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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

MAHASKA HEALTH PARTNERSHIP

Oskaloosa, IA · CCN 161379 · Rates published

3,289 distinct procedures filed
15 distinct payers
63,651 rate rows
2026-09-18 last MRF observed
Data quality

62,017 of 63,651 rate rows are consumer-grade (97.4%)

1,634 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 666
per-diem day rate — not a per-procedure price 665
exceeds 10× this hospital's gross charge — excluded from medians 170
percent-of-charges filed in the dollar field — excluded from medians 108
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 15
exceeds 3× this hospital's gross charge for a DRG stay — excluded 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbMHPOSKALOOSAIA&type=CDMWithoutLabel&fileType=CSV
Found on page https://apps.para-hcfs.com/PTT/FinalLinks/Mahaska_V2.aspx
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-11-11
Content fingerprint d6af67cafd5e6c44… · 28,360,193 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
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 $42,636.11 $54,186.02 $54,186.02 nat. median
$45,252
1.2× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 3 $46,430.94 $46,430.94 $46,430.94 nat. median
$42,580
1.1× median
94
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 $18,032.66 $46,164.90 $46,164.90 nat. median
$33,211
1.4× median
579
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 $36,177.52 $36,177.52 $36,177.52 nat. median
$30,183
1.2× median
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 $34,822.09 $34,822.09 $34,822.09 nat. median
$23,544
1.5× median
522
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 3 $33,520.16 $33,520.16 $33,520.16 nat. median
$20,538
1.6× median
480
MS_DRG 		Hip And Femur Procedures Except Major Joint With Mcc 3 $33,138.20 $33,138.20 $33,138.20 nat. median
$27,769
1.2× median
800
MS_DRG 		Splenic Procedures With Cc 3 $33,034.17 $33,034.17 $33,034.17 nat. median
$26,968
1.2× median
481
MS_DRG 		Hip And Femur Procedures Except Major Joint With Cc 3 $32,276.20 $32,276.20 $32,276.20 nat. median
$20,298
1.6× median
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 3 $31,730.75 $31,730.75 $31,730.75 nat. median
$28,649
1.1× median
465
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 3 $27,579.75 $27,579.75 $27,579.75 nat. median
$17,564
1.6× median
659
MS_DRG 		Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 $27,368.70 $27,368.70 $27,368.70 nat. median
$24,279
1.1× median
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 3 $24,119.47 $26,190.13 $26,190.13 nat. median
$19,186
1.4× median
475
MS_DRG 		Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 3 $25,033.86 $25,033.86 $25,033.86 nat. median
$21,207
1.2× median
397
MS_DRG 		Appendix Procedures With Mcc 3 $24,045.52 $24,045.52 $24,045.52 nat. median
$22,919
1.0× median
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 3 $23,189.46 $23,189.46 $23,189.46 nat. median
$19,146
1.2× median
180
MS_DRG 		Respiratory Neoplasms With Mcc 3 $23,130.01 $23,130.01 $23,130.01 nat. median
$16,994
1.4× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 $21,217.85 $22,997.74 $22,997.74 nat. median
$18,578
1.2× median
494
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 3 $22,966.53 $22,966.53 $22,966.53 nat. median
$18,763
1.2× median
398
MS_DRG 		Appendix Procedures With Cc 3 $21,719.59 $21,719.59 $21,719.59 nat. median
$15,000
1.4× median
418
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Cc 3 $21,686.89 $21,686.89 $21,686.89 nat. median
$16,451
1.3× median
489
MS_DRG 		Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 3 $21,621.50 $21,621.50 $21,621.50 nat. median
$12,125
1.8× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 3 $20,737.81 $21,401.54 $21,401.54 nat. median
$15,332
1.4× median
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 3 $20,669.07 $21,303.45 $21,303.45 nat. median
$17,247
1.2× median
331
MS_DRG 		Major Small And Large Bowel Procedures Without Cc/mcc 3 $20,973.51 $20,973.51 $20,973.51 nat. median
$16,511
1.3× median
552
MS_DRG 		Medical Back Problems Without Mcc 6 $12,668.52 $29,040.84 $20,854.68 nat. median
$9,816
outlier · 2.1×
657
MS_DRG 		Kidney And Ureter Procedures For Neoplasm With Cc 3 $20,842.72 $20,842.72 $20,842.72 nat. median
$18,031
1.2× median
HB-27100153
CDM 		Rhc Misc Implant Charge Level 32 15 $16,400.00 $38,800.00 $20,800.00 nat. median
$20,800
1.0× median
517
MS_DRG 		Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 3 $20,578.17 $20,578.17 $20,578.17 nat. median
$15,168
1.4× median
70
MS_DRG 		Other Cerebrovascular Disorders With Mcc 3 $7,711.00 $20,395.00 $20,395.00 nat. median
$16,280
1.3× median
562
MS_DRG 		Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 3 $10,468.50 $20,246.75 $20,246.75 nat. median
$13,928
1.5× median
682
MS_DRG 		Renal Failure With Mcc 3 $13,935.16 $19,601.73 $19,601.73 nat. median
$14,392
1.4× median
186
MS_DRG 		Pleural Effusion With Mcc 3 $17,691.00 $19,349.07 $19,349.07 nat. median
$15,109
1.3× median
157
MS_DRG 		Dental And Oral Diseases With Mcc 3 $7,091.00 $19,025.08 $19,025.08 nat. median
$16,375
1.2× median
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 6 $12,101.73 $24,785.73 $18,785.83 nat. median
$10,365
1.8× median
337
MS_DRG 		Peritoneal Adhesiolysis Without Cc/mcc 3 $18,518.28 $18,518.28 $18,518.28 nat. median
$15,099
1.2× median
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 4 $7,112.50 $20,327.00 $18,476.25 nat. median
$15,923
1.2× median
175
MS_DRG 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 3 $16,145.00 $17,885.15 $17,885.15 nat. median
$13,701
1.3× median
83
MS_DRG 		Traumatic Stupor And Coma >1 Hour With Cc 3 $7,517.82 $17,816.78 $17,816.78 nat. median
$13,754
1.3× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 3 $6,903.30 $17,671.13 $17,671.13 nat. median
$12,790
1.4× median
71
MS_DRG 		Other Cerebrovascular Disorders With Cc 5 $12,348.52 $25,032.52 $17,483.87 nat. median
$10,520
1.7× median
909
MS_DRG 		Other O.r. Procedures For Injuries Without Cc/mcc 3 $17,291.98 $17,324.84 $17,324.84 nat. median
$13,079
1.3× median
948
MS_DRG 		Signs And Symptoms Without Mcc 6 $9,935.37 $24,484.98 $17,210.17 nat. median
$7,969
outlier · 2.2×
291
MS_DRG 		Heart Failure And Shock With Mcc 3 $16,224.57 $17,061.78 $17,061.78 nat. median
$12,724
1.3× median
637
MS_DRG 		Diabetes With Mcc 3 $11,132.57 $17,011.25 $17,011.25 nat. median
$13,938
1.2× median
645
MS_DRG 		Endocrine Disorders Without Cc/mcc 6 $10,289.50 $22,973.50 $17,009.53 nat. median
$8,131
outlier · 2.1×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 3 $16,886.41 $16,886.41 $16,886.41 nat. median
$12,508
1.4× median
305
MS_DRG 		Hypertension Without Mcc 6 $10,098.85 $23,397.00 $16,747.92 nat. median
$8,032
outlier · 2.1×
723
MS_DRG 		Malignancy, Male Reproductive System With Cc 3 $12,728.52 $16,688.74 $16,688.74 nat. median
$11,433
1.5× median
HB-27100152
CDM 		Rhc Misc Implant Charge Level 31 15 $13,120.00 $31,040.00 $16,640.00 nat. median
$16,640
1.0× median

Other procedures at this hospital

Browse this hospital's 3,289 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
             
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 1 1 $2,651.85 $2,254.08 $2,651.85 $2,651.85 $2,651.85 2026-09-18
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 $5,702.00 $4,846.70 $5,702.00 $5,702.00 $5,702.00 2026-09-18
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 4 4 $7,812.25 $6,640.41 $7,812.25 $17,325.25 $9,233.87 2026-09-18
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 3 3 $28,013.31 $23,811.31 $25,033.86 $25,033.86 $25,033.86 2026-09-18
00792 HCPCS Anesthesia For Partial Removal Of Liver Or Management Of Bleeding Including Use … 4 4 $1,186.00 $1,008.10 $76.98 $1,186.00 $1,186.00 2026-09-18
01474 HCPCS Anesthesia For Repair Of Calf Muscle 4 4 $1,161.00 $986.85 $76.98 $1,161.00 $1,161.00 2026-09-18
398 MS_DRG Appendix Procedures With Cc 3 3 $41,364.66 $35,159.96 $21,719.59 $21,719.59 $21,719.59 2026-09-18
397 MS_DRG Appendix Procedures With Mcc 3 3 $65,936.39 $56,045.93 $24,045.52 $24,045.52 $24,045.52 2026-09-18
S2112 HCPCS Arthroscopy, Knee, Surgical For Harvesting Of Cartilage (chondrocyte Cells) 6 6 $1,635.00 $1,389.75 $76.98 $1,635.00 $1,132.17 2026-09-18
303 MS_DRG Atherosclerosis Without Mcc 3 3 $6,759.50 $5,745.58 $6,759.50 $8,291.61 $8,291.61 2026-09-18
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 $18,032.66 $15,327.76 $18,032.66 $46,164.90 $46,164.90 2026-09-18
38222 HCPCS Biopsy And Aspiration Of Bone Marrow Sample For Diagnosis 30 15 $4,394.50 $3,735.33 $58.88 $8,328.42 $1,158.88 2026-09-18
19084 HCPCS Biopsy Of Breast And Placement Of Locating Device Using Ultrasound, Each Additio… 30 15 $2,650.00 $2,252.50 $61.11 $3,783.00 $1,499.50 2026-09-18
19082 HCPCS Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, Each … 30 15 $2,650.00 $2,252.50 $65.20 $3,783.00 $1,499.50 2026-09-18
19081 HCPCS Biopsy Of Breast And Placement Of Locating Device Using X-ray With Needle, First… 30 15 $2,808.50 $2,387.22 $129.58 $3,993.49 $1,593.99 2026-09-18
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 4 4 $8,845.00 $7,518.25 $8,845.00 $21,529.00 $13,481.48 2026-09-18
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 5 5 $17,706.10 $15,050.19 $9,764.45 $36,732.10 $9,764.45 2026-09-18
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 3 3 $3,829.00 $3,254.65 $3,829.00 $7,129.39 $7,129.39 2026-09-18
C1757 HCPCS Catheter, Thrombectomy/embolectomy 75 15 $2,250.00 $1,912.50 $102.50 $9,457.50 $1,170.00 2026-09-18
603 MS_DRG Cellulitis Without Mcc 3 3 $16,426.02 $13,962.12 $12,059.17 $12,059.17 $12,059.17 2026-09-18
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 3 3 $11,076.00 $9,414.60 $11,076.00 $11,837.73 $11,837.73 2026-09-18
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 3 3 $23,264.93 $19,775.19 $14,811.65 $14,811.65 $14,811.65 2026-09-18
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 3 3 $9,002.06 $7,651.75 $9,002.06 $10,516.48 $10,516.48 2026-09-18
27810 HCPCS Closed Treatment Of 2 Broken Lower Leg Bones At Ankle With Manipulation 30 15 $2,991.00 $2,542.35 $419.30 $4,656.97 $1,574.70 2026-09-18
27818 HCPCS Closed Treatment Of 3 Broken Lower Leg Bones At Ankle With Manipulation 30 15 $2,757.00 $2,343.45 $429.94 $4,174.88 $1,487.32 2026-09-18
24505 HCPCS Closed Treatment Of Broken Middle Part Of Upper Arm Bone With Manipulation 33 15 $1,664.00 $1,414.40 $427.71 $4,656.97 $1,664.00 2026-09-18
25565 HCPCS Closed Treatment Of Broken Midpart Of Both Forearm Bones With Manipulation 30 15 $2,816.50 $2,394.03 $459.89 $4,173.91 $1,547.12 2026-09-18
25605 HCPCS Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist Wit… 46 15 $1,462.00 $1,242.70 $319.80 $4,139.96 $1,156.06 2026-09-18
26645 HCPCS Closed Treatment Of Broken Thumb At Wrist With Manipulation 30 15 $2,949.00 $2,506.65 $354.57 $4,656.97 $1,532.70 2026-09-18
23655 HCPCS Closed Treatment Of Dislocated Shoulder With Manipulation Under Anesthesia 30 15 $2,711.00 $2,304.35 $378.77 $4,139.96 $1,451.94 2026-09-18
32408 HCPCS Core Needle Biopsy Of Lung Or Center Cavity Of Chest (mediastinum), Accessed Thr… 30 15 $2,635.50 $2,240.18 $122.42 $4,715.17 $1,112.63 2026-09-18
HB-50050084 CDM Coronary Care Unit - Intermediate Ccu 9 9 $1,940.00 $1,649.00 $1,007.05 $1,881.80 $1,306.40 2026-09-18
20225 HCPCS Deep Biopsy Of Bone Using Needle Or Trocar 30 15 $2,605.50 $2,214.68 $105.89 $4,714.20 $1,171.80 2026-09-18
59414 HCPCS Delivery Of Placenta 15 15 $3,400.00 $2,890.00 $1,394.00 $3,684.42 $1,768.00 2026-09-18
157 MS_DRG Dental And Oral Diseases With Mcc 3 3 $7,091.00 $6,027.35 $7,091.00 $19,025.08 $19,025.08 2026-09-18
64635 HCPCS Destruction Of Lower Or Sacral Spinal Facet Joint Nerves Using Imaging Guidance,… 49 15 $5,157.00 $4,383.45 $162.49 $10,004.58 $2,114.37 2026-09-18
64625 HCPCS Destruction Of Nerves Supplying Joint Between Spine And Pelvis Using Imaging Gui… 30 15 $2,862.50 $2,433.12 $165.36 $5,002.29 $1,341.18 2026-09-18
64633 HCPCS Destruction Of Upper Or Middle Spinal Facet Joint Nerves Using Imaging Guidance,… 46 15 $5,157.00 $4,383.45 $162.01 $7,137.26 $2,495.93 2026-09-18
638 MS_DRG Diabetes With Cc 5 5 $8,952.28 $7,609.44 $8,952.28 $18,465.28 $11,006.93 2026-09-18
637 MS_DRG Diabetes With Mcc 3 3 $11,132.57 $9,462.68 $11,132.57 $17,011.25 $17,011.25 2026-09-18
375 MS_DRG Digestive Malignancy With Cc 3 3 $38,463.99 $32,694.39 $12,785.93 $12,785.93 $12,785.93 2026-09-18
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 5 5 $6,836.83 $5,811.31 $6,836.83 $16,349.83 $12,481.26 2026-09-18
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 4 4 $7,112.50 $6,045.63 $7,112.50 $20,327.00 $18,476.25 2026-09-18
41008 HCPCS Drainage Of Abscess, Cyst, Or Blood Accumulation Under Jaw Bone From Inside Mout… 30 15 $4,551.50 $3,868.77 $225.11 $8,130.54 $1,810.57 2026-09-18
27603 HCPCS Drainage Of Deep Abscess Or Blood Accumulation Of Leg Or Ankle 30 15 $4,182.50 $3,555.12 $338.41 $7,047.05 $2,039.33 2026-09-18
93229 HCPCS Electrocardiogram (ecg) Up To 30 Days Continuous With Transmission Of Patient Tr… 28 15 $2,711.60 $2,304.86 $165.79 $2,633.55 $1,410.91 2026-09-18
645 MS_DRG Endocrine Disorders Without Cc/mcc 6 6 $10,289.50 $8,746.08 $10,289.50 $22,973.50 $17,009.53 2026-09-18
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 3 3 $100,088.52 $85,075.24 $16,886.41 $16,886.41 $16,886.41 2026-09-18
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 5 5 $8,027.74 $6,823.58 $8,027.74 $17,540.74 $9,727.30 2026-09-18
27365 HCPCS Extensive Removal Of Growth Of Thigh Or Knee Bone 15 15 $5,734.00 $4,873.90 $1,653.95 $5,734.00 $1,703.57 2026-09-18
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 3 3 $10,468.50 $8,898.23 $10,468.50 $20,246.75 $20,246.75 2026-09-18
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 5 5 $9,011.00 $7,659.35 $9,011.00 $18,524.00 $11,613.31 2026-09-18
534 MS_DRG Fractures Of Femur Without Mcc 5 5 $15,467.00 $13,146.95 $8,291.61 $37,664.00 $8,291.61 2026-09-18
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 5 5 $9,125.30 $7,756.51 $9,125.30 $21,809.30 $11,518.19 2026-09-18
A9596 HCPCS Gallium Ga-68 Gozetotide, Diagnostic, (illuccix), 1 Millicurie 15 15 $9,840.00 $8,364.00 $4,034.40 $9,544.80 $5,116.80 2026-09-18
A9587 HCPCS Gallium Ga-68, Dotatate, Diagnostic, 0.1 Millicurie 15 15 $7,800.00 $6,630.00 $3,198.00 $7,566.00 $4,056.00 2026-09-18
HB-40000027 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $4,526.63 $3,847.64 $1,855.92 $4,390.83 $2,353.85 2026-09-18
HB-40000036 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $4,092.92 $3,478.98 $1,678.10 $3,970.13 $2,128.32 2026-09-18
HB-40000040 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $3,901.11 $3,315.94 $1,599.46 $3,784.08 $2,028.58 2026-09-18
HB-40000026 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $3,758.06 $3,194.35 $1,540.80 $3,645.32 $1,954.19 2026-09-18
HB-40000035 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $3,502.12 $2,976.80 $1,435.87 $3,397.06 $1,821.10 2026-09-18
HB-40000039 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $3,340.69 $2,839.59 $1,369.68 $3,240.47 $1,737.16 2026-09-18
HB-40000025 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $3,313.21 $2,816.23 $1,358.42 $3,213.81 $1,722.87 2026-09-18
HB-40000038 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $2,970.74 $2,525.13 $1,218.00 $2,881.62 $1,544.78 2026-09-18
HB-40000034 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $2,969.91 $2,524.42 $1,217.66 $2,880.81 $1,544.35 2026-09-18
HB-40000024 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $2,844.07 $2,417.46 $1,166.07 $2,758.75 $1,478.92 2026-09-18
HB-40000037 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $2,773.92 $2,357.83 $1,137.31 $2,690.70 $1,442.44 2026-09-18
HB-40000033 CDM Gastro - Intestinal (gi) Services - General Classification 15 15 $2,457.36 $2,088.76 $1,007.52 $2,383.64 $1,277.83 2026-09-18
378 MS_DRG Gastrointestinal Hemorrhage With Cc 3 3 $30,980.05 $26,333.04 $15,172.80 $15,172.80 $15,172.80 2026-09-18
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 3 3 $20,669.07 $17,568.71 $20,669.07 $21,303.45 $21,303.45 2026-09-18
389 MS_DRG Gastrointestinal Obstruction With Cc 3 3 $6,112.33 $5,195.48 $6,112.33 $11,895.69 $11,895.69 2026-09-18
388 MS_DRG Gastrointestinal Obstruction With Mcc 3 3 $70,656.15 $60,057.73 $14,875.56 $14,875.56 $14,875.56 2026-09-18
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 3 3 $3,897.10 $3,312.53 $3,897.10 $7,526.21 $7,526.21 2026-09-18
HB-90000671 CDM Hc Full Trauma Respons Wo Cc Fac Lev 4 15 15 $2,673.00 $2,272.05 $1,095.93 $2,592.81 $1,389.96 2026-09-18
HB-27002250 CDM Hc Misc Implant Charge Lvl2 15 15 $3,000.00 $2,550.00 $1,230.00 $2,910.00 $1,560.00 2026-09-18
HB-27002251 CDM Hc Misc Implant Charge Lvl3 15 15 $4,000.00 $3,400.00 $1,640.00 $3,880.00 $2,080.00 2026-09-18
HB-27002252 CDM Hc Misc Implant Charge Lvl4 15 15 $5,000.00 $4,250.00 $2,050.00 $4,850.00 $2,600.00 2026-09-18
HB-27002253 CDM Hc Misc Implant Charge Lvl5 15 15 $4,800.00 $4,080.00 $1,968.00 $4,656.00 $2,496.00 2026-09-18
HB-27002268 CDM Hc Misc Supply Charge Lvl 10 15 15 $5,600.00 $4,760.00 $2,296.00 $5,432.00 $2,912.00 2026-09-18
HB-27002269 CDM Hc Misc Supply Charge Lvl 11 15 15 $6,400.00 $5,440.00 $2,624.00 $6,208.00 $3,328.00 2026-09-18
HB-27002270 CDM Hc Misc Supply Charge Lvl 12 15 15 $7,200.00 $6,120.00 $2,952.00 $6,984.00 $3,744.00 2026-09-18
HB-27002272 CDM Hc Misc Supply Charge Lvl 14 15 15 $8,800.00 $7,480.00 $3,608.00 $8,536.00 $4,576.00 2026-09-18
HB-27002264 CDM Hc Misc Supply Charge Lvl 6 15 15 $3,000.00 $2,550.00 $1,230.00 $2,910.00 $1,560.00 2026-09-18
HB-27002265 CDM Hc Misc Supply Charge Lvl 7 15 15 $4,000.00 $3,400.00 $1,640.00 $3,880.00 $2,080.00 2026-09-18
HB-27002267 CDM Hc Misc Supply Charge Lvl 9 15 15 $4,800.00 $4,080.00 $1,968.00 $4,656.00 $2,496.00 2026-09-18
292 MS_DRG Heart Failure And Shock With Cc 3 3 $17,074.35 $14,513.19 $11,229.86 $11,229.86 $11,229.86 2026-09-18
291 MS_DRG Heart Failure And Shock With Mcc 3 3 $16,224.57 $13,790.88 $16,224.57 $17,061.78 $17,061.78 2026-09-18
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 3 3 $47,717.17 $40,559.60 $32,276.20 $32,276.20 $32,276.20 2026-09-18
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 3 $49,618.06 $42,175.35 $33,138.20 $33,138.20 $33,138.20 2026-09-18
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 3 3 $47,178.29 $40,101.55 $33,520.16 $33,520.16 $33,520.16 2026-09-18
J7327 HCPCS Hyaluronan Or Derivative, Monovisc, For Intra-articular Injection, Per Dose 30 15 $2,998.75 $2,548.94 $1,193.10 $2,994.88 $1,513.20 2026-09-18
304 MS_DRG Hypertension With Mcc 5 5 $16,829.58 $14,305.14 $12,910.78 $35,855.58 $12,910.78 2026-09-18
305 MS_DRG Hypertension Without Mcc 6 6 $10,713.00 $9,106.05 $10,098.85 $23,397.00 $16,747.92 2026-09-18
27412 HCPCS Implantation Of Self Cartilage Into Knee Joint 15 15 $3,835.00 $3,259.75 $1,347.36 $3,835.00 $1,387.78 2026-09-18
41010 HCPCS Incision Of Tissue Connecting Tongue And Floor Of Mouth 15 15 $2,764.00 $2,349.40 $1,133.24 $3,192.44 $1,437.28 2026-09-18
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 3 3 $23,735.51 $20,175.18 $23,189.46 $23,189.46 $23,189.46 2026-09-18
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 $42,636.11 $36,240.69 $42,636.11 $54,186.02 $54,186.02 2026-09-18
47531 HCPCS Injection Of Bile Duct For X-ray Through Already Existing Skin Access Using Imag… 15 15 $6,499.00 $5,524.15 $2,563.22 $6,304.03 $3,379.48 2026-09-18
0707T OTHER Injection Of Bone-substitute Material Into Defect Of Bone Using Imaging Guidance… 18 15 $2,900.00 $2,465.00 $746.43 $2,900.00 $1,508.00 2026-09-18
J1950 HCPCS Injection, Leuprolide Acetate (for Depot Suspension), Per 3.75 Mg 30 15 $2,321.36 $1,973.15 $788.66 $3,522.56 $1,488.92 2026-09-18
J9357 HCPCS Injection, Valrubicin, Intravesical, 200 Mg 15 15 $2,758.89 $2,345.06 $1,131.14 $2,676.12 $1,434.62 2026-09-18
HB-50050130 CDM Intensive Care Unit - General Classification 9 9 $2,720.00 $2,312.00 $1,411.95 $2,638.40 $1,831.65 2026-09-18
HB-50050007 CDM Intensive Care Unit - General Classification 9 9 $2,720.00 $2,312.00 $1,411.95 $2,638.40 $1,831.65 2026-09-18
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 3 3 $13,938.22 $11,847.48 $13,938.22 $14,833.94 $14,833.94 2026-09-18
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 3 3 $24,119.47 $20,501.55 $24,119.47 $26,190.13 $26,190.13 2026-09-18
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 3 3 $14,663.53 $12,464.00 $9,875.92 $9,875.92 $9,875.92 2026-09-18
C1776 HCPCS Joint Device (implantable) 315 15 $9,000.00 $7,650.00 $246.00 $46,560.00 $6,790.00 2026-09-18
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 3 3 $52,134.15 $44,314.03 $20,842.72 $20,842.72 $20,842.72 2026-09-18
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 3 $41,273.38 $35,082.37 $27,368.70 $27,368.70 $27,368.70 2026-09-18
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 5 5 $9,930.58 $8,440.99 $9,930.58 $22,614.58 $15,661.77 2026-09-18
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 5 5 $6,434.63 $5,469.43 $6,434.63 $15,947.63 $11,232.84 2026-09-18
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 3 3 $21,976.41 $18,679.95 $15,645.42 $15,645.42 $15,645.42 2026-09-18
688 MS_DRG Kidney And Urinary Tract Neoplasms Without Cc/mcc 5 5 $5,080.50 $4,318.43 $5,080.50 $11,422.50 $10,764.68 2026-09-18
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 3 3 $34,281.57 $29,139.33 $21,621.50 $21,621.50 $21,621.50 2026-09-18
HB-60060098 CDM Labor Room/delivery - Delivery Room 15 15 $7,393.57 $6,284.53 $3,031.36 $7,171.76 $3,844.66 2026-09-18
HB-60060097 CDM Labor Room/delivery - Delivery Room 15 15 $5,765.28 $4,900.49 $2,363.76 $5,592.32 $2,997.95 2026-09-18
HB-60060096 CDM Labor Room/delivery - Delivery Room 15 15 $4,623.47 $3,929.95 $1,895.62 $4,484.77 $2,404.20 2026-09-18
HB-60060095 CDM Labor Room/delivery - Delivery Room 15 15 $3,217.92 $2,735.23 $1,319.35 $3,121.38 $1,673.32 2026-09-18
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 3 3 $40,888.19 $34,754.96 $21,686.89 $21,686.89 $21,686.89 2026-09-18
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 3 3 $43,344.49 $36,842.81 $16,615.92 $16,615.92 $16,615.92 2026-09-18
55869 HCPCS Laparoscopy, Surgical Prostatectomy, Retropubic Radical, Including Nerve Sparing… 13 13 $4,929.00 $4,189.65 $1,232.15 $4,929.00 $1,232.15 2026-09-18
J9217 HCPCS Leuprolide Acetate (for Depot Suspension), 7.5 Mg 15 15 $4,335.35 $3,685.05 $1,777.49 $4,205.29 $2,254.38 2026-09-18
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 3 $41,958.46 $35,664.69 $34,822.09 $34,822.09 $34,822.09 2026-09-18
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 3 3 $41,098.79 $34,933.97 $22,966.53 $22,966.53 $22,966.53 2026-09-18
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 5 5 $16,518.09 $14,040.38 $14,171.09 $35,544.09 $14,171.09 2026-09-18
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 3 $27,300.83 $23,205.70 $13,922.89 $13,922.89 $13,922.89 2026-09-18
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 $58,275.87 $49,534.49 $46,430.94 $46,430.94 $46,430.94 2026-09-18
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 3 3 $44,910.49 $38,173.92 $20,973.51 $20,973.51 $20,973.51 2026-09-18
723 MS_DRG Malignancy, Male Reproductive System With Cc 3 3 $12,728.52 $10,819.24 $12,728.52 $16,688.74 $16,688.74 2026-09-18
97007 HCPCS Mechanical Scalp Cooling, Including Individual Cap Supply With Head Measurement,… 15 15 $6,200.00 $5,270.00 $2,542.00 $6,014.00 $3,224.00 2026-09-18
552 MS_DRG Medical Back Problems Without Mcc 6 6 $13,185.84 $11,207.96 $12,668.52 $29,040.84 $20,854.68 2026-09-18
760 MS_DRG Menstrual And Other Female Reproductive System Disorders With Cc/mcc 3 3 $9,136.63 $7,766.14 $9,136.63 $10,390.15 $10,390.15 2026-09-18
761 MS_DRG Menstrual And Other Female Reproductive System Disorders Without Cc/mcc 6 6 $4,356.00 $3,702.60 $4,356.00 $10,698.00 $8,713.06 2026-09-18
C1781 HCPCS Mesh (implantable) 165 15 $2,500.00 $2,125.00 $133.25 $15,520.00 $1,300.00 2026-09-18
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 3 3 $6,903.30 $5,867.81 $6,903.30 $17,671.13 $17,671.13 2026-09-18
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 3 3 $10,224.98 $8,691.23 $9,162.53 $9,162.53 $9,162.53 2026-09-18
74182 HCPCS MRI Scan Of Abdomen With Contrast 15 15 $3,200.00 $2,720.00 $988.62 $3,104.00 $1,664.00 2026-09-18
71552 HCPCS MRI Scan Of Chest Before And After Contrast 30 15 $2,999.00 $2,549.15 $99.04 $5,529.00 $1,087.33 2026-09-18
50200 HCPCS Needle Biopsy Of Kidney 30 15 $2,600.50 $2,210.43 $103.29 $4,714.20 $1,166.80 2026-09-18
78452 HCPCS Nuclear Medicine Studies Of Heart Muscle At Rest And With Stress And Spect 30 15 $2,091.00 $1,777.35 $71.60 $3,848.96 $1,240.64 2026-09-18
78812 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh 28 15 $4,472.00 $3,801.20 $82.94 $4,337.84 $1,833.52 2026-09-18
78815 HCPCS Nuclear Medicine Study From Skull Base To Mid-thigh With CT Scan 29 15 $4,920.00 $4,182.00 $104.92 $4,772.40 $2,017.20 2026-09-18
78814 HCPCS Nuclear Medicine Study Limited Area With CT Scan 28 15 $4,770.00 $4,054.50 $94.36 $4,626.90 $1,955.70 2026-09-18
78608 HCPCS Nuclear Medicine Study Of Brain With Metabolic Evaluation 28 15 $4,329.00 $3,679.65 $64.06 $4,199.13 $1,774.89 2026-09-18
78451 HCPCS Nuclear Medicine Study Of Heart Muscle At Rest And With Stress And Spect 30 15 $2,049.00 $1,741.65 $60.73 $3,798.52 $1,113.58 2026-09-18
78813 HCPCS Nuclear Medicine Study Whole Body 28 15 $4,621.00 $3,927.85 $84.97 $4,482.37 $1,894.61 2026-09-18
78816 HCPCS Nuclear Medicine Study Whole Body With CT Scan 29 15 $5,120.00 $4,352.00 $106.62 $4,966.40 $2,099.20 2026-09-18
C1783 HCPCS Ocular Implant, Aqueous Drainage Assist Device 165 15 $3,000.00 $2,550.00 $246.00 $5,820.00 $1,575.00 2026-09-18
HB-10010106 CDM Operating Room Services - General Classification 15 15 $9,249.88 $7,862.40 $3,792.45 $8,972.38 $4,809.94 2026-09-18
HB-10010105 CDM Operating Room Services - General Classification 15 15 $7,807.32 $6,636.22 $3,201.00 $7,573.10 $4,059.81 2026-09-18
HB-10010104 CDM Operating Room Services - General Classification 15 15 $6,328.53 $5,379.25 $2,594.70 $6,138.67 $3,290.84 2026-09-18
HB-50000071 CDM Operating Room Services - General Classification 15 15 $5,733.60 $4,873.56 $2,350.78 $5,561.59 $2,981.47 2026-09-18
HB-10010103 CDM Operating Room Services - General Classification 15 15 $4,941.12 $4,199.95 $2,025.86 $4,792.89 $2,569.38 2026-09-18
HB-10010102 CDM Operating Room Services - General Classification 15 15 $3,465.81 $2,945.94 $1,420.98 $3,361.84 $1,802.22 2026-09-18
HB-50000070 CDM Operating Room Services - General Classification 15 15 $2,866.80 $2,436.78 $1,175.39 $2,780.80 $1,490.74 2026-09-18
71 MS_DRG Other Cerebrovascular Disorders With Cc 5 5 $12,348.52 $10,496.24 $12,348.52 $25,032.52 $17,483.87 2026-09-18
70 MS_DRG Other Cerebrovascular Disorders With Mcc 3 3 $7,711.00 $6,554.35 $7,711.00 $20,395.00 $20,395.00 2026-09-18
72 MS_DRG Other Cerebrovascular Disorders Without Cc/mcc 3 3 $6,441.16 $5,474.99 $6,441.16 $10,008.19 $10,008.19 2026-09-18
394 MS_DRG Other Digestive System Diagnoses With Cc 3 3 $27,363.34 $23,258.84 $12,490.18 $12,490.18 $12,490.18 2026-09-18
951 MS_DRG Other Factors Influencing Health Status 3 3 $4,375.50 $3,719.18 $4,375.50 $6,800.93 $6,800.93 2026-09-18
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 6 6 $6,080.72 $5,168.61 $6,080.72 $14,273.64 $12,422.72 2026-09-18
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 3 3 $27,995.05 $23,795.79 $20,578.17 $20,578.17 $20,578.17 2026-09-18
909 MS_DRG Other O.r. Procedures For Injuries Without Cc/mcc 3 3 $17,291.98 $14,698.18 $17,291.98 $17,324.84 $17,324.84 2026-09-18
29999 HCPCS Other Procedure On Joint Using An Endoscope 7 4 $1,705.00 $1,449.25 $76.98 $3,012.00 $1,705.00 2026-09-18
45499 HCPCS Other Procedure On Rectum Using An Endoscope 4 4 $2,327.00 $1,977.95 $76.98 $2,327.00 $2,327.00 2026-09-18
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 3 $90,660.89 $77,061.76 $36,177.52 $36,177.52 $36,177.52 2026-09-18
44202 HCPCS Partial Removal And Reconnection Of Small Bowel Using An Endoscope 15 15 $4,867.00 $4,136.95 $1,147.42 $3,164.40 $1,181.84 2026-09-18
50543 HCPCS Partial Removal Of Kidney Using An Endoscope 15 15 $5,525.00 $4,696.25 $1,232.66 $5,525.00 $1,269.64 2026-09-18
44145 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum 15 15 $5,803.00 $4,932.55 $1,272.66 $3,720.30 $1,358.96 2026-09-18
44207 HCPCS Partial Removal Of Large Bowel And Reattachment To Rectum Using An Endoscope 15 15 $6,373.00 $5,417.05 $1,438.48 $4,049.20 $1,487.46 2026-09-18
44204 HCPCS Partial Removal Of Large Bowel Using An Endoscope 15 15 $5,398.00 $4,588.30 $1,266.72 $3,469.40 $1,276.72 2026-09-18
44140 HCPCS Partial Removal Of Large Bowel With Connection 15 15 $4,873.00 $4,142.05 $1,023.82 $3,069.30 $1,113.04 2026-09-18
44143 HCPCS Partial Removal Of Large Bowel With Creation Of Opening From Large Bowel To Skin 15 15 $6,002.00 $5,101.70 $1,163.16 $3,758.10 $1,363.40 2026-09-18
44205 HCPCS Partial Removal Of Small And Large Bowel With Attachment Of Small And Large Bowe… 15 15 $4,810.00 $4,088.50 $1,102.76 $3,010.20 $1,131.31 2026-09-18
300 MS_DRG Peripheral Vascular Disorders With Cc 3 3 $22,567.25 $19,182.16 $15,288.72 $15,288.72 $15,288.72 2026-09-18
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 3 3 $29,034.71 $24,679.50 $18,518.28 $18,518.28 $18,518.28 2026-09-18
19281 HCPCS Placement Of Locating Device In Breast Using Imaging Guidance, First Growth 30 15 $2,563.00 $2,178.55 $78.35 $4,714.20 $1,129.30 2026-09-18
186 MS_DRG Pleural Effusion With Mcc 3 3 $17,691.00 $15,037.35 $17,691.00 $19,349.07 $19,349.07 2026-09-18
200 MS_DRG Pneumothorax With Cc 3 3 $15,341.00 $13,039.85 $11,118.40 $11,118.40 $11,118.40 2026-09-18
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 3 3 $18,738.16 $15,927.44 $12,906.32 $12,906.32 $12,906.32 2026-09-18
792 OTHER Pr Anesth Hemorr/excise Liver 4 4 $1,186.00 $1,008.10 $355.80 $1,186.00 $1,186.00 2026-09-18
1474 OTHER Pr Anesth Lower Leg Surgery 4 4 $1,161.00 $986.85 $348.30 $1,161.00 $1,161.00 2026-09-18
23472 HCPCS Prosthetic Repair Of Shoulder Joint, Total Shoulder 15 15 $5,620.00 $4,777.00 $1,175.60 $5,620.00 $1,210.87 2026-09-18
189 MS_DRG Pulmonary Edema And Respiratory Failure 3 3 $19,958.35 $16,964.60 $13,320.97 $13,320.97 $13,320.97 2026-09-18
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 3 3 $16,145.00 $13,723.25 $16,145.00 $17,885.15 $17,885.15 2026-09-18
176 MS_DRG Pulmonary Embolism Without Mcc 5 5 $38,019.00 $32,316.15 $9,941.31 $76,071.00 $9,941.31 2026-09-18
812 MS_DRG Red Blood Cell Disorders Without Mcc 3 3 $8,578.62 $7,291.83 $8,578.62 $11,143.66 $11,143.66 2026-09-18
29828 HCPCS Release Of Tendon Connecting Biceps Muscle And Shoulder Using An Endoscope 18 15 $2,654.00 $2,255.90 $763.78 $3,125.00 $1,319.47 2026-09-18
32551 HCPCS Removal Of Fluid From Between Lung And Chest Cavity 30 15 $2,757.00 $2,343.45 $129.69 $4,746.21 $1,218.13 2026-09-18
10121 HCPCS Removal Of Foreign Body From Tissue, Accessed Beneath The Skin, Complex 30 15 $2,605.50 $2,214.68 $158.09 $4,363.06 $1,278.59 2026-09-18
54161 HCPCS Removal Of Foreskin (older Than 28 Days) 30 15 $2,155.00 $1,831.75 $167.58 $3,717.22 $1,109.82 2026-09-18
47563 HCPCS Removal Of Gallbladder With X-ray Study Of Bile Ducts Using An Endoscope 18 15 $2,099.00 $1,784.15 $607.09 $3,365.00 $1,105.17 2026-09-18
50545 HCPCS Removal Of Kidney And Lymph Nodes Using An Endoscope 15 15 $4,808.00 $4,086.80 $1,099.90 $2,918.25 $1,132.90 2026-09-18
50548 HCPCS Removal Of Kidney And Ureter Using An Endoscope 15 15 $4,975.00 $4,228.75 $1,104.33 $2,933.71 $1,137.46 2026-09-18
60252 HCPCS Removal Of Thyroid And Surrounding Lymph Nodes With Limited Neck Removal 15 15 $4,902.00 $4,166.70 $1,065.58 $4,902.00 $1,097.55 2026-09-18
683 MS_DRG Renal Failure With Cc 3 3 $12,271.83 $10,431.06 $11,075.30 $11,075.30 $11,075.30 2026-09-18
682 MS_DRG Renal Failure With Mcc 3 3 $13,935.16 $11,844.89 $13,935.16 $19,601.73 $19,601.73 2026-09-18
24605 HCPCS Repair Of Dislocated Elbow Under Anesthesia 30 15 $3,036.00 $2,580.60 $433.42 $4,139.96 $1,776.94 2026-09-18
43281 HCPCS Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope 15 15 $5,557.00 $4,723.45 $1,260.63 $5,557.00 $1,298.45 2026-09-18
27447 HCPCS Replacement Of Knee Joint, Both Sides Of Knee 18 15 $3,932.00 $3,342.20 $1,045.50 $5,989.00 $1,810.82 2026-09-18
178 MS_DRG Respiratory Infections And Inflammations With Cc 3 3 $13,708.00 $11,651.80 $12,512.47 $12,512.47 $12,512.47 2026-09-18
177 MS_DRG Respiratory Infections And Inflammations With Mcc 3 3 $20,737.81 $17,627.14 $20,737.81 $21,401.54 $21,401.54 2026-09-18
180 MS_DRG Respiratory Neoplasms With Mcc 3 3 $37,006.08 $31,455.17 $23,130.01 $23,130.01 $23,130.01 2026-09-18
27486 HCPCS Revision Of Component Of Total Knee Joint Prosthesis 15 15 $5,016.00 $4,263.60 $1,149.74 $5,016.00 $1,184.23 2026-09-18
HB-27100034 CDM Rhc Med/surg Supply Level 34 15 15 $2,125.00 $1,806.25 $871.25 $2,061.25 $1,105.00 2026-09-18
HB-27100035 CDM Rhc Med/surg Supply Level 35 15 15 $2,250.00 $1,912.50 $922.50 $2,182.50 $1,170.00 2026-09-18
HB-27100036 CDM Rhc Med/surg Supply Level 36 15 15 $2,500.00 $2,125.00 $1,025.00 $2,425.00 $1,300.00 2026-09-18
HB-27100037 CDM Rhc Med/surg Supply Level 37 15 15 $2,750.00 $2,337.50 $1,127.50 $2,667.50 $1,430.00 2026-09-18
HB-27100038 CDM Rhc Med/surg Supply Level 38 15 15 $3,000.00 $2,550.00 $1,230.00 $2,910.00 $1,560.00 2026-09-18
HB-27100039 CDM Rhc Med/surg Supply Level 39 15 15 $3,250.00 $2,762.50 $1,332.50 $3,152.50 $1,690.00 2026-09-18
HB-27100040 CDM Rhc Med/surg Supply Level 40 15 15 $3,500.00 $2,975.00 $1,435.00 $3,395.00 $1,820.00 2026-09-18
HB-27100041 CDM Rhc Med/surg Supply Level 41 15 15 $3,750.00 $3,187.50 $1,537.50 $3,637.50 $1,950.00 2026-09-18
HB-27100042 CDM Rhc Med/surg Supply Level 42 15 15 $4,000.00 $3,400.00 $1,640.00 $3,880.00 $2,080.00 2026-09-18
HB-27100043 CDM Rhc Med/surg Supply Level 43 15 15 $4,250.00 $3,612.50 $1,742.50 $4,122.50 $2,210.00 2026-09-18
HB-27100044 CDM Rhc Med/surg Supply Level 44 15 15 $4,500.00 $3,825.00 $1,845.00 $4,365.00 $2,340.00 2026-09-18
HB-27100045 CDM Rhc Med/surg Supply Level 45 15 15 $4,750.00 $4,037.50 $1,947.50 $4,607.50 $2,470.00 2026-09-18
HB-27100132 CDM Rhc Med/surg Supply Level 46 15 15 $5,000.00 $4,250.00 $2,050.00 $4,850.00 $2,600.00 2026-09-18
HB-27100133 CDM Rhc Med/surg Supply Level 47 15 15 $4,200.00 $3,570.00 $1,722.00 $4,074.00 $2,184.00 2026-09-18
HB-27100160 CDM Rhc Med/surg Supply Level 48 15 15 $4,400.00 $3,740.00 $1,804.00 $4,268.00 $2,288.00 2026-09-18
HB-27100161 CDM Rhc Med/surg Supply Level 49 15 15 $4,600.00 $3,910.00 $1,886.00 $4,462.00 $2,392.00 2026-09-18
HB-27100162 CDM Rhc Med/surg Supply Level 50 15 15 $4,800.00 $4,080.00 $1,968.00 $4,656.00 $2,496.00 2026-09-18
HB-27100163 CDM Rhc Med/surg Supply Level 51 15 15 $5,000.00 $4,250.00 $2,050.00 $4,850.00 $2,600.00 2026-09-18
HB-27100164 CDM Rhc Med/surg Supply Level 52 15 15 $5,200.00 $4,420.00 $2,132.00 $5,044.00 $2,704.00 2026-09-18
HB-27100165 CDM Rhc Med/surg Supply Level 53 15 15 $5,400.00 $4,590.00 $2,214.00 $5,238.00 $2,808.00 2026-09-18
HB-27100166 CDM Rhc Med/surg Supply Level 54 15 15 $5,600.00 $4,760.00 $2,296.00 $5,432.00 $2,912.00 2026-09-18
HB-27100167 CDM Rhc Med/surg Supply Level 55 15 15 $5,800.00 $4,930.00 $2,378.00 $5,626.00 $3,016.00 2026-09-18
HB-27100168 CDM Rhc Med/surg Supply Level 56 15 15 $6,000.00 $5,100.00 $2,460.00 $5,820.00 $3,120.00 2026-09-18
HB-27100169 CDM Rhc Med/surg Supply Level 57 15 15 $6,000.00 $5,100.00 $2,460.00 $5,820.00 $3,120.00 2026-09-18
HB-27100116 CDM Rhc Misc Implant Charge Level 10 15 15 $5,000.00 $4,250.00 $2,050.00 $4,850.00 $2,600.00 2026-09-18
HB-27100117 CDM Rhc Misc Implant Charge Level 11 15 15 $6,000.00 $5,100.00 $2,460.00 $5,820.00 $3,120.00 2026-09-18
HB-27100118 CDM Rhc Misc Implant Charge Level 12 15 15 $7,000.00 $5,950.00 $2,870.00 $6,790.00 $3,640.00 2026-09-18
HB-27100119 CDM Rhc Misc Implant Charge Level 13 15 15 $8,000.00 $6,800.00 $3,280.00 $7,760.00 $4,160.00 2026-09-18
HB-27100135 CDM Rhc Misc Implant Charge Level 14 15 15 $9,000.00 $7,650.00 $3,690.00 $8,730.00 $4,680.00 2026-09-18
HB-27100136 CDM Rhc Misc Implant Charge Level 15 15 15 $10,000.00 $8,500.00 $4,100.00 $9,700.00 $5,200.00 2026-09-18
HB-27100137 CDM Rhc Misc Implant Charge Level 16 15 15 $11,000.00 $9,350.00 $4,510.00 $10,670.00 $5,720.00 2026-09-18
HB-27100138 CDM Rhc Misc Implant Charge Level 17 15 15 $12,000.00 $10,200.00 $4,920.00 $11,640.00 $6,240.00 2026-09-18
HB-27100139 CDM Rhc Misc Implant Charge Level 18 15 15 $13,000.00 $11,050.00 $5,330.00 $12,610.00 $6,760.00 2026-09-18
HB-27100140 CDM Rhc Misc Implant Charge Level 19 15 15 $14,000.00 $11,900.00 $5,740.00 $13,580.00 $7,280.00 2026-09-18
HB-27100141 CDM Rhc Misc Implant Charge Level 20 15 15 $15,000.00 $12,750.00 $6,150.00 $14,550.00 $7,800.00 2026-09-18
HB-27100142 CDM Rhc Misc Implant Charge Level 21 15 15 $16,000.00 $13,600.00 $6,560.00 $15,520.00 $8,320.00 2026-09-18
HB-27100143 CDM Rhc Misc Implant Charge Level 22 15 15 $17,000.00 $14,450.00 $6,970.00 $16,490.00 $8,840.00 2026-09-18
HB-27100144 CDM Rhc Misc Implant Charge Level 23 15 15 $18,000.00 $15,300.00 $7,380.00 $17,460.00 $9,360.00 2026-09-18
HB-27100145 CDM Rhc Misc Implant Charge Level 24 15 15 $19,000.00 $16,150.00 $7,790.00 $18,430.00 $9,880.00 2026-09-18
HB-27100146 CDM Rhc Misc Implant Charge Level 25 15 15 $20,000.00 $17,000.00 $8,200.00 $19,400.00 $10,400.00 2026-09-18
HB-27100147 CDM Rhc Misc Implant Charge Level 26 15 15 $22,000.00 $18,700.00 $9,020.00 $21,340.00 $11,440.00 2026-09-18
HB-27100148 CDM Rhc Misc Implant Charge Level 27 15 15 $24,000.00 $20,400.00 $9,840.00 $23,280.00 $12,480.00 2026-09-18
HB-27100149 CDM Rhc Misc Implant Charge Level 28 15 15 $26,000.00 $22,100.00 $10,660.00 $25,220.00 $13,520.00 2026-09-18
HB-27100150 CDM Rhc Misc Implant Charge Level 29 15 15 $28,000.00 $23,800.00 $11,480.00 $27,160.00 $14,560.00 2026-09-18
HB-27100151 CDM Rhc Misc Implant Charge Level 30 15 15 $30,000.00 $25,500.00 $12,300.00 $29,100.00 $15,600.00 2026-09-18
HB-27100152 CDM Rhc Misc Implant Charge Level 31 15 15 $32,000.00 $27,200.00 $13,120.00 $31,040.00 $16,640.00 2026-09-18
HB-27100153 CDM Rhc Misc Implant Charge Level 32 15 15 $40,000.00 $34,000.00 $16,400.00 $38,800.00 $20,800.00 2026-09-18
HB-27100113 CDM Rhc Misc Implant Charge Level 7 15 15 $2,500.00 $2,125.00 $1,025.00 $2,425.00 $1,300.00 2026-09-18
HB-27100114 CDM Rhc Misc Implant Charge Level 8 15 15 $3,750.00 $3,187.50 $1,537.50 $3,637.50 $1,950.00 2026-09-18
HB-27100115 CDM Rhc Misc Implant Charge Level 9 15 15 $2,500.00 $2,125.00 $1,025.00 $2,425.00 $1,300.00 2026-09-18
HB-27100079 CDM Rhc Sterile Med/surg Supply Level 34 15 15 $2,125.00 $1,806.25 $871.25 $2,061.25 $1,105.00 2026-09-18
HB-27100080 CDM Rhc Sterile Med/surg Supply Level 35 15 15 $2,250.00 $1,912.50 $922.50 $2,182.50 $1,170.00 2026-09-18
HB-27100081 CDM Rhc Sterile Med/surg Supply Level 36 15 15 $2,500.00 $2,125.00 $1,025.00 $2,425.00 $1,300.00 2026-09-18
HB-27100082 CDM Rhc Sterile Med/surg Supply Level 37 15 15 $2,750.00 $2,337.50 $1,127.50 $2,667.50 $1,430.00 2026-09-18
HB-27100083 CDM Rhc Sterile Med/surg Supply Level 38 15 15 $3,000.00 $2,550.00 $1,230.00 $2,910.00 $1,560.00 2026-09-18
HB-27100084 CDM Rhc Sterile Med/surg Supply Level 39 15 15 $3,250.00 $2,762.50 $1,332.50 $3,152.50 $1,690.00 2026-09-18
HB-27100085 CDM Rhc Sterile Med/surg Supply Level 40 15 15 $3,500.00 $2,975.00 $1,435.00 $3,395.00 $1,820.00 2026-09-18
HB-27100086 CDM Rhc Sterile Med/surg Supply Level 41 15 15 $3,750.00 $3,187.50 $1,537.50 $3,637.50 $1,950.00 2026-09-18
HB-27100087 CDM Rhc Sterile Med/surg Supply Level 42 15 15 $4,000.00 $3,400.00 $1,640.00 $3,880.00 $2,080.00 2026-09-18
HB-27100088 CDM Rhc Sterile Med/surg Supply Level 43 15 15 $4,250.00 $3,612.50 $1,742.50 $4,122.50 $2,210.00 2026-09-18
HB-27100089 CDM Rhc Sterile Med/surg Supply Level 44 15 15 $4,500.00 $3,825.00 $1,845.00 $4,365.00 $2,340.00 2026-09-18
HB-27100090 CDM Rhc Sterile Med/surg Supply Level 45 15 15 $4,750.00 $4,037.50 $1,947.50 $4,607.50 $2,470.00 2026-09-18
HB-27100154 CDM Rhc Sterile Med/surg Supply Level 46 15 15 $5,000.00 $4,250.00 $2,050.00 $4,850.00 $2,600.00 2026-09-18
HB-27100155 CDM Rhc Sterile Med/surg Supply Level 47 15 15 $5,000.00 $4,250.00 $2,050.00 $4,850.00 $2,600.00 2026-09-18
HB-27100156 CDM Rhc Sterile Med/surg Supply Level 48 15 15 $6,000.00 $5,100.00 $2,460.00 $5,820.00 $3,120.00 2026-09-18
HB-27100157 CDM Rhc Sterile Med/surg Supply Level 49 15 15 $7,000.00 $5,950.00 $2,870.00 $6,790.00 $3,640.00 2026-09-18
HB-27100158 CDM Rhc Sterile Med/surg Supply Level 50 15 15 $8,000.00 $6,800.00 $3,280.00 $7,760.00 $4,160.00 2026-09-18
HB-27100159 CDM Rhc Sterile Med/surg Supply Level 51 15 15 $10,000.00 $8,500.00 $4,100.00 $9,700.00 $5,200.00 2026-09-18
HB-50050119 CDM Room & Board - Other - Sterile Environment 9 9 $2,365.00 $2,010.25 $1,227.67 $2,294.05 $1,592.59 2026-09-18
HB-50050102 CDM Room & Board - Private (one Bed) - Other 9 9 $1,683.00 $1,430.55 $873.65 $1,632.51 $1,133.33 2026-09-18
550 MS_DRG Septic Arthritis Without Cc/mcc 3 3 $25,192.59 $21,413.70 $12,353.44 $12,353.44 $12,353.44 2026-09-18
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 3 $21,217.85 $18,035.17 $21,217.85 $22,997.74 $22,997.74 2026-09-18
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 6 6 $12,101.73 $10,286.47 $12,101.73 $24,785.73 $18,785.83 2026-09-18
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 4 4 $14,778.08 $12,561.37 $7,634.70 $30,633.08 $7,634.70 2026-09-18
948 MS_DRG Signs And Symptoms Without Mcc 6 6 $11,800.98 $10,030.83 $9,935.37 $24,484.98 $17,210.17 2026-09-18
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 3 3 $11,948.18 $10,155.96 $11,772.33 $11,772.33 $11,772.33 2026-09-18
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 3 $16,036.21 $13,630.78 $16,036.21 $16,288.95 $16,288.95 2026-09-18
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 5 5 $9,058.16 $7,699.44 $7,853.18 $18,571.16 $7,853.18 2026-09-18
593 MS_DRG Skin Ulcers With Cc 5 5 $9,128.26 $7,759.02 $9,128.26 $21,812.26 $9,690.14 2026-09-18
95810 HCPCS Sleep Study In Sleep Lab (6 Years Or Older) 30 15 $1,760.50 $1,496.42 $114.44 $3,103.29 $1,306.67 2026-09-18
95811 HCPCS Sleep Study In Sleep Lab With Continuous Airway Pressure (6 Years Or Older) 30 15 $1,967.50 $1,672.38 $118.69 $3,480.36 $1,471.08 2026-09-18
800 MS_DRG Splenic Procedures With Cc 3 3 $44,808.76 $38,087.45 $33,034.17 $33,034.17 $33,034.17 2026-09-18
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 3 3 $32,607.07 $27,716.01 $16,092.77 $16,092.77 $16,092.77 2026-09-18
G0416 HCPCS Surgical Pathology, Gross And Microscopic Examinations, For Prostate Needle Biop… 15 15 $3,000.00 $2,550.00 $248.30 $2,910.00 $1,560.00 2026-09-18
312 MS_DRG Syncope And Collapse 4 4 $6,322.50 $5,374.13 $6,322.50 $15,835.50 $10,590.79 2026-09-18
69 MS_DRG Transient Ischemia Without Thrombolytic 3 3 $11,116.33 $9,448.88 $10,743.87 $10,743.87 $10,743.87 2026-09-18
669 MS_DRG Transurethral Procedures With Cc 3 3 $20,142.68 $17,121.28 $15,639.47 $15,639.47 $15,639.47 2026-09-18
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 3 3 $6,425.26 $5,461.47 $6,425.26 $11,121.37 $11,121.37 2026-09-18
86 MS_DRG Traumatic Stupor And Coma <1 Hour With Cc 5 5 $8,853.50 $7,525.48 $8,853.50 $24,708.50 $12,175.10 2026-09-18
83 MS_DRG Traumatic Stupor And Coma >1 Hour With Cc 3 3 $7,517.82 $6,390.15 $7,517.82 $17,816.78 $17,816.78 2026-09-18
59412 HCPCS Turning Of Fetus Through External Manipulation 30 15 $2,699.50 $2,294.58 $81.70 $5,881.95 $1,225.68 2026-09-18
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 3 3 $23,645.99 $20,099.09 $11,693.56 $11,693.56 $11,693.56 2026-09-18
693 MS_DRG Urinary Stones With Mcc 4 4 $4,233.48 $3,598.46 $4,233.48 $10,575.48 $10,575.48 2026-09-18
694 MS_DRG Urinary Stones Without Mcc 3 3 $7,582.00 $6,444.70 $7,582.00 $7,709.01 $7,709.01 2026-09-18
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 $41,277.45 $35,085.83 $31,730.75 $31,730.75 $31,730.75 2026-09-18
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 $48,692.58 $41,388.69 $27,579.75 $27,579.75 $27,579.75 2026-09-18
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