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

PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL

Hood River, OR · CCN 381318 · Rates published

1,006 distinct procedures filed
13 distinct payers
18,565 rate rows
2026-04-01 last MRF observed
Data quality

1,227 of 18,565 rate rows are consumer-grade (6.6%)

17,338 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 12,008
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 5,330
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/oregon/live/931265038_providence-hood-river-memorial-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 763b9593d5c295d4… · 168,208,302 bytes · first seen 2026-05-13

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
5094
OTHER 		Level 4 Breast/Lymphatic Surgery And Related Procedures 2 $82,268.83 $85,350.56 $83,809.70 nat. median
$16,222
outlier · 5.2×
483
MS_DRG 		Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 $78,848.34 $78,848.34 $78,848.34 nat. median
$19,495
outlier · 4.0×
330
MS_DRG 		Major Small And Large Bowel Procedures With Cc 1 $75,560.95 $75,560.95 $75,560.95 nat. median
$17,741
outlier · 4.3×
56
MS_DRG 		Degenerative Nervous System Disorders With Mcc 1 $74,742.15 $74,742.15 $74,742.15 nat. median
$14,194
outlier · 5.3×
502
MS_DRG 		Soft Tissue Procedures Without Cc/Mcc 1 $71,851.70 $71,851.70 $71,851.70 nat. median
$10,206
outlier · 7.0×
336
MS_DRG 		Peritoneal Adhesiolysis With Cc 1 $70,514.00 $70,514.00 $70,514.00 nat. median
$15,633
outlier · 4.5×
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $60,079.64 $60,079.64 $60,079.64 nat. median
$21,906
outlier · 2.7×
412
MS_DRG 		Cholecystectomy With C.d.e. With Cc 1 $58,345.67 $58,345.67 $58,345.67 nat. median
$14,862
outlier · 3.9×
413
MS_DRG 		Cholecystectomy With C.d.e. Without Cc/Mcc 1 $57,727.57 $57,727.57 $57,727.57 nat. median
$11,872
outlier · 4.9×
417
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 $52,393.93 $52,393.93 $52,393.93 nat. median
$17,369
outlier · 3.0×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 1 $51,116.63 $51,116.63 $51,116.63 nat. median
$7,418
outlier · 6.9×
796
MS_DRG 		Vaginal Delivery With Sterilization And/Or D&c With Mcc 1 $49,162.80 $49,162.80 $49,162.80 nat. median
$8,208
outlier · 6.0×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 $39,884.37 $56,523.80 $48,204.09 nat. median
$34,733
1.4× median
331
MS_DRG 		Major Small And Large Bowel Procedures Without Cc/Mcc 1 $45,924.04 $45,924.04 $45,924.04 nat. median
$12,648
outlier · 3.6×
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 1 $42,833.52 $42,833.52 $42,833.52 nat. median
$14,550
outlier · 2.9×
5116
OTHER 		Level 6 Musculoskeletal Procedures 3 $25,203.24 $66,748.75 $38,304.39 nat. median
$18,185
outlier · 2.1×
5362
OTHER 		Level 2 Laparoscopy And Related Services 7 $421.04 $49,914.02 $38,216.05 nat. median
$10,430
outlier · 3.7×
787
MS_DRG 		Cesarean Section Without Sterilization With Cc 2 $36,562.53 $39,478.27 $38,020.40 nat. median
$8,114
outlier · 4.7×
5092
OTHER 		Level 2 Breast/Lymphatic Surgery And Related Procedures 3 $31,886.80 $38,311.32 $37,769.52 nat. median
$6,603
outlier · 5.7×
418
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. With Cc 1 $37,462.56 $37,462.56 $37,462.56 nat. median
$12,668
outlier · 3.0×
786
MS_DRG 		Cesarean Section Without Sterilization With Mcc 1 $36,403.98 $36,403.98 $36,403.98 nat. median
$11,737
outlier · 3.1×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 $35,815.78 $35,815.78 $35,815.78 nat. median
$9,511
outlier · 3.8×
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 $35,785.83 $35,785.83 $35,785.83 nat. median
$24,822
1.4× median
419
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 1 $33,882.80 $33,882.80 $33,882.80 nat. median
$10,316
outlier · 3.3×
399
MS_DRG 		Appendix Procedures Without Cc/Mcc 1 $33,820.62 $33,820.62 $33,820.62 nat. median
$8,689
outlier · 3.9×
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 1 $33,400.14 $33,400.14 $33,400.14 nat. median
$12,760
outlier · 2.6×
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 1 $32,754.75 $32,754.75 $32,754.75 nat. median
$11,966
outlier · 2.7×
637
MS_DRG 		Diabetes With Mcc 2 $9,724.29 $55,067.72 $32,396.01 nat. median
$10,515
outlier · 3.1×
805
MS_DRG 		Vaginal Delivery Without Sterilization Or D&c With Mcc 1 $32,239.76 $32,239.76 $32,239.76 nat. median
$7,517
outlier · 4.3×
788
MS_DRG 		Cesarean Section Without Sterilization Without Cc/Mcc 3 $3,607.44 $40,186.92 $31,581.73 nat. median
$6,949
outlier · 4.5×
616
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 $31,111.17 $31,111.17 $31,111.17 nat. median
$25,616
1.2× median
5115
OTHER 		Level 5 Musculoskeletal Procedures 8 $7,951.47 $41,642.60 $30,679.04 nat. median
$13,292
outlier · 2.3×
921
MS_DRG 		Complications Of Treatment Without Cc/Mcc 1 $30,144.65 $30,144.65 $30,144.65 nat. median
$5,122
outlier · 5.9×
5093
OTHER 		Level 3 Breast/Lymphatic Surgery And Related Procedures 1 $30,059.90 $30,059.90 $30,059.90 nat. median
$8,851
outlier · 3.4×
951
MS_DRG 		Other Factors Influencing Health Status 3 $11,396.57 $41,428.95 $30,031.88 nat. median
$4,231
outlier · 7.1×
918
MS_DRG 		Poisoning And Toxic Effects Of Drugs Without Mcc 1 $29,271.49 $29,271.49 $29,271.49 nat. median
$5,899
outlier · 5.0×
307
MS_DRG 		Cardiac Congenital And Valvular Disorders Without Mcc 1 $12,309.78 $45,389.31 $28,849.54 nat. median
$6,843
outlier · 4.2×
785
MS_DRG 		Cesarean Section With Sterilization Without Cc/Mcc 2 $24,010.16 $33,602.78 $28,806.47 nat. median
$6,801
outlier · 4.2×
373
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 $27,821.85 $27,821.85 $27,821.85 nat. median
$5,408
outlier · 5.1×
863
MS_DRG 		Postoperative And Post-traumatic Infections Without Mcc 2 $13,695.98 $39,547.26 $26,621.62 nat. median
$7,491
outlier · 3.6×
76
MS_DRG 		Viral Meningitis Without Cc/Mcc 1 $25,924.81 $25,924.81 $25,924.81 nat. median
$6,260
outlier · 4.1×
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 2 $15,026.57 $30,974.56 $25,924.59 nat. median
$9,802
outlier · 2.6×
710
MS_DRG 		Penis Procedures Without Cc/Mcc 1 $25,564.94 $25,564.94 $25,564.94 nat. median
$10,412
outlier · 2.5×
593
MS_DRG 		Skin Ulcers With Cc 1 $25,334.81 $25,334.81 $25,334.81 nat. median
$8,571
outlier · 3.0×
897
MS_DRG 		Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 2 $16,270.68 $33,793.17 $25,031.92 nat. median
$5,898
outlier · 4.2×
758
MS_DRG 		Infections, Female Reproductive System With Cc 1 $24,648.79 $24,648.79 $24,648.79 nat. median
$7,191
outlier · 3.4×
693
MS_DRG 		Urinary Stones With Mcc 1 $24,014.79 $24,014.79 $24,014.79 nat. median
$9,957
outlier · 2.4×
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 2 $1,018.37 $45,050.38 $23,034.37 nat. median
$9,697
outlier · 2.4×
439
MS_DRG 		Disorders Of Pancreas Except Malignancy With Cc 1 $22,635.40 $22,635.40 $22,635.40 nat. median
$6,417
outlier · 3.5×
5155
OTHER 		Level 5 Airway Endoscopy 4 $5,831.44 $42,739.20 $22,488.38 nat. median
$6,919
outlier · 3.3×

Other procedures at this hospital

Browse this hospital's 1,006 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 2 2 — — $82,268.83 $85,350.56 $83,809.70 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 1 — — $78,848.34 $78,848.34 $78,848.34 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 1 1 — — $75,560.95 $75,560.95 $75,560.95 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 1 1 — — $74,742.15 $74,742.15 $74,742.15 2026-04-01
502 MS_DRG Soft Tissue Procedures Without Cc/Mcc 1 1 — — $71,851.70 $71,851.70 $71,851.70 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 1 1 — — $70,514.00 $70,514.00 $70,514.00 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $60,079.64 $60,079.64 $60,079.64 2026-04-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 1 1 — — $58,345.67 $58,345.67 $58,345.67 2026-04-01
413 MS_DRG Cholecystectomy With C.d.e. Without Cc/Mcc 1 1 — — $57,727.57 $57,727.57 $57,727.57 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 1 1 — — $52,393.93 $52,393.93 $52,393.93 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 1 1 — — $51,116.63 $51,116.63 $51,116.63 2026-04-01
796 MS_DRG Vaginal Delivery With Sterilization And/Or D&c With Mcc 1 1 — — $49,162.80 $49,162.80 $49,162.80 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 2 — — $39,884.37 $56,523.80 $48,204.09 2026-04-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/Mcc 1 1 — — $45,924.04 $45,924.04 $45,924.04 2026-04-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 1 1 — — $42,833.52 $42,833.52 $42,833.52 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 3 3 — — $25,203.24 $66,748.75 $38,304.39 2026-04-01
5362 OTHER Level 2 Laparoscopy And Related Services 8 7 — — $421.04 $49,914.02 $38,216.05 2026-04-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 2 2 — — $36,562.53 $39,478.27 $38,020.40 2026-04-01
5092 OTHER Level 2 Breast/Lymphatic Surgery And Related Procedures 3 3 — — $31,886.80 $38,311.32 $37,769.52 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 1 1 — — $37,462.56 $37,462.56 $37,462.56 2026-04-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 1 1 — — $36,403.98 $36,403.98 $36,403.98 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 1 1 — — $35,815.78 $35,815.78 $35,815.78 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $35,785.83 $35,785.83 $35,785.83 2026-04-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/Mcc 1 1 — — $33,882.80 $33,882.80 $33,882.80 2026-04-01
399 MS_DRG Appendix Procedures Without Cc/Mcc 1 1 — — $33,820.62 $33,820.62 $33,820.62 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 1 1 — — $33,400.14 $33,400.14 $33,400.14 2026-04-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 1 1 — — $32,754.75 $32,754.75 $32,754.75 2026-04-01
637 MS_DRG Diabetes With Mcc 2 2 — — $9,724.29 $55,067.72 $32,396.01 2026-04-01
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 1 1 — — $32,239.76 $32,239.76 $32,239.76 2026-04-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/Mcc 3 3 — — $3,607.44 $40,186.92 $31,581.73 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $31,111.17 $31,111.17 $31,111.17 2026-04-01
5115 OTHER Level 5 Musculoskeletal Procedures 11 8 — — $7,951.47 $41,642.60 $30,679.04 2026-04-01
921 MS_DRG Complications Of Treatment Without Cc/Mcc 1 1 — — $30,144.65 $30,144.65 $30,144.65 2026-04-01
5093 OTHER Level 3 Breast/Lymphatic Surgery And Related Procedures 1 1 — — $30,059.90 $30,059.90 $30,059.90 2026-04-01
951 MS_DRG Other Factors Influencing Health Status 3 3 — — $11,396.57 $41,428.95 $30,031.88 2026-04-01
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 1 1 — — $29,271.49 $29,271.49 $29,271.49 2026-04-01
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 2 1 — — $12,309.78 $45,389.31 $28,849.54 2026-04-01
785 MS_DRG Cesarean Section With Sterilization Without Cc/Mcc 2 2 — — $24,010.16 $33,602.78 $28,806.47 2026-04-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/Mcc 1 1 — — $27,821.85 $27,821.85 $27,821.85 2026-04-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 2 2 — — $13,695.98 $39,547.26 $26,621.62 2026-04-01
76 MS_DRG Viral Meningitis Without Cc/Mcc 1 1 — — $25,924.81 $25,924.81 $25,924.81 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 3 2 — — $15,026.57 $30,974.56 $25,924.59 2026-04-01
710 MS_DRG Penis Procedures Without Cc/Mcc 1 1 — — $25,564.94 $25,564.94 $25,564.94 2026-04-01
593 MS_DRG Skin Ulcers With Cc 1 1 — — $25,334.81 $25,334.81 $25,334.81 2026-04-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 2 2 — — $16,270.68 $33,793.17 $25,031.92 2026-04-01
758 MS_DRG Infections, Female Reproductive System With Cc 1 1 — — $24,648.79 $24,648.79 $24,648.79 2026-04-01
693 MS_DRG Urinary Stones With Mcc 1 1 — — $24,014.79 $24,014.79 $24,014.79 2026-04-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 2 2 — — $1,018.37 $45,050.38 $23,034.37 2026-04-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 1 1 — — $22,635.40 $22,635.40 $22,635.40 2026-04-01
5155 OTHER Level 5 Airway Endoscopy 4 4 — — $5,831.44 $42,739.20 $22,488.38 2026-04-01
915 MS_DRG Allergic Reactions With Mcc 1 1 — — $22,272.54 $22,272.54 $22,272.54 2026-04-01
5114 OTHER Level 4 Musculoskeletal Procedures 9 7 — — $4,962.44 $54,879.67 $21,729.61 2026-04-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 1 1 — — $21,116.88 $21,116.88 $21,116.88 2026-04-01
176 MS_DRG Pulmonary Embolism Without Mcc 1 1 — — $21,066.39 $21,066.39 $21,066.39 2026-04-01
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/Mcc 3 3 — — $15,709.55 $22,601.18 $21,029.47 2026-04-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 1 1 — — $21,026.64 $21,026.64 $21,026.64 2026-04-01
602 MS_DRG Cellulitis With Mcc 3 2 — — $5,696.81 $58,218.04 $20,335.61 2026-04-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 4 3 — — $8,167.48 $22,074.08 $20,186.72 2026-04-01
5361 OTHER Level 1 Laparoscopy And Related Services 12 8 — — $4,532.03 $31,500.48 $19,363.42 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 2 — — $17,275.09 $19,781.46 $18,528.28 2026-04-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 1 1 — — $18,434.40 $18,434.40 $18,434.40 2026-04-01
682 MS_DRG Renal Failure With Mcc 3 2 — — $13,867.94 $106,758.01 $18,423.56 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $18,307.77 $18,307.77 $18,307.77 2026-04-01
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 1 1 — — $18,215.89 $18,215.89 $18,215.89 2026-04-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 1 1 — — $17,964.47 $17,964.47 $17,964.47 2026-04-01
694 MS_DRG Urinary Stones Without Mcc 1 1 — — $17,901.02 $17,901.02 $17,901.02 2026-04-01
755 MS_DRG Malignancy, Female Reproductive System With Cc 1 1 — — $17,732.16 $17,732.16 $17,732.16 2026-04-01
5493 OTHER Level 3 Intraocular Procedures 1 1 — — $17,621.72 $17,621.72 $17,621.72 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 2 1 — — $15,436.31 $18,926.53 $17,181.42 2026-04-01
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization And/Or D&c 2 2 — — $11,043.42 $23,303.12 $17,173.27 2026-04-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/Mcc 4 3 — — $4,169.26 $20,337.10 $17,060.58 2026-04-01
180 MS_DRG Respiratory Neoplasms With Mcc 1 1 — — $17,058.80 $17,058.80 $17,058.80 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $16,961.02 $16,961.02 $16,961.02 2026-04-01
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 4 4 — — $14,244.80 $30,827.30 $16,685.20 2026-04-01
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 1 1 — — $16,652.65 $16,652.65 $16,652.65 2026-04-01
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 1 1 — — $16,643.30 $16,643.30 $16,643.30 2026-04-01
919 MS_DRG Complications Of Treatment With Mcc 2 1 — — $13,290.35 $19,633.04 $16,461.69 2026-04-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 1 1 — — $16,249.59 $16,249.59 $16,249.59 2026-04-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 1 1 — — $16,241.73 $16,241.73 $16,241.73 2026-04-01
386 MS_DRG Inflammatory Bowel Disease With Cc 2 1 — — $11,719.13 $20,515.87 $16,117.50 2026-04-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 1 1 — — $15,940.50 $15,940.50 $15,940.50 2026-04-01
60 MS_DRG Multiple Sclerosis And Cerebellar Ataxia Without Cc/Mcc 1 1 — — $15,867.56 $15,867.56 $15,867.56 2026-04-01
5161 OTHER Level 1 ENT Procedures 7 6 — — $180.15 $21,809.38 $15,866.48 2026-04-01
5415 OTHER Level 5 Gynecologic Procedures 6 6 — — $10,775.49 $25,679.67 $15,792.69 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 3 2 — — $10,015.94 $16,696.51 $15,669.26 2026-04-01
798 MS_DRG Vaginal Delivery With Sterilization And/Or D&c Without Cc/Mcc 2 2 — — $812.13 $30,387.09 $15,599.61 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 2 — — $8,329.44 $22,860.61 $15,595.03 2026-04-01
305 MS_DRG Hypertension Without Mcc 2 2 — — $9,881.87 $21,088.57 $15,485.22 2026-04-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 2 1 — — $14,221.34 $16,341.92 $15,281.63 2026-04-01
5694 OTHER Level 4 Drug Administration 11 7 — — $3,380.46 $85,738.50 $15,209.63 2026-04-01
5045 OTHER Trauma Response With Critical Care 1 1 — — $14,947.38 $14,947.38 $14,947.38 2026-04-01
975 MS_DRG HIV With Major Related Condition With Cc 1 1 — — $14,863.37 $14,863.37 $14,863.37 2026-04-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 1 1 — — $14,862.27 $14,862.27 $14,862.27 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 1 1 — — $14,833.22 $14,833.22 $14,833.22 2026-04-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 1 1 — — $14,742.04 $14,742.04 $14,742.04 2026-04-01
5871 OTHER Dental Procedures 2 2 — — $14,075.07 $15,024.08 $14,549.58 2026-04-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 1 1 — — $14,469.00 $14,469.00 $14,469.00 2026-04-01
683 MS_DRG Renal Failure With Cc 3 2 — — $7,852.00 $17,488.27 $14,228.93 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $14,227.97 $14,227.97 $14,227.97 2026-04-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 1 1 — — $14,031.33 $14,031.33 $14,031.33 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 5 4 — — $434.53 $16,448.02 $13,865.75 2026-04-01
603 MS_DRG Cellulitis Without Mcc 5 4 — — $10,206.62 $15,592.90 $13,803.77 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 2 1 — — $10,993.10 $16,168.82 $13,580.96 2026-04-01
5091 OTHER Level 1 Breast/Lymphatic Surgery And Related Procedures 7 5 — — $6,368.41 $43,609.75 $13,538.40 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 2 1 — — $9,524.80 $16,845.06 $13,184.93 2026-04-01
179 MS_DRG Respiratory Infections And Inflammations Without Cc/Mcc 2 1 — — $9,620.20 $16,520.48 $13,070.34 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $13,029.48 $13,029.48 $13,029.48 2026-04-01
141 MS_DRG Major Head And Neck Procedures With Cc 1 1 — — $13,020.67 $13,020.67 $13,020.67 2026-04-01
638 MS_DRG Diabetes With Cc 2 1 — — $3,601.89 $22,335.08 $12,968.49 2026-04-01
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/Mcc 1 1 — — $12,963.82 $12,963.82 $12,963.82 2026-04-01
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedures 1 1 — — $12,847.90 $12,847.90 $12,847.90 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 2 2 — — $357.87 $24,869.24 $12,613.56 2026-04-01
5164 OTHER Level 4 ENT Procedures 6 5 — — $8,120.73 $13,353.85 $12,583.17 2026-04-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 2 2 — — $11,281.32 $13,765.35 $12,523.33 2026-04-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 3 2 — — $1,532.86 $12,541.44 $12,304.33 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 1 1 — — $12,281.19 $12,281.19 $12,281.19 2026-04-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 1 1 — — $12,224.40 $12,224.40 $12,224.40 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 2 1 — — $11,371.48 $13,062.80 $12,217.14 2026-04-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 2 1 — — $9,002.12 $15,166.71 $12,084.42 2026-04-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 1 1 — — $12,009.03 $12,009.03 $12,009.03 2026-04-01
5413 OTHER Level 3 Gynecologic Procedures 1 1 — — $11,984.97 $11,984.97 $11,984.97 2026-04-01
5374 OTHER Level 4 Urology And Related Services 3 3 — — $5,341.88 $14,501.66 $11,716.65 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 4 3 — — $9,036.42 $15,395.10 $11,597.08 2026-04-01
811 MS_DRG Red Blood Cell Disorders With Mcc 2 1 — — $8,789.75 $14,162.57 $11,476.16 2026-04-01
5341 OTHER Level 1 Abdominal/Peritoneal/Biliary And Related Procedures 6 5 — — $5,214.79 $14,030.76 $11,159.35 2026-04-01
5183 OTHER Level 3 Vascular Procedures 8 6 — — $2,129.91 $15,393.94 $11,134.78 2026-04-01
5375 OTHER Level 5 Urology And Related Services 2 2 — — $7,503.86 $14,426.39 $10,965.12 2026-04-01
5073 OTHER Level 3 Excision/ Biopsy/ Incision And Drainage 7 6 — — $1,862.87 $15,678.32 $10,913.36 2026-04-01
639 MS_DRG Diabetes Without Cc/Mcc 2 2 — — $10,492.01 $11,318.73 $10,905.37 2026-04-01
55 MS_DRG Nervous System Neoplasms Without Mcc 1 1 — — $10,768.81 $10,768.81 $10,768.81 2026-04-01
5414 OTHER Level 4 Gynecologic Procedures 11 8 — — $1,829.25 $17,410.60 $10,595.37 2026-04-01
263 MS_DRG Vein Ligation And Stripping 1 1 — — $10,531.06 $10,531.06 $10,531.06 2026-04-01
684 MS_DRG Renal Failure Without Cc/Mcc 2 2 — — $9,770.32 $11,125.52 $10,447.92 2026-04-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 1 1 — — $10,389.75 $10,389.75 $10,389.75 2026-04-01
5313 OTHER Level 3 Lower Gi Procedures 9 7 — — $2,010.21 $12,025.92 $10,061.26 2026-04-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/Mcc 1 1 — — $10,022.47 $10,022.47 $10,022.47 2026-04-01
5165 OTHER Level 5 ENT Procedures 4 4 — — $8,269.98 $13,895.84 $10,004.58 2026-04-01
864 MS_DRG Fever And Inflammatory Conditions 2 2 — — $3,726.83 $16,267.78 $9,997.31 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 3 2 — — $3,853.78 $11,916.71 $9,970.28 2026-04-01
5113 OTHER Level 3 Musculoskeletal Procedures 10 7 — — $201.64 $19,817.35 $9,919.06 2026-04-01
5431 OTHER Level 1 Nerve Procedures 5 4 — — $4,342.21 $11,004.47 $9,902.28 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $9,769.45 $9,769.45 $9,769.45 2026-04-01
5053 OTHER Level 3 Skin Procedures 2 2 — — $2,468.24 $16,795.41 $9,631.83 2026-04-01
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 1 1 — — $9,596.73 $9,596.73 $9,596.73 2026-04-01
536 MS_DRG Fractures Of Hip And Pelvis Without Mcc 1 1 — — $9,360.00 $9,360.00 $9,360.00 2026-04-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 1 1 — — $9,330.63 $9,330.63 $9,330.63 2026-04-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 2 1 — — $6,128.28 $12,270.48 $9,199.38 2026-04-01
887 MS_DRG Other Mental Disorder Diagnoses 1 1 — — $9,190.02 $9,190.02 $9,190.02 2026-04-01
149 MS_DRG Dysequilibrium 1 1 — — $9,152.90 $9,152.90 $9,152.90 2026-04-01
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 1 1 — — $9,033.21 $9,033.21 $9,033.21 2026-04-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 1 1 — — $8,980.14 $8,980.14 $8,980.14 2026-04-01
75 MS_DRG Viral Meningitis With Cc/Mcc 1 1 — — $8,976.04 $8,976.04 $8,976.04 2026-04-01
292 MS_DRG Heart Failure And Shock With Cc 2 2 — — $4,779.88 $12,932.83 $8,856.35 2026-04-01
504 MS_DRG Foot Procedures With Cc 1 1 — — $8,792.38 $8,792.38 $8,792.38 2026-04-01
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 3 2 — — $3,784.08 $9,607.62 $8,478.69 2026-04-01
202 MS_DRG Bronchitis And Asthma With Cc/Mcc 1 1 — — $8,402.89 $8,402.89 $8,402.89 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 5 4 — — $4,476.03 $22,398.95 $8,392.96 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 3 2 — — $469.58 $22,096.75 $8,361.00 2026-04-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 2 2 — — $3,853.78 $12,659.51 $8,256.65 2026-04-01
0764 OTHER Ketorolac Tromethamine Inj 3 3 — — $378.39 $13,841.17 $8,072.57 2026-04-01
139 MS_DRG Salivary Gland Procedures 1 1 — — $8,043.07 $8,043.07 $8,043.07 2026-04-01
312 MS_DRG Syncope And Collapse 2 2 — — $4,411.35 $10,900.89 $7,656.12 2026-04-01
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 1 1 — — $7,581.71 $7,581.71 $7,581.71 2026-04-01
5302 OTHER Level 2 Upper Gi Procedures 6 4 — — $3,453.32 $11,846.38 $7,579.82 2026-04-01
540 MS_DRG Osteomyelitis With Cc 1 1 — — $7,423.44 $7,423.44 $7,423.44 2026-04-01
5412 OTHER Level 2 Gynecologic Procedures 2 2 — — $3,481.91 $11,030.22 $7,256.06 2026-04-01
792 MS_DRG Prematurity Without Major Problems 2 2 — — $3,763.05 $10,739.99 $7,251.52 2026-04-01
816 MS_DRG Reticuloendothelial And Immunity Disorders Without Cc/Mcc 1 1 — — $7,179.66 $7,179.66 $7,179.66 2026-04-01
5163 OTHER Level 3 ENT Procedures 8 6 — — $416.12 $9,429.48 $6,886.94 2026-04-01
1482 OTHER Darbepoetin Alfa, Esrd Use 5 4 — — $3,378.93 $25,874.75 $6,878.82 2026-04-01
5054 OTHER Level 4 Skin Procedures 1 1 — — $6,716.62 $6,716.62 $6,716.62 2026-04-01
5491 OTHER Level 1 Intraocular Procedures 12 7 — — $1,312.39 $10,232.33 $6,622.70 2026-04-01
949 MS_DRG Aftercare With Cc/Mcc 1 1 — — $6,606.97 $6,606.97 $6,606.97 2026-04-01
92 MS_DRG Other Disorders Of Nervous System With Cc 1 1 — — $6,548.33 $6,548.33 $6,548.33 2026-04-01
5072 OTHER Level 2 Excision/ Biopsy/ Incision And Drainage 7 5 — — $2,748.60 $9,087.55 $6,518.51 2026-04-01
5311 OTHER Level 1 Lower Gi Procedures 11 8 — — $881.55 $7,354.78 $6,504.97 2026-04-01
390 MS_DRG Gastrointestinal Obstruction Without Cc/Mcc 2 1 — — $2,425.06 $10,546.35 $6,485.70 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 1 1 — — $6,450.00 $6,450.00 $6,450.00 2026-04-01
5055 OTHER Level 5 Skin Procedures 1 1 — — $6,320.86 $6,320.86 $6,320.86 2026-04-01
5041 OTHER Critical Care 12 8 — — $577.81 $10,707.16 $6,269.31 2026-04-01
9031 OTHER Inj, Etelcalcetide, 0.1 Mg 1 1 — — $6,245.62 $6,245.62 $6,245.62 2026-04-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 1 1 — — $6,229.80 $6,229.80 $6,229.80 2026-04-01
5312 OTHER Level 2 Lower Gi Procedures 14 9 — — $910.92 $8,878.46 $6,226.50 2026-04-01
5153 OTHER Level 3 Airway Endoscopy 1 1 — — $5,992.02 $5,992.02 $5,992.02 2026-04-01
541 MS_DRG Osteomyelitis Without Cc/Mcc 1 1 — — $5,933.55 $5,933.55 $5,933.55 2026-04-01
5301 OTHER Level 1 Upper Gi Procedures 10 7 — — $168.04 $9,546.23 $5,809.89 2026-04-01
7048 OTHER Alteplase Recombinant 2 2 — — $3,708.10 $7,397.81 $5,552.95 2026-04-01
794 MS_DRG Neonate With Other Significant Problems 3 3 — — $3,058.80 $9,123.87 $5,535.05 2026-04-01
914 MS_DRG Traumatic Injury Without Mcc 1 1 — — $5,500.93 $5,500.93 $5,500.93 2026-04-01
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 1 1 — — $5,468.89 $5,468.89 $5,468.89 2026-04-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 2 2 — — $4,238.69 $6,625.53 $5,432.11 2026-04-01
5401 OTHER Dialysis 1 1 — — $5,304.20 $5,304.20 $5,304.20 2026-04-01
797 MS_DRG Vaginal Delivery With Sterilization And/Or D&c With Cc 1 1 — — $5,198.92 $5,198.92 $5,198.92 2026-04-01
5112 OTHER Level 2 Musculoskeletal Procedures 15 10 — — $2,075.08 $11,495.60 $5,192.27 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 2 — — $5,160.25 $5,217.56 $5,188.91 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 2 — — $765.86 $9,540.30 $5,153.08 2026-04-01
833 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures Without Cc/Mcc 3 3 — — $3,913.33 $5,716.57 $5,125.56 2026-04-01
5373 OTHER Level 3 Urology And Related Services 1 1 — — $5,055.87 $5,055.87 $5,055.87 2026-04-01
560 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Cc 2 2 — — $4,079.56 $5,823.97 $4,951.77 2026-04-01
606 MS_DRG Minor Skin Disorders With Mcc 1 1 — — $4,933.98 $4,933.98 $4,933.98 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 2 2 — — $1,451.13 $7,873.83 $4,662.48 2026-04-01
809 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $4,657.13 $4,657.13 $4,657.13 2026-04-01
795 MS_DRG Normal Newborn 5 5 — — $1,018.37 $5,107.87 $4,644.02 2026-04-01
101 MS_DRG Seizures Without Mcc 1 1 — — $4,622.68 $4,622.68 $4,622.68 2026-04-01
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/Mcc 1 1 — — $4,520.31 $4,520.31 $4,520.31 2026-04-01
69 MS_DRG Transient Ischemia Without Thrombolytic 1 1 — — $4,375.41 $4,375.41 $4,375.41 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 1 1 — — $4,367.86 $4,367.86 $4,367.86 2026-04-01
5594 OTHER Level 4 Nuclear Medicine And Related Services 3 3 — — $4,196.51 $6,640.12 $4,322.40 2026-04-01
284 MS_DRG Acute Myocardial Infarction, Expired With Cc 1 1 — — $4,223.74 $4,223.74 $4,223.74 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 1 1 — — $4,108.57 $4,108.57 $4,108.57 2026-04-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $3,932.79 $3,932.79 $3,932.79 2026-04-01
5241 OTHER Level 1 Blood Product Exchange And Related Services 8 6 — — $447.12 $33,119.40 $3,911.27 2026-04-01
375 MS_DRG Digestive Malignancy With Cc 2 2 — — $3,778.27 $4,000.73 $3,889.50 2026-04-01
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 2 2 — — $2,512.80 $4,799.86 $3,656.33 2026-04-01
5025 OTHER Level 5 Type A Ed Visits 21 13 — — $418.50 $5,850.52 $3,512.72 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 1 — — $3,386.13 $3,386.13 $3,386.13 2026-04-01
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $3,327.65 $3,327.65 $3,327.65 2026-04-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 2 2 — — $1,989.44 $4,507.48 $3,248.46 2026-04-01
103 MS_DRG Headaches Without Mcc 1 1 — — $3,242.34 $3,242.34 $3,242.34 2026-04-01
5593 OTHER Level 3 Nuclear Medicine And Related Services 10 7 — — $660.50 $4,275.75 $3,224.12 2026-04-01
313 MS_DRG Chest Pain 1 1 — — $3,074.55 $3,074.55 $3,074.55 2026-04-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 1 1 — — $3,026.81 $3,026.81 $3,026.81 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 1 1 — — $2,986.87 $2,986.87 $2,986.87 2026-04-01
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc/Mcc 3 3 — — $997.30 $29,789.53 $2,968.70 2026-04-01
5182 OTHER Level 2 Vascular Procedures 2 2 — — $255.87 $5,335.67 $2,795.77 2026-04-01
5572 OTHER Level 2 Imaging With Contrast 14 8 — — $305.64 $3,645.96 $2,615.66 2026-04-01
5781 OTHER Resuscitation And Cardioversion 9 5 — — $1,140.20 $3,532.71 $2,592.42 2026-04-01
539 MS_DRG Osteomyelitis With Mcc 2 2 — — $320.25 $4,792.98 $2,556.61 2026-04-01
5592 OTHER Level 2 Nuclear Medicine And Related Services 7 6 — — $668.40 $3,066.60 $2,508.80 2026-04-01
5573 OTHER Level 3 Imaging With Contrast 11 9 — — $359.18 $3,397.86 $2,394.46 2026-04-01
5181 OTHER Level 1 Vascular Procedures 2 2 — — $1,626.23 $2,605.83 $2,116.03 2026-04-01
5071 OTHER Level 1 Excision/ Biopsy/ Incision And Drainage 9 7 — — $432.54 $4,480.06 $2,081.58 2026-04-01
5524 OTHER Level 4 Imaging Without Contrast 16 10 — — $359.47 $3,992.59 $1,912.00 2026-04-01
5691 OTHER Level 1 Drug Administration 3 3 — — $791.13 $23,882.67 $1,737.40 2026-04-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/Mcc 2 2 — — $375.53 $3,023.53 $1,699.53 2026-04-01
5591 OTHER Level 1 Nuclear Medicine And Related Services 7 5 — — $30.00 $2,411.28 $1,686.73 2026-04-01
5024 OTHER Level 4 Type A Ed Visits 21 13 — — $193.25 $3,315.02 $1,621.58 2026-04-01
5052 OTHER Level 2 Skin Procedures 9 7 — — $278.21 $2,086.90 $1,592.83 2026-04-01
5674 OTHER Level 4 Pathology 1 1 — — $1,477.68 $1,477.68 $1,477.68 2026-04-01
9530 OTHER Plate Pheres Leukoredu Irrad 1 1 — — $1,436.34 $1,436.34 $1,436.34 2026-04-01
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses Without Cc/Mcc 2 2 — — $87.26 $2,780.97 $1,434.11 2026-04-01
5442 OTHER Level 2 Nerve Injections 5 5 — — $636.13 $2,740.45 $1,414.86 2026-04-01
5693 OTHER Level 3 Drug Administration 14 10 — — $201.50 $21,604.26 $1,381.74 2026-04-01
5523 OTHER Level 3 Imaging Without Contrast 17 11 — — $169.95 $3,430.13 $1,357.25 2026-04-01
784 MS_DRG Cesarean Section With Sterilization With Cc 1 1 — — $1,344.89 $1,344.89 $1,344.89 2026-04-01
5571 OTHER Level 1 Imaging With Contrast 15 10 — — $80.28 $2,893.23 $1,301.84 2026-04-01
5673 OTHER Level 3 Pathology 6 6 — — $201.94 $5,157.31 $1,189.58 2026-04-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 1 1 — — $1,093.83 $1,093.83 $1,093.83 2026-04-01
5672 OTHER Level 2 Pathology 9 8 — — $233.60 $2,485.60 $1,023.93 2026-04-01
5101 OTHER Level 1 Strapping And Cast Application 5 4 — — $203.22 $1,288.20 $993.00 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $961.35 $961.35 $961.35 2026-04-01
5441 OTHER Level 1 Nerve Injections 12 6 — — $164.77 $1,480.55 $896.78 2026-04-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 1 1 — — $895.85 $895.85 $895.85 2026-04-01
5023 OTHER Level 3 Type A Ed Visits 19 11 — — $179.12 $1,243.93 $759.00 2026-04-01
5723 OTHER Level 3 Diagnostic Tests And Related Services 1 1 — — $737.14 $737.14 $737.14 2026-04-01
5411 OTHER Level 1 Gynecologic Procedures 14 10 — — $93.45 $1,544.76 $733.62 2026-04-01
5671 OTHER Level 1 Pathology 11 8 — — $55.02 $1,182.92 $727.57 2026-04-01
5371 OTHER Level 1 Urology And Related Services 2 2 — — $406.67 $982.04 $694.36 2026-04-01
5823 OTHER Level 3 Health And Behavior Services 13 8 — — $107.54 $1,023.33 $616.00 2026-04-01
9011 OTHER Mmrv Vaccine Sc 3 2 — — $151.12 $705.35 $610.60 2026-04-01
5111 OTHER Level 1 Musculoskeletal Procedures 6 4 — — $42.00 $5,134.70 $601.08 2026-04-01
9398 OTHER Covid-19 Vaccine Administration 9 6 — — $205.57 $757.37 $561.79 2026-04-01
N903 OTHER Influenza Vaccines & Pneumococcal Pneumonia Vaccines 2 2 — — $142.15 $981.05 $561.60 2026-04-01
5722 OTHER Level 2 Diagnostic Tests And Related Services 9 7 — — $80.05 $1,298.24 $522.68 2026-04-01
5022 OTHER Level 2 Type A Ed Visits 17 11 — — $102.73 $1,071.61 $517.78 2026-04-01
5522 OTHER Level 2 Imaging Without Contrast 18 12 — — $79.90 $814.15 $515.83 2026-04-01
N905 OTHER Not Recognized By Opps 11 9 — — $72.42 $3,452.90 $469.00 2026-04-01
N804 OTHER Mammography Services 15 9 — — $52.04 $514.45 $445.22 2026-04-01
5692 OTHER Level 2 Drug Administration 16 11 — — $53.29 $537.31 $384.98 2026-04-01
5733 OTHER Level 3 Minor Procedures 15 10 — — $124.73 $568.84 $379.23 2026-04-01
0790 RC Inj, Methylpred Acetate 1 Mg 9 7 — — $75.06 $480.14 $357.52 2026-04-01
5734 OTHER Level 4 Minor Procedures 14 9 — — $46.04 $579.60 $355.77 2026-04-01
204 MS_DRG Respiratory Signs And Symptoms 1 1 — — $340.24 $340.24 $340.24 2026-04-01
5721 OTHER Level 1 Diagnostic Tests And Related Services 12 8 — — $79.68 $436.27 $330.77 2026-04-01
N801 OTHER Therapy Services 16 10 — — $62.32 $417.65 $330.27 2026-04-01
5012 OTHER Clinic Visits And Related Services 18 11 — — $83.39 $990.00 $327.74 2026-04-01
N902 OTHER Packaged Services 16 10 — — $84.02 $629.08 $313.44 2026-04-01
N900 OTHER Non-covered Services 12 9 — — $104.06 $1,149.36 $296.74 2026-04-01
5051 OTHER Level 1 Skin Procedures 10 7 — — $128.04 $1,405.62 $294.33 2026-04-01
5732 OTHER Level 2 Minor Procedures 13 9 — — $61.31 $1,110.96 $292.36 2026-04-01
5162 OTHER Level 2 ENT Procedures 1 1 — — $287.91 $287.91 $287.91 2026-04-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 1 1 — — $287.34 $287.34 $287.34 2026-04-01
N907 OTHER Not Billable To Fi 5 4 — — $141.14 $341.10 $277.49 2026-04-01
300 MS_DRG Peripheral Vascular Disorders With Cc 1 1 — — $260.98 $260.98 $260.98 2026-04-01
N700 OTHER Non-opps Clinic Services 16 9 — — $83.47 $358.00 $252.09 2026-04-01
5151 OTHER Level 1 Airway Endoscopy 4 3 — — $208.03 $1,535.64 $241.07 2026-04-01
5821 OTHER Level 1 Health And Behavior Services 6 4 — — $15.10 $640.50 $212.77 2026-04-01
5021 OTHER Level 1 Type A Ed Visits 18 12 — — $112.32 $710.76 $196.81 2026-04-01
0874 RC Synvisc Or Synvisc-one 2 2 — — $157.87 $233.93 $195.90 2026-04-01
N805 OTHER Durable Medical Equipment 2 2 — — $111.32 $275.52 $193.42 2026-04-01
881 MS_DRG Depressive Neuroses 1 1 — — $193.20 $193.20 $193.20 2026-04-01
5521 OTHER Level 1 Imaging Without Contrast 19 11 — — $20.97 $281.27 $182.44 2026-04-01
N999 OTHER Other Non-covered Services 1 1 — — $158.09 $158.09 $158.09 2026-04-01
N809 OTHER Other Medicine 6 5 — — $20.16 $324.99 $136.55 2026-04-01
N800 OTHER Clinical Diagnostic Lab Services 17 10 — — $9.91 $355.88 $115.00 2026-04-01
5741 OTHER Level 1 Electronic Analysis Of Devices 10 7 — — $35.73 $303.34 $107.23 2026-04-01
5822 OTHER Level 2 Health And Behavior Services 11 8 — — $26.03 $318.49 $72.01 2026-04-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 1 1 — — $63.06 $63.06 $63.06 2026-04-01
5791 OTHER Pulmonary Treatment 3 3 — — $9.15 $361.80 $35.23 2026-04-01
5102 OTHER Level 2 Strapping And Cast Application 1 1 — — $35.00 $35.00 $35.00 2026-04-01
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