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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

BAYSTATE NOBLE HOSPITAL

Westfield, MA · CCN 220065 · Rates published

277 distinct procedures filed
24 distinct payers
20,616 rate rows
2025-10-15 last MRF observed
Data quality

3,000 of 20,616 rate rows are consumer-grade (14.6%)

17,616 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 17,616
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://cdn1-originals.webdamdb.com/13686_164608646?cache=1761101956&response-content-disposition=inline;filename=222537423_baystate-noble-hospital_standardcharges.csv&Policy=eyJTdGF0ZW1lbnQiOlt7IlJlc291cmNlIjoiaHR0cCo6Ly9jZG4xLW9yaWdpbmFscy53ZWJkYW1kYi5jb20vMTM2ODZfMTY0NjA4NjQ2P2NhY2hlPTE3NjExMDE5NTYmcmVzcG9uc2UtY29udGVudC1kaXNwb3NpdGlvbj1pbmxpbmU7ZmlsZW5hbWU9MjIyNTM3NDIzX2JheXN0YXRlLW5vYmxlLWhvc3BpdGFsX3N0YW5kYXJkY2hhcmdlcy5jc3YiLCJDb25kaXRpb24iOnsiRGF0ZUxlc3NUaGFuIjp7IkFXUzpFcG9jaFRpbWUiOjIxNDc0MTQ0MDB9fX1dfQ__&Signature=dPo9BcIcxmadfkmKWBKGtwZ4p2R6HigGi7vYg8m8ziTvtPlDqR0nT6Fj6c6cy0NxMM1u5KnbSPnPiVrOngKtX2eiH0V-SWy0PcO~5ZKwQh0a2hemgbx7Sfw6b-0Vd-fGnCW0He783226F6tMBAs6aqrQLBqhAaVorRekOZ5KGo43IrnOvI8RDsUHsnv-F0T-b5sl3QjLnITaEmsZWnRMHkknaEXojU5fUm8DkEXro83SsXNwznYNPwcXHiMOlNC8aMeRTDyy3Yz~Ymd39R9kapYHuSLY0z2Q5dSQQK1ToO7DWLcEYQJelsK4vRs8PPTrWl~oeZlZq9eyxcWpsH~~eQ__&Key-Pair-Id=APKAI2ASI2IOLRFF2RHA
Found on page https://www.baystatehealth.org/patients-and-visitors/healthcare-prices-and-billing/hospital-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint ff91f6cfa92a4113… · 2,974,626 bytes · first seen 2026-05-06

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
999
MS_DRG 		Ungroupable 1 $68,762.09 $68,762.09 $68,762.09 nat. median
$9,134
outlier · 7.5×
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 1 $29,774.43 $29,774.43 $29,774.43 nat. median
$17,985
1.7× median
585
MS_DRG 		Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc 1 $29,285.40 $29,285.40 $29,285.40 nat. median
$19,623
1.5× median
840
MS_DRG 		Lymphoma And Non-acute Leukemia With Mcc 1 $27,844.81 $27,844.81 $27,844.81 nat. median
$31,382
0.9× median
862
MS_DRG 		Postoperative And Post-traumatic Infections With Mcc 1 $26,892.90 $26,892.90 $26,892.90 nat. median
$18,227
1.5× median
5464
OTHER 		Level 4 Neurostimulator And Related Procedures 1 $24,954.11 $24,954.11 $24,954.11 nat. median
$20,658
1.2× median
559
MS_DRG 		Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 $24,519.55 $24,519.55 $24,519.55 nat. median
$19,047
1.3× median
546
MS_DRG 		Connective Tissue Disorders With Cc 2 $24,076.67 $24,076.67 $24,076.67 nat. median
$12,460
1.9× median
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 6 $24,009.22 $24,009.22 $24,009.22 nat. median
$13,201
1.8× median
539
MS_DRG 		Osteomyelitis With Mcc 1 $23,022.46 $23,022.46 $23,022.46 nat. median
$19,718
1.2× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 $22,912.24 $22,912.24 $22,912.24 nat. median
$48,170
outlier · 0.5×
810
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 $22,656.17 $22,656.17 $22,656.17 nat. median
$10,938
outlier · 2.1×
982
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 $22,471.49 $22,471.49 $22,471.49 nat. median
$24,493
0.9× median
94
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 $22,375.24 $22,375.24 $22,375.24 nat. median
$35,264
0.6× median
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Mcc 4 $20,387.12 $20,387.12 $20,387.12 nat. median
$16,529
1.2× median
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 1 $20,319.82 $20,319.82 $20,319.82 nat. median
$48,178
outlier · 0.4×
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 $19,719.90 $19,719.90 $19,719.90 nat. median
$24,757
0.8× median
963
MS_DRG 		Other Multiple Significant Trauma With Mcc 1 $19,437.29 $19,437.29 $19,437.29 nat. median
$26,957
0.7× median
253
MS_DRG 		Other Vascular Procedures With Cc 1 $19,337.54 $19,337.54 $19,337.54 nat. median
$26,079
0.7× median
552
MS_DRG 		Medical Back Problems Without Mcc 7 $18,819.19 $18,819.19 $18,819.19 nat. median
$10,422
1.8× median
5115
OTHER 		Level 5 Musculoskeletal Procedures 4 $18,683.08 $18,683.08 $18,683.08 nat. median
$13,542
1.4× median
208
MS_DRG 		Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 $18,228.08 $18,228.08 $18,228.08 nat. median
$26,748
0.7× median
5223
OTHER 		Level 3 Pacemaker And Similar Procedures 2 $18,059.88 $18,059.88 $18,059.88 nat. median
$10,815
1.7× median
419
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 1 $18,015.67 $18,015.67 $18,015.67 nat. median
$14,421
1.2× median
82
MS_DRG 		Traumatic Stupor And Coma >1 Hour With Mcc 3 $17,607.30 $17,607.30 $17,607.30 nat. median
$22,770
0.8× median
682
MS_DRG 		Renal Failure With Mcc 4 $16,803.26 $16,803.26 $16,803.26 nat. median
$15,223
1.1× median
175
MS_DRG 		Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 2 $15,918.17 $15,918.17 $15,918.17 nat. median
$14,623
1.1× median
885
MS_DRG 		Psychoses 14 $15,173.90 $15,173.90 $15,173.90 nat. median
$12,884
1.2× median
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 1 $15,064.88 $15,064.88 $15,064.88 nat. median
$18,249
0.8× median
643
MS_DRG 		Endocrine Disorders With Mcc 1 $14,998.78 $14,998.78 $14,998.78 nat. median
$16,781
0.9× median
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 4 $14,935.00 $14,935.00 $14,935.00 nat. median
$22,361
0.7× median
393
MS_DRG 		Other Digestive System Diagnoses With Mcc 1 $14,645.68 $14,645.68 $14,645.68 nat. median
$16,482
0.9× median
722
MS_DRG 		Malignancy, Male Reproductive System With Mcc 1 $14,385.54 $14,385.54 $14,385.54 nat. median
$17,975
0.8× median
336
MS_DRG 		Peritoneal Adhesiolysis With Cc 1 $14,015.32 $14,015.32 $14,015.32 nat. median
$21,526
0.7× median
435
MS_DRG 		Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 $13,830.51 $13,830.51 $13,830.51 nat. median
$18,498
0.7× median
196
MS_DRG 		Interstitial Lung Disease With Mcc 1 $13,732.42 $13,732.42 $13,732.42 nat. median
$18,723
0.7× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 1 $13,607.91 $13,607.91 $13,607.91 nat. median
$17,807
0.8× median
617
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 $13,574.20 $13,574.20 $13,574.20 nat. median
$19,472
0.7× median
342
MS_DRG 		Appendectomy Without Complicated Principal Diagnosis With Cc 2 $13,429.56 $13,429.56 $13,429.56 nat. median
$13,424
1.0× median
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 7 $13,251.55 $13,251.55 $13,251.55 nat. median
$11,174
1.2× median
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 2 $12,965.50 $12,965.50 $12,965.50 nat. median
$16,971
0.8× median
922
MS_DRG 		Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 2 $12,876.93 $12,876.93 $12,876.93 nat. median
$17,445
0.7× median
513
MS_DRG 		Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc 1 $12,692.38 $12,692.38 $12,692.38 nat. median
$15,878
0.8× median
535
MS_DRG 		Fractures Of Hip And Pelvis With Mcc 3 $12,689.24 $12,689.24 $12,689.24 nat. median
$13,516
0.9× median
884
MS_DRG 		Organic Disturbances And Intellectual Disability 4 $12,668.92 $12,668.92 $12,668.92 nat. median
$14,858
0.9× median
669
MS_DRG 		Transurethral Procedures With Cc 1 $12,645.55 $12,645.55 $12,645.55 nat. median
$15,989
0.8× median
432
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Mcc 4 $12,600.47 $12,600.47 $12,600.47 nat. median
$19,681
0.6× median
642
MS_DRG 		Inborn And Other Disorders Of Metabolism 2 $12,490.41 $12,490.41 $12,490.41 nat. median
$14,073
0.9× median
812
MS_DRG 		Red Blood Cell Disorders Without Mcc 6 $12,475.70 $12,475.70 $12,475.70 nat. median
$9,870
1.3× median
74
MS_DRG 		Cranial And Peripheral Nerve Disorders Without Mcc 4 $12,393.55 $12,393.55 $12,393.55 nat. median
$11,117
1.1× median

Other procedures at this hospital

Browse this hospital's 277 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
             
101 MS_DRG Seizures Without Mcc 10 4 — — $8,788.17 $8,788.17 $8,788.17 2025-10-15
121 MS_DRG Acute Major Eye Infections With Cc/Mcc 2 1 — — $9,614.78 $9,614.78 $9,614.78 2025-10-15
125 MS_DRG Other Disorders Of The Eye Without Mcc 2 1 — — $7,227.05 $7,227.05 $7,227.05 2025-10-15
149 MS_DRG Dysequilibrium 2 1 — — $6,085.96 $6,085.96 $6,085.96 2025-10-15
1503 OTHER New Technology - Level 3 ($101 - $200) 14 4 — — $230.90 $230.90 $230.90 2025-10-15
1505 OTHER New Technology - Level 5 ($301 - $400) 0 0 — — — — — 2025-10-15
153 MS_DRG Otitis Media And Uri Without Mcc 4 2 — — $5,383.27 $5,383.27 $5,383.27 2025-10-15
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 2 1 — — $7,644.17 $7,644.17 $7,644.17 2025-10-15
157 MS_DRG Dental And Oral Diseases With Mcc 2 1 — — $6,699.87 $6,699.87 $6,699.87 2025-10-15
159 MS_DRG Dental And Oral Diseases Without Cc/Mcc 2 1 — — $10,194.61 $10,194.61 $10,194.61 2025-10-15
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 4 2 — — $15,918.17 $15,918.17 $15,918.17 2025-10-15
176 MS_DRG Pulmonary Embolism Without Mcc 12 4 — — $9,223.00 $9,223.00 $9,223.00 2025-10-15
177 MS_DRG Respiratory Infections And Inflammations With Mcc 26 9 — — $9,772.34 $9,772.34 $9,772.34 2025-10-15
178 MS_DRG Respiratory Infections And Inflammations With Cc 12 6 — — $8,694.65 $8,694.65 $8,694.65 2025-10-15
179 MS_DRG Respiratory Infections And Inflammations Without Cc/Mcc 4 2 — — $7,123.36 $7,123.36 $7,123.36 2025-10-15
184 MS_DRG Major Chest Trauma With Cc 2 1 — — $5,413.06 $5,413.06 $5,413.06 2025-10-15
189 MS_DRG Pulmonary Edema And Respiratory Failure 20 7 — — $10,410.50 $10,410.50 $10,410.50 2025-10-15
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 14 4 — — $10,770.33 $10,770.33 $10,770.33 2025-10-15
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 10 5 — — $7,903.42 $7,903.42 $7,903.42 2025-10-15
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 26 10 — — $7,821.74 $7,821.74 $7,821.74 2025-10-15
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 20 7 — — $8,421.00 $8,421.00 $8,421.00 2025-10-15
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 2 1 — — $3,357.40 $3,357.40 $3,357.40 2025-10-15
196 MS_DRG Interstitial Lung Disease With Mcc 2 1 — — $13,732.42 $13,732.42 $13,732.42 2025-10-15
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 14 6 — — $5,927.16 $5,927.16 $5,927.16 2025-10-15
203 MS_DRG Bronchitis And Asthma Without Cc/Mcc 4 2 — — $4,091.51 $4,091.51 $4,091.51 2025-10-15
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 6 3 — — $18,228.08 $18,228.08 $18,228.08 2025-10-15
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $19,337.54 $19,337.54 $19,337.54 2025-10-15
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 8 4 — — $20,387.12 $20,387.12 $20,387.12 2025-10-15
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 4 2 — — $10,939.68 $10,939.68 $10,939.68 2025-10-15
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 4 2 — — $4,279.59 $4,279.59 $4,279.59 2025-10-15
291 MS_DRG Heart Failure And Shock With Mcc 30 11 — — $10,171.28 $10,171.28 $10,171.28 2025-10-15
292 MS_DRG Heart Failure And Shock With Cc 4 2 — — $3,618.10 $3,618.10 $3,618.10 2025-10-15
299 MS_DRG Peripheral Vascular Disorders With Mcc 4 2 — — $11,822.67 $11,822.67 $11,822.67 2025-10-15
300 MS_DRG Peripheral Vascular Disorders With Cc 10 5 — — $7,756.25 $7,756.25 $7,756.25 2025-10-15
302 MS_DRG Atherosclerosis With Mcc 2 1 — — $10,685.70 $10,685.70 $10,685.70 2025-10-15
304 MS_DRG Hypertension With Mcc 6 3 — — $8,997.07 $8,997.07 $8,997.07 2025-10-15
305 MS_DRG Hypertension Without Mcc 10 4 — — $6,502.45 $6,502.45 $6,502.45 2025-10-15
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 8 2 — — $8,077.46 $8,077.46 $8,077.46 2025-10-15
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 8 4 — — $7,069.18 $7,069.18 $7,069.18 2025-10-15
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 2 1 — — $8,365.58 $8,365.58 $8,365.58 2025-10-15
312 MS_DRG Syncope And Collapse 8 4 — — $5,297.91 $5,297.91 $5,297.91 2025-10-15
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 1 — — $4,716.76 $4,716.76 $4,716.76 2025-10-15
315 MS_DRG Other Circulatory System Diagnoses With Cc 4 2 — — $9,361.10 $9,361.10 $9,361.10 2025-10-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $20,319.82 $20,319.82 $20,319.82 2025-10-15
336 MS_DRG Peritoneal Adhesiolysis With Cc 2 1 — — $14,015.32 $14,015.32 $14,015.32 2025-10-15
342 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Cc 4 2 — — $13,429.56 $13,429.56 $13,429.56 2025-10-15
349 MS_DRG Anal And Stomal Procedures Without Cc/Mcc 2 1 — — $6,979.74 $6,979.74 $6,979.74 2025-10-15
368 MS_DRG Major Esophageal Disorders With Mcc 2 1 — — $10,325.12 $10,325.12 $10,325.12 2025-10-15
369 MS_DRG Major Esophageal Disorders With Cc 4 2 — — $6,291.11 $6,291.11 $6,291.11 2025-10-15
370 MS_DRG Major Esophageal Disorders Without Cc/Mcc 2 1 — — $1,372.50 $1,372.50 $1,372.50 2025-10-15
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 2 1 — — $13,607.91 $13,607.91 $13,607.91 2025-10-15
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 4 2 — — $7,526.54 $7,526.54 $7,526.54 2025-10-15
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 4 2 — — $3,803.28 $3,803.28 $3,803.28 2025-10-15
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 2 1 — — $15,064.88 $15,064.88 $15,064.88 2025-10-15
378 MS_DRG Gastrointestinal Hemorrhage With Cc 4 2 — — $6,311.59 $6,311.59 $6,311.59 2025-10-15
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/Mcc 6 3 — — $6,375.14 $6,375.14 $6,375.14 2025-10-15
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 2 1 — — $10,828.75 $10,828.75 $10,828.75 2025-10-15
385 MS_DRG Inflammatory Bowel Disease With Mcc 2 1 — — $6,929.78 $6,929.78 $6,929.78 2025-10-15
386 MS_DRG Inflammatory Bowel Disease With Cc 8 3 — — $7,670.93 $7,670.93 $7,670.93 2025-10-15
387 MS_DRG Inflammatory Bowel Disease Without Cc/Mcc 2 1 — — $1,178.63 $1,178.63 $1,178.63 2025-10-15
389 MS_DRG Gastrointestinal Obstruction With Cc 2 1 — — $5,770.59 $5,770.59 $5,770.59 2025-10-15
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 14 7 — — $4,297.64 $4,297.64 $4,297.64 2025-10-15
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 10 5 — — $9,194.86 $9,194.86 $9,194.86 2025-10-15
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 32 10 — — $6,852.87 $6,852.87 $6,852.87 2025-10-15
393 MS_DRG Other Digestive System Diagnoses With Mcc 2 1 — — $14,645.68 $14,645.68 $14,645.68 2025-10-15
394 MS_DRG Other Digestive System Diagnoses With Cc 6 3 — — $5,620.27 $5,620.27 $5,620.27 2025-10-15
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 2 1 — — $2,008.98 $2,008.98 $2,008.98 2025-10-15
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 2 1 — — $12,233.60 $12,233.60 $12,233.60 2025-10-15
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 2 1 — — $18,015.67 $18,015.67 $18,015.67 2025-10-15
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 14 4 — — $12,600.47 $12,600.47 $12,600.47 2025-10-15
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 12 5 — — $7,909.66 $7,909.66 $7,909.66 2025-10-15
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 2 1 — — $13,830.51 $13,830.51 $13,830.51 2025-10-15
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 2 1 — — $9,877.29 $9,877.29 $9,877.29 2025-10-15
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 4 2 — — $12,965.50 $12,965.50 $12,965.50 2025-10-15
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 26 8 — — $9,418.96 $9,418.96 $9,418.96 2025-10-15
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/Mcc 8 3 — — $10,938.72 $10,938.72 $10,938.72 2025-10-15
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 4 2 — — $12,107.38 $12,107.38 $12,107.38 2025-10-15
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 2 1 — — $6,446.29 $6,446.29 $6,446.29 2025-10-15
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis Without C… 2 1 — — $9,518.77 $9,518.77 $9,518.77 2025-10-15
445 MS_DRG Disorders Of The Biliary Tract With Cc 10 5 — — $11,630.50 $11,630.50 $11,630.50 2025-10-15
446 MS_DRG Disorders Of The Biliary Tract Without Cc/Mcc 10 4 — — $4,884.19 $4,884.19 $4,884.19 2025-10-15
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 2 1 — — $12,328.61 $12,328.61 $12,328.61 2025-10-15
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 1 — — $19,719.90 $19,719.90 $19,719.90 2025-10-15
5012 OTHER Clinic Visits And Related Services 18 7 — — $184.75 $184.75 $184.75 2025-10-15
5021 OTHER Level 1 Type A Ed Visits 14 7 — — $116.06 $116.06 $116.06 2025-10-15
5022 OTHER Level 2 Type A Ed Visits 0 0 — — — — — 2025-10-15
5023 OTHER Level 3 Type A Ed Visits 0 0 — — — — — 2025-10-15
5024 OTHER Level 4 Type A Ed Visits 0 0 — — — — — 2025-10-15
5025 OTHER Level 5 Type A Ed Visits 0 0 — — — — — 2025-10-15
5041 OTHER Critical Care 56 19 — — $4,174.93 $4,174.93 $4,174.93 2025-10-15
5051 OTHER Level 1 Skin Procedures 34 11 — — $301.35 $301.35 $301.35 2025-10-15
5052 OTHER Level 2 Skin Procedures 22 8 — — $454.19 $454.19 $454.19 2025-10-15
5053 OTHER Level 3 Skin Procedures 8 4 — — $517.30 $517.30 $517.30 2025-10-15
5054 OTHER Level 4 Skin Procedures 20 7 — — $2,963.11 $2,963.11 $2,963.11 2025-10-15
5055 OTHER Level 5 Skin Procedures 10 5 — — $5,782.78 $5,782.78 $5,782.78 2025-10-15
5071 OTHER Level 1 Excision/ Biopsy/ Incision And Drainage 40 13 — — $776.38 $776.38 $776.38 2025-10-15
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 48 16 — — $1,874.74 $1,874.74 $1,874.74 2025-10-15
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 14 4 — — $2,131.40 $2,131.40 $2,131.40 2025-10-15
5091 OTHER Level 1 Breast/Lymphatic Surgery And Related Procedures 50 16 — — $4,538.51 $4,538.51 $4,538.51 2025-10-15
5092 OTHER Level 2 Breast/Lymphatic Surgery And Related Procedures 32 11 — — $8,582.48 $8,582.48 $8,582.48 2025-10-15
5093 OTHER Level 3 Breast/Lymphatic Surgery And Related Procedures 14 6 — — $8,444.27 $8,444.27 $8,444.27 2025-10-15
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 8 3 — — $9,872.58 $9,872.58 $9,872.58 2025-10-15
5101 OTHER Level 1 Strapping And Cast Application 2 1 — — $10.72 $10.72 $10.72 2025-10-15
5111 OTHER Level 1 Musculoskeletal Procedures 8 4 — — $500.83 $500.83 $500.83 2025-10-15
5112 OTHER Level 2 Musculoskeletal Procedures 36 11 — — $1,652.28 $1,652.28 $1,652.28 2025-10-15
5113 OTHER Level 3 Musculoskeletal Procedures 0 0 — — — — — 2025-10-15
5114 OTHER Level 4 Musculoskeletal Procedures 30 9 — — $6,963.52 $6,963.52 $6,963.52 2025-10-15
5115 OTHER Level 5 Musculoskeletal Procedures 8 4 — — $18,683.08 $18,683.08 $18,683.08 2025-10-15
513 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/Mcc 2 1 — — $12,692.38 $12,692.38 $12,692.38 2025-10-15
5153 OTHER Level 3 Airway Endoscopy 8 4 — — $2,356.82 $2,356.82 $2,356.82 2025-10-15
5161 OTHER Level 1 ENT Procedures 4 2 — — $376.49 $376.49 $376.49 2025-10-15
5162 OTHER Level 2 ENT Procedures 2 1 — — $889.00 $889.00 $889.00 2025-10-15
5164 OTHER Level 4 ENT Procedures 2 1 — — $3,333.94 $3,333.94 $3,333.94 2025-10-15
5181 OTHER Level 1 Vascular Procedures 6 3 — — $794.40 $794.40 $794.40 2025-10-15
5182 OTHER Level 2 Vascular Procedures 8 4 — — $1,226.86 $1,226.86 $1,226.86 2025-10-15
5183 OTHER Level 3 Vascular Procedures 6 3 — — $2,555.84 $2,555.84 $2,555.84 2025-10-15
52 MS_DRG Spinal Disorders And Injuries With Cc/Mcc 2 1 — — $9,000.00 $9,000.00 $9,000.00 2025-10-15
5222 OTHER Level 2 Pacemaker And Similar Procedures 8 3 — — $5,916.61 $5,916.61 $5,916.61 2025-10-15
5223 OTHER Level 3 Pacemaker And Similar Procedures 4 2 — — $18,059.88 $18,059.88 $18,059.88 2025-10-15
5241 OTHER Level 1 Blood Product Exchange And Related Services 10 4 — — $1,414.35 $1,414.35 $1,414.35 2025-10-15
5301 OTHER Level 1 Upper Gi Procedures 46 15 — — $1,095.01 $1,095.01 $1,095.01 2025-10-15
5302 OTHER Level 2 Upper Gi Procedures 46 15 — — $2,480.07 $2,480.07 $2,480.07 2025-10-15
5303 OTHER Level 3 Upper Gi Procedures 2 1 — — $8,137.25 $8,137.25 $8,137.25 2025-10-15
5311 OTHER Level 1 Lower Gi Procedures 54 18 — — $1,709.49 $1,709.49 $1,709.49 2025-10-15
5312 OTHER Level 2 Lower Gi Procedures 58 19 — — $1,945.61 $1,945.61 $1,945.61 2025-10-15
5313 OTHER Level 3 Lower Gi Procedures 2 1 — — $1,435.24 $1,435.24 $1,435.24 2025-10-15
534 MS_DRG Fractures Of Femur Without Mcc 2 1 — — $6,621.06 $6,621.06 $6,621.06 2025-10-15
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 26 9 — — $4,798.59 $4,798.59 $4,798.59 2025-10-15
535 MS_DRG Fractures Of Hip And Pelvis With Mcc 6 3 — — $12,689.24 $12,689.24 $12,689.24 2025-10-15
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 8 4 — — $5,191.30 $5,191.30 $5,191.30 2025-10-15
5361 OTHER Level 1 Laparoscopy And Related Services 42 14 — — $7,977.19 $7,977.19 $7,977.19 2025-10-15
5371 OTHER Level 1 Urology And Related Services 2 1 — — $388.50 $388.50 $388.50 2025-10-15
5373 OTHER Level 3 Urology And Related Services 26 9 — — $2,690.80 $2,690.80 $2,690.80 2025-10-15
5374 OTHER Level 4 Urology And Related Services 38 11 — — $4,609.90 $4,609.90 $4,609.90 2025-10-15
5375 OTHER Level 5 Urology And Related Services 32 10 — — $8,803.27 $8,803.27 $8,803.27 2025-10-15
539 MS_DRG Osteomyelitis With Mcc 2 1 — — $23,022.46 $23,022.46 $23,022.46 2025-10-15
540 MS_DRG Osteomyelitis With Cc 6 3 — — $12,085.84 $12,085.84 $12,085.84 2025-10-15
5412 OTHER Level 2 Gynecologic Procedures 2 1 — — $392.88 $392.88 $392.88 2025-10-15
5413 OTHER Level 3 Gynecologic Procedures 2 1 — — $714.42 $714.42 $714.42 2025-10-15
5414 OTHER Level 4 Gynecologic Procedures 24 9 — — $2,157.55 $2,157.55 $2,157.55 2025-10-15
5415 OTHER Level 5 Gynecologic Procedures 34 11 — — $6,235.97 $6,235.97 $6,235.97 2025-10-15
5416 OTHER Level 6 Gynecologic Procedures 6 3 — — $9,853.77 $9,853.77 $9,853.77 2025-10-15
5431 OTHER Level 1 Nerve Procedures 28 8 — — $2,511.03 $2,511.03 $2,511.03 2025-10-15
5441 OTHER Level 1 Nerve Injections 14 6 — — $479.86 $479.86 $479.86 2025-10-15
5442 OTHER Level 2 Nerve Injections 18 6 — — $2,124.40 $2,124.40 $2,124.40 2025-10-15
546 MS_DRG Connective Tissue Disorders With Cc 4 2 — — $24,076.67 $24,076.67 $24,076.67 2025-10-15
5462 OTHER Level 2 Neurostimulator And Related Procedures 2 1 — — $7,309.86 $7,309.86 $7,309.86 2025-10-15
5464 OTHER Level 4 Neurostimulator And Related Procedures 2 1 — — $24,954.11 $24,954.11 $24,954.11 2025-10-15
547 MS_DRG Connective Tissue Disorders Without Cc/Mcc 2 1 — — $5,692.72 $5,692.72 $5,692.72 2025-10-15
55 MS_DRG Nervous System Neoplasms Without Mcc 2 1 — — $7,500.06 $7,500.06 $7,500.06 2025-10-15
550 MS_DRG Septic Arthritis Without Cc/Mcc 4 2 — — $10,314.20 $10,314.20 $10,314.20 2025-10-15
551 MS_DRG Medical Back Problems With Mcc 2 1 — — $11,806.74 $11,806.74 $11,806.74 2025-10-15
552 MS_DRG Medical Back Problems Without Mcc 18 7 — — $18,819.19 $18,819.19 $18,819.19 2025-10-15
5521 OTHER Level 1 Imaging Without Contrast 0 0 — — — — — 2025-10-15
5522 OTHER Level 2 Imaging Without Contrast 70 20 — — $276.51 $276.51 $276.51 2025-10-15
5523 OTHER Level 3 Imaging Without Contrast 0 0 — — — — — 2025-10-15
5524 OTHER Level 4 Imaging Without Contrast 64 19 — — $774.06 $774.06 $774.06 2025-10-15
553 MS_DRG Bone Diseases And Arthropathies With Mcc 2 1 — — $11,896.46 $11,896.46 $11,896.46 2025-10-15
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 2 1 — — $5,372.12 $5,372.12 $5,372.12 2025-10-15
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 2 1 — — $10,611.04 $10,611.04 $10,611.04 2025-10-15
5571 OTHER Level 1 Imaging With Contrast 56 18 — — $592.78 $592.78 $592.78 2025-10-15
5572 OTHER Level 2 Imaging With Contrast 0 0 — — — — — 2025-10-15
5573 OTHER Level 3 Imaging With Contrast 14 6 — — $602.35 $602.35 $602.35 2025-10-15
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 6 2 — — $11,026.15 $11,026.15 $11,026.15 2025-10-15
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 4 1 — — $24,519.55 $24,519.55 $24,519.55 2025-10-15
5591 OTHER Level 1 Nuclear Medicine And Related Services 44 13 — — $1,932.73 $1,932.73 $1,932.73 2025-10-15
5592 OTHER Level 2 Nuclear Medicine And Related Services 32 10 — — $1,347.28 $1,347.28 $1,347.28 2025-10-15
5593 OTHER Level 3 Nuclear Medicine And Related Services 44 13 — — $3,022.93 $3,022.93 $3,022.93 2025-10-15
56 MS_DRG Degenerative Nervous System Disorders With Mcc 8 4 — — $14,935.00 $14,935.00 $14,935.00 2025-10-15
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 16 5 — — $11,944.26 $11,944.26 $11,944.26 2025-10-15
561 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue Without Cc/Mcc 12 5 — — $10,274.07 $10,274.07 $10,274.07 2025-10-15
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 1 — — $8,809.40 $8,809.40 $8,809.40 2025-10-15
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 2 1 — — $7,735.45 $7,735.45 $7,735.45 2025-10-15
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 4 2 — — $11,469.59 $11,469.59 $11,469.59 2025-10-15
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 4 2 — — $7,159.77 $7,159.77 $7,159.77 2025-10-15
5671 OTHER Level 1 Pathology 2 1 — — $209.72 $209.72 $209.72 2025-10-15
5673 OTHER Level 3 Pathology 6 3 — — $341.08 $341.08 $341.08 2025-10-15
5692 OTHER Level 2 Drug Administration 0 0 — — — — — 2025-10-15
5693 OTHER Level 3 Drug Administration 44 15 — — $1,267.14 $1,267.14 $1,267.14 2025-10-15
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 14 6 — — $24,009.22 $24,009.22 $24,009.22 2025-10-15
571 MS_DRG Skin Debridement With Cc 2 1 — — $5,548.75 $5,548.75 $5,548.75 2025-10-15
5722 OTHER Level 2 Diagnostic Tests And Related Services 46 15 — — $594.14 $594.14 $594.14 2025-10-15
5731 OTHER Level 1 Minor Procedures 0 0 — — — — — 2025-10-15
5732 OTHER Level 2 Minor Procedures 24 8 — — $85.57 $85.57 $85.57 2025-10-15
5733 OTHER Level 3 Minor Procedures 0 0 — — — — — 2025-10-15
5734 OTHER Level 4 Minor Procedures 48 15 — — $748.92 $748.92 $748.92 2025-10-15
5735 OTHER Level 5 Minor Procedures 6 3 — — $165.79 $165.79 $165.79 2025-10-15
5741 OTHER Level 1 Electronic Analysis Of Devices 2 1 — — $108.50 $108.50 $108.50 2025-10-15
5771 OTHER Cardiac Rehabilitation 38 13 — — $1,022.72 $1,022.72 $1,022.72 2025-10-15
5781 OTHER Resuscitation And Cardioversion 6 2 — — $1,688.87 $1,688.87 $1,688.87 2025-10-15
5791 OTHER Pulmonary Treatment 4 2 — — $71.02 $71.02 $71.02 2025-10-15
5823 OTHER Level 3 Health And Behavior Services 30 11 — — $2,268.38 $2,268.38 $2,268.38 2025-10-15
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/Mcc 2 1 — — $29,285.40 $29,285.40 $29,285.40 2025-10-15
602 MS_DRG Cellulitis With Mcc 8 4 — — $11,478.89 $11,478.89 $11,478.89 2025-10-15
603 MS_DRG Cellulitis Without Mcc 30 10 — — $12,232.88 $12,232.88 $12,232.88 2025-10-15
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 4 2 — — $8,269.17 $8,269.17 $8,269.17 2025-10-15
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 2 — — $13,574.20 $13,574.20 $13,574.20 2025-10-15
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 4 2 — — $9,524.59 $9,524.59 $9,524.59 2025-10-15
637 MS_DRG Diabetes With Mcc 8 3 — — $9,414.78 $9,414.78 $9,414.78 2025-10-15
638 MS_DRG Diabetes With Cc 20 9 — — $8,010.35 $8,010.35 $8,010.35 2025-10-15
639 MS_DRG Diabetes Without Cc/Mcc 6 3 — — $4,402.47 $4,402.47 $4,402.47 2025-10-15
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 4 2 — — $7,114.30 $7,114.30 $7,114.30 2025-10-15
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 10 4 — — $9,564.39 $9,564.39 $9,564.39 2025-10-15
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 24 8 — — $7,094.55 $7,094.55 $7,094.55 2025-10-15
642 MS_DRG Inborn And Other Disorders Of Metabolism 4 2 — — $12,490.41 $12,490.41 $12,490.41 2025-10-15
643 MS_DRG Endocrine Disorders With Mcc 2 1 — — $14,998.78 $14,998.78 $14,998.78 2025-10-15
644 MS_DRG Endocrine Disorders With Cc 4 2 — — $9,852.57 $9,852.57 $9,852.57 2025-10-15
645 MS_DRG Endocrine Disorders Without Cc/Mcc 4 2 — — $7,380.74 $7,380.74 $7,380.74 2025-10-15
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 14 7 — — $13,251.55 $13,251.55 $13,251.55 2025-10-15
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 10 4 — — $7,852.78 $7,852.78 $7,852.78 2025-10-15
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/Mcc 20 8 — — $5,886.84 $5,886.84 $5,886.84 2025-10-15
669 MS_DRG Transurethral Procedures With Cc 2 1 — — $12,645.55 $12,645.55 $12,645.55 2025-10-15
682 MS_DRG Renal Failure With Mcc 8 4 — — $16,803.26 $16,803.26 $16,803.26 2025-10-15
683 MS_DRG Renal Failure With Cc 18 8 — — $6,941.00 $6,941.00 $6,941.00 2025-10-15
684 MS_DRG Renal Failure Without Cc/Mcc 2 1 — — $5,763.87 $5,763.87 $5,763.87 2025-10-15
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 12 6 — — $10,165.75 $10,165.75 $10,165.75 2025-10-15
69 MS_DRG Transient Ischemia Without Thrombolytic 8 4 — — $4,748.06 $4,748.06 $4,748.06 2025-10-15
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 26 10 — — $4,968.82 $4,968.82 $4,968.82 2025-10-15
694 MS_DRG Urinary Stones Without Mcc 8 4 — — $12,246.70 $12,246.70 $12,246.70 2025-10-15
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 2 1 — — $5,885.64 $5,885.64 $5,885.64 2025-10-15
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 8 4 — — $9,753.72 $9,753.72 $9,753.72 2025-10-15
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 6 3 — — $10,605.92 $10,605.92 $10,605.92 2025-10-15
70 MS_DRG Nonspecific Cerebrovascular Disorders With Mcc 2 1 — — $2,302.00 $2,302.00 $2,302.00 2025-10-15
700 MS_DRG Other Kidney And Urinary Tract Diagnoses Without Cc/Mcc 2 1 — — $6,286.38 $6,286.38 $6,286.38 2025-10-15
71 MS_DRG Nonspecific Cerebrovascular Disorders With Cc 2 1 — — $7,513.32 $7,513.32 $7,513.32 2025-10-15
722 MS_DRG Malignancy, Male Reproductive System With Mcc 2 1 — — $14,385.54 $14,385.54 $14,385.54 2025-10-15
726 MS_DRG Benign Prostatic Hypertrophy Without Mcc 2 1 — — $4,978.10 $4,978.10 $4,978.10 2025-10-15
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 8 4 — — $12,393.55 $12,393.55 $12,393.55 2025-10-15
810 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 1 — — $22,656.17 $22,656.17 $22,656.17 2025-10-15
811 MS_DRG Red Blood Cell Disorders With Mcc 8 4 — — $6,902.69 $6,902.69 $6,902.69 2025-10-15
812 MS_DRG Red Blood Cell Disorders Without Mcc 12 6 — — $12,475.70 $12,475.70 $12,475.70 2025-10-15
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 2 1 — — $8,571.08 $8,571.08 $8,571.08 2025-10-15
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 6 3 — — $17,607.30 $17,607.30 $17,607.30 2025-10-15
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 6 3 — — $3,784.18 $3,784.18 $3,784.18 2025-10-15
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $27,844.81 $27,844.81 $27,844.81 2025-10-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $22,912.24 $22,912.24 $22,912.24 2025-10-15
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 12 3 — — $10,110.73 $10,110.73 $10,110.73 2025-10-15
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 2 1 — — $26,892.90 $26,892.90 $26,892.90 2025-10-15
864 MS_DRG Fever And Inflammatory Conditions 2 1 — — $7,651.04 $7,651.04 $7,651.04 2025-10-15
865 MS_DRG Viral Illness With Mcc 2 1 — — $6,595.00 $6,595.00 $6,595.00 2025-10-15
866 MS_DRG Viral Illness Without Mcc 2 1 — — $11,426.07 $11,426.07 $11,426.07 2025-10-15
869 MS_DRG Other Infectious And Parasitic Diseases Diagnoses Without Cc/Mcc 2 1 — — $5,723.23 $5,723.23 $5,723.23 2025-10-15
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 36 12 — — $11,326.73 $11,326.73 $11,326.73 2025-10-15
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 38 14 — — $9,014.08 $9,014.08 $9,014.08 2025-10-15
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 18 8 — — $9,513.97 $9,513.97 $9,513.97 2025-10-15
881 MS_DRG Depressive Neuroses 26 11 — — $5,814.37 $5,814.37 $5,814.37 2025-10-15
882 MS_DRG Neuroses Except Depressive 10 4 — — $6,325.28 $6,325.28 $6,325.28 2025-10-15
883 MS_DRG Disorders Of Personality And Impulse Control 10 4 — — $8,624.07 $8,624.07 $8,624.07 2025-10-15
884 MS_DRG Organic Disturbances And Intellectual Disability 8 4 — — $12,668.92 $12,668.92 $12,668.92 2025-10-15
885 MS_DRG Psychoses 46 14 — — $15,173.90 $15,173.90 $15,173.90 2025-10-15
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 8 4 — — $6,241.16 $6,241.16 $6,241.16 2025-10-15
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 10 4 — — $12,300.81 $12,300.81 $12,300.81 2025-10-15
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 36 11 — — $6,531.45 $6,531.45 $6,531.45 2025-10-15
91 MS_DRG Other Disorders Of Nervous System With Mcc 2 1 — — $29,774.43 $29,774.43 $29,774.43 2025-10-15
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 0 0 — — — — — 2025-10-15
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 10 3 — — $4,386.27 $4,386.27 $4,386.27 2025-10-15
92 MS_DRG Other Disorders Of Nervous System With Cc 2 1 — — $8,856.41 $8,856.41 $8,856.41 2025-10-15
921 MS_DRG Complications Of Treatment Without Cc/Mcc 2 1 — — $8,134.90 $8,134.90 $8,134.90 2025-10-15
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 4 2 — — $12,876.93 $12,876.93 $12,876.93 2025-10-15
935 MS_DRG Non-extensive Burns 2 1 — — $8,649.34 $8,649.34 $8,649.34 2025-10-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $22,375.24 $22,375.24 $22,375.24 2025-10-15
948 MS_DRG Signs And Symptoms Without Mcc 2 1 — — $6,986.89 $6,986.89 $6,986.89 2025-10-15
949 MS_DRG Aftercare With Cc/Mcc 6 3 — — $10,434.75 $10,434.75 $10,434.75 2025-10-15
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 2 1 — — $10,325.12 $10,325.12 $10,325.12 2025-10-15
950 MS_DRG Aftercare Without Cc/Mcc 4 2 — — $11,241.75 $11,241.75 $11,241.75 2025-10-15
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 1 — — $19,437.29 $19,437.29 $19,437.29 2025-10-15
977 MS_DRG HIV With Or Without Other Related Condition 2 1 — — $6,531.05 $6,531.05 $6,531.05 2025-10-15
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 1 — — $22,471.49 $22,471.49 $22,471.49 2025-10-15
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 4 2 — — $10,188.65 $10,188.65 $10,188.65 2025-10-15
999 MS_DRG Ungroupable 2 1 — — $68,762.09 $68,762.09 $68,762.09 2025-10-15
N700 OTHER Non-opps Clinic Services 8 4 — — $62.45 $62.45 $62.45 2025-10-15
N800 OTHER Clinical Diagnostic Lab Services 0 0 — — — — — 2025-10-15
N801 OTHER Therapy Services 0 0 — — — — — 2025-10-15
N804 OTHER Mammography Services 0 0 — — — — — 2025-10-15
N809 OTHER Other Medicine 16 6 — — $104.29 $104.29 $104.29 2025-10-15
N811 OTHER Observation, Other 2 1 — — $102.17 $102.17 $102.17 2025-10-15
N902 OTHER Packaged Services 0 0 — — — — — 2025-10-15
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