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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

STORMONT VAIL HOSPITAL

Topeka, KS · CCN 170086 · Rates published

11,738 distinct procedures filed
8 distinct payers
148,698 rate rows
2025-12-19 last MRF observed
Data quality

118,030 of 148,698 rate rows are consumer-grade (79.4%)

30,668 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 30,456
exceeds 10× this hospital's gross charge — excluded from medians 144
placeholder amount (≤ $0.02) — excluded from medians 40
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 28
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.stormontvail.org/wp-content/uploads/480543789_STORMONTVAIL_STANDARDCHARGE_10242022.txt
Found on page https://www.stormontvail.org/patient-resources/cost-of-care/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $298,340.52 $795,419.32 $304,710.56 nat. median
$168,055
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $163,391.75 $623,634.97 $193,889.54 nat. median
$186,516
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $147,907.10 $379,390.28 $165,115.05 nat. median
$131,925
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $116,505.34 $419,538.56 $147,043.74 nat. median
$145,435
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $86,507.40 $260,078.78 $96,235.27 nat. median
$97,418
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $76,734.02 $320,479.93 $92,060.78 nat. median
$2,736
outlier · 33.6×
7
MS_DRG 		Lung Transplant 5 $75,505.40 $230,494.46 $90,025.61 nat. median
$70,649
1.3× median
209
MS_DRG 		Complex Aortic Arch Procedures 5 $78,784.61 $260,180.45 $89,506.55 nat. median
$2,110
outlier · 42.4×
993
MS_DRG 		Birth Weight < 1000 Grams 3 $87,474.84 $88,332.44 $87,474.84 —
62991289303
NDC 		Isopropyl Alcohol 70 % Soln 4 $87,027.17 $117,821.40 $87,027.17 —
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $75,720.46 $248,621.91 $85,989.96 nat. median
$74,509
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 5 $83,601.70 $275,451.89 $84,801.84 nat. median
$72,715
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $66,069.41 $347,969.24 $78,874.18 nat. median
$65,418
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 5 $69,401.25 $377,171.04 $78,737.74 nat. median
$73,023
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $68,200.95 $224,875.07 $77,360.20 nat. median
$69,822
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $62,873.28 $196,726.14 $75,257.76 nat. median
$2,596
outlier · 29.0×
994
MS_DRG 		Birth Weight 1000 - 1499 Grams 3 $73,763.11 $74,486.28 $73,763.11 —
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $46,099.97 $148,684.33 $73,676.38 nat. median
$47,458
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 5 $60,114.78 $254,863.34 $71,837.01 nat. median
$69,922
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $58,696.32 $223,494.59 $70,194.13 nat. median
$59,651
1.2× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $46,099.97 $130,243.74 $70,167.98 nat. median
$45,446
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $60,460.95 $314,074.93 $66,968.63 nat. median
$2,633
outlier · 25.4×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $58,878.91 $185,465.76 $66,661.77 nat. median
$60,505
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $55,012.72 $231,834.56 $63,186.82 nat. median
$56,428
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $53,700.09 $179,606.42 $60,718.29 nat. median
$55,923
1.1× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $50,532.57 $222,422.22 $60,297.42 nat. median
$9,905
outlier · 6.1×
C1874
HCPCS 		Hc Stent-cardiac-des 1 $57,213.96 $60,225.22 $58,719.59 nat. median
$5,596
outlier · 10.5×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 $49,924.84 $179,556.35 $56,385.61 nat. median
$51,518
1.1× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 5 $46,832.42 $115,625.19 $55,811.83 nat. median
$2,958
outlier · 18.9×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 5 $50,216.31 $136,383.47 $55,470.40 nat. median
$37,013
1.5× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 $48,185.01 $149,233.23 $54,388.90 nat. median
$49,569
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 5 $53,472.02 $174,832.86 $53,520.72 nat. median
$55,935
1.0× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 5 $45,131.19 $127,114.46 $53,460.11 nat. median
$47,121
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $30,811.77 $155,641.43 $53,297.69 nat. median
$52,327
1.0× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 $46,866.18 $80,380.74 $52,875.35 nat. median
$2,633
outlier · 20.1×
10
MS_DRG 		Pancreas Transplant 5 $41,837.51 $102,263.26 $50,236.95 nat. median
$23,080
outlier · 2.2×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 5 $41,597.88 $153,152.65 $49,953.78 nat. median
$45,605
1.1× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 5 $43,020.65 $204,307.90 $48,462.02 nat. median
$44,036
1.1× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 5 $43,048.38 $139,669.54 $48,418.58 nat. median
$48,611
1.0× median
28
MS_DRG 		Spinal Procedures With Mcc 5 $42,193.10 $127,582.55 $48,246.92 nat. median
$41,895
1.2× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 5 $40,531.15 $65,835.09 $48,172.95 nat. median
$2,596
outlier · 18.6×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 5 $42,567.25 $137,286.40 $47,941.69 nat. median
$43,803
1.1× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 5 $40,065.35 $121,245.60 $47,608.29 nat. median
$38,795
1.2× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 5 $42,181.40 $160,761.46 $47,498.85 nat. median
$43,533
1.1× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 5 $42,971.73 $119,494.44 $47,339.35 nat. median
$41,943
1.1× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 5 $27,217.83 $134,896.07 $47,173.50 nat. median
$47,340
1.0× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 5 $45,935.29 $92,975.23 $47,154.55 nat. median
$43,299
1.1× median
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $37,538.64 $121,354.90 $47,120.04 nat. median
$38,832
1.2× median
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $39,531.35 $175,119.11 $46,960.92 nat. median
$10,799
outlier · 4.3×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 5 $38,849.20 $121,124.41 $46,133.97 nat. median
$38,844
1.2× median

Other procedures at this hospital

Browse this hospital's 11,738 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 16 5 — — $19,440.30 $66,370.49 $26,211.62 2025-12-19
834 MS_DRG Acute Leukemia With Mcc 16 5 — — $36,383.61 $133,035.61 $38,621.13 2025-12-19
850 MS_DRG Acute Leukemia With Other Procedures 16 5 — — $60,460.95 $314,074.93 $66,968.63 2025-12-19
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 16 5 — — $14,442.00 $39,473.50 $19,185.56 2025-12-19
949 MS_DRG Aftercare With Cc/mcc 16 5 — — $8,990.99 $27,189.87 $25,939.63 2025-12-19
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 16 5 — — $8,552.76 $25,694.74 $18,996.93 2025-12-19
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 16 5 — — $13,643.39 $45,625.11 $25,222.80 2025-12-19
245 MS_DRG Aicd Generator Procedures 16 5 — — $32,230.27 $111,351.67 $36,078.44 2025-12-19
265 MS_DRG Aicd Lead Procedures 16 5 — — $25,724.34 $70,523.85 $28,611.92 2025-12-19
14 MS_DRG Allogeneic Bone Marrow Transplant 16 5 — — $83,601.70 $275,451.89 $84,801.84 2025-12-19
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 16 5 — — $20,434.58 $63,761.57 $22,541.12 2025-12-19
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 16 5 — — $34,706.00 $114,953.78 $38,919.71 2025-12-19
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 16 5 — — $30,373.31 $86,155.93 $35,858.87 2025-12-19
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 16 5 — — $24,823.09 $95,170.72 $27,453.98 2025-12-19
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 16 5 — — $13,680.61 $47,673.27 $17,583.39 2025-12-19
347 MS_DRG Anal And Stomal Procedures With Mcc 16 5 — — $16,611.10 $58,111.30 $19,151.99 2025-12-19
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 5 — — $48,185.01 $149,233.23 $54,388.90 2025-12-19
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 16 5 — — $29,893.04 $92,763.78 $33,396.12 2025-12-19
397 MS_DRG Appendix Procedures With Mcc 16 5 — — $17,295.32 $50,858.68 $19,980.44 2025-12-19
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 16 5 — — $41,651.52 $146,712.20 $41,841.71 2025-12-19
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 16 5 — — $38,224.23 $103,883.71 $38,331.91 2025-12-19
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 16 5 — — $26,545.00 $69,497.39 $31,217.90 2025-12-19
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 16 5 — — $18,565.21 $55,319.45 $29,734.65 2025-12-19
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 16 5 — — $25,043.58 $81,805.36 $31,221.38 2025-12-19
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 16 5 — — $18,565.21 $51,928.80 $28,318.72 2025-12-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 16 5 — — $38,849.20 $121,124.41 $46,133.97 2025-12-19
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 16 5 — — $19,121.95 $76,378.46 $22,219.15 2025-12-19
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 16 5 — — $25,334.29 $86,669.17 $25,361.92 2025-12-19
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 16 5 — — $17,738.36 $52,254.33 $20,541.85 2025-12-19
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 16 5 — — $24,597.08 $74,159.22 $28,856.49 2025-12-19
994 MS_DRG Birth Weight 1000 - 1499 Grams 6 3 — — $73,763.11 $74,486.28 $73,763.11 2025-12-19
995 MS_DRG Birth Weight 1500 - 2000 Grams 6 3 — — $31,099.42 $31,404.32 $31,099.42 2025-12-19
993 MS_DRG Birth Weight < 1000 Grams 6 3 — — $87,474.84 $88,332.44 $87,474.84 2025-12-19
996 MS_DRG Birth Weight > 2000 Grams, W Respiratory Distrees Syndrome 6 3 — — $28,297.45 $28,574.88 $28,297.45 2025-12-19
J0202 HCPCS Campath 30 Mg/ml IV Soln 16 4 $30,996.58 — $8.42 $54,542.58 $20,149.27 2025-12-19
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 5 — — $49,924.84 $179,556.35 $56,385.61 2025-12-19
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 16 5 — — $42,181.40 $160,761.46 $47,498.85 2025-12-19
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 16 5 — — $32,616.82 $131,575.00 $36,047.19 2025-12-19
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 16 5 — — $22,443.81 $67,931.57 $24,847.03 2025-12-19
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 16 5 — — $23,206.59 $88,624.66 $25,722.42 2025-12-19
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 5 — — $68,200.95 $224,875.07 $77,360.20 2025-12-19
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 5 — — $46,099.97 $148,684.33 $73,676.38 2025-12-19
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 5 — — $46,099.97 $130,243.74 $70,167.98 2025-12-19
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 5 — — $53,700.09 $179,606.42 $60,718.29 2025-12-19
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 5 — — $37,538.64 $121,354.90 $47,120.04 2025-12-19
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 5 — — $35,522.51 $107,887.39 $39,856.78 2025-12-19
35 MS_DRG Carotid Artery Stent Procedures With Cc 16 5 — — $17,265.00 $54,763.41 $19,195.82 2025-12-19
34 MS_DRG Carotid Artery Stent Procedures With Mcc 16 5 — — $27,464.18 $87,560.19 $31,081.90 2025-12-19
472 MS_DRG Cervical Spinal Fusion With Cc 16 5 — — $21,093.30 $69,026.92 $23,378.01 2025-12-19
471 MS_DRG Cervical Spinal Fusion With Mcc 16 5 — — $24,546.91 $116,505.35 $34,065.19 2025-12-19
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 16 5 — — $17,615.03 $53,817.76 $22,264.77 2025-12-19
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 16 5 — — $17,937.65 $145,766.54 $33,897.06 2025-12-19
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 16 5 — — $17,181.46 $58,493.84 $18,656.87 2025-12-19
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 5 — — $298,340.52 $795,419.32 $304,710.56 2025-12-19
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 16 5 — — $25,312.98 $83,834.53 $25,341.25 2025-12-19
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 16 5 — — $23,470.60 $85,020.19 $23,554.55 2025-12-19
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 16 5 — — $16,040.58 $51,738.72 $18,540.55 2025-12-19
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 5 — — $62,873.28 $196,726.14 $75,257.76 2025-12-19
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 16 5 — — $40,531.15 $65,835.09 $48,172.95 2025-12-19
209 MS_DRG Complex Aortic Arch Procedures 16 5 — — $78,784.61 $260,180.45 $89,506.55 2025-12-19
380 MS_DRG Complicated Peptic Ulcer With Mcc 16 5 — — $14,313.82 $46,449.60 $19,990.25 2025-12-19
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 16 5 — — $75,720.46 $248,621.91 $85,989.96 2025-12-19
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 16 5 — — $46,866.18 $80,380.74 $52,875.35 2025-12-19
545 MS_DRG Connective Tissue Disorders With Mcc 16 5 — — $17,893.41 $57,997.26 $33,565.03 2025-12-19
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 5 — — $53,472.02 $174,832.86 $53,520.72 2025-12-19
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 16 5 — — $38,433.71 $116,607.53 $44,706.32 2025-12-19
231 MS_DRG Coronary Bypass With Ptca With Mcc 16 5 — — $58,878.91 $185,465.76 $66,661.77 2025-12-19
232 MS_DRG Coronary Bypass With Ptca Without Mcc 16 5 — — $42,567.25 $137,286.40 $47,941.69 2025-12-19
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 5 — — $32,788.99 $138,056.21 $41,230.51 2025-12-19
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 16 5 — — $29,656.01 $90,321.17 $31,227.61 2025-12-19
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 16 5 — — $27,054.02 $106,708.70 $30,611.02 2025-12-19
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 16 5 — — $22,505.15 $78,704.32 $25,765.74 2025-12-19
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 16 5 — — $22,914.44 $43,776.38 $24,538.80 2025-12-19
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 16 5 — — $22,217.14 $71,182.00 $23,202.34 2025-12-19
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 16 5 — — $32,122.10 $102,087.44 $38,807.71 2025-12-19
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 16 5 — — $18,177.27 $54,257.34 $20,259.00 2025-12-19
955 MS_DRG Craniotomy For Multiple Significant Trauma 16 5 — — $27,217.83 $134,896.07 $47,173.50 2025-12-19
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 5 — — $40,277.58 $127,085.92 $43,960.21 2025-12-19
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 5 — — $27,748.05 $90,233.26 $31,412.74 2025-12-19
56 MS_DRG Degenerative Nervous System Disorders With Mcc 16 5 — — $16,800.58 $43,988.01 $28,032.68 2025-12-19
374 MS_DRG Digestive Malignancy With Mcc 16 5 — — $15,530.00 $48,340.94 $21,788.38 2025-12-19
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 5 — — $116,505.34 $419,538.56 $147,043.74 2025-12-19
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 16 5 — — $40,116.35 $125,231.11 $45,128.89 2025-12-19
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 16 5 — — $43,020.65 $204,307.90 $48,462.02 2025-12-19
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 16 5 — — $33,597.34 $155,810.17 $43,104.18 2025-12-19
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 5 — — $147,907.10 $379,390.28 $165,115.05 2025-12-19
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 16 5 — — $27,478.62 $68,157.27 $27,626.11 2025-12-19
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 16 5 — — $17,733.54 $65,142.04 $23,550.99 2025-12-19
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 5 — — $33,121.88 $115,314.96 $37,519.99 2025-12-19
37 MS_DRG Extracranial Procedures With Mcc 16 5 — — $23,477.38 $73,391.75 $26,435.71 2025-12-19
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 10 3 — — $5,022.39 $41,746.61 $41,746.61 2025-12-19
503 MS_DRG Foot Procedures With Mcc 16 5 — — $17,104.05 $53,886.65 $20,025.29 2025-12-19
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 16 5 — — $10,610.93 $32,461.72 $19,270.44 2025-12-19
533 MS_DRG Fractures Of Femur With Mcc 16 5 — — $11,595.57 $34,286.54 $21,203.17 2025-12-19
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 16 5 — — $50,216.31 $136,383.47 $55,470.40 2025-12-19
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 16 5 — — $22,986.09 $58,596.03 $24,908.20 2025-12-19
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 16 5 — — $13,389.14 $41,602.45 $18,623.07 2025-12-19
93653 CPT Hc Ep & Ablate Supravent Arrhyt 16 5 $41,078.00 — $7,685.20 $42,072.81 $22,580.51 2025-12-19
93654 CPT Hc Ep & Ablate Ventric Tachy 16 5 $62,555.63 — $7,685.20 $42,021.46 $22,580.51 2025-12-19
33270 CPT Hc Ins/rep Subq Defibrillator 12 5 $49,942.38 — $21,241.62 $29,510.76 $25,480.31 2025-12-19
33221 CPT Hc Insert Gen Only Exist Mult Lea 16 5 $21,761.07 — $4,984.46 $27,515.71 $17,553.86 2025-12-19
33249 CPT Hc Insert/reposition Any Defib Sy 16 5 $77,564.02 — $28,147.14 $82,906.52 $29,510.76 2025-12-19
0571T CPT Hc Insj/rplcmt Icds Ss Eltrd Evicd 6 3 $70,552.50 — $29,510.76 $29,510.76 $29,510.76 2025-12-19
33229 CPT Hc Remove And Replace Multi Gen 16 5 $45,150.94 — $4,984.46 $27,515.71 $17,553.86 2025-12-19
33263 CPT Hc Remove/replace Dual Lead Defib 16 5 $55,177.15 — $16,733.50 $76,587.46 $20,660.37 2025-12-19
33264 CPT Hc Remove/replace Mult Lead Defib 16 5 $77,872.11 — $16,733.50 $62,670.11 $29,510.76 2025-12-19
33262 CPT Hc Remove/replace Single Lead Def 16 5 $55,177.15 — $16,733.50 $62,670.11 $20,660.37 2025-12-19
C1874 HCPCS Hc Stent-cardiac-des 4 1 $13,224.73 — $57,213.96 $60,225.22 $58,719.59 2025-12-19
33289 CPT Hc Tcat Impl Wrls P-art Prs Snr 12 5 $40,998.92 — $21,398.19 $26,166.57 $23,887.28 2025-12-19
33274 CPT Hc Tcat Insj/rpl Perm Ldls Pm 16 5 $37,950.94 — $11,198.04 $23,838.95 $17,553.86 2025-12-19
93656 CPT Hc Tx Atrial Fib Pulm Vein Isol 16 5 $62,171.16 — $7,685.20 $68,247.97 $22,580.51 2025-12-19
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 16 5 — — $163,391.75 $623,634.97 $193,889.54 2025-12-19
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 5 — — $66,069.41 $347,969.24 $78,874.18 2025-12-19
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 5 — — $24,208.12 $86,985.18 $24,269.78 2025-12-19
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 16 5 — — $20,789.43 $69,243.14 $24,211.13 2025-12-19
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 16 5 — — $15,225.44 $47,022.21 $18,501.17 2025-12-19
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 16 5 — — $20,860.40 $71,258.06 $31,371.53 2025-12-19
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 16 5 — — $20,570.33 $76,411.55 $23,974.96 2025-12-19
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 16 5 — — $15,385.29 $54,603.55 $17,689.28 2025-12-19
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 16 5 — — $42,971.73 $119,494.44 $47,339.35 2025-12-19
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 16 5 — — $18,966.24 $66,223.19 $20,396.45 2025-12-19
974 MS_DRG HIV With Major Related Condition With Mcc 16 5 — — $20,364.47 $63,039.25 $20,679.19 2025-12-19
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 16 5 — — $14,561.19 $56,559.73 $18,698.83 2025-12-19
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 5 — — $34,822.44 $121,972.68 $44,335.75 2025-12-19
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 16 5 — — $17,963.69 $59,358.73 $20,789.70 2025-12-19
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 16 5 — — $14,650.08 $41,167.63 $21,387.38 2025-12-19
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 16 5 — — $37,269.91 $170,004.71 $42,509.46 2025-12-19
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 5 — — $55,012.72 $231,834.56 $63,186.82 2025-12-19
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 16 5 — — $22,687.05 $118,748.37 $25,514.67 2025-12-19
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 16 5 — — $19,791.02 $63,780.59 $27,518.82 2025-12-19
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 16 5 — — $12,901.29 $44,950.30 $17,538.75 2025-12-19
62991289303 NDC Isopropyl Alcohol 70 % Soln 8 4 $133,887.96 — $87,027.17 $117,821.40 $87,027.17 2025-12-19
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 16 5 — — $22,731.15 $82,252.06 $23,672.69 2025-12-19
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 16 5 — — $18,301.31 $82,800.95 $18,892.50 2025-12-19
652 MS_DRG Kidney Transplant 16 5 — — $23,046.05 $74,940.92 $24,012.48 2025-12-19
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 16 5 — — $33,188.03 $103,753.17 $34,956.58 2025-12-19
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 16 5 — — $26,327.94 $84,920.29 $27,553.94 2025-12-19
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 16 5 — — $23,029.51 $76,347.54 $26,956.17 2025-12-19
J1930 HCPCS Lanreotide Acetate 120 Mg/0.5ml Sc Soln 48 8 $31,787.66 — $34.05 $66,979.40 $22,473.50 2025-12-19
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 16 5 — — $15,216.04 $88,189.86 $26,722.08 2025-12-19
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 16 5 — — $60,114.78 $254,863.34 $71,837.01 2025-12-19
6 MS_DRG Liver Transplant Without Mcc 16 5 — — $27,035.76 $114,835.00 $32,744.29 2025-12-19
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 16 5 — — $25,776.02 $71,640.58 $30,285.70 2025-12-19
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 16 5 — — $21,580.45 $53,442.34 $25,199.52 2025-12-19
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 16 5 — — $18,268.24 $48,844.67 $20,670.54 2025-12-19
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 16 5 — — $26,092.29 $75,047.86 $33,440.23 2025-12-19
7 MS_DRG Lung Transplant 16 5 — — $75,505.40 $230,494.46 $90,025.61 2025-12-19
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 5 — — $41,204.33 $140,551.08 $45,355.69 2025-12-19
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 16 5 — — $21,438.89 $74,724.73 $23,083.25 2025-12-19
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 16 5 — — $32,384.61 $105,820.23 $35,456.76 2025-12-19
654 MS_DRG Major Bladder Procedures With Cc 16 5 — — $20,081.79 $71,916.21 $20,813.79 2025-12-19
653 MS_DRG Major Bladder Procedures With Mcc 16 5 — — $36,598.79 $143,647.08 $38,637.08 2025-12-19
164 MS_DRG Major Chest Procedures With Cc 16 5 — — $18,184.87 $61,354.62 $19,519.47 2025-12-19
163 MS_DRG Major Chest Procedures With Mcc 16 5 — — $31,674.90 $118,841.03 $34,660.20 2025-12-19
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 16 5 — — $13,010.85 $42,422.19 $18,063.76 2025-12-19
140 MS_DRG Major Head And Neck Procedures With Mcc 16 5 — — $17,666.57 $84,737.87 $30,183.12 2025-12-19
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 16 5 — — $16,006.81 $53,095.43 $21,577.85 2025-12-19
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 16 5 — — $21,693.46 $78,319.70 $25,336.51 2025-12-19
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 16 5 — — $14,084.39 $45,500.23 $22,982.64 2025-12-19
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 16 5 — — $19,893.00 $45,500.23 $23,153.86 2025-12-19
595 MS_DRG Major Skin Disorders With Mcc 16 5 — — $15,405.97 $43,909.59 $21,913.55 2025-12-19
330 MS_DRG Major Small And Large Bowel Procedures With Cc 16 5 — — $17,311.16 $60,615.67 $18,256.01 2025-12-19
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 5 — — $32,465.22 $120,487.63 $42,703.17 2025-12-19
551 MS_DRG Medical Back Problems With Mcc 16 5 — — $12,342.49 $37,002.39 $22,669.28 2025-12-19
662 MS_DRG Minor Bladder Procedures With Mcc 16 5 — — $21,888.47 $68,661.00 $22,763.34 2025-12-19
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 16 5 — — $18,590.02 $73,726.79 $21,548.08 2025-12-19
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 5 — — $76,734.02 $320,479.93 $92,060.78 2025-12-19
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 5 — — $50,532.57 $222,422.22 $60,297.42 2025-12-19
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 5 — — $39,531.35 $175,119.11 $46,960.92 2025-12-19
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 16 5 — — $46,832.42 $115,625.19 $55,811.83 2025-12-19
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 16 5 — — $30,014.32 $49,143.13 $34,763.43 2025-12-19
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 5 — — $33,025.42 $123,113.18 $36,175.98 2025-12-19
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 5 — — $16,718.58 $54,984.41 $17,873.77 2025-12-19
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 16 5 — — $22,567.17 $78,982.61 $24,438.00 2025-12-19
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 16 5 — — $16,606.27 $43,743.27 $22,905.57 2025-12-19
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 16 5 — — $25,680.24 $74,182.97 $36,049.65 2025-12-19
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 5 — — $24,416.55 $76,326.19 $28,342.86 2025-12-19
619 MS_DRG O.r. Procedures For Obesity With Mcc 16 5 — — $20,688.84 $69,898.92 $22,730.58 2025-12-19
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 16 5 — — $16,895.66 $45,399.39 $18,072.52 2025-12-19
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 16 5 — — $25,795.33 $70,963.42 $28,061.17 2025-12-19
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 16 5 — — $27,424.21 $73,280.08 $29,889.38 2025-12-19
J9266 HCPCS Oncaspar 750 Unit/ml Ij Soln 24 8 $13,420.53 — $8,723.35 $29,276.78 $23,809.64 2025-12-19
113 MS_DRG Orbital Procedures With Cc/mcc 16 5 — — $16,993.51 $47,801.57 $18,182.34 2025-12-19
539 MS_DRG Osteomyelitis With Mcc 16 5 — — $14,365.51 $43,636.35 $26,640.22 2025-12-19
228 MS_DRG Other Cardiothoracic Procedures With Mcc 16 5 — — $34,883.07 $165,164.66 $39,122.94 2025-12-19
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 16 5 — — $22,494.80 $108,322.19 $24,905.54 2025-12-19
70 MS_DRG Other Cerebrovascular Disorders With Mcc 16 5 — — $12,264.64 $38,689.39 $19,451.38 2025-12-19
314 MS_DRG Other Circulatory System Diagnoses With Mcc 16 5 — — $15,161.36 $45,938.73 $24,603.26 2025-12-19
264 MS_DRG Other Circulatory System O.r. Procedures 16 5 — — $23,811.58 $66,719.78 $32,187.50 2025-12-19
357 MS_DRG Other Digestive System O.r. Procedures With Cc 16 5 — — $16,817.12 $49,424.44 $19,401.44 2025-12-19
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 5 — — $31,061.65 $89,311.36 $36,648.75 2025-12-19
91 MS_DRG Other Disorders Of Nervous System With Mcc 16 5 — — $12,894.41 $37,731.84 $19,163.92 2025-12-19
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 16 5 — — $15,518.15 $60,922.37 $26,609.07 2025-12-19
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 16 5 — — $15,806.29 $52,159.27 $18,250.53 2025-12-19
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 16 5 — — $26,472.64 $81,767.36 $29,338.62 2025-12-19
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 16 5 — — $31,544.67 $90,084.18 $35,291.62 2025-12-19
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 16 5 — — $17,366.96 $51,574.27 $19,020.58 2025-12-19
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 16 5 — — $18,485.29 $62,851.53 $18,987.16 2025-12-19
215 MS_DRG Other Heart Assist System Implant 16 5 — — $69,401.25 $377,171.04 $78,737.74 2025-12-19
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 5 — — $29,409.34 $101,338.97 $29,507.89 2025-12-19
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 16 5 — — $15,216.48 $61,939.12 $18,389.67 2025-12-19
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 16 5 — — $16,907.39 $55,001.04 $22,185.23 2025-12-19
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 5 — — $26,677.18 $79,738.20 $29,744.21 2025-12-19
271 MS_DRG Other Major Cardiovascular Procedures With Cc 16 5 — — $25,297.83 $74,670.06 $28,710.73 2025-12-19
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 16 5 — — $37,149.34 $112,504.07 $41,723.81 2025-12-19
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 16 5 — — $18,384.69 $53,480.37 $20,188.56 2025-12-19
963 MS_DRG Other Multiple Significant Trauma With Mcc 16 5 — — $19,290.50 $62,478.50 $19,630.48 2025-12-19
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 16 5 — — $11,429.51 $36,175.51 $20,877.21 2025-12-19
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 16 5 — — $15,112.44 $49,113.14 $17,616.03 2025-12-19
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 16 5 — — $22,752.52 $75,706.04 $26,620.38 2025-12-19
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 5 — — $27,247.80 $90,463.73 $29,691.40 2025-12-19
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 5 — — $17,039.29 $91,632.77 $29,828.96 2025-12-19
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 5 — — $30,811.77 $155,641.43 $53,297.69 2025-12-19
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 16 5 — — $11,904.74 $51,572.37 $21,079.52 2025-12-19
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 16 5 — — $28,245.56 $80,500.90 $30,811.22 2025-12-19
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 16 5 — — $26,547.75 $87,429.51 $28,905.67 2025-12-19
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 16 5 — — $23,108.06 $63,792.46 $23,309.52 2025-12-19
253 MS_DRG Other Vascular Procedures With Cc 16 5 — — $16,914.33 $61,844.11 $18,678.23 2025-12-19
252 MS_DRG Other Vascular Procedures With Mcc 16 5 — — $24,829.29 $78,105.86 $28,325.15 2025-12-19
10 MS_DRG Pancreas Transplant 16 5 — — $41,837.51 $102,263.26 $50,236.95 2025-12-19
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 16 5 — — $20,606.49 $66,707.90 $20,777.04 2025-12-19
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 16 5 — — $38,487.46 $132,793.25 $38,868.98 2025-12-19
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 16 5 — — $12,965.38 $45,382.76 $23,891.94 2025-12-19
709 MS_DRG Penis Procedures With Cc/mcc 16 5 — — $16,828.14 $46,858.29 $17,996.73 2025-12-19
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 16 5 — — $29,219.85 $84,347.75 $32,623.54 2025-12-19
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 16 5 — — $23,474.63 $57,493.52 $25,305.73 2025-12-19
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 16 5 — — $19,540.90 $74,096.22 $24,437.36 2025-12-19
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 16 5 — — $24,486.83 $93,361.23 $27,191.68 2025-12-19
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 16 5 — — $17,429.00 $65,723.34 $19,091.75 2025-12-19
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 16 5 — — $17,483.42 $71,144.61 $19,154.22 2025-12-19
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 16 5 — — $15,943.42 $50,738.38 $17,655.66 2025-12-19
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 16 5 — — $27,398.73 $90,394.85 $31,005.61 2025-12-19
336 MS_DRG Peritoneal Adhesiolysis With Cc 16 5 — — $15,323.29 $55,457.25 $17,592.70 2025-12-19
335 MS_DRG Peritoneal Adhesiolysis With Mcc 16 5 — — $25,398.43 $98,038.61 $29,791.71 2025-12-19
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 16 5 — — $16,783.14 $89,900.62 $22,793.17 2025-12-19
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 16 5 — — $15,549.28 $48,747.27 $19,334.56 2025-12-19
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 16 5 — — $32,135.87 $110,650.76 $41,068.00 2025-12-19
791 MS_DRG Prematurity With Major Problems 10 3 — — $4,048.23 $28,761.65 $28,761.65 2025-12-19
792 MS_DRG Prematurity Without Major Problems 10 3 — — $3,495.79 $17,669.47 $17,669.47 2025-12-19
665 MS_DRG Prostatectomy With Mcc 16 5 — — $22,299.83 $73,971.49 $23,207.23 2025-12-19
849 MS_DRG Radiotherapy 16 5 — — $17,956.87 $39,787.15 $19,463.04 2025-12-19
333 MS_DRG Rectal Resection With Cc 16 5 — — $16,932.19 $57,628.95 $19,540.77 2025-12-19
332 MS_DRG Rectal Resection With Mcc 16 5 — — $25,741.57 $108,277.07 $30,207.18 2025-12-19
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 16 5 — — $17,581.05 $54,780.05 $19,733.14 2025-12-19
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 16 5 — — $45,131.19 $127,114.46 $53,460.11 2025-12-19
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 16 5 — — $15,447.31 $39,494.88 $20,784.28 2025-12-19
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 16 5 — — $25,093.19 $81,679.45 $31,458.78 2025-12-19
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 16 5 — — $36,660.79 $119,739.18 $43,481.04 2025-12-19
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 16 5 — — $19,728.32 $65,372.55 $28,167.02 2025-12-19
548 MS_DRG Septic Arthritis With Mcc 16 5 — — $14,098.16 $44,510.72 $26,115.45 2025-12-19
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 5 — — $43,048.38 $139,669.54 $48,418.58 2025-12-19
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 16 5 — — $21,605.94 $58,023.37 $25,230.43 2025-12-19
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 16 5 — — $9,901.23 $30,071.42 $17,877.37 2025-12-19
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 16 5 — — $32,677.30 $129,110.37 $39,411.45 2025-12-19
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 5 — — $41,597.88 $153,152.65 $49,953.78 2025-12-19
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 16 5 — — $28,496.36 $47,289.66 $33,583.49 2025-12-19
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 16 5 — — $37,516.60 $121,309.51 $44,518.49 2025-12-19
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 16 5 — — $23,052.24 $79,270.77 $26,983.74 2025-12-19
570 MS_DRG Skin Debridement With Mcc 16 5 — — $21,058.85 $58,222.96 $21,168.95 2025-12-19
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 16 5 — — $19,057.89 $53,649.06 $19,078.75 2025-12-19
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 16 5 — — $34,564.75 $127,102.58 $35,277.02 2025-12-19
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 16 5 — — $24,712.84 $67,551.38 $24,985.85 2025-12-19
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 5 — — $45,935.29 $92,975.23 $47,154.55 2025-12-19
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 16 5 — — $25,317.81 $83,729.96 $28,019.22 2025-12-19
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 16 5 — — $26,102.64 $76,366.57 $28,406.08 2025-12-19
592 MS_DRG Skin Ulcers With Mcc 16 5 — — $14,128.47 $33,870.75 $19,997.78 2025-12-19
500 MS_DRG Soft Tissue Procedures With Mcc 16 5 — — $22,600.24 $76,090.95 $26,435.78 2025-12-19
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 16 5 — — $13,274.07 $35,438.93 $18,078.72 2025-12-19
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 5 — — $58,696.32 $223,494.59 $70,194.13 2025-12-19
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 5 — — $41,881.67 $168,084.88 $44,696.70 2025-12-19
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 5 — — $29,544.38 $125,897.90 $35,741.87 2025-12-19
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 16 5 — — $24,300.80 $72,583.89 $27,395.30 2025-12-19
28 MS_DRG Spinal Procedures With Mcc 16 5 — — $42,193.10 $127,582.55 $48,246.92 2025-12-19
30 MS_DRG Spinal Procedures Without Cc/mcc 16 5 — — $15,919.30 $42,726.33 $17,627.56 2025-12-19
800 MS_DRG Splenic Procedures With Cc 16 5 — — $20,151.39 $65,018.52 $21,726.62 2025-12-19
799 MS_DRG Splenic Procedures With Mcc 16 5 — — $31,999.45 $113,026.79 $35,024.45 2025-12-19
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 16 5 — — $17,635.01 $62,725.64 $20,391.75 2025-12-19
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 16 5 — — $35,158.68 $129,381.23 $41,609.44 2025-12-19
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 16 5 — — $11,038.83 $33,965.78 $20,110.35 2025-12-19
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 16 5 — — $21,603.20 $62,093.55 $23,775.24 2025-12-19
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 16 5 — — $24,581.15 $80,897.73 $29,843.44 2025-12-19
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 16 5 — — $31,799.82 $112,865.24 $38,374.44 2025-12-19
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 16 5 — — $16,802.17 $52,049.98 $20,650.25 2025-12-19
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 5 — — $86,507.40 $260,078.78 $96,235.27 2025-12-19
668 MS_DRG Transurethral Procedures With Mcc 16 5 — — $20,913.46 $58,263.36 $21,711.24 2025-12-19
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 16 5 — — $16,447.80 $48,369.46 $22,676.01 2025-12-19
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 16 5 — — $16,542.19 $47,925.12 $22,812.75 2025-12-19
24338015020 NDC Triptodur 22.5 Mg IM Srer 8 4 $55,757.21 — $36,242.19 $49,066.34 $36,242.19 2025-12-19
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 5 — — $39,146.86 $114,621.21 $44,016.27 2025-12-19
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 5 — — $25,643.04 $86,002.59 $28,518.61 2025-12-19
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 16 5 — — $21,302.08 $66,746.26 $23,018.12 2025-12-19
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 16 5 — — $19,379.67 $62,257.51 $21,330.44 2025-12-19
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 16 5 — — $25,480.43 $80,980.87 $26,494.46 2025-12-19
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 16 5 — — $25,423.25 $102,850.16 $26,433.09 2025-12-19
263 MS_DRG Vein Ligation And Stripping 16 5 — — $21,860.21 $49,550.34 $24,177.24 2025-12-19
31 MS_DRG Ventricular Shunt Procedures With Mcc 16 5 — — $31,665.96 $89,895.86 $35,978.62 2025-12-19
75 MS_DRG Viral Meningitis With Cc/mcc 16 5 — — $14,005.84 $40,195.80 $19,138.71 2025-12-19
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 5 — — $40,065.35 $121,245.60 $47,608.29 2025-12-19
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 5 — — $20,642.21 $73,508.16 $22,255.03 2025-12-19
901 MS_DRG Wound Debridements For Injuries With Mcc 16 5 — — $29,709.76 $93,545.47 $32,454.59 2025-12-19
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