Price Transparencybeta Hospital negotiated rates

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

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Hospital

DEKALB COMMUNITY HOSPITAL

Smithville, TN · CCN 440148 · Rates published

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You selected 93306 (CPT)

ECHO 2D COMP W CF DOP

This hospital’s price: $518 across 29 payers · range $149-$2,076

Source: https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/tn-csv/474063289_saint-thomas-dekalb-hospital-llc-_standardcharges.csv · observed 2026-01-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

16,413 distinct procedures filed
41 distinct payers
450,366 rate rows
2026-01-01 last MRF observed
Data quality

444,262 of 450,366 rate rows are consumer-grade (98.6%)

6,104 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
per-diem day rate — not a per-procedure price 4,841
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 565
placeholder amount (≤ $0.02) — excluded from medians 412
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 275
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 11
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://healthcare.ascension.org/-/media/project/ascension/healthcare/price-transparency-files/tn-csv/474063289_saint-thomas-dekalb-hospital-llc-_standardcharges.csv
Found on page https://healthcare.ascension.org/price-transparency
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-10-21
Content fingerprint 6d8d876cca485783… · 121,170,690 bytes · first seen 2026-05-15

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
0278
RC 		1 $250,000.00 $250,000.00 $250,000.00 nat. median
$1,467
outlier · 170.4×
0279
RC 		1 $250,000.00 $250,000.00 $250,000.00 nat. median
$215
outlier · 1162.5×
0274
RC 		1 $250,000.00 $250,000.00 $250,000.00 nat. median
$297
outlier · 842.7×
0270
RC 		1 $250,000.00 $250,000.00 $250,000.00 nat. median
$130
outlier · 1926.9×
0672
RC 		1 $250,000.00 $250,000.00 $250,000.00 nat. median
$40
outlier · 6250.0×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 38 $8,001.00 $721,270.94 $149,473.27 nat. median
$359,358
outlier · 0.4×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 38 $8,001.00 $424,425.61 $96,546.95 nat. median
$249,124
outlier · 0.4×
90288
CPT 		Botulism Ig IV 3 $75,005.70 $75,005.70 $75,005.70 nat. median
$51,570
1.5× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 38 $8,001.00 $278,276.59 $70,572.25 nat. median
$190,557
outlier · 0.4×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 $18,292.00 $152,832.26 $68,456.81 nat. median
$90,581
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 38 $8,001.00 $325,559.68 $67,822.56 nat. median
$198,433
outlier · 0.3×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 32 $15,440.00 $124,406.90 $58,989.66 nat. median
$77,043
0.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 34 $14,128.00 $238,897.21 $58,804.22 nat. median
$77,696
0.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 38 $8,001.00 $207,740.48 $58,117.33 nat. median
$126,722
outlier · 0.5×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 38 $8,001.00 $250,000.00 $57,841.51 nat. median
$103,967
0.6× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 34 $14,128.00 $210,213.70 $53,730.21 nat. median
$72,473
0.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 33 $14,128.00 $114,186.43 $53,498.59 nat. median
$71,758
0.7× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 29 $14,128.00 $135,945.73 $49,896.19 nat. median
$66,649
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 38 $8,001.00 $163,496.71 $48,228.31 nat. median
$93,917
0.5× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 34 $14,128.00 $121,355.69 $48,129.27 nat. median
$63,896
0.8× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 $11,792.00 $121,813.62 $46,011.78 nat. median
$62,038
0.7× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 $11,792.00 $110,740.18 $46,011.78 nat. median
$59,558
0.8× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 27 $14,128.00 $78,062.82 $44,417.85 nat. median
$60,543
0.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 37 $8,001.00 $187,247.76 $43,103.05 nat. median
$110,192
outlier · 0.4×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 38 $8,001.00 $151,220.43 $42,587.32 nat. median
$74,460
0.6× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 35 $10,900.00 $88,253.24 $42,424.07 nat. median
$57,804
0.7× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 35 $11,485.00 $88,054.22 $41,260.09 nat. median
$58,118
0.7× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 36 $10,900.00 $92,538.85 $41,066.53 nat. median
$55,491
0.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 37 $8,001.00 $149,802.01 $38,671.35 nat. median
$94,964
outlier · 0.4×
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 36 $10,900.00 $113,793.76 $36,427.06 nat. median
$58,331
0.6× median
7
MS_DRG 		Lung Transplant 37 $8,001.00 $169,598.22 $36,274.91 nat. median
$117,894
outlier · 0.3×
405
MS_DRG 		Pancreas, Liver And Shunt Procedures With Mcc 35 $9,457.68 $83,969.02 $34,807.85 nat. median
$50,825
0.7× median
0888T
OTHER 		Histotripsy Mal Renal Tissue 4 $31,325.90 $36,926.06 $34,125.97 nat. median
$18,255
1.9× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 31 $10,900.00 $119,993.48 $33,504.58 nat. median
$56,686
0.6× median
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 38 $8,001.00 $129,497.98 $32,549.86 nat. median
$51,590
0.6× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 $9,564.00 $102,097.18 $31,980.63 nat. median
$55,188
0.6× median
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 $9,564.00 $79,124.73 $29,505.42 nat. median
$50,679
0.6× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 38 $8,001.00 $108,736.98 $29,243.97 nat. median
$68,004
outlier · 0.4×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 38 $8,001.00 $144,913.07 $26,990.64 nat. median
$62,721
outlier · 0.4×
471
MS_DRG 		Cervical Spinal Fusion With Mcc 36 $9,564.00 $117,423.66 $26,986.89 nat. median
$44,860
0.6× median
653
MS_DRG 		Major Bladder Procedures With Mcc 36 $9,564.00 $88,320.86 $25,994.24 nat. median
$49,999
0.5× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 38 $8,001.00 $96,470.57 $25,347.80 nat. median
$47,451
0.5× median
834
MS_DRG 		Acute Leukemia With Mcc 38 $8,001.00 $88,652.12 $24,350.35 nat. median
$50,391
outlier · 0.5×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 38 $8,001.00 $92,138.06 $24,146.21 nat. median
$61,711
outlier · 0.4×
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 37 $8,394.50 $85,442.76 $24,141.29 nat. median
$45,888
0.5× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 38 $8,001.00 $87,842.78 $24,129.18 nat. median
$58,216
outlier · 0.4×
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 38 $7,338.66 $83,040.02 $23,987.79 nat. median
$50,905
outlier · 0.5×
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 36 $9,564.00 $94,026.65 $23,945.75 nat. median
$46,224
0.5× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 37 $8,001.00 $98,559.01 $23,872.22 nat. median
$53,907
outlier · 0.4×
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 35 $9,564.00 $77,915.86 $23,759.70 nat. median
$51,613
outlier · 0.5×

Other procedures at this hospital

Browse this hospital's 16,413 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
             
0279 RC — 1 1 — — $250,000.00 $250,000.00 $250,000.00 2026-01-01
0274 RC — 1 1 — — $250,000.00 $250,000.00 $250,000.00 2026-01-01
0278 RC — 1 1 — — $250,000.00 $250,000.00 $250,000.00 2026-01-01
0270 RC — 1 1 — — $250,000.00 $250,000.00 $250,000.00 2026-01-01
0672 RC — 1 1 — — $250,000.00 $250,000.00 $250,000.00 2026-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 68 38 — — $8,001.00 $721,270.94 $149,473.27 2026-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 68 38 — — $8,001.00 $424,425.61 $96,546.95 2026-01-01
90288 CPT Botulism Ig IV 9 3 — — $75,005.70 $75,005.70 $75,005.70 2026-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 68 38 — — $8,001.00 $278,276.59 $70,572.25 2026-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 44 29 — — $18,292.00 $152,832.26 $68,456.81 2026-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 68 38 — — $8,001.00 $325,559.68 $67,822.56 2026-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 53 32 — — $15,440.00 $124,406.90 $58,989.66 2026-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 54 34 — — $14,128.00 $238,897.21 $58,804.22 2026-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 68 38 — — $8,001.00 $207,740.48 $58,117.33 2026-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 68 38 — — $8,001.00 $250,000.00 $57,841.51 2026-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 34 — — $14,128.00 $210,213.70 $53,730.21 2026-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 54 33 — — $14,128.00 $114,186.43 $53,498.59 2026-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 45 29 — — $14,128.00 $135,945.73 $49,896.19 2026-01-01
215 MS_DRG Other Heart Assist System Implant 68 38 — — $8,001.00 $163,496.71 $48,228.31 2026-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 55 34 — — $14,128.00 $121,355.69 $48,129.27 2026-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 61 36 — — $11,792.00 $110,740.18 $46,011.78 2026-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 61 36 — — $11,792.00 $121,813.62 $46,011.78 2026-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 34 27 — — $14,128.00 $78,062.82 $44,417.85 2026-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 67 37 — — $8,001.00 $187,247.76 $43,103.05 2026-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 68 38 — — $8,001.00 $151,220.43 $42,587.32 2026-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 63 35 — — $10,900.00 $88,253.24 $42,424.07 2026-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 61 35 — — $11,485.00 $88,054.22 $41,260.09 2026-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 64 36 — — $10,900.00 $92,538.85 $41,066.53 2026-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 67 37 — — $8,001.00 $149,802.01 $38,671.35 2026-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 63 36 — — $10,900.00 $113,793.76 $36,427.06 2026-01-01
7 MS_DRG Lung Transplant 67 37 — — $8,001.00 $169,598.22 $36,274.91 2026-01-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 64 35 — — $9,457.68 $83,969.02 $34,807.85 2026-01-01
0888T OTHER Histotripsy Mal Renal Tissue 4 4 — — $31,325.90 $36,926.06 $34,125.97 2026-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 54 31 — — $10,900.00 $119,993.48 $33,504.58 2026-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 68 38 — — $8,001.00 $129,497.98 $32,549.86 2026-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 65 36 — — $9,564.00 $102,097.18 $31,980.63 2026-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 66 36 — — $9,564.00 $79,124.73 $29,505.42 2026-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 68 38 — — $8,001.00 $108,736.98 $29,243.97 2026-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 68 38 — — $8,001.00 $144,913.07 $26,990.64 2026-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 66 36 — — $9,564.00 $117,423.66 $26,986.89 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 65 36 — — $9,564.00 $88,320.86 $25,994.24 2026-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 69 38 — — $8,001.00 $96,470.57 $25,347.80 2026-01-01
834 MS_DRG Acute Leukemia With Mcc 68 38 — — $8,001.00 $88,652.12 $24,350.35 2026-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 68 38 — — $8,001.00 $92,138.06 $24,146.21 2026-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 67 37 — — $8,394.50 $85,442.76 $24,141.29 2026-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 68 38 — — $8,001.00 $87,842.78 $24,129.18 2026-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 66 38 — — $7,338.66 $83,040.02 $23,987.79 2026-01-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 65 36 — — $9,564.00 $94,026.65 $23,945.75 2026-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 67 37 — — $8,001.00 $98,559.01 $23,872.22 2026-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 65 35 — — $9,564.00 $77,915.86 $23,759.70 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 66 36 — — $9,564.00 $75,925.98 $23,566.87 2026-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 68 38 — — $8,001.00 $85,017.56 $22,838.83 2026-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 68 38 — — $8,001.00 $95,628.41 $22,837.63 2026-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 68 38 — — $8,001.00 $94,997.71 $22,736.11 2026-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 68 38 — — $8,001.00 $125,554.36 $22,433.93 2026-01-01
791 MS_DRG Prematurity With Major Problems 66 38 — — $5,178.98 $53,990.93 $22,257.75 2026-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 68 38 — — $8,001.00 $78,619.21 $22,237.05 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 68 38 — — $8,001.00 $88,274.64 $21,961.11 2026-01-01
245 MS_DRG Aicd Generator Procedures 68 38 — — $8,001.00 $79,331.34 $21,832.57 2026-01-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 68 38 — — $8,001.00 $80,151.52 $21,802.69 2026-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 68 38 — — $8,001.00 $92,133.69 $21,790.84 2026-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 68 38 — — $8,001.00 $83,336.01 $21,693.22 2026-01-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 68 38 — — $8,001.00 $73,886.38 $21,689.72 2026-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 68 38 — — $8,001.00 $89,034.56 $21,684.79 2026-01-01
27447 CPT Total Knee Arthroplasty 30 12 — — $2,118.00 $28,151.00 $21,669.50 2026-01-01
27130 CPT Total Hip Arthroplasty 29 11 — — $2,118.00 $28,151.00 $21,555.00 2026-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 68 38 — — $8,001.00 $157,395.08 $21,377.90 2026-01-01
28 MS_DRG Spinal Procedures With Mcc 68 38 — — $7,131.23 $85,280.46 $21,088.40 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 68 38 — — $8,001.00 $71,071.45 $21,047.70 2026-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 68 38 — — $8,001.00 $88,234.69 $21,012.00 2026-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 69 38 — — $8,001.00 $78,320.29 $21,007.90 2026-01-01
27438 CPT Revise Kneecap With Implant 30 12 — — $2,187.00 $28,151.00 $20,762.50 2026-01-01
27125 CPT Partial Hip Replacement 30 12 — — $2,118.00 $28,151.00 $20,762.50 2026-01-01
27132 CPT Total Hip Arthroplasty 30 12 — — $2,118.00 $28,151.00 $20,762.50 2026-01-01
27138 CPT Revise Hip Joint Replacement 30 12 — — $2,118.00 $28,151.00 $20,762.50 2026-01-01
27446 CPT Revision Of Knee Joint 30 12 — — $2,118.00 $28,151.00 $20,762.50 2026-01-01
163 MS_DRG Major Chest Procedures With Mcc 68 38 — — $8,001.00 $78,428.00 $20,444.00 2026-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 68 38 — — $6,569.04 $62,454.02 $20,438.33 2026-01-01
799 MS_DRG Splenic Procedures With Mcc 67 37 — — $8,394.50 $75,373.57 $20,315.96 2026-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 69 38 — — $8,001.00 $91,974.65 $20,300.00 2026-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 67 37 — — $8,001.00 $101,516.98 $20,300.00 2026-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 68 38 — — $5,701.58 $74,145.65 $20,135.00 2026-01-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 68 38 — — $5,094.49 $47,119.65 $20,135.00 2026-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 68 38 — — $5,117.52 $54,986.85 $20,135.00 2026-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 68 38 — — $8,001.00 $96,060.86 $20,135.00 2026-01-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 68 38 — — $7,475.64 $62,742.40 $20,135.00 2026-01-01
332 MS_DRG Rectal Resection With Mcc 68 38 — — $6,854.51 $60,952.08 $20,135.00 2026-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 68 38 — — $8,001.00 $80,080.03 $20,135.00 2026-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 68 38 — — $8,001.00 $66,608.14 $20,135.00 2026-01-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 68 38 — — $8,001.00 $164,551.95 $20,135.00 2026-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 68 38 — — $8,001.00 $72,453.22 $20,135.00 2026-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 68 37 — — $8,394.50 $69,035.00 $20,135.00 2026-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 68 37 — — $8,001.00 $61,867.11 $20,135.00 2026-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 68 38 — — $8,001.00 $70,590.86 $20,104.45 2026-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 69 38 — — $8,001.00 $75,435.02 $20,004.53 2026-01-01
0686T OTHER Histotripsy Mal Hepatcel Tis 12 6 — — $14,750.59 $26,376.06 $20,000.80 2026-01-01
662 MS_DRG Minor Bladder Procedures With Mcc 67 37 — — $6,380.59 $42,930.36 $19,970.00 2026-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 67 37 — — $8,001.00 $61,234.89 $19,970.00 2026-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 69 38 — — $7,051.12 $59,179.42 $19,970.00 2026-01-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 61 33 — — $8,001.00 $135,396.90 $19,970.00 2026-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 69 38 — — $7,042.83 $52,402.06 $19,970.00 2026-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 69 38 — — $7,234.83 $60,721.32 $19,970.00 2026-01-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 69 38 — — $8,001.00 $68,591.17 $19,970.00 2026-01-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 69 38 — — $8,001.00 $93,132.04 $19,970.00 2026-01-01
23472 CPT Reconstruct Shoulder Joint 29 11 — — $2,118.00 $28,151.00 $19,804.00 2026-01-01
23470 CPT Reconstruct Shoulder Joint 30 12 — — $2,118.00 $28,151.00 $19,793.00 2026-01-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 69 38 — — $5,277.98 $46,908.65 $19,788.64 2026-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 68 38 — — $8,001.00 $83,071.07 $19,739.80 2026-01-01
27702 CPT Reconstruct Ankle Joint 14 7 — — $2,118.00 $28,151.00 $19,688.00 2026-01-01
27700 CPT Revision Of Ankle Joint 15 8 — — $1,682.15 $28,151.00 $19,594.00 2026-01-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 69 38 — — $7,361.22 $67,487.00 $19,581.44 2026-01-01
503 MS_DRG Foot Procedures With Mcc 67 37 — — $5,811.90 $38,518.34 $19,531.20 2026-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 68 38 — — $7,240.13 $58,447.89 $19,483.53 2026-01-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 67 37 — — $8,001.00 $79,518.90 $19,451.61 2026-01-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 68 37 — — $7,577.48 $48,140.97 $19,401.00 2026-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 68 38 — — $7,196.38 $60,398.64 $19,401.00 2026-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 68 38 — — $8,001.00 $82,097.25 $19,401.00 2026-01-01
37 MS_DRG Extracranial Procedures With Mcc 68 38 — — $5,200.39 $47,984.18 $19,401.00 2026-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 68 38 — — $8,001.00 $67,518.09 $19,401.00 2026-01-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 68 38 — — $6,129.78 $51,446.76 $19,401.00 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 68 38 — — $7,611.47 $63,882.40 $19,292.42 2026-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 68 38 — — $6,240.75 $57,983.39 $19,217.83 2026-01-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 68 38 — — $7,856.88 $65,942.12 $19,131.00 2026-01-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 68 38 — — $8,001.00 $76,129.91 $19,131.00 2026-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 68 38 — — $5,673.95 $47,799.55 $19,131.00 2026-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 68 38 — — $4,989.28 $49,617.99 $19,131.00 2026-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 68 38 — — $6,432.29 $54,343.58 $19,131.00 2026-01-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 68 38 — — $8,001.00 $66,122.94 $19,131.00 2026-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 68 38 — — $7,226.08 $60,647.89 $19,131.00 2026-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 68 38 — — $8,001.00 $104,879.82 $19,131.00 2026-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 68 38 — — $7,015.66 $58,881.86 $19,131.00 2026-01-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 68 38 — — $6,160.63 $51,705.67 $19,131.00 2026-01-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 69 38 — — $7,315.64 $45,195.71 $19,102.80 2026-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 68 38 — — $8,001.00 $102,315.79 $18,998.65 2026-01-01
665 MS_DRG Prostatectomy With Mcc 68 38 — — $4,925.05 $44,496.77 $18,974.51 2026-01-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 68 38 — — $6,468.67 $43,585.35 $18,954.04 2026-01-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 68 38 — — $5,572.43 $46,768.90 $18,844.42 2026-01-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 69 38 — — $6,359.77 $53,377.03 $18,832.00 2026-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 67 37 — — $8,001.00 $79,356.94 $18,832.00 2026-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 68 38 — — $5,856.29 $58,239.81 $18,794.24 2026-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 68 38 — — $8,001.00 $79,233.73 $18,780.08 2026-01-01
6 MS_DRG Liver Transplant Without Mcc 67 37 — — $8,001.00 $68,747.48 $18,753.39 2026-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 68 38 — — $8,001.00 $86,371.27 $18,652.25 2026-01-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 68 38 — — $5,380.19 $45,155.51 $18,645.75 2026-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 68 38 — — $5,433.61 $62,395.40 $18,643.64 2026-01-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 68 38 — — $5,036.25 $42,268.81 $18,614.54 2026-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 61 33 — — $8,001.00 $86,183.85 $18,580.93 2026-01-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 68 38 — — $8,001.00 $89,688.86 $18,562.00 2026-01-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 68 38 — — $5,880.00 $49,350.32 $18,562.00 2026-01-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 68 38 — — $5,990.04 $44,774.35 $18,562.00 2026-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 66 36 — — $8,001.00 $47,570.96 $18,562.00 2026-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 68 38 — — $8,001.00 $57,006.03 $18,562.00 2026-01-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 68 38 — — $8,001.00 $59,424.08 $18,562.00 2026-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 68 38 — — $8,001.00 $50,744.80 $18,562.00 2026-01-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 66 36 — — $8,001.00 $40,012.95 $18,562.00 2026-01-01
974 MS_DRG HIV With Major Related Condition With Mcc 68 38 — — $4,954.75 $41,584.81 $18,562.00 2026-01-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 68 38 — — $7,516.39 $63,084.40 $18,562.00 2026-01-01
263 MS_DRG Vein Ligation And Stripping 68 38 — — $5,093.11 $42,746.06 $18,562.00 2026-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 68 38 — — $8,001.00 $78,781.59 $18,562.00 2026-01-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 68 38 — — $5,365.92 $45,035.72 $18,562.00 2026-01-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 68 38 — — $5,814.85 $49,931.56 $18,562.00 2026-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 68 38 — — $8,001.00 $106,014.02 $18,562.00 2026-01-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 68 38 — — $8,001.00 $107,986.79 $18,562.00 2026-01-01
654 MS_DRG Major Bladder Procedures With Cc 68 38 — — $5,675.79 $47,636.46 $18,562.00 2026-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 68 38 — — $8,001.00 $55,553.92 $18,562.00 2026-01-01
252 MS_DRG Other Vascular Procedures With Mcc 68 38 — — $8,001.00 $55,913.59 $18,562.00 2026-01-01
472 MS_DRG Cervical Spinal Fusion With Cc 69 38 — — $8,001.00 $46,602.04 $18,554.26 2026-01-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 68 38 — — $8,001.00 $66,130.45 $18,546.23 2026-01-01
140 MS_DRG Major Head And Neck Procedures With Mcc 68 38 — — $8,001.00 $58,327.73 $18,497.92 2026-01-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 68 38 — — $7,135.15 $59,884.67 $18,452.90 2026-01-01
1714562 CDM Sod Benz+sod Phenyl 50 Ml 28 14 $34,800.00 $10,440.00 70% off $6,612.00 $34,800.00 $18,444.00 2026-01-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 68 38 — — $6,619.00 $40,064.23 $18,416.83 2026-01-01
570 MS_DRG Skin Debridement With Mcc 68 38 — — $5,791.82 $48,610.29 $18,407.38 2026-01-01
668 MS_DRG Transurethral Procedures With Mcc 68 38 — — $5,487.48 $46,055.92 $18,340.94 2026-01-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 60 32 — — $8,394.50 $63,003.34 $18,334.60 2026-01-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 68 38 — — $6,334.68 $44,318.00 $18,316.69 2026-01-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 67 37 — — $6,773.92 $42,156.68 $18,292.00 2026-01-01
10 MS_DRG Pancreas Transplant 67 37 — — $8,001.00 $70,298.45 $18,292.00 2026-01-01
253 MS_DRG Other Vascular Procedures With Cc 68 38 — — $5,830.50 $48,934.90 $18,163.15 2026-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 68 38 — — $3,310.07 $51,492.11 $18,163.01 2026-01-01
33302290 CDM Lithotripsy (eswl) Bilateral 23 11 $32,951.95 $9,885.59 70% off $6,260.87 $32,951.95 $18,123.57 2026-01-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 68 38 — — $6,902.63 $40,880.40 $18,122.08 2026-01-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 68 38 — — $8,001.00 $72,484.55 $18,073.58 2026-01-01
793 MS_DRG Full Term Neonate With Major Problems 66 38 — — $1,433.80 $55,352.37 $18,066.34 2026-01-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 68 38 — — $4,704.74 $39,486.44 $18,048.39 2026-01-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 69 38 — — $5,181.75 $43,489.96 $17,865.05 2026-01-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 68 38 — — $3,434.16 $55,999.37 $17,811.41 2026-01-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 68 38 — — $5,909.01 $37,252.32 $17,801.53 2026-01-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 68 38 — — $8,001.00 $46,186.95 $17,754.60 2026-01-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 68 38 — — $8,001.00 $89,008.73 $17,639.99 2026-01-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 68 38 — — $4,326.95 $37,327.05 $17,492.92 2026-01-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 68 38 — — $8,001.00 $56,347.83 $17,483.50 2026-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 68 38 — — $5,670.73 $49,523.54 $17,483.50 2026-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 68 38 — — $4,931.27 $54,529.67 $17,483.50 2026-01-01
652 MS_DRG Kidney Transplant 68 38 — — $7,057.10 $46,624.38 $17,483.50 2026-01-01
265 MS_DRG Aicd Lead Procedures 68 38 — — $5,086.44 $49,273.64 $17,483.50 2026-01-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 68 38 — — $5,145.14 $46,973.12 $17,483.50 2026-01-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 68 38 — — $8,001.00 $71,199.64 $17,483.50 2026-01-01
500 MS_DRG Soft Tissue Procedures With Mcc 68 38 — — $6,985.73 $46,214.10 $17,483.50 2026-01-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 68 38 — — $6,823.20 $57,266.54 $17,425.50 2026-01-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 68 38 — — $4,923.90 $41,325.89 $17,408.23 2026-01-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 69 38 — — $6,345.04 $43,688.00 $17,306.64 2026-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 61 33 — — $8,001.00 $54,540.36 $17,246.22 2026-01-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 68 38 — — $7,034.08 $40,251.84 $17,227.69 2026-01-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 68 38 — — $4,789.69 $34,071.16 $17,210.90 2026-01-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 68 38 — — $7,306.66 $61,324.16 $17,208.67 2026-01-01
800 MS_DRG Splenic Procedures With Cc 68 38 — — $6,357.93 $43,246.86 $17,184.17 2026-01-01
164 MS_DRG Major Chest Procedures With Cc 68 38 — — $5,010.69 $38,672.20 $17,168.56 2026-01-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 69 38 — — $5,622.61 $47,190.12 $17,083.41 2026-01-01
545 MS_DRG Connective Tissue Disorders With Mcc 68 38 — — $3,974.02 $36,625.17 $17,020.56 2026-01-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 68 38 — — $8,001.00 $71,367.74 $17,015.15 2026-01-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 68 38 — — $4,138.63 $37,236.20 $16,939.39 2026-01-01
81416 CPT Exome Sequence Analysis 37 18 — — $9,749.29 $37,626.11 $16,800.00 2026-01-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 68 38 — — $4,555.32 $38,232.44 $16,774.81 2026-01-01
40006575 CDM Bronch W/ebus Bx 3 Or >station 25 12 $32,124.50 $9,637.35 70% off $5,004.00 $32,124.50 $16,704.74 2026-01-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 68 38 — — $4,373.22 $36,704.07 $16,701.47 2026-01-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 68 38 — — $5,097.49 $42,782.77 $16,699.24 2026-01-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 69 38 — — $7,052.50 $44,888.00 $16,675.00 2026-01-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 68 38 — — $5,602.59 $36,805.41 $16,675.00 2026-01-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 68 38 — — $5,500.14 $35,935.02 $16,675.00 2026-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 47 29 — — $9,564.00 $99,510.23 $16,675.00 2026-01-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 45 29 — — $10,594.00 $55,909.00 $16,675.00 2026-01-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 68 38 — — $5,027.27 $38,238.47 $16,675.00 2026-01-01
849 MS_DRG Radiotherapy 68 38 — — $2,046.41 $36,835.04 $16,617.00 2026-01-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 61 33 — — $8,001.00 $59,415.15 $16,559.00 2026-01-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 61 33 — — $8,001.00 $51,093.16 $16,559.00 2026-01-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 61 33 — — $8,001.00 $55,544.95 $16,559.00 2026-01-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 61 33 — — $8,001.00 $57,359.29 $16,559.00 2026-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 61 33 — — $8,001.00 $43,046.93 $16,559.00 2026-01-01
113 MS_DRG Orbital Procedures With Cc/mcc 68 38 — — $3,255.51 $34,589.15 $16,452.22 2026-01-01
333 MS_DRG Rectal Resection With Cc 68 38 — — $4,568.91 $31,372.07 $16,389.94 2026-01-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 68 38 — — $3,891.37 $34,880.00 $16,364.75 2026-01-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 68 38 — — $3,665.76 $32,494.49 $16,352.86 2026-01-01
709 MS_DRG Penis Procedures With Cc/mcc 68 38 — — $3,714.34 $33,876.27 $16,284.28 2026-01-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 68 38 — — $4,068.64 $34,147.77 $16,273.08 2026-01-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 50 31 — — $8,001.00 $72,068.37 $16,266.50 2026-01-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 50 31 — — $8,001.00 $33,687.07 $16,266.50 2026-01-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 68 38 — — $2,788.63 $44,089.41 $16,266.50 2026-01-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 50 31 — — $8,001.00 $75,591.53 $16,266.50 2026-01-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 50 31 — — $8,001.00 $105,550.29 $16,266.50 2026-01-01
850 MS_DRG Acute Leukemia With Other Procedures 50 31 — — $8,001.00 $116,576.59 $16,266.50 2026-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 31 — — $8,001.00 $72,511.01 $16,266.50 2026-01-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 68 38 — — $5,404.83 $35,807.54 $16,266.50 2026-01-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 50 31 — — $8,001.00 $81,499.63 $16,266.50 2026-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 31 — — $8,001.00 $132,566.19 $16,266.50 2026-01-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 50 31 — — $8,001.00 $78,901.39 $16,266.50 2026-01-01
209 MS_DRG Complex Aortic Arch Procedures 50 31 — — $8,001.00 $110,887.32 $16,266.50 2026-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 31 — — $8,001.00 $137,238.37 $16,266.50 2026-01-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 50 31 — — $8,001.00 $59,627.69 $16,266.50 2026-01-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 68 38 — — $5,828.43 $48,917.51 $16,173.01 2026-01-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 68 38 — — $2,909.26 $34,163.47 $16,117.83 2026-01-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 68 38 — — $2,645.67 $39,671.53 $16,072.25 2026-01-01
347 MS_DRG Anal And Stomal Procedures With Mcc 68 38 — — $4,897.20 $36,069.82 $16,063.85 2026-01-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 68 38 — — $3,124.06 $30,931.02 $16,058.95 2026-01-01
0569U OTHER Onc Sol Tum Ngs Tmm>20000dmr 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
0553T OTHER Perq Tcat Iliac Anast Implt 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
0632T OTHER Perq Tcat US Abltj Nrv P-art 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
0613T OTHER Perq Tcat Intratrl Septl Sht 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
0544U OTHER Nefro Trnsp Mntr 48vrnt Dpcr 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
0793T OTHER Prq Tcat Thrm Ablt Nrv P-art 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
0545F OTHER Follow Up Care Plan Mdd Docd 4 3 — — $14,749.00 $16,976.00 $16,001.00 2026-01-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 68 38 — — $5,480.34 $33,087.94 $15,993.87 2026-01-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 68 38 — — $1,466.72 $33,726.55 $15,974.00 2026-01-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 68 38 — — $2,461.49 $33,206.97 $15,974.00 2026-01-01
397 MS_DRG Appendix Procedures With Mcc 61 33 — — $8,001.00 $31,408.79 $15,974.00 2026-01-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 50 31 — — $8,001.00 $23,729.66 $15,974.00 2026-01-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 50 31 — — $8,001.00 $23,652.26 $15,974.00 2026-01-01
792 MS_DRG Prematurity Without Major Problems 66 38 — — $830.40 $34,164.61 $15,974.00 2026-01-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 68 38 — — $5,828.43 $57,181.00 $15,965.88 2026-01-01
0805T OTHER Tcat S&ivc Prstc Vl Impl Prq 5 4 — — $14,749.00 $16,976.00 $15,955.00 2026-01-01
0659T OTHER Tcat Intra-c Nfs Supersat O2 5 4 — — $14,749.00 $16,976.00 $15,955.00 2026-01-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 68 38 — — $7,374.80 $42,201.59 $15,924.60 2026-01-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 68 38 — — $4,035.49 $33,869.53 $15,898.01 2026-01-01
0570T OTHER Ttvr Perq Ea Addl Prosth 10 4 — — $14,749.00 $16,976.00 $15,862.50 2026-01-01
0569T OTHER Ttvr Perq Appr 1st Prosth 10 4 — — $14,749.00 $16,976.00 $15,862.50 2026-01-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 68 38 — — $3,970.57 $34,620.64 $15,853.92 2026-01-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 68 38 — — $5,038.09 $31,578.68 $15,664.98 2026-01-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 68 38 — — $3,109.55 $30,931.80 $15,655.89 2026-01-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 68 38 — — $4,242.46 $31,005.75 $15,532.03 2026-01-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 69 38 — — $5,184.97 $32,443.21 $15,484.44 2026-01-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 68 38 — — $3,388.12 $29,528.88 $15,469.05 2026-01-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 68 38 — — $3,339.77 $31,912.77 $15,450.16 2026-01-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 68 38 — — $4,059.43 $34,450.67 $15,385.78 2026-01-01
30 MS_DRG Spinal Procedures Without Cc/mcc 68 38 — — $4,230.26 $35,504.18 $15,361.29 2026-01-01
93583 CPT Perq Transcath Septal Reduxn 6 5 — — $614.85 $16,976.00 $15,352.00 2026-01-01
92998 CPT Pul Art Balloon Repr Percut 6 5 — — $304.57 $16,976.00 $15,352.00 2026-01-01
92972 CPT Perq Trluml Coronry Lithotrp 6 5 — — $10,471.00 $16,976.00 $15,352.00 2026-01-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 68 38 — — $5,059.73 $34,973.78 $15,337.49 2026-01-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 67 37 — — $4,496.32 $33,432.28 $15,310.20 2026-01-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 69 38 — — $8,001.00 $92,569.77 $15,272.41 2026-01-01
141 MS_DRG Major Head And Neck Procedures With Cc 68 38 — — $5,082.06 $32,346.50 $15,262.62 2026-01-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 68 38 — — $4,217.82 $35,399.84 $15,246.52 2026-01-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 68 38 — — $5,930.19 $32,482.10 $15,236.03 2026-01-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 66 36 — — $8,001.00 $36,355.61 $15,184.94 2026-01-01
30015932 CDM Brng Infinity Biofoam 3d 3 47 20 $36,652.00 $10,995.60 70% off $5,497.80 $36,652.00 $15,027.32 2026-01-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 68 38 — — $3,575.52 $30,055.89 $14,985.51 2026-01-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 67 37 — — $4,709.27 $27,895.39 $14,979.91 2026-01-01
374 MS_DRG Digestive Malignancy With Mcc 68 38 — — $4,869.34 $30,300.94 $14,965.92 2026-01-01
32 MS_DRG Ventricular Shunt Procedures With Cc 68 38 — — $7,277.65 $40,004.99 $14,912.03 2026-01-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 68 38 — — $8,001.00 $54,022.62 $14,911.34 2026-01-01
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