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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

SUMMIT HEALTHCARE REGIONAL MEDICAL CENTER

Show Low, AZ · CCN 030062 · Rates published

495 distinct procedures filed
19 distinct payers
8,684 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

1,295 of 8,684 rate rows are consumer-grade (14.9%)

7,389 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 7,389

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=L*__*5isnkJWsT9OFJEKfZzfA*-*
Found on page https://www.summithealthcare.net/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-19
Content fingerprint 61e8280c6b501f67… · 6,330,597 bytes · first seen 2026-05-15

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $293,340.22 $293,340.22 $293,340.22 nat. median
$133,176
outlier · 2.2×
9355
OTHER 		Inj. Teprotumumab-trbw 10 Mg 1 $173,562.16 $173,562.16 $173,562.16 nat. median
$369
outlier · 470.0×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 5 $138,292.36 $138,292.36 $138,292.36 nat. median
$66,526
outlier · 2.1×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $137,506.89 $137,506.89 $137,506.89 nat. median
$62,134
outlier · 2.2×
353
MS_DRG 		Hernia Procedures Except Inguinal And Femoral With Mcc 1 $115,037.56 $115,037.56 $115,037.56 nat. median
$28,775
outlier · 4.0×
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 1 $104,949.68 $104,949.68 $104,949.68 nat. median
$49,191
outlier · 2.1×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $104,310.64 $104,310.64 $104,310.64 nat. median
$72,138
1.4× median
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 5 $101,522.34 $101,522.34 $101,522.34 nat. median
$51,307
2.0× median
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $101,259.45 $101,259.45 $101,259.45 nat. median
$48,178
outlier · 2.1×
244
MS_DRG 		Permanent Cardiac Pacemaker Implant Without Cc/Mcc 1 $101,189.08 $101,189.08 $101,189.08 nat. median
$19,105
outlier · 5.3×
617
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 $97,936.97 $97,936.97 $97,936.97 nat. median
$19,476
outlier · 5.0×
5094
OTHER 		Level 4 Breast/Lymphatic Surgery And Related Procedures 1 $96,822.70 $96,822.70 $96,822.70 nat. median
$16,303
outlier · 5.9×
9494
OTHER 		Injection, Ocrelizumab 5 $93,473.34 $93,473.34 $93,473.34 nat. median
$61
outlier · 1529.8×
73
MS_DRG 		Cranial And Peripheral Nerve Disorders With Mcc 1 $92,316.74 $92,316.74 $92,316.74 nat. median
$16,028
outlier · 5.8×
0738
OTHER 		Rasburicase 3 $91,200.24 $91,200.24 $91,200.24 nat. median
$383
outlier · 238.0×
61
MS_DRG 		Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 $90,903.26 $90,903.26 $90,903.26 nat. median
$27,312
outlier · 3.3×
63
MS_DRG 		Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 $90,690.86 $90,690.86 $90,690.86 nat. median
$14,997
outlier · 6.0×
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $90,052.60 $90,052.60 $90,052.60 nat. median
$52,753
1.7× median
9010
OTHER 		Inj Efgartigimod 2mg 2 $83,540.18 $83,540.18 $83,540.18 nat. median
$33
outlier · 2514.8×
269
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 $83,416.95 $83,416.95 $83,416.95 nat. median
$41,527
outlier · 2.0×
9331
OTHER 		Inj, Polatuzumab Vedotin 1mg 2 $81,895.74 $81,895.74 $81,895.74 nat. median
$137
outlier · 595.8×
856
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 $78,684.10 $78,684.10 $78,684.10 nat. median
$43,966
1.8× median
628
MS_DRG 		Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 $77,439.04 $77,439.04 $77,439.04 nat. median
$37,237
outlier · 2.1×
616
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 $74,768.56 $74,768.56 $74,768.56 nat. median
$35,856
outlier · 2.1×
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 $72,383.06 $72,383.06 $72,383.06 nat. median
$37,664
1.9× median
495
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 $72,359.76 $72,359.76 $72,359.76 nat. median
$35,223
outlier · 2.1×
242
MS_DRG 		Permanent Cardiac Pacemaker Implant With Mcc 1 $69,811.82 $69,811.82 $69,811.82 nat. median
$32,829
outlier · 2.1×
252
MS_DRG 		Other Vascular Procedures With Mcc 1 $69,148.00 $69,148.00 $69,148.00 nat. median
$34,043
outlier · 2.0×
492
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 $68,056.93 $68,056.93 $68,056.93 nat. median
$35,489
1.9× median
5623
OTHER 		Level 3 Radiation Therapy 6 $68,043.07 $68,043.07 $68,043.07 nat. median
$723
outlier · 94.1×
328
MS_DRG 		Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 5 $67,576.67 $67,576.67 $67,576.67 nat. median
$16,642
outlier · 4.1×
485
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 $66,948.00 $66,948.00 $66,948.00 nat. median
$32,031
outlier · 2.1×
579
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 $64,215.70 $64,215.70 $64,215.70 nat. median
$31,572
outlier · 2.0×
500
MS_DRG 		Soft Tissue Procedures With Mcc 2 $63,868.15 $63,868.15 $63,868.15 nat. median
$31,070
outlier · 2.1×
896
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 2 $62,886.43 $62,886.43 $62,886.43 nat. median
$16,145
outlier · 3.9×
494
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc 3 $60,580.23 $60,580.23 $60,580.23 nat. median
$19,793
outlier · 3.1×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 $59,940.44 $59,940.44 $59,940.44 nat. median
$52,278
1.1× median
9290
OTHER 		Inj, Bupivacaine, Nos, 0.5mg 1 $59,479.00 $59,479.00 $59,479.00 nat. median
$3,856
outlier · 15.4×
673
MS_DRG 		Other Kidney And Urinary Tract Procedures With Mcc 3 $57,431.61 $57,431.61 $57,431.61 nat. median
$40,457
1.4× median
246
MS_DRG 		Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 1 $57,395.94 $57,395.94 $57,395.94 nat. median
$26,892
outlier · 2.1×
254
MS_DRG 		Other Vascular Procedures Without Cc/Mcc 3 $56,526.55 $56,526.55 $56,526.55 nat. median
$18,438
outlier · 3.1×
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 $56,073.50 $56,073.50 $56,073.50 nat. median
$26,748
outlier · 2.1×
503
MS_DRG 		Foot Procedures With Mcc 1 $54,188.96 $54,188.96 $54,188.96 nat. median
$26,999
outlier · 2.0×
510
MS_DRG 		Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 2 $54,170.97 $54,170.97 $54,170.97 nat. median
$29,046
1.9× median
659
MS_DRG 		Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 $53,377.44 $53,377.44 $53,377.44 nat. median
$25,587
outlier · 2.1×
468
MS_DRG 		Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 $53,078.06 $53,078.06 $53,078.06 nat. median
$27,218
2.0× median
934
MS_DRG 		Full Thickness Burn Without Skin Graft Or Inhalation Injury 1 $53,044.78 $53,044.78 $53,044.78 nat. median
$21,218
outlier · 2.5×
240
MS_DRG 		Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 $52,645.14 $52,645.14 $52,645.14 nat. median
$28,136
1.9× median
164
MS_DRG 		Major Chest Procedures With Cc 1 $52,583.66 $52,583.66 $52,583.66 nat. median
$25,707
outlier · 2.0×
907
MS_DRG 		Other O.r. Procedures For Injuries With Mcc 1 $52,294.76 $52,294.76 $52,294.76 nat. median
$38,112
1.4× median

Other procedures at this hospital

Browse this hospital's 495 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $293,340.22 $293,340.22 $293,340.22 2025-01-01
9355 OTHER Inj. Teprotumumab-trbw 10 Mg 1 1 — — $173,562.16 $173,562.16 $173,562.16 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 5 5 — — $138,292.36 $138,292.36 $138,292.36 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 2 — — $137,506.89 $137,506.89 $137,506.89 2025-01-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $115,037.56 $115,037.56 $115,037.56 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $104,949.68 $104,949.68 $104,949.68 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $104,310.64 $104,310.64 $104,310.64 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 5 5 — — $101,522.34 $101,522.34 $101,522.34 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $101,259.45 $101,259.45 $101,259.45 2025-01-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 1 1 — — $101,189.08 $101,189.08 $101,189.08 2025-01-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 — — $97,936.97 $97,936.97 $97,936.97 2025-01-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 1 1 — — $96,822.70 $96,822.70 $96,822.70 2025-01-01
9494 OTHER Injection, Ocrelizumab 6 5 — — $93,473.34 $93,473.34 $93,473.34 2025-01-01
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 1 1 — — $92,316.74 $92,316.74 $92,316.74 2025-01-01
0738 OTHER Rasburicase 3 3 — — $91,200.24 $91,200.24 $91,200.24 2025-01-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 4 — — $90,903.26 $90,903.26 $90,903.26 2025-01-01
63 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 3 — — $90,690.86 $90,690.86 $90,690.86 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $90,052.60 $90,052.60 $90,052.60 2025-01-01
9010 OTHER Inj Efgartigimod 2mg 3 2 — — $83,540.18 $83,540.18 $83,540.18 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 4 — — $83,416.95 $83,416.95 $83,416.95 2025-01-01
9331 OTHER Inj, Polatuzumab Vedotin 1mg 3 2 — — $81,895.74 $81,895.74 $81,895.74 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 1 — — $78,684.10 $78,684.10 $78,684.10 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $77,439.04 $77,439.04 $77,439.04 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $74,768.56 $74,768.56 $74,768.56 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $72,383.06 $72,383.06 $72,383.06 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $72,359.76 $72,359.76 $72,359.76 2025-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $69,811.82 $69,811.82 $69,811.82 2025-01-01
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $69,148.00 $69,148.00 $69,148.00 2025-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 2 — — $68,056.93 $68,056.93 $68,056.93 2025-01-01
5623 OTHER Level 3 Radiation Therapy 7 6 — — $68,043.07 $68,043.07 $68,043.07 2025-01-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 6 5 — — $67,576.67 $67,576.67 $67,576.67 2025-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $66,948.00 $66,948.00 $66,948.00 2025-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $64,215.70 $64,215.70 $64,215.70 2025-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 2 2 — — $63,868.15 $63,868.15 $63,868.15 2025-01-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 2 2 — — $62,886.43 $62,886.43 $62,886.43 2025-01-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc 3 3 — — $60,580.23 $60,580.23 $60,580.23 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 2 — — $59,940.44 $59,940.44 $59,940.44 2025-01-01
9290 OTHER Inj, Bupivacaine, Nos, 0.5mg 1 1 — — $59,479.00 $59,479.00 $59,479.00 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 — — $57,431.61 $57,431.61 $57,431.61 2025-01-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 1 1 — — $57,395.94 $57,395.94 $57,395.94 2025-01-01
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 3 3 — — $56,526.55 $56,526.55 $56,526.55 2025-01-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 2 — — $56,073.50 $56,073.50 $56,073.50 2025-01-01
503 MS_DRG Foot Procedures With Mcc 1 1 — — $54,188.96 $54,188.96 $54,188.96 2025-01-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 2 2 — — $54,170.97 $54,170.97 $54,170.97 2025-01-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $53,377.44 $53,377.44 $53,377.44 2025-01-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 1 — — $53,078.06 $53,078.06 $53,078.06 2025-01-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 1 1 — — $53,044.78 $53,044.78 $53,044.78 2025-01-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $52,645.14 $52,645.14 $52,645.14 2025-01-01
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $52,583.66 $52,583.66 $52,583.66 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $52,294.76 $52,294.76 $52,294.76 2025-01-01
800 MS_DRG Splenic Procedures With Cc 1 1 — — $51,455.18 $51,455.18 $51,455.18 2025-01-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 1 1 — — $51,255.88 $51,255.88 $51,255.88 2025-01-01
748 MS_DRG Female Reproductive System Reconstructive Procedures 1 1 — — $51,061.40 $51,061.40 $51,061.40 2025-01-01
1471 OTHER Injection, Pertuzumab, 1 Mg 4 4 — — $49,014.82 $49,014.82 $49,014.82 2025-01-01
9490 OTHER Inj, Bezlotoxumab, 10 Mg 1 1 — — $48,362.14 $48,362.14 $48,362.14 2025-01-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 2 2 — — $47,583.52 $47,583.52 $47,583.52 2025-01-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 3 3 — — $47,217.64 $47,217.64 $47,217.64 2025-01-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 1 — — $46,562.52 $46,562.52 $46,562.52 2025-01-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $46,251.44 $46,251.44 $46,251.44 2025-01-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 1 1 — — $45,880.96 $45,880.96 $45,880.96 2025-01-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 1 1 — — $45,836.76 $45,836.76 $45,836.76 2025-01-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 2 — — $45,831.22 $45,831.22 $45,831.22 2025-01-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 4 4 — — $45,807.57 $45,807.57 $45,807.57 2025-01-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $45,499.68 $45,499.68 $45,499.68 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $44,952.86 $44,952.86 $44,952.86 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 — — $43,790.73 $43,790.73 $43,790.73 2025-01-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 3 — — $42,910.82 $42,910.82 $42,910.82 2025-01-01
5223 OTHER Level 3 Pacemaker And Similar Procedures 6 4 — — $42,781.49 $42,781.49 $42,781.49 2025-01-01
9453 OTHER Injection, Nivolumab 6 5 — — $42,706.06 $42,706.06 $42,706.06 2025-01-01
374 MS_DRG Digestive Malignancy With Mcc 1 1 — — $41,884.66 $41,884.66 $41,884.66 2025-01-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc/Mcc 1 1 — — $41,787.94 $41,787.94 $41,787.94 2025-01-01
5378 OTHER Level 8 Urology And Related Services 1 1 — — $41,471.82 $41,471.82 $41,471.82 2025-01-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $41,184.64 $41,184.64 $41,184.64 2025-01-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 1 1 — — $40,961.46 $40,961.46 $40,961.46 2025-01-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 2 2 — — $40,892.78 $40,892.78 $40,892.78 2025-01-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $40,648.96 $40,648.96 $40,648.96 2025-01-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 1 1 — — $40,645.92 $40,645.92 $40,645.92 2025-01-01
9347 OTHER Inj Luspatercept-aamt 0.25mg 3 3 — — $40,562.30 $40,562.30 $40,562.30 2025-01-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 1 1 — — $40,476.18 $40,476.18 $40,476.18 2025-01-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 4 4 — — $39,835.57 $39,835.57 $39,835.57 2025-01-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 2 — — $39,427.96 $39,427.96 $39,427.96 2025-01-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc 1 1 — — $39,301.42 $39,301.42 $39,301.42 2025-01-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 7 6 — — $38,510.65 $38,510.65 $38,510.65 2025-01-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 1 1 — — $38,096.64 $38,096.64 $38,096.64 2025-01-01
9483 OTHER Inj, Atezolizumab,10 Mg 4 4 — — $37,599.40 $37,599.40 $37,599.40 2025-01-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 1 1 — — $37,548.98 $37,548.98 $37,548.98 2025-01-01
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $37,341.28 $37,341.28 $37,341.28 2025-01-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 — — $36,919.98 $36,919.98 $36,919.98 2025-01-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 2 — — $36,603.61 $36,603.61 $36,603.61 2025-01-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 1 1 — — $36,413.42 $36,413.42 $36,413.42 2025-01-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 1 1 — — $36,353.64 $36,353.64 $36,353.64 2025-01-01
9284 OTHER Ipilimumab Injection 3 3 — — $36,150.42 $36,150.42 $36,150.42 2025-01-01
858 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/Mcc 1 1 — — $35,040.44 $35,040.44 $35,040.44 2025-01-01
571 MS_DRG Skin Debridement With Cc 1 1 — — $34,826.24 $34,826.24 $34,826.24 2025-01-01
784 MS_DRG Cesarean Section With Sterilization With Cc 1 1 — — $33,753.30 $33,753.30 $33,753.30 2025-01-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 2 2 — — $33,517.61 $33,517.61 $33,517.61 2025-01-01
5155 OTHER Level 5 Airway Endoscopy 2 2 — — $33,321.27 $33,321.27 $33,321.27 2025-01-01
9295 OTHER Injection, Carfilzomib, 1 Mg 1 1 — — $33,103.36 $33,103.36 $33,103.36 2025-01-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 3 3 — — $33,091.05 $33,091.05 $33,091.05 2025-01-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 3 — — $32,878.12 $32,878.12 $32,878.12 2025-01-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 3 — — $32,496.42 $32,496.42 $32,496.42 2025-01-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $32,238.66 $32,238.66 $32,238.66 2025-01-01
504 MS_DRG Foot Procedures With Cc 5 4 — — $31,889.06 $31,889.06 $31,889.06 2025-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $31,575.82 $31,575.82 $31,575.82 2025-01-01
785 MS_DRG Cesarean Section With Sterilization Without Cc/Mcc 2 2 — — $31,200.22 $31,200.22 $31,200.22 2025-01-01
199 MS_DRG Pneumothorax With Mcc 3 3 — — $31,178.38 $31,178.38 $31,178.38 2025-01-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 2 2 — — $31,146.51 $31,146.51 $31,146.51 2025-01-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 6 5 — — $31,032.22 $31,032.22 $31,032.22 2025-01-01
9330 OTHER Inj., Kanjinti, 10 Mg 1 1 — — $31,024.56 $31,024.56 $31,024.56 2025-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 6 4 — — $30,992.14 $30,992.14 $30,992.14 2025-01-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 6 5 — — $30,815.24 $30,815.24 $30,815.24 2025-01-01
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/Mcc 2 2 — — $30,338.46 $30,338.46 $30,338.46 2025-01-01
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 1 1 — — $30,005.54 $30,005.54 $30,005.54 2025-01-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 3 3 — — $29,558.54 $29,558.54 $29,558.54 2025-01-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/Mc… 1 1 — — $29,321.00 $29,321.00 $29,321.00 2025-01-01
398 MS_DRG Appendix Procedures With Cc 3 3 — — $29,156.96 $29,156.96 $29,156.96 2025-01-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 1 1 — — $29,036.66 $29,036.66 $29,036.66 2025-01-01
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 1 1 — — $28,917.26 $28,917.26 $28,917.26 2025-01-01
5061 OTHER Hyperbaric Oxygen 8 7 — — $28,855.94 $28,855.94 $28,855.94 2025-01-01
643 MS_DRG Endocrine Disorders With Mcc 2 2 — — $28,701.28 $28,701.28 $28,701.28 2025-01-01
5194 OTHER Level 4 Endovascular Procedures 6 4 — — $27,851.24 $27,851.24 $27,851.24 2025-01-01
253 MS_DRG Other Vascular Procedures With Cc 5 4 — — $27,766.08 $27,766.08 $27,766.08 2025-01-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 5 4 — — $27,574.49 $27,574.49 $27,574.49 2025-01-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 3 3 — — $27,534.66 $27,534.66 $27,534.66 2025-01-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 1 1 — — $27,503.68 $27,503.68 $27,503.68 2025-01-01
70 MS_DRG Nonspecific Cerebrovascular Disorders With Mcc 2 2 — — $27,357.38 $27,357.38 $27,357.38 2025-01-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 1 1 — — $27,355.68 $27,355.68 $27,355.68 2025-01-01
100 MS_DRG Seizures With Mcc 3 3 — — $27,108.48 $27,108.48 $27,108.48 2025-01-01
642 MS_DRG Inborn And Other Disorders Of Metabolism 1 1 — — $26,566.78 $26,566.78 $26,566.78 2025-01-01
506 MS_DRG Major Thumb Or Joint Procedures 1 1 — — $26,289.12 $26,289.12 $26,289.12 2025-01-01
1207 OTHER Octreotide Injection, Depot 3 3 — — $26,164.29 $26,164.29 $26,164.29 2025-01-01
9364 OTHER Inj Enfort Vedo-ejfv 0.25mg 2 2 — — $25,992.47 $25,992.47 $25,992.47 2025-01-01
548 MS_DRG Septic Arthritis With Mcc 1 1 — — $25,839.72 $25,839.72 $25,839.72 2025-01-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 4 3 — — $25,817.27 $25,817.27 $25,817.27 2025-01-01
186 MS_DRG Pleural Effusion With Mcc 2 2 — — $25,757.96 $25,757.96 $25,757.96 2025-01-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 3 3 — — $25,512.17 $25,512.17 $25,512.17 2025-01-01
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/Mcc 1 1 — — $25,286.92 $25,286.92 $25,286.92 2025-01-01
627 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/Mcc 1 1 — — $25,199.18 $25,199.18 $25,199.18 2025-01-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 3 2 — — $25,059.35 $25,059.35 $25,059.35 2025-01-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 6 5 — — $24,880.66 $24,880.66 $24,880.66 2025-01-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 9 8 — — $24,841.76 $24,841.76 $24,841.76 2025-01-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 2 — — $24,609.96 $24,609.96 $24,609.96 2025-01-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 3 3 — — $24,576.54 $24,576.54 $24,576.54 2025-01-01
204 MS_DRG Respiratory Signs And Symptoms 2 2 — — $24,535.00 $24,535.00 $24,535.00 2025-01-01
533 MS_DRG Fractures Of Femur With Mcc 1 1 — — $24,360.46 $24,360.46 $24,360.46 2025-01-01
598 MS_DRG Malignant Breast Disorders With Cc 1 1 — — $24,222.30 $24,222.30 $24,222.30 2025-01-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 10 8 — — $24,103.23 $24,103.23 $24,103.23 2025-01-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 4 3 — — $23,821.87 $23,821.87 $23,821.87 2025-01-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 1 — — $23,449.29 $23,449.29 $23,449.29 2025-01-01
348 MS_DRG Anal And Stomal Procedures With Cc 1 1 — — $23,274.16 $23,274.16 $23,274.16 2025-01-01
881 MS_DRG Depressive Neuroses 10 8 — — $23,137.93 $23,137.93 $23,137.93 2025-01-01
386 MS_DRG Inflammatory Bowel Disease With Cc 3 3 — — $22,972.15 $22,972.15 $22,972.15 2025-01-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 4 4 — — $22,863.04 $22,863.04 $22,863.04 2025-01-01
304 MS_DRG Hypertension With Mcc 1 1 — — $22,674.32 $22,674.32 $22,674.32 2025-01-01
883 MS_DRG Disorders Of Personality And Impulse Control 1 1 — — $22,669.38 $22,669.38 $22,669.38 2025-01-01
5471 OTHER Implantation Of Drug Infusion Device 3 3 — — $22,646.75 $22,646.75 $22,646.75 2025-01-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 6 4 — — $22,622.99 $22,622.99 $22,622.99 2025-01-01
5361 OTHER Level 1 Laparoscopy And Related Services 21 14 — — $22,605.44 $22,605.44 $22,605.44 2025-01-01
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 1 1 — — $22,472.00 $22,472.00 $22,472.00 2025-01-01
603 MS_DRG Cellulitis Without Mcc 9 7 — — $22,363.61 $22,363.61 $22,363.61 2025-01-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 9 8 — — $22,246.99 $22,246.99 $22,246.99 2025-01-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/Mcc 8 8 — — $22,148.60 $22,148.60 $22,148.60 2025-01-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 3 3 — — $21,976.08 $21,976.08 $21,976.08 2025-01-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 2 — — $21,905.75 $21,905.75 $21,905.75 2025-01-01
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 1 1 — — $21,822.22 $21,822.22 $21,822.22 2025-01-01
300 MS_DRG Peripheral Vascular Disorders With Cc 1 1 — — $21,534.62 $21,534.62 $21,534.62 2025-01-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/Mcc 1 1 — — $21,028.58 $21,028.58 $21,028.58 2025-01-01
593 MS_DRG Skin Ulcers With Cc 1 1 — — $20,803.54 $20,803.54 $20,803.54 2025-01-01
884 MS_DRG Organic Disturbances And Intellectual Disability 7 5 — — $20,771.17 $20,771.17 $20,771.17 2025-01-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 3 2 — — $20,693.00 $20,693.00 $20,693.00 2025-01-01
5184 OTHER Level 4 Vascular Procedures 6 5 — — $20,621.28 $20,621.28 $20,621.28 2025-01-01
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/Mcc 2 2 — — $20,568.74 $20,568.74 $20,568.74 2025-01-01
683 MS_DRG Renal Failure With Cc 7 6 — — $20,486.32 $20,486.32 $20,486.32 2025-01-01
369 MS_DRG Major Esophageal Disorders With Cc 1 1 — — $20,376.58 $20,376.58 $20,376.58 2025-01-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 2 1 — — $20,296.58 $20,296.58 $20,296.58 2025-01-01
375 MS_DRG Digestive Malignancy With Cc 1 1 — — $20,096.16 $20,096.16 $20,096.16 2025-01-01
919 MS_DRG Complications Of Treatment With Mcc 3 2 — — $20,039.84 $20,039.84 $20,039.84 2025-01-01
184 MS_DRG Major Chest Trauma With Cc 1 1 — — $19,637.12 $19,637.12 $19,637.12 2025-01-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 5 5 — — $19,571.47 $19,571.47 $19,571.47 2025-01-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 — — $19,423.44 $19,423.44 $19,423.44 2025-01-01
513 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc 2 2 — — $19,297.32 $19,297.32 $19,297.32 2025-01-01
68 MS_DRG Nonspecific Cva And Precerebral Occlusion Without Infarction Without Mcc 2 2 — — $19,290.51 $19,290.51 $19,290.51 2025-01-01
93 MS_DRG Other Disorders Of Nervous System Without Cc/Mcc 1 1 — — $19,209.92 $19,209.92 $19,209.92 2025-01-01
920 MS_DRG Complications Of Treatment With Cc 2 2 — — $19,152.80 $19,152.80 $19,152.80 2025-01-01
103 MS_DRG Headaches Without Mcc 1 1 — — $19,118.60 $19,118.60 $19,118.60 2025-01-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 4 4 — — $18,901.12 $18,901.12 $18,901.12 2025-01-01
92 MS_DRG Other Disorders Of Nervous System With Cc 2 2 — — $18,452.32 $18,452.32 $18,452.32 2025-01-01
9013 OTHER Inj Risankizumab-rzaa?1 Mg 2 1 — — $18,425.03 $18,425.03 $18,425.03 2025-01-01
9512 OTHER Rbc Leukocytes Reduced 3 3 — — $18,385.79 $18,385.79 $18,385.79 2025-01-01
793 MS_DRG Full Term Neonate With Major Problems 5 5 — — $18,207.53 $18,207.53 $18,207.53 2025-01-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 1 1 — — $18,185.04 $18,185.04 $18,185.04 2025-01-01
399 MS_DRG Appendix Procedures Without Cc/Mcc 1 1 — — $18,184.84 $18,184.84 $18,184.84 2025-01-01
381 MS_DRG Complicated Peptic Ulcer With Cc 1 1 — — $18,133.84 $18,133.84 $18,133.84 2025-01-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 2 2 — — $17,878.30 $17,878.30 $17,878.30 2025-01-01
5092 OTHER Level 2 Breast/Lymphatic Surgery And Related Procedures 7 7 — — $17,868.10 $17,868.10 $17,868.10 2025-01-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 4 3 — — $17,855.20 $17,855.20 $17,855.20 2025-01-01
882 MS_DRG Neuroses Except Depressive 1 1 — — $17,814.20 $17,814.20 $17,814.20 2025-01-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 2 2 — — $17,692.19 $17,692.19 $17,692.19 2025-01-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 6 5 — — $17,685.60 $17,685.60 $17,685.60 2025-01-01
183 MS_DRG Major Chest Trauma With Mcc 2 2 — — $17,679.50 $17,679.50 $17,679.50 2025-01-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 9 7 — — $17,616.56 $17,616.56 $17,616.56 2025-01-01
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 2 2 — — $17,529.08 $17,529.08 $17,529.08 2025-01-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 8 7 — — $17,420.61 $17,420.61 $17,420.61 2025-01-01
9492 OTHER Inj., Durvalumab, 10 Mg 4 3 — — $17,371.65 $17,371.65 $17,371.65 2025-01-01
583 MS_DRG Mastectomy For Malignancy Without Cc/Mcc 3 2 — — $17,337.61 $17,337.61 $17,337.61 2025-01-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 11 7 — — $17,130.61 $17,130.61 $17,130.61 2025-01-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 3 3 — — $16,883.76 $16,883.76 $16,883.76 2025-01-01
200 MS_DRG Pneumothorax With Cc 2 2 — — $16,649.62 $16,649.62 $16,649.62 2025-01-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 1 1 — — $16,595.14 $16,595.14 $16,595.14 2025-01-01
9126 OTHER Natalizumab Injection 1 1 — — $16,553.72 $16,553.72 $16,553.72 2025-01-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 1 — — $16,381.44 $16,381.44 $16,381.44 2025-01-01
534 MS_DRG Fractures Of Femur Without Mcc 1 1 — — $16,366.44 $16,366.44 $16,366.44 2025-01-01
639 MS_DRG Diabetes Without Cc/Mcc 2 2 — — $16,356.77 $16,356.77 $16,356.77 2025-01-01
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc 2 1 — — $16,349.87 $16,349.87 $16,349.87 2025-01-01
5153 OTHER Level 3 Airway Endoscopy 7 6 — — $16,309.74 $16,309.74 $16,309.74 2025-01-01
38 MS_DRG Extracranial Procedures With Cc 2 2 — — $16,137.98 $16,137.98 $16,137.98 2025-01-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 7 6 — — $16,133.01 $16,133.01 $16,133.01 2025-01-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 2 — — $16,130.04 $16,130.04 $16,130.04 2025-01-01
101 MS_DRG Seizures Without Mcc 2 2 — — $16,110.71 $16,110.71 $16,110.71 2025-01-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 9 7 — — $16,039.76 $16,039.76 $16,039.76 2025-01-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 — — $15,985.62 $15,985.62 $15,985.62 2025-01-01
389 MS_DRG Gastrointestinal Obstruction With Cc 7 6 — — $15,919.46 $15,919.46 $15,919.46 2025-01-01
682 MS_DRG Renal Failure With Mcc 8 5 — — $15,788.32 $15,788.32 $15,788.32 2025-01-01
811 MS_DRG Red Blood Cell Disorders With Mcc 5 5 — — $15,731.44 $15,731.44 $15,731.44 2025-01-01
915 MS_DRG Allergic Reactions With Mcc 2 2 — — $15,693.53 $15,693.53 $15,693.53 2025-01-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 16 10 — — $15,570.99 $15,570.99 $15,570.99 2025-01-01
602 MS_DRG Cellulitis With Mcc 3 3 — — $15,547.19 $15,547.19 $15,547.19 2025-01-01
312 MS_DRG Syncope And Collapse 2 2 — — $15,145.12 $15,145.12 $15,145.12 2025-01-01
5791 OTHER Pulmonary Treatment 4 4 — — $15,053.79 $15,053.79 $15,053.79 2025-01-01
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 1 1 — — $15,039.82 $15,039.82 $15,039.82 2025-01-01
638 MS_DRG Diabetes With Cc 7 5 — — $15,003.91 $15,003.91 $15,003.91 2025-01-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 — — $14,960.02 $14,960.02 $14,960.02 2025-01-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 1 1 — — $14,801.10 $14,801.10 $14,801.10 2025-01-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 8 8 — — $14,752.86 $14,752.86 $14,752.86 2025-01-01
5415 OTHER Level 5 Gynecologic Procedures 12 9 — — $14,734.77 $14,734.77 $14,734.77 2025-01-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 8 7 — — $14,729.58 $14,729.58 $14,729.58 2025-01-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc 3 3 — — $14,442.68 $14,442.68 $14,442.68 2025-01-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 1 — — $14,325.20 $14,325.20 $14,325.20 2025-01-01
152 MS_DRG Otitis Media And Uri With Mcc 2 2 — — $14,311.79 $14,311.79 $14,311.79 2025-01-01
947 MS_DRG Signs And Symptoms With Mcc 1 1 — — $14,304.62 $14,304.62 $14,304.62 2025-01-01
0965 OTHER Albumin (human), 25%, 50ml 1 1 — — $14,285.80 $14,285.80 $14,285.80 2025-01-01
176 MS_DRG Pulmonary Embolism Without Mcc 4 2 — — $14,264.55 $14,264.55 $14,264.55 2025-01-01
39 MS_DRG Extracranial Procedures Without Cc/Mcc 6 5 — — $14,200.82 $14,200.82 $14,200.82 2025-01-01
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 6 6 — — $14,169.01 $14,169.01 $14,169.01 2025-01-01
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 3 3 — — $14,131.34 $14,131.34 $14,131.34 2025-01-01
305 MS_DRG Hypertension Without Mcc 1 1 — — $14,063.88 $14,063.88 $14,063.88 2025-01-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 5 4 — — $13,777.49 $13,777.49 $13,777.49 2025-01-01
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 1 1 — — $13,677.40 $13,677.40 $13,677.40 2025-01-01
816 MS_DRG Reticuloendothelial And Immunity Disorders Without Cc/Mcc 1 1 — — $13,663.90 $13,663.90 $13,663.90 2025-01-01
5113 OTHER Level 3 Musculoskeletal Procedures 19 12 — — $13,560.52 $13,560.52 $13,560.52 2025-01-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 15 13 — — $13,268.55 $13,268.55 $13,268.55 2025-01-01
885 MS_DRG Psychoses 9 7 — — $13,249.51 $13,249.51 $13,249.51 2025-01-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 1 1 — — $13,210.88 $13,210.88 $13,210.88 2025-01-01
553 MS_DRG Bone Diseases And Arthropathies With Mcc 1 1 — — $13,114.28 $13,114.28 $13,114.28 2025-01-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 2 2 — — $13,075.10 $13,075.10 $13,075.10 2025-01-01
1489 OTHER Inj Vedolizumab IV 1 Mg 2 2 — — $12,992.85 $12,992.85 $12,992.85 2025-01-01
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/Mcc 12 12 — — $12,938.34 $12,938.34 $12,938.34 2025-01-01
9036 OTHER Injection, Renflexis 1 1 — — $12,539.88 $12,539.88 $12,539.88 2025-01-01
794 MS_DRG Neonate With Other Significant Problems 7 7 — — $12,392.27 $12,392.27 $12,392.27 2025-01-01
9442 OTHER Inj. Pemetrexed, 10 Mg 3 3 — — $12,386.97 $12,386.97 $12,386.97 2025-01-01
0901 OTHER Alpha 1 Proteinase Inhibitor 2 2 — — $12,372.85 $12,372.85 $12,372.85 2025-01-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 6 5 — — $12,278.26 $12,278.26 $12,278.26 2025-01-01
9353 OTHER Inj Fam-trastu Deru-nxki 1mg 1 1 — — $12,224.76 $12,224.76 $12,224.76 2025-01-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 4 4 — — $12,219.02 $12,219.02 $12,219.02 2025-01-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 8 7 — — $12,136.14 $12,136.14 $12,136.14 2025-01-01
5432 OTHER Level 2 Nerve Procedures 3 3 — — $12,086.52 $12,086.52 $12,086.52 2025-01-01
60 MS_DRG Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc 1 1 — — $11,990.78 $11,990.78 $11,990.78 2025-01-01
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 1 1 — — $11,961.17 $11,961.17 $11,961.17 2025-01-01
951 MS_DRG Other Factors Influencing Health Status 1 1 — — $11,805.62 $11,805.62 $11,805.62 2025-01-01
9378 OTHER Daratumumab, Hyaluronidase 8 6 — — $11,799.63 $11,799.63 $11,799.63 2025-01-01
303 MS_DRG Atherosclerosis Without Mcc 2 2 — — $11,754.41 $11,754.41 $11,754.41 2025-01-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 3 2 — — $11,664.80 $11,664.80 $11,664.80 2025-01-01
644 MS_DRG Endocrine Disorders With Cc 1 1 — — $11,576.72 $11,576.72 $11,576.72 2025-01-01
387 MS_DRG Inflammatory Bowel Disease Without Cc/Mcc 1 1 — — $11,556.76 $11,556.76 $11,556.76 2025-01-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 5 5 — — $11,539.07 $11,539.07 $11,539.07 2025-01-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 2 2 — — $11,444.20 $11,444.20 $11,444.20 2025-01-01
9304 OTHER Inj., Cemiplimab-rwlc, 1 Mg 3 2 — — $11,392.61 $11,392.61 $11,392.61 2025-01-01
551 MS_DRG Medical Back Problems With Mcc 2 2 — — $11,362.27 $11,362.27 $11,362.27 2025-01-01
340 MS_DRG Appendectomy With Complicated Principal Diagnosis Without Cc/Mcc 1 1 — — $11,313.78 $11,313.78 $11,313.78 2025-01-01
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/Or D&c 1 1 — — $11,244.31 $11,244.31 $11,244.31 2025-01-01
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 20 12 — — $11,231.25 $11,231.25 $11,231.25 2025-01-01
5165 OTHER Level 5 ENT Procedures 3 3 — — $11,013.85 $11,013.85 $11,013.85 2025-01-01
2033 OTHER Cath, Trans Intra Litho/coro 1 1 — — $10,646.24 $10,646.24 $10,646.24 2025-01-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 5 5 — — $10,622.82 $10,622.82 $10,622.82 2025-01-01
5222 OTHER Level 2 Pacemaker And Similar Procedures 4 3 — — $10,583.68 $10,583.68 $10,583.68 2025-01-01
923 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 1 1 — — $10,376.48 $10,376.48 $10,376.48 2025-01-01
948 MS_DRG Signs And Symptoms Without Mcc 1 1 — — $10,346.30 $10,346.30 $10,346.30 2025-01-01
792 MS_DRG Prematurity Without Major Problems 2 2 — — $10,204.36 $10,204.36 $10,204.36 2025-01-01
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 2 2 — — $10,125.30 $10,125.30 $10,125.30 2025-01-01
5414 OTHER Level 4 Gynecologic Procedures 15 9 — — $10,049.19 $10,049.19 $10,049.19 2025-01-01
645 MS_DRG Endocrine Disorders Without Cc/Mcc 2 2 — — $9,998.89 $9,998.89 $9,998.89 2025-01-01
5192 OTHER Level 2 Endovascular Procedures 7 5 — — $9,838.23 $9,838.23 $9,838.23 2025-01-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 7 6 — — $9,603.17 $9,603.17 $9,603.17 2025-01-01
203 MS_DRG Bronchitis And Asthma Without Cc/Mcc 1 1 — — $9,282.30 $9,282.30 $9,282.30 2025-01-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 5 4 — — $9,277.04 $9,277.04 $9,277.04 2025-01-01
916 MS_DRG Allergic Reactions Without Mcc 1 1 — — $9,075.88 $9,075.88 $9,075.88 2025-01-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 2 1 — — $9,066.33 $9,066.33 $9,066.33 2025-01-01
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 2 2 — — $8,884.78 $8,884.78 $8,884.78 2025-01-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 5 4 — — $8,814.18 $8,814.18 $8,814.18 2025-01-01
5372 OTHER Level 2 Urology And Related Services 2 2 — — $8,734.33 $8,734.33 $8,734.33 2025-01-01
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