Hospital

KITTSON HEALTHCARE

Hallock, MN · CCN 241336 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $2,547 across 1 payer

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8074/410724034_kittson-memorial-hospital-association_standardcharges.csv · observed 2025-04-25

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.

1,919 distinct procedures filed

6 distinct payers

96,652 rate rows

2025-04-25 last MRF observed · ⚠ 16 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 — reason	Rows
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⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old.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 via	Discovered by HANK
Last fetch	success · 2026-08-11
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 $370,165 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 $261,939 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 $205,166 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 $199,832 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 $132,706 outlier · 0.4×
14 MS_DRG	Allogeneic Bone Marrow Transplant	1	$52,364.30	$52,364.30	$52,364.30	nat. median $114,305 outlier · 0.5×
7 MS_DRG	Lung Transplant	1	$52,232.40	$52,232.40	$52,232.40	nat. median $122,690 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 $108,240 outlier · 0.4×
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	1	$43,539.72	$43,539.72	$43,539.72	nat. median $100,978 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 $99,646 outlier · 0.4×
215 MS_DRG	Other Heart Assist System Implant	1	$42,345.02	$42,345.02	$42,345.02	nat. median $98,002 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 $96,835 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 $92,900 outlier · 0.4×
850 MS_DRG	Acute Leukemia With Other Procedures	1	$36,817.57	$36,817.57	$36,817.57	nat. median $81,364 outlier · 0.5×
231 MS_DRG	Coronary Bypass With Ptca With Mcc	1	$33,868.18	$33,868.18	$33,868.18	nat. median $79,040 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 $80,459 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 $81,124 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 $77,385 outlier · 0.4×
10 MS_DRG	Pancreas Transplant	1	$31,866.48	$31,866.48	$31,866.48	nat. median $67,750 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 $69,153 outlier · 0.5×
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 $73,475 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 $74,472 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 $71,485 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 $66,640 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 $68,581 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 $65,958 outlier · 0.4×
955 MS_DRG	Craniotomy For Multiple Significant Trauma	1	$27,291.12	$27,291.12	$27,291.12	nat. median $64,357 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 $62,262 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 $62,911 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 $65,792 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 $62,218 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 $63,840 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 $60,294 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 $58,419 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 $59,832 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 $59,159 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 $55,446 outlier · 0.4×
232 MS_DRG	Coronary Bypass With Ptca Without Mcc	1	$24,414.88	$24,414.88	$24,414.88	nat. median $59,257 outlier · 0.4×
28 MS_DRG	Spinal Procedures With Mcc	1	$24,298.16	$24,298.16	$24,298.16	nat. median $56,970 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 $52,535 outlier · 0.5×
16 MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	1	$24,123.89	$24,123.89	$24,123.89	nat. median $55,867 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 $60,162 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 $60,895 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 $57,082 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 $56,397 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 $57,394 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 $55,685 outlier · 0.4×
653 MS_DRG	Major Bladder Procedures With Mcc	1	$22,280.08	$22,280.08	$22,280.08	nat. median $51,176 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 $54,267 outlier · 0.4×
834 MS_DRG	Acute Leukemia With Mcc	1	$22,091.02	$22,091.02	$22,091.02	nat. median $52,155 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.

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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