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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

STARR COUNTY MEMORIAL HOSPITAL

Rio Grande City, TX · CCN 450654 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $6,066 across 7 payers · range $5,372-$10,241

Source: https://www.starrcountyhospital.com/docs/741794256_starr-county-hospital-district_standardcharges.csv · observed 2026-05-15

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

1,480 distinct procedures filed
8 distinct payers
20,532 rate rows
2026-05-15 last MRF observed
Data quality

20,123 of 20,532 rate rows are consumer-grade (98.0%)

409 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 149
placeholder amount (≤ $0.02) — excluded from medians 113
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 81
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 33
exceeds 3× this hospital's gross charge for a DRG stay — excluded 15
exceeds 10× this hospital's gross charge — excluded from medians 13
per-diem day rate — not a per-procedure price 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.starrcountyhospital.com/docs/741794256_starrcountymemorialhospital_standardcharges.csv
Found on page https://www.starrcountyhospital.com/getpage.php?name=Hospital_Pricing
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-04
Content fingerprint 0bf4fc8e95b01e8b… · 15,059,128 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
411
MS_DRG 		Cholecystectomy With C.d.e. With Mcc 7 $27,368.44 $41,406.99 $29,241.01 nat. median
$30,156
1.0× median
982
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis W 7 $19,975.35 $23,429.00 $22,177.93 nat. median
$24,391
0.9× median
314
MS_DRG 		Other Circulatory System Diagnoses With Mcc 7 $17,392.82 $22,617.83 $19,872.67 nat. median
$20,500
1.0× median
570
MS_DRG 		Skin Debridement With Mcc 7 $16,905.77 $26,996.03 $19,431.92 nat. median
$29,069
0.7× median
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 7 $15,994.19 $23,332.87 $19,043.81 nat. median
$19,136
1.0× median
377
MS_DRG 		Gastrointestinal Hemorrhage With Mcc 7 $15,168.04 $38,014.82 $18,222.17 nat. median
$18,028
1.0× median
52
MS_DRG 		Spinal Disorders And Injuries With Cc/mcc 7 $13,959.67 $20,751.07 $18,077.88 nat. median
$18,884
1.0× median
371
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections W 7 $14,787.54 $21,843.17 $17,828.21 nat. median
$17,605
1.0× median
580
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures With C 7 $13,786.56 $20,764.31 $17,504.56 nat. median
$17,681
1.0× median
742
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 7 $14,479.02 $18,819.10 $17,268.74 nat. median
$18,578
0.9× median
571
MS_DRG 		Skin Debridement With Cc 7 $14,331.61 $21,107.99 $17,228.30 nat. median
$17,113
1.0× median
988
MS_DRG 		Non-extensive O.r. Procedures Unrelated To Principal Diagnos 7 $14,725.83 $35,400.67 $16,898.91 nat. median
$17,137
1.0× median
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional 7 $14,588.12 $31,564.57 $16,767.95 nat. median
$34,945
outlier · 0.5×
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Mcc 7 $13,976.81 $19,669.53 $16,615.46 nat. median
$16,417
1.0× median
393
MS_DRG 		Other Digestive System Diagnoses With Mcc 7 $13,921.97 $24,146.32 $16,581.02 nat. median
$16,301
1.0× median
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With 7 $14,362.82 $20,026.08 $16,508.99 nat. median
$20,254
0.8× median
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 7 $15,502.45 $21,725.39 $16,318.37 nat. median
$16,167
1.0× median
70
MS_DRG 		Nonspecific Cerebrovascular Disorders With Mcc 7 $14,146.56 $17,562.58 $16,229.45 nat. median
$17,146
0.9× median
196
MS_DRG 		Interstitial Lung Disease With Mcc 7 $14,119.10 $19,206.39 $16,228.85 nat. median
$18,512
0.9× median
865
MS_DRG 		Viral Illness With Mcc 7 $11,940.58 $25,512.47 $15,856.24 nat. median
$14,970
1.1× median
811
MS_DRG 		Red Blood Cell Disorders With Mcc 7 $11,486.37 $29,385.90 $15,181.71 nat. median
$14,291
1.1× median
419
MS_DRG 		Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 7 $11,199.28 $22,677.84 $14,905.45 nat. median
$14,273
1.0× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And 7 $10,405.69 $17,995.75 $14,688.71 nat. median
$13,243
1.1× median
167
MS_DRG 		Other Respiratory System O.r. Procedures With Cc 7 $12,663.81 $18,587.00 $14,556.10 nat. median
$18,744
0.8× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 7 $11,428.10 $28,162.00 $14,536.58 nat. median
$13,455
1.1× median
553
MS_DRG 		Bone Diseases And Arthropathies With Mcc 7 $11,016.74 $22,005.52 $14,406.71 nat. median
$13,440
1.1× median
975
MS_DRG 		HIV With Major Related Condition With Cc 7 $11,500.94 $17,638.72 $14,397.38 nat. median
$13,992
1.0× median
291
MS_DRG 		Heart Failure And Shock With Mcc 7 $11,533.51 $21,671.21 $14,317.00 nat. median
$13,359
1.1× median
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 7 $10,583.95 $17,600.67 $14,205.79 nat. median
$13,072
1.1× median
743
MS_DRG 		Uterine And Adnexa Procedures For Non-malignancy Without Cc/ 7 $9,842.65 $17,161.20 $14,007.72 nat. median
$12,945
1.1× median
813
MS_DRG 		Coagulation Disorders 7 $12,169.73 $16,531.50 $13,988.20 nat. median
$15,573
0.9× median
308
MS_DRG 		Cardiac Arrhythmia And Conduction Disorders With Mcc 7 $10,178.59 $20,978.42 $13,744.35 nat. median
$12,590
1.1× median
908
MS_DRG 		Other O.r. Procedures For Injuries With Cc 7 $11,492.36 $20,004.64 $13,209.61 nat. median
$20,272
0.7× median
581
MS_DRG 		Other Skin, Subcutaneous Tissue And Breast Procedures Withou 7 $10,753.64 $15,923.93 $13,194.52 nat. median
$14,735
0.9× median
200
MS_DRG 		Pneumothorax With Cc 7 $9,273.60 $15,928.72 $12,993.03 nat. median
$11,584
1.1× median
596
MS_DRG 		Major Skin Disorders Without Mcc 7 $8,348.04 $21,554.97 $12,872.48 nat. median
$11,121
1.2× median
300
MS_DRG 		Peripheral Vascular Disorders With Cc 7 $8,806.53 $14,143.66 $12,534.91 nat. median
$11,280
1.1× median
637
MS_DRG 		Diabetes With Mcc 7 $10,859.91 $15,876.63 $12,482.66 nat. median
$14,602
0.9× median
644
MS_DRG 		Endocrine Disorders With Cc 7 $8,810.82 $15,496.27 $12,459.86 nat. median
$10,989
1.1× median
372
MS_DRG 		Major Gastrointestinal Disorders And Peritoneal Infections W 7 $8,762.83 $16,399.88 $12,431.15 nat. median
$11,013
1.1× median
815
MS_DRG 		Reticuloendothelial And Immunity Disorders With Cc 7 $8,679.70 $25,676.12 $12,380.93 nat. median
$10,828
1.1× median
433
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Cc 7 $8,844.24 $13,087.75 $12,366.65 nat. median
$11,345
1.1× median
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tp 7 $8,807.39 $19,804.08 $12,354.37 nat. median
$11,101
1.1× median
770
MS_DRG 		Abortion With D&c, Aspiration Curettage Or Hysterotomy 7 $6,738.59 $16,337.69 $12,299.84 nat. median
$10,652
1.2× median
602
MS_DRG 		Cellulitis With Mcc 7 $10,594.71 $15,762.80 $12,177.83 nat. median
$14,706
0.8× median
378
MS_DRG 		Gastrointestinal Hemorrhage With Cc 7 $8,468.02 $27,904.33 $12,141.96 nat. median
$10,606
1.1× median
202
MS_DRG 		Bronchitis And Asthma With Cc/mcc 7 $8,124.36 $15,795.30 $12,073.80 nat. median
$10,254
1.2× median
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 7 $8,316.33 $14,721.72 $12,017.10 nat. median
$10,430
1.2× median
552
MS_DRG 		Medical Back Problems Without Mcc 7 $7,814.98 $24,526.56 $12,002.75 nat. median
$10,356
1.2× median
920
MS_DRG 		Complications Of Treatment With Cc 7 $8,634.28 $13,215.81 $11,989.53 nat. median
$10,854
1.1× median

Other procedures at this hospital

Browse this hospital's 1,480 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
             
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 8 7 $47,594.24 $47,594.24 $27,368.44 $41,406.99 $29,241.01 2026-05-15
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis W 8 7 $22,960.17 $22,960.17 $19,975.35 $23,429.00 $22,177.93 2026-05-15
314 MS_DRG Other Circulatory System Diagnoses With Mcc 8 7 $22,617.83 $22,617.83 $17,392.82 $22,617.83 $19,872.67 2026-05-15
570 MS_DRG Skin Debridement With Mcc 8 7 $19,431.92 $19,431.92 $16,905.77 $26,996.03 $19,431.92 2026-05-15
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 8 7 $26,263.11 $26,263.11 $15,994.19 $23,332.87 $19,043.81 2026-05-15
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 8 7 $43,695.20 $43,695.20 $15,168.04 $38,014.82 $18,222.17 2026-05-15
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 8 7 $20,751.07 $20,751.07 $13,959.67 $20,751.07 $18,077.88 2026-05-15
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections W 8 7 $22,346.22 $22,346.22 $14,787.54 $21,843.17 $17,828.21 2026-05-15
580 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With C 8 7 $20,764.31 $20,764.31 $13,786.56 $20,764.31 $17,504.56 2026-05-15
742 MS_DRG Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 8 7 $17,268.74 $17,268.74 $14,479.02 $18,819.10 $17,268.74 2026-05-15
571 MS_DRG Skin Debridement With Cc 8 7 $22,581.23 $22,581.23 $14,331.61 $21,107.99 $17,228.30 2026-05-15
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnos 8 7 $40,690.42 $40,690.42 $14,725.83 $35,400.67 $16,898.91 2026-05-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional 8 7 $16,767.95 $16,767.95 $14,588.12 $31,564.57 $16,767.95 2026-05-15
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 8 7 $19,669.53 $19,669.53 $13,976.81 $19,669.53 $16,615.46 2026-05-15
393 MS_DRG Other Digestive System Diagnoses With Mcc 8 7 $27,754.39 $27,754.39 $13,921.97 $24,146.32 $16,581.02 2026-05-15
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With 8 7 $16,508.99 $16,508.99 $14,362.82 $20,026.08 $16,508.99 2026-05-15
177 MS_DRG Respiratory Infections And Inflammations With Mcc 8 7 $24,971.71 $24,971.71 $15,502.45 $21,725.39 $16,318.37 2026-05-15
70 MS_DRG Nonspecific Cerebrovascular Disorders With Mcc 8 7 $16,260.41 $16,260.41 $14,146.56 $17,562.58 $16,229.45 2026-05-15
196 MS_DRG Interstitial Lung Disease With Mcc 8 7 $16,228.85 $16,228.85 $14,119.10 $19,206.39 $16,228.85 2026-05-15
865 MS_DRG Viral Illness With Mcc 8 7 $29,324.68 $29,324.68 $11,940.58 $25,512.47 $15,856.24 2026-05-15
811 MS_DRG Red Blood Cell Disorders With Mcc 8 7 $33,776.90 $33,776.90 $11,486.37 $29,385.90 $15,181.71 2026-05-15
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 8 7 $26,066.48 $26,066.48 $11,199.28 $22,677.84 $14,905.45 2026-05-15
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And 8 7 $18,764.00 $18,764.00 $10,405.69 $17,995.75 $14,688.71 2026-05-15
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 8 7 $14,556.10 $14,556.10 $12,663.81 $18,587.00 $14,556.10 2026-05-15
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 8 7 $32,370.11 $32,370.11 $11,428.10 $28,162.00 $14,536.58 2026-05-15
553 MS_DRG Bone Diseases And Arthropathies With Mcc 8 7 $25,293.70 $25,293.70 $11,016.74 $22,005.52 $14,406.71 2026-05-15
975 MS_DRG HIV With Major Related Condition With Cc 8 7 $19,459.21 $19,459.21 $11,500.94 $17,638.72 $14,397.38 2026-05-15
291 MS_DRG Heart Failure And Shock With Mcc 8 7 $24,909.44 $24,909.44 $11,533.51 $21,671.21 $14,317.00 2026-05-15
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 8 7 $20,230.65 $20,230.65 $10,583.95 $17,600.67 $14,205.79 2026-05-15
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/ 8 7 $18,265.71 $18,265.71 $9,842.65 $17,161.20 $14,007.72 2026-05-15
813 MS_DRG Coagulation Disorders 8 7 $13,988.20 $13,988.20 $12,169.73 $16,531.50 $13,988.20 2026-05-15
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 8 7 $24,113.13 $24,113.13 $10,178.59 $20,978.42 $13,744.35 2026-05-15
908 MS_DRG Other O.r. Procedures For Injuries With Cc 8 7 $13,209.61 $13,209.61 $11,492.36 $20,004.64 $13,209.61 2026-05-15
581 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures Withou 8 7 $13,194.52 $13,194.52 $10,753.64 $15,923.93 $13,194.52 2026-05-15
200 MS_DRG Pneumothorax With Cc 8 7 $18,308.87 $18,308.87 $9,273.60 $15,928.72 $12,993.03 2026-05-15
596 MS_DRG Major Skin Disorders Without Mcc 8 7 $24,775.83 $24,775.83 $8,348.04 $21,554.97 $12,872.48 2026-05-15
300 MS_DRG Peripheral Vascular Disorders With Cc 8 7 $14,143.66 $14,143.66 $8,806.53 $14,143.66 $12,534.91 2026-05-15
637 MS_DRG Diabetes With Mcc 8 7 $12,482.66 $12,482.66 $10,859.91 $15,876.63 $12,482.66 2026-05-15
644 MS_DRG Endocrine Disorders With Cc 8 7 $17,811.80 $17,811.80 $8,810.82 $15,496.27 $12,459.86 2026-05-15
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections W 8 7 $18,850.44 $18,850.44 $8,762.83 $16,399.88 $12,431.15 2026-05-15
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 8 7 $29,512.78 $29,512.78 $8,679.70 $25,676.12 $12,380.93 2026-05-15
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 8 7 $13,087.75 $13,087.75 $8,844.24 $13,087.75 $12,366.65 2026-05-15
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tp 8 7 $22,763.31 $22,763.31 $8,807.39 $19,804.08 $12,354.37 2026-05-15
770 MS_DRG Abortion With D&c, Aspiration Curettage Or Hysterotomy 8 7 $18,778.95 $18,778.95 $6,738.59 $16,337.69 $12,299.84 2026-05-15
602 MS_DRG Cellulitis With Mcc 8 7 $12,177.83 $12,177.83 $10,594.71 $15,762.80 $12,177.83 2026-05-15
378 MS_DRG Gastrointestinal Hemorrhage With Cc 8 7 $32,073.94 $32,073.94 $8,468.02 $27,904.33 $12,141.96 2026-05-15
202 MS_DRG Bronchitis And Asthma With Cc/mcc 8 7 $18,155.52 $18,155.52 $8,124.36 $15,795.30 $12,073.80 2026-05-15
315 MS_DRG Other Circulatory System Diagnoses With Cc 8 7 $16,747.32 $16,747.32 $8,316.33 $14,721.72 $12,017.10 2026-05-15
552 MS_DRG Medical Back Problems Without Mcc 8 7 $28,191.45 $28,191.45 $7,814.98 $24,526.56 $12,002.75 2026-05-15
920 MS_DRG Complications Of Treatment With Cc 8 7 $13,215.81 $13,215.81 $8,634.28 $13,215.81 $11,989.53 2026-05-15
386 MS_DRG Inflammatory Bowel Disease With Cc 8 7 $13,495.94 $13,495.94 $8,443.16 $13,495.94 $11,925.93 2026-05-15
643 MS_DRG Endocrine Disorders With Mcc 8 7 $11,746.37 $11,746.37 $10,219.34 $17,424.37 $11,746.37 2026-05-15
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic 8 7 $12,896.24 $12,896.24 $7,999.24 $12,896.24 $11,730.67 2026-05-15
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 8 7 $15,988.22 $15,988.22 $8,301.76 $14,333.02 $11,699.92 2026-05-15
812 MS_DRG Red Blood Cell Disorders Without Mcc 8 7 $20,804.74 $20,804.74 $7,461.90 $18,100.12 $11,693.47 2026-05-15
158 MS_DRG Dental And Oral Diseases With Cc 8 7 $14,348.24 $14,348.24 $7,426.76 $14,251.24 $11,633.19 2026-05-15
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 8 7 $13,623.00 $13,623.00 $7,766.13 $12,344.35 $11,618.79 2026-05-15
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 8 7 $11,558.63 $11,558.63 $10,056.01 $20,729.00 $11,558.63 2026-05-15
642 MS_DRG Inborn And Other Disorders Of Metabolism 8 7 $11,538.53 $11,538.53 $10,038.52 $15,768.72 $11,538.53 2026-05-15
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 8 7 $20,917.32 $20,917.32 $7,382.20 $18,198.07 $11,514.07 2026-05-15
683 MS_DRG Renal Failure With Cc 8 7 $21,474.99 $21,474.99 $7,689.86 $18,683.24 $11,389.20 2026-05-15
349 MS_DRG Anal And Stomal Procedures Without Cc/mcc 8 7 $16,060.24 $16,060.24 $8,406.31 $13,972.41 $11,351.89 2026-05-15
189 MS_DRG Pulmonary Edema And Respiratory Failure 8 7 $11,312.75 $11,312.75 $9,842.09 $14,388.78 $11,312.75 2026-05-15
101 MS_DRG Seizures Without Mcc 8 7 $11,994.57 $11,994.57 $7,566.45 $11,994.57 $11,291.98 2026-05-15
819 MS_DRG Other Antepartum Diagnoses With O.r. Procedures Without Cc/m 8 7 $20,647.13 $20,647.13 $6,838.00 $17,963.00 $11,275.11 2026-05-15
384 MS_DRG Uncomplicated Peptic Ulcer Without Mcc 8 7 $21,497.93 $21,497.93 $7,457.61 $18,703.20 $11,238.51 2026-05-15
47564 HCPCS Lap Surg Chlistcmy W Explr Cmmn Dct 9 8 $22,892.00 $22,892.00 $1,945.52 $19,916.04 $11,207.70 2026-05-15
292 MS_DRG Heart Failure And Shock With Cc 8 7 $33,863.91 $33,863.91 $7,760.14 $29,461.60 $11,196.87 2026-05-15
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 8 7 $11,176.82 $11,176.82 $9,723.83 $13,444.91 $11,176.82 2026-05-15
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 8 7 $12,745.46 $12,745.46 $6,718.88 $12,745.46 $11,171.78 2026-05-15
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 8 7 $20,492.38 $20,492.38 $7,651.30 $17,828.37 $11,153.83 2026-05-15
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 8 7 $16,629.65 $16,629.65 $7,260.50 $14,467.80 $11,140.90 2026-05-15
446 MS_DRG Disorders Of The Biliary Tract Without Cc/mcc 8 7 $16,906.56 $16,906.56 $6,964.84 $14,708.71 $11,041.17 2026-05-15
855 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures Witho 8 7 $11,006.53 $11,006.53 $9,575.68 $16,323.80 $11,006.53 2026-05-15
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 8 7 $39,366.93 $39,366.93 $7,615.30 $34,249.23 $10,887.60 2026-05-15
948 MS_DRG Signs And Symptoms Without Mcc 8 7 $24,243.24 $24,243.24 $6,681.17 $21,091.62 $10,848.85 2026-05-15
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 8 7 $12,385.73 $12,385.73 $6,777.16 $12,385.73 $10,844.51 2026-05-15
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective 8 7 $11,365.03 $11,365.03 $6,785.73 $11,396.79 $10,788.23 2026-05-15
694 MS_DRG Urinary Stones Without Mcc 8 7 $13,357.37 $13,357.37 $6,345.23 $13,124.71 $10,713.94 2026-05-15
796 MS_DRG Vaginal Delivery With Sterilization And/or D&c With Mcc 8 7 $10,697.52 $10,697.52 $6,000.00 $13,883.21 $10,697.52 2026-05-15
603 MS_DRG Cellulitis Without Mcc 8 7 $10,641.26 $10,641.26 $7,228.80 $11,694.65 $10,641.26 2026-05-15
682 MS_DRG Renal Failure With Mcc 8 7 $10,628.41 $10,628.41 $9,246.72 $16,204.07 $10,628.41 2026-05-15
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 8 7 $10,560.99 $10,560.99 $6,746.30 $11,393.11 $10,534.60 2026-05-15
72 MS_DRG Nonspecific Cerebrovascular Disorders Without Cc/mcc 8 7 $13,182.22 $13,182.22 $6,328.95 $12,900.47 $10,530.96 2026-05-15
179 MS_DRG Respiratory Infections And Inflammations Without Cc/mcc 8 7 $12,063.65 $12,063.65 $7,422.48 $12,063.65 $10,508.86 2026-05-15
149 MS_DRG Dysequilibrium 8 7 $21,760.92 $21,760.92 $6,260.39 $18,932.00 $10,497.95 2026-05-15
566 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses 8 7 $13,120.44 $13,120.44 $6,493.49 $12,839.80 $10,481.44 2026-05-15
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 8 7 $10,403.36 $10,403.36 $8,906.80 $12,821.09 $10,403.36 2026-05-15
153 MS_DRG Otitis Media And Uri Without Mcc 8 7 $31,205.29 $31,205.29 $6,053.85 $27,148.60 $10,401.80 2026-05-15
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 8 7 $15,679.76 $15,679.76 $6,481.49 $13,641.39 $10,383.85 2026-05-15
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections W 8 7 $16,378.61 $16,378.61 $6,357.23 $14,249.39 $10,324.29 2026-05-15
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 8 7 $10,320.53 $10,320.53 $8,978.86 $13,833.70 $10,320.53 2026-05-15
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic 8 7 $10,317.39 $10,317.39 $8,976.13 $18,522.71 $10,317.39 2026-05-15
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 8 7 $20,539.89 $20,539.89 $6,323.80 $17,869.70 $10,293.44 2026-05-15
313 MS_DRG Chest Pain 8 7 $13,985.29 $13,985.29 $6,130.12 $12,582.13 $10,271.19 2026-05-15
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 8 7 $19,941.33 $19,941.33 $6,220.11 $17,348.96 $10,269.04 2026-05-15
305 MS_DRG Hypertension Without Mcc 8 7 $11,247.34 $11,247.34 $6,268.96 $11,247.34 $10,259.99 2026-05-15
434 MS_DRG Cirrhosis And Alcoholic Hepatitis Without Cc/mcc 8 7 $13,198.45 $13,198.45 $5,483.94 $12,516.17 $10,217.37 2026-05-15
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Dis 8 7 $10,264.23 $10,264.23 $6,526.06 $11,019.86 $10,214.08 2026-05-15
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 8 7 $10,149.40 $10,149.40 $8,829.98 $15,410.25 $10,149.40 2026-05-15
443 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic 8 7 $16,623.15 $16,623.15 $5,830.17 $14,462.14 $10,125.52 2026-05-15
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mc 8 7 $15,693.51 $15,693.51 $6,144.69 $13,653.35 $10,015.72 2026-05-15
786 MS_DRG Cesarean Section Without Sterilization With Mcc 8 7 $9,993.49 $9,993.49 $8,000.00 $17,449.49 $9,993.49 2026-05-15
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 8 7 $10,193.46 $10,193.46 $6,131.84 $10,591.15 $9,980.99 2026-05-15
J3101 HCPCS Tnkase IV Powder For Solution 50mg 9 8 $13,679.30 $13,679.30 $9,190.88 $13,679.30 $9,964.85 2026-05-15
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 8 7 $11,592.72 $11,592.72 $5,945.87 $11,592.72 $9,912.40 2026-05-15
916 MS_DRG Allergic Reactions Without Mcc 8 7 $15,317.40 $15,317.40 $5,426.52 $13,326.14 $9,885.83 2026-05-15
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 8 7 $27,780.03 $27,780.03 $6,077.84 $24,168.63 $9,711.47 2026-05-15
297 MS_DRG Cardiac Arrest, Unexplained With Cc 8 7 $11,692.01 $11,692.01 $6,196.11 $11,692.01 $9,654.05 2026-05-15
389 MS_DRG Gastrointestinal Obstruction With Cc 8 7 $9,452.39 $9,452.39 $7,196.23 $11,095.24 $9,452.39 2026-05-15
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 8 7 $9,362.53 $9,362.53 $8,145.40 $19,805.08 $9,362.53 2026-05-15
639 MS_DRG Diabetes Without Cc/mcc 8 7 $10,207.46 $10,207.46 $5,255.12 $10,207.46 $9,323.14 2026-05-15
178 MS_DRG Respiratory Infections And Inflammations With Cc 8 7 $9,257.63 $9,257.63 $8,054.14 $12,471.48 $9,257.63 2026-05-15
293 MS_DRG Heart Failure And Shock Without Cc/mcc 8 7 $10,979.48 $10,979.48 $5,615.92 $10,979.48 $9,166.10 2026-05-15
304 MS_DRG Hypertension With Mcc 8 7 $8,990.89 $8,990.89 $7,822.07 $14,053.21 $8,990.89 2026-05-15
445 MS_DRG Disorders Of The Biliary Tract With Cc 8 7 $8,765.96 $8,765.96 $7,626.39 $13,346.61 $8,765.96 2026-05-15
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And 8 7 $8,726.53 $8,726.53 $6,484.06 $11,009.50 $8,726.53 2026-05-15
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 8 7 $8,716.43 $8,716.43 $5,275.69 $9,850.55 $8,716.43 2026-05-15
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without M 8 7 $8,610.21 $8,610.21 $7,490.88 $12,028.01 $8,610.21 2026-05-15
311 MS_DRG Angina Pectoris 8 7 $8,541.33 $8,541.33 $5,870.45 $10,445.55 $8,541.33 2026-05-15
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 8 7 $8,525.89 $8,525.89 $5,845.60 $9,903.03 $8,525.89 2026-05-15
868 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Cc 8 7 $8,387.28 $8,387.28 $7,296.93 $12,878.74 $8,387.28 2026-05-15
864 MS_DRG Fever And Inflammatory Conditions 8 7 $8,385.79 $8,385.79 $7,262.22 $11,818.84 $8,385.79 2026-05-15
100 MS_DRG Seizures With Mcc 8 7 $8,382.85 $8,382.85 $7,293.08 $19,573.00 $8,382.85 2026-05-15
310 MS_DRG Cardiac Arrhythmia And Conduction Disorders Without Cc/mcc 8 7 $8,256.21 $8,256.21 $4,793.20 $9,441.82 $8,256.21 2026-05-15
787 MS_DRG Cesarean Section Without Sterilization With Cc 8 7 $8,127.46 $8,127.46 $7,070.89 $13,512.18 $8,127.46 2026-05-15
793 MS_DRG Full Term Neonate With Major Problems 4 4 $7,968.42 $7,968.42 $6,932.53 $7,968.42 $7,968.42 2026-05-15
798 MS_DRG Vaginal Delivery With Sterilization And/or D&c Without Cc/mc 8 7 $7,889.72 $7,889.72 $6,000.00 $12,331.79 $7,889.72 2026-05-15
638 MS_DRG Diabetes With Cc 8 7 $7,776.00 $7,776.00 $6,765.12 $11,881.66 $7,776.00 2026-05-15
785 MS_DRG Cesarean Section With Sterilization Without Cc/mcc 8 7 $7,514.99 $7,514.99 $6,538.04 $12,336.97 $7,514.99 2026-05-15
784 MS_DRG Cesarean Section With Sterilization With Cc 8 7 $7,400.93 $7,400.93 $6,438.81 $13,093.08 $7,400.93 2026-05-15
299 MS_DRG Peripheral Vascular Disorders With Mcc 8 7 $7,390.84 $7,390.84 $6,430.03 $17,325.32 $7,390.84 2026-05-15
684 MS_DRG Renal Failure Without Cc/mcc 8 7 $7,300.42 $7,300.42 $5,273.12 $9,694.59 $7,300.42 2026-05-15
696 MS_DRG Kidney And Urinary Tract Signs And Symptoms Without Mcc 8 7 $7,104.54 $7,104.54 $5,822.46 $10,350.19 $7,104.54 2026-05-15
885 MS_DRG Psychoses 8 7 $6,950.96 $6,950.96 $6,047.34 $15,581.73 $6,950.96 2026-05-15
783 MS_DRG Cesarean Section With Sterilization With Mcc 5 5 $6,929.86 $6,929.86 $6,028.98 $6,929.86 $6,929.86 2026-05-15
539 MS_DRG Osteomyelitis With Mcc 8 7 $6,827.54 $6,827.54 $5,939.96 $19,816.19 $6,827.54 2026-05-15
49595 HCPCS Rpr Aa Hrn 1st > 10 Rdc 9 8 $9,889.00 $9,889.00 $1,186.09 $9,394.55 $6,825.76 2026-05-15
49593 HCPCS Rpr Aa Hrn 1st 3-10 Rdc 9 8 $9,889.00 $9,889.00 $1,186.09 $9,394.55 $6,825.76 2026-05-15
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 8 7 $6,806.40 $6,806.40 $5,921.57 $16,138.29 $6,806.40 2026-05-15
600 MS_DRG Non-malignant Breast Disorders With Cc/mcc 8 7 $6,778.31 $6,778.31 $5,897.13 $12,956.35 $6,778.31 2026-05-15
312 MS_DRG Syncope And Collapse 8 7 $6,775.10 $6,775.10 $5,894.34 $11,699.83 $6,775.10 2026-05-15
805 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Mcc 8 7 $6,669.20 $6,669.20 $5,802.20 $13,234.26 $6,669.20 2026-05-15
44970 HCPCS Laparoscopy Surgical Appendectomy 9 8 $16,493.00 $16,493.00 $6,055.48 $16,493.00 $6,565.41 2026-05-15
47562 HCPCS Laparoscopic Cholecystectomy 9 8 $16,493.00 $16,493.00 $6,055.48 $16,493.00 $6,565.41 2026-05-15
49329 HCPCS Unlisted Laparoscopic Px Abd Pertoneum & 8 7 $16,493.00 $16,493.00 $6,055.48 $16,493.00 $6,469.80 2026-05-15
58661 HCPCS Lap Surg W Remov Total Adnexal Struct 9 8 $16,493.00 $16,493.00 $1,945.52 $16,493.00 $6,374.18 2026-05-15
58662 HCPCS Lap Fulg/exc Les Ovary 9 8 $16,493.00 $16,493.00 $1,945.52 $16,493.00 $6,374.18 2026-05-15
49320 HCPCS Laparoscopy Adb.dx 9 8 $16,493.00 $16,493.00 $1,945.52 $16,493.00 $6,374.18 2026-05-15
58660 HCPCS Laparoscopic Lysis Of Adhesn Sep 9 8 $16,493.00 $16,493.00 $1,945.52 $16,493.00 $6,374.18 2026-05-15
59151 HCPCS Lap Trt Ectpic Prgncy W Salpctmy Oophrct 9 8 $16,493.00 $16,493.00 $1,945.52 $16,493.00 $6,374.18 2026-05-15
49614 HCPCS Rpr Aa Hrn Rcr < 3 Ncr/strn 9 8 $16,493.00 $16,493.00 $1,945.52 $15,668.35 $6,374.18 2026-05-15
49594 HCPCS Rpr Aa Hrn 1st 3-10 Ncr/strn 9 8 $16,493.00 $16,493.00 $1,186.09 $15,668.35 $6,374.18 2026-05-15
49592 HCPCS Rpr Aa Hrn 1st < 3 Ncr/strn 9 8 $16,493.00 $16,493.00 $1,186.09 $15,668.35 $6,374.18 2026-05-15
58670 HCPCS Lap Surg W Fulguratn Of Oviducts 9 8 $16,493.00 $16,493.00 $1,945.52 $16,493.00 $6,374.18 2026-05-15
47610 HCPCS Cholecystectomy W/explr Common Duct 9 8 $6,648.00 $6,648.00 $5,539.79 $6,648.00 $6,093.90 2026-05-15
807 MS_DRG Vaginal Delivery Without Sterilization Or D&c Without Cc/mcc 8 7 $6,065.67 $6,065.67 $5,277.13 $10,240.80 $6,065.67 2026-05-15
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, 8 7 $5,814.15 $5,814.15 $5,058.31 $11,876.49 $5,814.15 2026-05-15
776 MS_DRG Postpartum And Post Abortion Diagnoses Without O.r. Procedur 8 7 $5,610.37 $5,610.37 $4,881.02 $10,096.68 $5,610.37 2026-05-15
47605 HCPCS Cholecystectomy W/cholangiogram 9 8 $5,954.00 $5,954.00 $4,961.71 $5,954.00 $5,457.85 2026-05-15
58925 HCPCS Ovarian Cystectomy Unil Or Bilat 9 8 $14,217.00 $14,217.00 $5,010.68 $14,217.00 $5,432.63 2026-05-15
57260 HCPCS Combined Anteroposterior Colporrhaphy 9 8 $14,217.00 $14,217.00 $1,572.80 $14,217.00 $5,274.40 2026-05-15
806 MS_DRG Vaginal Delivery Without Sterilization Or D&c With Cc 8 7 $5,184.01 $5,184.01 $4,510.09 $10,830.62 $5,184.01 2026-05-15
69140 HCPCS Excis Exostosis External Auditory Canal 9 8 $4,900.00 $4,900.00 $4,263.00 $6,428.90 $4,900.00 2026-05-15
32601 HCPCS Thoracoscopy Diag Wo Bx 9 8 $4,900.00 $4,900.00 $4,263.00 $6,565.41 $4,900.00 2026-05-15
789 MS_DRG Neonates, Died Or Transferred To Another Acute Care Facility 4 4 $4,858.58 $4,858.58 $4,226.96 $4,858.58 $4,858.58 2026-05-15
J2997 HCPCS Activase(alteplase) 50mg IV Kit 27 8 $8,710.00 $8,710.00 $177.06 $11,164.96 $4,799.20 2026-05-15
J7169 HCPCS Andexxa (FXa Recombinant) 200mg Injectio 9 8 $4,725.00 $4,725.00 $4,110.75 $23,831.45 $4,725.00 2026-05-15
J1162 HCPCS Digoxin Immune Fab(digibind)38mg Vial 9 8 $4,650.00 $4,650.00 $4,045.50 $5,215.56 $4,650.00 2026-05-15
794 MS_DRG Neonate With Other Significant Problems 4 4 $4,632.17 $4,632.17 $4,029.99 $4,632.17 $4,632.17 2026-05-15
J0180 HCPCS Agalsidase Beta Special Order 35mg 18 8 $5,880.73 $5,880.73 $1,059.38 $10,291.05 $4,443.06 2026-05-15
768 MS_DRG Vaginal Delivery With O.r. Procedures Except Sterilization A 5 5 $4,198.00 $4,198.00 $3,652.26 $4,198.00 $4,198.00 2026-05-15
49255 HCPCS Omenectomy Epiploectomy Resect Omen 9 8 $4,191.00 $4,191.00 $3,492.86 $7,030.53 $4,191.00 2026-05-15
19120 HCPCS Excis Of Cyst Fibroadenoma 1+ Les 9 8 $10,895.00 $10,895.00 $992.57 $10,895.00 $4,128.29 2026-05-15
Q0247 HCPCS Sotrovimab 500mg IV Injection 9 8 $4,410.00 $4,410.00 $3,836.70 $4,410.00 $4,123.35 2026-05-15
47100 HCPCS Biopsy Of Liver Wedge 9 8 $4,470.00 $4,470.00 $3,724.70 $4,470.00 $4,097.35 2026-05-15
J0630 HCPCS Calcitonin Salmon 400 I.u./2ml(miacalcin 9 8 $4,295.00 $4,295.00 $3,736.65 $4,295.00 $4,015.82 2026-05-15
47531 HCPCS Cholangio T-t 9 8 $7,148.00 $7,148.00 $3,586.30 $7,148.00 $3,888.30 2026-05-15
49591 HCPCS Rpr Aa Hrn 1st < 3 Cm Rdc 9 8 $9,889.00 $9,889.00 $1,186.09 $9,394.55 $3,775.05 2026-05-15
49507 HCPCS Rpr I/hern Init Block >5 Yr 9 8 $9,889.00 $9,889.00 $1,186.09 $9,889.00 $3,775.05 2026-05-15
49505 HCPCS Repr Init Ing Hernia >5yrs 9 8 $10,300.00 $10,300.00 $1,186.09 $10,300.00 $3,775.05 2026-05-15
49000 HCPCS Expl Lapartmy Explr Celiotomy Wo W Bx 9 8 $4,076.00 $4,076.00 $3,396.77 $4,076.00 $3,736.39 2026-05-15
58700 HCPCS Salpingectomy Complt Or Prtl Uni Or Bil 9 8 $4,051.00 $4,051.00 $3,375.44 $4,051.00 $3,713.22 2026-05-15
59515 HCPCS Cesarean Delivery 9 8 $3,916.00 $3,916.00 $3,406.92 $3,916.00 $3,661.46 2026-05-15
28805 HCPCS Amputatn Ft Transmetatarsal 9 8 $9,252.00 $9,252.00 $3,277.38 $9,252.00 $3,553.37 2026-05-15
23140 HCPCS Excis Benign Cyst Tum Cal Scap 9 8 $9,252.00 $9,252.00 $1,120.92 $9,252.00 $3,449.87 2026-05-15
28820 HCPCS Amputat Toe Mtatrsl Phlngl 9 8 $9,252.00 $9,252.00 $1,120.92 $8,049.24 $3,449.87 2026-05-15
28810 HCPCS Amputat Metatarsal With Toe 9 8 $9,252.00 $9,252.00 $1,120.92 $9,252.00 $3,449.87 2026-05-15
59820 HCPCS Trt Missed Abrtn Srgcl 1st Tri 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
59821 HCPCS Surg Trt Missed Abortn 2nd Trim 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
56440 HCPCS Marsupial Bartholins Glnd Cyst 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
56620 HCPCS Vulvectomy Simple Partl 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
58600 HCPCS Ligatn Trnsctn Fallopian Tubes 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
59320 HCPCS Cerclage Cervix W Pregnancy Vaginal 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
57200 HCPCS Colporrhaphy Sutureury Vagina 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
59812 HCPCS Trtment Of Miscarriage 9 8 $9,200.00 $9,200.00 $1,095.43 $9,200.00 $3,413.10 2026-05-15
56810 HCPCS Perineoplsty Rpr Perineum Non Obsttric 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
58558 HCPCS Hysteroscopy Surgical W Samp 9 8 $9,200.00 $9,200.00 $1,095.43 $9,200.00 $3,413.10 2026-05-15
58555 HCPCS Hysteroscopy Diagnostic 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
56700 HCPCS Part Hymenectomy Rev Hym Ring 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
56740 HCPCS Exc Of Bartholin's Gland Or Cyst 9 8 $8,936.00 $8,936.00 $1,095.43 $8,936.00 $3,413.10 2026-05-15
32550 HCPCS Insert Pleural Catheter 9 8 $3,200.00 $3,200.00 $2,784.00 $3,888.30 $3,200.00 2026-05-15
15839 HCPCS Excis Excessive Skin Subq Tiss Other 9 8 $8,122.00 $8,122.00 $2,909.48 $8,122.00 $3,154.49 2026-05-15
23076 HCPCS Excis Tum Sof Tiss Shldr Subq >= 3cm 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
22903 HCPCS Exc Of Abdom Wall Tum Subq 3+cm 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
22901 HCPCS Exc Abdl Tum Deep 5 Cm/> 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
21932 HCPCS Excis Sft Tum Back, Flank Subfasc <5cm 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
21556 HCPCS Excis Tum Soft Tis Neck Thor 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
11426 HCPCS Exc B9 Sclp Nk Hnd Ft Gn Ls 4.0 Cm 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
69110 HCPCS Excis External Ear Partl Simpl 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
57023 HCPCS I & D Vag Hema Non Obs 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
11770 HCPCS Exc Pilonidal Cyst Sinus Simp 9 8 $8,122.00 $8,122.00 $839.66 $8,122.00 $3,062.62 2026-05-15
795 MS_DRG Normal Newborn 7 6 $3,028.43 $3,028.43 $1,605.16 $6,734.39 $3,028.43 2026-05-15
G0330 HCPCS Facility Services For Dental Procedure P 9 8 $3,000.00 $3,000.00 $2,610.00 $3,600.57 $3,000.00 2026-05-15
36556 HCPCS Ins Non-tunneled Cent Ven Cath Age 5> 9 8 $3,000.00 $3,000.00 $2,610.00 $3,429.00 $3,000.00 2026-05-15
30310 HCPCS Rem Intranasal Foreign Body W/anesthesia 9 8 $3,000.00 $3,000.00 $2,610.00 $3,600.57 $3,000.00 2026-05-15
25270 HCPCS Repr Tndn Musc-ext Frarm Wrist Single 9 8 $3,000.00 $3,000.00 $2,610.00 $3,553.37 $3,000.00 2026-05-15
25260 HCPCS Repr Tndn Musc-flx Frarm Wrist Ea 9 8 $3,000.00 $3,000.00 $2,610.00 $3,553.37 $3,000.00 2026-05-15
46285 HCPCS Surg Tx Anal?fistula?2nd?stage 9 8 $8,026.00 $8,026.00 $968.13 $8,026.00 $2,926.55 2026-05-15
36561 HCPCS Centrally Ins Venous Access Device >5yrs 9 8 $2,700.00 $2,700.00 $2,349.00 $3,429.00 $2,700.00 2026-05-15
36560 HCPCS Centrally Ins Venous Access Device <5yrs 9 8 $2,700.00 $2,700.00 $2,349.00 $3,429.00 $2,700.00 2026-05-15
15273 HCPCS Application Graft Trunk,arms,legs 100 Sq 12 8 $3,300.00 $3,300.00 $2,066.67 $5,953.92 $2,679.11 2026-05-15
49596 HCPCS Repair Of Anterior Abdominal Hernia 9 8 $2,750.00 $2,750.00 $2,392.50 $2,750.00 $2,571.25 2026-05-15
36555 HCPCS Ins Non-tunneled Cent Ven Cath Age <5 9 8 $2,500.00 $2,500.00 $2,175.00 $3,429.00 $2,500.00 2026-05-15
26260 HCPCS Strapping Elbow Or Wrist 9 8 $2,500.00 $2,500.00 $2,175.00 $3,553.37 $2,500.00 2026-05-15
10180 HCPCS Incision And Drainage Complex Postoperat 9 8 $2,500.00 $2,500.00 $2,175.00 $3,154.49 $2,500.00 2026-05-15
J0135 HCPCS Humira Sc 40mg/0.8ml Nonformulary 9 8 $2,622.27 $2,622.27 $2,281.37 $2,622.27 $2,451.82 2026-05-15
66999 HCPCS Unlisted Proc Ante Seg Eye 9 8 $2,500.00 $2,500.00 $2,175.00 $2,506.28 $2,433.28 2026-05-15
J1306 HCPCS Inclisiran (leqvio) Subq Soln 189mg/1ml 9 8 $3,998.11 $3,998.11 $2,218.85 $3,998.11 $2,405.69 2026-05-15
21554 HCPCS Exc Tum Sft Tiss Neck Ant Thrx IM >=5 Cm 9 8 $2,400.00 $2,400.00 $2,088.00 $3,154.49 $2,400.00 2026-05-15
21501 HCPCS Inc & Drn Deep Sft Neck Thorax 9 8 $2,400.00 $2,400.00 $2,088.00 $3,154.49 $2,400.00 2026-05-15
69145 HCPCS Excis Soft Tiss Les Ext Canal 9 8 $2,400.00 $2,400.00 $2,088.00 $3,154.49 $2,400.00 2026-05-15
J9395 HCPCS Faslodex 250mg/5ml Inj (special Order) 9 8 $2,565.16 $2,565.16 $2,231.69 $2,565.16 $2,398.43 2026-05-15
J0875 HCPCS Dalbavancin 500mg Vial High Cost Item 9 8 $2,361.75 $2,361.75 $2,054.72 $4,543.21 $2,361.75 2026-05-15
J0840 HCPCS Antivenin,lat Mac(antivenin Spider) 13 5 $4,057.50 $4,057.50 $105.47 $5,188.00 $2,209.22 2026-05-15
44361 HCPCS Small Intest Endo W Bx 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
44360 HCPCS Small Intest Endo Diag 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
43255 HCPCS Egd Control Bleeding 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
43251 HCPCS Egd Removal Tumor Polyp/other Lesion Sna 9 8 $4,283.00 $4,283.00 $1,922.05 $4,283.00 $2,083.92 2026-05-15
43249 HCPCS Egd Balloon Dilat<30mm 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
43246 HCPCS Egd Place Perc Tube 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
43244 HCPCS Egd Band Ligatn 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
43202 HCPCS Esophgscpy W Biopsy 9 8 $5,439.00 $5,439.00 $1,922.05 $5,439.00 $2,083.92 2026-05-15
20102 HCPCS Explr Pentrtng Wnd Abd Flank Bck Sep 9 8 $2,000.00 $2,000.00 $1,740.00 $2,240.71 $2,000.00 2026-05-15
20101 HCPCS Explr Pentrtng Wnd Chest Sep Proc 9 8 $2,000.00 $2,000.00 $1,740.00 $2,240.71 $2,000.00 2026-05-15
792 MS_DRG Prematurity Without Major Problems 4 4 $1,908.80 $1,908.80 $1,660.66 $1,908.80 $1,908.80 2026-05-15
88309 HCPCS Surg/path Gm Level Vi 3 3 $1,884.39 $1,884.39 $1,639.42 $1,884.39 $1,884.39 2026-05-15
0722 RC — 9 8 $2,000.00 $2,000.00 $1,740.00 $2,000.00 $1,870.00 2026-05-15
15277 HCPCS Application Graft Head,face,hands 100sq 9 8 $1,800.00 $1,800.00 $1,566.00 $2,240.71 $1,800.00 2026-05-15
11044 HCPCS Debridement Muscle & 9 8 $2,774.90 $2,774.90 $1,654.31 $2,774.90 $1,793.63 2026-05-15
J3262 HCPCS Tocilizumab (actemra) 400mg/20ml Vial 18 8 $2,592.50 $2,592.50 $1,029.69 $3,670.00 $1,787.18 2026-05-15
24075 HCPCS Excis Tum Arm Elbow Area Subq 9 8 $4,634.00 $4,634.00 $501.04 $4,634.00 $1,741.38 2026-05-15
22902 HCPCS Exc Tum Sft Tiss Abd Wall Subq >=3 Cm 9 8 $4,634.00 $4,634.00 $501.04 $4,634.00 $1,741.38 2026-05-15
11624 HCPCS Ex Mal Sclp Nk Ft Hnd Gntl 3.1 4.0 Cm 9 8 $4,634.00 $4,634.00 $501.04 $4,634.00 $1,741.38 2026-05-15
19020 HCPCS Incis Of Breast Lesion 9 8 $4,634.00 $4,634.00 $501.04 $4,634.00 $1,741.38 2026-05-15
11406 HCPCS Exc B9 Lesion Mrgn Xcp Sk Tg T/a/l Ls 4. 9 8 $4,634.00 $4,634.00 $501.04 $4,634.00 $1,741.38 2026-05-15
27818 HCPCS Cltx Trimalleolar Ankle Fx W/manipulatio 9 8 $2,000.00 $2,000.00 $1,610.64 $2,000.00 $1,740.00 2026-05-15
55100 HCPCS Drn Scrotal Wall ABSCESS,Two Or More Procedures 9 8 $1,700.00 $1,700.00 $1,479.00 $1,793.63 $1,700.00 2026-05-15
26418 HCPCS Rep Extensor Tendon Of Finger Prim/sec W 9 8 $1,700.00 $1,700.00 $1,479.00 $1,746.27 $1,695.41 2026-05-15
26236 HCPCS Excis Tum Arm Elbow Area Subq 9 8 $4,594.00 $4,594.00 $610.83 $4,594.00 $1,695.41 2026-05-15
24605 HCPCS Tx Closed Elbow Dislocation W/anesthesia 9 8 $1,700.00 $1,700.00 $1,479.00 $1,746.27 $1,695.41 2026-05-15
26742 HCPCS Cltx Articular Fx Meta/interphalangeal W,Two Or More Procedures 9 8 $1,650.00 $1,650.00 $1,435.50 $1,746.27 $1,650.00 2026-05-15
43241 HCPCS Exam Of Esophagus/stomach/bowl W/scope 9 8 $1,600.00 $1,600.00 $1,392.00 $2,083.92 $1,600.00 2026-05-15
32557 HCPCS Insrt Pleurl Drng Cath Prq W Guid 9 8 $1,600.00 $1,600.00 $1,392.00 $1,709.52 $1,600.00 2026-05-15
47563 HCPCS Laparoscopic Cholecystectomy 9 8 $1,600.00 $1,600.00 $1,392.00 $6,565.41 $1,600.00 2026-05-15
58605 HCPCS Tubal Ligatn Postpartm Same Stay 9 8 $1,697.00 $1,697.00 $1,413.93 $1,697.00 $1,555.46 2026-05-15
15274 HCPCS Application Add Graft Trunk,arms,legs100 8 7 $1,650.00 $1,650.00 $1,435.50 $1,650.00 $1,542.75 2026-05-15
36569 HCPCS Insert Of Peripherally Ins Ven Cath Without 9 8 $1,500.00 $1,500.00 $1,305.00 $1,709.52 $1,500.00 2026-05-15
32551 HCPCS Tube Thoracostomy Incl Drainage Sys Open 9 8 $1,500.00 $1,500.00 $1,305.00 $1,709.52 $1,500.00 2026-05-15
10140 HCPCS Incision And Drainage Of Hematoma 9 8 $1,500.00 $1,500.00 $445.23 $1,793.63 $1,500.00 2026-05-15
69205 HCPCS Removal Fb Ext Auditory Canal 9 8 $1,500.00 $1,500.00 $1,305.00 $1,793.63 $1,500.00 2026-05-15
27842 HCPCS Clsd Trmt Of Ankle Dislocation W/anesthe 9 8 $1,500.00 $1,500.00 $1,305.00 $1,746.27 $1,500.00 2026-05-15
25605 HCPCS Clsd Trmt Distal Radial Fx W/manipulatio 9 8 $1,500.00 $1,500.00 $1,305.00 $1,746.27 $1,500.00 2026-05-15
24565 HCPCS Cltx Humeral Epicondylar Fx Med/lat W/ma 9 8 $1,500.00 $1,500.00 $1,305.00 $1,746.27 $1,500.00 2026-05-15
74185 HCPCS Magnetic Res Angiography Abdomen With Co 9 8 $1,600.00 $1,600.00 $1,354.43 $1,600.00 $1,477.21 2026-05-15
73725 HCPCS MRA Lower Extremety Without Contrast 9 8 $1,600.00 $1,600.00 $1,342.24 $1,600.00 $1,471.12 2026-05-15
G0390 HCPCS Ed Trauma Response 9 8 $4,500.00 $4,500.00 $1,335.10 $4,500.00 $1,447.53 2026-05-15
Q4100 HCPCS Skin Sub Graf To Trunk, Arms Leg 25sq Cm 10 8 $1,511.21 $1,511.21 $80.00 $1,511.21 $1,412.98 2026-05-15
24065 HCPCS Bx Soft Tiss Upper Arm/elbow Seperficl 9 8 $1,400.00 $1,400.00 $749.70 $1,793.63 $1,400.00 2026-05-15
23655 HCPCS Cltx Shldr Disl W Man, Anes 9 8 $1,400.00 $1,400.00 $1,218.00 $1,746.27 $1,400.00 2026-05-15
23605 HCPCS Cltx Prox Humeral Fx W/manipulation 9 8 $1,400.00 $1,400.00 $1,218.00 $1,746.27 $1,400.00 2026-05-15
20520 HCPCS Remove Fb Tendon Simp 9 8 $1,400.00 $1,400.00 $564.57 $1,793.63 $1,400.00 2026-05-15
30124 HCPCS Excis Dermoid Cyst Nose Simp 9 8 $1,400.00 $1,400.00 $1,218.00 $1,685.00 $1,400.00 2026-05-15
27781 HCPCS Cltx Proximal Fibula Or Shaft Fx W/manip 9 8 $1,400.00 $1,400.00 $1,218.00 $1,746.27 $1,400.00 2026-05-15
27752 HCPCS Cltx Tibial Shaft Fx (wwo Fibular Fx) With 9 8 $1,400.00 $1,400.00 $1,218.00 $1,746.27 $1,400.00 2026-05-15
25565 HCPCS Clsd Tx Radial And Ulnar Fx W/manipulati 9 8 $1,400.00 $1,400.00 $1,218.00 $1,746.27 $1,400.00 2026-05-15
24505 HCPCS Cltx Humerus Fx W/man 9 8 $1,400.00 $1,400.00 $1,218.00 $1,746.27 $1,400.00 2026-05-15
24535 HCPCS Clsd Tx Supra/transcondylar Humeral Fx 9 8 $1,350.00 $1,350.00 $1,174.50 $1,746.27 $1,350.00 2026-05-15
0110 RC — 1 1 $1,500.00 $1,500.00 $1,305.00 $1,305.00 $1,305.00 2026-05-15
25505 HCPCS Clsd Tx Of Radial Shaft Fx W/manipulatio 9 8 $1,300.00 $1,300.00 $1,131.00 $1,746.27 $1,300.00 2026-05-15
45338 HCPCS Sigmoid Flex Rem Tum Snare 9 8 $3,373.00 $3,373.00 $1,198.61 $3,373.00 $1,299.54 2026-05-15
45388 HCPCS Flexible Colonoscopy W/ablatin 9 8 $3,373.00 $3,373.00 $1,198.61 $3,373.00 $1,299.54 2026-05-15
45385 HCPCS Colonoscopy Lesn Remov Snare 9 8 $3,900.00 $3,900.00 $1,198.61 $3,900.00 $1,299.54 2026-05-15
45384 HCPCS Colnscpy Flex Splen Tum Bx 9 8 $3,373.00 $3,373.00 $1,198.61 $3,373.00 $1,299.54 2026-05-15
45382 HCPCS Colnsc Flexible W Control Bleed Any 9 8 $3,373.00 $3,373.00 $1,198.61 $3,373.00 $1,299.54 2026-05-15
45381 HCPCS Colnscpy W Submucos 9 8 $3,373.00 $3,373.00 $1,198.61 $3,373.00 $1,299.54 2026-05-15
45380 HCPCS Colnscpy Flex Splen Bx 9 8 $3,900.00 $3,900.00 $1,198.61 $3,900.00 $1,299.54 2026-05-15
45350 HCPCS Sgmdsc W/band Ligatn 9 8 $3,373.00 $3,373.00 $1,198.61 $3,373.00 $1,299.54 2026-05-15
45905 HCPCS Dilatn Anal Sphinctr Anes 9 8 $3,373.00 $3,373.00 $442.14 $3,373.00 $1,261.69 2026-05-15
46320 HCPCS Ext Exc Thrombosed Hemorrhoid 9 8 $1,250.00 $1,250.00 $517.14 $1,299.54 $1,250.00 2026-05-15
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