Price Transparency Hospital negotiated rates

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

NORTHERN LIGHT BLUE HILL MEMORIAL HOSPITAL

Blue Hill, ME · CCN 201300 · Rates published

14,672 distinct procedures filed
8 distinct payers
407,288 rate rows
2026-03-30 last MRF observed
Data quality

136,977 of 407,288 rate rows are consumer-grade (33.6%)

270,311 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 260,558
per-diem day rate — not a per-procedure price 3,883
template filing: same amount across many unrelated codes — excluded 3,462
placeholder amount (≤ $0.02) — excluded from medians 1,977
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 263
percent-of-charges filed in the dollar field — excluded from medians 168
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://northernlighthealth.org/NLH/media/Price-Transparency/010227195_Blue-Hill-Hospital_standardcharges.csv
Found on page https://northernlighthealth.org/Resources/Price-Transparency/Standard-Charges/Machine-Readable-Files
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-19
Content fingerprint efafe9245ce0ef43… · 145,488,733 bytes · first seen 2026-05-15

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
CPT 		Inj Hemgenix Per Tx Dose 1 $4,192,300.00 $4,192,300.00 $4,192,300.00 nat. median
$3,710,000
1.1× median
J1413
CPT 		Inj Delandistrogene Mox Rokl 1 $3,753,613.11 $3,753,613.11 $3,753,613.11 nat. median
$3,325,455
1.1× median
J1414
CPT 		Inj Beqvez Per Tx Dose 2 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J3394
CPT 		Inj Lovotibeglogene Autotem 1 $3,608,090.00 $3,608,090.00 $3,608,090.00 nat. median
$3,286,000
1.1× median
J3393
CPT 		Inj Betibeglogene Autotemce 1 $3,353,840.00 $3,353,840.00 $3,353,840.00 nat. median
$3,006,423
1.1× median
J3399
CPT 		Inj Onase Abepar-xioi Treat 1 $2,715,908.39 $2,715,908.39 $2,715,908.39 nat. median
$2,469,189
1.1× median
J3392
CPT 		Inj Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 3 $785,156.53 $1,306,495.61 $1,156,143.03 nat. median
$370,174
outlier · 3.1×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $509,535.00 $847,863.09 $750,290.32 nat. median
$265,286
outlier · 2.8×
Q2042
CPT 		Tisagenlecleucel Car-pos T 1 $639,154.94 $639,154.94 $639,154.94 nat. median
$754,974
0.8× median
Q2056
CPT 		Ciltacabtagene Car-pos T 1 $622,989.72 $622,989.72 $622,989.72 nat. median
$675,122
0.9× median
Q2055
CPT 		Idecabtagene Vicleucel Car 1 $596,993.05 $596,993.05 $596,993.05 nat. median
$625,184
1.0× median
Q2054
CPT 		Lisocabtagene Mara Car Pos T 1 $583,629.15 $583,629.15 $583,629.15 nat. median
$674,188
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $388,198.18 $645,959.38 $571,621.85 nat. median
$206,368
outlier · 2.8×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 3 $385,919.96 $642,168.43 $568,267.17 nat. median
$202,986
outlier · 2.8×
Q2041
CPT 		Axicabtagene Ciloleucel Car+ 1 $553,154.38 $553,154.38 $553,154.38 nat. median
$634,511
0.9× median
Q2053
CPT 		Brexucabtagene Car Pos T 1 $551,498.21 $551,498.21 $551,498.21 nat. median
$620,080
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 3 $251,848.35 $419,074.11 $370,846.72 nat. median
$133,176
outlier · 2.8×
7
MS_DRG 		Lung Transplant 3 $235,462.59 $391,808.30 $346,718.68 nat. median
$122,708
outlier · 2.8×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $218,511.37 $363,601.56 $321,758.00 nat. median
$117,303
outlier · 2.7×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $206,036.59 $342,843.61 $303,388.89 nat. median
$108,660
outlier · 2.8×
209
MS_DRG 		Kidney And Urinary Tract Signs And Symptoms Age 0-17 3 $205,800.22 $342,450.29 $303,040.83 nat. median
$98,017
outlier · 3.1×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $200,389.21 $333,446.41 $295,073.12 nat. median
$98,905
outlier · 3.0×
212
MS_DRG 		Testes Procedures Age 0-17 3 $197,714.61 $328,995.90 $291,134.78 nat. median
$102,358
outlier · 2.8×
J3403
CPT 		Revakinagene Per Implant 2 $249,194.60 $319,480.25 $284,337.42 nat. median
$265,000
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $187,467.15 $311,944.18 $276,045.39 nat. median
$100,136
outlier · 2.8×
215
MS_DRG 		Other Heart Assist System Implant 3 $181,039.76 $301,249.04 $266,581.05 nat. median
$99,019
outlier · 2.7×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $177,872.42 $295,978.61 $261,917.15 nat. median
$93,672
outlier · 2.8×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 $163,813.98 $272,585.45 $241,216.10 nat. median
$82,712
outlier · 2.9×
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $157,448.40 $261,993.17 $231,842.79 nat. median
$83,442
outlier · 2.8×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 3 $153,273.78 $255,046.62 $225,695.65 nat. median
$79,312
outlier · 2.8×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 3 $152,791.95 $254,244.87 $224,986.16 nat. median
$81,118
outlier · 2.8×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $143,071.77 $238,070.54 $210,673.20 nat. median
$77,576
outlier · 2.7×
0266T
CPT 		Implt/rpl Crtd Sns Dev Total 2 $161,600.59 $243,753.34 $207,180.25 nat. median
$42,941
outlier · 4.8×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 $139,608.07 $232,306.97 $205,572.89 nat. median
$74,915
outlier · 2.7×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 3 $139,006.24 $231,305.53 $204,686.70 nat. median
$73,807
outlier · 2.8×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 $138,546.23 $230,540.07 $204,009.33 nat. median
$72,138
outlier · 2.8×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $131,249.73 $218,398.74 $193,265.24 nat. median
$68,090
outlier · 2.8×
10
MS_DRG 		Pancreas Transplant 3 $130,469.72 $217,100.80 $192,116.67 nat. median
$68,882
outlier · 2.8×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 $130,415.17 $217,010.04 $192,036.35 nat. median
$64,027
outlier · 3.0×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $129,722.43 $215,857.32 $191,016.29 nat. median
$71,240
outlier · 2.7×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 $129,646.07 $215,730.25 $190,903.83 nat. median
$68,887
outlier · 2.8×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $125,671.45 $209,116.51 $185,051.21 nat. median
$66,526
outlier · 2.8×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 $125,055.07 $208,090.86 $184,143.60 nat. median
$65,950
outlier · 2.8×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 3 $122,385.93 $203,649.43 $180,213.29 nat. median
$64,732
outlier · 2.8×
317
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 $121,575.00 $202,300.06 $179,019.20 nat. median
$60,691
outlier · 2.9×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 $121,485.91 $202,151.81 $178,888.02 nat. median
$63,738
outlier · 2.8×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $119,553.15 $198,935.70 $176,042.02 nat. median
$64,510
outlier · 2.7×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $119,553.15 $198,935.70 $176,042.02 nat. median
$61,920
outlier · 2.8×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 $119,118.60 $198,212.61 $175,402.14 nat. median
$59,793
outlier · 2.9×

Other procedures at this hospital

Browse this hospital's 14,672 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 4 3 — — $49,204.56 $81,876.08 $72,453.71 2026-03-30
850 MS_DRG Acute Leukemia With Other Procedures 4 3 — — $157,448.40 $261,993.17 $231,842.79 2026-03-30
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 4 3 — — $99,818.23 $166,096.92 $146,982.35 2026-03-30
245 MS_DRG Aicd Generator Procedures 4 3 — — $82,954.28 $138,035.41 $122,150.18 2026-03-30
265 MS_DRG Aicd Lead Procedures 4 3 — — $65,786.69 $109,468.64 $96,870.90 2026-03-30
14 MS_DRG Allogeneic Bone Marrow Transplant 4 3 — — $218,511.37 $363,601.56 $321,758.00 2026-03-30
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 4 3 — — $51,828.24 $86,241.88 $76,317.10 2026-03-30
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 4 3 — — $89,487.13 $148,906.03 $131,769.80 2026-03-30
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 3 — — $78,054.19 $129,881.69 $114,934.79 2026-03-30
616 MS_DRG Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With… 4 3 — — $63,408.46 $105,511.29 $93,368.96 2026-03-30
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 3 — — $125,055.07 $208,090.86 $184,143.60 2026-03-30
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 3 — — $76,786.89 $127,772.92 $113,068.70 2026-03-30
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 4 3 — — $107,814.75 $179,403.07 $158,757.22 2026-03-30
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 4 3 — — $98,770.94 $164,354.24 $145,440.21 2026-03-30
Q2041 CPT Axicabtagene Ciloleucel Car+ 1 1 — — $553,154.38 $553,154.38 $553,154.38 2026-03-30
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 4 3 — — $67,952.18 $113,072.01 $100,059.59 2026-03-30
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 4 3 — — $46,895.42 $78,033.70 $69,053.51 2026-03-30
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 4 3 — — $63,990.29 $106,479.45 $94,225.71 2026-03-30
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 4 3 — — $46,895.42 $78,033.70 $69,053.51 2026-03-30
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 4 3 — — $100,420.06 $167,098.37 $147,868.55 2026-03-30
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 4 3 — — $48,364.54 $80,478.30 $71,216.79 2026-03-30
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 4 3 — — $64,830.31 $107,877.23 $95,462.63 2026-03-30
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 4 3 — — $44,713.56 $74,403.10 $65,840.73 2026-03-30
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 4 3 — — $62,812.09 $104,518.92 $92,490.80 2026-03-30
C9758 CPT Blind Interatrial Shunt Ide 3 2 — — $62,845.79 $94,794.64 $80,571.52 2026-03-30
C9782 CPT Blind Myocar Trpl Bon Marrow 3 2 — — $62,845.79 $94,794.64 $80,571.52 2026-03-30
C2616 CPT Brachytx Non-stryttrium-90 3 2 — — $17,485.10 $80,500.60 $62,790.47 2026-03-30
Q2053 CPT Brexucabtagene Car Pos T 1 1 — — $551,498.21 $551,498.21 $551,498.21 2026-03-30
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 3 — — $129,646.07 $215,730.25 $190,903.83 2026-03-30
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 3 — — $109,212.96 $181,729.68 $160,816.08 2026-03-30
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 4 3 — — $57,130.16 $95,064.24 $84,124.17 2026-03-30
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 4 3 — — $59,142.93 $98,413.46 $87,087.96 2026-03-30
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 3 — — $177,872.42 $295,978.61 $261,917.15 2026-03-30
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 3 — — $119,553.15 $198,935.70 $176,042.02 2026-03-30
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 3 — — $119,553.15 $198,935.70 $176,042.02 2026-03-30
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 3 — — $139,608.07 $232,306.97 $205,572.89 2026-03-30
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 3 — — $96,961.82 $161,343.86 $142,776.28 2026-03-30
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 3 — — $91,641.72 $152,491.25 $134,942.43 2026-03-30
35 MS_DRG Carotid Artery Stent Procedures With Cc 4 3 — — $43,464.45 $72,324.58 $64,001.40 2026-03-30
34 MS_DRG Carotid Artery Stent Procedures With Mcc 4 3 — — $70,377.68 $117,108.03 $103,631.15 2026-03-30
472 MS_DRG Cervical Spinal Fusion With Cc 4 3 — — $53,566.46 $89,134.26 $78,876.61 2026-03-30
471 MS_DRG Cervical Spinal Fusion With Mcc 4 3 — — $87,796.19 $146,092.32 $129,279.90 2026-03-30
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 4 3 — — $44,388.10 $73,861.53 $65,361.49 2026-03-30
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 3 — — $87,352.55 $145,354.10 $128,626.62 2026-03-30
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 4 3 — — $47,137.25 $78,436.09 $69,409.60 2026-03-30
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 4 3 — — $785,156.53 $1,306,495.61 $1,156,143.03 2026-03-30
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 4 3 — — $64,775.76 $107,786.46 $95,382.30 2026-03-30
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 4 3 — — $60,061.13 $99,941.34 $88,440.01 2026-03-30
Q2056 CPT Ciltacabtagene Car-pos T 1 1 — — $622,989.72 $622,989.72 $622,989.72 2026-03-30
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 3 — — $163,813.98 $272,585.45 $241,216.10 2026-03-30
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 4 3 — — $104,858.33 $174,483.61 $154,403.90 2026-03-30
545 MS_DRG Connective Tissue Disorders With Mcc 4 3 — — $45,122.66 $75,083.83 $66,443.12 2026-03-30
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 4 3 — — $139,006.24 $231,305.53 $204,686.70 2026-03-30
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 4 3 — — $99,323.68 $165,273.99 $146,254.12 2026-03-30
231 MS_DRG Coronary Bypass With Ptca With Mcc 4 3 — — $153,273.78 $255,046.62 $225,695.65 2026-03-30
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 3 — — $110,231.16 $183,423.96 $162,315.38 2026-03-30
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 4 3 — — $106,703.82 $177,554.49 $157,121.38 2026-03-30
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 4 3 — — $76,161.43 $126,732.14 $112,147.71 2026-03-30
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 4 3 — — $78,681.47 $130,925.49 $115,858.48 2026-03-30
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 4 3 — — $57,291.98 $95,333.51 $84,362.45 2026-03-30
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 4 3 — — $58,372.00 $97,130.65 $85,952.77 2026-03-30
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 4 3 — — $56,531.97 $94,068.85 $83,243.33 2026-03-30
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 4 3 — — $82,668.82 $137,560.41 $121,729.85 2026-03-30
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 4 3 — — $45,871.77 $76,330.34 $67,546.18 2026-03-30
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 3 — — $122,385.93 $203,649.43 $180,213.29 2026-03-30
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 3 — — $104,189.22 $173,370.23 $153,418.64 2026-03-30
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 3 — — $71,126.79 $118,354.53 $104,734.20 2026-03-30
J7330 CPT Cultured Chondrocytes Implnt 2 2 — — $156,380.06 $156,380.06 $156,380.06 2026-03-30
Q0480 CPT Driver Pneumatic Vad Rep 3 2 — — $99,999.91 $131,664.24 $102,698.11 2026-03-30
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 4 3 — — $385,919.96 $642,168.43 $568,267.17 2026-03-30
317 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 3 — — $121,575.00 $202,300.06 $179,019.20 2026-03-30
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 4 3 — — $111,427.54 $185,414.74 $164,077.06 2026-03-30
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 4 3 — — $86,561.62 $144,038.00 $127,461.99 2026-03-30
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 3 2 — — $125,689.75 $189,586.53 $161,140.70 2026-03-30
L8702 CPT Ewhf S/d Uprt Micro Sensor 3 2 — — $65,277.04 $83,688.52 $67,452.66 2026-03-30
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 3 — — $388,198.18 $645,959.38 $571,621.85 2026-03-30
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 4 3 — — $70,804.96 $117,819.02 $104,260.31 2026-03-30
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 4 3 — — $44,700.84 $74,381.92 $65,821.99 2026-03-30
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 3 — — $85,307.05 $141,950.41 $125,614.64 2026-03-30
37 MS_DRG Extracranial Procedures With Mcc 4 3 — — $59,857.49 $99,602.49 $88,140.15 2026-03-30
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome- Neonate 4 3 — — $108,065.66 $179,820.59 $159,126.70 2026-03-30
503 MS_DRG Foot Procedures With Mcc 4 3 — — $50,748.22 $84,444.73 $74,726.76 2026-03-30
793 MS_DRG Full Term Neonate With Major Problems 4 3 — — $75,812.33 $126,151.25 $111,633.66 2026-03-30
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 4 3 — — $130,415.17 $217,010.04 $192,036.35 2026-03-30
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 4 3 — — $58,561.10 $97,445.30 $86,231.22 2026-03-30
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 3 — — $509,535.00 $847,863.09 $750,290.32 2026-03-30
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 3 — — $206,036.59 $342,843.61 $303,388.89 2026-03-30
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 4 3 — — $61,948.43 $103,081.81 $91,219.08 2026-03-30
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 4 3 — — $52,764.62 $87,800.01 $77,695.91 2026-03-30
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 4 3 — — $52,951.90 $88,111.64 $77,971.68 2026-03-30
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 5 4 — — $46,750.00 $86,837.90 $66,905.68 2026-03-30
0686T CPT Histotripsy Mal Hepatcel Tis 3 2 — — $62,845.79 $94,794.64 $80,571.52 2026-03-30
0888T CPT Histotripsy Mal Renal Tissue 3 2 — — $62,845.79 $94,794.64 $80,571.52 2026-03-30
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 4 3 — — $111,298.45 $185,199.93 $163,886.98 2026-03-30
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 4 3 — — $47,953.63 $79,794.54 $70,611.72 2026-03-30
974 MS_DRG HIV With Major Related Condition With Mcc 4 3 — — $52,473.71 $87,315.93 $77,267.55 2026-03-30
Q2055 CPT Idecabtagene Vicleucel Car 1 1 — — $596,993.05 $596,993.05 $596,993.05 2026-03-30
C8003 CPT Imp Extar Knee Shck Absrb 3 2 — — $66,040.20 $99,613.00 $84,666.93 2026-03-30
0268T CPT Implt/rpl Crtd Sns Dev Gen 3 2 — — $109,433.22 $165,065.68 $140,299.00 2026-03-30
0266T CPT Implt/rpl Crtd Sns Dev Total 3 2 — — $161,600.59 $243,753.34 $207,180.25 2026-03-30
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 3 — — $89,794.41 $149,417.34 $132,222.27 2026-03-30
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 4 3 — — $45,308.12 $75,392.43 $66,716.21 2026-03-30
J1414 CPT Inj Beqvez Per Tx Dose 2 2 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-03-30
J3393 CPT Inj Betibeglogene Autotemce 1 1 — — $3,353,840.00 $3,353,840.00 $3,353,840.00 2026-03-30
J1413 CPT Inj Delandistrogene Mox Rokl 1 1 — — $3,753,613.11 $3,753,613.11 $3,753,613.11 2026-03-30
J3392 CPT Inj Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-30
J1411 CPT Inj Hemgenix Per Tx Dose 1 1 — — $4,192,300.00 $4,192,300.00 $4,192,300.00 2026-03-30
J3394 CPT Inj Lovotibeglogene Autotem 1 1 — — $3,608,090.00 $3,608,090.00 $3,608,090.00 2026-03-30
J3399 CPT Inj Onase Abepar-xioi Treat 1 1 — — $2,715,908.39 $2,715,908.39 $2,715,908.39 2026-03-30
0308T CPT Insj Ocular Telescope Prosth 3 2 — — $58,952.82 $88,922.62 $75,580.54 2026-03-30
0916T CPT Insj Perm Ccm-d Sys Pg Only 3 2 — — $80,606.17 $121,583.85 $103,341.24 2026-03-30
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 3 2 — — $115,135.83 $173,667.34 $147,610.04 2026-03-30
0515T CPT Insj Wcs Lv Compl Sys 3 2 — — $80,606.17 $121,583.85 $103,341.24 2026-03-30
0409T CPT Insj/rplc Car Modulj Pls Gn 3 2 — — $80,606.17 $121,583.85 $103,341.24 2026-03-30
0408T CPT Insj/rplc Cardiac Modulj Sys 3 2 — — $115,135.83 $173,667.34 $147,610.04 2026-03-30
0525T CPT Insj/rplcmt Compl Iims 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0571T CPT Insj/rplcmt Icds Ss Eltrd 3 2 — — $115,135.83 $173,667.34 $147,610.04 2026-03-30
0680T CPT Insj/rplcmt Pg Only Isdss 3 2 — — $77,008.60 $116,157.39 $98,728.98 2026-03-30
J9029 CPT Instill Adstiladrin Tx Dose 5 4 — — $61,299.24 $167,040.00 $78,588.77 2026-03-30
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 3 — — $96,252.71 $160,163.92 $141,732.12 2026-03-30
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 3 — — $143,071.77 $238,070.54 $210,673.20 2026-03-30
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 4 3 — — $57,771.99 $96,132.24 $85,069.26 2026-03-30
61 MS_DRG Ischemic Stroke- Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 3 — — $50,130.03 $83,416.06 $73,816.47 2026-03-30
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 4 3 — — $57,888.36 $96,325.87 $85,240.61 2026-03-30
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 4 3 — — $46,199.05 $76,874.93 $68,028.10 2026-03-30
209 MS_DRG Kidney And Urinary Tract Signs And Symptoms Age 0-17 4 3 — — $205,800.22 $342,450.29 $303,040.83 2026-03-30
652 MS_DRG Kidney Transplant 4 3 — — $58,719.28 $97,708.52 $86,464.15 2026-03-30
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 3 — — $85,481.60 $142,240.86 $125,871.67 2026-03-30
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 4 3 — — $67,379.44 $112,118.98 $99,216.24 2026-03-30
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 4 3 — — $58,675.64 $97,635.91 $86,399.90 2026-03-30
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 4 3 — — $43,389.90 $72,200.53 $63,891.64 2026-03-30
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 3 2 — — $109,433.22 $165,065.68 $140,299.00 2026-03-30
956 MS_DRG Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma 4 3 — — $68,419.46 $113,849.57 $100,747.67 2026-03-30
Q2054 CPT Lisocabtagene Mara Car Pos T 1 1 — — $583,629.15 $583,629.15 $583,629.15 2026-03-30
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 3 — — $187,467.15 $311,944.18 $276,045.39 2026-03-30
6 MS_DRG Liver Transplant Without Mcc 4 3 — — $84,310.67 $140,292.44 $124,147.46 2026-03-30
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 3 — — $65,923.05 $109,695.55 $97,071.70 2026-03-30
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 4 3 — — $54,851.94 $91,273.28 $80,769.48 2026-03-30
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Cc 4 3 — — $46,111.77 $76,729.71 $67,899.59 2026-03-30
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc 4 3 — — $66,757.61 $111,084.26 $98,300.59 2026-03-30
7 MS_DRG Lung Transplant 4 3 — — $235,462.59 $391,808.30 $346,718.68 2026-03-30
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 3 — — $106,634.72 $177,439.52 $157,019.64 2026-03-30
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 4 3 — — $58,817.47 $97,871.90 $86,608.73 2026-03-30
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 3 — — $83,361.56 $138,713.12 $122,749.90 2026-03-30
654 MS_DRG Major Bladder Procedures With Cc 4 3 — — $50,897.32 $84,692.82 $74,946.30 2026-03-30
653 MS_DRG Major Bladder Procedures With Mcc 4 3 — — $94,481.77 $157,217.08 $139,124.41 2026-03-30
164 MS_DRG Major Chest Procedures With Cc 4 3 — — $45,891.77 $76,363.62 $67,575.63 2026-03-30
163 MS_DRG Major Chest Procedures With Mcc 4 3 — — $81,488.80 $135,596.86 $119,992.26 2026-03-30
397 MS_DRG Major Head And Neck Procedures With Cc 4 3 — — $43,544.45 $72,457.70 $64,119.21 2026-03-30
140 MS_DRG Major Head And Neck Procedures With Mcc 4 3 — — $77,552.36 $129,046.65 $114,195.86 2026-03-30
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 5 4 — — $46,750.00 $91,769.47 $70,705.29 2026-03-30
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 4 3 — — $50,399.13 $83,863.83 $74,212.71 2026-03-30
330 MS_DRG Major Small And Large Bowel Procedures With Cc 4 3 — — $43,586.27 $72,527.29 $64,180.79 2026-03-30
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 3 — — $83,574.29 $139,067.11 $123,063.15 2026-03-30
662 MS_DRG Minor Bladder Procedures With Mcc 4 3 — — $55,664.68 $92,625.68 $81,966.24 2026-03-30
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 4 3 — — $46,960.88 $78,142.61 $69,149.90 2026-03-30
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 3 — — $200,389.21 $333,446.41 $295,073.12 2026-03-30
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 3 — — $131,249.73 $218,398.74 $193,265.24 2026-03-30
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 3 — — $102,220.10 $170,093.61 $150,519.10 2026-03-30
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 3 — — $121,485.91 $202,151.81 $178,888.02 2026-03-30
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 4 3 — — $77,106.90 $128,305.40 $113,539.92 2026-03-30
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 4 3 — — $85,052.50 $141,526.84 $125,239.82 2026-03-30
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 4 3 — — $57,455.62 $95,605.80 $84,603.40 2026-03-30
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 4 3 — — $65,670.32 $109,275.01 $96,699.55 2026-03-30
C9760 CPT Non-blind Interatrial Shunt 3 2 — — $98,756.63 $148,961.45 $126,611.06 2026-03-30
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 3 — — $62,335.71 $103,726.24 $91,789.34 2026-03-30
619 MS_DRG O.r. Procedures For Obesity With Mcc 4 3 — — $52,499.17 $87,358.29 $77,305.02 2026-03-30
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 4 3 — — $42,489.89 $70,702.91 $62,566.36 2026-03-30
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 4 3 — — $65,973.96 $109,780.27 $97,146.67 2026-03-30
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 4 3 — — $70,272.23 $116,932.55 $103,475.86 2026-03-30
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 3 2 — — $77,008.60 $116,157.39 $98,728.98 2026-03-30
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 3 2 — — $77,008.60 $116,157.39 $98,728.98 2026-03-30
113 MS_DRG Orbital Procedures With Cc/mcc 4 3 — — $42,748.07 $71,132.53 $62,946.54 2026-03-30
228 MS_DRG Other Cardiothoracic Procedures With Mcc 4 3 — — $89,954.41 $149,683.59 $132,457.88 2026-03-30
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 4 3 — — $57,264.71 $95,288.12 $84,322.29 2026-03-30
264 MS_DRG Other Circulatory System O.r. Procedures 4 3 — — $60,739.32 $101,069.85 $89,438.65 2026-03-30
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 3 — — $79,870.59 $132,904.16 $117,609.45 2026-03-30
143 MS_DRG Other Ear- Nose- Mouth And Throat O.r. Procedures With Mcc 4 3 — — $68,121.28 $113,353.38 $100,308.58 2026-03-30
628 MS_DRG Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc 4 3 — — $67,761.27 $112,754.33 $99,778.47 2026-03-30
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 4 3 — — $81,145.16 $135,025.04 $119,486.24 2026-03-30
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 4 3 — — $43,733.55 $72,772.35 $64,397.65 2026-03-30
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 4 3 — — $46,684.51 $77,682.74 $68,742.95 2026-03-30
215 MS_DRG Other Heart Assist System Implant 4 3 — — $181,039.76 $301,249.04 $266,581.05 2026-03-30
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 3 — — $75,510.51 $125,649.02 $111,189.23 2026-03-30
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 4 3 — — $42,520.80 $70,754.34 $62,611.88 2026-03-30
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 4 3 — — $76,394.16 $127,119.41 $112,490.40 2026-03-30
271 MS_DRG Other Major Cardiovascular Procedures With Cc 4 3 — — $64,661.21 $107,595.86 $95,213.64 2026-03-30
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 4 3 — — $95,934.52 $159,634.46 $141,263.60 2026-03-30
277 MS_DRG Other Major Cardiovascular Procedures With Mcc 4 3 — — $83,974.30 $139,732.72 $123,652.17 2026-03-30
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 4 3 — — $46,419.05 $77,241.02 $68,352.05 2026-03-30
963 MS_DRG Other Multiple Significant Trauma With Mcc 4 3 — — $49,706.39 $82,711.12 $73,192.66 2026-03-30
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 4 3 — — $57,944.72 $96,419.66 $85,323.61 2026-03-30
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 4 3 — — $69,806.76 $116,158.02 $102,790.46 2026-03-30
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 4 3 — — $76,617.80 $127,491.54 $112,819.71 2026-03-30
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 3 — — $138,546.23 $230,540.07 $204,009.33 2026-03-30
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 4 3 — — $53,530.09 $89,073.75 $78,823.07 2026-03-30
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 4 3 — — $72,439.54 $120,538.95 $106,667.23 2026-03-30
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 3 — — $67,959.45 $113,084.11 $100,070.30 2026-03-30
579 MS_DRG Other Skin- Subcutaneous Tissue And Breast Procedures With Mcc 4 3 — — $58,882.92 $97,980.82 $86,705.10 2026-03-30
253 MS_DRG Other Vascular Procedures With Cc 4 3 — — $47,193.61 $78,529.88 $69,492.60 2026-03-30
252 MS_DRG Other Vascular Procedures With Mcc 4 3 — — $63,424.82 $105,538.52 $93,393.06 2026-03-30
10 MS_DRG Pancreas Transplant 4 3 — — $130,469.72 $217,100.80 $192,116.67 2026-03-30
406 MS_DRG Pancreas- Liver And Shunt Procedures With Cc 4 3 — — $52,731.90 $87,745.55 $77,647.73 2026-03-30
405 MS_DRG Pancreas- Liver And Shunt Procedures With Mcc 4 3 — — $99,465.50 $165,509.98 $146,462.96 2026-03-30
C8005 CPT Pef Bronch Ablt 3d Nav Ebus 2 1 — — $62,845.79 $80,571.52 $71,708.65 2026-03-30
C9607 CPT Perc D-e Cor Revasc Chro Sin 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
C9602 CPT Perc D-e Cor Stent Ather S 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 4 3 — — $49,470.02 $82,317.80 $72,844.60 2026-03-30
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 4 3 — — $62,521.17 $104,034.84 $92,062.43 2026-03-30
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 4 3 — — $43,897.19 $73,044.65 $64,638.61 2026-03-30
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 4 3 — — $44,040.83 $73,283.66 $64,850.12 2026-03-30
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 4 3 — — $75,010.50 $124,817.00 $110,452.96 2026-03-30
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 4 3 — — $59,850.21 $99,590.38 $88,129.44 2026-03-30
40 MS_DRG Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc 4 3 — — $70,204.95 $116,820.61 $103,376.80 2026-03-30
335 MS_DRG Peritoneal Adhesiolysis With Mcc 4 3 — — $64,926.67 $108,037.58 $95,604.52 2026-03-30
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 4 3 — — $58,052.00 $96,598.16 $85,481.57 2026-03-30
0632T CPT Perq Tcat US Abltj Nrv P-art 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 4 3 — — $82,705.19 $137,620.92 $121,783.39 2026-03-30
791 MS_DRG Prematurity With Major Problems 4 3 — — $73,801.38 $122,805.05 $108,672.54 2026-03-30
792 MS_DRG Prematurity Without Major Problems 4 3 — — $44,531.74 $74,100.55 $65,572.99 2026-03-30
665 MS_DRG Prostatectomy With Mcc 4 3 — — $56,750.15 $94,431.91 $83,564.61 2026-03-30
0793T CPT Prq Tcat Thrm Ablt Nrv P-art 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
0956T CPT Prt Crn Ch Cr&tun Elt S-sclp 2 1 — — $80,801.21 $103,591.29 $92,196.25 2026-03-30
849 MS_DRG Radiotherapy 4 3 — — $49,264.56 $81,975.92 $72,542.07 2026-03-30
333 MS_DRG Rectal Resection With Cc 4 3 — — $42,586.25 $70,863.26 $62,708.26 2026-03-30
332 MS_DRG Rectal Resection With Mcc 4 3 — — $65,832.14 $109,544.28 $96,937.83 2026-03-30
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 4 3 — — $49,977.30 $83,161.92 $73,591.57 2026-03-30
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 4 3 — — $116,996.74 $194,681.85 $172,277.71 2026-03-30
J3403 CPT Revakinagene Per Implant 3 2 — — $249,194.60 $319,480.25 $284,337.42 2026-03-30
C9766 CPT Revasc Intra Lithotrip-ather 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
C9765 CPT Revasc Intra Lithotrip-stent 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
C9775 CPT Revasc Lith-sten-ath Tib/per 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
C9774 CPT Revasc Lithotr-ather Tib/per 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
C9773 CPT Revasc Lithotr-stent Tib/per 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
C9767 CPT Revasc Lithotrip-stent-ather 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 4 3 — — $64,121.20 $106,697.28 $94,418.48 2026-03-30
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 4 3 — — $94,645.41 $157,489.38 $139,365.37 2026-03-30
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 4 3 — — $49,964.57 $83,140.74 $73,572.83 2026-03-30
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 3 2 — — $80,606.17 $121,583.85 $103,341.24 2026-03-30
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 3 2 — — $80,606.17 $121,583.85 $103,341.24 2026-03-30
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 3 2 — — $80,606.17 $121,583.85 $103,341.24 2026-03-30
0960T CPT Rpl S-sclp Eltr Ra Rcvr&tlmt 2 1 — — $80,801.21 $103,591.29 $92,196.25 2026-03-30
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 4 3 — — $125,671.45 $209,116.51 $185,051.21 2026-03-30
510 MS_DRG Shoulderelbow Or Forearm Procexc Major Joint Proc W Mcc 4 3 — — $54,919.21 $91,385.23 $80,868.54 2026-03-30
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 3 — — $129,722.43 $215,857.32 $191,016.29 2026-03-30
8 MS_DRG Simultaneous Pancreas/kidney Transplant 4 3 — — $101,903.73 $169,567.17 $150,053.24 2026-03-30
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 3 — — $73,101.37 $121,640.23 $107,641.77 2026-03-30
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 4 3 — — $96,903.63 $161,247.05 $142,690.61 2026-03-30
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 4 3 — — $58,735.65 $97,735.75 $86,488.24 2026-03-30
Q2043 CPT Sipuleucel-t Auto Cd54+ 3 2 — — $53,489.57 $68,576.37 $62,756.25 2026-03-30
570 MS_DRG Skin Debridement With Mcc 4 3 — — $53,475.55 $88,982.98 $78,742.74 2026-03-30
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 4 3 — — $48,195.45 $80,196.93 $70,967.81 2026-03-30
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 3 — — $89,114.40 $148,285.81 $131,220.95 2026-03-30
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 4 3 — — $63,117.55 $105,027.21 $92,940.59 2026-03-30
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 3 — — $119,118.60 $198,212.61 $175,402.14 2026-03-30
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor… 4 3 — — $64,713.94 $107,683.60 $95,291.28 2026-03-30
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 4 3 — — $66,784.89 $111,129.64 $98,340.75 2026-03-30
500 MS_DRG Soft Tissue Procedures With Mcc 4 3 — — $57,542.90 $95,751.02 $84,731.92 2026-03-30
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 4 3 — — $152,791.95 $254,244.87 $224,986.16 2026-03-30
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 4 3 — — $108,422.03 $180,413.59 $159,651.45 2026-03-30
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 4 3 — — $75,866.88 $126,242.01 $111,713.98 2026-03-30
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 4 3 — — $62,030.25 $103,217.96 $91,339.55 2026-03-30
28 MS_DRG Spinal Procedures With Mcc 4 3 — — $109,243.86 $181,781.12 $160,861.60 2026-03-30
213 MS_DRG Splenic Procedures Age 0-17 4 3 — — $103,763.76 $172,662.26 $152,792.14 2026-03-30
800 MS_DRG Splenic Procedures With Cc 4 3 — — $51,080.96 $84,998.40 $75,216.71 2026-03-30
799 MS_DRG Splenic Procedures With Mcc 4 3 — — $82,345.18 $137,021.87 $121,253.28 2026-03-30
327 MS_DRG Stomach- Esophageal And Duodenal Procedures With Cc 4 3 — — $44,440.83 $73,949.27 $65,439.13 2026-03-30
326 MS_DRG Stomach- Esophageal And Duodenal Procedures With Mcc 4 3 — — $90,681.70 $150,893.79 $133,528.81 2026-03-30
0981T CPT Tcat Impl Wrls Ivc Snr 2 1 — — $64,484.09 $82,671.92 $73,578.01 2026-03-30
0645T CPT Tcat Impltj C Sins Rdctj Dev 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
0823T CPT Tcat Ins 1chmbr Ldls Pm Ra 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0795T CPT Tcat Ins 2chmbr Ldls Pm Cmpl 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0796T CPT Tcat Ins 2chmbr Ldls Pm Ra 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0797T CPT Tcat Ins 2chmbr Ldls Pm Rv 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0801T CPT Tcat Rmv&rpl 2chmbr Ldls Pm 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0825T CPT Tcat Rmv&rpl1chmb Ldls Pm Ra 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0802T CPT Tcat Rmv&rpl2chmb Ldls Pm Ra 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
0803T CPT Tcat Rmv&rpl2chmb Ldls Pm Rv 3 2 — — $68,486.15 $103,302.40 $87,802.76 2026-03-30
212 MS_DRG Testes Procedures Age 0-17 4 3 — — $197,714.61 $328,995.90 $291,134.78 2026-03-30
625 MS_DRG Thyroid- Parathyroid And Thyroglossal Procedures With Mcc 4 3 — — $54,911.94 $91,373.13 $80,857.83 2026-03-30
Q2042 CPT Tisagenlecleucel Car-pos T 1 1 — — $639,154.94 $639,154.94 $639,154.94 2026-03-30
12 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Cc 4 3 — — $76,655.98 $127,555.08 $112,875.94 2026-03-30
11 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Mcc 4 3 — — $99,167.31 $165,013.80 $146,023.88 2026-03-30
13 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses Without Cc/mcc 4 3 — — $52,397.35 $87,188.86 $77,155.09 2026-03-30
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 4 3 — — $251,848.35 $419,074.11 $370,846.72 2026-03-30
668 MS_DRG Transurethral Procedures With Mcc 4 3 — — $53,091.90 $88,344.60 $78,177.83 2026-03-30
0238T CPT Trluml Perip Athrc Iliac Art 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 3 — — $101,205.53 $168,405.38 $149,025.15 2026-03-30
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 3 — — $65,572.14 $109,111.63 $96,554.98 2026-03-30
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 4 3 — — $49,044.56 $81,609.84 $72,218.11 2026-03-30
173 MS_DRG Urethral Procedures Age 0-17 4 3 — — $54,117.38 $90,050.98 $79,687.84 2026-03-30
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 4 3 — — $64,992.13 $108,146.50 $95,700.91 2026-03-30
739 MS_DRG Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc 4 3 — — $65,143.04 $108,397.61 $95,923.13 2026-03-30
C9797 CPT Vasc Emb/occ W/prs Cath 3 2 — — $64,484.09 $97,265.82 $82,671.92 2026-03-30
263 MS_DRG Vein Ligation And Stripping 4 3 — — $55,590.13 $92,501.64 $81,856.48 2026-03-30
31 MS_DRG Ventricular Shunt Procedures With Mcc 4 3 — — $81,465.16 $135,557.53 $119,957.46 2026-03-30
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 4 3 — — $103,629.21 $172,438.37 $152,594.02 2026-03-30
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 4 3 — — $56,631.97 $94,235.25 $83,390.58 2026-03-30
901 MS_DRG Wound Debridements For Injuries With Mcc 4 3 — — $76,303.25 $126,968.13 $112,356.54 2026-03-30
A9543 CPT Y90 Ibritumomab Rx 3 2 — — $54,991.73 $70,502.22 $64,211.74 2026-03-30
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