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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 | $25,908,925 | 2,756 | $45,957 | $9,205 | $9,401 | $24,302 | $38,429 |
| Z5111 | Encounter for antineoplastic chemotherapy | $19,106,141 | 3,423 | $32,980 | $6,324 | $5,582 | $56,685 | $22,070 |
| E0500 | Thyrotoxicosis w diffuse goiter w/o thyrotoxic crisis | $4,218,821 | 77 | $193,998 | $40,199 | $54,790 | $0 | $12,803 |
| G35 | Multiple sclerosis | $4,112,815 | 542 | $36,878 | $7,152 | $7,588 | $0 | $18,643 |
| Z510 | Encounter for antineoplastic radiation therapy | $3,538,818 | 706 | $22,278 | $3,276 | $5,012 | $3,163 | $15,177 |
| M1711 | Unilateral primary osteoarthritis, right knee | $2,436,889 | 287 | $70,350 | $12,316 | $8,491 | $130,510 | $18,489 |
| M1712 | Unilateral primary osteoarthritis, left knee | $2,216,973 | 235 | $77,167 | $13,507 | $9,434 | $124,395 | $18,991 |
| M1611 | Unilateral primary osteoarthritis, right hip | $1,942,554 | 238 | $79,369 | $13,922 | $8,162 | $143,561 | $22,185 |
| G8929 | Other chronic pain | $1,836,338 | 2,262 | $4,788 | $791 | $812 | $10,876 | $3,126 |
| T82858A | Stenosis of other vascular prosth dev/grft, init | $1,709,783 | 371 | $23,144 | $4,328 | $4,609 | $4,771 | $24,806 |
| M1612 | Unilateral primary osteoarthritis, left hip | $1,543,732 | 187 | $79,466 | $13,965 | $8,255 | $118,272 | $22,976 |
| I25110 | Athscl heart disease of native cor art w unstable ang pctrs | $1,540,658 | 271 | $47,891 | $6,111 | $5,685 | $39,754 | $42,021 |
| Z1211 | Encounter for screening for malignant neoplasm of colon | $1,440,735 | 1,517 | $5,763 | $966 | $950 | $0 | $6,300 |
| I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,348,229 | 718 | $15,687 | $2,054 | $1,878 | $19,266 | $6,955 |
| U071 | COVID-19 | $1,331,856 | 2,627 | $2,051 | $410 | $507 | $2,602 | $3,457 |
| M810 | Age-related osteoporosis w/o current pathological fracture | $1,280,809 | 1,729 | $4,236 | $831 | $741 | $0 | $2,284 |
| R079 | Chest pain, unspecified | $1,245,137 | 1,042 | $11,192 | $1,303 | $1,195 | $12,408 | $7,142 |
| T82868A | Thrombosis due to vascular prosth dev/grft, init | $1,063,390 | 122 | $45,058 | $9,503 | $8,716 | $13,570 | $33,458 |
| M48062 | Spinal stenosis, lumbar region with neurogenic claudication | $1,047,312 | 226 | $44,307 | $7,477 | $4,634 | $207,878 | $10,343 |
| I480 | Paroxysmal atrial fibrillation | $1,019,381 | 576 | $13,135 | $2,350 | $1,770 | $0 | $6,710 |
| All Other | $100,536,147 | 107,571 | - | - | - | - | - | |
| Unclassified Services | $0 | 0 | - | - | - | - | - | |
| TOTAL FOR ALL CLAIMS | $180,425,443 | 127,483 | - | - | - | - | - |
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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 | $14,567,047 | 1,308 | 1,308 | $13,457 | $2,048 | $11,137 | $19,566 |
| 8011 | Comprehensive Observation Services | $7,047,575 | 3,380 | 3,382 | $1,724 | $237 | $2,084 | $2,912 |
| 1490 | Inj pembrolizumab | $4,805,035 | 492 | 128,200 | $187 | $39 | $37 | $203 |
| 5193 | Level 3 Endovascular Procedures | $3,901,782 | 429 | 429 | $17,927 | $1,992 | $9,095 | $25,375 |
| 5694 | Level 4 Drug Administration | $2,815,046 | 6,110 | 9,862 | $602 | $103 | $285 | $1,125 |
| 5012 | Clinic Visits and Related Services | $2,774,525 | 24,783 | 29,828 | $135 | $78 | $93 | $204 |
| 5114 | Level 4 Musculoskeletal Procedures | $2,724,110 | 484 | 484 | $6,954 | $1,058 | $5,628 | $12,864 |
| 5232 | Level 2 ICD and Similar Procedures | $2,363,126 | 79 | 79 | $21,336 | $3,247 | $29,913 | $51,040 |
| 5623 | Level 3 Radiation Therapy | $2,232,598 | 638 | 4,509 | $2,208 | $314 | $495 | $4,179 |
| 5524 | Level 4 Imaging without Contrast | $2,167,680 | 4,917 | 4,919 | $4,155 | $590 | $441 | $2,936 |
| 5693 | Level 3 Drug Administration | $2,147,217 | 9,324 | 11,576 | $488 | $69 | $185 | $572 |
| 5593 | Level 3 Nuclear Medicine and Related Services | $2,121,627 | 1,779 | 1,781 | $5,098 | $675 | $1,191 | $5,304 |
| 5192 | Level 2 Endovascular Procedures | $2,110,235 | 465 | 465 | $13,617 | $1,876 | $4,538 | $15,613 |
| 5594 | Level 4 Nuclear Medicine and Related Services | $2,082,593 | 1,536 | 1,536 | $7,951 | $1,054 | $1,356 | $7,938 |
| 5213 | Level 3 Electrophysiologic Procedures | $2,059,664 | 105 | 105 | $38,115 | $2,973 | $19,616 | $43,970 |
| 9453 | Injection, nivolumab | $2,009,256 | 217 | 96,380 | $104 | $22 | $21 | $117 |
| 5572 | Level 2 Imaging with Contrast | $1,999,768 | 6,003 | 6,027 | $4,425 | $165 | $332 | $5,155 |
| 5116 | Level 6 Musculoskeletal Procedures | $1,934,183 | 134 | 134 | $5,217 | $794 | $14,434 | $14,921 |
| 5024 | Level 4 Type A ED Visits | $1,805,885 | 5,432 | 5,433 | $1,600 | $220 | $332 | $2,102 |
| 5194 | Level 4 Endovascular Procedures | $1,795,100 | 122 | 124 | $20,460 | $2,348 | $14,477 | $29,846 |
| TOTAL FOR TOP 20 | $65,464,052 | 67,737 | 306,561 | - | - | - | - | |
| SERVICE MIX INDEX = 6.675 |
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 | 29,117 | 130,277 | $34 | $7 | $0 | 0.00 |
| IV Therapy | 33,808 | 61,142 | $353 | $50 | $53 | 1.09 |
| Medical Surgical Supplies | 36,594 | 96,611 | $2,360 | $485 | $5 | 73.90 |
| Laboratory | 274,246 | 351,001 | $221 | $13 | $2 | 1.68 |
| Laboratory - Pathological | 10,276 | 18,848 | $451 | $26 | $5 | 3.41 |
| Radiology - Diagnostic | 24,028 | 26,288 | $511 | $68 | $48 | 1.47 |
| Radiology - Therapeutic | 16,394 | 33,750 | $1,059 | $150 | $268 | 3.99 |
| Nuclear Medicine | 14,452 | 21,207 | $851 | $113 | $119 | 12.03 |
| CT Scan | 46,373 | 51,421 | $1,640 | $45 | $73 | 2.92 |
| Operating Room Services | 28,431 | 30,806 | $4,128 | $628 | $1,822 | 31.75 |
| Anesthesia | 11,044 | 700,106 | $27 | $4 | $0 | 0.00 |
| Blood Storage and Processing | 1,653 | 2,704 | $1,024 | $146 | $239 | 3.58 |
| Other Imaging Services | 13,976 | 14,012 | $1,537 | $204 | $238 | 5.85 |
| Respiratory Services | 3,266 | 7,749 | $308 | $34 | $36 | 0.90 |
| Physical Therapy | 10,840 | 17,377 | $215 | $55 | $21 | 0.00 |
| Occupational Therapy | 3,472 | 5,032 | $232 | $40 | $25 | 0.00 |
| Speech-Language Pathology | 935 | 1,122 | $537 | $85 | $46 | 0.00 |
| Emergency Room | 16,653 | 16,670 | $1,566 | $215 | $658 | 9.26 |
| Pulmonary Function | 2,660 | 3,308 | $415 | $59 | $43 | 2.81 |
| Cardiology | 11,401 | 11,416 | $3,195 | $454 | $209 | 5.85 |
| Cardiac Cath Lab | 1,236 | 1,263 | $21,466 | $1,674 | $5,016 | 93.58 |
| Clinic | 25,146 | 30,372 | $137 | $80 | $93 | 1.45 |
| Magnetic Resonance Technology (MRT) | 15,630 | 16,225 | $2,239 | $105 | $127 | 4.14 |
| Drugs Requiring Specific Identification | 161,522 | 7,699,922 | $48 | $10 | $9 | 0.75 |
| Recovery Room | 10,879 | 903,786 | $16 | $4 | $0 | 0.00 |
| EKG/ECG (Electrocardiogram) | 14,941 | 18,823 | $342 | $20 | $8 | 0.83 |
| EEG (Electroencephalogram) | 429 | 437 | $1,223 | $191 | $188 | 3.69 |
| Observation Room | 5,953 | 236,392 | $69 | $10 | $0 | 0.00 |
| Treatment Room | 2,560 | 3,110 | $367 | $213 | $91 | 2.70 |
| Lithotripsy | 154 | 154 | $15,202 | $2,160 | $2,594 | 37.42 |
| Psychiatric / Psychological Treatments | 11 | 11 | $845 | $129 | $450 | 5.92 |
| Other Diagnostic Services | 7,603 | 7,733 | $1,204 | $163 | $156 | 2.92 |
| Other Therapeutic Services | 97 | 570 | $245 | $27 | $51 | 0.68 |
| Other Therapeutic - Cardiac Rehab | 900 | 6,501 | $193 | $112 | $106 | 1.41 |
| Unclassified | 4,052 | 4,190 | $429 | $202 | $244 | 1.72 |
| 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 |
| Psychiatric / Psychological Services | 0 | 0 | $0 | $0 | $0 | 0.00 |