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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

Pioneer Specialty Hospital

Pontiac, MI · CCN 232039 · Rates published

3,074 distinct procedures filed
15 distinct payers
164,292 rate rows
2026-07-15 last MRF observed
Data quality

63,390 of 164,292 rate rows are consumer-grade (38.6%)

100,902 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
per-diem day rate — not a per-procedure price 98,438
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 2,464
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.pioneerspecialtyhospital.com/mrf-pioneer-gc
Found on page https://www.pioneerspecialtyhospital.com/pricetransparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-23
Content fingerprint 8b5abe782071bd70… · 4,032,517 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
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 2 $106,515.42 $106,515.42 $106,515.42 nat. median
$35,717
outlier · 3.0×
3001922
LOCAL 		Gentamicin Sulfate Ointment 0.1% 10 $75,730.00 $75,730.00 $75,730.00 nat. median
$75,730
1.0× median
167
MS_DRG 		Other Respiratory System O.r. Procedures With Cc 2 $71,779.36 $71,779.36 $71,779.36 nat. median
$17,843
outlier · 4.0×
168
MS_DRG 		Other Respiratory System O.r. Procedures Without Cc/mcc 2 $71,779.36 $71,779.36 $71,779.36 nat. median
$13,721
outlier · 5.2×
799
MS_DRG 		Splenic Procedures With Mcc 2 $63,519.70 $63,519.70 $63,519.70 nat. median
$43,255
1.5× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 $63,278.51 $63,278.51 $63,278.51 nat. median
$58,135
1.1× median
582
MS_DRG 		Mastectomy For Malignancy With Cc/mcc 2 $61,731.25 $61,731.25 $61,731.25 nat. median
$18,216
outlier · 3.4×
579
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 $61,731.25 $61,731.25 $61,731.25 nat. median
$30,210
outlier · 2.0×
619
MS_DRG 		O.r. Procedures For Obesity With Mcc 2 $59,505.92 $59,505.92 $59,505.92 nat. median
$26,760
outlier · 2.2×
518
MS_DRG 		Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$34,449
1.7× median
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$17,790
outlier · 3.2×
693
MS_DRG 		Urinary Stones With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$13,710
outlier · 4.2×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$49,364
1.2× median
252
MS_DRG 		Other Vascular Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$32,681
1.8× median
744
MS_DRG 		D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$19,066
outlier · 3.0×
745
MS_DRG 		D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$11,363
outlier · 5.1×
254
MS_DRG 		Other Vascular Procedures Without Cc/mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$17,494
outlier · 3.3×
423
MS_DRG 		Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$38,555
1.5× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$77,028
0.7× median
242
MS_DRG 		Permanent Cardiac Pacemaker Implant With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$30,990
1.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$72,398
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$90,551
0.6× median
492
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$33,640
1.7× median
519
MS_DRG 		Back And Neck Procedures Except Spinal Fusion With Cc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$19,479
outlier · 2.9×
493
MS_DRG 		Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$23,542
outlier · 2.4×
495
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$33,747
1.7× median
269
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$40,055
1.4× median
469
MS_DRG 		Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$29,471
1.9× median
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$50,627
1.1× median
274
MS_DRG 		Percutaneous And Other Intracardiac Procedures Without Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$30,820
1.9× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$42,641
1.3× median
221
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$46,508
1.2× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$63,873
0.9× median
271
MS_DRG 		Other Major Cardiovascular Procedures With Cc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$33,999
1.7× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$45,868
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$71,748
0.8× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$62,031
0.9× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$59,546
1.0× median
272
MS_DRG 		Other Major Cardiovascular Procedures Without Cc/mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$24,849
outlier · 2.3×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$51,598
1.1× median
253
MS_DRG 		Other Vascular Procedures With Cc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$24,940
outlier · 2.3×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$57,801
1.0× median
353
MS_DRG 		Hernia Procedures Except Inguinal And Femoral With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$27,394
outlier · 2.1×
236
MS_DRG 		Coronary Bypass Without Cardiac Catheterization Without Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$40,324
1.4× median
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$50,787
1.1× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$58,280
1.0× median
273
MS_DRG 		Percutaneous And Other Intracardiac Procedures With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$38,094
1.5× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$66,649
0.9× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$55,477
1.0× median
483
MS_DRG 		Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 $57,444.42 $57,444.42 $57,444.42 nat. median
$25,356
outlier · 2.3×

Other procedures at this hospital

Browse this hospital's 3,074 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
             
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 2 $106,515.42 $106,515.42 $106,515.42 $106,515.42 $106,515.42 2026-07-15
3001922 LOCAL Gentamicin Sulfate Ointment 0.1% 20 10 $75,730.00 $75,730.00 $75,730.00 $75,730.00 $75,730.00 2026-07-15
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 4 2 $71,779.36 $71,779.36 $71,779.36 $71,779.36 $71,779.36 2026-07-15
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 4 2 $71,779.36 $71,779.36 $71,779.36 $71,779.36 $71,779.36 2026-07-15
799 MS_DRG Splenic Procedures With Mcc 4 2 $63,519.70 $63,519.70 $63,519.70 $63,519.70 $63,519.70 2026-07-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 2 $63,278.51 $63,278.51 $63,278.51 $63,278.51 $63,278.51 2026-07-15
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 4 2 $61,731.25 $61,731.25 $61,731.25 $61,731.25 $61,731.25 2026-07-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 4 2 $61,731.25 $61,731.25 $61,731.25 $61,731.25 $61,731.25 2026-07-15
619 MS_DRG O.r. Procedures For Obesity With Mcc 4 2 $59,505.92 $59,505.92 $59,505.92 $59,505.92 $59,505.92 2026-07-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
745 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
253 MS_DRG Other Vascular Procedures With Cc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
254 MS_DRG Other Vascular Procedures Without Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
747 MS_DRG Vagina, Cervix And Vulva Procedures Without Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
693 MS_DRG Urinary Stones With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
746 MS_DRG Vagina, Cervix And Vulva Procedures With Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
252 MS_DRG Other Vascular Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
748 MS_DRG Female Reproductive System Reconstructive Procedures 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
786 MS_DRG Cesarean Section Without Sterilization With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
787 MS_DRG Cesarean Section Without Sterilization With Cc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 4 2 $57,444.42 $57,444.42 $57,444.42 $57,444.42 $57,444.42 2026-07-15
500 MS_DRG Soft Tissue Procedures With Mcc 4 2 $56,051.88 $56,051.88 $56,051.88 $56,051.88 $56,051.88 2026-07-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 4 2 $54,563.78 $54,563.78 $54,563.78 $54,563.78 $54,563.78 2026-07-15
653 MS_DRG Major Bladder Procedures With Mcc 4 2 $54,477.32 $54,477.32 $54,477.32 $54,477.32 $54,477.32 2026-07-15
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 4 2 $50,732.03 $50,732.03 $50,732.03 $50,732.03 $50,732.03 2026-07-15
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 4 2 $50,732.03 $50,732.03 $50,732.03 $50,732.03 $50,732.03 2026-07-15
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/mcc 4 2 $50,732.03 $50,732.03 $50,732.03 $50,732.03 $50,732.03 2026-07-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 4 2 $48,379.28 $48,379.28 $48,379.28 $48,379.28 $48,379.28 2026-07-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 2 $48,379.28 $48,379.28 $48,379.28 $48,379.28 $48,379.28 2026-07-15
654 MS_DRG Major Bladder Procedures With Cc 4 2 $47,623.85 $47,623.85 $47,623.85 $47,623.85 $47,623.85 2026-07-15
393 MS_DRG Other Digestive System Diagnoses With Mcc 4 2 $46,235.86 $46,235.86 $46,235.86 $46,235.86 $46,235.86 2026-07-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 4 2 $43,582.76 $43,582.76 $43,582.76 $43,582.76 $43,582.76 2026-07-15
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 4 2 $43,582.76 $43,582.76 $43,582.76 $43,582.76 $43,582.76 2026-07-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 4 2 $43,582.76 $43,582.76 $43,582.76 $43,582.76 $43,582.76 2026-07-15
380 MS_DRG Complicated Peptic Ulcer With Mcc 4 2 $43,582.76 $43,582.76 $43,582.76 $43,582.76 $43,582.76 2026-07-15
620 MS_DRG O.r. Procedures For Obesity With Cc 4 2 $43,173.19 $43,173.19 $43,173.19 $43,173.19 $43,173.19 2026-07-15
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
575 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
713 MS_DRG Transurethral Prostatectomy With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
116 MS_DRG Intraocular Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc* 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
136 MS_DRG Sinus And Mastoid Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
115 MS_DRG Extraocular Procedures Except Orbit 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
137 MS_DRG Mouth Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
501 MS_DRG Soft Tissue Procedures With Cc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
709 MS_DRG Penis Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
138 MS_DRG Mouth Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
670 MS_DRG Transurethral Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
662 MS_DRG Minor Bladder Procedures With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
711 MS_DRG Testes Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
663 MS_DRG Minor Bladder Procedures With Cc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
672 MS_DRG Urethral Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
668 MS_DRG Transurethral Procedures With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
117 MS_DRG Intraocular Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
655 MS_DRG Major Bladder Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
671 MS_DRG Urethral Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc* 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc* 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
615 MS_DRG Adrenal And Pituitary Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
664 MS_DRG Minor Bladder Procedures Without Cc/mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
669 MS_DRG Transurethral Procedures With Cc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 4 2 $42,982.06 $42,982.06 $42,982.06 $42,982.06 $42,982.06 2026-07-15
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 4 2 $42,335.85 $42,335.85 $42,335.85 $42,335.85 $42,335.85 2026-07-15
347 MS_DRG Anal And Stomal Procedures With Mcc 4 2 $40,661.17 $40,661.17 $40,661.17 $40,661.17 $40,661.17 2026-07-15
397 MS_DRG Appendix Procedures With Mcc 4 2 $40,661.17 $40,661.17 $40,661.17 $40,661.17 $40,661.17 2026-07-15
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 4 2 $40,661.17 $40,661.17 $40,661.17 $40,661.17 $40,661.17 2026-07-15
314 MS_DRG Other Circulatory System Diagnoses With Mcc 4 2 $40,187.89 $40,187.89 $40,187.89 $40,187.89 $40,187.89 2026-07-15
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 4 2 $39,914.84 $39,914.84 $39,914.84 $39,914.84 $39,914.84 2026-07-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 4 2 $39,914.84 $39,914.84 $39,914.84 $39,914.84 $39,914.84 2026-07-15
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 4 2 $38,859.06 $38,859.06 $38,859.06 $38,859.06 $38,859.06 2026-07-15
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 4 2 $35,241.19 $35,241.19 $35,241.19 $35,241.19 $35,241.19 2026-07-15
444 MS_DRG Disorders Of The Biliary Tract With Mcc* 4 2 $34,608.64 $34,608.64 $34,608.64 $34,608.64 $34,608.64 2026-07-15
299 MS_DRG Peripheral Vascular Disorders With Mcc 4 2 $34,503.97 $34,503.97 $34,503.97 $34,503.97 $34,503.97 2026-07-15
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
398 MS_DRG Appendix Procedures With Cc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
348 MS_DRG Anal And Stomal Procedures With Cc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 4 2 $33,011.32 $33,011.32 $33,011.32 $33,011.32 $33,011.32 2026-07-15
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 4 2 $32,724.62 $32,724.62 $32,724.62 $32,724.62 $32,724.62 2026-07-15
416 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc 4 2 $32,724.62 $32,724.62 $32,724.62 $32,724.62 $32,724.62 2026-07-15
394 MS_DRG Other Digestive System Diagnoses With Cc 4 2 $32,724.62 $32,724.62 $32,724.62 $32,724.62 $32,724.62 2026-07-15
472 MS_DRG Cervical Spinal Fusion With Cc 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
471 MS_DRG Cervical Spinal Fusion With Mcc 4 2 $31,991.94 $31,991.94 $31,991.94 $31,991.94 $31,991.94 2026-07-15
445 MS_DRG Disorders Of The Biliary Tract With Cc* 4 2 $31,609.68 $31,609.68 $31,609.68 $31,609.68 $31,609.68 2026-07-15
627 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures Without Cc/mcc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
381 MS_DRG Complicated Peptic Ulcer With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
694 MS_DRG Urinary Stones Without Mcc 6 3 $31,013.53 $31,013.53 $1,357.00 $31,013.53 $31,013.53 2026-07-15
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
626 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
800 MS_DRG Splenic Procedures With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
412 MS_DRG Cholecystectomy With C.d.e. With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
369 MS_DRG Major Esophageal Disorders With Cc* 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
368 MS_DRG Major Esophageal Disorders With Mcc* 4 2 $31,013.53 $31,013.53 $31,013.53 $31,013.53 $31,013.53 2026-07-15
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 4 2 $30,745.03 $30,745.03 $30,745.03 $30,745.03 $30,745.03 2026-07-15
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
505 MS_DRG Foot Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
503 MS_DRG Foot Procedures With Mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
504 MS_DRG Foot Procedures With Cc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
437 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc* 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
712 MS_DRG Testes Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
714 MS_DRG Transurethral Prostatectomy Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
413 MS_DRG Cholecystectomy With C.d.e. Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
382 MS_DRG Complicated Peptic Ulcer Without Cc/mcc 6 3 $29,065.79 $29,065.79 $1,357.00 $29,065.79 $29,065.79 2026-07-15
399 MS_DRG Appendix Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
302 MS_DRG Atherosclerosis With Mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
349 MS_DRG Anal And Stomal Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
330 MS_DRG Major Small And Large Bowel Procedures With Cc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
708 MS_DRG Major Male Pelvic Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
710 MS_DRG Penis Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 4 2 $29,065.79 $29,065.79 $29,065.79 $29,065.79 $29,065.79 2026-07-15
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 6 3 $28,506.05 $28,506.05 $1,357.00 $28,506.05 $28,506.05 2026-07-15
315 MS_DRG Other Circulatory System Diagnoses With Cc 4 2 $28,287.61 $28,287.61 $28,287.61 $28,287.61 $28,287.61 2026-07-15
300 MS_DRG Peripheral Vascular Disorders With Cc 4 2 $25,261.35 $25,261.35 $25,261.35 $25,261.35 $25,261.35 2026-07-15
36558 CPT Dialysis Catheter Placement Ij 20 10 $24,000.00 $24,000.00 $24,000.00 $24,000.00 $24,000.00 2026-07-15
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 6 3 $21,752.70 $21,752.70 $1,357.00 $21,752.70 $21,752.70 2026-07-15
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
508 MS_DRG Major Shoulder Or Elbow Joint Procedures Without Cc/mcc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
512 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures Without Cc/… 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
497 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
370 MS_DRG Major Esophageal Disorders Without Cc/mcc* 6 3 $21,752.70 $21,752.70 $1,357.00 $21,752.70 $21,752.70 2026-07-15
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
316 MS_DRG Other Circulatory System Diagnoses Without Cc/mcc 6 3 $21,752.70 $21,752.70 $1,357.00 $21,752.70 $21,752.70 2026-07-15
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 6 3 $21,752.70 $21,752.70 $1,357.00 $21,752.70 $21,752.70 2026-07-15
303 MS_DRG Atherosclerosis Without Mcc 6 3 $21,752.70 $21,752.70 $1,357.00 $21,752.70 $21,752.70 2026-07-15
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
801 MS_DRG Splenic Procedures Without Cc/mcc 4 2 $21,752.70 $21,752.70 $21,752.70 $21,752.70 $21,752.70 2026-07-15
31622 CPT Bronchoscopy, Diagnostic 20 10 $18,000.00 $18,000.00 $18,000.00 $18,000.00 $18,000.00 2026-07-15
75716 CPT Extremity Angio - Bilatteral 20 10 $11,625.00 $11,625.00 $11,625.00 $11,625.00 $11,625.00 2026-07-15
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 8 4 $21,752.70 $21,752.70 $1,132.00 $21,752.70 $11,554.85 2026-07-15
37191 CPT Ivc Filter Placement 20 10 $9,933.13 $9,933.13 $9,933.13 $9,933.13 $9,933.13 2026-07-15
1400029 LOCAL Room & Board - Sdu Isolation 20 10 $6,147.50 $6,147.50 $6,147.50 $6,147.50 $6,147.50 2026-07-15
77059 CPT MRI Breast Bilat W/Wo Contrast 20 10 $5,810.63 $5,810.63 $5,810.63 $5,810.63 $5,810.63 2026-07-15
70553 CPT MRI Brain W & Without Gad 20 10 $5,788.75 $5,788.75 $5,788.75 $5,788.75 $5,788.75 2026-07-15
74183 CPT MRI Abdomen W/Wo Contrast 20 10 $5,788.75 $5,788.75 $5,788.75 $5,788.75 $5,788.75 2026-07-15
72158 CPT MRI L Spine W & Without Gad 20 10 $5,768.13 $5,768.13 $5,768.13 $5,768.13 $5,768.13 2026-07-15
72156 CPT MRI Cervical W/Wo Contrast 20 10 $5,768.13 $5,768.13 $5,768.13 $5,768.13 $5,768.13 2026-07-15
6100009 LOCAL Anesth Gen & Agent Initial 15 Mins 20 10 $5,750.00 $5,750.00 $5,750.00 $5,750.00 $5,750.00 2026-07-15
6100011 LOCAL O.r. Procedure Initial 15 Mins 20 10 $5,750.00 $5,750.00 $5,750.00 $5,750.00 $5,750.00 2026-07-15
72197 CPT MRI Pelvis W/Wo Contrast 20 10 $5,744.38 $5,744.38 $5,744.38 $5,744.38 $5,744.38 2026-07-15
73220 CPT MRI Upper Extremity Other Than Joint 20 10 $5,737.50 $5,737.50 $5,737.50 $5,737.50 $5,737.50 2026-07-15
73720 CPT MRI Lower Extremity Other Than Joint 20 10 $5,734.38 $5,734.38 $5,734.38 $5,734.38 $5,734.38 2026-07-15
70543 CPT MRI Orbit Neck Face W&without Contrast 20 10 $5,717.50 $5,717.50 $5,717.50 $5,717.50 $5,717.50 2026-07-15
73723 CPT MRI Any Joint Of L/e W/Wo Contrast 20 10 $5,691.88 $5,691.88 $5,691.88 $5,691.88 $5,691.88 2026-07-15
72157 CPT MRI T Spine W & Without Gad 20 10 $5,675.00 $5,675.00 $5,675.00 $5,675.00 $5,675.00 2026-07-15
73223 CPT MRI Any Joint Of U/e W & Without Contrast 20 10 $5,652.50 $5,652.50 $5,652.50 $5,652.50 $5,652.50 2026-07-15
36561 CPT Tray, Hd Triple Lumen 13f 20Cm 100 10 $5,587.50 $5,587.50 $1,550.00 $17,760.00 $5,587.50 2026-07-15
70546 CPT MRA Head W/Wo Contrast 20 10 $5,523.75 $5,523.75 $5,523.75 $5,523.75 $5,523.75 2026-07-15
70549 CPT MRA Neck W/Wo Contrast 20 10 $5,521.88 $5,521.88 $5,521.88 $5,521.88 $5,521.88 2026-07-15
3001361 LOCAL Valcyte Soln 50Mg/1Ml 20 10 $5,100.00 $5,100.00 $5,100.00 $5,100.00 $5,100.00 2026-07-15
36556 CPT Insert Non-tunnel Cath 40 10 $4,888.75 $4,888.75 $4,547.50 $5,230.00 $4,888.75 2026-07-15
36569 CPT Insert Picc Cath 20 10 $4,861.45 $4,861.45 $4,861.45 $4,861.45 $4,861.45 2026-07-15
3001884 LOCAL Sirolimus Oral Solution 1Mg/1Ml 20 10 $4,736.80 $4,736.80 $4,736.80 $4,736.80 $4,736.80 2026-07-15
77058 CPT MRI Breast Unilat W/Wo Contrast 20 10 $4,608.75 $4,608.75 $4,608.75 $4,608.75 $4,608.75 2026-07-15
P9052 HCPCS Platelet, Pheresis Lr Hla 20 10 $4,476.25 $4,476.25 $4,476.25 $4,476.25 $4,476.25 2026-07-15
74177 CPT CT Abd And Pelvis With Contrast 20 10 $4,475.00 $4,475.00 $4,475.00 $4,475.00 $4,475.00 2026-07-15
94002 CPT Ventilator Therapy 1St Day 20 10 $4,440.00 $4,440.00 $4,440.00 $4,440.00 $4,440.00 2026-07-15
43246 CPT Percutaneous Plcmt Gastro Tube With Endo 20 10 $4,245.00 $4,245.00 $4,245.00 $4,245.00 $4,245.00 2026-07-15
43750 CPT Percutaneous Plcmt Gastro Tube No Endo 20 10 $4,245.00 $4,245.00 $4,245.00 $4,245.00 $4,245.00 2026-07-15
8000579 LOCAL Ascope, 4 Broncho Large 20 10 $4,062.50 $4,062.50 $4,062.50 $4,062.50 $4,062.50 2026-07-15
8000380 LOCAL Ascope, F / Ascope 3 Monitor 20 10 $4,062.50 $4,062.50 $4,062.50 $4,062.50 $4,062.50 2026-07-15
6100004 LOCAL Endoscopy Initial 15 Mins 20 10 $4,035.00 $4,035.00 $4,035.00 $4,035.00 $4,035.00 2026-07-15
70551 CPT MRI Brain 20 10 $3,983.13 $3,983.13 $3,983.13 $3,983.13 $3,983.13 2026-07-15
71275 CPT CT Angio Chest 20 10 $3,932.50 $3,932.50 $3,932.50 $3,932.50 $3,932.50 2026-07-15
50684 CPT Inj Proc Antegrade Pyelogram 20 10 $3,785.00 $3,785.00 $3,785.00 $3,785.00 $3,785.00 2026-07-15
93312 CPT Echo Transesophageal 20 10 $3,517.50 $3,517.50 $3,517.50 $3,517.50 $3,517.50 2026-07-15
3001771 LOCAL Atovaquone Oral Suspension 750Mg/5Ml 20 10 $3,445.50 $3,445.50 $3,445.50 $3,445.50 $3,445.50 2026-07-15
P9053 HCPCS Platelet, Pher Lr Cmv Neg Irrad Ea Unit 20 10 $3,418.75 $3,418.75 $3,418.75 $3,418.75 $3,418.75 2026-07-15
93320 CPT Doppler Echo Exam Heart 20 10 $3,362.50 $3,362.50 $3,362.50 $3,362.50 $3,362.50 2026-07-15
32405 CPT Percut Biopsy, Lung Or Mediastinum 20 10 $3,302.50 $3,302.50 $3,302.50 $3,302.50 $3,302.50 2026-07-15
C8928 HCPCS Tte W Or Without Fol W/Con,Stress 20 10 $3,265.00 $3,265.00 $3,265.00 $3,265.00 $3,265.00 2026-07-15
C8929 HCPCS Tte W Or Wo Fol Wcon,Doppler 20 10 $3,265.00 $3,265.00 $3,265.00 $3,265.00 $3,265.00 2026-07-15
73725 CPT MRA Lower Extremity W/Wo Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
73721 CPT MRI Lower Extremity Any Joint 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
73718 CPT MRI Lower Extremity Without Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
71555 CPT MRA Chest W/Wo Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
73221 CPT MRI Upper Extremity Any Joint 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
70336 CPT MRI Temporomandibular Joint Tmj 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
72198 CPT MRA Pelvis W/Wo Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
70552 CPT MRI Brain W/Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
72196 CPT MRI Pelvis W/Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
77084 CPT MRI Bone Study 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
70547 CPT MRA Neck Without Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
72149 CPT MRI Lumbar W/Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
70545 CPT MRA Head W/Contrastact 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
72148 CPT MRI Lumbar Without Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
72147 CPT MRI Thoracic W/Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
70544 CPT MRA Head Without Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
72142 CPT MRI Cervical W/Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
70540 CPT MRI Orbit Neck Face Without Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
74185 CPT MRA Abdomen W/Wo Contrast 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
74181 CPT MRI Abdomen 20 10 $3,186.25 $3,186.25 $3,186.25 $3,186.25 $3,186.25 2026-07-15
73701 CPT CT Low Ext W Contrast Bilateral 20 10 $3,136.88 $3,136.88 $3,136.88 $3,136.88 $3,136.88 2026-07-15
73201 CPT CT U/e W/Contrast Bilateral 20 10 $3,136.88 $3,136.88 $3,136.88 $3,136.88 $3,136.88 2026-07-15
99285 CPT High Complexity Etc Rapid Response 20 10 $3,125.00 $3,125.00 $3,125.00 $3,125.00 $3,125.00 2026-07-15
71550 CPT MRI Chest 20 10 $3,045.00 $3,045.00 $3,045.00 $3,045.00 $3,045.00 2026-07-15
72195 CPT MRI Pelvis Without Contrast 20 10 $3,045.00 $3,045.00 $3,045.00 $3,045.00 $3,045.00 2026-07-15
72146 CPT MRI T Spine Without Contras 20 10 $3,045.00 $3,045.00 $3,045.00 $3,045.00 $3,045.00 2026-07-15
72141 CPT MRI Cervical Spine 20 10 $3,045.00 $3,045.00 $3,045.00 $3,045.00 $3,045.00 2026-07-15
8000399 LOCAL Fecal Management Sysytem 20 10 $3,000.00 $3,000.00 $3,000.00 $3,000.00 $3,000.00 2026-07-15
78452 CPT Myocardial Perfusion Test Nuclear 20 10 $2,913.75 $2,913.75 $2,913.75 $2,913.75 $2,913.75 2026-07-15
32555 CPT Thoracentesis, Aspiration With U/s 40 10 $2,905.00 $2,905.00 $2,322.50 $3,487.50 $2,905.00 2026-07-15
93306 CPT Tte W/Doppler, Complete 20 10 $2,887.50 $2,887.50 $2,887.50 $2,887.50 $2,887.50 2026-07-15
93642 CPT Non-invasive Programmed Stimulation 20 10 $2,823.75 $2,823.75 $2,823.75 $2,823.75 $2,823.75 2026-07-15
74178 CPT CT Urogram 20 10 $2,811.88 $2,811.88 $2,811.88 $2,811.88 $2,811.88 2026-07-15
A6550 HCPCS Wound Vac Dressing Set 20 10 $2,750.00 $2,750.00 $2,750.00 $2,750.00 $2,750.00 2026-07-15
8000406 LOCAL Ascope, Bronchoscope 20 10 $2,537.50 $2,537.50 $2,537.50 $2,537.50 $2,537.50 2026-07-15
P9034 HCPCS Platelet, Pheresis, Each Unit 20 10 $2,510.63 $2,510.63 $2,510.63 $2,510.63 $2,510.63 2026-07-15
3001886 LOCAL Valganciclovir Hydrochloride 50Mg/1Ml 20 10 $2,500.83 $2,500.83 $2,500.83 $2,500.83 $2,500.83 2026-07-15
P9036 HCPCS Platelet, Pheresis, Irrad, Ea Unit 20 10 $2,480.63 $2,480.63 $2,480.63 $2,480.63 $2,480.63 2026-07-15
C1751 HCPCS Picc Kit 80 10 $2,437.82 $2,437.82 $825.00 $3,000.00 $2,437.82 2026-07-15
36430 CPT Blood Administration 20 10 $2,435.00 $2,435.00 $2,435.00 $2,435.00 $2,435.00 2026-07-15
P9055 HCPCS Platelet, Pher Lr Cmv Neg Apher Ea Unit 20 10 $2,415.00 $2,415.00 $2,415.00 $2,415.00 $2,415.00 2026-07-15
C1750 HCPCS Hemodialysis Catheter, Long Term 20 10 $2,387.50 $2,387.50 $2,387.50 $2,387.50 $2,387.50 2026-07-15
87901 CPT HIV 1 Genotype 20 10 $2,377.50 $2,377.50 $2,377.50 $2,377.50 $2,377.50 2026-07-15
93641 CPT Test Of Single/Dual Chamber Defib/Pm 20 10 $2,369.38 $2,369.38 $2,369.38 $2,369.38 $2,369.38 2026-07-15
C1788 HCPCS Port Indwelling Imp 20 10 $2,285.00 $2,285.00 $2,285.00 $2,285.00 $2,285.00 2026-07-15
70482 CPT CT Orbit,Sella,Ear W&without Contrast 20 10 $2,256.25 $2,256.25 $2,256.25 $2,256.25 $2,256.25 2026-07-15
71270 CPT CT Thorax W/Wo Contrast 20 10 $2,256.25 $2,256.25 $2,256.25 $2,256.25 $2,256.25 2026-07-15
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