Price Transparency 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 →

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Hospital

WELLSTAR PAULDING MEDICAL CENTER

Hiram, GA · CCN 110042 · Rates published

14,145 distinct procedures filed
26 distinct payers
212,662 rate rows
2026-04-01 last MRF observed
Data quality

137,871 of 212,662 rate rows are consumer-grade (64.8%)

74,791 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 74,743
placeholder amount (≤ $0.02) — excluded from medians 48
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.wellstar.org/wellstar-paulding-hospital_standard-charges
Found on page https://www.wellstar.org/financial-policy-and-privacy-info/hospital-pricing-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint a593b05ab87daf25… · 54,264,026 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
$3,325,455
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 6 $0.03 $4,812,016.79 $2,541,039.48 nat. median
$2,469,189
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $0.03 $1,159,783.35 $621,312.51 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $0.03 $1,152,532.70 $590,665.09 nat. median
$674,188
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $0.03 $1,109,103.13 $585,674.35 nat. median
$675,122
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $0.03 $1,178,375.50 $585,183.83 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $0.03 $1,120,267.47 $559,891.68 nat. median
$634,511
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $0.03 $1,120,791.00 $513,769.84 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 14 $314,457.94 $1,512,329.86 $336,470.00 nat. median
$370,174
0.9× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 3 $235,544.87 $355,377.59 $292,076.17 nat. median
$87,411
outlier · 3.3×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 3 $176,293.17 $265,981.76 $218,603.92 nat. median
$65,381
outlier · 3.3×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $204,070.55 $1,129,585.31 $218,355.49 nat. median
$265,286
0.8× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 3 $162,577.37 $245,288.10 $201,596.30 nat. median
$62,270
outlier · 3.2×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $155,474.73 $951,379.17 $166,357.96 nat. median
$206,368
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $150,706.50 $950,594.00 $165,381.65 nat. median
$202,986
0.8× 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
$48,483
outlier · 3.1×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 14 $89,558.00 $566,633.43 $142,725.60 nat. median
$133,176
1.1× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 16 $47,499.00 $632,835.00 $141,215.00 nat. median
$66,526
outlier · 2.1×
A9543
HCPCS 		Y90 Ibritumomab, Rx 7 $56,824.55 $240,299.05 $126,093.45 nat. median
$62,507
outlier · 2.0×
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 3 $97,230.64 $146,696.42 $120,566.21 nat. median
$39,075
outlier · 3.1×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $117,940.04 $117,940.04 $117,940.04 nat. median
$76,377
1.5× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 6 $63,342.28 $226,806.00 $114,360.00 nat. median
$69,774
1.6× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 7 $55,272.32 $196,075.84 $105,852.57 nat. median
$66,682
1.6× median
7
MS_DRG 		Lung Transplant 14 $94,303.59 $524,075.06 $100,904.84 nat. median
$122,708
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $87,514.57 $525,398.49 $93,640.59 nat. median
$117,303
0.8× median
90288
HCPCS 		Botulism Ig IV 1 $92,831.73 $92,831.73 $92,831.73 nat. median
$55,037
1.7× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 16 $18,102.00 $259,380.64 $89,263.73 nat. median
$62,134
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $82,518.37 $441,934.05 $88,294.66 nat. median
$108,660
0.8× median
5465
OTHER 		Level 5 Neurostimulator And Related Procedures 8 $24,248.00 $128,555.00 $87,629.00 nat. median
$31,444
outlier · 2.8×
209
MS_DRG 		Complex Aortic Arch Procedures 14 $82,423.71 $161,550.47 $87,369.13 nat. median
$98,017
0.9× median
J9226
HCPCS 		Supprelin La Implant 7 $45,020.65 $163,593.70 $86,268.99 nat. median
$60,368
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 $80,256.58 $420,354.09 $85,874.54 nat. median
$98,905
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 14 $79,185.39 $436,856.88 $84,728.37 nat. median
$102,358
0.8× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 17 $33,526.00 $245,181.00 $81,965.75 nat. median
$48,170
1.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $75,081.25 $427,051.45 $80,336.94 nat. median
$100,136
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 14 $50.00 $424,869.80 $77,582.55 nat. median
$99,019
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $36,995.00 $387,019.64 $76,225.23 nat. median
$93,672
0.8× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 14 $41,503.86 $216,589.67 $73,046.79 nat. median
$52,753
1.4× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 $65,608.07 $334,467.36 $70,200.63 nat. median
$82,712
0.8× median
64568
HCPCS 		Inc For Vagus N Elect Impl 7 $4,714.00 $167,946.40 $70,119.00 nat. median
$27,541
outlier · 2.5×
33276
HCPCS 		Insj Phrnc Nrv Stim Sys 7 $5,809.00 $167,946.40 $70,119.00 nat. median
$43,787
1.6× median
38240
HCPCS 		Transplt Allo Hct/donor 7 $6,760.00 $239,837.94 $68,361.77 nat. median
$15,912
outlier · 4.3×
850
MS_DRG 		Acute Leukemia With Other Procedures 14 $63,058.64 $369,409.98 $67,472.74 nat. median
$83,442
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 15 $36,995.00 $339,817.23 $65,683.76 nat. median
$79,312
0.8× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 18 $20,183.00 $184,145.54 $65,604.73 nat. median
$44,810
1.5× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $61,193.71 $339,624.73 $65,477.27 nat. median
$81,118
0.8× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $57,300.74 $323,258.29 $61,311.79 nat. median
$77,576
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 $36,995.00 $310,284.65 $59,827.47 nat. median
$74,915
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 15 $36,995.00 $313,444.84 $59,569.56 nat. median
$73,807
0.8× median

Other procedures at this hospital

Browse this hospital's 14,145 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
             
291 MS_DRG Heart Failure And Shock With Mcc 68 18 — — $8,052.00 $52,331.71 $32,998.78 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 64 18 — — $7,322.00 $52,849.05 $35,864.37 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 58 16 — — $14,034.00 $93,140.00 $42,335.25 2026-04-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 58 17 — — $6,305.00 $43,697.32 $28,896.33 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 57 17 — — $33,526.00 $245,181.00 $81,965.75 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 57 18 — — $9,938.00 $119,543.00 $35,215.50 2026-04-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 55 16 — — $7,916.00 $65,830.72 $36,225.57 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 54 16 — — $200.00 $73,454.00 $44,282.25 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 49 16 — — $8,279.00 $123,951.00 $28,091.25 2026-04-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 48 16 — — $9,581.00 $89,128.00 $33,453.50 2026-04-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 47 16 — — $12,046.00 $92,341.00 $45,085.00 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 47 16 — — $19,575.00 $185,395.00 $38,210.00 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 47 17 — — $200.00 $67,449.00 $37,313.75 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 43 18 — — $20,183.00 $184,145.54 $65,604.73 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 41 16 — — $47,499.00 $632,835.00 $141,215.00 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 41 16 — — $17,956.00 $107,643.15 $58,306.50 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 41 16 — — $11,978.00 $94,793.82 $34,214.64 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 38 16 — — $3,089.00 $131,772.00 $38,697.67 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 36 16 — — $18,102.00 $259,380.64 $89,263.73 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 35 15 — — $30.00 $170,810.96 $55,461.49 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 35 15 — — $23,327.50 $205,845.81 $41,111.66 2026-04-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 33 15 — — $15,866.06 $107,702.00 $29,749.00 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 33 16 — — $15,267.00 $84,715.69 $28,407.84 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 32 17 — — $28,681.00 $184,835.33 $58,908.98 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 32 17 — — $27,957.85 $159,754.28 $52,595.51 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 32 16 — — $16,916.86 $100,420.42 $27,797.86 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 32 16 — — $12,967.00 $83,211.79 $27,530.20 2026-04-01
215 MS_DRG Other Heart Assist System Implant 31 14 — — $50.00 $424,869.80 $77,582.55 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 31 16 — — $16,651.00 $168,035.76 $56,602.84 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 30 15 — — $34,165.77 $263,683.00 $46,968.75 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 30 16 — — $15,736.00 $136,032.77 $41,966.31 2026-04-01
5416 OTHER Level 6 Gynecologic Procedures 30 13 — — $7,202.00 $45,421.00 $39,233.50 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 30 15 — — $16,077.97 $91,854.20 $29,744.24 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 29 15 — — $23,830.00 $180,921.18 $58,297.75 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 29 16 — — $30,534.00 $171,059.60 $56,299.67 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 29 15 — — $18,960.00 $130,702.95 $32,788.00 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 29 14 — — $19,741.00 $119,750.54 $32,767.75 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 29 14 — — $24,326.31 $161,979.00 $32,145.90 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 29 14 — — $11.00 $95,307.16 $30,584.95 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 29 16 — — $17,439.71 $160,631.00 $29,323.00 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 29 15 — — $10,612.00 $150,149.38 $27,732.43 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 29 15 — — $13,303.00 $138,134.22 $27,709.83 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 29 14 — — $24,974.00 $154,997.95 $27,606.00 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 15 — — $150,706.50 $950,594.00 $165,381.65 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 28 14 — — $19,210.00 $116,782.85 $29,371.71 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 28 15 — — $16,203.00 $97,376.52 $27,397.00 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 27 15 — — $25,156.46 $137,909.64 $44,275.37 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 27 16 — — $23,970.22 $125,156.56 $44,107.00 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 27 16 — — $21,674.20 $123,055.11 $38,146.59 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 27 16 — — $8,279.00 $100,340.21 $32,720.14 2026-04-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 27 15 — — $15,418.95 $91,994.57 $28,525.06 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 27 15 — — $25,128.00 $145,332.89 $28,024.00 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 27 14 — — $14,058.00 $90,578.89 $27,702.00 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 26 14 — — $89,558.00 $566,633.43 $142,725.60 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 26 15 — — $22,279.00 $199,834.22 $38,548.95 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 26 14 — — $65.00 $154,440.50 $38,513.47 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 26 15 — — $31,350.50 $186,571.83 $35,986.24 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 26 15 — — $157.00 $124,009.59 $32,837.99 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 26 14 — — $23,184.49 $130,646.80 $32,806.05 2026-04-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 26 16 — — $15,227.43 $85,048.55 $27,485.51 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 26 15 — — $15,728.00 $146,315.43 $27,422.31 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 25 14 — — $41,503.86 $216,589.67 $73,046.79 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 25 15 — — $33,386.60 $234,141.75 $58,760.42 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 25 14 — — $43,740.17 $248,404.18 $57,985.50 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 25 15 — — $36,995.00 $244,967.26 $47,238.32 2026-04-01
849 MS_DRG Radiotherapy 25 14 — — $19,730.63 $107,113.77 $34,725.91 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 25 15 — — $26,181.00 $164,562.75 $32,850.06 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 25 14 — — $18,379.81 $100,933.75 $32,348.47 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 25 14 — — $26,202.00 $156,806.64 $32,144.91 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 25 15 — — $23,638.00 $132,411.38 $29,192.61 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 25 14 — — $16,498.14 $206,545.00 $29,036.73 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 25 14 — — $20,463.00 $253,706.00 $28,608.23 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 25 14 — — $15,768.00 $143,764.82 $28,142.27 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 25 14 — — $17,958.00 $128,501.24 $28,100.20 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 25 14 — — $25,122.00 $137,564.74 $27,179.99 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 14 — — $22,948.00 $140,484.31 $26,713.27 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 15 — — $36,995.00 $387,019.64 $76,225.23 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 24 15 — — $36,995.00 $339,817.23 $65,683.76 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 15 — — $36,995.00 $310,284.65 $59,827.47 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 15 — — $36,995.00 $313,444.84 $59,569.56 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 24 14 — — $32,519.00 $283,394.92 $55,558.36 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 15 — — $36,995.00 $258,967.57 $51,233.15 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 15 — — $36,995.00 $238,582.71 $51,233.15 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 24 15 — — $36,995.00 $235,963.92 $45,726.72 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 24 14 — — $30,685.70 $164,807.39 $43,420.26 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 14 — — $11,644.00 $200,636.30 $43,370.49 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 24 15 — — $36,995.00 $213,349.27 $42,564.04 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 24 15 — — $34,379.00 $216,385.14 $42,497.04 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 15 — — $36,995.00 $212,402.82 $41,551.90 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 24 14 — — $5,001.00 $223,547.72 $40,489.10 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 15 — — $36,702.83 $184,169.60 $39,272.03 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 14 — — $33,432.00 $203,676.18 $38,860.62 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 24 14 — — $33,858.00 $201,983.80 $38,348.70 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 24 14 — — $24,810.56 $141,535.04 $35,106.94 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 24 15 — — $30,502.92 $164,899.63 $34,816.56 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 24 15 — — $26,627.00 $169,599.82 $33,234.19 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 24 14 — — $29,736.00 $166,848.68 $32,906.16 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 24 14 — — $6,443.00 $158,262.42 $29,038.33 2026-04-01
503 MS_DRG Foot Procedures With Mcc 24 14 — — $20,324.84 $106,135.24 $28,759.65 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 24 12 — — $280.00 $50,240.00 $28,176.50 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 24 14 — — $19,907.58 $108,946.53 $28,169.22 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 24 14 — — $19,706.60 $109,536.06 $27,884.84 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 24 14 — — $871.00 $140,508.37 $27,758.92 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 24 14 — — $24,432.00 $137,352.19 $27,478.42 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 24 15 — — $24,018.00 $138,948.33 $27,048.32 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 24 14 — — $18,781.78 $207,144.00 $26,576.22 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 24 14 — — $18,697.31 $103,805.19 $26,456.69 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 23 14 — — $314,457.94 $1,512,329.86 $336,470.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 23 14 — — $204,070.55 $1,129,585.31 $218,355.49 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 14 — — $155,474.73 $951,379.17 $166,357.96 2026-04-01
7 MS_DRG Lung Transplant 23 14 — — $94,303.59 $524,075.06 $100,904.84 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 23 14 — — $87,514.57 $525,398.49 $93,640.59 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 23 14 — — $82,518.37 $441,934.05 $88,294.66 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 14 — — $80,256.58 $420,354.09 $85,874.54 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 23 14 — — $79,185.39 $436,856.88 $84,728.37 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 23 14 — — $75,081.25 $427,051.45 $80,336.94 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 23 14 — — $65,608.07 $334,467.36 $70,200.63 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 23 14 — — $63,058.64 $369,409.98 $67,472.74 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 14 — — $61,193.71 $339,624.73 $65,477.27 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 23 14 — — $57,300.74 $323,258.29 $61,311.79 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 23 14 — — $55,488.25 $299,324.22 $59,372.43 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 14 — — $52,565.98 $284,686.26 $56,245.60 2026-04-01
10 MS_DRG Pancreas Transplant 23 14 — — $52,253.58 $319,733.15 $55,911.33 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 23 14 — — $52,231.73 $267,834.56 $55,887.95 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 23 14 — — $51,954.29 $317,892.38 $55,591.09 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 23 14 — — $50,084.99 $267,381.39 $53,590.94 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 23 14 — — $49,015.99 $273,826.10 $52,447.11 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 23 14 — — $48,691.21 $248,083.34 $52,099.59 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 14 — — $48,655.53 $268,865.24 $52,061.42 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 23 14 — — $47,707.41 $246,952.41 $51,046.93 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 23 14 — — $44,627.12 $240,239.00 $47,751.02 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 23 14 — — $44,575.42 $253,613.69 $47,695.70 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 23 14 — — $43,752.55 $243,796.23 $46,815.23 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 14 — — $43,423.40 $230,156.86 $46,463.04 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 23 14 — — $43,280.68 $238,418.28 $46,310.33 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 23 14 — — $43,180.18 $242,047.69 $46,202.79 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 23 14 — — $42,707.58 $233,481.48 $45,697.11 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 23 14 — — $41,996.13 $219,372.89 $44,935.86 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 23 14 — — $41,728.15 $228,781.29 $44,649.12 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 14 — — $40,939.51 $220,780.54 $43,805.28 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 23 14 — — $40,812.80 $218,197.84 $43,669.70 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 23 14 — — $40,218.59 $246,106.22 $43,033.89 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 23 14 — — $39,977.55 $221,650.80 $42,775.98 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 23 14 — — $39,836.28 $217,700.55 $42,624.82 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 23 14 — — $39,558.11 $242,047.69 $42,327.18 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 23 14 — — $38,810.24 $206,523.57 $41,526.96 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 23 14 — — $38,549.55 $221,666.84 $41,248.02 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 23 14 — — $37,905.82 $204,301.81 $40,559.23 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 23 14 — — $35,690.63 $216,357.07 $38,188.97 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 23 14 — — $35,162.68 $194,785.13 $37,624.07 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 23 14 — — $34,985.00 $200,792.71 $37,433.95 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 23 14 — — $34,668.23 $188,665.26 $37,095.01 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 23 14 — — $34,235.68 $184,759.13 $36,632.18 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 23 14 — — $34,063.82 $191,504.62 $36,448.29 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 23 14 — — $33,766.72 $194,460.29 $36,130.39 2026-04-01
245 MS_DRG Aicd Generator Procedures 23 14 — — $33,223.48 $195,968.20 $35,549.12 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 23 14 — — $33,109.15 $179,345.09 $35,426.79 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 23 14 — — $32,979.53 $190,674.47 $35,288.10 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 23 14 — — $32,627.08 $168,047.79 $34,910.98 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 23 14 — — $32,498.92 $176,156.82 $34,773.84 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 23 14 — — $31,260.98 $179,842.38 $33,449.25 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 23 14 — — $30,881.58 $163,752.65 $33,043.29 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 23 14 — — $30,559.72 $177,668.74 $32,698.90 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 14 — — $30,384.95 $173,157.04 $32,511.90 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 23 14 — — $30,363.10 $167,257.74 $32,488.52 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 23 14 — — $30,242.22 $163,106.98 $32,359.18 2026-04-01
791 MS_DRG Prematurity With Major Problems 23 14 — — $29,557.71 $162,826.25 $31,626.75 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 23 14 — — $29,277.35 $157,576.64 $31,326.76 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 23 14 — — $29,012.29 $143,756.80 $31,043.15 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 23 14 — — $28,486.53 $152,451.35 $30,480.59 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 23 14 — — $28,357.64 $173,517.98 $30,342.67 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 23 14 — — $28,186.51 $155,944.40 $30,159.57 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 23 14 — — $28,144.27 $157,584.66 $30,114.37 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 23 14 — — $28,117.33 $151,264.27 $30,085.54 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 23 14 — — $27,402.23 $153,285.51 $29,320.39 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 23 14 — — $27,215.09 $143,724.72 $29,120.15 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 23 14 — — $26,985.70 $139,249.11 $28,874.70 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 23 14 — — $26,747.58 $154,837.53 $28,619.91 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 23 14 — — $26,422.80 $127,282.08 $28,272.40 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 23 14 — — $26,402.41 $141,178.11 $28,250.58 2026-04-01
332 MS_DRG Rectal Resection With Mcc 23 14 — — $26,366.00 $139,100.72 $28,211.62 2026-04-01
265 MS_DRG Aicd Lead Procedures 23 14 — — $26,347.80 $143,046.96 $28,192.15 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 23 14 — — $26,090.01 $159,641.99 $27,916.31 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 23 14 — — $26,029.57 $157,901.48 $27,851.64 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 23 14 — — $25,964.76 $140,408.11 $27,782.29 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 23 14 — — $24,843.33 $134,609.08 $26,582.36 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 23 14 — — $24,054.69 $109,740.59 $25,738.52 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 20 12 — — $8,422.00 $91,857.00 $48,184.00 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 18 14 — — $24,906.00 $125,101.00 $26,542.35 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 16 14 — — $82,423.71 $161,550.47 $87,369.13 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 16 14 — — $41,557.75 $81,453.19 $44,051.21 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 15 7 — — $56,824.55 $240,299.05 $126,093.45 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 15 7 — — $24,228.42 $90,952.25 $45,342.71 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 15 8 — — $13,080.00 $68,200.00 $43,954.53 2026-04-01
5624 OTHER Level 4 Radiation Therapy 15 10 — — $124.00 $35,479.50 $35,479.50 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 13 7 — — $55,272.32 $196,075.84 $105,852.57 2026-04-01
J9226 HCPCS Supprelin La Implant 13 7 — — $45,020.65 $163,593.70 $86,268.99 2026-04-01
J9266 HCPCS Pegaspargase Injection 13 7 — — $28,424.06 $94,617.96 $51,596.43 2026-04-01
69930 HCPCS Implant Cochlear Device 13 8 — — $3,721.00 $125,720.59 $35,834.54 2026-04-01
61886 HCPCS Implant Neurostim Arrays 13 8 — — $1,937.00 $117,658.44 $33,536.56 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 13 8 — — $1,694.00 $117,658.44 $33,536.56 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 13 8 — — $1,694.00 $117,658.44 $33,536.56 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 13 8 — — $278.00 $148,411.00 $33,324.00 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 13 8 — — $2,664.00 $103,460.29 $28,938.41 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 12 6 — — $63,342.28 $226,806.00 $114,360.00 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 12 8 — — $24,248.00 $128,555.00 $87,629.00 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 12 8 — — $2,323.00 $84,813.34 $31,969.24 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 12 7 — — $5,809.00 $103,460.29 $29,214.01 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 7 — — $0.03 $1,159,783.35 $621,312.51 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 11 7 — — $0.03 $1,152,532.70 $590,665.09 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 11 7 — — $0.03 $1,178,375.50 $585,183.83 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 11 7 — — $0.03 $1,120,267.47 $559,891.68 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 11 7 — — $0.03 $1,120,791.00 $513,769.84 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 11 7 — — $4,714.00 $167,946.40 $70,119.00 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 11 7 — — $5,809.00 $167,946.40 $70,119.00 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 11 7 — — $6,760.00 $239,837.94 $68,361.77 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 11 7 — — $5,809.00 $119,683.73 $56,112.48 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 11 7 — — $9,000.00 $119,683.73 $56,112.48 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 11 7 — — $5,809.00 $119,683.73 $56,112.48 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 11 7 — — $9,000.00 $119,683.73 $56,112.48 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 11 7 — — $5,809.00 $119,683.73 $56,112.48 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 11 7 — — $9,000.00 $119,683.73 $56,112.48 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 11 7 — — $9,000.00 $119,683.73 $56,112.48 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 11 7 — — $4,714.00 $117,658.44 $55,162.94 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 11 7 — — $5,809.00 $117,658.44 $55,162.94 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 11 7 — — $9,000.00 $109,367.80 $51,275.96 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 11 7 — — $5,063.00 $102,634.64 $48,119.19 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 11 7 — — $6,389.00 $167,946.40 $47,870.30 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 11 7 — — $5,809.00 $84,813.34 $39,763.85 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 11 7 — — $5,809.00 $84,813.34 $39,763.85 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 11 7 — — $5,809.00 $84,813.34 $39,763.85 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 11 7 — — $5,809.00 $84,813.34 $39,763.85 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 11 7 — — $6,389.00 $84,813.34 $39,763.85 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 11 7 — — $5,809.00 $84,813.34 $39,763.85 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 11 7 — — $8,245.00 $84,813.34 $39,763.85 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 11 7 — — $9,000.00 $84,813.34 $39,763.85 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 11 7 — — $9,000.00 $84,813.34 $39,763.85 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 11 7 — — $6,389.00 $73,443.60 $34,433.27 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 11 7 — — $9,000.00 $99,661.98 $34,203.00 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 11 7 — — $9,000.00 $99,661.98 $34,203.00 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 11 7 — — $8,245.00 $103,460.29 $34,203.00 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 11 7 — — $9,000.00 $99,661.98 $34,203.00 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 11 7 — — $4,714.00 $117,658.44 $33,536.56 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 11 7 — — $5,809.00 $117,658.44 $33,536.56 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 11 7 — — $4,714.00 $117,658.44 $33,536.56 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 11 7 — — $5,809.00 $117,658.44 $33,536.56 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 11 7 — — $9,000.00 $69,897.36 $32,770.65 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 11 7 — — $9,842.00 $69,897.36 $32,770.65 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 11 7 — — $9,842.00 $69,897.36 $32,770.65 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 11 7 — — $9,842.00 $69,897.36 $32,770.65 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 11 7 — — $9,842.00 $69,897.36 $32,770.65 2026-04-01
93580 HCPCS Transcath Closure Of Asd 11 7 — — $9,842.00 $69,897.36 $32,770.65 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 11 7 — — $5,063.00 $65,313.63 $30,621.62 2026-04-01
22630 HCPCS Lumbar Spine Fusion 11 7 — — $8,245.00 $103,460.29 $29,489.62 2026-04-01
22558 HCPCS Lumbar Spine Fusion 11 7 — — $8,245.00 $103,460.29 $29,489.62 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 11 7 — — $8,245.00 $103,460.29 $29,489.62 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 6 — — $0.03 $4,812,016.79 $2,541,039.48 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 10 6 — — $0.03 $1,109,103.13 $585,674.35 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 10 6 — — $6,389.00 $130,625.40 $49,237.46 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 10 7 — — $17,398.65 $65,313.63 $31,404.56 2026-04-01
78 MS_DRG Hypertensive Encephalopathy With Cc 10 6 — — $6,842.00 $40,015.77 $27,822.65 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 9 6 — — $18,418.00 $75,092.00 $55,341.00 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 9 6 — — $31,342.58 $117,658.44 $55,162.94 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 9 5 — — $275.00 $62,008.80 $43,366.27 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 9 7 — — $15,248.00 $69,883.00 $36,644.50 2026-04-01
1013T HCPCS Lap Srg Imp/rpl Eso Nea&pg/r 9 6 — — $19,704.96 $73,971.40 $34,680.72 2026-04-01
37294 HCPCS Rvsc Evsc Tpvt St Athr Cpx 1 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37292 HCPCS Rvsc Evsc Tpvt St Athrc Sf 1 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37288 HCPCS Revsc Evsc Tpvt Athrc Sf 1st 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
0981T HCPCS Tcat Impl Wrls Ivc Snr 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37277 HCPCS Rvsc Evsc Fpvt St Athr Cpx 1 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37290 HCPCS Revsc Evsc Tpvt Athrc Cplx 1 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37271 HCPCS Revsc Evsc Fpvt Athrc Sf 1st 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37273 HCPCS Revsc Evsc Fpvt Athrc Cplx 1 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37275 HCPCS Rvsc Evsc Fpvt St Athrc Sf 1 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37284 HCPCS Revsc Evasc Tpvt St Sf 1st 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
37286 HCPCS Revsc Evasc Tpvt St Cplx 1st 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
92930 HCPCS Prq Tcat Plmt Ntrac St 2+les 9 6 — — $18,619.69 $69,897.36 $32,770.65 2026-04-01
5194 OTHER Level 4 Endovascular Procedures 9 5 — — $14,589.00 $69,016.00 $29,916.00 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
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 4 — — $0.03 $3,548,614.97 $3,316,462.59 2026-04-01
509 MS_DRG Arthroscopy 7 4 — — $46,689.53 $70,442.68 $54,159.92 2026-04-01
5200 OTHER Implantation Wireless Pa Pressure Monitor 7 6 — — $8,422.00 $38,644.25 $38,644.25 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
5378 OTHER Level 8 Urology And Related Services 7 5 — — $100.00 $37,548.50 $36,482.00 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
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 3 — — $176,293.17 $265,981.76 $218,603.92 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
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
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 6 3 — — $97,230.64 $146,696.42 $120,566.21 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $117,940.04 $117,940.04 $117,940.04 2026-04-01
90288 HCPCS Botulism Ig IV 2 1 — — $92,831.73 $92,831.73 $92,831.73 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 2 1 — — $32,325.76 $32,325.76 $32,325.76 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 2 2 — — $6,389.00 $56,095.00 $31,242.00 2026-04-01
37231 HCPCS Hc Pta 1St Tib/Peroneal With Stent Plus Atherectomy 2 2 — — $6,389.00 $56,095.00 $31,242.00 2026-04-01
33967 HCPCS Hc Ip Only- Iabp Insertion 2 2 — — $5,063.00 $56,095.00 $30,579.00 2026-04-01
33968 HCPCS Hc Ip Only - Rem Iabp Assist Device Percutaneous 2 2 — — $3,391.00 $56,095.00 $29,743.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 1 1 — — $56,095.00 $56,095.00 $56,095.00 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 1 1 — — $56,095.00 $56,095.00 $56,095.00 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
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