Price Transparencybeta Hospital negotiated rates

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

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Hospital

RIVERSIDE UNIVERSITY HEALTH SYSTEM-MEDICAL CENTER

Moreno Valley, CA · CCN 050292 · Rates published

Your selected procedure

You selected 29806 (CPT)

HC Arthoscopy Shoulder Caps

This hospital’s price: $20,492 across 11 payers · range $846-$23,420

Source: https://www.ruhealth.org/956000930_riverside-university-health-system_standardcharges.csv · observed 2026-03-30

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

5,199 distinct procedures filed
12 distinct payers
127,585 rate rows
2026-01-01 last MRF observed
Data quality

125,977 of 127,585 rate rows are consumer-grade (98.7%)

1,608 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
placeholder amount (≤ $0.02) — excluded from medians 1,023
exceeds 10× this hospital's gross charge — excluded from medians 441
per-diem day rate — not a per-procedure price 109
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 15
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 13
percent-of-charges filed in the dollar field — excluded from medians 4
exceeds 3× this hospital's gross charge for a DRG stay — excluded 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.ruhealth.org/956000930_riverside-university-health-system_standardcharges.csv
Found on page https://www.ruhealth.org/resources/hospital-price-transparency
Discovered viaDiscovered by HANK
Last fetch success · 2026-11-06
Content fingerprint d63d65a4b5297651… · 70,648,140 bytes · first seen 2026-11-06

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
956
APR_DRG 		Ungroupable,moderate 1 $1,777,793.96 $1,777,793.96 $1,777,793.96 nat. median
$3,774
outlier · 471.0×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $245,676.03 $319,378.84 $255,787.17 nat. median
$190,274
1.3× median
J9347
HCPCS 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 11 $140.90 $249,799.10 $218,574.21 nat. median
$3,185
outlier · 68.6×
J9298
HCPCS 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 11 $197.83 $185,261.06 $162,103.43 nat. median
$558
outlier · 290.5×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $160,606.97 $209,776.37 $161,366.44 nat. median
$126,240
1.3× median
J2507
HCPCS 		Pegloticase 8 Mg/ml Intravenous Solution 11 $3,660.83 $181,034.36 $158,405.07 nat. median
$9,534
outlier · 16.6×
589
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $113,972.44 $113,972.44 $113,972.44 nat. median
$114,872
1.0× median
593
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure,extreme 1 $93,108.41 $130,334.57 $111,721.49 nat. median
$12,945
outlier · 8.6×
J0638
HCPCS 		Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 11 $141.60 $125,930.68 $110,189.35 nat. median
$250
outlier · 439.9×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $99,075.80 $133,584.92 $108,983.38 nat. median
$77,595
1.4× median
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution 11 $59.41 $121,553.60 $106,359.40 nat. median
$714
outlier · 149.1×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $92,963.37 $145,118.53 $102,259.71 nat. median
$74,260
1.4× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $90,785.25 $118,020.83 $99,863.78 nat. median
$72,153
1.4× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $90,117.51 $117,152.76 $99,129.26 nat. median
$67,850
1.5× median
602
APR_DRG 		Cellulitis With Mcc 1 $95,194.58 $95,194.58 $95,194.58 nat. median
$86,947
1.1× median
33249
CPT 		Hc Icd Insert/Repos Single/Dbl +Lead 11 $895.01 $108,258.93 $94,726.57 nat. median
$31,638
outlier · 3.0×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 $84,520.73 $277,754.56 $92,972.80 nat. median
$66,553
1.4× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 $81,633.75 $106,123.88 $89,797.13 nat. median
$63,874
1.4× median
4
APR_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $70,765.56 $106,754.93 $88,760.24 nat. median
$117,888
0.8× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 5 $82,021.34 $106,627.74 $88,379.33 nat. median
$62,605
1.4× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 5 $79,955.28 $103,941.86 $87,517.25 nat. median
$61,601
1.4× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 5 $79,389.31 $721,718.71 $87,328.24 nat. median
$60,364
1.4× median
PX-900700060
CDM 		Hc Surgery Level Vi 1st Hr 11 $101.90 $82,122.00 $82,122.00 nat. median
$82,122
1.0× median
33270
CPT 		Hc Insert Subq Defib Weltrd 11 $508.93 $92,168.16 $80,647.14 nat. median
$32,114
outlier · 2.5×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 5 $76,566.33 $99,536.23 $79,597.42 nat. median
$59,289
1.3× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 5 $72,983.03 $94,877.94 $79,009.64 nat. median
$58,315
1.4× median
28
MS_DRG 		Spinal Procedures With Mcc 5 $71,691.03 $93,198.34 $78,860.13 nat. median
$54,301
1.5× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 5 $71,671.58 $284,122.08 $78,838.74 nat. median
$56,565
1.4× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $71,174.23 $98,779.46 $78,291.65 nat. median
$55,148
1.4× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 5 $70,950.12 $92,235.16 $78,045.13 nat. median
$50,769
1.5× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 5 $58,974.22 $101,270.85 $77,900.65 nat. median
$58,210
1.3× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 5 $70,050.29 $91,065.38 $77,055.32 nat. median
$53,708
1.4× median
33264
CPT 		Hc Icd Remv Repl Ex Mult Leads 11 $325.02 $86,794.00 $77,005.39 nat. median
$31,574
outlier · 2.4×
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 5 $68,933.22 $432,947.92 $75,826.54 nat. median
$51,145
1.5× median
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 $68,512.46 $89,066.20 $75,363.71 nat. median
$53,315
1.4× median
J9043
HCPCS 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 11 $227.28 $85,831.99 $75,102.99 nat. median
$742
outlier · 101.3×
33231
CPT 		Hc Icd Ins Ex Mult Leads 11 $324.65 $82,193.26 $74,705.02 nat. median
$30,088
outlier · 2.5×
428
MS_DRG 		Genetic Disorders 5 $67,274.19 $282,830.19 $74,001.61 nat. median
$50,495
1.5× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 5 $68,160.30 $88,608.39 $72,813.97 nat. median
$49,857
1.5× median
834
MS_DRG 		Acute Leukemia With Mcc 5 $65,763.79 $85,492.93 $72,340.17 nat. median
$50,311
1.4× median
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 5 $65,541.98 $85,204.57 $72,096.18 nat. median
$50,653
1.4× median
11
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $65,354.48 $84,960.82 $71,391.68 nat. median
$49,925
1.4× median
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $63,967.56 $83,157.83 $70,364.32 nat. median
$50,491
1.4× median
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 5 $63,930.98 $263,624.35 $70,324.08 nat. median
$48,240
1.5× median
37224
CPT 		Hc Pta Fem/Pop 11 $7,244.35 $69,924.38 $69,924.38 nat. median
$7,353
outlier · 9.5×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 5 $63,521.67 $109,375.52 $69,873.84 nat. median
$51,294
1.4× median
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 5 $63,321.58 $82,318.05 $69,653.74 nat. median
$49,269
1.4× median
37229
CPT 		Hc Athrectomy Tibioperoneal 11 $22,815.81 $69,250.37 $69,250.37 nat. median
$17,216
outlier · 4.0×
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 5 $62,510.93 $81,264.21 $68,762.02 nat. median
$46,310
1.5× median
653
MS_DRG 		Major Bladder Procedures With Mcc 5 $62,408.03 $81,130.44 $68,648.83 nat. median
$49,933
1.4× median

Other procedures at this hospital

Browse this hospital's 5,199 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
             
956 APR_DRG Ungroupable,moderate 1 1 $1,777,793.96 — $1,777,793.96 $1,777,793.96 $1,777,793.96 2026-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 5 $1,893,444.04 $1,893,444.04 $245,676.03 $319,378.84 $255,787.17 2026-01-01
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 20 11 $249,799.10 $249,799.10 $140.90 $249,799.10 $218,574.21 2026-01-01
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 20 11 $185,261.06 $185,261.06 $197.83 $185,261.06 $162,103.43 2026-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 5 $1,342,212.66 $1,342,212.66 $160,606.97 $209,776.37 $161,366.44 2026-01-01
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 20 11 $181,034.36 $181,034.36 $3,660.83 $181,034.36 $158,405.07 2026-01-01
589 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 $685,029.61 — $113,972.44 $113,972.44 $113,972.44 2026-01-01
593 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure,extreme 2 1 $2,367,136.55 — $93,108.41 $130,334.57 $111,721.49 2026-01-01
J0638 HCPCS Canakinumab (pf) 150 Mg/ml Subcutaneous Solution 20 11 $125,930.68 $125,930.68 $141.60 $125,930.68 $110,189.35 2026-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 $576,523.43 $576,523.43 $99,075.80 $133,584.92 $108,983.38 2026-01-01
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 20 11 $121,553.60 $121,553.60 $59.41 $121,553.60 $106,359.40 2026-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 5 $599,781.42 $599,781.42 $92,963.37 $145,118.53 $102,259.71 2026-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 5 $598,821.79 $598,821.79 $90,785.25 $118,020.83 $99,863.78 2026-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 5 $717,253.23 $717,253.23 $90,117.51 $117,152.76 $99,129.26 2026-01-01
602 APR_DRG Cellulitis With Mcc 1 1 $2,174,825.64 — $95,194.58 $95,194.58 $95,194.58 2026-01-01
33249 CPT Hc Icd Insert/Repos Single/Dbl +Lead 20 11 $108,258.93 $108,258.93 $895.01 $108,258.93 $94,726.57 2026-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 5 $277,754.56 $277,754.56 $84,520.73 $277,754.56 $92,972.80 2026-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 5 $591,349.83 $591,349.83 $81,633.75 $106,123.88 $89,797.13 2026-01-01
4 APR_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 $1,602,724.35 — $70,765.56 $106,754.93 $88,760.24 2026-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 5 5 $631,349.32 $631,349.32 $82,021.34 $106,627.74 $88,379.33 2026-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 5 5 $682,869.19 $682,869.19 $79,955.28 $103,941.86 $87,517.25 2026-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 5 5 $721,718.71 $721,718.71 $79,389.31 $721,718.71 $87,328.24 2026-01-01
PX-900700060 CDM Hc Surgery Level Vi 1st Hr 17 11 $82,122.00 $82,122.00 $101.90 $82,122.00 $82,122.00 2026-01-01
33270 CPT Hc Insert Subq Defib Weltrd 20 11 $92,168.16 $92,168.16 $508.93 $92,168.16 $80,647.14 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 5 5 $665,639.97 $665,639.97 $76,566.33 $99,536.23 $79,597.42 2026-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 5 5 $1,278,429.18 $1,278,429.18 $72,983.03 $94,877.94 $79,009.64 2026-01-01
28 MS_DRG Spinal Procedures With Mcc 5 5 $552,240.75 $552,240.75 $71,691.03 $93,198.34 $78,860.13 2026-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 5 5 $284,122.08 $284,122.08 $71,671.58 $284,122.08 $78,838.74 2026-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 $351,881.03 $351,881.03 $71,174.23 $98,779.46 $78,291.65 2026-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 5 5 $4,049,115.53 $4,049,115.53 $70,950.12 $92,235.16 $78,045.13 2026-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 5 5 $216,968.50 $216,968.50 $58,974.22 $101,270.85 $77,900.65 2026-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 5 5 $477,802.07 $477,802.07 $70,050.29 $91,065.38 $77,055.32 2026-01-01
33264 CPT Hc Icd Remv Repl Ex Mult Leads 20 11 $86,794.00 $86,794.00 $325.02 $86,794.00 $77,005.39 2026-01-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 5 5 $432,947.92 $432,947.92 $68,933.22 $432,947.92 $75,826.54 2026-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 5 $427,378.42 $427,378.42 $68,512.46 $89,066.20 $75,363.71 2026-01-01
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 20 11 $85,831.99 $85,831.99 $227.28 $85,831.99 $75,102.99 2026-01-01
33231 CPT Hc Icd Ins Ex Mult Leads 20 11 $82,193.26 $82,193.26 $324.65 $82,193.26 $74,705.02 2026-01-01
428 MS_DRG Genetic Disorders 5 5 $282,830.19 $282,830.19 $67,274.19 $282,830.19 $74,001.61 2026-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 5 $353,273.95 $353,273.95 $68,160.30 $88,608.39 $72,813.97 2026-01-01
834 MS_DRG Acute Leukemia With Mcc 5 5 $187,795.97 $187,795.97 $65,763.79 $85,492.93 $72,340.17 2026-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 5 5 $283,743.31 $283,743.31 $65,541.98 $85,204.57 $72,096.18 2026-01-01
11 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 5 $381,692.45 $381,692.45 $65,354.48 $84,960.82 $71,391.68 2026-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 5 $525,604.09 $525,604.09 $63,967.56 $83,157.83 $70,364.32 2026-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 5 5 $263,624.35 $263,624.35 $63,930.98 $263,624.35 $70,324.08 2026-01-01
37224 CPT Hc Pta Fem/Pop 17 11 $69,924.38 $69,924.38 $7,244.35 $69,924.38 $69,924.38 2026-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 5 5 $245,365.63 $245,365.63 $63,521.67 $109,375.52 $69,873.84 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 5 5 $277,797.61 $277,797.61 $63,321.58 $82,318.05 $69,653.74 2026-01-01
37229 CPT Hc Athrectomy Tibioperoneal 17 11 $69,250.37 $69,250.37 $22,815.81 $69,250.37 $69,250.37 2026-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 5 5 $429,335.05 $429,335.05 $62,510.93 $81,264.21 $68,762.02 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 5 5 $415,795.52 $415,795.52 $62,408.03 $81,130.44 $68,648.83 2026-01-01
33230 CPT Hc Icd Insert Exist Dual Leads 20 11 $78,072.76 $78,072.76 $312.73 $78,072.76 $68,313.66 2026-01-01
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 20 11 $77,565.53 $77,565.53 $258.64 $77,565.53 $67,869.84 2026-01-01
0915T CPT Hc Insj Perm Ccm Dfib Sys Pg And Eltrd 15 10 $0.01 — $40,737.44 $67,216.78 $67,216.78 2026-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 5 $429,741.85 $429,741.85 $60,622.08 $78,808.70 $66,525.42 2026-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 5 5 $265,842.24 $265,842.24 $60,018.39 $78,023.91 $66,002.94 2026-01-01
J1744 HCPCS Icatibant 30 Mg/3 Ml Subcutaneous Syringe 17 11 $65,656.09 $65,656.09 $130.39 $65,656.09 $65,656.09 2026-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 5 5 $288,372.35 $288,372.35 $59,561.03 $95,734.60 $65,517.13 2026-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 5 5 $445,497.18 $445,497.18 $59,460.41 $77,298.53 $65,406.45 2026-01-01
PX-904300100 CDM Hc Trauma Activation Level A 15 11 $65,249.00 $65,249.00 $48,936.75 $65,249.00 $65,249.00 2026-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 5 5 $352,163.37 $352,163.37 $59,267.20 $77,047.36 $65,193.92 2026-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 5 5 $788,716.48 $788,716.48 $59,032.81 $76,742.65 $64,936.09 2026-01-01
5 APR_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 $1,258,653.58 — $53,576.11 $75,939.51 $64,757.81 2026-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 5 5 $233,734.34 $233,734.34 $58,203.87 $75,665.03 $64,024.26 2026-01-01
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 20 11 $72,270.57 $72,270.57 $243.71 $72,270.57 $63,236.75 2026-01-01
37227 CPT Hc Athrectomy & Stent Fem/Pop 17 11 $63,187.49 $63,187.49 $22,815.81 $63,187.49 $63,187.49 2026-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 5 $274,397.03 $274,397.03 $56,638.60 $73,630.18 $62,302.46 2026-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 5 5 $154,496.09 $154,496.09 $56,478.53 $75,684.67 $62,126.38 2026-01-01
J2182 HCPCS Mepolizumab 100 Mg/ml Subcutaneous Syringe 20 11 $70,516.30 $70,516.30 $31.27 $70,516.30 $61,701.76 2026-01-01
33240 CPT Hc Icd Insert Single/Dbl Chamber 20 11 $70,418.18 $70,418.18 $383.84 $70,418.18 $61,615.91 2026-01-01
J9022 HCPCS Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 20 11 $70,304.92 $70,304.92 $91.34 $70,304.92 $61,516.81 2026-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 5 5 $153,542.53 $153,542.53 $55,800.51 $153,542.53 $61,380.56 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 5 5 $454,661.52 $454,661.52 $55,548.97 $72,213.66 $61,103.87 2026-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 5 5 $351,679.81 $351,679.81 $55,415.19 $72,039.75 $60,956.71 2026-01-01
245 MS_DRG Aicd Generator Procedures 5 5 $109,434.91 $109,434.91 $55,159.07 $79,131.55 $60,674.98 2026-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 5 5 $291,668.16 $291,668.16 $55,002.44 $71,503.17 $60,502.68 2026-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 5 5 $431,221.17 $431,221.17 $54,979.57 $71,473.44 $60,477.53 2026-01-01
799 MS_DRG Splenic Procedures With Mcc 5 5 $541,744.48 $541,744.48 $54,776.05 $71,208.87 $60,253.66 2026-01-01
163 MS_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 5 5 $131,451.93 $131,451.93 $54,237.52 $71,726.93 $59,661.27 2026-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 5 5 $513,801.40 $513,801.40 $54,222.67 $70,489.47 $59,129.51 2026-01-01
36906 CPT Hc Throm Dialysis Crct W Stnt Plc 20 11 $67,422.65 $67,422.65 $6,259.85 $67,422.65 $58,994.82 2026-01-01
0238T CPT Hc Athrectomy Iliac 17 11 $58,868.50 $58,868.50 $22,815.81 $58,868.50 $58,868.50 2026-01-01
33263 CPT Hc Icd Remv Repl Ex Dual Leads 20 11 $66,610.37 $66,610.37 $313.48 $66,610.37 $58,284.07 2026-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 5 5 $605,353.50 $605,353.50 $55,460.77 $72,099.00 $57,933.63 2026-01-01
J1640 HCPCS Hemin 350 Mg Intravenous Powder For Solution 20 11 $65,918.89 $65,918.89 $34.18 $65,918.89 $57,679.03 2026-01-01
863 APR_DRG Neonatal Aftercare,extreme 1 1 $3,218,262.25 — $56,971.38 $56,971.38 $56,971.38 2026-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 5 5 $244,680.74 $244,680.74 $51,762.15 $244,680.74 $56,938.37 2026-01-01
33262 CPT Hc Removal Of Implatable Defibrillator W/replacement Defibrillator, Single Lead 20 11 $65,032.42 $65,032.42 $301.56 $65,032.42 $56,903.37 2026-01-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 5 5 $488,738.60 $488,738.60 $51,482.01 $488,738.60 $56,630.21 2026-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 5 5 $428,637.87 $428,637.87 $51,280.78 $66,665.01 $56,408.86 2026-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 5 5 $412,573.68 $412,573.68 $51,174.44 $66,526.77 $56,291.88 2026-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 5 5 $173,717.96 $173,717.96 $50,976.64 $66,269.63 $56,074.30 2026-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 5 5 $234,570.00 $234,570.00 $52,077.70 $67,701.01 $56,064.33 2026-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 $303,958.28 $303,958.28 $50,702.23 $77,873.26 $55,772.45 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 5 5 $310,382.67 $310,382.67 $53,219.93 $69,185.91 $55,238.53 2026-01-01
793 MS_DRG Full Term Neonate With Major Problems 5 5 $28,659.38 $28,659.38 $50,667.93 $65,868.31 $55,105.01 2026-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 5 5 $284,346.67 $284,346.67 $50,478.14 $65,621.58 $54,961.33 2026-01-01
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 20 11 $61,955.53 $61,955.53 $55.57 $61,955.53 $54,211.09 2026-01-01
791 MS_DRG Prematurity With Major Problems 5 5 $74,495.18 $74,495.18 $49,403.37 $64,224.38 $53,644.99 2026-01-01
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 35 11 $53,333.94 $53,333.94 $183.48 $217,541.66 $53,333.94 2026-01-01
C9047 HCPCS Caplacizumab-yhdp 11 Mg Injection Kit 19 11 $52,508.50 $52,508.50 $8,620.70 $52,508.50 $52,508.50 2026-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 5 $262,959.66 $262,959.66 $47,721.49 $62,037.94 $52,493.64 2026-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 5 5 $288,090.89 $288,090.89 $47,141.78 $61,284.31 $51,855.96 2026-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 5 5 $227,527.88 $227,527.88 $46,891.39 $60,958.81 $51,580.53 2026-01-01
J2327 HCPCS Risankizumab-rzaa 60 Mg/ml Intravenous Solution 20 11 $58,946.32 $58,946.32 $14.94 $58,946.32 $51,578.03 2026-01-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 5 5 $307,902.07 $307,902.07 $51,138.57 $66,557.99 $51,198.45 2026-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 5 5 $295,901.57 $295,901.57 $51,033.81 $66,343.95 $51,147.27 2026-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 5 5 $128,616.55 $128,616.55 $47,184.09 $61,339.32 $50,932.48 2026-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 5 5 $544,980.74 $544,980.74 $46,019.00 $59,824.70 $50,620.90 2026-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 5 5 $219,616.82 $219,616.82 $45,831.49 $219,616.82 $50,414.64 2026-01-01
166 MS_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 $327,572.04 $327,572.04 $45,729.73 $59,448.65 $50,302.70 2026-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 5 5 $226,844.65 $226,844.65 $45,605.09 $59,286.62 $50,165.60 2026-01-01
607 APR_DRG Minor Skin Disorders Without Mcc 3 1 $1,350,281.04 — $33,894.83 $70,859.17 $49,762.24 2026-01-01
PX-900700050 CDM Hc Surgery Level V 1st Hr 17 11 $49,450.50 $49,450.50 $101.90 $49,450.50 $49,450.50 2026-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 5 5 $327,490.75 $327,490.75 $44,481.17 $57,825.52 $48,929.29 2026-01-01
332 MS_DRG Rectal Resection With Mcc 5 5 $444,455.71 $444,455.71 $44,391.98 $57,709.57 $48,831.18 2026-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 5 5 $127,555.79 $127,555.79 $44,290.23 $57,577.30 $48,719.25 2026-01-01
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 20 11 $55,663.12 $55,663.12 $79.00 $55,663.12 $48,705.23 2026-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 5 5 $149,336.56 $149,336.56 $47,224.37 $63,111.07 $48,546.98 2026-01-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 5 5 $360,811.61 $360,811.61 $43,958.65 $57,146.25 $48,354.52 2026-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 5 5 $279,948.49 $279,948.49 $43,863.75 $57,022.88 $48,250.13 2026-01-01
J3380 HCPCS Vedolizumab 300 Mg Intravenous Solution 20 11 $55,130.78 $55,130.78 $21.31 $55,130.78 $48,239.43 2026-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 5 5 $254,453.43 $254,453.43 $43,822.58 $59,413.97 $48,204.84 2026-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 5 5 $336,652.10 $336,652.10 $43,762.00 $57,281.99 $48,138.20 2026-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 5 5 $259,519.83 $259,519.83 $43,727.69 $56,846.00 $48,100.46 2026-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 5 5 $216,188.49 $216,188.49 $43,688.83 $56,795.48 $48,057.71 2026-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 5 5 $243,714.01 $243,714.01 $43,655.67 $56,752.37 $48,021.24 2026-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 5 5 $309,250.43 $309,250.43 $44,973.96 $58,466.15 $47,905.04 2026-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 5 5 $281,096.85 $281,096.85 $43,316.09 $56,310.92 $47,647.70 2026-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 5 5 $105,364.03 $105,364.03 $43,233.75 $56,203.88 $47,557.13 2026-01-01
J3101 HCPCS Tenecteplase 50 Mg Intravenous Solution 17 11 $47,385.77 $47,385.77 $172.22 $47,385.77 $47,385.77 2026-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 5 5 $174,223.86 $174,223.86 $44,991.13 $58,488.47 $47,180.83 2026-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 5 5 $537,590.15 $537,590.15 $42,867.88 $58,676.70 $47,154.67 2026-01-01
252 MS_DRG Other Vascular Procedures With Mcc 5 5 $172,641.95 $172,641.95 $42,878.19 $55,741.65 $46,926.85 2026-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 5 5 $186,006.61 $186,006.61 $42,492.86 $55,240.72 $46,742.15 2026-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 5 $108,032.05 $108,032.05 $42,193.30 $54,851.29 $46,412.63 2026-01-01
33274 CPT Hc Transcatheter Insertion, Right Ventricular 20 11 $52,488.90 $52,488.90 $417.72 $52,488.90 $46,235.70 2026-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 5 5 $317,212.79 $317,212.79 $42,001.21 $54,601.57 $46,201.33 2026-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 5 5 $161,274.37 $161,274.37 $41,949.77 $58,898.75 $46,144.75 2026-01-01
J2323 HCPCS Natalizumab 300 Mg/15 Ml Intravenous Solution 20 11 $52,300.48 $52,300.48 $24.00 $52,300.48 $45,762.92 2026-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 5 5 $409,741.69 $409,741.69 $41,986.57 $59,442.70 $45,725.15 2026-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 5 5 $202,002.52 $202,002.52 $41,189.42 $53,546.25 $45,308.36 2026-01-01
37 MS_DRG Extracranial Procedures With Mcc 5 5 $331,234.50 $331,234.50 $40,634.88 $52,825.34 $44,698.37 2026-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 5 5 $151,214.29 $151,214.29 $43,715.09 $57,783.91 $44,449.16 2026-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 5 5 $79,879.76 $79,879.76 $40,185.55 $52,241.22 $44,204.11 2026-01-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 5 5 $55,843.30 $55,843.30 $39,980.88 $51,975.14 $43,978.97 2026-01-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 5 5 $175,441.18 $175,441.18 $39,929.42 $175,441.18 $43,922.36 2026-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 5 5 $252,701.62 $252,701.62 $39,891.70 $51,859.21 $43,880.87 2026-01-01
J1930 HCPCS Lanreotide 90 Mg/0.3 Ml Subcutaneous Syringe 20 11 $49,667.25 $49,667.25 $34.05 $49,667.25 $43,458.85 2026-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 5 5 $168,948.86 $168,948.86 $39,499.53 $53,778.51 $43,449.48 2026-01-01
955 APR_DRG Principal Diagnosis Invalid As Discharge Diagnosis,moderate 1 1 $43,380.52 — $43,380.52 $43,380.52 $43,380.52 2026-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 5 5 $475,189.83 $475,189.83 $39,323.45 $82,973.18 $43,255.80 2026-01-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 5 5 $519,837.72 $519,837.72 $39,124.50 $50,861.85 $43,036.95 2026-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 5 5 $175,433.70 $175,433.70 $42,684.93 $55,490.41 $42,950.24 2026-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 5 5 $253,908.37 $253,908.37 $39,179.37 $50,933.18 $42,947.34 2026-01-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 5 5 $211,343.60 $211,343.60 $39,004.45 $66,531.22 $42,904.90 2026-01-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 5 5 $128,351.27 $128,351.27 $38,919.82 $50,595.77 $42,811.80 2026-01-01
33221 CPT Hc Pace Ins Ex Mult Leads 20 11 $45,225.90 $45,225.90 $291.14 $45,225.90 $42,604.20 2026-01-01
33229 CPT Hc Pace Remv Repl Ex Mult Leads 20 11 $45,225.90 $45,225.90 $301.56 $45,225.90 $42,604.20 2026-01-01
665 MS_DRG Prostatectomy With Mcc 5 5 $203,185.77 $203,185.77 $38,680.88 $50,285.14 $42,548.97 2026-01-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 5 5 $352,606.02 $352,606.02 $38,543.66 $50,106.76 $42,398.03 2026-01-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 5 5 $311,108.89 $311,108.89 $39,432.06 $51,261.68 $42,371.17 2026-01-01
J0775 HCPCS Collagenase Clostridium Histolyticum 0.9 Mg Solution For Injection 20 11 $48,335.45 $48,335.45 $75.91 $48,335.45 $42,293.52 2026-01-01
974 MS_DRG HIV With Major Related Condition With Mcc 5 5 $188,074.15 $188,074.15 $40,249.34 $54,747.30 $42,113.31 2026-01-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 5 5 $246,475.34 $246,475.34 $37,674.73 $48,977.15 $41,442.20 2026-01-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 5 $196,217.92 $196,217.92 $38,606.55 $50,188.52 $41,272.52 2026-01-01
503 MS_DRG Foot Procedures With Mcc 5 5 $277,320.59 $277,320.59 $36,101.48 $53,075.06 $40,826.97 2026-01-01
472 MS_DRG Cervical Spinal Fusion With Cc 5 5 $249,656.43 $249,656.43 $36,678.85 $47,682.51 $40,346.74 2026-01-01
37231 CPT Hc Athrectomy & Stent Tibioperone 17 11 $40,090.16 $40,090.16 $22,815.81 $40,090.16 $40,090.16 2026-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 5 5 $322,973.44 $322,973.44 $38,613.71 $52,028.65 $40,022.04 2026-01-01
0823T CPT Hc Transcath Insrtn Sc Leadless Pmkr Ra 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0803T CPT Hc Transcath Rmvl Repl Dc Leadless Pmkr Rv Pm Compnt 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0802T CPT Hc Transcath Rmvl Repl Dc Leadless Pmkr Ra Pm Compnt 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0801T CPT Hc Transcath Rmvl Repl Dc Leadless Pmkr Ra Rv 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0797T CPT Hc Transcath Insrtn Dc Leadless Pmkr Rv Pm Compnt 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0796T CPT Hc Transcath Insrtn Dc Leadless Pmkr Ra Pm Compnt 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0795T CPT Hc Transcath Insrtn Dc Leadless Pmkr Ra Rv Comp Sys 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
0825T CPT Hc Transcath Rmvl Repl Sc Leadless Pmkr Ra 28 11 $33,642.79 $33,642.79 $24,231.82 $47,717.18 $39,982.50 2026-01-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 5 5 $304,074.96 $304,074.96 $36,292.38 $47,180.09 $39,921.62 2026-01-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 5 5 $251,398.51 $251,398.51 $36,174.62 $47,027.01 $39,792.08 2026-01-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 5 5 $243,219.60 $243,219.60 $36,154.03 $47,000.24 $39,769.43 2026-01-01
36905 CPT Hc Throm Dialysis Crct W Tran Bln 20 11 $45,263.42 $45,263.42 $2,072.22 $45,263.42 $39,605.49 2026-01-01
C1722 HCPCS Hc Gallant Dr Icd 96 11 $41,551.25 $41,551.25 $24,083.91 $72,047.26 $39,499.46 2026-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 5 5 $296,966.49 $296,966.49 $35,811.03 $296,966.49 $39,392.13 2026-01-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 5 5 $316,260.79 $316,260.79 $36,655.97 $47,652.76 $39,107.16 2026-01-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 5 5 $612,409.85 $612,409.85 $37,524.93 $48,782.41 $39,015.73 2026-01-01
PX-904300101 CDM Hc Trauma Activation Level B 15 11 $38,814.00 $38,814.00 $29,110.50 $38,814.00 $38,814.00 2026-01-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 5 5 $183,474.16 $183,474.16 $35,585.78 $46,261.51 $38,705.14 2026-01-01
37282 CPT Hc Ev Revasc Tpvt Uni Complex Lsn Initial Vsl 14 11 $38,665.50 $38,665.50 $7,918.69 $38,665.50 $38,665.50 2026-01-01
37280 CPT Hc Ev Revasc Tpvt Uni Strtfwrd Lsn Initial Vsl 14 11 $38,665.50 $38,665.50 $7,918.69 $38,665.50 $38,665.50 2026-01-01
37267 CPT Hc Ev Revasc Fpvt Stnt Uni Strtfwrd Lsn Initial Vsl 14 11 $38,665.50 $38,665.50 $7,918.69 $38,665.50 $38,665.50 2026-01-01
800 MS_DRG Splenic Procedures With Cc 5 5 $288,375.97 $288,375.97 $35,115.86 $45,650.62 $38,627.45 2026-01-01
654 MS_DRG Major Bladder Procedures With Cc 5 5 $347,036.47 $347,036.47 $35,000.37 $45,500.48 $38,500.41 2026-01-01
668 MS_DRG Transurethral Procedures With Mcc 5 5 $388,426.28 $388,426.28 $36,380.42 $47,294.55 $38,242.17 2026-01-01
J9273 HCPCS Tisotumab Vedotin-tftv 40 Mg Intravenous Solution 20 11 $43,595.54 $43,595.54 $188.76 $43,595.54 $38,146.10 2026-01-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 5 5 $204,153.08 $204,153.08 $34,517.87 $44,873.23 $37,969.66 2026-01-01
263 MS_DRG Vein Ligation And Stripping 5 5 $313,575.23 $313,575.23 $33,915.80 $49,336.82 $37,951.40 2026-01-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 5 5 $265,416.37 $265,416.37 $34,413.83 $44,737.98 $37,855.21 2026-01-01
299 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical,ext… 1 1 $368,040.77 — $37,707.94 $37,707.94 $37,707.94 2026-01-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 5 5 $374,976.02 $374,976.02 $34,251.46 $44,526.90 $37,676.61 2026-01-01
570 MS_DRG Skin Debridement With Mcc 5 5 $140,246.03 $140,246.03 $36,621.68 $47,608.18 $37,658.74 2026-01-01
C9602 HCPCS Hc Atherectomy W Coronary Stent 16 11 $28,242.50 $28,242.50 $21,181.88 $37,646.08 $37,646.08 2026-01-01
37230 CPT Hc Stent Tibioperoneal 16 11 $27,826.02 $27,826.02 $20,869.52 $37,646.08 $37,646.08 2026-01-01
0793T CPT Hc Perc Hc Transcath Abltn Pulm Arteries Rh Cath 16 11 $30,275.79 $30,275.79 $22,706.84 $37,646.08 $37,646.08 2026-01-01
37184 CPT Hc Prim Art Mech Thrombectomy 19 11 $11,923.38 $11,923.38 $2,026.80 $37,646.08 $37,646.08 2026-01-01
92933 CPT Hc Atherectomy W Coronary Stent 19 11 $22,248.27 $22,248.27 $540.15 $37,646.08 $37,646.08 2026-01-01
C9607 HCPCS Hc Pci Coro Bypass Chronic 1 Vsl 19 11 $27,156.26 $27,156.26 $541.18 $37,646.08 $37,646.08 2026-01-01
C9797 HCPCS Hc Vasc Embol Occ Px W Pressure Gen Cath 16 11 $37,178.25 $37,178.25 $22,815.81 $37,646.08 $37,646.08 2026-01-01
37242 CPT Hc Vasc Embol Occ Arterial 19 11 $35,516.25 $35,516.25 $428.15 $37,646.08 $37,646.08 2026-01-01
37225 CPT Hc Athrectomy Fem/Pop 16 11 $37,154.17 $37,154.17 $22,815.81 $37,646.08 $37,646.08 2026-01-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 5 5 $145,729.84 $145,729.84 $36,107.29 $48,788.35 $37,529.50 2026-01-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 5 5 $112,440.91 $112,440.91 $34,102.83 $112,440.91 $37,513.11 2026-01-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 5 5 $123,085.22 $123,085.22 $35,252.46 $48,733.37 $37,487.21 2026-01-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 5 5 $226,408.45 $226,408.45 $33,935.90 $44,116.67 $37,329.49 2026-01-01
0237T CPT Hc Athrectomy Brachiocephalic 17 11 $37,178.25 $37,178.25 $14,409.33 $37,178.25 $37,178.25 2026-01-01
0236T CPT Hc Athrectomy Aorta 17 11 $37,178.25 $37,178.25 $14,409.33 $37,178.25 $37,178.25 2026-01-01
0234T CPT Hc Athrectomy Renal 17 11 $37,178.25 $37,178.25 $14,409.33 $37,178.25 $37,178.25 2026-01-01
37221 CPT Hc Stent Iliac 17 11 $37,154.17 $37,154.17 $14,409.33 $37,154.17 $37,154.17 2026-01-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 5 5 $147,376.37 $147,376.37 $33,835.28 $43,985.86 $36,504.95 2026-01-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 5 5 $156,067.34 $156,067.34 $33,149.26 $43,094.04 $36,464.19 2026-01-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 5 5 $246,235.10 $246,235.10 $34,959.30 $46,726.77 $35,943.67 2026-01-01
253 MS_DRG Other Vascular Procedures With Cc 5 5 $171,280.56 $171,280.56 $32,671.33 $42,472.73 $35,938.46 2026-01-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 5 5 $287,484.19 $287,484.19 $32,524.99 $42,282.49 $35,777.49 2026-01-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 5 5 $83,645.95 $83,645.95 $32,351.19 $42,056.55 $35,586.31 2026-01-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 5 5 $508,630.01 $508,630.01 $33,301.32 $43,291.72 $35,448.39 2026-01-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 5 5 $99,087.59 $99,087.59 $32,184.26 $41,839.54 $35,402.69 2026-01-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 5 5 $423,357.17 $423,357.17 $32,045.92 $49,531.96 $35,250.51 2026-01-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 5 5 $162,276.64 $162,276.64 $34,687.09 $45,093.22 $35,219.08 2026-01-01
164 MS_DRG Major Chest Procedures With Cc 5 5 $256,300.03 $256,300.03 $31,852.69 $41,408.50 $35,037.96 2026-01-01
J9063 HCPCS Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 20 11 $39,954.17 $39,954.17 $69.49 $39,954.17 $34,959.90 2026-01-01
608 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,minor 1 1 $671,743.94 — $34,699.31 $34,699.31 $34,699.31 2026-01-01
37226 CPT Hc Stent Fem/Pop 17 11 $34,688.08 $34,688.08 $14,409.33 $34,688.08 $34,688.08 2026-01-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 5 5 $196,350.23 $196,350.23 $31,485.67 $40,931.37 $34,634.24 2026-01-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 5 5 $100,313.81 $100,313.81 $32,635.90 $42,426.67 $34,547.12 2026-01-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 5 5 $274,210.16 $274,210.16 $34,364.26 $44,748.35 $34,421.81 2026-01-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 5 5 $163,932.97 $163,932.97 $31,840.09 $41,392.12 $34,345.39 2026-01-01
545 MS_DRG Connective Tissue Disorders With Mcc 5 5 $86,500.07 $86,500.07 $31,369.05 $40,779.77 $34,300.40 2026-01-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 5 5 $221,654.40 $221,654.40 $31,103.77 $40,434.90 $34,214.15 2026-01-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 5 5 $140,940.64 $140,940.64 $31,064.91 $140,940.64 $34,171.40 2026-01-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 5 5 $150,968.66 $150,968.66 $32,483.84 $42,228.99 $34,126.24 2026-01-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 5 5 $359,046.40 $359,046.40 $30,402.91 $39,523.78 $33,443.20 2026-01-01
397 MS_DRG Appendix Procedures With Mcc 5 5 $205,338.72 $205,338.72 $30,376.59 $205,338.72 $33,414.25 2026-01-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 5 5 $243,935.87 $243,935.87 $30,279.40 $39,363.22 $33,307.34 2026-01-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 5 5 $187,962.18 $187,962.18 $30,907.11 $40,179.24 $33,258.36 2026-01-01
PX-900700040 CDM Hc Surgery Level IV 1st Hr 17 11 $33,216.70 $33,216.70 $101.90 $33,216.70 $33,216.70 2026-01-01
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 20 11 $37,876.20 $37,876.20 $17.02 $37,876.20 $33,141.68 2026-01-01
37244 CPT Hc Vasc Embol Occ Art Ven Hem Lym Extrvst 20 11 $37,440.70 $37,440.70 $595.31 $37,440.70 $32,760.61 2026-01-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 5 5 $119,256.11 $119,256.11 $29,732.89 $38,652.76 $32,706.18 2026-01-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 5 5 $242,537.42 $242,537.42 $29,713.45 $38,627.49 $32,684.80 2026-01-01
910 APR_DRG Craniotomy For Multiple Significant Trauma,minor 2 1 $717,052.35 — $24,228.86 $40,915.21 $32,572.03 2026-01-01
709 MS_DRG Penis Procedures With Cc/mcc 5 5 $427,314.86 $427,314.86 $29,601.39 $38,481.81 $32,561.53 2026-01-01
J9332 HCPCS Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 20 11 $37,197.64 $37,197.64 $32.15 $37,197.64 $32,547.93 2026-01-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 5 5 $114,163.00 $114,163.00 $31,111.77 $40,445.30 $32,489.16 2026-01-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 5 5 $85,472.43 $85,472.43 $32,193.09 $42,228.99 $32,483.84 2026-01-01
J9330 HCPCS Temsirolimus 30 Mg/3 Ml (10 Mg/ml) (first Dilution) Intravenous Soln 20 11 $37,120.04 $37,120.04 $26.71 $37,120.04 $32,480.03 2026-01-01
36903 CPT Hc Cath Dialysis Crct W Stnt Plc 20 11 $37,106.23 $37,106.23 $5,174.97 $37,106.23 $32,467.95 2026-01-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 5 5 $134,111.52 $134,111.52 $29,419.60 $38,245.48 $32,361.56 2026-01-01
347 MS_DRG Anal And Stomal Procedures With Mcc 5 5 $70,263.29 $70,263.29 $29,241.24 $38,163.80 $32,165.36 2026-01-01
PX-902341223 CDM Hc Room Picu Isolation 18 11 $32,049.60 $32,049.60 $24,037.20 $32,049.60 $32,049.60 2026-01-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 5 5 $196,251.33 $196,251.33 $31,981.20 $41,588.34 $31,991.03 2026-01-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 5 5 $154,015.50 $154,015.50 $29,081.16 $154,015.50 $31,989.28 2026-01-01
27827 CPT Hc Open Treatment Fx Distal Tibia Only 20 11 $36,559.00 $36,559.00 $903.94 $36,559.00 $31,989.12 2026-01-01
113 MS_DRG Orbital Procedures With Cc/mcc 5 5 $158,227.89 $158,227.89 $29,875.81 $38,838.55 $31,741.73 2026-01-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 5 5 $101,695.38 $101,695.38 $28,898.22 $37,567.69 $31,712.70 2026-01-01
792 MS_DRG Prematurity Without Major Problems 4 4 $12,572.43 $12,572.43 $30,997.45 $34,097.20 $31,682.35 2026-01-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 5 5 $322,841.02 $322,841.02 $28,589.53 $37,166.39 $31,448.48 2026-01-01
33208 CPT Hc Pacer Insert/Rpl, W A & V Lead 20 11 $35,935.16 $35,935.16 $744.60 $35,935.16 $31,443.26 2026-01-01
167 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures,extreme 2 1 $441,816.28 — $24,075.88 $38,790.22 $31,433.05 2026-01-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 5 5 $424,620.86 $424,620.86 $28,574.64 $37,147.03 $31,432.10 2026-01-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 5 5 $232,837.11 $232,837.11 $29,126.89 $37,864.96 $31,255.54 2026-01-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 5 5 $137,261.74 $137,261.74 $29,013.71 $37,717.82 $31,241.03 2026-01-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 5 5 $199,360.26 $199,360.26 $28,294.53 $36,782.89 $31,123.98 2026-01-01
J9271 HCPCS Pembrolizumab 25 Mg/ml Intravenous Solution 20 11 $35,439.96 $35,439.96 $60.29 $35,439.96 $31,009.97 2026-01-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 5 5 $221,608.88 $221,608.88 $28,133.32 $36,573.32 $30,946.65 2026-01-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 5 5 $269,325.36 $269,325.36 $30,712.75 $40,222.35 $30,940.27 2026-01-01
30 MS_DRG Spinal Procedures Without Cc/mcc 5 5 $181,862.80 $181,862.80 $28,093.30 $36,521.29 $30,902.63 2026-01-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 5 5 $83,598.97 $83,598.97 $28,238.50 $36,710.05 $30,892.71 2026-01-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 5 5 $274,817.57 $274,817.57 $28,054.42 $36,470.75 $30,859.86 2026-01-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 5 5 $237,504.85 $237,504.85 $28,009.83 $36,412.78 $30,810.81 2026-01-01
0235T CPT Hc Athrectomy Visceral 14 11 $30,747.70 $30,747.70 $6,297.13 $30,747.70 $30,747.70 2026-01-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 5 5 $124,921.94 $124,921.94 $27,948.08 $36,368.53 $30,742.89 2026-01-01
141 MS_DRG Major Head And Neck Procedures With Cc 5 5 $267,753.00 $267,753.00 $27,932.08 $267,753.00 $30,725.29 2026-01-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 5 5 $151,069.48 $151,069.48 $27,905.77 $36,277.50 $30,696.35 2026-01-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 5 5 $100,149.57 $100,149.57 $27,888.63 $36,255.22 $30,677.49 2026-01-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 5 5 $186,295.40 $186,295.40 $27,805.16 $36,146.71 $30,585.68 2026-01-01
C9608 HCPCS Hc Pci Coro Bypass Chronic Add 16 11 $30,583.30 $30,583.30 $22,937.48 $30,583.30 $30,583.30 2026-01-01
61626 CPT Hc Embolization, Extracranial 20 11 $34,848.00 $34,848.00 $678.33 $34,848.00 $30,492.00 2026-01-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 5 5 $184,848.82 $184,848.82 $29,583.09 $38,458.02 $30,477.63 2026-01-01
612 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 1 $603,810.47 — $19,933.97 $43,759.44 $30,278.08 2026-01-01
PX-902341726 CDM Hc Room Picu Trauma 18 11 $30,241.20 $30,241.20 $22,680.90 $30,241.20 $30,241.20 2026-01-01
C9603 HCPCS Hc Atherectomy W Coro Stent Add 19 11 $30,118.40 $30,118.40 $540.15 $30,118.40 $30,118.40 2026-01-01
32 MS_DRG Ventricular Shunt Procedures With Cc 5 5 $318,237.71 $318,237.71 $27,359.25 $35,567.03 $30,095.18 2026-01-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 5 5 $148,330.10 $148,330.10 $27,358.12 $37,861.93 $30,093.93 2026-01-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 5 5 $276,610.18 $276,610.18 $27,347.81 $35,552.15 $30,082.59 2026-01-01
130 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours,minor 2 1 $456,699.59 — $25,738.12 $34,417.70 $30,077.91 2026-01-01
169 APR_DRG Major Abdominal Vascular Procedures,minor 2 1 $326,091.09 — $24,252.45 $35,683.41 $29,967.93 2026-01-01
595 MS_DRG Major Skin Disorders With Mcc 5 5 $47,050.14 $47,050.14 $27,241.48 $35,413.92 $29,965.63 2026-01-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 5 5 $238,631.38 $238,631.38 $27,207.19 $238,631.38 $29,927.91 2026-01-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 5 5 $262,190.09 $262,190.09 $27,104.28 $35,235.56 $29,814.71 2026-01-01
333 MS_DRG Rectal Resection With Cc 5 5 $263,925.75 $263,925.75 $28,917.18 $38,706.25 $29,774.04 2026-01-01
655 MS_DRG Major Bladder Procedures Without Cc/mcc 5 5 $117,447.60 $117,447.60 $27,194.60 $35,352.98 $29,746.17 2026-01-01
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