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

RADY CHILDREN'S HOSPITAL - SAN DIEGO

San Diego, CA · CCN 053303 · Rates published

Your selected procedure

You selected 29916 (HCPCS)

Hip arthro w/labral repair

This hospital’s price: $12,807 across 5 payers · range $9,420-$18,901

Source: https://www.rchsd.org/wp-content/uploads/2026/03/95-1691313_rady-childrens-hospital-san-diego_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.

14,283 distinct procedures filed
30 distinct payers
106,300 rate rows
2026-04-01 last MRF observed
Data quality

71,050 of 106,300 rate rows are consumer-grade (66.8%)

35,250 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 35,224
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 19
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 7
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.rchsd.org/wp-content/uploads/2026/03/95-1691313_rady-childrens-hospital-san-diego_standardcharges.csv
Found on page https://www.rchsd.org/patients-visitors/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-22
Content fingerprint 69b09a53d778d6c2… · 33,103,452 bytes · first seen 2026-05-13

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
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $241,560.00 $2,718,648.99 $2,718,648.99 nat. median
$126,461
outlier · 21.5×
9141
OTHER 		Inj Onase Abepar-xioi Treat 1 $1,337,760.23 $1,337,760.23 $1,337,760.23 nat. median
$2,588,981
0.5× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $51,413.95 $1,017,004.46 $644,238.63 nat. median
$63,829
outlier · 10.1×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 4 $456,258.38 $830,050.58 $609,420.43 nat. median
$61,660
outlier · 9.9×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $229,681.74 $606,668.74 $606,668.74 nat. median
$62,577
outlier · 9.7×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 $245,000.00 $2,353,510.92 $560,480.98 nat. median
$190,359
outlier · 2.9×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $549,698.07 $549,698.07 $549,698.07 nat. median
$74,298
outlier · 7.4×
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 1 $495,145.66 $495,145.66 $495,145.66 nat. median
$29,799
outlier · 16.6×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $490,691.36 $490,691.36 $490,691.36 nat. median
$94,943
outlier · 5.2×
73
MS_DRG 		Cranial And Peripheral Nerve Disorders With Mcc 1 $465,456.75 $465,456.75 $465,456.75 nat. median
$15,332
outlier · 30.4×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $12,386.00 $515,216.00 $436,509.74 nat. median
$110,084
outlier · 4.0×
163
MS_DRG 		Major Chest Procedures With Mcc 7 $12,278.10 $1,201,289.15 $429,038.64 nat. median
$42,636
outlier · 10.1×
25
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Mcc 9 $27,116.80 $374,940.20 $374,940.20 nat. median
$42,767
outlier · 8.8×
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 3 $9,537.50 $1,571,645.00 $341,997.24 nat. median
$35,655
outlier · 9.6×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 2 $104,755.00 $561,218.48 $332,986.74 nat. median
$53,841
outlier · 6.2×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 8 $8,636.96 $2,473,372.65 $323,124.83 nat. median
$59,324
outlier · 5.4×
958
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Cc 1 $321,820.58 $321,820.58 $321,820.58 nat. median
$38,930
outlier · 8.3×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $244,788.68 $355,163.00 $299,975.84 nat. median
$67,908
outlier · 4.4×
496
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 $281,977.03 $535,262.00 $281,977.03 nat. median
$18,290
outlier · 15.4×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 7 $69,084.56 $521,704.72 $274,971.87 nat. median
$72,247
outlier · 3.8×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $239,565.53 $259,005.52 $249,285.52 nat. median
$68,400
outlier · 3.6×
9489
OTHER 		Inj, Nusinersen, 0.1mg 2 $4,594.00 $389,283.92 $248,574.31 nat. median
$1,286
outlier · 193.3×
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 11 $11,824.65 $366,395.29 $235,296.96 nat. median
$47,347
outlier · 5.0×
754
MS_DRG 		Malignancy, Female Reproductive System With Mcc 1 $232,830.00 $232,830.00 $232,830.00 nat. median
$17,557
outlier · 13.3×
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $221,900.19 $239,906.69 $230,903.44 nat. median
$63,504
outlier · 3.6×
856
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 $76,001.00 $369,041.67 $222,521.33 nat. median
$41,655
outlier · 5.3×
823
MS_DRG 		Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 $222,282.14 $222,282.14 $222,282.14 nat. median
$42,755
outlier · 5.2×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 7 $20,446.20 $386,288.56 $222,130.58 nat. median
$49,305
outlier · 4.5×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $208,629.77 $225,559.42 $217,094.60 nat. median
$75,037
outlier · 2.9×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $216,349.38 $216,349.38 $216,349.38 nat. median
$97,137
outlier · 2.2×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $216,074.46 $216,074.46 $216,074.46 nat. median
$63,564
outlier · 3.4×
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $207,623.52 $224,471.52 $216,047.52 nat. median
$1,036
outlier · 208.6×
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 $206,915.93 $557,456.95 $206,915.93 nat. median
$53,768
outlier · 3.8×
904
MS_DRG 		Skin Grafts For Injuries With Cc/Mcc 1 $206,511.85 $206,511.85 $206,511.85 nat. median
$34,740
outlier · 5.9×
834
MS_DRG 		Acute Leukemia With Mcc 7 $112,864.20 $2,007,253.53 $204,218.42 nat. median
$50,314
outlier · 4.1×
564
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 $199,208.44 $199,208.44 $199,208.44 nat. median
$14,987
outlier · 13.3×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 $21,377.68 $458,176.00 $195,683.48 nat. median
$45,362
outlier · 4.3×
269
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 6 $30,162.83 $332,167.15 $181,892.25 nat. median
$40,001
outlier · 4.5×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 2 $179,032.37 $179,032.37 $179,032.37 nat. median
$49,522
outlier · 3.6×
659
MS_DRG 		Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 $30,800.00 $320,550.26 $175,675.13 nat. median
$24,298
outlier · 7.2×
97
MS_DRG 		Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 5 $7,327.42 $1,339,513.06 $173,278.35 nat. median
$33,159
outlier · 5.2×
987
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 $26,374.88 $1,590,567.87 $168,307.00 nat. median
$31,832
outlier · 5.3×
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 5 $55,259.00 $185,928.00 $162,989.93 nat. median
$19,223
outlier · 8.5×
303
MS_DRG 		Atherosclerosis Without Mcc 2 $42,207.17 $277,241.88 $159,724.53 nat. median
$7,384
outlier · 21.6×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 9 $63,315.34 $1,036,739.89 $157,041.70 nat. median
$42,609
outlier · 3.7×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $31,394.67 $262,559.00 $147,744.35 nat. median
$248,541
0.6× median
252
MS_DRG 		Other Vascular Procedures With Mcc 6 $10,334.11 $210,606.44 $145,680.71 nat. median
$32,644
outlier · 4.5×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $21,413.59 $240,630.17 $140,115.98 nat. median
$50,558
outlier · 2.8×
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 8 $30,448.60 $156,320.26 $139,260.71 nat. median
$22,935
outlier · 6.1×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 7 $132.77 $596,978.02 $137,574.91 nat. median
$46,201
outlier · 3.0×

Other procedures at this hospital

Browse this hospital's 14,283 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
             
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 3 — — $241,560.00 $2,718,648.99 $2,718,648.99 2026-04-01
9141 OTHER Inj Onase Abepar-xioi Treat 1 1 — — $1,337,760.23 $1,337,760.23 $1,337,760.23 2025-07-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 4 — — $51,413.95 $1,017,004.46 $644,238.63 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $456,258.38 $830,050.58 $609,420.43 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $229,681.74 $606,668.74 $606,668.74 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 9 — — $245,000.00 $2,353,510.92 $560,480.98 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $549,698.07 $549,698.07 $549,698.07 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $495,145.66 $495,145.66 $495,145.66 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $490,691.36 $490,691.36 $490,691.36 2026-04-01
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 1 1 — — $465,456.75 $465,456.75 $465,456.75 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $12,386.00 $515,216.00 $436,509.74 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 8 7 — — $12,278.10 $1,201,289.15 $429,038.64 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 17 9 — — $27,116.80 $374,940.20 $374,940.20 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 3 — — $9,537.50 $1,571,645.00 $341,997.24 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 2 2 — — $104,755.00 $561,218.48 $332,986.74 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 15 8 — — $8,636.96 $2,473,372.65 $323,124.83 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 1 1 — — $321,820.58 $321,820.58 $321,820.58 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $244,788.68 $355,163.00 $299,975.84 2026-04-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 3 — — $281,977.03 $535,262.00 $281,977.03 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 7 — — $69,084.56 $521,704.72 $274,971.87 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 2 1 — — $239,565.53 $259,005.52 $249,285.52 2026-04-01
9489 OTHER Inj, Nusinersen, 0.1mg 3 2 — — $4,594.00 $389,283.92 $248,574.31 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 17 11 — — $11,824.65 $366,395.29 $235,296.96 2026-04-01
754 MS_DRG Malignancy, Female Reproductive System With Mcc 1 1 — — $232,830.00 $232,830.00 $232,830.00 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $221,900.19 $239,906.69 $230,903.44 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 2 — — $76,001.00 $369,041.67 $222,521.33 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $222,282.14 $222,282.14 $222,282.14 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 13 7 — — $20,446.20 $386,288.56 $222,130.58 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $208,629.77 $225,559.42 $217,094.60 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $216,349.38 $216,349.38 $216,349.38 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $216,074.46 $216,074.46 $216,074.46 2026-04-01
C9150 HCPCS Xe129 Xenon, Diagnostic 2 1 — — $207,623.52 $224,471.52 $216,047.52 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 5 4 — — $206,915.93 $557,456.95 $206,915.93 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 1 1 — — $206,511.85 $206,511.85 $206,511.85 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 9 7 — — $112,864.20 $2,007,253.53 $204,218.42 2026-04-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 1 — — $199,208.44 $199,208.44 $199,208.44 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 5 4 — — $21,377.68 $458,176.00 $195,683.48 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 10 6 — — $30,162.83 $332,167.15 $181,892.25 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 2 — — $179,032.37 $179,032.37 $179,032.37 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 2 — — $30,800.00 $320,550.26 $175,675.13 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 8 5 — — $7,327.42 $1,339,513.06 $173,278.35 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $26,374.88 $1,590,567.87 $168,307.00 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 6 5 — — $55,259.00 $185,928.00 $162,989.93 2026-04-01
303 MS_DRG Atherosclerosis Without Mcc 2 2 — — $42,207.17 $277,241.88 $159,724.53 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 15 9 — — $63,315.34 $1,036,739.89 $157,041.70 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 2 — — $31,394.67 $262,559.00 $147,744.35 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 8 6 — — $10,334.11 $210,606.44 $145,680.71 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 6 — — $21,413.59 $240,630.17 $140,115.98 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 12 8 — — $30,448.60 $156,320.26 $139,260.71 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 10 7 — — $132.77 $596,978.02 $137,574.91 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $60,477.26 $299,212.00 $134,439.00 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $104,063.00 $132,183.21 $132,183.21 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 2 — — $91,095.38 $170,385.00 $130,740.19 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $123,775.63 $133,819.64 $128,797.64 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 2 — — $25,742.53 $227,066.86 $126,404.69 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $42,807.14 $125,690.00 $125,690.00 2026-04-01
652 MS_DRG Kidney Transplant 2 2 — — $84,000.76 $159,950.00 $121,975.38 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 18 9 — — $21,506.00 $123,824.50 $121,297.48 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 2 — — $33,348.26 $225,572.40 $119,477.37 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 10 — — $21,168.15 $313,697.20 $114,177.59 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 12 9 — — $14,077.00 $189,060.55 $112,445.07 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 2 — — $43,908.50 $179,149.60 $111,529.05 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $104,205.00 $104,205.00 $104,205.00 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $103,079.40 $103,079.40 $103,079.40 2026-04-01
N999 OTHER Other Non-covered Services 1 1 — — $101,358.75 $101,358.75 $101,358.75 2025-07-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $99,802.81 $99,802.81 $99,802.81 2026-04-01
835 MS_DRG Acute Leukemia With Cc 1 1 — — $99,776.19 $99,776.19 $99,776.19 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 4 3 — — $80,281.50 $135,918.26 $94,697.00 2026-04-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 2 1 — — $61,199.50 $127,054.00 $94,126.75 2026-04-01
79 MS_DRG Hypertensive Encephalopathy Without Cc/Mcc 1 1 — — $91,225.18 $91,225.18 $91,225.18 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 2 1 — — $84,649.84 $91,518.91 $88,084.38 2026-04-01
71 MS_DRG Other Cerebrovascular Disorders With Cc 4 3 — — $85,356.32 $158,948.06 $85,356.32 2026-04-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 8 6 — — $12,261.93 $244,985.17 $81,708.82 2026-04-01
791 MS_DRG Prematurity With Major Problems 13 9 — — $15,604.68 $162,322.00 $81,265.00 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 7 5 — — $9,251.33 $219,673.00 $81,101.54 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 4 3 — — $7,754.17 $145,778.01 $79,928.07 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 6 4 — — $78,178.00 $132,066.00 $79,233.15 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 10 — — $20,864.78 $101,761.20 $78,952.99 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 2 — — $54,375.05 $99,498.00 $76,936.52 2026-04-01
J7311 HCPCS Fluocinolone Acetonide Implt 2 1 — — $72,868.02 $78,781.03 $75,824.52 2026-04-01
124 MS_DRG Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 1 1 — — $75,594.78 $75,594.78 $75,594.78 2026-04-01
869 MS_DRG Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc 3 3 — — $4,636.00 $124,949.00 $75,300.42 2026-04-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 9 7 — — $11,773.00 $195,215.48 $74,718.00 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $73,656.00 $73,656.00 $73,656.00 2026-04-01
52 MS_DRG Spinal Disorders And Injuries With Cc/Mcc 5 5 — — $8,785.92 $73,491.41 $73,491.41 2026-04-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 2 2 — — $33,078.37 $112,728.00 $72,903.18 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $72,791.49 $96,624.00 $72,791.49 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 8 5 — — $31,036.00 $126,744.00 $71,608.00 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 3 — — $9,001.80 $70,706.46 $70,706.46 2026-04-01
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $69,470.00 $69,470.00 $69,470.00 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 3 — — $18,089.19 $68,971.93 $68,971.93 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 14 9 — — $12,000.00 $74,473.00 $68,478.49 2026-04-01
5625 OTHER Level 5 Radiation Therapy 9 7 — — $24,470.00 $119,196.81 $66,957.00 2026-04-01
9236 OTHER Eculizumab Injection 1 1 — — $66,703.19 $66,703.19 $66,703.19 2025-07-01
86 MS_DRG Traumatic Stupor And Coma <1 Hour With Cc 6 3 — — $11,432.60 $121,318.97 $66,375.79 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 5 — — $1,676.00 $334,760.05 $66,318.85 2026-04-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 12 8 — — $14,995.08 $216,387.46 $65,893.15 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 10 9 — — $7,550.00 $65,854.01 $65,854.01 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 3 3 — — $44,688.00 $65,634.71 $65,634.71 2026-04-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 1 1 — — $65,460.35 $65,460.35 $65,460.35 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 2 — — $29,209.16 $101,280.48 $65,244.82 2026-04-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 1 — — $43,428.26 $86,730.00 $65,079.13 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 4 3 — — $675.00 $102,705.73 $64,744.86 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 6 3 — — $620.00 $82,175.00 $64,363.98 2026-04-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 6 5 — — $3,000.00 $83,972.35 $64,335.32 2026-04-01
9287 OTHER Brentuximab Vedotin Inj 2 2 — — $64,045.44 $64,045.44 $64,045.44 2025-07-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 1 1 — — $63,745.00 $63,745.00 $63,745.00 2026-04-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 3 3 — — $13,796.42 $116,098.86 $62,355.28 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 8 — — $17,735.06 $191,927.28 $61,635.85 2026-04-01
865 MS_DRG Viral Illness With Mcc 6 5 — — $40,132.00 $355,423.00 $61,575.15 2026-04-01
5463 OTHER Level 3 Neurostimulator And Related Procedures 2 1 — — $61,073.39 $61,073.39 $61,073.39 2026-04-01
J9226 HCPCS Supprelin La: 1 Vial, Glass In 1 Carton (67979-002-01) / 1 Implant In 1 Vial, G… 2 1 — — $58,227.75 $62,952.75 $60,590.25 2026-04-01
811 MS_DRG Red Blood Cell Disorders With Mcc 9 5 — — $4,583.65 $120,316.00 $60,550.66 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 2 — — $9,584.00 $111,413.09 $60,498.54 2026-04-01
1142 OTHER Supprelin La Implant 1 1 — — $60,482.11 $60,482.11 $60,482.11 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $60,298.07 $60,298.07 $60,298.07 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $60,283.76 $60,283.76 $60,283.76 2026-04-01
83 MS_DRG Traumatic Stupor And Coma >1 Hour With Cc 2 2 — — $52,600.20 $65,876.40 $59,238.30 2026-04-01
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $57,731.53 $57,731.53 $57,731.53 2026-04-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 7 4 — — $11,090.00 $121,534.78 $57,399.52 2026-04-01
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 1 1 — — $57,268.81 $57,268.81 $57,268.81 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 6 5 — — $10,562.00 $58,803.03 $57,149.51 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 5 3 — — $11,590.00 $66,935.00 $56,010.53 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 4 3 — — $20,914.50 $107,593.92 $55,166.58 2026-04-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 11 8 — — $4,455.47 $55,141.17 $55,141.17 2026-04-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 13 8 — — $9,608.66 $101,654.30 $54,175.15 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 2 — — $48,637.00 $59,314.00 $53,975.50 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 22 11 — — $6,075.00 $110,529.68 $53,820.42 2026-04-01
5166 OTHER Cochlear Implant Procedure 6 4 — — $24,169.92 $53,544.03 $53,544.03 2026-04-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/Mcc 5 4 — — $52,974.40 $54,426.56 $52,974.40 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 12 8 — — $8,326.60 $440,100.18 $52,885.50 2026-04-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 8 6 — — $8,263.69 $77,553.83 $52,255.54 2026-04-01
643 MS_DRG Endocrine Disorders With Mcc 4 3 — — $14,601.64 $74,295.47 $49,759.68 2026-04-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 7 6 — — $3,307.55 $55,852.51 $49,187.16 2026-04-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 4 3 — — $3,491.00 $275,793.98 $49,181.42 2026-04-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 5 4 — — $193.03 $67,705.79 $48,424.92 2026-04-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 2 — — $13,407.84 $83,364.00 $48,385.92 2026-04-01
304 MS_DRG Hypertension With Mcc 2 1 — — $20,085.04 $76,349.00 $48,217.02 2026-04-01
54 MS_DRG Nervous System Neoplasms With Mcc 5 4 — — $8,749.88 $848,913.64 $47,673.00 2026-04-01
914 MS_DRG Traumatic Injury Without Mcc 5 3 — — $26,138.91 $117,187.50 $47,613.70 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 2 1 — — $45,230.54 $48,900.86 $47,065.70 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 7 5 — — $11,750.00 $67,272.02 $46,721.02 2026-04-01
849 MS_DRG Radiotherapy 4 2 — — $31,036.00 $249,042.80 $46,455.50 2026-04-01
9310 OTHER Inj., Emapalumab-lzsg, 1 Mg 2 1 — — $46,294.80 $46,294.80 $46,294.80 2025-07-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 5 3 — — $4,257.84 $57,450.00 $46,058.96 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 4 — — $9,886.27 $461,361.41 $46,032.34 2026-04-01
883 MS_DRG Disorders Of Personality And Impulse Control 7 5 — — $8,665.14 $127,490.00 $45,845.23 2026-04-01
602 MS_DRG Cellulitis With Mcc 6 5 — — $12,000.00 $69,020.12 $45,168.15 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 15 9 — — $5,147.60 $76,867.12 $44,928.50 2026-04-01
9224 OTHER Galsulfase Injection 1 1 — — $44,879.34 $44,879.34 $44,879.34 2025-07-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 7 4 — — $11,361.30 $139,130.00 $44,828.19 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 5 3 — — $4,636.00 $253,107.98 $44,504.04 2026-04-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 3 2 — — $925.00 $77,283.00 $44,502.07 2026-04-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 13 8 — — $11,590.00 $82,854.47 $44,023.14 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 2 — — $10,941.85 $76,417.00 $43,679.43 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 2 — — $5,682.00 $81,523.14 $43,602.57 2026-04-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 3 2 — — $6,280.91 $194,930.85 $43,253.46 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $33,259.18 $52,959.73 $43,109.46 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 12 7 — — $6,937.00 $50,888.88 $42,966.27 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $42,513.68 $42,513.68 $42,513.68 2026-04-01
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/Mcc 8 5 — — $25,103.00 $115,809.56 $42,412.87 2026-04-01
9028 OTHER Inj Inotuzumab Ozogam 0.1 Mg 3 3 — — $42,336.39 $42,336.39 $42,336.39 2025-07-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 3 — — $42,310.78 $42,310.78 $42,310.78 2026-04-01
182 MS_DRG Respiratory Neoplasms Without Cc/Mcc 1 1 — — $41,810.35 $41,810.35 $41,810.35 2026-04-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 4 3 — — $10,364.00 $54,761.25 $41,699.28 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $41,611.00 $41,611.00 $41,611.00 2026-04-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 2 2 — — $23,584.72 $59,456.00 $41,520.36 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $5,848.07 $41,382.00 $41,382.00 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 16 10 — — $4,020.23 $45,471.82 $41,091.73 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 5 4 — — $40,513.99 $83,797.20 $40,513.99 2026-04-01
964 MS_DRG Other Multiple Significant Trauma With Cc 3 3 — — $40,306.07 $40,306.07 $40,306.07 2026-04-01
263 MS_DRG Vein Ligation And Stripping 3 3 — — $15,086.08 $40,267.90 $40,267.90 2026-04-01
157 MS_DRG Dental And Oral Diseases With Mcc 11 6 — — $11,474.72 $77,069.90 $40,217.03 2026-04-01
503 MS_DRG Foot Procedures With Mcc 1 1 — — $38,978.57 $38,978.57 $38,978.57 2026-04-01
147 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Cc 2 1 — — $38,795.00 $38,795.00 $38,795.00 2026-04-01
386 MS_DRG Inflammatory Bowel Disease With Cc 16 9 — — $8,969.96 $65,949.93 $38,717.94 2026-04-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 11 8 — — $6,000.00 $116,286.81 $38,525.00 2026-04-01
9013 OTHER Inj Risankizumab-rzaa?1 Mg 2 1 — — $38,402.36 $38,412.36 $38,407.36 2026-04-01
999 MS_DRG Ungroupable 1 1 — — $38,314.45 $38,314.45 $38,314.45 2026-04-01
9419 OTHER Inj Fensolvi 0.25 Mg 1 1 — — $38,142.96 $38,142.96 $38,142.96 2026-04-01
81552 HCPCS Onc Uveal Mlnma Mrna 15 Gene 3 2 — — $20,374.93 $41,031.23 $37,954.58 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 3 3 — — $31,999.10 $45,410.00 $37,863.85 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $178.78 $170,506.97 $37,769.35 2026-04-01
A9572 HCPCS Indium In-111 Pentetreotide 2 1 — — $35,965.01 $38,883.46 $37,424.24 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 9 6 — — $37,262.36 $553,380.06 $37,262.36 2026-04-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 8 7 — — $5,795.00 $399,457.33 $37,236.85 2026-04-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 4 4 — — $10,783.00 $43,375.39 $37,077.50 2026-04-01
0094U OTHER Genome Rapid Sequence Alys 3 2 — — $19,867.26 $40,008.63 $37,008.66 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 6 4 — — $14,958.09 $58,158.72 $36,575.29 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 1 1 — — $36,161.48 $36,161.48 $36,161.48 2025-07-01
545 MS_DRG Connective Tissue Disorders With Mcc 12 7 — — $4,574.45 $78,859.00 $35,964.76 2026-04-01
683 MS_DRG Renal Failure With Cc 2 2 — — $925.00 $70,722.68 $35,823.84 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 6 5 — — $1,850.00 $105,128.82 $35,787.90 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 3 3 — — $13,466.66 $34,956.67 $34,956.67 2026-04-01
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 2 2 — — $21,957.87 $47,687.32 $34,822.60 2026-04-01
186 MS_DRG Pleural Effusion With Mcc 3 2 — — $33,628.00 $392,217.06 $34,804.96 2026-04-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/Mc… 13 9 — — $5,372.83 $34,540.32 $34,540.32 2026-04-01
382 MS_DRG Complicated Peptic Ulcer Without Cc/Mcc 1 1 — — $34,340.71 $34,340.71 $34,340.71 2026-04-01
200 MS_DRG Pneumothorax With Cc 3 3 — — $34,163.10 $103,854.99 $34,163.10 2026-04-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 3 2 — — $33,345.60 $34,116.52 $34,116.52 2026-04-01
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $34,080.00 $34,080.00 $34,080.00 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 1 1 — — $34,077.00 $34,077.00 $34,077.00 2026-04-01
847 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Cc 17 10 — — $8,343.00 $63,663.00 $34,015.58 2026-04-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/Mcc 6 5 — — $4,017.60 $33,901.47 $33,901.47 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 2 — — $10,930.50 $56,861.60 $33,896.05 2026-04-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 17 9 — — $1,450.68 $37,274.40 $33,862.81 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 2 — — $15,518.00 $51,321.49 $33,419.74 2026-04-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 1 1 — — $32,986.35 $32,986.35 $32,986.35 2026-04-01
0267U OTHER Rare Do Id Opt Gen Mapg&seq 3 2 — — $17,658.56 $35,561.08 $32,894.61 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 37 16 — — $4,792.00 $74,463.60 $32,461.06 2026-04-01
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc 15 11 — — $715.19 $50,311.00 $32,276.31 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 1 1 — — $32,259.00 $32,259.00 $32,259.00 2026-04-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 6 4 — — $20,093.40 $91,511.00 $32,257.28 2026-04-01
839 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/Mcc 2 1 — — $32,200.00 $32,200.00 $32,200.00 2026-04-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 9 6 — — $10,002.00 $32,130.04 $32,130.04 2026-04-01
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 1 1 — — $32,103.38 $32,103.38 $32,103.38 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $32,103.38 $32,103.38 $32,103.38 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 13 8 — — $15,277.38 $77,057.64 $31,973.32 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 10 7 — — $7,207.78 $34,735.00 $31,834.44 2026-04-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 11 6 — — $6,996.31 $36,288.35 $31,370.16 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 18 9 — — $7,462.54 $97,447.44 $31,326.33 2026-04-01
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 9 7 — — $6,697.00 $39,464.65 $31,143.59 2026-04-01
89 MS_DRG Concussion With Cc 2 2 — — $19,904.86 $41,182.03 $30,543.44 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $11,261.34 $49,786.00 $30,523.67 2026-04-01
55 MS_DRG Nervous System Neoplasms Without Mcc 6 4 — — $8,258.80 $47,456.00 $30,495.90 2026-04-01
546 MS_DRG Connective Tissue Disorders With Cc 18 10 — — $15,646.50 $70,144.39 $30,488.79 2026-04-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 1 — — $30,336.96 $30,336.96 $30,336.96 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $30,304.77 $30,304.77 $30,304.77 2026-04-01
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/Mcc 15 9 — — $2,207.40 $29,991.60 $29,991.60 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 10 6 — — $5,302.00 $90,735.82 $29,903.81 2026-04-01
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc 9 6 — — $7,935.00 $53,122.92 $29,573.81 2026-04-01
5222 OTHER Level 2 Pacemaker And Similar Procedures 1 1 — — $29,252.80 $29,252.80 $29,252.80 2026-04-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 5 4 — — $20,004.00 $141,360.00 $28,975.00 2026-04-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 2 2 — — $6,410.78 $51,400.00 $28,905.39 2026-04-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 14 8 — — $2,396.00 $71,416.73 $28,745.67 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 16 10 — — $7,700.00 $74,296.04 $28,684.09 2026-04-01
792 MS_DRG Prematurity Without Major Problems 13 11 — — $3,366.00 $171,328.66 $28,645.28 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 4 4 — — $11,660.90 $29,472.50 $28,630.25 2026-04-01
547 MS_DRG Connective Tissue Disorders Without Cc/Mcc 18 10 — — $12,684.00 $28,549.81 $28,549.81 2026-04-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 16 11 — — $4,792.00 $198,492.44 $28,393.07 2026-04-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 7 5 — — $8,100.00 $174,862.84 $28,207.00 2026-04-01
595 MS_DRG Major Skin Disorders With Mcc 3 2 — — $28,152.03 $42,392.00 $28,152.03 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 7 6 — — $500.00 $143,756.99 $28,126.89 2026-04-01
398 MS_DRG Appendix Procedures With Cc 19 11 — — $2,396.00 $48,239.30 $28,122.51 2026-04-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 1 1 — — $27,998.15 $27,998.15 $27,998.15 2026-04-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 12 7 — — $7,120.00 $51,199.55 $27,856.78 2026-04-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 6 5 — — $5,795.00 $82,129.31 $27,717.29 2026-04-01
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 24 11 — — $3,072.00 $34,850.50 $27,469.25 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 2 — — $10,814.24 $27,439.00 $27,439.00 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 8 5 — — $20,450.33 $305,573.00 $27,140.37 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 5 4 — — $4,636.00 $64,416.00 $27,116.85 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 8 7 — — $2,200.00 $74,575.32 $27,110.75 2026-04-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 5 4 — — $4,990.50 $27,083.85 $27,083.85 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $27,071.85 $27,071.85 $27,071.85 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 4 4 — — $21,035.13 $120,207.93 $26,905.25 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 3 — — $19,311.50 $61,963.00 $26,768.00 2026-04-01
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 3 2 — — $14,348.06 $28,893.88 $26,727.33 2026-04-01
0212U OTHER Rare Ds Gen DNA Alys Proband 3 2 — — $14,346.36 $28,890.71 $26,724.39 2026-04-01
142 MS_DRG Major Head And Neck Procedures Without Cc/Mcc 8 7 — — $2,396.00 $33,515.85 $26,632.62 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 29 14 — — $4,792.00 $36,934.34 $26,541.53 2026-04-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 11 5 — — $4,954.40 $63,156.00 $26,305.95 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 6 4 — — $24,036.69 $51,195.68 $26,290.35 2026-04-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 15 9 — — $5,795.00 $72,139.00 $26,215.79 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 7 5 — — $20,283.84 $190,996.76 $25,847.99 2026-04-01
90 MS_DRG Concussion Without Cc/Mcc 10 8 — — $14,646.00 $71,854.40 $25,803.59 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 16 10 — — $6,425.00 $73,825.99 $25,750.83 2026-04-01
5626 OTHER Level 6 Radiation Therapy 4 3 — — $4,206.28 $29,359.59 $25,721.56 2026-04-01
5194 OTHER Level 4 Endovascular Procedures 12 8 — — $4,842.73 $109,913.60 $25,630.50 2026-04-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 13 9 — — $2,025.00 $97,679.29 $25,600.00 2026-04-01
0214U OTHER Rare Ds Xom DNA Alys Proband 3 2 — — $13,689.51 $27,568.37 $25,501.21 2026-04-01
0335U OTHER Rare Ds Whl Gen Seq Fetal 3 2 — — $13,689.51 $27,568.37 $25,501.21 2026-04-01
305 MS_DRG Hypertension Without Mcc 6 5 — — $10,901.02 $52,009.57 $25,430.20 2026-04-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 18 10 — — $3,310.00 $69,831.00 $25,319.50 2026-04-01
885 MS_DRG Psychoses 19 10 — — $2,922.52 $32,380.00 $25,251.50 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 9 6 — — $1,375.00 $44,647.05 $25,227.97 2026-04-01
204 MS_DRG Respiratory Signs And Symptoms 9 6 — — $925.00 $25,207.37 $25,207.37 2026-04-01
0800 RC Leuprolide Acetate 1 1 — — $25,165.94 $25,165.94 $25,165.94 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 9 8 — — $7,723.97 $305,079.25 $25,016.44 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 3 — — $24,928.08 $85,755.48 $24,928.08 2026-04-01
550 MS_DRG Septic Arthritis Without Cc/Mcc 4 3 — — $20,748.57 $24,857.67 $24,832.46 2026-04-01
446 MS_DRG Disorders Of The Biliary Tract Without Cc/Mcc 2 2 — — $20,088.00 $29,410.00 $24,749.00 2026-04-01
87 MS_DRG Traumatic Stupor And Coma <1 Hour Without Cc/Mcc 20 11 — — $3,821.00 $59,334.00 $24,625.98 2026-04-01
570 MS_DRG Skin Debridement With Mcc 1 1 — — $24,352.13 $24,352.13 $24,352.13 2026-04-01
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 1 1 — — $24,290.64 $24,290.64 $24,290.64 2026-04-01
949 MS_DRG Aftercare With Cc/Mcc 3 3 — — $11,773.00 $24,203.67 $24,203.67 2026-04-01
0108U OTHER Gi Barrett Esoph 9 Prtn Bmrk 3 2 — — $12,969.95 $26,119.41 $24,160.90 2026-04-01
0261U OTHER Onc Clrct Ca Img Alys W/ai 3 2 — — $6,585.41 $26,119.41 $24,160.90 2026-04-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 13 7 — — $5,795.00 $40,117.00 $24,143.50 2026-04-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 2 2 — — $6,643.00 $41,559.94 $24,101.47 2026-04-01
300 MS_DRG Peripheral Vascular Disorders With Cc 2 2 — — $24,066.76 $24,066.76 $24,066.76 2026-04-01
Q0224 HCPCS Inj, Pemivibart, 4500 Mg 2 1 — — $23,058.71 $24,929.85 $23,994.28 2026-04-01
800 MS_DRG Splenic Procedures With Cc 1 1 — — $23,826.44 $23,826.44 $23,826.44 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 34 14 — — $4,792.00 $34,711.89 $23,722.81 2026-04-01
0963 RC Albumin (human), 5%, 250 Ml 2 2 — — $23,639.08 $23,639.08 $23,639.08 2025-07-01
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 7 4 — — $6,514.67 $23,522.40 $23,522.40 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 2 1 — — $22,464.12 $24,287.01 $23,375.56 2026-04-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 5 4 — — $18,952.74 $100,100.00 $23,347.67 2026-04-01
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 3 2 — — $23,277.00 $46,415.00 $23,277.00 2026-04-01
615 MS_DRG Adrenal And Pituitary Procedures Without Cc/Mcc 6 4 — — $14,272.00 $29,792.00 $23,274.67 2026-04-01
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 3 2 — — $22,153.93 $25,039.52 $23,161.98 2026-04-01
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