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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

EDEN MEDICAL CENTER

Castro Valley, CA · CCN 050488 · Rates published

8,594 distinct procedures filed
10 distinct payers
85,060 rate rows
2026-04-01 last MRF observed
Data quality

44,238 of 85,060 rate rows are consumer-grade (52.0%)

40,822 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 40,802
placeholder amount (≤ $0.02) — excluded from medians 20
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/940562680-1063812907_eden-medical-center_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 3f0be86f3c37c473… · 18,037,863 bytes · first seen 2026-05-17

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 $1,476,857.10 nat. median
$754,974
2.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $533,230.17 $1,340,483.41 $1,340,483.41 nat. median
$634,511
outlier · 2.1×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 7 $470,742.86 $470,742.86 $470,742.86 nat. median
$370,174
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 9 $109,090.39 $533,607.00 $377,407.50 nat. median
$99,019
outlier · 3.8×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 7 $305,742.96 $305,742.96 $305,742.96 nat. median
$265,286
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $107,194.28 $411,119.00 $262,097.00 nat. median
$93,672
outlier · 2.8×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 9 $86,360.98 $414,588.00 $260,135.50 nat. median
$77,576
outlier · 3.4×
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 9 $35,296.56 $414,588.00 $260,135.50 nat. median
$34,274
outlier · 7.6×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 7 $233,105.09 $233,105.09 $233,105.09 nat. median
$206,368
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $192,388.99 $231,741.23 $231,741.23 nat. median
$202,986
1.1× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $72,281.64 $341,227.00 $227,916.00 nat. median
$64,510
outlier · 3.5×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 9 $98,778.24 $351,279.00 $223,950.50 nat. median
$82,712
outlier · 2.7×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $120,673.88 $351,279.00 $223,950.50 nat. median
$98,905
outlier · 2.3×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $72,281.64 $320,672.00 $215,253.50 nat. median
$61,920
outlier · 3.5×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 9 $78,323.73 $325,194.00 $212,128.50 nat. median
$68,887
outlier · 3.1×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 9 $66,701.06 $315,727.00 $211,096.50 nat. median
$59,899
outlier · 3.5×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 9 $92,468.38 $311,639.00 $208,670.50 nat. median
$79,312
outlier · 2.6×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 9 $67,417.27 $436,419.00 $206,804.50 nat. median
$60,726
outlier · 3.4×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 $65,618.03 $307,570.00 $195,802.50 nat. median
$58,024
outlier · 3.4×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 $92,179.94 $307,570.00 $195,802.50 nat. median
$81,118
outlier · 2.4×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 9 $46,129.00 $307,570.00 $195,802.50 nat. median
$42,730
outlier · 4.6×
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×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 9 $58,332.91 $310,887.00 $192,174.00 nat. median
$54,066
outlier · 3.6×
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×
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $56,824.55 $189,311.16 $189,311.16 nat. median
$62,507
outlier · 3.0×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 $84,287.45 $295,319.00 $188,373.50 nat. median
$74,915
outlier · 2.5×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 9 $83,927.17 $278,368.00 $177,393.00 nat. median
$73,807
outlier · 2.4×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 9 $60,171.34 $278,368.00 $177,393.00 nat. median
$53,268
outlier · 3.3×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 9 $66,091.52 $275,916.00 $175,912.00 nat. median
$59,099
outlier · 3.0×
209
MS_DRG 		Complex Aortic Arch Procedures 8 $123,913.16 $266,222.00 $173,063.00 nat. median
$98,017
1.8× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $79,283.76 $243,801.00 $164,910.00 nat. median
$68,090
outlier · 2.4×
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 9 $34,992.88 $231,802.00 $158,633.50 nat. median
$33,154
outlier · 4.8×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 9 $73,438.68 $282,353.00 $156,374.50 nat. median
$63,738
outlier · 2.5×
24
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 $43,136.00 $240,030.00 $155,857.00 nat. median
$38,489
outlier · 4.0×
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 9 $63,484.64 $227,150.00 $154,901.50 nat. median
$54,596
outlier · 2.8×
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 9 $50,982.48 $242,459.00 $153,752.50 nat. median
$46,109
outlier · 3.3×
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 9 $54,562.46 $228,310.00 $152,359.00 nat. median
$50,673
outlier · 3.0×
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 9 $58,722.58 $268,566.00 $152,340.00 nat. median
$51,319
outlier · 3.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 7 $151,479.72 $151,479.72 $151,479.72 nat. median
$133,176
1.1× median
402
MS_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 9 $44,473.44 $219,136.00 $149,568.00 nat. median
$39,420
outlier · 3.8×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $146,326.57 $146,326.57 $146,326.57 nat. median
$76,377
1.9× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 9 $52,531.37 $229,372.00 $145,825.00 nat. median
$47,651
outlier · 3.1×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 2 $63,342.28 $145,441.90 $145,441.90 nat. median
$69,774
outlier · 2.1×
7
MS_DRG 		Lung Transplant 7 $141,670.44 $141,670.44 $141,670.44 nat. median
$122,708
1.2× median
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $61,905.27 $203,151.00 $141,668.00 nat. median
$54,211
outlier · 2.6×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 9 $73,492.02 $208,354.00 $139,470.00 nat. median
$60,691
outlier · 2.3×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 9 $75,575.35 $209,543.00 $133,642.00 nat. median
$65,950
outlier · 2.0×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 9 $60,256.24 $183,808.00 $132,511.00 nat. median
$52,836
outlier · 2.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 7 $131,522.64 $131,522.64 $131,522.64 nat. median
$117,303
1.1× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 3 $55,272.32 $162,691.22 $131,139.34 nat. median
$66,682
2.0× median

Other procedures at this hospital

Browse this hospital's 8,594 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 14 7 — — $305,742.96 $305,742.96 $305,742.96 2026-04-01
10 MS_DRG Pancreas Transplant 14 7 — — $78,816.81 $78,816.81 $78,816.81 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 14 7 — — $60,077.73 $60,077.73 $60,077.73 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 14 7 — — $46,601.40 $46,601.40 $46,601.40 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 4 1 — — $49,308.00 $68,486.00 $58,897.00 2026-04-01
132 MS_DRG Cranial/Facial Procedures Without Cc/Mcc 10 3 — — $33,844.00 $49,436.00 $44,389.00 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 14 7 — — $131,522.64 $131,522.64 $131,522.64 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 16 7 — — $47,138.01 $149,774.07 $47,138.01 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 18 7 — — $41,492.12 $101,416.00 $41,492.12 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 14 7 — — $65,254.49 $65,254.49 $65,254.49 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 34 9 — — $49,494.55 $158,698.00 $122,199.00 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 32 9 — — $28,184.50 $75,301.00 $54,284.50 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 34 9 — — $21,547.02 $59,914.00 $46,133.00 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 14 7 — — $41,395.25 $41,395.25 $41,395.25 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 14 7 — — $59,840.44 $59,840.44 $59,840.44 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 14 7 — — $33,108.74 $33,108.74 $33,108.74 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 14 7 — — $470,742.86 $470,742.86 $470,742.86 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 7 — — $78,369.45 $78,369.45 $78,369.45 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 7 — — $124,054.66 $124,054.66 $124,054.66 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 32 9 — — $86,360.98 $414,588.00 $260,135.50 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 18 7 — — $70,751.25 $257,828.00 $70,751.25 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 30 8 — — $123,913.16 $266,222.00 $173,063.00 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 34 9 — — $58,332.91 $310,887.00 $192,174.00 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 14 7 — — $119,072.74 $119,072.74 $119,072.74 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 30 8 — — $62,829.38 $129,109.00 $83,755.00 2026-04-01
215 MS_DRG Other Heart Assist System Implant 32 9 — — $109,090.39 $533,607.00 $377,407.50 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 9 — — $107,194.28 $411,119.00 $262,097.00 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 9 — — $72,281.64 $341,227.00 $227,916.00 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 9 — — $72,281.64 $320,672.00 $215,253.50 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 9 — — $84,287.45 $295,319.00 $188,373.50 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 32 9 — — $35,296.56 $414,588.00 $260,135.50 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 9 — — $58,757.42 $183,588.00 $125,548.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 9 — — $55,572.56 $167,382.00 $114,544.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 32 9 — — $54,562.46 $228,310.00 $152,359.00 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 32 9 — — $34,992.88 $231,802.00 $158,633.50 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 40 10 — — $62,955.63 $243,357.00 $121,080.93 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 4 1 — — $159,032.00 $220,890.00 $189,961.00 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 32 9 — — $92,468.38 $311,639.00 $208,670.50 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 32 9 — — $66,701.06 $315,727.00 $211,096.50 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 32 9 — — $83,927.17 $278,368.00 $177,393.00 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 32 9 — — $60,171.34 $278,368.00 $177,393.00 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 32 9 — — $64,589.43 $203,824.00 $129,851.00 2026-04-01
23515 HCPCS Treat Clavicle Fracture 10 4 — — $10,317.50 $41,716.00 $36,813.00 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 32 9 — — $46,305.33 $183,626.00 $129,851.00 2026-04-01
23615 HCPCS Treat Humerus Fracture 10 4 — — $18,255.12 $55,255.00 $48,763.00 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 14 7 — — $54,282.72 $54,282.72 $54,282.72 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 34 10 — — $43,136.00 $240,030.00 $155,857.00 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 32 9 — — $35,464.18 $163,692.00 $108,666.50 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 32 9 — — $23,905.73 $122,131.00 $77,848.50 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 32 9 — — $20,385.62 $92,805.00 $62,425.50 2026-04-01
245 MS_DRG Aicd Generator Procedures 14 7 — — $50,371.85 $50,371.85 $50,371.85 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 38 10 — — $38,291.92 $163,471.00 $107,283.00 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 32 9 — — $24,467.38 $90,885.00 $57,958.50 2026-04-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 32 9 — — $16,978.72 $74,671.00 $47,145.50 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 36 10 — — $37,746.73 $146,761.00 $74,335.62 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 34 10 — — $28,963.85 $98,227.00 $63,807.00 2026-04-01
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 32 9 — — $20,104.80 $75,360.00 $48,119.50 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 32 9 — — $34,912.33 $83,123.00 $53,076.50 2026-04-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 32 9 — — $22,721.48 $83,123.00 $53,076.50 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 36 10 — — $34,554.22 $106,164.00 $66,942.50 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 32 9 — — $36,117.26 $72,298.00 $46,228.50 2026-04-01
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 32 9 — — $21,289.05 $72,298.00 $46,228.50 2026-04-01
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 32 9 — — $18,452.50 $72,298.00 $46,228.50 2026-04-01
263 MS_DRG Vein Ligation And Stripping 14 7 — — $33,990.40 $33,990.40 $33,990.40 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 18 7 — — $37,072.94 $95,518.00 $37,072.94 2026-04-01
265 MS_DRG Aicd Lead Procedures 14 7 — — $40,094.53 $40,094.53 $40,094.53 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 32 9 — — $67,417.27 $436,419.00 $206,804.50 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 32 9 — — $52,531.37 $229,372.00 $145,825.00 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 32 9 — — $75,575.35 $209,543.00 $133,642.00 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 34 10 — — $12,598.00 $128,461.00 $75,189.00 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 34 10 — — $28,172.53 $98,073.00 $73,378.00 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 32 9 — — $58,142.43 $168,499.00 $115,028.00 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 32 9 — — $39,420.77 $120,510.00 $77,873.50 2026-04-01
27130 HCPCS Total Hip Arthroplasty 6 2 — — $18,255.12 $63,249.00 $63,249.00 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 32 9 — — $28,500.16 $115,067.00 $64,601.50 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 32 9 — — $45,616.33 $97,942.00 $69,422.50 2026-04-01
27380 HCPCS Repair Of Kneecap Tendon 14 5 — — $10,317.50 $41,185.00 $36,615.00 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 32 9 — — $36,540.68 $90,885.00 $60,972.00 2026-04-01
27427 HCPCS Reconstruction Knee 14 5 — — $10,317.50 $45,428.00 $43,269.00 2026-04-01
27447 HCPCS Total Knee Arthroplasty 6 2 — — $18,255.12 $64,740.00 $64,740.00 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 32 9 — — $78,323.73 $325,194.00 $212,128.50 2026-04-01
27524 HCPCS Treat Kneecap Fracture 14 5 — — $10,317.50 $41,400.00 $37,752.00 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 32 9 — — $66,091.52 $275,916.00 $175,912.00 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 32 9 — — $50,982.48 $242,459.00 $153,752.50 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 7 — — $61,297.90 $61,297.90 $61,297.90 2026-04-01
27814 HCPCS Treatment Of Ankle Fracture 14 5 — — $10,317.50 $44,925.00 $39,943.00 2026-04-01
27829 HCPCS Treat Lower Leg Joint 14 5 — — $10,317.50 $41,626.00 $37,006.00 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 7 — — $39,966.09 $39,966.09 $39,966.09 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 32 9 — — $66,110.02 $187,485.00 $119,449.00 2026-04-01
28297 HCPCS Correction Hallux Valgus 10 4 — — $18,255.12 $41,948.00 $37,020.00 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 32 9 — — $24,797.19 $74,542.00 $47,470.00 2026-04-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 32 9 — — $12,359.25 $56,774.00 $36,156.00 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 34 9 — — $36,949.92 $100,553.00 $65,854.00 2026-04-01
29916 HCPCS Hip Arthro W/labral Repair 10 4 — — $10,317.50 $48,425.00 $41,728.00 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 8 — — $192,388.99 $231,741.23 $231,741.23 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 34 9 — — $24,605.62 $88,843.00 $61,138.00 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 32 9 — — $49,480.40 $134,179.00 $85,521.50 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 32 9 — — $73,492.02 $208,354.00 $139,470.00 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 30 8 — — $27,076.44 $81,897.00 $53,145.00 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 28 9 — — $49,288.82 $182,013.00 $94,719.91 2026-04-01
32 MS_DRG Ventricular Shunt Procedures With Cc 32 9 — — $23,906.82 $119,247.00 $82,042.00 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 28 9 — — $26,892.49 $104,205.00 $53,565.24 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 32 9 — — $30,326.61 $154,635.00 $98,456.00 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 32 9 — — $19,901.26 $126,540.00 $80,748.50 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 14 7 — — $47,813.95 $47,813.95 $47,813.95 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 14 7 — — $35,009.20 $35,009.20 $35,009.20 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 14 7 — — $35,655.75 $35,655.75 $35,655.75 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 14 7 — — $54,997.84 $54,997.84 $54,997.84 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 8 — — $32,074.00 $50,743.02 $50,743.02 2026-04-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/Mcc 32 9 — — $18,811.70 $72,298.00 $46,228.50 2026-04-01
332 MS_DRG Rectal Resection With Mcc 14 7 — — $40,121.74 $40,121.74 $40,121.74 2026-04-01
334 MS_DRG Rectal Resection Without Cc/Mcc 32 9 — — $18,539.58 $45,779.00 $33,180.50 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 32 9 — — $39,579.68 $115,294.00 $83,120.50 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 32 9 — — $23,664.09 $66,822.00 $48,174.50 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 14 7 — — $42,842.91 $42,842.91 $42,842.91 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 28 9 — — $32,298.92 $70,764.00 $43,393.96 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 8 — — $48,525.81 $59,566.00 $48,525.81 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 30 8 — — $38,139.64 $139,144.00 $90,441.00 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 30 8 — — $26,990.45 $114,017.00 $74,264.00 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 34 9 — — $36,545.03 $99,461.00 $64,318.00 2026-04-01
38 MS_DRG Extracranial Procedures With Cc 32 9 — — $18,373.05 $74,507.00 $50,396.00 2026-04-01
39 MS_DRG Extracranial Procedures Without Cc/Mcc 34 9 — — $13,506.50 $52,820.00 $33,534.00 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 32 9 — — $26,779.29 $70,496.00 $45,924.00 2026-04-01
398 MS_DRG Appendix Procedures With Cc 38 10 — — $16,767.63 $56,774.00 $32,882.00 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 14 7 — — $151,479.72 $151,479.72 $151,479.72 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 32 9 — — $42,739.51 $178,051.00 $128,362.00 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 32 9 — — $44,473.44 $219,136.00 $149,568.00 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 32 9 — — $60,256.24 $183,808.00 $132,511.00 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 32 9 — — $32,279.32 $83,930.00 $60,506.50 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 32 9 — — $24,871.20 $54,351.00 $39,184.00 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 18 7 — — $39,521.99 $118,188.00 $39,521.99 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 32 9 — — $24,643.71 $107,384.00 $73,266.00 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 14 7 — — $36,666.94 $36,666.94 $36,666.94 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 18 7 — — $39,489.34 $106,517.00 $39,489.34 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 36 10 — — $13,347.00 $70,664.00 $44,760.00 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 40 10 — — $13,746.00 $70,664.00 $44,760.00 2026-04-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 32 9 — — $19,517.03 $80,966.00 $56,077.00 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 14 7 — — $37,796.77 $37,796.77 $37,796.77 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 8 — — $45,915.66 $64,842.75 $45,915.66 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 9 — — $120,673.88 $351,279.00 $223,950.50 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 9 — — $79,283.76 $243,801.00 $164,910.00 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 9 — — $61,905.27 $203,151.00 $141,668.00 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 32 9 — — $98,778.24 $351,279.00 $223,950.50 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 32 9 — — $63,484.64 $227,150.00 $154,901.50 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 32 9 — — $73,438.68 $282,353.00 $156,374.50 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 32 9 — — $46,871.34 $202,907.00 $118,986.00 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 32 9 — — $58,722.58 $268,566.00 $152,340.00 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 32 9 — — $35,873.45 $165,463.00 $104,448.50 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 9 — — $92,179.94 $307,570.00 $195,802.50 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 9 — — $65,618.03 $307,570.00 $195,802.50 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 32 9 — — $46,129.00 $307,570.00 $195,802.50 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $192,725.00 $192,725.00 $192,725.00 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 4 2 — — $92,279.23 $144,893.00 $118,586.11 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 32 9 — — $60,827.68 $167,674.00 $106,988.00 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 34 10 — — $29,664.82 $150,671.00 $87,888.00 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 18 7 — — $62,748.83 $214,679.00 $62,748.83 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 8 — — $30,297.18 $81,039.00 $34,614.09 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 32 9 — — $57,370.71 $113,324.00 $75,702.50 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 32 9 — — $39,097.49 $136,629.00 $87,084.50 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 32 9 — — $30,622.67 $105,073.00 $70,637.00 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 34 10 — — $22,245.00 $107,835.00 $63,153.00 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 32 9 — — $21,707.03 $93,924.00 $62,490.50 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 34 10 — — $38,585.16 $122,600.00 $77,991.00 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 34 9 — — $31,786.28 $95,168.00 $61,707.00 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 32 9 — — $27,284.34 $80,633.00 $49,707.50 2026-04-01
47382 HCPCS Percut Ablate Liver Rf 10 4 — — $8,596.04 $36,568.00 $32,289.00 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 18 7 — — $47,438.43 $128,369.00 $47,438.43 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 18 7 — — $38,313.79 $89,645.00 $38,313.79 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 36 10 — — $63.75 $114,329.12 $65,950.00 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 40 10 — — $22,922.74 $103,546.00 $65,950.00 2026-04-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 34 9 — — $17,721.63 $69,643.00 $40,740.00 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 32 9 — — $30,882.82 $93,948.00 $59,852.00 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 18 7 — — $35,837.53 $100,097.00 $35,837.53 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 34 10 — — $40,675.77 $114,064.77 $59,666.00 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 36 9 — — $28,316.21 $97,969.15 $40,863.50 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 32 9 — — $40,176.16 $98,644.00 $62,811.00 2026-04-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 32 9 — — $20,346.44 $81,423.00 $54,477.00 2026-04-01
49653 HCPCS Lap Vent/abd Hern Proc Comp 2 1 — — $32,953.00 $32,953.00 $32,953.00 2026-04-01
49656 HCPCS Lap Inc Hernia Repair Recur 2 1 — — $52,171.00 $52,171.00 $52,171.00 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 32 9 — — $33,548.48 $66,375.00 $42,434.00 2026-04-01
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 32 9 — — $22,642.02 $58,149.00 $38,864.50 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 14 7 — — $112,938.13 $112,938.13 $112,938.13 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 14 7 — — $35,159.41 $35,159.41 $35,159.41 2026-04-01
501 MS_DRG Soft Tissue Procedures With Cc 32 9 — — $19,739.07 $47,206.00 $34,031.00 2026-04-01
503 MS_DRG Foot Procedures With Mcc 32 9 — — $31,091.80 $61,677.00 $39,462.00 2026-04-01
504 MS_DRG Foot Procedures With Cc 34 10 — — $13,347.00 $61,677.00 $36,257.00 2026-04-01
5045 OTHER Trauma Response With Critical Care 2 1 — — $45,867.32 $45,867.32 $45,867.32 2026-04-01
505 MS_DRG Foot Procedures Without Cc/Mcc 32 9 — — $20,225.62 $50,095.00 $33,597.00 2026-04-01
50544 HCPCS Laparoscopy Pyeloplasty 14 5 — — $15,114.39 $68,899.00 $65,254.00 2026-04-01
506 MS_DRG Major Thumb Or Joint Procedures 32 9 — — $15,397.17 $55,405.00 $36,879.00 2026-04-01
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/Mcc 32 9 — — $20,373.65 $59,024.00 $37,642.00 2026-04-01
508 MS_DRG Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc 32 9 — — $17,195.32 $59,024.00 $37,642.00 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 32 9 — — $33,588.75 $65,274.00 $44,304.50 2026-04-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 32 9 — — $23,345.17 $49,430.00 $34,956.50 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 12 5 — — $1,532.13 $61,261.96 $41,885.24 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 20 7 — — $8,358.00 $92,202.00 $35,399.96 2026-04-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 36 10 — — $23,331.02 $68,246.59 $39,131.00 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 34 10 — — $41,390.90 $76,178.00 $51,802.56 2026-04-01
5184 OTHER Level 4 Vascular Procedures 10 4 — — $1,093.08 $95,085.16 $89,581.90 2026-04-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 32 9 — — $22,483.10 $67,038.00 $46,264.00 2026-04-01
5362 OTHER Level 2 Laparoscopy And Related Services 12 5 — — $1,376.08 $89,729.17 $36,490.50 2026-04-01
5432 OTHER Level 2 Nerve Procedures 2 1 — — $40,319.02 $40,319.02 $40,319.02 2026-04-01
55866 HCPCS Laparo Radical Prostatectomy 14 5 — — $15,114.39 $69,572.00 $65,254.00 2026-04-01
5623 OTHER Level 3 Radiation Therapy 10 3 — — $8,469.42 $73,573.02 $46,847.18 2026-04-01
5691 OTHER Level 1 Drug Administration 2 1 — — $33,084.27 $33,084.27 $33,084.27 2026-04-01
570 MS_DRG Skin Debridement With Mcc 16 8 — — $8,898.00 $32,724.51 $32,724.51 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 14 7 — — $72,021.50 $72,021.50 $72,021.50 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 14 7 — — $38,496.66 $38,496.66 $38,496.66 2026-04-01
57425 HCPCS Laparoscopy Surg Colpopexy 14 5 — — $15,114.39 $43,300.00 $39,484.00 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 14 7 — — $54,059.58 $54,059.58 $54,059.58 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 32 9 — — $29,563.59 $80,847.00 $58,288.00 2026-04-01
578 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc 32 9 — — $18,196.71 $47,334.00 $34,122.00 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 34 10 — — $249.54 $51,364.00 $35,961.61 2026-04-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 32 9 — — $19,520.29 $68,747.00 $39,379.00 2026-04-01
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc 32 9 — — $16,419.24 $56,142.00 $38,037.50 2026-04-01
582 MS_DRG Mastectomy For Malignancy With Cc/Mcc 32 9 — — $21,681.99 $67,463.00 $46,738.50 2026-04-01
583 MS_DRG Mastectomy For Malignancy Without Cc/Mcc 32 9 — — $19,481.11 $52,220.00 $36,038.50 2026-04-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc 32 9 — — $24,012.40 $69,626.00 $48,278.00 2026-04-01
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc 32 9 — — $21,709.20 $59,265.00 $40,020.50 2026-04-01
58544 HCPCS Lsh W/t/o Uterus Above 250 G 14 5 — — $15,114.39 $59,137.00 $53,926.00 2026-04-01
58546 HCPCS Laparo-myomectomy Complex 14 5 — — $15,114.39 $72,146.00 $65,788.00 2026-04-01
58571 HCPCS Tlh W/t/o 250 G Or Less 14 5 — — $15,114.39 $44,246.00 $37,248.00 2026-04-01
58573 HCPCS Tlh W/t/o Uterus Over 250 G 14 5 — — $15,114.39 $47,427.00 $41,332.00 2026-04-01
59151 HCPCS Treat Ectopic Pregnancy 14 5 — — $8,596.04 $38,681.00 $36,568.00 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 14 7 — — $51,183.85 $51,183.85 $51,183.85 2026-04-01
60220 HCPCS Partial Removal Of Thyroid 14 5 — — $8,596.04 $36,061.00 $32,883.00 2026-04-01
60240 HCPCS Removal Of Thyroid 10 4 — — $8,596.04 $38,799.00 $33,434.00 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 28 9 — — $30,721.72 $102,102.00 $54,670.86 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 14 7 — — $38,670.81 $38,670.81 $38,670.81 2026-04-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 34 10 — — $21,069.18 $52,477.00 $35,592.00 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 20 7 — — $15,919.27 $106,125.00 $39,452.33 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 14 7 — — $33,584.40 $33,584.40 $33,584.40 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 18 7 — — $41,276.61 $108,019.00 $41,276.61 2026-04-01
63042 HCPCS Laminotomy Single Lumbar 14 5 — — $10,317.50 $41,121.00 $37,498.00 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 14 7 — — $51,884.82 $51,884.82 $51,884.82 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 14 7 — — $41,048.03 $41,048.03 $41,048.03 2026-04-01
652 MS_DRG Kidney Transplant 14 7 — — $35,863.65 $35,863.65 $35,863.65 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 14 7 — — $57,272.74 $57,272.74 $57,272.74 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 18 7 — — $35,366.22 $154,627.00 $35,366.22 2026-04-01
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc 32 9 — — $17,602.41 $49,493.00 $35,847.00 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 14 7 — — $34,035.02 $34,035.02 $34,035.02 2026-04-01
665 MS_DRG Prostatectomy With Mcc 14 7 — — $34,684.84 $34,684.84 $34,684.84 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 14 7 — — $32,494.84 $32,494.84 $32,494.84 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 18 8 — — $40,130.00 $46,444.66 $46,444.66 2026-04-01
7 MS_DRG Lung Transplant 14 7 — — $141,670.44 $141,670.44 $141,670.44 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 32 9 — — $25,063.86 $59,980.00 $43,240.50 2026-04-01
716 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy Without Cc/Mcc 32 9 — — $16,722.93 $49,208.00 $35,473.50 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 32 9 — — $23,895.94 $75,504.00 $54,432.50 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 14 7 — — $39,618.87 $39,618.87 $39,618.87 2026-04-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 32 9 — — $23,140.54 $60,844.00 $43,864.50 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 14 7 — — $39,709.21 $39,709.21 $39,709.21 2026-04-01
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 32 9 — — $20,408.48 $53,542.00 $38,601.00 2026-04-01
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc 32 9 — — $23,015.36 $45,535.00 $32,827.00 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 7 — — $65,404.69 $65,404.69 $65,404.69 2026-04-01
791 MS_DRG Prematurity With Major Problems 14 7 — — $44,892.50 $44,892.50 $44,892.50 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 18 8 — — $3,082.00 $46,096.35 $46,096.35 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 14 7 — — $50,007.21 $50,007.21 $50,007.21 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 14 7 — — $61,715.87 $61,715.87 $61,715.87 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 14 7 — — $44,077.24 $44,077.24 $44,077.24 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 14 7 — — $64,548.07 $64,548.07 $64,548.07 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 14 7 — — $50,615.67 $50,615.67 $50,615.67 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 14 7 — — $51,627.94 $51,627.94 $51,627.94 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 14 7 — — $35,107.16 $35,107.16 $35,107.16 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 14 7 — — $60,467.40 $60,467.40 $60,467.40 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 14 7 — — $53,004.86 $53,004.86 $53,004.86 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 14 7 — — $35,922.43 $35,922.43 $35,922.43 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 14 7 — — $94,967.51 $94,967.51 $94,967.51 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 22 9 — — $27,492.00 $201,289.95 $54,466.67 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 18 8 — — $26,694.00 $50,222.73 $50,222.73 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 8 — — $59,960.00 $75,944.34 $75,944.34 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 14 7 — — $42,779.78 $42,779.78 $42,779.78 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 14 7 — — $46,390.23 $46,390.23 $46,390.23 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 14 7 — — $40,692.10 $40,692.10 $40,692.10 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 8 — — $42,501.13 $44,973.80 $42,501.13 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 7 — — $233,105.09 $233,105.09 $233,105.09 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 14 7 — — $78,784.15 $78,784.15 $78,784.15 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 14 7 — — $35,768.95 $35,768.95 $35,768.95 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 14 7 — — $43,098.70 $43,098.70 $43,098.70 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 14 7 — — $40,206.64 $40,206.64 $40,206.64 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 20 7 — — $39,019.12 $114,567.00 $39,019.12 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 14 7 — — $73,977.47 $73,977.47 $73,977.47 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 18 8 — — $41,670.63 $344,132.83 $41,670.63 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 18 8 — — $83,651.79 $282,995.71 $83,651.79 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 20 8 — — $46,578.54 $286,012.40 $46,578.54 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 14 7 — — $32,757.16 $32,757.16 $32,757.16 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 14 7 — — $67,339.99 $67,339.99 $67,339.99 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 18 7 — — $40,024.87 $179,231.00 $40,024.87 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 8 — — $51,780.33 $111,194.80 $51,780.33 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 7 — — $28,194.04 $38,028.62 $38,028.62 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 2 — — $56,824.55 $189,311.16 $189,311.16 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 6 2 — — $3,159.80 $54,373.92 $54,373.92 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 4 1 — — $146,326.57 $146,326.57 $146,326.57 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 2 — — $63,342.28 $145,441.90 $145,441.90 2026-04-01
J9226 HCPCS Supprelin La Implant 14 3 — — $45,020.65 $129,708.04 $122,953.40 2026-04-01
J9266 HCPCS Pegaspargase Injection 14 3 — — $28,424.06 $62,262.23 $61,062.67 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 6 2 — — $24,228.42 $74,101.05 $74,101.05 2026-04-01
N905 OTHER Not Recognized By Opps 2 1 — — $34,275.01 $34,275.01 $34,275.01 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 2 — — $533,230.17 $1,340,483.41 $1,340,483.41 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 2 — — $591,726.20 $1,476,857.10 $1,476,857.10 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 10 3 — — $55,272.32 $162,691.22 $131,139.34 2026-04-01
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