Price Transparency Hospital negotiated rates

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

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Hospital

PROVIDENCE MISSION HOSPITAL

Mission Viejo, CA · CCN 050567 · Rates published

14,599 distinct procedures filed
30 distinct payers
226,347 rate rows
2026-04-01 last MRF observed
Data quality

151,333 of 226,347 rate rows are consumer-grade (66.9%)

75,014 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 74,921
placeholder amount (≤ $0.02) — excluded from medians 93
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/socal/live/951643360_providence-mission-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint bb7cffc569f83ae5… · 199,469,655 bytes · first seen 2026-05-05

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,137,732.50 $4,355,852.51 $3,779,451.13 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $2,823,169.92 $3,919,171.50 $3,400,555.26 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $2,758,574.18 $3,829,498.62 $3,322,748.62 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,497,572.00 $3,467,171.05 $3,008,367.13 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,199,024.17 $4,786,111.43 $2,710,435.32 nat. median
$2,469,189
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $1,982,200.00 $4,314,200.00 $2,443,185.93 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $655,027.00 $1,656,833.00 $1,425,647.00 nat. median
$824,563
1.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $500,220.59 $1,189,314.00 $1,088,715.39 nat. median
$675,122
1.6× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $477,921.71 $1,110,350.92 $1,061,726.93 nat. median
$674,188
1.6× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $475,813.92 $1,134,388.29 $1,035,595.00 nat. median
$625,184
1.7× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $452,071.75 $1,081,107.57 $983,920.87 nat. median
$634,511
1.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $415,897.01 $1,052,208.19 $905,187.61 nat. median
$620,080
1.5× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $598,237.50 $598,237.50 $598,237.50 nat. median
$459,112
1.3× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $1,597.00 $1,244,357.91 $568,117.25 nat. median
$754,974
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 21 $411,750.65 $903,838.07 $411,750.65 nat. median
$370,174
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 22 $255,326.65 $675,092.28 $267,404.62 nat. median
$265,286
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 $203,859.19 $568,588.07 $203,859.19 nat. median
$206,368
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 $250.00 $1,177,704.23 $202,666.06 nat. median
$202,986
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 23 $500.00 $641,753.16 $132,451.29 nat. median
$133,176
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $92,035.24 $169,820.76 $130,928.00 nat. median
$76,377
1.7× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 5 $10,137.00 $212,390.04 $124,168.76 nat. median
$87,411
1.4× median
7
MS_DRG 		Lung Transplant 21 $123,869.88 $313,211.43 $123,869.88 nat. median
$122,708
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 21 $114,992.34 $314,002.37 $114,992.34 nat. median
$117,303
1.0× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 $16,552.00 $183,513.39 $113,735.38 nat. median
$63,570
1.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 $108,459.16 $288,558.20 $108,459.16 nat. median
$108,660
1.0× median
209
MS_DRG 		Complex Aortic Arch Procedures 20 $108,335.37 $200,420.43 $108,335.37 nat. median
$98,017
1.1× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 5 $54,639.95 $135,956.56 $105,682.29 nat. median
$69,774
1.5× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 $7,501.50 $251,222.99 $105,501.57 nat. median
$98,905
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 21 $57,678.00 $261,085.82 $104,100.85 nat. median
$102,358
1.0× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 $16,552.00 $169,913.95 $99,433.87 nat. median
$54,196
1.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 23 $81,370.25 $266,996.90 $98,734.14 nat. median
$100,136
1.0× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $97,225.26 $97,225.26 $97,225.26 nat. median
$21,806
outlier · 4.5×
215
MS_DRG 		Other Heart Assist System Implant 21 $16,552.00 $362,006.61 $95,368.04 nat. median
$99,019
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 $16,552.00 $333,254.15 $93,709.28 nat. median
$93,672
1.0× median
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $91,591.34 $91,591.34 $91,591.34 nat. median
$775
outlier · 118.2×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 5 $10,137.00 $158,962.97 $90,919.69 nat. median
$65,381
1.4× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 5 $48,300.87 $122,172.78 $90,765.85 nat. median
$62,507
1.5× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 5 $16,552.00 $153,416.77 $89,298.97 nat. median
$49,935
1.8× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 6 $47,828.81 $122,586.77 $88,708.45 nat. median
$66,682
1.3× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 $50,470.00 $199,893.12 $86,346.71 nat. median
$82,712
1.0× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 $16,552.00 $125,081.80 $83,900.62 nat. median
$44,728
1.9× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 5 $10,137.00 $146,595.48 $83,475.26 nat. median
$62,270
1.3× median
850
MS_DRG 		Acute Leukemia With Other Procedures 23 $18,187.60 $220,776.44 $83,012.99 nat. median
$83,442
1.0× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 22 $90.00 $203,090.45 $80,826.70 nat. median
$79,312
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 $10,137.00 $202,975.40 $80,574.36 nat. median
$81,118
1.0× median
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 $16,552.00 $121,222.95 $75,995.56 nat. median
$48,649
1.6× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 $34,796.66 $299,232.34 $75,483.79 nat. median
$77,576
1.0× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 $16,552.00 $185,440.42 $73,669.81 nat. median
$74,915
1.0× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 22 $7,086.11 $187,329.09 $73,354.63 nat. median
$73,807
1.0× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 $38,754.21 $685,428.53 $73,113.72 nat. median
$72,138
1.0× median

Other procedures at this hospital

Browse this hospital's 14,599 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 3 — — $3,137,732.50 $4,355,852.51 $3,779,451.13 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 3 — — $2,823,169.92 $3,919,171.50 $3,400,555.26 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 3 — — $2,758,574.18 $3,829,498.62 $3,322,748.62 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 3 — — $2,497,572.00 $3,467,171.05 $3,008,367.13 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 4 — — $2,199,024.17 $4,786,111.43 $2,710,435.32 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 4 — — $1,982,200.00 $4,314,200.00 $2,443,185.93 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 5 4 — — $655,027.00 $1,656,833.00 $1,425,647.00 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 5 4 — — $500,220.59 $1,189,314.00 $1,088,715.39 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 4 — — $477,921.71 $1,110,350.92 $1,061,726.93 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 5 4 — — $475,813.92 $1,134,388.29 $1,035,595.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 4 — — $452,071.75 $1,081,107.57 $983,920.87 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 5 4 — — $415,897.01 $1,052,208.19 $905,187.61 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 2 1 — — $598,237.50 $598,237.50 $598,237.50 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 5 — — $1,597.00 $1,244,357.91 $568,117.25 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 31 21 — — $411,750.65 $903,838.07 $411,750.65 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 32 22 — — $255,326.65 $675,092.28 $267,404.62 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 21 — — $203,859.19 $568,588.07 $203,859.19 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 22 — — $250.00 $1,177,704.23 $202,666.06 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 40 23 — — $500.00 $641,753.16 $132,451.29 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 4 2 — — $92,035.24 $169,820.76 $130,928.00 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 11 5 — — $10,137.00 $212,390.04 $124,168.76 2026-04-01
7 MS_DRG Lung Transplant 31 21 — — $123,869.88 $313,211.43 $123,869.88 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 31 21 — — $114,992.34 $314,002.37 $114,992.34 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 11 5 — — $16,552.00 $183,513.39 $113,735.38 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 31 21 — — $108,459.16 $288,558.20 $108,459.16 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 22 20 — — $108,335.37 $200,420.43 $108,335.37 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 10 5 — — $54,639.95 $135,956.56 $105,682.29 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 37 23 — — $7,501.50 $251,222.99 $105,501.57 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 30 21 — — $57,678.00 $261,085.82 $104,100.85 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 11 5 — — $16,552.00 $169,913.95 $99,433.87 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 34 23 — — $81,370.25 $266,996.90 $98,734.14 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $97,225.26 $97,225.26 $97,225.26 2026-04-01
215 MS_DRG Other Heart Assist System Implant 39 21 — — $16,552.00 $362,006.61 $95,368.04 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 21 — — $16,552.00 $333,254.15 $93,709.28 2026-04-01
C9150 HCPCS Xe129 Xenon, Diagnostic 2 1 — — $91,591.34 $91,591.34 $91,591.34 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 11 5 — — $10,137.00 $158,962.97 $90,919.69 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 11 5 — — $48,300.87 $122,172.78 $90,765.85 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 11 5 — — $16,552.00 $153,416.77 $89,298.97 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 11 6 — — $47,828.81 $122,586.77 $88,708.45 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 32 21 — — $50,470.00 $199,893.12 $86,346.71 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 11 5 — — $16,552.00 $125,081.80 $83,900.62 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 11 5 — — $10,137.00 $146,595.48 $83,475.26 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 30 23 — — $18,187.60 $220,776.44 $83,012.99 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 39 22 — — $90.00 $203,090.45 $80,826.70 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 21 — — $10,137.00 $202,975.40 $80,574.36 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 11 5 — — $16,552.00 $121,222.95 $75,995.56 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 38 22 — — $34,796.66 $299,232.34 $75,483.79 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 41 22 — — $16,552.00 $185,440.42 $73,669.81 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 43 22 — — $7,086.11 $187,329.09 $73,354.63 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 40 22 — — $38,754.21 $685,428.53 $73,113.72 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 11 5 — — $16,552.00 $120,336.14 $70,932.16 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 21 — — $50,470.00 $213,590.44 $69,292.46 2026-04-01
10 MS_DRG Pancreas Transplant 31 21 — — $48,860.66 $191,087.28 $68,883.96 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 31 21 — — $68,855.39 $160,070.29 $68,855.39 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 31 21 — — $68,492.60 $189,987.15 $68,492.60 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 35 21 — — $41,777.37 $169,369.87 $68,452.60 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 44 23 — — $24,508.19 $285,197.21 $66,371.05 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 36 21 — — $16,552.00 $159,799.45 $66,048.25 2026-04-01
J9226 HCPCS Supprelin La Implant 12 6 — — $25,686.68 $97,205.89 $64,832.36 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 11 5 — — $10,137.00 $110,387.02 $64,707.25 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 32 21 — — $64,650.39 $861,509.90 $64,650.39 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 33 23 — — $9,847.97 $148,266.05 $64,225.70 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 33 21 — — $50,470.00 $312,728.22 $64,179.04 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 37 21 — — $16,552.00 $255,074.09 $63,166.83 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 21 — — $16,552.00 $142,588.03 $63,166.83 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 31 21 — — $62,939.25 $147,590.15 $62,939.25 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 41 23 — — $5,165.61 $240,225.79 $61,828.01 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 39 21 — — $16,552.00 $143,577.91 $58,911.36 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 31 21 — — $58,843.75 $151,571.24 $58,843.75 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 38 21 — — $16,552.00 $165,169.59 $58,284.80 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 36 21 — — $56,991.67 $539,015.15 $57,767.75 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 31 21 — — $57,678.00 $148,457.79 $57,751.56 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 39 21 — — $10,137.00 $137,552.35 $57,337.34 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 32 22 — — $1,148.89 $142,489.76 $57,150.71 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 31 21 — — $57,019.30 $144,658.86 $57,019.30 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 2 2 — — $50,007.71 $63,317.48 $56,662.60 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 36 21 — — $16,552.00 $317,139.29 $56,437.49 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 34 21 — — $54,601.02 $326,178.14 $56,401.31 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 33 21 — — $50,470.00 $131,107.36 $55,470.99 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 21 — — $45,048.55 $270,111.90 $55,120.57 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 22 20 — — $54,897.76 $101,560.86 $54,897.76 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 38 23 — — $4,171.49 $129,443.98 $54,827.29 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 37 21 — — $49,888.63 $145,840.81 $54,089.32 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 31 21 — — $53,923.63 $130,405.09 $53,923.63 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 28 21 — — $53,557.98 $119,909.51 $53,557.98 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 35 21 — — $10,137.00 $147,084.43 $53,146.62 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 11 5 — — $10,137.00 $87,672.55 $53,115.05 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 32 21 — — $52,717.38 $132,468.74 $52,831.44 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 36 21 — — $51,436.98 $260,913.88 $52,646.71 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 42 23 — — $7,284.55 $169,953.05 $52,572.43 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 33 21 — — $52,490.54 $148,843.84 $52,490.54 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 31 21 — — $52,282.96 $144,658.86 $52,282.96 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 22 — — $14,082.60 $139,387.24 $51,335.50 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 31 21 — — $50,470.00 $129,370.94 $51,305.03 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 34 23 — — $50,964.14 $148,548.73 $50,964.14 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 47 23 — — $16,552.00 $198,353.90 $50,797.50 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 9 7 — — $12,948.75 $92,633.48 $50,706.00 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 38 23 — — $5,295.76 $122,100.18 $50,122.37 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 31 21 — — $50,036.67 $133,602.43 $50,036.67 2026-04-01
2643 OTHER Brachytx, Non-stranded,c-131 1 1 — — $49,715.04 $49,715.04 $49,715.04 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 21 — — $16,552.00 $110,068.25 $48,549.31 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 22 — — $14,265.94 $121,726.28 $48,046.53 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 40 23 — — $12,356.79 $339,276.52 $47,665.65 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 51 23 — — $12,631.46 $119,875.95 $47,581.85 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 32 21 — — $46,549.96 $120,714.83 $47,420.93 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 31 21 — — $47,225.72 $129,304.96 $47,225.72 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 37 21 — — $10,137.00 $116,412.58 $46,535.36 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 31 21 — — $46,303.02 $120,002.98 $46,303.02 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 37 21 — — $16,552.00 $112,755.06 $45,888.80 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 9 5 — — $29,182.37 $63,670.99 $45,628.84 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 31 21 — — $45,323.19 $110,420.58 $45,323.19 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 39 21 — — $16,659.23 $276,442.14 $45,231.77 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 33 22 — — $20,003.27 $188,432.10 $45,098.46 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 31 21 — — $44,709.96 $116,218.44 $44,709.96 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 34 21 — — $100.00 $111,503.93 $44,533.80 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 43 23 — — $119.04 $180,102.06 $44,324.31 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 35 22 — — $30.00 $112,151.07 $44,212.90 2026-04-01
245 MS_DRG Aicd Generator Procedures 37 23 — — $7,268.23 $117,119.63 $43,999.60 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 38 21 — — $15,154.00 $108,126.84 $43,869.15 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 44 21 — — $32,458.62 $722,523.66 $43,850.10 2026-04-01
J9266 HCPCS Pegaspargase Injection 12 6 — — $2,205.40 $58,201.64 $43,710.46 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 31 21 — — $43,680.61 $113,955.86 $43,680.61 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 53 23 — — $9,374.00 $220,117.80 $43,312.76 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 32 21 — — $43,219.73 $100,433.11 $43,219.73 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 36 21 — — $16,552.00 $105,279.44 $43,052.14 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 11 5 — — $16,552.00 $72,138.89 $42,866.69 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 34 21 — — $21,409.26 $102,233.11 $42,384.64 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 11 5 — — $16,552.00 $71,793.75 $42,215.70 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 33 23 — — $119.04 $102,084.51 $41,761.88 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 5 4 — — $33,734.93 $73,423.09 $41,580.42 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 5 4 — — $33,734.93 $73,423.09 $41,580.42 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 5 4 — — $33,734.93 $73,423.09 $41,580.42 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 32 21 — — $20,493.28 $107,482.10 $41,433.37 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 35 23 — — $6,673.34 $101,360.67 $41,170.56 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 2 1 — — $37,303.52 $44,764.40 $41,033.96 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 38 21 — — $23,978.04 $409,991.12 $40,937.26 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 36 21 — — $16,552.00 $99,716.47 $40,769.67 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 32 21 — — $40,701.11 $98,350.29 $40,701.11 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 41 22 — — $24,824.32 $299,022.24 $40,681.12 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 38 21 — — $38,077.46 $202,337.14 $40,563.99 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 31 21 — — $40,516.38 $106,183.03 $40,516.38 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 41 21 — — $16,552.00 $132,433.24 $40,442.11 2026-04-01
5166 OTHER Cochlear Implant Procedure 1 1 — — $40,415.02 $40,415.02 $40,415.02 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 41 21 — — $10,137.00 $115,799.34 $40,287.85 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 36 23 — — $2,500.00 $99,960.94 $40,259.28 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 33 22 — — $7,119.12 $97,480.25 $40,101.21 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 8 6 — — $124.27 $74,170.01 $39,927.64 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 40 21 — — $36,779.01 $122,487.66 $39,839.35 2026-04-01
791 MS_DRG Prematurity With Major Problems 33 21 — — $3,750.00 $97,312.48 $39,206.13 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 39 21 — — $350.00 $195,451.44 $38,839.52 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 31 21 — — $38,492.91 $85,915.69 $38,492.91 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 7 6 — — $269.80 $94,806.86 $37,945.35 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 43 22 — — $10,832.12 $143,743.32 $37,805.41 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 9 5 — — $24,815.72 $54,143.71 $37,761.01 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 31 21 — — $30,491.15 $103,702.35 $37,636.87 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 34 21 — — $37,413.10 $93,623.25 $37,413.10 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 31 21 — — $37,357.87 $94,179.86 $37,357.87 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 2 1 — — $37,342.55 $37,342.55 $37,342.55 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 35 21 — — $30,525.50 $90,402.50 $37,322.64 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 36 21 — — $8,368.00 $263,559.29 $37,114.10 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 6 2 — — $4,619.72 $52,091.10 $36,532.82 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 40 22 — — $23,884.17 $467,254.95 $36,387.56 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 33 23 — — $7,121.50 $79,135.15 $36,231.39 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 36 24 — — $32,971.65 $355,395.93 $36,146.65 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 41 21 — — $10,137.00 $182,057.29 $36,142.84 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 32 21 — — $18,129.35 $94,584.92 $36,042.85 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 32 22 — — $11,133.04 $83,221.69 $35,842.89 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 31 21 — — $35,531.51 $92,538.05 $35,531.51 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 39 21 — — $10,137.00 $85,110.37 $35,517.23 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 31 21 — — $34,865.05 $76,069.64 $35,106.82 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 35 21 — — $10,137.00 $84,374.55 $35,080.16 2026-04-01
332 MS_DRG Rectal Resection With Mcc 31 21 — — $35,032.55 $83,133.01 $35,032.55 2026-04-01
265 MS_DRG Aicd Lead Procedures 35 21 — — $16,552.00 $85,491.46 $35,008.74 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 33 21 — — $15,691.11 $85,920.49 $34,947.80 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 7 5 — — $14,208.00 $64,562.94 $34,898.89 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 7 5 — — $14,208.00 $64,562.94 $34,898.89 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 23 — — $10,284.25 $76,798.27 $34,896.38 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 35 21 — — $9,565.00 $95,409.42 $34,671.66 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 35 21 — — $9,565.00 $94,369.21 $34,592.62 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 37 22 — — $22,914.04 $108,784.00 $34,558.34 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 32 21 — — $34,507.88 $83,914.36 $34,507.88 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 33 21 — — $21,630.00 $83,974.28 $34,479.31 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 32 21 — — $34,446.93 $104,048.15 $34,446.93 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 41 22 — — $16,552.00 $126,658.37 $34,419.32 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 35 21 — — $28,839.00 $82,088.00 $34,136.51 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 33 22 — — $34,067.95 $280,349.00 $34,067.95 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 37 23 — — $6,736.15 $82,215.03 $33,771.81 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 32 21 — — $32,748.06 $92,633.92 $33,763.24 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 32 22 — — $19,426.34 $83,041.93 $33,610.88 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 32 21 — — $32,726.01 $82,421.16 $33,450.91 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 22 20 — — $33,298.56 $61,602.34 $33,298.56 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 37 22 — — $29,021.10 $83,959.90 $33,201.43 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 40 22 — — $15,407.75 $225,674.95 $33,041.46 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 34 23 — — $4,873.38 $84,587.87 $32,998.61 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 38 22 — — $16,552.00 $83,765.76 $32,365.38 2026-04-01
81211 HCPCS Brca1&2 Seq & Com Dup/del 2 1 — — $29,225.77 $35,071.05 $32,148.41 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 34 21 — — $21,630.00 $67,967.22 $32,010.20 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 31 21 — — $31,903.55 $79,590.54 $31,903.55 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 43 21 — — $29,484.15 $93,282.02 $31,899.75 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 37 22 — — $16,552.00 $81,654.18 $31,529.33 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 36 22 — — $90.00 $86,238.83 $31,393.16 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 32 21 — — $30,417.19 $76,443.54 $31,358.88 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 33 21 — — $29,167.33 $73,960.45 $31,316.03 2026-04-01
652 MS_DRG Kidney Transplant 31 21 — — $31,307.46 $73,610.52 $31,307.46 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 36 22 — — $10,137.00 $77,263.24 $31,284.61 2026-04-01
2616 OTHER Brachytx, Non-str,yttrium-90 10 7 — — $667.22 $52,836.72 $31,256.90 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 31 21 — — $31,224.62 $76,223.03 $31,224.62 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 29 22 — — $24,151.49 $68,596.42 $31,125.59 2026-04-01
81436 HCPCS Hereditary Colon Ca Dsordrs 2 1 — — $28,205.52 $33,846.75 $31,026.14 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 46 23 — — $7,761.98 $81,299.46 $30,958.00 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 37 21 — — $10,137.00 $74,113.85 $30,901.82 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 32 21 — — $30,872.30 $78,080.55 $30,872.30 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 33 22 — — $15,652.36 $93,057.35 $30,811.36 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 32 22 — — $7,813.34 $75,942.61 $30,691.38 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 31 21 — — $30,645.67 $73,907.72 $30,645.67 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 1 1 — — $30,579.02 $30,579.02 $30,579.02 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 30 22 — — $18,306.92 $76,577.76 $30,559.97 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 38 22 — — $16,552.00 $136,310.14 $30,545.69 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 35 21 — — $16,552.00 $69,214.00 $30,475.22 2026-04-01
665 MS_DRG Prostatectomy With Mcc 33 21 — — $30,276.21 $82,291.73 $30,276.21 2026-04-01
G0419 HCPCS Sat Biopsy Prostate: >60 2 1 — — $27,494.73 $32,993.80 $30,244.26 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 37 22 — — $9,034.47 $75,783.55 $30,214.32 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 39 23 — — $13,037.90 $73,303.73 $30,161.94 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 18 9 — — $1,791.67 $93,666.22 $30,102.87 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 33 22 — — $21,174.10 $74,765.78 $29,707.74 2026-04-01
S3865 HCPCS Comp Genet Test Hyp Cardiomy 1 1 — — $29,701.94 $29,701.94 $29,701.94 2026-04-01
263 MS_DRG Vein Ligation And Stripping 36 23 — — $13,298.54 $64,279.78 $29,668.69 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 38 23 — — $6,398.37 $78,339.41 $29,438.26 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 9 5 — — $14,208.00 $64,047.70 $29,427.32 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 35 21 — — $10,137.00 $68,500.54 $29,317.33 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 32 22 — — $8,886.97 $68,713.86 $29,313.52 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 35 21 — — $10,137.00 $60,512.01 $29,282.09 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 28 21 — — $28,897.40 $73,543.41 $28,897.40 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 42 23 — — $10,137.00 $108,513.16 $28,608.87 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 34 22 — — $10,447.29 $188,028.92 $28,589.83 2026-04-01
570 MS_DRG Skin Debridement With Mcc 33 21 — — $11,330.62 $72,153.27 $28,561.26 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 31 21 — — $28,360.34 $69,893.08 $28,360.34 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 44 21 — — $10,137.00 $102,928.08 $28,287.02 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 33 22 — — $19,672.49 $70,293.35 $28,188.95 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 34 21 — — $26,587.12 $68,165.48 $28,171.81 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 31 21 — — $28,049.92 $65,346.36 $28,049.92 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 34 21 — — $25,104.00 $71,568.45 $28,036.59 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 31 21 — — $27,996.60 $63,510.41 $27,996.60 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 39 21 — — $17,955.21 $97,167.34 $27,886.14 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 34 23 — — $12,276.04 $69,794.82 $27,698.55 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 9 5 — — $17,888.41 $39,029.49 $27,633.59 2026-04-01
800 MS_DRG Splenic Procedures With Cc 32 21 — — $27,307.19 $69,833.16 $27,307.19 2026-04-01
509 MS_DRG Arthroscopy 13 6 — — $10,137.00 $42,099.79 $27,287.96 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 14 6 — — $11,790.00 $106,565.00 $27,256.00 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 31 21 — — $27,211.02 $67,635.30 $27,211.02 2026-04-01
503 MS_DRG Foot Procedures With Mcc 35 21 — — $10,137.00 $63,431.31 $27,132.93 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 40 22 — — $10,137.00 $61,072.86 $26,950.11 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 11 5 — — $16,552.00 $45,766.90 $26,852.63 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 38 21 — — $150.00 $64,790.30 $26,809.18 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 46 23 — — $7,577.00 $226,081.67 $26,729.19 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 38 23 — — $6,791.11 $62,872.86 $26,722.53 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 5 5 — — $203.86 $56,465.14 $26,709.30 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 37 22 — — $14,426.58 $65,111.47 $26,587.31 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 45 24 — — $1,000.00 $400,497.78 $26,463.52 2026-04-01
849 MS_DRG Radiotherapy 31 21 — — $26,355.92 $64,016.13 $26,355.92 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 31 21 — — $26,324.50 $65,463.80 $26,324.50 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 31 21 — — $26,240.70 $62,707.48 $26,240.70 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 35 21 — — $10,137.00 $68,634.76 $25,884.57 2026-04-01
0394T HCPCS Hdr Elctrnc Skn Surf Brchytx 3 1 — — $20,774.00 $28,699.00 $25,813.00 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 32 21 — — $25,233.77 $63,817.20 $25,796.02 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 31 21 — — $25,669.37 $63,591.90 $25,669.37 2026-04-01
G0418 HCPCS Sat Biopsy Prostate 41-60 2 1 — — $23,128.01 $27,753.72 $25,440.86 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 11 5 — — $16,552.00 $43,542.67 $25,381.83 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 39 23 — — $7,510.44 $102,092.00 $25,271.34 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 31 21 — — $25,241.83 $61,204.68 $25,241.83 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 33 23 — — $8,556.53 $64,579.38 $25,149.46 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 33 22 — — $13,784.71 $57,451.30 $25,115.18 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 32 21 — — $25,115.18 $57,451.30 $25,115.18 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 14 6 — — $11,790.00 $73,264.00 $25,065.31 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 31 21 — — $25,004.72 $62,038.77 $25,004.72 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 38 21 — — $250.00 $119,855.49 $24,865.70 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 32 21 — — $24,750.48 $61,938.11 $24,750.48 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 43 21 — — $10,137.00 $174,288.17 $24,704.77 2026-04-01
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
0981T HCPCS Tcat Impl Wrls Ivc Snr 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 5 4 — — $20,040.92 $43,618.46 $24,701.69 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 38 21 — — $24,040.49 $158,235.52 $24,589.55 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 38 22 — — $23,423.75 $75,234.12 $24,579.08 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 32 21 — — $23,837.42 $57,997.77 $24,283.89 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 34 21 — — $6,941.83 $60,559.95 $24,186.77 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 34 22 — — $971.30 $56,046.77 $23,972.52 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 37 21 — — $8,993.09 $58,685.65 $23,965.85 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 31 21 — — $20,234.87 $44,276.94 $23,933.48 2026-04-01
792 MS_DRG Prematurity Without Major Problems 35 23 — — $3,750.00 $58,716.81 $23,877.29 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 33 21 — — $23,829.68 $108,385.04 $23,829.68 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 38 21 — — $30.00 $60,562.00 $23,802.07 2026-04-01
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