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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

NORTHPORT VA MEDICAL CENTER

Northport, NY · CCN 33019F · Rates published

2,516 distinct procedures filed
15 distinct payers
47,124 rate rows
2026-03-26 last MRF observed
Data quality

32,223 of 47,124 rate rows are consumer-grade (68.4%)

14,901 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 12,557
per-diem day rate — not a per-procedure price 2,250
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 94
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://dch.pt.panaceainc.com/MRFDownload/dch/rmc
Found on page https://www.dchsystem.com/patient-visitor/understanding-the-cost-of-your-care/chargemaster/list-of-charges/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-13
Content fingerprint 0d6b0b9e91a4f7c6… · 280,265,183 bytes · first seen 2026-05-06

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $3,500.00 $563,437.00 $331,433.53 nat. median
$168,055
2.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 6 $216,257.85 $367,638.35 $216,257.85 nat. median
$186,516
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $3,500.00 $281,441.92 $165,554.07 nat. median
$131,925
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $3,500.00 $279,823.50 $164,602.06 nat. median
$145,435
1.1× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $3,500.00 $184,580.42 $108,576.72 nat. median
$97,418
1.1× median
25682002801
NDC 		Ravulizumab-cwvz 1100 Mg/11 Ml Via 10 $33,531.34 $197,243.17 $103,552.66 —
7
MS_DRG 		Lung Transplant 10 $3,500.00 $172,940.15 $101,729.50 nat. median
$70,649
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $3,500.00 $160,898.18 $94,645.99 nat. median
$72,715
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 $89,433.07 $152,036.22 $89,433.07 nat. median
$65,418
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 8 $87,547.61 $151,868.31 $89,334.30 nat. median
$2,110
outlier · 42.3×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $82,659.00 $148,024.39 $87,073.17 nat. median
$2,736
outlier · 31.8×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 10 $3,500.00 $146,124.38 $85,955.52 nat. median
$74,509
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 10 $3,500.00 $138,844.68 $81,673.34 nat. median
$69,922
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 10 $3,500.00 $134,278.73 $78,987.49 nat. median
$73,023
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $73,371.00 $132,028.70 $77,663.94 nat. median
$69,822
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $67,572.00 $122,041.73 $71,789.25 nat. median
$2,596
outlier · 27.7×
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $64,946.25 $117,519.67 $69,129.22 nat. median
$2,633
outlier · 26.3×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 10 $63,224.25 $114,554.08 $67,384.75 nat. median
$60,505
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 $63,025.50 $114,211.78 $67,183.40 nat. median
$59,651
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 $3,500.00 $107,306.67 $63,121.57 nat. median
$56,428
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 $57,587.25 $104,846.09 $61,674.17 nat. median
$55,923
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 10 $57,339.00 $104,418.56 $61,422.68 nat. median
$55,935
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 $3,500.00 $104,091.78 $61,230.46 nat. median
$52,327
1.2× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $54,139.50 $98,908.41 $58,181.42 nat. median
$9,905
outlier · 5.9×
10
MS_DRG 		Pancreas Transplant 10 $3,500.00 $98,354.30 $57,855.47 nat. median
$23,080
outlier · 2.5×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 10 $3,500.00 $98,315.56 $57,832.68 nat. median
$37,013
1.6× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 10 $3,500.00 $97,823.44 $57,543.20 nat. median
$45,605
1.3× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 $53,478.00 $97,769.19 $57,511.29 nat. median
$51,518
1.1× median
310453530
NDC 		Tremelimumab-actl 300 Mg/15 Ml Vial 10 $18,564.00 $109,200.00 $57,330.00 —
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 10 $3,500.00 $94,945.66 $55,850.39 nat. median
$48,611
1.1× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 $51,584.25 $94,507.79 $55,592.82 nat. median
$49,569
1.1× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 10 $3,500.00 $92,611.67 $54,477.45 nat. median
$47,340
1.2× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 8 $50,148.75 $92,035.59 $54,138.58 nat. median
$2,633
outlier · 20.6×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 8 $50,112.00 $91,972.30 $54,101.35 nat. median
$2,958
outlier · 18.3×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $49,314.75 $90,599.29 $53,293.70 nat. median
$45,446
1.2× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $49,314.75 $90,599.29 $53,293.70 nat. median
$47,458
1.1× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 $49,135.50 $90,290.59 $53,112.11 nat. median
$43,299
1.2× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 10 $3,500.00 $88,783.23 $52,225.43 nat. median
$47,121
1.1× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 10 $45,963.00 $84,826.94 $49,898.20 nat. median
$44,036
1.1× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 10 $3,500.00 $84,735.23 $49,844.25 nat. median
$41,943
1.2× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 10 $45,469.50 $83,977.04 $49,398.26 nat. median
$43,803
1.1× median
28
MS_DRG 		Spinal Procedures With Mcc 10 $3,500.00 $83,275.67 $48,985.69 nat. median
$41,895
1.2× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 $45,049.50 $83,253.73 $48,972.78 nat. median
$43,533
1.1× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 $44,723.25 $82,691.86 $48,642.27 nat. median
$42,674
1.1× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 10 $3,500.00 $82,438.70 $48,493.35 nat. median
$40,584
1.2× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 10 $3,500.00 $82,260.45 $48,388.50 nat. median
$38,932
1.2× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 10 $44,014.50 $81,471.26 $47,924.27 nat. median
$43,023
1.1× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 $3,500.00 $81,422.18 $47,895.40 nat. median
$40,726
1.2× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 8 $43,253.25 $80,160.24 $47,153.08 nat. median
$2,596
outlier · 18.2×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 $3,500.00 $79,684.92 $46,873.48 nat. median
$40,301
1.2× median

Other procedures at this hospital

Browse this hospital's 2,516 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 13 10 — — $3,500.00 $563,437.00 $331,433.53 2026-03-26
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 6 6 — — $216,257.85 $367,638.35 $216,257.85 2026-03-26
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 10 — — $3,500.00 $281,441.92 $165,554.07 2026-03-26
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 10 — — $3,500.00 $279,823.50 $164,602.06 2026-03-26
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 10 — — $3,500.00 $184,580.42 $108,576.72 2026-03-26
25682002801 NDC Ravulizumab-cwvz 1100 Mg/11 Ml Via 13 10 $197,243.17 $98,621.59 50% off $33,531.34 $197,243.17 $103,552.66 2026-03-26
7 MS_DRG Lung Transplant 13 10 — — $3,500.00 $172,940.15 $101,729.50 2026-03-26
14 MS_DRG Allogeneic Bone Marrow Transplant 13 10 — — $3,500.00 $160,898.18 $94,645.99 2026-03-26
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 6 — — $89,433.07 $152,036.22 $89,433.07 2026-03-26
209 MS_DRG Complex Aortic Arch Procedures 8 8 — — $87,547.61 $151,868.31 $89,334.30 2026-03-26
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 8 — — $82,659.00 $148,024.39 $87,073.17 2026-03-26
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 10 — — $3,500.00 $146,124.38 $85,955.52 2026-03-26
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 10 — — $3,500.00 $138,844.68 $81,673.34 2026-03-26
215 MS_DRG Other Heart Assist System Implant 13 10 — — $3,500.00 $134,278.73 $78,987.49 2026-03-26
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 10 — — $73,371.00 $132,028.70 $77,663.94 2026-03-26
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 8 — — $67,572.00 $122,041.73 $71,789.25 2026-03-26
850 MS_DRG Acute Leukemia With Other Procedures 10 8 — — $64,946.25 $117,519.67 $69,129.22 2026-03-26
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 10 — — $63,224.25 $114,554.08 $67,384.75 2026-03-26
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 10 — — $63,025.50 $114,211.78 $67,183.40 2026-03-26
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 10 — — $3,500.00 $107,306.67 $63,121.57 2026-03-26
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 10 — — $57,587.25 $104,846.09 $61,674.17 2026-03-26
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 10 — — $57,339.00 $104,418.56 $61,422.68 2026-03-26
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 10 — — $3,500.00 $104,091.78 $61,230.46 2026-03-26
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 8 — — $54,139.50 $98,908.41 $58,181.42 2026-03-26
10 MS_DRG Pancreas Transplant 13 10 — — $3,500.00 $98,354.30 $57,855.47 2026-03-26
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 13 10 — — $3,500.00 $98,315.56 $57,832.68 2026-03-26
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 13 10 — — $3,500.00 $97,823.44 $57,543.20 2026-03-26
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 10 — — $53,478.00 $97,769.19 $57,511.29 2026-03-26
310453530 NDC Tremelimumab-actl 300 Mg/15 Ml Vial 13 10 $109,200.00 $54,600.00 50% off $18,564.00 $109,200.00 $57,330.00 2026-03-26
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 13 10 — — $3,500.00 $94,945.66 $55,850.39 2026-03-26
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 10 — — $51,584.25 $94,507.79 $55,592.82 2026-03-26
955 MS_DRG Craniotomy For Multiple Significant Trauma 13 10 — — $3,500.00 $92,611.67 $54,477.45 2026-03-26
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 10 8 — — $50,148.75 $92,035.59 $54,138.58 2026-03-26
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 10 8 — — $50,112.00 $91,972.30 $54,101.35 2026-03-26
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 10 — — $49,314.75 $90,599.29 $53,293.70 2026-03-26
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 10 — — $49,314.75 $90,599.29 $53,293.70 2026-03-26
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 10 — — $49,135.50 $90,290.59 $53,112.11 2026-03-26
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 13 10 — — $3,500.00 $88,783.23 $52,225.43 2026-03-26
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 10 — — $45,963.00 $84,826.94 $49,898.20 2026-03-26
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 10 — — $3,500.00 $84,735.23 $49,844.25 2026-03-26
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 10 — — $45,469.50 $83,977.04 $49,398.26 2026-03-26
28 MS_DRG Spinal Procedures With Mcc 13 10 — — $3,500.00 $83,275.67 $48,985.69 2026-03-26
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 10 — — $45,049.50 $83,253.73 $48,972.78 2026-03-26
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 10 — — $44,723.25 $82,691.86 $48,642.27 2026-03-26
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 13 10 — — $3,500.00 $82,438.70 $48,493.35 2026-03-26
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 13 10 — — $3,500.00 $82,260.45 $48,388.50 2026-03-26
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 10 — — $44,014.50 $81,471.26 $47,924.27 2026-03-26
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 13 10 — — $3,500.00 $81,422.18 $47,895.40 2026-03-26
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 10 8 — — $43,253.25 $80,160.24 $47,153.08 2026-03-26
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 10 — — $3,500.00 $79,684.92 $46,873.48 2026-03-26
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 8 8 — — $45,761.78 $79,382.67 $46,695.69 2026-03-26
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 10 — — $3,500.00 $79,287.08 $46,639.46 2026-03-26
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 8 — — $42,165.00 $78,286.07 $46,050.63 2026-03-26
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 13 10 — — $3,500.00 $78,061.31 $45,918.42 2026-03-26
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 10 — — $3,500.00 $77,565.32 $45,626.66 2026-03-26
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 10 — — $3,500.00 $77,007.35 $45,298.44 2026-03-26
834 MS_DRG Acute Leukemia With Mcc 13 10 — — $3,500.00 $76,579.82 $45,046.95 2026-03-26
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 10 — — $41,028.75 $76,329.24 $44,899.55 2026-03-26
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 10 — — $40,970.25 $76,228.48 $44,840.28 2026-03-26
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 10 — — $3,500.00 $76,117.40 $44,774.94 2026-03-26
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 13 10 — — $3,500.00 $75,835.83 $44,609.31 2026-03-26
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 10 — — $39,996.00 $74,550.64 $43,853.32 2026-03-26
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 10 8 — — $39,972.00 $74,509.30 $43,829.00 2026-03-26
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 10 — — $3,500.00 $74,046.90 $43,557.00 2026-03-26
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 12 10 — — $39,572.25 $73,820.87 $43,424.04 2026-03-26
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 10 — — $3,500.00 $72,905.10 $42,885.35 2026-03-26
653 MS_DRG Major Bladder Procedures With Mcc 12 10 — — $38,973.00 $72,788.83 $42,816.96 2026-03-26
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 10 — — $37,801.50 $70,771.29 $41,630.17 2026-03-26
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 10 — — $37,405.50 $70,089.30 $41,229.00 2026-03-26
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 10 — — $3,500.00 $69,572.65 $40,925.09 2026-03-26
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 13 10 — — $3,500.00 $69,458.99 $40,858.23 2026-03-26
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 13 10 — — $3,500.00 $69,240.69 $40,729.82 2026-03-26
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 10 — — $3,500.00 $68,975.92 $40,574.07 2026-03-26
471 MS_DRG Cervical Spinal Fusion With Mcc 12 10 — — $36,215.25 $68,039.47 $40,023.22 2026-03-26
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 13 10 — — $3,500.00 $67,724.31 $39,837.83 2026-03-26
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 10 — — $35,706.00 $67,162.44 $39,507.32 2026-03-26
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 13 10 — — $3,500.00 $66,395.22 $39,056.01 2026-03-26
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 10 — — $3,500.00 $66,271.22 $38,983.07 2026-03-26
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 13 10 — — $3,500.00 $66,090.39 $38,876.70 2026-03-26
6 MS_DRG Liver Transplant Without Mcc 13 10 — — $3,500.00 $65,563.39 $38,566.70 2026-03-26
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 10 — — $34,638.75 $65,324.44 $38,426.14 2026-03-26
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 12 10 — — $34,473.75 $65,040.28 $38,258.99 2026-03-26
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 13 10 — — $3,500.00 $64,889.15 $38,170.09 2026-03-26
245 MS_DRG Aicd Generator Procedures 13 10 — — $3,500.00 $64,599.83 $37,999.90 2026-03-26
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 13 10 — — $3,500.00 $64,422.88 $37,895.81 2026-03-26
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 13 10 — — $3,500.00 $64,397.04 $37,880.61 2026-03-26
799 MS_DRG Splenic Procedures With Mcc 12 10 — — $33,966.75 $64,167.13 $37,745.37 2026-03-26
163 MS_DRG Major Chest Procedures With Mcc 13 10 — — $3,500.00 $63,558.77 $37,387.51 2026-03-26
31 MS_DRG Ventricular Shunt Procedures With Mcc 13 10 — — $3,500.00 $63,541.97 $37,377.63 2026-03-26
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 13 10 — — $3,500.00 $63,314.65 $37,243.91 2026-03-26
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 13 10 — — $3,500.00 $62,409.21 $36,711.30 2026-03-26
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 13 10 — — $3,500.00 $61,564.48 $36,214.40 2026-03-26
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 13 10 — — $3,500.00 $61,118.86 $35,952.27 2026-03-26
140 MS_DRG Major Head And Neck Procedures With Mcc 13 10 — — $3,500.00 $60,762.37 $35,742.57 2026-03-26
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 10 8 — — $31,806.00 $60,445.91 $35,556.42 2026-03-26
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 10 — — $31,674.00 $60,218.59 $35,422.70 2026-03-26
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 13 10 — — $3,500.00 $60,125.58 $35,367.99 2026-03-26
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 13 10 — — $3,500.00 $60,098.47 $35,352.04 2026-03-26
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 13 10 — — $3,500.00 $59,939.59 $35,258.58 2026-03-26
901 MS_DRG Wound Debridements For Injuries With Mcc 13 10 — — $3,500.00 $59,875.00 $35,220.59 2026-03-26
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 10 — — $31,416.00 $59,774.26 $35,161.33 2026-03-26
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 10 — — $31,294.50 $59,565.01 $35,038.24 2026-03-26
793 MS_DRG Full Term Neonate With Major Problems 13 10 — — $3,500.00 $59,526.27 $35,015.45 2026-03-26
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 10 — — $31,147.50 $59,311.84 $34,889.32 2026-03-26
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 12 10 — — $30,941.25 $58,956.65 $34,680.38 2026-03-26
791 MS_DRG Prematurity With Major Problems 13 10 — — $3,500.00 $58,097.70 $34,175.12 2026-03-26
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 10 8 — — $30,153.75 $57,600.42 $33,882.60 2026-03-26
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 13 10 — — $3,500.00 $57,130.27 $33,606.04 2026-03-26
51144005001 NDC Brentuximab 50 Mg Vial 13 10 $63,291.20 $31,645.60 50% off $10,759.50 $63,291.20 $33,227.88 2026-03-26
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 10 — — $3,500.00 $56,197.70 $33,057.47 2026-03-26
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 13 10 — — $3,500.00 $55,969.08 $32,922.99 2026-03-26
34 MS_DRG Carotid Artery Stent Procedures With Mcc 13 10 — — $3,500.00 $55,665.55 $32,744.44 2026-03-26
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 15 11 — — $940.63 $55,590.63 $32,700.37 2026-03-26
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 13 10 — — $3,500.00 $55,542.84 $32,672.26 2026-03-26
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 13 10 — — $3,500.00 $55,259.96 $32,505.86 2026-03-26
6302602 NDC Pembrolizumab 100 Mg/4 Ml Vial 13 10 $61,023.87 $30,511.94 50% off $10,374.06 $61,023.87 $32,037.53 2026-03-26
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 13 10 — — $3,500.00 $54,274.46 $31,926.15 2026-03-26
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 12 10 — — $28,099.50 $54,062.62 $31,801.54 2026-03-26
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 12 10 — — $28,032.75 $53,947.66 $31,733.92 2026-03-26
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 12 10 — — $28,029.75 $53,942.50 $31,730.88 2026-03-26
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 13 10 — — $3,500.00 $53,806.87 $31,651.10 2026-03-26
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 13 10 — — $3,500.00 $53,535.64 $31,491.55 2026-03-26
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 13 10 — — $3,500.00 $53,113.27 $31,243.10 2026-03-26
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 12 10 — — $27,537.00 $53,093.89 $31,231.70 2026-03-26
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 13 10 — — $3,500.00 $52,537.19 $30,904.23 2026-03-26
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 10 — — $27,192.75 $52,501.03 $30,882.96 2026-03-26
332 MS_DRG Rectal Resection With Mcc 13 10 — — $3,500.00 $52,436.45 $30,844.97 2026-03-26
265 MS_DRG Aicd Lead Procedures 13 10 — — $3,500.00 $52,404.15 $30,825.97 2026-03-26
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 13 10 — — $3,500.00 $52,321.48 $30,777.34 2026-03-26
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 10 — — $3,500.00 $52,251.74 $30,736.32 2026-03-26
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 13 10 — — $3,500.00 $51,946.92 $30,557.01 2026-03-26
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 13 10 — — $3,500.00 $51,839.70 $30,493.94 2026-03-26
335 MS_DRG Peritoneal Adhesiolysis With Mcc 13 10 — — $3,500.00 $51,793.20 $30,466.59 2026-03-26
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 13 10 — — $3,500.00 $51,724.74 $30,426.32 2026-03-26
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 12 10 — — $26,719.50 $51,686.00 $30,403.53 2026-03-26
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 13 10 — — $3,500.00 $51,642.09 $30,377.70 2026-03-26
271 MS_DRG Other Major Cardiovascular Procedures With Cc 12 10 — — $26,672.25 $51,604.62 $30,355.66 2026-03-26
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 13 10 — — $3,500.00 $51,221.00 $30,130.00 2026-03-26
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 13 10 — — $3,500.00 $51,128.01 $30,075.30 2026-03-26
252 MS_DRG Other Vascular Procedures With Mcc 12 10 — — $26,162.25 $50,726.30 $29,839.00 2026-03-26
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 13 10 — — $3,500.00 $50,714.69 $29,832.17 2026-03-26
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 12 10 — — $26,035.50 $50,508.02 $29,710.60 2026-03-26
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 13 10 — — $3,500.00 $50,291.03 $29,582.96 2026-03-26
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 8 8 — — $28,872.16 $50,084.36 $29,461.39 2026-03-26
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 10 — — $3,500.00 $49,952.61 $29,383.89 2026-03-26
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 13 10 — — $3,500.00 $49,735.63 $29,256.25 2026-03-26
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 13 10 — — $3,500.00 $49,677.50 $29,222.06 2026-03-26
25682000101 NDC Eculizumab 300 Mg/30 Ml Vial 13 10 $54,793.20 $27,396.60 50% off $9,314.84 $54,793.20 $28,766.43 2026-03-26
264 MS_DRG Other Circulatory System O.r. Procedures 13 10 — — $3,500.00 $48,818.56 $28,716.80 2026-03-26
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 12 10 — — $24,774.75 $48,336.76 $28,433.39 2026-03-26
37 MS_DRG Extracranial Procedures With Mcc 13 10 — — $3,500.00 $48,192.11 $28,348.30 2026-03-26
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 12 10 — — $24,687.75 $48,186.94 $28,345.26 2026-03-26
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 13 10 — — $3,500.00 $47,684.49 $28,049.70 2026-03-26
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 12 10 — — $24,288.75 $47,499.79 $27,941.05 2026-03-26
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 13 10 — — $3,500.00 $47,453.29 $27,913.70 2026-03-26
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 10 8 — — $24,228.00 $47,395.17 $27,879.51 2026-03-26
652 MS_DRG Kidney Transplant 12 10 — — $3,500.00 $47,383.54 $27,872.67 2026-03-26
50633012011 NDC Digoxin Immune Fab 40 Mg Vial 13 10 $53,064.00 $26,532.00 50% off $9,020.88 $53,064.00 $27,858.60 2026-03-26
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 13 10 — — $3,500.00 $47,352.55 $27,854.44 2026-03-26
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 13 10 — — $3,500.00 $47,271.17 $27,806.57 2026-03-26
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 13 10 — — $3,500.00 $47,136.84 $27,727.55 2026-03-26
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 12 10 — — $23,946.00 $46,909.51 $27,593.83 2026-03-26
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 12 10 — — $23,901.75 $46,833.30 $27,549.00 2026-03-26
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 12 10 — — $23,878.50 $46,793.27 $27,525.45 2026-03-26
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 13 10 — — $3,500.00 $46,710.59 $27,476.82 2026-03-26
500 MS_DRG Soft Tissue Procedures With Mcc 12 10 — — $23,736.00 $46,547.85 $27,381.09 2026-03-26
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 13 10 — — $3,500.00 $46,485.85 $27,344.62 2026-03-26
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 13 10 — — $3,500.00 $46,369.61 $27,276.24 2026-03-26
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 10 — — $3,500.00 $46,350.23 $27,264.84 2026-03-26
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 13 10 — — $3,500.00 $46,254.64 $27,208.61 2026-03-26
665 MS_DRG Prostatectomy With Mcc 13 10 — — $3,500.00 $45,984.69 $27,049.82 2026-03-26
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 10 — — $3,500.00 $45,900.73 $27,000.43 2026-03-26
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 13 10 — — $3,500.00 $45,829.69 $26,958.64 2026-03-26
662 MS_DRG Minor Bladder Procedures With Mcc 12 10 — — $22,961.25 $45,213.57 $26,596.22 2026-03-26
263 MS_DRG Vein Ligation And Stripping 13 10 — — $3,500.00 $45,160.62 $26,565.07 2026-03-26
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 12 10 — — $22,749.00 $44,848.04 $26,381.20 2026-03-26
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 12 10 — — $22,653.75 $44,684.01 $26,284.71 2026-03-26
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 12 10 — — $22,650.75 $44,678.84 $26,281.67 2026-03-26
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 13 10 — — $3,500.00 $44,636.22 $26,256.60 2026-03-26
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 13 10 — — $3,500.00 $44,114.39 $25,949.64 2026-03-26
472 MS_DRG Cervical Spinal Fusion With Cc 12 10 — — $22,095.75 $43,723.03 $25,719.43 2026-03-26
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 13 10 — — $3,500.00 $43,697.19 $25,704.23 2026-03-26
570 MS_DRG Skin Debridement With Mcc 13 10 — — $3,500.00 $43,658.45 $25,681.44 2026-03-26
668 MS_DRG Transurethral Procedures With Mcc 12 10 — — $21,900.00 $43,385.90 $25,521.12 2026-03-26
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 12 10 — — $21,842.25 $43,286.45 $25,462.62 2026-03-26
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 12 10 — — $21,765.00 $43,153.41 $25,384.36 2026-03-26
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 12 10 — — $21,751.50 $43,130.16 $25,370.68 2026-03-26
619 MS_DRG O.r. Procedures For Obesity With Mcc 12 10 — — $21,655.50 $42,964.83 $25,273.43 2026-03-26
974 MS_DRG HIV With Major Related Condition With Mcc 13 10 — — $3,500.00 $42,946.74 $25,262.79 2026-03-26
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 13 10 — — $3,500.00 $42,892.50 $25,230.88 2026-03-26
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 12 10 — — $21,526.50 $42,742.68 $25,142.75 2026-03-26
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 13 10 — — $3,500.00 $42,488.22 $24,993.07 2026-03-26
800 MS_DRG Splenic Procedures With Cc 12 10 — — $21,070.50 $41,957.36 $24,680.80 2026-03-26
654 MS_DRG Major Bladder Procedures With Cc 12 10 — — $20,994.75 $41,826.90 $24,604.06 2026-03-26
3232711 NDC Ipilimumab 50 Mg/10 Ml Vial 13 10 $46,845.06 $23,422.53 50% off $7,963.66 $46,845.06 $24,593.66 2026-03-26
503 MS_DRG Foot Procedures With Mcc 12 10 — — $20,933.25 $41,720.98 $24,541.75 2026-03-26
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 12 10 — — $20,789.25 $41,472.98 $24,395.87 2026-03-26
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 13 10 — — $3,500.00 $41,281.83 $24,283.43 2026-03-26
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 13 10 — — $3,500.00 $41,173.32 $24,219.60 2026-03-26
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 13 10 — — $3,500.00 $41,164.29 $24,214.29 2026-03-26
963 MS_DRG Other Multiple Significant Trauma With Mcc 13 10 — — $3,500.00 $40,980.88 $24,106.40 2026-03-26
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 12 10 — — $20,406.00 $40,812.95 $24,007.62 2026-03-26
849 MS_DRG Radiotherapy 13 10 — — $3,500.00 $40,667.01 $23,921.77 2026-03-26
288 MS_DRG Acute And Subacute Endocarditis With Mcc 13 10 — — $3,500.00 $40,624.37 $23,896.69 2026-03-26
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 13 10 — — $3,500.00 $40,510.71 $23,829.83 2026-03-26
50242010501 NDC Polatuzumab Vedotin-piiq 140 Mg Via 13 10 $44,990.40 $22,495.20 50% off $7,648.37 $44,990.40 $23,619.96 2026-03-26
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 13 10 — — $3,500.00 $40,027.64 $23,545.67 2026-03-26
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 13 10 — — $3,500.00 $39,907.52 $23,475.01 2026-03-26
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 13 10 — — $3,500.00 $39,735.73 $23,373.96 2026-03-26
253 MS_DRG Other Vascular Procedures With Cc 12 10 — — $19,467.00 $39,195.83 $23,056.37 2026-03-26
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 13 10 — — $3,500.00 $39,155.78 $23,032.81 2026-03-26
68727071201 NDC Lurbinectedin 4 Mg Vial 13 10 $43,848.00 $21,924.00 50% off $7,454.16 $43,848.00 $23,020.20 2026-03-26
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 13 10 — — $3,500.00 $39,030.49 $22,959.11 2026-03-26
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 13 10 — — $3,500.00 $38,983.99 $22,931.76 2026-03-26
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 13 10 — — $3,500.00 $38,983.99 $22,931.76 2026-03-26
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 13 10 — — $3,500.00 $38,834.17 $22,843.63 2026-03-26
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 12 10 — — $19,147.50 $38,645.59 $22,732.70 2026-03-26
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 12 10 — — $19,056.75 $38,489.29 $22,640.76 2026-03-26
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 12 10 — — $19,020.75 $38,427.29 $22,604.29 2026-03-26
164 MS_DRG Major Chest Procedures With Cc 13 10 — — $3,500.00 $38,271.01 $22,512.36 2026-03-26
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 13 10 — — $3,500.00 $38,256.80 $22,504.00 2026-03-26
82705001001 NDC Epcoritamab-bysp 48 Mg/0.8 Ml Vial 13 10 $42,631.57 $21,315.79 50% off $7,247.37 $42,631.57 $22,381.57 2026-03-26
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 12 10 — — $18,689.25 $37,856.40 $22,268.47 2026-03-26
545 MS_DRG Connective Tissue Disorders With Mcc 13 10 — — $3,500.00 $37,724.65 $22,190.97 2026-03-26
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 13 10 — — $3,500.00 $37,434.02 $22,020.01 2026-03-26
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 13 10 — — $3,500.00 $37,424.99 $22,014.70 2026-03-26
783 MS_DRG Cesarean Section With Sterilization With Mcc 12 9 — — $3,500.00 $37,381.06 $21,988.86 2026-03-26
792 MS_DRG Prematurity Without Major Problems 13 10 — — $3,500.00 $37,304.87 $21,944.04 2026-03-26
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 12 10 — — $18,331.50 $37,240.29 $21,906.05 2026-03-26
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 12 10 — — $18,309.75 $37,202.82 $21,884.01 2026-03-26
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 8 8 — — $21,304.11 $36,956.11 $21,738.89 2026-03-26
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 8 8 — — $21,245.29 $36,854.08 $21,678.87 2026-03-26
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 13 10 — — $3,500.00 $36,737.83 $21,610.49 2026-03-26
330 MS_DRG Major Small And Large Bowel Procedures With Cc 12 10 — — $17,979.00 $36,633.20 $21,548.94 2026-03-26
397 MS_DRG Appendix Procedures With Mcc 12 10 — — $17,961.75 $36,603.50 $21,531.47 2026-03-26
35 MS_DRG Carotid Artery Stent Procedures With Cc 13 10 — — $3,500.00 $36,546.67 $21,498.04 2026-03-26
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 12 10 — — $17,898.00 $36,493.71 $21,466.89 2026-03-26
113 MS_DRG Orbital Procedures With Cc/mcc 13 10 — — $3,500.00 $36,037.76 $21,198.68 2026-03-26
333 MS_DRG Rectal Resection With Cc 13 10 — — $3,500.00 $35,922.80 $21,131.06 2026-03-26
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 13 10 — — $3,500.00 $35,876.31 $21,103.71 2026-03-26
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 13 10 — — $3,500.00 $35,854.34 $21,090.79 2026-03-26
709 MS_DRG Penis Procedures With Cc/mcc 12 10 — — $17,453.25 $35,727.76 $21,016.33 2026-03-26
357 MS_DRG Other Digestive System O.r. Procedures With Cc 13 10 — — $3,500.00 $35,707.11 $21,004.18 2026-03-26
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 13 10 — — $3,500.00 $35,522.40 $20,895.53 2026-03-26
347 MS_DRG Anal And Stomal Procedures With Mcc 12 10 — — $17,217.00 $35,320.90 $20,777.00 2026-03-26
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 13 10 — — $3,500.00 $35,311.86 $20,771.68 2026-03-26
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 13 10 — — $3,500.00 $35,191.73 $20,701.02 2026-03-26
55135013201 NDC Sacituzumab Govitecan-hziy 180 Mg V 13 10 $39,399.86 $19,699.93 50% off $6,697.98 $39,399.86 $20,684.93 2026-03-26
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 13 10 — — $3,500.00 $35,140.07 $20,670.63 2026-03-26
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 13 10 — — $3,500.00 $35,063.86 $20,625.80 2026-03-26
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 13 10 — — $3,500.00 $35,014.78 $20,596.93 2026-03-26
56 MS_DRG Degenerative Nervous System Disorders With Mcc 15 11 — — $809.56 $35,676.10 $20,591.96 2026-03-26
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 13 10 — — $3,500.00 $34,933.40 $20,549.06 2026-03-26
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 13 10 — — $3,500.00 $34,584.66 $20,343.92 2026-03-26
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 13 10 — — $3,500.00 $34,567.87 $20,334.04 2026-03-26
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 12 10 — — $16,647.00 $34,339.25 $20,199.56 2026-03-26
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 13 10 — — $3,500.00 $34,251.41 $20,147.89 2026-03-26
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 13 10 — — $3,500.00 $34,223.01 $20,131.18 2026-03-26
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 13 10 — — $3,500.00 $34,188.12 $20,110.66 2026-03-26
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 13 10 — — $3,500.00 $34,069.29 $20,040.76 2026-03-26
30 MS_DRG Spinal Procedures Without Cc/mcc 13 10 — — $3,500.00 $34,024.09 $20,014.17 2026-03-26
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 12 10 — — $16,438.50 $33,980.18 $19,988.34 2026-03-26
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 12 10 — — $16,409.25 $33,929.81 $19,958.71 2026-03-26
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 13 10 — — $3,500.00 $33,860.06 $19,917.68 2026-03-26
141 MS_DRG Major Head And Neck Procedures With Cc 13 10 — — $3,500.00 $33,841.97 $19,907.04 2026-03-26
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 13 10 — — $3,500.00 $33,812.27 $19,889.57 2026-03-26
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 13 10 — — $3,500.00 $33,792.89 $19,878.17 2026-03-26
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 12 10 — — $16,275.00 $33,698.59 $19,822.70 2026-03-26
24582411 NDC Cabazitaxel 60 Mg/1.5 Ml Vial 13 10 $37,702.53 $18,851.27 50% off $6,409.43 $37,702.53 $19,793.83 2026-03-26
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 13 10 — — $3,500.00 $33,330.47 $19,606.16 2026-03-26
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 12 10 — — $16,055.25 $33,320.15 $19,600.09 2026-03-26
374 MS_DRG Digestive Malignancy With Mcc 13 10 — — $3,500.00 $33,294.31 $19,584.89 2026-03-26
32 MS_DRG Ventricular Shunt Procedures With Cc 13 10 — — $3,500.00 $33,194.86 $19,526.39 2026-03-26
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 12 10 — — $15,981.75 $33,193.57 $19,525.63 2026-03-26
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 13 10 — — $3,500.00 $33,181.94 $19,518.79 2026-03-26
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 13 10 — — $3,500.00 $33,139.31 $19,493.71 2026-03-26
595 MS_DRG Major Skin Disorders With Mcc 13 10 — — $3,500.00 $33,061.82 $19,448.13 2026-03-26
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 12 10 — — $15,882.75 $33,023.06 $19,425.33 2026-03-26
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 13 10 — — $3,500.00 $33,019.19 $19,423.05 2026-03-26
655 MS_DRG Major Bladder Procedures Without Cc/mcc 12 10 — — $15,874.50 $33,008.87 $19,416.98 2026-03-26
51144000301 NDC Tisotumab Vedotin-tftv 40 Mg Vial 13 10 $36,954.40 $18,477.20 50% off $6,282.25 $36,954.40 $19,401.06 2026-03-26
336 MS_DRG Peritoneal Adhesiolysis With Cc 13 10 — — $3,500.00 $32,906.82 $19,356.95 2026-03-26
412 MS_DRG Cholecystectomy With C.d.e. With Cc 12 10 — — $15,768.75 $32,826.75 $19,309.85 2026-03-26
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 12 10 — — $15,708.75 $32,723.40 $19,249.06 2026-03-26
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 13 10 — — $3,500.00 $32,706.62 $19,239.19 2026-03-26
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 13 10 — — $3,500.00 $32,679.49 $19,223.23 2026-03-26
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 13 10 — — $3,500.00 $32,631.70 $19,195.12 2026-03-26
835 MS_DRG Acute Leukemia With Cc 13 10 — — $3,500.00 $32,611.03 $19,182.96 2026-03-26
314 MS_DRG Other Circulatory System Diagnoses With Mcc 12 10 — — $15,639.00 $32,603.28 $19,178.40 2026-03-26
711 MS_DRG Testes Procedures With Cc/mcc 13 10 — — $3,500.00 $32,585.21 $19,167.77 2026-03-26
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 12 10 — — $15,595.50 $32,528.36 $19,134.33 2026-03-26
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 12 10 — — $15,585.75 $32,511.58 $19,124.46 2026-03-26
415 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Cc 13 10 — — $3,500.00 $32,364.33 $19,037.84 2026-03-26
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 13 10 — — $3,500.00 $32,285.53 $18,991.49 2026-03-26
935 MS_DRG Non-extensive Burns 13 10 — — $3,500.00 $32,277.80 $18,986.94 2026-03-26
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 12 10 — — $15,368.25 $32,137.00 $18,904.12 2026-03-26
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 13 10 — — $3,500.00 $31,860.58 $18,741.52 2026-03-26
886 MS_DRG Behavioral And Developmental Disorders 15 11 — — $763.29 $32,475.41 $18,721.12 2026-03-26
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 13 10 — — $3,500.00 $31,788.27 $18,698.98 2026-03-26
50242024501 NDC Pertuzumab-trastuzumab-hy-zzxf 15 M 13 10 $35,579.60 $17,789.80 50% off $6,048.53 $35,579.60 $18,679.29 2026-03-26
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