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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

UCHICAGO MEDICINE ADVENTHEALTH BOLINGBROOK

Bolingbrook, IL · CCN 140304 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc

This hospital’s price: $3,350 across 8 payers · range $2,872-$15,394

Source: https://www.adventhealth.com/sites/default/files/CDM/2025/651219504_uchicago-medicine-adventhealth-bolingbrook_standardcharges.json · observed 2025-08-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

444 distinct procedures filed
26 distinct payers
4,944 rate rows
2025-08-01 last MRF observed · ⚠ 12 mo old
Data quality

2,651 of 4,944 rate rows are consumer-grade (53.6%)

2,293 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 2,261
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 29
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://HospitalPriceDisclosure.com/download.aspx?pi=K1MLfPUji3qfpZEVcnmHMg*-*
Found on page https://HospitalPriceDisclosure.com/Default.aspx?ci=RsbcVwMa5jfnDZuYpIqAxQ*-*
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-11

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
503
MS_DRG 		Foot Procedures With Mcc 1 $212,771.58 $212,771.58 $212,771.58 nat. median
$26,831
outlier · 7.9×
505
MS_DRG 		Foot Procedures Without Cc/Mcc 1 $152,641.75 $152,641.75 $152,641.75 nat. median
$17,839
outlier · 8.6×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $152,168.70 $152,168.70 $152,168.70 nat. median
$199,832
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 $101,048.32 $109,172.88 $105,110.60 nat. median
$132,706
0.8× median
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 1 $90,438.62 $90,438.62 $90,438.62 nat. median
$18,578
outlier · 4.9×
9312
OTHER 		Inj., Ravulizumab-cwvz 10 Mg 2 $72,030.98 $105,650.58 $88,840.78 nat. median
$229
outlier · 387.4×
88
MS_DRG 		Concussion With Mcc 1 $82,445.64 $82,445.64 $82,445.64 nat. median
$14,345
outlier · 5.7×
496
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 $81,941.60 $81,941.60 $81,941.60 nat. median
$19,204
outlier · 4.3×
2026
OTHER 		Orth/devic/drug Bn/bn,tis/bn 1 $80,111.57 $80,111.57 $80,111.57 nat. median
$477
outlier · 167.8×
9284
OTHER 		Ipilimumab Injection 1 $77,600.37 $77,600.37 $77,600.37 nat. median
$189
outlier · 411.1×
808
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 $7,513.42 $138,099.45 $72,806.44 nat. median
$21,828
outlier · 3.3×
63
MS_DRG 		Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 $71,380.36 $71,380.36 $71,380.36 nat. median
$14,918
outlier · 4.8×
256
MS_DRG 		Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 1 $66,469.01 $66,469.01 $66,469.01 nat. median
$17,168
outlier · 3.9×
959
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 1 $65,814.63 $65,814.63 $65,814.63 nat. median
$27,330
outlier · 2.4×
987
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 $61,606.55 $61,606.55 $61,606.55 nat. median
$33,338
1.8× median
41
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 1 $58,881.16 $58,881.16 $58,881.16 nat. median
$22,340
outlier · 2.6×
5464
OTHER 		Level 4 Neurostimulator And Related Procedures 2 $21,565.79 $90,726.01 $56,145.90 nat. median
$20,895
outlier · 2.7×
988
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 $54,382.38 $54,382.38 $54,382.38 nat. median
$17,137
outlier · 3.2×
660
MS_DRG 		Kidney And Ureter Procedures For Non-neoplasm With Cc 1 $6,001.39 $99,554.66 $52,778.03 nat. median
$14,079
outlier · 3.7×
619
MS_DRG 		O.r. Procedures For Obesity With Mcc 1 $52,583.79 $52,583.79 $52,583.79 nat. median
$27,710
1.9× median
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 1 $52,394.28 $52,394.28 $52,394.28 nat. median
$37,051
1.4× median
673
MS_DRG 		Other Kidney And Urinary Tract Procedures With Mcc 2 $27,360.73 $76,202.05 $51,781.39 nat. median
$39,775
1.3× median
77
MS_DRG 		Hypertensive Encephalopathy With Mcc 1 $11,852.48 $88,476.39 $50,164.43 nat. median
$15,867
outlier · 3.2×
9236
OTHER 		Eculizumab Injection 1 $46,909.30 $46,909.30 $46,909.30 nat. median
$231
outlier · 202.7×
5465
OTHER 		Level 5 Neurostimulator And Related Procedures 5 $333.00 $134,514.02 $45,846.41 nat. median
$31,928
1.4× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $41,551.07 $48,674.63 $45,112.85 nat. median
$65,958
0.7× median
29
MS_DRG 		Spinal Procedures With Cc Or Spinal Neurostimulators 1 $44,581.35 $44,581.35 $44,581.35 nat. median
$33,440
1.3× median
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 $15,334.06 $72,612.07 $43,973.07 nat. median
$24,545
1.8× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 $11,858.79 $52,314.40 $43,165.71 nat. median
$45,808
0.9× median
713
MS_DRG 		Transurethral Prostatectomy With Cc/Mcc 1 $43,022.57 $43,022.57 $43,022.57 nat. median
$15,209
outlier · 2.8×
5461
OTHER 		Level 1 Neurostimulator And Related Procedures 2 $11,000.00 $74,022.72 $42,511.36 nat. median
$3,617
outlier · 11.8×
398
MS_DRG 		Appendix Procedures With Cc 1 $40,117.84 $40,117.84 $40,117.84 nat. median
$15,838
outlier · 2.5×
304
MS_DRG 		Hypertension With Mcc 1 $40,009.71 $40,009.71 $40,009.71 nat. median
$12,433
outlier · 3.2×
328
MS_DRG 		Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 1 $39,718.49 $39,718.49 $39,718.49 nat. median
$16,512
outlier · 2.4×
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 1 $39,623.79 $39,623.79 $39,623.79 nat. median
$48,652
0.8× median
620
MS_DRG 		O.r. Procedures For Obesity With Cc 2 $12,428.05 $49,720.80 $38,359.15 nat. median
$17,117
outlier · 2.2×
264
MS_DRG 		Other Circulatory System O.r. Procedures 2 $5,160.76 $68,039.89 $36,600.32 nat. median
$32,666
1.1× median
5471
OTHER 		Implantation Of Drug Infusion Device 3 $274.37 $95,224.25 $36,370.76 nat. median
$18,414
2.0× median
841
MS_DRG 		Lymphoma And Non-acute Leukemia With Cc 2 $8,836.47 $63,096.35 $35,966.41 nat. median
$16,539
outlier · 2.2×
344
MS_DRG 		Minor Small And Large Bowel Procedures With Mcc 1 $33,807.04 $33,807.04 $33,807.04 nat. median
$25,623
1.3× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $33,797.72 $33,797.72 $33,797.72 nat. median
$51,984
0.7× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 7 $7,550.97 $94,016.36 $32,830.57 nat. median
$47,707
0.7× median
298
MS_DRG 		Cardiac Arrest, Unexplained Without Cc/Mcc 1 $32,274.75 $32,274.75 $32,274.75 nat. median
$5,569
outlier · 5.8×
857
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 $14,966.86 $47,967.69 $31,467.28 nat. median
$21,203
1.5× median
419
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 2 $7,319.62 $57,761.20 $31,036.76 nat. median
$14,273
outlier · 2.2×
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 3 $8,011.42 $94,406.07 $30,691.48 nat. median
$24,077
1.3× median
2027
OTHER 		Probe, Robotic, Water-jet 2 $14,710.57 $46,184.57 $30,447.57 nat. median
$547
outlier · 55.7×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $29,798.45 $29,798.45 $29,798.45 nat. median
$62,218
outlier · 0.5×
354
MS_DRG 		Hernia Procedures Except Inguinal And Femoral With Cc 2 $19,978.66 $38,357.64 $29,168.15 nat. median
$17,345
1.7× median
554
MS_DRG 		Bone Diseases And Arthropathies Without Mcc 2 $5,698.96 $52,130.92 $28,914.94 nat. median
$9,200
outlier · 3.1×

Other procedures at this hospital

Browse this hospital's 444 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
             
503 MS_DRG Foot Procedures With Mcc 1 1 — — $212,771.58 $212,771.58 $212,771.58 2025-08-01
505 MS_DRG Foot Procedures Without Cc/Mcc 1 1 — — $152,641.75 $152,641.75 $152,641.75 2025-08-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $152,168.70 $152,168.70 $152,168.70 2025-08-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $101,048.32 $109,172.88 $105,110.60 2025-08-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 1 1 — — $90,438.62 $90,438.62 $90,438.62 2025-08-01
9312 OTHER Inj., Ravulizumab-cwvz 10 Mg 2 2 — — $72,030.98 $105,650.58 $88,840.78 2025-08-01
88 MS_DRG Concussion With Mcc 1 1 — — $82,445.64 $82,445.64 $82,445.64 2025-08-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $81,941.60 $81,941.60 $81,941.60 2025-08-01
2026 OTHER Orth/devic/drug Bn/bn,tis/bn 1 1 — — $80,111.57 $80,111.57 $80,111.57 2025-08-01
9284 OTHER Ipilimumab Injection 1 1 — — $77,600.37 $77,600.37 $77,600.37 2025-08-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 2 — — $7,513.42 $138,099.45 $72,806.44 2025-08-01
63 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $71,380.36 $71,380.36 $71,380.36 2025-08-01
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 1 1 — — $66,469.01 $66,469.01 $66,469.01 2025-08-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 1 1 — — $65,814.63 $65,814.63 $65,814.63 2025-08-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $61,606.55 $61,606.55 $61,606.55 2025-08-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 1 1 — — $58,881.16 $58,881.16 $58,881.16 2025-08-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 2 2 — — $21,565.79 $90,726.01 $56,145.90 2025-08-01
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $54,382.38 $54,382.38 $54,382.38 2025-08-01
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 2 1 — — $6,001.39 $99,554.66 $52,778.03 2025-08-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $52,583.79 $52,583.79 $52,583.79 2025-08-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $52,394.28 $52,394.28 $52,394.28 2025-08-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 2 — — $27,360.73 $76,202.05 $51,781.39 2025-08-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 2 1 — — $11,852.48 $88,476.39 $50,164.43 2025-08-01
9236 OTHER Eculizumab Injection 1 1 — — $46,909.30 $46,909.30 $46,909.30 2025-08-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 6 5 — — $333.00 $134,514.02 $45,846.41 2025-08-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $41,551.07 $48,674.63 $45,112.85 2025-08-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $44,581.35 $44,581.35 $44,581.35 2025-08-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 2 — — $15,334.06 $72,612.07 $43,973.07 2025-08-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 3 — — $11,858.79 $52,314.40 $43,165.71 2025-08-01
713 MS_DRG Transurethral Prostatectomy With Cc/Mcc 1 1 — — $43,022.57 $43,022.57 $43,022.57 2025-08-01
5461 OTHER Level 1 Neurostimulator And Related Procedures 2 2 — — $11,000.00 $74,022.72 $42,511.36 2025-08-01
398 MS_DRG Appendix Procedures With Cc 1 1 — — $40,117.84 $40,117.84 $40,117.84 2025-08-01
304 MS_DRG Hypertension With Mcc 1 1 — — $40,009.71 $40,009.71 $40,009.71 2025-08-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 1 1 — — $39,718.49 $39,718.49 $39,718.49 2025-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $39,623.79 $39,623.79 $39,623.79 2025-08-01
620 MS_DRG O.r. Procedures For Obesity With Cc 3 2 — — $12,428.05 $49,720.80 $38,359.15 2025-08-01
264 MS_DRG Other Circulatory System O.r. Procedures 2 2 — — $5,160.76 $68,039.89 $36,600.32 2025-08-01
5471 OTHER Implantation Of Drug Infusion Device 4 3 — — $274.37 $95,224.25 $36,370.76 2025-08-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 2 2 — — $8,836.47 $63,096.35 $35,966.41 2025-08-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $33,807.04 $33,807.04 $33,807.04 2025-08-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $33,797.72 $33,797.72 $33,797.72 2025-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 7 — — $7,550.97 $94,016.36 $32,830.57 2025-08-01
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/Mcc 1 1 — — $32,274.75 $32,274.75 $32,274.75 2025-08-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 2 — — $14,966.86 $47,967.69 $31,467.28 2025-08-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 5 2 — — $7,319.62 $57,761.20 $31,036.76 2025-08-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 4 3 — — $8,011.42 $94,406.07 $30,691.48 2025-08-01
2027 OTHER Probe, Robotic, Water-jet 2 2 — — $14,710.57 $46,184.57 $30,447.57 2025-08-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $29,798.45 $29,798.45 $29,798.45 2025-08-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 2 2 — — $19,978.66 $38,357.64 $29,168.15 2025-08-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 2 2 — — $5,698.96 $52,130.92 $28,914.94 2025-08-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $28,658.02 $28,658.02 $28,658.02 2025-08-01
5116 OTHER Level 6 Musculoskeletal Procedures 1 1 — — $28,630.09 $28,630.09 $28,630.09 2025-08-01
643 MS_DRG Endocrine Disorders With Mcc 2 2 — — $12,373.02 $43,188.25 $27,780.64 2025-08-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $27,325.34 $27,325.34 $27,325.34 2025-08-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 2 1 — — $7,128.52 $47,292.80 $27,210.66 2025-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $26,095.02 $26,095.02 $26,095.02 2025-08-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 2 — — $12,745.10 $39,061.39 $25,903.25 2025-08-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 2 2 — — $13,999.06 $36,990.19 $25,494.62 2025-08-01
5331 OTHER Complex Gi Procedures 1 1 — — $25,276.00 $25,276.00 $25,276.00 2025-08-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 2 — — $11,778.33 $38,569.46 $25,173.89 2025-08-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 3 — — $14,555.54 $26,072.11 $24,634.34 2025-08-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 3 — — $10,462.76 $29,418.26 $24,430.43 2025-08-01
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $24,340.60 $24,340.60 $24,340.60 2025-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 2 — — $19,031.93 $29,282.24 $24,157.08 2025-08-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/Mcc 1 1 — — $23,984.45 $23,984.45 $23,984.45 2025-08-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 6 5 — — $12,775.20 $86,960.03 $23,593.44 2025-08-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 2 1 — — $14,786.47 $32,326.87 $23,556.67 2025-08-01
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/Mcc 6 4 — — $5,042.10 $44,094.70 $23,425.55 2025-08-01
93 MS_DRG Other Disorders Of Nervous System Without Cc/Mcc 1 1 — — $23,339.86 $23,339.86 $23,339.86 2025-08-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 1 1 — — $23,167.51 $23,167.51 $23,167.51 2025-08-01
149 MS_DRG Dysequilibrium 1 1 — — $22,841.88 $22,841.88 $22,841.88 2025-08-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $22,765.05 $22,765.05 $22,765.05 2025-08-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 9 6 — — $9,165.52 $51,966.65 $22,459.22 2025-08-01
446 MS_DRG Disorders Of The Biliary Tract Without Cc/Mcc 2 2 — — $4,585.12 $39,453.82 $22,019.47 2025-08-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 2 2 — — $8,888.37 $34,063.94 $21,476.15 2025-08-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 1 1 — — $21,291.68 $21,291.68 $21,291.68 2025-08-01
570 MS_DRG Skin Debridement With Mcc 3 3 — — $14,027.81 $22,442.21 $21,170.01 2025-08-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 2 2 — — $14,192.41 $27,652.10 $20,922.25 2025-08-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 3 3 — — $17,037.98 $55,643.39 $20,860.36 2025-08-01
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $20,736.93 $20,736.93 $20,736.93 2025-08-01
5462 OTHER Level 2 Neurostimulator And Related Procedures 8 5 — — $6,268.88 $84,373.30 $20,640.29 2025-08-01
5054 OTHER Level 4 Skin Procedures 2 2 — — $1,751.11 $39,528.50 $20,639.81 2025-08-01
755 MS_DRG Malignancy, Female Reproductive System With Cc 1 1 — — $20,223.54 $20,223.54 $20,223.54 2025-08-01
348 MS_DRG Anal And Stomal Procedures With Cc 2 2 — — $15,809.12 $24,597.68 $20,203.40 2025-08-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 3 2 — — $14,042.86 $56,366.92 $20,039.17 2025-08-01
9347 OTHER Inj Luspatercept-aamt 0.25mg 1 1 — — $19,695.40 $19,695.40 $19,695.40 2025-08-01
5416 OTHER Level 6 Gynecologic Procedures 1 1 — — $19,538.36 $19,538.36 $19,538.36 2025-08-01
9150 OTHER Inj Mosunetuzumab-axgb, 1 Mg 1 1 — — $19,163.84 $19,163.84 $19,163.84 2025-08-01
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 2 1 — — $1,736.45 $36,066.92 $18,901.69 2025-08-01
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $18,874.05 $18,874.05 $18,874.05 2025-08-01
5303 OTHER Level 3 Upper Gi Procedures 1 1 — — $18,833.66 $18,833.66 $18,833.66 2025-08-01
791 MS_DRG Prematurity With Major Problems 4 4 — — $6,065.57 $50,436.81 $18,780.77 2025-08-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $10,362.56 $27,015.54 $18,689.05 2025-08-01
5731 OTHER Level 1 Minor Procedures 1 1 — — $18,503.09 $18,503.09 $18,503.09 2025-08-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 3 — — $10,465.60 $19,692.22 $18,108.77 2025-08-01
184 MS_DRG Major Chest Trauma With Cc 2 2 — — $6,178.61 $29,667.39 $17,923.00 2025-08-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $17,844.97 $17,844.97 $17,844.97 2025-08-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 1 1 — — $17,659.57 $17,659.57 $17,659.57 2025-08-01
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 1 1 — — $17,508.93 $17,508.93 $17,508.93 2025-08-01
947 MS_DRG Signs And Symptoms With Mcc 2 2 — — $9,625.67 $25,351.69 $17,488.68 2025-08-01
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 1 1 — — $17,374.98 $17,374.98 $17,374.98 2025-08-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 1 1 — — $17,364.90 $17,364.90 $17,364.90 2025-08-01
920 MS_DRG Complications Of Treatment With Cc 2 2 — — $8,262.50 $25,905.87 $17,084.18 2025-08-01
313 MS_DRG Chest Pain 2 2 — — $5,756.41 $27,436.93 $16,596.67 2025-08-01
637 MS_DRG Diabetes With Mcc 5 3 — — $11,160.55 $39,805.24 $16,570.49 2025-08-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 5 4 — — $14,538.07 $31,070.01 $16,492.19 2025-08-01
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/Mcc 2 2 — — $2,490.52 $30,257.30 $16,373.91 2025-08-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 1 1 — — $16,231.15 $16,231.15 $16,231.15 2025-08-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 2 — — $6,891.29 $25,305.37 $16,098.33 2025-08-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 3 2 — — $2,624.04 $27,426.00 $16,025.10 2025-08-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 3 — — $11,338.16 $21,674.09 $15,995.68 2025-08-01
5045 OTHER Trauma Response With Critical Care 1 1 — — $15,973.46 $15,973.46 $15,973.46 2025-08-01
501 MS_DRG Soft Tissue Procedures With Cc 2 1 — — $3,894.74 $27,207.28 $15,551.01 2025-08-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 2 — — $12,851.08 $18,155.38 $15,503.23 2025-08-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 1 1 — — $15,486.46 $15,486.46 $15,486.46 2025-08-01
916 MS_DRG Allergic Reactions Without Mcc 1 1 — — $15,287.13 $15,287.13 $15,287.13 2025-08-01
798 MS_DRG Vaginal Delivery With Sterilization And/Or D&c Without Cc/Mcc 1 1 — — $15,258.32 $15,258.32 $15,258.32 2025-08-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 1 1 — — $15,228.86 $15,228.86 $15,228.86 2025-08-01
374 MS_DRG Digestive Malignancy With Mcc 2 2 — — $14,474.90 $15,857.69 $15,166.30 2025-08-01
5165 OTHER Level 5 ENT Procedures 1 1 — — $15,151.37 $15,151.37 $15,151.37 2025-08-01
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 2 2 — — $3,838.20 $26,428.74 $15,133.47 2025-08-01
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/Mcc 5 4 — — $5,386.26 $36,003.47 $15,048.88 2025-08-01
196 MS_DRG Interstitial Lung Disease With Mcc 1 1 — — $14,694.54 $14,694.54 $14,694.54 2025-08-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 4 2 — — $11,681.56 $50,343.52 $14,674.92 2025-08-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 2 — — $13,830.68 $56,054.18 $14,502.94 2025-08-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 2 — — $2,800.44 $26,173.67 $14,487.06 2025-08-01
300 MS_DRG Peripheral Vascular Disorders With Cc 4 4 — — $5,685.10 $24,329.88 $14,476.65 2025-08-01
103 MS_DRG Headaches Without Mcc 4 3 — — $2,343.04 $54,861.58 $14,466.78 2025-08-01
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $14,407.07 $14,407.07 $14,407.07 2025-08-01
5164 OTHER Level 4 ENT Procedures 5 4 — — $3,383.00 $17,181.92 $14,396.11 2025-08-01
71 MS_DRG Nonspecific Cerebrovascular Disorders With Cc 2 2 — — $10,110.00 $18,566.24 $14,338.12 2025-08-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 5 4 — — $6,873.47 $15,778.92 $14,324.90 2025-08-01
5115 OTHER Level 5 Musculoskeletal Procedures 15 6 — — $4,159.73 $73,396.10 $14,322.75 2025-08-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 5 4 — — $9,778.56 $34,375.30 $14,288.78 2025-08-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 3 — — $9,658.07 $30,923.64 $14,260.56 2025-08-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 1 1 — — $14,240.78 $14,240.78 $14,240.78 2025-08-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 2 — — $13,072.82 $15,123.73 $14,098.27 2025-08-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 19 9 — — $4,352.44 $53,885.73 $14,055.78 2025-08-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 4 4 — — $6,833.07 $23,147.27 $14,051.40 2025-08-01
919 MS_DRG Complications Of Treatment With Mcc 3 2 — — $11,718.72 $27,664.26 $14,013.29 2025-08-01
125 MS_DRG Other Disorders Of The Eye Without Mcc 1 1 — — $13,897.84 $13,897.84 $13,897.84 2025-08-01
686 MS_DRG Kidney And Urinary Tract Neoplasms With Mcc 1 1 — — $13,789.27 $13,789.27 $13,789.27 2025-08-01
5153 OTHER Level 3 Airway Endoscopy 1 1 — — $13,769.85 $13,769.85 $13,769.85 2025-08-01
70 MS_DRG Nonspecific Cerebrovascular Disorders With Mcc 2 2 — — $13,621.12 $13,899.10 $13,760.11 2025-08-01
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc 1 1 — — $13,733.82 $13,733.82 $13,733.82 2025-08-01
598 MS_DRG Malignant Breast Disorders With Cc 1 1 — — $13,713.00 $13,713.00 $13,713.00 2025-08-01
621 MS_DRG O.r. Procedures For Obesity Without Cc/Mcc 8 4 — — $8,482.63 $61,629.00 $13,627.03 2025-08-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/Mcc 2 2 — — $6,321.39 $20,744.13 $13,532.76 2025-08-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 — — $13,510.94 $13,510.94 $13,510.94 2025-08-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 1 1 — — $13,296.40 $13,296.40 $13,296.40 2025-08-01
921 MS_DRG Complications Of Treatment Without Cc/Mcc 1 1 — — $13,241.59 $13,241.59 $13,241.59 2025-08-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc 3 3 — — $11,494.98 $20,108.45 $13,143.70 2025-08-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 6 4 — — $4,913.18 $13,713.00 $13,132.06 2025-08-01
884 MS_DRG Organic Disturbances And Intellectual Disability 16 9 — — $3,122.44 $65,018.12 $13,007.99 2025-08-01
551 MS_DRG Medical Back Problems With Mcc 1 1 — — $12,990.47 $12,990.47 $12,990.47 2025-08-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 2 2 — — $12,142.43 $13,713.00 $12,927.72 2025-08-01
746 MS_DRG Vagina, Cervix And Vulva Procedures With Cc/Mcc 1 1 — — $12,823.25 $12,823.25 $12,823.25 2025-08-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 2 2 — — $5,525.72 $19,806.23 $12,665.97 2025-08-01
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 2 2 — — $5,039.20 $20,182.70 $12,610.95 2025-08-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 5 4 — — $11,613.17 $29,509.06 $12,551.41 2025-08-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 6 3 — — $7,324.01 $51,017.71 $12,499.27 2025-08-01
100 MS_DRG Seizures With Mcc 1 1 — — $12,445.05 $12,445.05 $12,445.05 2025-08-01
157 MS_DRG Dental And Oral Diseases With Mcc 1 1 — — $12,336.66 $12,336.66 $12,336.66 2025-08-01
153 MS_DRG Otitis Media And Uri Without Mcc 3 2 — — $8,075.45 $13,052.04 $12,336.39 2025-08-01
9390 OTHER Pertuzu, Trastuzu, 10 Mg 2 2 — — $8,010.19 $16,615.26 $12,312.72 2025-08-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 6 3 — — $1,220.68 $22,712.00 $12,304.25 2025-08-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 3 3 — — $10,844.80 $16,155.30 $12,215.75 2025-08-01
102 MS_DRG Headaches With Mcc 2 2 — — $9,142.00 $15,230.35 $12,186.17 2025-08-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 7 6 — — $7,413.42 $81,671.32 $12,118.21 2025-08-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 4 4 — — $9,063.86 $85,363.97 $12,102.03 2025-08-01
5155 OTHER Level 5 Airway Endoscopy 3 3 — — $1,981.58 $39,921.28 $12,005.00 2025-08-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 3 3 — — $8,779.34 $12,378.06 $11,982.58 2025-08-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/Mc… 2 2 — — $10,803.10 $12,572.60 $11,687.85 2025-08-01
682 MS_DRG Renal Failure With Mcc 7 4 — — $5,763.30 $28,586.00 $11,503.27 2025-08-01
913 MS_DRG Traumatic Injury With Mcc 1 1 — — $11,497.35 $11,497.35 $11,497.35 2025-08-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 8 6 — — $2,831.48 $20,908.74 $11,459.56 2025-08-01
92 MS_DRG Other Disorders Of Nervous System With Cc 3 2 — — $7,878.60 $23,882.06 $11,276.84 2025-08-01
187 MS_DRG Pleural Effusion With Cc 1 1 — — $11,200.61 $11,200.61 $11,200.61 2025-08-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 3 2 — — $10,427.03 $27,954.14 $11,191.16 2025-08-01
948 MS_DRG Signs And Symptoms Without Mcc 4 3 — — $6,069.34 $16,579.49 $11,107.08 2025-08-01
813 MS_DRG Coagulation Disorders 3 3 — — $10,358.99 $17,894.86 $11,010.84 2025-08-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 9 6 — — $6,766.73 $36,070.84 $10,951.60 2025-08-01
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 2 2 — — $1,306.50 $20,423.20 $10,864.85 2025-08-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 3 3 — — $6,498.50 $21,595.44 $10,834.41 2025-08-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 1 1 — — $10,575.68 $10,575.68 $10,575.68 2025-08-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 1 1 — — $10,573.08 $10,573.08 $10,573.08 2025-08-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 5 4 — — $8,357.62 $15,586.16 $10,555.23 2025-08-01
504 MS_DRG Foot Procedures With Cc 2 2 — — $7,480.44 $13,440.70 $10,460.57 2025-08-01
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 2 2 — — $7,613.83 $12,967.24 $10,290.53 2025-08-01
399 MS_DRG Appendix Procedures Without Cc/Mcc 5 5 — — $1,589.60 $12,353.86 $10,116.90 2025-08-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 2 2 — — $7,165.62 $12,927.19 $10,046.41 2025-08-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 1 1 — — $10,018.54 $10,018.54 $10,018.54 2025-08-01
101 MS_DRG Seizures Without Mcc 6 4 — — $2,141.24 $22,785.82 $10,015.17 2025-08-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 11 7 — — $1,653.54 $29,831.36 $9,948.47 2025-08-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 1 1 — — $9,858.90 $9,858.90 $9,858.90 2025-08-01
394 MS_DRG Other Digestive System Diagnoses With Cc 5 3 — — $4,407.44 $44,884.32 $9,844.01 2025-08-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 2 2 — — $7,133.18 $12,534.60 $9,833.89 2025-08-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 6 3 — — $4,123.24 $16,401.98 $9,799.53 2025-08-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 2 1 — — $5,780.20 $13,740.75 $9,760.48 2025-08-01
5362 OTHER Level 2 Laparoscopy And Related Services 9 5 — — $949.58 $58,276.90 $9,554.95 2025-08-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 8 4 — — $2,832.66 $37,902.05 $9,554.93 2025-08-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 6 4 — — $8,685.22 $29,489.39 $9,543.20 2025-08-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 4 3 — — $6,848.33 $24,396.65 $9,487.16 2025-08-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 5 4 — — $4,193.92 $56,492.99 $9,486.98 2025-08-01
977 MS_DRG HIV With Or Without Other Related Condition 1 1 — — $9,485.37 $9,485.37 $9,485.37 2025-08-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 12 7 — — $2,557.72 $22,855.00 $9,399.03 2025-08-01
546 MS_DRG Connective Tissue Disorders With Cc 1 1 — — $9,362.60 $9,362.60 $9,362.60 2025-08-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 — — $9,307.98 $9,307.98 $9,307.98 2025-08-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 4 4 — — $2,577.50 $9,380.50 $9,273.47 2025-08-01
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 1 1 — — $9,264.69 $9,264.69 $9,264.69 2025-08-01
694 MS_DRG Urinary Stones Without Mcc 2 1 — — $6,503.05 $11,871.82 $9,187.43 2025-08-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 4 3 — — $8,668.98 $18,929.45 $9,148.34 2025-08-01
291 MS_DRG Heart Failure And Shock With Mcc 17 10 — — $2,742.19 $30,459.36 $9,052.03 2025-08-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $9,003.58 $9,003.58 $9,003.58 2025-08-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 6 5 — — $2,028.09 $20,465.35 $8,996.49 2025-08-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 2 — — $8,587.21 $97,636.98 $8,981.53 2025-08-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 8 5 — — $6,009.66 $30,354.09 $8,976.23 2025-08-01
5412 OTHER Level 2 Gynecologic Procedures 2 1 — — $137.71 $17,747.13 $8,942.42 2025-08-01
180 MS_DRG Respiratory Neoplasms With Mcc 1 1 — — $8,827.53 $8,827.53 $8,827.53 2025-08-01
5376 OTHER Level 6 Urology And Related Services 1 1 — — $8,581.09 $8,581.09 $8,581.09 2025-08-01
697 MS_DRG Urethral Stricture 1 1 — — $8,562.28 $8,562.28 $8,562.28 2025-08-01
375 MS_DRG Digestive Malignancy With Cc 2 2 — — $7,648.65 $9,376.64 $8,512.65 2025-08-01
602 MS_DRG Cellulitis With Mcc 2 2 — — $5,550.94 $11,446.97 $8,498.95 2025-08-01
915 MS_DRG Allergic Reactions With Mcc 2 2 — — $3,097.54 $13,644.62 $8,371.08 2025-08-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 2 2 — — $4,891.07 $11,806.51 $8,348.79 2025-08-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 3 3 — — $6,813.88 $28,042.97 $8,301.29 2025-08-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 5 5 — — $7,493.30 $16,566.56 $8,094.33 2025-08-01
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc/Mcc 4 2 — — $2,137.54 $22,235.48 $8,084.19 2025-08-01
885 MS_DRG Psychoses 16 8 — — $1,132.87 $32,270.65 $8,022.47 2025-08-01
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 4 4 — — $4,650.86 $19,823.44 $8,021.54 2025-08-01
552 MS_DRG Medical Back Problems Without Mcc 8 5 — — $2,532.08 $19,630.74 $7,980.56 2025-08-01
0800 RC Leuprolide Acetate 5 3 — — $36.18 $9,458.98 $7,961.20 2025-08-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 6 4 — — $5,449.61 $34,956.30 $7,933.98 2025-08-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 19 10 — — $2,927.05 $21,997.21 $7,813.35 2025-08-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 9 7 — — $4,743.62 $31,121.54 $7,812.76 2025-08-01
5114 OTHER Level 4 Musculoskeletal Procedures 14 7 — — $4,443.93 $60,997.30 $7,721.93 2025-08-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 1 1 — — $7,715.01 $7,715.01 $7,715.01 2025-08-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 6 4 — — $5,937.70 $20,979.86 $7,665.45 2025-08-01
302 MS_DRG Atherosclerosis With Mcc 1 1 — — $7,650.29 $7,650.29 $7,650.29 2025-08-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 4 3 — — $4,546.32 $11,742.01 $7,630.24 2025-08-01
596 MS_DRG Major Skin Disorders Without Mcc 1 1 — — $7,624.49 $7,624.49 $7,624.49 2025-08-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 2 2 — — $5,359.08 $9,845.60 $7,602.34 2025-08-01
881 MS_DRG Depressive Neuroses 3 3 — — $6,028.09 $10,106.87 $7,535.53 2025-08-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 3 2 — — $6,457.17 $23,453.25 $7,453.58 2025-08-01
158 MS_DRG Dental And Oral Diseases With Cc 1 1 — — $7,453.44 $7,453.44 $7,453.44 2025-08-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 1 1 — — $7,401.75 $7,401.75 $7,401.75 2025-08-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 8 6 — — $3,459.22 $16,330.99 $7,369.89 2025-08-01
811 MS_DRG Red Blood Cell Disorders With Mcc 6 4 — — $2,031.95 $12,661.20 $7,324.49 2025-08-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 6 5 — — $6,232.46 $32,101.06 $7,323.95 2025-08-01
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/Mcc 1 1 — — $7,313.60 $7,313.60 $7,313.60 2025-08-01
383 MS_DRG Uncomplicated Peptic Ulcer With Mcc 1 1 — — $7,222.11 $7,222.11 $7,222.11 2025-08-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 5 3 — — $3,847.29 $31,020.56 $7,206.06 2025-08-01
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 1 1 — — $7,186.24 $7,186.24 $7,186.24 2025-08-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 3 2 — — $6,974.32 $18,572.42 $7,185.00 2025-08-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 2 2 — — $3,692.72 $10,604.33 $7,148.52 2025-08-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 7 4 — — $1,981.95 $17,146.80 $7,069.48 2025-08-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 6 5 — — $3,556.95 $9,010.20 $7,068.32 2025-08-01
644 MS_DRG Endocrine Disorders With Cc 2 2 — — $6,789.05 $7,201.27 $6,995.16 2025-08-01
714 MS_DRG Transurethral Prostatectomy Without Cc/Mcc 1 1 — — $6,972.26 $6,972.26 $6,972.26 2025-08-01
9436 OTHER Inj Pegfilgrast Ex Bio 0.5mg 2 2 — — $1,901.55 $12,007.32 $6,954.44 2025-08-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 4 2 — — $4,020.09 $17,499.22 $6,857.15 2025-08-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $6,817.91 $6,817.91 $6,817.91 2025-08-01
312 MS_DRG Syncope And Collapse 7 7 — — $5,594.61 $7,167.58 $6,675.68 2025-08-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 7 4 — — $3,061.40 $25,662.83 $6,665.16 2025-08-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 1 1 — — $6,659.05 $6,659.05 $6,659.05 2025-08-01
638 MS_DRG Diabetes With Cc 11 7 — — $2,584.29 $19,176.92 $6,639.82 2025-08-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 5 3 — — $5,664.49 $29,738.77 $6,575.79 2025-08-01
69 MS_DRG Transient Ischemia Without Thrombolytic 5 3 — — $5,780.63 $25,682.88 $6,510.62 2025-08-01
5502 OTHER Level 2 Extraocular, Repair, And Plastic Eye Procedures 2 2 — — $1,183.69 $11,830.65 $6,507.17 2025-08-01
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 1 1 — — $6,475.33 $6,475.33 $6,475.33 2025-08-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 2 2 — — $6,472.39 $6,476.08 $6,474.24 2025-08-01
683 MS_DRG Renal Failure With Cc 8 5 — — $4,310.30 $9,142.00 $6,462.61 2025-08-01
292 MS_DRG Heart Failure And Shock With Cc 2 2 — — $4,611.75 $8,264.30 $6,438.02 2025-08-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 5 3 — — $4,036.32 $22,799.36 $6,413.50 2025-08-01
72 MS_DRG Nonspecific Cerebrovascular Disorders Without Cc/Mcc 1 1 — — $6,380.92 $6,380.92 $6,380.92 2025-08-01
1207 OTHER Octreotide Injection, Depot 5 3 — — $6,123.70 $20,266.25 $6,378.63 2025-08-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/Mcc 12 8 — — $5,190.53 $25,580.99 $6,335.55 2025-08-01
176 MS_DRG Pulmonary Embolism Without Mcc 7 5 — — $4,348.30 $20,422.94 $6,334.88 2025-08-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 10 6 — — $4,316.89 $26,678.26 $6,299.70 2025-08-01
204 MS_DRG Respiratory Signs And Symptoms 1 1 — — $6,280.19 $6,280.19 $6,280.19 2025-08-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 8 5 — — $4,571.00 $29,204.22 $6,253.15 2025-08-01
387 MS_DRG Inflammatory Bowel Disease Without Cc/Mcc 2 2 — — $4,798.47 $7,559.31 $6,178.89 2025-08-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 — — $6,159.65 $6,159.65 $6,159.65 2025-08-01
5163 OTHER Level 3 ENT Procedures 6 4 — — $4,328.10 $11,999.57 $6,121.28 2025-08-01
9300 OTHER Omalizumab Injection 2 1 — — $5,918.83 $6,071.66 $5,995.24 2025-08-01
5415 OTHER Level 5 Gynecologic Procedures 9 5 — — $1,817.69 $58,829.60 $5,980.54 2025-08-01
534 MS_DRG Fractures Of Femur Without Mcc 1 1 — — $5,953.60 $5,953.60 $5,953.60 2025-08-01
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 2 2 — — $5,003.14 $6,630.87 $5,817.01 2025-08-01
784 MS_DRG Cesarean Section With Sterilization With Cc 3 3 — — $4,456.04 $24,387.39 $5,807.76 2025-08-01
866 MS_DRG Viral Illness Without Mcc 1 1 — — $5,650.13 $5,650.13 $5,650.13 2025-08-01
797 MS_DRG Vaginal Delivery With Sterilization And/Or D&c With Cc 1 1 — — $5,604.74 $5,604.74 $5,604.74 2025-08-01
785 MS_DRG Cesarean Section With Sterilization Without Cc/Mcc 7 5 — — $4,746.74 $23,090.97 $5,554.45 2025-08-01
5361 OTHER Level 1 Laparoscopy And Related Services 21 9 — — $1,164.53 $44,784.44 $5,466.38 2025-08-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 3 3 — — $4,867.01 $27,844.34 $5,393.63 2025-08-01
5503 OTHER Level 3 Extraocular, Repair, And Plastic Eye Procedures 3 2 — — $4,191.63 $10,742.66 $5,346.58 2025-08-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 3 2 — — $3,248.19 $11,854.50 $5,340.55 2025-08-01
645 MS_DRG Endocrine Disorders Without Cc/Mcc 2 2 — — $4,224.27 $6,227.84 $5,226.06 2025-08-01
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 5 4 — — $3,698.62 $86,403.72 $5,215.70 2025-08-01
5184 OTHER Level 4 Vascular Procedures 5 3 — — $3,127.74 $24,070.45 $5,207.23 2025-08-01
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/Or D&c 5 4 — — $4,478.17 $18,261.87 $5,148.45 2025-08-01
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