Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

WELLSTAR SYLVAN GROVE MEDICAL CENTER

Jackson, GA · CCN 111319 · Rates published

45,957 distinct procedures filed
23 distinct payers
150,047 rate rows
2026-07-30 last MRF observed
Data quality

55,602 of 150,047 rate rows are consumer-grade (37.1%)

94,445 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 94,401
placeholder amount (≤ $0.02) — excluded from medians 34
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.wellstar.org/wellstar-sylvan-grove-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 · 2026-08-17
Content fingerprint 856046431eddf67b… · 29,870,906 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
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 $1,002,374.83 $1,512,329.86 $1,162,756.31 nat. median
$370,165
outlier · 3.1×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $748,691.08 $1,129,585.31 $868,482.78 nat. median
$261,939
outlier · 3.3×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $630,575.75 $951,379.17 $731,468.82 nat. median
$205,166
outlier · 3.6×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $569,636.15 $859,436.74 $660,778.79 nat. median
$199,832
outlier · 3.3×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $375,565.61 $566,633.43 $435,656.67 nat. median
$132,706
outlier · 3.3×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $348,235.02 $525,398.49 $403,953.15 nat. median
$114,305
outlier · 3.5×
7
MS_DRG 		Lung Transplant 4 $347,357.85 $524,075.06 $402,935.63 nat. median
$122,690
outlier · 3.3×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $292,914.65 $441,934.05 $339,781.43 nat. median
$108,240
outlier · 3.1×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $289,549.49 $436,856.88 $335,877.85 nat. median
$100,978
outlier · 3.3×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $283,050.44 $427,051.45 $328,338.93 nat. median
$99,646
outlier · 3.3×
215
MS_DRG 		Other Heart Assist System Implant 4 $281,604.43 $424,869.80 $326,661.56 nat. median
$98,002
outlier · 3.3×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $278,611.41 $420,354.09 $323,189.65 nat. median
$96,835
outlier · 3.3×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 3 $235,544.87 $355,377.59 $292,076.17 nat. median
$83,623
outlier · 3.5×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $36,995.00 $387,019.64 $284,112.60 nat. median
$92,900
outlier · 3.1×
850
MS_DRG 		Acute Leukemia With Other Procedures 4 $244,845.57 $369,409.98 $284,021.22 nat. median
$81,364
outlier · 3.5×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $225,103.86 $339,624.73 $261,120.81 nat. median
$80,459
outlier · 3.2×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 $221,685.54 $334,467.36 $257,155.56 nat. median
$81,124
outlier · 3.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $36,995.00 $339,817.23 $249,461.14 nat. median
$79,040
outlier · 3.2×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 $214,256.15 $323,258.29 $248,537.46 nat. median
$77,385
outlier · 3.2×
10
MS_DRG 		Pancreas Transplant 4 $211,919.68 $319,733.15 $245,827.15 nat. median
$67,750
outlier · 3.6×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 $210,699.61 $317,892.38 $244,411.87 nat. median
$69,153
outlier · 3.5×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 $198,392.61 $299,324.22 $230,135.73 nat. median
$71,485
outlier · 3.2×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 5 $36,995.00 $313,444.84 $230,101.06 nat. median
$73,475
outlier · 3.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $36,995.00 $310,284.65 $227,781.15 nat. median
$74,472
outlier · 3.1×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $188,690.54 $284,686.26 $218,881.32 nat. median
$66,640
outlier · 3.3×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 3 $176,293.17 $265,981.76 $218,603.92 nat. median
$62,767
outlier · 3.5×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 $187,834.64 $283,394.92 $217,888.46 nat. median
$68,581
outlier · 3.2×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 4 $184,910.73 $278,983.48 $214,496.72 nat. median
$65,958
outlier · 3.3×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 2 $114,360.00 $226,806.00 $213,828.00 nat. median
$69,291
outlier · 3.1×
A9543
HCPCS 		Y90 Ibritumomab, Rx 3 $126,093.45 $248,273.36 $211,255.48 nat. median
$63,643
outlier · 3.3×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 4 $181,492.41 $273,826.10 $210,531.47 nat. median
$64,357
outlier · 3.3×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 $178,204.34 $268,865.24 $206,717.30 nat. median
$62,262
outlier · 3.3×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 $177,521.21 $267,834.56 $205,924.87 nat. median
$62,911
outlier · 3.3×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $177,220.84 $267,381.39 $205,576.44 nat. median
$65,792
outlier · 3.1×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 3 $162,577.37 $245,288.10 $201,596.30 nat. median
$57,648
outlier · 3.5×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 4 $171,917.93 $259,380.64 $199,425.06 nat. median
$62,218
outlier · 3.2×
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 4 $168,095.59 $253,613.69 $194,991.13 nat. median
$60,294
outlier · 3.2×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 $164,642.71 $248,404.18 $190,985.80 nat. median
$58,419
outlier · 3.3×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 4 $164,430.07 $248,083.34 $190,739.12 nat. median
$59,832
outlier · 3.2×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $36,995.00 $258,967.57 $190,109.09 nat. median
$63,840
outlier · 3.0×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 $163,680.48 $246,952.41 $189,869.61 nat. median
$59,159
outlier · 3.2×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 4 $163,119.62 $246,106.22 $189,219.01 nat. median
$55,446
outlier · 3.4×
28
MS_DRG 		Spinal Procedures With Mcc 4 $161,588.56 $243,796.23 $187,442.97 nat. median
$56,970
outlier · 3.3×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 4 $160,429.63 $242,047.69 $186,098.61 nat. median
$55,867
outlier · 3.3×
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/Mcc 4 $160,429.63 $242,047.69 $186,098.61 nat. median
$52,535
outlier · 3.5×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 $159,230.82 $240,239.00 $184,707.99 nat. median
$60,162
outlier · 3.1×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 $158,024.05 $238,418.28 $183,308.13 nat. median
$51,433
outlier · 3.6×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 5 $36,995.00 $244,967.26 $179,831.40 nat. median
$59,257
outlier · 3.0×
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 $154,751.92 $233,481.48 $179,512.46 nat. median
$56,397
outlier · 3.2×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $152,548.36 $230,156.86 $176,956.33 nat. median
$57,394
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 45,957 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 8 5 — — $24,823.00 $109,536.06 $80,410.83 2026-04-01
835 MS_DRG Acute Leukemia With Cc 7 4 — — $56,771.70 $85,654.12 $65,855.26 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 7 4 — — $146,910.53 $221,650.80 $170,416.43 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 7 4 — — $244,845.57 $369,409.98 $284,021.22 2026-04-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 7 4 — — $60,572.78 $91,389.00 $70,264.52 2026-04-01
245 MS_DRG Aicd Generator Procedures 7 4 — — $129,888.06 $195,968.20 $150,670.34 2026-04-01
265 MS_DRG Aicd Lead Procedures 7 4 — — $94,811.77 $143,046.96 $109,981.79 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 7 4 — — $348,235.02 $525,398.49 $403,953.15 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 7 4 — — $77,403.87 $116,782.85 $89,788.61 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 7 4 — — $133,875.21 $201,983.80 $155,295.44 2026-04-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 7 4 — — $57,337.88 $86,508.34 $66,512.02 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 7 4 — — $119,199.84 $179,842.38 $138,271.99 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 7 4 — — $102,732.91 $154,997.95 $119,170.33 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 7 4 — — $62,906.59 $94,910.13 $72,971.74 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 7 4 — — $177,220.84 $267,381.39 $205,576.44 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 7 4 — — $110,587.59 $166,848.68 $128,281.77 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 7 4 — — $65,857.09 $99,361.67 $76,394.32 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 7 4 — — $160,429.63 $242,047.69 $186,098.61 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 7 4 — — $160,429.63 $242,047.69 $186,098.61 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 7 4 — — $95,260.99 $143,724.72 $110,502.89 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 7 4 — — $63,714.66 $96,129.29 $73,909.10 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 7 4 — — $96,978.12 $146,315.43 $112,494.77 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 7 4 — — $63,714.66 $96,129.29 $73,909.10 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 7 4 — — $163,119.62 $246,106.22 $189,219.01 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 7 4 — — $76,117.35 $114,841.81 $88,296.24 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 7 4 — — $93,062.74 $140,408.11 $107,952.92 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 7 4 — — $62,157.01 $93,779.19 $72,102.23 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 7 4 — — $91,406.74 $137,909.64 $106,031.96 2026-04-01
90288 HCPCS Botulism Ig IV 2 1 — — $92,831.73 $92,831.73 $92,831.73 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 7 4 — — $187,834.64 $283,394.92 $217,888.46 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 7 4 — — $164,642.71 $248,404.18 $190,985.80 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 7 4 — — $123,660.13 $186,571.83 $143,445.93 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 7 4 — — $74,570.34 $112,507.76 $86,501.70 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 7 4 — — $90,556.15 $136,626.31 $105,045.27 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 5 — — $36,995.00 $387,019.64 $284,112.60 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 5 — — $36,995.00 $258,967.57 $190,109.09 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 5 — — $36,995.00 $238,582.71 $175,144.48 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 5 — — $36,995.00 $310,284.65 $227,781.15 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 5 — — $36,995.00 $212,402.82 $155,925.72 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 5 — — $36,995.00 $184,169.60 $135,199.61 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 7 4 — — $60,461.14 $91,220.56 $70,135.02 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 7 4 — — $103,360.22 $155,944.40 $119,898.01 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 7 4 — — $77,005.16 $116,181.29 $89,326.10 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 7 4 — — $129,103.92 $194,785.13 $149,760.74 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 7 4 — — $62,922.54 $94,934.19 $72,990.24 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 7 4 — — $133,085.75 $200,792.71 $154,379.67 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 7 4 — — $67,877.24 $102,409.57 $78,737.70 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 7 4 — — $1,002,374.83 $1,512,329.86 $1,162,756.31 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 7 4 — — $93,129.19 $140,508.37 $108,030.00 2026-04-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 7 4 — — $56,657.40 $85,481.68 $65,722.67 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 7 4 — — $72,736.25 $109,740.59 $84,374.16 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 7 4 — — $58,831.73 $88,762.18 $68,244.89 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 7 4 — — $221,685.54 $334,467.36 $257,155.56 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 7 4 — — $145,400.73 $219,372.89 $168,665.06 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 6 3 — — $162,577.37 $245,288.10 $201,596.30 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 6 3 — — $235,544.87 $355,377.59 $292,076.17 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 6 3 — — $122,421.45 $184,702.98 $151,802.88 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 7 4 — — $289,549.49 $436,856.88 $335,877.85 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 7 4 — — $164,430.07 $248,083.34 $190,739.12 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 7 4 — — $67,162.21 $101,330.78 $77,908.27 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 5 — — $36,995.00 $313,444.84 $230,101.06 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 5 — — $36,995.00 $213,349.27 $156,620.52 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 5 — — $36,995.00 $339,817.23 $249,461.14 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 5 — — $36,995.00 $244,967.26 $179,831.40 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 8 5 — — $36,995.00 $235,963.92 $173,222.02 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 8 5 — — $36,995.00 $164,899.63 $121,053.45 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 7 4 — — $113,213.80 $170,810.96 $131,328.17 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 7 4 — — $84,926.30 $128,132.28 $98,514.63 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 7 4 — — $76,074.82 $114,777.65 $88,246.91 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 7 4 — — $81,295.33 $122,654.07 $94,302.71 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 7 4 — — $118,870.23 $179,345.09 $137,889.65 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 7 4 — — $65,591.28 $98,960.63 $76,085.98 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 7 4 — — $181,492.41 $273,826.10 $210,531.47 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 7 4 — — $151,636.63 $228,781.29 $175,898.72 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 7 4 — — $101,045.01 $152,451.35 $117,212.37 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $117,940.04 $117,940.04 $117,940.04 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 9 5 — — $10,484.00 $100,420.42 $70,229.69 2026-04-01
374 MS_DRG Digestive Malignancy With Mcc 7 4 — — $56,125.78 $84,679.60 $65,105.99 2026-04-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 7 4 — — $60,974.16 $91,994.57 $70,730.11 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 7 4 — — $569,636.15 $859,436.74 $660,778.79 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 7 4 — — $159,230.82 $240,239.00 $184,707.99 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 7 4 — — $125,047.66 $188,665.26 $145,055.47 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 7 4 — — $630,575.75 $951,379.17 $731,468.82 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 7 4 — — $115,008.01 $173,517.98 $133,409.47 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 7 4 — — $65,083.58 $98,194.64 $75,497.05 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 7 4 — — $126,374.05 $190,666.45 $146,594.09 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 7 4 — — $88,267.53 $133,173.35 $102,390.46 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 7 4 — — $158,024.05 $238,418.28 $183,308.13 2026-04-01
503 MS_DRG Foot Procedures With Mcc 7 4 — — $70,346.62 $106,135.24 $81,602.18 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 7 4 — — $110,858.72 $167,257.74 $128,596.28 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 7 4 — — $177,521.21 $267,834.56 $205,924.87 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 7 4 — — $84,532.90 $127,538.74 $98,058.29 2026-04-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 7 4 — — $57,034.85 $86,051.15 $66,160.51 2026-04-01
906 MS_DRG Hand Procedures For Injuries 7 4 — — $58,010.37 $87,522.97 $67,292.12 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 7 4 — — $748,691.08 $1,129,585.31 $868,482.78 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 7 4 — — $292,914.65 $441,934.05 $339,781.43 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 7 4 — — $93,809.67 $141,535.04 $108,819.35 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 7 4 — — $77,956.76 $117,617.01 $90,429.96 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 7 4 — — $78,174.72 $117,945.86 $90,682.79 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 7 4 — — $77,472.98 $116,887.12 $89,868.78 2026-04-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 7 4 — — $56,038.06 $84,547.25 $65,004.24 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 7 4 — — $168,095.59 $253,613.69 $194,991.13 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 7 4 — — $70,524.71 $106,403.93 $81,808.77 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 7 4 — — $79,370.87 $119,750.54 $92,070.32 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 3 2 — — $56,095.00 $111,047.40 $87,649.64 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 3 2 — — $56,095.00 $168,902.17 $133,314.37 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 4 3 — — $4,714.00 $111,047.40 $78,884.32 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 7 4 — — $132,944.87 $200,580.16 $154,216.25 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 7 4 — — $64,320.70 $97,043.66 $74,612.11 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 5 2 — — $114,360.00 $226,806.00 $213,828.00 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 4 3 — — $5,809.00 $117,652.12 $81,490.87 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 4 3 — — $5,809.00 $168,902.17 $101,716.68 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 4 3 — — $6,389.00 $84,294.95 $68,326.48 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 4 3 — — $9,000.00 $84,294.95 $68,326.48 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 4 3 — — $9,000.00 $117,652.12 $81,490.87 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 4 3 — — $9,000.00 $117,652.12 $81,490.87 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 4 3 — — $9,000.00 $117,652.12 $81,490.87 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 4 3 — — $5,809.00 $84,294.95 $68,326.48 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 4 3 — — $5,809.00 $117,652.12 $81,490.87 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 5 4 — — $2,323.00 $84,294.95 $66,533.95 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 7 4 — — $146,921.16 $221,666.84 $170,428.77 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 7 4 — — $214,256.15 $323,258.29 $248,537.46 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 7 4 — — $93,841.56 $141,583.16 $108,856.35 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 7 4 — — $71,853.76 $108,409.13 $83,350.47 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 7 4 — — $86,592.92 $130,646.80 $100,447.92 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 7 4 — — $68,690.62 $103,636.76 $79,681.22 2026-04-01
652 MS_DRG Kidney Transplant 7 4 — — $81,635.57 $123,167.40 $94,697.38 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 7 4 — — $122,458.67 $184,759.13 $142,052.24 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 7 4 — — $92,294.55 $139,249.11 $107,061.81 2026-04-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 7 4 — — $56,370.33 $85,048.55 $65,389.66 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 7 4 — — $85,686.51 $129,279.25 $99,396.48 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 7 4 — — $63,169.75 $95,307.16 $73,277.00 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 7 4 — — $101,597.90 $153,285.51 $117,853.71 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 7 4 — — $283,050.44 $427,051.45 $328,338.93 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 7 4 — — $128,888.61 $194,460.29 $149,510.98 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 7 4 — — $93,573.09 $141,178.11 $108,544.93 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 7 4 — — $67,109.05 $101,250.57 $77,846.60 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 7 4 — — $63,820.98 $96,289.70 $74,032.43 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 7 4 — — $94,389.13 $142,409.30 $109,491.53 2026-04-01
7 MS_DRG Lung Transplant 7 4 — — $347,357.85 $524,075.06 $402,935.63 2026-04-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 7 4 — — $59,334.11 $89,520.15 $68,827.65 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 7 4 — — $154,751.92 $233,481.48 $179,512.46 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 7 4 — — $84,777.44 $127,907.70 $98,341.96 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 7 4 — — $58,459.59 $88,200.73 $67,813.22 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 7 4 — — $124,377.82 $187,654.64 $144,278.45 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 7 4 — — $75,008.92 $113,169.48 $87,010.46 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 7 4 — — $148,167.81 $223,547.72 $171,874.88 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 7 4 — — $66,899.06 $100,933.75 $77,603.01 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 7 4 — — $122,509.17 $184,835.33 $142,110.82 2026-04-01
141 MS_DRG Major Head And Neck Procedures With Cc 7 4 — — $57,103.96 $86,155.42 $66,240.68 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 7 4 — — $112,411.05 $169,599.82 $130,396.99 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 7 4 — — $60,881.12 $91,854.20 $70,622.19 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 7 4 — — $86,880.00 $131,079.92 $100,780.93 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 7 4 — — $67,731.05 $102,189.00 $78,568.12 2026-04-01
595 MS_DRG Major Skin Disorders With Mcc 7 4 — — $56,218.82 $84,819.96 $65,213.91 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 7 4 — — $62,829.51 $94,793.82 $72,882.33 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 7 4 — — $122,051.98 $184,145.54 $141,580.48 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 7 4 — — $82,916.77 $125,100.42 $96,183.58 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 7 4 — — $71,619.85 $108,056.22 $83,079.13 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 4 — — $278,611.41 $420,354.09 $323,189.65 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 4 — — $188,690.54 $284,686.26 $218,881.32 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 4 — — $146,333.72 $220,780.54 $169,747.34 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 7 4 — — $178,204.34 $268,865.24 $206,717.30 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 7 4 — — $108,535.54 $163,752.65 $125,901.39 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 7 4 — — $126,929.59 $191,504.62 $147,238.52 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 7 4 — — $62,723.19 $94,633.41 $72,758.99 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 7 4 — — $81,965.17 $123,664.69 $95,079.72 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 7 4 — — $95,287.57 $143,764.82 $110,533.72 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 4 3 — — $5,063.00 $103,218.72 $75,794.74 2026-04-01
935 MS_DRG Non-extensive Burns 7 4 — — $58,379.85 $88,080.42 $67,720.71 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 7 4 — — $93,113.24 $140,484.31 $108,011.50 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 7 4 — — $72,470.44 $109,339.55 $84,065.82 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 7 4 — — $56,120.47 $84,671.58 $65,099.82 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 7 4 — — $84,362.78 $127,282.08 $97,860.95 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 7 4 — — $104,447.38 $157,584.66 $121,159.12 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 4 3 — — $4,714.00 $111,047.40 $71,872.32 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 7 4 — — $59,982.68 $90,498.69 $69,580.00 2026-04-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 7 4 — — $67,385.49 $101,667.65 $78,167.27 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 8 5 — — $36,995.00 $199,834.22 $146,699.07 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 8 5 — — $36,995.00 $124,567.03 $91,445.14 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 7 4 — — $57,239.53 $86,359.95 $66,397.94 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 7 4 — — $92,897.94 $140,159.47 $107,761.75 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 7 4 — — $59,857.75 $90,310.20 $69,435.08 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 7 4 — — $113,378.60 $171,059.60 $131,519.34 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 7 4 — — $87,762.49 $132,411.38 $101,804.62 2026-04-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 7 4 — — $59,809.91 $90,238.01 $69,379.58 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 7 4 — — $104,896.60 $158,262.42 $121,680.21 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 7 4 — — $116,757.04 $176,156.82 $135,438.35 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 7 4 — — $61,524.38 $92,824.72 $71,368.38 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 7 4 — — $68,802.26 $103,805.19 $79,810.73 2026-04-01
215 MS_DRG Other Heart Assist System Implant 7 4 — — $281,604.43 $424,869.80 $326,661.56 2026-04-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 7 4 — — $60,687.08 $91,561.44 $70,397.11 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 7 4 — — $108,107.59 $163,106.98 $125,404.96 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 7 4 — — $56,994.98 $85,991.00 $66,114.26 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 7 4 — — $61,356.92 $92,572.06 $71,174.12 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 7 4 — — $111,374.39 $168,035.76 $129,194.46 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 7 4 — — $91,555.60 $138,134.22 $106,204.63 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 7 4 — — $136,434.96 $205,845.81 $158,264.76 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 7 4 — — $66,505.66 $100,340.21 $77,146.67 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 7 4 — — $60,025.21 $90,562.85 $69,629.34 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 7 4 — — $72,209.94 $108,946.53 $83,763.64 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 7 4 — — $82,193.77 $124,009.59 $95,344.89 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 7 4 — — $105,885.41 $159,754.28 $122,827.24 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 7 4 — — $109,234.62 $164,807.39 $126,712.32 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 7 4 — — $198,392.61 $299,324.22 $230,135.73 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 7 4 — — $70,272.19 $106,022.94 $81,515.85 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 7 4 — — $95,282.25 $143,756.80 $110,527.56 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 7 4 — — $102,363.43 $154,440.50 $118,741.73 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 7 4 — — $86,630.14 $130,702.95 $100,491.09 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 7 4 — — $67,858.63 $102,381.50 $78,716.12 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 7 4 — — $91,178.15 $137,564.74 $105,766.79 2026-04-01
10 MS_DRG Pancreas Transplant 7 4 — — $211,919.68 $319,733.15 $245,827.15 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 7 4 — — $74,644.76 $112,620.05 $86,588.04 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 7 4 — — $144,292.30 $217,700.55 $167,379.29 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 7 4 — — $56,766.38 $85,646.10 $65,849.09 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 3 — — $51,596.43 $94,617.96 $73,170.32 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 7 4 — — $59,727.51 $90,113.69 $69,284.00 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 7 4 — — $103,931.71 $156,806.64 $120,560.94 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 7 4 — — $82,953.98 $125,156.56 $96,226.75 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 7 4 — — $75,668.13 $114,164.06 $87,775.15 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 8 5 — — $15,494.00 $92,748.52 $68,087.04 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 7 4 — — $60,035.85 $90,578.89 $69,641.67 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 7 4 — — $100,258.22 $151,264.27 $116,299.68 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 7 4 — — $56,149.70 $84,715.69 $65,133.74 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 7 4 — — $96,326.89 $145,332.89 $111,739.33 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 7 4 — — $59,879.02 $90,342.28 $69,459.75 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 7 4 — — $90,162.75 $136,032.77 $104,588.93 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 8 3 — — $45,342.71 $90,510.53 $75,212.66 2026-04-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 7 4 — — $57,917.34 $87,382.61 $67,184.20 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 7 4 — — $119,914.87 $180,921.18 $139,101.42 2026-04-01
791 MS_DRG Prematurity With Major Problems 7 4 — — $107,921.52 $162,826.25 $125,189.12 2026-04-01
792 MS_DRG Prematurity Without Major Problems 7 4 — — $65,118.13 $98,246.78 $75,537.13 2026-04-01
665 MS_DRG Prostatectomy With Mcc 7 4 — — $91,263.21 $137,693.07 $105,865.46 2026-04-01
849 MS_DRG Radiotherapy 7 4 — — $70,995.19 $107,113.77 $82,354.53 2026-04-01
333 MS_DRG Rectal Resection With Cc 7 4 — — $56,487.28 $85,225.01 $65,525.33 2026-04-01
332 MS_DRG Rectal Resection With Mcc 7 4 — — $92,196.20 $139,100.72 $106,947.73 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 7 4 — — $71,346.06 $107,643.15 $82,761.54 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 7 4 — — $171,917.93 $259,380.64 $199,425.06 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 7 4 — — $91,037.27 $137,352.19 $105,603.37 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 7 4 — — $135,411.59 $204,301.81 $157,077.65 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 7 4 — — $69,727.28 $105,200.81 $80,883.75 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 4 3 — — $5,809.00 $111,047.40 $71,872.32 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 4 3 — — $9,000.00 $84,294.95 $68,326.48 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 4 3 — — $5,809.00 $84,294.95 $68,326.48 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 4 3 — — $5,809.00 $117,652.12 $81,490.87 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 4 3 — — $5,809.00 $84,294.95 $68,326.48 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 4 3 — — $8,245.00 $84,294.95 $68,326.48 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 7 4 — — $184,910.73 $278,983.48 $214,496.72 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 7 4 — — $75,968.50 $114,617.23 $88,123.57 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 7 4 — — $144,621.90 $218,197.84 $167,761.63 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 7 4 — — $210,699.61 $317,892.38 $244,411.87 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 4 — — $104,442.07 $157,576.64 $121,152.95 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 7 4 — — $136,884.18 $206,523.57 $158,785.85 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 7 4 — — $82,023.65 $123,752.92 $95,147.56 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 7 4 — — $64,084.13 $96,686.73 $74,337.69 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 3 — — $105,852.57 $196,075.84 $162,542.48 2026-04-01
570 MS_DRG Skin Debridement With Mcc 7 4 — — $80,019.44 $120,729.08 $92,822.67 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 7 4 — — $70,774.57 $106,780.91 $82,098.61 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 7 4 — — $143,401.84 $216,357.07 $166,346.35 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 7 4 — — $92,095.19 $138,948.33 $106,830.56 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 7 4 — — $163,680.48 $246,952.41 $189,869.61 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 7 4 — — $99,519.26 $150,149.38 $115,442.50 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 7 4 — — $102,626.58 $154,837.53 $119,046.99 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 7 4 — — $84,221.90 $127,069.52 $97,697.53 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 3 — — $176,293.17 $265,981.76 $218,603.92 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 4 — — $225,103.86 $339,624.73 $261,120.81 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 4 — — $152,548.36 $230,156.86 $176,956.33 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 4 — — $114,768.78 $173,157.04 $133,131.96 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
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 7 4 — — $89,219.13 $134,609.08 $103,494.32 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 7 4 — — $161,588.56 $243,796.23 $187,442.97 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 7 4 — — $59,148.04 $89,239.42 $68,611.82 2026-04-01
800 MS_DRG Splenic Procedures With Cc 7 4 — — $77,446.40 $116,847.01 $89,837.94 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 7 4 — — $126,379.36 $190,674.47 $146,600.25 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 7 4 — — $64,541.33 $97,376.52 $74,868.04 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 7 4 — — $134,996.92 $203,676.18 $156,596.64 2026-04-01
J9226 HCPCS Supprelin La Implant 6 3 — — $86,268.99 $163,593.70 $133,829.18 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 4 3 — — $9,000.00 $103,939.25 $76,079.09 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 7 4 — — $76,205.07 $114,974.16 $88,397.99 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 7 4 — — $109,072.48 $164,562.75 $126,524.24 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 7 4 — — $143,420.44 $216,385.14 $166,367.93 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 7 4 — — $70,434.33 $106,267.58 $81,703.93 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 7 4 — — $375,565.61 $566,633.43 $435,656.67 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 4 3 — — $6,760.00 $195,422.03 $83,067.74 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 7 4 — — $77,512.85 $116,947.27 $89,915.03 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 7 4 — — $60,229.89 $90,871.65 $69,866.76 2026-04-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 7 4 — — $61,670.58 $93,045.29 $71,537.96 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 7 4 — — $132,982.08 $200,636.30 $154,259.42 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 7 4 — — $85,170.84 $128,501.24 $98,798.30 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 7 4 — — $81,561.14 $123,055.11 $94,611.05 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 7 4 — — $69,543.87 $104,924.10 $80,670.99 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 7 4 — — $105,810.99 $159,641.99 $122,740.90 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 7 4 — — $104,657.37 $157,901.48 $121,402.71 2026-04-01
263 MS_DRG Vein Ligation And Stripping 7 4 — — $71,287.58 $107,554.92 $82,693.70 2026-04-01
32 MS_DRG Ventricular Shunt Procedures With Cc 7 4 — — $56,763.73 $85,642.09 $65,846.01 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 7 4 — — $111,382.36 $168,047.79 $129,203.71 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 7 4 — — $143,556.01 $216,589.67 $166,525.18 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 7 4 — — $78,376.74 $118,250.65 $90,917.13 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 7 4 — — $117,759.15 $177,668.74 $136,600.79 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 8 3 — — $126,093.45 $248,273.36 $211,255.48 2026-04-01
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