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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

20,970 distinct procedures filed
51 distinct payers
1,241,696 rate rows
2026-05-28 last MRF observed
Data quality

864,920 of 1,241,696 rate rows are consumer-grade (69.7%)

376,776 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 362,765
per-diem day rate — not a per-procedure price 7,191
template filing: same amount across many unrelated codes — excluded 6,820
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 · 2026-05-18
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
$370,174
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
$265,286
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
$206,368
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
$202,986
0.9× median
583
APR_DRG 		Neonate With Ecmo 8 $159,230.49 $159,230.49 $159,230.49 nat. median
$11,771
outlier · 13.5×
161
APR_DRG 		Implantable Heart Assist Systems 8 $136,498.36 $136,498.36 $136,498.36 nat. median
$181,791
0.8× 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
$56,697
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
$60,726
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 24 $123,976.48 $123,976.48 $123,976.48 nat. median
$117,303
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
$34,721
outlier · 3.6×
7
MS_DRG 		Lung Transplant 24 $122,818.48 $122,818.48 $122,818.48 nat. median
$122,708
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
$79,557
1.5× median
588
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $122,422.12 $122,422.12 $122,422.12 nat. median
$281,646
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
$133,176
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
$108,660
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 24 $104,545.70 $104,545.70 $104,545.70 nat. median
$102,358
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
$100,136
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 36 $25,800.00 $164,781.00 $98,390.50 nat. median
$99,019
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
$47,651
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
$98,905
0.9× median
2
APR_DRG 		Heart And/or Lung Transplant 9 $87,593.99 $243,231.46 $87,593.99 nat. median
$136,483
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
$93,672
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 24 $87,437.55 $87,437.55 $87,437.55 nat. median
$83,442
1.0× 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
$81,118
1.1× median
283
MS_DRG 		Acute Myocardial Infarction, Expired With Mcc 37 $16,578.52 $150,192.51 $83,385.51 nat. median
$19,749
outlier · 4.2×
11
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $82,088.32 $82,088.32 $82,088.32 nat. median
$50,490
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
$77,576
1.1× median
779
MS_DRG 		Abortion Without D&c 36 $9,472.85 $80,462.68 $80,462.68 nat. median
$9,470
outlier · 8.5×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 24 $79,718.54 $79,718.54 $79,718.54 nat. median
$82,712
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
$65,950
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
$71,240
1.1× median
10
MS_DRG 		Pancreas Transplant 25 $76,218.00 $76,218.00 $76,218.00 nat. median
$68,882
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
$72,138
1.0× median
D1806
LOCAL 		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
$48,581
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
$74,915
0.9× median
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 37 $25,800.00 $106,871.30 $67,677.15 nat. median
$33,154
outlier · 2.0×
C0106
LOCAL 		Stroke M <41.50 And A <84.50- Tier Tier 2 24 $67,609.93 $67,609.93 $67,609.93 nat. median
$46,986
1.4× median
B0604
LOCAL 		Neurological M <43.50- Tier Tier 1 24 $66,799.88 $66,799.88 $66,799.88 nat. median
$46,423
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
$64,027
1.0× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 37 $25,800.00 $104,724.00 $66,603.50 nat. median
$50,673
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
$73,807
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 38 $25,800.00 $102,807.00 $65,645.00 nat. median
$79,312
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 24 $64,549.86 $64,549.86 $64,549.86 nat. median
$64,732
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
$60,185
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
$63,738
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
$63,570
1.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $63,499.33 $63,499.33 $63,499.33 nat. median
$69,774
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
$55,736
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
$25,699
outlier · 2.4×
B0704
LOCAL 		Fracture Of Lower Extremity M <41.50- Tier Tier 1 24 $62,425.06 $62,425.06 $62,425.06 nat. median
$43,383
1.4× median

Other procedures at this hospital

Browse this hospital's 20,970 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
             
779 MS_DRG Abortion Without D&c 165 36 — — $9,472.85 $80,462.68 $80,462.68 2026-03-12
690 APR_DRG Acute Leukemia 11 8 — — $29,088.06 $45,078.63 $29,088.06 2026-03-12
834 MS_DRG Acute Leukemia With Mcc 35 24 — — $53,970.81 $53,970.81 $53,970.81 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
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 174 37 — — $16,100.10 $28,068.00 $28,068.00 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
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 174 37 — — $15,312.03 $28,068.00 $28,068.00 2026-03-12
949 MS_DRG Aftercare With Cc/mcc 165 36 — — $9,165.83 $82,159.20 $45,662.51 2026-03-12
265 MS_DRG Aicd Lead Procedures 35 24 — — $34,066.49 $34,066.49 $34,066.49 2026-03-12
14 MS_DRG Allogeneic Bone Marrow Transplant 35 24 — — $123,976.48 $123,976.48 $123,976.48 2026-03-12
7 APR_DRG Allogeneic Bone Marrow Transplant 9 8 — — $60,953.18 $60,953.18 $60,953.18 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
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
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
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
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
8 APR_DRG Autologous Bone Marrow Transplant 9 8 — — $32,091.35 $32,091.35 $32,091.35 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
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
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
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
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
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
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
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 165 36 — — $15,512.95 $32,232.46 $32,232.46 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
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
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
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
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
A1404 LOCAL Cardiac M <45.50- Tier None 64 24 — — $38,791.35 $38,791.35 $38,791.35 2026-03-12
A1403 LOCAL Cardiac M >=45.50 And M <55.50- Tier None 64 24 — — $31,659.13 $31,659.13 $31,659.13 2026-03-12
D1402 LOCAL 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
226 MS_DRG Cardiac Pacemaker Implant With Mcc. 160 37 — — $10,844.00 $90,272.00 $50,558.00 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
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
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
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
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
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
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
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
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
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
471 MS_DRG Cervical Spinal Fusion With Mcc 173 36 — — $41,322.53 $47,416.04 $41,322.53 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
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
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
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
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 35 24 — — $27,536.87 $27,536.87 $27,536.87 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
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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 35 24 — — $104,545.70 $104,545.70 $104,545.70 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
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
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
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
231 MS_DRG Coronary Bypass With Ptca With Mcc 207 38 — — $25,800.00 $102,807.00 $65,645.00 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
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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 207 38 — — $25,800.00 $76,277.00 $52,380.00 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
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 35 24 — — $27,436.21 $27,436.21 $27,436.21 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
955 MS_DRG Craniotomy For Multiple Significant Trauma 35 24 — — $64,549.86 $64,549.86 $64,549.86 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
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
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
179 APR_DRG Defibrillator Implants 9 8 — — $33,165.99 $33,165.99 $33,165.99 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
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
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
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
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
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
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
178 APR_DRG External Heart Assist Devices 11 8 — — $47,567.30 $55,852.86 $47,567.30 2026-03-12
9 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 9 8 — — $53,776.32 $53,776.32 $53,776.32 2026-03-12
37 MS_DRG Extracranial Procedures With Mcc 35 24 — — $32,538.65 $32,538.65 $32,538.65 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
A0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier None 64 24 — — $42,262.24 $42,262.24 $42,262.24 2026-03-12
B0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier Tier 1 64 24 — — $62,425.06 $62,425.06 $62,425.06 2026-03-12
D0704 LOCAL Fracture Of Lower Extremity M <41.50- Tier Tier 3 64 24 — — $45,743.86 $45,743.86 $45,743.86 2026-03-12
A0703 LOCAL 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
C0703 LOCAL 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
D0703 LOCAL Fracture Of Lower Extremity M >=41.50 And M <52.50- Tier Tier 3 64 24 — — $37,444.84 $37,444.84 $37,444.84 2026-03-12
A0702 LOCAL 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
D0702 LOCAL 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
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
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
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
2 APR_DRG Heart And/or Lung Transplant 10 9 — — $87,593.99 $243,231.46 $87,593.99 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
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
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 35 24 — — $33,479.40 $33,479.40 $33,479.40 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
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
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
61886 HCPCS Implant Neurostim Arrays 57 23 — — $27,744.00 $39,961.24 $29,795.50 2026-03-12
161 APR_DRG Implantable Heart Assist Systems 9 8 — — $136,498.36 $136,498.36 $136,498.36 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
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
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 1 1 — — $63,499.33 $63,499.33 $63,499.33 2025-11-19
33270 HCPCS Ins/rep Subq Defibrillator 57 23 — — $27,744.00 $42,043.63 $29,795.50 2026-03-12
33276 HCPCS Insj Phrnc Nrv Stim Sys 13 2 — — $27,744.00 $59,010.96 $27,744.00 2026-03-12
0515T HCPCS Insj Wcs Lv Compl Sys 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0409T HCPCS Insj/rplc Car Modulj Pls Gn 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0408T HCPCS Insj/rplc Cardiac Modulj Sys 20 2 — — $27,744.00 $31,847.00 $28,769.75 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
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 12 1 — — $27,744.00 $31,847.00 $27,744.00 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
33231 HCPCS Insrt Pulse Gen W/mult Leads 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
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 165 36 — — $16,816.74 $56,797.81 $36,807.28 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
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
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
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
440 APR_DRG Kidney Transplant 9 8 — — $43,506.11 $43,506.11 $43,506.11 2026-03-12
652 MS_DRG Kidney Transplant 35 24 — — $29,329.21 $29,329.21 $29,329.21 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
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 35 24 — — $33,336.79 $33,336.79 $33,336.79 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
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
1 APR_DRG Liver Transplant And/or Intestinal Transplant 10 9 — — $61,435.84 $137,900.99 $61,435.84 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
6 MS_DRG Liver Transplant Without Mcc 35 24 — — $46,624.65 $46,624.65 $46,624.65 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
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
7 MS_DRG Lung Transplant 35 24 — — $122,818.48 $122,818.48 $122,818.48 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
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
169 APR_DRG Major Abdominal Vascular Procedures 11 8 — — $28,051.49 $33,780.09 $28,051.49 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
160 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 9 8 — — $29,125.93 $29,125.93 $29,125.93 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
163 MS_DRG Major Chest Procedures With Mcc 171 36 — — $25,800.00 $39,149.76 $35,574.88 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
140 MS_DRG Major Head And Neck Procedures With Mcc 35 24 — — $40,282.26 $40,282.26 $40,282.26 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
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
D1806 LOCAL 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
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
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
0275 RC Medical/Surgical Supplies And Devices - Pacemaker 32 11 — — $54,516.00 $54,516.00 $54,516.00 2026-03-12
D2004 LOCAL 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
A2003 LOCAL Miscellaneous M >=46.50 And M <55.50- Tier None 64 24 — — $31,731.55 $31,731.55 $31,731.55 2026-03-12
D2003 LOCAL 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
D2002 LOCAL 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
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
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
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
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
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
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
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
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
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
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
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
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
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
583 APR_DRG Neonate With Ecmo 9 8 — — $159,230.49 $159,230.49 $159,230.49 2026-03-12
A0604 LOCAL Neurological M <43.50- Tier None 64 24 — — $42,106.67 $42,106.67 $42,106.67 2026-03-12
B0604 LOCAL Neurological M <43.50- Tier Tier 1 64 24 — — $66,799.88 $66,799.88 $66,799.88 2026-03-12
C0604 LOCAL Neurological M <43.50- Tier Tier 2 64 24 — — $50,011.39 $50,011.39 $50,011.39 2026-03-12
D0604 LOCAL Neurological M <43.50- Tier Tier 3 64 24 — — $46,688.03 $46,688.03 $46,688.03 2026-03-12
A0603 LOCAL Neurological M >=43.50 And M <52.50- Tier None 64 24 — — $33,574.29 $33,574.29 $33,574.29 2026-03-12
D0603 LOCAL 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
A0602 LOCAL Neurological M >=52.50 And M <64.50- Tier None 64 24 — — $28,494.02 $28,494.02 $28,494.02 2026-03-12
B0602 LOCAL 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
C0602 LOCAL 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
D0602 LOCAL 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
B0601 LOCAL 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
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
A0305 LOCAL 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
C0305 LOCAL 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
D0305 LOCAL 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
A0304 LOCAL 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
B0304 LOCAL 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
C0304 LOCAL 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
D0304 LOCAL 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
A0303 LOCAL 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
B0303 LOCAL 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
C0303 LOCAL 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
D0303 LOCAL 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
C0302 LOCAL 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
D0302 LOCAL 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
B0301 LOCAL Non-traumatic Brain Injury M >=65.50- Tier Tier 1 64 24 — — $32,152.67 $32,152.67 $32,152.67 2026-03-12
A0504 LOCAL 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
B0504 LOCAL 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
D0504 LOCAL 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
A0502 LOCAL 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
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
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
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 57 23 — — $27,744.00 $39,961.24 $29,795.50 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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 195 37 — — $25,800.00 $104,724.00 $66,603.50 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
264 MS_DRG Other Circulatory System O.r. Procedures 171 36 — — $13,655.00 $29,570.23 $29,276.10 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
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
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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 183 36 — — $46,519.35 $56,477.00 $56,477.00 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
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
215 MS_DRG Other Heart Assist System Implant 189 36 — — $25,800.00 $164,781.00 $98,390.50 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
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
271 MS_DRG Other Major Cardiovascular Procedures With Cc 183 36 — — $29,300.64 $38,912.00 $34,106.32 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
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
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
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
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
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
A0904 LOCAL Other Orthopedic M <44.5- Tier None 64 24 — — $39,236.61 $39,236.61 $39,236.61 2026-03-12
B0904 LOCAL Other Orthopedic M <44.5- Tier Tier 1 64 24 — — $60,303.36 $60,303.36 $60,303.36 2026-03-12
D0904 LOCAL Other Orthopedic M <44.5- Tier Tier 3 64 24 — — $42,884.54 $42,884.54 $42,884.54 2026-03-12
B0903 LOCAL 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
D0902 LOCAL 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
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
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
253 MS_DRG Other Vascular Procedures With Cc 183 36 — — $21,705.69 $32,748.00 $27,226.85 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
10 MS_DRG Pancreas Transplant 37 25 — — $76,218.00 $76,218.00 $76,218.00 2026-03-12
6 APR_DRG Pancreas Transplant 9 8 — — $61,396.14 $61,396.14 $61,396.14 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
J9266 HCPCS Pegaspargase Injection 1 1 — — $28,424.06 $28,424.06 $28,424.06 2026-03-12
183 APR_DRG Percutaneous Structural Cardiac Procedures 9 8 — — $38,638.68 $38,638.68 $38,638.68 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
335 MS_DRG Peritoneal Adhesiolysis With Mcc 35 24 — — $34,460.74 $34,460.74 $34,460.74 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
199 MS_DRG Pneumothorax With Mcc 165 36 — — $17,101.20 $79,848.11 $57,494.04 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
665 MS_DRG Prostatectomy With Mcc 165 36 — — $27,878.97 $31,189.01 $27,878.97 2026-03-12
0100T HCPCS Prosth Retina Receive&gen 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
332 MS_DRG Rectal Resection With Mcc 35 24 — — $34,967.76 $34,967.76 $34,967.76 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
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
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
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
0520T HCPCS Rmv&rplcmt Pg Wcs Lv Battery 12 1 — — $27,744.00 $31,847.00 $27,744.00 2026-03-12
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 12 1 — — $27,744.00 $31,847.00 $27,744.00 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
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 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
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 12 1 — — $27,744.00 $31,847.00 $27,744.00 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
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 35 24 — — $52,304.15 $52,304.15 $52,304.15 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
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
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
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $55,945.97 $55,945.97 $55,945.97 2026-03-12
570 MS_DRG Skin Debridement With Mcc 35 24 — — $28,506.95 $28,506.95 $28,506.95 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
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
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
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
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 35 24 — — $36,418.47 $36,418.47 $36,418.47 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
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
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
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
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 35 24 — — $33,045.68 $33,045.68 $33,045.68 2026-03-12
28 MS_DRG Spinal Procedures With Mcc 35 24 — — $58,087.79 $58,087.79 $58,087.79 2026-03-12
800 MS_DRG Splenic Procedures With Cc 35 24 — — $27,782.37 $27,782.37 $27,782.37 2026-03-12
799 MS_DRG Splenic Procedures With Mcc 35 24 — — $47,759.21 $47,759.21 $47,759.21 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
A0106 LOCAL Stroke M <41.50 And A <84.50- Tier None 64 24 — — $58,879.06 $58,879.06 $58,879.06 2026-03-12
C0106 LOCAL 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
D0106 LOCAL 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
D0105 LOCAL 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
A0104 LOCAL Stroke M >=41.50 And M <50.50- Tier None 64 24 — — $41,398.54 $41,398.54 $41,398.54 2026-03-12
D0104 LOCAL 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
A0103 LOCAL Stroke M >=50.50 And M <63.50- Tier None 64 24 — — $32,437.00 $32,437.00 $32,437.00 2026-03-12
D0103 LOCAL 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
J9226 HCPCS Supprelin La Implant 1 1 — — $45,560.39 $45,560.39 $45,560.39 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
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 35 24 — — $28,158.52 $28,158.52 $28,158.52 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
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
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
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
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
669 MS_DRG Transurethral Procedures With Cc 165 36 — — $13,075.63 $66,359.17 $39,717.40 2026-03-12
C0205 LOCAL Traumatic Brain Injury M <35.50- Tier Tier 2 64 24 — — $58,288.96 $58,288.96 $58,288.96 2026-03-12
D0204 LOCAL 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
D0203 LOCAL 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
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
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
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
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
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
31 MS_DRG Ventricular Shunt Procedures With Mcc 35 24 — — $39,755.89 $39,755.89 $39,755.89 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
901 MS_DRG Wound Debridements For Injuries With Mcc 35 24 — — $41,717.25 $41,717.25 $41,717.25 2026-03-12
A9543 HCPCS Y90 Ibritumomab, Rx 1 1 — — $56,824.55 $56,824.55 $56,824.55 2026-03-12
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