCTION EXPIRED W MCC 1,180 5,519 $83,649, $70,889 $15, ACUTE MYOCARDIAL INFARCTION EXPIRED W CC $8,163, $33,319 $16, ACUTE MYOCARDIAL INFARCTION EXPIRED W/O CC/MCC $2,481, $28,858 $23, CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W MCC 4,366 30,565 $361,124, $82,713 $11, CIRCULATORY DISORDERS EXCEPT AMI W CARD CATH W/O MCC 24,346 70,306 $1,199,554, $5, $49,271 $17, ACUTE & SUBACUTE ENDOCARDITIS W MCC 494 7,466 $51,716, $104,690 $6, ACUTE & SUBACUTE ENDOCARDITIS W CC 244 2,833 $17,629, $72,253 $6, ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC $2,596, $42,558 $6, HEART FAILURE & SHOCK W MCC 23, ,809 $1,231,028, $8, $52,608 $8, HEART FAILURE & SHOCK W CC 27, ,547 $901,411, $5, $33,133 $7, HEART FAILURE & SHOCK W/O CC/MCC 10,998 31,544 $261,678, $23,793 $8, DEEP VEIN THROMBOPHLEBITIS W CC/MCC $3,403, $35,090 $7, DEEP VEIN THROMBOPHLEBITIS W/O CC/MCC $680, $19,436 $5, CARDIAC ARREST UNEXPLAINED W MCC $20,878, $54,800 $21, CARDIAC ARREST UNEXPLAINED W CC $2,619, $27,577 $27, CARDIAC ARREST UNEXPLAINED W/O CC/MCC $1,319, $21,998 $35, PERIPHERAL VASCULAR DISORDERS W MCC 3,698 22,137 $175,277, $47,398 $7, PERIPHERAL VASCULAR DISORDERS W CC 8,162 37,098 $267,489, $32,773 $7, PERIPHERAL VASCULAR DISORDERS W/O CC/MCC 5,737 17,519 $126,257, $22,008 $7, ATHEROSCLEROSIS W MCC 614 2,531 $22,857, $37,228 $9, ATHEROSCLEROSIS W/O MCC 4,513 9,697 $111,533, $24,714 $11, Page 4 of 13

5 Per HYPERTENSION W MCC 780 3,302 $30,657, $39,305 $9, HYPERTENSION W/O MCC 10,142 22,933 $249,429, $24,594 $10, CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC 393 2,175 $18,950, $48,220 $8, CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC 973 3,213 $29,172, $29,982 $9, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC 8,177 41,358 $356,241, $43,566 $8, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC 15,859 51,422 $455,802, $28,741 $8, CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC 23,201 47,906 $475,511, $2, $20,495 $9, ANGINA PECTORIS 1,753 3,351 $43,048, $24,557 $12, SYNCOPE & COLLAPSE 24,013 60,804 $704,108, $3, $29,322 $11, CHEST PAIN 35,534 61,384 $866,836, $3, $24,395 $14, OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC 7,800 61,490 $541,654, $69,443 $8, OTHER CIRCULATORY SYSTEM DIAGNOSES W CC 5,028 20,420 $179,879, $35,775 $8, OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC 2,022 4,611 $49,807, $24,633 $10, STOMACH ESOPHAGEAL & DUODENAL PROC W MCC 1,952 30,146 $376,635, $192,949 $12, STOMACH ESOPHAGEAL & DUODENAL PROC W CC 2,201 16,662 $208,074, $94,537 $12, STOMACH ESOPHAGEAL & DUODENAL PROC W/O CC/MCC 2,506 7,804 $132,845, $53,011 $17, MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC 6, ,709 $1,270,512, $182,624 $12, MAJOR SMALL & LARGE BOWEL PROCEDURES W CC 11,015 95,540 $1,092,191, $99,155 $11, MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC 6,148 29,489 $418,340, $68,045 $14, RECTAL RESECTION W MCC 242 3,466 $42,722, $176,538 $12, RECTAL RESECTION W CC 948 7,240 $88,359, $93,206 $12, RECTAL RESECTION W/O CC/MCC 726 3,226 $49,781, $68,570 $15, PERITONEAL ADHESIOLYSIS W MCC 1,096 14,423 $167,613, $152,932 $11, PERITONEAL ADHESIOLYSIS W CC 2,561 20,736 $225,467, $88,039 $10, PERITONEAL ADHESIOLYSIS W/O CC/MCC 1,938 8,989 $119,290, $61,553 $13, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC 299 2,674 $32,412, $108,403 $12, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC 1,237 7,694 $87,547, $70,774 $11, APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC 2,462 9,793 $124,166, $50,433 $12, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC 287 1,720 $24,142, $84,120 $14, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC 1,506 4,638 $84,301, $55,977 $18, APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC 9,044 14,431 $377,821, $41,776 $26, MINOR SMALL & LARGE BOWEL PROCEDURES W MCC 171 1,740 $17,581, $102,818 $10, MINOR SMALL & LARGE BOWEL PROCEDURES W CC 786 4,880 $47,038, $59,846 $9, MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC 826 3,665 $39,473, $47,789 $10, ANAL & STOMAL PROCEDURES W MCC 277 2,332 $23,578, $85,121 $10, ANAL & STOMAL PROCEDURES W CC 1,288 6,227 $66,268, $51,450 $10, ANAL & STOMAL PROCEDURES W/O CC/MCC 1,561 4,360 $55,587, $35,610 $12, INGUINAL & FEMORAL HERNIA PROCEDURES W MCC 250 1,761 $21,447, $85,791 $12, INGUINAL & FEMORAL HERNIA PROCEDURES W CC 792 3,459 $45,453, $57,391 $13, INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC 1,493 3,285 $60,986, $40,848 $18, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC 582 5,128 $67,107, $115,306 $13, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC 1,944 9,757 $129,302, $66,514 $13, HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC 2,754 7,551 $130,049, $47,222 $17, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC 1,202 15,141 $163,401, $135,941 $10, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC 1,426 10,254 $113,953, $79,911 $11, OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC 600 2,234 $30,937, $51,562 $13, MAJOR ESOPHAGEAL DISORDERS W MCC 550 4,176 $41,317, $75,123 $9, MAJOR ESOPHAGEAL DISORDERS W CC 1,109 4,634 $45,308, $40,855 $9, MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC 454 1,236 $14,346, $31,600 $11, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC 3,296 29,115 $214,918, $65,206 $7, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC 6,615 38,335 $266,341, $40,263 $6, MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC 3,609 13,774 $99,203, $27,488 $7, DIGESTIVE MALIGNANCY W MCC 1,340 11,171 $101,077, $75,431 $9, DIGESTIVE MALIGNANCY W CC 3,101 17,238 $150,604, $48,566 $8, DIGESTIVE MALIGNANCY W/O CC/MCC 499 1,708 $16,682, $33,432 $9, G.I. HEMORRHAGE W MCC 6,821 43,292 $423,273, $62,054 $9, G.I. HEMORRHAGE W CC 21,222 81,542 $775,133, $36,525 $9, G.I. HEMORRHAGE W/O CC/MCC 8,274 21,556 $223,820, $27,051 $10, COMPLICATED PEPTIC ULCER W MCC 444 3,396 $32,130, $72,366 $9, COMPLICATED PEPTIC ULCER W CC 1,029 4,527 $44,258, $43,011 $9, Page 5 of 13

6 Per COMPLICATED PEPTIC ULCER W/O CC/MCC 528 1,721 $18,439, $34,922 $10, UNCOMPLICATED PEPTIC ULCER W MCC 243 1,348 $12,656, $52,082 $9, UNCOMPLICATED PEPTIC ULCER W/O MCC 2,122 6,901 $78,017, $36,766 $11, INFLAMMATORY BOWEL DISEASE W MCC 628 4,975 $42,639, $67,897 $8, INFLAMMATORY BOWEL DISEASE W CC 3,519 17,006 $139,206, $39,559 $8, INFLAMMATORY BOWEL DISEASE W/O CC/MCC 3,209 11,058 $96,678, $30,127 $8, G.I. OBSTRUCTION W MCC 2,369 16,192 $136,694, $57,701 $8, G.I. OBSTRUCTION W CC 8,754 36,970 $288,732, $32,983 $7, G.I. OBSTRUCTION W/O CC/MCC 9,357 27,057 $230,064, $24,587 $8, ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W MCC 8,020 41,340 $366,934, $45,752 $8, ESOPHAGITIS GASTROENT & MISC DIGEST DISORDERS W/O MCC 74, ,824 $2,088,476, $3, $27,989 $9, OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC 3,571 26,219 $223,414, $62,564 $8, OTHER DIGESTIVE SYSTEM DIAGNOSES W CC 9,313 39,810 $340,464, $36,558 $8, OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC 5,576 14,121 $144,422, $25,901 $10, PANCREAS LIVER & SHUNT PROCEDURES W MCC ,167 $179,919, $183,218 $12, PANCREAS LIVER & SHUNT PROCEDURES W CC 1,060 8,304 $106,784, $100,740 $12, PANCREAS LIVER & SHUNT PROCEDURES W/O CC/MCC 461 2,217 $32,397, $70,276 $14, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC 172 2,587 $28,530, $165,873 $11, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC 173 1,502 $17,204, $99,446 $11, BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC $6,585, $67,204 $11, CHOLECYSTECTOMY W C.D.E. W MCC $11,116, $148,216 $12, CHOLECYSTECTOMY W C.D.E. W CC $8,994, $108,362 $13, CHOLECYSTECTOMY W C.D.E. W/O CC/MCC $4,736, $72,863 $13, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC 492 5,034 $64,733, $131,572 $12, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC 748 5,045 $64,167, $85,785 $12, CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC 617 2,638 $40,364, $65,421 $15, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC 4,066 28,587 $378,330, $93,047 $13, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC 8,031 36,028 $549,003, $68,361 $15, LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC 14,563 40,706 $761,669, $52,302 $18, HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC 133 1,777 $19,339, $145,410 $10, HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC $10,348, $76,659 $11, HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC $2,784, $51,574 $14, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC 260 3,580 $40,532, $155,893 $11, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC 137 1,231 $13,449, $98,169 $10, OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC $2,223, $67,388 $12, CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC 3,706 23,168 $211,202, $56,989 $9, CIRRHOSIS & ALCOHOLIC HEPATITIS W CC 3,610 14,033 $120,155, $33,284 $8, CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC $5,718, $23,629 $8, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC 2,194 15,238 $146,132, $66,605 $9, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC 2,372 11,641 $108,436, $45,715 $9, MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC 489 1,670 $17,775, $36,351 $10, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC 2,706 21,569 $193,831, $71,630 $8, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC 7,521 33,927 $286,530, $38,097 $8, DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC 8,026 24,996 $224,066, $27,918 $8, DISORDERS OF LIVER EXCEPT MALIGCIRRALC HEPA W MCC 3,847 28,634 $272,089, $70,728 $9, DISORDERS OF LIVER EXCEPT MALIGCIRRALC HEPA W CC 4,834 21,503 $174,329, $36,063 $8, DISORDERS OF LIVER EXCEPT MALIGCIRRALC HEPA W/O CC/MCC 1,705 5,444 $45,627, $26,761 $8, DISORDERS OF THE BILIARY TRACT W MCC 1,917 12,270 $124,938, $65,174 $10, DISORDERS OF THE BILIARY TRACT W CC 3,234 13,273 $140,157, $43,339 $10, DISORDERS OF THE BILIARY TRACT W/O CC/MCC 3,132 7,845 $95,500, $30,492 $12, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W MCC 230 3,227 $81,714, $355,282 $25, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC 694 4,415 $168,394, $242,643 $38, COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC 767 2,719 $144,999, $189,048 $53, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W MCC 287 3,889 $90,969, $316,966 $23, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W CC 850 5,457 $199,480, $234,683 $36, SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR 9+ FUS W/O CC/MCC 695 2,937 $129,030, $185,655 $43, SPINAL FUSION EXCEPT CERVICAL W MCC 628 5,940 $137,567, $219,056 $23, SPINAL FUSION EXCEPT CERVICAL W/O MCC 14,480 48,731 $1,827,995, $126,243 $37, BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC $8,321, $163,176 $17, BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC 1,594 6,477 $174,769, $109,642 $26, Page 6 of 13

7 Per WND DEBRID & SKN GRFT EXC HAND FOR MUSCULO-CONN TISS DIS W MCC ,331 $170,998, $211,110 $9, WND DEBRID & SKN GRFT EXC HAND FOR MUSCULO-CONN TISS DIS W CC 1,739 17,200 $205,524, $118,186 $11, WND DEBRID & SKN GRFT EXC HAND FOR MUSCULO-CONN TISS DIS W/O CC/MCC 557 2,696 $41,774, $74,999 $15, REVISION OF HIP OR KNEE REPLACEMENT W MCC 487 4,122 $73,909, $151,765 $17, REVISION OF HIP OR KNEE REPLACEMENT W CC 3,286 14,824 $353,109, $107,459 $23, REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC 2,502 7,989 $222,582, $88,962 $27, MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC 2,891 22,726 $331,416, $114,637 $14, MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC 62, ,753 $4,468,567, $11, $71,572 $21, CERVICAL SPINAL FUSION W MCC 563 4,663 $88,532, $157,251 $18, CERVICAL SPINAL FUSION W CC 2,698 8,846 $262,104, $97,148 $29, CERVICAL SPINAL FUSION W/O CC/MCC 9,101 15,071 $696,872, $76,571 $46, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC 320 4,324 $40,888, $127,777 $9, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC 586 5,301 $46,529, $79,402 $8, AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC $9,700, $45,976 $10, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 444 5,187 $51,443, $115,863 $9, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 1,662 11,418 $137,211, $82,558 $12, BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 804 3,474 $50,041, $62,241 $14, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC 2,989 26,068 $337,118, $112,786 $12, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC 10,438 57,048 $783,830, $75,094 $13, HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC 5,313 21,357 $327,270, $61,598 $15, MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W CC/MCC 2,144 7,337 $202,714, $94,550 $27, MAJOR JOINT & LIMB REATTACHMENT PROC OF UPPER EXTREMITY W/O CC/MCC 3,238 6,721 $262,942, $81,205 $39, KNEE PROCEDURES W PDX OF INFECTION W MCC 122 1,354 $14,670, $120,250 $10, KNEE PROCEDURES W PDX OF INFECTION W CC 465 3,456 $37,645, $80,959 $10, KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC 233 1,149 $12,926, $55,477 $11, KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC 675 3,617 $50,237, $74,426 $13, KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC 1,052 2,903 $56,609, $53,811 $19, BACK & NECK PROC EXC SPINAL FUSION W CC/MCC OR DISC DEVICE/NEUROSTIM 3,108 13,902 $249,729, $80,351 $17, BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC 6,261 12,956 $322,898, $51,573 $24, LOWER EXTREM & HUMER PROC EXCEPT HIPFOOTFEMUR W MCC 898 8,400 $114,690, $127,718 $13, LOWER EXTREM & HUMER PROC EXCEPT HIPFOOTFEMUR W CC 4,617 23,623 $379,975, $82,299 $16, LOWER EXTREM & HUMER PROC EXCEPT HIPFOOTFEMUR W/O CC/MCC 8,048 23,432 $465,280, $57,813 $19, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC 270 3,149 $30,291, $112,192 $9, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC 1,147 6,710 $77,878, $67,898 $11, LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC 1,120 3,030 $54,558, $48,713 $18, LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC 203 1,666 $18,218, $89,747 $10, LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC $6,908, $42,382 $15, SOFT TISSUE PROCEDURES W MCC 376 5,453 $48,875, $129,989 $8, SOFT TISSUE PROCEDURES W CC 1,340 7,793 $83,913, $62,622 $10, SOFT TISSUE PROCEDURES W/O CC/MCC 1,378 3,594 $60,501, $43,905 $16, FOOT PROCEDURES W MCC 139 1,502 $13,597, $97,826 $9, FOOT PROCEDURES W CC 660 4,233 $45,089, $68,318 $10, FOOT PROCEDURES W/O CC/MCC 846 2,655 $43,687, $51,640 $16, MAJOR THUMB OR JOINT PROCEDURES $10,333, $48,062 $12, MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC $11,343, $85,287 $13, MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC $8,777, $53,849 $20, ARTHROSCOPY $2,128, $56,017 $14, SHOULDERELBOW OR FOREARM PROCEXC MAJOR JOINT PROC W MCC 195 1,132 $18,052, $92,579 $15, SHOULDERELBOW OR FOREARM PROCEXC MAJOR JOINT PROC W CC 962 3,653 $64,831, $67,392 $17, SHOULDERELBOW OR FOREARM PROCEXC MAJOR JOINT PROC W/O CC/MCC 2,282 4,891 $108,713, $47,640 $22, HAND OR WRIST PROC EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC 615 2,688 $31,956, $51,962 $11, HAND OR WRIST PROC EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC 909 2,144 $30,812, $33,897 $14, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC 578 5,591 $68,873, $119,159 $12, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC 1,873 10,473 $143,869, $76,812 $13, OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC 1,752 5,774 $106,249, $60,645 $18, FRACTURES OF FEMUR W MCC $4,088, $49,256 $7, FRACTURES OF FEMUR W/O MCC 541 1,694 $12,478, $23,066 $7, FRACTURES OF HIP & PELVIS W MCC 813 4,032 $35,063, $43,128 $8, FRACTURES OF HIP & PELVIS W/O MCC 4,036 13,153 $97,850, $24,244 $7, SPRAINS STRAINS & DISLOCATIONS OF HIP PELVIS & THIGH W CC/MCC $3,634, $36,708 $9, Page 7 of 13

8 Per SPRAINS STRAINS & DISLOCATIONS OF HIP PELVIS & THIGH W/O CC/MCC $2,587, $23,522 $10, OSTEOMYELITIS W MCC ,004 $55,831, $89,906 $5, OSTEOMYELITIS W CC 1,015 8,635 $53,328, $52,541 $6, OSTEOMYELITIS W/O CC/MCC 445 2,460 $14,817, $33,299 $6, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC 695 6,273 $54,595, $78,554 $8, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC 1,850 10,100 $83,226, $44,987 $8, PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC 649 2,269 $19,522, $30,081 $8, CONNECTIVE TISSUE DISORDERS W MCC 776 7,790 $77,704, $100,135 $9, CONNECTIVE TISSUE DISORDERS W CC 1,573 8,326 $71,418, $45,403 $8, CONNECTIVE TISSUE DISORDERS W/O CC/MCC 1,144 3,810 $35,374, $30,922 $9, SEPTIC ARTHRITIS W MCC $6,290, $85,000 $6, SEPTIC ARTHRITIS W CC 281 1,793 $12,548, $44,656 $6, SEPTIC ARTHRITIS W/O CC/MCC $6,087, $33,083 $7, MEDICAL BACK PROBLEMS W MCC 1,600 9,571 $90,528, $56,580 $9, MEDICAL BACK PROBLEMS W/O MCC 13,148 43,899 $415,261, $31,584 $9, BONE DISEASES & ARTHROPATHIES W MCC 228 1,303 $14,578, $63,941 $11, BONE DISEASES & ARTHROPATHIES W/O MCC 2,143 6,557 $49,757, $23,219 $7, SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC 381 1,837 $17,208, $45,168 $9, SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC 3,546 9,567 $92,977, $26,220 $9, TENDONITIS MYOSITIS & BURSITIS W MCC 626 4,337 $32,642, $52,144 $7, TENDONITIS MYOSITIS & BURSITIS W/O MCC 4,279 15,255 $116,009, $27,111 $7, AFTERCARE MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC 408 5,523 $30,418, $74,556 $5, AFTERCARE MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC 953 5,863 $36,441, $38,239 $6, AFTERCARE MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC 681 1,735 $15,401, $22,616 $8, FX SPRN STRN & DISL EXCEPT FEMUR HIP PELVIS & THIGH W MCC 721 3,833 $35,418, $49,124 $9, FX SPRN STRN & DISL EXCEPT FEMUR HIP PELVIS & THIGH W/O MCC 5,847 16,431 $153,081, $26,181 $9, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC 280 2,329 $16,619, $59,356 $7, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC 965 4,040 $32,523, $33,703 $8, OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC 564 1,524 $13,082, $23,196 $8, SKIN DEBRIDEMENT W MCC ,016 $74,027, $105,603 $6, SKIN DEBRIDEMENT W CC 1,087 7,221 $59,057, $54,331 $8, SKIN DEBRIDEMENT W/O CC/MCC 878 3,795 $34,086, $38,823 $8, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC 401 7,596 $56,246, $140,266 $7, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC 251 2,919 $24,478, $97,522 $8, SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC $6,198, $65,251 $8, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC $11,189, $162,164 $13, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC 394 2,686 $36,300, $92,134 $13, SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC 468 1,585 $29,462, $62,954 $18, OTHER SKIN SUBCUT TISS & BREAST PROC W MCC 1,049 13,367 $108,820, $103,738 $8, OTHER SKIN SUBCUT TISS & BREAST PROC W CC 2,656 13,954 $162,102, $61,032 $11, OTHER SKIN SUBCUT TISS & BREAST PROC W/O CC/MCC 3,356 9,045 $164,693, $49,074 $18, MASTECTOMY FOR MALIGNANCY W CC/MCC 640 1,607 $36,863, $57,600 $22, MASTECTOMY FOR MALIGNANCY W/O CC/MCC 988 1,773 $60,006, $60,736 $33, BREAST BIOPSY LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC 313 1,639 $25,626, $81,874 $15, BREAST BIOPSY LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC 731 1,785 $44,845, $61,348 $25, SKIN ULCERS W MCC 1,203 14,291 $72,636, $60,380 $5, SKIN ULCERS W CC 1,120 6,302 $40,034, $35,745 $6, SKIN ULCERS W/O CC/MCC $4,657, $24,385 $6, MAJOR SKIN DISORDERS W MCC 184 1,420 $12,586, $68,407 $8, MAJOR SKIN DISORDERS W/O MCC 1,139 4,722 $32,174, $28,248 $6, MALIGNANT BREAST DISORDERS W MCC 162 1,161 $9,885, $61,020 $8, MALIGNANT BREAST DISORDERS W CC 431 2,029 $16,438, $38,141 $8, MALIGNANT BREAST DISORDERS W/O CC/MCC $2,031, $25,714 $10, NON-MALIGNANT BREAST DISORDERS W CC/MCC 389 1,747 $12,634, $32,479 $7, NON-MALIGNANT BREAST DISORDERS W/O CC/MCC 747 2,289 $16,730, $22,397 $7, CELLULITIS W MCC 3,742 25,735 $188,453, $50,362 $7, CELLULITIS W/O MCC 41, ,803 $1,057,886, $4, $25,607 $6, TRAUMA TO THE SKIN SUBCUT TISS & BREAST W MCC 455 2,338 $24,414, $53,658 $10, TRAUMA TO THE SKIN SUBCUT TISS & BREAST W/O MCC 4,113 10,502 $128,865, $31,331 $12, MINOR SKIN DISORDERS W MCC 322 2,229 $14,876, $46,200 $6, Page 8 of 13

9 Per MINOR SKIN DISORDERS W/O MCC 2,607 8,314 $54,472, $20,895 $6, ADRENAL & PITUITARY PROCEDURES W CC/MCC 404 2,448 $43,187, $106,900 $17, ADRENAL & PITUITARY PROCEDURES W/O CC/MCC 354 1,069 $23,566, $66,571 $22, AMPUTAT OF LOWER LIMB FOR ENDOCRINENUTRIT& METABOL DIS W MCC 312 4,770 $43,701, $140,068 $9, AMPUTAT OF LOWER LIMB FOR ENDOCRINENUTRIT& METABOL DIS W CC 1,943 16,110 $148,847, $76,607 $9, AMPUTAT OF LOWER LIMB FOR ENDOCRINENUTRIT& METABOL DIS W/O CC/MCC $2,006, $59,017 $9, O.R. PROCEDURES FOR OBESITY W MCC 210 1,737 $29,024, $138,213 $16, O.R. PROCEDURES FOR OBESITY W CC 889 2,854 $70,041, $78,787 $24, O.R. PROCEDURES FOR OBESITY W/O CC/MCC 5,798 10,981 $347,412, $59,919 $31, SKIN GRAFTS & WOUND DEBRID FOR ENDOC NUTRIT & METAB DIS W MCC 168 3,465 $27,445, $163,367 $7, SKIN GRAFTS & WOUND DEBRID FOR ENDOC NUTRIT & METAB DIS W CC 636 5,593 $46,527, $73,157 $8, SKIN GRAFTS & WOUND DEBRID FOR ENDOC NUTRIT & METAB DIS W/O CC/MCC $2,229, $45,509 $9, THYROID PARATHYROID & THYROGLOSSAL PROCEDURES W MCC 132 1,050 $14,249, $107,951 $13, THYROID PARATHYROID & THYROGLOSSAL PROCEDURES W CC 500 1,704 $29,638, $59,277 $17, THYROID PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC 1,931 2,924 $80,611, $41,746 $27, OTHER ENDOCRINE NUTRIT & METAB O.R. PROC W MCC 481 6,137 $58,948, $122,554 $9, OTHER ENDOCRINE NUTRIT & METAB O.R. PROC W CC 1,077 9,036 $86,131, $79,973 $9, OTHER ENDOCRINE NUTRIT & METAB O.R. PROC W/O CC/MCC $6,265, $67,372 $17, DIABETES W MCC 3,732 22,279 $189,162, $50,687 $8, DIABETES W CC 13,163 47,915 $375,433, $28,522 $7, DIABETES W/O CC/MCC 9,262 21,877 $184,166, $19,884 $8, MISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W MCC 6,642 32,462 $262,585, $39,534 $8, MISC DISORDERS OF NUTRITIONMETABOLISMFLUIDS/ELECTROLYTES W/O MCC 22,212 66,223 $512,000, $24, $23,051 $7, INBORN AND OTHER DISORDERS OF METABOLISM 657 2,633 $29,549, $44,977 $11, ENDOCRINE DISORDERS W MCC 1,017 7,176 $58,087, $57,117 $8, ENDOCRINE DISORDERS W CC 2,362 10,824 $84,301, $35,691 $7, ENDOCRINE DISORDERS W/O CC/MCC 1,907 5,110 $44,257, $23,208 $8, KIDNEY TRANSPLANT 904 6,305 $181,080, $200,311 $28, MAJOR BLADDER PROCEDURES W MCC 230 3,724 $49,112, $213,534 $13, MAJOR BLADDER PROCEDURES W CC 722 6,042 $78,219, $108,337 $12, MAJOR BLADDER PROCEDURES W/O CC/MCC 203 1,161 $18,149, $89,408 $15, KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC 427 4,295 $59,528, $139,412 $13, KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC 1,385 7,871 $112,677, $81,355 $14, KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC 1,290 4,100 $84,919, $65,829 $20, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC 598 6,992 $73,295, $122,567 $10, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC 2,244 12,127 $156,905, $69,922 $12, KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC 1,434 3,659 $78,903, $55,024 $21, MINOR BLADDER PROCEDURES W MCC 112 1,340 $12,700, $113,399 $9, MINOR BLADDER PROCEDURES W CC 274 1,566 $17,312, $63,184 $11, MINOR BLADDER PROCEDURES W/O CC/MCC $11,068, $47,302 $18, PROSTATECTOMY W MCC 116 1,316 $12,554, $108,231 $9, PROSTATECTOMY W CC 365 2,619 $26,814, $73,465 $10, PROSTATECTOMY W/O CC/MCC $9,331, $41,657 $14, TRANSURETHRAL PROCEDURES W MCC 532 4,757 $50,242, $94,440 $10, TRANSURETHRAL PROCEDURES W CC 4,991 16,965 $247,097, $49,509 $14, TRANSURETHRAL PROCEDURES W/O CC/MCC 1,263 3,041 $49,987, $39,578 $16, URETHRAL PROCEDURES W CC/MCC $8,385, $63,524 $11, URETHRAL PROCEDURES W/O CC/MCC $4,048, $41,736 $17, OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC 1,879 25,218 $230,688, $122,772 $9, OTHER KIDNEY & URINARY TRACT PROCEDURES W CC 1,393 11,776 $119,322, $85,658 $10, OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC $17,544, $58,874 $18, RENAL FAILURE W MCC 14, ,738 $821,127, $54,855 $8, RENAL FAILURE W CC 23, ,452 $823,868, $5, $34,425 $7, RENAL FAILURE W/O CC/MCC 5,561 15,880 $133,068, $23,929 $8, ADMIT FOR RENAL DIALYSIS 690 1,291 $11,978, $17,361 $9, KIDNEY & URINARY TRACT NEOPLASMS W MCC 211 1,523 $13,028, $61,745 $8, KIDNEY & URINARY TRACT NEOPLASMS W CC 577 2,621 $23,059, $39,965 $8, KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC $4,364, $27,279 $8, KIDNEY & URINARY TRACT INFECTIONS W MCC 9,658 52,726 $386,769, $40,047 $7, KIDNEY & URINARY TRACT INFECTIONS W/O MCC 36, ,279 $977,031, $4, $26,997 $7, Page 9 of 13