Average Gross Charges ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC ,254 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC - 280

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1 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC ,254 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC ,827 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC ,575 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC ,791 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/OCC/MCC ,355 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC ,494 ALLERGIC REACTIONS W MCC ,344 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS WCC ,775 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC ,846 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC ,978 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC ,473 ANGINA PECTORIS ,275 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC ,794 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC ,581 ATHEROSCLEROSIS W/O MCC ,735 BACK & NECK PROC EXC SPINAL FUSION W CC ,236 BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM ,972 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC ,138 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITYW/O MCC ,477 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC ,486 BONE DISEASES & ARTHROPATHIES W/O MCC ,895 BRONCHITIS & ASTHMA W CC/MCC ,214 BRONCHITIS & ASTHMA W/O CC/MCC ,556 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC ,857 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC ,007 CELLULITIS W MCC ,027 CELLULITIS W/O MCC ,839 CERVICAL SPINAL FUSION W CC ,304 CERVICAL SPINAL FUSION W/O CC/MCC ,263 CHEST PAIN ,979 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC ,241 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC ,065 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC ,081 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC ,505 COAGULATION DISORDERS ,058 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC ,795 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC ,871 COMPLICATIONS OF TREATMENT W CC ,617 COMPLICATIONS OF TREATMENT W/O CC/MCC ,398 CONNECTIVE TISSUE DISORDERS W CC ,310 DIABETES W CC ,768 DIABETES W MCC ,289 DIABETES W/O CC/MCC ,315 DIGESTIVE MALIGNANCY W CC ,034 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC ,338 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC ,074

2 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC ,696 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC ,021 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC ,389 DISORDERS OF PERSONALITY & IMPULSE CONTROL ,893 DISORDERS OF THE BILIARY TRACT W MCC ,059 DYSEQUILIBRIUM ,587 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC ,647 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC ,162 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSISW CC ,057 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSISW/O CC/MCC ,054 FOOT PROCEDURES W CC ,458 FRACTURES OF HIP & PELVIS W MCC ,416 FRACTURES OF HIP & PELVIS W/O MCC ,922 FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ ,723 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC ,790 G.I. HEMORRHAGE W CC ,846 G.I. HEMORRHAGE W MCC ,661 G.I. HEMORRHAGE W/O CC/MCC ,857 HEART FAILURE & SHOCK W CC ,003 HEART FAILURE & SHOCK W MCC ,277 HEART FAILURE & SHOCK W/O CC/MCC ,150 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC ,775 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC ,954 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC ,325 HYPERTENSION W MCC ,929 HYPERTENSION W/O MCC ,080 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC ,753 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC ,421 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC ,611 INFLAMMATORY BOWEL DISEASE W CC ,981 INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC ,910 INTERSTITIAL LUNG DISEASE W CC ,967 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPAIN 24 HRS ,418 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC ,919 KIDNEY & URINARY TRACT INFECTIONS W MCC ,224 KIDNEY & URINARY TRACT INFECTIONS W/O MCC ,325 KNEE PROCEDURES W PDX OF INFECTION W CC ,686 KNEE PROCEDURES W PDX OF INFECTION W MCC ,938 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC ,499 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC ,767 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC ,499 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC ,943 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC ,589 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC ,868 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR WCC ,521 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC ,717

3 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR WCC/MCC ,454 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC ,846 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC ,210 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC ,731 LYMPHOMA & NON-ACUTE LEUKEMIA W CC ,324 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W MCC ,614 MAJOR CHEST TRAUMA W MCC ,276 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC ,439 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS WCC ,273 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL WCC ,860 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITYW MCC ,105 MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITYW/O MCC ,564 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES ,251 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC ,606 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC ,540 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC ,747 MEDICAL BACK PROBLEMS W/O MCC ,949 MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTESW MCC ,658 MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTESW/O MCC ,169 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC ,668 NON-MALIGNANT BREAST DISORDERS W/O CC/MCC ,402 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC ,469 NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC ,329 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES WCC ,059 ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY ,981 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC ,470 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC ,358 OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC ,223 OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC ,822 OTHER MENTAL DISORDER DIAGNOSES ,641 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC ,527 OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC ,970 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC ,695 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC ,241 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC ,853 OTHER O.R. PROCEDURES FOR INJURIES W CC ,964 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC ,528 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC ,734 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC ,483 OTITIS MEDIA & URI W/O MCC ,019 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG WMCC ,582 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC ,844 PERIPHERAL VASCULAR DISORDERS W CC ,687 PERIPHERAL VASCULAR DISORDERS W MCC ,225 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC ,060 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC ,416

4 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC ,676 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/OCC/MCC ,023 PULMONARY EDEMA & RESPIRATORY FAILURE ,266 PULMONARY EMBOLISM W MCC ,126 PULMONARY EMBOLISM W/O MCC ,154 RED BLOOD CELL DISORDERS W MCC ,859 RED BLOOD CELL DISORDERS W/O MCC ,778 RENAL FAILURE W CC ,944 RENAL FAILURE W MCC ,023 RENAL FAILURE W/O CC/MCC ,205 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC ,183 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC ,310 RESPIRATORY NEOPLASMS W CC ,236 RESPIRATORY NEOPLASMS W MCC ,423 RESPIRATORY NEOPLASMS W/O CC/MCC ,614 RESPIRATORY SIGNS & SYMPTOMS ,864 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS ,701 REVISION OF HIP OR KNEE REPLACEMENT W CC ,648 REVISION OF HIP OR KNEE REPLACEMENT W MCC ,771 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC ,882 SEIZURES W/O MCC ,413 SEPTIC ARTHRITIS W/O CC/MCC ,660 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC ,021 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC ,059 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC ,745 SIMPLE PNEUMONIA & PLEURISY W CC ,067 SIMPLE PNEUMONIA & PLEURISY W MCC ,905 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC ,162 SKIN DEBRIDEMENT W CC ,041 SOFT TISSUE PROCEDURES W CC ,902 SOFT TISSUE PROCEDURES W/O CC/MCC ,197 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC ,642 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS WCC ,550 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS WMCC ,956 SPINAL FUSION EXCEPT CERVICAL W MCC ,984 SPINAL FUSION EXCEPT CERVICAL W/O MCC ,366 SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS ,186 SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH WCC/MCC ,044 STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC ,027 TENDONITIS, MYOSITIS & BURSITIS W/O MCC ,417 TRAUMATIC INJURY W/O MCC ,647 VIRAL ILLNESS W/O MCC ,662 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DISW CC ,518 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DISW MCC ,978 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DISW/O CC/MCC ,166 WOUND DEBRIDEMENTS FOR INJURIES W CC ,571

5 WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC ,377

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