Price Transparency Hospital negotiated rates

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

PROVIDENCE ST JOSEPH HOSPITAL

Eureka, CA · CCN 050006 · Rates published

14,644 distinct procedures filed
22 distinct payers
278,794 rate rows
2026-04-01 last MRF observed
Data quality

159,460 of 278,794 rate rows are consumer-grade (57.2%)

119,334 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 110,068
template filing: same amount across many unrelated codes — excluded 9,220
placeholder amount (≤ $0.02) — excluded from medians 46
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/norcal/live/814791043_providence-st-joseph-hospital-eureka_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 2f255cc0373cbc18… · 179,090,257 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,691,450.00 $3,691,450.00 $3,691,450.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,321,376.38 $3,321,376.38 $3,321,376.38 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,245,381.39 $3,245,381.39 $3,245,381.39 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,938,320.00 $2,938,320.00 $2,938,320.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,587,087.26 $2,587,087.26 $2,587,087.26 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $770,620.00 $1,656,833.00 $1,599,036.50 nat. median
$824,563
1.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $1,802.00 $1,244,357.91 $1,156,649.16 nat. median
$754,974
1.5× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $588,494.81 $1,189,314.00 $1,148,035.83 nat. median
$675,122
1.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $559,781.08 $1,134,388.29 $1,108,454.59 nat. median
$625,184
1.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $562,260.84 $1,110,350.92 $1,096,811.11 nat. median
$674,188
1.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $531,849.12 $1,081,107.57 $1,073,630.26 nat. median
$634,511
1.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,290.60 $1,052,208.19 $1,015,824.09 nat. median
$620,080
1.6× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $598,237.50 $598,237.50 $598,237.50 nat. median
$459,112
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 $457,515.57 $1,226,034.02 $457,515.57 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $297,076.56 $915,746.00 $297,076.56 nat. median
$265,286
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $226,446.52 $771,275.67 $226,446.52 nat. median
$206,368
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $225,120.36 $696,738.66 $225,120.36 nat. median
$202,986
1.1× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 4 $31,542.00 $288,101.84 $221,533.27 nat. median
$87,411
outlier · 2.5×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 $20,251.00 $248,931.38 $196,397.29 nat. median
$63,570
outlier · 3.1×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 $20,251.00 $230,484.07 $177,304.15 nat. median
$54,196
outlier · 3.3×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 4 $31,542.00 $215,629.34 $164,249.54 nat. median
$65,381
outlier · 2.5×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 $20,251.00 $208,106.06 $159,717.92 nat. median
$49,935
outlier · 3.2×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 4 $31,542.00 $198,853.15 $150,323.00 nat. median
$62,270
outlier · 2.4×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $147,077.42 $459,365.30 $147,077.42 nat. median
$133,176
1.1× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 $20,251.00 $169,670.37 $138,793.49 nat. median
$44,728
outlier · 3.1×
7
MS_DRG 		Lung Transplant 12 $137,539.29 $424,863.56 $137,539.29 nat. median
$122,708
1.1× median
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 $20,251.00 $164,435.94 $130,402.68 nat. median
$48,649
outlier · 2.7×
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $89,783.60 $169,820.76 $129,802.18 nat. median
$76,377
1.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $127,671.99 $425,936.46 $127,671.99 nat. median
$117,303
1.1× median
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 4 $20,251.00 $163,233.00 $125,965.16 nat. median
$39,020
outlier · 3.2×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $120,410.44 $358,272.49 $120,410.44 nat. median
$108,660
1.1× median
209
MS_DRG 		Complex Aortic Arch Procedures 12 $120,272.85 $120,272.85 $120,272.85 nat. median
$98,017
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 $18,400.00 $340,777.78 $117,123.10 nat. median
$98,905
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $115,566.23 $354,156.47 $115,566.23 nat. median
$102,358
1.1× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 4 $31,542.00 $149,737.27 $115,272.11 nat. median
$48,483
outlier · 2.4×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 3 $64,282.30 $135,956.56 $114,979.44 nat. median
$69,774
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 13 $109,601.19 $346,207.28 $109,601.19 nat. median
$100,136
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 12 $20,251.00 $344,438.63 $105,859.81 nat. median
$99,019
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 $20,251.00 $313,753.80 $104,016.11 nat. median
$93,672
1.1× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $97,225.26 $97,225.26 $97,225.26 nat. median
$21,806
outlier · 4.5×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 $95,832.70 $271,150.08 $95,832.70 nat. median
$82,712
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 3 $56,824.55 $122,172.78 $95,494.51 nat. median
$62,507
1.5× median
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 4 $31,542.00 $118,925.64 $92,883.79 nat. median
$39,075
outlier · 2.4×
850
MS_DRG 		Acute Leukemia With Other Procedures 12 $92,127.31 $299,477.79 $92,127.31 nat. median
$83,442
1.1× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 13 $20,251.00 $275,487.18 $89,697.26 nat. median
$79,312
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $31,542.00 $275,331.12 $89,416.79 nat. median
$81,118
1.1× median
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $89,350.56 $89,350.56 $89,350.56 nat. median
$775
outlier · 115.3×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 3 $53,266.71 $122,586.77 $84,080.57 nat. median
$66,682
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 $83,758.68 $262,062.98 $83,758.68 nat. median
$77,576
1.1× median

Other procedures at this hospital

Browse this hospital's 14,644 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
             
5232 OTHER Level 2 Icd And Similar Procedures 8 3 — — $290.21 $48,932.24 $29,839.18 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 34 12 — — $1,502.64 $88,800.03 $29,118.67 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 10 3 — — $1,802.00 $1,244,357.91 $1,156,649.16 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 14 5 — — $1,802.00 $126,547.00 $31,625.00 2026-04-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 8 3 — — $1,802.00 $35,376.00 $30,116.98 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 8 3 — — $1,802.00 $35,376.00 $30,116.98 2026-04-01
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 8 3 — — $1,802.00 $35,376.00 $28,199.38 2026-04-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 8 3 — — $1,802.00 $35,376.00 $28,199.38 2026-04-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 8 3 — — $1,802.00 $35,376.00 $28,199.38 2026-04-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 8 3 — — $1,802.00 $35,376.00 $28,199.38 2026-04-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 8 3 — — $1,802.00 $35,376.00 $28,199.38 2026-04-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 8 3 — — $1,802.00 $35,376.00 $28,199.38 2026-04-01
J9266 HCPCS Pegaspargase Injection 12 3 — — $2,151.45 $58,201.64 $42,636.09 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 13 — — $3,108.92 $165,118.69 $53,262.47 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 42 13 — — $3,241.53 $166,877.59 $56,320.14 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 34 13 — — $4,190.00 $221,988.68 $71,717.47 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 38 13 — — $4,190.00 $85,285.48 $29,561.08 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 42 13 — — $4,233.16 $135,594.55 $44,607.03 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 34 13 — — $4,400.00 $132,229.56 $44,431.34 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 34 13 — — $4,400.00 $123,591.12 $41,879.58 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 8 2 — — $4,506.70 $52,091.10 $28,298.90 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 38 13 — — $5,463.76 $106,265.47 $32,579.58 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 14 5 — — $5,835.00 $126,547.00 $31,625.00 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 14 5 — — $5,835.00 $113,226.00 $31,625.00 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 14 5 — — $5,835.00 $113,226.00 $28,608.96 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 14 5 — — $5,835.00 $113,226.00 $28,608.96 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 14 5 — — $5,835.00 $113,226.00 $28,608.96 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 14 5 — — $7,809.00 $126,547.00 $31,625.00 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 14 5 — — $7,809.00 $126,547.00 $31,625.00 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 14 5 — — $7,809.00 $126,547.00 $31,625.00 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 14 5 — — $7,809.00 $126,547.00 $31,625.00 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 14 5 — — $7,809.00 $113,226.00 $31,625.00 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 14 5 — — $7,809.00 $113,226.00 $28,608.96 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 14 5 — — $7,809.00 $113,226.00 $28,608.96 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 14 5 — — $8,018.00 $113,226.00 $28,608.96 2026-04-01
791 MS_DRG Prematurity With Major Problems 38 12 — — $8,126.08 $132,001.97 $43,436.46 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 34 13 — — $8,380.00 $107,344.87 $40,130.08 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 13 — — $8,380.00 $113,889.54 $36,762.31 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 46 13 — — $8,380.00 $83,536.25 $27,948.10 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 38 13 — — $8,800.00 $172,960.59 $58,292.96 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 34 13 — — $8,800.00 $179,703.58 $56,505.36 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 38 13 — — $8,800.00 $162,004.04 $52,839.12 2026-04-01
245 MS_DRG Aicd Generator Procedures 38 13 — — $8,800.00 $158,869.89 $48,764.35 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 34 13 — — $8,800.00 $114,741.35 $36,536.87 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 36 13 — — $8,800.00 $203,576.69 $34,666.71 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 32 13 — — $8,800.00 $103,875.84 $33,826.35 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 34 13 — — $8,899.43 $137,493.25 $45,619.90 2026-04-01
61886 HCPCS Implant Neurostim Arrays 14 5 — — $8,925.00 $126,547.00 $31,625.00 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 36 13 — — $9,601.02 $210,277.86 $68,580.43 2026-04-01
C9780 HCPCS Insert Cv Cath Inf & Sup App 6 2 — — $10,386.55 $35,376.00 $31,625.00 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 13 — — $10,579.47 $230,792.93 $76,877.09 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 14 5 — — $11,036.00 $126,547.00 $31,625.00 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 14 5 — — $11,046.00 $126,547.00 $31,625.00 2026-04-01
C9792 HCPCS Blind/nonblind Trans Atrial 6 2 — — $12,274.90 $35,376.00 $31,625.00 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 34 13 — — $12,570.00 $175,587.56 $60,799.21 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 38 13 — — $12,570.00 $111,522.66 $37,396.28 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 36 13 — — $12,595.83 $105,959.86 $34,752.44 2026-04-01
263 MS_DRG Vein Ligation And Stripping 34 13 — — $12,675.91 $87,193.93 $32,835.71 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 32 13 — — $13,200.00 $201,119.23 $71,245.44 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 10 3 — — $13,524.00 $35,376.00 $31,625.00 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 14 5 — — $13,524.00 $62,607.00 $31,625.00 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 14 5 — — $13,524.00 $113,226.00 $31,625.00 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 14 5 — — $13,524.00 $113,226.00 $31,625.00 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 14 5 — — $13,524.00 $113,226.00 $31,625.00 2026-04-01
69930 HCPCS Implant Cochlear Device 14 5 — — $13,524.00 $126,547.00 $31,625.00 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 14 5 — — $13,524.00 $113,226.00 $28,608.96 2026-04-01
C9783 HCPCS Blind Cor Sinus Reducer Impl 6 2 — — $14,847.76 $35,376.00 $31,625.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 38 13 — — $16,760.00 $254,107.29 $81,392.14 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 34 13 — — $16,760.00 $165,625.88 $55,569.75 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 34 13 — — $16,760.00 $87,600.33 $27,812.63 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 36 13 — — $17,269.53 $104,174.95 $38,646.22 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 44 13 — — $17,600.00 $102,859.94 $29,568.49 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 40 13 — — $17,600.00 $92,551.91 $29,273.20 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 13 — — $18,400.00 $340,777.78 $117,123.10 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 44 13 — — $19,025.49 $110,280.70 $34,268.76 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 36 12 — — $19,288.00 $199,516.39 $58,931.17 2026-04-01
509 MS_DRG Arthroscopy 12 4 — — $19,288.00 $57,107.33 $42,361.61 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 36 12 — — $19,288.00 $116,516.51 $40,031.65 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 38 12 — — $19,288.00 $261,742.78 $39,336.29 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 36 12 — — $19,288.00 $114,451.99 $38,850.49 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 36 12 — — $19,288.00 $129,420.52 $38,396.45 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 38 12 — — $19,288.00 $128,009.50 $38,308.60 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 36 12 — — $19,288.00 $104,805.68 $34,631.78 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 36 12 — — $19,288.00 $100,533.61 $34,206.31 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 36 12 — — $19,288.00 $92,919.30 $32,445.17 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 36 12 — — $19,288.00 $82,083.05 $32,406.01 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 42 12 — — $19,288.00 $95,617.79 $31,300.00 2026-04-01
503 MS_DRG Foot Procedures With Mcc 36 12 — — $19,288.00 $86,043.01 $30,017.24 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 36 12 — — $19,288.00 $82,843.83 $29,814.03 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 36 12 — — $19,288.00 $93,101.36 $28,629.70 2026-04-01
78 MS_DRG Hypertensive Encephalopathy With Cc 8 3 — — $19,811.32 $32,440.47 $29,955.46 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 12 4 — — $20,251.00 $248,931.38 $196,397.29 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 12 4 — — $20,251.00 $230,484.07 $177,304.15 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 12 4 — — $20,251.00 $208,106.06 $159,717.92 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 12 4 — — $20,251.00 $169,670.37 $138,793.49 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 12 4 — — $20,251.00 $164,435.94 $130,402.68 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 12 4 — — $20,251.00 $163,233.00 $125,965.16 2026-04-01
215 MS_DRG Other Heart Assist System Implant 36 12 — — $20,251.00 $344,438.63 $105,859.81 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 38 13 — — $20,251.00 $313,753.80 $104,016.11 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 38 13 — — $20,251.00 $275,487.18 $89,697.26 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 12 — — $20,251.00 $251,545.34 $81,742.47 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 12 4 — — $20,251.00 $97,854.62 $75,779.54 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 12 4 — — $20,251.00 $97,386.44 $75,072.37 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 12 — — $20,251.00 $209,942.99 $70,068.52 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 12 — — $20,251.00 $193,417.14 $70,068.52 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 36 12 — — $20,251.00 $198,593.05 $64,642.19 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 36 12 — — $20,251.00 $191,294.11 $62,588.93 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 13 — — $20,251.00 $172,193.31 $56,918.12 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 12 — — $20,251.00 $149,304.86 $53,821.30 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 12 4 — — $20,251.00 $62,081.66 $47,811.40 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 36 12 — — $20,251.00 $142,808.96 $47,711.26 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 12 4 — — $20,251.00 $59,064.55 $45,359.68 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 36 12 — — $20,251.00 $133,682.84 $44,810.24 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 38 13 — — $20,251.00 $100,985.52 $33,810.48 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 36 12 — — $20,251.00 $91,209.16 $33,732.16 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 36 13 — — $20,950.00 $111,984.33 $38,115.98 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 34 12 — — $21,583.70 $125,655.63 $37,386.75 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 34 13 — — $22,000.00 $129,511.55 $41,111.20 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 36 13 — — $22,000.00 $113,626.19 $35,833.05 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 6 2 — — $22,031.38 $35,376.00 $31,625.00 2026-04-01
343 MS_DRG Appendectomy Without Complicated Principal Diagnosis Without Cc/Mcc 8 3 — — $23,159.83 $35,525.86 $32,804.49 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 6 2 — — $23,577.55 $35,376.00 $31,625.00 2026-04-01
J9226 HCPCS Supprelin La Implant 12 3 — — $25,058.25 $97,205.89 $66,147.10 2026-04-01
340 MS_DRG Appendectomy With Complicated Principal Diagnosis Without Cc/Mcc 8 3 — — $25,644.08 $39,011.15 $36,022.80 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 32 13 — — $26,400.00 $138,475.11 $46,277.16 2026-04-01
294 MS_DRG Deep Vein Thrombophlebitis With Cc/Mcc 8 3 — — $26,765.12 $39,921.48 $36,863.40 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 38 13 — — $27,561.99 $133,608.06 $45,075.89 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 32 12 — — $27,915.29 $83,022.64 $27,915.29 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 34 12 — — $28,373.50 $87,886.44 $29,657.39 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 32 12 — — $28,390.51 $86,260.84 $28,390.51 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 32 12 — — $28,531.27 $86,566.45 $28,531.27 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 36 12 — — $28,550.96 $95,351.19 $31,190.98 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 32 12 — — $29,025.54 $85,061.15 $29,025.54 2026-04-01
849 MS_DRG Radiotherapy 32 12 — — $29,153.60 $86,836.30 $29,153.60 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 36 13 — — $29,410.79 $187,036.45 $29,410.79 2026-04-01
9512 OTHER Rbc Leukocytes Reduced 2 1 — — $29,852.00 $29,852.00 $29,852.00 2026-04-01
342 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Cc 8 3 — — $29,917.40 $47,246.44 $43,627.24 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 32 12 — — $30,104.03 $91,745.61 $30,104.03 2026-04-01
800 MS_DRG Splenic Procedures With Cc 32 12 — — $30,210.92 $94,726.96 $30,210.92 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 36 13 — — $30,492.28 $94,674.94 $30,645.92 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 38 13 — — $30,800.00 $157,910.78 $51,582.82 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 38 13 — — $30,843.03 $193,283.84 $63,381.66 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 34 12 — — $30,854.42 $94,759.48 $30,854.42 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 32 12 — — $30,977.19 $86,150.30 $30,977.19 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 34 13 — — $31,021.64 $97,080.83 $31,021.64 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 32 12 — — $31,036.46 $88,640.72 $31,036.46 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 32 12 — — $31,171.93 $91,300.20 $31,171.93 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 34 12 — — $31,381.49 $94,808.24 $31,381.49 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 12 4 — — $31,542.00 $288,101.84 $221,533.27 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 12 4 — — $31,542.00 $215,629.34 $164,249.54 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 12 4 — — $31,542.00 $198,853.15 $150,323.00 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 12 4 — — $31,542.00 $149,737.27 $115,272.11 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 12 4 — — $31,542.00 $118,925.64 $92,883.79 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 12 — — $31,542.00 $275,331.12 $89,416.79 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 12 — — $31,542.00 $186,586.37 $63,589.10 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 12 — — $31,542.00 $140,377.06 $44,638.78 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 36 12 — — $31,542.00 $94,187.26 $31,657.73 2026-04-01
570 MS_DRG Skin Debridement With Mcc 32 12 — — $31,604.81 $97,874.12 $31,604.81 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 6 2 — — $31,625.00 $35,376.00 $34,898.89 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 6 2 — — $31,625.00 $35,376.00 $34,898.89 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 32 12 — — $31,636.56 $85,951.97 $31,636.56 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 30 12 — — $31,978.42 $99,759.82 $31,978.42 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 8 3 — — $31,979.94 $50,270.05 $46,419.24 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 34 13 — — $32,440.93 $93,208.65 $32,440.93 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 38 13 — — $32,653.26 $124,946.73 $33,442.16 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 32 12 — — $32,879.10 $101,417.93 $32,879.10 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 34 12 — — $33,383.95 $99,434.70 $33,383.95 2026-04-01
665 MS_DRG Prostatectomy With Mcc 32 12 — — $33,510.96 $111,626.70 $33,510.96 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 32 12 — — $33,921.61 $100,254.00 $33,921.61 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 32 12 — — $33,972.41 $103,014.27 $33,972.41 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 32 12 — — $34,105.77 $114,780.36 $34,105.77 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 32 12 — — $34,173.50 $105,914.34 $34,173.50 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 30 12 — — $34,455.03 $93,049.34 $34,455.03 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 32 12 — — $34,565.11 $103,394.66 $34,565.11 2026-04-01
652 MS_DRG Kidney Transplant 32 12 — — $34,657.18 $99,850.85 $34,657.18 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 34 13 — — $34,714.34 $103,693.77 $34,714.34 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 34 12 — — $34,749.44 $107,962.60 $35,319.73 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 32 12 — — $34,903.79 $110,761.88 $34,903.79 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 34 12 — — $35,030.84 $113,827.76 $38,214.40 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 32 12 — — $35,315.50 $101,463.45 $35,315.50 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 8 3 — — $35,384.82 $52,942.54 $48,887.01 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 34 12 — — $35,436.20 $111,350.35 $37,801.64 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 32 12 — — $35,438.27 $88,965.84 $35,438.27 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 4 1 — — $36,428.97 $36,428.97 $36,428.97 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 34 12 — — $36,584.50 $109,126.53 $36,584.50 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 24 12 — — $36,870.26 $36,870.26 $36,870.26 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 32 12 — — $37,039.60 $111,802.27 $37,039.60 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 36 13 — — $37,217.41 $112,644.33 $37,217.41 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 32 12 — — $37,725.43 $118,616.78 $37,725.43 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 34 13 — — $38,146.67 $121,724.93 $38,146.67 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 34 12 — — $38,182.65 $113,909.04 $38,182.65 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 32 12 — — $38,270.50 $117,820.24 $38,270.50 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 34 12 — — $38,703.38 $116,549.02 $38,703.38 2026-04-01
265 MS_DRG Aicd Lead Procedures 32 12 — — $38,771.11 $115,967.05 $38,771.11 2026-04-01
332 MS_DRG Rectal Resection With Mcc 32 12 — — $38,797.57 $112,767.87 $38,797.57 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 32 12 — — $38,880.13 $103,186.59 $38,880.13 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 34 12 — — $39,352.17 $125,525.58 $39,352.17 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 40 14 — — $39,600.00 $149,285.35 $49,125.26 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 2 1 — — $39,688.16 $39,688.16 $39,688.16 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 2 1 — — $39,688.16 $39,688.16 $39,688.16 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 2 1 — — $39,688.16 $39,688.16 $39,688.16 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 32 12 — — $39,698.26 $112,888.17 $39,698.26 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 32 12 — — $39,920.52 $128,302.11 $39,920.52 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 32 12 — — $40,035.88 $125,203.71 $40,035.88 2026-04-01
81436 HCPCS Hereditary Colon Ca Dsordrs 4 1 — — $40,196.55 $48,235.96 $44,216.26 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 36 13 — — $40,303.65 $353,245.44 $40,303.65 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 34 13 — — $41,342.98 $122,628.76 $41,342.98 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 32 12 — — $41,382.14 $127,752.65 $41,382.14 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 32 12 — — $41,443.53 $126,422.91 $41,443.53 2026-04-01
81211 HCPCS Brca1&2 Seq & Com Dup/del 4 1 — — $41,650.44 $49,980.63 $45,815.54 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 32 12 — — $41,692.25 $140,669.67 $41,692.25 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 36 12 — — $42,211.86 $135,262.92 $45,174.32 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 32 12 — — $42,643.73 $116,542.52 $42,643.73 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 30 12 — — $43,028.98 $127,746.15 $43,028.98 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 38 12 — — $43,541.01 $159,010.00 $46,969.34 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 36 12 — — $43,850.84 $136,225.28 $44,945.71 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 32 12 — — $44,140.28 $127,121.92 $44,140.28 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 32 12 — — $44,892.79 $144,034.66 $44,892.79 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 32 12 — — $45,098.12 $133,409.74 $45,098.12 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 32 12 — — $45,360.60 $132,753.00 $45,360.60 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 32 12 — — $45,912.01 $145,796.81 $45,912.01 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 36 12 — — $46,924.91 $420,402.21 $48,598.19 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 32 12 — — $47,897.54 $136,235.03 $47,897.54 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 40 12 — — $47,911.30 $387,157.40 $47,911.30 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 8 3 — — $48,352.99 $73,444.61 $67,818.57 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 32 12 — — $48,409.79 $154,578.30 $48,409.79 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 36 13 — — $48,619.35 $146,671.39 $48,619.35 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 32 12 — — $49,001.43 $152,130.15 $49,001.43 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 30 12 — — $49,358.10 $151,252.33 $49,358.10 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 32 12 — — $49,553.91 $157,647.44 $49,553.91 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 32 12 — — $49,985.73 $155,251.30 $49,985.73 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 32 12 — — $50,133.90 $154,571.80 $50,133.90 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 32 12 — — $50,235.50 $149,782.78 $50,235.50 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 46 13 — — $50,581.88 $425,676.20 $52,745.98 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 32 12 — — $50,864.18 $152,949.45 $50,864.18 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 32 12 — — $51,324.58 $162,781.08 $51,324.58 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 32 12 — — $52,350.15 $175,398.99 $52,350.15 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 32 12 — — $52,567.12 $163,746.69 $52,567.12 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 4 1 — — $53,162.33 $63,794.93 $58,478.63 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 12 3 — — $53,266.71 $122,586.77 $84,080.57 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 34 13 — — $55,330.48 $176,488.14 $58,375.52 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 32 12 — — $55,474.49 $181,228.39 $55,474.49 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 10 3 — — $56,824.55 $122,172.78 $95,494.51 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 30 12 — — $56,884.26 $167,427.05 $56,884.26 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 32 12 — — $57,971.21 $196,226.18 $57,971.21 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 32 12 — — $58,201.94 $175,421.75 $58,201.94 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 8 3 — — $58,427.75 $86,368.13 $79,752.11 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 32 12 — — $58,580.84 $179,690.57 $58,580.84 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 12 — — $58,719.63 $185,471.21 $61,125.19 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 12 — — $59,388.39 $162,654.28 $59,388.39 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 32 12 — — $59,794.81 $176,891.29 $59,794.81 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 12 — — $59,978.96 $178,985.06 $59,978.96 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 24 12 — — $60,877.53 $60,877.53 $60,877.53 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 30 12 — — $61,514.68 $177,843.89 $61,514.68 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 32 12 — — $62,548.71 $189,281.61 $62,548.71 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 36 12 — — $63,220.27 $532,657.58 $64,067.49 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 32 12 — — $63,235.60 $196,226.18 $63,235.60 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 30 12 — — $64,049.50 $201,379.33 $64,049.50 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 12 3 — — $64,282.30 $135,956.56 $114,979.44 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 32 12 — — $65,263.46 $205,602.64 $65,263.46 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 32 12 — — $65,338.61 $194,759.88 $65,338.61 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 32 12 — — $69,815.56 $200,202.39 $69,815.56 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 38 13 — — $70,383.81 $226,169.73 $73,629.97 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 30 12 — — $71,193.58 $217,966.95 $71,193.58 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 32 12 — — $73,271.18 $216,764.01 $73,271.18 2026-04-01
10 MS_DRG Pancreas Transplant 32 12 — — $75,523.11 $259,205.17 $76,423.04 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 30 12 — — $75,943.59 $229,746.05 $75,943.59 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 32 12 — — $75,988.04 $257,712.87 $75,988.04 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 32 12 — — $76,391.29 $217,131.39 $76,391.29 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 34 13 — — $81,124.37 $242,659.81 $81,124.37 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 34 13 — — $83,758.68 $262,062.98 $83,758.68 2026-04-01
C9150 HCPCS Xe129 Xenon, Diagnostic 4 1 — — $89,350.56 $89,350.56 $89,350.56 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 8 2 — — $89,783.60 $169,820.76 $129,802.18 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 30 12 — — $92,127.31 $299,477.79 $92,127.31 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 30 12 — — $95,832.70 $271,150.08 $95,832.70 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 4 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 34 13 — — $109,601.19 $346,207.28 $109,601.19 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 30 12 — — $115,566.23 $354,156.47 $115,566.23 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 24 12 — — $120,272.85 $120,272.85 $120,272.85 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 32 12 — — $120,410.44 $358,272.49 $120,410.44 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 32 12 — — $127,671.99 $425,936.46 $127,671.99 2026-04-01
7 MS_DRG Lung Transplant 32 12 — — $137,539.29 $424,863.56 $137,539.29 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 32 12 — — $147,077.42 $459,365.30 $147,077.42 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 32 12 — — $225,120.36 $696,738.66 $225,120.36 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 32 12 — — $226,446.52 $771,275.67 $226,446.52 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 32 12 — — $297,076.56 $915,746.00 $297,076.56 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 32 12 — — $457,515.57 $1,226,034.02 $457,515.57 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 8 2 — — $489,290.60 $1,052,208.19 $1,015,824.09 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 2 — — $531,849.12 $1,081,107.57 $1,073,630.26 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 8 2 — — $559,781.08 $1,134,388.29 $1,108,454.59 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 2 — — $562,260.84 $1,110,350.92 $1,096,811.11 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 8 2 — — $588,494.81 $1,189,314.00 $1,148,035.83 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 4 1 — — $598,237.50 $598,237.50 $598,237.50 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 8 2 — — $770,620.00 $1,656,833.00 $1,599,036.50 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 2 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 1 — — $2,587,087.26 $2,587,087.26 $2,587,087.26 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 2 1 — — $2,938,320.00 $2,938,320.00 $2,938,320.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 1 — — $3,245,381.39 $3,245,381.39 $3,245,381.39 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $3,321,376.38 $3,321,376.38 $3,321,376.38 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 1 — — $3,691,450.00 $3,691,450.00 $3,691,450.00 2026-04-01
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