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

POMONA VALLEY HOSPITAL MEDICAL CENTER

Pomona, CA · CCN 050231 · Rates published

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You selected 482 (MS_DRG)

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

This hospital’s price: $51,298 across 2 payers · range $29,875-$51,298

Source: https://custom.pvhmc.org/CostEstimator/downloadable/Machine-Readable-File.csv · observed 2026-10-06

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.

26,184 distinct procedures filed
9 distinct payers
134,139 rate rows
2026-10-06 last MRF observed
Data quality

85,629 of 134,139 rate rows are consumer-grade (63.8%)

48,510 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 31,372
per-diem day rate — not a per-procedure price 16,987
placeholder amount (≤ $0.02) — excluded from medians 135
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://custom.pvhmc.org/CostEstimator/downloadable/Machine-Readable-File.csv
Found on page https://www.pvhmc.org/patients-visitors/financial-and-insurance-information/machine-readable-file/
Discovered viaDiscovered by HANK
Last fetch success · 2026-10-13
Content fingerprint f14f98fe4df4ec88… · 18,045,958 bytes · first seen 2026-10-13

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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,705,478
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,605,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,264,000.00 $3,264,000.00 $3,264,000.00 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,162,000.00 $3,162,000.00 $3,162,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,856,000.00 $4,850,948.67 $2,856,000.00 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,368,485.25 $4,271,819.03 $2,368,485.25 nat. median
$2,467,989
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,244,000.00 $3,847,800.00 $2,244,000.00 nat. median
$2,401,965
0.9× median
C9098
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 $1,361,514.42 $1,361,514.42 $1,361,514.42 nat. median
$32,174
outlier · 42.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $790,979.35 $1,358,185.43 $1,358,185.43 nat. median
$359,244
outlier · 3.8×
Q2057
HCPCS 		Afamitresgene Autoleucel Per Therapeutic Dose 2 $778,326.20 $1,271,523.00 $1,271,523.00 nat. median
$813,967
1.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $513,313.78 $881,407.70 $881,407.70 nat. median
$248,541
outlier · 3.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $388,781.99 $667,574.99 $667,574.99 nat. median
$190,359
outlier · 3.5×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $532,496.61 $1,361,514.47 $593,526.07 nat. median
$646,415
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $337,585.97 $579,666.65 $579,666.65 nat. median
$198,115
outlier · 2.9×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $497,226.98 $1,201,353.50 $567,823.25 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $508,376.11 $1,228,291.02 $563,662.54 nat. median
$623,527
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $513,651.60 $1,092,139.50 $537,514.16 nat. median
$608,239
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $813.12 $934,776.65 $529,806.61 nat. median
$739,658
0.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $471,240.00 $1,092,139.52 $494,344.70 nat. median
$592,235
0.8× median
Q2058
HCPCS 		Obecabtagene Autoleucel 10 Up To 400 Mil Cd19 2 $261,450.00 $459,112.50 $459,112.50 nat. median
$319,951
1.4× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 $253,716.09 $435,654.23 $435,654.23 nat. median
$126,461
outlier · 3.4×
7
MS_DRG 		Lung Transplant 2 $237,208.81 $407,309.69 $407,309.69 nat. median
$117,977
outlier · 3.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $220,131.87 $377,986.99 $377,986.99 nat. median
$110,084
outlier · 3.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $207,564.58 $356,407.77 $356,407.77 nat. median
$103,938
outlier · 3.4×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $199,180.89 $342,012.19 $342,012.19 nat. median
$97,137
outlier · 3.5×
J3402
HCPCS 		Injection Remestemcel-l-rknd Per Ther Dose 2 $203,685.71 $332,753.88 $332,753.88 nat. median
$209,753
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $188,857.43 $324,285.85 $324,285.85 nat. median
$94,943
outlier · 3.4×
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $158,616.06 $272,358.59 $272,358.59 nat. median
$78,164
outlier · 3.5×
J3403
HCPCS 		Revakinagene, Per Implant 1 $267,650.00 $267,650.00 $267,650.00 nat. median
$265,000
1.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $144,132.81 $247,489.50 $247,489.50 nat. median
$74,298
outlier · 3.3×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $139,573.71 $239,661.09 $239,661.09 nat. median
$67,908
outlier · 3.5×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 $131,382.35 $225,595.76 $225,595.76 nat. median
$61,263
outlier · 3.7×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $126,603.44 $217,389.93 $217,389.93 nat. median
$62,577
outlier · 3.5×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 2 $123,293.56 $211,706.56 $211,706.56 nat. median
$61,660
outlier · 3.4×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 $121,390.42 $208,438.69 $208,438.69 nat. median
$66,623
outlier · 3.1×
209
MS_DRG 		Complex Aortic Arch Procedures 3 $111,321.00 $355,998.90 $207,326.46 nat. median
$92,645
outlier · 2.2×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 $120,001.99 $206,054.63 $206,054.63 nat. median
$58,052
outlier · 3.5×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $117,864.40 $202,384.18 $202,384.18 nat. median
$59,324
outlier · 3.4×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $152,767.00 $346,638.78 $201,875.32 nat. median
$93,226
outlier · 2.2×
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 2 $112,123.85 $192,527.13 $192,527.13 nat. median
$58,234
outlier · 3.3×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 $108,867.09 $186,934.96 $186,934.96 nat. median
$50,808
outlier · 3.7×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 2 $108,614.31 $186,500.92 $186,500.92 nat. median
$53,841
outlier · 3.5×
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 $107,425.54 $184,459.69 $184,459.69 nat. median
$53,768
outlier · 3.4×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 $104,961.91 $180,229.40 $180,229.40 nat. median
$53,419
outlier · 3.4×
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 2 $104,397.74 $179,260.67 $179,260.67 nat. median
$49,873
outlier · 3.6×
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 2 $102,659.46 $176,275.88 $176,275.88 nat. median
$50,763
outlier · 3.5×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 $112,253.90 $192,750.44 $175,922.00 nat. median
$58,220
outlier · 3.0×
834
MS_DRG 		Acute Leukemia With Mcc 2 $100,558.50 $172,668.33 $172,668.33 nat. median
$50,314
outlier · 3.4×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 2 $100,203.15 $172,058.17 $172,058.17 nat. median
$50,728
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 26,184 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
             
J1414 HCPCS Inj, Beqvez, Per Tx Dose 3 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-10-06
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-10-06
C9172 HCPCS Inj, Beqvez, Per Tx Dose 3 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-10-06
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 1 — — $3,264,000.00 $3,264,000.00 $3,264,000.00 2026-10-06
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 1 — — $3,162,000.00 $3,162,000.00 $3,162,000.00 2026-10-06
J3393 HCPCS Inj, Betibeglogene Autotemce 5 2 — — $2,856,000.00 $4,850,948.67 $2,856,000.00 2026-10-06
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 2 — — $2,368,485.25 $4,271,819.03 $2,368,485.25 2026-10-06
J3392 HCPCS Inj, Exagamglogene Autotem 5 2 — — $2,244,000.00 $3,847,800.00 $2,244,000.00 2026-10-06
C9098 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 1 1 — — $1,361,514.42 $1,361,514.42 $1,361,514.42 2026-10-06
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 2 — — $790,979.35 $1,358,185.43 $1,358,185.43 2026-10-06
Q2057 HCPCS Afamitresgene Autoleucel Per Therapeutic Dose 3 2 — — $778,326.20 $1,271,523.00 $1,271,523.00 2026-10-06
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 2 — — $513,313.78 $881,407.70 $881,407.70 2026-10-06
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 2 — — $388,781.99 $667,574.99 $667,574.99 2026-10-06
Q2056 HCPCS Ciltacabtagene Car-pos T 7 4 — — $532,496.61 $1,361,514.47 $593,526.07 2026-10-06
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 2 — — $337,585.97 $579,666.65 $579,666.65 2026-10-06
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 4 — — $497,226.98 $1,201,353.50 $567,823.25 2026-10-06
Q2055 HCPCS Idecabtagene Vicleucel Car 7 4 — — $508,376.11 $1,228,291.02 $563,662.54 2026-10-06
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 7 4 — — $513,651.60 $1,092,139.50 $537,514.16 2026-10-06
Q2042 HCPCS Tisagenlecleucel Car-pos T 9 3 — — $813.12 $934,776.65 $529,806.61 2026-10-06
Q2053 HCPCS Brexucabtagene Car Pos T 7 4 — — $471,240.00 $1,092,139.52 $494,344.70 2026-10-06
Q2058 HCPCS Obecabtagene Autoleucel 10 Up To 400 Mil Cd19 3 2 — — $261,450.00 $459,112.50 $459,112.50 2026-10-06
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 2 — — $253,716.09 $435,654.23 $435,654.23 2026-10-06
7 MS_DRG Lung Transplant 3 2 — — $237,208.81 $407,309.69 $407,309.69 2026-10-06
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $220,131.87 $377,986.99 $377,986.99 2026-10-06
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $207,564.58 $356,407.77 $356,407.77 2026-10-06
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 2 — — $199,180.89 $342,012.19 $342,012.19 2026-10-06
J3402 HCPCS Injection Remestemcel-l-rknd Per Ther Dose 3 2 — — $203,685.71 $332,753.88 $332,753.88 2026-10-06
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 2 — — $188,857.43 $324,285.85 $324,285.85 2026-10-06
850 MS_DRG Acute Leukemia With Other Procedures 3 2 — — $158,616.06 $272,358.59 $272,358.59 2026-10-06
J3403 HCPCS Revakinagene, Per Implant 1 1 — — $267,650.00 $267,650.00 $267,650.00 2026-10-06
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $144,132.81 $247,489.50 $247,489.50 2026-10-06
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 2 — — $139,573.71 $239,661.09 $239,661.09 2026-10-06
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 2 — — $131,382.35 $225,595.76 $225,595.76 2026-10-06
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 2 — — $126,603.44 $217,389.93 $217,389.93 2026-10-06
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 2 — — $123,293.56 $211,706.56 $211,706.56 2026-10-06
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 2 — — $121,390.42 $208,438.69 $208,438.69 2026-10-06
209 MS_DRG Complex Aortic Arch Procedures 5 3 — — $111,321.00 $355,998.90 $207,326.46 2026-10-06
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $120,001.99 $206,054.63 $206,054.63 2026-10-06
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 2 — — $117,864.40 $202,384.18 $202,384.18 2026-10-06
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 3 — — $152,767.00 $346,638.78 $201,875.32 2026-10-06
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 2 — — $112,123.85 $192,527.13 $192,527.13 2026-10-06
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 2 — — $108,867.09 $186,934.96 $186,934.96 2026-10-06
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 2 — — $108,614.31 $186,500.92 $186,500.92 2026-10-06
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 2 — — $107,425.54 $184,459.69 $184,459.69 2026-10-06
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $104,961.91 $180,229.40 $180,229.40 2026-10-06
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $104,397.74 $179,260.67 $179,260.67 2026-10-06
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 2 — — $102,659.46 $176,275.88 $176,275.88 2026-10-06
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 5 3 — — $112,253.90 $192,750.44 $175,922.00 2026-10-06
834 MS_DRG Acute Leukemia With Mcc 3 2 — — $100,558.50 $172,668.33 $172,668.33 2026-10-06
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 2 — — $100,203.15 $172,058.17 $172,058.17 2026-10-06
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 2 — — $99,902.75 $171,542.35 $171,542.35 2026-10-06
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $96,966.53 $166,500.60 $166,500.60 2026-10-06
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 3 — — $121,635.00 $283,369.94 $165,028.84 2026-10-06
653 MS_DRG Major Bladder Procedures With Mcc 3 2 — — $95,182.46 $163,437.17 $163,437.17 2026-10-06
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 2 — — $91,354.21 $156,863.70 $156,863.70 2026-10-06
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 2 — — $90,460.34 $155,328.85 $155,328.85 2026-10-06
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $50,623.00 $206,806.34 $154,847.89 2026-10-06
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 2 — — $90,150.78 $154,797.31 $154,797.31 2026-10-06
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $89,775.28 $154,152.54 $154,152.54 2026-10-06
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 2 — — $88,623.14 $152,174.21 $152,174.21 2026-10-06
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 2 — — $88,000.36 $151,104.84 $151,104.84 2026-10-06
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 4 — — $50,623.00 $240,456.83 $150,521.07 2026-10-06
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 2 — — $86,115.54 $147,868.43 $147,868.43 2026-10-06
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $85,939.70 $147,566.49 $147,566.49 2026-10-06
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $85,683.26 $147,126.17 $147,126.17 2026-10-06
6 MS_DRG Liver Transplant Without Mcc 3 2 — — $84,935.93 $145,842.92 $145,842.92 2026-10-06
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $84,194.09 $144,569.12 $144,569.12 2026-10-06
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 2 — — $83,979.78 $144,201.13 $144,201.13 2026-10-06
245 MS_DRG Aicd Generator Procedures 3 2 — — $83,569.48 $143,496.60 $143,496.60 2026-10-06
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 2 — — $83,318.54 $143,065.71 $143,065.71 2026-10-06
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $83,281.90 $143,002.81 $143,002.81 2026-10-06
799 MS_DRG Splenic Procedures With Mcc 3 2 — — $82,955.86 $142,442.96 $142,442.96 2026-10-06
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $82,093.13 $140,961.57 $140,961.57 2026-10-06
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $82,069.32 $140,920.69 $140,920.69 2026-10-06
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $80,462.92 $138,162.35 $138,162.35 2026-10-06
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $79,264.99 $136,105.38 $136,105.38 2026-10-06
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $78,633.05 $135,020.29 $135,020.29 2026-10-06
140 MS_DRG Major Head And Neck Procedures With Mcc 3 2 — — $78,127.50 $134,152.22 $134,152.22 2026-10-06
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 2 — — $77,224.47 $132,601.63 $132,601.63 2026-10-06
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $77,186.01 $132,535.58 $132,535.58 2026-10-06
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 3 — — $103,581.00 $227,039.41 $132,223.10 2026-10-06
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $76,960.71 $132,148.72 $132,148.72 2026-10-06
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 5 3 — — $87,203.57 $149,736.68 $132,091.00 2026-10-06
901 MS_DRG Wound Debridements For Injuries With Mcc 3 2 — — $76,869.12 $131,991.46 $131,991.46 2026-10-06
793 MS_DRG Full Term Neonate With Major Problems 3 2 — — $76,374.56 $131,142.26 $131,142.26 2026-10-06
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 2 — — $76,070.50 $130,620.16 $130,620.16 2026-10-06
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 8 4 — — $29,619.00 $188,919.58 $128,807.95 2026-10-06
791 MS_DRG Prematurity With Major Problems 3 2 — — $74,348.70 $127,663.67 $127,663.67 2026-10-06
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 3 — — $117,993.00 $216,323.71 $125,982.49 2026-10-06
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 2 — — $72,976.76 $125,307.91 $125,307.91 2026-10-06
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $71,654.27 $123,037.08 $123,037.08 2026-10-06
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 3 — — $81,085.00 $210,303.80 $122,476.62 2026-10-06
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 5 3 — — $97,777.00 $210,149.68 $122,386.87 2026-10-06
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 2 — — $70,899.61 $121,741.26 $121,741.26 2026-10-06
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 2 — — $70,793.37 $121,558.83 $121,558.83 2026-10-06
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 2 — — $70,725.60 $121,442.46 $121,442.46 2026-10-06
215 MS_DRG Cardiovascular Surgery 6 3 — — $50,623.00 $313,167.56 $120,968.18 2026-10-06
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 2 — — $70,324.46 $120,753.66 $120,753.66 2026-10-06
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 2 — — $69,910.49 $120,042.85 $120,042.85 2026-10-06
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $68,926.87 $118,353.88 $118,353.88 2026-10-06
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 2 — — $68,626.47 $117,838.06 $117,838.06 2026-10-06
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 2 — — $68,463.45 $117,558.14 $117,558.14 2026-10-06
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $50,623.00 $206,806.34 $117,289.39 2026-10-06
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 2 — — $68,263.80 $117,215.31 $117,215.31 2026-10-06
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 2 — — $67,879.14 $116,554.82 $116,554.82 2026-10-06
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 2 — — $67,280.17 $115,526.34 $115,526.34 2026-10-06
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $50,623.00 $307,688.63 $114,605.50 2026-10-06
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 2 — — $66,463.23 $114,123.58 $114,123.58 2026-10-06
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 2 — — $66,411.95 $114,035.52 $114,035.52 2026-10-06
332 MS_DRG Rectal Resection With Mcc 3 2 — — $66,320.36 $113,878.26 $113,878.26 2026-10-06
265 MS_DRG Aicd Lead Procedures 3 2 — — $66,274.57 $113,799.63 $113,799.63 2026-10-06
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 2 — — $66,157.34 $113,598.33 $113,598.33 2026-10-06
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 2 — — $65,474.12 $112,425.17 $112,425.17 2026-10-06
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 2 — — $65,408.18 $112,311.95 $112,311.95 2026-10-06
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $65,311.10 $112,145.25 $112,145.25 2026-10-06
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 2 — — $65,256.14 $112,050.90 $112,050.90 2026-10-06
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 2 — — $65,193.87 $111,943.96 $111,943.96 2026-10-06
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 4 — — $50,623.00 $171,812.84 $111,459.64 2026-10-06
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 2 — — $64,591.24 $110,909.19 $110,909.19 2026-10-06
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 2 — — $64,464.85 $110,692.17 $110,692.17 2026-10-06
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 2 — — $63,878.71 $109,685.70 $109,685.70 2026-10-06
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 2 — — $63,585.63 $109,182.47 $109,182.47 2026-10-06
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $50,623.00 $241,497.89 $108,770.00 2026-10-06
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 2 — — $63,277.91 $108,654.08 $108,654.08 2026-10-06
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $62,798.00 $107,830.04 $107,830.04 2026-10-06
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $62,407.85 $107,160.11 $107,160.11 2026-10-06
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 5 3 — — $79,779.00 $181,386.83 $105,635.97 2026-10-06
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 8 4 — — $29,619.00 $145,261.06 $105,221.03 2026-10-06
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $61,189.77 $105,068.55 $105,068.55 2026-10-06
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 5 3 — — $96,498.00 $179,493.42 $104,533.29 2026-10-06
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 2 — — $60,506.55 $103,895.39 $103,895.39 2026-10-06
37 MS_DRG Extracranial Procedures With Mcc 3 2 — — $60,301.40 $103,543.13 $103,543.13 2026-10-06
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 3 — — $80,269.00 $176,823.14 $102,978.17 2026-10-06
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 3 — — $30,160.00 $175,068.12 $101,956.09 2026-10-06
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 2 — — $59,319.60 $101,857.30 $101,857.30 2026-10-06
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 2 — — $59,253.66 $101,744.07 $101,744.07 2026-10-06
652 MS_DRG Kidney Transplant 3 2 — — $59,154.75 $101,574.23 $101,574.23 2026-10-06
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 2 — — $59,110.79 $101,498.75 $101,498.75 2026-10-06
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 3 2 — — $58,995.39 $101,300.60 $101,300.60 2026-10-06
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 2 — — $58,804.90 $100,973.50 $100,973.50 2026-10-06
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 2 — — $58,374.45 $100,234.38 $100,234.38 2026-10-06
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 2 — — $58,317.66 $100,136.88 $100,136.88 2026-10-06
500 MS_DRG Soft Tissue Procedures With Mcc 3 2 — — $57,969.64 $99,539.29 $99,539.29 2026-10-06
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 2 — — $57,881.72 $99,388.32 $99,388.32 2026-10-06
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 2 — — $57,716.87 $99,105.25 $99,105.25 2026-10-06
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 5 3 — — $46,115.00 $168,601.59 $98,190.11 2026-10-06
665 MS_DRG Prostatectomy With Mcc 3 2 — — $57,171.02 $98,167.98 $98,167.98 2026-10-06
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $57,051.96 $97,963.54 $97,963.54 2026-10-06
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 2 — — $56,951.22 $97,790.56 $97,790.56 2026-10-06
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 5 3 — — $75,107.00 $167,626.58 $97,622.28 2026-10-06
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 2 — — $56,326.61 $96,718.05 $96,718.05 2026-10-06
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 5 3 — — $88,952.00 $165,950.19 $96,645.99 2026-10-06
10 MS_DRG Pancreas Transplant 3 2 — — $56,231.36 $96,554.49 $96,554.49 2026-10-06
662 MS_DRG Minor Bladder Procedures With Mcc 3 2 — — $56,077.50 $96,290.30 $96,290.30 2026-10-06
263 MS_DRG Vein Ligation And Stripping 3 2 — — $56,002.40 $96,161.34 $96,161.34 2026-10-06
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 5 3 — — $33,548.00 $163,720.24 $95,347.31 2026-10-06
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 2 — — $55,326.50 $95,000.77 $95,000.77 2026-10-06
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 2 — — $55,319.17 $94,988.19 $94,988.19 2026-10-06
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 2 — — $55,258.73 $94,884.39 $94,884.39 2026-10-06
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $62,618.51 $187,551.42 $93,676.00 2026-10-06
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 2 — — $54,518.72 $93,613.73 $93,613.73 2026-10-06
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 2 — — $53,927.08 $92,597.83 $92,597.83 2026-10-06
570 MS_DRG Skin Debridement With Mcc 3 2 — — $53,872.13 $92,503.48 $92,503.48 2026-10-06
668 MS_DRG Transurethral Procedures With Mcc 3 2 — — $53,485.64 $91,839.84 $91,839.84 2026-10-06
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 2 — — $53,344.60 $91,597.66 $91,597.66 2026-10-06
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 2 — — $53,155.93 $91,273.70 $91,273.70 2026-10-06
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 2 — — $53,122.96 $91,217.09 $91,217.09 2026-10-06
619 MS_DRG O.r. Procedures For Obesity With Mcc 3 2 — — $52,888.51 $90,814.50 $90,814.50 2026-10-06
974 MS_DRG HIV With Major Related Condition With Mcc 3 2 — — $52,862.86 $90,770.47 $90,770.47 2026-10-06
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 3 2 — — $52,785.93 $90,638.37 $90,638.37 2026-10-06
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 4 — — $29,619.00 $224,265.34 $90,140.50 2026-10-06
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $50,623.00 $158,524.37 $89,807.67 2026-10-06
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 9 5 — — $54,948.15 $153,973.89 $89,766.78 2026-10-06
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 2 — — $52,212.61 $89,653.93 $89,653.93 2026-10-06
800 MS_DRG Splenic Procedures With Cc 3 2 — — $51,459.78 $88,361.25 $88,361.25 2026-10-06
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $80,192.00 $264,303.74 $88,244.10 2026-10-06
654 MS_DRG Major Bladder Procedures With Cc 3 2 — — $51,274.78 $88,043.58 $88,043.58 2026-10-06
503 MS_DRG Foot Procedures With Mcc 3 2 — — $51,124.58 $87,785.68 $87,785.68 2026-10-06
A9543 HCPCS Y-90 Ibritumomb Tiuxtn Tx To 40 Mci 6 4 — — $67,535.48 $162,724.80 $87,564.28 2026-10-06
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 3 2 — — $50,772.89 $87,181.80 $87,181.80 2026-10-06
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 2 — — $50,501.80 $86,716.31 $86,716.31 2026-10-06
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 2 — — $50,347.94 $86,452.11 $86,452.11 2026-10-06
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $50,623.00 $167,727.23 $86,445.00 2026-10-06
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 2 — — $50,075.01 $85,983.48 $85,983.48 2026-10-06
849 MS_DRG Radiotherapy 3 2 — — $49,629.91 $85,219.19 $85,219.19 2026-10-06
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 2 — — $49,569.47 $85,115.40 $85,115.40 2026-10-06
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 8 4 — — $50,623.00 $131,746.14 $84,925.12 2026-10-06
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 2 — — $49,408.28 $84,838.62 $84,838.62 2026-10-06
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 3 2 — — $48,552.87 $83,369.82 $83,369.82 2026-10-06
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 2 — — $48,309.26 $82,951.50 $82,951.50 2026-10-06
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 5 3 — — $62,951.00 $140,367.13 $81,746.94 2026-10-06
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 4 — — $50,623.00 $265,137.21 $81,628.00 2026-10-06
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 2 — — $47,486.82 $81,539.31 $81,539.31 2026-10-06
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 2 — — $47,309.15 $81,234.23 $81,234.23 2026-10-06
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 3 2 — — $47,243.21 $81,121.00 $81,121.00 2026-10-06
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 3 2 — — $47,243.21 $81,121.00 $81,121.00 2026-10-06
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 3 2 — — $47,030.73 $80,756.16 $80,756.16 2026-10-06
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 2 — — $46,541.67 $79,916.39 $79,916.39 2026-10-06
164 MS_DRG Major Chest Procedures With Cc 3 2 — — $46,232.11 $79,384.85 $79,384.85 2026-10-06
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 2 — — $46,211.96 $79,350.25 $79,350.25 2026-10-06
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 2 — — $45,644.13 $78,375.24 $78,375.24 2026-10-06
545 MS_DRG Connective Tissue Disorders With Mcc 3 2 — — $45,457.30 $78,054.43 $78,054.43 2026-10-06
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 5 3 — — $73,344.00 $132,828.09 $77,741.00 2026-10-06
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 5 3 — — $59,552.00 $133,381.64 $77,678.73 2026-10-06
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 8 4 — — $50,623.00 $184,579.21 $77,546.50 2026-10-06
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 3 2 — — $45,045.17 $77,346.76 $77,346.76 2026-10-06
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 2 — — $45,032.34 $77,324.74 $77,324.74 2026-10-06
792 MS_DRG Prematurity Without Major Problems 3 2 — — $44,862.00 $77,032.24 $77,032.24 2026-10-06
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 2 — — $44,770.41 $76,874.98 $76,874.98 2026-10-06
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 5 3 — — $45,112.00 $129,755.23 $75,566.78 2026-10-06
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 2 — — $43,909.51 $75,396.73 $75,396.73 2026-10-06
397 MS_DRG Appendix Procedures With Mcc 3 2 — — $43,867.38 $75,324.39 $75,324.39 2026-10-06
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 2 — — $43,786.79 $75,186.01 $75,186.01 2026-10-06
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 2 — — $43,711.69 $75,057.05 $75,057.05 2026-10-06
113 MS_DRG Orbital Procedures With Cc/mcc 3 2 — — $43,065.10 $73,946.80 $73,946.80 2026-10-06
333 MS_DRG Rectal Resection With Cc 3 2 — — $42,902.08 $73,666.87 $73,666.87 2026-10-06
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 5 3 — — $57,053.00 $126,452.77 $73,643.50 2026-10-06
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 3 2 — — $42,836.14 $73,553.65 $73,553.65 2026-10-06
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 3 2 — — $42,805.00 $73,500.18 $73,500.18 2026-10-06
709 MS_DRG Penis Procedures With Cc/mcc 3 2 — — $42,625.49 $73,191.95 $73,191.95 2026-10-06
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 2 — — $42,596.18 $73,141.63 $73,141.63 2026-10-06
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 2 — — $42,552.22 $73,066.14 $73,066.14 2026-10-06
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $42,334.25 $72,691.86 $72,691.86 2026-10-06
347 MS_DRG Anal And Stomal Procedures With Mcc 3 2 — — $42,048.51 $72,201.21 $72,201.21 2026-10-06
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 3 2 — — $42,035.68 $72,179.19 $72,179.19 2026-10-06
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 3 2 — — $41,865.34 $71,886.69 $71,886.69 2026-10-06
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 3 2 — — $41,684.00 $71,575.32 $71,575.32 2026-10-06
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 3 2 — — $41,614.39 $71,455.80 $71,455.80 2026-10-06
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 3 2 — — $41,499.00 $71,257.65 $71,257.65 2026-10-06
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 3 2 — — $41,004.44 $70,408.45 $70,408.45 2026-10-06
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 3 2 — — $40,980.62 $70,367.56 $70,367.56 2026-10-06
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 3 2 — — $40,656.41 $69,810.86 $69,810.86 2026-10-06
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 3 2 — — $40,491.56 $69,527.79 $69,527.79 2026-10-06
J7330 HCPCS Cultured Chondrocytes Implnt 7 4 — — $61,878.30 $152,993.28 $69,492.58 2026-10-06
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 2 — — $40,442.10 $69,442.87 $69,442.87 2026-10-06
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 4 — — $50,623.00 $190,680.90 $69,276.50 2026-10-06
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 2 — — $40,273.59 $69,153.51 $69,153.51 2026-10-06
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 3 2 — — $40,147.20 $68,936.49 $68,936.49 2026-10-06
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 2 — — $40,075.76 $68,813.83 $68,813.83 2026-10-06
141 MS_DRG Major Head And Neck Procedures With Cc 3 2 — — $39,951.21 $68,599.96 $68,599.96 2026-10-06
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 3 2 — — $39,909.08 $68,527.62 $68,527.62 2026-10-06
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $39,881.60 $68,480.44 $68,480.44 2026-10-06
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 3 2 — — $39,225.86 $67,354.46 $67,354.46 2026-10-06
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 3 2 — — $39,211.20 $67,329.30 $67,329.30 2026-10-06
374 MS_DRG Digestive Malignancy With Mcc 3 2 — — $39,174.57 $67,266.39 $67,266.39 2026-10-06
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 5 3 — — $26,721.00 $115,479.16 $67,252.70 2026-10-06
32 MS_DRG Ventricular Shunt Procedures With Cc 3 2 — — $39,033.53 $67,024.21 $67,024.21 2026-10-06
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 3 2 — — $39,015.21 $66,992.76 $66,992.76 2026-10-06
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 3 2 — — $38,954.76 $66,888.97 $66,888.97 2026-10-06
595 MS_DRG Major Skin Disorders With Mcc 3 2 — — $38,844.86 $66,700.26 $66,700.26 2026-10-06
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 2 — — $38,784.42 $66,596.46 $66,596.46 2026-10-06
655 MS_DRG Major Bladder Procedures Without Cc/mcc 3 2 — — $38,769.76 $66,571.30 $66,571.30 2026-10-06
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 3 2 — — $38,744.12 $66,527.27 $66,527.27 2026-10-06
228 MS_DRG Other Cardiothoracic Procedures With Mcc 8 4 — — $50,623.00 $155,605.62 $66,491.00 2026-10-06
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 2 — — $38,625.06 $66,322.83 $66,322.83 2026-10-06
412 MS_DRG Cholecystectomy With C.d.e. With Cc 3 2 — — $38,511.49 $66,127.83 $66,127.83 2026-10-06
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 3 — — $39,201.00 $113,428.49 $66,058.43 2026-10-06
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 3 2 — — $38,364.96 $65,876.21 $65,876.21 2026-10-06
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 3 2 — — $38,341.14 $65,835.33 $65,835.33 2026-10-06
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 3 2 — — $38,302.68 $65,769.28 $65,769.28 2026-10-06
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 3 2 — — $38,234.91 $65,652.90 $65,652.90 2026-10-06
835 MS_DRG Acute Leukemia With Cc 3 2 — — $38,205.60 $65,602.58 $65,602.58 2026-10-06
314 MS_DRG Other Circulatory System Diagnoses With Mcc 3 2 — — $38,194.61 $65,583.71 $65,583.71 2026-10-06
711 MS_DRG Testes Procedures With Cc/mcc 3 2 — — $38,168.96 $65,539.68 $65,539.68 2026-10-06
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 3 2 — — $38,088.37 $65,401.29 $65,401.29 2026-10-06
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 3 2 — — $38,064.56 $65,360.40 $65,360.40 2026-10-06
886 MS_DRG Behavioral And Developmental Disorders 3 2 — — $38,013.27 $65,272.34 $65,272.34 2026-10-06
271 MS_DRG Other Major Cardiovascular Procedures With Cc 5 3 — — $59,037.00 $111,852.75 $65,140.75 2026-10-06
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 3 2 — — $37,855.74 $65,001.85 $65,001.85 2026-10-06
J9029 HCPCS Instill Adstiladrin, Tx Dose 7 4 — — $61,200.00 $175,679.23 $64,917.54 2026-10-06
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 3 2 — — $37,744.01 $64,809.99 $64,809.99 2026-10-06
935 MS_DRG Non-extensive Burns 3 2 — — $37,733.02 $64,791.12 $64,791.12 2026-10-06
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 5 3 — — $26,079.00 $110,918.62 $64,596.73 2026-10-06
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 3 2 — — $37,533.36 $64,448.29 $64,448.29 2026-10-06
90288 HCPCS Botulism Immune Globulin, Human, For Intravenous Use 4 3 — — $1,423.33 $69,300.00 $64,102.50 2026-10-06
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 3 2 — — $37,141.38 $63,775.22 $63,775.22 2026-10-06
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 3 2 — — $36,905.09 $63,369.49 $63,369.49 2026-10-06
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 3 2 — — $36,835.49 $63,249.97 $63,249.97 2026-10-06
28 MS_DRG Spinal Procedures With Mcc 8 4 — — $52,984.00 $188,973.05 $63,093.16 2026-10-06
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 5 3 — — $36,632.00 $108,150.85 $62,984.84 2026-10-06
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 3 2 — — $36,639.50 $62,913.44 $62,913.44 2026-10-06
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 3 2 — — $36,599.20 $62,844.24 $62,844.24 2026-10-06
908 MS_DRG Other O.r. Procedures For Injuries With Cc 3 2 — — $36,546.08 $62,753.03 $62,753.03 2026-10-06
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 3 2 — — $36,538.75 $62,740.45 $62,740.45 2026-10-06
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 3 2 — — $36,282.31 $62,300.12 $62,300.12 2026-10-06
539 MS_DRG Osteomyelitis With Mcc 3 2 — — $36,078.99 $61,951.00 $61,951.00 2026-10-06
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 3 2 — — $36,051.52 $61,903.83 $61,903.83 2026-10-06
883 MS_DRG Disorders Of Personality And Impulse Control 3 2 — — $36,016.72 $61,844.07 $61,844.07 2026-10-06
380 MS_DRG Complicated Peptic Ulcer With Mcc 3 2 — — $35,941.62 $61,715.11 $61,715.11 2026-10-06
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 3 2 — — $35,586.27 $61,104.95 $61,104.95 2026-10-06
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 2 — — $35,580.77 $61,095.51 $61,095.51 2026-10-06
100 MS_DRG Seizures With Mcc 3 2 — — $35,476.37 $60,916.23 $60,916.23 2026-10-06
592 MS_DRG Skin Ulcers With Mcc 3 2 — — $35,448.89 $60,869.06 $60,869.06 2026-10-06
548 MS_DRG Septic Arthritis With Mcc 3 2 — — $35,368.30 $60,730.67 $60,730.67 2026-10-06
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 3 2 — — $35,335.32 $60,674.05 $60,674.05 2026-10-06
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 3 2 — — $35,289.53 $60,595.42 $60,595.42 2026-10-06
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $43,816.47 $131,236.62 $60,347.50 2026-10-06
75 MS_DRG Viral Meningitis With Cc/mcc 3 2 — — $35,122.85 $60,309.21 $60,309.21 2026-10-06
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 5 3 — — $30,751.00 $103,530.55 $60,294.07 2026-10-06
902 MS_DRG Wound Debridements For Injuries With Cc 3 2 — — $35,067.90 $60,214.85 $60,214.85 2026-10-06
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