Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

ASCENSION ST VINCENT SALEM

Salem, IN · CCN 151314 · Rates published

Your selected procedure

You selected 93350 (CPT)

STRESS TTE ONLY

This hospital’s price: $100 across 19 payers · range $51-$396

Source: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/in-csv/270847538_st-vincent-salem-hospital-inc_standardcharges.csv · observed 2026-01-01

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.

5,706 distinct procedures filed
135 distinct payers
1,691,452 rate rows
2026-01-01 last MRF observed
Data quality

1,675,919 of 1,691,452 rate rows are consumer-grade (99.1%)

15,533 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
placeholder amount (≤ $0.02) — excluded from medians 9,633
per-diem day rate — not a per-procedure price 3,495
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,381
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 794
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 230
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/in-csv/270847538_st-vincent-salem-hospital-inc_standardcharges.csv
Found on page https://healthcare.ascension.org/price-transparency
Discovered viaDiscovered by HANK
Last fetch success · 2026-11-06
Content fingerprint 28a8b5dcec5a5b1a… · 23,599,222 bytes · first seen 2026-11-06

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
0266T
OTHER 		Implt/rpl Crtd Sns Dev Total 21 $232.94 $41,701.32 $41,701.32 nat. median
$39,035
1.1× median
0408T
OTHER 		Insj/rplc Cardiac Modulj Sys 32 $661.61 $26,229.13 $26,229.13 nat. median
$31,346
0.8× median
0268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 21 $682.10 $25,736.11 $25,736.11 nat. median
$28,044
0.9× median
0915T
OTHER 		Insj Perm Ccm-d Sys Pg&eltrd 1 $24,946.53 $24,946.53 $24,946.53 nat. median
$33,792
0.7× median
0620T
OTHER 		Evasc Ven Artlz Tibl/prnl Vn 30 $1,125.78 $24,104.09 $24,104.09 nat. median
$25,506
0.9× median
0505T
OTHER 		Ev Fempop Artl Revsc 13 $20,739.24 $22,765.08 $22,765.08 nat. median
$12,696
1.8× median
0409T
OTHER 		Insj/rplc Car Modulj Pls Gn 32 $534.00 $20,791.50 $20,791.50 nat. median
$22,950
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $17,561.53 $19,901.00 $19,607.18 nat. median
$90,512
outlier · 0.2×
0923T
OTHER 		Rmvl&rplcmt Perm Ccm-d Pg 1 $18,680.26 $18,680.26 $18,680.26 nat. median
$24,390
0.8× median
0916T
OTHER 		Insj Perm Ccm-d Sys Pg Only 1 $18,680.26 $18,680.26 $18,680.26 nat. median
$24,431
0.8× median
0614T
OTHER 		Rmvl&rplcmt Ss Impl Dfb Pg 31 $468.23 $18,739.11 $18,653.18 nat. median
$23,582
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 12 $15,311.00 $19,901.00 $18,509.00 nat. median
$76,979
outlier · 0.2×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 $13,965.00 $19,901.00 $17,864.26 nat. median
$71,737
outlier · 0.2×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 18 $13,400.00 $19,901.00 $16,214.50 nat. median
$77,487
outlier · 0.2×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 $13,400.00 $19,901.00 $16,214.50 nat. median
$72,247
outlier · 0.2×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 18 $13,400.00 $19,901.00 $16,214.50 nat. median
$66,584
outlier · 0.2×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 18 $13,400.00 $19,901.00 $16,214.50 nat. median
$63,829
outlier · 0.3×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 $12,200.00 $19,901.00 $15,894.00 nat. median
$59,493
outlier · 0.3×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 19 $12,200.00 $19,901.00 $15,894.00 nat. median
$60,517
outlier · 0.3×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 $12,200.00 $19,901.00 $15,894.00 nat. median
$61,995
outlier · 0.3×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$51,559
outlier · 0.3×
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically… 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$48,227
outlier · 0.3×
213
MS_DRG 		Endovascular Abdominal Aorta With Iliac Branch Procedures 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$48,413
outlier · 0.3×
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$45,843
outlier · 0.3×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$50,728
outlier · 0.3×
653
MS_DRG 		Major Bladder Procedures With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$49,995
outlier · 0.3×
799
MS_DRG 		Splenic Procedures With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$43,234
outlier · 0.3×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$46,201
outlier · 0.3×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$55,425
outlier · 0.3×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$50,558
outlier · 0.3×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$49,305
outlier · 0.3×
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$44,088
outlier · 0.3×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$55,110
outlier · 0.3×
221
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$46,440
outlier · 0.3×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$56,633
outlier · 0.3×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$58,220
outlier · 0.3×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$57,798
outlier · 0.3×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$58,052
outlier · 0.3×
471
MS_DRG 		Cervical Spinal Fusion With Mcc 23 $11,231.00 $19,901.00 $14,981.50 nat. median
$44,798
outlier · 0.3×
0414T
OTHER 		Rmvl & Rpl Car Modulj Pls Gn 32 $551.74 $14,910.63 $14,910.63 nat. median
$22,811
0.7× median
0617T
OTHER 		Insj Iris Prosth W/rmvl&insj 19 $14,751.66 $14,751.66 $14,751.66 nat. median
$5,391
outlier · 2.7×
0616T
OTHER 		Insertion Of Iris Prosthesis 19 $14,000.95 $14,000.95 $14,000.95 nat. median
$3,955
outlier · 3.5×
0308T
OTHER 		Insj Ocular Telescope Prosth 21 $2,443.30 $13,950.44 $13,950.44 nat. median
$16,719
0.8× median
0816T
OTHER 		Opn Insj/rplcmt Ins Ptn Subq 31 $158.60 $19,698.51 $13,827.80 nat. median
$21,802
0.6× median
0817T
OTHER 		Opn Insj/rplcmt Ins Ptn Subf 31 $158.60 $19,698.51 $13,827.80 nat. median
$22,202
0.6× median
413
MS_DRG 		Cholecystectomy With C.d.e. Without Cc/mcc 25 $7,939.93 $19,901.00 $13,700.00 nat. median
$16,447
0.8× median
411
MS_DRG 		Cholecystectomy With C.d.e. With Mcc 25 $7,939.93 $19,901.00 $13,700.00 nat. median
$29,355
outlier · 0.5×
421
MS_DRG 		Hepatobiliary Diagnostic Procedures With Cc 25 $7,939.93 $19,901.00 $13,700.00 nat. median
$16,663
0.8× median
419
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 25 $7,939.93 $19,901.00 $13,700.00 nat. median
$13,549
1.0× median
42
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 25 $7,939.93 $19,901.00 $13,700.00 nat. median
$16,972
0.8× median

Other procedures at this hospital

Browse this hospital's 5,706 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0266T OTHER Implt/rpl Crtd Sns Dev Total 21 21 — — $232.94 $41,701.32 $41,701.32 2026-01-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 34 32 — — $661.61 $26,229.13 $26,229.13 2026-01-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 21 21 — — $682.10 $25,736.11 $25,736.11 2026-01-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 1 1 — — $24,946.53 $24,946.53 $24,946.53 2026-01-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 32 30 — — $1,125.78 $24,104.09 $24,104.09 2026-01-01
0505T OTHER Ev Fempop Artl Revsc 15 13 — — $20,739.24 $22,765.08 $22,765.08 2026-01-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 34 32 — — $534.00 $20,791.50 $20,791.50 2026-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 8 — — $17,561.53 $19,901.00 $19,607.18 2026-01-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 1 1 — — $18,680.26 $18,680.26 $18,680.26 2026-01-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 1 1 — — $18,680.26 $18,680.26 $18,680.26 2026-01-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 33 31 — — $468.23 $18,739.11 $18,653.18 2026-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 12 — — $15,311.00 $19,901.00 $18,509.00 2026-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 14 — — $13,965.00 $19,901.00 $17,864.26 2026-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 18 — — $13,400.00 $19,901.00 $16,214.50 2026-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 22 18 — — $13,400.00 $19,901.00 $16,214.50 2026-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 18 — — $13,400.00 $19,901.00 $16,214.50 2026-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 22 18 — — $13,400.00 $19,901.00 $16,214.50 2026-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 19 — — $12,200.00 $19,901.00 $15,894.00 2026-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 19 — — $12,200.00 $19,901.00 $15,894.00 2026-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 19 — — $12,200.00 $19,901.00 $15,894.00 2026-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
799 MS_DRG Splenic Procedures With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 28 23 — — $11,231.00 $19,901.00 $14,981.50 2026-01-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 34 32 — — $551.74 $14,910.63 $14,910.63 2026-01-01
0617T OTHER Insj Iris Prosth W/rmvl&insj 19 19 — — $14,751.66 $14,751.66 $14,751.66 2026-01-01
0616T OTHER Insertion Of Iris Prosthesis 19 19 — — $14,000.95 $14,000.95 $14,000.95 2026-01-01
0308T OTHER Insj Ocular Telescope Prosth 21 21 — — $2,443.30 $13,950.44 $13,950.44 2026-01-01
0816T OTHER Opn Insj/rplcmt Ins Ptn Subq 33 31 — — $158.60 $19,698.51 $13,827.80 2026-01-01
0817T OTHER Opn Insj/rplcmt Ins Ptn Subf 33 31 — — $158.60 $19,698.51 $13,827.80 2026-01-01
413 MS_DRG Cholecystectomy With C.d.e. Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
369 MS_DRG Major Esophageal Disorders With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
358 MS_DRG Other Digestive System O.r. Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
387 MS_DRG Inflammatory Bowel Disease Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
37 MS_DRG Extracranial Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
410 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
389 MS_DRG Gastrointestinal Obstruction With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
381 MS_DRG Complicated Peptic Ulcer With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
382 MS_DRG Complicated Peptic Ulcer Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
39 MS_DRG Extracranial Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
394 MS_DRG Other Digestive System Diagnoses With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
312 MS_DRG Syncope And Collapse 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
416 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
397 MS_DRG Appendix Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
398 MS_DRG Appendix Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
376 MS_DRG Digestive Malignancy Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
399 MS_DRG Appendix Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
38 MS_DRG Extracranial Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
254 MS_DRG Other Vascular Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
386 MS_DRG Inflammatory Bowel Disease With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
158 MS_DRG Dental And Oral Diseases With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
215 MS_DRG Other Heart Assist System Implant 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
289 MS_DRG Acute And Subacute Endocarditis With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
183 MS_DRG Major Chest Trauma With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
292 MS_DRG Heart Failure And Shock With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
334 MS_DRG Rectal Resection Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
311 MS_DRG Angina Pectoris 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
305 MS_DRG Hypertension Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
332 MS_DRG Rectal Resection With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
349 MS_DRG Anal And Stomal Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
348 MS_DRG Anal And Stomal Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
375 MS_DRG Digestive Malignancy With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
28 MS_DRG Spinal Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
297 MS_DRG Cardiac Arrest, Unexplained With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
374 MS_DRG Digestive Malignancy With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
368 MS_DRG Major Esophageal Disorders With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
370 MS_DRG Major Esophageal Disorders Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
265 MS_DRG Aicd Lead Procedures 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
32 MS_DRG Ventricular Shunt Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
187 MS_DRG Pleural Effusion With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
188 MS_DRG Pleural Effusion Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
196 MS_DRG Interstitial Lung Disease With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
122 MS_DRG Acute Major Eye Infections Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
316 MS_DRG Other Circulatory System Diagnoses Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
163 MS_DRG Major Chest Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
121 MS_DRG Acute Major Eye Infections With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
114 MS_DRG Orbital Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
201 MS_DRG Pneumothorax Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
117 MS_DRG Intraocular Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
148 MS_DRG Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
141 MS_DRG Major Head And Neck Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
136 MS_DRG Sinus And Mastoid Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
184 MS_DRG Major Chest Trauma With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
200 MS_DRG Pneumothorax With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
30 MS_DRG Spinal Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
101 MS_DRG Seizures Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
202 MS_DRG Bronchitis And Asthma With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
300 MS_DRG Peripheral Vascular Disorders With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
290 MS_DRG Acute And Subacute Endocarditis Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
204 MS_DRG Respiratory Signs And Symptoms 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
123 MS_DRG Neurological Eye Disorders 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
253 MS_DRG Other Vascular Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
209 MS_DRG Complex Aortic Arch Procedures 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
115 MS_DRG Extraocular Procedures Except Orbit 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
181 MS_DRG Respiratory Neoplasms With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
245 MS_DRG Aicd Generator Procedures 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
263 MS_DRG Vein Ligation And Stripping 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
302 MS_DRG Atherosclerosis With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
142 MS_DRG Major Head And Neck Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
149 MS_DRG Dysequilibrium 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
138 MS_DRG Mouth Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
186 MS_DRG Pleural Effusion With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
165 MS_DRG Major Chest Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
139 MS_DRG Salivary Gland Procedures 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
176 MS_DRG Pulmonary Embolism Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
103 MS_DRG Headaches Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
199 MS_DRG Pneumothorax With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
164 MS_DRG Major Chest Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
124 MS_DRG Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
180 MS_DRG Respiratory Neoplasms With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
10 MS_DRG Pancreas Transplant 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
198 MS_DRG Interstitial Lung Disease Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
313 MS_DRG Chest Pain 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
303 MS_DRG Atherosclerosis Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
113 MS_DRG Orbital Procedures With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
333 MS_DRG Rectal Resection With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
182 MS_DRG Respiratory Neoplasms Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
150 MS_DRG Epistaxis With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
153 MS_DRG Otitis Media And Uri Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
137 MS_DRG Mouth Procedures With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
157 MS_DRG Dental And Oral Diseases With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
125 MS_DRG Other Disorders Of The Eye Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
102 MS_DRG Headaches With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
291 MS_DRG Heart Failure And Shock With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
116 MS_DRG Intraocular Procedures With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
252 MS_DRG Other Vascular Procedures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
152 MS_DRG Otitis Media And Uri With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
100 MS_DRG Seizures With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
185 MS_DRG Major Chest Trauma Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
147 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Cc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
159 MS_DRG Dental And Oral Diseases Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 33 25 — — $7,939.93 $19,901.00 $13,700.00 2026-01-01
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