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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

SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH

Plymouth, IN · CCN 150076 · Rates published

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You selected 482 (MS_DRG)

HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC

This hospital’s price: $21,551 across 20 payers · range $11,618-$40,043

Source: https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/plymouthmedicalcenter · observed 2025-01-01

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.

24,961 distinct procedures filed
54 distinct payers
3,547,652 rate rows
2025-01-01 last MRF observed · ⚠ 22 mo old

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 22 months old.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://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/plymouthmedicalcenter
Found on page https://www.sjmed.com/patients-visitors/billing-and-assistance/request-price-estimate#MRF
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-31
Content fingerprint 603d737c846b19b0… · 46,927,524 bytes · first seen 2026-05-09

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 19 $13,201.00 $867,571.90 $457,355.14 nat. median
$359,244
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 20 $187,899.41 $638,117.83 $336,901.18 nat. median
$248,541
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 $114,309.18 $620,694.67 $327,754.74 nat. median
$198,115
1.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 20 $126,405.75 $502,050.42 $265,471.40 nat. median
$190,359
1.4× median
J2326
HCPCS 		Inj Nusinersen 0.1mg 51 $326.73 $413,702.43 $248,221.46 nat. median
$2,492
outlier · 99.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 $78,360.98 $346,155.60 $183,633.03 nat. median
$126,461
1.5× median
7
MS_DRG 		Lung Transplant 19 $69,447.31 $288,849.19 $153,549.51 nat. median
$117,977
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 20 $98,886.35 $288,324.07 $153,273.84 nat. median
$103,938
1.5× median
27100000002-816
CDM 		Glove Vinyl Powder Free Lg 35 $55,604.16 $166,479.51 $146,501.97 nat. median
$81,142
1.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 19 $13,201.00 $269,881.27 $143,592.14 nat. median
$110,084
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve?procedures 19 $87,135.53 $253,628.44 $135,060.07 nat. median
$97,137
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 19 $76,789.58 $243,721.80 $129,859.50 nat. median
$94,943
1.4× median
27800000002-88968
CDM 		Device Impella 5.5 Smartassist 35 $48,847.50 $146,250.00 $128,700.00 nat. median
$71,282
1.8× median
27800000002-88967
CDM 		Device Impella 5.5 Smartassist 35 $48,847.50 $146,250.00 $128,700.00 nat. median
$71,282
1.8× median
215
MS_DRG 		Other Heart Assist System Implant 20 $82,702.06 $240,538.11 $128,188.19 nat. median
$93,787
1.4× median
27200000002-30479
CDM 		Stylet Steerable 30cm 35 $46,419.17 $138,979.55 $122,302.01 nat. median
$182
outlier · 672.3×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 $67,754.21 $228,540.40 $121,889.89 nat. median
$90,512
1.3× median
27800000002-91547
CDM 		Graft Bn Canc Crsh Frzdr 30ml 35 $46,220.59 $138,385.00 $121,778.80 nat. median
$67,449
1.8× median
'588-4
OTHER 		Neonate Bwt <1500g W Major Procedure 5 $115,628.23 $115,628.23 $115,628.23 nat. median
$202,324
0.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 20 $71,908.27 $208,668.25 $111,457.82 nat. median
$70,795
1.6× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 $68,646.37 $199,037.12 $106,401.87 nat. median
$74,298
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 $67,338.27 $198,495.51 $106,117.56 nat. median
$77,487
1.4× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 20 $55,880.29 $191,096.73 $102,233.49 nat. median
$76,979
1.3× median
'002-4
OTHER 		Heart &/or Lung Transplant 5 $101,004.57 $101,004.57 $101,004.57 nat. median
$205,014
outlier · 0.5×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 19 $64,986.50 $188,230.94 $100,729.08 nat. median
$66,623
1.5× median
J7330
HCPCS 		Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 35 $38,156.16 $114,240.00 $100,531.20 nat. median
$75,037
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 $52,676.64 $183,664.98 $98,332.14 nat. median
$71,737
1.4× median
27800000002-89099
CDM 		Valve Sapien Thv Edwards Resilia 20mm 35 $36,907.00 $110,500.00 $97,240.00 nat. median
$53,858
1.8× median
27800000002-89098
CDM 		Valve Sapien Thv Edwards Resilia 26mm 35 $36,907.00 $110,500.00 $97,240.00 nat. median
$53,858
1.8× median
27800000002-89097
CDM 		Valve Sapien Thv Edwards Resilia 29mm 35 $36,907.00 $110,500.00 $97,240.00 nat. median
$53,858
1.8× median
27800000002-89096
CDM 		Valve Sapien Thv Edwards Resilia 23mm 35 $36,907.00 $110,500.00 $97,240.00 nat. median
$53,858
1.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 $54,114.88 $181,583.34 $97,239.36 nat. median
$72,247
1.3× median
'161-4
OTHER 		Cardiac Defibrillator & Heart Assist Implant 5 $96,953.83 $96,953.83 $96,953.83 nat. median
$182,608
0.5× median
27800000002-90555
CDM 		Valve Aort 26mm Evolutr 35 $35,821.50 $107,250.00 $94,380.00 nat. median
$52,274
1.8× median
J1747
HCPCS 		Injection Spesolimab-sbzo 1 Mg 51 $16.24 $156,466.98 $93,880.19 nat. median
$92
outlier · 1019.0×
27800000002-91236
CDM 		Valve Sapien 3 Ultra Thv 26mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-90657
CDM 		Valve Sapien 3 Thv 26mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-91231
CDM 		Valve Sapien 3 Ultra Thv 20mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-91234
CDM 		Valve Sapien 3 Ultra Thv 23mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-88988
CDM 		Valve Hrt Sapien 3 Ultra 26mm 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-90659
CDM 		Valve Sapien 3 Thv 29mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-88987
CDM 		Valve Hrt Sapien 3 Ultra 23mm 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-91233
CDM 		Valve Sapien 3 Ultra Thv 23mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-91237
CDM 		Valve Sapien 3 Ultra Thv 26mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-90655
CDM 		Valve Sapien 3 Thv 23mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
27800000002-90653
CDM 		Valve Sapien 3 Thv 20mm W/command System 35 $35,278.75 $105,625.00 $92,950.00 nat. median
$51,482
1.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 $46,894.31 $170,310.91 $91,321.80 nat. median
$67,908
1.3× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 19 $57,348.54 $165,679.02 $88,890.24 nat. median
$66,584
1.3× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 20 $41,091.94 $162,945.10 $87,455.05 nat. median
$61,263
1.4× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 20 $36,003.33 $161,835.98 $86,872.80 nat. median
$58,234
1.5× median

Other procedures at this hospital

Browse this hospital's 24,961 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 66 19 — — $13,201.00 $867,571.90 $457,355.14 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 66 20 — — $187,899.41 $638,117.83 $336,901.18 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 66 20 — — $114,309.18 $620,694.67 $327,754.74 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 66 20 — — $126,405.75 $502,050.42 $265,471.40 2025-01-01
J2326 HCPCS Inj Nusinersen 0.1mg 132 51 $413,702.43 $343,373.02 $326.73 $413,702.43 $248,221.46 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 66 20 — — $78,360.98 $346,155.60 $183,633.03 2025-01-01
7 MS_DRG Lung Transplant 64 19 — — $69,447.31 $288,849.19 $153,549.51 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 66 20 — — $98,886.35 $288,324.07 $153,273.84 2025-01-01
27100000002-816 CDM Glove Vinyl Powder Free Lg 80 35 $166,479.51 $138,177.99 $55,604.16 $166,479.51 $146,501.97 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 66 19 — — $13,201.00 $269,881.27 $143,592.14 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve?procedures 64 19 — — $87,135.53 $253,628.44 $135,060.07 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 64 19 — — $76,789.58 $243,721.80 $129,859.50 2025-01-01
27800000002-88968 CDM Device Impella 5.5 Smartassist 80 35 $146,250.00 $121,387.50 $48,847.50 $146,250.00 $128,700.00 2025-01-01
27800000002-88967 CDM Device Impella 5.5 Smartassist 80 35 $146,250.00 $121,387.50 $48,847.50 $146,250.00 $128,700.00 2025-01-01
215 MS_DRG Other Heart Assist System Implant 66 20 — — $82,702.06 $240,538.11 $128,188.19 2025-01-01
27200000002-30479 CDM Stylet Steerable 30cm 80 35 $138,979.55 $115,353.03 $46,419.17 $138,979.55 $122,302.01 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 20 — — $67,754.21 $228,540.40 $121,889.89 2025-01-01
27800000002-91547 CDM Graft Bn Canc Crsh Frzdr 30ml 80 35 $138,385.00 $114,859.55 $46,220.59 $138,385.00 $121,778.80 2025-01-01
'588-4 OTHER Neonate Bwt <1500g W Major Procedure 10 5 — — $115,628.23 $115,628.23 $115,628.23 2025-01-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 66 20 — — $71,908.27 $208,668.25 $111,457.82 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 66 20 — — $68,646.37 $199,037.12 $106,401.87 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 66 20 — — $67,338.27 $198,495.51 $106,117.56 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 66 20 — — $55,880.29 $191,096.73 $102,233.49 2025-01-01
'002-4 OTHER Heart &/or Lung Transplant 10 5 — — $101,004.57 $101,004.57 $101,004.57 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 64 19 — — $64,986.50 $188,230.94 $100,729.08 2025-01-01
J7330 HCPCS Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 80 35 $114,240.00 $94,819.20 $38,156.16 $114,240.00 $100,531.20 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 66 20 — — $52,676.64 $183,664.98 $98,332.14 2025-01-01
27800000002-89099 CDM Valve Sapien Thv Edwards Resilia 20mm 80 35 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $97,240.00 2025-01-01
27800000002-89098 CDM Valve Sapien Thv Edwards Resilia 26mm 80 35 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $97,240.00 2025-01-01
27800000002-89097 CDM Valve Sapien Thv Edwards Resilia 29mm 80 35 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $97,240.00 2025-01-01
27800000002-89096 CDM Valve Sapien Thv Edwards Resilia 23mm 80 35 $110,500.00 $91,715.00 $36,907.00 $110,500.00 $97,240.00 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 66 20 — — $54,114.88 $181,583.34 $97,239.36 2025-01-01
'161-4 OTHER Cardiac Defibrillator & Heart Assist Implant 10 5 — — $96,953.83 $96,953.83 $96,953.83 2025-01-01
27800000002-90555 CDM Valve Aort 26mm Evolutr 80 35 $107,250.00 $89,017.50 $35,821.50 $107,250.00 $94,380.00 2025-01-01
J1747 HCPCS Injection Spesolimab-sbzo 1 Mg 132 51 $156,466.98 $129,867.59 $16.24 $156,466.98 $93,880.19 2025-01-01
27800000002-91236 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-90657 CDM Valve Sapien 3 Thv 26mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-91231 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-91234 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-88988 CDM Valve Hrt Sapien 3 Ultra 26mm 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-90659 CDM Valve Sapien 3 Thv 29mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-88987 CDM Valve Hrt Sapien 3 Ultra 23mm 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-91233 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-91237 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-90655 CDM Valve Sapien 3 Thv 23mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
27800000002-90653 CDM Valve Sapien 3 Thv 20mm W/command System 80 35 $105,625.00 $87,668.75 $35,278.75 $105,625.00 $92,950.00 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 66 20 — — $46,894.31 $170,310.91 $91,321.80 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 64 19 — — $57,348.54 $165,679.02 $88,890.24 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 66 20 — — $41,091.94 $162,945.10 $87,455.05 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 66 20 — — $36,003.33 $161,835.98 $86,872.80 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 66 20 — — $44,963.53 $161,414.48 $86,651.53 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 68 20 — — $13,201.00 $164,009.47 $86,594.21 2025-01-01
27800000002-89078 CDM Valve Aortic 34mm Evolut Fx 80 35 $97,987.50 $81,329.63 $32,727.83 $97,987.50 $86,229.00 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 80 35 $97,800.00 $81,174.00 $32,665.20 $97,800.00 $86,064.00 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 68 20 — — $13,201.00 $162,669.58 $85,902.18 2025-01-01
27800000002-90558 CDM Valve Aort 29mm Pro Perc 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90559 CDM Valve Aort 34mm Evolutr 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90158 CDM Kit Mitraclp 3 Sgc0301 Cds0501 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90154 CDM Kit Mitraclip 1 Mbr0301 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90153 CDM Kit Mitraclip 1 Mbr0301 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90837 CDM Valve Aortic Evolut Tm Pro 29mm 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90155 CDM Kit Mitraclip 3 Mbr0203 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-89075 CDM Valve Aortic 26mm Evolut Fx 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-89076 CDM Valve Aortic 29mm Evolut Fx 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-89080 CDM Valve Aortic 23mm Evolut Fx 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-91555 CDM Kit Mitraclip 2 Mbr0202 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90156 CDM Kit Mitraclp 1 Sgc0301 Cds0501 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-91517 CDM Kit Mitraclip G4 Delivery Sys Nt 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-91435 CDM Kit Mitraclip 1 Mbr0303 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-91511 CDM Kit Mitraclip G4 Delivery Sys Xtw 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90556 CDM Valve Aort 26mm Pro Perc 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-91556 CDM Kit Mitraclip 2 Mbr0202 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90151 CDM Kit Mitraclip 1 Mbr0101 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-91247 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90152 CDM Kit Mitraclip 1 Mbr0201 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
27800000002-90157 CDM Kit Mitraclp 2 Sgc0301 Cds0501 80 35 $97,500.00 $80,925.00 $32,565.00 $97,500.00 $85,800.00 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 66 20 — — $46,859.23 $156,177.40 $83,902.29 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 68 20 — — $36,494.43 $160,562.04 $83,423.27 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 20 — — $44,798.16 $149,890.08 $80,601.71 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 66 20 — — $51,050.44 $147,083.16 $79,128.18 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 66 20 — — $28,013.17 $146,423.82 $78,782.05 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 64 19 — — $50,764.13 $146,237.79 $78,684.40 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 66 19 — — $13,201.00 $145,456.00 $78,273.99 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 66 19 — — $13,201.00 $145,456.00 $78,273.99 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 66 20 — — $50,215.43 $144,620.44 $77,833.92 2025-01-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 66 20 — — $50,015.25 $144,043.92 $77,523.64 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 66 20 — — $40,643.79 $143,444.42 $77,200.99 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 66 20 — — $49,688.26 $143,102.19 $77,016.80 2025-01-01
27200000002-21552 CDM Hemostat D Stat Flowable 0330 80 35 $87,500.00 $72,625.00 $29,225.00 $87,500.00 $77,000.00 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 66 20 — — $42,347.63 $142,445.26 $76,663.25 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 66 20 — — $38,440.25 $141,972.11 $76,408.60 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 66 20 — — $41,363.99 $140,192.04 $75,450.57 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 68 20 — — $13,201.00 $141,374.91 $74,859.98 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 66 20 — — $41,595.94 $138,630.15 $74,609.98 2025-01-01
27800000002-91577 CDM Implant Gammatile Therapy Device 4pk 80 35 $84,500.00 $70,135.00 $28,223.00 $84,500.00 $74,360.00 2025-01-01
C1824 HCPCS Kit Ipg Optimizer Smart Mini 80 35 $84,500.00 $70,135.00 $28,223.00 $84,500.00 $74,360.00 2025-01-01
'001-4 OTHER Liver Transplant &/or Intestinal Transplant 10 5 — — $73,501.84 $73,501.84 $73,501.84 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 20 — — $39,242.06 $134,406.17 $72,336.66 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 66 20 — — $38,295.64 $134,093.78 $72,168.53 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 66 20 — — $38,290.63 $133,765.32 $71,991.75 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 66 20 — — $36,530.95 $133,648.19 $71,928.71 2025-01-01
27800000002-91232 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90268 CDM Set Pump Impella Cp 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90269 CDM Set Pump Impella Cp 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-91990 CDM Set Pump Aic Impella 5.0 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90267 CDM Set Pump Impella Cp 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90270 CDM Set Pump Impella Cp 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-91235 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90271 CDM Set Pump Impella Cp 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90654 CDM Valve Sapien 3 Thv 23mm W/command System 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90658 CDM Valve Sapien 3 Thv 29mm W/command System 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-91991 CDM Set Pump Aic Impella 5.0 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
27800000002-90656 CDM Valve Sapien 3 Thv 26mm W/command System 80 35 $81,250.00 $67,437.50 $27,137.50 $81,250.00 $71,500.00 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 68 20 — — $13,201.00 $132,162.11 $69,981.67 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 66 20 — — $40,010.22 $130,007.61 $69,969.37 2025-01-01
'007-4 OTHER Allogeneic Bone Marrow Transplant 10 5 — — $69,192.08 $69,192.08 $69,192.08 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 66 20 — — $43,280.45 $127,903.68 $68,837.05 2025-01-01
'004-4 OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 10 5 — — $68,020.03 $68,020.03 $68,020.03 2025-01-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 64 19 — — $38,900.57 $124,414.70 $66,959.30 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 66 20 — — $36,563.88 $124,021.93 $66,747.91 2025-01-01
'591-4 OTHER Neonate Birthwt 500-749g Without Major Procedure 10 5 — — $66,694.21 $66,694.21 $66,694.21 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 66 20 — — $35,133.51 $122,949.27 $66,170.62 2025-01-01
27800000002-90836 CDM Valve Aortic Evolut Tm Pro 26mm 80 35 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $66,000.00 2025-01-01
27800000002-89077 CDM Valve Aortic 34mm Evolut Fx 80 35 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $66,000.00 2025-01-01
27800000002-90838 CDM Valve Aortic Evolut Tm Pro 34mm 80 35 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $66,000.00 2025-01-01
27800000002-89079 CDM Valve Aortic 23mm Evolut Fx 80 35 $75,000.00 $62,250.00 $25,050.00 $75,000.00 $66,000.00 2025-01-01
'009-4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 10 5 — — $65,781.90 $65,781.90 $65,781.90 2025-01-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 66 20 — — $34,005.97 $121,993.78 $65,656.37 2025-01-01
27200000002-21145 CDM Glv Surg Orth Ltx Maxxus 8.5 80 35 $74,258.59 $61,634.63 $24,802.37 $74,258.59 $65,347.56 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 66 20 — — $38,982.19 $120,218.28 $64,700.81 2025-01-01
J9600 HCPCS Porfimer Per 75 Mg 132 51 $105,199.95 $87,315.96 $6,256.05 $105,199.95 $64,697.97 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 66 20 — — $33,897.15 $119,710.66 $64,427.61 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 66 20 — — $41,421.05 $119,292.62 $64,202.63 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 68 20 — — $36,077.06 $122,689.73 $63,900.90 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 66 20 — — $36,750.01 $118,387.64 $63,715.57 2025-01-01
'609-4 OTHER Neonate Bwt 1500-2499g W Major Procedure 10 5 — — $63,710.81 $63,710.81 $63,710.81 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 66 20 — — $34,054.65 $117,360.95 $63,163.01 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 66 20 — — $35,102.72 $116,543.26 $62,722.94 2025-01-01
27200000002-28034 CDM Clip Lig Ti Horizon Sm 6/cq 80 35 $71,250.00 $59,137.50 $23,797.50 $71,250.00 $62,700.00 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 66 20 — — $40,156.96 $115,652.04 $62,243.29 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 64 19 — — $34,599.45 $114,657.49 $61,708.03 2025-01-01
10 MS_DRG Pancreas Transplant 64 19 — — $30,811.62 $114,122.33 $61,420.01 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 66 20 — — $34,635.24 $113,966.15 $61,335.95 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 64 19 — — $39,376.98 $113,405.70 $61,034.32 2025-01-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $60,986.09 $60,986.09 $60,986.09 2025-01-01
'593-4 OTHER Neonate Birthwt 750-999g Without Major Procedure 10 5 — — $60,752.94 $60,752.94 $60,752.94 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 66 20 — — $34,744.06 $112,441.02 $60,515.13 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 66 20 — — $35,806.45 $111,825.45 $60,183.83 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 68 20 — — $13,201.00 $114,066.51 $59,736.11 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 66 20 — — $32,506.16 $110,332.45 $59,380.31 2025-01-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 66 20 — — $37,966.94 $109,344.79 $58,848.76 2025-01-01
'002-3 OTHER Heart &/or Lung Transplant 10 5 — — $58,449.60 $58,449.60 $58,449.60 2025-01-01
27000000004-1176 CDM Drape Surg W/17 5/8x11.75in Towl Ster 80 35 $66,068.70 $54,837.02 $22,066.95 $66,068.70 $58,140.46 2025-01-01
'002-2 OTHER Heart &/or Lung Transplant 10 5 — — $57,965.85 $57,965.85 $57,965.85 2025-01-01
245 MS_DRG Aicd Generator Procedures 66 20 — — $33,549.94 $107,640.52 $57,931.53 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 66 20 — — $37,371.99 $107,631.33 $57,926.58 2025-01-01
'002-1 OTHER Heart &/or Lung Transplant 10 5 — — $57,798.15 $57,798.15 $57,798.15 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 66 20 — — $36,302.57 $107,305.17 $57,751.05 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 66 20 — — $31,883.32 $106,962.91 $57,566.85 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 64 19 — — $37,104.81 $106,861.85 $57,512.46 2025-01-01
A9604 HCPCS Samarium Sm-153 Lexidronam Therapeutic Per 150 Millicuries 132 51 $95,760.00 $79,480.80 $4,660.16 $95,760.00 $57,456.00 2025-01-01
27800000002-89069 CDM Watchman Flx Procedure - Device 80 35 $65,100.00 $54,033.00 $21,743.40 $65,100.00 $57,288.00 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 64 19 — — $36,808.93 $106,009.72 $57,053.84 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 66 20 — — $33,338.75 $105,274.71 $56,658.27 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 66 20 — — $30,758.64 $104,989.91 $56,504.99 2025-01-01
'583-4 OTHER Neonate W Ecmo 10 5 — — $56,336.76 $56,336.76 $56,336.76 2025-01-01
'583-3 OTHER Neonate W Ecmo 10 5 — — $56,336.76 $56,336.76 $56,336.76 2025-01-01
'583-2 OTHER Neonate W Ecmo 10 5 — — $56,336.76 $56,336.76 $56,336.76 2025-01-01
27800000002-91443 CDM Stent Graft Confrm Thor 40x40x15 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91447 CDM Stent Graft Confrm Thor 40x40x10 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91518 CDM Stent Graft Confrm Thor 26x26x10 20f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91492 CDM Stent Graft Confrm Thor 28x28x10 20f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91503 CDM Stent Graft Confrm Thor 28x28x15 20f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91486 CDM Stent Graft Confrm Thor 45x45x15 24f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91487 CDM Stent Graft Confrm Thor 37x37x10 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91490 CDM Stent Graft Confrm Thor 45x45x10 24f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91485 CDM Stent Graft Confrm Thor 45x45x15 24f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91563 CDM Stent Graft Confrm Thor 37x37x20 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91433 CDM Stent Graft Confrm Thor 34x34x15 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91444 CDM Stent Graft Confrm Thor 40x40x15 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91448 CDM Stent Graft Confrm Thor 40x40x10 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91607 CDM Stent Graft Confrm Thor 45x45x20 24f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91495 CDM Stent Graft Confrm Thor 34x34x10 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91466 CDM Stent Graft Confrm Thor 21x21x10 18f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91565 CDM Stent Graft Confrm Thor 34x34x20 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91484 CDM Stent Graft Confrm Thor 45x45x15 24f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91465 CDM Stent Graft Confrm Thor 31x31x10 20f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91432 CDM Stent Graft Confrm Thor 34x34x15 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-89038 CDM Stent Graft Confrm Thor 40x40x20 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91562 CDM Stent Graft Confrm Thor 37x37x20 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91494 CDM Stent Graft Confrm Thor 34x34x10 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
27800000002-91564 CDM Stent Graft Confrm Thor 34x34x20 22f 80 35 $64,015.00 $53,132.45 $21,381.01 $64,015.00 $56,333.20 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 66 20 — — $36,237.90 $108,973.08 $56,168.75 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 64 19 — — $36,023.36 $103,747.28 $55,836.21 2025-01-01
27800000002-91560 CDM Stent Valiant Navion Vnmf4343c183tu Freeflo 175mm 80 35 $62,984.25 $52,276.93 $21,036.74 $62,984.25 $55,426.15 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 66 20 — — $28,184.98 $102,964.03 $55,414.67 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 66 20 — — $25,958.53 $102,389.82 $55,105.63 2025-01-01
27800000002-90266 CDM Set Pump Impella Cp 80 35 $62,500.00 $51,875.00 $20,875.00 $62,500.00 $55,000.00 2025-01-01
27800000002-90265 CDM Set Pump Impella Cp 80 35 $62,500.00 $51,875.00 $20,875.00 $62,500.00 $55,000.00 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 66 20 — — $26,909.25 $101,836.28 $54,807.72 2025-01-01
'583-1 OTHER Neonate W Ecmo 10 5 — — $54,795.21 $54,795.21 $54,795.21 2025-01-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $54,508.63 $54,508.63 $54,508.63 2025-01-01
33264 HCPCS Hc Removal/replacement Implantable Defibrillator W/lead(s) Multi 142 53 $76,754.00 $63,705.82 $367.53 $112,466.99 $54,495.34 2025-01-01
'631-4 OTHER Neonate Birthwt >2499g W Other Major Procedure 10 5 — — $53,626.40 $53,626.40 $53,626.40 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 66 20 — — $27,949.45 $99,077.70 $53,323.07 2025-01-01
27800000002-89043 CDM Plug Cardiac Amulet Amplatzer 20mm 80 35 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $53,173.12 2025-01-01
27800000002-88976 CDM Plug Cardiac Amulet Amplatzer 18mm 80 35 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $53,173.12 2025-01-01
27800000002-88977 CDM Plug Cardiac Amulet Amplatzer 18mm 80 35 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $53,173.12 2025-01-01
27800000002-88975 CDM Plug Cardiac Amulet Amplatzer 22mm 80 35 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $53,173.12 2025-01-01
27800000002-89042 CDM Plug Cardiac Amulet Amplatzer 20mm 80 35 $60,424.00 $50,151.92 $20,181.62 $60,424.00 $53,173.12 2025-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 64 19 — — $34,253.64 $98,650.48 $53,093.14 2025-01-01
793 MS_DRG Full Term Neonate With Major Problems 68 20 — — $13,201.00 $100,242.23 $53,079.65 2025-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 66 20 — — $27,085.36 $98,113.02 $52,803.88 2025-01-01
'630-4 OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 10 5 — — $52,530.42 $52,530.42 $52,530.42 2025-01-01
J9298 HCPCS Opdualag Per 1 Each 132 51 $87,194.88 $72,371.75 $50.49 $87,194.88 $52,316.93 2025-01-01
'588-3 OTHER Neonate Bwt <1500g W Major Procedure 10 5 — — $52,192.62 $52,192.62 $52,192.62 2025-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 66 20 — — $26,342.26 $96,762.44 $52,077.01 2025-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 66 20 — — $27,608.68 $96,463.84 $51,916.30 2025-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 66 20 — — $27,213.51 $96,381.16 $51,871.80 2025-01-01
791 MS_DRG Prematurity With Major Problems 68 20 — — $13,201.00 $97,678.89 $51,722.32 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 66 20 — — $24,636.27 $95,767.89 $51,541.75 2025-01-01
'588-2 OTHER Neonate Bwt <1500g W Major Procedure 10 5 — — $51,470.22 $51,470.22 $51,470.22 2025-01-01
'588-1 OTHER Neonate Bwt <1500g W Major Procedure 10 5 — — $51,470.22 $51,470.22 $51,470.22 2025-01-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 66 20 — — $24,374.25 $95,547.40 $51,423.08 2025-01-01
A9606 HCPCS Radium Ra-223 Dichloride Therapeutic Per Microcurie 132 51 $85,076.88 $70,613.81 $43.68 $85,076.88 $51,046.13 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 66 20 — — $28,674.66 $94,463.25 $50,839.60 2025-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 66 20 — — $30,533.14 $93,388.32 $50,261.08 2025-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 66 20 — — $26,381.63 $93,170.10 $50,143.63 2025-01-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 66 20 — — $25,413.73 $93,069.04 $50,089.24 2025-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 66 20 — — $30,988.45 $92,843.94 $49,968.09 2025-01-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 1 — — $49,924.72 $49,924.72 $49,924.72 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 66 20 — — $26,571.34 $92,637.22 $49,856.84 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic… 132 51 $55,035.00 $45,679.05 $17,678.68 $188,572.55 $49,531.50 2025-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 66 20 — — $27,235.70 $92,001.00 $49,514.42 2025-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 66 20 — — $25,227.60 $91,429.06 $49,206.61 2025-01-01
'611-4 OTHER Neonate Birthwt 1500-1999g W Major Anomaly 10 5 — — $48,981.26 $48,981.26 $48,981.26 2025-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 66 20 — — $27,187.02 $90,583.80 $48,751.70 2025-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 64 19 — — $31,367.37 $90,338.03 $48,619.42 2025-01-01
'593-3 OTHER Neonate Birthwt 750-999g Without Major Procedure 10 5 — — $48,568.14 $48,568.14 $48,568.14 2025-01-01
27800000002-89213 CDM Coil Web Sgl Layer 6x2mm 80 35 $54,845.88 $45,522.08 $18,318.52 $54,845.88 $48,264.38 2025-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 66 20 — — $22,079.07 $89,267.70 $48,043.38 2025-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 66 20 — — $26,113.17 $89,054.06 $47,928.40 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 66 20 — — $27,256.46 $88,992.06 $47,895.03 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 66 20 — — $24,024.89 $88,498.22 $47,629.25 2025-01-01
J9359 HCPCS Loncastuximab-lpyl 0.1 Mg 132 51 $78,900.03 $65,487.02 $54.13 $78,900.03 $47,340.02 2025-01-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 66 20 — — $28,433.40 $87,577.17 $47,133.55 2025-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 66 20 — — $20,939.36 $87,437.06 $47,058.14 2025-01-01
33270 HCPCS Hc Insertion/replacement Permanent Subcutaneous Implantable Defi 142 53 $56,241.00 $46,680.03 $510.83 $112,466.99 $47,018.97 2025-01-01
'006-4 OTHER Pancreas Transplant 10 5 — — $46,792.88 $46,792.88 $46,792.88 2025-01-01
332 MS_DRG Rectal Resection With Mcc 66 20 — — $30,167.09 $86,881.22 $46,758.99 2025-01-01
27000000004-1177 CDM Drape Surg W/17 5/8x11.75in Towl Ster 80 35 $53,078.20 $44,054.91 $17,728.12 $53,078.20 $46,708.82 2025-01-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 66 20 — — $24,399.30 $86,621.67 $46,619.30 2025-01-01
27800000002-89062 CDM Conduit Konect Resilia Aortic Vlv 23mm 80 35 $52,500.00 $43,575.00 $17,535.00 $52,500.00 $46,200.00 2025-01-01
27800000002-89196 CDM Conduit Konect Resilia Aortic Vlv 27mm 80 35 $52,500.00 $43,575.00 $17,535.00 $52,500.00 $46,200.00 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 66 20 — — $21,585.10 $85,815.48 $46,185.41 2025-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 68 20 — — $13,201.00 $87,094.83 $46,117.92 2025-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 66 20 — — $29,538.75 $85,673.06 $46,108.76 2025-01-01
27800000002-90902 CDM Coil Web Sngl Layer 9x4 80 35 $52,325.00 $43,429.75 $17,476.55 $52,325.00 $46,046.00 2025-01-01
27800000002-89711 CDM Coil Web Sngl Layer 5x4 80 35 $52,325.00 $43,429.75 $17,476.55 $52,325.00 $46,046.00 2025-01-01
27800000002-89712 CDM Coil Web Sngl Layer 9x5 80 35 $52,325.00 $43,429.75 $17,476.55 $52,325.00 $46,046.00 2025-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 68 20 — — $13,201.00 $86,768.67 $45,945.22 2025-01-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $45,836.21 $45,836.21 $45,836.21 2025-01-01
265 MS_DRG Aicd Lead Procedures 66 20 — — $21,248.63 $84,733.63 $45,603.17 2025-01-01
27800000002-88996 CDM Device Embol Pipeline Flex 4.25x25mm 80 35 $51,707.25 $42,917.02 $17,270.22 $51,707.25 $45,502.38 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 66 20 — — $25,259.10 $84,529.21 $45,493.15 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 66 20 — — $28,963.62 $92,371.74 $44,893.61 2025-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 66 20 — — $22,611.70 $83,079.88 $44,713.13 2025-01-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 64 19 — — $28,817.67 $82,994.89 $44,667.39 2025-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 66 20 — — $22,497.87 $82,944.35 $44,640.19 2025-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 66 20 — — $27,086.79 $82,919.09 $44,626.59 2025-01-01
'005-4 OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 10 5 — — $44,535.51 $44,535.51 $44,535.51 2025-01-01
'602-4 OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 10 5 — — $44,334.47 $44,334.47 $44,334.47 2025-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 66 20 — — $21,869.31 $82,301.21 $44,294.06 2025-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 66 20 — — $20,353.04 $81,786.73 $44,017.16 2025-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 66 20 — — $24,254.69 $81,430.70 $43,825.55 2025-01-01
27800000002-89710 CDM Coil Web Sngl Layer 11x6 80 35 $49,708.75 $41,258.26 $16,602.72 $49,708.75 $43,743.71 2025-01-01
27800000002-89709 CDM Coil Web Sngl Layer 10x5 80 35 $49,708.75 $41,258.26 $16,602.72 $49,708.75 $43,743.71 2025-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 66 20 — — $22,996.86 $81,118.34 $43,657.44 2025-01-01
37 MS_DRG Extracranial Procedures With Mcc 66 20 — — $22,112.72 $81,093.05 $43,643.83 2025-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 66 20 — — $22,343.95 $80,941.48 $43,562.25 2025-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 68 20 — — $24,609.78 $83,635.72 $43,560.27 2025-01-01
252 MS_DRG Other Vascular Procedures With Mcc 66 20 — — $23,533.06 $80,592.34 $43,374.35 2025-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 66 20 — — $19,220.48 $80,325.91 $43,230.96 2025-01-01
C1822 HCPCS Kit Ipg Omnia 400 35 $65,000.00 $53,950.00 $4,878.91 $84,500.00 $43,175.00 2025-01-01
'607-4 OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 10 5 — — $43,134.82 $43,134.82 $43,134.82 2025-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 64 19 — — $27,758.55 $79,944.62 $43,025.75 2025-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 66 20 — — $26,702.35 $79,705.73 $42,897.18 2025-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 66 20 — — $23,003.30 $79,218.81 $42,635.12 2025-01-01
27800000002-89010 CDM Device Embol Pipeline Flex 4x16mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-89019 CDM Device Embol Pipeline Flex 4.25x20mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-88994 CDM Device Embol Pipeline Flex 4.25x14mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-88997 CDM Device Embol Pipeline Flex 4.5x12mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-89002 CDM Device Embol Pipeline Flex 4x12mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-88989 CDM Device Embol Pipeline Flex 4.5x18mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-88995 CDM Device Embol Pipeline Flex 3x16mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
27800000002-89000 CDM Device Embol Pipeline Flex 4x10mm 80 35 $48,234.38 $40,034.54 $16,110.28 $48,234.38 $42,446.26 2025-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 66 20 — — $20,102.47 $78,575.67 $42,288.99 2025-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 66 20 — — $23,009.03 $78,350.57 $42,167.84 2025-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 66 20 — — $22,925.98 $78,042.79 $42,002.19 2025-01-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 66 20 — — $17,322.63 $77,996.85 $41,977.47 2025-01-01
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