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

SOUTHEAST IOWA REGIONAL MEDICAL CENTER

West Burlington, IA · CCN 160057 · 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: $13,340 across 10 payers · range $12,632-$26,413

Source: https://greatriver.pt.panaceainc.com/MRFDownload/greatriver/great-river-health · observed 2025-06-04

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.

1,729 distinct procedures filed
21 distinct payers
53,413 rate rows
2025-06-04 last MRF observed · ⚠ 17 mo old
Data quality

39,541 of 53,413 rate rows are consumer-grade (74.0%)

13,872 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 6,947
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,877
percent-of-charges filed in the dollar field — excluded from medians 44
placeholder amount (≤ $0.02) — excluded from medians 4

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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://greatriver.pt.panaceainc.com/MRFDownload/greatriver/great-river-health
Found on page https://www.greatriverhealth.org/family-planning/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-31
Content fingerprint 90ddcc2a3df778c7… · 111,857,173 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 10 $300,292.70 $612,641.42 $317,119.02 nat. median
$359,244
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $222,248.63 $450,610.97 $236,861.32 nat. median
$248,541
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $188,895.64 $438,307.49 $216,180.35 nat. median
$198,115
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $170,651.69 $354,526.10 $180,213.83 nat. median
$190,359
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $112,511.82 $244,439.98 $120,561.76 nat. median
$126,461
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $93,996.34 $196,343.08 $110,170.28 nat. median
$110,084
1.0× median
7
MS_DRG 		Lung Transplant 10 $100,602.63 $203,972.69 $109,892.80 nat. median
$117,977
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 $87,745.68 $203,601.87 $100,419.74 nat. median
$103,938
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 10 $86,743.99 $179,101.34 $91,604.52 nat. median
$97,137
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 10 $84,797.13 $172,105.70 $89,548.57 nat. median
$94,943
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 10 $83,776.48 $169,857.52 $89,089.44 nat. median
$93,787
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 $83,411.63 $156,983.94 $88,085.43 nat. median
$93,226
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $76,848.04 $161,385.26 $81,154.08 nat. median
$90,512
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 7 $73,350.86 $138,049.18 $77,460.93 nat. median
$78,164
1.0× median
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 2 $72,676.59 $147,352.41 $72,676.59 nat. median
$70,795
1.0× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 10 $66,556.65 $134,944.17 $71,255.25 nat. median
$76,979
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 $67,437.02 $140,168.87 $71,215.73 nat. median
$77,487
0.9× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 7 $66,413.03 $124,991.91 $70,134.35 nat. median
$77,936
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 $64,187.48 $140,551.33 $69,322.19 nat. median
$74,298
0.9× median
00597003510
NDC 		Spesolimab Sbzo 450 Mg/7.5 Ml Sol (Spevigo) 18 $48,968.08 $83,070.85 $68,424.15 nat. median
$53,690
1.3× median
10
MS_DRG 		Pancreas Transplant 10 $39,478.64 $119,483.08 $67,043.28 nat. median
$64,851
1.0× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 10 $63,122.08 $132,920.47 $66,659.00 nat. median
$66,623
1.0× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 10 $62,239.02 $129,696.19 $65,726.47 nat. median
$71,737
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 $61,610.77 $128,226.23 $65,063.01 nat. median
$72,247
0.9× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 $59,317.20 $120,266.13 $62,764.88 nat. median
$67,908
0.9× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 $56,556.10 $106,440.79 $59,725.11 nat. median
$63,564
0.9× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 $56,271.84 $116,995.29 $59,424.92 nat. median
$66,584
0.9× median
J2507
HCPCS 		Pegloticase 8 mg/mL Inj 20 $3,307.05 $86,640.95 $59,280.65 nat. median
$9,222
outlier · 6.4×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 10 $55,391.97 $115,816.33 $58,495.75 nat. median
$62,577
0.9× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 10 $49,948.65 $102,328.65 $57,417.74 nat. median
$61,660
0.9× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 10 $53,181.54 $115,064.72 $56,751.78 nat. median
$61,263
0.9× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 10 $51,495.86 $114,870.16 $56,655.82 nat. median
$59,324
1.0× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 7 $53,386.98 $100,476.38 $56,378.41 nat. median
$60,517
0.9× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 10 $50,358.00 $114,281.51 $56,365.49 nat. median
$58,234
1.0× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 $53,091.57 $113,983.86 $56,218.68 nat. median
$63,829
0.9× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 10 $48,864.21 $113,381.90 $55,921.79 nat. median
$53,342
1.0× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 2 $54,394.68 $110,285.66 $54,394.68 nat. median
$52,917
1.0× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $51,421.80 $105,845.84 $54,303.12 nat. median
$61,995
0.9× median
J9347
HCPCS 		Tremelimumab Actl (Imjudo) 300 Mg/15 Ml Inj 20 $135.45 $77,805.00 $53,235.00 nat. median
$2,840
outlier · 18.7×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 $49,323.65 $103,266.75 $52,087.41 nat. median
$56,633
0.9× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 7 $49,259.95 $92,709.16 $52,020.14 nat. median
$57,485
0.9× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 $49,035.41 $103,398.11 $51,783.00 nat. median
$58,052
0.9× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 10 $48,641.26 $98,916.71 $51,366.77 nat. median
$57,798
0.9× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement W Mcc 10 $47,702.46 $103,863.71 $51,227.26 nat. median
$58,220
0.9× median
28
MS_DRG 		Spinal Procedures With Mcc 10 $48,408.75 $100,205.43 $51,121.24 nat. median
$54,377
0.9× median
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 10 $48,061.58 $102,714.68 $50,754.61 nat. median
$50,830
1.0× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 10 $48,061.58 $102,714.68 $50,754.61 nat. median
$53,841
0.9× median
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 10 $44,011.79 $102,122.70 $50,368.57 nat. median
$51,462
1.0× median
454
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Cc 2 $50,162.71 $101,705.32 $50,162.71 nat. median
$49,522
1.0× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $46,721.37 $94,727.97 $50,026.41 nat. median
$59,493
0.8× median

Other procedures at this hospital

Browse this hospital's 1,729 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 Immunotherapy 11 10 — — $300,292.70 $612,641.42 $317,119.02 2025-06-04
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 11 10 — — $222,248.63 $450,610.97 $236,861.32 2025-06-04
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 10 — — $188,895.64 $438,307.49 $216,180.35 2025-06-04
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 11 10 — — $170,651.69 $354,526.10 $180,213.83 2025-06-04
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 10 — — $112,511.82 $244,439.98 $120,561.76 2025-06-04
14 MS_DRG Allogeneic Bone Marrow Transplant 11 10 — — $93,996.34 $196,343.08 $110,170.28 2025-06-04
7 MS_DRG Lung Transplant 11 10 — — $100,602.63 $203,972.69 $109,892.80 2025-06-04
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 10 — — $87,745.68 $203,601.87 $100,419.74 2025-06-04
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 11 10 — — $86,743.99 $179,101.34 $91,604.52 2025-06-04
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 11 10 — — $84,797.13 $172,105.70 $89,548.57 2025-06-04
215 MS_DRG Other Heart Assist System Implant 11 10 — — $83,776.48 $169,857.52 $89,089.44 2025-06-04
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 7 — — $83,411.63 $156,983.94 $88,085.43 2025-06-04
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 10 — — $76,848.04 $161,385.26 $81,154.08 2025-06-04
850 MS_DRG Acute Leukemia With Other Procedures 7 7 — — $73,350.86 $138,049.18 $77,460.93 2025-06-04
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 3 2 — — $72,676.59 $147,352.41 $72,676.59 2025-06-04
231 MS_DRG Coronary Bypass With Ptca With Mcc 11 10 — — $66,556.65 $134,944.17 $71,255.25 2025-06-04
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 10 — — $67,437.02 $140,168.87 $71,215.73 2025-06-04
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 7 7 — — $66,413.03 $124,991.91 $70,134.35 2025-06-04
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 11 10 — — $64,187.48 $140,551.33 $69,322.19 2025-06-04
00597003510 NDC Spesolimab Sbzo 450 Mg/7.5 Ml Sol (Spevigo) 22 18 $87,443.00 — $48,968.08 $83,070.85 $68,424.15 2025-06-04
10 MS_DRG Pancreas Transplant 11 10 — — $39,478.64 $119,483.08 $67,043.28 2025-06-04
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 11 10 — — $63,122.08 $132,920.47 $66,659.00 2025-06-04
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 11 10 — — $62,239.02 $129,696.19 $65,726.47 2025-06-04
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 10 — — $61,610.77 $128,226.23 $65,063.01 2025-06-04
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 11 10 — — $59,317.20 $120,266.13 $62,764.88 2025-06-04
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 7 — — $56,556.10 $106,440.79 $59,725.11 2025-06-04
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 11 10 — — $56,271.84 $116,995.29 $59,424.92 2025-06-04
J2507 HCPCS Pegloticase 8 mg/mL Inj 28 20 $91,201.00 — $3,307.05 $86,640.95 $59,280.65 2025-06-04
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 11 10 — — $55,391.97 $115,816.33 $58,495.75 2025-06-04
955 MS_DRG Craniotomy For Multiple Significant Trauma 11 10 — — $49,948.65 $102,328.65 $57,417.74 2025-06-04
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 11 10 — — $53,181.54 $115,064.72 $56,751.78 2025-06-04
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 11 10 — — $51,495.86 $114,870.16 $56,655.82 2025-06-04
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 7 7 — — $53,386.98 $100,476.38 $56,378.41 2025-06-04
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 11 10 — — $50,358.00 $114,281.51 $56,365.49 2025-06-04
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 11 10 — — $53,091.57 $113,983.86 $56,218.68 2025-06-04
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 11 10 — — $48,864.21 $113,381.90 $55,921.79 2025-06-04
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $54,394.68 $110,285.66 $54,394.68 2025-06-04
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 10 — — $51,421.80 $105,845.84 $54,303.12 2025-06-04
J9347 HCPCS Tremelimumab Actl (Imjudo) 300 Mg/15 Ml Inj 28 20 $81,900.00 — $135.45 $77,805.00 $53,235.00 2025-06-04
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 11 10 — — $49,323.65 $103,266.75 $52,087.41 2025-06-04
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 7 7 — — $49,259.95 $92,709.16 $52,020.14 2025-06-04
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 11 10 — — $49,035.41 $103,398.11 $51,783.00 2025-06-04
232 MS_DRG Coronary Bypass With Ptca Without Mcc 11 10 — — $48,641.26 $98,916.71 $51,366.77 2025-06-04
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 11 10 — — $47,702.46 $103,863.71 $51,227.26 2025-06-04
28 MS_DRG Spinal Procedures With Mcc 11 10 — — $48,408.75 $100,205.43 $51,121.24 2025-06-04
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 11 10 — — $48,061.58 $102,714.68 $50,754.61 2025-06-04
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 11 10 — — $48,061.58 $102,714.68 $50,754.61 2025-06-04
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 11 10 — — $44,011.79 $102,122.70 $50,368.57 2025-06-04
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 3 2 — — $50,162.71 $101,705.32 $50,162.71 2025-06-04
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 10 — — $46,721.37 $94,727.97 $50,026.41 2025-06-04
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 11 10 — — $47,336.18 $99,773.08 $49,988.58 2025-06-04
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 10 — — $45,700.66 $101,023.55 $49,826.45 2025-06-04
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 11 10 — — $46,360.76 $100,547.97 $49,591.89 2025-06-04
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 11 10 — — $46,853.65 $97,785.97 $49,479.00 2025-06-04
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 11 10 — — $45,427.54 $94,264.04 $47,972.98 2025-06-04
50242015001 NDC Ocrelizumab 300 Mg/10 Ml IV Sol 22 18 $60,871.00 — $34,087.76 $57,827.45 $47,631.56 2025-06-04
653 MS_DRG Major Bladder Procedures With Mcc 11 10 — — $44,388.42 $90,020.43 $46,875.64 2025-06-04
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 11 10 — — $42,960.72 $94,501.83 $46,609.83 2025-06-04
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 11 10 — — $44,011.79 $93,103.36 $46,477.90 2025-06-04
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 11 10 — — $43,006.11 $94,179.23 $46,450.72 2025-06-04
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 7 — — $43,827.06 $82,484.23 $46,282.82 2025-06-04
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 7 7 — — $43,559.51 $81,980.69 $46,000.28 2025-06-04
8 MS_DRG Simultaneous Pancreas/kidney Transplant 11 10 — — $43,153.73 $87,494.55 $45,753.06 2025-06-04
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 11 10 — — $43,226.68 $91,543.60 $45,648.80 2025-06-04
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 11 10 — — $42,289.29 $85,741.90 $45,372.99 2025-06-04
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 11 10 — — $42,362.73 $86,433.64 $44,736.45 2025-06-04
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 10 — — $42,175.61 $87,210.20 $44,538.84 2025-06-04
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 7 7 — — $41,008.29 $77,179.19 $43,306.10 2025-06-04
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 11 10 — — $40,872.13 $84,089.02 $43,162.32 2025-06-04
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 11 10 — — $40,566.36 $86,245.74 $42,839.42 2025-06-04
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 11 10 — — $40,442.15 $84,456.51 $42,708.24 2025-06-04
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 11 10 — — $39,422.87 $79,930.21 $42,354.23 2025-06-04
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 11 10 — — $39,727.97 $80,548.79 $42,104.49 2025-06-04
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 11 10 — — $36,581.88 $74,979.25 $42,071.69 2025-06-04
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 11 10 — — $39,823.45 $83,131.21 $42,054.87 2025-06-04
228 MS_DRG Other Cardiothoracic Procedures With Mcc 11 10 — — $39,680.12 $83,786.38 $41,903.52 2025-06-04
57894006103 NDC Ustekinumab 90 mg/mL Subcut Inj 22 18 $53,544.00 — $29,984.64 $50,866.80 $41,898.18 2025-06-04
75987013015 NDC Teprotumumab Trbw 500 Mg Inj 22 18 $52,919.00 — $29,634.64 $50,273.05 $41,409.12 2025-06-04
245 MS_DRG Aicd Generator Procedures 11 10 — — $37,164.19 $75,350.70 $41,092.07 2025-06-04
471 MS_DRG Cervical Spinal Fusion With Mcc 11 10 — — $38,676.83 $81,795.94 $40,844.02 2025-06-04
6 MS_DRG Liver Transplant Without Mcc 11 10 — — $38,612.34 $80,430.73 $40,775.90 2025-06-04
799 MS_DRG Splenic Procedures With Mcc 11 10 — — $37,860.67 $82,387.91 $40,635.05 2025-06-04
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 11 10 — — $37,953.99 $76,952.03 $40,156.18 2025-06-04
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 11 10 — — $37,461.74 $81,150.75 $40,024.86 2025-06-04
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 11 10 — — $37,853.50 $78,826.07 $39,974.55 2025-06-04
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 11 10 — — $36,922.24 $74,860.16 $39,348.93 2025-06-04
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 11 10 — — $37,041.31 $79,524.47 $39,222.76 2025-06-04
163 MS_DRG Major Chest Procedures With Mcc 11 10 — — $36,701.31 $78,380.43 $38,757.79 2025-06-04
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 11 10 — — $36,686.18 $74,786.99 $38,741.81 2025-06-04
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 10 — — $36,569.13 $77,299.57 $38,618.21 2025-06-04
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 11 10 — — $36,563.55 $75,107.92 $38,612.32 2025-06-04
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 11 10 — — $35,924.16 $73,637.96 $37,937.09 2025-06-04
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 3 2 — — $37,772.74 $76,584.54 $37,772.74 2025-06-04
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 11 10 — — $35,289.33 $71,549.41 $37,710.90 2025-06-04
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 11 10 — — $35,611.23 $73,431.77 $37,606.63 2025-06-04
901 MS_DRG Wound Debridements For Injuries With Mcc 11 10 — — $35,278.39 $71,965.13 $37,255.14 2025-06-04
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 11 10 — — $34,382.59 $75,344.05 $37,160.91 2025-06-04
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 11 10 — — $34,978.20 $72,532.16 $36,938.13 2025-06-04
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 11 10 — — $24,866.89 $64,842.75 $36,383.99 2025-06-04
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 11 10 — — $33,966.15 $71,148.66 $35,869.37 2025-06-04
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 11 10 — — $33,915.98 $68,842.28 $35,816.40 2025-06-04
140 MS_DRG Major Head And Neck Procedures With Mcc 11 10 — — $30,986.01 $63,378.63 $35,562.45 2025-06-04
31 MS_DRG Ventricular Shunt Procedures With Mcc 11 10 — — $33,368.16 $68,453.17 $35,237.87 2025-06-04
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 11 10 — — $30,329.07 $62,785.19 $35,229.47 2025-06-04
793 MS_DRG Full Term Neonate With Major Problems 11 10 — — $33,208.11 $69,994.64 $35,068.86 2025-06-04
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 11 10 — — $33,130.07 $69,151.57 $34,986.45 2025-06-04
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 11 10 — — $32,743.09 $67,199.38 $34,577.78 2025-06-04
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 11 10 — — $32,724.78 $67,259.24 $34,558.44 2025-06-04
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 11 10 — — $32,676.20 $66,595.76 $34,507.14 2025-06-04
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 7 7 — — $32,515.36 $61,195.18 $34,337.29 2025-06-04
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 11 10 — — $32,075.17 $65,032.67 $34,201.91 2025-06-04
791 MS_DRG Prematurity With Major Problems 11 10 — — $32,327.44 $68,138.89 $34,138.84 2025-06-04
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 11 10 — — $30,505.40 $61,849.97 $33,498.09 2025-06-04
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 11 10 — — $29,659.01 $60,133.90 $33,474.55 2025-06-04
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 11 10 — — $30,658.48 $67,475.41 $33,279.97 2025-06-04
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 11 10 — — $31,418.11 $66,755.39 $33,178.56 2025-06-04
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 11 10 — — $31,353.61 $64,638.58 $33,110.45 2025-06-04
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 11 10 — — $30,603.82 $62,049.51 $33,043.18 2025-06-04
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 7 — — $31,151.36 $58,628.07 $32,896.86 2025-06-04
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 11 10 — — $31,136.23 $64,801.54 $32,880.88 2025-06-04
34 MS_DRG Carotid Artery Stent Procedures With Mcc 11 10 — — $30,964.24 $64,874.70 $32,699.26 2025-06-04
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 11 10 — — $30,775.53 $65,810.89 $32,499.97 2025-06-04
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 11 10 — — $26,705.66 $57,862.30 $32,467.18 2025-06-04
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 11 10 — — $28,111.23 $65,228.89 $32,171.95 2025-06-04
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 11 10 — — $30,436.32 $64,488.92 $32,141.76 2025-06-04
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 11 10 — — $30,271.49 $63,002.33 $31,967.69 2025-06-04
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 11 10 — — $30,035.80 $64,028.31 $31,718.80 2025-06-04
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 11 10 — — $29,796.12 $63,614.26 $31,465.69 2025-06-04
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 11 10 — — $29,053.21 $60,240.32 $30,681.14 2025-06-04
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 11 10 — — $27,879.52 $61,894.86 $30,527.55 2025-06-04
335 MS_DRG Peritoneal Adhesiolysis With Mcc 11 10 — — $28,851.76 $59,447.14 $30,468.41 2025-06-04
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 11 10 — — $28,137.64 $57,049.30 $30,143.82 2025-06-04
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 11 10 — — $28,542.81 $60,476.45 $30,142.15 2025-06-04
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 11 10 — — $28,538.03 $60,724.21 $30,137.10 2025-06-04
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 2 — — $30,000.19 $60,825.65 $30,000.19 2025-06-04
265 MS_DRG Aicd Lead Procedures 11 10 — — $28,404.26 $58,767.03 $29,995.83 2025-06-04
332 MS_DRG Rectal Resection With Mcc 11 10 — — $27,619.94 $60,765.78 $29,970.67 2025-06-04
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 11 10 — — $28,276.86 $57,569.77 $29,861.30 2025-06-04
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 11 10 — — $26,251.30 $53,224.73 $29,678.82 2025-06-04
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 11 10 — — $28,033.20 $59,550.23 $29,603.98 2025-06-04
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 11 10 — — $27,899.43 $58,619.03 $29,462.71 2025-06-04
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 11 10 — — $27,693.94 $56,149.69 $29,453.47 2025-06-04
264 MS_DRG Other Circulatory System O.r. Procedures 11 10 — — $26,786.03 $54,308.91 $29,389.56 2025-06-04
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 11 10 — — $27,650.20 $57,508.25 $29,199.52 2025-06-04
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 11 10 — — $27,589.68 $56,633.58 $29,135.61 2025-06-04
271 MS_DRG Other Major Cardiovascular Procedures With Cc 11 10 — — $27,426.45 $57,471.66 $28,963.23 2025-06-04
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 11 10 — — $27,383.45 $56,021.65 $28,917.83 2025-06-04
665 MS_DRG Prostatectomy With Mcc 11 10 — — $25,335.19 $51,455.79 $28,872.42 2025-06-04
252 MS_DRG Other Vascular Procedures With Mcc 11 10 — — $27,314.97 $55,768.90 $28,845.51 2025-06-04
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 11 10 — — $27,273.57 $57,972.18 $28,801.79 2025-06-04
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 11 10 — — $27,122.28 $55,127.04 $28,642.01 2025-06-04
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 11 10 — — $27,009.21 $57,453.37 $28,522.61 2025-06-04
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 11 10 — — $26,728.13 $57,006.06 $28,225.78 2025-06-04
37 MS_DRG Extracranial Procedures With Mcc 11 10 — — $26,443.06 $56,131.40 $27,924.74 2025-06-04
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 11 10 — — $26,291.77 $55,299.97 $27,764.98 2025-06-04
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 11 10 — — $26,027.42 $55,369.81 $27,485.81 2025-06-04
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 11 10 — — $25,953.36 $55,576.01 $27,410.99 2025-06-04
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 11 10 — — $25,732.96 $52,173.80 $27,395.84 2025-06-04
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 11 10 — — $25,634.06 $54,774.51 $27,070.41 2025-06-04
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 11 10 — — $25,515.42 $53,221.40 $26,945.12 2025-06-04
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 11 10 — — $24,346.91 $49,363.57 $26,866.92 2025-06-04
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 11 10 — — $25,392.80 $51,967.61 $26,815.63 2025-06-04
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 11 10 — — $25,324.32 $53,469.17 $26,743.32 2025-06-04
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 11 10 — — $25,273.36 $53,465.84 $26,689.49 2025-06-04
500 MS_DRG Soft Tissue Procedures With Mcc 11 10 — — $25,231.15 $53,923.13 $26,644.93 2025-06-04
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 11 10 — — $24,851.34 $53,889.87 $26,579.36 2025-06-04
662 MS_DRG Minor Bladder Procedures With Mcc 11 10 — — $24,577.38 $49,830.84 $26,232.05 2025-06-04
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 11 10 — — $24,734.29 $52,872.20 $26,120.22 2025-06-04
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 11 10 — — $24,623.61 $52,571.22 $26,003.34 2025-06-04
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 7 7 — — $24,572.65 $46,246.68 $25,949.53 2025-06-04
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 11 10 — — $24,555.13 $52,443.18 $25,931.02 2025-06-04
652 MS_DRG Kidney Transplant 11 10 — — $24,456.39 $49,958.88 $25,826.75 2025-06-04
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 11 10 — — $24,434.10 $51,132.85 $25,803.21 2025-06-04
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 11 10 — — $24,219.79 $49,105.83 $25,719.12 2025-06-04
570 MS_DRG Skin Debridement With Mcc 11 10 — — $23,966.36 $48,592.01 $25,312.14 2025-06-04
974 MS_DRG HIV With Major Related Condition With Mcc 11 10 — — $23,777.98 $48,497.22 $25,110.33 2025-06-04
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 11 10 — — $21,788.91 $50,557.50 $24,935.78 2025-06-04
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 11 10 — — $23,478.58 $49,908.99 $24,794.16 2025-06-04
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 11 10 — — $23,418.07 $49,035.99 $24,730.24 2025-06-04
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 11 10 — — $23,354.36 $48,626.93 $24,662.98 2025-06-04
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 11 10 — — $23,208.65 $49,789.26 $24,556.87 2025-06-04
668 MS_DRG Transurethral Procedures With Mcc 11 10 — — $23,111.77 $46,859.31 $24,522.55 2025-06-04
800 MS_DRG Splenic Procedures With Cc 11 10 — — $23,109.31 $46,854.32 $24,501.53 2025-06-04
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 11 10 — — $23,039.60 $46,712.98 $24,488.08 2025-06-04
472 MS_DRG Cervical Spinal Fusion With Cc 11 10 — — $23,069.30 $49,144.08 $24,361.95 2025-06-04
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 11 10 — — $22,829.63 $48,575.38 $24,108.84 2025-06-04
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 11 10 — — $22,803.35 $47,329.90 $24,081.09 2025-06-04
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 11 10 — — $21,687.17 $43,970.93 $24,066.80 2025-06-04
510 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc 11 10 — — $22,312.95 $45,239.69 $24,033.16 2025-06-04
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A… 11 10 — — $22,667.99 $47,802.15 $23,938.14 2025-06-04
654 MS_DRG Major Bladder Procedures With Cc 11 10 — — $22,451.55 $45,520.71 $23,730.44 2025-06-04
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 11 10 — — $22,362.22 $48,013.33 $23,680.95 2025-06-04
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 11 10 — — $22,214.53 $45,040.14 $23,590.85 2025-06-04
263 MS_DRG Vein Ligation And Stripping 11 10 — — $21,356.54 $46,979.04 $23,170.82 2025-06-04
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 11 10 — — $20,186.04 $46,839.36 $23,101.93 2025-06-04
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 11 10 — — $21,526.15 $46,606.56 $22,987.11 2025-06-04
288 MS_DRG Acute And Subacute Endocarditis With Mcc 11 10 — — $21,266.44 $43,117.88 $22,968.60 2025-06-04
619 MS_DRG O.r. Procedures For Obesity With Mcc 11 10 — — $21,344.35 $43,275.85 $22,926.57 2025-06-04
963 MS_DRG Other Multiple Significant Trauma With Mcc 11 10 — — $21,632.05 $45,467.50 $22,844.16 2025-06-04
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 11 10 — — $21,127.22 $46,220.77 $22,796.83 2025-06-04
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 11 10 — — $21,455.28 $45,568.93 $22,657.48 2025-06-04
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 11 10 — — $21,370.08 $44,960.33 $22,567.51 2025-06-04
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 11 10 — — $20,834.20 $45,685.33 $22,532.75 2025-06-04
849 MS_DRG Radiotherapy 11 10 — — $21,268.95 $44,754.13 $22,460.71 2025-06-04
J9321 HCPCS Epcoritamab-bysp 48 Mg/0.8 Ml Sol (Epkinly) 26 20 $33,265.00 — $54.17 $31,601.75 $22,453.88 2025-06-04
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 11 10 — — $21,202.86 $44,050.74 $22,390.92 2025-06-04
13 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses Without Cc/mcc 11 10 — — $21,100.94 $44,659.35 $22,283.29 2025-06-04
503 MS_DRG Foot Procedures With Mcc 11 10 — — $21,073.87 $44,596.16 $22,254.70 2025-06-04
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 11 10 — — $20,769.43 $42,110.19 $22,232.00 2025-06-04
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 11 10 — — $20,888.34 $44,391.63 $22,058.77 2025-06-04
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 11 10 — — $20,612.04 $41,857.44 $21,766.99 2025-06-04
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 11 10 — — $19,198.67 $44,100.63 $21,751.15 2025-06-04
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 11 10 — — $20,577.80 $43,049.70 $21,730.84 2025-06-04
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 11 10 — — $20,044.42 $40,640.23 $21,474.37 2025-06-04
253 MS_DRG Other Vascular Procedures With Cc 11 10 — — $20,328.57 $42,421.14 $21,467.64 2025-06-04
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 11 10 — — $20,290.35 $41,308.69 $21,427.27 2025-06-04
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 11 10 — — $20,104.82 $43,417.20 $21,414.06 2025-06-04
J9026 HCPCS Tarlatamab-dlle 10 Mg Inj (Imdelltra) 26 20 $31,500.00 — $1,545.00 $29,925.00 $21,262.50 2025-06-04
545 MS_DRG Connective Tissue Disorders With Mcc 11 10 — — $20,120.74 $41,458.35 $21,248.17 2025-06-04
164 MS_DRG Major Chest Procedures With Cc 11 10 — — $20,041.91 $42,409.50 $21,164.92 2025-06-04
56 MS_DRG Degenerative Nervous System Disorders With Mcc 11 10 — — $19,634.34 $39,808.80 $21,056.45 2025-06-04
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 11 10 — — $19,924.07 $40,565.40 $21,040.47 2025-06-04
57894006003 NDC Ustekinumab 45 Mg/0.5 Ml Subcut Inj 22 18 $26,772.00 — $14,992.32 $25,433.40 $20,949.09 2025-06-04
347 MS_DRG Anal And Stomal Procedures With Mcc 11 10 — — $18,845.93 $42,387.89 $20,906.39 2025-06-04
397 MS_DRG Appendix Procedures With Mcc 11 10 — — $18,425.44 $37,357.75 $20,835.30 2025-06-04
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 11 10 — — $19,650.15 $40,455.65 $20,751.21 2025-06-04
792 MS_DRG Prematurity Without Major Problems 11 10 — — $19,506.03 $41,114.14 $20,599.01 2025-06-04
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 11 10 — — $19,494.88 $41,338.63 $20,587.23 2025-06-04
113 MS_DRG Orbital Procedures With Cc/mcc 11 10 — — $17,968.45 $41,692.81 $20,563.57 2025-06-04
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 11 10 — — $19,334.04 $41,528.19 $20,482.38 2025-06-04
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 11 10 — — $19,259.19 $39,908.57 $20,338.34 2025-06-04
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 11 10 — — $19,118.25 $39,936.84 $20,189.50 2025-06-04
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 11 10 — — $18,850.71 $40,916.26 $20,180.56 2025-06-04
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 11 10 — — $19,087.99 $39,645.84 $20,157.55 2025-06-04
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 11 10 — — $17,876.77 $36,245.29 $20,157.55 2025-06-04
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 11 10 — — $18,923.17 $38,541.70 $19,983.49 2025-06-04
330 MS_DRG Major Small And Large Bowel Procedures With Cc 11 10 — — $18,821.24 $39,444.63 $19,875.85 2025-06-04
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 11 10 — — $18,790.99 $38,531.72 $19,843.90 2025-06-04
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 11 10 — — $18,621.38 $39,637.52 $19,664.79 2025-06-04
J2997 HCPCS Alteplase Recombinant 100mg IV Inj 28 20 $30,103.00 — $89.16 $28,597.85 $19,566.95 2025-06-04
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 11 10 — — $18,380.91 $39,612.58 $19,537.57 2025-06-04
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 11 10 — — $18,474.87 $37,884.87 $19,510.07 2025-06-04
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 11 10 — — $18,256.49 $37,015.20 $19,464.66 2025-06-04
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 11 10 — — $18,414.36 $39,090.44 $19,446.17 2025-06-04
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 11 10 — — $17,313.32 $35,102.91 $19,290.60 2025-06-04
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 11 10 — — $17,962.06 $36,418.23 $19,258.65 2025-06-04
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 11 10 — — $17,483.09 $35,447.12 $19,199.79 2025-06-04
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 11 10 — — $18,146.81 $37,454.19 $19,163.63 2025-06-04
35 MS_DRG Carotid Artery Stent Procedures With Cc 11 10 — — $18,113.37 $38,237.40 $19,128.31 2025-06-04
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 11 10 — — $18,043.30 $37,793.41 $19,054.32 2025-06-04
30 MS_DRG Spinal Procedures Without Cc/mcc 11 10 — — $17,720.01 $38,561.65 $19,019.23 2025-06-04
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 11 10 — — $17,981.98 $36,707.57 $18,989.57 2025-06-04
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 11 10 — — $17,981.19 $37,093.35 $18,988.73 2025-06-04
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 11 10 — — $17,938.19 $37,873.23 $18,943.32 2025-06-04
357 MS_DRG Other Digestive System O.r. Procedures With Cc 11 10 — — $17,931.82 $36,529.64 $18,936.59 2025-06-04
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 11 10 — — $17,908.73 $37,627.13 $18,912.21 2025-06-04
709 MS_DRG Penis Procedures With Cc/mcc 11 10 — — $17,803.77 $36,097.30 $18,895.38 2025-06-04
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 11 10 — — $17,775.75 $37,116.63 $18,771.78 2025-06-04
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 11 10 — — $17,623.67 $35,844.55 $18,611.17 2025-06-04
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 11 10 — — $17,512.99 $37,129.93 $18,494.29 2025-06-04
935 MS_DRG Non-extensive Burns 11 10 — — $16,740.04 $33,940.57 $18,469.06 2025-06-04
58468004001 NDC Agalsidase Beta 35 Mg IV Inj 22 18 $23,580.00 — $13,204.80 $22,401.00 $18,451.35 2025-06-04
906 MS_DRG Hand Procedures For Injuries 11 10 — — $15,431.90 $32,706.86 $18,352.18 2025-06-04
835 MS_DRG Acute Leukemia Without Major O.r. Procedures With Cc 11 10 — — $17,007.36 $37,173.17 $18,334.41 2025-06-04
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 11 10 — — $17,349.75 $35,513.64 $18,321.91 2025-06-04
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 11 10 — — $17,273.31 $35,826.25 $18,241.19 2025-06-04
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 11 10 — — $17,177.76 $35,663.29 $18,140.28 2025-06-04
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 11 10 — — $15,828.10 $36,727.52 $18,114.61 2025-06-04
314 MS_DRG Other Circulatory System Diagnoses With Mcc 11 10 — — $17,147.50 $34,811.91 $18,108.32 2025-06-04
141 MS_DRG Major Head And Neck Procedures With Cc 11 10 — — $16,991.01 $34,449.41 $18,066.28 2025-06-04
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 11 10 — — $17,086.19 $34,795.28 $18,043.58 2025-06-04
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 11 10 — — $17,074.25 $34,791.96 $18,030.96 2025-06-04
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 11 10 — — $17,006.56 $35,768.05 $17,959.49 2025-06-04
32 MS_DRG Ventricular Shunt Procedures With Cc 11 10 — — $17,004.97 $35,814.61 $17,957.81 2025-06-04
412 MS_DRG Cholecystectomy With C.d.e. With Cc 11 10 — — $16,945.08 $34,356.29 $17,924.18 2025-06-04
333 MS_DRG Rectal Resection With Cc 11 10 — — $16,922.96 $34,579.11 $17,871.19 2025-06-04
595 MS_DRG Major Skin Disorders With Mcc 11 10 — — $16,841.74 $36,167.14 $17,838.22 2025-06-04
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 11 10 — — $16,471.03 $33,395.16 $17,834.20 2025-06-04
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 11 10 — — $16,743.80 $36,143.86 $17,826.74 2025-06-04
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 11 10 — — $16,812.28 $36,027.46 $17,769.33 2025-06-04
336 MS_DRG Peritoneal Adhesiolysis With Cc 11 10 — — $16,819.44 $35,008.13 $17,761.88 2025-06-04
374 MS_DRG Digestive Malignancy With Mcc 11 10 — — $16,812.28 $34,903.37 $17,754.32 2025-06-04
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 11 10 — — $16,786.00 $35,122.87 $17,726.57 2025-06-04
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 11 10 — — $16,052.76 $32,547.10 $17,629.02 2025-06-04
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 11 10 — — $16,645.86 $35,387.26 $17,578.58 2025-06-04
J9043 HCPCS Cabazitaxel 60 Mg/1.5 Ml Sol 1.5ml 28 20 $26,915.00 — $216.46 $25,569.25 $17,494.75 2025-06-04
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/mcc 11 10 — — $15,433.15 $35,447.12 $17,483.09 2025-06-04
655 MS_DRG Major Bladder Procedures Without Cc/mcc 11 10 — — $16,540.75 $35,049.70 $17,467.58 2025-06-04
J2323 HCPCS Natalizumab 300 Mg/15 Ml IV Conc 28 20 $26,873.00 — $24.15 $25,529.35 $17,467.45 2025-06-04
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 11 10 — — $16,521.64 $34,502.62 $17,447.40 2025-06-04
711 MS_DRG Testes Procedures With Cc/mcc 11 10 — — $15,213.38 $35,300.79 $17,410.92 2025-06-04
592 MS_DRG Skin Ulcers With Mcc 11 10 — — $16,373.54 $34,755.37 $17,290.99 2025-06-04
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 11 10 — — $15,649.73 $35,029.75 $17,277.24 2025-06-04
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 11 10 — — $16,063.42 $32,568.72 $17,216.16 2025-06-04
J3380 HCPCS Vedolizumab 300 Mg Inj 28 20 $26,385.00 — $22.26 $25,065.75 $17,150.25 2025-06-04
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 11 10 — — $16,149.79 $33,285.41 $17,054.71 2025-06-04
539 MS_DRG Osteomyelitis With Mcc 11 10 — — $16,103.60 $32,997.73 $17,005.94 2025-06-04
908 MS_DRG Other O.r. Procedures For Injuries With Cc 11 10 — — $16,061.40 $33,325.32 $16,961.36 2025-06-04
548 MS_DRG Septic Arthritis With Mcc 11 10 — — $15,991.25 $32,422.39 $16,940.35 2025-06-04
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 11 10 — — $15,947.78 $32,334.25 $16,922.68 2025-06-04
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