What the code on your hospital bill means
Inpatient hospital bills are built around MS-DRG codes — a number that decides what your stay is worth to the hospital, and which almost nobody explains to the patient holding the bill. Here are all 772 of them, each with what hospitals billed and what was actually paid.
The 60 most common hospital stays
Ordered by how many Medicare patients were treated — in other words, the bills the most people are actually holding.
Source: CMS Medicare Inpatient Hospitals — by Provider and Service, 2024 data, and CMS FY 2026 IPPS Final Rule (CMS-1833-F), Table 5. Both public federal datasets.
Browse every code, by body system
All 772 inpatient billing codes, grouped the way Medicare groups them — by major diagnostic category. Jump to a system, or use the search box above.
Alcohol/drug use and induced organic mental disorders 4 codes
- 897 Alcohol, drug abuse or dependence without rehabilitation therapy without MCCbilled $37,079 · paid $9,102
- 896 Alcohol, drug abuse or dependence without rehabilitation therapy with MCCbilled $77,866 · paid $17,500
- 895 Alcohol, drug abuse or dependence with rehabilitation therapybilled $34,206 · paid $13,997
- 894 Alcohol, drug abuse or dependence, left amabilled $28,188 · paid $6,823
Blood, blood-forming organs and immunological disorders 15 codes
- 812 Red blood cell disorders without MCCbilled $44,387 · paid $9,315
- 811 Red blood cell disorders with MCCbilled $68,165 · paid $13,767
- 813 Coagulation disordersbilled $80,085 · paid $17,095
- 809 Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with CCbilled $62,801 · paid $13,282
- 808 Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with MCCbilled $108,836 · paid $23,219
- 815 Reticuloendothelial and immunity disorders with CCbilled $55,967 · paid $11,649
- 814 Reticuloendothelial and immunity disorders with MCCbilled $118,948 · paid $27,115
- 810 Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders without CC/MCCbilled $58,661 · paid $11,888
- 799 Splenic procedures with MCCbilled $218,464 · paid $46,867
- 803 Other o.r. procedures of the blood and blood forming organs with CCbilled $105,416 · paid $18,720
- 802 Other o.r. procedures of the blood and blood forming organs with MCCbilled $205,196 · paid $38,326
- 816 Reticuloendothelial and immunity disorders without CC/MCCbilled $37,275 · paid $7,530
- 804 Other o.r. procedures of the blood and blood forming organs without CC/MCCbilled $78,973 · paid $13,681
- 800 Splenic procedures with CCbilled $153,340 · paid $30,782
- 801 Splenic procedures without CC/MCCbilled $91,066 · paid $19,034
Burns 6 codes
- 935 Non-extensive burnsbilled $102,372 · paid $24,888
- 928 Full thickness burn with skin graft or inhalation injury with CC/MCCbilled $344,467 · paid $82,671
- 934 Full thickness burn without skin graft or inhalation injurybilled $85,626 · paid $25,545
- 929 Full thickness burn with skin graft or inhalation injury without CC/MCCbilled $164,028 · paid $34,224
- 927 Extensive burns or full thickness burns with MV >96 hours with skin graftbilled $1,003,723 · paid $261,568
- 933 Extensive burns or full thickness burns with MV >96 hours without skin graftbilled $174,559 · paid $51,035
Circulatory system 101 codes
- 291 Heart failure and shock with MCCbilled $56,380 · paid $12,053
- 280 Acute myocardial infarction, discharged alive with MCCbilled $75,821 · paid $14,782
- 309 Cardiac arrhythmia and conduction disorders with CCbilled $36,115 · paid $7,304
- 274 Percutaneous and other intracardiac procedures without MCCbilled $156,757 · paid $27,537
- 312 Syncope and collapsebilled $45,536 · paid $8,563
- 322 Percutaneous cardiovascular procedures with intraluminal device without MCCbilled $114,560 · paid $17,280
- 308 Cardiac arrhythmia and conduction disorders with MCCbilled $56,635 · paid $11,419
- 267 Endovascular cardiac valve replacement and supplement procedures without MCCbilled $221,241 · paid $44,064
- 286 Circulatory disorders except ami, with cardiac catheterization with MCCbilled $112,267 · paid $21,752
- 281 Acute myocardial infarction, discharged alive with CCbilled $50,494 · paid $8,869
- 321 Percutaneous cardiovascular procedures with intraluminal device with MCC or 4+ arteries/intraluminal devicesbilled $163,668 · paid $26,715
- 287 Circulatory disorders except ami, with cardiac catheterization without MCCbilled $63,889 · paid $10,451
- 314 Other circulatory system diagnoses with MCCbilled $94,829 · paid $20,716
- 310 Cardiac arrhythmia and conduction disorders without CC/MCCbilled $28,728 · paid $5,627
- 266 Endovascular cardiac valve replacement and supplement procedures with MCCbilled $284,878 · paid $57,046
- 305 Hypertension without MCCbilled $40,100 · paid $7,334
- 313 Chest painbilled $39,935 · paid $7,113
- 243 Permanent cardiac pacemaker implant with CCbilled $111,073 · paid $20,395
- 300 Peripheral vascular disorders with CCbilled $49,396 · paid $10,493
- 252 Other vascular procedures with MCCbilled $170,864 · paid $33,351
- 270 Other major cardiovascular procedures with MCCbilled $259,138 · paid $49,908
- 315 Other circulatory system diagnoses with CCbilled $47,937 · paid $9,799
- 253 Other vascular procedures with CCbilled $131,847 · paid $24,853
- 299 Peripheral vascular disorders with MCCbilled $75,125 · paid $15,571
- 242 Permanent cardiac pacemaker implant with MCCbilled $160,613 · paid $30,388
- 236 Coronary bypass without cardiac catheterization without MCCbilled $210,757 · paid $37,974
- 219 Cardiac valve and other major cardiothoracic procedures without cardiac catheterization with MCCbilled $398,710 · paid $82,051
- 282 Acute myocardial infarction, discharged alive without CC/MCCbilled $43,381 · paid $7,211
- 292 Heart failure and shock with CCbilled $38,952 · paid $8,859
- 271 Other major cardiovascular procedures with CCbilled $173,893 · paid $32,775
- 304 Hypertension with MCCbilled $57,197 · paid $11,496
- 235 Coronary bypass without cardiac catheterization with MCCbilled $292,820 · paid $55,512
- 269 Aortic and heart assist procedures except pulsation balloon without MCCbilled $192,553 · paid $38,630
- 220 Cardiac valve and other major cardiothoracic procedures without cardiac catheterization with CCbilled $276,025 · paid $54,391
- 233 Coronary bypass with cardiac catheterization or open ablation with MCCbilled $385,245 · paid $70,178
- 244 Permanent cardiac pacemaker implant without CC/MCCbilled $93,150 · paid $16,690
- 264 Other circulatory system o.r. proceduresbilled $149,288 · paid $31,694
- 234 Coronary bypass with cardiac catheterization or open ablation without MCCbilled $268,844 · paid $47,494
- 273 Percutaneous and other intracardiac procedures with MCCbilled $214,406 · paid $37,052
- 283 Acute myocardial infarction, expired with MCCbilled $103,029 · paid $19,774
- 303 Atherosclerosis without MCCbilled $35,273 · paid $6,864
- 229 Other cardiothoracic procedures without MCCbilled $165,159 · paid $29,206
- 239 Amputation for circulatory system disorders except upper limb and toe with MCCbilled $214,912 · paid $44,938
- 228 Other cardiothoracic procedures with MCCbilled $250,730 · paid $49,266
- 324 Coronary intravascular lithotripsy with intraluminal device without MCCbilled $174,059 · paid $27,571
- 216 Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with MCCbilled $492,416 · paid $98,495
- 254 Other vascular procedures without CC/MCCbilled $91,212 · paid $16,686
- 240 Amputation for circulatory system disorders except upper limb and toe with CCbilled $127,976 · paid $25,921
- 323 Coronary intravascular lithotripsy with intraluminal device with MCCbilled $231,573 · paid $38,298
- 277 Cardiac defibrillator implant without MCCbilled $234,317 · paid $44,788
- 301 Peripheral vascular disorders without CC/MCCbilled $37,098 · paid $7,396
- 272 Other major cardiovascular procedures without CC/MCCbilled $125,298 · paid $23,235
- 215 Other heart assist system implantbilled $469,574 · paid $93,740
- 306 Cardiac congenital and valvular disorders with MCCbilled $72,644 · paid $15,565
- 275 Cardiac defibrillator implant with cardiac catheterization and MCCbilled $359,929 · paid $67,446
- 276 Cardiac defibrillator implant with MCC or carotid sinus neurostimulatorbilled $293,922 · paid $58,187
- 250 Percutaneous cardiovascular procedures without intraluminal device with MCCbilled $131,361 · paid $21,736
- 311 Angina pectorisbilled $40,285 · paid $7,163
- 268 Aortic and heart assist procedures except pulsation balloon with MCCbilled $348,594 · paid $71,204
- 251 Percutaneous cardiovascular procedures without intraluminal device without MCCbilled $95,679 · paid $14,784
- 307 Cardiac congenital and valvular disorders without MCCbilled $48,722 · paid $9,659
- 261 Cardiac pacemaker revision except device replacement with CCbilled $95,219 · paid $17,531
- 260 Cardiac pacemaker revision except device replacement with MCCbilled $163,555 · paid $31,828
- 296 Cardiac arrest, unexplained with MCCbilled $85,921 · paid $15,847
- 302 Atherosclerosis with MCCbilled $58,857 · paid $12,582
- 316 Other circulatory system diagnoses without CC/MCCbilled $37,676 · paid $7,088
- 293 Heart failure and shock without CC/MCCbilled $27,398 · paid $5,880
- 217 Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with CCbilled $331,660 · paid $62,024
- 279 Ultrasound accelerated and other thrombolysis of peripheral vascular structures without MCCbilled $167,679 · paid $30,164
- 317 Concomitant left atrial appendage closure and cardiac ablationbilled $361,833 · paid $57,086
- 221 Cardiac valve and other major cardiothoracic procedures without cardiac catheterization without CC/MCCbilled $232,005 · paid $44,816
- 255 Upper limb and toe amputation for circulatory system disorders with MCCbilled $118,657 · paid $25,072
- 256 Upper limb and toe amputation for circulatory system disorders with CCbilled $76,021 · paid $15,590
- 288 Acute and subacute endocarditis with MCCbilled $118,381 · paid $25,127
- 319 Other endovascular cardiac valve procedures with MCCbilled $235,139 · paid $44,934
- 278 Ultrasound accelerated and other thrombolysis of peripheral vascular structures with MCCbilled $235,446 · paid $43,954
- 212 Concomitant aortic and mitral valve proceduresbilled $568,203 · paid $119,502
- 325 Coronary intravascular lithotripsy without intraluminal devicebilled $176,300 · paid $25,311
- 231 Coronary bypass with ptca with MCCbilled $447,056 · paid $83,815
- 259 Cardiac pacemaker device replacement without MCCbilled $94,460 · paid $16,717
- 245 Aicd generator proceduresbilled $222,047 · paid $44,297
- 262 Cardiac pacemaker revision except device replacement without CC/MCCbilled $84,919 · paid $14,796
- 284 Acute myocardial infarction, expired with CCbilled $40,314 · paid $7,307
- 258 Cardiac pacemaker device replacement with MCCbilled $129,436 · paid $25,450
- 289 Acute and subacute endocarditis with CCbilled $72,498 · paid $14,219
- 232 Coronary bypass with ptca without MCCbilled $325,209 · paid $55,267
- 265 Aicd lead proceduresbilled $177,147 · paid $34,156
- 320 Other endovascular cardiac valve procedures without MCCbilled $136,976 · paid $23,170
- 241 Amputation for circulatory system disorders except upper limb and toe without CC/MCCbilled $67,091 · paid $13,287
- 218 Cardiac valve and other major cardiothoracic procedures with cardiac catheterization without CC/MCCbilled $319,239 · paid $49,631
- 297 Cardiac arrest, unexplained with CCbilled $43,152 · paid $7,813
- 263 Vein ligation and strippingbilled $169,138 · paid $33,964
- 285 Acute myocardial infarction, expired without CC/MCCbilled $33,322 · paid $5,253
- 298 Cardiac arrest, unexplained without CC/MCCbilled $24,296 · paid $4,851
- 257 Upper limb and toe amputation for circulatory system disorders without CC/MCCbilled $50,837 · paid $9,373
- 290 Acute and subacute endocarditis without CC/MCCbilled $37,735 · paid $9,589
- 209 Complex aortic arch procedures
- 213 Endovascular abdominal aorta with iliac branch procedures
- 318 Percutaneous coronary atherectomy without intraluminal device
- 359 Percutaneous coronary atherectomy with intraluminal device with MCC
- 360 Percutaneous coronary atherectomy with intraluminal device without MCC
Digestive system 58 codes
- 392 Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCbilled $40,165 · paid $7,830
- 378 Gastrointestinal hemorrhage with CCbilled $48,550 · paid $9,389
- 377 Gastrointestinal hemorrhage with MCCbilled $85,391 · paid $16,677
- 330 Major small and large bowel procedures with CCbilled $119,020 · paid $22,815
- 389 Gastrointestinal obstruction with CCbilled $38,925 · paid $7,916
- 391 Esophagitis, gastroenteritis and miscellaneous digestive disorders with MCCbilled $61,028 · paid $12,634
- 329 Major small and large bowel procedures with MCCbilled $214,982 · paid $43,388
- 394 Other digestive system diagnoses with CCbilled $47,064 · paid $9,479
- 393 Other digestive system diagnoses with MCCbilled $76,783 · paid $16,562
- 331 Major small and large bowel procedures without CC/MCCbilled $85,825 · paid $15,961
- 390 Gastrointestinal obstruction without CC/MCCbilled $27,938 · paid $5,847
- 388 Gastrointestinal obstruction with MCCbilled $68,423 · paid $13,978
- 372 Major gastrointestinal disorders and peritoneal infections with CCbilled $47,479 · paid $9,981
- 371 Major gastrointestinal disorders and peritoneal infections with MCCbilled $78,404 · paid $16,558
- 374 Digestive malignancy with MCCbilled $100,406 · paid $21,124
- 375 Digestive malignancy with CCbilled $60,967 · paid $12,091
- 326 Stomach, esophageal and duodenal procedures with MCCbilled $239,966 · paid $50,970
- 327 Stomach, esophageal and duodenal procedures with CCbilled $126,536 · paid $25,157
- 336 Peritoneal adhesiolysis with CCbilled $103,373 · paid $20,335
- 356 Other digestive system o.r. procedures with MCCbilled $209,071 · paid $40,861
- 379 Gastrointestinal hemorrhage without CC/MCCbilled $34,171 · paid $6,507
- 386 Inflammatory bowel disease with CCbilled $48,553 · paid $9,913
- 328 Stomach, esophageal and duodenal procedures without CC/MCCbilled $86,485 · paid $15,935
- 354 Hernia procedures except inguinal and femoral with CCbilled $88,606 · paid $17,030
- 381 Complicated peptic ulcer with CCbilled $55,717 · paid $10,152
- 395 Other digestive system diagnoses without CC/MCCbilled $34,600 · paid $6,874
- 380 Complicated peptic ulcer with MCCbilled $92,717 · paid $18,745
- 368 Major esophageal disorders with MCCbilled $78,609 · paid $16,130
- 335 Peritoneal adhesiolysis with MCCbilled $170,858 · paid $33,979
- 357 Other digestive system o.r. procedures with CCbilled $116,964 · paid $20,988
- 355 Hernia procedures except inguinal and femoral without CC/MCCbilled $72,213 · paid $13,071
- 398 Appendix procedures with CCbilled $79,157 · paid $14,367
- 369 Major esophageal disorders with CCbilled $50,964 · paid $9,864
- 351 Inguinal and femoral hernia procedures with CCbilled $83,897 · paid $13,826
- 337 Peritoneal adhesiolysis without CC/MCCbilled $79,837 · paid $14,509
- 399 Appendix procedures without CC/MCCbilled $63,554 · paid $10,805
- 373 Major gastrointestinal disorders and peritoneal infections without CC/MCCbilled $35,946 · paid $7,338
- 385 Inflammatory bowel disease with MCCbilled $75,883 · paid $16,170
- 384 Uncomplicated peptic ulcer without MCCbilled $47,209 · paid $8,612
- 353 Hernia procedures except inguinal and femoral with MCCbilled $146,984 · paid $28,142
- 352 Inguinal and femoral hernia procedures without CC/MCCbilled $67,096 · paid $10,539
- 345 Minor small and large bowel procedures with CCbilled $74,840 · paid $14,907
- 348 Anal and stomal procedures with CCbilled $67,549 · paid $12,643
- 387 Inflammatory bowel disease without CC/MCCbilled $34,186 · paid $7,323
- 350 Inguinal and femoral hernia procedures with MCCbilled $132,562 · paid $22,757
- 397 Appendix procedures with MCCbilled $120,947 · paid $21,784
- 344 Minor small and large bowel procedures with MCCbilled $127,463 · paid $26,956
- 358 Other digestive system o.r. procedures without CC/MCCbilled $76,136 · paid $13,625
- 347 Anal and stomal procedures with MCCbilled $118,481 · paid $24,278
- 382 Complicated peptic ulcer without CC/MCCbilled $42,142 · paid $7,783
- 383 Uncomplicated peptic ulcer with MCCbilled $74,261 · paid $13,379
- 346 Minor small and large bowel procedures without CC/MCCbilled $61,830 · paid $12,653
- 349 Anal and stomal procedures without CC/MCCbilled $53,761 · paid $9,470
- 376 Digestive malignancy without CC/MCCbilled $50,144 · paid $9,490
- 333 Rectal resection with CCbilled $119,995 · paid $20,824
- 334 Rectal resection without CC/MCCbilled $88,063 · paid $15,972
- 370 Major esophageal disorders without CC/MCCbilled $38,413 · paid $7,755
- 332 Rectal resection with MCCbilled $194,638 · paid $40,128
Ear, nose, mouth and throat 25 codes
- 149 Dysequilibriumbilled $44,396 · paid $7,342
- 153 Otitis media and uri without MCCbilled $37,757 · paid $7,823
- 155 Other ear, nose, mouth and throat diagnoses with CCbilled $47,140 · paid $9,822
- 158 Dental and oral diseases with CCbilled $46,994 · paid $9,903
- 141 Major head and neck procedures with CCbilled $128,642 · paid $24,714
- 152 Otitis media and uri with MCCbilled $56,918 · paid $12,406
- 154 Other ear, nose, mouth and throat diagnoses with MCCbilled $75,203 · paid $15,814
- 157 Dental and oral diseases with MCCbilled $89,599 · paid $18,146
- 144 Other ear, nose, mouth and throat o.r. procedures with CCbilled $102,738 · paid $19,974
- 151 Epistaxis without MCCbilled $34,108 · paid $7,525
- 146 Ear, nose, mouth and throat malignancy with MCCbilled $101,091 · paid $23,909
- 142 Major head and neck procedures without CC/MCCbilled $93,820 · paid $18,027
- 156 Other ear, nose, mouth and throat diagnoses without CC/MCCbilled $37,348 · paid $7,199
- 145 Other ear, nose, mouth and throat o.r. procedures without CC/MCCbilled $70,696 · paid $13,771
- 143 Other ear, nose, mouth and throat o.r. procedures with MCCbilled $200,229 · paid $40,094
- 147 Ear, nose, mouth and throat malignancy with CCbilled $63,516 · paid $13,723
- 150 Epistaxis with MCCbilled $59,475 · paid $13,034
- 140 Major head and neck procedures with MCCbilled $231,706 · paid $44,135
- 159 Dental and oral diseases without CC/MCCbilled $36,193 · paid $7,836
- 137 Mouth procedures with CC/MCCbilled $77,145 · paid $16,357
- 135 Sinus and mastoid procedures with CC/MCCbilled $118,723 · paid $29,425
- 139 Salivary gland proceduresbilled $64,278 · paid $13,326
- 138 Mouth procedures without CC/MCCbilled $52,385 · paid $10,015
- 148 Ear, nose, mouth and throat malignancy without CC/MCCbilled $40,720 · paid $9,839
- 136 Sinus and mastoid procedures without CC/MCCbilled $63,124 · paid $11,746
Endocrine, nutritional and metabolic 26 codes
- 640 Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with MCCbilled $60,293 · paid $12,791
- 641 Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes without MCCbilled $37,058 · paid $7,789
- 638 Diabetes with CCbilled $41,674 · paid $9,138
- 637 Diabetes with MCCbilled $66,501 · paid $13,857
- 643 Endocrine disorders with MCCbilled $74,096 · paid $15,593
- 644 Endocrine disorders with CCbilled $48,036 · paid $10,303
- 617 Amputation of lower limb for endocrine, nutritional and metabolic disorders with CCbilled $86,883 · paid $18,583
- 623 Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders with CCbilled $82,559 · paid $17,980
- 621 O.r. procedures for obesity without CC/MCCbilled $74,857 · paid $14,603
- 639 Diabetes without CC/MCCbilled $30,113 · paid $6,539
- 629 Other endocrine, nutritional and metabolic o.r. procedures with CCbilled $102,526 · paid $21,414
- 645 Endocrine disorders without CC/MCCbilled $36,561 · paid $7,656
- 616 Amputation of lower limb for endocrine, nutritional and metabolic disorders with MCCbilled $162,298 · paid $34,688
- 628 Other endocrine, nutritional and metabolic o.r. procedures with MCCbilled $170,401 · paid $36,602
- 614 Adrenal and pituitary procedures with CC/MCCbilled $124,899 · paid $26,246
- 622 Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders with MCCbilled $152,595 · paid $33,473
- 620 O.r. procedures for obesity with CCbilled $80,045 · paid $16,524
- 642 Inborn and other disorders of metabolismbilled $69,258 · paid $14,516
- 615 Adrenal and pituitary procedures without CC/MCCbilled $82,144 · paid $15,497
- 626 Thyroid, parathyroid and thyroglossal procedures with CCbilled $92,980 · paid $16,312
- 627 Thyroid, parathyroid and thyroglossal procedures without CC/MCCbilled $76,030 · paid $12,698
- 625 Thyroid, parathyroid and thyroglossal procedures with MCCbilled $167,279 · paid $31,285
- 619 O.r. procedures for obesity with MCCbilled $141,190 · paid $27,045
- 630 Other endocrine, nutritional and metabolic o.r. procedures without CC/MCCbilled $75,141 · paid $14,554
- 624 Skin grafts and wound debridement for endocrine, nutritional and metabolic disorders without CC/MCCbilled $57,390 · paid $12,282
- 618 Amputation of lower limb for endocrine, nutritional and metabolic disorders without CC/MCCbilled $68,304 · paid $11,437
Eye 10 codes
- 125 Other disorders of the eye without MCCbilled $43,825 · paid $8,907
- 123 Neurological eye disordersbilled $51,129 · paid $8,668
- 124 Other disorders of the eye with MCC or thrombolytic agentbilled $66,448 · paid $14,054
- 115 Extraocular procedures except orbitbilled $81,712 · paid $18,780
- 121 Acute major eye infections with CC/MCCbilled $56,158 · paid $15,091
- 113 Orbital procedures with CC/MCCbilled $125,686 · paid $28,200
- 116 Intraocular procedures with CC/MCCbilled $93,104 · paid $24,323
- 117 Intraocular procedures without CC/MCCbilled $61,258 · paid $16,005
- 122 Acute major eye infections without CC/MCCbilled $32,240 · paid $10,837
- 114 Orbital procedures without CC/MCCbilled $72,580 · paid $15,834
Factors influencing health status 10 codes
- 948 Signs and symptoms without MCCbilled $38,083 · paid $8,083
- 951 Other factors influencing health statusbilled $25,572 · paid $6,055
- 947 Signs and symptoms with MCCbilled $56,390 · paid $12,568
- 945 Rehabilitation with CC/MCCbilled $55,504 · paid $17,888
- 940 O.r. procedures with diagnoses of other contact with health services with CCbilled $110,297 · paid $21,869
- 949 Aftercare with CC/MCCbilled $48,408 · paid $19,182
- 946 Rehabilitation without CC/MCCbilled $36,631 · paid $11,367
- 941 O.r. procedures with diagnoses of other contact with health services without CC/MCCbilled $96,937 · paid $18,550
- 939 O.r. procedures with diagnoses of other contact with health services with MCCbilled $176,317 · paid $36,018
- 950 Aftercare without CC/MCCbilled $27,580 · paid $11,965
Female reproductive system 25 codes
- 742 Uterine and adnexa procedures for non-malignancy with CC/MCCbilled $101,252 · paid $18,630
- 743 Uterine and adnexa procedures for non-malignancy without CC/MCCbilled $69,785 · paid $12,084
- 737 Uterine and adnexa procedures for ovarian or adnexal malignancy with CCbilled $116,218 · paid $21,372
- 755 Malignancy, female reproductive system with CCbilled $54,805 · paid $11,672
- 754 Malignancy, female reproductive system with MCCbilled $89,754 · paid $19,547
- 740 Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy with CCbilled $106,335 · paid $19,245
- 760 Menstrual and other female reproductive system disorders with CC/MCCbilled $49,541 · paid $10,234
- 744 D&c, conization, laparoscopy and tubal interruption with CC/MCCbilled $107,352 · paid $21,018
- 746 Vagina, cervix and vulva procedures with CC/MCCbilled $89,509 · paid $17,830
- 748 Female reproductive system reconstructive proceduresbilled $74,609 · paid $13,033
- 758 Infections, female reproductive system with CCbilled $46,942 · paid $10,199
- 747 Vagina, cervix and vulva procedures without CC/MCCbilled $49,945 · paid $9,236
- 741 Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy without CC/MCCbilled $85,600 · paid $13,629
- 757 Infections, female reproductive system with MCCbilled $62,772 · paid $13,586
- 749 Other female reproductive system o.r. procedures with CC/MCCbilled $131,006 · paid $25,676
- 736 Uterine and adnexa procedures for ovarian or adnexal malignancy with MCCbilled $196,912 · paid $42,408
- 739 Uterine and adnexa procedures for non-ovarian and non-adnexal malignancy with MCCbilled $187,352 · paid $41,145
- 734 Pelvic evisceration, radical hysterectomy and radical vulvectomy with CC/MCCbilled $129,042 · paid $24,029
- 738 Uterine and adnexa procedures for ovarian or adnexal malignancy without CC/MCCbilled $80,003 · paid $14,216
- 759 Infections, female reproductive system without CC/MCCbilled $35,597 · paid $6,865
- 761 Menstrual and other female reproductive system disorders without CC/MCCbilled $33,228 · paid $6,907
- 735 Pelvic evisceration, radical hysterectomy and radical vulvectomy without CC/MCCbilled $84,881 · paid $13,601
- 756 Malignancy, female reproductive system without CC/MCCbilled $62,796 · paid $11,834
- 745 D&c, conization, laparoscopy and tubal interruption without CC/MCCbilled $65,358 · paid $10,823
- 750 Other female reproductive system o.r. procedures without CC/MCCbilled $91,200 · paid $13,684
Hepatobiliary system and pancreas 36 codes
- 418 Laparoscopic cholecystectomy without c.d.e. with CCbilled $93,210 · paid $15,160
- 432 Cirrhosis and alcoholic hepatitis with MCCbilled $95,676 · paid $19,651
- 445 Disorders of the biliary tract with CCbilled $58,184 · paid $10,692
- 441 Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCCbilled $86,228 · paid $18,915
- 439 Disorders of pancreas except malignancy with CCbilled $43,637 · paid $8,765
- 435 Malignancy of hepatobiliary system or pancreas with MCCbilled $94,481 · paid $18,294
- 444 Disorders of the biliary tract with MCCbilled $83,243 · paid $16,233
- 417 Laparoscopic cholecystectomy without c.d.e. with MCCbilled $124,948 · paid $21,530
- 442 Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CCbilled $47,638 · paid $10,049
- 438 Disorders of pancreas except malignancy with MCCbilled $79,250 · paid $16,600
- 419 Laparoscopic cholecystectomy without c.d.e. without CC/MCCbilled $77,870 · paid $12,488
- 433 Cirrhosis and alcoholic hepatitis with CCbilled $52,599 · paid $10,459
- 436 Malignancy of hepatobiliary system or pancreas with CCbilled $60,432 · paid $11,406
- 440 Disorders of pancreas except malignancy without CC/MCCbilled $32,767 · paid $6,383
- 446 Disorders of the biliary tract without CC/MCCbilled $45,756 · paid $7,988
- 406 Pancreas, liver and shunt procedures with CCbilled $161,923 · paid $31,740
- 405 Pancreas, liver and shunt procedures with MCCbilled $288,397 · paid $63,019
- 423 Other hepatobiliary or pancreas o.r. procedures with MCCbilled $208,980 · paid $42,294
- 407 Pancreas, liver and shunt procedures without CC/MCCbilled $125,052 · paid $23,248
- 443 Disorders of liver except malignancy, cirrhosis or alcoholic hepatitis without CC/MCCbilled $36,828 · paid $7,488
- 415 Cholecystectomy except by laparoscope without c.d.e. with CCbilled $107,130 · paid $19,628
- 414 Cholecystectomy except by laparoscope without c.d.e. with MCCbilled $175,144 · paid $34,532
- 408 Biliary tract procedures except only cholecystectomy with or without c.d.e. with MCCbilled $178,993 · paid $38,900
- 409 Biliary tract procedures except only cholecystectomy with or without c.d.e. with CCbilled $120,264 · paid $20,590
- 420 Hepatobiliary diagnostic procedures with MCCbilled $171,386 · paid $33,996
- 424 Other hepatobiliary or pancreas o.r. procedures with CCbilled $118,341 · paid $22,092
- 421 Hepatobiliary diagnostic procedures with CCbilled $95,677 · paid $17,323
- 416 Cholecystectomy except by laparoscope without c.d.e. without CC/MCCbilled $74,015 · paid $13,354
- 437 Malignancy of hepatobiliary system or pancreas without CC/MCCbilled $53,326 · paid $9,135
- 434 Cirrhosis and alcoholic hepatitis without CC/MCCbilled $34,674 · paid $7,131
- 410 Biliary tract procedures except only cholecystectomy with or without c.d.e. without CC/MCCbilled $90,010 · paid $15,569
- 412 Cholecystectomy with c.d.e. with CCbilled $110,390 · paid $20,517
- 411 Cholecystectomy with c.d.e. with MCCbilled $165,158 · paid $31,473
- 422 Hepatobiliary diagnostic procedures without CC/MCCbilled $74,672 · paid $14,379
- 413 Cholecystectomy with c.d.e. without CC/MCCbilled $92,097 · paid $17,218
- 425 Other hepatobiliary or pancreas o.r. procedures without CC/MCCbilled $78,577 · paid $15,802
Human immunodeficiency virus infections 6 codes
- 974 HIV with major related condition with MCCbilled $149,750 · paid $33,402
- 975 HIV with major related condition with CCbilled $68,377 · paid $17,230
- 977 HIV with or without other related conditionbilled $68,884 · paid $17,303
- 969 HIV with extensive o.r. procedures with MCCbilled $354,005 · paid $77,810
- 976 HIV with major related condition without CC/MCCbilled $46,191 · paid $11,667
- 970 HIV with extensive o.r. procedures without MCCbilled $150,211 · paid $28,617
Infectious and parasitic diseases 17 codes
- 871 Septicemia or severe sepsis without MV >96 hours with MCCbilled $90,297 · paid $18,228
- 872 Septicemia or severe sepsis without MV >96 hours without MCCbilled $49,049 · paid $10,091
- 853 Infectious and parasitic diseases with o.r. procedures with MCCbilled $228,948 · paid $46,478
- 870 Septicemia or severe sepsis with MV >96 hoursbilled $323,293 · paid $64,425
- 854 Infectious and parasitic diseases with o.r. procedures with CCbilled $98,272 · paid $19,069
- 862 Postoperative and post-traumatic infections with MCCbilled $83,228 · paid $18,317
- 863 Postoperative and post-traumatic infections without MCCbilled $45,194 · paid $10,173
- 857 Postoperative or post-traumatic infections with o.r. procedures with CCbilled $100,198 · paid $20,726
- 856 Postoperative or post-traumatic infections with o.r. procedures with MCCbilled $203,495 · paid $43,456
- 864 Fever and inflammatory conditionsbilled $46,536 · paid $8,985
- 866 Viral illness without MCCbilled $42,399 · paid $9,637
- 865 Viral illness with MCCbilled $74,310 · paid $16,774
- 867 Other infectious and parasitic diseases diagnoses with MCCbilled $101,536 · paid $21,917
- 868 Other infectious and parasitic diseases diagnoses with CCbilled $49,343 · paid $11,143
- 858 Postoperative or post-traumatic infections with o.r. procedures without CC/MCCbilled $66,162 · paid $12,252
- 869 Other infectious and parasitic diseases diagnoses without CC/MCCbilled $32,903 · paid $7,634
- 855 Infectious and parasitic diseases with o.r. procedures without CC/MCCbilled $78,090 · paid $15,838
Injuries, poisonings and toxic effects of drugs 20 codes
- 917 Poisoning and toxic effects of drugs with MCCbilled $74,877 · paid $15,930
- 919 Complications of treatment with MCCbilled $88,493 · paid $19,308
- 920 Complications of treatment with CCbilled $49,578 · paid $10,653
- 907 Other o.r. procedures for injuries with MCCbilled $183,657 · paid $38,069
- 908 Other o.r. procedures for injuries with CCbilled $97,248 · paid $19,650
- 918 Poisoning and toxic effects of drugs without MCCbilled $40,272 · paid $9,135
- 916 Allergic reactions without MCCbilled $33,989 · paid $7,444
- 909 Other o.r. procedures for injuries without CC/MCCbilled $68,213 · paid $13,213
- 914 Traumatic injury without MCCbilled $47,358 · paid $9,302
- 922 Other injury, poisoning and toxic effect diagnoses with MCCbilled $80,179 · paid $17,881
- 921 Complications of treatment without CC/MCCbilled $34,643 · paid $7,334
- 915 Allergic reactions with MCCbilled $78,940 · paid $17,224
- 902 Wound debridements for injuries with CCbilled $94,026 · paid $20,044
- 923 Other injury, poisoning and toxic effect diagnoses without MCCbilled $49,338 · paid $10,456
- 901 Wound debridements for injuries with MCCbilled $201,460 · paid $47,925
- 904 Skin grafts for injuries with CC/MCCbilled $176,673 · paid $39,868
- 913 Traumatic injury with MCCbilled $81,977 · paid $15,866
- 906 Hand procedures for injuriesbilled $93,876 · paid $22,179
- 903 Wound debridements for injuries without CC/MCCbilled $57,143 · paid $12,176
- 905 Skin grafts for injuries without CC/MCCbilled $74,471 · paid $18,792
Kidney and urinary tract 42 codes
- 690 Kidney and urinary tract infections without MCCbilled $37,821 · paid $7,851
- 689 Kidney and urinary tract infections with MCCbilled $51,326 · paid $10,743
- 683 Renal failure with CCbilled $40,705 · paid $8,658
- 698 Other kidney and urinary tract diagnoses with MCCbilled $73,427 · paid $15,441
- 682 Renal failure with MCCbilled $65,939 · paid $13,729
- 699 Other kidney and urinary tract diagnoses with CCbilled $47,479 · paid $10,420
- 660 Kidney and ureter procedures for non-neoplasm with CCbilled $67,483 · paid $12,804
- 673 Other kidney and urinary tract procedures with MCCbilled $173,196 · paid $37,323
- 659 Kidney and ureter procedures for non-neoplasm with MCCbilled $119,700 · paid $23,913
- 661 Kidney and ureter procedures for non-neoplasm without CC/MCCbilled $56,664 · paid $9,898
- 684 Renal failure without CC/MCCbilled $29,653 · paid $6,136
- 652 Kidney transplantbilled $336,427 · paid $45,545
- 674 Other kidney and urinary tract procedures with CCbilled $108,584 · paid $23,041
- 657 Kidney and ureter procedures for neoplasm with CCbilled $100,021 · paid $18,444
- 694 Urinary stones without MCCbilled $41,258 · paid $7,860
- 696 Kidney and urinary tract signs and symptoms without MCCbilled $32,909 · paid $6,956
- 658 Kidney and ureter procedures for neoplasm without CC/MCCbilled $85,026 · paid $15,012
- 669 Transurethral procedures with CCbilled $77,613 · paid $14,174
- 654 Major bladder procedures with CCbilled $154,790 · paid $29,790
- 650 Kidney transplant with hemodialysis with MCCbilled $419,556 · paid $57,737
- 656 Kidney and ureter procedures for neoplasm with MCCbilled $170,906 · paid $33,795
- 687 Kidney and urinary tract neoplasms with CCbilled $50,226 · paid $10,407
- 700 Other kidney and urinary tract diagnoses without CC/MCCbilled $33,346 · paid $7,107
- 663 Minor bladder procedures with CCbilled $75,782 · paid $13,554
- 686 Kidney and urinary tract neoplasms with MCCbilled $86,557 · paid $18,938
- 668 Transurethral procedures with MCCbilled $142,336 · paid $27,803
- 693 Urinary stones with MCCbilled $66,607 · paid $14,084
- 653 Major bladder procedures with MCCbilled $251,445 · paid $54,671
- 666 Prostatectomy with CCbilled $87,558 · paid $15,866
- 695 Kidney and urinary tract signs and symptoms with MCCbilled $53,247 · paid $11,400
- 662 Minor bladder procedures with MCCbilled $144,918 · paid $28,574
- 655 Major bladder procedures without CC/MCCbilled $118,473 · paid $22,265
- 651 Kidney transplant with hemodialysis without MCCbilled $373,716 · paid $49,724
- 670 Transurethral procedures without CC/MCCbilled $53,690 · paid $9,920
- 665 Prostatectomy with MCCbilled $148,465 · paid $29,384
- 697 Urethral stricturebilled $50,430 · paid $10,729
- 664 Minor bladder procedures without CC/MCCbilled $56,039 · paid $10,728
- 675 Other kidney and urinary tract procedures without CC/MCCbilled $83,538 · paid $14,846
- 671 Urethral procedures with CC/MCCbilled $97,205 · paid $17,194
- 667 Prostatectomy without CC/MCCbilled $61,809 · paid $9,711
- 688 Kidney and urinary tract neoplasms without CC/MCCbilled $41,390 · paid $7,771
- 672 Urethral procedures without CC/MCCbilled $65,210 · paid $11,273
Male reproductive system 21 codes
- 713 Transurethral prostatectomy with CC/MCCbilled $76,459 · paid $13,816
- 728 Inflammation of the male reproductive system without MCCbilled $38,579 · paid $8,288
- 726 Benign prostatic hypertrophy without MCCbilled $34,067 · paid $7,545
- 708 Major male pelvic procedures without CC/MCCbilled $89,001 · paid $15,507
- 707 Major male pelvic procedures with CC/MCCbilled $111,374 · paid $20,747
- 717 Other male reproductive system o.r. procedures except malignancy with CC/MCCbilled $96,415 · paid $17,791
- 727 Inflammation of the male reproductive system with MCCbilled $69,051 · paid $15,378
- 723 Malignancy, male reproductive system with CCbilled $56,397 · paid $11,214
- 714 Transurethral prostatectomy without CC/MCCbilled $55,438 · paid $9,230
- 722 Malignancy, male reproductive system with MCCbilled $86,955 · paid $19,242
- 725 Benign prostatic hypertrophy with MCCbilled $56,142 · paid $12,262
- 729 Other male reproductive system diagnoses with CC/MCCbilled $51,180 · paid $10,787
- 715 Other male reproductive system o.r. procedures for malignancy with CC/MCCbilled $120,310 · paid $22,411
- 709 Penis procedures with CC/MCCbilled $125,205 · paid $24,726
- 718 Other male reproductive system o.r. procedures except malignancy without CC/MCCbilled $72,500 · paid $11,203
- 711 Testes procedures with CC/MCCbilled $106,753 · paid $20,109
- 710 Penis procedures without CC/MCCbilled $73,730 · paid $13,122
- 730 Other male reproductive system diagnoses without CC/MCCbilled $35,183 · paid $6,837
- 712 Testes procedures without CC/MCCbilled $55,906 · paid $10,635
- 716 Other male reproductive system o.r. procedures for malignancy without CC/MCCbilled $87,385 · paid $13,455
- 724 Malignancy, male reproductive system without CC/MCCbilled $30,751 · paid $8,084
Mental diseases and disorders 9 codes
- 885 Psychosesbilled $44,040 · paid $14,279
- 884 Organic disturbances and intellectual disabilitybilled $62,403 · paid $16,059
- 880 Acute adjustment reaction and psychosocial dysfunctionbilled $46,037 · paid $9,825
- 881 Depressive neurosesbilled $31,924 · paid $9,572
- 882 Neuroses except depressivebilled $39,406 · paid $9,821
- 883 Disorders of personality and impulse controlbilled $56,979 · paid $19,610
- 876 O.r. procedures with principal diagnosis of mental illnessbilled $162,623 · paid $40,784
- 887 Other mental disorder diagnosesbilled $46,619 · paid $13,024
- 886 Behavioral and developmental disordersbilled $64,481 · paid $20,146
Multiple significant trauma 8 codes
- 956 Limb reattachment, hip and femur procedures for multiple significant traumabilled $176,346 · paid $35,170
- 964 Other multiple significant trauma with CCbilled $78,196 · paid $15,945
- 963 Other multiple significant trauma with MCCbilled $138,428 · paid $29,517
- 957 Other o.r. procedures for multiple significant trauma with MCCbilled $394,521 · paid $80,059
- 958 Other o.r. procedures for multiple significant trauma with CCbilled $214,768 · paid $43,358
- 965 Other multiple significant trauma without CC/MCCbilled $51,216 · paid $10,142
- 955 Craniotomy for multiple significant traumabilled $358,522 · paid $68,297
- 959 Other o.r. procedures for multiple significant trauma without CC/MCCbilled $158,288 · paid $28,825
Musculoskeletal system and connective tissue 105 codes
- 481 Hip and femur procedures except major joint with CCbilled $100,756 · paid $18,493
- 470 Major hip and knee joint replacement or reattachment of lower extremity without MCCbilled $93,184 · paid $17,364
- 552 Medical back problems without MCCbilled $48,855 · paid $9,347
- 522 Hip replacement with principal diagnosis of hip fracture without MCCbilled $102,323 · paid $18,379
- 480 Hip and femur procedures except major joint with MCCbilled $138,737 · paid $26,010
- 563 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without MCCbilled $42,606 · paid $8,686
- 467 Revision of hip or knee replacement with CCbilled $157,758 · paid $30,483
- 536 Fractures of hip and pelvis without MCCbilled $37,688 · paid $7,513
- 493 Lower extremity and humerus procedures except hip, foot and femur with CCbilled $119,061 · paid $22,375
- 472 Cervical spinal fusion with CCbilled $143,016 · paid $27,872
- 543 Pathological fractures and musculoskeletal and connective tissue malignancy with CCbilled $49,038 · paid $10,286
- 521 Hip replacement with principal diagnosis of hip fracture with MCCbilled $135,201 · paid $25,460
- 551 Medical back problems with MCCbilled $78,715 · paid $15,739
- 482 Hip and femur procedures except major joint without CC/MCCbilled $77,908 · paid $14,442
- 483 Major joint or limb reattachment procedures of upper extremitiesbilled $126,247 · paid $22,296
- 468 Revision of hip or knee replacement without CC/MCCbilled $123,873 · paid $23,778
- 516 Other musculoskeletal system and connective tissue o.r. procedures with CCbilled $101,552 · paid $18,613
- 554 Bone diseases and arthropathies without MCCbilled $37,968 · paid $8,478
- 542 Pathological fractures and musculoskeletal and connective tissue malignancy with MCCbilled $79,949 · paid $17,385
- 556 Signs and symptoms of musculoskeletal system and connective tissue without MCCbilled $40,348 · paid $8,233
- 565 Other musculoskeletal system and connective tissue diagnoses with CCbilled $47,869 · paid $10,035
- 519 Back and neck procedures except spinal fusion with CCbilled $104,607 · paid $19,512
- 558 Tendonitis, myositis and bursitis without MCCbilled $41,521 · paid $8,690
- 494 Lower extremity and humerus procedures except hip, foot and femur without CC/MCCbilled $95,089 · paid $17,608
- 535 Fractures of hip and pelvis with MCCbilled $58,462 · paid $11,993
- 562 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with MCCbilled $66,136 · paid $13,815
- 517 Other musculoskeletal system and connective tissue o.r. procedures without CC/MCCbilled $78,157 · paid $14,001
- 464 Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders with CCbilled $145,513 · paid $28,947
- 473 Cervical spinal fusion without CC/MCCbilled $115,049 · paid $22,040
- 492 Lower extremity and humerus procedures except hip, foot and femur with MCCbilled $164,409 · paid $31,824
- 564 Other musculoskeletal system and connective tissue diagnoses with MCCbilled $73,797 · paid $14,864
- 478 Biopsies of musculoskeletal system and connective tissue with CCbilled $118,089 · paid $21,917
- 469 Major hip and knee joint replacement or reattachment of lower extremity with MCC or total ankle replacementbilled $149,677 · paid $29,663
- 560 Aftercare, musculoskeletal system and connective tissue with CCbilled $46,938 · paid $13,132
- 557 Tendonitis, myositis and bursitis with MCCbilled $69,564 · paid $14,149
- 466 Revision of hip or knee replacement with MCCbilled $240,992 · paid $49,984
- 515 Other musculoskeletal system and connective tissue o.r. procedures with MCCbilled $150,074 · paid $28,460
- 402 Single level combined anterior and posterior spinal fusion except cervicalbilled $187,959 · paid $36,441
- 463 Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders with MCCbilled $237,937 · paid $52,235
- 501 Soft tissue procedures with CCbilled $89,456 · paid $17,229
- 457 Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions with CCbilled $289,269 · paid $60,307
- 448 Multiple level spinal fusion except cervical without MCCbilled $200,125 · paid $38,755
- 520 Back and neck procedures except spinal fusion without CC/MCCbilled $78,814 · paid $14,004
- 427 Multiple level combined anterior and posterior spinal fusion except cervical with CCbilled $341,611 · paid $68,981
- 451 Single level spinal fusion except cervical without MCCbilled $150,069 · paid $29,699
- 544 Pathological fractures and musculoskeletal and connective tissue malignancy without CC/MCCbilled $35,883 · paid $7,257
- 545 Connective tissue disorders with MCCbilled $116,295 · paid $27,689
- 471 Cervical spinal fusion with MCCbilled $238,955 · paid $47,770
- 477 Biopsies of musculoskeletal system and connective tissue with MCCbilled $157,901 · paid $31,810
- 546 Connective tissue disorders with CCbilled $57,695 · paid $12,918
- 539 Osteomyelitis with MCCbilled $81,395 · paid $18,534
- 475 Amputation for musculoskeletal system and connective tissue disorders with CCbilled $105,030 · paid $20,324
- 486 Knee procedures with principal diagnosis of infection with CCbilled $99,486 · paid $19,620
- 559 Aftercare, musculoskeletal system and connective tissue with MCCbilled $90,327 · paid $22,943
- 511 Shoulder, elbow or forearm procedures, except major joint procedures with CCbilled $102,822 · paid $18,320
- 540 Osteomyelitis with CCbilled $56,011 · paid $12,639
- 474 Amputation for musculoskeletal system and connective tissue disorders with MCCbilled $182,848 · paid $39,456
- 489 Knee procedures without principal diagnosis of infection without CC/MCCbilled $61,089 · paid $11,271
- 518 Back and neck procedures except spinal fusion with MCC or disc device or neurostimulatorbilled $182,142 · paid $35,606
- 488 Knee procedures without principal diagnosis of infection with CC/MCCbilled $96,295 · paid $18,870
- 428 Multiple level combined anterior and posterior spinal fusion except cervical without CC/MCCbilled $255,752 · paid $51,058
- 504 Foot procedures with CCbilled $86,086 · paid $16,718
- 553 Bone diseases and arthropathies with MCCbilled $63,397 · paid $14,722
- 534 Fractures of femur without MCCbilled $36,470 · paid $7,701
- 555 Signs and symptoms of musculoskeletal system and connective tissue with MCCbilled $64,343 · paid $14,170
- 500 Soft tissue procedures with MCCbilled $148,889 · paid $31,687
- 496 Local excision and removal of internal fixation devices except hip and femur with CCbilled $93,469 · paid $19,438
- 561 Aftercare, musculoskeletal system and connective tissue without CC/MCCbilled $32,510 · paid $11,165
- 456 Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions with MCCbilled $425,604 · paid $90,487
- 502 Soft tissue procedures without CC/MCCbilled $70,985 · paid $13,960
- 465 Wound debridement and skin graft except hand for musculoskeletal and connective tissue disorders without CC/MCCbilled $94,473 · paid $17,795
- 462 Bilateral or multiple major joint procedures of lower extremity without MCCbilled $138,303 · paid $29,222
- 513 Hand or wrist procedures, except major thumb or joint procedures with CC/MCCbilled $77,601 · paid $15,624
- 485 Knee procedures with principal diagnosis of infection with MCCbilled $152,105 · paid $30,763
- 512 Shoulder, elbow or forearm procedures, except major joint procedures without CC/MCCbilled $85,163 · paid $15,565
- 566 Other musculoskeletal system and connective tissue diagnoses without CC/MCCbilled $39,337 · paid $7,710
- 458 Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions without CC/MCCbilled $191,390 · paid $41,762
- 497 Local excision and removal of internal fixation devices except hip and femur without CC/MCCbilled $70,952 · paid $13,350
- 549 Septic arthritis with CCbilled $53,949 · paid $11,997
- 510 Shoulder, elbow or forearm procedures, except major joint procedures with MCCbilled $136,238 · paid $24,457
- 479 Biopsies of musculoskeletal system and connective tissue without CC/MCCbilled $90,119 · paid $16,457
- 537 Sprains, strains, and dislocations of hip, pelvis and thigh with CC/MCCbilled $44,713 · paid $8,930
- 533 Fractures of femur with MCCbilled $64,789 · paid $14,246
- 426 Multiple level combined anterior and posterior spinal fusion except cervical with MCC or custom-made anatomically designed interbody fusion devicebilled $509,174 · paid $103,472
- 498 Local excision and removal of internal fixation devices of hip and femur with CC/MCCbilled $130,645 · paid $26,916
- 503 Foot procedures with MCCbilled $125,433 · paid $25,128
- 505 Foot procedures without CC/MCCbilled $86,156 · paid $17,082
- 547 Connective tissue disorders without CC/MCCbilled $41,021 · paid $8,733
- 487 Knee procedures with principal diagnosis of infection without CC/MCCbilled $75,117 · paid $14,778
- 447 Multiple level spinal fusion except cervical with MCC or custom-made anatomically designed interbody fusion devicebilled $326,182 · paid $64,896
- 430 Combined anterior and posterior cervical spinal fusion without MCCbilled $266,524 · paid $52,961
- 548 Septic arthritis with MCCbilled $84,487 · paid $18,500
- 495 Local excision and removal of internal fixation devices except hip and femur with MCCbilled $170,850 · paid $34,552
- 506 Major thumb or joint proceduresbilled $70,067 · paid $14,798
- 507 Major shoulder or elbow joint procedures with CC/MCCbilled $99,222 · paid $19,641
- 541 Osteomyelitis without CC/MCCbilled $35,203 · paid $9,094
- 476 Amputation for musculoskeletal system and connective tissue disorders without CC/MCCbilled $59,680 · paid $12,444
- 514 Hand or wrist procedures, except major thumb or joint procedures without CC/MCCbilled $55,347 · paid $10,916
- 538 Sprains, strains, and dislocations of hip, pelvis and thigh without CC/MCCbilled $34,419 · paid $6,752
- 450 Single level spinal fusion except cervical with MCC or custom-made anatomically designed interbody fusion devicebilled $256,768 · paid $52,464
- 550 Septic arthritis without CC/MCCbilled $37,859 · paid $9,332
- 499 Local excision and removal of internal fixation devices of hip and femur without CC/MCCbilled $65,118 · paid $12,744
- 429 Combined anterior and posterior cervical spinal fusion with MCCbilled $464,049 · paid $81,569
- 461 Bilateral or multiple major joint procedures of lower extremity with MCCbilled $310,407 · paid $64,890
- 508 Major shoulder or elbow joint procedures without CC/MCCbilled $69,008 · paid $13,341
Myeloproliferative disorders and poorly differentiated neoplasms 28 codes
- 847 Chemotherapy without acute leukemia as secondary diagnosis with CCbilled $67,678 · paid $15,515
- 840 Lymphoma and non-acute leukemia with MCCbilled $155,957 · paid $34,735
- 841 Lymphoma and non-acute leukemia with CCbilled $83,307 · paid $16,550
- 834 Acute leukemia with MCCbilled $286,735 · paid $65,972
- 846 Chemotherapy without acute leukemia as secondary diagnosis with MCCbilled $134,446 · paid $32,291
- 823 Lymphoma and non-acute leukemia with other procedures with MCCbilled $245,686 · paid $49,976
- 843 Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with MCCbilled $100,360 · paid $20,165
- 829 Myeloproliferative disorders or poorly differentiated neoplasms with other procedures with CC/MCCbilled $166,692 · paid $35,953
- 824 Lymphoma and non-acute leukemia with other procedures with CCbilled $122,441 · paid $23,946
- 837 Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy agent with MCCbilled $234,123 · paid $61,690
- 827 Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedures with CCbilled $129,358 · paid $26,045
- 835 Acute leukemia with CCbilled $106,705 · paid $23,609
- 844 Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses with CCbilled $62,608 · paid $12,424
- 838 Chemotherapy with acute leukemia as secondary diagnosis with CC or high dose chemotherapy agentbilled $100,434 · paid $26,127
- 820 Lymphoma and leukemia with major o.r. procedures with MCCbilled $320,318 · paid $70,733
- 828 Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedures without CC/MCCbilled $96,173 · paid $18,461
- 821 Lymphoma and leukemia with major o.r. procedures with CCbilled $121,353 · paid $24,281
- 826 Myeloproliferative disorders or poorly differentiated neoplasms with major o.r. procedures with MCCbilled $260,670 · paid $53,045
- 842 Lymphoma and non-acute leukemia without CC/MCCbilled $53,076 · paid $11,312
- 822 Lymphoma and leukemia with major o.r. procedures without CC/MCCbilled $74,038 · paid $13,057
- 825 Lymphoma and non-acute leukemia with other procedures without CC/MCCbilled $77,666 · paid $13,552
- 839 Chemotherapy with acute leukemia as secondary diagnosis without CC/MCCbilled $63,317 · paid $17,284
- 830 Myeloproliferative disorders or poorly differentiated neoplasms with other procedures without CC/MCCbilled $85,243 · paid $16,566
- 849 Radiotherapybilled $136,574 · paid $32,405
- 836 Acute leukemia without CC/MCCbilled $61,658 · paid $13,625
- 845 Other myeloproliferative disorders or poorly differentiated neoplastic diagnoses without CC/MCCbilled $46,256 · paid $9,453
- 848 Chemotherapy without acute leukemia as secondary diagnosis without CC/MCCbilled $37,810 · paid $9,497
- 850 Acute leukemia with other proceduresbilled $516,007 · paid $113,354
Nervous system 72 codes
- 065 Intracranial hemorrhage or cerebral infarction with CC or tpa in 24 hoursbilled $55,724 · paid $9,914
- 064 Intracranial hemorrhage or cerebral infarction with MCCbilled $99,864 · paid $18,832
- 057 Degenerative nervous system disorders without MCCbilled $56,625 · paid $13,911
- 101 Seizures without MCCbilled $48,759 · paid $9,598
- 069 Transient ischemia without thrombolyticbilled $50,445 · paid $7,688
- 100 Seizures with MCCbilled $94,373 · paid $19,293
- 025 Craniotomy and endovascular intracranial procedures with MCCbilled $231,508 · paid $45,131
- 092 Other disorders of nervous system with CCbilled $51,562 · paid $10,433
- 070 Other cerebrovascular disorders with MCCbilled $76,029 · paid $16,466
- 071 Other cerebrovascular disorders with CCbilled $50,470 · paid $10,161
- 066 Intracranial hemorrhage or cerebral infarction without CC/MCCbilled $42,334 · paid $7,189
- 091 Other disorders of nervous system with MCCbilled $82,750 · paid $17,445
- 056 Degenerative nervous system disorders with MCCbilled $96,021 · paid $22,853
- 023 Craniotomy with major device implant or acute complex cns principal diagnosis with MCC or antineoplastic implant or epilepsy with neurostimulatorbilled $280,968 · paid $56,108
- 086 Traumatic stupor and coma <1 hour with CCbilled $68,314 · paid $12,685
- 074 Cranial and peripheral nerve disorders without MCCbilled $53,593 · paid $10,555
- 039 Extracranial procedures without CC/MCCbilled $63,845 · paid $10,599
- 083 Traumatic stupor and coma >1 hour with CCbilled $73,302 · paid $13,928
- 082 Traumatic stupor and coma >1 hour with MCCbilled $115,279 · paid $23,139
- 054 Nervous system neoplasms with MCCbilled $77,466 · paid $15,333
- 085 Traumatic stupor and coma <1 hour with MCCbilled $108,443 · paid $21,461
- 036 Carotid artery stent procedures without CC/MCCbilled $88,422 · paid $16,037
- 038 Extracranial procedures with CCbilled $87,494 · paid $14,971
- 027 Craniotomy and endovascular intracranial procedures without CC/MCCbilled $139,743 · paid $26,108
- 062 Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent with CCbilled $101,244 · paid $17,633
- 103 Headaches without MCCbilled $48,935 · paid $9,063
- 026 Craniotomy and endovascular intracranial procedures with CCbilled $165,029 · paid $31,688
- 035 Carotid artery stent procedures with CCbilled $113,494 · paid $20,360
- 093 Other disorders of nervous system without CC/MCCbilled $44,661 · paid $8,173
- 073 Cranial and peripheral nerve disorders with MCCbilled $78,653 · paid $16,061
- 024 Craniotomy with major device implant or acute complex cns principal diagnosis without MCCbilled $192,536 · paid $36,289
- 068 Precerebral occlusion without infarction without MCCbilled $52,806 · paid $8,505
- 041 Peripheral, cranial nerve and other nervous system procedures with CC or peripheral neurostimulatorbilled $115,360 · paid $21,822
- 087 Traumatic stupor and coma <1 hour without CC/MCCbilled $51,658 · paid $9,031
- 061 Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent with MCCbilled $148,180 · paid $25,973
- 040 Peripheral, cranial nerve and other nervous system procedures with MCCbilled $187,848 · paid $38,178
- 084 Traumatic stupor and coma >1 hour without CC/MCCbilled $53,346 · paid $9,788
- 029 Spinal procedures with CC or spinal neurostimulatorsbilled $171,291 · paid $34,381
- 072 Other cerebrovascular disorders without CC/MCCbilled $41,653 · paid $7,730
- 020 Intracranial vascular procedures with principal diagnosis hemorrhage with MCCbilled $406,537 · paid $89,830
- 055 Nervous system neoplasms without MCCbilled $55,758 · paid $11,340
- 037 Extracranial procedures with MCCbilled $177,018 · paid $32,658
- 033 Ventricular shunt procedures without CC/MCCbilled $86,578 · paid $16,253
- 028 Spinal procedures with MCCbilled $293,692 · paid $59,101
- 034 Carotid artery stent procedures with MCCbilled $192,285 · paid $35,022
- 032 Ventricular shunt procedures with CCbilled $105,099 · paid $21,644
- 097 Non-bacterial infection of nervous system except viral meningitis with MCCbilled $182,041 · paid $37,644
- 080 Nontraumatic stupor and coma with MCCbilled $88,942 · paid $20,468
- 059 Multiple sclerosis and cerebellar ataxia with CCbilled $63,804 · paid $12,994
- 094 Bacterial and tuberculous infections of nervous system with MCCbilled $162,696 · paid $35,399
- 042 Peripheral, cranial nerve and other nervous system procedures without CC/MCCbilled $93,262 · paid $17,994
- 063 Ischemic stroke, precerebral occlusion or transient ischemia with thrombolytic agent without CC/MCCbilled $82,557 · paid $14,704
- 067 Precerebral occlusion without infarction with MCCbilled $79,117 · paid $13,666
- 095 Bacterial and tuberculous infections of nervous system with CCbilled $122,902 · paid $24,355
- 098 Non-bacterial infection of nervous system except viral meningitis with CCbilled $118,966 · paid $22,491
- 089 Concussion with CCbilled $62,127 · paid $11,094
- 102 Headaches with MCCbilled $64,863 · paid $12,479
- 052 Spinal disorders and injuries with CC/MCCbilled $94,584 · paid $19,861
- 031 Ventricular shunt procedures with MCCbilled $209,327 · paid $43,883
- 060 Multiple sclerosis and cerebellar ataxia without CC/MCCbilled $51,131 · paid $9,854
- 030 Spinal procedures without CC/MCCbilled $115,331 · paid $22,794
- 081 Nontraumatic stupor and coma without MCCbilled $44,223 · paid $9,383
- 021 Intracranial vascular procedures with principal diagnosis hemorrhage with CCbilled $264,011 · paid $61,661
- 058 Multiple sclerosis and cerebellar ataxia with MCCbilled $87,416 · paid $19,042
- 088 Concussion with MCCbilled $73,497 · paid $13,769
- 022 Intracranial vascular procedures with principal diagnosis hemorrhage without CC/MCCbilled $166,094 · paid $36,202
- 075 Viral meningitis with CC/MCCbilled $90,980 · paid $18,826
- 090 Concussion without CC/MCCbilled $49,385 · paid $8,744
- 096 Bacterial and tuberculous infections of nervous system without CC/MCCbilled $128,292 · paid $24,508
- 099 Non-bacterial infection of nervous system except viral meningitis without CC/MCCbilled $79,112 · paid $14,851
- 053 Spinal disorders and injuries without CC/MCCbilled $48,620 · paid $11,147
- 076 Viral meningitis without CC/MCCbilled $40,954 · paid $9,410
Newborns and other neonates 7 codes
- 789 Neonates, died or transferred to another acute care facility
- 790 Extreme immaturity or respiratory distress syndrome, neonate
- 791 Prematurity with major problems
- 792 Prematurity without major problems
- 793 Full term neonate with major problems
- 794 Neonate with other significant problems
- 795 Normal newborn
Pre-MDC (transplants and other high-intensity care) 17 codes
- 003 ECMO or tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck with major o.r. proceduresbilled $1,053,024 · paid $223,606
- 004 Tracheostomy with MV >96 hours or principal diagnosis except face, mouth and neck without major o.r. proceduresbilled $613,613 · paid $125,491
- 001 Heart transplant or implant of heart assist system with MCCbilled $1,466,967 · paid $321,958
- 018 Chimeric antigen receptor (car) t-cell and other immunotherapiesbilled $2,203,276 · paid $464,910
- 016 Autologous bone marrow transplant with CC/MCCbilled $273,743 · paid $72,541
- 011 Tracheostomy for face, mouth and neck diagnoses or laryngectomy with MCCbilled $289,227 · paid $60,265
- 012 Tracheostomy for face, mouth and neck diagnoses or laryngectomy with CCbilled $239,304 · paid $49,992
- 005 Liver transplant with MCC or intestinal transplantbilled $822,216 · paid $152,447
- 014 Allogeneic bone marrow transplantbilled $579,837 · paid $150,978
- 007 Lung transplantbilled $1,053,162 · paid $186,440
- 006 Liver transplant without MCCbilled $467,353 · paid $73,105
- 013 Tracheostomy for face, mouth and neck diagnoses or laryngectomy without CC/MCCbilled $151,425 · paid $31,469
- 008 Simultaneous pancreas and kidney transplantbilled $604,304 · paid $94,821
- 019 Simultaneous pancreas and kidney transplant with hemodialysisbilled $649,858 · paid $116,134
- 002 Heart transplant or implant of heart assist system without MCCbilled $689,204 · paid $142,776
- 017 Autologous bone marrow transplant without CC/MCCbilled $170,664 · paid $53,797
- 010 Pancreas transplantbilled $537,602 · paid $86,192
Pregnancy, childbirth and the puerperium 23 codes
- 807 Vaginal delivery without sterilization or d&c without CC/MCCbilled $22,172 · paid $7,391
- 806 Vaginal delivery without sterilization or d&c with CCbilled $26,404 · paid $8,627
- 787 Cesarean section without sterilization with CCbilled $47,087 · paid $12,231
- 788 Cesarean section without sterilization without CC/MCCbilled $38,279 · paid $9,125
- 832 Other antepartum diagnoses without o.r. procedures with CCbilled $30,005 · paid $9,231
- 831 Other antepartum diagnoses without o.r. procedures with MCCbilled $53,775 · paid $12,628
- 786 Cesarean section without sterilization with MCCbilled $79,426 · paid $19,422
- 776 Postpartum and post abortion diagnoses without o.r. proceduresbilled $34,668 · paid $9,004
- 805 Vaginal delivery without sterilization or d&c with MCCbilled $42,953 · paid $12,612
- 784 Cesarean section with sterilization with CCbilled $46,119 · paid $12,422
- 833 Other antepartum diagnoses without o.r. procedures without CC/MCCbilled $20,580 · paid $6,094
- 785 Cesarean section with sterilization without CC/MCCbilled $41,344 · paid $9,638
- 768 Vaginal delivery with o.r. procedures except sterilization and/or d&cbilled $44,206 · paid $12,757
- 783 Cesarean section with sterilization with MCCbilled $117,258 · paid $27,911
- 769 Postpartum and post abortion diagnoses with o.r. proceduresbilled $74,835 · paid $15,530
- 770 Abortion with d&c, aspiration curettage or hysterotomybilled $71,883 · paid $13,670
- 797 Vaginal delivery with sterilization and/or d&c with CCbilled $40,081 · paid $12,100
- 798 Vaginal delivery with sterilization and/or d&c without CC/MCCbilled $39,579 · paid $8,556
- 779 Abortion without d&cbilled $36,416 · paid $11,937
- 817 Other antepartum diagnoses with o.r. procedures with MCCbilled $94,921 · paid $28,209
- 818 Other antepartum diagnoses with o.r. procedures with CCbilled $61,553 · paid $15,046
- 796 Vaginal delivery with sterilization and/or d&c with MCC
- 819 Other antepartum diagnoses with o.r. procedures without CC/MCC
Respiratory system 41 codes
- 177 Respiratory infections and inflammations with MCCbilled $70,592 · paid $14,972
- 193 Simple pneumonia and pleurisy with MCCbilled $59,757 · paid $12,050
- 189 Pulmonary edema and respiratory failurebilled $57,570 · paid $12,198
- 190 Chronic obstructive pulmonary disease with MCCbilled $50,592 · paid $10,597
- 194 Simple pneumonia and pleurisy with CCbilled $38,379 · paid $8,028
- 178 Respiratory infections and inflammations with CCbilled $45,313 · paid $9,493
- 208 Respiratory system diagnosis with ventilator support <=96 hoursbilled $135,710 · paid $25,293
- 175 Pulmonary embolism with MCC or acute cor pulmonalebilled $65,154 · paid $13,354
- 191 Chronic obstructive pulmonary disease with CCbilled $39,617 · paid $8,274
- 202 Bronchitis and asthma with CC/MCCbilled $46,151 · paid $9,505
- 176 Pulmonary embolism without MCCbilled $41,475 · paid $8,242
- 164 Major chest procedures with CCbilled $127,372 · paid $25,176
- 180 Respiratory neoplasms with MCCbilled $87,788 · paid $17,254
- 163 Major chest procedures with MCCbilled $210,509 · paid $43,876
- 184 Major chest trauma with CCbilled $55,456 · paid $10,943
- 207 Respiratory system diagnosis with ventilator support >96 hoursbilled $292,571 · paid $61,451
- 205 Other respiratory system diagnoses with MCCbilled $88,362 · paid $19,109
- 196 Interstitial lung disease with MCCbilled $86,178 · paid $18,762
- 186 Pleural effusion with MCCbilled $71,573 · paid $14,264
- 195 Simple pneumonia and pleurisy without CC/MCCbilled $30,173 · paid $6,244
- 166 Other respiratory system o.r. procedures with MCCbilled $179,865 · paid $38,990
- 183 Major chest trauma with MCCbilled $74,535 · paid $15,596
- 200 Pneumothorax with CCbilled $53,144 · paid $11,054
- 165 Major chest procedures without CC/MCCbilled $103,335 · paid $19,019
- 206 Other respiratory system diagnoses without MCCbilled $49,308 · paid $9,642
- 199 Pneumothorax with MCCbilled $80,926 · paid $16,777
- 179 Respiratory infections and inflammations without CC/MCCbilled $35,282 · paid $7,350
- 181 Respiratory neoplasms with CCbilled $56,337 · paid $11,278
- 192 Chronic obstructive pulmonary disease without CC/MCCbilled $31,109 · paid $6,575
- 204 Respiratory signs and symptomsbilled $42,809 · paid $8,184
- 167 Other respiratory system o.r. procedures with CCbilled $95,286 · paid $18,372
- 187 Pleural effusion with CCbilled $49,296 · paid $9,777
- 203 Bronchitis and asthma without CC/MCCbilled $32,445 · paid $7,195
- 185 Major chest trauma without CC/MCCbilled $43,102 · paid $8,478
- 197 Interstitial lung disease with CCbilled $47,651 · paid $10,364
- 168 Other respiratory system o.r. procedures without CC/MCCbilled $74,168 · paid $14,056
- 173 Ultrasound accelerated and other thrombolysis with principal diagnosis pulmonary embolismbilled $138,576 · paid $27,468
- 201 Pneumothorax without CC/MCCbilled $33,840 · paid $7,235
- 188 Pleural effusion without CC/MCCbilled $35,359 · paid $7,441
- 198 Interstitial lung disease without CC/MCCbilled $38,044 · paid $8,231
- 182 Respiratory neoplasms without CC/MCCbilled $39,705 · paid $8,539
Skin, subcutaneous tissue and breast 32 codes
- 603 Cellulitis without MCCbilled $37,289 · paid $8,681
- 602 Cellulitis with MCCbilled $60,149 · paid $13,660
- 605 Trauma to the skin, subcutaneous tissue and breast without MCCbilled $46,377 · paid $9,066
- 580 Other skin, subcutaneous tissue and breast procedures with CCbilled $83,431 · paid $17,114
- 607 Minor skin disorders without MCCbilled $41,278 · paid $9,514
- 571 Skin debridement with CCbilled $74,785 · paid $15,678
- 579 Other skin, subcutaneous tissue and breast procedures with MCCbilled $142,168 · paid $30,326
- 604 Trauma to the skin, subcutaneous tissue and breast with MCCbilled $72,676 · paid $14,668
- 593 Skin ulcers with CCbilled $47,945 · paid $11,491
- 592 Skin ulcers with MCCbilled $76,128 · paid $18,608
- 570 Skin debridement with MCCbilled $122,508 · paid $26,681
- 606 Minor skin disorders with MCCbilled $71,280 · paid $16,690
- 581 Other skin, subcutaneous tissue and breast procedures without CC/MCCbilled $85,875 · paid $14,420
- 596 Major skin disorders without MCCbilled $49,281 · paid $11,181
- 597 Malignant breast disorders with MCCbilled $84,420 · paid $17,212
- 577 Skin graft except for skin ulcer or cellulitis with CCbilled $144,736 · paid $28,884
- 574 Skin graft for skin ulcer or cellulitis with CCbilled $145,169 · paid $31,520
- 598 Malignant breast disorders with CCbilled $55,728 · paid $12,298
- 595 Major skin disorders with MCCbilled $97,411 · paid $22,960
- 572 Skin debridement without CC/MCCbilled $56,218 · paid $11,554
- 573 Skin graft for skin ulcer or cellulitis with MCCbilled $271,429 · paid $55,275
- 578 Skin graft except for skin ulcer or cellulitis without CC/MCCbilled $90,876 · paid $17,742
- 600 Non-malignant breast disorders with CC/MCCbilled $44,419 · paid $10,423
- 585 Breast biopsy, local excision and other breast procedures without CC/MCCbilled $115,873 · paid $19,785
- 584 Breast biopsy, local excision and other breast procedures with CC/MCCbilled $115,138 · paid $22,058
- 576 Skin graft except for skin ulcer or cellulitis with MCCbilled $254,663 · paid $56,061
- 582 Mastectomy for malignancy with CC/MCCbilled $103,199 · paid $19,920
- 594 Skin ulcers without CC/MCCbilled $35,584 · paid $8,331
- 583 Mastectomy for malignancy without CC/MCCbilled $97,729 · paid $16,819
- 601 Non-malignant breast disorders without CC/MCCbilled $27,369 · paid $6,666
- 575 Skin graft for skin ulcer or cellulitis without CC/MCCbilled $84,473 · paid $17,709
- 599 Malignant breast disorders without CC/MCCbilled $36,195 · paid $7,615
Other / ungroupable 8 codes
- 981 Extensive o.r. procedures unrelated to principal diagnosis with MCCbilled $216,247 · paid $44,974
- 982 Extensive o.r. procedures unrelated to principal diagnosis with CCbilled $117,854 · paid $23,369
- 987 Non-extensive o.r. procedures unrelated to principal diagnosis with MCCbilled $159,102 · paid $34,579
- 988 Non-extensive o.r. procedures unrelated to principal diagnosis with CCbilled $81,275 · paid $16,773
- 983 Extensive o.r. procedures unrelated to principal diagnosis without CC/MCCbilled $86,764 · paid $16,174
- 989 Non-extensive o.r. procedures unrelated to principal diagnosis without CC/MCCbilled $65,598 · paid $11,279
- 998 Principal diagnosis invalid as discharge diagnosis
- 999 Ungroupable
Frequently asked questions
What is an MS-DRG?
A Medicare Severity Diagnosis-Related Group is the code that classifies an inpatient hospital stay by diagnosis, procedures performed and severity. There are 772 of them, and the group assigned to your stay determines what Medicare pays the hospital. It usually appears on an itemized hospital bill or an explanation of benefits.
Why is the amount billed so much higher than the amount paid?
Hospitals maintain a "chargemaster" list price that almost nobody actually pays. Insurers negotiate down from it, Medicare ignores it and pays a set rate per DRG, and self-pay patients are the only people ever asked for the full figure. That is precisely why a self-pay bill is negotiable.
Do you list CPT codes too?
No. CPT codes and their descriptions are copyrighted by the American Medical Association and require a paid licence to republish, so we do not reproduce them. MS-DRG codes are published by CMS and are in the public domain, which is why we can give you the full list free.
Are these figures what I will be charged?
No. They are averages across Medicare patients nationally in 2024, published by CMS. Your own bill depends on your insurance, the specific hospital and its discount and assistance policies. Use these figures as a documented benchmark in a written request, not as a price quote.