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

HOLY CROSS GERMANTOWN HOSPITAL

Germantown, MD · CCN 210065 · Rates published

23,469 distinct procedures filed
38 distinct payers
2,609,589 rate rows
2025-01-01 last MRF observed · ⚠ 18 mo old
Data quality

2,484,737 of 2,609,589 rate rows are consumer-grade (95.2%)

124,852 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 88,168
template filing: same amount across many unrelated codes — excluded 25,902
exceeds 10× this hospital's gross charge — excluded from medians 10,466
percent-of-charges filed in the dollar field — excluded from medians 300
placeholder amount (≤ $0.02) — excluded from medians 16

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://trinityhealth.pt.panaceainc.com/MRFDownload/trinityhealth/holycrosshospital
Found on page https://www.holycrosshealth.org/for-patients/billing-financial-assistance-and-insurance/charge-estimates
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint b4cc9c668768c26d… · 45,372,322 bytes · first seen 2026-05-08

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 1 $381,137.73 $816,618.45 $462,928.53 nat. median
$370,174
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $280,335.02 $600,640.47 $340,493.91 nat. median
$265,286
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $272,680.75 $584,240.59 $331,197.07 nat. median
$206,474
1.6× median
J2326
HCPCS 		Inj Nusinersen 0.1mg 37 $100,888.23 $322,191.45 $302,013.80 nat. median
$2,675
outlier · 112.9×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $220,558.50 $472,564.45 $267,889.57 nat. median
$202,976
1.3× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $152,071.50 $325,825.50 $184,705.50 nat. median
$133,161
1.4× median
27100000002-816
CDM 		Glove Vinyl Powder Free Lg 37 $51,608.65 $164,814.71 $154,492.98 nat. median
$81,142
1.9× median
7
MS_DRG 		Lung Transplant 1 $126,895.91 $271,884.76 $154,127.32 nat. median
$122,708
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $126,665.21 $271,390.48 $153,847.12 nat. median
$108,660
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $118,563.01 $254,030.85 $144,006.21 nat. median
$117,357
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $111,422.89 $238,732.57 $135,333.85 nat. median
$102,358
1.3× median
27800000002-88967
CDM 		Device Impella 5.5 Smartassist 37 $45,337.50 $144,787.50 $134,988.75 nat. median
$71,282
1.9× median
27800000002-88968
CDM 		Device Impella 5.5 Smartassist 37 $45,337.50 $144,787.50 $134,988.75 nat. median
$71,282
1.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $107,070.75 $229,407.75 $130,047.75 nat. median
$100,136
1.3× median
27200000002-30479
CDM 		Stylet Steerable 30cm 37 $43,083.66 $137,589.75 $128,973.02 nat. median
$202
outlier · 638.1×
215
MS_DRG 		Other Heart Assist System Implant 1 $105,672.11 $226,411.04 $128,348.96 nat. median
$99,019
1.3× median
27800000002-91547
CDM 		Graft Bn Canc Crsh Frzdr 30ml 37 $42,899.35 $137,001.15 $127,729.36 nat. median
$67,449
1.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $100,401.33 $215,117.97 $121,947.09 nat. median
$93,672
1.3× median
J1747
HCPCS 		Injection Spesolimab-sbzo 1 Mg 37 $38,157.08 $121,856.49 $114,225.07 nat. median
$94
outlier · 1218.0×
453
MS_DRG 		Combined Anterior/posterior Spinal Fusion W Mcc 1 $91,671.18 $196,412.93 $111,343.49 nat. median
$87,428
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $87,440.08 $187,347.45 $106,204.41 nat. median
$77,570
1.4× median
J7330
HCPCS 		Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 37 $35,414.40 $113,097.60 $106,014.72 nat. median
$76,329
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $87,202.14 $186,837.65 $105,915.41 nat. median
$81,118
1.3× median
27800000002-89098
CDM 		Valve Sapien Thv Edwards Resilia 26mm 37 $34,255.00 $109,395.00 $101,991.50 nat. median
$53,858
1.9× median
27800000002-89096
CDM 		Valve Sapien Thv Edwards Resilia 23mm 37 $34,255.00 $109,395.00 $101,991.50 nat. median
$53,858
1.9× median
27800000002-89099
CDM 		Valve Sapien Thv Edwards Resilia 20mm 37 $34,255.00 $109,395.00 $101,991.50 nat. median
$53,858
1.9× median
27800000002-89097
CDM 		Valve Sapien Thv Edwards Resilia 29mm 37 $34,255.00 $109,395.00 $101,991.50 nat. median
$53,858
1.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $83,951.74 $179,873.41 $101,967.49 nat. median
$79,312
1.3× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $82,692.76 $177,175.93 $100,438.33 nat. median
$71,271
1.4× median
27800000002-90555
CDM 		Valve Aort 26mm Evolutr 37 $33,247.50 $106,177.50 $98,991.75 nat. median
$52,274
1.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 1 $80,686.86 $172,878.13 $98,001.97 nat. median
$73,807
1.3× median
27800000002-91234
CDM 		Valve Sapien 3 Ultra Thv 23mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-91236
CDM 		Valve Sapien 3 Ultra Thv 26mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-91231
CDM 		Valve Sapien 3 Ultra Thv 20mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-91233
CDM 		Valve Sapien 3 Ultra Thv 23mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-91237
CDM 		Valve Sapien 3 Ultra Thv 26mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-88988
CDM 		Valve Hrt Sapien 3 Ultra 26mm 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-90655
CDM 		Valve Sapien 3 Thv 23mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-88987
CDM 		Valve Hrt Sapien 3 Ultra 23mm 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-90657
CDM 		Valve Sapien 3 Thv 26mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-90653
CDM 		Valve Sapien 3 Thv 20mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
27800000002-90659
CDM 		Valve Sapien 3 Thv 29mm W/command System 37 $32,743.75 $104,568.75 $97,491.88 nat. median
$51,482
1.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $79,772.36 $170,918.75 $96,891.23 nat. median
$74,915
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $74,820.21 $160,308.36 $90,876.36 nat. median
$72,135
1.3× median
27800000002-89078
CDM 		Valve Aortic 34mm Evolut Fx 37 $30,376.13 $97,007.63 $90,442.46 nat. median
$47,759
1.9× median
27800000002-89075
CDM 		Valve Aortic 26mm Evolut Fx 37 $30,225.00 $96,525.00 $89,992.50 nat. median
$47,522
1.9× median
27800000002-89080
CDM 		Valve Aortic 23mm Evolut Fx 37 $30,225.00 $96,525.00 $89,992.50 nat. median
$47,522
1.9× median
27800000002-89076
CDM 		Valve Aortic 29mm Evolut Fx 37 $30,225.00 $96,525.00 $89,992.50 nat. median
$47,522
1.9× median
27800000002-90153
CDM 		Kit Mitraclip 1 Mbr0301 37 $30,225.00 $96,525.00 $89,992.50 nat. median
$47,522
1.9× median
27800000002-90156
CDM 		Kit Mitraclp 1 Sgc0301 Cds0501 37 $30,225.00 $96,525.00 $89,992.50 nat. median
$47,522
1.9× median

Other procedures at this hospital

Browse this hospital's 23,469 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 5 1 — — $381,137.73 $816,618.45 $462,928.53 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 5 1 — — $280,335.02 $600,640.47 $340,493.91 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 1 — — $272,680.75 $584,240.59 $331,197.07 2025-01-01
J2326 HCPCS Inj Nusinersen 0.1mg 58 37 $325,445.91 — $100,888.23 $322,191.45 $302,013.80 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 1 — — $220,558.50 $472,564.45 $267,889.57 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 1 — — $152,071.50 $325,825.50 $184,705.50 2025-01-01
27100000002-816 CDM Glove Vinyl Powder Free Lg 58 37 $166,479.51 — $51,608.65 $164,814.71 $154,492.98 2025-01-01
7 MS_DRG Lung Transplant 5 1 — — $126,895.91 $271,884.76 $154,127.32 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 1 — — $126,665.21 $271,390.48 $153,847.12 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 5 1 — — $118,563.01 $254,030.85 $144,006.21 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 5 1 — — $111,422.89 $238,732.57 $135,333.85 2025-01-01
27800000002-88968 CDM Device Impella 5.5 Smartassist 60 37 $146,250.00 — $45,337.50 $144,787.50 $134,988.75 2025-01-01
27800000002-88967 CDM Device Impella 5.5 Smartassist 60 37 $146,250.00 — $45,337.50 $144,787.50 $134,988.75 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 5 1 — — $107,070.75 $229,407.75 $130,047.75 2025-01-01
27200000002-30479 CDM Stylet Steerable 30cm 58 37 $138,979.55 — $43,083.66 $137,589.75 $128,973.02 2025-01-01
215 MS_DRG Other Heart Assist System Implant 5 1 — — $105,672.11 $226,411.04 $128,348.96 2025-01-01
27800000002-91547 CDM Graft Bn Canc Crsh Frzdr 30ml 60 37 $138,385.00 — $42,899.35 $137,001.15 $127,729.36 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 1 — — $100,401.33 $215,117.97 $121,947.09 2025-01-01
J1747 HCPCS Injection Spesolimab-sbzo 1 Mg 58 37 $123,087.36 — $38,157.08 $121,856.49 $114,225.07 2025-01-01
453 MS_DRG Combined Anterior/posterior Spinal Fusion W Mcc 5 1 — — $91,671.18 $196,412.93 $111,343.49 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 1 — — $87,440.08 $187,347.45 $106,204.41 2025-01-01
J7330 HCPCS Membrane Collgn Porcine Maci W/autologous Cult Chondrocytes 58 37 $114,240.00 — $35,414.40 $113,097.60 $106,014.72 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 1 — — $87,202.14 $186,837.65 $105,915.41 2025-01-01
27800000002-89097 CDM Valve Sapien Thv Edwards Resilia 29mm 60 37 $110,500.00 — $34,255.00 $109,395.00 $101,991.50 2025-01-01
27800000002-89098 CDM Valve Sapien Thv Edwards Resilia 26mm 60 37 $110,500.00 — $34,255.00 $109,395.00 $101,991.50 2025-01-01
27800000002-89099 CDM Valve Sapien Thv Edwards Resilia 20mm 60 37 $110,500.00 — $34,255.00 $109,395.00 $101,991.50 2025-01-01
27800000002-89096 CDM Valve Sapien Thv Edwards Resilia 23mm 60 37 $110,500.00 — $34,255.00 $109,395.00 $101,991.50 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 5 1 — — $83,951.74 $179,873.41 $101,967.49 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 5 1 — — $82,692.76 $177,175.93 $100,438.33 2025-01-01
27800000002-90555 CDM Valve Aort 26mm Evolutr 60 37 $107,250.00 — $33,247.50 $106,177.50 $98,991.75 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 5 1 — — $80,686.86 $172,878.13 $98,001.97 2025-01-01
27800000002-90653 CDM Valve Sapien 3 Thv 20mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-88988 CDM Valve Hrt Sapien 3 Ultra 26mm 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-91233 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-88987 CDM Valve Hrt Sapien 3 Ultra 23mm 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-91231 CDM Valve Sapien 3 Ultra Thv 20mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-90655 CDM Valve Sapien 3 Thv 23mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-91234 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-90657 CDM Valve Sapien 3 Thv 26mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-90659 CDM Valve Sapien 3 Thv 29mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-91236 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
27800000002-91237 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 60 37 $105,625.00 — $32,743.75 $104,568.75 $97,491.88 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 1 — — $79,772.36 $170,918.75 $96,891.23 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 1 — — $74,820.21 $160,308.36 $90,876.36 2025-01-01
27800000002-89078 CDM Valve Aortic 34mm Evolut Fx 60 37 $97,987.50 — $30,376.13 $97,007.63 $90,442.46 2025-01-01
27800000002-90556 CDM Valve Aort 26mm Pro Perc 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90155 CDM Kit Mitraclip 3 Mbr0203 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90558 CDM Valve Aort 29mm Pro Perc 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90158 CDM Kit Mitraclp 3 Sgc0301 Cds0501 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-91555 CDM Kit Mitraclip 2 Mbr0202 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90154 CDM Kit Mitraclip 1 Mbr0301 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-91511 CDM Kit Mitraclip G4 Delivery Sys Xtw 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90559 CDM Valve Aort 34mm Evolutr 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-91556 CDM Kit Mitraclip 2 Mbr0202 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-89075 CDM Valve Aortic 26mm Evolut Fx 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-91247 CDM Kit Mitraclip G4 Syst Cds0701nt/ntw/xt/xtw 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90153 CDM Kit Mitraclip 1 Mbr0301 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90837 CDM Valve Aortic Evolut Tm Pro 29mm 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90151 CDM Kit Mitraclip 1 Mbr0101 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-91435 CDM Kit Mitraclip 1 Mbr0303 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90156 CDM Kit Mitraclp 1 Sgc0301 Cds0501 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90152 CDM Kit Mitraclip 1 Mbr0201 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-89076 CDM Valve Aortic 29mm Evolut Fx 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-91517 CDM Kit Mitraclip G4 Delivery Sys Nt 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-89080 CDM Valve Aortic 23mm Evolut Fx 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
27800000002-90157 CDM Kit Mitraclp 2 Sgc0301 Cds0501 60 37 $97,500.00 — $30,225.00 $96,525.00 $89,992.50 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 1 — — $72,785.35 $155,948.51 $88,404.83 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 5 1 — — $72,051.89 $154,377.01 $87,513.97 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 5 1 — — $71,584.30 $153,375.15 $86,946.03 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 5 1 — — $71,463.26 $153,115.82 $86,799.02 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 5 1 — — $71,097.05 $152,331.18 $86,354.22 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 1 — — $70,911.87 $151,934.43 $86,129.31 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 5 1 — — $70,537.38 $151,132.05 $85,674.45 2025-01-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 5 1 — — $68,611.14 $147,004.93 $83,334.85 2025-01-01
27200000002-21552 CDM Hemostat D Stat Flowable 0330 58 37 $87,500.00 — $27,125.00 $86,625.00 $81,200.00 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 1 — — $65,849.03 $141,086.87 $79,979.99 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 5 1 — — $64,615.90 $138,444.81 $78,482.25 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 5 1 — — $64,326.24 $137,824.19 $78,130.43 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 5 1 — — $64,244.52 $137,649.08 $78,031.16 2025-01-01
C1824 HCPCS Kit Ipg Optimizer Smart Mini 60 37 $84,500.00 — $26,195.00 $83,655.00 $77,993.50 2025-01-01
27800000002-91577 CDM Implant Gammatile Therapy Device 4pk 60 37 $84,500.00 — $26,195.00 $83,655.00 $77,993.50 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 5 1 — — $63,901.07 $136,913.21 $77,614.01 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 5 1 — — $63,901.07 $136,913.21 $77,614.01 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 5 1 — — $63,532.78 $136,124.13 $77,166.69 2025-01-01
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 5 1 — — $63,273.12 $135,567.79 $76,851.31 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 5 1 — — $63,003.12 $134,989.28 $76,523.36 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 1 — — $62,848.98 $134,659.02 $76,336.14 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 5 1 — — $62,553.11 $134,025.11 $75,976.79 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 5 1 — — $62,340.00 $133,568.51 $75,717.95 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 5 1 — — $62,071.03 $132,992.22 $75,391.26 2025-01-01
27800000002-90656 CDM Valve Sapien 3 Thv 26mm W/command System 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-91232 CDM Valve Sapien 3 Ultra Thv 23mm W/command System 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90658 CDM Valve Sapien 3 Thv 29mm W/command System 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90654 CDM Valve Sapien 3 Thv 23mm W/command System 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-91235 CDM Valve Sapien 3 Ultra Thv 26mm W/command System 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-91991 CDM Set Pump Aic Impella 5.0 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90267 CDM Set Pump Impella Cp 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90269 CDM Set Pump Impella Cp 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-91990 CDM Set Pump Aic Impella 5.0 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90271 CDM Set Pump Impella Cp 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90268 CDM Set Pump Impella Cp 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
27800000002-90270 CDM Set Pump Impella Cp 60 37 $81,250.00 — $25,187.50 $80,437.50 $74,993.75 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 5 1 — — $61,538.27 $131,850.72 $74,744.16 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 5 1 — — $60,834.81 $130,343.50 $73,889.74 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 1 — — $58,932.36 $126,267.36 $71,579.04 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 5 1 — — $58,791.67 $125,965.91 $71,408.15 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 1 — — $58,643.74 $125,648.95 $71,228.47 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 1 — — $58,590.98 $125,535.91 $71,164.39 2025-01-01
A9542 HCPCS Indium In-111 Ibritumomab Tiuxetan Diagnostic Per Study Dose Up To 5 Millicuries 60 37 $76,936.00 — $826.00 $76,166.64 $71,011.93 2025-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 5 1 — — $57,921.66 $124,101.84 $70,351.44 2025-01-01
27800000002-89077 CDM Valve Aortic 34mm Evolut Fx 60 37 $75,000.00 — $23,250.00 $74,250.00 $69,225.00 2025-01-01
27800000002-90836 CDM Valve Aortic Evolut Tm Pro 26mm 60 37 $75,000.00 — $23,250.00 $74,250.00 $69,225.00 2025-01-01
27800000002-90838 CDM Valve Aortic Evolut Tm Pro 34mm 60 37 $75,000.00 — $23,250.00 $74,250.00 $69,225.00 2025-01-01
27800000002-89079 CDM Valve Aortic 23mm Evolut Fx 60 37 $75,000.00 — $23,250.00 $74,250.00 $69,225.00 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 5 1 — — $56,951.29 $122,022.76 $69,172.84 2025-01-01
27200000002-21145 CDM Glv Surg Orth Ltx Maxxus 8.5 58 37 $74,258.59 — $23,020.16 $73,516.00 $68,911.97 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 5 1 — — $56,003.69 $119,992.44 $68,021.88 2025-01-01
27200000002-28034 CDM Clip Lig Ti Horizon Sm 6/cq 58 37 $71,250.00 — $22,087.50 $70,537.50 $66,120.00 2025-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 5 1 — — $54,432.29 $116,625.58 $66,113.26 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 1 — — $54,255.39 $116,246.56 $65,898.40 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 5 1 — — $53,772.28 $115,211.45 $65,311.61 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 5 1 — — $53,655.38 $114,960.99 $65,169.63 2025-01-01
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 5 1 — — $53,341.92 $114,289.39 $64,788.91 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 5 1 — — $52,542.26 $112,576.04 $63,817.64 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 5 1 — — $52,313.63 $112,086.19 $63,539.95 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 5 1 — — $52,125.35 $111,682.79 $63,311.27 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 5 1 — — $51,717.76 $110,809.48 $62,816.20 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 5 1 — — $51,255.34 $109,818.71 $62,254.55 2025-01-01
A9606 HCPCS Radium Ra-223 Dichloride Therapeutic Per Microcurie 58 37 $66,927.15 — $20,747.42 $66,257.88 $62,108.40 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 5 1 — — $50,887.06 $109,029.64 $61,807.24 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 5 1 — — $50,485.67 $108,169.63 $61,319.71 2025-01-01
27000000004-1176 CDM Drape Surg W/17 5/8x11.75in Towl Ster 58 37 $66,068.70 — $20,481.30 $65,408.01 $61,311.76 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 5 1 — — $50,111.18 $107,367.26 $60,864.86 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 5 1 — — $50,037.73 $107,209.89 $60,775.65 2025-01-01
10 MS_DRG Pancreas Transplant 5 1 — — $49,796.69 $106,693.44 $60,482.88 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 5 1 — — $49,726.35 $106,542.72 $60,397.44 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 5 1 — — $49,473.93 $106,001.90 $60,090.86 2025-01-01
27800000002-89069 CDM Watchman Flx Procedure - Device 60 37 $65,100.00 — $20,181.00 $64,449.00 $60,087.30 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 1 — — $49,039.44 $105,070.97 $59,563.13 2025-01-01
J9600 HCPCS Porfimer Per 75 Mg 58 37 $63,961.57 — $19,828.09 $63,321.95 $59,356.33 2025-01-01
C1822 HCPCS Kit Ipg Omnia 300 37 $65,000.00 — $4,528.33 $83,655.00 $59,345.00 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 5 1 — — $48,762.19 $104,476.94 $59,226.38 2025-01-01
27800000002-91466 CDM Stent Graft Confrm Thor 21x21x10 18f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91465 CDM Stent Graft Confrm Thor 31x31x10 20f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91563 CDM Stent Graft Confrm Thor 37x37x20 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91607 CDM Stent Graft Confrm Thor 45x45x20 24f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91492 CDM Stent Graft Confrm Thor 28x28x10 20f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91490 CDM Stent Graft Confrm Thor 45x45x10 24f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91484 CDM Stent Graft Confrm Thor 45x45x15 24f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91564 CDM Stent Graft Confrm Thor 34x34x20 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91562 CDM Stent Graft Confrm Thor 37x37x20 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91486 CDM Stent Graft Confrm Thor 45x45x15 24f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91447 CDM Stent Graft Confrm Thor 40x40x10 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91444 CDM Stent Graft Confrm Thor 40x40x15 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91443 CDM Stent Graft Confrm Thor 40x40x15 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91448 CDM Stent Graft Confrm Thor 40x40x10 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91518 CDM Stent Graft Confrm Thor 26x26x10 20f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91495 CDM Stent Graft Confrm Thor 34x34x10 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91432 CDM Stent Graft Confrm Thor 34x34x15 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91433 CDM Stent Graft Confrm Thor 34x34x15 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-89038 CDM Stent Graft Confrm Thor 40x40x20 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91503 CDM Stent Graft Confrm Thor 28x28x15 20f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91485 CDM Stent Graft Confrm Thor 45x45x15 24f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91565 CDM Stent Graft Confrm Thor 34x34x20 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91487 CDM Stent Graft Confrm Thor 37x37x10 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
27800000002-91494 CDM Stent Graft Confrm Thor 34x34x10 22f 60 37 $64,015.00 — $19,844.65 $63,374.85 $59,085.85 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 1 — — $48,089.77 $103,036.22 $58,409.66 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 5 1 — — $47,873.56 $102,572.97 $58,147.05 2025-01-01
27800000002-91560 CDM Stent Valiant Navion Vnmf4343c183tu Freeflo 175mm 60 37 $62,984.25 — $19,525.12 $62,354.41 $58,134.46 2025-01-01
455 MS_DRG Combined Anterior/posterior Spinal Fusion Without Cc/mcc 5 1 — — $47,644.93 $102,083.12 $57,869.36 2025-01-01
27800000002-90266 CDM Set Pump Impella Cp 60 37 $62,500.00 — $19,375.00 $61,875.00 $57,687.50 2025-01-01
27800000002-90265 CDM Set Pump Impella Cp 60 37 $62,500.00 — $19,375.00 $61,875.00 $57,687.50 2025-01-01
J9359 HCPCS Loncastuximab-lpyl 0.1 Mg 58 37 $62,068.02 — $19,241.09 $61,447.34 $57,599.12 2025-01-01
245 MS_DRG Aicd Generator Procedures 5 1 — — $46,877.33 $100,438.48 $56,937.04 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 1 — — $46,873.20 $100,429.62 $56,932.02 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 5 1 — — $46,726.30 $100,114.87 $56,753.59 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 5 1 — — $46,572.16 $99,784.61 $56,566.37 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 5 1 — — $46,526.64 $99,687.09 $56,511.09 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 1 — — $46,142.84 $98,864.77 $56,044.93 2025-01-01
27800000002-89043 CDM Plug Cardiac Amulet Amplatzer 20mm 60 37 $60,424.00 — $18,731.44 $59,819.76 $55,771.35 2025-01-01
27800000002-88977 CDM Plug Cardiac Amulet Amplatzer 18mm 60 37 $60,424.00 — $18,731.44 $59,819.76 $55,771.35 2025-01-01
27800000002-88975 CDM Plug Cardiac Amulet Amplatzer 22mm 60 37 $60,424.00 — $18,731.44 $59,819.76 $55,771.35 2025-01-01
27800000002-88976 CDM Plug Cardiac Amulet Amplatzer 18mm 60 37 $60,424.00 — $18,731.44 $59,819.76 $55,771.35 2025-01-01
27800000002-89042 CDM Plug Cardiac Amulet Amplatzer 20mm 60 37 $60,424.00 — $18,731.44 $59,819.76 $55,771.35 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 5 1 — — $45,811.80 $98,155.49 $55,642.85 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 5 1 — — $45,683.52 $97,880.64 $55,487.04 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 5 1 — — $45,123.86 $96,681.51 $54,807.27 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 5 1 — — $44,771.09 $95,925.69 $54,378.81 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 5 1 — — $44,512.47 $95,371.56 $54,064.68 2025-01-01
A9604 HCPCS Samarium Sm-153 Lexidronam Therapeutic Per 150 Millicuries 58 37 $58,222.08 — $18,048.84 $57,639.86 $54,030.09 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 5 1 — — $44,263.15 $94,837.39 $53,761.87 2025-01-01
793 MS_DRG Full Term Neonate With Major Problems 5 1 — — $43,545.21 $93,299.13 $52,889.85 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 5 1 — — $43,020.72 $92,175.37 $52,252.81 2025-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 5 1 — — $42,828.30 $91,763.10 $52,019.10 2025-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 5 1 — — $42,586.23 $91,244.44 $51,725.08 2025-01-01
791 MS_DRG Prematurity With Major Problems 5 1 — — $42,390.71 $90,825.52 $51,487.60 2025-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 5 1 — — $41,977.94 $89,941.14 $50,986.26 2025-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 5 1 — — $41,843.46 $89,652.99 $50,822.91 2025-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 5 1 — — $41,806.21 $89,573.20 $50,777.68 2025-01-01
27800000002-89213 CDM Coil Web Sgl Layer 6x2mm 60 37 $54,845.88 — $17,002.22 $54,297.42 $50,622.75 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 5 1 — — $41,530.00 $88,981.39 $50,442.19 2025-01-01
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 5 1 — — $41,430.69 $88,768.61 $50,321.57 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 5 1 — — $40,942.41 $87,722.42 $49,728.50 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 5 1 — — $40,580.33 $86,946.65 $49,288.73 2025-01-01
27000000004-1177 CDM Drape Surg W/17 5/8x11.75in Towl Ster 58 37 $53,078.20 — $16,454.24 $52,547.42 $49,256.57 2025-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 5 1 — — $40,458.26 $86,685.10 $49,140.46 2025-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 5 1 — — $40,359.98 $86,474.53 $49,021.09 2025-01-01
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 5 1 — — $40,314.47 $86,377.01 $48,965.81 2025-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 5 1 — — $40,213.08 $86,159.79 $48,842.67 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 5 1 — — $40,119.98 $85,960.30 $48,729.58 2025-01-01
27800000002-89196 CDM Conduit Konect Resilia Aortic Vlv 27mm 60 37 $52,500.00 — $16,275.00 $51,975.00 $48,457.50 2025-01-01
27800000002-89062 CDM Conduit Konect Resilia Aortic Vlv 23mm 60 37 $52,500.00 — $16,275.00 $51,975.00 $48,457.50 2025-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 5 1 — — $39,833.42 $85,346.33 $48,381.53 2025-01-01
27800000002-90902 CDM Coil Web Sngl Layer 9x4 60 37 $52,325.00 — $16,220.75 $51,801.75 $48,295.98 2025-01-01
27800000002-89712 CDM Coil Web Sngl Layer 9x5 60 37 $52,325.00 — $16,220.75 $51,801.75 $48,295.98 2025-01-01
27800000002-89711 CDM Coil Web Sngl Layer 5x4 60 37 $52,325.00 — $16,220.75 $51,801.75 $48,295.98 2025-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 5 1 — — $39,575.83 $84,794.42 $48,068.66 2025-01-01
27800000002-88996 CDM Device Embol Pipeline Flex 4.25x25mm 60 37 $51,707.25 — $16,029.25 $51,190.18 $47,725.79 2025-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 5 1 — — $39,195.14 $83,978.75 $47,606.27 2025-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 5 1 — — $39,084.44 $83,741.59 $47,471.83 2025-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 5 1 — — $38,602.37 $82,708.70 $46,886.30 2025-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 5 1 — — $38,506.16 $82,502.56 $46,769.44 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 5 1 — — $38,478.23 $82,442.72 $46,735.52 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 5 1 — — $38,255.81 $81,966.17 $46,465.37 2025-01-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 5 1 — — $37,840.98 $81,077.35 $45,961.51 2025-01-01
332 MS_DRG Rectal Resection With Mcc 5 1 — — $37,803.73 $80,997.56 $45,916.28 2025-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 5 1 — — $37,777.87 $80,942.15 $45,884.87 2025-01-01
27800000002-89710 CDM Coil Web Sngl Layer 11x6 60 37 $49,708.75 — $15,409.71 $49,211.66 $45,881.18 2025-01-01
27800000002-89709 CDM Coil Web Sngl Layer 10x5 60 37 $49,708.75 — $15,409.71 $49,211.66 $45,881.18 2025-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 5 1 — — $37,623.73 $80,611.89 $45,697.65 2025-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 5 1 — — $37,476.83 $80,297.15 $45,519.23 2025-01-01
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 5 1 — — $37,410.62 $80,155.29 $45,438.81 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 5 1 — — $37,047.51 $79,377.30 $44,997.78 2025-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 5 1 — — $36,983.38 $79,239.88 $44,919.88 2025-01-01
27800000002-89019 CDM Device Embol Pipeline Flex 4.25x20mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-89002 CDM Device Embol Pipeline Flex 4x12mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-88995 CDM Device Embol Pipeline Flex 3x16mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-88997 CDM Device Embol Pipeline Flex 4.5x12mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-88994 CDM Device Embol Pipeline Flex 4.25x14mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-89000 CDM Device Embol Pipeline Flex 4x10mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-89010 CDM Device Embol Pipeline Flex 4x16mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
27800000002-88989 CDM Device Embol Pipeline Flex 4.5x18mm 60 37 $48,234.38 — $14,952.66 $47,752.04 $44,520.33 2025-01-01
265 MS_DRG Aicd Lead Procedures 5 1 — — $36,560.26 $78,333.33 $44,405.97 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 5 1 — — $36,468.19 $78,136.06 $44,294.14 2025-01-01
L8614 HCPCS Dornhoffer Fixed Part W/window 420 37 $48,329.75 — $40.71 $63,970.83 $44,125.06 2025-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 5 1 — — $36,065.77 $77,273.84 $43,805.36 2025-01-01
27800000002-89197 CDM Kit Ipg Pulse Senza Sys 60 37 $47,229.00 — $14,640.99 $46,756.71 $43,592.37 2025-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 5 1 — — $35,815.42 $76,737.45 $43,501.29 2025-01-01
27000000004-1301 CDM Marker Skin 1.5mm Arrow D Spot Lead Sm 99/bx 58 37 $46,865.70 — $14,528.37 $46,397.04 $43,491.37 2025-01-01
27000000004-2122 CDM Tube Insufl Std Filt 10ft Ster 58 37 $46,865.70 — $14,528.37 $46,397.04 $43,491.37 2025-01-01
27200000002-18300 CDM Set Tubing Cardiovasc Proc Kit Bld Syst Vein 50-70cm 58 37 $46,838.16 — $14,519.83 $46,369.78 $43,465.81 2025-01-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 5 1 — — $35,777.15 $76,655.44 $43,454.80 2025-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 5 1 — — $35,754.39 $76,606.67 $43,427.15 2025-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 5 1 — — $35,743.01 $76,582.29 $43,413.33 2025-01-01
27800000002-89224 CDM Vein Saphns 85cm Or Greater A B Ab O Bld Type 60 37 $46,838.16 — $14,519.83 $46,369.78 $43,231.62 2025-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 5 1 — — $35,491.63 $76,043.68 $43,108.00 2025-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 5 1 — — $35,464.73 $75,986.05 $43,075.33 2025-01-01
27200000002-18301 CDM Set Tubing Cardiovasc Proc Kit Bld Syst Vein 50-70cm 58 37 $46,371.50 — $14,375.17 $45,907.79 $43,032.75 2025-01-01
27800000002-89225 CDM Vein Saphns 85cm Or Greater A B Ab O Bld Type 60 37 $46,371.50 — $14,375.17 $45,907.79 $42,800.89 2025-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 5 1 — — $35,233.00 $75,489.56 $42,793.88 2025-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 5 1 — — $34,931.96 $74,844.56 $42,428.24 2025-01-01
37 MS_DRG Extracranial Procedures With Mcc 5 1 — — $34,920.58 $74,820.17 $42,414.41 2025-01-01
27800000002-89752 CDM Device Embol 4x14mm Pipeline 60 37 $45,937.50 — $14,240.63 $45,478.13 $42,400.31 2025-01-01
27800000002-89743 CDM Device Embol 3.75x12 Pipeline 60 37 $45,937.50 — $14,240.63 $45,478.13 $42,400.31 2025-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 5 1 — — $34,852.31 $74,673.89 $42,331.49 2025-01-01
27200000002-17552 CDM Cannula Angiovac 180d Dilator 58 37 $45,500.00 — $14,105.00 $45,045.00 $42,224.00 2025-01-01
27800000002-91561 CDM Stent Graft Confrm Thor 37x37x20 22f 60 37 $45,725.00 — $14,174.75 $45,267.75 $42,204.18 2025-01-01
27800000002-91491 CDM Stent Graft Confrm Thor 28x28x10 20f 60 37 $45,725.00 — $14,174.75 $45,267.75 $42,204.18 2025-01-01
27800000002-91502 CDM Stent Graft Confrm Thor 28x28x15 20f 60 37 $45,725.00 — $14,174.75 $45,267.75 $42,204.18 2025-01-01
27800000002-89037 CDM Stent Graft Confrm Thor 40x40x20 22f 60 37 $45,725.00 — $14,174.75 $45,267.75 $42,204.18 2025-01-01
27800000002-91446 CDM Stent Graft Confrm Thor 40x40x10 22f 60 37 $45,725.00 — $14,174.75 $45,267.75 $42,204.18 2025-01-01
27800000002-91464 CDM Stent Graft Confrm Thor 31x31x10 20f 60 37 $45,725.00 — $14,174.75 $45,267.75 $42,204.18 2025-01-01
252 MS_DRG Other Vascular Procedures With Mcc 5 1 — — $34,695.06 $74,336.98 $42,140.50 2025-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 5 1 — — $34,575.06 $74,079.86 $41,994.74 2025-01-01
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 5 1 — — $34,446.78 $73,805.02 $41,838.94 2025-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 5 1 — — $34,403.33 $73,711.92 $41,786.16 2025-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 5 1 — — $34,295.74 $73,481.41 $41,655.49 2025-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 5 1 — — $34,076.43 $73,011.51 $41,389.11 2025-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 5 1 — — $33,786.77 $72,390.89 $41,037.29 2025-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 5 1 — — $33,685.39 $72,173.67 $40,914.15 2025-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 5 1 — — $33,546.77 $71,876.66 $40,745.78 2025-01-01
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 5 1 — — $33,526.08 $71,832.33 $40,720.65 2025-01-01
27100000002-663 CDM Glv Exam Pow Ltx Sm 58 37 $43,692.98 — $13,544.82 $43,256.05 $40,547.09 2025-01-01
27200000002-31348 CDM Electrd Lapscp Lwire 33cm Ez Cln Disp 58 37 $43,692.98 — $13,544.82 $43,256.05 $40,547.09 2025-01-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 5 1 — — $33,264.35 $71,271.56 $40,402.76 2025-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 5 1 — — $33,262.28 $71,267.12 $40,400.24 2025-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 5 1 — — $33,112.28 $70,945.73 $40,218.05 2025-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 5 1 — — $33,110.21 $70,941.30 $40,215.54 2025-01-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan Therapeutic Per Treatment Dose Up To 40 Millic… 58 37 $43,294.20 — $13,421.20 $42,861.26 $40,177.02 2025-01-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 5 1 — — $32,892.96 $70,475.83 $39,951.67 2025-01-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 5 1 — — $32,705.72 $70,074.65 $39,724.25 2025-01-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 5 1 — — $32,626.06 $69,903.98 $39,627.50 2025-01-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 5 1 — — $32,458.47 $69,544.90 $39,423.94 2025-01-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 5 1 — — $32,330.19 $69,270.06 $39,268.14 2025-01-01
27800000002-88920 CDM Device Clsur Watchman Flx Laa 20mm 60 37 $42,500.00 — $13,175.00 $42,075.00 $39,227.50 2025-01-01
27800000002-89067 CDM Watchman Flx Procedure - Device 60 37 $42,500.00 — $13,175.00 $42,075.00 $39,227.50 2025-01-01
27800000002-89194 CDM Device Watchman Flx Pro Procedure 60 37 $42,500.00 — $13,175.00 $42,075.00 $39,227.50 2025-01-01
27800000002-89068 CDM Watchman Flx Procedure - Device 60 37 $42,500.00 — $13,175.00 $42,075.00 $39,227.50 2025-01-01
665 MS_DRG Prostatectomy With Mcc 5 1 — — $31,956.74 $68,469.90 $38,814.54 2025-01-01
27200000002-17628 CDM Set Circuit Adv Hls Beq-hls 7050 7.0 58 37 $41,795.60 — $12,956.64 $41,377.64 $38,786.32 2025-01-01
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