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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 MID COAST HOSPITAL

Brunswick, ME · CCN 200021 · Rates published

11,238 distinct procedures filed
9 distinct payers
593,474 rate rows
2025-09-09 last MRF observed
Data quality

261,810 of 593,474 rate rows are consumer-grade (44.1%)

331,664 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 331,316
placeholder amount (≤ $0.02) — excluded from medians 162
exceeds 10× this hospital's gross charge — excluded from medians 88
percent-of-charges filed in the dollar field — excluded from medians 50
per-diem day rate — not a per-procedure price 48
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8025/010238552-1932164795_mainehealth_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/MidCoastHospital/8025
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 1f5167273096c422… · 158,098,473 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
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $770,620.00 $978,687.40 $774,473.10 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $578,324.58 $734,472.22 $581,216.20 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $553,378.83 $702,791.11 $556,145.72 nat. median
$674,867
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $541,635.66 $687,877.28 $544,343.83 nat. median
$673,137
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $541,260.45 $687,400.77 $543,966.75 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $533,076.48 $677,007.12 $535,741.86 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $489,720.00 $621,944.40 $492,168.60 nat. median
$619,808
0.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $270,375.00 $343,376.25 $271,726.88 nat. median
$324,450
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 5 $265,572.31 $681,190.09 $266,900.17 nat. median
$370,174
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $198,572.08 $508,791.89 $199,564.94 nat. median
$265,286
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $167,365.68 $428,494.74 $168,202.51 nat. median
$206,474
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 5 $151,281.98 $387,109.78 $152,038.39 nat. median
$202,976
0.7× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 5 $106,120.90 $134,773.54 $106,651.51 nat. median
$111,989
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 5 $100,026.40 $255,224.11 $100,526.53 nat. median
$133,161
0.8× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 5 $93,216.70 $118,385.21 $93,682.79 nat. median
$96,983
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 5 $92,808.67 $236,652.18 $93,272.71 nat. median
$117,357
0.8× median
7
MS_DRG 		Lung Transplant 5 $92,577.03 $236,056.11 $93,039.92 nat. median
$122,708
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $78,192.80 $199,044.10 $78,583.76 nat. median
$108,660
0.7× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $77,309.71 $196,771.83 $77,696.26 nat. median
$102,358
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 5 $75,593.37 $192,355.53 $75,971.33 nat. median
$100,136
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 5 $75,210.11 $191,369.32 $75,586.16 nat. median
$99,019
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $74,371.94 $189,212.65 $74,743.80 nat. median
$98,894
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $68,585.55 $174,323.67 $68,928.48 nat. median
$93,672
0.7× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 5 $67,452.66 $85,664.88 $67,789.93 nat. median
$70,825
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $65,502.45 $166,390.59 $65,829.96 nat. median
$83,470
0.8× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 5 $63,431.05 $80,644.15 $63,748.21 nat. median
$69,774
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $60,321.87 $153,060.41 $60,623.48 nat. median
$79,312
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $60,288.87 $152,975.52 $60,590.32 nat. median
$81,118
0.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $59,386.13 $150,652.67 $59,683.06 nat. median
$82,711
0.7× median
38240
CPT 		Transplt Allo Hct/donor 5 $57,758.40 $206,572.67 $58,047.19 nat. median
$15,979
outlier · 3.6×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $57,424.10 $145,604.18 $57,711.22 nat. median
$77,570
0.7× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 5 $56,824.55 $83,155.26 $57,108.67 nat. median
$62,507
0.9× median
10
MS_DRG 		Pancreas Transplant 5 $56,805.66 $144,012.87 $57,089.69 nat. median
$68,884
0.8× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 5 $56,484.86 $143,187.41 $56,767.29 nat. median
$71,271
0.8× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 5 $55,945.97 $71,051.38 $56,225.70 nat. median
$66,682
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 5 $55,706.36 $141,184.27 $55,984.89 nat. median
$73,807
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $55,152.50 $139,759.14 $55,428.26 nat. median
$74,915
0.7× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $53,233.99 $134,822.63 $53,500.16 nat. median
$72,135
0.7× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $50,696.35 $128,293.02 $50,949.83 nat. median
$68,090
0.7× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 $50,445.74 $127,648.18 $50,697.97 nat. median
$68,886
0.7× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 5 $49,670.05 $125,652.27 $49,918.40 nat. median
$66,526
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 5 $48,770.12 $123,336.65 $49,013.97 nat. median
$64,732
0.8× median

Other procedures at this hospital

Browse this hospital's 11,238 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 10 5 — — $4,377,500.00 $4,508,825.00 $4,377,500.00 2025-09-09
J1414 HCPCS Inj, Beqvez, Per Tx Dose 10 5 — — $3,710,000.00 $3,821,300.00 $3,710,000.00 2025-09-09
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 10 5 — — $3,685,266.67 $3,795,824.67 $3,685,266.67 2025-09-09
J1413 HCPCS Inj Delandistrogene Mox Rokl 10 5 — — $3,324,571.90 $3,424,309.06 $3,324,571.90 2025-09-09
J3394 HCPCS Inj, Lovotibeglogene Autotem 10 5 — — $3,261,355.00 $3,359,195.65 $3,261,355.00 2025-09-09
J3393 HCPCS Inj, Betibeglogene Autotemce 10 5 — — $2,950,686.67 $3,039,207.27 $2,950,686.67 2025-09-09
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 5 — — $2,452,115.60 $2,525,679.06 $2,452,115.60 2025-09-09
J3392 HCPCS Inj, Exagamglogene Autotem 10 5 — — $2,332,000.00 $2,401,960.00 $2,332,000.00 2025-09-09
Q2057 HCPCS Afamitresgene Autoleucel 12 5 — — $770,620.00 $978,687.40 $774,473.10 2025-09-09
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 5 — — $578,324.58 $734,472.22 $581,216.20 2025-09-09
Q2056 HCPCS Ciltacabtagene Car-pos T 12 5 — — $553,378.83 $702,791.11 $556,145.72 2025-09-09
Q2054 HCPCS Lisocabtagene Mara Car Pos T 12 5 — — $541,635.66 $687,877.28 $544,343.83 2025-09-09
Q2055 HCPCS Idecabtagene Vicleucel Car 12 5 — — $541,260.45 $687,400.77 $543,966.75 2025-09-09
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 12 5 — — $533,076.48 $677,007.12 $535,741.86 2025-09-09
Q2053 HCPCS Brexucabtagene Car Pos T 12 5 — — $489,720.00 $621,944.40 $492,168.60 2025-09-09
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 12 5 — — $270,375.00 $343,376.25 $271,726.88 2025-09-09
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 5 — — $265,572.31 $681,190.09 $266,900.17 2025-09-09
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 12 5 — — $198,572.08 $508,791.89 $199,564.94 2025-09-09
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 5 — — $167,365.68 $428,494.74 $168,202.51 2025-09-09
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 12 5 — — $151,281.98 $387,109.78 $152,038.39 2025-09-09
Q0480 HCPCS Driver Pneumatic Vad, Rep 12 5 — — $106,120.90 $134,773.54 $106,651.51 2025-09-09
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 12 5 — — $100,026.40 $255,224.11 $100,526.53 2025-09-09
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 12 5 — — $93,216.70 $118,385.21 $93,682.79 2025-09-09
14 MS_DRG Allogeneic Bone Marrow Transplant 12 5 — — $92,808.67 $236,652.18 $93,272.71 2025-09-09
7 MS_DRG Lung Transplant 12 5 — — $92,577.03 $236,056.11 $93,039.92 2025-09-09
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 5 — — $78,192.80 $199,044.10 $78,583.76 2025-09-09
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 5 — — $77,309.71 $196,771.83 $77,696.26 2025-09-09
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 12 5 — — $75,593.37 $192,355.53 $75,971.33 2025-09-09
215 MS_DRG Other Heart Assist System Implant 12 5 — — $75,210.11 $191,369.32 $75,586.16 2025-09-09
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 5 — — $74,371.94 $189,212.65 $74,743.80 2025-09-09
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 5 — — $68,585.55 $174,323.67 $68,928.48 2025-09-09
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 12 5 — — $67,452.66 $85,664.88 $67,789.93 2025-09-09
850 MS_DRG Acute Leukemia With Other Procedures 12 5 — — $65,502.45 $166,390.59 $65,829.96 2025-09-09
J9029 HCPCS Instill Adstiladrin, Tx Dose 12 5 — — $63,431.05 $80,644.15 $63,748.21 2025-09-09
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 5 — — $60,321.87 $153,060.41 $60,623.48 2025-09-09
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 5 — — $60,288.87 $152,975.52 $60,590.32 2025-09-09
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 5 — — $59,386.13 $150,652.67 $59,683.06 2025-09-09
38240 CPT Transplt Allo Hct/donor 12 5 — — $57,758.40 $206,572.67 $58,047.19 2025-09-09
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 5 — — $57,424.10 $145,604.18 $57,711.22 2025-09-09
A9543 HCPCS Y90 Ibritumomab, Rx 12 5 — — $56,824.55 $83,155.26 $57,108.67 2025-09-09
10 MS_DRG Pancreas Transplant 12 5 — — $56,805.66 $144,012.87 $57,089.69 2025-09-09
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 5 — — $56,484.86 $143,187.41 $56,767.29 2025-09-09
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 12 5 — — $55,945.97 $71,051.38 $56,225.70 2025-09-09
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 5 — — $55,706.36 $141,184.27 $55,984.89 2025-09-09
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 5 — — $55,152.50 $139,759.14 $55,428.26 2025-09-09
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 5 — — $53,233.99 $134,822.63 $53,500.16 2025-09-09
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 5 — — $50,696.35 $128,293.02 $50,949.83 2025-09-09
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 5 — — $50,445.74 $127,648.18 $50,697.97 2025-09-09
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 12 5 — — $49,670.05 $125,652.27 $49,918.40 2025-09-09
955 MS_DRG Craniotomy For Multiple Significant Trauma 12 5 — — $48,770.12 $123,336.65 $49,013.97 2025-09-09
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 12 5 — — $47,902.48 $121,104.11 $48,141.99 2025-09-09
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 12 5 — — $47,721.38 $120,638.10 $47,959.99 2025-09-09
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 5 — — $47,642.05 $120,433.99 $47,880.26 2025-09-09
L7181 HCPCS Electronic Elbo Simultaneous 12 5 — — $47,211.27 $59,958.31 $47,447.32 2025-09-09
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 12 5 — — $46,235.28 $116,814.25 $46,466.46 2025-09-09
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 5 — — $46,170.01 $116,646.27 $46,400.86 2025-09-09
J9226 HCPCS Supprelin La Implant 12 5 — — $45,560.39 $56,080.98 $45,788.19 2025-09-09
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 12 5 — — $45,232.17 $114,233.11 $45,458.33 2025-09-09
L7180 HCPCS Electronic Elbow Sequential 12 5 — — $45,177.95 $57,376.00 $45,403.84 2025-09-09
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 5 — — $44,320.30 $111,886.78 $44,541.90 2025-09-09
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 12 5 — — $44,264.13 $111,742.28 $44,485.45 2025-09-09
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 5 — — $44,066.17 $111,232.92 $44,286.50 2025-09-09
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 12 5 — — $43,915.24 $110,844.57 $44,134.82 2025-09-09
33276 CPT Insj Phrnc Nrv Stim Sys 10 5 — — $43,947.49 $45,265.91 $43,947.49 2025-09-09
0266T CPT Apc 10 5 — — $43,947.49 $45,265.91 $43,947.49 2025-09-09
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 5 — — $43,718.69 $110,338.82 $43,937.29 2025-09-09
28 MS_DRG Spinal Procedures With Mcc 12 5 — — $43,513.72 $109,811.39 $43,731.29 2025-09-09
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 12 5 — — $43,207.66 $109,023.87 $43,423.70 2025-09-09
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 12 5 — — $43,207.66 $109,023.87 $43,423.70 2025-09-09
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 5 — — $42,891.07 $108,209.24 $43,105.53 2025-09-09
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 5 — — $42,599.73 $107,459.65 $42,812.73 2025-09-09
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 5 — — $42,568.15 $107,378.37 $42,780.99 2025-09-09
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 5 — — $42,142.76 $106,283.77 $42,353.48 2025-09-09
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 12 5 — — $41,708.23 $105,165.70 $41,916.77 2025-09-09
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 5 — — $41,126.29 $103,668.31 $41,331.92 2025-09-09
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 5 — — $40,885.51 $103,048.77 $41,089.94 2025-09-09
653 MS_DRG Major Bladder Procedures With Mcc 12 5 — — $39,969.44 $100,691.60 $40,169.29 2025-09-09
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 12 5 — — $39,823.40 $50,575.72 $40,022.51 2025-09-09
834 MS_DRG Acute Leukemia With Mcc 12 5 — — $39,637.40 $99,837.24 $39,835.58 2025-09-09
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 5 — — $39,637.40 $99,837.24 $39,835.58 2025-09-09
33229 CPT Hc Remv&replc Pm Gen Mult Leads 44 9 $48,269.95 $48,269.95 $18,624.89 $66,611.87 $39,822.71 2025-09-09
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 5 — — $39,474.54 $99,418.19 $39,671.92 2025-09-09
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 12 5 — — $39,238.68 $98,811.29 $39,434.88 2025-09-09
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 12 5 — — $39,032.30 $98,280.25 $39,227.46 2025-09-09
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 5 — — $38,945.26 $98,056.27 $39,139.99 2025-09-09
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 5 — — $38,750.79 $97,555.94 $38,944.54 2025-09-09
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 12 5 — — $38,715.00 $97,463.82 $38,908.57 2025-09-09
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 12 5 — — $38,710.78 $97,452.98 $38,904.33 2025-09-09
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 5 — — $38,183.60 $96,096.48 $38,374.52 2025-09-09
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 5 — — $38,018.63 $95,672.01 $38,208.72 2025-09-09
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 12 5 — — $36,989.54 $93,024.04 $37,174.49 2025-09-09
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 12 5 — — $36,869.50 $92,715.17 $37,053.85 2025-09-09
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 5 — — $36,599.93 $92,021.57 $36,782.93 2025-09-09
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 5 — — $36,490.43 $91,739.79 $36,672.88 2025-09-09
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 12 5 — — $36,194.89 $90,979.36 $36,375.86 2025-09-09
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 5 — — $35,986.41 $90,442.90 $36,166.34 2025-09-09
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 5 — — $35,959.03 $90,372.46 $36,138.82 2025-09-09
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 5 — — $35,945.01 $90,336.33 $36,124.74 2025-09-09
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 5 — — $35,818.65 $90,011.21 $35,997.74 2025-09-09
245 MS_DRG Aicd Generator Procedures 12 5 — — $35,141.23 $88,268.17 $35,316.93 2025-09-09
471 MS_DRG Cervical Spinal Fusion With Mcc 12 5 — — $34,934.15 $87,735.32 $35,108.82 2025-09-09
6 MS_DRG Liver Transplant Without Mcc 12 5 — — $34,877.29 $87,589.01 $35,051.68 2025-09-09
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 12 5 — — $34,359.94 $86,257.80 $34,531.74 2025-09-09
L8701 HCPCS Ewh S/d Uprt Micro Sensor 12 5 — — $34,284.44 $43,541.24 $34,455.86 2025-09-09
799 MS_DRG Splenic Procedures With Mcc 12 5 — — $34,214.63 $85,883.91 $34,385.71 2025-09-09
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 5 — — $34,208.30 $85,867.65 $34,379.34 2025-09-09
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 10 5 — — $34,181.49 $35,206.93 $34,181.49 2025-09-09
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 5 — — $33,862.93 $84,978.97 $34,032.24 2025-09-09
33208 CPT Hc Insrt Heart Pm Atrial & Vent 44 9 $41,076.90 $41,076.90 $10,220.44 $38,776.59 $33,888.44 2025-09-09
33214 CPT Hc Upgrade Of Pacemaker System 44 9 $41,076.90 $41,076.90 $10,220.44 $38,776.59 $33,888.44 2025-09-09
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 12 5 — — $33,686.04 $84,523.80 $33,854.47 2025-09-09
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 5 — — $33,492.29 $84,025.27 $33,659.75 2025-09-09
163 MS_DRG Major Chest Procedures With Mcc 12 5 — — $33,192.54 $83,254.00 $33,358.51 2025-09-09
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 12 5 — — $33,179.21 $83,219.68 $33,345.10 2025-09-09
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 5 — — $33,076.01 $82,954.16 $33,241.39 2025-09-09
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 12 5 — — $33,071.10 $82,941.52 $33,236.46 2025-09-09
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 12 5 — — $32,507.41 $81,491.09 $32,669.94 2025-09-09
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 12 5 — — $32,318.58 $81,005.21 $32,480.18 2025-09-09
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 12 5 — — $32,231.54 $80,781.23 $32,392.70 2025-09-09
901 MS_DRG Wound Debridements For Injuries With Mcc 12 5 — — $31,938.10 $80,026.22 $32,097.79 2025-09-09
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 12 5 — — $31,673.48 $79,345.26 $31,831.85 2025-09-09
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
0408T CPT Insj/rplc Cardiac Modulj Sys 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
33270 CPT Ins/rep Subq Defibrillator 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
33249 CPT Insj/rplcmt Defib W/lead(s) 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
33231 CPT Insrt Pulse Gen W/mult Leads 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
0571T CPT Insj/rplcmt Icds Ss Eltrd 12 5 — — $31,311.34 $111,984.87 $31,467.90 2025-09-09
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 12 5 — — $31,210.86 $78,154.93 $31,366.92 2025-09-09
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 5 — — $31,148.40 $77,994.18 $31,304.14 2025-09-09
69930 CPT Implant Cochlear Device 12 5 — — $31,063.52 $111,098.54 $31,218.83 2025-09-09
33206 CPT Hc Insert Heart Pm Atrial 44 9 $37,630.20 $37,630.20 $10,220.44 $36,553.36 $31,044.92 2025-09-09
33207 CPT Hc Insert Heart Pm Ventricular 44 9 $37,630.20 $37,630.20 $10,220.44 $36,553.36 $31,044.92 2025-09-09
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 12 5 — — $30,781.25 $77,049.50 $30,935.15 2025-09-09
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 12 5 — — $30,737.02 $76,935.71 $30,890.71 2025-09-09
140 MS_DRG Major Head And Neck Procedures With Mcc 12 5 — — $30,525.03 $76,390.22 $30,677.65 2025-09-09
31 MS_DRG Ventricular Shunt Procedures With Mcc 12 5 — — $30,254.06 $75,693.01 $30,405.33 2025-09-09
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 12 5 — — $30,247.05 $75,674.94 $30,398.28 2025-09-09
793 MS_DRG Full Term Neonate With Major Problems 12 5 — — $30,112.97 $75,329.95 $30,263.53 2025-09-09
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 5 — — $30,044.18 $75,152.93 $30,194.40 2025-09-09
33228 CPT Hc Remv&replc Pm Gen Dual Lead 44 9 $36,341.60 $36,341.60 $10,220.44 $36,553.36 $29,981.82 2025-09-09
33213 CPT Hc Insert Pulse Gen Dual Leads 44 9 $36,341.60 $36,341.60 $10,220.44 $36,553.36 $29,981.82 2025-09-09
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
61886 CPT Implant Neurostim Arrays 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
0268T CPT Apc 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
64568 CPT Opn Impltj Crnl Nrv Nea&pg 12 5 — — $29,760.51 $106,438.32 $29,909.31 2025-09-09
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 5 — — $29,703.03 $74,275.09 $29,851.54 2025-09-09
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 12 5 — — $29,686.87 $74,233.55 $29,835.31 2025-09-09
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 12 5 — — $29,644.06 $74,123.37 $29,792.28 2025-09-09
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 12 5 — — $29,502.25 $73,758.50 $29,649.76 2025-09-09
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 5 — — $29,389.23 $73,467.70 $29,536.17 2025-09-09
791 MS_DRG Prematurity With Major Problems 12 5 — — $29,336.58 $73,332.23 $29,483.26 2025-09-09
L6700 HCPCS Ue Add Ext Power Myoel 12 5 — — $28,931.56 $36,743.08 $29,076.22 2025-09-09
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 12 5 — — $28,801.68 $71,955.86 $28,945.69 2025-09-09
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 12 5 — — $28,782.01 $71,905.28 $28,925.92 2025-09-09
L5856 HCPCS Elec Knee-shin Swing/stance 12 5 — — $28,607.84 $36,331.96 $28,750.88 2025-09-09
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 12 5 — — $28,534.92 $71,269.48 $28,677.60 2025-09-09
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 12 5 — — $28,478.06 $71,123.18 $28,620.45 2025-09-09
J9266 HCPCS Pegaspargase Injection 12 5 — — $28,424.06 $34,308.87 $28,566.18 2025-09-09
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 12 5 — — $28,421.92 $70,978.68 $28,564.03 2025-09-09
33227 CPT Hc Remove & Replace Pm Gen Singl 44 9 $34,525.55 $34,525.55 $8,082.32 $32,592.12 $28,483.58 2025-09-09
33212 CPT Hc Insert Pulse Gen Sngl Lead 44 9 $34,525.55 $34,525.55 $8,082.32 $32,592.12 $28,483.58 2025-09-09
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 12 5 — — $28,299.76 $70,664.39 $28,441.26 2025-09-09
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 12 5 — — $28,286.43 $70,630.07 $28,427.86 2025-09-09
L6880 HCPCS Elec Hand Ind Art Digits 12 5 — — $28,151.96 $35,752.99 $28,292.72 2025-09-09
34 MS_DRG Carotid Artery Stent Procedures With Mcc 12 5 — — $28,134.80 $70,239.92 $28,275.47 2025-09-09
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 12 5 — — $27,968.43 $69,811.83 $28,108.27 2025-09-09
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 12 5 — — $27,941.05 $69,741.39 $28,080.75 2025-09-09
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 12 5 — — $27,865.24 $69,546.31 $28,004.57 2025-09-09
33289 CPT Tcat Impl Wrls P-art Prs Snr 12 5 — — $27,763.11 $99,294.62 $27,901.93 2025-09-09
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 12 5 — — $27,669.39 $69,042.37 $27,807.74 2025-09-09
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 5 — — $27,524.09 $68,668.47 $27,661.71 2025-09-09
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 5 — — $27,316.29 $68,133.82 $27,452.87 2025-09-09
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 12 5 — — $27,104.98 $67,590.14 $27,240.50 2025-09-09
C9760 HCPCS Non-blind Interatrial Shunt 10 5 — — $26,856.99 $27,662.70 $26,856.99 2025-09-09
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 12 5 — — $26,450.06 $65,904.90 $26,582.31 2025-09-09
335 MS_DRG Peritoneal Adhesiolysis With Mcc 12 5 — — $26,272.46 $65,447.92 $26,403.82 2025-09-09
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 12 5 — — $26,001.48 $64,750.70 $26,131.49 2025-09-09
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 12 5 — — $26,000.09 $64,747.09 $26,130.09 2025-09-09
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 12 5 — — $25,995.88 $64,736.25 $26,125.86 2025-09-09
37238 CPT Hc Open/perq Place Stent Same 44 9 $31,540.80 $31,540.80 $11,075.20 $39,610.40 $26,021.16 2025-09-09
265 MS_DRG Aicd Lead Procedures 12 5 — — $25,877.95 $64,432.80 $26,007.34 2025-09-09
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 12 5 — — $25,765.62 $64,143.80 $25,894.45 2025-09-09
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 12 5 — — $25,619.63 $63,768.10 $25,747.73 2025-09-09
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 12 5 — — $25,613.29 $63,751.84 $25,741.35 2025-09-09
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 5 — — $25,550.82 $63,591.08 $25,678.58 2025-09-09
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 12 5 — — $25,432.88 $63,287.63 $25,560.04 2025-09-09
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 5 — — $25,425.18 $63,267.76 $25,552.31 2025-09-09
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 12 5 — — $25,415.34 $63,242.48 $25,542.42 2025-09-09
264 MS_DRG Other Circulatory System O.r. Procedures 12 5 — — $25,371.82 $63,130.49 $25,498.68 2025-09-09
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 12 5 — — $25,213.18 $62,722.27 $25,339.25 2025-09-09
332 MS_DRG Rectal Resection With Mcc 12 5 — — $25,186.49 $62,653.64 $25,312.42 2025-09-09
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 12 5 — — $25,159.82 $62,585.00 $25,285.62 2025-09-09
37236 CPT Hc Open/perq Place Stent 1st 44 9 $30,622.00 $30,622.00 $11,075.20 $39,610.40 $25,263.15 2025-09-09
37226 CPT Hc Fem/popl Revasc W/stent 44 9 $30,622.00 $30,622.00 $11,075.20 $39,610.40 $25,263.15 2025-09-09
271 MS_DRG Other Major Cardiovascular Procedures With Cc 12 5 — — $25,015.90 $62,214.72 $25,140.98 2025-09-09
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 12 5 — — $24,978.01 $62,117.18 $25,102.90 2025-09-09
665 MS_DRG Prostatectomy With Mcc 12 5 — — $24,940.10 $62,019.64 $25,064.80 2025-09-09
252 MS_DRG Other Vascular Procedures With Mcc 12 5 — — $24,917.63 $61,961.84 $25,042.22 2025-09-09
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 12 5 — — $24,881.14 $61,867.91 $25,005.54 2025-09-09
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 12 5 — — $24,747.75 $61,524.73 $24,871.49 2025-09-09
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 12 5 — — $24,648.09 $61,268.24 $24,771.33 2025-09-09
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 12 5 — — $24,400.27 $60,630.63 $24,522.27 2025-09-09
37241 CPT Hc Vasc Embolize/occlude Venous 44 9 $29,691.90 $29,691.90 $11,075.20 $39,610.40 $24,495.81 2025-09-09
J9600 HCPCS Porfimer Sodium Injection 12 5 — — $24,228.42 $29,866.79 $24,349.56 2025-09-09
37 MS_DRG Extracranial Procedures With Mcc 12 5 — — $24,148.96 $59,983.99 $24,269.71 2025-09-09
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 12 5 — — $24,015.59 $59,640.80 $24,135.67 2025-09-09
93653 CPT Compre Ep Eval Tx Svt 12 5 — — $23,958.24 $85,686.56 $24,078.04 2025-09-09
93656 CPT Compre Ep Eval Abltj Atr Fib 12 5 — — $23,958.24 $85,686.56 $24,078.04 2025-09-09
93654 CPT Compre Ep Eval Tx Vt 12 5 — — $23,958.24 $85,686.56 $24,078.04 2025-09-09
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 12 5 — — $23,782.54 $59,041.12 $23,901.46 2025-09-09
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 12 5 — — $23,717.25 $58,873.14 $23,835.83 2025-09-09
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 12 5 — — $23,707.42 $58,847.85 $23,825.96 2025-09-09
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 12 5 — — $23,435.77 $58,148.83 $23,552.95 2025-09-09
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 5 — — $23,331.15 $57,879.70 $23,447.81 2025-09-09
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 12 5 — — $23,265.87 $57,711.72 $23,382.20 2025-09-09
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 12 5 — — $23,223.06 $57,601.54 $23,339.18 2025-09-09
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 12 5 — — $23,162.68 $57,446.20 $23,278.50 2025-09-09
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 12 5 — — $23,117.77 $57,330.60 $23,233.36 2025-09-09
500 MS_DRG Soft Tissue Procedures With Mcc 12 5 — — $23,080.55 $57,234.87 $23,195.96 2025-09-09
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 12 5 — — $22,745.72 $56,373.28 $22,859.45 2025-09-09
662 MS_DRG Minor Bladder Procedures With Mcc 12 5 — — $22,735.89 $56,347.99 $22,849.57 2025-09-09
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 12 5 — — $22,642.53 $56,107.76 $22,755.74 2025-09-09
L6975 HCPCS Interscap-thor Myoelectronic 12 5 — — $22,626.12 $28,735.17 $22,739.25 2025-09-09
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 12 5 — — $22,544.96 $55,856.69 $22,657.68 2025-09-09
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 12 5 — — $22,500.03 $55,741.09 $22,612.53 2025-09-09
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 12 5 — — $22,484.58 $55,701.35 $22,597.01 2025-09-09
652 MS_DRG Kidney Transplant 12 5 — — $22,397.53 $55,477.38 $22,509.52 2025-09-09
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 12 5 — — $22,377.89 $55,426.80 $22,489.78 2025-09-09
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 12 5 — — $22,307.68 $55,246.18 $22,419.22 2025-09-09
Q0483 HCPCS Monitor Elec Vad, Rep 12 5 — — $22,092.08 $28,056.94 $22,202.54 2025-09-09
570 MS_DRG Skin Debridement With Mcc 12 5 — — $21,967.92 $54,371.95 $22,077.76 2025-09-09
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
0515T CPT Insj Wcs Lv Compl Sys 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
0409T CPT Insj/rplc Car Modulj Pls Gn 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
0916T CPT Insj Perm Ccm-d Sys Pg Only 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
33240 CPT Insrt Pulse Gen W/singl Lead 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
33230 CPT Insrt Pulse Gen W/dual Leads 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 12 5 — — $21,920.95 $78,400.19 $22,030.56 2025-09-09
L5858 HCPCS Stance Phase Only 12 5 — — $21,898.50 $27,811.10 $22,008.00 2025-09-09
0956T CPT Prt Crn Ch Cr&tun Elt S-sclp 10 5 — — $21,973.99 $22,633.21 $21,973.99 2025-09-09
0960T CPT Rpl S-sclp Eltr Ra Rcvr&tlmt 10 5 — — $21,973.99 $22,633.21 $21,973.99 2025-09-09
974 MS_DRG HIV With Major Related Condition With Mcc 12 5 — — $21,799.45 $53,938.45 $21,908.44 2025-09-09
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 5 — — $21,535.51 $53,259.29 $21,643.19 2025-09-09
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 12 5 — — $21,482.17 $53,122.02 $21,589.58 2025-09-09
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 12 5 — — $21,426.00 $52,977.52 $21,533.13 2025-09-09
668 MS_DRG Transurethral Procedures With Mcc 12 5 — — $21,308.78 $52,675.87 $21,415.32 2025-09-09
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 12 5 — — $21,297.54 $52,646.97 $21,404.03 2025-09-09
800 MS_DRG Splenic Procedures With Cc 12 5 — — $21,291.22 $52,630.72 $21,397.68 2025-09-09
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 12 5 — — $21,279.99 $52,601.82 $21,386.39 2025-09-09
472 MS_DRG Cervical Spinal Fusion With Cc 12 5 — — $21,174.69 $52,330.88 $21,280.56 2025-09-09
33285 CPT Hc Insj Subq Car Rhythm Mntr 44 9 $25,571.85 $25,571.85 $8,082.32 $28,906.39 $21,096.78 2025-09-09
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 12 5 — — $20,963.40 $51,787.19 $21,068.22 2025-09-09
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
64580 CPT Opn Impltj Nea Neuromuscular 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
63655 CPT Implant Neuroelectrodes 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
0680T CPT Insj/rplcmt Pg Only Isdss 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
61885 CPT Insrt/redo Neurostim 1 Array 12 5 — — $20,942.59 $74,901.08 $21,047.31 2025-09-09
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 12 5 — — $20,940.23 $51,727.59 $21,044.93 2025-09-09
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 12 5 — — $20,928.30 $51,696.88 $21,032.94 2025-09-09
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 12 5 — — $20,900.22 $51,624.63 $21,004.72 2025-09-09
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 12 5 — — $20,820.90 $51,420.52 $20,925.01 2025-09-09
L5973 HCPCS Ank-foot Sys Dors-plant Flex 12 5 — — $20,672.48 $26,254.05 $20,775.84 2025-09-09
654 MS_DRG Major Bladder Procedures With Cc 12 5 — — $20,647.50 $50,974.38 $20,750.74 2025-09-09
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 12 5 — — $20,551.32 $50,726.92 $20,654.08 2025-09-09
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 12 5 — — $20,530.99 $50,674.54 $20,633.65 2025-09-09
L6970 HCPCS Interscapular-thor Switch CT 12 5 — — $20,074.32 $25,494.39 $20,174.69 2025-09-09
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 12 5 — — $20,045.91 $49,426.42 $20,146.14 2025-09-09
288 MS_DRG Acute And Subacute Endocarditis With Mcc 12 5 — — $20,011.52 $49,337.91 $20,111.58 2025-09-09
619 MS_DRG O.r. Procedures For Obesity With Mcc 12 5 — — $19,976.41 $49,247.60 $20,076.29 2025-09-09
963 MS_DRG Other Multiple Significant Trauma With Mcc 12 5 — — $19,907.62 $49,070.58 $20,007.16 2025-09-09
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 12 5 — — $19,814.27 $48,830.35 $19,913.34 2025-09-09
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 12 5 — — $19,751.78 $48,669.59 $19,850.54 2025-09-09
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 12 5 — — $19,676.67 $48,476.33 $19,775.06 2025-09-09
263 MS_DRG Vein Ligation And Stripping 12 5 — — $19,664.73 $48,445.62 $19,763.06 2025-09-09
54416 CPT Remv/repl Penis Contain Pros 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
54410 CPT Remove/replace Penis Prosth 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
54405 CPT Insert Multi-comp Penis Pros 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
54411 CPT Remov/replc Penis Pros Comp 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
53447 CPT Remove/replace Ur Sphincter 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
53445 CPT Insert Uro/ves Nck Sphincter 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
54401 CPT Insert Self-contd Prosthesis 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
53444 CPT Insert Tandem Cuff 12 5 — — $19,657.55 $70,305.17 $19,755.84 2025-09-09
849 MS_DRG Radiotherapy 12 5 — — $19,587.53 $48,246.93 $19,685.47 2025-09-09
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 12 5 — — $19,529.24 $48,097.01 $19,626.89 2025-09-09
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 12 5 — — $19,462.57 $47,925.42 $19,559.89 2025-09-09
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 12 5 — — $19,439.40 $47,865.81 $19,536.60 2025-09-09
503 MS_DRG Foot Procedures With Mcc 12 5 — — $19,415.53 $47,804.40 $19,512.61 2025-09-09
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 12 5 — — $19,396.58 $47,755.63 $19,493.57 2025-09-09
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 12 5 — — $19,251.98 $47,383.54 $19,348.24 2025-09-09
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 12 5 — — $19,204.24 $47,260.71 $19,300.26 2025-09-09
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