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

AFFILIATE OF VITRUVIAN HEALTH

Cleveland, TN · CCN 440185 · Rates published

16,276 distinct procedures filed
52 distinct payers
354,362 rate rows
2026-08-01 last MRF observed
Data quality

320,087 of 354,362 rate rows are consumer-grade (90.3%)

34,275 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 18,389
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 7,660
per-diem day rate — not a per-procedure price 6,338
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 1,678
placeholder amount (≤ $0.02) — excluded from medians 152
exceeds 10× this hospital's gross charge — excluded from medians 31
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 27
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://vitruvianhealth.com/wp-content/uploads/2026/04/992892769_bradley-medical-center_standardcharges.csv.zip
Found on page https://vitruvianhealth.com/patients-visitors/patient-resources/billing-insurance/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-01
Content fingerprint eeddfdc8a5dffb14… · 1,524,345 bytes · first seen 2026-07-31

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
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,238,720.00 $4,297,014.34 $3,847,800.00 nat. median
$2,332,000
1.6× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 5 $3,543,792.00 $3,876,022.50 $3,802,193.50 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 5 $3,188,521.32 $3,487,445.20 $3,421,017.67 nat. median
$3,325,455
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,483,603.77 $4,767,045.90 $3,405,198.12 nat. median
$2,455,111
1.4× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 5 $3,115,566.13 $3,407,650.46 $3,342,742.83 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 6 $2,820,787.20 $4,995,144.00 $3,085,236.00 nat. median
$2,968,000
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $589,613.58 $1,044,107.37 $641,818.95 nat. median
$621,313
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $564,955.02 $1,000,441.17 $641,459.34 nat. median
$599,737
1.1× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $539,770.40 $955,843.42 $612,864.31 nat. median
$579,571
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $537,389.84 $951,627.84 $610,161.38 nat. median
$574,037
1.1× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $510,575.15 $904,143.50 $579,715.53 nat. median
$562,501
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $469,718.98 $831,794.02 $533,326.76 nat. median
$513,770
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 36 $1,545.60 $736,653.41 $300,494.10 nat. median
$168,055
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 33 $1,877.60 $465,420.93 $183,479.48 nat. median
$186,516
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 39 $1,521.00 $428,765.96 $151,174.32 nat. median
$131,925
1.1× median
7
MS_DRG 		Lung Transplant 33 $1,877.60 $489,194.40 $149,561.86 nat. median
$70,649
outlier · 2.1×
22558
CPT 		Lumbar Spine Fusion 23 $395.00 $345,798.90 $146,964.54 nat. median
$8,474
outlier · 17.3×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 39 $1,521.00 $352,508.12 $141,679.68 nat. median
$145,435
1.0× median
0715T
CPT 		Perq Trluml Coronry Lithotrp 21 $4,230.00 $152,443.80 $128,730.32 nat. median
$2,547
outlier · 50.5×
23474
CPT 		Revis Reconst Shoulder Joint 23 $395.00 $239,888.70 $101,952.70 nat. median
$12,255
outlier · 8.3×
A9543
HCPCS 		Y90 Ibritumomab, Rx 7 $54,551.57 $216,196.26 $96,601.73 nat. median
$65,477
1.5× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 39 $1,521.00 $240,040.52 $96,035.79 nat. median
$97,418
1.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 7 $61,711.01 $226,441.01 $88,626.18 nat. median
$66,211
1.3× median
27487
CPT 		Revise/replace Knee Joint 23 $395.00 $190,553.40 $80,985.20 nat. median
$11,543
outlier · 7.0×
209
MS_DRG 		Complex Aortic Arch Procedures 8 $57,155.59 $187,982.63 $80,712.96 nat. median
$2,110
outlier · 38.2×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 33 $1,877.60 $200,285.52 $80,417.65 nat. median
$65,418
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 33 $1,545.60 $199,593.28 $78,092.37 nat. median
$72,715
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $33,983.66 $183,040.09 $77,870.29 nat. median
$2,736
outlier · 28.5×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 7 $54,018.42 $197,960.67 $77,609.71 nat. median
$63,499
1.2× median
212
MS_DRG 		Hip & Femur Procedures Except Major Joint Age 0-17 39 $1,521.00 $180,597.05 $72,004.74 nat. median
$74,509
1.0× median
22846
CPT 		Insert Spine Fixation Device 23 $90.00 $169,313.40 $71,958.20 nat. median
$4,916
outlier · 14.6×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 33 $1,877.60 $171,236.78 $70,460.09 nat. median
$69,922
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 39 $1,521.00 $179,015.87 $68,084.07 nat. median
$73,023
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 $30,058.63 $162,472.74 $66,913.20 nat. median
$69,822
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $27,058.07 $149,631.44 $63,876.28 nat. median
$2,596
outlier · 24.6×
850
MS_DRG 		Acute Leukemia With Other Procedures 8 $29,884.69 $143,816.98 $61,440.74 nat. median
$2,633
outlier · 23.3×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 31 $1,521.00 $145,528.02 $58,230.79 nat. median
$2,106
outlier · 27.7×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 $37,794.52 $184,421.42 $57,932.90 nat. median
$59,651
1.0× median
38240
HCPCS 		Transplt Allo Hct/donor 7 $4,557.00 $106,150.98 $57,608.39 nat. median
$28,331
outlier · 2.0×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 29 $18,565.90 $140,003.78 $56,350.65 nat. median
$60,505
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 39 $1,521.00 $138,907.29 $55,626.19 nat. median
$56,428
1.0× median
50740
CPT 		Fusion Of Ureter & Kidney 23 $395.00 $74,811.60 $53,199.36 nat. median
$2,656
outlier · 20.0×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 $33,256.67 $162,278.62 $52,795.03 nat. median
$55,923
0.9× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 34 $1,877.60 $131,478.84 $52,594.80 nat. median
$45,605
1.2× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 29 $15,945.90 $128,340.10 $52,545.52 nat. median
$55,935
0.9× median
49616
CPT 		Rpr Aa Hrn Rcr 3-10 Ncr/strn 23 $395.00 $75,229.20 $51,824.56 nat. median
$5,322
outlier · 9.7×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 $23,042.15 $119,886.51 $51,416.91 nat. median
$9,905
outlier · 5.2×
50546
CPT 		Laparoscopic Nephrectomy 23 $395.00 $118,562.40 $50,389.02 nat. median
$4,668
outlier · 10.8×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 29 $22,825.12 $118,421.68 $49,085.34 nat. median
$51,518
1.0× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 39 $1,521.00 $126,551.30 $48,636.66 nat. median
$52,327
0.9× median

Other procedures at this hospital

Browse this hospital's 16,276 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
             
J3392 HCPCS Inj, Exagamglogene Autotem 11 7 — — $2,238,720.00 $4,297,014.34 $3,847,800.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 5 5 — — $3,543,792.00 $3,876,022.50 $3,802,193.50 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 5 5 — — $3,188,521.32 $3,487,445.20 $3,421,017.67 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 7 — — $2,483,603.77 $4,767,045.90 $3,405,198.12 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 5 5 — — $3,115,566.13 $3,407,650.46 $3,342,742.83 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 9 6 — — $2,820,787.20 $4,995,144.00 $3,085,236.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 7 — — $589,613.58 $1,044,107.37 $641,818.95 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 10 7 — — $564,955.02 $1,000,441.17 $641,459.34 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 10 7 — — $539,770.40 $955,843.42 $612,864.31 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 10 7 — — $537,389.84 $951,627.84 $610,161.38 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 10 7 — — $510,575.15 $904,143.50 $579,715.53 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 10 7 — — $469,718.98 $831,794.02 $533,326.76 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 47 36 — — $1,545.60 $736,653.41 $300,494.10 2026-08-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 37 33 — — $1,877.60 $465,420.93 $183,479.48 2026-08-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 50 39 — — $1,521.00 $428,765.96 $151,174.32 2026-08-01
7 MS_DRG Lung Transplant 37 33 — — $1,877.60 $489,194.40 $149,561.86 2026-08-01
22558 CPT Lumbar Spine Fusion 34 23 $384,221.00 $43,340.13 89% off $395.00 $345,798.90 $146,964.54 2026-08-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 50 39 — — $1,521.00 $352,508.12 $141,679.68 2026-08-01
0715T CPT Perq Trluml Coronry Lithotrp 25 21 $169,382.00 $19,106.29 89% off $4,230.00 $152,443.80 $128,730.32 2026-08-01
23474 CPT Revis Reconst Shoulder Joint 34 23 $266,543.00 $30,066.05 89% off $395.00 $239,888.70 $101,952.70 2026-08-01
A9543 HCPCS Y90 Ibritumomab, Rx 13 7 — — $54,551.57 $216,196.26 $96,601.73 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 50 39 — — $1,521.00 $240,040.52 $96,035.79 2026-08-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 12 7 — — $61,711.01 $226,441.01 $88,626.18 2026-04-01
27487 CPT Revise/replace Knee Joint 34 23 $211,726.00 $23,882.69 89% off $395.00 $190,553.40 $80,985.20 2026-08-01
209 MS_DRG Complex Aortic Arch Procedures 12 8 — — $57,155.59 $187,982.63 $80,712.96 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 37 33 — — $1,877.60 $200,285.52 $80,417.65 2026-08-01
14 MS_DRG Allogeneic Bone Marrow Transplant 37 33 — — $1,545.60 $199,593.28 $78,092.37 2026-08-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $33,983.66 $183,040.09 $77,870.29 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 12 7 — — $54,018.42 $197,960.67 $77,609.71 2026-04-01
212 MS_DRG Hip & Femur Procedures Except Major Joint Age 0-17 49 39 — — $1,521.00 $180,597.05 $72,004.74 2026-08-01
22846 CPT Insert Spine Fixation Device 34 23 $188,126.00 $21,220.61 89% off $90.00 $169,313.40 $71,958.20 2026-08-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 37 33 — — $1,877.60 $171,236.78 $70,460.09 2026-08-01
215 MS_DRG Other Heart Assist System Implant 52 39 — — $1,521.00 $179,015.87 $68,084.07 2026-08-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 29 — — $30,058.63 $162,472.74 $66,913.20 2026-08-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 8 — — $27,058.07 $149,631.44 $63,876.28 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 14 8 — — $29,884.69 $143,816.98 $61,440.74 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 36 31 — — $1,521.00 $145,528.02 $58,230.79 2026-08-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 29 — — $37,794.52 $184,421.42 $57,932.90 2026-08-01
38240 HCPCS Transplt Allo Hct/donor 13 7 — — $4,557.00 $106,150.98 $57,608.39 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 40 29 — — $18,565.90 $140,003.78 $56,350.65 2026-08-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 50 39 — — $1,521.00 $138,907.29 $55,626.19 2026-08-01
50740 CPT Fusion Of Ureter & Kidney 31 23 $83,124.00 $9,376.39 89% off $395.00 $74,811.60 $53,199.36 2026-08-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 29 — — $33,256.67 $162,278.62 $52,795.03 2026-08-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 38 34 — — $1,877.60 $131,478.84 $52,594.80 2026-08-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 40 29 — — $15,945.90 $128,340.10 $52,545.52 2026-08-01
49616 CPT Rpr Aa Hrn Rcr 3-10 Ncr/strn 32 23 $83,588.00 $9,428.73 89% off $395.00 $75,229.20 $51,824.56 2026-08-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $23,042.15 $119,886.51 $51,416.91 2026-04-01
50546 CPT Laparoscopic Nephrectomy 34 23 $131,736.00 $14,859.82 89% off $395.00 $118,562.40 $50,389.02 2026-08-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 39 29 — — $22,825.12 $118,421.68 $49,085.34 2026-08-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 50 39 — — $1,521.00 $126,551.30 $48,636.66 2026-08-01
49596 CPT Rpr Aa Hrn 1st > 10 Ncr/strn 32 23 $77,617.00 $8,755.20 89% off $395.00 $69,855.30 $48,122.54 2026-08-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 8 — — $20,069.55 $111,049.39 $47,715.27 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 14 8 — — $21,750.99 $110,968.01 $47,681.18 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 50 39 — — $1,521.00 $126,480.28 $47,498.48 2026-08-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 40 29 — — $19,198.97 $114,228.16 $47,388.19 2026-08-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 56 39 — — $1,521.00 $335,785.75 $46,862.34 2026-08-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 50 39 — — $1,521.00 $119,124.20 $46,420.26 2026-08-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 54 39 — — $1,521.00 $113,907.27 $45,612.35 2026-08-01
J9226 HCPCS Supprelin La Implant 10 7 — — $39,526.49 $86,868.63 $44,879.04 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 29 — — $19,271.42 $109,202.58 $44,823.97 2026-08-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 37 32 — — $1,521.00 $155,005.58 $43,797.34 2026-08-01
50545 CPT Laparo Radical Nephrectomy 34 23 $114,385.00 $12,902.63 89% off $395.00 $102,946.50 $43,752.26 2026-08-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 40 29 — — $13,930.54 $108,805.65 $43,383.77 2026-08-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 40 29 — — $27,486.93 $134,124.67 $42,884.99 2026-08-01
276 MS_DRG Non-maligant Breast Disorders 39 29 — — $20,146.76 $102,611.62 $42,706.35 2026-08-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 50 39 — — $1,521.00 $112,458.51 $42,240.03 2026-08-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 9 7 — — $38,726.64 $74,332.17 $41,953.86 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 37 33 — — $1,545.60 $102,074.18 $41,665.59 2026-08-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 40 29 — — $13,962.03 $100,687.66 $41,541.70 2026-08-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 29 — — $23,690.05 $115,597.51 $41,518.32 2026-08-01
64568 HCPCS Inc For Vagus N Elect Impl 13 7 — — $4,896.88 $74,332.17 $41,516.00 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 1 1 — — $41,516.00 $41,516.00 $41,516.00 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 13 7 — — $4,896.88 $74,332.17 $41,516.00 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 14 8 — — $17,747.07 $95,780.00 $41,319.32 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 12 8 — — $29,242.89 $94,780.20 $41,295.71 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 50 39 — — $1,521.00 $111,790.11 $41,092.33 2026-08-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 37 33 — — $1,545.60 $102,074.18 $40,812.38 2026-08-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 40 29 — — $14,640.03 $97,465.71 $40,604.27 2026-08-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 50 39 — — $1,521.00 $101,497.94 $40,581.65 2026-08-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 50 39 — — $1,521.00 $99,964.98 $40,578.73 2026-08-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 36 31 — — $1,521.00 $101,091.61 $40,456.23 2026-08-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 13 7 — — $4,896.88 $74,332.17 $40,340.25 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 8 — — $17,856.07 $93,370.18 $40,309.90 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 50 39 — — $1,521.00 $99,785.85 $40,262.40 2026-08-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 40 29 — — $17,519.55 $109,202.58 $40,207.64 2026-08-01
J9600 HCPCS Porfimer Sodium Injection 5 2 — — $4,741.36 $80,426.50 $39,976.89 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 52 39 — — $1,521.00 $99,210.62 $39,703.83 2026-08-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 50 39 — — $1,521.00 $107,559.28 $38,309.18 2026-08-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 14 8 — — $16,707.65 $88,514.00 $38,275.78 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 51 39 — — $1,521.00 $94,657.30 $38,258.17 2026-08-01
47605 CPT Removal Of Gallbladder 34 23 $99,945.00 $11,273.80 89% off $395.00 $89,950.50 $38,228.96 2026-08-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 39 29 — — $9,797.63 $91,199.42 $37,928.48 2026-08-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 51 39 — — $1,521.00 $92,717.81 $37,848.19 2026-08-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 29 — — $17,338.89 $88,567.14 $36,955.80 2026-08-01
653 MS_DRG Major Bladder Procedures With Mcc 40 29 — — $13,972.72 $89,716.63 $36,896.21 2026-08-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 40 29 — — $10,809.83 $90,724.52 $36,410.61 2026-08-01
50650 CPT Removal Of Ureter 34 23 $95,062.00 $10,722.99 89% off $395.00 $85,555.80 $36,361.21 2026-08-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 37 33 — — $1,877.60 $93,081.20 $36,314.13 2026-08-01
58150 CPT Total Hysterectomy 34 23 $94,170.00 $10,622.38 89% off $395.00 $84,753.00 $36,020.02 2026-08-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 50 39 — — $1,521.00 $94,079.17 $35,807.08 2026-08-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 42 29 — — $14,473.74 $87,628.79 $35,790.15 2026-08-01
6 MS_DRG Liver Transplant Without Mcc 37 33 — — $1,877.60 $88,938.95 $35,562.52 2026-08-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 50 39 — — $1,521.00 $86,451.28 $35,115.19 2026-08-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 50 39 — — $1,521.00 $90,581.69 $34,924.37 2026-08-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 41 29 — — $14,875.40 $84,300.32 $34,681.37 2026-08-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 50 39 — — $1,521.00 $109,226.88 $34,147.67 2026-08-01
0499T CPT Cysto F/urtl Strix/stenosis 27 22 $44,683.00 $5,040.24 89% off $133.50 $40,214.70 $33,959.08 2026-08-01
10 MS_DRG Pancreas Transplant 37 33 — — $1,877.60 $119,174.03 $33,947.08 2026-08-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 58 40 — — $1,161.38 $89,849.59 $33,877.92 2026-08-01
471 MS_DRG Cervical Spinal Fusion With Mcc 40 29 — — $18,576.91 $90,647.52 $33,809.63 2026-08-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 40 29 — — $20,638.73 $100,708.36 $33,450.69 2026-08-01
799 MS_DRG Splenectomy With Mcc 40 29 — — $12,078.41 $82,286.56 $33,341.32 2026-08-01
277 MS_DRG Cellulitis Age >17 W Cc 39 29 — — $15,514.78 $79,499.05 $33,083.98 2026-08-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 29 — — $13,172.75 $83,707.64 $32,971.04 2026-08-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 50 39 — — $1,521.00 $100,207.18 $32,861.78 2026-08-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 9 7 — — $2,278.00 $57,814.10 $32,630.88 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 51 39 — — $1,521.00 $104,316.54 $32,616.11 2026-08-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 52 39 — — $1,521.00 $78,819.23 $32,167.68 2026-08-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 50 39 — — $1,521.00 $104,370.24 $31,737.32 2026-08-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 45 29 — — $11,111.24 $76,338.67 $31,602.80 2026-08-01
163 MS_DRG Major Chest Procedures With Mcc 51 39 — — $1,521.00 $78,385.35 $31,373.73 2026-08-01
69930 HCPCS Implant Cochlear Device 13 7 — — $4,896.88 $55,643.26 $31,103.66 2026-04-01
245 MS_DRG Aicd Generator Procedures 50 39 — — $1,521.00 $75,772.34 $30,797.21 2026-08-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 40 29 — — $19,863.22 $96,924.17 $30,794.57 2026-08-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 14 8 — — $13,247.45 $70,431.21 $30,701.37 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 36 31 — — $1,521.00 $85,055.51 $30,674.44 2026-08-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 50 39 — — $1,521.00 $83,202.94 $30,602.38 2026-08-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 45 34 — — $1,877.60 $78,080.85 $30,573.32 2026-08-01
278 MS_DRG Cellulitis Age >17 Without Cc 49 39 — — $1,521.00 $92,443.45 $30,328.30 2026-08-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 9 7 — — $27,597.78 $52,971.37 $30,185.08 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 52 39 — — $1,521.00 $75,544.81 $30,116.94 2026-08-01
27535 CPT Treat Knee Fracture 34 23 $78,563.00 $8,861.91 89% off $395.00 $70,706.70 $30,050.35 2026-08-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 50 39 — — $1,521.00 $75,511.59 $30,035.05 2026-08-01
J9266 HCPCS Pegaspargase Injection 12 7 — — $24,646.02 $96,336.00 $29,703.14 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 50 39 — — $1,521.00 $74,119.84 $29,677.75 2026-08-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 9 7 — — $27,130.77 $52,074.99 $29,674.28 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 13 7 — — $4,896.88 $52,971.37 $29,610.12 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 13 7 — — $4,896.88 $52,971.37 $29,610.12 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 13 7 — — $4,896.88 $52,971.37 $29,610.12 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 13 7 — — $4,896.88 $52,971.37 $29,610.12 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 13 7 — — $4,896.88 $52,971.37 $29,610.12 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 13 7 — — $4,896.88 $52,971.37 $29,610.12 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 40 29 — — $11,934.13 $70,138.91 $29,495.58 2026-08-01
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 54 43 $108,162.00 $12,200.67 89% off $360.10 $97,345.80 $29,493.01 2026-08-01
33249 CPT Eltrd/insert Pace-defib 54 43 $142,151.00 $16,034.63 89% off $709.81 $127,935.90 $29,493.01 2026-08-01
0908T OTHER Opn Imp Int Nstm Sys Vgs Nrv 9 7 — — $2,278.00 $52,074.99 $29,391.67 2026-04-01
0909T OTHER Rplcmt Int Nstim Sys Vgs Nrv 9 7 — — $2,278.00 $52,074.99 $29,391.67 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 11 7 — — $2,870.00 $52,074.99 $29,391.67 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 50 39 — — $1,521.00 $72,140.21 $29,366.08 2026-08-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 52 40 — — $1,521.00 $297,014.58 $29,287.41 2026-08-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 8 — — $12,691.72 $66,772.46 $29,168.83 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 51 40 — — $1,521.00 $72,955.62 $29,128.26 2026-08-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 13 7 — — $4,896.88 $52,074.99 $29,109.06 2026-04-01
61886 HCPCS Implant Neurostim Arrays 13 7 — — $4,896.88 $52,074.99 $29,109.06 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 13 7 — — $4,896.88 $52,074.99 $29,109.06 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 13 7 — — $4,896.88 $52,074.99 $29,109.06 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 13 7 — — $4,654.45 $52,074.99 $29,109.06 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 40 29 — — $9,787.63 $69,567.59 $28,504.43 2026-08-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 50 39 — — $1,521.00 $108,763.00 $28,327.31 2026-08-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 13 7 — — $4,654.45 $52,074.99 $28,261.22 2026-04-01
323 MS_DRG Urinary Stones W Cc, &/or Esw Lithotripsy 50 39 — — $1,521.00 $71,869.46 $28,212.19 2026-08-01
793 MS_DRG Full Term Neonate With Major Problems 52 39 — — $718.39 $70,221.98 $28,108.38 2026-08-01
0055T CPT Bone Srgry Cmptr Ct/mri Imag 20 14 $200,125.00 $22,574.10 89% off $90.00 $180,112.50 $27,797.36 2026-08-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 40 29 — — $10,851.41 $68,516.30 $27,781.65 2026-08-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 40 29 — — $9,281.12 $68,973.02 $27,613.82 2026-08-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 43 30 — — $10,660.05 $67,769.60 $27,595.70 2026-08-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 50 39 — — $1,521.00 $69,984.45 $27,583.46 2026-08-01
791 MS_DRG Prematurity With Major Problems 51 39 — — $718.39 $68,415.50 $27,385.78 2026-08-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 50 39 — — $1,521.00 $70,019.33 $27,319.93 2026-08-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 13 7 — — $4,896.88 $48,405.60 $27,057.93 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 52 39 — — $1,521.00 $86,196.58 $26,920.83 2026-08-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 50 39 — — $1,521.00 $65,237.87 $26,625.38 2026-08-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 50 39 — — $1,521.00 $127,029.13 $26,483.15 2026-08-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 50 39 — — $1,521.00 $69,237.09 $26,300.20 2026-08-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 50 39 — — $1,521.00 $83,656.39 $26,252.65 2026-08-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 9 7 — — $23,856.83 $45,790.97 $26,093.41 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 9 7 — — $23,856.83 $45,790.97 $26,093.41 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 50 39 — — $1,521.00 $65,008.01 $26,022.79 2026-08-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 54 39 — — $1,521.00 $66,149.25 $25,989.18 2026-08-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 40 29 — — $9,362.43 $62,069.08 $25,966.66 2026-08-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 50 39 — — $1,521.00 $66,676.01 $25,892.71 2026-08-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 51 39 — — $1,521.00 $80,964.05 $25,834.31 2026-08-01
140 MS_DRG Major Head And Neck Procedures With Mcc 50 39 — — $1,521.00 $70,838.10 $25,822.05 2026-08-01
0871T OTHER Rplcmt Subq Prtl Ascites Pmp 9 7 — — $2,278.00 $45,425.54 $25,638.65 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 45 37 — — $1,521.00 $64,188.26 $25,514.27 2026-08-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 40 29 — — $12,668.99 $61,819.36 $25,503.78 2026-08-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 50 39 — — $1,521.00 $121,504.24 $25,452.86 2026-08-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 50 39 — — $1,521.00 $63,763.09 $25,423.78 2026-08-01
C9760 HCPCS Non-blind Interatrial Shunt 13 7 — — $4,896.88 $45,425.54 $25,392.12 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 12 8 — — $17,960.72 $57,108.27 $25,363.46 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 51 39 — — $1,521.00 $69,780.17 $25,293.01 2026-08-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 40 29 — — $16,446.12 $81,839.62 $25,104.70 2026-08-01
92925 CPT Ic-atherect Coro Add 20 14 $49,465.00 $5,579.65 89% off $90.00 $44,518.50 $25,103.49 2026-08-01
92921 CPT Ic-ptca, Addl 20 14 $49,465.00 $5,579.65 89% off $90.00 $44,518.50 $25,103.49 2026-08-01
570 MS_DRG Skin Debridement With Mcc 50 39 — — $1,521.00 $70,408.67 $25,062.07 2026-08-01
332 MS_DRG Rectal Resection With Mcc 50 39 — — $1,521.00 $61,237.90 $25,004.39 2026-08-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 50 39 — — $1,521.00 $60,956.28 $24,878.14 2026-08-01
27702 HCPCS Reconstruct Ankle Joint 13 7 — — $4,654.45 $45,790.97 $24,850.87 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 13 7 — — $4,654.45 $45,790.97 $24,850.87 2026-04-01
22558 HCPCS Lumbar Spine Fusion 13 7 — — $2,253.54 $45,790.97 $24,850.87 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 13 7 — — $3,544.00 $45,790.97 $24,850.87 2026-04-01
22630 HCPCS Lumbar Spine Fusion 13 7 — — $4,654.45 $45,790.97 $24,850.87 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 13 7 — — $4,557.00 $45,790.97 $24,850.87 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 50 39 — — $1,521.00 $60,817.01 $24,795.70 2026-08-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 40 29 — — $9,594.75 $60,977.93 $24,778.88 2026-08-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 44 30 — — $9,606.36 $59,063.03 $24,738.14 2026-08-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 38 33 — — $1,521.00 $61,296.19 $24,538.06 2026-08-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 52 40 — — $819.12 $59,954.27 $24,469.24 2026-08-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 50 39 — — $1,521.00 $60,622.81 $24,268.71 2026-08-01
265 MS_DRG Aicd Lead Procedures 50 39 — — $1,521.00 $60,091.07 $24,199.04 2026-08-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 37 29 — — $7,372.36 $57,653.01 $24,049.39 2026-08-01
252 MS_DRG Other Vascular Procedures With Mcc 41 30 — — $13,505.95 $65,903.36 $23,916.15 2026-08-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 52 39 — — $1,521.00 $58,569.77 $23,883.29 2026-08-01
C9606 HCPCS Ic-prq De Cr Rev Ami 38 24 $64,208.00 $7,242.66 89% off $947.00 $57,787.20 $23,876.28 2026-08-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 40 29 — — $9,059.80 $62,223.53 $23,836.41 2026-08-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 45 34 — — $1,877.60 $61,545.93 $23,710.60 2026-08-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 42 29 — — $15,342.79 $74,866.39 $23,688.78 2026-08-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 14 8 — — $10,011.42 $53,650.48 $23,672.36 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 50 39 — — $1,521.00 $66,167.93 $23,528.29 2026-08-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 50 39 — — $1,521.00 $57,577.92 $23,511.11 2026-08-01
93654 HCPCS Ep & Ablate Ventric Tachy 15 7 — — $1,327.29 $44,109.86 $23,250.00 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 15 7 — — $991.18 $44,109.86 $23,250.00 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 15 7 — — $1,331.81 $44,109.86 $23,250.00 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 52 39 — — $1,521.00 $56,938.87 $23,170.99 2026-08-01
37 MS_DRG Extracranial Procedures With Mcc 50 39 — — $1,521.00 $56,726.45 $23,152.02 2026-08-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 51 39 — — $1,521.00 $63,376.59 $23,120.12 2026-08-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 40 29 — — $7,396.59 $54,668.55 $23,033.64 2026-08-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 42 30 — — $249.15 $56,185.83 $22,943.14 2026-08-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 50 39 — — $1,521.00 $83,362.54 $22,764.80 2026-08-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 41 29 — — $9,713.66 $55,985.08 $22,623.71 2026-08-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 50 39 — — $1,521.00 $55,405.56 $22,612.99 2026-08-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 41 29 — — $14,353.91 $70,041.06 $22,579.47 2026-08-01
500 MS_DRG Soft Tissue Procedures With Mcc 40 29 — — $9,275.61 $54,576.77 $22,569.55 2026-08-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 40 29 — — $13,074.63 $63,798.72 $22,494.60 2026-08-01
264 MS_DRG Other Circulatory System O.r. Procedures 50 39 — — $1,521.00 $55,480.68 $22,439.87 2026-08-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 50 39 — — $1,521.00 $61,002.84 $22,363.29 2026-08-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 50 39 — — $1,521.00 $60,262.13 $22,093.11 2026-08-01
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 54 43 $205,736.00 $23,207.02 89% off $332.43 $185,162.40 $22,028.85 2026-08-01
279 MS_DRG Cellulitis Age 0-17 49 39 — — $1,521.00 $59,895.09 $22,007.93 2026-08-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 50 39 — — $1,521.00 $71,895.12 $21,869.23 2026-08-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 40 29 — — $10,432.32 $54,861.21 $21,867.26 2026-08-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 50 39 — — $1,521.00 $53,136.05 $21,686.85 2026-08-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 50 39 — — $1,521.00 $54,134.84 $21,673.52 2026-08-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 50 39 — — $1,521.00 $56,585.12 $21,578.34 2026-08-01
0888T OTHER Histotripsy Mal Renal Tissue 10 7 — — $15,060.62 $54,251.55 $21,571.21 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 50 39 — — $1,521.00 $53,725.22 $21,497.93 2026-08-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 9 7 — — $19,557.04 $41,516.00 $21,390.52 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 9 7 — — $19,557.04 $41,516.00 $21,390.52 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 40 29 — — $6,228.27 $50,845.39 $21,365.19 2026-08-01
665 MS_DRG Prostatectomy With Mcc 50 39 — — $1,521.00 $52,088.75 $21,259.46 2026-08-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 49 39 — — $1,521.00 $51,860.50 $21,164.62 2026-08-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 40 29 — — $9,980.21 $50,157.82 $21,044.26 2026-08-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 13 7 — — $4,896.88 $41,516.00 $20,983.08 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 41 29 — — $11,256.74 $54,928.17 $20,960.96 2026-08-01
92929 CPT Ic-prq Stnt W-ang Ea 20 14 $41,203.00 $4,647.70 89% off $90.00 $37,082.70 $20,910.52 2026-08-01
92938 CPT Ic-prq Rv Byp Grf Ad 20 14 $41,203.00 $4,647.70 89% off $90.00 $37,082.70 $20,910.52 2026-08-01
92934 CPT Ic-prq St-at-ang Ea 20 14 $41,203.00 $4,647.70 89% off $90.00 $37,082.70 $20,910.52 2026-08-01
92944 CPT Ic-prq Revsc Chr Add 20 14 $41,203.00 $4,647.70 89% off $90.00 $37,082.70 $20,910.52 2026-08-01
652 MS_DRG Kidney Transplant 44 33 — — $1,877.60 $53,635.54 $20,906.83 2026-08-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 50 39 — — $1,521.00 $64,674.87 $20,894.40 2026-08-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 44 30 — — $8,411.15 $80,972.15 $20,733.77 2026-08-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 50 39 — — $1,521.00 $51,728.94 $20,692.31 2026-08-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 40 29 — — $7,124.84 $49,421.04 $20,664.54 2026-08-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 42 29 — — $9,364.26 $50,552.55 $20,644.76 2026-08-01
20985 CPT Cptr-asst Dir Ms Px 21 15 $182,649.00 $20,602.81 89% off $90.00 $164,384.10 $20,602.81 2026-08-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 40 29 — — $6,612.21 $48,823.73 $20,588.67 2026-08-01
324 MS_DRG Urinary Stones Without Cc 51 39 — — $1,521.00 $52,331.81 $20,475.68 2026-08-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 51 39 — — $1,521.00 $51,637.59 $20,373.31 2026-08-01
0823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 13 7 — — $4,654.45 $37,537.92 $20,371.92 2026-04-01
0796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 13 7 — — $4,654.45 $37,537.92 $20,371.92 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 40 29 — — $7,286.24 $48,495.36 $20,222.50 2026-08-01
93654 CPT Ep-ablate Vent Tacy 54 43 $14,170.00 $1,598.38 89% off $891.85 $51,423.70 $20,190.73 2026-08-01
974 MS_DRG HIV With Major Related Condition With Mcc 50 39 — — $1,521.00 $49,294.79 $20,119.30 2026-08-01
800 MS_DRG Splenectomy With Cc 40 29 — — $8,442.02 $47,695.45 $20,042.14 2026-08-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 13 7 — — $12,051.56 $39,648.46 $19,972.41 2026-04-01
92941 CPT Ic-prq Card Rev 1 Vs 34 23 $41,203.00 $4,647.70 89% off $585.68 $37,082.70 $19,944.40 2026-08-01
321 MS_DRG Kidney & Urinary Tract Infections Age >17 Without Cc 44 30 — — $9,325.93 $48,618.12 $19,942.77 2026-08-01
64590 CPT Implant Neuroreceiver 54 43 $153,188.00 $17,279.61 89% off $404.89 $137,869.20 $19,798.28 2026-08-01
654 MS_DRG Major Bladder Procedures With Cc 40 29 — — $7,536.28 $46,490.77 $19,775.90 2026-08-01
54416 HCPCS Remv/repl Penis Contain Pros 13 7 — — $4,654.45 $34,977.09 $19,551.62 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 13 7 — — $4,654.45 $34,977.09 $19,551.62 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 13 7 — — $4,654.45 $34,977.09 $19,551.62 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 13 7 — — $4,654.45 $34,977.09 $19,551.62 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 13 7 — — $4,654.45 $34,977.09 $19,551.62 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 13 7 — — $4,654.45 $34,977.09 $19,551.62 2026-04-01
263 MS_DRG Vein Ligation And Stripping 50 39 — — $1,521.00 $50,777.30 $19,516.19 2026-08-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 38 30 — — $7,310.93 $50,164.46 $19,478.01 2026-08-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 51 39 — — $1,521.00 $47,557.84 $19,422.92 2026-08-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 52 40 — — $1,521.00 $47,454.23 $19,380.65 2026-08-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 3 2 — — $2,077.62 $19,300.39 $19,300.09 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 50 39 — — $1,521.00 $48,158.41 $19,282.95 2026-08-01
503 MS_DRG Foot Procedures With Mcc 40 29 — — $5,673.15 $46,354.59 $19,213.49 2026-08-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 51 39 — — $1,521.00 $47,680.85 $19,059.28 2026-08-01
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