Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

MAIN LINE HOSPITAL LANKENAU

Wynnewood, PA · CCN 390195 · Rates published

13,490 distinct procedures filed
27 distinct payers
255,751 rate rows
2026-04-01 last MRF observed
Data quality

188,632 of 255,751 rate rows are consumer-grade (73.8%)

67,119 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 66,864
placeholder amount (≤ $0.02) — excluded from medians 255
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.mainlinehealth.org/-/media/files/pdf/basic-content/patient-services/patient-billing/price-transparency/2026/23-1352160_lankenau-medical-center_standardcharges.csv
Found on page https://www.mainlinehealth.org/patient-services/patient-billing/price-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint ee55095ae2db2022… · 60,042,530 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $269,934.17 $739,657.75 $621,312.51 nat. median
$754,974
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $341,000.00 $707,336.18 $594,162.39 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $361,064.00 $703,172.73 $590,665.09 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $369,160.00 $696,647.42 $585,183.83 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $269,934.17 $666,537.71 $559,891.68 nat. median
$634,511
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $489,304.61 $611,630.76 $538,235.07 nat. median
$620,080
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 15 $385,344.20 $1,480,646.55 $423,878.62 nat. median
$370,174
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 17 $213,534.74 $961,283.91 $279,198.64 nat. median
$265,286
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 19 $82,797.00 $915,099.30 $262,232.35 nat. median
$202,986
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $190,673.80 $732,645.01 $209,741.18 nat. median
$206,368
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 17 $82,797.00 $475,716.59 $138,168.78 nat. median
$133,176
1.0× median
7
MS_DRG 		Lung Transplant 15 $115,771.49 $444,840.37 $127,348.64 nat. median
$122,708
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $107,458.52 $412,898.62 $118,204.37 nat. median
$117,303
1.0× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $101,340.82 $389,391.97 $111,474.90 nat. median
$108,660
1.0× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $101,224.91 $388,946.59 $111,347.40 nat. median
$98,017
1.1× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 17 $81,446.93 $373,710.59 $108,541.80 nat. median
$102,358
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 $51,807.95 $378,750.44 $107,442.74 nat. median
$98,905
1.1× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 $47,908.53 $264,218.56 $107,001.82 nat. median
$74,915
1.4× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 8 $103,977.10 $179,355.00 $105,298.90 nat. median
$62,270
1.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $92,234.28 $354,401.00 $101,457.71 nat. median
$100,136
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 15 $76,906.68 $357,325.00 $97,990.48 nat. median
$99,019
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $54,416.82 $336,321.31 $97,682.33 nat. median
$93,672
1.0× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 3 $96,334.40 $112,749.10 $96,334.40 nat. median
$65,381
1.5× median
230
MS_DRG 		Other Cardiothoracic Procedures Without Cc/mcc 1 $70,763.00 $94,350.00 $94,350.00 nat. median
$29,793
outlier · 3.2×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 $39,716.42 $183,858.84 $90,386.00 nat. median
$52,879
1.7× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $41,623.97 $309,830.54 $88,294.93 nat. median
$82,712
1.1× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 $51,181.72 $263,084.52 $85,586.00 nat. median
$73,807
1.2× median
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $77,512.93 $297,835.68 $85,264.22 nat. median
$83,442
1.0× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 8 $78,295.20 $139,806.00 $84,412.95 nat. median
$48,483
1.7× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 16 $61,420.10 $289,969.29 $83,993.29 nat. median
$79,312
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 $58,391.90 $289,061.37 $82,752.32 nat. median
$81,118
1.0× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 $53,279.64 $245,446.83 $78,695.54 nat. median
$68,887
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 $70,462.56 $270,745.34 $77,508.82 nat. median
$77,576
1.0× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 18 $44,926.22 $240,296.23 $77,470.63 nat. median
$60,726
1.3× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 17 $37,020.95 $442,737.09 $75,569.37 nat. median
$65,950
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 15 $80.00 $262,217.71 $75,067.53 nat. median
$72,138
1.0× median
236
MS_DRG 		Coronary Bypass Without Cardiac Catheterization Without Mcc 19 $30,695.40 $144,663.98 $73,634.98 nat. median
$42,002
1.8× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 19 $16,092.05 $170,353.07 $73,148.67 nat. median
$48,170
1.5× median
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 19 $38,165.17 $181,923.08 $71,926.99 nat. median
$51,307
1.4× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $35,374.27 $248,468.68 $71,131.47 nat. median
$68,090
1.0× median
10
MS_DRG 		Pancreas Transplant 15 $64,282.44 $246,998.85 $70,710.68 nat. median
$68,882
1.0× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 15 $64,255.69 $246,896.06 $70,681.26 nat. median
$64,027
1.1× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 10 $63,235.61 $125,536.04 $70,499.96 nat. median
$69,774
1.0× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 15 $63,915.97 $245,590.72 $70,307.57 nat. median
$71,240
1.0× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 19 $29,207.12 $237,957.33 $69,113.15 nat. median
$66,526
1.0× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 16 $53,295.38 $497,194.82 $68,515.61 nat. median
$52,278
1.3× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 3 $68,258.01 $150,643.80 $68,258.01 nat. median
$87,411
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $68,066.13 $68,066.13 $68,066.13 nat. median
$76,377
0.9× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 17 $45,080.34 $208,862.68 $67,946.69 nat. median
$59,899
1.1× median
38240
HCPCS 		Transplt Allo Hct/donor 9 $1,719.63 $81,462.04 $67,450.57 nat. median
$15,912
outlier · 4.2×

Other procedures at this hospital

Browse this hospital's 13,490 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 35 15 — — $18,814.92 $93,868.30 $26,872.56 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 32 15 — — $40,101.34 $189,241.27 $54,175.88 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 31 15 — — $77,512.93 $297,835.68 $85,264.22 2026-04-01
245 MS_DRG Aicd Generator Procedures 34 15 — — $36,985.30 $157,463.97 $45,078.69 2026-04-01
265 MS_DRG Aicd Lead Procedures 36 16 — — $32,561.56 $125,114.54 $36,338.70 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 31 15 — — $107,458.52 $412,898.62 $118,204.37 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 44 15 — — $16,544.73 $98,812.20 $28,622.21 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 44 17 — — $23,078.10 $169,774.06 $49,177.21 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 39 16 — — $25,325.43 $148,230.57 $42,049.58 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 41 16 — — $16,544.73 $120,633.15 $34,848.74 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 45 17 — — $37,020.95 $442,737.09 $75,569.37 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 58 17 — — $31,580.79 $145,842.56 $42,359.02 2026-04-01
509 MS_DRG Arthroscopy 4 2 — — $26,902.00 $35,869.00 $32,864.75 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 31 15 — — $53,172.33 $204,309.36 $58,489.56 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 31 15 — — $48,737.20 $187,267.82 $53,610.92 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 15 10 — — $269,934.17 $666,537.71 $559,891.68 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 36 16 — — $15,064.58 $129,195.05 $37,154.00 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 35 15 — — $23,297.19 $89,517.12 $25,999.66 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 34 15 — — $16,092.23 $121,729.50 $34,848.65 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 34 16 — — $23,297.19 $89,517.12 $25,929.77 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 31 15 — — $49,545.94 $190,375.32 $54,500.53 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 31 15 — — $24,017.65 $92,285.42 $26,419.42 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 32 15 — — $28,044.04 $123,312.38 $35,301.79 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 43 17 — — $18,030.11 $85,405.75 $24,672.18 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 34 15 — — $20,517.74 $119,509.40 $34,213.08 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 15 10 — — $489,304.61 $611,630.76 $538,235.07 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 46 16 — — $53,279.64 $245,446.83 $78,695.54 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 46 17 — — $47,329.19 $261,534.53 $63,821.75 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 50 17 — — $25,707.69 $159,386.06 $49,154.82 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 31 15 — — $28,316.35 $108,802.74 $31,147.98 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 46 16 — — $14,958.00 $112,595.46 $32,702.62 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 41 16 — — $54,416.82 $336,321.31 $97,682.33 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 37 17 — — $49,391.85 $226,428.41 $65,411.08 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 32 15 — — $43,153.56 $226,428.41 $64,821.79 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 72 17 — — $47,908.53 $264,218.56 $107,001.82 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 71 20 — — $39,716.42 $183,858.84 $90,386.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 16 — — $45,241.00 $173,834.02 $50,488.96 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 42 16 — — $17,544.36 $83,052.02 $24,057.07 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 36 15 — — $29,641.08 $133,765.47 $38,120.24 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 57 18 — — $18,514.39 $102,087.53 $29,650.66 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 39 16 — — $40,107.95 $166,587.75 $48,384.33 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 43 17 — — $19,706.46 $84,792.47 $24,715.69 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 40 16 — — $8,734.59 $85,265.28 $24,187.79 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 31 15 — — $43,137.56 $165,751.76 $47,451.32 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 35 15 — — $19,685.21 $89,972.79 $25,757.36 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 28 15 — — $385,344.20 $1,480,646.55 $423,878.62 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 38 15 — — $10,969.48 $123,209.59 $35,112.04 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 31 15 — — $29,753.71 $114,325.66 $32,729.08 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 15 10 — — $341,000.00 $707,336.18 $594,162.39 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 87 20 — — $900.00 $76,963.77 $37,626.10 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 36 15 — — $41,623.97 $309,830.54 $88,294.93 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 36 15 — — $41,623.97 $198,738.50 $57,153.35 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 16 8 — — $103,977.10 $179,355.00 $105,298.90 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 3 — — $68,258.01 $150,643.80 $68,258.01 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 11 8 — — $78,295.20 $139,806.00 $84,412.95 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 16 9 — — $3,152.66 $35,140.76 $29,096.55 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 27 14 — — $101,224.91 $388,946.59 $111,347.40 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 38 17 — — $81,446.93 $373,710.59 $108,541.80 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 39 16 — — $6,236.59 $230,238.26 $65,912.47 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 46 17 — — $18,130.45 $86,176.62 $24,962.15 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 59 16 — — $51,181.72 $263,084.52 $85,586.00 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 45 16 — — $38,375.52 $188,309.38 $54,693.23 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 38 16 — — $61,420.10 $289,969.29 $83,993.29 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 47 17 — — $45,080.34 $208,862.68 $67,946.69 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 62 17 — — $12,690.02 $202,216.02 $64,755.93 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 77 19 — — $30,695.40 $144,663.98 $73,634.98 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 39 17 — — $21,898.07 $149,412.61 $42,384.90 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 39 16 — — $22,606.23 $109,107.68 $31,235.28 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 31 15 — — $28,925.36 $111,142.80 $31,817.90 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 38 16 — — $20,593.47 $107,675.58 $30,545.07 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 48 18 — — $33,522.01 $156,926.08 $48,396.16 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 39 16 — — $18,566.18 $87,588.20 $25,074.70 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 31 15 — — $60,318.11 $231,766.31 $66,349.92 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 15 — — $30,144.56 $197,477.69 $56,533.80 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 32 15 — — $29,169.22 $135,177.05 $38,698.41 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 1 — — $68,066.13 $68,066.13 $68,066.13 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 72 19 — — $82,797.00 $915,099.30 $262,232.35 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 28 14 — — $30,484.75 $196,675.97 $56,048.35 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 67 18 — — $44,926.22 $240,296.23 $77,470.63 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 59 17 — — $17,632.96 $164,261.41 $47,879.65 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 16 9 — — $7,418.60 $33,850.65 $28,028.33 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 16 9 — — $7,418.60 $33,850.65 $28,028.33 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 13 9 — — $6,180.00 $57,043.76 $48,829.46 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 15 — — $190,673.80 $732,645.01 $209,741.18 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 31 15 — — $35,022.54 $134,570.61 $38,524.79 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 57 17 — — $18,867.26 $85,381.78 $27,208.95 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 66 18 — — $18,419.97 $161,897.37 $53,320.54 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 33 15 — — $26,396.73 $113,941.95 $32,619.24 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 50 16 — — $53,295.38 $497,194.82 $68,515.61 2026-04-01
503 MS_DRG Foot Procedures With Mcc 35 16 — — $21,770.75 $96,777.07 $27,957.15 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 46 15 — — $2,168.00 $144,006.16 $41,226.00 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 31 15 — — $64,255.69 $246,896.06 $70,681.26 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 31 15 — — $29,018.09 $111,499.11 $31,919.90 2026-04-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 72 19 — — $12,169.78 $146,043.11 $25,805.89 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 93 20 — — $6,055.56 $83,696.00 $26,212.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 40 17 — — $213,534.74 $961,283.91 $279,198.64 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 31 15 — — $101,340.82 $389,391.97 $111,474.90 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 32 15 — — $30,679.26 $117,881.99 $33,900.59 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 32 15 — — $26,175.47 $100,576.63 $28,923.90 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 55 18 — — $22,164.08 $100,929.51 $26,401.46 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 44 16 — — $22,450.02 $99,487.11 $28,610.57 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 14 9 — — $6,180.00 $44,367.51 $37,623.65 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 34 15 — — $54,880.76 $210,873.83 $61,082.29 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 32 15 — — $23,816.13 $91,511.10 $26,316.82 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 41 17 — — $2,050.00 $100,028.47 $29,052.62 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 15 10 — — $369,160.00 $696,647.42 $585,183.83 2026-04-01
69930 HCPCS Implant Cochlear Device 16 9 — — $6,878.52 $42,701.57 $35,356.90 2026-04-01
61886 HCPCS Implant Neurostim Arrays 16 9 — — $3,152.66 $39,963.22 $33,089.55 2026-04-01
5200 OTHER Implantation Wireless Pa Pressure Monitor 4 4 — — $29,259.25 $31,882.83 $29,259.25 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 16 9 — — $3,152.66 $57,043.76 $47,232.24 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 83 19 — — $16,092.05 $170,353.07 $73,148.67 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 34 15 — — $18,318.05 $86,526.08 $24,770.64 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 18 10 — — $63,235.61 $125,536.04 $70,499.96 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 16 9 — — $4,585.68 $40,651.12 $33,659.13 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 13 9 — — $4,845.00 $28,807.23 $24,658.99 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 13 9 — — $9,355.00 $40,651.12 $34,797.36 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 13 9 — — $4,845.00 $57,043.76 $48,829.46 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 13 9 — — $6,180.00 $28,807.23 $24,658.99 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 13 9 — — $9,355.00 $28,807.23 $24,658.99 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 13 9 — — $9,355.00 $40,651.12 $34,797.36 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 16 9 — — $4,585.68 $40,651.12 $33,659.13 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 13 9 — — $9,355.00 $40,651.12 $34,797.36 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 16 9 — — $3,152.66 $40,651.12 $33,659.13 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 16 9 — — $3,152.66 $39,963.22 $33,089.55 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 16 9 — — $3,152.66 $39,963.22 $33,089.55 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 31 15 — — $47,502.25 $182,522.65 $52,252.48 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 31 15 — — $70,462.56 $270,745.34 $77,508.82 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 31 15 — — $28,631.11 $110,012.18 $31,494.22 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 34 15 — — $21,355.82 $95,612.17 $27,371.80 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 32 15 — — $23,880.76 $110,231.46 $31,557.00 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 38 16 — — $11,184.73 $88,204.90 $25,251.25 2026-04-01
652 MS_DRG Kidney Transplant 31 15 — — $29,095.67 $111,797.20 $32,005.24 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 15 — — $42,220.04 $162,226.28 $46,442.04 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 15 — — $33,342.65 $128,115.80 $36,676.92 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 36 16 — — $24,840.81 $111,714.98 $31,836.33 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 52 17 — — $15,467.68 $82,911.54 $25,570.01 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 13 9 — — $4,845.00 $39,963.22 $34,208.52 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 12 7 — — $2,050.00 $39,392.04 $26,751.00 2026-04-01
5624 OTHER Level 4 Radiation Therapy 14 7 — — $9,953.36 $82,956.40 $40,831.00 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 17 10 — — $25,500.00 $35,858.20 $28,911.67 2026-04-01
5626 OTHER Level 6 Radiation Therapy 34 10 — — $2,311.03 $77,610.88 $39,819.82 2026-04-01
5627 OTHER Level 7 Radiation Therapy 11 5 — — $7,014.62 $31,063.95 $26,062.61 2026-04-01
5378 OTHER Level 8 Urology And Related Services 5 3 — — $4,872.29 $24,842.94 $24,842.94 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 47 17 — — $16,080.66 $130,075.54 $37,237.95 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 15 10 — — $361,064.00 $703,172.73 $590,665.09 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 31 15 — — $92,234.28 $354,401.00 $101,457.71 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 31 15 — — $41,645.81 $160,019.86 $45,810.39 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 31 15 — — $32,628.43 $125,371.48 $35,891.27 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 32 15 — — $19,065.17 $104,509.82 $29,919.01 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 56 19 — — $18,160.19 $88,040.45 $26,493.60 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 46 16 — — $26,328.04 $126,944.06 $36,506.66 2026-04-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc 55 17 — — $14,314.95 $69,895.68 $25,016.21 2026-04-01
22558 HCPCS Lumbar Spine Fusion 16 9 — — $5,445.50 $35,140.76 $29,096.55 2026-04-01
22630 HCPCS Lumbar Spine Fusion 16 9 — — $5,445.50 $35,140.76 $29,096.55 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 16 9 — — $5,445.50 $35,140.76 $29,096.55 2026-04-01
7 MS_DRG Lung Transplant 31 15 — — $115,771.49 $444,840.37 $127,348.64 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 32 15 — — $51,148.04 $202,085.80 $57,853.00 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 40 17 — — $26,136.87 $111,982.21 $32,437.07 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 35 15 — — $26,378.62 $158,231.45 $45,298.41 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 44 17 — — $20,863.36 $97,057.99 $28,189.86 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 34 15 — — $43,856.07 $179,185.60 $51,297.15 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 63 17 — — $19,029.53 $87,625.89 $37,345.86 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 62 18 — — $14,025.59 $154,702.52 $53,096.60 2026-04-01
165 MS_DRG Major Chest Procedures Without Cc/Mcc 59 17 — — $14,369.23 $66,733.38 $30,996.36 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 31 15 — — $38,331.50 $147,284.96 $42,164.65 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 35 16 — — $22,738.06 $105,071.70 $30,079.86 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 58 17 — — $14,260.24 $67,237.00 $32,074.26 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 41 17 — — $18,383.07 $96,119.25 $27,917.21 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 75 19 — — $17,871.79 $83,281.56 $38,714.17 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 68 17 — — $10,645.12 $158,632.29 $56,857.71 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 31 15 — — $27,597.67 $106,041.29 $30,357.44 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 34 16 — — $23,329.28 $89,640.43 $25,965.49 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 39 16 — — $51,807.95 $378,750.44 $107,442.74 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 48 15 — — $35,374.27 $248,468.68 $71,131.47 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 42 15 — — $34,951.90 $193,767.20 $56,278.42 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 34 15 — — $38,520.82 $230,070.39 $65,864.41 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 45 16 — — $27,804.69 $146,445.58 $42,305.49 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 35 15 — — $21,837.70 $161,417.73 $46,210.57 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 35 15 — — $24,002.94 $109,416.03 $31,608.32 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 40 16 — — $29,444.97 $129,804.04 $36,275.01 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 13 9 — — $6,012.00 $34,860.32 $29,840.44 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 43 16 — — $20,997.70 $118,611.74 $33,647.41 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 31 15 — — $26,045.29 $100,076.42 $28,649.82 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 32 15 — — $32,653.40 $125,467.42 $35,918.74 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 42 18 — — $19,458.73 $133,566.78 $41,192.12 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 16 9 — — $3,152.66 $39,963.22 $33,089.55 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 16 9 — — $3,152.66 $39,963.22 $33,089.55 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 3 1 — — $70,763.00 $94,350.00 $94,350.00 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 38 15 — — $38,218.21 $170,654.55 $48,854.88 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 44 17 — — $24,197.52 $109,056.30 $31,731.46 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 44 16 — — $26,335.71 $134,366.70 $33,576.31 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 48 16 — — $32,486.55 $151,653.26 $43,217.86 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 32 15 — — $33,706.45 $129,513.66 $37,245.63 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 37 15 — — $8,057.49 $128,835.29 $36,882.89 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 35 16 — — $33,114.01 $154,055.00 $43,701.84 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 40 16 — — $17,709.03 $89,119.66 $25,814.64 2026-04-01
215 MS_DRG Other Heart Assist System Implant 33 15 — — $76,906.68 $357,325.00 $97,990.48 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 34 15 — — $33,328.83 $143,437.45 $41,249.84 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 50 18 — — $10,876.17 $145,102.51 $38,518.78 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 58 17 — — $26,283.54 $122,993.76 $35,786.75 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 71 19 — — $38,165.17 $181,923.08 $71,926.99 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 48 17 — — $19,247.12 $88,619.46 $27,330.33 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 40 17 — — $15,761.52 $94,813.91 $27,538.08 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 36 16 — — $22,384.68 $130,111.01 $31,587.40 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 52 15 — — $15,374.75 $132,689.68 $40,029.20 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 37 15 — — $37,873.19 $145,523.95 $42,266.48 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 36 15 — — $80.00 $262,217.71 $75,067.53 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 31 15 — — $26,550.86 $102,019.02 $29,205.95 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 33 15 — — $27,561.43 $137,650.71 $39,406.56 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 44 17 — — $17,482.33 $155,774.79 $38,679.80 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 39 16 — — $12,876.82 $112,105.52 $32,093.50 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 57 17 — — $19,284.15 $90,079.00 $26,332.30 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 56 18 — — $25,823.09 $120,664.00 $35,046.07 2026-04-01
10 MS_DRG Pancreas Transplant 31 15 — — $64,282.44 $246,998.85 $70,710.68 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 53 16 — — $14,154.64 $100,514.96 $29,193.91 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 36 16 — — $38,404.84 $366,202.99 $54,230.99 2026-04-01
J9266 HCPCS Pegaspargase Injection 18 10 — — $27,070.53 $53,599.65 $31,635.98 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 53 16 — — $29,607.90 $142,495.25 $41,386.82 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 64 17 — — $23,521.50 $113,928.24 $36,711.86 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 64 19 — — $21,872.52 $94,368.50 $47,002.29 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 76 18 — — $13,754.98 $61,553.10 $33,981.61 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 27 14 — — $30,960.13 $118,961.20 $34,056.14 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 27 14 — — $21,897.28 $84,138.11 $24,087.01 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 43 15 — — $23,251.88 $133,440.02 $37,853.85 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 35 15 — — $32,139.80 $123,493.97 $35,868.02 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 41 16 — — $26,275.24 $110,539.82 $31,357.59 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 16 9 — — $24,228.42 $47,103.13 $26,530.12 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 47 16 — — $22,627.55 $156,994.59 $45,761.49 2026-04-01
791 MS_DRG Prematurity With Major Problems 57 19 — — $3,141.00 $140,216.86 $47,603.39 2026-04-01
792 MS_DRG Prematurity Without Major Problems 45 15 — — $1,461.50 $85,063.13 $24,130.44 2026-04-01
665 MS_DRG Prostatectomy With Mcc 31 15 — — $28,130.00 $108,086.71 $30,943.00 2026-04-01
849 MS_DRG Radiotherapy 31 15 — — $24,459.02 $93,981.34 $26,904.92 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 16 9 — — $5,445.50 $35,140.76 $29,096.55 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 16 9 — — $5,445.50 $35,140.76 $29,096.55 2026-04-01
332 MS_DRG Rectal Resection With Mcc 32 15 — — $32,583.85 $126,424.83 $36,005.15 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 58 17 — — $9,211.17 $95,324.37 $27,735.96 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 48 16 — — $47,867.27 $221,611.30 $63,731.13 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 16 9 — — $4,845.00 $39,963.22 $33,089.55 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 50 16 — — $26,302.78 $121,976.18 $35,331.96 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 39 15 — — $41,100.66 $179,493.95 $52,132.85 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 40 15 — — $18,120.48 $95,300.40 $27,282.54 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 10 9 — — $31,970.58 $39,963.22 $35,007.79 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 13 9 — — $4,845.00 $39,963.22 $34,208.52 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 13 9 — — $9,355.00 $28,807.23 $24,658.99 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 16 9 — — $3,725.87 $40,651.12 $33,659.13 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 13 9 — — $4,845.00 $28,807.23 $24,658.99 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 13 9 — — $8,017.00 $28,807.23 $24,658.99 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 16 9 — — $3,152.66 $39,963.22 $33,089.55 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 63 19 — — $29,207.12 $237,957.33 $69,113.15 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 96 19 — — $10,250.00 $67,702.97 $27,289.37 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 36 15 — — $20,735.90 $104,636.58 $30,309.31 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 31 15 — — $50,273.54 $193,171.05 $55,300.89 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 15 — — $63,915.97 $245,590.72 $70,307.57 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 44 16 — — $30,010.49 $166,984.00 $39,763.58 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 34 15 — — $42,061.84 $183,749.22 $52,603.62 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 42 17 — — $23,720.32 $111,828.02 $32,392.41 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 10 — — $55,272.32 $69,090.40 $60,799.56 2026-04-01
570 MS_DRG Skin Debridement With Mcc 34 15 — — $22,532.83 $101,916.24 $29,176.52 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 33 15 — — $23,934.72 $91,966.77 $26,567.54 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 32 15 — — $41,301.87 $169,071.67 $48,401.74 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 35 16 — — $22,329.28 $120,084.99 $34,377.86 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 32 15 — — $23,987.51 $225,609.59 $64,587.38 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 34 15 — — $21,173.30 $123,093.13 $35,399.21 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 34 15 — — $17,782.75 $126,995.47 $36,356.19 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 34 15 — — $21,116.82 $109,580.48 $31,439.08 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 3 — — $96,334.40 $112,749.10 $96,334.40 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 15 — — $58,391.90 $289,061.37 $82,752.32 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 15 — — $46,960.79 $205,453.70 $58,817.17 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 34 16 — — $33,100.00 $144,108.94 $41,442.94 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 14 8 — — $50,899.73 $62,184.30 $50,899.73 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 37 16 — — $25,805.76 $118,036.15 $34,098.51 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 37 16 — — $49,740.82 $207,002.31 $59,799.23 2026-04-01
800 MS_DRG Splenic Procedures With Cc 32 16 — — $25,349.79 $97,404.03 $28,011.52 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 33 15 — — $40,681.93 $156,316.25 $45,156.94 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 45 16 — — $16,868.93 $119,164.52 $24,523.72 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 47 18 — — $35,793.65 $172,025.02 $49,963.54 2026-04-01
J9226 HCPCS Supprelin La Implant 12 10 — — $45,020.65 $56,275.81 $48,622.31 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 13 9 — — $9,355.00 $37,147.27 $31,798.06 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 33 15 — — $21,921.36 $104,622.87 $29,951.37 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 15 10 — — $269,934.17 $739,657.75 $621,312.51 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 31 15 — — $37,891.91 $145,595.87 $41,681.10 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 32 15 — — $45,437.07 $188,014.74 $53,824.75 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 31 15 — — $25,995.36 $99,884.57 $28,594.90 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 53 17 — — $82,797.00 $475,716.59 $138,168.78 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 16 9 — — $1,719.63 $81,462.04 $67,450.57 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 34 15 — — $16,616.62 $101,193.33 $28,969.57 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 16 9 — — $7,418.60 $33,850.65 $28,028.33 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 34 16 — — $35,172.74 $191,855.41 $54,924.25 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 41 15 — — $26,347.21 $124,710.24 $36,010.74 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 31 15 — — $26,838.87 $103,125.67 $29,522.76 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 34 16 — — $19,788.72 $93,566.78 $26,786.24 2026-04-01
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/Mcc 59 17 — — $12,360.17 $89,538.68 $31,052.20 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 33 15 — — $32,245.91 $167,746.33 $35,792.96 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 34 15 — — $17,366.55 $123,617.31 $35,389.09 2026-04-01
263 MS_DRG Vein Ligation And Stripping 31 15 — — $27,561.11 $105,900.81 $30,317.22 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 31 15 — — $40,250.36 $154,657.98 $44,275.40 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 40 15 — — $33,930.87 $196,422.45 $55,720.51 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 39 15 — — $22,853.59 $107,864.01 $31,159.96 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 35 15 — — $12,588.61 $144,931.22 $41,490.82 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 13 9 — — $56,824.55 $74,954.81 $63,075.25 2026-04-01
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