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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

MEDICAL CENTER OF THE ROCKIES

Loveland, CO · CCN 060119 · Rates published

19,923 distinct procedures filed
27 distinct payers
590,575 rate rows
2025-11-01 last MRF observed
Data quality

581,643 of 590,575 rate rows are consumer-grade (98.5%)

8,932 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 4,144
template filing: same amount across many unrelated codes — excluded 2,700
per-diem day rate — not a per-procedure price 1,171
placeholder amount (≤ $0.02) — excluded from medians 385
exceeds 10× this hospital's gross charge — excluded from medians 302
percent-of-charges filed in the dollar field — excluded from medians 230
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8081/430730045_medical-center-of-the-rockies_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/MedicalCenteroftheRockies/8081
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint a24cc945b866e3b4… · 305,439,017 bytes · first seen 2026-05-09

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 9 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 9 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 9 $3,316,462.59 $3,316,462.59 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 9 $3,248,445.72 $3,248,445.72 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 9 $2,945,740.00 $2,945,740.00 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 9 $2,455,110.61 $2,455,110.61 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 9 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 9 $770,620.00 $3,729,800.80 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $591,726.20 $2,799,090.98 $591,726.20 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $565,868.95 $2,678,353.55 $565,868.95 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $562,538.19 $2,621,516.59 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $557,317.93 $2,619,700.58 $557,317.93 nat. median
$625,184
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 $325,606.56 $1,508,159.29 $553,905.78 nat. median
$370,174
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $533,230.17 $2,580,090.17 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $489,304.61 $2,370,244.80 $489,304.61 nat. median
$620,080
0.8× median
J0225
HCPCS 		Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 26 $3,996.49 $578,852.35 $404,689.41 nat. median
$8,223
outlier · 49.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $211,543.56 $978,734.71 $359,462.57 nat. median
$265,286
1.4× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 9 $278,250.00 $1,308,615.00 $278,250.00 nat. median
$324,450
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $161,329.62 $745,666.21 $273,862.86 nat. median
$206,368
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 14 $160,386.78 $741,290.11 $272,255.64 nat. median
$202,986
1.3× median
J3403
HCPCS 		Revakinagene, Per Implant 9 $257,500.00 $257,500.00 $257,500.00 nat. median
$265,000
1.0× median
Q2043
HCPCS 		Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 27 $55,272.32 $354,447.70 $247,802.79 nat. median
$66,682
outlier · 3.7×
90288
CPT 		Botulism Ig IV 2 $207,483.30 $215,276.10 $211,379.70 nat. median
$55,037
outlier · 3.8×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 9 $205,640.00 $205,640.00 $205,640.00 nat. median
$209,753
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 7 $113,213.84 $279,295.91 $202,073.54 nat. median
$76,377
outlier · 2.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 14 $104,902.70 $483,760.15 $177,671.91 nat. median
$133,176
1.3× median
7
MS_DRG 		Lung Transplant 14 $98,121.63 $452,285.74 $166,112.22 nat. median
$122,708
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $91,106.54 $419,725.16 $154,153.60 nat. median
$117,303
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $85,943.98 $395,763.12 $145,353.00 nat. median
$108,660
1.3× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $85,846.17 $395,309.09 $145,186.25 nat. median
$98,017
1.5× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $83,606.87 $384,915.41 $141,368.93 nat. median
$98,905
1.4× median
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 21 $708.19 $199,693.90 $139,610.74 nat. median
$21,340
outlier · 6.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 14 $82,500.03 $379,777.94 $139,482.08 nat. median
$102,358
1.4× median
J2351
HCPCS 		Ocrelizumab 920 Mg-hyaluronidase-ocsq 23,000 Unit/23 Ml Subcut Soln 27 $37.88 $199,216.25 $139,276.80 nat. median
$78
outlier · 1786.7×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $78,259.22 $360,094.21 $132,252.78 nat. median
$100,136
1.3× median
J9347
HCPCS 		Tremelimumab-actl 20 Mg/ml Intravenous Solution 25 $140.90 $199,723.85 $131,776.56 nat. median
$3,461
outlier · 38.1×
215
MS_DRG 		Other Heart Assist System Implant 14 $75,599.30 $347,748.23 $127,718.44 nat. median
$99,019
1.3× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 $74,288.55 $341,664.29 $125,483.98 nat. median
$93,672
1.3× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 $68,470.61 $314,660.28 $115,566.14 nat. median
$82,712
1.4× median
850
MS_DRG 		Acute Leukemia With Other Procedures 14 $65,836.29 $302,433.04 $111,075.41 nat. median
$83,442
1.3× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 9 $110,139.19 $255,999.82 $110,139.19 nat. median
$111,989
1.0× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 15 $63,342.28 $307,006.28 $109,101.41 nat. median
$69,774
1.6× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 14 $64,108.65 $294,414.26 $108,130.33 nat. median
$79,312
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $63,909.27 $293,488.75 $107,790.41 nat. median
$81,118
1.3× median
E0194NU
HCPCS 		Other Outpatient 1 $99,973.10 $110,792.70 $105,382.90 —
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $59,886.66 $274,817.84 $100,933.10 nat. median
$77,576
1.3× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 14 $58,453.25 $268,164.63 $98,489.55 nat. median
$74,915
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 $58,204.20 $267,008.61 $98,064.98 nat. median
$73,807
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 $58,013.83 $266,125.01 $97,740.46 nat. median
$72,138
1.4× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 9 $93,216.70 $93,216.70 $93,216.70 nat. median
$96,983
1.0× median

Other procedures at this hospital

Browse this hospital's 19,923 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 21 14 — — $14,112.00 $94,514.04 $34,008.82 2025-11-01
834 MS_DRG Acute Leukemia With Mcc 21 14 — — $41,986.65 $191,734.76 $70,418.95 2025-11-01
850 MS_DRG Acute Leukemia With Other Procedures 21 14 — — $65,836.29 $302,433.04 $111,075.41 2025-11-01
Q2057 HCPCS Afamitresgene Autoleucel 12 9 — — $770,620.00 $3,729,800.80 $770,620.00 2025-11-01
245 MS_DRG Aicd Generator Procedures 21 14 — — $35,007.69 $159,341.82 $58,521.90 2025-11-01
265 MS_DRG Aicd Lead Procedures 21 14 — — $27,903.06 $126,365.64 $46,410.65 2025-11-01
14 MS_DRG Allogeneic Bone Marrow Transplant 21 14 — — $91,106.54 $419,725.16 $154,153.60 2025-11-01
J0206 HCPCS Allopurinol 500 Mg Intravenous Solution 68 27 $52,761.01 $36,932.71 30% off $3.64 $51,178.18 $35,779.88 2025-11-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 21 14 — — $22,126.52 $99,553.71 $36,563.36 2025-11-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 21 14 — — $37,711.24 $171,890.37 $63,130.65 2025-11-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 21 14 — — $32,979.83 $149,929.53 $55,065.03 2025-11-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 21 14 — — $26,918.86 $121,797.45 $44,732.88 2025-11-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 21 14 — — $52,430.66 $240,210.66 $88,222.82 2025-11-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 21 14 — — $32,455.38 $147,495.26 $54,170.99 2025-11-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 21 14 — — $45,295.94 $207,094.77 $76,060.26 2025-11-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 21 14 — — $41,553.25 $189,723.08 $69,680.11 2025-11-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 14 9 — — $533,230.17 $2,580,090.17 $533,230.17 2025-11-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 21 14 — — $28,799.24 $130,525.20 $47,938.35 2025-11-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 21 14 — — $20,085.13 $90,078.56 $33,083.40 2025-11-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 21 14 — — $27,159.65 $122,915.05 $45,143.34 2025-11-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 21 14 — — $20,085.13 $90,078.56 $33,083.40 2025-11-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 9 9 — — $93,216.70 $93,216.70 $93,216.70 2025-11-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 21 14 — — $42,235.72 $192,890.78 $70,843.52 2025-11-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 21 14 — — $20,693.10 $92,900.50 $34,119.82 2025-11-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 21 14 — — $27,507.28 $124,528.58 $45,735.95 2025-11-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 21 14 — — $26,672.06 $120,651.91 $44,312.15 2025-11-01
90288 CPT Botulism Ig IV 2 2 — — $207,483.30 $215,276.10 $211,379.70 2025-11-01
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 65 25 $61,000.00 $42,700.00 30% off $258.64 $59,170.00 $39,040.00 2025-11-01
Q2053 HCPCS Brexucabtagene Car Pos T 14 9 — — $489,304.61 $2,370,244.80 $489,304.61 2025-11-01
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 65 25 $71,434.71 $50,004.30 30% off $227.28 $69,291.67 $45,718.21 2025-11-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 21 14 — — $54,330.58 $249,029.22 $91,461.64 2025-11-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 21 14 — — $45,874.57 $209,780.51 $77,046.66 2025-11-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 21 14 — — $35,429.82 $161,301.11 $59,241.50 2025-11-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 21 14 — — $24,320.66 $109,737.84 $40,303.72 2025-11-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 21 14 — — $25,153.61 $113,604.04 $41,723.67 2025-11-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $74,288.55 $341,664.29 $125,483.98 2025-11-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $50,153.74 $229,642.35 $84,341.37 2025-11-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 14 — — $50,153.74 $229,642.35 $84,341.37 2025-11-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $58,453.25 $268,164.63 $98,489.55 2025-11-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $40,804.56 $186,248.04 $68,403.83 2025-11-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 21 14 — — $38,602.89 $176,028.99 $64,650.65 2025-11-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 21 14 — — $29,802.99 $135,184.20 $49,649.47 2025-11-01
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 65 25 $54,351.71 $38,046.20 30% off $28.96 $52,721.16 $34,785.09 2025-11-01
472 MS_DRG Cervical Spinal Fusion With Cc 21 14 — — $22,845.86 $102,892.54 $37,789.62 2025-11-01
471 MS_DRG Cervical Spinal Fusion With Mcc 21 14 — — $37,011.47 $168,642.35 $61,937.73 2025-11-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 21 14 — — $36,827.87 $167,790.18 $61,624.76 2025-11-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 21 14 — — $20,185.20 $90,543.06 $33,254.00 2025-11-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 21 14 — — $325,606.56 $1,508,159.29 $553,905.78 2025-11-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 21 14 — — $27,484.70 $124,423.81 $45,697.47 2025-11-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 21 14 — — $25,533.61 $115,367.75 $42,371.43 2025-11-01
Q2056 HCPCS Ciltacabtagene Car-pos T 14 9 — — $565,868.95 $2,678,353.55 $565,868.95 2025-11-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 14 — — $68,470.61 $314,660.28 $115,566.14 2025-11-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 21 14 — — $44,072.44 $201,415.97 $73,974.59 2025-11-01
209 MS_DRG Complex Aortic Arch Procedures 21 14 — — $85,846.17 $395,309.09 $145,186.25 2025-11-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 21 14 — — $82,500.03 $379,777.94 $139,482.08 2025-11-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 21 14 — — $50,990.46 $233,526.01 $85,767.74 2025-11-01
545 MS_DRG Connective Tissue Disorders With Mcc 21 14 — — $19,351.49 $86,673.37 $31,832.77 2025-11-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 21 14 — — $58,204.20 $267,008.61 $98,064.98 2025-11-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 21 14 — — $41,782.00 $190,784.80 $70,070.05 2025-11-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 21 14 — — $64,108.65 $294,414.26 $108,130.33 2025-11-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 21 14 — — $46,295.93 $211,736.31 $77,764.97 2025-11-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 21 14 — — $44,836.18 $204,960.86 $75,276.53 2025-11-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 21 14 — — $32,196.54 $146,293.84 $53,729.74 2025-11-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 21 14 — — $33,239.44 $151,134.45 $55,507.56 2025-11-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 21 14 — — $24,387.62 $110,048.68 $40,417.88 2025-11-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 21 14 — — $24,834.57 $112,123.22 $41,179.80 2025-11-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 21 14 — — $24,073.11 $108,588.81 $39,881.71 2025-11-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 21 14 — — $34,889.57 $158,793.50 $58,320.52 2025-11-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 21 14 — — $19,661.49 $88,112.28 $32,361.24 2025-11-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 21 14 — — $51,326.06 $235,083.67 $86,339.82 2025-11-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $43,795.54 $200,130.73 $73,502.56 2025-11-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 14 — — $30,113.01 $136,623.11 $50,177.94 2025-11-01
J7330 HCPCS Cultured Chondrocytes Implnt 7 7 — — $113,213.84 $279,295.91 $202,073.54 2025-11-01
J9144 HCPCS Daratumumab 1,800 Mg-hyaluronidase-fihj 30,000 Unit/15 Ml Subcut Soln 65 25 $52,332.08 $36,632.46 30% off $55.18 $50,762.12 $33,492.53 2025-11-01
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 68 27 $58,677.05 $41,073.94 30% off $243.71 $56,916.74 $39,791.84 2025-11-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 11 9 — — $110,139.19 $255,999.82 $110,139.19 2025-11-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 21 14 — — $160,386.78 $741,290.11 $272,255.64 2025-11-01
E0766 HCPCS Elec Stim Cancer Treatment 2 1 — — $35,318.61 $39,140.97 $37,229.79 2025-11-01
L7181 HCPCS Electronic Elbo Simultaneous 11 9 — — $48,901.12 $119,154.76 $48,901.12 2025-11-01
L7180 HCPCS Electronic Elbow Sequential 11 9 — — $42,853.91 $104,419.87 $42,853.91 2025-11-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 21 14 — — $43,619.48 $199,313.48 $73,202.41 2025-11-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 21 14 — — $46,791.05 $214,034.37 $78,608.99 2025-11-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 21 14 — — $36,500.56 $166,270.94 $61,066.78 2025-11-01
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 17 14 — — $8,845.00 $49,590.00 $35,174.80 2025-11-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 9 9 — — $34,284.44 $34,284.44 $34,284.44 2025-11-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 9 9 — — $67,452.66 $67,452.66 $67,452.66 2025-11-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 14 — — $161,329.62 $745,666.21 $273,862.86 2025-11-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 21 14 — — $29,979.81 $136,004.94 $49,950.90 2025-11-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 14 — — $35,981.36 $163,861.12 $60,181.72 2025-11-01
37 MS_DRG Extracranial Procedures With Mcc 21 14 — — $25,449.34 $114,976.59 $42,227.77 2025-11-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 21 14 — — $45,399.78 $207,576.74 $76,237.27 2025-11-01
503 MS_DRG Foot Procedures With Mcc 21 14 — — $21,679.56 $97,479.17 $35,801.44 2025-11-01
793 MS_DRG Full Term Neonate With Major Problems 21 14 — — $32,052.08 $145,623.28 $53,483.46 2025-11-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 21 14 — — $54,648.87 $250,506.55 $92,004.22 2025-11-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 21 14 — — $24,912.83 $112,486.44 $41,313.20 2025-11-01
J9203 HCPCS Gemtuzumab Ozogamicin 4.5 Mg (1 Mg/ml Initial Concentration) IV Soln 65 25 $49,973.90 $34,981.73 30% off $236.62 $48,474.68 $31,983.30 2025-11-01
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 48 21 $205,870.00 $144,109.00 30% off $708.19 $199,693.90 $139,610.74 2025-11-01
C2616 HCPCS Hb Brachy Tx Ns Spheres Yt-90 103 27 $54,397.38 $38,078.17 30% off $15,006.64 $52,765.46 $36,889.58 2025-11-01
33230 CPT Hb Insert Dfib Pulse Gen Only W Exist Dual Lead 75 27 $56,420.00 $39,494.00 30% off $850.87 $54,727.40 $38,261.22 2025-11-01
33270 CPT Hb Insert/replace S-icd W Subq Lead 67 25 $81,589.00 $57,112.30 30% off $1,247.84 $79,141.33 $55,329.58 2025-11-01
0571T CPT Hb Insert/rplcmt Icds W/substernal Electrode 71 27 $82,751.00 $57,925.70 30% off $4,016.00 $80,268.47 $53,043.39 2025-11-01
33276 CPT Hb Insertion Phrenic Nerve Stimulator System 65 26 $90,563.00 $63,394.10 30% off $2,547.86 $87,846.11 $61,415.30 2025-11-01
33249 CPT Hb Insrt/repl Dfib W Leads Sngl/dual Chmb 69 26 $69,891.00 $48,923.70 30% off $2,027.76 $67,794.27 $47,396.58 2025-11-01
C1815 HCPCS Hb Or-impl Urinary Incont Male (40) 94 27 $53,379.89 $37,365.93 30% off $8,836.51 $51,778.49 $33,114.21 2025-11-01
93581 CPT Hb Perq Trnscath Clo Vent Septal Defec 68 27 $47,323.00 $33,126.10 30% off $2,910.11 $45,903.31 $32,092.09 2025-11-01
C9600 HCPCS Hb Prq Drug Eluding Cor Stent Single 71 27 $47,475.00 $33,232.50 30% off $4,048.00 $46,050.75 $32,195.17 2025-11-01
C9607 HCPCS Hb Radiant Ccl Prq Drug Eluding Cor Revasc Chro One Vessel 71 27 $49,234.00 $34,463.80 30% off $4,048.00 $47,756.98 $33,388.04 2025-11-01
C9606 HCPCS Hb Radiant Ccl Prq Drug Eluding Cor Revasc W Ami One Vessel 54 24 $47,739.00 $33,417.30 30% off $1,473.00 $47,571.00 $32,374.21 2025-11-01
92943 CPT Hb Radiant Ccl Prq Trluml Coronry Chronic Occlus Revasc One Vsl (bare Metal) 67 25 $47,475.00 $33,232.50 30% off $1,455.05 $46,050.75 $32,195.17 2025-11-01
93653 CPT Hb Radiant Ccl-ep Eval With Ablation Supravent Arrhythmia 70 27 $63,476.00 $44,433.20 30% off $1,861.42 $61,571.72 $43,046.25 2025-11-01
93654 CPT Hb Radiant Ccl-ep Eval With Ablation Ventricular Tachycardia 67 25 $72,537.00 $50,775.90 30% off $2,243.59 $70,360.89 $49,190.96 2025-11-01
0515T CPT Hb Radiant Ccl-insertion Wrls Car Stimulator Lv Pacg Compl Sys 71 27 $69,790.00 $48,853.00 30% off $4,016.00 $67,696.30 $47,328.09 2025-11-01
93591 CPT Hb Radiant Ccl-perq Transcath Cls Paravalvr Leak 1 Aortic Valve 67 25 $49,629.00 $34,740.30 30% off $1,965.67 $48,140.13 $33,655.90 2025-11-01
93590 CPT Hb Radiant Ccl-perq Transcath Cls Paravalvr Leak 1 Mitral Valve 67 25 $51,085.00 $35,759.50 30% off $2,384.01 $49,552.45 $34,643.29 2025-11-01
0520T CPT Hb Radiant Ccl-rmvl&rplcmt Pg Wcs Lv Pacg Battery Compnt Only 71 27 $69,790.00 $48,853.00 30% off $4,016.00 $67,696.30 $47,328.09 2025-11-01
33289 CPT Hb Radiant Ccl-tcat Impl Wrls P-art Prs Snr L-t Hemodyn Mntr 67 25 $60,510.00 $42,357.00 30% off $735.92 $58,694.70 $41,034.86 2025-11-01
0823T CPT Hb Radiant Ccl-tcat Insj Perm 1chmbr Ldls Pacemaker R Atrial 71 27 $48,717.00 $34,101.90 30% off $4,016.00 $49,590.00 $33,037.43 2025-11-01
93656 CPT Hb Radiant Compre Ep Eval Abltj Atr Fib Pulm Vein Isolation 67 25 $91,433.00 $64,003.10 30% off $2,110.79 $88,690.01 $62,005.29 2025-11-01
33287 CPT Hb Radiant-rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator 66 27 $83,651.00 $58,555.70 30% off $1,718.68 $81,141.47 $56,727.93 2025-11-01
A9543 HCPCS Hb Radiant-yttriumy90ibritumomab/dose To 40 Mc 91 27 $74,079.32 $51,855.53 30% off $14,689.93 $283,465.47 $50,236.89 2025-11-01
33288 CPT Hb Rmvl&rplcmt Phrnc Nrv Stim Trnsvns Stimj/snsg Ld 63 25 $55,659.00 $38,961.30 30% off $2,201.55 $53,989.23 $37,745.15 2025-11-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 21 14 — — $211,543.56 $978,734.71 $359,462.57 2025-11-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 14 — — $85,943.98 $395,763.12 $145,353.00 2025-11-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 21 14 — — $26,314.66 $118,992.97 $43,702.87 2025-11-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 21 14 — — $22,514.02 $101,352.35 $37,223.95 2025-11-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 21 14 — — $22,591.52 $101,712.08 $37,356.07 2025-11-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 21 14 — — $22,274.74 $100,241.74 $36,816.06 2025-11-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 21 14 — — $46,737.62 $213,786.40 $78,517.92 2025-11-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 21 14 — — $20,523.06 $92,111.20 $33,829.93 2025-11-01
974 MS_DRG HIV With Major Related Condition With Mcc 21 14 — — $22,393.64 $100,793.55 $37,018.72 2025-11-01
Q2055 HCPCS Idecabtagene Vicleucel Car 12 9 — — $557,317.93 $2,619,700.58 $557,317.93 2025-11-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 21 14 — — $37,838.40 $172,480.61 $63,347.42 2025-11-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 21 14 — — $19,428.24 $87,029.61 $31,963.60 2025-11-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 9 9 — — $3,316,462.59 $3,316,462.59 $3,316,462.59 2025-11-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 9 9 — — $2,455,110.61 $2,455,110.61 $2,455,110.61 2025-11-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 9 9 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2025-11-01
J3393 HCPCS Inj, Betibeglogene Autotemce 9 9 — — $2,945,740.00 $2,945,740.00 $2,945,740.00 2025-11-01
J3392 HCPCS Inj, Exagamglogene Autotem 9 9 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-11-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 9 9 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2025-11-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 9 9 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 2025-11-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 9 9 — — $205,640.00 $205,640.00 $205,640.00 2025-11-01
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 17 14 — — $8,845.00 $49,590.00 $32,221.25 2025-11-01
0408T CPT Insj/rplc Cardiac Modulj Sys 19 14 — — $2,299.63 $49,590.00 $32,221.25 2025-11-01
33231 CPT Insrt Pulse Gen W/mult Leads 21 14 — — $886.97 $47,571.00 $32,221.25 2025-11-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 19 15 — — $63,342.28 $307,006.28 $109,101.41 2025-11-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 21 14 — — $40,511.10 $184,885.97 $67,903.57 2025-11-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 21 14 — — $59,886.66 $274,817.84 $100,933.10 2025-11-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 21 14 — — $24,586.27 $110,970.70 $40,756.51 2025-11-01
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 86 27 $44,164.05 $30,914.84 30% off $183.48 $171,356.32 $41,514.21 2025-11-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 21 14 — — $21,423.72 $96,291.72 $35,365.32 2025-11-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 11 9 — — $39,482.40 $96,204.65 $39,482.40 2025-11-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 21 14 — — $24,634.43 $111,194.22 $40,838.60 2025-11-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 21 14 — — $19,796.93 $88,740.93 $32,592.12 2025-11-01
652 MS_DRG Kidney Transplant 21 14 — — $24,978.29 $112,790.29 $41,424.80 2025-11-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 21 14 — — $36,053.60 $164,196.40 $60,304.86 2025-11-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 21 14 — — $28,562.20 $129,425.07 $47,534.30 2025-11-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 21 14 — — $24,960.25 $112,706.47 $41,394.01 2025-11-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 21 14 — — $28,992.61 $131,422.78 $48,268.00 2025-11-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 14 9 — — $562,538.19 $2,621,516.59 $562,538.19 2025-11-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 21 14 — — $78,259.22 $360,094.21 $132,252.78 2025-11-01
6 MS_DRG Liver Transplant Without Mcc 21 14 — — $35,569.02 $161,947.23 $59,478.80 2025-11-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 21 14 — — $27,959.50 $126,627.57 $46,506.85 2025-11-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 21 14 — — $23,377.83 $105,361.74 $38,696.49 2025-11-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 21 14 — — $19,760.82 $88,573.29 $32,530.55 2025-11-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 21 14 — — $28,304.86 $128,230.63 $47,095.61 2025-11-01
7 MS_DRG Lung Transplant 21 14 — — $98,121.63 $452,285.74 $166,112.22 2025-11-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 21 14 — — $44,807.59 $204,828.14 $75,227.79 2025-11-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 21 14 — — $25,018.92 $112,978.88 $41,494.06 2025-11-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 21 14 — — $35,176.23 $160,124.14 $58,809.23 2025-11-01
654 MS_DRG Major Bladder Procedures With Cc 21 14 — — $21,741.26 $97,765.55 $35,906.62 2025-11-01
653 MS_DRG Major Bladder Procedures With Mcc 21 14 — — $39,778.22 $181,484.27 $66,654.22 2025-11-01
164 MS_DRG Major Chest Procedures With Cc 21 14 — — $19,669.76 $88,150.70 $32,375.35 2025-11-01
163 MS_DRG Major Chest Procedures With Mcc 21 14 — — $34,401.23 $156,526.87 $57,488.05 2025-11-01
140 MS_DRG Major Head And Neck Procedures With Mcc 21 14 — — $32,772.16 $148,965.60 $54,711.00 2025-11-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 21 14 — — $23,501.24 $105,934.51 $38,906.86 2025-11-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 21 14 — — $21,535.08 $96,808.61 $35,555.16 2025-11-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 21 14 — — $35,264.29 $160,532.76 $58,959.31 2025-11-01
662 MS_DRG Minor Bladder Procedures With Mcc 21 14 — — $23,714.17 $106,922.89 $39,269.86 2025-11-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 21 14 — — $20,112.22 $90,204.29 $33,129.58 2025-11-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $83,606.87 $384,915.41 $141,368.93 2025-11-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $54,994.24 $252,109.61 $92,592.98 2025-11-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 — — $42,980.64 $196,348.35 $72,113.39 2025-11-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 21 14 — — $50,953.60 $233,354.88 $85,704.88 2025-11-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 21 14 — — $32,587.81 $148,109.94 $54,396.74 2025-11-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 21 14 — — $35,876.02 $163,372.17 $60,002.14 2025-11-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 21 14 — — $24,455.35 $110,363.00 $40,533.32 2025-11-01
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 68 27 $75,219.90 $52,653.93 30% off $197.83 $72,963.30 $51,010.38 2025-11-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 21 14 — — $27,854.92 $126,142.12 $46,328.56 2025-11-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 21 14 — — $26,474.93 $119,736.87 $43,976.09 2025-11-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 21 14 — — $14,112.00 $100,842.45 $36,285.96 2025-11-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 21 14 — — $27,980.57 $126,725.36 $46,542.77 2025-11-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 12 9 — — $278,250.00 $1,308,615.00 $278,250.00 2025-11-01
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 65 25 $102,688.80 $71,882.16 30% off $47.87 $99,608.14 $65,720.83 2025-11-01
J2351 HCPCS Ocrelizumab 920 Mg-hyaluronidase-ocsq 23,000 Unit/23 Ml Subcut Soln 68 27 $205,377.58 $143,764.31 30% off $37.88 $199,216.25 $139,276.80 2025-11-01
0553T CPT Op Surgery 6 6 — — $7,574.00 $44,198.00 $33,813.00 2025-11-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 21 14 — — $37,904.62 $172,787.95 $63,460.30 2025-11-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 21 14 — — $24,376.32 $109,996.29 $40,398.64 2025-11-01
264 MS_DRG Other Circulatory System O.r. Procedures 21 14 — — $25,814.28 $116,670.46 $42,849.88 2025-11-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 21 14 — — $33,731.52 $153,418.54 $56,346.45 2025-11-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 21 14 — — $28,869.21 $130,850.01 $48,057.64 2025-11-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 21 14 — — $28,720.23 $130,158.49 $47,803.66 2025-11-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 21 14 — — $34,259.02 $155,866.78 $57,245.62 2025-11-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 21 14 — — $19,997.84 $89,673.43 $32,934.61 2025-11-01
215 MS_DRG Other Heart Assist System Implant 21 14 — — $75,599.30 $347,748.23 $127,718.44 2025-11-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 21 14 — — $31,927.17 $145,043.53 $53,270.53 2025-11-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 21 14 — — $32,292.85 $146,740.88 $53,893.92 2025-11-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 21 14 — — $27,437.32 $124,203.78 $45,616.66 2025-11-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 21 14 — — $40,379.43 $184,274.78 $67,679.10 2025-11-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 21 14 — — $19,887.97 $89,163.53 $32,747.33 2025-11-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 21 14 — — $21,248.41 $95,477.97 $35,066.45 2025-11-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 21 14 — — $24,657.75 $111,302.48 $40,878.37 2025-11-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 21 14 — — $29,566.72 $134,087.55 $49,246.70 2025-11-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 21 14 — — $32,385.40 $147,170.46 $54,051.70 2025-11-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 21 14 — — $58,013.83 $266,125.01 $97,740.46 2025-11-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 21 14 — — $22,830.81 $102,822.69 $37,763.97 2025-11-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 21 14 — — $30,656.27 $139,144.69 $51,104.05 2025-11-01
E0194NU HCPCS Other Outpatient 2 1 — — $99,973.10 $110,792.70 $105,382.90 2025-11-01
K0606NUKF HCPCS Other Outpatient 2 1 — — $77,361.67 $85,734.14 $81,547.90 2025-11-01
E0766RRKF HCPCS Other Outpatient 2 1 — — $35,318.61 $39,140.97 $37,229.79 2025-11-01
E0764NUKF HCPCS Other Outpatient 2 1 — — $33,996.73 $37,676.03 $35,836.38 2025-11-01
E0483NU HCPCS Other Outpatient 2 1 — — $32,659.70 $36,194.30 $34,427.00 2025-11-01
K0864NU HCPCS Other Outpatient 2 1 — — $31,678.88 $35,107.33 $33,393.11 2025-11-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 21 14 — — $28,802.26 $130,539.17 $47,943.48 2025-11-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 21 14 — — $25,046.01 $113,104.61 $41,540.24 2025-11-01
253 MS_DRG Other Vascular Procedures With Cc 21 14 — — $20,208.51 $90,651.33 $33,293.76 2025-11-01
252 MS_DRG Other Vascular Procedures With Mcc 21 14 — — $26,925.63 $121,828.88 $44,744.42 2025-11-01
0266T CPT Outpatient Rates 19 14 — — $608.96 $49,590.00 $45,224.60 2025-11-01
10 MS_DRG Pancreas Transplant 21 14 — — $54,671.42 $250,611.32 $92,042.70 2025-11-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 21 14 — — $22,500.48 $101,289.49 $37,200.87 2025-11-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 21 14 — — $41,840.70 $191,057.21 $70,170.10 2025-11-01
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 69 27 $134,075.75 $93,853.03 30% off $26,587.22 $137,572.45 $90,923.47 2025-11-01
J9305 HCPCS Pemetrexed Disodium 100 Mg Intravenous Powder For Solution 86 27 $35,410.27 $24,787.19 30% off $3.77 $171,740.28 $34,728.67 2025-11-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 21 14 — — $31,720.23 $144,083.09 $52,917.79 2025-11-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 21 14 — — $25,446.32 $114,962.62 $42,222.64 2025-11-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 21 14 — — $21,150.58 $95,023.94 $34,899.70 2025-11-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 21 14 — — $26,551.66 $120,093.11 $44,106.92 2025-11-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 21 14 — — $29,731.52 $134,852.41 $49,527.61 2025-11-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 21 14 — — $27,547.16 $124,713.68 $45,803.93 2025-11-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 21 14 — — $24,702.15 $111,508.54 $40,954.05 2025-11-01
J9600 HCPCS Porfimer Sodium Injection 19 15 — — $24,228.42 $117,265.54 $40,115.56 2025-11-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 21 14 — — $34,904.62 $158,863.35 $58,346.17 2025-11-01
791 MS_DRG Prematurity With Major Problems 21 14 — — $31,219.86 $141,760.58 $52,064.79 2025-11-01
665 MS_DRG Prostatectomy With Mcc 21 14 — — $24,163.40 $109,007.91 $40,035.63 2025-11-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 2 — — $78,406.07 $81,350.90 $79,878.49 2025-11-01
849 MS_DRG Radiotherapy 21 14 — — $21,065.56 $94,629.29 $34,754.76 2025-11-01
332 MS_DRG Rectal Resection With Mcc 21 14 — — $27,921.87 $126,452.95 $46,442.72 2025-11-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 21 14 — — $49,095.80 $224,731.90 $82,537.90 2025-11-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 21 14 — — $21,360.52 $95,998.35 $35,257.57 2025-11-01
J3403 HCPCS Revakinagene, Per Implant 9 9 — — $257,500.00 $257,500.00 $257,500.00 2025-11-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 21 14 — — $27,213.83 $123,166.51 $45,235.70 2025-11-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 21 14 — — $39,845.94 $181,798.60 $66,769.67 2025-11-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 21 14 — — $21,355.24 $95,973.90 $35,248.60 2025-11-01
J2327 HCPCS Risankizumab-rzaa 60 Mg/ml Intravenous Solution 68 27 $51,604.20 $36,122.94 30% off $11.90 $50,056.07 $34,995.39 2025-11-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 21 14 — — $52,685.73 $241,394.62 $88,657.66 2025-11-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 21 14 — — $23,405.67 $105,490.96 $38,743.95 2025-11-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 21 14 — — $42,849.70 $195,740.66 $71,890.20 2025-11-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 21 14 — — $54,362.19 $249,175.91 $91,515.51 2025-11-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 21 14 — — $30,930.17 $140,415.96 $51,570.95 2025-11-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 21 14 — — $40,780.50 $186,136.28 $68,362.78 2025-11-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 21 14 — — $24,985.07 $112,821.72 $41,436.34 2025-11-01
Q2043 HCPCS Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 69 27 $365,410.00 $255,787.00 30% off $55,272.32 $354,447.70 $247,802.79 2025-11-01
570 MS_DRG Skin Debridement With Mcc 21 14 — — $22,808.24 $102,717.92 $37,725.49 2025-11-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 21 14 — — $20,623.13 $92,575.70 $34,000.53 2025-11-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 21 14 — — $37,557.00 $171,174.41 $62,867.69 2025-11-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 21 14 — — $26,798.49 $121,238.65 $44,527.65 2025-11-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 21 14 — — $49,973.90 $228,807.65 $84,034.81 2025-11-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 21 14 — — $27,459.12 $124,305.06 $45,653.86 2025-11-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 21 14 — — $28,316.16 $128,283.02 $47,114.85 2025-11-01
500 MS_DRG Soft Tissue Procedures With Mcc 21 14 — — $24,491.46 $110,530.64 $40,594.89 2025-11-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $63,909.27 $293,488.75 $107,790.41 2025-11-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $45,547.26 $208,261.27 $76,488.68 2025-11-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 14 — — $32,074.64 $145,728.06 $53,521.94 2025-11-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 21 14 — — $26,348.50 $119,150.13 $43,760.59 2025-11-01
28 MS_DRG Spinal Procedures With Mcc 21 14 — — $45,887.35 $209,839.88 $77,068.46 2025-11-01
800 MS_DRG Splenic Procedures With Cc 21 14 — — $21,817.26 $98,118.30 $36,036.17 2025-11-01
799 MS_DRG Splenic Procedures With Mcc 21 14 — — $34,755.62 $158,171.83 $58,092.20 2025-11-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 21 14 — — $38,205.59 $174,184.95 $63,973.38 2025-11-01
J9226 HCPCS Supprelin La Implant 25 15 — — $36,534.28 $220,512.29 $51,577.80 2025-11-01
J3241 HCPCS Teprotumumab-trbw 500 Mg Intravenous Solution 67 26 $87,117.85 $60,982.50 30% off $287.95 $84,504.31 $59,078.97 2025-11-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 21 14 — — $23,402.68 $105,476.99 $38,738.82 2025-11-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 9 — — $591,726.20 $2,799,090.98 $591,726.20 2025-11-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 21 14 — — $32,401.21 $147,243.80 $54,078.63 2025-11-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 21 14 — — $41,717.29 $190,484.44 $69,959.74 2025-11-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 21 14 — — $22,362.03 $100,646.87 $36,964.85 2025-11-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 21 14 — — $104,902.70 $483,760.15 $177,671.91 2025-11-01
668 MS_DRG Transurethral Procedures With Mcc 21 14 — — $22,649.46 $101,981.00 $37,454.84 2025-11-01
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 65 25 $205,900.88 $144,130.62 30% off $140.90 $199,723.85 $131,776.56 2025-11-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 14 — — $42,560.78 $194,399.54 $71,397.65 2025-11-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 14 — — $27,814.27 $125,953.52 $46,259.29 2025-11-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 21 14 — — $23,073.85 $103,950.77 $38,178.28 2025-11-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 21 14 — — $20,974.53 $94,206.70 $34,599.55 2025-11-01
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 87 25 $133,076.40 $93,153.48 30% off $149.40 $129,084.11 $59,884.43 2025-11-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 21 14 — — $27,636.70 $125,129.29 $45,956.58 2025-11-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 21 14 — — $27,574.24 $124,839.41 $45,850.11 2025-11-01
263 MS_DRG Vein Ligation And Stripping 21 14 — — $23,683.32 $106,779.70 $39,217.27 2025-11-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 21 14 — — $34,391.43 $156,481.46 $57,471.37 2025-11-01
J0225 HCPCS Vutrisiran 25 Mg/0.5 Ml Subcutaneous Syringe 67 26 $596,755.00 $417,728.50 30% off $3,996.49 $578,852.35 $404,689.41 2025-11-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 14 — — $43,563.79 $199,055.04 $73,107.49 2025-11-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 21 14 — — $24,114.48 $108,780.90 $39,952.26 2025-11-01
901 MS_DRG Wound Debridements For Injuries With Mcc 21 14 — — $32,255.24 $146,566.26 $53,829.79 2025-11-01
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