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

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 · 2026-09-21
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
$97,418
outlier · 27.9×
9141
OTHER 		Inj Onase Abepar-xioi Treat 1 $1,337,760.23 $1,337,760.23 $1,337,760.23 nat. median
$2,508,045
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
$49,569
outlier · 13.0×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 4 $456,258.38 $830,050.58 $609,420.43 nat. median
$47,340
outlier · 12.9×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $229,681.74 $606,668.74 $606,668.74 nat. median
$48,611
outlier · 12.5×
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
$145,435
outlier · 3.9×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $549,698.07 $549,698.07 $549,698.07 nat. median
$56,428
outlier · 9.7×
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 1 $495,145.66 $495,145.66 $495,145.66 nat. median
$22,339
outlier · 22.2×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $490,691.36 $490,691.36 $490,691.36 nat. median
$69,922
outlier · 7.0×
73
MS_DRG 		Cranial And Peripheral Nerve Disorders With Mcc 1 $465,456.75 $465,456.75 $465,456.75 nat. median
$11,281
outlier · 41.3×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $12,386.00 $515,216.00 $436,509.74 nat. median
$72,715
outlier · 6.0×
163
MS_DRG 		Major Chest Procedures With Mcc 7 $12,278.10 $1,201,289.15 $429,038.64 nat. median
$31,995
outlier · 13.4×
25
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Mcc 9 $27,116.80 $374,940.20 $374,940.20 nat. median
$32,531
outlier · 11.5×
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 3 $9,537.50 $1,571,645.00 $341,997.24 nat. median
$26,952
outlier · 12.7×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 2 $104,755.00 $561,218.48 $332,986.74 nat. median
$38,932
outlier · 8.6×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 8 $8,636.96 $2,473,372.65 $323,124.83 nat. median
$47,121
outlier · 6.9×
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
$29,495
outlier · 10.9×
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
$52,327
outlier · 5.7×
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
$13,828
outlier · 20.4×
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
$55,923
outlier · 4.9×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $239,565.53 $259,005.52 $249,285.52 nat. median
$66,211
outlier · 3.8×
9489
OTHER 		Inj, Nusinersen, 0.1mg 2 $4,594.00 $389,283.92 $248,574.31 nat. median
$1,294
outlier · 192.2×
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 11 $11,824.65 $366,395.29 $235,296.96 nat. median
$35,725
outlier · 6.6×
754
MS_DRG 		Malignancy, Female Reproductive System With Mcc 1 $232,830.00 $232,830.00 $232,830.00 nat. median
$12,953
outlier · 18.0×
A9543
HCPCS 		Y90 Ibritumomab, Rx 1 $221,900.19 $239,906.69 $230,903.44 nat. median
$65,477
outlier · 3.5×
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
$31,991
outlier · 7.0×
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
$32,245
outlier · 6.9×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 7 $20,446.20 $386,288.56 $222,130.58 nat. median
$37,725
outlier · 5.9×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $208,629.77 $225,559.42 $217,094.60 nat. median
$92,809
outlier · 2.3×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $216,349.38 $216,349.38 $216,349.38 nat. median
$74,509
outlier · 2.9×
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
$9,905
outlier · 21.8×
C9150
HCPCS 		Xe129 Xenon, Diagnostic 1 $207,623.52 $224,471.52 $216,047.52 nat. median
$77,438
outlier · 2.8×
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
$40,726
outlier · 5.1×
904
MS_DRG 		Skin Grafts For Injuries With Cc/Mcc 1 $206,511.85 $206,511.85 $206,511.85 nat. median
$25,168
outlier · 8.2×
834
MS_DRG 		Acute Leukemia With Mcc 7 $112,864.20 $2,007,253.53 $204,218.42 nat. median
$37,487
outlier · 5.4×
564
MS_DRG 		Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 $199,208.44 $199,208.44 $199,208.44 nat. median
$11,130
outlier · 17.9×
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
$34,733
outlier · 5.6×
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
$30,768
outlier · 5.9×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 2 $179,032.37 $179,032.37 $179,032.37 nat. median
$2,106
outlier · 85.0×
659
MS_DRG 		Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 $30,800.00 $320,550.26 $175,675.13 nat. median
$18,590
outlier · 9.5×
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
$24,748
outlier · 7.0×
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
$24,316
outlier · 6.9×
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 5 $55,259.00 $185,928.00 $162,989.93 nat. median
$14,700
outlier · 11.1×
303
MS_DRG 		Atherosclerosis Without Mcc 2 $42,207.17 $277,241.88 $159,724.53 nat. median
$5,236
outlier · 30.5×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 9 $63,315.34 $1,036,739.89 $157,041.70 nat. median
$33,435
outlier · 4.7×
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
$186,516
0.8× median
252
MS_DRG 		Other Vascular Procedures With Mcc 6 $10,334.11 $210,606.44 $145,680.71 nat. median
$25,156
outlier · 5.8×
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
$38,832
outlier · 3.6×
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 8 $30,448.60 $156,320.26 $139,260.71 nat. median
$17,741
outlier · 7.8×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 7 $132.77 $596,978.02 $137,574.91 nat. median
$35,986
outlier · 3.8×

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.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0094U OTHER Genome Rapid Sequence Alys 3 2 — — $19,867.26 $40,008.63 $37,008.66 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
0211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 3 2 — — $22,153.93 $25,039.52 $23,161.98 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
0214U OTHER Rare Ds Xom DNA Alys Proband 3 2 — — $13,689.51 $27,568.37 $25,501.21 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
0265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 3 2 — — $14,348.06 $28,893.88 $26,727.33 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
0335U OTHER Rare Ds Whl Gen Seq Fetal 3 2 — — $13,689.51 $27,568.37 $25,501.21 2026-04-01
0800 RC Leuprolide Acetate 1 1 — — $25,165.94 $25,165.94 $25,165.94 2026-04-01
0963 RC Albumin (human), 5%, 250 Ml 2 2 — — $23,639.08 $23,639.08 $23,639.08 2025-07-01
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
1142 OTHER Supprelin La Implant 1 1 — — $60,482.11 $60,482.11 $60,482.11 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
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $12,386.00 $515,216.00 $436,509.74 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
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
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
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
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
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
157 MS_DRG Dental And Oral Diseases With Mcc 11 6 — — $11,474.72 $77,069.90 $40,217.03 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
163 MS_DRG Major Chest Procedures With Mcc 8 7 — — $12,278.10 $1,201,289.15 $429,038.64 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
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
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 3 2 — — $925.00 $77,283.00 $44,502.07 2026-04-01
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $69,470.00 $69,470.00 $69,470.00 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
182 MS_DRG Respiratory Neoplasms Without Cc/Mcc 1 1 — — $41,810.35 $41,810.35 $41,810.35 2026-04-01
186 MS_DRG Pleural Effusion With Mcc 3 2 — — $33,628.00 $392,217.06 $34,804.96 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
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 2 2 — — $6,643.00 $41,559.94 $24,101.47 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
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
200 MS_DRG Pneumothorax With Cc 3 3 — — $34,163.10 $103,854.99 $34,163.10 2026-04-01
204 MS_DRG Respiratory Signs And Symptoms 9 6 — — $925.00 $25,207.37 $25,207.37 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
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
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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $216,349.38 $216,349.38 $216,349.38 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
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
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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 17 11 — — $11,824.65 $366,395.29 $235,296.96 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
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
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
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 17 9 — — $27,116.80 $374,940.20 $374,940.20 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
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 7 5 — — $11,750.00 $67,272.02 $46,721.02 2026-04-01
263 MS_DRG Vein Ligation And Stripping 3 3 — — $15,086.08 $40,267.90 $40,267.90 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
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
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
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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 13 7 — — $20,446.20 $386,288.56 $222,130.58 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
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 3 3 — — $31,999.10 $45,410.00 $37,863.85 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
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $34,080.00 $34,080.00 $34,080.00 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
300 MS_DRG Peripheral Vascular Disorders With Cc 2 2 — — $24,066.76 $24,066.76 $24,066.76 2026-04-01
303 MS_DRG Atherosclerosis Without Mcc 2 2 — — $42,207.17 $277,241.88 $159,724.53 2026-04-01
304 MS_DRG Hypertension With Mcc 2 1 — — $20,085.04 $76,349.00 $48,217.02 2026-04-01
305 MS_DRG Hypertension Without Mcc 6 5 — — $10,901.02 $52,009.57 $25,430.20 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
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 6 4 — — $20,093.40 $91,511.00 $32,257.28 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
31 MS_DRG Ventricular Shunt Procedures With Mcc 8 5 — — $20,450.33 $305,573.00 $27,140.37 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
315 MS_DRG Other Circulatory System Diagnoses With Cc 18 9 — — $7,462.54 $97,447.44 $31,326.33 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
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 3 — — $19,311.50 $61,963.00 $26,768.00 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
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
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
33 MS_DRG Ventricular Shunt Procedures Without Cc/Mcc 6 5 — — $4,017.60 $33,901.47 $33,901.47 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
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
335 MS_DRG Peritoneal Adhesiolysis With Mcc 6 4 — — $78,178.00 $132,066.00 $79,233.15 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 5 3 — — $11,590.00 $66,935.00 $56,010.53 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
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
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
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
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
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
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 5 4 — — $18,952.74 $100,100.00 $23,347.67 2026-04-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 9 6 — — $10,002.00 $32,130.04 $32,130.04 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
382 MS_DRG Complicated Peptic Ulcer Without Cc/Mcc 1 1 — — $34,340.71 $34,340.71 $34,340.71 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
386 MS_DRG Inflammatory Bowel Disease With Cc 16 9 — — $8,969.96 $65,949.93 $38,717.94 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 9 6 — — $1,375.00 $44,647.05 $25,227.97 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
393 MS_DRG Other Digestive System Diagnoses With Mcc 8 7 — — $5,795.00 $399,457.33 $37,236.85 2026-04-01
398 MS_DRG Appendix Procedures With Cc 19 11 — — $2,396.00 $48,239.30 $28,122.51 2026-04-01
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
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
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
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 2 — — $25,742.53 $227,066.86 $126,404.69 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
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
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
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
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $5,848.07 $41,382.00 $41,382.00 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
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
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
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
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
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 8 6 — — $12,261.93 $244,985.17 $81,708.82 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
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
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
445 MS_DRG Disorders Of The Biliary Tract With Cc 5 4 — — $4,990.50 $27,083.85 $27,083.85 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
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $178.78 $170,506.97 $37,769.35 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
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
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
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
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
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
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
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
471 MS_DRG Cervical Spinal Fusion With Mcc 5 3 — — $4,636.00 $253,107.98 $44,504.04 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
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
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
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
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
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
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
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
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
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
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
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $490,691.36 $490,691.36 $490,691.36 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
503 MS_DRG Foot Procedures With Mcc 1 1 — — $38,978.57 $38,978.57 $38,978.57 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
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
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
5166 OTHER Cochlear Implant Procedure 6 4 — — $24,169.92 $53,544.03 $53,544.03 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
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
5194 OTHER Level 4 Endovascular Procedures 12 8 — — $4,842.73 $109,913.60 $25,630.50 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
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
5213 OTHER Level 3 Electrophysiologic Procedures 8 7 — — $2,200.00 $74,575.32 $27,110.75 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
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 1 1 — — $57,268.81 $57,268.81 $57,268.81 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
54 MS_DRG Nervous System Neoplasms With Mcc 5 4 — — $8,749.88 $848,913.64 $47,673.00 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
545 MS_DRG Connective Tissue Disorders With Mcc 12 7 — — $4,574.45 $78,859.00 $35,964.76 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
5463 OTHER Level 3 Neurostimulator And Related Procedures 2 1 — — $61,073.39 $61,073.39 $61,073.39 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
547 MS_DRG Connective Tissue Disorders Without Cc/Mcc 18 10 — — $12,684.00 $28,549.81 $28,549.81 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
550 MS_DRG Septic Arthritis Without Cc/Mcc 4 3 — — $20,748.57 $24,857.67 $24,832.46 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
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 3 — — $9,001.80 $70,706.46 $70,706.46 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
5625 OTHER Level 5 Radiation Therapy 9 7 — — $24,470.00 $119,196.81 $66,957.00 2026-04-01
5626 OTHER Level 6 Radiation Therapy 4 3 — — $4,206.28 $29,359.59 $25,721.56 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
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
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
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 10 7 — — $7,207.78 $34,735.00 $31,834.44 2026-04-01
570 MS_DRG Skin Debridement With Mcc 1 1 — — $24,352.13 $24,352.13 $24,352.13 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
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
595 MS_DRG Major Skin Disorders With Mcc 3 2 — — $28,152.03 $42,392.00 $28,152.03 2026-04-01
602 MS_DRG Cellulitis With Mcc 6 5 — — $12,000.00 $69,020.12 $45,168.15 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
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 6 5 — — $3,000.00 $83,972.35 $64,335.32 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
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
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 6 5 — — $55,259.00 $185,928.00 $162,989.93 2026-04-01
643 MS_DRG Endocrine Disorders With Mcc 4 3 — — $14,601.64 $74,295.47 $49,759.68 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
652 MS_DRG Kidney Transplant 2 2 — — $84,000.76 $159,950.00 $121,975.38 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
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
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
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
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 4 3 — — $675.00 $102,705.73 $64,744.86 2026-04-01
683 MS_DRG Renal Failure With Cc 2 2 — — $925.00 $70,722.68 $35,823.84 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
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 29 14 — — $4,792.00 $36,934.34 $26,541.53 2026-04-01
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
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
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
71 MS_DRG Other Cerebrovascular Disorders With Cc 4 3 — — $85,356.32 $158,948.06 $85,356.32 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
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
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 8 6 — — $8,263.69 $77,553.83 $52,255.54 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
754 MS_DRG Malignancy, Female Reproductive System With Mcc 1 1 — — $232,830.00 $232,830.00 $232,830.00 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
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 10 — — $21,168.15 $313,697.20 $114,177.59 2026-04-01
791 MS_DRG Prematurity With Major Problems 13 9 — — $15,604.68 $162,322.00 $81,265.00 2026-04-01
792 MS_DRG Prematurity Without Major Problems 13 11 — — $3,366.00 $171,328.66 $28,645.28 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
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 3 2 — — $23,277.00 $46,415.00 $23,277.00 2026-04-01
800 MS_DRG Splenic Procedures With Cc 1 1 — — $23,826.44 $23,826.44 $23,826.44 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
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
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
811 MS_DRG Red Blood Cell Disorders With Mcc 9 5 — — $4,583.65 $120,316.00 $60,550.66 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
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 11 6 — — $6,996.31 $36,288.35 $31,370.16 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
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
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
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
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
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
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
834 MS_DRG Acute Leukemia With Mcc 9 7 — — $112,864.20 $2,007,253.53 $204,218.42 2026-04-01
835 MS_DRG Acute Leukemia With Cc 1 1 — — $99,776.19 $99,776.19 $99,776.19 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
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
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
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $495,145.66 $495,145.66 $495,145.66 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
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
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
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
849 MS_DRG Radiotherapy 4 2 — — $31,036.00 $249,042.80 $46,455.50 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
850 MS_DRG Acute Leukemia With Other Procedures 4 3 — — $80,281.50 $135,918.26 $94,697.00 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
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
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
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
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
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 5 3 — — $4,257.84 $57,450.00 $46,058.96 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
865 MS_DRG Viral Illness With Mcc 6 5 — — $40,132.00 $355,423.00 $61,575.15 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
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
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
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
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
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
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 17 9 — — $1,450.68 $37,274.40 $33,862.81 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
885 MS_DRG Psychoses 19 10 — — $2,922.52 $32,380.00 $25,251.50 2026-04-01
89 MS_DRG Concussion With Cc 2 2 — — $19,904.86 $41,182.03 $30,543.44 2026-04-01
90 MS_DRG Concussion Without Cc/Mcc 10 8 — — $14,646.00 $71,854.40 $25,803.59 2026-04-01
9013 OTHER Inj Risankizumab-rzaa?1 Mg 2 1 — — $38,402.36 $38,412.36 $38,407.36 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
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 1 1 — — $206,511.85 $206,511.85 $206,511.85 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
914 MS_DRG Traumatic Injury Without Mcc 5 3 — — $26,138.91 $117,187.50 $47,613.70 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
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
9224 OTHER Galsulfase Injection 1 1 — — $44,879.34 $44,879.34 $44,879.34 2025-07-01
9236 OTHER Eculizumab Injection 1 1 — — $66,703.19 $66,703.19 $66,703.19 2025-07-01
9287 OTHER Brentuximab Vedotin Inj 2 2 — — $64,045.44 $64,045.44 $64,045.44 2025-07-01
9310 OTHER Inj., Emapalumab-lzsg, 1 Mg 2 1 — — $46,294.80 $46,294.80 $46,294.80 2025-07-01
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
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
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
9419 OTHER Inj Fensolvi 0.25 Mg 1 1 — — $38,142.96 $38,142.96 $38,142.96 2026-04-01
9489 OTHER Inj, Nusinersen, 0.1mg 3 2 — — $4,594.00 $389,283.92 $248,574.31 2026-04-01
949 MS_DRG Aftercare With Cc/Mcc 3 3 — — $11,773.00 $24,203.67 $24,203.67 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
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $456,258.38 $830,050.58 $609,420.43 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
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
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
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
964 MS_DRG Other Multiple Significant Trauma With Cc 3 3 — — $40,306.07 $40,306.07 $40,306.07 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
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
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
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
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
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
999 MS_DRG Ungroupable 1 1 — — $38,314.45 $38,314.45 $38,314.45 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 2 1 — — $221,900.19 $239,906.69 $230,903.44 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
A9572 HCPCS Indium In-111 Pentetreotide 2 1 — — $35,965.01 $38,883.46 $37,424.24 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 2 1 — — $22,464.12 $24,287.01 $23,375.56 2026-04-01
C9150 HCPCS Xe129 Xenon, Diagnostic 2 1 — — $207,623.52 $224,471.52 $216,047.52 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
J7311 HCPCS Fluocinolone Acetonide Implt 2 1 — — $72,868.02 $78,781.03 $75,824.52 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $208,629.77 $225,559.42 $217,094.60 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 2 1 — — $239,565.53 $259,005.52 $249,285.52 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
N999 OTHER Other Non-covered Services 1 1 — — $101,358.75 $101,358.75 $101,358.75 2025-07-01
Q0224 HCPCS Inj, Pemivibart, 4500 Mg 2 1 — — $23,058.71 $24,929.85 $23,994.28 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $123,775.63 $133,819.64 $128,797.64 2026-04-01
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