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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

Memorial Hospital For Cancer And Allied Diseases

Basking Ridge, NY · CCN 330154 · Rates published

19,327 distinct procedures filed
27 distinct payers
1,706,963 rate rows
2025-12-01 last MRF observed
Data quality

1,678,947 of 1,706,963 rate rows are consumer-grade (98.4%)

28,016 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
template filing: same amount across many unrelated codes — excluded 11,567
per-diem day rate — not a per-procedure price 10,466
exceeds 10× this hospital's gross charge — excluded from medians 4,973
placeholder amount (≤ $0.02) — excluded from medians 1,009
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.mskcc.org/hpt/16/131924236_memorial-hospital-for-cancer-and-allied-diseases-northern-nj_standardcharges.json
Found on page https://www.mskcc.org/insurance-assistance/understanding-cost-your-care-msk/download
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-18
Content fingerprint 0c06a1456bd40082… · 110,338,382 bytes · first seen 2026-05-13

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
J3392
HCPCS 		Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 9 $1,554,120.00 $3,777,840.00 $2,728,440.00 nat. median
$2,448,600
1.1× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2.68x 10exp9 To 10x 10exp9 Cell IV Suspension 12 $513,566.00 $1,248,404.40 $1,017,588.30 nat. median
$824,563
1.2× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 12 $392,282.00 $953,579.05 $763,923.08 nat. median
$674,867
1.1× median
Q2054
HCPCS 		Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 12 $375,356.00 $912,434.85 $743,735.78 nat. median
$673,137
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension 12 $373,210.00 $907,218.14 $739,483.59 nat. median
$625,184
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Intravenous Suspension 12 $355,738.00 $864,747.58 $704,865.36 nat. median
$634,303
1.1× median
Q2055
CPT 		Idecabtagene Vicleucel Inj 1 Dose (007300) 10 $380,384.92 $855,866.08 $671,379.39 nat. median
$625,184
1.1× median
Q2056
CPT 		Ciltacabtagene Autoleucel Inj 1 Dose (007558) 10 $365,534.64 $822,452.94 $662,988.46 nat. median
$674,867
1.0× median
Q2054
CPT 		Lisocabtagene Maraleucel Inj 1 Dose (007137) 10 $372,042.79 $837,096.27 $656,655.52 nat. median
$673,137
1.0× median
Q2041
CPT 		Axicabtagene Inj 1 Dose (006256) 10 $352,598.40 $793,346.40 $623,013.56 nat. median
$634,303
1.0× median
Q2042
HCPCS 		Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 12 $287,823.00 $849,346.22 $606,367.16 nat. median
$753,246
0.8× median
Q2053
CPT 		Brexucabtagene Autoleucel Inj 1 Dose (006923) 10 $323,596.80 $728,092.80 $586,923.69 nat. median
$619,808
0.9× median
Q2042
CPT 		Tisagenlecleucel Inj 1 Dose (peds) (006257) 10 $271,602.34 $778,217.16 $529,624.56 nat. median
$753,246
0.7× median
C9399
HCPCS 		Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension 13 $40.80 $736,965.00 $524,064.00 nat. median
$2,475
outlier · 211.7×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $21,043.80 $907,759.35 $522,521.97 nat. median
$202,976
outlier · 2.6×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $21,043.80 $741,331.00 $372,238.50 nat. median
$117,357
outlier · 3.2×
Q2058
HCPCS 		Obecabtagene Autoleucel Intravenous Suspension (10 X 10^6 Cells) Second Infusion 12 $185,435.00 $450,765.00 $355,603.50 nat. median
$324,450
1.1× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $21,043.80 $592,396.68 $340,993.77 nat. median
$133,161
outlier · 2.6×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 8 $21,043.80 $425,840.00 $305,793.77 nat. median
$56,918
outlier · 5.4×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 $194,724.48 $385,322.57 $240,051.78 nat. median
$82,711
outlier · 2.9×
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $187,157.77 $370,349.50 $230,723.71 nat. median
$83,470
outlier · 2.8×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $21,043.80 $359,396.61 $206,874.90 nat. median
$81,118
outlier · 2.6×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $156,015.60 $308,725.08 $192,332.38 nat. median
$68,090
outlier · 2.8×
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 3 $21,043.80 $395,194.00 $185,286.50 nat. median
$53,807
outlier · 3.4×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 $144,409.42 $285,758.67 $178,024.55 nat. median
$63,724
outlier · 2.8×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 4 $21,043.80 $295,603.86 $170,154.70 nat. median
$66,526
outlier · 2.6×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $21,043.80 $1,846,841.99 $169,692.00 nat. median
$370,174
outlier · 0.5×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 4 $21,043.80 $275,199.25 $158,409.45 nat. median
$62,134
outlier · 2.5×
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 $124,644.33 $246,647.33 $153,658.61 nat. median
$54,592
outlier · 2.8×
28
MS_DRG 		Spinal Procedures With Mcc 4 $21,043.80 $256,962.97 $147,912.33 nat. median
$57,822
outlier · 2.6×
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $21,043.80 $255,029.86 $146,799.60 nat. median
$58,020
outlier · 2.5×
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 $21,043.80 $250,825.77 $144,379.65 nat. median
$56,696
outlier · 2.5×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 $21,043.80 $245,073.47 $141,068.52 nat. median
$55,916
outlier · 2.5×
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 4 $21,043.80 $243,756.22 $140,310.29 nat. median
$52,746
outlier · 2.7×
834
MS_DRG 		Acute Leukemia With Mcc 4 $21,043.80 $234,792.04 $135,150.35 nat. median
$53,172
outlier · 2.5×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 4 $21,043.80 $233,962.34 $134,672.77 nat. median
$52,836
outlier · 2.5×
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 $21,043.80 $233,260.95 $134,269.04 nat. median
$52,857
outlier · 2.5×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 4 $21,043.80 $229,262.14 $131,967.25 nat. median
$55,736
outlier · 2.4×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 $21,043.80 $226,405.24 $130,322.76 nat. median
$54,045
outlier · 2.4×
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 4 $21,043.80 $225,656.80 $129,891.95 nat. median
$51,307
outlier · 2.5×
653
MS_DRG 		Major Bladder Procedures With Mcc 4 $21,043.80 $222,239.64 $127,924.98 nat. median
$51,418
outlier · 2.5×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 4 $21,043.80 $213,301.12 $122,779.81 nat. median
$48,178
outlier · 2.5×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 $21,043.80 $211,214.04 $121,578.45 nat. median
$48,170
outlier · 2.5×
576
MS_DRG 		Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 $21,043.80 $209,614.52 $120,657.74 nat. median
$49,182
outlier · 2.5×
837
MS_DRG 		Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 $21,043.80 $205,470.30 $118,272.26 nat. median
$47,311
outlier · 2.5×
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 $21,043.80 $200,658.90 $115,502.74 nat. median
$46,084
outlier · 2.5×
826
MS_DRG 		Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r.… 4 $21,043.80 $200,060.15 $115,158.08 nat. median
$46,259
outlier · 2.5×
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 4 $21,043.80 $196,583.11 $113,156.64 nat. median
$44,810
outlier · 2.5×
448
MS_DRG 		Multiple Level Spinal Fusion Except Cervical Without Mcc 3 $91,656.41 $181,370.53 $112,991.88 nat. median
$41,164
outlier · 2.7×
823
MS_DRG 		Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 $21,043.80 $196,082.73 $112,868.61 nat. median
$45,112
outlier · 2.5×

Other procedures at this hospital

Browse this hospital's 19,327 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
             
100 MS_DRG Seizures With Mcc 8 4 — — $21,043.80 $82,833.06 $47,680.15 2025-12-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 8 4 — — $21,043.80 $233,260.95 $134,269.04 2025-12-01
115 MS_DRG Extraocular Procedures Except Orbit 8 4 — — $21,043.80 $65,644.60 $37,786.17 2025-12-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 8 4 — — $21,043.80 $180,309.89 $103,789.49 2025-12-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 8 4 — — $21,043.80 $123,248.82 $70,944.15 2025-12-01
137 MS_DRG Mouth Procedures With Cc/mcc 8 4 — — $21,043.80 $63,861.18 $36,759.60 2025-12-01
14 MS_DRG Allogeneic Bone Marrow Transplant 18 8 — — $21,043.80 $741,331.00 $372,238.50 2025-12-01
140 MS_DRG Major Head And Neck Procedures With Mcc 8 4 — — $21,043.80 $182,418.35 $105,003.15 2025-12-01
141 MS_DRG Major Head And Neck Procedures With Cc 8 4 — — $21,043.80 $93,281.28 $53,694.32 2025-12-01
142 MS_DRG Major Head And Neck Procedures Without Cc/mcc 8 4 — — $21,043.80 $68,274.84 $39,300.18 2025-12-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 8 4 — — $21,043.80 $160,234.59 $92,233.80 2025-12-01
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 8 4 — — $21,043.80 $74,112.67 $42,660.54 2025-12-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 8 4 — — $21,043.80 $90,556.96 $52,126.15 2025-12-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 8 4 — — $21,043.80 $66,867.77 $38,490.24 2025-12-01
157 MS_DRG Dental And Oral Diseases With Mcc 8 4 — — $21,043.80 $73,424.10 $42,264.18 2025-12-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 18 8 — — $21,043.80 $425,840.00 $305,793.77 2025-12-01
163 MS_DRG Major Chest Procedures With Mcc 8 4 — — $21,043.80 $191,677.62 $110,332.96 2025-12-01
164 MS_DRG Major Chest Procedures With Cc 8 4 — — $21,043.80 $107,946.43 $62,135.83 2025-12-01
165 MS_DRG Major Chest Procedures Without Cc/mcc 8 4 — — $21,043.80 $81,866.51 $47,123.78 2025-12-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 8 4 — — $21,043.80 $159,853.95 $92,014.70 2025-12-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 8 4 — — $21,043.80 $77,127.81 $44,396.10 2025-12-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 8 3 — — $21,043.80 $395,194.00 $185,286.50 2024-09-15
177 MS_DRG Respiratory Infections And Inflammations With Mcc 8 4 — — $21,043.80 $66,833.55 $38,470.54 2025-12-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 8 4 — — $21,043.80 $191,677.62 $110,332.96 2025-12-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 6 — — $21,043.80 $1,846,841.99 $169,692.00 2025-12-01
180 MS_DRG Respiratory Neoplasms With Mcc 8 4 — — $21,043.80 $75,528.29 $43,475.38 2025-12-01
183 MS_DRG Major Chest Trauma With Mcc 8 4 — — $21,043.80 $65,430.76 $37,663.07 2025-12-01
186 MS_DRG Pleural Effusion With Mcc 8 4 — — $21,043.80 $66,653.93 $38,367.15 2025-12-01
196 MS_DRG Interstitial Lung Disease With Mcc 8 4 — — $21,043.80 $80,711.77 $46,459.09 2025-12-01
199 MS_DRG Pneumothorax With Mcc 8 4 — — $21,043.80 $75,447.03 $43,428.62 2025-12-01
205 MS_DRG Other Respiratory System Diagnoses With Mcc 8 4 — — $21,043.80 $78,308.21 $45,075.56 2025-12-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 8 4 — — $21,043.80 $275,199.25 $158,409.45 2025-12-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 8 4 — — $21,043.80 $117,556.40 $67,667.50 2025-12-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 8 4 — — $21,043.80 $226,405.24 $130,322.76 2025-12-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 4 — — $21,043.80 $245,073.47 $141,068.52 2025-12-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 8 4 — — $21,043.80 $194,453.27 $111,930.66 2025-12-01
252 MS_DRG Other Vascular Procedures With Mcc 8 4 — — $21,043.80 $149,187.61 $85,874.97 2025-12-01
253 MS_DRG Other Vascular Procedures With Cc 8 4 — — $21,043.80 $111,008.62 $63,898.48 2025-12-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 8 4 — — $21,043.80 $132,974.27 $76,542.29 2025-12-01
263 MS_DRG Vein Ligation And Stripping 8 4 — — $21,043.80 $130,758.88 $75,267.07 2025-12-01
264 MS_DRG Other Circulatory System O.r. Procedures 8 4 — — $21,043.80 $142,870.78 $82,238.89 2025-12-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 8 4 — — $21,043.80 $107,899.39 $62,108.76 2025-12-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 8 4 — — $21,043.80 $225,656.80 $129,891.95 2025-12-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 8 4 — — $21,043.80 $152,095.84 $87,548.99 2025-12-01
28 MS_DRG Spinal Procedures With Mcc 8 4 — — $21,043.80 $256,962.97 $147,912.33 2025-12-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 8 4 — — $21,043.80 $68,604.15 $39,489.74 2025-12-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 8 4 — — $21,043.80 $115,738.76 $66,621.24 2025-12-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 8 4 — — $21,043.80 $145,907.31 $83,986.77 2025-12-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 8 4 — — $21,043.80 $69,827.31 $40,193.81 2025-12-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 4 — — $21,043.80 $907,759.35 $522,521.97 2025-12-01
30 MS_DRG Spinal Procedures Without Cc/mcc 8 4 — — $21,043.80 $93,884.31 $54,041.43 2025-12-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 8 4 — — $21,043.80 $191,622.02 $110,300.95 2025-12-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 8 4 — — $21,043.80 $89,179.83 $51,333.45 2025-12-01
32 MS_DRG Ventricular Shunt Procedures With Cc 8 4 — — $21,043.80 $91,138.61 $52,460.96 2025-12-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 8 4 — — $21,043.80 $213,301.12 $122,779.81 2025-12-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 8 4 — — $21,043.80 $104,533.55 $60,171.32 2025-12-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 8 4 — — $21,043.80 $68,527.17 $39,445.43 2025-12-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 8 4 — — $21,043.80 $196,583.11 $113,156.64 2025-12-01
33 MS_DRG Ventricular Shunt Procedures Without Cc/mcc 8 4 — — $21,043.80 $71,118.91 $40,937.27 2025-12-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 8 4 — — $21,043.80 $102,523.45 $59,014.27 2025-12-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 8 4 — — $21,043.80 $71,974.27 $41,429.64 2025-12-01
332 MS_DRG Rectal Resection With Mcc 8 4 — — $21,043.80 $154,850.10 $89,134.39 2025-12-01
333 MS_DRG Rectal Resection With Cc 8 4 — — $21,043.80 $100,171.21 $57,660.28 2025-12-01
334 MS_DRG Rectal Resection Without Cc/mcc 8 4 — — $21,043.80 $70,049.71 $40,321.82 2025-12-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 8 4 — — $21,043.80 $152,720.25 $87,908.41 2025-12-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 8 4 — — $21,043.80 $90,184.88 $51,911.98 2025-12-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc/mcc 8 4 — — $21,043.80 $65,648.88 $37,788.63 2025-12-01
345 MS_DRG Minor Small And Large Bowel Procedures With Cc 8 4 — — $21,043.80 $64,353.01 $37,042.71 2025-12-01
351 MS_DRG Inguinal And Femoral Hernia Procedures With Cc 8 4 — — $21,043.80 $65,199.82 $37,530.14 2025-12-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 8 4 — — $21,043.80 $124,112.74 $71,441.43 2025-12-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 8 4 — — $21,043.80 $71,952.88 $41,417.32 2025-12-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 8 4 — — $21,043.80 $187,871.27 $108,141.95 2025-12-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 8 4 — — $21,043.80 $99,456.98 $57,249.16 2025-12-01
368 MS_DRG Major Esophageal Disorders With Mcc 8 4 — — $21,043.80 $68,082.38 $39,189.40 2025-12-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 8 4 — — $21,043.80 $75,831.94 $43,650.18 2025-12-01
374 MS_DRG Digestive Malignancy With Mcc 8 4 — — $21,043.80 $91,467.92 $52,650.52 2025-12-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 8 4 — — $21,043.80 $78,179.90 $45,001.71 2025-12-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 8 4 — — $21,043.80 $83,919.37 $48,305.44 2025-12-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 8 4 — — $21,043.80 $67,671.81 $38,953.07 2025-12-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 8 4 — — $21,043.80 $68,398.86 $39,371.57 2025-12-01
397 MS_DRG Appendix Procedures With Mcc 8 4 — — $21,043.80 $102,425.08 $58,957.65 2025-12-01
398 MS_DRG Appendix Procedures With Cc 8 4 — — $21,043.80 $64,733.64 $37,261.81 2025-12-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 4 — — $21,043.80 $592,396.68 $340,993.77 2025-12-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 8 4 — — $21,043.80 $165,135.80 $95,055.02 2025-12-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 8 4 — — $21,043.80 $233,962.34 $134,672.77 2025-12-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 8 4 — — $21,043.80 $124,035.75 $71,397.12 2025-12-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 8 4 — — $21,043.80 $94,927.85 $54,642.11 2025-12-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 4 — — $21,043.80 $152,493.58 $87,777.94 2025-12-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 4 — — $21,043.80 $93,118.77 $53,600.77 2025-12-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 8 4 — — $21,043.80 $94,034.00 $54,127.60 2025-12-01
410 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 4 — — $21,043.80 $67,902.75 $39,086.00 2025-12-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 8 4 — — $21,043.80 $152,365.28 $87,704.09 2025-12-01
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 8 4 — — $21,043.80 $88,388.63 $50,878.02 2025-12-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 8 4 — — $21,043.80 $72,346.35 $41,643.81 2025-12-01
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 8 4 — — $21,043.80 $74,309.40 $42,773.77 2025-12-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 8 4 — — $21,043.80 $177,615.50 $102,238.55 2025-12-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 8 4 — — $21,043.80 $93,572.11 $53,861.73 2025-12-01
425 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures Without Cc/mcc 8 4 — — $21,043.80 $64,164.83 $36,934.38 2025-12-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 3 — — $156,015.60 $308,725.08 $192,332.38 2025-12-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 3 — — $194,724.48 $385,322.57 $240,051.78 2025-12-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 3 — — $124,644.33 $246,647.33 $153,658.61 2025-12-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 8 4 — — $21,043.80 $84,175.98 $48,453.15 2025-12-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 8 4 — — $21,043.80 $78,551.99 $45,215.88 2025-12-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 8 4 — — $21,043.80 $69,720.39 $40,132.26 2025-12-01
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 8 4 — — $21,043.80 $76,755.73 $44,181.93 2025-12-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 8 4 — — $21,043.80 $71,461.05 $41,134.21 2025-12-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 3 — — $144,409.42 $285,758.67 $178,024.55 2025-12-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 6 3 — — $91,656.41 $181,370.53 $112,991.88 2025-12-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 6 3 — — $69,818.64 $138,157.75 $86,070.78 2025-12-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $21,043.80 $359,396.61 $206,874.90 2025-12-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $21,043.80 $255,029.86 $146,799.60 2025-12-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 4 — — $21,043.80 $178,453.76 $102,721.07 2025-12-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 8 4 — — $21,043.80 $229,262.14 $131,967.25 2025-12-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 8 4 — — $21,043.80 $113,762.88 $65,483.88 2025-12-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 4 — — $21,043.80 $243,756.22 $140,310.29 2025-12-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 4 — — $21,043.80 $133,209.49 $76,677.68 2025-12-01
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 8 4 — — $21,043.80 $77,996.00 $44,895.85 2025-12-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 8 4 — — $21,043.80 $150,825.63 $86,817.84 2025-12-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 8 4 — — $21,043.80 $117,526.46 $67,650.26 2025-12-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 8 4 — — $21,043.80 $129,723.90 $74,671.32 2025-12-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 8 4 — — $21,043.80 $82,495.20 $47,485.66 2025-12-01
472 MS_DRG Cervical Spinal Fusion With Cc 8 4 — — $21,043.80 $125,998.80 $72,527.09 2025-12-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 8 4 — — $21,043.80 $104,409.52 $60,099.92 2025-12-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 8 4 — — $21,043.80 $97,327.14 $56,023.18 2025-12-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 8 4 — — $21,043.80 $147,746.33 $85,045.34 2025-12-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 8 4 — — $21,043.80 $105,175.07 $60,540.58 2025-12-01
479 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/mcc 8 4 — — $21,043.80 $79,501.44 $45,762.40 2025-12-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 8 4 — — $21,043.80 $124,553.25 $71,695.01 2025-12-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 8 4 — — $21,043.80 $89,577.58 $51,562.40 2025-12-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 8 4 — — $21,043.80 $69,754.61 $40,151.96 2025-12-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 8 4 — — $21,043.80 $118,548.62 $68,238.64 2025-12-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 8 4 — — $21,043.80 $157,026.99 $90,387.45 2025-12-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 8 4 — — $21,043.80 $108,463.92 $62,433.71 2025-12-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 8 4 — — $21,043.80 $85,813.99 $49,396.02 2025-12-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 8 4 — — $21,043.80 $155,063.94 $89,257.48 2025-12-01
496 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 8 4 — — $21,043.80 $77,149.20 $44,408.41 2025-12-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 8 4 — — $21,043.80 $129,022.50 $74,267.58 2025-12-01
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 8 4 — — $21,043.80 $86,168.97 $49,600.35 2025-12-01
500 MS_DRG Soft Tissue Procedures With Mcc 8 4 — — $21,043.80 $135,352.17 $77,911.05 2025-12-01
501 MS_DRG Soft Tissue Procedures With Cc 8 4 — — $21,043.80 $74,762.74 $43,034.73 2025-12-01
504 MS_DRG Foot Procedures With Cc 8 4 — — $21,043.80 $79,941.95 $46,015.96 2025-12-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 8 4 — — $21,043.80 $88,931.78 $51,190.67 2025-12-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 8 4 — — $21,043.80 $136,297.34 $78,455.11 2025-12-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 8 4 — — $21,043.80 $88,876.18 $51,158.66 2025-12-01
517 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures Without Cc/mc… 8 4 — — $21,043.80 $65,721.59 $37,830.48 2025-12-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 8 4 — — $21,043.80 $159,836.85 $92,004.86 2025-12-01
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 8 4 — — $21,043.80 $85,544.55 $49,240.92 2025-12-01
520 MS_DRG Back And Neck Procedures Except Spinal Fusion Without Cc/mcc 8 4 — — $21,043.80 $63,891.12 $36,776.83 2025-12-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 8 4 — — $21,043.80 $122,752.71 $70,658.58 2025-12-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 8 4 — — $21,043.80 $90,569.79 $52,133.54 2025-12-01
539 MS_DRG Osteomyelitis With Mcc 8 4 — — $21,043.80 $84,240.13 $48,490.07 2025-12-01
54 MS_DRG Nervous System Neoplasms With Mcc 8 4 — — $21,043.80 $65,302.46 $37,589.23 2025-12-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 8 4 — — $21,043.80 $75,549.67 $43,487.70 2025-12-01
544 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 8 4 — — $21,043.80 $147,746.33 $85,045.34 2025-12-01
545 MS_DRG Connective Tissue Disorders With Mcc 8 4 — — $21,043.80 $106,137.35 $61,094.49 2025-12-01
551 MS_DRG Medical Back Problems With Mcc 8 4 — — $21,043.80 $71,683.44 $41,262.23 2025-12-01
557 MS_DRG Tendonitis, Myositis And Bursitis With Mcc 8 4 — — $21,043.80 $63,591.74 $36,604.50 2025-12-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 8 4 — — $21,043.80 $79,758.04 $45,910.10 2025-12-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 8 4 — — $21,043.80 $99,354.34 $57,190.07 2025-12-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 8 4 — — $21,043.80 $66,016.68 $38,000.35 2025-12-01
570 MS_DRG Skin Debridement With Mcc 8 4 — — $21,043.80 $125,784.96 $72,404.00 2025-12-01
571 MS_DRG Skin Debridement With Cc 8 4 — — $21,043.80 $72,256.54 $41,592.11 2025-12-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 8 4 — — $21,043.80 $209,614.52 $120,657.74 2025-12-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 8 4 — — $21,043.80 $113,365.14 $65,254.93 2025-12-01
578 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/mcc 8 4 — — $21,043.80 $68,702.52 $39,546.35 2025-12-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 8 4 — — $21,043.80 $138,504.17 $79,725.39 2025-12-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 8 4 — — $21,043.80 $73,903.10 $42,539.90 2025-12-01
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 8 4 — — $21,043.80 $82,396.83 $47,429.04 2025-12-01
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 8 4 — — $21,043.80 $73,749.14 $42,451.28 2025-12-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 8 4 — — $21,043.80 $91,553.46 $52,699.75 2025-12-01
585 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures Without Cc/mcc 8 4 — — $21,043.80 $82,503.75 $47,490.58 2025-12-01
595 MS_DRG Major Skin Disorders With Mcc 8 4 — — $21,043.80 $90,698.10 $52,207.39 2025-12-01
597 MS_DRG Malignant Breast Disorders With Mcc 8 4 — — $21,043.80 $71,298.53 $41,040.67 2025-12-01
606 MS_DRG Minor Skin Disorders With Mcc 8 4 — — $21,043.80 $64,716.54 $37,251.96 2025-12-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 8 4 — — $21,043.80 $93,738.90 $53,957.74 2025-12-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 8 4 — — $21,043.80 $149,149.12 $85,852.81 2025-12-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 8 4 — — $21,043.80 $129,163.64 $74,348.83 2025-12-01
626 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Cc 8 4 — — $21,043.80 $64,126.34 $36,912.23 2025-12-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 8 4 — — $21,043.80 $93,182.92 $53,637.69 2025-12-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 8 4 — — $21,043.80 $86,006.45 $49,506.79 2025-12-01
643 MS_DRG Endocrine Disorders With Mcc 8 4 — — $21,043.80 $70,400.40 $40,523.69 2025-12-01
653 MS_DRG Major Bladder Procedures With Mcc 8 4 — — $21,043.80 $222,239.64 $127,924.98 2025-12-01
654 MS_DRG Major Bladder Procedures With Cc 8 4 — — $21,043.80 $119,720.46 $68,913.17 2025-12-01
655 MS_DRG Major Bladder Procedures Without Cc/mcc 8 4 — — $21,043.80 $90,522.75 $52,106.46 2025-12-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 8 4 — — $21,043.80 $136,164.76 $78,378.79 2025-12-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 8 4 — — $21,043.80 $78,265.44 $45,050.94 2025-12-01
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 8 4 — — $21,043.80 $66,367.38 $38,202.21 2025-12-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 8 4 — — $21,043.80 $108,669.21 $62,551.88 2025-12-01
663 MS_DRG Minor Bladder Procedures With Cc 8 4 — — $21,043.80 $65,015.91 $37,424.28 2025-12-01
665 MS_DRG Prostatectomy With Mcc 8 4 — — $21,043.80 $133,487.48 $76,837.71 2025-12-01
668 MS_DRG Transurethral Procedures With Mcc 8 4 — — $21,043.80 $124,882.56 $71,884.56 2025-12-01
669 MS_DRG Transurethral Procedures With Cc 8 4 — — $21,043.80 $66,375.94 $38,207.13 2025-12-01
671 MS_DRG Urethral Procedures With Cc/mcc 8 4 — — $21,043.80 $76,768.56 $44,189.31 2025-12-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 8 4 — — $21,043.80 $179,694.03 $103,434.99 2025-12-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 8 4 — — $21,043.80 $100,017.24 $57,571.65 2025-12-01
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/mcc 8 4 — — $21,043.80 $70,199.40 $40,407.99 2025-12-01
686 MS_DRG Kidney And Urinary Tract Neoplasms With Mcc 8 4 — — $21,043.80 $77,140.64 $44,403.49 2025-12-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 8 4 — — $21,043.80 $70,755.38 $40,728.02 2025-12-01
70 MS_DRG Other Cerebrovascular Disorders With Mcc 8 4 — — $21,043.80 $71,200.17 $40,984.05 2025-12-01
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 8 4 — — $21,043.80 $85,548.83 $49,243.38 2025-12-01
708 MS_DRG Major Male Pelvic Procedures Without Cc/mcc 8 4 — — $21,043.80 $65,614.67 $37,768.93 2025-12-01
709 MS_DRG Penis Procedures With Cc/mcc 8 4 — — $21,043.80 $99,525.41 $57,288.54 2025-12-01
711 MS_DRG Testes Procedures With Cc/mcc 8 4 — — $21,043.80 $89,119.96 $51,298.99 2025-12-01
713 MS_DRG Transurethral Prostatectomy With Cc/mcc 8 4 — — $21,043.80 $64,297.41 $37,010.70 2025-12-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 8 4 — — $21,043.80 $95,684.85 $55,077.85 2025-12-01
717 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc 8 4 — — $21,043.80 $80,852.90 $46,540.33 2025-12-01
722 MS_DRG Malignancy, Male Reproductive System With Mcc 8 4 — — $21,043.80 $77,397.25 $44,551.19 2025-12-01
727 MS_DRG Inflammation Of The Male Reproductive System With Mcc 8 4 — — $21,043.80 $63,420.67 $36,506.04 2025-12-01
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 8 4 — — $21,043.80 $68,612.70 $39,494.66 2025-12-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 8 4 — — $21,043.80 $91,095.84 $52,436.34 2025-12-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 8 4 — — $21,043.80 $152,874.22 $87,997.04 2025-12-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 8 4 — — $21,043.80 $88,127.74 $50,727.85 2025-12-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 8 4 — — $21,043.80 $150,812.80 $86,810.45 2025-12-01
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 8 4 — — $21,043.80 $77,392.97 $44,548.73 2025-12-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 8 4 — — $21,043.80 $78,470.73 $45,169.11 2025-12-01
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 8 4 — — $21,043.80 $87,635.91 $50,444.74 2025-12-01
746 MS_DRG Vagina, Cervix And Vulva Procedures With Cc/mcc 8 4 — — $21,043.80 $74,292.29 $42,763.93 2025-12-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 8 4 — — $21,043.80 $109,811.12 $63,209.18 2025-12-01
754 MS_DRG Malignancy, Female Reproductive System With Mcc 8 4 — — $21,043.80 $78,765.83 $45,338.97 2025-12-01
799 MS_DRG Splenic Procedures With Mcc 8 4 — — $21,043.80 $193,692.00 $111,492.46 2025-12-01
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 8 4 — — $21,043.80 $77,410.08 $44,558.58 2025-12-01
801 MS_DRG Splenic Procedures Without Cc/mcc 8 4 — — $21,043.80 $81,639.84 $46,993.30 2025-12-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 8 4 — — $21,043.80 $170,391.99 $98,080.57 2025-12-01
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 8 4 — — $21,043.80 $79,501.44 $45,762.40 2025-12-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 8 4 — — $21,043.80 $94,427.47 $54,354.08 2025-12-01
813 MS_DRG Coagulation Disorders 8 4 — — $21,043.80 $65,234.03 $37,549.83 2025-12-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 8 4 — — $21,043.80 $90,954.71 $52,355.10 2025-12-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 8 4 — — $21,043.80 $97,750.54 $56,266.90 2025-12-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 8 4 — — $21,043.80 $250,825.77 $144,379.65 2025-12-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 8 4 — — $21,043.80 $95,740.44 $55,109.85 2025-12-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 8 4 — — $21,043.80 $196,082.73 $112,868.61 2025-12-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 8 4 — — $21,043.80 $96,895.18 $55,774.54 2025-12-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 8 4 — — $21,043.80 $200,060.15 $115,158.08 2025-12-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 8 4 — — $21,043.80 $98,845.40 $56,897.12 2025-12-01
828 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 8 4 — — $21,043.80 $72,868.12 $41,944.15 2025-12-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 8 4 — — $21,043.80 $135,146.88 $77,792.88 2025-12-01
830 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 8 4 — — $21,043.80 $64,365.84 $37,050.09 2025-12-01
834 MS_DRG Acute Leukemia With Mcc 8 4 — — $21,043.80 $234,792.04 $135,150.35 2025-12-01
835 MS_DRG Acute Leukemia With Cc 8 4 — — $21,043.80 $89,205.49 $51,348.22 2025-12-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 8 4 — — $21,043.80 $205,470.30 $118,272.26 2025-12-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 8 4 — — $21,043.80 $89,273.92 $51,387.61 2025-12-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 8 4 — — $21,043.80 $138,350.20 $79,636.76 2025-12-01
841 MS_DRG Lymphoma And Non-acute Leukemia With Cc 8 4 — — $21,043.80 $69,771.72 $40,161.81 2025-12-01
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 8 4 — — $21,043.80 $85,313.61 $49,107.99 2025-12-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 8 4 — — $21,043.80 $110,876.04 $63,822.17 2025-12-01
849 MS_DRG Radiotherapy 8 4 — — $21,043.80 $115,879.90 $66,702.47 2025-12-01
850 MS_DRG Acute Leukemia With Other Procedures 6 3 — — $187,157.77 $370,349.50 $230,723.71 2025-12-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 8 4 — — $21,043.80 $211,214.04 $121,578.45 2025-12-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 8 4 — — $21,043.80 $85,454.74 $49,189.23 2025-12-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 8 4 — — $21,043.80 $194,538.80 $111,979.90 2025-12-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 8 4 — — $21,043.80 $91,587.67 $52,719.45 2025-12-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 8 4 — — $21,043.80 $77,996.00 $44,895.85 2025-12-01
865 MS_DRG Viral Illness With Mcc 8 4 — — $21,043.80 $64,079.29 $36,885.15 2025-12-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 8 4 — — $21,043.80 $89,521.98 $51,530.40 2025-12-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 8 4 — — $21,043.80 $295,603.86 $170,154.70 2025-12-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 8 4 — — $21,043.80 $83,076.84 $47,820.46 2025-12-01
884 MS_DRG Organic Disturbances And Intellectual Disability 8 4 — — $21,043.80 $68,809.44 $39,607.90 2025-12-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 8 4 — — $21,043.80 $74,634.44 $42,960.88 2025-12-01
901 MS_DRG Wound Debridements For Injuries With Mcc 8 4 — — $21,043.80 $179,480.19 $103,311.90 2025-12-01
902 MS_DRG Wound Debridements For Injuries With Cc 8 4 — — $21,043.80 $81,879.34 $47,131.16 2025-12-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 8 4 — — $21,043.80 $164,199.18 $94,515.89 2025-12-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 8 4 — — $21,043.80 $85,330.71 $49,117.83 2025-12-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 8 4 — — $21,043.80 $75,109.16 $43,234.13 2025-12-01
915 MS_DRG Allergic Reactions With Mcc 8 4 — — $21,043.80 $71,918.67 $41,397.63 2025-12-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 8 4 — — $21,043.80 $67,077.33 $38,610.87 2025-12-01
919 MS_DRG Complications Of Treatment With Mcc 8 4 — — $21,043.80 $78,299.65 $45,070.63 2025-12-01
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 8 4 — — $21,043.80 $74,818.34 $43,066.73 2025-12-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 8 4 — — $21,043.80 $155,183.69 $89,326.41 2025-12-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 8 4 — — $21,043.80 $150,517.70 $86,640.59 2025-12-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 8 4 — — $21,043.80 $99,944.54 $57,529.81 2025-12-01
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 8 4 — — $21,043.80 $86,720.67 $49,917.92 2025-12-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 8 4 — — $21,043.80 $110,307.23 $63,494.75 2025-12-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 8 4 — — $21,043.80 $154,469.46 $88,915.30 2025-12-01
974 MS_DRG HIV With Major Related Condition With Mcc 8 4 — — $21,043.80 $123,428.45 $71,047.55 2025-12-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 8 4 — — $21,043.80 $98,148.28 $56,495.85 2025-12-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 8 4 — — $21,043.80 $200,658.90 $115,502.74 2025-12-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 8 4 — — $21,043.80 $105,145.13 $60,523.35 2025-12-01
983 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 8 4 — — $21,043.80 $73,304.35 $42,195.26 2025-12-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 8 4 — — $21,043.80 $146,625.81 $84,400.35 2025-12-01
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 8 4 — — $21,043.80 $70,293.48 $40,462.15 2025-12-01
C1820 HCPCS Battery Neurostimulator Restore Sensor MRI Spinal Cord Stimulation 88 13 $53,240.00 $53,240.00 $19,712.00 $47,916.00 $37,134.90 2025-12-01
C1826 HCPCS Ins 977119 Inceptiv MRI US Eman 81 13 $53,240.00 $53,240.00 $19,712.00 $47,916.00 $37,268.00 2025-12-01
C9399 HCPCS Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension 104 13 $818,850.00 $818,850.00 $40.80 $736,965.00 $524,064.00 2025-12-01
J3392 HCPCS Exagamglogene Autotemcel 4 X 10exp6 To 13 X 10exp6 Cell/ml IV Susp 61 9 $4,197,600.00 $4,197,600.00 $1,554,120.00 $3,777,840.00 $2,728,440.00 2025-12-01
J9226 HCPCS Histrelin 50 Mg (65 Mcg/day) Implant Kit 68 11 $95,746.55 $95,746.55 $35,450.00 $89,753.97 $62,235.26 2025-12-01
J9226 CPT Histrelin Implant 50mg(003109) 32 11 $90,425.78 $90,425.78 $36,170.31 $87,820.14 $58,776.76 2024-09-15
Q2041 HCPCS Axicabtagene Ciloleucel Intravenous Suspension 68 12 $960,830.64 $960,830.64 $355,738.00 $864,747.58 $704,865.36 2025-12-01
Q2041 CPT Axicabtagene Inj 1 Dose (006256) 20 10 $881,496.00 $881,496.00 $352,598.40 $793,346.40 $623,013.56 2024-09-15
Q2042 HCPCS Tisagenlecleucel 0.2 X10exp6 To 2.5x10exp8 Cell Intravenous Suspension 132 12 $943,718.02 $943,718.02 $287,823.00 $849,346.22 $606,367.16 2025-12-01
Q2042 CPT Tisagenlecleucel Inj 1 Dose (peds) (006257) 39 10 $864,685.73 $864,685.73 $271,602.34 $778,217.16 $529,624.56 2024-09-15
Q2053 CPT Brexucabtagene Autoleucel Inj 1 Dose (006923) 20 10 $808,992.00 $808,992.00 $323,596.80 $728,092.80 $586,923.69 2024-09-15
Q2054 HCPCS Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 68 12 $1,013,816.50 $1,013,816.50 $375,356.00 $912,434.85 $743,735.78 2025-12-01
Q2054 CPT Lisocabtagene Maraleucel Inj 1 Dose (007137) 20 10 $930,106.97 $930,106.97 $372,042.79 $837,096.27 $656,655.52 2024-09-15
Q2055 HCPCS Idecabtagene Vicleucel 300 X 10exp6 To 510 X 10exp6 Cell IV Suspension 68 12 $1,008,020.16 $1,008,020.16 $373,210.00 $907,218.14 $739,483.59 2025-12-01
Q2055 CPT Idecabtagene Vicleucel Inj 1 Dose (007300) 20 10 $950,962.31 $950,962.31 $380,384.92 $855,866.08 $671,379.39 2024-09-15
Q2056 HCPCS Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 68 12 $1,059,532.28 $1,059,532.28 $392,282.00 $953,579.05 $763,923.08 2025-12-01
Q2056 CPT Ciltacabtagene Autoleucel Inj 1 Dose (007558) 20 10 $913,836.60 $913,836.60 $365,534.64 $822,452.94 $662,988.46 2024-09-15
Q2057 HCPCS Afamitresgene Autoleucel 2.68x 10exp9 To 10x 10exp9 Cell IV Suspension 68 12 $1,387,116.00 $1,387,116.00 $513,566.00 $1,248,404.40 $1,017,588.30 2025-12-01
Q2058 HCPCS Obecabtagene Autoleucel Intravenous Suspension (10 X 10^6 Cells) Second Infusion 68 12 $500,850.00 $500,850.00 $185,435.00 $450,765.00 $355,603.50 2025-12-01
SUP-MSK0007125 CDM Ins 977006 Vanta US Eman Cardio 73 13 $59,200.00 $59,200.00 $21,919.00 $53,280.00 $42,032.00 2025-12-01
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