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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

ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL

Sebastian, FL · CCN 100217 · Rates published

12,711 distinct procedures filed
64 distinct payers
256,000 rate rows
2026-04-01 last MRF observed
Data quality

187,638 of 256,000 rate rows are consumer-grade (73.3%)

68,362 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 54,269
template filing: same amount across many unrelated codes — excluded 14,039
placeholder amount (≤ $0.02) — excluded from medians 54
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=AEq1Okiq8l6y84nlCfk8rw*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
Found on page https://www.orlandohealth.com/patients-and-visitors/patient-financial-resources/financial-information-prior-to-care/pricing-transparency-guide
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint d743ffa81958ccaa… · 48,322,626 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 6 $4,432,920.00 $4,820,350.00 $4,685,200.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 6 $3,626,302.40 $4,238,056.67 $3,869,530.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 6 $3,263,399.19 $3,813,931.98 $3,482,285.72 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 6 $3,196,470.58 $3,735,712.57 $3,410,868.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,898,608.16 $4,868,633.01 $3,122,484.40 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $2,415,828.84 $4,787,465.68 $2,823,377.20 nat. median
$2,468,984
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 10 $2,294,688.00 $4,547,400.00 $2,681,800.00 nat. median
$2,448,600
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $758,290.08 $1,502,709.00 $886,213.00 nat. median
$824,563
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $582,258.58 $1,153,866.09 $680,485.13 nat. median
$753,246
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $556,815.04 $1,103,444.44 $650,749.29 nat. median
$674,867
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $553,537.57 $1,096,949.46 $646,918.91 nat. median
$673,137
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $548,400.85 $1,086,769.97 $640,915.62 nat. median
$625,184
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $524,698.49 $1,039,798.83 $613,214.70 nat. median
$634,303
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $481,475.73 $954,143.99 $562,700.30 nat. median
$619,808
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 21 $110,095.49 $1,305,761.51 $539,785.00 nat. median
$370,174
1.5× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 22 $205,115.53 $847,386.69 $394,449.82 nat. median
$265,286
1.5× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $273,798.00 $542,587.50 $319,987.50 nat. median
$324,450
1.0× median
9312
OTHER 		Inj., Ravulizumab-cwvz 10 Mg 3 $280,217.29 $280,217.29 $280,217.29 nat. median
$229
outlier · 1222.1×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 $156,270.86 $645,596.42 $267,692.57 nat. median
$206,474
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 19 $153,163.55 $641,807.60 $266,928.12 nat. median
$202,976
1.3× median
9489
OTHER 		Inj, Nusinersen, 0.1mg 2 $257,011.77 $257,011.77 $257,011.77 nat. median
$1,280
outlier · 200.8×
9257
OTHER 		Inj., Emicizumab-kxwh 0.5 Mg 1 $197,486.36 $197,486.36 $197,486.36 nat. median
$56
outlier · 3497.8×
1809
OTHER 		Injection, Alemtuzumab 1 $181,845.95 $181,845.95 $181,845.95 nat. median
$2,465
outlier · 73.8×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 11 $90,480.00 $175,562.60 $175,562.60 nat. median
$65,393
outlier · 2.7×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 19 $101,382.65 $418,838.63 $173,142.50 nat. median
$133,161
1.3× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 21 $87,962.70 $522,963.92 $165,786.93 nat. median
$117,357
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 $80,667.54 $333,259.05 $152,037.45 nat. median
$98,894
1.5× median
9394
OTHER 		Inj. Inebilizumab-cdon, 1 Mg 1 $150,277.95 $150,277.95 $150,277.95 nat. median
$505
outlier · 297.3×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $149,749.00 $149,749.00 $149,749.00 nat. median
$87,428
1.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 $82,940.93 $615,011.66 $147,506.73 nat. median
$108,660
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 19 $82,845.77 $343,910.42 $147,337.50 nat. median
$98,047
1.5× median
7
MS_DRG 		Lung Transplant 19 $94,786.49 $391,588.15 $143,665.43 nat. median
$122,708
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 $71,603.32 $403,905.92 $141,896.82 nat. median
$93,672
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 20 $79,590.88 $328,811.04 $139,150.75 nat. median
$102,358
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 19 $75,465.72 $333,652.78 $134,212.40 nat. median
$100,136
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 $55,957.57 $231,175.56 $131,715.78 nat. median
$73,807
1.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $82,553.84 $130,327.56 $130,327.56 nat. median
$76,329
1.7× median
215
MS_DRG 		Other Heart Assist System Implant 19 $72,878.34 $353,909.79 $129,610.86 nat. median
$99,019
1.3× median
9331
OTHER 		Inj, Polatuzumab Vedotin 1mg 2 $126,544.80 $126,544.80 $126,544.80 nat. median
$137
outlier · 920.6×
850
MS_DRG 		Acute Leukemia With Other Procedures 20 $63,381.54 $406,606.11 $117,699.82 nat. median
$83,470
1.4× median
25
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Mcc 26 $33,278.69 $160,911.80 $115,022.42 nat. median
$45,125
outlier · 2.5×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 14 $112,127.00 $114,766.01 $114,766.01 nat. median
$62,372
1.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 21 $61,701.03 $254,903.32 $114,579.11 nat. median
$79,312
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 $61,507.07 $254,102.01 $114,218.91 nat. median
$81,118
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 19 $65,944.03 $272,432.28 $114,157.79 nat. median
$82,711
1.4× median
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 28 $140.00 $159,544.76 $113,493.24 nat. median
$51,307
outlier · 2.2×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 $48,446.76 $218,276.03 $113,288.07 nat. median
$68,090
1.7× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 24 $34,845.75 $205,143.65 $108,800.27 nat. median
$47,651
outlier · 2.3×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 $41,941.83 $173,272.81 $108,632.54 nat. median
$55,916
1.9× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 22 $43,401.30 $244,402.82 $103,837.94 nat. median
$56,918
1.8× median

Other procedures at this hospital

Browse this hospital's 12,711 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 6 6 — — $4,432,920.00 $4,820,350.00 $4,685,200.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 6 — — $3,626,302.40 $4,238,056.67 $3,869,530.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 6 — — $3,263,399.19 $3,813,931.98 $3,482,285.72 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 6 — — $3,196,470.58 $3,735,712.57 $3,410,868.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 9 7 — — $2,898,608.16 $4,868,633.01 $3,122,484.40 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 13 10 — — $2,415,828.84 $4,787,465.68 $2,823,377.20 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 13 10 — — $2,294,688.00 $4,547,400.00 $2,681,800.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 13 10 — — $758,290.08 $1,502,709.00 $886,213.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 13 10 — — $582,258.58 $1,153,866.09 $680,485.13 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 13 10 — — $556,815.04 $1,103,444.44 $650,749.29 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 13 10 — — $553,537.57 $1,096,949.46 $646,918.91 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 13 10 — — $548,400.85 $1,086,769.97 $640,915.62 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 13 10 — — $524,698.49 $1,039,798.83 $613,214.70 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 13 10 — — $481,475.73 $954,143.99 $562,700.30 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 44 21 — — $110,095.49 $1,305,761.51 $539,785.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 48 22 — — $205,115.53 $847,386.69 $394,449.82 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 13 10 — — $273,798.00 $542,587.50 $319,987.50 2026-04-01
9312 OTHER Inj., Ravulizumab-cwvz 10 Mg 4 3 — — $280,217.29 $280,217.29 $280,217.29 2025-11-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 40 21 — — $156,270.86 $645,596.42 $267,692.57 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 37 19 — — $153,163.55 $641,807.60 $266,928.12 2026-04-01
9489 OTHER Inj, Nusinersen, 0.1mg 2 2 — — $257,011.77 $257,011.77 $257,011.77 2025-11-01
9257 OTHER Inj., Emicizumab-kxwh 0.5 Mg 1 1 — — $197,486.36 $197,486.36 $197,486.36 2025-11-01
1809 OTHER Injection, Alemtuzumab 1 1 — — $181,845.95 $181,845.95 $181,845.95 2025-11-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 14 11 — — $90,480.00 $175,562.60 $175,562.60 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 35 19 — — $101,382.65 $418,838.63 $173,142.50 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 47 21 — — $87,962.70 $522,963.92 $165,786.93 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 21 — — $80,667.54 $333,259.05 $152,037.45 2026-04-01
9394 OTHER Inj. Inebilizumab-cdon, 1 Mg 1 1 — — $150,277.95 $150,277.95 $150,277.95 2025-11-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $149,749.00 $149,749.00 $149,749.00 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 35 19 — — $82,940.93 $615,011.66 $147,506.73 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 35 19 — — $82,845.77 $343,910.42 $147,337.50 2026-04-01
7 MS_DRG Lung Transplant 35 19 — — $94,786.49 $391,588.15 $143,665.43 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 22 — — $71,603.32 $403,905.92 $141,896.82 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 36 20 — — $79,590.88 $328,811.04 $139,150.75 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 35 19 — — $75,465.72 $333,652.78 $134,212.40 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 54 24 — — $55,957.57 $231,175.56 $131,715.78 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $82,553.84 $130,327.56 $130,327.56 2026-04-01
215 MS_DRG Other Heart Assist System Implant 35 19 — — $72,878.34 $353,909.79 $129,610.86 2026-04-01
9331 OTHER Inj, Polatuzumab Vedotin 1mg 5 2 — — $126,544.80 $126,544.80 $126,544.80 2025-11-01
850 MS_DRG Acute Leukemia With Other Procedures 38 20 — — $63,381.54 $406,606.11 $117,699.82 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 66 26 — — $33,278.69 $160,911.80 $115,022.42 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 28 14 — — $112,127.00 $114,766.01 $114,766.01 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 42 21 — — $61,701.03 $254,903.32 $114,579.11 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 46 22 — — $61,507.07 $254,102.01 $114,218.91 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 35 19 — — $65,944.03 $272,432.28 $114,157.79 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 64 28 — — $140.00 $159,544.76 $113,493.24 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 53 22 — — $48,446.76 $218,276.03 $113,288.07 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 56 24 — — $34,845.75 $205,143.65 $108,800.27 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 59 26 — — $41,941.83 $173,272.81 $108,632.54 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 48 22 — — $43,401.30 $244,402.82 $103,837.94 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 36 18 — — $31,539.11 $103,336.71 $103,336.71 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 55 24 — — $52,499.19 $216,888.10 $100,831.85 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 56 24 — — $39,983.18 $165,181.12 $99,939.91 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 52 25 — — $43,645.76 $180,312.22 $99,440.43 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 35 19 — — $57,594.16 $237,936.77 $98,958.03 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 67 26 — — $23,799.38 $352,588.06 $98,673.07 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 19 — — $56,199.83 $232,176.44 $95,978.75 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 35 19 — — $55,772.39 $230,410.54 $95,154.00 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 59 25 — — $33,804.22 $151,631.35 $93,877.82 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 55 24 — — $40,182.26 $267,400.46 $93,454.57 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 55 21 — — $47,097.55 $194,572.46 $93,333.55 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 36 19 — — $48,548.56 $215,609.04 $91,244.38 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 60 26 — — $30,659.12 $126,660.93 $89,735.30 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 35 19 — — $52,220.33 $215,736.03 $89,724.73 2026-04-01
10 MS_DRG Pancreas Transplant 35 19 — — $52,521.15 $216,978.82 $89,696.25 2026-04-01
0100T HCPCS Prosth Retina Receive&Gen 3 1 — — $19,992.00 $89,169.00 $88,839.00 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $87,629.00 $87,629.00 $87,629.00 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 35 19 — — $48,904.68 $203,715.60 $86,974.79 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 42 22 — — $49,266.99 $203,535.00 $86,918.80 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 38 20 — — $48,940.55 $202,186.39 $86,224.29 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 35 19 — — $50,341.46 $207,973.94 $85,973.75 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 35 19 — — $48,126.64 $238,243.98 $85,591.08 2026-04-01
1233 OTHER Inj, Vasopressin, 1 Unit 1 1 — — $84,935.85 $84,935.85 $84,935.85 2025-11-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 54 22 — — $35,164.15 $148,535.22 $84,706.20 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 52 23 — — $41,816.52 $181,678.98 $84,569.70 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 20 — — $48,126.64 $238,243.98 $84,141.02 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 47 23 — — $41,149.15 $169,998.04 $81,545.57 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 39 21 — — $44,803.67 $185,095.87 $81,134.00 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 14 11 — — $62,328.81 $123,517.45 $80,574.31 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 35 19 — — $44,855.64 $273,212.93 $79,773.75 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 14 11 — — $55,915.36 $110,807.87 $79,554.37 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 42 21 — — $42,211.18 $174,385.57 $78,386.36 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 64 28 — — $32,803.67 $135,520.67 $78,374.26 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 43 22 — — $42,926.27 $211,879.53 $76,342.46 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 37 21 — — $44,374.03 $226,044.81 $76,243.26 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 41 22 — — $38,746.95 $219,387.67 $75,997.57 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 57 26 — — $32,152.25 $132,829.49 $75,650.63 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 35 19 — — $43,964.15 $181,627.57 $75,539.00 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 35 19 — — $43,502.31 $179,719.55 $74,745.46 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $74,614.73 $74,614.73 $74,614.73 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 35 19 — — $41,770.55 $173,398.45 $74,287.06 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 35 19 — — $42,954.09 $177,454.73 $73,803.51 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 35 19 — — $41,021.79 $177,442.56 $72,955.42 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 22 — — $36,890.77 $172,568.97 $72,731.80 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 65 28 — — $7,271.17 $119,266.32 $72,681.13 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 14 11 — — $54,387.97 $107,781.03 $71,854.01 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 40 21 — — $40,740.73 $168,310.76 $71,799.47 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 44 21 — — $38,034.05 $157,128.74 $70,629.41 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 61 25 — — $25,389.42 $105,479.22 $70,235.51 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 35 19 — — $39,032.40 $172,568.97 $69,417.37 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 39 21 — — $40,424.53 $273,186.98 $69,037.50 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 35 19 — — $40,040.27 $165,416.98 $68,797.01 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 35 19 — — $39,760.67 $244,402.82 $68,316.60 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 35 19 — — $39,920.23 $164,921.08 $68,176.25 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 37 20 — — $39,008.98 $161,156.44 $67,025.05 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 49 24 — — $14,154.00 $66,317.91 $66,317.91 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 65 27 — — $22,456.86 $106,637.33 $66,040.34 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 20 10 — — $9,491.00 $128,088.31 $65,160.82 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 51 24 — — $360.00 $128,233.31 $65,131.83 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 47 22 — — $31,820.91 $146,010.23 $64,651.36 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 35 19 — — $36,211.54 $168,099.48 $64,400.61 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 50 24 — — $27,965.19 $183,749.95 $64,400.38 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 55 24 — — $18,659.77 $172,099.00 $63,626.87 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 35 19 — — $36,504.31 $150,809.00 $62,721.54 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 3 1 — — $15,990.00 $62,139.00 $61,909.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 3 1 — — $15,990.00 $62,139.00 $61,909.00 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 29 17 — — $55,082.00 $61,665.01 $61,665.01 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 41 21 — — $34,238.25 $141,447.32 $60,891.20 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 55 26 — — $29,427.28 $121,571.88 $60,849.60 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 46 23 — — $30,858.20 $127,483.41 $60,838.32 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 53 24 — — $30,910.89 $127,701.12 $60,628.07 2026-04-01
9378 OTHER Daratumumab, Hyaluronidase 14 10 — — $60,395.84 $60,395.84 $60,395.84 2025-11-01
6 MS_DRG Liver Transplant Without Mcc 35 19 — — $33,939.63 $333,652.78 $60,360.11 2026-04-01
5166 OTHER Cochlear Implant Procedure 7 5 — — $59,480.46 $59,480.46 $59,480.46 2025-11-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 54 26 — — $28,101.01 $116,092.75 $59,184.26 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 35 19 — — $34,340.72 $141,870.65 $59,004.08 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 41 21 — — $33,148.41 $213,165.77 $58,952.97 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 46 21 — — $28,632.39 $135,448.83 $58,878.15 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 60 24 — — $33,293.33 $137,543.59 $58,827.63 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 35 19 — — $34,410.99 $142,160.93 $58,767.50 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 42 19 — — $17,756.22 $149,333.39 $57,601.75 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 35 19 — — $36,023.43 $148,822.36 $57,477.84 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 55 25 — — $23,369.08 $96,543.89 $57,404.76 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 35 19 — — $33,557.56 $138,635.18 $57,310.00 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 40 22 — — $28,154.16 $198,101.23 $56,978.54 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $56,497.80 $56,497.80 $56,497.80 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 41 21 — — $30,835.44 $274,638.77 $56,006.25 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 60 27 — — $2,978.33 $94,059.75 $55,556.18 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 40 22 — — $22,987.32 $148,202.49 $55,335.96 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 45 22 — — $32,438.96 $157,400.89 $54,910.46 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 11 9 — — $295.00 $54,837.62 $54,837.62 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 58 25 — — $18,465.88 $99,395.18 $54,504.54 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 19 — — $30,540.54 $154,165.38 $54,314.98 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 52 22 — — $25,428.81 $116,727.18 $54,301.38 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 23 15 — — $285.00 $54,182.44 $54,182.44 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 36 19 — — $22,208.53 $208,999.01 $53,982.79 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 44 22 — — $26,603.42 $129,808.71 $53,824.38 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 39 21 — — $24,156.19 $128,974.14 $53,316.25 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 35 19 — — $30,842.83 $160,694.90 $53,283.00 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 35 19 — — $30,397.08 $125,578.41 $52,228.13 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 49 22 — — $21,227.46 $140,371.04 $52,203.60 2026-04-01
9236 OTHER Eculizumab Injection 5 2 — — $52,109.25 $52,109.25 $52,109.25 2025-11-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 37 19 — — $5,642.28 $172,341.48 $52,100.94 2026-04-01
J9226 HCPCS Supprelin La Implant 14 11 — — $44,300.32 $87,790.27 $51,998.85 2026-04-01
33225 HCPCS L Ventric Pacing Lead Add-on 3 1 — — $13,595.00 $52,053.00 $51,860.00 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 62 27 — — $13,170.35 $97,520.49 $51,721.10 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 56 25 — — $22,938.40 $95,279.94 $51,618.69 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 47 22 — — $27,277.59 $112,690.98 $51,411.21 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 14 10 — — $19,992.00 $89,693.78 $51,056.46 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 14 10 — — $19,992.00 $89,693.78 $51,056.46 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 74 29 — — $9,999.48 $60,808.62 $50,874.28 2026-04-01
5194 OTHER Level 4 Endovascular Procedures 31 17 — — $9.17 $123,678.24 $50,622.18 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 46 23 — — $26,136.52 $107,976.87 $50,262.13 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 51 23 — — $23,644.29 $97,680.84 $50,236.99 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 58 26 — — $21,123.52 $87,266.87 $50,076.25 2026-04-01
245 MS_DRG Aicd Generator Procedures 38 19 — — $3,046.24 $137,957.85 $49,966.24 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 36 20 — — $32,665.34 $134,949.17 $49,849.43 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 35 19 — — $30,195.80 $124,746.87 $49,767.00 2026-04-01
791 MS_DRG Prematurity With Major Problems 35 19 — — $29,709.07 $122,736.04 $49,687.00 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 54 24 — — $24,970.54 $103,159.96 $49,219.07 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 42 22 — — $26,396.35 $109,050.32 $49,018.15 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 52 25 — — $28,261.31 $116,754.97 $48,780.75 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 40 21 — — $26,097.72 $111,751.35 $48,604.14 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 14 10 — — $12,392.00 $89,693.78 $48,526.64 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 40 22 — — $24,423.08 $117,042.23 $48,383.75 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 66 29 — — $17,858.86 $83,816.71 $48,109.19 2026-04-01
265 MS_DRG Aicd Lead Procedures 40 22 — — $26,482.72 $109,407.13 $47,771.16 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 44 22 — — $26,435.87 $109,213.61 $47,686.65 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 44 21 — — $18,775.83 $113,289.69 $46,832.50 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 35 19 — — $27,354.44 $113,008.48 $46,716.25 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 35 19 — — $27,123.89 $112,055.98 $46,604.14 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 52 23 — — $22,196.42 $103,667.96 $46,596.29 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 84 31 — — $12,660.40 $93,845.43 $46,506.37 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 57 25 — — $12,280.55 $78,492.93 $46,356.00 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 40 21 — — $24,937.61 $103,023.89 $46,309.26 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 62 26 — — $195.00 $83,094.02 $45,887.24 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 49 22 — — $23,129.01 $165,694.57 $45,834.93 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 43 23 — — $25,525.35 $105,452.00 $45,822.63 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 41 21 — — $25,759.57 $106,419.62 $45,812.24 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 40 21 — — $26,162.87 $108,085.73 $45,741.20 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 41 22 — — $26,459.71 $111,067.20 $45,690.32 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 62 27 — — $272.38 $97,520.49 $45,662.14 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 44 22 — — $25,285.28 $104,460.19 $45,611.15 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 36 19 — — $26,029.65 $126,324.52 $45,508.31 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 40 22 — — $28,288.39 $116,866.85 $45,392.04 2026-04-01
332 MS_DRG Rectal Resection With Mcc 37 20 — — $26,501.02 $109,482.73 $45,258.75 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 62 25 — — $15,512.94 $94,211.67 $45,170.98 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 69 29 — — $12,973.78 $132,218.05 $44,962.63 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 46 23 — — $23,303.21 $96,271.74 $44,813.50 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 35 19 — — $28,477.17 $126,896.79 $44,766.19 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 35 19 — — $25,168.17 $104,478.42 $44,760.47 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 38 21 — — $26,075.76 $107,725.90 $44,667.88 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 40 21 — — $26,050.88 $107,623.09 $44,625.25 2026-04-01
9111 OTHER Inj Teclistamab Cqyv 0.5 Mg 1 1 — — $44,482.02 $44,482.02 $44,482.02 2025-11-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 54 24 — — $22,200.92 $91,717.90 $44,479.98 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 40 22 — — $20,522.29 $117,752.82 $44,353.88 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 43 22 — — $23,620.13 $97,581.05 $43,838.58 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 53 25 — — $18,686.19 $77,197.61 $43,459.72 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 39 20 — — $25,408.24 $104,968.19 $43,392.50 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 50 24 — — $21,765.07 $95,697.22 $43,387.21 2026-04-01
9276 OTHER Cabazitaxel Injection 2 1 — — $42,921.47 $42,921.47 $42,921.47 2025-11-01
9150 OTHER Inj Mosunetuzumab-axgb, 1 Mg 1 1 — — $42,553.72 $42,553.72 $42,553.72 2025-11-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 64 26 — — $23,080.39 $99,534.42 $42,253.97 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 35 19 — — $24,177.86 $99,885.19 $42,242.19 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 41 22 — — $21,785.19 $93,430.80 $42,087.53 2026-04-01
652 MS_DRG Kidney Transplant 35 19 — — $23,637.71 $101,111.88 $42,038.60 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 63 25 — — $16,188.63 $88,062.13 $41,808.86 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 38 21 — — $20,964.38 $128,029.12 $41,363.37 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 35 19 — — $23,256.37 $219,387.67 $41,360.41 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 41 21 — — $22,827.18 $106,804.24 $41,313.07 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 44 23 — — $23,574.02 $97,390.55 $41,215.06 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 103 39 — — $9,101.58 $58,737.32 $41,080.24 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 35 19 — — $23,052.16 $168,099.48 $40,997.23 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 40 22 — — $16,373.76 $109,718.58 $40,852.32 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 54 25 — — $20,009.52 $82,664.64 $40,848.14 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 44 23 — — $18,273.51 $98,358.17 $40,783.60 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 35 19 — — $24,450.87 $101,013.06 $40,782.00 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 36 19 — — $27,167.30 $127,047.98 $40,703.60 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 35 19 — — $22,797.45 $97,243.99 $40,544.24 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 35 19 — — $22,757.19 $102,922.76 $40,472.65 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 40 22 — — $21,548.77 $160,694.90 $40,016.18 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 35 19 — — $23,677.22 $97,816.91 $39,974.58 2026-04-01
33968 HCPCS Remove Aortic Assist Device 4 2 — — $15,990.00 $62,139.00 $39,879.00 2026-04-01
33967 HCPCS Insert I-aort Percut Device 4 2 — — $15,990.00 $62,139.00 $39,879.00 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 42 21 — — $7,811.64 $97,076.08 $39,467.06 2026-04-01
800 MS_DRG Splenic Procedures With Cc 39 20 — — $20,562.86 $133,400.76 $38,755.67 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 39 20 — — $21,092.78 $117,230.59 $38,584.35 2026-04-01
69930 HCPCS Implant Cochlear Device 14 10 — — $19,992.00 $89,169.00 $38,219.62 2026-04-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 68 27 — — $11,208.32 $50,887.53 $38,088.33 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 51 25 — — $13,095.37 $90,702.56 $37,956.60 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 13 10 — — $28,126.13 $69,762.05 $37,921.94 2026-04-01
9472 OTHER Inj Talimogene Laherparepvec 1 1 — — $37,758.08 $37,758.08 $37,758.08 2025-11-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 43 23 — — $10,534.88 $102,558.92 $37,756.25 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 46 22 — — $18,877.96 $84,358.14 $37,705.59 2026-04-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 50 23 — — $15,305.40 $83,510.42 $37,629.26 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 35 19 — — $23,703.58 $97,925.76 $37,552.00 2026-04-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 53 24 — — $16,042.46 $110,424.99 $37,311.01 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 20 12 — — $37,073.36 $37,073.36 $37,073.36 2025-11-01
472 MS_DRG Cervical Spinal Fusion With Cc 37 19 — — $20,067.69 $89,084.17 $37,050.15 2026-04-01
J9266 HCPCS Pegaspargase Injection 14 11 — — $27,969.27 $55,426.92 $36,951.28 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 40 22 — — $21,133.77 $87,309.20 $36,948.71 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 43 24 — — $20,180.06 $108,654.05 $36,914.74 2026-04-01
570 MS_DRG Skin Debridement With Mcc 40 22 — — $21,526.81 $88,932.98 $36,875.51 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 41 22 — — $19,469.36 $91,355.57 $36,694.70 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 54 22 — — $13,674.68 $78,392.02 $36,490.68 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 35 19 — — $20,488.94 $101,655.75 $36,438.66 2026-04-01
374 MS_DRG Digestive Malignancy With Mcc 57 26 — — $15,653.81 $64,670.01 $36,407.09 2026-04-01
1488 OTHER Injection, Ramucirumab 1 1 — — $36,398.21 $36,398.21 $36,398.21 2025-11-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 61 26 — — $16,729.00 $69,111.97 $36,384.89 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 14 10 — — $19,992.00 $89,169.00 $36,384.39 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 14 10 — — $19,992.00 $89,169.00 $36,384.39 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 14 10 — — $19,992.00 $89,169.00 $36,384.39 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 44 22 — — $20,863.68 $86,193.42 $36,362.21 2026-04-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 47 21 — — $15,278.32 $148,535.22 $36,225.00 2026-04-01
37233 HCPCS Tibper Revasc W/ather Add-on 3 1 — — $12,392.00 $36,234.00 $36,100.00 2026-04-01
92925 HCPCS Prq Card Angio/athrect Addl 3 1 — — $12,392.00 $36,234.00 $36,100.00 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 52 25 — — $19,401.29 $80,151.87 $35,972.47 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 14 10 — — $15,990.00 $62,836.89 $35,768.69 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 47 21 — — $18,793.05 $77,639.09 $35,758.61 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 40 21 — — $18,611.58 $91,222.00 $35,696.81 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 41 21 — — $22,408.06 $92,573.64 $35,678.41 2026-04-01
9309 OTHER Inj. Tagraxofusp-erzs 10 Mcg 1 1 — — $35,634.32 $35,634.32 $35,634.32 2025-11-01
665 MS_DRG Prostatectomy With Mcc 38 21 — — $17,776.68 $94,378.85 $35,593.79 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 39 19 — — $18,890.29 $132,593.95 $35,416.82 2026-04-01
5223 OTHER Level 3 Pacemaker And Similar Procedures 32 17 — — $150.00 $35,283.47 $35,283.47 2026-04-01
9237 OTHER Inj, Lanreotide Acetate 11 8 — — $34,944.40 $34,944.40 $34,944.40 2025-11-01
682 MS_DRG Renal Failure With Mcc 68 26 — — $5,628.19 $44,782.48 $34,909.90 2026-04-01
33820 HCPCS Revise Major Vessel 4 2 — — $13,595.00 $52,053.00 $34,854.50 2026-04-01
33824 HCPCS Revise Major Vessel 4 2 — — $13,595.00 $52,053.00 $34,854.50 2026-04-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 60 24 — — $12,864.39 $75,607.55 $34,821.77 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 38 20 — — $19,303.94 $157,890.46 $34,821.64 2026-04-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 56 26 — — $14,640.08 $93,480.40 $34,740.98 2026-04-01
9182 OTHER Inj Mogamulizumab-kpkc, 1 Mg 1 1 — — $34,656.70 $34,656.70 $34,656.70 2025-11-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 56 25 — — $13,548.00 $74,237.31 $34,556.71 2026-04-01
0720 OTHER Inj Glofitamab Gxbm, 2.5 Mg 1 1 — — $34,498.56 $34,498.56 $34,498.56 2025-11-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 52 25 — — $16,522.76 $74,963.65 $34,436.57 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 12 10 — — $4,976.00 $62,836.89 $34,318.61 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 12 10 — — $4,976.00 $62,836.89 $34,318.61 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 20 10 — — $12,323.00 $89,169.00 $34,089.88 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 20 10 — — $12,323.00 $89,169.00 $34,089.88 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 20 10 — — $12,323.00 $89,169.00 $34,089.88 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 20 10 — — $12,323.00 $89,169.00 $34,089.88 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 69 28 — — $12,767.75 $66,910.65 $34,075.36 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 37 20 — — $18,777.11 $81,830.08 $34,033.17 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 39 20 — — $19,743.09 $81,563.98 $33,922.50 2026-04-01
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/Mcc 50 22 — — $12,545.29 $117,756.23 $33,823.22 2026-04-01
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/Mcc 54 25 — — $10,703.58 $75,607.55 $33,685.61 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 20 10 — — $12,323.00 $62,836.89 $33,513.01 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 20 10 — — $12,323.00 $62,836.89 $33,513.01 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 20 10 — — $12,323.00 $62,836.89 $33,513.01 2026-04-01
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