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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

BRISTOL HOSPITAL

Bristol, CT · CCN 070029 · Rates published

15,407 distinct procedures filed
9 distinct payers
322,786 rate rows
2025-08-20 last MRF observed
Data quality

265,547 of 322,786 rate rows are consumer-grade (82.3%)

57,239 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
professional (physician) fee — not the facility price 54,029
per-diem day rate — not a per-procedure price 1,230
template filing: same amount across many unrelated codes — excluded 939
exceeds 10× this hospital's gross charge — excluded from medians 525
placeholder amount (≤ $0.02) — excluded from medians 484
percent-of-charges filed in the dollar field — excluded from medians 30
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/7807/060646559_bristol-hospital,-inc_standardcharges.csv
Found on page https://www.bristolhealth.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-19
Content fingerprint 4e437a7dcdaa3e53… · 177,571,088 bytes · first seen 2026-05-14

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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 6 $3,710,000.00 $3,895,500.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 6 $3,685,266.67 $3,932,600.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 6 $3,322,473.30 $3,493,760.00 $3,322,473.30 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 6 $3,286,000.00 $3,450,300.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 6 $2,948,213.33 $3,095,624.00 $2,948,213.33 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,423,131.23 $4,846,262.46 $2,432,041.49 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $4,664,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $770,620.00 $1,541,240.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $541,736.85 $1,157,542.25 $578,771.12 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $537,627.68 $1,106,338.60 $553,169.30 nat. median
$674,867
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $513,771.72 $1,055,244.92 $527,622.46 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $502,284.73 $1,032,884.57 $516,442.29 nat. median
$673,137
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $476,406.40 $1,005,681.46 $502,840.73 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $476,406.40 $978,798.31 $489,399.16 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $339,689.55 $679,379.10 $343,086.45 nat. median
$370,174
0.9× median
C9301
HCPCS 		Outpatient Services 7 $278,250.00 $556,500.00 $278,250.00 nat. median
$459,112
0.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $253,822.74 $507,645.48 $256,360.96 nat. median
$265,286
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $213,828.94 $427,657.88 $215,967.23 nat. median
$206,474
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 8 $193,216.22 $386,432.44 $195,148.38 nat. median
$202,976
1.0× median
453
MS_DRG 		Ms-DRG Carveouts 1 $159,683.00 $159,683.00 $159,683.00 nat. median
$87,428
1.8× median
C9273
HCPCS 		Pharmacy: Rev Code 0636 1 $138,703.92 $138,703.92 $138,703.92 nat. median
$138,704
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $76,600.37 $213,147.00 $137,997.14 nat. median
$81,118
1.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $75,443.42 $206,022.00 $136,076.00 nat. median
$82,711
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 8 $127,527.60 $255,055.20 $128,802.88 nat. median
$133,161
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 4 $68,248.13 $251,327.03 $127,652.31 nat. median
$76,329
1.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $118,277.42 $236,554.84 $119,460.20 nat. median
$117,357
1.0× median
7
MS_DRG 		Lung Transplant 8 $117,980.54 $235,961.08 $119,160.35 nat. median
$122,708
1.0× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $64,306.69 $181,435.00 $115,731.39 nat. median
$68,090
1.7× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 8 $60,726.10 $168,855.00 $109,246.38 nat. median
$63,724
1.7× median
459
MS_DRG 		Ms-DRG Carveouts 1 $106,834.00 $106,834.00 $106,834.00 nat. median
$65,393
1.6× median
454
MS_DRG 		Ms-DRG Carveouts 1 $105,144.00 $105,144.00 $105,144.00 nat. median
$62,372
1.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $99,545.87 $199,091.74 $100,541.33 nat. median
$108,660
0.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 7 $99,999.91 $199,999.82 $99,999.91 nat. median
$111,989
0.9× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 8 $55,616.10 $148,211.00 $99,991.39 nat. median
$55,736
1.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $98,414.12 $196,828.24 $99,398.26 nat. median
$102,358
1.0× median
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $49,924.94 $141,412.00 $97,403.00 nat. median
$54,210
1.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 8 $96,214.49 $192,428.98 $97,176.64 nat. median
$100,136
1.0× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 8 $49,622.67 $132,679.00 $96,782.00 nat. median
$54,592
1.8× median
215
MS_DRG 		Other Heart Assist System Implant 8 $95,723.28 $191,446.56 $96,680.51 nat. median
$99,019
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $17,119.00 $270,136.00 $96,542.07 nat. median
$98,894
1.0× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $52,041.81 $153,155.00 $94,688.00 nat. median
$58,020
1.6× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 7 $93,216.70 $186,433.40 $93,216.70 nat. median
$96,983
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $87,233.30 $174,466.60 $88,105.64 nat. median
$93,672
0.9× median
455
MS_DRG 		Ms-DRG Carveouts 1 $87,738.00 $87,738.00 $87,738.00 nat. median
$48,483
1.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $83,282.06 $166,564.12 $84,114.88 nat. median
$83,470
1.0× median
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 8 $46,740.19 $122,317.00 $83,915.73 nat. median
$51,319
1.6× median
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 8 $46,240.89 $109,625.00 $83,011.41 nat. median
$49,191
1.7× median
471
MS_DRG 		Cervical Spinal Fusion With Mcc 8 $44,106.02 $117,668.00 $79,126.93 nat. median
$46,647
1.7× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 8 $41,718.37 $96,316.00 $78,921.00 nat. median
$44,810
1.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 8 $76,642.64 $153,285.28 $77,409.07 nat. median
$79,312
1.0× median

Other procedures at this hospital

Browse this hospital's 15,407 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
             
0266T CPT Outpatient Services 8 7 — — $10,879.00 $107,594.40 $53,797.20 2025-08-20
0268T CPT Outpatient Services 8 7 — — $10,879.00 $72,861.13 $36,430.57 2025-08-20
0408T CPT Insj/rplc Cardiac Modulj Sys 9 7 — — $10,492.00 $76,657.96 $38,328.98 2025-08-20
0409T CPT Insj/rplc Car Modulj Pls Gn 9 7 — — $10,492.00 $53,667.94 $26,833.97 2025-08-20
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 9 7 — — $10,492.00 $53,667.94 $26,833.97 2025-08-20
0515T CPT Insj Wcs Lv Compl Sys 9 7 — — $9,530.00 $53,667.94 $26,833.97 2025-08-20
0571T CPT Insj/rplcmt Icds Ss Eltrd 9 7 — — $10,492.00 $76,657.96 $38,328.98 2025-08-20
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 9 7 — — $10,492.00 $53,667.94 $26,833.97 2025-08-20
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 9 7 — — $9,530.00 $83,684.80 $41,842.40 2025-08-20
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 9 7 — — $4,409.00 $72,861.13 $36,430.57 2025-08-20
0680T CPT Insj/rplcmt Pg Only Isdss 9 7 — — $4,409.00 $51,272.68 $25,636.34 2025-08-20
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 9 7 — — $5,244.00 $51,272.68 $25,636.34 2025-08-20
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 9 7 — — $5,244.00 $51,272.68 $25,636.34 2025-08-20
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 8 7 — — $10,879.00 $76,657.96 $38,328.98 2025-08-20
0916T CPT Insj Perm Ccm-d Sys Pg Only 8 7 — — $10,879.00 $53,667.94 $26,833.97 2025-08-20
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 8 7 — — $10,879.00 $53,667.94 $26,833.97 2025-08-20
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 8 8 — — $253,822.74 $507,645.48 $256,360.96 2025-08-20
10 MS_DRG Pancreas Transplant 8 8 — — $72,136.33 $144,272.66 $72,857.70 2025-08-20
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 8 8 — — $48,951.52 $97,903.04 $49,441.04 2025-08-20
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 8 8 — — $37,326.28 $74,652.56 $37,699.54 2025-08-20
14 MS_DRG Allogeneic Bone Marrow Transplant 8 8 — — $118,277.42 $236,554.84 $119,460.20 2025-08-20
140 MS_DRG Major Head And Neck Procedures With Mcc 8 8 — — $38,455.35 $76,910.70 $38,839.90 2025-08-20
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 8 8 — — $30,112.93 $60,225.86 $30,414.06 2025-08-20
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 8 8 — — $54,709.26 $109,418.52 $55,256.35 2025-08-20
163 MS_DRG Major Chest Procedures With Mcc 8 8 — — $41,873.99 $83,747.98 $42,292.73 2025-08-20
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 8 8 — — $35,046.57 $70,093.14 $35,397.04 2025-08-20
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 8 8 — — $54,709.26 $109,418.52 $55,256.35 2025-08-20
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 8 8 — — $28,014.04 $56,028.08 $28,294.18 2025-08-20
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 8 — — $339,689.55 $679,379.10 $343,086.45 2025-08-20
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 8 — — $71,725.19 $143,450.38 $72,442.44 2025-08-20
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 8 — — $99,545.87 $199,091.74 $100,541.33 2025-08-20
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 8 — — $72,928.93 $145,857.86 $73,658.22 2025-08-20
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 8 8 — — $58,589.45 $117,178.90 $59,175.35 2025-08-20
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 8 8 — — $24,552.20 $49,104.40 $24,797.72 2025-08-20
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 8 8 — — $50,133.65 $100,267.30 $50,634.99 2025-08-20
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 8 — — $98,414.12 $196,828.24 $99,398.26 2025-08-20
215 MS_DRG Other Heart Assist System Implant 8 8 — — $95,723.28 $191,446.56 $96,680.51 2025-08-20
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 8 — — $87,233.30 $174,466.60 $88,105.64 2025-08-20
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 8 — — $58,505.77 $117,011.54 $59,090.83 2025-08-20
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 8 — — $53,930.17 $107,860.34 $54,469.47 2025-08-20
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 8 — — $70,017.66 $140,035.32 $70,717.83 2025-08-20
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 8 8 — — $32,168.60 $64,337.20 $32,490.28 2025-08-20
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 8 — — $48,059.07 $96,118.14 $48,539.66 2025-08-20
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 8 — — $41,724.65 $83,449.30 $42,141.90 2025-08-20
228 MS_DRG Other Cardiothoracic Procedures With Mcc 8 8 — — $45,239.59 $90,479.18 $45,691.99 2025-08-20
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 8 8 — — $28,353.21 $56,706.42 $28,636.74 2025-08-20
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 8 — — $51,733.24 $103,466.48 $52,250.57 2025-08-20
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 8 — — $76,642.64 $153,285.28 $77,409.07 2025-08-20
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 8 — — $55,364.21 $110,728.42 $55,917.85 2025-08-20
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 8 — — $70,727.48 $141,454.96 $71,434.76 2025-08-20
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 8 — — $48,270.49 $96,540.98 $48,753.19 2025-08-20
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 8 8 — — $53,344.50 $106,689.00 $53,877.94 2025-08-20
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 8 8 — — $37,401.85 $74,803.70 $37,775.87 2025-08-20
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 8 8 — — $45,721.77 $91,443.54 $46,178.99 2025-08-20
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 8 — — $34,609.36 $69,218.72 $34,955.46 2025-08-20
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 8 8 — — $26,607.01 $53,214.02 $26,873.08 2025-08-20
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 11 8 — — $30,923.50 $61,847.00 $32,469.68 2025-08-20
245 MS_DRG Aicd Generator Procedures 8 8 — — $44,371.42 $88,742.84 $44,815.13 2025-08-20
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 8 8 — — $40,642.37 $81,284.74 $41,048.79 2025-08-20
252 MS_DRG Other Vascular Procedures With Mcc 8 8 — — $31,268.95 $62,537.90 $31,581.64 2025-08-20
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 8 8 — — $25,647.07 $51,294.14 $25,903.54 2025-08-20
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 8 8 — — $27,924.08 $55,848.16 $28,203.32 2025-08-20
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 8 8 — — $31,051.23 $62,102.46 $31,361.74 2025-08-20
263 MS_DRG Vein Ligation And Stripping 8 8 — — $24,536.91 $49,073.82 $24,782.28 2025-08-20
264 MS_DRG Other Circulatory System O.r. Procedures 8 8 — — $31,851.03 $63,702.06 $32,169.54 2025-08-20
265 MS_DRG Aicd Lead Procedures 8 8 — — $32,499.67 $64,999.34 $32,824.67 2025-08-20
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 8 8 — — $54,303.51 $108,607.02 $54,846.54 2025-08-20
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 8 8 — — $42,733.16 $85,466.32 $43,160.49 2025-08-20
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 8 8 — — $60,392.33 $120,784.66 $60,996.26 2025-08-20
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 8 8 — — $37,839.09 $75,678.18 $38,217.48 2025-08-20
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 8 8 — — $46,586.35 $93,172.70 $47,052.21 2025-08-20
271 MS_DRG Other Major Cardiovascular Procedures With Cc 8 8 — — $31,394.91 $62,789.82 $31,708.86 2025-08-20
27131 CPT Hip Arthroplasty 3 1 — — $26,280.00 $29,200.00 $29,200.00 2025-08-20
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 8 8 — — $35,586.37 $71,172.74 $35,942.24 2025-08-20
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 8 8 — — $28,485.46 $56,970.92 $28,770.31 2025-08-20
27439 CPT Knee Arthroscopy 3 1 — — $28,113.00 $31,237.00 $31,237.00 2025-08-20
27444 CPT Knee Arthroscopy 3 1 — — $28,113.00 $31,237.00 $31,237.00 2025-08-20
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 8 — — $63,985.52 $127,971.04 $64,625.38 2025-08-20
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 8 8 — — $56,135.20 $112,270.40 $56,696.55 2025-08-20
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 8 8 — — $42,258.15 $84,516.30 $42,680.73 2025-08-20
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 8 8 — — $45,419.50 $90,839.00 $45,873.69 2025-08-20
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 8 8 — — $29,235.76 $58,471.52 $29,528.12 2025-08-20
28 MS_DRG Spinal Procedures With Mcc 8 8 — — $55,101.53 $110,203.06 $55,652.54 2025-08-20
288 MS_DRG Acute And Subacute Endocarditis With Mcc 8 8 — — $24,981.33 $49,962.66 $25,231.15 2025-08-20
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 8 8 — — $30,605.92 $61,211.84 $30,911.98 2025-08-20
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 8 8 — — $193,216.22 $386,432.44 $195,148.38 2025-08-20
31 MS_DRG Ventricular Shunt Procedures With Mcc 8 8 — — $38,108.09 $76,216.18 $38,489.17 2025-08-20
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 8 8 — — $56,063.25 $112,126.50 $56,623.88 2025-08-20
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 8 8 — — $39,927.17 $79,854.34 $40,326.44 2025-08-20
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 8 8 — — $26,018.63 $52,037.26 $26,278.82 2025-08-20
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 8 8 — — $38,727.05 $77,454.10 $39,114.32 2025-08-20
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 8 8 — — $29,152.10 $58,304.20 $29,443.62 2025-08-20
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 8 8 — — $26,156.26 $52,312.52 $26,417.82 2025-08-20
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 8 — — $46,100.55 $96,211.00 $64,916.29 2025-08-20
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 12 8 — — $22,251.80 $45,965.00 $31,463.92 2025-08-20
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 15 8 — — $14,743.34 $34,945.00 $26,452.00 2025-08-20
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 15 8 — — $41,718.37 $96,316.00 $78,921.00 2025-08-20
330 MS_DRG Major Small And Large Bowel Procedures With Cc 15 8 — — $21,672.43 $51,457.00 $38,882.00 2025-08-20
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 15 8 — — $15,260.64 $36,621.00 $27,248.00 2025-08-20
332 MS_DRG Rectal Resection With Mcc 8 8 — — $31,613.52 $63,227.04 $31,929.65 2025-08-20
33289 CPT Tcat Impl Wrls P-art Prs Snr 13 8 — — $9,479.00 $67,971.00 $33,985.50 2025-08-20
335 MS_DRG Peritoneal Adhesiolysis With Mcc 10 8 — — $33,005.28 $75,198.00 $34,160.46 2025-08-20
34 MS_DRG Carotid Artery Stent Procedures With Mcc 8 8 — — $35,392.05 $70,784.10 $35,745.97 2025-08-20
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 10 8 — — $24,648.45 $57,890.00 $25,511.14 2025-08-20
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 10 8 — — $26,794.12 $63,729.00 $27,731.92 2025-08-20
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 9 8 — — $38,783.70 $77,567.40 $39,559.37 2025-08-20
37 MS_DRG Extracranial Procedures With Mcc 8 8 — — $30,283.84 $60,567.68 $30,586.68 2025-08-20
37183 CPT Or Services - Minor Surgery 31 9 $44,943.00 $24,718.65 45% off $6,816.05 $36,403.83 $36,403.83 2025-08-20
37221 CPT Or Services - Other Or Service 31 9 $44,943.00 $24,718.65 45% off $9,479.00 $36,403.83 $36,403.83 2025-08-20
37226 CPT Or Services - Other Or Service 31 9 $44,943.00 $24,718.65 45% off $9,479.00 $36,403.83 $36,403.83 2025-08-20
37236 CPT Or Services - Other Or Service 31 9 $44,943.00 $24,718.65 45% off $9,479.00 $36,403.83 $36,403.83 2025-08-20
37238 CPT Or Services - Other Or Service 31 9 $44,943.00 $24,718.65 45% off $9,479.00 $36,403.83 $36,403.83 2025-08-20
37241 CPT Or Services - Other Or Service 31 9 $40,885.00 $22,486.75 45% off $9,479.00 $33,116.85 $33,116.85 2025-08-20
37242 CPT Or Services - Other Or Service 31 9 $37,166.00 $20,441.30 45% off $9,479.00 $42,933.80 $30,104.46 2025-08-20
37243 CPT Or Services - Minor Surgery 32 9 $40,858.00 $22,471.90 45% off $9,479.00 $33,116.85 $33,094.98 2025-08-20
37244 CPT Or Services - Other Or Service 31 9 $40,885.00 $22,486.75 45% off $9,479.00 $33,116.85 $33,116.85 2025-08-20
397 MS_DRG Appendix Procedures With Mcc 14 8 — — $22,698.93 $47,733.00 $40,619.13 2025-08-20
398 MS_DRG Appendix Procedures With Cc 14 8 — — $14,020.94 $32,311.00 $25,017.04 2025-08-20
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 8 8 — — $127,527.60 $255,055.20 $128,802.88 2025-08-20
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 8 8 — — $34,343.05 $68,686.10 $34,686.48 2025-08-20
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 15 8 — — $35,603.46 $94,230.00 $69,519.00 2025-08-20
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 8 8 — — $49,246.60 $98,493.20 $49,739.07 2025-08-20
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 8 8 — — $25,673.15 $51,346.30 $25,929.88 2025-08-20
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 8 — — $31,906.81 $63,813.62 $32,225.88 2025-08-20
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 8 8 — — $25,025.41 $50,050.82 $25,275.67 2025-08-20
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 8 8 — — $31,929.31 $63,858.62 $32,248.61 2025-08-20
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 15 8 — — $21,787.59 $50,488.00 $38,722.69 2025-08-20
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 15 8 — — $15,327.22 $34,817.00 $27,021.97 2025-08-20
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 8 8 — — $32,160.51 $64,321.02 $32,482.11 2025-08-20
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 8 8 — — $36,999.71 $73,999.42 $37,369.71 2025-08-20
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 8 — — $17,119.00 $270,136.00 $96,542.07 2025-08-20
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 8 — — $64,306.69 $181,435.00 $115,731.39 2025-08-20
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 8 — — $49,924.94 $141,412.00 $97,403.00 2025-08-20
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 8 — — $75,443.42 $206,022.00 $136,076.00 2025-08-20
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 15 8 — — $49,622.67 $132,679.00 $96,782.00 2025-08-20
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 15 8 — — $60,726.10 $168,855.00 $109,246.38 2025-08-20
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 15 8 — — $37,144.57 $103,748.00 $66,536.55 2025-08-20
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 15 8 — — $46,740.19 $122,317.00 $83,915.73 2025-08-20
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 15 8 — — $28,170.57 $73,888.00 $50,283.28 2025-08-20
453 MS_DRG Ms-DRG Carveouts 1 1 — — $159,683.00 $159,683.00 $159,683.00 2025-08-20
454 MS_DRG Ms-DRG Carveouts 1 1 — — $105,144.00 $105,144.00 $105,144.00 2025-08-20
455 MS_DRG Ms-DRG Carveouts 1 1 — — $87,738.00 $87,738.00 $87,738.00 2025-08-20
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 8 — — $76,600.37 $213,147.00 $137,997.14 2025-08-20
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 8 — — $52,041.81 $153,155.00 $94,688.00 2025-08-20
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 8 — — $39,254.22 $110,649.00 $75,783.00 2025-08-20
459 MS_DRG Ms-DRG Carveouts 1 1 — — $106,834.00 $106,834.00 $106,834.00 2025-08-20
460 MS_DRG Inpatient Ms-DRG Surgical 1 1 — — $68,004.00 $68,004.00 $68,004.00 2025-08-20
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 15 8 — — $55,616.10 $148,211.00 $99,991.39 2025-08-20
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 15 8 — — $26,171.56 $69,311.00 $47,144.00 2025-08-20
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 8 — — $48,997.40 $97,994.80 $49,487.38 2025-08-20
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 8 — — $26,934.46 $53,868.92 $27,203.81 2025-08-20
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 15 8 — — $46,240.89 $109,625.00 $83,011.41 2025-08-20
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 15 8 — — $31,222.18 $74,477.00 $57,121.00 2025-08-20
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 15 8 — — $24,007.91 $56,874.00 $44,086.00 2025-08-20
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 15 8 — — $29,814.22 $71,331.00 $53,260.20 2025-08-20
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 15 8 — — $17,370.30 $43,232.00 $30,722.34 2025-08-20
471 MS_DRG Cervical Spinal Fusion With Mcc 14 8 — — $44,106.02 $117,668.00 $79,126.93 2025-08-20
472 MS_DRG Cervical Spinal Fusion With Cc 15 8 — — $26,472.05 $72,044.00 $48,474.00 2025-08-20
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 15 8 — — $21,705.71 $59,685.00 $39,657.00 2025-08-20
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 8 8 — — $40,753.94 $81,507.88 $41,161.48 2025-08-20
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 8 8 — — $31,346.33 $62,692.66 $31,659.79 2025-08-20
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 15 8 — — $26,866.09 $63,012.00 $47,920.65 2025-08-20
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 15 8 — — $19,074.25 $45,243.00 $33,808.42 2025-08-20
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 15 8 — — $14,679.47 $34,194.00 $26,271.00 2025-08-20
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 15 8 — — $23,332.28 $53,632.00 $39,948.00 2025-08-20
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 8 8 — — $29,369.82 $58,739.64 $29,663.52 2025-08-20
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 14 8 — — $32,355.73 $74,448.00 $55,717.00 2025-08-20
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 14 8 — — $22,008.00 $52,443.00 $37,028.00 2025-08-20
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 14 8 — — $17,369.41 $40,897.00 $27,541.50 2025-08-20
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 8 8 — — $32,080.44 $64,160.88 $32,401.24 2025-08-20
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 8 8 — — $96,214.49 $192,428.98 $97,176.64 2025-08-20
500 MS_DRG Soft Tissue Procedures With Mcc 8 8 — — $28,914.59 $57,829.18 $29,203.74 2025-08-20
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 8 8 — — $26,120.29 $52,240.58 $26,381.50 2025-08-20
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 8 8 — — $28,228.16 $56,456.32 $28,510.44 2025-08-20
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 15 8 — — $32,650.81 $78,876.00 $58,397.70 2025-08-20
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 15 8 — — $18,147.61 $42,989.00 $31,775.00 2025-08-20
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 14 8 — — $26,629.49 $63,067.00 $47,580.06 2025-08-20
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 14 8 — — $19,372.93 $45,260.00 $34,414.19 2025-08-20
570 MS_DRG Skin Debridement With Mcc 8 8 — — $27,488.65 $54,977.30 $27,763.53 2025-08-20
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 8 8 — — $55,809.54 $111,619.08 $56,367.64 2025-08-20
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 8 8 — — $31,579.35 $63,158.70 $31,895.14 2025-08-20
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 8 8 — — $48,946.13 $97,892.26 $49,435.59 2025-08-20
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 14 8 — — $29,730.58 $73,107.00 $50,690.50 2025-08-20
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 15 8 — — $16,358.21 $39,748.00 $28,889.26 2025-08-20
58150 CPT Total Hysterectomy 6 4 — — $12,810.00 $26,899.00 $26,433.00 2025-08-20
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 15 8 — — $16,162.09 $37,599.00 $29,406.00 2025-08-20
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 15 8 — — $15,185.97 $33,561.00 $25,909.00 2025-08-20
6 MS_DRG Liver Transplant Without Mcc 8 8 — — $44,033.16 $88,066.32 $44,473.49 2025-08-20
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 8 8 — — $24,728.52 $49,457.04 $24,975.81 2025-08-20
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 8 8 — — $35,178.82 $70,357.64 $35,530.61 2025-08-20
61626 CPT Or Services - Minor Surgery 31 9 $37,168.00 $20,442.40 45% off $9,479.00 $30,106.08 $30,106.08 2025-08-20
61885 CPT Insrt/redo Neurostim 1 Array 15 8 — — $7,011.00 $55,654.00 $25,636.34 2025-08-20
61886 CPT Implant Neurostim Arrays 15 8 — — $10,879.00 $72,861.13 $36,430.57 2025-08-20
619 MS_DRG O.r. Procedures For Obesity With Mcc 15 8 — — $24,936.34 $64,254.00 $45,681.00 2025-08-20
620 MS_DRG O.r. Procedures For Obesity With Cc 15 8 — — $14,774.83 $34,269.00 $26,887.00 2025-08-20
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 15 8 — — $13,558.51 $29,284.00 $24,852.00 2025-08-20
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 8 8 — — $34,072.25 $68,144.50 $34,412.97 2025-08-20
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 8 8 — — $26,201.25 $52,402.50 $26,463.26 2025-08-20
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 8 8 — — $35,904.85 $71,809.70 $36,263.90 2025-08-20
63655 CPT Implant Neuroelectrodes 15 8 — — $10,336.00 $55,654.00 $25,636.34 2025-08-20
63685 CPT Or Services 31 9 $60,320.00 $33,176.00 45% off $11,280.00 $72,861.13 $48,859.20 2025-08-20
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 15 8 — — $10,879.00 $55,654.00 $25,636.34 2025-08-20
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 8 8 — — $41,856.91 $83,713.82 $42,275.48 2025-08-20
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 8 8 — — $31,647.72 $63,295.44 $31,964.19 2025-08-20
652 MS_DRG Kidney Transplant 8 8 — — $28,039.22 $56,078.44 $28,319.61 2025-08-20
653 MS_DRG Major Bladder Procedures With Mcc 8 8 — — $50,559.19 $101,118.38 $51,064.78 2025-08-20
654 MS_DRG Major Bladder Procedures With Cc 8 8 — — $25,796.41 $51,592.82 $26,054.38 2025-08-20
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 8 8 — — $29,717.97 $59,435.94 $30,015.15 2025-08-20
662 MS_DRG Minor Bladder Procedures With Mcc 8 8 — — $28,472.86 $56,945.72 $28,757.59 2025-08-20
665 MS_DRG Prostatectomy With Mcc 8 8 — — $31,297.75 $62,595.50 $31,610.73 2025-08-20
668 MS_DRG Transurethral Procedures With Mcc 8 8 — — $26,643.87 $53,287.74 $26,910.31 2025-08-20
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 8 8 — — $38,099.09 $76,198.18 $38,480.08 2025-08-20
7 MS_DRG Lung Transplant 8 8 — — $117,980.54 $235,961.08 $119,160.35 2025-08-20
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 8 8 — — $35,831.98 $71,663.96 $36,190.30 2025-08-20
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 8 8 — — $36,221.51 $72,443.02 $36,583.73 2025-08-20
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 15 8 — — $16,841.33 $39,026.00 $28,702.00 2025-08-20
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 8 8 — — $4,306.00 $107,779.38 $53,889.69 2025-08-20
791 MS_DRG Prematurity With Major Problems 8 8 — — $4,306.00 $73,864.48 $36,932.24 2025-08-20
793 MS_DRG Full Term Neonate With Major Problems 8 8 — — $1,920.00 $75,854.48 $37,927.24 2025-08-20
799 MS_DRG Splenic Procedures With Mcc 8 8 — — $43,183.88 $86,367.76 $43,615.72 2025-08-20
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 8 8 — — $49,358.17 $98,716.34 $49,851.75 2025-08-20
800 MS_DRG Splenic Procedures With Cc 8 8 — — $26,621.38 $53,242.76 $26,887.60 2025-08-20
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 8 8 — — $32,658.03 $65,316.06 $32,984.61 2025-08-20
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 8 8 — — $52,787.63 $105,575.26 $53,315.50 2025-08-20
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 8 8 — — $42,506.46 $85,012.92 $42,931.52 2025-08-20
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 8 8 — — $43,370.11 $86,740.22 $43,803.81 2025-08-20
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 8 8 — — $28,150.79 $56,301.58 $28,432.30 2025-08-20
834 MS_DRG Acute Leukemia With Mcc 8 8 — — $50,133.65 $100,267.30 $50,634.99 2025-08-20
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 8 8 — — $45,454.59 $90,909.18 $45,909.13 2025-08-20
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 8 8 — — $29,097.21 $58,194.42 $29,388.18 2025-08-20
850 MS_DRG Acute Leukemia With Other Procedures 8 8 — — $83,282.06 $166,564.12 $84,114.88 2025-08-20
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 8 8 — — $45,401.52 $90,803.04 $45,855.54 2025-08-20
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 8 8 — — $40,995.95 $81,991.90 $41,405.91 2025-08-20
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 11 8 — — $62,991.42 $125,982.84 $66,140.99 2025-08-20
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 8 8 — — $35,760.01 $71,520.02 $36,117.61 2025-08-20
901 MS_DRG Wound Debridements For Injuries With Mcc 8 8 — — $40,266.33 $80,532.66 $40,669.00 2025-08-20
90288 CPT Botulism Ig IV 4 3 — — $372.86 $131,620.39 $50,424.61 2025-08-20
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 8 8 — — $35,143.75 $70,287.50 $35,495.19 2025-08-20
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 8 8 — — $36,246.71 $72,493.42 $36,609.18 2025-08-20
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 8 — — $213,828.94 $427,657.88 $215,967.23 2025-08-20
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 8 8 — — $60,494.00 $120,988.00 $61,098.94 2025-08-20
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 8 8 — — $29,019.85 $58,039.70 $29,310.05 2025-08-20
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 8 8 — — $39,334.29 $78,668.58 $39,727.64 2025-08-20
93653 CPT Compre Ep Eval Tx Svt 9 7 — — $10,492.00 $58,655.75 $29,327.87 2025-08-20
93654 CPT Compre Ep Eval Tx Vt 9 7 — — $10,492.00 $58,655.75 $29,327.87 2025-08-20
93656 CPT Compre Ep Eval Abltj Atr Fib 9 7 — — $10,492.00 $58,655.75 $29,327.87 2025-08-20
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 8 8 — — $28,962.27 $57,924.54 $29,251.90 2025-08-20
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 8 8 — — $33,232.89 $66,465.78 $33,565.22 2025-08-20
955 MS_DRG Craniotomy For Multiple Significant Trauma 8 8 — — $61,838.06 $123,676.12 $62,456.44 2025-08-20
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 8 8 — — $34,795.58 $69,591.16 $35,143.54 2025-08-20
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 8 — — $67,558.92 $135,117.84 $68,234.51 2025-08-20
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 8 8 — — $37,381.17 $74,762.34 $37,754.98 2025-08-20
963 MS_DRG Other Multiple Significant Trauma With Mcc 8 8 — — $24,848.18 $49,696.36 $25,096.66 2025-08-20
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 8 8 — — $57,303.84 $114,607.68 $57,876.88 2025-08-20
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 8 8 — — $32,656.21 $65,312.42 $32,982.77 2025-08-20
974 MS_DRG HIV With Major Related Condition With Mcc 8 8 — — $27,272.73 $54,545.46 $27,545.46 2025-08-20
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 8 8 — — $43,175.80 $86,351.60 $43,607.56 2025-08-20
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 8 8 — — $31,919.41 $63,838.82 $32,238.60 2025-08-20
A9543 HCPCS Y90 Ibritumomab, Rx 15 8 — — $56,824.55 $200,313.86 $69,491.66 2025-08-20
A9545 HCPCS Lab/Rad/Drugs 2 1 — — $63,120.47 $63,120.47 $63,120.47 2025-08-20
C1767 HCPCS Med/surg - Other Implant 21 9 $58,112.66 $31,961.97 45% off $14,295.71 $47,071.25 $35,448.72 2025-08-20
C1816 HCPCS Med/surg - Other Implant 21 9 $45,990.15 $25,294.59 45% off $11,313.58 $37,252.02 $28,053.99 2025-08-20
C9150 HCPCS Rad/Therapy/Drugs 6 3 — — $941.20 $168,629.76 $61,750.00 2025-08-20
C9273 HCPCS Pharmacy: Rev Code 0636 2 1 — — $138,703.92 $138,703.92 $138,703.92 2025-08-20
C9301 HCPCS Outpatient Services 7 7 — — $278,250.00 $556,500.00 $278,250.00 2025-08-20
C9760 HCPCS Non-blind Interatrial Shunt 10 7 — — $10,879.00 $65,752.60 $32,876.30 2025-08-20
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 6 — — $3,685,266.67 $3,932,600.00 $3,685,266.67 2025-08-20
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 6 — — $3,322,473.30 $3,493,760.00 $3,322,473.30 2025-08-20
J1414 HCPCS Inj, Beqvez, Per Tx Dose 6 6 — — $3,710,000.00 $3,895,500.00 $3,710,000.00 2025-08-20
J2507 HCPCS Pegloticase 1 Mg(cq8) Sdvial 30 9 $113,240.27 $62,282.15 45% off $3,565.32 $91,724.62 $34,538.28 2025-08-20
J3392 HCPCS Inj, Exagamglogene Autotem 7 7 — — $2,332,000.00 $4,664,000.00 $2,332,000.00 2025-08-20
J3393 HCPCS Inj, Betibeglogene Autotemce 6 6 — — $2,948,213.33 $3,095,624.00 $2,948,213.33 2025-08-20
J3394 HCPCS Inj, Lovotibeglogene Autotem 6 6 — — $3,286,000.00 $3,450,300.00 $3,286,000.00 2025-08-20
J3399 HCPCS Inj Onase Abepar-xioi Treat 8 7 — — $2,423,131.23 $4,846,262.46 $2,432,041.49 2025-08-20
J7310 HCPCS Rad/Therapy/Drugs 4 3 — — $34,987.77 $71,589.12 $61,737.60 2025-08-20
J7330 HCPCS Cultured Chondrocytes Implnt 7 4 — — $68,248.13 $251,327.03 $127,652.31 2025-08-20
J9029 HCPCS Instill Adstiladrin, Tx Dose 15 8 — — $63,235.61 $251,680.50 $71,436.75 2025-08-20
J9226 HCPCS Supprelin La Implant 15 8 — — $45,212.04 $212,051.29 $49,678.03 2025-08-20
J9266 HCPCS Pegaspargase Injection 15 8 — — $27,070.53 $108,825.00 $30,391.72 2025-08-20
J9359 HCPCS Loncas Tes-lpyl 0.075mg(cq133) 30 9 $97,713.54 $53,742.45 45% off $212.00 $79,147.97 $29,802.63 2025-08-20
J9600 HCPCS Porfimer Sodium Injection 15 8 — — $24,197.85 $98,323.18 $25,851.38 2025-08-20
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 7 7 — — $93,216.70 $186,433.40 $93,216.70 2025-08-20
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 7 7 — — $39,823.40 $79,646.80 $39,823.40 2025-08-20
L5856 HCPCS Elec Knee-shin Swing/stance 7 7 — — $28,607.84 $57,215.68 $28,607.84 2025-08-20
L6700 HCPCS Ue Add Ext Power Myoel 7 7 — — $28,931.56 $57,863.12 $28,931.56 2025-08-20
L6880 HCPCS Elec Hand Ind Art Digits 7 7 — — $28,151.96 $56,303.92 $28,151.96 2025-08-20
L7180 HCPCS Electronic Elbow Sequential 7 7 — — $45,177.95 $90,355.90 $45,177.95 2025-08-20
L7181 HCPCS Electronic Elbo Simultaneous 7 7 — — $47,211.27 $94,422.54 $47,211.27 2025-08-20
L8701 HCPCS Ewh S/d Uprt Micro Sensor 7 7 — — $34,284.44 $68,568.88 $34,284.44 2025-08-20
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 7 7 — — $67,452.66 $134,905.32 $67,452.66 2025-08-20
Q0480 HCPCS Driver Pneumatic Vad, Rep 7 7 — — $99,999.91 $199,999.82 $99,999.91 2025-08-20
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 7 — — $476,406.40 $1,005,681.46 $502,840.73 2025-08-20
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 7 — — $541,736.85 $1,157,542.25 $578,771.12 2025-08-20
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 8 — — $56,632.26 $280,103.69 $62,451.88 2025-08-20
Q2053 HCPCS Brexucabtagene Car Pos T 8 7 — — $476,406.40 $978,798.31 $489,399.16 2025-08-20
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 7 — — $502,284.73 $1,032,884.57 $516,442.29 2025-08-20
Q2055 HCPCS Idecabtagene Vicleucel Car 8 7 — — $513,771.72 $1,055,244.92 $527,622.46 2025-08-20
Q2056 HCPCS Ciltacabtagene Car-pos T 8 7 — — $537,627.68 $1,106,338.60 $553,169.30 2025-08-20
Q2057 HCPCS Afamitresgene Autoleucel 7 7 — — $770,620.00 $1,541,240.00 $770,620.00 2025-08-20
Q4244 HCPCS Pharmacy: Rev Code 0636 3 2 — — $28,321.85 $44,295.77 $44,295.77 2025-08-20
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