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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

RAINY LAKE MEDICAL CENTER

International Falls, MN · CCN 241322 · Rates published

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You selected 93306 (CPT)

ECHO (2D) COMPLETE W DOPPLER & COLOR

This hospital’s price: $1,025 across 8 payers · range $284-$1,262

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8047/410726171_international-falls-memorial-hospital-association_standardcharges.csv · observed 2026-05-06

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

2,931 distinct procedures filed
8 distinct payers
226,793 rate rows
2026-05-06 last MRF observed
Data quality

125,989 of 226,793 rate rows are consumer-grade (55.6%)

100,804 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
professional (physician) fee — not the facility price 100,715
placeholder amount (≤ $0.02) — excluded from medians 43
percent-of-charges filed in the dollar field — excluded from medians 28
per-diem day rate — not a per-procedure price 12
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 3
template filing: same amount across many unrelated codes — excluded 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8047/410726171_international-falls-memorial-hospital-association_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/hospital/RainyLake/8047or
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-22
Content fingerprint c2da2a6ea58fd3f8… · 114,329,302 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $267,042.44 $401,600.04 $334,321.24 nat. median
$359,454
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $173,299.80 $260,622.27 $216,961.03 nat. median
$249,036
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $132,031.49 $198,559.65 $165,295.57 nat. median
$198,418
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 2 $131,256.64 $197,394.36 $164,325.50 nat. median
$190,559
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 2 $85,657.06 $128,818.02 $107,237.54 nat. median
$126,695
0.8× median
7
MS_DRG 		Lung Transplant 2 $80,084.04 $120,436.86 $100,260.45 nat. median
$117,974
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $74,318.69 $111,766.47 $93,042.58 nat. median
$110,307
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $70,075.85 $105,385.74 $87,730.80 nat. median
$104,013
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 2 $69,995.46 $105,264.84 $87,630.15 nat. median
$92,678
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $68,155.10 $102,497.16 $85,326.13 nat. median
$93,276
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $67,245.43 $101,129.13 $84,187.28 nat. median
$97,323
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $63,760.13 $95,887.65 $79,823.89 nat. median
$95,038
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 2 $61,574.09 $92,600.10 $77,087.10 nat. median
$93,901
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $60,496.84 $90,980.04 $75,738.44 nat. median
$90,551
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $55,715.37 $83,789.28 $69,752.32 nat. median
$78,049
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $53,550.35 $80,533.35 $67,041.85 nat. median
$78,268
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $52,130.50 $78,398.07 $65,264.29 nat. median
$77,028
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $51,966.63 $78,151.62 $65,059.12 nat. median
$77,632
0.8× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $48,660.66 $73,179.84 $60,920.25 nat. median
$74,370
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $47,482.61 $71,408.19 $59,445.40 nat. median
$72,398
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 $47,277.92 $71,100.36 $59,189.14 nat. median
$71,748
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $47,121.46 $70,865.07 $58,993.26 nat. median
$67,976
0.9× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $44,639.82 $67,132.98 $55,886.40 nat. median
$63,648
0.9× median
10
MS_DRG 		Pancreas Transplant 2 $44,374.53 $66,734.01 $55,554.27 nat. median
$64,933
0.9× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 $44,355.98 $66,706.11 $55,531.04 nat. median
$61,308
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 $44,120.37 $66,351.78 $55,236.07 nat. median
$66,715
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $44,094.39 $66,312.72 $55,203.56 nat. median
$66,649
0.8× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $42,742.57 $64,279.74 $53,511.15 nat. median
$62,655
0.9× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 $42,532.93 $63,964.47 $53,248.70 nat. median
$63,873
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 2 $41,625.12 $62,599.23 $52,112.18 nat. median
$61,728
0.8× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 $41,349.32 $62,184.45 $51,766.88 nat. median
$57,556
0.9× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 $41,319.01 $62,138.88 $51,728.94 nat. median
$60,596
0.9× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $40,661.66 $61,150.29 $50,905.98 nat. median
$62,031
0.8× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $40,661.66 $61,150.29 $50,905.98 nat. median
$59,546
0.9× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 $40,513.86 $60,928.02 $50,720.94 nat. median
$58,135
0.9× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $39,792.18 $59,842.71 $49,817.44 nat. median
$59,371
0.8× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 $37,898.03 $56,994.12 $47,446.07 nat. median
$58,280
0.8× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 2 $37,854.12 $56,928.09 $47,391.10 nat. median
$58,251
0.8× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 2 $37,491.12 $56,382.18 $46,936.65 nat. median
$57,801
0.8× median
28
MS_DRG 		Spinal Procedures With Mcc 2 $37,155.33 $55,877.19 $46,516.26 nat. median
$54,460
0.9× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 $37,144.81 $55,861.38 $46,503.10 nat. median
$56,687
0.8× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $36,875.81 $55,456.83 $46,166.32 nat. median
$55,167
0.8× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 2 $36,669.26 $55,146.21 $45,907.74 nat. median
$53,927
0.9× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 2 $36,291.42 $54,577.98 $45,434.70 nat. median
$55,477
0.8× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 $36,267.92 $54,542.64 $45,405.28 nat. median
$53,856
0.8× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 $35,663.75 $53,634.03 $44,648.89 nat. median
$51,241
0.9× median
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 $35,436.18 $53,291.79 $44,363.99 nat. median
$53,523
0.8× median
213
MS_DRG 		Endovascular Abdominal Aorta With Iliac Branch Procedures 2 $35,291.47 $53,074.17 $44,182.82 nat. median
$48,463
0.9× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 2 $35,245.71 $53,005.35 $44,125.53 nat. median
$49,929
0.9× median
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $34,766.45 $52,284.60 $43,525.52 nat. median
$50,573
0.9× median

Other procedures at this hospital

Browse this hospital's 2,931 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $267,042.44 $401,600.04 $334,321.24 2026-05-06
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $173,299.80 $260,622.27 $216,961.03 2026-05-06
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 2 — — $132,031.49 $198,559.65 $165,295.57 2026-05-06
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 2 2 — — $131,256.64 $197,394.36 $164,325.50 2026-05-06
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 2 2 — — $85,657.06 $128,818.02 $107,237.54 2026-05-06
7 MS_DRG Lung Transplant 2 2 — — $80,084.04 $120,436.86 $100,260.45 2026-05-06
14 MS_DRG Allogeneic Bone Marrow Transplant 2 2 — — $74,318.69 $111,766.47 $93,042.58 2026-05-06
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $70,075.85 $105,385.74 $87,730.80 2026-05-06
209 MS_DRG Complex Aortic Arch Procedures 2 2 — — $69,995.46 $105,264.84 $87,630.15 2026-05-06
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $68,155.10 $102,497.16 $85,326.13 2026-05-06
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 2 — — $67,245.43 $101,129.13 $84,187.28 2026-05-06
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $63,760.13 $95,887.65 $79,823.89 2026-05-06
215 MS_DRG Other Heart Assist System Implant 2 2 — — $61,574.09 $92,600.10 $77,087.10 2026-05-06
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $60,496.84 $90,980.04 $75,738.44 2026-05-06
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $55,715.37 $83,789.28 $69,752.32 2026-05-06
850 MS_DRG Acute Leukemia With Other Procedures 2 2 — — $53,550.35 $80,533.35 $67,041.85 2026-05-06
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 2 — — $52,130.50 $78,398.07 $65,264.29 2026-05-06
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $51,966.63 $78,151.62 $65,059.12 2026-05-06
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $48,660.66 $73,179.84 $60,920.25 2026-05-06
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $47,482.61 $71,408.19 $59,445.40 2026-05-06
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 2 — — $47,277.92 $71,100.36 $59,189.14 2026-05-06
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $47,121.46 $70,865.07 $58,993.26 2026-05-06
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $44,639.82 $67,132.98 $55,886.40 2026-05-06
10 MS_DRG Pancreas Transplant 2 2 — — $44,374.53 $66,734.01 $55,554.27 2026-05-06
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 2 — — $44,355.98 $66,706.11 $55,531.04 2026-05-06
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $44,120.37 $66,351.78 $55,236.07 2026-05-06
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 — — $44,094.39 $66,312.72 $55,203.56 2026-05-06
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 2 — — $42,742.57 $64,279.74 $53,511.15 2026-05-06
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 2 — — $42,532.93 $63,964.47 $53,248.70 2026-05-06
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $41,625.12 $62,599.23 $52,112.18 2026-05-06
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 2 — — $41,349.32 $62,184.45 $51,766.88 2026-05-06
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $41,319.01 $62,138.88 $51,728.94 2026-05-06
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $40,661.66 $61,150.29 $50,905.98 2026-05-06
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $40,661.66 $61,150.29 $50,905.98 2026-05-06
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 2 — — $40,513.86 $60,928.02 $50,720.94 2026-05-06
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 2 — — $39,792.18 $59,842.71 $49,817.44 2026-05-06
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 2 — — $37,898.03 $56,994.12 $47,446.07 2026-05-06
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 2 — — $37,854.12 $56,928.09 $47,391.10 2026-05-06
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 2 — — $37,491.12 $56,382.18 $46,936.65 2026-05-06
28 MS_DRG Spinal Procedures With Mcc 2 2 — — $37,155.33 $55,877.19 $46,516.26 2026-05-06
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 2 — — $37,144.81 $55,861.38 $46,503.10 2026-05-06
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $36,875.81 $55,456.83 $46,166.32 2026-05-06
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 2 — — $36,669.26 $55,146.21 $45,907.74 2026-05-06
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 2 — — $36,291.42 $54,577.98 $45,434.70 2026-05-06
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 2 — — $36,267.92 $54,542.64 $45,405.28 2026-05-06
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 2 — — $35,663.75 $53,634.03 $44,648.89 2026-05-06
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 2 — — $35,436.18 $53,291.79 $44,363.99 2026-05-06
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 2 2 — — $35,291.47 $53,074.17 $44,182.82 2026-05-06
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 — — $35,245.71 $53,005.35 $44,125.53 2026-05-06
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $34,766.45 $52,284.60 $43,525.52 2026-05-06
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 2 — — $34,658.85 $52,122.78 $43,390.82 2026-05-06
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 2 — — $34,421.38 $51,765.66 $43,093.52 2026-05-06
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 2 — — $34,154.23 $51,363.90 $42,759.07 2026-05-06
834 MS_DRG Acute Leukemia With Mcc 2 2 — — $33,949.54 $51,056.07 $42,502.81 2026-05-06
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 2 — — $33,829.57 $50,875.65 $42,352.61 2026-05-06
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 2 — — $33,781.34 $50,803.11 $42,292.22 2026-05-06
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 2 — — $33,728.15 $50,723.13 $42,225.64 2026-05-06
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 2 — — $33,593.34 $50,520.39 $42,056.86 2026-05-06
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $32,978.04 $49,595.04 $41,286.54 2026-05-06
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 2 — — $32,958.25 $49,565.28 $41,261.76 2026-05-06
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 2 — — $32,736.86 $49,232.34 $40,984.60 2026-05-06
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 2 — — $32,628.64 $49,069.59 $40,849.11 2026-05-06
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 2 — — $32,190.19 $48,410.22 $40,300.21 2026-05-06
653 MS_DRG Major Bladder Procedures With Mcc 2 2 — — $32,134.54 $48,326.52 $40,230.53 2026-05-06
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $31,168.60 $46,873.86 $39,021.23 2026-05-06
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 2 — — $30,842.08 $46,382.82 $38,612.45 2026-05-06
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 2 — — $30,594.72 $46,010.82 $38,302.77 2026-05-06
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 2 — — $30,540.30 $45,928.98 $38,234.64 2026-05-06
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 2 — — $30,435.79 $45,771.81 $38,103.80 2026-05-06
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 2 — — $30,309.02 $45,581.16 $37,945.09 2026-05-06
471 MS_DRG Cervical Spinal Fusion With Mcc 2 2 — — $29,860.68 $44,906.91 $37,383.79 2026-05-06
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 2 — — $29,709.79 $44,679.99 $37,194.89 2026-05-06
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 2 — — $29,440.79 $44,275.44 $36,858.12 2026-05-06
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 2 — — $29,073.46 $43,723.02 $36,398.24 2026-05-06
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 2 — — $29,014.09 $43,633.74 $36,323.92 2026-05-06
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 2 — — $28,927.52 $43,503.54 $36,215.53 2026-05-06
6 MS_DRG Liver Transplant Without Mcc 2 2 — — $28,675.21 $43,124.10 $35,899.65 2026-05-06
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 2 — — $28,560.80 $42,952.05 $35,756.43 2026-05-06
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 2 — — $28,424.76 $42,747.45 $35,586.10 2026-05-06
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 2 — — $28,352.40 $42,638.64 $35,495.52 2026-05-06
245 MS_DRG Aicd Generator Procedures 2 2 — — $28,213.88 $42,430.32 $35,322.10 2026-05-06
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 2 — — $28,129.16 $42,302.91 $35,216.04 2026-05-06
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 2 — — $28,116.79 $42,284.31 $35,200.55 2026-05-06
799 MS_DRG Splenic Procedures With Mcc 2 2 — — $28,006.72 $42,118.77 $35,062.74 2026-05-06
163 MS_DRG Major Chest Procedures With Mcc 2 2 — — $27,715.45 $41,680.74 $34,698.10 2026-05-06
31 MS_DRG Ventricular Shunt Procedures With Mcc 2 2 — — $27,707.41 $41,668.65 $34,688.03 2026-05-06
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 2 — — $27,598.57 $41,504.97 $34,551.77 2026-05-06
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 2 — — $27,165.08 $40,853.04 $34,009.06 2026-05-06
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 2 — — $26,760.64 $40,244.82 $33,502.73 2026-05-06
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 — — $26,547.29 $39,923.97 $33,235.63 2026-05-06
140 MS_DRG Major Head And Neck Procedures With Mcc 2 2 — — $26,376.62 $39,667.29 $33,021.96 2026-05-06
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $26,225.11 $39,439.44 $32,832.28 2026-05-06
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 2 — — $26,116.27 $39,275.76 $32,696.01 2026-05-06
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 2 — — $26,071.74 $39,208.80 $32,640.27 2026-05-06
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 2 — — $26,058.76 $39,189.27 $32,624.01 2026-05-06
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 2 — — $25,982.69 $39,074.88 $32,528.78 2026-05-06
901 MS_DRG Wound Debridements For Injuries With Mcc 2 2 — — $25,951.77 $39,028.38 $32,490.07 2026-05-06
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 2 — — $25,903.54 $38,955.84 $32,429.69 2026-05-06
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $25,803.36 $38,805.18 $32,304.27 2026-05-06
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $25,682.15 $38,622.90 $32,152.53 2026-05-06
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 2 — — $25,512.09 $38,367.15 $31,939.62 2026-05-06
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $24,862.77 $37,390.65 $31,126.71 2026-05-06
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 2 — — $24,637.67 $37,052.13 $30,844.90 2026-05-06
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 2 — — $24,191.19 $36,380.67 $30,285.93 2026-05-06
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 2 2 — — $24,081.73 $36,216.06 $30,148.89 2026-05-06
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 2 — — $23,936.41 $35,997.51 $29,966.96 2026-05-06
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 2 — — $23,900.54 $35,943.57 $29,922.06 2026-05-06
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 2 — — $23,877.66 $35,909.16 $29,893.41 2026-05-06
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 2 — — $23,742.23 $35,705.49 $29,723.86 2026-05-06
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $23,270.39 $34,995.90 $29,133.15 2026-05-06
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 2 — — $23,168.97 $34,843.38 $29,006.17 2026-05-06
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 2 — — $23,113.94 $34,760.61 $28,937.28 2026-05-06
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 2 — — $23,111.46 $34,756.89 $28,934.17 2026-05-06
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 2 — — $23,046.53 $34,659.24 $28,852.88 2026-05-06
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $22,916.67 $34,463.94 $28,690.31 2026-05-06
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 2 — — $22,714.45 $34,159.83 $28,437.14 2026-05-06
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 2 — — $22,705.17 $34,145.88 $28,425.52 2026-05-06
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 2 — — $22,438.64 $33,745.05 $28,091.85 2026-05-06
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 2 — — $22,421.33 $33,719.01 $28,070.17 2026-05-06
332 MS_DRG Rectal Resection With Mcc 2 2 — — $22,390.41 $33,672.51 $28,031.46 2026-05-06
265 MS_DRG Aicd Lead Procedures 2 2 — — $22,374.95 $33,649.26 $28,012.11 2026-05-06
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 2 2 — — $22,335.37 $33,589.74 $27,962.56 2026-05-06
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 2 — — $22,301.98 $33,539.52 $27,920.75 2026-05-06
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 2 2 — — $22,156.04 $33,320.04 $27,738.04 2026-05-06
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 2 — — $22,104.71 $33,242.85 $27,673.78 2026-05-06
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 2 — — $22,082.45 $33,209.37 $27,645.91 2026-05-06
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 2 — — $22,049.67 $33,160.08 $27,604.88 2026-05-06
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 2 — — $22,031.12 $33,132.18 $27,581.65 2026-05-06
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 2 — — $22,010.09 $33,100.56 $27,555.32 2026-05-06
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 2 — — $21,992.16 $33,073.59 $27,532.88 2026-05-06
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 2 — — $21,808.49 $32,797.38 $27,302.93 2026-05-06
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 2 — — $21,763.97 $32,730.42 $27,247.19 2026-05-06
252 MS_DRG Other Vascular Procedures With Mcc 2 2 — — $21,571.65 $32,441.19 $27,006.42 2026-05-06
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 2 — — $21,566.08 $32,432.82 $26,999.45 2026-05-06
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 2 — — $21,467.14 $32,284.02 $26,875.58 2026-05-06
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 2 — — $21,363.25 $32,127.78 $26,745.51 2026-05-06
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 2 2 — — $21,264.30 $31,978.98 $26,621.64 2026-05-06
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 2 — — $21,201.23 $31,884.12 $26,542.67 2026-05-06
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 2 — — $21,097.33 $31,727.88 $26,412.61 2026-05-06
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 2 — — $21,069.51 $31,686.03 $26,377.77 2026-05-06
J2507 HCPCS Pegloticase Inj 8 Mg/ml (For IV Infusion) 29 8 $43,957.80 $33,847.51 23% off $9,609.18 $42,639.07 $26,124.12 2026-05-06
264 MS_DRG Other Circulatory System O.r. Procedures 2 2 — — $20,658.27 $31,067.58 $25,862.93 2026-05-06
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 2 — — $20,427.61 $30,720.69 $25,574.15 2026-05-06
37 MS_DRG Extracranial Procedures With Mcc 2 2 — — $20,358.35 $30,616.53 $25,487.44 2026-05-06
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 2 — — $20,355.87 $30,612.81 $25,484.34 2026-05-06
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 2 — — $20,115.32 $30,251.04 $25,183.18 2026-05-06
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 2 — — $20,026.88 $30,118.05 $25,072.47 2026-05-06
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 2 — — $20,004.62 $30,084.57 $25,044.60 2026-05-06
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $19,976.79 $30,042.72 $25,009.76 2026-05-06
652 MS_DRG Kidney Transplant 2 2 — — $19,971.23 $30,034.35 $25,002.79 2026-05-06
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 2 — — $19,956.39 $30,012.03 $24,984.21 2026-05-06
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 2 2 — — $19,917.43 $29,953.44 $24,935.43 2026-05-06
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 2 2 — — $19,853.11 $29,856.72 $24,854.92 2026-05-06
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 2 — — $19,744.28 $29,693.04 $24,718.66 2026-05-06
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 2 — — $19,707.79 $29,638.17 $24,672.98 2026-05-06
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 2 — — $19,688.62 $29,609.34 $24,648.98 2026-05-06
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 2 — — $19,649.04 $29,549.82 $24,599.43 2026-05-06
500 MS_DRG Soft Tissue Procedures With Mcc 2 2 — — $19,571.12 $29,432.64 $24,501.88 2026-05-06
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 2 — — $19,541.44 $29,388.00 $24,464.72 2026-05-06
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 2 — — $19,485.78 $29,304.30 $24,395.04 2026-05-06
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 2 — — $19,476.51 $29,290.35 $24,383.43 2026-05-06
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 2 2 — — $19,430.75 $29,221.53 $24,326.14 2026-05-06
665 MS_DRG Prostatectomy With Mcc 2 2 — — $19,301.50 $29,027.16 $24,164.33 2026-05-06
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 — — $19,261.30 $28,966.71 $24,114.00 2026-05-06
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 2 — — $19,227.29 $28,915.56 $24,071.43 2026-05-06
662 MS_DRG Minor Bladder Procedures With Mcc 2 2 — — $18,932.32 $28,471.95 $23,702.14 2026-05-06
263 MS_DRG Vein Ligation And Stripping 2 2 — — $18,906.96 $28,433.82 $23,670.39 2026-05-06
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 2 — — $18,757.31 $28,208.76 $23,483.03 2026-05-06
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 2 2 — — $18,678.77 $28,090.65 $23,384.71 2026-05-06
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 2 — — $18,676.30 $28,086.93 $23,381.61 2026-05-06
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 2 2 — — $18,655.89 $28,056.24 $23,356.07 2026-05-06
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 2 2 — — $18,406.06 $27,680.52 $23,043.29 2026-05-06
472 MS_DRG Cervical Spinal Fusion With Cc 2 2 — — $18,218.68 $27,398.73 $22,808.71 2026-05-06
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 2 2 — — $18,206.31 $27,380.13 $22,793.22 2026-05-06
570 MS_DRG Skin Debridement With Mcc 2 2 — — $18,187.76 $27,352.23 $22,769.99 2026-05-06
668 MS_DRG Transurethral Procedures With Mcc 2 2 — — $18,057.28 $27,156.00 $22,606.64 2026-05-06
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 2 — — $18,009.66 $27,084.39 $22,547.03 2026-05-06
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 2 — — $17,945.97 $26,988.60 $22,467.28 2026-05-06
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 2 — — $17,934.84 $26,971.86 $22,453.35 2026-05-06
619 MS_DRG O.r. Procedures For Obesity With Mcc 2 2 — — $17,855.68 $26,852.82 $22,354.25 2026-05-06
974 MS_DRG HIV With Major Related Condition With Mcc 2 2 — — $17,847.02 $26,839.80 $22,343.41 2026-05-06
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 2 2 — — $17,821.05 $26,800.74 $22,310.90 2026-05-06
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 2 — — $17,749.32 $26,692.86 $22,221.09 2026-05-06
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 2 — — $17,627.49 $26,509.65 $22,068.57 2026-05-06
800 MS_DRG Splenic Procedures With Cc 2 2 — — $17,373.33 $26,127.42 $21,750.38 2026-05-06
654 MS_DRG Major Bladder Procedures With Cc 2 2 — — $17,310.87 $26,033.49 $21,672.18 2026-05-06
503 MS_DRG Foot Procedures With Mcc 2 2 — — $17,260.16 $25,957.23 $21,608.69 2026-05-06
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 2 — — $17,141.43 $25,778.67 $21,460.05 2026-05-06
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 2 — — $17,049.91 $25,641.03 $21,345.47 2026-05-06
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 2 — — $16,997.96 $25,562.91 $21,280.43 2026-05-06
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 2 2 — — $16,993.63 $25,556.40 $21,275.01 2026-05-06
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 2 — — $16,905.82 $25,424.34 $21,165.08 2026-05-06
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 2 — — $16,825.43 $25,303.44 $21,064.43 2026-05-06
849 MS_DRG Radiotherapy 2 2 — — $16,755.55 $25,198.35 $20,976.95 2026-05-06
288 MS_DRG Acute And Subacute Endocarditis With Mcc 2 2 — — $16,735.14 $25,167.66 $20,951.40 2026-05-06
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 2 2 — — $16,680.72 $25,085.82 $20,883.27 2026-05-06
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 2 — — $16,449.44 $24,738.00 $20,593.72 2026-05-06
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 2 2 — — $16,391.93 $24,651.51 $20,521.72 2026-05-06
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 2 2 — — $16,309.68 $24,527.82 $20,418.75 2026-05-06
253 MS_DRG Other Vascular Procedures With Cc 2 2 — — $16,051.19 $24,139.08 $20,095.14 2026-05-06
J2350 HCPCS Ocrelizumab Soln For IV Infusion 300 Mg/10ml 29 8 $33,803.40 $26,028.62 23% off $7,389.42 $32,789.30 $20,089.36 2026-05-06
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 2 2 — — $16,032.02 $24,110.25 $20,071.14 2026-05-06
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 2 — — $15,972.04 $24,020.04 $19,996.04 2026-05-06
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 2 2 — — $15,949.77 $23,986.56 $19,968.17 2026-05-06
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 2 2 — — $15,949.77 $23,986.56 $19,968.17 2026-05-06
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 2 2 — — $15,878.04 $23,878.68 $19,878.36 2026-05-06
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 2 — — $15,787.75 $23,742.90 $19,765.33 2026-05-06
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 2 — — $15,712.93 $23,630.37 $19,671.65 2026-05-06
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 2 — — $15,683.24 $23,585.73 $19,634.49 2026-05-06
164 MS_DRG Major Chest Procedures With Cc 2 2 — — $15,608.42 $23,473.20 $19,540.81 2026-05-06
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 2 2 — — $15,601.61 $23,462.97 $19,532.29 2026-05-06
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 2 2 — — $15,409.91 $23,174.67 $19,292.29 2026-05-06
545 MS_DRG Connective Tissue Disorders With Mcc 2 2 — — $15,346.83 $23,079.81 $19,213.32 2026-05-06
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 2 2 — — $15,207.69 $22,870.56 $19,039.12 2026-05-06
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 2 — — $15,203.36 $22,864.05 $19,033.71 2026-05-06
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 2 — — $15,114.93 $22,731.06 $18,923.00 2026-05-06
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 2 — — $15,097.00 $22,704.09 $18,900.54 2026-05-06
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 2 2 — — $14,978.88 $22,526.46 $18,752.67 2026-05-06
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 2 2 — — $14,930.03 $22,452.99 $18,691.51 2026-05-06
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 2 2 — — $14,874.38 $22,369.29 $18,621.83 2026-05-06
330 MS_DRG Major Small And Large Bowel Procedures With Cc 2 2 — — $14,824.28 $22,293.96 $18,559.12 2026-05-06
397 MS_DRG Appendix Procedures With Mcc 2 2 — — $14,810.06 $22,272.57 $18,541.31 2026-05-06
35 MS_DRG Carotid Artery Stent Procedures With Cc 2 2 — — $14,782.85 $22,231.65 $18,507.25 2026-05-06
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 2 2 — — $14,757.50 $22,193.52 $18,475.51 2026-05-06
113 MS_DRG Orbital Procedures With Cc/mcc 2 2 — — $14,539.20 $21,865.23 $18,202.22 2026-05-06
333 MS_DRG Rectal Resection With Cc 2 2 — — $14,484.16 $21,782.46 $18,133.31 2026-05-06
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 2 2 — — $14,461.90 $21,748.98 $18,105.44 2026-05-06
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 2 2 — — $14,451.39 $21,733.17 $18,092.28 2026-05-06
709 MS_DRG Penis Procedures With Cc/mcc 2 2 — — $14,390.79 $21,642.03 $18,016.41 2026-05-06
357 MS_DRG Other Digestive System O.r. Procedures With Cc 2 2 — — $14,380.89 $21,627.15 $18,004.02 2026-05-06
56 MS_DRG Degenerative Nervous System Disorders With Mcc 2 2 — — $14,366.05 $21,604.83 $17,985.44 2026-05-06
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 2 — — $14,292.46 $21,494.16 $17,893.31 2026-05-06
347 MS_DRG Anal And Stomal Procedures With Mcc 2 2 — — $14,195.99 $21,349.08 $17,772.53 2026-05-06
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 2 2 — — $14,191.66 $21,342.57 $17,767.11 2026-05-06
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 2 2 — — $14,134.15 $21,256.08 $17,695.12 2026-05-06
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 2 2 — — $14,109.41 $21,218.88 $17,664.15 2026-05-06
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 2 2 — — $14,072.93 $21,164.01 $17,618.47 2026-05-06
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 2 2 — — $14,049.43 $21,128.67 $17,589.05 2026-05-06
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 2 2 — — $14,010.47 $21,070.08 $17,540.28 2026-05-06
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 2 2 — — $13,843.50 $20,818.98 $17,331.24 2026-05-06
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 2 2 — — $13,835.46 $20,806.89 $17,321.17 2026-05-06
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 2 2 — — $13,726.01 $20,642.28 $17,184.15 2026-05-06
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 2 2 — — $13,683.96 $20,579.04 $17,131.50 2026-05-06
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 2 2 — — $13,670.35 $20,558.58 $17,114.47 2026-05-06
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 2 — — $13,653.65 $20,533.47 $17,093.56 2026-05-06
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 2 2 — — $13,596.76 $20,447.91 $17,022.33 2026-05-06
30 MS_DRG Spinal Procedures Without Cc/mcc 2 2 — — $13,575.12 $20,415.36 $16,995.24 2026-05-06
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 2 2 — — $13,554.09 $20,383.74 $16,968.92 2026-05-06
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 2 2 — — $13,529.97 $20,347.47 $16,938.72 2026-05-06
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 2 2 — — $13,496.58 $20,297.25 $16,896.92 2026-05-06
141 MS_DRG Major Head And Neck Procedures With Cc 2 2 — — $13,487.92 $20,284.23 $16,886.08 2026-05-06
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 2 2 — — $13,473.70 $20,262.84 $16,868.27 2026-05-06
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 2 — — $13,464.42 $20,248.89 $16,856.65 2026-05-06
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 2 2 — — $13,419.28 $20,181.00 $16,800.14 2026-05-06
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 2 — — $13,243.04 $19,915.95 $16,579.50 2026-05-06
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 2 2 — — $13,238.09 $19,908.51 $16,573.30 2026-05-06
374 MS_DRG Digestive Malignancy With Mcc 2 2 — — $13,225.72 $19,889.91 $16,557.81 2026-05-06
32 MS_DRG Ventricular Shunt Procedures With Cc 2 2 — — $13,178.10 $19,818.30 $16,498.20 2026-05-06
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 2 — — $13,177.49 $19,817.37 $16,497.43 2026-05-06
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 2 2 — — $13,171.92 $19,809.00 $16,490.46 2026-05-06
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 2 2 — — $13,151.51 $19,778.31 $16,464.91 2026-05-06
595 MS_DRG Major Skin Disorders With Mcc 2 2 — — $13,114.41 $19,722.51 $16,418.46 2026-05-06
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 2 — — $13,095.86 $19,694.61 $16,395.24 2026-05-06
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 2 2 — — $13,094.00 $19,691.82 $16,392.91 2026-05-06
655 MS_DRG Major Bladder Procedures Without Cc/mcc 2 2 — — $13,089.05 $19,684.38 $16,386.72 2026-05-06
336 MS_DRG Peritoneal Adhesiolysis With Cc 2 2 — — $13,040.20 $19,610.91 $16,325.56 2026-05-06
412 MS_DRG Cholecystectomy With C.d.e. With Cc 2 2 — — $13,001.86 $19,553.25 $16,277.56 2026-05-06
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 2 — — $12,952.39 $19,478.85 $16,215.62 2026-05-06
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 2 2 — — $12,944.35 $19,466.76 $16,205.56 2026-05-06
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 2 2 — — $12,931.36 $19,447.23 $16,189.30 2026-05-06
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 2 2 — — $12,908.48 $19,412.82 $16,160.65 2026-05-06
835 MS_DRG Acute Leukemia With Cc 2 2 — — $12,898.59 $19,397.94 $16,148.26 2026-05-06
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 2 — — $12,894.88 $19,392.36 $16,143.62 2026-05-06
711 MS_DRG Testes Procedures With Cc/mcc 2 2 — — $12,886.22 $19,379.34 $16,132.78 2026-05-06
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 2 2 — — $12,859.01 $19,338.42 $16,098.72 2026-05-06
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 2 — — $12,850.97 $19,326.33 $16,088.65 2026-05-06
886 MS_DRG Behavioral And Developmental Disorders 2 2 — — $12,833.66 $19,300.29 $16,066.98 2026-05-06
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 2 2 — — $12,780.47 $19,220.31 $16,000.39 2026-05-06
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 2 2 — — $12,742.75 $19,163.58 $15,953.17 2026-05-06
935 MS_DRG Non-extensive Burns 2 2 — — $12,739.04 $19,158.00 $15,948.52 2026-05-06
744 MS_DRG D&C, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 2 2 — — $12,671.63 $19,056.63 $15,864.13 2026-05-06
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 2 2 — — $12,539.30 $18,857.61 $15,698.45 2026-05-06
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 2 2 — — $12,504.67 $18,805.53 $15,655.10 2026-05-06
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 2 2 — — $12,459.52 $18,737.64 $15,598.58 2026-05-06
J3241 HCPCS Teprotumumab-trbw For IV Soln 500 Mg 29 8 $26,207.40 $20,179.70 23% off $5,728.94 $25,421.18 $15,575.06 2026-05-06
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 2 2 — — $12,436.02 $18,702.30 $15,569.16 2026-05-06
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 2 2 — — $12,408.20 $18,660.45 $15,534.33 2026-05-06
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 2 2 — — $12,369.86 $18,602.79 $15,486.33 2026-05-06
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 2 2 — — $12,369.24 $18,601.86 $15,485.55 2026-05-06
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 2 — — $12,356.25 $18,582.33 $15,469.29 2026-05-06
908 MS_DRG Other O.r. Procedures For Injuries With Cc 2 2 — — $12,338.32 $18,555.36 $15,446.84 2026-05-06
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 2 2 — — $12,335.84 $18,551.64 $15,443.74 2026-05-06
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 2 2 — — $12,249.27 $18,421.44 $15,335.35 2026-05-06
539 MS_DRG Osteomyelitis With Mcc 2 2 — — $12,180.62 $18,318.21 $15,249.42 2026-05-06
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 2 2 — — $12,171.35 $18,304.26 $15,237.81 2026-05-06
883 MS_DRG Disorders Of Personality And Impulse Control 2 2 — — $12,159.60 $18,286.59 $15,223.10 2026-05-06
906 MS_DRG Hand Procedures For Injuries 2 2 — — $12,147.23 $18,267.99 $15,207.61 2026-05-06
380 MS_DRG Complicated Peptic Ulcer With Mcc 2 2 — — $12,134.24 $18,248.46 $15,191.35 2026-05-06
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 2 2 — — $12,014.28 $18,068.04 $15,041.16 2026-05-06
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 2 — — $12,012.42 $18,065.25 $15,038.83 2026-05-06
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