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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 | $38,852,494 | 3,893 | $54,553 | $10,126 | $9,980 | $0 | $47,840 |
Z5111 | Encounter for antineoplastic chemotherapy | $19,109,225 | 5,288 | $23,498 | $4,265 | $3,614 | $9,042 | $25,689 |
Z510 | Encounter for antineoplastic radiation therapy | $5,552,805 | 6,044 | $4,618 | $715 | $919 | $0 | $17,727 |
C61 | Malignant neoplasm of prostate | $3,228,498 | 1,431 | $17,898 | $2,708 | $2,256 | $46,704 | $8,510 |
G7000 | Myasthenia gravis without (acute) exacerbation | $3,128,445 | 202 | $100,747 | $18,972 | $15,487 | $0 | $40,804 |
M1712 | Unilateral primary osteoarthritis, left knee | $2,874,704 | 283 | $103,188 | $18,155 | $10,158 | $812,168 | $22,952 |
M810 | Age-related osteoporosis w/o current pathological fracture | $2,774,707 | 2,567 | $6,064 | $1,102 | $1,081 | $0 | $3,149 |
G35 | Multiple sclerosis | $2,254,968 | 973 | $14,226 | $2,383 | $2,318 | $0 | $22,283 |
M1711 | Unilateral primary osteoarthritis, right knee | $2,217,053 | 209 | $104,993 | $18,519 | $10,608 | $613,716 | $22,541 |
Z1211 | Encounter for screening for malignant neoplasm of colon | $2,163,515 | 2,054 | $7,391 | $1,410 | $1,053 | $0 | $7,998 |
I480 | Paroxysmal atrial fibrillation | $1,659,121 | 581 | $24,458 | $4,570 | $2,856 | $11,797 | $10,217 |
M1611 | Unilateral primary osteoarthritis, right hip | $1,630,889 | 224 | $70,319 | $12,543 | $7,281 | $265,103 | $28,446 |
G8929 | Other chronic pain | $1,484,758 | 2,294 | $4,646 | $839 | $647 | $0 | $3,703 |
I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,482,015 | 707 | $21,046 | $2,822 | $2,096 | $55,855 | $8,025 |
M12811 | Oth specific arthropathies, NEC, right shoulder | $1,167,610 | 123 | $87,592 | $15,095 | $9,493 | $66,479 | $20,781 |
I4819 | Other persistent atrial fibrillation | $1,167,158 | 345 | $30,458 | $5,768 | $3,383 | $17,645 | $26,818 |
G4733 | Obstructive sleep apnea (adult) (pediatric) | $1,163,576 | 1,559 | $4,915 | $839 | $746 | $5,892 | $3,990 |
J4550 | Severe persistent asthma, uncomplicated | $1,115,153 | 295 | $20,852 | $3,906 | $3,780 | $0 | $11,896 |
M1612 | Unilateral primary osteoarthritis, left hip | $1,113,344 | 173 | $63,473 | $11,300 | $6,436 | $194,657 | $28,905 |
I25110 | Athscl heart disease of native cor art w unstable ang pctrs | $1,009,437 | 150 | $69,175 | $9,539 | $6,730 | $93,222 | $44,975 |
All Other | $97,572,342 | 113,552 | - | - | - | - | - | |
Unclassified Services | $0 | 0 | - | - | - | - | - | |
TOTAL FOR ALL CLAIMS | $192,721,817 | 142,947 | - | - | - | - | - |
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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 | $6,855,101 | 620 | 620 | $18,073 | $3,206 | $11,057 | $23,959 |
5116 | Level 6 Musculoskeletal Procedures | $5,132,351 | 323 | 323 | $17,912 | $3,178 | $15,890 | $22,837 |
8011 | Comprehensive Observation Services | $3,828,830 | 1,637 | 1,637 | $1,720 | $346 | $2,339 | $3,626 |
5012 | Clinic Visits and Related Services | $3,674,431 | 34,961 | 36,889 | $132 | $68 | $100 | $233 |
5213 | Level 3 Electrophysiologic Procedures | $3,393,836 | 167 | 167 | $48,215 | $4,132 | $20,322 | $58,903 |
5193 | Level 3 Endovascular Procedures | $2,824,351 | 299 | 299 | $22,495 | $2,791 | $9,446 | $30,040 |
5694 | Level 4 Drug Administration | $2,598,264 | 7,999 | 8,950 | $763 | $128 | $290 | $1,354 |
5524 | Level 4 Imaging without Contrast | $2,330,830 | 4,928 | 4,946 | $4,622 | $705 | $471 | $3,417 |
5594 | Level 4 Nuclear Medicine and Related Services | $2,321,274 | 1,734 | 1,734 | $10,059 | $1,424 | $1,339 | $9,034 |
5114 | Level 4 Musculoskeletal Procedures | $2,235,475 | 369 | 466 | $6,265 | $1,111 | $4,797 | $15,708 |
5693 | Level 3 Drug Administration | $2,109,542 | 11,528 | 11,550 | $624 | $95 | $183 | $702 |
5623 | Level 3 Radiation Therapy | $2,069,726 | 3,885 | 4,081 | $2,753 | $420 | $507 | $4,966 |
5024 | Level 4 Type A ED Visits | $2,034,108 | 5,382 | 5,383 | $1,600 | $322 | $378 | $2,654 |
5232 | Level 2 ICD and Similar Procedures | $1,808,743 | 64 | 64 | $23,946 | $4,248 | $28,262 | $61,266 |
5572 | Level 2 Imaging with Contrast | $1,751,162 | 5,500 | 5,509 | $5,633 | $230 | $318 | $5,814 |
5593 | Level 3 Nuclear Medicine and Related Services | $1,655,485 | 1,365 | 1,366 | $6,538 | $926 | $1,212 | $6,141 |
5312 | Level 2 Lower GI Procedures | $1,615,010 | 1,430 | 1,757 | $3,553 | $630 | $919 | $4,072 |
5442 | Level 2 Nerve Injections | $1,605,697 | 2,720 | 2,729 | $3,523 | $625 | $588 | $2,957 |
5362 | Level 2 Laparoscopy and Related Services | $1,480,170 | 170 | 170 | $39,057 | $6,929 | $8,707 | $28,449 |
5374 | Level 4 Urology and Related Services | $1,453,026 | 489 | 489 | $9,552 | $1,512 | $2,971 | $11,248 |
TOTAL FOR TOP 20 | $52,777,412 | 85,570 | 89,129 | - | - | - | - | |
SERVICE MIX INDEX = 5.876 |
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 | 33,398 | 114,425 | $42 | $8 | $0 | 0.00 |
IV Therapy | 32,237 | 43,495 | $468 | $71 | $77 | 1.09 |
Medical Surgical Supplies | 28,835 | 77,652 | $2,973 | $587 | $4 | 94.25 |
Laboratory | 250,455 | 288,599 | $279 | $16 | $3 | 1.91 |
Laboratory - Pathological | 4,169 | 8,147 | $636 | $35 | $9 | 3.73 |
Radiology - Diagnostic | 20,051 | 21,746 | $703 | $100 | $53 | 1.42 |
Radiology - Therapeutic | 26,709 | 30,854 | $1,326 | $202 | $269 | 3.79 |
Nuclear Medicine | 9,670 | 28,127 | $1,324 | $193 | $190 | 11.60 |
CT Scan | 30,173 | 31,478 | $3,113 | $89 | $114 | 2.70 |
Operating Room Services | 23,611 | 24,824 | $5,200 | $922 | $1,887 | 31.26 |
Anesthesia | 10,003 | 566,427 | $34 | $5 | $0 | 0.00 |
Blood Storage and Processing | 1,528 | 1,921 | $1,364 | $208 | $272 | 3.53 |
Other Imaging Services | 12,226 | 12,259 | $2,261 | $320 | $277 | 6.13 |
Respiratory Services | 1,851 | 4,122 | $409 | $55 | $52 | 1.13 |
Physical Therapy | 6,160 | 10,283 | $293 | $74 | $39 | 1.72 |
Occupational Therapy | 2,256 | 3,540 | $284 | $51 | $31 | 0.00 |
Speech-Language Pathology | 783 | 1,085 | $638 | $121 | $57 | 4.45 |
Emergency Room | 13,543 | 13,544 | $1,540 | $310 | $560 | 7.51 |
Pulmonary Function | 2,754 | 3,573 | $539 | $82 | $60 | 2.14 |
Cardiology | 9,824 | 9,835 | $3,820 | $583 | $262 | 5.98 |
Cardiac Cath Lab | 1,160 | 1,198 | $27,426 | $2,350 | $5,721 | 109.43 |
Clinic | 35,099 | 37,072 | $133 | $68 | $100 | 1.45 |
Magnetic Resonance Technology (MRT) | 10,079 | 10,231 | $4,229 | $222 | $188 | 3.80 |
Drugs Requiring Specific Identification | 142,098 | 8,641,406 | $64 | $12 | $10 | 0.00 |
Recovery Room | 9,634 | 717,949 | $20 | $5 | $0 | 0.00 |
EKG/ECG (Electrocardiogram) | 11,815 | 15,030 | $410 | $29 | $10 | 0.76 |
EEG (Electroencephalogram) | 289 | 294 | $1,575 | $255 | $226 | 3.47 |
Observation Room | 3,049 | 83,981 | $74 | $11 | $0 | 0.00 |
Treatment Room | 1,955 | 2,032 | $581 | $299 | $175 | 2.63 |
Lithotripsy | 199 | 199 | $19,288 | $2,941 | $2,771 | 38.01 |
Other Diagnostic Services | 6,429 | 6,674 | $1,492 | $218 | $171 | 3.12 |
Other Therapeutic - Cardiac Rehab | 826 | 6,091 | $244 | $125 | $114 | 1.44 |
Unclassified | 1,220 | 1,256 | $183 | $45 | $30 | 0.78 |
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 |
Gastrointestinal Services | 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 |
Other Therapeutic Services | 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 |