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

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Hospital

SUTTER SANTA ROSA REGIONAL HOSPITAL

Santa Rosa, CA · CCN 050291 · Rates published

8,886 distinct procedures filed
6 distinct payers
33,091 rate rows
2026-04-01 last MRF observed
Data quality

18,962 of 33,091 rate rows are consumer-grade (57.3%)

14,129 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 14,119
placeholder amount (≤ $0.02) — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Files/billing-insurance/costs-and-charges/940562680-1740413798_sutter-santa-rosa-regional-hospital_standardcharges.csv
Found on page https://www.sutterhealth.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-19
Content fingerprint 31ac172a9dabc0ac… · 14,631,526 bytes · first seen 2026-05-15

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
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $591,726.20 $1,476,857.10 $1,034,291.65 nat. median
$754,974
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $533,230.17 $1,340,483.41 $936,856.79 nat. median
$634,511
1.5× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 $525,410.73 $525,410.73 $525,410.73 nat. median
$370,174
1.4× median
215
MS_DRG 		Other Heart Assist System Implant 6 $121,535.91 $533,607.00 $459,855.00 nat. median
$99,019
outlier · 4.6×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $341,147.36 $341,147.36 $341,147.36 nat. median
$265,286
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 $96,152.89 $414,588.00 $325,512.00 nat. median
$77,576
outlier · 4.2×
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 6 $39,126.77 $414,588.00 $325,512.00 nat. median
$34,274
outlier · 9.5×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $119,418.43 $411,119.00 $325,384.00 nat. median
$93,672
outlier · 3.5×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $80,429.80 $341,227.00 $292,847.00 nat. median
$64,510
outlier · 4.5×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 $110,019.83 $351,279.00 $277,982.00 nat. median
$82,712
outlier · 3.4×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $134,471.75 $351,279.00 $277,982.00 nat. median
$98,905
outlier · 2.8×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $80,429.80 $320,672.00 $276,578.00 nat. median
$61,920
outlier · 4.5×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 6 $74,197.70 $315,727.00 $270,645.00 nat. median
$59,899
outlier · 4.5×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 6 $87,177.30 $325,194.00 $269,935.00 nat. median
$68,887
outlier · 3.9×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 6 $102,973.31 $311,639.00 $267,411.00 nat. median
$79,312
outlier · 3.4×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 6 $64,852.58 $310,887.00 $266,920.00 nat. median
$54,066
outlier · 4.9×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $260,029.12 $260,029.12 $260,029.12 nat. median
$206,368
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $258,506.05 $258,506.05 $258,506.05 nat. median
$202,986
1.3× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 6 $74,997.53 $436,419.00 $256,605.00 nat. median
$60,726
outlier · 4.2×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $51,223.88 $307,570.00 $242,806.00 nat. median
$42,730
outlier · 5.7×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $102,651.20 $307,570.00 $238,901.00 nat. median
$81,118
outlier · 2.9×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $93,837.27 $295,319.00 $233,679.00 nat. median
$74,915
outlier · 3.1×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $63,333.65 $307,570.00 $227,251.00 nat. median
$58,024
outlier · 3.9×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 6 $66,905.64 $278,368.00 $220,043.00 nat. median
$53,268
outlier · 4.1×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 $93,434.93 $278,368.00 $220,043.00 nat. median
$73,807
outlier · 3.0×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 6 $73,516.99 $275,916.00 $218,184.00 nat. median
$59,099
outlier · 3.7×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 $70,158.44 $243,357.00 $213,618.00 nat. median
$55,929
outlier · 3.8×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $88,249.41 $243,801.00 $212,389.00 nat. median
$68,090
outlier · 3.1×
24
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 $48,054.96 $240,030.00 $210,697.00 nat. median
$38,489
outlier · 5.5×
209
MS_DRG 		Complex Aortic Arch Procedures 5 $138,089.22 $266,222.00 $206,669.00 nat. median
$98,017
outlier · 2.1×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $204,301.00 $204,301.00 $204,301.00 nat. median
$62,270
outlier · 3.3×
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 6 $38,787.63 $231,802.00 $203,477.00 nat. median
$33,154
outlier · 6.1×
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 $70,605.76 $227,150.00 $199,213.00 nat. median
$54,596
outlier · 3.6×
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 6 $56,644.00 $242,459.00 $197,796.00 nat. median
$46,109
outlier · 4.3×
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 6 $60,641.93 $228,310.00 $195,897.00 nat. median
$50,673
outlier · 3.9×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $192,725.00 $192,725.00 $192,725.00 nat. median
$65,381
outlier · 2.9×
402
MS_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 $49,375.04 $219,136.00 $192,255.00 nat. median
$39,420
outlier · 4.9×
230
MS_DRG 		Other Cardiothoracic Procedures Without Cc/mcc 1 $159,032.00 $220,890.00 $189,961.00 nat. median
$29,793
outlier · 6.4×
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 6 $58,373.72 $229,372.00 $186,896.00 nat. median
$47,651
outlier · 3.9×
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $68,842.00 $203,151.00 $177,398.00 nat. median
$54,211
outlier · 3.3×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 6 $67,000.45 $183,808.00 $171,523.00 nat. median
$52,836
outlier · 3.2×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 $81,721.93 $282,353.00 $168,901.00 nat. median
$63,738
outlier · 2.6×
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 6 $65,287.75 $268,566.00 $168,901.00 nat. median
$51,319
outlier · 3.3×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $168,874.13 $168,874.13 $168,874.13 nat. median
$133,176
1.3× median
319
MS_DRG 		Other Endovascular Cardiac Valve Procedures With Mcc 6 $54,752.61 $182,013.00 $167,176.00 nat. median
$43,762
outlier · 3.8×
40
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 6 $47,438.67 $178,051.00 $165,972.00 nat. median
$37,698
outlier · 4.4×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 3 $48,463.41 $265,993.23 $165,945.38 nat. median
$87,411
1.9× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 $84,108.04 $209,543.00 $165,796.00 nat. median
$65,950
outlier · 2.5×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $65,326.65 $183,588.00 $161,147.00 nat. median
$52,879
outlier · 3.0×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 6 $71,839.54 $203,824.00 $161,046.00 nat. median
$57,424
outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 8,886 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
             
0408T HCPCS Insj/rplc Cardiac Modulj Sys 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
0763 OTHER Inj, Bupivacaine Liposome 1 1 — — $85,361.35 $85,361.35 $85,361.35 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 4 — — $341,147.36 $341,147.36 $341,147.36 2026-04-01
10 MS_DRG Pancreas Transplant 4 4 — — $87,727.94 $87,727.94 $87,727.94 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 4 — — $66,801.10 $66,801.10 $66,801.10 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 4 — — $51,751.43 $51,751.43 $51,751.43 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 2 1 — — $49,308.00 $68,486.00 $58,897.00 2026-04-01
132 MS_DRG Cranial/Facial Procedures Without Cc/Mcc 6 3 — — $33,844.00 $49,436.00 $44,389.00 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 4 4 — — $146,587.10 $146,587.10 $146,587.10 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 4 4 — — $52,350.69 $52,350.69 $52,350.69 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 6 4 — — $46,045.66 $101,416.00 $46,045.66 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 4 4 — — $72,582.24 $72,582.24 $72,582.24 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 13 6 — — $54,982.35 $158,698.00 $148,097.00 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 14 6 — — $11,394.34 $75,301.00 $64,123.00 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 13 6 — — $23,772.00 $59,914.00 $53,794.00 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 4 — — $45,937.48 $45,937.48 $45,937.48 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 4 4 — — $66,536.11 $66,536.11 $66,536.11 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 4 — — $525,410.73 $525,410.73 $525,410.73 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 4 — — $87,228.35 $87,228.35 $87,228.35 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 4 — — $138,247.24 $138,247.24 $138,247.24 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 6 — — $96,152.89 $414,588.00 $325,512.00 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 6 4 — — $78,720.75 $257,828.00 $78,720.75 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 12 5 — — $138,089.22 $266,222.00 $206,669.00 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 6 — — $64,852.58 $310,887.00 $266,920.00 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 4 4 — — $132,683.69 $132,683.69 $132,683.69 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 12 5 — — $69,874.00 $129,109.00 $106,002.00 2026-04-01
215 MS_DRG Other Heart Assist System Implant 13 6 — — $121,535.91 $533,607.00 $459,855.00 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 6 — — $119,418.43 $411,119.00 $325,384.00 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 6 — — $80,429.80 $341,227.00 $292,847.00 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 6 — — $80,429.80 $320,672.00 $276,578.00 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 6 — — $93,837.27 $295,319.00 $233,679.00 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 13 6 — — $39,126.77 $414,588.00 $325,512.00 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 6 — — $65,326.65 $183,588.00 $161,147.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 6 — — $61,769.96 $167,382.00 $146,919.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 6 — — $60,641.93 $228,310.00 $195,897.00 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 6 — — $38,787.63 $231,802.00 $203,477.00 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 6 — — $70,158.44 $243,357.00 $213,618.00 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 2 1 — — $159,032.00 $220,890.00 $189,961.00 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 6 — — $102,973.31 $311,639.00 $267,411.00 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 13 6 — — $74,197.70 $315,727.00 $270,645.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 6 — — $93,434.93 $278,368.00 $220,043.00 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 13 6 — — $66,905.64 $278,368.00 $220,043.00 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 13 6 — — $71,839.54 $203,824.00 $161,046.00 2026-04-01
23515 HCPCS Treat Clavicle Fracture 6 4 — — $9,978.11 $41,716.00 $38,375.50 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 13 6 — — $51,420.80 $183,626.00 $161,046.00 2026-04-01
23615 HCPCS Treat Humerus Fracture 6 4 — — $17,654.63 $55,255.00 $50,832.00 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 4 4 — — $60,329.54 $60,329.54 $60,329.54 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 6 — — $48,054.96 $240,030.00 $210,697.00 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 13 6 — — $39,313.97 $163,692.00 $139,706.00 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 14 6 — — $25,059.34 $122,131.00 $90,321.00 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 13 6 — — $22,475.01 $92,805.00 $80,044.00 2026-04-01
245 MS_DRG Aicd Generator Procedures 4 4 — — $55,962.08 $55,962.08 $55,962.08 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 13 6 — — $55,771.24 $163,471.00 $131,297.00 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 13 6 — — $27,033.31 $90,885.00 $72,237.00 2026-04-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 13 6 — — $18,670.35 $74,671.00 $60,943.00 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 13 6 — — $42,905.90 $146,761.00 $128,952.00 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 14 6 — — $27,846.61 $98,227.00 $80,572.50 2026-04-01
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 13 6 — — $22,161.40 $75,360.00 $59,608.00 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 13 6 — — $38,697.68 $83,123.00 $65,840.00 2026-04-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 13 6 — — $25,083.57 $83,123.00 $65,840.00 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 13 6 — — $38,297.77 $106,164.00 $93,140.00 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 13 6 — — $40,043.29 $72,298.00 $57,134.00 2026-04-01
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 13 6 — — $23,483.91 $72,298.00 $57,134.00 2026-04-01
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 13 6 — — $20,316.20 $72,298.00 $57,134.00 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 6 4 — — $41,110.54 $95,518.00 $41,110.54 2026-04-01
265 MS_DRG Aicd Lead Procedures 4 4 — — $44,484.90 $44,484.90 $44,484.90 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 6 — — $74,997.53 $436,419.00 $256,605.00 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 13 6 — — $58,373.72 $229,372.00 $186,896.00 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 13 6 — — $84,108.04 $209,543.00 $165,796.00 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 14 6 — — $45,917.63 $128,461.00 $95,219.00 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 13 6 — — $31,171.02 $98,073.00 $75,821.00 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 6 — — $64,639.86 $168,499.00 $145,273.00 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 13 6 — — $43,732.48 $120,510.00 $78,577.00 2026-04-01
27130 HCPCS Total Hip Arthroplasty 2 2 — — $17,654.63 $63,249.00 $40,451.82 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 14 6 — — $31,536.90 $115,067.00 $75,276.00 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 13 6 — — $50,651.36 $97,942.00 $86,390.00 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 13 6 — — $40,516.14 $90,885.00 $76,114.00 2026-04-01
27427 HCPCS Reconstruction Knee 7 5 — — $9,978.11 $45,428.00 $43,269.00 2026-04-01
27447 HCPCS Total Knee Arthroplasty 2 2 — — $17,654.63 $64,740.00 $41,197.32 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 6 — — $87,177.30 $325,194.00 $269,935.00 2026-04-01
27524 HCPCS Treat Kneecap Fracture 7 5 — — $9,978.11 $41,400.00 $37,752.00 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 6 — — $73,516.99 $275,916.00 $218,184.00 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 13 6 — — $56,644.00 $242,459.00 $197,796.00 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 4 — — $68,163.73 $68,163.73 $68,163.73 2026-04-01
27814 HCPCS Treatment Of Ankle Fracture 7 5 — — $9,978.11 $44,925.00 $39,943.00 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 4 — — $44,341.46 $44,341.46 $44,341.46 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 13 6 — — $73,537.66 $187,485.00 $148,207.00 2026-04-01
28297 HCPCS Correction Hallux Valgus 6 4 — — $17,654.63 $41,948.00 $38,591.00 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 14 6 — — $27,401.62 $74,542.00 $58,995.00 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 13 6 — — $41,973.58 $100,553.00 $88,220.00 2026-04-01
29916 HCPCS Hip Arthro W/labral Repair 6 4 — — $9,978.11 $48,425.00 $43,251.00 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 4 — — $258,506.05 $258,506.05 $258,506.05 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 13 6 — — $27,187.68 $88,843.00 $70,168.00 2026-04-01
304 MS_DRG Hypertension With Mcc 13 6 — — $14,969.01 $45,898.00 $42,831.00 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 13 6 — — $54,966.55 $134,179.00 $106,186.00 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 13 6 — — $81,781.49 $208,354.00 $140,740.00 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 12 5 — — $29,946.97 $81,897.00 $65,233.00 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 11 6 — — $54,752.61 $182,013.00 $167,176.00 2026-04-01
32 MS_DRG Ventricular Shunt Procedures With Cc 13 6 — — $26,407.30 $119,247.00 $101,800.00 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 11 6 — — $29,741.54 $104,205.00 $95,710.00 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 14 6 — — $29,166.00 $154,635.00 $114,235.50 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 15 6 — — $20,203.65 $126,540.00 $87,233.00 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 4 4 — — $53,105.55 $53,105.55 $53,105.55 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 4 4 — — $38,805.87 $38,805.87 $38,805.87 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 4 4 — — $39,527.90 $39,527.90 $39,527.90 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 5 4 — — $56,000.14 $61,128.15 $61,128.15 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 5 4 — — $56,376.58 $59,550.42 $56,376.58 2026-04-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/Mcc 13 6 — — $20,717.33 $72,298.00 $57,134.00 2026-04-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 14 6 — — $20,960.44 $45,669.00 $39,097.58 2026-04-01
332 MS_DRG Rectal Resection With Mcc 4 4 — — $44,515.29 $44,515.29 $44,515.29 2026-04-01
33231 HCPCS Hchg Insrt Imp Defib Pulse Gen Only W Multi Leads 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
33249 HCPCS Hchg Insrt/rplc Perm Imp Defib W Tv Leads Sngl/dual 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
33264 HCPCS Hchg Remove Replace Imp Defib Puls Gen Sys Mult Lead 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
33270 HCPCS Hchg Ins/rep Subq Defibrillator 1 1 — — $43,163.23 $43,163.23 $43,163.23 2026-04-01
334 MS_DRG Rectal Resection Without Cc/Mcc 13 6 — — $20,413.44 $45,779.00 $40,454.00 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 13 6 — — $43,909.94 $115,294.00 $107,595.00 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 14 6 — — $100.00 $66,822.00 $56,907.00 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 4 4 — — $47,554.15 $47,554.15 $47,554.15 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 11 6 — — $35,779.16 $70,764.00 $66,588.00 2026-04-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 13 6 — — $20,954.36 $41,031.00 $38,290.00 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 4 — — $53,900.52 $53,900.52 $53,900.52 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 12 5 — — $42,301.78 $139,144.00 $114,230.50 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 12 5 — — $29,850.94 $114,017.00 $93,569.50 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 13 6 — — $40,521.00 $99,461.00 $86,753.00 2026-04-01
38 MS_DRG Extracranial Procedures With Cc 13 6 — — $20,227.47 $74,507.00 $64,599.00 2026-04-01
39 MS_DRG Extracranial Procedures Without Cc/Mcc 14 6 — — $14,486.82 $52,820.00 $41,230.50 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 13 6 — — $29,615.13 $70,496.00 $53,900.00 2026-04-01
398 MS_DRG Appendix Procedures With Cc 14 6 — — $18,902.52 $56,774.00 $44,933.00 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 4 — — $168,874.13 $168,874.13 $168,874.13 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 13 6 — — $47,438.67 $178,051.00 $165,972.00 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 13 6 — — $49,375.04 $219,136.00 $192,255.00 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 13 6 — — $67,000.45 $183,808.00 $171,523.00 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 13 6 — — $35,757.28 $83,930.00 $78,319.00 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 13 6 — — $27,484.27 $54,351.00 $50,723.00 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 6 4 — — $43,845.52 $118,188.00 $43,845.52 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 13 6 — — $27,230.23 $107,384.00 $94,119.00 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 4 4 — — $40,657.14 $40,657.14 $40,657.14 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 6 4 — — $43,809.05 $106,517.00 $43,809.05 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 13 6 — — $29,511.80 $70,664.00 $55,682.00 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 15 6 — — $2,358.34 $70,664.00 $48,748.53 2026-04-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 13 6 — — $21,505.00 $80,966.00 $69,410.00 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 4 4 — — $41,918.88 $41,918.88 $41,918.88 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 4 — — $50,985.64 $50,985.64 $50,985.64 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 6 — — $134,471.75 $351,279.00 $277,982.00 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 6 — — $88,249.41 $243,801.00 $212,389.00 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 6 — — $68,842.00 $203,151.00 $177,398.00 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 13 6 — — $110,019.83 $351,279.00 $277,982.00 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 13 6 — — $70,605.76 $227,150.00 $199,213.00 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 13 6 — — $81,721.93 $282,353.00 $168,901.00 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 13 6 — — $52,052.89 $202,907.00 $127,301.00 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 13 6 — — $65,287.75 $268,566.00 $168,901.00 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 13 6 — — $39,771.01 $165,463.00 $131,702.00 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 4 3 — — $48,463.41 $265,993.23 $165,945.38 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $204,301.00 $204,301.00 $204,301.00 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $43,191.72 $43,191.72 $43,191.72 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 6 — — $102,651.20 $307,570.00 $238,901.00 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 6 — — $63,333.65 $307,570.00 $227,251.00 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 6 — — $51,223.88 $307,570.00 $242,806.00 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $192,725.00 $192,725.00 $192,725.00 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 2 — — $120,841.00 $144,893.00 $132,867.00 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 6 — — $67,638.61 $167,674.00 $132,878.00 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 13 6 — — $32,837.54 $150,671.00 $107,632.00 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 4 — — $69,784.05 $214,679.00 $69,784.05 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 4 — — $38,364.62 $81,039.00 $38,364.62 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 6 — — $63,778.04 $113,324.00 $97,181.00 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 14 6 — — $28,435.72 $136,629.00 $101,103.50 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 13 6 — — $33,907.22 $105,073.00 $90,656.00 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 13 6 — — $37,373.95 $107,835.00 $85,496.00 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 19 6 — — $20,820.88 $94,904.00 $79,497.00 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 13 6 — — $59,199.08 $122,600.00 $104,980.00 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 13 6 — — $36,315.21 $95,168.00 $83,303.00 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 17 6 — — $26,318.34 $80,633.00 $61,205.72 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 6 4 — — $52,686.19 $128,369.00 $52,686.19 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 6 4 — — $42,496.26 $89,645.00 $42,496.26 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 14 6 — — $35,276.19 $103,546.00 $76,517.00 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 13 6 — — $25,963.63 $103,546.00 $81,759.00 2026-04-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 14 6 — — $17,767.14 $69,643.00 $51,294.00 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 13 6 — — $34,197.73 $93,948.00 $74,306.00 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 6 4 — — $39,730.90 $100,097.00 $39,730.90 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 13 6 — — $45,134.00 $86,388.00 $68,518.00 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 13 6 — — $31,331.48 $56,164.00 $44,509.00 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 6 — — $44,576.06 $98,644.00 $77,828.00 2026-04-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 6 — — $22,431.25 $81,423.00 $69,689.00 2026-04-01
49656 HCPCS Lap Inc Hernia Repair Recur 1 1 — — $52,171.00 $52,171.00 $52,171.00 2026-04-01
497 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 6 — — $15,191.46 $49,424.00 $39,104.00 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 13 6 — — $37,174.61 $66,375.00 $52,576.00 2026-04-01
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 13 6 — — $24,994.84 $58,149.00 $49,741.00 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 4 — — $125,832.87 $125,832.87 $125,832.87 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 4 4 — — $38,973.61 $38,973.61 $38,973.61 2026-04-01
501 MS_DRG Soft Tissue Procedures With Cc 13 6 — — $21,752.98 $47,206.00 $44,050.00 2026-04-01
503 MS_DRG Foot Procedures With Mcc 13 6 — — $34,431.12 $61,677.00 $49,069.00 2026-04-01
504 MS_DRG Foot Procedures With Cc 13 6 — — $23,225.00 $61,677.00 $49,069.00 2026-04-01
505 MS_DRG Foot Procedures Without Cc/Mcc 13 6 — — $22,296.32 $50,095.00 $43,288.00 2026-04-01
50544 HCPCS Laparoscopy Pyeloplasty 7 5 — — $14,617.22 $68,899.00 $65,254.00 2026-04-01
506 MS_DRG Major Thumb Or Joint Procedures 13 6 — — $16,904.16 $55,405.00 $47,566.00 2026-04-01
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/Mcc 13 6 — — $22,461.64 $59,024.00 $46,792.00 2026-04-01
508 MS_DRG Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc 13 6 — — $18,912.25 $59,024.00 $46,792.00 2026-04-01
5092 OTHER Level 2 Breast/Lymphatic Surgery And Related Procedures 2 2 — — $46,566.92 $61,466.28 $54,016.60 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 13 6 — — $37,219.58 $65,274.00 $54,468.00 2026-04-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 14 6 — — $22,434.35 $49,430.00 $40,481.50 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 8 4 — — $18,175.99 $59,174.22 $42,451.44 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 6 4 — — $39,242.25 $92,202.00 $39,242.25 2026-04-01
5165 OTHER Level 5 ENT Procedures 5 4 — — $9,983.16 $62,083.05 $40,920.40 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 13 6 — — $44,759.00 $76,178.00 $60,221.00 2026-04-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 13 6 — — $24,817.37 $67,038.00 $57,211.00 2026-04-01
5192 OTHER Level 2 Endovascular Procedures 1 1 — — $56,609.49 $56,609.49 $56,609.49 2026-04-01
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc 13 6 — — $18,663.06 $50,038.00 $39,529.00 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 1 1 — — $43,858.76 $43,858.76 $43,858.76 2026-04-01
5362 OTHER Level 2 Laparoscopy And Related Services 5 3 — — $14,241.53 $54,319.06 $47,798.12 2026-04-01
55866 HCPCS Laparo Radical Prostatectomy 7 5 — — $14,617.22 $69,572.00 $65,254.00 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 4 — — $80,139.29 $80,139.29 $80,139.29 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 4 4 — — $42,700.48 $42,700.48 $42,700.48 2026-04-01
57425 HCPCS Laparoscopy Surg Colpopexy 7 5 — — $14,617.22 $43,300.00 $39,484.00 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 4 — — $60,080.35 $60,080.35 $60,080.35 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 13 6 — — $32,724.49 $80,847.00 $75,452.00 2026-04-01
578 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc 13 6 — — $20,030.55 $47,334.00 $44,167.00 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 13 6 — — $34,508.00 $51,364.00 $47,931.00 2026-04-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 14 6 — — $1,375.00 $68,747.00 $46,480.00 2026-04-01
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc 13 6 — — $18,045.56 $56,142.00 $47,788.00 2026-04-01
582 MS_DRG Mastectomy For Malignancy With Cc/Mcc 13 6 — — $23,922.73 $67,463.00 $58,132.00 2026-04-01
583 MS_DRG Mastectomy For Malignancy Without Cc/Mcc 13 6 — — $21,464.89 $52,220.00 $44,264.00 2026-04-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc 13 6 — — $26,525.21 $69,626.00 $59,650.00 2026-04-01
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc 13 6 — — $23,953.11 $59,265.00 $47,789.00 2026-04-01
58544 HCPCS Lsh W/t/o Uterus Above 250 G 7 5 — — $14,617.22 $59,137.00 $53,926.00 2026-04-01
58546 HCPCS Laparo-myomectomy Complex 7 5 — — $14,617.22 $72,146.00 $65,788.00 2026-04-01
58571 HCPCS Tlh W/t/o 250 G Or Less 7 5 — — $14,617.22 $44,246.00 $39,047.00 2026-04-01
58573 HCPCS Tlh W/t/o Uterus Over 250 G 7 5 — — $14,617.22 $47,427.00 $41,853.00 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 4 4 — — $56,868.88 $56,868.88 $56,868.88 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 11 6 — — $34,017.83 $102,102.00 $96,081.00 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 4 — — $42,894.96 $42,894.96 $42,894.96 2026-04-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 17 6 — — $11,532.14 $52,477.00 $47,888.00 2026-04-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 11 6 — — $21,863.59 $67,226.00 $63,262.00 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 6 4 — — $43,767.73 $106,125.00 $43,767.73 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 6 4 — — $45,804.98 $108,019.00 $45,804.98 2026-04-01
63 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 11 6 — — $17,567.85 $45,264.00 $42,598.00 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 4 — — $57,651.69 $57,651.69 $57,651.69 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 4 4 — — $45,549.72 $45,549.72 $45,549.72 2026-04-01
652 MS_DRG Kidney Transplant 4 4 — — $39,760.07 $39,760.07 $39,760.07 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 4 4 — — $63,668.64 $63,668.64 $63,668.64 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 6 4 — — $39,204.57 $154,627.00 $39,204.57 2026-04-01
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc 13 6 — — $19,366.86 $49,493.00 $43,293.00 2026-04-01
665 MS_DRG Prostatectomy With Mcc 4 4 — — $38,443.64 $38,443.64 $38,443.64 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 5 4 — — $25,165.83 $51,576.39 $51,576.39 2026-04-01
7 MS_DRG Lung Transplant 4 4 — — $157,919.63 $157,919.63 $157,919.63 2026-04-01
708 MS_DRG Major Male Pelvic Procedures Without Cc/Mcc 13 6 — — $19,152.92 $44,115.00 $38,583.00 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 13 6 — — $27,699.43 $59,980.00 $55,969.00 2026-04-01
716 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy Without Cc/Mcc 13 6 — — $18,384.70 $49,208.00 $45,916.00 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 13 6 — — $26,395.15 $75,504.00 $70,457.00 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 4 4 — — $43,953.70 $43,953.70 $43,953.70 2026-04-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 13 6 — — $25,551.56 $60,844.00 $56,778.00 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 4 4 — — $44,054.59 $44,054.59 $44,054.59 2026-04-01
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 13 6 — — $22,500.54 $53,542.00 $49,966.00 2026-04-01
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc 13 6 — — $25,411.77 $45,535.00 $42,490.00 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 4 — — $72,749.98 $72,749.98 $72,749.98 2026-04-01
791 MS_DRG Prematurity With Major Problems 4 4 — — $49,843.02 $49,843.02 $49,843.02 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 4 4 — — $51,187.42 $51,187.42 $51,187.42 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 4 4 — — $55,554.87 $55,554.87 $55,554.87 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 4 — — $68,630.50 $68,630.50 $68,630.50 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 4 4 — — $48,932.58 $48,932.58 $48,932.58 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 4 — — $71,793.35 $71,793.35 $71,793.35 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 4 — — $56,234.36 $56,234.36 $56,234.36 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 4 4 — — $57,364.82 $57,364.82 $57,364.82 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 4 4 — — $38,915.27 $38,915.27 $38,915.27 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 4 4 — — $67,236.27 $67,236.27 $67,236.27 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 4 — — $58,902.49 $58,902.49 $58,902.49 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 4 4 — — $39,825.71 $39,825.71 $39,825.71 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 4 4 — — $105,764.21 $105,764.21 $105,764.21 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 8 5 — — $48,330.04 $77,601.00 $60,534.96 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 4 4 — — $55,795.55 $55,795.55 $55,795.55 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 5 4 — — $84,520.11 $171,925.59 $84,520.11 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 4 4 — — $47,483.65 $47,483.65 $47,483.65 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 4 4 — — $51,515.61 $51,515.61 $51,515.61 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 4 4 — — $45,152.23 $45,152.23 $45,152.23 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 5 4 — — $47,172.47 $55,366.98 $47,172.47 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 4 — — $260,029.12 $260,029.12 $260,029.12 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 4 — — $87,691.47 $87,691.47 $87,691.47 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 4 4 — — $39,654.32 $39,654.32 $39,654.32 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 4 4 — — $47,839.80 $47,839.80 $47,839.80 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 4 4 — — $44,610.10 $44,610.10 $44,610.10 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 6 4 — — $43,283.94 $114,567.00 $43,283.94 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $82,323.62 $82,323.62 $82,323.62 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 4 4 — — $46,245.01 $46,245.01 $46,245.01 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 4 — — $93,127.39 $93,127.39 $93,127.39 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 4 4 — — $51,725.90 $51,725.90 $51,725.90 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 4 4 — — $74,911.22 $74,911.22 $74,911.22 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 6 4 — — $44,407.10 $179,231.00 $44,407.10 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 4 — — $49,936.58 $57,535.00 $57,535.00 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 4 — — $42,177.79 $42,177.79 $42,177.79 2026-04-01
999 MS_DRG Ungroupable 1 1 — — $56,760.00 $56,760.00 $56,760.00 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 2 2 — — $56,824.55 $189,311.16 $123,067.85 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $146,326.57 $146,326.57 $146,326.57 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 3 2 — — $63,342.28 $145,441.90 $145,441.90 2026-04-01
J9226 HCPCS Supprelin La Implant 6 3 — — $45,020.65 $129,708.04 $113,470.54 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 3 — — $28,424.06 $62,262.23 $61,049.99 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 2 2 — — $24,228.42 $74,101.05 $49,164.74 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 2 — — $533,230.17 $1,340,483.41 $936,856.79 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 2 — — $591,726.20 $1,476,857.10 $1,034,291.65 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 3 — — $55,272.32 $162,691.22 $131,139.34 2026-04-01
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