Price Transparencybeta 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

OKLAHOMA SURGICAL HOSPITAL, LLC

Tulsa, OK · CCN 370210 · Rates published

20,526 distinct procedures filed
11 distinct payers
277,273 rate rows
2025-10-31 last MRF observed
Data quality

214,666 of 277,273 rate rows are consumer-grade (77.4%)

62,607 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 60,630
template filing: same amount across many unrelated codes — excluded 1,661
placeholder amount (≤ $0.02) — excluded from medians 194
exceeds 10× this hospital's gross charge — excluded from medians 92
percent-of-charges filed in the dollar field — excluded from medians 22
per-diem day rate — not a per-procedure price 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://oklahomasurgicalhospital.pt.panaceainc.com/MRFDownload/oklahomasurgicalhospital/oklahomasurgicalhospital
Found on page https://www.oklahomasurgicalhospital.com/patients-visitors/price-transparency/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 92f7f9c7d8ec56ce… · 6,114,593 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 2 $4,163,965.55 $4,163,965.55 $4,163,965.55 nat. median
$4,505,000
0.9× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,102,266.10 $4,468,960.00 $3,687,033.05 nat. median
$3,286,000
1.1× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 2 $3,529,026.20 $3,529,026.20 $3,529,026.20 nat. median
$3,710,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,806,752.17 $4,036,480.00 $3,332,576.08 nat. median
$3,004,655
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 2 $2,218,245.04 $2,218,245.04 $2,218,245.04 nat. median
$2,448,600
0.9× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 6 $19,098.56 $4,238,123.44 $1,182,366.40 nat. median
$2,468,984
outlier · 0.5×
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $733,029.16 $733,029.16 $733,029.16 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $19,098.56 $942,214.61 $291,172.66 nat. median
$753,246
outlier · 0.4×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $19,098.56 $913,836.60 $279,308.21 nat. median
$674,867
outlier · 0.4×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 6 $19,098.56 $893,502.38 $273,723.04 nat. median
$673,137
outlier · 0.4×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 6 $19,098.56 $906,218.15 $273,544.59 nat. median
$625,184
outlier · 0.4×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $19,098.56 $880,446.44 $269,652.21 nat. median
$634,303
outlier · 0.4×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 $203,950.82 $401,829.88 $259,133.97 nat. median
$370,174
0.7× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 2 $257,186.11 $257,186.11 $257,186.11 nat. median
$324,450
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $19,098.56 $808,992.00 $249,031.44 nat. median
$619,808
outlier · 0.4×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $152,334.16 $300,133.23 $193,551.35 nat. median
$265,286
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $108,767.31 $232,148.61 $163,005.22 nat. median
$206,474
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $115,902.09 $228,353.69 $147,261.82 nat. median
$202,976
0.7× median
16249662
CDM 		Contrast Delivery Injector Standard 5 $3,812.00 $131,257.20 $109,381.00 nat. median
$109,381
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $76,415.04 $150,555.15 $97,090.72 nat. median
$133,161
0.7× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $92,910.14 $92,910.14 $92,910.14 nat. median
$111,989
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $70,854.53 $139,599.67 $90,025.71 nat. median
$117,357
0.8× median
7
MS_DRG 		Lung Transplant 8 $70,676.07 $139,248.06 $89,798.95 nat. median
$122,708
0.7× median
J7330
HCPCS 		Tissue Maci - Autologous Chondrocyte Membrane 6 $3,812.00 $104,504.00 $83,603.20 nat. median
$76,329
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $56,650.96 $111,615.38 $82,598.53 nat. median
$98,894
0.8× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 5 $60,336.88 $114,298.79 $82,549.13 nat. median
$69,774
1.2× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $79,234.20 $79,234.20 $79,234.20 nat. median
$96,983
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $50,859.53 $107,837.30 $75,719.08 nat. median
$108,660
0.7× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $58,914.21 $116,074.50 $74,854.68 nat. median
$102,358
0.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 8 $57,591.95 $113,469.35 $73,174.66 nat. median
$100,136
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 8 $57,296.67 $112,887.59 $72,799.49 nat. median
$99,019
0.7× median
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $49,817.95 $98,152.79 $72,635.83 nat. median
$83,470
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $52,193.14 $102,832.47 $66,315.09 nat. median
$93,672
0.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 $45,105.96 $88,869.09 $65,765.63 nat. median
$82,711
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 8 $45,826.85 $90,289.40 $58,226.26 nat. median
$79,312
0.7× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $45,801.43 $90,239.32 $58,193.97 nat. median
$81,118
0.7× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 1 $57,334.76 $57,334.76 $57,334.76 nat. median
$70,825
0.8× median
38240
HCPCS 		Transplt Allo Hct/donor 7 $4,835.93 $88,876.99 $56,257.37 nat. median
$15,979
outlier · 3.5×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 $38,411.40 $75,679.26 $56,004.79 nat. median
$68,090
0.8× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 $43,594.42 $85,891.02 $55,389.81 nat. median
$77,570
0.7× median
10
MS_DRG 		Pancreas Transplant 8 $40,524.39 $84,952.31 $54,784.45 nat. median
$68,884
0.8× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 $42,870.83 $84,465.38 $54,470.44 nat. median
$71,271
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 $42,271.09 $83,283.74 $53,708.42 nat. median
$73,807
0.7× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 $41,844.40 $82,443.06 $53,166.27 nat. median
$74,915
0.7× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 $36,259.01 $71,438.57 $52,866.56 nat. median
$63,724
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 $40,366.39 $79,531.05 $51,288.36 nat. median
$72,135
0.7× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 $33,456.05 $65,916.09 $48,779.76 nat. median
$60,691
0.8× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 $38,218.33 $75,298.88 $48,559.10 nat. median
$68,886
0.7× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 8 $37,620.75 $74,121.50 $47,799.83 nat. median
$66,526
0.7× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 8 $36,927.44 $72,755.53 $46,918.94 nat. median
$64,732
0.7× median

Other procedures at this hospital

Browse this hospital's 20,526 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 2 — — $4,163,965.55 $4,163,965.55 $4,163,965.55 2025-10-31
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $3,102,266.10 $4,468,960.00 $3,687,033.05 2025-10-31
J1414 HCPCS Inj, Beqvez, Per Tx Dose 2 2 — — $3,529,026.20 $3,529,026.20 $3,529,026.20 2025-10-31
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,806,752.17 $4,036,480.00 $3,332,576.08 2025-10-31
J3392 HCPCS Inj, Exagamglogene Autotem 2 2 — — $2,218,245.04 $2,218,245.04 $2,218,245.04 2025-10-31
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 6 — — $19,098.56 $4,238,123.44 $1,182,366.40 2025-10-31
Q2057 HCPCS Afamitresgene Autoleucel 2 2 — — $733,029.16 $733,029.16 $733,029.16 2025-10-31
Q2042 HCPCS Tisagenlecleucel Car-pos T 10 6 — — $19,098.56 $942,214.61 $291,172.66 2025-10-31
Q2056 HCPCS Ciltacabtagene Car-pos T 10 6 — — $19,098.56 $913,836.60 $279,308.21 2025-10-31
Q2054 HCPCS Lisocabtagene Mara Car Pos T 10 6 — — $19,098.56 $893,502.38 $273,723.04 2025-10-31
Q2055 HCPCS Idecabtagene Vicleucel Car 10 6 — — $19,098.56 $906,218.15 $273,544.59 2025-10-31
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 10 6 — — $19,098.56 $880,446.44 $269,652.21 2025-10-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 8 — — $203,950.82 $401,829.88 $259,133.97 2025-10-31
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 2 2 — — $257,186.11 $257,186.11 $257,186.11 2025-10-31
Q2053 HCPCS Brexucabtagene Car Pos T 10 6 — — $19,098.56 $808,992.00 $249,031.44 2025-10-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 12 8 — — $152,334.16 $300,133.23 $193,551.35 2025-10-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 8 — — $108,767.31 $232,148.61 $163,005.22 2025-10-31
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 8 — — $115,902.09 $228,353.69 $147,261.82 2025-10-31
16249662 CDM Contrast Delivery Injector Standard 5 5 $218,762.00 — $3,812.00 $131,257.20 $109,381.00 2025-10-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 8 — — $76,415.04 $150,555.15 $97,090.72 2025-10-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $92,910.14 $92,910.14 $92,910.14 2025-10-31
14 MS_DRG Allogeneic Bone Marrow Transplant 12 8 — — $70,854.53 $139,599.67 $90,025.71 2025-10-31
7 MS_DRG Lung Transplant 12 8 — — $70,676.07 $139,248.06 $89,798.95 2025-10-31
J7330 HCPCS Tissue Maci - Autologous Chondrocyte Membrane 10 6 $104,504.00 — $3,812.00 $104,504.00 $83,603.20 2025-10-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $56,650.96 $111,615.38 $82,598.53 2025-10-31
J9029 HCPCS Instill Adstiladrin, Tx Dose 5 5 — — $60,336.88 $114,298.79 $82,549.13 2025-10-31
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $79,234.20 $79,234.20 $79,234.20 2025-10-31
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 8 — — $50,859.53 $107,837.30 $75,719.08 2025-10-31
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 8 — — $58,914.21 $116,074.50 $74,854.68 2025-10-31
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 12 8 — — $57,591.95 $113,469.35 $73,174.66 2025-10-31
215 MS_DRG Other Heart Assist System Implant 12 8 — — $57,296.67 $112,887.59 $72,799.49 2025-10-31
850 MS_DRG Acute Leukemia With Other Procedures 3 3 — — $49,817.95 $98,152.79 $72,635.83 2025-10-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 8 — — $52,193.14 $102,832.47 $66,315.09 2025-10-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 3 — — $45,105.96 $88,869.09 $65,765.63 2025-10-31
231 MS_DRG Coronary Bypass With Ptca With Mcc 12 8 — — $45,826.85 $90,289.40 $58,226.26 2025-10-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 8 — — $45,801.43 $90,239.32 $58,193.97 2025-10-31
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $57,334.76 $57,334.76 $57,334.76 2025-10-31
38240 HCPCS Transplt Allo Hct/donor 11 7 — — $4,835.93 $88,876.99 $56,257.37 2025-10-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $38,411.40 $75,679.26 $56,004.79 2025-10-31
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 8 — — $43,594.42 $85,891.02 $55,389.81 2025-10-31
10 MS_DRG Pancreas Transplant 12 8 — — $40,524.39 $84,952.31 $54,784.45 2025-10-31
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 8 — — $42,870.83 $84,465.38 $54,470.44 2025-10-31
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 8 — — $42,271.09 $83,283.74 $53,708.42 2025-10-31
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 8 — — $41,844.40 $82,443.06 $53,166.27 2025-10-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 3 — — $36,259.01 $71,438.57 $52,866.56 2025-10-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 8 — — $40,366.39 $79,531.05 $51,288.36 2025-10-31
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 3 — — $33,456.05 $65,916.09 $48,779.76 2025-10-31
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 12 8 — — $38,218.33 $75,298.88 $48,559.10 2025-10-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 12 8 — — $37,620.75 $74,121.50 $47,799.83 2025-10-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 12 8 — — $36,927.44 $72,755.53 $46,918.94 2025-10-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 12 8 — — $36,119.49 $71,163.67 $45,892.37 2025-10-31
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 8 — — $36,058.38 $71,043.27 $45,814.73 2025-10-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 12 8 — — $34,974.61 $68,908.01 $44,437.73 2025-10-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 8 — — $34,924.32 $68,808.92 $44,373.83 2025-10-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 12 8 — — $34,201.81 $67,385.41 $43,455.83 2025-10-31
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 3 — — $29,766.17 $58,646.18 $43,399.83 2025-10-31
A9543 HCPCS Y90 Ibritumomab, Rx 10 6 — — $19,098.56 $117,857.84 $43,142.03 2025-10-31
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 3 — — $29,584.46 $58,288.17 $43,134.89 2025-10-31
33276 HCPCS Insj Phrnc Nrv Stim Sys 10 6 — — $28,868.32 $73,365.76 $42,805.38 2025-10-31
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 10 6 — — $19,098.56 $99,923.00 $42,724.17 2025-10-31
276 MS_DRG Cardiac Defibrillator Implant With Mcc 12 8 — — $33,499.31 $66,001.33 $42,563.25 2025-10-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 8 — — $33,303.54 $65,615.62 $42,314.51 2025-10-31
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 12 8 — — $32,398.24 $63,831.97 $42,166.78 2025-10-31
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 8 — — $33,035.84 $65,088.19 $41,974.39 2025-10-31
28 MS_DRG Spinal Procedures With Mcc 12 8 — — $32,877.93 $64,777.07 $41,773.75 2025-10-31
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $41,672.63 $41,672.63 $41,672.63 2025-10-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 12 8 — — $32,642.14 $64,312.51 $41,474.16 2025-10-31
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 12 8 — — $32,642.14 $64,312.51 $41,474.16 2025-10-31
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $41,334.02 $41,334.02 $41,334.02 2025-10-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 8 — — $32,398.24 $63,831.97 $41,164.27 2025-10-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 8 — — $32,173.81 $63,389.79 $40,879.11 2025-10-31
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 12 8 — — $32,149.47 $63,341.84 $40,848.19 2025-10-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 3 — — $27,851.74 $54,874.31 $40,608.54 2025-10-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 8 — — $31,821.75 $62,696.15 $40,431.79 2025-10-31
0266T HCPCS Implt/rpl Crtd Sns Dev Total 10 6 — — $22,062.46 $73,365.76 $40,019.39 2025-10-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 12 8 — — $31,486.99 $62,036.60 $40,006.46 2025-10-31
33231 HCPCS Insrt Pulse Gen W/mult Leads 11 7 — — $30,497.62 $67,074.02 $39,744.37 2025-10-31
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 11 7 — — $30,497.62 $67,074.02 $39,744.37 2025-10-31
33270 HCPCS Ins/rep Subq Defibrillator 11 7 — — $30,497.62 $67,074.02 $39,744.37 2025-10-31
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 8 — — $31,038.67 $61,153.30 $39,436.84 2025-10-31
69930 HCPCS Implant Cochlear Device 11 7 — — $30,256.23 $55,785.63 $39,357.94 2025-10-31
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 8 — — $30,853.18 $60,787.84 $39,201.15 2025-10-31
33249 HCPCS 33249 Insertion Or Replacement Of Permanent Implantable Defibril 25 10 $93,121.50 — $1,175.00 $67,074.02 $38,612.18 2025-10-31
653 MS_DRG Major Bladder Procedures With Mcc 12 8 — — $30,147.43 $59,397.36 $38,304.45 2025-10-31
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 8 — — $28,883.58 $56,907.28 $37,979.44 2025-10-31
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 12 8 — — $29,891.63 $58,893.38 $37,979.44 2025-10-31
J9226 HCPCS Supprelin La Implant 10 6 — — $19,098.56 $79,484.85 $37,784.68 2025-10-31
33264 HCPCS Rem & Rep Icd Gen Multi Leads Charge 14 10 $73,245.00 — $1,170.00 $67,074.02 $37,760.44 2025-10-31
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 12 8 — — $29,425.46 $57,974.92 $37,387.14 2025-10-31
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 12 8 — — $29,358.40 $57,842.79 $37,301.94 2025-10-31
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 8 — — $29,208.60 $57,547.65 $37,111.61 2025-10-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 12 8 — — $29,181.02 $57,493.31 $37,076.56 2025-10-31
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 12 8 — — $29,177.78 $57,486.92 $37,072.44 2025-10-31
33240 HCPCS Insrt Pulse Gen W/singl Lead 11 7 — — $21,351.26 $67,074.02 $36,615.06 2025-10-31
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 11 7 — — $21,351.26 $67,074.02 $36,615.06 2025-10-31
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 8 — — $28,771.64 $56,686.73 $36,556.41 2025-10-31
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 8 — — $28,644.55 $56,436.33 $36,394.93 2025-10-31
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 11 7 — — $28,868.32 $48,719.21 $35,850.57 2025-10-31
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 11 7 — — $28,868.32 $48,719.21 $35,850.57 2025-10-31
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 11 7 — — $28,868.32 $48,719.21 $35,850.57 2025-10-31
0735T HCPCS Prep Tum Cav Iort Prim Crnot 5 1 — — $28,868.32 $48,719.21 $35,850.57 2025-10-31
61886 HCPCS Implant Neurostim Arrays 11 7 — — $28,868.32 $48,719.21 $35,850.57 2025-10-31
C1882 HCPCS Defibrillator Crtd Ampila Dtmb1qq - Xx 49 6 $36,385.00 — $3,812.00 $42,941.00 $35,778.00 2025-10-31
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 12 8 — — $27,759.26 $54,692.11 $35,270.11 2025-10-31
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 12 8 — — $27,551.59 $54,282.96 $35,006.26 2025-10-31
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 12 8 — — $27,467.23 $54,116.74 $34,899.06 2025-10-31
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 12 8 — — $27,239.55 $53,668.16 $34,609.78 2025-10-31
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 8 — — $27,078.93 $53,351.71 $34,405.71 2025-10-31
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 8 — — $27,057.84 $53,310.16 $34,378.91 2025-10-31
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 12 8 — — $27,047.03 $53,288.85 $34,365.17 2025-10-31
228 MS_DRG Other Cardiothoracic Procedures With Mcc 12 8 — — $26,949.68 $53,097.06 $34,241.49 2025-10-31
C2624 HCPCS Cardiomems Pa Sensor And Delivery System 10 6 $40,000.00 — $17,600.00 $40,000.00 $34,000.00 2025-10-31
C1826 HCPCS Inceptiv Spinal Cord Stimulator Kit Closed-loop Technology Recha 11 7 $48,000.00 — $21,120.00 $48,000.00 $33,600.00 2025-10-31
245 MS_DRG Aicd Generator Procedures 12 8 — — $26,427.81 $52,068.85 $33,578.41 2025-10-31
471 MS_DRG Cervical Spinal Fusion With Mcc 13 9 — — $21,735.00 $51,754.53 $33,375.71 2025-10-31
6 MS_DRG Liver Transplant Without Mcc 12 8 — — $26,224.47 $51,668.22 $33,320.05 2025-10-31
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 1 1 — — $32,938.01 $32,938.01 $32,938.01 2025-10-31
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 12 8 — — $25,825.90 $50,882.95 $32,813.64 2025-10-31
799 MS_DRG Splenic Procedures With Mcc 12 8 — — $25,713.95 $50,662.39 $32,671.41 2025-10-31
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 8 — — $25,709.09 $50,652.80 $32,665.22 2025-10-31
61737 HCPCS Litt Icr Mlt Trj Mlt/cplx Ls 6 2 — — $1,588.69 $48,719.21 $32,359.44 2025-10-31
61736 HCPCS Litt Icr 1 Traj 1 Smpl Les 6 2 — — $1,319.84 $48,719.21 $32,359.44 2025-10-31
61889 HCPCS Ins Sk-mnt Crnl Nstm Pg/rcvr 6 2 — — $1,372.96 $48,719.21 $32,359.44 2025-10-31
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 11 7 — — $22,062.46 $48,235.48 $32,351.90 2025-10-31
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 8 — — $25,443.01 $50,128.57 $32,327.16 2025-10-31
J1413 HCPCS Inj Delandistrogene Mox Rokl 9 5 — — $19,098.56 $4,524,937.44 $32,231.41 2025-10-31
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 3 — — $22,083.56 $43,509.69 $32,198.40 2025-10-31
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 12 8 — — $25,306.73 $49,860.07 $32,154.00 2025-10-31
C1822 HCPCS Ipg Kit Nevro 40 6 $37,698.00 — $14,675.76 $43,696.00 $31,970.60 2025-10-31
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 12 8 — — $25,157.47 $49,565.99 $31,964.35 2025-10-31
163 MS_DRG Major Chest Procedures With Mcc 12 8 — — $24,926.55 $49,111.02 $31,670.95 2025-10-31
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 12 8 — — $24,916.27 $49,090.78 $31,657.90 2025-10-31
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 8 — — $24,836.78 $48,934.15 $31,556.89 2025-10-31
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 13 9 — — $22,907.00 $48,926.69 $31,552.08 2025-10-31
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 12 8 — — $24,398.73 $48,071.09 $31,000.32 2025-10-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $21,157.17 $41,684.49 $30,847.70 2025-10-31
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 12 8 — — $24,253.25 $47,784.47 $30,815.48 2025-10-31
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 12 8 — — $24,186.19 $47,652.35 $30,730.28 2025-10-31
0408T HCPCS Insj/rplc Cardiac Modulj Sys 10 7 — — $15,420.05 $51,104.35 $30,497.62 2025-10-31
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 3 3 — — $30,497.62 $48,181.00 $30,497.62 2025-10-31
901 MS_DRG Wound Debridements For Injuries With Mcc 12 8 — — $23,960.14 $47,206.97 $30,443.06 2025-10-31
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 12 8 — — $23,756.26 $46,805.28 $30,184.01 2025-10-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 4 — — $19,098.56 $4,823,000.00 $30,118.55 2025-10-31
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 12 8 — — $23,399.87 $46,103.11 $29,731.20 2025-10-31
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 8 — — $23,351.74 $46,008.29 $29,670.05 2025-10-31
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 12 8 — — $23,068.90 $45,451.03 $29,310.68 2025-10-31
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 12 8 — — $23,034.83 $45,383.90 $29,267.39 2025-10-31
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $29,141.77 $29,141.77 $29,141.77 2025-10-31
140 MS_DRG Major Head And Neck Procedures With Mcc 12 8 — — $22,871.51 $45,062.12 $29,059.88 2025-10-31
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 8 4 — — $22,062.46 $45,794.62 $28,987.09 2025-10-31
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 11 7 — — $20,398.33 $48,719.21 $28,868.32 2025-10-31
31 MS_DRG Ventricular Shunt Procedures With Mcc 12 8 — — $22,662.76 $44,650.84 $28,794.65 2025-10-31
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 12 8 — — $22,657.35 $44,640.18 $28,787.78 2025-10-31
793 MS_DRG Full Term Neonate With Major Problems 12 8 — — $22,554.06 $44,436.67 $28,656.54 2025-10-31
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 12 8 — — $22,501.06 $44,332.25 $28,589.20 2025-10-31
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 8 — — $22,238.23 $43,814.42 $28,255.26 2025-10-31
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 12 8 — — $22,225.79 $43,789.91 $28,239.45 2025-10-31
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 12 8 — — $22,192.80 $43,724.92 $28,197.54 2025-10-31
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 8 — — $21,996.49 $43,338.14 $27,948.11 2025-10-31
791 MS_DRG Prematurity With Major Problems 12 8 — — $21,955.93 $43,258.23 $27,896.58 2025-10-31
22837 HCPCS Ant Thrc Vrt Body Tethrg 8+ 5 1 — — $22,062.46 $37,233.40 $27,398.61 2025-10-31
63685 HCPCS 63685 Neurostim Ins/Rep Gen/Receiver 26 10 $83,496.50 — $640.00 $50,098.00 $27,398.61 2025-10-31
22838 HCPCS Rev Rplc/rmv Thrc Vrt Tethrg 5 1 — — $22,062.46 $37,233.40 $27,398.61 2025-10-31
0790T HCPCS Revj Rplcmt/rmvl Vrt Tethrg 5 1 — — $22,062.46 $37,233.40 $27,398.61 2025-10-31
22836 HCPCS Ant Thrc Vrt Body Tethrg <7 5 1 — — $22,062.46 $37,233.40 $27,398.61 2025-10-31
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 12 8 — — $21,543.84 $42,446.32 $27,372.99 2025-10-31
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 12 8 — — $21,528.70 $42,416.48 $27,353.75 2025-10-31
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 12 8 — — $21,338.34 $42,041.43 $27,111.88 2025-10-31
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 12 8 — — $21,294.54 $41,955.12 $27,056.22 2025-10-31
33230 HCPCS Ins Icd Gen W/exist Dual Leads Charge 14 10 $51,525.00 — $1,170.00 $67,074.02 $27,054.46 2025-10-31
33262 HCPCS Rem & Rep Icd Gen Sgl Lead Sys Charge 14 10 $51,525.00 — $1,170.00 $67,074.02 $27,054.46 2025-10-31
33263 HCPCS Rem & Rep Icd Gen W/dual Lead Charge 14 10 $51,525.00 — $1,170.00 $67,074.02 $27,054.46 2025-10-31
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 12 8 — — $21,251.27 $41,869.88 $27,001.25 2025-10-31
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 12 8 — — $21,146.90 $41,664.24 $26,868.64 2025-10-31
34 MS_DRG Carotid Artery Stent Procedures With Mcc 12 8 — — $21,030.08 $41,434.09 $26,720.22 2025-10-31
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 12 8 — — $20,901.92 $41,181.57 $26,557.37 2025-10-31
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 12 8 — — $20,880.82 $41,140.02 $26,530.57 2025-10-31
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 12 8 — — $20,822.42 $41,024.94 $26,456.36 2025-10-31
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 12 8 — — $20,671.53 $40,727.67 $26,264.66 2025-10-31
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 8 — — $20,559.59 $40,507.11 $26,122.42 2025-10-31
C1722 HCPCS Emblem MRI S-icd 40 6 $27,444.00 — $11,471.68 $42,000.00 $26,072.00 2025-10-31
C1721 HCPCS Defibrillator Dynagen D153 100 6 $26,930.00 — $10,643.60 $117,800.00 $26,000.00 2025-10-31
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 8 — — $20,399.51 $40,191.72 $25,919.03 2025-10-31
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 12 8 — — $20,236.73 $39,871.01 $25,712.21 2025-10-31
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 11 7 — — $20,398.33 $37,233.40 $25,674.34 2025-10-31
61885 HCPCS Insrt/redo Neurostim 1 Array 11 7 — — $20,398.33 $37,233.40 $25,674.34 2025-10-31
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 10 6 — — $10,794.89 $44,834.95 $25,299.32 2025-10-31
0817T HCPCS 0817t Open Insert/Rplcmt Integrated Neurostim Ptn Subfascial 14 10 $47,195.00 — $640.00 $48,719.21 $25,108.00 2025-10-31
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 12 8 — — $19,732.16 $38,876.89 $25,071.12 2025-10-31
335 MS_DRG Peritoneal Adhesiolysis With Mcc 12 8 — — $19,595.34 $38,607.32 $24,897.28 2025-10-31
L5856 HCPCS Elec Knee-shin Swing/stance 1 1 — — $24,764.33 $24,764.33 $24,764.33 2025-10-31
0680T HCPCS Insj/rplcmt Pg Only Isdss 8 4 — — $20,398.33 $37,233.40 $24,730.53 2025-10-31
L6880 HCPCS Elec Hand Ind Art Digits 1 1 — — $24,647.37 $24,647.37 $24,647.37 2025-10-31
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 12 8 — — $19,386.59 $38,196.04 $24,632.05 2025-10-31
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 12 8 — — $19,385.51 $38,193.91 $24,630.67 2025-10-31
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 12 8 — — $19,382.27 $38,187.52 $24,626.55 2025-10-31
L6700 HCPCS Ue Add Ext Power Myoel 1 1 — — $24,591.83 $24,591.83 $24,591.83 2025-10-31
265 MS_DRG Aicd Lead Procedures 12 8 — — $19,291.41 $38,008.51 $24,511.11 2025-10-31
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 12 8 — — $19,204.88 $37,838.03 $24,401.17 2025-10-31
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 3 — — $16,689.08 $32,881.33 $24,333.11 2025-10-31
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 12 8 — — $14,936.89 $30,620.29 $24,258.25 2025-10-31
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 12 8 — — $19,087.53 $37,606.82 $24,252.07 2025-10-31
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 12 8 — — $19,039.40 $37,511.99 $24,190.91 2025-10-31
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 12 8 — — $18,948.55 $37,332.98 $24,075.48 2025-10-31
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 12 8 — — $18,942.60 $37,321.26 $24,067.92 2025-10-31
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 12 8 — — $18,935.03 $37,306.35 $24,058.30 2025-10-31
264 MS_DRG Other Circulatory System O.r. Procedures 12 8 — — $18,901.50 $37,240.29 $24,015.70 2025-10-31
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 12 8 — — $18,779.28 $36,999.48 $23,860.41 2025-10-31
332 MS_DRG Rectal Resection With Mcc 12 8 — — $18,758.72 $36,958.99 $23,834.29 2025-10-31
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 12 8 — — $18,738.17 $36,918.50 $23,808.18 2025-10-31
54416 HCPCS Remv/repl Penis Contain Pros 11 7 — — $19,146.69 $35,513.24 $23,674.70 2025-10-31
271 MS_DRG Other Major Cardiovascular Procedures With Cc 12 8 — — $18,627.31 $36,700.08 $23,667.32 2025-10-31
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 12 8 — — $18,598.11 $36,642.54 $23,630.22 2025-10-31
665 MS_DRG Prostatectomy With Mcc 12 8 — — $18,568.90 $36,585.00 $23,593.11 2025-10-31
252 MS_DRG Other Vascular Procedures With Mcc 12 8 — — $18,551.60 $36,550.91 $23,571.13 2025-10-31
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 13 9 — — $14,700.00 $36,495.50 $23,535.40 2025-10-31
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 12 8 — — $18,420.72 $36,293.06 $23,404.84 2025-10-31
93653 HCPCS Compre Ep Eval Tx Svt 11 7 — — $14,837.88 $36,893.09 $23,335.61 2025-10-31
93654 HCPCS Compre Ep Eval Tx Vt 11 7 — — $14,837.88 $36,893.09 $23,335.61 2025-10-31
93656 HCPCS Compre Ep Eval Abltj Atr Fib 11 7 — — $14,837.88 $36,893.09 $23,335.61 2025-10-31
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 12 8 — — $18,343.93 $36,141.76 $23,307.27 2025-10-31
C1820 HCPCS Neurostimulator Urology Rechargable 80 6 $36,000.00 — $2,200.00 $47,476.00 $23,210.00 2025-10-31
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 12 8 — — $18,153.03 $35,765.63 $23,064.72 2025-10-31
37 MS_DRG Extracranial Procedures With Mcc 12 8 — — $17,959.42 $35,384.18 $22,818.72 2025-10-31
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 12 8 — — $17,856.67 $35,181.74 $22,688.17 2025-10-31
C1767 HCPCS Neurostimulator 90 6 $33,570.00 — $9,218.88 $47,476.00 $22,672.00 2025-10-31
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 13 9 — — $10,500.00 $34,827.99 $22,460.05 2025-10-31
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 12 8 — — $17,626.83 $34,728.90 $22,396.14 2025-10-31
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 12 8 — — $17,619.26 $34,713.99 $22,386.52 2025-10-31
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 12 8 — — $17,409.97 $34,301.64 $22,120.61 2025-10-31
27278 HCPCS Arthrd Si Jt Prq Wo Tfxj Dev 11 7 — — $17,492.98 $37,233.40 $22,062.46 2025-10-31
0786T HCPCS Insj/rplcmt Prq Ra Sac Nstim 8 4 — — $15,282.22 $37,233.40 $22,062.46 2025-10-31
64590 HCPCS 64590 Implant Neuroreceiver *dont Upd $ Ck W Mb* 26 10 $54,670.00 — $640.00 $37,233.40 $22,062.46 2025-10-31
62361 HCPCS Implant Spine Infusion Pump 11 7 — — $16,811.98 $37,233.40 $22,062.46 2025-10-31
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 12 8 — — $17,329.39 $34,142.88 $22,018.22 2025-10-31
0515T HCPCS Insj Wcs Lv Compl Sys 10 7 — — $15,420.05 $36,615.06 $21,981.44 2025-10-31
0409T HCPCS Insj/rplc Car Modulj Pls Gn 10 7 — — $15,420.05 $36,615.06 $21,981.44 2025-10-31
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 12 8 — — $17,279.10 $34,043.79 $21,954.32 2025-10-31
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 12 8 — — $17,246.11 $33,978.79 $21,912.41 2025-10-31
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 12 8 — — $17,199.60 $33,887.16 $21,853.31 2025-10-31
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 12 8 — — $17,164.99 $33,818.97 $21,809.34 2025-10-31
500 MS_DRG Soft Tissue Procedures With Mcc 12 8 — — $17,136.32 $33,762.49 $21,772.92 2025-10-31
C2616 HCPCS Brachytx, Non-str,yttrium-90 11 7 — — $16,632.18 $36,335.12 $21,530.19 2025-10-31
62362 HCPCS 62362 Placement Of Infusion Pump 24 10 $48,297.50 — $640.00 $37,233.40 $21,496.89 2025-10-31
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 12 8 — — $16,878.36 $33,254.25 $21,445.16 2025-10-31
662 MS_DRG Minor Bladder Procedures With Mcc 12 8 — — $16,870.79 $33,239.33 $21,435.54 2025-10-31
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 2 2 — — $21,402.93 $21,402.93 $21,402.93 2025-10-31
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 2 2 — — $21,402.93 $21,402.93 $21,402.93 2025-10-31
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 11 7 — — $4,170.64 $36,615.06 $21,351.26 2025-10-31
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 3 3 — — $21,351.26 $33,731.34 $21,351.26 2025-10-31
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 3 3 — — $21,351.26 $33,731.34 $21,351.26 2025-10-31
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 12 8 — — $16,798.87 $33,097.62 $21,344.15 2025-10-31
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 12 8 — — $16,723.69 $32,949.52 $21,248.64 2025-10-31
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 12 8 — — $16,677.19 $32,857.88 $21,189.55 2025-10-31
33288 HCPCS Rmv&rplcmt Phrnc Nrv Stim Ld 11 7 — — $11,862.01 $37,233.40 $21,160.00 2025-10-31
64583 HCPCS Rev/rplct Hpglsl Nstm Ary Pg 11 7 — — $11,862.01 $37,233.40 $21,160.00 2025-10-31
652 MS_DRG Kidney Transplant 12 8 — — $16,610.13 $32,725.76 $21,104.35 2025-10-31
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 12 8 — — $16,594.98 $32,695.93 $21,085.11 2025-10-31
54411 HCPCS 54411 Remove/replace Penile Prosth Infected With Irr Debr 24 10 $51,775.00 — $1,465.00 $35,513.24 $21,043.19 2025-10-31
54410 HCPCS 54410 Rem/rev Penile Prosthesis 24 10 $51,775.00 — $1,170.00 $35,513.24 $21,043.19 2025-10-31
54401 HCPCS 54401 Insert Self Contain Prosthesis 24 10 $51,775.00 — $1,170.00 $35,513.24 $21,043.19 2025-10-31
54405 HCPCS 54405 Insert Multi Comp Penis Proced 26 10 $51,775.00 — $1,170.00 $35,513.24 $21,043.19 2025-10-31
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 12 8 — — $16,540.90 $32,589.38 $21,016.40 2025-10-31
570 MS_DRG Skin Debridement With Mcc 12 8 — — $16,279.16 $32,073.68 $20,683.83 2025-10-31
0888T HCPCS Histotripsy Mal Renal Tissue 5 5 — — $16,646.83 $28,531.63 $20,606.17 2025-10-31
974 MS_DRG HIV With Major Related Condition With Mcc 12 8 — — $16,149.36 $31,817.96 $20,518.92 2025-10-31
0797T HCPCS Tcat Ins 2chmbr Ldls Pm Rv 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0825T HCPCS Tcat Rmv&rpl1chmb Ldls Pm Ra 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0801T HCPCS Tcat Rmv&rpl 2chmbr Ldls Pm 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0795T HCPCS Tcat Ins 2chmbr Ldls Pm Cmpl 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0802T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Ra 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
33221 HCPCS Insert Pulse Gen Mult Leads 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0803T HCPCS Tcat Rmv&rpl2chmb Ldls Pm Rv 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 10 7 — — $15,420.05 $30,267.68 $20,504.81 2025-10-31
69714 HCPCS Impl Oi Implt Skull Perq Esp 11 7 — — $12,239.18 $48,719.21 $20,444.07 2025-10-31
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 12 8 — — $15,946.02 $31,417.33 $20,260.56 2025-10-31
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 12 8 — — $15,904.92 $31,336.35 $20,208.34 2025-10-31
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 12 8 — — $15,861.66 $31,251.11 $20,153.37 2025-10-31
C9797 HCPCS Vasc Emb/occ W/prs Cath 6 6 — — $17,080.79 $27,238.46 $20,126.19 2025-10-31
C9782 HCPCS Blind Myocar Trpl Bon Marrow 10 6 — — $15,805.38 $28,531.63 $20,117.17 2025-10-31
C9758 HCPCS Blind Interatrial Shunt Ide 10 6 — — $15,805.38 $28,531.63 $20,117.17 2025-10-31
668 MS_DRG Transurethral Procedures With Mcc 12 8 — — $15,771.35 $31,073.17 $20,038.62 2025-10-31
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 12 8 — — $15,762.69 $31,056.12 $20,027.62 2025-10-31
800 MS_DRG Splenic Procedures With Cc 13 9 — — $15,435.00 $31,046.53 $20,021.44 2025-10-31
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 12 8 — — $15,749.17 $31,029.49 $20,010.45 2025-10-31
472 MS_DRG Cervical Spinal Fusion With Cc 13 9 — — $9,975.00 $30,869.66 $19,907.38 2025-10-31
L8614 HCPCS Cochlear Device 1 1 — — $19,746.21 $19,746.21 $19,746.21 2025-10-31
L6975 HCPCS Interscap-thor Myoelectronic 1 1 — — $19,700.61 $19,700.61 $19,700.61 2025-10-31
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 12 8 — — $15,505.27 $30,548.95 $19,700.55 2025-10-31
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 12 8 — — $15,487.43 $30,513.78 $19,677.88 2025-10-31
0645T HCPCS Tcat Impltj C Sins Rdctj Dev 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
0793T HCPCS Prq Tcat Thrm Ablt Nrv P-art 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
C9602 HCPCS Perc D-e Cor Stent Ather S 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
33902 HCPCS Perq P-art Revsc 1 Abnor Uni 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
0632T HCPCS Perq Tcat US Abltj Nrv P-art 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
92933 HCPCS Prq Card Stent/ath/angio 11 7 — — $15,805.38 $27,238.46 $19,672.22 2025-10-31
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 12 8 — — $15,478.23 $30,495.67 $19,666.20 2025-10-31
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 12 8 — — $15,456.60 $30,453.05 $19,638.71 2025-10-31
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