Price Transparencybeta 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

PETALUMA VALLEY HOSPITAL

Petaluma, CA · CCN 050136 · Rates published

13,703 distinct procedures filed
19 distinct payers
283,156 rate rows
2026-04-01 last MRF observed
Data quality

183,474 of 283,156 rate rows are consumer-grade (64.8%)

99,682 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 97,020
template filing: same amount across many unrelated codes — excluded 2,610
placeholder amount (≤ $0.02) — excluded from medians 52
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/norcal/live/852390012_petaluma-valley-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint b2ab65fb2c390725… · 175,643,620 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 2 $3,617,621.00 $3,691,450.00 $3,654,535.50 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,254,948.85 $3,321,376.38 $3,288,162.62 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,180,473.76 $3,245,381.39 $3,212,927.58 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,879,553.60 $2,938,320.00 $2,908,936.80 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,535,345.51 $2,587,087.26 $2,561,216.38 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,285,360.00 $2,332,000.00 $2,308,680.00 nat. median
$2,448,600
0.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $755,207.60 $1,656,833.00 $1,213,726.50 nat. median
$824,563
1.5× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $576,724.91 $1,189,314.00 $1,106,338.60 nat. median
$674,867
1.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $548,585.46 $1,134,388.29 $1,055,244.92 nat. median
$625,184
1.7× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $551,015.62 $1,110,350.92 $1,032,884.57 nat. median
$673,137
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $521,212.14 $1,081,107.57 $1,005,681.46 nat. median
$634,303
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $479,504.79 $1,052,208.19 $978,798.31 nat. median
$619,808
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $593.00 $1,244,357.91 $614,180.81 nat. median
$753,246
0.8× 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 11 $369,818.40 $896,522.29 $442,254.10 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 11 $281,592.10 $669,627.99 $287,338.88 nat. median
$265,286
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 $208,353.13 $563,985.85 $219,140.58 nat. median
$206,474
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 $188,144.83 $509,481.57 $217,860.09 nat. median
$202,976
1.1× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 $117,516.83 $335,905.22 $142,504.11 nat. median
$133,161
1.1× median
7
MS_DRG 		Lung Transplant 11 $114,666.59 $310,676.25 $133,294.36 nat. median
$122,708
1.1× median
0427T
HCPCS 		Insj/rplc Nstim Apnea Pls Gn 1 $126,547.00 $126,547.00 $126,547.00 nat. median
$15,886
outlier · 8.0×
0312T
HCPCS 		Laps Impltj Nstim Vagus 1 $126,547.00 $126,547.00 $126,547.00 nat. median
$8,204
outlier · 15.4×
0424T
HCPCS 		Insj/rplc Nstim Apnea Compl 1 $126,547.00 $126,547.00 $126,547.00 nat. median
$24,752
outlier · 5.1×
0316T
HCPCS 		Replc Vagus Nerve Pls Gen 1 $126,547.00 $126,547.00 $126,547.00 nat. median
$9,564
outlier · 13.2×
0431T
HCPCS 		Rmvl/rplc Nstim Apnea Pls Gn 1 $126,547.00 $126,547.00 $126,547.00 nat. median
$18,872
outlier · 6.7×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 11 $121,291.46 $311,460.80 $123,766.80 nat. median
$117,357
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 $114,420.14 $261,982.35 $116,755.25 nat. median
$108,660
1.1× median
209
MS_DRG 		Complex Aortic Arch Procedures 11 $114,289.95 $116,622.40 $116,622.40 nat. median
$98,047
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $9,929.43 $249,189.56 $113,581.10 nat. median
$98,894
1.1× median
0426T
HCPCS 		Insj/rplc Nstim Apnea Stm Ld 1 $113,226.00 $113,226.00 $113,226.00 nat. median
$13,244
outlier · 8.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 11 $109,836.26 $258,972.56 $112,077.82 nat. median
$102,358
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 11 $101,282.23 $253,159.82 $106,318.15 nat. median
$100,136
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 11 $14,171.00 $251,866.51 $102,705.59 nat. median
$99,019
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 $14,171.00 $229,428.61 $100,925.36 nat. median
$93,672
1.1× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $97,225.26 $97,225.26 $97,225.26 nat. median
$21,806
outlier · 4.5×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $62,996.65 $135,956.56 $95,644.77 nat. median
$69,774
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 11 $91,163.24 $198,275.16 $93,023.71 nat. median
$82,711
1.1× median
850
MS_DRG 		Acute Leukemia With Other Procedures 11 $87,656.97 $218,989.45 $89,445.89 nat. median
$83,470
1.1× median
69715
HCPCS 		Temple Bne Implnt W/Stimulat 1 $89,248.00 $89,248.00 $89,248.00 nat. median
$6,822
outlier · 13.1×
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $55,688.06 $122,172.78 $88,592.01 nat. median
$62,507
1.4× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 12 $12,000.00 $201,446.61 $87,099.51 nat. median
$79,312
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 $14,122.00 $201,332.50 $86,828.69 nat. median
$81,118
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $69,535.73 $169,820.76 $83,293.90 nat. median
$76,329
1.1× median
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $69,200.35 $82,892.16 $82,892.16 nat. median
$775
outlier · 107.0×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 11 $79,738.08 $191,630.33 $81,365.39 nat. median
$77,570
1.0× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 $14,171.00 $183,939.44 $79,418.59 nat. median
$74,915
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 $8,000.00 $185,812.83 $79,080.32 nat. median
$73,807
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 11 $73,517.87 $177,442.00 $78,821.77 nat. median
$72,135
1.1× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 11 $73,226.31 $168,764.49 $74,720.72 nat. median
$68,090
1.1× median
10
MS_DRG 		Pancreas Transplant 11 $35,840.55 $189,540.59 $74,282.31 nat. median
$68,884
1.1× median

Other procedures at this hospital

Browse this hospital's 13,703 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 2 — — $3,617,621.00 $3,691,450.00 $3,654,535.50 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 2 — — $3,254,948.85 $3,321,376.38 $3,288,162.62 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 2 — — $3,180,473.76 $3,245,381.39 $3,212,927.58 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 2 — — $2,879,553.60 $2,938,320.00 $2,908,936.80 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 2 — — $2,535,345.51 $2,587,087.26 $2,561,216.38 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 2 — — $2,285,360.00 $2,332,000.00 $2,308,680.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 8 3 — — $755,207.60 $1,656,833.00 $1,213,726.50 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 10 3 — — $576,724.91 $1,189,314.00 $1,106,338.60 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 10 3 — — $548,585.46 $1,134,388.29 $1,055,244.92 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 10 3 — — $551,015.62 $1,110,350.92 $1,032,884.57 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 10 3 — — $521,212.14 $1,081,107.57 $1,005,681.46 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 10 3 — — $479,504.79 $1,052,208.19 $978,798.31 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 14 4 — — $593.00 $1,244,357.91 $614,180.81 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 4 1 — — $598,237.50 $598,237.50 $598,237.50 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 34 11 — — $369,818.40 $896,522.29 $442,254.10 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 34 11 — — $281,592.10 $669,627.99 $287,338.88 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 34 11 — — $208,353.13 $563,985.85 $219,140.58 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 34 11 — — $188,144.83 $509,481.57 $217,860.09 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 34 11 — — $117,516.83 $335,905.22 $142,504.11 2026-04-01
7 MS_DRG Lung Transplant 34 11 — — $114,666.59 $310,676.25 $133,294.36 2026-04-01
0316T HCPCS Replc Vagus Nerve Pls Gen 2 1 — — $126,547.00 $126,547.00 $126,547.00 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 2 1 — — $126,547.00 $126,547.00 $126,547.00 2026-04-01
0312T HCPCS Laps Impltj Nstim Vagus 2 1 — — $126,547.00 $126,547.00 $126,547.00 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 2 1 — — $126,547.00 $126,547.00 $126,547.00 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 2 1 — — $126,547.00 $126,547.00 $126,547.00 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 34 11 — — $121,291.46 $311,460.80 $123,766.80 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 34 11 — — $114,420.14 $261,982.35 $116,755.25 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 22 11 — — $114,289.95 $116,622.40 $116,622.40 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 12 — — $9,929.43 $249,189.56 $113,581.10 2026-04-01
0426T HCPCS Insj/rplc Nstim Apnea Stm Ld 2 1 — — $113,226.00 $113,226.00 $113,226.00 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 30 11 — — $109,836.26 $258,972.56 $112,077.82 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 34 11 — — $101,282.23 $253,159.82 $106,318.15 2026-04-01
215 MS_DRG Other Heart Assist System Implant 40 11 — — $14,171.00 $251,866.51 $102,705.59 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 11 — — $14,171.00 $229,428.61 $100,925.36 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 4 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 16 4 — — $62,996.65 $135,956.56 $95,644.77 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 30 11 — — $91,163.24 $198,275.16 $93,023.71 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 30 11 — — $87,656.97 $218,989.45 $89,445.89 2026-04-01
69715 HCPCS Temple Bne Implnt W/Stimulat 2 1 — — $89,248.00 $89,248.00 $89,248.00 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 14 4 — — $55,688.06 $122,172.78 $88,592.01 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 42 12 — — $12,000.00 $201,446.61 $87,099.51 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 11 — — $14,122.00 $201,332.50 $86,828.69 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 10 2 — — $69,535.73 $169,820.76 $83,293.90 2026-04-01
C9150 HCPCS Xe129 Xenon, Diagnostic 6 1 — — $69,200.35 $82,892.16 $82,892.16 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 34 11 — — $79,738.08 $191,630.33 $81,365.39 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 11 — — $14,171.00 $183,939.44 $79,418.59 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 42 12 — — $8,000.00 $185,812.83 $79,080.32 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 34 11 — — $73,517.87 $177,442.00 $78,821.77 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 11 — — $73,226.31 $168,764.49 $74,720.72 2026-04-01
10 MS_DRG Pancreas Transplant 34 11 — — $35,840.55 $189,540.59 $74,282.31 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 34 11 — — $64,655.06 $158,774.66 $74,251.65 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 34 11 — — $65,999.44 $188,449.37 $73,862.29 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 30 11 — — $72,342.98 $167,998.97 $73,819.37 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 36 11 — — $59,247.00 $165,383.83 $71,585.40 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 40 11 — — $14,171.00 $158,506.01 $71,238.96 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 34 11 — — $62,295.22 $162,326.49 $69,738.75 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 32 12 — — $44,045.46 $147,065.96 $69,282.96 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 30 11 — — $67,848.23 $159,385.65 $69,232.89 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 11 — — $14,171.00 $153,518.23 $68,146.56 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 11 — — $14,171.00 $141,433.90 $68,146.56 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 34 11 — — $54,858.03 $146,395.54 $67,902.32 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 34 11 — — $56,731.44 $153,763.10 $66,709.71 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 40 11 — — $14,171.00 $142,415.77 $63,579.50 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 34 11 — — $57,335.77 $150,344.40 $63,506.95 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 40 11 — — $14,171.00 $145,218.72 $62,907.07 2026-04-01
69718 HCPCS Revise Temple Bone Implant 2 1 — — $62,607.00 $62,607.00 $62,607.00 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 2 1 — — $62,607.00 $62,607.00 $62,607.00 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 34 11 — — $57,658.74 $144,524.52 $62,352.15 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 30 11 — — $61,088.08 $147,256.16 $62,334.78 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 11 — — $14,122.00 $136,438.99 $61,890.23 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 34 11 — — $56,143.96 $141,336.43 $61,689.93 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 34 11 — — $60,317.92 $143,487.98 $61,548.90 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 40 11 — — $14,171.00 $139,881.46 $60,924.50 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 34 11 — — $56,344.08 $138,409.85 $60,885.66 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 30 11 — — $58,689.49 $130,046.16 $59,887.23 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 34 11 — — $56,096.41 $135,623.54 $59,511.15 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 22 11 — — $58,086.58 $59,272.02 $59,272.02 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 38 12 — — $7,202.35 $128,396.24 $59,196.39 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 11 — — $57,236.30 $130,880.62 $58,404.39 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 34 11 — — $53,763.31 $129,349.58 $58,226.57 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 11 — — $56,677.46 $118,938.94 $57,834.14 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 40 11 — — $14,122.00 $145,893.91 $57,392.66 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 34 11 — — $55,913.31 $131,396.52 $57,054.40 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 34 11 — — $55,719.02 $129,054.78 $56,856.14 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 42 12 — — $6,619.62 $126,475.30 $56,776.43 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 34 11 — — $49,697.47 $128,274.99 $56,688.55 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 34 11 — — $47,852.79 $143,487.98 $56,465.76 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 11 — — $14,171.00 $125,914.24 $55,448.93 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 30 11 — — $54,307.91 $122,428.97 $55,416.23 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 14 4 — — $41,254.08 $122,586.77 $55,143.81 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 34 11 — — $53,949.36 $131,406.03 $55,050.37 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 40 11 — — $14,171.00 $122,027.19 $54,871.53 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 36 12 — — $52,952.92 $121,111.89 $54,146.98 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 34 11 — — $52,973.90 $132,521.03 $54,055.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 11 — — $14,171.00 $109,177.34 $52,458.73 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 12 — — $36,000.00 $120,741.01 $51,919.14 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 40 11 — — $14,171.00 $118,463.46 $51,510.36 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 40 12 — — $9,929.43 $118,905.66 $51,420.43 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 34 11 — — $47,639.79 $119,737.75 $51,247.73 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 34 11 — — $50,017.47 $128,258.35 $51,038.23 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 40 11 — — $14,122.00 $115,470.32 $50,297.32 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 34 11 — — $49,047.00 $119,031.66 $50,047.96 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 40 11 — — $14,171.00 $111,842.41 $49,603.42 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 34 11 — — $44,711.28 $109,526.82 $48,996.39 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 34 11 — — $45,649.47 $113,028.73 $48,898.28 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 34 11 — — $47,780.11 $113,525.60 $48,755.21 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 34 11 — — $46,480.67 $115,277.75 $48,338.26 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 30 11 — — $47,186.22 $110,601.40 $48,149.20 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 38 11 — — $40,093.48 $109,163.08 $47,924.37 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 34 11 — — $44,552.77 $111,243.30 $47,804.80 2026-04-01
245 MS_DRG Aicd Generator Procedures 40 11 — — $14,171.00 $116,171.65 $47,575.89 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 34 11 — — $45,034.25 $107,251.65 $47,435.88 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 34 11 — — $44,499.27 $106,317.33 $47,415.44 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 34 11 — — $46,288.87 $113,033.48 $47,233.54 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 34 11 — — $45,817.16 $109,571.99 $46,752.20 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 34 11 — — $43,254.95 $99,620.19 $46,738.92 2026-04-01
49654 HCPCS Lap Inc Hernia Repair 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
49655 HCPCS Lap Inc Hern Repair Comp 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
49657 HCPCS Lap Inc Hern Recur Comp 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
49656 HCPCS Lap Inc Hernia Repair Recur 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
0548T HCPCS Tprnl Balo Cntnc Dev Bi 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
0454T HCPCS Insj/rplcmt Subq Electrode 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
19324 HCPCS Enlarge Breast 2 1 — — $46,622.00 $46,622.00 $46,622.00 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 40 11 — — $14,171.00 $104,427.30 $46,559.05 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 34 11 — — $42,514.90 $101,405.62 $45,842.67 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 32 12 — — $12,000.00 $101,258.22 $45,174.32 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 34 11 — — $40,349.23 $106,612.13 $44,821.75 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 36 12 — — $16,000.00 $100,540.25 $44,539.70 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 30 11 — — $43,403.53 $97,074.00 $44,289.32 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 40 11 — — $14,171.00 $98,909.35 $44,109.46 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 34 11 — — $37,962.63 $97,554.23 $44,035.88 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 34 11 — — $41,662.90 $97,699.25 $44,014.42 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 34 11 — — $34,308.93 $99,613.06 $43,888.72 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 34 11 — — $42,225.62 $105,323.57 $43,837.62 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 40 11 — — $14,171.00 $97,753.93 $43,757.91 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 11 — — $14,122.00 $102,649.00 $43,592.36 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 36 12 — — $6,619.62 $99,151.84 $43,561.70 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 34 11 — — $41,401.35 $96,691.24 $43,392.05 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 34 11 — — $38,015.14 $92,956.34 $43,111.02 2026-04-01
791 MS_DRG Prematurity With Major Problems 34 11 — — $38,344.05 $96,524.82 $42,431.43 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 30 11 — — $41,197.22 $93,412.80 $42,037.98 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 34 11 — — $36,742.09 $85,220.28 $41,665.99 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 34 11 — — $38,959.28 $90,374.48 $40,928.15 2026-04-01
J9226 HCPCS Supprelin La Implant 16 4 — — $19,407.15 $97,205.89 $40,761.69 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 34 11 — — $22,366.04 $102,862.97 $40,747.27 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 34 11 — — $39,376.36 $92,445.20 $40,507.11 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 34 11 — — $32,309.70 $93,417.56 $40,447.84 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 34 11 — — $39,209.92 $89,670.77 $40,410.03 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 34 11 — — $39,202.99 $94,703.73 $40,186.22 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 36 11 — — $38,130.06 $90,868.98 $39,406.48 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 34 11 — — $29,362.37 $78,494.62 $39,238.88 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 34 11 — — $37,560.41 $91,553.67 $39,147.93 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 40 11 — — $14,122.00 $85,201.26 $39,143.84 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 34 11 — — $36,637.08 $93,819.34 $39,036.54 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 34 11 — — $36,592.50 $82,548.08 $38,821.93 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 36 11 — — $36,867.91 $91,789.04 $38,487.75 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 40 11 — — $14,122.00 $84,421.47 $38,472.42 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 34 11 — — $33,547.08 $75,453.92 $38,031.97 2026-04-01
2040 OTHER Endo, Single, Urinary Tract 2 1 — — $38,009.06 $38,009.06 $38,009.06 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 40 11 — — $14,122.00 $83,691.61 $38,003.35 2026-04-01
332 MS_DRG Rectal Resection With Mcc 34 11 — — $37,193.21 $82,460.12 $37,952.26 2026-04-01
265 MS_DRG Aicd Lead Procedures 40 11 — — $14,171.00 $84,799.48 $37,926.71 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 34 11 — — $37,104.07 $85,225.04 $37,861.30 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 11 — — $37,050.00 $76,176.65 $37,806.12 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 40 11 — — $11,126.00 $94,637.16 $37,564.94 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 40 11 — — $11,126.00 $93,605.37 $37,480.12 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 34 11 — — $36,694.46 $86,154.60 $37,443.33 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 34 11 — — $36,641.39 $83,235.15 $37,389.17 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 34 11 — — $35,917.83 $83,294.59 $37,358.51 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 36 11 — — $35,792.01 $89,009.86 $37,323.76 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 40 11 — — $14,171.00 $81,887.17 $37,294.12 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 34 11 — — $35,429.41 $81,423.57 $36,990.61 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 34 11 — — $35,993.12 $86,737.06 $36,917.03 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 42 12 — — $3,309.81 $81,549.57 $36,599.20 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 34 11 — — $35,858.21 $91,884.13 $36,590.01 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 36 11 — — $32,163.08 $82,369.78 $36,426.50 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 34 11 — — $33,256.81 $81,754.03 $36,254.81 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 22 11 — — $35,369.47 $36,091.30 $36,091.30 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 34 11 — — $32,317.62 $83,280.32 $35,987.06 2026-04-01
0404T HCPCS Trnscrv Uterin Fibroid Abltj 2 1 — — $35,965.00 $35,965.00 $35,965.00 2026-04-01
19366 HCPCS Breast Reconstruction 2 1 — — $35,965.00 $35,965.00 $35,965.00 2026-04-01
0425T HCPCS Insj/rplc Nstim Apnea Sen Ld 2 1 — — $35,965.00 $35,965.00 $35,965.00 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 34 11 — — $32,643.57 $79,797.43 $35,815.37 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 36 12 — — $8,000.00 $83,903.20 $35,769.39 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 42 11 — — $11,709.62 $83,087.75 $35,089.80 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 34 11 — — $34,014.44 $65,055.17 $34,708.61 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 34 11 — — $32,442.45 $78,946.32 $34,594.15 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 34 11 — — $32,548.46 $74,193.90 $34,590.07 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 40 11 — — $14,171.00 $80,993.26 $34,192.53 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 34 11 — — $29,005.71 $77,481.84 $34,046.39 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 34 11 — — $31,857.94 $75,824.80 $34,009.60 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 30 11 — — $33,284.34 $73,361.81 $33,963.61 2026-04-01
652 MS_DRG Kidney Transplant 34 11 — — $31,523.08 $73,014.71 $33,954.42 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 40 11 — — $14,122.00 $76,637.87 $33,929.89 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 34 11 — — $29,809.17 $75,606.07 $33,865.51 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 6 1 — — $28,213.56 $33,795.82 $33,795.82 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 30 11 — — $33,084.05 $68,041.19 $33,759.23 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 42 12 — — $8,000.00 $80,641.41 $33,579.36 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 40 11 — — $14,122.00 $73,513.96 $33,519.07 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 34 11 — — $32,511.80 $77,448.56 $33,487.39 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 34 11 — — $32,753.55 $83,931.73 $33,421.99 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 34 11 — — $31,245.69 $75,327.92 $33,293.22 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 34 11 — — $31,758.87 $73,309.51 $33,244.17 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 30 11 — — $32,489.15 $75,957.93 $33,152.19 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 40 11 — — $14,171.00 $73,844.42 $33,136.86 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 40 11 — — $14,171.00 $66,695.58 $33,061.24 2026-04-01
665 MS_DRG Prostatectomy With Mcc 34 11 — — $30,084.59 $81,625.65 $32,847.65 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 34 11 — — $29,468.37 $70,100.02 $32,781.23 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 34 11 — — $30,295.61 $72,710.40 $32,725.02 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 36 12 — — $8,000.00 $74,160.62 $32,237.55 2026-04-01
263 MS_DRG Vein Ligation And Stripping 42 12 — — $4,550.54 $63,759.49 $32,195.65 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 38 12 — — $8,000.00 $77,705.32 $31,948.34 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 40 11 — — $14,122.00 $67,946.09 $31,818.56 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 34 11 — — $28,147.77 $68,157.68 $31,814.47 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 40 11 — — $14,122.00 $60,022.22 $31,780.75 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 30 11 — — $30,740.52 $72,948.14 $31,367.88 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 40 11 — — $14,122.00 $68,873.28 $31,058.23 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 34 11 — — $27,087.72 $62,851.32 $31,037.79 2026-04-01
570 MS_DRG Skin Debridement With Mcc 34 11 — — $28,099.22 $71,569.25 $31,007.14 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 12 4 — — $15,176.53 $36,759.36 $30,886.89 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 34 11 — — $27,294.78 $69,327.36 $30,791.51 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 40 11 — — $14,122.00 $69,919.33 $30,712.82 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 4 1 — — $27,727.71 $33,490.44 $30,609.08 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 36 12 — — $8,000.00 $69,724.39 $30,607.56 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 34 11 — — $28,502.44 $66,762.15 $30,589.16 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 34 11 — — $29,849.18 $64,817.43 $30,458.35 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 36 11 — — $14,547.34 $70,989.16 $30,444.05 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 34 11 — — $26,951.99 $62,996.35 $30,401.12 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 34 11 — — $29,676.93 $69,291.70 $30,282.58 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 34 11 — — $27,639.54 $69,229.89 $30,081.26 2026-04-01
800 MS_DRG Splenic Procedures With Cc 34 11 — — $29,068.02 $69,267.93 $29,661.24 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 34 11 — — $28,732.28 $67,087.85 $29,558.02 2026-04-01
503 MS_DRG Foot Procedures With Mcc 40 11 — — $14,122.00 $62,917.89 $29,474.22 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 8 3 — — $20,143.00 $37,014.57 $29,400.64 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 40 11 — — $14,122.00 $60,578.53 $29,278.01 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 34 11 — — $28,544.22 $64,265.88 $29,126.76 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 36 12 — — $25,186.57 $63,811.79 $29,040.92 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 34 11 — — $27,779.23 $62,363.96 $29,033.76 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 34 11 — — $26,988.65 $64,584.45 $28,888.65 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 30 11 — — $28,180.68 $67,677.45 $28,755.80 2026-04-01
849 MS_DRG Radiotherapy 34 11 — — $24,643.66 $63,497.98 $28,640.32 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 34 11 — — $26,560.67 $64,933.93 $28,606.59 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 34 11 — — $25,193.50 $62,199.92 $28,516.66 2026-04-01
J9266 HCPCS Pegaspargase Injection 16 4 — — $1,666.25 $58,201.64 $28,139.82 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 40 11 — — $14,122.00 $68,079.23 $28,134.46 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 34 11 — — $25,237.09 $63,300.65 $28,039.42 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 34 11 — — $27,345.43 $63,077.18 $27,903.50 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 42 12 — — $4,000.00 $60,692.64 $27,476.32 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 34 11 — — $26,450.70 $60,709.29 $27,444.64 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 36 12 — — $26,798.61 $64,056.67 $27,345.52 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 34 11 — — $24,846.76 $56,986.28 $27,308.73 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 34 11 — — $23,098.17 $56,986.28 $27,308.73 2026-04-01
0467T HCPCS Revj/rplmnt Ch Respir Eltrd 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0432T HCPCS Repos Nstim Apnea Stimj Ld 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0468T HCPCS Rmvl Chwal Respir Eltrd/ra 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
49653 HCPCS Lap Vent/abd Hern Proc Comp 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0313T HCPCS Laps Rmvl Nstim Array Vagus 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
49565 HCPCS Rerepair Ventrl Hern Reduce 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0428T HCPCS Rmvl Nstim Apnea Pls Gen 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0315T HCPCS Rmvl Vagus Nerve Pls Gen 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
49566 HCPCS Rerepair Ventrl Hern Block 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0191T HCPCS Insert Ant Segment Drain Int 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0433T HCPCS Repos Nstim Apnea Sensing Ld 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
49652 HCPCS Lap Vent/abd Hernia Repair 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0549T HCPCS Tprnl Balo Cntnc Dev Uni 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0430T HCPCS Rmvl Nstim Apnea Stimj Ld 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
69605 HCPCS Mastoid Surgery Revision 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0429T HCPCS Rmvl Nstim Apnea Sen Ld 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
0314T HCPCS Laps Rmvl Vgl Arry&pls Gen 2 1 — — $27,307.00 $27,307.00 $27,307.00 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 34 11 — — $26,646.38 $61,536.62 $27,190.18 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 40 11 — — $14,171.00 $59,482.55 $27,040.98 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 34 11 — — $26,378.97 $61,436.77 $26,917.32 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 42 11 — — $14,122.00 $133,236.57 $26,868.27 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 34 11 — — $26,146.55 $59,834.40 $26,744.61 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 34 11 — — $24,884.40 $58,664.72 $26,733.37 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 6 1 — — $22,257.59 $31,993.79 $26,661.56 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 36 11 — — $16,699.47 $57,528.33 $26,416.57 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 34 11 — — $24,762.55 $60,069.77 $26,312.33 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 34 11 — — $23,349.81 $55,593.12 $26,082.40 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 34 11 — — $25,175.67 $58,210.64 $26,075.24 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 34 11 — — $18,552.84 $43,791.71 $26,040.50 2026-04-01
792 MS_DRG Prematurity Without Major Problems 34 11 — — $23,135.82 $58,241.55 $25,980.20 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 38 11 — — $25,410.52 $57,725.65 $25,929.10 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 40 11 — — $14,122.00 $56,277.81 $25,899.47 2026-04-01
S3865 HCPCS Comp Genet Test Hyp Cardiomy 2 1 — — $25,885.04 $25,885.04 $25,885.04 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 22 11 — — $25,190.19 $25,704.28 $25,704.28 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 22 11 — — $25,111.07 $25,623.54 $25,623.54 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 42 12 — — $14,171.00 $55,027.30 $25,531.57 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 36 12 — — $8,000.00 $56,194.60 $25,448.79 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 32 11 — — $24,724.00 $58,902.46 $25,425.29 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 34 11 — — $23,153.65 $54,076.34 $25,380.32 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 34 11 — — $24,009.61 $56,498.91 $25,338.42 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 4 1 — — $22,946.59 $27,715.65 $25,331.12 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 36 12 — — $8,000.00 $53,648.41 $24,977.68 2026-04-01
333 MS_DRG Rectal Resection With Cc 34 11 — — $21,210.89 $50,522.13 $24,886.72 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 34 11 — — $23,582.62 $54,877.52 $24,849.93 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 34 11 — — $21,969.76 $50,194.05 $24,832.56 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 34 11 — — $22,903.99 $53,420.18 $24,732.41 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 34 11 — — $22,327.41 $53,536.67 $24,716.06 2026-04-01
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