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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

NORTHWEST COMMUNITY HOSPITAL 1

Arlington Heights, IL · CCN 140252 · Rates published

14,475 distinct procedures filed
15 distinct payers
105,960 rate rows
2026-04-01 last MRF observed
Data quality

76,983 of 105,960 rate rows are consumer-grade (72.7%)

28,977 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 28,977
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.endeavorhealth.org/362340313_endeavor-health-northwest-community-hospital_standardcharges.json
Found on page https://www.endeavorhealth.org/patients-visitors/billing-insurance/price-transparency
Discovered viaCMS hospital list
Last fetch success · 2026-05-18
Content fingerprint 385a55833341ac1b… · 27,173,070 bytes · first seen 2026-05-18

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 13 $330,815.59 $403,595.02 $330,815.59 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 13 $214,686.01 $291,522.24 $214,686.01 nat. median
$265,286
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 $163,562.31 $245,530.98 $163,562.31 nat. median
$206,474
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 $124,516.02 $621,861.96 $162,602.41 nat. median
$202,976
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 2 $110,901.76 $149,999.93 $136,644.39 nat. median
$111,989
1.2× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 $40,897.92 $193,465.80 $106,113.06 nat. median
$133,161
0.8× median
7
MS_DRG 		Lung Transplant 13 $99,209.13 $135,252.77 $99,209.13 nat. median
$122,708
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 13 $92,066.95 $135,594.32 $92,066.95 nat. median
$117,357
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 $86,810.86 $114,053.90 $86,810.86 nat. median
$108,660
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 13 $86,711.27 $105,787.75 $86,711.27 nat. median
$98,047
0.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $56,824.55 $111,186.65 $85,119.36 nat. median
$62,507
1.4× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 $84,431.41 $108,484.56 $84,431.41 nat. median
$98,894
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 13 $83,304.51 $112,743.59 $83,304.51 nat. median
$102,358
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 13 $78,986.87 $110,213.01 $78,986.87 nat. median
$100,136
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 13 $31,344.11 $109,649.97 $76,278.77 nat. median
$99,019
0.8× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $55,272.32 $91,070.45 $75,279.46 nat. median
$66,682
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 $74,944.26 $99,881.64 $74,944.26 nat. median
$93,672
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $69,524.43 $79,005.03 $74,264.73 nat. median
$76,329
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 13 $69,020.91 $86,319.00 $69,020.91 nat. median
$82,711
0.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 13 $66,338.86 $95,336.96 $66,338.86 nat. median
$83,470
0.8× median
K0606
HCPCS 		Aed Garment W Elec Analysis 1 $60,916.79 $69,223.62 $65,070.21 nat. median
$3,697
outlier · 17.6×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 13 $64,579.93 $87,699.69 $64,579.93 nat. median
$79,312
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 $63,013.44 $87,650.01 $64,376.92 nat. median
$81,118
0.8× median
J9226
HCPCS 		Supprelin La Implant 2 $45,020.65 $73,937.55 $61,210.68 nat. median
$60,368
1.0× median
E0194
HCPCS 		Air Fluidized Bed 1 $56,441.96 $64,138.59 $60,290.27 nat. median
$4,451
outlier · 13.5×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 $60,281.45 $83,426.18 $60,281.45 nat. median
$77,570
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 $58,822.06 $80,077.95 $58,822.06 nat. median
$74,915
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 $58,568.49 $80,893.53 $58,568.49 nat. median
$73,807
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 $58,374.67 $77,249.30 $58,374.67 nat. median
$72,135
0.8× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 $55,300.38 $73,471.55 $55,300.38 nat. median
$68,090
0.8× median
10
MS_DRG 		Pancreas Transplant 13 $54,971.74 $82,516.41 $54,971.74 nat. median
$68,884
0.8× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 13 $54,948.75 $69,122.48 $54,948.75 nat. median
$64,023
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 $54,656.88 $82,041.35 $54,656.88 nat. median
$71,271
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 $54,624.70 $73,138.28 $54,624.70 nat. median
$68,886
0.8× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 13 $52,950.05 $71,999.78 $52,950.05 nat. median
$66,526
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 13 $52,690.34 $69,005.52 $52,690.34 nat. median
$65,950
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 13 $51,565.74 $70,668.77 $51,565.74 nat. median
$64,732
0.8× median
L7181
HCPCS 		Electronic Elbo Simultaneous 2 $46,795.08 $62,856.84 $51,257.21 nat. median
$50,598
1.0× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 13 $51,224.06 $64,025.10 $51,224.06 nat. median
$60,691
0.8× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 13 $49,621.14 $69,388.47 $51,186.53 nat. median
$63,724
0.8× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 $50,372.18 $61,573.19 $50,372.18 nat. median
$61,920
0.8× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 $50,372.18 $66,834.09 $50,372.18 nat. median
$64,508
0.8× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 13 $50,189.09 $63,733.23 $50,189.09 nat. median
$59,793
0.8× median
L7180
HCPCS 		Electronic Elbow Sequential 2 $45,450.00 $61,050.07 $49,783.86 nat. median
$49,027
1.0× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 13 $49,295.07 $66,940.70 $49,295.07 nat. median
$62,134
0.8× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 $46,948.56 $62,000.64 $46,948.56 nat. median
$60,726
0.8× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 13 $46,894.17 $65,452.37 $46,894.17 nat. median
$60,185
0.8× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 13 $46,444.48 $63,220.91 $46,444.48 nat. median
$59,898
0.8× median
28
MS_DRG 		Spinal Procedures With Mcc 13 $46,028.50 $62,918.69 $46,028.50 nat. median
$57,822
0.8× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 $46,015.47 $161,569.14 $46,015.47 nat. median
$59,099
0.8× median

Other procedures at this hospital

Browse this hospital's 14,475 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
             
0408T HCPCS Insj/rplc Cardiac Modulj Sys 4 3 — — $6,520.00 $42,853.40 $27,784.94 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 4 3 — — $6,520.00 $30,367.87 $22,884.82 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 4 3 — — $6,520.00 $30,367.87 $22,884.82 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 4 3 — — $3,811.00 $30,367.87 $22,884.82 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 4 3 — — $6,520.00 $42,853.40 $27,784.94 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 4 3 — — $5,419.00 $30,367.87 $22,884.82 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 4 3 — — $3,811.00 $60,134.11 $28,395.51 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 4 3 — — $1,566.00 $42,128.23 $17,592.84 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 3 2 — — $3,811.00 $46,771.12 $36,712.02 2026-04-01
0888T HCPCS Histotripsy Mal Renal Tissue 3 2 — — $3,811.00 $23,385.89 $18,356.27 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 3 3 — — $1,566.00 $42,128.23 $33,067.68 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 3 3 — — $1,566.00 $42,128.23 $33,067.68 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 3 3 — — $21,933.00 $42,853.40 $33,636.89 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 3 3 — — $21,933.00 $30,367.87 $23,836.63 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 3 3 — — $21,933.00 $30,367.87 $23,836.63 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 22 13 — — $214,686.01 $291,522.24 $214,686.01 2026-04-01
10 MS_DRG Pancreas Transplant 22 13 — — $54,971.74 $82,516.41 $54,971.74 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 22 13 — — $41,782.87 $55,844.46 $41,782.87 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 22 13 — — $18,011.35 $23,355.81 $18,011.35 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 23 13 — — $32,298.01 $202,218.32 $32,298.01 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 22 13 — — $22,076.95 $27,425.43 $22,076.95 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 22 13 — — $92,066.95 $135,594.32 $92,066.95 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 22 13 — — $32,675.69 $43,770.15 $32,675.69 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 22 13 — — $28,702.02 $35,016.46 $28,702.02 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 22 13 — — $45,426.36 $62,467.43 $45,426.36 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 22 13 — — $34,334.26 $47,702.12 $34,334.26 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 23 13 — — $19,335.91 $43,256.58 $19,335.91 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 22 13 — — $28,633.84 $39,857.85 $28,633.84 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 22 13 — — $41,615.86 $62,467.43 $41,615.86 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 22 13 — — $22,801.66 $31,757.94 $22,801.66 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 22 13 — — $330,815.59 $403,595.02 $330,815.59 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 22 13 — — $54,656.88 $82,041.35 $54,656.88 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 22 13 — — $86,810.86 $114,053.90 $86,810.86 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 22 13 — — $60,281.45 $83,426.18 $60,281.45 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 22 13 — — $49,295.07 $66,940.70 $49,295.07 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 22 13 — — $21,057.29 $27,780.44 $21,057.29 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 17 13 — — $86,711.27 $105,787.75 $86,711.27 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 22 13 — — $40,554.84 $57,207.56 $40,554.84 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 22 13 — — $83,304.51 $112,743.59 $83,304.51 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 17 13 — — $43,719.53 $53,337.83 $43,719.53 2026-04-01
215 MS_DRG Other Heart Assist System Implant 23 13 — — $31,344.11 $109,649.97 $76,278.77 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 13 — — $74,944.26 $99,881.64 $74,944.26 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 13 — — $50,372.18 $66,834.09 $50,372.18 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 22 13 — — $50,372.18 $61,573.19 $50,372.18 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 13 — — $58,822.06 $80,077.95 $58,822.06 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 22 13 — — $24,341.48 $36,539.64 $24,341.48 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 13 — — $40,853.61 $54,816.71 $40,853.61 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 13 — — $38,612.06 $47,530.31 $38,612.06 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 22 13 — — $37,901.13 $51,573.02 $37,901.13 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 23 13 — — $23,187.18 $32,148.14 $24,127.75 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 13 — — $43,898.79 $59,043.65 $43,898.79 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 22 13 — — $64,579.93 $87,699.69 $64,579.93 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 22 13 — — $46,444.48 $63,220.91 $46,444.48 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 22 13 — — $58,568.49 $80,893.53 $58,568.49 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 22 13 — — $41,848.75 $55,060.97 $41,848.75 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 22 13 — — $44,958.28 $60,897.33 $44,958.28 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 22 13 — — $32,089.64 $42,557.13 $32,089.64 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 22 13 — — $37,704.25 $52,127.78 $37,704.25 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 22 13 — — $29,968.36 $39,344.49 $29,968.36 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 22 13 — — $21,837.16 $30,139.20 $21,837.16 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 22 13 — — $24,459.46 $35,107.20 $24,459.46 2026-04-01
245 MS_DRG Aicd Generator Procedures 22 13 — — $34,951.72 $50,575.28 $34,951.72 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 23 13 — — $34,831.44 $224,833.72 $34,831.44 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 22 13 — — $26,723.23 $35,502.57 $26,723.23 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 23 13 — — $19,884.42 $40,060.18 $19,884.42 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 22 13 — — $20,664.29 $27,078.71 $20,664.29 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 22 13 — — $24,071.06 $29,366.69 $24,071.06 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 22 13 — — $23,819.02 $31,654.44 $23,819.02 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 22 13 — — $24,919.11 $35,260.38 $24,919.11 2026-04-01
263 MS_DRG Vein Ligation And Stripping 22 13 — — $23,422.19 $28,575.07 $23,422.19 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 29 13 — — $16,428.88 $456,272.74 $25,591.73 2026-04-01
265 MS_DRG Aicd Lead Procedures 22 13 — — $27,718.37 $36,917.42 $27,718.37 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 22 13 — — $46,948.56 $62,000.64 $46,948.56 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 22 13 — — $36,471.62 $48,690.54 $36,471.62 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 22 13 — — $52,690.34 $69,005.52 $52,690.34 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 23 13 — — $30,756.91 $43,060.14 $32,353.17 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 23 13 — — $19,327.48 $80,875.88 $19,327.48 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 25 13 — — $16,991.75 $97,391.32 $40,420.78 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 23 13 — — $27,244.17 $38,153.78 $27,244.17 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 23 13 — — $19,558.07 $60,879.16 $19,558.07 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 24 13 — — $29,099.01 $40,468.50 $31,604.71 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 23 13 — — $23,285.45 $32,300.28 $25,217.12 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 13 — — $54,624.70 $73,138.28 $54,624.70 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 23 13 — — $46,015.47 $161,569.14 $46,015.47 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 22 13 — — $35,381.49 $48,150.27 $35,381.49 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 13 — — $42,641.65 $52,022.81 $42,641.65 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 22 13 — — $27,627.98 $33,706.14 $27,627.98 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 22 13 — — $46,028.50 $62,918.69 $46,028.50 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 22 13 — — $20,731.71 $28,268.96 $20,731.71 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 22 13 — — $26,135.65 $34,739.78 $26,135.65 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 13 — — $124,516.02 $621,861.96 $162,602.41 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 22 13 — — $34,324.30 $43,369.61 $34,324.30 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 22 13 — — $51,224.06 $64,025.10 $51,224.06 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 17 13 — — $18,556.03 $22,638.36 $18,556.03 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 22 13 — — $34,189.47 $45,462.38 $34,189.47 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 22 13 — — $18,426.57 $23,956.11 $18,426.57 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 24 13 — — $20,843.56 $122,234.15 $20,843.56 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 22 13 — — $33,151.43 $44,082.72 $33,151.43 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 22 13 — — $24,139.24 $33,068.25 $24,139.24 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 22 13 — — $24,594.29 $30,005.03 $24,594.29 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 22 13 — — $38,207.57 $52,564.55 $38,207.57 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 23 13 — — $12,014.95 $25,130.84 $18,724.57 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 22 13 — — $35,212.95 $47,524.10 $35,212.95 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 24 13 — — $17,618.10 $76,186.24 $18,364.51 2026-04-01
332 MS_DRG Rectal Resection With Mcc 22 13 — — $27,737.53 $35,898.98 $27,737.53 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 4 3 — — $2,118.00 $60,134.11 $34,567.01 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 4 3 — — $2,118.00 $42,128.23 $24,010.84 2026-04-01
333 MS_DRG Rectal Resection With Cc 22 13 — — $17,943.17 $21,994.79 $17,943.17 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 22 13 — — $27,356.02 $37,507.37 $27,356.02 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 23 13 — — $29,652.73 $120,564.66 $29,652.73 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 22 13 — — $19,786.36 $27,887.04 $19,786.36 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 22 13 — — $17,586.18 $24,494.31 $17,586.18 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 22 13 — — $18,313.19 $23,542.11 $18,313.19 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 22 13 — — $19,089.99 $25,044.93 $19,089.99 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 22 13 — — $22,231.70 $30,354.48 $22,231.70 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 22 13 — — $33,652.44 $44,146.89 $33,652.44 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 22 13 — — $17,815.23 $23,307.17 $17,815.23 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 17 13 — — $26,342.49 $32,137.84 $26,342.49 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 17 13 — — $18,495.51 $22,564.52 $18,495.51 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 22 13 — — $25,220.18 $34,369.25 $25,220.18 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 24 13 — — $6,385.82 $25,643.16 $18,346.89 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 30 13 — — $40,897.92 $193,465.80 $106,113.06 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 22 13 — — $29,579.95 $39,038.13 $29,579.95 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 22 13 — — $30,800.32 $40,667.22 $30,800.32 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 23 13 — — $20,750.75 $56,183.94 $41,908.51 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 22 13 — — $22,217.91 $29,064.87 $22,217.91 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 22 13 — — $27,315.41 $36,236.39 $27,315.41 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 22 13 — — $24,384.09 $30,873.30 $25,305.98 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 22 13 — — $27,292.43 $36,262.26 $27,292.43 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 22 13 — — $18,281.78 $24,596.78 $18,281.78 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 22 13 — — $26,101.17 $36,527.22 $26,101.17 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 22 13 — — $31,815.38 $42,094.49 $31,815.38 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 13 — — $84,431.41 $108,484.56 $84,431.41 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 13 — — $55,300.38 $73,471.55 $55,300.38 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 13 — — $43,069.12 $60,072.16 $43,069.12 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 22 13 — — $69,020.91 $86,319.00 $69,020.91 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 22 13 — — $44,180.71 $56,615.54 $44,180.71 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 13 — — $49,621.14 $69,388.47 $51,186.53 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 25 13 — — $14,236.89 $45,204.84 $32,488.00 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 23 13 — — $37,234.60 $53,299.40 $40,829.10 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 24 13 — — $24,747.51 $39,964.35 $24,747.51 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 13 — — $63,013.44 $87,650.01 $64,376.92 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 13 — — $45,682.23 $362,389.51 $45,682.23 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 13 — — $31,965.53 $44,688.20 $31,965.53 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 22 13 — — $42,310.70 $63,514.85 $42,310.70 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 22 13 — — $20,377.78 $29,638.26 $20,377.78 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 23 13 — — $26,157.24 $55,897.25 $43,662.84 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 13 — — $5,197.37 $30,518.01 $23,861.15 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 23 13 — — $39,877.62 $70,696.48 $39,877.62 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 26 13 — — $19,996.11 $40,893.59 $27,016.64 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 22 13 — — $21,051.93 $27,150.12 $21,051.93 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 25 13 — — $15,730.50 $33,828.98 $23,236.79 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 22 13 — — $36,991.79 $50,269.95 $36,991.79 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 26 13 — — $14,197.38 $144,281.39 $22,569.54 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 25 13 — — $18,311.30 $169,285.39 $18,702.36 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 22 13 — — $32,887.13 $46,413.54 $32,887.13 2026-04-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 23 13 — — $17,433.72 $26,677.46 $17,433.72 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 23 13 — — $17,417.92 $35,591.58 $26,465.06 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 23 13 — — $13,102.43 $24,202.44 $18,839.48 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 27 13 — — $13,201.66 $51,688.09 $22,310.60 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 25 13 — — $17,129.53 $26,372.84 $21,235.02 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 22 13 — — $24,722.23 $33,364.26 $24,722.23 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 22 13 — — $28,127.46 $36,752.85 $28,127.46 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 24 13 — — $7,785.55 $24,850.35 $19,428.60 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 22 13 — — $27,775.83 $36,435.11 $27,775.83 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 22 13 — — $22,497.63 $28,195.62 $23,111.16 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 22 13 — — $78,986.87 $110,213.01 $78,986.87 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 22 13 — — $24,244.96 $32,793.98 $24,244.96 2026-04-01
503 MS_DRG Foot Procedures With Mcc 22 13 — — $21,382.11 $27,391.28 $21,382.11 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 22 13 — — $23,139.50 $29,580.30 $23,139.50 2026-04-01
5111 OTHER Level 1 Musculoskeletal Procedures 1 1 — — $20,369.08 $20,369.08 $20,369.08 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 27 14 — — $19,677.32 $262,457.56 $24,414.26 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 23 13 — — $28,630.78 $37,092.33 $28,630.78 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 22 13 — — $21,988.08 $30,166.11 $21,988.08 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 26 13 — — $23.00 $26,151.35 $19,011.85 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 23 13 — — $38.58 $25,916.40 $17,796.85 2026-04-01
570 MS_DRG Skin Debridement With Mcc 22 13 — — $22,531.23 $31,157.64 $22,531.23 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 22 13 — — $50,189.09 $63,733.23 $50,189.09 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 22 13 — — $26,593.77 $35,859.65 $26,593.77 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 22 13 — — $37,547.20 $55,837.22 $37,547.20 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 22 13 — — $20,306.53 $27,557.91 $20,306.53 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 22 13 — — $24,809.56 $33,731.69 $24,809.56 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 22 13 — — $35,523.22 $50,186.12 $35,523.22 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 22 13 — — $21,121.64 $27,978.12 $21,121.64 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 22 13 — — $26,716.34 $40,001.72 $26,716.34 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 4 3 — — $2,118.00 $42,128.23 $21,328.84 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 22 13 — — $22,119.85 $28,218.24 $22,119.85 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 22 13 — — $27,266.39 $38,750.40 $27,266.39 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 22 13 — — $23,136.44 $29,672.42 $23,136.44 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 22 13 — — $28,550.34 $40,844.21 $28,550.34 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 22 13 — — $36,016.57 $47,682.45 $36,016.57 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 22 13 — — $28,389.46 $35,937.27 $28,389.46 2026-04-01
652 MS_DRG Kidney Transplant 22 13 — — $24,740.61 $31,786.92 $24,740.61 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 22 13 — — $39,808.68 $57,692.97 $39,808.68 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 23 13 — — $21,444.93 $29,206.67 $21,444.93 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 22 13 — — $24,390.51 $33,717.20 $24,390.51 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 22 13 — — $19,465.37 $26,746.47 $19,465.37 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 22 13 — — $23,453.60 $32,285.79 $23,453.60 2026-04-01
665 MS_DRG Prostatectomy With Mcc 22 13 — — $23,910.95 $35,535.69 $23,910.95 2026-04-01
66683 HCPCS Implantation Iris Prosthesis 3 3 — — $4,985.00 $22,473.01 $17,639.73 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 22 13 — — $22,369.59 $30,181.64 $22,369.59 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 23 13 — — $32,187.70 $124,621.07 $32,187.70 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 22 13 — — $17,915.59 $23,890.91 $17,915.59 2026-04-01
7 MS_DRG Lung Transplant 22 13 — — $99,209.13 $135,252.77 $99,209.13 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 22 13 — — $17,827.49 $23,256.45 $17,827.49 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 22 13 — — $27,383.60 $40,751.06 $27,383.60 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 22 13 — — $27,447.18 $41,200.25 $27,447.18 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 27 13 — — $19,669.92 $126,932.53 $19,669.92 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 22 13 — — $16,414.08 $22,945.86 $18,808.08 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 30 13 — — $6,918.25 $126,501.54 $45,532.07 2026-04-01
791 MS_DRG Prematurity With Major Problems 31 14 — — $10,875.64 $113,993.22 $31,095.26 2026-04-01
792 MS_DRG Prematurity Without Major Problems 31 14 — — $1,277.45 $25,355.43 $18,762.88 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 34 14 — — $10.04 $43,165.71 $31,942.55 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 22 13 — — $34,695.08 $49,209.08 $34,695.08 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 22 13 — — $42,935.82 $56,312.28 $42,935.82 2026-04-01
800 MS_DRG Splenic Procedures With Cc 22 13 — — $21,522.30 $30,155.76 $21,522.30 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 23 13 — — $30,521.47 $75,117.41 $30,521.47 2026-04-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 22 13 — — $17,478.92 $26,238.29 $17,478.92 2026-04-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 22 13 — — $17,509.57 $24,013.04 $17,509.57 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 22 13 — — $44,929.17 $60,256.67 $44,929.17 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 22 13 — — $35,123.32 $48,429.72 $35,123.32 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 22 13 — — $35,835.78 $49,423.32 $35,835.78 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 25 13 — — $17,705.68 $69,460.38 $17,705.68 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 32 13 — — $7,233.42 $65,244.43 $24,208.19 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 22 13 — — $42,057.13 $57,203.42 $42,057.13 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 22 13 — — $36,804.87 $51,820.38 $36,804.87 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 22 13 — — $24,781.98 $33,010.29 $24,781.98 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 27 13 — — $12.64 $37,945.71 $19,860.67 2026-04-01
849 MS_DRG Radiotherapy 41 14 — — $280.00 $43,012.00 $20,756.99 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 22 13 — — $66,338.86 $95,336.96 $66,338.86 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 22 13 — — $37,833.72 $51,765.53 $37,833.72 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 22 13 — — $34,846.77 $46,691.96 $34,846.77 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 22 13 — — $52,950.05 $71,999.78 $52,950.05 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 22 13 — — $29,608.30 $40,669.29 $29,608.30 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 22 13 — — $32,149.39 $45,852.57 $32,149.39 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 22 13 — — $28,138.95 $39,960.32 $28,138.95 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 22 13 — — $29,412.18 $41,229.23 $29,412.18 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 13 — — $163,562.31 $245,530.98 $163,562.31 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 22 13 — — $54,948.75 $69,122.48 $54,948.75 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 22 13 — — $24,673.96 $32,915.07 $24,673.96 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 22 13 — — $29,832.76 $44,781.35 $29,832.76 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 47 14 — — $4,536.09 $86,304.26 $27,797.28 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 23 13 — — $4,487.54 $37,760.94 $26,961.48 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 47 14 — — $6,697.40 $53,526.88 $17,902.57 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 22 13 — — $19,758.78 $24,808.95 $19,758.78 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 22 13 — — $51,565.74 $70,668.77 $51,565.74 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 23 13 — — $28,827.66 $39,559.77 $28,827.66 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 22 13 — — $58,374.67 $77,249.30 $58,374.67 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 22 13 — — $32,281.92 $42,533.33 $32,281.92 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 22 13 — — $22,554.22 $27,516.15 $22,554.22 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 25 13 — — $6.35 $24,808.95 $19,758.78 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 22 13 — — $20,943.15 $28,116.81 $20,943.15 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 22 13 — — $46,894.17 $65,452.37 $46,894.17 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 22 13 — — $27,669.34 $37,102.68 $27,669.34 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 22 13 — — $20,204.64 $27,460.62 $20,204.64 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 22 13 — — $22,109.12 $30,905.10 $22,109.12 2026-04-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 23 13 — — $158.18 $22,450.19 $17,580.81 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 13 — — $13,152.52 $110,956.13 $35,943.03 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 35 14 — — $1,734.00 $289,369.74 $18,834.12 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 13 — — $23,365.30 $37,790.46 $26,264.35 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 4 2 — — $56,824.55 $111,186.65 $85,119.36 2026-04-01
C8003 HCPCS Imp Extar Knee Shck Absrb 3 3 — — $9,590.00 $23,937.91 $18,789.56 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 4 3 — — $1,017.00 $36,748.88 $25,389.14 2026-04-01
E0194 HCPCS Air Fluidized Bed 2 1 — — $56,441.96 $64,138.59 $60,290.27 2026-04-01
E0483 HCPCS Chest Compression Gen System 2 1 — — $18,196.12 $20,677.41 $19,436.76 2026-04-01
E0764 HCPCS Functional Neuromuscularstim 2 1 — — $19,193.58 $21,810.89 $20,502.24 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 2 1 — — $25,344.00 $28,800.00 $27,072.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $69,524.43 $79,005.03 $74,264.73 2026-04-01
J9226 HCPCS Supprelin La Implant 4 2 — — $45,020.65 $73,937.55 $61,210.68 2026-04-01
J9266 HCPCS Pegaspargase Injection 4 2 — — $28,424.06 $40,036.43 $35,722.15 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 4 2 — — $24,228.42 $32,734.80 $29,836.81 2026-04-01
K0606 HCPCS Aed Garment W Elec Analysis 2 1 — — $60,916.79 $69,223.62 $65,070.21 2026-04-01
K0839 HCPCS Pwc Gp2 Vhd Sing Pow Opt S/b 2 1 — — $17,084.50 $19,414.20 $18,249.35 2026-04-01
K0840 HCPCS Pwc Gp2 Xhd Sing Pow Opt S/b 2 1 — — $26,112.37 $29,673.15 $27,892.76 2026-04-01
K0853 HCPCS Pwc Gp 3 Vhd Cap Chair 2 1 — — $16,313.87 $18,538.49 $17,426.18 2026-04-01
K0854 HCPCS Pwc Gp 3 Xhd Seat/back 2 1 — — $21,612.15 $24,559.26 $23,085.71 2026-04-01
K0855 HCPCS Pwc Gp 3 Xhd Cap Chair 2 1 — — $20,415.85 $23,199.83 $21,807.84 2026-04-01
K0860 HCPCS Pwc Gp3 Vhd Sing Pow Opt S/b 2 1 — — $22,544.10 $25,618.29 $24,081.19 2026-04-01
K0862 HCPCS Pwc Gp3 Hd Mult Pow Opt S/b 2 1 — — $20,763.43 $23,594.81 $22,179.12 2026-04-01
K0863 HCPCS Pwc Gp3 Vhd Mult Pow Opt S/b 2 1 — — $22,544.10 $25,618.29 $24,081.19 2026-04-01
K0864 HCPCS Pwc Gp3 Xhd Mult Pow Opt S/b 2 1 — — $26,827.48 $30,485.78 $28,656.63 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 4 2 — — $37,499.95 $50,371.27 $41,075.74 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 4 2 — — $28,036.15 $37,659.16 $30,709.53 2026-04-01
L5858 HCPCS Stance Phase Only 4 2 — — $21,705.46 $29,155.55 $23,775.17 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 4 2 — — $16,945.24 $22,761.46 $18,561.04 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 4 2 — — $20,618.98 $27,696.15 $22,585.09 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 4 2 — — $27,903.77 $37,481.35 $30,564.52 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 4 2 — — $17,552.48 $23,577.12 $19,226.18 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 4 2 — — $18,787.98 $25,236.69 $20,579.50 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 4 2 — — $20,708.78 $27,816.78 $22,683.46 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 4 2 — — $45,450.00 $61,050.07 $49,783.86 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 4 2 — — $46,795.08 $62,856.84 $51,257.21 2026-04-01
L8614 HCPCS Cochlear Device 2 1 — — $22,867.10 $25,985.34 $24,426.22 2026-04-01
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 2 1 — — $16,617.02 $18,882.98 $17,750.00 2026-04-01
Q0479 HCPCS Power Module Combo Vad, Rep 4 2 — — $14,780.89 $20,689.25 $18,518.69 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 2 — — $110,901.76 $149,999.93 $136,644.39 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 4 2 — — $17,892.75 $25,044.99 $22,417.47 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 4 2 — — $23,087.32 $32,315.99 $28,925.66 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 4 2 — — $20,015.46 $28,016.22 $25,076.99 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 2 — — $55,272.32 $91,070.45 $75,279.46 2026-04-01
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