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

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Hospital

Vibra Hospital Of Central Dakotas Llc

Mandan, ND · CCN 352005 · Rates published

5,551 distinct procedures filed
42 distinct payers
215,068 rate rows
2026-08-01 last MRF observed
Data quality

214,700 of 215,068 rate rows are consumer-grade (99.8%)

368 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
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 285
per-diem day rate — not a per-procedure price 77
percent-of-charges filed in the dollar field — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://vhcentraldakotas.com/wp-content/uploads/sites/25/2025/09/462632340_vibra-hospital-of-central-dakota_standardcharges.csv
Found on page https://vhcentraldakotas.com/about-us/price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-11-02
Content fingerprint d0c7f71cade2d038… · 8,238,244 bytes · first seen 2026-05-09

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
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $159,702.86 $159,702.86 $159,702.86 nat. median
$190,359
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $131,354.32 $131,354.32 $131,354.32 nat. median
$126,461
1.0× median
163
MS_DRG 		Major Chest Procedures With Mcc 10 $108,405.72 $108,405.72 $108,405.72 nat. median
$42,636
outlier · 2.5×
165
MS_DRG 		Major Chest Procedures Without Cc/mcc 10 $108,405.72 $108,405.72 $108,405.72 nat. median
$18,640
outlier · 5.8×
164
MS_DRG 		Major Chest Procedures With Cc 10 $108,405.72 $108,405.72 $108,405.72 nat. median
$24,221
outlier · 4.5×
140
MS_DRG 		Major Head And Neck Procedures With Mcc 10 $107,020.30 $107,020.30 $107,020.30 nat. median
$38,337
outlier · 2.8×
11
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 10 $107,020.30 $107,020.30 $107,020.30 nat. median
$49,944
outlier · 2.1×
166
MS_DRG 		Other Respiratory System O.r. Procedures With Mcc 10 $107,020.30 $107,020.30 $107,020.30 nat. median
$35,655
outlier · 3.0×
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 10 $107,006.58 $107,006.58 $107,006.58 nat. median
$43,609
outlier · 2.5×
68875010201
NDC 		Gattex 17 $29,076.10 $99,999.99 $99,999.99 nat. median
$100,000
1.0× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 10 $94,743.55 $94,743.55 $94,743.55 nat. median
$62,577
1.5× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 12 $30,533.31 $88,913.81 $88,913.81 nat. median
$59,324
1.5× median
168
MS_DRG 		Other Respiratory System O.r. Procedures Without Cc/mcc 10 $72,119.59 $72,119.59 $72,119.59 nat. median
$13,713
outlier · 5.3×
173
MS_DRG 		Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 10 $72,119.59 $72,119.59 $72,119.59 nat. median
$28,086
outlier · 2.6×
12
MS_DRG 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 10 $72,119.59 $72,119.59 $72,119.59 nat. median
$38,687
1.9× median
167
MS_DRG 		Other Respiratory System O.r. Procedures With Cc 10 $72,119.59 $72,119.59 $72,119.59 nat. median
$17,834
outlier · 4.0×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 10 $69,325.89 $69,325.89 $69,325.89 nat. median
$45,362
1.5× median
40
MS_DRG 		Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 10 $67,167.74 $67,167.74 $67,167.74 nat. median
$35,821
1.9× median
799
MS_DRG 		Splenic Procedures With Mcc 10 $63,820.79 $63,820.79 $63,820.79 nat. median
$43,234
1.5× median
356
MS_DRG 		Other Digestive System O.r. Procedures With Mcc 10 $63,820.79 $63,820.79 $63,820.79 nat. median
$40,205
1.6× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 $63,578.45 $63,578.45 $63,578.45 nat. median
$58,052
1.1× median
579
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 10 $62,023.86 $62,023.86 $62,023.86 nat. median
$30,192
outlier · 2.1×
582
MS_DRG 		Mastectomy For Malignancy With Cc/mcc 10 $62,023.86 $62,023.86 $62,023.86 nat. median
$18,195
outlier · 3.4×
856
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 10 $61,616.92 $61,616.92 $61,616.92 nat. median
$41,655
1.5× median
205
MS_DRG 		Other Respiratory System Diagnoses With Mcc 12 $21,415.88 $59,961.73 $59,961.73 nat. median
$17,319
outlier · 3.5×
619
MS_DRG 		O.r. Procedures For Obesity With Mcc 10 $59,787.98 $59,787.98 $59,787.98 nat. median
$26,741
outlier · 2.2×
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 10 $59,787.98 $59,787.98 $59,787.98 nat. median
$33,559
1.8× median
551
MS_DRG 		Medical Back Problems With Mcc 12 $21,415.88 $59,710.25 $59,710.25 nat. median
$16,085
outlier · 3.7×
61
MS_DRG 		Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 $59,477.06 $59,477.06 $59,477.06 nat. median
$25,952
outlier · 2.3×
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 10 $59,477.06 $59,477.06 $59,477.06 nat. median
$19,223
outlier · 3.1×
901
MS_DRG 		Wound Debridements For Injuries With Mcc 10 $58,667.75 $58,667.75 $58,667.75 nat. median
$39,584
1.5× median
264
MS_DRG 		Other Circulatory System O.r. Procedures 10 $58,096.21 $58,096.21 $58,096.21 nat. median
$31,156
1.9× median
245
MS_DRG 		Aicd Generator Procedures 10 $58,096.21 $58,096.21 $58,096.21 nat. median
$42,812
1.4× median
263
MS_DRG 		Vein Ligation And Stripping 10 $58,096.21 $58,096.21 $58,096.21 nat. median
$26,998
outlier · 2.2×
253
MS_DRG 		Other Vascular Procedures With Cc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$24,911
outlier · 2.3×
202
MS_DRG 		Bronchitis And Asthma With Cc/mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$9,788
outlier · 5.9×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$61,995
0.9× median
24
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$36,527
1.6× median
477
MS_DRG 		Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$31,866
1.8× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$57,798
1.0× median
256
MS_DRG 		Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$16,501
outlier · 3.5×
274
MS_DRG 		Percutaneous And Other Intracardiac Procedures Without Mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$30,779
1.9× median
743
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$12,360
outlier · 4.7×
240
MS_DRG 		Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$26,726
outlier · 2.2×
33
MS_DRG 		Ventricular Shunt Procedures Without Cc/mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$16,263
outlier · 3.5×
808
MS_DRG 		Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$20,978
outlier · 2.8×
495
MS_DRG 		Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$33,724
1.7× median
749
MS_DRG 		Other Female Reproductive System O.r. Procedures With Cc/mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$24,308
outlier · 2.4×
250
MS_DRG 		Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$21,616
outlier · 2.7×
857
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 10 $57,716.71 $57,716.71 $57,716.71 nat. median
$20,372
outlier · 2.8×

Other procedures at this hospital

Browse this hospital's 5,551 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 19 12 $46,592.19 $46,592.19 $21,415.88 $46,592.19 $46,592.19 2026-07-15
850 MS_DRG Acute Leukemia With Other Procedures 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
615 MS_DRG Adrenal And Pituitary Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
245 MS_DRG Aicd Generator Procedures 10 10 $58,096.21 $58,096.21 $58,096.21 $58,096.21 $58,096.21 2026-07-15
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
519 MS_DRG Back And Neck Procedures Except Spinal Fusion With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc* 10 10 $48,978.96 $48,978.96 $48,978.96 $48,978.96 $48,978.96 2026-07-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
202 MS_DRG Bronchitis And Asthma With Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
35 MS_DRG Carotid Artery Stent Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
784 MS_DRG Cesarean Section With Sterilization With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
783 MS_DRG Cesarean Section With Sterilization With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
787 MS_DRG Cesarean Section Without Sterilization With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
786 MS_DRG Cesarean Section Without Sterilization With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 10 10 $43,789.35 $43,789.35 $43,789.35 $43,789.35 $43,789.35 2026-07-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 10 10 $43,789.35 $43,789.35 $43,789.35 $43,789.35 $43,789.35 2026-07-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
380 MS_DRG Complicated Peptic Ulcer With Mcc 10 10 $43,789.35 $43,789.35 $43,789.35 $43,789.35 $43,789.35 2026-07-15
919 MS_DRG Complications Of Treatment With Mcc 19 12 $49,033.82 $49,033.82 $47,630.18 $49,033.82 $49,033.82 2026-07-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
545 MS_DRG Connective Tissue Disorders With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
73 MS_DRG Cranial And Peripheral Nerve Disorders With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
744 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption With Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
745 MS_DRG D&c, Conization, Laparoscopy And Tubal Interruption Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
157 MS_DRG Dental And Oral Diseases With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
374 MS_DRG Digestive Malignancy With Mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 19 12 $47,904.46 $47,904.46 $47,904.46 $56,554.95 $47,904.46 2026-07-15
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 10 $159,702.86 $159,702.86 $159,702.86 $159,702.86 $159,702.86 2026-07-15
643 MS_DRG Endocrine Disorders With Mcc* 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 10 10 $107,006.58 $107,006.58 $107,006.58 $107,006.58 $107,006.58 2026-07-15
38 MS_DRG Extracranial Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
37 MS_DRG Extracranial Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
39 MS_DRG Extracranial Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
115 MS_DRG Extraocular Procedures Except Orbit 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
748 MS_DRG Female Reproductive System Reconstructive Procedures 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
388 MS_DRG Gastrointestinal Obstruction With Mcc 10 10 $45,179.34 $45,179.34 $45,179.34 $45,179.34 $45,179.34 2026-07-15
68875010201 NDC Gattex 39 17 $99,999.99 $99,999.99 $29,076.10 $99,999.99 $99,999.99 2026-07-15
55292070255 NDC Hemin For Injection 39 17 $51,333.70 $51,333.70 $29,076.10 $51,333.70 $51,333.70 2026-07-15
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
974 MS_DRG HIV With Major Related Condition With Mcc* 10 10 $52,106.44 $52,106.44 $52,106.44 $52,106.44 $52,106.44 2026-07-15
304 MS_DRG Hypertension With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
78 MS_DRG Hypertensive Encephalopathy With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
77 MS_DRG Hypertensive Encephalopathy With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 10 10 $69,325.89 $69,325.89 $69,325.89 $69,325.89 $69,325.89 2026-07-15
386 MS_DRG Inflammatory Bowel Disease With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
385 MS_DRG Inflammatory Bowel Disease With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
387 MS_DRG Inflammatory Bowel Disease Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
197 MS_DRG Interstitial Lung Disease With Cc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
196 MS_DRG Interstitial Lung Disease With Mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
198 MS_DRG Interstitial Lung Disease Without Cc/mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 10 10 $59,477.06 $59,477.06 $59,477.06 $59,477.06 $59,477.06 2026-07-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
116 MS_DRG Intraocular Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
117 MS_DRG Intraocular Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 10 $59,477.06 $59,477.06 $59,477.06 $59,477.06 $59,477.06 2026-07-15
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
658 MS_DRG Kidney And Ureter Procedures For Neoplasm Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 10 10 $43,789.35 $43,789.35 $43,789.35 $43,789.35 $43,789.35 2026-07-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
499 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur Without… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
822 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures Without Cc/mcc 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
654 MS_DRG Major Bladder Procedures With Cc 10 10 $47,849.59 $47,849.59 $47,849.59 $47,849.59 $47,849.59 2026-07-15
653 MS_DRG Major Bladder Procedures With Mcc 10 10 $54,735.54 $54,735.54 $54,735.54 $54,735.54 $54,735.54 2026-07-15
655 MS_DRG Major Bladder Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
164 MS_DRG Major Chest Procedures With Cc 10 10 $108,405.72 $108,405.72 $108,405.72 $108,405.72 $108,405.72 2026-07-15
163 MS_DRG Major Chest Procedures With Mcc 10 10 $108,405.72 $108,405.72 $108,405.72 $108,405.72 $108,405.72 2026-07-15
165 MS_DRG Major Chest Procedures Without Cc/mcc 10 10 $108,405.72 $108,405.72 $108,405.72 $108,405.72 $108,405.72 2026-07-15
141 MS_DRG Major Head And Neck Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
140 MS_DRG Major Head And Neck Procedures With Mcc 10 10 $107,020.30 $107,020.30 $107,020.30 $107,020.30 $107,020.30 2026-07-15
142 MS_DRG Major Head And Neck Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
755 MS_DRG Malignancy, Female Reproductive System With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
754 MS_DRG Malignancy, Female Reproductive System With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
582 MS_DRG Mastectomy For Malignancy With Cc/mcc 10 10 $62,023.86 $62,023.86 $62,023.86 $62,023.86 $62,023.86 2026-07-15
583 MS_DRG Mastectomy For Malignancy Without Cc/mcc 10 10 $50,972.50 $50,972.50 $50,972.50 $50,972.50 $50,972.50 2026-07-15
551 MS_DRG Medical Back Problems With Mcc 19 12 $59,710.25 $59,710.25 $21,415.88 $59,710.25 $59,710.25 2026-07-15
663 MS_DRG Minor Bladder Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
662 MS_DRG Minor Bladder Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
664 MS_DRG Minor Bladder Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
606 MS_DRG Minor Skin Disorders With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 19 12 $44,735.82 $44,735.82 $44,735.82 $56,554.95 $44,735.82 2026-07-15
137 MS_DRG Mouth Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
138 MS_DRG Mouth Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
828 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
54 MS_DRG Nervous System Neoplasms With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
620 MS_DRG O.r. Procedures For Obesity With Cc 10 10 $43,377.83 $43,377.83 $43,377.83 $43,377.83 $43,377.83 2026-07-15
619 MS_DRG O.r. Procedures For Obesity With Mcc 10 10 $59,787.98 $59,787.98 $59,787.98 $59,787.98 $59,787.98 2026-07-15
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 10 10 $54,200.57 $54,200.57 $54,200.57 $54,200.57 $54,200.57 2026-07-15
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
113 MS_DRG Orbital Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
114 MS_DRG Orbital Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
539 MS_DRG Osteomyelitis With Mcc* 19 12 $44,319.74 $44,319.74 $44,319.74 $53,718.92 $44,319.74 2026-07-15
818 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
264 MS_DRG Other Circulatory System O.r. Procedures 10 10 $58,096.21 $58,096.21 $58,096.21 $58,096.21 $58,096.21 2026-07-15
393 MS_DRG Other Digestive System Diagnoses With Mcc 19 12 $46,455.02 $46,455.02 $46,455.02 $56,554.95 $46,455.02 2026-07-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 10 10 $63,820.79 $63,820.79 $63,820.79 $63,820.79 $63,820.79 2026-07-15
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
144 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
145 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
750 MS_DRG Other Female Reproductive System O.r. Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
215 MS_DRG Other Heart Assist System Implant 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
922 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc* 10 10 $47,849.59 $47,849.59 $47,849.59 $47,849.59 $47,849.59 2026-07-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc* 10 10 $54,735.54 $54,735.54 $54,735.54 $54,735.54 $54,735.54 2026-07-15
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/mcc* 10 10 $47,849.59 $47,849.59 $47,849.59 $47,849.59 $47,849.59 2026-07-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
717 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
963 MS_DRG Other Multiple Significant Trauma With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 10 10 $54,822.41 $54,822.41 $54,822.41 $54,822.41 $54,822.41 2026-07-15
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
908 MS_DRG Other O.r. Procedures For Injuries With Cc* 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc* 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 10 $57,492.66 $57,492.66 $57,492.66 $57,492.66 $57,492.66 2026-07-15
205 MS_DRG Other Respiratory System Diagnoses With Mcc 19 12 $59,961.73 $59,961.73 $21,415.88 $59,961.73 $59,961.73 2026-07-15
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 10 10 $72,119.59 $72,119.59 $72,119.59 $72,119.59 $72,119.59 2026-07-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 10 10 $107,020.30 $107,020.30 $107,020.30 $107,020.30 $107,020.30 2026-07-15
168 MS_DRG Other Respiratory System O.r. Procedures Without Cc/mcc 10 10 $72,119.59 $72,119.59 $72,119.59 $72,119.59 $72,119.59 2026-07-15
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 10 10 $50,972.50 $50,972.50 $50,972.50 $50,972.50 $50,972.50 2026-07-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 10 10 $62,023.86 $62,023.86 $62,023.86 $62,023.86 $62,023.86 2026-07-15
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/mcc 10 10 $50,972.50 $50,972.50 $50,972.50 $50,972.50 $50,972.50 2026-07-15
253 MS_DRG Other Vascular Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
252 MS_DRG Other Vascular Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
254 MS_DRG Other Vascular Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
152 MS_DRG Otitis Media And Uri With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
735 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
709 MS_DRG Penis Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 10 10 $67,167.74 $67,167.74 $67,167.74 $67,167.74 $67,167.74 2026-07-15
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 10 10 $61,616.92 $61,616.92 $61,616.92 $61,616.92 $61,616.92 2026-07-15
666 MS_DRG Prostatectomy With Cc 10 10 $47,849.59 $47,849.59 $47,849.59 $47,849.59 $47,849.59 2026-07-15
665 MS_DRG Prostatectomy With Mcc 10 10 $54,735.54 $54,735.54 $54,735.54 $54,735.54 $54,735.54 2026-07-15
667 MS_DRG Prostatectomy Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
189 MS_DRG Pulmonary Edema And Respiratory Failure 19 12 $44,749.54 $44,749.54 $44,749.54 $70,667.93 $44,749.54 2026-07-15
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 19 12 $53,990.25 $53,990.25 $21,415.88 $53,990.25 $53,990.25 2026-07-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 19 12 $88,913.81 $88,913.81 $30,533.31 $88,913.81 $88,913.81 2026-07-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
139 MS_DRG Salivary Gland Procedures 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 10 10 $94,743.55 $94,743.55 $94,743.55 $94,743.55 $94,743.55 2026-07-15
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
136 MS_DRG Sinus And Mastoid Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
570 MS_DRG Skin Debridement With Mcc* 10 10 $53,830.21 $53,830.21 $53,830.21 $53,830.21 $53,830.21 2026-07-15
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
578 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/mcc* 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 10 $63,578.45 $63,578.45 $63,578.45 $63,578.45 $63,578.45 2026-07-15
575 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 10 10 $59,787.98 $59,787.98 $59,787.98 $59,787.98 $59,787.98 2026-07-15
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 10 10 $43,377.83 $43,377.83 $43,377.83 $43,377.83 $43,377.83 2026-07-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
905 MS_DRG Skin Grafts For Injuries Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
501 MS_DRG Soft Tissue Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
500 MS_DRG Soft Tissue Procedures With Mcc 10 10 $56,317.57 $56,317.57 $56,317.57 $56,317.57 $56,317.57 2026-07-15
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
53 MS_DRG Spinal Disorders And Injuries Without Cc/mcc 10 10 $48,608.60 $48,608.60 $48,608.60 $48,608.60 $48,608.60 2026-07-15
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 10 10 $54,822.41 $54,822.41 $54,822.41 $54,822.41 $54,822.41 2026-07-15
28 MS_DRG Spinal Procedures With Mcc 10 10 $54,822.41 $54,822.41 $54,822.41 $54,822.41 $54,822.41 2026-07-15
799 MS_DRG Splenic Procedures With Mcc 10 10 $63,820.79 $63,820.79 $63,820.79 $63,820.79 $63,820.79 2026-07-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
312 MS_DRG Syncope And Collapse 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
711 MS_DRG Testes Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 10 10 $72,119.59 $72,119.59 $72,119.59 $72,119.59 $72,119.59 2026-07-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 10 10 $107,020.30 $107,020.30 $107,020.30 $107,020.30 $107,020.30 2026-07-15
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 10 $131,354.32 $131,354.32 $131,354.32 $131,354.32 $131,354.32 2026-07-15
669 MS_DRG Transurethral Procedures With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
668 MS_DRG Transurethral Procedures With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
670 MS_DRG Transurethral Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
713 MS_DRG Transurethral Prostatectomy With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc* 10 10 $49,056.69 $49,056.69 $49,056.69 $49,056.69 $49,056.69 2026-07-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 10 10 $72,119.59 $72,119.59 $72,119.59 $72,119.59 $72,119.59 2026-07-15
256 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
257 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
671 MS_DRG Urethral Procedures With Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
672 MS_DRG Urethral Procedures Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
693 MS_DRG Urinary Stones With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
740 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
741 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy Without… 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
738 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
746 MS_DRG Vagina, Cervix And Vulva Procedures With Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
747 MS_DRG Vagina, Cervix And Vulva Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
263 MS_DRG Vein Ligation And Stripping 10 10 $58,096.21 $58,096.21 $58,096.21 $58,096.21 $58,096.21 2026-07-15
32 MS_DRG Ventricular Shunt Procedures With Cc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
33 MS_DRG Ventricular Shunt Procedures Without Cc/mcc 10 10 $57,716.71 $57,716.71 $57,716.71 $57,716.71 $57,716.71 2026-07-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 10 10 $57,661.84 $57,661.84 $57,661.84 $57,661.84 $57,661.84 2026-07-15
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 10 10 $43,606.45 $43,606.45 $43,606.45 $43,606.45 $43,606.45 2026-07-15
902 MS_DRG Wound Debridements For Injuries With Cc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
901 MS_DRG Wound Debridements For Injuries With Mcc 10 10 $58,667.75 $58,667.75 $58,667.75 $58,667.75 $58,667.75 2026-07-15
903 MS_DRG Wound Debridements For Injuries Without Cc/mcc 10 10 $43,185.80 $43,185.80 $43,185.80 $43,185.80 $43,185.80 2026-07-15
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