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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

INTEGRIS CANADIAN VALLEY HOSPITAL

Yukon, OK · CCN 370211 · Rates published

16,397 distinct procedures filed
33 distinct payers
164,084 rate rows
2026-04-01 last MRF observed
Data quality

122,465 of 164,084 rate rows are consumer-grade (74.6%)

41,619 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 40,903
template filing: same amount across many unrelated codes — excluded 685
placeholder amount (≤ $0.02) — excluded from medians 31
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/Download.aspx?pxi=PnMmi0OJplyABzmiE7PkYQ*-*&f=1Uqk9sV2mcxtBmvoqWiwog*-*
Found on page https://hospitalpricedisclosure.com/default.aspx?ci=fFJE38ye7xsB8Of*_*qxAfVQ*-*
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint cc3b171d24bab4b8… · 48,123,554 bytes · first seen 2026-05-08

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 4 $79.40 $4,640,150.00 $4,550,050.00 nat. median
$4,505,000
1.0× median
H2000
HCPCS 		Comp Multidisipln Evaluation 1 $4,165,959.00 $4,165,959.00 $4,165,959.00 nat. median
$173
outlier · 24108.6×
H2010
HCPCS 		Comprehensive Medication Services, Per 15 Minutes 1 $3,807,119.13 $3,807,119.13 $3,807,119.13 nat. median
$32
outlier · 118601.8×
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $13.04 $3,795,824.67 $3,722,119.33 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,408,903.61 $3,408,903.61 $3,408,903.61 nat. median
$3,710,000
0.9× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,334.25 $3,415,956.47 $3,349,627.21 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $89.91 $3,345,899.09 $3,280,930.17 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $42.45 $4,864,551.99 $3,019,383.50 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $38.88 $3,998,166.53 $2,516,488.37 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $141.40 $3,847,800.00 $2,390,300.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 3 $770,620.00 $1,271,523.00 $793,738.60 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $1,284.99 $954,972.35 $606,519.36 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $565,868.94 $912,729.35 $582,845.01 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $562,538.19 $852,129.78 $579,414.33 nat. median
$674,188
0.9× median
M1107
HCPCS 		Docu Dx Degen Neuro 1 $578,544.93 $578,544.93 $578,544.93 nat. median
$260
outlier · 2222.4×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $557,317.93 $870,577.06 $574,037.47 nat. median
$625,184
0.9× median
M1106
HCPCS 		Start Eoc Doc Med Rec 1 $552,546.94 $552,546.94 $552,546.94 nat. median
$260
outlier · 2122.5×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $533,230.17 $829,687.20 $549,227.08 nat. median
$634,511
0.9× median
M1070
HCPCS 		Pt Not Scrn Fut Fall No Rsn 1 $540,429.11 $540,429.11 $540,429.11 nat. median
$260
outlier · 2075.9×
M1058
HCPCS 		Pt Prm Nurs Hm Res In Pp 1 $523,694.85 $523,694.85 $523,694.85 nat. median
$260
outlier · 2011.7×
M1069
HCPCS 		Pt Scr Ft Fall Rsk 1 $512,361.60 $512,361.60 $512,361.60 nat. median
$260
outlier · 1968.1×
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $489,304.61 $807,508.61 $503,983.75 nat. median
$620,080
0.8× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $459,112.50 $459,112.50 $459,112.50 nat. median
$459,112
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 $300,544.32 $1,018,662.39 $376,110.77 nat. median
$370,174
1.0× median
J3403
HCPCS 		Revakinagene, Per Implant 4 $61.30 $265,225.00 $260,075.00 nat. median
$265,000
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $195,389.97 $661,070.91 $248,901.32 nat. median
$265,286
0.9× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 4 $422.01 $211,809.20 $207,696.40 nat. median
$209,753
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $146,860.41 $500,692.70 $181,182.11 nat. median
$202,986
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $149,097.89 $503,648.47 $179,515.01 nat. median
$206,368
0.9× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $490.71 $130,327.56 $130,327.56 nat. median
$76,377
1.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 $1,225.00 $326,748.15 $113,581.48 nat. median
$133,176
0.9× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $84,359.46 $283,496.73 $109,911.68 nat. median
$117,303
0.9× median
7
MS_DRG 		Lung Transplant 12 $90,826.64 $305,489.26 $108,494.62 nat. median
$122,708
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $79,600.12 $267,311.95 $103,673.72 nat. median
$108,660
1.0× median
209
MS_DRG 		Complex Aortic Arch Procedures 12 $79,509.94 $267,005.29 $103,555.52 nat. median
$98,017
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $77,445.54 $259,985.04 $100,546.46 nat. median
$98,905
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $76,425.14 $256,515.02 $99,512.34 nat. median
$102,358
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 12 $72,515.56 $243,219.95 $94,388.13 nat. median
$100,136
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 12 $70,063.39 $234,881.05 $91,174.14 nat. median
$99,019
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $68,855.00 $230,771.75 $89,590.32 nat. median
$93,672
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 $63,491.47 $212,532.32 $81,218.05 nat. median
$82,712
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 12 $61,062.89 $204,273.62 $79,377.37 nat. median
$83,442
1.0× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 12 $59,470.20 $198,857.46 $77,289.86 nat. median
$79,312
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $59,286.37 $198,232.34 $77,048.92 nat. median
$81,118
0.9× median
A5083
HCPCS 		Stoma Absorptive Cover 1 $74,643.30 $74,643.30 $74,643.30 nat. median
$1
A9699
HCPCS 		Radiopharm Rx Agent Noc 2 $1,373.18 $74,614.73 $74,614.73 nat. median
$21,806
outlier · 3.4×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 $55,577.96 $185,621.37 $72,188.39 nat. median
$77,576
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 $54,256.50 $181,127.56 $70,456.38 nat. median
$74,915
0.9× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 12 $54,026.89 $180,346.75 $70,155.43 nat. median
$73,807
1.0× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 $28,912.71 $179,749.94 $69,844.00 nat. median
$72,138
1.0× median

Other procedures at this hospital

Browse this hospital's 16,397 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
             
0266T HCPCS Implt/rpl Crtd Sns Dev Total 6 3 — — $11,888.00 $76,500.85 $23,295.15 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 6 3 — — $11,888.00 $51,805.10 $23,295.15 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 9 4 — — $8,396.00 $41,207.16 $30,188.86 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 9 4 — — $8,396.00 $41,207.16 $21,393.20 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 9 4 — — $8,396.00 $41,207.16 $21,393.20 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 9 4 — — $8,396.00 $41,207.16 $30,188.86 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 9 4 — — $7,519.00 $41,207.16 $21,393.20 2026-04-01
0896T HCPCS Connj Lvr Algrft Prfu Dev Ea 1 1 — — $31,961.30 $31,961.30 $31,961.30 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 9 4 — — $8,396.00 $41,207.16 $30,188.86 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 9 4 — — $5,610.00 $41,207.16 $21,393.20 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 9 4 — — $5,610.00 $41,207.16 $21,393.20 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 9 4 — — $5,270.00 $32,706.80 $26,096.68 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 26 12 — — $195,389.97 $661,070.91 $248,901.32 2026-04-01
10 MS_DRG Pancreas Transplant 26 12 — — $38,601.00 $169,271.46 $52,039.31 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 26 12 — — $38,827.65 $128,659.71 $48,558.63 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 26 12 — — $30,239.19 $99,453.50 $36,104.70 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 26 12 — — $20,984.11 $67,980.34 $24,680.40 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 26 12 — — $84,359.46 $283,496.73 $109,911.68 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 26 12 — — $30,581.18 $100,616.46 $38,614.94 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 26 12 — — $26,983.06 $88,380.57 $31,501.42 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 26 12 — — $42,126.80 $139,878.90 $54,558.24 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 26 12 — — $32,083.00 $105,723.60 $41,394.04 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 26 12 — — $18,502.12 $59,540.00 $23,593.87 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 27 12 — — $26,921.32 $88,170.62 $33,980.26 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 26 12 — — $38,676.43 $128,145.46 $46,458.93 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 26 12 — — $21,640.33 $70,211.91 $27,707.06 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 26 12 — — $300,544.32 $1,018,662.39 $376,110.77 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 26 12 — — $50,484.95 $168,301.93 $64,608.37 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 26 12 — — $79,600.12 $267,311.95 $103,673.72 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 26 12 — — $55,577.96 $185,621.37 $72,188.39 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 29 12 — — $37,667.05 $151,791.61 $52,764.54 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 31 12 — — $4,256.08 $64,840.57 $22,683.52 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 26 12 — — $79,509.94 $267,005.29 $103,555.52 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 26 12 — — $37,715.68 $124,878.31 $48,776.68 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 12 — — $76,425.14 $256,515.02 $99,512.34 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 26 12 — — $40,581.28 $134,623.15 $52,532.56 2026-04-01
215 MS_DRG Other Heart Assist System Implant 26 12 — — $70,063.39 $234,881.05 $91,174.14 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 12 — — $68,855.00 $230,771.75 $89,590.32 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 12 — — $46,605.20 $155,108.30 $60,229.69 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 12 — — $46,605.20 $155,108.30 $57,269.32 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 12 — — $54,256.50 $181,127.56 $70,456.38 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 26 12 — — $23,034.63 $87,523.08 $29,534.53 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 12 — — $37,986.22 $125,798.30 $49,062.26 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 12 — — $35,956.51 $118,896.00 $45,055.64 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 26 12 — — $35,312.77 $116,706.89 $45,627.24 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 26 12 — — $22,841.09 $74,295.26 $29,280.87 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 12 — — $40,743.60 $135,175.14 $52,582.54 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 26 12 — — $59,470.20 $198,857.46 $77,289.86 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 26 12 — — $43,048.70 $143,013.95 $55,760.41 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 26 12 — — $54,026.89 $180,346.75 $70,155.43 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 26 12 — — $38,887.31 $128,862.58 $49,256.67 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 26 12 — — $41,702.96 $138,437.57 $54,002.72 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 26 12 — — $30,050.51 $98,811.87 $37,800.67 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 26 12 — — $35,134.50 $116,100.64 $44,808.57 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 26 12 — — $28,129.71 $92,279.92 $36,212.55 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 28 13 — — $1,860.00 $67,241.98 $25,054.40 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 26 12 — — $23,141.45 $75,316.68 $29,674.54 2026-04-01
245 MS_DRG Aicd Generator Procedures 26 12 — — $32,642.10 $107,624.92 $42,126.85 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 26 12 — — $32,533.19 $107,254.56 $41,465.18 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 26 12 — — $25,191.28 $82,287.39 $31,474.86 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 26 12 — — $18,998.79 $61,229.01 $24,038.28 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 26 12 — — $19,704.96 $63,630.43 $24,410.47 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 26 12 — — $22,789.76 $74,120.69 $29,160.15 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 26 12 — — $22,561.54 $73,344.60 $28,605.58 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 26 12 — — $23,557.66 $76,732.06 $30,220.06 2026-04-01
263 MS_DRG Vein Ligation And Stripping 26 12 — — $22,202.21 $72,122.66 $25,706.62 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 27 12 — — $24,166.71 $78,803.22 $30,619.94 2026-04-01
265 MS_DRG Aicd Lead Procedures 26 12 — — $26,092.37 $85,351.67 $32,570.27 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 26 12 — — $43,505.14 $144,566.14 $56,364.79 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 26 12 — — $34,018.36 $112,305.08 $43,930.68 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 12 — — $48,704.28 $162,246.50 $62,784.79 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 26 12 — — $30,289.14 $99,623.35 $39,042.86 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 26 12 — — $18,494.49 $59,514.05 $22,897.99 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 26 12 — — $37,594.29 $124,465.49 $47,849.15 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 26 12 — — $25,662.98 $83,891.48 $32,505.97 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 26 12 — — $18,703.29 $60,224.10 $23,454.10 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 26 12 — — $29,611.41 $97,318.65 $35,997.43 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 26 12 — — $23,827.50 $77,649.69 $28,277.34 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 26 12 — — $50,455.82 $168,202.86 $65,474.91 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 26 12 — — $42,660.24 $141,692.93 $55,257.40 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 26 12 — — $33,031.26 $108,948.29 $42,636.90 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 12 — — $39,605.27 $131,304.10 $46,800.61 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 12 — — $26,010.52 $85,073.32 $31,833.83 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 26 12 — — $42,672.03 $141,733.03 $54,161.74 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 26 12 — — $19,766.00 $63,838.01 $25,250.42 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 26 12 — — $24,659.23 $80,478.07 $31,316.39 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 12 — — $146,860.41 $500,692.70 $181,182.11 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 26 12 — — $32,073.98 $105,692.93 $40,049.55 2026-04-01
3141F HCPCS Upper Gi Endo Not Barrtts 1 1 — — $34,595.10 $34,595.10 $34,595.10 2026-04-01
3150F HCPCS Forceps Esoph Biopsy Done 1 1 — — $22,015.49 $22,015.49 $22,015.49 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 26 12 — — $47,376.57 $157,731.46 $60,275.17 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 26 12 — — $17,795.95 $57,138.58 $22,668.32 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 26 12 — — $31,951.89 $105,277.76 $40,095.82 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 26 12 — — $17,678.72 $56,739.92 $22,268.97 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 26 12 — — $19,867.28 $64,182.42 $25,383.15 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 26 12 — — $31,011.95 $102,081.38 $39,663.07 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 26 12 — — $22,851.49 $74,330.64 $28,660.63 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 26 12 — — $23,263.54 $75,731.86 $27,295.18 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 28 12 — — $24,050.59 $117,650.47 $43,269.68 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 34 13 — — $12,853.43 $225,862.45 $40,867.48 2026-04-01
332 MS_DRG Rectal Resection With Mcc 26 12 — — $26,109.71 $85,410.65 $33,564.98 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 10 5 — — $5,610.00 $43,633.45 $24,481.63 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 30 12 — — $14,309.30 $84,235.89 $31,748.87 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 26 12 — — $27,843.91 $91,308.03 $35,837.96 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 26 12 — — $18,910.00 $60,927.06 $24,128.47 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 26 12 — — $16,917.75 $54,152.15 $21,517.28 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 26 12 — — $17,576.05 $56,390.80 $21,626.82 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 26 12 — — $18,279.45 $58,782.77 $23,207.13 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 26 12 — — $21,124.23 $68,456.85 $27,030.61 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 28 12 — — $29,974.63 $103,624.13 $37,155.40 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 26 12 — — $24,846.52 $81,114.99 $31,909.35 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 26 12 — — $17,741.15 $56,952.23 $22,596.49 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 26 12 — — $23,830.28 $77,659.12 $30,266.72 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 27 12 — — $1,225.00 $326,748.15 $113,581.48 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 26 12 — — $27,778.01 $91,083.93 $35,751.59 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 26 12 — — $28,883.05 $94,841.75 $37,199.93 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 26 12 — — $38,941.42 $129,046.58 $50,383.22 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 26 12 — — $21,111.74 $68,414.38 $26,683.49 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 26 12 — — $25,727.49 $84,110.86 $33,064.01 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 26 12 — — $23,907.97 $77,923.33 $30,679.21 2026-04-01
4120F HCPCS Antibiot Rxd/given 1 1 — — $21,261.47 $21,261.47 $21,261.47 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 26 12 — — $25,706.68 $84,040.10 $33,036.74 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 26 12 — — $24,628.01 $80,371.92 $31,622.94 2026-04-01
4210F HCPCS Ace/arb Thxpy For Mos/> 1 1 — — $27,069.16 $27,069.16 $27,069.16 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 26 12 — — $29,802.17 $97,967.36 $37,172.93 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 12 — — $77,445.54 $259,985.04 $100,546.46 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 12 — — $51,067.65 $170,283.45 $66,276.82 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 12 — — $39,992.34 $132,620.39 $51,760.65 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 26 12 — — $63,491.47 $212,532.32 $81,218.05 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 26 12 — — $40,998.87 $136,043.24 $52,632.40 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 26 12 — — $47,342.58 $157,615.87 $61,394.45 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 26 12 — — $30,411.23 $100,038.52 $38,994.11 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 26 12 — — $37,964.02 $125,722.81 $49,092.62 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 26 12 — — $23,402.28 $76,203.65 $29,585.90 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 12 — — $59,286.37 $198,232.34 $77,048.92 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 12 — — $42,358.49 $140,666.79 $54,861.90 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 12 — — $29,938.14 $98,429.71 $38,582.82 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 26 12 — — $39,305.60 $130,285.03 $48,705.69 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 26 12 — — $19,445.52 $62,748.18 $24,830.37 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 13 — — $7,652.05 $134,448.58 $49,106.89 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 31 12 — — $12,467.04 $100,011.92 $27,243.60 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 27 12 — — $18,876.85 $122,792.99 $47,712.70 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 28 12 — — $10,351.83 $83,190.87 $31,355.00 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 27 12 — — $2,545.64 $64,824.06 $25,188.17 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 27 12 — — $22,034.34 $71,551.79 $27,802.31 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 26 12 — — $34,489.37 $113,906.81 $44,548.02 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 26 12 — — $21,430.14 $69,497.14 $27,169.76 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 26 12 — — $17,928.44 $57,589.14 $22,165.24 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 26 12 — — $30,772.63 $101,267.54 $38,174.17 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 26 12 — — $24,957.51 $81,492.42 $31,319.46 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 27 12 — — $11,198.78 $58,011.40 $21,445.79 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 28 12 — — $12,612.36 $68,699.82 $25,893.26 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 27 12 — — $18,262.69 $65,387.85 $23,882.69 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 26 12 — — $23,379.39 $76,125.80 $29,986.40 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 26 12 — — $26,462.80 $86,611.36 $32,624.93 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 26 12 — — $18,586.05 $59,825.43 $22,146.25 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 26 12 — — $26,144.40 $85,528.60 $30,957.13 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 26 12 — — $21,920.58 $71,164.92 $25,365.25 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 26 12 — — $72,515.56 $243,219.95 $94,388.13 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 26 12 — — $22,947.22 $74,656.18 $28,678.85 2026-04-01
503 MS_DRG Foot Procedures With Mcc 26 12 — — $20,354.94 $65,840.77 $24,690.41 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 27 12 — — $19,982.35 $71,252.21 $25,336.77 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 5 3 — — $16,165.72 $45,692.38 $32,307.67 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 26 12 — — $23,100.53 $75,177.51 $28,589.97 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 26 12 — — $26,918.54 $88,161.19 $31,423.22 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 28 12 — — $20,752.08 $67,706.70 $25,518.94 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 26 12 — — $18,208.69 $58,542.16 $22,694.31 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 7 4 — — $28,412.25 $69,885.74 $28,982.50 2026-04-01
570 MS_DRG Skin Debridement With Mcc 27 12 — — $7,260.39 $69,379.20 $25,340.52 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 26 12 — — $38,928.33 $154,544.51 $50,777.04 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 26 12 — — $25,074.05 $81,888.73 $30,024.06 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 26 12 — — $34,992.29 $115,617.05 $44,174.79 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 26 12 — — $19,381.01 $62,528.79 $23,847.74 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 26 12 — — $23,458.47 $76,394.73 $27,499.24 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 26 12 — — $33,159.59 $109,384.70 $42,805.10 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 26 12 — — $20,119.09 $65,038.72 $25,713.20 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 27 12 — — $25,185.04 $89,858.44 $32,740.55 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 26 12 — — $21,022.95 $68,112.44 $26,897.88 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 27 12 — — $25,683.10 $83,959.89 $33,388.03 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 26 12 — — $21,943.47 $71,242.77 $26,699.42 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 27 12 — — $20,115.64 $87,913.50 $34,159.85 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 10 5 — — $32.25 $43,633.45 $23,024.94 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 4 3 — — $8,126.00 $43,633.45 $42,786.19 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 3 — — $6,521.00 $30,568.34 $29,974.78 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 26 12 — — $33,606.32 $110,903.86 $43,164.26 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 26 12 — — $26,700.03 $87,418.12 $34,338.70 2026-04-01
652 MS_DRG Kidney Transplant 26 12 — — $23,396.03 $76,182.42 $30,008.22 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 26 12 — — $37,040.04 $122,580.69 $47,891.12 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 26 12 — — $20,411.82 $66,034.20 $26,096.88 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 26 12 — — $23,079.02 $75,104.38 $29,592.72 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 28 12 — — $10,369.28 $59,938.66 $23,747.53 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 26 12 — — $22,230.65 $72,219.38 $28,480.78 2026-04-01
665 MS_DRG Prostatectomy With Mcc 26 12 — — $22,644.78 $73,627.67 $29,023.56 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 26 12 — — $21,249.09 $68,881.46 $26,004.01 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 26 12 — — $30,139.30 $99,113.81 $36,045.72 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 26 12 — — $17,216.03 $55,166.50 $21,813.84 2026-04-01
7 MS_DRG Lung Transplant 26 12 — — $90,826.64 $305,489.26 $108,494.62 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 26 12 — — $17,136.26 $54,895.22 $21,609.77 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 26 12 — — $25,789.23 $84,320.81 $33,144.93 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 26 12 — — $25,846.81 $84,516.60 $33,220.40 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 26 12 — — $18,804.56 $60,568.50 $23,990.28 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 26 12 — — $42,222.53 $140,204.43 $53,163.02 2026-04-01
791 MS_DRG Prematurity With Major Problems 27 12 — — $15,730.83 $95,749.94 $35,410.55 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 28 13 — — $15,730.83 $98,358.95 $36,149.79 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 27 13 — — $23,774.30 $106,834.67 $41,511.90 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 26 12 — — $39,871.64 $132,209.94 $49,932.86 2026-04-01
800 MS_DRG Splenic Procedures With Cc 26 12 — — $20,481.88 $66,272.45 $25,745.73 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 26 12 — — $28,630.55 $93,983.09 $33,732.37 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 26 12 — — $41,676.60 $138,347.93 $52,828.68 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 26 12 — — $32,797.49 $108,153.32 $41,669.49 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 26 12 — — $33,442.61 $110,347.15 $43,176.05 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 26 12 — — $17,025.97 $54,520.14 $21,659.11 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 26 12 — — $22,913.93 $74,542.95 $29,376.33 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 26 12 — — $39,075.99 $129,504.22 $50,559.60 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 26 12 — — $34,320.12 $113,331.23 $44,326.18 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 26 12 — — $23,433.49 $76,309.80 $29,575.39 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 26 12 — — $18,977.29 $61,155.88 $23,283.54 2026-04-01
849 MS_DRG Radiotherapy 26 12 — — $17,243.04 $63,915.86 $21,300.24 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 26 12 — — $61,062.89 $204,273.62 $79,377.37 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 35 13 — — $5,548.58 $116,499.30 $40,496.52 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 26 12 — — $32,547.07 $107,301.74 $42,002.29 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 33 12 — — $1,350.72 $163,046.18 $59,552.07 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 26 12 — — $27,803.68 $91,171.21 $34,522.86 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 26 12 — — $30,104.62 $98,995.86 $38,801.03 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 26 12 — — $26,473.20 $86,646.74 $32,377.30 2026-04-01
90695 HCPCS H5n8 Vacc Drv Cll Cul Adj IM 1 1 — — $49,500.90 $49,500.90 $49,500.90 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 26 12 — — $27,626.10 $90,567.32 $35,552.47 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 26 12 — — $149,097.89 $503,648.47 $179,515.01 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 26 12 — — $50,749.25 $169,200.69 $60,308.06 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 26 12 — — $23,335.68 $75,977.19 $27,291.60 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 26 12 — — $28,006.93 $91,862.39 $33,354.24 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 9 4 — — $8,396.00 $25,892.76 $24,508.10 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 9 4 — — $8,396.00 $25,892.76 $24,508.10 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 9 4 — — $8,396.00 $25,892.76 $24,508.10 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 26 12 — — $26,163.82 $85,594.65 $33,308.68 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 26 12 — — $25,407.01 $83,021.03 $32,478.16 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 26 12 — — $17,204.24 $55,126.40 $21,892.77 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 26 12 — — $18,885.03 $60,842.14 $23,083.68 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 26 12 — — $47,685.95 $158,783.55 $59,703.36 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 26 12 — — $27,096.82 $88,767.44 $34,858.76 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 27 12 — — $28,912.71 $179,749.94 $69,844.00 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 27 12 — — $28,359.76 $99,403.96 $38,624.61 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 26 12 — — $21,416.27 $69,449.96 $26,399.94 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 26 12 — — $18,885.03 $60,842.14 $22,406.27 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 26 12 — — $19,957.46 $64,489.08 $25,359.02 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 26 12 — — $43,455.89 $144,398.65 $54,091.41 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 26 12 — — $26,047.98 $85,200.70 $32,858.52 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 26 12 — — $19,288.75 $62,215.05 $24,394.63 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 26 12 — — $21,013.24 $68,079.41 $26,510.65 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 26 12 — — $33,539.73 $110,677.40 $42,146.46 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 27 12 — — $18,047.76 $57,994.88 $22,534.61 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 26 12 — — $24,775.76 $80,874.38 $31,213.75 2026-04-01
A5083 HCPCS Stoma Absorptive Cover 1 1 — — $74,643.30 $74,643.30 $74,643.30 2026-04-01
A7523 HCPCS Tracheostomy Shower Protect 1 1 — — $30,918.62 $30,918.62 $30,918.62 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 3 — — $56,824.55 $93,760.51 $58,529.29 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 3 2 — — $1,373.18 $74,614.73 $74,614.73 2026-04-01
B4164 HCPCS Parenteral 50% Dextrose Solu 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
B4178 HCPCS Parenteral Sol Amino Acid > 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
B5200 HCPCS Parenteral Sol Hepatic Fream 1 1 — — $31,500.90 $31,500.90 $31,500.90 2026-04-01
C1714 HCPCS Cath, Trans Atherectomy, Dir 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1715 HCPCS Brachytherapy Needle 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1722 HCPCS Aicd, Single Chamber 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1724 HCPCS Cath, Trans Atherec,rotation 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C1725 HCPCS Cath, Translumin Non-laser 1 1 — — $30,073.16 $30,073.16 $30,073.16 2026-04-01
C9301 HCPCS Obecabtagene Car Pos T 2 1 — — $459,112.50 $459,112.50 $459,112.50 2026-04-01
H2000 HCPCS Comp Multidisipln Evaluation 1 1 — — $4,165,959.00 $4,165,959.00 $4,165,959.00 2026-04-01
H2010 HCPCS Comprehensive Medication Services, Per 15 Minutes 1 1 — — $3,807,119.13 $3,807,119.13 $3,807,119.13 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 4 — — $13.04 $3,795,824.67 $3,722,119.33 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 4 — — $3,334.25 $3,415,956.47 $3,349,627.21 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $3,408,903.61 $3,408,903.61 $3,408,903.61 2026-04-01
J3265 HCPCS Injection Torsemide 10 Mg/ml 1 1 — — $29,390.86 $29,390.86 $29,390.86 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 4 4 — — $79.40 $4,640,150.00 $4,550,050.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 6 4 — — $141.40 $3,847,800.00 $2,390,300.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 6 4 — — $42.45 $4,864,551.99 $3,019,383.50 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $89.91 $3,345,899.09 $3,280,930.17 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 4 — — $38.88 $3,998,166.53 $2,516,488.37 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 4 — — $422.01 $211,809.20 $207,696.40 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 4 4 — — $61.30 $265,225.00 $260,075.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $490.71 $130,327.56 $130,327.56 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 6 4 — — $938.10 $104,338.76 $64,925.84 2026-04-01
J9226 HCPCS Supprelin La Implant 6 4 — — $1,296.38 $74,599.87 $46,146.16 2026-04-01
J9266 HCPCS Pegaspargase Injection 6 4 — — $144.18 $44,666.37 $29,134.66 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 5 3 — — $24,228.42 $39,976.89 $24,955.27 2026-04-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 4 4 — — $843.93 $40,711.39 $39,920.88 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 4 4 — — $0.62 $36,019.23 $35,319.83 2026-04-01
M1005 HCPCS TB Scr No Perf 1 1 — — $28,897.68 $28,897.68 $28,897.68 2026-04-01
M1058 HCPCS Pt Prm Nurs Hm Res In Pp 1 1 — — $523,694.85 $523,694.85 $523,694.85 2026-04-01
M1060 HCPCS Pt Died In Pp 1 1 — — $63,217.07 $63,217.07 $63,217.07 2026-04-01
M1069 HCPCS Pt Scr Ft Fall Rsk 1 1 — — $512,361.60 $512,361.60 $512,361.60 2026-04-01
M1070 HCPCS Pt Not Scrn Fut Fall No Rsn 1 1 — — $540,429.11 $540,429.11 $540,429.11 2026-04-01
M1106 HCPCS Start Eoc Doc Med Rec 1 1 — — $552,546.94 $552,546.94 $552,546.94 2026-04-01
M1107 HCPCS Docu Dx Degen Neuro 1 1 — — $578,544.93 $578,544.93 $578,544.93 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 5 3 — — $533,230.17 $829,687.20 $549,227.08 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 4 — — $1,284.99 $954,972.35 $606,519.36 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 6 4 — — $1,732.50 $94,078.22 $56,654.13 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 5 3 — — $489,304.61 $807,508.61 $503,983.75 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 5 3 — — $562,538.19 $852,129.78 $579,414.33 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 5 3 — — $557,317.93 $870,577.06 $574,037.47 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 5 3 — — $565,868.94 $912,729.35 $582,845.01 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 5 3 — — $770,620.00 $1,271,523.00 $793,738.60 2026-04-01
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