Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

STANFORD HEALTH CARE TRI-VALLEY

Pleasanton, CA · CCN 050283 · Rates published

15,438 distinct procedures filed
8 distinct payers
84,286 rate rows
2026-04-01 last MRF observed
Data quality

68,860 of 84,286 rate rows are consumer-grade (81.7%)

15,426 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 15,411
placeholder amount (≤ $0.02) — excluded from medians 15
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stanfordhealthcare.org/content/dam/valleycare/patients-visitors/941429628_stanford-health-care---tri-valley_standardcharges.json
Found on page https://stanfordhealthcare.org/for-patients-visitors/price-transparency.html
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 943ea067763abb1d… · 45,240,568 bytes · first seen 2026-05-08

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,004,655
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $557,317.93 $1,384,229.88 $1,365,136.90 nat. median
$625,184
outlier · 2.2×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $565,868.94 $1,385,638.43 $1,238,582.74 nat. median
$674,867
1.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $562,538.19 $1,358,307.10 $1,212,773.02 nat. median
$673,137
1.8× median
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $1,179,463.30 $1,179,463.30 $1,179,463.30 nat. median
$29,278
outlier · 40.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $533,230.17 $1,286,622.73 $1,169,133.54 nat. median
$634,303
1.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $1,711.00 $1,365,317.58 $1,125,423.00 nat. median
$753,246
1.5× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $489,304.61 $1,210,586.70 $1,088,441.35 nat. median
$619,808
1.8× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 2 $474,961.29 $474,961.29 $474,961.29 nat. median
$370,174
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $308,519.69 $666,032.50 $308,519.69 nat. median
$265,286
1.2× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $299,538.24 $299,538.24 $299,538.24 nat. median
$87,428
outlier · 3.4×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $238,128.96 $238,128.96 $238,128.96 nat. median
$63,570
outlier · 3.7×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $235,247.13 $332,017.73 $235,247.13 nat. median
$206,474
1.1× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $211,648.85 $211,648.85 $211,648.85 nat. median
$54,196
outlier · 3.9×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $31,643.30 $493,575.75 $210,783.67 nat. median
$202,976
1.0× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $200,988.78 $200,988.78 $200,988.78 nat. median
$62,372
outlier · 3.2×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $186,249.56 $186,249.56 $186,249.56 nat. median
$49,935
outlier · 3.7×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 2 $108,243.35 $250,459.38 $179,351.36 nat. median
$111,989
1.6× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $178,088.54 $178,088.54 $178,088.54 nat. median
$65,393
outlier · 2.7×
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $173,669.25 $173,669.25 $173,669.25 nat. median
$44,728
outlier · 3.9×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $163,250.58 $163,250.58 $163,250.58 nat. median
$48,704
outlier · 3.4×
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $155,889.64 $156,515.70 $155,889.64 nat. median
$76,329
outlier · 2.0×
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 $154,850.90 $154,850.90 $154,850.90 nat. median
$48,483
outlier · 3.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $76,000.00 $299,697.34 $152,908.55 nat. median
$133,161
1.1× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 3 $63,342.28 $166,539.39 $151,531.48 nat. median
$69,774
outlier · 2.2×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 7 $14,000.00 $303,431.27 $146,736.59 nat. median
$74,915
2.0× median
7
MS_DRG 		Lung Transplant 3 $143,013.56 $270,781.27 $143,013.56 nat. median
$122,708
1.2× median
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 $141,274.80 $141,274.80 $141,274.80 nat. median
$39,020
outlier · 3.6×
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 $52,338.03 $689,133.96 $139,006.17 nat. median
$46,084
outlier · 3.0×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 7 $18,000.00 $283,723.28 $133,961.98 nat. median
$53,268
outlier · 2.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $132,777.10 $281,979.01 $132,777.10 nat. median
$117,357
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 6 $55.00 $462,852.06 $130,104.42 nat. median
$99,019
1.3× median
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 $59,376.08 $238,993.24 $126,773.50 nat. median
$52,879
outlier · 2.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $125,243.86 $383,225.04 $125,243.86 nat. median
$108,660
1.2× median
209
MS_DRG 		Complex Aortic Arch Procedures 2 $125,101.13 $125,101.13 $125,101.13 nat. median
$98,047
1.3× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $121,833.54 $223,476.14 $121,833.54 nat. median
$98,894
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $120,218.41 $120,218.41 $120,218.41 nat. median
$102,358
1.2× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 3 $55,272.32 $144,617.39 $119,352.48 nat. median
$66,682
1.8× median
237
MS_DRG 		Major Cardiovasc Procedures W Mcc 2 $96,429.00 $140,509.45 $118,469.23 nat. median
$35,643
outlier · 3.3×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 6 $44,000.00 $924,327.00 $118,374.36 nat. median
$66,526
1.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $114,030.20 $287,525.76 $114,030.20 nat. median
$100,136
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $12,000.00 $265,876.43 $113,676.58 nat. median
$93,672
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 3 $56,824.55 $140,774.65 $109,568.61 nat. median
$62,507
1.8× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 4 $71,474.71 $217,504.00 $108,340.26 nat. median
$62,134
1.7× median
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 1 $105,832.66 $105,832.66 $105,832.66 nat. median
$39,075
outlier · 2.7×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 6 $12,000.00 $229,147.30 $105,026.76 nat. median
$57,424
1.8× median
230
MS_DRG 		Other Cardiothoracic Procedures Without Cc/mcc 1 $100,409.35 $100,409.35 $100,409.35 nat. median
$29,847
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 15,438 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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 — — $308,519.69 $666,032.50 $308,519.69 2026-04-01
10 MS_DRG Pancreas Transplant 3 3 — — $79,610.74 $106,710.48 $79,610.74 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 — — $60,707.93 $137,069.47 $60,707.93 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 3 — — $47,113.84 $84,921.24 $47,113.84 2026-04-01
129 MS_DRG Major Head & Neck Procedures W Cc/Mcc Or Major Device 1 1 — — $60,742.68 $60,742.68 $60,742.68 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 3 3 — — $32,464.60 $52,074.17 $32,464.60 2026-04-01
130 MS_DRG Major Head & Neck Procedures Without Cc/Mcc 1 1 — — $32,528.87 $32,528.87 $32,528.87 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 1 1 — — $61,881.11 $61,881.11 $61,881.11 2026-04-01
132 MS_DRG Cranial/Facial Procedures Without Cc/Mcc 1 1 — — $32,847.08 $32,847.08 $32,847.08 2026-04-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/Mcc 1 1 — — $47,295.51 $47,295.51 $47,295.51 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 3 3 — — $132,777.10 $281,979.01 $132,777.10 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 2 2 — — $47,655.15 $47,655.15 $47,655.15 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 2 — — $41,959.93 $41,959.93 $41,959.93 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 3 3 — — $65,929.92 $173,169.99 $65,929.92 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 6 5 — — $28,816.19 $139,656.31 $45,488.13 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 6 5 — — $28,536.03 $139,094.38 $49,737.00 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 4 — — $41,862.21 $332,965.00 $72,121.96 2026-04-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 5 5 — — $20,623.99 $75,775.44 $56,441.34 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 3 3 — — $60,468.57 $118,572.08 $60,468.57 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 3 — — $33,503.29 $63,939.94 $33,503.29 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 8 5 — — $17,981.15 $227,725.72 $41,905.79 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 2 2 — — $474,961.29 $474,961.29 $474,961.29 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $79,159.47 $79,159.47 $79,159.47 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 — — $125,243.86 $383,225.04 $125,243.86 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 — — $87,220.83 $233,262.53 $87,220.83 2026-04-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 5 3 — — $20,927.03 $740,643.95 $35,440.51 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 4 4 — — $71,474.71 $217,504.00 $108,340.26 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 5 5 — — $26,000.00 $62,281.61 $31,003.19 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 2 2 — — $125,101.13 $125,101.13 $125,101.13 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 — — $58,947.86 $176,577.04 $58,947.86 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 2 — — $120,218.41 $120,218.41 $120,218.41 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 2 2 — — $63,483.62 $63,483.62 $63,483.62 2026-04-01
215 MS_DRG Other Heart Assist System Implant 8 6 — — $55.00 $462,852.06 $130,104.42 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 5 — — $12,000.00 $265,876.43 $113,676.58 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 4 — — $2,000.00 $178,272.34 $73,018.47 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $2,000.00 $141,916.71 $73,018.47 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 7 — — $14,000.00 $303,431.27 $146,736.59 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 3 — — $35,710.23 $113,842.80 $35,710.23 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 4 — — $59,376.08 $238,993.24 $126,773.50 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $56,163.39 $119,776.34 $56,163.39 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $238,128.96 $238,128.96 $238,128.96 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $173,669.25 $173,669.25 $173,669.25 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $211,648.85 $211,648.85 $211,648.85 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $163,250.58 $163,250.58 $163,250.58 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 1 — — $186,249.56 $186,249.56 $186,249.56 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 1 — — $141,274.80 $141,274.80 $141,274.80 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 4 3 — — $55,144.46 $201,474.32 $92,427.23 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 4 3 — — $35,403.89 $127,701.45 $56,226.44 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $63,740.54 $147,104.10 $63,740.54 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 1 1 — — $100,409.35 $100,409.35 $100,409.35 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 4 3 — — $85,201.00 $216,943.23 $93,381.60 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 3 — — $67,389.13 $155,512.01 $70,614.07 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 7 5 — — $22,000.00 $195,913.86 $84,765.75 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 7 — — $18,000.00 $283,723.28 $133,961.98 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 10 6 — — $12,000.00 $229,147.30 $105,026.76 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 9 6 — — $16,000.00 $190,155.34 $95,631.00 2026-04-01
237 MS_DRG Major Cardiovasc Procedures W Mcc 2 2 — — $96,429.00 $140,509.45 $118,469.23 2026-04-01
238 MS_DRG Major Cardiovasc Procedures Without Mcc 2 2 — — $51,301.00 $84,981.59 $68,141.29 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $54,862.28 $130,030.42 $54,862.28 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $43,774.89 $99,652.23 $43,774.89 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 3 — — $32,120.93 $71,496.02 $32,120.93 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 8 5 — — $712.06 $101,045.77 $37,868.57 2026-04-01
245 MS_DRG Aicd Generator Procedures 4 4 — — $50,917.24 $115,123.87 $69,458.62 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 1 1 — — $87,033.51 $87,033.51 $87,033.51 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 1 1 — — $54,392.17 $54,392.17 $54,392.17 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 1 1 — — $80,639.11 $80,639.11 $80,639.11 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 1 1 — — $49,739.70 $49,739.70 $49,739.70 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 — — $50,744.86 $128,730.15 $50,744.86 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 7 4 — — $22,000.00 $362,081.57 $47,500.00 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 3 — — $30,439.93 $69,106.69 $30,439.93 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 4 3 — — $35,028.00 $81,511.44 $35,322.64 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 3 — — $34,961.41 $81,665.06 $34,961.41 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 4 3 — — $36,538.10 $99,569.93 $37,134.55 2026-04-01
263 MS_DRG Vein Ligation And Stripping 3 3 — — $34,392.65 $44,511.16 $34,392.65 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 3 3 — — $37,502.13 $70,171.06 $37,502.13 2026-04-01
265 MS_DRG Aicd Lead Procedures 3 3 — — $40,550.12 $63,458.45 $40,550.12 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 3 — — $26,000.00 $185,878.00 $68,111.60 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 6 5 — — $2,000.00 $139,568.00 $51,361.82 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 2 — — $76,340.96 $106,609.00 $76,340.96 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 6 5 — — $30,857.05 $148,138.38 $56,910.95 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 8 6 — — $24,000.00 $225,546.00 $80,215.18 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 7 6 — — $20,163.00 $66,930.52 $46,696.00 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 4 3 — — $21,561.00 $46,120.17 $36,608.58 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 4 3 — — $27,097.00 $57,875.00 $36,965.22 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 2 — — $79,113.35 $105,926.00 $79,113.35 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 3 — — $10,000.00 $110,834.00 $66,774.26 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 5 3 — — $30,000.00 $315,727.63 $51,533.21 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 3 — — $47,500.00 $404,674.98 $61,938.76 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 2 — — $32,247.00 $93,378.71 $40,420.56 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 3 3 — — $66,792.93 $154,924.96 $66,792.93 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 3 — — $30,536.55 $78,603.65 $30,536.55 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 4 4 — — $26,780.52 $77,654.51 $38,281.70 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 9 6 — — $6,000.00 $126,783.88 $30,614.47 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 6 5 — — $31,643.30 $493,575.75 $210,783.67 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 3 — — $50,018.00 $122,151.95 $50,018.00 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 8 6 — — $18,000.00 $93,648.00 $35,407.50 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 4 — — $54,709.67 $150,434.81 $74,239.42 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $49,824.75 $69,496.00 $49,824.75 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 9 6 — — $8,000.00 $84,390.65 $30,696.85 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 5 5 — — $8,000.00 $306,888.23 $48,336.99 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 5 5 — — $2,000.00 $62,661.78 $35,420.36 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 2 2 — — $36,072.56 $36,072.56 $36,072.56 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 — — $55,583.66 $155,821.99 $55,583.66 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 6 4 — — $27,659.84 $75,355.70 $43,968.00 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 7 5 — — $28,100.00 $204,087.42 $51,291.65 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 10 6 — — $16,988.03 $71,298.23 $43,884.00 2026-04-01
332 MS_DRG Rectal Resection With Mcc 3 3 — — $40,577.57 $133,569.15 $40,577.57 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 5 5 — — $18,000.00 $184,248.00 $40,030.78 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 1 1 — — $89,535.30 $89,535.30 $89,535.30 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 1 1 — — $50,705.31 $50,705.31 $50,705.31 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 3 — — $43,322.52 $96,020.23 $43,322.52 2026-04-01
340 MS_DRG Appendectomy With Complicated Principal Diagnosis Without Cc/Mcc 1 1 — — $33,763.31 $33,763.31 $33,763.31 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 1 1 — — $64,657.22 $64,657.22 $64,657.22 2026-04-01
342 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Cc 1 1 — — $36,970.11 $36,970.11 $36,970.11 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 3 — — $32,686.39 $77,997.41 $32,686.39 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 5 5 — — $12,451.82 $108,707.53 $49,055.07 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 2 2 — — $38,578.15 $38,578.15 $38,578.15 2026-04-01
368 MS_DRG Major Esophageal Disorders With Mcc 5 4 — — $18,301.76 $100,000.00 $45,639.00 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 3 3 — — $36,969.61 $84,614.00 $36,969.61 2026-04-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 8 6 — — $8,000.00 $48,390.05 $32,913.00 2026-04-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 4 4 — — $18,196.36 $348,024.00 $34,507.07 2026-04-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 7 5 — — $14,000.00 $204,720.00 $31,304.22 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 4 — — $76,000.00 $299,697.34 $152,908.55 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 4 3 — — $3,262.00 $110,636.00 $43,218.21 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 5 — — $22,451.73 $47,395.29 $36,386.63 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 6 5 — — $47,000.27 $164,763.84 $60,887.99 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 3 — — $32,666.63 $72,906.03 $32,666.63 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 — — $39,972.58 $110,268.41 $39,972.58 2026-04-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 4 3 — — $24,729.34 $63,422.78 $36,210.67 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 3 — — $37,092.58 $98,264.17 $37,092.58 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 3 — — $39,939.64 $100,645.26 $39,939.64 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 8 6 — — $6,000.00 $99,111.59 $30,399.38 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 — — $38,232.29 $104,537.87 $38,232.29 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 4 — — $46,422.12 $115,192.45 $59,037.06 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $121,833.54 $223,476.14 $121,833.54 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 5 — — $31,382.64 $233,487.37 $80,081.77 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 5 — — $36,647.05 $62,551.43 $50,056.86 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $99,746.58 $99,746.58 $99,746.58 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 3 — — $11,575.00 $64,144.60 $64,144.60 2026-04-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 10 7 — — $8,000.00 $292,171.26 $44,369.37 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $74,185.62 $74,185.62 $74,185.62 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $47,386.14 $47,386.14 $47,386.14 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 2 — — $59,340.94 $59,340.94 $59,340.94 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $36,292.16 $44,528.71 $36,292.16 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $299,538.24 $299,538.24 $299,538.24 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $200,988.78 $200,988.78 $200,988.78 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $154,850.90 $154,850.90 $154,850.90 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $93,090.63 $269,250.57 $93,090.63 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 4 — — $39,510.76 $174,372.13 $66,296.64 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $46,637.32 $138,709.91 $46,637.32 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $178,088.54 $178,088.54 $178,088.54 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $105,832.66 $105,832.66 $105,832.66 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 3 — — $61,464.43 $148,091.65 $61,464.43 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $63,402.37 $138,361.52 $63,402.37 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 4 — — $10,000.00 $81,357.83 $35,021.80 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 — — $57,977.25 $136,644.28 $57,977.25 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 4 4 — — $35,556.98 $88,981.18 $39,544.37 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 3 3 — — $30,995.50 $70,500.24 $30,995.50 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 4 4 — — $34,126.94 $94,415.46 $34,563.47 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 — — $53,841.16 $124,661.98 $53,841.16 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 5 5 — — $313.81 $76,551.74 $33,170.60 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 3 — — $47,958.19 $98,996.60 $47,958.19 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 3 — — $38,753.83 $94,903.75 $38,753.83 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 5 5 — — $27,824.54 $105,354.00 $32,000.00 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 4 4 — — $22,000.00 $83,823.96 $32,799.48 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 7 5 — — $12,000.00 $81,888.00 $45,046.02 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 4 4 — — $31,257.92 $65,869.72 $32,202.52 2026-04-01
484 MS_DRG Major Joint & Limb Reattachment Proc Of Upper Extremity Without Cc/mcc 1 1 — — $54,696.66 $54,696.66 $54,696.66 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 3 — — $36,255.92 $86,205.06 $36,255.92 2026-04-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 4 3 — — $23,782.88 $135,807.42 $40,202.63 2026-04-01
490 MS_DRG Back & Neck Proc Exc Spinal Fusion W Cc/mcc Or Disc Device/neurostim 1 1 — — $49,341.94 $49,341.94 $49,341.94 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 3 — — $41,136.44 $83,662.11 $41,136.44 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 3 — — $40,632.47 $79,528.11 $40,632.47 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 3 — — $33,946.87 $55,678.73 $33,946.87 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 3 — — $114,030.20 $287,525.76 $114,030.20 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 4 3 — — $35,571.88 $190,979.75 $61,260.18 2026-04-01
503 MS_DRG Foot Procedures With Mcc 3 3 — — $31,468.73 $63,153.95 $31,468.73 2026-04-01
509 MS_DRG Arthroscopy 1 1 — — $38,366.40 $38,366.40 $38,366.40 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 3 — — $33,987.50 $61,738.46 $33,987.50 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 4 3 — — $35,814.54 $88,704.12 $52,046.90 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 2 — — $41,857.82 $41,857.82 $41,857.82 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 3 — — $12,000.00 $32,337.24 $32,337.24 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 4 4 — — $27,692.80 $80,817.56 $40,825.96 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 4 4 — — $28,071.59 $67,858.54 $44,743.79 2026-04-01
570 MS_DRG Skin Debridement With Mcc 3 3 — — $33,115.70 $69,013.43 $33,115.70 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $72,756.05 $93,951.86 $72,756.05 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 3 — — $38,938.29 $74,022.51 $38,938.29 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $54,637.20 $95,836.44 $54,637.20 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 3 — — $36,381.09 $73,888.09 $36,381.09 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 3 3 — — $51,736.34 $140,065.05 $51,736.34 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 4 — — $2,000.00 $79,015.13 $31,095.42 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 4 — — $16,000.00 $120,517.01 $39,113.96 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 4 3 — — $32,526.09 $95,883.07 $32,595.20 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 — — $39,902.31 $105,171.54 $39,902.31 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 3 — — $33,983.11 $61,960.66 $33,983.11 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 3 — — $41,742.53 $89,225.32 $41,742.53 2026-04-01
643 MS_DRG Endocrine Disorders With Mcc 8 6 — — $18,896.87 $114,250.06 $38,550.28 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 1 1 — — $45,139.64 $45,139.64 $45,139.64 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 2 — — $52,443.43 $52,443.43 $52,443.43 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $41,511.95 $41,511.95 $41,511.95 2026-04-01
652 MS_DRG Kidney Transplant 3 3 — — $36,282.28 $83,686.80 $36,282.28 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $57,878.43 $162,531.86 $57,878.43 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 3 3 — — $31,558.77 $83,854.14 $31,558.77 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 3 — — $35,780.50 $99,740.01 $35,780.50 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 4 4 — — $28,721.59 $95,007.99 $49,478.79 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 3 3 — — $34,437.67 $81,563.57 $34,437.67 2026-04-01
665 MS_DRG Prostatectomy With Mcc 3 3 — — $35,093.16 $92,651.58 $35,093.16 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 3 3 — — $32,884.03 $69,984.52 $32,884.03 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 7 5 — — $10,236.00 $312,330.27 $46,955.73 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 6 6 — — $2,000.00 $81,942.00 $42,517.39 2026-04-01
682 MS_DRG Renal Failure With Mcc 6 5 — — $14,000.00 $83,064.00 $31,050.01 2026-04-01
691 MS_DRG Urinary Stones W Esw Lithotripsy W Cc/Mcc 1 1 — — $41,940.78 $41,940.78 $41,940.78 2026-04-01
7 MS_DRG Lung Transplant 3 3 — — $143,013.56 $270,781.27 $143,013.56 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 4 3 — — $24,209.99 $227,715.78 $45,871.04 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 — — $40,070.30 $124,201.12 $40,070.30 2026-04-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 4 4 — — $23,447.99 $81,353.38 $39,459.12 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 4 4 — — $14,000.00 $92,369.03 $40,161.44 2026-04-01
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 6 4 — — $20,692.07 $51,915.00 $33,238.50 2026-04-01
75 MS_DRG Viral Meningitis With Cc/Mcc 4 4 — — $21,876.79 $71,652.00 $34,524.43 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 1 1 — — $45,501.46 $45,501.46 $45,501.46 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 7 6 — — $22,174.48 $178,514.00 $66,081.44 2026-04-01
791 MS_DRG Prematurity With Major Problems 7 6 — — $12,000.00 $338,678.84 $45,390.01 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 4 4 — — $30,399.00 $137,711.38 $50,549.42 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 3 — — $62,360.38 $140,386.00 $62,360.38 2026-04-01
800 MS_DRG Splenic Procedures With Cc 3 3 — — $31,669.66 $69,608.70 $31,669.66 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $44,567.63 $95,123.20 $44,567.63 2026-04-01
81529 HCPCS Onc Cutan Mlnma Mrna 31 Gene 4 2 — — $7,193.00 $51,142.23 $36,612.37 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $65,217.33 $166,558.87 $65,217.33 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $51,163.19 $122,341.23 $51,163.19 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $52,184.31 $138,633.10 $52,184.31 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 3 — — $35,519.18 $78,345.79 $35,519.18 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 5 4 — — $40,000.00 $147,051.98 $61,101.00 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $53,573.26 $178,458.88 $53,573.26 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 4 4 — — $36,000.00 $83,256.12 $36,341.57 2026-04-01
849 MS_DRG Radiotherapy 3 3 — — $30,572.78 $36,009.99 $30,572.78 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 2 2 — — $95,902.56 $95,902.56 $95,902.56 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 10 7 — — $18,797.28 $149,965.26 $55,047.84 2026-04-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 10 7 — — $5,620.00 $250,832.61 $48,148.89 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 5 3 — — $50,766.82 $136,029.80 $57,875.00 2026-04-01
865 MS_DRG Viral Illness With Mcc 4 4 — — $17,274.06 $71,652.00 $30,320.65 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 4 4 — — $23,805.94 $81,888.00 $46,910.32 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 6 6 — — $44,000.00 $924,327.00 $118,374.36 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 10 7 — — $12,000.00 $61,416.00 $43,842.00 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 3 — — $43,258.84 $77,684.68 $43,258.84 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 4 4 — — $19,947.46 $112,553.50 $46,900.83 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 3 3 — — $41,152.91 $85,195.56 $41,152.91 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 7 6 — — $5,620.00 $108,798.06 $48,565.00 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 3 — — $235,247.13 $332,017.73 $235,247.13 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 3 3 — — $79,577.80 $134,167.17 $79,577.80 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 3 3 — — $36,186.75 $59,744.15 $36,186.75 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 3 — — $43,580.54 $62,682.12 $43,580.54 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 — — $40,663.21 $84,095.54 $40,663.21 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 — — $39,465.32 $93,938.14 $39,465.32 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $74,729.12 $149,583.95 $74,729.12 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $42,140.00 $99,638.51 $42,140.00 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 4 — — $30,000.00 $181,097.83 $84,487.96 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 — — $47,090.78 $102,845.31 $47,090.78 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 3 3 — — $33,148.64 $67,787.22 $33,148.64 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 3 — — $30,839.59 $77,616.10 $30,839.59 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $68,033.64 $154,052.63 $68,033.64 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 3 — — $40,479.85 $88,163.70 $40,479.85 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 3 3 — — $32,510.72 $74,239.22 $32,510.72 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 4 — — $52,338.03 $689,133.96 $139,006.17 2026-04-01
984 MS_DRG Prostatic O.r. Procedure Unrelated To Principal Diagnosis W Mcc 1 1 — — $96,818.50 $96,818.50 $96,818.50 2026-04-01
985 MS_DRG Prostatic O.r. Procedure Unrelated To Principal Diagnosis W Cc 1 1 — — $58,265.57 $58,265.57 $58,265.57 2026-04-01
986 MS_DRG Prostatic O.r. Procedure Unrelated To Principal Diagnosis Without Cc/Mcc 1 1 — — $30,120.34 $30,120.34 $30,120.34 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 4 — — $38,466.16 $183,274.00 $65,920.97 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 3 3 — — $56,824.55 $140,774.65 $109,568.61 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 1 1 — — $90,930.21 $90,930.21 $90,930.21 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $100,053.67 $100,053.67 $100,053.67 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 2 2 — — $17,771.01 $48,248.98 $33,010.00 2026-04-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 1 1 — — $1,179,463.30 $1,179,463.30 $1,179,463.30 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 1 1 — — $32,891.61 $32,891.61 $32,891.61 2026-04-01
E0764 HCPCS Functional Neuromuscularstim 1 1 — — $36,493.52 $36,493.52 $36,493.52 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 1 1 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 1 1 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $155,889.64 $156,515.70 $155,889.64 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 4 3 — — $63,342.28 $166,539.39 $151,531.48 2026-04-01
J9226 HCPCS Supprelin La Implant 5 3 — — $45,020.65 $119,211.17 $94,940.24 2026-04-01
J9266 HCPCS Pegaspargase Injection 5 3 — — $8,213.48 $71,159.75 $58,081.95 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 5 3 — — $24,228.42 $59,932.65 $58,210.70 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 2 2 — — $28,851.23 $66,757.58 $47,804.40 2026-04-01
L5858 HCPCS Stance Phase Only 2 2 — — $22,336.47 $51,683.33 $37,009.90 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 2 2 — — $21,127.66 $48,886.37 $35,007.01 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 2 2 — — $19,237.24 $44,512.21 $31,874.72 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 2 2 — — $22,747.26 $52,633.86 $37,690.56 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 2 2 — — $44,356.85 $102,635.38 $73,496.12 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 2 2 — — $48,155.50 $111,424.85 $79,790.18 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 2 2 — — $108,243.35 $250,459.38 $179,351.36 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 2 2 — — $22,533.92 $52,140.20 $37,337.06 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 2 2 — — $19,535.67 $45,202.74 $32,369.20 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 3 — — $533,230.17 $1,286,622.73 $1,169,133.54 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 7 3 — — $1,711.00 $1,365,317.58 $1,125,423.00 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 3 — — $55,272.32 $144,617.39 $119,352.48 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 3 — — $489,304.61 $1,210,586.70 $1,088,441.35 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 3 — — $562,538.19 $1,358,307.10 $1,212,773.02 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 5 3 — — $557,317.93 $1,384,229.88 $1,365,136.90 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 4 3 — — $565,868.94 $1,385,638.43 $1,238,582.74 2026-04-01
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