Abdominal Pain 16,500.25 2.8 6,000.09 Acute & Subacute Endocarditis 15,339.30 3.0 5,113.10 Acute Myocardial Infarction 17,687.46 2.6 6,802.87 Alcohol Abuse & Dependence 19,126.64 4.2 4,553.96 Alcoholic Liver Disease 21,089.81 4.6 4,584.74 Allergic Reactions 6,342.14 1.5 4,228.09 Amputation of Lower Limb Except Toes 30,830.49 8.7 3,557.36 Anal Procedures 15,198.51 2.7 5,699.44 Angina Pectoris & Coronary Atherosclerosis 8,562.27 1.0 8,562.27 Appendectomy 31,210.55 3.5 8,917.30 Asthma 13,404.93 1.5 8,936.62 Bacterial & Tuberculous Infections of Nervous System 6,234.17 1.0 6,234.17 Cardiac Arrest 16,142.40 1.0 16,142.40 Cardiac Arrhythmia & Conduction Disorders 15,563.08 2.7 5,671.29 Cardiac Catheterization w/ Circ Disord Exc Ischemic Heart Disease 38,319.14 9.0 4,257.68 Cardiac Pacemaker & Defibrillator Device Replacement 21,186.69 2.0 10,593.35 Cellulitis & Other Bacterial Skin Infections 13,268.19 3.7 3,602.62 Cesarean Delivery 13,843.32 2.9 4,749.17 Chest Pain 6,317.93 1.0 6,317.93 Chronic Obstructive Pulmonary Disease 16,167.47 3.7 4,356.82 Coagulation & Platelet Disorders 30,726.57 6.5 4,727.16 Connective Tissue Disorders 13,872.38 2.5 5,548.95 Contusion, Open Wound & Other Trauma To Skin & Subcutaneous Tissue 3,542.10 1.0 3,542.10 CVA & Precerebral Occulusion w/ Infarct 24,878.99 5.2 4,827.27 D&C, Aspiration Curettage or Hysterotomy For Obstetric Diagnoses 16,832.81 1.0 16,832.81 Degenerative Nervous System Disorders Exc Mult Sclerosis 26,998.63 12.5 2,159.89 Dental & Oral Diseases & Injuries 8,162.75 2.0 4,081.38 Depression Except Major Depressive Disorder 13,871.98 1.0 13,871.98 Diabetes 13,226.30 2.7 4,906.53 Digestive Malignancy 14,116.97 3.4 4,152.05 Disorders of Pancreas Except Malignancy 13,518.17 3.5 3,862.33 Disorders of the Gallbladder & Biliary Tract 11,507.00 2.5 4,602.80 Diverticulitis & Diverticulosis 13,144.77 3.3 3,964.30 Page: 1 of 5
Drug & Alcohol Abuse or Dependence, Left Against Medical Advice 6,969.26 1.5 4,646.17 Electrolyte Disorders Except Hypovolemia Related 10,876.17 2.5 4,409.26 False Labor 2,439.90 1.0 2,439.90 Fever 18,247.87 4.0 4,561.97 Foot & Toe Procedures 24,016.40 6.0 4,002.73 Fracture of Pelvis or Dislocation of Hip 6,742.48 2.0 3,371.24 Fracture or Dislocation Except Femur, Pelvis & Back 7,363.54 1.5 4,909.02 Fractures of Femur 7,972.51 3.0 2,657.50 Gastrointestinal Vascular Insufficiency 13,375.27 2.7 5,015.73 Heart Failure 16,388.98 3.6 4,558.18 Hepatic Coma & Other Major Acute Liver Disorders 15,565.79 4.5 3,459.06 Hernia Procedures Except Inguinal, Femoral & Umbilical 28,451.26 4.8 5,886.47 Hip & Femur Procedures for Non-Trauma Except Joint Replacement 22,955.53 4.0 5,738.88 Hip & Femur Procedures for Trauma Except Joint Replacement 24,074.76 3.7 6,565.84 Hip Joint Replacement 46,123.13 3.6 12,723.62 Hypertension 16,306.82 2.3 7,247.47 Hypovolemia & Related Electrolyte Disorders 11,133.68 3.2 3,455.28 Infections Of The Upper Respiratory Tract 12,673.81 3.2 3,960.57 Infectious & Parasitic Diseases Including HIV W O.R. Procedure 40,168.71 9.5 4,228.29 Inflammatory Bowel Disease 11,945.78 3.5 3,451.00 Inguinal, Femoral & Umbilical Hernia Procedures 17,821.49 3.0 5,940.50 Interstitial Lung Disease 11,099.34 4.0 2,774.84 Intestinal Obstruction 10,201.50 2.1 4,904.57 Kidney & Urinary Tract Infections 13,516.10 3.2 4,252.26 Kidney & Urinary Tract Procedures for Nonmalignancy 28,674.18 4.0 7,168.54 Knee & Lower Leg Procedures Except Foot 27,284.37 3.0 9,094.79 Knee Joint Replacement 40,108.21 2.8 14,324.36 Laparoscopic Cholecystectomy 32,835.46 5.0 6,567.09 Lymphatic & Other Malignancies & Neoplasms Of Uncertain Behavior 22,855.50 4.5 5,079.00 Major Bladder Procedures 43,828.55 3.0 14,609.52 Major Chest & Respiratory Trauma 13,735.53 4.0 3,433.88 Major Esophageal Disorders 23,459.59 3.3 7,037.88 Major Gastrointestinal & Peritoneal Infections 20,240.50 4.6 4,416.11 Page: 2 of 5
Major Hematologic/Immunologic Diag Exc Sickle Cell Crisis & Coagul 13,416.93 3.3 4,025.08 Major Pancreas, Liver & Shunt Procedures 26,234.20 6.0 4,372.37 Major Respiratory & Chest Procedures 25,400.54 6.5 3,907.77 Major Respiratory Infections & Inflammations 22,035.52 5.9 3,715.29 Major Small & Large Bowel Procedures 42,088.33 6.0 7,051.07 Male Reproductive System Diagnoses Except Malignancy 11,039.36 2.7 4,139.76 Malfunction, Reaction & Comp of Orthopedic Device or Procedure 20,068.19 6.0 3,344.70 Malfunction, Reaction & Complic of Genitourinary Device Or Proc 16,433.77 3.6 4,533.45 Malfunction, Reaction & Complication Of G.I. Device Or Procedure 18,510.60 4.8 3,856.38 Malignancy of Hepatobiliary System & Pancreas 13,484.12 3.0 4,494.71 Malnutrition, Failure To Thrive & Other Nutritional Disorders 13,587.57 2.3 5,823.24 Mastectomy Procedures 24,255.61 2.0 12,127.80 Menstrual & Other Female Reproductive System Disorders 26,233.35 1.0 26,233.35 Minor Small & Large Bowel Procedures 23,714.04 4.8 4,963.40 Moderately Extensive Procedure Unrelated To Principal Diagnosis 30,002.63 4.5 6,667.25 Neonate, Birthwt > 2499g W Other Significant Condition 3,008.77 2.1 1,410.36 Neonate, Birthwt > 2499g W Resp Dist Synd/Oth Maj Resp Cond 4,590.76 4.0 1,147.69 Neonate, Birthwt > 2499g w/ Major Anomaly 3,730.01 3.0 1,243.34 Neonate, Birthwt 1000-1249G W OR W/O Other Significant Condition 11,758.95 2.0 5,879.48 Neonate, Birthwt 1500-1999G W OR W/O Other Significant Condition 3,266.48 3.0 1,088.83 Neonate, Bwt > 2499g, Normal Newborn Or Neonate W Other Problem 2,717.28 2.3 1,202.37 Neonate, BWT 2000-2499G W Major Anomaly 3,707.48 3.0 1,235.83 Neonate, BWT 2000-2499G, Normal Newborn Or Neonate W Other Problem 2,886.26 2.3 1,236.97 Neonate, Transferred <5 Days Old, Born Here 2,252.63 1.3 1,778.39 Nervous System Malignancy 15,864.26 3.0 5,288.09 Non-Bacterial Gastroenteritis, Nausea & Vomiting 15,218.92 2.9 5,268.09 Nonextensive Procedure Unrelated To Principal Diagnosis 14,615.30 2.0 7,307.65 Nontraumatic Stupor & Coma 19,452.28 3.4 5,763.64 O.R. Procedure For Other Complications Of Treatment 66,439.46 9.5 6,993.63 Opioid Abuse & Dependence 16,820.25 5.0 3,364.05 Osteomyelitis, Septic Arthritis & Other Musculoskeletal Infections 19,305.85 5.9 3,296.12 Other & Unspecified Gastrointestinal Hemorrhage 16,583.46 2.9 5,662.65 Other Aftercare & Convalescence 1,988.25 1.0 1,988.25 Page: 3 of 5
Other Anemia & Disorders Of Blood & Blood Forming Organs 19,680.68 3.8 5,221.41 Other Antepartum Diagnoses 7,281.42 1.9 3,832.33 Other Back & Neck Disorders, Fractures & Injuries 15,532.04 3.4 4,568.25 Other Bladder Procedures 18,562.92 4.0 4,640.73 Other Circulatory System Diagnoses 30,025.92 4.0 7,506.48 Other Complications of Treatment 13,473.89 2.3 5,774.53 Other Digestive System & Abdominal Procedures 14,528.02 1.0 14,528.02 Other Digestive System Diagnoses 17,518.51 3.0 5,925.38 Other Disorders of Nervous System 19,578.66 2.0 9,789.33 Other Disorders Of The Liver 28,739.37 5.0 5,747.87 Other Ear, Nose, Mouth & Throat Procedures 69,308.38 12.0 5,775.70 Other Ear, Nose, Mouth,Throat & Cranial/Facial Diagnoses 5,797.60 2.5 2,319.04 Other Endocrine Disorders 20,912.12 2.0 10,456.06 Other Esophageal Disorders 8,234.42 1.3 6,175.82 Other Female Reproductive System & Related Procedures 22,837.60 5.0 4,567.52 Other Hepatobiliary, Pancreas & Abdominal Procedures 36,629.58 4.0 9,157.39 Other Infectious & Parasitic Diseases 11,918.04 4.0 2,979.51 Other Kidney & Urinary Tract Diagnoses, Signs & Symptoms 14,655.96 3.4 4,310.58 Other Kidney, Urinary Tract & Related Procedures 29,212.63 6.0 4,868.77 Other Musculoskeletal System & Connective Tissue Diagnoses 13,217.10 2.6 5,083.50 Other Nervous System & Related Procedures 14,989.80 5.0 2,997.96 Other O.R. Proc For Obstetric Diagnoses Except Delivery Diagnoses 39,955.23 2.0 19,977.62 Other O.R. Procedures For Lymphatic/Hematopietic/Other Neoplasms 21,119.61 7.0 3,017.09 Other Pneumonia 16,767.41 4.3 3,880.36 Other Respiratory & Chest Procedures 50,469.70 8.0 6,308.71 Other Respiratory Diagnosis Except Signs, Symptoms & Minor Diagnoses 22,555.66 6.9 3,280.82 Other Skin, Subcutaneous Tissue & Breast Disorders 13,540.94 1.0 13,540.94 Other Skin, Subcutaneous Tissue & Related Procedures 19,354.91 4.6 4,207.59 Other Vascular Procedures 19,259.65 5.0 3,851.93 Peptic Ulcer & Gastritis 20,045.05 3.4 5,914.93 Peripheral & Other Vascular Disorders 8,523.60 2.3 3,652.97 Peripheral, Cranial & Autonomic Nerve Disorders 29,715.02 2.0 14,857.51 Peritoneal Adhesiolysis 28,224.60 5.5 5,131.75 Page: 4 of 5
Poisoning Of Medicinal Agents 18,245.29 2.8 6,410.51 Post-Op,Post-Trauma, Other Device Infections W O.R. Procedure 32,425.63 7.8 4,157.13 Post-Operative, Post-Traumatic, Other Device Infections 20,327.29 6.3 3,233.89 Postpartum & Post Abortion Diagnoses w/o Procedure 15,346.02 2.4 6,318.95 Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 19,648.09 2.6 7,556.96 Pulmonary Edema & Respiratory Failure 22,691.71 4.9 4,673.63 Pulmonary Embolism 17,143.34 2.2 7,659.79 Renal Failure 13,879.15 3.2 4,307.32 Respiratory Malignancy 25,568.25 5.5 4,648.77 Respiratory System Diagnosis w/ Ventilator Support 96+ Hours 63,129.94 11.3 5,570.29 Respiratory System Signs, Symptoms & Other Diagnoses 15,882.97 4.0 3,970.74 Seizure 24,688.77 3.0 8,229.59 Septicemia & Disseminated Infections 21,624.84 5.1 4,264.85 Shoulder, Upper Arm & Forearm Procedures 45,465.52 1.0 45,465.52 Sickle Cell Anemia Crisis 5,287.20 2.0 2,643.60 Signs, Symptoms & Other Factors Influencing Health Status 11,928.99 1.7 7,157.40 Skin Ulcers 14,220.61 4.1 3,432.56 Syncope & Collapse 17,172.48 2.8 6,244.54 Threatened Abortion 2,870.80 2.0 1,435.40 Tonsill & Adenoid Procedures 17,766.75 1.5 11,844.50 Toxic Effects Of Non-Medicinal Substances 20,294.64 6.0 3,382.44 Urethral & Transurethral Procedures 19,732.24 2.8 6,964.32 Urinary Stones & Acquired Upper Urinary Tract Obstruction 8,534.61 2.0 4,267.30 Uterine & Adnexa Procedures For Leiomyoma 17,750.58 1.0 17,750.58 Uterine & Adnexa Procedures for Non-Malignancy Except Leiomyoma 39,576.22 2.8 13,968.08 Vaginal Delivery 6,924.52 2.5 2,775.87 Vaginal Delivery w/ Complicating Procedures Exc Sterilization &/or D&C 8,620.49 2.8 3,078.75 Vaginal Delivery w/ Sterilization &/or D&C 11,216.29 2.2 5,176.75 Vertigo & Other Labyrinth Disorders 18,283.05 3.3 5,625.55 Page: 5 of 5