Price Transparency Hospital negotiated rates

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

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Hospital

GRACE SURGICAL HOSPITAL

Lubbock, TX · CCN 450162 · Rates published

20,062 distinct procedures filed
17 distinct payers
454,210 rate rows
2026-04-01 last MRF observed
Data quality

374,386 of 454,210 rate rows are consumer-grade (82.4%)

79,824 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 79,796
placeholder amount (≤ $0.02) — excluded from medians 28
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/txnm/live/264021016_grace-surgical-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint cc2e8609f5f493bd… · 173,024,196 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $3,580,706.50 $3,894,479.75 $3,783,736.25 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 $570,839.96 $1,936,825.91 $1,732,143.60 nat. median
$675,122
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×
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.04 $3,504,052.08 $1,610,867.56 nat. median
$3,325,455
outlier · 0.5×
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 $542,987.65 $1,894,411.57 $1,562,654.28 nat. median
$625,184
outlier · 2.5×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $545,393.01 $1,895,724.80 $1,528,383.91 nat. median
$674,188
outlier · 2.3×
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×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $595,755.38 $2,024,136.03 $1,436,870.60 nat. median
$754,974
1.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $474,611.88 $1,955,361.41 $1,389,439.92 nat. median
$620,080
outlier · 2.2×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $515,893.64 $1,865,767.67 $1,325,269.00 nat. median
$634,511
outlier · 2.1×
Q2057
HCPCS 		Afamitresgene Autoleucel 5 $747,501.40 $2,697,170.00 $811,077.55 nat. median
$824,563
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 10 $285,503.92 $722,810.67 $358,738.60 nat. median
$370,174
1.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 5 $62,353.83 $604,800.00 $222,008.69 nat. median
$69,774
outlier · 3.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $196,360.56 $471,421.04 $210,887.24 nat. median
$265,286
0.8× median
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 $55,119.81 $287,036.19 $203,962.06 nat. median
$62,507
outlier · 3.3×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 6 $54,581.12 $320,473.36 $199,416.10 nat. median
$66,682
outlier · 3.0×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $148,722.78 $418,279.34 $192,435.27 nat. median
$202,986
0.9× median
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 $153,644.62 $187,296.06 $164,719.78 nat. median
$87,411
1.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $149,600.74 $397,048.50 $160,668.15 nat. median
$206,368
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 4 $142,789.46 $256,139.76 $154,821.87 nat. median
$76,377
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… 2 $11,101.00 $150,213.53 $138,715.89 nat. median
$63,570
outlier · 2.2×
J9226
HCPCS 		Supprelin La Implant 6 $39,938.22 $193,421.45 $137,441.33 nat. median
$60,368
outlier · 2.3×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $11,101.00 $139,081.81 $128,436.21 nat. median
$54,196
outlier · 2.4×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 $97,055.33 $288,396.80 $126,874.09 nat. median
$133,176
1.0× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $114,995.06 $140,181.42 $123,284.24 nat. median
$65,381
1.9× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 4 $108,147.40 $412,870.36 $117,066.78 nat. median
$111,989
1.0× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 $11,101.00 $125,578.17 $115,966.16 nat. median
$49,935
outlier · 2.3×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $106,048.32 $129,275.16 $113,692.60 nat. median
$62,270
1.8× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 10 $76,193.70 $211,308.53 $97,816.01 nat. median
$102,358
1.0× median
7
MS_DRG 		Lung Transplant 10 $90,740.71 $218,717.44 $97,453.67 nat. median
$122,708
0.8× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $11,101.00 $102,384.79 $94,548.05 nat. median
$44,728
outlier · 2.1×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $11,101.00 $99,226.16 $91,631.19 nat. median
$48,649
1.9× median
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 $11,101.00 $98,500.26 $90,960.85 nat. median
$39,020
outlier · 2.3×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $84,208.19 $219,269.76 $90,437.88 nat. median
$117,303
0.8× 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
C1820
HCPCS 		Chrgr Ipg Sns Axonics 1 $85,783.24 $85,783.24 $85,783.24 nat. median
$22,013
outlier · 3.9×
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 $79,854.84 $97,344.74 $85,611.01 nat. median
$48,483
1.8× median
J9600
HCPCS 		Porfimer Sodium Injection 4 $81,050.29 $114,062.22 $84,332.07 nat. median
$31,644
outlier · 2.7×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 $79,400.75 $184,436.72 $84,251.19 nat. median
$108,660
0.8× median
C1722
HCPCS 		Aicd, Single Chamber 1 $84,113.86 $84,113.86 $84,113.86 nat. median
$20,768
outlier · 4.1×
C1816
HCPCS 		Receiver/transmitter, Neuro 1 $82,097.12 $82,097.12 $82,097.12 nat. median
$13,332
outlier · 6.2×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 10 $77,224.41 $175,430.54 $81,048.32 nat. median
$98,905
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 8 $79,309.66 $85,379.27 $80,928.22 nat. median
$98,017
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 10 $11,101.00 $200,402.42 $80,208.69 nat. median
$99,019
0.8× median

Other procedures at this hospital

Browse this hospital's 20,062 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 4 — — $3,580,706.50 $3,894,479.75 $3,783,736.25 2026-04-01
C9098 HCPCS Ciltacabtagene Car Pos T 8 1 — — $1,791,273.00 $1,810,431.00 $1,791,273.00 2026-04-01
Q2040 HCPCS Tisagenlecleucel Car-pos T 12 2 — — $1,687,675.00 $2,375,068.19 $1,696,700.00 2026-04-01
C9081 HCPCS Idecabtagene Car Pos T 8 1 — — $1,615,997.90 $1,633,281.30 $1,615,997.90 2026-04-01
C9076 HCPCS Lisocabtagene Car Pos T 8 1 — — $1,580,557.66 $1,597,462.02 $1,580,557.66 2026-04-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 12 2 — — $1,436,870.60 $2,022,110.69 $1,444,554.40 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 12 5 — — $747,501.40 $2,697,170.00 $811,077.55 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 26 6 — — $595,755.38 $2,024,136.03 $1,436,870.60 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 22 5 — — $570,839.96 $1,936,825.91 $1,732,143.60 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 22 5 — — $545,393.01 $1,895,724.80 $1,528,383.91 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 22 5 — — $542,987.65 $1,894,411.57 $1,562,654.28 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 26 6 — — $515,893.64 $1,865,767.67 $1,325,269.00 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 26 6 — — $474,611.88 $1,955,361.41 $1,389,439.92 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 44 10 — — $285,503.92 $722,810.67 $358,738.60 2026-04-01
C9074 HCPCS Injection, Lumasiran 12 2 — — $205,700.00 $289,482.00 $206,800.00 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 36 10 — — $196,360.56 $471,421.04 $210,887.24 2026-04-01
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 12 2 — — $188,309.00 $265,007.61 $189,316.00 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 8 1 — — $153,644.62 $187,296.06 $164,719.78 2026-04-01
A9545 HCPCS I-131 Tositumomab, Rx, Per Dose 2 1 — — $153,339.01 $153,339.01 $153,339.01 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 36 10 — — $149,600.74 $397,048.50 $160,668.15 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 10 — — $148,722.78 $418,279.34 $192,435.27 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 16 4 — — $142,789.46 $256,139.76 $154,821.87 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 8 1 — — $114,995.06 $140,181.42 $123,284.24 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 10 4 — — $108,147.40 $412,870.36 $117,066.78 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 8 1 — — $106,048.32 $129,275.16 $113,692.60 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 10 — — $97,055.33 $288,396.80 $126,874.09 2026-04-01
7 MS_DRG Lung Transplant 36 10 — — $90,740.71 $218,717.44 $97,453.67 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 8 1 — — $88,550.00 $92,400.00 $88,550.00 2026-04-01
C1820 HCPCS Chrgr Ipg Sns Axonics 2 1 — — $85,783.24 $85,783.24 $85,783.24 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 36 10 — — $84,208.19 $219,269.76 $90,437.88 2026-04-01
C1722 HCPCS Aicd, Single Chamber 2 1 — — $84,113.86 $84,113.86 $84,113.86 2026-04-01
C1816 HCPCS Receiver/transmitter, Neuro 2 1 — — $82,097.12 $82,097.12 $82,097.12 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 16 4 — — $81,050.29 $114,062.22 $84,332.07 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 8 1 — — $79,854.84 $97,344.74 $85,611.01 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 36 10 — — $79,400.75 $184,436.72 $84,251.19 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 20 8 — — $79,309.66 $85,379.27 $80,928.22 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 36 10 — — $77,224.41 $175,430.54 $81,048.32 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 44 10 — — $76,193.70 $211,308.53 $97,816.01 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 36 10 — — $72,244.61 $178,225.62 $77,589.24 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 8 1 — — $63,423.01 $77,314.00 $67,994.73 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 36 10 — — $63,129.34 $139,586.58 $66,028.13 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 22 5 — — $62,353.83 $604,800.00 $222,008.69 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 36 10 — — $60,676.22 $154,169.53 $65,165.02 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 10 — — $58,881.75 $178,165.23 $78,147.31 2026-04-01
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 2 1 — — $58,173.44 $58,173.44 $58,173.44 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 44 10 — — $55,135.87 $165,826.20 $72,380.31 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 22 5 — — $55,119.81 $287,036.19 $203,962.06 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 28 6 — — $54,581.12 $320,473.36 $199,416.10 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 44 10 — — $53,391.85 $141,893.19 $67,506.41 2026-04-01
C1767 HCPCS Disc - Imp Ipg Vns Model-104 2 1 — — $53,130.94 $53,130.94 $53,130.94 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 40 10 — — $50,579.99 $118,810.94 $54,321.87 2026-04-01
10 MS_DRG Pancreas Transplant 36 10 — — $50,279.39 $133,437.41 $53,999.04 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 36 10 — — $50,258.37 $111,778.05 $52,566.15 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 36 10 — — $49,991.41 $132,669.18 $53,689.75 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 44 10 — — $49,961.98 $138,034.16 $63,597.12 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 10 4 — — $48,506.94 $90,533.98 $52,507.51 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 44 10 — — $48,430.27 $136,643.19 $62,466.79 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 10 4 — — $48,112.81 $89,798.38 $52,080.87 2026-04-01
K0014 HCPCS Other Power Whlchr Base 2 1 — — $48,104.96 $48,104.96 $48,104.96 2026-04-01
K0868 HCPCS Pwc Gp 4 Std Seat/back 2 1 — — $47,502.83 $47,502.83 $47,502.83 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 44 10 — — $47,164.12 $119,482.60 $61,312.01 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 8 1 — — $47,112.22 $52,117.42 $48,677.90 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 36 10 — — $46,834.21 $103,535.08 $49,002.96 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 36 10 — — $46,817.28 $112,208.20 $50,280.80 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 44 10 — — $45,904.98 $121,991.85 $56,693.48 2026-04-01
E0464 HCPCS Press Supp Vent Noninv Int 2 1 — — $45,357.83 $45,357.83 $45,357.83 2026-04-01
E0463 HCPCS Press Supp Vent Invasive Int 2 1 — — $45,357.83 $45,357.83 $45,357.83 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 44 10 — — $45,087.28 $135,526.88 $58,077.55 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 44 10 — — $42,941.06 $122,541.17 $54,228.60 2026-04-01
L8614 HCPCS Cochlear Device 2 1 — — $42,898.70 $42,898.70 $42,898.70 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 44 10 — — $42,891.32 $134,832.37 $56,786.29 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 44 10 — — $42,099.54 $127,368.67 $56,097.27 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 44 10 — — $42,087.63 $121,836.86 $55,619.82 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 36 10 — — $41,645.49 $99,501.47 $44,726.41 2026-04-01
K0891 HCPCS Pwc Gp5 Ped Mult Pow Opt S/b 2 1 — — $41,550.84 $41,550.84 $41,550.84 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 36 10 — — $41,548.80 $101,016.16 $44,622.56 2026-04-01
K0885 HCPCS Pwc Gp4 Std Mult Pow Opt Cap 2 1 — — $41,531.16 $41,531.16 $41,531.16 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 44 10 — — $41,094.05 $118,629.18 $52,359.21 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 36 10 — — $40,409.48 $91,553.06 $42,355.00 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 10 — — $40,151.62 $111,215.22 $51,243.18 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 8 1 — — $40,062.68 $44,318.94 $41,394.09 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 20 8 — — $39,987.66 $43,047.94 $40,803.73 2026-04-01
J9226 HCPCS Supprelin La Implant 28 6 — — $39,938.22 $193,421.45 $137,441.33 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 44 10 — — $39,935.80 $111,115.17 $49,548.00 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 44 10 — — $39,392.78 $92,140.53 $46,855.17 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 36 10 — — $39,270.85 $91,062.67 $41,634.11 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 44 10 — — $38,699.09 $133,770.99 $55,105.30 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 44 10 — — $38,467.17 $109,845.83 $49,629.51 2026-04-01
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 2 1 — — $38,356.71 $38,356.71 $38,356.71 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 44 10 — — $38,331.23 $108,005.58 $48,828.18 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 44 10 — — $38,216.32 $101,160.57 $48,595.96 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 36 10 — — $38,063.56 $101,016.16 $40,879.49 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 44 10 — — $37,876.96 $87,507.83 $46,979.03 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 36 10 — — $37,343.96 $86,190.53 $39,499.88 2026-04-01
K0879 HCPCS Pwc Gp4 Hd Sing Pow Opt S/b 2 1 — — $37,173.80 $37,173.80 $37,173.80 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 44 10 — — $37,093.11 $120,487.08 $49,633.11 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 44 10 — — $36,473.70 $101,755.02 $46,092.98 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 44 10 — — $36,410.64 $106,208.50 $50,054.25 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 44 10 — — $34,946.19 $99,644.04 $45,604.85 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 44 10 — — $34,604.26 $98,080.42 $44,911.62 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 44 10 — — $34,485.85 $94,303.79 $45,225.90 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 44 10 — — $34,342.20 $111,495.77 $48,444.21 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 44 10 — — $33,834.20 $96,505.02 $43,614.07 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 44 10 — — $33,663.24 $93,318.93 $44,959.21 2026-04-01
0809T HCPCS Arthrd Si Jt Prq Tfx&implt 8 1 — — $33,503.37 $46,422.98 $41,605.50 2026-04-01
0775T HCPCS Arthrd Si Jt Prq Iartic Impl 8 1 — — $33,503.37 $46,422.98 $41,605.50 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 44 10 — — $33,358.44 $95,743.81 $42,390.96 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 36 10 — — $32,942.22 $77,107.36 $35,087.42 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 44 10 — — $32,874.95 $93,001.10 $42,691.85 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 44 10 — — $32,776.86 $86,103.12 $42,879.53 2026-04-01
K0884 HCPCS Pwc Gp4 Std Mult Pow Opt S/b 2 1 — — $32,704.74 $32,704.74 $32,704.74 2026-04-01
L5969 HCPCS Ak/ft Power Asst Incl Motors 2 1 — — $32,517.49 $32,517.49 $32,517.49 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 36 10 — — $32,490.98 $81,156.04 $34,894.65 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 44 10 — — $32,361.35 $93,825.09 $41,775.04 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 44 10 — — $32,207.20 $88,614.33 $41,231.76 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 44 10 — — $32,125.22 $88,322.01 $42,017.49 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 14 2 — — $32,074.19 $61,731.73 $51,540.17 2026-04-01
C1899 HCPCS Lead, Pmkr/aicd Combination 2 1 — — $31,974.45 $31,974.45 $31,974.45 2026-04-01
245 MS_DRG Aicd Generator Procedures 44 10 — — $31,968.27 $88,900.77 $43,878.96 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 44 10 — — $31,872.27 $86,880.03 $40,588.01 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 44 10 — — $31,858.25 $86,636.75 $40,376.34 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 44 10 — — $31,733.54 $97,203.46 $42,693.65 2026-04-01
D7949 HCPCS Reconstruct Midface W/graft 2 1 — — $31,677.06 $31,677.06 $31,677.06 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 44 10 — — $31,403.51 $92,475.32 $41,386.21 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 44 10 — — $31,394.40 $80,762.88 $38,663.48 2026-04-01
K0869 HCPCS Pwc Gp 4 Std Cap Chair 2 1 — — $31,341.28 $31,341.28 $31,341.28 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 44 10 — — $31,271.07 $85,575.37 $39,647.35 2026-04-01
E0461 HCPCS Vol Vent Noninvasive Interfa 2 1 — — $30,784.46 $30,784.46 $30,784.46 2026-04-01
E0450 HCPCS Volume Vent Stationary/porta 2 1 — — $30,784.46 $30,784.46 $30,784.46 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 44 10 — — $30,779.90 $83,943.09 $38,722.79 2026-04-01
C1817 HCPCS Occldr Asd Cardioform 27mm 10f 2 1 — — $30,451.74 $30,451.74 $30,451.74 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 44 10 — — $30,321.64 $81,221.96 $38,443.93 2026-04-01
S4011 HCPCS Ivf Package 2 1 — — $30,258.27 $30,258.27 $30,258.27 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 44 10 — — $30,079.90 $84,415.90 $40,268.25 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 8 4 — — $30,068.36 $32,703.22 $31,773.27 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 8 4 — — $30,068.36 $32,703.22 $31,773.27 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 8 4 — — $30,068.36 $32,703.22 $31,773.27 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 44 10 — — $29,886.51 $74,121.90 $38,052.85 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 40 10 — — $29,714.84 $68,340.52 $31,913.14 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 44 10 — — $29,541.07 $78,571.45 $37,214.53 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 44 10 — — $29,526.36 $79,354.24 $37,238.29 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 44 10 — — $29,440.18 $72,550.43 $37,624.65 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 44 10 — — $29,405.14 $84,906.37 $39,781.56 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 44 10 — — $29,236.98 $95,767.99 $39,843.26 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 36 10 — — $29,215.96 $69,803.33 $31,377.34 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 44 10 — — $29,099.64 $76,727.28 $36,788.37 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 8 1 — — $28,879.18 $31,947.30 $29,838.93 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 10 4 — — $28,825.68 $53,800.58 $31,203.06 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 10 4 — — $28,689.53 $53,546.52 $31,055.68 2026-04-01
791 MS_DRG Prematurity With Major Problems 36 10 — — $28,440.99 $67,953.89 $30,545.04 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 42 10 — — $28,171.23 $84,250.24 $30,327.19 2026-04-01
C1772 HCPCS Infusion Pump, Programmable 2 1 — — $27,986.39 $27,986.39 $27,986.39 2026-04-01
K0890 HCPCS Pwc Gp5 Ped Sing Pow Opt S/b 2 1 — — $27,867.99 $27,867.99 $27,867.99 2026-04-01
J9266 HCPCS Pegaspargase Injection 28 6 — — $27,571.34 $99,484.21 $65,529.25 2026-04-01
K0877 HCPCS Pwc Gp4 Std Sing Pow Opt S/b 2 1 — — $27,526.57 $27,526.57 $27,526.57 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 10 — — $27,410.28 $74,331.82 $34,498.96 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 36 10 — — $27,286.26 $72,415.98 $29,304.89 2026-04-01
D7858 HCPCS Tmj Reconstruction 2 1 — — $27,203.28 $27,203.28 $27,203.28 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 44 10 — — $27,139.01 $66,513.72 $33,645.18 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 44 10 — — $27,121.60 $76,540.90 $34,917.29 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 36 10 — — $27,080.96 $65,766.37 $29,084.40 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 44 10 — — $27,055.03 $75,542.30 $34,154.00 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 44 10 — — $26,901.58 $72,972.24 $35,770.35 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 14 4 — — $26,744.68 $96,148.48 $29,013.66 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 44 10 — — $26,366.95 $76,085.75 $34,321.94 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 44 10 — — $26,189.68 $79,609.29 $34,580.56 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 44 10 — — $26,186.87 $77,185.07 $33,599.92 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 44 10 — — $26,113.31 $78,759.79 $35,436.32 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 36 10 — — $25,966.16 $58,114.21 $27,158.48 2026-04-01
342 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Cc 8 1 — — $25,772.06 $28,510.08 $26,628.54 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 44 10 — — $25,737.03 $64,619.88 $34,669.45 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 44 10 — — $25,726.52 $67,922.35 $32,292.05 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 44 10 — — $25,404.90 $70,258.95 $31,959.47 2026-04-01
332 MS_DRG Rectal Resection With Mcc 44 10 — — $25,369.87 $71,169.27 $31,671.56 2026-04-01
265 MS_DRG Aicd Lead Procedures 44 10 — — $25,352.36 $69,334.91 $32,173.24 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 44 10 — — $25,307.51 $71,351.72 $32,242.07 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 44 10 — — $25,104.31 $70,947.57 $35,745.22 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 44 10 — — $25,046.15 $76,262.32 $35,355.50 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 44 10 — — $25,020.93 $70,137.32 $32,541.28 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 44 10 — — $24,997.17 $65,244.38 $31,280.02 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 44 10 — — $24,983.79 $73,025.21 $31,633.07 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 44 10 — — $24,962.77 $69,160.30 $31,634.74 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 44 10 — — $24,938.94 $75,053.80 $33,619.74 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 52 10 — — $24,710.52 $68,397.13 $32,308.40 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 44 10 — — $24,660.07 $71,073.14 $32,761.28 2026-04-01
93651 HCPCS Ablate Heart Dysrhythm Focus 8 1 — — $24,593.91 $37,576.03 $32,022.56 2026-04-01
93652 HCPCS Ablate Heart Dysrhythm Focus 8 1 — — $24,593.91 $37,576.03 $32,022.56 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 44 10 — — $24,442.16 $65,797.63 $30,973.27 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 44 10 — — $24,435.85 $77,645.44 $34,705.38 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 16 1 — — $24,388.15 $83,047.24 $44,074.02 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 16 1 — — $24,388.15 $83,047.24 $44,074.02 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 44 10 — — $24,323.74 $66,817.81 $31,111.72 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 44 10 — — $24,259.00 $62,792.03 $30,244.82 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 44 10 — — $24,206.03 $66,095.84 $30,890.84 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 44 10 — — $24,028.84 $63,080.42 $30,170.27 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 44 10 — — $24,022.45 $66,246.90 $31,455.64 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 44 10 — — $23,873.20 $62,795.95 $31,690.91 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 44 10 — — $23,407.24 $64,075.10 $31,382.91 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 44 10 — — $23,067.41 $66,225.32 $29,818.65 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 44 10 — — $22,691.83 $65,570.05 $29,265.51 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 44 10 — — $22,666.61 $61,312.77 $28,766.81 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 44 10 — — $22,611.95 $64,624.43 $28,946.74 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 10 4 — — $22,341.00 $28,756.84 $27,257.67 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 10 4 — — $22,341.00 $28,756.84 $27,257.67 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 44 10 — — $22,330.28 $62,024.93 $28,080.90 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 44 10 — — $22,308.55 $61,556.04 $29,252.94 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 44 10 — — $22,263.71 $68,208.79 $31,701.68 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 44 10 — — $22,175.43 $63,619.94 $28,451.95 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 44 10 — — $22,141.80 $61,873.87 $27,934.78 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 44 10 — — $22,078.73 $58,240.46 $28,689.92 2026-04-01
665 MS_DRG Prostatectomy With Mcc 44 10 — — $21,869.92 $60,604.53 $30,830.66 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 44 10 — — $21,785.84 $57,936.37 $27,612.28 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 44 10 — — $21,668.20 $51,878.07 $26,973.85 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 44 10 — — $21,451.61 $58,791.75 $28,011.06 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 44 10 — — $21,253.32 $65,326.78 $29,349.92 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 44 10 — — $20,855.33 $60,327.90 $27,553.10 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 14 2 — — $20,831.33 $61,731.73 $44,551.67 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 14 2 — — $20,831.33 $61,731.73 $44,551.67 2026-04-01
0426T HCPCS Insj/rplc Nstim Apnea Stm Ld 14 2 — — $20,831.33 $40,872.37 $34,124.57 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 44 10 — — $20,717.28 $56,512.04 $26,671.84 2026-04-01
570 MS_DRG Skin Debridement With Mcc 44 10 — — $20,607.98 $57,330.15 $27,032.28 2026-04-01
0316T HCPCS Replc Vagus Nerve Pls Gen 14 2 — — $20,527.32 $61,731.73 $44,551.67 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 16 3 — — $20,527.32 $61,731.73 $39,278.49 2026-04-01
0283T HCPCS Periph Field Stimul Perm 16 3 — — $20,458.59 $55,464.27 $43,167.94 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 46 10 — — $20,231.71 $45,631.76 $28,322.55 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 44 10 — — $20,221.91 $57,218.32 $26,813.17 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 46 10 — — $19,614.41 $53,706.55 $29,314.63 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 26 4 — — $19,125.77 $68,752.75 $28,392.15 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 10 2 — — $17,845.57 $50,978.17 $49,628.45 2026-04-01
0387T HCPCS Leadless C Pm Ins/rpl Ventr 14 2 — — $17,815.81 $33,963.23 $28,356.09 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 18 4 — — $17,237.88 $83,919.61 $66,998.95 2026-04-01
C9746 HCPCS Trans Imp Balloon Cont 14 2 — — $17,236.40 $33,279.38 $27,785.14 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 16 4 — — $15,789.91 $90,943.76 $59,919.36 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 54 10 — — $15,045.29 $66,913.96 $26,724.82 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 46 10 — — $13,452.79 $128,408.57 $44,980.49 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 10 2 — — $13,169.00 $59,048.75 $54,529.04 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 10 2 — — $12,751.00 $58,766.24 $54,268.16 2026-04-01
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 18 4 — — $12,177.10 $45,629.68 $42,197.71 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 10 2 — — $11,101.00 $150,213.53 $138,715.89 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 10 2 — — $11,101.00 $139,081.81 $128,436.21 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 10 2 — — $11,101.00 $125,578.17 $115,966.16 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 10 2 — — $11,101.00 $102,384.79 $94,548.05 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 10 2 — — $11,101.00 $99,226.16 $91,631.19 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 10 2 — — $11,101.00 $98,500.26 $90,960.85 2026-04-01
215 MS_DRG Other Heart Assist System Implant 46 10 — — $11,101.00 $200,402.42 $80,208.69 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 10 2 — — $9,481.00 $35,641.53 $32,913.45 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 10 2 — — $9,330.00 $37,462.16 $34,594.73 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 46 10 — — $8,409.00 $76,454.58 $31,119.22 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 10 — — $8,145.00 $190,406.63 $73,793.02 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 46 10 — — $8,145.00 $159,210.73 $64,152.11 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 46 10 — — $8,145.00 $153,019.03 $59,173.42 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 10 — — $8,145.00 $162,985.23 $58,576.83 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 10 — — $8,145.00 $124,879.74 $49,598.40 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 46 10 — — $8,145.00 $111,762.59 $49,598.40 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 46 10 — — $8,145.00 $116,704.57 $46,245.94 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 46 10 — — $8,145.00 $115,370.49 $44,546.25 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 46 10 — — $8,145.00 $101,976.72 $41,205.91 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 10 — — $8,145.00 $110,850.76 $40,226.05 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 46 10 — — $8,145.00 $98,253.60 $38,018.93 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 46 10 — — $8,145.00 $79,283.62 $31,596.70 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 22 4 — — $8,144.00 $68,439.20 $33,108.49 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 28 5 — — $8,144.00 $48,151.33 $32,471.10 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 14 4 — — $8,144.00 $33,266.15 $30,585.94 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 22 4 — — $8,144.00 $60,465.64 $30,254.76 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 28 5 — — $8,144.00 $48,151.33 $28,051.07 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 28 5 — — $8,144.00 $48,151.33 $28,051.07 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 46 10 — — $7,599.00 $134,481.19 $51,880.95 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 46 10 — — $7,599.00 $99,210.46 $39,799.86 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 46 10 — — $7,599.00 $98,853.40 $37,725.54 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 46 10 — — $7,599.00 $81,586.87 $31,856.18 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 46 10 — — $7,599.00 $67,806.60 $26,825.66 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 22 4 — — $6,415.00 $46,680.79 $32,609.92 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 30 5 — — $5,553.47 $68,439.20 $33,266.15 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 22 4 — — $5,305.00 $95,401.06 $46,459.55 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 28 5 — — $5,305.00 $68,439.20 $35,124.21 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 22 4 — — $5,305.00 $62,722.93 $32,548.23 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 22 4 — — $5,305.00 $44,186.82 $31,889.55 2026-04-01
69930 HCPCS Implant Cochlear Device 38 7 — — $5,197.00 $70,189.64 $33,122.37 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 22 4 — — $4,566.00 $63,734.58 $32,548.23 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 14 4 — — $4,465.00 $36,307.39 $33,382.15 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 14 4 — — $4,465.00 $32,703.22 $30,068.36 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 14 4 — — $4,465.00 $32,703.22 $30,068.36 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 30 5 — — $4,008.34 $61,731.73 $44,247.19 2026-04-01
0312T HCPCS Laps Impltj Nstim Vagus 14 2 — — $3,731.75 $61,731.73 $44,551.67 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 16 3 — — $3,731.75 $61,731.73 $33,446.33 2026-04-01
61886 HCPCS Implant Neurostim Arrays 36 6 — — $3,386.00 $61,731.73 $31,196.65 2026-04-01
C9741 HCPCS Impl Pressure Sensor W/angio 14 2 — — $3,359.56 $69,172.57 $49,921.71 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 22 5 — — $3,065.01 $79,774.76 $56,686.32 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 30 5 — — $2,501.28 $68,439.20 $33,266.15 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 30 5 — — $2,470.76 $68,439.20 $33,266.15 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 30 5 — — $2,400.46 $48,151.33 $27,500.02 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 30 5 — — $2,394.24 $48,151.33 $27,500.02 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 38 7 — — $2,374.89 $61,731.73 $30,998.31 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 30 5 — — $2,307.75 $48,151.33 $27,500.02 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 30 5 — — $2,275.20 $48,151.33 $27,500.02 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 44 5 — — $1,882.28 $106,467.76 $26,913.39 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 38 5 — — $1,874.26 $106,467.76 $27,569.81 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 38 5 — — $1,408.84 $106,467.76 $27,569.81 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 30 5 — — $1,371.40 $79,364.07 $57,276.90 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 4 — — $0.04 $3,504,052.08 $1,610,867.56 2026-04-01
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