| 871 |
Septicemia or severe sepsis without MV >96 hours with complication |
$26,850.27 |
| 795 |
Normal newborn |
$3,172.16 |
| 454 |
Combined anterior and posterior spinal fusion with comorbidity |
$99,159.40 |
| 794 |
Neonate with other significant problems |
$10,503.81 |
| 806 |
Vaginal delivery without sterilization or D&C with comorbidity |
$12,348.46 |
| 189 |
Pulmonary edema and respiratory failure |
$20,348.18 |
| 834 |
Acute leukemia without major O.R. procedures with complication |
$141,393.66 |
| 807 |
Vaginal delivery without sterilization or D&C without comorbidity/complication |
$11,313.66 |
| 793 |
Full term neonate with major problems |
$72,273.37 |
| 392 |
Esophagitis, gastroenteritis and miscellaneous digestive disorders without complication |
$11,188.65 |
| 847 |
Chemotherapy without acute leukemia as secondary diagnosis with comorbidity |
$26,663.22 |
| 203 |
Bronchitis and asthma without comorbidity/complication |
$12,060.74 |
| 016 |
Autologous bone marrow transplant with comorbidity/complication |
$135,342.13 |
| 640 |
Miscellaneous disorders of nutrition, metabolism, fluids and electrolytes with complication |
$2,627.79 |
| 787 |
Cesarean section without sterilization with comorbidity |
$41,035.19 |
| 193 |
Simple pneumonia and pleurisy with complication |
$24,358.20 |
| 330 |
Major small and large bowel procedures with comorbidity |
$52,850.30 |
| 014 |
Allogeneic bone marrow transplant |
$332,719.40 |
| 790 |
Extreme immaturity or respiratory distress syndrome, neonate |
$619,333.37 |
| 840 |
Lymphoma and non-acute leukemia with complication |
$75,903.58 |
| 194 |
Simple pneumonia and pleurisy with comorbidity |
$8,592.43 |
| 872 |
Septicemia or severe sepsis without MV >96 hours without complication |
$12,435.99 |
| 792 |
Prematurity without major problems |
$76,767.28 |
| 467 |
Revision of hip or knee replacement with comorbidity |
$45,203.83 |
| 331 |
Major small and large bowel procedures without comorbidity/complication |
$30,856.93 |
| 786 |
Vaginal delivery without sterilization/dace with comorbidity |
$49,909.23 |
| 177 |
Respiratory infections and inflammations with complication |
$22,111.24 |
| 202 |
Bronchitis and asthma with comorbidity/complication |
$16,866.17 |
| 144 |
Other ear, nose, mouth and throat O.R. procedures with comorbidity |
$10,019.67 |
| 846 |
Chemotherapy without acute leukemia as secondary diagnosis with complication |
$62,889.23 |
| 470 |
Major hip and knee joint replacement or reattachment of lower extremity without complication |
$15,662.40 |
| 460 |
Spinal fusion except cervical without complication |
$39,426.51 |
| 833 |
Other antepartum diagnoses without O.R. procedures without comorbidity/complication |
$14,708.24 |
| 788 |
Cesarean section without sterilization without comorbidity/complication |
$33,109.43 |
| 683 |
Renal failure with comorbidity |
$8,062.44 |
| 791 |
Prematurity with major problems |
$194,746.52 |
| 776 |
Postpartum and post abortion diagnoses without O.R. procedures |
$9,540.75 |
| 698 |
Other kidney and urinary tract diagnoses with complication |
$15,650.39 |
| 690 |
Kidney and urinary tract infections without complication |
$24,593.90 |
| 457 |
Spinal fusion except cervical with spinal curvature, malignancy, infection or extensive fusions with comorbidity |
$135,197.98 |
| 837 |
Chemotherapy with acute leukemia as secondary diagnosis or with high dose chemotherapy agent with complication |
$141,611.33 |
| 857 |
Postoperative or post-traumatic infections with O.R. procedures with comorbidity |
$39,694.70 |
| 560 |
Aftercare, musculoskeletal system and connective tissue with comorbidity |
$3,977.36 |
| 853 |
Infectious and parasitic diseases with O.R. procedures with complication |
$99,266.33 |
| 809 |
Major hematological and immunological diagnoses except sickle cell crisis and coagulation disorders with comorbidity |
$27,894.95 |
| 101 |
Seizures without complication |
$10,780.40 |
| 805 |
Vaginal delivery without sterilization or D&C with complication |
$25,208.78 |
| 314 |
Other circulatory system diagnoses with complication |
$92,588.03 |
| 603 |
Cellulitis without complication |
$17,494.97 |
| 432 |
Cirrhosis and Alcoholic Hepatitis with MCC |
$68,917.61 |