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

SUTTER MATERNITY & SURGERY CENTER OF SANTA CRUZ

Santa Cruz, CA · CCN 050714 · Rates published

Your selected procedure

You selected 29806 (HCPCS)

Shoulder arthroscopy/surgery

This hospital’s price: $15,226 across 5 payers · range $10,227-$16,750

Source: https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Files/billing-insurance/costs-and-charges/940562680-1689035628_sutter-maternity-surgery-center-of-santa-cruz_standardcharges.csv · observed 2026-04-01

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.

7,950 distinct procedures filed
7 distinct payers
29,062 rate rows
2026-04-01 last MRF observed
Data quality

17,895 of 29,062 rate rows are consumer-grade (61.6%)

11,167 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 11,145
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 12
placeholder amount (≤ $0.02) — excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://edge.sitecorecloud.io/sutterhealt962c-sutterhealt8fce-production57cc-4860/media/Project/SutterHealth/SutterHealth/Files/billing-insurance/costs-and-charges/940562680-1689035628_sutter-maternity-surgery-center-of-santa-cruz_standardcharges.csv
Found on page https://www.sutterhealth.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-25
Content fingerprint 0fa05696e21e0a20… · 12,434,371 bytes · first seen 2026-09-20

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
$739,658
2.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $533,230.17 $1,340,483.41 $1,340,483.41 nat. median
$607,251
outlier · 2.2×
215
MS_DRG 		Other Heart Assist System Implant 6 $107,881.42 $533,607.00 $464,032.00 nat. median
$93,531
outlier · 5.0×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 3 $457,788.46 $457,788.46 $457,788.46 nat. median
$360,195
1.3× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $106,046.89 $411,119.00 $329,877.50 nat. median
$90,525
outlier · 3.6×
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 6 $36,484.20 $414,588.00 $326,799.50 nat. median
$32,135
outlier · 10.2×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 $85,890.20 $414,588.00 $326,799.50 nat. median
$74,260
outlier · 4.4×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $298,147.28 $298,147.28 $298,147.28 nat. median
$247,805
1.2× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $72,268.11 $341,227.00 $296,891.50 nat. median
$61,992
outlier · 4.8×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 $97,904.17 $351,279.00 $281,916.00 nat. median
$77,933
outlier · 3.6×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $119,088.71 $351,279.00 $281,916.00 nat. median
$93,094
outlier · 3.0×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $72,268.11 $320,672.00 $280,397.50 nat. median
$59,554
outlier · 4.7×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 6 $66,868.77 $315,727.00 $275,000.00 nat. median
$57,665
outlier · 4.8×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 6 $78,113.97 $325,194.00 $272,689.00 nat. median
$66,553
outlier · 4.1×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 6 $91,799.25 $311,639.00 $271,848.00 nat. median
$76,979
outlier · 3.5×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 6 $58,772.40 $310,887.00 $267,954.50 nat. median
$51,294
outlier · 5.2×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 6 $67,561.72 $436,419.00 $260,240.50 nat. median
$58,153
outlier · 4.5×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $65,820.92 $307,570.00 $246,344.50 nat. median
$55,148
outlier · 4.5×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $46,964.83 $307,570.00 $246,344.50 nat. median
$40,320
outlier · 6.1×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $91,520.17 $307,570.00 $246,344.50 nat. median
$77,595
outlier · 3.2×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $83,884.01 $295,319.00 $237,027.50 nat. median
$72,153
outlier · 3.3×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $227,868.47 $227,868.47 $227,868.47 nat. median
$197,664
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $226,548.92 $226,548.92 $226,548.92 nat. median
$190,274
1.2× median
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 6 $60,551.11 $278,368.00 $223,244.00 nat. median
$51,524
outlier · 4.3×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 $83,535.43 $278,368.00 $223,244.00 nat. median
$71,672
outlier · 3.1×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 6 $66,279.03 $275,916.00 $221,280.50 nat. median
$56,565
outlier · 3.9×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 $63,369.26 $243,357.00 $216,141.50 nat. median
$53,315
outlier · 4.1×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $79,042.82 $243,801.00 $214,816.50 nat. median
$63,446
outlier · 3.4×
24
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 $44,219.35 $240,030.00 $213,438.00 nat. median
$36,511
outlier · 5.8×
209
MS_DRG 		Complex Aortic Arch Procedures 5 $122,222.79 $266,222.00 $209,673.00 nat. median
$92,760
outlier · 2.3×
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 6 $36,190.38 $231,802.00 $205,666.00 nat. median
$30,744
outlier · 6.7×
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 $63,756.81 $227,150.00 $201,797.00 nat. median
$51,145
outlier · 3.9×
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 6 $51,660.69 $242,459.00 $200,197.00 nat. median
$44,064
outlier · 4.5×
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 6 $55,124.39 $228,310.00 $198,452.50 nat. median
$47,242
outlier · 4.2×
402
MS_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 $45,363.04 $219,136.00 $194,921.50 nat. median
$36,878
outlier · 5.3×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $192,725.00 $192,725.00 $192,725.00 nat. median
$52,652
outlier · 3.7×
230
MS_DRG 		Other Cardiothoracic Procedures Without Cc/mcc 1 $159,032.00 $220,890.00 $189,961.00 nat. median
$12,593
outlier · 15.1×
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $56,824.55 $189,311.16 $189,311.16 nat. median
$63,915
outlier · 3.0×
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 6 $53,159.28 $229,372.00 $187,059.50 nat. median
$45,788
outlier · 4.1×
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $62,228.73 $203,151.00 $179,982.00 nat. median
$50,495
outlier · 3.6×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 6 $60,633.26 $183,808.00 $173,610.50 nat. median
$50,653
outlier · 3.4×
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 6 $59,149.41 $268,566.00 $172,003.50 nat. median
$48,240
outlier · 3.6×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 $73,387.58 $282,353.00 $172,003.50 nat. median
$60,364
outlier · 2.8×
319
MS_DRG 		Other Endovascular Cardiac Valve Procedures With Mcc 6 $50,022.04 $182,013.00 $168,691.00 nat. median
$41,461
outlier · 4.1×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 $75,454.85 $209,543.00 $168,163.50 nat. median
$63,874
outlier · 2.6×
40
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 6 $43,685.42 $178,051.00 $166,063.00 nat. median
$35,776
outlier · 4.6×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $59,183.11 $183,588.00 $163,502.50 nat. median
$50,491
outlier · 3.2×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 6 $64,825.72 $203,824.00 $163,362.00 nat. median
$55,354
outlier · 3.0×
236
MS_DRG 		Coronary Bypass Without Cardiac Catheterization Without Mcc 6 $47,135.44 $183,626.00 $163,362.00 nat. median
$40,285
outlier · 4.1×
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 $118,400.91 $186,655.00 $152,527.96 nat. median
$38,705
outlier · 3.9×

Other procedures at this hospital

Browse this hospital's 7,950 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
             
Q2042 HCPCS Tisagenlecleucel Car-pos T 3 2 — — $591,726.20 $1,476,857.10 $1,476,857.10 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 3 2 — — $533,230.17 $1,340,483.41 $1,340,483.41 2026-04-01
215 MS_DRG Other Heart Assist System Implant 12 6 — — $107,881.42 $533,607.00 $464,032.00 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 3 3 — — $457,788.46 $457,788.46 $457,788.46 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 6 — — $106,046.89 $411,119.00 $329,877.50 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 12 6 — — $36,484.20 $414,588.00 $326,799.50 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 6 — — $85,890.20 $414,588.00 $326,799.50 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 — — $298,147.28 $298,147.28 $298,147.28 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 6 — — $72,268.11 $341,227.00 $296,891.50 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 6 — — $97,904.17 $351,279.00 $281,916.00 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 6 — — $119,088.71 $351,279.00 $281,916.00 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 6 — — $72,268.11 $320,672.00 $280,397.50 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 6 — — $66,868.77 $315,727.00 $275,000.00 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 6 — — $78,113.97 $325,194.00 $272,689.00 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 6 — — $91,799.25 $311,639.00 $271,848.00 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 6 — — $58,772.40 $310,887.00 $267,954.50 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 6 — — $67,561.72 $436,419.00 $260,240.50 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 6 — — $65,820.92 $307,570.00 $246,344.50 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 6 — — $46,964.83 $307,570.00 $246,344.50 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 6 — — $91,520.17 $307,570.00 $246,344.50 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 6 — — $83,884.01 $295,319.00 $237,027.50 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 3 — — $227,868.47 $227,868.47 $227,868.47 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 3 — — $226,548.92 $226,548.92 $226,548.92 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 6 — — $60,551.11 $278,368.00 $223,244.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 6 — — $83,535.43 $278,368.00 $223,244.00 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 6 — — $66,279.03 $275,916.00 $221,280.50 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 6 — — $63,369.26 $243,357.00 $216,141.50 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 6 — — $79,042.82 $243,801.00 $214,816.50 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 6 — — $44,219.35 $240,030.00 $213,438.00 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 11 5 — — $122,222.79 $266,222.00 $209,673.00 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 12 6 — — $36,190.38 $231,802.00 $205,666.00 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 12 6 — — $63,756.81 $227,150.00 $201,797.00 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 6 — — $51,660.69 $242,459.00 $200,197.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 6 — — $55,124.39 $228,310.00 $198,452.50 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 12 6 — — $45,363.04 $219,136.00 $194,921.50 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $192,725.00 $192,725.00 $192,725.00 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 2 1 — — $159,032.00 $220,890.00 $189,961.00 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 3 2 — — $56,824.55 $189,311.16 $189,311.16 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 6 — — $53,159.28 $229,372.00 $187,059.50 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 6 — — $62,228.73 $203,151.00 $179,982.00 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 6 — — $60,633.26 $183,808.00 $173,610.50 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 12 6 — — $59,149.41 $268,566.00 $172,003.50 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 12 6 — — $73,387.58 $282,353.00 $172,003.50 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 10 6 — — $50,022.04 $182,013.00 $168,691.00 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 6 — — $75,454.85 $209,543.00 $168,163.50 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 6 — — $43,685.42 $178,051.00 $166,063.00 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 6 — — $59,183.11 $183,588.00 $163,502.50 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 6 — — $64,825.72 $203,824.00 $163,362.00 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 6 — — $47,135.44 $183,626.00 $163,362.00 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 2 — — $118,400.91 $186,655.00 $152,527.96 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 12 6 — — $66,296.93 $187,485.00 $150,326.00 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 12 6 — — $50,221.07 $158,698.00 $149,900.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 6 — — $56,101.69 $167,382.00 $149,178.00 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 12 6 — — $58,588.10 $168,499.00 $149,119.50 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 3 — — $148,894.07 $148,894.07 $148,894.07 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $146,326.57 $146,326.57 $146,326.57 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 3 2 — — $63,342.28 $145,441.90 $145,441.90 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 12 6 — — $73,439.18 $208,354.00 $142,990.50 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 12 6 — — $36,646.38 $163,692.00 $141,576.00 2026-04-01
7 MS_DRG Lung Transplant 3 3 — — $139,403.36 $139,403.36 $139,403.36 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 2 — — $128,305.00 $144,893.00 $136,599.00 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 12 6 — — $50,904.55 $163,471.00 $135,313.00 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 12 6 — — $61,186.14 $167,674.00 $134,665.00 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 12 6 — — $37,042.35 $165,463.00 $131,702.00 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 3 — — $55,272.32 $162,691.22 $131,139.34 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 12 6 — — $39,758.34 $146,761.00 $130,725.50 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 12 6 — — $47,683.06 $202,907.00 $130,099.50 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 3 3 — — $129,585.14 $129,585.14 $129,585.14 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 12 6 — — $31,675.66 $154,635.00 $123,809.00 2026-04-01
J9226 HCPCS Supprelin La Implant 7 3 — — $45,020.65 $129,708.04 $122,953.40 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 — — $122,359.69 $122,359.69 $122,359.69 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 11 5 — — $39,234.94 $139,144.00 $122,000.00 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 3 — — $117,539.57 $117,539.57 $117,539.57 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 11 5 — — $63,122.83 $129,109.00 $113,349.00 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 3 — — $111,604.19 $111,604.19 $111,604.19 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 12 6 — — $31,035.36 $150,671.00 $110,885.50 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 12 6 — — $40,161.69 $136,629.00 $109,589.00 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 12 6 — — $40,628.22 $115,294.00 $108,905.00 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 12 6 — — $50,207.38 $134,179.00 $107,622.00 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 12 6 — — $53,874.34 $122,600.00 $106,652.50 2026-04-01
999 MS_DRG Ungroupable 2 2 — — $39,908.00 $172,231.00 $106,069.50 2026-04-01
32 MS_DRG Ventricular Shunt Procedures With Cc 12 6 — — $25,464.37 $119,247.00 $103,249.00 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 6 — — $47,497.71 $128,461.00 $103,136.00 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 12 6 — — $21,588.89 $126,540.00 $101,532.50 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 11 5 — — $28,447.85 $114,017.00 $99,914.00 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 6 — — $57,841.44 $113,324.00 $98,599.50 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 12 6 — — $25,463.31 $122,131.00 $97,888.00 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 6 — — $32,057.94 $102,102.00 $96,921.50 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 10 6 — — $28,353.07 $104,205.00 $96,577.50 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 12 6 — — $26,177.33 $107,384.00 $95,482.00 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 12 6 — — $40,474.46 $120,510.00 $95,158.50 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 12 6 — — $35,765.97 $106,164.00 $94,486.50 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 3 3 — — $94,217.21 $94,217.21 $94,217.21 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 12 6 — — $31,962.11 $105,073.00 $92,003.00 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 12 6 — — $38,950.60 $100,553.00 $89,833.00 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 12 6 — — $37,692.12 $99,461.00 $87,646.00 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 12 6 — — $30,357.15 $98,227.00 $87,368.00 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 12 6 — — $46,468.81 $97,942.00 $86,681.00 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 12 6 — — $34,965.60 $107,835.00 $86,606.50 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 12 6 — — $34,048.33 $95,168.00 $84,506.00 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 — — $83,268.99 $83,268.99 $83,268.99 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 12 6 — — $25,079.98 $103,546.00 $82,981.50 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 12 6 — — $33,692.38 $103,546.00 $82,981.50 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 12 6 — — $23,336.01 $93,924.00 $81,454.00 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 12 6 — — $22,057.53 $92,805.00 $81,241.00 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 12 6 — — $33,564.95 $83,930.00 $79,270.50 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 6 — — $41,205.33 $98,644.00 $79,042.50 2026-04-01
10 MS_DRG Pancreas Transplant 3 3 — — $78,591.03 $78,591.03 $78,591.03 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 3 3 — — $78,559.44 $78,559.44 $78,559.44 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 — — $78,158.20 $78,158.20 $78,158.20 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 12 6 — — $29,591.54 $98,073.00 $76,803.50 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 12 6 — — $37,687.91 $90,885.00 $76,757.50 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 12 6 — — $29,908.53 $115,067.00 $76,714.00 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 12 6 — — $30,937.42 $80,847.00 $76,371.50 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $75,811.85 $75,811.85 $75,811.85 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 12 6 — — $32,213.80 $93,948.00 $75,327.50 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 3 2 — — $24,228.42 $74,101.05 $74,101.05 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $73,908.87 $73,908.87 $73,908.87 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 12 6 — — $26,006.72 $90,885.00 $73,026.50 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $72,016.42 $72,016.42 $72,016.42 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 12 6 — — $25,453.83 $75,504.00 $71,314.50 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 12 6 — — $26,140.47 $88,843.00 $71,273.00 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 12 6 — — $29,603.12 $75,301.00 $71,119.50 2026-04-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 6 — — $22,019.61 $81,423.00 $70,945.00 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 5 3 — — $70,787.43 $257,828.00 $70,787.43 2026-04-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 12 6 — — $21,217.14 $80,966.00 $70,532.00 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 12 6 — — $41,688.71 $86,388.00 $69,412.00 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 11 5 — — $28,531.05 $81,897.00 $67,700.00 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $67,486.95 $67,486.95 $67,486.95 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 10 6 — — $33,583.91 $70,764.00 $67,172.00 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 12 6 — — $36,112.45 $83,123.00 $66,794.00 2026-04-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 12 6 — — $24,317.52 $83,123.00 $66,794.00 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 — — $65,614.51 $65,614.51 $65,614.51 2026-04-01
38 MS_DRG Extracranial Procedures With Cc 12 6 — — $20,110.31 $74,507.00 $65,596.50 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 3 3 — — $65,469.18 $65,469.18 $65,469.18 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $64,785.70 $64,785.70 $64,785.70 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 12 6 — — $28,732.19 $80,633.00 $64,742.50 2026-04-01
27447 HCPCS Total Knee Arthroplasty 3 2 — — $18,095.36 $64,740.00 $64,740.00 2026-04-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 6 — — $21,527.81 $67,226.00 $63,815.50 2026-04-01
58546 HCPCS Laparo-myomectomy Complex 7 5 — — $14,982.12 $72,146.00 $63,668.00 2026-04-01
50544 HCPCS Laparoscopy Pyeloplasty 7 5 — — $14,982.12 $65,622.00 $63,415.00 2026-04-01
55866 HCPCS Laparo Radical Prostatectomy 7 5 — — $14,982.12 $66,265.00 $63,415.00 2026-04-01
27130 HCPCS Total Hip Arthroplasty 3 2 — — $18,095.36 $63,249.00 $63,249.00 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 12 6 — — $25,229.52 $66,822.00 $63,121.50 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 5 4 — — $1,226.35 $68,059.69 $63,084.94 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 3 — — $63,044.90 $214,679.00 $63,044.90 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 13 7 — — $42,380.61 $77,052.40 $62,168.00 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 4 4 — — $36,803.93 $90,454.33 $62,105.90 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 3 — — $62,045.49 $62,045.49 $62,045.49 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 3 — — $61,641.09 $61,641.09 $61,641.09 2026-04-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 12 6 — — $18,761.27 $74,671.00 $61,475.00 2026-04-01
J9266 HCPCS Pegaspargase Injection 7 3 — — $28,424.06 $62,262.23 $61,062.67 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 3 3 — — $60,837.56 $60,837.56 $60,837.56 2026-04-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc 12 6 — — $25,566.52 $69,626.00 $60,563.00 2026-04-01
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 12 6 — — $21,785.82 $75,360.00 $60,539.50 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 — — $60,460.55 $60,460.55 $60,460.55 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 3 3 — — $60,230.97 $60,230.97 $60,230.97 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 12 6 — — $26,325.82 $74,542.00 $59,780.00 2026-04-01
582 MS_DRG Mastectomy For Malignancy With Cc/Mcc 12 6 — — $23,311.79 $67,463.00 $59,021.50 2026-04-01
131 MS_DRG Cranial/Facial Procedures W Cc/Mcc 2 1 — — $49,308.00 $68,486.00 $58,897.00 2026-04-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 12 6 — — $24,086.89 $67,038.00 $58,136.50 2026-04-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/Mcc 12 6 — — $20,534.72 $72,298.00 $58,036.50 2026-04-01
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 12 6 — — $22,931.62 $72,298.00 $58,036.50 2026-04-01
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/Mcc 12 6 — — $20,187.19 $72,298.00 $58,036.50 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 12 6 — — $37,278.25 $72,298.00 $58,036.50 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $57,746.66 $57,746.66 $57,746.66 2026-04-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 12 6 — — $24,722.97 $60,844.00 $57,470.00 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 12 6 — — $26,583.83 $59,980.00 $56,652.00 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 12 6 — — $20,836.96 $70,664.00 $56,290.50 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 12 6 — — $28,154.03 $70,664.00 $56,290.50 2026-04-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 12 6 — — $20,198.77 $69,643.00 $55,722.00 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 4 4 — — $19,558.40 $55,545.64 $55,545.64 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $55,031.72 $55,031.72 $55,031.72 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $54,853.74 $54,853.74 $54,853.74 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $54,637.85 $54,637.85 $54,637.85 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 12 6 — — $34,831.85 $65,274.00 $54,468.00 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 3 2 — — $3,159.80 $54,373.92 $54,373.92 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 12 6 — — $23,181.20 $59,914.00 $53,802.50 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $53,617.38 $53,617.38 $53,617.38 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 12 6 — — $34,792.89 $66,375.00 $53,325.50 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 3 — — $52,533.72 $52,533.72 $52,533.72 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $52,432.62 $52,432.62 $52,432.62 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $52,285.19 $52,285.19 $52,285.19 2026-04-01
58544 HCPCS Lsh W/t/o Uterus Above 250 G 7 5 — — $14,982.12 $59,137.00 $52,190.00 2026-04-01
49656 HCPCS Lap Inc Hernia Repair Recur 1 1 — — $52,171.00 $52,171.00 $52,171.00 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 3 3 — — $51,855.51 $51,855.51 $51,855.51 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 — — $51,429.00 $51,429.00 $51,429.00 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 12 6 — — $26,397.43 $54,351.00 $51,341.00 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $51,305.79 $51,305.79 $51,305.79 2026-04-01
245 MS_DRG Aicd Generator Procedures 3 3 — — $51,069.89 $51,069.89 $51,069.89 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 3 — — $50,925.61 $50,925.61 $50,925.61 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 3 3 — — $50,717.09 $50,717.09 $50,717.09 2026-04-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 13 6 — — $21,220.30 $68,747.00 $50,716.00 2026-04-01
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 12 6 — — $22,079.64 $53,542.00 $50,574.00 2026-04-01
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 12 6 — — $24,240.64 $58,149.00 $50,557.00 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 12 6 — — $28,243.54 $70,496.00 $50,206.00 2026-04-01
504 MS_DRG Foot Procedures With Cc 12 6 — — $22,707.30 $61,677.00 $49,714.00 2026-04-01
503 MS_DRG Foot Procedures With Mcc 12 6 — — $32,416.00 $61,677.00 $49,714.00 2026-04-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 12 6 — — $22,718.89 $52,477.00 $49,566.50 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 — — $49,283.80 $49,283.80 $49,283.80 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 3 — — $48,595.06 $48,595.06 $48,595.06 2026-04-01
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc 12 6 — — $23,338.12 $59,265.00 $48,520.00 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 12 6 — — $34,508.00 $51,364.00 $48,514.50 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 5 3 — — $48,231.73 $128,369.00 $48,231.73 2026-04-01
506 MS_DRG Major Thumb Or Joint Procedures 12 6 — — $17,231.08 $55,405.00 $48,066.50 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 3 3 — — $47,941.07 $47,941.07 $47,941.07 2026-04-01
23615 HCPCS Treat Humerus Fracture 5 4 — — $18,095.36 $55,255.00 $47,888.00 2026-04-01
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc 13 7 — — $18,219.96 $56,142.00 $47,788.00 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 3 — — $47,421.89 $47,421.89 $47,421.89 2026-04-01
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/Mcc 12 6 — — $22,045.94 $59,024.00 $47,412.50 2026-04-01
508 MS_DRG Major Shoulder Or Elbow Joint Procedures Without Cc/Mcc 12 6 — — $18,970.84 $59,024.00 $47,412.50 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 — — $47,399.77 $47,399.77 $47,399.77 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 — — $47,270.24 $47,270.24 $47,270.24 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 — — $47,217.58 $47,217.58 $47,217.58 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 3 3 — — $46,933.24 $46,933.24 $46,933.24 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 — — $46,758.42 $46,758.42 $46,758.42 2026-04-01
716 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy Without Cc/Mcc 12 6 — — $18,513.78 $49,208.00 $46,477.00 2026-04-01
39 MS_DRG Extracranial Procedures Without Cc/Mcc 12 6 — — $15,401.82 $52,820.00 $45,990.00 2026-04-01
791 MS_DRG Prematurity With Major Problems 3 3 — — $45,768.49 $45,768.49 $45,768.49 2026-04-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 12 6 — — $14,291.83 $56,774.00 $45,552.00 2026-04-01
398 MS_DRG Appendix Procedures With Cc 12 6 — — $18,962.41 $56,774.00 $45,302.50 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 12 6 — — $29,730.55 $56,164.00 $45,108.00 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $44,979.70 $44,979.70 $44,979.70 2026-04-01
578 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/Mcc 12 6 — — $19,939.71 $47,334.00 $44,705.00 2026-04-01
583 MS_DRG Mastectomy For Malignancy Without Cc/Mcc 12 6 — — $21,182.39 $52,220.00 $44,597.50 2026-04-01
501 MS_DRG Soft Tissue Procedures With Cc 12 6 — — $21,431.97 $47,206.00 $44,585.50 2026-04-01
132 MS_DRG Cranial/Facial Procedures Without Cc/Mcc 5 3 — — $33,844.00 $49,436.00 $44,389.00 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 3 — — $44,032.95 $44,032.95 $44,032.95 2026-04-01
5376 OTHER Level 6 Urology And Related Services 5 4 — — $677.32 $54,925.09 $43,919.81 2026-04-01
505 MS_DRG Foot Procedures Without Cc/Mcc 12 6 — — $21,902.72 $50,095.00 $43,802.50 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 3 — — $43,785.47 $43,785.47 $43,785.47 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 3 — — $43,724.39 $43,724.39 $43,724.39 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
61886 HCPCS Implant Neurostim Arrays 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 1 1 — — $43,492.09 $43,492.09 $43,492.09 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 — — $43,454.79 $43,454.79 $43,454.79 2026-04-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 12 6 — — $24,907.27 $45,952.00 $43,401.00 2026-04-01
304 MS_DRG Hypertension With Mcc 12 6 — — $15,554.52 $45,898.00 $43,350.50 2026-04-01
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc 12 6 — — $19,364.70 $49,493.00 $43,293.00 2026-04-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 12 6 — — $24,920.96 $49,430.00 $43,065.00 2026-04-01
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc 12 6 — — $24,601.86 $45,535.00 $43,007.00 2026-04-01
63 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 6 — — $17,806.09 $45,264.00 $42,968.50 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $42,651.26 $42,651.26 $42,651.26 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 5 3 — — $42,478.55 $101,416.00 $42,478.55 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 3 — — $42,384.82 $42,384.82 $42,384.82 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 5 3 — — $42,270.03 $108,019.00 $42,270.03 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 3 — — $42,048.88 $42,048.88 $42,048.88 2026-04-01
29916 HCPCS Hip Arthro W/labral Repair 5 4 — — $10,227.20 $44,774.00 $41,728.00 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 3 3 — — $41,704.51 $41,704.51 $41,704.51 2026-04-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 12 6 — — $14,687.80 $43,875.00 $41,434.00 2026-04-01
58573 HCPCS Tlh W/t/o Uterus Over 250 G 7 5 — — $14,982.12 $47,427.00 $41,332.00 2026-04-01
27427 HCPCS Reconstruction Knee 7 5 — — $10,227.20 $44,774.00 $41,295.00 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 — — $41,234.81 $41,234.81 $41,234.81 2026-04-01
332 MS_DRG Rectal Resection With Mcc 3 3 — — $41,152.67 $41,152.67 $41,152.67 2026-04-01
265 MS_DRG Aicd Lead Procedures 3 3 — — $41,126.34 $41,126.34 $41,126.34 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 5 3 — — $41,058.94 $179,231.00 $41,058.94 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 3 — — $41,002.08 $41,002.08 $41,002.08 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 3 — — $40,753.54 $40,753.54 $40,753.54 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 — — $40,666.13 $40,666.13 $40,666.13 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 5 3 — — $40,572.40 $118,188.00 $40,572.40 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 5 3 — — $40,540.81 $106,517.00 $40,540.81 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 5 3 — — $40,505.00 $106,125.00 $40,505.00 2026-04-01
334 MS_DRG Rectal Resection Without Cc/Mcc 12 6 — — $20,271.44 $45,779.00 $40,454.00 2026-04-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 13 6 — — $20,745.34 $45,669.00 $40,352.00 2026-04-01
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc 12 6 — — $18,754.95 $50,038.00 $40,176.50 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 5 3 — — $40,085.86 $114,567.00 $40,085.86 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 — — $39,748.86 $39,748.86 $39,748.86 2026-04-01
497 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 6 — — $15,747.24 $49,424.00 $39,731.50 2026-04-01
27814 HCPCS Treatment Of Ankle Fracture 7 5 — — $10,227.20 $44,925.00 $39,648.00 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 3 — — $39,580.37 $39,580.37 $39,580.37 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 5 3 — — $39,403.44 $89,645.00 $39,403.44 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $39,127.52 $39,127.52 $39,127.52 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 — — $38,903.21 $38,903.21 $38,903.21 2026-04-01
57425 HCPCS Laparoscopy Surg Colpopexy 7 5 — — $14,982.12 $43,300.00 $38,827.00 2026-04-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 12 6 — — $20,740.08 $41,031.00 $38,757.00 2026-04-01
708 MS_DRG Major Male Pelvic Procedures Without Cc/Mcc 12 6 — — $19,179.35 $44,115.00 $38,583.00 2026-04-01
713 MS_DRG Transurethral Prostatectomy With Cc/Mcc 12 6 — — $18,854.99 $40,715.00 $38,465.00 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 5 3 — — $38,202.89 $95,518.00 $38,202.89 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 3 — — $37,810.07 $37,810.07 $37,810.07 2026-04-01
58571 HCPCS Tlh W/t/o 250 G Or Less 7 5 — — $14,982.12 $44,246.00 $37,248.00 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 3 — — $37,089.74 $37,089.74 $37,089.74 2026-04-01
652 MS_DRG Kidney Transplant 3 3 — — $37,032.87 $37,032.87 $37,032.87 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 5 3 — — $37,007.60 $100,097.00 $37,007.60 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 3 3 — — $36,941.25 $36,941.25 $36,941.25 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 3 — — $36,831.73 $36,831.73 $36,831.73 2026-04-01
27829 HCPCS Treat Lower Leg Joint 7 5 — — $10,227.20 $41,626.00 $36,735.00 2026-04-01
63042 HCPCS Laminotomy Single Lumbar 7 5 — — $10,227.20 $41,121.00 $36,725.00 2026-04-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 10 6 — — $11,078.78 $47,718.00 $36,621.49 2026-04-01
513 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc 12 6 — — $19,601.65 $41,316.00 $36,610.00 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 5 3 — — $36,584.24 $92,202.00 $36,584.24 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 5 3 — — $36,551.60 $154,627.00 $36,551.60 2026-04-01
27524 HCPCS Treat Kneecap Fracture 7 5 — — $10,227.20 $41,400.00 $36,535.00 2026-04-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 12 6 — — $22,345.03 $38,599.00 $36,454.50 2026-04-01
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