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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

LONGS PEAK HOSPITAL

Longmont, CO · CCN 060128 · Rates published

19,972 distinct procedures filed
25 distinct payers
622,242 rate rows
2025-11-01 last MRF observed
Data quality

617,019 of 622,242 rate rows are consumer-grade (99.2%)

5,223 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 1,973
per-diem day rate — not a per-procedure price 1,136
placeholder amount (≤ $0.02) — excluded from medians 971
template filing: same amount across many unrelated codes — excluded 946
exceeds 10× this hospital's gross charge — excluded from medians 145
percent-of-charges filed in the dollar field — excluded from medians 52
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8083/611786722_longs-peak-hospital_standardcharges.csv
Found on page https://www.uchealth.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-18
Content fingerprint a66e35bb8a25846d… · 317,747,725 bytes · first seen 2026-05-18

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 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 $338,579.12 $1,486,956.54 $633,837.14 nat. median
$370,174
1.7× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $591,726.20 $591,726.20 $591,726.20 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $565,868.95 $1,271,682.00 $565,868.95 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $562,538.19 $1,172,582.42 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $557,317.93 $557,317.93 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $533,230.17 $1,159,555.20 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $489,304.61 $1,159,555.20 $489,304.61 nat. median
$620,080
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $220,050.16 $964,974.97 $411,334.80 nat. median
$265,286
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 $167,870.18 $735,183.12 $313,382.64 nat. median
$206,368
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 16 $166,890.43 $730,868.54 $311,543.49 nat. median
$202,986
1.5× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 9 $278,250.00 $278,250.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 9 $257,500.00 $257,500.00 $257,500.00 nat. median
$265,000
1.0× median
J3285
HCPCS 		Treprostinil Sodium 5 Mg/ml Injection Solution 23 $50.25 $307,805.48 $229,095.23 nat. median
$968
outlier · 236.7×
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 9 $205,640.00 $205,640.00 $205,640.00 nat. median
$209,753
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 16 $109,233.95 $476,959.11 $203,310.85 nat. median
$133,176
1.5× median
Q2043
HCPCS 		Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 25 $55,272.32 $262,050.71 $195,040.60 nat. median
$66,682
outlier · 2.9×
7
MS_DRG 		Lung Transplant 16 $102,187.38 $445,927.19 $190,083.04 nat. median
$122,708
1.5× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 16 $94,897.64 $413,824.37 $176,398.74 nat. median
$117,303
1.5× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 $89,532.95 $390,199.20 $166,328.16 nat. median
$108,660
1.5× median
209
MS_DRG 		Complex Aortic Arch Procedures 16 $89,431.31 $389,751.56 $166,137.35 nat. median
$98,017
1.7× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 $87,104.33 $379,504.00 $161,769.17 nat. median
$98,905
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 16 $85,954.15 $374,438.76 $159,610.04 nat. median
$102,358
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 16 $81,547.30 $355,031.76 $151,337.52 nat. median
$100,136
1.5× median
215
MS_DRG 		Other Heart Assist System Implant 16 $78,783.25 $342,859.34 $146,148.85 nat. median
$99,019
1.5× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $77,421.16 $336,860.94 $143,591.94 nat. median
$93,672
1.5× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 $71,375.44 $310,236.57 $132,242.91 nat. median
$82,712
1.6× median
90288
CPT 		Botulism Ig IV 1 $130,529.40 $130,529.40 $130,529.40 nat. median
$55,037
outlier · 2.4×
850
MS_DRG 		Acute Leukemia With Other Procedures 16 $68,637.96 $298,181.22 $127,104.14 nat. median
$83,442
1.5× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 16 $66,842.71 $290,275.18 $123,734.07 nat. median
$79,312
1.6× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 $66,635.50 $289,362.68 $123,345.11 nat. median
$81,118
1.5× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 $62,455.41 $270,954.26 $115,498.25 nat. median
$77,576
1.5× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 $60,965.87 $264,394.58 $112,702.09 nat. median
$74,915
1.5× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 $60,707.06 $263,254.82 $112,216.25 nat. median
$73,807
1.5× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 $60,509.23 $262,383.64 $111,844.89 nat. median
$72,138
1.6× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 9 $110,139.19 $257,999.82 $110,139.19 nat. median
$111,989
1.0× median
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 20 $559.97 $149,430.69 $109,884.82 nat. median
$21,340
outlier · 5.1×
E0194NU
HCPCS 		Other Outpatient 1 $101,271.46 $111,658.27 $106,464.87 —
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 $57,371.43 $248,565.27 $105,954.61 nat. median
$68,090
1.6× median
10
MS_DRG 		Pancreas Transplant 16 $57,035.98 $247,088.05 $105,324.92 nat. median
$68,882
1.5× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 16 $57,012.54 $246,984.75 $105,280.89 nat. median
$64,027
1.6× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 $56,714.63 $245,672.82 $104,721.66 nat. median
$71,240
1.5× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 $56,681.78 $245,528.19 $104,660.01 nat. median
$68,887
1.5× median

Other procedures at this hospital

Browse this hospital's 19,972 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
             
L8614 HCPCS Hb Or Impl Ear Cochlear Complete (40) 664 25 $76,827.36 $26,889.58 65% off $8,775.14 $159,564.54 $36,522.55 2025-11-01
C1767 HCPCS Hb Or-impl Pain Svc Transmitter (28) 649 25 $76,827.36 $26,889.58 65% off $8,775.14 $186,190.78 $37,231.73 2025-11-01
C1882 HCPCS Hb Xper-medtronic Cobalt Xt Vr MRI Surescan 568 25 $93,481.82 $32,718.64 65% off $11,215.15 $128,350.47 $42,459.34 2025-11-01
C1721 HCPCS Hb Xper-boston Scientific Icd Dual 325 25 $68,671.94 $24,035.18 65% off $10,626.71 $93,345.82 $34,401.74 2025-11-01
C2616 HCPCS Hb Xper-boston Scientific Brachy Tx Ns Spheres Yt-90 Per Source 91 25 $69,763.76 $24,417.32 65% off $17,485.10 $152,701.25 $43,672.11 2025-11-01
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 82 25 $136,335.18 $47,717.32 65% off $149.40 $96,593.48 $62,577.85 2025-11-01
C1815 HCPCS Hb Or-impl Urinary Incont Male (40) 82 25 $88,646.96 $31,026.44 65% off $15,573.50 $79,782.26 $44,944.01 2025-11-01
A9543 HCPCS Hb Radiant-yttriumy90ibritumomab/dose To 40 Mc 76 23 $173,183.79 $60,614.33 65% off $1,798.00 $181,678.98 $90,228.76 2025-11-01
33230 CPT Hb Insert Dfib Pulse Gen Only W Exist Dual Lead 75 25 $76,432.00 $26,751.20 65% off $861.92 $56,232.00 $39,821.07 2025-11-01
33240 CPT Hb Radiant Ccl-insert Dfib Pulse Gen Only W Exist Sngl Lead 69 25 $73,601.00 $25,760.35 65% off $822.98 $56,232.00 $38,346.12 2025-11-01
37231 CPT Hb Radiant Ccl-revasc Tibio/peroneal Stent Ather Uni Init+/- Pta 69 25 $67,743.00 $23,710.05 65% off $3,094.88 $47,995.92 $35,294.11 2025-11-01
33264 CPT Hb Remv&replc Cvd Gen Mult Lead 66 25 $97,107.00 $33,987.45 65% off $908.01 $68,800.31 $50,592.75 2025-11-01
33263 CPT Hb Radiant Ccl-remv&replc Cvd Gen Dual Lead 66 25 $93,203.00 $32,621.05 65% off $870.69 $66,034.33 $48,558.76 2025-11-01
0520T CPT Hb Radiant Ccl-rmvl&rplcmt Pg Wcs Lv Pacg Battery Compnt Only 66 25 $78,240.00 $27,384.00 65% off $3,751.00 $56,232.00 $40,763.04 2025-11-01
0515T CPT Hb Radiant Ccl-insertion Wrls Car Stimulator Lv Pacg Compl Sys 66 25 $78,240.00 $27,384.00 65% off $3,751.00 $56,232.00 $40,763.04 2025-11-01
33270 CPT Hb Insert/replace S-icd W Subq Lead 66 25 $75,244.00 $26,335.40 65% off $1,264.04 $56,232.00 $39,202.12 2025-11-01
33249 CPT Hb Radiant Ccl-insrt/repl Dfib W Leads Sngl/dual Chmb 66 25 $73,768.00 $25,818.80 65% off $2,054.10 $56,232.00 $38,433.13 2025-11-01
Q2043 HCPCS Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 64 25 $374,358.16 $131,025.36 65% off $55,272.32 $262,050.71 $195,040.60 2025-11-01
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 64 25 $137,359.00 $48,075.65 65% off $28,424.06 $96,151.30 $71,564.04 2025-11-01
J3285 HCPCS Treprostinil Sodium 5 Mg/ml Injection Solution 62 23 $439,722.12 $153,902.75 65% off $50.25 $307,805.48 $229,095.23 2025-11-01
J9228 HCPCS Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 62 23 $180,981.95 $63,343.69 65% off $183.48 $126,687.37 $94,291.60 2025-11-01
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 62 23 $138,517.18 $48,481.02 65% off $3,295.57 $96,962.03 $72,167.45 2025-11-01
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 62 23 $111,670.83 $39,084.80 65% off $2,210.45 $78,169.58 $58,180.50 2025-11-01
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 62 23 $105,203.44 $36,821.21 65% off $54.07 $73,642.41 $54,810.99 2025-11-01
33276 CPT Hb Radiant-insertion Phrenic Nerve Stimulator System 62 23 $90,449.00 $31,657.15 65% off $2,475.70 $63,314.30 $47,123.93 2025-11-01
33287 CPT Hb Rmvl&rplcmt Phrenic Nrv Stimulator Pls Generator 62 23 $79,691.00 $27,891.85 65% off $1,670.00 $55,783.70 $41,519.01 2025-11-01
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 62 23 $77,061.89 $26,971.67 65% off $197.83 $53,943.32 $40,149.25 2025-11-01
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 62 23 $73,184.00 $25,614.40 65% off $227.28 $51,228.80 $38,128.86 2025-11-01
J7330 HCPCS Hb Autologous Cultured Chondrocyctes, Implant 55 25 $182,777.50 $63,972.13 65% off $53,517.25 $169,346.84 $95,227.08 2025-11-01
0909T CPT Hb Replacement Int Neurostimulation Sys Vagus Nerve 55 25 $121,083.00 $42,379.05 65% off $1,650.00 $84,758.10 $63,084.25 2025-11-01
0908T CPT Hb Open Impltj Int Neurostimulation Sys Vagus Nerve 50 21 $121,080.00 $42,378.00 65% off $1,650.00 $84,756.00 $63,082.68 2025-11-01
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 47 20 $210,911.35 $73,818.98 65% off $559.97 $149,430.69 $109,884.82 2025-11-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 16 — — $338,579.12 $1,486,956.54 $633,837.14 2025-11-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 25 16 — — $220,050.16 $964,974.97 $411,334.80 2025-11-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 25 16 — — $167,870.18 $735,183.12 $313,382.64 2025-11-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 25 16 — — $166,890.43 $730,868.54 $311,543.49 2025-11-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 25 16 — — $109,233.95 $476,959.11 $203,310.85 2025-11-01
7 MS_DRG Lung Transplant 25 16 — — $102,187.38 $445,927.19 $190,083.04 2025-11-01
14 MS_DRG Allogeneic Bone Marrow Transplant 25 16 — — $94,897.64 $413,824.37 $176,398.74 2025-11-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 25 16 — — $89,532.95 $390,199.20 $166,328.16 2025-11-01
209 MS_DRG Complex Aortic Arch Procedures 25 16 — — $89,431.31 $389,751.56 $166,137.35 2025-11-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 25 16 — — $87,104.33 $379,504.00 $161,769.17 2025-11-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 25 16 — — $85,954.15 $374,438.76 $159,610.04 2025-11-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 25 16 — — $81,547.30 $355,031.76 $151,337.52 2025-11-01
215 MS_DRG Other Heart Assist System Implant 25 16 — — $78,783.25 $342,859.34 $146,148.85 2025-11-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 16 — — $77,421.16 $336,860.94 $143,591.94 2025-11-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 25 16 — — $71,375.44 $310,236.57 $132,242.91 2025-11-01
850 MS_DRG Acute Leukemia With Other Procedures 25 16 — — $68,637.96 $298,181.22 $127,104.14 2025-11-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 25 16 — — $66,842.71 $290,275.18 $123,734.07 2025-11-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 16 — — $66,635.50 $289,362.68 $123,345.11 2025-11-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 25 16 — — $62,455.41 $270,954.26 $115,498.25 2025-11-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 25 16 — — $60,965.87 $264,394.58 $112,702.09 2025-11-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 25 16 — — $60,707.06 $263,254.82 $112,216.25 2025-11-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 25 16 — — $60,509.23 $262,383.64 $111,844.89 2025-11-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 25 16 — — $57,371.43 $248,565.27 $105,954.61 2025-11-01
10 MS_DRG Pancreas Transplant 25 16 — — $57,035.98 $247,088.05 $105,324.92 2025-11-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 25 16 — — $57,012.54 $246,984.75 $105,280.89 2025-11-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 25 16 — — $56,714.63 $245,672.82 $104,721.66 2025-11-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 25 16 — — $56,681.78 $245,528.19 $104,660.01 2025-11-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 25 16 — — $54,972.53 $238,000.92 $101,451.40 2025-11-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 25 16 — — $54,707.46 $236,833.61 $100,953.82 2025-11-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 25 16 — — $53,559.61 $231,778.70 $98,799.09 2025-11-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 25 16 — — $53,210.89 $230,242.94 $98,144.45 2025-11-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 25 16 — — $53,172.57 $230,074.21 $98,072.52 2025-11-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 16 — — $52,341.40 $226,413.88 $96,512.25 2025-11-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 16 — — $52,341.40 $226,413.88 $96,512.25 2025-11-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 25 16 — — $52,154.51 $225,590.91 $96,161.45 2025-11-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 25 16 — — $51,242.03 $221,572.46 $94,448.53 2025-11-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 25 16 — — $48,847.05 $211,025.33 $89,952.66 2025-11-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 25 16 — — $48,791.52 $210,780.84 $89,848.44 2025-11-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 25 16 — — $48,332.55 $208,759.57 $88,986.84 2025-11-01
28 MS_DRG Spinal Procedures With Mcc 25 16 — — $47,907.97 $206,889.80 $88,189.83 2025-11-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 25 16 — — $47,894.68 $206,831.26 $88,164.87 2025-11-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 16 — — $47,554.55 $205,333.39 $87,526.38 2025-11-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 25 16 — — $5,377.00 $204,658.48 $87,238.69 2025-11-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 25 16 — — $47,293.39 $204,183.29 $87,036.14 2025-11-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 25 16 — — $46,815.65 $202,079.37 $86,139.31 2025-11-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 25 16 — — $46,785.94 $201,948.52 $86,083.53 2025-11-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 25 16 — — $46,022.00 $198,584.32 $84,649.49 2025-11-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 25 16 — — $45,734.26 $197,317.15 $84,109.34 2025-11-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 25 16 — — $45,551.30 $196,511.39 $83,765.88 2025-11-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 25 16 — — $45,493.43 $196,256.58 $83,657.26 2025-11-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 25 16 — — $44,887.44 $193,587.95 $82,519.72 2025-11-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 25 16 — — $44,751.40 $192,988.80 $82,264.32 2025-11-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 25 16 — — $44,451.14 $191,666.53 $81,700.68 2025-11-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 25 16 — — $44,113.36 $190,178.98 $81,066.59 2025-11-01
834 MS_DRG Acute Leukemia With Mcc 25 16 — — $43,854.55 $189,039.22 $80,580.75 2025-11-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 25 16 — — $43,702.86 $188,371.20 $80,296.00 2025-11-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 25 16 — — $43,641.86 $188,102.61 $80,181.51 2025-11-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 25 16 — — $43,574.62 $187,806.48 $80,055.28 2025-11-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 25 16 — — $43,404.17 $187,055.82 $79,735.30 2025-11-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 25 16 — — $42,626.17 $183,629.64 $78,274.84 2025-11-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 25 16 — — $42,601.14 $183,519.45 $78,227.87 2025-11-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 25 16 — — $42,321.22 $182,286.71 $77,702.40 2025-11-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 25 16 — — $42,184.40 $181,684.11 $77,445.53 2025-11-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 25 16 — — $41,630.01 $179,242.74 $76,404.86 2025-11-01
653 MS_DRG Major Bladder Procedures With Mcc 25 16 — — $41,559.65 $178,932.84 $76,272.76 2025-11-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 25 16 — — $40,338.31 $173,554.25 $73,980.06 2025-11-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 25 16 — — $39,925.46 $171,736.13 $73,205.06 2025-11-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 25 16 — — $39,612.68 $170,358.77 $72,617.94 2025-11-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 25 16 — — $39,543.88 $170,055.75 $72,488.77 2025-11-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 25 16 — — $39,411.73 $169,473.82 $72,240.71 2025-11-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 25 16 — — $39,251.44 $168,767.92 $71,939.81 2025-11-01
471 MS_DRG Cervical Spinal Fusion With Mcc 25 16 — — $38,684.57 $166,271.46 $70,875.66 2025-11-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 25 16 — — $38,493.77 $165,431.27 $70,517.52 2025-11-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 25 16 — — $38,153.64 $163,933.39 $69,879.02 2025-11-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 25 16 — — $37,689.19 $161,888.01 $69,007.15 2025-11-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 16 — — $37,614.12 $161,557.44 $68,866.24 2025-11-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 25 16 — — $37,504.66 $161,075.37 $68,660.75 2025-11-01
6 MS_DRG Liver Transplant Without Mcc 25 16 — — $37,185.64 $159,670.46 $68,061.89 2025-11-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 25 16 — — $37,040.99 $159,033.43 $67,790.34 2025-11-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 25 16 — — $36,868.97 $158,275.88 $67,467.43 2025-11-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 25 16 — — $36,777.48 $157,873.00 $67,295.69 2025-11-01
245 MS_DRG Aicd Generator Procedures 25 16 — — $36,602.33 $157,101.68 $66,966.91 2025-11-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 25 16 — — $36,495.22 $156,629.94 $66,765.82 2025-11-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 25 16 — — $36,479.58 $156,561.07 $66,736.46 2025-11-01
799 MS_DRG Splenic Procedures With Mcc 25 16 — — $36,340.39 $155,948.14 $66,475.19 2025-11-01
163 MS_DRG Major Chest Procedures With Mcc 25 16 — — $35,972.11 $154,326.30 $65,783.86 2025-11-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 25 16 — — $35,961.95 $154,281.54 $65,764.78 2025-11-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 25 16 — — $35,824.33 $153,675.50 $65,506.45 2025-11-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 25 16 — — $35,276.21 $151,261.68 $64,477.52 2025-11-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 25 16 — — $34,764.84 $149,009.69 $63,517.58 2025-11-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 25 16 — — $34,495.09 $147,821.72 $63,011.19 2025-11-01
140 MS_DRG Major Head And Neck Procedures With Mcc 25 16 — — $34,279.28 $146,871.34 $62,606.07 2025-11-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 25 16 — — $34,087.71 $146,027.71 $62,246.46 2025-11-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 25 16 — — $33,950.10 $145,421.67 $61,988.13 2025-11-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 25 16 — — $33,893.79 $145,173.74 $61,882.45 2025-11-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 25 16 — — $33,877.38 $145,101.43 $61,851.62 2025-11-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 25 16 — — $33,781.20 $144,677.89 $61,671.08 2025-11-01
901 MS_DRG Wound Debridements For Injuries With Mcc 25 16 — — $33,742.11 $144,505.72 $61,597.69 2025-11-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 25 16 — — $33,681.12 $144,237.14 $61,483.21 2025-11-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 16 — — $33,554.46 $143,679.31 $61,245.42 2025-11-01
793 MS_DRG Full Term Neonate With Major Problems 25 16 — — $5,377.00 $143,576.01 $61,201.39 2025-11-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 25 16 — — $33,401.19 $143,004.40 $60,957.73 2025-11-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 25 16 — — $33,186.17 $142,057.47 $60,554.09 2025-11-01
791 MS_DRG Prematurity With Major Problems 25 16 — — $5,377.00 $139,767.61 $59,578.00 2025-11-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 25 16 — — $32,365.17 $138,441.90 $59,012.90 2025-11-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 25 16 — — $32,080.55 $137,188.50 $58,478.62 2025-11-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 25 16 — — $31,516.01 $134,702.36 $57,418.87 2025-11-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 25 16 — — $31,377.61 $134,092.88 $57,159.07 2025-11-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 25 16 — — $31,193.87 $133,283.68 $56,814.13 2025-11-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 25 16 — — $31,119.58 $132,956.56 $56,674.69 2025-11-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 25 16 — — $30,948.34 $132,202.46 $56,353.25 2025-11-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 25 16 — — $30,351.75 $129,575.14 $55,233.31 2025-11-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 25 16 — — $30,223.51 $129,010.42 $54,992.59 2025-11-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 25 16 — — $30,153.93 $128,703.96 $54,861.96 2025-11-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 25 16 — — $30,150.80 $128,690.19 $54,856.09 2025-11-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 25 16 — — $30,068.69 $128,328.63 $54,701.97 2025-11-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 25 16 — — $29,904.49 $127,605.52 $54,393.73 2025-11-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 25 16 — — $29,648.81 $126,479.53 $53,913.76 2025-11-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 25 16 — — $29,637.07 $126,427.87 $53,891.74 2025-11-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 25 16 — — $29,300.08 $124,943.77 $53,259.12 2025-11-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 25 16 — — $29,278.18 $124,847.35 $53,218.02 2025-11-01
332 MS_DRG Rectal Resection With Mcc 25 16 — — $29,239.10 $124,675.18 $53,144.63 2025-11-01
265 MS_DRG Aicd Lead Procedures 25 16 — — $29,219.54 $124,589.10 $53,107.94 2025-11-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 25 16 — — $29,169.50 $124,368.72 $53,014.00 2025-11-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 25 16 — — $29,127.27 $124,182.78 $52,934.74 2025-11-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 25 16 — — $28,942.74 $123,370.14 $52,588.34 2025-11-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 25 16 — — $28,877.84 $123,084.33 $52,466.51 2025-11-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 25 16 — — $28,849.70 $122,960.37 $52,413.67 2025-11-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 25 16 — — $28,808.25 $122,777.87 $52,335.88 2025-11-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 25 16 — — $28,784.80 $122,674.57 $52,291.84 2025-11-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 25 16 — — $28,758.21 $122,557.49 $52,241.94 2025-11-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 25 16 — — $28,735.54 $122,457.63 $52,199.37 2025-11-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 25 16 — — $28,503.31 $121,434.94 $51,763.43 2025-11-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 25 16 — — $28,447.01 $121,187.02 $51,657.75 2025-11-01
252 MS_DRG Other Vascular Procedures With Mcc 25 16 — — $28,203.84 $120,116.12 $51,201.27 2025-11-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 25 16 — — $28,196.80 $120,085.13 $51,188.06 2025-11-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 25 16 — — $28,071.70 $119,534.19 $50,953.21 2025-11-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 25 16 — — $27,940.34 $118,955.70 $50,706.62 2025-11-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 25 16 — — $27,815.24 $118,404.75 $50,471.77 2025-11-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 16 — — $27,735.47 $118,053.53 $50,322.06 2025-11-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 25 16 — — $27,604.11 $117,475.03 $50,075.46 2025-11-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 25 16 — — $27,568.93 $117,320.08 $50,009.41 2025-11-01
264 MS_DRG Other Circulatory System O.r. Procedures 25 16 — — $27,048.96 $115,030.22 $49,033.33 2025-11-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 25 16 — — $26,757.31 $113,745.83 $48,485.84 2025-11-01
37 MS_DRG Extracranial Procedures With Mcc 25 16 — — $26,669.73 $113,360.17 $48,321.44 2025-11-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 25 16 — — $26,666.61 $113,346.40 $48,315.57 2025-11-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 25 16 — — $26,362.44 $112,006.92 $47,744.60 2025-11-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 25 16 — — $26,250.62 $111,514.51 $47,534.70 2025-11-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 25 16 — — $26,222.48 $111,390.55 $47,481.86 2025-11-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 25 16 — — $26,187.29 $111,235.59 $47,415.81 2025-11-01
652 MS_DRG Kidney Transplant 25 16 — — $26,180.26 $111,204.60 $47,402.60 2025-11-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 25 16 — — $26,161.49 $111,121.96 $47,367.37 2025-11-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 25 16 — — $26,112.22 $110,905.03 $47,274.90 2025-11-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 25 16 — — $26,030.90 $110,546.91 $47,122.25 2025-11-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 25 16 — — $25,893.29 $109,940.88 $46,863.92 2025-11-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 25 16 — — $25,847.15 $109,737.71 $46,777.32 2025-11-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 25 16 — — $25,822.93 $109,630.97 $46,731.82 2025-11-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 25 16 — — $25,772.89 $109,410.59 $46,637.88 2025-11-01
500 MS_DRG Soft Tissue Procedures With Mcc 25 16 — — $25,674.35 $108,976.72 $46,452.93 2025-11-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 25 16 — — $25,636.82 $108,811.44 $46,382.48 2025-11-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 25 16 — — $25,566.46 $108,501.53 $46,250.38 2025-11-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 25 16 — — $25,554.73 $108,449.88 $46,228.36 2025-11-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 25 16 — — $25,496.87 $108,195.07 $46,119.74 2025-11-01
665 MS_DRG Prostatectomy With Mcc 25 16 — — $25,333.45 $107,475.40 $45,812.97 2025-11-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 25 16 — — $25,282.63 $107,251.58 $45,717.57 2025-11-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 25 16 — — $25,239.62 $107,062.19 $45,636.84 2025-11-01
662 MS_DRG Minor Bladder Procedures With Mcc 25 16 — — $24,866.64 $105,419.69 $44,936.70 2025-11-01
263 MS_DRG Vein Ligation And Stripping 25 16 — — $24,834.59 $105,278.51 $44,876.52 2025-11-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 25 16 — — $24,645.37 $104,445.21 $44,521.31 2025-11-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 25 16 — — $24,546.07 $104,007.90 $44,334.90 2025-11-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 25 16 — — $24,542.94 $103,994.12 $44,329.03 2025-11-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 25 16 — — $24,517.13 $103,880.49 $44,280.59 2025-11-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 25 16 — — $24,201.24 $102,489.36 $43,687.60 2025-11-01
472 MS_DRG Cervical Spinal Fusion With Cc 25 16 — — $23,964.32 $101,446.01 $43,242.86 2025-11-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 25 16 — — $23,948.69 $101,377.14 $43,213.50 2025-11-01
570 MS_DRG Skin Debridement With Mcc 25 16 — — $23,925.23 $101,273.84 $43,169.47 2025-11-01
668 MS_DRG Transurethral Procedures With Mcc 25 16 — — $23,760.24 $100,547.28 $42,859.76 2025-11-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 25 16 — — $23,700.03 $100,282.14 $42,746.74 2025-11-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 25 16 — — $23,619.50 $99,927.47 $42,595.56 2025-11-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 25 16 — — $23,605.43 $99,865.49 $42,569.14 2025-11-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 25 16 — — $23,505.34 $99,424.73 $42,381.26 2025-11-01
974 MS_DRG HIV With Major Related Condition With Mcc 25 16 — — $23,494.39 $99,376.52 $42,360.71 2025-11-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 25 16 — — $23,461.56 $99,231.90 $42,299.06 2025-11-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 25 16 — — $23,370.85 $98,832.47 $42,128.80 2025-11-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 25 16 — — $23,216.82 $98,154.12 $41,839.64 2025-11-01
800 MS_DRG Splenic Procedures With Cc 25 16 — — $22,895.45 $96,738.88 $41,236.37 2025-11-01
654 MS_DRG Major Bladder Procedures With Cc 25 16 — — $22,816.47 $96,391.10 $41,088.13 2025-11-01
503 MS_DRG Foot Procedures With Mcc 25 16 — — $22,752.36 $96,108.74 $40,967.77 2025-11-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 25 16 — — $22,602.24 $95,447.60 $40,685.95 2025-11-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 25 16 — — $22,486.51 $94,937.98 $40,468.71 2025-11-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 25 16 — — $22,420.83 $94,648.74 $40,345.42 2025-11-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 25 16 — — $22,415.35 $94,624.63 $40,335.14 2025-11-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 25 16 — — $22,304.33 $94,135.67 $40,126.72 2025-11-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 25 16 — — $22,202.68 $93,688.03 $39,935.90 2025-11-01
849 MS_DRG Radiotherapy 25 16 — — $22,114.32 $93,298.92 $39,770.04 2025-11-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 25 16 — — $22,088.52 $93,185.29 $39,721.60 2025-11-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 25 16 — — $22,019.71 $92,882.27 $39,592.44 2025-11-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 25 16 — — $21,727.27 $91,594.44 $39,043.48 2025-11-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 25 16 — — $21,654.56 $91,274.20 $38,906.97 2025-11-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 25 16 — — $21,550.57 $90,816.23 $38,711.76 2025-11-01
253 MS_DRG Other Vascular Procedures With Cc 25 16 — — $21,223.73 $89,376.89 $38,098.22 2025-11-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 25 16 — — $21,199.48 $89,270.15 $38,052.72 2025-11-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 25 16 — — $21,123.64 $88,936.14 $37,910.34 2025-11-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 25 16 — — $21,095.49 $88,812.17 $37,857.50 2025-11-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 25 16 — — $21,095.49 $88,812.17 $37,857.50 2025-11-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 25 16 — — $21,004.80 $88,412.74 $37,687.23 2025-11-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 25 16 — — $20,890.63 $87,910.00 $37,472.93 2025-11-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 25 16 — — $20,796.03 $87,493.35 $37,295.33 2025-11-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 25 16 — — $20,758.50 $87,328.07 $37,224.88 2025-11-01
164 MS_DRG Major Chest Procedures With Cc 25 16 — — $20,663.88 $86,911.42 $37,047.27 2025-11-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 25 16 — — $20,655.27 $86,873.54 $37,031.13 2025-11-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 25 16 — — $20,412.89 $85,806.08 $36,576.11 2025-11-01
545 MS_DRG Connective Tissue Disorders With Mcc 25 16 — — $20,333.14 $85,454.86 $36,426.39 2025-11-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 25 16 — — $20,157.20 $84,680.09 $36,096.14 2025-11-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 25 16 — — $20,151.72 $84,655.99 $36,085.86 2025-11-01
792 MS_DRG Prematurity Without Major Problems 25 16 — — $5,377.00 $84,335.75 $35,949.36 2025-11-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 25 16 — — $20,039.91 $84,163.58 $35,875.97 2025-11-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 25 16 — — $20,017.23 $84,063.72 $35,833.40 2025-11-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 25 16 — — $19,867.89 $83,406.03 $35,553.05 2025-11-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 25 16 — — $19,806.12 $83,134.01 $35,437.10 2025-11-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 25 16 — — $19,735.76 $82,824.10 $35,304.99 2025-11-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 25 16 — — $19,672.42 $82,545.18 $35,186.10 2025-11-01
397 MS_DRG Appendix Procedures With Mcc 25 16 — — $19,654.44 $82,465.99 $35,152.34 2025-11-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 25 16 — — $19,620.03 $82,314.48 $35,087.76 2025-11-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 25 16 — — $19,587.97 $82,173.30 $35,027.58 2025-11-01
113 MS_DRG Orbital Procedures With Cc/mcc 25 16 — — $19,311.95 $80,957.78 $34,509.45 2025-11-01
333 MS_DRG Rectal Resection With Cc 25 16 — — $19,242.37 $80,651.31 $34,378.81 2025-11-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 25 16 — — $19,214.22 $80,527.35 $34,325.97 2025-11-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 25 16 — — $19,200.93 $80,468.81 $34,301.02 2025-11-01
709 MS_DRG Penis Procedures With Cc/mcc 25 16 — — $19,124.30 $80,131.36 $34,157.17 2025-11-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 25 16 — — $19,111.78 $80,076.27 $34,133.69 2025-11-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 25 16 — — $19,093.02 $79,993.63 $34,098.46 2025-11-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 25 16 — — $18,999.98 $79,583.86 $33,923.79 2025-11-01
0266T CPT Op Surgery 22 15 — — $616.87 $45,224.60 $35,809.00 2025-11-01
J9226 HCPCS Supprelin La Implant 21 14 — — $41,262.24 $129,427.95 $51,577.80 2025-11-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 16 14 — — $63,342.28 $180,194.95 $63,342.28 2025-11-01
Q2056 HCPCS Ciltacabtagene Car-pos T 11 9 — — $565,868.95 $1,271,682.00 $565,868.95 2025-11-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 11 9 — — $562,538.19 $1,172,582.42 $562,538.19 2025-11-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 11 9 — — $533,230.17 $1,159,555.20 $533,230.17 2025-11-01
Q2053 HCPCS Brexucabtagene Car Pos T 11 9 — — $489,304.61 $1,159,555.20 $489,304.61 2025-11-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 11 9 — — $110,139.19 $257,999.82 $110,139.19 2025-11-01
L7181 HCPCS Electronic Elbo Simultaneous 11 9 — — $48,901.12 $120,085.66 $48,901.12 2025-11-01
L7180 HCPCS Electronic Elbow Sequential 11 9 — — $42,853.91 $105,235.65 $42,853.91 2025-11-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 11 9 — — $39,482.40 $96,956.25 $39,482.40 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
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 9 9 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 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
J3394 HCPCS Inj, Lovotibeglogene Autotem 9 9 — — $3,248,445.72 $3,248,445.72 $3,248,445.72 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
J3399 HCPCS Inj Onase Abepar-xioi Treat 9 9 — — $2,455,110.61 $2,455,110.61 $2,455,110.61 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
Q2057 HCPCS Afamitresgene Autoleucel 9 9 — — $770,620.00 $770,620.00 $770,620.00 2025-11-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 9 9 — — $591,726.20 $591,726.20 $591,726.20 2025-11-01
Q2055 HCPCS Idecabtagene Vicleucel Car 9 9 — — $557,317.93 $557,317.93 $557,317.93 2025-11-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 9 9 — — $278,250.00 $278,250.00 $278,250.00 2025-11-01
J3403 HCPCS Revakinagene, Per Implant 9 9 — — $257,500.00 $257,500.00 $257,500.00 2025-11-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 9 9 — — $205,640.00 $205,640.00 $205,640.00 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
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 9 9 — — $67,452.66 $67,452.66 $67,452.66 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
E0194NU HCPCS Other Outpatient 2 1 — — $101,271.46 $111,658.27 $106,464.87 2025-11-01
K0606NUKF HCPCS Other Outpatient 2 1 — — $78,366.37 $86,403.94 $82,385.15 2025-11-01
E0766 HCPCS Elec Stim Cancer Treatment 2 1 — — $35,777.29 $39,446.76 $37,612.03 2025-11-01
E0766RRKF HCPCS Other Outpatient 2 1 — — $35,777.29 $39,446.76 $37,612.03 2025-11-01
E0764NUKF HCPCS Other Outpatient 2 1 — — $34,438.25 $37,970.38 $36,204.32 2025-11-01
E0483NU HCPCS Other Outpatient 2 1 — — $33,083.86 $36,477.07 $34,780.46 2025-11-01
90288 CPT Botulism Ig IV 1 1 — — $130,529.40 $130,529.40 $130,529.40 2025-11-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $40,491.40 $40,491.40 $40,491.40 2025-11-01
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