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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.

Slice
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
             
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
10 MS_DRG Pancreas Transplant 1 1 — — $49,383.17 $49,383.17 $49,383.17 2026-04-08
100T OTHER Prosth Retina Receive&gen 13 11 — — $10,000.00 $181,442.80 $95,721.40 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
113 MS_DRG Orbital Procedures With Cc/mcc 1 1 — — $16,180.27 $16,180.27 $16,180.27 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
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
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 — — $82,707.19 $82,707.19 $82,707.19 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
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
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 1 1 — — $40,808.20 $40,808.20 $40,808.20 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
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $17,370.17 $17,370.17 $17,370.17 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
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $37,385.09 $37,385.09 $37,385.09 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
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
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $49,100.32 $49,100.32 $49,100.32 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
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
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
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
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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $74,835.56 $74,835.56 $74,835.56 2026-04-08
21243 CPT Reconstruction Of Jaw Joint 13 11 — — $1,625.00 $30,510.75 $16,067.88 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
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
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
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
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
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
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 13 11 — — $2,641.00 $30,510.75 $16,575.88 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
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $21,674.86 $21,674.86 $21,674.86 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $58,014.57 $58,014.57 $58,014.57 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
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
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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $40,387.71 $40,387.71 $40,387.71 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
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
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
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
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $21,972.85 $21,972.85 $21,972.85 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
245 MS_DRG Aicd Generator Procedures 1 1 — — $31,398.44 $31,398.44 $31,398.44 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
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $24,006.48 $24,006.48 $24,006.48 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
25442 CPT Reconstruct Wrist Joint 13 11 — — $4,290.00 $30,510.75 $17,400.38 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
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $21,623.93 $21,623.93 $21,623.93 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
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
263 MS_DRG Vein Ligation And Stripping 1 1 — — $21,041.03 $21,041.03 $21,041.03 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
265 MS_DRG Aicd Lead Procedures 1 1 — — $24,900.45 $24,900.45 $24,900.45 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
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
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
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
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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $36,311.50 $36,311.50 $36,311.50 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
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 1 1 — — $17,569.75 $17,569.75 $17,569.75 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
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 1 1 — — $22,653.48 $22,653.48 $22,653.48 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
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
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $31,784.52 $31,784.52 $31,784.52 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
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
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $41,349.12 $41,349.12 $41,349.12 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
28705 CPT Fusion Of Foot Bones 13 11 — — $2,641.00 $30,510.75 $16,575.88 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
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $23,478.63 $23,478.63 $23,478.63 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
308T OTHER Insj Ocular Telescope Prosth 13 11 — — $7,385.00 $23,523.22 $15,454.11 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
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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 1 1 — — $30,713.68 $30,713.68 $30,713.68 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
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
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
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
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 1 1 — — $22,093.97 $22,093.97 $22,093.97 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
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $16,820.98 $16,820.98 $16,820.98 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
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
332 MS_DRG Rectal Resection With Mcc 1 1 — — $24,917.66 $24,917.66 $24,917.66 2026-04-08
33276 CPT Insj Phrnc Nrv Stim Sys 13 11 — — $5,000.00 $64,481.49 $34,740.75 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
33289 CPT Tcat Impl Wrls P-art Prs Snr 13 11 — — $5,000.00 $40,735.13 $22,867.56 2026-04-08
333 MS_DRG Rectal Resection With Cc 1 1 — — $16,119.02 $16,119.02 $16,119.02 2026-04-08
335 MS_DRG Peritoneal Adhesiolysis With Mcc 1 1 — — $24,574.93 $24,574.93 $24,574.93 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
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
347 MS_DRG Anal And Stomal Procedures With Mcc 1 1 — — $15,798.32 $15,798.32 $15,798.32 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
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 1 1 — — $17,149.26 $17,149.26 $17,149.26 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
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
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
37 MS_DRG Extracranial Procedures With Mcc 1 1 — — $22,656.23 $22,656.23 $22,656.23 2026-04-08
397 MS_DRG Appendix Procedures With Mcc 1 1 — — $16,481.70 $16,481.70 $16,481.70 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
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
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
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $37,647.98 $37,647.98 $37,647.98 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
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
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
408T OTHER Insj/rplc Cardiac Modulj Sys 13 11 — — $10,000.00 $45,941.24 $27,970.62 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
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 1 1 — — $22,733.31 $22,733.31 $22,733.31 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
414T OTHER Rmvl & Rpl Car Modulj Pls Gn 13 11 — — $10,000.00 $32,163.28 $21,081.64 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
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $23,447.66 $23,447.66 $23,447.66 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $33,231.11 $33,231.11 $33,231.11 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
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 1 1 — — $16,801.03 $16,801.03 $16,801.03 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
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
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
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
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
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
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
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
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
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
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
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $70,956.86 $70,956.86 $70,956.86 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
503 MS_DRG Foot Procedures With Mcc 1 1 — — $19,208.35 $19,208.35 $19,208.35 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
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
515T OTHER Insj Wcs Lv Compl Sys 13 11 — — $10,000.00 $32,163.28 $21,081.64 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
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
525T OTHER Insj/rplcmt Compl Iims 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
53445 CPT Insert Uro/ves Nck Sphincter 13 11 — — $5,000.00 $26,865.91 $15,932.95 2026-04-08
54401 CPT Insert Self-contd Prosthesis 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
54410 CPT Remove/replace Penis Prosth 13 11 — — $4,000.00 $26,865.91 $15,432.95 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
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 — — $15,987.57 $15,987.57 $15,987.57 2026-04-08
570 MS_DRG Skin Debridement With Mcc 1 1 — — $20,240.65 $20,240.65 $20,240.65 2026-04-08
571T OTHER Insj/rplcmt Icds Ss Eltrd 13 11 — — $10,000.00 $45,941.24 $27,970.62 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
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
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
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
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
6 MS_DRG Liver Transplant Without Mcc 1 1 — — $31,911.83 $31,911.83 $31,911.83 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
614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 13 11 — — $10,000.00 $32,163.28 $21,081.64 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
61885 CPT Insrt/redo Neurostim 1 Array 15 13 — — $2,500.00 $29,978.12 $16,239.06 2026-04-08
61886 CPT Implant Neurostim Arrays 13 11 — — $4,000.00 $40,906.23 $22,453.12 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
620T OTHER Evasc Ven Artlz Tibl/prnl Vn 13 11 — — $4,290.00 $50,152.43 $27,221.22 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
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 1 1 — — $20,784.33 $20,784.33 $20,784.33 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
64568 CPT Opn Impltj Crnl Nrv Nea&pg 15 13 — — $5,000.00 $40,906.23 $22,953.12 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
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $25,503.32 $25,503.32 $25,503.32 2026-04-08
652 MS_DRG Kidney Transplant 1 1 — — $22,225.42 $22,225.42 $22,225.42 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
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $19,264.78 $19,264.78 $19,264.78 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
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
662 MS_DRG Minor Bladder Procedures With Mcc 1 1 — — $21,069.24 $21,069.24 $21,069.24 2026-04-08
665 MS_DRG Prostatectomy With Mcc 1 1 — — $21,480.10 $21,480.10 $21,480.10 2026-04-08
668 MS_DRG Transurethral Procedures With Mcc 1 1 — — $20,095.44 $20,095.44 $20,095.44 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
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
674T OTHER Laps Insj Nw/rpcmt Prm Isdss 13 11 — — $7,385.00 $43,665.79 $25,525.40 2026-04-08
680T OTHER Insj/rplcmt Pg Only Isdss 13 11 — — $4,290.00 $30,727.80 $17,508.90 2026-04-08
686T OTHER Histotripsy Mal Hepatcel Tis 13 11 — — $24,073.50 $24,073.50 $24,073.50 2026-04-08
7 MS_DRG Lung Transplant 1 1 — — $89,123.28 $89,123.28 $89,123.28 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
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
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
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
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
795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 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
797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 13 11 — — $4,290.00 $27,327.20 $15,808.60 2026-04-08
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $31,167.89 $31,167.89 $31,167.89 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
800 MS_DRG Splenic Procedures With Cc 1 1 — — $19,334.29 $19,334.29 $19,334.29 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
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
802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 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
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
81416 CPT Exome Sequence Analysis 13 11 — — $18,495.00 $18,495.00 $18,495.00 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
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
817T OTHER Opn Insj/rplcmt Ins Ptn Subf 13 11 — — $4,290.00 $30,727.80 $17,508.90 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
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
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
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
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
825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 13 11 — — $4,290.00 $26,016.38 $15,153.19 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
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
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
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $37,781.49 $37,781.49 $37,781.49 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
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $22,262.58 $22,262.58 $22,262.58 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
849 MS_DRG Radiotherapy 1 1 — — $18,646.78 $18,646.78 $18,646.78 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
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $59,594.68 $59,594.68 $59,594.68 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
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
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
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
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
901 MS_DRG Wound Debridements For Injuries With Mcc 1 1 — — $28,881.00 $28,881.00 $28,881.00 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
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
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
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
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
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
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
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
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
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
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
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
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
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $46,323.43 $46,323.43 $46,323.43 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
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
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
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
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
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
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
963 MS_DRG Other Multiple Significant Trauma With Mcc 1 1 — — $18,814.01 $18,814.01 $18,814.01 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
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
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
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $19,861.45 $19,861.45 $19,861.45 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
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
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
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
A9543 HCPCS Y90 Ibritumomab, Rx 13 11 — — $77,299.65 $77,299.65 $77,299.65 2026-04-08
A9604 HCPCS Sm 153 Lexidronam 13 11 — — $18,562.49 $18,562.49 $18,562.49 2026-04-08
C2616 HCPCS Brachytx, Non-str,yttrium-90 13 11 — — $27,062.38 $27,062.38 $27,062.38 2026-04-08
J1413 HCPCS Inj Delandistrogene Mox Rokl 15 13 — — $3,648,000.00 $3,720,960.00 $3,684,480.00 2026-04-08
J7311 HCPCS Inj., Retisert, 0.01 Mg 3 3 — — $319.75 $19,731.90 $19,345.00 2026-04-08
J7330 HCPCS Cultured Chondrocytes Implnt 14 12 — — $16,585.69 $16,917.40 $16,751.54 2026-04-08
J9029 HCPCS Instill Adstiladrin, Tx Dose 15 13 — — $60,636.60 $69,768.00 $65,202.30 2026-04-08
J9226 HCPCS Supprelin La Implant 15 13 — — $14,834.06 $40,740.89 $27,787.47 2026-04-08
J9266 HCPCS Pegaspargase Injection 15 13 — — $26,815.15 $27,611.94 $27,213.54 2026-04-08
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 15 13 — — $454,860.00 $463,957.20 $459,408.60 2026-04-08
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 13 — — $52,916.50 $53,974.83 $53,445.67 2026-04-08
Q2053 HCPCS Brexucabtagene Car Pos T 15 13 — — $454,860.00 $463,957.20 $459,408.60 2026-04-08
Q2054 HCPCS Lisocabtagene Mara Car Pos T 14 12 — — $467,742.00 $477,096.84 $472,419.42 2026-04-08
Q2055 HCPCS Idecabtagene Vicleucel Car 14 12 — — $478,230.00 $487,794.60 $483,012.30 2026-04-08
Q2056 HCPCS Ciltacabtagene Car-pos T 15 13 — — $530,100.00 $540,702.00 $535,401.00 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
S2095 HCPCS Transcath Emboliz Microspher 13 11 — — $17,000.00 $17,000.00 $17,000.00 2026-04-08
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