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Drill down to more granular utilization statistics for ICD diagnoses and procedures
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Statistics for the Top 20 Medical Diagnoses
ICD-10 Diagnosis Codes
| ICD-10 Code |
ICD-10 Description | Total Payment | Number Patient Claims | Average Charge | Average Cost | Average Payment | Total Outlier Amount |
National Average Charge |
|---|---|---|---|---|---|---|---|---|
| Z5112 | Encounter for antineoplastic immunotherapy | $42,634,811 | 3,917 | $63,048 | $9,830 | $10,885 | $32,862 | $50,880 |
| Z5111 | Encounter for antineoplastic chemotherapy | $18,000,927 | 5,156 | $23,759 | $3,628 | $3,491 | $10,151 | $27,954 |
| Z510 | Encounter for antineoplastic radiation therapy | $4,891,466 | 6,276 | $4,241 | $593 | $779 | $4,686 | $17,868 |
| M810 | Age-related osteoporosis w/o current pathological fracture | $3,733,996 | 2,984 | $7,253 | $1,111 | $1,251 | $0 | $3,557 |
| G7000 | Myasthenia gravis without (acute) exacerbation | $2,966,915 | 200 | $100,214 | $15,822 | $14,835 | $0 | $43,311 |
| M1711 | Unilateral primary osteoarthritis, right knee | $2,580,511 | 279 | $102,819 | $16,437 | $9,249 | $605,676 | $22,848 |
| I480 | Paroxysmal atrial fibrillation | $2,405,051 | 637 | $36,051 | $8,581 | $3,776 | $42,940 | $11,896 |
| C61 | Malignant neoplasm of prostate | $2,392,287 | 1,375 | $17,056 | $2,414 | $1,740 | $54,023 | $9,092 |
| Z1211 | Encounter for screening for malignant neoplasm of colon | $2,308,111 | 2,014 | $8,078 | $1,427 | $1,146 | $12,179 | $8,593 |
| G8929 | Other chronic pain | $2,255,666 | 2,981 | $5,613 | $860 | $757 | $9,531 | $3,952 |
| I4819 | Other persistent atrial fibrillation | $1,925,976 | 339 | $53,932 | $12,722 | $5,681 | $41,601 | $32,556 |
| M1712 | Unilateral primary osteoarthritis, left knee | $1,896,693 | 214 | $97,287 | $15,800 | $8,863 | $437,521 | $23,131 |
| M1611 | Unilateral primary osteoarthritis, right hip | $1,729,236 | 229 | $82,557 | $13,213 | $7,551 | $488,757 | $29,377 |
| G35 | Multiple sclerosis | $1,500,644 | 814 | $13,384 | $1,866 | $1,844 | $0 | $23,562 |
| I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,467,550 | 720 | $22,432 | $3,091 | $2,038 | $75,627 | $8,262 |
| M1612 | Unilateral primary osteoarthritis, left hip | $1,402,902 | 187 | $80,786 | $12,813 | $7,502 | $364,474 | $29,920 |
| G3184 | Mild cognitive impairment of uncertain or unknown etiology | $1,233,520 | 1,304 | $7,060 | $957 | $946 | $0 | $3,591 |
| C7A8 | Other malignant neuroendocrine tumors | $1,212,305 | 362 | $27,988 | $4,222 | $3,349 | $0 | $21,408 |
| M12811 | Oth specific arthropathies, NEC, right shoulder | $1,107,401 | 114 | $102,394 | $16,891 | $9,714 | $121,075 | $20,395 |
| M19012 | Primary osteoarthritis, left shoulder | $1,061,959 | 92 | $115,161 | $18,794 | $11,543 | $112,834 | $19,754 |
| All Other | $102,682,798 | 117,899 | - | - | - | - | - | |
| Unclassified Services | $0 | 0 | - | - | - | - | - | |
| TOTAL FOR ALL CLAIMS | $201,390,725 | 148,093 | - | - | - | - | - |
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- (Only ICDs representing more than 10 patients are reported.)
Statistics for the Top 20 Ambulatory Payment Classifications (APCs)
- APC descriptions / Definitions
- Please note: APC Statistics reflect composite APCs.
| APC Number |
APC Description | Total Payment | Number Patient Claims |
Units of Service | Average Charge |
Average Cost | Average Payment | National Average Charge |
|---|---|---|---|---|---|---|---|---|
| 5115 | Level 5 Musculoskeletal Procedures | $6,613,652 | 576 | 576 | $18,149 | $2,517 | $11,482 | $25,708 |
| 5116 | Level 6 Musculoskeletal Procedures | $5,525,193 | 334 | 334 | $20,071 | $2,784 | $16,542 | $24,140 |
| 5213 | Level 3 Electrophysiologic Procedures | $5,014,659 | 228 | 228 | $51,108 | $4,022 | $21,994 | $61,601 |
| 5012 | Clinic Visits and Related Services | $4,089,520 | 37,611 | 39,417 | $148 | $56 | $104 | $247 |
| 8011 | Comprehensive Observation Services | $3,738,396 | 1,567 | 1,568 | $1,921 | $371 | $2,384 | $3,912 |
| 5193 | Level 3 Endovascular Procedures | $2,980,447 | 292 | 292 | $25,219 | $2,490 | $10,207 | $32,088 |
| 5694 | Level 4 Drug Administration | $2,625,229 | 7,753 | 8,752 | $809 | $119 | $300 | $1,441 |
| 5693 | Level 3 Drug Administration | $2,421,958 | 12,730 | 12,790 | $658 | $91 | $189 | $748 |
| 5524 | Level 4 Imaging without Contrast | $2,355,908 | 4,755 | 4,763 | $4,786 | $664 | $495 | $3,582 |
| 5114 | Level 4 Musculoskeletal Procedures | $2,291,194 | 359 | 359 | $8,460 | $1,173 | $6,382 | $17,211 |
| 5623 | Level 3 Radiation Therapy | $2,233,193 | 4,153 | 4,265 | $2,923 | $405 | $524 | $5,303 |
| 5594 | Level 4 Nuclear Medicine and Related Services | $2,220,762 | 1,686 | 1,686 | $10,666 | $1,426 | $1,317 | $9,418 |
| 5024 | Level 4 Type A ED Visits | $2,209,817 | 5,747 | 5,758 | $1,788 | $346 | $384 | $2,882 |
| 5572 | Level 2 Imaging with Contrast | $2,063,684 | 6,499 | 6,600 | $5,792 | $223 | $313 | $5,798 |
| 5312 | Level 2 Lower GI Procedures | $1,731,523 | 1,456 | 1,786 | $3,769 | $523 | $969 | $4,308 |
| 5232 | Level 2 ICD and Similar Procedures | $1,684,477 | 58 | 58 | $28,985 | $3,976 | $29,043 | $64,792 |
| 5442 | Level 2 Nerve Injections | $1,637,291 | 2,628 | 2,631 | $3,732 | $518 | $622 | $3,120 |
| 5374 | Level 4 Urology and Related Services | $1,520,648 | 489 | 489 | $9,176 | $1,273 | $3,110 | $11,885 |
| 5362 | Level 2 Laparoscopy and Related Services | $1,498,050 | 161 | 161 | $42,839 | $5,942 | $9,305 | $30,710 |
| 5593 | Level 3 Nuclear Medicine and Related Services | $1,484,240 | 1,259 | 1,259 | $6,819 | $912 | $1,179 | $6,394 |
| TOTAL FOR TOP 20 | $55,939,841 | 90,341 | 93,772 | - | - | - | - | |
| SERVICE MIX INDEX = 5.872 |
Search for Other APCs
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- (Only APCs representing more than 10 patients are reported.)
View characteristics, claims and quality data for Ambulatory Surgery Centers.
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Service Statistics
| Service | Number Patient Claims | Units of Service | Average Charge | Average Cost | Average Payment | Service Mix Index - SMI |
|---|---|---|---|---|---|---|
| Pharmacy | 34,882 | 398,146 | $14 | $2 | $0 | 0.00 |
| IV Therapy | 34,873 | 46,547 | $498 | $69 | $81 | 1.14 |
| Medical Surgical Supplies | 30,708 | 83,432 | $3,454 | $746 | $5 | 74.67 |
| Laboratory | 263,025 | 304,445 | $300 | $16 | $3 | 2.01 |
| Laboratory - Pathological | 4,216 | 7,984 | $748 | $38 | $12 | 3.77 |
| Radiology - Diagnostic | 19,769 | 21,154 | $726 | $97 | $56 | 1.39 |
| Radiology - Therapeutic | 26,852 | 30,978 | $1,395 | $194 | $275 | 3.84 |
| Nuclear Medicine | 8,035 | 16,685 | $1,730 | $233 | $200 | 10.97 |
| CT Scan | 26,256 | 26,343 | $4,040 | $110 | $145 | 2.72 |
| Operating Room Services | 24,610 | 25,560 | $5,563 | $772 | $1,918 | 31.07 |
| Anesthesia | 10,084 | 575,885 | $36 | $5 | $0 | 0.00 |
| Blood Storage and Processing | 1,425 | 1,730 | $1,418 | $197 | $283 | 3.62 |
| Other Imaging Services | 12,095 | 12,133 | $2,387 | $319 | $274 | 5.74 |
| Respiratory Services | 1,897 | 4,136 | $410 | $48 | $58 | 1.17 |
| Physical Therapy | 6,108 | 10,245 | $313 | $77 | $39 | 1.77 |
| Occupational Therapy | 2,531 | 3,939 | $304 | $54 | $31 | 0.00 |
| Speech-Language Pathology | 899 | 1,116 | $696 | $128 | $73 | 0.00 |
| Emergency Room | 14,267 | 14,305 | $1,721 | $333 | $549 | 7.18 |
| Pulmonary Function | 2,624 | 3,700 | $523 | $73 | $58 | 1.77 |
| Cardiology | 9,596 | 9,609 | $3,947 | $548 | $279 | 6.20 |
| Cardiac Cath Lab | 1,386 | 1,426 | $27,651 | $2,176 | $5,966 | 123.60 |
| Clinic | 37,924 | 39,774 | $152 | $58 | $104 | 1.46 |
| Magnetic Resonance Technology (MRT) | 8,891 | 8,938 | $5,645 | $284 | $257 | 4.03 |
| Drugs Requiring Specific Identification | 141,186 | 9,598,312 | $63 | $10 | $10 | 0.00 |
| Recovery Room | 9,682 | 715,820 | $21 | $5 | $0 | 0.00 |
| EKG/ECG (Electrocardiogram) | 11,718 | 14,875 | $415 | $31 | $10 | 0.74 |
| EEG (Electroencephalogram) | 246 | 249 | $1,649 | $224 | $234 | 3.51 |
| Gastrointestinal Services | 18 | 18 | $2,261 | $314 | $203 | 5.27 |
| Observation Room | 2,976 | 83,478 | $74 | $10 | $0 | 0.00 |
| Treatment Room | 1,733 | 1,808 | $690 | $262 | $212 | 3.08 |
| Lithotripsy | 165 | 165 | $20,384 | $2,827 | $2,895 | 38.68 |
| Other Diagnostic Services | 7,117 | 7,350 | $1,581 | $214 | $174 | 3.11 |
| Other Therapeutic Services | 23 | 27 | $260 | $34 | $10 | 0.67 |
| Other Therapeutic - Cardiac Rehab | 722 | 5,256 | $259 | $98 | $114 | 1.41 |
| Unclassified | 1,099 | 1,123 | $202 | $40 | $38 | 0.94 |
| Ambulatory Surgical Care | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Audiology | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Blood Products | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Cast Room | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Labor & Delivery | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Oncology | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Other Therapeutic - Education / Training | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Psychiatric / Psychological Services | 0 | 0 | $0 | $0 | $0 | 0.00 |
| Psychiatric / Psychological Treatments | 0 | 0 | $0 | $0 | $0 | 0.00 |