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

PINEWOOD SPRINGS

Columbia, TN · CCN 444029 · Rates published

12,336 distinct procedures filed
16 distinct payers
90,015 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

76,377 of 90,015 rate rows are consumer-grade (84.8%)

13,638 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 12,911
per-diem day rate — not a per-procedure price 563
placeholder amount (≤ $0.02) — excluded from medians 164

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/6d8533508f614ad6a2fc7a194c0c116d?download=true
Found on page https://www.tristarhealth.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 1667334d5c1f59a4… · 67,155,220 bytes · first seen 2026-05-08

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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 5 $3,672,900.00 $4,223,835.00 $3,709,629.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 5 $3,605,000.00 $4,145,750.00 $3,641,050.00 nat. median
$3,605,000
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 6 $3,325,455.00 $4,788,655.20 $3,358,709.55 nat. median
$13,041
outlier · 257.5×
748
OTHER 		Inj, Lovotibeglogene Auto 6 $3,286,000.00 $4,731,840.00 $3,318,860.00 nat. median
$17,963
outlier · 184.8×
746
OTHER 		Inj, Betibeglogene Autote 6 $2,968,000.00 $4,273,920.00 $2,997,680.00 nat. median
$21,896
outlier · 136.9×
9141
OTHER 		Inj Onase Abepar-xioi Tre 6 $2,388,614.00 $3,439,604.16 $2,412,500.14 nat. median
$2,588,981
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 6 $529,192.90 $762,037.78 $534,484.83 nat. median
$566,531
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 6 $527,123.40 $759,057.70 $532,394.63 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 6 $526,587.60 $758,286.14 $531,853.48 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 6 $516,726.10 $744,085.58 $521,893.36 nat. median
$562,201
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 6 $489,456.00 $704,816.64 $494,350.56 nat. median
$532,192
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 6 $460,530.40 $663,163.78 $465,135.70 nat. median
$489,450
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $2,253.12 $573,024.23 $432,454.79 nat. median
$206,474
outlier · 2.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $1,854.72 $910,889.88 $362,532.17 nat. median
$370,174
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $2,253.12 $680,359.39 $277,638.70 nat. median
$265,286
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $2,253.12 $517,646.48 $218,437.14 nat. median
$202,976
1.1× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $181,017.23 $253,183.05 $217,100.14 nat. median
$98,894
outlier · 2.2×
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $159,079.15 $222,498.95 $190,789.05 nat. median
$83,470
outlier · 2.3×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $144,031.80 $201,452.70 $172,742.25 nat. median
$82,711
outlier · 2.1×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $2,253.12 $341,288.41 $150,608.85 nat. median
$133,161
1.1× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $122,594.55 $171,469.10 $147,031.83 nat. median
$68,090
outlier · 2.2×
1908
OTHER 		New Technology - Level 52 6 $139,965.00 $201,549.60 $141,364.65 nat. median
$152,962
0.9× median
1907
OTHER 		New Technology - Level 52 6 $139,965.00 $201,549.60 $141,364.65 nat. median
$153,199
0.9× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 5 $115,781.53 $161,939.95 $138,860.74 nat. median
$63,724
outlier · 2.2×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 $106,832.22 $149,422.83 $128,127.52 nat. median
$60,691
outlier · 2.1×
1906
OTHER 		New Technology - Level 51 6 $126,198.00 $181,725.12 $127,459.98 nat. median
$138,020
0.9× median
1905
OTHER 		New Technology - Level 51 6 $126,198.00 $181,725.12 $127,459.98 nat. median
$137,903
0.9× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 $2,253.12 $314,996.79 $126,172.21 nat. median
$56,696
outlier · 2.2×
7
MS_DRG 		Lung Transplant 4 $2,253.12 $315,655.12 $125,675.40 nat. median
$122,708
1.0× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $2,253.12 $266,180.85 $125,446.93 nat. median
$108,660
1.2× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 $2,253.12 $161,319.17 $121,745.71 nat. median
$64,023
1.9× median
428
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $95,074.80 $132,978.11 $114,026.46 nat. median
$54,210
outlier · 2.1×
1903
OTHER 		New Technology - Level 50 6 $112,431.00 $161,900.64 $113,555.31 nat. median
$119,935
0.9× median
1904
OTHER 		New Technology - Level 50 6 $112,431.00 $161,900.64 $113,555.31 nat. median
$120,174
0.9× median
430
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 5 $94,468.63 $132,130.27 $113,299.45 nat. median
$54,592
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $1,854.72 $316,452.24 $112,775.26 nat. median
$117,357
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $2,253.12 $263,122.83 $110,351.21 nat. median
$102,358
1.1× median
450
MS_DRG 		Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 5 $88,935.32 $124,391.00 $106,663.16 nat. median
$51,319
outlier · 2.1×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $2,253.12 $257,216.93 $106,040.92 nat. median
$100,136
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 4 $2,253.12 $255,902.90 $104,655.74 nat. median
$99,019
1.1× median
826
MS_DRG 		Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 4 $2,253.12 $241,075.40 $103,488.14 nat. median
$46,259
outlier · 2.2×
823
MS_DRG 		Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 $2,253.12 $234,521.98 $101,407.62 nat. median
$45,112
outlier · 2.2×
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 6 $99,999.90 $143,999.86 $100,999.90 nat. median
$111,989
0.9× median
1902
OTHER 		New Technology - Level 49 6 $98,663.96 $142,076.10 $99,650.60 nat. median
$105,172
0.9× median
1901
OTHER 		New Technology - Level 49 6 $98,663.96 $142,076.10 $99,650.60 nat. median
$105,693
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $2,253.12 $233,105.41 $99,435.65 nat. median
$93,672
1.1× median
K1007
HCPCS 		Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 6 $91,031.90 $131,085.94 $91,942.22 nat. median
$96,983
0.9× median
1585
OTHER 		New Technology - Level 48 6 $87,191.46 $125,555.70 $88,063.37 nat. median
$95,360
0.9× median
1599
OTHER 		New Technology - Level 48 6 $87,191.46 $125,555.70 $88,063.37 nat. median
$95,288
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 $2,253.12 $194,701.38 $86,599.07 nat. median
$77,570
1.1× median

Other procedures at this hospital

Browse this hospital's 12,336 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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 8 4 — — $2,253.12 $680,359.39 $277,638.70 2024-10-01
10 MS_DRG Pancreas Transplant 8 4 — — $2,253.12 $192,578.15 $49,317.74 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 8 4 — — $2,253.12 $130,330.72 $52,828.87 2024-10-01
113 MS_DRG Orbital Procedures With Cc/mcc 8 4 — — $2,253.12 $54,508.17 $25,688.54 2024-10-01
1142 OTHER Supprelin La Implant 8 6 — — $45,350.21 $65,304.30 $45,803.71 2024-10-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 8 4 — — $2,253.12 $99,117.63 $41,032.20 2024-10-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 8 4 — — $2,253.12 $64,005.92 $27,516.34 2024-10-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 8 4 — — $2,253.12 $58,235.29 $27,172.09 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 8 4 — — $1,854.72 $316,452.24 $112,775.26 2024-10-01
140 MS_DRG Major Head And Neck Procedures With Mcc 8 4 — — $2,253.12 $102,151.49 $38,708.52 2024-10-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 8 4 — — $2,253.12 $79,752.56 $34,072.43 2024-10-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 6 4 — — $1,854.72 $109,970.43 $49,713.40 2024-10-01
1578 OTHER New Technology - Level 41 8 6 — — $25,239.96 $36,345.54 $25,492.36 2024-10-01
1579 OTHER New Technology - Level 42 8 6 — — $32,123.46 $46,257.78 $32,444.69 2024-10-01
1580 OTHER New Technology - Level 43 8 6 — — $41,301.46 $59,474.10 $41,714.47 2024-10-01
1581 OTHER New Technology - Level 44 8 6 — — $50,479.46 $72,690.42 $50,984.25 2024-10-01
1582 OTHER New Technology - Level 45 8 6 — — $59,657.46 $85,906.74 $60,254.03 2024-10-01
1583 OTHER New Technology - Level 46 8 6 — — $68,835.46 $99,123.06 $69,523.81 2024-10-01
1584 OTHER New Technology - Level 47 8 6 — — $78,013.46 $112,339.38 $78,793.59 2024-10-01
1585 OTHER New Technology - Level 48 8 6 — — $87,191.46 $125,555.70 $88,063.37 2024-10-01
1592 OTHER New Technology - Level 41 8 6 — — $25,239.96 $36,345.54 $25,492.36 2024-10-01
1593 OTHER New Technology - Level 42 8 6 — — $32,123.46 $46,257.78 $32,444.69 2024-10-01
1594 OTHER New Technology - Level 43 8 6 — — $41,301.46 $59,474.10 $41,714.47 2024-10-01
1595 OTHER New Technology - Level 44 8 6 — — $50,479.46 $72,690.42 $50,984.25 2024-10-01
1596 OTHER New Technology - Level 45 8 6 — — $59,657.46 $85,906.74 $60,254.03 2024-10-01
1597 OTHER New Technology - Level 46 8 6 — — $68,835.46 $99,123.06 $69,523.81 2024-10-01
1598 OTHER New Technology - Level 47 8 6 — — $78,013.46 $112,339.38 $78,793.59 2024-10-01
1599 OTHER New Technology - Level 48 8 6 — — $87,191.46 $125,555.70 $88,063.37 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 8 4 — — $1,854.72 $145,787.50 $60,781.68 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 8 4 — — $2,253.12 $111,327.98 $48,293.19 2024-10-01
164 MS_DRG Major Chest Procedures With Cc 8 4 — — $2,253.12 $60,793.30 $26,130.12 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 8 6 — — $65,476.58 $94,286.28 $66,131.35 2024-10-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 8 4 — — $2,253.12 $93,020.90 $41,574.19 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 8 4 — — $1,854.72 $145,787.50 $60,781.68 2024-10-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 8 4 — — $2,253.12 $74,117.20 $31,504.92 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 8 4 — — $1,854.72 $910,889.88 $362,532.17 2024-10-01
180 MS_DRG Respiratory Neoplasms With Mcc 6 4 — — $1,854.72 $42,215.69 $30,183.31 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 8 4 — — $2,253.12 $191,469.44 $81,897.40 2024-10-01
1901 OTHER New Technology - Level 49 8 6 — — $98,663.96 $142,076.10 $99,650.60 2024-10-01
1902 OTHER New Technology - Level 49 8 6 — — $98,663.96 $142,076.10 $99,650.60 2024-10-01
1903 OTHER New Technology - Level 50 8 6 — — $112,431.00 $161,900.64 $113,555.31 2024-10-01
1904 OTHER New Technology - Level 50 8 6 — — $112,431.00 $161,900.64 $113,555.31 2024-10-01
1905 OTHER New Technology - Level 51 8 6 — — $126,198.00 $181,725.12 $127,459.98 2024-10-01
1906 OTHER New Technology - Level 51 8 6 — — $126,198.00 $181,725.12 $127,459.98 2024-10-01
1907 OTHER New Technology - Level 52 8 6 — — $139,965.00 $201,549.60 $141,364.65 2024-10-01
1908 OTHER New Technology - Level 52 8 6 — — $139,965.00 $201,549.60 $141,364.65 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 4 — — $2,253.12 $266,180.85 $125,446.93 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 4 — — $2,253.12 $194,701.38 $86,599.07 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 8 4 — — $1,854.72 $156,227.29 $67,974.72 2024-10-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 8 4 — — $1,854.72 $64,834.44 $26,605.39 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 8 4 — — $2,253.12 $133,511.93 $62,921.71 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 4 — — $2,253.12 $263,122.83 $110,351.21 2024-10-01
215 MS_DRG Other Heart Assist System Implant 8 4 — — $2,253.12 $255,902.90 $104,655.74 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $2,253.12 $233,105.41 $99,435.65 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $2,253.12 $155,978.50 $65,215.68 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 4 — — $2,253.12 $143,700.51 $58,365.54 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $2,253.12 $186,887.24 $79,005.10 2024-10-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 8 4 — — $2,253.12 $85,276.81 $40,190.02 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $2,253.12 $127,932.13 $53,733.55 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 4 — — $2,253.12 $110,927.01 $47,627.23 2024-10-01
22610 CPT Arthrodesis, Posterior Or Posterolateral Technique, Single Interspace; Thoracic … 4 1 — — $4,844.00 $53,928.00 $24,468.50 2024-10-01
22630 CPT Arthrodesis, Posterior Interbody Technique, Including Laminectomy And/or Discect… 4 1 — — $4,844.00 $53,928.00 $24,468.50 2024-10-01
22633 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
22634 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 4 1 — — $1,730.00 $69,657.00 $28,757.00 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 8 4 — — $2,253.12 $120,361.95 $51,624.01 2024-10-01
22800 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; Up To 6 Vert… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
22802 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 7 To 12 Vert… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
22804 CPT Arthrodesis, Posterior, For Spinal Deformity, With Or Without Cast; 13 Or More V… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
22808 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 2 To 3 Verteb… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
22810 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 4 To 7 Verteb… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
22812 CPT Arthrodesis, Anterior, For Spinal Deformity, With Or Without Cast; 8 Or More Ver… 4 1 — — $4,844.00 $69,657.00 $30,716.00 2024-10-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 8 4 — — $2,253.12 $75,027.85 $32,576.59 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 4 — — $2,253.12 $137,797.03 $58,079.69 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 4 — — $2,253.12 $204,674.98 $83,144.28 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 4 — — $2,253.12 $147,545.99 $60,946.38 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 4 — — $2,253.12 $188,790.65 $79,910.80 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 4 — — $2,253.12 $128,502.18 $53,255.08 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 8 4 — — $2,253.12 $142,123.19 $60,249.68 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 8 4 — — $2,253.12 $99,320.53 $41,404.12 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 8 4 — — $2,253.12 $121,656.66 $49,248.07 2024-10-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 8 4 — — $2,253.12 $91,822.82 $38,818.15 2024-10-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 8 4 — — $2,253.12 $70,339.36 $28,781.65 2024-10-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 8 4 — — $2,253.12 $81,933.76 $35,399.23 2024-10-01
245 MS_DRG Aicd Generator Procedures 8 4 — — $2,253.12 $118,033.41 $46,426.46 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 8 4 — — $2,253.12 $108,021.16 $45,244.12 2024-10-01
252 MS_DRG Other Vascular Procedures With Mcc 8 4 — — $2,253.12 $82,856.48 $34,361.35 2024-10-01
253 MS_DRG Other Vascular Procedures With Cc 8 4 — — $2,253.12 $61,665.30 $26,137.29 2024-10-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 8 4 — — $2,253.12 $63,196.73 $28,148.49 2024-10-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 8 4 — — $2,253.12 $67,764.44 $27,750.96 2024-10-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 8 4 — — $2,253.12 $73,875.65 $30,255.99 2024-10-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 8 4 — — $2,253.12 $82,291.25 $33,965.88 2024-10-01
263 MS_DRG Vein Ligation And Stripping 8 4 — — $2,253.12 $64,781.29 $28,945.58 2024-10-01
264 MS_DRG Other Circulatory System O.r. Procedures 8 4 — — $2,253.12 $84,419.31 $33,461.80 2024-10-01
265 MS_DRG Aicd Lead Procedures 8 4 — — $2,253.12 $86,158.47 $36,208.62 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 8 4 — — $2,253.12 $144,698.11 $63,994.42 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 8 4 — — $2,253.12 $113,634.78 $50,000.09 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 8 4 — — $2,253.12 $161,046.22 $70,229.83 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 8 4 — — $2,253.12 $100,494.46 $42,606.93 2024-10-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 8 4 — — $2,253.12 $59,604.88 $24,926.28 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 8 4 — — $2,253.12 $123,982.78 $51,810.47 2024-10-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 8 4 — — $2,253.12 $83,199.48 $35,410.50 2024-10-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 8 4 — — $2,253.12 $60,435.81 $24,993.90 2024-10-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 8 4 — — $2,253.12 $94,446.05 $39,926.71 2024-10-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 8 4 — — $2,253.12 $75,382.92 $33,203.62 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 4 — — $2,253.12 $170,691.31 $72,085.29 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 8 4 — — $2,253.12 $149,616.07 $63,626.60 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 8 4 — — $2,253.12 $112,373.89 $48,998.08 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 8 4 — — $2,253.12 $120,845.05 $45,699.03 2024-10-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 8 4 — — $2,253.12 $77,397.45 $32,791.75 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 8 4 — — $2,253.12 $146,840.66 $61,740.41 2024-10-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 8 4 — — $1,854.72 $65,974.55 $25,515.12 2024-10-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 8 4 — — $2,253.12 $81,076.26 $35,123.62 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 4 — — $2,253.12 $517,646.48 $218,437.14 2024-10-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 8 4 — — $2,253.12 $101,216.70 $42,176.63 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 7 5 — — $106,832.22 $149,422.83 $128,127.52 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 8 4 — — $2,253.12 $106,100.84 $44,689.85 2024-10-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 8 4 — — $2,253.12 $68,762.04 $29,452.74 2024-10-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 8 4 — — $2,253.12 $102,880.98 $42,416.37 2024-10-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 8 4 — — $2,253.12 $77,175.22 $30,414.79 2024-10-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 8 4 — — $2,253.12 $69,131.61 $27,092.17 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 8 4 — — $2,253.12 $122,676.00 $52,036.90 2024-10-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 8 4 — — $2,253.12 $58,650.76 $25,587.11 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 8 4 — — $2,253.12 $110,912.51 $46,276.88 2024-10-01
332 MS_DRG Rectal Resection With Mcc 8 4 — — $2,253.12 $83,781.62 $37,440.13 2024-10-01
333 MS_DRG Rectal Resection With Cc 6 4 — — $2,253.12 $108,329.47 $46,055.17 2024-10-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 8 4 — — $2,253.12 $87,535.30 $36,627.67 2024-10-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 8 4 — — $2,253.12 $93,926.72 $39,971.79 2024-10-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 8 4 — — $2,253.12 $65,083.23 $28,076.77 2024-10-01
347 MS_DRG Anal And Stomal Procedures With Mcc 8 4 — — $2,253.12 $57,165.22 $26,116.81 2024-10-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 8 4 — — $2,253.12 $58,450.27 $24,589.20 2024-10-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 8 4 — — $2,253.12 $70,841.78 $29,960.92 2024-10-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 8 4 — — $2,253.12 $103,030.74 $43,837.43 2024-10-01
37 MS_DRG Extracranial Procedures With Mcc 8 4 — — $2,253.12 $80,211.51 $34,584.71 2024-10-01
374 MS_DRG Digestive Malignancy With Mcc 6 4 — — $1,854.72 $109,345.31 $45,760.43 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 4 — — $2,253.12 $341,288.41 $150,608.85 2024-10-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 8 4 — — $2,253.12 $91,107.83 $39,450.30 2024-10-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 7 5 — — $67,857.28 $94,909.83 $81,383.55 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 8 4 — — $2,253.12 $131,123.00 $56,403.53 2024-10-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 8 4 — — $2,253.12 $67,832.07 $29,582.85 2024-10-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 4 — — $2,253.12 $84,569.07 $38,135.80 2024-10-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 8 4 — — $2,253.12 $66,097.74 $31,150.42 2024-10-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 8 4 — — $2,253.12 $84,629.46 $36,117.43 2024-10-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 8 4 — — $2,253.12 $85,247.83 $32,793.80 2024-10-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 8 4 — — $2,253.12 $98,240.80 $40,069.12 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 5 — — $181,017.23 $253,183.05 $217,100.14 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 5 — — $122,594.55 $171,469.10 $147,031.83 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 5 — — $95,074.80 $132,978.11 $114,026.46 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 7 5 — — $144,031.80 $201,452.70 $172,742.25 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 7 5 — — $94,468.63 $132,130.27 $113,299.45 2024-10-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 6 4 — — $1,854.72 $44,070.80 $31,034.89 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 7 5 — — $115,781.53 $161,939.95 $138,860.74 2024-10-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 7 5 — — $70,516.86 $98,629.70 $84,573.28 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 7 5 — — $88,935.32 $124,391.00 $106,663.16 2024-10-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 7 5 — — $53,291.77 $74,537.50 $63,914.64 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 5 2 — — $2,253.12 $92,326.93 $77,041.01 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 5 2 — — $2,253.12 $63,725.73 $53,175.11 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 5 2 — — $2,253.12 $47,985.75 $40,041.09 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 4 — — $2,253.12 $204,559.03 $84,912.46 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 4 — — $2,253.12 $138,625.54 $67,349.27 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 4 — — $2,253.12 $104,294.04 $59,304.24 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 5 2 — — $2,253.12 $69,101.93 $57,661.22 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 5 2 — — $2,253.12 $38,111.66 $31,801.78 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 8 4 — — $2,253.12 $148,231.99 $69,858.94 2024-10-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 8 4 — — $2,253.12 $69,170.26 $29,161.76 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 8 4 — — $2,253.12 $130,453.91 $58,027.44 2024-10-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 8 4 — — $2,253.12 $71,223.43 $30,750.85 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 8 4 — — $2,253.12 $123,052.82 $53,139.32 2024-10-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 8 4 — — $2,253.12 $82,728.46 $35,718.89 2024-10-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 8 4 — — $2,253.12 $63,363.40 $27,351.39 2024-10-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 8 4 — — $2,253.12 $78,950.62 $34,115.47 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 10 4 — — $2,253.12 $117,320.84 $46,154.98 2024-10-01
472 MS_DRG Cervical Spinal Fusion With Cc 10 4 — — $2,253.12 $69,977.03 $31,015.15 2024-10-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 10 4 — — $2,253.12 $57,179.72 $28,437.50 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 8 4 — — $2,253.12 $108,320.68 $44,084.34 2024-10-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 8 4 — — $2,253.12 $83,064.21 $34,517.09 2024-10-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 8 4 — — $2,253.12 $71,039.85 $30,212.96 2024-10-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 8 4 — — $2,253.12 $61,549.36 $25,451.87 2024-10-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 8 4 — — $2,253.12 $77,866.06 $33,748.68 2024-10-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 8 4 — — $2,253.12 $85,774.40 $35,470.94 2024-10-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 8 4 — — $2,253.12 $57,996.15 $24,606.61 2024-10-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 8 4 — — $2,253.12 $85,032.85 $36,691.18 2024-10-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 8 4 — — $2,253.12 $60,984.13 $26,751.00 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 8 4 — — $2,253.12 $257,216.93 $106,040.92 2024-10-01
500 MS_DRG Soft Tissue Procedures With Mcc 8 4 — — $2,253.12 $76,535.12 $33,224.11 2024-10-01
503 MS_DRG Foot Procedures With Mcc 8 4 — — $2,253.12 $63,926.21 $27,477.41 2024-10-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 8 4 — — $2,253.12 $69,034.99 $27,873.90 2024-10-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 8 4 — — $2,253.12 $74,692.09 $32,391.15 2024-10-01
5166 OTHER Cochlear Implant Procedur 8 6 — — $29,324.99 $42,227.99 $29,618.24 2024-10-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 8 4 — — $2,253.12 $86,566.69 $37,414.51 2024-10-01
5200 OTHER Implantation Wireless Pa 8 6 — — $25,416.15 $36,599.26 $25,670.31 2024-10-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 8 4 — — $2,253.12 $70,402.16 $30,677.08 2024-10-01
5232 OTHER Level 2 Icd And Similar P 8 6 — — $28,769.34 $41,427.85 $29,057.03 2024-10-01
5244 OTHER Level 4 Blood Product Exc 8 6 — — $47,786.33 $68,812.32 $48,264.19 2024-10-01
545 MS_DRG Connective Tissue Disorders With Mcc 8 4 — — $1,854.72 $61,032.44 $24,533.09 2024-10-01
5465 OTHER Level 5 Neurostimulator A 8 6 — — $27,154.30 $39,102.19 $27,425.84 2024-10-01
570 MS_DRG Skin Debridement With Mcc 8 4 — — $2,253.12 $72,716.21 $29,939.40 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 8 4 — — $2,253.12 $148,741.66 $63,707.54 2024-10-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 8 4 — — $2,253.12 $83,689.83 $34,894.12 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 8 4 — — $2,253.12 $130,313.81 $58,226.20 2024-10-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 8 4 — — $2,253.12 $64,315.10 $27,141.36 2024-10-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 8 4 — — $2,253.12 $78,723.56 $34,242.51 2024-10-01
597 MS_DRG Malignant Breast Disorders With Mcc 6 4 — — $1,854.72 $42,428.26 $29,063.72 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 8 4 — — $2,253.12 $117,125.18 $49,556.46 2024-10-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 8 4 — — $1,854.72 $65,295.80 $27,579.55 2024-10-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 8 4 — — $2,253.12 $93,356.66 $40,548.61 2024-10-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 9 4 — — $2,253.12 $65,856.19 $27,115.45 2024-10-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 8 4 — — $2,253.12 $90,436.32 $39,195.18 2024-10-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 8 4 — — $2,253.12 $69,249.97 $29,929.15 2024-10-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 8 4 — — $2,253.12 $95,322.88 $41,130.56 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 8 4 — — $2,253.12 $111,282.09 $46,079.13 2024-10-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 8 4 — — $2,253.12 $83,870.99 $35,433.04 2024-10-01
652 MS_DRG Kidney Transplant 8 4 — — $2,253.12 $74,184.84 $30,781.58 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 8 4 — — $2,253.12 $134,644.80 $55,465.04 2024-10-01
654 MS_DRG Major Bladder Procedures With Cc 8 4 — — $2,253.12 $68,162.99 $28,047.06 2024-10-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 6 4 — — $2,253.12 $163,450.13 $70,600.88 2024-10-01
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 6 4 — — $2,253.12 $96,071.75 $39,616.41 2024-10-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 10 4 — — $2,253.12 $83,028.00 $35,801.44 2024-10-01
662 MS_DRG Minor Bladder Procedures With Mcc 8 4 — — $2,253.12 $75,349.11 $30,702.69 2024-10-01
665 MS_DRG Prostatectomy With Mcc 8 4 — — $2,253.12 $82,933.78 $31,649.38 2024-10-01
668 MS_DRG Transurethral Procedures With Mcc 8 4 — — $2,253.12 $70,438.40 $28,871.82 2024-10-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 8 4 — — $2,253.12 $101,209.45 $37,887.86 2024-10-01
7 MS_DRG Lung Transplant 8 4 — — $2,253.12 $315,655.12 $125,675.40 2024-10-01
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 10 4 — — $2,253.12 $46,872.78 $26,976.74 2024-10-01
714 OTHER Inj Delandistrogene Mox R 8 6 — — $3,325,455.00 $4,788,655.20 $3,358,709.55 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 8 6 — — $63,354.77 $91,230.87 $63,988.32 2024-10-01
722 MS_DRG Malignancy, Male Reproductive System With Mcc 6 4 — — $1,854.72 $41,759.16 $31,206.14 2024-10-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 8 4 — — $2,253.12 $95,105.48 $39,826.31 2024-10-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 10 4 — — $2,253.12 $96,153.81 $52,773.12 2024-10-01
746 OTHER Inj, Betibeglogene Autote 8 6 — — $2,968,000.00 $4,273,920.00 $2,997,680.00 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 8 6 — — $3,286,000.00 $4,731,840.00 $3,318,860.00 2024-10-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 8 4 — — $2,253.12 $62,522.80 $25,789.97 2024-10-01
754 MS_DRG Malignancy, Female Reproductive System With Mcc 6 4 — — $1,854.72 $43,701.23 $31,706.77 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 7 5 — — $3,605,000.00 $4,145,750.00 $3,641,050.00 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 8 4 — — $1,854.72 $143,601.48 $59,040.99 2024-10-01
791 MS_DRG Prematurity With Major Problems 8 4 — — $1,854.72 $98,071.72 $40,321.37 2024-10-01
793 MS_DRG Full Term Neonate With Major Problems 8 4 — — $1,854.72 $100,740.84 $41,419.51 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 8 4 — — $2,253.12 $114,844.95 $50,762.36 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 8 4 — — $2,253.12 $131,422.52 $53,908.74 2024-10-01
800 MS_DRG Splenic Procedures With Cc 8 4 — — $2,253.12 $70,378.01 $28,868.74 2024-10-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 8 4 — — $2,253.12 $86,586.01 $35,150.26 2024-10-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 8 4 — — $2,253.12 $61,235.34 $28,859.53 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 6 4 — — $2,253.12 $314,996.79 $126,172.21 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 6 4 — — $2,253.12 $234,521.98 $101,407.62 2024-10-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 6 4 — — $2,253.12 $116,320.69 $47,663.23 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 6 4 — — $2,253.12 $241,075.40 $103,488.14 2024-10-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 6 4 — — $2,253.12 $120,712.22 $51,139.42 2024-10-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 6 4 — — $2,253.12 $164,294.06 $66,827.78 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 8 4 — — $1,854.72 $133,502.27 $55,094.16 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 8 4 — — $1,854.72 $120,939.25 $47,664.96 2024-10-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 8 4 — — $1,854.72 $77,039.96 $30,751.97 2024-10-01
843 OTHER Pegaspargase Injection 8 6 — — $27,070.53 $38,981.56 $27,341.24 2024-10-01
849 MS_DRG Radiotherapy 8 4 — — $1,854.72 $64,515.59 $26,483.38 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 7 5 — — $159,079.15 $222,498.95 $190,789.05 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 8 4 — — $2,253.12 $120,811.23 $51,220.33 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 8 4 — — $2,253.12 $108,970.45 $45,371.17 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 8 4 — — $1,854.72 $168,034.26 $68,534.61 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 8 4 — — $2,253.12 $107,011.48 $44,340.47 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 8 6 — — $489,456.00 $704,816.64 $494,350.56 2024-10-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 8 4 — — $2,253.12 $93,260.04 $33,361.40 2024-10-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 8 4 — — $2,253.12 $96,221.44 $38,108.14 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 7 5 — — $3,672,900.00 $4,223,835.00 $3,709,629.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 8 6 — — $2,388,614.00 $3,439,604.16 $2,412,500.14 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 8 6 — — $529,192.90 $762,037.78 $534,484.83 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 3 — — $2,253.12 $573,024.23 $432,454.79 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 8 6 — — $55,015.23 $79,221.93 $55,565.38 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 4 3 — — $2,253.12 $161,319.17 $121,745.71 2024-10-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 4 3 — — $2,253.12 $76,817.73 $57,973.46 2024-10-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 4 3 — — $1,854.72 $104,511.44 $78,873.58 2024-10-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 4 3 — — $1,854.72 $51,829.38 $39,115.04 2024-10-01
935 MS_DRG Non-extensive Burns 4 3 — — $1,854.72 $53,051.63 $40,037.45 2024-10-01
93660 CPT Evaluation Of Cardiovascular Function With Tilt Table Evaluation, With Continuou… 2 1 — — $24,862.00 $29,572.00 $27,217.00 2024-10-01
93662 CPT Intracardiac Echocardiography During Therapeutic/diagnostic Intervention, Includ… 2 1 — — $24,862.00 $29,572.00 $27,217.00 2024-10-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 8 4 — — $2,253.12 $76,663.14 $32,942.35 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 8 6 — — $460,530.40 $663,163.78 $465,135.70 2024-10-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 8 4 — — $1,854.72 $88,127.10 $35,647.37 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 8 6 — — $516,726.10 $744,085.58 $521,893.36 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 8 6 — — $526,587.60 $758,286.14 $531,853.48 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 8 6 — — $527,123.40 $759,057.70 $532,394.63 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 8 4 — — $2,253.12 $164,927.92 $62,397.14 2024-10-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 8 4 — — $2,253.12 $92,325.24 $39,734.10 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 8 4 — — $2,253.12 $180,285.67 $74,100.58 2024-10-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 8 4 — — $2,253.12 $99,264.97 $41,441.00 2024-10-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 8 4 — — $2,253.12 $63,858.57 $25,945.71 2024-10-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 8 4 — — $1,854.72 $65,619.47 $26,905.51 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 8 4 — — $2,253.12 $152,753.80 $70,413.23 2024-10-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 8 4 — — $1,854.72 $86,590.84 $35,787.10 2024-10-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 8 4 — — $2,253.12 $64,088.05 $28,478.39 2024-10-01
974 MS_DRG HIV With Major Related Condition With Mcc 8 4 — — $1,854.72 $72,126.83 $28,698.36 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 8 4 — — $2,253.12 $114,840.12 $48,567.77 2024-10-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 8 4 — — $2,253.12 $59,143.52 $25,470.31 2024-10-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 8 4 — — $2,253.12 $84,614.96 $34,595.98 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 8 6 — — $91,031.90 $131,085.94 $91,942.22 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 8 6 — — $37,701.50 $54,290.16 $38,078.51 2024-10-01
L5856 HCPCS Addition To Lower Extremity Prosthesis, Endoskeletal Knee-shin System, Microproc… 8 6 — — $28,454.30 $40,974.19 $28,738.84 2024-10-01
L6880 HCPCS Electric Hand, Switch Or Myoelectric Controlled, Independently Articulating Digi… 8 6 — — $28,320.00 $40,780.80 $28,603.20 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 8 6 — — $38,289.50 $55,136.88 $38,672.39 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 8 6 — — $47,493.00 $68,389.92 $47,967.93 2024-10-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 8 6 — — $33,480.90 $48,212.50 $33,815.71 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 8 6 — — $65,871.70 $94,855.25 $66,530.42 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 8 6 — — $99,999.90 $143,999.86 $100,999.90 2024-10-01
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