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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 | $25,873,265 | 3,421 | $35,289 | $7,013 | $7,563 | $2,340 | $41,993 |
| Z5111 | Encounter for antineoplastic chemotherapy | $16,823,220 | 5,292 | $18,031 | $3,494 | $3,179 | $3,191 | $22,863 |
| G35 | Multiple sclerosis | $3,082,189 | 715 | $22,385 | $4,277 | $4,311 | $0 | $19,328 |
| Z510 | Encounter for antineoplastic radiation therapy | $2,967,574 | 561 | $24,038 | $3,986 | $5,290 | $0 | $16,087 |
| M1711 | Unilateral primary osteoarthritis, right knee | $2,393,649 | 244 | $83,846 | $16,409 | $9,810 | $233,938 | $21,251 |
| M1712 | Unilateral primary osteoarthritis, left knee | $2,232,749 | 218 | $88,513 | $17,375 | $10,242 | $231,431 | $21,624 |
| G8929 | Other chronic pain | $1,961,722 | 2,684 | $3,965 | $770 | $731 | $0 | $3,330 |
| Z1211 | Encounter for screening for malignant neoplasm of colon | $1,706,635 | 1,731 | $5,879 | $1,147 | $986 | $3,617 | $6,751 |
| M1611 | Unilateral primary osteoarthritis, right hip | $1,457,754 | 193 | $70,901 | $13,757 | $7,553 | $85,482 | $25,048 |
| E0500 | Thyrotoxicosis w diffuse goiter w/o thyrotoxic crisis | $1,412,694 | 37 | $136,910 | $27,841 | $38,181 | $0 | $9,628 |
| M810 | Age-related osteoporosis w/o current pathological fracture | $1,403,183 | 1,799 | $4,063 | $794 | $780 | $0 | $2,501 |
| I25110 | Athscl heart disease of native cor art w unstable ang pctrs | $1,321,234 | 213 | $52,901 | $7,562 | $6,203 | $42,718 | $42,483 |
| U071 | COVID-19 | $1,291,875 | 1,553 | $4,333 | $696 | $832 | $0 | $4,403 |
| I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,258,108 | 669 | $16,091 | $2,260 | $1,881 | $26,631 | $7,155 |
| T82858A | Stenosis of other vascular prosth dev/grft, init | $1,182,141 | 253 | $23,763 | $5,321 | $4,672 | $2,387 | $25,930 |
| Z4502 | Encntr for adjust and mgmt of automatic implntbl card defib | $1,121,194 | 46 | $126,923 | $23,202 | $24,374 | $0 | $21,935 |
| M1612 | Unilateral primary osteoarthritis, left hip | $1,113,140 | 153 | $68,189 | $13,242 | $7,275 | $65,665 | $25,707 |
| I480 | Paroxysmal atrial fibrillation | $1,104,616 | 531 | $15,614 | $3,113 | $2,080 | $0 | $7,227 |
| R079 | Chest pain, unspecified | $1,075,077 | 915 | $10,766 | $1,411 | $1,175 | $0 | $7,242 |
| C61 | Malignant neoplasm of prostate | $997,569 | 1,305 | $6,581 | $1,048 | $764 | $23,047 | $6,506 |
| All Other | $92,708,637 | 107,169 | - | - | - | - | - | |
| Unclassified Services | $0 | 0 | - | - | - | - | - | |
| TOTAL FOR ALL CLAIMS | $164,488,225 | 129,702 | - | - | - | - | - |
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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 | $11,532,634 | 1,010 | 1,010 | $14,089 | $2,581 | $11,418 | $21,355 |
| 8011 | Comprehensive Observation Services | $7,226,787 | 3,426 | 3,426 | $1,734 | $328 | $2,109 | $3,095 |
| 5193 | Level 3 Endovascular Procedures | $3,267,153 | 352 | 352 | $17,776 | $2,145 | $9,282 | $26,722 |
| 5213 | Level 3 Electrophysiologic Procedures | $2,698,310 | 137 | 137 | $38,115 | $3,011 | $19,696 | $52,237 |
| 5012 | Clinic Visits and Related Services | $2,647,945 | 25,652 | 27,914 | $133 | $64 | $95 | $212 |
| 5694 | Level 4 Drug Administration | $2,588,279 | 7,754 | 8,753 | $603 | $107 | $296 | $1,209 |
| 5114 | Level 4 Musculoskeletal Procedures | $2,447,321 | 424 | 535 | $5,586 | $1,023 | $4,574 | $13,763 |
| 5232 | Level 2 ICD and Similar Procedures | $2,287,564 | 75 | 75 | $20,792 | $3,809 | $30,501 | $54,660 |
| 5524 | Level 4 Imaging without Contrast | $2,046,083 | 4,568 | 4,593 | $4,142 | $672 | $445 | $3,071 |
| 5693 | Level 3 Drug Administration | $2,021,347 | 10,487 | 10,718 | $495 | $80 | $189 | $610 |
| 5594 | Level 4 Nuclear Medicine and Related Services | $1,823,011 | 1,331 | 1,331 | $7,955 | $1,176 | $1,370 | $8,306 |
| 5623 | Level 3 Radiation Therapy | $1,813,018 | 499 | 3,631 | $2,212 | $359 | $499 | $4,411 |
| 5024 | Level 4 Type A ED Visits | $1,667,154 | 4,941 | 4,941 | $1,600 | $302 | $337 | $2,261 |
| 5593 | Level 3 Nuclear Medicine and Related Services | $1,650,008 | 1,368 | 1,369 | $5,140 | $760 | $1,205 | $5,583 |
| 5572 | Level 2 Imaging with Contrast | $1,648,029 | 5,038 | 5,052 | $4,453 | $214 | $326 | $5,339 |
| 5192 | Level 2 Endovascular Procedures | $1,598,591 | 349 | 349 | $14,012 | $2,176 | $4,580 | $16,519 |
| 5442 | Level 2 Nerve Injections | $1,541,399 | 2,618 | 2,695 | $2,700 | $495 | $572 | $2,583 |
| 5312 | Level 2 Lower GI Procedures | $1,471,912 | 1,362 | 1,690 | $2,779 | $509 | $871 | $3,638 |
| 5183 | Level 3 Vascular Procedures | $1,470,295 | 556 | 556 | $5,113 | $927 | $2,644 | $8,774 |
| 5194 | Level 4 Endovascular Procedures | $1,384,178 | 93 | 93 | $22,284 | $3,126 | $14,884 | $32,073 |
| TOTAL FOR TOP 20 | $54,831,018 | 72,040 | 79,220 | - | - | - | - | |
| SERVICE MIX INDEX = 6.353 |
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 | 33,057 | 105,643 | $37 | $7 | $0 | 0.00 |
| IV Therapy | 32,786 | 48,827 | $359 | $58 | $64 | 1.09 |
| Medical Surgical Supplies | 32,024 | 81,360 | $2,266 | $516 | $7 | 125.59 |
| Laboratory | 251,361 | 304,736 | $221 | $14 | $3 | 1.90 |
| Laboratory - Pathological | 6,578 | 12,621 | $470 | $29 | $4 | 3.20 |
| Radiology - Diagnostic | 21,492 | 23,293 | $526 | $78 | $50 | 1.59 |
| Radiology - Therapeutic | 19,085 | 30,220 | $1,036 | $168 | $265 | 3.83 |
| Nuclear Medicine | 11,945 | 17,741 | $853 | $126 | $115 | 11.45 |
| CT Scan | 38,982 | 42,585 | $1,819 | $56 | $78 | 2.81 |
| Operating Room Services | 24,738 | 26,872 | $4,022 | $737 | $1,758 | 29.37 |
| Anesthesia | 9,747 | 579,666 | $27 | $4 | $0 | 0.00 |
| Blood Storage and Processing | 1,624 | 2,165 | $1,037 | $168 | $253 | 3.62 |
| Other Imaging Services | 13,409 | 13,439 | $1,457 | $215 | $224 | 5.48 |
| Respiratory Services | 3,099 | 7,255 | $268 | $34 | $32 | 0.73 |
| Physical Therapy | 9,675 | 14,936 | $217 | $56 | $21 | 0.00 |
| Occupational Therapy | 3,538 | 5,056 | $231 | $46 | $28 | 0.00 |
| Speech-Language Pathology | 778 | 920 | $536 | $108 | $47 | 0.00 |
| Emergency Room | 15,034 | 15,037 | $1,574 | $297 | $704 | 9.76 |
| Pulmonary Function | 2,658 | 3,678 | $381 | $62 | $48 | 1.84 |
| Cardiology | 10,320 | 10,329 | $3,232 | $525 | $219 | 5.86 |
| Cardiac Cath Lab | 1,181 | 1,205 | $21,669 | $1,712 | $5,330 | 100.86 |
| Clinic | 25,820 | 28,148 | $134 | $64 | $95 | 1.45 |
| Magnetic Resonance Technology (MRT) | 13,870 | 14,321 | $2,448 | $150 | $136 | 4.07 |
| Drugs Requiring Specific Identification | 148,163 | 6,784,262 | $52 | $11 | $10 | 0.00 |
| Recovery Room | 9,673 | 776,108 | $16 | $4 | $0 | 0.00 |
| EKG/ECG (Electrocardiogram) | 14,011 | 17,626 | $343 | $23 | $9 | 0.82 |
| EEG (Electroencephalogram) | 353 | 364 | $1,251 | $191 | $180 | 3.66 |
| Observation Room | 5,452 | 233,948 | $68 | $11 | $0 | 0.00 |
| Treatment Room | 2,462 | 2,568 | $407 | $195 | $150 | 2.44 |
| Lithotripsy | 143 | 143 | $15,202 | $2,467 | $2,732 | 37.66 |
| Other Diagnostic Services | 6,386 | 6,501 | $1,216 | $186 | $168 | 3.10 |
| Other Therapeutic - Cardiac Rehab | 765 | 5,539 | $193 | $92 | $108 | 1.41 |
| Unclassified | 2,203 | 2,342 | $400 | $132 | $137 | 0.91 |
| 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 |