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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

LAKESIDE MEDICAL CENTER

Belle Glade, FL · CCN 100130 · Rates published

52,316 distinct procedures filed
20 distinct payers
784,514 rate rows
2025-12-02 last MRF observed
Data quality

529,847 of 784,514 rate rows are consumer-grade (67.5%)

254,667 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 249,027
placeholder amount (≤ $0.02) — excluded from medians 4,893
exceeds 10× this hospital's gross charge — excluded from medians 456
percent-of-charges filed in the dollar field — excluded from medians 245
per-diem day rate — not a per-procedure price 46
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hcdpbc.pt.panaceainc.com/MRFDownload/hcdpbc/hcdpbc
Found on page https://www.hcdpbc.org/for-patients/hospital/billing---financial-assistance/billing-information
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint c0edfb20f38cf08a… · 260,443,247 bytes · first seen 2026-05-08

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 16 $4,158,625.00 $4,815,250.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 16 $3,524,500.00 $4,081,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 16 $3,501,003.34 $4,053,793.34 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 16 $3,158,343.31 $3,657,029.09 $3,324,571.90 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 16 $3,098,287.25 $3,587,490.50 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 16 $2,803,152.34 $3,245,755.34 $2,950,686.67 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 16 $2,329,509.82 $2,697,327.16 $2,452,115.60 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 16 $2,215,400.00 $2,565,200.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 16 $732,089.00 $847,682.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 16 $529,810.07 $636,157.04 $578,324.58 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 16 $525,709.89 $608,716.71 $553,378.83 nat. median
$674,867
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 16 $514,553.88 $595,799.23 $541,635.66 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 16 $514,197.43 $595,386.50 $541,260.45 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 16 $474,456.00 $586,384.13 $533,076.48 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 16 $465,234.00 $538,692.00 $489,720.00 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 $159,652.61 $438,942.92 $399,039.02 nat. median
$370,174
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 17 $119,247.12 $330,967.59 $300,879.63 nat. median
$265,286
1.1× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 16 $256,856.25 $297,412.50 $270,375.00 nat. median
$324,450
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 17 $100,427.63 $280,676.41 $255,160.37 nat. median
$206,474
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 17 $90,728.11 $254,756.45 $231,596.77 nat. median
$202,976
1.1× median
5834
APR_DRG 		10 $208,261.09 $218,674.14 $208,261.09 nat. median
$309,665
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 17 $59,817.66 $172,154.68 $156,504.25 nat. median
$133,161
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 17 $55,464.90 $160,522.82 $145,929.84 nat. median
$117,357
1.2× median
7
MS_DRG 		Lung Transplant 17 $55,325.20 $160,149.50 $145,590.45 nat. median
$122,708
1.2× median
5884
APR_DRG 		10 $127,555.93 $133,933.73 $127,555.93 nat. median
$246,434
0.5× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 17 $46,650.58 $136,968.37 $124,516.70 nat. median
$108,660
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 17 $46,118.02 $135,545.22 $123,222.93 nat. median
$102,358
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 17 $45,082.96 $132,779.23 $120,708.39 nat. median
$100,136
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 17 $44,851.81 $132,161.55 $120,146.86 nat. median
$99,019
1.2× median
0114
APR_DRG 		10 $119,243.35 $125,205.52 $119,243.35 nat. median
$197,700
0.6× median
0024
APR_DRG 		10 $119,164.66 $125,122.89 $119,164.66 nat. median
$372,987
outlier · 0.3×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 $112,972.96 $130,810.80 $118,918.91 nat. median
$98,894
1.2× median
5833
APR_DRG 		10 $118,611.61 $124,542.19 $118,611.61 nat. median
$244,017
outlier · 0.5×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 $40,856.77 $121,485.63 $110,441.48 nat. median
$93,672
1.2× median
850
MS_DRG 		Acute Leukemia With Other Procedures 17 $100,628.35 $116,517.04 $105,924.58 nat. median
$83,470
1.3× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 17 $35,873.24 $108,168.17 $98,334.70 nat. median
$79,312
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 $35,853.34 $108,115.00 $98,286.36 nat. median
$81,118
1.2× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 17 $92,115.60 $106,660.17 $96,963.79 nat. median
$82,711
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 17 $34,125.70 $103,498.23 $94,089.30 nat. median
$77,570
1.2× median
10
MS_DRG 		Pancreas Transplant 17 $33,752.74 $102,501.56 $93,183.24 nat. median
$68,884
1.4× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 17 $33,559.27 $101,984.58 $92,713.25 nat. median
$71,271
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 17 $33,089.79 $100,729.98 $91,572.71 nat. median
$73,807
1.2× median
5832
APR_DRG 		10 $91,071.80 $95,625.39 $91,071.80 nat. median
$156,126
0.6× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 $32,755.78 $99,837.40 $90,761.27 nat. median
$74,915
1.2× median
1614
APR_DRG 		10 $88,926.10 $93,372.41 $88,926.10 nat. median
$207,730
outlier · 0.4×
6094
APR_DRG 		10 $88,871.47 $93,315.04 $88,871.47 nat. median
$162,982
0.5× median
0113
APR_DRG 		10 $88,742.47 $93,179.59 $88,742.47 nat. median
$128,705
0.7× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 17 $31,598.79 $96,745.59 $87,950.54 nat. median
$72,135
1.2× median
0094
APR_DRG 		10 $87,176.40 $91,535.22 $87,176.40 nat. median
$166,008
0.5× median
Q048000
HCPCS 		Driver Pneumatic Vad, Rep 1 $86,664.80 $86,664.80 $86,664.80 —

Other procedures at this hospital

Browse this hospital's 52,316 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
             
0014 APR_DRG — 15 10 — — $66,329.56 $69,646.04 $66,329.56 2025-12-02
0021 APR_DRG — 15 10 — — $43,443.38 $45,615.55 $43,443.38 2025-12-02
0022 APR_DRG — 15 10 — — $49,153.15 $51,610.81 $49,153.15 2025-12-02
0023 APR_DRG — 15 10 — — $64,911.19 $68,156.75 $64,911.19 2025-12-02
0024 APR_DRG — 15 10 — — $119,164.66 $125,122.89 $119,164.66 2025-12-02
0043 APR_DRG — 15 10 — — $46,198.90 $48,508.85 $46,198.90 2025-12-02
0044 APR_DRG — 15 10 — — $66,996.16 $70,345.97 $66,996.16 2025-12-02
0054 APR_DRG — 15 10 — — $46,671.81 $49,005.40 $46,671.81 2025-12-02
0064 APR_DRG — 15 10 — — $43,326.23 $45,492.54 $43,326.23 2025-12-02
0073 APR_DRG — 15 10 — — $44,622.06 $46,853.16 $44,622.06 2025-12-02
0074 APR_DRG — 15 10 — — $70,159.55 $73,667.53 $70,159.55 2025-12-02
0093 APR_DRG — 15 10 — — $58,587.99 $61,517.39 $58,587.99 2025-12-02
0094 APR_DRG — 15 10 — — $87,176.40 $91,535.22 $87,176.40 2025-12-02
0112 APR_DRG — 15 10 — — $70,549.09 $74,076.54 $70,549.09 2025-12-02
0113 APR_DRG — 15 10 — — $88,742.47 $93,179.59 $88,742.47 2025-12-02
0114 APR_DRG — 15 10 — — $119,243.35 $125,205.52 $119,243.35 2025-12-02
0266T HCPCS Implt/rpl Crtd Sns Dev Total 19 16 — $45,170.60 $21,682.20 $49,687.66 $45,170.60 2025-12-02
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 24 17 — — $119,247.12 $330,967.59 $300,879.63 2025-12-02
10 MS_DRG Pancreas Transplant 24 17 — — $33,752.74 $102,501.56 $93,183.24 2025-12-02
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 24 17 — — $22,842.90 $73,347.27 $66,679.34 2025-12-02
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 24 17 — — $17,372.52 $58,728.82 $53,389.84 2025-12-02
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 24 17 — — $11,218.46 $42,283.36 $38,439.42 2025-12-02
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 24 17 — — $10,207.10 $39,580.73 $35,982.48 2025-12-02
14 MS_DRG Allogeneic Bone Marrow Transplant 24 17 — — $55,464.90 $160,522.82 $145,929.84 2025-12-02
140 MS_DRG Major Head And Neck Procedures With Mcc 24 17 — — $17,903.81 $60,148.58 $54,680.53 2025-12-02
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 24 17 — — $13,978.20 $49,658.20 $45,143.82 2025-12-02
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 24 17 — — $25,552.26 $80,587.49 $73,261.35 2025-12-02
1604 APR_DRG — 15 10 — — $51,048.39 $53,600.81 $51,048.39 2025-12-02
1611 APR_DRG — 15 10 — — $51,234.89 $53,796.63 $51,234.89 2025-12-02
1612 APR_DRG — 15 10 — — $51,234.89 $53,796.63 $51,234.89 2025-12-02
1613 APR_DRG — 15 10 — — $69,631.30 $73,112.87 $69,631.30 2025-12-02
1614 APR_DRG — 15 10 — — $88,926.10 $93,372.41 $88,926.10 2025-12-02
163 MS_DRG Major Chest Procedures With Mcc 24 17 — — $19,512.50 $64,447.46 $58,588.60 2025-12-02
164 MS_DRG Major Chest Procedures With Cc 24 17 — — $10,655.42 $40,778.76 $37,071.60 2025-12-02
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 24 17 — — $16,299.78 $55,862.16 $50,783.78 2025-12-02
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 24 17 — — $25,552.26 $80,587.49 $73,261.35 2025-12-02
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 24 17 — — $12,990.55 $47,018.92 $42,744.47 2025-12-02
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 17 — — $159,652.61 $438,942.92 $399,039.02 2025-12-02
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 24 17 — — $33,559.27 $101,984.58 $92,713.25 2025-12-02
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 17 — — $46,650.58 $136,968.37 $124,516.70 2025-12-02
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 17 — — $34,125.70 $103,498.23 $94,089.30 2025-12-02
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 24 17 — — $27,378.12 $85,466.71 $77,697.01 2025-12-02
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 24 17 — — $11,361.55 $42,665.73 $38,787.03 2025-12-02
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 24 17 — — $23,399.16 $74,833.77 $68,030.70 2025-12-02
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 24 17 — — $46,118.02 $135,545.22 $123,222.93 2025-12-02
215 MS_DRG Other Heart Assist System Implant 24 17 — — $44,851.81 $132,161.55 $120,146.86 2025-12-02
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 17 — — $40,856.77 $121,485.63 $110,441.48 2025-12-02
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 17 — — $27,338.74 $85,361.50 $77,601.36 2025-12-02
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 17 — — $25,185.65 $79,607.79 $72,370.72 2025-12-02
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 17 — — $32,755.78 $99,837.40 $90,761.27 2025-12-02
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 24 17 — — $14,945.52 $52,243.18 $47,493.80 2025-12-02
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 17 — — $22,422.94 $72,225.03 $65,659.12 2025-12-02
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 17 — — $19,442.22 $64,259.67 $58,417.88 2025-12-02
228 MS_DRG Other Cardiothoracic Procedures With Mcc 24 17 — — $21,096.20 $68,679.60 $62,436.00 2025-12-02
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 24 17 — — $13,150.15 $47,445.41 $43,132.19 2025-12-02
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 17 — — $24,151.86 $76,845.20 $69,859.27 2025-12-02
231 MS_DRG Coronary Bypass With Ptca With Mcc 24 17 — — $35,873.24 $108,168.17 $98,334.70 2025-12-02
232 MS_DRG Coronary Bypass With Ptca Without Mcc 24 17 — — $25,860.45 $81,411.06 $74,010.05 2025-12-02
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 17 — — $33,089.79 $100,729.98 $91,572.71 2025-12-02
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 24 17 — — $22,522.43 $72,490.89 $65,900.81 2025-12-02
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 24 17 — — $24,910.05 $78,871.32 $71,701.20 2025-12-02
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 24 17 — — $17,408.08 $58,823.85 $53,476.23 2025-12-02
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 24 17 — — $21,323.11 $69,285.96 $62,987.24 2025-12-02
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 17 — — $16,094.04 $55,312.36 $50,283.96 2025-12-02
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 24 17 — — $12,328.45 $45,249.59 $41,135.99 2025-12-02
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 24 17 — — $14,359.62 $50,677.48 $46,070.44 2025-12-02
245 MS_DRG Aicd Generator Procedures 24 17 — — $20,687.68 $67,587.91 $61,443.55 2025-12-02
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 24 17 — — $18,932.95 $62,898.74 $57,180.67 2025-12-02
252 MS_DRG Other Vascular Procedures With Mcc 24 17 — — $14,522.19 $51,111.90 $46,465.36 2025-12-02
253 MS_DRG Other Vascular Procedures With Cc 24 17 — — $10,807.82 $41,186.02 $37,441.84 2025-12-02
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 24 17 — — $11,076.64 $41,904.39 $38,094.90 2025-12-02
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 24 17 — — $11,876.75 $44,042.52 $40,038.65 2025-12-02
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 24 17 — — $12,948.22 $46,905.79 $42,641.63 2025-12-02
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 24 17 — — $14,419.74 $50,838.13 $46,216.48 2025-12-02
263 MS_DRG Vein Ligation And Stripping 24 17 — — $11,354.35 $42,646.51 $38,769.55 2025-12-02
264 MS_DRG Other Circulatory System O.r. Procedures 24 17 — — $14,796.09 $51,843.84 $47,130.76 2025-12-02
265 MS_DRG Aicd Lead Procedures 24 17 — — $15,101.31 $52,659.50 $47,872.27 2025-12-02
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 24 17 — — $25,361.33 $80,077.27 $72,797.52 2025-12-02
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 24 17 — — $19,916.78 $65,527.84 $59,570.76 2025-12-02
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 24 17 — — $28,226.48 $87,733.80 $79,758.00 2025-12-02
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 24 17 — — $17,613.82 $59,373.66 $53,976.05 2025-12-02
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 24 17 — — $10,447.14 $40,222.17 $36,565.61 2025-12-02
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 24 17 — — $21,729.94 $70,373.13 $63,975.57 2025-12-02
271 MS_DRG Other Major Cardiovascular Procedures With Cc 24 17 — — $14,581.45 $51,270.27 $46,609.34 2025-12-02
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 24 17 — — $10,592.76 $40,611.33 $36,919.39 2025-12-02
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 24 17 — — $16,553.79 $56,540.92 $51,400.84 2025-12-02
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 24 17 — — $13,212.38 $47,611.71 $43,283.37 2025-12-02
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 24 17 — — $29,917.30 $92,252.14 $83,865.58 2025-12-02
276 MS_DRG Cardiac Defibrillator Implant With Mcc 24 17 — — $26,223.25 $82,380.56 $74,891.42 2025-12-02
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 24 17 — — $19,693.26 $64,930.53 $59,027.75 2025-12-02
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 17 — — $21,180.87 $68,905.85 $62,641.68 2025-12-02
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 17 — — $13,565.44 $48,555.20 $44,141.09 2025-12-02
28 MS_DRG Spinal Procedures With Mcc 24 17 — — $25,736.83 $81,080.73 $73,709.75 2025-12-02
288 MS_DRG Acute And Subacute Endocarditis With Mcc 24 17 — — $11,563.48 $43,205.36 $39,277.60 2025-12-02
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 24 17 — — $14,210.19 $50,278.14 $45,707.40 2025-12-02
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 17 — — $90,728.11 $254,756.45 $231,596.77 2025-12-02
31 MS_DRG Ventricular Shunt Procedures With Mcc 24 17 — — $17,740.40 $59,711.92 $54,283.56 2025-12-02
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 19 17 — — $71,068.69 $82,290.07 $74,809.15 2025-12-02
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 24 17 — — $18,596.39 $61,999.37 $56,363.06 2025-12-02
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 24 17 — — $12,051.59 $44,509.73 $40,463.39 2025-12-02
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 24 17 — — $18,031.66 $60,490.23 $54,991.12 2025-12-02
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 24 17 — — $13,526.07 $48,449.98 $44,045.44 2025-12-02
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 24 17 — — $12,116.36 $44,682.81 $40,620.74 2025-12-02
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 17 — — $21,501.34 $69,762.23 $63,420.21 2025-12-02
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 24 17 — — $10,279.07 $39,773.05 $36,157.32 2025-12-02
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 24 17 — — $19,439.26 $64,251.75 $58,410.68 2025-12-02
332 MS_DRG Rectal Resection With Mcc 24 17 — — $14,684.33 $51,545.18 $46,859.25 2025-12-02
33276 HCPCS Insj Phrnc Nrv Stim Sys 18 16 — $45,170.60 $42,912.07 $49,687.66 $45,170.60 2025-12-02
335 MS_DRG Peritoneal Adhesiolysis With Mcc 24 17 — — $15,339.23 $53,295.28 $48,450.25 2025-12-02
34 MS_DRG Carotid Artery Stent Procedures With Mcc 24 17 — — $16,462.34 $56,296.57 $51,178.70 2025-12-02
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 24 17 — — $11,406.84 $42,786.79 $38,897.08 2025-12-02
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 24 17 — — $10,239.28 $39,666.70 $36,060.64 2025-12-02
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 24 17 — — $12,416.50 $45,484.90 $41,349.91 2025-12-02
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 24 17 — — $18,058.33 $60,561.51 $55,055.92 2025-12-02
37 MS_DRG Extracranial Procedures With Mcc 24 17 — — $14,058.63 $49,873.14 $45,339.22 2025-12-02
38240 HCPCS Transplt Allo Hct/donor 18 16 — $59,365.89 $56,397.59 $65,302.48 $59,365.89 2025-12-02
397 MS_DRG Appendix Procedures With Mcc 24 17 — — $10,489.47 $40,335.30 $36,668.45 2025-12-02
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 24 17 — — $59,817.66 $172,154.68 $156,504.25 2025-12-02
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 24 17 — — $15,968.73 $54,977.49 $49,979.54 2025-12-02
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 19 17 — — $48,849.36 $56,562.42 $51,420.38 2025-12-02
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 17 — — $22,981.75 $73,718.33 $67,016.66 2025-12-02
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 24 17 — — $11,889.02 $44,075.32 $40,068.47 2025-12-02
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 24 17 — — $14,822.33 $51,913.98 $47,194.53 2025-12-02
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 24 17 — — $11,584.22 $43,260.79 $39,327.99 2025-12-02
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 24 17 — — $14,832.92 $51,942.26 $47,220.24 2025-12-02
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 24 17 — — $10,060.63 $39,189.30 $35,626.64 2025-12-02
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 24 17 — — $14,941.71 $52,233.01 $47,484.55 2025-12-02
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 24 17 — — $17,218.85 $58,318.17 $53,016.52 2025-12-02
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 17 — — $112,972.96 $130,810.80 $118,918.91 2025-12-02
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 17 — — $80,021.10 $92,656.01 $84,232.74 2025-12-02
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 19 17 — — $64,402.50 $74,571.32 $67,792.11 2025-12-02
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 19 17 — — $92,115.60 $106,660.17 $96,963.79 2025-12-02
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 19 17 — — $64,074.22 $74,191.21 $67,446.55 2025-12-02
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 19 17 — — $76,132.57 $88,153.51 $80,139.55 2025-12-02
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 19 17 — — $50,523.00 $58,500.31 $53,182.10 2025-12-02
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 19 17 — — $60,943.86 $70,566.57 $64,151.43 2025-12-02
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 19 17 — — $40,777.25 $47,215.76 $42,923.42 2025-12-02
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 17 — — $35,853.34 $108,115.00 $98,286.36 2025-12-02
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 17 — — $24,297.06 $77,233.22 $70,212.02 2025-12-02
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 17 — — $18,279.73 $61,153.17 $55,593.79 2025-12-02
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 24 17 — — $25,978.98 $81,727.81 $74,298.01 2025-12-02
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 24 17 — — $12,123.55 $44,702.05 $40,638.23 2025-12-02
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 17 — — $22,864.49 $73,404.97 $66,731.79 2025-12-02
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 17 — — $12,482.54 $45,661.37 $41,510.34 2025-12-02
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 24 17 — — $21,567.38 $69,938.72 $63,580.65 2025-12-02
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 24 17 — — $14,500.17 $51,053.07 $46,411.88 2025-12-02
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 24 17 — — $11,105.43 $41,981.31 $38,164.83 2025-12-02
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 24 17 — — $13,837.65 $49,282.62 $44,802.38 2025-12-02
471 MS_DRG Cervical Spinal Fusion With Mcc 24 17 — — $20,562.80 $67,254.18 $61,140.16 2025-12-02
472 MS_DRG Cervical Spinal Fusion With Cc 24 17 — — $12,264.95 $45,079.89 $40,981.72 2025-12-02
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 17 — — $18,985.44 $63,039.02 $57,308.20 2025-12-02
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 24 17 — — $14,558.59 $51,209.19 $46,553.81 2025-12-02
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 24 17 — — $12,450.37 $45,575.40 $41,432.18 2025-12-02
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 24 17 — — $10,787.50 $41,131.72 $37,392.47 2025-12-02
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 24 17 — — $13,628.52 $48,723.76 $44,294.33 2025-12-02
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 24 17 — — $15,033.58 $52,478.49 $47,707.72 2025-12-02
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 24 17 — — $10,164.35 $39,466.47 $35,878.61 2025-12-02
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 24 17 — — $14,904.04 $52,132.31 $47,393.01 2025-12-02
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 24 17 — — $10,688.86 $40,868.12 $37,152.84 2025-12-02
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 24 17 — — $45,082.96 $132,779.23 $120,708.39 2025-12-02
500 MS_DRG Soft Tissue Procedures With Mcc 24 17 — — $13,414.31 $48,151.33 $43,773.94 2025-12-02
503 MS_DRG Foot Procedures With Mcc 24 17 — — $11,204.06 $42,244.91 $38,404.46 2025-12-02
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 24 17 — — $12,099.42 $44,637.56 $40,579.60 2025-12-02
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 24 17 — — $13,091.30 $47,288.16 $42,989.24 2025-12-02
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 24 17 — — $15,172.43 $52,849.54 $48,045.04 2025-12-02
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 24 17 — — $12,339.03 $45,277.87 $41,161.70 2025-12-02
545 MS_DRG Connective Tissue Disorders With Mcc 24 17 — — $10,697.33 $40,890.75 $37,173.41 2025-12-02
56 MS_DRG Degenerative Nervous System Disorders With Mcc 24 17 — — $10,600.81 $40,632.82 $36,938.93 2025-12-02
570 MS_DRG Skin Debridement With Mcc 24 17 — — $12,743.32 $46,358.25 $42,143.86 2025-12-02
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 24 17 — — $26,070.00 $81,971.04 $74,519.13 2025-12-02
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 24 17 — — $14,668.24 $51,502.19 $46,820.17 2025-12-02
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 17 — — $22,840.36 $73,340.49 $66,673.17 2025-12-02
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 24 17 — — $11,272.64 $42,428.17 $38,571.06 2025-12-02
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 24 17 — — $13,798.28 $49,177.40 $44,706.73 2025-12-02
5831 APR_DRG — 15 10 — — $81,748.00 $85,835.40 $81,748.00 2025-12-02
5832 APR_DRG — 15 10 — — $91,071.80 $95,625.39 $91,071.80 2025-12-02
5833 APR_DRG — 15 10 — — $118,611.61 $124,542.19 $118,611.61 2025-12-02
5834 APR_DRG — 15 10 — — $208,261.09 $218,674.14 $208,261.09 2025-12-02
5881 APR_DRG — 15 10 — — $62,395.71 $65,515.50 $62,395.71 2025-12-02
5882 APR_DRG — 15 10 — — $72,794.69 $76,434.42 $72,794.69 2025-12-02
5883 APR_DRG — 15 10 — — $84,952.00 $89,199.60 $84,952.00 2025-12-02
5884 APR_DRG — 15 10 — — $127,555.93 $133,933.73 $127,555.93 2025-12-02
5891 APR_DRG — 15 10 — — $59,458.71 $62,431.65 $59,458.71 2025-12-02
5892 APR_DRG — 15 10 — — $59,458.71 $62,431.65 $59,458.71 2025-12-02
5893 APR_DRG — 15 10 — — $59,458.71 $62,431.65 $59,458.71 2025-12-02
5912 APR_DRG — 15 10 — — $54,106.85 $56,812.19 $54,106.85 2025-12-02
5913 APR_DRG — 15 10 — — $63,082.79 $66,236.93 $63,082.79 2025-12-02
5914 APR_DRG — 15 10 — — $83,645.03 $87,827.28 $83,645.03 2025-12-02
5932 APR_DRG — 15 10 — — $43,270.17 $45,433.68 $43,270.17 2025-12-02
5933 APR_DRG — 15 10 — — $53,796.73 $56,486.57 $53,796.73 2025-12-02
5934 APR_DRG — 15 10 — — $73,539.99 $77,216.99 $73,539.99 2025-12-02
6 MS_DRG Liver Transplant Without Mcc 24 17 — — $20,528.51 $67,162.55 $61,056.86 2025-12-02
6023 APR_DRG — 15 10 — — $38,465.25 $40,388.51 $38,465.25 2025-12-02
6024 APR_DRG — 15 10 — — $55,400.16 $58,170.17 $55,400.16 2025-12-02
6034 APR_DRG — 15 10 — — $40,520.03 $42,546.03 $40,520.03 2025-12-02
6074 APR_DRG — 15 10 — — $42,824.57 $44,965.80 $42,824.57 2025-12-02
6094 APR_DRG — 15 10 — — $88,871.47 $93,315.04 $88,871.47 2025-12-02
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 24 17 — — $11,444.52 $42,887.47 $38,988.61 2025-12-02
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 24 17 — — $16,362.01 $56,028.46 $50,934.96 2025-12-02
619 MS_DRG O.r. Procedures For Obesity With Mcc 24 17 — — $11,542.31 $43,148.80 $39,226.18 2025-12-02
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 24 17 — — $15,841.31 $54,636.98 $49,669.98 2025-12-02
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 24 17 — — $12,137.52 $44,739.38 $40,672.16 2025-12-02
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 24 17 — — $16,703.65 $56,941.40 $51,764.91 2025-12-02
6303 APR_DRG — 15 10 — — $42,730.78 $44,867.32 $42,730.78 2025-12-02
6304 APR_DRG — 15 10 — — $77,520.20 $81,396.21 $77,520.20 2025-12-02
6314 APR_DRG — 15 10 — — $85,478.45 $89,752.37 $85,478.45 2025-12-02
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 24 17 — — $19,504.45 $64,425.97 $58,569.06 2025-12-02
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 24 17 — — $14,700.41 $51,588.17 $46,898.34 2025-12-02
652 MS_DRG Kidney Transplant 24 17 — — $13,002.40 $47,050.60 $42,773.27 2025-12-02
653 MS_DRG Major Bladder Procedures With Mcc 24 17 — — $23,599.40 $75,368.88 $68,517.16 2025-12-02
654 MS_DRG Major Bladder Procedures With Cc 24 17 — — $11,947.02 $44,230.31 $40,209.37 2025-12-02
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 24 17 — — $13,792.35 $49,161.56 $44,692.33 2025-12-02
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 24 17 — — $10,940.32 $41,540.11 $37,763.74 2025-12-02
662 MS_DRG Minor Bladder Procedures With Mcc 24 17 — — $13,206.45 $47,595.87 $43,268.97 2025-12-02
665 MS_DRG Prostatectomy With Mcc 24 17 — — $14,535.73 $51,148.10 $46,498.27 2025-12-02
668 MS_DRG Transurethral Procedures With Mcc 24 17 — — $12,345.81 $45,295.98 $41,178.16 2025-12-02
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 24 17 — — $17,736.17 $59,700.60 $54,273.27 2025-12-02
7 MS_DRG Lung Transplant 24 17 — — $55,325.20 $160,149.50 $145,590.45 2025-12-02
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 24 17 — — $16,669.36 $56,849.77 $51,681.61 2025-12-02
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 24 17 — — $16,852.66 $57,339.61 $52,126.92 2025-12-02
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 24 17 — — $10,958.53 $41,588.76 $37,807.96 2025-12-02
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 24 17 — — $25,166.60 $79,556.88 $72,324.44 2025-12-02
791 MS_DRG Prematurity With Major Problems 24 17 — — $17,187.10 $58,233.33 $52,939.39 2025-12-02
792 MS_DRG Prematurity Without Major Problems 24 17 — — $10,370.51 $40,017.41 $36,379.46 2025-12-02
793 MS_DRG Full Term Neonate With Major Problems 24 17 — — $17,655.31 $59,484.52 $54,076.84 2025-12-02
799 MS_DRG Splenic Procedures With Mcc 24 17 — — $20,128.88 $66,094.61 $60,086.01 2025-12-02
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 24 17 — — $23,034.24 $73,858.61 $67,144.19 2025-12-02
800 MS_DRG Splenic Procedures With Cc 24 17 — — $12,335.22 $45,267.70 $41,152.45 2025-12-02
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 24 17 — — $15,175.82 $52,858.60 $48,053.27 2025-12-02
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 24 17 — — $10,732.04 $40,983.53 $37,257.75 2025-12-02
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 17 — — $24,648.01 $78,171.06 $71,064.60 2025-12-02
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 17 — — $19,810.10 $65,242.76 $59,311.60 2025-12-02
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 24 17 — — $20,216.51 $66,328.79 $60,298.90 2025-12-02
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 24 17 — — $13,054.90 $47,190.87 $42,900.79 2025-12-02
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 24 17 — — $23,399.16 $74,833.77 $68,030.70 2025-12-02
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 24 17 — — $21,197.38 $68,949.97 $62,681.79 2025-12-02
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 24 17 — — $13,500.25 $48,380.98 $43,982.71 2025-12-02
8414 APR_DRG — 15 10 — — $79,102.08 $83,057.18 $79,102.08 2025-12-02
8424 APR_DRG — 15 10 — — $44,285.70 $46,499.99 $44,285.70 2025-12-02
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 24 17 — — $10,811.21 $41,195.07 $37,450.06 2025-12-02
849 MS_DRG Radiotherapy 24 17 — — $11,307.78 $42,522.06 $38,656.42 2025-12-02
850 MS_DRG Acute Leukemia With Other Procedures 19 17 — — $100,628.35 $116,517.04 $105,924.58 2025-12-02
8513 APR_DRG — 15 10 — — $40,865.01 $42,908.26 $40,865.01 2025-12-02
8514 APR_DRG — 15 10 — — $40,865.01 $42,908.26 $40,865.01 2025-12-02
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 24 17 — — $21,172.40 $68,883.22 $62,621.11 2025-12-02
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 24 17 — — $19,099.32 $63,343.34 $57,584.85 2025-12-02
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 24 17 — — $29,449.51 $91,002.08 $82,729.16 2025-12-02
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 24 17 — — $16,635.49 $56,759.26 $51,599.33 2025-12-02
901 MS_DRG Wound Debridements For Injuries With Mcc 24 17 — — $18,755.99 $62,425.86 $56,750.78 2025-12-02
9028800 HCPCS Botulism Ig IV 1 1 — — $48,705.00 $48,705.00 $48,705.00 2025-12-02
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 24 17 — — $16,345.50 $55,984.34 $50,894.85 2025-12-02
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 24 17 — — $16,864.52 $57,371.29 $52,155.72 2025-12-02
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 17 — — $100,427.63 $280,676.41 $255,160.37 2025-12-02
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 24 17 — — $28,274.32 $87,861.63 $79,874.21 2025-12-02
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 24 17 — — $13,463.84 $48,283.69 $43,894.26 2025-12-02
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 24 17 — — $18,317.41 $61,253.85 $55,685.32 2025-12-02
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 24 17 — — $13,436.75 $48,211.28 $43,828.44 2025-12-02
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 24 17 — — $15,446.33 $53,581.50 $48,710.45 2025-12-02
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 24 17 — — $10,148.26 $39,423.48 $35,839.53 2025-12-02
955 MS_DRG Craniotomy For Multiple Significant Trauma 24 17 — — $28,906.79 $89,551.77 $81,410.70 2025-12-02
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 24 17 — — $16,181.67 $55,546.52 $50,496.84 2025-12-02
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 17 — — $31,598.79 $96,745.59 $87,950.54 2025-12-02
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 24 17 — — $17,398.35 $58,797.84 $53,452.58 2025-12-02
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 24 17 — — $11,192.63 $42,214.36 $38,376.69 2025-12-02
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 24 17 — — $10,148.26 $39,423.48 $35,839.53 2025-12-02
963 MS_DRG Other Multiple Significant Trauma With Mcc 24 17 — — $11,500.82 $43,037.93 $39,125.39 2025-12-02
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 24 17 — — $26,773.17 $83,850.11 $76,227.37 2025-12-02
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 24 17 — — $15,174.97 $52,856.34 $48,051.22 2025-12-02
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 24 17 — — $11,232.43 $42,320.70 $38,473.36 2025-12-02
974 MS_DRG HIV With Major Related Condition With Mcc 24 17 — — $12,641.72 $46,086.74 $41,897.04 2025-12-02
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 17 — — $20,125.07 $66,084.44 $60,076.76 2025-12-02
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 24 17 — — $10,364.58 $40,001.57 $36,365.06 2025-12-02
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 17 — — $14,828.26 $51,929.81 $47,208.92 2025-12-02
A9543 HCPCS Y90 Ibritumomab, Rx 19 16 — $56,824.55 $50,967.20 $62,507.01 $56,824.55 2025-12-02
A954300 HCPCS Y90 Ibritumomab, Rx 1 1 — $56,824.55 $61,523.28 $61,523.28 $61,523.28 2025-12-02
C915000 HCPCS Xe129 Xenon, Diagnostic 1 1 — — $51,792.00 $51,792.00 $51,792.00 2025-12-02
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 18 16 — $3,685,266.67 $3,501,003.34 $4,053,793.34 $3,685,266.67 2025-12-02
J1413 HCPCS Inj Delandistrogene Mox Rokl 18 16 — $3,324,571.90 $3,158,343.31 $3,657,029.09 $3,324,571.90 2025-12-02
J1414 HCPCS Inj, Beqvez, Per Tx Dose 18 16 — $3,710,000.00 $3,524,500.00 $4,081,000.00 $3,710,000.00 2025-12-02
J3391 HCPCS Inj, Atidarsagene Autotemcel 18 16 — $4,377,500.00 $4,158,625.00 $4,815,250.00 $4,377,500.00 2025-12-02
J3392 HCPCS Inj, Exagamglogene Autotem 18 16 — $2,332,000.00 $2,215,400.00 $2,565,200.00 $2,332,000.00 2025-12-02
J3393 HCPCS Inj, Betibeglogene Autotemce 18 16 — $2,950,686.67 $2,803,152.34 $3,245,755.34 $2,950,686.67 2025-12-02
J3394 HCPCS Inj, Lovotibeglogene Autotem 18 16 — $3,261,355.00 $3,098,287.25 $3,587,490.50 $3,261,355.00 2025-12-02
J3399 HCPCS Inj Onase Abepar-xioi Treat 18 16 — $2,452,115.60 $2,329,509.82 $2,697,327.16 $2,452,115.60 2025-12-02
J733000 HCPCS Cultured Chondrocytes Implnt 1 1 — — $55,946.32 $55,946.32 $55,946.32 2025-12-02
J9029 HCPCS Instill Adstiladrin, Tx Dose 18 16 — $63,431.05 $60,259.50 $69,774.16 $63,431.05 2025-12-02
J902900 HCPCS Instill Adstiladrin, Tx Dose 1 1 — $63,431.05 $63,505.40 $63,505.40 $63,505.40 2025-12-02
J9226 HCPCS Supprelin La Implant 19 16 — $45,560.39 $43,282.37 $50,116.43 $45,560.39 2025-12-02
J922600 HCPCS Supprelin La Implant 1 1 — $45,560.39 $44,578.75 $44,578.75 $44,578.75 2025-12-02
Q048000 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $86,664.80 $86,664.80 $86,664.80 2025-12-02
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 19 16 — $533,076.48 $474,456.00 $586,384.13 $533,076.48 2025-12-02
Q2042 HCPCS Tisagenlecleucel Car-pos T 19 16 — $578,324.58 $529,810.07 $636,157.04 $578,324.58 2025-12-02
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 19 16 — $55,945.97 $53,148.67 $61,540.57 $55,945.97 2025-12-02
Q204300 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — $55,945.97 $55,453.57 $55,453.57 $55,453.57 2025-12-02
Q2053 HCPCS Brexucabtagene Car Pos T 18 16 — $489,720.00 $465,234.00 $538,692.00 $489,720.00 2025-12-02
Q2054 HCPCS Lisocabtagene Mara Car Pos T 18 16 — $541,635.66 $514,553.88 $595,799.23 $541,635.66 2025-12-02
Q2055 HCPCS Idecabtagene Vicleucel Car 18 16 — $541,260.45 $514,197.43 $595,386.50 $541,260.45 2025-12-02
Q2056 HCPCS Ciltacabtagene Car-pos T 18 16 — $553,378.83 $525,709.89 $608,716.71 $553,378.83 2025-12-02
Q2057 HCPCS Afamitresgene Autoleucel 18 16 — $770,620.00 $732,089.00 $847,682.00 $770,620.00 2025-12-02
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 18 16 — $270,375.00 $256,856.25 $297,412.50 $270,375.00 2025-12-02
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