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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

SAMUEL MAHELONA MEMORIAL HOSPITAL

Kapaa, HI · CCN 121306 · Rates published

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You selected 45378 (HCPCS)

This facility hasn’t published a payer-negotiated rate for this exact code. See its full rate list below.

1,998 distinct procedures filed
20 distinct payers
266,906 rate rows
2026-06-15 last MRF observed
Data quality

168,713 of 266,906 rate rows are consumer-grade (63.2%)

98,193 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 94,202
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 3,587
per-diem day rate — not a per-procedure price 318
placeholder amount (≤ $0.02) — excluded from medians 59
exceeds 10× this hospital's gross charge — excluded from medians 17
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://tq-consumer-static-prd.turquoise.health/consumer-downloads/machine-readable-files/990262217_samuel-mahelona-memorial-hospital_standardcharges.csv
Found on page https://pricetransparency.healthcare/hhsc/charges/
Discovered viaCMS hospital list
Last fetch success · 2026-09-21

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
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $382,502.88 $382,502.88 $382,502.88 nat. median
$131,925
outlier · 2.9×
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 2 $10,400.00 $696,862.50 $353,631.25 nat. median
$32,772
outlier · 10.8×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 $271,980.45 $271,980.45 $271,980.45 nat. median
$40,584
outlier · 6.7×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $10,400.00 $466,787.19 $238,593.60 nat. median
$145,435
1.6× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $224,860.87 $224,860.87 $224,860.87 nat. median
$47,340
outlier · 4.7×
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 $214,242.38 $214,242.38 $214,242.38 nat. median
$27,340
outlier · 7.8×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 $10,400.00 $404,593.14 $207,496.57 nat. median
$97,418
outlier · 2.1×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $193,360.92 $193,360.92 $193,360.92 nat. median
$45,446
outlier · 4.3×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $193,360.92 $193,360.92 $193,360.92 nat. median
$69,822
outlier · 2.8×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $193,360.92 $193,360.92 $193,360.92 nat. median
$47,458
outlier · 4.1×
209
MS_DRG 		Complex Aortic Arch Procedures 1 $193,360.92 $193,360.92 $193,360.92 nat. median
$2,110
outlier · 91.6×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $185,231.13 $185,231.13 $185,231.13 nat. median
$47,121
outlier · 3.9×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $10,400.00 $358,611.26 $184,505.63 nat. median
$69,922
outlier · 2.6×
6
MS_DRG 		Liver Transplant Without Mcc 2 $10,400.00 $358,611.26 $184,505.63 nat. median
$31,278
outlier · 5.9×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $182,695.02 $182,695.02 $182,695.02 nat. median
$48,611
outlier · 3.8×
215
MS_DRG 		Other Heart Assist System Implant 1 $170,630.70 $170,630.70 $170,630.70 nat. median
$73,023
outlier · 2.3×
264
MS_DRG 		Other Circulatory System O.r. Procedures 1 $161,742.45 $161,742.45 $161,742.45 nat. median
$23,998
outlier · 6.7×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $160,035.90 $160,035.90 $160,035.90 nat. median
$51,518
outlier · 3.1×
651
MS_DRG 		Kidney Transplant With Hemodialysis Without Mcc 1 $154,726.66 $154,726.66 $154,726.66 nat. median
$24,308
outlier · 6.4×
650
MS_DRG 		Kidney Transplant With Hemodialysis With Mcc 1 $154,726.66 $154,726.66 $154,726.66 nat. median
$29,718
outlier · 5.2×
652
MS_DRG 		Kidney Transplant 1 $154,726.66 $154,726.66 $154,726.66 nat. median
$21,500
outlier · 7.2×
855
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures Without Cc/mcc 1 $154,039.30 $154,039.30 $154,039.30 nat. median
$10,915
outlier · 14.1×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 $154,039.30 $154,039.30 $154,039.30 nat. median
$34,733
outlier · 4.4×
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 1 $154,039.30 $154,039.30 $154,039.30 nat. median
$14,550
outlier · 10.6×
958
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Cc 1 $152,759.39 $152,759.39 $152,759.39 nat. median
$29,495
outlier · 5.2×
959
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 1 $152,759.39 $152,759.39 $152,759.39 nat. median
$19,279
outlier · 7.9×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $152,759.39 $152,759.39 $152,759.39 nat. median
$52,327
outlier · 2.9×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $140,505.46 $140,505.46 $140,505.46 nat. median
$43,803
outlier · 3.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $140,505.46 $140,505.46 $140,505.46 nat. median
$60,505
outlier · 2.3×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $10,400.00 $270,036.89 $140,218.45 nat. median
$186,516
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $10,400.00 $270,036.89 $140,218.45 nat. median
$65,418
outlier · 2.1×
834
MS_DRG 		Acute Leukemia With Mcc 1 $139,699.59 $139,699.59 $139,699.59 nat. median
$37,487
outlier · 3.7×
835
MS_DRG 		Acute Leukemia With Cc 1 $139,699.59 $139,699.59 $139,699.59 nat. median
$15,118
outlier · 9.2×
850
MS_DRG 		Acute Leukemia With Other Procedures 1 $139,699.59 $139,699.59 $139,699.59 nat. median
$2,633
outlier · 53.1×
836
MS_DRG 		Acute Leukemia Without Cc/mcc 1 $139,699.59 $139,699.59 $139,699.59 nat. median
$8,880
outlier · 15.7×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $137,281.98 $137,281.98 $137,281.98 nat. median
$30,649
outlier · 4.5×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $137,281.98 $137,281.98 $137,281.98 nat. median
$59,651
outlier · 2.3×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $137,281.98 $137,281.98 $137,281.98 nat. median
$42,674
outlier · 3.2×
319
MS_DRG 		Other Endovascular Cardiac Valve Procedures With Mcc 1 $132,162.35 $132,162.35 $132,162.35 nat. median
$31,388
outlier · 4.2×
320
MS_DRG 		Other Endovascular Cardiac Valve Procedures Without Mcc 1 $132,162.35 $132,162.35 $132,162.35 nat. median
$16,917
outlier · 7.8×
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 $10,400.00 $245,292.00 $127,846.00 nat. median
$23,282
outlier · 5.5×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 $10,400.00 $245,292.00 $127,846.00 nat. median
$38,173
outlier · 3.3×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $10,400.00 $245,292.00 $127,846.00 nat. median
$56,428
outlier · 2.3×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $127,540.46 $127,540.46 $127,540.46 nat. median
$74,509
1.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $127,327.14 $127,327.14 $127,327.14 nat. median
$55,935
outlier · 2.3×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $126,639.79 $126,639.79 $126,639.79 nat. median
$35,986
outlier · 3.5×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $125,762.81 $125,762.81 $125,762.81 nat. median
$55,923
outlier · 2.2×
221
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $125,762.81 $125,762.81 $125,762.81 nat. median
$35,297
outlier · 3.6×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $125,762.81 $125,762.81 $125,762.81 nat. median
$38,832
outlier · 3.2×
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 2 $10,400.00 $228,961.32 $119,680.66 nat. median
$29,295
outlier · 4.1×

Other procedures at this hospital

Browse this hospital's 1,998 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
             
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 1 — — $382,502.88 $382,502.88 $382,502.88 2026-06-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 2 — — $10,400.00 $696,862.50 $353,631.25 2026-06-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 1 — — $271,980.45 $271,980.45 $271,980.45 2026-06-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 2 — — $10,400.00 $466,787.19 $238,593.60 2026-06-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $224,860.87 $224,860.87 $224,860.87 2026-06-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $214,242.38 $214,242.38 $214,242.38 2026-06-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 2 — — $10,400.00 $404,593.14 $207,496.57 2026-06-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $193,360.92 $193,360.92 $193,360.92 2026-06-15
209 MS_DRG Complex Aortic Arch Procedures 2 1 — — $193,360.92 $193,360.92 $193,360.92 2026-06-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $193,360.92 $193,360.92 $193,360.92 2026-06-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $193,360.92 $193,360.92 $193,360.92 2026-06-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $185,231.13 $185,231.13 $185,231.13 2026-06-15
6 MS_DRG Liver Transplant Without Mcc 4 2 — — $10,400.00 $358,611.26 $184,505.63 2026-06-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 2 — — $10,400.00 $358,611.26 $184,505.63 2026-06-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $182,695.02 $182,695.02 $182,695.02 2026-06-15
215 MS_DRG Other Heart Assist System Implant 2 1 — — $170,630.70 $170,630.70 $170,630.70 2026-06-15
264 MS_DRG Other Circulatory System O.r. Procedures 2 1 — — $161,742.45 $161,742.45 $161,742.45 2026-06-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $160,035.90 $160,035.90 $160,035.90 2026-06-15
652 MS_DRG Kidney Transplant 2 1 — — $154,726.66 $154,726.66 $154,726.66 2026-06-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 1 — — $154,726.66 $154,726.66 $154,726.66 2026-06-15
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $154,726.66 $154,726.66 $154,726.66 2026-06-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $154,039.30 $154,039.30 $154,039.30 2026-06-15
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 1 — — $154,039.30 $154,039.30 $154,039.30 2026-06-15
855 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures Without Cc/mcc 2 1 — — $154,039.30 $154,039.30 $154,039.30 2026-06-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $152,759.39 $152,759.39 $152,759.39 2026-06-15
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 2 1 — — $152,759.39 $152,759.39 $152,759.39 2026-06-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 1 — — $152,759.39 $152,759.39 $152,759.39 2026-06-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $140,505.46 $140,505.46 $140,505.46 2026-06-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $140,505.46 $140,505.46 $140,505.46 2026-06-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 2 — — $10,400.00 $270,036.89 $140,218.45 2026-06-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 2 — — $10,400.00 $270,036.89 $140,218.45 2026-06-15
834 MS_DRG Acute Leukemia With Mcc 2 1 — — $139,699.59 $139,699.59 $139,699.59 2026-06-15
836 MS_DRG Acute Leukemia Without Cc/mcc 2 1 — — $139,699.59 $139,699.59 $139,699.59 2026-06-15
835 MS_DRG Acute Leukemia With Cc 2 1 — — $139,699.59 $139,699.59 $139,699.59 2026-06-15
850 MS_DRG Acute Leukemia With Other Procedures 2 1 — — $139,699.59 $139,699.59 $139,699.59 2026-06-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $137,281.98 $137,281.98 $137,281.98 2026-06-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $137,281.98 $137,281.98 $137,281.98 2026-06-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $137,281.98 $137,281.98 $137,281.98 2026-06-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 1 — — $132,162.35 $132,162.35 $132,162.35 2026-06-15
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 2 1 — — $132,162.35 $132,162.35 $132,162.35 2026-06-15
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 4 2 — — $10,400.00 $245,292.00 $127,846.00 2026-06-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 2 — — $10,400.00 $245,292.00 $127,846.00 2026-06-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 2 — — $10,400.00 $245,292.00 $127,846.00 2026-06-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 1 — — $127,540.46 $127,540.46 $127,540.46 2026-06-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $127,327.14 $127,327.14 $127,327.14 2026-06-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $126,639.79 $126,639.79 $126,639.79 2026-06-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $125,762.81 $125,762.81 $125,762.81 2026-06-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $125,762.81 $125,762.81 $125,762.81 2026-06-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $125,762.81 $125,762.81 $125,762.81 2026-06-15
14 MS_DRG Allogeneic Bone Marrow Transplant 4 2 — — $10,400.00 $228,961.32 $119,680.66 2026-06-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 4 2 — — $10,400.00 $228,961.32 $119,680.66 2026-06-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 4 2 — — $10,400.00 $228,961.32 $119,680.66 2026-06-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $115,594.65 $115,594.65 $115,594.65 2026-06-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $115,594.65 $115,594.65 $115,594.65 2026-06-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $115,594.65 $115,594.65 $115,594.65 2026-06-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 1 — — $115,594.65 $115,594.65 $115,594.65 2026-06-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 1 — — $115,594.65 $115,594.65 $115,594.65 2026-06-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 1 — — $115,594.65 $115,594.65 $115,594.65 2026-06-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $112,679.31 $112,679.31 $112,679.31 2026-06-15
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 1 — — $112,679.31 $112,679.31 $112,679.31 2026-06-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 1 — — $111,754.93 $111,754.93 $111,754.93 2026-06-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 1 — — $111,280.89 $111,280.89 $111,280.89 2026-06-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $111,280.89 $111,280.89 $111,280.89 2026-06-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 1 — — $103,008.89 $103,008.89 $103,008.89 2026-06-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 1 — — $103,008.89 $103,008.89 $103,008.89 2026-06-15
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $101,136.43 $101,136.43 $101,136.43 2026-06-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $101,136.43 $101,136.43 $101,136.43 2026-06-15
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $101,136.43 $101,136.43 $101,136.43 2026-06-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 1 — — $100,780.90 $100,780.90 $100,780.90 2026-06-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 1 — — $99,074.36 $99,074.36 $99,074.36 2026-06-15
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 2 1 — — $99,074.36 $99,074.36 $99,074.36 2026-06-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $97,201.90 $97,201.90 $97,201.90 2026-06-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $96,822.67 $96,822.67 $96,822.67 2026-06-15
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 2 1 — — $96,822.67 $96,822.67 $96,822.67 2026-06-15
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 2 1 — — $96,822.67 $96,822.67 $96,822.67 2026-06-15
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 2 1 — — $96,040.50 $96,040.50 $96,040.50 2026-06-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 1 — — $96,040.50 $96,040.50 $96,040.50 2026-06-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 1 — — $96,040.50 $96,040.50 $96,040.50 2026-06-15
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 1 — — $96,040.50 $96,040.50 $96,040.50 2026-06-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 1 — — $93,433.28 $93,433.28 $93,433.28 2026-06-15
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 2 1 — — $92,532.61 $92,532.61 $92,532.61 2026-06-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 1 — — $92,532.61 $92,532.61 $92,532.61 2026-06-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 1 — — $92,366.69 $92,366.69 $92,366.69 2026-06-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 1 — — $90,375.73 $90,375.73 $90,375.73 2026-06-15
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 1 — — $89,640.96 $89,640.96 $89,640.96 2026-06-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 1 — — $85,990.86 $85,990.86 $85,990.86 2026-06-15
642 MS_DRG Inborn And Other Disorders Of Metabolism 2 1 — — $85,327.20 $85,327.20 $85,327.20 2026-06-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 1 — — $84,260.61 $84,260.61 $84,260.61 2026-06-15
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $82,293.34 $82,293.34 $82,293.34 2026-06-15
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 1 — — $80,800.12 $80,800.12 $80,800.12 2026-06-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 1 — — $80,800.12 $80,800.12 $80,800.12 2026-06-15
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 2 1 — — $80,800.12 $80,800.12 $80,800.12 2026-06-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 1 — — $80,444.59 $80,444.59 $80,444.59 2026-06-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 2 1 — — $79,283.19 $79,283.19 $79,283.19 2026-06-15
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 2 1 — — $77,718.86 $77,718.86 $77,718.86 2026-06-15
245 MS_DRG Aicd Generator Procedures 2 1 — — $77,315.92 $77,315.92 $77,315.92 2026-06-15
265 MS_DRG Aicd Lead Procedures 2 1 — — $77,315.92 $77,315.92 $77,315.92 2026-06-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 1 — — $76,510.06 $76,510.06 $76,510.06 2026-06-15
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 2 1 — — $76,510.06 $76,510.06 $76,510.06 2026-06-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $76,510.06 $76,510.06 $76,510.06 2026-06-15
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $73,452.50 $73,452.50 $73,452.50 2026-06-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $73,452.50 $73,452.50 $73,452.50 2026-06-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $71,911.87 $71,911.87 $71,911.87 2026-06-15
252 MS_DRG Other Vascular Procedures With Mcc 2 1 — — $71,911.87 $71,911.87 $71,911.87 2026-06-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $71,911.87 $71,911.87 $71,911.87 2026-06-15
618 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $71,603.74 $71,603.74 $71,603.74 2026-06-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $71,603.74 $71,603.74 $71,603.74 2026-06-15
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $71,603.74 $71,603.74 $71,603.74 2026-06-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 1 — — $71,580.04 $71,580.04 $71,580.04 2026-06-15
333 MS_DRG Rectal Resection With Cc 2 1 — — $71,224.51 $71,224.51 $71,224.51 2026-06-15
332 MS_DRG Rectal Resection With Mcc 2 1 — — $71,224.51 $71,224.51 $71,224.51 2026-06-15
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 1 — — $70,205.32 $70,205.32 $70,205.32 2026-06-15
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $67,550.70 $67,550.70 $67,550.70 2026-06-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $66,318.20 $66,318.20 $66,318.20 2026-06-15
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 1 — — $66,318.20 $66,318.20 $66,318.20 2026-06-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 1 — — $65,464.92 $65,464.92 $65,464.92 2026-06-15
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 2 1 — — $65,464.92 $65,464.92 $65,464.92 2026-06-15
905 MS_DRG Skin Grafts For Injuries Without Cc/mcc 2 1 — — $65,061.99 $65,061.99 $65,061.99 2026-06-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 1 — — $65,061.99 $65,061.99 $65,061.99 2026-06-15
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 2 1 — — $64,422.04 $64,422.04 $64,422.04 2026-06-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 1 — — $63,497.66 $63,497.66 $63,497.66 2026-06-15
163 MS_DRG Major Chest Procedures With Mcc 2 1 — — $63,450.25 $63,450.25 $63,450.25 2026-06-15
164 MS_DRG Major Chest Procedures With Cc 2 1 — — $63,213.23 $63,213.23 $63,213.23 2026-06-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 1 — — $63,023.62 $63,023.62 $63,023.62 2026-06-15
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $61,909.62 $61,909.62 $61,909.62 2026-06-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 2 1 — — $61,625.20 $61,625.20 $61,625.20 2026-06-15
791 MS_DRG Prematurity With Major Problems 2 1 — — $61,577.80 $61,577.80 $61,577.80 2026-06-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 1 — — $61,435.58 $61,435.58 $61,435.58 2026-06-15
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 1 — — $61,435.58 $61,435.58 $61,435.58 2026-06-15
140 MS_DRG Major Head And Neck Procedures With Mcc 2 1 — — $61,340.78 $61,340.78 $61,340.78 2026-06-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $60,890.44 $60,890.44 $60,890.44 2026-06-15
570 MS_DRG Skin Debridement With Mcc 2 1 — — $60,795.63 $60,795.63 $60,795.63 2026-06-15
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 2 1 — — $60,511.21 $60,511.21 $60,511.21 2026-06-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $60,416.40 $60,416.40 $60,416.40 2026-06-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $59,894.95 $59,894.95 $59,894.95 2026-06-15
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 2 1 — — $59,894.95 $59,894.95 $59,894.95 2026-06-15
137 MS_DRG Mouth Procedures With Cc/mcc 2 1 — — $59,776.44 $59,776.44 $59,776.44 2026-06-15
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 2 1 — — $58,235.81 $58,235.81 $58,235.81 2026-06-15
422 MS_DRG Hepatobiliary Diagnostic Procedures Without Cc/mcc 2 1 — — $58,093.60 $58,093.60 $58,093.60 2026-06-15
357 MS_DRG Other Digestive System O.r. Procedures With Cc 2 1 — — $58,022.50 $58,022.50 $58,022.50 2026-06-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 1 — — $57,975.09 $57,975.09 $57,975.09 2026-06-15
839 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/mcc 2 1 — — $57,975.09 $57,975.09 $57,975.09 2026-06-15
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 2 1 — — $57,975.09 $57,975.09 $57,975.09 2026-06-15
571 MS_DRG Skin Debridement With Cc 2 1 — — $57,951.39 $57,951.39 $57,951.39 2026-06-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 1 — — $57,738.07 $57,738.07 $57,738.07 2026-06-15
975 MS_DRG HIV With Major Related Condition With Cc 2 1 — — $57,643.26 $57,643.26 $57,643.26 2026-06-15
976 MS_DRG HIV With Major Related Condition Without Cc/mcc 2 1 — — $57,643.26 $57,643.26 $57,643.26 2026-06-15
974 MS_DRG HIV With Major Related Condition With Mcc 2 1 — — $57,643.26 $57,643.26 $57,643.26 2026-06-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 2 — — $10,400.00 $104,857.65 $57,628.82 2026-06-15
754 MS_DRG Malignancy, Female Reproductive System With Mcc 2 1 — — $57,382.54 $57,382.54 $57,382.54 2026-06-15
755 MS_DRG Malignancy, Female Reproductive System With Cc 2 1 — — $57,382.54 $57,382.54 $57,382.54 2026-06-15
868 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Cc 2 1 — — $57,192.93 $57,192.93 $57,192.93 2026-06-15
869 MS_DRG Other Infectious And Parasitic Diseases Diagnoses Without Cc/mcc 2 1 — — $57,192.93 $57,192.93 $57,192.93 2026-06-15
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 2 1 — — $57,192.93 $57,192.93 $57,192.93 2026-06-15
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 2 1 — — $57,050.71 $57,050.71 $57,050.71 2026-06-15
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 2 1 — — $57,050.71 $57,050.71 $57,050.71 2026-06-15
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 1 — — $57,050.71 $57,050.71 $57,050.71 2026-06-15
615 MS_DRG Adrenal And Pituitary Procedures Without Cc/mcc 2 1 — — $57,050.71 $57,050.71 $57,050.71 2026-06-15
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 1 — — $56,576.67 $56,576.67 $56,576.67 2026-06-15
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 2 1 — — $56,576.67 $56,576.67 $56,576.67 2026-06-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $56,576.67 $56,576.67 $56,576.67 2026-06-15
374 MS_DRG Digestive Malignancy With Mcc 2 1 — — $55,936.72 $55,936.72 $55,936.72 2026-06-15
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 2 1 — — $55,913.02 $55,913.02 $55,913.02 2026-06-15
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 2 1 — — $55,913.02 $55,913.02 $55,913.02 2026-06-15
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 2 1 — — $55,913.02 $55,913.02 $55,913.02 2026-06-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 2 — — $10,400.00 $99,927.63 $55,163.82 2026-06-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 1 — — $54,988.64 $54,988.64 $54,988.64 2026-06-15
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/mcc 2 1 — — $54,988.64 $54,988.64 $54,988.64 2026-06-15
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 2 1 — — $54,988.64 $54,988.64 $54,988.64 2026-06-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 1 — — $54,751.62 $54,751.62 $54,751.62 2026-06-15
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 1 — — $54,751.62 $54,751.62 $54,751.62 2026-06-15
375 MS_DRG Digestive Malignancy With Cc 2 1 — — $54,633.11 $54,633.11 $54,633.11 2026-06-15
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 1 — — $53,519.12 $53,519.12 $53,519.12 2026-06-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 1 — — $53,400.61 $53,400.61 $53,400.61 2026-06-15
336 MS_DRG Peritoneal Adhesiolysis With Cc 2 1 — — $53,400.61 $53,400.61 $53,400.61 2026-06-15
598 MS_DRG Malignant Breast Disorders With Cc 2 1 — — $51,978.49 $51,978.49 $51,978.49 2026-06-15
597 MS_DRG Malignant Breast Disorders With Mcc 2 1 — — $51,978.49 $51,978.49 $51,978.49 2026-06-15
711 MS_DRG Testes Procedures With Cc/mcc 2 1 — — $51,883.68 $51,883.68 $51,883.68 2026-06-15
620 MS_DRG O.r. Procedures For Obesity With Cc 2 1 — — $51,717.76 $51,717.76 $51,717.76 2026-06-15
619 MS_DRG O.r. Procedures For Obesity With Mcc 2 1 — — $51,717.76 $51,717.76 $51,717.76 2026-06-15
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 1 — — $51,646.66 $51,646.66 $51,646.66 2026-06-15
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 2 1 — — $51,504.45 $51,504.45 $51,504.45 2026-06-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $51,314.83 $51,314.83 $51,314.83 2026-06-15
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 2 1 — — $51,314.83 $51,314.83 $51,314.83 2026-06-15
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 2 1 — — $51,314.83 $51,314.83 $51,314.83 2026-06-15
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/mcc 2 1 — — $51,030.41 $51,030.41 $51,030.41 2026-06-15
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $50,817.09 $50,817.09 $50,817.09 2026-06-15
63 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $50,817.09 $50,817.09 $50,817.09 2026-06-15
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $50,817.09 $50,817.09 $50,817.09 2026-06-15
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 1 — — $50,580.07 $50,580.07 $50,580.07 2026-06-15
141 MS_DRG Major Head And Neck Procedures With Cc 2 1 — — $50,390.45 $50,390.45 $50,390.45 2026-06-15
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $50,129.73 $50,129.73 $50,129.73 2026-06-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 1 — — $50,082.33 $50,082.33 $50,082.33 2026-06-15
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 1 — — $49,750.50 $49,750.50 $49,750.50 2026-06-15
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 4 2 — — $10,400.00 $89,095.82 $49,747.91 2026-06-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 4 2 — — $10,400.00 $89,095.82 $49,747.91 2026-06-15
254 MS_DRG Other Vascular Procedures Without Cc/mcc 2 1 — — $48,826.12 $48,826.12 $48,826.12 2026-06-15
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 1 — — $48,517.99 $48,517.99 $48,517.99 2026-06-15
28 MS_DRG Spinal Procedures With Mcc 4 2 — — $10,400.00 $86,038.26 $48,219.13 2026-06-15
290 MS_DRG Acute And Subacute Endocarditis Without Cc/mcc 2 1 — — $47,996.55 $47,996.55 $47,996.55 2026-06-15
289 MS_DRG Acute And Subacute Endocarditis With Cc 2 1 — — $47,996.55 $47,996.55 $47,996.55 2026-06-15
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 2 1 — — $47,996.55 $47,996.55 $47,996.55 2026-06-15
288 MS_DRG Acute And Subacute Endocarditis With Mcc 2 1 — — $47,996.55 $47,996.55 $47,996.55 2026-06-15
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 2 1 — — $47,996.55 $47,996.55 $47,996.55 2026-06-15
479 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc 2 1 — — $47,830.64 $47,830.64 $47,830.64 2026-06-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $47,830.64 $47,830.64 $47,830.64 2026-06-15
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 2 1 — — $47,830.64 $47,830.64 $47,830.64 2026-06-15
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 1 — — $47,759.53 $47,759.53 $47,759.53 2026-06-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 1 — — $47,475.11 $47,475.11 $47,475.11 2026-06-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 1 — — $46,811.45 $46,811.45 $46,811.45 2026-06-15
830 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 1 — — $46,811.45 $46,811.45 $46,811.45 2026-06-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 1 — — $46,811.45 $46,811.45 $46,811.45 2026-06-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 2 — — $10,400.00 $83,122.91 $46,761.46 2026-06-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 2 — — $10,400.00 $83,122.91 $46,761.46 2026-06-15
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 4 2 — — $10,400.00 $83,122.91 $46,761.46 2026-06-15
500 MS_DRG Soft Tissue Procedures With Mcc 2 1 — — $46,408.52 $46,408.52 $46,408.52 2026-06-15
501 MS_DRG Soft Tissue Procedures With Cc 2 1 — — $46,408.52 $46,408.52 $46,408.52 2026-06-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 1 — — $46,361.11 $46,361.11 $46,361.11 2026-06-15
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 2 1 — — $46,361.11 $46,361.11 $46,361.11 2026-06-15
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $46,242.60 $46,242.60 $46,242.60 2026-06-15
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $46,242.60 $46,242.60 $46,242.60 2026-06-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $46,076.69 $46,076.69 $46,076.69 2026-06-15
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $46,076.69 $46,076.69 $46,076.69 2026-06-15
624 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $46,076.69 $46,076.69 $46,076.69 2026-06-15
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 2 1 — — $46,052.99 $46,052.99 $46,052.99 2026-06-15
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 2 1 — — $46,052.99 $46,052.99 $46,052.99 2026-06-15
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 1 — — $46,005.58 $46,005.58 $46,005.58 2026-06-15
654 MS_DRG Major Bladder Procedures With Cc 2 1 — — $45,792.26 $45,792.26 $45,792.26 2026-06-15
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $45,792.26 $45,792.26 $45,792.26 2026-06-15
655 MS_DRG Major Bladder Procedures Without Cc/mcc 2 1 — — $45,792.26 $45,792.26 $45,792.26 2026-06-15
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 1 — — $45,650.05 $45,650.05 $45,650.05 2026-06-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 1 — — $45,626.35 $45,626.35 $45,626.35 2026-06-15
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 2 1 — — $45,626.35 $45,626.35 $45,626.35 2026-06-15
738 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/mcc 2 1 — — $45,626.35 $45,626.35 $45,626.35 2026-06-15
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 1 — — $45,602.65 $45,602.65 $45,602.65 2026-06-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 2 — — $10,400.00 $80,563.10 $45,481.55 2026-06-15
165 MS_DRG Major Chest Procedures Without Cc/mcc 2 1 — — $45,436.73 $45,436.73 $45,436.73 2026-06-15
410 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $45,247.12 $45,247.12 $45,247.12 2026-06-15
297 MS_DRG Cardiac Arrest, Unexplained With Cc 2 1 — — $44,678.27 $44,678.27 $44,678.27 2026-06-15
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/mcc 2 1 — — $44,678.27 $44,678.27 $44,678.27 2026-06-15
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 2 1 — — $44,678.27 $44,678.27 $44,678.27 2026-06-15
908 MS_DRG Other O.r. Procedures For Injuries With Cc 2 1 — — $44,370.14 $44,370.14 $44,370.14 2026-06-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 1 — — $44,156.83 $44,156.83 $44,156.83 2026-06-15
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 2 1 — — $44,156.83 $44,156.83 $44,156.83 2026-06-15
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 2 1 — — $43,967.21 $43,967.21 $43,967.21 2026-06-15
799 MS_DRG Splenic Procedures With Mcc 2 1 — — $43,730.19 $43,730.19 $43,730.19 2026-06-15
801 MS_DRG Splenic Procedures Without Cc/mcc 2 1 — — $43,730.19 $43,730.19 $43,730.19 2026-06-15
800 MS_DRG Splenic Procedures With Cc 2 1 — — $43,730.19 $43,730.19 $43,730.19 2026-06-15
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 4 2 — — $10,400.00 $76,652.27 $43,526.14 2026-06-15
723 MS_DRG Malignancy, Male Reproductive System With Cc 2 1 — — $43,350.96 $43,350.96 $43,350.96 2026-06-15
722 MS_DRG Malignancy, Male Reproductive System With Mcc 2 1 — — $43,350.96 $43,350.96 $43,350.96 2026-06-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 1 — — $43,279.85 $43,279.85 $43,279.85 2026-06-15
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 2 1 — — $43,279.85 $43,279.85 $43,279.85 2026-06-15
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 2 1 — — $43,279.85 $43,279.85 $43,279.85 2026-06-15
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 2 1 — — $43,232.45 $43,232.45 $43,232.45 2026-06-15
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 2 1 — — $42,971.73 $42,971.73 $42,971.73 2026-06-15
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 2 1 — — $42,971.73 $42,971.73 $42,971.73 2026-06-15
804 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs Without Cc/mcc 2 1 — — $42,260.67 $42,260.67 $42,260.67 2026-06-15
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 2 1 — — $42,260.67 $42,260.67 $42,260.67 2026-06-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 1 — — $42,260.67 $42,260.67 $42,260.67 2026-06-15
178 MS_DRG Respiratory Infections And Inflammations With Cc 2 1 — — $42,142.16 $42,142.16 $42,142.16 2026-06-15
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 1 — — $42,142.16 $42,142.16 $42,142.16 2026-06-15
964 MS_DRG Other Multiple Significant Trauma With Cc 2 1 — — $41,928.84 $41,928.84 $41,928.84 2026-06-15
965 MS_DRG Other Multiple Significant Trauma Without Cc/mcc 2 1 — — $41,928.84 $41,928.84 $41,928.84 2026-06-15
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 1 — — $41,928.84 $41,928.84 $41,928.84 2026-06-15
412 MS_DRG Cholecystectomy With C.d.e. With Cc 2 1 — — $41,881.43 $41,881.43 $41,881.43 2026-06-15
845 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 2 1 — — $41,620.71 $41,620.71 $41,620.71 2026-06-15
844 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 2 1 — — $41,620.71 $41,620.71 $41,620.71 2026-06-15
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 2 1 — — $41,597.01 $41,597.01 $41,597.01 2026-06-15
716 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy Without Cc/mcc 2 1 — — $41,597.01 $41,597.01 $41,597.01 2026-06-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 1 — — $41,431.10 $41,431.10 $41,431.10 2026-06-15
977 MS_DRG HIV With Or Without Other Related Condition 2 1 — — $41,431.10 $41,431.10 $41,431.10 2026-06-15
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 1 — — $41,407.39 $41,407.39 $41,407.39 2026-06-15
434 MS_DRG Cirrhosis And Alcoholic Hepatitis Without Cc/mcc 2 1 — — $41,336.29 $41,336.29 $41,336.29 2026-06-15
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 2 1 — — $41,336.29 $41,336.29 $41,336.29 2026-06-15
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 2 1 — — $41,336.29 $41,336.29 $41,336.29 2026-06-15
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 1 — — $40,814.84 $40,814.84 $40,814.84 2026-06-15
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 2 1 — — $40,791.14 $40,791.14 $40,791.14 2026-06-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 4 2 — — $10,400.00 $71,177.11 $40,788.56 2026-06-15
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 2 1 — — $40,696.33 $40,696.33 $40,696.33 2026-06-15
476 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc… 2 1 — — $40,696.33 $40,696.33 $40,696.33 2026-06-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $40,696.33 $40,696.33 $40,696.33 2026-06-15
595 MS_DRG Major Skin Disorders With Mcc 2 1 — — $40,506.72 $40,506.72 $40,506.72 2026-06-15
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 2 1 — — $40,483.02 $40,483.02 $40,483.02 2026-06-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 1 — — $40,483.02 $40,483.02 $40,483.02 2026-06-15
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 2 1 — — $40,483.02 $40,483.02 $40,483.02 2026-06-15
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 1 — — $40,483.02 $40,483.02 $40,483.02 2026-06-15
545 MS_DRG Connective Tissue Disorders With Mcc 2 1 — — $40,032.68 $40,032.68 $40,032.68 2026-06-15
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 1 — — $39,724.55 $39,724.55 $39,724.55 2026-06-15
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 2 1 — — $39,606.04 $39,606.04 $39,606.04 2026-06-15
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 2 1 — — $39,487.53 $39,487.53 $39,487.53 2026-06-15
735 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc 2 1 — — $39,487.53 $39,487.53 $39,487.53 2026-06-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 1 — — $39,203.11 $39,203.11 $39,203.11 2026-06-15
540 MS_DRG Osteomyelitis With Cc 2 1 — — $39,013.49 $39,013.49 $39,013.49 2026-06-15
541 MS_DRG Osteomyelitis Without Cc/mcc 2 1 — — $39,013.49 $39,013.49 $39,013.49 2026-06-15
539 MS_DRG Osteomyelitis With Mcc 2 1 — — $39,013.49 $39,013.49 $39,013.49 2026-06-15
437 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas Without Cc/mcc 2 1 — — $38,634.26 $38,634.26 $38,634.26 2026-06-15
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 2 1 — — $38,634.26 $38,634.26 $38,634.26 2026-06-15
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 2 1 — — $38,634.26 $38,634.26 $38,634.26 2026-06-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 1 — — $38,586.86 $38,586.86 $38,586.86 2026-06-15
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