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 QUEEN OF THE VALLEY MEDICAL CENTER

Napa, CA · CCN 050009 · Rates published

14,557 distinct procedures filed
19 distinct payers
322,892 rate rows
2026-04-01 last MRF observed
Data quality

213,386 of 322,892 rate rows are consumer-grade (66.1%)

109,506 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 109,318
template filing: same amount across many unrelated codes — excluded 142
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-queen-of-the-valley-medical-center_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 a4bbab7b8b12c2bb… · 188,950,942 bytes · first seen 2026-05-08

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 $1,656,833.00 nat. median
$824,563
outlier · 2.0×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $588,494.81 $1,189,314.00 $1,147,826.30 nat. median
$675,122
1.7× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $559,781.08 $1,134,388.29 $1,094,816.60 nat. median
$625,184
1.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $562,260.84 $1,110,350.92 $1,071,617.74 nat. median
$674,188
1.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $531,849.12 $1,081,107.57 $1,043,394.52 nat. median
$634,511
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,290.60 $1,052,208.19 $1,015,503.25 nat. median
$620,080
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $1,727.00 $1,244,357.91 $885,861.53 nat. median
$754,974
1.2× 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 $472,961.36 $1,708,988.55 $472,961.36 nat. median
$370,174
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $307,112.67 $1,276,473.08 $307,112.67 nat. median
$265,286
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $234,101.13 $1,075,093.57 $234,101.13 nat. median
$206,368
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $232,730.26 $971,195.23 $232,730.26 nat. median
$202,986
1.1× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $152,055.87 $640,316.68 $152,055.87 nat. median
$133,176
1.1× median
7
MS_DRG 		Lung Transplant 12 $142,196.13 $592,224.16 $142,196.13 nat. median
$122,708
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $131,996.13 $593,719.69 $131,996.13 nat. median
$117,303
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $124,489.73 $499,401.78 $124,489.73 nat. median
$108,660
1.1× median
209
MS_DRG 		Complex Aortic Arch Procedures 12 $124,347.50 $124,347.50 $124,347.50 nat. median
$98,017
1.3× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 $7,699.59 $475,015.63 $121,091.55 nat. median
$98,905
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $119,482.18 $493,664.40 $119,482.18 nat. median
$102,358
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 12 $113,316.01 $482,583.90 $113,316.01 nat. median
$100,136
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 12 $17,987.00 $480,118.55 $109,448.48 nat. median
$99,019
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $4,455.00 $437,346.48 $107,542.61 nat. median
$93,672
1.1× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 3 $64,282.30 $135,956.56 $103,634.61 nat. median
$69,774
1.5× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 $99,083.28 $377,960.46 $99,083.28 nat. median
$82,712
1.2× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $97,225.26 $97,225.26 $97,225.26 nat. median
$21,806
outlier · 4.5×
A9543
HCPCS 		Y90 Ibritumomab, Rx 3 $56,824.55 $122,172.78 $95,992.69 nat. median
$62,507
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 12 $95,252.95 $417,446.90 $95,252.95 nat. median
$83,442
1.1× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 13 $4,455.00 $384,006.01 $92,740.97 nat. median
$79,312
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $23,296.00 $383,788.48 $92,451.04 nat. median
$81,118
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $75,269.24 $169,820.76 $90,251.99 nat. median
$76,377
1.2× median
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $74,906.21 $89,816.69 $89,816.69 nat. median
$775
outlier · 115.9×
5045
OTHER 		Trauma Response With Critical Care 7 $2,144.22 $123,792.79 $86,952.44 nat. median
$1,392
outlier · 62.5×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 $86,602.15 $365,293.80 $86,602.15 nat. median
$77,576
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 $4,455.00 $350,633.10 $84,517.95 nat. median
$74,915
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 $4,455.00 $354,204.24 $84,155.81 nat. median
$73,807
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 $81,600.00 $377,836.36 $83,879.02 nat. median
$72,138
1.2× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $79,488.52 $321,705.99 $79,488.52 nat. median
$68,090
1.2× median
10
MS_DRG 		Pancreas Transplant 12 $69,680.52 $361,310.26 $79,019.16 nat. median
$68,882
1.1× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 12 $78,986.34 $302,662.94 $78,986.34 nat. median
$64,027
1.2× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 $78,569.50 $359,230.12 $78,569.50 nat. median
$71,240
1.1× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 $78,523.55 $369,193.03 $78,523.55 nat. median
$68,887
1.1× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 13 $43,483.00 $499,397.61 $76,131.92 nat. median
$66,526
1.1× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 $5,940.00 $302,150.84 $75,761.03 nat. median
$65,950
1.1× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 12 $74,154.94 $309,433.60 $74,154.94 nat. median
$64,732
1.1× median

Other procedures at this hospital

Browse this hospital's 14,557 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
             
37292 HCPCS Hc Revsc Evasc Tpvt St Athrc Uni Sf Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37290 HCPCS Hc Revsc Evasc Tpvt Athrc Uni Cplx Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37288 HCPCS Hc Revsc Evasc Tpvt Athrc Uni Sf Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
0645T HCPCS Tcat Impltj C Sins Rdctj Dev 10 3 — — $1,727.00 $35,769.00 $26,028.38 2026-04-01
37294 HCPCS Hc Revsc Evasc Tpvt St Athrc Uni Cplx Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37277 HCPCS Hc Revsc Evasc Fpvt St Athrc Uni Cplx Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37273 HCPCS Hc Revsc Evasc Fpvt Athrc Uni Cplx Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
37275 HCPCS Hc Revsc Evasc Fpvt St Athrc Uni Sf Les 1st Vsl Cdm 2 1 — — $26,028.38 $26,028.38 $26,028.38 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 36 12 — — $26,079.40 $95,682.00 $26,079.40 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 38 12 — — $24,486.74 $104,609.85 $26,098.00 2026-04-01
340 MS_DRG Appendectomy With Complicated Principal Diagnosis Without Cc/Mcc 4 1 — — $23,660.21 $28,577.50 $26,118.85 2026-04-01
333 MS_DRG Rectal Resection With Cc 36 12 — — $26,137.38 $96,307.41 $26,137.38 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 10 4 — — $2,172.95 $50,454.19 $26,224.48 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 36 12 — — $26,234.76 $102,266.86 $26,234.76 2026-04-01
81211 HCPCS Brca1&2 Seq & Com Dup/del 6 1 — — $22,037.12 $31,708.42 $26,423.79 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 40 12 — — $7,560.00 $107,700.60 $26,620.96 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 36 12 — — $26,665.82 $103,082.60 $26,665.82 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 32 12 — — $26,713.96 $112,282.35 $26,713.96 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 42 12 — — $26,518.01 $521,025.96 $26,739.12 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 42 12 — — $17,987.00 $104,895.36 $26,827.74 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 24 12 — — $26,926.21 $26,926.21 $26,926.21 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 24 12 — — $27,012.64 $27,012.64 $27,012.64 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 44 12 — — $23,296.00 $335,437.01 $27,221.60 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 36 12 — — $27,253.33 $110,039.06 $27,253.33 2026-04-01
792 MS_DRG Prematurity Without Major Problems 46 13 — — $43.03 $111,022.49 $27,308.04 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 38 12 — — $17,388.00 $83,477.60 $27,372.59 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 40 12 — — $26,946.57 $110,963.57 $27,409.78 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 36 12 — — $27,417.44 $105,973.95 $27,417.44 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 38 12 — — $27,663.61 $114,507.52 $27,663.61 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 36 12 — — $27,775.20 $109,662.92 $27,775.20 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 36 12 — — $28,114.36 $111,829.16 $28,114.36 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 38 12 — — $25,134.00 $114,058.86 $28,126.40 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 44 12 — — $13,727.00 $108,810.92 $28,258.78 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 38 12 — — $28,311.30 $117,113.36 $28,311.30 2026-04-01
0036U HCPCS Xome Tum & Nml Spec Seq Alys 14 3 — — $4,780.00 $42,226.47 $28,313.95 2026-04-01
5622 OTHER Level 2 Radiation Therapy 20 6 — — $6,379.79 $71,500.34 $28,408.67 2026-04-01
J9266 HCPCS Pegaspargase Injection 14 3 — — $1,803.64 $58,201.64 $28,424.06 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 46 12 — — $5,940.00 $113,388.14 $28,443.68 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 36 12 — — $28,603.41 $117,303.70 $28,603.41 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 40 12 — — $23,460.40 $108,629.64 $28,730.32 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 44 12 — — $26,924.38 $108,629.64 $28,730.32 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 38 13 — — $10,200.00 $122,107.51 $28,769.71 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 38 13 — — $19,765.00 $115,726.60 $28,875.84 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 44 13 — — $17,987.00 $115,694.88 $28,909.75 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 36 12 — — $29,367.07 $120,240.37 $29,367.07 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 36 12 — — $29,512.58 $120,666.37 $29,512.58 2026-04-01
0211U HCPCS Onc Pan-tum Dna&rna Gnrj Seq 14 3 — — $7,350.00 $50,082.52 $29,595.72 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 44 13 — — $13,727.00 $129,775.49 $29,614.33 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 36 12 — — $30,023.51 $118,568.10 $30,023.51 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 36 12 — — $30,119.79 $123,779.78 $30,119.79 2026-04-01
849 MS_DRG Radiotherapy 36 12 — — $30,155.90 $121,042.52 $30,155.90 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 44 13 — — $11,859.00 $236,460.15 $30,279.52 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 36 12 — — $30,421.75 $123,113.60 $30,421.75 2026-04-01
342 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Cc 4 1 — — $27,602.94 $33,339.64 $30,471.29 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 38 12 — — $18,779.00 $118,880.80 $30,577.11 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 58 13 — — $25,083.16 $289,805.40 $30,584.77 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 38 12 — — $20,367.53 $122,506.32 $30,676.67 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 42 12 — — $13,727.00 $115,477.34 $30,838.59 2026-04-01
0214U HCPCS Rare Ds Xom DNA Alys Proband 14 3 — — $5,224.60 $46,885.00 $30,947.47 2026-04-01
503 MS_DRG Foot Procedures With Mcc 42 12 — — $13,727.00 $119,936.73 $31,048.65 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 36 12 — — $31,138.37 $127,885.69 $31,138.37 2026-04-01
800 MS_DRG Splenic Procedures With Cc 36 12 — — $31,248.87 $132,041.44 $31,248.87 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 36 12 — — $31,698.53 $131,968.93 $31,698.53 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 38 12 — — $31,914.06 $132,086.76 $31,914.06 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 36 12 — — $32,040.97 $120,086.29 $32,040.97 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 38 13 — — $15,300.00 $135,322.53 $32,086.93 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 36 12 — — $32,102.24 $123,557.72 $32,102.24 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 6 2 — — $24,321.49 $35,769.00 $32,162.00 2026-04-01
C9783 HCPCS Blind Cor Sinus Reducer Impl 6 2 — — $16,391.15 $35,769.00 $32,162.00 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 6 2 — — $26,028.38 $35,769.00 $32,162.00 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 36 12 — — $32,242.28 $127,264.82 $32,242.28 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 36 12 — — $32,261.98 $132,911.56 $32,261.98 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 46 12 — — $13,727.00 $133,283.18 $32,374.67 2026-04-01
0212U HCPCS Rare Ds Gen DNA Alys Proband 14 3 — — $5,475.20 $49,133.87 $32,431.92 2026-04-01
0265U HCPCS Rar Do Whl Gn&mtcdrl DNA Als 14 3 — — $5,475.80 $49,139.26 $32,435.45 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 36 12 — — $32,458.91 $132,154.74 $32,458.91 2026-04-01
S3865 HCPCS Comp Genet Test Hyp Cardiomy 2 1 — — $32,488.46 $32,488.46 $32,488.46 2026-04-01
294 MS_DRG Deep Vein Thrombophlebitis With Cc/Mcc 12 4 — — $24,694.53 $55,647.20 $32,554.01 2026-04-01
570 MS_DRG Skin Debridement With Mcc 36 12 — — $32,689.76 $136,428.32 $32,689.76 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 36 12 — — $32,722.58 $119,809.84 $32,722.58 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 44 12 — — $23,296.00 $131,289.14 $32,744.46 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 32 12 — — $33,075.96 $139,056.82 $33,075.96 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 44 12 — — $13,727.00 $114,416.88 $33,517.97 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 10 2 — — $23,296.00 $91,490.33 $33,520.00 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 10 2 — — $23,296.00 $156,608.60 $33,520.00 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 10 2 — — $23,296.00 $111,457.82 $33,520.00 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 10 2 — — $23,296.00 $213,879.91 $33,520.00 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 10 2 — — $23,296.00 $141,866.20 $33,520.00 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 36 12 — — $33,554.07 $129,925.04 $33,554.07 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 42 12 — — $13,727.00 $129,521.70 $33,558.45 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 40 13 — — $16,934.39 $148,125.15 $33,697.39 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 6 1 — — $28,128.06 $40,472.46 $33,727.19 2026-04-01
263 MS_DRG Vein Ligation And Stripping 44 13 — — $15,300.00 $121,541.03 $33,962.16 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 36 12 — — $34,007.01 $141,368.09 $34,007.01 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 36 12 — — $34,528.89 $138,603.63 $34,528.89 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 36 12 — — $34,589.06 $133,627.60 $34,589.06 2026-04-01
665 MS_DRG Prostatectomy With Mcc 36 12 — — $34,660.17 $155,598.25 $34,660.17 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 16 4 — — $3,281.88 $38,126.21 $34,691.40 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 42 12 — — $17,987.00 $127,137.92 $34,888.83 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 48 13 — — $4,455.00 $140,765.35 $34,969.79 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 36 13 — — $34,986.21 $144,794.21 $34,986.21 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 36 12 — — $35,084.67 $139,745.67 $35,084.67 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 38 13 — — $27,671.00 $143,593.25 $35,137.19 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 36 12 — — $35,275.04 $159,994.20 $35,275.04 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 36 12 — — $35,345.06 $147,635.71 $35,345.06 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 42 12 — — $13,727.00 $140,135.41 $35,378.98 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 52 13 — — $4,428.00 $153,722.05 $35,443.53 2026-04-01
509 MS_DRG Arthroscopy 18 5 — — $13,727.00 $79,602.82 $35,535.75 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 32 12 — — $35,636.08 $129,702.98 $35,636.08 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 36 12 — — $35,749.87 $144,123.48 $35,749.87 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 44 12 — — $13,727.00 $247,228.61 $35,818.79 2026-04-01
652 MS_DRG Kidney Transplant 36 12 — — $35,845.05 $139,183.71 $35,845.05 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 32 12 — — $35,854.90 $139,845.37 $35,854.90 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 44 13 — — $8,734.03 $144,540.42 $35,904.13 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 36 12 — — $35,943.52 $147,699.15 $35,943.52 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 4 1 — — $32,647.40 $39,432.48 $36,039.94 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 42 12 — — $17,987.00 $154,392.77 $36,099.97 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 38 12 — — $13,100.00 $141,431.54 $36,525.56 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 36 12 — — $36,529.94 $150,490.80 $36,529.94 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 6 1 — — $30,539.89 $36,619.01 $36,619.01 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 36 12 — — $36,652.47 $124,010.91 $36,652.47 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 14 4 — — $26,898.24 $43,067.08 $36,908.64 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 46 13 — — $3,953.00 $158,385.37 $37,060.56 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 40 13 — — $9,088.70 $159,939.81 $37,788.11 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 36 12 — — $37,837.35 $152,113.22 $37,837.35 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 38 12 — — $35,954.30 $158,752.46 $38,021.15 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 24 12 — — $38,132.75 $38,132.75 $38,132.75 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 36 12 — — $38,307.80 $155,842.98 $38,307.80 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 36 12 — — $38,491.60 $157,016.74 $38,491.60 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 38 12 — — $17,885.38 $175,153.40 $38,666.65 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 50 14 — — $5,591.81 $155,453.23 $38,676.50 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 38 13 — — $35,879.00 $165,341.84 $39,016.75 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 40 12 — — $18,779.00 $155,213.04 $39,095.53 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 46 12 — — $5,940.00 $156,096.76 $39,420.46 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 38 13 — — $86.06 $169,674.34 $39,452.19 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 36 12 — — $39,489.39 $158,779.65 $39,489.39 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 36 12 — — $39,522.21 $158,666.35 $39,522.21 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 36 12 — — $39,580.20 $164,231.52 $39,580.20 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 42 12 — — $13,727.00 $178,434.50 $39,619.58 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 42 12 — — $13,727.00 $180,401.34 $39,710.39 2026-04-01
0267U HCPCS Rare Do Id Opt Gen Mapg&seq 14 3 — — $6,739.33 $60,478.05 $39,919.88 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 32 12 — — $39,968.59 $145,211.14 $39,968.59 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 36 12 — — $40,027.67 $162,459.55 $40,027.67 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 12 4 — — $29,505.93 $70,072.24 $40,032.54 2026-04-01
265 MS_DRG Aicd Lead Procedures 42 12 — — $17,987.00 $161,648.34 $40,097.69 2026-04-01
332 MS_DRG Rectal Resection With Mcc 36 12 — — $40,125.04 $157,188.95 $40,125.04 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 42 12 — — $13,727.00 $159,536.48 $40,179.75 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 36 12 — — $40,210.38 $143,833.44 $40,210.38 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 42 12 — — $13,727.00 $160,927.77 $40,681.92 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 36 12 — — $40,698.34 $174,972.13 $40,698.34 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 8 4 — — $24,373.55 $45,311.12 $41,045.68 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 36 12 — — $41,056.10 $157,356.63 $41,056.10 2026-04-01
J9226 HCPCS Supprelin La Implant 14 3 — — $21,007.35 $97,205.89 $41,173.43 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 36 12 — — $41,285.85 $178,842.37 $41,285.85 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 44 12 — — $13,727.00 $162,414.23 $41,400.73 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 44 13 — — $11,191.03 $188,700.00 $41,405.10 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 38 13 — — $41,502.48 $149,629.74 $41,502.48 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 42 12 — — $41,243.25 $201,126.12 $41,681.90 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 42 12 — — $41,819.22 $180,528.24 $42,516.68 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 40 13 — — $75.00 $170,934.20 $42,756.28 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 36 12 — — $42,796.76 $178,076.48 $42,796.76 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 36 12 — — $42,860.21 $176,222.93 $42,860.21 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 36 12 — — $43,117.32 $196,081.72 $43,117.32 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 12 — — $43,310.97 $172,275.65 $43,310.97 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 2 1 — — $43,813.66 $43,813.66 $43,813.66 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 2 1 — — $43,813.66 $43,813.66 $43,813.66 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 2 1 — — $43,813.66 $43,813.66 $43,813.66 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 2 1 — — $44,035.39 $44,035.39 $44,035.39 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 36 12 — — $44,100.89 $162,450.49 $44,100.89 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 36 12 — — $43,322.27 $178,067.41 $44,499.13 2026-04-01
791 MS_DRG Prematurity With Major Problems 42 12 — — $44,920.34 $183,999.67 $44,920.34 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 38 12 — — $13,100.00 $177,197.29 $45,647.90 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 36 12 — — $45,948.77 $184,316.90 $45,948.77 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 52 14 — — $2,823.00 $189,007.42 $46,130.38 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 12 — — $23,296.00 $195,673.85 $46,163.21 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 52 12 — — $4,455.00 $186,342.66 $46,340.44 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 36 12 — — $46,425.78 $200,772.23 $46,425.78 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 38 12 — — $46,480.49 $189,886.61 $46,480.49 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 38 12 — — $46,615.06 $228,715.04 $46,615.06 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 36 12 — — $46,638.03 $185,961.98 $46,638.03 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 46 12 — — $5,940.00 $188,545.17 $46,716.80 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 36 12 — — $46,909.36 $333,075.36 $46,909.36 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 40 13 — — $11,572.95 $191,654.05 $47,177.41 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 36 12 — — $47,479.37 $203,228.52 $47,479.37 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 34 12 — — $47,856.82 $193,022.68 $47,856.82 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 36 12 — — $48,572.34 $193,303.66 $48,572.34 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 4 1 — — $44,612.33 $53,884.08 $49,248.21 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 42 12 — — $17,987.00 $199,063.71 $49,339.29 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 36 12 — — $49,531.84 $189,900.21 $49,531.84 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 44 13 — — $27,671.00 $208,870.74 $49,546.06 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 36 12 — — $50,061.37 $215,469.19 $50,061.37 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 44 12 — — $35,968.05 $202,666.57 $50,256.11 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 38 12 — — $50,278.00 $204,447.60 $50,278.00 2026-04-01
245 MS_DRG Aicd Generator Procedures 46 13 — — $4,428.00 $221,451.29 $50,427.88 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 36 12 — — $50,672.95 $212,056.66 $50,672.95 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 46 12 — — $47,966.86 $208,091.25 $50,800.96 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 32 12 — — $51,041.66 $210,833.05 $51,041.66 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 36 12 — — $51,244.06 $219,747.30 $51,244.06 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 36 12 — — $51,690.44 $216,407.29 $51,690.44 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 38 12 — — $51,843.61 $215,460.12 $51,843.61 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 36 12 — — $51,948.64 $208,784.63 $51,948.64 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 42 12 — — $17,987.00 $213,198.70 $52,598.51 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 36 12 — — $53,074.43 $226,903.17 $53,074.43 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 42 12 — — $23,296.00 $220,114.38 $53,341.39 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 36 12 — — $54,134.59 $244,491.47 $54,134.59 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 36 12 — — $54,358.87 $228,249.14 $54,358.87 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 4 1 — — $17,771.01 $91,084.50 $54,427.76 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 52 13 — — $29,734.30 $322,499.90 $54,543.77 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 46 12 — — $4,455.00 $225,820.05 $54,640.05 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 12 3 — — $44,655.65 $122,586.77 $54,906.90 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 12 — — $55,077.67 $230,161.61 $55,077.67 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 12 — — $4,455.00 $208,118.44 $55,655.34 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 36 12 — — $57,364.27 $252,617.17 $57,364.27 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 40 13 — — $18,779.00 $230,868.58 $57,462.74 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 46 12 — — $5,940.00 $232,613.36 $58,238.44 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 38 13 — — $35,700.00 $250,491.71 $58,429.90 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 32 12 — — $58,821.57 $233,379.25 $58,821.57 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 48 12 — — $4,455.00 $240,023.02 $58,856.58 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 4 1 — — $53,907.69 $65,111.28 $59,509.49 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 36 12 — — $59,945.18 $273,522.82 $59,945.18 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 36 12 — — $60,183.69 $244,523.20 $60,183.69 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 52 12 — — $4,455.00 $260,927.32 $60,277.78 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 38 13 — — $23,718.00 $246,009.66 $60,363.12 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 36 12 — — $60,575.36 $250,473.58 $60,575.36 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 42 12 — — $13,727.00 $278,109.11 $60,937.50 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 32 12 — — $61,410.14 $226,726.43 $61,410.14 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 36 12 — — $61,830.26 $246,571.62 $61,830.26 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 12 — — $43,269.75 $249,490.16 $62,020.63 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 38 13 — — $15,812.00 $244,754.32 $62,868.53 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 24 12 — — $62,949.49 $62,949.49 $62,949.49 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 40 12 — — $62,018.23 $481,746.57 $63,205.50 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 32 12 — — $63,608.12 $247,899.46 $63,608.12 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 36 12 — — $64,677.03 $263,842.69 $64,677.03 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 44 12 — — $4,455.00 $266,647.93 $64,718.60 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 36 12 — — $65,387.08 $273,522.82 $65,387.08 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 40 13 — — $43,526.03 $269,421.46 $65,538.06 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 12 — — $23,296.00 $260,085.74 $65,752.49 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 36 12 — — $66,228.41 $280,705.89 $66,228.41 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 38 12 — — $57,839.95 $275,498.73 $66,247.01 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 44 12 — — $4,455.00 $276,822.05 $66,841.09 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 36 12 — — $67,483.31 $286,592.82 $67,483.31 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 42 12 — — $17,987.00 $271,478.94 $67,560.99 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 44 13 — — $70,489.95 $316,899.85 $70,912.12 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 36 12 — — $72,188.90 $279,065.34 $72,188.90 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 12 — — $4,455.00 $292,642.91 $72,450.38 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 12 — — $4,455.00 $269,607.26 $72,450.38 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 32 12 — — $73,613.37 $303,827.64 $73,613.37 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 34 13 — — $73,666.98 $280,343.33 $73,666.98 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 36 12 — — $74,154.94 $309,433.60 $74,154.94 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 44 12 — — $5,940.00 $302,150.84 $75,761.03 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 48 13 — — $43,483.00 $499,397.61 $76,131.92 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 36 12 — — $78,523.55 $369,193.03 $78,523.55 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 36 12 — — $78,569.50 $359,230.12 $78,569.50 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 36 12 — — $78,986.34 $302,662.94 $78,986.34 2026-04-01
10 MS_DRG Pancreas Transplant 36 12 — — $69,680.52 $361,310.26 $79,019.16 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 12 — — $79,488.52 $321,705.99 $79,488.52 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 40 13 — — $81,600.00 $377,836.36 $83,879.02 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 46 12 — — $4,455.00 $354,204.24 $84,155.81 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 50 13 — — $4,455.00 $350,633.10 $84,517.95 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 36 12 — — $86,602.15 $365,293.80 $86,602.15 2026-04-01
5045 OTHER Trauma Response With Critical Care 20 7 — — $2,144.22 $123,792.79 $86,952.44 2026-04-01
C9150 HCPCS Xe129 Xenon, Diagnostic 6 1 — — $74,906.21 $89,816.69 $89,816.69 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 10 2 — — $75,269.24 $169,820.76 $90,251.99 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 12 — — $23,296.00 $383,788.48 $92,451.04 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 46 13 — — $4,455.00 $384,006.01 $92,740.97 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 32 12 — — $95,252.95 $417,446.90 $95,252.95 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 12 3 — — $56,824.55 $122,172.78 $95,992.69 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 4 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 32 12 — — $99,083.28 $377,960.46 $99,083.28 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 14 3 — — $64,282.30 $135,956.56 $103,634.61 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 12 — — $4,455.00 $437,346.48 $107,542.61 2026-04-01
215 MS_DRG Other Heart Assist System Implant 46 12 — — $17,987.00 $480,118.55 $109,448.48 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 36 12 — — $113,316.01 $482,583.90 $113,316.01 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 32 12 — — $119,482.18 $493,664.40 $119,482.18 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 36 13 — — $7,699.59 $475,015.63 $121,091.55 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 24 12 — — $124,347.50 $124,347.50 $124,347.50 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 36 12 — — $124,489.73 $499,401.78 $124,489.73 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 36 12 — — $131,996.13 $593,719.69 $131,996.13 2026-04-01
7 MS_DRG Lung Transplant 36 12 — — $142,196.13 $592,224.16 $142,196.13 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 38 12 — — $152,055.87 $640,316.68 $152,055.87 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 12 — — $232,730.26 $971,195.23 $232,730.26 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 36 12 — — $234,101.13 $1,075,093.57 $234,101.13 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 36 12 — — $307,112.67 $1,276,473.08 $307,112.67 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 36 12 — — $472,961.36 $1,708,988.55 $472,961.36 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 4 1 — — $598,237.50 $598,237.50 $598,237.50 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 3 — — $1,727.00 $1,244,357.91 $885,861.53 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 8 2 — — $489,290.60 $1,052,208.19 $1,015,503.25 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 2 — — $531,849.12 $1,081,107.57 $1,043,394.52 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 2 — — $562,260.84 $1,110,350.92 $1,071,617.74 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 8 2 — — $559,781.08 $1,134,388.29 $1,094,816.60 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 8 2 — — $588,494.81 $1,189,314.00 $1,147,826.30 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 6 2 — — $770,620.00 $1,656,833.00 $1,656,833.00 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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