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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

GOOD SAMARITAN MEDICAL CENTER

West Palm Beach, FL · CCN 100287 · Rates published

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This hospital’s price: $222 across 5 payers · range $81-$11,496

Source: https://mrfs.hyvehealthcare.com/TenetHealth/752932824_good-samaritan-medical-center_standardcharges.json · observed 2026-09-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

17,414 distinct procedures filed
21 distinct payers
496,144 rate rows
2026-09-01 last MRF observed
Data quality

459,164 of 496,144 rate rows are consumer-grade (92.5%)

36,980 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 31,297
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2,301
per-diem day rate — not a per-procedure price 2,292
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 860
placeholder amount (≤ $0.02) — excluded from medians 110
exceeds 10× this hospital's gross charge — excluded from medians 74
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 46
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/TenetHealth/752932824_GoodSamaritanMedicalCenter_standardcharges.json
Found on page https://www.palmbeachhealthnetwork.com/patients/pricing-info-estimates/hospital-pricing-information
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 06f547e46d3c5c0a… · 3,248,605 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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $83,977.27 $952,483.02 $596,786.30 nat. median
$359,358
1.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $147,965.08 $470,927.98 $314,983.93 nat. median
$198,433
1.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $209,232.22 $468,164.24 $293,332.26 nat. median
$190,557
1.5× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 1 $154,530.00 $221,299.20 $185,466.60 nat. median
$68,423
outlier · 2.7×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $83,977.27 $265,078.82 $166,087.38 nat. median
$110,192
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $112,446.11 $239,850.02 $152,291.53 nat. median
$97,414
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 3 $120,606.14 $219,621.55 $143,630.25 nat. median
$93,917
1.5× median
583
MS_DRG 		Mastectomy For Malignancy Without Cc/mcc 5 $7,259.98 $481,083.01 $138,429.27 nat. median
$16,731
outlier · 8.3×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $12.09 $275,270.19 $138,154.61 nat. median
$103,967
1.3× median
Q0480
HCPCS 		Dme Pos 1 $50,827.03 $361,599.71 $130,660.60 nat. median
$111,503
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $27,000.00 $215,779.22 $126,052.44 nat. median
$90,581
1.4× median
L2006
HCPCS 		Dme Pos 1 $95,196.24 $136,328.55 $114,254.34 nat. median
$39,921
outlier · 2.9×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 $19,775.00 $198,724.75 $113,680.30 nat. median
$78,037
1.5× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 $55,215.07 $168,072.13 $105,307.02 nat. median
$68,004
1.5× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 2 $7,217.00 $115,091.86 $104,626.55 nat. median
$71,201
1.5× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $52,971.52 $185,353.79 $104,503.49 nat. median
$77,696
1.3× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $60,969.60 $157,367.87 $103,819.58 nat. median
$66,660
1.6× median
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 5 $9.67 $275,452.03 $102,793.25 nat. median
$50,083
outlier · 2.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 $23,625.00 $169,360.26 $100,153.07 nat. median
$72,473
1.4× median
10
MS_DRG 		Pancreas Transplant 3 $56,834.18 $158,274.41 $99,168.17 nat. median
$64,903
1.5× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 $51,399.25 $158,208.24 $99,126.71 nat. median
$61,329
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $5.68 $305,520.33 $98,328.16 nat. median
$126,722
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $43,405.34 $204,038.00 $98,261.12 nat. median
$63,896
1.5× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 $73,453.75 $157,275.23 $96,067.57 nat. median
$66,649
1.4× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $16,939.94 $152,453.57 $95,521.08 nat. median
$62,721
1.5× median
7
MS_DRG 		Lung Transplant 5 $7.72 $285,642.56 $94,972.15 nat. median
$117,894
0.8× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 $73,747.70 $135,174.12 $93,876.48 nat. median
$58,331
1.6× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 3 $55,293.37 $148,467.87 $93,023.80 nat. median
$61,711
1.5× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $27,000.00 $204,038.00 $90,870.65 nat. median
$62,038
1.5× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $27,000.00 $204,038.00 $90,870.65 nat. median
$59,558
1.5× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 $21,475.08 $144,504.23 $90,540.35 nat. median
$58,118
1.6× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 3 $54,251.46 $135,017.51 $89,261.33 nat. median
$58,216
1.5× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 3 $72,931.84 $130,791.39 $87,480.86 nat. median
$53,907
1.6× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 $52,100.82 $132,487.58 $85,813.29 nat. median
$56,686
1.5× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $52,971.52 $131,528.10 $84,010.52 nat. median
$55,188
1.5× median
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 3 $72,931.84 $119,820.24 $83,977.27 nat. median
$50,898
1.6× median
28
MS_DRG 		Spinal Procedures With Mcc 3 $31,896.29 $132,525.07 $83,034.71 nat. median
$54,505
1.5× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 $35,335.22 $129,359.89 $81,051.54 nat. median
$53,879
1.5× median
278
MS_DRG 		Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures… 3 $46,566.58 $122,773.67 $76,924.88 nat. median
$48,086
1.6× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 4 $23,625.00 $161,519.00 $76,377.23 nat. median
$55,491
1.4× median
834
MS_DRG 		Acute Leukemia With Mcc 3 $41,054.26 $121,090.72 $75,870.42 nat. median
$50,391
1.5× median
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 4 $43,405.34 $204,038.00 $75,379.86 nat. median
$49,396
1.5× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 $57,982.72 $96,463.01 $74,386.24 nat. median
$50,905
1.5× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 $19,775.00 $127,204.92 $73,579.03 nat. median
$51,243
1.4× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $6.51 $618,123.16 $73,293.51 nat. median
$249,124
outlier · 0.3×
576
MS_DRG 		Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 $17,533.98 $108,105.77 $72,307.40 nat. median
$46,668
1.5× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 2 $7,217.00 $79,438.50 $72,215.15 nat. median
$49,639
1.5× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 5 $3.30 $227,418.70 $72,090.30 nat. median
$94,964
0.8× median
653
MS_DRG 		Major Bladder Procedures With Mcc 3 $34,929.11 $114,616.99 $71,814.25 nat. median
$49,999
1.4× median
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 4 $52,100.82 $103,069.00 $71,547.49 nat. median
$44,167
1.6× median

Other procedures at this hospital

Browse this hospital's 17,414 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 3 — — $83,977.27 $952,483.02 $596,786.30 2026-09-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 9 3 — — $147,965.08 $470,927.98 $314,983.93 2026-09-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 3 — — $209,232.22 $468,164.24 $293,332.26 2026-09-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 4 1 — — $154,530.00 $221,299.20 $185,466.60 2026-09-01
14 MS_DRG Allogeneic Bone Marrow Transplant 9 3 — — $83,977.27 $265,078.82 $166,087.38 2026-09-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 4 — — $112,446.11 $239,850.02 $152,291.53 2026-09-01
215 MS_DRG Other Heart Assist System Implant 9 3 — — $120,606.14 $219,621.55 $143,630.25 2026-09-01
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 45 5 — — $7,259.98 $481,083.01 $138,429.27 2026-09-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 41 5 — — $12.09 $275,270.19 $138,154.61 2026-09-01
Q0480 HCPCS Dme Pos 11 1 — — $50,827.03 $361,599.71 $130,660.60 2026-09-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 4 — — $27,000.00 $215,779.22 $126,052.44 2026-09-01
L2006 HCPCS Dme Pos 4 1 — — $95,196.24 $136,328.55 $114,254.34 2026-09-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 3 — — $19,775.00 $198,724.75 $113,680.30 2026-09-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 9 3 — — $55,215.07 $168,072.13 $105,307.02 2026-09-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 2 — — $7,217.00 $115,091.86 $104,626.55 2026-09-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 4 — — $52,971.52 $185,353.79 $104,503.49 2026-09-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 9 3 — — $60,969.60 $157,367.87 $103,819.58 2026-09-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 49 5 — — $9.67 $275,452.03 $102,793.25 2026-09-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 4 — — $23,625.00 $169,360.26 $100,153.07 2026-09-01
10 MS_DRG Pancreas Transplant 9 3 — — $56,834.18 $158,274.41 $99,168.17 2026-09-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 9 3 — — $51,399.25 $158,208.24 $99,126.71 2026-09-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 49 5 — — $5.68 $305,520.33 $98,328.16 2026-09-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 4 — — $43,405.34 $204,038.00 $98,261.12 2026-09-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 4 — — $73,453.75 $157,275.23 $96,067.57 2026-09-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 9 3 — — $16,939.94 $152,453.57 $95,521.08 2026-09-01
7 MS_DRG Lung Transplant 41 5 — — $7.72 $285,642.56 $94,972.15 2026-09-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 9 3 — — $73,747.70 $135,174.12 $93,876.48 2026-09-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 9 3 — — $55,293.37 $148,467.87 $93,023.80 2026-09-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 4 — — $27,000.00 $204,038.00 $90,870.65 2026-09-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 4 — — $27,000.00 $204,038.00 $90,870.65 2026-09-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 9 3 — — $21,475.08 $144,504.23 $90,540.35 2026-09-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 9 3 — — $54,251.46 $135,017.51 $89,261.33 2026-09-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 9 3 — — $72,931.84 $130,791.39 $87,480.86 2026-09-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 4 — — $52,100.82 $132,487.58 $85,813.29 2026-09-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 4 — — $52,971.52 $131,528.10 $84,010.52 2026-09-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 9 3 — — $72,931.84 $119,820.24 $83,977.27 2026-09-01
28 MS_DRG Spinal Procedures With Mcc 9 3 — — $31,896.29 $132,525.07 $83,034.71 2026-09-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 9 3 — — $35,335.22 $129,359.89 $81,051.54 2026-09-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 9 3 — — $46,566.58 $122,773.67 $76,924.88 2026-09-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 17 4 — — $23,625.00 $161,519.00 $76,377.23 2026-09-01
834 MS_DRG Acute Leukemia With Mcc 9 3 — — $41,054.26 $121,090.72 $75,870.42 2026-09-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 14 4 — — $43,405.34 $204,038.00 $75,379.86 2026-09-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 6 2 — — $57,982.72 $96,463.01 $74,386.24 2026-09-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 10 3 — — $19,775.00 $127,204.92 $73,579.03 2026-09-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 41 5 — — $6.51 $618,123.16 $73,293.51 2026-09-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 9 3 — — $17,533.98 $108,105.77 $72,307.40 2026-09-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 2 — — $7,217.00 $79,438.50 $72,215.15 2026-09-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 49 5 — — $3.30 $227,418.70 $72,090.30 2026-09-01
653 MS_DRG Major Bladder Procedures With Mcc 9 3 — — $34,929.11 $114,616.99 $71,814.25 2026-09-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 4 — — $52,100.82 $103,069.00 $71,547.49 2026-09-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 9 3 — — $57,620.52 $105,008.97 $70,487.75 2026-09-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 4 — — $23,625.00 $149,246.00 $69,655.56 2026-09-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 12 4 — — $28,161.90 $204,038.00 $69,137.01 2026-09-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 10 3 — — $19,775.00 $117,554.99 $68,580.48 2026-09-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 9 3 — — $40,785.95 $108,930.70 $68,251.45 2026-09-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 9 3 — — $27,889.42 $108,557.94 $68,017.89 2026-09-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 9 3 — — $51,036.98 $105,968.45 $66,395.43 2026-09-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 9 3 — — $40,461.26 $103,487.03 $64,840.68 2026-09-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 9 3 — — $31,256.32 $103,178.23 $64,647.20 2026-09-01
799 MS_DRG Splenic Procedures With Mcc 9 3 — — $35,383.25 $99,893.95 $64,350.34 2026-09-01
6 MS_DRG Liver Transplant Without Mcc 41 5 — — $5.56 $135,409.18 $64,083.34 2026-09-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 9 3 — — $36,886.61 $101,385.00 $63,523.63 2026-09-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 9 3 — — $31,220.82 $101,126.93 $63,361.94 2026-09-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 9 3 — — $40,785.95 $100,330.68 $62,863.03 2026-09-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 9 3 — — $35,364.46 $100,286.56 $62,835.39 2026-09-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 5 — — $7,217.00 $92,035.04 $62,566.26 2026-09-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 9 3 — — $47,756.95 $92,945.99 $62,167.67 2026-09-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 9 3 — — $23,520.28 $98,826.39 $61,920.51 2026-09-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 9 3 — — $31,883.76 $96,891.99 $60,708.50 2026-09-01
593 MS_DRG Skin Ulcers With Cc 49 5 — — $9.16 $169,877.42 $60,599.21 2026-09-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 14 4 — — $23,871.06 $204,038.00 $60,334.75 2026-09-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 2 — — $0.15 $193,190.79 $59,760.60 2026-09-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 9 3 — — $20,292.23 $94,688.50 $59,327.88 2026-09-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 9 3 — — $40,280.65 $92,992.31 $58,265.12 2026-09-01
L7181 HCPCS Dme Pos 11 1 — — $22,612.00 $171,734.54 $58,128.47 2026-09-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 9 3 — — $22,498.20 $92,674.69 $58,066.11 2026-09-01
901 MS_DRG Wound Debridements For Injuries With Mcc 9 3 — — $21,721.46 $92,564.41 $57,997.01 2026-09-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 17 4 — — $23,625.00 $161,519.00 $57,048.00 2026-09-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 14 4 — — $40,807.35 $204,038.00 $55,690.50 2026-09-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 9 3 — — $19,033.16 $87,877.29 $55,060.26 2026-09-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 3 2 — — $7,217.00 $59,817.53 $54,378.32 2026-09-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 9 3 — — $15,653.74 $85,894.37 $53,817.84 2026-09-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 9 3 — — $18,629.14 $85,376.03 $53,493.07 2026-09-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 9 3 — — $25,596.79 $85,248.10 $53,412.92 2026-09-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 9 3 — — $26,417.38 $84,683.44 $53,059.13 2026-09-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 9 3 — — $28,075.25 $82,202.03 $52,140.33 2026-09-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 9 3 — — $33,119.86 $83,000.49 $52,004.66 2026-09-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 10 3 — — $19,775.00 $88,680.17 $51,902.32 2026-09-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 9 3 — — $22,234.07 $76,921.58 $51,402.61 2026-09-01
791 MS_DRG Prematurity With Major Problems 6 2 — — $25,516.40 $65,877.57 $50,801.24 2026-09-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 9 3 — — $20,182.61 $81,017.57 $50,762.24 2026-09-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 9 3 — — $14,140.00 $80,984.48 $50,741.51 2026-09-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 9 3 — — $25,452.72 $78,842.75 $50,486.95 2026-09-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 9 3 — — $12,489.37 $80,033.82 $50,145.87 2026-09-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 9 3 — — $18,985.14 $79,972.06 $50,107.17 2026-09-01
332 MS_DRG Rectal Resection With Mcc 9 3 — — $28,985.62 $79,861.78 $50,038.07 2026-09-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 9 3 — — $15,990.95 $79,025.82 $49,514.30 2026-09-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 9 3 — — $30,780.25 $78,763.34 $49,349.84 2026-09-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 9 3 — — $36,628.74 $78,646.44 $49,276.59 2026-09-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 9 3 — — $26,880.91 $78,580.27 $49,235.13 2026-09-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 9 3 — — $25,919.39 $77,786.22 $48,737.61 2026-09-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 9 3 — — $28,985.62 $77,627.41 $48,638.11 2026-09-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 12 4 — — $28,161.90 $90,996.15 $48,313.06 2026-09-01
C2616 HCPCS Yttrium90 Nostrnd Pr Ea 1 1 $321,029.00 $240,771.75 25% off $48,041.71 $48,041.71 $48,041.71 2026-09-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 9 3 — — $21,475.08 $76,568.67 $47,974.75 2026-09-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 9 3 — — $29,900.05 $65,216.19 $47,782.74 2026-09-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 9 3 — — $24,191.57 $76,198.11 $47,742.57 2026-09-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 9 3 — — $20,428.99 $75,620.22 $47,380.49 2026-09-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 9 3 — — $34,091.53 $63,969.71 $47,070.25 2026-09-01
L7180 HCPCS Dme Pos 11 1 — — $18,230.11 $138,454.76 $46,863.97 2026-09-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 41 5 — — $4.05 $123,620.66 $46,746.07 2026-09-01
163 MS_DRG Major Chest Procedures With Mcc 49 5 — — $3.71 $98,855.06 $45,932.23 2026-09-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 9 3 — — $32,220.97 $72,860.89 $45,651.61 2026-09-01
37 MS_DRG Extracranial Procedures With Mcc 9 3 — — $17,411.83 $72,613.85 $45,496.82 2026-09-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 10 3 — — $19,775.00 $71,252.93 $45,150.57 2026-09-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 9 3 — — $18,511.16 $71,431.59 $44,756.07 2026-09-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 9 3 — — $19,396.48 $71,352.19 $44,706.32 2026-09-01
652 MS_DRG Kidney Transplant 9 3 — — $34,742.23 $71,233.08 $44,631.69 2026-09-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 9 3 — — $19,400.65 $71,041.19 $44,511.46 2026-09-01
A9543 HCPCS Y90 Ibritumomab, Rx 11 1 — — $26,470.50 $246,591.24 $44,175.97 2026-09-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 9 3 — — $25,978.90 $70,225.08 $44,000.12 2026-09-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 14 4 — — $23,871.06 $204,038.00 $43,792.89 2026-09-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 44 5 — — $11,691.40 $149,246.00 $43,741.69 2026-09-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 9 3 — — $23,118.34 $69,700.12 $43,671.20 2026-09-01
665 MS_DRG Prostatectomy With Mcc 9 3 — — $13,559.47 $68,844.31 $43,134.98 2026-09-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 9 3 — — $33,413.22 $68,700.94 $43,045.15 2026-09-01
602 MS_DRG Cellulitis With Mcc 49 5 — — $6.37 $127,974.22 $43,045.06 2026-09-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 9 3 — — $32,818.74 $64,078.04 $42,805.00 2026-09-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 9 3 — — $31,710.06 $63,563.86 $42,515.20 2026-09-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 12 4 — — $17,604.97 $72,605.03 $42,447.76 2026-09-01
L6880 HCPCS Dme Pos 11 1 — — $13,483.50 $102,405.12 $42,406.54 2026-09-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 9 3 — — $8,035.67 $66,623.17 $41,743.31 2026-09-01
265 MS_DRG Aicd Lead Procedures 13 3 — — $7,405.00 $79,806.64 $41,727.12 2026-09-01
800 MS_DRG Splenic Procedures With Cc 9 3 — — $33,268.58 $61,966.94 $41,447.08 2026-09-01
654 MS_DRG Major Bladder Procedures With Cc 9 3 — — $32,321.66 $61,744.16 $41,255.83 2026-09-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 9 3 — — $32,103.00 $65,650.45 $41,133.85 2026-09-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 9 3 — — $31,923.77 $60,628.08 $40,980.13 2026-09-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 17 4 — — $14,580.00 $70,293.45 $40,784.00 2026-09-01
570 MS_DRG Skin Debridement With Mcc 9 3 — — $21,475.08 $64,871.84 $40,646.00 2026-09-01
668 MS_DRG Transurethral Procedures With Mcc 9 3 — — $11,866.10 $64,406.44 $40,354.40 2026-09-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 9 3 — — $14,217.19 $64,009.41 $40,105.64 2026-09-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 9 3 — — $29,352.20 $54,227.13 $39,901.46 2026-09-01
974 MS_DRG HIV With Major Related Condition With Mcc 9 3 — — $19,781.71 $63,656.50 $39,884.52 2026-09-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 27 5 — — $19,167.59 $120,662.82 $39,708.26 2026-09-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 9 3 — — $29,486.80 $53,911.72 $39,669.37 2026-09-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 9 3 — — $20,507.29 $63,308.00 $39,666.16 2026-09-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 2 — — $7,217.00 $58,804.00 $38,165.00 2026-09-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 9 3 — — $23,461.81 $60,813.35 $38,103.12 2026-09-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 10 4 — — $10,825.00 $66,541.56 $37,801.93 2026-09-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 9 3 — — $20,446.74 $60,299.43 $37,781.12 2026-09-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 45 5 — — $11,205.35 $82,442.45 $37,542.87 2026-09-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 10 4 — — $10,825.00 $52,645.65 $37,519.65 2026-09-01
849 MS_DRG Radiotherapy 9 3 — — $12,084.30 $59,763.44 $37,445.29 2026-09-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 9 3 — — $17,548.60 $59,496.55 $37,278.07 2026-09-01
164 MS_DRG Major Chest Procedures With Cc 9 3 — — $30,112.57 $55,671.87 $37,236.57 2026-09-01
471 MS_DRG Cervical Spinal Fusion With Mcc 12 4 — — $10,100.00 $106,506.64 $37,162.67 2026-09-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 9 3 — — $28,007.38 $52,875.04 $36,886.61 2026-09-01
503 MS_DRG Foot Procedures With Mcc 10 4 — — $10,825.00 $61,563.29 $36,702.76 2026-09-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 9 3 — — $17,533.98 $58,466.49 $36,632.67 2026-09-01
J7330 HCPCS Cultured Chondrocytes Implnt 11 1 — — $17,515.94 $120,798.37 $36,616.69 2026-09-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 9 3 — — $10,430.60 $57,182.77 $35,828.35 2026-09-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 9 3 — — $25,735.72 $56,889.41 $35,644.54 2026-09-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 10 4 — — $13,250.00 $59,690.65 $35,538.78 2026-09-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 9 3 — — $20,888.35 $56,633.55 $35,484.23 2026-09-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 35 5 — — $21,998.15 $204,038.00 $35,449.91 2026-09-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 9 3 — — $23,109.84 $48,024.71 $35,337.58 2026-09-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 9 3 — — $26,354.40 $49,376.80 $35,335.22 2026-09-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 9 3 — — $25,701.19 $56,044.63 $35,115.24 2026-09-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 28 5 — — $19,622.52 $147,376.05 $35,000.21 2026-09-01
L5856 HCPCS Dme Pos 11 1 — — $13,547.47 $102,890.82 $34,826.36 2026-09-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 9 3 — — $25,216.21 $48,173.52 $34,756.55 2026-09-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 49 5 — — $2.49 $116,765.35 $34,743.44 2026-09-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 9 3 — — $11,875.50 $54,963.84 $34,438.06 2026-09-01
655 MS_DRG Major Bladder Procedures Without Cc/mcc 9 3 — — $24,886.79 $46,685.85 $34,352.42 2026-09-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 9 3 — — $25,937.62 $51,293.55 $34,308.10 2026-09-01
545 MS_DRG Connective Tissue Disorders With Mcc 9 3 — — $14,294.45 $54,738.86 $34,297.09 2026-09-01
333 MS_DRG Rectal Resection With Cc 9 3 — — $24,552.66 $51,661.91 $34,235.79 2026-09-01
L5991 HCPCS Dme Pos 4 1 — — $28,417.46 $40,696.06 $34,106.58 2026-09-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 9 3 — — $27,359.18 $50,978.14 $34,097.13 2026-09-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 9 3 — — $24,191.57 $54,242.57 $33,986.14 2026-09-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 9 3 — — $23,634.07 $60,281.33 $33,878.50 2026-09-01
835 MS_DRG Acute Leukemia With Cc 9 3 — — $26,394.55 $48,490.42 $33,852.53 2026-09-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 35 5 — — $19,390.09 $204,038.00 $33,765.62 2026-09-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 9 3 — — $26,363.85 $49,972.34 $33,424.40 2026-09-01
397 MS_DRG Appendix Procedures With Mcc 9 3 — — $23,454.50 $52,824.31 $33,097.52 2026-09-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 27 5 — — $11,870.19 $91,602.72 $33,037.57 2026-09-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 9 3 — — $18,629.14 $52,727.26 $33,036.71 2026-09-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 9 3 — — $19,221.08 $52,636.82 $32,980.05 2026-09-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 9 3 — — $24,065.03 $48,173.52 $32,429.16 2026-09-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 9 3 — — $22,498.20 $51,582.50 $32,319.45 2026-09-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 9 3 — — $12,489.37 $51,545.00 $32,295.96 2026-09-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 9 3 — — $24,394.44 $46,374.84 $32,220.97 2026-09-01
709 MS_DRG Penis Procedures With Cc/mcc 9 3 — — $11,803.46 $51,328.84 $32,160.52 2026-09-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 9 3 — — $26,716.88 $48,057.79 $32,143.84 2026-09-01
Q4244 HCPCS Procenta, Per 200 Mg 4 1 — — $26,462.66 $37,896.62 $31,760.43 2026-09-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 9 3 — — $20,292.23 $50,195.11 $31,450.17 2026-09-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 9 3 — — $14,207.80 $50,111.30 $31,397.66 2026-09-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 48 5 — — $5,878.98 $60,012.69 $31,395.68 2026-09-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 9 3 — — $24,857.28 $46,511.60 $31,109.65 2026-09-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 49 5 — — $1.82 $126,393.23 $31,005.01 2026-09-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 9 3 — — $12,257.60 $49,348.13 $30,919.49 2026-09-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 9 3 — — $23,712.00 $46,123.39 $30,850.00 2026-09-01
607 MS_DRG Minor Skin Disorders Without Mcc 49 5 — — $4.36 $98,924.77 $30,712.65 2026-09-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 9 3 — — $19,058.22 $48,957.72 $30,674.87 2026-09-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 9 3 — — $13,537.55 $48,759.20 $30,550.49 2026-09-01
L5973 HCPCS Dme Pos 11 1 — — $9,709.30 $73,740.58 $30,536.38 2026-09-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 9 3 — — $13,256.71 $48,699.65 $30,513.18 2026-09-01
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 9 3 — — $23,328.27 $45,585.20 $30,490.03 2026-09-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 45 5 — — $4,366.52 $54,393.62 $30,290.68 2026-09-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 9 3 — — $23,304.66 $45,450.65 $30,062.98 2026-09-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 4 1 — — $25,028.08 $35,842.19 $30,038.65 2026-09-01
A9604 HCPCS Sm 153 Lexidronam 11 1 — — $4,948.78 $65,002.30 $30,020.42 2026-09-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 49 5 — — $2.11 $173,562.12 $29,778.95 2026-09-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 9 3 — — $9,646.56 $47,217.42 $29,584.47 2026-09-01
374 MS_DRG Digestive Malignancy With Mcc 9 3 — — $14,600.34 $47,173.31 $29,556.83 2026-09-01
32 MS_DRG Ventricular Shunt Procedures With Cc 9 3 — — $23,520.28 $47,003.47 $29,450.42 2026-09-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 9 3 — — $19,306.69 $46,981.41 $29,436.60 2026-09-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 9 3 — — $23,662.41 $44,008.13 $29,435.19 2026-09-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 9 3 — — $13,657.61 $46,908.62 $29,390.99 2026-09-01
595 MS_DRG Major Skin Disorders With Mcc 9 3 — — $10,698.91 $46,776.28 $29,308.07 2026-09-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 45 5 — — $8,944.28 $61,042.03 $29,269.18 2026-09-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 9 3 — — $20,507.29 $46,710.11 $29,266.61 2026-09-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 9 3 — — $12,861.04 $46,703.49 $29,262.47 2026-09-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 49 5 — — $1.91 $55,647.61 $29,177.68 2026-09-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 18 5 — — $5,130.00 $48,139.40 $28,959.03 2026-09-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 9 3 — — $19,173.06 $46,169.71 $28,928.02 2026-09-01
J9226 HCPCS Supprelin La Implant 15 2 — — $0.15 $161,186.58 $28,883.52 2026-09-01
886 MS_DRG Behavioral And Developmental Disorders 9 3 — — $6,698.30 $45,774.89 $28,680.65 2026-09-01
472 MS_DRG Cervical Spinal Fusion With Cc 13 5 — — $7,217.00 $64,982.13 $28,668.34 2026-09-01
935 MS_DRG Non-extensive Burns 9 3 — — $14,282.96 $45,437.42 $28,469.20 2026-09-01
630 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures Without Cc/mcc 49 5 — — $2.81 $179,071.85 $28,375.11 2026-09-01
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 48 5 — — $9,714.08 $63,560.38 $28,370.18 2026-09-01
J7310 HCPCS Ganciclovir Long Act Implant 11 1 — — $10,176.00 $61,327.36 $28,323.20 2026-09-01
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 9 3 — — $11,446.42 $45,197.00 $28,318.56 2026-09-01
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 9 3 — — $12,489.37 $44,724.98 $28,022.81 2026-09-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 10 4 — — $10,825.00 $37,862.28 $27,947.40 2026-09-01
850 MS_DRG Acute Leukemia With Other Procedures 47 5 — — $1.55 $191,002.59 $27,869.84 2026-09-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 9 3 — — $12,167.82 $44,356.63 $27,792.02 2026-09-01
289 MS_DRG Acute And Subacute Endocarditis With Cc 9 3 — — $17,447.20 $37,649.09 $27,702.99 2026-09-01
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 9 3 — — $15,844.79 $44,120.62 $27,644.15 2026-09-01
L8614 HCPCS Dme Pos 11 1 — — $10,683.85 $81,142.14 $27,464.89 2026-09-01
479 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc 9 3 — — $22,008.25 $41,001.76 $27,424.35 2026-09-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 18 4 — — $4,104.00 $51,793.00 $27,416.50 2026-09-01
30 MS_DRG Spinal Procedures Without Cc/mcc 49 5 — — $1.66 $48,419.53 $27,380.43 2026-09-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 41 5 — — $5.07 $77,599.26 $27,258.64 2026-09-01
Q0483 HCPCS Dme Pos 11 1 — — $10,581.08 $80,361.55 $27,200.69 2026-09-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 9 3 — — $13,875.80 $43,412.59 $27,200.52 2026-09-01
883 MS_DRG Disorders Of Personality And Impulse Control 9 3 — — $7,560.65 $43,370.68 $27,174.27 2026-09-01
906 MS_DRG Hand Procedures For Injuries 9 3 — — $9,703.98 $43,326.57 $27,146.63 2026-09-01
592 MS_DRG Skin Ulcers With Mcc 9 3 — — $10,821.06 $42,686.91 $27,146.22 2026-09-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 10 4 — — $10,825.00 $45,845.08 $27,080.36 2026-09-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 9 3 — — $21,774.47 $40,364.31 $26,997.99 2026-09-01
L5858 HCPCS Dme Pos 11 1 — — $10,488.38 $79,657.55 $26,962.37 2026-09-01
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 9 3 — — $18,629.14 $42,852.34 $26,849.50 2026-09-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 9 3 — — $16,939.94 $42,845.72 $26,845.35 2026-09-01
100 MS_DRG Seizures With Mcc 9 3 — — $10,619.57 $42,720.00 $26,766.58 2026-09-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 18 5 — — $2,565.00 $48,807.73 $26,724.05 2026-09-01
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 9 3 — — $8,424.04 $39,923.17 $26,702.93 2026-09-01
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 9 3 — — $9,148.57 $42,550.16 $26,660.16 2026-09-01
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/mcc 9 3 — — $10,150.81 $39,843.76 $26,649.82 2026-09-01
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 9 3 — — $9,169.45 $42,495.02 $26,625.61 2026-09-01
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 10 4 — — $13,532.00 $47,790.02 $26,552.43 2026-09-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 52 5 — — $2.17 $70,811.79 $26,513.44 2026-09-01
575 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 9 3 — — $11,566.48 $39,636.43 $26,511.14 2026-09-01
75 MS_DRG Viral Meningitis With Cc/mcc 9 3 — — $15,214.21 $42,294.30 $26,499.85 2026-09-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 35 5 — — $15,532.14 $204,038.00 $26,467.86 2026-09-01
902 MS_DRG Wound Debridements For Injuries With Cc 9 3 — — $21,721.46 $42,228.13 $26,458.39 2026-09-01
165 MS_DRG Major Chest Procedures Without Cc/mcc 49 5 — — $4.03 $62,299.77 $26,454.24 2026-09-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 49 5 — — $1.92 $75,249.66 $26,388.51 2026-09-01
801 MS_DRG Splenic Procedures Without Cc/mcc 9 3 — — $14,054.33 $42,104.61 $26,381.00 2026-09-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 49 5 — — $4.70 $65,941.10 $26,265.01 2026-09-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 9 3 — — $22,234.07 $41,253.21 $26,261.33 2026-09-01
603 MS_DRG Cellulitis Without Mcc 49 5 — — $0.85 $93,601.30 $26,218.66 2026-09-01
303 MS_DRG Atherosclerosis Without Mcc 45 5 — — $5,802.55 $78,865.27 $26,192.95 2026-09-01
717 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc 9 3 — — $9,551.56 $41,698.76 $26,126.71 2026-09-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 32 5 — — $8,577.42 $110,007.08 $25,980.60 2026-09-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 49 5 — — $1.65 $78,505.27 $25,971.66 2026-09-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 9 3 — — $22,099.16 $38,758.56 $25,923.97 2026-09-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 36 5 — — $9,426.69 $66,614.35 $25,879.60 2026-09-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 9 3 — — $7,082.50 $41,134.10 $25,772.92 2026-09-01
L5859 HCPCS Dme Pos 10 1 — — $10,564.07 $62,188.04 $25,752.42 2026-09-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 45 5 — — $9,791.68 $67,945.94 $25,712.50 2026-09-01
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 9 3 — — $19,033.16 $41,001.76 $25,690.00 2026-09-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 49 5 — — $4.69 $182,725.76 $25,620.86 2026-09-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 10 4 — — $10,825.00 $39,016.63 $25,484.61 2026-09-01
754 MS_DRG Malignancy, Female Reproductive System With Mcc 9 3 — — $13,257.76 $40,622.38 $25,452.29 2026-09-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 9 3 — — $14,226.59 $40,512.09 $25,383.19 2026-09-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 10 4 — — $10,825.00 $39,788.62 $25,371.78 2026-09-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 9 3 — — $12,425.69 $40,470.18 $25,356.94 2026-09-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 5 — — $0.77 $124,004.45 $25,356.48 2026-09-01
919 MS_DRG Complications Of Treatment With Mcc 9 3 — — $10,567.37 $40,381.96 $25,301.66 2026-09-01
A9545 HCPCS I131 Tositumomab, Rx 5 1 — — $19,250.00 $37,030.31 $25,278.18 2026-09-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 9 3 — — $10,331.42 $40,320.20 $25,262.96 2026-09-01
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 9 3 — — $17,479.08 $34,228.05 $25,185.71 2026-09-01
116 MS_DRG Intraocular Procedures With Cc/mcc 9 3 — — $6,906.06 $39,881.26 $24,987.94 2026-09-01
686 MS_DRG Kidney And Urinary Tract Neoplasms With Mcc 9 3 — — $12,238.81 $39,784.21 $24,927.13 2026-09-01
571 MS_DRG Skin Debridement With Cc 9 3 — — $19,976.26 $37,265.30 $24,925.19 2026-09-01
671 MS_DRG Urethral Procedures With Cc/mcc 9 3 — — $11,256.41 $39,592.31 $24,806.90 2026-09-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 22 6 — — $10,800.00 $63,687.38 $24,581.29 2026-09-01
855 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures Without Cc/mcc 9 3 — — $20,093.15 $48,173.52 $24,299.56 2026-09-01
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