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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

HOLLYWOOD PRESBYTERIAN MEDICAL CENTER

Los Angeles, CA · CCN 050063 · Rates published

Your selected procedure

You selected 27447 (HCPCS)

Total knee arthroplasty

This hospital’s price: $11,148 across 1 payer

Source: https://www.hollywoodpresbyterian.com/wp-content/uploads/2025/10/hpmc-cms-report-with-ndc.json · observed 2026-03-12

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

20,967 distinct procedures filed
51 distinct payers
1,241,696 rate rows
2026-05-28 last MRF observed
Data quality

851,066 of 1,241,696 rate rows are consumer-grade (68.5%)

390,630 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 352,887
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 23,714
per-diem day rate — not a per-procedure price 7,191
template filing: same amount across many unrelated codes — excluded 6,820
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hollywoodpresbyterian.com/300284087_HOLLYWOOD-PRESBYTERIAN-MEDICAL-CENTER_STANDARDCHARGES.json
Found on page https://www.hollywoodpresbyterian.com/billing-and-financial-services/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-12
Content fingerprint 1d2ed541d19190ce… · 199,285,202 bytes · first seen 2026-05-13

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $362,342.07 $362,342.07 $362,342.07 nat. median
$370,165
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 25 $266,990.14 $266,990.14 $266,990.14 nat. median
$261,939
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 $232,457.36 $232,457.36 $232,457.36 nat. median
$205,166
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 $184,143.04 $205,514.19 $184,143.04 nat. median
$199,832
0.9× median
583
APR_DRG 		Neonate With Ecmo 8 $159,230.49 $159,230.49 $159,230.49 nat. median
$13,007
outlier · 12.2×
161
APR_DRG 		Implantable Heart Assist Systems 8 $136,498.36 $136,498.36 $136,498.36 nat. median
$157,885
0.9× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 36 $58,286.36 $131,224.42 $131,224.42 nat. median
$56,397
outlier · 2.3×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 36 $91,269.09 $130,183.00 $130,183.00 nat. median
$60,162
outlier · 2.2×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 24 $123,976.48 $123,976.48 $123,976.48 nat. median
$114,305
1.1× median
467
MS_DRG 		Revision Of Hip Or Knee Replacement With Cc 36 $29,420.18 $218,034.36 $123,727.27 nat. median
$34,366
outlier · 3.6×
7
MS_DRG 		Lung Transplant 24 $122,818.48 $122,818.48 $122,818.48 nat. median
$122,690
1.0× median
589
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 8 $919.31 $122,725.79 $122,725.79 nat. median
$66,644
1.8× median
588
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $122,422.12 $122,422.12 $122,422.12 nat. median
$280,935
outlier · 0.4×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 36 $62,057.21 $163,268.89 $112,663.05 nat. median
$132,706
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 $108,448.54 $108,448.54 $108,448.54 nat. median
$108,240
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 24 $104,545.70 $104,545.70 $104,545.70 nat. median
$100,978
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 24 $100,854.53 $100,854.53 $100,854.53 nat. median
$99,646
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 36 $25,800.00 $164,781.00 $98,390.50 nat. median
$98,002
1.0× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 36 $69,327.56 $97,750.00 $97,750.00 nat. median
$47,266
outlier · 2.1×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 36 $90,757.99 $101,533.58 $90,757.99 nat. median
$96,835
0.9× median
2
APR_DRG 		Heart And/or Lung Transplant 9 $87,593.99 $243,231.46 $87,593.99 nat. median
$137,947
0.6× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 38 $25,800.00 $146,630.00 $87,556.50 nat. median
$92,900
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 24 $87,437.55 $87,437.55 $87,437.55 nat. median
$81,364
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 $85,724.74 $85,724.74 $85,724.74 nat. median
$80,459
1.1× median
283
MS_DRG 		Acute Myocardial Infarction, Expired With Mcc 37 $16,578.52 $150,192.51 $83,385.51 nat. median
$19,554
outlier · 4.3×
11
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $82,088.32 $82,088.32 $82,088.32 nat. median
$52,667
1.6× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 $81,475.79 $81,475.79 $81,475.79 nat. median
$77,385
1.1× median
779
MS_DRG 		Abortion Without D&c 36 $9,472.85 $80,462.68 $80,462.68 nat. median
$9,267
outlier · 8.7×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 24 $79,718.54 $79,718.54 $79,718.54 nat. median
$81,124
1.0× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 36 $77,769.00 $98,282.00 $77,769.00 nat. median
$65,792
1.2× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 24 $77,052.27 $77,052.27 $77,052.27 nat. median
$69,153
1.1× median
10
MS_DRG 		Pancreas Transplant 25 $76,218.00 $76,218.00 $76,218.00 nat. median
$67,750
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 $71,434.29 $71,434.29 $71,434.29 nat. median
$71,485
1.0× median
D1806
HCPCS 		Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 3 24 $69,905.98 $69,905.98 $69,905.98 nat. median
$49,816
1.4× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 $25,800.00 $108,040.00 $68,261.50 nat. median
$74,472
0.9× median
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 37 $25,800.00 $106,871.30 $67,677.15 nat. median
$32,689
outlier · 2.1×
C0106
HCPCS 		Stroke M <41.50 And A <84.50- Tier Tier 2 24 $67,609.93 $67,609.93 $67,609.93 nat. median
$47,992
1.4× median
B0604
HCPCS 		Neurological M <43.50- Tier Tier 1 24 $66,799.88 $66,799.88 $66,799.88 nat. median
$46,532
1.4× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 24 $66,701.53 $66,701.53 $66,701.53 nat. median
$62,911
1.1× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 37 $25,800.00 $104,724.00 $66,603.50 nat. median
$50,071
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 38 $25,800.00 $103,778.00 $66,130.50 nat. median
$73,475
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 38 $25,800.00 $102,807.00 $65,645.00 nat. median
$79,040
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 24 $64,549.86 $64,549.86 $64,549.86 nat. median
$64,357
1.0× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 24 $63,961.79 $63,961.79 $63,961.79 nat. median
$60,294
1.1× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 24 $63,879.34 $63,879.34 $63,879.34 nat. median
$62,262
1.0× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Mcc. 37 $10,844.00 $116,295.00 $63,569.50 nat. median
$58,534
1.1× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $63,499.33 $63,499.33 $63,499.33 nat. median
$69,291
0.9× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 24 $62,833.90 $62,833.90 $62,833.90 nat. median
$55,446
1.1× median
749
MS_DRG 		Other Female Reproductive System O.r. Procedures With Cc/mcc 36 $22,275.68 $103,219.63 $62,747.65 nat. median
$25,340
outlier · 2.5×
B0704
HCPCS 		Fracture Of Lower Extremity M <41.50- Tier Tier 1 24 $62,425.06 $62,425.06 $62,425.06 nat. median
$43,685
1.4× median

Other procedures at this hospital

Browse this hospital's 20,967 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 35 24 — — $362,342.07 $362,342.07 $362,342.07 2026-03-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 37 25 — — $266,990.14 $266,990.14 $266,990.14 2026-03-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 35 24 — — $232,457.36 $232,457.36 $232,457.36 2026-03-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 165 36 — — $184,143.04 $205,514.19 $184,143.04 2026-03-12
583 APR_DRG Neonate With Ecmo 9 8 — — $159,230.49 $159,230.49 $159,230.49 2026-03-12
161 APR_DRG Implantable Heart Assist Systems 9 8 — — $136,498.36 $136,498.36 $136,498.36 2026-03-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 165 36 — — $58,286.36 $131,224.42 $131,224.42 2026-03-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 183 36 — — $91,269.09 $130,183.00 $130,183.00 2026-03-12
14 MS_DRG Allogeneic Bone Marrow Transplant 35 24 — — $123,976.48 $123,976.48 $123,976.48 2026-03-12
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 165 36 — — $29,420.18 $218,034.36 $123,727.27 2026-03-12
7 MS_DRG Lung Transplant 35 24 — — $122,818.48 $122,818.48 $122,818.48 2026-03-12
589 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 11 8 — — $919.31 $122,725.79 $122,725.79 2026-03-12
588 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 9 8 — — $122,422.12 $122,422.12 $122,422.12 2026-03-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 165 36 — — $62,057.21 $163,268.89 $112,663.05 2026-03-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 35 24 — — $108,448.54 $108,448.54 $108,448.54 2026-03-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 35 24 — — $104,545.70 $104,545.70 $104,545.70 2026-03-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 35 24 — — $100,854.53 $100,854.53 $100,854.53 2026-03-12
215 MS_DRG Other Heart Assist System Implant 189 36 — — $25,800.00 $164,781.00 $98,390.50 2026-03-12
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 183 36 — — $69,327.56 $97,750.00 $97,750.00 2026-03-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 165 36 — — $90,757.99 $101,533.58 $90,757.99 2026-03-12
2 APR_DRG Heart And/or Lung Transplant 10 9 — — $87,593.99 $243,231.46 $87,593.99 2026-03-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 207 38 — — $25,800.00 $146,630.00 $87,556.50 2026-03-12
850 MS_DRG Acute Leukemia With Other Procedures 35 24 — — $87,437.55 $87,437.55 $87,437.55 2026-03-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 24 — — $85,724.74 $85,724.74 $85,724.74 2026-03-12
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 174 37 — — $16,578.52 $150,192.51 $83,385.51 2026-03-12
11 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 8 — — $82,088.32 $82,088.32 $82,088.32 2026-03-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 35 24 — — $81,475.79 $81,475.79 $81,475.79 2026-03-12
779 MS_DRG Abortion Without D&c 165 36 — — $9,472.85 $80,462.68 $80,462.68 2026-03-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 35 24 — — $79,718.54 $79,718.54 $79,718.54 2026-03-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 183 36 — — $77,769.00 $98,282.00 $77,769.00 2026-03-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 35 24 — — $77,052.27 $77,052.27 $77,052.27 2026-03-12
10 MS_DRG Pancreas Transplant 37 25 — — $76,218.00 $76,218.00 $76,218.00 2026-03-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 35 24 — — $71,434.29 $71,434.29 $71,434.29 2026-03-12
D1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50- Tier Tier 3 64 24 — — $69,905.98 $69,905.98 $69,905.98 2026-03-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 168 38 — — $25,800.00 $108,040.00 $68,261.50 2026-03-12
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 195 37 — — $25,800.00 $106,871.30 $67,677.15 2026-03-12
C0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 2 64 24 — — $67,609.93 $67,609.93 $67,609.93 2026-03-12
B0604 HCPCS Neurological M <43.50- Tier Tier 1 64 24 — — $66,799.88 $66,799.88 $66,799.88 2026-03-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 35 24 — — $66,701.53 $66,701.53 $66,701.53 2026-03-12
228 MS_DRG Other Cardiothoracic Procedures With Mcc 195 37 — — $25,800.00 $104,724.00 $66,603.50 2026-03-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 207 38 — — $25,800.00 $103,778.00 $66,130.50 2026-03-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 207 38 — — $25,800.00 $102,807.00 $65,645.00 2026-03-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 35 24 — — $64,549.86 $64,549.86 $64,549.86 2026-03-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 35 24 — — $63,961.79 $63,961.79 $63,961.79 2026-03-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 35 24 — — $63,879.34 $63,879.34 $63,879.34 2026-03-12
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Mcc. 160 37 — — $10,844.00 $116,295.00 $63,569.50 2026-03-12
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 1 1 — — $63,499.33 $63,499.33 $63,499.33 2025-11-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 35 24 — — $62,833.90 $62,833.90 $62,833.90 2026-03-12
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 165 36 — — $22,275.68 $103,219.63 $62,747.65 2026-03-12
B0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 1 64 24 — — $62,425.06 $62,425.06 $62,425.06 2026-03-12
D0106 HCPCS Stroke M <41.50 And A <84.50- Tier Tier 3 64 24 — — $61,783.99 $61,783.99 $61,783.99 2026-03-12
1 APR_DRG Liver Transplant And/or Intestinal Transplant 10 9 — — $61,435.84 $137,900.99 $61,435.84 2026-03-12
6 APR_DRG Pancreas Transplant 9 8 — — $61,396.14 $61,396.14 $61,396.14 2026-03-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 165 36 — — $61,359.86 $68,645.04 $61,359.86 2026-03-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 207 38 — — $25,800.00 $94,014.00 $61,248.50 2026-03-12
7 APR_DRG Allogeneic Bone Marrow Transplant 9 8 — — $60,953.18 $60,953.18 $60,953.18 2026-03-12
B0904 HCPCS Other Orthopedic M <44.5- Tier Tier 1 64 24 — — $60,303.36 $60,303.36 $60,303.36 2026-03-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 35 24 — — $59,938.55 $59,938.55 $59,938.55 2026-03-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 35 24 — — $59,542.36 $59,542.36 $59,542.36 2026-03-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 35 24 — — $59,542.36 $59,542.36 $59,542.36 2026-03-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 35 24 — — $59,286.25 $59,286.25 $59,286.25 2026-03-12
224 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc. 160 37 — — $10,844.00 $106,954.00 $58,899.00 2026-03-12
A0106 HCPCS Stroke M <41.50 And A <84.50- Tier None 64 24 — — $58,879.06 $58,879.06 $58,879.06 2026-03-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 24 — — $58,562.05 $58,562.05 $58,562.05 2026-03-12
C0205 HCPCS Traumatic Brain Injury M <35.50- Tier Tier 2 64 24 — — $58,288.96 $58,288.96 $58,288.96 2026-03-12
B0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 1 64 24 — — $58,224.58 $58,224.58 $58,224.58 2026-03-12
28 MS_DRG Spinal Procedures With Mcc 35 24 — — $58,087.79 $58,087.79 $58,087.79 2026-03-12
B0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 1 64 24 — — $57,993.90 $57,993.90 $57,993.90 2026-03-12
199 MS_DRG Pneumothorax With Mcc 165 36 — — $17,101.20 $79,848.11 $57,494.04 2026-03-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 35 24 — — $56,923.00 $56,923.00 $56,923.00 2026-03-12
A9543 HCPCS Y90 Ibritumomab, Rx 1 1 — — $56,824.55 $56,824.55 $56,824.55 2026-03-12
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 183 36 — — $46,519.35 $56,477.00 $56,477.00 2026-03-12
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $55,945.97 $55,945.97 $55,945.97 2026-03-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 24 — — $54,643.64 $54,643.64 $54,643.64 2026-03-12
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 35 24 — — $54,553.42 $54,553.42 $54,553.42 2026-03-12
0275 RC Medical/Surgical Supplies And Devices - Pacemaker 32 11 — — $54,516.00 $54,516.00 $54,516.00 2026-03-12
D0105 HCPCS Stroke M <41.50 And A >=84.50- Tier Tier 3 64 24 — — $54,319.16 $54,319.16 $54,319.16 2026-03-12
834 MS_DRG Acute Leukemia With Mcc 35 24 — — $53,970.81 $53,970.81 $53,970.81 2026-03-12
9 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 8 — — $53,776.32 $53,776.32 $53,776.32 2026-03-12
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 35 24 — — $52,944.31 $52,944.31 $52,944.31 2026-03-12
165 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 11 8 — — $44,351.41 $52,856.10 $52,856.10 2026-03-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 35 24 — — $52,598.15 $52,598.15 $52,598.15 2026-03-12
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 207 38 — — $25,800.00 $76,277.00 $52,380.00 2026-03-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 35 24 — — $52,304.15 $52,304.15 $52,304.15 2026-03-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 165 36 — — $27,643.41 $76,178.24 $51,910.82 2026-03-12
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 165 36 — — $15,827.40 $87,670.16 $51,748.78 2026-03-12
232 MS_DRG Coronary Bypass With Ptca Without Mcc 203 38 — — $25,800.00 $74,366.00 $51,424.50 2026-03-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 35 24 — — $51,229.61 $51,229.61 $51,229.61 2026-03-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 183 36 — — $43,637.73 $58,673.00 $51,132.36 2026-03-12
226 MS_DRG Cardiac Pacemaker Implant With Mcc. 160 37 — — $10,844.00 $90,272.00 $50,558.00 2026-03-12
C0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 2 64 24 — — $50,381.55 $50,381.55 $50,381.55 2026-03-12
C0604 HCPCS Neurological M <43.50- Tier Tier 2 64 24 — — $50,011.39 $50,011.39 $50,011.39 2026-03-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 207 38 — — $25,800.00 $71,013.00 $49,748.00 2026-03-12
B0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 1 64 24 — — $48,984.07 $48,984.07 $48,984.07 2026-03-12
514 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc 177 36 — — $28,745.96 $48,762.00 $48,762.00 2026-03-12
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 183 36 — — $41,659.04 $48,342.00 $48,342.00 2026-03-12
B0903 HCPCS Other Orthopedic M >=44.50 And M <51.50- Tier Tier 1 64 24 — — $47,940.66 $47,940.66 $47,940.66 2026-03-12
4 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 9 — — $47,904.96 $243,231.46 $47,904.96 2026-03-12
799 MS_DRG Splenic Procedures With Mcc 35 24 — — $47,759.21 $47,759.21 $47,759.21 2026-03-12
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Mcc. 160 37 — — $10,844.00 $106,954.00 $47,698.00 2026-03-12
178 APR_DRG External Heart Assist Devices 11 8 — — $47,567.30 $55,852.86 $47,567.30 2026-03-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 165 36 — — $47,460.31 $53,066.64 $47,460.31 2026-03-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 35 24 — — $47,321.26 $47,321.26 $47,321.26 2026-03-12
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 35 24 — — $47,179.00 $47,179.00 $47,179.00 2026-03-12
D0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier Tier 3 64 24 — — $47,004.54 $47,004.54 $47,004.54 2026-03-12
D0604 HCPCS Neurological M <43.50- Tier Tier 3 64 24 — — $46,688.03 $46,688.03 $46,688.03 2026-03-12
6 MS_DRG Liver Transplant Without Mcc 35 24 — — $46,624.65 $46,624.65 $46,624.65 2026-03-12
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 165 36 — — $35,367.12 $57,825.61 $46,596.36 2026-03-12
C0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 2 64 24 — — $45,993.32 $45,993.32 $45,993.32 2026-03-12
D0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier Tier 3 64 24 — — $45,743.86 $45,743.86 $45,743.86 2026-03-12
949 MS_DRG Aftercare With Cc/mcc 165 36 — — $9,165.83 $82,159.20 $45,662.51 2026-03-12
J9226 HCPCS Supprelin La Implant 1 1 — — $45,560.39 $45,560.39 $45,560.39 2026-03-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 203 38 — — $25,800.00 $61,971.00 $45,227.00 2026-03-12
B0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 1 64 24 — — $45,204.72 $45,204.72 $45,204.72 2026-03-12
225 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc. 154 37 — — $10,844.00 $79,363.00 $45,103.50 2026-03-12
653 MS_DRG Major Bladder Procedures With Mcc 165 36 — — $45,082.30 $52,790.67 $45,082.30 2026-03-12
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 35 24 — — $45,076.40 $45,076.40 $45,076.40 2026-03-12
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50- Tier None 64 24 — — $44,303.47 $44,303.47 $44,303.47 2026-03-12
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 35 24 — — $44,229.49 $44,229.49 $44,229.49 2026-03-12
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 24 — — $43,675.97 $43,675.97 $43,675.97 2026-03-12
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 35 24 — — $43,670.88 $43,670.88 $43,670.88 2026-03-12
440 APR_DRG Kidney Transplant 9 8 — — $43,506.11 $43,506.11 $43,506.11 2026-03-12
D0104 HCPCS Stroke M >=41.50 And M <50.50- Tier Tier 3 64 24 — — $43,439.77 $43,439.77 $43,439.77 2026-03-12
D0904 HCPCS Other Orthopedic M <44.5- Tier Tier 3 64 24 — — $42,884.54 $42,884.54 $42,884.54 2026-03-12
D0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier Tier 3 64 24 — — $42,793.34 $42,793.34 $42,793.34 2026-03-12
162 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 11 8 — — $42,774.92 $46,047.19 $42,774.92 2026-03-12
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 35 24 — — $42,756.62 $42,756.62 $42,756.62 2026-03-12
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 165 36 — — $39,512.42 $45,782.74 $42,647.58 2026-03-12
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 165 36 — — $42,641.62 $47,704.42 $42,641.62 2026-03-12
D0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier Tier 3 64 24 — — $42,621.67 $42,621.67 $42,621.67 2026-03-12
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 165 36 — — $42,066.27 $48,958.34 $42,495.52 2026-03-12
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 35 24 — — $42,342.17 $42,342.17 $42,342.17 2026-03-12
D2004 HCPCS Miscellaneous M <46.50 And A >=77.50- Tier Tier 3 64 24 — — $42,272.97 $42,272.97 $42,272.97 2026-03-12
A0704 HCPCS Fracture Of Lower Extremity M <41.50- Tier None 64 24 — — $42,262.24 $42,262.24 $42,262.24 2026-03-12
A0604 HCPCS Neurological M <43.50- Tier None 64 24 — — $42,106.67 $42,106.67 $42,106.67 2026-03-12
5 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 13 8 — — $42,073.33 $107,973.81 $42,073.33 2026-03-12
901 MS_DRG Wound Debridements For Injuries With Mcc 35 24 — — $41,717.25 $41,717.25 $41,717.25 2026-03-12
A0104 HCPCS Stroke M >=41.50 And M <50.50- Tier None 64 24 — — $41,398.54 $41,398.54 $41,398.54 2026-03-12
D0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50- Tier Tier 3 64 24 — — $41,331.49 $41,331.49 $41,331.49 2026-03-12
471 MS_DRG Cervical Spinal Fusion With Mcc 173 36 — — $41,322.53 $47,416.04 $41,322.53 2026-03-12
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 35 24 — — $40,900.61 $40,900.61 $40,900.61 2026-03-12
140 MS_DRG Major Head And Neck Procedures With Mcc 35 24 — — $40,282.26 $40,282.26 $40,282.26 2026-03-12
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50- Tier None 64 24 — — $40,172.73 $40,172.73 $40,172.73 2026-03-12
303 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 9 8 — — $39,978.14 $39,978.14 $39,978.14 2026-03-12
31 MS_DRG Ventricular Shunt Procedures With Mcc 35 24 — — $39,755.89 $39,755.89 $39,755.89 2026-03-12
669 MS_DRG Transurethral Procedures With Cc 165 36 — — $13,075.63 $66,359.17 $39,717.40 2026-03-12
C0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 2 64 24 — — $39,528.98 $39,528.98 $39,528.98 2026-03-12
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50- Tier None 64 24 — — $39,435.10 $39,435.10 $39,435.10 2026-03-12
A0904 HCPCS Other Orthopedic M <44.5- Tier None 64 24 — — $39,236.61 $39,236.61 $39,236.61 2026-03-12
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 35 24 — — $39,068.31 $39,068.31 $39,068.31 2026-03-12
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 35 24 — — $39,030.37 $39,030.37 $39,030.37 2026-03-12
227 MS_DRG Cardiac Pacemaker Implant Without Mcc. 160 37 — — $10,844.00 $67,197.00 $39,020.50 2026-03-12
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 165 36 — — $38,889.50 $43,539.09 $38,889.50 2026-03-12
C0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 2 64 24 — — $38,823.54 $38,823.54 $38,823.54 2026-03-12
A1404 HCPCS Cardiac M <45.50- Tier None 64 24 — — $38,791.35 $38,791.35 $38,791.35 2026-03-12
183 APR_DRG Percutaneous Structural Cardiac Procedures 9 8 — — $38,638.68 $38,638.68 $38,638.68 2026-03-12
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 203 38 — — $25,800.00 $48,345.00 $38,414.00 2026-03-12
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 35 24 — — $38,149.72 $38,149.72 $38,149.72 2026-03-12
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 35 24 — — $37,937.81 $37,937.81 $37,937.81 2026-03-12
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 177 36 — — $26,203.83 $48,762.00 $37,482.92 2026-03-12
D0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 68 24 — — $115.46 $37,444.84 $37,444.84 2026-03-12
163 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 11 8 — — $37,242.51 $42,459.38 $37,242.51 2026-03-12
D0603 HCPCS Neurological M >=43.50 And M <52.50- Tier Tier 3 64 24 — — $37,227.57 $37,227.57 $37,227.57 2026-03-12
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 165 36 — — $28,931.60 $37,158.33 $37,158.33 2026-03-12
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 35 24 — — $36,876.36 $36,876.36 $36,876.36 2026-03-12
299 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 8 7 — — $36,836.25 $36,836.25 $36,836.25 2026-03-12
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 165 36 — — $16,816.74 $56,797.81 $36,807.28 2026-03-12
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 35 24 — — $36,806.37 $36,806.37 $36,806.37 2026-03-12
D0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier Tier 3 64 24 — — $36,760.86 $36,760.86 $36,760.86 2026-03-12
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 165 36 — — $23,035.33 $50,255.55 $36,645.44 2026-03-12
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 24 — — $36,521.63 $36,521.63 $36,521.63 2026-03-12
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 35 24 — — $36,418.47 $36,418.47 $36,418.47 2026-03-12
609 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 9 8 — — $36,370.59 $36,370.59 $36,370.59 2026-03-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 169 36 — — $11,968.00 $67,820.65 $36,263.79 2026-03-12
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 165 36 — — $36,196.21 $41,243.96 $36,196.21 2026-03-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 168 36 — — $17,162.88 $65,999.99 $36,042.05 2026-03-12
163 MS_DRG Major Chest Procedures With Mcc 171 36 — — $25,800.00 $39,149.76 $35,574.88 2026-03-12
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 35 24 — — $35,570.41 $35,570.41 $35,570.41 2026-03-12
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 165 36 — — $35,157.72 $39,331.96 $35,157.72 2026-03-12
B0601 HCPCS Neurological M >=64.50- Tier Tier 1 64 24 — — $35,124.66 $35,124.66 $35,124.66 2026-03-12
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 35 24 — — $35,057.42 $35,057.42 $35,057.42 2026-03-12
332 MS_DRG Rectal Resection With Mcc 35 24 — — $34,967.76 $34,967.76 $34,967.76 2026-03-12
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 35 24 — — $34,920.53 $34,920.53 $34,920.53 2026-03-12
D2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier Tier 3 64 24 — — $34,660.62 $34,660.62 $34,660.62 2026-03-12
A0303 HCPCS Non-traumatic Brain Injury M >=42.50 And M <52.50- Tier None 64 24 — — $34,647.21 $34,647.21 $34,647.21 2026-03-12
A0703 HCPCS Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier None 64 24 — — $34,596.24 $34,596.24 $34,596.24 2026-03-12
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 35 24 — — $34,520.50 $34,520.50 $34,520.50 2026-03-12
335 MS_DRG Peritoneal Adhesiolysis With Mcc 35 24 — — $34,460.74 $34,460.74 $34,460.74 2026-03-12
252 MS_DRG Other Vascular Procedures With Mcc 183 36 — — $29,134.49 $39,744.00 $34,439.25 2026-03-12
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 165 36 — — $34,437.99 $38,526.77 $34,437.99 2026-03-12
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 165 36 — — $33,803.02 $37,816.42 $34,341.79 2026-03-12
271 MS_DRG Other Major Cardiovascular Procedures With Cc 183 36 — — $29,300.64 $38,912.00 $34,106.32 2026-03-12
265 MS_DRG Aicd Lead Procedures 35 24 — — $34,066.49 $34,066.49 $34,066.49 2026-03-12
D0103 HCPCS Stroke M >=50.50 And M <63.50- Tier Tier 3 64 24 — — $34,038.33 $34,038.33 $34,038.33 2026-03-12
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 35 24 — — $33,924.19 $33,924.19 $33,924.19 2026-03-12
C0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 2 64 24 — — $33,845.20 $33,845.20 $33,845.20 2026-03-12
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 165 36 — — $33,711.47 $37,714.00 $33,711.47 2026-03-12
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 35 24 — — $33,684.25 $33,684.25 $33,684.25 2026-03-12
A0603 HCPCS Neurological M >=43.50 And M <52.50- Tier None 64 24 — — $33,574.29 $33,574.29 $33,574.29 2026-03-12
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 165 36 — — $33,487.66 $38,697.24 $33,487.66 2026-03-12
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 35 24 — — $33,479.40 $33,479.40 $33,479.40 2026-03-12
166 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 11 8 — — $33,363.20 $37,917.40 $33,363.20 2026-03-12
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 35 24 — — $33,336.79 $33,336.79 $33,336.79 2026-03-12
D0203 HCPCS Traumatic Brain Injury M >=49.50 And M <61.50- Tier Tier 3 64 24 — — $33,324.84 $33,324.84 $33,324.84 2026-03-12
C0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 2 64 24 — — $33,260.46 $33,260.46 $33,260.46 2026-03-12
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 165 36 — — $33,199.43 $37,470.15 $33,199.43 2026-03-12
179 APR_DRG Defibrillator Implants 9 8 — — $33,165.99 $33,165.99 $33,165.99 2026-03-12
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 35 24 — — $33,091.50 $33,091.50 $33,091.50 2026-03-12
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 35 24 — — $33,045.68 $33,045.68 $33,045.68 2026-03-12
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 35 24 — — $32,601.18 $32,601.18 $32,601.18 2026-03-12
D0602 HCPCS Neurological M >=52.50 And M <64.50- Tier Tier 3 64 24 — — $31,594.75 $33,490.44 $32,542.60 2026-03-12
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 165 36 — — $32,539.88 $38,912.79 $32,539.88 2026-03-12
37 MS_DRG Extracranial Procedures With Mcc 35 24 — — $32,538.65 $32,538.65 $32,538.65 2026-03-12
A0103 HCPCS Stroke M >=50.50 And M <63.50- Tier None 64 24 — — $32,437.00 $32,437.00 $32,437.00 2026-03-12
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 183 36 — — $25,783.35 $32,334.00 $32,333.00 2026-03-12
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 165 36 — — $15,512.95 $32,232.46 $32,232.46 2026-03-12
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 35 24 — — $32,216.69 $32,216.69 $32,216.69 2026-03-12
B0301 HCPCS Non-traumatic Brain Injury M >=65.50- Tier Tier 1 64 24 — — $32,152.67 $32,152.67 $32,152.67 2026-03-12
8 APR_DRG Autologous Bone Marrow Transplant 9 8 — — $32,091.35 $32,091.35 $32,091.35 2026-03-12
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 35 24 — — $32,056.67 $32,056.67 $32,056.67 2026-03-12
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 165 36 — — $9,534.60 $54,557.22 $32,045.91 2026-03-12
165 MS_DRG Major Chest Procedures Without Cc/mcc 171 36 — — $21,618.04 $32,000.00 $32,000.00 2026-03-12
164 MS_DRG Major Chest Procedures With Cc 171 36 — — $24,584.24 $32,000.00 $32,000.00 2026-03-12
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 173 36 — — $31,961.72 $37,116.38 $31,961.72 2026-03-12
A2003 HCPCS Miscellaneous M >=46.50 And M <55.50- Tier None 64 24 — — $31,731.55 $31,731.55 $31,731.55 2026-03-12
A1403 HCPCS Cardiac M >=45.50 And M <55.50- Tier None 64 24 — — $31,659.13 $31,659.13 $31,659.13 2026-03-12
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 173 36 — — $23,376.40 $42,567.44 $31,411.06 2026-03-12
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 165 36 — — $16,559.32 $46,185.62 $31,372.47 2026-03-12
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 35 24 — — $31,341.17 $31,341.17 $31,341.17 2026-03-12
500 MS_DRG Soft Tissue Procedures With Mcc 35 24 — — $31,258.54 $31,258.54 $31,258.54 2026-03-12
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 35 24 — — $30,995.38 $30,995.38 $30,995.38 2026-03-12
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 35 24 — — $30,993.46 $30,993.46 $30,993.46 2026-03-12
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 35 24 — — $30,927.26 $30,927.26 $30,927.26 2026-03-12
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 195 37 — — $10,844.00 $49,803.00 $30,885.50 2026-03-12
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 35 24 — — $30,851.76 $30,851.76 $30,851.76 2026-03-12
D0302 HCPCS Non-traumatic Brain Injury M >=52.50 And M <65.50- Tier Tier 3 64 24 — — $30,551.34 $30,551.34 $30,551.34 2026-03-12
130 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 15 8 — — $30,460.88 $52,905.03 $30,460.88 2026-03-12
D0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier Tier 3 64 24 — — $30,449.41 $30,449.41 $30,449.41 2026-03-12
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 35 24 — — $30,400.63 $30,400.63 $30,400.63 2026-03-12
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 195 38 — — $25,800.00 $116,295.00 $30,241.50 2026-03-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 189 38 — — $25,800.00 $45,323.04 $30,241.50 2026-03-12
230 MS_DRG Hip & Femur Procedures Except Major Joint With Mcc. 142 37 — — $25,800.00 $32,000.00 $30,241.50 2026-03-12
D0902 HCPCS Other Orthopedic M >=51.50 And M <63.50- Tier Tier 3 64 24 — — $29,969.28 $29,969.28 $29,969.28 2026-03-12
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 165 36 — — $29,820.41 $35,201.04 $29,820.41 2026-03-12
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 65 24 — — $27,744.00 $37,279.21 $29,795.50 2026-03-12
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
33231 HCPCS Insrt Pulse Gen W/mult Leads 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
33249 HCPCS Insj/rplcmt Defib W/lead(s) 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
33240 HCPCS Insrt Pulse Gen W/singl Lead 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
33270 HCPCS Ins/rep Subq Defibrillator 57 23 — — $27,744.00 $42,043.63 $29,795.50 2026-03-12
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 57 23 — — $27,744.00 $39,961.24 $29,795.50 2026-03-12
33230 HCPCS Insrt Pulse Gen W/dual Leads 196 46 — — $27,744.00 $31,847.00 $29,795.50 2026-03-12
61886 HCPCS Implant Neurostim Arrays 57 23 — — $27,744.00 $39,961.24 $29,795.50 2026-03-12
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 165 36 — — $29,722.82 $33,980.69 $29,722.82 2026-03-12
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 35 24 — — $29,641.06 $29,641.06 $29,641.06 2026-03-12
602 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 13 8 — — $29,478.45 $103,459.28 $29,478.45 2026-03-12
D2002 HCPCS Miscellaneous M >=55.50 And M <66.50- Tier Tier 3 64 24 — — $29,456.97 $29,456.97 $29,456.97 2026-03-12
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 165 36 — — $26,090.06 $37,383.39 $29,368.32 2026-03-12
652 MS_DRG Kidney Transplant 35 24 — — $29,329.21 $29,329.21 $29,329.21 2026-03-12
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 165 36 — — $29,315.90 $32,829.75 $29,315.90 2026-03-12
264 MS_DRG Other Circulatory System O.r. Procedures 171 36 — — $13,655.00 $29,570.23 $29,276.10 2026-03-12
160 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 9 8 — — $29,125.93 $29,125.93 $29,125.93 2026-03-12
690 APR_DRG Acute Leukemia 11 8 — — $29,088.06 $45,078.63 $29,088.06 2026-03-12
910 APR_DRG Craniotomy For Multiple Significant Trauma 9 8 — — $29,007.56 $29,007.56 $29,007.56 2026-03-12
A0502 HCPCS Non-traumatic Spinal Cord Injury M >=53.50 And M <60.50- Tier None 64 24 — — $28,939.28 $28,939.28 $28,939.28 2026-03-12
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 189 36 — — $10,844.00 $45,863.00 $28,915.50 2026-03-12
0408T OTHER Insj/rplc Cardiac Modulj Sys 20 2 — — $27,744.00 $31,847.00 $28,769.75 2026-03-12
570 MS_DRG Skin Debridement With Mcc 35 24 — — $28,506.95 $28,506.95 $28,506.95 2026-03-12
A0602 HCPCS Neurological M >=52.50 And M <64.50- Tier None 64 24 — — $28,494.02 $28,494.02 $28,494.02 2026-03-12
J9266 HCPCS Pegaspargase Injection 1 1 — — $28,424.06 $28,424.06 $28,424.06 2026-03-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 165 36 — — $24,853.98 $49,995.54 $28,328.53 2026-03-12
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 35 24 — — $28,188.40 $28,188.40 $28,188.40 2026-03-12
167 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 9 8 — — $28,187.83 $28,187.83 $28,187.83 2026-03-12
300 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 40 16 — — $26,954.63 $28,179.84 $28,179.84 2026-03-12
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 35 24 — — $28,158.52 $28,158.52 $28,158.52 2026-03-12
A0702 HCPCS Fracture Of Lower Extremity M >=52.50 And M <61.50- Tier None 64 24 — — $28,131.91 $28,131.91 $28,131.91 2026-03-12
D1402 HCPCS Cardiac M >=55.50 And M <68.50- Tier Tier 3 64 24 — — $28,118.50 $28,118.50 $28,118.50 2026-03-12
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 174 37 — — $16,100.10 $28,068.00 $28,068.00 2026-03-12
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 174 37 — — $15,312.03 $28,068.00 $28,068.00 2026-03-12
169 APR_DRG Major Abdominal Vascular Procedures 11 8 — — $28,051.49 $33,780.09 $28,051.49 2026-03-12
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 165 36 — — $27,991.73 $32,097.17 $27,991.73 2026-03-12
665 MS_DRG Prostatectomy With Mcc 165 36 — — $27,878.97 $31,189.01 $27,878.97 2026-03-12
800 MS_DRG Splenic Procedures With Cc 35 24 — — $27,782.37 $27,782.37 $27,782.37 2026-03-12
0515T OTHER Insj Wcs Lv Compl Sys 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0409T OTHER Insj/rplc Car Modulj Pls Gn 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0100T OTHER Prosth Retina Receive&gen 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0571T OTHER Insj/rplcmt Icds Ss Eltrd 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
33276 HCPCS Insj Phrnc Nrv Stim Sys 13 2 — — $27,744.00 $59,010.96 $27,744.00 2026-03-12
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0520T OTHER Rmv&rplcmt Pg Wcs Lv Battery 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 35 24 — — $27,536.87 $27,536.87 $27,536.87 2026-03-12
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 35 24 — — $27,463.70 $27,463.70 $27,463.70 2026-03-12
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 35 24 — — $27,436.21 $27,436.21 $27,436.21 2026-03-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 159 36 — — $27,408.89 $50,385.78 $27,408.89 2026-03-12
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 165 36 — — $27,271.99 $31,752.08 $27,271.99 2026-03-12
253 MS_DRG Other Vascular Procedures With Cc 183 36 — — $21,705.69 $32,748.00 $27,226.85 2026-03-12
607 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 15 8 — — $27,164.37 $165,158.03 $27,164.37 2026-03-12
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