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

LEGACY GOOD SAMARITAN MEDICAL CENTER

Portland, OR · CCN 380017 · Rates published

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You selected 93306 (HCPCS)

Tte w/doppler complete

This hospital’s price: $674 across 11 payers · range $607-$2,349

Source: https://www.legacyhealth.org/-/media/Files/JSON/930386793_legacy-good-samaritan-medical-center_IP-REHAB_standardcharges.json · observed 2026-04-01

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.

14,261 distinct procedures filed
31 distinct payers
472,753 rate rows
2026-04-01 last MRF observed
Data quality

366,753 of 472,753 rate rows are consumer-grade (77.6%)

106,000 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 84,636
professional (physician) fee — not the facility price 17,039
template filing: same amount across many unrelated codes — excluded 2,417
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,778
placeholder amount (≤ $0.02) — excluded from medians 92
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 38
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.legacyhealth.org/-/media/Files/JSON/930386793_legacy-good-samaritan-medical-center_standardcharges.json
Found on page https://www.legacyhealth.org/Patients-and-Visitors/paying-for-your-care/estimate-hospital-costs
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-22
Content fingerprint f8b1ff03f4e25fe3… · 63,458,812 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 9 $3,685,266.67 $4,134,424.00 $3,909,659.83 nat. median
$3,705,478
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 9 $3,316,462.59 $3,719,941.54 $3,518,054.65 nat. median
$3,324,572
1.1× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 9 $3,245,381.39 $3,638,259.20 $3,441,728.37 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 9 $2,938,320.00 $3,299,228.80 $3,118,551.80 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 9 $2,455,110.60 $4,910,221.21 $2,700,621.67 nat. median
$2,467,386
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 9 $2,332,000.00 $4,664,000.00 $2,495,240.00 nat. median
$2,401,965
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 13 $770,620.00 $2,980,372.85 $855,388.20 nat. median
$813,967
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 13 $591,726.20 $2,375,344.27 $669,457.08 nat. median
$739,258
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 13 $565,868.94 $2,276,003.67 $641,459.34 nat. median
$646,415
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 13 $562,260.84 $2,175,616.43 $624,262.07 nat. median
$640,950
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 13 $557,317.93 $2,164,953.33 $619,977.64 nat. median
$622,450
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 13 $531,849.12 $2,062,267.69 $591,112.10 nat. median
$608,239
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 13 $489,290.60 $1,892,385.57 $543,120.27 nat. median
$591,721
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 23 $402,924.61 $1,187,527.00 $447,246.32 nat. median
$359,454
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 23 $261,965.46 $770,657.25 $290,781.67 nat. median
$249,036
1.2× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 11 $202,713.58 $795,312.70 $226,621.60 nat. median
$209,753
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 $199,911.04 $587,732.37 $221,901.25 nat. median
$198,418
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 23 $101,694.36 $583,693.00 $218,620.49 nat. median
$190,559
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 2 $177,719.40 $177,719.40 $177,719.40 nat. median
$75,000
outlier · 2.4×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 23 $16,298.12 $398,959.57 $146,427.27 nat. median
$126,695
1.2× median
7
MS_DRG 		Lung Transplant 23 $121,798.56 $356,130.50 $135,196.41 nat. median
$117,974
1.1× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 23 $113,129.32 $330,492.25 $125,573.54 nat. median
$110,307
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 23 $106,749.43 $311,624.50 $118,491.86 nat. median
$104,013
1.1× median
209
MS_DRG 		Complex Aortic Arch Procedures 22 $106,628.55 $311,267.00 $117,291.41 nat. median
$92,678
1.3× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 $103,861.23 $303,083.00 $115,285.96 nat. median
$93,276
1.2× median
0424T
OTHER 		Insj/rplc Nstim Apnea Compl 2 $82,074.08 $120,301.16 $114,887.99 nat. median
$22,425
outlier · 5.1×
0427T
OTHER 		Insj/rplc Nstim Apnea Pls Gn 2 $82,074.08 $120,301.16 $114,887.99 nat. median
$22,408
outlier · 5.1×
0431T
OTHER 		Rmvl/rplc Nstim Apnea Pls Gn 2 $82,074.08 $120,301.16 $114,887.99 nat. median
$22,408
outlier · 5.1×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 23 $102,493.38 $299,037.75 $113,767.65 nat. median
$97,323
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 23 $97,252.60 $283,538.75 $107,950.39 nat. median
$95,038
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 23 $87,041.92 $269,027.00 $103,427.11 nat. median
$90,551
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 23 $41.24 $273,817.50 $103,362.03 nat. median
$93,901
1.1× median
0312T
OTHER 		Laps Impltj Nstim Vagus 3 $7,920.26 $120,301.16 $98,481.04 nat. median
$17,924
outlier · 5.5×
0316T
OTHER 		Replc Vagus Nerve Pls Gen 3 $7,920.26 $120,301.16 $98,481.04 nat. median
$14,923
outlier · 6.6×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 23 $85,155.82 $247,764.00 $94,522.96 nat. median
$78,049
1.2× median
850
MS_DRG 		Acute Leukemia With Other Procedures 23 $42,526.09 $238,136.25 $90,090.35 nat. median
$78,268
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 23 $79,518.91 $231,093.50 $88,265.99 nat. median
$77,632
1.1× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 26 $13,301.83 $231,822.25 $87,741.86 nat. median
$77,028
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 23 $74,547.78 $216,392.00 $82,748.04 nat. median
$74,370
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 23 $72,468.58 $210,243.00 $80,440.12 nat. median
$71,748
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 23 $72,233.32 $209,547.25 $80,178.99 nat. median
$67,976
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 23 $71,288.79 $211,153.25 $80,054.01 nat. median
$72,398
1.1× median
0426T
OTHER 		Insj/rplc Nstim Apnea Stm Ld 2 $54,340.97 $79,651.00 $76,066.95 nat. median
$13,386
outlier · 5.7×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 $68,501.72 $198,511.50 $76,036.91 nat. median
$63,648
1.2× median
10
MS_DRG 		Pancreas Transplant 23 $68,102.81 $197,521.17 $75,594.12 nat. median
$64,933
1.2× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 23 $68,074.91 $197,249.25 $75,563.15 nat. median
$61,308
1.2× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 23 $67,720.63 $196,383.99 $75,169.90 nat. median
$66,715
1.1× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 23 $67,681.57 $196,086.00 $75,126.54 nat. median
$66,649
1.1× median
0775T
OTHER 		Arthrd Si Jt Prq Iartic Impl 3 $7,920.26 $90,467.87 $74,058.88 nat. median
$7,510
outlier · 9.9×
0809T
OTHER 		Arthrd Si Jt Prq Tfx&implt 3 $7,920.26 $90,467.87 $74,058.88 nat. median
$4,772
outlier · 15.5×

Other procedures at this hospital

Browse this hospital's 14,261 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 14 9 — — $3,685,266.67 $4,134,424.00 $3,909,659.83 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 14 9 — — $3,316,462.59 $3,719,941.54 $3,518,054.65 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 14 9 — — $3,245,381.39 $3,638,259.20 $3,441,728.37 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 14 9 — — $2,938,320.00 $3,299,228.80 $3,118,551.80 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 15 9 — — $2,455,110.60 $4,910,221.21 $2,700,621.67 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 16 9 — — $2,332,000.00 $4,664,000.00 $2,495,240.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 24 13 — — $770,620.00 $2,980,372.85 $855,388.20 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 24 13 — — $591,726.20 $2,375,344.27 $669,457.08 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 24 13 — — $565,868.94 $2,276,003.67 $641,459.34 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 24 13 — — $562,260.84 $2,175,616.43 $624,262.07 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 24 13 — — $557,317.93 $2,164,953.33 $619,977.64 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 24 13 — — $531,849.12 $2,062,267.69 $591,112.10 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 24 13 — — $489,290.60 $1,892,385.57 $543,120.27 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 56 23 — — $402,924.61 $1,187,527.00 $447,246.32 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 56 23 — — $261,965.46 $770,657.25 $290,781.67 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 24 11 — — $202,713.58 $795,312.70 $226,621.60 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 56 23 — — $199,911.04 $587,732.37 $221,901.25 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 64 23 — — $101,694.36 $583,693.00 $218,620.49 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $177,719.40 $177,719.40 $177,719.40 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 68 23 — — $16,298.12 $398,959.57 $146,427.27 2026-04-01
7 MS_DRG Lung Transplant 56 23 — — $121,798.56 $356,130.50 $135,196.41 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 56 23 — — $113,129.32 $330,492.25 $125,573.54 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 56 23 — — $106,749.43 $311,624.50 $118,491.86 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 46 22 — — $106,628.55 $311,267.00 $117,291.41 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 23 — — $103,861.23 $303,083.00 $115,285.96 2026-04-01
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 6 2 — — $82,074.08 $120,301.16 $114,887.99 2026-04-01
0424T OTHER Insj/rplc Nstim Apnea Compl 6 2 — — $82,074.08 $120,301.16 $114,887.99 2026-04-01
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 6 2 — — $82,074.08 $120,301.16 $114,887.99 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 56 23 — — $102,493.38 $299,037.75 $113,767.65 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 56 23 — — $97,252.60 $283,538.75 $107,950.39 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 62 23 — — $87,041.92 $269,027.00 $103,427.11 2026-04-01
215 MS_DRG Other Heart Assist System Implant 64 23 — — $41.24 $273,817.50 $103,362.03 2026-04-01
0312T OTHER Laps Impltj Nstim Vagus 8 3 — — $7,920.26 $120,301.16 $98,481.04 2026-04-01
0316T OTHER Replc Vagus Nerve Pls Gen 8 3 — — $7,920.26 $120,301.16 $98,481.04 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 56 23 — — $85,155.82 $247,764.00 $94,522.96 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 58 23 — — $42,526.09 $238,136.25 $90,090.35 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 23 — — $79,518.91 $231,093.50 $88,265.99 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 62 26 — — $13,301.83 $231,822.25 $87,741.86 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 56 23 — — $74,547.78 $216,392.00 $82,748.04 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 56 23 — — $72,468.58 $210,243.00 $80,440.12 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 56 23 — — $72,233.32 $209,547.25 $80,178.99 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 58 23 — — $71,288.79 $211,153.25 $80,054.01 2026-04-01
0426T OTHER Insj/rplc Nstim Apnea Stm Ld 6 2 — — $54,340.97 $79,651.00 $76,066.95 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 23 — — $68,501.72 $198,511.50 $76,036.91 2026-04-01
10 MS_DRG Pancreas Transplant 56 23 — — $68,102.81 $197,521.17 $75,594.12 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 56 23 — — $68,074.91 $197,249.25 $75,563.15 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 56 23 — — $67,720.63 $196,383.99 $75,169.90 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 56 23 — — $67,681.57 $196,086.00 $75,126.54 2026-04-01
0775T OTHER Arthrd Si Jt Prq Iartic Impl 8 3 — — $7,920.26 $90,467.87 $74,058.88 2026-04-01
0809T OTHER Arthrd Si Jt Prq Tfx&implt 8 3 — — $7,920.26 $90,467.87 $74,058.88 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 36 15 — — $13,821.00 $270,400.67 $73,761.53 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 56 23 — — $65,333.63 $189,142.25 $72,520.33 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 76 24 — — $92.51 $190,074.50 $72,213.75 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 58 23 — — $63,508.28 $183,744.00 $71,129.27 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 56 23 — — $63,968.57 $185,105.25 $71,005.11 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 24 13 — — $63,342.28 $248,611.79 $70,826.95 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 56 23 — — $63,553.85 $183,878.75 $70,544.77 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 23 — — $62,519.82 $180,820.75 $69,397.00 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 23 — — $62,519.82 $180,820.75 $69,397.00 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 56 23 — — $62,297.58 $180,163.50 $69,150.32 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 76 26 — — $8,659.39 $176,954.25 $66,109.41 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 56 23 — — $58,364.20 $168,531.00 $64,784.26 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 56 23 — — $58,298.18 $168,335.75 $64,710.98 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 56 23 — — $57,752.34 $166,721.50 $64,105.10 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 56 23 — — $57,247.42 $165,228.25 $63,544.64 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 62 23 — — $56,516.54 $163,066.75 $63,298.52 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 23 — — $56,827.12 $163,985.25 $63,078.10 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 24 11 — — $56,824.55 $219,768.94 $63,075.24 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 66 23 — — $177.60 $165,181.50 $62,954.77 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 56 23 — — $56,644.86 $163,446.25 $62,875.79 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 30 15 — — $55,272.32 $217,621.10 $62,463.25 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 56 23 — — $55,948.38 $161,386.50 $62,102.71 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 56 23 — — $55,913.05 $161,282.00 $62,063.49 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 56 23 — — $55,004.56 $158,595.25 $61,055.07 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 56 23 — — $54,662.36 $157,583.25 $60,675.22 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 46 22 — — $54,444.77 $156,939.75 $59,889.25 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 60 23 — — $28,886.78 $156,736.25 $59,813.56 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 12 5 — — $14,884.00 $120,301.16 $59,613.04 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 12 5 — — $14,884.00 $120,301.16 $59,613.04 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 60 23 — — $51,356.18 $154,605.00 $59,557.39 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 56 23 — — $53,136.43 $153,070.50 $58,981.43 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 58 24 — — $15,947.24 $154,126.50 $58,842.86 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 56 23 — — $52,734.73 $152,036.74 $58,535.55 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 68 23 — — $51,560.41 $267,924.25 $58,516.12 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 56 23 — — $52,426.94 $150,972.25 $58,193.90 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 56 23 — — $52,174.01 $150,224.25 $57,913.15 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 56 23 — — $51,891.33 $149,529.51 $57,599.38 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 64 23 — — $35,387.43 $149,987.75 $57,303.44 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 56 23 — — $50,966.10 $146,652.00 $56,572.37 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 56 23 — — $50,936.34 $146,564.00 $56,539.33 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 70 23 — — $4,217.83 $145,098.25 $56,331.99 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 56 23 — — $50,603.45 $145,579.50 $56,169.83 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 60 23 — — $24,872.39 $142,901.00 $55,164.50 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 66 24 — — $75.90 $143,148.50 $54,759.58 2026-04-01
69715 HCPCS Temple Bne Implnt W/Stimulat 8 3 — — $7,920.26 $65,879.63 $53,930.44 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 8 3 — — $7,920.26 $65,854.39 $53,909.78 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 8 3 — — $7,920.26 $65,854.39 $53,909.78 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 56 23 — — $48,245.28 $138,605.50 $53,552.26 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 91 25 — — $100.10 $153,552.08 $52,529.73 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 36 15 — — $6,072.60 $189,347.94 $52,385.85 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 20 9 — — $7,920.26 $189,347.94 $52,385.85 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 36 15 — — $9,105.00 $189,347.94 $52,385.85 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 70 23 — — $30,527.16 $136,053.50 $52,120.58 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 58 23 — — $46,952.75 $134,783.00 $52,091.21 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 68 23 — — $42,632.44 $135,346.75 $51,857.71 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 34 15 — — $13,746.00 $189,347.94 $51,406.68 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 56 23 — — $46,278.59 $132,789.25 $51,369.24 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 56 23 — — $46,051.70 $132,118.25 $51,117.39 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 102 24 — — $4,133.09 $246,180.99 $51,084.56 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 56 23 — — $45,647.20 $130,922.00 $50,668.39 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 66 24 — — $38,744.26 $139,585.30 $50,237.92 2026-04-01
J9226 HCPCS Supprelin La Implant 30 15 — — $41,173.43 $174,117.36 $49,972.93 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 56 23 — — $44,875.40 $128,639.50 $49,811.69 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 72 25 — — $20,446.82 $165,590.60 $49,506.15 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 56 23 — — $44,496.01 $127,517.50 $49,390.57 2026-04-01
0398T OTHER Mrgfus Strtctc Les Abltj 6 2 — — $35,233.91 $51,644.57 $49,320.72 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 60 23 — — $40,875.43 $127,008.75 $48,756.39 2026-04-01
245 MS_DRG Aicd Generator Procedures 56 23 — — $43,802.33 $125,466.00 $48,620.58 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 96 25 — — $3,765.89 $150,149.43 $48,531.35 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 56 23 — — $43,656.34 $125,034.25 $48,458.54 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 66 23 — — $213.57 $126,082.00 $48,411.68 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 56 23 — — $43,490.82 $124,544.75 $48,274.81 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 66 23 — — $18,955.00 $125,089.25 $48,042.42 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 56 23 — — $43,040.76 $123,213.75 $47,775.24 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 56 23 — — $42,877.10 $122,729.75 $47,593.58 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 75 25 — — $24,793.42 $123,249.50 $47,358.14 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 6 2 — — $33,543.34 $49,166.59 $46,954.25 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 72 23 — — $21,032.13 $120,802.00 $46,447.78 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 70 23 — — $23.40 $119,003.50 $45,778.82 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 56 23 — — $41,039.66 $117,295.75 $45,554.02 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 66 24 — — $3,677.98 $118,054.75 $45,425.94 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 56 23 — — $40,648.18 $116,138.00 $45,119.48 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 56 23 — — $40,581.23 $115,940.00 $45,045.17 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 56 23 — — $40,561.70 $115,882.25 $45,023.49 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 60 23 — — $40,177.66 $114,746.50 $44,998.98 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 62 23 — — $28,432.58 $116,622.00 $44,893.02 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 56 23 — — $40,400.84 $115,406.50 $44,844.93 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 62 23 — — $38,250.52 $114,207.50 $44,794.86 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 56 23 — — $40,328.31 $115,192.00 $44,764.43 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 66 23 — — $27,064.40 $115,544.00 $44,492.06 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 56 23 — — $39,739.69 $113,451.25 $44,111.06 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 78 24 — — $979.64 $114,664.00 $43,361.75 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 58 23 — — $38,424.85 $109,562.75 $43,035.83 2026-04-01
791 MS_DRG Prematurity With Major Problems 64 23 — — $5,396.32 $111,622.50 $43,033.45 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 64 23 — — $25,200.25 $110,563.75 $43,027.29 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 56 23 — — $37,588.89 $107,193.99 $41,723.67 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 60 23 — — $3,217.28 $107,577.25 $41,528.83 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 56 23 — — $37,370.37 $106,444.25 $41,481.11 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 87 25 — — $17,226.00 $106,284.75 $41,048.07 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 58 24 — — $20,576.32 $106,183.00 $41,010.23 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 68 24 — — $30,464.35 $105,580.75 $40,786.22 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 56 23 — — $36,368.89 $103,482.50 $40,369.47 2026-04-01
69718 HCPCS Revise Temple Bone Implant 8 3 — — $7,920.26 $49,166.59 $40,248.79 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 56 23 — — $36,216.39 $103,031.50 $40,200.19 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 58 23 — — $35,532.93 $101,010.25 $39,796.88 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 56 23 — — $35,837.00 $101,909.50 $39,779.07 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 68 23 — — $35,206.41 $102,786.75 $39,746.99 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 58 23 — — $35,364.38 $102,775.75 $39,742.90 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 60 23 — — $34,764.21 $102,487.00 $39,635.50 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 56 23 — — $35,518.98 $100,969.00 $39,426.07 2026-04-01
332 MS_DRG Rectal Resection With Mcc 58 23 — — $35,045.67 $99,569.25 $39,251.15 2026-04-01
69930 HCPCS Implant Cochlear Device 36 15 — — $12,230.00 $141,741.27 $39,214.77 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 56 23 — — $35,118.20 $99,783.75 $38,981.20 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 56 23 — — $35,092.17 $99,706.75 $38,952.31 2026-04-01
265 MS_DRG Aicd Lead Procedures 56 23 — — $35,022.43 $99,500.50 $38,874.90 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 56 23 — — $34,912.70 $99,176.00 $38,753.10 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 16 7 — — $15,483.00 $630,040.57 $38,698.00 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 60 23 — — $25,674.90 $98,621.84 $38,509.51 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 62 23 — — $16,100.88 $99,324.50 $38,459.20 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 56 23 — — $34,533.31 $98,054.00 $38,331.97 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 56 23 — — $34,505.41 $97,971.50 $38,301.00 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 62 23 — — $33,919.07 $98,298.75 $38,077.68 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 70 23 — — $28,187.92 $121,576.88 $38,040.85 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 58 24 — — $28,668.94 $97,878.00 $37,921.18 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 62 23 — — $30,938.04 $97,798.25 $37,891.51 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 34 15 — — $14,884.00 $134,935.12 $37,680.66 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 34 15 — — $14,884.00 $134,935.12 $37,680.66 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 34 15 — — $14,884.00 $134,935.12 $37,680.66 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 68 23 — — $26,765.14 $96,981.50 $37,587.73 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 70 23 — — $16,709.60 $96,783.50 $37,514.08 2026-04-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 18 10 — — $6,072.60 $147,271.09 $37,441.07 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 36 15 — — $10,243.00 $134,935.12 $37,331.76 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 36 15 — — $14,755.00 $134,935.12 $37,331.76 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 36 15 — — $10,243.00 $134,935.12 $37,331.76 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 36 15 — — $10,243.00 $134,935.12 $37,331.76 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 74 24 — — $5,851.51 $95,928.25 $37,195.97 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 64 23 — — $14,463.72 $95,903.50 $37,186.77 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 9 7 — — $34,299.09 $132,651.74 $37,043.02 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 9 7 — — $34,299.09 $132,651.74 $37,043.02 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 58 23 — — $33,438.61 $95,463.50 $37,023.11 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 62 23 — — $19,887.73 $95,001.50 $36,851.27 2026-04-01
D2956 HCPCS Indirect Rest Remov 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D2989 HCPCS Excavate Tooth Non-restorabl 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D4286 HCPCS Remove Non-resorb Barrier 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7300 HCPCS Rem Anchorage Dev Without Flap 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7298 HCPCS Remove Screw Retained Plate 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D5995 HCPCS Peri Medicament W/seal, Max 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7939 HCPCS Indexing For Osteotomy 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7284 HCPCS Exc Biopsy Of Saliv Glands 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D5996 HCPCS Peri Medicament W/seal, Mand 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
0496T OTHER Mntr Cdvr Don Lng Ea Addl Hr 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7299 HCPCS Rem Anchorage Device W/flap 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7509 HCPCS Marsupialization Odon Cyst 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
92970 HCPCS Cardioassist Internal 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7956 HCPCS Tiss Regen Edent Resorb 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
0709T OTHER Id Ca Immntx Each Addl Njx 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6089 HCPCS Access/retorq Implant Screw 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
0495T OTHER Mntr Cdvr Don Lng 1st 2 Hrs 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6198 HCPCS Remove Interim Implant 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6197 HCPCS Replace Material Prosthesis 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
0732T OTHER Immntx Admn Electroporatn IM 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D9949 HCPCS Repair Sleep Apnea Appliance 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6191 HCPCS Semi Precision Abutment 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6107 HCPCS Tissue Regen Non-resorbable 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7252 HCPCS Part Extract For Implant 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
92971 HCPCS Cardioassist External 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6192 HCPCS Semi Precision Attachment 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6105 HCPCS Remove Implant Body 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7993 HCPCS Surg Place Craniofacial Impl 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6106 HCPCS Tissue Regen Resorbable 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7994 HCPCS Surg Place Zygomatic Impl 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7962 HCPCS Lingual Frenectomy 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7957 HCPCS Tiss Regen Edent Nonresorb 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7961 HCPCS Buccal/labial Frenectomy 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
0708T OTHER Id Ca Immntx Prep & 1st Njx 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D6193 HCPCS Replace Implnt Screw 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
D7259 HCPCS Nerve Dissection 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
92975 HCPCS Dissolve Clot Heart Vessel 1 1 — — $36,803.00 $36,803.00 $36,803.00 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 56 23 — — $33,101.30 $93,819.00 $36,742.44 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 36 15 — — $4,275.00 $132,651.74 $36,700.03 2026-04-01
61886 HCPCS Implant Neurostim Arrays 36 15 — — $8,991.00 $132,651.74 $36,700.03 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 20 9 — — $7,920.26 $132,651.74 $36,700.03 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 36 15 — — $4,275.00 $132,651.74 $36,700.03 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 36 15 — — $4,275.00 $132,651.74 $36,700.03 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 36 15 — — $9,105.00 $132,651.74 $36,700.03 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 56 23 — — $33,059.46 $93,695.25 $36,696.01 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 48 22 — — $33,352.37 $94,561.50 $36,687.61 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 70 23 — — $13,910.78 $94,281.00 $36,583.27 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 62 23 — — $20,770.60 $91,866.50 $36,334.02 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 36 15 — — $9,105.00 $132,651.74 $36,185.54 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 28 13 — — $10,243.00 $132,651.74 $36,185.54 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 27 12 — — $6,072.60 $132,651.74 $36,014.05 2026-04-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 27 12 — — $6,072.60 $132,651.74 $36,014.05 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 18 10 — — $27,783.79 $110,141.40 $35,702.31 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 60 23 — — $23,815.16 $90,840.75 $35,624.61 2026-04-01
652 MS_DRG Kidney Transplant 84 23 — — $24,409.53 $192,433.40 $35,465.22 2026-04-01
509 MS_DRG Arthroscopy 10 4 — — $24,459.26 $43,517.29 $35,327.25 2026-04-01
5166 OTHER Cochlear Implant Procedure 14 11 — — $23,408.50 $60,321.89 $35,308.56 2026-04-01
C9790 HCPCS Kidney Histotripsy W/image 10 4 — — $13,746.00 $51,644.57 $35,233.91 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 32 13 — — $13,746.00 $147,271.09 $35,233.91 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 58 23 — — $21,454.08 $90,532.75 $35,189.11 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 60 23 — — $28,177.28 $90,521.75 $35,185.02 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 58 23 — — $31,385.68 $256,997.13 $35,151.96 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 60 24 — — $22,487.49 $89,452.00 $34,787.12 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 56 23 — — $31,327.09 $88,572.00 $34,773.07 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 62 23 — — $24,860.18 $89,058.75 $34,640.85 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 68 24 — — $16,793.83 $88,959.75 $34,604.03 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 66 23 — — $20,233.14 $88,836.00 $34,558.00 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 60 23 — — $17,685.48 $87,554.50 $34,391.17 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 58 23 — — $18,507.94 $88,286.00 $34,353.43 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 56 23 — — $30,923.53 $87,465.66 $34,325.11 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 70 23 — — $30,438.55 $87,802.00 $34,173.40 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 36 15 — — $12,230.00 $123,304.62 $34,114.01 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 58 23 — — $27,435.61 $87,639.75 $34,113.06 2026-04-01
52 MS_DRG Spinal Disorders And Injuries With Cc/Mcc 80 23 — — $18,220.48 $267,262.48 $33,943.51 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 64 24 — — $16,229.18 $87,032.00 $33,887.00 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 60 23 — — $16,539.15 $86,900.00 $33,837.90 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 71 25 — — $25,327.37 $93,232.39 $33,745.84 2026-04-01
665 MS_DRG Prostatectomy With Mcc 56 23 — — $30,400.94 $85,833.00 $33,745.04 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 66 23 — — $29,160.68 $86,611.25 $33,730.50 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 58 23 — — $24,789.40 $86,407.75 $33,654.81 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 56 23 — — $30,289.35 $85,503.00 $33,621.18 2026-04-01
2050 OTHER Cath Coronary Drug-delivery 2 1 — — $33,446.48 $33,446.48 $33,446.48 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 6 6 — — $27,139.76 $112,178.27 $33,423.19 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 66 24 — — $16,116.88 $85,654.25 $33,374.54 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 30 14 — — $10,243.00 $116,644.32 $33,176.15 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 30 14 — — $6,072.60 $116,644.32 $33,176.15 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 56 23 — — $29,845.80 $84,191.25 $33,128.84 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 60 23 — — $29,582.64 $83,413.00 $32,836.73 2026-04-01
263 MS_DRG Vein Ligation And Stripping 58 24 — — $16,206.64 $84,078.50 $32,788.44 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 56 23 — — $29,460.83 $83,052.75 $32,701.52 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 56 23 — — $29,430.14 $82,962.00 $32,667.46 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 32 14 — — $7,920.26 $115,713.45 $32,612.19 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 58 24 — — $22,270.97 $83,063.75 $32,411.00 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 36 15 — — $14,755.00 $116,644.32 $32,271.34 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 56 23 — — $29,054.47 $81,851.00 $32,250.46 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 30 14 — — $17,599.00 $112,361.99 $31,958.16 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 30 14 — — $17,599.00 $112,361.99 $31,958.16 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 30 14 — — $17,599.00 $112,361.99 $31,958.16 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 56 23 — — $28,754.12 $80,962.75 $31,917.07 2026-04-01
570 MS_DRG Skin Debridement With Mcc 56 23 — — $28,726.23 $80,880.25 $31,886.11 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 36 15 — — $10,615.00 $116,644.32 $31,818.94 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 36 15 — — $10,243.00 $116,644.32 $31,818.94 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 62 23 — — $18,995.29 $81,017.75 $31,649.99 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 58 23 — — $28,530.02 $80,300.00 $31,383.02 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 72 23 — — $18,805.31 $80,088.25 $31,304.26 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 56 23 — — $28,174.81 $79,249.50 $31,274.04 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 64 23 — — $18,886.61 $79,805.00 $31,198.92 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 76 23 — — $18,084.27 $79,755.50 $31,180.50 2026-04-01
77 MS_DRG Hypertensive Encephalopathy With Mcc 10 4 — — $21,530.84 $38,307.11 $31,097.64 2026-04-01
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