MEDICARE DRG MEDICARE DRG DESCRIPTION

Transcription

1 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 1 Heart Tranplant Or Implnt Of Heart Asist Sys W MCC $587,744 3 Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth $571,997 4 Trach W Mv 96+ Hrs Or Pdx Exc Face Mouth Neck W/O $371, Tracheostomy For Face,Mouth Neck Diagnoses W MCC $90, Cranio W Major Dev Impl/Acute Complex Cns Pdx W Mc $111, Cranio W Maj Dev Impl/Acute Complx Cns Pdx W/O MCC $67, Craniotomy Endovascular Intracranial Px W MCC $47, Craniotomy Endovascular Intracranial Px W Cc $44, Craniotomyendovascular Intracranial Px Wo Cc/MCC $39, Spinal Procedures W MCC $87, Spinal Procedures W Cc Or Spinal Neurostimulators $36, Spinal Procedures W/O Cc/MCC $22, Ventricular Shunt Procedures W MCC $58, Ventricular Shunt Procedures W Cc $35, Ventricular Shunt Procedures W/O Cc/MCC $32, Extracranial Procedures W MCC $69, Extracranial Procedures W Cc $32, Extracranial Procedures W/O Cc/MCC $20, Periph/Cranial Nerve Other Nerv Syst Proc W MCC $49, Periph/Cranial Nerve Other Nerv Syst Px W Cc Or P $52, Periph/Cranial Nerve Oth Nerv Syst Px W/O Cc/MCC $26, Nervous System Neoplasms W MCC $39, Nervous System Neoplasms W/O MCC $22, Degenerative Nervous System Disorders W MCC $34, Degenerative Nervous System Disorders W/O MCC $20, Multiple Sclerosis Cerebellar Ataxia W MCC $28, Multiple Sclerosis Cerebellar Ataxia W Cc $28, Multiple Sclerosis Cerebellar Ataxia W/O Cc/MCC $25, Acute Ischemic Stroke W Use Of Thrombo Agent W MCC $86, Acute Ischemic Stroke W Use Of Thrombo Agent W Cc $82,380 1 of 21 FY2018

2 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 63 Acute Ischemic Stroke W Use Of Thrombo Agent W/O C $76, Intracranial Hemorage Or Cerebral Infarction W MCC $34, Intracranial Hemorrhage Or Cerebral Infarction Wcc $24, Intracranl Hemorage Or Cerebral Infarct W/O Cc/MCC $23, Nonspecific Cva Precerebral Occlusion W/O Infarct $30, Nonspecific Cva Precerebral Occlusion W/O Infarct $16, Transient Ischemia $21, Nonspecific Cerebrovascular Disorders W MCC $26, Nonspecific Cerebrovascular Disorders W Cc $24, Nonspecific Cerebrovascular Disorders W/O Cc/MCC $21, Cranial Peripheral Nerve Disorders W MCC $27, Cranial Peripheral Nerve Disorders W/O MCC $30, Viral Meningitis W/O Cc/MCC $22, Hypertensive Encephalopathy W MCC $56, Hypertensive Encephalopathy W Cc $27, Traumatic Stupor Coma, Coma >1 Hr W MCC $35, Traumatic Stupor Coma, Coma >1 Hr W Cc $23, Traumatic Stupor Coma, Coma >1 Hr W/O Cc/MCC $13, Traumatic Stupor Coma, Coma <1 Hr W MCC $16, Traumatic Stupor Coma, Coma <1 Hr W Cc $20, Traumatic Stupor Coma, Coma <1 Hr W/O Cc/MCC $14, Concussion W MCC $21, Concussion W/O Cc/MCC $20, Other Disorders Of Nervous System W MCC $49, Other Disorders Of Nervous System W Cc $27, Other Disorders Of Nervous System W/O Cc/MCC $12, Bacterial Tuberculs Infect Of Nervous Sys W MCC $37, Bacterial Tubercul Infect Of Nervous System W Cc $126, Bacterial Tubercul Infect Of Nerv Sys W/O Cc/MCC $42, Non-Bacterial Infect Of Nervous Sys Exc Viral Meni $181,446 2 of 21 FY2018

3 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 98 Non-Bacterial Infect Of Nerv Sys Exc Viral Meningi $36, Seizures W MCC $43, Seizures W/O MCC $21, Headaches W MCC $28, Headaches W/O MCC $22, Extraocular Procedures Except Orbit $33, Intraocular Procedures W Cc/MCC $29, Intraocular Procedures W/O Cc/MCC $34, Neurological Eye Disorders $23, Other Disorders Of The Eye W MCC $10, Other Disorders Of The Eye W/O MCC $14, Major Head Neck Px W Cc/MCC Or Major Device $88, Cranial/Facial Procedures W Cc/MCC $22, Cranial/Facial Procedures W/O Cc/MCC $29, Other Ear, Nose, Mouth Throat O.R. Px W Cc/MCC $32, Other Ear, Nose, Mouth Throat O.R. Px W/O Cc/MCC $23, Sinus Mastoid Procedures W Cc/MCC $40, Mouth Procedures W Cc/MCC $17, Mouth Procedures W/O Cc/MCC $18, Dysequilibrium $16, Epistaxis W MCC $24, Epistaxis W/O MCC $16, Otitis Media Uri W MCC $26, Otitis Media Uri W/O MCC $12, Other Ear, Nose, Mouth Throat Diagnoses W MCC $18, Other Ear, Nose, Mouth Throat Diagnoses W Cc $20, Other Ear, Nose, Mouth Throat Dx W/O Cc/MCC $16, Dental Oral Diseases W MCC $25, Dental Oral Diseases W Cc $18, Dental Oral Diseases W/O Cc/MCC $9,956 3 of 21 FY2018

4 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 163 Major Chest Procedures W MCC $95, Major Chest Procedures W Cc $56, Major Chest Procedures W/O Cc/MCC $40, Other Resp System O.R. Procedures W MCC $104, Other Resp System O.R. Procedures W Cc $67, Other Resp System O.R. Procedures W/O Cc/MCC $31, Pulmonary Embolism W MCC $39, Pulmonary Embolism W/O MCC $19, Respiratory Infections Inflammations W MCC $49, Respiratory Infections Inflammations W Cc $31, Respiratory Infections Inflammations W/O Cc/MCC $25, Respiratory Neoplasms W MCC $30, Respiratory Neoplasms W Cc $26, Respiratory Neoplasms W/O Cc/MCC $25, Major Chest Trauma W MCC $29, Major Chest Trauma W Cc $20, Major Chest Trauma W/O Cc/MCC $20, Pleural Effusion W MCC $43, Pleural Effusion W Cc $23, Pleural Effusion W/O Cc/MCC $21, Pulmonary Edema Respiratory Failure $49, Chronic Obstructive Pulmonary Disease W MCC $41, Chronic Obstructive Pulmonary Disease W Cc $26, Chronic Obstructive Pulmonary Disease W/O Cc/MCC $20, Simple Pneumonia Pleurisy W MCC $33, Simple Pneumonia Pleurisy W Cc $22, Simple Pneumonia Pleurisy W/O Cc/MCC $15, Interstitial Lung Disease W MCC $49, Interstitial Lung Disease W Cc $32, Interstitial Lung Disease W/O Cc/MCC $13,293 4 of 21 FY2018

5 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 199 Pneumothorax W MCC $31, Pneumothorax W Cc $20, Pneumothorax W/O Cc/MCC $15, Bronchitis Asthma W Cc/MCC $27, Bronchitis Asthma W/O Cc/MCC $14, Respiratory Signs Symptoms $20, Other Respiratory System Diagnoses W MCC $45, Other Respiratory System Diagnoses W/O MCC $20, Respiratory System Dx W Ventilator Support 96+ Hrs $121, Respiratory System Dx W Ventilator Support <96 Hrs $65, Other Heart Assist System Implant $273, Cardiac Valve Oth Maj Cardiothoracic Proc W Card $221, Card Valve Oth Maj Cardiothoracic Proc W Card Cat $118, Cardiac Valve Oth Maj Cardiothoracic Px W/O Card $123, Cardiac Valve Oth Maj Cardiothoracic Proc W/O Car $91, Cardiac Valve Oth Maj Cardiothoracic Px W/O Card $100, Card Defib Implant W Card Cath W Ami/Hf/Shock W/O $119, Card Defib Implant W Card Cath W/O Ami/Hf/Shock W $220, Card Defib Implant W Cardcath W/O Ami/Hf/Shock W/O $126, Cardiac Defiblator Implant W/O Cardiac Cath W MCC $150, Cardiac Defibrilator Implant W/O Card Cath W/O MCC $97, Other Cardiothoracic Procedures W MCC $120, Other Cardiothoracic Procedures W Cc $101, Coronary Bypass W Ptca W MCC $517, Coronary Bypass W Cardiac Cath W MCC $135, Coronary Bypass W Cardiac Cath W/O MCC $100, Coronary Bypass W/O Cardiac Cath W MCC $109, Coronary Bypass W/O Cardiac Cath W/O MCC $94, Amputat For Circ Sys Dorder Exc Upper Limb Toe W $106, Amputat For Circ Sys Dorder Exc Upper Limb Toe W $44,569 5 of 21 FY2018

6 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 241 Amputat For Circ Sys Dorders Exc Upper Limb Toe W $24, Permanent Cardiac Pacemaker Implant W MCC $63, Permanent Cardiac Pacemaker Implant W Cc $50, Permanent Cardiac Pacemaker Implant W/O Cc/MCC $48, Aicd Generator Procedures $151, Perc Cardiovasc Px W Drugeluting Stent W MCC Or 4+ $79, Perc Cardiovasc Proc W Drug-Eluting Stent W/O MCC $53, Perc Cardiovasc Px W Nondrug-Eluting Stent W MCC O $114, Perc Cardiovasc Px W Nondrug-Eluting Stent W/O MCC $63, Perc Cardiovasc Px W/O Coronary Artery Stent W MCC $93, Perc Cardiovasc Proc W/O Coronary Artery Stent W/O $44, Other Vascular Procedures W MCC $67, Other Vascular Procedures W Cc $54, Other Vascular Procedures W/O Cc/MCC $33, Upper Limb Toe Amputat For Circ Sys Dorder W MCC $75, Upper Limb Toe Amputat For Circ Sys Dorder W Cc $14, Cardiac Pacemaker Device Replacement W MCC $44, Cardiac Pacemaker Device Replacement W/O MCC $19, Card Pacemaker Revision Except Device Replace W Mc $74, Cardiac Pacemaker Revis Except Dvice Replace W Cc $53, Cardiac Pacemaker Revision Except Device Replaceme $32, Vein Ligation Stripping $81, Other Circulatory System O.R. Procedures $121, Endovascular Cardiac Valve Replacement W MCC $113, Endovascular Cardiac Valve Replacement W/O MCC $103, Aortic Heart Assist Px Ex Pulsation Balloon W MCC $94, Aortic Heart Assist Px Ex Pulsation Balloon W/O Mc $63, Other Major Cardiovascular Px W MCC $104, Other Major Cardiovascular Px W CC $62, Other Major Cardiovascular Px W/O CC/MCC $37,715 6 of 21 FY2018

7 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 273 Percutaneous intracardiac Px W MCC $82, Percutaneous intracardiac Px W/O MCC $72, Acute Myocardial Infarction Discharged Alive W MCC $42, Acute Myocardial Infarction, Discharged Alive W Cc $26, Acute Myocardal Infarcton, Dischg Alive W/O Cc/MCC $29, Acute Myocardial Infarction, Expired W MCC $39, Circulatory Disorders Except Ami W Card Cath W MCC $49, Circulatory Disordr Except Ami W Card Cath W/O MCC $29, Acute Subacute Endocarditis W MCC $47, Heart Failure Shock W MCC $38, Heart Failure Shock W Cc $24, Heart Failure Shock W/O Cc/MCC $19, Cardiac Arrest, Unexplained W MCC $33, Peripheral Vascular Disorders W MCC $29, Peripheral Vascular Disorders W Cc $24, Peripheral Vascular Disorders W/O Cc/MCC $16, Atherosclerosis W MCC $28, Atherosclerosis W/O MCC $21, Hypertension W MCC $41, Hypertension W/O MCC $20, Cardiac Congenital Valvular Disorders W MCC $55, Cardiac Congenital Valvular Disorders W/O MCC $21, Cardiac Arrhythmia Conduction Disorders W MCC $32, Cardiac Arrhythmia Conduction Disorders W Cc $22, Cardiac Arrhythmia Conduction Disorders W/O Cc/Mc $16, Angina Pectoris $29, Syncope Collapse $21, Chest Pain $20, Other Circulatory System Diagnoses W MCC $47, Other Circulatory System Diagnoses W Cc $24,900 7 of 21 FY2018

8 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 316 Other Circulatory System Diagnoses W/O Cc/MCC $23, Stomach, Esophageal Duodenal Proc W MCC $55, Stomach, Esophageal Duodenal Proc W Cc $58, Stomach, Esophageal Duodenal Proc W/O Cc/MCC $40, Major Small Large Bowel Procedures W MCC $97, Major Small Large Bowel Procedures W Cc $51, Major Small Large Bowel Procedures W/O Cc/MCC $35, Peritoneal Adhesiolysis W MCC $48, Peritoneal Adhesiolysis W Cc $36, Peritoneal Adhesiolysis W/O Cc/MCC $34, Appendectomy W Complicated Principal Diag W MCC $32, Appendectomy W Complicated Principal Diag W Cc $49, Appendectomy W Complicated Principal Dx W/O Cc/MCC $30, Appendectomy W/O Complicated Principal Diag W MCC $30, Appendectomy W/O Complicated Principal Diag W Cc $27, Appendectomy W/O Complicated Pdiag W/O Cc/MCC $23, Minor Small Large Bowel Procedures W Cc $41, Minor Small Large Bowel Procedures W/O Cc/MCC $29, Anal Stomal Procedures W MCC $42, Anal Stomal Procedures W Cc $24, Anal Stomal Procedures W/O Cc/MCC $19, Inguinal Femoral Hernia Procedures W MCC $36, Inguinal Femoral Hernia Procedures W Cc $29, Inguinal Femoral Hernia Procedures W/O Cc/MCC $20, Hernia Procedures Except Inguinal Femoral W MCC $41, Hernia Procedures Except Inguinal Femoral W Cc $23, Hernia Px Except Inguinal Femoral W/O Cc/MCC $25, Other Digestive System O.R. Procedures W MCC $88, Other Digestive System O.R. Procedures W Cc $39, Other Digestive System O.R. Procedures W/O Cc/MCC $27,643 8 of 21 FY2018

9 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 368 Major Esophageal Disorders W MCC $53, Major Esophageal Disorders W Cc $24, Major Gastro Disordr Peritoneal Infections W MCC $32, Major Gastroix Disordr Peritoneal Infection W Cc $23, Maj Gastro Disorder Peritoneal Infect W/O Cc/MCC $16, Digestive Malignancy W MCC $55, Digestive Malignancy W Cc $28, Digestive Malignancy W/O Cc/MCC $9, G.I. Hemorrhage W MCC $39, G.I. Hemorrhage W Cc $24, G.I. Hemorrhage W/O Cc/MCC $13, Complicated Peptic Ulcer W MCC $51, Complicated Peptic Ulcer W Cc $23, Complicated Peptic Ulcer W/O Cc/MCC $19, Uncomplicated Peptic Ulcer W MCC $26, Uncomplicated Peptic Ulcer W/O MCC $12, Inflammatory Bowel Disease W MCC $19, Inflammatory Bowel Disease W Cc $20, Inflammatory Bowel Disease W/O Cc/MCC $17, G.I. Obstruction W MCC $27, G.I. Obstruction W Cc $19, G.I. Obstruction W/O Cc/MCC $14, Esophagitis Gastroent Misc Digest Disorder W MCC $30, Esophagitis,Gastroent Misc Digest Dorder W/O MCC $17, Other Digestive System Diagnoses W MCC $35, Other Digestive System Diagnoses W Cc $22, Other Digestive System Diagnoses W/O Cc/MCC $16, Pancreas, Liver Shunt Procedures W Cc $52, Cholecystectomy Except By Laparos W/O C.D.E. W MCC $123, Cholecystectomy Except By Laparo W/O C.D.E. W Cc $40,758 9 of 21 FY2018

10 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 417 Laparoscopic Cholecystectomy W/O C.D.E. W MCC $45, Laparoscopic Cholecystectomy W/O C.D.E. W Cc $33, Laparoscopic Cholecystectomy W/O C.D.E. W/O Cc/MCC $29, Other Hepatobiliary Or Pancreas O.R. Px W MCC $48, Other Hepatobiliary Or Pancreas O.R. Px W/O Cc/MCC $28, Cirrhosis Alcoholic Hepatitis W MCC $42, Cirrhosis Alcoholic Hepatitis W Cc $22, Malignancy Of Hepatobiliary Sys Or Pancreas W MCC $34, Malignancy Of Hepatobiliary System Or Pancreas Wcc $18, Malign Of Hepatobiliary Sys Or Pancreas W/O Cc/MCC $16, Disorders Of Pancreas Except Malignancy W MCC $46, Disorders Of Pancreas Except Malignancy W Cc $19, Disorders Of Pancreas Except Malignancy W/O Cc/MCC $17, Disorder Of Liver Except Malig,Cirr,Alc Hepa W MCC $58, Disorders Of Liver Except Malig,Cirr,Alc Hepa W Cc $36, Dorder Of Liver Except Malig,Cirr,Alc Hepa W/O Cc/ $18, Disorders Of The Biliary Tract W MCC $36, Disorders Of The Biliary Tract W Cc $30, Disorders Of The Biliary Tract W/O Cc/MCC $23, Combined Anterior/Posterior Spinal Fusion W MCC $140, Combined Anterior/Posterior Spinal Fusion W Cc $97, Combine Anterior/Posterior Spinal Fusion W/O Cc/Mc $85, Spinal Fus Exc Cerv W Spinal Curv/Malig/Infec Or 9 $110, Spinal Fus Exc Cerv W Spinal Curv/Malig/Infec Or 9 $77, Spinal Fus Exc Cerv W Spinal Curv/Malig/Infec Or 9 $60, Spinal Fusion Except Cervical W MCC $109, Spinal Fusion Except Cervical W/O MCC $58, Bilateral Or Multiple Maj Joint Px Of Lower Extrem $81, Bilater Or Multi Maj Joint Px Of Low Extrem W/O Mc $50, Wnd Debrid Skn Grft Exc Hand, For Muscoconn Tiss $63, of 21 FY2018

11 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 464 Wnd Debrid Skn Grft Exc Hand, For Muscoconn Tiss $55, Wnd Debrid Skn Grft Exc Hand, For Muscoconn Tiss $41, Revision Of Hip Or Knee Replacement W MCC $96, Revision Of Hip Or Knee Replacement W Cc $60, Revision Of Hip Or Knee Replacement W/O Cc/MCC $60, Major Joint Replace Or Reattach Of Lower Extremity $63, Maj Joint Replace Or Reatach Of Low Extrem W/O MCC $33, Cervical Spinal Fusion W MCC $84, Cervical Spinal Fusion W Cc $46, Cervical Spinal Fusion W/O Cc/MCC $44, Amputat For Musculoskel Sys Conn Tisue Dis W MCC $80, Amputat For Musculoskel Sys Conn Tissue Dis W Cc $60, Biop Of Musculoskeletal Sys Connect Tissue W MCC $67, Biopsies Of Muslcoskel Sys Connective Tissue W Cc $51, Biop Of Musculoskel Sys Connect Tisue W/O Cc/MCC $36, Hip Femur Procedures Except Major Joint W MCC $61, Hip Femur Procedures Except Major Joint W Cc $41, Hip Femur Px Except Major Joint W/O Cc/MCC $32, Major Joint Limb Reattachment Proc Of Upper Extre $36, Knee Procedures W Pdx Of Infection W MCC $78, Knee Procedures W Pdx Of Infection W Cc $23, Knee Procedures W/O Pdx Of Infection W Cc/MCC $36, Knee Procedures W/O Pdx Of Infection W/O Cc/MCC $13, Lower Extrem Humer Px Except Hip Foot Femur W MCC $83, Lower Extrem Humer Px Except Hip,Foot,Femur W Cc $42, Lower Extrem Humer Px Except Hip,Foot,Femur W/O C $29, Local Excision Removal Int Fix Devices Exc Hip F $37, Local Excision Remove Int Fix Devices Exc Hip Fe $70, Local Excision Remove Int Fix Devices Of Hip Fem $135, Soft Tissue Procedures W MCC $45, of 21 FY2018

12 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 501 Soft Tissue Procedures W Cc $20, Soft Tissue Procedures W/O Cc/MCC $25, Foot Procedures W MCC $59, Foot Procedures W Cc $32, Foot Procedures W/O Cc/MCC $24, Major Thumb Or Joint Procedures $19, Major Shoulder Or Elbow Joint Procedures W Cc/MCC $32, Shoulder,Elbow Or Forearm Px,Exc Major Joint Proc $44, Should Elbow Or Forearm Px Exc Major Joint Px W Cc $28, Shoulder,Elbow Or Forearm Px,Exc Major Joint Px W/ $29, Hand Or Wrist Px, Except Major Thumb Or Joint Px W $43, Hand Or Wrist Px, Except Major Thumb Or Joint Px W $26, Other Musculoskelet Sys Conn Tiss O.R. Px W MCC $62, Other Musculoskelet Sys Conn Tiss O.R. Proc W Cc $38, Other Musculoskel Sys Conn Tiss Or Px W/O Cc/MCC $24, Back Neck Proc Exc Spinal Fusion W CC Disc Device/ $57, Back Neck Proc Exc Spinal Fusion W CC $29, Back Neck Proc Exc Spinal Fusion W/O CC/MCC $22, Fractures Of Femur W MCC $32, Fractures Of Hip Pelvis W MCC $32, Fractures Of Hip Pelvis W/O MCC $16, Osteomyelitis W MCC $94, Osteomyelitis W Cc $9, Osteomyelitis W/O Cc/MCC $63, Pathologi Fract Musculoskelet Conn Tiss Malig W $44, Patho Fracts Musculoskel Conn Tiss Malig W Cc $24, Patholo Fract Musculoskel Conn Tiss Malig W/O Cc $25, Connective Tissue Disorders W MCC $76, Connective Tissue Disorders W Cc $38, Connective Tissue Disorders W/O Cc/MCC $19, of 21 FY2018

13 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 549 Septic Arthritis W Cc $40, Medical Back Problems W MCC $28, Medical Back Problems W/O MCC $19, Bone Diseases Arthropathies W MCC $46, Bone Diseases Arthropathies W/O MCC $23, Signs Symptoms Of Muslcoskel Sys Conn Tissue W M $49, Signs Symptm Of Musculoskel Sys Conn Tisue W/O M $20, Tendonitis, Myositis Bursitis W MCC $21, Tendonitis, Myositis Bursitis W/O MCC $16, Aftercare, Musculoskeltal Sys Conect Tisue W MCC $53, Aftercare, Musculoskel Sys Connect Tisue W Cc $18, Aftercare Musculoskel Sys Connect Tisue W/O Cc/MCC $16, Fx Sprn Strn Disl Excpt Femur Hip Pelvis Thigh W $54, Fx, Sprn, Strn Disl Except Femur, Hip, Pelvis Th $14, Other Musculoskeletal Sys Connect Tisue Dx W MCC $16, Other Musculoskel Sys Connect Tisue Dx W/O Cc/MCC $22, Skin Debridement W MCC $31, Skin Debridement W CC $27, Skin Debridement W/O CC/MCC $21, Skin Graft /Or Debrid For Skn Ulcer Or Cellulitis $26, Skin Graft /Or Debrid For Skn Ulcer Or Cellulitis $130, Skin Graft /Or Debrid Exc For Skin Ulcer Or Cellul $116, Skin Graft /Or Debrid Exc For Skin Ulcer Or Cellul $46, Other Skin, Subcut Tiss Breast Proc W MCC $64, Other Skin, Subcut Tiss Breast Proc W Cc $35, Other Skin, Subcut Tiss Breast Proc W/O Cc/MCC $23, Mastectomy For Malignancy W Cc/MCC $30, Breast Biop, Local Excision Other Breast Procedur $77, Breast Biop, Local Excis Other Breast Px W/O Cc/M $33, Skin Ulcers W MCC $75, of 21 FY2018

14 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 593 Skin Ulcers W Cc $20, Major Skin Disorders W MCC $37, Major Skin Disorders W/O MCC $22, Malignant Breast Disorders W MCC $114, Malignant Breast Disorders W Cc $6, Non-Malignant Breast Disorders W/O Cc/MCC $10, Cellulitis W MCC $36, Cellulitis W/O MCC $18, Trauma To The Skin, Subcut Tiss Breast W MCC $30, Trauma To The Skin, Subcut Tiss Breast W/O MCC $16, Minor Skin Disorders W MCC $23, Minor Skin Disorders W/O MCC $18, Adrenal Pituitary Procedures W/O Cc/MCC $31, Amputat Of Lower Limb For Endocrine,Nutrit, Metabo $59, Amputat Of Lower Limb For Endocrine,Nutrit, Metabo $40, O.R. Procedures For Obesity W Cc $24, Skin Grafts Wound Debrid For Endoc, Nutrit Metab $170, Skin Grafts Wound Debrid For Endoc, Nutrit Metab $38, Thyroid, Parathyroid Thyroglossal Px W MCC $34, Thyroid, Parathyroid Thyroglossal Px W Cc $39, Thyroid, Parathyroid Thyroglossal Px W/O Cc/MCC $24, Other Endocrine, Nutrit Metab O.R. Proc W MCC $152, Other Endocrine, Nutrit Metab O.R. Proc W Cc $45, Diabetes W MCC $36, Diabetes W Cc $19, Diabetes W/O Cc/MCC $19, Nutritional Misc Metabolic Disorders W MCC $24, Nutritional Misc Metabolic Disorders W/O MCC $15, Inborn Errors Of Metabolism $50, Endocrine Disorders W MCC $29, of 21 FY2018

15 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 644 Endocrine Disorders W Cc $18, Endocrine Disorders W/O Cc/MCC $14, Major Bladder Procedures W MCC $118, Major Bladder Procedures W Cc $26, Major Bladder Procedures W/O Cc/MCC $24, Kidney Ureter Procedures For Neoplasm W MCC $48, Kidney Ureter Procedures For Neoplasm W Cc $33, Kidney Ureter Procedures For Neoplasm W/O Cc/MCC $32, Kidney Ureter Procedures For Non-Neoplasm W MCC $87, Kidney Ureter Procedures For Non-Neoplasm W Cc $30, Kidney Ureter Px For Non-Neoplasm W/O Cc/MCC $32, Minor Bladder Procedures W Cc $34, Prostatectomy W Cc $21, Prostatectomy W/O Cc/MCC $22, Transurethral Procedures W MCC $44, Transurethral Procedures W Cc $26, Transurethral Procedures W/O Cc/MCC $17, Other Kidney Urinary Tract Procedures W MCC $61, Other Kidney Urinary Tract Procedures W Cc $70, Other Kidney Urinary Tract Procedures W/O Cc/MCC $27, Renal Failure W MCC $36, Renal Failure W Cc $25, Renal Failure W/O Cc/MCC $16, Kidney Urinary Tract Neoplasms W MCC $37, Kidney Urinary Tract Neoplasms W Cc $29, Kidney Urinary Tract Infections W MCC $24, Kidney Urinary Tract Infections W/O MCC $17, Urinary Stones W Esw Lithotripsy W Cc/MCC $21, Urinary Stones W/O Esw Lithotripsy W MCC $33, Urinary Stones W/O Esw Lithotripsy W/O MCC $20, of 21 FY2018

16 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 695 Kidney Urinary Tract Signs Symptoms W MCC $6, Kidney Urinary Tract Signs Symptoms W/O MCC $18, Urethral Stricture $9, Other Kidney Urinary Tract Diagnoses W MCC $34, Other Kidney Urinary Tract Diagnoses W Cc $26, Other Kidney Urinary Tract Diagnoses W/O Cc/MCC $21, Major Male Pelvic Procedures W Cc/MCC $33, Major Male Pelvic Procedures W/O Cc/MCC $33, Penis Procedures W Cc/MCC $53, Transurethral Prostatectomy W Cc/MCC $20, Transurethral Prostatectomy W/O Cc/MCC $16, Oth Male Reproduc Sys Or Px For Malign W/O Cc/MCC $33, Oth Male Reproduct Sys Or Px Exc Malign W Cc/MCC $12, Malignancy, Male Reproductive System W MCC $30, Malignancy, Male Reproductive System W Cc $30, Benign Prostatic Hypertrophy W MCC $27, Benign Prostatic Hypertrophy W/O MCC $13, Inflammation Of The Male Reproductive System W MCC $31, Inflammation Of Male Reproductive System W/O MCC $24, Pelvic Eviscerat Rad Hyster Rad Vulvectomy W/O Cc $39, Uterine Adnexa Px For Ovari Or Adnexal Malignan W $108, Uterine Adnexa Proc For Ovari Or Adnexal Malig W C $37, Uterine,Adnexa Px For Non-Ovari/Adnexal Malig W Mc $39, Uterine,Adnexa Px For Non-Ovari/Adnexal Malig W/O $32, Uterine Adnexa Proc For Non-Malignancy W Cc/MCC $33, Uterine Adnexa Px For Non-Malignancy W/O Cc/MCC $20, Dc, Conization, Laparo Tubal Interrupt W Cc/MCC $38, Dc Conization Laparo Tubal Interrupt W/O Cc/MCC $10, Vagina, Cervix Vulva Procedures W Cc/MCC $22, Vagina, Cervix Vulva Procedures W/O Cc/MCC $20, of 21 FY2018

17 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 749 Other Female Reproductive System O.R. Px W Cc/MCC $22, Other Female Reproductive System Or Px W/O Cc/MCC $13, Malignancy, Female Reproductive System W MCC $43, Infections, Female Reproductive System W Cc $17, Infections, Female Reproductive System W/O Cc/MCC $22, Menstrual Oth Female Reproduct Sys Dorder W Cc/Mc $20, Menstrual Other Female Reproduct Sys Dorder W/O C $14, Cesarean Section W Cc/MCC $17, Cesarean Section W/O Cc/MCC $14, Vaginal Delivery W Sterilization /Or Dc $12, Vaginal Delivery W O.R. Proc Except Steril Or Dc $8, Postpartum Post Abortion Dx W O.R. Procedure $27, Abortion W Dc, Aspiration Curettage Or Hysterotomy $10, Vaginal Delivery W Complicating Diagnoses $10, Vaginal Delivery W/O Complicating Diagnoses $8, Postpartum Post Abortion Dx W/O O.R. Procedure $14, Ectopic Pregnancy $24, Threatened Abortion $9, Abortion W/O Dc $7, False Labor $4, Other Antepartum Diagnoses W Medical Complications $10, Other Antepartum Dx W/O Medical Complications $5, Neonates, Died Or Transf To Another Acute Care Fac $16, Extreme Immaturity Or Respiratory Distress Syndrom $61, Prematurity W Major Problems $46, Prematurity W/O Major Problems $21, Full Term Neonate W Major Problems $13, Neonate W Other Significant Problems $6, Normal Newborn $4, Splenectomy W Cc $41, of 21 FY2018

18 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 801 Splenectomy W/O Cc/MCC $27, Oth Or Px Of The Blood Blood Forming Organs W MCC $35, Other O.R. Proc Of The Blood Blood Forming Organs $29, Other O.R. Px Of The Blood Blood Forming Organs W $32, Major Hematol/Immun Diag Exc Sickle Cell Crisis C $64, Major Hematol/Immun Diag Exc Sickle Cell Crisis C $29, Maj Hematol/Immun Dx Exc Sickle Cell Crisis Coagu $30, Red Blood Cell Disorders W MCC $43, Red Blood Cell Disorders W/O MCC $27, Coagulation Disorders $34, Reticuloendothelial Immunity Disorders W MCC $39, Reticuloendothelial Immunity Disorders W Cc $37, Reticuloendothelial Immunity Disorder W/O Cc/MCC $18, Lymphoma Leukemia W Major O.R. Procedure W MCC $126, Lymphoma Non-Acute Leukemia W Other O.R. Px W Cc $67, Lymphoma Non-Acute Leukemia W Other O.R. Px W/O C $28, Myeloprolif Disord Or Poor Diff Neopl W Maj O.R. P $73, Myeloprolif Disord Or Poor Diff Neopl W Maj O.R. P $66, Myeloprolif Disord Or Poorly Diff Neopl W Maj O.R. $31, Myeloprolif Disord Or Poorly Diff Neopl W Other O. $66, Myeloprolif Disord Or Poorly Diff Neopl W Other O. $29, Acute Leukemia W/O Major O.R. Procedure W MCC $17, Acute Leukemia W/O Major O.R. Procedure W Cc $55, Acute Leukemia W/O Major O.R. Procedure W/O Cc/MCC $11, Lymphoma Non-Acute Leukemia W MCC $87, Lymphoma Non-Acute Leukemia W Cc $43, Lymphoma Non-Acute Leukemia W/O Cc/MCC $34, Other Myeloprolif Dis Or Poorly Dif Neopl Dx W MCC $36, Other Myeloprolif Dis Or Poorly Diff Neopl Dx W Cc $62, Chemo W/O Acute Leukemia As Secondary Dx W MCC $21, of 21 FY2018

19 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 847 Chemotherapy W/O Acute Leukemia As Second Dx W Cc $40, Radiotherapy $25, Infectious Parasitic Diseases W O.R. Px W MCC $135, Infectious Parasitic Diseases W O.R. Px W Cc $57, Infectious Parasitic Disease W Or Px W/O Cc/MCC $25, Postop Or Post-Trauma Infections W O.R. Proc W MCC $74, Postop Or Post-Traumatic Infection W O.R. Px W Cc $32, Postop Or Post-Trauma Infect W Or Px W/O Cc/MCC $42, Postoperative Post-Traumatic Infections W MCC $37, Postoperative Post-Traumatic Infections W/O MCC $24, Fever $23, Viral Illness W MCC $43, Viral Illness W/O MCC $23, Other Infectious Parasitic Diseases Dx W MCC $67, Other Infectious Parasitic Diseases Dx W Cc $12, Other Infectious Parasitic Diseases Dx W/O Cc/MCC $33, Septicemia Or Severe Sepsis W Mv 96+ Hours $244, Septicemia Or Severe Sepsis W/O Mv 96+ Hours W MCC $52, Septicemia Or Severe Sepsis W/O Mv 96+ Hrs W/O MCC $25, Acute Adjustment Reaction Psychosocial Dysfunct $28, Depressive Neuroses $10, Neuroses Except Depressive $13, Organic Disturbances Mental Retardation $17, Psychoses $28, Other Mental Disorder Diagnoses $31, Alcohol/Drug Abuse Or Dependence, Left Ama $16, Alcohol/Drug Abuse Or Dependence W/O Rehabilitatio $47, Alcohol/Drug Abuse Or Depend W/O Rehab Therapy W/O $15, Wound Debridements For Injuries W MCC $34, Wound Debridements For Injuries W Cc $45, of 21 FY2018

20 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. 903 Wound Debridements For Injuries W/O Cc/MCC $14, Other O.R. Procedures For Injuries W MCC $136, Other O.R. Procedures For Injuries W Cc $43, Other O.R. Procedures For Injuries W/O Cc/MCC $25, Traumatic Injury W/O MCC $30, Allergic Reactions W MCC $53, Allergic Reactions W/O MCC $18, Poisoning Toxic Effects Of Drugs W MCC $30, Poisoning Toxic Effects Of Drugs W/O MCC $15, Complications Of Treatment W MCC $34, Complications Of Treatment W Cc $21, Complications Of Treatment W/O Cc/MCC $15, Non-Extensive Burns $58, O.R. Px W Dx Of Other Contact W Health Serv W MCC $43, O.R. Px W Dx Of Other Contact W Health Serv W Cc $49, Or Px W Dx Of Oth Contact W Health Serv W/O Cc/MCC $77, Signs Symptoms W MCC $35, Signs Symptoms W/O MCC $27, Aftercare W Cc/MCC $92, Limb Reatach, Hip Femur Px For Multie Significant $43, Other Or Px For Multiple Significant Trauma W MCC $38, Other Multiple Significant Trauma W Cc $16, Hiv W Major Related Condition W MCC $103, Hiv W Major Related Condition W Cc $45, Extensive O.R. Px Unrelated To Pdx W MCC $102, Extensive O.R. Procedure Unrelated To Pdx W Cc $42, Extensive O.R. Px Unrelated To Pdx W/O Cc/MCC $31, Non-Extensive O.R. Proc Unrelated To Pdx W MCC $78, Non-Extensive O.R. Proc Unrelated To Pdx W Cc $35, Non-Extensive O.R. Px Unrelated To Pdx W/O Cc/MCC $16, of 21 FY2018

21 While the file below represents our charges for each (diagnosis related groups) service historically provided at St. s together with additional insights into pricing transparency for our services and frequently asked questions. Total FY18 Inpatients $33, of 21 FY2018