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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

ATRIUM HEALTH NAVICENT PEACH

Byron, GA · CCN 111310 · Rates published

9,087 distinct procedures filed
17 distinct payers
849,875 rate rows
2025-11-19 last MRF observed
Data quality

664,806 of 849,875 rate rows are consumer-grade (78.2%)

185,069 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
professional (physician) fee — not the facility price 184,248
percent-of-charges filed in the dollar field — excluded from medians 502
template filing: same amount across many unrelated codes — excluded 136
per-diem day rate — not a per-procedure price 115
placeholder amount (≤ $0.02) — excluded from medians 36
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 26
exceeds 10× this hospital's gross charge — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11182/453765471_the-medical-center-of-peach-county-inc_standardcharges.csv
Found on page https://navicenthealth.org/for-patients-and-visitors/pt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-11
Content fingerprint 5a40b2f7b89271e4… · 1,264,008,707 bytes · first seen 2026-05-09

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
J2326
HCPCS 		Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 17 $2,207.41 $1,378,686.64 $941,361.31 nat. median
$2,353
outlier · 400.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $367,247.25 $393,475.37 $367,247.25 nat. median
$370,165
1.0× median
J0801
HCPCS 		Corticotropin 80 Unit/ml Injection Gel 17 $97,516.86 $431,860.38 $294,872.41 nat. median
$5,203
outlier · 56.7×
C9293
HCPCS 		Glucarpidase 1,000 Unit Intravenous Solution 17 $728.60 $411,660.32 $281,079.90 nat. median
$24,377
outlier · 11.5×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $274,302.91 $293,893.11 $274,302.91 nat. median
$261,939
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $231,012.63 $247,511.12 $231,012.63 nat. median
$205,166
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 2 $208,700.92 $223,605.96 $208,700.92 nat. median
$199,832
1.0× median
J9269
HCPCS 		Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 17 $641.37 $290,438.12 $198,309.90 nat. median
$498
outlier · 398.5×
J9348
HCPCS 		Naxitamab-gqgk 4 Mg/ml Intravenous Solution 17 $1,152.41 $260,617.11 $177,948.24 nat. median
$829
outlier · 214.6×
J2350
HCPCS 		Ocrelizumab 30 Mg/ml Intravenous Solution 17 $122.11 $206,381.28 $140,916.25 nat. median
$331
outlier · 426.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 2 $137,597.94 $147,424.93 $137,597.94 nat. median
$132,706
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $127,585.33 $136,697.24 $127,585.33 nat. median
$114,305
1.1× median
7
MS_DRG 		Lung Transplant 2 $127,263.97 $136,352.93 $127,263.97 nat. median
$122,690
1.0× median
J9274
HCPCS 		Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 17 $405.23 $176,225.70 $120,326.15 nat. median
$410
outlier · 293.2×
J9334
HCPCS 		Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln 17 $36,319.70 $160,844.38 $109,823.85 nat. median
$77
outlier · 1430.9×
J9266
HCPCS 		Pegaspargase 750 Unit/ml Injection Solution 17 $36,143.69 $160,064.90 $109,291.62 nat. median
$32,688
outlier · 3.3×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $107,309.84 $114,973.71 $107,309.84 nat. median
$108,240
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $106,084.80 $113,661.18 $106,084.80 nat. median
$100,978
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $103,703.86 $111,110.20 $103,703.86 nat. median
$99,646
1.0× median
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 17 $4,540.28 $151,777.40 $103,632.96 nat. median
$3,876
outlier · 26.7×
215
MS_DRG 		Other Heart Assist System Implant 2 $103,172.16 $110,540.53 $103,172.16 nat. median
$98,002
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $102,009.45 $109,294.77 $102,009.45 nat. median
$96,835
1.1× median
J1304
HCPCS 		Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 17 $32,284.85 $142,975.78 $97,623.25 nat. median
$188
outlier · 520.5×
J3357
HCPCS 		Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 17 $293.55 $282,698.52 $96,512.76 nat. median
$12,959
outlier · 7.4×
J1305
HCPCS 		Evinacumab-dgnb 150 Mg/ml Intravenous Solution 17 $349.47 $421,741.79 $96,184.34 nat. median
$301
outlier · 319.9×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $93,982.41 $100,694.46 $93,982.41 nat. median
$92,900
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $89,705.48 $96,112.08 $89,705.48 nat. median
$81,364
1.1× median
J9298
HCPCS 		Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 17 $365.08 $130,112.72 $88,840.40 nat. median
$550
outlier · 161.6×
J9043
HCPCS 		Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 17 $409.61 $123,567.52 $84,371.37 nat. median
$709
outlier · 119.1×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $82,518.84 $88,412.18 $82,518.84 nat. median
$79,040
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $82,473.07 $88,363.14 $82,473.07 nat. median
$80,459
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $81,220.76 $87,021.40 $81,220.76 nat. median
$81,124
1.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $78,498.99 $84,105.25 $78,498.99 nat. median
$77,385
1.0× median
10
MS_DRG 		Pancreas Transplant 2 $77,641.07 $83,186.06 $77,641.07 nat. median
$67,750
1.1× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 $77,196.05 $82,709.25 $77,196.05 nat. median
$69,153
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 $76,116.10 $81,552.17 $76,116.10 nat. median
$73,475
1.0× median
J2329
HCPCS 		Ublituximab-xiiy 25 Mg/ml Intravenous Solution 17 $130.34 $111,095.52 $75,855.54 nat. median
$168
outlier · 450.6×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $75,347.78 $80,728.97 $75,347.78 nat. median
$74,472
1.0× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $72,686.38 $77,877.51 $72,686.38 nat. median
$71,485
1.0× median
J9382
HCPCS 		Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 17 $23,077.68 $204,355.97 $69,782.50 nat. median
$94
outlier · 746.0×
J2840
HCPCS 		Sebelipase Alfa 2 Mg/ml Intravenous Solution 17 $1,014.92 $102,097.73 $69,711.89 nat. median
$657
outlier · 106.1×
J9272
HCPCS 		Dostarlimab-gxly 50 Mg/ml Intravenous Solution 17 $451.16 $101,507.69 $69,309.01 nat. median
$741
outlier · 93.5×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $69,166.09 $74,105.81 $69,166.09 nat. median
$66,640
1.0× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $68,818.45 $73,733.33 $68,818.45 nat. median
$68,581
1.0× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $67,742.40 $72,580.43 $67,742.40 nat. median
$65,958
1.0× median
J9228
HCPCS 		Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 17 $333.86 $305,510.30 $67,358.74 nat. median
$8,184
outlier · 8.2×
J0222
HCPCS 		Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution 17 $199.74 $97,848.79 $66,810.74 nat. median
$154
outlier · 434.0×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 2 $66,493.99 $71,242.86 $66,493.99 nat. median
$64,357
1.0× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 $65,290.37 $69,953.29 $65,290.37 nat. median
$62,262
1.0× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 $65,039.13 $69,684.10 $65,039.13 nat. median
$62,911
1.0× median

Other procedures at this hospital

Browse this hospital's 9,087 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 2 — — $274,302.91 $293,893.11 $274,302.91 2025-11-19
10 MS_DRG Pancreas Transplant 3 2 — — $77,641.07 $83,186.06 $77,641.07 2025-11-19
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 2 — — $52,545.27 $56,297.96 $52,545.27 2025-11-19
113 MS_DRG Orbital Procedures With Cc/mcc 3 2 — — $21,974.77 $23,544.17 $21,974.77 2025-11-19
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 2 — — $39,961.83 $42,815.83 $39,961.83 2025-11-19
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 3 2 — — $25,805.70 $27,648.70 $25,805.70 2025-11-19
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 3 2 — — $23,479.29 $25,156.14 $23,479.29 2025-11-19
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $127,585.33 $136,697.24 $127,585.33 2025-11-19
140 MS_DRG Major Head And Neck Procedures With Mcc 3 2 — — $41,183.95 $44,125.23 $41,183.95 2025-11-19
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 2 — — $32,153.90 $34,450.27 $32,153.90 2025-11-19
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 2 — — $22,339.95 $23,935.42 $22,339.95 2025-11-19
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 2 — — $58,777.59 $62,975.38 $58,777.59 2025-11-19
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $44,884.39 $48,089.95 $44,884.39 2025-11-19
164 MS_DRG Major Chest Procedures With Cc 3 2 — — $24,510.55 $26,261.04 $24,510.55 2025-11-19
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 2 — — $37,494.22 $40,171.99 $37,494.22 2025-11-19
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 2 — — $58,777.59 $62,975.38 $58,777.59 2025-11-19
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 2 — — $29,882.03 $32,016.15 $29,882.03 2025-11-19
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 2 — — $367,247.25 $393,475.37 $367,247.25 2025-11-19
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 2 — — $77,196.05 $82,709.25 $77,196.05 2025-11-19
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $107,309.84 $114,973.71 $107,309.84 2025-11-19
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $78,498.99 $84,105.25 $78,498.99 2025-11-19
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 2 — — $62,977.59 $67,475.34 $62,977.59 2025-11-19
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 2 — — $26,134.84 $28,001.35 $26,134.84 2025-11-19
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $53,824.85 $57,668.92 $53,824.85 2025-11-19
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 2 — — $106,084.80 $113,661.18 $106,084.80 2025-11-19
215 MS_DRG Other Heart Assist System Implant 3 2 — — $103,172.16 $110,540.53 $103,172.16 2025-11-19
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $93,982.41 $100,694.46 $93,982.41 2025-11-19
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $62,887.03 $67,378.31 $62,887.03 2025-11-19
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $57,934.28 $62,071.84 $57,934.28 2025-11-19
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $75,347.78 $80,728.97 $75,347.78 2025-11-19
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 2 — — $34,379.04 $36,834.32 $34,379.04 2025-11-19
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $51,579.26 $55,262.96 $51,579.26 2025-11-19
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $44,722.74 $47,916.75 $44,722.74 2025-11-19
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 2 — — $48,527.38 $51,993.11 $48,527.38 2025-11-19
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 2 — — $30,249.15 $32,409.49 $30,249.15 2025-11-19
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $55,556.26 $59,523.99 $55,556.26 2025-11-19
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 2 — — $82,518.84 $88,412.18 $82,518.84 2025-11-19
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 2 — — $59,486.52 $63,734.94 $59,486.52 2025-11-19
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 2 — — $76,116.10 $81,552.17 $76,116.10 2025-11-19
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 2 — — $51,808.11 $55,508.15 $51,808.11 2025-11-19
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 2 — — $57,300.34 $61,392.62 $57,300.34 2025-11-19
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 2 — — $40,043.63 $42,903.47 $40,043.63 2025-11-19
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 2 — — $49,049.33 $52,552.35 $49,049.33 2025-11-19
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $37,020.95 $39,664.92 $37,020.95 2025-11-19
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 2 — — $28,359.00 $30,384.35 $28,359.00 2025-11-19
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 2 — — $33,031.30 $35,390.33 $33,031.30 2025-11-19
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 3 2 — — $21,937.77 $23,504.52 $21,937.77 2025-11-19
245 MS_DRG Aicd Generator Procedures 3 2 — — $47,587.66 $50,986.28 $47,587.66 2025-11-19
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $43,551.26 $46,661.61 $43,551.26 2025-11-19
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 3 2 — — $22,520.10 $24,128.44 $22,520.10 2025-11-19
252 MS_DRG Other Vascular Procedures With Mcc 3 2 — — $33,405.24 $35,790.98 $33,405.24 2025-11-19
253 MS_DRG Other Vascular Procedures With Cc 3 2 — — $24,861.11 $26,636.65 $24,861.11 2025-11-19
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 2 — — $25,479.48 $27,299.17 $25,479.48 2025-11-19
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 2 — — $27,319.96 $29,271.10 $27,319.96 2025-11-19
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 2 — — $29,784.65 $31,911.81 $29,784.65 2025-11-19
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 2 — — $33,169.58 $35,538.49 $33,169.58 2025-11-19
263 MS_DRG Vein Ligation And Stripping 3 2 — — $26,118.29 $27,983.61 $26,118.29 2025-11-19
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $34,035.28 $36,466.02 $34,035.28 2025-11-19
265 MS_DRG Aicd Lead Procedures 3 2 — — $34,737.39 $37,218.27 $34,737.39 2025-11-19
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 2 — — $58,338.41 $62,504.83 $58,338.41 2025-11-19
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 2 — — $45,814.37 $49,086.35 $45,814.37 2025-11-19
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 2 — — $64,929.09 $69,566.20 $64,929.09 2025-11-19
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $40,516.90 $43,410.54 $40,516.90 2025-11-19
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 2 — — $24,031.44 $25,747.72 $24,031.44 2025-11-19
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $49,985.15 $53,555.00 $49,985.15 2025-11-19
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 2 — — $33,541.57 $35,937.04 $33,541.57 2025-11-19
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 3 2 — — $24,366.42 $26,106.63 $24,366.42 2025-11-19
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 2 — — $38,078.50 $40,798.00 $38,078.50 2025-11-19
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 3 2 — — $30,392.30 $32,562.86 $30,392.30 2025-11-19
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 2 — — $68,818.45 $73,733.33 $68,818.45 2025-11-19
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 3 2 — — $60,321.07 $64,629.09 $60,321.07 2025-11-19
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 3 2 — — $45,300.20 $48,535.46 $45,300.20 2025-11-19
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $48,722.14 $52,201.78 $48,722.14 2025-11-19
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $31,204.45 $33,433.01 $31,204.45 2025-11-19
28 MS_DRG Spinal Procedures With Mcc 3 2 — — $59,202.17 $63,430.28 $59,202.17 2025-11-19
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 3 2 — — $21,553.12 $23,092.40 $21,553.12 2025-11-19
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 2 — — $26,599.35 $28,499.02 $26,599.35 2025-11-19
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 2 — — $32,687.54 $35,022.03 $32,687.54 2025-11-19
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 3 2 — — $208,700.92 $223,605.96 $208,700.92 2025-11-19
30 MS_DRG Spinal Procedures Without Cc/mcc 3 2 — — $21,670.95 $23,218.64 $21,670.95 2025-11-19
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $40,808.06 $43,722.50 $40,808.06 2025-11-19
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 2 — — $60,243.16 $64,545.62 $60,243.16 2025-11-19
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $42,777.09 $45,832.15 $42,777.09 2025-11-19
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 2 — — $22,541.52 $24,151.40 $22,541.52 2025-11-19
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 3 2 — — $27,722.14 $29,702.00 $27,722.14 2025-11-19
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $41,478.04 $44,440.32 $41,478.04 2025-11-19
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 2 — — $31,113.88 $33,335.98 $31,113.88 2025-11-19
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 2 — — $27,871.13 $29,861.63 $27,871.13 2025-11-19
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 2 — — $49,459.30 $52,991.59 $49,459.30 2025-11-19
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 2 — — $23,644.84 $25,333.51 $23,644.84 2025-11-19
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $44,715.92 $47,909.45 $44,715.92 2025-11-19
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 2 — — $23,017.71 $24,661.59 $23,017.71 2025-11-19
332 MS_DRG Rectal Resection With Mcc 3 2 — — $33,778.20 $36,190.58 $33,778.20 2025-11-19
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 2 — — $35,284.67 $37,804.64 $35,284.67 2025-11-19
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 2 — — $37,868.16 $40,572.63 $37,868.16 2025-11-19
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 2 — — $26,239.04 $28,112.98 $26,239.04 2025-11-19
347 MS_DRG Anal And Stomal Procedures With Mcc 3 2 — — $23,047.90 $24,693.94 $23,047.90 2025-11-19
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 2 — — $22,152.00 $23,734.06 $22,152.00 2025-11-19
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 2 — — $23,553.30 $25,235.43 $23,553.30 2025-11-19
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 2 — — $28,561.55 $30,601.37 $28,561.55 2025-11-19
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $41,539.39 $44,506.05 $41,539.39 2025-11-19
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 2 — — $21,929.98 $23,496.17 $21,929.98 2025-11-19
37 MS_DRG Extracranial Procedures With Mcc 3 2 — — $32,338.92 $34,648.51 $32,338.92 2025-11-19
397 MS_DRG Appendix Procedures With Mcc 3 2 — — $24,128.82 $25,852.05 $24,128.82 2025-11-19
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 3 2 — — $137,597.94 $147,424.93 $137,597.94 2025-11-19
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 2 — — $36,732.71 $39,356.09 $36,732.71 2025-11-19
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 2 — — $38,097.00 $40,817.82 $38,097.00 2025-11-19
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 2 — — $52,864.68 $56,640.18 $52,864.68 2025-11-19
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 2 — — $27,348.20 $29,301.36 $27,348.20 2025-11-19
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $34,095.66 $36,530.71 $34,095.66 2025-11-19
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 2 — — $21,990.35 $23,560.86 $21,990.35 2025-11-19
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 2 — — $26,647.06 $28,550.15 $26,647.06 2025-11-19
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 2 — — $34,120.00 $36,556.79 $34,120.00 2025-11-19
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 2 — — $23,142.36 $24,795.14 $23,142.36 2025-11-19
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $34,370.27 $36,824.93 $34,370.27 2025-11-19
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 2 — — $39,608.34 $42,437.10 $39,608.34 2025-11-19
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 2 — — $22,234.78 $23,822.74 $22,234.78 2025-11-19
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $102,009.45 $109,294.77 $102,009.45 2025-11-19
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $69,166.09 $74,105.81 $69,166.09 2025-11-19
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $53,598.93 $57,426.86 $53,598.93 2025-11-19
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 2 — — $81,220.76 $87,021.40 $81,220.76 2025-11-19
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 2 — — $53,271.73 $57,076.30 $53,271.73 2025-11-19
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 2 — — $65,290.37 $69,953.29 $65,290.37 2025-11-19
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $39,765.12 $42,605.07 $39,765.12 2025-11-19
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 2 — — $50,151.67 $53,733.41 $50,151.67 2025-11-19
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $30,051.47 $32,197.69 $30,051.47 2025-11-19
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $82,473.07 $88,363.14 $82,473.07 2025-11-19
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $55,890.28 $59,881.86 $55,890.28 2025-11-19
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $42,048.68 $45,051.72 $42,048.68 2025-11-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 2 — — $59,759.18 $64,027.08 $59,759.18 2025-11-19
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 3 2 — — $27,887.68 $29,879.37 $27,887.68 2025-11-19
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $52,594.94 $56,351.17 $52,594.94 2025-11-19
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $28,713.47 $30,764.13 $28,713.47 2025-11-19
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 2 — — $49,611.21 $53,154.36 $49,611.21 2025-11-19
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 2 — — $33,354.60 $35,736.72 $33,354.60 2025-11-19
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 2 — — $25,545.70 $27,370.12 $25,545.70 2025-11-19
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 2 — — $31,830.60 $34,103.88 $31,830.60 2025-11-19
471 MS_DRG Cervical Spinal Fusion With Mcc 3 2 — — $47,300.39 $50,678.49 $47,300.39 2025-11-19
472 MS_DRG Cervical Spinal Fusion With Cc 3 2 — — $28,212.93 $30,227.85 $28,212.93 2025-11-19
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 3 2 — — $23,053.74 $24,700.20 $23,053.74 2025-11-19
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $43,672.01 $46,790.98 $43,672.01 2025-11-19
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 2 — — $33,488.98 $35,880.70 $33,488.98 2025-11-19
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 3 2 — — $22,773.29 $24,399.71 $22,773.29 2025-11-19
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 2 — — $28,639.46 $30,684.84 $28,639.46 2025-11-19
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 3 2 — — $24,814.37 $26,586.57 $24,814.37 2025-11-19
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 2 — — $31,349.54 $33,588.47 $31,349.54 2025-11-19
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 2 — — $34,581.59 $37,051.34 $34,581.59 2025-11-19
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 2 — — $23,380.94 $25,050.76 $23,380.94 2025-11-19
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 2 — — $34,283.60 $36,732.07 $34,283.60 2025-11-19
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 2 — — $24,587.48 $26,343.47 $24,587.48 2025-11-19
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 2 — — $103,703.86 $111,110.20 $103,703.86 2025-11-19
500 MS_DRG Soft Tissue Procedures With Mcc 3 2 — — $30,856.80 $33,060.54 $30,856.80 2025-11-19
503 MS_DRG Foot Procedures With Mcc 3 2 — — $25,772.59 $27,613.22 $25,772.59 2025-11-19
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 2 — — $27,832.18 $29,819.90 $27,832.18 2025-11-19
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 2 — — $30,113.79 $32,264.46 $30,113.79 2025-11-19
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 2 — — $34,900.99 $37,393.56 $34,900.99 2025-11-19
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 2 — — $28,383.35 $30,410.44 $28,383.35 2025-11-19
545 MS_DRG Connective Tissue Disorders With Mcc 3 2 — — $24,606.95 $26,364.34 $24,606.95 2025-11-19
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 2 — — $24,384.93 $26,126.45 $24,384.93 2025-11-19
570 MS_DRG Skin Debridement With Mcc 3 2 — — $29,313.33 $31,406.83 $29,313.33 2025-11-19
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $59,968.55 $64,251.39 $59,968.55 2025-11-19
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 2 — — $33,741.20 $36,150.93 $33,741.20 2025-11-19
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $52,539.43 $56,291.70 $52,539.43 2025-11-19
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 3 2 — — $25,930.35 $27,782.24 $25,930.35 2025-11-19
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 2 — — $31,740.04 $34,006.85 $31,740.04 2025-11-19
6 MS_DRG Liver Transplant Without Mcc 3 2 — — $47,221.51 $50,593.98 $47,221.51 2025-11-19
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 2 — — $26,325.71 $28,205.84 $26,325.71 2025-11-19
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 3 2 — — $22,192.90 $23,777.88 $22,192.90 2025-11-19
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 2 — — $37,637.37 $40,325.36 $37,637.37 2025-11-19
619 MS_DRG O.r. Procedures For Obesity With Mcc 3 2 — — $26,550.66 $28,446.86 $26,550.66 2025-11-19
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 2 — — $36,439.60 $39,042.04 $36,439.60 2025-11-19
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 2 — — $27,919.82 $29,913.80 $27,919.82 2025-11-19
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 2 — — $38,423.23 $41,167.34 $38,423.23 2025-11-19
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 3 2 — — $21,901.74 $23,465.92 $21,901.74 2025-11-19
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 2 — — $44,865.89 $48,070.13 $44,865.89 2025-11-19
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 2 — — $33,815.21 $36,230.22 $33,815.21 2025-11-19
652 MS_DRG Kidney Transplant 3 2 — — $29,909.29 $32,045.36 $29,909.29 2025-11-19
653 MS_DRG Major Bladder Procedures With Mcc 3 2 — — $54,285.45 $58,162.42 $54,285.45 2025-11-19
654 MS_DRG Major Bladder Procedures With Cc 3 2 — — $27,481.61 $29,444.30 $27,481.61 2025-11-19
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 2 — — $31,726.40 $33,992.25 $31,726.40 2025-11-19
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 2 — — $25,165.91 $26,963.22 $25,165.91 2025-11-19
662 MS_DRG Minor Bladder Procedures With Mcc 3 2 — — $30,378.66 $32,548.25 $30,378.66 2025-11-19
665 MS_DRG Prostatectomy With Mcc 3 2 — — $33,436.40 $35,824.36 $33,436.40 2025-11-19
668 MS_DRG Transurethral Procedures With Mcc 3 2 — — $28,398.93 $30,427.13 $28,398.93 2025-11-19
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $40,798.32 $43,712.07 $40,798.32 2025-11-19
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 3 2 — — $22,479.20 $24,084.62 $22,479.20 2025-11-19
7 MS_DRG Lung Transplant 3 2 — — $127,263.97 $136,352.93 $127,263.97 2025-11-19
709 MS_DRG Penis Procedures With Cc/mcc 3 2 — — $21,882.26 $23,445.05 $21,882.26 2025-11-19
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 3 2 — — $21,991.33 $23,561.91 $21,991.33 2025-11-19
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 2 — — $38,344.35 $41,082.83 $38,344.35 2025-11-19
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 2 — — $38,766.00 $41,534.60 $38,766.00 2025-11-19
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 3 2 — — $25,207.79 $27,008.08 $25,207.79 2025-11-19
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 2 — — $57,890.46 $62,024.89 $57,890.46 2025-11-19
791 MS_DRG Prematurity With Major Problems 3 2 — — $39,535.31 $42,358.84 $39,535.31 2025-11-19
792 MS_DRG Prematurity Without Major Problems 3 2 — — $23,855.18 $25,558.87 $23,855.18 2025-11-19
793 MS_DRG Full Term Neonate With Major Problems 3 2 — — $40,612.33 $43,512.79 $40,612.33 2025-11-19
799 MS_DRG Splenic Procedures With Mcc 3 2 — — $46,302.24 $49,609.06 $46,302.24 2025-11-19
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 2 — — $52,985.43 $56,769.55 $52,985.43 2025-11-19
800 MS_DRG Splenic Procedures With Cc 3 2 — — $28,374.58 $30,401.04 $28,374.58 2025-11-19
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 2 — — $34,908.78 $37,401.90 $34,908.78 2025-11-19
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 2 — — $22,302.94 $23,895.78 $22,302.94 2025-11-19
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 3 2 — — $24,686.80 $26,449.89 $24,686.80 2025-11-19
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 3 2 — — $22,594.11 $24,207.74 $22,594.11 2025-11-19
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 2 — — $56,697.56 $60,746.79 $56,697.56 2025-11-19
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 3 2 — — $21,739.11 $23,291.68 $21,739.11 2025-11-19
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 2 — — $45,568.97 $48,823.42 $45,568.97 2025-11-19
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 3 2 — — $21,417.76 $22,947.37 $21,417.76 2025-11-19
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $46,503.82 $49,825.04 $46,503.82 2025-11-19
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $22,980.71 $24,621.95 $22,980.71 2025-11-19
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 2 — — $30,030.04 $32,174.73 $30,030.04 2025-11-19
834 MS_DRG Acute Leukemia With Mcc 3 2 — — $53,824.85 $57,668.92 $53,824.85 2025-11-19
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 2 — — $48,760.11 $52,242.47 $48,760.11 2025-11-19
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 2 — — $31,054.48 $33,272.34 $31,054.48 2025-11-19
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 2 — — $24,868.90 $26,645.00 $24,868.90 2025-11-19
849 MS_DRG Radiotherapy 3 2 — — $26,011.17 $27,868.84 $26,011.17 2025-11-19
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 3 2 — — $22,066.31 $23,642.24 $22,066.31 2025-11-19
850 MS_DRG Acute Leukemia With Other Procedures 3 2 — — $89,705.48 $96,112.08 $89,705.48 2025-11-19
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 2 — — $48,702.66 $52,180.91 $48,702.66 2025-11-19
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 2 — — $43,933.96 $47,071.64 $43,933.96 2025-11-19
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 2 — — $67,742.40 $72,580.43 $67,742.40 2025-11-19
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 2 — — $38,266.44 $40,999.36 $38,266.44 2025-11-19
901 MS_DRG Wound Debridements For Injuries With Mcc 3 2 — — $43,144.21 $46,225.49 $43,144.21 2025-11-19
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 2 — — $37,599.39 $40,284.67 $37,599.39 2025-11-19
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 2 — — $38,793.27 $41,563.81 $38,793.27 2025-11-19
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 2 — — $231,012.63 $247,511.12 $231,012.63 2025-11-19
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 2 — — $65,039.13 $69,684.10 $65,039.13 2025-11-19
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 3 2 — — $30,970.74 $33,182.61 $30,970.74 2025-11-19
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 2 — — $42,135.35 $45,144.58 $42,135.35 2025-11-19
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 2 — — $30,908.41 $33,115.83 $30,908.41 2025-11-19
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 2 — — $35,531.04 $38,068.60 $35,531.04 2025-11-19
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 3 2 — — $23,343.93 $25,011.11 $23,343.93 2025-11-19
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 2 — — $66,493.99 $71,242.86 $66,493.99 2025-11-19
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $37,222.53 $39,880.90 $37,222.53 2025-11-19
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 2 — — $72,686.38 $77,877.51 $72,686.38 2025-11-19
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $40,021.23 $42,879.48 $40,021.23 2025-11-19
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 2 — — $25,746.30 $27,585.05 $25,746.30 2025-11-19
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 3 2 — — $23,343.93 $25,011.11 $23,343.93 2025-11-19
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 2 — — $26,455.22 $28,344.61 $26,455.22 2025-11-19
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 2 — — $61,586.03 $65,984.39 $61,586.03 2025-11-19
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 2 — — $34,906.83 $37,399.82 $34,906.83 2025-11-19
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 2 — — $25,837.84 $27,683.13 $25,837.84 2025-11-19
974 MS_DRG HIV With Major Related Condition With Mcc 3 2 — — $29,079.62 $31,156.43 $29,079.62 2025-11-19
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $46,293.48 $49,599.67 $46,293.48 2025-11-19
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 2 — — $23,841.55 $25,544.26 $23,841.55 2025-11-19
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $34,109.29 $36,545.32 $34,109.29 2025-11-19
A9517 HCPCS Sodium Iodide-131 (i-131) 500 Mci/0.5 Ml Oral Kit (therapeutic) 41 17 $42,187.50 $21,093.75 50% off $8,859.38 $39,234.38 $30,375.01 2025-11-19
C9293 HCPCS Glucarpidase 1,000 Unit Intravenous Solution 40 17 $442,645.50 $221,322.75 50% off $728.60 $411,660.32 $281,079.90 2025-11-19
C9482 HCPCS Sotalol 150 Mg/10 Ml (15 Mg/ml) Intravenous Solution 40 17 $38,972.25 $19,486.13 50% off $39.75 $36,244.19 $24,747.38 2025-11-19
J0202 HCPCS Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 40 17 $163,201.50 $81,600.75 50% off $4,540.28 $151,777.40 $103,632.96 2025-11-19
J0222 HCPCS Patisiran (lipid Complex) 2 Mg/ml Intravenous Solution 40 17 $105,213.75 $52,606.88 50% off $199.74 $97,848.79 $66,810.74 2025-11-19
J0517 HCPCS Benralizumab 30 Mg/ml Subcutaneous Syringe 40 17 $55,627.40 $27,813.70 50% off $339.82 $51,733.48 $35,323.40 2025-11-19
J0565 HCPCS Bezlotoxumab 25 Mg/ml Intravenous Solution 40 17 $40,874.60 $20,437.30 50% off $79.23 $38,013.38 $25,955.37 2025-11-19
J0584 HCPCS Burosumab-twza 30 Mg/ml Subcutaneous Solution 92 17 $66,891.90 $33,445.95 50% off $847.07 $93,723.31 $28,543.47 2025-11-19
J0739 HCPCS Cabotegravir ER 600 Mg/3 Ml (200 Mg/ml) IM Suspension,extended Release 66 17 $36,517.30 $18,258.65 50% off $12.45 $40,265.42 $23,097.19 2025-11-19
J0801 HCPCS Corticotropin 80 Unit/ml Injection Gel 40 17 $464,366.00 $232,183.00 50% off $97,516.86 $431,860.38 $294,872.41 2025-11-19
J1299 HCPCS Eculizumab 300 Mg/30 Ml Intravenous Solution 40 17 $60,387.70 $30,193.85 50% off $12,681.42 $56,160.56 $38,346.19 2025-11-19
J1303 HCPCS Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 66 17 $50,648.65 $25,324.33 50% off $441.12 $172,649.80 $38,985.44 2025-11-19
J1304 HCPCS Tofersen 100 Mg/15 Ml (6.7 Mg/ml) Intrathecal Solution 40 17 $153,737.40 $76,868.70 50% off $32,284.85 $142,975.78 $97,623.25 2025-11-19
J1305 HCPCS Evinacumab-dgnb 150 Mg/ml Intravenous Solution 66 17 $291,940.40 $145,970.20 50% off $349.47 $421,741.79 $96,184.34 2025-11-19
J1306 HCPCS Inclisiran 284 Mg/1.5 Ml Subcutaneous Syringe 40 17 $36,713.85 $18,356.93 50% off $23.97 $34,143.88 $23,313.29 2025-11-19
J1323 HCPCS Elranatamab-bcmm 40 Mg/ml Subcutaneous Solution 68 17 $69,940.05 $34,970.03 50% off $14,687.41 $112,315.36 $44,411.93 2025-11-19
J1743 HCPCS Idursulfase 6 Mg/3 Ml Intravenous Solution 40 17 $34,746.45 $17,373.23 50% off $1,079.38 $32,314.20 $22,063.99 2025-11-19
J1930 HCPCS Lanreotide 60 Mg/0.2 Ml Subcutaneous Syringe 92 17 $87,161.05 $43,580.53 50% off $107.71 $95,596.10 $41,558.21 2025-11-19
J1932 HCPCS Lanreotide 120 Mg/0.5 Ml Subcutaneous Syringe 40 17 $62,611.80 $31,305.90 50% off $102.15 $58,228.97 $39,758.49 2025-11-19
J2267 HCPCS Mirikizumab-mrkz 100 Mg/ml Subcutaneous Pen Injector 68 17 $54,058.35 $27,029.18 50% off $11,352.25 $95,931.50 $34,327.06 2025-11-19
J2323 HCPCS Natalizumab 300 Mg/15 Ml Intravenous Solution 40 17 $91,805.45 $45,902.73 50% off $49.42 $85,379.07 $58,296.46 2025-11-19
J2326 HCPCS Nusinersen (pf) 12 Mg/5 Ml Intrathecal Solution 40 17 $1,482,458.75 $741,229.38 50% off $2,207.41 $1,378,686.64 $941,361.31 2025-11-19
J2329 HCPCS Ublituximab-xiiy 25 Mg/ml Intravenous Solution 40 17 $119,457.55 $59,728.78 50% off $130.34 $111,095.52 $75,855.54 2025-11-19
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 40 17 $221,915.35 $110,957.68 50% off $122.11 $206,381.28 $140,916.25 2025-11-19
J2427 HCPCS Paliperidone Palmitate (3 Month) 273 Mg/0.88 Ml Intramuscular Syringe 118 17 $54,708.70 $27,354.35 50% off $24.08 $101,759.58 $23,935.06 2025-11-19
J2506 HCPCS Pegfilgrastim 6 Mg/0.6 Ml (deliverable) Wearable Subcutaneous Injector 40 17 $48,331.50 $24,165.75 50% off $170.40 $44,948.30 $30,690.51 2025-11-19
J2840 HCPCS Sebelipase Alfa 2 Mg/ml Intravenous Solution 40 17 $109,782.50 $54,891.25 50% off $1,014.92 $102,097.73 $69,711.89 2025-11-19
J3110 HCPCS Teriparatide 20 Mcg/dose (560 Mcg/2.24 Ml) Subcutaneous Pen Injector 40 17 $39,792.20 $19,896.10 50% off $104.16 $37,006.75 $25,268.05 2025-11-19
J3263 HCPCS Toripalimab-tpzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 40 17 $99,929.55 $49,964.78 50% off $20,985.21 $92,934.48 $63,455.26 2025-11-19
J3357 HCPCS Ustekinumab 45 Mg/0.5 Ml Subcutaneous Syringe 66 17 $151,988.60 $75,994.30 50% off $293.55 $282,698.52 $96,512.76 2025-11-19
J7504 HCPCS Lymphocyte,anti-thymo Immune Globulin 50 Mg/ml Intravenous Solution 40 17 $34,090.40 $17,045.20 50% off $5,943.31 $31,704.07 $21,647.40 2025-11-19
J9022 HCPCS Atezolizumab 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 66 17 $104,129.35 $52,064.68 50% off $164.38 $96,840.30 $46,295.03 2025-11-19
J9038 HCPCS Axatilimab-csfr 50 Mg/ml Intravenous Solution 68 17 $50,818.75 $25,409.38 50% off $10,671.94 $115,494.38 $32,651.05 2025-11-19
J9043 HCPCS Cabazitaxel 10 Mg/ml (first Dilution) Intravenous Solution 40 17 $132,868.30 $66,434.15 50% off $409.61 $123,567.52 $84,371.37 2025-11-19
J9061 HCPCS Amivantamab-vmjw 50 Mg/ml Intravenous Solution 40 17 $35,261.80 $17,630.90 50% off $39.03 $32,793.47 $22,391.24 2025-11-19
J9063 HCPCS Mirvetuximab Soravtansine-gynx 5 Mg/ml Intravenous Solution 40 17 $71,331.05 $35,665.53 50% off $130.82 $66,337.88 $45,295.22 2025-11-19
J9119 HCPCS Cemiplimab-rwlc 50 Mg/ml Intravenous Solution 40 17 $98,162.55 $49,081.28 50% off $53.52 $91,291.17 $62,333.22 2025-11-19
J9204 HCPCS Mogamulizumab-kpkc 4 Mg/ml Intravenous Solution 40 17 $43,419.75 $21,709.88 50% off $450.72 $40,380.37 $27,571.54 2025-11-19
J9210 HCPCS Emapalumab-lzsg 5 Mg/ml Intravenous Solution 66 17 $217,443.23 $108,721.61 50% off $782.76 $337,639.85 $61,057.92 2025-11-19
J9228 HCPCS Ipilimumab 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 66 17 $82,164.10 $41,082.05 50% off $333.86 $305,510.30 $67,358.74 2025-11-19
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 40 17 $172,112.80 $86,056.40 50% off $36,143.69 $160,064.90 $109,291.62 2025-11-19
J9269 HCPCS Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 40 17 $312,299.05 $156,149.53 50% off $641.37 $290,438.12 $198,309.90 2025-11-19
J9271 HCPCS Pembrolizumab 25 Mg/ml Intravenous Solution 40 17 $53,534.25 $26,767.13 50% off $108.96 $49,786.85 $33,994.25 2025-11-19
J9272 HCPCS Dostarlimab-gxly 50 Mg/ml Intravenous Solution 40 17 $109,148.05 $54,574.03 50% off $451.16 $101,507.69 $69,309.01 2025-11-19
J9274 HCPCS Tebentafusp-tebn 100 Mcg/0.5 Ml Intravenous Solution 40 17 $189,490.00 $94,745.00 50% off $405.23 $176,225.70 $120,326.15 2025-11-19
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 40 17 $139,906.15 $69,953.08 50% off $365.08 $130,112.72 $88,840.40 2025-11-19
J9301 HCPCS Obinutuzumab 1,000 Mg/40 Ml Intravenous Solution 40 17 $79,717.70 $39,858.85 50% off $140.27 $74,137.46 $50,620.74 2025-11-19
J9306 HCPCS Pertuzumab 420 Mg/14 Ml (30 Mg/ml) Intravenous Solution 40 17 $63,139.60 $31,569.80 50% off $30.55 $58,719.83 $40,093.64 2025-11-19
J9307 HCPCS Pralatrexate 20 Mg/ml (1 Ml) Intravenous Solution 118 17 $67,912.00 $33,956.00 50% off $708.78 $126,269.82 $39,899.97 2025-11-19
J9332 HCPCS Efgartigimod Alfa-fcab 20 Mg/ml Intravenous Solution 40 17 $66,571.60 $33,285.80 50% off $63.24 $61,911.59 $42,272.96 2025-11-19
J9333 HCPCS Rozanolixizumab-noli 140 Mg/ml Subcutaneous Solution 68 17 $131,726.00 $65,863.01 50% off $13,833.87 $183,746.10 $45,388.26 2025-11-19
J9334 HCPCS Efgartigimod Alfa 1008 Mg-hyaluron-qvfc 11,200 Unit/5.6 Ml Subcut Soln 40 17 $172,950.95 $86,475.48 50% off $36,319.70 $160,844.38 $109,823.85 2025-11-19
J9347 HCPCS Tremelimumab-actl 20 Mg/ml Intravenous Solution 66 17 $375,374.30 $187,687.15 50% off $271.50 $349,098.10 $27,881.08 2025-11-19
J9348 HCPCS Naxitamab-gqgk 4 Mg/ml Intravenous Solution 40 17 $280,233.45 $140,116.73 50% off $1,152.41 $260,617.11 $177,948.24 2025-11-19
J9382 HCPCS Zenocutuzumab-zbco 375 Mg/18.75 Ml (20 Mg/ml) Intravenous Solution 68 17 $109,893.70 $54,946.85 50% off $23,077.68 $204,355.97 $69,782.50 2025-11-19
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