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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

BOLIVAR MEDICAL CENTER

Cleveland, MS · CCN 250093 · Rates published

10,818 distinct procedures filed
10 distinct payers
112,634 rate rows
2025-01-01 last MRF observed · ⚠ 17 mo old
Data quality

79,942 of 112,634 rate rows are consumer-grade (71.0%)

32,692 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 32,692

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 17 months old.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://hospitalpricedisclosure.com/download.aspx?pi=eoROtF*_*Ds07dFfOoe4qILQ*-*
Found on page https://hospitalpricedisclosure.com/default.aspx?pi=eoROtF*_*Ds07dFfOoe4qILQ*-*
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 29fe00551ae6e8ef… · 15,219,937 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 4 $282,678.25 $437,873.59 $353,347.81 nat. median
$370,174
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $183,739.91 $284,162.35 $229,674.89 nat. median
$265,286
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $140,184.30 $216,494.07 $175,230.38 nat. median
$206,474
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $139,366.50 $215,223.53 $174,208.12 nat. median
$202,976
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $91,239.55 $140,453.20 $114,049.44 nat. median
$133,161
0.9× median
7
MS_DRG 		Lung Transplant 4 $85,357.65 $131,315.03 $106,697.06 nat. median
$122,708
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $79,272.76 $121,861.51 $99,090.95 nat. median
$117,357
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $74,794.76 $114,904.45 $93,493.45 nat. median
$108,660
0.9× median
209
MS_DRG 		Complex Aortic Arch Procedures 4 $74,709.91 $114,772.63 $93,387.39 nat. median
$98,047
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $72,767.55 $111,754.97 $90,959.44 nat. median
$98,894
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $71,807.46 $110,263.37 $89,759.33 nat. median
$102,358
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $68,128.99 $104,548.47 $85,161.24 nat. median
$100,136
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 4 $65,821.78 $100,963.98 $82,277.23 nat. median
$99,019
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $64,684.82 $99,197.59 $80,856.02 nat. median
$93,672
0.9× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 $59,638.34 $91,357.34 $74,547.92 nat. median
$82,711
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 4 $57,353.32 $87,807.33 $71,691.65 nat. median
$83,470
0.9× median
38240
HCPCS 		Transplt Allo Hct/donor 4 $3,956.00 $126,024.38 $70,940.50 nat. median
$15,979
outlier · 4.4×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 4 $55,854.78 $85,479.19 $69,818.48 nat. median
$79,312
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $55,681.82 $85,210.48 $69,602.27 nat. median
$81,118
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 $52,192.62 $79,789.63 $65,240.78 nat. median
$77,570
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 $50,949.28 $77,857.96 $63,686.60 nat. median
$74,915
0.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 $50,733.24 $77,522.33 $63,416.55 nat. median
$73,807
0.9× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 $50,568.12 $77,265.79 $63,210.15 nat. median
$72,135
0.9× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $47,948.93 $73,196.60 $59,936.16 nat. median
$68,090
0.9× median
10
MS_DRG 		Pancreas Transplant 4 $47,668.93 $72,761.60 $59,586.16 nat. median
$68,884
0.9× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 $47,649.35 $72,731.18 $59,561.69 nat. median
$64,023
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 $47,400.69 $72,344.84 $59,250.86 nat. median
$71,271
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 $47,373.27 $72,302.26 $59,216.59 nat. median
$68,886
0.9× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $45,725.27 $69,741.91 $57,156.59 nat. median
$65,950
0.9× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 4 $44,767.14 $68,253.35 $55,958.92 nat. median
$64,732
0.9× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 4 $44,476.05 $67,801.11 $55,595.06 nat. median
$60,691
0.9× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 $44,444.07 $67,751.42 $55,555.09 nat. median
$63,724
0.9× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $43,750.27 $66,673.54 $54,687.84 nat. median
$61,920
0.9× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $43,750.27 $66,673.54 $54,687.84 nat. median
$64,508
0.8× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 $43,594.28 $66,431.20 $54,492.85 nat. median
$59,793
0.9× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 4 $12,707.17 $97,289.79 $53,741.76 nat. median
$66,526
0.8× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 4 $42,832.61 $65,247.86 $53,540.76 nat. median
$62,134
0.9× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 $40,833.47 $62,141.98 $51,041.84 nat. median
$60,726
0.8× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 4 $40,787.13 $62,069.98 $50,983.91 nat. median
$60,185
0.8× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 4 $40,404.01 $61,474.76 $50,505.01 nat. median
$59,898
0.8× median
28
MS_DRG 		Spinal Procedures With Mcc 4 $40,049.61 $60,924.16 $50,062.01 nat. median
$57,822
0.9× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 $40,038.51 $60,906.92 $50,048.14 nat. median
$59,099
0.8× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $39,754.60 $60,465.83 $49,693.25 nat. median
$58,020
0.9× median
33276
HCPCS 		Insj Phrnc Nrv Stim Sys 4 $20,524.00 $88,248.51 $49,676.05 nat. median
$43,787
1.1× median
0620T
HCPCS 		Evasc Ven Artlz Tibl/prnl Vn 4 $7,797.00 $88,248.51 $49,676.05 nat. median
$33,076
1.5× median
64568
HCPCS 		Inc For Vagus N Elect Impl 4 $20,524.00 $88,248.51 $49,676.05 nat. median
$27,591
1.8× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 $39,626.67 $60,267.09 $49,533.34 nat. median
$52,303
0.9× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 4 $39,536.60 $60,127.16 $49,420.75 nat. median
$56,918
0.9× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 4 $39,137.82 $59,507.60 $48,922.28 nat. median
$57,424
0.9× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 $39,113.02 $59,469.07 $48,891.27 nat. median
$56,696
0.9× median

Other procedures at this hospital

Browse this hospital's 10,818 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 10 4 — — $282,678.25 $437,873.59 $353,347.81 2025-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 10 4 — — $183,739.91 $284,162.35 $229,674.89 2025-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 4 — — $140,184.30 $216,494.07 $175,230.38 2025-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 4 — — $139,366.50 $215,223.53 $174,208.12 2025-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 4 — — $91,239.55 $140,453.20 $114,049.44 2025-01-01
7 MS_DRG Lung Transplant 10 4 — — $85,357.65 $131,315.03 $106,697.06 2025-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 10 4 — — $79,272.76 $121,861.51 $99,090.95 2025-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 4 — — $74,794.76 $114,904.45 $93,493.45 2025-01-01
209 MS_DRG Complex Aortic Arch Procedures 10 4 — — $74,709.91 $114,772.63 $93,387.39 2025-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 4 — — $72,767.55 $111,754.97 $90,959.44 2025-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 10 4 — — $71,807.46 $110,263.37 $89,759.33 2025-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 10 4 — — $68,128.99 $104,548.47 $85,161.24 2025-01-01
215 MS_DRG Other Heart Assist System Implant 10 4 — — $65,821.78 $100,963.98 $82,277.23 2025-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 4 — — $64,684.82 $99,197.59 $80,856.02 2025-01-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 4 — — $59,638.34 $91,357.34 $74,547.92 2025-01-01
850 MS_DRG Acute Leukemia With Other Procedures 10 4 — — $57,353.32 $87,807.33 $71,691.65 2025-01-01
38240 HCPCS Transplt Allo Hct/donor 10 4 — — $3,956.00 $126,024.38 $70,940.50 2025-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 10 4 — — $55,854.78 $85,479.19 $69,818.48 2025-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 4 — — $55,681.82 $85,210.48 $69,602.27 2025-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 4 — — $52,192.62 $79,789.63 $65,240.78 2025-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 4 — — $50,949.28 $77,857.96 $63,686.60 2025-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 10 4 — — $50,733.24 $77,522.33 $63,416.55 2025-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 4 — — $50,568.12 $77,265.79 $63,210.15 2025-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 4 — — $47,948.93 $73,196.60 $59,936.16 2025-01-01
10 MS_DRG Pancreas Transplant 10 4 — — $47,668.93 $72,761.60 $59,586.16 2025-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 10 4 — — $47,649.35 $72,731.18 $59,561.69 2025-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 10 4 — — $47,400.69 $72,344.84 $59,250.86 2025-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 4 — — $47,373.27 $72,302.26 $59,216.59 2025-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 4 — — $45,725.27 $69,741.91 $57,156.59 2025-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 10 4 — — $44,767.14 $68,253.35 $55,958.92 2025-01-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 10 4 — — $44,476.05 $67,801.11 $55,595.06 2025-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 10 4 — — $44,444.07 $67,751.42 $55,555.09 2025-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 4 — — $43,750.27 $66,673.54 $54,687.84 2025-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 4 — — $43,750.27 $66,673.54 $54,687.84 2025-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 4 — — $43,594.28 $66,431.20 $54,492.85 2025-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 4 — — $12,707.17 $97,289.79 $53,741.76 2025-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 10 4 — — $42,832.61 $65,247.86 $53,540.76 2025-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 10 4 — — $40,833.47 $62,141.98 $51,041.84 2025-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 10 4 — — $40,787.13 $62,069.98 $50,983.91 2025-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 10 4 — — $40,404.01 $61,474.76 $50,505.01 2025-01-01
28 MS_DRG Spinal Procedures With Mcc 10 4 — — $40,049.61 $60,924.16 $50,062.01 2025-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 4 — — $40,038.51 $60,906.92 $50,048.14 2025-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 4 — — $39,754.60 $60,465.83 $49,693.25 2025-01-01
64568 HCPCS Inc For Vagus N Elect Impl 10 4 — — $20,524.00 $88,248.51 $49,676.05 2025-01-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 10 4 — — $20,524.00 $88,248.51 $49,676.05 2025-01-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 10 4 — — $7,797.00 $88,248.51 $49,676.05 2025-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 10 4 — — $39,626.67 $60,267.09 $49,533.34 2025-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 10 4 — — $39,536.60 $60,127.16 $49,420.75 2025-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 10 4 — — $39,137.82 $59,507.60 $48,922.28 2025-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 4 — — $39,113.02 $59,469.07 $48,891.27 2025-01-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 10 4 — — $38,475.36 $58,478.39 $48,094.20 2025-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 4 — — $38,235.17 $58,105.24 $47,793.96 2025-01-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 10 4 — — $38,082.45 $57,867.97 $47,603.06 2025-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 10 4 — — $38,034.15 $57,792.93 $47,542.69 2025-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 4 — — $37,528.32 $57,007.08 $46,910.40 2025-01-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 10 4 — — $37,414.76 $56,830.64 $46,768.45 2025-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 4 — — $37,164.13 $56,441.27 $46,455.16 2025-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 10 4 — — $36,882.18 $56,003.22 $46,102.72 2025-01-01
834 MS_DRG Acute Leukemia With Mcc 10 4 — — $36,666.14 $55,667.59 $45,832.68 2025-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 10 4 — — $36,539.52 $55,470.87 $45,674.40 2025-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 10 4 — — $36,488.61 $55,391.78 $45,610.76 2025-01-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 10 4 — — $36,432.48 $55,304.57 $45,540.60 2025-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 10 4 — — $36,290.20 $55,083.52 $45,362.75 2025-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 4 — — $35,640.79 $54,074.59 $44,550.99 2025-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 10 4 — — $35,619.90 $54,042.14 $44,524.88 2025-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 10 4 — — $35,386.25 $53,679.13 $44,232.81 2025-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 10 4 — — $35,272.03 $53,501.68 $44,090.04 2025-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 10 4 — — $34,809.28 $52,782.76 $43,511.60 2025-01-01
653 MS_DRG Major Bladder Procedures With Mcc 10 4 — — $34,750.54 $52,691.50 $43,438.18 2025-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 4 — — $33,731.06 $51,107.63 $42,163.82 2025-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 10 4 — — $33,386.45 $50,572.24 $41,733.06 2025-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 10 4 — — $33,125.38 $50,166.64 $41,406.72 2025-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 10 4 — — $32,823.84 $49,698.17 $41,029.80 2025-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 10 4 — — $32,350.65 $48,963.02 $40,438.31 2025-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 10 4 — — $32,191.40 $48,715.60 $40,239.25 2025-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 10 4 — — $31,907.49 $48,274.51 $39,884.36 2025-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 10 4 — — $31,519.80 $47,672.20 $39,399.75 2025-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 10 4 — — $31,457.14 $47,574.85 $39,321.43 2025-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 4 — — $31,365.77 $47,432.89 $39,207.21 2025-01-01
6 MS_DRG Liver Transplant Without Mcc 10 4 — — $31,099.48 $47,019.18 $38,874.35 2025-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 10 4 — — $30,978.73 $46,831.59 $38,723.41 2025-01-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 10 4 — — $3,956.00 $68,637.95 $38,637.05 2025-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 10 4 — — $30,758.78 $46,489.87 $38,448.48 2025-01-01
245 MS_DRG Aicd Generator Procedures 10 4 — — $30,612.58 $46,262.74 $38,265.73 2025-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 10 4 — — $30,523.16 $46,123.82 $38,153.95 2025-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 10 4 — — $30,510.11 $46,103.54 $38,137.64 2025-01-01
799 MS_DRG Splenic Procedures With Mcc 10 4 — — $30,393.93 $45,923.05 $37,992.41 2025-01-01
163 MS_DRG Major Chest Procedures With Mcc 10 4 — — $30,086.52 $45,445.45 $37,608.15 2025-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 10 4 — — $30,078.04 $45,432.27 $37,597.55 2025-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 10 4 — — $29,963.17 $45,253.81 $37,453.96 2025-01-01
69930 HCPCS Implant Cochlear Device 10 4 — — $20,524.00 $66,060.69 $37,186.28 2025-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 12 4 — — $28,613.52 $49,906.04 $37,077.35 2025-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 10 4 — — $29,505.64 $44,542.99 $36,882.05 2025-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 5 — — $7,429.97 $50,077.40 $36,726.36 2025-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 10 4 — — $29,078.79 $43,879.84 $36,348.49 2025-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 10 4 — — $28,853.62 $43,530.01 $36,067.02 2025-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 10 4 — — $28,673.48 $43,250.14 $35,841.85 2025-01-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 10 4 — — $28,513.58 $43,001.71 $35,641.98 2025-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 10 4 — — $28,398.71 $42,823.25 $35,498.39 2025-01-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 10 4 — — $28,351.71 $42,750.24 $35,439.64 2025-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 10 4 — — $28,338.01 $42,728.95 $35,422.51 2025-01-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
33270 HCPCS Ins/rep Subq Defibrillator 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 10 4 — — $20,524.00 $62,888.58 $35,400.67 2025-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 10 4 — — $28,225.10 $42,553.52 $35,281.38 2025-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 10 4 — — $28,174.19 $42,474.43 $35,217.74 2025-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 4 — — $28,068.45 $42,310.16 $35,085.56 2025-01-01
793 MS_DRG Full Term Neonate With Major Problems 10 4 — — $28,048.87 $42,279.74 $35,061.09 2025-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 10 4 — — $27,940.53 $42,111.42 $34,925.66 2025-01-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 10 4 — — $13,702.00 $61,824.38 $34,801.62 2025-01-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 10 4 — — $13,702.00 $61,824.38 $34,801.62 2025-01-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 10 4 — — $3,956.00 $61,824.38 $34,801.62 2025-01-01
63685 HCPCS Insrt/redo Spine N Generator 10 4 — — $13,702.00 $61,824.38 $34,801.62 2025-01-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 10 4 — — $13,702.00 $61,824.38 $34,801.62 2025-01-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 10 4 — — $3,956.00 $61,824.38 $34,801.62 2025-01-01
61886 HCPCS Implant Neurostim Arrays 10 4 — — $20,524.00 $61,824.38 $34,801.62 2025-01-01
61885 HCPCS Insrt/redo Neurostim 1 Array 10 4 — — $13,702.00 $61,824.38 $34,801.62 2025-01-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 10 4 — — $7,797.00 $61,824.38 $34,801.62 2025-01-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 10 4 — — $27,761.04 $41,832.57 $34,701.30 2025-01-01
791 MS_DRG Prematurity With Major Problems 10 4 — — $27,327.02 $41,158.26 $34,158.78 2025-01-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 10 4 — — $27,075.74 $40,767.87 $33,844.68 2025-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 10 4 — — $26,838.16 $40,398.77 $33,547.70 2025-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 14 4 — — $30,230.81 $46,608.51 $32,965.45 2025-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 4 — — $26,366.93 $39,666.67 $32,958.66 2025-01-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 10 4 — — $26,251.41 $39,487.19 $32,814.26 2025-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 10 4 — — $26,098.03 $39,248.90 $32,622.54 2025-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 10 4 — — $26,060.17 $39,190.09 $32,575.21 2025-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 10 4 — — $26,036.02 $39,152.57 $32,545.02 2025-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 10 4 — — $25,893.09 $38,930.50 $32,366.36 2025-01-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 10 4 — — $20,524.00 $57,468.01 $32,349.37 2025-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 10 4 — — $25,395.10 $38,156.82 $31,743.88 2025-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 10 4 — — $25,288.06 $37,990.52 $31,610.08 2025-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 10 4 — — $25,229.97 $37,900.28 $31,537.46 2025-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 10 4 — — $25,227.36 $37,896.22 $31,534.20 2025-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 10 4 — — $25,158.83 $37,789.75 $31,448.54 2025-01-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 10 4 — — $25,021.77 $37,576.81 $31,277.21 2025-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 10 4 — — $24,808.34 $37,245.23 $31,010.42 2025-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 10 4 — — $24,798.55 $37,230.02 $30,998.19 2025-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 10 4 — — $24,517.25 $36,792.99 $30,646.56 2025-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 10 4 — — $24,498.97 $36,764.60 $30,623.71 2025-01-01
22630 HCPCS Lumbar Spine Fusion 10 4 — — $7,797.00 $54,363.87 $30,602.02 2025-01-01
22558 HCPCS Lumbar Spine Fusion 10 4 — — $7,797.00 $54,363.87 $30,602.02 2025-01-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 10 4 — — $13,702.00 $54,363.87 $30,602.02 2025-01-01
22633 HCPCS Lumbar Spine Fusion Combined 10 4 — — $10,779.00 $54,363.87 $30,602.02 2025-01-01
27702 HCPCS Reconstruct Ankle Joint 10 4 — — $4,564.00 $54,363.87 $30,602.02 2025-01-01
20696 HCPCS Comp Multiplane Ext Fixation 10 4 — — $3,066.00 $54,363.87 $30,602.02 2025-01-01
21243 HCPCS Reconstruction Of Jaw Joint 10 4 — — $3,956.00 $54,363.87 $30,602.02 2025-01-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 10 4 — — $13,702.00 $54,363.87 $30,602.02 2025-01-01
332 MS_DRG Rectal Resection With Mcc 10 4 — — $24,466.34 $36,713.90 $30,582.92 2025-01-01
265 MS_DRG Aicd Lead Procedures 10 4 — — $24,450.02 $36,688.55 $30,562.52 2025-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 10 4 — — $24,408.25 $36,623.65 $30,510.31 2025-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 4 — — $24,373.01 $36,568.90 $30,466.26 2025-01-01
0871T HCPCS Rplcmt Subq Prtl Ascites Pmp 10 4 — — $3,956.00 $53,930.03 $30,357.80 2025-01-01
C9760 HCPCS Non-blind Interatrial Shunt 10 4 — — $20,524.00 $53,930.03 $30,357.80 2025-01-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 10 4 — — $24,218.98 $36,329.59 $30,273.72 2025-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 10 4 — — $24,164.81 $36,245.43 $30,206.01 2025-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 10 4 — — $24,141.31 $36,208.93 $30,176.64 2025-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 10 4 — — $24,106.72 $36,155.18 $30,133.40 2025-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 10 4 — — $24,087.14 $36,124.76 $30,108.92 2025-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 10 4 — — $24,046.02 $36,060.88 $30,057.52 2025-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 10 4 — — $23,852.17 $35,759.72 $29,815.21 2025-01-01
252 MS_DRG Other Vascular Procedures With Mcc 10 4 — — $23,602.20 $35,371.36 $29,502.75 2025-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 12 4 — — $23,805.18 $35,686.72 $29,481.72 2025-01-01
93654 HCPCS Ep & Ablate Ventric Tachy 10 4 — — $10,779.00 $52,368.03 $29,478.53 2025-01-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 10 4 — — $10,779.00 $52,368.03 $29,478.53 2025-01-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 10 4 — — $10,779.00 $52,368.03 $29,478.53 2025-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 10 4 — — $23,491.90 $35,200.00 $29,364.88 2025-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 10 4 — — $23,382.25 $35,029.64 $29,227.81 2025-01-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 10 4 — — $23,277.82 $34,867.40 $29,097.28 2025-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 10 4 — — $23,101.60 $34,593.62 $28,877.00 2025-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 10 4 — — $23,072.23 $34,547.99 $28,840.29 2025-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 14 4 — — $21,317.52 $42,604.22 $28,257.73 2025-01-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 10 4 — — $22,394.75 $33,495.46 $27,993.44 2025-01-01
37 MS_DRG Extracranial Procedures With Mcc 10 4 — — $22,321.65 $33,381.89 $27,902.06 2025-01-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 10 4 — — $22,319.04 $33,377.84 $27,898.80 2025-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 10 4 — — $22,065.15 $32,983.39 $27,581.44 2025-01-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 10 4 — — $21,948.32 $32,801.89 $27,435.40 2025-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 4 — — $23,211.25 $34,763.98 $27,413.35 2025-01-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 10 4 — — $21,918.95 $32,756.26 $27,398.69 2025-01-01
652 MS_DRG Kidney Transplant 10 4 — — $21,913.08 $32,747.13 $27,391.35 2025-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 10 4 — — $21,897.41 $32,722.79 $27,371.76 2025-01-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 10 4 — — $21,856.29 $32,658.91 $27,320.36 2025-01-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 10 4 — — $21,788.42 $32,553.46 $27,235.52 2025-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 10 4 — — $21,673.54 $32,374.99 $27,091.93 2025-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 12 4 — — $23,610.42 $36,090.29 $27,073.07 2025-01-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 10 4 — — $21,635.04 $32,315.17 $27,043.80 2025-01-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 10 4 — — $21,614.80 $32,283.73 $27,018.50 2025-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 10 4 — — $21,573.03 $32,218.84 $26,966.29 2025-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 10 4 — — $21,490.80 $32,091.07 $26,863.50 2025-01-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 10 4 — — $21,459.47 $32,042.40 $26,824.34 2025-01-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 10 4 — — $21,400.73 $31,951.14 $26,750.91 2025-01-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 10 4 — — $21,390.94 $31,935.93 $26,738.68 2025-01-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 10 4 — — $21,342.64 $31,860.89 $26,678.30 2025-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 12 4 — — $23,151.53 $35,362.24 $26,545.87 2025-01-01
665 MS_DRG Prostatectomy With Mcc 10 4 — — $21,206.23 $31,648.97 $26,507.79 2025-01-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 10 4 — — $21,163.81 $31,583.06 $26,454.76 2025-01-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 10 4 — — $21,127.91 $31,527.29 $26,409.89 2025-01-01
662 MS_DRG Minor Bladder Procedures With Mcc 10 4 — — $20,816.58 $31,043.61 $26,020.72 2025-01-01
263 MS_DRG Vein Ligation And Stripping 10 4 — — $20,789.82 $31,002.04 $25,987.28 2025-01-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 10 4 — — $20,631.88 $30,756.65 $25,789.85 2025-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 12 4 — — $22,638.20 $33,873.68 $25,786.15 2025-01-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 10 4 — — $20,548.99 $30,627.87 $25,686.24 2025-01-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 10 4 — — $20,546.38 $30,623.81 $25,682.98 2025-01-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 10 4 — — $20,524.84 $30,590.35 $25,656.05 2025-01-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 10 4 — — $20,261.16 $30,180.70 $25,326.45 2025-01-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
0515T HCPCS Insj Wcs Lv Compl Sys 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 10 4 — — $7,797.00 $44,565.71 $25,086.52 2025-01-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 10 4 — — $20,069.22 $44,565.71 $25,086.52 2025-01-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 10 4 — — $7,797.00 $44,565.71 $25,086.52 2025-01-01
472 MS_DRG Cervical Spinal Fusion With Cc 10 4 — — $20,063.40 $29,873.45 $25,079.25 2025-01-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 10 4 — — $20,050.34 $29,853.17 $25,062.92 2025-01-01
570 MS_DRG Skin Debridement With Mcc 10 4 — — $20,030.76 $29,822.75 $25,038.45 2025-01-01
668 MS_DRG Transurethral Procedures With Mcc 10 4 — — $19,893.05 $29,608.80 $24,866.31 2025-01-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 10 4 — — $19,842.79 $29,530.72 $24,803.49 2025-01-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 10 4 — — $19,775.57 $29,426.28 $24,719.46 2025-01-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 10 4 — — $19,763.82 $29,408.03 $24,704.78 2025-01-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 10 4 — — $19,680.28 $29,278.24 $24,600.35 2025-01-01
974 MS_DRG HIV With Major Related Condition With Mcc 10 4 — — $19,671.14 $29,264.04 $24,588.92 2025-01-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 10 4 — — $19,643.73 $29,221.45 $24,554.66 2025-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 10 4 — — $19,568.02 $29,103.83 $24,460.02 2025-01-01
800 MS_DRG Splenic Procedures With Cc 10 4 — — $19,171.19 $28,487.32 $23,963.99 2025-01-01
654 MS_DRG Major Bladder Procedures With Cc 10 4 — — $19,105.27 $28,384.90 $23,881.59 2025-01-01
503 MS_DRG Foot Procedures With Mcc 10 4 — — $19,051.75 $28,301.75 $23,814.69 2025-01-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 10 4 — — $18,926.44 $28,107.07 $23,658.05 2025-01-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 4 — — $18,829.84 $27,956.99 $23,537.30 2025-01-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 10 4 — — $18,770.45 $27,864.72 $23,463.06 2025-01-01
54401 HCPCS Insert Self-contd Prosthesis 10 4 — — $10,779.00 $41,525.45 $23,375.13 2025-01-01
54405 HCPCS Insert Multi-comp Penis Pros 10 4 — — $10,779.00 $41,525.45 $23,375.13 2025-01-01
54416 HCPCS Remv/repl Penis Contain Pros 10 4 — — $10,779.00 $41,525.45 $23,375.13 2025-01-01
54411 HCPCS Remov/replc Penis Pros Comp 10 4 — — $998.00 $41,525.45 $23,375.13 2025-01-01
53444 HCPCS Insert Tandem Cuff 10 4 — — $7,797.00 $41,525.45 $23,375.13 2025-01-01
53445 HCPCS Insert Uro/ves Nck Sphincter 10 4 — — $10,779.00 $41,525.45 $23,375.13 2025-01-01
53447 HCPCS Remove/replace Ur Sphincter 10 4 — — $10,779.00 $41,525.45 $23,375.13 2025-01-01
54417 HCPCS Remv/replc Penis Pros Compl 10 4 — — $998.00 $41,525.45 $23,375.13 2025-01-01
54410 HCPCS Remove/replace Penis Prosth 10 4 — — $10,779.00 $41,525.45 $23,375.13 2025-01-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 10 4 — — $18,677.77 $27,720.73 $23,347.21 2025-01-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 10 4 — — $18,592.92 $27,588.91 $23,241.15 2025-01-01
849 MS_DRG Radiotherapy 10 4 — — $18,519.17 $27,474.33 $23,148.96 2025-01-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 10 4 — — $18,497.63 $27,440.87 $23,122.04 2025-01-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 10 4 — — $18,440.19 $27,351.64 $23,050.24 2025-01-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 10 4 — — $18,196.09 $26,972.40 $22,745.11 2025-01-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 10 4 — — $18,135.39 $26,878.10 $22,669.24 2025-01-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 10 4 — — $18,048.59 $26,743.24 $22,560.74 2025-01-01
164 MS_DRG Major Chest Procedures With Cc 12 4 — — $17,308.46 $25,593.36 $22,305.65 2025-01-01
253 MS_DRG Other Vascular Procedures With Cc 10 4 — — $17,775.77 $26,319.38 $22,219.71 2025-01-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 10 4 — — $17,755.54 $26,287.95 $22,194.43 2025-01-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 10 4 — — $17,692.23 $26,189.59 $22,115.29 2025-01-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 10 4 — — $17,668.73 $26,153.09 $22,085.91 2025-01-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 10 4 — — $17,668.73 $26,153.09 $22,085.91 2025-01-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 10 4 — — $17,593.02 $26,035.46 $21,991.28 2025-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 14 4 — — $1,350.00 $32,838.39 $21,971.82 2025-01-01
0680T HCPCS Insj/rplcmt Pg Only Isdss 10 4 — — $7,797.00 $38,868.74 $21,879.64 2025-01-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 10 4 — — $7,797.00 $38,868.74 $21,879.64 2025-01-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 10 4 — — $13,702.00 $38,868.74 $21,879.64 2025-01-01
64580 HCPCS Implant Neuroelectrodes 10 4 — — $7,797.00 $38,868.74 $21,879.64 2025-01-01
63655 HCPCS Implant Neuroelectrodes 10 4 — — $7,797.00 $38,868.74 $21,879.64 2025-01-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 10 4 — — $7,797.00 $38,868.74 $21,879.64 2025-01-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 10 4 — — $17,497.73 $25,887.42 $21,872.16 2025-01-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 12 4 — — $10,412.13 $28,904.07 $21,869.37 2025-01-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 10 4 — — $17,418.76 $25,764.73 $21,773.45 2025-01-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 10 4 — — $17,387.43 $25,716.05 $21,734.29 2025-01-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 10 4 — — $13,702.00 $38,591.41 $21,723.53 2025-01-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
0525T HCPCS Insj/rplcmt Compl Iims 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
33221 HCPCS Insert Pulse Gen Mult Leads 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 10 4 — — $7,797.00 $38,591.41 $21,723.53 2025-01-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 10 4 — — $17,301.28 $25,582.21 $21,626.60 2025-01-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 12 4 — — $18,775.02 $27,871.82 $21,527.32 2025-01-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 10 4 — — $17,098.95 $25,267.87 $21,373.69 2025-01-01
545 MS_DRG Connective Tissue Disorders With Mcc 10 4 — — $17,032.37 $25,164.44 $21,290.46 2025-01-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 10 4 — — $16,885.52 $24,936.29 $21,106.90 2025-01-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 10 4 — — $16,858.76 $24,894.71 $21,073.45 2025-01-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 10 4 — — $16,787.62 $24,784.19 $20,984.52 2025-01-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 10 4 — — $16,768.69 $24,754.78 $20,960.86 2025-01-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 2 1 — — $20,894.40 $20,894.40 $20,894.40 2025-01-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 12 4 — — $15,997.23 $23,556.23 $20,863.33 2025-01-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 10 4 — — $16,644.03 $24,561.11 $20,805.04 2025-01-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 10 4 — — $16,592.47 $24,481.00 $20,740.59 2025-01-01
92933 HCPCS Prq Card Stent/ath/angio 10 4 — — $4,564.00 $36,728.01 $20,674.60 2025-01-01
0238T HCPCS Trluml Perip Athrc Iliac Art 10 4 — — $7,797.00 $36,728.01 $20,674.60 2025-01-01
37242 HCPCS Vasc Embolize/occlude Artery 10 4 — — $7,797.00 $36,728.01 $20,674.60 2025-01-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 10 4 — — $7,797.00 $36,728.01 $20,674.60 2025-01-01
37182 HCPCS Insert Hepatic Shunt (tips) 10 4 — — $7,797.00 $36,728.01 $20,674.60 2025-01-01
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