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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

ELY - BLOOMENSON COMMUNITY HOSPITAL

Ely, MN · CCN 241318 · Rates published

4,524 distinct procedures filed
34 distinct payers
127,140 rate rows
2026-08-04 last MRF observed
Data quality

105,306 of 127,140 rate rows are consumer-grade (82.8%)

21,834 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
exceeds 10× this hospital's gross charge — excluded from medians 8,475
professional (physician) fee — not the facility price 8,034
per-diem day rate — not a per-procedure price 3,554
template filing: same amount across many unrelated codes — excluded 1,423
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 148
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 115
percent-of-charges filed in the dollar field — excluded from medians 49
placeholder amount (≤ $0.02) — excluded from medians 36
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://apps.para-hcfs.com/PTT/FinalLinks/Reports.aspx?dbName=dbECHELYMN&type=CDMWithoutLabel&fileType=CSV
Found on page https://www.ebch.org/patients-visitor-info/billing-insurance/#price-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-10
Content fingerprint b3e0310f564b44b3… · 17,280,773 bytes · first seen 2026-08-12

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
J2507
HCPCS 		Pegloticase 8 Mg/ml Solution 1 Ml Vial 8 $2,966.54 $47,400.03 $18,924.16 nat. median
$4,390
outlier · 4.3×
J2350
HCPCS 		Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial 8 $47.48 $32,487.00 $11,299.99 nat. median
$133
outlier · 85.0×
12000001
CDM 		Room & Board - Semi-private (two Beds) - General Classification 10 $542.25 $6,462.65 $9,445.54 nat. median
$1,344
outlier · 7.0×
12000000
CDM 		Room & Board - Semi-private (two Beds) - General Classification 10 $502.25 $6,462.65 $9,380.53 nat. median
$1,372
outlier · 6.8×
12000011
CDM 		Room & Board - Semi-private (two Beds) - General Classification 10 $296.43 $6,462.65 $9,046.06 nat. median
$764
outlier · 11.8×
96377
HCPCS 		Application Of On-body Injector For Under Skin Injection 10 $4,566.07 $13,355.00 $9,001.13 nat. median
$60
outlier · 150.0×
12000010
CDM 		Room & Board - Semi-private (two Beds) - General Classification 10 $256.77 $6,462.65 $8,981.61 nat. median
$675
outlier · 13.3×
J9119
HCPCS 		Cemiplimab-rwlc 350 Mg/7ml Solution 7 Ml Vial 8 $22.79 $18,834.93 $8,069.69 nat. median
$53
outlier · 151.5×
157
MS_DRG 		Dental And Oral Diseases With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$11,790
0.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$72,715
outlier · 0.1×
154
MS_DRG 		Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$11,032
0.6× median
152
MS_DRG 		Otitis Media And Uri With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$8,314
0.8× median
155
MS_DRG 		Other Ear, Nose, Mouth And Throat Diagnoses With Cc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$6,927
1.0× median
150
MS_DRG 		Epistaxis With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$9,501
0.7× median
158
MS_DRG 		Dental And Oral Diseases With Cc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$6,793
1.0× median
151
MS_DRG 		Epistaxis Without Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$5,673
1.2× median
116
MS_DRG 		Intraocular Procedures With Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$12,417
0.6× median
125
MS_DRG 		Other Disorders Of The Eye Without Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$5,925
1.2× median
153
MS_DRG 		Otitis Media And Uri Without Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$5,379
1.3× median
100
MS_DRG 		Seizures With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$13,848
0.5× median
140
MS_DRG 		Major Head And Neck Procedures With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$28,105
outlier · 0.2×
146
MS_DRG 		Ear, Nose, Mouth And Throat Malignancy With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$14,541
outlier · 0.5×
137
MS_DRG 		Mouth Procedures With Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$10,613
0.7× median
136
MS_DRG 		Sinus And Mastoid Procedures Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$7,209
1.0× median
135
MS_DRG 		Sinus And Mastoid Procedures With Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$15,526
outlier · 0.4×
101
MS_DRG 		Seizures Without Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$6,782
1.0× median
148
MS_DRG 		Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$5,634
1.2× median
142
MS_DRG 		Major Head And Neck Procedures Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$11,405
0.6× median
138
MS_DRG 		Mouth Procedures Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$6,233
1.1× median
115
MS_DRG 		Extraocular Procedures Except Orbit 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$10,959
0.6× median
123
MS_DRG 		Neurological Eye Disorders 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$5,994
1.2× median
12
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$28,888
outlier · 0.2×
122
MS_DRG 		Acute Major Eye Infections Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$5,366
1.3× median
145
MS_DRG 		Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$8,643
0.8× median
144
MS_DRG 		Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$12,620
0.5× median
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$37,371
outlier · 0.2×
102
MS_DRG 		Headaches With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$8,305
0.8× median
103
MS_DRG 		Headaches Without Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$6,384
1.1× median
114
MS_DRG 		Orbital Procedures Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$9,291
0.7× median
147
MS_DRG 		Ear, Nose, Mouth And Throat Malignancy With Cc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$8,900
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$186,516
outlier · 0.0×
10
MS_DRG 		Pancreas Transplant 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$23,080
outlier · 0.3×
124
MS_DRG 		Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$9,359
0.7× median
139
MS_DRG 		Salivary Gland Procedures 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$8,855
0.8× median
113
MS_DRG 		Orbital Procedures With Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$15,919
outlier · 0.4×
141
MS_DRG 		Major Head And Neck Procedures With Cc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$14,978
outlier · 0.5×
117
MS_DRG 		Intraocular Procedures Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$7,630
0.9× median
13
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$19,678
outlier · 0.4×
121
MS_DRG 		Acute Major Eye Infections With Cc/mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$8,182
0.8× median
143
MS_DRG 		Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 $5,225.00 $10,200.00 $6,927.00 nat. median
$24,795
outlier · 0.3×

Other procedures at this hospital

Browse this hospital's 4,524 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
             
J2507 HCPCS Pegloticase 8 Mg/ml Solution 1 Ml Vial 28 8 $48,367.38 — $2,966.54 $47,400.03 $18,924.16 2024-07-01
J2350 HCPCS Ocrelizumab 300 Mg/10ml Solution 10 Ml Vial 28 8 $33,150.00 — $47.48 $32,487.00 $11,299.99 2024-07-01
12000001 CDM Room & Board - Semi-private (two Beds) - General Classification 19 10 $1,586.00 $1,284.66 $542.25 $6,462.65 $9,445.54 2026-08-04
12000000 CDM Room & Board - Semi-private (two Beds) - General Classification 19 10 $1,469.00 $1,189.89 $502.25 $6,462.65 $9,380.53 2026-08-04
12000011 CDM Room & Board - Semi-private (two Beds) - General Classification 19 10 $867.00 $702.27 $296.43 $6,462.65 $9,046.06 2026-08-04
96377 HCPCS Application Of On-body Injector For Under Skin Injection 20 10 $13,355.00 $10,817.55 $4,566.07 $13,355.00 $9,001.13 2026-08-04
12000010 CDM Room & Board - Semi-private (two Beds) - General Classification 19 10 $751.00 $608.31 $256.77 $6,462.65 $8,981.61 2026-08-04
J9119 HCPCS Cemiplimab-rwlc 350 Mg/7ml Solution 7 Ml Vial 28 8 $19,219.32 — $22.79 $18,834.93 $8,069.69 2024-07-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
434 MS_DRG Cirrhosis And Alcoholic Hepatitis Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
413 MS_DRG Cholecystectomy With C.d.e. Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
398 MS_DRG Appendix Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
422 MS_DRG Hepatobiliary Diagnostic Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
334 MS_DRG Rectal Resection Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
386 MS_DRG Inflammatory Bowel Disease With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
399 MS_DRG Appendix Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
416 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
382 MS_DRG Complicated Peptic Ulcer Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
38 MS_DRG Extracranial Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
374 MS_DRG Digestive Malignancy With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
410 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
389 MS_DRG Gastrointestinal Obstruction With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
397 MS_DRG Appendix Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
381 MS_DRG Complicated Peptic Ulcer With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
368 MS_DRG Major Esophageal Disorders With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
303 MS_DRG Atherosclerosis Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
369 MS_DRG Major Esophageal Disorders With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
254 MS_DRG Other Vascular Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
39 MS_DRG Extracranial Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
333 MS_DRG Rectal Resection With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
253 MS_DRG Other Vascular Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
347 MS_DRG Anal And Stomal Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
358 MS_DRG Other Digestive System O.r. Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
252 MS_DRG Other Vascular Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
265 MS_DRG Aicd Lead Procedures 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
387 MS_DRG Inflammatory Bowel Disease Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
332 MS_DRG Rectal Resection With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
394 MS_DRG Other Digestive System Diagnoses With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
305 MS_DRG Hypertension Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
349 MS_DRG Anal And Stomal Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
312 MS_DRG Syncope And Collapse 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
188 MS_DRG Pleural Effusion Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
379 MS_DRG Gastrointestinal Hemorrhage Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
375 MS_DRG Digestive Malignancy With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
292 MS_DRG Heart Failure And Shock With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
304 MS_DRG Hypertension With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
294 MS_DRG Deep Vein Thrombophlebitis With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
302 MS_DRG Atherosclerosis With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
32 MS_DRG Ventricular Shunt Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
215 MS_DRG Other Heart Assist System Implant 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
37 MS_DRG Extracranial Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
204 MS_DRG Respiratory Signs And Symptoms 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
313 MS_DRG Chest Pain 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
156 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
245 MS_DRG Aicd Generator Procedures 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
311 MS_DRG Angina Pectoris 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
116 MS_DRG Intraocular Procedures With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
198 MS_DRG Interstitial Lung Disease Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
115 MS_DRG Extraocular Procedures Except Orbit 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
196 MS_DRG Interstitial Lung Disease With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
125 MS_DRG Other Disorders Of The Eye Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
117 MS_DRG Intraocular Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
262 MS_DRG Cardiac Pacemaker Revision Except Device Replacement Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
201 MS_DRG Pneumothorax Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
137 MS_DRG Mouth Procedures With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
200 MS_DRG Pneumothorax With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
263 MS_DRG Vein Ligation And Stripping 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
176 MS_DRG Pulmonary Embolism Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
181 MS_DRG Respiratory Neoplasms With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
141 MS_DRG Major Head And Neck Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
123 MS_DRG Neurological Eye Disorders 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
152 MS_DRG Otitis Media And Uri With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
122 MS_DRG Acute Major Eye Infections Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
149 MS_DRG Dysequilibrium 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
348 MS_DRG Anal And Stomal Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
316 MS_DRG Other Circulatory System Diagnoses Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
165 MS_DRG Major Chest Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
139 MS_DRG Salivary Gland Procedures 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
28 MS_DRG Spinal Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
159 MS_DRG Dental And Oral Diseases Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
164 MS_DRG Major Chest Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
197 MS_DRG Interstitial Lung Disease With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
370 MS_DRG Major Esophageal Disorders Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
147 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
153 MS_DRG Otitis Media And Uri Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
285 MS_DRG Acute Myocardial Infarction, Expired Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
150 MS_DRG Epistaxis With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
180 MS_DRG Respiratory Neoplasms With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
289 MS_DRG Acute And Subacute Endocarditis With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
138 MS_DRG Mouth Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
290 MS_DRG Acute And Subacute Endocarditis Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
140 MS_DRG Major Head And Neck Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
291 MS_DRG Heart Failure And Shock With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
295 MS_DRG Deep Vein Thrombophlebitis Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
293 MS_DRG Heart Failure And Shock Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
121 MS_DRG Acute Major Eye Infections With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
136 MS_DRG Sinus And Mastoid Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
297 MS_DRG Cardiac Arrest, Unexplained With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
298 MS_DRG Cardiac Arrest, Unexplained Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
158 MS_DRG Dental And Oral Diseases With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
151 MS_DRG Epistaxis Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
30 MS_DRG Spinal Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
300 MS_DRG Peripheral Vascular Disorders With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
376 MS_DRG Digestive Malignancy Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
383 MS_DRG Uncomplicated Peptic Ulcer With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
157 MS_DRG Dental And Oral Diseases With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
101 MS_DRG Seizures Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
148 MS_DRG Ear, Nose, Mouth And Throat Malignancy Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
102 MS_DRG Headaches With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
103 MS_DRG Headaches Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
185 MS_DRG Major Chest Trauma Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
183 MS_DRG Major Chest Trauma With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
186 MS_DRG Pleural Effusion With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
202 MS_DRG Bronchitis And Asthma With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
184 MS_DRG Major Chest Trauma With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
199 MS_DRG Pneumothorax With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
182 MS_DRG Respiratory Neoplasms Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
142 MS_DRG Major Head And Neck Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
124 MS_DRG Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
113 MS_DRG Orbital Procedures With Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
114 MS_DRG Orbital Procedures Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
187 MS_DRG Pleural Effusion With Cc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
10 MS_DRG Pancreas Transplant 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
100 MS_DRG Seizures With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 2 — — $5,225.00 $10,200.00 $6,927.00 2024-07-01
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