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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

WELLSTAR SPALDING MEDICAL CENTER

Griffin, GA · CCN 110031 · Rates published

46,513 distinct procedures filed
26 distinct payers
250,057 rate rows
2026-07-31 last MRF observed
Data quality

143,097 of 250,057 rate rows are consumer-grade (57.2%)

106,960 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 106,872
placeholder amount (≤ $0.02) — excluded from medians 50
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 28
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.wellstar.org/wellstar-spalding-regional-hospital_standard-charges
Found on page https://www.wellstar.org/financial-policy-and-privacy-info/hospital-pricing-transparency
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-08-17
Content fingerprint a42080542bd840e0… · 54,807,021 bytes · first seen 2026-05-05

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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $0.03 $3,943,235.33 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.03 $3,548,614.97 $3,316,462.59 nat. median
$3,324,572
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 8 $0.03 $4,812,016.79 $2,577,866.14 nat. median
$2,460,273
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $0.03 $1,159,783.35 $627,229.78 nat. median
$691,418
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $0.03 $1,152,532.70 $596,290.47 nat. median
$624,417
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 8 $0.03 $1,109,103.13 $594,162.39 nat. median
$631,793
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $0.03 $1,178,375.50 $590,757.01 nat. median
$610,161
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $0.03 $1,120,267.47 $565,223.98 nat. median
$588,565
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $0.03 $1,120,791.00 $518,662.89 nat. median
$577,541
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 14 $336,450.71 $1,512,329.86 $465,984.23 nat. median
$370,165
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $219,316.51 $1,129,585.31 $303,753.37 nat. median
$261,939
1.2× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 3 $235,544.87 $355,377.59 $292,076.17 nat. median
$83,623
outlier · 3.5×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $167,750.54 $951,379.17 $232,334.50 nat. median
$205,166
1.1× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 3 $176,293.17 $265,981.76 $218,603.92 nat. median
$62,767
outlier · 3.5×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $109,804.32 $566,633.43 $209,177.23 nat. median
$132,706
1.6× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 3 $162,577.37 $245,288.10 $201,596.30 nat. median
$57,648
outlier · 3.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 14 $162,156.00 $859,436.74 $178,457.10 nat. median
$199,832
0.9× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 3 $122,421.45 $184,702.98 $151,802.88 nat. median
$46,399
outlier · 3.3×
7
MS_DRG 		Lung Transplant 14 $102,840.66 $524,075.06 $142,434.32 nat. median
$122,690
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $95,636.69 $525,398.49 $132,456.82 nat. median
$114,305
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $90,335.14 $441,934.05 $125,114.17 nat. median
$108,240
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $87,935.10 $420,354.09 $121,790.12 nat. median
$96,835
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 14 $86,798.45 $436,856.88 $120,215.85 nat. median
$100,978
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 9 $56,824.55 $240,299.05 $118,734.79 nat. median
$63,643
1.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $117,940.04 $117,940.04 $117,940.04 nat. median
$75,807
1.6× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 8 $63,342.28 $226,806.00 $114,360.00 nat. median
$69,291
1.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $82,443.46 $427,051.45 $114,184.19 nat. median
$99,646
1.1× median
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 4 $27,314.00 $146,696.42 $112,787.69 nat. median
$37,051
outlier · 3.0×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 9 $55,272.32 $196,075.84 $104,053.18 nat. median
$65,655
1.6× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 16 $46,605.00 $309,010.00 $103,935.59 nat. median
$65,958
1.6× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 $72,391.29 $334,467.36 $100,261.93 nat. median
$81,124
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 15 $57,870.54 $345,790.00 $98,379.92 nat. median
$68,581
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $90,234.69 $176,859.99 $94,746.42 nat. median
$96,134
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $67,707.13 $339,624.73 $93,774.38 nat. median
$80,459
1.2× median
90288
HCPCS 		Botulism Ig IV 1 $92,831.73 $92,831.73 $92,831.73 nat. median
$52,716
1.8× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 17 $6,742.00 $238,418.28 $92,772.07 nat. median
$51,433
1.8× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 16 $2,359.00 $259,380.64 $92,390.85 nat. median
$62,218
1.5× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 17 $1,824.00 $275,744.00 $89,683.50 nat. median
$47,707
1.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $63,576.22 $323,258.29 $88,053.07 nat. median
$77,385
1.1× median
38240
HCPCS 		Transplt Allo Hct/donor 9 $6,760.00 $240,440.90 $87,381.52 nat. median
$13,835
outlier · 6.3×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 $61,652.95 $299,324.22 $85,389.34 nat. median
$71,485
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 14 $33,532.00 $424,869.80 $85,291.77 nat. median
$98,002
0.9× median
J9226
HCPCS 		Supprelin La Implant 9 $45,020.65 $163,593.70 $84,778.60 nat. median
$55,200
1.5× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $36,995.00 $387,019.64 $83,851.48 nat. median
$92,900
0.9× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 16 $49,186.83 $248,404.18 $83,617.61 nat. median
$58,419
1.4× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $58,552.07 $284,686.26 $81,094.62 nat. median
$66,640
1.2× median
10
MS_DRG 		Pancreas Transplant 14 $58,220.58 $319,733.15 $80,635.51 nat. median
$67,750
1.2× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 14 $58,197.39 $267,834.56 $80,603.38 nat. median
$62,911
1.3× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 $57,902.99 $317,892.38 $80,195.64 nat. median
$69,153
1.2× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 $55,919.45 $267,381.39 $77,448.43 nat. median
$65,792
1.2× median

Other procedures at this hospital

Browse this hospital's 46,513 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
             
834 MS_DRG Acute Leukemia With Mcc 23 15 — — $41,008.00 $221,650.80 $48,357.85 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 23 14 — — $69,686.03 $369,409.98 $74,564.05 2026-04-01
245 MS_DRG Aicd Generator Procedures 22 14 — — $38,027.37 $195,968.20 $52,667.91 2026-04-01
265 MS_DRG Aicd Lead Procedures 22 14 — — $30,731.45 $143,046.96 $42,563.06 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 22 14 — — $95,636.69 $525,398.49 $132,456.82 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 26 14 — — $14,397.00 $201,983.80 $43,659.97 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 14 — — $21,254.00 $179,842.38 $38,461.06 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 25 14 — — $29,720.75 $187,856.00 $45,021.50 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 22 14 — — $55,919.45 $267,381.39 $77,448.43 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 22 14 — — $35,406.34 $166,848.68 $49,037.78 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 26 14 — — $878.00 $99,361.67 $31,330.06 2026-04-01
509 MS_DRG Arthroscopy 7 4 — — $46,689.53 $70,442.68 $54,159.92 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 22 14 — — $48,592.62 $242,047.69 $67,300.77 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 22 14 — — $44,749.17 $242,047.69 $61,977.60 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 12 9 — — $0.03 $1,120,267.47 $565,223.98 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 22 14 — — $31,651.75 $143,724.72 $43,837.68 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 22 14 — — $29,968.01 $146,315.43 $41,505.69 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 22 14 — — $22,703.00 $96,129.29 $31,443.65 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 22 14 — — $45,450.01 $246,106.22 $62,948.26 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 22 14 — — $23,327.35 $114,841.81 $32,308.38 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 22 14 — — $30,325.01 $140,408.11 $42,000.14 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 23 15 — — $27,340.00 $137,909.64 $31,530.01 2026-04-01
90288 HCPCS Botulism Ig IV 2 1 — — $92,831.73 $92,831.73 $92,831.73 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 12 9 — — $0.03 $1,120,791.00 $518,662.89 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 25 15 — — $57,870.54 $345,790.00 $98,379.92 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 25 16 — — $49,186.83 $248,404.18 $83,617.61 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 22 14 — — $38,460.86 $186,571.83 $53,268.29 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 22 14 — — $27,052.58 $112,507.76 $37,467.82 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 15 — — $36,995.00 $387,019.64 $83,851.48 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 15 — — $36,995.00 $258,967.57 $57,331.92 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 15 — — $36,995.00 $238,582.71 $57,331.92 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 15 — — $36,995.00 $310,284.65 $66,451.50 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 15 — — $36,995.00 $212,402.82 $47,058.94 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 15 — — $36,995.00 $184,169.60 $44,639.73 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 22 14 — — $32,682.54 $155,944.40 $45,265.32 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 22 14 — — $25,538.07 $116,181.29 $35,370.22 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 22 14 — — $40,085.09 $194,785.13 $55,517.85 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 22 14 — — $39,896.55 $200,792.71 $55,256.72 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 22 14 — — $22,805.77 $102,409.57 $31,585.99 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 22 14 — — $336,450.71 $1,512,329.86 $465,984.23 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 22 14 — — $30,301.82 $140,508.37 $41,968.02 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 22 14 — — $28,298.19 $109,740.59 $39,192.99 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 11 8 — — $0.03 $1,109,103.13 $594,162.39 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 35 16 — — $17,699.00 $88,762.18 $33,480.25 2026-04-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 41 16 — — $3,109.00 $394,329.00 $35,244.23 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 14 — — $72,391.29 $334,467.36 $100,261.93 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 22 14 — — $47,336.20 $219,372.89 $65,560.63 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 6 3 — — $162,577.37 $245,288.10 $201,596.30 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 6 3 — — $235,544.87 $355,377.59 $292,076.17 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 6 3 — — $122,421.45 $184,702.98 $151,802.88 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 15 14 — — $90,234.69 $176,859.99 $94,746.42 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 22 14 — — $86,798.45 $436,856.88 $120,215.85 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 22 14 — — $54,440.48 $248,083.34 $75,400.07 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 23 15 — — $36,995.00 $313,444.84 $66,177.83 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 23 15 — — $36,995.00 $213,349.27 $48,132.95 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 23 15 — — $36,995.00 $339,817.23 $72,665.72 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 23 15 — — $36,995.00 $244,967.26 $53,092.92 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 23 15 — — $36,995.00 $235,963.92 $51,488.94 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 23 15 — — $35,140.53 $164,899.63 $37,600.37 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 24 15 — — $33,137.00 $170,810.96 $38,746.30 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 22 14 — — $26,798.36 $122,654.07 $37,115.73 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 22 14 — — $37,906.05 $179,345.09 $52,499.88 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 22 14 — — $54,785.11 $273,826.10 $75,877.38 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 23 14 — — $45,605.00 $228,781.29 $50,345.47 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 14 — — $33,000.90 $152,451.35 $45,706.24 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $117,940.04 $117,940.04 $117,940.04 2026-04-01
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/Mcc 23 15 — — $18,606.87 $162,159.00 $31,631.68 2026-04-01
294 MS_DRG Deep Vein Thrombophlebitis With Cc/Mcc 7 4 — — $32,638.81 $49,243.70 $37,861.07 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 25 14 — — $162,156.00 $859,436.74 $178,457.10 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 15 14 — — $46,871.02 $91,867.20 $49,214.57 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 22 14 — — $50,127.99 $240,239.00 $69,427.26 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 22 14 — — $39,560.42 $188,665.26 $54,791.18 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 12 9 — — $9,000.00 $99,912.54 $39,385.88 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 12 9 — — $9,000.00 $99,912.54 $39,385.88 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 12 9 — — $6,389.00 $168,368.63 $61,188.87 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 14 — — $167,750.54 $951,379.17 $232,334.50 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 22 14 — — $32,864.13 $173,517.98 $45,516.82 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 30 17 — — $1,751.00 $190,666.45 $67,517.14 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 36 17 — — $6,742.00 $238,418.28 $92,772.07 2026-04-01
503 MS_DRG Foot Procedures With Mcc 22 14 — — $24,340.37 $106,135.24 $33,711.42 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 38 16 — — $2,561.00 $167,257.74 $35,692.01 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 22 14 — — $58,197.39 $267,834.56 $80,603.38 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 22 14 — — $27,660.70 $127,538.74 $38,310.07 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 2 1 — — $32,325.76 $32,325.76 $32,325.76 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 22 14 — — $219,316.51 $1,129,585.31 $303,753.37 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 14 — — $90,335.14 $441,934.05 $125,114.17 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 22 14 — — $29,100.26 $141,535.04 $40,303.86 2026-04-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 31 15 — — $16,200.00 $84,547.25 $32,021.00 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 11 8 — — $6,389.00 $130,953.79 $58,415.55 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 22 14 — — $50,073.13 $253,613.69 $69,351.29 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 22 14 — — $23,152.72 $106,403.93 $32,066.51 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 30 16 — — $23,450.00 $119,750.54 $43,377.45 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 8 5 — — $13,122.00 $62,008.80 $45,520.90 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 12 9 — — $0.03 $1,178,375.50 $590,757.01 2026-04-01
69930 HCPCS Implant Cochlear Device 14 10 — — $3,721.00 $126,036.66 $45,804.50 2026-04-01
61886 HCPCS Implant Neurostim Arrays 14 10 — — $1,937.00 $117,954.23 $42,867.17 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 1 1 — — $56,095.00 $56,095.00 $56,095.00 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 1 1 — — $56,095.00 $56,095.00 $56,095.00 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 12 9 — — $4,714.00 $168,368.63 $72,612.24 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 46 17 — — $1,824.00 $275,744.00 $89,683.50 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 4 — — $0.03 $3,548,614.97 $3,316,462.59 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 11 8 — — $0.03 $4,812,016.79 $2,577,866.14 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 13 8 — — $63,342.28 $226,806.00 $114,360.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 4 — — $0.03 $3,943,235.33 $3,685,266.67 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 12 9 — — $5,809.00 $119,984.62 $54,466.96 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 12 9 — — $5,809.00 $85,026.56 $38,597.77 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 12 9 — — $9,000.00 $119,984.62 $54,466.96 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 12 9 — — $5,809.00 $168,368.63 $72,612.24 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 12 9 — — $6,389.00 $85,026.56 $38,597.77 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 12 9 — — $9,000.00 $85,026.56 $38,597.77 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 12 9 — — $9,000.00 $119,984.62 $54,466.96 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 12 9 — — $9,000.00 $119,984.62 $54,466.96 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 12 9 — — $9,000.00 $119,984.62 $54,466.96 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 12 9 — — $5,809.00 $85,026.56 $38,597.77 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 12 9 — — $5,809.00 $119,984.62 $54,466.96 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 13 10 — — $2,323.00 $85,026.56 $37,928.44 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 14 10 — — $1,694.00 $117,954.23 $42,867.17 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 14 10 — — $1,694.00 $117,954.23 $42,867.17 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 22 14 — — $43,678.96 $221,666.84 $60,495.36 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 14 — — $63,576.22 $323,258.29 $88,053.07 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 22 14 — — $27,325.35 $141,583.16 $37,845.60 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 22 14 — — $27,374.80 $130,646.80 $37,914.10 2026-04-01
652 MS_DRG Kidney Transplant 22 14 — — $27,727.93 $123,167.40 $38,403.18 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 22 14 — — $39,101.43 $184,759.13 $54,155.48 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 22 14 — — $31,408.34 $139,249.11 $43,500.55 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 22 14 — — $27,709.38 $129,279.25 $38,377.49 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 12 9 — — $5,809.00 $117,954.23 $42,867.17 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 4 4 — — $30,687.00 $116,852.00 $43,542.50 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 7 5 — — $35,112.00 $41,764.00 $41,764.00 2026-04-01
5194 OTHER Level 4 Endovascular Procedures 8 7 — — $16,697.00 $33,053.00 $32,159.39 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 3 3 — — $30,308.00 $117,046.00 $56,092.00 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 26 15 — — $27,121.00 $153,285.51 $34,079.85 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 12 9 — — $0.03 $1,152,532.70 $596,290.47 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 22 14 — — $82,443.46 $427,051.45 $114,184.19 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 22 14 — — $38,603.81 $194,460.29 $53,466.28 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 22 14 — — $30,789.40 $141,178.11 $42,643.32 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 22 14 — — $26,084.38 $101,250.57 $36,126.87 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 30 16 — — $1,043.00 $96,289.70 $42,614.79 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 26 15 — — $19,849.75 $142,409.30 $33,324.17 2026-04-01
22558 HCPCS Lumbar Spine Fusion 12 9 — — $8,245.00 $103,720.39 $37,694.28 2026-04-01
22630 HCPCS Lumbar Spine Fusion 12 9 — — $8,245.00 $103,720.39 $37,694.28 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 12 9 — — $8,245.00 $103,720.39 $40,235.18 2026-04-01
7 MS_DRG Lung Transplant 22 14 — — $102,840.66 $524,075.06 $142,434.32 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 22 14 — — $48,091.13 $233,481.48 $66,606.21 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 29 15 — — $484.00 $127,907.70 $48,874.60 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 25 14 — — $1,707.00 $187,654.64 $40,874.49 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 22 14 — — $24,403.74 $113,169.48 $33,799.18 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 22 14 — — $42,926.34 $223,547.72 $59,452.98 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 24 14 — — $11,088.00 $184,835.33 $40,022.89 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 22 14 — — $35,731.65 $169,599.82 $49,488.34 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 32 16 — — $17,724.00 $146,636.00 $34,312.70 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 36 16 — — $18,761.00 $135,813.00 $36,774.00 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 37 16 — — $25,651.00 $280,789.00 $75,050.09 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 24 14 — — $24,216.00 $163,863.00 $36,605.24 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — — $87,935.10 $420,354.09 $121,790.12 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — — $58,552.07 $284,686.26 $81,094.62 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 14 — — $46,214.99 $220,780.54 $64,007.76 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 22 14 — — $54,402.62 $268,865.24 $75,347.62 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 22 14 — — $35,542.34 $163,752.65 $49,226.14 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 22 14 — — $38,919.08 $191,504.62 $53,902.93 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 23 14 — — $27,190.90 $146,105.00 $46,224.53 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 23 14 — — $8,879.00 $143,764.82 $32,829.74 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 12 9 — — $5,063.00 $102,892.67 $46,708.08 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 14 — — $25,634.00 $140,484.31 $40,531.82 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 22 14 — — $25,084.49 $109,339.55 $34,742.01 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 22 14 — — $30,811.04 $127,282.08 $42,673.29 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 22 14 — — $32,637.72 $157,584.66 $45,203.24 2026-04-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 12 9 — — $4,714.00 $117,954.23 $42,867.17 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 12 9 — — $4,714.00 $117,954.23 $53,545.27 2026-04-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 28 16 — — $20,403.42 $101,667.65 $38,496.67 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 1 1 — — $36,995.00 $36,995.00 $36,995.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 24 15 — — $25,267.00 $199,834.22 $43,872.46 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 23 15 — — $27,109.76 $124,567.03 $36,995.00 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 36 16 — — $16,332.00 $86,359.95 $34,088.90 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 28 15 — — $400.00 $190,976.00 $56,977.82 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 22 14 — — $31,723.61 $132,411.38 $43,937.20 2026-04-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 25 15 — — $19,609.08 $90,238.01 $33,335.44 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 25 15 — — $28,683.50 $158,262.42 $33,780.55 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 22 14 — — $37,258.52 $176,156.82 $51,603.05 2026-04-01
215 MS_DRG Other Heart Assist System Implant 23 14 — — $33,532.00 $424,869.80 $85,291.77 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 23 14 — — $31,157.00 $163,106.98 $37,304.37 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 31 15 — — $18,033.00 $92,572.06 $35,434.56 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 27 14 — — $32,092.00 $169,632.00 $59,835.00 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 28 14 — — $20,101.00 $138,134.22 $47,847.17 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 28 15 — — $43,543.74 $205,845.81 $47,436.00 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 22 14 — — $23,897.61 $108,946.53 $33,098.19 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 22 14 — — $27,398.76 $124,009.59 $37,947.28 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 29 14 — — $28,144.50 $213,586.00 $34,710.70 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 22 14 — — $35,334.48 $164,807.39 $48,938.26 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 14 — — $61,652.95 $299,324.22 $85,389.34 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 22 14 — — $25,522.62 $106,022.94 $35,348.82 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 22 14 — — $33,558.79 $143,756.80 $46,478.93 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 26 15 — — $15,144.00 $154,440.50 $47,428.50 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 25 14 — — $27,797.47 $130,702.95 $47,255.70 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 27 14 — — $27,044.00 $137,564.74 $31,808.64 2026-04-01
10 MS_DRG Pancreas Transplant 22 14 — — $58,220.58 $319,733.15 $80,635.51 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 22 14 — — $25,183.40 $112,620.05 $34,879.01 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 22 14 — — $45,044.34 $217,700.55 $62,386.41 2026-04-01
J9266 HCPCS Pegaspargase Injection 14 9 — — $28,424.06 $94,617.96 $51,596.43 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 22 14 — — $34,651.40 $156,806.64 $47,992.19 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 22 14 — — $28,208.55 $125,156.56 $39,068.85 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 42 17 — — $23,040.00 $363,945.00 $60,912.21 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 51 16 — — $15,082.00 $108,914.00 $42,493.75 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 29 16 — — $15,494.00 $92,748.52 $33,384.04 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 24 15 — — $19,762.84 $90,578.89 $34,189.71 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 22 14 — — $32,609.13 $151,264.27 $45,163.64 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 26 15 — — $18,338.00 $133,535.00 $32,986.62 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 25 15 — — $28,351.00 $145,332.89 $32,491.58 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 31 16 — — $19,401.00 $136,032.77 $46,655.40 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 12 9 — — $9,842.00 $70,073.08 $31,809.64 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 12 9 — — $9,842.00 $70,073.08 $31,809.64 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 12 9 — — $9,842.00 $70,073.08 $31,809.64 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 16 9 — — $24,228.42 $92,334.41 $45,342.71 2026-04-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 25 15 — — $19,320.86 $87,382.61 $32,397.50 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 25 15 — — $26,419.00 $180,921.18 $40,576.02 2026-04-01
791 MS_DRG Prematurity With Major Problems 27 15 — — $2,467.00 $162,826.25 $36,527.18 2026-04-01
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
849 MS_DRG Radiotherapy 22 14 — — $23,709.84 $107,113.77 $32,838.13 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 12 9 — — $8,245.00 $103,720.39 $37,694.28 2026-04-01
332 MS_DRG Rectal Resection With Mcc 22 14 — — $30,750.77 $139,100.72 $42,589.82 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 43 16 — — $12,865.00 $64,828.12 $32,778.25 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 45 17 — — $4,768.00 $107,643.15 $42,262.42 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 33 16 — — $2,359.00 $259,380.64 $92,390.85 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 12 9 — — $5,809.00 $117,954.23 $42,867.17 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 23 15 — — $26,214.00 $137,352.19 $32,125.31 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 22 14 — — $42,995.89 $204,301.81 $59,549.30 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 22 14 — — $24,007.34 $105,200.81 $33,250.17 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 10 8 — — $30,951.02 $117,954.23 $53,545.27 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 12 9 — — $5,809.00 $117,954.23 $53,545.27 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 12 9 — — $9,000.00 $85,026.56 $38,597.77 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 12 9 — — $5,809.00 $85,026.56 $38,597.77 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 12 9 — — $5,809.00 $119,984.62 $54,466.96 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 12 9 — — $5,809.00 $85,026.56 $38,597.77 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 12 9 — — $5,809.00 $85,026.56 $38,597.77 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 12 9 — — $8,245.00 $85,026.56 $38,597.77 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 12 9 — — $4,714.00 $117,954.23 $42,867.17 2026-04-01
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
100 MS_DRG Seizures With Mcc 36 14 — — $724.00 $79,614.46 $31,766.92 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 41 16 — — $46,605.00 $309,010.00 $103,935.59 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 67 18 — — $716.00 $78,696.08 $50,428.76 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 22 14 — — $26,112.97 $114,617.23 $36,166.47 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 22 14 — — $46,080.54 $218,197.84 $63,821.55 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 22 14 — — $57,902.99 $317,892.38 $80,195.64 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 22 14 — — $33,840.06 $157,576.64 $46,868.48 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 22 14 — — $43,955.59 $206,523.57 $60,878.49 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 22 14 — — $27,734.88 $123,752.92 $38,412.81 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 14 9 — — $55,272.32 $196,075.84 $104,053.18 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 22 14 — — $23,255.49 $106,780.91 $32,208.85 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 22 14 — — $40,645.31 $216,357.07 $56,293.76 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 22 14 — — $29,597.11 $138,948.33 $40,992.00 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 22 14 — — $53,396.55 $246,952.41 $73,954.23 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 25 14 — — $29,056.00 $171,918.00 $51,468.44 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 22 14 — — $31,155.67 $154,837.53 $43,150.60 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 22 14 — — $27,227.99 $127,069.52 $37,710.76 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 3 — — $176,293.17 $265,981.76 $218,603.92 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 14 — — $67,707.13 $339,624.73 $93,774.38 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 14 — — $48,850.71 $230,156.86 $67,658.24 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 14 — — $35,015.35 $173,157.04 $48,496.25 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 7 4 — — $27,314.00 $146,696.42 $112,787.69 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 22 14 — — $29,135.03 $134,609.08 $40,352.01 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 22 14 — — $49,199.97 $243,796.23 $68,141.96 2026-04-01
800 MS_DRG Splenic Procedures With Cc 22 14 — — $24,481.78 $116,847.01 $33,907.26 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 22 14 — — $37,768.51 $190,674.47 $52,309.39 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 24 15 — — $21,659.85 $97,376.52 $36,299.87 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 25 14 — — $38,247.00 $203,676.18 $44,203.18 2026-04-01
J9226 HCPCS Supprelin La Implant 14 9 — — $45,020.65 $163,593.70 $84,778.60 2026-04-01
0981T OTHER Tcat Impl Wrls Ivc Snr 10 8 — — $18,387.08 $70,073.08 $31,809.64 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 12 9 — — $9,000.00 $109,642.75 $49,772.28 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 12 9 — — $6,389.00 $73,628.24 $33,423.51 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 12 9 — — $9,000.00 $70,073.08 $31,809.64 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 22 14 — — $26,109.88 $114,974.16 $36,162.18 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 9 — — $0.03 $1,159,783.35 $627,229.78 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 23 14 — — $21,957.00 $164,562.75 $37,825.25 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 23 14 — — $38,125.00 $216,385.14 $48,061.85 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 22 14 — — $25,041.22 $106,267.58 $34,682.09 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 30 16 — — $109,804.32 $566,633.43 $209,177.23 2026-04-01
93580 HCPCS Transcath Closure Of Asd 12 9 — — $9,842.00 $70,073.08 $31,809.64 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 12 9 — — $9,842.00 $70,073.08 $31,809.64 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 12 9 — — $6,760.00 $240,440.90 $87,381.52 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 12 9 — — $9,000.00 $99,912.54 $39,385.88 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 14 — — $45,783.82 $200,636.30 $63,410.59 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 14 — — $30,640.27 $128,501.24 $42,436.77 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 22 14 — — $25,772.20 $123,055.11 $35,694.49 2026-04-01
999 MS_DRG Ungroupable 1 1 — — $49,558.00 $49,558.00 $49,558.00 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 23 15 — — $12,726.00 $159,641.99 $32,589.96 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 22 14 — — $30,393.78 $157,901.48 $42,095.39 2026-04-01
263 MS_DRG Vein Ligation And Stripping 22 14 — — $26,398.10 $107,554.92 $36,561.37 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 22 14 — — $37,394.52 $168,047.79 $51,791.41 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 14 — — $41,251.00 $216,589.67 $50,090.81 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 22 14 — — $35,200.80 $177,668.74 $48,753.11 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 16 9 — — $56,824.55 $240,299.05 $118,734.79 2026-04-01
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