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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 | $30,117,519 | 3,581 | $35,625 | $7,081 | $8,410 | $2,340 | $42,142 |
Z5111 | Encounter for antineoplastic chemotherapy | $19,077,497 | 5,569 | $18,117 | $3,509 | $3,426 | $3,191 | $23,014 |
G35 | Multiple sclerosis | $3,630,313 | 741 | $22,427 | $4,286 | $4,899 | $0 | $19,491 |
Z510 | Encounter for antineoplastic radiation therapy | $3,313,866 | 620 | $24,275 | $4,018 | $5,345 | $0 | $16,476 |
M1711 | Unilateral primary osteoarthritis, right knee | $2,516,346 | 258 | $83,591 | $16,346 | $9,753 | $260,006 | $21,404 |
M1712 | Unilateral primary osteoarthritis, left knee | $2,326,935 | 229 | $88,367 | $17,340 | $10,161 | $256,452 | $21,772 |
G8929 | Other chronic pain | $2,017,440 | 2,753 | $3,993 | $775 | $733 | $0 | $3,373 |
Z1211 | Encounter for screening for malignant neoplasm of colon | $1,742,696 | 1,765 | $5,904 | $1,153 | $987 | $3,655 | $6,765 |
M810 | Age-related osteoporosis w/o current pathological fracture | $1,616,258 | 1,868 | $4,085 | $799 | $865 | $0 | $2,538 |
M1611 | Unilateral primary osteoarthritis, right hip | $1,495,917 | 198 | $70,752 | $13,723 | $7,555 | $88,605 | $25,268 |
E0500 | Thyrotoxicosis w diffuse goiter w/o thyrotoxic crisis | $1,412,694 | 37 | $136,910 | $27,841 | $38,181 | $0 | $9,916 |
U071 | COVID-19 | $1,388,140 | 1,647 | $4,479 | $708 | $843 | $0 | $4,491 |
I25110 | Athscl heart disease of native cor art w unstable ang pctrs | $1,387,989 | 222 | $53,343 | $7,620 | $6,252 | $44,752 | $42,570 |
I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,376,905 | 703 | $16,751 | $2,350 | $1,959 | $30,728 | $7,194 |
T82858A | Stenosis of other vascular prosth dev/grft, init | $1,223,526 | 261 | $23,831 | $5,338 | $4,688 | $2,387 | $26,021 |
C61 | Malignant neoplasm of prostate | $1,196,841 | 1,391 | $7,677 | $1,222 | $860 | $23,047 | $6,678 |
Z4502 | Encntr for adjust and mgmt of automatic implntbl card defib | $1,172,771 | 48 | $127,346 | $23,291 | $24,433 | $0 | $21,600 |
M1612 | Unilateral primary osteoarthritis, left hip | $1,162,907 | 162 | $67,194 | $13,054 | $7,178 | $68,014 | $25,892 |
I480 | Paroxysmal atrial fibrillation | $1,134,928 | 550 | $15,495 | $3,086 | $2,064 | $0 | $7,257 |
R079 | Chest pain, unspecified | $1,123,433 | 960 | $10,761 | $1,407 | $1,170 | $0 | $7,277 |
All Other | $100,574,263 | 112,468 | - | - | - | - | - | |
Unclassified Services | $0 | 0 | - | - | - | - | - | |
TOTAL FOR ALL CLAIMS | $181,009,184 | 136,031 | - | - | - | - | - |
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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 | $12,126,620 | 1,063 | 1,063 | $13,922 | $2,551 | $11,408 | $21,264 |
8011 | Comprehensive Observation Services | $7,774,022 | 3,692 | 3,692 | $1,735 | $328 | $2,106 | $3,098 |
5193 | Level 3 Endovascular Procedures | $3,454,358 | 373 | 373 | $17,726 | $2,150 | $9,261 | $26,691 |
5012 | Clinic Visits and Related Services | $2,760,680 | 26,702 | 29,173 | $133 | $64 | $95 | $213 |
5213 | Level 3 Electrophysiologic Procedures | $2,757,720 | 140 | 140 | $38,115 | $3,011 | $19,698 | $52,221 |
5694 | Level 4 Drug Administration | $2,707,309 | 8,111 | 9,161 | $602 | $107 | $296 | $1,211 |
5114 | Level 4 Musculoskeletal Procedures | $2,596,861 | 449 | 560 | $5,574 | $1,021 | $4,637 | $13,786 |
5232 | Level 2 ICD and Similar Procedures | $2,378,456 | 78 | 78 | $20,580 | $3,770 | $30,493 | $54,803 |
5524 | Level 4 Imaging without Contrast | $2,137,934 | 4,775 | 4,800 | $4,141 | $672 | $445 | $3,078 |
5693 | Level 3 Drug Administration | $2,113,612 | 10,981 | 11,221 | $494 | $80 | $188 | $611 |
5594 | Level 4 Nuclear Medicine and Related Services | $2,058,664 | 1,503 | 1,503 | $7,955 | $1,176 | $1,370 | $8,307 |
5623 | Level 3 Radiation Therapy | $2,028,371 | 550 | 4,060 | $2,213 | $359 | $500 | $4,417 |
5024 | Level 4 Type A ED Visits | $1,779,858 | 5,282 | 5,282 | $1,600 | $302 | $337 | $2,264 |
5572 | Level 2 Imaging with Contrast | $1,726,111 | 5,279 | 5,295 | $4,451 | $213 | $326 | $5,346 |
5593 | Level 3 Nuclear Medicine and Related Services | $1,722,274 | 1,430 | 1,431 | $5,136 | $759 | $1,204 | $5,588 |
5192 | Level 2 Endovascular Procedures | $1,672,892 | 366 | 366 | $14,011 | $2,167 | $4,571 | $16,507 |
5442 | Level 2 Nerve Injections | $1,605,722 | 2,710 | 2,828 | $2,664 | $488 | $568 | $2,578 |
5194 | Level 4 Endovascular Procedures | $1,595,075 | 108 | 110 | $22,136 | $3,065 | $14,501 | $32,077 |
5183 | Level 3 Vascular Procedures | $1,536,529 | 581 | 581 | $5,093 | $923 | $2,645 | $8,752 |
5312 | Level 2 Lower GI Procedures | $1,512,957 | 1,402 | 1,737 | $2,781 | $509 | $871 | $3,638 |
TOTAL FOR TOP 20 | $58,046,025 | 75,575 | 83,454 | - | - | - | - | |
SERVICE MIX INDEX = 6.363 |
Search for Other APCs
- Enter APC desired and statistics will appear in a new window.
- (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 | 34,815 | 111,022 | $38 | $8 | $0 | 0.00 |
IV Therapy | 34,368 | 51,173 | $359 | $58 | $64 | 1.08 |
Medical Surgical Supplies | 33,851 | 86,293 | $2,264 | $516 | $7 | 114.20 |
Laboratory | 267,202 | 326,580 | $221 | $14 | $3 | 1.91 |
Laboratory - Pathological | 7,167 | 13,798 | $473 | $29 | $4 | 3.23 |
Radiology - Diagnostic | 22,959 | 25,011 | $520 | $77 | $49 | 1.57 |
Radiology - Therapeutic | 20,254 | 32,575 | $1,050 | $170 | $267 | 3.87 |
Nuclear Medicine | 12,635 | 18,736 | $922 | $136 | $116 | 11.43 |
CT Scan | 41,334 | 45,175 | $1,825 | $56 | $78 | 2.82 |
Operating Room Services | 26,146 | 28,535 | $3,990 | $731 | $1,748 | 29.29 |
Anesthesia | 10,257 | 613,074 | $27 | $4 | $0 | 0.00 |
Blood Storage and Processing | 1,705 | 2,275 | $1,035 | $168 | $251 | 3.61 |
Other Imaging Services | 14,217 | 14,253 | $1,500 | $222 | $232 | 5.74 |
Respiratory Services | 3,412 | 8,006 | $275 | $35 | $32 | 0.75 |
Physical Therapy | 10,512 | 16,321 | $217 | $56 | $21 | 0.00 |
Occupational Therapy | 3,886 | 5,551 | $232 | $46 | $28 | 0.00 |
Speech-Language Pathology | 864 | 1,018 | $537 | $108 | $49 | 0.00 |
Emergency Room | 16,121 | 16,125 | $1,575 | $298 | $705 | 9.80 |
Pulmonary Function | 2,843 | 4,042 | $372 | $60 | $47 | 1.77 |
Cardiology | 10,855 | 10,868 | $3,232 | $524 | $218 | 5.86 |
Cardiac Cath Lab | 1,272 | 1,303 | $21,489 | $1,698 | $5,216 | 98.95 |
Clinic | 26,894 | 29,444 | $135 | $64 | $95 | 1.45 |
Magnetic Resonance Technology (MRT) | 14,557 | 15,029 | $2,454 | $150 | $136 | 4.07 |
Drugs Requiring Specific Identification | 157,192 | 7,158,701 | $52 | $11 | $10 | 0.00 |
Recovery Room | 10,171 | 824,567 | $16 | $4 | $0 | 0.00 |
EKG/ECG (Electrocardiogram) | 14,917 | 18,878 | $341 | $22 | $9 | 0.81 |
EEG (Electroencephalogram) | 385 | 396 | $1,253 | $191 | $176 | 3.67 |
Observation Room | 5,884 | 254,085 | $69 | $11 | $0 | 0.00 |
Treatment Room | 2,601 | 2,716 | $398 | $190 | $147 | 2.40 |
Lithotripsy | 149 | 149 | $15,202 | $2,467 | $2,718 | 37.65 |
Other Diagnostic Services | 6,718 | 6,842 | $1,216 | $186 | $167 | 3.09 |
Other Therapeutic - Cardiac Rehab | 848 | 6,043 | $193 | $92 | $108 | 1.41 |
Unclassified | 2,348 | 2,492 | $395 | $129 | $132 | 0.90 |
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 |