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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

GEISINGER-LEWISTOWN HOSPITAL

Lewistown, PA · CCN 390048 · Rates published

9,284 distinct procedures filed
28 distinct payers
275,758 rate rows
2026-07-01 last MRF observed
Data quality

249,803 of 275,758 rate rows are consumer-grade (90.6%)

25,955 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
exceeds 10× this hospital's gross charge — excluded from medians 21,836
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,369
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1,419
per-diem day rate — not a per-procedure price 141
placeholder amount (≤ $0.02) — excluded from medians 108
exceeds 3× this hospital's gross charge for a DRG stay — excluded 53
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 28
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.geisinger.org/-/media/OneGeisinger/pdfs/ghs/patient-care/patients-and-visitors/billing-and-insurance/hosp-charges-csv/23-1352187_Geisinger-Lewistown-Hospital_standardcharges
Found on page https://www.geisinger.org/patient-care/patients-and-visitors/billing-and-insurance/tools-to-use/shop-services-and-view-hospital-charge-lists
Discovered viaCMS hospital list
Last fetch success · 2026-08-03
Content fingerprint 1471d2feec903898… · 123,607,319 bytes · first seen 2026-08-03

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
J3590
HCPCS 		Omidubicel-onlv Susp 1 Each Flex Cont 15 $1.00 $1,843,452.00 $632,304.04 nat. median
$1,549
outlier · 408.3×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 $286,353.78 $1,050,702.00 $448,419.90 nat. median
$168,055
outlier · 2.7×
583 - 4
OTHER 		Neonate With Ecmo 9 $12,413.27 $482,824.53 $412,412.47 —
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 11 $185,832.09 $714,701.00 $305,229.31 nat. median
$186,516
1.6× median
588 - 4
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $12,413.27 $295,720.86 $252,594.82 —
002 - 4
OTHER 		Heart And/or Lung Transplant 9 $12,413.27 $276,266.76 $235,977.78 —
583 - 3
OTHER 		Neonate With Ecmo 9 $12,413.27 $274,984.09 $234,882.17 —
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $16,340.00 $528,465.31 $203,223.16 nat. median
$131,925
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth… 12 $16,340.00 $496,506.00 $202,030.51 nat. median
$145,435
1.4× median
583 - 2
OTHER 		Neonate With Ecmo 9 $12,413.27 $211,137.41 $180,346.48 —
161 - 4
OTHER 		Implantable Heart Assist Systems 9 $12,413.27 $206,163.35 $176,097.80 —
609 - 4
OTHER 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 9 $12,413.27 $206,036.56 $175,989.51 —
009 - 4
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 9 $12,413.27 $202,106.46 $172,632.54 —
631 - 4
OTHER 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 9 $12,413.27 $198,170.09 $169,270.22 —
588 - 3
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $12,413.27 $196,950.04 $168,228.10 —
591 - 4
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 9 $12,413.27 $193,919.11 $165,639.18 —
583 - 1
OTHER 		Neonate With Ecmo 9 $12,413.27 $189,521.80 $161,883.15 —
841 - 4
OTHER 		Extensive Third Degree Burns With Skin Graft 9 $12,413.27 $183,387.17 $156,643.16 —
630 - 4
OTHER 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 9 $12,413.27 $179,720.00 $153,510.79 —
593 - 4
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 9 $12,413.27 $170,492.61 $145,629.06 —
588 - 2
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $12,413.27 $168,764.69 $144,153.12 —
7
MS_DRG 		Lung Transplant 11 $85,875.37 $298,991.14 $141,050.34 nat. median
$70,649
2.0× median
007 - 4
OTHER 		Allogeneic Bone Marrow Transplant 9 $12,413.27 $162,655.09 $138,934.51 —
161 - 3
OTHER 		Implantable Heart Assist Systems 9 $12,413.27 $161,430.36 $137,888.39 —
004 - 4
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 9 $12,413.27 $155,320.76 $132,669.77 —
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck… 12 $16,340.00 $305,487.00 $131,843.54 nat. median
$97,418
1.4× median
001 - 4
OTHER 		Liver Transplant And/or Intestinal Transplant 9 $12,413.27 $153,775.96 $131,350.25 —
14
MS_DRG 		Allogeneic Bone Marrow Transplant 11 $79,693.10 $309,288.00 $130,895.96 nat. median
$72,715
1.8× median
002 - 3
OTHER 		Heart And/or Lung Transplant 9 $12,413.27 $150,487.56 $128,541.42 —
591 - 3
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 9 $12,413.27 $146,249.12 $124,921.07 —
588 - 1
OTHER 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $12,413.27 $144,655.79 $123,560.11 —
589 - 3
OTHER 		Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A… 9 $12,413.27 $137,846.57 $117,743.90 —
589 - 2
OTHER 		Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A… 9 $12,413.27 $137,846.57 $117,743.90 —
589 - 1
OTHER 		Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A… 9 $12,413.27 $137,846.57 $117,743.90 —
009 - 3
OTHER 		Extracorporeal Membrane Oxygenation (ecmo) 9 $12,413.27 $135,828.29 $116,019.96 —
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 11 $68,370.99 $295,468.00 $112,299.39 nat. median
$69,922
1.6× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 $75,143.43 $441,398.00 $111,823.17 nat. median
$65,418
1.7× median
602 - 4
OTHER 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 9 $12,413.27 $128,437.61 $109,707.09 —
591 - 2
OTHER 		Neonate Birth Weight 500-749 Grams Without Major Procedure 9 $12,413.27 $125,439.55 $107,146.24 —
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 11 $64,871.70 $268,063.00 $106,551.81 nat. median
$69,822
1.5× median
593 - 3
OTHER 		Neonate Birth Weight 750-999 Grams Without Major Procedure 9 $12,413.27 $124,720.37 $106,531.95 —
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 12 $16,340.00 $303,158.00 $103,504.32 nat. median
$74,509
1.4× median
161 - 1
OTHER 		Implantable Heart Assist Systems 9 $12,413.27 $118,781.37 $101,459.05 —
161 - 2
OTHER 		Implantable Heart Assist Systems 9 $12,413.27 $118,781.37 $101,459.05 —
160 - 4
OTHER 		Major Cardiothoracic Repair Of Heart Anomaly 9 $12,413.27 $118,348.61 $101,089.40 —
002 - 2
OTHER 		Heart And/or Lung Transplant 9 $12,413.27 $113,954.43 $97,336.04 —
005 - 4
OTHER 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 9 $12,413.27 $108,202.47 $92,422.92 —
004 - 3
OTHER 		Tracheostomy With Mv >96 Hours With Extensive Procedure 9 $12,413.27 $107,105.30 $91,485.75 —
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $16,340.00 $295,019.00 $88,848.89 nat. median
$2,736
outlier · 32.5×
007 - 3
OTHER 		Allogeneic Bone Marrow Transplant 9 $12,413.27 $103,450.66 $88,364.08 —

Other procedures at this hospital

Browse this hospital's 9,284 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
             
J3590 HCPCS Omidubicel-onlv Susp 1 Each Flex Cont 23 15 $2,048,280.00 $1,024,140.00 50% off $1.00 $1,843,452.00 $632,304.04 2026-07-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 19 11 — — $286,353.78 $1,050,702.00 $448,419.90 2026-07-01
583 - 4 OTHER Neonate With Ecmo 10 9 — — $12,413.27 $482,824.53 $412,412.47 2026-07-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 19 11 — — $185,832.09 $714,701.00 $305,229.31 2026-07-01
588 - 4 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 10 9 — — $12,413.27 $295,720.86 $252,594.82 2026-07-01
002 - 4 OTHER Heart And/or Lung Transplant 10 9 — — $12,413.27 $276,266.76 $235,977.78 2026-07-01
583 - 3 OTHER Neonate With Ecmo 10 9 — — $12,413.27 $274,984.09 $234,882.17 2026-07-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 12 — — $16,340.00 $528,465.31 $203,223.16 2026-07-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth … 20 12 — — $16,340.00 $496,506.00 $202,030.51 2026-07-01
583 - 2 OTHER Neonate With Ecmo 10 9 — — $12,413.27 $211,137.41 $180,346.48 2026-07-01
161 - 4 OTHER Implantable Heart Assist Systems 10 9 — — $12,413.27 $206,163.35 $176,097.80 2026-07-01
609 - 4 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 9 — — $12,413.27 $206,036.56 $175,989.51 2026-07-01
009 - 4 OTHER Extracorporeal Membrane Oxygenation (ecmo) 10 9 — — $12,413.27 $202,106.46 $172,632.54 2026-07-01
631 - 4 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 9 — — $12,413.27 $198,170.09 $169,270.22 2026-07-01
588 - 3 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 10 9 — — $12,413.27 $196,950.04 $168,228.10 2026-07-01
591 - 4 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 10 9 — — $12,413.27 $193,919.11 $165,639.18 2026-07-01
583 - 1 OTHER Neonate With Ecmo 10 9 — — $12,413.27 $189,521.80 $161,883.15 2026-07-01
841 - 4 OTHER Extensive Third Degree Burns With Skin Graft 10 9 — — $12,413.27 $183,387.17 $156,643.16 2026-07-01
630 - 4 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 9 — — $12,413.27 $179,720.00 $153,510.79 2026-07-01
593 - 4 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 10 9 — — $12,413.27 $170,492.61 $145,629.06 2026-07-01
588 - 2 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 10 9 — — $12,413.27 $168,764.69 $144,153.12 2026-07-01
7 MS_DRG Lung Transplant 19 11 — — $85,875.37 $298,991.14 $141,050.34 2026-07-01
007 - 4 OTHER Allogeneic Bone Marrow Transplant 10 9 — — $12,413.27 $162,655.09 $138,934.51 2026-07-01
161 - 3 OTHER Implantable Heart Assist Systems 10 9 — — $12,413.27 $161,430.36 $137,888.39 2026-07-01
004 - 4 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 10 9 — — $12,413.27 $155,320.76 $132,669.77 2026-07-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face Mouth And Neck… 20 12 — — $16,340.00 $305,487.00 $131,843.54 2026-07-01
001 - 4 OTHER Liver Transplant And/or Intestinal Transplant 10 9 — — $12,413.27 $153,775.96 $131,350.25 2026-07-01
14 MS_DRG Allogeneic Bone Marrow Transplant 19 11 — — $79,693.10 $309,288.00 $130,895.96 2026-07-01
002 - 3 OTHER Heart And/or Lung Transplant 10 9 — — $12,413.27 $150,487.56 $128,541.42 2026-07-01
591 - 3 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 10 9 — — $12,413.27 $146,249.12 $124,921.07 2026-07-01
588 - 1 OTHER Neonate Birth Weight < 1500 Grams With Major Procedure 10 9 — — $12,413.27 $144,655.79 $123,560.11 2026-07-01
589 - 3 OTHER Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A… 10 9 — — $12,413.27 $137,846.57 $117,743.90 2026-07-01
589 - 2 OTHER Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A… 10 9 — — $12,413.27 $137,846.57 $117,743.90 2026-07-01
589 - 1 OTHER Neonate Birth Weight < 500 Grams Or Birth Weight 500-999 Grams And Gestational A… 10 9 — — $12,413.27 $137,846.57 $117,743.90 2026-07-01
009 - 3 OTHER Extracorporeal Membrane Oxygenation (ecmo) 10 9 — — $12,413.27 $135,828.29 $116,019.96 2026-07-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 19 11 — — $68,370.99 $295,468.00 $112,299.39 2026-07-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 19 11 — — $75,143.43 $441,398.00 $111,823.17 2026-07-01
602 - 4 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $128,437.61 $109,707.09 2026-07-01
591 - 2 OTHER Neonate Birth Weight 500-749 Grams Without Major Procedure 10 9 — — $12,413.27 $125,439.55 $107,146.24 2026-07-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 19 11 — — $64,871.70 $268,063.00 $106,551.81 2026-07-01
593 - 3 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 10 9 — — $12,413.27 $124,720.37 $106,531.95 2026-07-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 20 12 — — $16,340.00 $303,158.00 $103,504.32 2026-07-01
161 - 1 OTHER Implantable Heart Assist Systems 10 9 — — $12,413.27 $118,781.37 $101,459.05 2026-07-01
161 - 2 OTHER Implantable Heart Assist Systems 10 9 — — $12,413.27 $118,781.37 $101,459.05 2026-07-01
160 - 4 OTHER Major Cardiothoracic Repair Of Heart Anomaly 10 9 — — $12,413.27 $118,348.61 $101,089.40 2026-07-01
002 - 2 OTHER Heart And/or Lung Transplant 10 9 — — $12,413.27 $113,954.43 $97,336.04 2026-07-01
005 - 4 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 9 — — $12,413.27 $108,202.47 $92,422.92 2026-07-01
004 - 3 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 10 9 — — $12,413.27 $107,105.30 $91,485.75 2026-07-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 12 $329,514.53 $164,757.27 50% off $16,340.00 $295,019.00 $88,848.89 2026-07-01
007 - 3 OTHER Allogeneic Bone Marrow Transplant 10 9 — — $12,413.27 $103,450.66 $88,364.08 2026-07-01
842 - 4 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 10 9 — — $12,413.27 $102,670.43 $87,697.62 2026-07-01
215 MS_DRG Other Heart Assist System Implant 20 12 — — $16,340.00 $434,438.00 $86,160.24 2026-07-01
002 - 1 OTHER Heart And/or Lung Transplant 10 9 — — $12,413.27 $100,717.89 $86,029.84 2026-07-01
006 - 4 OTHER Pancreas Transplant 10 9 — — $12,413.27 $100,446.34 $85,797.89 2026-07-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 20 12 — — $16,340.00 $234,741.00 $85,757.21 2026-07-01
593 - 2 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 10 9 — — $12,413.27 $100,316.43 $85,686.92 2026-07-01
607 - 4 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $99,282.64 $84,803.89 2026-07-01
630 - 3 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 9 — — $12,413.27 $99,065.87 $84,618.74 2026-07-01
850 MS_DRG Acute Leukemia With Other Procedures 20 12 — — $16,340.00 $259,265.00 $82,424.82 2026-07-01
603 - 4 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 9 — — $12,413.27 $93,940.76 $80,241.04 2026-07-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 12 — — $16,340.00 $217,423.00 $80,239.38 2026-07-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 20 12 — — $16,340.00 $264,687.00 $79,987.14 2026-07-01
602 - 3 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $89,176.42 $76,171.49 2026-07-01
209 MS_DRG Complex Aortic Arch Procedures 17 12 — — $12,413.27 $229,726.36 $75,807.80 2026-07-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 12 — — $16,340.00 $265,770.00 $74,898.60 2026-07-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 12 — — $16,340.00 $206,858.00 $72,770.27 2026-07-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 12 — — $16,340.00 $192,673.00 $72,529.46 2026-07-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 12 — — $16,340.00 $216,918.00 $71,671.21 2026-07-01
10 MS_DRG Pancreas Transplant 19 11 $82,157.24 $41,078.62 50% off $47,583.50 $145,638.01 $71,301.30 2026-07-01
611 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 10 9 — — $12,413.27 $82,574.59 $70,532.44 2026-07-01
613 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 10 9 — — $12,413.27 $81,815.49 $69,884.04 2026-07-01
863 - 4 OTHER Neonatal Aftercare 10 9 — — $12,413.27 $80,761.35 $68,983.62 2026-07-01
001 - 3 OTHER Liver Transplant And/or Intestinal Transplant 10 9 — — $12,413.27 $79,837.13 $68,194.19 2026-07-01
162 - 4 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $79,535.05 $67,936.17 2026-07-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 12 — — $16,340.00 $187,513.00 $67,910.17 2026-07-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 20 12 — — $16,340.00 $198,034.00 $67,870.18 2026-07-01
303 - 4 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 9 — — $12,413.27 $79,150.81 $67,607.96 2026-07-01
005 - 3 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 9 — — $12,413.27 $78,525.52 $67,073.85 2026-07-01
440 - 4 OTHER Kidney Transplant 10 9 — — $12,413.27 $77,879.90 $66,522.39 2026-07-01
006 - 3 OTHER Pancreas Transplant 10 9 — — $12,413.27 $77,409.56 $66,120.65 2026-07-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 20 12 $271,897.97 $135,948.98 50% off $16,340.00 $165,217.00 $65,789.46 2026-07-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 20 12 — — $16,340.00 $176,782.00 $65,466.78 2026-07-01
593 - 1 OTHER Neonate Birth Weight 750-999 Grams Without Major Procedure 10 9 — — $12,413.27 $76,344.47 $65,210.88 2026-07-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 20 12 — — $16,340.00 $156,855.00 $64,069.48 2026-07-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 12 $260,757.44 $130,378.72 50% off $16,340.00 $199,802.00 $63,720.60 2026-07-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 20 12 — — $16,340.00 $174,113.00 $63,644.96 2026-07-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 20 12 — — $16,340.00 $188,699.00 $63,187.52 2026-07-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 12 — — $16,340.00 $178,143.00 $62,586.51 2026-07-01
007 - 2 OTHER Allogeneic Bone Marrow Transplant 10 9 — — $12,413.27 $72,850.26 $62,226.25 2026-07-01
008 - 4 OTHER Autologous Bone Marrow Transplant 10 9 — — $12,413.27 $72,343.93 $61,793.76 2026-07-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 12 — — $16,340.00 $156,756.00 $61,612.24 2026-07-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 20 12 $231,198.25 $115,599.13 50% off $16,340.00 $150,373.00 $61,248.21 2026-07-01
609 - 3 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 9 — — $12,413.27 $71,472.14 $61,049.10 2026-07-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 19 11 — — $37,165.22 $150,025.00 $61,043.90 2026-07-01
602 - 2 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $71,256.93 $60,865.27 2026-07-01
163 - 4 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $69,596.30 $59,446.82 2026-07-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 12 — — $16,340.00 $142,638.87 $59,037.37 2026-07-01
004 - 2 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 10 9 — — $12,413.27 $68,444.34 $58,462.85 2026-07-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 20 12 — — $16,340.00 $253,095.00 $58,332.72 2026-07-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 20 12 — — $16,340.00 $171,172.00 $58,265.15 2026-07-01
009 - 2 OTHER Extracorporeal Membrane Oxygenation (ecmo) 10 9 — — $12,413.27 $68,172.00 $58,230.23 2026-07-01
607 - 3 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $68,070.27 $58,143.34 2026-07-01
Q2043 HCPCS Sipuleucel-t Susp 250 Ml Flex Cont 36 21 $250,410.00 $125,205.00 50% off $1.00 $258,796.41 $57,861.48 2026-07-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 12 — — $16,340.00 $157,552.00 $57,706.41 2026-07-01
28 MS_DRG Spinal Procedures With Mcc 20 12 — — $16,340.00 $151,901.00 $57,189.56 2026-07-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 20 12 — — $16,340.00 $174,796.00 $57,173.38 2026-07-01
006 - 2 OTHER Pancreas Transplant 10 9 — — $12,413.27 $66,735.98 $57,003.62 2026-07-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 20 12 — — $16,340.00 $194,423.00 $56,759.32 2026-07-01
178 - 4 OTHER External Heart Assist Systems 10 9 — — $12,413.27 $66,180.34 $56,529.03 2026-07-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 12 — — $16,340.00 $155,445.00 $55,823.67 2026-07-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 12 — — $16,340.00 $160,689.00 $55,758.86 2026-07-01
612 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $65,047.17 $55,561.10 2026-07-01
633 - 4 OTHER Neonate Birth Weight > 2499 Grams With Major Anomaly 10 9 — — $12,413.27 $64,876.57 $55,415.38 2026-07-01
007 - 1 OTHER Allogeneic Bone Marrow Transplant 10 9 — — $12,413.27 $64,308.41 $54,930.08 2026-07-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 20 12 — — $16,340.00 $153,963.00 $54,893.71 2026-07-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 12 — — $16,340.00 $149,007.00 $54,543.44 2026-07-01
621 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Major Anomaly 10 9 — — $12,413.27 $63,790.35 $54,487.57 2026-07-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 12 — — $16,340.00 $150,148.00 $54,250.27 2026-07-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 20 12 — — $16,340.00 $151,486.00 $53,652.12 2026-07-01
165 - 4 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $62,524.92 $53,406.68 2026-07-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 12 $246,403.75 $123,201.88 50% off $16,340.00 $154,952.00 $53,083.63 2026-07-01
001 - 2 OTHER Liver Transplant And/or Intestinal Transplant 10 9 — — $12,413.27 $61,698.51 $52,700.79 2026-07-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 12 — — $16,340.00 $155,597.18 $52,570.27 2026-07-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 20 12 — — $16,340.00 $125,545.00 $52,414.23 2026-07-01
167 - 4 OTHER Other Cardiothoracic And Thoracic Vascular Procedures 10 9 — — $12,413.27 $61,262.62 $52,328.46 2026-07-01
405 MS_DRG Pancreas Liver And Shunt Procedures With Mcc 20 12 — — $16,340.00 $155,895.00 $52,070.56 2026-07-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 12 — — $16,340.00 $137,403.00 $51,996.31 2026-07-01
11 MS_DRG Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Mcc 20 12 — — $16,340.00 $133,359.00 $51,914.45 2026-07-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 19 11 — — $39,321.03 $165,448.00 $51,628.64 2026-07-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 19 11 — — $31,175.92 $127,031.00 $51,206.47 2026-07-01
841 - 3 OTHER Extensive Third Degree Burns With Skin Graft 10 9 — — $12,413.27 $59,639.55 $50,942.10 2026-07-01
183 - 4 OTHER Percutaneous Structural Cardiac Procedures 10 9 — — $12,413.27 $59,562.86 $50,876.59 2026-07-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 12 — — $16,340.00 $146,523.00 $50,759.86 2026-07-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 20 12 — — $16,340.00 $144,945.00 $50,729.40 2026-07-01
910 - 4 OTHER Craniotomy For Multiple Significant Trauma 10 9 — — $12,413.27 $59,387.56 $50,726.85 2026-07-01
6 MS_DRG Liver Transplant Without Mcc 19 11 — — $30,748.87 $133,586.00 $50,505.04 2026-07-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 20 12 — — $16,340.00 $201,407.00 $50,388.65 2026-07-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 20 12 — — $16,340.00 $133,271.00 $50,222.07 2026-07-01
631 - 3 OTHER Neonate Birth Weight > 2499 Grams With Other Major Procedure 10 9 — — $12,413.27 $58,244.99 $49,750.91 2026-07-01
162 - 3 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $58,180.04 $49,695.43 2026-07-01
680 - 4 OTHER Major O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms 10 9 — — $12,413.27 $57,725.36 $49,307.07 2026-07-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 20 12 — — $16,340.00 $144,991.00 $48,675.99 2026-07-01
608 - 4 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 10 9 — — $12,413.27 $56,627.40 $48,369.22 2026-07-01
625 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 10 9 — — $12,413.27 $56,545.23 $48,299.04 2026-07-01
911 - 4 OTHER Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 10 9 — — $12,413.27 $56,486.54 $48,248.90 2026-07-01
304 - 4 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 10 9 — — $12,413.27 $55,820.57 $47,680.05 2026-07-01
166 - 4 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $55,740.74 $47,611.87 2026-07-01
326 MS_DRG Stomach Esophageal And Duodenal Procedures With Mcc 20 12 $98,437.70 $49,218.85 50% off $16,340.00 $151,562.00 $47,472.20 2026-07-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 12 — — $16,340.00 $205,790.00 $47,091.46 2026-07-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 20 12 $129,972.49 $64,986.25 50% off $16,340.00 $146,557.00 $47,007.71 2026-07-01
179 - 4 OTHER Defibrillator Implants 10 9 — — $12,413.27 $55,013.72 $46,990.88 2026-07-01
303 - 3 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 9 — — $12,413.27 $54,929.99 $46,919.35 2026-07-01
271997 LOCAL Valve Transcath Resilia 23mm 23 14 $119,000.00 $59,500.00 50% off $1.00 $107,100.00 $46,909.80 2026-07-01
160 - 3 OTHER Major Cardiothoracic Repair Of Heart Anomaly 10 9 — — $12,413.27 $54,854.86 $46,855.18 2026-07-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 20 12 — — $16,340.00 $133,950.00 $46,846.84 2026-07-01
091 - 4 OTHER Other Major Head And Neck Procedures 10 9 — — $12,413.27 $54,692.87 $46,716.81 2026-07-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 20 12 — — $16,340.00 $133,309.86 $46,651.71 2026-07-01
614 - 4 OTHER Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 10 9 — — $12,413.27 $54,590.35 $46,629.24 2026-07-01
740 - 4 OTHER Mental Illness Diagnosis With O.r. Procedure 16 15 $152,160.97 $76,080.48 50% off $12,413.27 $136,944.87 $46,352.59 2026-07-01
001 - 1 OTHER Liver Transplant And/or Intestinal Transplant 10 9 — — $12,413.27 $54,203.76 $46,299.03 2026-07-01
850 - 4 OTHER Procedure With Diagnosis Of Rehabilitation Aftercare Or Other Contact With Healt… 10 9 — — $12,413.27 $53,852.38 $45,998.89 2026-07-01
021 - 4 OTHER Open Craniotomy Except Trauma 10 9 — — $12,413.27 $53,776.47 $45,934.05 2026-07-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 12 — — $16,340.00 $130,452.00 $45,752.56 2026-07-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 20 12 — — $16,340.00 $181,915.00 $45,729.38 2026-07-01
178 - 3 OTHER External Heart Assist Systems 10 9 — — $12,413.27 $53,400.05 $45,612.53 2026-07-01
603 - 3 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 9 — — $12,413.27 $53,194.23 $45,436.72 2026-07-01
602 - 1 OTHER Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $53,081.54 $45,340.46 2026-07-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 20 12 — — $16,340.00 $190,039.00 $45,315.32 2026-07-01
440 - 3 OTHER Kidney Transplant 10 9 — — $12,413.27 $52,949.28 $45,227.49 2026-07-01
471 MS_DRG Cervical Spinal Fusion With Mcc 20 12 — — $16,340.00 $137,180.00 $45,172.54 2026-07-01
912 - 4 OTHER Musculoskeletal And Other Procedures For Multiple Significant Trauma 10 9 — — $12,413.27 $52,520.43 $44,861.19 2026-07-01
005 - 2 OTHER Tracheostomy With Mv >96 Hours Without Extensive Procedure 10 9 — — $12,413.27 $52,360.00 $44,724.15 2026-07-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 20 12 $114,411.79 $57,205.89 50% off $16,340.00 $140,644.00 $44,658.55 2026-07-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 12 — — $16,340.00 $143,270.00 $44,525.29 2026-07-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 19 11 — — $36,022.67 $117,099.00 $44,246.64 2026-07-01
690 - 4 OTHER Acute Leukemia 10 9 — — $12,413.27 $51,599.33 $44,074.42 2026-07-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 20 12 — — $16,340.00 $134,608.00 $43,960.86 2026-07-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 20 12 — — $16,340.00 $125,597.00 $43,640.08 2026-07-01
008 - 3 OTHER Autologous Bone Marrow Transplant 10 9 — — $12,413.27 $50,919.27 $43,493.53 2026-07-01
245 MS_DRG Aicd Generator Procedures 20 12 — — $16,340.00 $130,840.00 $43,426.87 2026-07-01
607 - 2 OTHER Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $50,841.02 $43,426.68 2026-07-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 20 12 — — $16,340.00 $122,084.00 $43,277.43 2026-07-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 20 12 $196,518.59 $98,259.30 50% off $16,340.00 $142,921.00 $43,272.07 2026-07-01
799 MS_DRG Splenic Procedures With Mcc 20 12 — — $16,340.00 $141,105.00 $43,108.01 2026-07-01
260 - 4 OTHER Major Pancreas Liver And Shunt Procedures 10 9 — — $12,413.27 $50,175.04 $42,857.83 2026-07-01
163 - 3 OTHER Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $50,032.61 $42,736.18 2026-07-01
163 MS_DRG Major Chest Procedures With Mcc 20 12 — — $16,340.00 $141,668.00 $42,659.68 2026-07-01
009 - 1 OTHER Extracorporeal Membrane Oxygenation (ecmo) 10 9 — — $12,413.27 $49,920.70 $42,640.59 2026-07-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 20 12 — — $16,340.00 $115,421.00 $42,479.79 2026-07-01
169 - 4 OTHER Major Abdominal Vascular Procedures 10 9 — — $12,413.27 $49,696.88 $42,449.40 2026-07-01
653 MS_DRG Major Bladder Procedures With Mcc 19 12 $52,167.62 $26,083.81 50% off $16,340.00 $144,519.00 $42,325.21 2026-07-01
280889 LOCAL Valve Heart Precision Mitral Pascal System 23 14 $107,100.00 $53,550.00 50% off $1.00 $96,390.00 $42,218.82 2026-07-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 20 12 $107,866.83 $53,933.41 50% off $16,340.00 $135,605.00 $41,926.50 2026-07-01
023 - 4 OTHER Spinal Procedures 10 9 — — $12,413.27 $49,033.26 $41,882.56 2026-07-01
608 - 3 OTHER Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 10 9 — — $12,413.27 $48,881.44 $41,752.88 2026-07-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 20 12 — — $16,340.00 $116,789.00 $41,734.00 2026-07-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 20 12 $151,350.56 $75,675.28 50% off $16,340.00 $108,571.00 $41,683.75 2026-07-01
120 - 4 OTHER Major Respiratory And Chest Procedures 10 9 — — $12,413.27 $48,372.76 $41,318.38 2026-07-01
681 - 4 OTHER Other O.r. Procedures For Lymphatic Hematopoietic Or Other Neoplasms 10 9 — — $12,413.27 $48,294.50 $41,251.54 2026-07-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 20 12 — — $16,340.00 $116,527.00 $41,190.04 2026-07-01
312 - 4 OTHER Skin Graft Except Hand For Musculoskeletal And Connective Tissue Diagnoses 10 9 — — $12,413.27 $48,203.72 $41,174.00 2026-07-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 20 12 $54,815.23 $27,407.62 50% off $16,340.00 $101,169.00 $40,861.65 2026-07-01
130 - 4 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 10 9 — — $12,413.27 $47,803.83 $40,832.42 2026-07-01
220 - 4 OTHER Major Stomach Esophageal And Duodenal Procedures 10 9 — — $12,413.27 $47,646.53 $40,698.06 2026-07-01
140 MS_DRG Major Head And Neck Procedures With Mcc 20 12 — — $16,340.00 $112,042.00 $40,598.94 2026-07-01
695 - 4 OTHER Chemotherapy For Acute Leukemia 10 9 — — $12,413.27 $47,490.79 $40,565.04 2026-07-01
004 - 1 OTHER Tracheostomy With Mv >96 Hours With Extensive Procedure 10 9 — — $12,413.27 $47,353.84 $40,448.07 2026-07-01
C2616 HCPCS Brachytherapy Yttrium 90 1 Each 1 Each 36 20 $125,965.00 $62,982.50 50% off $1.00 $113,368.50 $40,396.85 2026-07-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 19 11 — — $24,573.90 $103,964.00 $40,362.65 2026-07-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 20 12 — — $16,340.00 $109,889.00 $40,198.22 2026-07-01
12 MS_DRG Tracheostomy For Face Mouth And Neck Diagnoses Or Laryngectomy With Cc 20 12 — — $16,340.00 $93,710.00 $40,129.68 2026-07-01
020 - 4 OTHER Open Craniotomy For Trauma 10 9 — — $12,413.27 $46,980.55 $40,129.21 2026-07-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 20 12 — — $16,340.00 $108,653.00 $40,109.70 2026-07-01
089 - 4 OTHER Major Cranial Or Facial Bone Procedures 10 9 — — $12,413.27 $46,952.38 $40,105.15 2026-07-01
361 - 4 OTHER Skin Graft For Skin And Subcutaneous Tissue Diagnoses 10 9 — — $12,413.27 $46,899.95 $40,060.36 2026-07-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 20 12 — — $16,340.00 $114,927.00 $39,947.92 2026-07-01
901 MS_DRG Wound Debridements For Injuries With Mcc 20 12 — — $16,340.00 $112,388.00 $39,945.03 2026-07-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 20 12 — — $16,340.00 $106,822.00 $39,870.79 2026-07-01
261 - 4 OTHER Major Biliary Tract Procedures 10 9 — — $12,413.27 $46,654.22 $39,850.46 2026-07-01
950 - 4 OTHER Extensive O.r. Procedure Unrelated To Principal Diagnosis 10 9 — — $12,413.27 $46,647.17 $39,844.45 2026-07-01
609 - 2 OTHER Neonate Birth Weight 1500-2499 Grams With Major Procedure 10 9 — — $12,413.27 $46,636.22 $39,835.09 2026-07-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature Malignancy Infection Or Exte… 20 12 — — $16,340.00 $148,157.00 $39,716.59 2026-07-01
165 - 3 OTHER Coronary Bypass With Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $46,463.27 $39,687.36 2026-07-01
006 - 1 OTHER Pancreas Transplant 10 9 — — $12,413.27 $46,353.71 $39,593.78 2026-07-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 20 12 — — $16,340.00 $118,110.00 $39,530.03 2026-07-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 20 12 — — $16,340.00 $99,917.00 $39,268.26 2026-07-01
623 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 10 9 — — $12,413.27 $45,568.78 $38,923.32 2026-07-01
027 - 4 OTHER Other Open Craniotomy 10 9 — — $12,413.27 $45,259.66 $38,659.29 2026-07-01
630 - 2 OTHER Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 10 9 — — $12,413.27 $45,148.53 $38,564.36 2026-07-01
440 - 2 OTHER Kidney Transplant 10 9 — — $12,413.27 $45,123.49 $38,542.97 2026-07-01
612 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $45,044.45 $38,475.46 2026-07-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 20 12 $119,997.68 $59,998.84 50% off $16,340.00 $110,593.00 $38,268.83 2026-07-01
092 - 4 OTHER Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 10 9 — — $12,413.27 $44,757.25 $38,230.14 2026-07-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 17 12 — — $12,413.27 $115,827.24 $38,222.03 2026-07-01
401 - 4 OTHER Adrenal Procedures 10 9 — — $12,413.27 $44,391.78 $37,917.97 2026-07-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 20 12 $147,689.05 $73,844.52 50% off $16,340.00 $98,580.00 $37,793.38 2026-07-01
613 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 10 9 — — $12,413.27 $44,211.01 $37,763.56 2026-07-01
611 - 3 OTHER Neonate Birth Weight 1500-1999 Grams With Major Anomaly 10 9 — — $12,413.27 $44,037.28 $37,615.16 2026-07-01
162 - 2 OTHER Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $43,984.06 $37,569.71 2026-07-01
710 - 4 OTHER Infectious And Parasitic Diseases Including HIV With O.r. Procedure 16 15 $218,582.69 $109,291.34 50% off $12,413.27 $196,724.42 $37,566.48 2026-07-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 20 12 $222,940.69 $111,470.34 50% off $16,340.00 $94,575.00 $37,537.79 2026-07-01
441 - 4 OTHER Major Bladder Procedures 10 9 — — $12,413.27 $43,781.37 $37,396.57 2026-07-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 12 — — $16,340.00 $105,441.00 $37,235.14 2026-07-01
178 - 2 OTHER External Heart Assist Systems 10 9 — — $12,413.27 $43,479.30 $37,138.56 2026-07-01
603 - 2 OTHER Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 10 9 — — $12,413.27 $43,402.60 $37,073.04 2026-07-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 20 12 — — $16,340.00 $79,162.62 $37,066.65 2026-07-01
183 - 3 OTHER Percutaneous Structural Cardiac Procedures 10 9 — — $12,413.27 $43,282.09 $36,970.11 2026-07-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 20 12 — — $16,340.00 $104,168.00 $36,842.97 2026-07-01
834 MS_DRG Acute Leukemia With Mcc 13 10 $25,615.84 $12,807.92 50% off $16,340.00 $76,449.71 $36,768.67 2026-07-01
40 MS_DRG Peripheral Cranial Nerve And Other Nervous System Procedures With Mcc 20 12 $78,422.93 $39,211.46 50% off $16,340.00 $106,845.00 $36,752.55 2026-07-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 20 12 $93,355.59 $46,677.80 50% off $16,340.00 $106,598.00 $36,544.10 2026-07-01
511 - 4 OTHER Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 10 9 — — $12,413.27 $42,366.47 $36,188.01 2026-07-01
440 - 1 OTHER Kidney Transplant 10 9 — — $12,413.27 $42,227.95 $36,069.69 2026-07-01
622 - 4 OTHER Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 10 9 — — $12,413.27 $42,181.78 $36,030.26 2026-07-01
321 - 4 OTHER Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 10 9 — — $12,413.27 $42,049.52 $35,917.29 2026-07-01
022 - 4 OTHER Ventricular Shunt Procedures 10 9 — — $12,413.27 $42,022.13 $35,893.89 2026-07-01
956 MS_DRG Limb Reattachment Hip And Femur Procedures For Multiple Significant Trauma 20 12 $120,758.99 $60,379.50 50% off $16,340.00 $115,894.08 $35,817.84 2026-07-01
792 - 4 OTHER Extensive O.r. Procedures For Other Complications Of Treatment 10 9 — — $12,413.27 $41,896.92 $35,786.94 2026-07-01
179 - 3 OTHER Defibrillator Implants 10 9 — — $12,413.27 $41,895.36 $35,785.61 2026-07-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 20 12 $39,954.06 $19,977.03 50% off $16,340.00 $103,045.00 $35,577.02 2026-07-01
842 - 3 OTHER Burns With Skin Graft Except Extensive Third Degree Burns 10 9 — — $12,413.27 $41,471.20 $35,423.31 2026-07-01
651 - 4 OTHER Other Procedures Of Blood And Blood-forming Organs 10 9 — — $12,413.27 $41,464.15 $35,417.29 2026-07-01
863 - 3 OTHER Neonatal Aftercare 10 9 — — $12,413.27 $41,313.90 $35,288.94 2026-07-01
652 MS_DRG Kidney Transplant 19 11 — — $21,415.46 $99,696.19 $35,174.91 2026-07-01
304 - 3 OTHER Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 10 9 — — $12,413.27 $41,150.34 $35,149.24 2026-07-01
160 - 2 OTHER Major Cardiothoracic Repair Of Heart Anomaly 10 9 — — $12,413.27 $41,097.13 $35,103.79 2026-07-01
030 - 4 OTHER Percutaneous Intracranial And Extracranial Vascular Procedures 10 9 — — $12,413.27 $41,022.00 $35,039.61 2026-07-01
170 - 4 OTHER Permanent Cardiac Pacemaker Implant With Ami Heart Failure Or Shock 10 9 — — $12,413.27 $40,990.69 $35,012.87 2026-07-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 20 12 — — $16,340.00 $94,677.00 $34,962.13 2026-07-01
181 - 4 OTHER Lower Extremity Arterial Procedures 10 9 — — $12,413.27 $40,899.91 $34,935.33 2026-07-01
166 - 3 OTHER Coronary Bypass Without Ami Or Complex Principal Diagnosis 10 9 — — $12,413.27 $40,894.44 $34,930.65 2026-07-01
143 MS_DRG Other Ear Nose Mouth And Throat O.r. Procedures With Mcc 20 12 — — $16,340.00 $83,422.00 $34,888.66 2026-07-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip Foot And Femur With Mcc 20 12 $147,505.80 $73,752.90 50% off $16,340.00 $89,714.00 $34,765.36 2026-07-01
628 MS_DRG Other Endocrine Nutritional And Metabolic O.r. Procedures With Mcc 20 12 $105,630.17 $52,815.09 50% off $16,340.00 $92,700.00 $34,640.63 2026-07-01
121 - 4 OTHER Other Respiratory And Chest Procedures 10 9 — — $12,413.27 $40,546.97 $34,633.86 2026-07-01
512 - 4 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 10 9 — — $12,413.27 $40,530.54 $34,619.82 2026-07-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 20 12 — — $16,340.00 $87,103.24 $34,510.96 2026-07-01
303527 LOCAL Valve Aortic Navitor With Radiopaque Marker 27mm 23 14 $87,500.00 $43,750.00 50% off $1.00 $78,750.00 $34,492.50 2026-07-01
332 MS_DRG Rectal Resection With Mcc 20 12 — — $16,340.00 $132,425.00 $34,463.37 2026-07-01
265 MS_DRG Aicd Lead Procedures 20 12 — — $16,340.00 $84,594.40 $34,439.57 2026-07-01
230 - 4 OTHER Major Small Bowel Procedures 10 9 — — $12,413.27 $40,303.59 $34,425.98 2026-07-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 20 12 $49,103.69 $24,551.85 50% off $16,340.00 $89,013.00 $34,378.65 2026-07-01
130 - 3 OTHER Respiratory System Diagnosis With Ventilator Support > 96 Hours 16 15 $196,581.55 $98,290.77 50% off $12,413.27 $176,923.39 $34,185.27 2026-07-01
008 - 2 OTHER Autologous Bone Marrow Transplant 10 9 — — $12,413.27 $39,965.52 $34,137.21 2026-07-01
303 - 2 OTHER Dorsal And Lumbar Fusion Procedure For Curvature Of Back 10 9 — — $12,413.27 $39,950.65 $34,124.50 2026-07-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 20 12 — — $16,340.00 $93,258.00 $34,102.61 2026-07-01
405 - 4 OTHER Other Procedures For Endocrine Nutritional And Metabolic Disorders 10 9 — — $12,413.27 $39,852.04 $34,040.28 2026-07-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 20 12 — — $16,340.00 $124,805.00 $34,023.61 2026-07-01
264 - 4 OTHER Other Hepatobiliary Pancreas And Abdominal Procedures 10 9 — — $12,413.27 $39,773.78 $33,973.43 2026-07-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 20 12 — — $16,340.00 $109,680.00 $33,938.90 2026-07-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 20 12 — — $16,340.00 $100,049.00 $33,910.35 2026-07-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 20 12 — — $16,340.00 $88,455.00 $33,850.38 2026-07-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 20 12 — — $16,340.00 $90,087.00 $33,738.04 2026-07-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 20 12 $100,977.98 $50,488.99 50% off $16,340.00 $120,695.00 $33,715.86 2026-07-01
176 - 4 OTHER Insertion Revision And Replacements Of Pacemaker And Other Cardiac Devices 10 9 — — $12,413.27 $39,469.36 $33,713.40 2026-07-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 20 12 — — $16,340.00 $78,407.53 $33,647.31 2026-07-01
404 - 4 OTHER Thyroid Parathyroid And Thyroglossal Procedures 10 9 — — $12,413.27 $39,375.45 $33,633.19 2026-07-01
634 - 4 OTHER Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 10 9 — — $12,413.27 $39,351.98 $33,613.13 2026-07-01
182 - 4 OTHER Other Peripheral Vascular And Related Procedures 16 15 $125,768.09 $62,884.05 50% off $12,413.27 $113,191.28 $33,542.11 2026-07-01
403 - 4 OTHER Procedures For Obesity 10 9 — — $12,413.27 $39,265.11 $33,538.93 2026-07-01
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