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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

2,365 distinct procedures filed
11 distinct payers
31,022 rate rows
2025-08-07 last MRF observed
Data quality

27,318 of 31,022 rate rows are consumer-grade (88.1%)

3,704 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 3,587
per-diem day rate — not a per-procedure price 108
placeholder amount (≤ $0.02) — excluded from medians 9
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hhsc.org/standardcharge/smmh/99-0262217_Samuel-Mahelona-Memorial-Hospital_standardcharges.csv
Found on page https://www.hhsc.org/standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint ab1413dd87bb9c46… · 6,307,992 bytes · first seen 2026-05-08

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
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 1 $663,305.00 $663,305.00 $663,305.00 nat. median
$53,167
outlier · 12.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $444,327.00 $444,327.00 $444,327.00 nat. median
$202,976
outlier · 2.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $385,107.00 $385,107.00 $385,107.00 nat. median
$133,161
outlier · 2.9×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $364,092.00 $364,092.00 $364,092.00 nat. median
$206,474
1.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $341,344.00 $341,344.00 $341,344.00 nat. median
$100,136
outlier · 3.4×
6
MS_DRG 		Liver Transplant Without Mcc 1 $341,344.00 $341,344.00 $341,344.00 nat. median
$46,260
outlier · 7.4×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 $258,885.00 $258,885.00 $258,885.00 nat. median
$52,303
outlier · 4.9×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $257,036.00 $257,036.00 $257,036.00 nat. median
$108,660
outlier · 2.4×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $257,036.00 $257,036.00 $257,036.00 nat. median
$265,286
1.0× median
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 $233,473.00 $233,473.00 $233,473.00 nat. median
$34,274
outlier · 6.8×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $233,473.00 $233,473.00 $233,473.00 nat. median
$77,570
outlier · 3.0×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $233,473.00 $233,473.00 $233,473.00 nat. median
$54,045
outlier · 4.3×
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 1 $217,942.00 $217,942.00 $217,942.00 nat. median
$53,807
outlier · 4.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $217,942.00 $217,942.00 $217,942.00 nat. median
$117,357
1.9× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 1 $217,942.00 $217,942.00 $217,942.00 nat. median
$56,918
outlier · 3.8×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $214,034.00 $214,034.00 $214,034.00 nat. median
$64,732
outlier · 3.3×
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 $203,918.00 $203,918.00 $203,918.00 nat. median
$37,662
outlier · 5.4×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $184,063.00 $184,063.00 $184,063.00 nat. median
$64,508
outlier · 2.9×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $184,063.00 $184,063.00 $184,063.00 nat. median
$93,672
2.0× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $184,063.00 $184,063.00 $184,063.00 nat. median
$61,920
outlier · 3.0×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $176,319.00 $176,319.00 $176,319.00 nat. median
$62,134
outlier · 2.8×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $173,891.00 $173,891.00 $173,891.00 nat. median
$66,526
outlier · 2.6×
215
MS_DRG 		Other Heart Assist System Implant 1 $162,410.00 $162,410.00 $162,410.00 nat. median
$99,019
1.6× median
264
MS_DRG 		Other Circulatory System O.r. Procedures 1 $153,953.00 $153,953.00 $153,953.00 nat. median
$33,061
outlier · 4.7×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $152,334.00 $152,334.00 $152,334.00 nat. median
$68,886
outlier · 2.2×
650
MS_DRG 		Kidney Transplant With Hemodialysis With Mcc 1 $147,282.00 $147,282.00 $147,282.00 nat. median
$45,278
outlier · 3.3×
651
MS_DRG 		Kidney Transplant With Hemodialysis Without Mcc 1 $147,282.00 $147,282.00 $147,282.00 nat. median
$35,527
outlier · 4.1×
652
MS_DRG 		Kidney Transplant 1 $147,282.00 $147,282.00 $147,282.00 nat. median
$31,494
outlier · 4.7×
855
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures Without Cc/mcc 1 $146,628.00 $146,628.00 $146,628.00 nat. median
$16,326
outlier · 9.0×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 $146,628.00 $146,628.00 $146,628.00 nat. median
$48,170
outlier · 3.0×
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 1 $146,628.00 $146,628.00 $146,628.00 nat. median
$20,421
outlier · 7.2×
958
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Cc 1 $145,407.00 $145,407.00 $145,407.00 nat. median
$41,228
outlier · 3.5×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $145,407.00 $145,407.00 $145,407.00 nat. median
$72,135
outlier · 2.0×
959
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 1 $145,407.00 $145,407.00 $145,407.00 nat. median
$27,489
outlier · 5.3×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $133,736.00 $133,736.00 $133,736.00 nat. median
$59,898
outlier · 2.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $133,736.00 $133,736.00 $133,736.00 nat. median
$79,312
1.7× median
834
MS_DRG 		Acute Leukemia Without Major O.r. Procedures With Mcc 1 $132,980.00 $132,980.00 $132,980.00 nat. median
$53,172
outlier · 2.5×
835
MS_DRG 		Acute Leukemia Without Major O.r. Procedures With Cc 1 $132,980.00 $132,980.00 $132,980.00 nat. median
$21,480
outlier · 6.2×
836
MS_DRG 		Acute Leukemia Without Major O.r. Procedures Without Cc/mcc 1 $132,980.00 $132,980.00 $132,980.00 nat. median
$13,339
outlier · 10.0×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $130,674.00 $130,674.00 $130,674.00 nat. median
$81,118
1.6× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $130,674.00 $130,674.00 $130,674.00 nat. median
$58,020
outlier · 2.3×
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $130,674.00 $130,674.00 $130,674.00 nat. median
$42,730
outlier · 3.1×
319
MS_DRG 		Other Endovascular Cardiac Valve Procedures With Mcc 1 $125,804.00 $125,804.00 $125,804.00 nat. median
$43,757
outlier · 2.9×
320
MS_DRG 		Other Endovascular Cardiac Valve Procedures Without Mcc 1 $125,804.00 $125,804.00 $125,804.00 nat. median
$24,229
outlier · 5.2×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $121,396.00 $121,396.00 $121,396.00 nat. median
$74,915
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve�procedures 1 $121,396.00 $121,396.00 $121,396.00 nat. median
$102,358
1.2× median
221
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $121,396.00 $121,396.00 $121,396.00 nat. median
$48,732
outlier · 2.5×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $121,396.00 $121,396.00 $121,396.00 nat. median
$52,879
outlier · 2.3×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $121,201.00 $121,201.00 $121,201.00 nat. median
$73,807
1.6× median
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $120,540.00 $120,540.00 $120,540.00 nat. median
$48,178
outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 2,365 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
             
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $96,258.00 $96,258.00 $96,258.00 2025-08-07
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $96,258.00 $96,258.00 $96,258.00 2025-08-07
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $96,258.00 $96,258.00 $96,258.00 2025-08-07
31 MS_DRG Ventricular Shunt Procedures With Mcc 1 1 — — $51,228.00 $51,228.00 $51,228.00 2025-08-07
32 MS_DRG Ventricular Shunt Procedures With Cc 1 1 — — $51,228.00 $51,228.00 $51,228.00 2025-08-07
738 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/mcc 1 1 — — $43,422.00 $43,422.00 $43,422.00 2025-08-07
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 1 1 — — $43,422.00 $43,422.00 $43,422.00 2025-08-07
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 1 1 — — $43,422.00 $43,422.00 $43,422.00 2025-08-07
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $68,448.00 $68,448.00 $68,448.00 2025-08-07
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $68,448.00 $68,448.00 $68,448.00 2025-08-07
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 1 1 — — $55,441.00 $55,441.00 $55,441.00 2025-08-07
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $385,107.00 $385,107.00 $385,107.00 2025-08-07
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 1 1 — — $79,121.00 $79,121.00 $79,121.00 2025-08-07
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $79,121.00 $79,121.00 $79,121.00 2025-08-07
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $79,121.00 $79,121.00 $79,121.00 2025-08-07
711 MS_DRG Testes Procedures With Cc/mcc 1 1 — — $49,395.00 $49,395.00 $49,395.00 2025-08-07
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $120,540.00 $120,540.00 $120,540.00 2025-08-07
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $85,317.00 $85,317.00 $85,317.00 2025-08-07
801 MS_DRG Splenic Procedures Without Cc/mcc 1 1 — — $41,621.00 $41,621.00 $41,621.00 2025-08-07
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $41,621.00 $41,621.00 $41,621.00 2025-08-07
800 MS_DRG Splenic Procedures With Cc 1 1 — — $41,621.00 $41,621.00 $41,621.00 2025-08-07
30 MS_DRG Spinal Procedures Without Cc/mcc 1 1 — — $44,916.00 $44,916.00 $44,916.00 2025-08-07
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $81,898.00 $81,898.00 $81,898.00 2025-08-07
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $67,759.00 $67,759.00 $67,759.00 2025-08-07
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $75,463.00 $75,463.00 $75,463.00 2025-08-07
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $130,674.00 $130,674.00 $130,674.00 2025-08-07
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $130,674.00 $130,674.00 $130,674.00 2025-08-07
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $130,674.00 $130,674.00 $130,674.00 2025-08-07
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $80,196.00 $80,196.00 $80,196.00 2025-08-07
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $44,181.00 $44,181.00 $44,181.00 2025-08-07
501 MS_DRG Soft Tissue Procedures With Cc 1 1 — — $44,181.00 $44,181.00 $44,181.00 2025-08-07
905 MS_DRG Skin Grafts For Injuries Without Cc/mcc 1 1 — — $61,930.00 $61,930.00 $61,930.00 2025-08-07
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 1 1 — — $61,930.00 $61,930.00 $61,930.00 2025-08-07
624 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $43,859.00 $43,859.00 $43,859.00 2025-08-07
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $43,859.00 $43,859.00 $43,859.00 2025-08-07
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $43,859.00 $43,859.00 $43,859.00 2025-08-07
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $57,951.00 $57,951.00 $57,951.00 2025-08-07
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 1 — — $54,964.00 $54,964.00 $54,964.00 2025-08-07
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $57,009.00 $57,009.00 $57,009.00 2025-08-07
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 1 1 — — $57,009.00 $57,009.00 $57,009.00 2025-08-07
570 MS_DRG Skin Debridement With Mcc 1 1 — — $57,873.00 $57,873.00 $57,873.00 2025-08-07
571 MS_DRG Skin Debridement With Cc 1 1 — — $55,169.00 $55,169.00 $55,169.00 2025-08-07
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 1 1 — — $663,305.00 $663,305.00 $663,305.00 2025-08-07
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 1 1 — — $38,835.00 $38,835.00 $38,835.00 2025-08-07
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 1 1 — — $38,856.00 $38,856.00 $38,856.00 2025-08-07
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $173,891.00 $173,891.00 $173,891.00 2025-08-07
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 1 1 — — $53,850.00 $53,850.00 $53,850.00 2025-08-07
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $53,850.00 $53,850.00 $53,850.00 2025-08-07
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $53,850.00 $53,850.00 $53,850.00 2025-08-07
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $176,319.00 $176,319.00 $176,319.00 2025-08-07
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 — — $66,823.00 $66,823.00 $66,823.00 2025-08-07
177 MS_DRG Respiratory Infections And Inflammations With Mcc 1 1 — — $40,112.00 $40,112.00 $40,112.00 2025-08-07
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 — — $40,112.00 $40,112.00 $40,112.00 2025-08-07
332 MS_DRG Rectal Resection With Mcc 1 1 — — $67,787.00 $67,787.00 $67,787.00 2025-08-07
333 MS_DRG Rectal Resection With Cc 1 1 — — $67,787.00 $67,787.00 $67,787.00 2025-08-07
189 MS_DRG Pulmonary Edema And Respiratory Failure 1 1 — — $43,412.00 $43,412.00 $43,412.00 2025-08-07
791 MS_DRG Prematurity With Major Problems 1 1 — — $58,606.00 $58,606.00 $58,606.00 2025-08-07
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 1 1 — — $41,841.00 $41,841.00 $41,841.00 2025-08-07
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $68,136.00 $68,136.00 $68,136.00 2025-08-07
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 1 1 — — $50,943.00 $50,943.00 $50,943.00 2025-08-07
335 MS_DRG Peritoneal Adhesiolysis With Mcc 1 1 — — $57,513.00 $57,513.00 $57,513.00 2025-08-07
336 MS_DRG Peritoneal Adhesiolysis With Cc 1 1 — — $50,841.00 $50,841.00 $50,841.00 2025-08-07
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 1 1 — — $47,701.00 $47,701.00 $47,701.00 2025-08-07
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 1 — — $62,871.00 $62,871.00 $62,871.00 2025-08-07
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 1 1 — — $55,286.00 $55,286.00 $55,286.00 2025-08-07
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $45,692.00 $45,692.00 $45,692.00 2025-08-07
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 1 1 — — $38,531.00 $38,531.00 $38,531.00 2025-08-07
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 1 1 — — $54,304.00 $54,304.00 $54,304.00 2025-08-07
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 1 1 — — $50,836.00 $50,836.00 $50,836.00 2025-08-07
735 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc 1 1 — — $37,576.00 $37,576.00 $37,576.00 2025-08-07
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 1 1 — — $37,576.00 $37,576.00 $37,576.00 2025-08-07
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $88,925.00 $88,925.00 $88,925.00 2025-08-07
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $49,171.00 $49,171.00 $49,171.00 2025-08-07
254 MS_DRG Other Vascular Procedures Without Cc/mcc 1 1 — — $46,481.00 $46,481.00 $46,481.00 2025-08-07
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $68,448.00 $68,448.00 $68,448.00 2025-08-07
253 MS_DRG Other Vascular Procedures With Cc 1 1 — — $64,292.00 $64,292.00 $64,292.00 2025-08-07
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $44,567.00 $44,567.00 $44,567.00 2025-08-07
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 1 1 — — $41,147.00 $41,147.00 $41,147.00 2025-08-07
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $60,444.00 $60,444.00 $60,444.00 2025-08-07
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 1 1 — — $57,594.00 $57,594.00 $57,594.00 2025-08-07
804 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs Without Cc/mcc 1 1 — — $40,235.00 $40,235.00 $40,235.00 2025-08-07
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $40,235.00 $40,235.00 $40,235.00 2025-08-07
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 1 1 — — $40,235.00 $40,235.00 $40,235.00 2025-08-07
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 1 1 — — $145,407.00 $145,407.00 $145,407.00 2025-08-07
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $145,407.00 $145,407.00 $145,407.00 2025-08-07
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 1 1 — — $145,407.00 $145,407.00 $145,407.00 2025-08-07
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $45,200.00 $45,200.00 $45,200.00 2025-08-07
908 MS_DRG Other O.r. Procedures For Injuries With Cc 1 1 — — $42,240.00 $42,240.00 $42,240.00 2025-08-07
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 1 1 — — $43,843.00 $43,843.00 $43,843.00 2025-08-07
844 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 1 1 — — $39,624.00 $39,624.00 $39,624.00 2025-08-07
845 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 1 1 — — $39,624.00 $39,624.00 $39,624.00 2025-08-07
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $58,480.00 $58,480.00 $58,480.00 2025-08-07
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 1 1 — — $58,480.00 $58,480.00 $58,480.00 2025-08-07
965 MS_DRG Other Multiple Significant Trauma Without Cc/mcc 1 1 — — $39,919.00 $39,919.00 $39,919.00 2025-08-07
963 MS_DRG Other Multiple Significant Trauma With Mcc 1 1 — — $39,919.00 $39,919.00 $39,919.00 2025-08-07
964 MS_DRG Other Multiple Significant Trauma With Cc 1 1 — — $39,919.00 $39,919.00 $39,919.00 2025-08-07
716 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy Without Cc/mcc 1 1 — — $39,601.00 $39,601.00 $39,601.00 2025-08-07
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 1 1 — — $39,601.00 $39,601.00 $39,601.00 2025-08-07
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 1 1 — — $91,416.00 $91,416.00 $91,416.00 2025-08-07
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $105,929.00 $105,929.00 $105,929.00 2025-08-07
271 MS_DRG Other Major Cardiovascular Procedures With Cc 1 1 — — $91,416.00 $91,416.00 $91,416.00 2025-08-07
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/mcc 1 1 — — $52,341.00 $52,341.00 $52,341.00 2025-08-07
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $52,341.00 $52,341.00 $52,341.00 2025-08-07
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $52,341.00 $52,341.00 $52,341.00 2025-08-07
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 1 1 — — $37,709.00 $37,709.00 $37,709.00 2025-08-07
869 MS_DRG Other Infectious And Parasitic Diseases Diagnoses Without Cc/mcc 1 1 — — $54,435.00 $54,435.00 $54,435.00 2025-08-07
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 1 — — $54,435.00 $54,435.00 $54,435.00 2025-08-07
868 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Cc 1 1 — — $54,435.00 $54,435.00 $54,435.00 2025-08-07
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 1 1 — — $92,153.00 $92,153.00 $92,153.00 2025-08-07
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $92,153.00 $92,153.00 $92,153.00 2025-08-07
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 1 1 — — $92,153.00 $92,153.00 $92,153.00 2025-08-07
215 MS_DRG Other Heart Assist System Implant 1 1 — — $162,410.00 $162,410.00 $162,410.00 2025-08-07
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 1 1 — — $125,804.00 $125,804.00 $125,804.00 2025-08-07
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 1 1 — — $125,804.00 $125,804.00 $125,804.00 2025-08-07
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $37,311.00 $37,311.00 $37,311.00 2025-08-07
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 1 1 — — $95,934.00 $95,934.00 $95,934.00 2025-08-07
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $59,991.00 $59,991.00 $59,991.00 2025-08-07
357 MS_DRG Other Digestive System O.r. Procedures With Cc 1 1 — — $55,238.00 $55,238.00 $55,238.00 2025-08-07
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $153,953.00 $153,953.00 $153,953.00 2025-08-07
314 MS_DRG Other Circulatory System Diagnoses With Mcc 1 1 — — $37,806.00 $37,806.00 $37,806.00 2025-08-07
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $107,250.00 $107,250.00 $107,250.00 2025-08-07
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $107,250.00 $107,250.00 $107,250.00 2025-08-07
541 MS_DRG Osteomyelitis Without Cc/mcc 1 1 — — $37,132.00 $37,132.00 $37,132.00 2025-08-07
539 MS_DRG Osteomyelitis With Mcc 1 1 — — $37,132.00 $37,132.00 $37,132.00 2025-08-07
540 MS_DRG Osteomyelitis With Cc 1 1 — — $37,132.00 $37,132.00 $37,132.00 2025-08-07
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 1 1 — — $81,850.00 $81,850.00 $81,850.00 2025-08-07
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 1 1 — — $49,017.00 $49,017.00 $49,017.00 2025-08-07
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $49,231.00 $49,231.00 $49,231.00 2025-08-07
620 MS_DRG O.r. Procedures For Obesity With Cc 1 1 — — $49,231.00 $49,231.00 $49,231.00 2025-08-07
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 1 1 — — $61,318.00 $61,318.00 $61,318.00 2025-08-07
830 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $44,556.00 $44,556.00 $44,556.00 2025-08-07
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $44,556.00 $44,556.00 $44,556.00 2025-08-07
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $69,908.00 $69,908.00 $69,908.00 2025-08-07
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $69,908.00 $69,908.00 $69,908.00 2025-08-07
137 MS_DRG Mouth Procedures With Cc/mcc 1 1 — — $56,900.00 $56,900.00 $56,900.00 2025-08-07
597 MS_DRG Malignant Breast Disorders With Mcc 1 1 — — $49,487.00 $49,487.00 $49,487.00 2025-08-07
598 MS_DRG Malignant Breast Disorders With Cc 1 1 — — $49,487.00 $49,487.00 $49,487.00 2025-08-07
722 MS_DRG Malignancy, Male Reproductive System With Mcc 1 1 — — $41,272.00 $41,272.00 $41,272.00 2025-08-07
723 MS_DRG Malignancy, Male Reproductive System With Cc 1 1 — — $41,272.00 $41,272.00 $41,272.00 2025-08-07
754 MS_DRG Malignancy, Female Reproductive System With Mcc 1 1 — — $54,616.00 $54,616.00 $54,616.00 2025-08-07
755 MS_DRG Malignancy, Female Reproductive System With Cc 1 1 — — $54,616.00 $54,616.00 $54,616.00 2025-08-07
437 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas Without Cc/mcc 1 1 — — $36,769.00 $36,769.00 $36,769.00 2025-08-07
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 1 1 — — $36,769.00 $36,769.00 $36,769.00 2025-08-07
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $76,687.00 $76,687.00 $76,687.00 2025-08-07
330 MS_DRG Major Small And Large Bowel Procedures With Cc 1 1 — — $62,081.00 $62,081.00 $62,081.00 2025-08-07
595 MS_DRG Major Skin Disorders With Mcc 1 1 — — $38,555.00 $38,555.00 $38,555.00 2025-08-07
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 1 — — $38,988.00 $38,988.00 $38,988.00 2025-08-07
140 MS_DRG Major Head And Neck Procedures With Mcc 1 1 — — $58,399.00 $58,399.00 $58,399.00 2025-08-07
141 MS_DRG Major Head And Neck Procedures With Cc 1 1 — — $47,972.00 $47,972.00 $47,972.00 2025-08-07
165 MS_DRG Major Chest Procedures Without Cc/mcc 1 1 — — $43,259.00 $43,259.00 $43,259.00 2025-08-07
163 MS_DRG Major Chest Procedures With Mcc 1 1 — — $60,393.00 $60,393.00 $60,393.00 2025-08-07
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $60,167.00 $60,167.00 $60,167.00 2025-08-07
655 MS_DRG Major Bladder Procedures Without Cc/mcc 1 1 — — $43,597.00 $43,597.00 $43,597.00 2025-08-07
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $43,597.00 $43,597.00 $43,597.00 2025-08-07
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $43,597.00 $43,597.00 $43,597.00 2025-08-07
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/mcc 1 1 — — $48,578.00 $48,578.00 $48,578.00 2025-08-07
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $88,073.00 $88,073.00 $88,073.00 2025-08-07
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 1 1 — — $88,073.00 $88,073.00 $88,073.00 2025-08-07
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $78,322.00 $78,322.00 $78,322.00 2025-08-07
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 1 1 — — $73,985.00 $73,985.00 $73,985.00 2025-08-07
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $72,830.00 $72,830.00 $72,830.00 2025-08-07
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $72,830.00 $72,830.00 $72,830.00 2025-08-07
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 1 1 — — $52,126.00 $52,126.00 $52,126.00 2025-08-07
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $52,126.00 $52,126.00 $52,126.00 2025-08-07
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 1 1 — — $40,909.00 $40,909.00 $40,909.00 2025-08-07
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 1 1 — — $40,909.00 $40,909.00 $40,909.00 2025-08-07
6 MS_DRG Liver Transplant Without Mcc 1 1 — — $341,344.00 $341,344.00 $341,344.00 2025-08-07
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $341,344.00 $341,344.00 $341,344.00 2025-08-07
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $203,918.00 $203,918.00 $203,918.00 2025-08-07
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $42,031.00 $42,031.00 $42,031.00 2025-08-07
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 1 1 — — $42,031.00 $42,031.00 $42,031.00 2025-08-07
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $147,282.00 $147,282.00 $147,282.00 2025-08-07
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 1 1 — — $147,282.00 $147,282.00 $147,282.00 2025-08-07
652 MS_DRG Kidney Transplant 1 1 — — $147,282.00 $147,282.00 $147,282.00 2025-08-07
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $45,461.00 $45,461.00 $45,461.00 2025-08-07
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 1 1 — — $43,828.00 $43,828.00 $43,828.00 2025-08-07
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 1 1 — — $41,198.00 $41,198.00 $41,198.00 2025-08-07
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $41,198.00 $41,198.00 $41,198.00 2025-08-07
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 1 1 — — $41,198.00 $41,198.00 $41,198.00 2025-08-07
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $48,370.00 $48,370.00 $48,370.00 2025-08-07
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $48,370.00 $48,370.00 $48,370.00 2025-08-07
63 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $48,370.00 $48,370.00 $48,370.00 2025-08-07
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $233,473.00 $233,473.00 $233,473.00 2025-08-07
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $233,473.00 $233,473.00 $233,473.00 2025-08-07
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $233,473.00 $233,473.00 $233,473.00 2025-08-07
855 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures Without Cc/mcc 1 1 — — $146,628.00 $146,628.00 $146,628.00 2025-08-07
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $146,628.00 $146,628.00 $146,628.00 2025-08-07
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 1 1 — — $146,628.00 $146,628.00 $146,628.00 2025-08-07
642 MS_DRG Inborn And Other Disorders Of Metabolism 1 1 — — $81,222.00 $81,222.00 $81,222.00 2025-08-07
977 MS_DRG HIV With Or Without Other Related Condition 1 1 — — $39,440.00 $39,440.00 $39,440.00 2025-08-07
976 MS_DRG HIV With Major Related Condition Without Cc/mcc 1 1 — — $54,862.00 $54,862.00 $54,862.00 2025-08-07
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $54,862.00 $54,862.00 $54,862.00 2025-08-07
975 MS_DRG HIV With Major Related Condition With Cc 1 1 — — $54,862.00 $54,862.00 $54,862.00 2025-08-07
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 1 1 — — $94,313.00 $94,313.00 $94,313.00 2025-08-07
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 1 1 — — $94,313.00 $94,313.00 $94,313.00 2025-08-07
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 1 1 — — $48,150.00 $48,150.00 $48,150.00 2025-08-07
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $47,362.00 $47,362.00 $47,362.00 2025-08-07
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 1 1 — — $46,189.00 $46,189.00 $46,189.00 2025-08-07
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $39,421.00 $39,421.00 $39,421.00 2025-08-07
422 MS_DRG Hepatobiliary Diagnostic Procedures Without Cc/mcc 1 1 — — $55,298.00 $55,298.00 $55,298.00 2025-08-07
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $62,316.00 $62,316.00 $62,316.00 2025-08-07
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 1 1 — — $62,316.00 $62,316.00 $62,316.00 2025-08-07
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $257,036.00 $257,036.00 $257,036.00 2025-08-07
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $257,036.00 $257,036.00 $257,036.00 2025-08-07
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 1 — — $258,885.00 $258,885.00 $258,885.00 2025-08-07
39 MS_DRG Extracranial Procedures Without Cc/mcc 1 1 — — $40,122.00 $40,122.00 $40,122.00 2025-08-07
37 MS_DRG Extracranial Procedures With Mcc 1 1 — — $61,909.00 $61,909.00 $61,909.00 2025-08-07
38 MS_DRG Extracranial Procedures With Cc 1 1 — — $51,534.00 $51,534.00 $51,534.00 2025-08-07
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $72,821.00 $72,821.00 $72,821.00 2025-08-07
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $43,447.00 $43,447.00 $43,447.00 2025-08-07
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 1 1 — — $58,649.00 $58,649.00 $58,649.00 2025-08-07
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 — — $364,092.00 $364,092.00 $364,092.00 2025-08-07
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $76,577.00 $76,577.00 $76,577.00 2025-08-07
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $87,931.00 $87,931.00 $87,931.00 2025-08-07
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $444,327.00 $444,327.00 $444,327.00 2025-08-07
374 MS_DRG Digestive Malignancy With Mcc 1 1 — — $53,248.00 $53,248.00 $53,248.00 2025-08-07
375 MS_DRG Digestive Malignancy With Cc 1 1 — — $52,003.00 $52,003.00 $52,003.00 2025-08-07
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $99,820.00 $99,820.00 $99,820.00 2025-08-07
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $95,109.00 $95,109.00 $95,109.00 2025-08-07
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $214,034.00 $214,034.00 $214,034.00 2025-08-07
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 1 1 — — $72,958.00 $72,958.00 $72,958.00 2025-08-07
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $84,808.00 $84,808.00 $84,808.00 2025-08-07
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 1 1 — — $84,808.00 $84,808.00 $84,808.00 2025-08-07
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 1 1 — — $38,531.00 $38,531.00 $38,531.00 2025-08-07
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 1 1 — — $38,531.00 $38,531.00 $38,531.00 2025-08-07
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $86,024.00 $86,024.00 $86,024.00 2025-08-07
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $92,523.00 $92,523.00 $92,523.00 2025-08-07
232 MS_DRG Coronary Bypass With Ptca Without Mcc 1 1 — — $133,736.00 $133,736.00 $133,736.00 2025-08-07
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $133,736.00 $133,736.00 $133,736.00 2025-08-07
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $106,381.00 $106,381.00 $106,381.00 2025-08-07
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $121,201.00 $121,201.00 $121,201.00 2025-08-07
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $38,113.00 $38,113.00 $38,113.00 2025-08-07
212 MS_DRG Concomitant Aortic And Mitral Valve�procedures 1 1 — — $121,396.00 $121,396.00 $121,396.00 2025-08-07
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 1 1 — — $110,034.00 $110,034.00 $110,034.00 2025-08-07
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $110,034.00 $110,034.00 $110,034.00 2025-08-07
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $110,034.00 $110,034.00 $110,034.00 2025-08-07
434 MS_DRG Cirrhosis And Alcoholic Hepatitis Without Cc/mcc 1 1 — — $39,339.00 $39,339.00 $39,339.00 2025-08-07
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 — — $39,339.00 $39,339.00 $39,339.00 2025-08-07
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 1 1 — — $39,339.00 $39,339.00 $39,339.00 2025-08-07
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 1 1 — — $47,666.00 $47,666.00 $47,666.00 2025-08-07
412 MS_DRG Cholecystectomy With C.d.e. With Cc 1 1 — — $39,874.00 $39,874.00 $39,874.00 2025-08-07
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $39,442.00 $39,442.00 $39,442.00 2025-08-07
839 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Without Cc/mcc 1 1 — — $55,181.00 $55,181.00 $55,181.00 2025-08-07
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 1 1 — — $55,181.00 $55,181.00 $55,181.00 2025-08-07
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $55,181.00 $55,181.00 $55,181.00 2025-08-07
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 1 1 — — $43,787.00 $43,787.00 $43,787.00 2025-08-07
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $58,934.00 $58,934.00 $58,934.00 2025-08-07
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $47,714.00 $47,714.00 $47,714.00 2025-08-07
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $121,396.00 $121,396.00 $121,396.00 2025-08-07
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $121,396.00 $121,396.00 $121,396.00 2025-08-07
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $121,396.00 $121,396.00 $121,396.00 2025-08-07
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $184,063.00 $184,063.00 $184,063.00 2025-08-07
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $184,063.00 $184,063.00 $184,063.00 2025-08-07
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $184,063.00 $184,063.00 $184,063.00 2025-08-07
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $98,048.00 $98,048.00 $98,048.00 2025-08-07
276 MS_DRG Cardiac Defibrillator Implant With Mcc 1 1 — — $98,048.00 $98,048.00 $98,048.00 2025-08-07
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $152,334.00 $152,334.00 $152,334.00 2025-08-07
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/mcc 1 1 — — $42,537.00 $42,537.00 $42,537.00 2025-08-07
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 1 1 — — $42,537.00 $42,537.00 $42,537.00 2025-08-07
297 MS_DRG Cardiac Arrest, Unexplained With Cc 1 1 — — $42,537.00 $42,537.00 $42,537.00 2025-08-07
479 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc 1 1 — — $45,523.00 $45,523.00 $45,523.00 2025-08-07
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $45,523.00 $45,523.00 $45,523.00 2025-08-07
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 1 1 — — $45,523.00 $45,523.00 $45,523.00 2025-08-07
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $44,016.00 $44,016.00 $44,016.00 2025-08-07
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $44,016.00 $44,016.00 $44,016.00 2025-08-07
410 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $43,059.00 $43,059.00 $43,059.00 2025-08-07
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 1 — — $63,120.00 $63,120.00 $63,120.00 2025-08-07
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $63,120.00 $63,120.00 $63,120.00 2025-08-07
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 1 1 — — $48,856.00 $48,856.00 $48,856.00 2025-08-07
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 1 — — $48,856.00 $48,856.00 $48,856.00 2025-08-07
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $48,856.00 $48,856.00 $48,856.00 2025-08-07
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $44,135.00 $44,135.00 $44,135.00 2025-08-07
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 1 1 — — $44,135.00 $44,135.00 $44,135.00 2025-08-07
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $217,942.00 $217,942.00 $217,942.00 2025-08-07
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 1 1 — — $217,942.00 $217,942.00 $217,942.00 2025-08-07
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 1 — — $91,416.00 $91,416.00 $91,416.00 2025-08-07
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $105,929.00 $105,929.00 $105,929.00 2025-08-07
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $68,156.00 $68,156.00 $68,156.00 2025-08-07
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $68,156.00 $68,156.00 $68,156.00 2025-08-07
618 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $68,156.00 $68,156.00 $68,156.00 2025-08-07
476 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders Without Cc… 1 1 — — $38,738.00 $38,738.00 $38,738.00 2025-08-07
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $38,738.00 $38,738.00 $38,738.00 2025-08-07
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 1 1 — — $38,738.00 $38,738.00 $38,738.00 2025-08-07
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 1 1 — — $76,913.00 $76,913.00 $76,913.00 2025-08-07
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $76,913.00 $76,913.00 $76,913.00 2025-08-07
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $76,913.00 $76,913.00 $76,913.00 2025-08-07
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 — — $217,942.00 $217,942.00 $217,942.00 2025-08-07
265 MS_DRG Aicd Lead Procedures 1 1 — — $73,587.00 $73,587.00 $73,587.00 2025-08-07
245 MS_DRG Aicd Generator Procedures 1 1 — — $73,587.00 $73,587.00 $73,587.00 2025-08-07
615 MS_DRG Adrenal And Pituitary Procedures Without Cc/mcc 1 1 — — $54,302.00 $54,302.00 $54,302.00 2025-08-07
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 1 1 — — $54,302.00 $54,302.00 $54,302.00 2025-08-07
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 1 1 — — $53,216.00 $53,216.00 $53,216.00 2025-08-07
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 1 1 — — $53,216.00 $53,216.00 $53,216.00 2025-08-07
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 1 1 — — $53,216.00 $53,216.00 $53,216.00 2025-08-07
836 MS_DRG Acute Leukemia Without Major O.r. Procedures Without Cc/mcc 1 1 — — $132,980.00 $132,980.00 $132,980.00 2025-08-07
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 1 1 — — $132,980.00 $132,980.00 $132,980.00 2025-08-07
835 MS_DRG Acute Leukemia Without Major O.r. Procedures With Cc 1 1 — — $132,980.00 $132,980.00 $132,980.00 2025-08-07
290 MS_DRG Acute And Subacute Endocarditis Without Cc/mcc 1 1 — — $45,692.00 $45,692.00 $45,692.00 2025-08-07
288 MS_DRG Acute And Subacute Endocarditis With Mcc 1 1 — — $45,692.00 $45,692.00 $45,692.00 2025-08-07
289 MS_DRG Acute And Subacute Endocarditis With Cc 1 1 — — $45,692.00 $45,692.00 $45,692.00 2025-08-07
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