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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

BRADLEY COUNTY MEDICAL CENTER

Warren, AR · CCN 041327 · Rates published

20,185 distinct procedures filed
14 distinct payers
278,723 rate rows
2026-04-08 last MRF observed
Data quality

152,111 of 278,723 rate rows are consumer-grade (54.6%)

126,612 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 113,813
per-diem day rate — not a per-procedure price 9,291
template filing: same amount across many unrelated codes — excluded 1,774
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,534
exceeds 10× this hospital's gross charge — excluded from medians 87
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 76
placeholder amount (≤ $0.02) — excluded from medians 37
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/BradleyCountyMedicalCenter/710797499_bradley-county-medical-center_standardcharges.csv
Found on page https://www.bradleycountymedicalcenter.com/getpage.php?name=charge_transparency&sub=Charge+Transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-20
Content fingerprint 7a3ff7ff6a34f0a4… · 57,623,069 bytes · first seen 2026-05-09

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
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $3,648,000.00 $3,720,960.00 $3,684,480.00 nat. median
$3,325,455
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $530,100.00 $540,702.00 $535,401.00 nat. median
$599,737
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 12 $478,230.00 $487,794.60 $483,012.30 nat. median
$574,037
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 12 $467,742.00 $477,096.84 $472,419.42 nat. median
$579,571
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $454,860.00 $463,957.20 $459,408.60 nat. median
$562,501
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $454,860.00 $463,957.20 $459,408.60 nat. median
$513,770
0.9× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 13 $299,250.00 $305,235.00 $302,242.50 nat. median
$286,598
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $297,184.03 $297,184.03 $297,184.03 nat. median
$168,055
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $192,860.48 $192,860.48 $192,860.48 nat. median
$186,516
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $146,934.14 $146,934.14 $146,934.14 nat. median
$131,925
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $146,071.83 $146,071.83 $146,071.83 nat. median
$145,435
1.0× median
100T
OTHER 		Prosth Retina Receive&gen 11 $10,000.00 $181,442.80 $95,721.40 nat. median
$2,520
outlier · 38.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $95,325.33 $95,325.33 $95,325.33 nat. median
$97,418
1.0× median
7
MS_DRG 		Lung Transplant 1 $89,123.28 $89,123.28 $89,123.28 nat. median
$70,649
1.3× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $82,707.19 $82,707.19 $82,707.19 nat. median
$72,715
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $77,985.45 $77,985.45 $77,985.45 nat. median
$65,418
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 11 $77,299.65 $77,299.65 $77,299.65 nat. median
$65,477
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $75,847.90 $75,847.90 $75,847.90 nat. median
$2,736
outlier · 27.7×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $74,835.56 $74,835.56 $74,835.56 nat. median
$74,509
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $70,956.86 $70,956.86 $70,956.86 nat. median
$69,922
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 1 $68,524.07 $68,524.07 $68,524.07 nat. median
$73,023
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $67,325.23 $67,325.23 $67,325.23 nat. median
$69,822
1.0× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 13 $60,636.60 $69,768.00 $65,202.30 nat. median
$66,211
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 $62,004.07 $62,004.07 $62,004.07 nat. median
$2,596
outlier · 23.9×
850
MS_DRG 		Acute Leukemia With Other Procedures 1 $59,594.68 $59,594.68 $59,594.68 nat. median
$2,633
outlier · 22.6×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $58,014.57 $58,014.57 $58,014.57 nat. median
$60,505
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $57,832.20 $57,832.20 $57,832.20 nat. median
$59,651
1.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $54,153.08 $54,153.08 $54,153.08 nat. median
$56,428
1.0× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 13 $52,916.50 $53,974.83 $53,445.67 nat. median
$63,499
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $52,842.06 $52,842.06 $52,842.06 nat. median
$55,923
0.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $52,614.27 $52,614.27 $52,614.27 nat. median
$55,935
0.9× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $52,440.15 $52,440.15 $52,440.15 nat. median
$52,327
1.0× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $49,678.41 $49,678.41 $49,678.41 nat. median
$9,905
outlier · 5.0×
10
MS_DRG 		Pancreas Transplant 1 $49,383.17 $49,383.17 $49,383.17 nat. median
$23,080
outlier · 2.1×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 $49,362.52 $49,362.52 $49,362.52 nat. median
$37,013
1.3× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $49,100.32 $49,100.32 $49,100.32 nat. median
$45,605
1.1× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $49,071.41 $49,071.41 $49,071.41 nat. median
$51,518
1.0× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $47,567.01 $47,567.01 $47,567.01 nat. median
$48,611
1.0× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 $47,333.71 $47,333.71 $47,333.71 nat. median
$49,569
1.0× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $46,323.43 $46,323.43 $46,323.43 nat. median
$47,340
1.0× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 $46,016.49 $46,016.49 $46,016.49 nat. median
$2,633
outlier · 17.5×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 $45,982.77 $45,982.77 $45,982.77 nat. median
$2,958
outlier · 15.5×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $45,251.21 $45,251.21 $45,251.21 nat. median
$45,446
1.0× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $45,251.21 $45,251.21 $45,251.21 nat. median
$47,458
1.0× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 $45,086.73 $45,086.73 $45,086.73 nat. median
$43,299
1.0× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $44,283.61 $44,283.61 $44,283.61 nat. median
$47,121
0.9× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 $42,175.65 $42,175.65 $42,175.65 nat. median
$44,036
1.0× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 1 $42,126.79 $42,126.79 $42,126.79 nat. median
$41,943
1.0× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $41,722.81 $41,722.81 $41,722.81 nat. median
$43,803
1.0× median
28
MS_DRG 		Spinal Procedures With Mcc 1 $41,349.12 $41,349.12 $41,349.12 nat. median
$41,895
1.0× median

Other procedures at this hospital

Browse this hospital's 20,185 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
             
J1413 HCPCS Inj Delandistrogene Mox Rokl 15 13 — — $3,648,000.00 $3,720,960.00 $3,684,480.00 2026-04-08
Q2056 HCPCS Ciltacabtagene Car-pos T 15 13 — — $530,100.00 $540,702.00 $535,401.00 2026-04-08
Q2055 HCPCS Idecabtagene Vicleucel Car 14 12 — — $478,230.00 $487,794.60 $483,012.30 2026-04-08
Q2054 HCPCS Lisocabtagene Mara Car Pos T 14 12 — — $467,742.00 $477,096.84 $472,419.42 2026-04-08
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 15 13 — — $454,860.00 $463,957.20 $459,408.60 2026-04-08
Q2053 HCPCS Brexucabtagene Car Pos T 15 13 — — $454,860.00 $463,957.20 $459,408.60 2026-04-08
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 15 13 — — $299,250.00 $305,235.00 $302,242.50 2026-04-08
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $297,184.03 $297,184.03 $297,184.03 2026-04-08
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $192,860.48 $192,860.48 $192,860.48 2026-04-08
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 — — $146,934.14 $146,934.14 $146,934.14 2026-04-08
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $146,071.83 $146,071.83 $146,071.83 2026-04-08
100T OTHER Prosth Retina Receive&gen 13 11 — — $10,000.00 $181,442.80 $95,721.40 2026-04-08
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $95,325.33 $95,325.33 $95,325.33 2026-04-08
7 MS_DRG Lung Transplant 1 1 — — $89,123.28 $89,123.28 $89,123.28 2026-04-08
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 — — $82,707.19 $82,707.19 $82,707.19 2026-04-08
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $77,985.45 $77,985.45 $77,985.45 2026-04-08
A9543 HCPCS Y90 Ibritumomab, Rx 13 11 — — $77,299.65 $77,299.65 $77,299.65 2026-04-08
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $75,847.90 $75,847.90 $75,847.90 2026-04-08
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $74,835.56 $74,835.56 $74,835.56 2026-04-08
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $70,956.86 $70,956.86 $70,956.86 2026-04-08
215 MS_DRG Other Heart Assist System Implant 1 1 — — $68,524.07 $68,524.07 $68,524.07 2026-04-08
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $67,325.23 $67,325.23 $67,325.23 2026-04-08
J9029 HCPCS Instill Adstiladrin, Tx Dose 15 13 — — $60,636.60 $69,768.00 $65,202.30 2026-04-08
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $62,004.07 $62,004.07 $62,004.07 2026-04-08
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $59,594.68 $59,594.68 $59,594.68 2026-04-08
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $58,014.57 $58,014.57 $58,014.57 2026-04-08
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $57,832.20 $57,832.20 $57,832.20 2026-04-08
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $54,153.08 $54,153.08 $54,153.08 2026-04-08
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 13 — — $52,916.50 $53,974.83 $53,445.67 2026-04-08
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $52,842.06 $52,842.06 $52,842.06 2026-04-08
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $52,614.27 $52,614.27 $52,614.27 2026-04-08
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $52,440.15 $52,440.15 $52,440.15 2026-04-08
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $49,678.41 $49,678.41 $49,678.41 2026-04-08
10 MS_DRG Pancreas Transplant 1 1 — — $49,383.17 $49,383.17 $49,383.17 2026-04-08
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 1 — — $49,362.52 $49,362.52 $49,362.52 2026-04-08
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $49,100.32 $49,100.32 $49,100.32 2026-04-08
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $49,071.41 $49,071.41 $49,071.41 2026-04-08
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $47,567.01 $47,567.01 $47,567.01 2026-04-08
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $47,333.71 $47,333.71 $47,333.71 2026-04-08
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $46,323.43 $46,323.43 $46,323.43 2026-04-08
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 1 — — $46,016.49 $46,016.49 $46,016.49 2026-04-08
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $45,982.77 $45,982.77 $45,982.77 2026-04-08
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $45,251.21 $45,251.21 $45,251.21 2026-04-08
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $45,251.21 $45,251.21 $45,251.21 2026-04-08
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $45,086.73 $45,086.73 $45,086.73 2026-04-08
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $44,283.61 $44,283.61 $44,283.61 2026-04-08
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $42,175.65 $42,175.65 $42,175.65 2026-04-08
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 1 1 — — $42,126.79 $42,126.79 $42,126.79 2026-04-08
232 MS_DRG Coronary Bypass With Ptca Without Mcc 1 1 — — $41,722.81 $41,722.81 $41,722.81 2026-04-08
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $41,349.12 $41,349.12 $41,349.12 2026-04-08
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 1 — — $41,337.42 $41,337.42 $41,337.42 2026-04-08
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $41,038.05 $41,038.05 $41,038.05 2026-04-08
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 1 1 — — $40,808.20 $40,808.20 $40,808.20 2026-04-08
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $40,387.71 $40,387.71 $40,387.71 2026-04-08
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $40,361.55 $40,361.55 $40,361.55 2026-04-08
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $39,689.18 $39,689.18 $39,689.18 2026-04-08
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $39,435.92 $39,435.92 $39,435.92 2026-04-08
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $39,223.96 $39,223.96 $39,223.96 2026-04-08
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $38,690.60 $38,690.60 $38,690.60 2026-04-08
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 1 1 — — $38,570.86 $38,570.86 $38,570.86 2026-04-08
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $38,306.59 $38,306.59 $38,306.59 2026-04-08
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $38,009.29 $38,009.29 $38,009.29 2026-04-08
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $37,781.49 $37,781.49 $37,781.49 2026-04-08
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $37,647.98 $37,647.98 $37,647.98 2026-04-08
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $37,594.30 $37,594.30 $37,594.30 2026-04-08
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $37,535.12 $37,535.12 $37,535.12 2026-04-08
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $37,385.09 $37,385.09 $37,385.09 2026-04-08
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $36,700.33 $36,700.33 $36,700.33 2026-04-08
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 1 1 — — $36,678.31 $36,678.31 $36,678.31 2026-04-08
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $36,431.93 $36,431.93 $36,431.93 2026-04-08
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $36,311.50 $36,311.50 $36,311.50 2026-04-08
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $35,823.56 $35,823.56 $35,823.56 2026-04-08
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $35,761.62 $35,761.62 $35,761.62 2026-04-08
33276 CPT Insj Phrnc Nrv Stim Sys 13 11 — — $5,000.00 $64,481.49 $34,740.75 2026-04-08
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $34,686.66 $34,686.66 $34,686.66 2026-04-08
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $34,323.29 $34,323.29 $34,323.29 2026-04-08
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $34,048.01 $34,048.01 $34,048.01 2026-04-08
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $33,987.45 $33,987.45 $33,987.45 2026-04-08
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $33,871.14 $33,871.14 $33,871.14 2026-04-08
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $33,730.06 $33,730.06 $33,730.06 2026-04-08
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $33,231.11 $33,231.11 $33,231.11 2026-04-08
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $33,063.19 $33,063.19 $33,063.19 2026-04-08
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $32,763.83 $32,763.83 $32,763.83 2026-04-08
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 1 1 — — $32,355.03 $32,355.03 $32,355.03 2026-04-08
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $32,288.97 $32,288.97 $32,288.97 2026-04-08
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $32,192.62 $32,192.62 $32,192.62 2026-04-08
6 MS_DRG Liver Transplant Without Mcc 1 1 — — $31,911.83 $31,911.83 $31,911.83 2026-04-08
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $31,784.52 $31,784.52 $31,784.52 2026-04-08
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $31,633.11 $31,633.11 $31,633.11 2026-04-08
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $31,552.59 $31,552.59 $31,552.59 2026-04-08
245 MS_DRG Aicd Generator Procedures 1 1 — — $31,398.44 $31,398.44 $31,398.44 2026-04-08
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 1 — — $31,304.15 $31,304.15 $31,304.15 2026-04-08
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $31,290.39 $31,290.39 $31,290.39 2026-04-08
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $31,167.89 $31,167.89 $31,167.89 2026-04-08
163 MS_DRG Major Chest Procedures With Mcc 1 1 — — $30,843.75 $30,843.75 $30,843.75 2026-04-08
31 MS_DRG Ventricular Shunt Procedures With Mcc 1 1 — — $30,834.80 $30,834.80 $30,834.80 2026-04-08
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 1 1 — — $30,713.68 $30,713.68 $30,713.68 2026-04-08
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $30,231.25 $30,231.25 $30,231.25 2026-04-08
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 1 1 — — $29,781.17 $29,781.17 $29,781.17 2026-04-08
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $29,543.74 $29,543.74 $29,543.74 2026-04-08
140 MS_DRG Major Head And Neck Procedures With Mcc 1 1 — — $29,353.79 $29,353.79 $29,353.79 2026-04-08
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $29,185.19 $29,185.19 $29,185.19 2026-04-08
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 1 — — $29,064.06 $29,064.06 $29,064.06 2026-04-08
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $29,014.51 $29,014.51 $29,014.51 2026-04-08
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 1 1 — — $29,000.06 $29,000.06 $29,000.06 2026-04-08
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $28,915.41 $28,915.41 $28,915.41 2026-04-08
901 MS_DRG Wound Debridements For Injuries With Mcc 1 1 — — $28,881.00 $28,881.00 $28,881.00 2026-04-08
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $28,827.32 $28,827.32 $28,827.32 2026-04-08
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $28,715.83 $28,715.83 $28,715.83 2026-04-08
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $28,580.95 $28,580.95 $28,580.95 2026-04-08
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 1 1 — — $28,391.69 $28,391.69 $28,391.69 2026-04-08
408T OTHER Insj/rplc Cardiac Modulj Sys 13 11 — — $10,000.00 $45,941.24 $27,970.62 2026-04-08
571T OTHER Insj/rplcmt Icds Ss Eltrd 13 11 — — $10,000.00 $45,941.24 $27,970.62 2026-04-08
J9226 HCPCS Supprelin La Implant 15 13 — — $14,834.06 $40,740.89 $27,787.47 2026-04-08
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $27,669.08 $27,669.08 $27,669.08 2026-04-08
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $27,418.58 $27,418.58 $27,418.58 2026-04-08
620T OTHER Evasc Ven Artlz Tibl/prnl Vn 13 11 — — $4,290.00 $50,152.43 $27,221.22 2026-04-08
J9266 HCPCS Pegaspargase Injection 15 13 — — $26,815.15 $27,611.94 $27,213.54 2026-04-08
C2616 HCPCS Brachytx, Non-str,yttrium-90 13 11 — — $27,062.38 $27,062.38 $27,062.38 2026-04-08
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $26,921.70 $26,921.70 $26,921.70 2026-04-08
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 1 1 — — $26,799.88 $26,799.88 $26,799.88 2026-04-08
34 MS_DRG Carotid Artery Stent Procedures With Mcc 1 1 — — $26,638.16 $26,638.16 $26,638.16 2026-04-08
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 1 1 — — $26,598.24 $26,598.24 $26,598.24 2026-04-08
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 1 — — $26,572.78 $26,572.78 $26,572.78 2026-04-08
915T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 13 11 — — $10,000.00 $42,878.49 $26,439.24 2026-04-08
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $26,422.06 $26,422.06 $26,422.06 2026-04-08
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $25,896.97 $25,896.97 $25,896.97 2026-04-08
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 1 1 — — $25,784.10 $25,784.10 $25,784.10 2026-04-08
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $25,722.85 $25,722.85 $25,722.85 2026-04-08
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $25,720.10 $25,720.10 $25,720.10 2026-04-08
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $25,647.84 $25,647.84 $25,647.84 2026-04-08
674T OTHER Laps Insj Nw/rpcmt Prm Isdss 13 11 — — $7,385.00 $43,665.79 $25,525.40 2026-04-08
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $25,503.32 $25,503.32 $25,503.32 2026-04-08
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 1 1 — — $25,278.27 $25,278.27 $25,278.27 2026-04-08
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 1 1 — — $25,267.95 $25,267.95 $25,267.95 2026-04-08
888T OTHER Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 13 11 — — $25,076.58 $25,076.58 $25,076.58 2026-04-08
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 1 1 — — $24,971.34 $24,971.34 $24,971.34 2026-04-08
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $24,952.07 $24,952.07 $24,952.07 2026-04-08
332 MS_DRG Rectal Resection With Mcc 1 1 — — $24,917.66 $24,917.66 $24,917.66 2026-04-08
265 MS_DRG Aicd Lead Procedures 1 1 — — $24,900.45 $24,900.45 $24,900.45 2026-04-08
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $24,856.41 $24,856.41 $24,856.41 2026-04-08
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $24,819.24 $24,819.24 $24,819.24 2026-04-08
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 1 1 — — $24,656.83 $24,656.83 $24,656.83 2026-04-08
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 1 1 — — $24,599.71 $24,599.71 $24,599.71 2026-04-08
335 MS_DRG Peritoneal Adhesiolysis With Mcc 1 1 — — $24,574.93 $24,574.93 $24,574.93 2026-04-08
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $24,538.46 $24,538.46 $24,538.46 2026-04-08
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $24,517.81 $24,517.81 $24,517.81 2026-04-08
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $24,494.41 $24,494.41 $24,494.41 2026-04-08
271 MS_DRG Other Major Cardiovascular Procedures With Cc 1 1 — — $24,474.46 $24,474.46 $24,474.46 2026-04-08
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 13 11 — — $5,000.00 $43,665.79 $24,332.90 2026-04-08
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $24,270.06 $24,270.06 $24,270.06 2026-04-08
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 1 — — $24,220.51 $24,220.51 $24,220.51 2026-04-08
686T OTHER Histotripsy Mal Hepatcel Tis 13 11 — — $24,073.50 $24,073.50 $24,073.50 2026-04-08
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $24,006.48 $24,006.48 $24,006.48 2026-04-08
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $24,000.29 $24,000.29 $24,000.29 2026-04-08
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 1 — — $23,890.17 $23,890.17 $23,890.17 2026-04-08
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $23,774.56 $23,774.56 $23,774.56 2026-04-08
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $23,594.25 $23,594.25 $23,594.25 2026-04-08
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $23,478.63 $23,478.63 $23,478.63 2026-04-08
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $23,447.66 $23,447.66 $23,447.66 2026-04-08
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $22,990.01 $22,990.01 $22,990.01 2026-04-08
64568 CPT Opn Impltj Crnl Nrv Nea&pg 15 13 — — $5,000.00 $40,906.23 $22,953.12 2026-04-08
33289 CPT Tcat Impl Wrls P-art Prs Snr 13 11 — — $5,000.00 $40,735.13 $22,867.56 2026-04-08
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 1 1 — — $22,733.31 $22,733.31 $22,733.31 2026-04-08
37 MS_DRG Extracranial Procedures With Mcc 1 1 — — $22,656.23 $22,656.23 $22,656.23 2026-04-08
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 1 1 — — $22,653.48 $22,653.48 $22,653.48 2026-04-08
61886 CPT Implant Neurostim Arrays 13 11 — — $4,000.00 $40,906.23 $22,453.12 2026-04-08
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 1 1 — — $22,385.77 $22,385.77 $22,385.77 2026-04-08
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $22,287.36 $22,287.36 $22,287.36 2026-04-08
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $22,262.58 $22,262.58 $22,262.58 2026-04-08
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $22,231.61 $22,231.61 $22,231.61 2026-04-08
652 MS_DRG Kidney Transplant 1 1 — — $22,225.42 $22,225.42 $22,225.42 2026-04-08
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $22,208.90 $22,208.90 $22,208.90 2026-04-08
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 1 1 — — $22,165.55 $22,165.55 $22,165.55 2026-04-08
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 1 1 — — $22,093.97 $22,093.97 $22,093.97 2026-04-08
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $21,972.85 $21,972.85 $21,972.85 2026-04-08
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $21,932.25 $21,932.25 $21,932.25 2026-04-08
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $21,910.91 $21,910.91 $21,910.91 2026-04-08
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $21,866.87 $21,866.87 $21,866.87 2026-04-08
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $21,780.15 $21,780.15 $21,780.15 2026-04-08
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $21,747.12 $21,747.12 $21,747.12 2026-04-08
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 1 1 — — $21,685.18 $21,685.18 $21,685.18 2026-04-08
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $21,674.86 $21,674.86 $21,674.86 2026-04-08
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $21,623.93 $21,623.93 $21,623.93 2026-04-08
665 MS_DRG Prostatectomy With Mcc 1 1 — — $21,480.10 $21,480.10 $21,480.10 2026-04-08
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $21,435.37 $21,435.37 $21,435.37 2026-04-08
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 1 1 — — $21,397.51 $21,397.51 $21,397.51 2026-04-08
515T OTHER Insj Wcs Lv Compl Sys 13 11 — — $10,000.00 $32,163.28 $21,081.64 2026-04-08
614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 13 11 — — $10,000.00 $32,163.28 $21,081.64 2026-04-08
414T OTHER Rmvl & Rpl Car Modulj Pls Gn 13 11 — — $10,000.00 $32,163.28 $21,081.64 2026-04-08
409T OTHER Insj/rplc Car Modulj Pls Gn 13 11 — — $10,000.00 $32,163.28 $21,081.64 2026-04-08
662 MS_DRG Minor Bladder Procedures With Mcc 1 1 — — $21,069.24 $21,069.24 $21,069.24 2026-04-08
263 MS_DRG Vein Ligation And Stripping 1 1 — — $21,041.03 $21,041.03 $21,041.03 2026-04-08
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 1 — — $20,874.48 $20,874.48 $20,874.48 2026-04-08
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 1 1 — — $20,787.08 $20,787.08 $20,787.08 2026-04-08
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 1 1 — — $20,784.33 $20,784.33 $20,784.33 2026-04-08
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 1 1 — — $20,761.62 $20,761.62 $20,761.62 2026-04-08
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 1 1 — — $20,483.58 $20,483.58 $20,483.58 2026-04-08
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $20,275.06 $20,275.06 $20,275.06 2026-04-08
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 1 1 — — $20,261.30 $20,261.30 $20,261.30 2026-04-08
570 MS_DRG Skin Debridement With Mcc 1 1 — — $20,240.65 $20,240.65 $20,240.65 2026-04-08
668 MS_DRG Transurethral Procedures With Mcc 1 1 — — $20,095.44 $20,095.44 $20,095.44 2026-04-08
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $20,042.45 $20,042.45 $20,042.45 2026-04-08
916T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 13 11 — — $10,000.00 $30,019.07 $20,009.53 2026-04-08
923T OTHER Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 13 11 — — $10,000.00 $30,019.07 $20,009.53 2026-04-08
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $19,971.56 $19,971.56 $19,971.56 2026-04-08
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $19,959.18 $19,959.18 $19,959.18 2026-04-08
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $19,871.09 $19,871.09 $19,871.09 2026-04-08
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $19,861.45 $19,861.45 $19,861.45 2026-04-08
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 1 1 — — $19,832.55 $19,832.55 $19,832.55 2026-04-08
960T OTHER Replacement Of Sub-scalp Implanted Electrode Array, Receiver, And Telemetry Unit… 13 11 — — $7,385.00 $32,241.09 $19,813.04 2026-04-08
956T OTHER Partial Craniectomy, Channel Creation, And Tunneling Of Electrode For Sub-scalp … 13 11 — — $7,385.00 $32,241.09 $19,813.04 2026-04-08
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 1 1 — — $19,752.72 $19,752.72 $19,752.72 2026-04-08
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $19,617.14 $19,617.14 $19,617.14 2026-04-08
J7311 HCPCS Inj., Retisert, 0.01 Mg 3 3 — — $319.75 $19,731.90 $19,345.00 2026-04-08
800 MS_DRG Splenic Procedures With Cc 1 1 — — $19,334.29 $19,334.29 $19,334.29 2026-04-08
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $19,264.78 $19,264.78 $19,264.78 2026-04-08
503 MS_DRG Foot Procedures With Mcc 1 1 — — $19,208.35 $19,208.35 $19,208.35 2026-04-08
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 1 — — $19,076.22 $19,076.22 $19,076.22 2026-04-08
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $18,974.36 $18,974.36 $18,974.36 2026-04-08
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 — — $18,916.55 $18,916.55 $18,916.55 2026-04-08
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 1 1 — — $18,911.74 $18,911.74 $18,911.74 2026-04-08
963 MS_DRG Other Multiple Significant Trauma With Mcc 1 1 — — $18,814.01 $18,814.01 $18,814.01 2026-04-08
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 1 1 — — $18,724.55 $18,724.55 $18,724.55 2026-04-08
849 MS_DRG Radiotherapy 1 1 — — $18,646.78 $18,646.78 $18,646.78 2026-04-08
288 MS_DRG Acute And Subacute Endocarditis With Mcc 1 1 — — $18,624.07 $18,624.07 $18,624.07 2026-04-08
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 1 1 — — $18,563.51 $18,563.51 $18,563.51 2026-04-08
A9604 HCPCS Sm 153 Lexidronam 13 11 — — $18,562.49 $18,562.49 $18,562.49 2026-04-08
81416 CPT Exome Sequence Analysis 13 11 — — $18,495.00 $18,495.00 $18,495.00 2026-04-08
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 1 — — $18,306.12 $18,306.12 $18,306.12 2026-04-08
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 1 1 — — $18,242.12 $18,242.12 $18,242.12 2026-04-08
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 1 1 — — $18,150.59 $18,150.59 $18,150.59 2026-04-08
253 MS_DRG Other Vascular Procedures With Cc 1 1 — — $17,862.92 $17,862.92 $17,862.92 2026-04-08
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 1 1 — — $17,841.59 $17,841.59 $17,841.59 2026-04-08
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $17,774.83 $17,774.83 $17,774.83 2026-04-08
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 1 1 — — $17,750.05 $17,750.05 $17,750.05 2026-04-08
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $17,750.05 $17,750.05 $17,750.05 2026-04-08
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 1 1 — — $17,670.22 $17,670.22 $17,670.22 2026-04-08
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 1 1 — — $17,569.75 $17,569.75 $17,569.75 2026-04-08
817T OTHER Opn Insj/rplcmt Ins Ptn Subf 13 11 — — $4,290.00 $30,727.80 $17,508.90 2026-04-08
816T OTHER Opn Insj/rplcmt Ins Ptn Subq 13 11 — — $4,290.00 $30,727.80 $17,508.90 2026-04-08
680T OTHER Insj/rplcmt Pg Only Isdss 13 11 — — $4,290.00 $30,727.80 $17,508.90 2026-04-08
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $17,486.47 $17,486.47 $17,486.47 2026-04-08
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $17,453.44 $17,453.44 $17,453.44 2026-04-08
25442 CPT Reconstruct Wrist Joint 13 11 — — $4,290.00 $30,510.75 $17,400.38 2026-04-08
24361 CPT Reconstruct Elbow Joint 13 11 — — $4,290.00 $30,510.75 $17,400.38 2026-04-08
24363 CPT Replace Elbow Joint 13 11 — — $4,290.00 $30,510.75 $17,400.38 2026-04-08
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $17,370.17 $17,370.17 $17,370.17 2026-04-08
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 1 1 — — $17,362.60 $17,362.60 $17,362.60 2026-04-08
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 1 1 — — $17,149.26 $17,149.26 $17,149.26 2026-04-08
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $17,079.06 $17,079.06 $17,079.06 2026-04-08
S2095 HCPCS Transcath Emboliz Microspher 13 11 — — $17,000.00 $17,000.00 $17,000.00 2026-04-08
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 1 1 — — $16,924.21 $16,924.21 $16,924.21 2026-04-08
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $16,919.40 $16,919.40 $16,919.40 2026-04-08
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $16,820.98 $16,820.98 $16,820.98 2026-04-08
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 1 1 — — $16,801.03 $16,801.03 $16,801.03 2026-04-08
J7330 HCPCS Cultured Chondrocytes Implnt 14 12 — — $16,585.69 $16,917.40 $16,751.54 2026-04-08
28705 CPT Fusion Of Foot Bones 13 11 — — $2,641.00 $30,510.75 $16,575.88 2026-04-08
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 13 11 — — $2,641.00 $30,510.75 $16,575.88 2026-04-08
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 1 1 — — $16,553.27 $16,553.27 $16,553.27 2026-04-08
330 MS_DRG Major Small And Large Bowel Procedures With Cc 1 1 — — $16,497.53 $16,497.53 $16,497.53 2026-04-08
397 MS_DRG Appendix Procedures With Mcc 1 1 — — $16,481.70 $16,481.70 $16,481.70 2026-04-08
35 MS_DRG Carotid Artery Stent Procedures With Cc 1 1 — — $16,451.42 $16,451.42 $16,451.42 2026-04-08
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 — — $16,423.20 $16,423.20 $16,423.20 2026-04-08
61885 CPT Insrt/redo Neurostim 1 Array 15 13 — — $2,500.00 $29,978.12 $16,239.06 2026-04-08
113 MS_DRG Orbital Procedures With Cc/mcc 1 1 — — $16,180.27 $16,180.27 $16,180.27 2026-04-08
333 MS_DRG Rectal Resection With Cc 1 1 — — $16,119.02 $16,119.02 $16,119.02 2026-04-08
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $16,094.25 $16,094.25 $16,094.25 2026-04-08
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 1 1 — — $16,082.55 $16,082.55 $16,082.55 2026-04-08
21243 CPT Reconstruction Of Jaw Joint 13 11 — — $1,625.00 $30,510.75 $16,067.88 2026-04-08
709 MS_DRG Penis Procedures With Cc/mcc 1 1 — — $16,015.10 $16,015.10 $16,015.10 2026-04-08
357 MS_DRG Other Digestive System O.r. Procedures With Cc 1 1 — — $16,004.09 $16,004.09 $16,004.09 2026-04-08
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 — — $15,987.57 $15,987.57 $15,987.57 2026-04-08
53445 CPT Insert Uro/ves Nck Sphincter 13 11 — — $5,000.00 $26,865.91 $15,932.95 2026-04-08
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $15,905.68 $15,905.68 $15,905.68 2026-04-08
525T OTHER Insj/rplcmt Compl Iims 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
347 MS_DRG Anal And Stomal Procedures With Mcc 1 1 — — $15,798.32 $15,798.32 $15,798.32 2026-04-08
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 1 1 — — $15,793.50 $15,793.50 $15,793.50 2026-04-08
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 1 1 — — $15,729.50 $15,729.50 $15,729.50 2026-04-08
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 1 1 — — $15,701.97 $15,701.97 $15,701.97 2026-04-08
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 1 1 — — $15,661.37 $15,661.37 $15,661.37 2026-04-08
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 1 1 — — $15,635.22 $15,635.22 $15,635.22 2026-04-08
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 1 1 — — $15,591.86 $15,591.86 $15,591.86 2026-04-08
308T OTHER Insj Ocular Telescope Prosth 13 11 — — $7,385.00 $23,523.22 $15,454.11 2026-04-08
54410 CPT Remove/replace Penis Prosth 13 11 — — $4,000.00 $26,865.91 $15,432.95 2026-04-08
54405 CPT Insert Multi-comp Penis Pros 13 11 — — $4,000.00 $26,865.91 $15,432.95 2026-04-08
54401 CPT Insert Self-contd Prosthesis 13 11 — — $4,000.00 $26,865.91 $15,432.95 2026-04-08
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $15,406.05 $15,406.05 $15,406.05 2026-04-08
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 1 1 — — $15,397.10 $15,397.10 $15,397.10 2026-04-08
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 1 1 — — $15,275.29 $15,275.29 $15,275.29 2026-04-08
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 1 1 — — $15,228.49 $15,228.49 $15,228.49 2026-04-08
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 1 1 — — $15,213.35 $15,213.35 $15,213.35 2026-04-08
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $15,194.77 $15,194.77 $15,194.77 2026-04-08
825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 13 11 — — $4,290.00 $26,016.38 $15,153.19 2026-04-08
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