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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

MAINEHEALTH MAINE MEDICAL CENTER

Portland, ME · CCN 200009 · Rates published

11,570 distinct procedures filed
11 distinct payers
483,726 rate rows
2025-09-09 last MRF observed
Data quality

311,058 of 483,726 rate rows are consumer-grade (64.3%)

172,668 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
professional (physician) fee — not the facility price 172,202
percent-of-charges filed in the dollar field — excluded from medians 112
placeholder amount (≤ $0.02) — excluded from medians 108
exceeds 10× this hospital's gross charge — excluded from medians 94
per-diem day rate — not a per-procedure price 94
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 58
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/7975/010238552-1760436216_mainehealth_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/mainemedicalcenter/7975
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 541ed4bc440f38a1… · 1,184,369,198 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 5 $4,377,500.00 $4,508,825.00 $4,377,500.00 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 5 $3,710,000.00 $3,821,300.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 5 $3,685,266.67 $3,795,824.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 5 $3,324,571.90 $3,424,309.06 $3,324,571.90 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $3,261,355.00 $3,359,195.65 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $2,950,686.67 $3,039,207.27 $2,950,686.67 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,452,115.60 $2,525,679.06 $2,452,115.60 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $2,332,000.00 $2,401,960.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
J9281
HCPCS 		Mitomycin 80 (2 X 40) Mg Ul Solr 9 $317.42 $1,904,354.95 $1,697,307.00 nat. median
$545
outlier · 3116.2×
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $770,620.00 $793,738.60 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $578,324.58 $595,674.32 $578,324.58 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $553,378.83 $569,980.19 $553,378.83 nat. median
$674,867
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $541,635.66 $557,884.73 $541,635.66 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $541,260.45 $557,498.26 $541,260.45 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $533,076.48 $549,068.77 $533,076.48 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $489,720.00 $504,411.60 $489,720.00 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $307,536.87 $1,077,745.46 $309,074.55 nat. median
$370,174
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $270,375.00 $278,486.25 $270,375.00 nat. median
$324,450
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $230,024.09 $804,985.51 $231,174.21 nat. median
$265,286
0.9× median
J9355
HCPCS 		Trastuzumab 150 Mg/7.15ml IV (wet Solr Vial) 9 $76.18 $232,161.60 $206,920.20 nat. median
$989
outlier · 209.3×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $193,921.32 $677,943.30 $194,890.92 nat. median
$206,474
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 5 $175,314.04 $612,466.05 $176,190.61 nat. median
$202,976
0.9× median
0811
RC 		Hc Renal Allograft Live 9 $120,099.61 $153,471.50 $136,785.55 nat. median
$60,209
outlier · 2.3×
J2326
HCPCS 		Nusinersen 12 Mg/5ml It Soln 9 $1,246.94 $145,449.95 $129,636.13 nat. median
$2,675
outlier · 48.5×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 5 $116,016.30 $403,803.04 $116,596.38 nat. median
$133,161
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 5 $107,666.09 $374,419.44 $108,204.42 nat. median
$117,357
0.9× median
7
MS_DRG 		Lung Transplant 5 $107,398.09 $373,476.38 $107,935.08 nat. median
$122,708
0.9× median
J0225
HCPCS 		Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy 9 $4,983.86 $119,293.08 $106,323.13 nat. median
$8,223
outlier · 12.9×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 5 $106,120.90 $109,304.53 $106,120.90 nat. median
$111,989
0.9× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 5 $93,216.70 $96,013.20 $93,216.70 nat. median
$96,983
1.0× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $90,756.97 $314,917.79 $91,210.76 nat. median
$108,660
0.8× median
A9543
HCPCS 		Hc Y-90 Zevalin 9 $56,824.55 $128,949.58 $90,246.39 nat. median
$62,507
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $89,735.29 $311,322.71 $90,183.96 nat. median
$102,358
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 5 $87,749.66 $304,335.46 $88,188.41 nat. median
$100,136
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 5 $87,306.26 $302,775.12 $87,742.79 nat. median
$99,019
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $86,336.58 $299,362.94 $86,768.26 nat. median
$98,894
0.9× median
460
MS_DRG 		DRG 460 1 $83,290.99 $83,290.99 $83,290.99 nat. median
$39,075
outlier · 2.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $79,642.29 $275,806.34 $80,040.50 nat. median
$93,672
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $76,075.46 $263,255.01 $76,455.84 nat. median
$83,470
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $70,082.01 $242,164.66 $70,432.42 nat. median
$79,312
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $70,043.83 $242,030.34 $70,394.05 nat. median
$81,118
0.9× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $68,999.46 $238,355.25 $69,344.46 nat. median
$82,711
0.8× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 5 $67,452.66 $69,476.24 $67,452.66 nat. median
$70,825
1.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $66,729.58 $230,367.78 $67,063.23 nat. median
$77,570
0.9× median
10
MS_DRG 		Pancreas Transplant 5 $66,014.10 $227,850.08 $66,344.17 nat. median
$68,884
1.0× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 5 $65,642.99 $226,544.08 $65,971.21 nat. median
$71,271
0.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 5 $64,742.33 $223,374.81 $65,066.04 nat. median
$73,807
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $64,101.57 $221,120.03 $64,422.08 nat. median
$74,915
0.9× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 5 $63,431.05 $125,055.58 $63,748.21 nat. median
$69,774
0.9× median
0812
RC 		Hc Kidney Acquisition 9 $21,176.42 $144,350.07 $62,237.35 nat. median
$70,278
0.9× median

Other procedures at this hospital

Browse this hospital's 11,570 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
             
0266T CPT Apc 5 5 — — $43,553.28 $44,859.88 $43,553.28 2025-09-09
0268T CPT Apc 6 5 — — $29,493.56 $133,962.94 $29,641.03 2025-09-09
0408T CPT Insj/rplc Cardiac Modulj Sys 6 5 — — $31,030.48 $140,943.81 $31,185.63 2025-09-09
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 6 5 — — $21,724.32 $98,674.23 $21,832.94 2025-09-09
0515T CPT Insj Wcs Lv Compl Sys 6 5 — — $21,724.32 $98,674.23 $21,832.94 2025-09-09
0569T CPT Hc Ttvr Percutaneous Approach Initial Prosthesis - Cath Lab Rate 16 9 $31,438.75 $31,438.75 $23,126.34 $29,552.43 $26,339.38 2025-09-09
0571T CPT Insj/rplcmt Icds Ss Eltrd 6 5 — — $31,030.48 $140,943.81 $31,185.63 2025-09-09
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 5 5 — — $33,874.88 $34,891.13 $33,874.88 2025-09-09
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 6 5 — — $29,493.56 $133,962.94 $29,641.03 2025-09-09
0795T CPT Hc Tcat Ins 2chmbr Ldls Pm Cmpl 22 9 $27,686.75 $27,686.75 $18,457.83 $83,837.49 $23,195.96 2025-09-09
0811 RC Hc Renal Allograft Live 16 9 $163,267.55 $163,267.55 $120,099.61 $153,471.50 $136,785.55 2025-09-09
0812 RC Hc Kidney Acquisition 36 9 $74,567.00 $74,567.00 $21,176.42 $144,350.07 $62,237.35 2025-09-09
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 6 5 — — $31,030.48 $140,943.81 $31,185.63 2025-09-09
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 6 5 — — $230,024.09 $804,985.51 $231,174.21 2025-09-09
10 MS_DRG Pancreas Transplant 6 5 — — $66,014.10 $227,850.08 $66,344.17 2025-09-09
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 6 5 — — $45,084.95 $154,202.47 $45,310.38 2025-09-09
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 6 5 — — $34,590.74 $117,274.35 $34,763.69 2025-09-09
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 6 5 — — $22,784.97 $75,730.93 $22,898.90 2025-09-09
14 MS_DRG Allogeneic Bone Marrow Transplant 6 5 — — $107,666.09 $374,419.44 $108,204.42 2025-09-09
140 MS_DRG Major Head And Neck Procedures With Mcc 6 5 — — $35,609.99 $120,860.85 $35,788.04 2025-09-09
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 6 5 — — $28,079.17 $94,360.74 $28,219.56 2025-09-09
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 6 5 — — $50,282.53 $172,492.20 $50,533.94 2025-09-09
163 MS_DRG Major Chest Procedures With Mcc 6 5 — — $38,696.01 $131,720.38 $38,889.49 2025-09-09
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 6 5 — — $32,532.84 $110,032.76 $32,695.50 2025-09-09
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 6 5 — — $50,282.53 $172,492.20 $50,533.94 2025-09-09
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 6 5 — — $26,184.50 $87,693.56 $26,315.42 2025-09-09
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 5 — — $307,536.87 $1,077,745.46 $309,074.55 2025-09-09
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 6 5 — — $65,642.99 $226,544.08 $65,971.21 2025-09-09
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 5 — — $90,756.97 $314,917.79 $91,210.76 2025-09-09
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 5 — — $66,729.58 $230,367.78 $67,063.23 2025-09-09
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 6 5 — — $53,785.20 $184,817.77 $54,054.12 2025-09-09
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 6 5 — — $23,059.47 $76,696.86 $23,174.76 2025-09-09
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 6 5 — — $46,152.09 $157,957.58 $46,382.85 2025-09-09
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 6 5 — — $89,735.29 $311,322.71 $90,183.96 2025-09-09
215 MS_DRG Other Heart Assist System Implant 6 5 — — $87,306.26 $302,775.12 $87,742.79 2025-09-09
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 5 — — $79,642.29 $275,806.34 $80,040.50 2025-09-09
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 5 — — $53,709.67 $184,551.99 $53,978.22 2025-09-09
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 5 — — $49,579.24 $170,017.37 $49,827.13 2025-09-09
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 5 — — $64,101.57 $221,120.03 $64,422.08 2025-09-09
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 6 5 — — $29,934.88 $100,890.75 $30,084.56 2025-09-09
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 5 — — $44,279.34 $151,367.56 $44,500.74 2025-09-09
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 5 — — $38,561.21 $131,245.99 $38,754.01 2025-09-09
22513 CPT Hc Perc Kyphoplasty Thor 22 9 $32,469.60 $32,469.60 $6,913.99 $31,404.08 $27,203.03 2025-09-09
22514 CPT Hc Perc Kyphoplasty Ls 22 9 $32,469.60 $32,469.60 $6,913.99 $31,404.08 $27,203.03 2025-09-09
228 MS_DRG Other Cardiothoracic Procedures With Mcc 6 5 — — $41,734.15 $142,411.30 $41,942.82 2025-09-09
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 6 5 — — $26,490.69 $88,770.94 $26,623.14 2025-09-09
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 5 — — $47,596.03 $163,038.69 $47,834.01 2025-09-09
231 MS_DRG Coronary Bypass With Ptca With Mcc 6 5 — — $70,082.01 $242,164.66 $70,432.42 2025-09-09
232 MS_DRG Coronary Bypass With Ptca Without Mcc 6 5 — — $50,873.75 $174,572.66 $51,128.12 2025-09-09
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 5 — — $64,742.33 $223,374.81 $65,066.04 2025-09-09
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 6 5 — — $44,470.19 $152,039.13 $44,692.54 2025-09-09
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 6 5 — — $49,050.55 $168,156.96 $49,295.81 2025-09-09
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 6 5 — — $34,658.98 $117,514.40 $34,832.28 2025-09-09
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 6 5 — — $42,169.47 $143,943.07 $42,380.32 2025-09-09
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 5 — — $32,138.15 $108,643.88 $32,298.84 2025-09-09
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 6 5 — — $24,914.36 $83,224.01 $25,038.93 2025-09-09
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 6 5 — — $28,810.89 $96,935.59 $28,954.94 2025-09-09
245 MS_DRG Aicd Generator Procedures 6 5 — — $40,950.46 $139,653.55 $41,155.21 2025-09-09
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 6 5 — — $37,584.22 $127,808.09 $37,772.14 2025-09-09
252 MS_DRG Other Vascular Procedures With Mcc 6 5 — — $29,122.75 $98,032.98 $29,268.36 2025-09-09
253 MS_DRG Other Vascular Procedures With Cc 6 5 — — $21,997.23 $72,958.89 $22,107.22 2025-09-09
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 6 5 — — $22,512.92 $74,773.58 $22,625.49 2025-09-09
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 6 5 — — $24,047.81 $80,174.77 $24,168.05 2025-09-09
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 6 5 — — $26,103.28 $87,407.78 $26,233.79 2025-09-09
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 6 5 — — $28,926.22 $97,341.40 $29,070.85 2025-09-09
263 MS_DRG Vein Ligation And Stripping 6 5 — — $23,045.65 $76,648.28 $23,160.88 2025-09-09
264 MS_DRG Other Circulatory System O.r. Procedures 6 5 — — $29,648.19 $99,881.95 $29,796.43 2025-09-09
265 MS_DRG Aicd Lead Procedures 6 5 — — $30,233.73 $101,942.41 $30,384.90 2025-09-09
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 6 5 — — $49,916.27 $171,203.35 $50,165.85 2025-09-09
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 6 5 — — $39,471.59 $134,449.55 $39,668.95 2025-09-09
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 5 — — $55,412.69 $190,544.74 $55,689.76 2025-09-09
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 6 5 — — $35,053.67 $118,903.28 $35,228.94 2025-09-09
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 6 5 — — $42,949.90 $146,689.39 $43,164.65 2025-09-09
271 MS_DRG Other Major Cardiovascular Procedures With Cc 6 5 — — $29,236.44 $98,433.06 $29,382.62 2025-09-09
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 6 5 — — $33,020.12 $111,747.42 $33,185.22 2025-09-09
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 6 5 — — $26,610.06 $89,191.03 $26,743.11 2025-09-09
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 6 5 — — $58,656.29 $201,958.68 $58,949.57 2025-09-09
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 6 5 — — $51,569.74 $177,021.77 $51,827.59 2025-09-09
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 6 5 — — $39,042.79 $132,940.65 $39,238.01 2025-09-09
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 6 5 — — $41,896.59 $142,982.86 $42,106.07 2025-09-09
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 6 5 — — $27,287.36 $91,574.41 $27,423.79 2025-09-09
28 MS_DRG Spinal Procedures With Mcc 6 5 — — $50,636.61 $112,706.03 $50,889.79 2025-09-09
288 MS_DRG Acute And Subacute Endocarditis With Mcc 6 5 — — $23,446.84 $78,060.01 $23,564.08 2025-09-09
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 6 5 — — $28,524.22 $64,654.97 $28,666.84 2025-09-09
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 6 5 — — $175,314.04 $612,466.05 $176,190.61 2025-09-09
31 MS_DRG Ventricular Shunt Procedures With Mcc 6 5 — — $35,296.48 $119,757.75 $35,472.96 2025-09-09
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 5 — — $51,504.77 $176,793.15 $51,762.29 2025-09-09
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 6 5 — — $36,938.60 $125,536.16 $37,123.29 2025-09-09
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 6 5 — — $24,383.21 $81,355.02 $24,505.12 2025-09-09
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 6 5 — — $35,855.22 $121,723.90 $36,034.49 2025-09-09
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 6 5 — — $27,211.82 $91,308.64 $27,347.88 2025-09-09
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 6 5 — — $24,507.49 $81,792.26 $24,630.03 2025-09-09
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 6 5 — — $42,511.37 $145,146.19 $42,723.93 2025-09-09
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 6 5 — — $38,555.53 $120,974.82 $38,748.31 2025-09-09
332 MS_DRG Rectal Resection With Mcc 6 5 — — $29,433.80 $99,127.50 $29,580.97 2025-09-09
33276 CPT Insj Phrnc Nrv Stim Sys 5 5 — — $43,553.28 $44,859.88 $43,553.28 2025-09-09
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 6 5 — — $29,493.56 $133,962.94 $29,641.03 2025-09-09
33289 CPT Hc Tcat Impl Wrls P-art Prs Snr L-t Hemodyn Mntr - Cath Lab Rate 22 9 $53,687.20 $53,687.20 $27,514.07 $124,971.90 $44,979.14 2025-09-09
33418 CPT Hc Repair Tcat Mitral Valve; Initial Prosth - Cath Lab Rate 16 9 $31,438.75 $31,438.75 $23,126.34 $29,552.43 $26,339.38 2025-09-09
33477 CPT Hc Implant Tcat Pulm Vlv Perq - Cath Lab Rate 16 9 $31,438.75 $31,438.75 $23,126.34 $29,552.43 $26,339.38 2025-09-09
335 MS_DRG Peritoneal Adhesiolysis With Mcc 6 5 — — $30,690.13 $103,548.47 $30,843.58 2025-09-09
33741 CPT Hc Tas Congenital Cardiac Anomalies Any Method - Cath Lab Rate 16 9 $35,777.80 $35,777.80 $26,318.15 $33,631.13 $29,974.64 2025-09-09
33902 CPT Hc Perq P-art Revsc St 1st Abnor Connj Unilateral - Cath Lab Rate 22 9 $29,635.75 $29,635.75 $17,379.23 $78,938.36 $24,828.83 2025-09-09
34 MS_DRG Carotid Artery Stent Procedures With Mcc 6 5 — — $32,844.70 $111,130.14 $33,008.93 2025-09-09
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 6 5 — — $23,146.37 $77,002.64 $23,262.10 2025-09-09
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 6 5 — — $25,083.26 $83,818.42 $25,208.67 2025-09-09
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 6 5 — — $35,906.38 $121,903.94 $36,085.91 2025-09-09
36903 CPT Hc Intro Cath Dialysis Circuit With Tcat Plmt IV Stent 22 9 $45,558.65 $45,558.65 $10,975.86 $49,853.52 $38,169.04 2025-09-09
36905 CPT Hc Thrmbc/nfs Dial Circuit Trluml Balo Angiop 22 9 $45,558.65 $45,558.65 $10,975.86 $49,853.52 $38,169.04 2025-09-09
36906 CPT Hc Thrmbc/nfs Dial Circuit Tcat Plmt IV Stent 22 9 $69,053.85 $69,053.85 $17,379.23 $78,938.36 $57,853.32 2025-09-09
37 MS_DRG Extracranial Procedures With Mcc 6 5 — — $28,233.48 $94,903.72 $28,374.65 2025-09-09
37182 CPT Hc Insert Hepatic Shunt (tips) 16 9 $31,581.60 $31,581.60 $23,231.42 $29,686.70 $26,459.06 2025-09-09
37225 CPT Hc Fem/popl Revas W/ather 31 9 $47,284.90 $47,284.90 $4,384.73 $44,447.81 $34,782.77 2025-09-09
37229 CPT Hc Tib/per Revasc W/ather 32 9 $47,284.90 $47,284.90 $8,316.25 $78,938.36 $36,622.15 2025-09-09
37233 CPT Hc Ir Atherect Subsq Ves Tib-peri 26 9 $47,284.90 $47,284.90 $3,989.78 $44,447.81 $39,466.34 2025-09-09
37235 CPT Hc Ir, Stent, Ather Incl Pta Sq T-p 26 9 $27,007.65 $27,007.65 $3,989.78 $25,387.19 $22,212.44 2025-09-09
37243 CPT Hc Vasc Embolize/occlude Organ 22 9 $47,767.05 $47,767.05 $10,975.86 $49,853.52 $40,019.24 2025-09-09
38240 CPT Transplt Allo Hct/donor 6 5 — — $57,240.31 $259,991.72 $57,526.51 2025-09-09
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 6 5 — — $116,016.30 $403,803.04 $116,596.38 2025-09-09
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 6 5 — — $31,897.77 $107,797.98 $32,057.26 2025-09-09
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 5 — — $33,035.55 $111,801.72 $33,200.73 2025-09-09
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 6 5 — — $45,351.34 $155,139.81 $45,578.10 2025-09-09
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 6 5 — — $24,071.36 $80,257.64 $24,191.72 2025-09-09
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 6 5 — — $29,698.55 $100,059.14 $29,847.04 2025-09-09
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 6 5 — — $23,486.65 $78,200.05 $23,604.08 2025-09-09
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 6 5 — — $29,718.86 $100,130.58 $29,867.46 2025-09-09
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 6 5 — — $29,927.55 $100,865.03 $30,077.19 2025-09-09
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 6 5 — — $34,295.96 $116,236.98 $34,467.44 2025-09-09
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 5 — — $86,336.58 $299,362.94 $86,768.26 2025-09-09
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 5 — — $58,946.22 $202,978.90 $59,240.95 2025-09-09
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 5 — — $45,963.67 $157,294.57 $46,193.49 2025-09-09
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 5 — — $68,999.46 $238,355.25 $69,344.46 2025-09-09
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 5 — — $45,690.81 $156,334.36 $45,919.26 2025-09-09
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 5 — — $55,713.98 $191,604.97 $55,992.55 2025-09-09
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 6 5 — — $34,426.71 $116,697.08 $34,598.85 2025-09-09
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 6 5 — — $43,088.78 $147,178.06 $43,304.22 2025-09-09
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 6 5 — — $26,325.80 $88,190.81 $26,457.43 2025-09-09
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 5 — — $70,043.83 $242,030.34 $70,394.05 2025-09-09
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 5 — — $47,874.59 $164,018.91 $48,113.96 2025-09-09
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 5 — — $36,331.11 $123,398.55 $36,512.76 2025-09-09
460 MS_DRG DRG 460 1 1 — — $83,290.99 $83,290.99 $83,290.99 2025-09-09
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 6 5 — — $51,101.13 $175,372.83 $51,356.63 2025-09-09
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 6 5 — — $24,521.29 $81,840.85 $24,643.90 2025-09-09
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 5 — — $45,126.39 $154,348.21 $45,352.02 2025-09-09
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 5 — — $25,209.96 $84,264.24 $25,336.01 2025-09-09
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 6 5 — — $42,638.05 $145,592.00 $42,851.24 2025-09-09
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 6 5 — — $29,080.52 $97,884.37 $29,225.93 2025-09-09
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 6 5 — — $22,568.13 $74,967.91 $22,680.97 2025-09-09
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 6 5 — — $27,809.56 $93,411.96 $27,948.61 2025-09-09
471 MS_DRG Cervical Spinal Fusion With Mcc 6 5 — — $40,710.89 $138,810.51 $40,914.44 2025-09-09
472 MS_DRG Cervical Spinal Fusion With Cc 6 5 — — $24,792.53 $82,795.34 $24,916.49 2025-09-09
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 6 5 — — $37,684.93 $128,162.46 $37,873.35 2025-09-09
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 6 5 — — $29,192.60 $98,278.74 $29,338.56 2025-09-09
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 6 5 — — $25,148.23 $84,047.05 $25,273.97 2025-09-09
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 6 5 — — $21,958.23 $72,821.72 $22,068.02 2025-09-09
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 6 5 — — $27,408.38 $92,000.22 $27,545.42 2025-09-09
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 6 5 — — $30,103.80 $101,485.16 $30,254.32 2025-09-09
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 6 5 — — $29,855.28 $100,610.69 $30,004.56 2025-09-09
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 6 5 — — $21,769.02 $72,155.86 $21,877.86 2025-09-09
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 6 5 — — $87,749.66 $304,335.46 $88,188.41 2025-09-09
500 MS_DRG Soft Tissue Procedures With Mcc 6 5 — — $26,997.43 $90,554.19 $27,132.42 2025-09-09
503 MS_DRG Foot Procedures With Mcc 6 5 — — $22,757.37 $75,633.77 $22,871.15 2025-09-09
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 6 5 — — $24,474.99 $81,677.95 $24,597.37 2025-09-09
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 6 5 — — $26,377.79 $88,373.71 $26,509.68 2025-09-09
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 6 5 — — $30,370.18 $102,422.51 $30,522.03 2025-09-09
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 6 5 — — $24,934.65 $83,295.45 $25,059.33 2025-09-09
545 MS_DRG Connective Tissue Disorders With Mcc 6 5 — — $21,785.27 $72,213.02 $21,894.19 2025-09-09
570 MS_DRG Skin Debridement With Mcc 6 5 — — $25,710.22 $86,024.62 $25,838.77 2025-09-09
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 6 5 — — $51,275.75 $175,987.25 $51,532.13 2025-09-09
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 6 5 — — $29,402.93 $99,018.91 $29,549.94 2025-09-09
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 6 5 — — $45,080.10 $154,185.32 $45,305.50 2025-09-09
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 6 5 — — $22,888.93 $76,096.73 $23,003.38 2025-09-09
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 6 5 — — $27,734.04 $93,146.19 $27,872.71 2025-09-09
6 MS_DRG Liver Transplant Without Mcc 6 5 — — $40,645.10 $138,579.03 $40,848.32 2025-09-09
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 6 5 — — $23,218.65 $77,256.98 $23,334.75 2025-09-09
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 6 5 — — $32,652.22 $110,452.85 $32,815.48 2025-09-09
61886 CPT Implant Neurostim Arrays 6 5 — — $29,493.56 $133,962.94 $29,641.03 2025-09-09
619 MS_DRG O.r. Procedures For Obesity With Mcc 6 5 — — $23,406.24 $77,917.13 $23,523.27 2025-09-09
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 6 5 — — $31,653.32 $106,937.79 $31,811.58 2025-09-09
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 6 5 — — $24,548.08 $81,935.15 $24,670.82 2025-09-09
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 6 5 — — $33,307.61 $112,759.07 $33,474.15 2025-09-09
63685 CPT Hc Insrt/redo Spine N Generator 24 9 $46,870.25 $46,870.25 $29,493.56 $133,962.94 $39,267.90 2025-09-09
64568 CPT Opn Impltj Crnl Nrv Nea&pg 6 5 — — $29,493.56 $133,962.94 $29,641.03 2025-09-09
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 6 5 — — $29,493.56 $133,962.94 $29,641.03 2025-09-09
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 6 5 — — $38,680.59 $131,666.08 $38,873.99 2025-09-09
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 6 5 — — $29,464.65 $99,236.10 $29,611.97 2025-09-09
652 MS_DRG Kidney Transplant 6 5 — — $26,207.24 $87,773.58 $26,338.28 2025-09-09
653 MS_DRG Major Bladder Procedures With Mcc 6 5 — — $46,536.22 $159,309.30 $46,768.90 2025-09-09
654 MS_DRG Major Bladder Procedures With Cc 6 5 — — $24,182.62 $80,649.16 $24,303.53 2025-09-09
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 6 5 — — $27,722.65 $93,106.18 $27,861.26 2025-09-09
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 6 5 — — $22,251.41 $73,853.38 $22,362.67 2025-09-09
662 MS_DRG Minor Bladder Procedures With Mcc 6 5 — — $26,598.68 $89,151.02 $26,731.67 2025-09-09
665 MS_DRG Prostatectomy With Mcc 6 5 — — $29,148.75 $98,124.43 $29,294.50 2025-09-09
668 MS_DRG Transurethral Procedures With Mcc 6 5 — — $24,947.64 $83,341.18 $25,072.38 2025-09-09
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 6 5 — — $35,288.37 $119,729.17 $35,464.81 2025-09-09
69930 CPT Implant Cochlear Device 6 5 — — $30,784.88 $139,828.28 $30,938.81 2025-09-09
7 MS_DRG Lung Transplant 6 5 — — $107,398.09 $373,476.38 $107,935.08 2025-09-09
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 6 5 — — $33,241.81 $112,527.59 $33,408.02 2025-09-09
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 6 5 — — $33,593.46 $113,765.01 $33,761.43 2025-09-09
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 6 5 — — $22,286.32 $73,976.26 $22,397.75 2025-09-09
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 5 5 — — $49,542.69 $51,028.97 $49,542.69 2025-09-09
791 MS_DRG Prematurity With Major Problems 5 5 — — $34,235.05 $35,262.10 $34,235.05 2025-09-09
793 MS_DRG Full Term Neonate With Major Problems 5 5 — — $35,133.26 $36,187.26 $35,133.26 2025-09-09
799 MS_DRG Splenic Procedures With Mcc 6 5 — — $39,878.47 $135,881.30 $40,077.86 2025-09-09
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 6 5 — — $45,452.06 $155,494.18 $45,679.32 2025-09-09
800 MS_DRG Splenic Procedures With Cc 6 5 — — $24,927.35 $83,269.73 $25,051.99 2025-09-09
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 6 5 — — $30,376.67 $102,445.37 $30,528.56 2025-09-09
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 6 5 — — $21,851.84 $72,447.35 $21,961.10 2025-09-09
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 6 5 — — $48,547.85 $166,388.00 $48,790.59 2025-09-09
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 6 5 — — $39,266.93 $133,729.39 $39,463.26 2025-09-09
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 6 5 — — $40,046.58 $136,472.85 $40,246.82 2025-09-09
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 6 5 — — $26,307.94 $88,127.94 $26,439.48 2025-09-09
834 MS_DRG Acute Leukemia With Mcc 6 5 — — $46,152.09 $157,957.58 $46,382.85 2025-09-09
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 6 5 — — $41,928.26 $143,094.31 $42,137.90 2025-09-09
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 6 5 — — $27,162.30 $91,134.32 $27,298.11 2025-09-09
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 6 5 — — $22,003.72 $72,981.76 $22,113.74 2025-09-09
849 MS_DRG Radiotherapy 6 5 — — $22,956.34 $76,333.92 $23,071.12 2025-09-09
850 MS_DRG Acute Leukemia With Other Procedures 6 5 — — $76,075.46 $263,255.01 $76,455.84 2025-09-09
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 6 5 — — $41,880.34 $142,925.70 $42,089.74 2025-09-09
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 6 5 — — $37,903.40 $128,931.20 $38,092.92 2025-09-09
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 6 5 — — $57,758.91 $198,800.84 $58,047.71 2025-09-09
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 6 5 — — $33,176.84 $112,298.97 $33,342.72 2025-09-09
901 MS_DRG Wound Debridements For Injuries With Mcc 6 5 — — $37,244.77 $126,613.54 $37,430.99 2025-09-09
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 6 5 — — $32,620.55 $110,341.40 $32,783.65 2025-09-09
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 6 5 — — $33,616.20 $113,845.02 $33,784.28 2025-09-09
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 6 5 — — $193,921.32 $677,943.30 $194,890.92 2025-09-09
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 6 5 — — $55,504.46 $190,867.67 $55,781.98 2025-09-09
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 6 5 — — $27,092.45 $90,888.55 $27,227.91 2025-09-09
92924 CPT Hc Prq Card Angio/athrect 1 Art - Cath Lab Rate 22 9 $27,324.00 $27,324.00 $10,975.86 $49,853.52 $22,892.04 2025-09-09
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 6 5 — — $36,403.40 $123,652.89 $36,585.42 2025-09-09
93653 CPT Hc Ep & Ablate Incl 3d Mapg Supravent Arrhyt - Cath Lab Rate 24 9 $31,166.15 $31,166.15 $22,925.82 $107,844.84 $26,111.00 2025-09-09
93654 CPT Hc Ep & Ablate Incl 3d Mapg Ventric Tachy - Cath Lab Rate 24 9 $28,534.20 $28,534.20 $20,989.76 $107,844.84 $23,905.96 2025-09-09
93656 CPT Hc Ep & Abltj Atr Fib Pulm Vein Isltn - Cath Lab Rate 24 9 $26,172.95 $26,172.95 $19,252.82 $107,844.84 $22,487.80 2025-09-09
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 6 5 — — $27,040.48 $90,705.65 $27,175.68 2025-09-09
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 6 5 — — $30,895.61 $104,271.49 $31,050.09 2025-09-09
955 MS_DRG Craniotomy For Multiple Significant Trauma 6 5 — — $56,717.77 $195,137.18 $57,001.36 2025-09-09
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 6 5 — — $32,306.27 $109,235.44 $32,467.80 2025-09-09
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 6 5 — — $61,882.04 $213,309.74 $62,191.45 2025-09-09
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 6 5 — — $34,640.28 $117,448.67 $34,813.48 2025-09-09
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 6 5 — — $22,735.44 $75,556.61 $22,849.11 2025-09-09
963 MS_DRG Other Multiple Significant Trauma With Mcc 6 5 — — $23,326.66 $77,637.06 $23,443.29 2025-09-09
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 6 5 — — $52,624.69 $180,734.01 $52,887.82 2025-09-09
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 6 5 — — $30,375.04 $102,439.66 $30,526.92 2025-09-09
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 6 5 — — $22,811.77 $75,825.24 $22,925.83 2025-09-09
974 MS_DRG HIV With Major Related Condition With Mcc 6 5 — — $25,515.30 $85,338.76 $25,642.88 2025-09-09
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 5 — — $39,871.16 $135,855.58 $40,070.51 2025-09-09
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 5 — — $29,709.92 $100,099.14 $29,858.47 2025-09-09
A9543 HCPCS Hc Y-90 Zevalin 22 9 $107,718.30 $107,718.30 $56,824.55 $128,949.58 $90,246.39 2025-09-09
C1982 HCPCS Hc Trinav Catheter 2.4f X 150 Cm 16 9 $40,246.00 $40,246.00 $29,604.96 $37,831.24 $33,718.10 2025-09-09
C2616 HCPCS Hc Y-90 Microspheres 22 9 $47,109.85 $47,109.85 $17,485.10 $76,865.12 $39,468.64 2025-09-09
C2642 HCPCS Device Gammatile Therapy 9 Pack (810921) 112 9 $44,520.00 $44,520.00 $107.86 $58,110.80 $36,369.08 2025-09-09
C9606 HCPCS Hc Perc D-e Cor Revasc W Ami S - Cath Lab Rate 16 9 $33,063.80 $33,063.80 $24,321.73 $31,079.97 $27,700.85 2025-09-09
C9760 HCPCS Non-blind Interatrial Shunt 5 5 — — $26,616.08 $27,414.57 $26,616.08 2025-09-09
C9767 HCPCS Hc Revasc Lithotrip-stent-ather 22 9 $30,490.35 $30,490.35 $17,379.23 $78,938.36 $25,544.81 2025-09-09
C9797 HCPCS Hc Vasc Emb/occ With Prs Cath 22 9 $26,068.85 $26,068.85 $17,379.23 $78,938.36 $21,840.49 2025-09-09
J0202 HCPCS Alemtuzumab 12 Mg/1.2ml IV Soln 22 9 $34,075.49 $34,075.49 $2,440.70 $32,030.96 $28,548.44 2025-09-09
J0225 HCPCS Vutrisiran Sodium 25 Mg/0.5ml Sc Sosy 22 9 $126,907.53 $126,907.53 $4,983.86 $119,293.08 $106,323.13 2025-09-09
J0801 HCPCS Corticotropin 80 Unit/ml Ij Gel 17 9 $50,446.60 $50,446.60 $6,852.59 $47,419.80 $42,264.16 2025-09-09
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 5 — — $3,685,266.67 $3,795,824.67 $3,685,266.67 2025-09-09
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 5 — — $3,324,571.90 $3,424,309.06 $3,324,571.90 2025-09-09
J1414 HCPCS Inj, Beqvez, Per Tx Dose 5 5 — — $3,710,000.00 $3,821,300.00 $3,710,000.00 2025-09-09
J2326 HCPCS Nusinersen 12 Mg/5ml It Soln 22 9 $154,733.99 $154,733.99 $1,246.94 $145,449.95 $129,636.13 2025-09-09
J2327 HCPCS Risankizumab-rzaa 180 Mg/1.2ml Sc Soct 22 9 $26,778.88 $26,778.88 $14.84 $25,172.15 $22,435.35 2025-09-09
J3391 HCPCS Inj, Atidarsagene Autotemcel 5 5 — — $4,377,500.00 $4,508,825.00 $4,377,500.00 2025-09-09
J3392 HCPCS Inj, Exagamglogene Autotem 5 5 — — $2,332,000.00 $2,401,960.00 $2,332,000.00 2025-09-09
J3393 HCPCS Inj, Betibeglogene Autotemce 5 5 — — $2,950,686.67 $3,039,207.27 $2,950,686.67 2025-09-09
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 5 — — $3,261,355.00 $3,359,195.65 $3,261,355.00 2025-09-09
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,452,115.60 $2,525,679.06 $2,452,115.60 2025-09-09
J9029 HCPCS Instill Adstiladrin, Tx Dose 6 5 — — $63,431.05 $125,055.58 $63,748.21 2025-09-09
J9118 HCPCS Calaspargase Pegol-mknl 3750 Unit/5ml IV Soln 16 9 $33,648.39 $33,648.39 $24,751.76 $31,629.49 $28,190.62 2025-09-09
J9226 HCPCS Histrelin Acetate (cpp) 50 Mg Sc Kit 22 9 $55,483.23 $55,483.23 $40,813.46 $86,965.26 $46,483.85 2025-09-09
J9228 HCPCS Ipilimumab 5 Mg/ml IV Soln (combined) 22 9 $40,331.99 $40,331.99 $183.41 $37,912.07 $33,790.14 2025-09-09
J9229 HCPCS Inotuzumab Ozogamicin 0.9 Mg IV Solr 22 9 $27,320.49 $27,320.49 $2,698.05 $25,681.26 $22,889.10 2025-09-09
J9266 HCPCS Pegaspargase Injection 6 5 — — $28,424.06 $53,203.07 $28,566.18 2025-09-09
J9281 HCPCS Mitomycin 80 (2 X 40) Mg Ul Solr 22 9 $2,025,909.52 $2,025,909.52 $317.42 $1,904,354.95 $1,697,307.00 2025-09-09
J9355 HCPCS Trastuzumab 150 Mg/7.15ml IV (wet Solr Vial) 32 9 $246,980.43 $246,980.43 $76.18 $232,161.60 $206,920.20 2025-09-09
J9600 HCPCS Porfimer Sodium Injection 6 5 — — $24,228.42 $46,314.69 $24,349.56 2025-09-09
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 5 5 — — $93,216.70 $96,013.20 $93,216.70 2025-09-09
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 5 5 — — $39,823.40 $41,018.10 $39,823.40 2025-09-09
L5856 HCPCS Elec Knee-shin Swing/stance 5 5 — — $28,607.84 $29,466.08 $28,607.84 2025-09-09
L5858 HCPCS Stance Phase Only 5 5 — — $21,898.50 $22,555.46 $21,898.50 2025-09-09
L6700 HCPCS Ue Add Ext Power Myoel 5 5 — — $28,931.56 $29,799.51 $28,931.56 2025-09-09
L6880 HCPCS Elec Hand Ind Art Digits 5 5 — — $28,151.96 $28,996.52 $28,151.96 2025-09-09
L6975 HCPCS Interscap-thor Myoelectronic 5 5 — — $22,626.12 $23,304.90 $22,626.12 2025-09-09
L7180 HCPCS Electronic Elbow Sequential 5 5 — — $45,177.95 $46,533.29 $45,177.95 2025-09-09
L7181 HCPCS Electronic Elbo Simultaneous 5 5 — — $47,211.27 $48,627.61 $47,211.27 2025-09-09
L8701 HCPCS Ewh S/d Uprt Micro Sensor 5 5 — — $34,284.44 $35,312.97 $34,284.44 2025-09-09
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 5 5 — — $67,452.66 $69,476.24 $67,452.66 2025-09-09
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 5 — — $106,120.90 $109,304.53 $106,120.90 2025-09-09
Q0482 HCPCS Hc Heartmate Ii System Controller 22 9 $45,586.20 $45,586.20 $5,362.73 $42,851.03 $38,192.12 2025-09-09
Q0483 HCPCS Monitor Elec Vad, Rep 5 5 — — $22,092.08 $22,754.84 $22,092.08 2025-09-09
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 5 — — $533,076.48 $549,068.77 $533,076.48 2025-09-09
Q2042 HCPCS Tisagenlecleucel Car-pos T 5 5 — — $578,324.58 $595,674.32 $578,324.58 2025-09-09
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 5 — — $55,945.97 $109,326.87 $56,225.70 2025-09-09
Q2053 HCPCS Brexucabtagene Car Pos T 5 5 — — $489,720.00 $504,411.60 $489,720.00 2025-09-09
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 5 — — $541,635.66 $557,884.73 $541,635.66 2025-09-09
Q2055 HCPCS Idecabtagene Vicleucel Car 5 5 — — $541,260.45 $557,498.26 $541,260.45 2025-09-09
Q2056 HCPCS Ciltacabtagene Car-pos T 5 5 — — $553,378.83 $569,980.19 $553,378.83 2025-09-09
Q2057 HCPCS Afamitresgene Autoleucel 5 5 — — $770,620.00 $793,738.60 $770,620.00 2025-09-09
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 5 5 — — $270,375.00 $278,486.25 $270,375.00 2025-09-09
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