Hospital

COVENANT MEDICAL CENTER

Lubbock, TX · CCN 450040 · Rates published

20,240 distinct procedures filed

19 distinct payers

252,308 rate rows

2026-04-01 last MRF observed

Data quality

186,638 of 252,308 rate rows are consumer-grade (74.0%)

65,670 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 — reason	Rows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	65,658
placeholder amount (≤ $0.02) — excluded from medians	12

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://pricetransparency.providence.org/txnm/live/822913146_covenant-medical-center_standardcharges.json
Found on page	https://www.providence.org/billing-support/pricing-transparency
Discovered via	Discovered by HANK
Last fetch	Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint	d2483db3152f941b… · 205,065,868 bytes · first seen 2026-05-18

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
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	3	$3,691,450.00	$3,894,479.75	$3,876,022.50	nat. median $3,710,000 1.0× median
C9098 HCPCS	Ciltacabtagene Car Pos T	1	$1,791,273.00	$1,810,431.00	$1,791,273.00	nat. median $57,174 outlier · 31.3×
Q2056 HCPCS	Ciltacabtagene Car-pos T	5	$588,494.81	$1,936,825.91	$1,732,143.60	nat. median $674,867 outlier · 2.6×
Q2040 HCPCS	Tisagenlecleucel Car-pos T	2	$1,687,675.00	$2,375,068.19	$1,696,700.00	nat. median $25,594 outlier · 66.3×
C9081 HCPCS	Idecabtagene Car Pos T	1	$1,615,997.90	$1,633,281.30	$1,615,997.90	nat. median $30,475 outlier · 53.0×
C9076 HCPCS	Lisocabtagene Car Pos T	1	$1,580,557.66	$1,597,462.02	$1,580,557.66	nat. median $30,475 outlier · 51.9×
Q2055 HCPCS	Idecabtagene Vicleucel Car	5	$559,781.08	$1,894,411.57	$1,562,654.28	nat. median $625,184 outlier · 2.5×
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	5	$562,260.84	$1,895,724.80	$1,528,383.91	nat. median $673,137 outlier · 2.3×
Q2042 HCPCS	Tisagenlecleucel Car-pos T	6	$614,180.81	$2,024,136.03	$1,444,554.40	nat. median $753,246 1.9× median
C9073 HCPCS	Brexucabtagene Autoleucel Ca	2	$1,436,870.60	$2,022,110.69	$1,444,554.40	nat. median $29,278 outlier · 49.3×
Q2053 HCPCS	Brexucabtagene Car Pos T	6	$489,290.60	$1,955,361.41	$1,396,870.08	nat. median $619,808 outlier · 2.3×
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	6	$531,849.12	$1,865,767.67	$1,332,356.00	nat. median $634,303 outlier · 2.1×
Q2057 HCPCS	Afamitresgene Autoleucel	4	$770,620.00	$2,697,170.00	$813,004.10	nat. median $824,563 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	12	$311,003.22	$855,644.44	$473,878.06	nat. median $370,174 1.3× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	12	$201,828.58	$639,095.62	$248,824.04	nat. median $265,286 0.9× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	12	$124,480.37	$1,375,575.64	$242,196.66	nat. median $202,976 1.2× median
J9029 HCPCS	Inj, Adstiladrin, Per Tx Dos	5	$64,282.30	$604,800.00	$228,424.35	nat. median $69,774 outlier · 3.3×
C9074 HCPCS	Injection, Lumasiran	2	$205,700.00	$289,482.00	$206,800.00	nat. median $9,821 outlier · 21.1×
A9543 HCPCS	Y90 Ibritumomab, Rx	5	$56,824.55	$287,036.19	$203,962.06	nat. median $62,507 outlier · 3.3×
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	6	$56,269.19	$320,473.36	$203,021.31	nat. median $66,682 outlier · 3.0×
C9031 HCPCS	Lutetium Lu 177 Dotatate, Tx	2	$188,309.00	$265,007.61	$189,316.00	nat. median $664 outlier · 285.1×
453 MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	1	$159,930.55	$187,843.96	$173,408.73	nat. median $87,428 2.0× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	12	$153,766.65	$538,270.33	$162,223.82	nat. median $206,474 0.8× median
J7330 HCPCS	Cultured Chondrocytes Implnt	4	$142,789.46	$256,139.76	$154,821.87	nat. median $76,329 outlier · 2.0×
A9545 HCPCS	I-131 Tositumomab, Rx, Per Dose	1	$153,339.01	$153,339.01	$153,339.01	nat. median $35,867 outlier · 4.3×
222 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	1	$135,812.77	$149,112.29	$143,132.48	nat. median $63,570 outlier · 2.3×
J9226 HCPCS	Supprelin La Implant	6	$41,173.43	$193,421.45	$137,441.33	nat. median $60,368 outlier · 2.3×
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	12	$78,315.44	$247,164.44	$136,886.07	nat. median $102,358 1.3× median
224 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	1	$125,748.23	$138,062.17	$132,525.51	nat. median $54,196 outlier · 2.4×
459 MS_DRG	Spinal Fusion Except Cervical With Mcc	1	$119,699.75	$140,591.50	$129,787.48	nat. median $65,393 2.0× median
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	12	$70,901.43	$320,589.28	$126,010.73	nat. median $133,161 0.9× median
215 MS_DRG	Other Heart Assist System Implant	12	$48,553.84	$240,382.40	$121,592.65	nat. median $99,019 1.2× median
454 MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	1	$110,386.98	$129,653.33	$119,689.88	nat. median $62,372 1.9× median
226 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	1	$113,539.16	$124,657.53	$119,658.42	nat. median $49,935 outlier · 2.4×
Q0480 HCPCS	Driver Pneumatic Vad, Rep	3	$111,492.17	$412,870.36	$117,345.51	nat. median $111,989 1.0× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	$1,000.00	$728,930.23	$114,058.24	nat. median $93,672 1.2× median
7 MS_DRG	Lung Transplant	12	$93,267.55	$296,510.65	$98,397.27	nat. median $122,708 0.8× median
223 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	1	$92,569.30	$101,634.18	$97,558.38	nat. median $44,728 outlier · 2.2×
225 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	1	$89,713.48	$98,498.71	$94,548.65	nat. median $48,704 1.9× median
227 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	1	$89,057.18	$97,778.13	$93,856.96	nat. median $39,020 outlier · 2.4×
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	13	$27,983.84	$192,152.53	$92,178.85	nat. median $81,118 1.1× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	12	$86,553.11	$297,259.42	$91,313.53	nat. median $117,357 0.8× median
455 MS_DRG	Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc	1	$83,121.87	$97,629.51	$90,126.99	nat. median $48,483 1.9× median
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	1	$88,550.00	$92,400.00	$88,550.00	nat. median $96,983 0.9× median
231 MS_DRG	Coronary Bypass With Ptca With Mcc	12	$13,392.24	$192,261.45	$88,023.88	nat. median $79,312 1.1× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	12	$81,611.81	$250,036.99	$86,100.46	nat. median $108,660 0.8× median
955 MS_DRG	Craniotomy For Multiple Significant Trauma	12	$48,477.49	$154,925.05	$85,801.51	nat. median $64,732 1.3× median
C1820 HCPCS	Disc - Ipg Sns Recharge Axonics	1	$85,783.24	$85,783.24	$85,783.24	nat. median $22,013 outlier · 3.9×
217 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	12	$42,394.92	$146,518.41	$85,024.20	nat. median $64,508 1.3× median
J9600 HCPCS	Porfimer Sodium Injection	4	$81,050.29	$114,062.22	$84,332.07	nat. median $31,627 outlier · 2.7×

Other procedures at this hospital

Browse this hospital's 20,240 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	3	3	—	—	$3,691,450.00	$3,894,479.75	$3,876,022.50	2026-04-01
C9098	HCPCS	Ciltacabtagene Car Pos T	4	1	—	—	$1,791,273.00	$1,810,431.00	$1,791,273.00	2026-04-01
Q2056	HCPCS	Ciltacabtagene Car-pos T	10	5	—	—	$588,494.81	$1,936,825.91	$1,732,143.60	2026-04-01
Q2040	HCPCS	Tisagenlecleucel Car-pos T	6	2	—	—	$1,687,675.00	$2,375,068.19	$1,696,700.00	2026-04-01
C9081	HCPCS	Idecabtagene Car Pos T	4	1	—	—	$1,615,997.90	$1,633,281.30	$1,615,997.90	2026-04-01
C9076	HCPCS	Lisocabtagene Car Pos T	4	1	—	—	$1,580,557.66	$1,597,462.02	$1,580,557.66	2026-04-01
Q2055	HCPCS	Idecabtagene Vicleucel Car	10	5	—	—	$559,781.08	$1,894,411.57	$1,562,654.28	2026-04-01
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	10	5	—	—	$562,260.84	$1,895,724.80	$1,528,383.91	2026-04-01
Q2042	HCPCS	Tisagenlecleucel Car-pos T	12	6	—	—	$614,180.81	$2,024,136.03	$1,444,554.40	2026-04-01
C9073	HCPCS	Brexucabtagene Autoleucel Ca	6	2	—	—	$1,436,870.60	$2,022,110.69	$1,444,554.40	2026-04-01
Q2053	HCPCS	Brexucabtagene Car Pos T	12	6	—	—	$489,290.60	$1,955,361.41	$1,396,870.08	2026-04-01
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	12	6	—	—	$531,849.12	$1,865,767.67	$1,332,356.00	2026-04-01
Q2057	HCPCS	Afamitresgene Autoleucel	5	4	—	—	$770,620.00	$2,697,170.00	$813,004.10	2026-04-01
18	MS_DRG	Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies	23	12	—	—	$311,003.22	$855,644.44	$473,878.06	2026-04-01
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	21	12	—	—	$201,828.58	$639,095.62	$248,824.04	2026-04-01
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…	32	12	—	—	$124,480.37	$1,375,575.64	$242,196.66	2026-04-01
J9029	HCPCS	Inj, Adstiladrin, Per Tx Dos	10	5	—	—	$64,282.30	$604,800.00	$228,424.35	2026-04-01
C9074	HCPCS	Injection, Lumasiran	6	2	—	—	$205,700.00	$289,482.00	$206,800.00	2026-04-01
A9543	HCPCS	Y90 Ibritumomab, Rx	10	5	—	—	$56,824.55	$287,036.19	$203,962.06	2026-04-01
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	13	6	—	—	$56,269.19	$320,473.36	$203,021.31	2026-04-01
C9031	HCPCS	Lutetium Lu 177 Dotatate, Tx	6	2	—	—	$188,309.00	$265,007.61	$189,316.00	2026-04-01
453	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Mcc	4	1	—	—	$159,930.55	$187,843.96	$173,408.73	2026-04-01
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	19	12	—	—	$153,766.65	$538,270.33	$162,223.82	2026-04-01
J7330	HCPCS	Cultured Chondrocytes Implnt	8	4	—	—	$142,789.46	$256,139.76	$154,821.87	2026-04-01
A9545	HCPCS	I-131 Tositumomab, Rx, Per Dose	1	1	—	—	$153,339.01	$153,339.01	$153,339.01	2026-04-01
222	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	4	1	—	—	$135,812.77	$149,112.29	$143,132.48	2026-04-01
J9226	HCPCS	Supprelin La Implant	13	6	—	—	$41,173.43	$193,421.45	$137,441.33	2026-04-01
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	23	12	—	—	$78,315.44	$247,164.44	$136,886.07	2026-04-01
224	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	4	1	—	—	$125,748.23	$138,062.17	$132,525.51	2026-04-01
459	MS_DRG	Spinal Fusion Except Cervical With Mcc	4	1	—	—	$119,699.75	$140,591.50	$129,787.48	2026-04-01
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…	28	12	—	—	$70,901.43	$320,589.28	$126,010.73	2026-04-01
215	MS_DRG	Other Heart Assist System Implant	26	12	—	—	$48,553.84	$240,382.40	$121,592.65	2026-04-01
454	MS_DRG	Combined Anterior And Posterior Spinal Fusion With Cc	4	1	—	—	$110,386.98	$129,653.33	$119,689.88	2026-04-01
226	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	4	1	—	—	$113,539.16	$124,657.53	$119,658.42	2026-04-01
Q0480	HCPCS	Driver Pneumatic Vad, Rep	4	3	—	—	$111,492.17	$412,870.36	$117,345.51	2026-04-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	28	13	—	—	$1,000.00	$728,930.23	$114,058.24	2026-04-01
7	MS_DRG	Lung Transplant	19	12	—	—	$93,267.55	$296,510.65	$98,397.27	2026-04-01
223	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	4	1	—	—	$92,569.30	$101,634.18	$97,558.38	2026-04-01
225	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	4	1	—	—	$89,713.48	$98,498.71	$94,548.65	2026-04-01
227	MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	4	1	—	—	$89,057.18	$97,778.13	$93,856.96	2026-04-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	25	13	—	—	$27,983.84	$192,152.53	$92,178.85	2026-04-01
14	MS_DRG	Allogeneic Bone Marrow Transplant	19	12	—	—	$86,553.11	$297,259.42	$91,313.53	2026-04-01
455	MS_DRG	Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc	4	1	—	—	$83,121.87	$97,629.51	$90,126.99	2026-04-01
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	4	1	—	—	$88,550.00	$92,400.00	$88,550.00	2026-04-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	25	12	—	—	$13,392.24	$192,261.45	$88,023.88	2026-04-01
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	19	12	—	—	$81,611.81	$250,036.99	$86,100.46	2026-04-01
955	MS_DRG	Craniotomy For Multiple Significant Trauma	23	12	—	—	$48,477.49	$154,925.05	$85,801.51	2026-04-01
C1820	HCPCS	Disc - Ipg Sns Recharge Axonics	1	1	—	—	$85,783.24	$85,783.24	$85,783.24	2026-04-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	25	12	—	—	$42,394.92	$146,518.41	$85,024.20	2026-04-01
J9600	HCPCS	Porfimer Sodium Injection	8	4	—	—	$81,050.29	$114,062.22	$84,332.07	2026-04-01
C1722	HCPCS	Aicd, Single Chamber	1	1	—	—	$84,113.86	$84,113.86	$84,113.86	2026-04-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	19	12	—	—	$79,374.86	$237,827.50	$83,740.48	2026-04-01
C1816	HCPCS	Receiver/transmitter, Neuro	1	1	—	—	$82,097.12	$82,097.12	$82,097.12	2026-04-01
209	MS_DRG	Complex Aortic Arch Procedures	10	8	—	—	$81,518.18	$86,001.68	$81,518.18	2026-04-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	26	12	—	—	$43,601.48	$160,338.89	$81,104.24	2026-04-01
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	23	12	—	—	$44,085.70	$143,489.29	$79,468.09	2026-04-01
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	29	12	—	—	$31,999.68	$249,133.34	$78,346.95	2026-04-01
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	19	12	—	—	$74,256.39	$241,616.73	$78,340.49	2026-04-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	23	12	—	—	$47,355.42	$134,985.08	$78,331.44	2026-04-01
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	27	12	—	—	$40,879.97	$179,354.10	$78,065.86	2026-04-01
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	25	12	—	—	$517.37	$140,541.86	$77,680.46	2026-04-01
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	23	12	—	—	$47,183.29	$139,720.48	$77,380.82	2026-04-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	28	12	—	—	$54,319.14	$249,087.51	$77,271.77	2026-04-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	25	12	—	—	$42,946.34	$133,541.27	$76,954.25	2026-04-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	24	12	—	—	$20,872.28	$151,278.77	$76,521.36	2026-04-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	30	12	—	—	$17,946.07	$179,182.82	$75,256.19	2026-04-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	32	12	—	—	$12,076.02	$324,347.55	$71,786.67	2026-04-01
460	MS_DRG	Spinal Fusion Except Cervical Without Mcc	4	1	—	—	$66,017.78	$77,540.16	$71,581.45	2026-04-01
C2616	HCPCS	Brachytx, Non-str,yttrium-90	8	4	—	—	$17,771.01	$83,919.61	$70,759.10	2026-04-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	24	12	—	—	$15,714.04	$139,241.72	$70,432.65	2026-04-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	26	12	—	—	$40,826.37	$138,597.33	$70,106.70	2026-04-01
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	24	12	—	—	$35,298.52	$122,410.28	$70,067.10	2026-04-01
653	MS_DRG	Major Bladder Procedures With Mcc	25	12	—	—	$37,424.56	$126,478.60	$70,047.13	2026-04-01
834	MS_DRG	Acute Leukemia With Mcc	29	13	—	—	$33,388.82	$450,000.00	$69,452.74	2026-04-01
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/Mcc	24	12	—	—	$19,327.17	$248,156.71	$69,271.15	2026-04-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	19	12	—	—	$64,887.28	$189,234.60	$68,456.08	2026-04-01
850	MS_DRG	Acute Leukemia With Other Procedures	19	12	—	—	$62,365.86	$209,004.40	$65,795.98	2026-04-01
J9266	HCPCS	Pegaspargase Injection	13	6	—	—	$28,424.06	$99,484.21	$65,529.25	2026-04-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	36	14	—	—	$27,099.23	$281,071.36	$65,474.47	2026-04-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	37	13	—	—	$18,987.57	$261,329.63	$64,500.36	2026-04-01
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	24	12	—	—	$33,689.59	$108,349.29	$62,018.65	2026-04-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	32	12	—	—	$26,358.71	$223,968.06	$61,329.72	2026-04-01
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	26	12	—	—	$29,955.60	$156,130.24	$60,771.83	2026-04-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	23	12	—	—	$36,299.60	$104,199.29	$60,466.54	2026-04-01
J7310	HCPCS	Ganciclovir Long Act Implant	8	4	—	—	$15,789.91	$90,943.76	$59,919.36	2026-04-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	41	14	—	—	$4,310.00	$503,318.75	$59,788.14	2026-04-01
799	MS_DRG	Splenic Procedures With Mcc	23	12	—	—	$32,617.21	$107,879.61	$59,746.52	2026-04-01
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	28	12	—	—	$34,600.65	$113,604.29	$58,935.76	2026-04-01
K0880	HCPCS	Pwc Gp4 Vhd Sing Pow Opt S/b	1	1	—	—	$58,173.44	$58,173.44	$58,173.44	2026-04-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	31	12	—	—	$5,334.11	$314,765.87	$58,089.20	2026-04-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	24	12	—	—	$34,063.00	$113,515.80	$57,419.71	2026-04-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	23	12	—	—	$30,051.13	$97,968.61	$56,850.90	2026-04-01
A9604	HCPCS	Sm 153 Lexidronam	10	5	—	—	$3,159.80	$79,774.76	$56,686.32	2026-04-01
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	27	12	—	—	$436.61	$157,050.00	$56,391.63	2026-04-01
248	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4…	4	1	—	—	$53,387.83	$58,615.86	$56,265.21	2026-04-01
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	25	12	—	—	$28,352.85	$122,426.16	$56,050.90	2026-04-01
246	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar…	4	1	—	—	$53,132.41	$58,335.42	$55,996.01	2026-04-01
28	MS_DRG	Spinal Procedures With Mcc	28	12	—	—	$21,231.87	$137,934.78	$55,910.74	2026-04-01
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	23	12	—	—	$32,141.88	$99,665.83	$55,197.52	2026-04-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	24	12	—	—	$37,089.68	$161,069.50	$54,717.86	2026-04-01
10	MS_DRG	Pancreas Transplant	19	12	—	—	$51,679.51	$180,898.29	$54,521.88	2026-04-01
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc	19	12	—	—	$51,657.90	$151,535.17	$54,499.08	2026-04-01
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	19	12	—	—	$51,383.50	$179,856.82	$54,209.59	2026-04-01
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	32	12	—	—	$12,555.62	$287,554.63	$53,860.70	2026-04-01
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	24	12	—	—	$30,363.70	$93,106.15	$53,293.54	2026-04-01
C1767	HCPCS	Disc - Imp Ipg Vns Model-103	1	1	—	—	$53,130.94	$53,130.94	$53,130.94	2026-04-01
L7180	HCPCS	Electronic Elbow Sequential	4	3	—	—	$50,007.15	$90,533.98	$52,632.53	2026-04-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	40	13	—	—	$644.59	$353,326.51	$52,392.29	2026-04-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	29	12	—	—	$9,602.45	$144,216.69	$52,280.88	2026-04-01
L7181	HCPCS	Electronic Elbo Simultaneous	4	3	—	—	$49,600.83	$89,798.38	$52,204.88	2026-04-01
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	49	13	—	—	$23,171.72	$640,789.49	$51,956.88	2026-04-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	33	13	—	—	$33,347.93	$113,062.00	$51,763.66	2026-04-01
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	31	12	—	—	$24,014.53	$388,289.41	$51,641.25	2026-04-01
0424T	HCPCS	Insj/rplc Nstim Apnea Compl	7	2	—	—	$32,074.19	$61,731.73	$51,540.17	2026-04-01
245	MS_DRG	Aicd Generator Procedures	25	12	—	—	$4,859.70	$110,874.69	$50,762.23	2026-04-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	22	12	—	—	$685.51	$161,109.00	$50,647.34	2026-04-01
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	21	12	—	—	$42,241.52	$140,360.34	$50,564.09	2026-04-01
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	23	12	—	—	$25,803.38	$90,322.08	$50,022.71	2026-04-01
C9741	HCPCS	Impl Pressure Sensor W/angio	7	2	—	—	$3,359.56	$69,172.57	$49,921.71	2026-04-01
338	MS_DRG	Appendectomy With Complicated Principal Diagnosis With Mcc	4	1	—	—	$47,121.00	$51,735.34	$49,660.61	2026-04-01
81280	HCPCS	Long Qt Synd Gene Full Seq	5	2	—	—	$17,845.57	$50,978.17	$49,628.45	2026-04-01
471	MS_DRG	Cervical Spinal Fusion With Mcc	30	12	—	—	$12,319.66	$110,205.33	$49,625.09	2026-04-01
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	23	12	—	—	$26,840.47	$89,541.55	$49,590.43	2026-04-01
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	39	13	—	—	$619.92	$517,436.10	$48,891.66	2026-04-01
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	26	12	—	—	$342.57	$110,305.34	$48,884.06	2026-04-01
904	MS_DRG	Skin Grafts For Injuries With Cc/Mcc	23	12	—	—	$26,453.73	$87,603.82	$48,517.27	2026-04-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	25	12	—	—	$33,262.51	$105,558.42	$48,328.26	2026-04-01
K0014	HCPCS	Other Power Whlchr Base	1	1	—	—	$48,104.96	$48,104.96	$48,104.96	2026-04-01
31	MS_DRG	Ventricular Shunt Procedures With Mcc	26	12	—	—	$29,274.76	$95,077.91	$48,093.27	2026-04-01
K0868	HCPCS	Pwc Gp 4 Std Seat/back	1	1	—	—	$47,502.83	$47,502.83	$47,502.83	2026-04-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	32	12	—	—	$24,822.34	$182,939.87	$47,192.30	2026-04-01
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	33	14	—	—	$20,163.75	$102,361.40	$46,864.56	2026-04-01
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	25	12	—	—	$30,917.54	$101,751.04	$46,585.11	2026-04-01
33276	HCPCS	Insj Phrnc Nrv Stim Sys	11	4	—	—	$3,340.00	$95,401.06	$46,459.55	2026-04-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	29	12	—	—	$527.87	$135,922.18	$46,343.68	2026-04-01
901	MS_DRG	Wound Debridements For Injuries With Mcc	25	12	—	—	$29,094.35	$100,521.24	$46,022.07	2026-04-01
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	34	12	—	—	$16,092.00	$166,986.65	$45,719.76	2026-04-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	42	13	—	—	$26,157.46	$203,328.22	$45,715.31	2026-04-01
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	26	12	—	—	$20,809.79	$79,496.68	$45,503.54	2026-04-01
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	24	12	—	—	$25,679.51	$79,439.96	$45,471.08	2026-04-01
E0464	HCPCS	Press Supp Vent Noninv Int	1	1	—	—	$45,357.83	$45,357.83	$45,357.83	2026-04-01
E0463	HCPCS	Press Supp Vent Invasive Int	1	1	—	—	$45,357.83	$45,357.83	$45,357.83	2026-04-01
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	24	12	—	—	$563.99	$89,337.34	$45,189.51	2026-04-01
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	19	12	—	—	$42,805.18	$134,892.05	$45,159.46	2026-04-01
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	25	12	—	—	$22,910.52	$81,339.11	$45,047.71	2026-04-01
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	23	12	—	—	$26,916.09	$81,316.42	$45,035.14	2026-04-01
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	30	12	—	—	$850.63	$114,278.19	$44,858.08	2026-04-01
265	MS_DRG	Aicd Lead Procedures	23	12	—	—	$26,058.33	$80,932.96	$44,822.77	2026-04-01
0312T	HCPCS	Laps Impltj Nstim Vagus	7	2	—	—	$3,731.75	$61,731.73	$44,551.67	2026-04-01
0316T	HCPCS	Replc Vagus Nerve Pls Gen	7	2	—	—	$20,527.32	$61,731.73	$44,551.67	2026-04-01
0427T	HCPCS	Insj/rplc Nstim Apnea Pls Gn	7	2	—	—	$20,831.33	$61,731.73	$44,551.67	2026-04-01
0431T	HCPCS	Rmvl/rplc Nstim Apnea Pls Gn	7	2	—	—	$20,831.33	$61,731.73	$44,551.67	2026-04-01
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	32	14	—	—	$15,786.01	$173,805.16	$44,481.42	2026-04-01
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	25	12	—	—	$22,883.69	$128,241.48	$44,364.10	2026-04-01
64568	HCPCS	Inc For Vagus N Elect Impl	15	5	—	—	$2,875.00	$61,731.73	$44,247.19	2026-04-01
G2171	HCPCS	Avf Use Magnetic/art/ven	8	1	—	—	$24,388.15	$83,047.24	$44,074.02	2026-04-01
G2170	HCPCS	Avf By Tissue W Thermal E	8	1	—	—	$24,388.15	$83,047.24	$44,074.02	2026-04-01
140	MS_DRG	Major Head And Neck Procedures With Mcc	25	12	—	—	$7,287.31	$95,956.01	$43,931.95	2026-04-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	19	12	—	—	$41,534.75	$124,116.57	$43,819.16	2026-04-01
332	MS_DRG	Rectal Resection With Mcc	23	12	—	—	$26,076.34	$78,700.27	$43,586.25	2026-04-01
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	23	12	—	—	$25,001.08	$78,614.04	$43,538.49	2026-04-01
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	35	12	—	—	$16,273.33	$98,491.90	$43,283.40	2026-04-01
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	36	12	—	—	$400.00	$125,106.13	$43,202.90	2026-04-01
0283T	HCPCS	Periph Field Stimul Perm	8	3	—	—	$20,458.59	$55,464.27	$43,167.94	2026-04-01
L8614	HCPCS	Cochlear Device	1	1	—	—	$42,898.70	$42,898.70	$42,898.70	2026-04-01
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	23	12	—	—	$23,426.72	$77,300.29	$42,810.90	2026-04-01
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	20	12	—	—	$36,862.13	$124,912.99	$42,615.44	2026-04-01
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	19	12	—	—	$40,364.42	$123,451.75	$42,584.46	2026-04-01
341	MS_DRG	Appendectomy Without Complicated Principal Diagnosis With Mcc	4	1	—	—	$40,070.14	$43,994.03	$42,229.75	2026-04-01
J1412	HCPCS	Inj Roctavian Ml 2x10^13vc G	8	4	—	—	$12,553.71	$45,629.68	$42,197.71	2026-04-01
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	20	12	—	—	$33,859.56	$369,385.50	$41,790.27	2026-04-01
37	MS_DRG	Extracranial Procedures With Mcc	23	12	—	—	$23,709.76	$75,346.68	$41,728.95	2026-04-01
0775T	HCPCS	Arthrd Si Jt Prq Iartic Impl	4	1	—	—	$33,503.37	$46,422.98	$41,605.50	2026-04-01
0809T	HCPCS	Arthrd Si Jt Prq Tfx&implt	4	1	—	—	$33,503.37	$46,422.98	$41,605.50	2026-04-01
K0891	HCPCS	Pwc Gp5 Ped Mult Pow Opt S/b	1	1	—	—	$41,550.84	$41,550.84	$41,550.84	2026-04-01
K0885	HCPCS	Pwc Gp4 Std Mult Pow Opt Cap	1	1	—	—	$41,531.16	$41,531.16	$41,531.16	2026-04-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	37	13	—	—	$3,691.53	$312,885.79	$41,506.28	2026-04-01
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/Mcc	19	12	—	—	$39,123.51	$136,945.50	$41,275.30	2026-04-01
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	10	8	—	—	$41,101.19	$43,361.76	$41,101.19	2026-04-01
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	28	12	—	—	$23,234.54	$80,572.19	$40,755.84	2026-04-01
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	29	12	—	—	$25,722.92	$88,717.90	$40,618.10	2026-04-01
579	MS_DRG	Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc	28	12	—	—	$9,134.13	$73,948.98	$40,574.06	2026-04-01
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	21	12	—	—	$36,342.31	$116,846.69	$40,494.98	2026-04-01
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	24	12	—	—	$22,852.70	$79,875.61	$40,403.49	2026-04-01
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	25	12	—	—	$25,457.19	$88,230.07	$40,394.75	2026-04-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	23	12	—	—	$25,973.35	$72,703.30	$40,264.97	2026-04-01
840	MS_DRG	Lymphoma And Non-acute Leukemia With Mcc	29	12	—	—	$19,702.18	$163,112.63	$40,078.99	2026-04-01
974	MS_DRG	HIV With Major Related Condition With Mcc	27	12	—	—	$20,785.02	$94,447.57	$40,039.27	2026-04-01
939	MS_DRG	O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc	23	12	—	—	$26,132.52	$72,013.52	$39,882.95	2026-04-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	29	12	—	—	$10,668.66	$227,132.86	$39,551.29	2026-04-01
0268T	HCPCS	Implt/rpl Crtd Sns Dev Gen	8	3	—	—	$20,527.32	$61,731.73	$39,278.49	2026-04-01
173	MS_DRG	Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary…	23	12	—	—	$21,436.08	$69,622.00	$38,558.47	2026-04-01
K0886	HCPCS	Pwc Gp4 Hd Mult Pow S/b	1	1	—	—	$38,356.71	$38,356.71	$38,356.71	2026-04-01
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	41	13	—	—	$13,122.76	$625,800.77	$37,944.66	2026-04-01
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	29	12	—	—	$17,681.39	$82,782.20	$37,900.53	2026-04-01
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	36	12	—	—	$11,798.32	$114,997.68	$37,264.21	2026-04-01
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	25	12	—	—	$25,742.50	$81,334.57	$37,237.76	2026-04-01
K0879	HCPCS	Pwc Gp4 Hd Sing Pow Opt S/b	1	1	—	—	$37,173.80	$37,173.80	$37,173.80	2026-04-01
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	30	12	—	—	$357.71	$117,798.22	$36,902.56	2026-04-01
654	MS_DRG	Major Bladder Procedures With Cc	24	12	—	—	$20,160.60	$64,028.91	$36,649.87	2026-04-01
829	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce…	30	12	—	—	$21,338.75	$155,637.21	$36,412.15	2026-04-01
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	31	12	—	—	$4,713.64	$308,542.06	$36,390.07	2026-04-01
5231	OTHER	Level 1 Icd And Similar Procedures	4	4	—	—	$16,524.00	$62,381.34	$36,274.36	2026-04-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	31	12	—	—	$30,906.52	$140,366.59	$36,173.16	2026-04-01
625	MS_DRG	Thyroid, Parathyroid And Thyroglossal Procedures With Mcc	23	12	—	—	$21,750.81	$65,049.96	$36,026.35	2026-04-01
325	MS_DRG	Coronary Intravascular Lithotripsy Without Intraluminal Device	23	12	—	—	$23,121.35	$64,938.78	$35,964.78	2026-04-01
247	MS_DRG	Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc	4	1	—	—	$33,870.71	$37,187.51	$35,696.19	2026-04-01
665	MS_DRG	Prostatectomy With Mcc	25	12	—	—	$268.84	$77,903.85	$35,667.05	2026-04-01
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	36	12	—	—	$200.00	$127,778.20	$35,564.42	2026-04-01
406	MS_DRG	Pancreas, Liver And Shunt Procedures With Cc	27	12	—	—	$12,636.68	$63,718.06	$35,288.71	2026-04-01
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	23	12	—	—	$22,629.45	$63,654.53	$35,253.53	2026-04-01
6	MS_DRG	Liver Transplant Without Mcc	19	12	—	—	$33,395.75	$110,021.54	$35,232.52	2026-04-01
33270	HCPCS	Ins/rep Subq Defibrillator	14	5	—	—	$3,340.00	$68,439.20	$35,124.21	2026-04-01
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	39	12	—	—	$17,187.31	$122,635.57	$34,924.79	2026-04-01
749	MS_DRG	Other Female Reproductive System O.r. Procedures With Cc/Mcc	25	12	—	—	$18,491.90	$99,339.70	$34,707.86	2026-04-01
411	MS_DRG	Cholecystectomy With C.d.e. With Mcc	23	12	—	—	$23,790.42	$62,088.92	$34,386.45	2026-04-01
503	MS_DRG	Foot Procedures With Mcc	24	13	—	—	$20,101.55	$60,049.09	$34,371.83	2026-04-01
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	28	12	—	—	$12,181.16	$85,582.14	$34,260.16	2026-04-01
0426T	HCPCS	Insj/rplc Nstim Apnea Stm Ld	7	2	—	—	$20,831.33	$40,872.37	$34,124.57	2026-04-01
163	MS_DRG	Major Chest Procedures With Mcc	37	13	—	—	$28,437.34	$119,641.60	$34,053.29	2026-04-01
999	MS_DRG	Ungroupable	1	1	—	—	$33,973.60	$33,973.60	$33,973.60	2026-04-01
249	MS_DRG	Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc	4	1	—	—	$32,224.62	$35,380.23	$33,961.39	2026-04-01
0266T	HCPCS	Implt/rpl Crtd Sns Dev Total	8	3	—	—	$3,731.75	$61,731.73	$33,669.83	2026-04-01
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	28	12	—	—	$21,394.11	$82,924.54	$33,627.94	2026-04-01
849	MS_DRG	Radiotherapy	23	12	—	—	$19,513.86	$60,602.72	$33,563.36	2026-04-01
577	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Cc	23	12	—	—	$19,090.38	$60,414.39	$33,459.06	2026-04-01
800	MS_DRG	Splenic Procedures With Cc	24	12	—	—	$20,233.34	$66,109.58	$33,440.21	2026-04-01
96	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc	26	12	—	—	$18,575.44	$54,387.93	$33,400.30	2026-04-01
970	MS_DRG	HIV With Extensive O.r. Procedures Without Mcc	23	12	—	—	$18,994.60	$60,201.11	$33,340.93	2026-04-01
13	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc	23	12	—	—	$20,754.77	$60,123.96	$33,298.21	2026-04-01
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	34	12	—	—	$378.37	$96,781.93	$33,297.96	2026-04-01
33231	HCPCS	Insrt Pulse Gen W/mult Leads	15	5	—	—	$2,470.76	$68,439.20	$33,266.15	2026-04-01
33249	HCPCS	Insj/rplcmt Defib W/lead(s)	15	5	—	—	$5,129.00	$68,439.20	$33,266.15	2026-04-01
33264	HCPCS	Rmvl & Rplcmt Dfb Gen Mlt Ld	15	5	—	—	$2,501.28	$68,439.20	$33,266.15	2026-04-01
0571T	HCPCS	Insj/rplcmt Icds Ss Eltrd	11	4	—	—	$5,129.00	$68,439.20	$33,108.49	2026-04-01
982	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc	31	12	—	—	$15,585.10	$55,556.47	$32,831.94	2026-04-01
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	24	12	—	—	$20,176.19	$64,848.02	$32,802.08	2026-04-01
K0884	HCPCS	Pwc Gp4 Std Mult Pow Opt S/b	1	1	—	—	$32,704.74	$32,704.74	$32,704.74	2026-04-01
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	36	12	—	—	$14,926.30	$119,815.00	$32,672.39	2026-04-01
64656	HCPCS	Revj/rplcmt Bat Mod Sys Pg	3	3	—	—	$30,998.31	$32,703.22	$32,548.23	2026-04-01
64582	HCPCS	Opn Mpltj Hpglsl Nstm Ary Pg	11	4	—	—	$2,875.00	$63,734.58	$32,548.23	2026-04-01
33287	HCPCS	Rmv&rplcmt Phrnc Nrv Stim Pg	11	4	—	—	$3,340.00	$62,722.93	$32,548.23	2026-04-01
C8011	HCPCS	Opn Mplnt Hpgls Ns Ary Rec	3	3	—	—	$30,998.31	$32,703.22	$32,548.23	2026-04-01
C8007	HCPCS	Opn Mplnt Hpgls Ns Ary Ps Gn	3	3	—	—	$30,998.31	$32,703.22	$32,548.23	2026-04-01
L5969	HCPCS	Ak/ft Power Asst Incl Motors	1	1	—	—	$32,517.49	$32,517.49	$32,517.49	2026-04-01
0408T	HCPCS	Insj/rplc Cardiac Modulj Sys	14	5	—	—	$5,129.00	$48,151.33	$32,471.10	2026-04-01
662	MS_DRG	Minor Bladder Procedures With Mcc	25	12	—	—	$3,690.68	$70,779.19	$32,405.14	2026-04-01
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	32	12	—	—	$18,193.53	$86,725.72	$32,145.39	2026-04-01
95	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Cc	27	12	—	—	$17,314.65	$147,012.51	$32,141.37	2026-04-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	27	12	—	—	$15,320.82	$92,647.81	$32,069.43	2026-04-01
93652	HCPCS	Ablate Heart Dysrhythm Focus	4	1	—	—	$24,593.91	$37,576.03	$32,022.56	2026-04-01
93651	HCPCS	Ablate Heart Dysrhythm Focus	4	1	—	—	$24,593.91	$37,576.03	$32,022.56	2026-04-01
C1899	HCPCS	Lead, Pmkr/aicd Combination	1	1	—	—	$31,974.45	$31,974.45	$31,974.45	2026-04-01
500	MS_DRG	Soft Tissue Procedures With Mcc	28	12	—	—	$9,068.38	$71,893.27	$31,971.44	2026-04-01
61891	HCPCS	Rev/rplcmt Sk-mnt Crnl Nstm	11	4	—	—	$3,340.00	$44,186.82	$31,889.55	2026-04-01
614	MS_DRG	Adrenal And Pituitary Procedures With Cc/Mcc	26	12	—	—	$15,785.38	$130,988.43	$31,753.28	2026-04-01
69930	HCPCS	Implant Cochlear Device	20	9	—	—	$3,300.00	$70,189.64	$31,752.19	2026-04-01
793	MS_DRG	Full Term Neonate With Major Problems	19	12	—	—	$30,029.53	$94,630.91	$31,681.15	2026-04-01
D7949	HCPCS	Reconstruct Midface W/graft	1	1	—	—	$31,677.06	$31,677.06	$31,677.06	2026-04-01
5232	OTHER	Level 2 Icd And Similar Procedures	12	7	—	—	$24,312.42	$83,867.61	$31,593.22	2026-04-01
K0869	HCPCS	Pwc Gp 4 Std Cap Chair	1	1	—	—	$31,341.28	$31,341.28	$31,341.28	2026-04-01
619	MS_DRG	O.r. Procedures For Obesity With Mcc	24	12	—	—	$19,935.80	$61,862.02	$31,291.67	2026-04-01
L5856	HCPCS	Elec Knee-shin Swing/stance	4	3	—	—	$29,717.20	$53,800.58	$31,277.36	2026-04-01
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	26	12	—	—	$2,891.11	$80,077.55	$31,274.92	2026-04-01
61886	HCPCS	Implant Neurostim Arrays	18	7	—	—	$2,300.00	$61,731.73	$31,196.65	2026-04-01
397	MS_DRG	Appendix Procedures With Mcc	25	12	—	—	$200.00	$56,216.74	$31,134.29	2026-04-01
L6880	HCPCS	Elec Hand Ind Art Digits	4	3	—	—	$29,576.84	$53,546.52	$31,129.62	2026-04-01
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	28	12	—	—	$276.59	$111,338.63	$30,985.82	2026-04-01
344	MS_DRG	Minor Small And Large Bowel Procedures With Mcc	24	12	—	—	$4,906.54	$61,135.94	$30,924.40	2026-04-01
791	MS_DRG	Prematurity With Major Problems	19	12	—	—	$29,232.98	$92,123.67	$30,840.79	2026-04-01
208	MS_DRG	Respiratory System Diagnosis With Ventilator Support <=96 Hours	40	13	—	—	$13,761.79	$228,794.70	$30,806.18	2026-04-01
E0461	HCPCS	Vol Vent Noninvasive Interfa	1	1	—	—	$30,784.46	$30,784.46	$30,784.46	2026-04-01
E0450	HCPCS	Volume Vent Stationary/porta	1	1	—	—	$30,784.46	$30,784.46	$30,784.46	2026-04-01
473	MS_DRG	Cervical Spinal Fusion Without Cc/Mcc	24	12	—	—	$17,582.28	$53,711.77	$30,744.38	2026-04-01
464	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	37	12	—	—	$268.28	$93,525.16	$30,630.82	2026-04-01
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	22	12	—	—	$24,807.97	$109,779.99	$30,475.89	2026-04-01
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	25	12	—	—	$4,403.68	$64,975.08	$30,453.70	2026-04-01
C1817	HCPCS	Occldr Asd Cardioform 27mm 10f	1	1	—	—	$30,451.74	$30,451.74	$30,451.74	2026-04-01
339	MS_DRG	Appendectomy With Complicated Principal Diagnosis With Cc	4	1	—	—	$28,884.56	$31,713.09	$30,441.31	2026-04-01
33289	HCPCS	Tcat Impl Wrls P-art Prs Snr	11	4	—	—	$5,129.00	$60,465.64	$30,382.00	2026-04-01
0915T	HCPCS	Insj Perm Ccm-d Sys Pg&eltrd	7	3	—	—	$5,129.00	$33,266.15	$30,382.00	2026-04-01
959	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc	24	12	—	—	$11,373.82	$59,985.55	$30,342.50	2026-04-01
135	MS_DRG	Sinus And Mastoid Procedures With Cc/Mcc	25	12	—	—	$15,344.11	$54,703.32	$30,296.12	2026-04-01
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	27	12	—	—	$19,459.90	$87,694.58	$30,283.79	2026-04-01
S4011	HCPCS	Ivf Package	1	1	—	—	$30,258.27	$30,258.27	$30,258.27	2026-04-01
255	MS_DRG	Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc	26	12	—	—	$16,718.04	$59,363.85	$30,041.19	2026-04-01
821	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Cc	25	13	—	—	$16,122.43	$69,220.40	$29,931.57	2026-04-01
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	32	12	—	—	$618.52	$70,810.95	$29,894.46	2026-04-01
30	MS_DRG	Spinal Procedures Without Cc/Mcc	27	12	—	—	$15,809.87	$52,495.94	$29,837.71	2026-04-01
146	MS_DRG	Ear, Nose, Mouth And Throat Malignancy With Mcc	24	12	—	—	$15,249.55	$52,048.59	$29,792.39	2026-04-01
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	35	12	—	—	$20,965.15	$110,664.60	$29,723.12	2026-04-01
659	MS_DRG	Kidney And Ureter Procedures For Non-neoplasm With Mcc	28	12	—	—	$16,460.36	$110,335.26	$29,659.60	2026-04-01
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	19	12	—	—	$28,046.09	$98,172.82	$29,588.62	2026-04-01
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	29	12	—	—	$307.57	$82,226.29	$29,511.49	2026-04-01
93654	HCPCS	Ep & Ablate Ventric Tachy	16	4	—	—	$5,129.00	$106,467.76	$29,483.53	2026-04-01
93653	HCPCS	Ep & Ablate Supravent Arrhyt	16	4	—	—	$3,988.12	$106,467.76	$29,483.53	2026-04-01
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	19	12	—	—	$27,835.07	$89,158.09	$29,366.00	2026-04-01
41	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	26	12	—	—	$15,536.90	$51,247.63	$29,333.92	2026-04-01
253	MS_DRG	Other Vascular Procedures With Cc	34	12	—	—	$15,840.47	$61,376.14	$29,300.36	2026-04-01
906	MS_DRG	Hand Procedures For Injuries	25	12	—	—	$14,146.92	$107,998.45	$29,263.80	2026-04-01

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