Price Transparencybeta 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 MAYO HOSPITAL

Dover Foxcroft, ME · CCN 201309 · Rates published

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You selected 93306 (CPT)

Tte w/doppler complete

This hospital’s price: $1,317 across 8 payers · range $74-$2,970

Source: https://northernlighthealth.org/NLH/media/Price-Transparency/843689003_Mayo-hospital_standardcharges.csv · observed 2026-03-30

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

16,106 distinct procedures filed
8 distinct payers
373,509 rate rows
2026-03-30 last MRF observed
Data quality

138,116 of 373,509 rate rows are consumer-grade (37.0%)

235,393 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 227,103
per-diem day rate — not a per-procedure price 3,825
template filing: same amount across many unrelated codes — excluded 1,731
placeholder amount (≤ $0.02) — excluded from medians 1,710
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 757
percent-of-charges filed in the dollar field — excluded from medians 180
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 65
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 22
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://northernlighthealth.org/NLH/media/Price-Transparency/843689003_Mayo-hospital_standardcharges.csv
Found on page https://northernlighthealth.org/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch not_modified · 2026-09-20
Content fingerprint 5e35990179252b56… · 120,902,718 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj Hemgenix Per Tx Dose 1 $4,192,300.00 $4,192,300.00 $4,192,300.00 nat. median
$3,703,693
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,753,613.11 $3,753,613.11 $3,753,613.11 nat. median
$3,324,572
1.1× median
J1414
HCPCS 		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
HCPCS 		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
HCPCS 		Inj Betibeglogene Autotemce 1 $3,353,840.00 $3,353,840.00 $3,353,840.00 nat. median
$2,994,107
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,715,908.39 $2,715,908.39 $2,715,908.39 nat. median
$2,466,282
1.1× median
J3392
HCPCS 		Inj Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,401,960
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 3 $1,006,610.93 $1,306,495.61 $1,305,675.14 nat. median
$359,358
outlier · 3.6×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $653,250.00 $847,863.09 $847,330.64 nat. median
$249,124
outlier · 3.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $497,689.98 $645,959.38 $645,553.72 nat. median
$198,433
outlier · 3.3×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 3 $494,769.18 $642,168.43 $641,765.15 nat. median
$190,557
outlier · 3.4×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $639,154.94 $639,154.94 $639,154.94 nat. median
$738,272
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $622,989.72 $622,989.72 $622,989.72 nat. median
$646,415
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $596,993.05 $596,993.05 $596,993.05 nat. median
$622,245
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $583,629.15 $583,629.15 $583,629.15 nat. median
$640,950
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $553,154.38 $553,154.38 $553,154.38 nat. median
$608,101
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $551,498.21 $551,498.21 $551,498.21 nat. median
$591,650
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 3 $322,882.51 $419,074.11 $418,810.93 nat. median
$126,722
outlier · 3.3×
7
MS_DRG 		Lung Transplant 3 $301,875.12 $391,808.30 $391,562.25 nat. median
$117,894
outlier · 3.3×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $280,142.78 $363,601.56 $363,373.22 nat. median
$110,192
outlier · 3.3×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $264,149.47 $342,843.61 $342,628.30 nat. median
$103,967
outlier · 3.3×
209
MS_DRG 		Kidney And Urinary Tract Signs And Symptoms Age 0-17 3 $263,846.43 $342,450.29 $342,235.24 nat. median
$92,655
outlier · 3.7×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $256,909.24 $333,446.41 $333,237.00 nat. median
$93,270
outlier · 3.6×
212
MS_DRG 		Testes Procedures Age 0-17 3 $253,480.27 $328,995.90 $328,789.29 nat. median
$97,414
outlier · 3.4×
J3403
HCPCS 		Revakinagene Per Implant 2 $319,480.25 $319,480.25 $319,480.25 nat. median
$265,000
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $240,342.50 $311,944.18 $311,748.28 nat. median
$94,964
outlier · 3.3×
215
MS_DRG 		Other Heart Assist System Implant 3 $232,102.25 $301,249.04 $301,059.85 nat. median
$93,917
outlier · 3.2×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $228,041.57 $295,978.61 $295,792.74 nat. median
$90,581
outlier · 3.3×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 $210,017.92 $272,585.45 $272,414.27 nat. median
$78,037
outlier · 3.5×
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $201,856.93 $261,993.17 $261,828.64 nat. median
$78,262
outlier · 3.3×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 3 $196,504.85 $255,046.62 $254,886.46 nat. median
$77,043
outlier · 3.3×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 3 $195,887.12 $254,244.87 $254,085.20 nat. median
$77,696
outlier · 3.3×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $183,425.35 $238,070.54 $237,921.04 nat. median
$74,460
outlier · 3.2×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 $178,984.71 $232,306.97 $232,161.08 nat. median
$72,473
outlier · 3.2×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 3 $178,213.13 $231,305.53 $231,160.27 nat. median
$71,758
outlier · 3.2×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 $177,623.37 $230,540.07 $230,395.30 nat. median
$68,004
outlier · 3.4×
0266T
CPT 		Implt/rpl Crtd Sns Dev Total 2 $207,180.25 $243,753.34 $225,466.79 nat. median
$42,790
outlier · 5.3×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $168,268.89 $218,398.74 $218,261.59 nat. median
$63,648
outlier · 3.4×
10
MS_DRG 		Pancreas Transplant 3 $167,268.87 $217,100.80 $216,964.47 nat. median
$64,903
outlier · 3.3×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 $167,198.94 $217,010.04 $216,873.76 nat. median
$61,329
outlier · 3.5×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $166,310.81 $215,857.32 $215,721.77 nat. median
$66,660
outlier · 3.2×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 $166,212.90 $215,730.25 $215,594.77 nat. median
$66,649
outlier · 3.2×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $161,117.24 $209,116.51 $208,985.18 nat. median
$62,721
outlier · 3.3×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 $160,327.01 $208,090.86 $207,960.18 nat. median
$63,896
outlier · 3.3×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 3 $156,905.04 $203,649.43 $203,521.54 nat. median
$61,711
outlier · 3.3×
317
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 $155,865.39 $202,300.06 $202,173.01 nat. median
$57,560
outlier · 3.5×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 $155,751.17 $202,151.81 $202,024.86 nat. median
$60,543
outlier · 3.3×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $153,273.27 $198,935.70 $198,810.77 nat. median
$62,038
outlier · 3.2×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $153,273.27 $198,935.70 $198,810.77 nat. median
$59,558
outlier · 3.3×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 $152,716.15 $198,212.61 $198,088.13 nat. median
$58,118
outlier · 3.4×

Other procedures at this hospital

Browse this hospital's 16,106 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
             
J1411 HCPCS Inj Hemgenix Per Tx Dose 1 1 — — $4,192,300.00 $4,192,300.00 $4,192,300.00 2026-03-30
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $3,753,613.11 $3,753,613.11 $3,753,613.11 2026-03-30
J1414 HCPCS Inj Beqvez Per Tx Dose 2 2 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2026-03-30
J3394 HCPCS Inj Lovotibeglogene Autotem 1 1 — — $3,608,090.00 $3,608,090.00 $3,608,090.00 2026-03-30
J3393 HCPCS Inj Betibeglogene Autotemce 1 1 — — $3,353,840.00 $3,353,840.00 $3,353,840.00 2026-03-30
J3399 HCPCS Inj Onase Abepar-xioi Treat 1 1 — — $2,715,908.39 $2,715,908.39 $2,715,908.39 2026-03-30
J3392 HCPCS Inj Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-03-30
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 3 3 — — $1,006,610.93 $1,306,495.61 $1,305,675.14 2026-03-30
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 3 — — $653,250.00 $847,863.09 $847,330.64 2026-03-30
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 3 — — $497,689.98 $645,959.38 $645,553.72 2026-03-30
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 3 3 — — $494,769.18 $642,168.43 $641,765.15 2026-03-30
Q2042 HCPCS Tisagenlecleucel Car-pos T 1 1 — — $639,154.94 $639,154.94 $639,154.94 2026-03-30
Q2056 HCPCS Ciltacabtagene Car-pos T 1 1 — — $622,989.72 $622,989.72 $622,989.72 2026-03-30
Q2055 HCPCS Idecabtagene Vicleucel Car 1 1 — — $596,993.05 $596,993.05 $596,993.05 2026-03-30
Q2054 HCPCS Lisocabtagene Mara Car Pos T 1 1 — — $583,629.15 $583,629.15 $583,629.15 2026-03-30
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 1 1 — — $553,154.38 $553,154.38 $553,154.38 2026-03-30
Q2053 HCPCS Brexucabtagene Car Pos T 1 1 — — $551,498.21 $551,498.21 $551,498.21 2026-03-30
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 3 3 — — $322,882.51 $419,074.11 $418,810.93 2026-03-30
7 MS_DRG Lung Transplant 3 3 — — $301,875.12 $391,808.30 $391,562.25 2026-03-30
14 MS_DRG Allogeneic Bone Marrow Transplant 3 3 — — $280,142.78 $363,601.56 $363,373.22 2026-03-30
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 3 — — $264,149.47 $342,843.61 $342,628.30 2026-03-30
209 MS_DRG Kidney And Urinary Tract Signs And Symptoms Age 0-17 3 3 — — $263,846.43 $342,450.29 $342,235.24 2026-03-30
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $256,909.24 $333,446.41 $333,237.00 2026-03-30
212 MS_DRG Testes Procedures Age 0-17 3 3 — — $253,480.27 $328,995.90 $328,789.29 2026-03-30
J3403 HCPCS Revakinagene Per Implant 2 2 — — $319,480.25 $319,480.25 $319,480.25 2026-03-30
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 3 — — $240,342.50 $311,944.18 $311,748.28 2026-03-30
215 MS_DRG Other Heart Assist System Implant 3 3 — — $232,102.25 $301,249.04 $301,059.85 2026-03-30
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $228,041.57 $295,978.61 $295,792.74 2026-03-30
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 3 — — $210,017.92 $272,585.45 $272,414.27 2026-03-30
850 MS_DRG Acute Leukemia With Other Procedures 3 3 — — $201,856.93 $261,993.17 $261,828.64 2026-03-30
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 — — $196,504.85 $255,046.62 $254,886.46 2026-03-30
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 3 3 — — $195,887.12 $254,244.87 $254,085.20 2026-03-30
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 — — $183,425.35 $238,070.54 $237,921.04 2026-03-30
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $178,984.71 $232,306.97 $232,161.08 2026-03-30
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 3 3 — — $178,213.13 $231,305.53 $231,160.27 2026-03-30
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 3 — — $177,623.37 $230,540.07 $230,395.30 2026-03-30
0266T CPT Implt/rpl Crtd Sns Dev Total 2 2 — — $207,180.25 $243,753.34 $225,466.79 2026-03-30
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $168,268.89 $218,398.74 $218,261.59 2026-03-30
10 MS_DRG Pancreas Transplant 3 3 — — $167,268.87 $217,100.80 $216,964.47 2026-03-30
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 3 — — $167,198.94 $217,010.04 $216,873.76 2026-03-30
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 — — $166,310.81 $215,857.32 $215,721.77 2026-03-30
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 3 — — $166,212.90 $215,730.25 $215,594.77 2026-03-30
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $161,117.24 $209,116.51 $208,985.18 2026-03-30
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 3 — — $160,327.01 $208,090.86 $207,960.18 2026-03-30
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $156,905.04 $203,649.43 $203,521.54 2026-03-30
317 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 3 — — $155,865.39 $202,300.06 $202,173.01 2026-03-30
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 3 — — $155,751.17 $202,151.81 $202,024.86 2026-03-30
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $153,273.27 $198,935.70 $198,810.77 2026-03-30
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $153,273.27 $198,935.70 $198,810.77 2026-03-30
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $152,716.15 $198,212.61 $198,088.13 2026-03-30
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 — — $149,995.82 $194,681.85 $194,559.59 2026-03-30
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 3 3 — — $142,855.82 $185,414.74 $185,298.30 2026-03-30
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $142,690.32 $185,199.93 $185,083.63 2026-03-30
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 — — $141,321.99 $183,423.96 $183,308.77 2026-03-30
28 MS_DRG Spinal Procedures With Mcc 3 3 — — $140,056.24 $181,781.12 $181,666.96 2026-03-30
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 3 3 — — $140,016.61 $181,729.68 $181,615.56 2026-03-30
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 3 3 — — $139,002.60 $180,413.59 $180,300.29 2026-03-30
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome- Neonate 3 3 — — $138,545.72 $179,820.59 $179,707.67 2026-03-30
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 3 — — $138,224.03 $179,403.07 $179,290.41 2026-03-30
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 — — $136,799.77 $177,554.49 $177,442.99 2026-03-30
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $136,711.19 $177,439.52 $177,328.09 2026-03-30
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 2 2 — — $161,140.70 $189,586.53 $175,363.61 2026-03-30
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 3 — — $134,433.75 $174,483.61 $174,374.04 2026-03-30
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $133,575.93 $173,370.23 $173,261.35 2026-03-30
213 MS_DRG Splenic Procedures Age 0-17 3 3 — — $133,030.46 $172,662.26 $172,553.83 2026-03-30
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $132,857.97 $172,438.37 $172,330.08 2026-03-30
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $131,051.41 $170,093.61 $169,986.79 2026-03-30
8 MS_DRG Simultaneous Pancreas/kidney Transplant 3 3 — — $130,645.80 $169,567.17 $169,460.69 2026-03-30
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 3 — — $129,750.68 $168,405.38 $168,299.62 2026-03-30
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 3 3 — — $128,743.67 $167,098.37 $166,993.43 2026-03-30
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 3 3 — — $127,972.09 $166,096.92 $165,992.62 2026-03-30
405 MS_DRG Pancreas- Liver And Shunt Procedures With Mcc 3 3 — — $127,519.87 $165,509.98 $165,406.04 2026-03-30
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 3 3 — — $127,338.05 $165,273.99 $165,170.20 2026-03-30
11 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Mcc 3 3 — — $127,137.58 $165,013.80 $164,910.17 2026-03-30
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 3 — — $126,629.41 $164,354.24 $164,251.02 2026-03-30
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $124,310.02 $161,343.86 $161,242.54 2026-03-30
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 3 — — $124,235.43 $161,247.05 $161,145.79 2026-03-30
0915T CPT Insj Perm Ccm-d Sys Pg&eltrd 2 2 — — $147,610.04 $173,667.34 $160,638.69 2026-03-30
0408T CPT Insj/rplc Cardiac Modulj Sys 2 2 — — $147,610.04 $173,667.34 $160,638.69 2026-03-30
0571T CPT Insj/rplcmt Icds Ss Eltrd 2 2 — — $147,610.04 $173,667.34 $160,638.69 2026-03-30
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 — — $123,400.91 $160,163.92 $160,063.34 2026-03-30
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 — — $122,992.98 $159,634.46 $159,534.21 2026-03-30
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 — — $121,340.27 $157,489.38 $157,390.47 2026-03-30
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $121,130.47 $157,217.08 $157,118.35 2026-03-30
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $156,380.06 $156,380.06 $156,380.06 2026-03-30
0268T CPT Implt/rpl Crtd Sns Dev Gen 2 2 — — $140,299.00 $165,065.68 $152,682.34 2026-03-30
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 2 2 — — $140,299.00 $165,065.68 $152,682.34 2026-03-30
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $117,489.38 $152,491.25 $152,395.49 2026-03-30
326 MS_DRG Stomach- Esophageal And Duodenal Procedures With Mcc 3 3 — — $116,258.59 $150,893.79 $150,799.03 2026-03-30
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 3 — — $115,326.17 $149,683.59 $149,589.59 2026-03-30
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $115,121.04 $149,417.34 $149,323.51 2026-03-30
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $114,727.09 $148,906.03 $148,812.52 2026-03-30
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $114,249.23 $148,285.81 $148,192.68 2026-03-30
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 — — $112,559.22 $146,092.32 $146,000.57 2026-03-30
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $111,990.44 $145,354.10 $145,262.81 2026-03-30
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 3 3 — — $110,976.44 $144,038.00 $143,947.55 2026-03-30
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 3 — — $109,591.80 $142,240.86 $142,151.53 2026-03-30
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $109,368.02 $141,950.41 $141,861.26 2026-03-30
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $109,041.67 $141,526.84 $141,437.96 2026-03-30
6 MS_DRG Liver Transplant Without Mcc 3 3 — — $108,090.60 $140,292.44 $140,204.33 2026-03-30
277 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 — — $107,659.36 $139,732.72 $139,644.97 2026-03-30
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 — — $107,146.53 $139,067.11 $138,979.77 2026-03-30
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $106,873.80 $138,713.12 $138,626.01 2026-03-30
245 MS_DRG Aicd Generator Procedures 3 3 — — $106,351.64 $138,035.41 $137,948.73 2026-03-30
C9760 HCPCS Non-blind Interatrial Shunt 2 2 — — $126,611.06 $148,961.45 $137,786.26 2026-03-30
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 3 — — $106,032.29 $137,620.92 $137,534.49 2026-03-30
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 — — $105,985.67 $137,560.41 $137,474.02 2026-03-30
799 MS_DRG Splenic Procedures With Mcc 3 3 — — $105,570.74 $137,021.87 $136,935.82 2026-03-30
163 MS_DRG Major Chest Procedures With Mcc 3 3 — — $104,472.82 $135,596.86 $135,511.70 2026-03-30
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 3 — — $104,442.52 $135,557.53 $135,472.40 2026-03-30
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 3 — — $104,032.25 $135,025.04 $134,940.24 2026-03-30
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 — — $102,398.19 $132,904.16 $132,820.70 2026-03-30
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 3 — — $100,873.68 $130,925.49 $130,843.27 2026-03-30
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 3 — — $100,069.47 $129,881.69 $129,800.12 2026-03-30
140 MS_DRG Major Head And Neck Procedures With Mcc 3 3 — — $99,426.11 $129,046.65 $128,965.61 2026-03-30
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 3 — — $98,855.00 $128,305.40 $128,224.83 2026-03-30
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 — — $98,444.73 $127,772.92 $127,692.68 2026-03-30
12 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Cc 3 3 — — $98,276.90 $127,555.08 $127,474.98 2026-03-30
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 3 — — $98,227.95 $127,491.54 $127,411.48 2026-03-30
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 — — $97,941.23 $127,119.41 $127,039.58 2026-03-30
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 — — $97,824.68 $126,968.13 $126,888.40 2026-03-30
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 3 — — $97,642.85 $126,732.14 $126,652.56 2026-03-30
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 3 3 — — $97,265.23 $126,242.01 $126,162.73 2026-03-30
793 MS_DRG Full Term Neonate With Major Problems 3 3 — — $97,195.29 $126,151.25 $126,072.03 2026-03-30
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 — — $96,808.34 $125,649.02 $125,570.11 2026-03-30
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 3 3 — — $96,167.30 $124,817.00 $124,738.62 2026-03-30
791 MS_DRG Prematurity With Major Problems 3 3 — — $94,617.16 $122,805.05 $122,727.92 2026-03-30
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $93,719.70 $121,640.23 $121,563.84 2026-03-30
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $92,871.20 $120,538.95 $120,463.25 2026-03-30
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $91,188.19 $118,354.53 $118,280.21 2026-03-30
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 3 — — $90,775.59 $117,819.02 $117,745.03 2026-03-30
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 3 — — $90,227.80 $117,108.03 $117,034.49 2026-03-30
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 3 — — $90,092.60 $116,932.55 $116,859.12 2026-03-30
40 MS_DRG Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc 3 3 — — $90,006.35 $116,820.61 $116,747.24 2026-03-30
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 3 — — $89,495.85 $116,158.02 $116,085.07 2026-03-30
Q0480 HCPCS Driver Pneumatic Vad Rep 2 2 — — $99,999.91 $131,664.24 $115,832.07 2026-03-30
956 MS_DRG Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma 3 3 — — $87,717.26 $113,849.57 $113,778.07 2026-03-30
143 MS_DRG Other Ear- Nose- Mouth And Throat O.r. Procedures With Mcc 3 3 — — $87,334.97 $113,353.38 $113,282.20 2026-03-30
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 3 — — $87,127.51 $113,084.11 $113,013.10 2026-03-30
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 3 — — $87,118.18 $113,072.01 $113,001.00 2026-03-30
628 MS_DRG Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc 3 3 — — $86,873.42 $112,754.33 $112,683.52 2026-03-30
0515T CPT Insj Wcs Lv Compl Sys 2 2 — — $103,341.24 $121,583.85 $112,462.55 2026-03-30
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 2 2 — — $103,341.24 $121,583.85 $112,462.55 2026-03-30
0409T CPT Insj/rplc Car Modulj Pls Gn 2 2 — — $103,341.24 $121,583.85 $112,462.55 2026-03-30
0923T CPT Rmvl&rplcmt Perm Ccm-d Pg 2 2 — — $103,341.24 $121,583.85 $112,462.55 2026-03-30
0614T CPT Rmvl&rplcmt Ss Impl Dfb Pg 2 2 — — $103,341.24 $121,583.85 $112,462.55 2026-03-30
0916T CPT Insj Perm Ccm-d Sys Pg Only 2 2 — — $103,341.24 $121,583.85 $112,462.55 2026-03-30
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 3 3 — — $86,383.90 $112,118.98 $112,048.57 2026-03-30
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 3 — — $85,621.65 $111,129.64 $111,059.85 2026-03-30
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc 3 3 — — $85,586.68 $111,084.26 $111,014.50 2026-03-30
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 3 — — $84,582.00 $109,780.27 $109,711.33 2026-03-30
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 3 — — $84,516.73 $109,695.55 $109,626.67 2026-03-30
332 MS_DRG Rectal Resection With Mcc 3 3 — — $84,400.18 $109,544.28 $109,475.49 2026-03-30
265 MS_DRG Aicd Lead Procedures 3 3 — — $84,341.91 $109,468.64 $109,399.90 2026-03-30
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 3 — — $84,192.72 $109,275.01 $109,206.38 2026-03-30
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 3 — — $84,066.84 $109,111.63 $109,043.11 2026-03-30
739 MS_DRG Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc 3 3 — — $83,516.72 $108,397.61 $108,329.54 2026-03-30
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 3 — — $83,323.24 $108,146.50 $108,078.58 2026-03-30
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 3 — — $83,239.32 $108,037.58 $107,969.73 2026-03-30
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 3 — — $83,115.78 $107,877.23 $107,809.48 2026-03-30
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 3 — — $83,045.84 $107,786.46 $107,718.77 2026-03-30
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor… 3 3 — — $82,966.59 $107,683.60 $107,615.97 2026-03-30
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 3 — — $82,898.99 $107,595.86 $107,528.29 2026-03-30
0816T CPT Opn Insj/rplcmt Ins Ptn Subq 2 2 — — $98,728.98 $116,157.39 $107,443.18 2026-03-30
0680T CPT Insj/rplcmt Pg Only Isdss 2 2 — — $98,728.98 $116,157.39 $107,443.18 2026-03-30
0817T CPT Opn Insj/rplcmt Ins Ptn Subf 2 2 — — $98,728.98 $116,157.39 $107,443.18 2026-03-30
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 3 — — $82,206.67 $106,697.28 $106,630.28 2026-03-30
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 3 — — $82,038.83 $106,479.45 $106,412.58 2026-03-30
252 MS_DRG Other Vascular Procedures With Mcc 3 3 — — $81,313.88 $105,538.52 $105,472.24 2026-03-30
616 MS_DRG Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With… 3 3 — — $81,292.90 $105,511.29 $105,445.03 2026-03-30
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 3 — — $80,919.93 $105,027.21 $104,961.25 2026-03-30
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 3 — — $80,528.32 $104,518.92 $104,453.29 2026-03-30
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 3 3 — — $80,155.35 $104,034.84 $103,969.51 2026-03-30
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $79,917.58 $103,726.24 $103,661.10 2026-03-30
0960T CPT Rpl S-sclp Eltr Ra Rcvr&tlmt 1 1 — — $103,591.29 $103,591.29 $103,591.29 2026-03-30
0956T CPT Prt Crn Ch Cr&tun Elt S-sclp 1 1 — — $103,591.29 $103,591.29 $103,591.29 2026-03-30
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 3 — — $79,525.97 $103,217.96 $103,153.14 2026-03-30
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 3 — — $79,421.07 $103,081.81 $103,017.08 2026-03-30
264 MS_DRG Other Circulatory System O.r. Procedures 3 3 — — $77,870.92 $101,069.85 $101,006.38 2026-03-30
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 3 — — $77,001.44 $99,941.34 $99,878.58 2026-03-30
37 MS_DRG Extracranial Procedures With Mcc 3 3 — — $76,740.37 $99,602.49 $99,539.94 2026-03-30
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 3 3 — — $76,731.04 $99,590.38 $99,527.84 2026-03-30
J9029 HCPCS Instill Adstiladrin Tx Dose 4 4 — — $71,644.31 $167,040.00 $98,965.46 2026-03-30
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 3 — — $75,824.26 $98,413.46 $98,351.66 2026-03-30
579 MS_DRG Other Skin- Subcutaneous Tissue And Breast Procedures With Mcc 3 3 — — $75,490.92 $97,980.82 $97,919.29 2026-03-30
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 3 — — $75,407.01 $97,871.90 $97,810.44 2026-03-30
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 3 — — $75,302.11 $97,735.75 $97,674.37 2026-03-30
652 MS_DRG Kidney Transplant 3 3 — — $75,281.13 $97,708.52 $97,647.16 2026-03-30
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 3 — — $75,225.19 $97,635.91 $97,574.60 2026-03-30
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 3 3 — — $75,078.33 $97,445.30 $97,384.11 2026-03-30
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 3 — — $74,835.90 $97,130.65 $97,069.65 2026-03-30
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 3 — — $74,425.64 $96,598.16 $96,537.50 2026-03-30
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 3 — — $74,288.11 $96,419.66 $96,359.11 2026-03-30
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 3 — — $74,215.84 $96,325.87 $96,265.38 2026-03-30
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 3 — — $74,066.66 $96,132.24 $96,071.87 2026-03-30
500 MS_DRG Soft Tissue Procedures With Mcc 3 3 — — $73,772.94 $95,751.02 $95,690.89 2026-03-30
0801T CPT Tcat Rmv&rpl 2chmbr Ldls Pm 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0525T CPT Insj/rplcmt Compl Iims 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0796T CPT Tcat Ins 2chmbr Ldls Pm Ra 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0802T CPT Tcat Rmv&rpl2chmb Ldls Pm Ra 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0797T CPT Tcat Ins 2chmbr Ldls Pm Rv 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0823T CPT Tcat Ins 1chmbr Ldls Pm Ra 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0795T CPT Tcat Ins 2chmbr Ldls Pm Cmpl 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0803T CPT Tcat Rmv&rpl2chmb Ldls Pm Rv 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
0825T CPT Tcat Rmv&rpl1chmb Ldls Pm Ra 2 2 — — $87,802.76 $103,302.40 $95,552.58 2026-03-30
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 3 — — $73,661.05 $95,605.80 $95,545.76 2026-03-30
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 3 — — $73,451.26 $95,333.51 $95,273.64 2026-03-30
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 3 — — $73,416.29 $95,288.12 $95,228.28 2026-03-30
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 3 — — $73,243.80 $95,064.24 $95,004.54 2026-03-30
665 MS_DRG Prostatectomy With Mcc 3 3 — — $72,756.61 $94,431.91 $94,372.60 2026-03-30
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $72,605.09 $94,235.25 $94,176.07 2026-03-30
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 3 — — $72,476.88 $94,068.85 $94,009.77 2026-03-30
662 MS_DRG Minor Bladder Procedures With Mcc 3 3 — — $71,364.97 $92,625.68 $92,567.51 2026-03-30
263 MS_DRG Vein Ligation And Stripping 3 3 — — $71,269.40 $92,501.64 $92,443.55 2026-03-30
C8003 HCPCS Imp Extar Knee Shck Absrb 2 2 — — $84,666.93 $99,613.00 $92,139.96 2026-03-30
510 MS_DRG Shoulderelbow Or Forearm Procexc Major Joint Proc W Mcc 3 3 — — $70,409.24 $91,385.23 $91,327.84 2026-03-30
625 MS_DRG Thyroid- Parathyroid And Thyroglossal Procedures With Mcc 3 3 — — $70,399.92 $91,373.13 $91,315.74 2026-03-30
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 3 — — $70,323.00 $91,273.28 $91,215.96 2026-03-30
173 MS_DRG Urethral Procedures Age 0-17 3 3 — — $69,381.25 $90,050.98 $89,994.43 2026-03-30
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
0793T CPT Prq Tcat Thrm Ablt Nrv P-art 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9773 HCPCS Revasc Lithotr-stent Tib/per 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9602 HCPCS Perc D-e Cor Stent Ather S 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9797 HCPCS Vasc Emb/occ W/prs Cath 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
0645T CPT Tcat Impltj C Sins Rdctj Dev 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9765 HCPCS Revasc Intra Lithotrip-stent 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9774 HCPCS Revasc Lithotr-ather Tib/per 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
0238T CPT Trluml Perip Athrc Iliac Art 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
0632T CPT Perq Tcat US Abltj Nrv P-art 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9766 HCPCS Revasc Intra Lithotrip-ather 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9767 HCPCS Revasc Lithotrip-stent-ather 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
C9775 HCPCS Revasc Lith-sten-ath Tib/per 2 2 — — $82,671.92 $97,265.82 $89,968.87 2026-03-30
472 MS_DRG Cervical Spinal Fusion With Cc 3 3 — — $68,674.95 $89,134.26 $89,078.28 2026-03-30
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 3 — — $68,628.33 $89,073.75 $89,017.81 2026-03-30
570 MS_DRG Skin Debridement With Mcc 3 3 — — $68,558.39 $88,982.98 $88,927.10 2026-03-30
668 MS_DRG Transurethral Procedures With Mcc 3 3 — — $68,066.54 $88,344.60 $88,289.12 2026-03-30
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 3 — — $67,887.05 $88,111.64 $88,056.30 2026-03-30
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 3 — — $67,646.95 $87,800.01 $87,744.87 2026-03-30
406 MS_DRG Pancreas- Liver And Shunt Procedures With Cc 3 3 — — $67,605.00 $87,745.55 $87,690.45 2026-03-30
C9758 HCPCS Blind Interatrial Shunt Ide 2 2 — — $80,571.52 $94,794.64 $87,683.08 2026-03-30
0686T CPT Histotripsy Mal Hepatcel Tis 2 2 — — $80,571.52 $94,794.64 $87,683.08 2026-03-30
0888T CPT Histotripsy Mal Renal Tissue 2 2 — — $80,571.52 $94,794.64 $87,683.08 2026-03-30
C9782 HCPCS Blind Myocar Trpl Bon Marrow 2 2 — — $80,571.52 $94,794.64 $87,683.08 2026-03-30
619 MS_DRG O.r. Procedures For Obesity With Mcc 3 3 — — $67,306.62 $87,358.29 $87,303.43 2026-03-30
974 MS_DRG HIV With Major Related Condition With Mcc 3 3 — — $67,273.99 $87,315.93 $87,261.10 2026-03-30
13 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses Without Cc/mcc 3 3 — — $67,176.08 $87,188.86 $87,134.10 2026-03-30
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 3 — — $66,446.47 $86,241.88 $86,187.72 2026-03-30
800 MS_DRG Splenic Procedures With Cc 3 3 — — $65,488.41 $84,998.40 $84,945.02 2026-03-30
654 MS_DRG Major Bladder Procedures With Cc 3 3 — — $65,252.97 $84,692.82 $84,639.63 2026-03-30
503 MS_DRG Foot Procedures With Mcc 3 3 — — $65,061.82 $84,444.73 $84,391.70 2026-03-30
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 3 3 — — $64,614.26 $83,863.83 $83,811.17 2026-03-30
61 MS_DRG Ischemic Stroke- Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 3 — — $64,269.27 $83,416.06 $83,363.68 2026-03-30
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 3 — — $64,073.46 $83,161.92 $83,109.69 2026-03-30
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 3 — — $64,057.14 $83,140.74 $83,088.53 2026-03-30
0981T CPT Tcat Impl Wrls Ivc Snr 1 1 — — $82,671.92 $82,671.92 $82,671.92 2026-03-30
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 3 — — $63,726.14 $82,711.12 $82,659.18 2026-03-30
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 3 3 — — $63,423.10 $82,317.80 $82,266.11 2026-03-30
0308T CPT Insj Ocular Telescope Prosth 2 2 — — $75,580.54 $88,922.62 $82,251.58 2026-03-30
849 MS_DRG Radiotherapy 3 3 — — $63,159.69 $81,975.92 $81,924.44 2026-03-30
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 3 — — $63,082.77 $81,876.08 $81,824.66 2026-03-30
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 3 — — $62,877.63 $81,609.84 $81,558.59 2026-03-30
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 4 4 — — $46,750.00 $91,769.47 $81,208.57 2026-03-30
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 1 1 — — $80,571.52 $80,571.52 $80,571.52 2026-03-30
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 3 3 — — $62,005.82 $80,478.30 $80,427.76 2026-03-30
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 3 3 — — $61,789.04 $80,196.93 $80,146.57 2026-03-30
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 3 — — $61,479.01 $79,794.54 $79,744.43 2026-03-30
253 MS_DRG Other Vascular Procedures With Cc 3 3 — — $60,504.63 $78,529.88 $78,480.56 2026-03-30
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 3 — — $60,432.37 $78,436.09 $78,386.83 2026-03-30
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 3 — — $60,206.26 $78,142.61 $78,093.54 2026-03-30
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 3 3 — — $60,122.34 $78,033.70 $77,984.69 2026-03-30
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 3 3 — — $60,122.34 $78,033.70 $77,984.69 2026-03-30
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 3 3 — — $59,851.94 $77,682.74 $77,633.95 2026-03-30
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 3 3 — — $59,511.60 $77,241.02 $77,192.51 2026-03-30
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 4 4 — — $46,750.00 $86,837.90 $76,844.52 2026-03-30
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 3 — — $59,229.55 $76,874.93 $76,826.65 2026-03-30
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Cc 3 3 — — $59,117.66 $76,729.71 $76,681.52 2026-03-30
164 MS_DRG Major Chest Procedures With Cc 3 3 — — $58,835.60 $76,363.62 $76,315.66 2026-03-30
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 3 — — $58,809.96 $76,330.34 $76,282.40 2026-03-30
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 2 — — $67,452.66 $83,688.52 $75,570.59 2026-03-30
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 3 — — $58,087.34 $75,392.43 $75,345.09 2026-03-30
545 MS_DRG Connective Tissue Disorders With Mcc 3 3 — — $57,849.57 $75,083.83 $75,036.68 2026-03-30
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 3 3 — — $57,325.08 $74,403.10 $74,356.37 2026-03-30
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 3 — — $57,308.77 $74,381.92 $74,335.21 2026-03-30
792 MS_DRG Prematurity Without Major Problems 3 3 — — $57,091.98 $74,100.55 $74,054.01 2026-03-30
327 MS_DRG Stomach- Esophageal And Duodenal Procedures With Cc 3 3 — — $56,975.43 $73,949.27 $73,902.83 2026-03-30
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 3 3 — — $56,907.83 $73,861.53 $73,815.15 2026-03-30
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 3 3 — — $56,462.60 $73,283.66 $73,237.64 2026-03-30
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 3 3 — — $56,278.44 $73,044.65 $72,998.77 2026-03-30
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 3 — — $56,068.65 $72,772.35 $72,726.65 2026-03-30
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 3 — — $55,879.83 $72,527.29 $72,481.74 2026-03-30
397 MS_DRG Major Head And Neck Procedures With Cc 3 3 — — $55,826.22 $72,457.70 $72,412.20 2026-03-30
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 3 — — $55,723.65 $72,324.58 $72,279.16 2026-03-30
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 3 — — $55,628.08 $72,200.53 $72,155.19 2026-03-30
113 MS_DRG Orbital Procedures With Cc/mcc 3 3 — — $54,805.22 $71,132.53 $71,087.86 2026-03-30
333 MS_DRG Rectal Resection With Cc 3 3 — — $54,597.76 $70,863.26 $70,818.76 2026-03-30
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 3 3 — — $54,513.84 $70,754.34 $70,709.91 2026-03-30
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 3 3 — — $54,474.21 $70,702.91 $70,658.51 2026-03-30
709 MS_DRG Penis Procedures With Cc/mcc 3 3 — — $54,245.77 $70,406.41 $70,362.20 2026-03-30
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 3 — — $54,208.47 $70,358.00 $70,313.82 2026-03-30
56 MS_DRG Degenerative Nervous System Disorders With Mcc 3 3 — — $54,152.53 $70,285.39 $70,241.25 2026-03-30
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