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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

SCHUYLKILL MEDICAL CENTER - SOUTH JACKSON STREET

Pottsville, PA · CCN 390030 · Rates published

23,182 distinct procedures filed
23 distinct payers
894,854 rate rows
2026-07-01 last MRF observed
Data quality

870,324 of 894,854 rate rows are consumer-grade (97.3%)

24,530 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 20,298
placeholder amount (≤ $0.02) — excluded from medians 2,557
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 770
exceeds 10× this hospital's gross charge — excluded from medians 596
per-diem day rate — not a per-procedure price 250
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 59
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://lvhn.pt.panaceainc.com/MRFDownload/lvhn/schuylkill
Found on page https://www.lvhn.org/get-price-quote
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-13
Content fingerprint eae31209eba6d3b2… · 436,128,558 bytes · first seen 2026-07-17

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 13 $4,505,000.00 $4,955,500.00 $4,730,250.00 nat. median
$4,505,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 13 $2,440,200.00 $4,660,455.63 $3,876,022.50 nat. median
$3,685,267
1.1× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 13 $2,194,088.40 $4,211,472.75 $3,502,611.00 nat. median
$3,335,820
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 13 $2,231,040.00 $4,193,237.68 $3,487,445.20 nat. median
$3,325,455
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 2 $2,440,200.00 $3,710,000.00 $3,486,000.00 nat. median
$3,508,750
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 13 $2,161,320.00 $4,097,294.00 $3,407,650.46 nat. median
$3,248,446
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 13 $2,091,600.00 $4,014,750.00 $3,339,000.00 nat. median
$3,180,000
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 13 $1,952,160.00 $3,709,629.00 $3,085,236.00 nat. median
$2,968,000
1.0× median
C9309
HCPCS 		Inj Onase Abepar-brve Treat 13 $2,664,228.59 $3,363,588.59 $2,797,440.02 nat. median
$2,664,229
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 13 $2,423,131.23 $3,266,197.67 $2,716,441.62 nat. median
$2,455,111
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 13 $1,533,840.00 $2,944,150.00 $2,448,600.00 nat. median
$2,332,000
1.1× median
7377600111
NDC 		Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension 12 $5,000.00 $3,183,884.55 $1,608,022.50 —
Q2057
HCPCS 		Afamitresgene Autoleucel 18 $585,235.00 $4,689,222.70 $838,012.90 nat. median
$813,967
1.0× median
5789411101
NDC 		Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 22 $446,281.05 $3,580,990.92 $694,423.88 —
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 18 $430,243.11 $3,737,290.23 $666,386.18 nat. median
$621,313
1.1× median
7315390001
NDC 		Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 22 $426,954.72 $3,421,357.21 $663,467.79 —
7128711901
NDC 		Axicabtagene Ciloleucel Intravenous Suspension 22 $404,164.86 $3,236,301.90 $627,581.96 —
Q2055
HCPCS 		Idecabtagene Vicleucel Car 18 $423,826.21 $3,406,267.87 $607,813.70 nat. median
$574,037
1.1× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 7 $329,096.12 $774,828.98 $592,344.26 nat. median
$168,055
outlier · 3.5×
7128722001
NDC 		Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 22 $371,705.10 $2,977,333.30 $577,362.91 —
7128721901
NDC 		Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 22 $371,705.10 $2,977,333.30 $577,362.91 —
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $344,748.21 $344,748.21 $344,748.21 nat. median
$2,313,353
outlier · 0.1×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 16 $183,015.00 $1,693,151.25 $301,901.25 nat. median
$286,598
1.1× median
J3403
HCPCS 		Revakinagene, Per Implant 16 $201,250.00 $1,595,692.49 $286,667.41 nat. median
$264,195
1.1× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $278,250.00 $278,250.00 $278,250.00 nat. median
$377,029
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 17 $213,570.14 $565,962.82 $262,109.88 nat. median
$186,516
1.4× median
111
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 $72,914.14 $871,119.68 $241,694.95 nat. median
$30,753
outlier · 7.9×
0-D
OTHER 		Kidney Transplant With Hemodialysis With Mcc - Deceased Donor 2 $149,495.00 $305,846.00 $227,670.50 —
5831
APR_DRG 		Neonate With Ecmo 8 $152,101.66 $468,265.45 $224,810.96 nat. median
$173,909
1.3× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 19 $153,154.30 $1,233,512.13 $218,930.67 nat. median
$207,733
1.1× median
1-D
OTHER 		Kidney Transplant With Hemodialysis Without Mcc - Deceased Donor 2 $149,495.00 $250,308.00 $199,901.50 —
0-L
OTHER 		Kidney Transplant With Hemodialysis With Mcc - Living Donor 2 $125,664.00 $255,387.00 $190,525.50 —
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 $157,316.55 $431,623.68 $185,890.32 nat. median
$131,925
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 17 $23,636.00 $429,101.31 $183,956.27 nat. median
$145,435
1.3× median
2-D
OTHER 		Kidney Transplant - Deceased Donor 2 $149,495.00 $211,987.00 $180,741.00 —
1-L
OTHER 		Kidney Transplant With Hemodialysis Without Mcc - Living Donor 2 $125,664.00 $209,014.00 $167,339.00 —
2-L
OTHER 		Kidney Transplant - Living Donor 2 $125,664.00 $180,057.00 $152,860.50 —
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 8 $125,610.19 $313,099.93 $150,260.56 nat. median
$130,862
1.1× median
J3404
HCPCS 		Inj Zopapogene Per Ther Dose 16 $121,900.00 $741,761.50 $133,480.50 nat. median
$128,604
1.0× median
1611
APR_DRG 		Implantable Heart Assist Systems 8 $100,319.79 $235,881.84 $131,296.11 nat. median
$108,954
1.2× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 8 $2,913.05 $144,259.88 $124,137.70 nat. median
$99,483
1.2× median
21
APR_DRG 		Heart And/or Lung Transplant 8 $88,283.26 $329,898.12 $123,580.11 nat. median
$77,825
1.6× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 17 $86,359.65 $229,941.83 $122,214.59 nat. median
$65,418
1.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 17 $23,636.00 $280,662.74 $120,320.47 nat. median
$97,418
1.2× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 17 $52,470.33 $658,660.78 $117,985.25 nat. median
$108,243
1.1× median
5911
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 8 $9,155.97 $202,857.21 $117,416.78 nat. median
$30,994
outlier · 3.8×
209
MS_DRG 		Complex Aortic Arch Procedures 16 $86,260.57 $229,680.14 $115,586.06 nat. median
$2,110
outlier · 54.8×
7
MS_DRG 		Lung Transplant 16 $95,576.05 $262,521.10 $113,061.75 nat. median
$70,649
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 17 $82,871.52 $220,728.07 $109,361.05 nat. median
$74,509
1.5× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 16 $78,576.32 $209,382.50 $105,680.54 nat. median
$69,922
1.5× median

Other procedures at this hospital

Browse this hospital's 23,182 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 14 13 — — $4,505,000.00 $4,955,500.00 $4,730,250.00 2026-07-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 17 13 — — $2,440,200.00 $4,660,455.63 $3,876,022.50 2026-07-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 17 13 — — $2,194,088.40 $4,211,472.75 $3,502,611.00 2026-07-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 17 13 — — $2,231,040.00 $4,193,237.68 $3,487,445.20 2026-07-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 3 2 — — $2,440,200.00 $3,710,000.00 $3,486,000.00 2026-07-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 17 13 — — $2,161,320.00 $4,097,294.00 $3,407,650.46 2026-07-01
J3387 HCPCS Inj Elivaldogene Autotemecel 17 13 — — $2,091,600.00 $4,014,750.00 $3,339,000.00 2026-07-01
J3393 HCPCS Inj, Betibeglogene Autotemce 17 13 — — $1,952,160.00 $3,709,629.00 $3,085,236.00 2026-07-01
C9309 HCPCS Inj Onase Abepar-brve Treat 15 13 — — $2,664,228.59 $3,363,588.59 $2,797,440.02 2026-07-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 15 13 — — $2,423,131.23 $3,266,197.67 $2,716,441.62 2026-07-01
J3392 HCPCS Inj, Exagamglogene Autotem 17 13 — — $1,533,840.00 $2,944,150.00 $2,448,600.00 2026-07-01
7377600111 NDC Lifileucel 7.5 X 10exp9 To 72 X 10exp9 Cell Intravenous Suspension 19 12 $4,594,350.00 $2,297,175.00 50% off $5,000.00 $3,183,884.55 $1,608,022.50 2026-07-01
Q2057 HCPCS Afamitresgene Autoleucel 34 18 — — $585,235.00 $4,689,222.70 $838,012.90 2026-07-01
5789411101 NDC Ciltacabtagene Autoleucel 0.5 X 10exp6 To 1x 10exp8 Cell IV Suspension 41 22 $4,289,773.13 $2,144,886.57 50% off $446,281.05 $3,580,990.92 $694,423.88 2026-07-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 34 18 — — $430,243.11 $3,737,290.23 $666,386.18 2026-07-01
7315390001 NDC Lisocabtagene Maraleucel 1.5 X 10exp6 To 70 X 10exp6 Cell/ml IV Susp 41 22 $4,184,384.40 $2,092,192.20 50% off $426,954.72 $3,421,357.21 $663,467.79 2026-07-01
7128711901 NDC Axicabtagene Ciloleucel Intravenous Suspension 41 22 $4,116,750.00 $2,058,375.00 50% off $404,164.86 $3,236,301.90 $627,581.96 2026-07-01
Q2055 HCPCS Idecabtagene Vicleucel Car 34 18 — — $423,826.21 $3,406,267.87 $607,813.70 2026-07-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 10 7 — — $329,096.12 $774,828.98 $592,344.26 2026-07-01
7128722001 NDC Brexucabtagene Autoleucel 1x 10exp6 To 1x 10exp8 Cell IV Suspension 41 22 $3,776,850.00 $1,888,425.00 50% off $371,705.10 $2,977,333.30 $577,362.91 2026-07-01
7128721901 NDC Brexucabtagene Autoleucel 2x 10exp6 To 2x 10exp8 Cell IV Suspension 41 22 $3,776,850.00 $1,888,425.00 50% off $371,705.10 $2,977,333.30 $577,362.91 2026-07-01
C9098 HCPCS Ciltacabtagene Car Pos T 2 1 — — $344,748.21 $344,748.21 $344,748.21 2026-07-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 28 16 — — $183,015.00 $1,693,151.25 $301,901.25 2026-07-01
J3403 HCPCS Revakinagene, Per Implant 28 16 — — $201,250.00 $1,595,692.49 $286,667.41 2026-07-01
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-07-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 30 17 — — $213,570.14 $565,962.82 $262,109.88 2026-07-01
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 55 19 — — $72,914.14 $871,119.68 $241,694.95 2026-07-01
0-D OTHER Kidney Transplant With Hemodialysis With Mcc - Deceased Donor 2 2 — — $149,495.00 $305,846.00 $227,670.50 2026-07-01
5831 APR_DRG Neonate With Ecmo 36 8 — — $152,101.66 $468,265.45 $224,810.96 2026-07-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 35 19 — — $153,154.30 $1,233,512.13 $218,930.67 2026-07-01
1-D OTHER Kidney Transplant With Hemodialysis Without Mcc - Deceased Donor 2 2 — — $149,495.00 $250,308.00 $199,901.50 2026-07-01
0-L OTHER Kidney Transplant With Hemodialysis With Mcc - Living Donor 2 2 — — $125,664.00 $255,387.00 $190,525.50 2026-07-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 16 — — $157,316.55 $431,623.68 $185,890.32 2026-07-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 30 17 — — $23,636.00 $429,101.31 $183,956.27 2026-07-01
2-D OTHER Kidney Transplant - Deceased Donor 2 2 — — $149,495.00 $211,987.00 $180,741.00 2026-07-01
1-L OTHER Kidney Transplant With Hemodialysis Without Mcc - Living Donor 2 2 — — $125,664.00 $209,014.00 $167,339.00 2026-07-01
2-L OTHER Kidney Transplant - Living Donor 2 2 — — $125,664.00 $180,057.00 $152,860.50 2026-07-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 36 8 — — $125,610.19 $313,099.93 $150,260.56 2026-07-01
J3404 HCPCS Inj Zopapogene Per Ther Dose 26 16 — — $121,900.00 $741,761.50 $133,480.50 2026-07-01
1611 APR_DRG Implantable Heart Assist Systems 36 8 — — $100,319.79 $235,881.84 $131,296.11 2026-07-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 36 8 — — $2,913.05 $144,259.88 $124,137.70 2026-07-01
21 APR_DRG Heart And/or Lung Transplant 36 8 — — $88,283.26 $329,898.12 $123,580.11 2026-07-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 30 17 — — $86,359.65 $229,941.83 $122,214.59 2026-07-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 30 17 — — $23,636.00 $280,662.74 $120,320.47 2026-07-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 27 17 — — $52,470.33 $658,660.78 $117,985.25 2026-07-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 36 8 — — $9,155.97 $202,857.21 $117,416.78 2026-07-01
209 MS_DRG Complex Aortic Arch Procedures 28 16 — — $86,260.57 $229,680.14 $115,586.06 2026-07-01
7 MS_DRG Lung Transplant 29 16 — — $95,576.05 $262,521.10 $113,061.75 2026-07-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 30 17 — — $82,871.52 $220,728.07 $109,361.05 2026-07-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 29 16 — — $78,576.32 $209,382.50 $105,680.54 2026-07-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 26 16 — — $93,216.70 $578,568.07 $104,113.73 2026-07-01
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 36 8 — — $54,715.89 $188,600.20 $102,281.24 2026-07-01
71 APR_DRG Allogeneic Bone Marrow Transplant 65 19 — — $51,780.51 $243,753.38 $101,126.50 2026-07-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 10 7 — — $42,090.78 $114,676.99 $97,113.83 2026-07-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 10 7 — — $41,838.53 $122,234.76 $96,531.82 2026-07-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 17 — — $23,636.00 $223,689.27 $92,802.45 2026-07-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 17 — — $74,554.72 $198,759.63 $92,205.42 2026-07-01
850 MS_DRG Acute Leukemia With Other Procedures 29 16 — — $65,994.05 $176,146.97 $90,750.37 2026-07-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 11 8 — — $42,712.66 $289,334.00 $87,278.76 2026-07-01
270006206-10806601-5290 CDM Hb Kit Protek Duo Dl31 17 12 $247,005.00 $123,502.50 50% off $5,000.00 $171,174.47 $86,451.75 2026-07-01
215 MS_DRG Other Heart Assist System Implant 30 17 — — $71,118.19 $223,425.29 $86,375.43 2026-07-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 10 7 — — $58,264.07 $137,177.82 $85,937.27 2026-07-01
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 36 8 — — $45,399.55 $138,694.86 $83,095.57 2026-07-01
270006205-10806601-5291 CDM Hb Kit Protek Duo Dl29 17 12 $233,020.00 $116,510.00 50% off $5,000.00 $161,482.86 $81,557.00 2026-07-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 17 — — $23,636.00 $170,991.55 $81,361.01 2026-07-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 30 17 — — $23,636.00 $183,194.69 $80,532.02 2026-07-01
J9183 HCPCS Gemcitabine Intravesical Sys 33 19 — — $73,088.26 $444,742.06 $79,666.20 2026-07-01
A0407 HCPCS Traumatic Spinal Cord Injury M <24.50 And A >=61.50 36 9 — — $68,091.22 $231,736.35 $79,554.57 2026-07-01
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 36 8 — — $41,140.62 $227,056.19 $78,714.85 2026-07-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 36 8 — — $36,731.46 $170,349.07 $77,450.73 2026-07-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 30 17 — — $64,244.27 $171,525.02 $76,788.47 2026-07-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 30 17 — — $23,636.00 $160,229.76 $76,240.35 2026-07-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 26 16 — — $67,452.66 $418,658.41 $75,337.87 2026-07-01
481000464-10806601-2958 CDM Hb 37294-50 Revsc Evasc Tpvt St Athrc Cplx Les 1st Vsl Bilateral 41 22 $191,580.00 $95,790.00 50% off $15,388.80 $132,764.94 $74,076.87 2026-07-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 30 17 — — $54,340.78 $145,365.38 $72,523.44 2026-07-01
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 10 7 — — $46,704.54 $109,961.88 $71,813.49 2026-07-01
481000460-10806601-2962 CDM Hb 37290-50 Revsc Evasc Tpvt Athrc Cplx Les 1st Vsl Bilateral 41 22 $184,945.00 $92,472.50 50% off $15,388.80 $128,166.89 $71,777.85 2026-07-01
481000448-10806601-2974 CDM Hb 37277-50 Revsc Evasc Fpvt St Athrc Cplx Les 1st Vsl Bilateral 41 22 $184,945.00 $92,472.50 50% off $15,388.80 $128,166.89 $71,777.85 2026-07-01
481000456-10806601-2966 CDM Hb 37286-50 Revsc Evasc Tpvt St Plmt Cplx Les 1st Vsl Bilateral 41 22 $184,945.00 $92,472.50 50% off $15,388.80 $128,166.89 $71,777.85 2026-07-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 30 17 — — $58,516.32 $156,394.89 $70,914.96 2026-07-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 30 17 — — $54,372.79 $355,181.00 $70,702.80 2026-07-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 36 19 — — $48,812.46 $391,157.80 $69,899.90 2026-07-01
810000002-10806601-235 CDM Hb Organ Processing - Lrd 16 11 $199,025.00 $99,512.50 50% off $5,000.00 $137,924.33 $69,658.75 2026-07-01
810000001-10806601-236 CDM Hb Organ Processing 16 11 $199,025.00 $99,512.50 50% off $5,000.00 $137,924.33 $69,658.75 2026-07-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $48,644.95 $232,043.63 $69,492.79 2026-07-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 10 7 — — $43,670.62 $102,818.77 $69,085.57 2026-07-01
560000237-10806601-2317 CDM Hb Trnsplj Allogeneic Hematopoietic Cells Per Donor 35 19 $187,650.00 $93,825.00 50% off $133.43 $391,536.22 $68,205.16 2026-07-01
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 10 7 — — $41,565.70 $97,862.92 $67,439.14 2026-07-01
810000003-10806601-234 CDM Hb Pancreas Organ Processing 16 11 $192,395.00 $96,197.50 50% off $5,000.00 $133,329.74 $67,338.25 2026-07-01
6301 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 36 8 — — $21,034.16 $193,418.55 $66,668.53 2026-07-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 30 17 — — $23,636.00 $155,219.26 $66,542.69 2026-07-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 30 17 — — $50,957.82 $136,429.43 $66,009.69 2026-07-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 36 8 — — $48,950.70 $173,009.06 $65,288.53 2026-07-01
61 APR_DRG Pancreas Transplant 66 20 — — $40,400.34 $179,679.00 $65,233.29 2026-07-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 10 7 — — $36,282.06 $85,423.03 $64,678.95 2026-07-01
A1904 HCPCS Guillain-barr? M <38.50 36 9 — — $54,382.87 $216,951.20 $63,784.02 2026-07-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 17 — — $23,636.00 $147,140.88 $63,079.48 2026-07-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 30 17 — — $45,776.30 $122,742.68 $62,564.01 2026-07-01
A1806 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50 36 9 — — $52,922.76 $183,633.48 $62,495.19 2026-07-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 10 7 — — $41,631.24 $98,017.23 $62,202.21 2026-07-01
A9543 HCPCS Y90 Ibritumomab, Rx 31 17 — — $43,039.62 $345,777.39 $61,938.76 2026-07-01
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 10 7 — — $27,304.52 $68,073.76 $61,208.53 2026-07-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 30 17 — — $23,636.00 $140,282.42 $61,148.83 2026-07-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 17 — — $50,110.36 $134,190.90 $60,728.78 2026-07-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 29 16 — — $31,305.30 $146,216.90 $60,661.32 2026-07-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 30 17 — — $15,491.00 $140,964.83 $60,431.80 2026-07-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 30 17 — — $46,203.07 $123,869.99 $60,168.26 2026-07-01
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 36 8 — — $29,468.13 $97,669.64 $59,229.59 2026-07-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 36 8 — — $39,976.75 $218,053.98 $59,203.89 2026-07-01
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 10 7 — — $31,440.44 $74,023.85 $59,190.85 2026-07-01
3023789006 NDC Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspension 38 19 $77,600.00 $38,800.00 50% off $10,864.00 $342,398.02 $59,082.65 2026-07-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 28 16 — — $43,492.28 $116,709.54 $58,514.03 2026-07-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 30 17 — — $23,636.00 $136,330.78 $58,445.18 2026-07-01
A0406 HCPCS Traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50 36 9 — — $49,723.03 $169,221.53 $58,093.09 2026-07-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 17 — — $23,636.00 $121,866.99 $57,986.62 2026-07-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 17 — — $50,110.36 $134,190.90 $57,527.81 2026-07-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 36 8 — — $21,981.50 $116,446.32 $57,463.69 2026-07-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 30 17 — — $23,636.00 $133,709.80 $56,529.10 2026-07-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 30 17 — — $15,491.00 $131,360.54 $56,314.43 2026-07-01
270006137-10806601-5359 CDM Hb Set Usa Hls Advanced 7.0 17 12 $160,030.00 $80,015.00 50% off $5,000.00 $110,900.79 $56,010.50 2026-07-01
A0404 HCPCS Traumatic Spinal Cord Injury M <31.50 And A <61.50 36 9 — — $47,718.51 $162,396.43 $55,750.46 2026-07-01
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 36 8 — — $32,165.99 $230,420.78 $55,192.46 2026-07-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 30 17 — — $23,636.00 $119,888.15 $54,956.57 2026-07-01
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 10 7 — — $32,130.14 $75,647.69 $54,832.64 2026-07-01
9101 APR_DRG Craniotomy For Multiple Significant Trauma 66 20 — — $19,011.61 $137,327.24 $54,571.31 2026-07-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 30 17 — — $44,724.60 $119,964.66 $54,456.74 2026-07-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 30 17 — — $37,704.14 $101,420.40 $53,626.26 2026-07-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 30 17 — — $23,636.00 $125,051.64 $53,609.80 2026-07-01
A0106 HCPCS Stroke M <41.50 And A <84.50 36 9 — — $45,088.22 $144,809.65 $53,494.70 2026-07-01
270006272-10806601-5224 CDM Hb Protek Duo Cannula Veno-venous 29fr 17 12 $152,290.00 $76,145.00 50% off $5,000.00 $105,536.97 $53,301.50 2026-07-01
270006273-10806601-5223 CDM Hb Protek Duo Cannula Veno-venous 31fr 17 12 $152,290.00 $76,145.00 50% off $5,000.00 $105,536.97 $53,301.50 2026-07-01
481000211-10806601-3167 CDM Hb 33270 Insert Subq Defib W/eltrd 41 22 $163,510.00 $81,755.00 50% off $15,388.80 $195,384.12 $52,911.84 2026-07-01
28 MS_DRG Spinal Procedures With Mcc 30 17 — — $23,636.00 $122,776.89 $52,890.04 2026-07-01
L7181 HCPCS Electronic Elbo Simultaneous 27 17 — — $23,653.04 $293,026.22 $52,489.50 2026-07-01
270006248-10806601-5248 CDM Hb Centrimag Blood Pump 23 15 $154,070.00 $77,035.00 50% off $5,000.00 $106,770.51 $52,383.80 2026-07-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 27 17 — — $45,295.41 $121,472.44 $52,315.37 2026-07-01
481000462-10806601-2960 CDM Hb 37292-50 Revsc Evasc Tpvt St Athrc Sf Les 1st Vsl Bilateral 41 22 $127,720.00 $63,860.00 50% off $15,388.80 $88,509.96 $51,949.38 2026-07-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 30 17 — — $23,636.00 $111,950.69 $51,639.58 2026-07-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 30 17 — — $23,636.00 $108,393.61 $51,575.73 2026-07-01
A0505 HCPCS Non-traumatic Spinal Cord Injury M <39.50 36 9 — — $42,935.60 $159,722.63 $51,061.67 2026-07-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 29 16 — — $40,251.57 $121,194.63 $50,759.14 2026-07-01
653 MS_DRG Major Bladder Procedures With Mcc 30 17 — — $23,636.00 $106,432.90 $50,642.78 2026-07-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 30 17 — — $23,636.00 $117,921.41 $50,553.05 2026-07-01
481000454-10806601-2968 CDM Hb 37284-50 Revsc Evasc Tpvt St Plmt Sf Les 1st Vsl Bilateral 41 22 $123,295.00 $61,647.50 50% off $15,388.80 $85,443.44 $50,416.12 2026-07-01
481000458-10806601-2964 CDM Hb 37288-50 Revsc Evasc Tpvt Athrc Sf Les 1st Vsl Bilateral 41 22 $123,295.00 $61,647.50 50% off $15,388.80 $85,443.44 $50,416.12 2026-07-01
481000446-10806601-2976 CDM Hb 37275-50 Revsc Evasc Fpvt St Athrc Sf Les 1st Vsl Bilateral 41 22 $123,295.00 $61,647.50 50% off $15,388.80 $85,443.44 $50,416.12 2026-07-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 30 17 — — $23,636.00 $116,560.57 $49,969.67 2026-07-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 30 17 — — $40,641.27 $112,608.00 $49,905.60 2026-07-01
481000452-10806601-2970 CDM Hb 37282-50 Revsc Evasc Tpvt Angiop Cplx Les 1st Vsl Bilateral 41 22 $121,335.00 $60,667.50 50% off $15,388.80 $84,085.16 $49,736.98 2026-07-01
481000432-10806601-2990 CDM Hb 37260-50 Revsc Evasc Ivt St Plmt Cplx Les 1st Vsl Bilateral 41 22 $121,335.00 $60,667.50 50% off $15,388.80 $84,085.16 $49,736.98 2026-07-01
481000468-10806601-2954 CDM Hb 37298-50 Revsc Evasc Imvt Angiop Cplx Les 1st Vsl Bilateral 41 22 $121,335.00 $60,667.50 50% off $15,388.80 $84,085.16 $49,736.98 2026-07-01
481000440-10806601-2982 CDM Hb 37269-50 Revsc Evasc Fpvt St Plmt Cplx Les 1st Vsl Bilateral 41 22 $121,335.00 $60,667.50 50% off $15,388.80 $84,085.16 $49,736.98 2026-07-01
481000444-10806601-2978 CDM Hb 37273-50 Revsc Evasc Fpvt Athrc Cplx Les 1st Vsl Bilateral 41 22 $121,335.00 $60,667.50 50% off $15,388.80 $84,085.16 $49,736.98 2026-07-01
6031 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 36 8 — — $12,955.45 $102,349.37 $49,366.57 2026-07-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 26 16 — — $45,057.20 $274,173.06 $49,337.63 2026-07-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 26 16 — — $45,057.20 $274,173.06 $49,337.63 2026-07-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 17 — — $23,636.00 $115,000.45 $49,300.83 2026-07-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 28 17 — — $11,806.38 $274,173.06 $48,887.07 2026-07-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 17 — — $41,990.00 $113,877.19 $48,819.29 2026-07-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 30 17 — — $35,197.59 $112,608.00 $48,252.02 2026-07-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 30 17 — — $23,636.00 $100,490.37 $47,815.22 2026-07-01
6 MS_DRG Liver Transplant Without Mcc 29 16 — — $35,338.58 $95,171.89 $47,616.41 2026-07-01
A0105 HCPCS Stroke M <41.50 And A >=84.50 36 9 — — $40,027.89 $128,557.23 $47,490.82 2026-07-01
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 35 20 — — $884.64 $274,173.06 $47,310.06 2026-07-01
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 36 8 — — $30,547.41 $86,518.14 $47,116.21 2026-07-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 30 17 — — $23,636.00 $109,114.29 $47,091.79 2026-07-01
1781 APR_DRG External Heart Assist Devices 36 8 — — $34,678.46 $74,384.82 $46,937.00 2026-07-01
L7180 HCPCS Electronic Elbow Sequential 27 17 — — $20,995.68 $260,105.45 $46,592.43 2026-07-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 30 17 — — $23,636.00 $108,041.34 $46,591.08 2026-07-01
481000292-10806601-3103 CDM Hb Tcat Impl Wrls P-art Prs Snr 41 22 $143,595.00 $71,797.50 50% off $15,388.80 $178,543.27 $46,467.34 2026-07-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 30 17 — — $23,636.00 $102,225.63 $46,306.28 2026-07-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 29 16 — — $33,511.96 $111,181.70 $46,126.20 2026-07-01
A0205 HCPCS Traumatic Brain Injury M <35.50 36 9 — — $38,788.89 $139,303.58 $46,076.51 2026-07-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 30 17 — — $39,363.00 $106,614.09 $45,705.60 2026-07-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 30 17 — — $23,636.00 $95,993.22 $45,675.38 2026-07-01
A2102 HCPCS Burns M <52.50 36 9 — — $32,276.79 $130,116.53 $45,506.54 2026-07-01
510 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc 10 7 — — $23,019.23 $54,196.83 $45,002.47 2026-07-01
481000262-10806601-3138 CDM Hb Transcath Insert Or Replace Leadless Pacemaker Ventr 33274 71 22 $79,950.00 $39,975.00 50% off $6,597.50 $119,896.95 $44,772.00 2026-07-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 30 17 — — $23,636.00 $96,275.03 $44,639.71 2026-07-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 30 17 — — $38,411.36 $112,608.00 $44,610.20 2026-07-01
6797900201 NDC Histrelin 50 Mg (65 Mcg/day) Implant Kit 39 20 $50,196.02 $25,098.01 50% off $9,035.28 $250,540.32 $44,467.30 2026-07-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 30 17 — — $23,636.00 $101,243.26 $44,346.69 2026-07-01
2991 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 36 8 — — $28,171.64 $75,379.85 $44,208.32 2026-07-01
A0405 HCPCS Traumatic Spinal Cord Injury M >=31.50 And M <41.50 36 9 — — $37,798.10 $128,633.93 $44,159.77 2026-07-01
245 MS_DRG Aicd Generator Procedures 30 17 — — $34,770.05 $93,670.15 $44,081.52 2026-07-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 36 8 — — $29,270.54 $87,764.80 $44,062.89 2026-07-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 30 17 — — $32,979.12 $88,939.47 $43,561.00 2026-07-01
4401 APR_DRG Kidney Transplant 64 19 — — $24,612.02 $81,665.14 $43,448.45 2026-07-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 30 17 — — $23,636.00 $100,903.03 $43,257.26 2026-07-01
A1805 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.50 36 9 — — $36,527.80 $126,747.43 $43,135.18 2026-07-01
A1705 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50 36 9 — — $36,098.11 $130,658.45 $43,060.76 2026-07-01
1601 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 36 8 — — $25,002.13 $138,083.49 $43,028.81 2026-07-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 16 — — $35,829.37 $96,468.29 $43,004.64 2026-07-01
471 MS_DRG Cervical Spinal Fusion With Mcc 30 17 — — $23,636.00 $99,030.90 $42,454.68 2026-07-01
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 26 16 — — $37,828.21 $234,788.26 $42,250.32 2026-07-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 30 17 — — $15,491.00 $98,539.73 $42,244.10 2026-07-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 30 17 — — $23,636.00 $94,121.06 $42,207.04 2026-07-01
6311 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 36 8 — — $7,797.22 $215,257.84 $42,134.16 2026-07-01
A1004 HCPCS Amputation Lower Extremity M <47.50 36 9 — — $34,521.19 $120,827.23 $41,765.55 2026-07-01
163 MS_DRG Major Chest Procedures With Mcc 30 17 — — $23,636.00 $92,047.62 $41,642.04 2026-07-01
A1903 HCPCS Guillain-barr? M >=38.50 And M <51.50 36 9 — — $35,368.05 $141,087.80 $41,480.56 2026-07-01
481000419-10806601-3003 CDM Hb 37294 Revsc Evasc Tpvt St Athrc Uni Cplx Les 1st Vsl 41 22 $127,720.00 $63,860.00 50% off $15,388.80 $114,107.68 $41,330.19 2026-07-01
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 10 7 — — $25,086.05 $59,062.97 $41,225.36 2026-07-01
6081 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 36 8 — — $17,366.63 $60,405.02 $40,996.36 2026-07-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 30 17 — — $23,636.00 $93,354.09 $40,933.04 2026-07-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 17 — — $23,636.00 $85,823.25 $40,836.32 2026-07-01
81 APR_DRG Autologous Bone Marrow Transplant 36 8 — — $28,436.21 $83,930.76 $40,491.86 2026-07-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 30 17 — — $23,636.00 $94,356.58 $40,450.79 2026-07-01
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 36 8 — — $26,737.10 $77,252.73 $40,349.05 2026-07-01
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 36 8 — — $28,750.86 $67,250.54 $40,153.26 2026-07-01
799 MS_DRG Splenic Procedures With Mcc 30 17 — — $23,636.00 $92,995.77 $40,104.82 2026-07-01
A1504 HCPCS Pulmonary M <45.50 36 9 — — $35,171.98 $119,758.73 $40,057.75 2026-07-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 30 17 — — $23,636.00 $93,394.36 $40,038.28 2026-07-01
A0305 HCPCS Non-traumatic Brain Injury M <42.50 And A <78.50 36 9 — — $34,193.70 $121,159.55 $39,947.16 2026-07-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 30 17 — — $22,511.00 $91,667.15 $39,940.23 2026-07-01
481000411-10806601-3011 CDM Hb 37286 Revsc Evasc Tpvt St Plmt Uni Cplx Les 1st Vsl 41 22 $123,295.00 $61,647.50 50% off $15,388.80 $114,107.68 $39,898.26 2026-07-01
481000402-10806601-3020 CDM Hb 37277 Revsc Evasc Fpvt St Athrc Uni Cplx Les 1st Vsl 41 22 $123,295.00 $61,647.50 50% off $15,388.80 $114,107.68 $39,898.26 2026-07-01
481000415-10806601-3007 CDM Hb 37290 Revsc Evasc Tpvt Athrc Uni Cplx Les 1st Vsl 41 22 $123,295.00 $61,647.50 50% off $15,388.80 $114,107.68 $39,898.26 2026-07-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A… 10 7 — — $20,735.22 $48,819.31 $39,821.06 2026-07-01
A0604 HCPCS Neurological M <43.50 36 9 — — $32,739.86 $125,244.38 $39,457.99 2026-07-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 30 17 — — $23,636.00 $85,428.71 $39,406.27 2026-07-01
A0704 HCPCS Fracture Of Lower Extremity M <41.50 36 9 — — $33,202.92 $117,279.20 $39,106.94 2026-07-01
A1304 HCPCS Rheumatoid Other Arthritis M <44.50 And A >=64.50 36 9 — — $31,801.21 $117,136.05 $38,958.21 2026-07-01
A1103 HCPCS Amputation Non-lower Extremity M <52.50 36 9 — — $28,762.09 $98,894.90 $38,947.57 2026-07-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 30 17 — — $23,636.00 $92,021.45 $38,904.32 2026-07-01
A1305 HCPCS Rheumatoid Other Arthritis M <51.50 And A <64.50 36 9 — — $31,738.64 $116,906.00 $38,879.51 2026-07-01
140 MS_DRG Major Head And Neck Procedures With Mcc 30 17 — — $23,636.00 $87,689.36 $38,490.69 2026-07-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 26 16 — — $35,044.60 $213,246.39 $38,373.83 2026-07-01
L8701 HCPCS Ewh S/d Uprt Micro Sensor 26 16 — — $34,284.44 $212,793.24 $38,292.29 2026-07-01
6121 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 36 8 — — $19,390.54 $81,505.91 $38,259.24 2026-07-01
A1604 HCPCS Pain Syndrome M <43.50 36 9 — — $31,075.33 $102,499.15 $38,213.83 2026-07-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 30 17 — — $31,922.84 $86,149.38 $38,193.85 2026-07-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 30 17 — — $23,636.00 $90,255.99 $38,157.93 2026-07-01
A0104 HCPCS Stroke M >=41.50 And M <50.50 36 9 — — $32,118.26 $103,153.55 $38,107.50 2026-07-01
901 MS_DRG Wound Debridements For Injuries With Mcc 30 17 — — $23,636.00 $86,306.40 $37,979.32 2026-07-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 30 17 — — $23,636.00 $86,841.86 $37,932.65 2026-07-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 22 11 — — $1,563.80 $79,629.10 $37,889.03 2026-07-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 30 17 — — $23,636.00 $88,244.97 $37,830.71 2026-07-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 30 17 — — $23,636.00 $86,654.65 $37,659.01 2026-07-01
A0805 HCPCS Replacement Of Lower-extremity Joint M <42.50 36 9 — — $30,764.54 $106,900.98 $37,454.58 2026-07-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 30 17 — — $23,636.00 $87,196.16 $37,381.10 2026-07-01
A1704 HCPCS Major Multiple Trauma Without Brain Or Spinal Cord Injury M >=36.50 And M <41.50 36 9 — — $31,008.58 $112,233.23 $36,988.82 2026-07-01
A1404 HCPCS Cardiac M <45.50 36 9 — — $30,672.76 $109,753.70 $36,780.39 2026-07-01
835 MS_DRG Acute Leukemia Without Major O.r. Procedures With Cc 10 7 — — $15,895.88 $46,746.85 $36,675.72 2026-07-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 30 17 — — $23,636.00 $86,407.05 $36,530.70 2026-07-01
A0304 HCPCS Non-traumatic Brain Injury M <42.50 And A >=78.50 36 9 — — $31,215.08 $110,607.48 $36,467.76 2026-07-01
1831 APR_DRG Percutaneous Structural Cardiac Procedures 36 8 — — $26,808.15 $63,421.44 $36,349.42 2026-07-01
A1204 HCPCS Osteoarthritis M <49.50 And A <74.50 36 9 — — $29,410.80 $109,738.38 $36,233.81 2026-07-01
A0904 HCPCS Other Orthopedic M <44.5 36 9 — — $30,610.18 $114,937.70 $36,216.81 2026-07-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 30 17 — — $23,636.00 $80,575.23 $36,058.69 2026-07-01
A1804 HCPCS Major Multiple Trauma With Brain Or Spinal Cord Injury M >=40.50 And M <45.50 36 9 — — $30,447.48 $105,648.43 $35,955.21 2026-07-01
A0504 HCPCS Non-traumatic Spinal Cord Injury M >=39.50 And M <48.50 36 9 — — $30,218.03 $112,417.28 $35,938.19 2026-07-01
A0204 HCPCS Traumatic Brain Injury M >=35.50 And M <49.50 36 9 — — $30,234.72 $108,582.95 $35,914.79 2026-07-01
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 10 7 — — $23,116.02 $54,424.71 $35,850.25 2026-07-01
481000465-10806601-2957 CDM Hb 37295-50 Revsc Evsc Tpvt St Athrc Cplx Les Ea Add Vsl Bilat 41 22 $95,805.00 $47,902.50 50% off $5,000.00 $66,392.87 $35,696.43 2026-07-01
A2004 HCPCS Miscellaneous M <46.50 And A >=77.50 37 9 — — $49.73 $108,030.83 $35,693.73 2026-07-01
793 MS_DRG Full Term Neonate With Major Problems 27 17 — — $9,181.00 $85,762.86 $35,580.63 2026-07-01
332 MS_DRG Rectal Resection With Mcc 30 17 — — $23,636.00 $74,713.21 $35,549.96 2026-07-01
265 MS_DRG Aicd Lead Procedures 30 17 — — $27,574.30 $74,662.89 $35,526.01 2026-07-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 28 16 — — $26,205.57 $71,047.45 $35,445.62 2026-07-01
69930 HCPCS Implant Cochlear Device 35 20 — — $884.64 $205,239.26 $35,415.16 2026-07-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 30 17 — — $27,484.37 $74,425.34 $35,412.98 2026-07-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 30 17 — — $23,636.00 $79,745.85 $35,325.70 2026-07-01
481000031-10806601-3321 CDM Hb Icd Insert Generator, Leads Single/dual 33249 35 19 $277,025.00 $138,512.50 50% off $915.68 $195,384.12 $35,320.05 2026-07-01
481000340-10806601-3074 CDM Hb 37236-50 Open/perq Place Arterial Stent 1st Lesion Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
481000442-10806601-2980 CDM Hb 37271-50 Revsc Evasc Fpvt Athrc Sf Les 1st Vsl Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
481000342-10806601-3073 CDM Hb 37238-50 Open/perq Place Venous Stent 1st Lesion Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
481000450-10806601-2972 CDM Hb 37280-50 Revsc Evasc Tpvt Angiop Sf Les 1st Vsl Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
481000430-10806601-2992 CDM Hb 37258-50 Revsc Evasc Ivt St Plmt Sf Les 1st Vsl Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
481000438-10806601-2984 CDM Hb 37267-50 Revsc Evasc Fpvt St Plmt Sf Les 1st Vsl Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
481000466-10806601-2956 CDM Hb 37296-50 Revsc Evasc Imvt Angiop Sf Les 1st Vsl Bilateral 41 22 $80,890.00 $40,445.00 50% off $14,560.20 $56,056.77 $35,308.49 2026-07-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 30 17 — — $23,636.00 $79,113.76 $35,294.33 2026-07-01
A1203 HCPCS Osteoarthritis M <49.50 And A >=74.50 36 9 — — $28,568.11 $106,594.23 $35,193.82 2026-07-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 30 17 — — $23,636.00 $82,028.65 $35,165.79 2026-07-01
1791 APR_DRG Defibrillator Implants 36 8 — — $24,152.92 $56,630.39 $35,139.63 2026-07-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 30 17 — — $23,636.00 $73,783.18 $35,107.43 2026-07-01
481000024-10806601-3328 CDM Hb Icd Gen Insertion With Multiple Lead 33231 35 19 $149,855.00 $74,927.50 50% off $915.68 $195,384.12 $34,998.96 2026-07-01
481000034-10806601-3318 CDM Hb Icd Removal/rplcmnt Pace With Mult Lead 33264 35 19 $163,510.00 $81,755.00 50% off $915.68 $195,384.12 $34,998.96 2026-07-01
481000370-10806601-3052 CDM Hb 0915t Insj Perm Ccm-d Sys Pg&dual Transvns Eltrds/lds 35 19 $167,725.00 $83,862.50 50% off $6,597.50 $195,384.12 $34,998.96 2026-07-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 30 17 — — $23,636.00 $85,415.33 $34,989.47 2026-07-01
481000197-10806601-3182 CDM Hb C9607 Perc Revas Chrn Occl W D Stnt Sgl 41 22 $79,950.00 $39,975.00 50% off $14,391.00 $55,405.35 $34,898.18 2026-07-01
481000192-10806601-3190 CDM Hb C9602 Perc Arther W Drug Elud Stent Sgl Maj C Art/ Branch 41 22 $79,950.00 $39,975.00 50% off $14,391.00 $55,405.35 $34,898.18 2026-07-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 28 17 — — $24,147.15 $195,384.12 $34,838.42 2026-07-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 28 17 — — $16,951.90 $195,384.12 $34,838.42 2026-07-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 30 17 — — $24,332.33 $66,099.36 $34,744.57 2026-07-01
1661 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 36 8 — — $24,266.60 $58,337.43 $34,690.01 2026-07-01
791 MS_DRG Prematurity With Major Problems 27 17 — — $25,562.67 $83,536.43 $34,656.94 2026-07-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 16 — — $28,241.90 $76,426.32 $34,652.34 2026-07-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 26 16 — — $30,098.76 $192,077.77 $34,564.53 2026-07-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 26 16 — — $31,565.78 $192,077.77 $34,564.53 2026-07-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 26 16 — — $31,565.78 $192,077.77 $34,564.53 2026-07-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 26 16 — — $31,565.78 $192,077.77 $34,564.53 2026-07-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 26 16 — — $31,565.78 $192,077.77 $34,564.53 2026-07-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 26 16 — — $31,565.78 $192,077.77 $34,564.53 2026-07-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 26 16 — — $31,565.78 $192,077.77 $34,564.53 2026-07-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 29 16 — — $28,262.66 $80,218.93 $34,548.43 2026-07-01
481000449-10806601-2973 CDM Hb 37278-50 Revsc Evsc Fpvt St Athrc Cplx Les Ea Add Vsl Bilat 41 22 $92,475.00 $46,237.50 50% off $5,000.00 $64,085.18 $34,542.59 2026-07-01
A0403 HCPCS Traumatic Spinal Cord Injury M >=41.50 And M <47.50 36 9 — — $29,448.35 $100,224.13 $34,407.08 2026-07-01
81415QW OTHER Exome Sequence Analysis 4 1 — — $17,457.52 $62,608.80 $34,382.79 2026-07-01
3001 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 66 20 — — $21,063.26 $82,761.39 $34,335.40 2026-07-01
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