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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

KETTERING HEALTH MAIN CAMPUS

Kettering, OH · CCN 360079 · Rates published

13,805 distinct procedures filed
22 distinct payers
236,551 rate rows
2026-04-01 last MRF observed
Data quality

184,693 of 236,551 rate rows are consumer-grade (78.1%)

51,858 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 51,605
placeholder amount (≤ $0.02) — excluded from medians 253
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://ketteringhealth.org/wp-content/uploads/2021/12/1043233984_Kettering-Health-Main-Campus_StandardCharges.json
Found on page https://ketteringhealth.org/billing-insurance/patient-pricing/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 3dca40fa2b586f52… · 4,664,355 bytes · first seen 2026-05-13

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $4,526,200.00 $4,526,200.00 $4,526,200.00 nat. median
$3,710,000
1.2× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $3,685,266.67 $4,526,200.00 $4,197,865.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,316,462.59 $4,959,717.15 $4,052,573.44 nat. median
$3,325,455
1.2× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,248,445.72 $4,857,998.99 $3,895,460.00 nat. median
$3,286,000
1.2× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,455,110.60 $3,809,595.13 $3,671,578.93 nat. median
$2,468,984
1.5× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $2,945,740.00 $4,570,904.76 $3,620,960.00 nat. median
$3,004,655
1.2× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 6 $2,332,000.00 $4,897,200.00 $3,487,468.98 nat. median
$2,448,600
1.4× median
Q2057
HCPCS 		Afamitresgene Autoleucel 6 $770,620.00 $2,070,347.69 $1,193,382.13 nat. median
$824,563
1.4× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $591,726.20 $1,589,731.61 $901,051.07 nat. median
$753,246
1.2× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $565,868.94 $1,520,263.51 $861,676.94 nat. median
$674,867
1.3× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 6 $562,538.19 $1,511,315.09 $856,605.02 nat. median
$673,137
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 6 $557,317.93 $1,497,290.36 $848,655.89 nat. median
$625,184
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $533,230.17 $1,432,576.18 $811,976.24 nat. median
$634,303
1.3× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $489,304.61 $1,314,565.76 $745,088.59 nat. median
$619,808
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 15 $339,526.08 $797,852.34 $419,935.86 nat. median
$370,174
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $150.00 $592,649.22 $231,559.39 nat. median
$265,286
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $168,148.34 $499,151.43 $218,214.51 nat. median
$206,474
1.1× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 6 $110,901.76 $297,948.67 $172,086.26 nat. median
$111,989
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 $61,267.79 $450,912.84 $167,164.77 nat. median
$202,976
0.8× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 5 $113,585.43 $186,452.72 $164,139.71 nat. median
$87,428
1.9× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 $98,142.30 $161,102.52 $141,823.20 nat. median
$63,570
outlier · 2.2×
90288
HCPCS 		Botulism Ig IV 1 $135,886.95 $135,886.95 $135,886.95 nat. median
$55,037
outlier · 2.5×
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $88,813.56 $187,316.25 $134,648.12 nat. median
$76,329
1.8× median
7
MS_DRG 		Lung Transplant 15 $102,208.22 $274,961.68 $132,640.71 nat. median
$122,708
1.1× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 $90,869.37 $149,163.86 $131,313.25 nat. median
$54,196
outlier · 2.4×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $94,889.91 $275,656.04 $123,143.38 nat. median
$117,357
1.0× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 5 $85,012.82 $139,550.22 $122,850.09 nat. median
$65,393
1.9× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 5 $82,046.74 $134,681.34 $118,563.87 nat. median
$49,935
outlier · 2.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $89,504.21 $231,865.51 $116,154.09 nat. median
$108,660
1.1× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 5 $78,398.73 $128,693.07 $113,292.22 nat. median
$62,372
1.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 15 $83,991.39 $229,201.72 $111,491.51 nat. median
$102,358
1.1× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 15 $14,883.56 $481,790.60 $109,282.40 nat. median
$133,161
0.8× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 6 $68,801.71 $184,842.67 $106,759.61 nat. median
$70,825
1.5× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $81,487.28 $224,057.19 $105,750.11 nat. median
$100,136
1.1× median
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $68,527.37 $193,814.96 $103,027.22 nat. median
$83,470
1.2× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 9 $63,342.28 $170,175.37 $98,288.22 nat. median
$69,774
1.4× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 $66,893.30 $109,806.67 $96,665.98 nat. median
$44,728
outlier · 2.2×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 $64,829.60 $106,419.07 $93,683.78 nat. median
$48,704
1.9× median
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 5 $64,355.33 $105,640.55 $92,998.43 nat. median
$39,020
outlier · 2.4×
38240
HCPCS 		Transplt Allo Hct/donor 7 $13,471.00 $213,577.45 $92,685.66 nat. median
$15,979
outlier · 5.8×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $6,530.08 $220,543.35 $91,419.39 nat. median
$98,894
0.9× median
209
MS_DRG 		Complex Aortic Arch Procedures 15 $89,402.17 $210,086.16 $89,402.17 nat. median
$98,047
0.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 8 $56,824.55 $195,821.64 $87,998.49 nat. median
$62,507
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 15 $30,054.20 $296,407.98 $87,649.71 nat. median
$73,807
1.2× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 15 $34,230.78 $212,681.10 $86,592.46 nat. median
$79,312
1.1× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 8 $55,272.32 $159,077.71 $85,525.65 nat. median
$66,682
1.3× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 5 $59,034.58 $96,906.43 $85,309.53 nat. median
$48,483
1.8× median
215
MS_DRG 		Other Heart Assist System Implant 15 $74,926.60 $222,912.56 $82,648.02 nat. median
$99,019
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $52,634.38 $216,693.72 $81,212.22 nat. median
$93,672
0.9× median
2039
OTHER 		Gen, Neuro, Imp Led, Ex Cntr 1 $51,295.62 $106,121.03 $78,708.32 nat. median
$293
outlier · 268.2×

Other procedures at this hospital

Browse this hospital's 13,805 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
             
0408T HCPCS Insj/rplc Cardiac Modulj Sys 13 7 — — $23,576.00 $106,579.25 $47,990.55 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 13 7 — — $18,353.44 $75,526.90 $34,008.29 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 13 7 — — $18,353.44 $75,526.90 $34,008.29 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 13 7 — — $14,014.53 $75,526.90 $34,008.29 2026-04-01
0525T HCPCS Insj/rplcmt Compl Iims 13 7 — — $10,672.27 $65,402.07 $28,382.37 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 13 7 — — $18,353.44 $106,579.25 $47,990.55 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 13 7 — — $11,376.86 $75,526.90 $34,008.29 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 15 8 — — $14,014.53 $149,557.51 $45,569.35 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 13 7 — — $10,817.74 $104,775.70 $45,469.24 2026-04-01
0680T HCPCS Insj/rplcmt Pg Only Isdss 13 7 — — $10,817.74 $65,872.07 $28,586.33 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 11 7 — — $14,014.53 $116,322.88 $52,168.63 2026-04-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 13 7 — — $18,978.72 $65,402.07 $28,382.37 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 13 7 — — $18,978.72 $65,402.07 $28,382.37 2026-04-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 13 7 — — $18,978.72 $65,402.07 $28,382.37 2026-04-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 13 7 — — $18,978.72 $65,402.07 $28,382.37 2026-04-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 13 7 — — $18,978.72 $65,402.07 $28,382.37 2026-04-01
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 13 7 — — $18,978.72 $65,402.07 $28,382.37 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 13 7 — — $8,386.90 $65,872.07 $28,586.33 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 13 7 — — $8,386.90 $65,872.07 $28,586.33 2026-04-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 13 7 — — $11,376.86 $65,402.07 $28,382.37 2026-04-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 13 7 — — $11,376.86 $65,402.07 $28,382.37 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 13 7 — — $3,086.00 $104,775.70 $45,469.24 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 13 7 — — $3,086.00 $104,775.70 $45,469.24 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 13 7 — — $18,353.44 $106,579.25 $47,990.55 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 13 7 — — $10,817.74 $75,526.90 $34,008.29 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 13 7 — — $10,817.74 $75,526.90 $34,008.29 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 33 16 — — $150.00 $592,649.22 $231,559.39 2026-04-01
10 MS_DRG Pancreas Transplant 28 15 — — $56,879.93 $167,751.48 $73,815.93 2026-04-01
1013T HCPCS Lap Srg Imp/rpl Eso Nea&pg/r 9 7 — — $19,115.10 $65,872.07 $29,660.91 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 31 15 — — $40,524.76 $113,528.82 $45,534.12 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 29 15 — — $20,148.33 $86,339.64 $35,329.43 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 28 15 — — $23,173.96 $55,754.44 $29,148.90 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 28 15 — — $94,889.91 $275,656.04 $123,143.38 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 28 15 — — $34,034.07 $88,982.39 $44,167.71 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 29 15 — — $29,962.41 $70,408.67 $42,321.19 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 28 15 — — $47,099.17 $126,992.96 $61,122.95 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 41 15 — — $2,914.90 $96,975.86 $36,279.71 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 38 15 — — $8,698.87 $81,028.89 $29,892.55 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 28 15 — — $43,194.71 $126,992.96 $56,055.93 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 28 15 — — $339,526.08 $797,852.34 $419,935.86 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 15 — — $56,557.31 $166,785.69 $73,397.25 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 15 — — $89,504.21 $231,865.51 $116,154.09 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 39 15 — — $11,796.59 $292,072.60 $65,436.61 2026-04-01
2039 OTHER Gen, Neuro, Imp Led, Ex Cntr 2 1 — — $51,295.62 $106,121.03 $78,708.32 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 14 8 — — $10,499.00 $92,132.15 $34,027.25 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 37 15 — — $24,256.26 $136,086.88 $51,063.28 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 19 15 — — $89,402.17 $210,086.16 $89,402.17 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 33 15 — — $40,788.03 $203,567.21 $65,077.17 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 30 15 — — $83,991.39 $229,201.72 $111,491.51 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 22 15 — — $42,694.87 $220,229.53 $45,350.25 2026-04-01
215 MS_DRG Other Heart Assist System Implant 31 15 — — $74,926.60 $222,912.56 $82,648.02 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 38 15 — — $52,634.38 $216,693.72 $81,212.22 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 15 — — $46,885.27 $173,326.85 $54,775.30 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 15 — — $52,166.95 $125,175.01 $65,515.43 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 48 15 — — $39,474.77 $269,050.38 $63,242.58 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 15 — — $3,459.63 $195,157.40 $44,534.34 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 37 16 — — $21,090.53 $170,808.09 $42,122.67 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 9 5 — — $98,142.30 $161,102.52 $141,823.20 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 9 5 — — $66,893.30 $109,806.67 $96,665.98 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 5 — — $90,869.37 $149,163.86 $131,313.25 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 5 — — $64,829.60 $106,419.07 $93,683.78 2026-04-01
22558 HCPCS Lumbar Spine Fusion 13 7 — — $11,376.86 $92,132.15 $39,982.35 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 9 5 — — $82,046.74 $134,681.34 $118,563.87 2026-04-01
22630 HCPCS Lumbar Spine Fusion 15 8 — — $11,376.86 $92,132.15 $28,072.16 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 13 7 — — $11,376.86 $92,132.15 $39,982.35 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 9 5 — — $64,355.33 $105,640.55 $92,998.43 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 30 15 — — $37,574.04 $104,845.20 $41,357.79 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 45 15 — — $29,493.31 $198,130.50 $50,994.78 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 32 15 — — $34,230.78 $212,681.10 $86,592.46 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 30 15 — — $44,195.60 $175,423.87 $62,476.80 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 41 15 — — $30,054.20 $296,407.98 $87,649.71 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 40 15 — — $21,817.56 $140,796.54 $45,605.01 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 40 15 — — $27,677.84 $130,340.90 $57,094.93 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 46 16 — — $22,394.06 $89,950.88 $39,321.71 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 40 16 — — $3,201.01 $105,973.00 $40,166.29 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 38 15 — — $1,064.56 $79,985.26 $32,822.97 2026-04-01
245 MS_DRG Aicd Generator Procedures 31 15 — — $36,366.23 $117,528.80 $38,184.54 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 9 5 — — $38,395.04 $63,026.21 $55,483.79 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 9 5 — — $24,475.97 $40,177.79 $35,369.67 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 9 5 — — $38,579.62 $63,329.20 $55,750.53 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 9 5 — — $23,286.46 $38,225.18 $33,650.73 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 54 16 — — $20,145.09 $94,095.35 $36,810.40 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 45 15 — — $14,552.90 $104,727.61 $27,934.83 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 29 15 — — $25,217.25 $59,258.02 $35,959.62 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 30 15 — — $25,515.06 $71,682.48 $27,872.47 2026-04-01
2616 OTHER Brachytx, Non-str,yttrium-90 7 4 — — $19,310.39 $89,911.72 $27,765.72 2026-04-01
265 MS_DRG Aicd Lead Procedures 29 15 — — $28,954.51 $75,051.14 $44,749.20 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 37 15 — — $43,286.23 $206,349.92 $48,658.91 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 39 15 — — $34,966.01 $98,985.28 $37,923.61 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 38 15 — — $5,980.05 $140,284.56 $54,542.28 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 43 15 — — $17,259.33 $136,508.67 $33,703.60 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 41 16 — — $3,352.71 $107,999.24 $41,970.15 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 45 15 — — $15,947.72 $72,473.62 $28,743.77 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 37 15 — — $13,314.39 $82,270.31 $34,583.51 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 35 15 — — $24,726.94 $148,686.23 $56,524.34 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 42 15 — — $36,109.19 $130,327.95 $48,895.38 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 35 15 — — $33,778.75 $97,886.94 $38,646.93 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 15 8 — — $11,376.86 $92,132.15 $28,072.16 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 31 15 — — $36,713.30 $105,266.02 $46,458.08 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 34 15 — — $15,915.84 $67,822.53 $28,861.88 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 33 16 — — $21,708.78 $127,910.34 $50,101.97 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 35 15 — — $19,865.31 $70,624.12 $28,699.39 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 43 16 — — $61,267.79 $450,912.84 $167,164.77 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 36 15 — — $11,943.16 $88,168.10 $36,616.42 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 33 15 — — $4,344.62 $130,159.63 $53,039.84 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 28 15 — — $35,585.18 $92,422.59 $46,180.67 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 32 15 — — $22,759.73 $89,617.83 $35,384.58 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 29 15 — — $25,753.39 $60,517.89 $29,324.06 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 44 16 — — $23,436.72 $129,421.66 $40,571.62 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 49 16 — — $13,764.38 $117,184.84 $38,465.60 2026-04-01
332 MS_DRG Rectal Resection With Mcc 29 15 — — $28,329.90 $72,980.71 $30,422.84 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 13 7 — — $10,817.74 $65,402.07 $28,382.37 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 13 7 — — $10,817.74 $65,402.07 $28,382.37 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 13 7 — — $10,817.74 $75,526.90 $34,008.29 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 13 7 — — $10,817.74 $106,579.25 $47,990.55 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 13 7 — — $18,353.44 $75,526.90 $34,008.29 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 13 7 — — $18,353.44 $106,579.25 $47,990.55 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 13 7 — — $10,817.74 $75,526.90 $34,008.29 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 13 7 — — $10,817.74 $75,526.90 $34,008.29 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 13 7 — — $10,817.74 $106,579.25 $47,990.55 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 13 7 — — $10,817.74 $106,579.25 $47,990.55 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 13 7 — — $14,014.53 $65,402.07 $29,449.27 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 13 7 — — $10,817.74 $149,557.51 $64,903.09 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 13 7 — — $10,817.74 $104,775.70 $45,469.24 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 13 7 — — $23,576.00 $97,392.83 $43,854.09 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 35 15 — — $17,623.98 $76,250.48 $30,012.37 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 9 5 — — $34,051.02 $55,895.42 $49,206.35 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 9 5 — — $20,872.83 $34,263.16 $30,162.85 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 34 15 — — $27,300.96 $81,817.93 $31,709.97 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 9 5 — — $28,955.86 $47,531.62 $41,843.46 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 39 15 — — $18,293.89 $89,748.28 $36,786.66 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 15 8 — — $6,350.00 $62,244.11 $27,915.32 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 13 7 — — $13,471.00 $213,577.45 $92,685.66 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 41 15 — — $14,883.56 $481,790.60 $109,282.40 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 34 15 — — $10,196.94 $79,362.44 $31,633.54 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 42 17 — — $22,181.52 $139,877.38 $32,915.26 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 37 15 — — $21,414.00 $234,029.01 $43,494.57 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 32 15 — — $18,152.62 $132,419.84 $29,968.69 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 30 15 — — $24,215.88 $62,231.53 $31,440.97 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 31 15 — — $20,850.73 $73,723.46 $29,943.96 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 28 15 — — $27,297.43 $74,257.90 $35,425.24 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 35 15 — — $16,295.28 $85,575.85 $34,810.17 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 15 — — $6,530.08 $220,543.35 $91,419.39 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 15 — — $4,639.24 $175,545.66 $60,077.52 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 35 15 — — $22,213.40 $210,405.53 $61,819.33 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 33 15 — — $5,859.72 $175,481.94 $74,839.34 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 30 15 — — $12,885.44 $115,096.37 $48,113.94 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 30 15 — — $37,944.97 $141,063.07 $56,197.14 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 40 15 — — $2,755.51 $89,230.67 $35,533.84 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 30 15 — — $38,860.82 $108,354.84 $44,507.97 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 9 5 — — $113,585.43 $186,452.72 $164,139.71 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 9 5 — — $78,398.73 $128,693.07 $113,292.22 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 9 5 — — $59,034.58 $96,906.43 $85,309.53 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 15 — — $61,830.25 $178,187.81 $69,842.90 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 15 — — $43,247.07 $120,754.30 $61,463.19 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 15 — — $33,306.40 $90,848.73 $43,223.38 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 9 5 — — $85,012.82 $139,550.22 $122,850.09 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 9 5 — — $46,886.96 $76,965.87 $67,755.28 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 28 15 — — $43,906.68 $129,122.30 $56,979.89 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 28 15 — — $21,432.89 $60,253.01 $27,814.53 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 34 15 — — $25,297.83 $113,636.13 $46,424.46 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 29 15 — — $25,556.31 $107,189.17 $43,484.28 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 30 15 — — $25,821.73 $77,854.27 $36,642.58 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 28 15 — — $22,123.67 $55,194.75 $28,427.01 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 39 15 — — $3,172.62 $139,561.18 $38,456.61 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 35 15 — — $14,256.94 $50,669.46 $30,342.77 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 35 15 — — $2,929.26 $94,356.26 $34,250.72 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 32 15 — — $4,850.25 $72,355.79 $28,362.04 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 28 15 — — $22,311.28 $53,614.57 $28,044.19 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 28 15 — — $25,884.48 $67,827.77 $33,591.58 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 35 15 — — $17,999.82 $74,716.59 $30,842.36 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 29 15 — — $26,698.12 $74,070.63 $30,464.05 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 28 15 — — $24,233.68 $56,946.72 $28,903.48 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 28 15 — — $81,487.28 $224,057.19 $105,750.11 2026-04-01
509 MS_DRG Arthroscopy 10 6 — — $8,093.37 $36,958.52 $31,570.96 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 30 15 — — $11,303.15 $133,581.76 $31,054.85 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 37 15 — — $21,388.76 $65,062.98 $39,516.77 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 34 15 — — $16,979.04 $98,839.15 $38,660.51 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 13 7 — — $4,802.00 $70,374.47 $30,540.23 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 13 7 — — $5,437.00 $70,374.47 $30,540.23 2026-04-01
5463 OTHER Level 3 Neurostimulator And Related Procedures 2 2 — — $28,464.52 $31,098.86 $29,781.69 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 11 8 — — $20,076.46 $94,622.11 $28,463.21 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 29 15 — — $22,843.80 $129,566.27 $54,578.32 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 29 15 — — $27,802.17 $72,900.75 $42,968.25 2026-04-01
5743 OTHER Level 3 Electronic Analysis Of Devices 1 1 — — $51,459.52 $51,459.52 $51,459.52 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 28 15 — — $39,025.71 $113,514.09 $50,645.62 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 28 15 — — $36,951.82 $102,025.70 $47,954.23 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 33 15 — — $19,436.12 $81,321.36 $29,324.15 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 16 9 — — $4,830.00 $104,775.70 $31,164.47 2026-04-01
61886 HCPCS Implant Neurostim Arrays 16 9 — — $6,350.00 $104,775.70 $46,229.59 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 13 7 — — $10,817.74 $104,775.70 $45,469.24 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 28 15 — — $23,217.92 $57,366.18 $29,662.91 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 31 15 — — $12,212.94 $78,777.50 $29,915.94 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 33 15 — — $9,669.28 $83,034.10 $31,297.34 2026-04-01
63283 HCPCS Bx/exc Idrl Spine Lesn Scrl 5 3 — — $3,086.00 $32,957.00 $27,619.94 2026-04-01
63286 HCPCS Bx/exc Idrl Imed Lesn Thrc 5 3 — — $3,086.00 $32,957.00 $27,619.94 2026-04-01
63287 HCPCS Bx/exc Idrl Imed Lesn Thrlmb 5 3 — — $21,466.00 $32,957.00 $27,619.94 2026-04-01
63290 HCPCS Bx/exc Xdrl/idrl Lsn Any Lvl 5 3 — — $21,466.00 $32,957.00 $27,619.94 2026-04-01
63295 HCPCS Repair Laminectomy Defect 5 3 — — $3,086.00 $32,957.00 $27,619.94 2026-04-01
63655 HCPCS Implant Neuroelectrodes 14 8 — — $19,115.10 $65,872.07 $29,064.36 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 16 9 — — $4,830.00 $104,775.70 $31,164.47 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 15 8 — — $3,958.00 $149,557.51 $50,273.00 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 13 7 — — $8,386.90 $104,775.70 $45,469.24 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 16 9 — — $4,830.00 $65,872.07 $29,064.36 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 15 — — $37,457.34 $96,935.89 $48,610.26 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 15 — — $29,642.14 $73,058.56 $37,815.46 2026-04-01
652 MS_DRG Kidney Transplant 28 15 — — $25,903.32 $64,621.12 $33,282.57 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 29 15 — — $40,419.67 $117,286.74 $43,410.11 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 30 15 — — $21,463.06 $59,375.60 $29,233.58 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 28 15 — — $25,544.58 $68,545.27 $33,150.48 2026-04-01
665 MS_DRG Prostatectomy With Mcc 28 15 — — $25,053.19 $72,242.17 $32,512.78 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 41 15 — — $2,986.67 $88,161.79 $33,534.04 2026-04-01
69930 HCPCS Implant Cochlear Device 16 9 — — $15,624.00 $111,955.12 $49,397.32 2026-04-01
7 MS_DRG Lung Transplant 28 15 — — $102,208.22 $274,961.68 $132,640.71 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 33 15 — — $27,979.96 $82,844.73 $30,042.04 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 30 15 — — $28,421.96 $83,757.91 $34,427.98 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 46 18 — — $12,123.34 $301,107.36 $49,567.86 2026-04-01
791 MS_DRG Prematurity With Major Problems 39 15 — — $2,202.76 $85,428.56 $32,414.67 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 44 16 — — $1,147.55 $87,753.59 $33,282.85 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 33 15 — — $6,968.29 $100,039.43 $44,873.22 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 28 15 — — $44,547.22 $114,479.87 $57,811.15 2026-04-01
800 MS_DRG Splenic Procedures With Cc 29 15 — — $22,605.64 $61,305.06 $34,937.02 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 29 15 — — $31,826.72 $105,961.05 $45,947.40 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 30 15 — — $44,333.90 $150,053.21 $60,461.81 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 32 15 — — $258.58 $98,455.05 $47,422.46 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 33 15 — — $21,067.18 $152,586.93 $39,135.68 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 35 15 — — $2,274.41 $394,391.35 $39,525.58 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 31 15 — — $41,675.93 $116,291.50 $45,829.19 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 30 15 — — $11,910.32 $105,348.08 $40,178.33 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 29 15 — — $68,527.37 $193,814.96 $103,027.22 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 54 16 — — $10,067.55 $220,156.78 $40,392.18 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 44 16 — — $1,281.28 $94,922.26 $37,433.83 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 44 15 — — $16,970.12 $146,371.72 $54,808.39 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 28 15 — — $30,891.04 $82,678.51 $40,088.85 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 30 15 — — $33,449.96 $93,215.84 $43,467.86 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $135,886.95 $135,886.95 $135,886.95 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 30 15 — — $24,983.92 $81,237.20 $38,134.98 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 42 15 — — $8,530.74 $83,816.82 $30,690.08 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 15 — — $168,148.34 $499,151.43 $218,214.51 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 28 15 — — $56,856.38 $140,522.32 $72,652.10 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 28 15 — — $25,835.02 $66,914.59 $33,527.39 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 28 15 — — $31,121.03 $91,038.09 $40,387.32 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 13 7 — — $18,062.32 $62,244.11 $28,027.31 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 13 7 — — $18,062.32 $62,244.11 $28,027.31 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 13 7 — — $18,353.44 $88,749.73 $38,514.49 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 13 7 — — $18,353.44 $88,749.73 $38,514.49 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 13 7 — — $18,353.44 $88,749.73 $38,514.49 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 30 15 — — $18,583.17 $68,230.19 $35,584.45 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 33 16 — — $25,603.44 $76,765.98 $29,587.90 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 33 15 — — $4,456.14 $72,664.83 $30,724.75 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 30 16 — — $13,357.76 $143,665.84 $56,059.44 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 41 16 — — $13,962.57 $80,422.91 $30,091.15 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 33 15 — — $8,985.32 $350,039.54 $63,385.13 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 33 15 — — $18,084.26 $298,211.08 $35,312.12 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 28 15 — — $48,603.17 $133,061.18 $63,074.76 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 31 15 — — $27,168.99 $75,427.78 $35,550.82 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 44 15 — — $10,332.68 $100,035.23 $37,381.98 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 37 15 — — $1,829.54 $73,706.62 $28,107.71 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 14 8 — — $56,824.55 $195,821.64 $87,998.49 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 2 1 — — $55,169.68 $55,169.68 $55,169.68 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 11 7 — — $17,771.01 $61,240.23 $36,309.70 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 13 7 — — $23,576.00 $91,396.90 $41,154.24 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 3 — — $3,685,266.67 $4,526,200.00 $4,197,865.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 4 — — $3,316,462.59 $4,959,717.15 $4,052,573.44 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 2 1 — — $4,526,200.00 $4,526,200.00 $4,526,200.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 9 6 — — $2,332,000.00 $4,897,200.00 $3,487,468.98 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 7 5 — — $2,945,740.00 $4,570,904.76 $3,620,960.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 4 — — $3,248,445.72 $4,857,998.99 $3,895,460.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,455,110.60 $3,809,595.13 $3,671,578.93 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 5 3 — — $5,007.82 $47,318.40 $32,730.24 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 5 3 — — $88,813.56 $187,316.25 $134,648.12 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 17 9 — — $63,342.28 $170,175.37 $98,288.22 2026-04-01
J9226 HCPCS Supprelin La Implant 17 9 — — $45,020.65 $126,141.59 $69,858.54 2026-04-01
J9266 HCPCS Pegaspargase Injection 17 9 — — $28,424.06 $76,364.08 $43,929.38 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 16 8 — — $24,228.42 $83,492.94 $38,301.50 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 7 6 — — $29,559.78 $79,415.30 $45,867.91 2026-04-01
L5858 HCPCS Stance Phase Only 7 6 — — $22,885.05 $61,482.98 $35,510.73 2026-04-01
L5859 HCPCS Knee-shin Pro Flex/ext Cont 7 6 — — $17,866.14 $47,999.17 $27,722.89 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 7 6 — — $21,739.52 $58,405.39 $33,733.21 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 7 6 — — $29,510.19 $79,282.08 $45,790.96 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 7 6 — — $29,420.21 $79,040.34 $45,651.34 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 7 6 — — $18,506.37 $49,719.21 $28,716.33 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 7 6 — — $19,809.02 $53,218.91 $30,737.66 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 7 6 — — $21,834.21 $58,659.79 $33,880.14 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 7 6 — — $47,919.99 $128,741.85 $74,357.45 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 7 6 — — $49,338.18 $132,551.95 $76,558.05 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 7 6 — — $34,970.13 $93,950.75 $54,263.15 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 7 6 — — $68,801.71 $184,842.67 $106,759.61 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 7 6 — — $110,901.76 $297,948.67 $172,086.26 2026-04-01
Q0481 HCPCS Microprcsr Cu Elec Vad, Rep 7 6 — — $17,892.75 $48,070.66 $27,764.18 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 7 6 — — $23,087.32 $62,026.39 $35,824.59 2026-04-01
Q0489 HCPCS Pwr Pck Base Combo Vad, Rep 7 6 — — $20,015.46 $53,773.53 $31,057.99 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 12 6 — — $533,230.17 $1,432,576.18 $811,976.24 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 6 — — $591,726.20 $1,589,731.61 $901,051.07 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 8 — — $55,272.32 $159,077.71 $85,525.65 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 12 6 — — $489,304.61 $1,314,565.76 $745,088.59 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 12 6 — — $562,538.19 $1,511,315.09 $856,605.02 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 12 6 — — $557,317.93 $1,497,290.36 $848,655.89 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 12 6 — — $565,868.94 $1,520,263.51 $861,676.94 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 10 6 — — $770,620.00 $2,070,347.69 $1,193,382.13 2026-04-01
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