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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

UPPER VALLEY MEDICAL CENTER

Troy, OH · CCN 360174 · Rates published

13,545 distinct procedures filed
8 distinct payers
267,390 rate rows
2026-04-01 last MRF observed
Data quality

214,032 of 267,390 rate rows are consumer-grade (80.0%)

53,358 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 53,112
placeholder amount (≤ $0.02) — excluded from medians 246
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.premierhealth.com/docs/default-source/default-document-library/31-0537095_upper-valley-medical-center_standardcharges.json?sfvrsn=a2e45a04_6
Found on page https://www.premierhealth.com/patient-and-visitor-guide/patient-guide/costs-and-insurance/pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 0bdb1fbc643f4b9a… · 55,216,044 bytes · first seen 2026-05-05

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
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,945,740.00 $4,868,633.01 $4,868,633.01 nat. median
$3,004,655
1.6× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,455,110.60 $4,045,990.74 $4,045,990.74 nat. median
$2,468,984
1.6× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,332,000.00 $3,847,800.00 $3,847,800.00 nat. median
$2,448,600
1.6× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,685,266.67 $3,906,382.67 $3,795,824.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $3,316,462.59 $4,974,693.88 $3,482,285.72 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $3,248,445.72 $4,872,668.57 $3,410,868.00 nat. median
$3,286,000
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $591,726.20 $1,826,895.47 $954,235.56 nat. median
$753,246
1.3× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $565,868.94 $1,747,063.78 $913,075.07 nat. median
$674,867
1.4× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $562,538.19 $1,736,780.39 $893,698.84 nat. median
$673,137
1.3× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $557,317.93 $1,720,663.39 $893,079.74 nat. median
$625,184
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $533,230.17 $1,646,294.83 $879,576.19 nat. median
$634,303
1.4× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $770,620.00 $2,379,212.19 $816,857.20 nat. median
$824,563
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $489,304.61 $1,510,679.05 $808,038.00 nat. median
$619,808
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 5 $7,042.49 $1,184,288.83 $325,858.41 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $23,674.24 $884,565.79 $211,660.83 nat. median
$265,286
0.8× median
230
MS_DRG 		Other Cardiothoracic Procedures Without Cc/mcc 2 $9,552.34 $169,334.00 $169,334.00 nat. median
$29,847
outlier · 5.7×
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $7,642.44 $165,365.00 $165,365.00 nat. median
$44,728
outlier · 3.7×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $153,702.52 $745,014.53 $161,387.65 nat. median
$206,474
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $14,034.57 $673,015.43 $160,443.72 nat. median
$202,976
0.8× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $157,945.00 $157,945.00 $157,945.00 nat. median
$63,570
outlier · 2.5×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $8,505.09 $148,170.00 $148,170.00 nat. median
$48,704
outlier · 3.0×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 $10,867.26 $146,575.00 $146,575.00 nat. median
$49,935
outlier · 2.9×
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 $5,920.69 $146,575.00 $146,575.00 nat. median
$39,020
outlier · 3.8×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $5,660.12 $141,521.00 $141,521.00 nat. median
$54,196
outlier · 2.6×
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $78,986.40 $130,327.56 $130,327.56 nat. median
$76,329
1.7× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 3 $110,901.76 $342,398.09 $117,555.87 nat. median
$111,989
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $24,738.61 $443,724.39 $104,894.16 nat. median
$133,161
0.8× median
7
MS_DRG 		Lung Transplant 4 $18,864.70 $410,397.40 $95,302.09 nat. median
$122,708
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $9,030.49 $411,433.76 $88,479.40 nat. median
$117,357
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $13,821.57 $502,714.00 $85,913.09 nat. median
$108,660
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $79,593.55 $329,174.65 $83,573.23 nat. median
$98,894
0.8× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $56,824.55 $175,440.11 $83,563.34 nat. median
$62,507
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $10,055.02 $342,097.81 $82,465.07 nat. median
$102,358
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 2 $14,435.72 $122,593.08 $81,728.72 nat. median
$98,047
0.8× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $55,272.32 $170,647.77 $81,280.72 nat. median
$66,682
1.2× median
525
MS_DRG 		Other Heart Assist System Implant 1 $80,761.79 $80,761.79 $80,761.79 nat. median
$52
outlier · 1547.5×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 5 $63,342.28 $195,562.96 $79,212.69 nat. median
$69,774
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $74,494.53 $334,419.28 $75,984.42 nat. median
$100,136
0.8× median
246
MS_DRG 		Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 2 $4,243.67 $75,814.00 $75,814.00 nat. median
$26,892
outlier · 2.8×
215
MS_DRG 		Other Heart Assist System Implant 5 $71,958.30 $332,710.85 $75,556.22 nat. median
$99,019
0.8× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $74,614.73 $74,614.73 $74,614.73 nat. median
$21,806
outlier · 3.4×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $13,465.86 $303,070.81 $74,243.90 nat. median
$93,672
0.8× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 3 $68,801.71 $212,418.40 $72,929.81 nat. median
$70,825
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $65,161.05 $261,917.70 $68,419.10 nat. median
$82,711
0.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $62,649.21 $289,280.88 $65,781.67 nat. median
$83,470
0.8× median
248
MS_DRG 		Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 2 $5,976.07 $65,707.00 $65,707.00 nat. median
$22,464
outlier · 2.9×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $60,811.78 $189,273.21 $63,852.37 nat. median
$81,118
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 4 $61,001.91 $157,429.00 $62,221.95 nat. median
$79,312
0.8× median
38240
HCPCS 		Transplt Allo Hct/donor 4 $10,075.00 $190,324.08 $61,645.42 nat. median
$15,979
outlier · 3.9×
247
MS_DRG 		Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 2 $4,135.75 $60,652.00 $60,652.00 nat. median
$16,343
outlier · 3.7×

Other procedures at this hospital

Browse this hospital's 13,545 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
             
0100T HCPCS Prosth Retina Receive&Gen 8 1 — — $37,596.00 $37,596.00 $37,596.00 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
0520T HCPCS Rmvl&rplcmt Pg Wcs New Eltrd 17 4 — — $10,243.34 $37,596.00 $31,625.30 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 17 4 — — $16,745.00 $133,274.35 $43,167.18 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 17 4 — — $21,392.00 $93,368.19 $30,241.69 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 17 4 — — $14,500.58 $103,658.16 $33,574.58 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 17 4 — — $3,595.00 $93,368.19 $30,241.69 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 17 4 — — $3,595.00 $93,368.19 $30,241.69 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 39 5 — — $23,674.24 $884,565.79 $211,660.83 2026-04-01
10 MS_DRG Pancreas Transplant 24 3 — — $8,691.11 $106,782.39 $52,003.48 2026-04-01
104 MS_DRG Cardiac Valve & Oth Major Cardiothoracic Proc W Cardiac Cath 1 1 — — $56,217.80 $56,217.80 $56,217.80 2026-04-01
105 MS_DRG Cardiac Valve & Oth Major Cardiothoracic Proc Without Cardiac Cath 1 1 — — $41,135.27 $41,135.27 $41,135.27 2026-04-01
106 MS_DRG Coronary Bypass W Ptca 1 1 — — $51,874.02 $51,874.02 $51,874.02 2026-04-01
107 MS_DRG No Longer Valid 1 1 — — $38,167.47 $38,167.47 $38,167.47 2026-04-01
108 MS_DRG Other Cardiothoracic Procedures 1 1 — — $36,708.42 $36,708.42 $36,708.42 2026-04-01
109 MS_DRG No Longer Valid 1 1 — — $28,009.50 $28,009.50 $28,009.50 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 40 5 — — $6,227.41 $169,448.82 $41,237.69 2026-04-01
110 MS_DRG Major Cardiovascular Procedures W Cc 1 1 — — $28,106.77 $28,106.77 $28,106.77 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 39 5 — — $6,486.56 $128,867.28 $32,307.15 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 39 5 — — $5,801.41 $83,216.97 $22,256.13 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 31 4 — — $9,030.49 $411,433.76 $88,479.40 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 24 3 — — $3,745.25 $56,641.68 $31,122.42 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 39 5 — — $4,006.53 $103,689.89 $28,770.98 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 31 4 — — $8,842.34 $189,544.88 $43,925.16 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 39 5 — — $7,121.30 $144,742.50 $34,309.52 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 39 5 — — $10,453.33 $120,940.66 $28,703.93 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 24 3 — — $4,967.16 $80,838.81 $39,495.22 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 39 5 — — $5,280.27 $96,363.10 $22,968.78 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 39 5 — — $7,042.49 $1,184,288.83 $325,858.41 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 39 5 — — $5,004.08 $248,938.01 $54,294.03 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 39 5 — — $13,821.57 $502,714.00 $85,913.09 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 39 5 — — $20,105.78 $253,140.00 $59,825.03 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 17 4 — — $7,853.00 $82,101.21 $26,592.35 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 42 5 — — $8,427.70 $203,118.12 $47,854.24 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 23 2 — — $14,435.72 $122,593.08 $81,728.72 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 39 5 — — $10,818.98 $173,584.86 $40,426.61 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 39 5 — — $10,055.02 $342,097.81 $82,465.07 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 17 4 — — $10,075.00 $82,101.21 $26,592.35 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 23 2 — — $13,455.92 $62,198.06 $41,465.37 2026-04-01
215 MS_DRG Other Heart Assist System Implant 38 5 — — $71,958.30 $332,710.85 $75,556.22 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 5 — — $13,465.86 $303,070.81 $74,243.90 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 5 — — $20,830.69 $202,794.65 $50,080.62 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 5 — — $11,191.02 $186,831.49 $50,080.62 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 39 5 — — $7,235.61 $242,980.48 $58,389.92 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 39 5 — — $7,956.26 $110,872.21 $24,482.99 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 39 5 — — $4,178.35 $166,330.30 $40,720.41 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 5 — — $36,682.04 $165,365.00 $38,516.14 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 8 1 — — $157,945.00 $157,945.00 $157,945.00 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 9 2 — — $7,642.44 $165,365.00 $165,365.00 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 2 — — $5,660.12 $141,521.00 $141,521.00 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 2 — — $8,505.09 $148,170.00 $148,170.00 2026-04-01
22558 HCPCS Lumbar Spine Fusion 17 4 — — $16,745.00 $82,101.21 $26,592.35 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 9 2 — — $10,867.26 $146,575.00 $146,575.00 2026-04-01
22630 HCPCS Lumbar Spine Fusion 17 4 — — $16,745.00 $82,101.21 $26,592.35 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 17 4 — — $16,056.00 $82,101.21 $26,592.35 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 9 2 — — $5,920.69 $146,575.00 $146,575.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 32 4 — — $8,270.79 $132,294.00 $36,736.56 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 39 5 — — $5,220.63 $132,294.00 $24,272.81 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 39 5 — — $5,939.15 $179,156.10 $43,714.92 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 9 2 — — $9,552.34 $169,334.00 $169,334.00 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 31 4 — — $61,001.91 $157,429.00 $62,221.95 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 39 5 — — $7,074.44 $191,831.16 $46,218.26 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 39 5 — — $13,874.82 $245,455.20 $58,140.57 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 39 5 — — $8,266.53 $167,071.46 $41,699.00 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 39 5 — — $5,333.52 $184,780.74 $44,756.79 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 39 5 — — $5,356.24 $129,131.08 $32,102.24 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 40 5 — — $7,675.81 $158,171.28 $37,623.44 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 39 5 — — $7,192.30 $119,382.97 $30,016.25 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 40 5 — — $9,585.00 $91,451.36 $21,810.61 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 32 4 — — $8,248.78 $68,794.00 $23,896.17 2026-04-01
245 MS_DRG Aicd Generator Procedures 32 4 — — $3,366.11 $65,448.91 $33,283.62 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 9 2 — — $4,243.67 $75,814.00 $75,814.00 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 9 2 — — $4,135.75 $60,652.00 $60,652.00 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 9 2 — — $5,976.07 $65,707.00 $65,707.00 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 9 2 — — $4,974.26 $49,280.00 $49,280.00 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 39 5 — — $4,361.53 $140,443.16 $34,798.43 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 39 5 — — $1,814.05 $107,725.43 $26,825.12 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 39 5 — — $5,080.05 $88,103.59 $24,217.06 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 39 5 — — $4,032.80 $96,049.05 $23,969.21 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 32 4 — — $4,957.22 $45,619.24 $24,335.26 2026-04-01
263 MS_DRG Vein Ligation And Stripping 39 5 — — $14,493.23 $84,225.07 $23,578.98 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 42 5 — — $4,580.63 $109,757.33 $25,100.23 2026-04-01
265 MS_DRG Aicd Lead Procedures 39 5 — — $11,345.80 $112,018.49 $27,803.70 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 39 5 — — $6,117.36 $210,612.00 $46,713.95 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 39 5 — — $6,415.56 $158,143.00 $36,411.32 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 38 5 — — $49,866.87 $209,383.42 $52,360.21 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 31 4 — — $30,820.37 $104,849.00 $31,436.78 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 31 4 — — $38,375.98 $127,161.00 $39,143.50 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 32 4 — — $13,952.21 $84,396.00 $26,556.31 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 38 5 — — $30,119.40 $122,793.55 $31,625.37 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 38 5 — — $24,137.19 $98,008.72 $25,344.05 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 39 5 — — $4,071.85 $221,923.43 $54,262.39 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 39 5 — — $5,135.43 $194,522.57 $45,796.39 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 39 5 — — $6,302.67 $153,460.00 $35,339.33 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 17 4 — — $13,382.00 $82,101.21 $26,592.35 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 39 5 — — $3,927.01 $157,116.07 $42,478.70 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 39 5 — — $5,527.35 $100,627.90 $27,714.80 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 39 5 — — $9,410.34 $190,914.14 $45,809.20 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 39 5 — — $5,013.31 $105,410.88 $26,247.30 2026-04-01
294 MS_DRG Deep Vein Thrombophlebitis With Cc/Mcc 17 4 — — $5,544.39 $38,562.20 $27,443.56 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 39 5 — — $14,034.57 $673,015.43 $160,443.72 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 39 5 — — $6,663.35 $131,596.37 $34,299.72 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 39 5 — — $5,746.03 $194,271.33 $50,918.33 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 39 5 — — $4,374.31 $137,946.46 $34,167.14 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 42 6 — — $5,915.01 $133,760.18 $32,357.16 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 39 5 — — $3,496.04 $100,338.98 $24,284.11 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 39 5 — — $4,707.30 $89,881.11 $24,731.58 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 40 5 — — $3,105.54 $159,496.57 $37,755.35 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 46 7 — — $3,231.21 $180,040.88 $34,838.60 2026-04-01
332 MS_DRG Rectal Resection With Mcc 39 5 — — $4,282.72 $108,928.24 $27,822.53 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 17 4 — — $21,799.53 $67,303.87 $37,596.00 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 17 4 — — $30,762.25 $94,975.37 $37,596.00 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 17 4 — — $37,596.00 $133,274.35 $43,167.18 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 17 4 — — $21,392.00 $93,368.19 $30,241.69 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 17 4 — — $28,110.75 $86,789.13 $37,596.00 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 42 6 — — $7,718.41 $113,808.58 $26,793.86 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 39 5 — — $6,977.17 $122,118.34 $29,705.88 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 39 5 — — $13,444.56 $92,104.58 $22,408.30 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 41 6 — — $5,261.81 $133,954.89 $33,639.04 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 23 2 — — $5,700.59 $37,786.73 $25,191.15 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 39 5 — — $8,194.82 $104,286.58 $25,347.06 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 17 4 — — $10,075.00 $190,324.08 $61,645.42 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 39 5 — — $24,738.61 $443,724.39 $104,894.16 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 40 5 — — $6,830.91 $118,453.38 $29,352.08 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 24 3 — — $8,188.43 $52,396.09 $29,366.07 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 39 5 — — $13,671.05 $170,478.90 $41,757.75 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 39 5 — — $19,627.24 $88,191.52 $22,394.74 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 39 5 — — $15,605.80 $109,952.05 $27,407.44 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 40 5 — — $2,805.21 $85,936.64 $25,189.24 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 39 5 — — $4,610.74 $110,030.56 $27,384.84 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 39 5 — — $4,274.91 $110,834.53 $26,213.40 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 40 6 — — $12,662.14 $127,727.28 $31,832.55 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 5 — — $79,593.55 $329,174.65 $83,573.23 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 5 — — $52,311.27 $222,934.67 $54,926.83 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 38 5 — — $40,856.25 $172,890.81 $42,899.06 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 38 5 — — $65,161.05 $261,917.70 $68,419.10 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 38 5 — — $41,897.29 $171,788.49 $43,992.15 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 39 5 — — $3,856.01 $210,545.40 $50,881.41 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 39 5 — — $697.22 $128,232.90 $32,493.97 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 39 5 — — $3,062.94 $161,726.33 $40,696.30 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 39 5 — — $1,881.50 $96,909.55 $24,882.26 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 37 4 — — $60,811.78 $189,273.21 $63,852.37 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 38 5 — — $43,303.52 $265,956.38 $45,468.70 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 38 5 — — $30,457.33 $135,597.37 $31,980.20 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 39 5 — — $8,600.94 $192,723.06 $42,153.26 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 39 5 — — $5,021.83 $169,608.98 $43,482.89 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 42 6 — — $3,637.33 $92,600.78 $23,438.97 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 40 6 — — $4,555.36 $159,986.49 $39,381.98 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 45 6 — — $3,978.84 $107,558.98 $26,338.96 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 38 5 — — $22,282.55 $102,647.24 $23,396.68 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 39 5 — — $21,671.33 $152,534.08 $36,922.84 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 38 5 — — $21,657.64 $90,980.28 $22,740.52 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 38 5 — — $31,320.44 $140,832.58 $32,886.46 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 39 5 — — $14,328.51 $107,995.51 $26,571.24 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 41 6 — — $18,013.67 $92,362.10 $22,485.89 2026-04-01
484 MS_DRG Major Joint & Limb Reattachment Proc Of Upper Extremity Without Cc/mcc 1 1 — — $36,116.99 $36,116.99 $36,116.99 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 39 5 — — $22,583.68 $101,237.16 $24,857.40 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 39 5 — — $26,862.84 $111,519.16 $28,205.98 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 24 3 — — $26,533.52 $62,792.40 $26,533.52 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 39 5 — — $18,834.17 $79,288.20 $23,273.12 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 30 4 — — $74,494.53 $334,419.28 $75,984.42 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 24 3 — — $6,699.56 $42,438.40 $23,226.73 2026-04-01
503 MS_DRG Foot Procedures With Mcc 39 5 — — $8,638.57 $83,113.33 $21,572.85 2026-04-01
509 MS_DRG Arthroscopy 17 4 — — $4,869.89 $55,162.88 $39,257.78 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 39 5 — — $9,044.69 $89,755.49 $23,301.00 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 39 5 — — $23,385.29 $97,110.54 $24,554.55 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 39 5 — — $12,431.39 $112,549.24 $28,700.92 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 42 5 — — $4,961.48 $91,533.01 $21,640.90 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 2 2 — — $20,232.26 $28,494.28 $24,363.27 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 2 2 — — $25,685.85 $29,458.38 $27,572.11 2026-04-01
525 MS_DRG Other Heart Assist System Implant 1 1 — — $80,761.79 $80,761.79 $80,761.79 2026-04-01
528 MS_DRG Intracranial Vascular Proc W Pdx Hemorrhage 1 1 — — $48,621.51 $48,621.51 $48,621.51 2026-04-01
531 MS_DRG Spinal Procedures W Cc 1 1 — — $21,995.80 $21,995.80 $21,995.80 2026-04-01
570 MS_DRG Skin Debridement With Mcc 38 5 — — $21,621.76 $94,541.61 $22,702.85 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 38 5 — — $47,524.35 $193,385.71 $49,900.57 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 38 5 — — $25,426.47 $108,808.90 $26,697.79 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 38 5 — — $35,684.77 $169,426.83 $37,469.01 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 39 5 — — $20,803.14 $102,352.04 $24,943.28 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 31 4 — — $5,573.50 $152,279.70 $34,465.01 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 41 6 — — $11,440.63 $121,377.18 $26,818.33 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 17 4 — — $21,392.00 $93,368.19 $30,241.69 2026-04-01
61886 HCPCS Implant Neurostim Arrays 17 4 — — $30,241.69 $93,368.19 $37,596.00 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 17 4 — — $16,745.00 $93,368.19 $30,241.69 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 38 5 — — $21,236.49 $85,622.59 $22,298.31 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 38 5 — — $26,056.41 $117,580.32 $27,359.23 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 38 5 — — $22,188.56 $90,034.99 $23,297.99 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 39 5 — — $25,062.04 $123,933.55 $28,621.82 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 17 4 — — $21,392.00 $93,368.19 $30,241.69 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 17 4 — — $37,596.00 $133,274.35 $43,167.18 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 17 4 — — $21,392.00 $93,368.19 $30,241.69 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 17 4 — — $19,012.83 $58,700.21 $21,392.00 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 38 5 — — $34,251.28 $144,682.84 $35,963.84 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 38 5 — — $27,108.21 $109,044.44 $28,463.62 2026-04-01
652 MS_DRG Kidney Transplant 30 4 — — $23,690.93 $96,451.04 $24,164.75 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 39 5 — — $37,802.72 $175,057.75 $39,692.86 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 38 5 — — $20,604.40 $88,621.77 $21,634.62 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 38 5 — — $23,363.05 $102,308.07 $24,531.20 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 38 5 — — $22,485.59 $97,964.76 $23,609.87 2026-04-01
665 MS_DRG Prostatectomy With Mcc 38 5 — — $22,913.92 $107,825.93 $24,059.62 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 38 5 — — $21,470.38 $91,580.12 $22,543.90 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 41 6 — — $7,999.81 $131,586.95 $31,585.35 2026-04-01
69930 HCPCS Implant Cochlear Device 17 4 — — $32,313.90 $99,765.94 $37,596.00 2026-04-01
7 MS_DRG Lung Transplant 31 4 — — $18,864.70 $410,397.40 $95,302.09 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 38 5 — — $26,166.18 $123,650.91 $27,474.49 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 38 5 — — $26,225.73 $125,013.88 $27,537.02 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 17 4 — — $8,684.01 $48,558.41 $34,557.57 2026-04-01
78 MS_DRG Hypertensive Encephalopathy With Cc 17 4 — — $8,859.38 $31,335.91 $22,300.83 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 38 5 — — $43,162.89 $164,296.02 $45,321.03 2026-04-01
791 MS_DRG Prematurity With Major Problems 38 5 — — $26,457.00 $112,204.92 $29,642.29 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 38 5 — — $26,457.00 $115,258.70 $30,435.81 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 38 5 — — $33,013.65 $149,315.07 $34,664.33 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 31 4 — — $11,067.48 $170,868.32 $41,546.04 2026-04-01
800 MS_DRG Splenic Procedures With Cc 38 5 — — $20,676.86 $91,501.61 $21,710.70 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 39 5 — — $24,479.31 $112,574.36 $30,560.16 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 38 5 — — $42,598.25 $182,836.77 $44,728.16 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 3 — — $31,756.43 $62,672.54 $33,414.71 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 38 5 — — $34,081.96 $149,965.16 $35,786.06 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 38 5 — — $23,192.29 $96,840.46 $24,351.90 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 24 3 — — $38,369.34 $74,027.13 $39,908.48 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 38 5 — — $34,989.55 $157,238.55 $36,739.03 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 40 5 — — $131.86 $100,163.11 $24,678.86 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 38 5 — — $62,649.21 $289,280.88 $65,781.67 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 49 7 — — $3,665.27 $164,683.48 $37,031.69 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 38 5 — — $33,155.71 $141,677.38 $34,813.50 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 43 6 — — $16,247.13 $218,468.88 $51,112.29 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 38 5 — — $28,249.69 $125,870.47 $29,662.17 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 38 5 — — $30,629.52 $139,130.43 $32,161.00 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 38 5 — — $26,873.60 $121,251.56 $28,217.28 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 40 5 — — $28,066.02 $125,101.82 $29,609.65 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 38 5 — — $153,702.52 $745,014.53 $161,387.65 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 38 5 — — $51,981.96 $209,738.29 $54,581.06 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 38 5 — — $23,628.51 $99,874.18 $24,809.94 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 38 5 — — $28,459.91 $135,880.01 $29,882.91 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 17 4 — — $17,965.68 $55,467.25 $21,392.00 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 17 4 — — $17,965.68 $55,467.25 $21,392.00 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 17 4 — — $16,056.00 $79,087.05 $25,616.07 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 17 4 — — $16,056.00 $79,087.05 $25,616.07 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 17 4 — — $16,056.00 $79,087.05 $25,616.07 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 38 5 — — $26,553.61 $99,673.19 $27,881.29 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 43 6 — — $8,147.96 $114,578.00 $26,543.99 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 38 5 — — $48,813.64 $214,430.20 $51,254.32 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 41 6 — — $13,205.10 $120,036.19 $28,344.16 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 38 5 — — $55,190.45 $234,397.50 $57,949.97 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 38 5 — — $30,753.64 $129,058.85 $32,291.32 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 38 5 — — $21,643.29 $83,025.40 $22,725.45 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 39 6 — — $36,176.28 $198,602.08 $46,660.47 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 40 6 — — $3,853.88 $112,580.64 $27,491.14 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 39 5 — — $18,884.84 $93,775.33 $22,287.76 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 43 6 — — $7,187.32 $149,308.79 $34,866.05 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 40 5 — — $10,168.77 $110,011.72 $26,122.68 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 24 4 — — $56,824.55 $175,440.11 $83,563.34 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 8 1 — — $74,614.73 $74,614.73 $74,614.73 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 17 4 — — $16,787.53 $51,829.82 $21,392.00 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 17 4 — — $26,380.13 $81,446.01 $37,596.00 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 17 4 — — $16,787.53 $51,829.82 $21,392.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 1 — — $3,685,266.67 $3,906,382.67 $3,795,824.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 3 — — $3,316,462.59 $4,974,693.88 $3,482,285.72 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 15 4 — — $2,332,000.00 $3,847,800.00 $3,847,800.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 15 4 — — $2,945,740.00 $4,868,633.01 $4,868,633.01 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 3 — — $3,248,445.72 $4,872,668.57 $3,410,868.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 15 4 — — $2,455,110.60 $4,045,990.74 $4,045,990.74 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 10 2 — — $78,986.40 $130,327.56 $130,327.56 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 26 5 — — $63,342.28 $195,562.96 $79,212.69 2026-04-01
J9226 HCPCS Supprelin La Implant 26 5 — — $45,020.65 $138,996.75 $56,300.57 2026-04-01
J9266 HCPCS Pegaspargase Injection 26 5 — — $28,424.06 $87,756.44 $35,545.71 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 26 5 — — $24,228.42 $74,802.82 $31,451.59 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 9 3 — — $29,559.78 $91,262.86 $31,333.37 2026-04-01
L5858 HCPCS Stance Phase Only 9 3 — — $22,885.05 $70,655.30 $24,258.15 2026-04-01
L5973 HCPCS Ank-foot Sys Dors-plant Flex 9 3 — — $21,739.52 $67,118.59 $23,043.89 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 9 3 — — $29,510.19 $91,109.76 $31,280.80 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 9 3 — — $29,420.21 $90,831.96 $31,185.42 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 9 3 — — $21,834.21 $67,410.94 $23,144.26 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 9 3 — — $47,919.99 $147,948.18 $50,795.19 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 9 3 — — $49,338.18 $152,326.70 $52,298.47 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 9 3 — — $34,970.13 $107,966.78 $37,068.34 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 9 3 — — $68,801.71 $212,418.40 $72,929.81 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 9 3 — — $110,901.76 $342,398.09 $117,555.87 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 9 3 — — $23,087.32 $71,279.79 $24,472.56 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 17 4 — — $533,230.17 $1,646,294.83 $879,576.19 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 17 4 — — $591,726.20 $1,826,895.47 $954,235.56 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 24 4 — — $55,272.32 $170,647.77 $81,280.72 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 17 4 — — $489,304.61 $1,510,679.05 $808,038.00 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 17 4 — — $562,538.19 $1,736,780.39 $893,698.84 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 17 4 — — $557,317.93 $1,720,663.39 $893,079.74 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 17 4 — — $565,868.94 $1,747,063.78 $913,075.07 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 9 3 — — $770,620.00 $2,379,212.19 $816,857.20 2026-04-01
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