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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 | $34,588,809 | 3,748 | $44,488 | $8,821 | $9,229 | $11,467 | $44,028 |
| Z5111 | Encounter for antineoplastic chemotherapy | $17,557,498 | 5,302 | $20,037 | $3,875 | $3,311 | $4,183 | $23,942 |
| Z510 | Encounter for antineoplastic radiation therapy | $3,835,601 | 4,184 | $4,359 | $720 | $917 | $0 | $17,054 |
| G35 | Multiple sclerosis | $3,120,387 | 931 | $17,371 | $3,263 | $3,352 | $0 | $21,045 |
| M1711 | Unilateral primary osteoarthritis, right knee | $2,825,488 | 261 | $100,013 | $19,164 | $10,826 | $555,236 | $22,747 |
| G7000 | Myasthenia gravis without (acute) exacerbation | $2,495,747 | 180 | $86,607 | $17,416 | $13,865 | $0 | $35,193 |
| M1712 | Unilateral primary osteoarthritis, left knee | $2,484,942 | 246 | $90,452 | $17,503 | $10,101 | $422,841 | $22,995 |
| M810 | Age-related osteoporosis w/o current pathological fracture | $2,291,028 | 2,165 | $5,395 | $1,051 | $1,058 | $0 | $2,793 |
| Z1211 | Encounter for screening for malignant neoplasm of colon | $1,746,729 | 1,685 | $7,062 | $1,444 | $1,037 | $0 | $7,314 |
| G8929 | Other chronic pain | $1,634,241 | 2,513 | $4,248 | $858 | $650 | $0 | $3,525 |
| I480 | Paroxysmal atrial fibrillation | $1,531,496 | 484 | $24,468 | $4,906 | $3,164 | $8,221 | $8,424 |
| M1611 | Unilateral primary osteoarthritis, right hip | $1,449,894 | 214 | $61,753 | $11,963 | $6,775 | $138,842 | $27,187 |
| I4819 | Other persistent atrial fibrillation | $1,325,524 | 301 | $35,594 | $7,227 | $4,404 | $7,686 | $21,225 |
| I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,267,232 | 571 | $20,606 | $2,915 | $2,219 | $27,424 | $7,663 |
| M1612 | Unilateral primary osteoarthritis, left hip | $1,197,415 | 161 | $68,353 | $13,316 | $7,437 | $112,577 | $27,806 |
| C7A8 | Other malignant neuroendocrine tumors | $1,094,496 | 300 | $20,653 | $3,900 | $3,648 | $0 | $19,474 |
| C61 | Malignant neoplasm of prostate | $1,040,542 | 1,236 | $8,826 | $1,449 | $842 | $24,847 | $7,604 |
| R079 | Chest pain, unspecified | $1,012,281 | 870 | $11,986 | $1,579 | $1,164 | $18,868 | $7,550 |
| Z4502 | Encntr for adjust and mgmt of automatic implntbl card defib | $935,801 | 38 | $146,035 | $26,006 | $24,626 | $0 | $22,332 |
| D839 | Common variable immunodeficiency, unspecified | $930,461 | 249 | $27,726 | $5,512 | $3,737 | $0 | $16,457 |
| All Other | $90,200,179 | 104,668 | - | - | - | - | - | |
| Unclassified Services | $0 | 0 | - | - | - | - | - | |
| TOTAL FOR ALL CLAIMS | $174,565,791 | 130,307 | - | - | - | - | - |
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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 | $10,089,303 | 870 | 924 | $16,583 | $3,237 | $10,919 | $22,439 |
| 8011 | Comprehensive Observation Services | $6,311,821 | 2,903 | 2,903 | $1,756 | $391 | $2,174 | $3,352 |
| 5193 | Level 3 Endovascular Procedures | $3,667,863 | 387 | 388 | $20,731 | $2,765 | $9,453 | $28,582 |
| 5213 | Level 3 Electrophysiologic Procedures | $3,314,762 | 158 | 158 | $43,832 | $3,923 | $20,980 | $55,694 |
| 5012 | Clinic Visits and Related Services | $3,122,419 | 30,909 | 32,132 | $130 | $77 | $97 | $223 |
| 5694 | Level 4 Drug Administration | $2,622,012 | 7,959 | 8,795 | $691 | $126 | $298 | $1,277 |
| 5693 | Level 3 Drug Administration | $1,913,312 | 10,281 | 10,387 | $570 | $93 | $184 | $656 |
| 5623 | Level 3 Radiation Therapy | $1,898,175 | 2,612 | 3,680 | $2,534 | $413 | $516 | $4,678 |
| 5114 | Level 4 Musculoskeletal Procedures | $1,854,946 | 317 | 317 | $7,570 | $1,478 | $5,852 | $14,808 |
| 5024 | Level 4 Type A ED Visits | $1,771,586 | 5,189 | 5,189 | $1,600 | $356 | $341 | $2,458 |
| 5524 | Level 4 Imaging without Contrast | $1,750,367 | 3,867 | 3,884 | $4,195 | $684 | $451 | $3,253 |
| 5594 | Level 4 Nuclear Medicine and Related Services | $1,589,012 | 1,193 | 1,193 | $9,147 | $1,428 | $1,332 | $8,661 |
| 5572 | Level 2 Imaging with Contrast | $1,555,857 | 4,810 | 4,820 | $5,122 | $248 | $323 | $5,556 |
| 5312 | Level 2 Lower GI Procedures | $1,549,439 | 1,410 | 1,780 | $3,172 | $619 | $870 | $3,831 |
| 5442 | Level 2 Nerve Injections | $1,531,955 | 2,625 | 2,709 | $3,066 | $598 | $566 | $2,738 |
| 5232 | Level 2 ICD and Similar Procedures | $1,527,598 | 53 | 53 | $24,085 | $4,701 | $28,823 | $58,314 |
| 5362 | Level 2 Laparoscopy and Related Services | $1,460,750 | 180 | 180 | $34,572 | $6,748 | $8,115 | $26,282 |
| 5374 | Level 4 Urology and Related Services | $1,430,144 | 502 | 502 | $8,066 | $1,385 | $2,849 | $10,666 |
| 5194 | Level 4 Endovascular Procedures | $1,405,952 | 92 | 92 | $23,037 | $3,778 | $15,282 | $34,247 |
| 5116 | Level 6 Musculoskeletal Procedures | $1,379,654 | 71 | 71 | $8,204 | $1,601 | $19,432 | $17,196 |
| TOTAL FOR TOP 20 | $51,746,927 | 76,388 | 80,157 | - | - | - | - | |
| SERVICE MIX INDEX = 6.179 |
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 | 32,409 | 102,252 | $44 | $9 | $0 | 0.00 |
| IV Therapy | 30,568 | 42,337 | $421 | $69 | $72 | 1.06 |
| Medical Surgical Supplies | 29,574 | 78,266 | $2,517 | $548 | $7 | 91.93 |
| Laboratory | 246,613 | 296,849 | $254 | $17 | $3 | 1.97 |
| Laboratory - Pathological | 7,123 | 14,219 | $554 | $36 | $5 | 3.40 |
| Radiology - Diagnostic | 20,630 | 22,419 | $611 | $95 | $50 | 1.48 |
| Radiology - Therapeutic | 24,031 | 30,110 | $1,213 | $198 | $277 | 3.99 |
| Nuclear Medicine | 9,577 | 14,846 | $1,204 | $189 | $114 | 11.13 |
| CT Scan | 39,051 | 42,666 | $2,100 | $73 | $78 | 2.77 |
| Operating Room Services | 21,950 | 23,137 | $4,950 | $966 | $1,902 | 32.16 |
| Anesthesia | 9,566 | 552,096 | $31 | $5 | $0 | 0.00 |
| Blood Storage and Processing | 1,749 | 2,320 | $1,227 | $200 | $255 | 3.68 |
| Other Imaging Services | 10,808 | 10,864 | $1,734 | $271 | $223 | 5.50 |
| Respiratory Services | 2,788 | 6,464 | $284 | $41 | $27 | 0.63 |
| Physical Therapy | 8,476 | 13,084 | $257 | $69 | $28 | 1.81 |
| Occupational Therapy | 3,423 | 5,023 | $264 | $53 | $26 | 0.00 |
| Speech-Language Pathology | 957 | 1,143 | $598 | $125 | $47 | 0.00 |
| Emergency Room | 14,766 | 14,766 | $1,576 | $351 | $658 | 9.08 |
| Pulmonary Function | 2,863 | 3,660 | $474 | $77 | $51 | 2.09 |
| Cardiology | 8,716 | 8,724 | $3,454 | $563 | $227 | 5.91 |
| Cardiac Cath Lab | 1,333 | 1,365 | $24,571 | $2,199 | $5,313 | 101.14 |
| Clinic | 31,009 | 32,258 | $131 | $77 | $97 | 1.41 |
| Magnetic Resonance Technology (MRT) | 12,098 | 12,459 | $2,813 | $176 | $132 | 3.94 |
| Drugs Requiring Specific Identification | 138,954 | 6,917,310 | $63 | $13 | $11 | 0.00 |
| Recovery Room | 9,458 | 734,848 | $18 | $6 | $0 | 0.00 |
| EKG/ECG (Electrocardiogram) | 12,829 | 16,636 | $370 | $27 | $8 | 0.76 |
| EEG (Electroencephalogram) | 347 | 354 | $1,367 | $250 | $183 | 3.33 |
| Observation Room | 4,718 | 184,691 | $69 | $11 | $0 | 0.00 |
| Treatment Room | 2,162 | 2,195 | $408 | $241 | $134 | 2.01 |
| Lithotripsy | 180 | 180 | $17,500 | $2,852 | $2,687 | 37.45 |
| Psychiatric / Psychological Treatments | 24 | 24 | $972 | $190 | $436 | 5.65 |
| Other Diagnostic Services | 6,568 | 6,754 | $1,366 | $216 | $160 | 3.00 |
| Other Therapeutic - Cardiac Rehab | 575 | 4,272 | $222 | $131 | $108 | 1.40 |
| Unclassified | 1,419 | 1,500 | $252 | $59 | $27 | 0.68 |
| 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 |