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

SAINT JOHN'S HEALTH CENTER

Santa Monica, CA · CCN 050290 · Rates published

17,335 distinct procedures filed
24 distinct payers
577,702 rate rows
2026-04-01 last MRF observed
Data quality

439,838 of 577,702 rate rows are consumer-grade (76.1%)

137,864 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 137,252
placeholder amount (≤ $0.02) — excluded from medians 612
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/socal/live/951684082_providence-st-johns-health-center_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 021e37693b7f1dd6… · 220,477,680 bytes · first seen 2026-05-06

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 5 $4,335,000.00 $4,955,500.00 $4,420,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 6 $3,570,000.00 $4,798,885.00 $3,728,364.50 nat. median
$3,710,000
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
$3,570,000
1.0× median
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
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 6 $3,264,000.00 $4,317,789.29 $3,354,590.15 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 6 $3,162,000.00 $4,218,995.81 $3,277,835.21 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 6 $2,856,000.00 $3,819,816.00 $2,967,703.20 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,439,539.81 $4,786,111.43 $2,638,829.00 nat. median
$2,469,189
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,244,000.00 $4,990,480.00 $2,410,912.96 nat. median
$2,448,600
1.0× median
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $841,376.10 $841,376.10 $841,376.10 nat. median
$29,278
outlier · 28.7×
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $741,540.00 $1,656,833.00 $816,857.20 nat. median
$824,563
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $566,416.65 $1,259,378.89 $623,804.49 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $541,977.41 $1,203,238.19 $618,486.92 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $538,878.68 $1,197,931.51 $615,759.19 nat. median
$625,184
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $352.70 $1,314,346.93 $614,180.81 nat. median
$754,974
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $513,651.60 $1,138,157.11 $563,760.06 nat. median
$634,511
0.9× median
C9301
HCPCS 		Obecabtagene Car Pos T 2 $535,500.00 $598,237.50 $535,500.00 nat. median
$459,112
1.2× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $471,240.00 $1,052,208.19 $518,648.04 nat. median
$620,080
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $278,250.00 $595,455.00 $438,243.75 nat. median
$324,450
1.4× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 19 $411,571.01 $916,546.41 $411,571.01 nat. median
$370,174
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 19 $137,220.24 $684,584.35 $267,169.94 nat. median
$265,286
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 19 $185,766.92 $620,384.54 $204,283.57 nat. median
$202,986
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 19 $203,600.28 $576,582.65 $203,600.28 nat. median
$206,368
1.0× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 2 $119,277.77 $218,035.45 $180,663.43 nat. median
$87,411
outlier · 2.1×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $109,255.35 $193,411.14 $165,483.04 nat. median
$63,570
outlier · 2.6×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $95,517.18 $171,429.12 $144,674.59 nat. median
$54,196
outlier · 2.7×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 7 $108,243.35 $231,640.77 $141,839.87 nat. median
$111,989
1.3× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $132,218.57 $148,895.03 $140,556.80 nat. median
$96,983
1.4× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 19 $150.00 $343,407.78 $133,567.25 nat. median
$133,176
1.0× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 2 $87,338.37 $158,815.66 $132,286.60 nat. median
$65,381
outlier · 2.0×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 $85,781.49 $155,007.51 $129,928.48 nat. median
$49,935
outlier · 2.6×
7
MS_DRG 		Lung Transplant 19 $123,580.46 $317,615.31 $123,580.46 nat. median
$122,708
1.0× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $80,595.79 $139,135.22 $122,073.98 nat. median
$44,728
outlier · 2.7×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 2 $79,116.75 $141,965.25 $119,833.76 nat. median
$62,270
1.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 19 $114,699.53 $318,417.37 $114,699.53 nat. median
$117,303
1.0× median
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $73,002.10 $130,927.89 $110,572.25 nat. median
$48,649
outlier · 2.3×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 $108,163.86 $324,809.54 $108,163.86 nat. median
$108,660
1.0× median
209
MS_DRG 		Complex Aortic Arch Procedures 18 $108,040.02 $231,205.64 $108,040.02 nat. median
$98,017
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 $5,296.26 $254,755.29 $105,205.14 nat. median
$98,905
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 18 $103,803.89 $264,756.80 $103,803.89 nat. median
$102,358
1.0× median
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 $68,138.15 $121,202.40 $103,205.09 nat. median
$39,020
outlier · 2.6×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 19 $38,165.33 $258,814.22 $98,435.13 nat. median
$100,136
1.0× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $97,225.26 $97,225.26 $97,225.26 nat. median
$21,806
outlier · 4.5×
215
MS_DRG 		Other Heart Assist System Implant 19 $85,601.48 $298,674.03 $96,623.86 nat. median
$99,019
1.0× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 $62,158.43 $111,562.67 $94,147.94 nat. median
$48,483
1.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 $73,465.83 $234,552.97 $93,408.35 nat. median
$93,672
1.0× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 6 $68,801.71 $147,235.66 $92,558.54 nat. median
$70,825
1.3× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 9 $61,200.00 $175,173.79 $89,929.45 nat. median
$69,774
1.3× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 18 $86,042.98 $202,703.70 $86,042.98 nat. median
$82,712
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 18 $658.38 $223,880.65 $82,707.99 nat. median
$83,442
1.0× median

Other procedures at this hospital

Browse this hospital's 17,335 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 16 5 — — $4,335,000.00 $4,955,500.00 $4,420,000.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 20 6 — — $3,570,000.00 $4,798,885.00 $3,728,364.50 2026-04-01
C9172 HCPCS Inj, Beqvez, Per Tx Dose 8 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 8 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 20 6 — — $3,264,000.00 $4,317,789.29 $3,354,590.15 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 20 6 — — $3,162,000.00 $4,218,995.81 $3,277,835.21 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 20 6 — — $2,856,000.00 $3,819,816.00 $2,967,703.20 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 22 7 — — $2,439,539.81 $4,786,111.43 $2,638,829.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 24 7 — — $2,244,000.00 $4,990,480.00 $2,410,912.96 2026-04-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 2 1 — — $841,376.10 $841,376.10 $841,376.10 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 24 7 — — $741,540.00 $1,656,833.00 $816,857.20 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 24 7 — — $566,416.65 $1,259,378.89 $623,804.49 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 26 7 — — $541,977.41 $1,203,238.19 $618,486.92 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 26 7 — — $538,878.68 $1,197,931.51 $615,759.19 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 12 2 — — $535,500.00 $598,237.50 $535,500.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 24 7 — — $513,651.60 $1,138,157.11 $563,760.06 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 24 7 — — $471,240.00 $1,052,208.19 $518,648.04 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 64 19 — — $411,571.01 $916,546.41 $411,571.01 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 24 7 — — $278,250.00 $595,455.00 $438,243.75 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 66 19 — — $203,600.28 $576,582.65 $203,600.28 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 80 19 — — $185,766.92 $620,384.54 $204,283.57 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 70 19 — — $137,220.24 $684,584.35 $267,169.94 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 4 1 — — $132,218.57 $148,895.03 $140,556.80 2026-04-01
7 MS_DRG Lung Transplant 66 19 — — $123,580.46 $317,615.31 $123,580.46 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 10 2 — — $119,277.77 $218,035.45 $180,663.43 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 66 19 — — $114,699.53 $318,417.37 $114,699.53 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 10 2 — — $109,255.35 $193,411.14 $165,483.04 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 18 7 — — $108,243.35 $231,640.77 $141,839.87 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 66 19 — — $108,163.86 $324,809.54 $108,163.86 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 42 18 — — $108,040.02 $231,205.64 $108,040.02 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 56 18 — — $103,803.89 $264,756.80 $103,803.89 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 4 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 10 2 — — $95,517.18 $171,429.12 $144,674.59 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 10 2 — — $87,338.37 $158,815.66 $132,286.60 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 56 18 — — $86,042.98 $202,703.70 $86,042.98 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 10 2 — — $85,781.49 $155,007.51 $129,928.48 2026-04-01
215 MS_DRG Other Heart Assist System Implant 72 19 — — $85,601.48 $298,674.03 $96,623.86 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 10 2 — — $80,595.79 $139,135.22 $122,073.98 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 10 2 — — $79,116.75 $141,965.25 $119,833.76 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 68 19 — — $78,789.05 $210,484.05 $80,268.42 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 74 19 — — $75,000.28 $307,757.72 $82,693.51 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 68 19 — — $73,465.83 $234,552.97 $93,408.35 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 10 2 — — $73,002.10 $130,927.89 $110,572.25 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 66 19 — — $72,804.94 $181,405.23 $72,804.94 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 16 6 — — $68,801.71 $147,235.66 $92,558.54 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 68 19 — — $68,544.99 $162,320.94 $71,972.24 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 64 19 — — $68,182.05 $192,658.44 $68,182.05 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 60 19 — — $68,142.05 $181,021.95 $68,142.05 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 10 2 — — $68,138.15 $121,202.40 $103,205.09 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 18 5 — — $67,138.44 $169,820.76 $78,986.40 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 66 19 — — $65,736.77 $162,046.30 $65,736.77 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 66 19 — — $64,338.38 $165,952.11 $64,338.38 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 70 19 — — $63,170.90 $189,963.02 $73,045.94 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 19 — — $62,854.26 $144,592.88 $62,854.26 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 19 — — $62,854.26 $156,947.11 $62,854.26 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 66 19 — — $62,626.59 $149,665.33 $62,626.59 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 2 1 — — $62,332.60 $62,332.60 $62,332.60 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 10 2 — — $62,158.43 $111,562.67 $94,147.94 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 4 2 — — $61,897.19 $64,865.52 $63,381.35 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 38 9 — — $61,200.00 $175,173.79 $89,929.45 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 66 19 — — $58,529.53 $153,702.39 $58,529.53 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 66 19 — — $57,970.37 $148,462.23 $57,970.37 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 66 19 — — $57,453.11 $147,752.53 $57,453.11 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 56 18 — — $57,436.92 $150,545.17 $57,436.92 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 30 9 — — $56,824.55 $162,256.63 $80,599.94 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 66 19 — — $56,704.38 $159,585.17 $56,704.38 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 34 9 — — $56,269.19 $122,586.77 $73,149.95 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 80 19 — — $56,232.18 $146,349.00 $72,037.79 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 66 19 — — $56,122.36 $143,005.76 $56,122.36 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 66 19 — — $56,086.16 $141,501.28 $56,086.16 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 72 19 — — $55,908.62 $150,965.27 $59,873.68 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 74 19 — — $55,870.17 $171,455.00 $64,456.89 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 42 18 — — $54,582.03 $116,805.54 $54,582.03 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 66 19 — — $53,607.54 $132,238.64 $53,607.54 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 56 18 — — $53,241.75 $121,595.48 $53,241.75 2026-04-01
129 MS_DRG Major Head & Neck Procedures W Cc/Mcc Or Major Device 2 1 — — $53,061.40 $53,061.40 $53,061.40 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 66 19 — — $52,830.23 $149,152.49 $52,830.23 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 70 19 — — $52,514.92 $135,417.47 $52,587.72 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 66 19 — — $52,173.90 $131,140.06 $52,173.90 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 66 19 — — $51,966.24 $146,692.83 $51,966.24 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 72 19 — — $51,315.85 $147,732.73 $53,773.29 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 10 2 — — $51,022.85 $91,794.15 $77,281.49 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 56 18 — — $50,987.93 $125,163.46 $50,987.93 2026-04-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/Mcc 2 1 — — $49,760.85 $49,760.85 $49,760.85 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 66 19 — — $49,719.09 $135,480.93 $49,719.09 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 66 19 — — $48,231.16 $111,615.85 $48,231.16 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 18 7 — — $48,155.50 $103,052.77 $66,964.47 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 76 19 — — $48,107.58 $246,736.55 $68,982.22 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 68 19 — — $47,347.16 $145,703.86 $49,714.52 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 66 19 — — $47,102.35 $122,412.13 $47,102.35 2026-04-01
10 MS_DRG Pancreas Transplant 66 19 — — $46,936.04 $193,774.04 $68,573.57 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 76 19 — — $46,726.97 $138,652.73 $57,545.18 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 58 18 — — $46,301.20 $162,945.58 $63,866.85 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 66 19 — — $46,216.45 $118,049.39 $46,216.45 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 66 19 — — $45,984.02 $138,854.76 $45,984.02 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 64 19 — — $45,003.81 $111,973.14 $45,003.81 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 74 19 — — $44,912.36 $115,553.26 $57,607.85 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 66 19 — — $44,779.00 $116,237.67 $44,779.00 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 66 19 — — $44,390.35 $117,852.51 $44,390.35 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 18 7 — — $44,356.85 $94,923.66 $61,682.12 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 56 18 — — $44,214.12 $113,071.72 $44,214.12 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 74 19 — — $43,843.99 $171,175.71 $45,569.64 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 66 19 — — $43,360.60 $115,558.12 $43,360.60 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 76 19 — — $42,911.94 $114,801.59 $49,531.57 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 68 19 — — $42,899.55 $101,845.24 $45,044.53 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 66 19 — — $42,731.90 $106,759.71 $42,731.90 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 10 2 — — $41,178.18 $71,770.68 $62,370.31 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 66 19 — — $41,112.51 $108,993.34 $41,112.51 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 68 19 — — $40,934.78 $131,123.04 $46,907.07 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 10 2 — — $40,552.83 $73,539.16 $61,423.13 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 68 19 — — $40,379.97 $99,733.14 $42,398.97 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 66 19 — — $40,359.97 $99,881.40 $40,359.97 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 66 19 — — $40,195.17 $107,676.01 $40,195.17 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 68 19 — — $40,120.87 $99,937.30 $42,126.92 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 68 19 — — $39,966.55 $126,363.78 $41,964.88 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 16 6 — — $39,938.10 $85,467.53 $53,728.50 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 66 19 — — $39,779.84 $98,850.87 $39,779.84 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 16 6 — — $39,688.16 $84,932.66 $45,244.18 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 16 6 — — $39,688.16 $84,932.66 $45,244.18 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 16 6 — — $39,688.16 $84,932.66 $45,244.18 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 72 19 — — $39,672.95 $103,670.55 $44,167.35 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 66 19 — — $39,517.88 $95,032.55 $39,517.88 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 64 18 — — $39,387.04 $150,350.73 $63,913.53 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 68 19 — — $39,134.68 $101,837.95 $40,242.80 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 68 19 — — $38,789.52 $101,118.52 $40,448.56 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 66 19 — — $38,170.93 $87,123.70 $38,170.93 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 70 19 — — $38,165.33 $258,814.22 $98,435.13 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 66 19 — — $37,090.70 $94,509.99 $37,090.70 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 66 19 — — $37,000.21 $91,673.60 $37,000.21 2026-04-01
132 MS_DRG Cranial/Facial Procedures Without Cc/Mcc 2 1 — — $36,841.43 $36,841.43 $36,841.43 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 74 19 — — $36,791.59 $107,704.99 $40,470.75 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 10 2 — — $36,311.63 $67,450.30 $54,999.22 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 82 19 — — $35,981.38 $129,807.18 $61,538.61 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 68 19 — — $35,823.77 $93,598.56 $37,614.96 2026-04-01
5166 OTHER Cochlear Implant Procedure 8 3 — — $35,820.59 $55,414.59 $39,938.98 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 68 19 — — $35,719.94 $232,269.21 $37,505.93 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 64 19 — — $35,519.89 $84,391.82 $35,519.89 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 68 19 — — $35,208.40 $93,839.17 $36,968.82 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 16 6 — — $34,970.13 $74,836.08 $47,045.11 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 68 19 — — $34,783.55 $84,701.68 $36,522.73 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 66 19 — — $34,756.88 $85,560.89 $34,756.88 2026-04-01
332 MS_DRG Rectal Resection With Mcc 66 19 — — $34,709.25 $84,301.89 $34,709.25 2026-04-01
265 MS_DRG Aicd Lead Procedures 66 19 — — $34,685.43 $86,693.50 $34,685.43 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 68 19 — — $34,624.47 $87,128.56 $36,355.69 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 56 18 — — $34,573.03 $77,878.08 $34,573.03 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 68 19 — — $34,348.22 $96,750.91 $36,065.63 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 68 19 — — $34,269.15 $100,149.82 $35,982.60 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 68 19 — — $34,234.86 $93,757.33 $35,946.60 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 66 19 — — $34,184.37 $85,094.24 $34,184.37 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 66 19 — — $34,155.80 $85,155.00 $34,155.80 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 66 19 — — $34,123.41 $90,997.92 $34,123.41 2026-04-01
J9226 HCPCS Supprelin La Implant 38 9 — — $33,730.64 $97,205.89 $51,185.25 2026-04-01
L8614 HCPCS Cochlear Device 4 1 — — $33,581.40 $37,816.96 $35,699.18 2026-04-01
130 MS_DRG Major Head & Neck Procedures Without Cc/Mcc 2 1 — — $33,506.12 $33,506.12 $33,506.12 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 68 19 — — $33,439.45 $93,936.39 $35,111.42 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 72 19 — — $33,410.38 $131,937.26 $52,330.12 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 66 19 — — $33,287.04 $84,209.53 $33,287.04 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 66 19 — — $33,127.01 $83,580.03 $33,127.01 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 72 19 — — $32,717.40 $119,426.08 $38,329.93 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 66 19 — — $31,685.75 $88,781.01 $31,685.75 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 76 19 — — $31,652.77 $83,242.19 $33,812.87 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 66 19 — — $31,579.06 $80,709.61 $31,579.06 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 74 19 — — $31,439.24 $120,440.50 $32,413.27 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 68 19 — — $31,204.69 $85,749.33 $32,764.93 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 66 19 — — $31,068.47 $79,212.43 $31,068.47 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 66 19 — — $30,991.32 $87,732.73 $30,991.32 2026-04-01
652 MS_DRG Kidney Transplant 66 19 — — $30,982.74 $78,455.21 $30,982.74 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 68 19 — — $30,959.88 $78,349.60 $32,507.88 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 66 19 — — $30,899.87 $77,294.76 $30,899.87 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 56 18 — — $30,800.80 $69,560.91 $30,800.80 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 72 19 — — $30,547.41 $79,178.40 $32,460.42 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 66 19 — — $30,486.45 $114,309.26 $30,486.45 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 66 19 — — $30,366.42 $77,010.39 $30,366.42 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 66 19 — — $30,150.18 $70,894.55 $30,150.18 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 10 2 — — $30,050.38 $59,291.64 $45,515.65 2026-04-01
665 MS_DRG Prostatectomy With Mcc 66 19 — — $29,951.10 $83,448.79 $29,951.10 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 72 19 — — $29,830.26 $93,263.91 $32,585.89 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 64 18 — — $29,635.27 $103,519.86 $41,441.15 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 16 6 — — $29,510.19 $63,151.81 $39,699.88 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 66 19 — — $29,290.10 $105,160.44 $37,314.56 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 68 19 — — $29,033.61 $95,143.37 $30,220.68 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 66 19 — — $28,991.84 $69,463.69 $28,991.84 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 68 19 — — $28,946.91 $75,155.92 $30,576.94 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 18 7 — — $28,851.23 $61,741.63 $40,120.18 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 68 19 — — $28,824.47 $74,946.90 $30,320.70 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 16 6 — — $28,715.00 $61,450.10 $38,630.12 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 68 19 — — $28,034.50 $70,875.81 $29,436.22 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 68 19 — — $27,845.89 $68,253.30 $29,238.18 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 68 19 — — $27,710.62 $72,574.73 $29,096.15 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 72 19 — — $27,432.34 $97,735.11 $38,517.67 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 86 19 — — $26,836.70 $132,892.75 $48,405.00 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 44 18 — — $26,557.20 $70,565.62 $32,974.59 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 74 19 — — $26,097.59 $150,715.73 $40,616.21 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 10 2 — — $25,794.91 $47,160.28 $39,070.12 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 74 19 — — $25,412.38 $157,197.45 $61,514.93 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 70 19 — — $24,793.26 $85,140.42 $32,877.43 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 10 2 — — $24,382.04 $44,422.95 $36,930.12 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 90 19 — — $24,263.14 $195,466.86 $53,525.01 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 84 19 — — $23,462.63 $112,618.11 $33,154.01 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 78 19 — — $23,029.75 $59,634.68 $29,421.29 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 18 7 — — $22,747.26 $48,679.14 $31,632.08 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 86 19 — — $22,729.48 $84,739.08 $33,118.40 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 18 7 — — $22,533.92 $48,222.59 $31,335.41 2026-04-01
L5858 HCPCS Stance Phase Only 18 7 — — $22,336.47 $47,800.05 $31,060.83 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 10 2 — — $21,990.93 $39,775.77 $33,308.45 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 76 19 — — $21,615.44 $191,767.82 $50,646.91 2026-04-01
509 MS_DRG Arthroscopy 24 6 — — $21,283.51 $42,691.73 $32,574.33 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 18 7 — — $21,127.66 $45,213.19 $29,379.87 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 26 6 — — $18,735.31 $37,580.39 $30,103.37 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 12 4 — — $18,298.91 $56,878.55 $32,045.09 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 82 19 — — $17,910.06 $70,495.89 $31,111.43 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 82 19 — — $17,452.69 $222,383.26 $66,059.70 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 70 19 — — $17,312.15 $128,167.80 $33,744.28 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 84 19 — — $17,050.12 $61,540.17 $29,007.97 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 68 19 — — $15,472.84 $86,307.06 $35,194.11 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 80 19 — — $14,862.36 $83,155.32 $30,713.62 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 94 19 — — $14,688.31 $240,218.88 $51,343.26 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 70 19 — — $12,420.17 $128,726.57 $51,018.42 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 68 19 — — $11,070.99 $69,680.00 $28,988.03 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 70 19 — — $10,116.00 $71,665.72 $29,889.18 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 26 6 — — $10,009.68 $34,584.93 $29,091.07 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 18 7 — — $9,891.00 $74,683.62 $38,388.77 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 18 7 — — $9,891.00 $74,683.62 $38,388.77 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 24 8 — — $9,891.00 $74,087.61 $35,791.90 2026-04-01
0312T HCPCS Laps Impltj Nstim Vagus 8 3 — — $8,837.00 $126,240.00 $44,079.50 2026-04-01
0316T HCPCS Replc Vagus Nerve Pls Gen 10 4 — — $8,837.00 $126,240.00 $37,462.23 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 68 19 — — $8,044.05 $95,504.07 $37,035.45 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 26 5 — — $7,657.42 $61,001.22 $34,365.59 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 72 19 — — $7,641.41 $86,015.88 $31,144.46 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 74 19 — — $7,112.08 $131,264.01 $54,511.54 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 70 19 — — $7,058.35 $102,785.85 $40,849.60 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 72 20 — — $6,516.43 $109,647.15 $43,549.21 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 72 19 — — $6,283.32 $79,440.89 $29,112.82 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 78 19 — — $5,719.00 $87,104.26 $35,819.96 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 8 3 — — $5,559.00 $126,240.00 $68,750.58 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 8 3 — — $5,559.00 $126,240.00 $58,628.70 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 8 3 — — $5,559.00 $126,240.00 $58,628.70 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 70 20 — — $5,296.26 $254,755.29 $105,205.14 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 68 19 — — $5,048.44 $75,817.02 $29,382.40 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 70 19 — — $4,900.35 $92,898.57 $36,064.77 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 70 19 — — $4,873.38 $85,777.21 $32,674.53 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 78 20 — — $4,763.63 $123,816.96 $49,804.83 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 38 9 — — $4,588.50 $126,240.00 $41,178.75 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 38 9 — — $4,588.50 $93,018.00 $29,181.13 2026-04-01
0426T HCPCS Insj/rplc Nstim Apnea Stm Ld 8 3 — — $4,005.00 $93,018.00 $48,330.20 2026-04-01
J9266 HCPCS Pegaspargase Injection 40 9 — — $3,655.56 $71,798.10 $34,108.87 2026-04-01
69930 HCPCS Implant Cochlear Device 38 9 — — $3,409.47 $126,240.00 $43,255.81 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 36 8 — — $3,409.47 $93,018.00 $33,953.83 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 36 8 — — $3,409.47 $93,018.00 $33,953.83 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 36 8 — — $3,409.47 $93,018.00 $33,953.83 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 36 9 — — $2,821.63 $74,683.62 $32,485.94 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 82 19 — — $2,457.00 $93,094.44 $37,483.17 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 38 9 — — $2,455.49 $74,683.62 $34,898.89 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 80 19 — — $2,176.00 $101,366.43 $39,937.97 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 38 9 — — $2,159.89 $126,240.00 $37,629.42 2026-04-01
61886 HCPCS Implant Neurostim Arrays 38 9 — — $1,746.72 $126,240.00 $40,481.92 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 38 9 — — $1,746.72 $74,683.62 $34,898.89 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 36 8 — — $1,746.72 $93,018.00 $29,577.06 2026-04-01
791 MS_DRG Prematurity With Major Problems 80 19 — — $1,723.20 $108,920.00 $40,828.64 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 38 9 — — $1,528.38 $126,240.00 $57,784.15 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 38 9 — — $1,528.38 $126,240.00 $41,178.75 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 38 9 — — $1,528.38 $126,240.00 $41,178.75 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 38 9 — — $1,528.38 $126,240.00 $39,688.16 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 38 9 — — $1,528.38 $93,018.00 $39,688.16 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 38 9 — — $1,528.38 $93,018.00 $29,181.13 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 38 9 — — $1,528.38 $93,018.00 $29,181.13 2026-04-01
90288 HCPCS Botulism Ig IV 4 2 — — $1,419.23 $96,922.95 $49,171.09 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 38 9 — — $1,142.09 $173,128.88 $78,268.00 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 36 8 — — $1,142.09 $93,018.00 $41,737.46 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 38 9 — — $1,142.09 $126,240.00 $41,178.75 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 34 9 — — $1,142.09 $84,932.66 $39,688.16 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 36 8 — — $1,142.09 $93,018.00 $29,577.06 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 36 8 — — $1,142.09 $93,018.00 $29,577.06 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 38 9 — — $1,142.09 $93,018.00 $29,181.13 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 74 19 — — $779.00 $142,421.78 $50,480.21 2026-04-01
245 MS_DRG Aicd Generator Procedures 72 19 — — $703.74 $120,706.39 $43,679.72 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 58 18 — — $658.38 $223,880.65 $82,707.99 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 8 3 — — $638.18 $70,303.68 $53,126.32 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 60 18 — — $385.00 $132,950.78 $55,155.48 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 34 7 — — $352.70 $1,314,346.93 $614,180.81 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 32 8 — — $352.70 $121,233.42 $45,915.65 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 28 8 — — $352.70 $94,292.96 $44,502.75 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 36 8 — — $352.70 $126,240.00 $41,737.46 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 30 8 — — $352.70 $84,932.66 $39,688.16 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 32 9 — — $352.70 $121,233.42 $38,363.57 2026-04-01
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 28 8 — — $352.70 $74,087.61 $34,966.58 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 32 9 — — $352.70 $86,394.63 $30,223.66 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 32 9 — — $352.70 $84,932.66 $29,882.08 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 32 9 — — $352.70 $84,932.66 $29,882.08 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 74 19 — — $291.39 $83,716.14 $34,095.78 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 80 19 — — $150.00 $343,407.78 $133,567.25 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 60 18 — — $150.00 $77,654.48 $30,234.96 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 68 19 — — $145.82 $61,967.12 $28,956.60 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 68 19 — — $90.00 $113,727.96 $43,893.10 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 66 19 — — $81.69 $80,247.82 $35,908.55 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 72 19 — — $49.60 $205,945.99 $80,520.86 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 70 19 — — $49.10 $129,300.17 $52,255.82 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 70 19 — — $49.10 $83,371.01 $33,448.03 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 70 19 — — $36.82 $188,047.79 $73,361.25 2026-04-01
263 MS_DRG Vein Ligation And Stripping 76 19 — — $32.82 $65,183.58 $29,343.35 2026-04-01
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