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Hospital

ST MARY'S REGIONAL MEDICAL CENTER

Lewiston, ME · CCN 200034 · Rates published

397 distinct procedures filed
54 distinct payers
381,815 rate rows
2025-08-01 last MRF observed
Data quality

1,806 of 381,815 rate rows are consumer-grade (0.5%)

380,009 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 380,009
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stmarysmaine.com/CMS%20Files/010211551_st-mary-_s-regional-medical-center_standardcharges.csv
Found on page https://stmarysmaine.com/pricing/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-15
Content fingerprint faa8c9d0b874bdcd… · 5,091,452 bytes · first seen 2026-05-05

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
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 2 $114,310.91 $114,310.91 $114,310.91 nat. median
$52,746
outlier · 2.2×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 1 $101,273.09 $101,273.09 $101,273.09 nat. median
$51,307
2.0× median
467
MS_DRG 		Revision Of Hip Or Knee Replacement With Cc 4 $72,036.88 $72,036.88 $72,036.88 nat. median
$34,720
outlier · 2.1×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $67,497.68 $67,497.68 $67,497.68 nat. median
$48,178
1.4× median
9149
OTHER 		Inj Ublituximab-xiiy, 1 Mg 3 $63,752.26 $63,752.26 $63,752.26 nat. median
$72
outlier · 890.5×
466
MS_DRG 		Revision Of Hip Or Knee Replacement With Mcc 1 $60,686.85 $60,686.85 $60,686.85 nat. median
$49,191
1.2× median
354
MS_DRG 		Hernia Procedures Except Inguinal And Femoral With Cc 1 $60,376.86 $60,376.86 $60,376.86 nat. median
$17,599
outlier · 3.4×
460
MS_DRG 		Spinal Fusion Except Cervical Without Mcc 2 $59,365.66 $59,365.66 $59,365.66 nat. median
$39,075
1.5× median
9494
OTHER 		Injection, Ocrelizumab 10 $57,490.89 $57,490.89 $57,490.89 nat. median
$61
outlier · 940.9×
279
MS_DRG 		Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures… 1 $57,436.89 $57,436.89 $57,436.89 nat. median
$33,732
1.7× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $57,346.19 $57,346.19 $57,346.19 nat. median
$62,134
0.9× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 $53,402.11 $53,402.11 $53,402.11 nat. median
$48,170
1.1× median
876
MS_DRG 		O.r. Procedures With Principal Diagnosis Of Mental Illness 1 $52,258.00 $52,258.00 $52,258.00 nat. median
$34,345
1.5× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 8 $51,270.29 $51,270.29 $51,270.29 nat. median
$19,634
outlier · 2.6×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 5 $48,766.21 $48,766.21 $48,766.21 nat. median
$44,810
1.1× median
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 1 $47,504.82 $47,504.82 $47,504.82 nat. median
$31,382
1.5× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 $46,470.88 $46,470.88 $46,470.88 nat. median
$46,084
1.0× median
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $45,885.90 $45,885.90 $45,885.90 nat. median
$30,262
1.5× median
5116
OTHER 		Level 6 Musculoskeletal Procedures 9 $43,086.69 $43,086.69 $43,086.69 nat. median
$18,574
outlier · 2.3×
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 $42,702.09 $42,702.09 $42,702.09 nat. median
$48,483
0.9× median
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 7 $37,230.92 $37,230.92 $37,230.92 nat. median
$24,346
1.5× median
9433
OTHER 		Inj Aval Alfa-nqpt 4mg 2 $36,656.56 $36,656.56 $36,656.56 nat. median
$82
outlier · 448.7×
269
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 $36,654.84 $36,654.84 $36,654.84 nat. median
$41,524
0.9× median
355
MS_DRG 		Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc 1 $36,214.95 $36,214.95 $36,214.95 nat. median
$14,203
outlier · 2.5×
885
MS_DRG 		Psychoses 11 $33,235.14 $33,235.14 $33,235.14 nat. median
$12,884
outlier · 2.6×
331
MS_DRG 		Major Small And Large Bowel Procedures Without Cc/Mcc 5 $31,809.90 $31,809.90 $31,809.90 nat. median
$17,703
1.8× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 7 $31,690.95 $31,690.95 $31,690.95 nat. median
$13,648
outlier · 2.3×
374
MS_DRG 		Digestive Malignancy With Mcc 1 $30,857.26 $30,857.26 $30,857.26 nat. median
$21,276
1.5× median
616
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 $30,840.02 $30,840.02 $30,840.02 nat. median
$35,856
0.9× median
346
MS_DRG 		Minor Small And Large Bowel Procedures Without Cc/Mcc 3 $30,252.16 $30,252.16 $30,252.16 nat. median
$13,112
outlier · 2.3×
579
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 $30,216.91 $30,216.91 $30,216.91 nat. median
$31,571
1.0× median
5115
OTHER 		Level 5 Musculoskeletal Procedures 10 $29,555.97 $29,555.97 $29,555.97 nat. median
$13,542
outlier · 2.2×
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 1 $29,013.34 $29,013.34 $29,013.34 nat. median
$37,476
0.8× median
0813
OTHER 		Injection, Imetelstat, 1 Mg 2 $28,070.42 $28,070.42 $28,070.42 nat. median
$57
outlier · 492.2×
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 $27,535.19 $27,535.19 $27,535.19 nat. median
$35,324
0.8× median
5376
OTHER 		Level 6 Urology And Related Services 5 $27,075.49 $27,075.49 $27,075.49 nat. median
$9,689
outlier · 2.8×
58
MS_DRG 		Multiple Sclerosis And Cerebellar Ataxia With Mcc 1 $26,635.07 $26,635.07 $26,635.07 nat. median
$17,928
1.5× median
271
MS_DRG 		Other Major Cardiovascular Procedures With Cc 2 $25,493.78 $25,493.78 $25,493.78 nat. median
$35,597
0.7× median
97
MS_DRG 		Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 $25,278.43 $25,278.43 $25,278.43 nat. median
$35,069
0.7× median
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 5 $25,049.27 $25,049.27 $25,049.27 nat. median
$20,421
1.2× median
486
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Cc 1 $24,697.43 $24,697.43 $24,697.43 nat. median
$21,377
1.2× median
935
MS_DRG 		Non-extensive Burns 1 $24,452.82 $24,452.82 $24,452.82 nat. median
$20,285
1.2× median
336
MS_DRG 		Peritoneal Adhesiolysis With Cc 3 $24,401.17 $24,401.17 $24,401.17 nat. median
$21,526
1.1× median
34
MS_DRG 		Carotid Artery Stent Procedures With Mcc 1 $23,957.28 $23,957.28 $23,957.28 nat. median
$38,285
0.6× median
94
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 $23,828.44 $23,828.44 $23,828.44 nat. median
$35,264
0.7× median
399
MS_DRG 		Appendix Procedures Without Cc/Mcc 2 $23,815.74 $23,815.74 $23,815.74 nat. median
$12,332
1.9× median
27
MS_DRG 		Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 2 $23,187.47 $23,187.47 $23,187.47 nat. median
$25,625
0.9× median
668
MS_DRG 		Transurethral Procedures With Mcc 1 $22,950.48 $22,950.48 $22,950.48 nat. median
$28,493
0.8× median
515
MS_DRG 		Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 $22,534.36 $22,534.36 $22,534.36 nat. median
$31,607
0.7× median
521
MS_DRG 		Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 $21,661.03 $21,661.03 $21,661.03 nat. median
$28,961
0.7× median

Other procedures at this hospital

Browse this hospital's 397 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
             
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 — — $114,310.91 $114,310.91 $114,310.91 2025-08-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $101,273.09 $101,273.09 $101,273.09 2025-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 4 4 — — $72,036.88 $72,036.88 $72,036.88 2025-08-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $67,497.68 $67,497.68 $67,497.68 2025-08-01
9149 OTHER Inj Ublituximab-xiiy, 1 Mg 3 3 — — $63,752.26 $63,752.26 $63,752.26 2025-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $60,686.85 $60,686.85 $60,686.85 2025-08-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 1 1 — — $60,376.86 $60,376.86 $60,376.86 2025-08-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 2 — — $59,365.66 $59,365.66 $59,365.66 2025-08-01
9494 OTHER Injection, Ocrelizumab 12 10 — — $57,490.89 $57,490.89 $57,490.89 2025-08-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $57,436.89 $57,436.89 $57,436.89 2025-08-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 2 — — $57,346.19 $57,346.19 $57,346.19 2025-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 4 — — $53,402.11 $53,402.11 $53,402.11 2025-08-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 1 1 — — $52,258.00 $52,258.00 $52,258.00 2025-08-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 13 8 — — $51,270.29 $51,270.29 $51,270.29 2025-08-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 5 5 — — $48,766.21 $48,766.21 $48,766.21 2025-08-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $47,504.82 $47,504.82 $47,504.82 2025-08-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $46,470.88 $46,470.88 $46,470.88 2025-08-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $45,885.90 $45,885.90 $45,885.90 2025-08-01
5116 OTHER Level 6 Musculoskeletal Procedures 11 9 — — $43,086.69 $43,086.69 $43,086.69 2025-08-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 2 — — $42,702.09 $42,702.09 $42,702.09 2025-08-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 8 7 — — $37,230.92 $37,230.92 $37,230.92 2025-08-01
9433 OTHER Inj Aval Alfa-nqpt 4mg 3 2 — — $36,656.56 $36,656.56 $36,656.56 2025-08-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 — — $36,654.84 $36,654.84 $36,654.84 2025-08-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/Mcc 1 1 — — $36,214.95 $36,214.95 $36,214.95 2025-08-01
885 MS_DRG Psychoses 17 11 — — $33,235.14 $33,235.14 $33,235.14 2025-08-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 5 5 — — $31,809.90 $31,809.90 $31,809.90 2025-08-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 10 7 — — $31,690.95 $31,690.95 $31,690.95 2025-08-01
374 MS_DRG Digestive Malignancy With Mcc 1 1 — — $30,857.26 $30,857.26 $30,857.26 2025-08-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $30,840.02 $30,840.02 $30,840.02 2025-08-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/Mcc 3 3 — — $30,252.16 $30,252.16 $30,252.16 2025-08-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $30,216.91 $30,216.91 $30,216.91 2025-08-01
5115 OTHER Level 5 Musculoskeletal Procedures 17 10 — — $29,555.97 $29,555.97 $29,555.97 2025-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $29,013.34 $29,013.34 $29,013.34 2025-08-01
0813 OTHER Injection, Imetelstat, 1 Mg 2 2 — — $28,070.42 $28,070.42 $28,070.42 2025-08-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $27,535.19 $27,535.19 $27,535.19 2025-08-01
5376 OTHER Level 6 Urology And Related Services 5 5 — — $27,075.49 $27,075.49 $27,075.49 2025-08-01
58 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Mcc 1 1 — — $26,635.07 $26,635.07 $26,635.07 2025-08-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 2 — — $25,493.78 $25,493.78 $25,493.78 2025-08-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $25,278.43 $25,278.43 $25,278.43 2025-08-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 7 5 — — $25,049.27 $25,049.27 $25,049.27 2025-08-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 1 1 — — $24,697.43 $24,697.43 $24,697.43 2025-08-01
935 MS_DRG Non-extensive Burns 1 1 — — $24,452.82 $24,452.82 $24,452.82 2025-08-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 3 — — $24,401.17 $24,401.17 $24,401.17 2025-08-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 1 1 — — $23,957.28 $23,957.28 $23,957.28 2025-08-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 1 — — $23,828.44 $23,828.44 $23,828.44 2025-08-01
399 MS_DRG Appendix Procedures Without Cc/Mcc 2 2 — — $23,815.74 $23,815.74 $23,815.74 2025-08-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 2 2 — — $23,187.47 $23,187.47 $23,187.47 2025-08-01
668 MS_DRG Transurethral Procedures With Mcc 1 1 — — $22,950.48 $22,950.48 $22,950.48 2025-08-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $22,534.36 $22,534.36 $22,534.36 2025-08-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 3 — — $21,661.03 $21,661.03 $21,661.03 2025-08-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 5 5 — — $21,583.88 $21,583.88 $21,583.88 2025-08-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 1 1 — — $21,417.49 $21,417.49 $21,417.49 2025-08-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $21,372.92 $21,372.92 $21,372.92 2025-08-01
5362 OTHER Level 2 Laparoscopy And Related Services 7 6 — — $21,328.55 $21,328.55 $21,328.55 2025-08-01
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc 2 2 — — $21,181.65 $21,181.65 $21,181.65 2025-08-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 2 2 — — $20,706.90 $20,706.90 $20,706.90 2025-08-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $20,533.22 $20,533.22 $20,533.22 2025-08-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 2 — — $20,202.74 $20,202.74 $20,202.74 2025-08-01
920 MS_DRG Complications Of Treatment With Cc 1 1 — — $20,192.41 $20,192.41 $20,192.41 2025-08-01
1475 OTHER Golimumab For IV Use 1mg 1 1 — — $20,146.36 $20,146.36 $20,146.36 2025-08-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $19,477.76 $19,477.76 $19,477.76 2025-08-01
36 MS_DRG Carotid Artery Stent Procedures Without Cc/Mcc 3 3 — — $18,926.02 $18,926.02 $18,926.02 2025-08-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 1 — — $18,911.09 $18,911.09 $18,911.09 2025-08-01
5114 OTHER Level 4 Musculoskeletal Procedures 19 11 — — $18,480.85 $18,480.85 $18,480.85 2025-08-01
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $18,292.92 $18,292.92 $18,292.92 2025-08-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 1 1 — — $18,228.42 $18,228.42 $18,228.42 2025-08-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 2 2 — — $18,077.13 $18,077.13 $18,077.13 2025-08-01
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $17,989.82 $17,989.82 $17,989.82 2025-08-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 3 3 — — $17,984.35 $17,984.35 $17,984.35 2025-08-01
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $17,824.77 $17,824.77 $17,824.77 2025-08-01
5193 OTHER Level 3 Endovascular Procedures 7 7 — — $17,813.50 $17,813.50 $17,813.50 2025-08-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 2 2 — — $17,802.67 $17,802.67 $17,802.67 2025-08-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $17,786.37 $17,786.37 $17,786.37 2025-08-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 — — $17,728.34 $17,728.34 $17,728.34 2025-08-01
5192 OTHER Level 2 Endovascular Procedures 12 8 — — $17,210.83 $17,210.83 $17,210.83 2025-08-01
9126 OTHER Natalizumab Injection 3 3 — — $17,065.74 $17,065.74 $17,065.74 2025-08-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 3 — — $16,819.40 $16,819.40 $16,819.40 2025-08-01
0723 OTHER Inj Efgart-alfa 2mg Hya-qvfc 1 1 — — $16,487.43 $16,487.43 $16,487.43 2025-08-01
254 MS_DRG Other Vascular Procedures Without Cc/Mcc 1 1 — — $16,318.04 $16,318.04 $16,318.04 2025-08-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 1 1 — — $16,318.04 $16,318.04 $16,318.04 2025-08-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 1 1 — — $16,015.72 $16,015.72 $16,015.72 2025-08-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc 2 2 — — $15,741.48 $15,741.48 $15,741.48 2025-08-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 1 1 — — $15,643.01 $15,643.01 $15,643.01 2025-08-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 2 — — $15,531.38 $15,531.38 $15,531.38 2025-08-01
5184 OTHER Level 4 Vascular Procedures 9 7 — — $15,397.32 $15,397.32 $15,397.32 2025-08-01
906 MS_DRG Hand Procedures For Injuries 1 1 — — $15,397.16 $15,397.16 $15,397.16 2025-08-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 1 1 — — $15,397.16 $15,397.16 $15,397.16 2025-08-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 5 5 — — $15,342.18 $15,342.18 $15,342.18 2025-08-01
884 MS_DRG Organic Disturbances And Intellectual Disability 1 1 — — $15,194.81 $15,194.81 $15,194.81 2025-08-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/Mc… 2 2 — — $15,137.83 $15,137.83 $15,137.83 2025-08-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $15,093.61 $15,093.61 $15,093.61 2025-08-01
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/Mcc 2 2 — — $15,055.58 $15,055.58 $15,055.58 2025-08-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $14,947.07 $14,947.07 $14,947.07 2025-08-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 16 10 — — $14,860.61 $14,860.61 $14,860.61 2025-08-01
5361 OTHER Level 1 Laparoscopy And Related Services 10 7 — — $14,682.55 $14,682.55 $14,682.55 2025-08-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 3 3 — — $14,663.27 $14,663.27 $14,663.27 2025-08-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 1 1 — — $14,641.24 $14,641.24 $14,641.24 2025-08-01
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 1 1 — — $14,641.24 $14,641.24 $14,641.24 2025-08-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 3 3 — — $14,532.64 $14,532.64 $14,532.64 2025-08-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 4 4 — — $14,431.70 $14,431.70 $14,431.70 2025-08-01
0764 OTHER Ketorolac Tromethamine Inj 1 1 — — $14,329.43 $14,329.43 $14,329.43 2025-08-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 1 1 — — $14,276.09 $14,276.09 $14,276.09 2025-08-01
5415 OTHER Level 5 Gynecologic Procedures 2 2 — — $14,250.16 $14,250.16 $14,250.16 2025-08-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 9 7 — — $14,247.36 $14,247.36 $14,247.36 2025-08-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 2 2 — — $14,147.23 $14,147.23 $14,147.23 2025-08-01
199 MS_DRG Pneumothorax With Mcc 1 1 — — $14,117.68 $14,117.68 $14,117.68 2025-08-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 1 1 — — $14,034.28 $14,034.28 $14,034.28 2025-08-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc 1 1 — — $13,900.46 $13,900.46 $13,900.46 2025-08-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 2 — — $13,834.69 $13,834.69 $13,834.69 2025-08-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 2 2 — — $13,717.86 $13,717.86 $13,717.86 2025-08-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 6 5 — — $13,703.83 $13,703.83 $13,703.83 2025-08-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 6 5 — — $13,625.31 $13,625.31 $13,625.31 2025-08-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 2 2 — — $13,599.30 $13,599.30 $13,599.30 2025-08-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 3 3 — — $13,595.83 $13,595.83 $13,595.83 2025-08-01
5091 OTHER Level 1 Breast/Lymphatic Surgery And Related Procedures 1 1 — — $13,590.92 $13,590.92 $13,590.92 2025-08-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 1 — — $13,516.65 $13,516.65 $13,516.65 2025-08-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 1 — — $13,494.49 $13,494.49 $13,494.49 2025-08-01
5165 OTHER Level 5 ENT Procedures 8 5 — — $13,467.61 $13,467.61 $13,467.61 2025-08-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 2 2 — — $13,340.00 $13,340.00 $13,340.00 2025-08-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $13,052.81 $13,052.81 $13,052.81 2025-08-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 1 1 — — $12,965.54 $12,965.54 $12,965.54 2025-08-01
682 MS_DRG Renal Failure With Mcc 7 6 — — $12,840.98 $12,840.98 $12,840.98 2025-08-01
5375 OTHER Level 5 Urology And Related Services 14 9 — — $12,766.04 $12,766.04 $12,766.04 2025-08-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 4 4 — — $12,747.65 $12,747.65 $12,747.65 2025-08-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $12,725.58 $12,725.58 $12,725.58 2025-08-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 2 2 — — $12,581.62 $12,581.62 $12,581.62 2025-08-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 2 2 — — $12,503.52 $12,503.52 $12,503.52 2025-08-01
886 MS_DRG Behavioral And Developmental Disorders 1 1 — — $12,470.27 $12,470.27 $12,470.27 2025-08-01
5113 OTHER Level 3 Musculoskeletal Procedures 17 10 — — $12,450.86 $12,450.86 $12,450.86 2025-08-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 2 1 — — $12,430.49 $12,430.49 $12,430.49 2025-08-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $12,416.18 $12,416.18 $12,416.18 2025-08-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 1 1 — — $12,149.05 $12,149.05 $12,149.05 2025-08-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 1 1 — — $12,002.42 $12,002.42 $12,002.42 2025-08-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/Mcc 2 2 — — $11,829.06 $11,829.06 $11,829.06 2025-08-01
387 MS_DRG Inflammatory Bowel Disease Without Cc/Mcc 1 1 — — $11,783.67 $11,783.67 $11,783.67 2025-08-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 2 2 — — $11,713.36 $11,713.36 $11,713.36 2025-08-01
0932 OTHER Factor Ix Recombinant Nos 1 1 — — $11,644.40 $11,644.40 $11,644.40 2025-08-01
398 MS_DRG Appendix Procedures With Cc 1 1 — — $11,555.60 $11,555.60 $11,555.60 2025-08-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 1 1 — — $11,476.95 $11,476.95 $11,476.95 2025-08-01
1490 OTHER Inj Pembrolizumab 1 1 — — $11,453.42 $11,453.42 $11,453.42 2025-08-01
881 MS_DRG Depressive Neuroses 2 2 — — $11,351.09 $11,351.09 $11,351.09 2025-08-01
551 MS_DRG Medical Back Problems With Mcc 2 2 — — $11,262.60 $11,262.60 $11,262.60 2025-08-01
555 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $11,098.55 $11,098.55 $11,098.55 2025-08-01
5223 OTHER Level 3 Pacemaker And Similar Procedures 2 2 — — $11,026.04 $11,026.04 $11,026.04 2025-08-01
5374 OTHER Level 4 Urology And Related Services 15 8 — — $10,978.48 $10,978.48 $10,978.48 2025-08-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 6 5 — — $10,968.94 $10,968.94 $10,968.94 2025-08-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 — — $10,813.78 $10,813.78 $10,813.78 2025-08-01
951 MS_DRG Other Factors Influencing Health Status 2 2 — — $10,803.50 $10,803.50 $10,803.50 2025-08-01
183 MS_DRG Major Chest Trauma With Mcc 1 1 — — $10,700.29 $10,700.29 $10,700.29 2025-08-01
501 MS_DRG Soft Tissue Procedures With Cc 1 1 — — $10,632.04 $10,632.04 $10,632.04 2025-08-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 5 4 — — $10,584.74 $10,584.74 $10,584.74 2025-08-01
571 MS_DRG Skin Debridement With Cc 2 1 — — $10,558.37 $10,558.37 $10,558.37 2025-08-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 4 4 — — $10,520.42 $10,520.42 $10,520.42 2025-08-01
86 MS_DRG Traumatic Stupor And Coma <1 Hour With Cc 1 1 — — $10,509.81 $10,509.81 $10,509.81 2025-08-01
358 MS_DRG Other Digestive System O.r. Procedures Without Cc/Mcc 1 1 — — $10,501.13 $10,501.13 $10,501.13 2025-08-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 2 2 — — $10,456.18 $10,456.18 $10,456.18 2025-08-01
5461 OTHER Level 1 Neurostimulator And Related Procedures 1 1 — — $10,443.00 $10,443.00 $10,443.00 2025-08-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/Mcc 1 1 — — $10,382.45 $10,382.45 $10,382.45 2025-08-01
5431 OTHER Level 1 Nerve Procedures 15 10 — — $10,276.55 $10,276.55 $10,276.55 2025-08-01
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 1 1 — — $10,144.01 $10,144.01 $10,144.01 2025-08-01
5222 OTHER Level 2 Pacemaker And Similar Procedures 2 2 — — $10,104.50 $10,104.50 $10,104.50 2025-08-01
948 MS_DRG Signs And Symptoms Without Mcc 1 1 — — $10,067.26 $10,067.26 $10,067.26 2025-08-01
869 MS_DRG Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc 1 1 — — $10,031.28 $10,031.28 $10,031.28 2025-08-01
9132 OTHER Prothrombin Complex Kcentra 1 1 — — $9,785.12 $9,785.12 $9,785.12 2025-08-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 7 6 — — $9,784.27 $9,784.27 $9,784.27 2025-08-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 4 3 — — $9,775.17 $9,775.17 $9,775.17 2025-08-01
5054 OTHER Level 4 Skin Procedures 12 8 — — $9,772.00 $9,772.00 $9,772.00 2025-08-01
389 MS_DRG Gastrointestinal Obstruction With Cc 5 5 — — $9,741.89 $9,741.89 $9,741.89 2025-08-01
643 MS_DRG Endocrine Disorders With Mcc 1 1 — — $9,709.72 $9,709.72 $9,709.72 2025-08-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 2 — — $9,697.08 $9,697.08 $9,697.08 2025-08-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 5 4 — — $9,653.76 $9,653.76 $9,653.76 2025-08-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 2 2 — — $9,626.12 $9,626.12 $9,626.12 2025-08-01
895 MS_DRG Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy 6 5 — — $9,497.60 $9,497.60 $9,497.60 2025-08-01
291 MS_DRG Heart Failure And Shock With Mcc 8 6 — — $9,380.22 $9,380.22 $9,380.22 2025-08-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 2 2 — — $9,304.80 $9,304.80 $9,304.80 2025-08-01
39 MS_DRG Extracranial Procedures Without Cc/Mcc 1 1 — — $9,252.99 $9,252.99 $9,252.99 2025-08-01
38 MS_DRG Extracranial Procedures With Cc 1 1 — — $9,252.99 $9,252.99 $9,252.99 2025-08-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 7 7 — — $9,241.16 $9,241.16 $9,241.16 2025-08-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 6 5 — — $9,171.56 $9,171.56 $9,171.56 2025-08-01
5164 OTHER Level 4 ENT Procedures 7 4 — — $9,157.26 $9,157.26 $9,157.26 2025-08-01
304 MS_DRG Hypertension With Mcc 1 1 — — $9,101.51 $9,101.51 $9,101.51 2025-08-01
638 MS_DRG Diabetes With Cc 5 3 — — $8,971.92 $8,971.92 $8,971.92 2025-08-01
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 1 1 — — $8,966.42 $8,966.42 $8,966.42 2025-08-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 1 1 — — $8,950.54 $8,950.54 $8,950.54 2025-08-01
603 MS_DRG Cellulitis Without Mcc 5 5 — — $8,947.03 $8,947.03 $8,947.03 2025-08-01
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $8,935.39 $8,935.39 $8,935.39 2025-08-01
687 MS_DRG Kidney And Urinary Tract Neoplasms With Cc 1 1 — — $8,812.68 $8,812.68 $8,812.68 2025-08-01
9378 OTHER Daratumumab, Hyaluronidase 2 2 — — $8,812.03 $8,812.03 $8,812.03 2025-08-01
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 14 8 — — $8,722.83 $8,722.83 $8,722.83 2025-08-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 2 2 — — $8,671.45 $8,671.45 $8,671.45 2025-08-01
882 MS_DRG Neuroses Except Depressive 4 4 — — $8,638.60 $8,638.60 $8,638.60 2025-08-01
552 MS_DRG Medical Back Problems Without Mcc 3 3 — — $8,565.40 $8,565.40 $8,565.40 2025-08-01
602 MS_DRG Cellulitis With Mcc 2 2 — — $8,539.05 $8,539.05 $8,539.05 2025-08-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 1 — — $8,412.26 $8,412.26 $8,412.26 2025-08-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 1 1 — — $8,367.80 $8,367.80 $8,367.80 2025-08-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 4 4 — — $8,356.73 $8,356.73 $8,356.73 2025-08-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 3 3 — — $8,342.31 $8,342.31 $8,342.31 2025-08-01
196 MS_DRG Interstitial Lung Disease With Mcc 2 2 — — $8,274.87 $8,274.87 $8,274.87 2025-08-01
5414 OTHER Level 4 Gynecologic Procedures 10 7 — — $8,239.99 $8,239.99 $8,239.99 2025-08-01
9186 OTHER Inj., Rituximab, 10 Mg 1 1 — — $8,167.32 $8,167.32 $8,167.32 2025-08-01
644 MS_DRG Endocrine Disorders With Cc 1 1 — — $8,159.71 $8,159.71 $8,159.71 2025-08-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 6 5 — — $8,145.10 $8,145.10 $8,145.10 2025-08-01
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 1 1 — — $8,007.12 $8,007.12 $8,007.12 2025-08-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 3 3 — — $7,956.04 $7,956.04 $7,956.04 2025-08-01
975 MS_DRG HIV With Major Related Condition With Cc 1 1 — — $7,918.02 $7,918.02 $7,918.02 2025-08-01
757 MS_DRG Infections, Female Reproductive System With Mcc 1 1 — — $7,886.64 $7,886.64 $7,886.64 2025-08-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 — — $7,872.28 $7,872.28 $7,872.28 2025-08-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 2 2 — — $7,826.24 $7,826.24 $7,826.24 2025-08-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 5 4 — — $7,725.15 $7,725.15 $7,725.15 2025-08-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 1 — — $7,618.83 $7,618.83 $7,618.83 2025-08-01
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 11 8 — — $7,604.98 $7,604.98 $7,604.98 2025-08-01
811 MS_DRG Red Blood Cell Disorders With Mcc 2 1 — — $7,596.70 $7,596.70 $7,596.70 2025-08-01
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 1 1 — — $7,594.00 $7,594.00 $7,594.00 2025-08-01
5191 OTHER Level 1 Endovascular Procedures 10 7 — — $7,576.47 $7,576.47 $7,576.47 2025-08-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 2 2 — — $7,505.48 $7,505.48 $7,505.48 2025-08-01
305 MS_DRG Hypertension Without Mcc 2 2 — — $7,463.40 $7,463.40 $7,463.40 2025-08-01
300 MS_DRG Peripheral Vascular Disorders With Cc 2 2 — — $7,461.30 $7,461.30 $7,461.30 2025-08-01
1207 OTHER Octreotide Injection, Depot 1 1 — — $7,402.63 $7,402.63 $7,402.63 2025-08-01
5154 OTHER Level 4 Airway Endoscopy 7 6 — — $7,397.23 $7,397.23 $7,397.23 2025-08-01
5183 OTHER Level 3 Vascular Procedures 11 8 — — $7,349.89 $7,349.89 $7,349.89 2025-08-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 1 1 — — $7,284.95 $7,284.95 $7,284.95 2025-08-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 — — $7,226.38 $7,226.38 $7,226.38 2025-08-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 1 1 — — $7,155.50 $7,155.50 $7,155.50 2025-08-01
5313 OTHER Level 3 Lower Gi Procedures 5 4 — — $7,062.09 $7,062.09 $7,062.09 2025-08-01
69 MS_DRG Transient Ischemia Without Thrombolytic 1 1 — — $7,027.38 $7,027.38 $7,027.38 2025-08-01
9200 OTHER Inj, Remdesivir, 1 Mg 3 2 — — $6,973.35 $6,973.35 $6,973.35 2025-08-01
684 MS_DRG Renal Failure Without Cc/Mcc 1 1 — — $6,920.39 $6,920.39 $6,920.39 2025-08-01
694 MS_DRG Urinary Stones Without Mcc 2 1 — — $6,900.49 $6,900.49 $6,900.49 2025-08-01
292 MS_DRG Heart Failure And Shock With Cc 1 1 — — $6,811.93 $6,811.93 $6,811.93 2025-08-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 6 5 — — $6,781.98 $6,781.98 $6,781.98 2025-08-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/Mcc 1 1 — — $6,777.83 $6,777.83 $6,777.83 2025-08-01
1489 OTHER Inj Vedolizumab IV 1 Mg 1 1 — — $6,709.20 $6,709.20 $6,709.20 2025-08-01
695 MS_DRG Kidney And Urinary Tract Signs And Symptoms With Mcc 1 1 — — $6,706.62 $6,706.62 $6,706.62 2025-08-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 1 1 — — $6,675.30 $6,675.30 $6,675.30 2025-08-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 1 — — $6,675.30 $6,675.30 $6,675.30 2025-08-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 18 9 — — $6,673.38 $6,673.38 $6,673.38 2025-08-01
637 MS_DRG Diabetes With Mcc 4 4 — — $6,662.93 $6,662.93 $6,662.93 2025-08-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $6,622.93 $6,622.93 $6,622.93 2025-08-01
683 MS_DRG Renal Failure With Cc 6 6 — — $6,591.19 $6,591.19 $6,591.19 2025-08-01
437 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas Without Cc/Mcc 1 1 — — $6,582.39 $6,582.39 $6,582.39 2025-08-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 5 5 — — $6,550.22 $6,550.22 $6,550.22 2025-08-01
5112 OTHER Level 2 Musculoskeletal Procedures 12 8 — — $6,549.07 $6,549.07 $6,549.07 2025-08-01
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 2 2 — — $6,484.66 $6,484.66 $6,484.66 2025-08-01
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $6,480.48 $6,480.48 $6,480.48 2025-08-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 1 1 — — $6,465.85 $6,465.85 $6,465.85 2025-08-01
297 MS_DRG Cardiac Arrest, Unexplained With Cc 1 1 — — $6,332.18 $6,332.18 $6,332.18 2025-08-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 7 6 — — $6,321.62 $6,321.62 $6,321.62 2025-08-01
201 MS_DRG Pneumothorax Without Cc/Mcc 1 1 — — $6,298.64 $6,298.64 $6,298.64 2025-08-01
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/Mcc 1 1 — — $6,252.89 $6,252.89 $6,252.89 2025-08-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/Mcc 1 1 — — $6,206.68 $6,206.68 $6,206.68 2025-08-01
394 MS_DRG Other Digestive System Diagnoses With Cc 1 1 — — $6,116.36 $6,116.36 $6,116.36 2025-08-01
0948 OTHER Gamunex-c/gammaked 3 3 — — $6,102.69 $6,102.69 $6,102.69 2025-08-01
5462 OTHER Level 2 Neurostimulator And Related Procedures 5 4 — — $5,989.40 $5,989.40 $5,989.40 2025-08-01
9473 OTHER Injection, Mepolizumab, 1mg 2 1 — — $5,934.68 $5,934.68 $5,934.68 2025-08-01
101 MS_DRG Seizures Without Mcc 1 1 — — $5,912.40 $5,912.40 $5,912.40 2025-08-01
5025 OTHER Level 5 Type A Ed Visits 32 18 — — $5,889.49 $5,889.49 $5,889.49 2025-08-01
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $5,797.42 $5,797.42 $5,797.42 2025-08-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 3 3 — — $5,438.96 $5,438.96 $5,438.96 2025-08-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 2 2 — — $5,430.25 $5,430.25 $5,430.25 2025-08-01
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 6 4 — — $5,353.49 $5,353.49 $5,353.49 2025-08-01
9357 OTHER Inj. Eptinezumab-jjmr 1 Mg 4 3 — — $5,347.14 $5,347.14 $5,347.14 2025-08-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 2 2 — — $5,239.10 $5,239.10 $5,239.10 2025-08-01
9466 OTHER Inj., Benralizumab, 1 Mg 1 1 — — $4,931.29 $4,931.29 $4,931.29 2025-08-01
1704 OTHER Humate-p, Inj 1 1 — — $4,753.74 $4,753.74 $4,753.74 2025-08-01
313 MS_DRG Chest Pain 1 1 — — $4,703.40 $4,703.40 $4,703.40 2025-08-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 3 3 — — $4,574.31 $4,574.31 $4,574.31 2025-08-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 20 10 — — $4,519.57 $4,519.57 $4,519.57 2025-08-01
9327 OTHER Inj. Romosozumab-aqqg 1 Mg 2 2 — — $4,514.02 $4,514.02 $4,514.02 2025-08-01
5153 OTHER Level 3 Airway Endoscopy 4 4 — — $4,509.94 $4,509.94 $4,509.94 2025-08-01
312 MS_DRG Syncope And Collapse 3 3 — — $4,464.45 $4,464.45 $4,464.45 2025-08-01
0759 OTHER Naltrexone, Depot Form 1 1 — — $4,325.36 $4,325.36 $4,325.36 2025-08-01
0944 OTHER Gammagard Liquid Injection 3 2 — — $4,234.71 $4,234.71 $4,234.71 2025-08-01
9133 OTHER Rabies Ig, Im/sc 3 3 — — $4,175.91 $4,175.91 $4,175.91 2025-08-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 1 1 — — $4,032.19 $4,032.19 $4,032.19 2025-08-01
9286 OTHER Belatacept Injection 3 2 — — $4,028.13 $4,028.13 $4,028.13 2025-08-01
5373 OTHER Level 3 Urology And Related Services 10 8 — — $3,691.12 $3,691.12 $3,691.12 2025-08-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 17 9 — — $3,485.35 $3,485.35 $3,485.35 2025-08-01
5302 OTHER Level 2 Upper Gi Procedures 12 8 — — $3,446.74 $3,446.74 $3,446.74 2025-08-01
9215 OTHER Cetuximab Injection 1 1 — — $3,409.09 $3,409.09 $3,409.09 2025-08-01
5443 OTHER Level 3 Nerve Injections 20 10 — — $3,386.80 $3,386.80 $3,386.80 2025-08-01
5303 OTHER Level 3 Upper Gi Procedures 1 1 — — $3,324.73 $3,324.73 $3,324.73 2025-08-01
1823 OTHER Injection, Dalbavancin 2 2 — — $3,273.66 $3,273.66 $3,273.66 2025-08-01
2072 OTHER Inj, Erzofri, 1 Mg 1 1 — — $3,214.72 $3,214.72 $3,214.72 2025-08-01
5312 OTHER Level 2 Lower Gi Procedures 25 13 — — $3,103.18 $3,103.18 $3,103.18 2025-08-01
9336 OTHER Inj Truxima 10 Mg 1 1 — — $3,029.59 $3,029.59 $3,029.59 2025-08-01
9255 OTHER Inj, Invega Sustenna, 1 Mg 1 1 — — $2,895.92 $2,895.92 $2,895.92 2025-08-01
9522 OTHER Rbc Leukoreduced Irradiated 1 1 — — $2,876.07 $2,876.07 $2,876.07 2025-08-01
1468 OTHER Inj, Abilify Maintena, 1 Mg 2 2 — — $2,844.70 $2,844.70 $2,844.70 2025-08-01
5573 OTHER Level 3 Imaging With Contrast 16 8 — — $2,813.47 $2,813.47 $2,813.47 2025-08-01
5182 OTHER Level 2 Vascular Procedures 7 5 — — $2,778.80 $2,778.80 $2,778.80 2025-08-01
9161 OTHER Inj Cefazolin Sodium, Baxter 1 1 — — $2,760.11 $2,760.11 $2,760.11 2025-08-01
9367 OTHER Inj Ruxience, 10 Mg 1 1 — — $2,714.75 $2,714.75 $2,714.75 2025-08-01
9530 OTHER Plate Pheres Leukoredu Irrad 1 1 — — $2,482.85 $2,482.85 $2,482.85 2025-08-01
5111 OTHER Level 1 Musculoskeletal Procedures 3 3 — — $2,453.01 $2,453.01 $2,453.01 2025-08-01
9230 OTHER Abatacept Injection 1 1 — — $2,323.19 $2,323.19 $2,323.19 2025-08-01
5311 OTHER Level 1 Lower Gi Procedures 21 10 — — $2,272.11 $2,272.11 $2,272.11 2025-08-01
7043 OTHER Infliximab Not Biosimil 10mg 1 1 — — $2,227.15 $2,227.15 $2,227.15 2025-08-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 1 1 — — $2,114.94 $2,114.94 $2,114.94 2025-08-01
9300 OTHER Omalizumab Injection 2 2 — — $2,037.51 $2,037.51 $2,037.51 2025-08-01
9239 OTHER Buprenorphine Xr Over 100 Mg 1 1 — — $1,962.87 $1,962.87 $1,962.87 2025-08-01
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