Price Transparency Hospital negotiated rates

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

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Hospital

AULTMAN ORRVILLE HOSPITAL

Orrville, OH · CCN 361323 · Rates published

8,731 distinct procedures filed
25 distinct payers
142,738 rate rows
2026-04-01 last MRF observed
Data quality

68,938 of 142,738 rate rows are consumer-grade (48.3%)

73,800 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 73,598
placeholder amount (≤ $0.02) — excluded from medians 202
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://aultman.org/pricing-transparency/2026/1891718375_aultman-orrville-hospital_standardcharges.json
Found on page https://aultman.org/home/patients-and-visitors/insurance-and-billing/pricing#/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint aaefac624b1e3ead… · 23,005,720 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
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $4,910,199.00 $4,910,199.00 $4,910,199.00 nat. median
$2,469,189
2.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $4,663,978.91 $4,663,978.91 $4,663,978.91 nat. median
$2,448,600
1.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $2,311,860.00 $2,311,860.00 $2,311,860.00 nat. median
$824,563
outlier · 2.8×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $1,736,313.36 $1,736,313.36 $1,736,313.36 nat. median
$754,974
outlier · 2.3×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $1,659,507.90 $1,659,507.90 $1,659,507.90 nat. median
$675,122
outlier · 2.5×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $1,582,867.38 $1,582,867.38 $1,582,867.38 nat. median
$625,184
outlier · 2.5×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $1,549,326.87 $1,549,326.87 $1,549,326.87 nat. median
$674,188
outlier · 2.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $1,508,522.19 $1,508,522.19 $1,508,522.19 nat. median
$634,511
outlier · 2.4×
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $1,468,197.48 $1,468,197.48 $1,468,197.48 nat. median
$620,080
outlier · 2.4×
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $1,113,000.00 $1,113,000.00 $1,113,000.00 nat. median
$3,710,000
outlier · 0.3×
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $1,105,580.01 $1,105,580.01 $1,105,580.01 nat. median
$3,710,000
outlier · 0.3×
C9301
HCPCS 		Obecabtagene Car Pos T 1 $834,750.00 $834,750.00 $834,750.00 nat. median
$459,112
1.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $556,497.48 $1,004,518.82 $780,508.15 nat. median
$324,450
outlier · 2.4×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 $396,849.93 $725,600.59 $561,225.26 nat. median
$370,174
1.5× median
J3403
HCPCS 		Revakinagene, Per Implant 1 $386,250.00 $515,000.00 $450,625.00 nat. median
$265,000
1.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $257,539.64 $470,885.59 $364,212.61 nat. median
$265,286
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $196,211.10 $358,752.45 $277,481.78 nat. median
$206,368
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $195,059.59 $356,647.04 $275,853.32 nat. median
$202,986
1.4× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $127,294.37 $232,745.07 $180,019.72 nat. median
$133,176
1.4× median
7
MS_DRG 		Lung Transplant 1 $119,012.34 $217,602.21 $168,307.27 nat. median
$122,708
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $110,444.50 $201,936.77 $156,190.64 nat. median
$117,303
1.3× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $104,139.24 $190,408.24 $147,273.74 nat. median
$108,660
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 1 $104,019.77 $190,189.80 $147,104.79 nat. median
$98,017
1.5× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $101,284.83 $185,189.22 $143,237.02 nat. median
$98,905
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $99,932.98 $182,717.50 $141,325.24 nat. median
$102,358
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $94,753.50 $173,247.33 $134,000.41 nat. median
$100,136
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 1 $91,504.83 $167,307.47 $129,406.15 nat. median
$99,019
1.3× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $89,903.93 $164,380.39 $127,142.16 nat. median
$93,672
1.4× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 2 $95,013.42 $189,706.83 $126,684.56 nat. median
$69,774
1.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 $82,798.22 $151,388.31 $117,093.26 nat. median
$82,712
1.4× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $81,436.27 $148,898.10 $115,167.18 nat. median
$87,411
1.3× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $85,236.83 $205,144.04 $113,649.10 nat. median
$62,507
1.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 1 $79,580.81 $145,505.58 $112,543.19 nat. median
$83,442
1.3× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $82,908.48 $171,051.30 $110,544.64 nat. median
$66,682
1.7× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $77,470.78 $141,647.61 $109,559.19 nat. median
$79,312
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $77,227.25 $141,202.33 $109,214.79 nat. median
$81,118
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $72,314.27 $132,219.45 $102,266.86 nat. median
$77,576
1.3× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $70,563.58 $129,018.47 $99,791.02 nat. median
$74,915
1.3× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $70,259.39 $128,462.30 $99,360.85 nat. median
$73,807
1.3× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $70,026.88 $128,037.18 $99,032.03 nat. median
$72,138
1.4× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $66,338.93 $121,294.14 $93,816.54 nat. median
$68,090
1.4× median
10
MS_DRG 		Pancreas Transplant 1 $65,944.68 $120,573.29 $93,258.98 nat. median
$68,882
1.4× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 1 $65,917.11 $120,522.88 $93,219.99 nat. median
$64,027
1.5× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 $65,566.97 $119,882.68 $92,724.82 nat. median
$71,240
1.3× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 $65,528.38 $119,812.11 $92,670.24 nat. median
$68,887
1.3× median
J9226
HCPCS 		Supprelin La Implant 2 $67,530.98 $135,636.12 $90,041.30 nat. median
$60,368
1.5× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $63,519.44 $116,138.98 $89,829.21 nat. median
$66,526
1.4× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 $63,207.90 $115,569.35 $89,388.62 nat. median
$65,950
1.4× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $61,858.81 $113,102.67 $87,480.74 nat. median
$64,732
1.4× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 $61,448.94 $112,353.26 $86,901.10 nat. median
$60,691
1.4× median

Other procedures at this hospital

Browse this hospital's 8,731 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
             
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 1 — — $4,910,199.00 $4,910,199.00 $4,910,199.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 2 1 — — $4,663,978.91 $4,663,978.91 $4,663,978.91 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 2 1 — — $2,311,860.00 $2,311,860.00 $2,311,860.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 1 — — $1,736,313.36 $1,736,313.36 $1,736,313.36 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 2 1 — — $1,659,507.90 $1,659,507.90 $1,659,507.90 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 2 1 — — $1,582,867.38 $1,582,867.38 $1,582,867.38 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 1 — — $1,549,326.87 $1,549,326.87 $1,549,326.87 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 1 — — $1,508,522.19 $1,508,522.19 $1,508,522.19 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 2 1 — — $1,468,197.48 $1,468,197.48 $1,468,197.48 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 2 1 — — $1,113,000.00 $1,113,000.00 $1,113,000.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 1 — — $1,105,580.01 $1,105,580.01 $1,105,580.01 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 2 1 — — $834,750.00 $834,750.00 $834,750.00 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 4 1 — — $556,497.48 $1,004,518.82 $780,508.15 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 1 — — $396,849.93 $725,600.59 $561,225.26 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 4 1 — — $386,250.00 $515,000.00 $450,625.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 1 — — $257,539.64 $470,885.59 $364,212.61 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 1 — — $196,211.10 $358,752.45 $277,481.78 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 1 — — $195,059.59 $356,647.04 $275,853.32 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 1 — — $127,294.37 $232,745.07 $180,019.72 2026-04-01
7 MS_DRG Lung Transplant 4 1 — — $119,012.34 $217,602.21 $168,307.27 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 4 1 — — $110,444.50 $201,936.77 $156,190.64 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 1 — — $104,139.24 $190,408.24 $147,273.74 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 4 1 — — $104,019.77 $190,189.80 $147,104.79 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 1 — — $101,284.83 $185,189.22 $143,237.02 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 4 1 — — $99,932.98 $182,717.50 $141,325.24 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 1 — — $94,753.50 $173,247.33 $134,000.41 2026-04-01
215 MS_DRG Other Heart Assist System Implant 4 1 — — $91,504.83 $167,307.47 $129,406.15 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 1 — — $89,903.93 $164,380.39 $127,142.16 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 2 — — $95,013.42 $189,706.83 $126,684.56 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 1 — — $82,798.22 $151,388.31 $117,093.26 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 4 1 — — $81,436.27 $148,898.10 $115,167.18 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 10 2 — — $85,236.83 $205,144.04 $113,649.10 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 4 1 — — $79,580.81 $145,505.58 $112,543.19 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 2 — — $82,908.48 $171,051.30 $110,544.64 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 4 1 — — $77,470.78 $141,647.61 $109,559.19 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 1 — — $77,227.25 $141,202.33 $109,214.79 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 1 — — $72,314.27 $132,219.45 $102,266.86 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 1 — — $70,563.58 $129,018.47 $99,791.02 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 1 — — $70,259.39 $128,462.30 $99,360.85 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 1 — — $70,026.88 $128,037.18 $99,032.03 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 1 — — $66,338.93 $121,294.14 $93,816.54 2026-04-01
10 MS_DRG Pancreas Transplant 4 1 — — $65,944.68 $120,573.29 $93,258.98 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 1 — — $65,917.11 $120,522.88 $93,219.99 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 1 — — $65,566.97 $119,882.68 $92,724.82 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 1 — — $65,528.38 $119,812.11 $92,670.24 2026-04-01
J9226 HCPCS Supprelin La Implant 6 2 — — $67,530.98 $135,636.12 $90,041.30 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 4 1 — — $63,519.44 $116,138.98 $89,829.21 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 1 — — $63,207.90 $115,569.35 $89,388.62 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 1 — — $61,858.81 $113,102.67 $87,480.74 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 4 1 — — $61,448.94 $112,353.26 $86,901.10 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 1 — — $61,403.90 $112,270.92 $86,837.41 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 1 — — $60,950.84 $111,442.54 $86,196.69 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 1 — — $60,427.01 $110,484.77 $85,455.89 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 1 — — $60,427.01 $110,484.77 $85,455.89 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 1 — — $60,207.37 $110,083.17 $85,145.27 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 4 1 — — $59,134.89 $108,122.26 $83,628.57 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
61886 HCPCS Implant Neurostim Arrays 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 4 1 — — $58,387.26 $105,393.29 $81,890.27 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 1 — — $56,320.00 $102,975.51 $79,647.76 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 4 1 — — $56,254.75 $102,856.20 $79,555.48 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 4 1 — — $56,208.80 $102,772.19 $79,490.49 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 1 — — $55,715.29 $101,869.87 $78,792.58 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 1 — — $55,200.65 $100,928.90 $78,064.77 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 1 — — $54,800.89 $100,197.97 $77,499.43 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 1 — — $54,620.77 $99,868.63 $77,244.70 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 4 1 — — $54,493.94 $99,636.75 $77,065.35 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 4 1 — — $53,932.43 $98,610.09 $76,271.26 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 1 — — $53,897.51 $98,546.23 $76,221.87 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 4 1 — — $52,999.65 $96,904.58 $74,952.12 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 1 — — $52,661.46 $96,286.23 $74,473.85 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 4 1 — — $52,446.41 $95,893.04 $74,169.73 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 1 — — $51,666.18 $94,466.47 $73,066.32 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 1 — — $51,506.27 $94,174.09 $72,840.18 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 1 — — $51,153.38 $93,528.86 $72,341.12 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 4 1 — — $50,756.37 $92,802.97 $71,779.67 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 4 1 — — $50,452.18 $92,246.79 $71,349.49 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 4 1 — — $50,273.90 $91,920.81 $71,097.35 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 4 1 — — $50,202.21 $91,789.75 $70,995.98 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 1 — — $50,123.18 $91,645.24 $70,884.21 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 4 1 — — $49,922.84 $91,278.94 $70,600.89 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 1 — — $49,008.43 $89,607.04 $69,307.74 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 4 1 — — $48,979.02 $89,553.27 $69,266.15 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 1 — — $48,650.02 $88,951.72 $68,800.87 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 4 1 — — $48,489.20 $88,657.67 $68,573.43 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 4 1 — — $47,754.92 $87,315.11 $67,535.01 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 1 — — $46,319.44 $84,690.48 $65,504.96 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 4 1 — — $45,834.21 $83,803.28 $64,818.74 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 4 1 — — $45,466.61 $83,131.16 $64,298.89 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 1 — — $45,385.73 $82,983.30 $64,184.51 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 4 1 — — $45,230.42 $82,699.33 $63,964.88 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 1 — — $45,042.03 $82,354.86 $63,698.44 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 4 1 — — $44,375.75 $81,136.65 $62,756.20 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 1 — — $44,151.52 $80,726.65 $62,439.08 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 4 1 — — $43,751.75 $79,995.72 $61,873.74 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 1 — — $43,205.87 $78,997.62 $61,101.74 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 1 — — $43,117.64 $78,836.32 $60,976.98 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 4 1 — — $42,988.98 $78,601.07 $60,795.03 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 4 1 — — $42,614.03 $77,915.51 $60,264.77 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 4 1 — — $42,444.02 $77,604.66 $60,024.34 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 4 1 — — $42,325.46 $77,387.90 $59,856.68 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 1 — — $42,241.84 $77,234.99 $59,738.42 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 1 — — $42,134.31 $77,038.39 $59,586.35 2026-04-01
245 MS_DRG Aicd Generator Procedures 4 1 — — $41,928.46 $76,662.01 $59,295.24 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 4 1 — — $41,802.55 $76,431.81 $59,117.18 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 4 1 — — $41,784.17 $76,398.20 $59,091.18 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 4 1 — — $41,620.59 $76,099.11 $58,859.85 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 4 1 — — $41,187.74 $75,307.69 $58,247.71 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 4 1 — — $41,175.80 $75,285.84 $58,230.82 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 4 1 — — $41,014.05 $74,990.11 $58,002.08 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 1 — — $40,369.83 $73,812.22 $57,091.03 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 2 — — $42,636.09 $81,211.59 $56,848.12 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 4 1 — — $39,768.81 $72,713.30 $56,241.06 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 1 — — $39,451.75 $72,133.60 $55,792.68 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 4 1 — — $39,198.11 $71,669.84 $55,433.97 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 6 1 — — $8,330.17 $100,957.46 $55,216.28 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 4 1 — — $38,972.95 $71,258.16 $55,115.56 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 1 — — $38,811.21 $70,962.43 $54,886.82 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 1 — — $38,745.04 $70,841.45 $54,793.24 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 4 1 — — $38,725.74 $70,806.16 $54,765.95 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 4 1 — — $38,612.70 $70,599.48 $54,606.09 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 4 1 — — $38,566.75 $70,515.47 $54,541.11 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 4 1 — — $38,495.07 $70,384.41 $54,439.74 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 1 — — $38,346.19 $70,112.20 $54,229.19 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 1 — — $38,166.07 $69,782.86 $53,974.46 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 4 1 — — $37,913.35 $69,320.78 $53,617.07 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 2 — — $17,221.00 $95,768.70 $52,378.41 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 1 — — $36,948.40 $67,556.46 $52,252.43 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 4 1 — — $36,613.88 $66,944.83 $51,779.35 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
1013T HCPCS Lap Srg Imp/rpl Eso Nea&pg/r 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
64580 HCPCS Implant Neuroelectrodes 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
63655 HCPCS Implant Neuroelectrodes 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
0680T HCPCS Insj/rplcmt Pg Only Isdss 4 1 — — $36,707.84 $66,260.35 $51,484.10 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 1 — — $35,950.36 $65,731.66 $50,841.01 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 4 1 — — $35,787.70 $65,434.24 $50,610.97 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 4 1 — — $35,571.73 $65,039.37 $50,305.55 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 4 1 — — $35,518.43 $64,941.91 $50,230.17 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 4 1 — — $35,484.43 $64,879.74 $50,182.08 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 4 1 — — $35,283.17 $64,511.76 $49,897.46 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 4 1 — — $34,581.97 $63,229.69 $48,905.83 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 4 1 — — $34,431.25 $62,954.12 $48,692.68 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 1 — — $34,349.46 $62,804.57 $48,577.01 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 4 1 — — $34,345.79 $62,797.85 $48,571.82 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 10 2 — — $36,342.63 $87,467.76 $48,456.84 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 4 1 — — $34,249.29 $62,621.42 $48,435.35 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 4 1 — — $34,056.30 $62,268.56 $48,162.43 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 6 2 — — $6,728.08 $87,466.34 $47,837.63 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 4 1 — — $34,103.75 $61,559.78 $47,831.76 2026-04-01
62360 HCPCS Insert Spine Infusion Device 4 1 — — $34,103.75 $61,559.78 $47,831.76 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 4 1 — — $34,103.75 $61,559.78 $47,831.76 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 4 1 — — $33,755.79 $61,719.10 $47,737.44 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 4 1 — — $33,742.00 $61,693.89 $47,717.94 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 4 1 — — $33,616.10 $61,463.69 $47,539.90 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 4 1 — — $33,345.92 $60,969.69 $47,157.81 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 1 — — $33,320.18 $60,922.64 $47,121.41 2026-04-01
332 MS_DRG Rectal Resection With Mcc 4 1 — — $33,274.23 $60,838.62 $47,056.43 2026-04-01
265 MS_DRG Aicd Lead Procedures 4 1 — — $33,251.26 $60,796.61 $47,023.93 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 4 1 — — $33,192.44 $60,689.08 $46,940.76 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 1 — — $33,142.82 $60,598.34 $46,870.58 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 4 1 — — $32,925.93 $60,201.79 $46,563.86 2026-04-01
22610 HCPCS Thorax Spine Fusion 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22612 HCPCS Lumbar Spine Fusion 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
24361 HCPCS Reconstruct Elbow Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22800 HCPCS Post Fusion <=6 Vert Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22802 HCPCS Post Fusion 7-12 Vert Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22600 HCPCS Neck Spine Fusion 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
23472 HCPCS Reconstruct Shoulder Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22533 HCPCS Lat Lumbar Spine Fusion 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22556 HCPCS Thorax Spine Fusion 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22804 HCPCS Post Fusion 13/> Vert Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
20982 HCPCS Ablate Bone Tumor(s) Perq 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
25446 HCPCS Wrist Replacement 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
0656T HCPCS Vrt Bdy Tethering Ant 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
C8003 HCPCS Imp Extar Knee Shck Absrb 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
25442 HCPCS Reconstruct Wrist Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22586 HCPCS Prescrl Fuse With Instr L5-s1 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22862 HCPCS Revise Lumbar Artif Disc 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
0657T HCPCS Vrt Bdy Tethering Ant 8+ Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22819 HCPCS Kyphectomy 3 Or More 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
20838 HCPCS Replantation Foot Complete 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22856 HCPCS Cerv Artific Diskectomy 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22810 HCPCS Ant Fusion 4-7 Vert Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22808 HCPCS Ant Fusion 2-3 Vert Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
28705 HCPCS Fusion Of Foot Bones 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
20808 HCPCS Replantation Hand Complete 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22812 HCPCS Ant Fusion 8/> Vert Seg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27703 HCPCS Reconstruction Ankle Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22818 HCPCS Kyphectomy 1-2 Segments 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22857 HCPCS Lumbar Artif Diskectomy 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
20805 HCPCS Replant Forearm Complete 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22837 HCPCS Ant Thrc Vrt Body Tethrg 8+ 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22838 HCPCS Rev Rplc/rmv Thrc Vrt Tethrg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
23616 HCPCS Treat Humerus Fracture 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
24371 HCPCS Revise Reconst Elbow Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
24363 HCPCS Replace Elbow Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
20802 HCPCS Replantation Arm Complete 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27487 HCPCS Revise/replace Knee Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
22861 HCPCS Revise Cerv Artific Disc 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27295 HCPCS Amputation Of Leg At Hip 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27290 HCPCS Amputation Of Leg At Hip 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27278 HCPCS Arthrd Si Jt Prq Wo Tfxj Dev 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27279 HCPCS Arthrodesis Sacroiliac Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
0790T HCPCS Revj Rplcmt/rmvl Vrt Tethrg 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
27280 HCPCS Fusion Of Sacroiliac Joint 4 1 — — $33,176.54 $59,886.08 $46,531.31 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 4 1 — — $32,849.66 $60,062.32 $46,455.99 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 4 1 — — $32,816.57 $60,001.83 $46,409.20 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 4 1 — — $32,767.86 $59,912.78 $46,340.32 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 4 1 — — $32,740.29 $59,862.37 $46,301.33 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 4 1 — — $32,709.05 $59,805.24 $46,257.14 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 4 1 — — $32,682.40 $59,756.51 $46,219.46 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 4 1 — — $32,343.29 $59,136.48 $45,739.89 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 4 1 — — $32,057.48 $58,613.90 $45,335.69 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 4 1 — — $31,902.17 $58,329.93 $45,116.05 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 4 1 — — $31,747.77 $58,047.64 $44,897.71 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 4 1 — — $31,600.73 $57,778.80 $44,689.76 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 1 — — $31,507.00 $57,607.41 $44,557.21 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 4 1 — — $31,352.60 $57,325.11 $44,338.85 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 4 1 — — $31,311.25 $57,249.50 $44,280.38 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 4 1 — — $30,700.11 $56,132.10 $43,416.10 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 4 1 — — $30,357.33 $55,505.35 $42,931.34 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 4 1 — — $30,254.40 $55,317.16 $42,785.78 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 4 1 — — $30,250.72 $55,310.44 $42,780.58 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 4 1 — — $29,893.23 $54,656.80 $42,275.01 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 4 1 — — $29,761.82 $54,416.52 $42,089.17 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 4 1 — — $29,728.73 $54,356.02 $42,042.38 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 4 1 — — $29,687.38 $54,280.41 $41,983.90 2026-04-01
652 MS_DRG Kidney Transplant 4 1 — — $29,679.11 $54,265.29 $41,972.20 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 4 1 — — $29,657.05 $54,224.96 $41,941.00 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 4 1 — — $29,599.15 $54,119.10 $41,859.12 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 4 1 — — $29,503.58 $53,944.35 $41,723.96 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 4 1 — — $29,341.83 $53,648.62 $41,495.23 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 4 1 — — $29,287.61 $53,549.48 $41,418.54 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 4 1 — — $29,259.12 $53,497.39 $41,378.25 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 4 1 — — $29,200.31 $53,389.85 $41,295.08 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 4 1 — — $29,084.51 $53,178.13 $41,131.32 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 4 1 — — $29,040.40 $53,097.48 $41,068.94 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 4 1 — — $28,957.69 $52,946.25 $40,951.97 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 4 1 — — $28,943.91 $52,921.05 $40,932.48 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 4 1 — — $28,875.90 $52,796.71 $40,836.31 2026-04-01
665 MS_DRG Prostatectomy With Mcc 4 1 — — $28,683.83 $52,445.52 $40,564.68 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 4 1 — — $28,573.55 $52,243.89 $40,408.72 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 4 1 — — $28,135.19 $51,442.38 $39,788.78 2026-04-01
263 MS_DRG Vein Ligation And Stripping 4 1 — — $28,097.51 $51,373.49 $39,735.50 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 4 1 — — $27,875.11 $50,966.86 $39,420.99 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 4 1 — — $27,758.40 $50,753.46 $39,255.93 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 4 1 — — $27,754.72 $50,746.74 $39,250.73 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 4 1 — — $27,353.12 $50,012.45 $38,682.78 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 4 1 — — $27,074.66 $49,503.32 $38,288.99 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 4 1 — — $27,056.28 $49,469.71 $38,262.99 2026-04-01
570 MS_DRG Skin Debridement With Mcc 4 1 — — $27,028.71 $49,419.30 $38,224.01 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 4 1 — — $26,669.38 $48,762.31 $37,715.85 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 4 1 — — $26,652.84 $48,732.06 $37,692.45 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 4 1 — — $26,535.21 $48,516.98 $37,526.10 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 4 1 — — $26,522.34 $48,493.46 $37,507.90 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 4 1 — — $26,483.74 $48,422.89 $37,453.32 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 4 1 — — $26,196.10 $47,896.95 $37,046.52 2026-04-01
800 MS_DRG Splenic Procedures With Cc 4 1 — — $25,818.39 $47,206.35 $36,512.37 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 4 1 — — $25,725.57 $47,036.64 $36,381.10 2026-04-01
503 MS_DRG Foot Procedures With Mcc 4 1 — — $25,650.21 $46,898.85 $36,274.53 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 6 2 — — $25,107.31 $45,320.54 $36,023.43 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 1 — — $25,337.75 $46,327.55 $35,832.65 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 4 1 — — $25,260.55 $46,186.41 $35,723.48 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 4 1 — — $25,123.62 $45,936.04 $35,529.83 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 4 1 — — $25,004.15 $45,717.60 $35,360.88 2026-04-01
849 MS_DRG Radiotherapy 4 1 — — $24,900.31 $45,527.73 $35,214.02 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 4 1 — — $24,869.98 $45,472.28 $35,171.13 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 4 1 — — $24,789.11 $45,324.41 $35,056.76 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 4 1 — — $24,445.40 $44,695.98 $34,570.69 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 4 1 — — $24,359.93 $44,539.71 $34,449.82 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 4 1 — — $24,237.71 $44,316.23 $34,276.97 2026-04-01
0220T HCPCS Plmt Post Facet Implt Thor 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
0629T HCPCS Perq Njx Algc CT Lmbr 1st 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
0219T HCPCS Plmt Post Facet Implt Cerv 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
23473 HCPCS Revis Reconst Shoulder Joint 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22590 HCPCS Spine & Skull Spinal Fusion 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
25810 HCPCS Fusion/graft Of Wrist Joint 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
23470 HCPCS Reconstruct Shoulder Joint 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22595 HCPCS Neck Spinal Fusion 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
23474 HCPCS Revis Reconst Shoulder Joint 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22548 HCPCS Neck Spine Fusion 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22551 HCPCS Neck Spine Fuse&remov Bel C2 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22554 HCPCS Neck Spine Fusion 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
0202T HCPCS Post Vert Arthrplst 1 Lumbar 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22532 HCPCS Lat Thorax Spine Fusion 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
22869 HCPCS Insj Stablj Dev Without Dcmprn 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
25444 HCPCS Reconstruct Wrist Joint 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
25491 HCPCS Reinforce Ulna 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
C9734 HCPCS U/s Trtmt, Not Leiomyomata 4 1 — — $24,292.65 $43,850.02 $34,071.33 2026-04-01
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