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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

SEQUOYAH COUNTY-CITY OF SALLISAW HOSPITAL AUTHORIT

Sallisaw, OK · CCN 370112 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $5,345 across 6 payers · range $1,811-$5,398

Source: https://nhssequoyah.com/wp-content/uploads/2026/03/731066229_northeastern-health-system-sequoyah_standardcharges.csv · observed 2026-02-10

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

5,204 distinct procedures filed
8 distinct payers
67,655 rate rows
2026-02-10 last MRF observed
Data quality

19,430 of 67,655 rate rows are consumer-grade (28.7%)

48,225 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 34,734
placeholder amount (≤ $0.02) — excluded from medians 13,467
per-diem day rate — not a per-procedure price 22
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://nhssequoyah.com/wp-content/uploads/2026/03/731066229_northeastern-health-system-sequoyah_standardcharges.csv
Found on page https://nhssequoyah.com/cms-hpt.txt
Discovered viaCMS hospital list
Last fetch success · 2026-08-01
Content fingerprint f80395d5a5725c25… · 79,485,028 bytes · first seen 2026-06-08

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 $220,099.44 $345,729.34 $342,339.84 nat. median
$370,165
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 6 $219,965.13 $236,775.38 $224,364.43 nat. median
$261,939
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 6 $74,937.30 $170,935.98 $169,260.14 nat. median
$205,166
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 6 $157,947.89 $169,932.81 $168,266.80 nat. median
$199,832
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 6 $104,510.45 $110,896.82 $109,809.60 nat. median
$132,706
0.8× median
0N24
OTHER 		Less Than 1000 Grams - Discharged Alive 1 $107,541.76 $107,541.76 $107,541.76 nat. median
$107,542
1.0× median
0N14
OTHER 		Less Than 750 Grams - Discharged Alive 1 $105,124.19 $105,124.19 $105,124.19 nat. median
$105,124
1.0× median
0N80
OTHER 		2500 And Greater Grams - O.r. Performed 1 $103,372.08 $103,372.08 $103,372.08 nat. median
$103,372
1.0× median
7
MS_DRG 		Lung Transplant 6 $76,272.13 $103,681.65 $102,665.16 nat. median
$122,690
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 6 $94,330.87 $103,970.84 $96,217.49 nat. median
$114,305
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 5 $88,843.50 $90,620.37 $90,620.37 nat. median
$96,134
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 $54,886.23 $90,724.45 $89,834.99 nat. median
$108,240
0.8× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $32,526.28 $88,237.73 $87,372.65 nat. median
$96,835
0.9× median
0N48
OTHER 		Less Than 2000 Grams - O.r. Excl Circumc 1 $87,287.41 $87,287.41 $87,287.41 nat. median
$87,287
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 6 $63,578.66 $87,060.02 $86,206.49 nat. median
$100,978
0.9× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 6 $80,929.15 $155,716.19 $82,547.73 nat. median
$99,646
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 6 $54,649.60 $79,717.55 $78,936.01 nat. median
$98,002
0.8× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $62,891.40 $78,322.87 $77,555.00 nat. median
$92,900
0.8× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 $41,070.39 $72,132.49 $71,425.31 nat. median
$81,124
0.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 6 $52,970.81 $69,329.53 $68,649.83 nat. median
$81,364
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 6 $49,455.85 $67,491.31 $66,829.63 nat. median
$79,040
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $54,831.41 $67,279.15 $66,619.55 nat. median
$80,459
0.8× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 $61,763.77 $67,849.53 $62,999.05 nat. median
$77,385
0.8× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 $60,268.49 $61,473.86 $61,077.71 nat. median
$74,472
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 $38,448.34 $61,208.86 $60,608.78 nat. median
$73,475
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 6 $46,687.50 $61,006.30 $60,408.20 nat. median
$71,485
0.8× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 $41,432.25 $57,793.42 $57,226.82 nat. median
$66,640
0.9× median
10
MS_DRG 		Pancreas Transplant 6 $46,532.90 $57,449.96 $56,886.72 nat. median
$67,750
0.8× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 6 $28,391.24 $57,425.94 $56,862.94 nat. median
$62,911
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 6 $46,264.95 $57,120.90 $56,560.89 nat. median
$69,153
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 6 $34,474.17 $57,087.28 $56,527.60 nat. median
$68,581
0.8× median
0N50
OTHER 		Less Than 2500 Grams - O.r. Performed 1 $56,460.31 $56,460.31 $56,460.31 nat. median
$56,460
1.0× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 6 $38,751.19 $55,337.12 $54,794.60 nat. median
$65,958
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 $49,695.72 $55,065.72 $54,525.86 nat. median
$65,792
0.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 6 $52,833.73 $56,571.70 $53,890.40 nat. median
$64,357
0.8× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 $36,105.17 $53,533.33 $53,008.50 nat. median
$59,832
0.9× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 $35,612.47 $53,494.10 $52,969.65 nat. median
$62,262
0.9× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $37,689.24 $52,643.05 $52,126.94 nat. median
$63,840
0.8× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $34,722.48 $52,643.05 $52,126.94 nat. median
$60,895
0.9× median
0N39
OTHER 		Less Than 1500 Grams - No O.r. Performed 1 $51,996.69 $51,996.69 $51,996.69 nat. median
$51,997
1.0× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 6 $39,578.54 $52,451.69 $51,937.46 nat. median
$59,159
0.9× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 6 $45,269.16 $51,517.37 $51,012.30 nat. median
$62,218
0.8× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 6 $40,288.48 $49,065.08 $48,584.05 nat. median
$60,162
0.8× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 6 $37,165.29 $49,008.24 $48,527.76 nat. median
$60,294
0.8× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 6 $35,651.70 $48,538.28 $48,062.42 nat. median
$59,257
0.8× median
28
MS_DRG 		Spinal Procedures With Mcc 6 $33,760.04 $48,103.54 $47,631.93 nat. median
$56,970
0.8× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 6 $24,909.70 $48,089.93 $47,618.46 nat. median
$58,419
0.8× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 6 $46,651.71 $77,700.32 $47,584.74 nat. median
$51,433
0.9× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 6 $46,543.39 $60,858.92 $47,474.26 nat. median
$55,867
0.8× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 $40,363.35 $47,741.66 $47,273.61 nat. median
$57,394
0.8× median

Other procedures at this hospital

Browse this hospital's 5,204 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $220,099.44 $345,729.34 $342,339.84 2026-02-10
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 6 6 — — $219,965.13 $236,775.38 $224,364.43 2026-02-10
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 6 6 — — $74,937.30 $170,935.98 $169,260.14 2026-02-10
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 6 6 — — $157,947.89 $169,932.81 $168,266.80 2026-02-10
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 6 6 — — $104,510.45 $110,896.82 $109,809.60 2026-02-10
0N24 OTHER Less Than 1000 Grams - Discharged Alive 1 1 — — $107,541.76 $107,541.76 $107,541.76 2026-02-10
0N14 OTHER Less Than 750 Grams - Discharged Alive 1 1 — — $105,124.19 $105,124.19 $105,124.19 2026-02-10
0N80 OTHER 2500 And Greater Grams - O.r. Performed 1 1 — — $103,372.08 $103,372.08 $103,372.08 2026-02-10
7 MS_DRG Lung Transplant 6 6 — — $76,272.13 $103,681.65 $102,665.16 2026-02-10
14 MS_DRG Allogeneic Bone Marrow Transplant 6 6 — — $94,330.87 $103,970.84 $96,217.49 2026-02-10
209 MS_DRG Complex Aortic Arch Procedures 5 5 — — $88,843.50 $90,620.37 $90,620.37 2026-02-10
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 6 — — $54,886.23 $90,724.45 $89,834.99 2026-02-10
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 6 — — $32,526.28 $88,237.73 $87,372.65 2026-02-10
0N48 OTHER Less Than 2000 Grams - O.r. Excl Circumc 1 1 — — $87,287.41 $87,287.41 $87,287.41 2026-02-10
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 6 6 — — $63,578.66 $87,060.02 $86,206.49 2026-02-10
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 6 6 — — $80,929.15 $155,716.19 $82,547.73 2026-02-10
215 MS_DRG Other Heart Assist System Implant 6 6 — — $54,649.60 $79,717.55 $78,936.01 2026-02-10
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 6 — — $62,891.40 $78,322.87 $77,555.00 2026-02-10
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 6 — — $41,070.39 $72,132.49 $71,425.31 2026-02-10
850 MS_DRG Acute Leukemia With Other Procedures 6 6 — — $52,970.81 $69,329.53 $68,649.83 2026-02-10
231 MS_DRG Coronary Bypass With Ptca With Mcc 6 6 — — $49,455.85 $67,491.31 $66,829.63 2026-02-10
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 6 — — $54,831.41 $67,279.15 $66,619.55 2026-02-10
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 6 — — $61,763.77 $67,849.53 $62,999.05 2026-02-10
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 6 — — $60,268.49 $61,473.86 $61,077.71 2026-02-10
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 6 — — $38,448.34 $61,208.86 $60,608.78 2026-02-10
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 6 6 — — $46,687.50 $61,006.30 $60,408.20 2026-02-10
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 6 — — $41,432.25 $57,793.42 $57,226.82 2026-02-10
10 MS_DRG Pancreas Transplant 6 6 — — $46,532.90 $57,449.96 $56,886.72 2026-02-10
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 6 6 — — $28,391.24 $57,425.94 $56,862.94 2026-02-10
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 6 6 — — $46,264.95 $57,120.90 $56,560.89 2026-02-10
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 6 6 — — $34,474.17 $57,087.28 $56,527.60 2026-02-10
0N50 OTHER Less Than 2500 Grams - O.r. Performed 1 1 — — $56,460.31 $56,460.31 $56,460.31 2026-02-10
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 6 6 — — $38,751.19 $55,337.12 $54,794.60 2026-02-10
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 6 6 — — $49,695.72 $55,065.72 $54,525.86 2026-02-10
955 MS_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $52,833.73 $56,571.70 $53,890.40 2026-02-10
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 6 — — $36,105.17 $53,533.33 $53,008.50 2026-02-10
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 6 — — $35,612.47 $53,494.10 $52,969.65 2026-02-10
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 6 — — $34,722.48 $52,643.05 $52,126.94 2026-02-10
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 6 — — $37,689.24 $52,643.05 $52,126.94 2026-02-10
0N39 OTHER Less Than 1500 Grams - No O.r. Performed 1 1 — — $51,996.69 $51,996.69 $51,996.69 2026-02-10
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 6 6 — — $39,578.54 $52,451.69 $51,937.46 2026-02-10
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 6 6 — — $45,269.16 $51,517.37 $51,012.30 2026-02-10
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 6 6 — — $40,288.48 $49,065.08 $48,584.05 2026-02-10
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 6 6 — — $37,165.29 $49,008.24 $48,527.76 2026-02-10
232 MS_DRG Coronary Bypass With Ptca Without Mcc 6 6 — — $35,651.70 $48,538.28 $48,062.42 2026-02-10
28 MS_DRG Spinal Procedures With Mcc 6 6 — — $33,760.04 $48,103.54 $47,631.93 2026-02-10
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 6 6 — — $24,909.70 $48,089.93 $47,618.46 2026-02-10
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 6 6 — — $46,651.71 $77,700.32 $47,584.74 2026-02-10
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 6 6 — — $46,543.39 $60,858.92 $47,474.26 2026-02-10
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 6 — — $40,363.35 $47,741.66 $47,273.61 2026-02-10
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 6 6 — — $31,178.29 $46,985.08 $46,524.44 2026-02-10
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 6 6 — — $33,980.06 $46,954.65 $46,494.31 2026-02-10
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 6 — — $31,249.04 $46,172.45 $45,719.78 2026-02-10
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 5 5 — — $44,794.59 $45,690.48 $45,690.48 2026-02-10
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 6 — — $43,997.33 $45,877.83 $45,428.04 2026-02-10
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 6 — — $31,574.38 $45,631.23 $45,183.87 2026-02-10
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 6 — — $22,772.84 $45,010.75 $44,569.47 2026-02-10
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 6 6 — — $31,755.78 $44,871.44 $44,431.53 2026-02-10
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 6 6 — — $29,199.88 $44,564.00 $44,127.10 2026-02-10
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 6 6 — — $34,963.56 $44,218.14 $43,784.63 2026-02-10
834 MS_DRG Acute Leukemia With Mcc 6 6 — — $38,497.96 $43,953.14 $43,522.22 2026-02-10
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 6 6 — — $35,525.52 $43,797.82 $43,368.43 2026-02-10
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 6 6 — — $28,081.50 $43,735.37 $43,306.59 2026-02-10
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 6 6 — — $29,693.32 $43,666.52 $43,238.41 2026-02-10
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 6 6 — — $35,226.78 $43,491.98 $43,065.59 2026-02-10
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 6 — — $41,858.20 $43,700.75 $42,695.36 2026-02-10
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 6 6 — — $19,431.05 $42,669.74 $42,251.41 2026-02-10
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 6 6 — — $31,170.32 $42,383.12 $41,967.60 2026-02-10
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 6 6 — — $41,257.19 $42,243.01 $41,828.87 2026-02-10
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 6 6 — — $28,881.03 $41,675.37 $41,266.79 2026-02-10
653 MS_DRG Major Bladder Procedures With Mcc 6 6 — — $32,534.38 $41,603.32 $41,195.44 2026-02-10
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 6 — — $36,893.69 $40,352.76 $39,957.15 2026-02-10
228 MS_DRG Other Cardiothoracic Procedures With Mcc 6 6 — — $38,833.12 $83,231.69 $39,609.78 2026-02-10
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 6 6 — — $29,100.17 $39,930.03 $39,538.56 2026-02-10
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 6 6 — — $28,974.26 $39,539.33 $39,151.69 2026-02-10
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 6 6 — — $24,177.81 $39,404.03 $39,017.71 2026-02-10
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 6 6 — — $31,487.83 $39,239.90 $38,855.19 2026-02-10
471 MS_DRG Cervical Spinal Fusion With Mcc 6 6 — — $23,630.03 $38,659.45 $38,280.43 2026-02-10
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 6 6 — — $14,934.09 $38,464.10 $38,087.00 2026-02-10
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 6 6 — — $29,617.91 $38,115.83 $37,742.15 2026-02-10
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 6 6 — — $26,889.19 $37,640.26 $37,271.24 2026-02-10
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 6 — — $35,821.15 $37,563.41 $37,195.14 2026-02-10
6 MS_DRG Liver Transplant Without Mcc 6 6 — — $36,396.73 $72,811.18 $37,124.66 2026-02-10
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 6 6 — — $27,870.93 $37,451.32 $37,084.15 2026-02-10
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 6 6 — — $23,578.99 $36,976.55 $36,614.04 2026-02-10
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 6 6 — — $25,632.67 $36,800.42 $36,439.63 2026-02-10
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 6 6 — — $32,230.24 $36,706.74 $36,346.87 2026-02-10
245 MS_DRG Aicd Generator Procedures 6 6 — — $28,520.52 $36,527.40 $36,169.29 2026-02-10
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 6 6 — — $24,347.74 $36,417.71 $36,060.68 2026-02-10
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 6 6 — — $33,298.06 $36,401.71 $36,044.83 2026-02-10
799 MS_DRG Splenic Procedures With Mcc 6 6 — — $19,542.11 $36,259.19 $35,903.71 2026-02-10
163 MS_DRG Major Chest Procedures With Mcc 6 6 — — $35,178.53 $36,947.16 $35,882.10 2026-02-10
31 MS_DRG Ventricular Shunt Procedures With Mcc 6 6 — — $25,901.64 $35,871.70 $35,520.01 2026-02-10
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 6 6 — — $25,637.26 $35,730.78 $35,380.48 2026-02-10
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 6 6 — — $22,681.03 $35,169.55 $34,824.75 2026-02-10
0N10 OTHER Less Than 750 Grams - Discharged Dead 1 1 — — $34,810.65 $34,810.65 $34,810.65 2026-02-10
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 6 6 — — $24,859.20 $34,645.95 $34,306.29 2026-02-10
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 6 6 — — $19,237.16 $34,369.74 $34,032.78 2026-02-10
140 MS_DRG Major Head And Neck Procedures With Mcc 6 6 — — $27,606.15 $34,148.76 $33,813.97 2026-02-10
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 6 6 — — $33,092.22 $37,911.02 $33,754.06 2026-02-10
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 6 6 — — $21,037.54 $33,952.62 $33,619.75 2026-02-10
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 6 6 — — $24,889.45 $33,811.70 $33,480.21 2026-02-10
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 6 — — $32,751.56 $38,024.50 $33,406.59 2026-02-10
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 6 6 — — $25,823.39 $33,737.24 $33,406.49 2026-02-10
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 6 6 — — $21,861.31 $33,638.77 $33,308.98 2026-02-10
901 MS_DRG Wound Debridements For Injuries With Mcc 6 6 — — $24,755.23 $33,598.74 $33,269.34 2026-02-10
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 6 6 — — $22,278.87 $33,536.29 $33,207.51 2026-02-10
793 MS_DRG Full Term Neonate With Major Problems 6 6 — — $9,832.08 $33,382.57 $33,055.29 2026-02-10
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 6 6 — — $23,413.32 $33,249.67 $32,923.69 2026-02-10
0N37 OTHER Less Than 1500 Grams - Discharged Dead 1 1 — — $32,728.68 $32,728.68 $32,728.68 2026-02-10
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 6 6 — — $24,899.71 $33,029.50 $32,705.68 2026-02-10
791 MS_DRG Prematurity With Major Problems 6 6 — — $9,916.27 $32,497.09 $32,178.49 2026-02-10
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 6 — — $15,691.83 $32,188.85 $31,873.28 2026-02-10
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 6 6 — — $20,921.83 $31,897.43 $31,584.71 2026-02-10
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 6 6 — — $24,624.33 $31,319.39 $31,012.33 2026-02-10
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 6 6 — — $25,253.19 $31,177.68 $30,872.01 2026-02-10
34 MS_DRG Carotid Artery Stent Procedures With Mcc 6 6 — — $22,695.61 $30,989.53 $30,685.71 2026-02-10
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 6 6 — — $10,932.18 $30,943.09 $30,639.72 2026-02-10
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 6 6 — — $23,523.97 $30,913.47 $30,610.40 2026-02-10
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 6 6 — — $27,295.40 $30,738.13 $30,436.78 2026-02-10
0571T OTHER Insj/rplcmt Icds Ss Eltrd 5 5 $72,503.00 $54,377.25 25% off $29,663.18 $30,256.44 $30,256.44 2026-02-10
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 6 6 — — $29,536.53 $46,710.99 $30,127.26 2026-02-10
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 6 6 — — $22,074.24 $29,995.96 $29,701.88 2026-02-10
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 6 6 — — $28,495.81 $29,924.71 $29,631.33 2026-02-10
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 6 6 — — $21,007.37 $29,921.51 $29,628.16 2026-02-10
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 6 6 — — $16,628.41 $29,837.44 $29,544.92 2026-02-10
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 6 6 — — $20,265.83 $29,669.31 $29,378.44 2026-02-10
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 6 6 — — $18,697.95 $29,407.51 $29,119.20 2026-02-10
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 6 6 — — $23,835.53 $29,395.49 $29,107.30 2026-02-10
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 6 6 — — $18,524.18 $29,050.43 $28,765.62 2026-02-10
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 6 6 — — $20,546.54 $29,028.02 $28,743.43 2026-02-10
332 MS_DRG Rectal Resection With Mcc 6 6 — — $20,244.22 $28,987.98 $28,703.78 2026-02-10
265 MS_DRG Aicd Lead Procedures 6 6 — — $20,818.54 $28,967.97 $28,683.97 2026-02-10
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 6 6 — — $24,978.76 $28,916.72 $28,633.22 2026-02-10
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 6 6 — — $18,701.60 $28,873.50 $28,590.42 2026-02-10
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 6 6 — — $23,233.74 $28,684.54 $28,403.32 2026-02-10
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 6 6 — — $22,980.44 $28,618.10 $28,337.53 2026-02-10
335 MS_DRG Peritoneal Adhesiolysis With Mcc 6 6 — — $17,197.25 $28,589.27 $28,308.99 2026-02-10
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 6 6 — — $20,434.47 $28,546.84 $28,266.97 2026-02-10
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 6 6 — — $20,449.12 $28,522.82 $28,243.18 2026-02-10
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 6 6 — — $16,467.73 $28,495.60 $28,216.23 2026-02-10
271 MS_DRG Other Major Cardiovascular Procedures With Cc 6 6 — — $22,519.48 $28,472.38 $28,193.24 2026-02-10
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 6 6 — — $14,481.83 $28,234.60 $27,957.79 2026-02-10
0N38 OTHER Less Than 1500 Grams - O.r. Performed 1 1 — — $27,957.28 $27,957.28 $27,957.28 2026-02-10
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 6 6 — — $16,887.45 $28,176.96 $27,900.72 2026-02-10
252 MS_DRG Other Vascular Procedures With Mcc 6 6 — — $24,865.14 $27,927.97 $27,654.17 2026-02-10
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 6 6 — — $18,585.95 $27,920.76 $27,647.03 2026-02-10
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 5 5 — — $26,990.25 $27,530.06 $27,530.06 2026-02-10
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 6 6 — — $17,342.54 $27,792.65 $27,520.18 2026-02-10
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 6 6 — — $19,572.83 $27,658.16 $27,387.00 2026-02-10
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 6 6 — — $22,697.70 $27,448.39 $27,179.29 2026-02-10
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 6 6 — — $18,853.57 $27,313.89 $27,046.10 2026-02-10
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 6 6 — — $21,779.42 $27,277.86 $27,010.43 2026-02-10
264 MS_DRG Other Circulatory System O.r. Procedures 6 6 — — $19,813.44 $26,745.45 $26,483.24 2026-02-10
37 MS_DRG Extracranial Procedures With Mcc 6 6 — — $25,840.34 $32,733.74 $26,357.15 2026-02-10
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 6 6 — — $15,836.98 $26,446.82 $26,187.53 2026-02-10
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 6 6 — — $17,938.52 $26,353.94 $26,095.57 2026-02-10
652 MS_DRG Kidney Transplant 6 6 — — $25,348.98 $40,412.50 $25,855.96 2026-02-10
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 6 6 — — $17,449.07 $26,042.51 $25,787.19 2026-02-10
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 6 6 — — $15,656.93 $25,928.02 $25,673.83 2026-02-10
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 6 6 — — $20,656.11 $25,899.20 $25,645.28 2026-02-10
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 6 6 — — $14,590.59 $25,863.17 $25,609.61 2026-02-10
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 6 6 — — $25,002.80 $25,836.75 $25,583.45 2026-02-10
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 6 6 — — $25,060.92 $27,670.49 $25,562.14 2026-02-10
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 6 6 — — $13,546.47 $25,786.31 $25,533.51 2026-02-10
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 6 6 — — $25,014.61 $30,451.53 $25,514.90 2026-02-10
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 6 6 — — $24,990.28 $29,790.74 $25,490.09 2026-02-10
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 6 6 — — $16,704.36 $25,703.04 $25,451.05 2026-02-10
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 6 6 — — $24,721.05 $34,177.19 $25,215.47 2026-02-10
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 6 6 — — $16,119.51 $25,438.84 $25,189.44 2026-02-10
500 MS_DRG Soft Tissue Procedures With Mcc 6 6 — — $19,851.24 $25,337.96 $25,089.55 2026-02-10
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 6 6 — — $15,185.83 $25,299.53 $25,051.49 2026-02-10
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 6 6 — — $18,647.93 $25,227.48 $24,980.15 2026-02-10
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 6 6 — — $16,373.96 $25,156.22 $24,909.59 2026-02-10
665 MS_DRG Prostatectomy With Mcc 6 6 — — $20,039.33 $24,988.90 $24,743.91 2026-02-10
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 6 — — $16,345.00 $24,936.86 $24,692.38 2026-02-10
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 6 6 — — $21,145.90 $24,892.81 $24,648.76 2026-02-10
662 MS_DRG Minor Bladder Procedures With Mcc 6 6 — — $18,206.68 $24,510.93 $24,270.62 2026-02-10
263 MS_DRG Vein Ligation And Stripping 6 6 — — $15,653.14 $24,478.10 $24,238.12 2026-02-10
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 6 6 — — $17,519.15 $24,284.35 $24,046.27 2026-02-10
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 6 6 — — $19,556.56 $24,182.67 $23,945.58 2026-02-10
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 6 6 — — $16,732.91 $24,179.47 $23,942.42 2026-02-10
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 6 6 — — $16,596.27 $24,153.05 $23,916.25 2026-02-10
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 6 6 — — $17,909.02 $23,829.60 $23,595.97 2026-02-10
472 MS_DRG Cervical Spinal Fusion With Cc 6 6 — — $16,176.02 $23,587.01 $23,355.76 2026-02-10
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 6 6 — — $22,136.69 $23,571.00 $23,339.91 2026-02-10
570 MS_DRG Skin Debridement With Mcc 6 6 — — $16,742.37 $23,546.98 $23,316.12 2026-02-10
668 MS_DRG Transurethral Procedures With Mcc 6 6 — — $17,020.11 $23,378.05 $23,148.85 2026-02-10
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 6 6 — — $20,144.04 $23,316.40 $23,087.81 2026-02-10
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 6 6 — — $19,397.43 $23,233.94 $23,006.15 2026-02-10
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 6 6 — — $19,090.46 $23,219.52 $22,991.88 2026-02-10
619 MS_DRG O.r. Procedures For Obesity With Mcc 6 6 — — $15,912.86 $23,117.05 $22,890.41 2026-02-10
974 MS_DRG HIV With Major Related Condition With Mcc 6 6 — — $19,707.31 $23,105.84 $22,879.31 2026-02-10
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 6 6 — — $19,419.58 $23,072.22 $22,846.02 2026-02-10
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 6 6 — — $20,644.36 $22,979.35 $22,754.06 2026-02-10
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 6 6 — — $14,380.50 $22,821.62 $22,597.88 2026-02-10
800 MS_DRG Splenic Procedures With Cc 6 6 — — $12,338.90 $22,492.57 $22,272.06 2026-02-10
654 MS_DRG Major Bladder Procedures With Cc 6 6 — — $16,033.30 $22,411.71 $22,191.99 2026-02-10
503 MS_DRG Foot Procedures With Mcc 6 6 — — $16,922.89 $22,346.06 $22,126.98 2026-02-10
C1785 HCPCS Pmkr, Dual, Rate-resp 1 1 $59,400.00 $44,550.00 25% off $22,025.53 $22,025.53 $22,025.53 2026-02-10
0275 RC — 1 1 $52,060.00 $39,045.00 25% off $22,025.53 $22,025.53 $22,025.53 2026-02-10
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 6 6 — — $11,121.34 $22,192.33 $21,974.76 2026-02-10
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 6 6 — — $14,763.82 $22,073.84 $21,857.43 2026-02-10
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 6 6 — — $13,887.80 $22,006.59 $21,790.84 2026-02-10
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 6 6 — — $14,122.61 $22,000.98 $21,785.28 2026-02-10
963 MS_DRG Other Multiple Significant Trauma With Mcc 6 6 — — $18,700.38 $21,887.30 $21,672.72 2026-02-10
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 6 6 — — $16,636.98 $21,783.22 $21,569.66 2026-02-10
849 MS_DRG Radiotherapy 6 6 — — $15,588.94 $21,692.75 $21,480.08 2026-02-10
288 MS_DRG Acute And Subacute Endocarditis With Mcc 6 6 — — $13,481.45 $21,666.33 $21,453.92 2026-02-10
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 6 6 — — $10,427.67 $21,595.88 $21,384.15 2026-02-10
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 6 6 — — $20,805.87 $25,419.47 $21,221.99 2026-02-10
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 5 5 $51,947.00 $38,960.25 25% off $20,767.08 $21,182.42 $21,182.42 2026-02-10
0N70 OTHER Less Than 2500 Grams - No O.r.- No Dx Pr 1 1 — — $21,181.81 $21,181.81 $21,181.81 2026-02-10
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 6 6 — — $16,713.67 $21,296.45 $21,087.66 2026-02-10
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 6 6 — — $15,485.65 $21,115.50 $20,908.49 2026-02-10
253 MS_DRG Other Vascular Procedures With Cc 6 6 — — $16,109.32 $20,780.85 $20,577.11 2026-02-10
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 6 6 — — $8,595.83 $20,756.02 $20,552.53 2026-02-10
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 6 6 — — $15,726.12 $20,678.37 $20,475.64 2026-02-10
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 6 6 — — $11,748.99 $20,649.54 $20,447.10 2026-02-10
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 6 6 — — $12,643.31 $20,649.54 $20,447.10 2026-02-10
0N20 OTHER Less Than 1000 Grams - Discharged Dead 1 1 — — $20,376.27 $20,376.27 $20,376.27 2026-02-10
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 6 6 — — $12,445.09 $20,556.67 $20,355.13 2026-02-10
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 6 6 — — $18,286.07 $20,439.78 $20,239.39 2026-02-10
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 6 6 — — $12,915.38 $20,342.91 $20,143.47 2026-02-10
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 6 6 — — $15,462.90 $20,304.48 $20,105.42 2026-02-10
164 MS_DRG Major Chest Procedures With Cc 6 6 — — $15,532.37 $20,207.60 $20,009.49 2026-02-10
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 6 6 — — $18,347.84 $20,198.79 $20,000.76 2026-02-10
545 MS_DRG Connective Tissue Disorders With Mcc 6 6 — — $19,479.35 $19,975.13 $19,868.94 2026-02-10
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 6 6 — — $14,123.35 $19,950.61 $19,755.01 2026-02-10
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 6 6 — — $12,775.22 $19,688.81 $19,495.78 2026-02-10
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 6 6 — — $12,552.64 $19,683.20 $19,490.22 2026-02-10
783 MS_DRG Cesarean Section With Sterilization With Mcc 6 6 — — $5,189.70 $19,655.97 $19,463.26 2026-02-10
792 MS_DRG Prematurity Without Major Problems 6 6 — — $14,298.47 $19,608.74 $19,416.50 2026-02-10
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 5 5 — — $19,012.33 $19,392.58 $19,392.58 2026-02-10
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 6 6 — — $11,241.78 $19,568.71 $19,376.86 2026-02-10
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 6 6 — — $11,984.53 $19,545.50 $19,353.88 2026-02-10
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 5 5 — — $18,950.32 $19,329.33 $19,329.33 2026-02-10
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 6 6 — — $13,509.34 $19,257.26 $19,068.46 2026-02-10
330 MS_DRG Major Small And Large Bowel Procedures With Cc 6 6 — — $12,542.72 $19,192.42 $19,004.26 2026-02-10
397 MS_DRG Appendix Procedures With Mcc 6 6 — — $9,567.17 $19,174.00 $18,986.02 2026-02-10
35 MS_DRG Carotid Artery Stent Procedures With Cc 6 6 — — $13,153.28 $19,138.78 $18,951.14 2026-02-10
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 6 6 — — $10,954.66 $19,105.96 $18,918.65 2026-02-10
0N76 OTHER 2500 And Greater Grams - No O.r.- Major 1 1 — — $18,905.68 $18,905.68 $18,905.68 2026-02-10
113 MS_DRG Orbital Procedures With Cc/mcc 6 6 — — $11,602.42 $18,823.34 $18,638.79 2026-02-10
333 MS_DRG Rectal Resection With Cc 6 6 — — $12,403.31 $18,752.08 $18,568.24 2026-02-10
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 6 6 — — $12,164.59 $18,723.25 $18,539.69 2026-02-10
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 6 6 — — $12,347.07 $18,709.65 $18,526.22 2026-02-10
709 MS_DRG Penis Procedures With Cc/mcc 6 6 — — $15,815.78 $18,631.19 $18,448.53 2026-02-10
357 MS_DRG Other Digestive System O.r. Procedures With Cc 6 6 — — $12,275.37 $18,618.38 $18,435.85 2026-02-10
56 MS_DRG Degenerative Nervous System Disorders With Mcc 6 6 — — $10,701.96 $18,599.16 $18,416.82 2026-02-10
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 6 6 — — $17,908.28 $18,503.89 $18,322.48 2026-02-10
347 MS_DRG Anal And Stomal Procedures With Mcc 6 6 — — $14,538.07 $18,378.99 $18,198.81 2026-02-10
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 6 6 — — $13,013.00 $18,373.38 $18,193.25 2026-02-10
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 6 6 — — $16,109.52 $18,298.93 $18,119.53 2026-02-10
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 6 6 — — $8,441.97 $18,266.90 $18,087.82 2026-02-10
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 6 6 — — $12,617.45 $18,219.67 $18,041.04 2026-02-10
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 6 6 — — $10,859.87 $18,189.24 $18,010.92 2026-02-10
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 6 6 — — $15,472.69 $18,138.80 $17,960.97 2026-02-10
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 6 6 — — $13,028.46 $17,922.63 $17,746.92 2026-02-10
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 6 6 — — $13,180.15 $17,912.23 $17,736.62 2026-02-10
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 6 6 — — $14,987.42 $17,770.52 $17,596.30 2026-02-10
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 6 6 — — $17,203.87 $21,191.94 $17,547.95 2026-02-10
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 6 6 — — $11,391.25 $17,716.07 $17,542.39 2026-02-10
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 6 6 — — $7,116.39 $17,698.47 $17,524.96 2026-02-10
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 6 6 — — $13,924.46 $17,676.84 $17,503.54 2026-02-10
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 6 6 — — $17,090.06 $18,041.75 $17,431.86 2026-02-10
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 6 6 — — $12,308.05 $17,603.19 $17,430.61 2026-02-10
30 MS_DRG Spinal Procedures Without Cc/mcc 6 6 — — $11,860.85 $17,575.17 $17,402.86 2026-02-10
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 6 6 — — $13,325.50 $17,516.73 $17,344.99 2026-02-10
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 6 6 — — $14,942.12 $17,473.49 $17,302.18 2026-02-10
141 MS_DRG Major Head And Neck Procedures With Cc 6 6 — — $15,516.91 $17,462.28 $17,291.08 2026-02-10
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 6 6 — — $10,302.23 $17,443.87 $17,272.85 2026-02-10
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 6 6 — — $14,071.43 $17,373.42 $17,203.09 2026-02-10
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 6 6 — — $10,842.99 $17,145.24 $16,977.15 2026-02-10
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 6 6 — — $6,443.17 $17,138.84 $16,970.81 2026-02-10
374 MS_DRG Digestive Malignancy With Mcc 6 6 — — $9,941.52 $17,122.82 $16,954.95 2026-02-10
C9766 HCPCS Revasc Intra Lithotrip-ather 5 5 $39,730.00 $29,797.50 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 5 5 $16,604.00 $12,453.00 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
C9765 HCPCS Revasc Intra Lithotrip-stent 5 5 $39,730.00 $29,797.50 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
C9602 HCPCS Perc D-e Cor Stent Ather S 5 5 $21,609.00 $16,206.75 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
C9767 HCPCS Revasc Lithotrip-stent-ather 5 5 $39,730.00 $29,797.50 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
0238T OTHER Trluml Perip Athrc Iliac Art 5 5 $15,267.00 $11,450.25 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
C9775 HCPCS Revasc Lith-sten-ath Tib/per 5 5 $39,730.00 $29,797.50 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
C9774 HCPCS Revasc Lithotr-ather Tib/per 5 5 $39,730.00 $29,797.50 25% off $16,613.45 $16,945.72 $16,945.72 2026-02-10
32 MS_DRG Ventricular Shunt Procedures With Cc 6 6 — — $11,009.75 $17,061.17 $16,893.90 2026-02-10
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 6 6 — — $11,800.77 $17,060.38 $16,893.12 2026-02-10
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 6 6 — — $12,272.60 $17,053.17 $16,885.98 2026-02-10
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 6 6 — — $14,929.16 $17,026.75 $16,859.82 2026-02-10
595 MS_DRG Major Skin Disorders With Mcc 6 6 — — $12,344.37 $16,978.71 $16,812.25 2026-02-10
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 6 6 — — $12,459.74 $16,954.70 $16,788.47 2026-02-10
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 6 6 — — $7,796.97 $16,952.29 $16,786.09 2026-02-10
655 MS_DRG Major Bladder Procedures Without Cc/mcc 6 6 — — $11,203.64 $16,945.88 $16,779.75 2026-02-10
336 MS_DRG Peritoneal Adhesiolysis With Cc 6 6 — — $11,155.97 $16,882.63 $16,717.11 2026-02-10
835 MS_DRG Acute Leukemia With Cc 6 6 — — $16,371.86 $19,241.96 $16,699.30 2026-02-10
412 MS_DRG Cholecystectomy With C.d.e. With Cc 6 6 — — $12,440.71 $16,833.00 $16,667.97 2026-02-10
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 6 6 — — $16,429.94 $16,758.54 $16,644.12 2026-02-10
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 6 6 — — $13,315.44 $16,768.94 $16,604.54 2026-02-10
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 6 6 — — $11,647.32 $16,741.73 $16,577.60 2026-02-10
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 6 6 — — $5,817.08 $16,712.10 $16,548.25 2026-02-10
314 MS_DRG Other Circulatory System Diagnoses With Mcc 6 6 — — $13,073.55 $16,694.49 $16,530.82 2026-02-10
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