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 →

Export CSV
Hospital

DR DAN C TRIGG MEMORIAL HOSPITAL

Tucumcari, NM · CCN 321302 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

Vaginal Delivery Without Sterilization Or D&C Without Cc/Mcc

This hospital’s price: $10,459 across 3 payers · range $2,373-$11,436

Source: https://onbaseext.phs.org/PEL/DisplayDocument?ContentID=PEL_00954561 · 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.

12,240 distinct procedures filed
9 distinct payers
78,448 rate rows
2026-04-01 last MRF observed
Data quality

61,448 of 78,448 rate rows are consumer-grade (78.3%)

17,000 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 16,520
template filing: same amount across many unrelated codes — excluded 444
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 20
placeholder amount (≤ $0.02) — excluded from medians 16
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://onbaseext.phs.org/PEL/DisplayDocument?ContentID=PEL_00954561
Found on page https://www.phs.org/tools-resources/patient/standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-13
Content fingerprint 9d798fbc7cd4a348… · 10,469,338 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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $4,402,595.74 $4,402,595.74 $4,402,595.74 nat. median
$2,460,273
1.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $984,816.97 $2,630,033.35 $1,807,425.16 nat. median
$691,418
outlier · 2.6×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $989,817.28 $2,571,961.50 $1,780,889.39 nat. median
$631,793
outlier · 2.8×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $944,981.41 $2,387,877.90 $1,666,429.65 nat. median
$610,161
outlier · 2.7×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $924,257.25 $2,335,509.66 $1,629,883.46 nat. median
$624,417
outlier · 2.6×
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $875,952.00 $2,197,189.20 $1,536,570.60 nat. median
$577,541
outlier · 2.7×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $875,952.00 $2,123,190.60 $1,499,571.30 nat. median
$588,565
outlier · 2.5×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 3 $140,433.54 $676,771.38 $618,974.09 nat. median
$370,165
1.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $104,892.24 $505,492.24 $462,322.44 nat. median
$261,939
1.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $441,114.19 $441,114.19 $441,114.19 nat. median
$111,503
outlier · 4.0×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $88,344.18 $425,744.55 $389,385.33 nat. median
$205,166
1.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $79,806.49 $384,600.08 $351,754.66 nat. median
$199,832
1.8× median
33276
HCPCS 		Insj Phrnc Nrv Stim Sys 1 $241,652.69 $241,652.69 $241,652.69 nat. median
$43,061
outlier · 5.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $52,617.05 $253,569.87 $231,914.62 nat. median
$132,706
1.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $48,788.01 $235,117.14 $215,037.78 nat. median
$114,305
1.9× median
7
MS_DRG 		Lung Transplant 3 $48,665.12 $234,524.90 $214,496.12 nat. median
$122,690
1.7× median
L7180
HCPCS 		Electronic Elbow Sequential 1 $197,851.26 $197,851.26 $197,851.26 nat. median
$46,980
outlier · 4.2×
L7181
HCPCS 		Electronic Elbo Simultaneous 1 $196,243.70 $196,243.70 $196,243.70 nat. median
$50,449
outlier · 3.9×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $41,037.58 $197,766.59 $180,877.03 nat. median
$108,240
1.7× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 1 $28,440.00 $331,866.00 $180,153.00 nat. median
$69,291
outlier · 2.6×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 3 $40,566.12 $195,494.54 $178,799.02 nat. median
$100,978
1.8× median
0571T
OTHER 		Insj/rplcmt Icds Ss Eltrd 1 $176,344.84 $176,344.84 $176,344.84 nat. median
$32,779
outlier · 5.4×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $39,655.60 $191,106.59 $174,785.80 nat. median
$99,646
1.8× median
215
MS_DRG 		Other Heart Assist System Implant 3 $39,453.01 $190,130.29 $173,892.88 nat. median
$98,002
1.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $39,033.69 $188,109.50 $172,044.67 nat. median
$96,835
1.8× median
33270
HCPCS 		Ins/rep Subq Defibrillator 1 $165,495.02 $165,495.02 $165,495.02 nat. median
$31,963
outlier · 5.2×
64582
HCPCS 		Opn Mpltj Hpglsl Nstm Ary Pg 1 $161,440.89 $161,440.89 $161,440.89 nat. median
$28,070
outlier · 5.8×
33287
HCPCS 		Rmv&rplcmt Phrnc Nrv Stim Pg 1 $159,043.67 $159,043.67 $159,043.67 nat. median
$29,000
outlier · 5.5×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 $35,938.28 $173,192.25 $158,401.38 nat. median
$92,900
1.7× median
0266T
OTHER 		Implt/rpl Crtd Sns Dev Total 1 $158,117.07 $158,117.07 $158,117.07 nat. median
$39,896
outlier · 4.0×
33289
HCPCS 		Tcat Impl Wrls P-art Prs Snr 1 $157,559.72 $157,559.72 $157,559.72 nat. median
$27,692
outlier · 5.7×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $152,549.00 $152,549.00 $152,549.00 nat. median
$83,623
1.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $34,303.07 $165,311.89 $151,194.00 nat. median
$81,364
1.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $122,955.60 $176,375.50 $149,665.55 nat. median
$65,655
outlier · 2.3×
C9760
HCPCS 		Non-blind Interatrial Shunt 1 $147,677.69 $147,677.69 $147,677.69 nat. median
$27,848
outlier · 5.3×
0424T
OTHER 		Insj/rplc Nstim Apnea Compl 1 $143,531.45 $143,531.45 $143,531.45 nat. median
$22,425
outlier · 6.4×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 3 $31,555.11 $152,069.06 $139,082.13 nat. median
$79,040
1.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 $31,537.24 $151,982.92 $139,003.35 nat. median
$80,459
1.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 $31,058.33 $149,674.98 $136,892.51 nat. median
$81,124
1.7× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $30,017.46 $144,658.89 $132,304.81 nat. median
$77,385
1.7× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $131,808.37 $131,808.37 $131,808.37 nat. median
$58,534
outlier · 2.3×
10
MS_DRG 		Pancreas Transplant 3 $29,690.12 $143,081.38 $130,862.02 nat. median
$67,750
1.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $29,519.19 $142,257.63 $130,108.62 nat. median
$69,153
1.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 $29,106.20 $140,267.35 $128,288.31 nat. median
$73,475
1.7× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 $28,812.74 $138,853.15 $126,994.89 nat. median
$74,472
1.7× median
0614T
OTHER 		Rmvl&rplcmt Ss Impl Dfb Pg 1 $123,725.66 $123,725.66 $123,725.66 nat. median
$23,467
outlier · 5.3×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 $27,794.97 $133,948.34 $122,508.95 nat. median
$71,485
1.7× median
64568
HCPCS 		Inc For Vagus N Elect Impl 1 $122,459.74 $122,459.74 $122,459.74 nat. median
$27,651
outlier · 4.4×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $122,040.58 $122,040.58 $122,040.58 nat. median
$51,048
outlier · 2.4×
33230
HCPCS 		Insrt Pulse Gen W/dual Leads 1 $120,889.65 $120,889.65 $120,889.65 nat. median
$22,374
outlier · 5.4×

Other procedures at this hospital

Browse this hospital's 12,240 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 1 — — $4,402,595.74 $4,402,595.74 $4,402,595.74 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 1 — — $984,816.97 $2,630,033.35 $1,807,425.16 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 8 1 — — $989,817.28 $2,571,961.50 $1,780,889.39 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 8 1 — — $944,981.41 $2,387,877.90 $1,666,429.65 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 1 — — $924,257.25 $2,335,509.66 $1,629,883.46 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 8 1 — — $875,952.00 $2,197,189.20 $1,536,570.60 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 1 — — $875,952.00 $2,123,190.60 $1,499,571.30 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 3 — — $140,433.54 $676,771.38 $618,974.09 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 12 3 — — $104,892.24 $505,492.24 $462,322.44 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 1 — — $441,114.19 $441,114.19 $441,114.19 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 3 — — $88,344.18 $425,744.55 $389,385.33 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 3 — — $79,806.49 $384,600.08 $351,754.66 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 4 1 — — $241,652.69 $241,652.69 $241,652.69 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 3 — — $52,617.05 $253,569.87 $231,914.62 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 12 3 — — $48,788.01 $235,117.14 $215,037.78 2026-04-01
7 MS_DRG Lung Transplant 12 3 — — $48,665.12 $234,524.90 $214,496.12 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 4 1 — — $197,851.26 $197,851.26 $197,851.26 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 4 1 — — $196,243.70 $196,243.70 $196,243.70 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 3 — — $41,037.58 $197,766.59 $180,877.03 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 8 1 — — $28,440.00 $331,866.00 $180,153.00 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 3 — — $40,566.12 $195,494.54 $178,799.02 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 4 1 — — $176,344.84 $176,344.84 $176,344.84 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 12 3 — — $39,655.60 $191,106.59 $174,785.80 2026-04-01
215 MS_DRG Other Heart Assist System Implant 12 3 — — $39,453.01 $190,130.29 $173,892.88 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 3 — — $39,033.69 $188,109.50 $172,044.67 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 4 1 — — $165,495.02 $165,495.02 $165,495.02 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 4 1 — — $161,440.89 $161,440.89 $161,440.89 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 4 1 — — $159,043.67 $159,043.67 $159,043.67 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 3 — — $35,938.28 $173,192.25 $158,401.38 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 4 1 — — $158,117.07 $158,117.07 $158,117.07 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 4 1 — — $157,559.72 $157,559.72 $157,559.72 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $152,549.00 $152,549.00 $152,549.00 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 12 3 — — $34,303.07 $165,311.89 $151,194.00 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 1 — — $122,955.60 $176,375.50 $149,665.55 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 4 1 — — $147,677.69 $147,677.69 $147,677.69 2026-04-01
0424T OTHER Insj/rplc Nstim Apnea Compl 4 1 — — $143,531.45 $143,531.45 $143,531.45 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 3 — — $31,555.11 $152,069.06 $139,082.13 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 3 — — $31,537.24 $151,982.92 $139,003.35 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 3 — — $31,058.33 $149,674.98 $136,892.51 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 3 — — $30,017.46 $144,658.89 $132,304.81 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $131,808.37 $131,808.37 $131,808.37 2026-04-01
10 MS_DRG Pancreas Transplant 12 3 — — $29,690.12 $143,081.38 $130,862.02 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 3 — — $29,519.19 $142,257.63 $130,108.62 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 3 — — $29,106.20 $140,267.35 $128,288.31 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 3 — — $28,812.74 $138,853.15 $126,994.89 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 4 1 — — $123,725.66 $123,725.66 $123,725.66 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 3 — — $27,794.97 $133,948.34 $122,508.95 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 4 1 — — $122,459.74 $122,459.74 $122,459.74 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $122,040.58 $122,040.58 $122,040.58 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 4 1 — — $120,889.65 $120,889.65 $120,889.65 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 4 1 — — $120,665.89 $120,665.89 $120,665.89 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 4 1 — — $118,353.99 $118,353.99 $118,353.99 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 8 1 — — $64,481.96 $171,825.00 $118,153.48 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 4 1 — — $118,120.99 $118,120.99 $118,120.99 2026-04-01
0520T OTHER Rmvl&rplcmt Pg Wcs New Eltrd 4 1 — — $118,120.99 $118,120.99 $118,120.99 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 4 1 — — $117,764.26 $117,764.26 $117,764.26 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 4 1 — — $117,764.26 $117,764.26 $117,764.26 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 4 1 — — $117,764.26 $117,764.26 $117,764.26 2026-04-01
A9607 HCPCS Lutetium Lu 177 Vipivotide 8 1 — — $406.94 $235,071.75 $117,739.35 2026-04-01
0775T OTHER Arthrd Si Jt Prq Iartic Impl 4 1 — — $117,590.27 $117,590.27 $117,590.27 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 4 1 — — $117,574.81 $117,574.81 $117,574.81 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 8 1 — — $115,020.84 $118,712.98 $116,866.91 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 3 — — $26,435.70 $127,397.81 $116,517.85 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 3 — — $26,315.79 $126,819.93 $115,989.32 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 12 3 — — $25,906.15 $124,845.80 $114,183.78 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $114,175.04 $114,175.04 $114,175.04 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 12 3 — — $25,427.24 $122,537.86 $112,072.95 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 4 1 — — $112,042.47 $112,042.47 $112,042.47 2026-04-01
0816T OTHER Opn Insj/rplcmt Ins Ptn Subq 4 1 — — $112,042.47 $112,042.47 $112,042.47 2026-04-01
0817T OTHER Opn Insj/rplcmt Ins Ptn Subf 4 1 — — $112,042.47 $112,042.47 $112,042.47 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 1 — — $110,191.49 $110,191.49 $110,191.49 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 12 3 — — $24,966.57 $120,317.86 $110,042.54 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 12 3 — — $24,870.87 $119,856.64 $109,620.70 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 3 — — $24,828.79 $119,653.84 $109,435.22 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 12 3 — — $24,085.84 $116,073.48 $106,160.63 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 3 — — $24,047.49 $115,888.63 $105,991.57 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $105,292.10 $105,292.10 $105,292.10 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 12 3 — — $23,550.33 $113,492.76 $103,800.30 2026-04-01
81162 HCPCS Brca1&2 Seq & Full Dup/del 4 1 — — $101,705.33 $101,705.33 $101,705.33 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 3 — — $23,066.58 $111,161.49 $101,668.13 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 12 3 — — $23,036.79 $111,017.92 $101,536.82 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 3 — — $22,931.77 $110,511.82 $101,073.94 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 12 3 — — $22,853.19 $110,133.15 $100,727.61 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 3 — — $22,747.43 $109,623.46 $100,261.45 2026-04-01
0825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
0796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 4 1 — — $99,799.68 $99,799.68 $99,799.68 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 12 3 — — $22,638.69 $109,099.42 $99,782.17 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 12 3 — — $22,476.32 $108,316.95 $99,066.52 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 12 3 — — $22,476.32 $108,316.95 $99,066.52 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 3 — — $22,308.37 $107,507.55 $98,326.25 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 3 — — $22,154.57 $106,766.36 $97,648.35 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 3 — — $22,139.30 $106,692.77 $97,581.05 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 3 — — $21,911.39 $105,594.44 $96,576.52 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 12 3 — — $21,680.87 $104,483.54 $95,560.49 2026-04-01
27278 HCPCS Arthrd Si Jt Prq Wo Tfxj Dev 4 1 — — $95,450.46 $95,450.46 $95,450.46 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 3 — — $21,372.15 $102,995.77 $94,199.77 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 3 — — $21,244.42 $102,380.20 $93,636.77 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 4 1 — — $93,533.59 $93,533.59 $93,533.59 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 4 1 — — $93,517.91 $93,517.91 $93,517.91 2026-04-01
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 4 1 — — $93,219.82 $93,219.82 $93,219.82 2026-04-01
0426T OTHER Insj/rplc Nstim Apnea Stm Ld 4 1 — — $93,219.82 $93,219.82 $93,219.82 2026-04-01
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 4 1 — — $93,219.82 $93,219.82 $93,219.82 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 4 1 — — $93,034.23 $93,034.23 $93,034.23 2026-04-01
36837 HCPCS Prq Av Fstl Crt Uxtr Sep Acs 4 1 — — $92,243.71 $92,243.71 $92,243.71 2026-04-01
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 4 1 — — $92,243.71 $92,243.71 $92,243.71 2026-04-01
0645T OTHER Tcat Impltj C Sins Rdctj Dev 4 1 — — $92,243.71 $92,243.71 $92,243.71 2026-04-01
36836 HCPCS Prq Av Fstl Crtj Uxtr 1 Acs 4 1 — — $92,243.71 $92,243.71 $92,243.71 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 4 1 — — $91,830.38 $91,830.38 $91,830.38 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 4 1 — — $91,530.20 $91,530.20 $91,530.20 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 12 3 — — $20,758.43 $100,038.16 $91,494.75 2026-04-01
L5858 HCPCS Stance Phase Only 4 1 — — $91,025.85 $91,025.85 $91,025.85 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 3 — — $20,583.78 $99,196.46 $90,724.94 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 12 3 — — $20,582.29 $99,189.28 $90,718.37 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 3 — — $20,501.47 $98,799.84 $90,362.19 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $89,839.92 $89,839.92 $89,839.92 2026-04-01
0793T OTHER Prq Tcat Thrm Ablt Nrv P-art 4 1 — — $89,811.64 $89,811.64 $89,811.64 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 12 3 — — $20,370.76 $98,169.92 $89,786.06 2026-04-01
E0194 HCPCS Air Fluidized Bed 8 1 — — $15,597.17 $163,770.23 $89,683.70 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 12 3 — — $20,261.65 $97,644.08 $89,305.13 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 3 — — $20,215.47 $97,421.54 $89,101.59 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 3 — — $20,112.31 $96,924.42 $88,646.93 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 4 1 — — $88,646.51 $88,646.51 $88,646.51 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 12 3 — — $20,093.32 $96,832.89 $88,563.22 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 12 3 — — $20,090.72 $96,820.33 $88,551.73 2026-04-01
0632T OTHER Perq Tcat US Abltj Nrv P-art 4 1 — — $88,080.40 $88,080.40 $88,080.40 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 4 1 — — $88,039.70 $88,039.70 $88,039.70 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 3 — — $19,811.41 $95,474.33 $87,320.68 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $87,068.31 $87,068.31 $87,068.31 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 3 — — $19,723.53 $95,050.79 $86,933.31 2026-04-01
J9226 HCPCS Supprelin La Implant 8 1 — — $81,322.85 $92,462.93 $86,892.89 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 4 1 — — $86,890.09 $86,890.09 $86,890.09 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 1 — — $86,431.35 $86,431.35 $86,431.35 2026-04-01
61624 HCPCS Transcath Occlusion Cns 4 1 — — $86,263.68 $86,263.68 $86,263.68 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 4 1 — — $86,263.68 $86,263.68 $86,263.68 2026-04-01
C9774 HCPCS Revasc Lithotr-ather Tib/per 4 1 — — $86,263.68 $86,263.68 $86,263.68 2026-04-01
C9767 HCPCS Revasc Lithotrip-stent-ather 4 1 — — $86,263.68 $86,263.68 $86,263.68 2026-04-01
C9773 HCPCS Revasc Lithotr-stent Tib/per 4 1 — — $86,263.68 $86,263.68 $86,263.68 2026-04-01
C9775 HCPCS Revasc Lith-sten-ath Tib/per 4 1 — — $86,263.68 $86,263.68 $86,263.68 2026-04-01
22857 HCPCS Lumbar Artif Diskectomy 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22862 HCPCS Revise Lumbar Artif Disc 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
20802 HCPCS Replantation Arm Complete 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22849 HCPCS Reinsert Spinal Fixation 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22818 HCPCS Kyphectomy 1-2 Segments 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22819 HCPCS Kyphectomy 3 Or More 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
20805 HCPCS Replant Forearm Complete 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22810 HCPCS Ant Fusion 4-7 Vert Seg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27591 HCPCS Amputate Leg At Thigh 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27592 HCPCS Amputate Leg At Thigh 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
20808 HCPCS Replantation Hand Complete 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22600 HCPCS Neck Spine Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22808 HCPCS Ant Fusion 2-3 Vert Seg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22812 HCPCS Ant Fusion 8/> Vert Seg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22800 HCPCS Post Fusion <=6 Vert Seg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27590 HCPCS Amputate Leg At Thigh 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27295 HCPCS Amputation Of Leg At Hip 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22802 HCPCS Post Fusion 7-12 Vert Seg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27280 HCPCS Fusion Of Sacroiliac Joint 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27284 HCPCS Fusion Of Hip Joint 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22610 HCPCS Thorax Spine Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22590 HCPCS Spine & Skull Spinal Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
20838 HCPCS Replantation Foot Complete 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22533 HCPCS Lat Lumbar Spine Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27880 HCPCS Amputation Of Lower Leg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22532 HCPCS Lat Thorax Spine Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22556 HCPCS Thorax Spine Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27286 HCPCS Fusion Of Hip Joint 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22548 HCPCS Neck Spine Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22595 HCPCS Neck Spinal Fusion 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
22804 HCPCS Post Fusion 13/> Vert Seg 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
27290 HCPCS Amputation Of Leg At Hip 4 1 — — $85,211.86 $85,211.86 $85,211.86 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 12 3 — — $19,177.59 $92,419.81 $84,527.02 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 12 3 — — $19,114.65 $92,116.51 $84,249.63 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 3 — — $18,971.28 $91,425.57 $83,617.69 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 3 — — $18,913.18 $91,145.60 $83,361.63 2026-04-01
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 4 1 — — $83,350.78 $83,350.78 $83,350.78 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 12 3 — — $18,756.03 $90,388.25 $82,668.96 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 4 1 — — $82,453.67 $82,453.67 $82,453.67 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 3 — — $18,645.42 $89,855.24 $82,181.46 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 3 — — $18,630.90 $89,785.25 $82,117.45 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 3 — — $18,625.69 $89,760.12 $82,094.47 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 3 — — $18,556.42 $89,426.31 $81,789.17 2026-04-01
245 MS_DRG Aicd Generator Procedures 12 3 — — $18,197.42 $87,696.26 $80,206.86 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 12 3 — — $18,087.57 $87,166.83 $79,722.65 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 4 1 — — $79,612.08 $79,612.08 $79,612.08 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 12 3 — — $18,057.40 $87,021.46 $79,589.70 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 4 1 — — $79,380.09 $79,380.09 $79,380.09 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 4 1 — — $79,380.09 $79,380.09 $79,380.09 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 4 1 — — $79,380.09 $79,380.09 $79,380.09 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 1 — — $79,285.40 $79,285.40 $79,285.40 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 4 1 — — $78,961.18 $78,961.18 $78,961.18 2026-04-01
22869 HCPCS Insj Stablj Dev Without Dcmprn 4 1 — — $78,961.18 $78,961.18 $78,961.18 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 12 3 — — $17,782.94 $85,698.80 $78,379.99 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 12 3 — — $17,705.85 $85,327.30 $78,040.22 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 3 — — $17,705.11 $85,323.71 $78,036.94 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 3 — — $17,519.28 $84,428.17 $77,217.88 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 4 1 — — $77,132.59 $77,132.59 $77,132.59 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 4 1 — — $77,132.59 $77,132.59 $77,132.59 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 12 3 — — $17,425.43 $83,975.92 $76,804.25 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 3 — — $17,324.89 $83,491.36 $76,361.07 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 12 3 — — $17,163.64 $82,714.27 $75,650.35 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 12 3 — — $17,156.56 $82,680.17 $75,619.16 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 3 — — $17,101.82 $82,416.35 $75,377.87 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 12 3 — — $17,099.58 $82,405.59 $75,368.03 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 4 1 — — $75,120.34 $75,120.34 $75,120.34 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 4 1 — — $74,636.07 $74,636.07 $74,636.07 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 12 3 — — $16,800.17 $80,962.68 $74,048.34 2026-04-01
L5969 HCPCS Ak/ft Power Asst Incl Motors 4 1 — — $74,010.20 $74,010.20 $74,010.20 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 12 3 — — $16,700.00 $80,479.91 $73,606.81 2026-04-01
K0606 HCPCS Aed Garment W Elec Analysis 8 1 — — $12,789.25 $134,287.11 $73,538.18 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 12 3 — — $16,653.82 $80,257.37 $73,403.27 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 12 3 — — $16,498.15 $79,507.20 $72,717.17 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 12 3 — — $16,357.76 $78,830.62 $72,098.36 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 4 1 — — $71,168.72 $71,168.72 $71,168.72 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 12 3 — — $16,112.72 $77,649.73 $71,018.32 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 3 — — $16,079.20 $77,488.21 $70,870.60 2026-04-01
69729 HCPCS Impl Oi Implt Sk Tc Esp>=100 4 1 — — $70,068.19 $70,068.19 $70,068.19 2026-04-01
69730 HCPCS Rplc Oi Implt Sk Tc Esp>=100 4 1 — — $70,068.19 $70,068.19 $70,068.19 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 12 3 — — $15,884.43 $76,549.60 $70,012.15 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 12 3 — — $15,861.35 $76,438.33 $69,910.38 2026-04-01
33288 HCPCS Rmv&rplcmt Phrnc Nrv Stim Ld 4 1 — — $69,769.51 $69,769.51 $69,769.51 2026-04-01
64596 HCPCS Ins/rplcmt Prq Eltrd Ra Pn 1 4 1 — — $69,769.51 $69,769.51 $69,769.51 2026-04-01
0784T OTHER Ins/rplmt Eltrd Ra Spi Nstim 4 1 — — $69,769.51 $69,769.51 $69,769.51 2026-04-01
0786T OTHER Insj/rplcmt Prq Ra Sac Nstim 4 1 — — $69,769.51 $69,769.51 $69,769.51 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 12 3 — — $15,748.88 $75,896.34 $69,414.68 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 12 3 — — $15,604.76 $75,201.81 $68,779.46 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 12 3 — — $15,603.64 $75,196.42 $68,774.53 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 12 3 — — $15,531.40 $74,848.26 $68,456.10 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 3 — — $15,493.41 $74,665.20 $68,288.68 2026-04-01
69719 HCPCS Revj/rplcmt Oi Implt Tc Esp 4 1 — — $67,625.97 $67,625.97 $67,625.97 2026-04-01
64628 HCPCS Trml Dstrj Ios Bvn 1st 2 L/s 4 1 — — $67,625.97 $67,625.97 $67,625.97 2026-04-01
69716 HCPCS Impltj Oi Implt Skl Tc Esp 4 1 — — $67,625.97 $67,625.97 $67,625.97 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 3 — — $15,312.43 $73,792.99 $67,490.96 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 12 3 — — $15,303.86 $73,751.72 $67,453.21 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 12 3 — — $15,281.14 $73,642.24 $67,353.08 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 4 1 — — $67,127.69 $67,127.69 $67,127.69 2026-04-01
C9790 HCPCS Kidney Histotripsy W/image 4 1 — — $67,127.69 $67,127.69 $67,127.69 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 4 1 — — $67,127.69 $67,127.69 $67,127.69 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 12 3 — — $15,205.92 $73,279.72 $67,021.52 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 3 — — $15,145.96 $72,990.78 $66,757.26 2026-04-01
791 MS_DRG Prematurity With Major Problems 12 3 — — $15,119.89 $72,865.15 $66,642.36 2026-04-01
27712 HCPCS Realignment Of Lower Leg 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27715 HCPCS Revision Of Lower Leg 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27703 HCPCS Reconstruction Ankle Joint 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22865 HCPCS Remove Lumb Artif Disc 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
0220T OTHER Plmt Post Facet Implt Thor 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22850 HCPCS Remove Spine Fixation Device 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22852 HCPCS Remove Spine Fixation Device 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22855 HCPCS Remove Spine Fixation Device 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
0627T OTHER Perq Njx Algc Fluor Lmbr 1st 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22327 HCPCS Treat Thorax Spine Fracture 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27077 HCPCS Resect Hip Tum W/innom Bone 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22830 HCPCS Exploration Of Spinal Fusion 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27598 HCPCS Amputate Lower Leg At Knee 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
0629T OTHER Perq Njx Algc CT Lmbr 1st 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27580 HCPCS Fusion Of Knee 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27486 HCPCS Revise/replace Knee Joint 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27487 HCPCS Revise/replace Knee Joint 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27132 HCPCS Total Hip Arthroplasty 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22319 HCPCS Treat Odontoid Fx W/graft 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27078 HCPCS Rsect Hip Tum Incl Femur 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
25905 HCPCS Amputation Of Forearm 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27125 HCPCS Partial Hip Replacement 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27445 HCPCS Revision Of Knee Joint 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
23900 HCPCS Amputation Of Arm & Girdle 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
0202T OTHER Post Vert Arthrplst 1 Lumbar 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
0219T OTHER Plmt Post Facet Implt Cerv 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
23920 HCPCS Amputation At Shoulder Joint 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27120 HCPCS Reconstruction Of Hip Socket 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27282 HCPCS Fusion Of Pubic Bones 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22318 HCPCS Treat Odontoid Fx Without Graft 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27122 HCPCS Reconstruction Of Hip Socket 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
24940 HCPCS Revision Of Upper Arm 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27176 HCPCS Treat Slipped Epiphysis 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
24920 HCPCS Amputation Of Upper Arm 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27888 HCPCS Amputation Of Foot At Ankle 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
24900 HCPCS Amputation Of Upper Arm 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
24931 HCPCS Amputate Upper Arm & Implant 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
25900 HCPCS Amputation Of Forearm 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22325 HCPCS Treat Spine Fracture 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
22326 HCPCS Treat Neck Spine Fracture 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27134 HCPCS Revise Hip Joint Replacement 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27137 HCPCS Revise Hip Joint Replacement 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27138 HCPCS Revise Hip Joint Replacement 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27140 HCPCS Transplant Femur Ridge 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
27130 HCPCS Total Hip Arthroplasty 4 1 — — $66,130.26 $66,130.26 $66,130.26 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 4 1 — — $65,567.66 $65,567.66 $65,567.66 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 12 3 — — $14,834.63 $71,490.44 $65,385.05 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 12 3 — — $14,824.21 $71,440.19 $65,339.09 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 4 1 — — $65,200.18 $65,200.18 $65,200.18 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 4 1 — — $65,200.18 $65,200.18 $65,200.18 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 8 1 — — $54,186.88 $75,404.25 $64,795.57 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 12 3 — — $14,696.10 $70,822.83 $64,774.45 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 12 3 — — $14,662.58 $70,661.31 $64,626.72 2026-04-01
See an error in this hospital's data? Submit a correction