Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

CORNING HOSPITAL

Corning, NY · CCN 330277 · Rates published

5,591 distinct procedures filed
26 distinct payers
484,903 rate rows
2026-07-15 last MRF observed
Data quality

476,862 of 484,903 rate rows are consumer-grade (98.3%)

8,041 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 3,634
per-diem day rate — not a per-procedure price 2,241
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,283
exceeds 10× this hospital's gross charge — excluded from medians 383
placeholder amount (≤ $0.02) — excluded from medians 268
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 115
exceeds 3× this hospital's gross charge for a DRG stay — excluded 91
percent-of-charges filed in the dollar field — excluded from medians 16
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 10
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://rca.centaurihs.com/ptapp/api/cdm/export/oneclick?recno=610595ce3b92de5ca677fdabb3743fc4dcbb0c455c5fe0d50b08b409b931c15b
Found on page https://www.guthrie.org/about-us/hospital-price-transparency
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint e220c37cb878c7e5… · 160,184,298 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
0845
RC 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 14 $4,505,000.00 $4,955,500.00 $4,640,150.00 nat. median
$1,060
outlier · 4377.5×
9138
OTHER 		Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 14 $3,685,266.67 $4,053,793.33 $3,795,824.67 nat. median
$3,765,001
1.0× median
0714
OTHER 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 14 $3,316,462.59 $3,648,108.85 $3,424,247.62 nat. median
$4,693,518
0.7× median
0748
OTHER 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 14 $3,248,445.71 $3,573,290.29 $3,354,020.20 —
0746
OTHER 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 $2,945,740.00 $4,713,184.00 $3,048,840.90 —
9141
OTHER 		Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 15 $2,455,110.60 $3,928,176.97 $2,541,039.48 nat. median
$2,508,045
1.0× median
0824
RC 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 $2,332,000.00 $3,731,200.00 $2,413,620.00 nat. median
$1,136
outlier · 2123.7×
2067
OTHER 		Medicine, Laboratory, Or Ancillary Diagnostic Service Under Opps 15 $770,620.00 $2,668,502.94 $809,151.00 nat. median
$838,386
1.0× median
9194
OTHER 		Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 15 $591,726.20 $2,049,029.49 $621,312.51 nat. median
$555,653
1.1× median
9498
OTHER 		Pulmonary Function Testing, Cardiac Stress Testing, Or Related Physiologic Diagn… 15 $565,868.94 $1,959,490.98 $594,162.39 nat. median
$553,480
1.1× median
9413
OTHER 		Pulmonary Function Testing, Cardiac Stress Testing, Or Related Physiologic Diagn… 15 $562,538.19 $1,947,957.23 $590,665.09 nat. median
$542,562
1.1× median
9422
OTHER 		Pulmonary Function Testing, Cardiac Stress Testing, Or Related Physiologic Diagn… 15 $557,317.93 $1,929,880.54 $585,183.83 nat. median
$552,917
1.1× median
9035
OTHER 		Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 15 $533,230.17 $1,846,469.44 $559,891.68 nat. median
$513,929
1.1× median
9391
OTHER 		Cardiac Catheterization / Electrophysiology / Vascular Diagnostic Study 15 $489,304.61 $1,694,364.00 $513,769.84 nat. median
$483,557
1.1× median
0831
RC 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 $278,250.00 $963,524.10 $292,162.50 nat. median
$670
outlier · 435.7×
J3357
HCPCS 		Ustekinumab 90 Mg/ml Sc Sosy 24 $15,432.42 $284,085.75 $284,085.75 nat. median
$20,264
outlier · 14.0×
0897
OTHER 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 $257,500.00 $891,671.00 $270,375.00 —
J0202
HCPCS 		Alemtuzumab 12 Mg/1.2ml IV Soln 24 $29,288.42 $258,724.50 $258,724.50 nat. median
$3,427
outlier · 75.5×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $207,272.18 $365,641.41 $225,146.24 nat. median
$186,516
1.2× median
0886
OTHER 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 $205,640.00 $712,090.19 $215,922.00 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $155,416.03 $287,674.81 $178,297.19 nat. median
$145,435
1.2× median
J2507
HCPCS 		Pegloticase 8 Mg/ml IV Soln 25 $28,400.38 $161,591.50 $161,591.50 nat. median
$4,390
outlier · 36.8×
4
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure,extreme 9 $114,268.29 $258,611.75 $143,840.93 nat. median
$159,438
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $96,344.93 $222,656.27 $116,355.35 nat. median
$97,418
1.2× median
J2840
HCPCS 		Sebelipase Alfa 20 Mg/10ml IV Soln 25 $10,793.86 $107,230.75 $107,230.75 nat. median
$742
outlier · 144.5×
5
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure,extreme 9 $87,287.83 $197,327.75 $104,747.97 nat. median
$153,542
0.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $97,506.27 $97,506.27 $97,506.27 nat. median
$65,418
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 14 $80,161.12 $145,329.06 $87,073.79 nat. median
$74,509
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $6,735.92 $98,007.84 $83,728.76 nat. median
$2,736
outlier · 30.6×
215
MS_DRG 		Other Heart Assist System Implant 15 $74,655.33 $139,721.19 $83,641.38 nat. median
$73,023
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $73,349.22 $130,953.61 $82,178.06 nat. median
$69,822
1.2× median
37231
CPT 		Tib/per Revasc Stent & Ather 25 $13,969.50 $81,218.00 $81,218.00 nat. median
$19,288
outlier · 4.2×
37229
CPT 		Tib/per Revasc With Ather 25 $13,879.02 $80,692.00 $80,692.00 nat. median
$18,507
outlier · 4.4×
J2329
HCPCS 		Ublituximab-xiiy 150 Mg/6ml IV Soln 25 $10,785.60 $115,516.00 $77,580.54 nat. median
$116
outlier · 670.0×
J9043
HCPCS 		Cabazitaxel 60 Mg/1.5ml IV Soln 24 $13,386.91 $145,660.75 $76,177.11 nat. median
$509
outlier · 149.6×
J9345
HCPCS 		Retifanlimab-dlwr 500 Mg/20ml IV Soln 25 $14,991.00 $118,335.25 $76,006.73 nat. median
$34
outlier · 2230.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 15 $16,104.98 $109,498.39 $70,813.35 nat. median
$60,505
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 $63,006.79 $113,737.89 $70,590.74 nat. median
$59,651
1.2× median
61623
CPT 		Endovasc Temp B Vessel Occl 25 $11,196.90 $67,860.00 $67,860.00 nat. median
$11,794
outlier · 5.8×
36906
CPT 		Thrmbc/Nfs Dialysis Circuit W/Stenting 25 $19,474.02 $118,024.37 $67,686.98 nat. median
$18,501
outlier · 3.7×
37227
CPT 		Fem/Popl Revasc Stnt & Ather 25 $13,963.57 $81,183.54 $67,382.34 nat. median
$19,510
outlier · 3.5×
0717
OTHER 		Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 $63,342.28 $219,341.65 $66,509.40 nat. median
$163,445
outlier · 0.4×
37230
CPT 		Tib/per Revasc With Stent 25 $13,618.79 $79,179.00 $65,718.57 nat. median
$17,953
outlier · 3.7×
312
APR_DRG 		Skin Graft For Musculoskeletal And Connective Tissue Diagnoses,extreme 9 $57,128.37 $99,974.65 $64,591.16 nat. median
$16,336
outlier · 4.0×
J2350
HCPCS 		Ocrelizumab 300 Mg/10ml IV Soln 24 $15,867.90 $207,050.50 $62,996.68 nat. median
$133
outlier · 473.8×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 15 $57,515.80 $105,240.00 $62,475.66 nat. median
$55,935
1.1× median
5244
OTHER 		Level 4 Gastrointestinal / Hepatobiliary Procedure Û Includes Upper/lower Gi End… 15 $59,142.33 $204,798.06 $62,099.45 nat. median
$54,832
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 $56,935.23 $104,047.22 $61,845.02 nat. median
$55,923
1.1× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 $61,393.94 $61,393.94 $61,393.94 nat. median
$43,299
1.4× median
J1628
HCPCS 		Guselkumab 200 Mg/20ml IV Soln 4 $24,977.49 $97,094.33 $61,035.91 nat. median
$127
outlier · 480.6×

Other procedures at this hospital

Browse this hospital's 5,591 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
             
0845 RC Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 14 $4,505,000.00 $3,604,000.00 20% off $4,505,000.00 $4,955,500.00 $4,640,150.00 2026-07-15
9138 OTHER Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 15 14 $3,685,266.67 $2,948,213.33 20% off $3,685,266.67 $4,053,793.33 $3,795,824.67 2026-07-15
0714 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 14 14 $3,316,462.59 $2,653,170.07 20% off $3,316,462.59 $3,648,108.85 $3,424,247.62 2026-07-15
0748 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 14 14 $3,248,445.71 $2,598,756.57 $3,248,445.71 $3,573,290.29 $3,354,020.20 2026-07-15
0746 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 15 $2,945,740.00 $2,356,592.00 20% off $2,945,740.00 $4,713,184.00 $3,048,840.90 2026-07-15
9141 OTHER Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 15 15 $2,455,110.60 $1,964,088.48 20% off $2,455,110.60 $3,928,176.97 $2,541,039.48 2026-07-15
0824 RC Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 15 15 $2,332,000.00 $1,865,600.00 20% off $2,332,000.00 $3,731,200.00 $2,413,620.00 2026-07-15
2067 OTHER Medicine, Laboratory, Or Ancillary Diagnostic Service Under Opps 21 15 $770,620.00 $616,496.00 20% off $770,620.00 $2,668,502.94 $809,151.00 2026-07-15
9194 OTHER Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 21 15 $591,726.20 $473,380.96 $591,726.20 $2,049,029.49 $621,312.51 2026-07-15
9498 OTHER Pulmonary Function Testing, Cardiac Stress Testing, Or Related Physiologic Diagn… 21 15 $565,868.94 $452,695.16 $565,868.94 $1,959,490.98 $594,162.39 2026-07-15
9413 OTHER Pulmonary Function Testing, Cardiac Stress Testing, Or Related Physiologic Diagn… 21 15 $562,538.19 $450,030.55 20% off $562,538.19 $1,947,957.23 $590,665.09 2026-07-15
9422 OTHER Pulmonary Function Testing, Cardiac Stress Testing, Or Related Physiologic Diagn… 21 15 $557,317.93 $445,854.35 $557,317.93 $1,929,880.54 $585,183.83 2026-07-15
9035 OTHER Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 21 15 $533,230.17 $426,584.14 $533,230.17 $1,846,469.44 $559,891.68 2026-07-15
9391 OTHER Cardiac Catheterization / Electrophysiology / Vascular Diagnostic Study 21 15 $489,304.61 $391,443.69 $489,304.61 $1,694,364.00 $513,769.84 2026-07-15
0831 RC Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 21 15 $278,250.00 $222,600.00 20% off $278,250.00 $963,524.10 $292,162.50 2026-07-15
J3357 HCPCS Ustekinumab 90 Mg/ml Sc Sosy 51 24 $284,085.75 $227,268.60 20% off $15,432.42 $284,085.75 $284,085.75 2026-07-15
0897 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 21 15 $257,500.00 $206,000.00 20% off $257,500.00 $891,671.00 $270,375.00 2026-07-15
J0202 HCPCS Alemtuzumab 12 Mg/1.2ml IV Soln 50 24 $258,724.50 $206,979.60 20% off $29,288.42 $258,724.50 $258,724.50 2026-07-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 26 15 $606,157.35 $484,925.88 $207,272.18 $365,641.41 $225,146.24 2026-07-15
0886 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 21 15 $205,640.00 $164,512.00 20% off $205,640.00 $712,090.19 $215,922.00 2026-07-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 26 15 $389,301.76 $311,441.41 $155,416.03 $287,674.81 $178,297.19 2026-07-15
J2507 HCPCS Pegloticase 8 Mg/ml IV Soln 56 25 $161,591.50 $129,273.20 20% off $28,400.38 $161,591.50 $161,591.50 2026-07-15
4 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure,extreme 15 9 $475,719.17 $380,575.34 $114,268.29 $258,611.75 $143,840.93 2026-07-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 29 16 $231,829.97 $185,463.98 $96,344.93 $222,656.27 $116,355.35 2026-07-15
J2840 HCPCS Sebelipase Alfa 20 Mg/10ml IV Soln 51 25 $107,230.75 $85,784.60 $10,793.86 $107,230.75 $107,230.75 2026-07-15
5 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure,extreme 12 9 $231,829.97 $185,463.98 $87,287.83 $197,327.75 $104,747.97 2026-07-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 $509,022.61 $407,218.09 $97,506.27 $97,506.27 $97,506.27 2026-07-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 25 14 $312,842.95 $250,274.36 20% off $80,161.12 $145,329.06 $87,073.79 2026-07-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 15 $200,328.10 $160,262.48 20% off $6,735.92 $98,007.84 $83,728.76 2026-07-15
215 MS_DRG Other Heart Assist System Implant 26 15 $819,068.73 $655,254.98 20% off $74,655.33 $139,721.19 $83,641.38 2026-07-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 15 $249,591.32 $199,673.06 $73,349.22 $130,953.61 $82,178.06 2026-07-15
37231 CPT Tib/per Revasc Stent & Ather 49 25 $81,218.00 $64,974.40 20% off $13,969.50 $81,218.00 $81,218.00 2026-07-15
37229 CPT Tib/per Revasc With Ather 49 25 $80,692.00 $64,553.60 20% off $13,879.02 $80,692.00 $80,692.00 2026-07-15
J2329 HCPCS Ublituximab-xiiy 150 Mg/6ml IV Soln 60 25 $115,516.00 $92,412.80 20% off $10,785.60 $115,516.00 $77,580.54 2026-07-15
J9043 HCPCS Cabazitaxel 60 Mg/1.5ml IV Soln 60 24 $145,660.75 $116,528.60 $13,386.91 $145,660.75 $76,177.11 2026-07-15
J9345 HCPCS Retifanlimab-dlwr 500 Mg/20ml IV Soln 60 25 $118,335.25 $94,668.20 20% off $14,991.00 $118,335.25 $76,006.73 2026-07-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 28 15 $275,943.79 $220,755.03 20% off $16,104.98 $109,498.39 $70,813.35 2026-07-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 15 $155,148.82 $124,119.06 $63,006.79 $113,737.89 $70,590.74 2026-07-15
61623 CPT Endovasc Temp B Vessel Occl 53 25 $67,860.00 $54,288.00 20% off $11,196.90 $67,860.00 $67,860.00 2026-07-15
36906 CPT Thrmbc/Nfs Dialysis Circuit W/Stenting 58 25 $118,024.37 $94,419.50 $19,474.02 $118,024.37 $67,686.98 2026-07-15
37227 CPT Fem/Popl Revasc Stnt & Ather 46 25 $81,183.54 $64,946.83 20% off $13,963.57 $81,183.54 $67,382.34 2026-07-15
0717 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 21 15 $63,342.28 $50,673.83 $63,342.28 $219,341.65 $66,509.40 2026-07-15
37230 CPT Tib/per Revasc With Stent 46 25 $79,179.00 $63,343.20 20% off $13,618.79 $79,179.00 $65,718.57 2026-07-15
312 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses,extreme 15 9 $73,289.45 $58,631.56 20% off $57,128.37 $99,974.65 $64,591.16 2026-07-15
J2350 HCPCS Ocrelizumab 300 Mg/10ml IV Soln 58 24 $207,050.50 $165,640.40 20% off $15,867.90 $207,050.50 $62,996.68 2026-07-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 26 15 $234,847.01 $187,877.61 $57,515.80 $105,240.00 $62,475.66 2026-07-15
5244 OTHER Level 4 Gastrointestinal / Hepatobiliary Procedure Û Includes Upper/lower Gi End… 21 15 $59,142.33 $47,313.86 20% off $59,142.33 $204,798.06 $62,099.45 2026-07-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 15 $251,745.49 $201,396.39 20% off $56,935.23 $104,047.22 $61,845.02 2026-07-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 $150,206.15 $120,164.92 20% off $61,393.94 $61,393.94 $61,393.94 2026-07-15
J1628 HCPCS Guselkumab 200 Mg/20ml IV Soln 5 4 $151,378.75 $121,103.00 20% off $24,977.49 $97,094.33 $61,035.91 2026-07-15
1643 OTHER New Technology Apc Û Mid Cost Band (Temporary Payment Classification For Emergin… 21 15 $56,824.55 $45,459.64 20% off $56,824.55 $196,772.05 $59,665.78 2026-07-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 26 15 $250,535.28 $200,428.22 20% off $54,924.19 $97,588.12 $59,660.56 2026-07-15
182 APR_DRG Other Upper Vascular Procedures,extreme 14 8 $185,844.91 $148,675.93 $9,866.25 $89,836.71 $59,155.83 2026-07-15
J9298 HCPCS Nivolumab-relatlimab-rmbw 240-80 Mg/20ml IV Soln 55 25 $91,073.00 $72,858.40 20% off $15,240.00 $204,914.25 $58,578.15 2026-07-15
9273 OTHER Diagnostic Imaging Apc Û Ct, Mri, Nuclear Medicine, Or Advanced Radiologic Studi… 21 15 $55,272.32 $44,217.86 $55,272.32 $191,397.00 $58,035.94 2026-07-15
950 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis,major 15 9 $114,313.37 $91,450.70 $8,996.85 $90,184.42 $57,072.35 2026-07-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 15 $311,619.59 $249,295.67 20% off $21,797.85 $66,452.86 $56,771.13 2026-07-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 25 14 $129,152.03 $103,321.62 20% off $52,001.45 $94,934.05 $56,485.78 2026-07-15
912 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma,extreme 15 9 $214,404.87 $171,523.90 $48,146.43 $97,579.03 $56,241.94 2026-07-15
J9223 HCPCS Lurbinectedin 4 Mg IV Solr 60 25 $83,495.00 $66,796.00 20% off $7,407.26 $83,495.00 $56,075.24 2026-07-15
J9289 HCPCS Nivolumab-hyaluronidase-nvhy 600-10000 Mg-ut/5ml Sc Soln 60 25 $83,422.25 $66,737.80 $8,020.80 $83,422.25 $56,026.39 2026-07-15
181 APR_DRG Lower Vascular Procedures,extreme 14 8 $357,866.88 $286,293.50 20% off $9,454.23 $94,720.01 $55,708.55 2026-07-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 26 15 $436,916.22 $349,532.98 $51,188.35 $93,977.40 $55,602.57 2026-07-15
169 APR_DRG Major Abdominal Vascular Procedures,extreme 12 9 $134,389.89 $107,511.91 20% off $45,666.11 $102,787.30 $54,679.78 2026-07-15
910 APR_DRG Craniotomy For Multiple Significant Trauma,extreme 12 9 $272,701.39 $218,161.11 20% off $45,663.59 $102,781.58 $54,676.74 2026-07-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 26 15 $272,701.39 $218,161.11 20% off $49,971.59 $82,175.07 $54,577.88 2026-07-15
441 APR_DRG Major Bladder Procedures,major 15 9 $244,758.63 $195,806.90 20% off $43,022.63 $96,800.91 $54,156.88 2026-07-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 29 16 $141,562.43 $113,249.94 20% off $10,887.72 $93,209.64 $54,053.15 2026-07-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 21 14 $137,006.62 $109,605.30 $49,335.52 $62,729.17 $53,589.96 2026-07-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 26 15 $60,091.79 $48,073.43 20% off $49,145.68 $93,367.51 $53,383.74 2026-07-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 15 $274,467.43 $219,573.94 20% off $49,062.53 $92,490.47 $53,293.42 2026-07-15
321 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures,majo… 15 9 $106,860.51 $85,488.41 $44,918.30 $90,979.83 $52,958.36 2026-07-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 15 $178,833.90 $143,067.12 20% off $47,519.48 $85,886.99 $51,617.31 2026-07-15
177 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,extreme 15 9 $75,534.97 $60,427.98 $40,321.81 $90,724.07 $50,757.09 2026-07-15
710 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure,extreme 15 9 $101,174.06 $80,939.25 $8,545.90 $90,522.78 $50,644.48 2026-07-15
305 APR_DRG Amputation Of Lower Limb Except Toes,extreme 15 9 $136,368.53 $109,094.82 20% off $40,115.17 $90,259.12 $50,496.97 2026-07-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 25 14 $102,983.46 $82,386.77 $45,580.56 $83,794.23 $49,511.18 2026-07-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 21 14 $233,199.36 $186,559.49 $45,521.69 $57,879.96 $49,447.24 2026-07-15
911 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,extre… 12 9 $159,356.24 $127,484.99 20% off $41,302.72 $92,931.12 $49,430.90 2026-07-15
37236 CPT Open/Perq Place Stent 1st Artery 58 25 $73,272.00 $58,617.60 20% off $12,089.88 $73,272.00 $49,348.69 2026-07-15
264 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures,minor 15 9 $61,264.59 $49,011.67 20% off $9,081.82 $88,172.56 $49,329.61 2026-07-15
710 MS_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure,extreme 3 3 $272,217.20 $217,773.76 20% off $45,391.05 $56,811.44 $49,113.11 2026-07-15
161 APR_DRG Implantable Heart Assist Systems,moderate 15 9 $112,536.90 $90,029.52 $39,017.70 $87,789.83 $49,091.10 2026-07-15
36903 CPT Intro Cath Dialysis Circuit W/Stenting 58 25 $72,854.55 $58,283.64 20% off $12,021.00 $72,854.55 $49,067.54 2026-07-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 26 15 $143,991.34 $115,193.07 20% off $44,869.96 $92,002.02 $49,049.99 2026-07-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 26 15 $158,307.96 $126,646.37 $44,949.95 $80,264.46 $48,826.19 2026-07-15
220 APR_DRG Major Stomach, Esophageal And Duodenal Procedures,extreme 15 9 $207,197.47 $165,757.98 $7,712.90 $91,282.49 $48,694.07 2026-07-15
130 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours,extreme 15 9 $100,704.99 $80,563.99 20% off $38,672.46 $87,013.04 $48,680.89 2026-07-15
28 MS_DRG Spinal Procedures With Mcc 26 15 $165,843.26 $132,674.61 $44,735.08 $81,310.17 $48,592.80 2026-07-15
301 APR_DRG Hip Joint Replacement,extreme 15 9 $175,801.57 $140,641.26 $38,552.13 $86,742.29 $48,529.42 2026-07-15
447 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures,extreme 15 9 $245,355.08 $196,284.06 20% off $23,766.55 $98,274.50 $48,486.63 2026-07-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 26 15 $162,270.08 $129,816.06 20% off $44,082.40 $84,278.63 $47,883.83 2026-07-15
1142 OTHER Medicine, Laboratory, Or Ancillary Diagnostic Service Under Opps 21 15 $45,020.65 $36,016.52 20% off $45,020.65 $155,897.51 $47,271.68 2026-07-15
1580 OTHER New Technology Apc Û Low Cost Band (Temporary Payment Classification For Emergin… 21 15 $45,000.50 $36,000.40 $45,000.50 $155,827.73 $47,250.53 2026-07-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 26 15 $201,676.22 $161,340.98 $43,298.00 $79,346.94 $47,031.79 2026-07-15
C2616 HCPCS Bs Therasphere Yttrium Y90 106 25 $69,473.51 $55,578.81 $11,463.13 $75,936.26 $46,790.41 2026-07-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 26 15 $111,889.11 $89,511.29 $42,842.52 $81,588.12 $46,537.03 2026-07-15
690 APR_DRG Acute Leukemia,major 12 9 $111,889.11 $89,511.29 $38,610.09 $86,872.71 $46,191.85 2026-07-15
J1299 HCPCS Eculizumab 300 Mg/30ml IV Soln 60 25 $68,507.75 $54,806.20 20% off $6,715.65 $68,507.75 $46,009.81 2026-07-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 15 $145,359.83 $116,287.86 20% off $42,232.51 $81,974.02 $45,874.42 2026-07-15
650 APR_DRG Splenic Procedures,extreme 15 9 $161,616.30 $129,293.04 20% off $8,599.32 $81,771.11 $45,748.21 2026-07-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 15 $164,270.71 $131,416.57 $41,980.12 $76,489.12 $45,600.26 2026-07-15
224 APR_DRG Peritoneal Adhesiolysis,moderate 15 9 $80,053.72 $64,042.98 $35,495.99 $79,865.98 $44,682.35 2026-07-15
653 MS_DRG Major Bladder Procedures With Mcc 26 15 $160,946.69 $128,757.35 20% off $41,019.85 $73,045.70 $44,557.19 2026-07-15
834 MS_DRG Acute Leukemia With Mcc 26 15 $120,098.57 $96,078.86 $40,671.80 $75,547.31 $44,179.12 2026-07-15
J9042 HCPCS Brentuximab Vedotin 50 Mg IV Solr 59 24 $118,699.50 $94,959.60 $11,964.40 $118,699.50 $44,049.13 2026-07-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 14 $155,397.72 $124,318.18 $40,501.09 $51,496.36 $43,993.69 2026-07-15
J9356 HCPCS Trastuzumab-hyaluronidase-oysk 600-10000 Mg-unt/5ml Sc Soln 60 25 $65,497.00 $52,397.60 20% off $3,778.38 $65,497.00 $43,987.79 2026-07-15
J9063 HCPCS Mirvetuximab Soravtansine-gynx 100 Mg/20ml IV Soln 60 25 $68,131.50 $54,505.20 20% off $6,952.00 $68,131.50 $43,760.86 2026-07-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 21 14 $85,351.90 $68,281.52 $40,253.85 $51,182.00 $43,725.13 2026-07-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 26 15 $210,216.64 $168,173.31 20% off $39,946.27 $74,281.66 $43,391.03 2026-07-15
J2323 HCPCS Natalizumab 300 Mg/15ml IV Conc 65 25 $123,380.50 $98,704.40 20% off $7,164.00 $123,380.50 $43,150.12 2026-07-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 26 15 $143,270.52 $114,616.42 $39,704.92 $69,573.96 $43,128.86 2026-07-15
304 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,minor 15 9 $162,295.85 $129,836.68 20% off $33,977.69 $76,449.79 $42,771.11 2026-07-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 26 15 $200,042.42 $160,033.94 $39,147.89 $70,135.26 $42,523.80 2026-07-15
303 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back,moderate 15 9 $311,414.59 $249,131.67 20% off $33,730.73 $75,894.13 $42,435.85 2026-07-15
J9347 HCPCS Tremelimumab-actl 300 Mg/15ml IV Soln 110 25 $352,705.25 $282,164.20 $3,529.13 $793,586.81 $42,349.50 2026-07-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 16 $185,336.34 $148,269.07 20% off $15,437.49 $70,765.39 $42,335.96 2026-07-15
37225 CPT Fem/Popl Revasc With Ather 46 25 $50,202.64 $40,162.11 20% off $8,634.85 $50,202.64 $41,668.19 2026-07-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 26 15 $210,591.33 $168,473.06 20% off $36,748.09 $76,682.07 $41,171.35 2026-07-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 21 14 $136,034.39 $108,827.51 20% off $37,896.23 $48,184.34 $41,164.20 2026-07-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 26 15 $190,161.94 $152,129.55 20% off $37,770.41 $68,232.75 $41,027.53 2026-07-15
J9022 HCPCS Atezolizumab 1200 Mg/20ml IV Soln 59 24 $111,388.75 $89,111.00 20% off $10,586.76 $111,388.75 $41,015.75 2026-07-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 26 15 $140,698.27 $112,558.62 $37,487.84 $69,982.79 $40,720.60 2026-07-15
37238 CPT Open/Perq Place Stent 1st Vein 57 25 $58,067.00 $46,453.60 20% off $9,581.06 $58,067.00 $40,646.90 2026-07-15
47540 CPT Perq Plmt Bile Stent; New Access W/Sep Bil Drain 51 25 $40,612.00 $32,489.60 20% off $6,408.11 $40,612.00 $40,612.00 2026-07-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 26 15 $103,803.12 $83,042.50 $37,373.05 $68,530.95 $40,595.91 2026-07-15
471 MS_DRG Cervical Spinal Fusion With Mcc 26 15 $143,391.50 $114,713.20 20% off $36,204.50 $66,372.07 $40,562.33 2026-07-15
J9273 HCPCS Tisotumab Vedotin-tftv 40 Mg IV Solr 60 25 $63,070.50 $50,456.40 20% off $7,545.92 $63,070.50 $40,510.18 2026-07-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 26 15 $102,080.79 $81,664.63 20% off $37,063.27 $64,858.15 $40,259.41 2026-07-15
J9144 HCPCS Daratumumab-hyaluronidase-fihj 1800-30000 Mg-ut/15ml Sc Soln 56 24 $110,476.00 $88,380.80 20% off $3,283.89 $110,476.00 $40,054.39 2026-07-15
47538 CPT Perq Plmt Bile Duct Stent; Each Stent; Existing Access 61 25 $40,039.00 $32,031.20 20% off $6,408.11 $40,039.00 $40,039.00 2026-07-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 26 15 $44,836.64 $35,869.31 20% off $36,844.72 $65,360.09 $40,022.02 2026-07-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 25 14 $171,726.32 $137,381.06 $36,816.03 $60,184.18 $39,990.85 2026-07-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 26 15 $61,328.83 $49,063.06 20% off $36,801.31 $67,455.55 $39,974.86 2026-07-15
120 APR_DRG Major Respiratory And Chest Procedures,moderate 15 9 $141,619.07 $113,295.26 $30,520.35 $87,268.19 $39,949.44 2026-07-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 26 15 $115,658.78 $92,527.02 20% off $36,668.86 $67,987.18 $39,830.99 2026-07-15
37226 CPT Fem/Popl Revasc With Stent 48 25 $48,845.81 $39,076.65 $8,059.56 $48,845.81 $39,809.33 2026-07-15
0236T CPT Trluml Perip Athrc Abd Aorta 51 25 $39,615.00 $31,692.00 20% off $6,813.78 $39,615.00 $39,615.00 2026-07-15
0235T CPT Trluml Perip Athrc Visceral 51 25 $39,615.00 $31,692.00 20% off $6,813.78 $39,615.00 $39,615.00 2026-07-15
0234T CPT Trluml Perip Athrc Renal Art 51 25 $39,615.00 $31,692.00 20% off $6,813.78 $39,615.00 $39,615.00 2026-07-15
0238T CPT Trluml Perip Athrc Iliac 51 25 $39,615.00 $31,692.00 20% off $6,813.78 $39,615.00 $39,615.00 2026-07-15
0237T CPT Trluml Perip Athrc Brchiocph 51 25 $39,615.00 $31,692.00 20% off $6,813.78 $39,615.00 $39,615.00 2026-07-15
245 MS_DRG Aicd Generator Procedures 29 16 $50,190.76 $40,152.61 $5,989.28 $61,142.18 $39,059.68 2026-07-15
47539 CPT Perq Plmt Bile Stent; New Access Without Sep Bil Drain 52 25 $38,923.00 $31,138.40 $1,976.00 $38,923.00 $38,923.00 2026-07-15
J1162 HCPCS Digoxin Immune Fab 40 Mg IV Solr 57 25 $38,916.00 $31,132.80 20% off $4,968.58 $38,916.00 $38,916.00 2026-07-15
C9797 HCPCS Vascular Emb Or Occlusion W/Use Of Press -gen Cath; Rad S/i 61 25 $53,184.00 $42,547.20 20% off $8,775.36 $53,184.00 $38,218.02 2026-07-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 26 15 $176,093.01 $140,874.41 $35,139.80 $62,441.56 $38,170.07 2026-07-15
799 MS_DRG Splenic Procedures With Mcc 26 15 $204,792.00 $163,833.60 20% off $34,987.48 $66,852.42 $38,004.61 2026-07-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 26 15 $229,323.96 $183,459.17 $34,980.86 $63,962.22 $37,997.42 2026-07-15
37221 CPT Iliac Revasc With Stent 48 25 $48,096.00 $38,476.80 $7,935.84 $48,096.00 $37,995.84 2026-07-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 26 15 $113,928.85 $91,143.08 20% off $33,301.49 $55,545.28 $37,637.36 2026-07-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 26 15 $158,202.20 $126,561.76 20% off $34,618.82 $65,848.54 $37,604.17 2026-07-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 26 15 $189,241.75 $151,393.40 20% off $34,433.39 $60,744.14 $37,402.75 2026-07-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 25 14 $112,536.90 $90,029.52 $34,230.30 $64,528.92 $37,182.15 2026-07-15
47556 CPT Perc Dil Biliary Stricture W Stent 52 25 $36,909.00 $29,527.20 20% off $1,976.00 $36,909.00 $36,909.00 2026-07-15
37239 CPT Open/Perq Place Stent Ea Add Vein 60 25 $36,857.00 $29,485.60 20% off $1,976.00 $36,857.00 $36,857.00 2026-07-15
37237 CPT Open/Perq Place Stent Ea Add Artery 49 25 $36,857.00 $29,485.60 20% off $6,339.40 $36,857.00 $36,857.00 2026-07-15
163 MS_DRG Major Chest Procedures With Mcc 26 15 $112,372.64 $89,898.11 20% off $33,916.10 $63,600.60 $36,840.85 2026-07-15
1579 OTHER New Technology Apc Û Low Cost Band (Temporary Payment Classification For Emergin… 21 15 $35,000.50 $28,000.40 $35,000.50 $121,199.73 $36,750.53 2026-07-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 15 $144,575.84 $115,660.67 20% off $33,793.95 $62,723.56 $36,708.17 2026-07-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 26 15 $123,781.39 $99,025.11 20% off $33,788.80 $60,945.18 $36,702.57 2026-07-15
163 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,major 15 9 $228,219.17 $182,575.34 $29,051.07 $65,364.91 $36,569.49 2026-07-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 26 15 $113,780.21 $91,024.17 $33,197.93 $59,752.40 $36,060.74 2026-07-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 26 15 $86,544.41 $69,235.53 $31,916.05 $58,057.68 $35,845.73 2026-07-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 26 15 $100,921.02 $80,736.82 $32,908.74 $59,585.09 $35,746.62 2026-07-15
901 MS_DRG Wound Debridements For Injuries With Mcc 26 15 $421,238.34 $336,990.67 20% off $31,465.16 $58,395.01 $35,252.53 2026-07-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 25 14 $177,531.32 $142,025.06 $32,323.76 $58,855.12 $35,111.19 2026-07-15
20983 CPT Ablate Bone Tumor(S) Perq 51 25 $35,020.00 $28,016.00 20% off $1,976.00 $35,020.00 $35,020.00 2026-07-15
546 APR_DRG Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses,extreme 15 9 $195,589.53 $156,471.62 20% off $27,552.30 $61,992.67 $34,682.83 2026-07-15
23 APR_DRG Spinal Procedures,major 15 9 $111,861.52 $89,489.22 $27,481.11 $61,832.49 $34,593.22 2026-07-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 15 $281,849.07 $225,479.26 $31,773.35 $61,136.78 $34,513.32 2026-07-15
162 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,moderate 12 9 $164,850.38 $131,880.30 20% off $28,651.02 $64,464.79 $34,211.73 2026-07-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 26 15 $121,101.23 $96,880.98 20% off $31,388.51 $57,732.50 $34,095.29 2026-07-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 28 15 $93,730.53 $74,984.42 20% off $31,342.15 $55,861.02 $34,044.93 2026-07-15
37228 CPT Tib/per Revasc With Tla 49 25 $45,219.00 $36,175.20 20% off $3,606.00 $45,219.00 $33,914.25 2026-07-15
140 MS_DRG Major Head And Neck Procedures With Mcc 28 15 $212,611.50 $170,089.20 $8,271.38 $50,977.90 $33,803.55 2026-07-15
C9765 HCPCS Ivl W/Stent Fem/Pop 51 25 $33,711.50 $26,969.20 20% off $5,798.38 $33,711.50 $33,711.50 2026-07-15
37242 CPT Vasc Embolize/Occlude Artery 58 25 $50,035.00 $40,028.00 20% off $8,255.78 $50,035.00 $33,698.57 2026-07-15
5232 OTHER Level 2 Gastrointestinal / Hepatobiliary Procedure Û Includes Upper/lower Gi End… 21 15 $32,061.58 $25,649.26 20% off $32,061.58 $111,022.84 $33,664.66 2026-07-15
J9309 HCPCS Polatuzumab Vedotin-piiq 140 Mg IV Solr 116 25 $184,246.00 $147,396.80 20% off $3,987.48 $184,246.00 $33,647.75 2026-07-15
J9319 HCPCS Romidepsin 10 Mg IV Solr 51 25 $33,594.00 $26,875.20 20% off $3,107.50 $33,594.00 $33,594.00 2026-07-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 26 15 $86,209.36 $68,967.49 $29,538.63 $49,897.11 $33,487.03 2026-07-15
5166 OTHER Level 6 Urinary And Male Genital System Procedure Û Includes Renal, Ureteral, Bl… 21 15 $31,807.82 $25,446.26 $31,807.82 $110,144.12 $33,398.21 2026-07-15
793 MS_DRG Full Term Neonate With Major Problems 25 16 $17,446.25 $13,957.00 20% off $21,724.35 $39,019.20 $33,334.37 2026-07-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 26 15 $146,923.19 $117,538.55 20% off $30,615.88 $56,111.99 $33,256.04 2026-07-15
36905 CPT Throbc/Nfs Dialysis Circuit W/Angioplasty 58 25 $49,298.25 $39,438.60 20% off $8,134.21 $49,298.25 $33,202.38 2026-07-15
37241 CPT Vasc Embolize/Occlude Venous 58 25 $49,091.12 $39,272.90 $8,100.03 $49,091.12 $33,062.86 2026-07-15
J0896 HCPCS Luspatercept-aamt 75 Mg Sc Solr 146 25 $95,529.50 $76,423.60 $4,196.20 $288,671.63 $33,014.25 2026-07-15
363 APR_DRG Breast Procedures Except Mastectomy,major 8 5 $373,302.10 $298,641.68 $18,723.56 $33,466.81 $32,981.53 2026-07-15
61635 CPT Intracran Angioplsty W/Stent 53 25 $32,956.00 $26,364.80 20% off $1,976.00 $32,956.00 $32,956.00 2026-07-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 26 15 $160,856.47 $128,685.18 $30,258.27 $54,527.91 $32,867.58 2026-07-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 26 15 $216,696.83 $173,357.46 20% off $30,241.34 $54,576.49 $32,849.20 2026-07-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 26 15 $148,568.16 $118,854.53 $29,968.17 $54,038.12 $32,800.44 2026-07-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 21 14 $178,432.15 $142,745.72 $30,047.82 $38,205.23 $32,638.98 2026-07-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 26 15 $142,133.57 $113,706.86 $29,929.35 $52,769.77 $32,510.30 2026-07-15
J3380 HCPCS Vedolizumab 300 Mg IV Solr 64 25 $91,021.00 $72,816.80 $6,501.00 $91,021.00 $32,440.94 2026-07-15
5465 OTHER Level 5 Abdominal / Peritoneal / Hernia Procedure Û Includes Laparoscopic And Op… 21 15 $30,473.59 $24,378.87 20% off $6,660.23 $105,523.95 $31,997.27 2026-07-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 26 15 $114,696.66 $91,757.33 $29,313.45 $50,187.21 $31,841.29 2026-07-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 20 14 $17,383.87 $13,907.10 $28,915.37 $34,925.61 $31,408.88 2026-07-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 26 15 $153,968.36 $123,174.69 $27,942.70 $54,167.65 $31,306.09 2026-07-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 21 14 $121,791.52 $97,433.22 $28,787.33 $36,602.54 $31,269.80 2026-07-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 26 15 $84,794.00 $67,835.20 20% off $28,773.35 $52,582.22 $31,254.61 2026-07-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 26 15 $343,341.95 $274,673.56 20% off $28,614.41 $52,641.59 $31,081.97 2026-07-15
J0491 HCPCS Anifrolumab-fnia 300 Mg/2ml IV Soln 60 25 $53,390.50 $42,712.40 20% off $5,431.20 $53,390.50 $30,961.97 2026-07-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 26 15 $102,190.42 $81,752.34 $28,440.02 $53,401.25 $30,892.54 2026-07-15
174 APR_DRG Percutaneous Cardiac Intervention With Ami,extreme 15 9 $98,189.98 $78,551.98 20% off $24,535.22 $55,204.24 $30,884.93 2026-07-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 26 15 $89,065.00 $71,252.00 20% off $28,289.63 $43,935.91 $30,861.36 2026-07-15
681 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms,major 15 9 $37,466.88 $29,973.50 20% off $24,475.37 $55,069.57 $30,809.59 2026-07-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 26 15 $136,511.66 $109,209.33 $28,331.85 $54,751.90 $30,775.04 2026-07-15
166 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis,major 12 9 $192,274.70 $153,819.76 20% off $25,713.32 $57,854.97 $30,677.87 2026-07-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 26 15 $95,416.51 $76,333.21 $28,126.55 $52,328.55 $30,552.04 2026-07-15
J9204 HCPCS Mogamulizumab-kpkc 20 Mg/5ml IV Soln 60 25 $47,330.75 $37,864.60 20% off $4,969.94 $47,330.75 $30,400.54 2026-07-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 15 $120,362.11 $96,289.69 $27,974.24 $51,122.28 $30,386.59 2026-07-15
37243 CPT Vasc Embolize/Occlude Organ 58 25 $44,842.85 $35,874.28 20% off $2,601.00 $44,842.85 $30,201.66 2026-07-15
165 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis,moderate 12 9 $157,631.15 $126,104.92 20% off $25,279.88 $56,879.73 $30,156.47 2026-07-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 29 16 $107,210.47 $85,768.38 $14,711.46 $51,954.80 $30,150.00 2026-07-15
37248 CPT Trluml Balo Angiop 1st Vein 49 25 $30,072.00 $24,057.60 20% off $5,172.38 $30,072.00 $30,072.00 2026-07-15
J9228 HCPCS Ipilimumab 50 Mg/10ml IV Soln 58 24 $89,612.50 $71,690.00 20% off $9,002.55 $89,612.50 $30,008.11 2026-07-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 26 15 $92,047.13 $73,637.70 20% off $26,686.08 $51,618.82 $29,898.20 2026-07-15
5200 OTHER Level 0 Gastrointestinal / Hepatobiliary Procedure Û Includes Upper/lower Gi End… 21 15 $28,428.33 $22,742.66 20% off $28,428.33 $98,441.62 $29,849.75 2026-07-15
0843 RC Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 21 15 $28,424.06 $22,739.25 $28,424.06 $98,426.83 $29,845.26 2026-07-15
36226 CPT Place Cath Vertebral Art 51 25 $29,537.00 $23,629.60 20% off $5,080.36 $29,537.00 $29,537.00 2026-07-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 20 14 $126,144.90 $100,915.92 20% off $26,848.41 $32,446.25 $29,163.67 2026-07-15
J9119 HCPCS Cemiplimab-rwlc 350 Mg/7ml IV Soln 54 24 $59,041.50 $47,233.20 20% off $10,043.95 $59,041.50 $29,077.94 2026-07-15
J9999 HCPCS Telisotuzumab Vedotin-tllv 20 Mg IV Solr 90 25 $29,071.50 $23,257.20 20% off $8,686.56 $145,356.75 $29,071.50 2026-07-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 26 15 $96,162.32 $76,929.86 $26,662.24 $48,237.48 $28,961.45 2026-07-15
1592 OTHER New Technology Apc Û Low Cost Band (Temporary Payment Classification For Emergin… 21 15 $27,500.50 $22,000.40 $8,580.52 $95,228.73 $28,875.53 2026-07-15
696 APR_DRG Other Chemotherapy,moderate 14 8 $62,029.03 $49,623.22 20% off $6,741.44 $63,221.64 $28,817.07 2026-07-15
35372 CPT Teaec W/wo Patch Graft Deep Profund Femoral 50 25 $28,693.00 $22,954.40 $4,935.20 $28,693.00 $28,693.00 2026-07-15
37211 CPT Thrombolytic Art Therapy 49 25 $28,693.00 $22,954.40 $4,935.20 $28,693.00 $28,693.00 2026-07-15
J9024 HCPCS Atezolizumab-hyaluronidas-tqjs 1875-30000 Mg-ut/15ml Sc Soln 54 24 $58,239.00 $46,591.20 20% off $11,863.13 $58,239.00 $28,682.71 2026-07-15
J9301 HCPCS Obinutuzumab 1000 Mg/40ml IV Soln 58 24 $86,560.00 $69,248.00 20% off $7,482.70 $86,560.00 $28,682.64 2026-07-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 25 15 $81,722.34 $65,377.87 20% off $26,378.21 $46,291.78 $28,652.93 2026-07-15
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 26 15 $74,374.57 $59,499.66 $26,376.74 $49,072.69 $28,651.33 2026-07-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 26 15 $123,808.98 $99,047.18 20% off $25,744.97 $49,273.74 $28,646.53 2026-07-15
974 MS_DRG HIV With Major Related Condition With Mcc 26 15 $50,428.07 $40,342.46 $23,352.59 $39,352.33 $28,642.06 2026-07-15
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 29 16 $217,829.58 $174,263.66 20% off $6,720.68 $43,188.39 $28,620.52 2026-07-15
265 MS_DRG Aicd Lead Procedures 26 15 $126,280.02 $101,024.02 $26,125.22 $47,685.61 $28,512.25 2026-07-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 26 15 $130,027.57 $104,022.06 $26,130.97 $46,714.12 $28,384.37 2026-07-15
J9286 HCPCS Glofitamab-gxbm 2.5 Mg/2.5ml IV Soln 110 25 $28,180.75 $22,544.60 20% off $2,770.57 $113,861.00 $28,180.75 2026-07-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 26 15 $84,070.64 $67,256.51 20% off $25,905.80 $48,321.13 $28,139.78 2026-07-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 26 15 $88,284.05 $70,627.24 $25,782.18 $47,565.52 $28,005.50 2026-07-15
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 15 $79,795.37 $63,836.30 $25,774.09 $45,561.81 $27,996.71 2026-07-15
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 26 15 $150,414.15 $120,331.32 $25,763.79 $50,223.64 $27,985.52 2026-07-15
264 MS_DRG Other Circulatory System O.r. Procedures 26 15 $76,651.52 $61,321.22 $24,716.02 $44,068.14 $27,935.96 2026-07-15
60699 CPT Adrenal Bx Percutaneous Needle (720) 54 25 $27,751.00 $22,200.80 20% off $1,976.00 $27,751.00 $27,751.00 2026-07-15
37233 CPT Tib/per Revasc With Ather Add-on 49 25 $27,749.00 $22,199.20 20% off $4,772.83 $27,749.00 $27,749.00 2026-07-15
332 MS_DRG Rectal Resection With Mcc 26 15 $120,551.62 $96,441.30 $25,523.91 $49,307.47 $27,724.95 2026-07-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 26 15 $71,349.08 $57,079.26 20% off $25,024.09 $45,954.46 $27,694.58 2026-07-15
37 MS_DRG Extracranial Procedures With Mcc 26 15 $195,036.77 $156,029.42 $24,683.42 $45,546.97 $27,654.49 2026-07-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 26 15 $120,268.42 $96,214.74 $25,345.10 $46,634.51 $27,530.73 2026-07-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 26 15 $103,288.59 $82,630.87 20% off $25,305.36 $45,457.92 $27,487.56 2026-07-15
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 26 15 $103,957.40 $83,165.92 20% off $25,287.41 $38,405.13 $27,468.06 2026-07-15
665 MS_DRG Prostatectomy With Mcc 26 15 $50,174.04 $40,139.23 20% off $25,265.63 $41,681.23 $27,444.40 2026-07-15
252 MS_DRG Other Vascular Procedures With Mcc 29 16 $91,958.89 $73,567.11 20% off $12,858.75 $45,252.82 $27,418.82 2026-07-15
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 26 15 $122,710.98 $98,168.78 20% off $25,203.82 $47,040.65 $27,377.26 2026-07-15
694 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior,major 15 9 $43,124.24 $34,499.39 20% off $21,716.59 $48,862.32 $27,336.84 2026-07-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 26 15 $157,841.49 $126,273.19 20% off $25,064.01 $44,731.99 $27,225.40 2026-07-15
49419 CPT Insert Tun Ip Cath W/Port 52 25 $27,221.00 $21,776.80 20% off $1,976.00 $27,221.00 $27,221.00 2026-07-15
32994 CPT Ablate Pulm Tumor Perq Crybl 51 25 $27,175.00 $21,740.00 20% off $4,674.10 $27,175.00 $27,175.00 2026-07-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 26 15 $84,471.71 $67,577.37 $24,959.52 $46,619.66 $27,111.90 2026-07-15
361 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses,major 15 9 $113,053.89 $90,443.11 20% off $21,454.51 $48,272.64 $27,006.93 2026-07-15
V2785 HCPCS Supplies With HCPCS Code V2785 62 25 $27,006.53 $21,605.22 20% off $4,456.08 $27,006.53 $27,006.53 2026-07-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 26 15 $84,323.58 $67,458.86 20% off $24,699.77 $46,256.70 $26,829.75 2026-07-15
J9332 HCPCS Efgartigimod Alfa-fcab 400 Mg/20ml IV Soln 60 25 $26,741.50 $21,393.20 20% off $6,479.20 $26,741.50 $26,741.50 2026-07-15
Q5117 HCPCS Trastuzumab-anns 420 Mg IV Solr 37 21 $37,980.75 $30,384.60 20% off $2,168.61 $37,980.75 $26,586.53 2026-07-15
36223 CPT Place Cath Carotid/Inom Art W/Ips Intracran Carot 61 25 $26,554.00 $21,243.20 20% off $4,567.29 $26,554.00 $26,554.00 2026-07-15
36225 CPT Place Cath Subclavian Art 51 25 $26,554.00 $21,243.20 20% off $3,457.03 $26,554.00 $26,554.00 2026-07-15
463 MS_DRG Kidney And Urinary Tract Infections,major 6 6 $66,773.60 $53,418.89 $8,325.22 $47,912.90 $26,498.45 2026-07-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 25 14 $44,075.95 $35,260.76 $24,296.53 $44,872.32 $26,391.74 2026-07-15
42182 CPT Repair Laceration Of Palate > 2cm Or Complex 48 25 $26,344.00 $21,075.20 20% off $6,497.41 $26,344.00 $26,344.00 2026-07-15
J2802 HCPCS Romiplostim 250 Mcg Sc Solr 189 25 $26,298.50 $21,038.80 20% off $1,374.50 $130,097.81 $26,298.38 2026-07-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 29 16 $106,126.14 $84,900.91 20% off $7,037.98 $44,928.99 $26,126.37 2026-07-15
36516 CPT Therapeutic Leukopheresis Or White Blood Cell Depletion 50 25 $26,076.00 $20,860.80 20% off $4,302.54 $26,076.00 $26,076.00 2026-07-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 26 15 $91,929.89 $73,543.91 20% off $23,631.61 $45,096.30 $26,052.04 2026-07-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 26 15 $95,932.33 $76,745.86 20% off $23,973.50 $42,335.64 $26,040.85 2026-07-15
J2506 HCPCS Pegfilgrastim Inf Dev 6 Mg/0.6ml Sc Sosy 35 20 $34,693.00 $27,754.40 $239.76 $34,693.00 $26,019.75 2026-07-15
5213 OTHER Level 3 Gastrointestinal / Hepatobiliary Procedure Û Includes Upper/lower Gi End… 21 15 $24,532.30 $19,625.84 20% off $24,532.30 $84,950.45 $25,758.92 2026-07-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 26 15 $189,607.93 $151,686.34 20% off $23,688.73 $44,445.94 $25,731.52 2026-07-15
61645 CPT Perq Art M-thrombect &/Nfs 53 25 $25,630.00 $20,504.00 20% off $1,976.00 $25,630.00 $25,630.00 2026-07-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 28 15 $82,031.59 $65,625.27 20% off $7,530.07 $43,185.70 $25,612.43 2026-07-15
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 25 14 $68,468.15 $54,774.52 20% off $23,510.66 $40,055.32 $25,538.10 2026-07-15
45 MS_DRG Cva And Precerebral Occlusion With Infarction,extreme 3 3 $96,566.94 $77,253.55 20% off $23,582.44 $29,515.78 $25,516.20 2026-07-15
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 26 15 $103,959.38 $83,167.50 20% off $23,465.77 $42,168.32 $25,489.34 2026-07-15
842 MS_DRG Lymphoma And Non-acute Leukemia Without Cc/mcc 26 15 $27,576.64 $22,061.31 20% off $23,465.77 $42,168.32 $25,489.34 2026-07-15
260 APR_DRG Major Pancreas, Liver And Shunt Procedures,major 15 9 $210,216.64 $168,173.31 20% off $9,610.47 $45,514.18 $25,463.66 2026-07-15
0856 OTHER Clinic Visit, Minor Procedure, Observation, Or Diagnostic Ancillary Service 21 15 $24,228.42 $19,382.74 $24,228.42 $83,898.17 $25,439.84 2026-07-15
J9306 HCPCS Pertuzumab 420 Mg/14ml IV Soln 58 24 $68,547.75 $54,838.20 20% off $4,334.39 $68,547.75 $25,372.49 2026-07-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 26 15 $82,814.80 $66,251.84 20% off $23,355.40 $43,384.04 $25,369.45 2026-07-15
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 26 15 $156,373.93 $125,099.14 20% off $19,797.46 $35,230.22 $25,341.90 2026-07-15
500 MS_DRG Soft Tissue Procedures With Mcc 26 15 $63,769.38 $51,015.50 20% off $23,316.40 $43,755.10 $25,327.08 2026-07-15
221 APR_DRG Major Small & Large Bowel Procedures,major 15 9 $106,826.08 $85,460.86 20% off $9,779.31 $44,893.31 $25,116.31 2026-07-15
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 26 15 $87,297.15 $69,837.72 $21,298.20 $43,728.11 $24,945.82 2026-07-15
662 MS_DRG Minor Bladder Procedures With Mcc 26 15 $55,854.00 $44,683.20 20% off $22,955.11 $40,434.47 $24,934.63 2026-07-15
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 29 16 $114,999.68 $91,999.74 20% off $16,904.78 $42,902.34 $24,828.33 2026-07-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 26 15 $124,402.73 $99,522.18 20% off $22,754.96 $42,658.12 $24,717.23 2026-07-15
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 21 14 $116,785.76 $93,428.61 $22,707.86 $28,872.62 $24,666.07 2026-07-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 26 15 $80,382.40 $64,305.92 $22,691.68 $42,554.22 $24,648.49 2026-07-15
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 25 14 $95,100.02 $76,080.02 $22,579.83 $41,490.98 $24,527.00 2026-07-15
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