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

SAMUEL MAHELONA MEMORIAL HOSPITAL

Kapaa, HI · CCN 121306 · Rates published

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.

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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
             
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
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
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
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
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
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
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 1 — — $39,724.55 $39,724.55 $39,724.55 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
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
595 MS_DRG Major Skin Disorders With Mcc 2 1 — — $40,506.72 $40,506.72 $40,506.72 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
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 4 2 — — $10,400.00 $71,177.11 $40,788.56 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
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
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
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
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
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
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
412 MS_DRG Cholecystectomy With C.d.e. With Cc 2 1 — — $41,881.43 $41,881.43 $41,881.43 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
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
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
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
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
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
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
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
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
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 2 1 — — $43,967.21 $43,967.21 $43,967.21 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
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
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
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
165 MS_DRG Major Chest Procedures Without Cc/mcc 2 1 — — $45,436.73 $45,436.73 $45,436.73 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
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 1 — — $45,602.65 $45,602.65 $45,602.65 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
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
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
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 1 — — $46,005.58 $46,005.58 $46,005.58 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
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
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
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
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
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
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
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
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
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
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
28 MS_DRG Spinal Procedures With Mcc 4 2 — — $10,400.00 $86,038.26 $48,219.13 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
254 MS_DRG Other Vascular Procedures Without Cc/mcc 2 1 — — $48,826.12 $48,826.12 $48,826.12 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
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
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 1 — — $50,082.33 $50,082.33 $50,082.33 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
141 MS_DRG Major Head And Neck Procedures With Cc 2 1 — — $50,390.45 $50,390.45 $50,390.45 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
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
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
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
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
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 1 — — $51,646.66 $51,646.66 $51,646.66 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
711 MS_DRG Testes Procedures With Cc/mcc 2 1 — — $51,883.68 $51,883.68 $51,883.68 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
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
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 1 — — $53,519.12 $53,519.12 $53,519.12 2026-06-15
375 MS_DRG Digestive Malignancy With Cc 2 1 — — $54,633.11 $54,633.11 $54,633.11 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
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
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
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
374 MS_DRG Digestive Malignancy With Mcc 2 1 — — $55,936.72 $55,936.72 $55,936.72 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
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
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
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
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
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
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
571 MS_DRG Skin Debridement With Cc 2 1 — — $57,951.39 $57,951.39 $57,951.39 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
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
422 MS_DRG Hepatobiliary Diagnostic Procedures Without Cc/mcc 2 1 — — $58,093.60 $58,093.60 $58,093.60 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
137 MS_DRG Mouth Procedures With Cc/mcc 2 1 — — $59,776.44 $59,776.44 $59,776.44 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
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $60,416.40 $60,416.40 $60,416.40 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
570 MS_DRG Skin Debridement With Mcc 2 1 — — $60,795.63 $60,795.63 $60,795.63 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
140 MS_DRG Major Head And Neck Procedures With Mcc 2 1 — — $61,340.78 $61,340.78 $61,340.78 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
791 MS_DRG Prematurity With Major Problems 2 1 — — $61,577.80 $61,577.80 $61,577.80 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
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $61,909.62 $61,909.62 $61,909.62 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
164 MS_DRG Major Chest Procedures With Cc 2 1 — — $63,213.23 $63,213.23 $63,213.23 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
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
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
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
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
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
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $67,550.70 $67,550.70 $67,550.70 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
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
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 1 — — $71,580.04 $71,580.04 $71,580.04 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
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
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
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
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
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 2 1 — — $77,718.86 $77,718.86 $77,718.86 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
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
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
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $82,293.34 $82,293.34 $82,293.34 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
642 MS_DRG Inborn And Other Disorders Of Metabolism 2 1 — — $85,327.20 $85,327.20 $85,327.20 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
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 1 — — $89,640.96 $89,640.96 $89,640.96 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
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
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
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 1 — — $93,433.28 $93,433.28 $93,433.28 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
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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $97,201.90 $97,201.90 $97,201.90 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
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
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
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
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
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
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
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
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
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
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $126,639.79 $126,639.79 $126,639.79 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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 1 — — $127,540.46 $127,540.46 $127,540.46 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
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
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
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
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
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
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
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
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
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
264 MS_DRG Other Circulatory System O.r. Procedures 2 1 — — $161,742.45 $161,742.45 $161,742.45 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
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
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
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
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
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
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
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $224,860.87 $224,860.87 $224,860.87 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
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 1 — — $271,980.45 $271,980.45 $271,980.45 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
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
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