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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

KITTSON HEALTHCARE

Hallock, MN · CCN 241336 · Rates published

1,919 distinct procedures filed
6 distinct payers
96,652 rate rows
2025-04-25 last MRF observed · ⚠ 14 mo old
Data quality

96,152 of 96,652 rate rows are consumer-grade (99.5%)

500 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
percent-of-charges filed in the dollar field — excluded from medians 360
per-diem day rate — not a per-procedure price 102
exceeds 10× this hospital's gross charge — excluded from medians 30
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8074/410724034_kittson-memorial-hospital-association_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/KittsonMemorialHealthcareCenter/8074
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint bab564638ee0e334… · 18,721,349 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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $150,727.67 $150,727.67 $150,727.67 nat. median
$370,174
outlier · 0.4×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $112,581.10 $112,581.10 $112,581.10 nat. median
$265,286
outlier · 0.4×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $94,820.03 $94,820.03 $94,820.03 nat. median
$206,368
outlier · 0.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 1 $85,656.51 $85,656.51 $85,656.51 nat. median
$202,986
outlier · 0.4×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 1 $56,474.01 $56,474.01 $56,474.01 nat. median
$133,176
outlier · 0.4×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $52,364.30 $52,364.30 $52,364.30 nat. median
$117,303
outlier · 0.4×
7
MS_DRG 		Lung Transplant 1 $52,232.40 $52,232.40 $52,232.40 nat. median
$122,708
outlier · 0.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $44,045.74 $44,045.74 $44,045.74 nat. median
$108,660
outlier · 0.4×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $43,539.72 $43,539.72 $43,539.72 nat. median
$102,358
outlier · 0.4×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $42,562.45 $42,562.45 $42,562.45 nat. median
$100,136
outlier · 0.4×
215
MS_DRG 		Other Heart Assist System Implant 1 $42,345.02 $42,345.02 $42,345.02 nat. median
$99,019
outlier · 0.4×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $41,894.96 $41,894.96 $41,894.96 nat. median
$98,905
outlier · 0.4×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $38,572.65 $38,572.65 $38,572.65 nat. median
$93,672
outlier · 0.4×
850
MS_DRG 		Acute Leukemia With Other Procedures 1 $36,817.57 $36,817.57 $36,817.57 nat. median
$83,442
outlier · 0.4×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $33,868.18 $33,868.18 $33,868.18 nat. median
$79,312
outlier · 0.4×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $33,848.99 $33,848.99 $33,848.99 nat. median
$81,118
outlier · 0.4×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 $33,334.98 $33,334.98 $33,334.98 nat. median
$82,712
outlier · 0.4×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $32,217.82 $32,217.82 $32,217.82 nat. median
$77,576
outlier · 0.4×
10
MS_DRG 		Pancreas Transplant 1 $31,866.48 $31,866.48 $31,866.48 nat. median
$68,882
outlier · 0.5×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $31,683.02 $31,683.02 $31,683.02 nat. median
$71,240
outlier · 0.4×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $31,239.75 $31,239.75 $31,239.75 nat. median
$73,807
outlier · 0.4×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $30,924.79 $30,924.79 $30,924.79 nat. median
$74,915
outlier · 0.4×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $29,832.41 $29,832.41 $29,832.41 nat. median
$72,138
outlier · 0.4×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $28,373.50 $28,373.50 $28,373.50 nat. median
$68,090
outlier · 0.4×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $28,244.80 $28,244.80 $28,244.80 nat. median
$68,887
outlier · 0.4×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $27,805.13 $27,805.13 $27,805.13 nat. median
$66,526
outlier · 0.4×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $27,291.12 $27,291.12 $27,291.12 nat. median
$64,732
outlier · 0.4×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 $26,796.69 $26,796.69 $26,796.69 nat. median
$63,738
outlier · 0.4×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 $26,693.96 $26,693.96 $26,693.96 nat. median
$64,027
outlier · 0.4×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 $26,648.80 $26,648.80 $26,648.80 nat. median
$65,950
outlier · 0.4×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $25,851.40 $25,851.40 $25,851.40 nat. median
$62,134
outlier · 0.4×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $25,810.23 $25,810.23 $25,810.23 nat. median
$64,510
outlier · 0.4×
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 1 $25,276.63 $25,276.63 $25,276.63 nat. median
$60,185
outlier · 0.4×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 $24,757.42 $24,757.42 $24,757.42 nat. median
$59,099
outlier · 0.4×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 $24,725.44 $24,725.44 $24,725.44 nat. median
$60,691
outlier · 0.4×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 $24,612.73 $24,612.73 $24,612.73 nat. median
$59,793
outlier · 0.4×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 $24,528.39 $24,528.39 $24,528.39 nat. median
$55,736
outlier · 0.4×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $24,414.88 $24,414.88 $24,414.88 nat. median
$59,899
outlier · 0.4×
28
MS_DRG 		Spinal Procedures With Mcc 1 $24,298.16 $24,298.16 $24,298.16 nat. median
$57,823
outlier · 0.4×
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 1 $24,123.89 $24,123.89 $24,123.89 nat. median
$53,805
outlier · 0.4×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 1 $24,123.89 $24,123.89 $24,123.89 nat. median
$56,920
outlier · 0.4×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 $23,943.63 $23,943.63 $23,943.63 nat. median
$60,726
outlier · 0.4×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $23,778.55 $23,778.55 $23,778.55 nat. median
$61,920
outlier · 0.4×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $23,517.55 $23,517.55 $23,517.55 nat. median
$57,424
outlier · 0.4×
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 $23,270.13 $23,270.13 $23,270.13 nat. median
$56,697
outlier · 0.4×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $22,938.78 $22,938.78 $22,938.78 nat. median
$58,024
outlier · 0.4×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 $22,801.69 $22,801.69 $22,801.69 nat. median
$55,929
outlier · 0.4×
653
MS_DRG 		Major Bladder Procedures With Mcc 1 $22,280.08 $22,280.08 $22,280.08 nat. median
$51,418
outlier · 0.4×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $22,092.62 $22,092.62 $22,092.62 nat. median
$54,066
outlier · 0.4×
834
MS_DRG 		Acute Leukemia With Mcc 1 $22,091.02 $22,091.02 $22,091.02 nat. median
$53,173
outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 1,919 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $150,727.67 $150,727.67 $150,727.67 2025-04-25
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $112,581.10 $112,581.10 $112,581.10 2025-04-25
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 1 — — $94,820.03 $94,820.03 $94,820.03 2025-04-25
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 2 1 — — $85,656.51 $85,656.51 $85,656.51 2025-04-25
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 2 1 — — $56,474.01 $56,474.01 $56,474.01 2025-04-25
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $52,364.30 $52,364.30 $52,364.30 2025-04-25
7 MS_DRG Lung Transplant 2 1 — — $52,232.40 $52,232.40 $52,232.40 2025-04-25
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $44,045.74 $44,045.74 $44,045.74 2025-04-25
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 1 — — $43,539.72 $43,539.72 $43,539.72 2025-04-25
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $42,562.45 $42,562.45 $42,562.45 2025-04-25
215 MS_DRG Other Heart Assist System Implant 2 1 — — $42,345.02 $42,345.02 $42,345.02 2025-04-25
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $41,894.96 $41,894.96 $41,894.96 2025-04-25
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $38,572.65 $38,572.65 $38,572.65 2025-04-25
850 MS_DRG Acute Leukemia With Other Procedures 2 1 — — $36,817.57 $36,817.57 $36,817.57 2025-04-25
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $33,868.18 $33,868.18 $33,868.18 2025-04-25
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $33,848.99 $33,848.99 $33,848.99 2025-04-25
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 1 — — $33,334.98 $33,334.98 $33,334.98 2025-04-25
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $32,217.82 $32,217.82 $32,217.82 2025-04-25
10 MS_DRG Pancreas Transplant 2 1 — — $31,866.48 $31,866.48 $31,866.48 2025-04-25
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $31,683.02 $31,683.02 $31,683.02 2025-04-25
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $31,239.75 $31,239.75 $31,239.75 2025-04-25
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $30,924.79 $30,924.79 $30,924.79 2025-04-25
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $29,832.41 $29,832.41 $29,832.41 2025-04-25
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $28,373.50 $28,373.50 $28,373.50 2025-04-25
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $28,244.80 $28,244.80 $28,244.80 2025-04-25
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $27,805.13 $27,805.13 $27,805.13 2025-04-25
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $27,291.12 $27,291.12 $27,291.12 2025-04-25
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 1 — — $26,796.69 $26,796.69 $26,796.69 2025-04-25
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 1 — — $26,693.96 $26,693.96 $26,693.96 2025-04-25
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 1 — — $26,648.80 $26,648.80 $26,648.80 2025-04-25
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $25,851.40 $25,851.40 $25,851.40 2025-04-25
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $25,810.23 $25,810.23 $25,810.23 2025-04-25
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 1 — — $25,276.63 $25,276.63 $25,276.63 2025-04-25
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 1 — — $24,757.42 $24,757.42 $24,757.42 2025-04-25
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 1 — — $24,725.44 $24,725.44 $24,725.44 2025-04-25
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $24,612.73 $24,612.73 $24,612.73 2025-04-25
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $24,528.39 $24,528.39 $24,528.39 2025-04-25
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $24,414.88 $24,414.88 $24,414.88 2025-04-25
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $24,298.16 $24,298.16 $24,298.16 2025-04-25
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $24,123.89 $24,123.89 $24,123.89 2025-04-25
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $24,123.89 $24,123.89 $24,123.89 2025-04-25
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 1 — — $23,943.63 $23,943.63 $23,943.63 2025-04-25
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $23,778.55 $23,778.55 $23,778.55 2025-04-25
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $23,517.55 $23,517.55 $23,517.55 2025-04-25
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 1 — — $23,270.13 $23,270.13 $23,270.13 2025-04-25
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $22,938.78 $22,938.78 $22,938.78 2025-04-25
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $22,801.69 $22,801.69 $22,801.69 2025-04-25
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $22,280.08 $22,280.08 $22,280.08 2025-04-25
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $22,092.62 $22,092.62 $22,092.62 2025-04-25
834 MS_DRG Acute Leukemia With Mcc 2 1 — — $22,091.02 $22,091.02 $22,091.02 2025-04-25
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $22,004.28 $22,004.28 $22,004.28 2025-04-25
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 1 — — $21,863.99 $21,863.99 $21,863.99 2025-04-25
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 1 — — $21,746.88 $21,746.88 $21,746.88 2025-04-25
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 1 — — $21,697.31 $21,697.31 $21,697.31 2025-04-25
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $21,586.60 $21,586.60 $21,586.60 2025-04-25
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $21,566.21 $21,566.21 $21,566.21 2025-04-25
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $21,563.42 $21,563.42 $21,563.42 2025-04-25
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 1 — — $21,263.64 $21,263.64 $21,263.64 2025-04-25
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $21,169.31 $21,169.31 $21,169.31 2025-04-25
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 1 — — $20,583.35 $20,583.35 $20,583.35 2025-04-25
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $20,515.80 $20,515.80 $20,515.80 2025-04-25
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $20,361.92 $20,361.92 $20,361.92 2025-04-25
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $20,299.56 $20,299.56 $20,299.56 2025-04-25
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 1 — — $20,130.89 $20,130.89 $20,130.89 2025-04-25
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 1 — — $20,012.18 $20,012.18 $20,012.18 2025-04-25
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $19,996.59 $19,996.59 $19,996.59 2025-04-25
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $19,991.00 $19,991.00 $19,991.00 2025-04-25
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $19,916.65 $19,916.65 $19,916.65 2025-04-25
245 MS_DRG Aicd Generator Procedures 2 1 — — $19,531.34 $19,531.34 $19,531.34 2025-04-25
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $19,413.43 $19,413.43 $19,413.43 2025-04-25
6 MS_DRG Liver Transplant Without Mcc 2 1 — — $19,381.05 $19,381.05 $19,381.05 2025-04-25
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $19,086.47 $19,086.47 $19,086.47 2025-04-25
799 MS_DRG Splenic Procedures With Mcc 2 1 — — $19,003.74 $19,003.74 $19,003.74 2025-04-25
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $19,002.94 $19,002.94 $19,002.94 2025-04-25
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 1 — — $18,803.49 $18,803.49 $18,803.49 2025-04-25
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 1 — — $18,702.76 $18,702.76 $18,702.76 2025-04-25
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 1 — — $18,594.84 $18,594.84 $18,594.84 2025-04-25
163 MS_DRG Major Chest Procedures With Mcc 2 1 — — $18,421.77 $18,421.77 $18,421.77 2025-04-25
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 1 — — $18,414.18 $18,414.18 $18,414.18 2025-04-25
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $18,355.42 $18,355.42 $18,355.42 2025-04-25
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 1 — — $18,353.02 $18,353.02 $18,353.02 2025-04-25
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 1 — — $18,031.67 $18,031.67 $18,031.67 2025-04-25
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $17,924.15 $17,924.15 $17,924.15 2025-04-25
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 1 — — $17,874.58 $17,874.58 $17,874.58 2025-04-25
901 MS_DRG Wound Debridements For Injuries With Mcc 2 1 — — $17,707.51 $17,707.51 $17,707.51 2025-04-25
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 1 — — $17,556.82 $17,556.82 $17,556.82 2025-04-25
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 2 1 — — $17,293.82 $17,293.82 $17,293.82 2025-04-25
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $17,257.85 $17,257.85 $17,257.85 2025-04-25
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 1 — — $17,048.80 $17,048.80 $17,048.80 2025-04-25
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 1 — — $17,024.02 $17,024.02 $17,024.02 2025-04-25
140 MS_DRG Major Head And Neck Procedures With Mcc 2 1 — — $16,903.31 $16,903.31 $16,903.31 2025-04-25
31 MS_DRG Ventricular Shunt Procedures With Mcc 2 1 — — $16,748.63 $16,748.63 $16,748.63 2025-04-25
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 1 — — $16,747.43 $16,747.43 $16,747.43 2025-04-25
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 1 — — $16,629.12 $16,629.12 $16,629.12 2025-04-25
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 1 — — $16,434.86 $16,434.86 $16,434.86 2025-04-25
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 1 — — $16,425.67 $16,425.67 $16,425.67 2025-04-25
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 1 — — $16,401.29 $16,401.29 $16,401.29 2025-04-25
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 2 1 — — $16,320.55 $16,320.55 $16,320.55 2025-04-25
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $16,256.20 $16,256.20 $16,256.20 2025-04-25
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 1 — — $15,922.05 $15,922.05 $15,922.05 2025-04-25
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 2 1 — — $15,910.86 $15,910.86 $15,910.86 2025-04-25
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 1 — — $15,773.36 $15,773.36 $15,773.36 2025-04-25
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 1 — — $15,737.39 $15,737.39 $15,737.39 2025-04-25
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 1 — — $15,705.81 $15,705.81 $15,705.81 2025-04-25
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 1 — — $15,705.01 $15,705.01 $15,705.01 2025-04-25
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 1 — — $15,628.27 $15,628.27 $15,628.27 2025-04-25
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 1 — — $15,542.33 $15,542.33 $15,542.33 2025-04-25
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $15,448.01 $15,448.01 $15,448.01 2025-04-25
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 1 — — $15,432.02 $15,432.02 $15,432.02 2025-04-25
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 1 — — $15,392.45 $15,392.45 $15,392.45 2025-04-25
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $15,277.33 $15,277.33 $15,277.33 2025-04-25
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $15,194.20 $15,194.20 $15,194.20 2025-04-25
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 1 — — $15,075.88 $15,075.88 $15,075.88 2025-04-25
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $14,964.77 $14,964.77 $14,964.77 2025-04-25
460 MS_DRG Other Inpatient Ms-DRG 2 1 — — $14,620.63 $14,620.63 $14,620.63 2025-04-25
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $14,582.65 $14,582.65 $14,582.65 2025-04-25
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $14,484.73 $14,484.73 $14,484.73 2025-04-25
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 2 1 — — $14,328.45 $14,328.45 $14,328.45 2025-04-25
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 1 — — $14,327.65 $14,327.65 $14,327.65 2025-04-25
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 1 — — $14,324.45 $14,324.45 $14,324.45 2025-04-25
265 MS_DRG Aicd Lead Procedures 2 1 — — $14,256.90 $14,256.90 $14,256.90 2025-04-25
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 1 — — $14,193.35 $14,193.35 $14,193.35 2025-04-25
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 1 — — $14,111.01 $14,111.01 $14,111.01 2025-04-25
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 1 — — $14,106.21 $14,106.21 $14,106.21 2025-04-25
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 1 — — $14,070.64 $14,070.64 $14,070.64 2025-04-25
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 1 — — $14,003.89 $14,003.89 $14,003.89 2025-04-25
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $14,001.49 $14,001.49 $14,001.49 2025-04-25
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $13,993.90 $13,993.90 $13,993.90 2025-04-25
264 MS_DRG Other Circulatory System O.r. Procedures 2 1 — — $13,969.12 $13,969.12 $13,969.12 2025-04-25
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $13,878.38 $13,878.38 $13,878.38 2025-04-25
332 MS_DRG Rectal Resection With Mcc 2 1 — — $13,863.59 $13,863.59 $13,863.59 2025-04-25
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 1 — — $13,848.41 $13,848.41 $13,848.41 2025-04-25
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 1 — — $13,767.27 $13,767.27 $13,767.27 2025-04-25
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $13,744.88 $13,744.88 $13,744.88 2025-04-25
665 MS_DRG Prostatectomy With Mcc 2 1 — — $13,723.30 $13,723.30 $13,723.30 2025-04-25
252 MS_DRG Other Vascular Procedures With Mcc 2 1 — — $13,710.51 $13,710.51 $13,710.51 2025-04-25
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 1 — — $13,689.33 $13,689.33 $13,689.33 2025-04-25
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 1 — — $13,616.98 $13,616.98 $13,616.98 2025-04-25
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 1 — — $13,557.82 $13,557.82 $13,557.82 2025-04-25
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 1 — — $13,415.93 $13,415.93 $13,415.93 2025-04-25
37 MS_DRG Extracranial Procedures With Mcc 2 1 — — $13,272.84 $13,272.84 $13,272.84 2025-04-25
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 1 — — $13,196.89 $13,196.89 $13,196.89 2025-04-25
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 1 — — $13,064.19 $13,064.19 $13,064.19 2025-04-25
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 1 — — $13,026.62 $13,026.62 $13,026.62 2025-04-25
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 1 — — $13,021.03 $13,021.03 $13,021.03 2025-04-25
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 1 — — $12,884.73 $12,884.73 $12,884.73 2025-04-25
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $12,807.19 $12,807.19 $12,807.19 2025-04-25
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 1 — — $12,770.42 $12,770.42 $12,770.42 2025-04-25
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $12,748.03 $12,748.03 $12,748.03 2025-04-25
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 2 1 — — $12,711.26 $12,711.26 $12,711.26 2025-04-25
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 1 — — $12,685.68 $12,685.68 $12,685.68 2025-04-25
500 MS_DRG Soft Tissue Procedures With Mcc 2 1 — — $12,664.49 $12,664.49 $12,664.49 2025-04-25
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 1 — — $12,473.84 $12,473.84 $12,473.84 2025-04-25
662 MS_DRG Minor Bladder Procedures With Mcc 2 1 — — $12,468.24 $12,468.24 $12,468.24 2025-04-25
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 1 — — $12,415.08 $12,415.08 $12,415.08 2025-04-25
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 1 — — $12,359.52 $12,359.52 $12,359.52 2025-04-25
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 2 1 — — $12,333.94 $12,333.94 $12,333.94 2025-04-25
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 1 — — $12,325.15 $12,325.15 $12,325.15 2025-04-25
652 MS_DRG Kidney Transplant 2 1 — — $12,275.59 $12,275.59 $12,275.59 2025-04-25
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 2 1 — — $12,264.39 $12,264.39 $12,264.39 2025-04-25
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 1 — — $12,224.42 $12,224.42 $12,224.42 2025-04-25
570 MS_DRG Skin Debridement With Mcc 2 1 — — $12,032.57 $12,032.57 $12,032.57 2025-04-25
974 MS_DRG HIV With Major Related Condition With Mcc 2 1 — — $11,935.04 $11,935.04 $11,935.04 2025-04-25
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $11,785.55 $11,785.55 $11,785.55 2025-04-25
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 1 — — $11,755.18 $11,755.18 $11,755.18 2025-04-25
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 1 — — $11,722.40 $11,722.40 $11,722.40 2025-04-25
668 MS_DRG Transurethral Procedures With Mcc 2 1 — — $11,655.65 $11,655.65 $11,655.65 2025-04-25
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 2 1 — — $11,649.66 $11,649.66 $11,649.66 2025-04-25
800 MS_DRG Splenic Procedures With Cc 2 1 — — $11,645.66 $11,645.66 $11,645.66 2025-04-25
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 1 — — $11,639.26 $11,639.26 $11,639.26 2025-04-25
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $11,579.31 $11,579.31 $11,579.31 2025-04-25
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 1 — — $11,459.00 $11,459.00 $11,459.00 2025-04-25
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 1 — — $11,445.81 $11,445.81 $11,445.81 2025-04-25
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 2 1 — — $11,439.41 $11,439.41 $11,439.41 2025-04-25
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 2 1 — — $11,423.43 $11,423.43 $11,423.43 2025-04-25
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 2 1 — — $11,378.26 $11,378.26 $11,378.26 2025-04-25
J3101 HCPCS Tenecteplase For IV Soln Kit 50 Mg 54 6 $19,402.20 $19,402.20 $6,208.70 $16,530.67 $11,369.68 2025-04-25
654 MS_DRG Major Bladder Procedures With Cc 2 1 — — $11,279.13 $11,279.13 $11,279.13 2025-04-25
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 1 — — $11,224.38 $11,224.38 $11,224.38 2025-04-25
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 2 1 — — $11,213.18 $11,213.18 $11,213.18 2025-04-25
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 1 — — $10,937.39 $10,937.39 $10,937.39 2025-04-25
288 MS_DRG Acute And Subacute Endocarditis With Mcc 2 1 — — $10,917.01 $10,917.01 $10,917.01 2025-04-25
619 MS_DRG O.r. Procedures For Obesity With Mcc 2 1 — — $10,897.42 $10,897.42 $10,897.42 2025-04-25
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 1 — — $10,858.25 $10,858.25 $10,858.25 2025-04-25
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $10,804.69 $10,804.69 $10,804.69 2025-04-25
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 1 — — $10,769.52 $10,769.52 $10,769.52 2025-04-25
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 1 — — $10,728.35 $10,728.35 $10,728.35 2025-04-25
263 MS_DRG Vein Ligation And Stripping 2 1 — — $10,719.55 $10,719.55 $10,719.55 2025-04-25
849 MS_DRG Radiotherapy 2 1 — — $10,675.59 $10,675.59 $10,675.59 2025-04-25
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 2 1 — — $10,642.41 $10,642.41 $10,642.41 2025-04-25
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 2 1 — — $10,604.84 $10,604.84 $10,604.84 2025-04-25
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 2 1 — — $10,591.25 $10,591.25 $10,591.25 2025-04-25
503 MS_DRG Foot Procedures With Mcc 2 1 — — $10,578.06 $10,578.06 $10,578.06 2025-04-25
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 2 1 — — $10,566.87 $10,566.87 $10,566.87 2025-04-25
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 2 1 — — $10,484.93 $10,484.93 $10,484.93 2025-04-25
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 2 1 — — $10,457.35 $10,457.35 $10,457.35 2025-04-25
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 2 1 — — $10,345.83 $10,345.83 $10,345.83 2025-04-25
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 1 — — $10,329.05 $10,329.05 $10,329.05 2025-04-25
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 2 1 — — $10,206.74 $10,206.74 $10,206.74 2025-04-25
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $10,203.94 $10,203.94 $10,203.94 2025-04-25
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 1 — — $10,184.76 $10,184.76 $10,184.76 2025-04-25
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 2 1 — — $10,132.79 $10,132.79 $10,132.79 2025-04-25
545 MS_DRG Connective Tissue Disorders With Mcc 2 1 — — $10,099.22 $10,099.22 $10,099.22 2025-04-25
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 2 1 — — $10,091.23 $10,091.23 $10,091.23 2025-04-25
164 MS_DRG Major Chest Procedures With Cc 2 1 — — $10,059.65 $10,059.65 $10,059.65 2025-04-25
56 MS_DRG Degenerative Nervous System Disorders With Mcc 2 1 — — $10,008.49 $10,008.49 $10,008.49 2025-04-25
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 1 — — $10,000.49 $10,000.49 $10,000.49 2025-04-25
397 MS_DRG Appendix Procedures With Mcc 2 1 — — $9,902.97 $9,902.97 $9,902.97 2025-04-25
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 2 1 — — $9,863.00 $9,863.00 $9,863.00 2025-04-25
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 1 — — $9,786.65 $9,786.65 $9,786.65 2025-04-25
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 1 — — $9,705.12 $9,705.12 $9,705.12 2025-04-25
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 2 1 — — $9,671.94 $9,671.94 $9,671.94 2025-04-25
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 2 1 — — $9,636.37 $9,636.37 $9,636.37 2025-04-25
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 1 — — $9,596.80 $9,596.80 $9,596.80 2025-04-25
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 2 1 — — $9,580.81 $9,580.81 $9,580.81 2025-04-25
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 2 1 — — $9,580.81 $9,580.81 $9,580.81 2025-04-25
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 2 1 — — $9,498.87 $9,498.87 $9,498.87 2025-04-25
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 1 — — $9,461.70 $9,461.70 $9,461.70 2025-04-25
347 MS_DRG Anal And Stomal Procedures With Mcc 2 1 — — $9,459.30 $9,459.30 $9,459.30 2025-04-25
330 MS_DRG Major Small And Large Bowel Procedures With Cc 2 1 — — $9,447.71 $9,447.71 $9,447.71 2025-04-25
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $9,431.72 $9,431.72 $9,431.72 2025-04-25
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 2 1 — — $9,346.58 $9,346.58 $9,346.58 2025-04-25
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 2 1 — — $9,273.44 $9,273.44 $9,273.44 2025-04-25
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 2 1 — — $9,251.46 $9,251.46 $9,251.46 2025-04-25
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 2 1 — — $9,243.86 $9,243.86 $9,243.86 2025-04-25
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 2 1 — — $9,226.28 $9,226.28 $9,226.28 2025-04-25
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 2 1 — — $9,168.72 $9,168.72 $9,168.72 2025-04-25
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 1 — — $9,154.73 $9,154.73 $9,154.73 2025-04-25
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 2 1 — — $9,125.55 $9,125.55 $9,125.55 2025-04-25
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 2 1 — — $9,108.36 $9,108.36 $9,108.36 2025-04-25
35 MS_DRG Carotid Artery Stent Procedures With Cc 2 1 — — $9,091.58 $9,091.58 $9,091.58 2025-04-25
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 2 1 — — $9,056.80 $9,056.80 $9,056.80 2025-04-25
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 2 1 — — $9,027.62 $9,027.62 $9,027.62 2025-04-25
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 2 1 — — $9,026.03 $9,026.03 $9,026.03 2025-04-25
113 MS_DRG Orbital Procedures With Cc/mcc 2 1 — — $9,019.63 $9,019.63 $9,019.63 2025-04-25
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 1 — — $9,004.04 $9,004.04 $9,004.04 2025-04-25
357 MS_DRG Other Digestive System O.r. Procedures With Cc 2 1 — — $9,000.84 $9,000.84 $9,000.84 2025-04-25
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 2 1 — — $8,993.65 $8,993.65 $8,993.65 2025-04-25
709 MS_DRG Penis Procedures With Cc/mcc 2 1 — — $8,981.26 $8,981.26 $8,981.26 2025-04-25
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 2 1 — — $8,922.10 $8,922.10 $8,922.10 2025-04-25
30 MS_DRG Spinal Procedures Without Cc/mcc 2 1 — — $8,894.12 $8,894.12 $8,894.12 2025-04-25
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 2 1 — — $8,846.56 $8,846.56 $8,846.56 2025-04-25
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 2 1 — — $8,790.60 $8,790.60 $8,790.60 2025-04-25
935 MS_DRG Non-extensive Burns 2 1 — — $8,778.61 $8,778.61 $8,778.61 2025-04-25
906 MS_DRG Hand Procedures For Injuries 2 1 — — $8,723.05 $8,723.05 $8,723.05 2025-04-25
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 1 — — $8,709.06 $8,709.06 $8,709.06 2025-04-25
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 2 1 — — $8,669.89 $8,669.89 $8,669.89 2025-04-25
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 2 1 — — $8,621.93 $8,621.93 $8,621.93 2025-04-25
314 MS_DRG Other Circulatory System Diagnoses With Mcc 2 1 — — $8,607.14 $8,607.14 $8,607.14 2025-04-25
141 MS_DRG Major Head And Neck Procedures With Cc 2 1 — — $8,586.76 $8,586.76 $8,586.76 2025-04-25
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 2 1 — — $8,576.36 $8,576.36 $8,576.36 2025-04-25
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 2 1 — — $8,570.37 $8,570.37 $8,570.37 2025-04-25
835 MS_DRG Acute Leukemia With Cc 2 1 — — $8,536.79 $8,536.79 $8,536.79 2025-04-25
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 2 1 — — $8,535.99 $8,535.99 $8,535.99 2025-04-25
32 MS_DRG Ventricular Shunt Procedures With Cc 2 1 — — $8,535.59 $8,535.59 $8,535.59 2025-04-25
412 MS_DRG Cholecystectomy With C.d.e. With Cc 2 1 — — $8,519.61 $8,519.61 $8,519.61 2025-04-25
333 MS_DRG Rectal Resection With Cc 2 1 — — $8,494.02 $8,494.02 $8,494.02 2025-04-25
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 2 1 — — $8,476.44 $8,476.44 $8,476.44 2025-04-25
595 MS_DRG Major Skin Disorders With Mcc 2 1 — — $8,453.66 $8,453.66 $8,453.66 2025-04-25
336 MS_DRG Peritoneal Adhesiolysis With Cc 2 1 — — $8,443.26 $8,443.26 $8,443.26 2025-04-25
374 MS_DRG Digestive Malignancy With Mcc 2 1 — — $8,439.67 $8,439.67 $8,439.67 2025-04-25
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 2 1 — — $8,438.87 $8,438.87 $8,438.87 2025-04-25
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 2 1 — — $8,426.48 $8,426.48 $8,426.48 2025-04-25
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 2 1 — — $8,404.49 $8,404.49 $8,404.49 2025-04-25
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $8,378.91 $8,378.91 $8,378.91 2025-04-25
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 2 1 — — $8,354.93 $8,354.93 $8,354.93 2025-04-25
655 MS_DRG Major Bladder Procedures Without Cc/mcc 2 1 — — $8,302.57 $8,302.57 $8,302.57 2025-04-25
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 1 — — $8,293.38 $8,293.38 $8,293.38 2025-04-25
592 MS_DRG Skin Ulcers With Mcc 2 1 — — $8,218.63 $8,218.63 $8,218.63 2025-04-25
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 2 1 — — $8,183.06 $8,183.06 $8,183.06 2025-04-25
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 2 1 — — $8,106.32 $8,106.32 $8,106.32 2025-04-25
539 MS_DRG Osteomyelitis With Mcc 2 1 — — $8,084.73 $8,084.73 $8,084.73 2025-04-25
908 MS_DRG Other O.r. Procedures For Injuries With Cc 2 1 — — $8,061.95 $8,061.95 $8,061.95 2025-04-25
548 MS_DRG Septic Arthritis With Mcc 2 1 — — $8,051.96 $8,051.96 $8,051.96 2025-04-25
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 2 1 — — $8,043.56 $8,043.56 $8,043.56 2025-04-25
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 1 — — $8,040.37 $8,040.37 $8,040.37 2025-04-25
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 2 1 — — $7,987.21 $7,987.21 $7,987.21 2025-04-25
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 1 — — $7,986.81 $7,986.81 $7,986.81 2025-04-25
575 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 2 1 — — $7,980.01 $7,980.01 $7,980.01 2025-04-25
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 2 1 — — $7,950.43 $7,950.43 $7,950.43 2025-04-25
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 2 1 — — $7,945.24 $7,945.24 $7,945.24 2025-04-25
100 MS_DRG Seizures With Mcc 2 1 — — $7,934.84 $7,934.84 $7,934.84 2025-04-25
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 2 1 — — $7,934.05 $7,934.05 $7,934.05 2025-04-25
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 2 1 — — $7,906.07 $7,906.07 $7,906.07 2025-04-25
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 1 — — $7,885.68 $7,885.68 $7,885.68 2025-04-25
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 2 1 — — $7,880.88 $7,880.88 $7,880.88 2025-04-25
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 2 1 — — $7,855.30 $7,855.30 $7,855.30 2025-04-25
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 2 1 — — $7,843.31 $7,843.31 $7,843.31 2025-04-25
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 2 1 — — $7,839.72 $7,839.72 $7,839.72 2025-04-25
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 2 1 — — $7,830.52 $7,830.52 $7,830.52 2025-04-25
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 2 1 — — $7,815.73 $7,815.73 $7,815.73 2025-04-25
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 2 1 — — $7,810.94 $7,810.94 $7,810.94 2025-04-25
744 MS_DRG D&C, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 2 1 — — $7,809.74 $7,809.74 $7,809.74 2025-04-25
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 2 1 — — $7,756.18 $7,756.18 $7,756.18 2025-04-25
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/mcc 2 1 — — $7,746.59 $7,746.59 $7,746.59 2025-04-25
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $7,723.00 $7,723.00 $7,723.00 2025-04-25
380 MS_DRG Complicated Peptic Ulcer With Mcc 2 1 — — $7,691.43 $7,691.43 $7,691.43 2025-04-25
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $7,650.26 $7,650.26 $7,650.26 2025-04-25
711 MS_DRG Testes Procedures With Cc/mcc 2 1 — — $7,636.67 $7,636.67 $7,636.67 2025-04-25
J2506 HCPCS Pegfilgrastim Soln Prefilled Syringe 6 Mg/0.6ml 54 6 $12,993.43 $12,993.43 $4,157.90 $11,070.40 $7,614.15 2025-04-25
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