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

TAHOE FOREST HOSPITAL

Truckee, CA · CCN 051328 · Rates published

Your selected procedure

You selected 508 (MS_DRG)

MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC

This hospital’s price: $42,795 across 2 payers · range $42,371-$43,219

Source: https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbTFHDTruckeeCA&type=CDMWithoutLabel · observed 2025-10-04

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.

6,740 distinct procedures filed
25 distinct payers
223,856 rate rows
2025-10-04 last MRF observed · ⚠ 13 mo old
Data quality

211,815 of 223,856 rate rows are consumer-grade (94.6%)

12,041 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,771
template filing: same amount across many unrelated codes — excluded 4,833
percent-of-charges filed in the dollar field — excluded from medians 306
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 54
exceeds 3× this hospital's gross charge for a DRG stay — excluded 46
exceeds 10× this hospital's gross charge — excluded from medians 20
placeholder amount (≤ $0.02) — excluded from medians 8
per-diem day rate — not a per-procedure price 3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbTFHDTruckeeCA&type=CDMWithoutLabel
Discovered viaDiscovered by HANK
Last fetch success · 2026-11-08
Content fingerprint 3f53469e746e1053… · 76,944,354 bytes · first seen 2026-05-04

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
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 3 $87,900.96 $116,908.28 $89,658.98 nat. median
$59,289
1.5× median
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 $68,336.66 $69,703.39 $69,020.02 nat. median
$35,358
2.0× median
958
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Cc 2 $68,336.66 $69,703.39 $69,020.02 nat. median
$38,903
1.8× median
654
MS_DRG 		Major Bladder Procedures With Cc 3 $67,254.72 $89,448.78 $68,599.82 nat. median
$26,712
outlier · 2.6×
77371
HCPCS 		Complete Single Session Course Of Cranial Lesion Surgery Using Radiation 22 $1,078.50 $73,817.97 $68,490.90 nat. median
$9,357
outlier · 7.3×
J2350
HCPCS 		Injection, Ocrelizumab, 1 Mg 22 $62.81 $70,805.64 $65,695.95 nat. median
$714
outlier · 92.1×
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 3 $56,443.79 $75,070.24 $57,572.66 nat. median
$18,107
outlier · 3.2×
940
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 2 $56,443.79 $57,572.66 $57,008.23 nat. median
$21,594
outlier · 2.6×
941
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 2 $56,443.79 $57,572.66 $57,008.23 nat. median
$18,995
outlier · 3.0×
939
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 $56,443.79 $57,572.66 $57,008.23 nat. median
$32,092
1.8× median
J3241
HCPCS 		Injection, Teprotumumab-trbw, 10 Mg 21 $352.56 $60,407.24 $56,047.95 nat. median
$738
outlier · 75.9×
327
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Cc 3 $54,931.39 $73,058.75 $56,030.02 nat. median
$23,547
outlier · 2.4×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 3 $54,931.39 $73,058.75 $56,030.02 nat. median
$46,321
1.2× median
328
MS_DRG 		Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 3 $54,931.39 $73,058.75 $56,030.02 nat. median
$15,736
outlier · 3.6×
982
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 $54,810.36 $55,906.57 $55,358.46 nat. median
$23,126
outlier · 2.4×
801
MS_DRG 		Splenic Procedures Without Cc/mcc 3 $50,965.70 $67,784.38 $51,985.01 nat. median
$17,864
outlier · 2.9×
834
MS_DRG 		Acute Leukemia With Mcc 3 $49,195.45 $65,429.95 $50,179.36 nat. median
$50,311
1.0× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 $48,499.77 $64,504.69 $49,469.76 nat. median
$45,281
1.1× median
498
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$26,319
1.9× median
496
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$18,258
outlier · 2.7×
497
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$12,950
outlier · 3.8×
481
MS_DRG 		Hip And Femur Procedures Except Major Joint With Cc 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$20,298
outlier · 2.4×
482
MS_DRG 		Hip And Femur Procedures Except Major Joint Without Cc/mcc 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$15,976
outlier · 3.1×
495
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$33,725
1.5× median
480
MS_DRG 		Hip And Femur Procedures Except Major Joint With Mcc 2 $48,948.12 $49,927.08 $49,437.60 nat. median
$27,774
1.8× median
242
MS_DRG 		Permanent Cardiac Pacemaker Implant With Mcc 2 $48,802.88 $49,778.94 $49,290.91 nat. median
$30,977
1.6× median
243
MS_DRG 		Permanent Cardiac Pacemaker Implant With Cc 2 $48,802.88 $49,778.94 $49,290.91 nat. median
$21,217
outlier · 2.3×
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 $48,499.77 $49,469.76 $48,984.76 nat. median
$19,149
outlier · 2.6×
263
MS_DRG 		Vein Ligation And Stripping 3 $47,091.57 $62,631.79 $48,033.40 nat. median
$27,055
1.8× median
492
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$33,640
1.4× median
487
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$15,472
outlier · 3.1×
494
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$18,763
outlier · 2.6×
462
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$26,390
1.8× median
489
MS_DRG 		Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$12,125
outlier · 4.0×
488
MS_DRG 		Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$18,136
outlier · 2.6×
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$23,545
outlier · 2.0×
485
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$30,552
1.6× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 $47,508.35 $48,458.51 $47,983.43 nat. median
$53,268
0.9× median
336
MS_DRG 		Peritoneal Adhesiolysis With Cc 3 $44,737.20 $59,500.48 $45,631.94 nat. median
$20,257
outlier · 2.3×
337
MS_DRG 		Peritoneal Adhesiolysis Without Cc/mcc 3 $44,737.20 $59,500.48 $45,631.94 nat. median
$15,105
outlier · 3.0×
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 2 $44,076.25 $44,957.78 $44,517.01 nat. median
$17,777
outlier · 2.5×
261
MS_DRG 		Cardiac Pacemaker Revision Except Device Replacement With Cc 3 $42,581.75 $56,633.73 $43,433.38 nat. median
$18,555
outlier · 2.3×
512
MS_DRG 		Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 3 $42,371.26 $56,353.77 $43,218.68 nat. median
$16,057
outlier · 2.7×
509
MS_DRG 		Arthroscopy 3 $42,371.26 $56,353.77 $43,218.68 nat. median
$16,613
outlier · 2.6×
511
MS_DRG 		Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 2 $42,371.26 $43,218.68 $42,794.97 nat. median
$19,650
outlier · 2.2×
508
MS_DRG 		Major Shoulder Or Elbow Joint Procedures Without Cc/mcc 2 $42,371.26 $43,218.68 $42,794.97 nat. median
$14,497
outlier · 3.0×
858
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/mcc 3 $40,897.80 $54,394.08 $41,715.76 nat. median
$13,544
outlier · 3.1×
856
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 $40,897.80 $41,715.76 $41,306.78 nat. median
$41,637
1.0× median
857
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 $40,897.80 $41,715.76 $41,306.78 nat. median
$20,333
outlier · 2.0×
264
MS_DRG 		Other Circulatory System O.r. Procedures 3 $40,350.52 $53,666.19 $41,157.53 nat. median
$31,077
1.3× median

Other procedures at this hospital

Browse this hospital's 6,740 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
             
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 $140,938.00 $140,938.00 $87,900.96 $116,908.28 $89,658.98 2025-10-04
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 $123,315.74 $123,315.74 $68,336.66 $69,703.39 $69,020.02 2025-10-04
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 2 $56,833.50 $56,833.50 $68,336.66 $69,703.39 $69,020.02 2025-10-04
654 MS_DRG Major Bladder Procedures With Cc 3 3 $79,502.50 $79,502.50 $67,254.72 $89,448.78 $68,599.82 2025-10-04
77371 HCPCS Complete Single Session Course Of Cranial Lesion Surgery Using Radiation 22 22 $76,101.00 $76,101.00 $1,078.50 $73,817.97 $68,490.90 2025-10-04
J2350 HCPCS Injection, Ocrelizumab, 1 Mg 22 22 $72,995.50 $72,995.50 $62.81 $70,805.64 $65,695.95 2025-10-04
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 3 3 $27,350.10 $27,350.10 $56,443.79 $75,070.24 $57,572.66 2025-10-04
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 2 2 $66,833.00 $66,833.00 $56,443.79 $57,572.66 $57,008.23 2025-10-04
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 2 2 $138,595.50 $138,595.50 $56,443.79 $57,572.66 $57,008.23 2025-10-04
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 2 $60,918.00 $60,918.00 $56,443.79 $57,572.66 $57,008.23 2025-10-04
J3241 HCPCS Injection, Teprotumumab-trbw, 10 Mg 21 21 $62,275.50 $62,275.50 $352.56 $60,407.24 $56,047.95 2025-10-04
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 3 $79,377.13 $79,377.13 $54,931.39 $73,058.75 $56,030.02 2025-10-04
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 $159,622.50 $159,622.50 $54,931.39 $73,058.75 $56,030.02 2025-10-04
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 3 3 $44,199.50 $44,199.50 $54,931.39 $73,058.75 $56,030.02 2025-10-04
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 2 $24,070.00 $24,070.00 $54,810.36 $55,906.57 $55,358.46 2025-10-04
801 MS_DRG Splenic Procedures Without Cc/mcc 3 3 $64,063.80 $64,063.80 $50,965.70 $67,784.38 $51,985.01 2025-10-04
834 MS_DRG Acute Leukemia With Mcc 3 3 $35,839.50 $35,839.50 $49,195.45 $65,429.95 $50,179.36 2025-10-04
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 $39,133.98 $39,133.98 $48,499.77 $64,504.69 $49,469.76 2025-10-04
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 2 2 $37,772.50 $37,772.50 $48,948.12 $49,927.08 $49,437.60 2025-10-04
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 2 $78,061.25 $78,061.25 $48,948.12 $49,927.08 $49,437.60 2025-10-04
497 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 2 $118,277.02 $118,277.02 $48,948.12 $49,927.08 $49,437.60 2025-10-04
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 2 $84,310.12 $84,310.12 $48,948.12 $49,927.08 $49,437.60 2025-10-04
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 2 2 $76,498.05 $76,498.05 $48,948.12 $49,927.08 $49,437.60 2025-10-04
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 2 $124,521.53 $124,521.53 $48,948.12 $49,927.08 $49,437.60 2025-10-04
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 2 $122,608.42 $122,608.42 $48,948.12 $49,927.08 $49,437.60 2025-10-04
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 2 $79,928.00 $79,928.00 $48,802.88 $49,778.94 $49,290.91 2025-10-04
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 2 $82,484.96 $82,484.96 $48,802.88 $49,778.94 $49,290.91 2025-10-04
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 2 $60,121.38 $60,121.38 $48,499.77 $49,469.76 $48,984.76 2025-10-04
263 MS_DRG Vein Ligation And Stripping 3 3 $95,603.50 $95,603.50 $47,091.57 $62,631.79 $48,033.40 2025-10-04
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 2 $96,916.33 $96,916.33 $47,508.35 $48,458.51 $47,983.43 2025-10-04
487 MS_DRG Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 2 2 $48,384.17 $48,384.17 $47,508.35 $48,458.51 $47,983.43 2025-10-04
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 2 2 $69,009.75 $69,009.75 $47,508.35 $48,458.51 $47,983.43 2025-10-04
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 2 $104,965.28 $104,965.28 $47,508.35 $48,458.51 $47,983.43 2025-10-04
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 2 2 $54,514.00 $54,514.00 $47,508.35 $48,458.51 $47,983.43 2025-10-04
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 2 2 $68,974.50 $68,974.50 $47,508.35 $48,458.51 $47,983.43 2025-10-04
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 2 $78,629.04 $78,629.04 $47,508.35 $48,458.51 $47,983.43 2025-10-04
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 2 $134,063.00 $134,063.00 $47,508.35 $48,458.51 $47,983.43 2025-10-04
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 2 $182,030.99 $182,030.99 $47,508.35 $48,458.51 $47,983.43 2025-10-04
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 3 $89,172.00 $89,172.00 $44,737.20 $59,500.48 $45,631.94 2025-10-04
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 3 3 $24,846.50 $24,846.50 $44,737.20 $59,500.48 $45,631.94 2025-10-04
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 2 2 $53,078.13 $53,078.13 $44,076.25 $44,957.78 $44,517.01 2025-10-04
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 3 3 $46,017.50 $46,017.50 $42,581.75 $56,633.73 $43,433.38 2025-10-04
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 3 3 $31,892.00 $31,892.00 $42,371.26 $56,353.77 $43,218.68 2025-10-04
509 MS_DRG Arthroscopy 3 3 $250,232.50 $250,232.50 $42,371.26 $56,353.77 $43,218.68 2025-10-04
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 2 2 $90,890.50 $90,890.50 $42,371.26 $43,218.68 $42,794.97 2025-10-04
508 MS_DRG Major Shoulder Or Elbow Joint Procedures Without Cc/mcc 2 2 $57,607.00 $57,607.00 $42,371.26 $43,218.68 $42,794.97 2025-10-04
858 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/mcc 3 3 $43,589.00 $43,589.00 $40,897.80 $54,394.08 $41,715.76 2025-10-04
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 2 $69,427.00 $69,427.00 $40,897.80 $41,715.76 $41,306.78 2025-10-04
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 2 $84,355.00 $84,355.00 $40,897.80 $41,715.76 $41,306.78 2025-10-04
264 MS_DRG Other Circulatory System O.r. Procedures 3 3 $126,747.50 $126,747.50 $40,350.52 $53,666.19 $41,157.53 2025-10-04
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 $42,195.27 $42,195.27 $40,275.79 $53,566.81 $41,081.31 2025-10-04
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 3 3 $20,083.50 $20,083.50 $40,275.79 $53,566.81 $41,081.31 2025-10-04
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 $71,903.50 $71,903.50 $40,275.79 $53,566.81 $41,081.31 2025-10-04
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 3 3 $34,719.69 $34,719.69 $40,197.91 $53,463.22 $41,001.87 2025-10-04
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 3 3 $25,920.00 $25,920.00 $40,197.91 $53,463.22 $41,001.87 2025-10-04
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 3 $166,532.49 $166,532.49 $40,197.91 $53,463.22 $41,001.87 2025-10-04
476 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc… 3 3 $27,632.88 $27,632.88 $40,197.91 $53,463.22 $41,001.87 2025-10-04
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 3 $28,054.21 $28,054.21 $40,197.91 $53,463.22 $41,001.87 2025-10-04
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 $154,161.31 $154,161.31 $40,004.26 $53,205.66 $40,804.34 2025-10-04
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/mcc 3 3 $22,479.50 $22,479.50 $40,004.26 $53,205.66 $40,804.34 2025-10-04
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 3 3 $36,216.83 $36,216.83 $40,004.26 $53,205.66 $40,804.34 2025-10-04
908 MS_DRG Other O.r. Procedures For Injuries With Cc 3 3 $93,338.00 $93,338.00 $40,004.26 $53,205.66 $40,804.34 2025-10-04
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 $48,948.00 $48,948.00 $40,197.91 $41,001.87 $40,599.89 2025-10-04
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 2 $83,116.00 $83,116.00 $40,004.26 $40,804.34 $40,404.30 2025-10-04
479 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc 2 2 $51,523.00 $51,523.00 $40,004.26 $40,804.34 $40,404.30 2025-10-04
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 2 $70,558.50 $70,558.50 $40,004.26 $40,804.34 $40,404.30 2025-10-04
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 2 $93,069.00 $93,069.00 $40,004.26 $40,804.34 $40,404.30 2025-10-04
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 2 $94,337.55 $94,337.55 $40,004.26 $40,804.34 $40,404.30 2025-10-04
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 2 $157,187.00 $157,187.00 $39,837.97 $40,634.73 $40,236.35 2025-10-04
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc 2 2 $17,296.50 $17,296.50 $39,512.76 $40,303.01 $39,907.89 2025-10-04
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 2 2 $47,080.74 $47,080.74 $39,512.76 $40,303.01 $39,907.89 2025-10-04
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 3 3 $36,050.00 $36,050.00 $38,239.27 $50,858.23 $39,004.06 2025-10-04
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 2 2 $30,531.50 $30,531.50 $38,075.09 $38,836.59 $38,455.84 2025-10-04
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 3 3 $59,790.45 $59,790.45 $37,296.26 $49,604.03 $38,042.19 2025-10-04
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 2 2 $106,682.50 $106,682.50 $37,296.26 $38,042.19 $37,669.23 2025-10-04
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 2 2 $80,932.74 $80,932.74 $37,296.26 $38,042.19 $37,669.23 2025-10-04
138 MS_DRG Mouth Procedures Without Cc/mcc 3 3 $17,382.50 $17,382.50 $36,106.97 $48,022.28 $36,829.11 2025-10-04
139 MS_DRG Salivary Gland Procedures 3 3 $41,591.25 $41,591.25 $36,106.97 $48,022.28 $36,829.11 2025-10-04
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 3 $34,985.90 $34,985.90 $35,507.07 $47,224.40 $36,217.21 2025-10-04
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 $44,731.35 $44,731.35 $35,507.07 $47,224.40 $36,217.21 2025-10-04
663 MS_DRG Minor Bladder Procedures With Cc 2 2 $42,341.25 $42,341.25 $35,598.63 $36,310.61 $35,954.62 2025-10-04
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 3 3 $25,723.50 $25,723.50 $35,061.87 $46,632.29 $35,763.11 2025-10-04
501 MS_DRG Soft Tissue Procedures With Cc 3 3 $51,245.70 $51,245.70 $34,882.96 $46,394.33 $35,580.61 2025-10-04
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 3 3 $30,105.00 $30,105.00 $34,882.96 $46,394.33 $35,580.61 2025-10-04
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 3 3 $15,702.58 $15,702.58 $34,882.96 $46,394.33 $35,580.61 2025-10-04
500 MS_DRG Soft Tissue Procedures With Mcc 2 2 $112,250.50 $112,250.50 $34,882.96 $35,580.61 $35,231.79 2025-10-04
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 2 2 $42,629.50 $42,629.50 $34,882.96 $35,580.61 $35,231.79 2025-10-04
711 MS_DRG Testes Procedures With Cc/mcc 3 3 $119,113.75 $119,113.75 $34,194.64 $45,478.87 $34,878.53 2025-10-04
288 MS_DRG Acute And Subacute Endocarditis With Mcc 2 2 $14,913.00 $14,913.00 $34,421.97 $35,110.41 $34,766.19 2025-10-04
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 2 2 $85,857.50 $85,857.50 $34,421.97 $35,110.41 $34,766.19 2025-10-04
504 MS_DRG Foot Procedures With Cc 3 3 $28,886.00 $28,886.00 $33,772.60 $44,917.56 $34,448.05 2025-10-04
505 MS_DRG Foot Procedures Without Cc/mcc 2 2 $143,929.54 $143,929.54 $33,772.60 $34,448.05 $34,110.32 2025-10-04
503 MS_DRG Foot Procedures With Mcc 2 2 $156,725.00 $156,725.00 $33,772.60 $34,448.05 $34,110.32 2025-10-04
J9316 HCPCS Injection, Pertuzumab, Trastuzumab, And Hyaluronidase-zzxf, Per 10 Mg 39 21 $52,119.50 $52,119.50 $107.65 $50,555.92 $33,007.75 2025-10-04
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 3 3 $60,753.95 $60,753.95 $31,983.41 $42,537.93 $32,623.08 2025-10-04
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 3 3 $43,827.71 $43,827.71 $31,983.41 $42,537.93 $32,623.08 2025-10-04
J1930 HCPCS Injection, Lanreotide, 1 Mg 22 22 $35,914.00 $35,914.00 $68.69 $34,836.58 $32,322.60 2025-10-04
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/mcc 2 2 $11,749.50 $11,749.50 $31,983.41 $32,623.08 $32,303.25 2025-10-04
906 MS_DRG Hand Procedures For Injuries 3 3 $54,661.00 $54,661.00 $31,178.27 $41,467.10 $31,801.84 2025-10-04
514 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc 3 3 $30,792.52 $30,792.52 $31,178.27 $41,467.10 $31,801.84 2025-10-04
506 MS_DRG Major Thumb Or Joint Procedures 3 3 $29,465.50 $29,465.50 $31,178.27 $41,467.10 $31,801.84 2025-10-04
289 MS_DRG Acute And Subacute Endocarditis With Cc 3 3 $25,383.00 $25,383.00 $30,936.21 $41,145.15 $31,554.93 2025-10-04
513 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/mcc 2 2 $110,232.00 $110,232.00 $31,178.27 $31,801.84 $31,490.06 2025-10-04
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 2 2 $77,323.66 $77,323.66 $31,016.19 $31,636.52 $31,326.35 2025-10-04
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 2 2 $37,136.50 $37,136.50 $31,016.19 $31,636.52 $31,326.35 2025-10-04
670 MS_DRG Transurethral Procedures Without Cc/mcc 3 3 $21,842.00 $21,842.00 $30,707.82 $40,841.40 $31,321.98 2025-10-04
669 MS_DRG Transurethral Procedures With Cc 2 2 $30,583.95 $30,583.95 $30,707.82 $31,321.98 $31,014.90 2025-10-04
J9144 HCPCS Injection, Daratumumab, 10 Mg And Hyaluronidase-fihj 21 21 $34,315.00 $34,315.00 $69.30 $33,285.55 $30,883.50 2025-10-04
460000004 CDM Hchg Optime Sup Pacemaker Rev Cd 275 18 18 $34,046.65 $34,046.65 $29,246.07 $33,025.25 $30,641.99 2025-10-04
J9228 HCPCS Injection, Ipilimumab, 1 Mg 22 22 $32,332.00 $32,332.00 $159.88 $31,362.04 $29,098.80 2025-10-04
J2323 HCPCS Injection, Natalizumab, 1 Mg 22 22 $32,222.00 $32,222.00 $25.12 $31,255.34 $28,999.80 2025-10-04
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 3 3 $50,532.00 $50,532.00 $28,354.50 $37,711.49 $28,921.59 2025-10-04
571 MS_DRG Skin Debridement With Cc 3 3 $22,983.50 $22,983.50 $28,354.50 $37,711.49 $28,921.59 2025-10-04
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 $54,206.06 $54,206.06 $28,354.50 $37,711.49 $28,921.59 2025-10-04
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 3 $35,190.50 $35,190.50 $28,354.50 $37,711.49 $28,921.59 2025-10-04
572 MS_DRG Skin Debridement Without Cc/mcc 3 3 $38,368.99 $38,368.99 $28,354.50 $37,711.49 $28,921.59 2025-10-04
601 MS_DRG Non-malignant Breast Disorders Without Cc/mcc 3 3 $21,866.00 $21,866.00 $28,354.50 $37,711.49 $28,921.59 2025-10-04
J3380 HCPCS Injection, Vedolizumab, Intravenous, 1 Mg 22 22 $31,637.00 $31,637.00 $24.96 $30,687.89 $28,473.30 2025-10-04
964 MS_DRG Other Multiple Significant Trauma With Cc 3 3 $20,204.93 $20,204.93 $27,555.68 $36,649.06 $28,106.80 2025-10-04
965 MS_DRG Other Multiple Significant Trauma Without Cc/mcc 3 3 $39,689.50 $39,689.50 $27,555.68 $36,649.06 $28,106.80 2025-10-04
J9022 HCPCS Injection, Atezolizumab, 10 Mg 40 22 $40,395.50 $40,395.50 $82.86 $39,183.64 $26,863.15 2025-10-04
91 MS_DRG Other Disorders Of Nervous System With Mcc 3 3 $14,156.50 $14,156.50 $26,233.78 $34,890.93 $26,758.46 2025-10-04
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 3 3 $16,948.00 $16,948.00 $26,233.78 $34,890.93 $26,758.46 2025-10-04
J9301 HCPCS Injection, Obinutuzumab, 10 Mg 22 22 $29,215.00 $29,215.00 $68.82 $28,338.55 $26,293.50 2025-10-04
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 3 3 $33,822.38 $33,822.38 $25,232.89 $33,559.74 $25,737.55 2025-10-04
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 3 3 $38,777.39 $38,777.39 $25,232.89 $33,559.74 $25,737.55 2025-10-04
811 MS_DRG Red Blood Cell Disorders With Mcc 3 3 $28,113.17 $28,113.17 $24,822.43 $33,013.83 $25,318.87 2025-10-04
812 MS_DRG Red Blood Cell Disorders Without Mcc 3 3 $22,789.00 $22,789.00 $24,822.43 $33,013.83 $25,318.87 2025-10-04
545 MS_DRG Connective Tissue Disorders With Mcc 3 3 $50,781.82 $50,781.82 $24,409.86 $32,465.11 $24,898.06 2025-10-04
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 3 3 $14,920.33 $14,920.33 $24,395.12 $32,445.52 $24,883.03 2025-10-04
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 3 3 $38,306.30 $38,306.30 $24,395.12 $32,445.52 $24,883.03 2025-10-04
813 MS_DRG Coagulation Disorders 1 1 $8,311.00 $8,311.00 $24,822.43 $24,822.43 $24,822.43 2025-10-04
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 2 2 $10,774.50 $10,774.50 $24,395.12 $24,883.03 $24,639.07 2025-10-04
J9311 HCPCS Injection, Rituximab 10 Mg And Hyaluronidase 22 22 $26,975.00 $26,975.00 $49.51 $26,165.75 $24,277.50 2025-10-04
549 MS_DRG Septic Arthritis With Cc 3 3 $13,160.50 $13,160.50 $23,786.80 $31,636.44 $24,262.54 2025-10-04
548 MS_DRG Septic Arthritis With Mcc 3 3 $18,779.00 $18,779.00 $23,786.80 $31,636.44 $24,262.54 2025-10-04
539 MS_DRG Osteomyelitis With Mcc 3 3 $52,538.67 $52,538.67 $23,786.80 $31,636.44 $24,262.54 2025-10-04
540 MS_DRG Osteomyelitis With Cc 2 2 $43,497.42 $43,497.42 $23,786.80 $24,262.54 $24,024.67 2025-10-04
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 3 $55,988.00 $55,988.00 $23,461.59 $31,203.91 $23,930.82 2025-10-04
J9308 HCPCS Injection, Ramucirumab, 5 Mg 22 22 $26,537.00 $26,537.00 $63.79 $25,740.89 $23,883.30 2025-10-04
83 MS_DRG Traumatic Stupor And Coma >1 Hour With Cc 3 3 $18,024.50 $18,024.50 $23,377.39 $31,091.93 $23,844.94 2025-10-04
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 3 3 $16,142.00 $16,142.00 $23,280.56 $30,963.15 $23,746.17 2025-10-04
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 3 3 $37,637.67 $37,637.67 $23,280.56 $30,963.15 $23,746.17 2025-10-04
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 3 3 $11,716.00 $11,716.00 $23,280.56 $30,963.15 $23,746.17 2025-10-04
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 3 3 $10,934.00 $10,934.00 $23,280.56 $30,963.15 $23,746.17 2025-10-04
149 MS_DRG Dysequilibrium 2 2 $8,569.00 $8,569.00 $23,461.59 $23,930.82 $23,696.21 2025-10-04
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 3 $20,378.74 $20,378.74 $23,167.95 $30,813.37 $23,631.31 2025-10-04
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 3 3 $14,023.68 $14,023.68 $23,167.95 $30,813.37 $23,631.31 2025-10-04
55 MS_DRG Nervous System Neoplasms Without Mcc 3 3 $58,561.61 $58,561.61 $23,152.16 $30,792.38 $23,615.21 2025-10-04
54 MS_DRG Nervous System Neoplasms With Mcc 3 3 $14,178.50 $14,178.50 $23,152.16 $30,792.38 $23,615.21 2025-10-04
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 2 2 $8,138.00 $8,138.00 $23,377.39 $23,844.94 $23,611.17 2025-10-04
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 $193,402.80 $193,402.80 $22,890.10 $30,443.83 $23,347.90 2025-10-04
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 3 $34,110.87 $34,110.87 $22,890.10 $30,443.83 $23,347.90 2025-10-04
375 MS_DRG Digestive Malignancy With Cc 3 3 $23,359.00 $23,359.00 $22,799.59 $30,323.45 $23,255.58 2025-10-04
374 MS_DRG Digestive Malignancy With Mcc 3 3 $81,159.50 $81,159.50 $22,799.59 $30,323.45 $23,255.58 2025-10-04
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 3 3 $33,065.00 $33,065.00 $22,792.22 $30,313.65 $23,248.06 2025-10-04
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 3 3 $57,601.85 $57,601.85 $22,792.22 $30,313.65 $23,248.06 2025-10-04
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 2 $25,439.90 $25,439.90 $22,890.10 $23,347.90 $23,119.00 2025-10-04
444 MS_DRG Disorders Of The Biliary Tract With Mcc 3 3 $56,231.09 $56,231.09 $22,481.74 $29,900.71 $22,931.38 2025-10-04
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 3 3 $18,207.90 $18,207.90 $22,382.81 $29,769.14 $22,830.46 2025-10-04
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 3 3 $16,478.00 $16,478.00 $22,382.81 $29,769.14 $22,830.46 2025-10-04
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc 2 2 $40,347.50 $40,347.50 $22,481.74 $22,931.38 $22,706.56 2025-10-04
445 MS_DRG Disorders Of The Biliary Tract With Cc 2 2 $22,915.75 $22,915.75 $22,481.74 $22,931.38 $22,706.56 2025-10-04
382 MS_DRG Complicated Peptic Ulcer Without Cc/mcc 3 3 $13,335.50 $13,335.50 $22,032.34 $29,303.01 $22,472.98 2025-10-04
380 MS_DRG Complicated Peptic Ulcer With Mcc 3 3 $33,574.00 $33,574.00 $22,032.34 $29,303.01 $22,472.98 2025-10-04
381 MS_DRG Complicated Peptic Ulcer With Cc 3 3 $27,599.90 $27,599.90 $22,032.34 $29,303.01 $22,472.98 2025-10-04
383 MS_DRG Uncomplicated Peptic Ulcer With Mcc 3 3 $12,774.50 $12,774.50 $22,032.34 $29,303.01 $22,472.98 2025-10-04
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 3 $30,442.50 $30,442.50 $21,944.98 $29,186.83 $22,383.88 2025-10-04
847 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc 3 3 $54,823.02 $54,823.02 $21,944.98 $29,186.83 $22,383.88 2025-10-04
180 MS_DRG Respiratory Neoplasms With Mcc 3 3 $18,826.84 $18,826.84 $21,593.46 $28,719.30 $22,025.33 2025-10-04
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 3 3 $17,936.00 $17,936.00 $21,593.46 $28,719.30 $22,025.33 2025-10-04
828 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 $16,248.00 $16,248.00 $21,593.46 $28,719.30 $22,025.33 2025-10-04
71 MS_DRG Other Cerebrovascular Disorders With Cc 3 3 $13,163.00 $13,163.00 $21,493.47 $28,586.32 $21,923.34 2025-10-04
70 MS_DRG Other Cerebrovascular Disorders With Mcc 3 3 $30,309.00 $30,309.00 $21,493.47 $28,586.32 $21,923.34 2025-10-04
189 MS_DRG Pulmonary Edema And Respiratory Failure 3 3 $27,883.71 $27,883.71 $21,405.07 $28,468.74 $21,833.17 2025-10-04
196 MS_DRG Interstitial Lung Disease With Mcc 3 3 $12,128.50 $12,128.50 $21,405.07 $28,468.74 $21,833.17 2025-10-04
369 MS_DRG Major Esophageal Disorders With Cc 3 3 $21,932.50 $21,932.50 $21,329.29 $28,367.96 $21,755.88 2025-10-04
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 3 $25,690.00 $25,690.00 $21,088.27 $28,047.41 $21,510.04 2025-10-04
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 3 $14,328.83 $14,328.83 $21,088.27 $28,047.41 $21,510.04 2025-10-04
184 MS_DRG Major Chest Trauma With Cc 3 3 $11,463.50 $11,463.50 $21,083.01 $28,040.41 $21,504.67 2025-10-04
914 MS_DRG Traumatic Injury Without Mcc 3 3 $20,778.00 $20,778.00 $21,052.49 $27,999.81 $21,473.54 2025-10-04
552 MS_DRG Medical Back Problems Without Mcc 3 3 $13,070.75 $13,070.75 $21,052.49 $27,999.81 $21,473.54 2025-10-04
551 MS_DRG Medical Back Problems With Mcc 3 3 $32,832.00 $32,832.00 $21,052.49 $27,999.81 $21,473.54 2025-10-04
47135 HCPCS Transplantation Of Donor Liver 44 22 $23,723.00 $23,723.00 $85.00 $23,011.31 $21,350.70 2025-10-04
J9306 HCPCS Injection, Pertuzumab, 1 Mg 22 22 $23,703.50 $23,703.50 $16.96 $22,992.40 $21,333.15 2025-10-04
434 MS_DRG Cirrhosis And Alcoholic Hepatitis Without Cc/mcc 3 3 $15,842.85 $15,842.85 $20,899.88 $27,796.84 $21,317.88 2025-10-04
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 3 3 $46,666.25 $46,666.25 $20,899.88 $27,796.84 $21,317.88 2025-10-04
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 3 3 $39,211.67 $39,211.67 $20,899.88 $27,796.84 $21,317.88 2025-10-04
88 MS_DRG Concussion With Mcc 2 2 $8,025.00 $8,025.00 $21,018.81 $21,439.19 $21,229.00 2025-10-04
755 MS_DRG Malignancy, Female Reproductive System With Cc 3 3 $18,418.38 $18,418.38 $20,698.86 $27,529.49 $21,112.84 2025-10-04
642 MS_DRG Inborn And Other Disorders Of Metabolism 3 3 $48,350.53 $48,350.53 $20,547.31 $27,327.92 $20,958.25 2025-10-04
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 3 3 $42,785.50 $42,785.50 $20,395.75 $27,126.35 $20,803.67 2025-10-04
378 MS_DRG Gastrointestinal Hemorrhage With Cc 3 3 $23,982.59 $23,982.59 $20,395.75 $27,126.35 $20,803.67 2025-10-04
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 3 3 $27,068.48 $27,068.48 $20,250.51 $26,933.18 $20,655.52 2025-10-04
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 3 3 $14,591.50 $14,591.50 $20,013.71 $26,618.23 $20,413.98 2025-10-04
69 MS_DRG Transient Ischemia Without Thrombolytic 3 3 $0.07 $0.07 $19,856.89 $26,409.66 $20,254.03 2025-10-04
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 3 3 $16,309.84 $16,309.84 $19,849.52 $26,399.86 $20,246.51 2025-10-04
385 MS_DRG Inflammatory Bowel Disease With Mcc 3 3 $136,002.50 $136,002.50 $19,822.16 $26,363.47 $20,218.60 2025-10-04
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 3 3 $31,888.98 $31,888.98 $19,731.65 $26,243.09 $20,126.28 2025-10-04
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 3 3 $10,037.00 $10,037.00 $19,731.65 $26,243.09 $20,126.28 2025-10-04
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 3 3 $14,957.30 $14,957.30 $19,731.65 $26,243.09 $20,126.28 2025-10-04
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 3 3 $56,464.50 $56,464.50 $19,662.18 $26,150.70 $20,055.43 2025-10-04
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 3 3 $16,171.50 $16,171.50 $19,662.18 $26,150.70 $20,055.43 2025-10-04
292 MS_DRG Heart Failure And Shock With Cc 3 3 $23,953.13 $23,953.13 $19,511.68 $25,950.53 $19,901.91 2025-10-04
291 MS_DRG Heart Failure And Shock With Mcc 3 3 $27,756.47 $27,756.47 $19,511.68 $25,950.53 $19,901.91 2025-10-04
293 MS_DRG Heart Failure And Shock Without Cc/mcc 3 3 $8,926.50 $8,926.50 $19,511.68 $25,950.53 $19,901.91 2025-10-04
722 MS_DRG Malignancy, Male Reproductive System With Mcc 3 3 $31,773.92 $31,773.92 $19,508.52 $25,946.33 $19,898.69 2025-10-04
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 3 3 $20,105.25 $20,105.25 $19,488.53 $25,919.74 $19,878.30 2025-10-04
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 3 3 $53,284.94 $53,284.94 $19,488.53 $25,919.74 $19,878.30 2025-10-04
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 3 3 $20,108.91 $20,108.91 $19,488.53 $25,919.74 $19,878.30 2025-10-04
785 MS_DRG Cesarean Section With Sterilization Without Cc/mcc 3 3 $45,308.25 $45,308.25 $19,449.58 $25,867.95 $19,838.58 2025-10-04
783 MS_DRG Cesarean Section With Sterilization With Mcc 3 3 $51,646.50 $51,646.50 $19,449.58 $25,867.95 $19,838.58 2025-10-04
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 3 3 $23,842.00 $23,842.00 $19,430.64 $25,842.75 $19,819.25 2025-10-04
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 3 3 $17,991.11 $17,991.11 $19,430.64 $25,842.75 $19,819.25 2025-10-04
694 MS_DRG Urinary Stones Without Mcc 3 3 $31,521.50 $31,521.50 $19,406.43 $25,810.56 $19,794.56 2025-10-04
205 MS_DRG Other Respiratory System Diagnoses With Mcc 3 3 $45,130.86 $45,130.86 $19,401.17 $25,803.56 $19,789.19 2025-10-04
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 3 3 $11,516.50 $11,516.50 $19,401.17 $25,803.56 $19,789.19 2025-10-04
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 2 2 $47,486.86 $47,486.86 $19,449.58 $19,838.58 $19,644.08 2025-10-04
786 MS_DRG Cesarean Section Without Sterilization With Mcc 2 2 $63,460.11 $63,460.11 $19,449.58 $19,838.58 $19,644.08 2025-10-04
787 MS_DRG Cesarean Section Without Sterilization With Cc 2 2 $43,172.85 $43,172.85 $19,449.58 $19,838.58 $19,644.08 2025-10-04
784 MS_DRG Cesarean Section With Sterilization With Cc 2 2 $44,134.69 $44,134.69 $19,449.58 $19,838.58 $19,644.08 2025-10-04
644 MS_DRG Endocrine Disorders With Cc 3 3 $12,320.38 $12,320.38 $19,065.43 $25,357.03 $19,446.74 2025-10-04
643 MS_DRG Endocrine Disorders With Mcc 3 3 $28,562.00 $28,562.00 $19,065.43 $25,357.03 $19,446.74 2025-10-04
394 MS_DRG Other Digestive System Diagnoses With Cc 3 3 $23,655.64 $23,655.64 $18,861.26 $25,085.47 $19,238.48 2025-10-04
393 MS_DRG Other Digestive System Diagnoses With Mcc 3 3 $28,690.56 $28,690.56 $18,861.26 $25,085.47 $19,238.48 2025-10-04
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 3 3 $23,403.46 $23,403.46 $18,861.26 $25,085.47 $19,238.48 2025-10-04
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 3 3 $27,088.32 $27,088.32 $18,861.26 $25,085.47 $19,238.48 2025-10-04
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 3 3 $19,070.10 $19,070.10 $18,861.26 $25,085.47 $19,238.48 2025-10-04
919 MS_DRG Complications Of Treatment With Mcc 3 3 $64,497.13 $64,497.13 $18,849.68 $25,070.07 $19,226.67 2025-10-04
920 MS_DRG Complications Of Treatment With Cc 3 3 $11,983.06 $11,983.06 $18,849.68 $25,070.07 $19,226.67 2025-10-04
593 MS_DRG Skin Ulcers With Cc 3 3 $23,244.49 $23,244.49 $18,708.65 $24,882.50 $19,082.82 2025-10-04
592 MS_DRG Skin Ulcers With Mcc 3 3 $62,753.00 $62,753.00 $18,708.65 $24,882.50 $19,082.82 2025-10-04
J9271 HCPCS Injection, Pembrolizumab, 1 Mg 22 22 $21,059.50 $21,059.50 $54.85 $20,427.72 $18,953.55 2025-10-04
177 MS_DRG Respiratory Infections And Inflammations With Mcc 3 3 $25,892.31 $25,892.31 $18,565.51 $24,692.13 $18,936.82 2025-10-04
178 MS_DRG Respiratory Infections And Inflammations With Cc 3 3 $53,801.75 $53,801.75 $18,565.51 $24,692.13 $18,936.82 2025-10-04
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 3 3 $13,324.50 $13,324.50 $18,565.51 $24,692.13 $18,936.82 2025-10-04
102 MS_DRG Headaches With Mcc 3 3 $40,983.70 $40,983.70 $18,510.78 $24,619.34 $18,881.00 2025-10-04
J0717 HCPCS Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Adm… 22 22 $20,917.00 $20,917.00 $12.78 $20,289.49 $18,825.30 2025-10-04
299 MS_DRG Peripheral Vascular Disorders With Mcc 3 3 $13,151.00 $13,151.00 $18,229.78 $24,245.60 $18,594.37 2025-10-04
300 MS_DRG Peripheral Vascular Disorders With Cc 3 3 $32,676.00 $32,676.00 $18,229.78 $24,245.60 $18,594.37 2025-10-04
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 3 3 $60,529.00 $60,529.00 $18,020.33 $23,967.04 $18,380.74 2025-10-04
101 MS_DRG Seizures Without Mcc 3 3 $26,974.85 $26,974.85 $18,015.07 $23,960.05 $18,375.37 2025-10-04
125 MS_DRG Other Disorders Of The Eye Without Mcc 2 2 $7,334.00 $7,334.00 $18,181.36 $18,544.99 $18,363.18 2025-10-04
595 MS_DRG Major Skin Disorders With Mcc 3 3 $22,460.50 $22,460.50 $17,944.56 $23,866.26 $18,303.45 2025-10-04
797 MS_DRG Vaginal Delivery With Sterilization And/or D&c With Cc 3 3 $27,277.13 $27,277.13 $17,932.98 $23,850.86 $18,291.64 2025-10-04
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/or D&c 3 3 $39,167.93 $39,167.93 $17,932.98 $23,850.86 $18,291.64 2025-10-04
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 3 3 $25,701.60 $25,701.60 $17,932.98 $23,850.86 $18,291.64 2025-10-04
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 3 3 $29,052.75 $29,052.75 $17,932.98 $23,850.86 $18,291.64 2025-10-04
796 MS_DRG Vaginal Delivery With Sterilization And/or D&c With Mcc 3 3 $50,405.00 $50,405.00 $17,932.98 $23,850.86 $18,291.64 2025-10-04
798 MS_DRG Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 3 3 $35,191.67 $35,191.67 $17,932.98 $23,850.86 $18,291.64 2025-10-04
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 3 3 $25,976.64 $25,976.64 $17,932.98 $23,850.86 $18,291.64 2025-10-04
758 MS_DRG Infections, Female Reproductive System With Cc 3 3 $15,752.00 $15,752.00 $17,919.30 $23,832.67 $18,277.68 2025-10-04
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 3 3 $12,357.99 $12,357.99 $17,815.10 $23,694.09 $18,171.41 2025-10-04
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 3 3 $19,033.50 $19,033.50 $17,815.10 $23,694.09 $18,171.41 2025-10-04
314 MS_DRG Other Circulatory System Diagnoses With Mcc 3 3 $15,707.20 $15,707.20 $17,751.96 $23,610.10 $18,106.99 2025-10-04
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 3 3 $22,502.50 $22,502.50 $17,625.66 $23,442.13 $17,978.17 2025-10-04
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 $54,570.50 $54,570.50 $17,625.66 $23,442.13 $17,978.17 2025-10-04
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 3 3 $12,666.00 $12,666.00 $17,625.66 $23,442.13 $17,978.17 2025-10-04
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 3 3 $24,505.50 $24,505.50 $17,625.66 $23,442.13 $17,978.17 2025-10-04
315 MS_DRG Other Circulatory System Diagnoses With Cc 2 2 $56,767.09 $56,767.09 $17,751.96 $18,106.99 $17,929.47 2025-10-04
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 3 $28,712.39 $28,712.39 $17,537.25 $23,324.55 $17,888.00 2025-10-04
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 3 3 $15,790.50 $15,790.50 $17,537.25 $23,324.55 $17,888.00 2025-10-04
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 3 3 $11,112.17 $11,112.17 $17,537.25 $23,324.55 $17,888.00 2025-10-04
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 $105,728.51 $105,728.51 $17,625.66 $17,978.17 $17,801.92 2025-10-04
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 $73,233.83 $73,233.83 $17,625.66 $17,978.17 $17,801.92 2025-10-04
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 3 3 $15,946.48 $15,946.48 $17,413.06 $23,159.37 $17,761.32 2025-10-04
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 3 3 $12,049.00 $12,049.00 $17,413.06 $23,159.37 $17,761.32 2025-10-04
312 MS_DRG Syncope And Collapse 3 3 $25,253.76 $25,253.76 $17,344.65 $23,068.39 $17,691.54 2025-10-04
884 MS_DRG Organic Disturbances And Intellectual Disability 3 3 $9,664.00 $9,664.00 $17,279.40 $22,981.60 $17,624.99 2025-10-04
77 MS_DRG Hypertensive Encephalopathy With Mcc 3 3 $25,244.00 $25,244.00 $17,169.94 $22,836.02 $17,513.34 2025-10-04
304 MS_DRG Hypertension With Mcc 3 3 $10,498.50 $10,498.50 $17,169.94 $22,836.02 $17,513.34 2025-10-04
78 MS_DRG Hypertensive Encephalopathy With Cc 3 3 $12,706.50 $12,706.50 $17,169.94 $22,836.02 $17,513.34 2025-10-04
305 MS_DRG Hypertension Without Mcc 3 3 $53,300.50 $53,300.50 $17,169.94 $22,836.02 $17,513.34 2025-10-04
683 MS_DRG Renal Failure With Cc 3 3 $8,933.75 $8,933.75 $17,139.42 $22,795.43 $17,482.21 2025-10-04
682 MS_DRG Renal Failure With Mcc 3 3 $9,686.00 $9,686.00 $17,139.42 $22,795.43 $17,482.21 2025-10-04
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 3 3 $13,705.13 $13,705.13 $17,139.42 $22,795.43 $17,482.21 2025-10-04
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 3 3 $21,277.20 $21,277.20 $17,139.42 $22,795.43 $17,482.21 2025-10-04
637 MS_DRG Diabetes With Mcc 3 3 $42,689.50 $42,689.50 $17,114.16 $22,761.83 $17,456.44 2025-10-04
638 MS_DRG Diabetes With Cc 3 3 $26,901.30 $26,901.30 $17,114.16 $22,761.83 $17,456.44 2025-10-04
639 MS_DRG Diabetes Without Cc/mcc 3 3 $13,754.11 $13,754.11 $17,114.16 $22,761.83 $17,456.44 2025-10-04
J9356 HCPCS Injection, Trastuzumab, 10 Mg And Hyaluronidase-oysk 22 22 $19,176.00 $19,176.00 $85.99 $18,600.72 $17,258.40 2025-10-04
389 MS_DRG Gastrointestinal Obstruction With Cc 3 3 $11,671.00 $11,671.00 $16,818.42 $22,368.50 $17,154.79 2025-10-04
388 MS_DRG Gastrointestinal Obstruction With Mcc 3 3 $21,427.75 $21,427.75 $16,818.42 $22,368.50 $17,154.79 2025-10-04
725 MS_DRG Benign Prostatic Hypertrophy With Mcc 3 3 $12,507.00 $12,507.00 $16,740.53 $22,264.91 $17,075.35 2025-10-04
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 3 3 $16,722.78 $16,722.78 $16,690.02 $22,197.72 $17,023.82 2025-10-04
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 3 3 $15,452.92 $15,452.92 $16,690.02 $22,197.72 $17,023.82 2025-10-04
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 2 2 $7,148.38 $7,148.38 $16,818.42 $17,154.79 $16,986.60 2025-10-04
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 3 3 $19,177.00 $19,177.00 $16,617.40 $22,101.14 $16,949.74 2025-10-04
602 MS_DRG Cellulitis With Mcc 3 3 $36,018.00 $36,018.00 $16,473.21 $21,909.37 $16,802.67 2025-10-04
603 MS_DRG Cellulitis Without Mcc 3 3 $23,152.04 $23,152.04 $16,473.21 $21,909.37 $16,802.67 2025-10-04
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 2 $38,178.17 $38,178.17 $16,617.40 $16,949.74 $16,783.57 2025-10-04
607 MS_DRG Minor Skin Disorders Without Mcc 3 3 $15,493.50 $15,493.50 $16,433.21 $21,856.18 $16,761.88 2025-10-04
947 MS_DRG Signs And Symptoms With Mcc 3 3 $88,119.25 $88,119.25 $16,432.16 $21,854.78 $16,760.81 2025-10-04
948 MS_DRG Signs And Symptoms Without Mcc 3 3 $20,621.31 $20,621.31 $16,432.16 $21,854.78 $16,760.81 2025-10-04
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 3 3 $20,143.73 $20,143.73 $16,401.64 $21,814.18 $16,729.67 2025-10-04
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 3 3 $16,476.42 $16,476.42 $16,339.55 $21,731.59 $16,666.34 2025-10-04
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 3 3 $19,010.28 $19,010.28 $16,339.55 $21,731.59 $16,666.34 2025-10-04
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 3 3 $30,966.50 $30,966.50 $16,304.81 $21,685.40 $16,630.91 2025-10-04
923 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 3 3 $23,786.73 $23,786.73 $16,304.81 $21,685.40 $16,630.91 2025-10-04
J2353 HCPCS Injection, Octreotide, Depot Form For Intramuscular Injection, 1 Mg 40 22 $17,492.50 $17,492.50 $212.29 $25,407.70 $16,617.88 2025-10-04
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