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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

BOB WILSON MEMORIAL HOSPITAL

Ulysses, KS · CCN 171388 · Rates published

9,019 distinct procedures filed
11 distinct payers
283,450 rate rows
2026-02-03 last MRF observed
Data quality

282,690 of 283,450 rate rows are consumer-grade (99.7%)

760 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
per-diem day rate — not a per-procedure price 704
placeholder amount (≤ $0.02) — excluded from medians 32
exceeds 10× this hospital's gross charge — excluded from medians 20
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://csdam.widen.net/content/ugisgfupgt/original/480543721_bob-wilson-memorial-grant-county-hospital_standardcharges.csv
Found on page https://www.mountain.commonspirit.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch success · 2026-08-03
Content fingerprint a29fc2667dab1dbc… · 200,353,468 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $4,156,250.00 $4,156,250.00 $4,156,250.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,800,000.00 $3,800,000.00 $3,800,000.00 nat. median
$3,324,572
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,757,427.68 $2,757,427.68 $2,757,427.68 nat. median
$2,460,273
1.1× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $633,752.65 $633,752.65 $633,752.65 nat. median
$624,417
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $633,752.65 $633,752.65 $633,752.65 nat. median
$610,161
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $633,752.65 $633,752.65 $633,752.65 nat. median
$631,793
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $556,322.26 $556,322.26 $556,322.26 nat. median
$370,165
1.5× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $451,069.50 $451,069.50 $451,069.50 nat. median
$588,565
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $451,069.50 $451,069.50 $451,069.50 nat. median
$577,541
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $396,095.52 $396,095.52 $396,095.52 nat. median
$261,939
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $215,286.74 $215,286.74 $215,286.74 nat. median
$199,832
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $196,759.65 $196,759.65 $196,759.65 nat. median
$108,240
1.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $170,134.38 $170,134.38 $170,134.38 nat. median
$114,305
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $156,554.42 $156,554.42 $156,554.42 nat. median
$205,166
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $150,131.64 $150,131.64 $150,131.64 nat. median
$99,646
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $145,860.78 $145,860.78 $145,860.78 nat. median
$100,978
1.4× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $135,650.80 $135,650.80 $135,650.80 nat. median
$132,706
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 1 $133,382.11 $133,382.11 $133,382.11 nat. median
$98,002
1.4× median
7
MS_DRG 		Lung Transplant 1 $128,988.63 $128,988.63 $128,988.63 nat. median
$122,690
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $113,125.95 $113,125.95 $113,125.95 nat. median
$92,900
1.2× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $107,800.63 $107,800.63 $107,800.63 nat. median
$69,153
1.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $103,533.24 $103,533.24 $103,533.24 nat. median
$83,623
1.2× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 1 $96,910.95 $96,910.95 $96,910.95 nat. median
$55,867
1.7× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $96,907.47 $96,907.47 $96,907.47 nat. median
$80,459
1.2× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $93,696.87 $93,696.87 $93,696.87 nat. median
$79,040
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $93,253.13 $93,253.13 $93,253.13 nat. median
$77,385
1.2× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $91,325.92 $91,325.92 $91,325.92 nat. median
$73,475
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $90,795.55 $90,795.55 $90,795.55 nat. median
$74,472
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $85,965.87 $85,965.87 $85,965.87 nat. median
$68,581
1.3× median
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 1 $80,186.36 $80,186.36 $80,186.36 nat. median
$53,073
1.5× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 $79,963.77 $79,963.77 $79,963.77 nat. median
$60,162
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $78,808.82 $78,808.82 $78,808.82 nat. median
$71,485
1.1× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $78,785.70 $78,785.70 $78,785.70 nat. median
$62,218
1.3× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 $78,464.63 $78,464.63 $78,464.63 nat. median
$65,792
1.2× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 $78,195.25 $78,195.25 $78,195.25 nat. median
$56,397
1.4× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $75,875.19 $75,875.19 $75,875.19 nat. median
$62,767
1.2× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 $75,686.79 $75,686.79 $75,686.79 nat. median
$58,419
1.3× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $74,705.75 $74,705.75 $74,705.75 nat. median
$57,082
1.3× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $74,151.14 $74,151.14 $74,151.14 nat. median
$57,648
1.3× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $73,058.10 $73,058.10 $73,058.10 nat. median
$63,840
1.1× median
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 $72,935.77 $72,935.77 $72,935.77 nat. median
$53,013
1.4× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $72,624.68 $72,624.68 $72,624.68 nat. median
$64,357
1.1× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $72,556.67 $72,556.67 $72,556.67 nat. median
$65,958
1.1× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 1 $72,377.54 $72,377.54 $72,377.54 nat. median
$60,294
1.2× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 1 $72,296.67 $72,296.67 $72,296.67 nat. median
$50,071
1.4× median
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $70,668.45 $70,668.45 $70,668.45 nat. median
$54,267
1.3× median
J9269
HCPCS 		Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 11 $381.83 $102,784.66 $70,326.35 nat. median
$498
outlier · 141.3×
6
MS_DRG 		Liver Transplant Without Mcc 1 $70,293.14 $70,293.14 $70,293.14 nat. median
$46,106
1.5× median
834
MS_DRG 		Acute Leukemia With Mcc 1 $69,700.30 $69,700.30 $69,700.30 nat. median
$52,155
1.3× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 $69,195.82 $69,195.82 $69,195.82 nat. median
$55,446
1.2× median

Other procedures at this hospital

Browse this hospital's 9,019 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
             
J9269 HCPCS Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 42 11 $108,194.38 $43,277.76 60% off $381.83 $102,784.66 $70,326.35 2026-02-03
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 42 11 $97,449.98 $38,980.00 60% off $179.97 $92,577.48 $63,342.49 2026-02-03
A9543 HCPCS Y-90 Zevalin 44 11 $70,810.44 $28,324.18 60% off $22,659.34 $67,269.92 $61,959.14 2026-02-03
33276 CPT Hc Insert Phrenic Nerve Stim Sys With Imaging Gdnce 44 11 $67,856.15 $27,142.46 60% off $1,267.00 $64,463.34 $59,374.13 2026-02-03
33287 CPT Hc Rmvl & Replcmnt Phrenic Nerve Stim Pulse Gen 44 11 $67,856.15 $27,142.46 60% off $1,267.00 $64,463.34 $59,374.13 2026-02-03
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 68 11 $100,210.60 $40,084.24 60% off $4,119.68 $95,200.07 $56,390.78 2026-02-03
J9281 HCPCS Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 42 11 $82,845.00 $33,138.00 60% off $351.55 $78,702.75 $53,849.25 2026-02-03
C2616 HCPCS Yttrium-90 Brachytx Src Non-stranded 42 11 $79,875.00 $31,950.00 60% off $25,560.00 $75,881.25 $51,918.75 2026-02-03
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 42 11 $69,000.33 $27,600.14 60% off $68.68 $65,550.31 $44,850.21 2026-02-03
J7311 HCPCS Fluocinolone 0.59 Mg Intravitreal Implant 42 11 $66,587.50 $26,635.00 60% off $349.57 $63,258.13 $43,281.88 2026-02-03
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 42 11 $65,104.83 $26,041.94 60% off $20,833.55 $61,849.59 $42,318.14 2026-02-03
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 42 11 $60,331.15 $24,132.46 60% off $166.25 $57,314.59 $39,215.25 2026-02-03
J9228 HCPCS Ipilimumab 5 Mg/ml Injection (so) 68 11 $119,454.58 $47,781.84 60% off $201.88 $113,481.85 $38,225.47 2026-02-03
J3241 HCPCS Teprotumumab-trbw 500 Mg Intravenous Solution 42 11 $55,721.05 $22,288.42 60% off $389.73 $52,935.00 $36,218.68 2026-02-03
J9298 HCPCS Nivolumab 240 Mg-relatlimab-rmbw 80 Mg/20 Ml Intravenous Solution 42 11 $50,863.68 $20,345.48 60% off $215.41 $48,320.50 $33,061.39 2026-02-03
A9604 HCPCS Samarium-153 Lexidronam 44 11 $34,492.50 $13,797.00 60% off $287.15 $32,767.88 $30,180.94 2026-02-03
0620T CPT Hc Revasc Venous Tib/per Arterialization 44 11 $29,830.81 $11,932.33 60% off $1,267.00 $28,339.27 $26,101.96 2026-02-03
J9042 HCPCS Brentuximab Vedotin 50 Mg Intravenous Solution 42 11 $39,557.00 $15,822.80 60% off $269.72 $37,579.15 $25,712.05 2026-02-03
619 MS_DRG O.r. Procedures For Obesity With Mcc 4 2 — — $19,294.00 $32,482.49 $25,888.25 2026-02-03
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 1 — — $4,156,250.00 $4,156,250.00 $4,156,250.00 2026-02-03
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $3,800,000.00 $3,800,000.00 $3,800,000.00 2026-02-03
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 1 — — $2,757,427.68 $2,757,427.68 $2,757,427.68 2026-02-03
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 1 — — $633,752.65 $633,752.65 $633,752.65 2026-02-03
Q2055 HCPCS Idecabtagene Vicleucel Car 2 1 — — $633,752.65 $633,752.65 $633,752.65 2026-02-03
Q2056 HCPCS Ciltacabtagene Car-pos T 2 1 — — $633,752.65 $633,752.65 $633,752.65 2026-02-03
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $556,322.26 $556,322.26 $556,322.26 2026-02-03
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 1 — — $451,069.50 $451,069.50 $451,069.50 2026-02-03
Q2053 HCPCS Brexucabtagene Car Pos T 2 1 — — $451,069.50 $451,069.50 $451,069.50 2026-02-03
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $396,095.52 $396,095.52 $396,095.52 2026-02-03
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $215,286.74 $215,286.74 $215,286.74 2026-02-03
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $196,759.65 $196,759.65 $196,759.65 2026-02-03
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $170,134.38 $170,134.38 $170,134.38 2026-02-03
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 1 — — $156,554.42 $156,554.42 $156,554.42 2026-02-03
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $150,131.64 $150,131.64 $150,131.64 2026-02-03
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 1 — — $145,860.78 $145,860.78 $145,860.78 2026-02-03
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $135,650.80 $135,650.80 $135,650.80 2026-02-03
215 MS_DRG Other Heart Assist System Implant 2 1 — — $133,382.11 $133,382.11 $133,382.11 2026-02-03
7 MS_DRG Lung Transplant 2 1 — — $128,988.63 $128,988.63 $128,988.63 2026-02-03
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $113,125.95 $113,125.95 $113,125.95 2026-02-03
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $107,800.63 $107,800.63 $107,800.63 2026-02-03
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $103,533.24 $103,533.24 $103,533.24 2026-02-03
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $96,910.95 $96,910.95 $96,910.95 2026-02-03
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $96,907.47 $96,907.47 $96,907.47 2026-02-03
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $93,696.87 $93,696.87 $93,696.87 2026-02-03
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $93,253.13 $93,253.13 $93,253.13 2026-02-03
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $91,325.92 $91,325.92 $91,325.92 2026-02-03
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $90,795.55 $90,795.55 $90,795.55 2026-02-03
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $85,965.87 $85,965.87 $85,965.87 2026-02-03
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 1 — — $80,186.36 $80,186.36 $80,186.36 2026-02-03
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 1 — — $79,963.77 $79,963.77 $79,963.77 2026-02-03
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $78,808.82 $78,808.82 $78,808.82 2026-02-03
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $78,785.70 $78,785.70 $78,785.70 2026-02-03
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 1 — — $78,464.63 $78,464.63 $78,464.63 2026-02-03
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 1 — — $78,195.25 $78,195.25 $78,195.25 2026-02-03
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $75,875.19 $75,875.19 $75,875.19 2026-02-03
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 1 — — $75,686.79 $75,686.79 $75,686.79 2026-02-03
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $74,705.75 $74,705.75 $74,705.75 2026-02-03
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $74,151.14 $74,151.14 $74,151.14 2026-02-03
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $73,058.10 $73,058.10 $73,058.10 2026-02-03
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 1 — — $72,935.77 $72,935.77 $72,935.77 2026-02-03
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $72,624.68 $72,624.68 $72,624.68 2026-02-03
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $72,556.67 $72,556.67 $72,556.67 2026-02-03
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 1 — — $72,377.54 $72,377.54 $72,377.54 2026-02-03
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $72,296.67 $72,296.67 $72,296.67 2026-02-03
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $70,668.45 $70,668.45 $70,668.45 2026-02-03
6 MS_DRG Liver Transplant Without Mcc 2 1 — — $70,293.14 $70,293.14 $70,293.14 2026-02-03
834 MS_DRG Acute Leukemia With Mcc 2 1 — — $69,700.30 $69,700.30 $69,700.30 2026-02-03
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $69,195.82 $69,195.82 $69,195.82 2026-02-03
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $68,759.72 $68,759.72 $68,759.72 2026-02-03
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 1 — — $68,450.95 $68,450.95 $68,450.95 2026-02-03
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $68,218.19 $68,218.19 $68,218.19 2026-02-03
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $66,203.53 $66,203.53 $66,203.53 2026-02-03
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $65,616.49 $65,616.49 $65,616.49 2026-02-03
90288 CPT Botulism Ig IV 2 1 — — $65,376.15 $65,376.15 $65,376.15 2026-02-03
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $64,821.73 $64,821.73 $64,821.73 2026-02-03
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 1 — — $64,653.06 $64,653.06 $64,653.06 2026-02-03
245 MS_DRG Aicd Generator Procedures 2 1 — — $64,650.52 $64,650.52 $64,650.52 2026-02-03
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 1 — — $64,437.76 $64,437.76 $64,437.76 2026-02-03
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 1 — — $63,915.00 $63,915.00 $63,915.00 2026-02-03
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $63,912.73 $63,912.73 $63,912.73 2026-02-03
10 MS_DRG Pancreas Transplant 2 1 — — $63,611.51 $63,611.51 $63,611.51 2026-02-03
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 1 — — $63,597.96 $63,597.96 $63,597.96 2026-02-03
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 1 — — $62,379.52 $62,379.52 $62,379.52 2026-02-03
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $61,780.37 $61,780.37 $61,780.37 2026-02-03
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $61,600.28 $61,600.28 $61,600.28 2026-02-03
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $61,515.96 $61,515.96 $61,515.96 2026-02-03
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $60,514.22 $60,514.22 $60,514.22 2026-02-03
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $60,404.37 $60,404.37 $60,404.37 2026-02-03
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $60,237.00 $60,237.00 $60,237.00 2026-02-03
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $59,905.72 $59,905.72 $59,905.72 2026-02-03
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $59,671.91 $59,671.91 $59,671.91 2026-02-03
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $58,448.73 $58,448.73 $58,448.73 2026-02-03
799 MS_DRG Splenic Procedures With Mcc 2 1 — — $58,002.50 $58,002.50 $58,002.50 2026-02-03
27125 CPT Partial Hip Replacement 2 1 — — $57,593.14 $57,593.14 $57,593.14 2026-02-03
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $56,563.54 $56,563.54 $56,563.54 2026-02-03
163 MS_DRG Major Chest Procedures With Mcc 2 1 — — $56,418.19 $56,418.19 $56,418.19 2026-02-03
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $56,314.17 $56,314.17 $56,314.17 2026-02-03
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 1 — — $56,065.40 $56,065.40 $56,065.40 2026-02-03
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $55,978.72 $55,978.72 $55,978.72 2026-02-03
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $55,537.00 $55,537.00 $55,537.00 2026-02-03
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 2 1 — — $55,315.24 $55,315.24 $55,315.24 2026-02-03
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 1 — — $55,059.22 $55,059.22 $55,059.22 2026-02-03
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 1 — — $54,792.95 $54,792.95 $54,792.95 2026-02-03
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 1 — — $54,568.60 $54,568.60 $54,568.60 2026-02-03
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33249 CPT Insj/rplcmt Defib W/lead(s) 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33240 CPT Insrt Pulse Gen W/singl Lead 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33214 CPT Upgrade Of Pacemaker System 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33231 CPT Insrt Pulse Gen W/mult Leads 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
33230 CPT Insrt Pulse Gen W/dual Leads 2 1 — — $54,294.63 $54,294.63 $54,294.63 2026-02-03
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 1 — — $54,238.05 $54,238.05 $54,238.05 2026-02-03
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 1 — — $54,185.25 $54,185.25 $54,185.25 2026-02-03
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $54,040.24 $54,040.24 $54,040.24 2026-02-03
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $52,741.28 $52,741.28 $52,741.28 2026-02-03
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 1 — — $52,554.28 $52,554.28 $52,554.28 2026-02-03
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 1 — — $52,387.10 $52,387.10 $52,387.10 2026-02-03
J9226 HCPCS Supprelin La Implant 2 1 — — $52,245.75 $52,245.75 $52,245.75 2026-02-03
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $51,997.62 $51,997.62 $51,997.62 2026-02-03
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $51,984.82 $51,984.82 $51,984.82 2026-02-03
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 1 — — $51,573.98 $51,573.98 $51,573.98 2026-02-03
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 1 — — $50,678.10 $50,678.10 $50,678.10 2026-02-03
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 2 1 — — $49,362.87 $49,362.87 $49,362.87 2026-02-03
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 1 — — $48,623.90 $48,623.90 $48,623.90 2026-02-03
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 1 — — $48,541.63 $48,541.63 $48,541.63 2026-02-03
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $48,401.93 $48,401.93 $48,401.93 2026-02-03
652 MS_DRG Kidney Transplant 2 1 — — $48,178.47 $48,178.47 $48,178.47 2026-02-03
901 MS_DRG Wound Debridements For Injuries With Mcc 2 1 — — $48,101.03 $48,101.03 $48,101.03 2026-02-03
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 1 — — $48,010.89 $48,010.89 $48,010.89 2026-02-03
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 1 — — $47,728.15 $47,728.15 $47,728.15 2026-02-03
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 1 — — $47,391.14 $47,391.14 $47,391.14 2026-02-03
793 MS_DRG Full Term Neonate With Major Problems 2 1 — — $47,066.39 $47,066.39 $47,066.39 2026-02-03
332 MS_DRG Rectal Resection With Mcc 2 1 — — $46,465.10 $46,465.10 $46,465.10 2026-02-03
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 1 — — $46,088.14 $46,088.14 $46,088.14 2026-02-03
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 1 — — $45,939.48 $45,939.48 $45,939.48 2026-02-03
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $45,930.77 $45,930.77 $45,930.77 2026-02-03
140 MS_DRG Major Head And Neck Procedures With Mcc 2 1 — — $45,914.60 $45,914.60 $45,914.60 2026-02-03
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $44,692.36 $44,692.36 $44,692.36 2026-02-03
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 1 — — $44,489.55 $44,489.55 $44,489.55 2026-02-03
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $44,385.87 $44,385.87 $44,385.87 2026-02-03
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $44,098.53 $44,098.53 $44,098.53 2026-02-03
791 MS_DRG Prematurity With Major Problems 2 1 — — $43,651.17 $43,651.17 $43,651.17 2026-02-03
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 1 — — $43,549.77 $43,549.77 $43,549.77 2026-02-03
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 1 — — $43,411.68 $43,411.68 $43,411.68 2026-02-03
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $43,343.70 $43,343.70 $43,343.70 2026-02-03
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 2 1 — — $43,090.01 $43,090.01 $43,090.01 2026-02-03
63655 CPT Implant Neuroelectrodes 2 1 — — $42,506.18 $42,506.18 $42,506.18 2026-02-03
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 2 1 — — $42,373.35 $42,373.35 $42,373.35 2026-02-03
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $42,288.82 $42,288.82 $42,288.82 2026-02-03
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 1 — — $42,065.07 $42,065.07 $42,065.07 2026-02-03
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 1 — — $41,996.99 $41,996.99 $41,996.99 2026-02-03
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 1 — — $41,957.55 $41,957.55 $41,957.55 2026-02-03
64568 CPT Opn Impltj Crnl Nrv Nea&pg 2 1 — — $41,949.67 $41,949.67 $41,949.67 2026-02-03
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $41,704.13 $41,704.13 $41,704.13 2026-02-03
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 2 1 — — $41,642.77 $41,642.77 $41,642.77 2026-02-03
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 1 — — $41,460.62 $41,460.62 $41,460.62 2026-02-03
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $41,441.08 $41,441.08 $41,441.08 2026-02-03
31 MS_DRG Ventricular Shunt Procedures With Mcc 2 1 — — $41,376.74 $41,376.74 $41,376.74 2026-02-03
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 1 — — $41,354.29 $41,354.29 $41,354.29 2026-02-03
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 1 — — $41,197.65 $41,197.65 $41,197.65 2026-02-03
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 1 — — $41,038.06 $41,038.06 $41,038.06 2026-02-03
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $40,992.97 $40,992.97 $40,992.97 2026-02-03
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 1 — — $40,924.28 $40,924.28 $40,924.28 2026-02-03
33224 CPT Insert Pacing Lead & Connect 2 1 — — $40,782.65 $40,782.65 $40,782.65 2026-02-03
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $40,733.82 $40,733.82 $40,733.82 2026-02-03
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 1 — — $40,418.30 $40,418.30 $40,418.30 2026-02-03
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 1 — — $40,201.88 $40,201.88 $40,201.88 2026-02-03
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 1 — — $40,197.45 $40,197.45 $40,197.45 2026-02-03
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 1 — — $40,176.04 $40,176.04 $40,176.04 2026-02-03
252 MS_DRG Other Vascular Procedures With Mcc 2 1 — — $39,664.20 $39,664.20 $39,664.20 2026-02-03
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 1 — — $39,625.02 $39,625.02 $39,625.02 2026-02-03
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 1 — — $39,362.97 $39,362.97 $39,362.97 2026-02-03
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 1 — — $39,101.02 $39,101.02 $39,101.02 2026-02-03
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 1 — — $39,081.88 $39,081.88 $39,081.88 2026-02-03
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 1 — — $38,459.91 $38,459.91 $38,459.91 2026-02-03
93654 CPT Compre Ep Eval Tx Vt 2 1 — — $38,448.26 $38,448.26 $38,448.26 2026-02-03
93656 CPT Compre Ep Eval Abltj Atr Fib 2 1 — — $38,448.26 $38,448.26 $38,448.26 2026-02-03
93653 CPT Compre Ep Eval Tx Svt 2 1 — — $38,448.26 $38,448.26 $38,448.26 2026-02-03
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 1 — — $38,420.42 $38,420.42 $38,420.42 2026-02-03
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 1 — — $38,026.06 $38,026.06 $38,026.06 2026-02-03
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 1 — — $37,890.79 $37,890.79 $37,890.79 2026-02-03
265 MS_DRG Aicd Lead Procedures 2 1 — — $37,330.52 $37,330.52 $37,330.52 2026-02-03
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $37,325.62 $37,325.62 $37,325.62 2026-02-03
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 1 — — $37,149.38 $37,149.38 $37,149.38 2026-02-03
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 1 — — $37,082.55 $37,082.55 $37,082.55 2026-02-03
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 1 — — $37,034.43 $37,034.43 $37,034.43 2026-02-03
37 MS_DRG Extracranial Procedures With Mcc 2 1 — — $36,933.02 $36,933.02 $36,933.02 2026-02-03
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $36,913.85 $36,913.85 $36,913.85 2026-02-03
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 1 — — $36,904.31 $36,904.31 $36,904.31 2026-02-03
264 MS_DRG Other Circulatory System O.r. Procedures 2 1 — — $36,662.58 $36,662.58 $36,662.58 2026-02-03
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 1 — — $36,496.03 $36,496.03 $36,496.03 2026-02-03
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $36,338.07 $36,338.07 $36,338.07 2026-02-03
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 1 — — $36,328.45 $36,328.45 $36,328.45 2026-02-03
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 1 — — $36,324.34 $36,324.34 $36,324.34 2026-02-03
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $36,289.59 $36,289.59 $36,289.59 2026-02-03
500 MS_DRG Soft Tissue Procedures With Mcc 2 1 — — $35,940.27 $35,940.27 $35,940.27 2026-02-03
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 1 — — $35,811.72 $35,811.72 $35,811.72 2026-02-03
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 2 1 — — $35,810.08 $35,810.08 $35,810.08 2026-02-03
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 1 — — $35,445.42 $35,445.42 $35,445.42 2026-02-03
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 1 — — $35,437.71 $35,437.71 $35,437.71 2026-02-03
27702 CPT Reconstruct Ankle Joint 2 1 — — $35,351.14 $35,351.14 $35,351.14 2026-02-03
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 1 — — $34,617.68 $34,617.68 $34,617.68 2026-02-03
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 1 — — $34,503.55 $34,503.55 $34,503.55 2026-02-03
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $34,410.03 $34,410.03 $34,410.03 2026-02-03
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 1 — — $34,287.56 $34,287.56 $34,287.56 2026-02-03
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 1 — — $34,085.50 $34,085.50 $34,085.50 2026-02-03
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $33,871.18 $33,871.18 $33,871.18 2026-02-03
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 1 — — $33,459.40 $33,459.40 $33,459.40 2026-02-03
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 1 — — $33,439.05 $33,439.05 $33,439.05 2026-02-03
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 2 1 — — $33,351.68 $33,351.68 $33,351.68 2026-02-03
164 MS_DRG Major Chest Procedures With Cc 2 1 — — $33,198.69 $33,198.69 $33,198.69 2026-02-03
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 2 1 — — $33,109.88 $33,109.88 $33,109.88 2026-02-03
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 1 — — $33,005.90 $33,005.90 $33,005.90 2026-02-03
974 MS_DRG HIV With Major Related Condition With Mcc 2 1 — — $32,851.52 $32,851.52 $32,851.52 2026-02-03
654 MS_DRG Major Bladder Procedures With Cc 2 1 — — $32,709.66 $32,709.66 $32,709.66 2026-02-03
330 MS_DRG Major Small And Large Bowel Procedures With Cc 2 1 — — $32,595.26 $32,595.26 $32,595.26 2026-02-03
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 2 1 — — $32,546.74 $32,546.74 $32,546.74 2026-02-03
L5856 HCPCS Elec Knee-shin Swing/stance 2 1 — — $32,382.06 $32,382.06 $32,382.06 2026-02-03
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 2 1 — — $32,087.70 $32,087.70 $32,087.70 2026-02-03
570 MS_DRG Skin Debridement With Mcc 2 1 — — $32,021.15 $32,021.15 $32,021.15 2026-02-03
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 2 1 — — $31,852.05 $31,852.05 $31,852.05 2026-02-03
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 1 — — $31,758.61 $31,758.61 $31,758.61 2026-02-03
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $31,549.34 $31,549.34 $31,549.34 2026-02-03
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 1 — — $31,458.89 $31,458.89 $31,458.89 2026-02-03
665 MS_DRG Prostatectomy With Mcc 2 1 — — $31,193.66 $31,193.66 $31,193.66 2026-02-03
800 MS_DRG Splenic Procedures With Cc 2 1 — — $31,145.66 $31,145.66 $31,145.66 2026-02-03
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $30,886.20 $30,886.20 $30,886.20 2026-02-03
C7534 HCPCS Fem/pop Revasc W/arthr & US 2 1 — — $30,731.23 $30,731.23 $30,731.23 2026-02-03
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 2 1 — — $30,692.62 $30,692.62 $30,692.62 2026-02-03
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 2 1 — — $30,643.02 $30,643.02 $30,643.02 2026-02-03
61889 CPT Ins Sk-mnt Crnl Nstm Pg/rcvr 2 1 — — $30,643.02 $30,643.02 $30,643.02 2026-02-03
61885 CPT Insrt/redo Neurostim 1 Array 2 1 — — $30,643.02 $30,643.02 $30,643.02 2026-02-03
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 2 1 — — $30,643.02 $30,643.02 $30,643.02 2026-02-03
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 2 1 — — $30,579.95 $30,579.95 $30,579.95 2026-02-03
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 2 1 — — $30,520.29 $30,520.29 $30,520.29 2026-02-03
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 1 — — $30,292.60 $30,292.60 $30,292.60 2026-02-03
288 MS_DRG Acute And Subacute Endocarditis With Mcc 2 1 — — $30,259.91 $30,259.91 $30,259.91 2026-02-03
33229 CPT Remv&replc Pm Gen Mult Leads 2 1 — — $30,188.62 $30,188.62 $30,188.62 2026-02-03
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 2 1 — — $30,119.06 $30,119.06 $30,119.06 2026-02-03
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 1 — — $30,069.10 $30,069.10 $30,069.10 2026-02-03
662 MS_DRG Minor Bladder Procedures With Mcc 2 1 — — $29,957.83 $29,957.83 $29,957.83 2026-02-03
C9606 HCPCS Perc D-e Cor Revasc W Ami S 2 1 — — $29,569.17 $29,569.17 $29,569.17 2026-02-03
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 2 1 — — $29,212.08 $29,212.08 $29,212.08 2026-02-03
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 2 1 — — $28,883.49 $28,883.49 $28,883.49 2026-02-03
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 1 — — $28,751.52 $28,751.52 $28,751.52 2026-02-03
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 1 — — $28,610.24 $28,610.24 $28,610.24 2026-02-03
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 1 — — $28,583.19 $28,583.19 $28,583.19 2026-02-03
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 2 1 — — $28,568.52 $28,568.52 $28,568.52 2026-02-03
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 2 1 — — $28,331.92 $28,331.92 $28,331.92 2026-02-03
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 2 1 — — $28,291.26 $28,291.26 $28,291.26 2026-02-03
22856 CPT Tot Disc Arthrp 1ntrspc Crv 2 1 — — $28,285.36 $28,285.36 $28,285.36 2026-02-03
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 2 1 — — $28,253.04 $28,253.04 $28,253.04 2026-02-03
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 2 1 — — $27,926.67 $27,926.67 $27,926.67 2026-02-03
37227 CPT Fee Schedule #987 2 1 — — $27,730.06 $27,730.06 $27,730.06 2026-02-03
37230 CPT Fee Schedule #987 2 1 — — $27,730.06 $27,730.06 $27,730.06 2026-02-03
37229 CPT Fee Schedule #987 2 1 — — $27,730.06 $27,730.06 $27,730.06 2026-02-03
37231 CPT Fee Schedule #987 2 1 — — $27,730.06 $27,730.06 $27,730.06 2026-02-03
835 MS_DRG Acute Leukemia With Cc 2 1 — — $27,464.59 $27,464.59 $27,464.59 2026-02-03
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 2 1 — — $27,393.18 $27,393.18 $27,393.18 2026-02-03
C9604 HCPCS Perc D-e Cor Revasc T Cabg S 2 1 — — $27,390.81 $27,390.81 $27,390.81 2026-02-03
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 2 1 — — $27,317.74 $27,317.74 $27,317.74 2026-02-03
53447 CPT Remove/replace Ur Sphincter 2 1 — — $27,191.17 $27,191.17 $27,191.17 2026-02-03
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 1 — — $27,125.64 $27,125.64 $27,125.64 2026-02-03
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 1 — — $27,076.67 $27,076.67 $27,076.67 2026-02-03
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 1 — — $26,947.21 $26,947.21 $26,947.21 2026-02-03
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 2 1 — — $26,854.64 $26,854.64 $26,854.64 2026-02-03
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 2 1 — — $26,575.19 $26,575.19 $26,575.19 2026-02-03
30 MS_DRG Spinal Procedures Without Cc/mcc 2 1 — — $26,557.15 $26,557.15 $26,557.15 2026-02-03
165 MS_DRG Major Chest Procedures Without Cc/mcc 2 1 — — $26,552.45 $26,552.45 $26,552.45 2026-02-03
J9600 HCPCS Porfimer Sodium Injection 2 1 — — $26,497.31 $26,497.31 $26,497.31 2026-02-03
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $26,484.57 $26,484.57 $26,484.57 2026-02-03
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 2 1 — — $26,477.15 $26,477.15 $26,477.15 2026-02-03
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 1 — — $26,476.49 $26,476.49 $26,476.49 2026-02-03
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 2 1 — — $26,427.58 $26,427.58 $26,427.58 2026-02-03
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $26,396.55 $26,396.55 $26,396.55 2026-02-03
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 2 1 — — $26,385.99 $26,385.99 $26,385.99 2026-02-03
53444 CPT Insert Tandem Cuff 2 1 — — $26,371.36 $26,371.36 $26,371.36 2026-02-03
792 MS_DRG Prematurity Without Major Problems 2 1 — — $26,338.53 $26,338.53 $26,338.53 2026-02-03
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 2 1 — — $26,285.59 $26,285.59 $26,285.59 2026-02-03
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 1 — — $26,207.82 $26,207.82 $26,207.82 2026-02-03
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 2 1 — — $26,132.12 $26,132.12 $26,132.12 2026-02-03
709 MS_DRG Penis Procedures With Cc/mcc 2 1 — — $26,096.27 $26,096.27 $26,096.27 2026-02-03
397 MS_DRG Appendix Procedures With Mcc 2 1 — — $26,025.59 $26,025.59 $26,025.59 2026-02-03
53445 CPT Insert Uro/ves Nck Sphincter 2 1 — — $25,975.30 $25,975.30 $25,975.30 2026-02-03
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 1 — — $25,912.74 $25,912.74 $25,912.74 2026-02-03
347 MS_DRG Anal And Stomal Procedures With Mcc 2 1 — — $25,901.05 $25,901.05 $25,901.05 2026-02-03
336 MS_DRG Peritoneal Adhesiolysis With Cc 2 1 — — $25,819.07 $25,819.07 $25,819.07 2026-02-03
412 MS_DRG Cholecystectomy With C.d.e. With Cc 2 1 — — $25,663.56 $25,663.56 $25,663.56 2026-02-03
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 2 1 — — $25,656.75 $25,656.75 $25,656.75 2026-02-03
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 2 1 — — $25,585.31 $25,585.31 $25,585.31 2026-02-03
357 MS_DRG Other Digestive System O.r. Procedures With Cc 2 1 — — $25,562.15 $25,562.15 $25,562.15 2026-02-03
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 2 1 — — $25,559.81 $25,559.81 $25,559.81 2026-02-03
141 MS_DRG Major Head And Neck Procedures With Cc 2 1 — — $25,462.62 $25,462.62 $25,462.62 2026-02-03
C9600 HCPCS Perc Drug-el Cor Stent Sing 2 1 — — $25,424.94 $25,424.94 $25,424.94 2026-02-03
545 MS_DRG Connective Tissue Disorders With Mcc 2 1 — — $25,270.00 $25,270.00 $25,270.00 2026-02-03
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 2 1 — — $25,208.31 $25,208.31 $25,208.31 2026-02-03
C9601 HCPCS Perc Drug-el Cor Stent Bran 2 1 — — $25,199.99 $25,199.99 $25,199.99 2026-02-03
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 1 — — $25,064.96 $25,064.96 $25,064.96 2026-02-03
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 2 1 — — $25,064.11 $25,064.11 $25,064.11 2026-02-03
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