Estimated Insurance Payments *
Rank	APR- DRG	Description	Median   Charge	Private Insurance	Medicare
1	640	Normal Newborn, Birthweight 2500g+	$3,498	$1,959	$909
2	560	Vaginal Delivery	$14,577	$8,163	$3,790
3	720	Blood Infection/Septicemia	$21,808	$12,213	$5,670
4	194	Heart Failure	$19,215	$10,761	$4,996
5	751	Psychoses	$9,675	$5,418	$2,515
6	540	Cesarean Delivery	$24,746	$13,858	$6,434
7	301	Hip Replacement	$75,983	$42,551	$19,756
8	302	Knee Replacement	$68,362	$38,283	$17,774
9	139	Pneumonia	$13,173	$7,377	$3,425
10	753	Bipolar Disorders	NR	NR	NR
11	775	Alcohol Abuse/Dependence	$11,304	$6,330	$2,939
12	201	Heart Abnormal Rhythm and Conduction Disorders	$11,930	$6,681	$3,102
13	133	Respiratory failure	NR	NR	NR
14	045	Stroke and Precerebral Occlusion with Infarct	$24,256	$13,583	$6,307
15	469	Acute Kidney Injury	$14,976	$8,387	$3,894
16	140	Chronic Obstructive Pulmonary Disease	$15,667	$8,773	$4,073
17	463	Kidney/Urinary Tract Infection	$19,767	$11,069	$5,139
18	174	Percutaneous coronary intervention w AMI	$77,371	$43,328	$20,116
19	383	Cellulitis & other skin infections	$13,518	$7,570	$3,515
20	750	Schizophrenia	$5,354	$2,998	$1,392
21	137	Respiratory Infections and Inflammations	$18,772	$10,513	$4,881
22	420	Diabetes	$16,154	$9,046	$4,200
23	282	Disorders of Pancreas Except Malignancy	$21,542	$12,063	$5,601
24	308	Hip & femur fracture repair	$68,532	$38,378	$17,818
25	247	Intestinal Obstruction without Surgery	$19,234	$10,771	$5,001
26	231	Major large bowel procedures	$73,721	$41,284	$19,168
27	190	Circulatory Disorders with Heart Attack	$31,819	$17,819	$8,273
28	710	Infectious & parasitic diseases including HIV w O.R. procedure	$26,370	$14,767	$6,856
29	058	Other Disorders of Nervous System	$34,055	$19,071	$8,854
30	466	Malfunction, reaction, complic of genitourinary device or proc	$12,202	$6,833	$3,172
31	254	Other Digestive System Diagnoses	$19,257	$10,784	$5,007
32	754	Depression	NR	NR	NR
33	134	Pulmonary Embolism	$18,519	$10,371	$4,815
34	304	Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature	$85,555	$47,911	$22,244
35	053	Seizure	$19,961	$11,178	$5,190
36	241	Peptic Ulcer/Gastritis	$16,053	$8,990	$4,174
37	192	Cardiac catheterization for other non-coronary conditions	$28,397	$15,903	$7,383
38	175	Percutaneous coronary intervention w/o AMI	$98,829	$55,344	$25,695
39	244	Diverticulitis & Diverticulosis	$22,129	$12,392	$5,753
40	263	Laparoscopic Cholecystectomy	$50,430	$28,241	$13,112
41	322	Shoulder & Elbow Joint Replacement	$68,787	$38,521	$17,885
42	249	Other gastroenteritis, nausea & vomiting	$19,528	$10,936	$5,077
43	862	Other Factors Influencing Health Status	$29,605	$16,579	$7,697
44	773	Opioid Abuse/Dependence	$8,305	$4,651	$2,159
45	230	Major small bowel procedures	$59,581	$33,365	$15,491
46	313	Other Knee/Lower Leg Surgery	$63,052	$35,309	$16,394
47	426	Non-hypovolemic sodium disorders	$12,641	$7,079	$3,287
48	861	Signs & Symptoms	$14,684	$8,223	$3,818
49	253	Other and Unspecified Gastrointestinal Hemorrhage	$13,100	$7,336	$3,406
50	347	Other Back/Neck Disorders, Fractures, Injuries	$24,396	$13,662	$6,343
51	566	Other Antepartum Diagnoses	$7,814	$4,376	$2,032
52	052	Nontraumatic stupor & coma	$16,503	$9,242	$4,291
53	248	Major G.I. Bacterial Infections	$17,899	$10,023	$4,654
54	182	Other Peripheral Vascular Procedures	$107,959	$60,457	$28,069
55	663	Red Blood Cell Disorders Except Sickle Cell Anemia Crisis	$20,752	$11,621	$5,395
56	055	Head trauma w coma >1 hr or hemorrhage	$18,042	$10,103	$4,691
57	351	Other Musculoskeletal System and Connective Tissue Diagnoses	$26,326	$14,742	$6,845
58	755	Neuroses Other Than Depression	$36,921	$20,676	$9,599
59	166	Coronary bypass w/o AMI or complex PDX	$160,143	$89,680	$41,637
60	021	Craniotomy Except For Trauma	$87,014	$48,728	$22,624
61	721	Postoperative and Post-Traumatic Infections	$26,759	$14,985	$6,957
62	280	Alcoholic Liver Disease	$21,840	$12,230	$5,678
63	113	Epiglottitis, Ear Infection, URI and Laryngotracheitis	$14,083	$7,886	$3,662
64	817	Overdose	$9,916	$5,553	$2,578
65	143	Other respiratory diagnoses except signs, symptoms & minor diagnoses	$8,848	$4,955	$2,301
66	425	Other Electrolyte Disorders	$14,462	$8,099	$3,760
67	024	Extracranial Vascular Procedures	$59,070	$33,079	$15,358
68	539	Cesarean delivery with sterlization	$25,802	$14,449	$6,709
69	812	Poisoning of Medicinal Agents	$11,544	$6,465	$3,001
70	171	Pacemaker Implant without Heart Attack, Heart Failure or Shock	$47,523	$26,613	$12,356
71	284	Disorders of gallbladder & biliary tract	$26,701	$14,953	$6,942
72	321	Upper Spinal Fusion	$73,916	$41,393	$19,218
73	696	Other Chemotherapy	$39,643	$22,200	$10,307
74	197	Peripheral and Other Vascular Disorders	$12,871	$7,208	$3,346
75	042	Degenerative nervous system disorders exc mult sclerosis	$15,053	$8,430	$3,914

NR = No Cases Reported This report was produced in part by using computer software created, owned and licensed by the 3M Company. All copyrights in and to the 3M™ APR DRG Software, and to the 3M™ APR DRG Classification System(s) (including the selection, coordination and arrangement of all codes) are owned by 3M. All rights reserved.

	With No Other Procedures			With 1 or More Additional Procedures
Principal Procedure	Median Charge	Average Commercial Insurance Payment	Average Medicare Insurance Payment*	Median Charge	Average Commercial Insurance Payment	Average Medicare Insurance Payment*
Cataract Surgery with Intraocular Lens - Stage 1 66984)	$10,245	$5,737	$2,664	$22,352	$12,517	$5,811
Colonoscopy and Biopsy 45380)	$8,126	$4,551	$2,113	$9,298	$5,207	$2,418
Lesion Removal Colonoscopy by Snare Technique 45385)	$8,056	$4,512	$2,095	$9,527	$5,335	$2,477
Upper GI Endoscopy with Biopsy 43239)	$7,689	$4,306	$1,999	$9,872	$5,528	$2,567
Diagnostic Colonoscopy 45378)	$7,282	$4,078	$1,893	$8,863	$4,963	$2,304
Injection into Lumbar or Sacral Area, Single Level 64483)	$2,002	$1,121	$520	$2,125	$1,190	$552
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)	$2,036	$1,140	$529	$2,110	$1,182	$549
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)	$2,127	$1,191	$553	$2,298	$1,287	$597
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)	$7,211	$4,038	$1,875	$8,439	$4,726	$2,194
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)	$7,126	$3,991	$1,853	$7,613	$4,264	$1,980
Carpal Tunnel Surgery 64721)	$9,267	$5,190	$2,409	$12,289	$6,882	$3,195
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)	NR	NR	NR	NR	NR	NR
Uppr GI Endoscopy- Diagnostic 43235)	$6,893	$3,860	$1,792	$8,916	$4,993	$2,318
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)	$26,665	$14,932	$6,933	$34,986	$19,592	$9,096
Drain/Inject Major Joint or Bursa 20610)	$2,129	$1,192	$554	$18,243	$10,216	$4,743
Total Knee Arthroscopy 27447)	$52,794	$29,565	$13,727	$58,886	$32,976	$15,310
Left Heart Artery/Ventricle Angiography 93458)	$15,586	$8,728	$4,052	$16,502	$9,241	$4,291
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)	$2,054	$1,150	$534	NR	NR	NR
Creation of Eardrum Opening 69436)	$12,054	$6,750	$3,134	$31,005	$17,363	$8,061
Unlisted Dental Surgery Procedure 41899)	$22,537	$12,620	$5,860	$23,695	$13,269	$6,161
Esophageal Endoscopy with Dilation 43249)	$10,040	$5,623	$2,610	$11,231	$6,290	$2,920
Laparoscopic Cholecystectomy 47562)	$29,545	$16,545	$7,682	$35,103	$19,658	$9,127
Arthroscopic Rotator Cuff Repair 29827)	$37,382	$20,934	$9,719	$44,593	$24,972	$11,594
Cystourethroscopy with Lithotripsy and Stent 52356)	$23,674	$13,258	$6,155	$29,654	$16,606	$7,710
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)	$1,962	$1,099	$510	$2,107	$1,180	$548
Hysteroscopy with Biopsy 58558)	$19,374	$10,849	$5,037	$26,232	$14,690	$6,820
After Cataract Laser Surgery 66821)	NR	NR	NR	NR	NR	NR
Laparoscopic Hernia Repair - Initial 49650)	$35,718	$20,002	$9,287	$54,708	$30,637	$14,224
Uppr GI Endoscopy with Guide Wire 43248)	$9,368	$5,246	$2,436	$10,455	$5,855	$2,718
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)	$8,172	$4,576	$2,125	$8,695	$4,869	$2,261
Removal of Tonsils And Adenoids - < Age 12 42820)	NR	NR	NR	NR	NR	NR
Cataract Surgery- Complex 66982)	$11,932	$6,682	$3,102	$22,085	$12,368	$5,742
Incision of Finger Tendon Sheath 26055)	$8,853	$4,958	$2,302	$10,747	$6,019	$2,794
ABD Paracentesis w/Imaging 49083)	NR	NR	NR	NR	NR	NR
Laparoscopic Appendectomy 44970)	$29,218	$16,362	$7,597	$36,272	$20,313	$9,431
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)	$20,438	$11,445	$5,314	$29,789	$16,682	$7,745
Laparoscopy, Removal of Tubes & Ovaries 58571)	$56,709	$31,757	$14,744	$63,324	$35,461	$16,464
Cystourethroscopy with Stent 52332)	$11,626	$6,511	$3,023	$19,150	$10,724	$4,979
Laparoscopy - Removal of Adnexal Structures 58661)	$30,087	$16,848	$7,823	$41,401	$23,185	$10,764
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)	NR	NR	NR	NR	NR	NR
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)	NR	NR	NR	NR	NR	NR
Unlisted Cystourethoscopy 52000)	$10,641	$5,959	$2,767	$12,697	$7,110	$3,301
Angioplasty - peripheral segment of the dialysis circuit 36902)	NR	NR	NR	NR	NR	NR
Mastectomy, Partial 19301)	$16,612	$9,303	$4,319	$32,720	$18,323	$8,507
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)	$21,644	$12,121	$5,627	$31,248	$17,499	$8,125
Coronary Artery Angio S&I 93454)	$15,505	$8,683	$4,031	$15,844	$8,872	$4,119
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)	$32,482	$18,190	$8,445	$42,675	$23,898	$11,095
TOTAL HIP ARTHROPLASTY 27130)	$63,217	$35,402	$16,436	NR	NR	NR
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)	$25,727	$14,407	$6,689	$27,115	$15,185	$7,050
Wrist Endoscopy/Surgery 29848)	NR	NR	NR	NR	NR	NR
FNA BX W/US GDN 1ST LES 10005)	NR	NR	NR	NR	NR	NR
Debridement Skin/Tissue 11042)	$16,737	$9,372	$4,352	$22,483	$12,591	$5,846
Low Back Disk Surgery 63030)	$34,657	$19,408	$9,011	$39,551	$22,148	$10,283
Removal of Tonsils 42826)	$18,049	$10,107	$4,693	NR	NR	NR
Biopsy breast w/stereotactic image; 1 lesion 19081)	NR	NR	NR	NR	NR	NR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)	$51,388	$28,777	$13,361	$62,024	$34,733	$16,126
Fragmenting of Kidney Stone 50590)	NR	NR	NR	NR	NR	NR
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)	$19,216	$10,761	$4,996	$44,474	$24,905	$11,563
DX BONE MARROW BX & ASPIR 38222)	NR	NR	NR	NR	NR	NR
Repair of Nasal Septum 30520)	$16,409	$9,189	$4,266	$27,075	$15,162	$7,040
Decompression of Ulnar Nerve at Elbow 64718)	$19,247	$10,779	$5,004	$17,814	$9,976	$4,632
Right and Left Heart Artery/Ventricle Angiography 93460)	$17,342	$9,712	$4,509	$23,864	$13,364	$6,205
SHOULDER ARTHROSCOPY/SURGERY 29823)	NR	NR	NR	$39,995	$22,397	$10,399
ESOPHAGUS MOTILITY STUDY 91010)	$701	$392	$182	$1,737	$973	$452
Upper GI Endoscopy w Removal of Foreign Body 43247)	$8,848	$4,955	$2,300	$18,602	$10,417	$4,836
Removal of Adenoids 42830)	NR	NR	NR	NR	NR	NR
Repair of wrist joints 25447)	$24,879	$13,932	$6,468	$23,359	$13,081	$6,073
Hysteroscopy with Ablation 58563)	$21,789	$12,202	$5,665	$38,636	$21,636	$10,045
REMOVAL OF SPINAL LAMINA 63047)	$29,157	$16,328	$7,581	$34,275	$19,194	$8,911
Repair of upper eyelid with excessive skin 15823)	$9,875	$5,530	$2,567	$13,180	$7,381	$3,427
REPAIR DETACHED RETINA 67108)	$26,870	$15,047	$6,986	$26,388	$14,777	$6,861
TX ATRIAL FIB PULM VEIN ISOL 93656)	NR	NR	NR	$125,560	$70,314	$32,646
OPEN TX OF DISTAL RADIAL FX W INT FIX 3+ FRAG 25609)	$38,789	$21,722	$10,085	$42,318	$23,698	$11,003
Implant Neuroelectrodes 63650)	NR	NR	NR	NR	NR	NR
INSERT ANT SEGMENT DRAIN INT 0191T)	$18,212	$10,199	$4,735	$18,365	$10,284	$4,775

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