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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 | $41,372,191 | 4,097 | $55,201 | $8,612 | $10,098 | $3,855 | $48,209 |
| Z5111 | Encounter for antineoplastic chemotherapy | $20,592,257 | 5,584 | $23,930 | $3,671 | $3,688 | $13,943 | $25,951 |
| Z510 | Encounter for antineoplastic radiation therapy | $5,672,709 | 6,251 | $4,589 | $642 | $907 | $0 | $17,962 |
| C61 | Malignant neoplasm of prostate | $3,540,036 | 1,543 | $18,939 | $2,582 | $2,294 | $47,325 | $8,632 |
| G7000 | Myasthenia gravis without (acute) exacerbation | $3,473,807 | 217 | $103,163 | $16,314 | $16,008 | $0 | $42,388 |
| M1712 | Unilateral primary osteoarthritis, left knee | $2,957,284 | 295 | $102,119 | $16,503 | $10,025 | $835,459 | $22,942 |
| M810 | Age-related osteoporosis w/o current pathological fracture | $2,902,747 | 2,682 | $6,075 | $933 | $1,082 | $0 | $3,215 |
| G35 | Multiple sclerosis | $2,364,816 | 1,016 | $14,461 | $2,053 | $2,328 | $0 | $22,583 |
| M1711 | Unilateral primary osteoarthritis, right knee | $2,297,471 | 226 | $101,172 | $16,404 | $10,166 | $630,638 | $22,527 |
| Z1211 | Encounter for screening for malignant neoplasm of colon | $2,228,528 | 2,125 | $7,390 | $1,269 | $1,049 | $0 | $8,002 |
| I480 | Paroxysmal atrial fibrillation | $1,791,938 | 614 | $25,485 | $5,391 | $2,918 | $12,918 | $10,210 |
| M1611 | Unilateral primary osteoarthritis, right hip | $1,654,734 | 234 | $68,485 | $11,343 | $7,072 | $267,815 | $28,602 |
| G8929 | Other chronic pain | $1,641,970 | 2,470 | $4,814 | $728 | $665 | $0 | $3,739 |
| I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,527,865 | 730 | $21,059 | $2,810 | $2,093 | $60,921 | $8,052 |
| I4819 | Other persistent atrial fibrillation | $1,212,245 | 360 | $30,795 | $6,621 | $3,367 | $17,645 | $26,890 |
| M1612 | Unilateral primary osteoarthritis, left hip | $1,183,856 | 183 | $64,182 | $10,623 | $6,469 | $210,195 | $29,031 |
| M12811 | Oth specific arthropathies, NEC, right shoulder | $1,182,271 | 128 | $85,320 | $13,500 | $9,236 | $67,601 | $20,670 |
| J4550 | Severe persistent asthma, uncomplicated | $1,173,271 | 307 | $21,092 | $3,322 | $3,822 | $0 | $12,004 |
| G4733 | Obstructive sleep apnea (adult) (pediatric) | $1,110,540 | 1,600 | $4,665 | $715 | $694 | $26,098 | $3,999 |
| I25110 | Athscl heart disease of native cor art w unstable ang pctrs | $1,077,826 | 159 | $70,291 | $10,376 | $6,779 | $109,754 | $44,945 |
| All Other | $103,652,687 | 119,519 | - | - | - | - | - | |
| Unclassified Services | $0 | 0 | - | - | - | - | - | |
| TOTAL FOR ALL CLAIMS | $204,611,049 | 150,340 | - | - | - | - | - |
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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 | $7,132,584 | 648 | 648 | $18,004 | $2,501 | $11,007 | $23,891 |
| 5116 | Level 6 Musculoskeletal Procedures | $5,307,252 | 336 | 336 | $17,946 | $2,493 | $15,795 | $22,794 |
| 8011 | Comprehensive Observation Services | $4,104,233 | 1,767 | 1,767 | $1,718 | $333 | $2,323 | $3,629 |
| 5012 | Clinic Visits and Related Services | $3,819,134 | 36,470 | 38,569 | $132 | $50 | $99 | $233 |
| 5213 | Level 3 Electrophysiologic Procedures | $3,544,346 | 177 | 177 | $48,215 | $3,799 | $20,025 | $58,958 |
| 5193 | Level 3 Endovascular Procedures | $3,018,615 | 321 | 321 | $22,420 | $2,327 | $9,404 | $29,989 |
| 5694 | Level 4 Drug Administration | $2,746,502 | 8,481 | 9,504 | $764 | $114 | $289 | $1,354 |
| 5594 | Level 4 Nuclear Medicine and Related Services | $2,545,073 | 1,909 | 1,909 | $10,056 | $1,346 | $1,333 | $9,028 |
| 5524 | Level 4 Imaging without Contrast | $2,421,852 | 5,146 | 5,164 | $4,623 | $642 | $469 | $3,419 |
| 5114 | Level 4 Musculoskeletal Procedures | $2,333,540 | 388 | 485 | $6,308 | $876 | $4,811 | $15,729 |
| 5693 | Level 3 Drug Administration | $2,224,775 | 12,206 | 12,238 | $623 | $87 | $182 | $702 |
| 5024 | Level 4 Type A ED Visits | $2,187,429 | 5,816 | 5,817 | $1,600 | $310 | $376 | $2,659 |
| 5623 | Level 3 Radiation Therapy | $2,155,804 | 4,034 | 4,266 | $2,754 | $383 | $505 | $4,968 |
| 5232 | Level 2 ICD and Similar Procedures | $1,968,831 | 71 | 71 | $23,726 | $3,296 | $27,730 | $61,463 |
| 5572 | Level 2 Imaging with Contrast | $1,840,609 | 5,810 | 5,820 | $5,632 | $220 | $316 | $5,819 |
| 5593 | Level 3 Nuclear Medicine and Related Services | $1,719,551 | 1,423 | 1,424 | $6,537 | $875 | $1,208 | $6,142 |
| 5442 | Level 2 Nerve Injections | $1,677,898 | 2,859 | 2,868 | $3,522 | $489 | $585 | $2,947 |
| 5312 | Level 2 Lower GI Procedures | $1,662,741 | 1,478 | 1,817 | $3,550 | $493 | $915 | $4,071 |
| 5362 | Level 2 Laparoscopy and Related Services | $1,621,836 | 187 | 187 | $38,432 | $5,338 | $8,673 | $28,287 |
| 5374 | Level 4 Urology and Related Services | $1,524,876 | 515 | 515 | $9,373 | $1,302 | $2,961 | $11,236 |
| TOTAL FOR TOP 20 | $55,557,481 | 90,042 | 93,903 | - | - | - | - | |
| SERVICE MIX INDEX = 5.878 |
Search for Other APCs
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- (Only APCs representing more than 10 patients are reported.)
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Service Statistics
| Service | Number Patient Claims | Units of Service | Average Charge | Average Cost | Average Payment | Service Mix Index - SMI |
|---|---|---|---|---|---|---|
| Pharmacy | 35,328 | 124,269 | $41 | $6 | $0 | 0.00 |
| IV Therapy | 34,166 | 46,141 | $468 | $65 | $77 | 1.09 |
| Medical Surgical Supplies | 30,523 | 82,067 | $2,977 | $615 | $5 | 84.87 |
| Laboratory | 267,752 | 312,827 | $279 | $15 | $3 | 1.90 |
| Laboratory - Pathological | 4,505 | 8,841 | $648 | $33 | $10 | 3.74 |
| Radiology - Diagnostic | 21,469 | 23,401 | $702 | $94 | $53 | 1.41 |
| Radiology - Therapeutic | 27,980 | 32,321 | $1,320 | $183 | $267 | 3.78 |
| Nuclear Medicine | 10,215 | 29,421 | $1,391 | $189 | $189 | 11.56 |
| CT Scan | 31,769 | 33,087 | $3,150 | $86 | $114 | 2.70 |
| Operating Room Services | 25,101 | 26,383 | $5,199 | $722 | $1,873 | 31.25 |
| Anesthesia | 10,500 | 596,125 | $34 | $5 | $0 | 0.00 |
| Blood Storage and Processing | 1,604 | 2,014 | $1,362 | $189 | $270 | 3.53 |
| Other Imaging Services | 12,952 | 12,987 | $2,315 | $310 | $283 | 6.33 |
| Respiratory Services | 2,036 | 4,509 | $412 | $48 | $52 | 1.14 |
| Physical Therapy | 6,721 | 11,313 | $293 | $72 | $39 | 1.72 |
| Occupational Therapy | 2,526 | 4,032 | $282 | $51 | $31 | 0.00 |
| Speech-Language Pathology | 893 | 1,239 | $636 | $117 | $56 | 4.45 |
| Emergency Room | 14,692 | 14,693 | $1,540 | $298 | $555 | 7.49 |
| Pulmonary Function | 2,940 | 3,941 | $522 | $73 | $57 | 2.10 |
| Cardiology | 10,293 | 10,305 | $3,823 | $531 | $260 | 5.98 |
| Cardiac Cath Lab | 1,229 | 1,271 | $27,316 | $2,152 | $5,647 | 110.09 |
| Clinic | 36,613 | 38,756 | $133 | $51 | $99 | 1.45 |
| Magnetic Resonance Technology (MRT) | 10,517 | 10,674 | $4,264 | $215 | $188 | 3.80 |
| Drugs Requiring Specific Identification | 150,736 | 9,204,993 | $64 | $10 | $10 | 0.00 |
| Recovery Room | 10,092 | 756,901 | $20 | $5 | $0 | 0.00 |
| EKG/ECG (Electrocardiogram) | 12,683 | 16,227 | $407 | $30 | $10 | 0.76 |
| EEG (Electroencephalogram) | 311 | 316 | $1,581 | $215 | $228 | 3.52 |
| Observation Room | 3,279 | 90,655 | $74 | $10 | $0 | 0.00 |
| Treatment Room | 2,050 | 2,134 | $591 | $225 | $177 | 2.68 |
| Lithotripsy | 204 | 204 | $19,287 | $2,679 | $2,752 | 38.01 |
| Other Diagnostic Services | 6,780 | 7,030 | $1,493 | $203 | $169 | 3.09 |
| Other Therapeutic - Cardiac Rehab | 946 | 6,921 | $244 | $93 | $113 | 1.44 |
| Unclassified | 1,344 | 1,381 | $188 | $37 | $31 | 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 |