Hospital

HARLEM HOSPITAL CENTER

New York, NY · CCN 330240 · Rates published

Your selected procedure

You selected 470 (MS_DRG)

Major joint replacement or reattachment of lower extremity w/o MCC

This hospital’s price: $34,814 across 21 payers · range $17,861-$57,747

Source: https://nychh.pt.panaceainc.com/MRFDownload/nychh/harlem · observed 2025-09-05

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.

5,853 distinct procedures filed

28 distinct payers

181,010 rate rows

2025-09-05 last MRF observed

Data quality

136,057 of 181,010 rate rows are consumer-grade (75.2%)

44,953 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	32,867
template filing: same amount across many unrelated codes — excluded	10,667
placeholder amount (≤ $0.02) — excluded from medians	499
per-diem day rate — not a per-procedure price	404
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	269
exceeds 10× this hospital's gross charge — excluded from medians	247

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://nychh.pt.panaceainc.com/MRFDownload/nychh/harlem
Found on page	https://www.nychealthandhospitals.org/paying-for-your-health-care/facility-charges/
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-08-18
Content fingerprint	276ef8b3c6b1a99a… · 29,614,126 bytes · first seen 2026-05-14

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
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	5	$3,605,000.00	$4,565,876.22	$4,390,265.60	nat. median $3,710,000 1.2× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	5	$3,672,900.00	$4,535,437.05	$4,360,997.17	nat. median $3,710,000 1.2× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	6	$3,325,454.76	$4,722,145.76	$3,934,165.40	nat. median $3,324,572 1.2× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	6	$3,286,000.00	$4,666,120.00	$3,859,357.05	nat. median $3,286,000 1.2× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	6	$2,968,000.00	$4,214,560.00	$3,491,724.58	nat. median $2,997,086 1.2× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	8	$2,388,614.23	$4,352,603.27	$2,901,735.52	nat. median $2,460,273 1.2× median
J3392 HCPCS	Inj, Exagamglogene Autotem	8	$2,332,000.00	$4,139,393.28	$2,759,595.52	nat. median $2,405,851 1.1× median
Q2057 HCPCS	Afamitresgene Autoleucel	16	$755,207.60	$1,823,841.77	$911,920.88	nat. median $809,151 1.1× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	16	$529,192.86	$1,368,732.35	$684,366.18	nat. median $691,418 1.0× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	16	$527,123.43	$1,309,692.74	$654,846.37	nat. median $631,793 1.0× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	16	$516,726.08	$1,281,899.95	$640,949.97	nat. median $624,417 1.0× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	16	$526,587.59	$1,281,011.93	$640,505.97	nat. median $610,161 1.0× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	16	$489,455.96	$1,261,642.77	$630,821.38	nat. median $588,565 1.1× median
Q2053 HCPCS	Brexucabtagene Car Pos T	16	$460,530.40	$1,159,030.12	$579,515.06	nat. median $577,541 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	21	$17,861.00	$1,155,029.93	$503,579.52	nat. median $370,165 1.4× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	21	$17,861.00	$862,710.52	$378,699.00	nat. median $261,939 1.4× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	7	$319,950.96	$639,901.92	$326,349.98	nat. median $302,242 1.1× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	20	$17,861.00	$726,558.20	$320,533.95	nat. median $205,166 1.6× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	21	$17,861.00	$656,385.61	$290,555.83	nat. median $199,832 1.5× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	21	$17,861.00	$432,759.51	$195,021.48	nat. median $132,706 1.5× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	21	$17,861.00	$401,268.83	$181,568.48	nat. median $114,305 1.6× median
7 MS_DRG	Lung Transplant	21	$17,861.00	$400,258.14	$181,136.71	nat. median $122,690 1.5× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	21	$17,861.00	$337,500.35	$154,326.23	nat. median $108,240 1.4× median
212 MS_DRG	Concomitant Aortic And Mitral Valve?procedures	21	$17,861.00	$333,647.48	$152,680.26	nat. median $100,978 1.5× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	21	$17,861.00	$326,159.17	$149,481.21	nat. median $99,646 1.5× median
215 MS_DRG	Other Heart Assist System Implant	21	$17,861.00	$324,486.94	$148,766.82	nat. median $98,002 1.5× median
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$136,900.27	$320,830.08	$147,204.59	nat. median $96,835 1.5× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	22	$17,861.00	$295,584.24	$136,419.43	nat. median $92,900 1.5× median
850 MS_DRG	Acute Leukemia With Other Procedures	17	$121,525.82	$282,132.86	$130,672.92	nat. median $81,364 1.6× median
B0407 HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	$125,875.38	$125,875.38	$125,875.38	nat. median $83,710 1.5× median
231 MS_DRG	Coronary Bypass With Ptca With Mcc	22	$17,861.00	$259,530.14	$121,016.91	nat. median $79,040 1.5× median
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	21	$17,861.00	$259,386.19	$120,955.41	nat. median $80,459 1.5× median
429 MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	17	$110,923.71	$255,447.56	$119,272.81	nat. median $81,124 1.5× median
B1904 HCPCS	Guillain-barr? M <38.50	1	$116,427.42	$116,427.42	$116,427.42	nat. median $73,807 1.6× median
20 MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	21	$17,861.00	$246,887.31	$115,615.82	nat. median $77,385 1.5× median
10 MS_DRG	Pancreas Transplant	21	$17,861.00	$244,189.07	$114,463.12	nat. median $67,750 1.7× median
19 MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	21	$17,861.00	$242,789.42	$113,865.18	nat. median $69,153 1.6× median
233 MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	22	$17,861.00	$239,392.88	$112,414.16	nat. median $73,475 1.5× median
219 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	22	$17,861.00	$236,976.41	$111,381.83	nat. median $74,472 1.5× median
957 MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	20	$17,861.00	$228,606.05	$107,805.96	nat. median $71,485 1.5× median
427 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	17	$95,860.76	$217,534.39	$103,076.09	nat. median $66,640 1.5× median
275 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	21	$17,861.00	$216,441.01	$102,608.99	nat. median $68,581 1.5× median
870 MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	21	$17,861.00	$213,056.73	$101,163.20	nat. median $65,958 1.5× median
C0407 HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	$100,918.15	$100,918.15	$100,918.15	nat. median $70,140 1.4× median
955 MS_DRG	Craniotomy For Multiple Significant Trauma	20	$17,861.00	$209,130.34	$99,485.83	nat. median $64,357 1.5× median
D0407 HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	$98,321.99	$98,321.99	$98,321.99	nat. median $68,033 1.4× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	3	$35,858.53	$122,219.08	$97,904.99	nat. median $111,503 0.9× median
447 MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	17	$91,017.84	$205,344.85	$97,868.64	nat. median $62,262 1.6× median
928 MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	20	$17,861.00	$204,554.67	$97,531.07	nat. median $62,911 1.6× median
268 MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	21	$17,861.00	$204,208.59	$97,383.23	nat. median $65,792 1.5× median

Other procedures at this hospital

Browse this hospital's 5,853 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J1414	HCPCS	Inj, Beqvez, Per Tx Dose	6	5	—	—	$3,605,000.00	$4,565,876.22	$4,390,265.60	2025-09-05
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	6	5	—	—	$3,672,900.00	$4,535,437.05	$4,360,997.17	2025-09-05
J1413	HCPCS	Inj Delandistrogene Mox Rokl	7	6	—	—	$3,325,454.76	$4,722,145.76	$3,934,165.40	2025-09-05
J3394	HCPCS	Inj, Lovotibeglogene Autotem	7	6	—	—	$3,286,000.00	$4,666,120.00	$3,859,357.05	2025-09-05
J3393	HCPCS	Inj, Betibeglogene Autotemce	7	6	—	—	$2,968,000.00	$4,214,560.00	$3,491,724.58	2025-09-05
J3399	HCPCS	Inj Onase Abepar-xioi Treat	9	8	—	—	$2,388,614.23	$4,352,603.27	$2,901,735.52	2025-09-05
J3392	HCPCS	Inj, Exagamglogene Autotem	9	8	—	—	$2,332,000.00	$4,139,393.28	$2,759,595.52	2025-09-05
Q2057	HCPCS	Afamitresgene Autoleucel	30	16	—	—	$755,207.60	$1,823,841.77	$911,920.88	2025-09-05
Q2042	HCPCS	Tisagenlecleucel Car-pos T	31	16	—	—	$529,192.86	$1,368,732.35	$684,366.18	2025-09-05
Q2056	HCPCS	Ciltacabtagene Car-pos T	31	16	—	—	$527,123.43	$1,309,692.74	$654,846.37	2025-09-05
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	31	16	—	—	$516,726.08	$1,281,899.95	$640,949.97	2025-09-05
Q2055	HCPCS	Idecabtagene Vicleucel Car	31	16	—	—	$526,587.59	$1,281,011.93	$640,505.97	2025-09-05
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	31	16	—	—	$489,455.96	$1,261,642.77	$630,821.38	2025-09-05
Q2053	HCPCS	Brexucabtagene Car Pos T	31	16	—	—	$460,530.40	$1,159,030.12	$579,515.06	2025-09-05
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	33	21	—	—	$17,861.00	$1,155,029.93	$503,579.52	2025-09-05
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	33	21	—	—	$17,861.00	$862,710.52	$378,699.00	2025-09-05
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	8	7	—	—	$319,950.96	$639,901.92	$326,349.98	2025-09-05
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	32	20	—	—	$17,861.00	$726,558.20	$320,533.95	2025-09-05
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	33	21	—	—	$17,861.00	$656,385.61	$290,555.83	2025-09-05
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	33	21	—	—	$17,861.00	$432,759.51	$195,021.48	2025-09-05
14	MS_DRG	Allogeneic Bone Marrow Transplant	33	21	—	—	$17,861.00	$401,268.83	$181,568.48	2025-09-05
7	MS_DRG	Lung Transplant	33	21	—	—	$17,861.00	$400,258.14	$181,136.71	2025-09-05
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	33	21	—	—	$17,861.00	$337,500.35	$154,326.23	2025-09-05
212	MS_DRG	Concomitant Aortic And Mitral Valve?procedures	33	21	—	—	$17,861.00	$333,647.48	$152,680.26	2025-09-05
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	33	21	—	—	$17,861.00	$326,159.17	$149,481.21	2025-09-05
215	MS_DRG	Other Heart Assist System Implant	33	21	—	—	$17,861.00	$324,486.94	$148,766.82	2025-09-05
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	28	17	—	—	$136,900.27	$320,830.08	$147,204.59	2025-09-05
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	35	22	—	—	$17,861.00	$295,584.24	$136,419.43	2025-09-05
850	MS_DRG	Acute Leukemia With Other Procedures	28	17	—	—	$121,525.82	$282,132.86	$130,672.92	2025-09-05
B0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	1	—	—	$125,875.38	$125,875.38	$125,875.38	2025-09-05
231	MS_DRG	Coronary Bypass With Ptca With Mcc	35	22	—	—	$17,861.00	$259,530.14	$121,016.91	2025-09-05
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	21	—	—	$17,861.00	$259,386.19	$120,955.41	2025-09-05
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	28	17	—	—	$110,923.71	$255,447.56	$119,272.81	2025-09-05
B1904	HCPCS	Guillain-barr? M <38.50	1	1	—	—	$116,427.42	$116,427.42	$116,427.42	2025-09-05
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	33	21	—	—	$17,861.00	$246,887.31	$115,615.82	2025-09-05
10	MS_DRG	Pancreas Transplant	33	21	—	—	$17,861.00	$244,189.07	$114,463.12	2025-09-05
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	33	21	—	—	$17,861.00	$242,789.42	$113,865.18	2025-09-05
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	35	22	—	—	$17,861.00	$239,392.88	$112,414.16	2025-09-05
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	35	22	—	—	$17,861.00	$236,976.41	$111,381.83	2025-09-05
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	32	20	—	—	$17,861.00	$228,606.05	$107,805.96	2025-09-05
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	28	17	—	—	$95,860.76	$217,534.39	$103,076.09	2025-09-05
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	33	21	—	—	$17,861.00	$216,441.01	$102,608.99	2025-09-05
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	33	21	—	—	$17,861.00	$213,056.73	$101,163.20	2025-09-05
C0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	1	—	—	$100,918.15	$100,918.15	$100,918.15	2025-09-05
955	MS_DRG	Craniotomy For Multiple Significant Trauma	32	20	—	—	$17,861.00	$209,130.34	$99,485.83	2025-09-05
D0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	1	—	—	$98,321.99	$98,321.99	$98,321.99	2025-09-05
Q0480	HCPCS	Driver Pneumatic Vad, Rep	8	3	—	—	$35,858.53	$122,219.08	$97,904.99	2025-09-05
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	28	17	—	—	$91,017.84	$205,344.85	$97,868.64	2025-09-05
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	32	20	—	—	$17,861.00	$204,554.67	$97,531.07	2025-09-05
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	33	21	—	—	$17,861.00	$204,208.59	$97,383.23	2025-09-05
B1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	1	1	—	—	$96,759.96	$96,759.96	$96,759.96	2025-09-05
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	33	21	—	—	$17,861.00	$198,070.93	$94,761.19	2025-09-05
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	35	22	—	—	$17,861.00	$197,786.10	$94,639.50	2025-09-05
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	32	20	—	—	$17,861.00	$193,694.34	$92,891.48	2025-09-05
B0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	1	1	—	—	$92,239.02	$92,239.02	$92,239.02	2025-09-05
276	MS_DRG	Cardiac Defibrillator Implant With Mcc	33	21	—	—	$17,861.00	$189,715.89	$91,191.86	2025-09-05
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	28	17	—	—	$84,711.09	$189,470.87	$91,087.19	2025-09-05
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	33	21	—	—	$17,861.00	$188,607.19	$90,718.22	2025-09-05
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	33	21	—	—	$17,861.00	$187,948.71	$90,436.91	2025-09-05
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	33	21	—	—	$17,861.00	$187,091.15	$90,070.56	2025-09-05
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	2	1	—	—	$67,727.85	$111,750.95	$89,739.40	2025-09-05
28	MS_DRG	Spinal Procedures With Mcc	33	21	—	—	$17,861.00	$186,196.85	$89,688.51	2025-09-05
B0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	1	1	—	—	$89,293.64	$89,293.64	$89,293.64	2025-09-05
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	33	21	—	—	$17,861.00	$184,861.51	$89,118.04	2025-09-05
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	33	21	—	—	$17,861.00	$184,861.51	$89,118.04	2025-09-05
A0407	HCPCS	Traumatic Spinal Cord Injury M <24.50 And A >=61.50	1	1	—	—	$88,817.18	$88,817.18	$88,817.18	2025-09-05
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	33	21	—	—	$17,861.00	$183,480.23	$88,527.95	2025-09-05
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	33	21	—	—	$17,861.00	$182,209.21	$87,984.97	2025-09-05
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	29	19	—	—	$17,861.00	$124,855.05	$87,926.09	2025-09-05
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	35	22	—	—	$17,861.00	$180,215.39	$87,133.20	2025-09-05
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$178,319.58	$86,323.30	2025-09-05
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	21	—	—	$17,861.00	$175,780.60	$85,238.63	2025-09-05
B0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	1	1	—	—	$85,062.36	$85,062.36	$85,062.36	2025-09-05
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	33	21	—	—	$17,861.00	$174,730.10	$84,789.85	2025-09-05
653	MS_DRG	Major Bladder Procedures With Mcc	33	21	—	—	$17,861.00	$170,733.27	$83,082.38	2025-09-05
834	MS_DRG	Acute Leukemia Without Major O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$169,284.62	$82,463.51	2025-09-05
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	33	21	—	—	$17,861.00	$169,284.62	$82,463.51	2025-09-05
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	28	17	—	—	$76,408.76	$168,574.07	$82,159.96	2025-09-05
C1904	HCPCS	Guillain-barr? M <38.50	1	1	—	—	$81,938.31	$81,938.31	$81,938.31	2025-09-05
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	28	17	—	—	$75,999.91	$167,545.00	$81,720.33	2025-09-05
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	33	21	—	—	$17,861.00	$166,644.57	$81,335.66	2025-09-05
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	33	21	—	—	$17,861.00	$166,264.79	$81,173.42	2025-09-05
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	33	21	—	—	$17,861.00	$165,416.43	$80,810.99	2025-09-05
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	33	21	—	—	$17,861.00	$165,260.23	$80,744.27	2025-09-05
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	33	21	—	—	$17,861.00	$165,241.85	$80,736.42	2025-09-05
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	35	22	—	—	$17,861.00	$162,941.77	$79,753.80	2025-09-05
C1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	1	1	—	—	$79,723.86	$79,723.86	$79,723.86	2025-09-05
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	35	22	—	—	$17,861.00	$162,222.03	$79,446.33	2025-09-05
B0106	HCPCS	Stroke M <41.50 And A <84.50	1	1	—	—	$77,799.07	$77,799.07	$77,799.07	2025-09-05
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	28	17	—	—	$72,101.24	$157,732.11	$77,528.21	2025-09-05
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	33	21	—	—	$17,861.00	$157,208.39	$77,304.47	2025-09-05
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	33	21	—	—	$17,861.00	$156,032.31	$76,802.05	2025-09-05
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	33	21	—	—	$17,861.00	$155,554.53	$76,597.94	2025-09-05
B1903	HCPCS	Guillain-barr? M >=38.50 And M <51.50	1	1	—	—	$76,155.83	$76,155.83	$76,155.83	2025-09-05
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	33	21	—	—	$17,861.00	$154,265.14	$76,047.10	2025-09-05
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	33	21	—	—	$17,861.00	$153,355.51	$75,658.50	2025-09-05
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	33	21	—	—	$17,861.00	$153,236.07	$75,607.48	2025-09-05
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$153,174.82	$75,581.31	2025-09-05
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	35	22	—	—	$17,861.00	$152,623.53	$75,345.80	2025-09-05
J9029	HCPCS	Instill Adstiladrin, Tx Dose	32	17	—	—	$62,162.43	$150,123.53	$75,061.77	2025-09-05
B0205	HCPCS	Traumatic Brain Injury M <35.50	1	1	—	—	$74,496.35	$74,496.35	$74,496.35	2025-09-05
245	MS_DRG	Aicd Generator Procedures	35	22	—	—	$17,861.00	$149,668.02	$74,083.19	2025-09-05
C0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	1	1	—	—	$74,000.94	$74,000.94	$74,000.94	2025-09-05
471	MS_DRG	Cervical Spinal Fusion With Mcc	33	21	—	—	$17,861.00	$148,764.53	$73,697.21	2025-09-05
6	MS_DRG	Liver Transplant Without Mcc	33	21	—	—	$17,861.00	$148,516.45	$73,591.23	2025-09-05
D1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	1	1	—	—	$73,010.12	$73,010.12	$73,010.12	2025-09-05
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	33	21	—	—	$17,861.00	$146,259.24	$72,626.93	2025-09-05
799	MS_DRG	Splenic Procedures With Mcc	33	21	—	—	$17,861.00	$145,625.26	$72,356.09	2025-09-05
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	32	20	—	—	$17,861.00	$145,597.70	$72,344.32	2025-09-05
D0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	1	1	—	—	$72,103.22	$72,103.22	$72,103.22	2025-09-05
D1904	HCPCS	Guillain-barr? M <38.50	1	1	—	—	$71,818.97	$71,818.97	$71,818.97	2025-09-05
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	33	21	—	—	$17,861.00	$144,090.85	$71,700.59	2025-09-05
C0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	1	1	—	—	$71,643.01	$71,643.01	$71,643.01	2025-09-05
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	33	21	—	—	$17,861.00	$143,319.05	$71,370.87	2025-09-05
A1904	HCPCS	Guillain-barr? M <38.50	1	1	—	—	$71,339.81	$71,339.81	$71,339.81	2025-09-05
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	33	21	—	—	$17,861.00	$142,473.74	$71,009.75	2025-09-05
B0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	1	1	—	—	$70,733.41	$70,733.41	$70,733.41	2025-09-05
163	MS_DRG	Major Chest Procedures With Mcc	33	21	—	—	$17,861.00	$141,165.97	$70,451.06	2025-09-05
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	33	21	—	—	$17,861.00	$141,107.78	$70,426.20	2025-09-05
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	33	21	—	—	$17,861.00	$140,657.56	$70,233.87	2025-09-05
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	33	21	—	—	$17,861.00	$140,636.12	$70,224.71	2025-09-05
B1705	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	1	1	—	—	$69,829.22	$69,829.22	$69,829.22	2025-09-05
D0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	1	1	—	—	$69,807.56	$69,807.56	$69,807.56	2025-09-05
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$138,176.77	$69,174.06	2025-09-05
B0105	HCPCS	Stroke M <41.50 And A >=84.50	1	1	—	—	$69,065.80	$69,065.80	$69,065.80	2025-09-05
C0106	HCPCS	Stroke M <41.50 And A <84.50	1	1	—	—	$68,998.12	$68,998.12	$68,998.12	2025-09-05
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	33	21	—	—	$17,861.00	$137,352.91	$68,822.10	2025-09-05
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	33	21	—	—	$17,861.00	$136,973.13	$68,659.86	2025-09-05
A1806	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50	1	1	—	—	$68,643.48	$68,643.48	$68,643.48	2025-09-05
901	MS_DRG	Wound Debridements For Injuries With Mcc	32	20	—	—	$17,861.00	$135,692.92	$68,112.94	2025-09-05
B1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	1	1	—	—	$68,064.15	$68,064.15	$68,064.15	2025-09-05
B2102	HCPCS	Burns M <52.50	1	1	—	—	$67,961.28	$67,961.28	$67,961.28	2025-09-05
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	33	21	—	—	$17,861.00	$134,538.29	$67,619.68	2025-09-05
B0604	HCPCS	Neurological M <43.50	1	1	—	—	$67,252.01	$67,252.01	$67,252.01	2025-09-05
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	32	20	—	—	$17,861.00	$132,519.97	$66,757.44	2025-09-05
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	33	21	—	—	$17,861.00	$132,247.39	$66,640.99	2025-09-05
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	34	17	—	—	$54,827.05	$132,408.45	$66,204.22	2025-09-05
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$130,645.59	$65,956.70	2025-09-05
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	33	21	—	—	$17,861.00	$130,452.64	$65,874.27	2025-09-05
C0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	1	1	—	—	$65,671.03	$65,671.03	$65,671.03	2025-09-05
140	MS_DRG	Major Head And Neck Procedures With Mcc	33	21	—	—	$17,861.00	$129,527.71	$65,479.13	2025-09-05
B0305	HCPCS	Non-traumatic Brain Injury M <42.50 And A <78.50	1	1	—	—	$65,216.23	$65,216.23	$65,216.23	2025-09-05
A0406	HCPCS	Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50	1	1	—	—	$65,156.67	$65,156.67	$65,156.67	2025-09-05
B1004	HCPCS	Amputation Lower Extremity M <47.50	1	1	—	—	$65,078.16	$65,078.16	$65,078.16	2025-09-05
31	MS_DRG	Ventricular Shunt Procedures With Mcc	33	21	—	—	$17,861.00	$128,345.51	$64,974.09	2025-09-05
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	33	21	—	—	$17,861.00	$128,314.88	$64,961.00	2025-09-05
793	MS_DRG	Full Term Neonate With Major Problems	29	19	—	—	$17,861.00	$91,889.76	$64,711.10	2025-09-05
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	33	21	—	—	$17,861.00	$127,429.76	$64,582.87	2025-09-05
B1504	HCPCS	Pulmonary M <45.50	1	1	—	—	$64,155.03	$64,155.03	$64,155.03	2025-09-05
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	35	22	—	—	$17,861.00	$125,941.29	$63,946.99	2025-09-05
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	32	20	—	—	$17,861.00	$125,870.84	$63,916.90	2025-09-05
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	33	21	—	—	$17,861.00	$125,684.02	$63,837.08	2025-09-05
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	28	17	—	—	$59,122.69	$125,065.35	$63,572.79	2025-09-05
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$124,572.26	$63,362.13	2025-09-05
B0704	HCPCS	Fracture Of Lower Extremity M <41.50	1	1	—	—	$63,286.03	$63,286.03	$63,286.03	2025-09-05
791	MS_DRG	Prematurity With Major Problems	29	19	—	—	$17,861.00	$89,834.88	$63,264.00	2025-09-05
A0404	HCPCS	Traumatic Spinal Cord Injury M <31.50 And A <61.50	1	1	—	—	$63,082.99	$63,082.99	$63,082.99	2025-09-05
D0106	HCPCS	Stroke M <41.50 And A <84.50	1	1	—	—	$62,663.39	$62,663.39	$62,663.39	2025-09-05
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	32	20	—	—	$17,861.00	$122,008.78	$62,267.00	2025-09-05
B1304	HCPCS	Rheumatoid Other Arthritis M <44.50 And A >=64.50	1	1	—	—	$62,254.61	$62,254.61	$62,254.61	2025-09-05
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	33	21	—	—	$17,861.00	$121,923.02	$62,230.37	2025-09-05
B1305	HCPCS	Rheumatoid Other Arthritis M <51.50 And A <64.50	1	1	—	—	$62,162.56	$62,162.56	$62,162.56	2025-09-05
B0904	HCPCS	Other Orthopedic M <44.5	1	1	—	—	$61,959.53	$61,959.53	$61,959.53	2025-09-05
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$120,844.95	$61,769.81	2025-09-05
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	33	21	—	—	$17,861.00	$120,596.88	$61,663.83	2025-09-05
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	18	12	—	—	$17,861.00	$92,636.39	$61,559.15	2025-09-05
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	28	17	—	—	$57,038.29	$119,818.95	$61,331.49	2025-09-05
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	33	21	—	—	$17,861.00	$119,760.76	$61,306.63	2025-09-05
C0105	HCPCS	Stroke M <41.50 And A >=84.50	1	1	—	—	$61,263.79	$61,263.79	$61,263.79	2025-09-05
D0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	1	1	—	—	$61,231.30	$61,231.30	$61,231.30	2025-09-05
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	33	21	—	—	$17,861.00	$119,099.21	$61,024.02	2025-09-05
B2005	HCPCS	Miscellaneous M <46.50 And A <77.50	1	1	—	—	$60,741.31	$60,741.31	$60,741.31	2025-09-05
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	33	21	—	—	$17,861.00	$118,373.36	$60,713.93	2025-09-05
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	32	20	—	—	$17,861.00	$118,253.91	$60,662.90	2025-09-05
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$117,923.14	$60,521.59	2025-09-05
B0504	HCPCS	Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50	1	1	—	—	$60,354.18	$60,354.18	$60,354.18	2025-09-05
B1704	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	1	1	—	—	$60,251.31	$60,251.31	$60,251.31	2025-09-05
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	32	20	—	—	$17,861.00	$117,068.64	$60,156.55	2025-09-05
A5104	HCPCS	Expired, Not Orthopedic, Length Of Stay Is 16 Days Or More	1	1	—	—	$60,121.37	$60,121.37	$60,121.37	2025-09-05
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	33	21	—	—	$17,861.00	$116,434.67	$59,885.71	2025-09-05
B0304	HCPCS	Non-traumatic Brain Injury M <42.50 And A >=78.50	1	1	—	—	$59,674.69	$59,674.69	$59,674.69	2025-09-05
B1204	HCPCS	Osteoarthritis M <49.50 And A <74.50	1	1	—	—	$59,536.62	$59,536.62	$59,536.62	2025-09-05
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	33	21	—	—	$17,861.00	$115,528.11	$59,498.42	2025-09-05
A0106	HCPCS	Stroke M <41.50 And A <84.50	1	1	—	—	$59,468.95	$59,468.95	$59,468.95	2025-09-05
C0205	HCPCS	Traumatic Brain Injury M <35.50	1	1	—	—	$59,398.56	$59,398.56	$59,398.56	2025-09-05
B1404	HCPCS	Cardiac M <45.50	1	1	—	—	$59,154.92	$59,154.92	$59,154.92	2025-09-05
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	33	21	—	—	$17,861.00	$114,606.23	$59,104.59	2025-09-05
B0204	HCPCS	Traumatic Brain Injury M >=35.50 And M <49.50	1	1	—	—	$58,486.25	$58,486.25	$58,486.25	2025-09-05
B2004	HCPCS	Miscellaneous M <46.50 And A >=77.50	1	1	—	—	$58,150.56	$58,150.56	$58,150.56	2025-09-05
B1203	HCPCS	Osteoarthritis M <49.50 And A >=74.50	1	1	—	—	$58,053.11	$58,053.11	$58,053.11	2025-09-05
C2102	HCPCS	Burns M <52.50	1	1	—	—	$57,971.89	$57,971.89	$57,971.89	2025-09-05
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	33	21	—	—	$17,861.00	$111,748.73	$57,883.85	2025-09-05
B0805	HCPCS	Replacement Of Lower-extremity Joint M <42.50	1	1	—	—	$57,684.93	$57,684.93	$57,684.93	2025-09-05
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	33	21	—	—	$17,861.00	$110,973.87	$57,552.82	2025-09-05
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	33	21	—	—	$17,861.00	$109,791.67	$57,047.78	2025-09-05
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	33	21	—	—	$17,861.00	$109,785.54	$57,045.16	2025-09-05
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	33	21	—	—	$17,861.00	$109,767.17	$57,037.31	2025-09-05
B1804	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50	1	1	—	—	$57,021.68	$57,021.68	$57,021.68	2025-09-05
265	MS_DRG	Aicd Lead Procedures	33	21	—	—	$17,861.00	$109,252.63	$56,817.50	2025-09-05
C0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	1	1	—	—	$56,788.87	$56,788.87	$56,788.87	2025-09-05
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	33	21	—	—	$17,861.00	$108,762.60	$56,608.16	2025-09-05
A0505	HCPCS	Non-traumatic Spinal Cord Injury M <39.50	1	1	—	—	$56,504.61	$56,504.61	$56,504.61	2025-09-05
A5102	HCPCS	Expired, Orthopedic, Length Of Stay Is 14 Days Or More	1	1	—	—	$56,344.89	$56,344.89	$56,344.89	2025-09-05
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	33	21	—	—	$17,861.00	$108,125.56	$56,336.01	2025-09-05
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	33	21	—	—	$17,861.00	$108,098.00	$56,324.23	2025-09-05
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	33	21	—	—	$17,861.00	$107,825.42	$56,207.79	2025-09-05
C1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	1	1	—	—	$56,128.32	$56,128.32	$56,128.32	2025-09-05
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	33	21	—	—	$17,861.00	$107,310.88	$55,987.98	2025-09-05
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	32	20	—	—	$17,861.00	$107,277.19	$55,973.58	2025-09-05
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	33	21	—	—	$17,861.00	$107,234.32	$55,955.26	2025-09-05
264	MS_DRG	Other Circulatory System O.r. Procedures	33	21	—	—	$17,861.00	$107,044.43	$55,874.14	2025-09-05
B1604	HCPCS	Pain Syndrome M <43.50	1	1	—	—	$55,873.85	$55,873.85	$55,873.85	2025-09-05
B0104	HCPCS	Stroke M >=41.50 And M <50.50	1	1	—	—	$55,706.00	$55,706.00	$55,706.00	2025-09-05
D0105	HCPCS	Stroke M <41.50 And A >=84.50	1	1	—	—	$55,649.15	$55,649.15	$55,649.15	2025-09-05
C1705	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	1	1	—	—	$55,630.20	$55,630.20	$55,630.20	2025-09-05
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	33	21	—	—	$17,861.00	$106,352.26	$55,578.44	2025-09-05
332	MS_DRG	Rectal Resection With Mcc	33	21	—	—	$17,861.00	$106,235.87	$55,528.73	2025-09-05
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	33	21	—	—	$17,861.00	$106,119.49	$55,479.01	2025-09-05
D0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	1	1	—	—	$55,340.54	$55,340.54	$55,340.54	2025-09-05
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	33	21	—	—	$17,861.00	$105,491.64	$55,210.78	2025-09-05
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	33	21	—	—	$17,861.00	$105,326.25	$55,140.13	2025-09-05
665	MS_DRG	Prostatectomy With Mcc	33	21	—	—	$17,861.00	$105,160.87	$55,069.48	2025-09-05
252	MS_DRG	Other Vascular Procedures With Mcc	35	22	—	—	$17,861.00	$105,062.86	$55,027.61	2025-09-05
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	33	21	—	—	$17,861.00	$104,903.60	$54,959.57	2025-09-05
B0403	HCPCS	Traumatic Spinal Cord Injury M >=41.50 And M <47.50	1	1	—	—	$54,958.83	$54,958.83	$54,958.83	2025-09-05
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	35	22	—	—	$14,696.00	$104,321.69	$54,710.97	2025-09-05
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	35	22	—	—	$17,861.00	$103,886.78	$54,525.18	2025-09-05
D0205	HCPCS	Traumatic Brain Injury M <35.50	1	1	—	—	$54,395.74	$54,395.74	$54,395.74	2025-09-05
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	33	21	—	—	$17,861.00	$102,805.65	$54,063.31	2025-09-05
C1004	HCPCS	Amputation Lower Extremity M <47.50	1	1	—	—	$53,943.65	$53,943.65	$53,943.65	2025-09-05
B1902	HCPCS	Guillain-barr? M >=51.50 And M <66.50	1	1	—	—	$53,935.53	$53,935.53	$53,935.53	2025-09-05
J9226	HCPCS	Supprelin La Implant	35	18	—	—	$44,649.18	$107,828.69	$53,914.34	2025-09-05
C1903	HCPCS	Guillain-barr? M >=38.50 And M <51.50	1	1	—	—	$53,691.88	$53,691.88	$53,691.88	2025-09-05
37	MS_DRG	Extracranial Procedures With Mcc	33	21	—	—	$17,861.00	$101,709.20	$53,594.91	2025-09-05
B0603	HCPCS	Neurological M >=43.50 And M <52.50	1	1	—	—	$53,372.44	$53,372.44	$53,372.44	2025-09-05
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$101,127.29	$53,346.31	2025-09-05
B1103	HCPCS	Amputation Non-lower Extremity M <52.50	1	1	—	—	$53,166.70	$53,166.70	$53,166.70	2025-09-05
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	33	21	—	—	$17,861.00	$100,110.47	$52,911.92	2025-09-05
A0105	HCPCS	Stroke M <41.50 And A >=84.50	1	1	—	—	$52,817.47	$52,817.47	$52,817.47	2025-09-05
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	33	21	—	—	$17,861.00	$99,825.64	$52,790.24	2025-09-05
656	MS_DRG	Kidney And Ureter Procedures For Neoplasm With Mcc	33	21	—	—	$17,861.00	$99,782.77	$52,771.92	2025-09-05
B1703	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=41.50 And M <50.50	1	1	—	—	$52,411.40	$52,411.40	$52,411.40	2025-09-05
485	MS_DRG	Knee Procedures With Principal Diagnosis Of Infection With Mcc	33	21	—	—	$17,861.00	$98,597.50	$52,265.57	2025-09-05
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	33	21	—	—	$17,861.00	$98,141.16	$52,070.62	2025-09-05
324	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc	33	21	—	—	$17,861.00	$97,856.33	$51,948.94	2025-09-05
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	33	21	—	—	$17,861.00	$97,669.50	$51,869.12	2025-09-05
C1504	HCPCS	Pulmonary M <45.50	1	1	—	—	$51,807.71	$51,807.71	$51,807.71	2025-09-05
C0305	HCPCS	Non-traumatic Brain Injury M <42.50 And A <78.50	1	1	—	—	$51,796.88	$51,796.88	$51,796.88	2025-09-05
D1705	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50	1	1	—	—	$51,788.76	$51,788.76	$51,788.76	2025-09-05
929	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc	32	20	—	—	$17,861.00	$97,406.11	$51,756.60	2025-09-05
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	32	20	—	—	$17,861.00	$97,210.10	$51,672.86	2025-09-05
500	MS_DRG	Soft Tissue Procedures With Mcc	33	21	—	—	$17,861.00	$97,047.77	$51,603.52	2025-09-05
B0903	HCPCS	Other Orthopedic M >=44.50 And M <51.50	1	1	—	—	$51,583.01	$51,583.01	$51,583.01	2025-09-05
B0703	HCPCS	Fracture Of Lower Extremity M >=41.50 And M <52.50	1	1	—	—	$51,450.36	$51,450.36	$51,450.36	2025-09-05
D1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	1	1	—	—	$51,426.00	$51,426.00	$51,426.00	2025-09-05
B1503	HCPCS	Pulmonary M >=45.50 And M <56.50	1	1	—	—	$51,415.17	$51,415.17	$51,415.17	2025-09-05
C0604	HCPCS	Neurological M <43.50	1	1	—	—	$51,141.75	$51,141.75	$51,141.75	2025-09-05
A0205	HCPCS	Traumatic Brain Injury M <35.50	1	1	—	—	$51,130.92	$51,130.92	$51,130.92	2025-09-05
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	33	21	—	—	$17,861.00	$95,586.87	$50,979.41	2025-09-05
662	MS_DRG	Minor Bladder Procedures With Mcc	33	21	—	—	$17,861.00	$95,543.99	$50,961.09	2025-09-05
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	35	22	—	—	$17,861.00	$95,136.65	$50,787.07	2025-09-05
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	33	21	—	—	$17,861.00	$94,710.93	$50,605.21	2025-09-05
B0503	HCPCS	Non-traumatic Spinal Cord Injury M >=48.50 And M <53.50	1	1	—	—	$50,603.02	$50,603.02	$50,603.02	2025-09-05
C0704	HCPCS	Fracture Of Lower Extremity M <41.50	1	1	—	—	$50,565.12	$50,565.12	$50,565.12	2025-09-05
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	28	17	—	—	$46,984.97	$94,514.92	$50,521.47	2025-09-05
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	33	21	—	—	$17,861.00	$94,447.54	$50,492.68	2025-09-05
C1103	HCPCS	Amputation Non-lower Extremity M <52.50	1	1	—	—	$50,489.32	$50,489.32	$50,489.32	2025-09-05
B0303	HCPCS	Non-traumatic Brain Injury M >=42.50 And M <52.50	1	1	—	—	$50,446.01	$50,446.01	$50,446.01	2025-09-05
652	MS_DRG	Kidney Transplant	33	21	—	—	$17,861.00	$94,067.77	$50,330.44	2025-09-05
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	33	21	—	—	$17,861.00	$93,982.01	$50,293.81	2025-09-05
C1304	HCPCS	Rheumatoid Other Arthritis M <44.50 And A >=64.50	1	1	—	—	$50,256.51	$50,256.51	$50,256.51	2025-09-05
C1305	HCPCS	Rheumatoid Other Arthritis M <51.50 And A <64.50	1	1	—	—	$50,180.71	$50,180.71	$50,180.71	2025-09-05
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	33	21	—	—	$17,861.00	$93,675.74	$50,162.97	2025-09-05
A0405	HCPCS	Traumatic Spinal Cord Injury M >=31.50 And M <41.50	1	1	—	—	$50,029.11	$50,029.11	$50,029.11	2025-09-05
570	MS_DRG	Skin Debridement With Mcc	33	21	—	—	$17,861.00	$92,193.40	$49,529.70	2025-09-05
C1604	HCPCS	Pain Syndrome M <43.50	1	1	—	—	$49,479.56	$49,479.56	$49,479.56	2025-09-05
C0104	HCPCS	Stroke M >=41.50 And M <50.50	1	1	—	—	$49,436.24	$49,436.24	$49,436.24	2025-09-05
974	MS_DRG	HIV With Major Related Condition With Mcc	32	20	—	—	$17,861.00	$91,458.35	$49,215.68	2025-09-05
B1003	HCPCS	Amputation Lower Extremity M >=47.50 And M <55.50	1	1	—	—	$49,187.18	$49,187.18	$49,187.18	2025-09-05
D1004	HCPCS	Amputation Lower Extremity M <47.50	1	1	—	—	$49,170.94	$49,170.94	$49,170.94	2025-09-05
B1803	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=45.50 And M <55.50	1	1	—	—	$48,916.47	$48,916.47	$48,916.47	2025-09-05
C2005	HCPCS	Miscellaneous M <46.50 And A <77.50	1	1	—	—	$48,881.27	$48,881.27	$48,881.27	2025-09-05
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	33	21	—	—	$17,861.00	$90,306.77	$48,723.72	2025-09-05
C0805	HCPCS	Replacement Of Lower-extremity Joint M <42.50	1	1	—	—	$48,651.17	$48,651.17	$48,651.17	2025-09-05
D1504	HCPCS	Pulmonary M <45.50	1	1	—	—	$48,626.80	$48,626.80	$48,626.80	2025-09-05
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	33	21	—	—	$17,861.00	$90,074.01	$48,624.28	2025-09-05
353	MS_DRG	Hernia Procedures Except Inguinal And Femoral With Mcc	33	21	—	—	$17,861.00	$89,828.99	$48,519.61	2025-09-05
B1303	HCPCS	Rheumatoid Other Arthritis M >=44.50 And M <51.50 And A >=64.50	1	1	—	—	$48,453.54	$48,453.54	$48,453.54	2025-09-05
A1805	HCPCS	Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50	1	1	—	—	$48,366.92	$48,366.92	$48,366.92	2025-09-05
D0305	HCPCS	Non-traumatic Brain Injury M <42.50 And A <78.50	1	1	—	—	$48,310.07	$48,310.07	$48,310.07	2025-09-05
668	MS_DRG	Transurethral Procedures With Mcc	33	21	—	—	$17,861.00	$89,317.52	$48,301.11	2025-09-05
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	33	21	—	—	$17,861.00	$89,268.52	$48,280.17	2025-09-05
800	MS_DRG	Splenic Procedures With Cc	33	21	—	—	$17,861.00	$89,240.95	$48,268.40	2025-09-05
240	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc	33	21	—	—	$17,861.00	$89,191.95	$48,247.46	2025-09-05
D0604	HCPCS	Neurological M <43.50	1	1	—	—	$48,218.02	$48,218.02	$48,218.02	2025-09-05
D0704	HCPCS	Fracture Of Lower Extremity M <41.50	1	1	—	—	$48,101.61	$48,101.61	$48,101.61	2025-09-05
472	MS_DRG	Cervical Spinal Fusion With Cc	33	21	—	—	$17,861.00	$88,732.54	$48,051.20	2025-09-05
C1704	HCPCS	Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50	1	1	—	—	$48,025.81	$48,025.81	$48,025.81	2025-09-05
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	2	1	—	—	$36,229.52	$59,778.71	$48,004.11	2025-09-05
B0402	HCPCS	Traumatic Spinal Cord Injury M >=47.50 And M <56.50	1	1	—	—	$47,952.72	$47,952.72	$47,952.72	2025-09-05

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