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

GOOD SAMARITAN MEDICAL CENTER LLC

Lafayette, CO · CCN 060116 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $10,065 across 9 payers · range $4,617-$14,185

Source: https://intermountainhealthcare.org/sc10media/files/intermountain-health/locations/hospital-prices/431982139_good-samaritan-medical-center_standardcharges.ashx · observed 2026-07-15

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.

23,284 distinct procedures filed
21 distinct payers
1,400,991 rate rows
2026-07-15 last MRF observed
Data quality

1,384,996 of 1,400,991 rate rows are consumer-grade (98.9%)

15,995 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
placeholder amount (≤ $0.02) — excluded from medians 4,677
per-diem day rate — not a per-procedure price 4,492
template filing: same amount across many unrelated codes — excluded 3,819
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2,784
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 223
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://intermountainhealthcare.org/sc10media/files/intermountain-health/locations/hospital-prices/431982139_good-samaritan-medical-center_standardcharges.ashx
Found on page https://intermountainhealthcare.org/locations/intermountain-health-good-samaritan-hospital/about/hospital-pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-18
Content fingerprint ac156875ef6366d3… · 5,790,261 bytes · first seen 2026-05-17

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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 6 $2,430,559.50 $3,884,946.48 $3,884,946.48 nat. median
$2,460,273
1.6× median
J3393
HCPCS 		Inj Betibeglogene Autotemce 6 $50.00 $4,897,200.00 $2,916,282.60 nat. median
$2,997,086
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 17 $295,711.17 $991,606.64 $908,566.11 nat. median
$370,165
outlier · 2.5×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $50.00 $1,538,488.12 $863,696.72 nat. median
$691,418
1.2× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $50.00 $1,471,259.27 $837,683.55 nat. median
$631,793
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $50.00 $1,449,026.62 $830,699.97 nat. median
$610,161
1.4× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $50.00 $1,462,599.29 $819,043.85 nat. median
$624,417
1.3× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $50.00 $1,386,398.44 $807,075.90 nat. median
$588,565
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $50.00 $1,272,191.99 $741,576.00 nat. median
$577,541
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 17 $191,904.65 $643,512.82 $508,745.88 nat. median
$261,939
1.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 17 $146,205.93 $490,271.53 $449,214.52 nat. median
$205,166
outlier · 2.2×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 17 $145,347.88 $487,394.27 $446,578.21 nat. median
$199,832
outlier · 2.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 17 $94,852.90 $318,069.70 $291,433.46 nat. median
$132,706
outlier · 2.2×
J3403
HCPCS 		Revakinagene Per Implant 5 $254,925.00 $669,500.00 $254,925.00 nat. median
$265,000
1.0× median
7
MS_DRG 		Lung Transplant 16 $88,681.58 $297,375.44 $251,220.93 nat. median
$122,690
outlier · 2.0×
209
MS_DRG 		Complex Aortic Arch Procedures 17 $77,509.92 $259,913.60 $238,147.55 nat. median
$96,134
outlier · 2.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 16 $82,297.29 $275,967.04 $233,135.24 nat. median
$114,305
outlier · 2.0×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 $75,471.99 $253,079.82 $231,886.05 nat. median
$96,835
outlier · 2.4×
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 17 $74,464.67 $249,701.96 $228,791.06 nat. median
$100,978
outlier · 2.3×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 17 $70,605.19 $236,760.01 $216,932.92 nat. median
$99,646
outlier · 2.2×
215
MS_DRG 		Other Heart Assist System Implant 17 $68,184.46 $228,642.59 $209,495.28 nat. median
$98,002
outlier · 2.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 $66,991.56 $224,642.44 $205,830.11 nat. median
$92,900
outlier · 2.2×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 17 $77,598.95 $260,212.12 $205,717.50 nat. median
$108,240
1.9× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 5 $203,583.60 $534,664.00 $203,583.60 nat. median
$209,736
1.0× median
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 4 $134,303.38 $203,484.33 $203,484.33 nat. median
$83,623
outlier · 2.4×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 17 $61,696.77 $206,887.44 $189,561.98 nat. median
$81,124
outlier · 2.3×
850
MS_DRG 		Acute Leukemia With Other Procedures 17 $59,299.32 $198,848.10 $182,195.88 nat. median
$81,364
outlier · 2.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 17 $57,727.05 $193,575.79 $177,365.10 nat. median
$79,040
outlier · 2.2×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 17 $57,545.58 $192,967.27 $176,807.54 nat. median
$80,459
outlier · 2.2×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 17 $53,884.70 $180,691.25 $165,559.55 nat. median
$77,385
outlier · 2.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 $52,580.17 $176,316.80 $161,551.43 nat. median
$74,472
outlier · 2.2×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 17 $52,353.51 $175,556.73 $160,855.01 nat. median
$73,475
outlier · 2.2×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 17 $52,180.25 $174,975.76 $160,322.70 nat. median
$71,485
outlier · 2.2×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 4 $100,519.14 $152,297.50 $152,297.50 nat. median
$62,767
outlier · 2.4×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 $49,432.20 $165,760.71 $151,879.34 nat. median
$66,640
outlier · 2.3×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 17 $49,117.88 $164,706.71 $150,913.61 nat. median
$62,911
outlier · 2.4×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 17 $48,856.97 $163,831.82 $150,111.98 nat. median
$69,153
outlier · 2.2×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 17 $48,828.21 $163,735.38 $150,023.62 nat. median
$68,581
outlier · 2.2×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 17 $47,331.26 $158,715.66 $145,424.27 nat. median
$65,958
outlier · 2.2×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 17 $47,099.12 $157,937.22 $144,711.02 nat. median
$65,792
outlier · 2.2×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $142,064.43 $142,064.43 $142,064.43 nat. median
$97,404
1.5× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 17 $46,093.85 $154,566.25 $141,622.34 nat. median
$64,357
outlier · 2.2×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 17 $45,788.43 $153,542.10 $140,683.96 nat. median
$59,832
outlier · 2.4×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 17 $45,754.88 $153,429.58 $140,580.86 nat. median
$62,262
outlier · 2.3×
454
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Cc 4 $92,698.64 $140,448.60 $140,448.60 nat. median
$57,648
outlier · 2.4×
Q2043
HCPCS 		Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 21 $50.00 $551,465.43 $140,347.95 nat. median
$65,655
outlier · 2.1×
10
MS_DRG 		Pancreas Transplant 16 $49,138.42 $164,775.60 $139,201.40 nat. median
$67,750
outlier · 2.1×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 $45,026.95 $150,988.61 $138,344.31 nat. median
$63,840
outlier · 2.2×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 $45,026.95 $150,988.61 $138,344.31 nat. median
$60,895
outlier · 2.3×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 17 $44,863.28 $150,439.80 $137,841.46 nat. median
$59,159
outlier · 2.3×

Other procedures at this hospital

Browse this hospital's 23,284 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
             
J3399 HCPCS Inj Onase Abepar-xioi Treat 19 6 — — $2,430,559.50 $3,884,946.48 $3,884,946.48 2026-07-15
J3393 HCPCS Inj Betibeglogene Autotemce 31 6 — — $50.00 $4,897,200.00 $2,916,282.60 2026-07-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 53 17 — — $295,711.17 $991,606.64 $908,566.11 2026-07-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 41 9 — — $50.00 $1,538,488.12 $863,696.72 2026-07-15
Q2056 HCPCS Ciltacabtagene Car-pos T 41 9 — — $50.00 $1,471,259.27 $837,683.55 2026-07-15
Q2055 HCPCS Idecabtagene Vicleucel Car 41 9 — — $50.00 $1,449,026.62 $830,699.97 2026-07-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 41 9 — — $50.00 $1,462,599.29 $819,043.85 2026-07-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 41 9 — — $50.00 $1,386,398.44 $807,075.90 2026-07-15
Q2053 HCPCS Brexucabtagene Car Pos T 41 9 — — $50.00 $1,272,191.99 $741,576.00 2026-07-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 43 17 — — $191,904.65 $643,512.82 $508,745.88 2026-07-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 54 17 — — $146,205.93 $490,271.53 $449,214.52 2026-07-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 54 17 — — $145,347.88 $487,394.27 $446,578.21 2026-07-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 54 17 — — $94,852.90 $318,069.70 $291,433.46 2026-07-15
J3403 HCPCS Revakinagene Per Implant 9 5 — — $254,925.00 $669,500.00 $254,925.00 2026-07-15
7 MS_DRG Lung Transplant 42 16 — — $88,681.58 $297,375.44 $251,220.93 2026-07-15
209 MS_DRG Complex Aortic Arch Procedures 54 17 — — $77,509.92 $259,913.60 $238,147.55 2026-07-15
14 MS_DRG Allogeneic Bone Marrow Transplant 42 16 — — $82,297.29 $275,967.04 $233,135.24 2026-07-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 54 17 — — $75,471.99 $253,079.82 $231,886.05 2026-07-15
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 54 17 — — $74,464.67 $249,701.96 $228,791.06 2026-07-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 53 17 — — $70,605.19 $236,760.01 $216,932.92 2026-07-15
215 MS_DRG Other Heart Assist System Implant 54 17 — — $68,184.46 $228,642.59 $209,495.28 2026-07-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 17 — — $66,991.56 $224,642.44 $205,830.11 2026-07-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 43 17 — — $77,598.95 $260,212.12 $205,717.50 2026-07-15
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 9 5 — — $203,583.60 $534,664.00 $203,583.60 2026-07-15
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 10 4 — — $134,303.38 $203,484.33 $203,484.33 2026-07-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 54 17 — — $61,696.77 $206,887.44 $189,561.98 2026-07-15
850 MS_DRG Acute Leukemia With Other Procedures 54 17 — — $59,299.32 $198,848.10 $182,195.88 2026-07-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 54 17 — — $57,727.05 $193,575.79 $177,365.10 2026-07-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 54 17 — — $57,545.58 $192,967.27 $176,807.54 2026-07-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 54 17 — — $53,884.70 $180,691.25 $165,559.55 2026-07-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 17 — — $52,580.17 $176,316.80 $161,551.43 2026-07-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 54 17 — — $52,353.51 $175,556.73 $160,855.01 2026-07-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 54 17 — — $52,180.25 $174,975.76 $160,322.70 2026-07-15
459 MS_DRG Spinal Fusion Except Cervical With Mcc 10 4 — — $100,519.14 $152,297.50 $152,297.50 2026-07-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 54 17 — — $49,432.20 $165,760.71 $151,879.34 2026-07-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 54 17 — — $49,117.88 $164,706.71 $150,913.61 2026-07-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 53 17 — — $48,856.97 $163,831.82 $150,111.98 2026-07-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 54 17 — — $48,828.21 $163,735.38 $150,023.62 2026-07-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 54 17 — — $47,331.26 $158,715.66 $145,424.27 2026-07-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 54 17 — — $47,099.12 $157,937.22 $144,711.02 2026-07-15
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 3 1 — — $142,064.43 $142,064.43 $142,064.43 2026-07-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 54 17 — — $46,093.85 $154,566.25 $141,622.34 2026-07-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 54 17 — — $45,788.43 $153,542.10 $140,683.96 2026-07-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 54 17 — — $45,754.88 $153,429.58 $140,580.86 2026-07-15
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 10 4 — — $92,698.64 $140,448.60 $140,448.60 2026-07-15
Q2043 HCPCS Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 126 21 $551,465.43 — $50.00 $551,465.43 $140,347.95 2026-07-15
10 MS_DRG Pancreas Transplant 42 16 — — $49,138.42 $164,775.60 $139,201.40 2026-07-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 17 — — $45,026.95 $150,988.61 $138,344.31 2026-07-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 17 — — $45,026.95 $150,988.61 $138,344.31 2026-07-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 54 17 — — $44,863.28 $150,439.80 $137,841.46 2026-07-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 54 17 — — $44,064.13 $147,760.02 $135,386.09 2026-07-15
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 54 17 — — $41,966.62 $140,726.45 $128,941.54 2026-07-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 54 17 — — $41,918.00 $140,563.41 $128,792.15 2026-07-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 54 17 — — $41,516.03 $139,215.48 $127,557.10 2026-07-15
28 MS_DRG Spinal Procedures With Mcc 54 17 — — $41,144.19 $137,968.59 $126,414.63 2026-07-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 54 17 — — $41,132.55 $137,929.56 $126,378.86 2026-07-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 54 17 — — $40,834.67 $136,930.67 $125,463.62 2026-07-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome- Neonate 45 15 — — $40,700.45 $136,106.15 $125,051.24 2026-07-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 54 17 — — $40,187.54 $134,760.66 $123,475.34 2026-07-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 54 17 — — $40,161.52 $134,673.40 $123,395.39 2026-07-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 54 17 — — $39,492.48 $132,429.92 $121,339.78 2026-07-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 54 17 — — $39,240.48 $131,584.88 $120,565.51 2026-07-15
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 54 17 — — $39,080.24 $131,047.54 $120,073.18 2026-07-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 54 17 — — $39,029.56 $130,877.62 $119,917.48 2026-07-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 54 17 — — $38,498.85 $129,097.99 $118,286.88 2026-07-15
Q9982 HCPCS Flutemetamol F-18 5 Mci (185 Mbq) Intravenous Solution 180 21 $405,240.00 — $50.00 $607,860.00 $117,519.60 2026-07-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 54 17 — — $38,116.74 $127,816.65 $117,112.85 2026-07-15
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 54 17 — — $37,820.91 $126,824.65 $116,203.92 2026-07-15
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 54 17 — — $37,594.24 $126,064.57 $115,507.50 2026-07-15
405 MS_DRG Pancreas- Liver And Shunt Procedures With Mcc 54 17 — — $37,461.40 $125,619.09 $115,099.32 2026-07-15
16 MS_DRG Autolous Bone Marrow Transplant With Cc/mcc 42 16 — — $40,605.95 $136,163.70 $115,030.25 2026-07-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 54 17 — — $37,407.98 $125,439.98 $114,935.21 2026-07-15
11 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Mcc 54 17 — — $37,349.09 $125,242.50 $114,754.26 2026-07-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 17 — — $36,518.44 $122,457.09 $112,202.11 2026-07-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 54 17 — — $36,496.53 $122,383.60 $112,134.78 2026-07-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 54 17 — — $36,251.37 $121,561.53 $111,381.55 2026-07-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 54 17 — — $36,131.53 $121,159.68 $111,013.35 2026-07-15
Q0480 HCPCS Driver Pneumatic Vad Rep 12 6 — — $109,037.80 $286,361.89 $110,139.19 2026-07-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 54 17 — — $35,646.02 $119,531.60 $109,521.62 2026-07-15
653 MS_DRG Major Bladder Procedures With Mcc 54 17 — — $35,584.39 $119,324.93 $109,332.26 2026-07-15
8 MS_DRG Simultaneous Pancreas/kidney Transplant 42 16 — — $38,379.70 $128,698.43 $108,723.64 2026-07-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 17 — — $34,514.75 $115,738.11 $106,045.81 2026-07-15
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 10 4 — — $69,802.47 $105,758.39 $105,758.39 2026-07-15
17 MS_DRG Autolous Bone Marrow Transplant Without Cc/mcc 42 16 — — $37,199.81 $124,741.90 $105,381.18 2026-07-15
326 MS_DRG Stomach- Esophageal And Duodenal Procedures With Mcc 54 17 — — $34,153.18 $114,525.67 $104,934.90 2026-07-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 54 17 — — $33,879.26 $113,607.15 $104,093.30 2026-07-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 54 17 — — $33,819.00 $113,405.07 $103,908.14 2026-07-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 54 17 — — $33,703.27 $113,017.00 $103,552.57 2026-07-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 54 17 — — $33,562.89 $112,546.26 $103,121.25 2026-07-15
471 MS_DRG Cervical Spinal Fusion With Mcc 54 17 — — $33,066.42 $110,881.44 $101,595.85 2026-07-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 54 17 — — $32,899.33 $110,321.14 $101,082.47 2026-07-15
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 54 17 — — $32,601.45 $109,322.25 $100,167.23 2026-07-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 53 17 — — $32,194.68 $107,958.25 $98,917.46 2026-07-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 54 17 — — $32,128.94 $107,737.80 $98,715.47 2026-07-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 54 17 — — $32,033.07 $107,416.32 $98,420.91 2026-07-15
6 MS_DRG Liver Transplant Without Mcc 53 17 — — $31,753.68 $106,479.43 $97,562.48 2026-07-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 54 17 — — $31,626.99 $106,054.62 $97,173.24 2026-07-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 54 17 — — $31,476.34 $105,549.43 $96,710.36 2026-07-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 54 17 — — $31,396.22 $105,280.76 $96,464.19 2026-07-15
245 MS_DRG Aicd Generator Procedures 54 17 — — $31,242.82 $104,766.39 $95,992.90 2026-07-15
A9607 HCPCS Lutetium Lu-177 Vipivotide Tetraxetan 27 Mci/ml (1,000 Mbq/ml) IV Soln 118 21 $349,346.82 — $50.00 $349,346.82 $95,983.04 2026-07-15
C1826 HCPCS Hc Gen Neuro Rchg W Bat & Lds & Cmpnts Implant Lvl 56 79 21 $167,425.75 — $26.03 $167,425.75 $95,851.24 2026-07-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 54 17 — — $31,149.01 $104,451.80 $95,704.65 2026-07-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 54 17 — — $31,135.31 $104,405.87 $95,662.57 2026-07-15
799 MS_DRG Splenic Procedures With Mcc 54 17 — — $31,013.42 $103,997.13 $95,288.06 2026-07-15
163 MS_DRG Major Chest Procedures With Mcc 54 17 — — $30,690.88 $102,915.57 $94,297.07 2026-07-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 54 17 — — $30,681.98 $102,885.72 $94,269.72 2026-07-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 54 17 — — $30,561.46 $102,481.57 $93,899.42 2026-07-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 54 17 — — $30,081.42 $100,871.87 $92,424.51 2026-07-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 54 17 — — $29,633.57 $99,370.09 $91,048.50 2026-07-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 54 17 — — $29,397.32 $98,577.86 $90,322.62 2026-07-15
C1823 HCPCS Hc Neurostim Generator/lead Lvl 46 280 16 $203,749.65 — $13,686.98 $272,719.90 $89,885.67 2026-07-15
140 MS_DRG Major Head And Neck Procedures With Mcc 54 17 — — $29,208.32 $97,944.08 $89,741.91 2026-07-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 54 17 — — $29,040.54 $97,381.49 $89,226.43 2026-07-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 54 17 — — $28,920.02 $96,977.34 $88,856.13 2026-07-15
12 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Cc 54 17 — — $28,870.71 $96,812.01 $88,704.64 2026-07-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 54 17 — — $28,856.33 $96,763.79 $88,660.46 2026-07-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 54 17 — — $28,772.10 $96,481.34 $88,401.66 2026-07-15
901 MS_DRG Wound Debridements For Injuries With Mcc 54 17 — — $28,737.86 $96,366.53 $88,296.46 2026-07-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 54 17 — — $28,684.45 $96,187.41 $88,132.35 2026-07-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 54 17 — — $28,573.52 $95,815.41 $87,791.50 2026-07-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 54 17 — — $28,439.30 $95,365.34 $87,379.12 2026-07-15
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 54 17 — — $28,250.98 $94,733.86 $86,800.52 2026-07-15
791 MS_DRG Prematurity With Major Problems 45 15 — — $27,795.60 $96,758.00 $85,401.36 2026-07-15
J7330 HCPCS Cultured Chondrocytes Implnt 26 4 — — $50.00 $203,694.25 $85,400.52 2026-07-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 54 17 — — $27,531.95 $92,322.74 $84,591.32 2026-07-15
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 10 4 — — $55,439.13 $83,996.36 $83,996.36 2026-07-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 54 17 — — $27,282.69 $91,486.89 $83,825.46 2026-07-15
A9543 HCPCS Y90 Ibritumomab Rx 48 9 — — $50.00 $147,743.83 $82,995.41 2026-07-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 54 17 — — $26,788.27 $89,828.96 $82,306.38 2026-07-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 54 17 — — $26,667.06 $89,422.51 $81,933.97 2026-07-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 54 17 — — $26,506.14 $88,882.88 $81,439.53 2026-07-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 54 17 — — $26,466.42 $88,749.70 $81,317.50 2026-07-15
40 MS_DRG Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc 54 17 — — $26,441.08 $88,664.74 $81,239.65 2026-07-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 54 17 — — $26,291.11 $88,161.85 $80,778.87 2026-07-15
956 MS_DRG Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma 54 17 — — $25,768.62 $86,409.77 $79,173.52 2026-07-15
143 MS_DRG Other Ear- Nose- Mouth And Throat O.r. Procedures With Mcc 54 17 — — $25,656.31 $86,033.18 $78,828.46 2026-07-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 54 17 — — $25,595.37 $85,828.81 $78,641.21 2026-07-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 54 17 — — $25,592.63 $85,819.62 $78,632.79 2026-07-15
628 MS_DRG Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc 54 17 — — $25,520.73 $85,578.51 $78,411.87 2026-07-15
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 53 17 — — $25,376.92 $85,096.29 $77,970.03 2026-07-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 54 17 — — $25,152.99 $84,345.40 $77,282.02 2026-07-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc 54 17 — — $25,142.72 $84,310.95 $77,250.46 2026-07-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 54 17 — — $24,847.58 $83,321.25 $76,343.64 2026-07-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 54 17 — — $24,828.40 $83,256.95 $76,284.73 2026-07-15
332 MS_DRG Rectal Resection With Mcc 54 17 — — $24,794.16 $83,142.13 $76,179.53 2026-07-15
265 MS_DRG Aicd Lead Procedures 54 17 — — $24,777.04 $83,084.73 $76,126.93 2026-07-15
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 54 17 — — $24,733.22 $82,937.76 $75,992.27 2026-07-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 54 17 — — $24,696.24 $82,813.76 $75,878.66 2026-07-15
739 MS_DRG Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc 54 17 — — $24,534.63 $82,271.84 $75,382.11 2026-07-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 54 17 — — $24,477.79 $82,081.24 $75,207.48 2026-07-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 54 17 — — $24,453.14 $81,998.58 $75,131.74 2026-07-15
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 54 17 — — $24,416.84 $81,876.87 $75,020.22 2026-07-15
793 MS_DRG Full Term Neonate With Major Problems 45 15 — — $25,181.10 $95,483.84 $74,987.60 2026-07-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 54 17 — — $24,396.30 $81,807.98 $74,957.10 2026-07-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor… 54 17 — — $24,373.02 $81,729.91 $74,885.57 2026-07-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 54 17 — — $24,353.16 $81,663.32 $74,824.55 2026-07-15
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 54 17 — — $24,149.78 $80,981.32 $74,199.66 2026-07-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 54 17 — — $24,100.47 $80,815.98 $74,048.18 2026-07-15
252 MS_DRG Other Vascular Procedures With Mcc 54 17 — — $23,887.50 $80,101.83 $73,393.83 2026-07-15
616 MS_DRG Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With… 54 17 — — $23,881.34 $80,081.17 $73,374.90 2026-07-15
J9029 HCPCS Instill Adstiladrin Tx Dose 53 11 — — $50.00 $164,689.93 $73,080.00 2026-07-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 54 17 — — $23,771.77 $79,713.76 $73,038.26 2026-07-15
J9226 HCPCS Supprelin La Implant 61 13 — — $50.00 $117,053.69 $72,861.11 2026-07-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 54 17 — — $23,656.73 $79,327.98 $72,684.78 2026-07-15
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 54 17 — — $23,547.16 $78,960.57 $72,348.14 2026-07-15
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 54 17 — — $23,477.31 $78,726.35 $72,133.54 2026-07-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 54 17 — — $23,362.27 $78,340.57 $71,780.06 2026-07-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 54 17 — — $23,331.45 $78,237.24 $71,685.38 2026-07-15
264 MS_DRG Other Circulatory System O.r. Procedures 54 17 — — $22,876.07 $76,710.20 $70,286.22 2026-07-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 54 17 — — $22,620.64 $75,853.68 $69,501.43 2026-07-15
37 MS_DRG Extracranial Procedures With Mcc 54 17 — — $22,543.95 $75,596.49 $69,265.78 2026-07-15
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 54 17 — — $22,541.21 $75,587.31 $69,257.37 2026-07-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 54 17 — — $22,274.82 $74,694.05 $68,438.91 2026-07-15
579 MS_DRG Other Skin- Subcutaneous Tissue And Breast Procedures With Mcc 54 17 — — $22,176.90 $74,365.68 $68,138.04 2026-07-15
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 54 17 — — $22,152.25 $74,283.01 $68,062.30 2026-07-15
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 54 17 — — $22,121.43 $74,179.68 $67,967.62 2026-07-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 54 17 — — $22,098.83 $74,103.90 $67,898.18 2026-07-15
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 54 17 — — $22,055.69 $73,959.23 $67,765.63 2026-07-15
0427T CPT Insj/rplc Nstim Apnea Pls Gn 15 4 — — $4,129.00 $67,659.00 $67,659.00 2026-07-15
0424T CPT Insj/rplc Nstim Apnea Compl 15 4 — — $4,129.00 $67,659.00 $67,659.00 2026-07-15
0431T CPT Rmvl/rplc Nstim Apnea Pls Gn 15 4 — — $4,129.00 $67,659.00 $67,659.00 2026-07-15
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 54 17 — — $21,984.47 $73,720.42 $67,546.82 2026-07-15
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 12 6 — — $66,778.13 $175,376.92 $67,452.66 2026-07-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 54 17 — — $21,863.95 $73,316.27 $67,176.51 2026-07-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 54 17 — — $21,823.55 $73,180.78 $67,052.38 2026-07-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 54 17 — — $21,802.32 $73,109.60 $66,987.15 2026-07-15
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 54 17 — — $21,758.49 $72,962.64 $66,852.50 2026-07-15
500 MS_DRG Soft Tissue Procedures With Mcc 54 17 — — $21,672.21 $72,673.30 $66,587.39 2026-07-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 54 17 — — $21,639.34 $72,563.08 $66,486.40 2026-07-15
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 54 17 — — $21,577.71 $72,356.41 $66,297.04 2026-07-15
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 54 17 — — $21,567.44 $72,321.97 $66,265.48 2026-07-15
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 54 17 — — $21,516.76 $72,152.04 $66,109.78 2026-07-15
C1882 HCPCS Hc Icd Biv/crt-d Lvl 46 910 16 $131,067.25 — $13,686.98 $286,355.95 $65,861.87 2026-07-15
665 MS_DRG Prostatectomy With Mcc 54 17 — — $21,373.64 $71,672.12 $65,670.05 2026-07-15
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 54 17 — — $21,329.13 $71,522.86 $65,533.29 2026-07-15
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 54 17 — — $21,291.47 $71,396.56 $65,417.57 2026-07-15
662 MS_DRG Minor Bladder Procedures With Mcc 54 17 — — $20,964.82 $70,301.22 $64,413.96 2026-07-15
263 MS_DRG Vein Ligation And Stripping 54 17 — — $20,936.75 $70,207.08 $64,327.70 2026-07-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 54 17 — — $20,771.03 $69,651.37 $63,818.53 2026-07-15
510 MS_DRG Shoulderelbow Or Forearm Procexc Major Joint Proc W Mcc 54 17 — — $20,684.06 $69,359.74 $63,551.32 2026-07-15
625 MS_DRG Thyroid- Parathyroid And Thyroglossal Procedures With Mcc 54 17 — — $20,681.32 $69,350.56 $63,542.90 2026-07-15
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 54 17 — — $20,658.72 $69,274.78 $63,473.47 2026-07-15
A9606 HCPCS Radium Ra 223 Dichlor 1,100 Kbq/ml (30 Microcurie/ml) Intravenous Soln 118 21 $230,906.68 — $50.00 $230,906.68 $63,441.61 2026-07-15
652 MS_DRG Kidney Transplant 42 16 — — $22,115.27 $74,159.01 $62,649.07 2026-07-15
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 54 17 — — $20,382.07 $68,347.07 $62,623.46 2026-07-15
C2616 HCPCS Hc Brachytx Non-str Yttrium-90 79 21 $144,174.05 — $17,310.25 $144,174.05 $62,585.96 2026-07-15
C1717 HCPCS Hc Brachytherapy Source Hdr Ir192 79 21 $144,174.05 — $338.97 $144,174.05 $62,585.96 2026-07-15
472 MS_DRG Cervical Spinal Fusion With Cc 54 17 — — $20,174.58 $67,651.29 $61,985.94 2026-07-15
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 54 17 — — $20,160.88 $67,605.37 $61,943.86 2026-07-15
570 MS_DRG Skin Debridement With Mcc 54 17 — — $20,140.34 $67,536.48 $61,880.74 2026-07-15
668 MS_DRG Transurethral Procedures With Mcc 54 17 — — $19,995.85 $67,051.96 $61,436.80 2026-07-15
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 54 17 — — $19,943.12 $66,875.14 $61,274.79 2026-07-15
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 54 17 — — $19,872.58 $66,638.63 $61,058.08 2026-07-15
406 MS_DRG Pancreas- Liver And Shunt Procedures With Cc 54 17 — — $19,860.26 $66,597.29 $61,020.21 2026-07-15
619 MS_DRG O.r. Procedures For Obesity With Mcc 54 17 — — $19,772.60 $66,303.37 $60,750.90 2026-07-15
974 MS_DRG HIV With Major Related Condition With Mcc 54 17 — — $19,763.02 $66,271.22 $60,721.44 2026-07-15
13 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses Without Cc/mcc 54 17 — — $19,734.26 $66,174.77 $60,633.07 2026-07-15
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 54 17 — — $19,654.82 $65,908.40 $60,389.01 2026-07-15
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 54 17 — — $19,519.92 $65,456.03 $59,974.52 2026-07-15
800 MS_DRG Splenic Procedures With Cc 54 17 — — $19,238.47 $64,512.25 $59,109.78 2026-07-15
654 MS_DRG Major Bladder Procedures With Cc 54 17 — — $19,169.31 $64,280.33 $58,897.27 2026-07-15
503 MS_DRG Foot Procedures With Mcc 54 17 — — $19,113.15 $64,092.03 $58,724.74 2026-07-15
90288 CPT Botulism Ig IV 11 1 — — $58,446.00 $58,446.00 $58,446.00 2026-07-15
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 54 17 — — $18,981.67 $63,651.14 $58,320.78 2026-07-15
C9608 HCPCS Perc D-e Cor Revasc Chro Add 34 5 — — $7,617.00 $58,947.00 $58,282.00 2026-07-15
C9601 HCPCS Perc Drug-el Cor Stent Bran 35 5 — — $4,669.00 $58,947.00 $58,282.00 2026-07-15
61 MS_DRG Ischemic Stroke- Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 54 17 — — $18,880.32 $63,311.29 $58,009.38 2026-07-15
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 54 17 — — $18,822.80 $63,118.40 $57,832.65 2026-07-15
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 54 17 — — $18,818.01 $63,102.32 $57,817.92 2026-07-15
963 MS_DRG Other Multiple Significant Trauma With Mcc 54 17 — — $18,720.77 $62,776.25 $57,519.15 2026-07-15
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 54 17 — — $18,631.75 $62,477.73 $57,245.63 2026-07-15
849 MS_DRG Radiotherapy 54 17 — — $18,554.36 $62,218.25 $57,007.88 2026-07-15
288 MS_DRG Acute And Subacute Endocarditis With Mcc 54 17 — — $18,531.77 $62,142.47 $56,938.45 2026-07-15
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 54 17 — — $18,471.50 $61,940.40 $56,753.30 2026-07-15
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 54 17 — — $18,215.39 $61,081.58 $55,966.40 2026-07-15
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 54 17 — — $18,151.71 $60,868.02 $55,770.73 2026-07-15
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 54 17 — — $18,060.63 $60,562.62 $55,490.90 2026-07-15
253 MS_DRG Other Vascular Procedures With Cc 54 17 — — $17,774.39 $59,602.76 $54,611.42 2026-07-15
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 54 17 — — $17,753.16 $59,531.58 $54,546.20 2026-07-15
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 54 17 — — $17,686.74 $59,308.84 $54,342.11 2026-07-15
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 54 17 — — $17,662.08 $59,226.17 $54,266.37 2026-07-15
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 54 17 — — $17,662.08 $59,226.17 $54,266.37 2026-07-15
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 54 17 — — $17,582.65 $58,959.80 $54,022.30 2026-07-15
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 54 17 — — $17,482.67 $58,624.54 $53,715.12 2026-07-15
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 54 17 — — $17,399.81 $58,346.69 $53,460.54 2026-07-15
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Cc 54 17 — — $17,366.94 $58,236.46 $53,359.54 2026-07-15
164 MS_DRG Major Chest Procedures With Cc 54 17 — — $17,284.08 $57,958.61 $53,104.96 2026-07-15
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 54 17 — — $17,276.55 $57,933.35 $53,081.82 2026-07-15
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 54 17 — — $17,064.26 $57,221.50 $52,429.58 2026-07-15
C1820 HCPCS Hc Generator Neuro Rechg Battery System Implant Lvl 16 210 16 $131,067.25 — $500.14 $144,174.05 $52,295.83 2026-07-15
545 MS_DRG Connective Tissue Disorders With Mcc 54 17 — — $16,994.41 $56,987.28 $52,214.97 2026-07-15
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 54 17 — — $16,840.34 $56,470.61 $51,741.57 2026-07-15
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 54 17 — — $16,835.54 $56,454.54 $51,726.84 2026-07-15
327 MS_DRG Stomach- Esophageal And Duodenal Procedures With Cc 54 17 — — $16,737.62 $56,126.16 $51,425.97 2026-07-15
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 54 17 — — $16,717.76 $56,059.57 $51,364.95 2026-07-15
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 54 17 — — $16,586.96 $55,620.98 $50,963.09 2026-07-15
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 54 17 — — $16,532.87 $55,439.57 $50,796.87 2026-07-15
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 54 17 — — $16,471.24 $55,232.90 $50,607.51 2026-07-15
C1721 HCPCS Hc Icd Dual Chamber Lvl 44 630 16 $98,472.55 — $11,311.53 $193,816.50 $50,443.35 2026-07-15
330 MS_DRG Major Small And Large Bowel Procedures With Cc 54 17 — — $16,415.77 $55,046.90 $50,437.09 2026-07-15
397 MS_DRG Appendix Procedures With Mcc 54 17 — — $16,400.02 $54,994.09 $50,388.70 2026-07-15
35 MS_DRG Carotid Artery Stent Procedures With Cc 54 17 — — $16,369.89 $54,893.05 $50,296.12 2026-07-15
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 54 17 — — $16,341.81 $54,798.90 $50,209.86 2026-07-15
113 MS_DRG Orbital Procedures With Cc/mcc 54 17 — — $16,100.08 $53,988.31 $49,467.14 2026-07-15
333 MS_DRG Rectal Resection With Cc 54 17 — — $16,039.13 $53,783.94 $49,279.89 2026-07-15
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 54 17 — — $16,014.48 $53,701.27 $49,204.14 2026-07-15
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 54 17 — — $16,002.84 $53,662.23 $49,168.38 2026-07-15
709 MS_DRG Penis Procedures With Cc/mcc 54 17 — — $15,935.73 $53,437.20 $48,962.18 2026-07-15
357 MS_DRG Other Digestive System O.r. Procedures With Cc 54 17 — — $15,924.77 $53,400.46 $48,928.52 2026-07-15
L7181 HCPCS Electronic Elbo Simultaneous 12 6 — — $48,412.11 $127,142.91 $48,901.12 2026-07-15
56 MS_DRG Degenerative Nervous System Disorders With Mcc 54 17 — — $15,908.34 $53,345.35 $48,878.02 2026-07-15
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 54 17 — — $15,826.85 $53,072.09 $48,627.65 2026-07-15
26497 CPT Hc Valve Implant Lvl 59 127 21 $193,816.50 — $3,228.16 $193,816.50 $48,454.12 2026-07-15
347 MS_DRG Anal And Stomal Procedures With Mcc 54 17 — — $15,720.02 $52,713.86 $48,299.42 2026-07-15
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 54 17 — — $15,715.23 $52,697.79 $48,284.70 2026-07-15
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 54 17 — — $15,651.54 $52,484.23 $48,089.02 2026-07-15
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 54 17 — — $15,624.15 $52,392.38 $48,004.86 2026-07-15
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 54 17 — — $15,583.75 $52,256.90 $47,880.73 2026-07-15
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 54 17 — — $15,557.73 $52,169.64 $47,800.78 2026-07-15
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 54 17 — — $15,514.58 $52,024.97 $47,668.22 2026-07-15
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 54 17 — — $15,329.69 $51,404.97 $47,100.14 2026-07-15
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 54 17 — — $15,320.79 $51,375.12 $47,072.79 2026-07-15
C9602 HCPCS Perc D-e Cor Stent Ather S 47 10 — — $11,476.00 $58,947.00 $46,919.97 2026-07-15
407 MS_DRG Pancreas- Liver And Shunt Procedures Without Cc/mcc 54 17 — — $15,199.58 $50,968.67 $46,700.38 2026-07-15
286 MS_DRG Circulatory Disorders Except Ami- With Cardiac Catheterization With Mcc 54 17 — — $15,153.02 $50,812.53 $46,557.31 2026-07-15
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 54 17 — — $15,137.95 $50,762.01 $46,511.02 2026-07-15
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 54 17 — — $15,119.46 $50,700.01 $46,454.22 2026-07-15
41 MS_DRG Peripheral- Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 54 17 — — $15,056.46 $50,488.75 $46,260.65 2026-07-15
30 MS_DRG Spinal Procedures Without Cc/mcc 54 17 — — $15,032.49 $50,408.38 $46,187.01 2026-07-15
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 54 17 — — $15,009.21 $50,330.30 $46,115.47 2026-07-15
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 54 17 — — $14,982.50 $50,240.75 $46,033.42 2026-07-15
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 54 17 — — $14,945.53 $50,116.75 $45,919.80 2026-07-15
141 MS_DRG Major Head And Neck Procedures With Cc 54 17 — — $14,935.94 $50,084.60 $45,890.34 2026-07-15
629 MS_DRG Other Endocrine- Nutritional And Metabolic O.r. Procedures With Cc 54 17 — — $14,920.19 $50,031.78 $45,841.95 2026-07-15
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 54 17 — — $14,909.92 $49,997.34 $45,810.39 2026-07-15
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 54 17 — — $14,859.93 $49,829.71 $45,656.80 2026-07-15
93654 CPT Hc Ep & Ablate Ventricular Tachycardia 119 21 $86,625.00 — $10,328.00 $86,625.00 $45,094.00 2026-07-15
93653 CPT Hc Ep & Ablate Supravent Arryth 119 21 $84,819.90 — $10,328.00 $84,819.90 $45,094.00 2026-07-15
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 54 17 — — $14,664.76 $49,175.26 $45,057.16 2026-07-15
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