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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 | $36,883,020 | 3,962 | $44,911 | $8,333 | $9,309 | $11,467 | $44,298 |
| Z5111 | Encounter for antineoplastic chemotherapy | $18,812,253 | 5,592 | $20,224 | $3,656 | $3,364 | $4,183 | $24,183 |
| Z510 | Encounter for antineoplastic radiation therapy | $4,078,297 | 4,424 | $4,379 | $678 | $922 | $0 | $17,406 |
| G35 | Multiple sclerosis | $3,331,588 | 981 | $17,727 | $3,092 | $3,396 | $0 | $21,303 |
| M1711 | Unilateral primary osteoarthritis, right knee | $2,944,861 | 274 | $99,467 | $17,440 | $10,748 | $579,248 | $22,592 |
| M1712 | Unilateral primary osteoarthritis, left knee | $2,599,333 | 268 | $87,029 | $15,391 | $9,699 | $452,847 | $22,820 |
| G7000 | Myasthenia gravis without (acute) exacerbation | $2,582,236 | 186 | $86,559 | $16,310 | $13,883 | $0 | $36,254 |
| M810 | Age-related osteoporosis w/o current pathological fracture | $2,404,547 | 2,316 | $5,295 | $963 | $1,038 | $0 | $2,820 |
| Z1211 | Encounter for screening for malignant neoplasm of colon | $1,827,439 | 1,758 | $7,098 | $1,318 | $1,039 | $0 | $7,320 |
| G8929 | Other chronic pain | $1,693,088 | 2,608 | $4,258 | $783 | $649 | $0 | $3,540 |
| I480 | Paroxysmal atrial fibrillation | $1,613,661 | 591 | $21,256 | $3,861 | $2,730 | $8,221 | $8,339 |
| M1611 | Unilateral primary osteoarthritis, right hip | $1,504,904 | 219 | $62,399 | $11,059 | $6,872 | $146,042 | $27,212 |
| C61 | Malignant neoplasm of prostate | $1,472,952 | 1,311 | $10,709 | $1,610 | $1,124 | $26,779 | $7,726 |
| I2510 | Athscl heart disease of native coronary artery w/o ang pctrs | $1,452,082 | 699 | $19,151 | $2,528 | $2,077 | $27,424 | $7,663 |
| I4819 | Other persistent atrial fibrillation | $1,362,854 | 342 | $32,199 | $5,975 | $3,985 | $7,686 | $21,095 |
| M1612 | Unilateral primary osteoarthritis, left hip | $1,275,561 | 170 | $68,424 | $12,183 | $7,503 | $118,717 | $27,920 |
| C7A8 | Other malignant neuroendocrine tumors | $1,158,424 | 323 | $20,554 | $3,589 | $3,586 | $0 | $19,790 |
| R079 | Chest pain, unspecified | $1,125,799 | 968 | $11,864 | $1,442 | $1,163 | $18,868 | $7,570 |
| Z4502 | Encntr for adjust and mgmt of automatic implntbl card defib | $993,446 | 40 | $147,748 | $24,103 | $24,836 | $0 | $21,866 |
| D839 | Common variable immunodeficiency, unspecified | $987,233 | 264 | $27,767 | $5,168 | $3,740 | $0 | $16,645 |
| All Other | $98,450,783 | 114,202 | - | - | - | - | - | |
| Unclassified Services | $0 | 0 | - | - | - | - | - | |
| TOTAL FOR ALL CLAIMS | $188,554,361 | 141,498 | - | - | - | - | - |
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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 | $10,641,246 | 917 | 971 | $16,593 | $2,944 | $10,959 | $22,329 |
| 8011 | Comprehensive Observation Services | $6,631,937 | 3,051 | 3,051 | $1,759 | $354 | $2,174 | $3,361 |
| 5193 | Level 3 Endovascular Procedures | $3,927,580 | 415 | 416 | $20,832 | $2,572 | $9,441 | $28,583 |
| 5213 | Level 3 Electrophysiologic Procedures | $3,378,086 | 161 | 161 | $43,832 | $3,756 | $20,982 | $55,658 |
| 5012 | Clinic Visits and Related Services | $3,276,759 | 32,475 | 33,910 | $131 | $67 | $97 | $222 |
| 5694 | Level 4 Drug Administration | $2,767,593 | 8,408 | 9,288 | $690 | $116 | $298 | $1,278 |
| 5524 | Level 4 Imaging without Contrast | $2,176,943 | 4,815 | 4,837 | $4,208 | $642 | $450 | $3,257 |
| 5594 | Level 4 Nuclear Medicine and Related Services | $2,099,437 | 1,577 | 1,577 | $9,149 | $1,296 | $1,331 | $8,680 |
| 5693 | Level 3 Drug Administration | $2,034,771 | 10,957 | 11,064 | $569 | $87 | $184 | $657 |
| 5623 | Level 3 Radiation Therapy | $1,998,779 | 2,780 | 3,875 | $2,534 | $386 | $516 | $4,676 |
| 5114 | Level 4 Musculoskeletal Procedures | $1,998,016 | 341 | 341 | $7,465 | $1,324 | $5,859 | $14,788 |
| 5024 | Level 4 Type A ED Visits | $1,900,743 | 5,577 | 5,577 | $1,600 | $322 | $341 | $2,465 |
| 5232 | Level 2 ICD and Similar Procedures | $1,729,355 | 60 | 60 | $23,483 | $4,166 | $28,823 | $58,122 |
| 5572 | Level 2 Imaging with Contrast | $1,718,399 | 5,379 | 5,392 | $5,130 | $209 | $319 | $5,567 |
| 5312 | Level 2 Lower GI Procedures | $1,623,069 | 1,477 | 1,864 | $3,174 | $563 | $871 | $3,839 |
| 5593 | Level 3 Nuclear Medicine and Related Services | $1,609,606 | 1,353 | 1,354 | $5,921 | $838 | $1,189 | $5,881 |
| 5442 | Level 2 Nerve Injections | $1,603,289 | 2,751 | 2,835 | $3,069 | $545 | $566 | $2,729 |
| 5362 | Level 2 Laparoscopy and Related Services | $1,559,011 | 192 | 192 | $34,777 | $6,169 | $8,120 | $26,338 |
| 5194 | Level 4 Endovascular Procedures | $1,545,002 | 101 | 101 | $22,561 | $3,434 | $15,297 | $34,258 |
| 5116 | Level 6 Musculoskeletal Procedures | $1,517,460 | 78 | 78 | $8,328 | $1,477 | $19,455 | $17,317 |
| TOTAL FOR TOP 20 | $55,737,081 | 82,865 | 86,944 | - | - | - | - | |
| SERVICE MIX INDEX = 6.115 |
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 | 34,458 | 108,273 | $45 | $9 | $0 | 0.00 |
| IV Therapy | 32,342 | 44,795 | $421 | $64 | $72 | 1.07 |
| Medical Surgical Supplies | 31,338 | 83,080 | $2,547 | $505 | $7 | 88.84 |
| Laboratory | 264,211 | 319,644 | $254 | $14 | $3 | 2.00 |
| Laboratory - Pathological | 7,605 | 15,283 | $555 | $31 | $5 | 3.42 |
| Radiology - Diagnostic | 22,639 | 24,665 | $606 | $86 | $50 | 1.47 |
| Radiology - Therapeutic | 25,304 | 31,632 | $1,208 | $184 | $276 | 3.97 |
| Nuclear Medicine | 11,470 | 19,410 | $1,229 | $176 | $131 | 11.60 |
| CT Scan | 42,650 | 46,558 | $2,093 | $60 | $78 | 2.75 |
| Operating Room Services | 23,629 | 24,968 | $4,883 | $866 | $1,884 | 31.83 |
| Anesthesia | 10,101 | 585,494 | $31 | $5 | $0 | 0.00 |
| Blood Storage and Processing | 1,868 | 2,462 | $1,231 | $188 | $257 | 3.69 |
| Other Imaging Services | 12,802 | 12,862 | $1,870 | $265 | $252 | 6.10 |
| Respiratory Services | 3,044 | 7,289 | $288 | $39 | $28 | 0.64 |
| Physical Therapy | 9,187 | 14,419 | $259 | $65 | $29 | 1.76 |
| Occupational Therapy | 3,703 | 5,493 | $264 | $48 | $26 | 0.00 |
| Speech-Language Pathology | 1,037 | 1,240 | $594 | $113 | $48 | 0.00 |
| Emergency Room | 15,893 | 15,893 | $1,578 | $318 | $650 | 8.97 |
| Pulmonary Function | 3,046 | 4,043 | $457 | $70 | $50 | 1.93 |
| Cardiology | 10,439 | 10,447 | $3,465 | $528 | $232 | 5.87 |
| Cardiac Cath Lab | 1,415 | 1,448 | $24,435 | $2,094 | $5,218 | 99.82 |
| Clinic | 32,588 | 34,050 | $131 | $67 | $97 | 1.41 |
| Magnetic Resonance Technology (MRT) | 14,210 | 14,638 | $2,805 | $147 | $131 | 3.92 |
| Drugs Requiring Specific Identification | 148,714 | 7,564,962 | $62 | $12 | $11 | 0.00 |
| Recovery Room | 9,968 | 777,501 | $18 | $5 | $0 | 0.00 |
| EKG/ECG (Electrocardiogram) | 13,974 | 18,150 | $376 | $27 | $8 | 0.78 |
| EEG (Electroencephalogram) | 377 | 385 | $1,335 | $216 | $185 | 3.29 |
| Observation Room | 4,971 | 194,158 | $69 | $11 | $0 | 3.18 |
| Treatment Room | 2,279 | 2,321 | $428 | $220 | $140 | 2.11 |
| Lithotripsy | 188 | 188 | $17,499 | $2,669 | $2,695 | 37.45 |
| Psychiatric / Psychological Treatments | 24 | 24 | $972 | $172 | $436 | 5.65 |
| Other Diagnostic Services | 7,014 | 7,210 | $1,363 | $198 | $158 | 2.98 |
| Other Therapeutic - Cardiac Rehab | 820 | 6,095 | $222 | $114 | $108 | 1.40 |
| Unclassified | 1,544 | 1,628 | $250 | $53 | $27 | 0.69 |
| 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 |