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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

WELLSPAN EVANGELICAL COMMUNITY HOSPITAL

Lewisburg, PA · CCN 390013 · Rates published

1,453 distinct procedures filed
27 distinct payers
75,392 rate rows
2026-01-01 last MRF observed
Data quality

75,088 of 75,392 rate rows are consumer-grade (99.6%)

304 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
per-diem day rate — not a per-procedure price 122
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 88
exceeds 10× this hospital's gross charge — excluded from medians 60
placeholder amount (≤ $0.02) — excluded from medians 34
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.wellspan.org/-/media/Project/Wellspan-Site-Tenant/wellspan-site/data/media/files/Patient-Resources/Cost/240795411_evangelical-community-hospital_standardcharges.csv
Found on page https://www.wellspan.org/Patient-Resources/Billing-and-Insurance/Cost-Estimates
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-05-19
Content fingerprint 404598efccffe934… · 7,005,673 bytes · first seen 2026-05-17

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
005 SOI 4
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 7 $94,677.17 $109,744.36 $99,185.60 —
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 $36,645.09 $117,213.00 $41,042.50 nat. median
$54,210
0.8× median
00304 SOI 3
APR_DRG 		Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 7 $36,006.55 $41,736.73 $37,721.15 —
00710 SOI 4
APR_DRG 		Infectious And Parasitic Diseases Including HIV With O.r. Procedure 7 $34,676.75 $40,195.31 $36,328.03 —
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With McC 21 $32,190.58 $108,791.00 $36,053.45 nat. median
$48,170
0.7× median
00299 SOI 2
APR_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 $34,315.88 $39,777.01 $35,949.97 —
00175 SOI 4
APR_DRG 		Percutaneous Cardiac Intervention Without Ami 7 $33,013.48 $38,267.34 $34,585.55 —
329
MS_DRG 		Major Small And Large Bowel Procedures With McC 21 $29,960.72 $105,628.00 $33,556.01 nat. median
$44,810
0.7× median
00300 SOI 3
APR_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 $31,827.48 $36,892.60 $33,343.07 —
00174 SOI 4
APR_DRG 		Percutaneous Cardiac Intervention With Ami 7 $29,342.50 $34,012.15 $30,739.76 —
00171 SOI 4
APR_DRG 		Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 7 $29,167.20 $33,808.95 $30,556.12 —
00299 SOI 1
APR_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 $28,543.39 $33,085.86 $29,902.60 —
0024 SOI 4
APR_DRG 		Open Extracranial Vascular Procedures 7 $28,526.27 $33,066.02 $29,884.66 —
C9606
HCPCS 		Percutaneous Transluminal Revascularization 2 $25,823.26 $40,741.00 $28,518.70 nat. median
$18,105
1.6× median
00304 SOI 2
APR_DRG 		Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 7 $25,867.36 $29,983.97 $27,099.14 —
00181 SOI 3
APR_DRG 		Lower Extremity Vascular Procedures 7 $24,590.29 $28,503.66 $25,761.26 —
467
MS_DRG 		Revision Of Hip Or Knee Replacement With Cc 21 $22,986.94 $74,019.81 $25,745.37 nat. median
$34,720
0.7× median
00950 SOI 3
APR_DRG 		Extensive O.r. Procedure Unrelated To Principal Diagnosis 7 $24,520.44 $28,422.70 $25,688.08 —
00300 SOI 2
APR_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 $24,392.39 $28,274.27 $25,553.94 —
00169 SOI 2
APR_DRG 		Major Abdominal Vascular Procedures 7 $24,076.72 $27,908.36 $25,223.23 —
00308 SOI 4
APR_DRG 		Hip And Femur Fracture Repair 7 $23,777.48 $27,561.50 $24,909.74 —
C1778
HCPCS 		Lead, Neurostimulator (Implantable) 2 $20,693.95 $37,164.78 $24,090.55 nat. median
$4,308
outlier · 5.6×
C1764
HCPCS 		Device Cardiac 9.4mmx46.5mm Assert-iq Thk3.1mm 3+ Icm 2 $19,004.70 $28,528.86 $23,766.78 nat. median
$7,664
outlier · 3.1×
00710 SOI 3
APR_DRG 		Infectious And Parasitic Diseases Including HIV With O.r. Procedure 7 $22,555.88 $26,145.48 $23,629.97 —
C1821
HCPCS 		Cage Spinal Modulus L50 Mm X W18 Mm X H10 Mm 10 D Xl 1 $15,364.25 $25,533.87 $23,502.48 nat. median
$3,460
outlier · 6.8×
C1785
HCPCS 		Pacemaker Cardiac Assurity MRI Thk6mm 2 Chamber Pulse Generator Is-1 Connector R… 2 $12,132.61 $33,780.96 $22,956.78 nat. median
$6,506
outlier · 3.5×
00300 SOI 1
APR_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 $21,474.65 $24,892.18 $22,497.25 —
00231 SOI 3
APR_DRG 		Major Large Bowel Procedures 7 $20,966.56 $24,303.24 $21,964.97 —
0030 SOI 2
APR_DRG 		Percutaneous Intracranial And Extracranial Vascular Procedures 7 $20,785.78 $24,093.69 $21,775.58 —
00174 SOI 3
APR_DRG 		Percutaneous Cardiac Intervention With Ami 7 $20,685.81 $23,977.81 $21,670.85 —
00720 SOI 4
APR_DRG 		Septicemia And Disseminated Infections 7 $20,645.41 $23,930.98 $21,628.52 —
00313 SOI 3
APR_DRG 		Knee And Lower Leg Procedures Except Foot 7 $20,491.34 $23,752.39 $21,467.11 —
00711 SOI 3
APR_DRG 		Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 7 $20,085.28 $23,281.70 $21,041.72 —
00323 SOI 3
APR_DRG 		Non-elective Or Complex Hip Joint Replacement 7 $19,493.65 $22,595.92 $20,421.92 —
00951 SOI 3
APR_DRG 		Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 7 $19,304.65 $22,376.85 $20,223.92 —
00304 SOI 1
APR_DRG 		Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 7 $18,986.24 $22,007.77 $19,890.35 —
321
MS_DRG 		Percutaneous Cardiovascular Procedures With Intraluminal Device With McC Or 4+ A… 21 $17,734.61 $61,204.00 $19,862.76 nat. median
$28,170
0.7× median
C1761
HCPCS 		Catheter Ultrasound Shockwave C2+ 2.5mm .044in 138cm 12mm Coronary Arterial Conn… 1 $19,849.36 $19,849.36 $19,849.36 nat. median
$7,414
outlier · 2.7×
00181 SOI 2
APR_DRG 		Lower Extremity Vascular Procedures 7 $18,409.68 $21,339.45 $19,286.33 —
0024 SOI 3
APR_DRG 		Open Extracranial Vascular Procedures 7 $18,240.54 $21,143.39 $19,109.14 —
00694 SOI 4
APR_DRG 		Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 7 $18,172.07 $21,064.02 $19,037.40 —
0045 SOI 4
APR_DRG 		Cva And Precerebral Occlusion With Infarction 7 $18,015.94 $20,883.05 $18,873.84 —
00206 SOI 4
APR_DRG 		Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure 7 $17,857.76 $20,699.70 $18,708.13 —
00283 SOI 4
APR_DRG 		Other Disorders Of The Liver 7 $17,839.96 $20,679.06 $18,689.48 —
00194 SOI 4
APR_DRG 		Heart Failure 7 $17,813.25 $20,648.11 $18,661.50 —
00174 SOI 2
APR_DRG 		Percutaneous Cardiac Intervention With Ami 7 $17,616.04 $20,419.51 $18,454.90 —
00321 SOI 2
APR_DRG 		Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 7 $17,599.61 $20,400.46 $18,437.69 —
00200 SOI 4
APR_DRG 		Cardiac Structural And Valvular Disorders 7 $17,488.68 $20,271.88 $18,321.47 —
23472
CPT 		Prosthetic Repair Of Shoulder Joint, Total Shoulder 26 $853.60 $75,463.52 $18,222.35 nat. median
$16,400
1.1× median
23430
CPT 		Anchoring Of Biceps Tendon 26 $853.60 $75,463.52 $18,222.35 nat. median
$6,990
outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 1,453 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
             
005 SOI 4 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 7 — — $94,677.17 $109,744.36 $99,185.60 2026-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 46 21 — — $36,645.09 $117,213.00 $41,042.50 2026-01-01
00304 SOI 3 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 14 7 — — $36,006.55 $41,736.73 $37,721.15 2026-01-01
00710 SOI 4 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 14 7 — — $34,676.75 $40,195.31 $36,328.03 2026-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With McC 46 21 — — $32,190.58 $108,791.00 $36,053.45 2026-01-01
00299 SOI 2 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 7 — — $34,315.88 $39,777.01 $35,949.97 2026-01-01
00175 SOI 4 APR_DRG Percutaneous Cardiac Intervention Without Ami 14 7 — — $33,013.48 $38,267.34 $34,585.55 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With McC 46 21 — — $29,960.72 $105,628.00 $33,556.01 2026-01-01
00300 SOI 3 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 7 — — $31,827.48 $36,892.60 $33,343.07 2026-01-01
00174 SOI 4 APR_DRG Percutaneous Cardiac Intervention With Ami 14 7 — — $29,342.50 $34,012.15 $30,739.76 2026-01-01
00171 SOI 4 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 14 7 — — $29,167.20 $33,808.95 $30,556.12 2026-01-01
00299 SOI 1 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 7 — — $28,543.39 $33,085.86 $29,902.60 2026-01-01
0024 SOI 4 APR_DRG Open Extracranial Vascular Procedures 14 7 — — $28,526.27 $33,066.02 $29,884.66 2026-01-01
C9606 HCPCS Percutaneous Transluminal Revascularization 6 2 $26,594.50 $21,275.60 20% off $25,823.26 $40,741.00 $28,518.70 2026-01-01
00304 SOI 2 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 14 7 — — $25,867.36 $29,983.97 $27,099.14 2026-01-01
00181 SOI 3 APR_DRG Lower Extremity Vascular Procedures 14 7 — — $24,590.29 $28,503.66 $25,761.26 2026-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 46 21 — — $22,986.94 $74,019.81 $25,745.37 2026-01-01
00950 SOI 3 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 14 7 — — $24,520.44 $28,422.70 $25,688.08 2026-01-01
00300 SOI 2 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 7 — — $24,392.39 $28,274.27 $25,553.94 2026-01-01
00169 SOI 2 APR_DRG Major Abdominal Vascular Procedures 14 7 — — $24,076.72 $27,908.36 $25,223.23 2026-01-01
00308 SOI 4 APR_DRG Hip And Femur Fracture Repair 14 7 — — $23,777.48 $27,561.50 $24,909.74 2026-01-01
C1778 HCPCS Lead, Neurostimulator (Implantable) 6 2 $21,312.00 $17,049.60 20% off $20,693.95 $37,164.78 $24,090.55 2026-01-01
C1764 HCPCS Device Cardiac 9.4mmx46.5mm Assert-iq Thk3.1mm 3+ Icm 4 2 $19,572.30 $15,657.84 $19,004.70 $28,528.86 $23,766.78 2026-01-01
00710 SOI 3 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 14 7 — — $22,555.88 $26,145.48 $23,629.97 2026-01-01
C1821 HCPCS Cage Spinal Modulus L50 Mm X W18 Mm X H10 Mm 10 D Xl 6 1 $21,913.06 $17,530.45 $15,364.25 $25,533.87 $23,502.48 2026-01-01
C1785 HCPCS Pacemaker Cardiac Assurity MRI Thk6mm 2 Chamber Pulse Generator Is-1 Connector R… 4 2 $12,494.96 $9,995.97 $12,132.61 $33,780.96 $22,956.78 2026-01-01
00300 SOI 1 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 7 — — $21,474.65 $24,892.18 $22,497.25 2026-01-01
00231 SOI 3 APR_DRG Major Large Bowel Procedures 14 7 — — $20,966.56 $24,303.24 $21,964.97 2026-01-01
0030 SOI 2 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 14 7 — — $20,785.78 $24,093.69 $21,775.58 2026-01-01
00174 SOI 3 APR_DRG Percutaneous Cardiac Intervention With Ami 14 7 — — $20,685.81 $23,977.81 $21,670.85 2026-01-01
00720 SOI 4 APR_DRG Septicemia And Disseminated Infections 14 7 — — $20,645.41 $23,930.98 $21,628.52 2026-01-01
00313 SOI 3 APR_DRG Knee And Lower Leg Procedures Except Foot 14 7 — — $20,491.34 $23,752.39 $21,467.11 2026-01-01
00711 SOI 3 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 14 7 — — $20,085.28 $23,281.70 $21,041.72 2026-01-01
00323 SOI 3 APR_DRG Non-elective Or Complex Hip Joint Replacement 14 7 — — $19,493.65 $22,595.92 $20,421.92 2026-01-01
00951 SOI 3 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 14 7 — — $19,304.65 $22,376.85 $20,223.92 2026-01-01
00304 SOI 1 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 14 7 — — $18,986.24 $22,007.77 $19,890.35 2026-01-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With McC Or 4+ A… 46 21 — — $17,734.61 $61,204.00 $19,862.76 2026-01-01
C1761 HCPCS Catheter Ultrasound Shockwave C2+ 2.5mm .044in 138cm 12mm Coronary Arterial Conn… 2 1 $20,442.18 $16,353.74 20% off $19,849.36 $19,849.36 $19,849.36 2026-01-01
00181 SOI 2 APR_DRG Lower Extremity Vascular Procedures 14 7 — — $18,409.68 $21,339.45 $19,286.33 2026-01-01
0024 SOI 3 APR_DRG Open Extracranial Vascular Procedures 14 7 — — $18,240.54 $21,143.39 $19,109.14 2026-01-01
00694 SOI 4 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 14 7 — — $18,172.07 $21,064.02 $19,037.40 2026-01-01
0045 SOI 4 APR_DRG Cva And Precerebral Occlusion With Infarction 14 7 — — $18,015.94 $20,883.05 $18,873.84 2026-01-01
00206 SOI 4 APR_DRG Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure 14 7 — — $17,857.76 $20,699.70 $18,708.13 2026-01-01
00283 SOI 4 APR_DRG Other Disorders Of The Liver 14 7 — — $17,839.96 $20,679.06 $18,689.48 2026-01-01
00194 SOI 4 APR_DRG Heart Failure 14 7 — — $17,813.25 $20,648.11 $18,661.50 2026-01-01
00174 SOI 2 APR_DRG Percutaneous Cardiac Intervention With Ami 14 7 — — $17,616.04 $20,419.51 $18,454.90 2026-01-01
00321 SOI 2 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 14 7 — — $17,599.61 $20,400.46 $18,437.69 2026-01-01
00200 SOI 4 APR_DRG Cardiac Structural And Valvular Disorders 14 7 — — $17,488.68 $20,271.88 $18,321.47 2026-01-01
27702 CPT Reconstruction Of Ankle Joint With Prosthesis 58 26 — — $853.60 $75,463.52 $18,222.35 2026-01-01
23430 CPT Anchoring Of Biceps Tendon 58 26 — — $853.60 $75,463.52 $18,222.35 2026-01-01
23472 CPT Prosthetic Repair Of Shoulder Joint, Total Shoulder 58 26 — — $853.60 $75,463.52 $18,222.35 2026-01-01
0050 SOI 3 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 14 7 — — $16,997.02 $19,701.98 $17,806.41 2026-01-01
00227 SOI 3 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 14 7 — — $16,873.77 $19,559.11 $17,677.28 2026-01-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 46 21 — — $15,625.33 $54,087.00 $17,500.37 2026-01-01
00308 SOI 3 APR_DRG Hip And Femur Fracture Repair 14 7 — — $16,501.26 $19,127.32 $17,287.04 2026-01-01
00190 SOI 4 APR_DRG Acute Myocardial Infarction 14 7 — — $16,332.81 $18,932.06 $17,110.56 2026-01-01
0052 SOI 4 APR_DRG Alteration In Consciousness 14 7 — — $15,991.12 $18,535.99 $16,752.60 2026-01-01
00175 SOI 1 APR_DRG Percutaneous Cardiac Intervention Without Ami 14 7 — — $15,885.66 $18,413.75 $16,642.13 2026-01-01
00325 SOI 1 APR_DRG Non-elective Or Complex Knee Joint Replacement 14 7 — — $15,845.95 $18,367.72 $16,600.52 2026-01-01
00136 SOI 4 APR_DRG Respiratory Malignancy 14 7 — — $15,835.68 $18,355.81 $16,589.76 2026-01-01
00326 SOI 3 APR_DRG Elective Knee Joint Replacement 14 7 — — $15,728.17 $18,231.20 $16,477.13 2026-01-01
00263 SOI 3 APR_DRG Cholecystectomy 14 7 — — $15,696.67 $18,194.69 $16,444.13 2026-01-01
00253 SOI 4 APR_DRG Other And Unspecified Gastrointestinal Hemorrhage 14 7 — — $15,652.85 $18,143.89 $16,398.22 2026-01-01
00421 SOI 4 APR_DRG Malnutrition, Failure To Thrive And Other Nutritional Disorders 14 7 — — $15,556.30 $18,031.97 $16,297.07 2026-01-01
00710 SOI 2 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 14 7 — — $15,213.92 $17,635.11 $15,938.39 2026-01-01
00134 SOI 4 APR_DRG Pulmonary Embolism 14 7 — — $15,165.30 $17,578.75 $15,887.46 2026-01-01
00137 SOI 4 APR_DRG Major Respiratory Infections And Inflammations 14 7 — — $15,122.85 $17,529.54 $15,842.98 2026-01-01
00230 SOI 2 APR_DRG Major Small Bowel Procedures 14 7 — — $15,112.57 $17,517.63 $15,832.22 2026-01-01
00466 SOI 4 APR_DRG Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure 14 7 — — $15,043.41 $17,437.47 $15,759.77 2026-01-01
00192 SOI 3 APR_DRG Cardiac Catheterization For Other Non-coronary Conditions 14 7 — — $15,039.99 $17,433.50 $15,756.18 2026-01-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without McC 46 21 — — $13,803.51 $46,608.00 $15,459.93 2026-01-01
00231 SOI 2 APR_DRG Major Large Bowel Procedures 14 7 — — $14,579.15 $16,899.32 $15,273.39 2026-01-01
00323 SOI 2 APR_DRG Non-elective Or Complex Hip Joint Replacement 14 7 — — $14,494.92 $16,801.69 $15,185.16 2026-01-01
00313 SOI 2 APR_DRG Knee And Lower Leg Procedures Except Foot 14 7 — — $14,427.13 $16,723.11 $15,114.14 2026-01-01
C1732 HCPCS Catheter Electrophysiology Carto 3 Thermocool Sf D-d Curve 7.5fr Bidirectional D… 4 2 $13,248.27 $10,598.62 $12,864.07 $16,618.12 $14,741.09 2026-01-01
00171 SOI 2 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 14 7 — — $14,031.34 $16,264.33 $14,699.50 2026-01-01
00426 SOI 4 APR_DRG Non-hypovolemic Sodium Disorders 14 7 — — $13,928.63 $16,145.27 $14,591.90 2026-01-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 46 21 — — $13,023.93 $50,364.00 $14,586.80 2026-01-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 46 21 — — $13,005.03 $43,826.00 $14,565.63 2026-01-01
00174 SOI 1 APR_DRG Percutaneous Cardiac Intervention With Ami 14 7 — — $13,901.93 $16,114.32 $14,563.92 2026-01-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With McC 46 21 — — $12,661.52 $40,771.13 $14,180.90 2026-01-01
100 MS_DRG Seizures With McC 46 21 — — $12,624.37 $40,651.50 $14,139.29 2026-01-01
470 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity 46 21 — — $12,572.88 $44,010.00 $14,081.63 2026-01-01
00181 SOI 1 APR_DRG Lower Extremity Vascular Procedures 14 7 — — $13,399.31 $15,531.72 $14,037.38 2026-01-01
00201 SOI 4 APR_DRG Cardiac Arrhythmia And Conduction Disorders 14 7 — — $13,338.37 $15,461.08 $13,973.53 2026-01-01
00226 SOI 3 APR_DRG Anal And Perineal Procedures 14 7 — — $13,152.80 $15,245.98 $13,779.13 2026-01-01
00951 SOI 2 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 14 7 — — $13,149.38 $15,242.01 $13,775.54 2026-01-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 46 21 — — $12,190.91 $42,778.00 $13,653.82 2026-01-01
00308 SOI 2 APR_DRG Hip And Femur Fracture Repair 14 7 — — $12,996.68 $15,065.01 $13,615.57 2026-01-01
00224 SOI 2 APR_DRG Peritoneal Adhesiolysis 14 7 — — $12,646.08 $14,658.62 $13,248.28 2026-01-01
0058 SOI 3 APR_DRG Other Disorders Of Nervous System 14 7 — — $12,624.85 $14,634.01 $13,226.04 2026-01-01
00139 SOI 4 APR_DRG Other Pneumonia 14 7 — — $12,496.81 $14,485.58 $13,091.89 2026-01-01
00661 SOI 3 APR_DRG Coagulation And Platelet Disorders 14 7 — — $12,465.99 $14,449.86 $13,059.61 2026-01-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/McC 46 21 — — $11,529.97 $37,263.00 $12,913.57 2026-01-01
27447 CPT Replacement Of Knee Joint, Both Sides Of Knee 58 26 — — $853.60 $52,798.96 $12,873.27 2026-01-01
00770 SOI 4 APR_DRG Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice 14 7 — — $12,282.48 $14,237.14 $12,867.36 2026-01-01
27130 CPT Replacement Of Thigh Bone And Hip Joint With Prosthesis 56 26 — — $853.60 $52,798.96 $12,811.38 2026-01-01
C1714 HCPCS System Internal Fixation 4 Leg Low Profile Broad Bridge Dynaclip Forte L30 Mm X … 4 2 $11,939.10 $9,551.28 20% off $11,592.87 $13,997.91 $12,795.39 2026-01-01
22551 CPT Fusion Of Upper Spine Bone With Removal Of Disc And Release Of Spinal Cord Or Ne… 58 26 — — $853.60 $52,798.96 $12,749.48 2026-01-01
28715 CPT Fusion Of 3 Bones Of Ankle 58 26 — — $853.60 $52,798.96 $12,749.48 2026-01-01
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 54 25 $91,300.50 $73,040.40 20% off $9,678.90 $40,396.80 $12,745.30 2026-01-01
00140 SOI 4 APR_DRG Chronic Obstructive Pulmonary Disease 14 7 — — $12,132.51 $14,063.32 $12,710.25 2026-01-01
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 38 18 — — $11,747.03 $31,129.40 $12,686.79 2026-01-01
0030 SOI 1 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 14 7 — — $12,103.07 $14,029.19 $12,679.41 2026-01-01
92979 CPT Ultrasound Of Heart Blood Vessel Or Graft, Ea Addl Vessel 6 2 $4,164.00 $3,331.20 20% off $4,043.24 $18,076.00 $12,653.20 2026-01-01
0043 SOI 2 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 14 7 — — $12,057.19 $13,976.01 $12,631.34 2026-01-01
00323 SOI 1 APR_DRG Non-elective Or Complex Hip Joint Replacement 14 7 — — $12,002.41 $13,912.51 $12,573.95 2026-01-01
00220 SOI 1 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 14 7 — — $11,793.56 $13,670.42 $12,355.16 2026-01-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 46 21 — — $11,026.12 $35,504.99 $12,349.25 2026-01-01
00462 SOI 3 APR_DRG Nephritis And Nephrosis 14 7 — — $11,784.66 $13,660.10 $12,345.83 2026-01-01
C1874 HCPCS System Coronary Stent 38mm 2.75mm Xience Skypoint Multi-link Pebax Everolimus Co… 14 2 $12,178.32 $9,742.66 $3,988.84 $42,190.45 $12,247.48 2026-01-01
00223 SOI 2 APR_DRG Other Small And Large Bowel Procedures 14 7 — — $11,687.42 $13,547.39 $12,243.97 2026-01-01
00792 SOI 1 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 14 7 — — $11,611.42 $13,459.29 $12,164.34 2026-01-01
00171 SOI 1 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 14 7 — — $11,586.08 $13,429.92 $12,137.80 2026-01-01
00463 SOI 4 APR_DRG Kidney And Urinary Tract Infections 14 7 — — $11,552.53 $13,391.03 $12,102.65 2026-01-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With McC 46 21 — — $10,783.64 $34,724.20 $12,077.68 2026-01-01
00721 SOI 3 APR_DRG Post-operative, Post-traumatic, Other Device Infections 14 7 — — $11,453.24 $13,275.94 $11,998.63 2026-01-01
00263 SOI 2 APR_DRG Cholecystectomy 14 7 — — $11,404.62 $13,219.58 $11,947.70 2026-01-01
00231 SOI 1 APR_DRG Major Large Bowel Procedures 14 7 — — $11,371.07 $13,180.69 $11,912.54 2026-01-01
C1889 HCPCS Substitute Bone Graft I Factor Allograft Putty Syringe 5cc 2 1 $12,178.32 $9,742.66 $11,825.15 $11,825.15 $11,825.15 2026-01-01
00344 SOI 3 APR_DRG Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections 14 7 — — $11,221.79 $13,007.66 $11,756.16 2026-01-01
0360 RC — 10 1 $12,093.25 $9,674.60 20% off $3,671.11 $17,120.67 $11,742.55 2026-01-01
00720 SOI 3 APR_DRG Septicemia And Disseminated Infections 14 7 — — $11,195.77 $12,977.49 $11,728.90 2026-01-01
620 MS_DRG O.r. Procedures For Obesity With Cc 46 21 — — $10,431.01 $38,048.00 $11,682.73 2026-01-01
368 MS_DRG Major Esophageal Disorders With McC 46 21 — — $10,376.26 $39,928.00 $11,621.41 2026-01-01
00694 SOI 3 APR_DRG Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior 14 7 — — $11,010.20 $12,762.39 $11,534.49 2026-01-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With McC 46 21 — — $10,271.32 $33,074.47 $11,503.88 2026-01-01
177 MS_DRG Respiratory Infections And Inflammations With McC 46 21 — — $10,185.93 $39,755.00 $11,408.24 2026-01-01
0045 SOI 3 APR_DRG Cva And Precerebral Occlusion With Infarction 14 7 — — $10,867.08 $12,596.50 $11,384.57 2026-01-01
00313 SOI 1 APR_DRG Knee And Lower Leg Procedures Except Foot 14 7 — — $10,828.74 $12,552.05 $11,344.39 2026-01-01
00660 SOI 3 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 14 7 — — $10,735.61 $12,444.11 $11,246.83 2026-01-01
00422 SOI 4 APR_DRG Hypovolemia And Related Electrolyte Disorders 14 7 — — $10,712.33 $12,417.12 $11,222.44 2026-01-01
00403 SOI 2 APR_DRG Procedures For Obesity 14 7 — — $10,489.78 $12,159.16 $10,989.30 2026-01-01
92973 CPT Removal Of Blood Clot In Heart Artery 8 3 $9,499.25 $7,599.40 20% off $209.20 $18,076.00 $10,938.49 2026-01-01
0481 RC — 52 23 $23,965.00 $19,172.00 20% off $331.35 $40,741.00 $10,909.86 2026-01-01
37228 CPT Balloon Dilation Of Artery Of Leg, Initial Vessel 60 27 $6,122.00 $4,897.60 $518.43 $33,310.51 $10,909.86 2026-01-01
37226 CPT Insertion Of Stent In Arteries Of Leg 60 27 $11,342.50 $9,074.00 20% off $468.11 $37,768.17 $10,909.86 2026-01-01
727 MS_DRG Inflammation Of The Male Reproductive System With McC 46 21 — — $9,665.78 $31,124.59 $10,825.67 2026-01-01
00710 SOI 1 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 14 7 — — $10,315.17 $11,956.76 $10,806.37 2026-01-01
00192 SOI 2 APR_DRG Cardiac Catheterization For Other Non-coronary Conditions 14 7 — — $10,310.38 $11,951.20 $10,801.35 2026-01-01
00324 SOI 1 APR_DRG Elective Hip Joint Replacement 14 7 — — $10,276.82 $11,912.31 $10,766.20 2026-01-01
00206 SOI 3 APR_DRG Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure 14 7 — — $10,251.49 $11,882.94 $10,739.65 2026-01-01
0024 SOI 2 APR_DRG Open Extracranial Vascular Procedures 14 7 — — $10,241.22 $11,871.03 $10,728.89 2026-01-01
00308 SOI 1 APR_DRG Hip And Femur Fracture Repair 14 7 — — $10,078.25 $11,682.13 $10,558.16 2026-01-01
00224 SOI 1 APR_DRG Peritoneal Adhesiolysis 14 7 — — $10,057.02 $11,657.52 $10,535.92 2026-01-01
58571 CPT Remove Uterus/Tubes/Ovaries Through Abdomen With Endoscope, 250.0g Or Less 58 26 — — $853.60 $42,722.39 $10,416.43 2026-01-01
00314 SOI 2 APR_DRG Foot And Toe Procedures 14 7 — — $9,921.44 $11,500.36 $10,393.89 2026-01-01
602 MS_DRG Cellulitis With McC 46 21 — — $9,264.26 $30,994.00 $10,375.97 2026-01-01
00228 SOI 2 APR_DRG Inguinal, Femoral And Umbilical Hernia Procedures 14 7 — — $9,853.65 $11,421.78 $10,322.87 2026-01-01
58542 CPT Partial Removal Of Uterus, Tubes, And/or Ovaries With Retention Of Cervix Using … 58 26 — — $853.60 $42,722.39 $10,316.27 2026-01-01
43281 CPT Repair Of Hernia Of Muscle At Esophagus And Stomach Using An Endoscope 58 26 — — $853.60 $42,722.39 $10,316.27 2026-01-01
00310 SOI 1 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 14 7 — — $9,787.91 $11,345.58 $10,254.00 2026-01-01
C1876 HCPCS Stent Nitinol Od10 Mm Odsec6 Fr L60 Mm L80 Cm Delivery System Radiopaque Cathete… 14 2 $9,855.74 $7,884.59 20% off $4,458.11 $14,139.50 $10,252.33 2026-01-01
811 MS_DRG Red Blood Cell Disorders With McC 46 21 — — $9,153.45 $29,474.85 $10,251.86 2026-01-01
00315 SOI 1 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 14 7 — — $9,668.76 $11,207.48 $10,129.18 2026-01-01
794 MS_DRG Neonate With Other Significant Problems 38 18 — — $6,762.57 $25,493.22 $10,101.16 2026-01-01
00242 SOI 3 APR_DRG Major Esophageal Disorders 14 7 — — $9,613.98 $11,143.98 $10,071.79 2026-01-01
00241 SOI 3 APR_DRG Peptic Ulcer And Gastritis 14 7 — — $9,594.81 $11,121.75 $10,051.70 2026-01-01
00143 SOI 3 APR_DRG Other Respiratory Diagnoses Except Signs, Symptoms And Miscellaneous Diagnoses 14 7 — — $9,583.85 $11,109.05 $10,040.23 2026-01-01
00283 SOI 3 APR_DRG Other Disorders Of The Liver 14 7 — — $9,528.39 $11,044.76 $9,982.12 2026-01-01
0053 SOI 3 APR_DRG Seizure 14 7 — — $9,480.45 $10,989.20 $9,931.90 2026-01-01
00384 SOI 3 APR_DRG Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue 14 7 — — $9,446.90 $10,950.31 $9,896.75 2026-01-01
00197 SOI 3 APR_DRG Peripheral And Other Vascular Disorders 14 7 — — $9,425.67 $10,925.70 $9,874.51 2026-01-01
92978 CPT Ultrasound Of Heart Blood Vessel Or Graft Initial Vessel 8 3 $7,134.00 $5,707.20 20% off $300.06 $18,076.00 $9,790.16 2026-01-01
00230 SOI 1 APR_DRG Major Small Bowel Procedures 14 7 — — $9,321.59 $10,805.05 $9,765.47 2026-01-01
00134 SOI 3 APR_DRG Pulmonary Embolism 14 7 — — $9,290.09 $10,768.54 $9,732.48 2026-01-01
00194 SOI 3 APR_DRG Heart Failure 14 7 — — $9,248.32 $10,720.12 $9,688.72 2026-01-01
00469 SOI 3 APR_DRG Acute Kidney Injury 14 7 — — $9,216.82 $10,683.61 $9,655.72 2026-01-01
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 46 21 — — $8,615.05 $40,163.00 $9,648.86 2026-01-01
00191 SOI 2 APR_DRG Cardiac Catheterization For Coronary Artery Disease 14 7 — — $9,151.09 $10,607.42 $9,586.85 2026-01-01
0052 SOI 3 APR_DRG Alteration In Consciousness 14 7 — — $9,143.55 $10,598.68 $9,578.96 2026-01-01
0058 SOI 2 APR_DRG Other Disorders Of Nervous System 14 7 — — $9,099.04 $10,547.09 $9,532.33 2026-01-01
00421 SOI 3 APR_DRG Malnutrition, Failure To Thrive And Other Nutritional Disorders 14 7 — — $9,073.71 $10,517.72 $9,505.79 2026-01-01
00951 SOI 1 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 14 7 — — $9,073.71 $10,517.72 $9,505.79 2026-01-01
00254 SOI 3 APR_DRG Other Digestive System Diagnoses 14 7 — — $8,997.70 $10,429.62 $9,426.16 2026-01-01
00133 SOI 3 APR_DRG Respiratory Failure 14 7 — — $8,994.96 $10,426.44 $9,423.29 2026-01-01
291 MS_DRG Heart Failure And Shock With McC 46 21 — — $8,368.01 $31,502.00 $9,372.17 2026-01-01
00466 SOI 3 APR_DRG Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure 14 7 — — $8,917.58 $10,336.75 $9,342.23 2026-01-01
00248 SOI 3 APR_DRG Major Gastrointestinal And Peritoneal Infections 14 7 — — $8,892.93 $10,308.18 $9,316.40 2026-01-01
00244 SOI 3 APR_DRG Diverticulitis And Diverticulosis 14 7 — — $8,707.36 $10,093.08 $9,122.00 2026-01-01
00860 SOI 1 APR_DRG Rehabilitation 14 7 — — $8,653.95 $10,031.17 $9,066.04 2026-01-01
00862 SOI 3 APR_DRG Other Aftercare And Convalescence 14 7 — — $8,625.19 $9,997.83 $9,035.92 2026-01-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 46 21 — — $8,052.53 $25,929.81 $9,018.83 2026-01-01
00661 SOI 2 APR_DRG Coagulation And Platelet Disorders 14 7 — — $8,600.54 $9,969.26 $9,010.09 2026-01-01
00468 SOI 3 APR_DRG Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms 14 7 — — $8,575.89 $9,940.68 $8,984.27 2026-01-01
C1762 HCPCS Graft Soft Tissue Anterior Tibialis Tendon Allograft Frozen 4 2 $9,807.90 $7,846.32 20% off $8,397.15 $9,523.47 $8,960.31 2026-01-01
00540 SOI 3 APR_DRG Cesarean Section Without Sterilization 14 7 — — $8,534.80 $9,893.06 $8,941.22 2026-01-01
00403 SOI 1 APR_DRG Procedures For Obesity 14 7 — — $8,484.82 $9,835.12 $8,888.86 2026-01-01
00663 SOI 3 APR_DRG Other Anemia And Disorders Of Blood And Blood-forming Organs 14 7 — — $8,383.47 $9,717.64 $8,782.69 2026-01-01
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With McC 46 21 — — $7,838.09 $25,239.27 $8,778.66 2026-01-01
C2623 HCPCS Balloon Dilatation Lutonix 035 9mm 60mm 75cm Paclitaxel Latex Free Accepts .035i… 6 1 $9,007.61 $7,206.09 $8,150.90 $14,739.21 $8,746.39 2026-01-01
J3101 HCPCS Tenecteplase IV Push For Acute Ischemic Stroke 54 25 $58,729.50 $46,983.60 20% off $6,539.40 $27,510.40 $8,611.05 2026-01-01
00233 SOI 1 APR_DRG Appendectomy With Complex Principal Diagnosis 14 7 — — $8,145.86 $9,442.22 $8,533.76 2026-01-01
0047 SOI 3 APR_DRG Transient Ischemia 14 7 — — $8,135.59 $9,430.31 $8,523.00 2026-01-01
00192 SOI 1 APR_DRG Cardiac Catheterization For Other Non-coronary Conditions 14 7 — — $8,042.46 $9,322.37 $8,425.44 2026-01-01
00137 SOI 3 APR_DRG Major Respiratory Infections And Inflammations 14 7 — — $8,036.30 $9,315.22 $8,418.98 2026-01-01
00247 SOI 3 APR_DRG Intestinal Obstruction 14 7 — — $7,961.66 $9,228.71 $8,340.79 2026-01-01
00501 SOI 3 APR_DRG Male Reproductive System Diagnoses Except Malignancy 14 7 — — $7,939.75 $9,203.31 $8,317.83 2026-01-01
00426 SOI 3 APR_DRG Non-hypovolemic Sodium Disorders 14 7 — — $7,887.71 $9,142.98 $8,263.31 2026-01-01
00228 SOI 1 APR_DRG Inguinal, Femoral And Umbilical Hernia Procedures 14 7 — — $7,874.70 $9,127.90 $8,249.68 2026-01-01
00861 SOI 3 APR_DRG Signs, Symptoms And Other Factors Influencing Health Status 14 7 — — $7,808.28 $9,050.91 $8,180.10 2026-01-01
0045 SOI 2 APR_DRG Cva And Precerebral Occlusion With Infarction 14 7 — — $7,798.01 $9,039.00 $8,169.34 2026-01-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 46 21 — — $7,279.48 $29,385.00 $8,153.02 2026-01-01
00420 SOI 3 APR_DRG Diabetes 14 7 — — $7,771.30 $9,008.05 $8,141.36 2026-01-01
0024 SOI 1 APR_DRG Open Extracranial Vascular Procedures 14 7 — — $7,725.42 $8,954.87 $8,093.30 2026-01-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With McC 46 21 — — $7,220.17 $24,444.00 $8,086.59 2026-01-01
00191 SOI 1 APR_DRG Cardiac Catheterization For Coronary Artery Disease 14 7 — — $7,695.29 $8,919.94 $8,061.74 2026-01-01
J0180 HCPCS Agalsidase Beta 35 Mg Intravenous Solution 54 25 $58,784.50 $47,027.60 20% off $6,117.65 $25,789.12 $8,055.39 2026-01-01
0046 SOI 2 APR_DRG Nonspecific Cva And Precerebral Occlusion Without Infarction 14 7 — — $7,662.42 $8,881.84 $8,027.30 2026-01-01
00139 SOI 3 APR_DRG Other Pneumonia 14 7 — — $7,642.57 $8,858.83 $8,006.50 2026-01-01
00383 SOI 3 APR_DRG Cellulitis And Other Skin Infections 14 7 — — $7,630.93 $8,845.33 $7,994.30 2026-01-01
33285 CPT Insertion Of Heart Rhythm Monitor Under Skin 50 23 $29,808.00 $23,846.40 $92.15 $34,157.00 $7,961.66 2026-01-01
33210 CPT Insertion Of Temporary Pacemaker Lead In Single Heart Chamber 60 27 $9,299.00 $7,439.20 20% off $181.39 $18,724.00 $7,961.66 2026-01-01
00344 SOI 2 APR_DRG Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections 14 7 — — $7,593.95 $8,802.47 $7,955.57 2026-01-01
00196 SOI 3 APR_DRG Cardiac Arrest And Shock 14 7 — — $7,591.21 $8,799.30 $7,952.70 2026-01-01
00812 SOI 3 APR_DRG Poisoning Of Medicinal Agents 14 7 — — $7,558.34 $8,761.20 $7,918.26 2026-01-01
00314 SOI 1 APR_DRG Foot And Toe Procedures 14 7 — — $7,526.84 $8,724.69 $7,885.26 2026-01-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without McC 46 21 — — $6,975.08 $24,895.00 $7,812.09 2026-01-01
00136 SOI 2 APR_DRG Respiratory Malignancy 14 7 — — $7,441.25 $8,625.47 $7,795.59 2026-01-01
00114 SOI 3 APR_DRG Dental Diseases And Disorders 14 7 — — $7,411.12 $8,590.55 $7,764.03 2026-01-01
00249 SOI 3 APR_DRG Other Gastroenteritis, Nausea And Vomiting 14 7 — — $7,357.02 $8,527.84 $7,707.36 2026-01-01
00190 SOI 2 APR_DRG Acute Myocardial Infarction 14 7 — — $7,314.57 $8,478.63 $7,662.88 2026-01-01
00201 SOI 3 APR_DRG Cardiac Arrhythmia And Conduction Disorders 14 7 — — $7,296.08 $8,457.20 $7,643.51 2026-01-01
00425 SOI 3 APR_DRG Other Non-hypovolemic Electrolyte Disorders 14 7 — — $7,207.06 $8,354.01 $7,550.26 2026-01-01
644 MS_DRG Endocrine Disorders With Cc 46 21 — — $6,681.11 $21,513.73 $7,482.84 2026-01-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without McC 46 21 — — $6,670.03 $21,893.00 $7,470.43 2026-01-01
00720 SOI 2 APR_DRG Septicemia And Disseminated Infections 14 7 — — $7,042.04 $8,162.72 $7,377.37 2026-01-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 46 21 — — $6,585.30 $22,209.00 $7,375.54 2026-01-01
00347 SOI 2 APR_DRG Other Back And Neck Disorders, Fractures And Injuries 14 7 — — $7,018.75 $8,135.74 $7,352.98 2026-01-01
00721 SOI 2 APR_DRG Post-operative, Post-traumatic, Other Device Infections 14 7 — — $6,957.13 $8,064.30 $7,288.42 2026-01-01
00463 SOI 3 APR_DRG Kidney And Urinary Tract Infections 14 7 — — $6,938.64 $8,042.87 $7,269.05 2026-01-01
00773 SOI 3 APR_DRG Opioid Abuse And Dependence 14 7 — — $6,938.64 $8,042.87 $7,269.05 2026-01-01
00140 SOI 3 APR_DRG Chronic Obstructive Pulmonary Disease 14 7 — — $6,844.14 $7,933.34 $7,170.05 2026-01-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 46 21 — — $6,392.36 $20,994.00 $7,159.44 2026-01-01
63030 CPT Partial Removal Of Spine Bone With Release Of Lower Spinal Cord Or Nerves And/or… 58 26 — — $853.60 $29,314.26 $7,147.31 2026-01-01
00349 SOI 2 APR_DRG Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure 14 7 — — $6,813.33 $7,897.62 $7,137.77 2026-01-01
00660 SOI 2 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 14 7 — — $6,786.62 $7,866.66 $7,109.79 2026-01-01
00862 SOI 2 APR_DRG Other Aftercare And Convalescence 14 7 — — $6,774.30 $7,852.38 $7,096.88 2026-01-01
29828 CPT Arthroscopy, Shoulder, Surgical; Biceps Tenodesis 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
29827 CPT Arthroscopy, Shoulder, Surgical; With Rotator Cuff Repair 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
29826 CPT Arthroscopy, Shoulder, Surgical; Decompression Of Subacromial Space With Partial… 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
29824 CPT Arthroscopy, Shoulder, Surgical; Distal Claviculectomy Including Distal Articula… 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
29823 CPT Removal Of Extensive Shoulder Joint Tissue Using An Endoscope 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
28750 CPT Fusion Of Big Toe At Joint With Foot 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
28285 CPT Correction Of Toe Joint Deformity 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
28110 CPT Removal Of Bunion At Fifth Toe Joint 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
27698 CPT Secondary Repair Of Disrupted Collateral Ligament Of Ankle 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
24685 CPT Treatment Of Broken Forearm Bone On Small Finger Side At Elbow 58 26 — — $853.60 $29,314.26 $7,078.58 2026-01-01
00200 SOI 2 APR_DRG Cardiac Structural And Valvular Disorders 14 7 — — $6,750.33 $7,824.60 $7,071.77 2026-01-01
552 MS_DRG Medical Back Problems Without McC 46 21 — — $6,265.91 $20,176.73 $7,017.82 2026-01-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/McC 46 21 — — $6,249.61 $29,385.00 $6,999.56 2026-01-01
785 MS_DRG Cesarean Section With Sterilization Without Cc/McC 46 21 — — $6,243.09 $29,385.00 $6,992.26 2026-01-01
206 MS_DRG Other Respiratory System Diagnoses Without McC 46 21 — — $6,134.24 $19,752.75 $6,870.35 2026-01-01
00422 SOI 3 APR_DRG Hypovolemia And Related Electrolyte Disorders 14 7 — — $6,554.49 $7,597.59 $6,866.61 2026-01-01
0047 SOI 2 APR_DRG Transient Ischemia 14 7 — — $6,496.97 $7,530.92 $6,806.35 2026-01-01
00241 SOI 2 APR_DRG Peptic Ulcer And Gastritis 14 7 — — $6,469.58 $7,499.17 $6,777.65 2026-01-01
00364 SOI 1 APR_DRG Other Skin, Subcutaneous Tissue And Related Procedures 14 7 — — $6,436.71 $7,461.07 $6,743.22 2026-01-01
00280 SOI 2 APR_DRG Alcoholic Liver Disease 14 7 — — $6,405.90 $7,425.35 $6,710.94 2026-01-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 46 21 — — $5,990.84 $21,222.00 $6,709.74 2026-01-01
00813 SOI 2 APR_DRG Other Complications Of Treatment 14 7 — — $6,326.46 $7,333.28 $6,627.73 2026-01-01
00190 SOI 1 APR_DRG Acute Myocardial Infarction 14 7 — — $6,325.10 $7,331.69 $6,626.29 2026-01-01
00243 SOI 2 APR_DRG Other Esophageal Disorders 14 7 — — $6,308.66 $7,312.64 $6,609.07 2026-01-01
00661 SOI 1 APR_DRG Coagulation And Platelet Disorders 14 7 — — $6,301.13 $7,303.91 $6,601.18 2026-01-01
00283 SOI 2 APR_DRG Other Disorders Of The Liver 14 7 — — $6,250.46 $7,245.17 $6,548.10 2026-01-01
0058 SOI 1 APR_DRG Other Disorders Of Nervous System 14 7 — — $6,242.92 $7,236.44 $6,540.21 2026-01-01
00144 SOI 2 APR_DRG Respiratory Signs, Symptoms And Miscellaneous Diagnoses 14 7 — — $6,235.39 $7,227.71 $6,532.32 2026-01-01
00561 SOI 3 APR_DRG Postpartum And Post Abortion Diagnoses Without Procedure 14 7 — — $6,227.18 $7,218.19 $6,523.71 2026-01-01
00245 SOI 2 APR_DRG Inflammatory Bowel Disease 14 7 — — $6,179.24 $7,162.62 $6,473.49 2026-01-01
38525 CPT Biopsy Or Removal Of Deep Lymph Nodes Of Underarm 58 26 — — $853.60 $26,760.77 $6,461.98 2026-01-01
00133 SOI 2 APR_DRG Respiratory Failure 14 7 — — $6,112.82 $7,085.63 $6,403.91 2026-01-01
683 MS_DRG Renal Failure With Cc 46 21 — — $5,708.60 $19,569.00 $6,393.63 2026-01-01
J3380 HCPCS Vedolizumab 300 Mg Intravenous Solution 54 25 $67,694.75 $54,155.80 $4,855.20 $21,177.60 $6,393.30 2026-01-01
00254 SOI 2 APR_DRG Other Digestive System Diagnoses 14 7 — — $6,050.51 $7,013.40 $6,338.63 2026-01-01
00246 SOI 2 APR_DRG Gastrointestinal Vascular Insufficiency 14 7 — — $6,042.29 $7,003.88 $6,330.02 2026-01-01
00253 SOI 2 APR_DRG Other And Unspecified Gastrointestinal Hemorrhage 14 7 — — $6,041.61 $7,003.08 $6,329.30 2026-01-01
64555 CPT Insertion Of Peripheral Nerve Neurostimulator Electrode Through Skin 50 23 $24,831.25 $19,865.00 20% off $157.40 $24,338.00 $6,313.64 2026-01-01
63650 CPT Insertion Of Spinal Neurostimulator Electrode Array Through Skin 60 27 $23,939.00 $19,151.20 20% off $410.25 $24,338.00 $6,313.64 2026-01-01
00465 SOI 2 APR_DRG Urinary Stones And Acquired Upper Urinary Tract Obstruction 14 7 — — $6,025.86 $6,984.83 $6,312.80 2026-01-01
0053 SOI 2 APR_DRG Seizure 14 7 — — $6,000.52 $6,955.46 $6,286.26 2026-01-01
0270 RC — 2 1 $6,458.86 $5,167.09 $6,271.55 $6,271.55 $6,271.55 2026-01-01
00197 SOI 2 APR_DRG Peripheral And Other Vascular Disorders 14 7 — — $5,986.14 $6,938.79 $6,271.20 2026-01-01
00663 SOI 2 APR_DRG Other Anemia And Disorders Of Blood And Blood-forming Organs 14 7 — — $5,973.13 $6,923.71 $6,257.57 2026-01-01
49593 CPT Initial Repair Of Sliding Hernia Of Abdomen, 3-10 Cm In Length 58 26 — — $853.60 $25,604.77 $6,242.87 2026-01-01
00281 SOI 1 APR_DRG Malignancy Of Hepatobiliary System And Pancreas 14 7 — — $5,951.22 $6,898.31 $6,234.61 2026-01-01
0042 SOI 1 APR_DRG Degenerative Nervous System Disorders Except Multiple Sclerosis 14 7 — — $5,950.53 $6,897.52 $6,233.89 2026-01-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 46 21 — — $5,494.81 $19,553.00 $6,154.19 2026-01-01
00248 SOI 2 APR_DRG Major Gastrointestinal And Peritoneal Infections 14 7 — — $5,868.36 $6,802.27 $6,147.81 2026-01-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 46 21 — — $5,483.08 $18,528.00 $6,141.05 2026-01-01
00134 SOI 2 APR_DRG Pulmonary Embolism 14 7 — — $5,855.35 $6,787.19 $6,134.18 2026-01-01
00282 SOI 2 APR_DRG Disorders Of Pancreas Except Malignancy 14 7 — — $5,786.88 $6,707.82 $6,062.44 2026-01-01
00539 SOI 2 APR_DRG Cesarean Section With Sterilization 14 7 — — $5,785.51 $6,706.23 $6,061.01 2026-01-01
00204 SOI 2 APR_DRG Syncope And Collapse 14 7 — — $5,773.18 $6,691.94 $6,048.10 2026-01-01
00207 SOI 2 APR_DRG Other Circulatory System Diagnoses 14 7 — — $5,753.32 $6,668.92 $6,027.29 2026-01-01
C1776 HCPCS Liner Acetabular Pinnacle Neutral 50mm 32mm Altrx Hip Sterile Latex Free 76 2 $6,034.80 $4,827.84 20% off $3,636.88 $31,674.51 $5,971.69 2026-01-01
00466 SOI 2 APR_DRG Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure 14 7 — — $5,687.59 $6,592.73 $5,958.42 2026-01-01
00194 SOI 2 APR_DRG Heart Failure 14 7 — — $5,669.78 $6,572.09 $5,939.77 2026-01-01
42820 CPT Removal Of Tonsils And Adenoid Glands (younger Than 12 Years) 58 26 — — $853.60 $24,274.88 $5,918.62 2026-01-01
00540 SOI 2 APR_DRG Cesarean Section Without Sterilization 14 7 — — $5,645.13 $6,543.51 $5,913.95 2026-01-01
00351 SOI 2 APR_DRG Other Musculoskeletal System And Connective Tissue Diagnoses 14 7 — — $5,640.34 $6,537.96 $5,908.93 2026-01-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 46 21 — — $5,252.98 $20,159.00 $5,883.34 2026-01-01
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