Price Transparencybeta Hospital negotiated rates

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

PROVIDENCE ST JOSEPH MEDICAL CENTER

Polson, MT · CCN 271343 · Rates published

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You selected 93350 (HCPCS)

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This hospital’s price: $1,642 across 1 payer

Source: https://pricetransparency.providence.org/wamt/live/810463482_providence-st-joseph-medical-center_standardcharges.json · observed 2026-04-01

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.

9,545 distinct procedures filed
10 distinct payers
28,719 rate rows
2026-04-01 last MRF observed
Data quality

12,948 of 28,719 rate rows are consumer-grade (45.1%)

15,771 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 13,089
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,667
placeholder amount (≤ $0.02) — excluded from medians 9
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/wamt/live/810463482_providence-st-joseph-medical-center_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-12
Content fingerprint bf8c2b4fee3de4b4… · 10,689,259 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
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $1,733,895.00 $2,378,903.94 $2,056,399.47 nat. median
$813,967
outlier · 2.5×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $1,301,230.30 $1,785,287.98 $1,543,259.14 nat. median
$739,258
outlier · 2.1×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $1,245,102.37 $1,708,280.45 $1,476,691.41 nat. median
$646,415
outlier · 2.3×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $1,218,680.23 $1,672,029.27 $1,445,354.75 nat. median
$640,950
outlier · 2.3×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $1,217,836.01 $1,670,871.00 $1,444,353.50 nat. median
$622,450
outlier · 2.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $1,199,422.07 $1,645,607.08 $1,422,514.58 nat. median
$608,239
outlier · 2.3×
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $1,101,870.00 $1,511,765.64 $1,306,817.82 nat. median
$591,721
outlier · 2.2×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 $1,221,129.44 $1,221,129.44 $1,221,129.44 nat. median
$359,454
outlier · 3.4×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $950,887.84 $950,887.84 $950,887.84 nat. median
$249,036
outlier · 3.8×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $683,690.19 $683,690.19 $683,690.19 nat. median
$190,559
outlier · 3.6×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $641,294.64 $641,294.64 $641,294.64 nat. median
$198,418
outlier · 3.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $463,911.75 $463,911.75 $463,911.75 nat. median
$126,695
outlier · 3.7×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $455,175.21 $455,175.21 $455,175.21 nat. median
$104,013
outlier · 4.4×
7
MS_DRG 		Lung Transplant 1 $412,411.42 $412,411.42 $412,411.42 nat. median
$117,974
outlier · 3.5×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $385,374.09 $385,374.09 $385,374.09 nat. median
$95,038
outlier · 4.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $378,144.31 $378,144.31 $378,144.31 nat. median
$110,307
outlier · 3.4×
215
MS_DRG 		Other Heart Assist System Implant 1 $348,083.31 $348,083.31 $348,083.31 nat. median
$93,901
outlier · 3.7×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $329,120.35 $329,120.35 $329,120.35 nat. median
$90,551
outlier · 3.6×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $314,302.69 $314,302.69 $314,302.69 nat. median
$74,370
outlier · 4.2×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $309,285.76 $309,285.76 $309,285.76 nat. median
$70,732
outlier · 4.4×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $285,447.77 $285,447.77 $285,447.77 nat. median
$77,632
outlier · 3.7×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $283,555.87 $283,555.87 $283,555.87 nat. median
$77,028
outlier · 3.7×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $274,606.49 $274,606.49 $274,606.49 nat. median
$72,398
outlier · 3.8×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $261,653.70 $261,653.70 $261,653.70 nat. median
$71,748
outlier · 3.6×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $258,670.57 $258,670.57 $258,670.57 nat. median
$47,543
outlier · 5.4×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $250,356.33 $250,356.33 $250,356.33 nat. median
$67,976
outlier · 3.7×
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 1 $244,852.92 $244,852.92 $244,852.92 nat. median
$58,251
outlier · 4.2×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $241,035.33 $241,035.33 $241,035.33 nat. median
$66,715
outlier · 3.6×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $239,501.53 $239,501.53 $239,501.53 nat. median
$39,452
outlier · 6.1×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 $233,812.31 $233,812.31 $233,812.31 nat. median
$63,873
outlier · 3.7×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $229,423.77 $229,423.77 $229,423.77 nat. median
$62,655
outlier · 3.7×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $229,366.33 $229,366.33 $229,366.33 nat. median
$51,514
outlier · 4.5×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $227,569.02 $227,569.02 $227,569.02 nat. median
$61,728
outlier · 3.7×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $224,089.27 $224,089.27 $224,089.27 nat. median
$52,712
outlier · 4.3×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 $222,998.05 $222,998.05 $222,998.05 nat. median
$58,280
outlier · 3.8×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $221,822.37 $221,822.37 $221,822.37 nat. median
$59,371
outlier · 3.7×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 $216,731.12 $216,731.12 $216,731.12 nat. median
$53,342
outlier · 4.1×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $216,248.01 $216,248.01 $216,248.01 nat. median
$38,225
outlier · 5.7×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $214,487.86 $214,487.86 $214,487.86 nat. median
$62,031
outlier · 3.5×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 1 $209,166.88 $209,166.88 $209,166.88 nat. median
$61,308
outlier · 3.4×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $205,774.97 $205,774.97 $205,774.97 nat. median
$49,540
outlier · 4.2×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 1 $205,555.37 $205,555.37 $205,555.37 nat. median
$53,927
outlier · 3.8×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $203,947.25 $203,947.25 $203,947.25 nat. median
$55,167
outlier · 3.7×
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $202,366.16 $202,366.16 $202,366.16 nat. median
$55,477
outlier · 3.6×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $200,633.04 $200,633.04 $200,633.04 nat. median
$59,546
outlier · 3.4×
28
MS_DRG 		Spinal Procedures With Mcc 1 $198,565.46 $198,565.46 $198,565.46 nat. median
$54,460
outlier · 3.6×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 $198,328.97 $198,328.97 $198,328.97 nat. median
$58,135
outlier · 3.4×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $197,899.92 $197,899.92 $197,899.92 nat. median
$57,801
outlier · 3.4×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 $193,629.62 $193,629.62 $193,629.62 nat. median
$53,523
outlier · 3.6×
576
MS_DRG 		Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 1 $190,845.82 $190,845.82 $190,845.82 nat. median
$46,674
outlier · 4.1×

Other procedures at this hospital

Browse this hospital's 9,545 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
             
Q2057 HCPCS Afamitresgene Autoleucel 2 2 — — $1,733,895.00 $2,378,903.94 $2,056,399.47 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 2 — — $1,301,230.30 $1,785,287.98 $1,543,259.14 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 2 2 — — $1,245,102.37 $1,708,280.45 $1,476,691.41 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 2 — — $1,218,680.23 $1,672,029.27 $1,445,354.75 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 2 2 — — $1,217,836.01 $1,670,871.00 $1,444,353.50 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 2 — — $1,199,422.07 $1,645,607.08 $1,422,514.58 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 2 2 — — $1,101,870.00 $1,511,765.64 $1,306,817.82 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 1 — — $1,221,129.44 $1,221,129.44 $1,221,129.44 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $950,887.84 $950,887.84 $950,887.84 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $683,690.19 $683,690.19 $683,690.19 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 — — $641,294.64 $641,294.64 $641,294.64 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $463,911.75 $463,911.75 $463,911.75 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $455,175.21 $455,175.21 $455,175.21 2026-04-01
7 MS_DRG Lung Transplant 1 1 — — $412,411.42 $412,411.42 $412,411.42 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $385,374.09 $385,374.09 $385,374.09 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 — — $378,144.31 $378,144.31 $378,144.31 2026-04-01
215 MS_DRG Other Heart Assist System Implant 1 1 — — $348,083.31 $348,083.31 $348,083.31 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $329,120.35 $329,120.35 $329,120.35 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $314,302.69 $314,302.69 $314,302.69 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $309,285.76 $309,285.76 $309,285.76 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $285,447.77 $285,447.77 $285,447.77 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $283,555.87 $283,555.87 $283,555.87 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $274,606.49 $274,606.49 $274,606.49 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $261,653.70 $261,653.70 $261,653.70 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $258,670.57 $258,670.57 $258,670.57 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $250,356.33 $250,356.33 $250,356.33 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 1 1 — — $244,852.92 $244,852.92 $244,852.92 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $241,035.33 $241,035.33 $241,035.33 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $239,501.53 $239,501.53 $239,501.53 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $233,812.31 $233,812.31 $233,812.31 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $229,423.77 $229,423.77 $229,423.77 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $229,366.33 $229,366.33 $229,366.33 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $227,569.02 $227,569.02 $227,569.02 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $224,089.27 $224,089.27 $224,089.27 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $222,998.05 $222,998.05 $222,998.05 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $221,822.37 $221,822.37 $221,822.37 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $216,731.12 $216,731.12 $216,731.12 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 1 — — $216,248.01 $216,248.01 $216,248.01 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $214,487.86 $214,487.86 $214,487.86 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 1 1 — — $209,166.88 $209,166.88 $209,166.88 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $205,774.97 $205,774.97 $205,774.97 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 1 1 — — $205,555.37 $205,555.37 $205,555.37 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $203,947.25 $203,947.25 $203,947.25 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $202,366.16 $202,366.16 $202,366.16 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $200,633.04 $200,633.04 $200,633.04 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $198,565.46 $198,565.46 $198,565.46 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $198,328.97 $198,328.97 $198,328.97 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 1 1 — — $197,899.92 $197,899.92 $197,899.92 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $193,629.62 $193,629.62 $193,629.62 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $190,845.82 $190,845.82 $190,845.82 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 1 1 — — $188,889.72 $188,889.72 $188,889.72 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $187,727.55 $187,727.55 $187,727.55 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $187,227.55 $187,227.55 $187,227.55 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $186,825.52 $186,825.52 $186,825.52 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $183,619.42 $183,619.42 $183,619.42 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $181,832.24 $181,832.24 $181,832.24 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $179,649.80 $179,649.80 $179,649.80 2026-04-01
0424T OTHER Insj/rplc Nstim Apnea Compl 1 1 — — $179,467.84 $179,467.84 $179,467.84 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $177,200.46 $177,200.46 $177,200.46 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $177,082.21 $177,082.21 $177,082.21 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $176,308.56 $176,308.56 $176,308.56 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $175,936.94 $175,936.94 $175,936.94 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $175,213.96 $175,213.96 $175,213.96 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $174,501.12 $174,501.12 $174,501.12 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $174,345.71 $174,345.71 $174,345.71 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $173,713.95 $173,713.95 $173,713.95 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $172,933.54 $172,933.54 $172,933.54 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 1 1 — — $172,724.08 $172,724.08 $172,724.08 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $170,869.34 $170,869.34 $170,869.34 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $170,170.01 $170,170.01 $170,170.01 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 1 — — $169,619.33 $169,619.33 $169,619.33 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 2 2 — — $142,719.87 $195,811.66 $169,265.77 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $166,497.69 $166,497.69 $166,497.69 2026-04-01
245 MS_DRG Aicd Generator Procedures 1 1 — — $164,730.78 $164,730.78 $164,730.78 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 1 1 — — $163,639.56 $163,639.56 $163,639.56 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $162,605.77 $162,605.77 $162,605.77 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 1 1 — — $162,477.39 $162,477.39 $162,477.39 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $161,757.79 $161,757.79 $161,757.79 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $159,852.37 $159,852.37 $159,852.37 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $157,098.98 $157,098.98 $157,098.98 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 1 1 — — $156,889.52 $156,889.52 $156,889.52 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $156,193.57 $156,193.57 $156,193.57 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $154,744.23 $154,744.23 $154,744.23 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $153,396.25 $153,396.25 $153,396.25 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 2 — — $125,878.43 $172,705.21 $149,291.82 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 1 — — $149,078.66 $149,078.66 $149,078.66 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 1 1 — — $148,602.30 $148,602.30 $148,602.30 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 1 1 — — $147,639.46 $147,639.46 $147,639.46 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $147,247.56 $147,247.56 $147,247.56 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $146,163.10 $146,163.10 $146,163.10 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 1 1 — — $145,494.17 $145,494.17 $145,494.17 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 1 — — $144,470.52 $144,470.52 $144,470.52 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 1 1 — — $144,095.52 $144,095.52 $144,095.52 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $142,652.94 $142,652.94 $142,652.94 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 1 1 — — $140,896.17 $140,896.17 $140,896.17 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 1 1 — — $140,416.44 $140,416.44 $140,416.44 2026-04-01
10 MS_DRG Pancreas Transplant 1 1 — — $140,095.49 $140,095.49 $140,095.49 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 1 1 — — $139,223.86 $139,223.86 $139,223.86 2026-04-01
791 MS_DRG Prematurity With Major Problems 1 1 — — $138,923.19 $138,923.19 $138,923.19 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $138,409.67 $138,409.67 $138,409.67 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 1 1 — — $137,808.51 $137,808.51 $137,808.51 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $137,784.67 $137,784.67 $137,784.67 2026-04-01
332 MS_DRG Rectal Resection With Mcc 1 1 — — $137,173.18 $137,173.18 $137,173.18 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 1 1 — — $135,575.19 $135,575.19 $135,575.19 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 1 1 — — $135,115.73 $135,115.73 $135,115.73 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $133,406.26 $133,406.26 $133,406.26 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $132,835.31 $132,835.31 $132,835.31 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $132,078.55 $132,078.55 $132,078.55 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 1 1 — — $131,835.30 $131,835.30 $131,835.30 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $131,358.95 $131,358.95 $131,358.95 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $130,598.81 $130,598.81 $130,598.81 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $128,784.61 $128,784.61 $128,784.61 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $128,521.09 $128,521.09 $128,521.09 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 1 — — $127,987.31 $127,987.31 $127,987.31 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $127,230.54 $127,230.54 $127,230.54 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $127,179.87 $127,179.87 $127,179.87 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $125,936.62 $125,936.62 $125,936.62 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $125,487.29 $125,487.29 $125,487.29 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 1 1 — — $124,453.50 $124,453.50 $124,453.50 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $123,970.39 $123,970.39 $123,970.39 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $123,845.39 $123,845.39 $123,845.39 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $123,135.92 $123,135.92 $123,135.92 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $122,497.41 $122,497.41 $122,497.41 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $122,335.24 $122,335.24 $122,335.24 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 1 — — $121,777.81 $121,777.81 $121,777.81 2026-04-01
J9226 HCPCS Supprelin La Implant 2 2 — — $102,510.88 $140,644.93 $121,577.90 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 1 1 — — $119,997.39 $119,997.39 $119,997.39 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $119,804.82 $119,804.82 $119,804.82 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $119,416.30 $119,416.30 $119,416.30 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 1 1 — — $118,196.70 $118,196.70 $118,196.70 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $118,041.30 $118,041.30 $118,041.30 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 1 1 — — $117,696.70 $117,696.70 $117,696.70 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 1 1 — — $117,348.72 $117,348.72 $117,348.72 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $115,460.20 $115,460.20 $115,460.20 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $114,960.20 $114,960.20 $114,960.20 2026-04-01
265 MS_DRG Aicd Lead Procedures 1 1 — — $114,260.87 $114,260.87 $114,260.87 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 1 1 — — $114,129.11 $114,129.11 $114,129.11 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 1 1 — — $113,953.43 $113,953.43 $113,953.43 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 1 1 — — $113,497.35 $113,497.35 $113,497.35 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $112,950.05 $112,950.05 $112,950.05 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $112,108.83 $112,108.83 $112,108.83 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $111,814.90 $111,814.90 $111,814.90 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $111,666.26 $111,666.26 $111,666.26 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $111,517.61 $111,517.61 $111,517.61 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $110,176.38 $110,176.38 $110,176.38 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $109,831.78 $109,831.78 $109,831.78 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 1 — — $109,169.62 $109,169.62 $109,169.62 2026-04-01
69930 HCPCS Implant Cochlear Device 1 1 — — $108,779.48 $108,779.48 $108,779.48 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 1 1 — — $108,260.83 $108,260.83 $108,260.83 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 1 1 — — $107,983.80 $107,983.80 $107,983.80 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 1 1 — — $107,183.12 $107,183.12 $107,183.12 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $106,916.22 $106,916.22 $106,916.22 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $106,477.03 $106,477.03 $106,477.03 2026-04-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 1 1 — — $105,737.16 $105,737.16 $105,737.16 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $105,331.76 $105,331.76 $105,331.76 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $104,966.89 $104,966.89 $104,966.89 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 1 1 — — $104,665.75 $104,665.75 $104,665.75 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 1 1 — — $104,665.75 $104,665.75 $104,665.75 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 1 1 — — $104,665.75 $104,665.75 $104,665.75 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 1 1 — — $104,665.75 $104,665.75 $104,665.75 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 1 1 — — $104,665.75 $104,665.75 $104,665.75 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 1 1 — — $104,665.75 $104,665.75 $104,665.75 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 1 1 — — $104,632.43 $104,632.43 $104,632.43 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 1 1 — — $104,338.51 $104,338.51 $104,338.51 2026-04-01
652 MS_DRG Kidney Transplant 1 1 — — $104,227.02 $104,227.02 $104,227.02 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $103,750.66 $103,750.66 $103,750.66 2026-04-01
665 MS_DRG Prostatectomy With Mcc 1 1 — — $103,389.18 $103,389.18 $103,389.18 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 2 — — $2,970.15 $203,416.84 $103,193.49 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 1 1 — — $102,659.44 $102,659.44 $102,659.44 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 1 1 — — $102,466.87 $102,466.87 $102,466.87 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 1 1 — — $102,145.92 $102,145.92 $102,145.92 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 1 1 — — $102,000.65 $102,000.65 $102,000.65 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 2 — — $38,044.45 $165,575.38 $101,809.92 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 1 1 — — $101,683.08 $101,683.08 $101,683.08 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 1 1 — — $101,196.59 $101,196.59 $101,196.59 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $100,919.56 $100,919.56 $100,919.56 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 1 — — $100,865.51 $100,865.51 $100,865.51 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 1 1 — — $100,203.34 $100,203.34 $100,203.34 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 1 1 — — $99,284.42 $99,284.42 $99,284.42 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $99,074.96 $99,074.96 $99,074.96 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $98,976.98 $98,976.98 $98,976.98 2026-04-01
570 MS_DRG Skin Debridement With Mcc 1 1 — — $98,551.31 $98,551.31 $98,551.31 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $97,693.19 $97,693.19 $97,693.19 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 1 1 — — $97,571.57 $97,571.57 $97,571.57 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 1 1 — — $97,203.32 $97,203.32 $97,203.32 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $97,061.43 $97,061.43 $97,061.43 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $96,885.76 $96,885.76 $96,885.76 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $96,328.32 $96,328.32 $96,328.32 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $96,031.02 $96,031.02 $96,031.02 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
61886 HCPCS Implant Neurostim Arrays 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 1 1 — — $95,797.36 $95,797.36 $95,797.36 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 1 1 — — $95,551.29 $95,551.29 $95,551.29 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 1 1 — — $95,368.85 $95,368.85 $95,368.85 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 1 — — $94,233.71 $94,233.71 $94,233.71 2026-04-01
263 MS_DRG Vein Ligation And Stripping 1 1 — — $94,122.22 $94,122.22 $94,122.22 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 1 1 — — $93,689.79 $93,689.79 $93,689.79 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $91,696.53 $91,696.53 $91,696.53 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 1 1 — — $91,098.56 $91,098.56 $91,098.56 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 1 1 — — $90,338.42 $90,338.42 $90,338.42 2026-04-01
800 MS_DRG Splenic Procedures With Cc 1 1 — — $89,814.76 $89,814.76 $89,814.76 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 1 1 — — $89,747.20 $89,747.20 $89,747.20 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $89,734.74 $89,734.74 $89,734.74 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 1 1 — — $89,097.36 $89,097.36 $89,097.36 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $88,936.38 $88,936.38 $88,936.38 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 1 1 — — $88,470.16 $88,470.16 $88,470.16 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 1 1 — — $87,841.78 $87,841.78 $87,841.78 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 1 1 — — $87,716.78 $87,716.78 $87,716.78 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $87,253.94 $87,253.94 $87,253.94 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $87,057.99 $87,057.99 $87,057.99 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 1 1 — — $86,780.96 $86,780.96 $86,780.96 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 1 1 — — $86,676.23 $86,676.23 $86,676.23 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 1 1 — — $86,591.77 $86,591.77 $86,591.77 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $86,530.96 $86,530.96 $86,530.96 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $86,378.93 $86,378.93 $86,378.93 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 1 1 — — $85,750.55 $85,750.55 $85,750.55 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 1 1 — — $85,645.82 $85,645.82 $85,645.82 2026-04-01
503 MS_DRG Foot Procedures With Mcc 1 1 — — $85,585.01 $85,585.01 $85,585.01 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 1 1 — — $85,345.14 $85,345.14 $85,345.14 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $84,750.54 $84,750.54 $84,750.54 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $84,737.03 $84,737.03 $84,737.03 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 1 1 — — $84,304.59 $84,304.59 $84,304.59 2026-04-01
792 MS_DRG Prematurity Without Major Problems 1 1 — — $83,824.86 $83,824.86 $83,824.86 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 1 1 — — $83,493.78 $83,493.78 $83,493.78 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 1 1 — — $82,794.45 $82,794.45 $82,794.45 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $82,253.90 $82,253.90 $82,253.90 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $81,747.14 $81,747.14 $81,747.14 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 1 1 — — $81,487.01 $81,487.01 $81,487.01 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 1 1 — — $81,385.66 $81,385.66 $81,385.66 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 — — $80,328.22 $80,328.22 $80,328.22 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $80,264.03 $80,264.03 $80,264.03 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 1 1 — — $80,084.97 $80,084.97 $80,084.97 2026-04-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 1 1 — — $80,020.78 $80,020.78 $80,020.78 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 1 — — $79,649.16 $79,649.16 $79,649.16 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 1 1 — — $79,628.89 $79,628.89 $79,628.89 2026-04-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 1 1 — — $79,389.02 $79,389.02 $79,389.02 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 1 1 — — $79,355.24 $79,355.24 $79,355.24 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 1 1 — — $79,189.70 $79,189.70 $79,189.70 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 1 1 — — $79,095.10 $79,095.10 $79,095.10 2026-04-01
849 MS_DRG Radiotherapy 1 1 — — $79,017.40 $79,017.40 $79,017.40 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 1 1 — — $78,990.37 $78,990.37 $78,990.37 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 1 1 — — $78,909.29 $78,909.29 $78,909.29 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 2 — — $40,013.02 $117,767.65 $78,890.33 2026-04-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 1 1 — — $77,557.93 $77,557.93 $77,557.93 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 1 1 — — $77,375.50 $77,375.50 $77,375.50 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 1 1 — — $77,172.79 $77,172.79 $77,172.79 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 1 1 — — $77,155.90 $77,155.90 $77,155.90 2026-04-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/Mcc 1 1 — — $76,662.65 $76,662.65 $76,662.65 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 1 1 — — $76,619.96 $76,619.96 $76,619.96 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 1 1 — — $76,619.96 $76,619.96 $76,619.96 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 1 1 — — $76,619.96 $76,619.96 $76,619.96 2026-04-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 1 1 — — $76,530.90 $76,530.90 $76,530.90 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 1 1 — — $76,318.06 $76,318.06 $76,318.06 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 1 1 — — $75,885.62 $75,885.62 $75,885.62 2026-04-01
J9266 HCPCS Pegaspargase Injection 2 2 — — $63,954.13 $87,745.07 $75,849.60 2026-04-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 1 — — $75,804.54 $75,804.54 $75,804.54 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 1 1 — — $75,446.43 $75,446.43 $75,446.43 2026-04-01
333 MS_DRG Rectal Resection With Cc 1 1 — — $75,443.05 $75,443.05 $75,443.05 2026-04-01
141 MS_DRG Major Head And Neck Procedures With Cc 1 1 — — $75,426.16 $75,426.16 $75,426.16 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 — — $75,365.35 $75,365.35 $75,365.35 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 1 1 — — $75,193.05 $75,193.05 $75,193.05 2026-04-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 1 1 — — $75,138.99 $75,138.99 $75,138.99 2026-04-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 1 1 — — $75,041.02 $75,041.02 $75,041.02 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
0520T OTHER Rmvl&rplcmt Pg Wcs New Eltrd 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 1 1 — — $74,456.69 $74,456.69 $74,456.69 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 1 1 — — $74,436.29 $74,436.29 $74,436.29 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 1 1 — — $73,824.80 $73,824.80 $73,824.80 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 2 — — $26,169.72 $120,727.12 $73,448.42 2026-04-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 1 1 — — $73,409.25 $73,409.25 $73,409.25 2026-04-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $73,054.52 $73,054.52 $73,054.52 2026-04-01
655 MS_DRG Major Bladder Procedures Without Cc/Mcc 1 1 — — $72,929.52 $72,929.52 $72,929.52 2026-04-01
595 MS_DRG Major Skin Disorders With Mcc 1 1 — — $72,345.06 $72,345.06 $72,345.06 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $72,331.54 $72,331.54 $72,331.54 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 2 2 — — $1,813.75 $142,703.62 $72,258.68 2026-04-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc 1 1 — — $72,155.87 $72,155.87 $72,155.87 2026-04-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $72,007.22 $72,007.22 $72,007.22 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 1 1 — — $71,858.57 $71,858.57 $71,858.57 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 1 1 — — $71,655.86 $71,655.86 $71,655.86 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
23616 HCPCS Hc Pr 23616 Open Prox Humeral Fracture Prosthetic Rplcmt Rhc 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
25446 HCPCS Wrist Replacement 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
22630 HCPCS Lumbar Spine Fusion 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
22856 HCPCS Cerv Artific Diskectomy 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
22612 HCPCS Lumbar Spine Fusion 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
25442 HCPCS Reconstruct Wrist Joint 1 1 — — $71,452.46 $71,452.46 $71,452.46 2026-04-01
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