Hospital

NAVICENT HEALTH BALDWIN

Milledgeville, GA · CCN 110150 · Rates published

14,428 distinct procedures filed

16 distinct payers

734,450 rate rows

2025-11-19 last MRF observed

Data quality

562,650 of 734,450 rate rows are consumer-grade (76.6%)

171,800 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 — reason	Rows
professional (physician) fee — not the facility price	171,122
percent-of-charges filed in the dollar field — excluded from medians	328
per-diem day rate — not a per-procedure price	146
exceeds 10× this hospital's gross charge — excluded from medians	124
placeholder amount (≤ $0.02) — excluded from medians	80

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/11180/823914925_navicent-health-baldwin-inc_standardcharges.csv
Found on page	https://navicenthealth.org/for-patients-and-visitors/pt
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-05-15
Content fingerprint	061fa910c2a97037… · 1,233,273,241 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
J3391 HCPCS	Inj, Atidarsagene Autotemcel	9	$4,505,000.00	$4,595,100.00	$4,505,000.00	nat. median $4,505,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	9	$3,685,266.67	$3,758,972.00	$3,685,266.67	nat. median $3,710,000 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	9	$3,316,462.59	$3,382,791.84	$3,316,462.59	nat. median $3,325,455 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	9	$3,248,445.72	$3,313,414.63	$3,248,445.72	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	9	$2,945,740.00	$3,004,654.80	$2,945,740.00	nat. median $3,006,423 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	9	$2,455,110.61	$2,504,212.82	$2,455,110.61	nat. median $2,469,189 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	9	$2,332,000.00	$2,378,640.00	$2,332,000.00	nat. median $2,448,600 1.0× median
J2326 HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	16	$1,280.25	$1,260,089.94	$882,062.96	nat. median $2,677 outlier · 329.5×
Q2057 HCPCS	Afamitresgene Autoleucel	9	$770,620.00	$786,032.40	$770,620.00	nat. median $824,563 0.9× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	10	$518,240.68	$603,560.73	$591,726.20	nat. median $754,974 0.8× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	10	$507,495.55	$577,186.32	$565,868.95	nat. median $675,122 0.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	10	$474,060.62	$573,788.95	$562,538.19	nat. median $674,188 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	10	$484,690.30	$568,464.29	$557,317.93	nat. median $625,184 0.9× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	10	$459,381.45	$543,894.77	$533,230.17	nat. median $634,511 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	10	$449,440.00	$499,090.70	$489,304.61	nat. median $620,080 0.8× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	9	$278,250.00	$283,815.00	$278,250.00	nat. median $324,450 0.9× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	$273,602.14	$660,992.25	$276,338.16	nat. median $370,174 0.7× median
J0801 HCPCS	Corticotropin 80 Unit/ml Injection Gel	16	$3,370.39	$394,711.10	$276,297.77	nat. median $5,814 outlier · 47.5×
C9293 HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	16	$516.74	$376,248.68	$263,374.08	nat. median $21,340 outlier · 12.3×
J3403 HCPCS	Revakinagene, Per Implant	9	$257,500.00	$262,650.00	$257,500.00	nat. median $265,000 1.0× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	10	$204,789.94	$493,705.79	$206,837.84	nat. median $265,286 0.8× median
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	9	$205,640.00	$209,752.80	$205,640.00	nat. median $209,753 1.0× median
J9269 HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	16	$326.65	$265,454.19	$185,817.93	nat. median $509 outlier · 364.9×
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	10	$172,739.58	$415,789.52	$174,466.98	nat. median $206,368 0.8× median
J9348 HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	16	$610.03	$238,198.43	$166,738.90	nat. median $887 outlier · 188.0×
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	10	$156,220.89	$375,631.65	$157,783.10	nat. median $202,986 0.8× median
J2350 HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	16	$58.76	$188,628.05	$132,039.64	nat. median $712 outlier · 185.5×
Q0480 HCPCS	Driver Pneumatic Vad, Rep	9	$129,537.54	$132,128.29	$129,537.54	nat. median $111,989 1.2× median
J9274 HCPCS	Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution	16	$208.93	$161,066.50	$112,746.55	nat. median $418 outlier · 269.5×
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	9	$111,860.04	$114,097.24	$111,860.04	nat. median $96,983 1.2× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	10	$103,579.15	$247,656.51	$104,614.94	nat. median $133,176 0.8× median
J9334 HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln	16	$33.17	$147,008.31	$102,905.82	nat. median $73 outlier · 1402.8×
J9266 HCPCS	Pegaspargase 750 Unit/ml Injection Solution	16	$25,781.46	$146,295.88	$102,407.12	nat. median $34,109 outlier · 3.0×
J9228 HCPCS	Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution	16	$172.71	$279,229.85	$98,551.71	nat. median $9,906 outlier · 9.9×
14 MS_DRG	Allogeneic Bone Marrow Transplant	10	$96,166.22	$229,635.25	$97,127.88	nat. median $117,303 0.8× median
J0202 HCPCS	Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution	16	$2,347.58	$138,721.28	$97,104.90	nat. median $4,053 outlier · 24.0×
7 MS_DRG	Lung Transplant	10	$95,928.30	$229,056.86	$96,887.58	nat. median $122,708 0.8× median
J1304 HCPCS	Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution	16	$150.84	$130,676.79	$91,473.76	nat. median $195 outlier · 469.7×
J3357 HCPCS	Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe	16	$149.40	$258,380.37	$90,433.21	nat. median $14,306 outlier · 6.3×
J9298 HCPCS	Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution	16	$187.00	$118,920.23	$83,244.16	nat. median $562 outlier · 148.2×
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	10	$81,155.08	$193,142.28	$81,966.63	nat. median $108,660 0.8× median
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	10	$80,248.11	$190,937.39	$81,050.59	nat. median $102,358 0.8× median
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	9	$80,943.19	$82,562.05	$80,943.19	nat. median $70,825 1.1× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	10	$78,485.35	$186,652.03	$79,270.20	nat. median $100,136 0.8× median
J9043 HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	16	$211.76	$112,938.06	$79,056.64	nat. median $739 outlier · 107.0×
215 MS_DRG	Other Heart Assist System Implant	10	$78,091.70	$185,695.06	$78,872.62	nat. median $99,019 0.8× median
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	$77,230.87	$183,602.34	$78,003.18	nat. median $98,905 0.8× median
J1305 HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	16	$179.14	$385,462.93	$77,585.02	nat. median $298 outlier · 260.7×
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	$71,288.00	$169,154.83	$72,000.88	nat. median $93,672 0.8× median
J2329 HCPCS	Ublituximab-xiiy 25 Mg/ml Intravenous Solution	16	$67.23	$101,538.92	$71,077.24	nat. median $168 outlier · 422.0×

Other procedures at this hospital

Browse this hospital's 14,428 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J9307	HCPCS	Pralatrexate 40 Mg/2 Ml (20 Mg/ml) Intravenous Solution	83	16	$108,839.65	$54,419.83 50% off	$299.28	$115,407.90	$54,329.60	2025-11-19
J2427	HCPCS	Paliperidone Palmitate (3 Month) 819 Mg/2.63 Ml Intramuscular Syringe	83	16	$72,947.70	$36,473.85 50% off	$12.18	$93,006.07	$43,766.96	2025-11-19
J1930	HCPCS	Lanreotide 90 Mg/0.3 Ml Subcutaneous Syringe	68	16	$87,161.05	$43,580.53 50% off	$34.05	$87,372.78	$51,860.82	2025-11-19
J0584	HCPCS	Burosumab-twza 30 Mg/ml Subcutaneous Solution	68	16	$66,891.90	$33,445.95 50% off	$447.86	$85,661.09	$46,824.33	2025-11-19
J0739	HCPCS	Cabotegravir ER 600 Mg/3 Ml (200 Mg/ml) IM Suspension,extended Release	54	16	$43,296.15	$21,648.08 50% off	$7.02	$36,801.73	$25,761.21	2025-11-19
J9228	HCPCS	Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution	53	16	$328,505.70	$164,252.85 50% off	$172.71	$279,229.85	$98,551.71	2025-11-19
J3357	HCPCS	Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe	53	16	$151,988.60	$75,994.30 50% off	$149.40	$258,380.37	$90,433.21	2025-11-19
J1305	HCPCS	Evinacumab-dgnb 150 Mg/ml Intravenous Solution	53	16	$130,395.00	$65,197.50 50% off	$179.14	$385,462.93	$77,585.02	2025-11-19
J9382	HCPCS	Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution	53	16	$109,893.70	$54,946.85 50% off	$32.91	$186,776.96	$65,921.28	2025-11-19
J1303	HCPCS	Ravulizumab-cwvz 100 Mg/ml Intravenous Solution	53	16	$185,644.95	$92,822.48 50% off	$221.74	$157,798.21	$55,693.49	2025-11-19
J9022	HCPCS	Atezolizumab 840 Mg/14 Ml (60 Mg/ml) Intravenous Solution	53	16	$72,905.55	$36,452.78 50% off	$83.94	$88,509.95	$43,378.81	2025-11-19
J9210	HCPCS	Emapalumab-lzsg 5 Mg/ml Intravenous Solution	53	16	$71,832.85	$35,916.43 50% off	$364.87	$308,595.56	$42,740.54	2025-11-19
J9038	HCPCS	Axatilimab-csfr 50 Mg/ml Intravenous Solution	53	16	$50,818.75	$25,409.38 50% off	$55.65	$105,559.38	$33,032.19	2025-11-19
J2267	HCPCS	Mirikizumab-mrkz 100 Mg/ml Subcutaneous Pen Injector	53	16	$54,058.35	$27,029.18 50% off	$43.05	$87,679.33	$32,164.72	2025-11-19
J1323	HCPCS	Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution	52	16	$69,940.05	$34,970.03 50% off	$181.67	$102,653.82	$41,614.33	2025-11-19
J9333	HCPCS	Rozanolixizumab-noli 140 Mg/ml Subcutaneous Solution	52	16	$65,875.55	$32,937.78 50% off	$22.85	$167,939.98	$41,007.53	2025-11-19
A9517	HCPCS	Sodium Iodide-131 (i-131) 500 Mci/0.5 Ml Oral Kit (therapeutic)	39	16	$42,187.50	$21,093.75 50% off	$23.13	$35,859.38	$28,687.51	2025-11-19
J2326	HCPCS	Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution	38	16	$1,482,458.75	$741,229.38 50% off	$1,280.25	$1,260,089.94	$882,062.96	2025-11-19
J9269	HCPCS	Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution	38	16	$312,299.05	$156,149.53 50% off	$326.65	$265,454.19	$185,817.93	2025-11-19
J9348	HCPCS	Naxitamab-gqgk 4 Mg/ml Intravenous Solution	38	16	$280,233.45	$140,116.73 50% off	$610.03	$238,198.43	$166,738.90	2025-11-19
J2350	HCPCS	Ocrelizumab 30 Mg/ml Intravenous Solution	38	16	$221,915.35	$110,957.68 50% off	$58.76	$188,628.05	$132,039.64	2025-11-19
J9274	HCPCS	Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution	38	16	$189,490.00	$94,745.00 50% off	$208.93	$161,066.50	$112,746.55	2025-11-19
J9266	HCPCS	Pegaspargase 750 Unit/ml Injection Solution	38	16	$172,112.80	$86,056.40 50% off	$25,781.46	$146,295.88	$102,407.12	2025-11-19
J0202	HCPCS	Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution	38	16	$163,201.50	$81,600.75 50% off	$2,347.58	$138,721.28	$97,104.90	2025-11-19
J9298	HCPCS	Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution	38	16	$139,906.15	$69,953.08 50% off	$187.00	$118,920.23	$83,244.16	2025-11-19
J9043	HCPCS	Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution	38	16	$132,868.30	$66,434.15 50% off	$211.76	$112,938.06	$79,056.64	2025-11-19
J2329	HCPCS	Ublituximab-xiiy 25 Mg/ml Intravenous Solution	38	16	$119,457.55	$59,728.78 50% off	$67.23	$101,538.92	$71,077.24	2025-11-19
J2840	HCPCS	Sebelipase Alfa 2 Mg/ml Intravenous Solution	38	16	$109,782.50	$54,891.25 50% off	$539.91	$93,315.13	$65,320.59	2025-11-19
J9272	HCPCS	Dostarlimab-gxly 50 Mg/ml Intravenous Solution	38	16	$109,148.05	$54,574.03 50% off	$232.55	$92,775.84	$64,943.09	2025-11-19
J0222	HCPCS	Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution	38	16	$105,213.75	$52,606.88 50% off	$99.20	$89,431.69	$62,602.18	2025-11-19
J9119	HCPCS	Cemiplimab-rwlc 50 Mg/ml Intravenous Solution	38	16	$98,162.55	$49,081.28 50% off	$27.58	$83,438.17	$58,406.72	2025-11-19
J2323	HCPCS	Natalizumab 300 Mg/15 Ml Intravenous Solution	38	16	$91,805.45	$45,902.73 50% off	$24.00	$78,034.63	$54,624.24	2025-11-19
J9301	HCPCS	Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution	38	16	$79,717.70	$39,858.85 50% off	$70.22	$67,760.05	$47,432.04	2025-11-19
J9063	HCPCS	Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution	38	16	$71,331.05	$35,665.53 50% off	$65.68	$60,631.39	$42,441.97	2025-11-19
J9332	HCPCS	Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution	38	16	$66,571.60	$33,285.80 50% off	$32.07	$56,585.86	$39,610.10	2025-11-19
J9306	HCPCS	Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution	38	16	$63,139.60	$31,569.80 50% off	$15.42	$53,668.66	$37,568.06	2025-11-19
J1932	HCPCS	Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe	38	16	$62,611.80	$31,305.90 50% off	$29.84	$53,220.03	$37,254.02	2025-11-19
J0517	HCPCS	Benralizumab 30 Mg/ml Subcutaneous Syringe	38	16	$55,627.40	$27,813.70 50% off	$164.59	$47,283.29	$33,098.31	2025-11-19
J9271	HCPCS	Pembrolizumab 25 Mg/ml Intravenous Solution	38	16	$53,534.25	$26,767.13 50% off	$57.31	$45,504.11	$31,852.88	2025-11-19
J2506	HCPCS	Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector	38	16	$48,331.50	$24,165.75 50% off	$89.34	$41,081.78	$28,757.24	2025-11-19
J9204	HCPCS	Mogamulizumab-kpkc 4 Mg/ml Intravenous Solution	38	16	$43,419.75	$21,709.88 50% off	$234.16	$36,906.79	$25,834.76	2025-11-19
J0565	HCPCS	Bezlotoxumab 25 Mg/ml Intravenous Solution	38	16	$40,874.60	$20,437.30 50% off	$39.83	$34,743.41	$24,320.38	2025-11-19
C9482	HCPCS	Sotalol 150 Mg/10 Ml (15 Mg/ml) Intravenous Solution	38	16	$38,972.25	$19,486.13 50% off	$25.05	$33,126.41	$23,188.49	2025-11-19
J9334	HCPCS	Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln	37	16	$172,950.95	$86,475.48 50% off	$33.17	$147,008.31	$102,905.82	2025-11-19
J1304	HCPCS	Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution	37	16	$153,737.40	$76,868.70 50% off	$150.84	$130,676.79	$91,473.76	2025-11-19
J3263	HCPCS	Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution	37	16	$99,929.55	$49,964.78 50% off	$39.41	$84,940.12	$59,458.08	2025-11-19
J1299	HCPCS	Eculizumab 300 Mg/30 Ml Intravenous Solution	37	16	$60,387.70	$30,193.85 50% off	$44.82	$51,329.55	$35,930.68	2025-11-19
C9293	HCPCS	Glucarpidase 1,000 Unit Intravenous Solution	29	16	$442,645.50	$221,322.75 50% off	$516.74	$376,248.68	$263,374.08	2025-11-19
J3110	HCPCS	Teriparatide 20 Mcg/dose (560 Mcg/2.24 Ml) Subcutaneous Pen Injector	29	16	$39,792.20	$19,896.10 50% off	$73.87	$33,823.37	$23,676.36	2025-11-19
J0801	HCPCS	Corticotropin 80 Unit/ml Injection Gel	28	16	$464,366.00	$232,183.00 50% off	$3,370.39	$394,711.10	$276,297.77	2025-11-19
38240	CPT	Transplt Allo Hct/donor	12	10	—	—	$6,311.09	$58,779.65	$57,627.10	2025-11-19
0408T	CPT	Insj/rplc Cardiac Modulj Sys	12	10	—	—	$3,842.99	$31,864.97	$31,240.16	2025-11-19
33264	CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	12	10	—	—	$3,842.99	$31,864.97	$31,240.16	2025-11-19
33270	CPT	Ins/rep Subq Defibrillator	12	10	—	—	$3,842.99	$31,864.97	$31,240.16	2025-11-19
33249	CPT	Insj/rplcmt Defib W/lead(s)	12	10	—	—	$3,842.99	$31,864.97	$31,240.16	2025-11-19
33231	CPT	Insrt Pulse Gen W/mult Leads	12	10	—	—	$3,842.99	$31,864.97	$31,240.16	2025-11-19
69930	CPT	Implant Cochlear Device	12	10	—	—	$3,842.99	$31,612.76	$30,992.90	2025-11-19
0268T	CPT	Apc	12	10	—	—	$3,842.99	$30,286.71	$29,692.86	2025-11-19
61886	CPT	Implant Neurostim Arrays	12	10	—	—	$3,842.99	$30,286.71	$29,692.86	2025-11-19
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	12	10	—	—	$3,842.99	$30,286.71	$29,692.86	2025-11-19
0414T	CPT	Rmvl & Rpl Car Modulj Pls Gn	12	10	—	—	$3,842.99	$22,308.54	$21,871.12	2025-11-19
0409T	CPT	Insj/rplc Car Modulj Pls Gn	12	10	—	—	$3,842.99	$22,308.54	$21,871.12	2025-11-19
33263	CPT	Rmvl & Rplcmt Dfb Gen 2 Lead	12	10	—	—	$3,842.99	$22,308.54	$21,871.12	2025-11-19
33240	CPT	Insrt Pulse Gen W/singl Lead	12	10	—	—	$3,842.99	$22,308.54	$21,871.12	2025-11-19
33262	CPT	Rmvl& Replc Pulse Gen 1 Lead	12	10	—	—	$3,842.99	$22,308.54	$21,871.12	2025-11-19
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	11	10	—	—	$273,602.14	$660,992.25	$276,338.16	2025-11-19
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	11	10	—	—	$204,789.94	$493,705.79	$206,837.84	2025-11-19
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	11	10	—	—	$172,739.58	$415,789.52	$174,466.98	2025-11-19
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	11	10	—	—	$156,220.89	$375,631.65	$157,783.10	2025-11-19
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	11	10	—	—	$103,579.15	$247,656.51	$104,614.94	2025-11-19
14	MS_DRG	Allogeneic Bone Marrow Transplant	11	10	—	—	$96,166.22	$229,635.25	$97,127.88	2025-11-19
7	MS_DRG	Lung Transplant	11	10	—	—	$95,928.30	$229,056.86	$96,887.58	2025-11-19
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	11	10	—	—	$81,155.08	$193,142.28	$81,966.63	2025-11-19
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	11	10	—	—	$80,248.11	$190,937.39	$81,050.59	2025-11-19
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	11	10	—	—	$78,485.35	$186,652.03	$79,270.20	2025-11-19
215	MS_DRG	Other Heart Assist System Implant	11	10	—	—	$78,091.70	$185,695.06	$78,872.62	2025-11-19
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	10	—	—	$77,230.87	$183,602.34	$78,003.18	2025-11-19
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	11	10	—	—	$71,288.00	$169,154.83	$72,000.88	2025-11-19
850	MS_DRG	Acute Leukemia With Other Procedures	11	10	—	—	$68,121.51	$161,456.97	$68,802.73	2025-11-19
231	MS_DRG	Coronary Bypass With Ptca With Mcc	11	10	—	—	$62,800.84	$148,522.05	$63,428.85	2025-11-19
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	11	10	—	—	$62,766.95	$148,439.67	$63,394.62	2025-11-19
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	11	10	—	—	$61,839.80	$146,185.70	$62,458.20	2025-11-19
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	11	10	—	—	$59,824.70	$141,286.90	$60,422.95	2025-11-19
10	MS_DRG	Pancreas Transplant	11	10	—	—	$59,189.53	$139,742.77	$59,781.43	2025-11-19
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	11	10	—	—	$58,860.03	$138,941.79	$59,448.63	2025-11-19
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	11	10	—	—	$58,060.51	$136,998.04	$58,641.12	2025-11-19
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	11	10	—	—	$57,491.67	$135,615.16	$58,066.59	2025-11-19
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	11	10	—	—	$55,521.28	$130,825.03	$56,076.49	2025-11-19
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	10	—	—	$52,915.00	$124,489.02	$53,444.15	2025-11-19
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	11	10	—	—	$52,657.61	$123,863.31	$53,184.19	2025-11-19
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	11	10	—	—	$51,860.96	$121,926.58	$52,379.57	2025-11-19
955	MS_DRG	Craniotomy For Multiple Significant Trauma	11	10	—	—	$50,936.68	$119,679.61	$51,446.05	2025-11-19
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	11	10	—	—	$50,045.58	$117,513.28	$50,546.04	2025-11-19
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	11	10	—	—	$49,859.56	$117,061.08	$50,358.16	2025-11-19
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	11	10	—	—	$49,778.10	$116,863.03	$50,275.88	2025-11-19
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	11	10	—	—	$48,333.29	$113,350.61	$48,816.62	2025-11-19
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	11	10	—	—	$48,266.23	$113,187.61	$48,748.89	2025-11-19
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	11	10	—	—	$47,303.03	$110,846.01	$47,776.06	2025-11-19
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	11	10	—	—	$46,366.50	$108,569.25	$46,830.17	2025-11-19
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	11	10	—	—	$46,308.82	$108,429.03	$46,771.91	2025-11-19
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	11	10	—	—	$46,105.52	$107,934.77	$46,566.58	2025-11-19
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	11	10	—	—	$45,950.51	$107,557.94	$46,410.02	2025-11-19
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	11	10	—	—	$45,748.63	$107,067.18	$46,206.12	2025-11-19
28	MS_DRG	Spinal Procedures With Mcc	11	10	—	—	$45,538.12	$106,555.40	$45,993.50	2025-11-19
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	11	10	—	—	$45,223.78	$105,791.22	$45,676.02	2025-11-19
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	11	10	—	—	$45,223.78	$105,791.22	$45,676.02	2025-11-19
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	11	10	—	—	$44,898.63	$105,000.75	$45,347.62	2025-11-19
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	11	10	—	—	$44,599.44	$104,273.38	$45,045.43	2025-11-19
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	11	10	—	—	$44,566.99	$104,194.51	$45,012.66	2025-11-19
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	11	10	—	—	$44,130.08	$103,132.37	$44,571.38	2025-11-19
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	11	10	—	—	$43,683.81	$102,047.45	$44,120.65	2025-11-19
0266T	CPT	Fee Schedule	11	9	—	—	$6,575.00	$44,724.54	$43,847.59	2025-11-19
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	11	10	—	—	$43,086.14	$100,594.46	$43,517.00	2025-11-19
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	11	10	—	—	$42,838.84	$99,993.29	$43,267.23	2025-11-19
653	MS_DRG	Major Bladder Procedures With Mcc	11	10	—	—	$41,897.97	$97,706.01	$42,316.95	2025-11-19
834	MS_DRG	Acute Leukemia With Mcc	11	10	—	—	$41,556.97	$96,876.99	$41,972.54	2025-11-19
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	11	10	—	—	$41,556.97	$96,876.99	$41,972.54	2025-11-19
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	11	10	—	—	$41,389.70	$96,470.36	$41,803.60	2025-11-19
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	11	10	—	—	$41,147.47	$95,881.45	$41,558.94	2025-11-19
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	11	10	—	—	$40,935.50	$95,366.16	$41,344.86	2025-11-19
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	11	10	—	—	$40,846.09	$95,148.82	$41,254.55	2025-11-19
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	11	10	—	—	$40,646.41	$94,663.33	$41,052.87	2025-11-19
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	11	10	—	—	$40,609.62	$94,573.94	$41,015.72	2025-11-19
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	11	10	—	—	$40,605.31	$94,563.42	$41,011.36	2025-11-19
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	11	10	—	—	$40,063.85	$93,247.15	$40,464.49	2025-11-19
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	11	10	—	—	$39,894.43	$92,835.26	$40,293.37	2025-11-19
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	11	10	—	—	$38,837.50	$90,265.80	$39,225.88	2025-11-19
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	11	10	—	—	$38,714.22	$89,966.09	$39,101.36	2025-11-19
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	11	10	—	—	$38,437.37	$89,293.05	$38,821.74	2025-11-19
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	11	10	—	—	$38,324.89	$89,019.63	$38,708.14	2025-11-19
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	11	10	—	—	$38,021.38	$88,281.75	$38,401.59	2025-11-19
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	11	10	—	—	$37,807.25	$87,761.19	$38,185.32	2025-11-19
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	11	10	—	—	$37,779.12	$87,692.84	$38,156.91	2025-11-19
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	11	10	—	—	$37,764.71	$87,657.79	$38,142.36	2025-11-19
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	11	10	—	—	$37,634.95	$87,342.30	$38,011.30	2025-11-19
245	MS_DRG	Aicd Generator Procedures	11	10	—	—	$36,939.21	$85,650.94	$37,308.60	2025-11-19
471	MS_DRG	Cervical Spinal Fusion With Mcc	11	10	—	—	$36,726.53	$85,133.90	$37,093.80	2025-11-19
6	MS_DRG	Liver Transplant Without Mcc	11	10	—	—	$36,668.13	$84,991.93	$37,034.81	2025-11-19
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	11	10	—	—	$36,136.79	$83,700.19	$36,498.16	2025-11-19
799	MS_DRG	Splenic Procedures With Mcc	11	10	—	—	$35,987.55	$83,337.38	$36,347.43	2025-11-19
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	11	10	—	—	$35,981.05	$83,321.61	$36,340.86	2025-11-19
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	11	10	—	—	$35,626.35	$82,459.28	$35,982.61	2025-11-19
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	11	10	—	—	$35,444.65	$82,017.60	$35,799.10	2025-11-19
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	11	10	—	—	$35,245.68	$81,533.85	$35,598.14	2025-11-19
163	MS_DRG	Major Chest Procedures With Mcc	11	10	—	—	$34,937.81	$80,785.45	$35,287.19	2025-11-19
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	11	10	—	—	$34,924.12	$80,752.15	$35,273.36	2025-11-19
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	11	10	—	—	$34,818.14	$80,494.50	$35,166.32	2025-11-19
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	11	10	—	—	$34,813.09	$80,482.23	$35,161.22	2025-11-19
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	11	10	—	—	$34,234.16	$79,074.81	$34,576.50	2025-11-19
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	11	10	—	—	$34,040.22	$78,603.34	$34,380.62	2025-11-19
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	11	10	—	—	$33,950.81	$78,386.00	$34,290.32	2025-11-19
901	MS_DRG	Wound Debridements For Injuries With Mcc	11	10	—	—	$33,649.47	$77,653.37	$33,985.96	2025-11-19
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	11	10	—	—	$33,377.65	$76,992.61	$33,711.43	2025-11-19
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	11	10	—	—	$32,902.55	$75,837.58	$33,231.58	2025-11-19
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	11	10	—	—	$32,838.38	$75,681.59	$33,166.76	2025-11-19
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	11	10	—	—	$32,461.31	$74,764.92	$32,785.92	2025-11-19
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	11	10	—	—	$32,415.89	$74,654.50	$32,740.05	2025-11-19
140	MS_DRG	Major Head And Neck Procedures With Mcc	11	10	—	—	$32,198.16	$74,125.19	$32,520.14	2025-11-19
31	MS_DRG	Ventricular Shunt Procedures With Mcc	11	10	—	—	$31,919.87	$73,448.65	$32,239.07	2025-11-19
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	11	10	—	—	$31,912.67	$73,431.12	$32,231.80	2025-11-19
793	MS_DRG	Full Term Neonate With Major Problems	11	10	—	—	$31,774.95	$73,096.35	$32,092.70	2025-11-19
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	11	10	—	—	$31,704.29	$72,924.59	$32,021.33	2025-11-19
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	11	10	—	—	$31,353.91	$72,072.78	$31,667.45	2025-11-19
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	11	10	—	—	$31,337.35	$72,032.46	$31,650.72	2025-11-19
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	11	10	—	—	$31,293.37	$71,925.55	$31,606.30	2025-11-19
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	11	10	—	—	$31,147.73	$71,571.50	$31,459.21	2025-11-19
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	11	10	—	—	$31,031.65	$71,289.32	$31,341.97	2025-11-19
791	MS_DRG	Prematurity With Major Problems	11	10	—	—	$30,977.58	$71,157.87	$31,287.36	2025-11-19
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	11	10	—	—	$30,428.20	$69,822.31	$30,732.48	2025-11-19
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	11	10	—	—	$30,408.02	$69,773.23	$30,712.10	2025-11-19
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	11	10	—	—	$30,154.23	$69,156.28	$30,455.77	2025-11-19
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	11	10	—	—	$30,095.85	$69,014.32	$30,396.81	2025-11-19
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	11	10	—	—	$30,038.15	$68,874.10	$30,338.53	2025-11-19
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	11	10	—	—	$29,912.72	$68,569.13	$30,211.85	2025-11-19
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	11	10	—	—	$29,899.02	$68,535.83	$30,198.01	2025-11-19
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	11	10	—	—	$29,743.28	$68,157.24	$30,040.71	2025-11-19
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	11	10	—	—	$29,572.41	$67,741.86	$29,868.13	2025-11-19
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	11	10	—	—	$29,544.31	$67,673.50	$29,839.75	2025-11-19
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	11	10	—	—	$29,466.45	$67,484.21	$29,761.11	2025-11-19
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	11	10	—	—	$29,265.29	$66,995.20	$29,557.94	2025-11-19
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	11	10	—	—	$29,116.05	$66,632.40	$29,407.21	2025-11-19
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	11	10	—	—	$28,902.64	$66,113.60	$29,191.67	2025-11-19
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	11	10	—	—	$28,685.63	$65,586.03	$28,972.49	2025-11-19
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	11	10	—	—	$28,012.99	$63,950.76	$28,293.12	2025-11-19
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	11	10	—	—	$27,830.57	$63,507.33	$28,108.88	2025-11-19
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	11	10	—	—	$27,552.28	$62,830.79	$27,827.80	2025-11-19
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	11	10	—	—	$27,550.83	$62,827.28	$27,826.34	2025-11-19
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	11	10	—	—	$27,546.51	$62,816.77	$27,821.98	2025-11-19
33289	CPT	Tcat Impl Wrls P-art Prs Snr	11	10	—	—	$4,405.24	$28,254.00	$27,700.00	2025-11-19
265	MS_DRG	Aicd Lead Procedures	11	10	—	—	$27,425.39	$62,522.31	$27,699.64	2025-11-19
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	11	10	—	—	$27,310.05	$62,241.88	$27,583.15	2025-11-19
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	11	10	—	—	$27,160.09	$61,877.32	$27,431.69	2025-11-19
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	11	10	—	—	$27,153.59	$61,861.55	$27,425.13	2025-11-19
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	11	10	—	—	$27,089.43	$61,705.56	$27,360.32	2025-11-19
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	11	10	—	—	$26,968.31	$61,411.10	$27,237.99	2025-11-19
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	11	10	—	—	$26,960.36	$61,391.82	$27,229.96	2025-11-19
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	11	10	—	—	$26,950.27	$61,367.29	$27,219.77	2025-11-19
264	MS_DRG	Other Circulatory System O.r. Procedures	11	10	—	—	$26,905.59	$61,258.62	$27,174.65	2025-11-19
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	11	10	—	—	$26,742.66	$60,862.51	$27,010.09	2025-11-19
332	MS_DRG	Rectal Resection With Mcc	11	10	—	—	$26,715.24	$60,795.90	$26,982.39	2025-11-19
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	11	10	—	—	$26,687.86	$60,729.30	$26,954.74	2025-11-19
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	11	10	—	—	$26,540.06	$60,370.00	$26,805.46	2025-11-19
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	11	10	—	—	$26,501.12	$60,275.35	$26,766.13	2025-11-19
665	MS_DRG	Prostatectomy With Mcc	11	10	—	—	$26,462.19	$60,180.71	$26,726.81	2025-11-19
252	MS_DRG	Other Vascular Procedures With Mcc	11	10	—	—	$26,439.12	$60,124.62	$26,703.51	2025-11-19
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	11	10	—	—	$26,401.63	$60,033.48	$26,665.65	2025-11-19
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	11	10	—	—	$26,264.65	$59,700.47	$26,527.30	2025-11-19
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	11	10	—	—	$26,162.27	$59,451.58	$26,423.89	2025-11-19
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	11	10	—	—	$25,907.78	$58,832.88	$26,166.86	2025-11-19
37	MS_DRG	Extracranial Procedures With Mcc	11	10	—	—	$25,649.66	$58,205.41	$25,906.16	2025-11-19
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	11	10	—	—	$25,512.71	$57,872.40	$25,767.84	2025-11-19
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	11	10	—	—	$25,273.33	$57,290.50	$25,526.06	2025-11-19
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	11	10	—	—	$25,206.27	$57,127.50	$25,458.33	2025-11-19
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	11	10	—	—	$25,196.18	$57,102.97	$25,448.14	2025-11-19
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	11	10	—	—	$24,917.17	$56,424.67	$25,166.34	2025-11-19
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	11	10	—	—	$24,809.75	$56,163.52	$25,057.85	2025-11-19
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	11	10	—	—	$24,742.68	$56,000.52	$24,990.11	2025-11-19
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	11	10	—	—	$24,698.72	$55,893.60	$24,945.71	2025-11-19
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	11	10	—	—	$24,636.71	$55,742.87	$24,883.08	2025-11-19
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	11	10	—	—	$24,590.58	$55,630.70	$24,836.49	2025-11-19
500	MS_DRG	Soft Tissue Procedures With Mcc	11	10	—	—	$24,552.37	$55,537.80	$24,797.89	2025-11-19
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	11	10	—	—	$24,208.47	$54,701.77	$24,450.55	2025-11-19
662	MS_DRG	Minor Bladder Procedures With Mcc	11	10	—	—	$24,198.37	$54,677.23	$24,440.35	2025-11-19
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	11	10	—	—	$24,102.48	$54,444.12	$24,343.50	2025-11-19
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	11	10	—	—	$24,002.27	$54,200.49	$24,242.29	2025-11-19
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	11	10	—	—	$23,956.13	$54,088.32	$24,195.69	2025-11-19
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	11	10	—	—	$23,940.27	$54,049.76	$24,179.67	2025-11-19
652	MS_DRG	Kidney Transplant	11	10	—	—	$23,850.87	$53,832.43	$24,089.38	2025-11-19
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	11	10	—	—	$23,830.69	$53,783.35	$24,069.00	2025-11-19
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	11	10	—	—	$23,758.57	$53,608.08	$23,996.16	2025-11-19
93656	CPT	Compre Ep Eval Abltj Atr Fib	11	9	—	—	$6,575.00	$24,381.86	$23,903.78	2025-11-19
93653	CPT	Compre Ep Eval Tx Svt	11	9	—	—	$6,575.00	$24,381.86	$23,903.78	2025-11-19
93654	CPT	Compre Ep Eval Tx Vt	11	9	—	—	$6,575.00	$24,381.86	$23,903.78	2025-11-19
570	MS_DRG	Skin Debridement With Mcc	11	10	—	—	$23,409.65	$52,759.78	$23,643.75	2025-11-19
974	MS_DRG	HIV With Major Related Condition With Mcc	11	10	—	—	$23,236.61	$52,339.13	$23,468.98	2025-11-19
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	11	10	—	—	$22,965.52	$51,680.11	$23,195.18	2025-11-19
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	11	10	—	—	$22,910.74	$51,546.91	$23,139.85	2025-11-19
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	11	10	—	—	$22,853.05	$51,406.69	$23,081.58	2025-11-19
668	MS_DRG	Transurethral Procedures With Mcc	11	10	—	—	$22,732.66	$51,113.99	$22,959.99	2025-11-19
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	11	10	—	—	$22,721.11	$51,085.95	$22,948.32	2025-11-19
800	MS_DRG	Splenic Procedures With Cc	11	10	—	—	$22,714.63	$51,070.17	$22,941.78	2025-11-19
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	11	10	—	—	$22,703.10	$51,042.13	$22,930.13	2025-11-19
472	MS_DRG	Cervical Spinal Fusion With Cc	11	10	—	—	$22,594.96	$50,779.22	$22,820.91	2025-11-19
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	11	10	—	—	$22,377.93	$50,251.66	$22,601.71	2025-11-19
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	11	10	—	—	$22,354.14	$50,193.82	$22,577.68	2025-11-19
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	11	10	—	—	$22,341.90	$50,164.03	$22,565.32	2025-11-19
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	11	10	—	—	$22,313.04	$50,093.92	$22,536.17	2025-11-19
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	11	10	—	—	$22,231.60	$49,895.86	$22,453.92	2025-11-19
654	MS_DRG	Major Bladder Procedures With Cc	11	10	—	—	$22,053.51	$49,462.95	$22,274.05	2025-11-19
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	11	10	—	—	$21,954.74	$49,222.83	$22,174.29	2025-11-19
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	11	10	—	—	$21,933.84	$49,172.00	$22,153.18	2025-11-19
Q2042	HCPCS	Tisagenlecleucel Car-pos T	10	10	—	—	$518,240.68	$603,560.73	$591,726.20	2025-11-19
Q2056	HCPCS	Ciltacabtagene Car-pos T	10	10	—	—	$507,495.55	$577,186.32	$565,868.95	2025-11-19
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	10	10	—	—	$474,060.62	$573,788.95	$562,538.19	2025-11-19
Q2055	HCPCS	Idecabtagene Vicleucel Car	10	10	—	—	$484,690.30	$568,464.29	$557,317.93	2025-11-19
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	10	10	—	—	$459,381.45	$543,894.77	$533,230.17	2025-11-19
Q2053	HCPCS	Brexucabtagene Car Pos T	10	10	—	—	$449,440.00	$499,090.70	$489,304.61	2025-11-19
J9029	HCPCS	Instill Adstiladrin, Tx Dose	10	10	—	—	$63,342.28	$64,609.13	$63,423.84	2025-11-19
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	10	10	—	—	$55,272.32	$56,377.77	$55,362.94	2025-11-19
J9226	HCPCS	Supprelin La Implant	10	10	—	—	$44,578.75	$45,921.06	$45,020.65	2025-11-19
33276	CPT	Insj Phrnc Nrv Stim Sys	10	10	—	—	$4,405.24	$44,724.54	$43,847.59	2025-11-19
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	10	9	—	—	$8,741.66	$34,785.86	$34,103.79	2025-11-19
0571T	CPT	Insj/rplcmt Icds Ss Eltrd	10	9	—	—	$8,741.66	$31,864.97	$31,240.16	2025-11-19
33287	CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	10	10	—	—	$4,405.24	$30,286.71	$29,692.86	2025-11-19
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	10	10	—	—	$4,405.24	$30,286.71	$29,692.86	2025-11-19
C9760	HCPCS	Non-blind Interatrial Shunt	10	9	—	—	$2,223.96	$27,331.86	$26,795.94	2025-11-19
0515T	CPT	Insj Wcs Lv Compl Sys	10	9	—	—	$8,741.66	$22,308.54	$21,871.12	2025-11-19
J3391	HCPCS	Inj, Atidarsagene Autotemcel	9	9	—	—	$4,505,000.00	$4,595,100.00	$4,505,000.00	2025-11-19
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	9	9	—	—	$3,685,266.67	$3,758,972.00	$3,685,266.67	2025-11-19
J1413	HCPCS	Inj Delandistrogene Mox Rokl	9	9	—	—	$3,316,462.59	$3,382,791.84	$3,316,462.59	2025-11-19
J3394	HCPCS	Inj, Lovotibeglogene Autotem	9	9	—	—	$3,248,445.72	$3,313,414.63	$3,248,445.72	2025-11-19
J3393	HCPCS	Inj, Betibeglogene Autotemce	9	9	—	—	$2,945,740.00	$3,004,654.80	$2,945,740.00	2025-11-19
J3399	HCPCS	Inj Onase Abepar-xioi Treat	9	9	—	—	$2,455,110.61	$2,504,212.82	$2,455,110.61	2025-11-19
J3392	HCPCS	Inj, Exagamglogene Autotem	9	9	—	—	$2,332,000.00	$2,378,640.00	$2,332,000.00	2025-11-19
Q2057	HCPCS	Afamitresgene Autoleucel	9	9	—	—	$770,620.00	$786,032.40	$770,620.00	2025-11-19
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	9	9	—	—	$278,250.00	$283,815.00	$278,250.00	2025-11-19
J3403	HCPCS	Revakinagene, Per Implant	9	9	—	—	$257,500.00	$262,650.00	$257,500.00	2025-11-19
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	9	9	—	—	$205,640.00	$209,752.80	$205,640.00	2025-11-19
Q0480	HCPCS	Driver Pneumatic Vad, Rep	9	9	—	—	$129,537.54	$132,128.29	$129,537.54	2025-11-19
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	9	9	—	—	$111,860.04	$114,097.24	$111,860.04	2025-11-19
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	9	9	—	—	$80,943.19	$82,562.05	$80,943.19	2025-11-19
L7181	HCPCS	Electronic Elbo Simultaneous	9	9	—	—	$57,614.51	$58,766.80	$57,614.51	2025-11-19
A9543	HCPCS	Y90 Ibritumomab, Rx	9	9	—	—	$56,824.55	$57,961.04	$56,824.55	2025-11-19
L7180	HCPCS	Electronic Elbow Sequential	9	9	—	—	$52,277.90	$53,323.46	$52,277.90	2025-11-19
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	9	9	—	—	$41,141.33	$41,964.16	$41,141.33	2025-11-19
L6700	HCPCS	Ue Add Ext Power Myoel	9	9	—	—	$34,717.87	$35,412.23	$34,717.87	2025-11-19
L5856	HCPCS	Elec Knee-shin Swing/stance	9	9	—	—	$34,568.35	$35,259.72	$34,568.35	2025-11-19
L6880	HCPCS	Elec Hand Ind Art Digits	9	9	—	—	$34,363.97	$35,051.25	$34,363.97	2025-11-19
0915T	CPT	Insj Perm Ccm-d Sys Pg&eltrd	9	9	—	—	$31,240.16	$31,864.97	$31,240.16	2025-11-19
0674T	CPT	Laps Insj Nw/rpcmt Prm Isdss	9	9	—	—	$29,692.86	$30,286.71	$29,692.86	2025-11-19
Q0483	HCPCS	Monitor Elec Vad, Rep	9	9	—	—	$26,966.90	$27,506.24	$26,966.90	2025-11-19
L5858	HCPCS	Stance Phase Only	9	9	—	—	$26,723.96	$27,258.44	$26,723.96	2025-11-19
L6975	HCPCS	Interscap-thor Myoelectronic	9	9	—	—	$25,573.88	$26,085.36	$25,573.88	2025-11-19
L5973	HCPCS	Ank-foot Sys Dors-plant Flex	9	9	—	—	$25,092.86	$25,594.72	$25,092.86	2025-11-19
J9600	HCPCS	Porfimer Sodium Injection	9	9	—	—	$24,228.42	$24,712.99	$24,228.42	2025-11-19
Q0489	HCPCS	Pwr Pck Base Combo Vad, Rep	9	9	—	—	$23,378.84	$23,846.42	$23,378.84	2025-11-19
L6970	HCPCS	Interscapular-thor Switch CT	9	9	—	—	$23,340.59	$23,807.40	$23,340.59	2025-11-19
L6965	HCPCS	Shldr Disartic Myoelectronic	9	9	—	—	$22,680.77	$23,134.39	$22,680.77	2025-11-19
0960T	CPT	Rpl S-sclp Eltr Ra Rcvr&tlmt	9	9	—	—	$21,924.04	$22,362.52	$21,924.04	2025-11-19
0956T	CPT	Prt Crn Ch Cr&tun Elt S-sclp	9	9	—	—	$21,924.04	$22,362.52	$21,924.04	2025-11-19

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