Price Transparencybeta Hospital negotiated rates

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 →

Export CSV
Hospital

Lake City Medical Center Suwannee Campus

Lake City, FL · CCN 101301 · Rates published

7,678 distinct procedures filed
41 distinct payers
194,711 rate rows
2026-03-01 last MRF observed
Data quality

186,934 of 194,711 rate rows are consumer-grade (96.0%)

7,777 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
template filing: same amount across many unrelated codes — excluded 4,445
exceeds 10× this hospital's gross charge — excluded from medians 1,897
per-diem day rate — not a per-procedure price 469
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 362
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 345
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 199
placeholder amount (≤ $0.02) — excluded from medians 49
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 11
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/95-4176924_HCA-FLORIDA-LAKE-CITY-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://hcafloridahealthcare.com/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-10-22
Content fingerprint 6f1b43cd80f3b49e… · 244,366,261 bytes · first seen 2026-05-11

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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,850,948.67 $4,850,948.67 $4,850,948.67 nat. median
$2,994,107
1.6× median
906
OTHER 		Inj Elivaldogene Autoteme 17 $3,180,000.00 $3,816,000.00 $3,339,000.00 nat. median
$24,952
outlier · 133.8×
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 $920,834.85 $920,834.85 $920,834.85 nat. median
$622,245
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 $878,117.20 $878,117.20 $878,117.20 nat. median
$608,101
1.4× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 $807,592.83 $807,592.83 $807,592.83 nat. median
$591,650
1.4× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $517,662.00 $517,662.00 $517,662.00 nat. median
$249,124
outlier · 2.1×
215
MS_DRG 		Other Heart Assist System Implant 1 $272,653.00 $272,653.00 $272,653.00 nat. median
$93,917
outlier · 2.9×
1907
OTHER 		New Technology - Level 52 17 $155,876.90 $187,052.28 $163,670.74 nat. median
$155,877
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 11 $127,555.94 $191,333.91 $153,067.13 nat. median
$247,214
0.6× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $134,726.00 $134,726.00 $134,726.00 nat. median
$57,804
outlier · 2.3×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $126,801.00 $126,801.00 $126,801.00 nat. median
$66,649
1.9× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $118,877.00 $118,877.00 $118,877.00 nat. median
$59,558
2.0× median
319
MS_DRG 		Other Endovascular Cardiac Valve Procedures With Mcc 1 $118,877.00 $118,877.00 $118,877.00 nat. median
$41,619
outlier · 2.9×
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 $34,972.05 $118,877.00 $118,877.00 nat. median
$45,888
outlier · 2.6×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $47,999.62 $118,877.00 $118,877.00 nat. median
$62,038
1.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $78,863.70 $118,877.00 $118,877.00 nat. median
$97,414
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $71,028.49 $118,877.00 $118,877.00 nat. median
$90,581
1.3× median
1599
OTHER 		New Technology - Level 48 17 $97,103.81 $116,524.57 $101,959.00 nat. median
$97,104
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $100,239.80 $100,239.80 $100,239.80 nat. median
$126,722
0.8× median
269
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 $31,112.25 $95,102.00 $95,102.00 nat. median
$40,092
outlier · 2.4×
271
MS_DRG 		Other Major Cardiovascular Procedures With Cc 1 $95,102.00 $95,102.00 $95,102.00 nat. median
$34,048
outlier · 2.8×
272
MS_DRG 		Other Major Cardiovascular Procedures Without Cc/mcc 1 $95,102.00 $95,102.00 $95,102.00 nat. median
$24,851
outlier · 3.8×
279
MS_DRG 		Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 1 $26,683.81 $95,102.00 $95,102.00 nat. median
$31,993
outlier · 3.0×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 11 $77,520.20 $116,280.30 $93,024.24 nat. median
$154,011
0.6× median
24
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$36,642
1.8× median
26
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures With Cc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$29,611
outlier · 2.3×
32
MS_DRG 		Ventricular Shunt Procedures With Cc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$20,676
outlier · 3.3×
34
MS_DRG 		Carotid Artery Stent Procedures With Mcc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$36,390
1.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$74,460
0.9× median
36
MS_DRG 		Carotid Artery Stent Procedures Without Cc/mcc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$18,636
outlier · 3.6×
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$32,364
outlier · 2.1×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$51,590
1.3× median
27
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$24,379
outlier · 2.8×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 $67,364.00 $67,364.00 $67,364.00 nat. median
$53,532
1.3× median
58544
CPT 		Laparoscopy, Surgical, Supracervical Hysterectomy, For Uterus Greater Than 250 G… 1 $27,648.00 $66,131.00 $66,131.00 nat. median
$10,283
outlier · 6.4×
0515T
CPT 		Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including… 1 $64,410.00 $64,410.00 $64,410.00 nat. median
$22,680
outlier · 2.8×
0915T
CPT 		Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 $64,410.00 $64,410.00 $64,410.00 nat. median
$32,703
2.0× median
462
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 $63,401.00 $63,401.00 $63,401.00 nat. median
$26,439
outlier · 2.4×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 $63,401.00 $63,401.00 $63,401.00 nat. median
$53,342
1.2× median
05244
OTHER 		Level 4 Blood Product Exc 1 $62,571.25 $62,571.25 $62,571.25 nat. median
$57,707
1.1× median
00717
OTHER 		Instill Adstiladrin, Tx D 1 $62,346.55 $62,346.55 $62,346.55 nat. median
$62,347
1.0× median
O000004001
CDM 		Cysto Add On To Eswl 14 $8,211.36 $131,968.35 $60,998.70 nat. median
$26,265
outlier · 2.3×
37
MS_DRG 		Extracranial Procedures With Mcc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$31,308
1.9× median
471
MS_DRG 		Cervical Spinal Fusion With Mcc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$44,860
1.3× median
472
MS_DRG 		Cervical Spinal Fusion With Cc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$28,262
outlier · 2.1×
40
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$35,905
1.7× median
473
MS_DRG 		Cervical Spinal Fusion Without Cc/mcc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$23,504
outlier · 2.5×
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$19,268
outlier · 3.1×
39
MS_DRG 		Extracranial Procedures Without Cc/mcc 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$12,026
outlier · 4.9×
41
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 1 $59,438.00 $59,438.00 $59,438.00 nat. median
$21,312
outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 7,678 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,850,948.67 $4,850,948.67 $4,850,948.67 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 20 17 — — $3,180,000.00 $3,816,000.00 $3,339,000.00 2026-03-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 1 1 — — $920,834.85 $920,834.85 $920,834.85 2026-03-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 1 1 — — $878,117.20 $878,117.20 $878,117.20 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 1 1 — — $807,592.83 $807,592.83 $807,592.83 2026-03-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $517,662.00 $517,662.00 $517,662.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 2 1 — — $272,653.00 $272,653.00 $272,653.00 2026-03-01
1907 OTHER New Technology - Level 52 20 17 — — $155,876.90 $187,052.28 $163,670.74 2026-03-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 13 11 — — $127,555.94 $191,333.91 $153,067.13 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $134,726.00 $134,726.00 $134,726.00 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $126,801.00 $126,801.00 $126,801.00 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 1 — — $78,863.70 $118,877.00 $118,877.00 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 1 — — $34,972.05 $118,877.00 $118,877.00 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 1 — — $71,028.49 $118,877.00 $118,877.00 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 1 — — $47,999.62 $118,877.00 $118,877.00 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 1 — — $118,877.00 $118,877.00 $118,877.00 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $118,877.00 $118,877.00 $118,877.00 2026-03-01
1599 OTHER New Technology - Level 48 20 17 — — $97,103.81 $116,524.57 $101,959.00 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $100,239.80 $100,239.80 $100,239.80 2026-03-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 1 — — $95,102.00 $95,102.00 $95,102.00 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 1 — — $31,112.25 $95,102.00 $95,102.00 2026-03-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 1 — — $26,683.81 $95,102.00 $95,102.00 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 1 — — $95,102.00 $95,102.00 $95,102.00 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 11 — — $77,520.20 $116,280.30 $93,024.24 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
32 MS_DRG Ventricular Shunt Procedures With Cc 2 1 — — $67,364.00 $67,364.00 $67,364.00 2026-03-01
58544 CPT Laparoscopy, Surgical, Supracervical Hysterectomy, For Uterus Greater Than 250 G… 3 1 — — $27,648.00 $66,131.00 $66,131.00 2026-03-01
0915T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 1 1 — — $64,410.00 $64,410.00 $64,410.00 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $63,401.00 $63,401.00 $63,401.00 2026-03-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 1 — — $63,401.00 $63,401.00 $63,401.00 2026-03-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $62,571.25 $62,571.25 $62,571.25 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $62,346.55 $62,346.55 $62,346.55 2026-03-01
O000004001 CDM Cysto Add On To Eswl 26 14 $146,631.50 $146,631.50 $8,211.36 $131,968.35 $60,998.70 2026-03-01
67 MS_DRG Precerebral Occlusion Without Infarction With Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
39 MS_DRG Extracranial Procedures Without Cc/mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
38 MS_DRG Extracranial Procedures With Cc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
37 MS_DRG Extracranial Procedures With Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
30 MS_DRG Spinal Procedures Without Cc/mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
69 MS_DRG Transient Ischemia Without Thrombolytic 2 1 — — $59,438.00 $59,438.00 $59,438.00 2026-03-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 3 1 — — $5,704.73 $59,438.00 $59,438.00 2026-03-01
1595 OTHER New Technology - Level 44 20 17 — — $56,218.21 $67,461.85 $59,029.12 2026-03-01
265 MS_DRG Aicd Lead Procedures 2 1 — — $57,458.00 $57,458.00 $57,458.00 2026-03-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 2 1 — — $55,477.00 $55,477.00 $55,477.00 2026-03-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 2 1 — — $55,477.00 $55,477.00 $55,477.00 2026-03-01
300 MS_DRG Peripheral Vascular Disorders With Cc 2 1 — — $55,477.00 $55,477.00 $55,477.00 2026-03-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 2 1 — — $54,531.00 $54,531.00 $54,531.00 2026-03-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 1 — — $54,531.00 $54,531.00 $54,531.00 2026-03-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 1 — — $30,410.79 $54,531.00 $54,531.00 2026-03-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 2 1 — — $54,531.00 $54,531.00 $54,531.00 2026-03-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 1 — — $54,531.00 $54,531.00 $54,531.00 2026-03-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 2 1 — — $54,531.00 $54,531.00 $54,531.00 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 1 — — $38,164.15 $53,496.00 $53,496.00 2026-03-01
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $53,496.00 $53,496.00 $53,496.00 2026-03-01
254 MS_DRG Other Vascular Procedures Without Cc/mcc 2 1 — — $53,496.00 $53,496.00 $53,496.00 2026-03-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 1 — — $53,496.00 $53,496.00 $53,496.00 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 2 1 — — $53,496.00 $53,496.00 $53,496.00 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc Trauma 1 1 — — $52,288.76 $52,288.76 $52,288.76 2026-03-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 2 1 — — $51,513.00 $51,513.00 $51,513.00 2026-03-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 2 1 — — $51,513.00 $51,513.00 $51,513.00 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 13 11 — — $42,730.78 $64,096.17 $51,276.94 2026-03-01
C000033701 CDM Ins Icd Lead/generator 25 13 $120,856.75 $120,856.75 $6,767.98 $108,771.07 $50,276.41 2026-03-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 3 2 — — $39,717.00 $49,531.00 $49,531.00 2026-03-01
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 3 2 — — $39,717.00 $49,531.00 $49,531.00 2026-03-01
C000034001 CDM Rem/replace Icd Gen Mult 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000033801 CDM Rem/replace Icd Gen Sgl 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000033001 CDM Ins Icd Gen Only Mult Ld 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
C000033901 CDM Rem/replace Icd Gen Dual 25 13 $116,936.25 $116,936.25 $6,548.43 $105,242.63 $48,645.48 2026-03-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without 2 1 — — $47,551.00 $47,551.00 $47,551.00 2026-03-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 1 — — $22,568.41 $47,551.00 $47,551.00 2026-03-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 2 1 — — $47,551.00 $47,551.00 $47,551.00 2026-03-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 1 — — $47,551.00 $47,551.00 $47,551.00 2026-03-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 1 — — $47,551.00 $47,551.00 $47,551.00 2026-03-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 1 — — $47,551.00 $47,551.00 $47,551.00 2026-03-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 1 — — $47,551.00 $47,551.00 $47,551.00 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 1 1 — — $46,899.70 $46,899.70 $46,899.70 2026-03-01
61798 CPT Stereotactic Radiosurgery (particle Beam, Gamma Ray, Or Linear Accelerator); 1 C… 2 2 — — $6,073.00 $84,464.00 $45,268.50 2026-03-01
620 MS_DRG O.r. Procedures For Obesity With Cc 4 3 — — $11,394.39 $49,531.00 $44,624.00 2026-03-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 1 — — $43,588.00 $43,588.00 $43,588.00 2026-03-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 3 1 — — $11,823.99 $43,588.00 $43,588.00 2026-03-01
C000032901 CDM Ins Icd Gen Only Dual Ld 25 13 $101,088.00 $101,088.00 $5,660.93 $90,979.20 $42,052.61 2026-03-01
C000033401 CDM Ins Icd Gen Only Sgl Ld 25 13 $101,088.00 $101,088.00 $5,660.93 $90,979.20 $42,052.61 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 13 11 — — $34,140.79 $51,211.18 $40,968.95 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 1 1 — — $40,754.58 $40,754.58 $40,754.58 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 1 — — $40,747.28 $40,747.28 $40,747.28 2026-03-01
O000002901 CDM Eswl-bilateral 30 13 $149,763.25 $149,763.25 $8,386.74 $134,786.92 $40,361.19 2026-03-01
O000002801 CDM Eswl-unilateral 30 13 $149,763.25 $149,763.25 $8,386.74 $134,786.92 $40,361.19 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $40,011.48 $40,011.48 $40,011.48 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 1 1 — — $39,976.89 $39,976.89 $39,976.89 2026-03-01
33202 CPT Insertion Of Epicardial Electrode(s); Open Incision (eg, Thoracotomy, Median Ste… 7 4 — — $6,641.00 $42,268.00 $39,626.00 2026-03-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 2 1 — — $39,626.00 $39,626.00 $39,626.00 2026-03-01
33213 CPT Insertion Of Pacemaker Pulse Generator Only; With Existing Dual Leads 7 4 — — $3,242.00 $42,268.00 $39,626.00 2026-03-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 2 1 — — $39,626.00 $39,626.00 $39,626.00 2026-03-01
33233 CPT Removal Of Permanent Pacemaker Pulse Generator Only 6 3 — — $3,242.00 $42,268.00 $39,626.00 2026-03-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 7 4 — — $3,242.00 $83,378.00 $39,626.00 2026-03-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 2 1 — — $39,626.00 $39,626.00 $39,626.00 2026-03-01
33244 CPT Removal Of Single Or Dual Chamber Implantable Defibrillator Electrode(s); By Tra… 7 4 — — $6,641.00 $42,268.00 $39,626.00 2026-03-01
33210 CPT Insertion Or Replacement Of Temporary Transvenous Single Chamber Cardiac Electro… 6 3 — — $6,641.00 $42,268.00 $39,626.00 2026-03-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 7 4 — — $6,641.00 $83,378.00 $39,626.00 2026-03-01
33229 CPT Removal Of Permanent Pacemaker Pulse Generator With Replacement Of Pacemaker Pul… 7 4 — — $3,242.00 $42,268.00 $39,626.00 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $38,673.18 $38,673.18 $38,673.18 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 2 2 — — $36,237.40 $39,055.87 $37,646.64 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 42 24 — — $11,680.00 $104,904.34 $37,618.01 2026-03-01
C000034301 CDM Ins/repl Ldls Ppm Vent 25 13 $87,991.50 $87,991.50 $4,927.52 $79,192.35 $36,604.46 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 44 24 — — $9,905.00 $203,272.31 $36,380.36 2026-03-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 2 1 — — $35,663.00 $35,663.00 $35,663.00 2026-03-01
33207 CPT Insertion Of New Or Replacement Of Permanent Pacemaker With Transvenous Electrod… 3 1 — — $21,437.00 $38,807.00 $35,328.00 2026-03-01
N000000501 CDM Lvl 5 Bedside Proc 26 14 $82,881.00 $82,881.00 $4,641.34 $74,592.90 $34,478.50 2026-03-01
C000024901 CDM Cth Plc/inj R&lhc/grafts 25 13 $82,089.25 $82,089.25 $4,597.00 $73,880.32 $34,149.13 2026-03-01
C000041201 CDM Ins Rvad Perc Venous 26 14 $80,775.00 $80,775.00 $4,523.40 $72,697.50 $33,602.40 2026-03-01
C000013001 CDM Ptca Stent W Angio Addl 25 13 $78,325.00 $78,325.00 $4,386.20 $70,492.50 $32,583.20 2026-03-01
C000012501 CDM Ptca Stent W Angio Sgl 25 13 $78,325.00 $78,325.00 $4,386.20 $70,492.50 $32,583.20 2026-03-01
C000004101 CDM Perc Drug El Cor Stnt Ad 25 13 $78,325.00 $78,325.00 $4,386.20 $70,492.50 $32,583.20 2026-03-01
C000004701 CDM Perc Drug El Cor Stnt Sl 25 13 $78,325.00 $78,325.00 $4,386.20 $70,492.50 $32,583.20 2026-03-01
C000024601 CDM Cth Plc/inj Lhc & L Vent 25 13 $78,317.75 $78,317.75 $4,385.79 $70,485.98 $32,580.18 2026-03-01
C000024801 CDM Cth Plc/inj R&lhc/l Vent 25 13 $77,347.25 $77,347.25 $4,331.45 $69,612.52 $32,176.46 2026-03-01
43644 CPT Laparoscopy, Surgical, Gastric Restrictive Procedure; With Gastric Bypass And Ro… 4 3 — — $3,242.00 $49,531.00 $31,806.00 2026-03-01
C000024701 CDM Cth Plc/inj Lhc W Graft 25 13 $74,670.00 $74,670.00 $4,181.52 $67,203.00 $31,062.72 2026-03-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 13 11 — — $25,123.52 $37,685.28 $30,148.22 2026-03-01
33225 CPT Insertion Of Pacing Electrode, Cardiac Venous System, For Left Ventricular Pacin… 4 2 — — $3,242.00 $42,268.00 $29,970.00 2026-03-01
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 4 2 — — $3,242.00 $42,268.00 $29,970.00 2026-03-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 2 1 — — $29,719.00 $29,719.00 $29,719.00 2026-03-01
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 10 7 — — $2,250.00 $83,378.00 $28,649.00 2026-03-01
33211 CPT Insertion Or Replacement Of Temporary Transvenous Dual Chamber Pacing Electrodes… 8 5 — — $2,250.00 $42,268.00 $28,649.00 2026-03-01
33237 CPT Removal Of Permanent Epicardial Pacemaker And Electrodes By Thoracotomy; Dual Le… 8 5 — — $2,250.00 $42,268.00 $28,649.00 2026-03-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 10 7 — — $2,250.00 $83,378.00 $28,649.00 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $28,637.87 $28,637.87 $28,637.87 2026-03-01
C1822 HCPCS Implant Pulse 8.5x15.5in 18 12 $57,000.00 $57,000.00 $3,192.00 $51,300.00 $28,500.00 2026-03-01
C000032101 CDM Art Thrmb Noncor Ini Vsl 26 14 $67,885.00 $67,885.00 $3,801.56 $61,096.50 $28,240.16 2026-03-01
I000197002 CDM Periph Ath Ili Art Each 26 14 $67,688.25 $67,688.25 $3,790.54 $60,919.43 $28,158.31 2026-03-01
I000031802 CDM Vasc Emboliz Arterial 26 14 $67,687.25 $67,687.25 $3,790.49 $60,918.53 $28,157.90 2026-03-01
93623 CPT Programmed Stimulation And Pacing After Intravenous Drug Infusion (List Separate… 4 3 — — $10,204.00 $27,266.00 $27,178.50 2026-03-01
36832 CPT Revision, Open, Arteriovenous Fistula; Without Thrombectomy, Autogenous Or Nonau… 4 3 — — $10,204.00 $27,266.00 $27,178.50 2026-03-01
C9602 HCPCS Percutaneous Transluminal Coronary Atherectomy, With Drug Eluting Intracoronary … 4 3 — — $10,204.00 $27,266.00 $27,178.50 2026-03-01
36838 CPT Distal Revascularization And Interval Ligation (dril), Upper Extremity Hemodialy… 4 3 — — $10,204.00 $27,266.00 $27,178.50 2026-03-01
36810 CPT Insertion Of Cannula For Hemodialysis, Other Purpose (separate Procedure); Arter… 4 3 — — $10,204.00 $27,266.00 $27,178.50 2026-03-01
93620 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 5 4 — — $8,095.00 $27,266.00 $27,091.00 2026-03-01
93616 CPT Esophageal Recording Of Atrial Electrogram With Or Without Ventricular Electrogr… 5 4 — — $8,095.00 $27,266.00 $27,091.00 2026-03-01
93631 CPT Intra-operative Epicardial And Endocardial Pacing And Mapping To Localize The Si… 5 4 — — $8,095.00 $27,266.00 $27,091.00 2026-03-01
93583 CPT Percutaneous Transcatheter Septal Reduction Therapy (eg, Alcohol Septal Ablation… 5 4 — — $7,728.00 $27,266.00 $27,091.00 2026-03-01
36830 CPT Creation Of Arteriovenous Fistula By Other Than Direct Arteriovenous Anastomosis… 5 4 — — $9,518.00 $27,266.00 $27,091.00 2026-03-01
92987 CPT Percutaneous Balloon Valvuloplasty; Mitral Valve 5 4 — — $10,204.00 $27,266.00 $27,091.00 2026-03-01
92990 CPT Percutaneous Balloon Valvuloplasty; Pulmonary Valve 5 4 — — $10,204.00 $27,266.00 $27,091.00 2026-03-01
92928 CPT Percutaneous Transcatheter Placement Of Intracoronary Stent(s), With Coronary An… 5 4 — — $10,204.00 $27,266.00 $27,091.00 2026-03-01
92944 CPT Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary… 5 4 — — $10,523.00 $27,266.00 $27,091.00 2026-03-01
36572 CPT Insertion Of Peripherally Inserted Central Venous Catheter (picc), Without Subcu… 5 4 — — $9,518.00 $27,266.00 $27,091.00 2026-03-01
36558 CPT Insertion Of Tunneled Centrally Inserted Central Venous Catheter, Without Subcut… 5 4 — — $9,518.00 $27,266.00 $27,091.00 2026-03-01
36596 CPT Mechanical Removal Of Intraluminal (intracatheter) Obstructive Material From Cen… 5 4 — — $9,518.00 $27,266.00 $27,091.00 2026-03-01
C9605 HCPCS Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass… 5 4 — — $10,204.00 $27,266.00 $27,091.00 2026-03-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 44 24 — — $9,905.00 $140,811.89 $26,206.83 2026-03-01
C000035401 CDM Ins Lvad Perc Arterial 26 14 $60,359.50 $60,359.50 $3,380.13 $54,323.55 $25,109.55 2026-03-01
C000035501 CDM Rem Lvad Perc Sep Sess 26 14 $60,359.50 $60,359.50 $3,380.13 $54,323.55 $25,109.55 2026-03-01
93609 CPT Intraventricular And/or Intra-atrial Mapping Of Tachycardia Site(s) With Cathete… 6 5 — — $8,095.00 $27,266.00 $24,693.00 2026-03-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 41 24 — — $11,680.00 $78,075.00 $24,328.73 2026-03-01
C1820 HCPCS Device Neurostimulator 54 12 $51,900.00 $51,900.00 $1,596.17 $51,030.00 $24,227.55 2026-03-01
C9608 HCPCS Percutaneous Transluminal Revascularization Of Chronic Total Occlusion, Coronary… 3 3 — — $10,204.00 $27,091.00 $24,030.00 2026-03-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 13 11 — — $19,305.57 $28,958.35 $23,166.68 2026-03-01
C1882 HCPCS Crt Defib Card 71x51x12 36 12 $46,159.50 $46,159.50 $2,528.57 $42,449.40 $23,079.75 2026-03-01
27138 CPT Revision Of Total Hip Arthroplasty; Femoral Component Only, With Or Without Allo… 27 17 — — $2,250.00 $43,358.00 $22,627.00 2026-03-01
C000024001 CDM Cath Hrt Lt/inj L Vent 25 13 $54,301.25 $54,301.25 $3,040.87 $48,871.13 $22,589.32 2026-03-01
37229 CPT Revascularization, Endovascular, Open Or Percutaneous, Tibial, Peroneal Artery, … 3 3 — — $21,996.80 $23,154.53 $22,459.89 2026-03-01
93612 CPT Intraventricular Pacing 1 1 — — $22,295.00 $22,295.00 $22,295.00 2026-03-01
36575 CPT Repair Of Tunneled Or Non-tunneled Central Venous Access Catheter, Without Subcu… 1 1 — — $22,295.00 $22,295.00 $22,295.00 2026-03-01
92938 CPT Percutaneous Transluminal Revascularization Of Or Through Coronary Artery Bypass… 1 1 — — $22,295.00 $22,295.00 $22,295.00 2026-03-01
C000032501 CDM Lv Lead New/upgd Ppm/icd 25 13 $53,166.00 $53,166.00 $2,977.30 $47,849.40 $22,117.06 2026-03-01
C000008701 CDM Ins Lv Ld W Exst Ppm/icd 25 13 $53,166.00 $53,166.00 $2,977.30 $47,849.40 $22,117.06 2026-03-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 6 2 — — $15,631.00 $54,531.00 $21,886.14 2026-03-01
33217 CPT Insertion Of 2 Transvenous Electrodes, Permanent Pacemaker Or Implantable Defibr… 2 1 — — $21,852.00 $21,852.00 $21,852.00 2026-03-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $21,700.38 $21,700.38 $21,700.38 2026-03-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc Tr… 1 1 — — $21,256.68 $21,256.68 $21,256.68 2026-03-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 44 24 — — $9,905.00 $115,420.17 $21,128.61 2026-03-01
5224 OTHER Level 4 Pacemaker And Sim 20 17 — — $20,114.58 $24,137.50 $21,120.31 2026-03-01
2304 APR_DRG Major Small Bowel Procedures 13 11 — — $17,384.47 $26,076.71 $20,861.36 2026-03-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours Trauma 1 1 — — $20,525.78 $20,525.78 $20,525.78 2026-03-01
C1767 HCPCS Nrstm Imp 44mm 51mm 72 12 $40,854.75 $40,854.75 $1,629.60 $51,705.00 $20,519.17 2026-03-01
32608 CPT Thoracoscopy; With Diagnostic Biopsy(ies) Of Lung Nodule(s) Or Mass(es) (eg, Wed… 11 4 — — $9,010.00 $26,752.00 $20,498.00 2026-03-01
62362 CPT Implantation Or Replacement Of Device For Intrathecal Or Epidural Drug Infusion;… 12 5 — — $3,950.00 $26,752.00 $20,498.00 2026-03-01
31295 CPT Nasal/sinus Endoscopy, Surgical, With Dilation (eg, Balloon Dilation); Maxillary… 13 6 — — $3,950.00 $26,752.00 $20,498.00 2026-03-01
52597 CPT Transurethral Robotic-assisted Waterjet Resection Of Prostate, Including Intraop… 10 3 — — $9,010.00 $26,752.00 $20,498.00 2026-03-01
22548 CPT Arthrodesis, Anterior Transoral Or Extraoral Technique, Clivus-c1-c2 (atlas-axis… 17 9 — — $3,950.00 $37,129.00 $20,498.00 2026-03-01
21454 CPT Open Treatment Of Mandibular Fracture With External Fixation 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
20838 CPT Replantation, Foot, Complete Amputation 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
25825 CPT Arthrodesis, Wrist; With Autograft (includes Obtaining Graft) 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
60200 CPT Excision Of Cyst Or Adenoma Of Thyroid, Or Transection Of Isthmus 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
15876 CPT Suction Assisted Lipectomy; Head And Neck 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
21172 CPT Reconstruction Superior-lateral Orbital Rim And Lower Forehead, Advancement Or A… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
57109 CPT Vaginectomy, Partial Removal Of Vaginal Wall; With Removal Of Paravaginal Tissue… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
25442 CPT Arthroplasty With Prosthetic Replacement; Distal Ulna 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
53460 CPT Urethromeatoplasty, With Partial Excision Of Distal Urethral Segment (Richardson… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
53430 CPT Urethroplasty, Reconstruction Of Female Urethra 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
25447 CPT Arthroplasty, Intercarpal Or Carpometacarpal Joints; Interposition (eg, Tendon) 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
20805 CPT Replantation, Forearm (includes Radius And Ulna To Radial Carpal Joint), Complet… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
69421 CPT Myringotomy Including Aspiration And/or Eustachian Tube Inflation Requiring Gene… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
26428 CPT Repair Of Extensor Tendon, Central Slip, Secondary (eg, Boutonniere Deformity); … 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
26434 CPT Repair Of Extensor Tendon, Distal Insertion, Primary Or Secondary; With Free Gra… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
62330 CPT Decompression, Percutaneous, With Partial Removal Of The Ligamentum Flavum, Incl… 10 3 — — $4,121.00 $26,752.00 $20,445.50 2026-03-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
514 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 2 — — $15,631.00 $27,626.50 $20,422.00 2026-03-01
376 MS_DRG Digestive Malignancy Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 5 2 — — $15,631.00 $43,588.00 $20,422.00 2026-03-01
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
181 MS_DRG Respiratory Neoplasms With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
176 MS_DRG Pulmonary Embolism Without Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
245 MS_DRG Aicd Generator Procedures 5 2 — — $15,631.00 $57,458.00 $20,422.00 2026-03-01
204 MS_DRG Respiratory Signs And Symptoms 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
334 MS_DRG Rectal Resection Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
358 MS_DRG Other Digestive System O.r. Procedures Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
149 MS_DRG Dysequilibrium 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 2 — — $15,631.00 $31,612.67 $20,422.00 2026-03-01
500 MS_DRG Soft Tissue Procedures With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
117 MS_DRG Intraocular Procedures Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
113 MS_DRG Orbital Procedures With Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
508 MS_DRG Major Shoulder Or Elbow Joint Procedures Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 2 — — $15,631.00 $26,822.37 $20,422.00 2026-03-01
103 MS_DRG Headaches Without Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
550 MS_DRG Septic Arthritis Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
553 MS_DRG Bone Diseases And Arthropathies With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
374 MS_DRG Digestive Malignancy With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 5 2 — — $15,631.00 $29,719.00 $20,422.00 2026-03-01
153 MS_DRG Otitis Media And Uri Without Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
333 MS_DRG Rectal Resection With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
497 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
121 MS_DRG Acute Major Eye Infections With Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 5 2 — — $15,631.00 $51,513.00 $20,422.00 2026-03-01
533 MS_DRG Fractures Of Femur With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 2 — — $15,631.00 $52,015.21 $20,422.00 2026-03-01
158 MS_DRG Dental And Oral Diseases With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
159 MS_DRG Dental And Oral Diseases Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
487 MS_DRG Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 5 2 — — $15,631.00 $51,513.00 $20,422.00 2026-03-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
505 MS_DRG Foot Procedures Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 5 2 — — $15,631.00 $51,513.00 $20,422.00 2026-03-01
164 MS_DRG Major Chest Procedures With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
503 MS_DRG Foot Procedures With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
381 MS_DRG Complicated Peptic Ulcer With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
264 MS_DRG Other Circulatory System O.r. Procedures 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
506 MS_DRG Major Thumb Or Joint Procedures 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
548 MS_DRG Septic Arthritis With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
416 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 1 — — $15,631.00 $20,422.00 $20,422.00 2026-03-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 5 2 — — $15,631.00 $54,531.00 $20,422.00 2026-03-01
See an error in this hospital's data? Submit a correction