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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

OHIOHEALTH MANSFIELD HOSPITAL

Mansfield, OH · CCN 360118 · Rates published

10,122 distinct procedures filed
14 distinct payers
65,942 rate rows
2026-04-01 last MRF observed
Data quality

39,003 of 65,942 rate rows are consumer-grade (59.1%)

26,939 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 26,927
placeholder amount (≤ $0.02) — excluded from medians 12
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.ohiohealth.com/siteassets/patients-and-visitors/preparing-for-your-visit/out-of-pocket-estimates/310714456_ohiohealth-mansfield-hospital_standardcharges.json
Found on page https://www.ohiohealth.com/billing-insurance/pre-visit-financial-checklist/healthcare-estimates-and-pricing
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint bb75c43939c5d3e8… · 20,545,274 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $0.07 $3,832,677.33 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.07 $3,449,121.09 $3,316,462.59 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $0.07 $3,378,383.54 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $0.07 $3,063,569.60 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $0.07 $2,553,315.03 $2,455,110.60 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $0.07 $2,425,280.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $770,620.00 $1,310,054.00 $789,885.50 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $0.07 $983,151.78 $594,684.83 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $0.07 $940,744.01 $568,698.28 nat. median
$675,122
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $0.07 $920,780.62 $565,350.88 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $0.07 $920,142.76 $560,104.52 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $0.07 $906,230.01 $535,896.32 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $0.07 $832,524.00 $491,751.13 nat. median
$620,080
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $394,322.50 $394,322.50 $394,322.50 nat. median
$76,377
outlier · 5.2×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 $299,853.88 $311,848.04 $299,853.88 nat. median
$370,174
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $194,876.42 $202,671.48 $194,876.42 nat. median
$265,286
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $148,662.21 $154,608.70 $148,662.21 nat. median
$206,368
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $118,095.39 $551,452.82 $147,794.49 nat. median
$202,986
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $93,536.95 $291,945.96 $96,729.92 nat. median
$133,176
0.7× median
7
MS_DRG 		Lung Transplant 8 $90,488.99 $94,108.55 $90,488.99 nat. median
$122,708
0.7× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $63,342.28 $412,113.26 $86,854.38 nat. median
$69,774
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $84,032.68 $87,393.99 $84,032.68 nat. median
$117,303
0.7× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $79,281.35 $82,452.60 $79,281.35 nat. median
$108,660
0.7× median
209
MS_DRG 		Complex Aortic Arch Procedures 8 $79,191.32 $82,358.97 $79,191.32 nat. median
$98,017
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $42,963.00 $242,400.61 $77,130.40 nat. median
$98,905
0.8× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $55,272.32 $360,987.25 $76,295.68 nat. median
$66,682
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $76,111.71 $79,156.18 $76,111.71 nat. median
$102,358
0.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 8 $72,208.70 $75,097.05 $72,208.70 nat. median
$100,136
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 8 $36,479.85 $72,551.10 $69,760.67 nat. median
$99,019
0.7× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $68,554.31 $237,804.54 $68,554.31 nat. median
$93,672
0.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $17,711.67 $178,557.22 $63,199.79 nat. median
$82,712
0.8× median
J9226
HCPCS 		Supprelin La Implant 4 $45,020.65 $294,201.70 $62,137.07 nat. median
$60,368
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $60,775.30 $63,206.31 $60,775.30 nat. median
$83,442
0.7× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 8 $59,185.29 $76,450.40 $59,185.29 nat. median
$79,312
0.7× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $56,824.55 $421,582.72 $59,097.53 nat. median
$62,507
0.9× median
5378
OTHER 		Level 8 Urology And Related Services 1 $59,064.43 $59,064.43 $59,064.43 nat. median
$20,900
outlier · 2.8×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $36,617.26 $282,018.14 $59,001.77 nat. median
$81,118
0.7× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 $54,884.75 $57,511.58 $55,299.60 nat. median
$77,576
0.7× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 $53,980.36 $464,423.82 $53,980.36 nat. median
$74,915
0.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 $51,620.42 $55,901.19 $53,751.14 nat. median
$73,807
0.7× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 $19,073.32 $55,718.97 $53,575.93 nat. median
$72,138
0.7× median
J9216
HCPCS 		Interferon Gamma 1-b Inj 1 $52,923.72 $52,923.72 $52,923.72 nat. median
$10,268
outlier · 5.2×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $28,763.12 $57,923.16 $50,796.87 nat. median
$68,090
0.7× median
10
MS_DRG 		Pancreas Transplant 8 $50,499.78 $52,519.77 $50,499.78 nat. median
$68,882
0.7× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 8 $50,479.01 $52,498.17 $50,479.01 nat. median
$64,027
0.8× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 $50,215.16 $52,223.77 $50,215.16 nat. median
$71,240
0.7× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 $45,670.10 $187,752.02 $50,186.08 nat. median
$68,887
0.7× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 10 $12,051.48 $171,089.65 $48,672.24 nat. median
$66,526
0.7× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 8 $43,753.50 $203,433.14 $48,437.48 nat. median
$65,950
0.7× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 8 $47,420.87 $49,317.70 $47,420.87 nat. median
$64,732
0.7× median

Other procedures at this hospital

Browse this hospital's 10,122 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
             
Q2057 HCPCS Afamitresgene Autoleucel 4 3 — — $770,620.00 $1,310,054.00 $789,885.50 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 1 — — $394,322.50 $394,322.50 $394,322.50 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 8 — — $299,853.88 $311,848.04 $299,853.88 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 8 8 — — $194,876.42 $202,671.48 $194,876.42 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 8 — — $148,662.21 $154,608.70 $148,662.21 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 8 — — $118,095.39 $551,452.82 $147,794.49 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 8 — — $93,536.95 $291,945.96 $96,729.92 2026-04-01
7 MS_DRG Lung Transplant 8 8 — — $90,488.99 $94,108.55 $90,488.99 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 8 8 — — $84,032.68 $87,393.99 $84,032.68 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 8 — — $79,281.35 $82,452.60 $79,281.35 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 8 8 — — $79,191.32 $82,358.97 $79,191.32 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 8 — — $76,111.71 $79,156.18 $76,111.71 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 8 8 — — $72,208.70 $75,097.05 $72,208.70 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 8 — — $68,554.31 $237,804.54 $68,554.31 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 4 — — $63,342.28 $412,113.26 $86,854.38 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 8 8 — — $60,775.30 $63,206.31 $60,775.30 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 9 8 — — $59,185.29 $76,450.40 $59,185.29 2026-04-01
5378 OTHER Level 8 Urology And Related Services 1 1 — — $59,064.43 $59,064.43 $59,064.43 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 4 — — $56,824.55 $421,582.72 $59,097.53 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $55,272.32 $360,987.25 $76,295.68 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 9 8 — — $54,884.75 $57,511.58 $55,299.60 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 11 8 — — $53,980.36 $464,423.82 $53,980.36 2026-04-01
J9216 HCPCS Interferon Gamma 1-b Inj 2 1 — — $52,923.72 $52,923.72 $52,923.72 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 11 8 — — $51,620.42 $55,901.19 $53,751.14 2026-04-01
10 MS_DRG Pancreas Transplant 8 8 — — $50,499.78 $52,519.77 $50,499.78 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 8 8 — — $50,479.01 $52,498.17 $50,479.01 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 8 — — $50,215.16 $52,223.77 $50,215.16 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 8 8 — — $47,420.87 $49,317.70 $47,420.87 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 10 8 — — $47,112.01 $190,013.28 $47,112.01 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 9 8 — — $47,078.07 $48,961.19 $47,078.07 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 8 — — $46,341.93 $48,195.61 $46,341.93 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 8 8 — — $46,176.42 $48,023.48 $46,176.42 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 11 8 — — $45,670.10 $187,752.02 $50,186.08 2026-04-01
J9226 HCPCS Supprelin La Implant 6 4 — — $45,020.65 $294,201.70 $62,137.07 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 8 — — $43,753.50 $203,433.14 $48,437.48 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 8 8 — — $43,197.92 $44,925.84 $43,197.92 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 9 — — $42,963.00 $242,400.61 $77,130.40 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 8 — — $42,791.41 $44,503.07 $42,791.41 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 8 — — $41,912.95 $48,195.61 $46,341.93 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 8 8 — — $41,871.06 $43,545.90 $41,871.06 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 11 8 — — $41,501.88 $125,290.85 $42,415.38 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 9 9 — — $41,447.94 $190,223.53 $41,447.94 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 9 8 — — $40,745.04 $43,080.47 $40,745.04 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 14 8 — — $40,564.56 $192,019.51 $43,247.09 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 8 8 — — $40,328.14 $41,941.27 $40,328.14 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 9 8 — — $40,208.41 $43,078.48 $41,421.62 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 8 — — $39,740.20 $41,329.81 $39,740.20 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 8 8 — — $39,619.70 $41,204.49 $39,619.70 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 8 — — $39,153.08 $53,550.76 $42,102.36 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 8 8 — — $39,054.61 $40,616.79 $39,054.61 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 8 8 — — $38,691.04 $40,238.68 $38,691.04 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 8 8 — — $38,577.47 $40,120.57 $38,577.47 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 8 8 — — $38,426.50 $39,963.56 $38,426.50 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 8 8 — — $37,715.29 $39,223.90 $37,715.29 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 8 8 — — $37,467.37 $38,966.06 $37,467.37 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 8 8 — — $36,792.86 $38,264.57 $36,792.86 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 8 — — $36,617.26 $282,018.14 $59,001.77 2026-04-01
215 MS_DRG Other Heart Assist System Implant 9 8 — — $36,479.85 $72,551.10 $69,760.67 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 8 — — $35,711.15 $37,139.60 $35,711.15 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 9 8 — — $35,171.52 $44,099.75 $42,403.61 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 8 8 — — $34,748.56 $36,138.50 $34,748.56 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 11 8 — — $34,711.20 $45,969.33 $35,345.51 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 8 — — $34,503.89 $337,660.42 $37,737.45 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 9 8 — — $34,291.97 $40,927.93 $39,353.78 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 8 8 — — $34,077.51 $35,440.61 $34,077.51 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 8 — — $33,472.94 $41,887.98 $40,276.90 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 8 8 — — $33,364.92 $34,699.52 $33,364.92 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 9 8 — — $32,996.60 $34,529.54 $33,201.48 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 8 8 — — $32,918.94 $34,235.70 $32,918.94 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 8 — — $32,859.62 $36,471.24 $35,068.50 2026-04-01
245 MS_DRG Aicd Generator Procedures 8 8 — — $32,402.32 $33,698.41 $32,402.32 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 16 8 — — $32,241.08 $136,034.24 $33,776.27 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 10 9 — — $32,170.33 $104,027.89 $32,170.33 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 14 8 — — $31,939.71 $117,217.09 $33,298.44 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 8 8 — — $31,835.16 $33,108.57 $31,835.16 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 10 8 — — $30,929.91 $234,470.19 $32,307.45 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 8 8 — — $30,344.87 $31,558.66 $30,344.87 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 9 8 — — $30,174.95 $32,981.80 $31,713.27 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 8 8 — — $30,003.46 $31,203.60 $30,003.46 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 9 8 — — $29,988.91 $178,630.39 $29,988.91 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 3 3 — — $29,971.44 $31,170.29 $30,271.15 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 8 8 — — $29,869.11 $31,063.87 $29,869.11 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 14 8 — — $29,842.65 $90,184.48 $32,293.60 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 13 8 — — $29,727.18 $99,414.70 $34,890.53 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 8 — — $29,702.91 $30,891.03 $29,702.91 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 10 8 — — $29,670.33 $33,859.75 $32,557.45 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
61886 HCPCS Implant Neurostim Arrays 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 3 3 — — $29,464.26 $30,642.83 $29,758.90 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 9 8 — — $29,198.74 $32,005.92 $30,774.92 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 16 8 — — $28,851.53 $89,564.86 $37,346.18 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $28,763.12 $57,923.16 $50,796.87 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 4 — — $28,424.06 $175,958.45 $38,940.96 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 10 8 — — $27,930.15 $30,749.86 $29,567.17 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 8 — — $27,897.52 $29,013.42 $27,897.52 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 8 8 — — $27,774.95 $28,885.95 $27,774.95 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 8 8 — — $27,612.21 $28,716.70 $27,612.21 2026-04-01
A9571 HCPCS Indium In-111 Auto Platelet 2 1 — — $27,364.74 $27,364.74 $27,364.74 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 13 8 — — $27,004.37 $43,134.96 $29,903.73 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 8 8 — — $26,752.80 $27,822.91 $26,752.80 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 8 8 — — $26,470.25 $27,529.06 $26,470.25 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 10 8 — — $26,262.52 $27,941.02 $26,866.37 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 9 8 — — $26,243.80 $27,293.55 $26,243.80 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 12 8 — — $26,009.77 $219,500.49 $30,175.20 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 8 8 — — $25,934.94 $26,972.34 $25,934.94 2026-04-01
332 MS_DRG Rectal Resection With Mcc 8 8 — — $25,880.92 $26,916.16 $25,880.92 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 8 8 — — $25,618.46 $26,643.20 $25,618.46 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 8 8 — — $25,560.98 $26,583.42 $25,560.98 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 8 — — $25,499.35 $26,519.32 $25,499.35 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 8 8 — — $25,478.57 $26,497.71 $25,478.57 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 11 8 — — $25,387.36 $126,131.46 $28,649.59 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 3 3 — — $24,957.55 $25,955.85 $25,207.12 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 3 3 — — $24,957.55 $25,955.85 $25,207.12 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 3 3 — — $24,957.55 $25,955.85 $25,207.12 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 9 8 — — $24,860.09 $28,648.28 $27,546.42 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 9 8 — — $24,755.76 $27,755.93 $26,688.39 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 9 8 — — $24,713.05 $29,533.42 $28,397.52 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 9 8 — — $24,621.55 $34,102.45 $32,790.82 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 8 8 — — $24,401.71 $25,377.78 $24,401.71 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 10 8 — — $24,359.66 $76,526.86 $24,730.66 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 11 8 — — $24,344.57 $51,602.83 $26,691.16 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 5 4 — — $24,228.42 $151,599.50 $25,197.56 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 8 — — $23,974.69 $389,740.41 $40,490.19 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 10 8 — — $23,925.09 $42,058.28 $25,819.29 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 8 8 — — $23,682.88 $24,630.20 $23,682.88 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 8 8 — — $23,605.32 $24,549.53 $23,605.32 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 10 8 — — $23,469.06 $26,557.49 $25,536.05 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 13 9 — — $23,305.44 $121,574.67 $29,587.64 2026-04-01
652 MS_DRG Kidney Transplant 8 8 — — $23,171.81 $24,098.68 $23,171.81 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 8 8 — — $23,111.56 $24,036.02 $23,111.56 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 13 8 — — $23,083.75 $26,238.44 $25,229.27 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 10 8 — — $23,018.53 $75,612.73 $25,179.41 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 10 9 — — $22,876.80 $45,423.14 $22,876.80 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 8 8 — — $22,855.33 $23,769.54 $22,855.33 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 4 3 — — $22,838.94 $73,819.29 $28,321.58 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 8 8 — — $22,811.01 $23,723.45 $22,811.01 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 9 8 — — $22,753.45 $26,952.17 $25,915.55 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 10 8 — — $22,723.75 $56,155.16 $22,723.75 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 8 8 — — $22,566.55 $23,469.21 $22,566.55 2026-04-01
665 MS_DRG Prostatectomy With Mcc 9 8 — — $22,421.82 $23,761.40 $22,421.82 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 14 8 — — $22,303.42 $125,507.34 $22,917.66 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 9 8 — — $22,215.45 $25,604.65 $24,619.86 2026-04-01
263 MS_DRG Vein Ligation And Stripping 8 8 — — $21,979.99 $22,859.19 $21,979.99 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 8 8 — — $21,812.40 $22,684.90 $21,812.40 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 10 8 — — $21,585.33 $29,107.15 $23,234.14 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 8 8 — — $21,419.06 $22,275.82 $21,419.06 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 9 8 — — $21,381.23 $22,566.78 $21,698.83 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 10 8 — — $21,381.11 $126,823.16 $22,338.72 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 11 8 — — $21,328.60 $138,396.85 $25,781.89 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 3 3 — — $21,239.12 $22,088.69 $21,451.51 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 8 8 — — $21,195.38 $22,043.20 $21,195.38 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 8 8 — — $21,028.48 $21,869.62 $21,028.48 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 8 8 — — $20,891.36 $21,727.01 $20,891.36 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 2 2 — — $20,847.11 $20,978.77 $20,912.94 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 8 8 — — $20,802.72 $21,634.83 $20,802.72 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 8 8 — — $20,763.94 $21,594.50 $20,763.94 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 9 8 — — $20,485.42 $22,888.73 $22,008.39 2026-04-01
265 MS_DRG Aicd Lead Procedures 9 8 — — $20,401.61 $26,898.15 $25,863.61 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 12 8 — — $20,399.87 $31,819.16 $22,690.51 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 10 8 — — $20,296.89 $21,739.98 $20,903.83 2026-04-01
800 MS_DRG Splenic Procedures With Cc 8 8 — — $20,262.56 $21,073.06 $20,262.56 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 9 8 — — $20,192.62 $71,840.17 $20,192.62 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 11 8 — — $20,072.11 $24,137.58 $23,209.21 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 12 8 — — $19,980.42 $118,427.85 $22,617.80 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 9 8 — — $19,852.10 $23,961.12 $23,039.54 2026-04-01
54417 HCPCS Remv/replc Penis Pros Compl 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
53444 HCPCS Insert Tandem Cuff 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 3 3 — — $19,790.19 $20,581.80 $19,988.09 2026-04-01
849 MS_DRG Radiotherapy 8 8 — — $19,570.74 $20,353.57 $19,570.74 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 8 8 — — $19,547.89 $20,329.81 $19,547.89 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 16 9 — — $19,460.68 $240,660.04 $38,637.02 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 10 8 — — $19,227.94 $69,071.45 $19,227.94 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 8 8 — — $19,163.54 $19,930.08 $19,163.54 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 12 8 — — $19,144.10 $50,068.31 $30,536.00 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 8 — — $19,073.32 $55,718.97 $53,575.93 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 8 8 — — $19,071.44 $19,834.30 $19,071.44 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 9 8 — — $18,956.16 $24,081.40 $23,155.19 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 12 8 — — $18,826.25 $53,671.23 $19,739.02 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 9 8 — — $18,821.21 $20,696.38 $19,900.37 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 9 8 — — $18,769.54 $23,271.87 $22,376.80 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 8 8 — — $18,693.32 $19,441.05 $18,693.32 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 8 8 — — $18,668.39 $19,415.13 $18,668.39 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 8 8 — — $18,668.39 $19,415.13 $18,668.39 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 9 8 — — $18,588.06 $37,807.60 $18,588.06 2026-04-01
0680T HCPCS Insj/rplcmt Pg Only Isdss 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
64580 HCPCS Implant Neuroelectrodes 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
63655 HCPCS Implant Neuroelectrodes 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
1013T HCPCS Lap Srg Imp/rpl Eso Nea&pg/r 3 3 — — $18,524.06 $19,265.02 $18,709.30 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 9 8 — — $18,516.06 $22,590.56 $21,721.69 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 10 8 — — $18,501.35 $228,612.92 $21,724.46 2026-04-01
0525T HCPCS Insj/rplcmt Compl Iims 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 3 3 — — $18,391.89 $19,127.57 $18,575.81 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 13 8 — — $18,278.35 $21,814.17 $20,975.16 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 12 8 — — $18,271.80 $21,510.95 $20,683.61 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 10 8 — — $17,782.71 $25,531.19 $24,549.22 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 8 — — $17,711.67 $178,557.22 $63,199.79 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 16 9 — — $16,726.16 $197,604.97 $29,815.09 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 8 6 — — $16,661.35 $69,437.81 $19,849.26 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 11 8 — — $16,631.16 $20,266.42 $19,486.94 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 2 2 — — $16,426.09 $62,385.22 $39,405.65 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 11 8 — — $16,131.55 $28,490.55 $27,394.76 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 10 8 — — $16,098.21 $25,410.20 $24,432.88 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 14 8 — — $15,968.26 $121,015.91 $23,178.04 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 13 8 — — $15,176.70 $41,249.57 $20,002.87 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 15 8 — — $14,750.68 $67,073.48 $45,368.26 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 11 9 — — $14,416.62 $28,674.92 $27,572.04 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 12 8 — — $13,943.62 $58,122.42 $20,793.02 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 14 9 — — $13,896.56 $164,816.62 $34,246.49 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 16 8 — — $13,397.34 $115,621.10 $22,916.70 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 13 8 — — $12,543.96 $49,092.71 $26,615.68 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 16 9 — — $12,376.96 $127,346.07 $25,434.94 2026-04-01
Q0224 HCPCS Inj, Pemivibart, 4500 Mg 3 2 — — $12,306.30 $42,792.75 $42,792.75 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 15 8 — — $12,158.28 $100,409.05 $19,837.36 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 19 10 — — $12,051.48 $171,089.65 $48,672.24 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 14 8 — — $12,041.68 $86,105.20 $30,053.32 2026-04-01
570 MS_DRG Skin Debridement With Mcc 11 8 — — $11,080.43 $22,021.58 $21,174.60 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 10 8 — — $10,683.03 $40,378.41 $38,825.39 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 17 8 — — $10,536.19 $88,541.29 $23,602.55 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 13 8 — — $10,248.83 $34,092.84 $29,376.73 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 21 10 — — $9,833.27 $262,287.43 $32,638.47 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 15 8 — — $9,672.10 $26,547.88 $24,964.03 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 18 9 — — $9,140.89 $79,625.27 $19,842.20 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 22 9 — — $9,091.09 $111,271.02 $19,648.99 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 13 8 — — $8,949.80 $67,245.71 $41,966.63 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 14 8 — — $8,792.67 $47,043.46 $24,957.80 2026-04-01
503 MS_DRG Foot Procedures With Mcc 10 8 — — $8,363.51 $20,941.26 $20,135.83 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 12 8 — — $8,214.30 $56,420.09 $22,628.19 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 13 9 — — $8,157.60 $21,369.07 $20,547.18 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 14 9 — — $7,419.97 $31,498.87 $26,233.41 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 17 10 — — $6,720.44 $144,035.14 $21,209.23 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 17 9 — — $6,668.89 $133,124.50 $18,781.97 2026-04-01
5416 OTHER Level 6 Gynecologic Procedures 2 2 — — $6,601.78 $63,337.63 $34,969.71 2026-04-01
5222 OTHER Level 2 Pacemaker And Similar Procedures 13 6 — — $6,244.59 $152,178.50 $18,932.58 2026-04-01
5092 OTHER Level 2 Breast/Lymphatic Surgery And Related Procedures 11 6 — — $5,786.21 $56,590.40 $24,156.97 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 18 9 — — $5,273.85 $44,752.78 $23,941.19 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 13 8 — — $4,905.49 $59,686.66 $25,455.03 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 11 8 — — $3,684.76 $25,840.88 $24,847.00 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 12 9 — — $3,616.65 $99,058.57 $23,333.17 2026-04-01
2040 OTHER Endo, Single, Urinary Tract 2 2 — — $2,471.76 $40,436.86 $21,454.31 2026-04-01
5622 OTHER Level 2 Radiation Therapy 17 9 — — $2,016.12 $135,461.05 $37,502.04 2026-04-01
791 MS_DRG Prematurity With Major Problems 13 9 — — $1,977.00 $30,072.86 $28,916.21 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 15 8 — — $1,584.02 $170,754.05 $31,844.16 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 18 10 — — $1,457.10 $30,902.93 $29,682.13 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 22 9 — — $300.00 $214,867.17 $35,007.56 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 12 8 — — $261.16 $32,476.93 $31,227.82 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 13 8 — — $150.00 $38,329.40 $36,855.19 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 9 8 — — $73.96 $19,510.92 $18,760.50 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 4 — — $0.07 $3,832,677.33 $3,685,266.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 4 — — $0.07 $3,449,121.09 $3,316,462.59 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 4 — — $0.07 $3,378,383.54 $3,248,445.72 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 5 4 — — $0.07 $3,063,569.60 $2,945,740.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 4 — — $0.07 $2,553,315.03 $2,455,110.60 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 4 — — $0.07 $2,425,280.00 $2,332,000.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 4 — — $0.07 $983,151.78 $594,684.83 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 6 4 — — $0.07 $940,744.01 $568,698.28 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 4 — — $0.07 $920,780.62 $565,350.88 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 6 4 — — $0.07 $920,142.76 $560,104.52 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 4 — — $0.07 $906,230.01 $535,896.32 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 6 4 — — $0.07 $832,524.00 $491,751.13 2026-04-01
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