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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

SIERRA MEDICAL CENTER

El Paso, TX · CCN 450668 · Rates published

20,084 distinct procedures filed
8 distinct payers
379,316 rate rows
2026-09-01 last MRF observed
Data quality

362,115 of 379,316 rate rows are consumer-grade (95.5%)

17,201 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 12,280
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 3,002
per-diem day rate — not a per-procedure price 1,751
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 98
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 45
placeholder amount (≤ $0.02) — excluded from medians 20
exceeds 10× this hospital's gross charge — excluded from medians 5
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/TenetHealth/954537720_the-hospitals-of-providence-sierra-campus_standardcharges.json
Discovered viaPublic MRF directory
Last fetch success · 2026-10-05
Content fingerprint afcc02d6a14034fa… · 77,370,384 bytes · first seen 2026-09-05

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
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,296,000.00 $3,296,000.00 $3,296,000.00 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 2 $3,286,000.00 $3,286,000.00 $3,286,000.00 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 2 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,222,890.60 $2,222,890.60 $2,222,890.60 nat. median
$2,455,111
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $527,123.43 $527,123.43 $527,123.43 nat. median
$599,737
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $516,726.08 $516,726.08 $516,726.08 nat. median
$579,571
0.9× median
C9098
HCPCS 		Ciltacabtagene Car Pos T 2 $478,950.00 $478,950.00 $478,950.00 nat. median
$2,313,353
outlier · 0.2×
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $469,754.01 $469,754.01 $469,754.01 nat. median
$513,770
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $109,145.89 $1,455,001.26 $309,646.24 nat. median
$168,055
1.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 3 $108,538.60 $944,237.29 $216,783.24 nat. median
$186,516
1.2× median
Q0480
HCPCS 		Dme Pos 3 $1.00 $364,699.85 $203,081.08 nat. median
$108,243
1.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 $76,849.19 $719,383.75 $182,570.67 nat. median
$131,925
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $89,188.29 $715,161.89 $177,542.54 nat. median
$145,435
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 3 $36,447.53 $270,331.80 $146,522.57 nat. median
$65,477
outlier · 2.2×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $56,756.21 $466,709.07 $119,681.10 nat. median
$97,418
1.2× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 3 $35,880.08 $194,847.01 $110,718.18 nat. median
$63,499
1.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 3 $57,823.73 $404,931.12 $105,364.67 nat. median
$72,715
1.4× median
7
MS_DRG 		Lung Transplant 3 $46,554.47 $436,344.04 $105,099.29 nat. median
$70,649
1.5× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 2 $37,352.25 $171,928.88 $92,838.76 nat. median
$2,106
outlier · 44.1×
L7180
HCPCS 		Dme Pos 3 $47,877.56 $174,609.46 $91,087.18 nat. median
$42,745
outlier · 2.1×
L7181
HCPCS 		Dme Pos 3 $47,488.54 $173,190.71 $90,347.09 nat. median
$48,410
1.9× median
J9226
HCPCS 		Supprelin La Implant 3 $21,173.64 $162,568.43 $89,458.68 nat. median
$57,036
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 3 $38,783.06 $335,491.16 $86,432.74 nat. median
$73,023
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 $59,087.14 $381,813.67 $84,807.61 nat. median
$65,418
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $33,782.92 $366,391.93 $83,510.73 nat. median
$74,509
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 3 $50,753.76 $347,401.99 $81,957.78 nat. median
$69,922
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $39,669.00 $329,621.66 $77,040.77 nat. median
$69,822
1.1× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $1.00 $121,833.98 $74,496.78 nat. median
$92,809
0.8× median
850
MS_DRG 		Acute Leukemia With Other Procedures 3 $28,134.84 $291,773.19 $74,082.10 nat. median
$2,633
outlier · 28.1×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $22,239.69 $283,144.16 $70,177.30 nat. median
$59,651
1.2× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 4 $34,713.01 $284,037.05 $68,717.14 nat. median
$60,505
1.1× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $43,383.46 $93,644.08 $68,513.77 nat. median
$2,024
outlier · 33.9×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $47,550.05 $265,131.35 $68,277.52 nat. median
$56,428
1.2× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $42,718.05 $88,607.88 $65,662.96 nat. median
$2,024
outlier · 32.4×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 $28,368.46 $257,597.37 $64,850.04 nat. median
$55,935
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 $32,136.47 $258,712.64 $64,155.68 nat. median
$55,923
1.1× median
10
MS_DRG 		Pancreas Transplant 3 $18,866.69 $241,778.04 $64,118.87 nat. median
$23,080
outlier · 2.8×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 $27,724.32 $240,393.21 $63,751.35 nat. median
$45,605
1.4× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 2 $22,992.25 $118,668.45 $63,173.84 nat. median
$2,106
outlier · 30.0×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 $25,469.42 $256,744.91 $61,041.28 nat. median
$52,327
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 $34,800.14 $240,251.70 $60,066.49 nat. median
$51,518
1.2× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $20,915.00 $371,348.31 $59,891.53 nat. median
$2,736
outlier · 21.9×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 3 $24,412.43 $232,886.19 $57,811.75 nat. median
$48,611
1.2× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $18,627.81 $231,743.96 $56,366.20 nat. median
$49,569
1.1× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 $27,689.53 $202,386.38 $56,335.26 nat. median
$43,533
1.3× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $36,949.67 $75,178.90 $56,064.28 nat. median
$2,024
outlier · 27.7×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 3 $23,454.86 $226,797.68 $54,913.19 nat. median
$47,340
1.2× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 3 $31,206.39 $216,810.78 $54,777.18 nat. median
$47,121
1.2× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $30,387.11 $221,548.16 $54,698.42 nat. median
$47,458
1.2× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 3 $15,510.78 $128,679.88 $54,537.40 nat. median
$2,106
outlier · 25.9×

Other procedures at this hospital

Browse this hospital's 20,084 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0489 RC — 1 1 — — $19,872.00 $19,872.00 $19,872.00 2026-09-01
0480 RC — 1 1 — — $19,872.00 $19,872.00 $19,872.00 2026-09-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 16 3 — — $11,932.69 $91,182.70 $22,117.03 2026-09-01
834 MS_DRG Acute Leukemia With Mcc 16 3 — — $26,586.64 $184,976.69 $46,201.79 2026-09-01
850 MS_DRG Acute Leukemia With Other Procedures 10 3 — — $28,134.84 $291,773.19 $74,082.10 2026-09-01
836 MS_DRG Acute Leukemia Without Cc/mcc 16 3 — — $7,678.28 $41,089.83 $23,187.91 2026-09-01
245 MS_DRG Aicd Generator Procedures 16 3 — — $14,722.66 $153,725.51 $39,299.65 2026-09-01
265 MS_DRG Aicd Lead Procedures 16 3 — — $11,029.79 $121,911.63 $29,491.28 2026-09-01
K1014 HCPCS Ak 4 Bar Link Hydl Swg/stanc 1 1 — — $23,128.91 $23,128.91 $23,128.91 2026-09-01
L5969 HCPCS Ak/ft Power Asst Incl Motors 5 3 — — $13,782.16 $50,263.54 $30,734.22 2026-09-01
14 MS_DRG Allogeneic Bone Marrow Transplant 10 3 — — $57,823.73 $404,931.12 $105,364.67 2026-09-01
Q4225 HCPCS Amnio Or Derma Tl, Per Sq Cm 1 1 — — $28,027.20 $28,027.20 $28,027.20 2026-09-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 16 3 — — $9,963.45 $96,044.75 $23,763.79 2026-09-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 16 3 — — $19,745.91 $165,831.76 $40,887.92 2026-09-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 16 3 — — $14,695.18 $144,644.97 $36,499.79 2026-09-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 16 3 — — $15,384.34 $117,504.46 $32,481.89 2026-09-01
347 MS_DRG Anal And Stomal Procedures With Mcc 16 3 — — $7,791.58 $77,347.95 $20,046.79 2026-09-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 19 4 — — $18,627.81 $231,743.96 $56,366.20 2026-09-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 19 4 — — $7,456.50 $142,296.50 $35,582.31 2026-09-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 2 2 — — $10,153.90 $28,082.11 $19,118.00 2026-09-01
397 MS_DRG Appendix Procedures With Mcc 14 3 — — $6,127.60 $80,693.76 $19,926.47 2026-09-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 10 3 — — $30,361.09 $199,795.31 $48,540.71 2026-09-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 10 3 — — $25,718.54 $183,035.92 $48,540.71 2026-09-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 21 5 — — $9,234.81 $125,924.59 $25,746.26 2026-09-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 16 3 — — $10,679.80 $86,903.56 $19,856.49 2026-09-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 16 3 — — $13,953.97 $118,582.66 $30,197.38 2026-09-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 16 3 — — $8,036.31 $86,903.56 $19,278.28 2026-09-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 16 3 — — $24,142.56 $186,091.96 $51,977.85 2026-09-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 16 3 — — $17,545.09 $89,626.04 $23,713.33 2026-09-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 16 3 — — $13,958.94 $120,139.33 $29,656.01 2026-09-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 16 3 — — $7,831.93 $82,860.28 $19,608.67 2026-09-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 16 3 — — $10,799.97 $116,399.29 $28,274.81 2026-09-01
Q2053 HCPCS Brexucabtagene Car Pos T 2 2 — — $469,754.01 $469,754.01 $469,754.01 2026-09-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 18 4 — — $34,800.14 $240,251.70 $60,066.49 2026-09-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $43,383.46 $93,644.08 $68,513.77 2026-09-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $36,949.67 $75,178.90 $56,064.28 2026-09-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $42,718.05 $88,607.88 $65,662.96 2026-09-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $31,891.96 $63,441.38 $47,666.67 2026-09-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 18 4 — — $27,689.53 $202,386.38 $56,335.26 2026-09-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 2 — — $34,792.46 $70,479.90 $52,636.18 2026-09-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 2 — — $27,026.60 $59,769.44 $43,398.02 2026-09-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 18 4 — — $20,074.26 $155,615.74 $49,739.53 2026-09-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 20 4 — — $9,771.35 $105,869.92 $22,062.41 2026-09-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 20 4 — — $10,145.02 $109,599.84 $25,961.06 2026-09-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 4 — — $39,669.00 $329,621.66 $77,040.77 2026-09-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 4 — — $30,387.11 $221,548.16 $54,698.42 2026-09-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 4 — — $23,023.59 $221,548.16 $50,390.57 2026-09-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 4 — — $32,136.47 $258,712.64 $64,155.68 2026-09-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 4 — — $23,303.11 $179,683.36 $44,863.05 2026-09-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 4 — — $17,529.01 $169,824.50 $39,472.46 2026-09-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 16 3 — — $9,793.28 $80,545.51 $18,994.90 2026-09-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 16 3 — — $21,691.46 $130,419.37 $32,349.81 2026-09-01
472 MS_DRG Cervical Spinal Fusion With Cc 21 5 — — $8,244.20 $99,265.89 $24,302.25 2026-09-01
471 MS_DRG Cervical Spinal Fusion With Mcc 21 5 — — $9,641.82 $162,698.22 $37,381.78 2026-09-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 21 5 — — $6,452.73 $82,257.16 $20,246.00 2026-09-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 16 3 — — $9,494.75 $161,876.08 $40,556.96 2026-09-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 16 3 — — $5,904.80 $87,351.69 $20,759.14 2026-09-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 3 — — $109,145.89 $1,455,001.26 $309,646.24 2026-09-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 16 3 — — $9,551.47 $120,038.24 $29,188.79 2026-09-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 16 3 — — $6,779.33 $111,301.39 $23,177.31 2026-09-01
C9098 HCPCS Ciltacabtagene Car Pos T 2 2 — — $478,950.00 $478,950.00 $478,950.00 2026-09-01
Q2056 HCPCS Ciltacabtagene Car-pos T 2 2 — — $527,123.43 $527,123.43 $527,123.43 2026-09-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 4 — — $20,915.00 $303,569.46 $52,962.57 2026-09-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 14 4 — — $16,481.97 $194,316.67 $40,915.26 2026-09-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 6 2 — — $22,992.25 $118,668.45 $63,173.84 2026-09-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 6 2 — — $37,352.25 $171,928.88 $92,838.76 2026-09-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 6 2 — — $16,107.56 $89,357.85 $47,858.49 2026-09-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 18 4 — — $33,782.92 $366,391.93 $83,510.73 2026-09-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 4 — — $14,382.00 $225,294.93 $38,980.01 2026-09-01
545 MS_DRG Connective Tissue Disorders With Mcc 16 3 — — $7,956.20 $83,618.40 $20,848.61 2026-09-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 20 4 — — $28,368.46 $257,597.37 $64,850.04 2026-09-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 20 4 — — $25,605.97 $184,060.21 $45,062.10 2026-09-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 4 — — $34,713.01 $284,037.05 $68,717.14 2026-09-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 4 — — $29,428.95 $204,273.24 $51,740.69 2026-09-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 20 4 — — $26,409.45 $197,736.61 $49,839.18 2026-09-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 20 4 — — $22,866.57 $141,137.43 $37,417.84 2026-09-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 18 4 — — $12,104.90 $145,807.42 $35,195.93 2026-09-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 18 4 — — $8,679.86 $106,169.79 $27,062.50 2026-09-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 18 4 — — $7,731.64 $108,171.22 $23,061.87 2026-09-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 16 3 — — $17,550.36 $104,761.38 $24,969.44 2026-09-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 16 3 — — $23,962.16 $153,196.51 $36,913.21 2026-09-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 16 3 — — $14,778.51 $85,006.59 $20,352.83 2026-09-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 16 3 — — $23,454.86 $226,797.68 $54,913.19 2026-09-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 3 — — $24,383.20 $193,076.73 $47,234.46 2026-09-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 3 — — $22,230.92 $131,807.56 $31,521.98 2026-09-01
J7330 HCPCS Cultured Chondrocytes Implnt 5 3 — — $1.00 $121,833.98 $74,496.78 2026-09-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 16 3 — — $4,220.05 $78,274.53 $20,345.12 2026-09-01
Q0480 HCPCS Dme Pos 5 3 — — $1.00 $364,699.85 $203,081.08 2026-09-01
L7180 HCPCS Dme Pos 5 3 — — $47,877.56 $174,609.46 $91,087.18 2026-09-01
L7181 HCPCS Dme Pos 5 3 — — $47,488.54 $173,190.71 $90,347.09 2026-09-01
L5856 HCPCS Dme Pos 5 3 — — $29,028.47 $103,763.24 $54,129.37 2026-09-01
L6880 HCPCS Dme Pos 5 3 — — $28,891.37 $103,273.16 $53,873.72 2026-09-01
L6975 HCPCS Dme Pos 5 3 — — $22,633.97 $82,546.09 $43,061.19 2026-09-01
L6970 HCPCS Dme Pos 5 3 — — $22,513.14 $82,105.42 $42,831.30 2026-09-01
Q0483 HCPCS Dme Pos 5 3 — — $1.00 $81,042.94 $42,277.05 2026-09-01
L6965 HCPCS Dme Pos 5 3 — — $22,149.18 $80,778.06 $42,138.88 2026-09-01
L5858 HCPCS Dme Pos 5 3 — — $22,027.14 $80,332.98 $41,906.70 2026-09-01
L5973 HCPCS Dme Pos 5 3 — — $1.00 $74,365.83 $38,793.86 2026-09-01
Q0489 HCPCS Dme Pos 5 3 — — $19,265.12 $70,259.89 $36,651.95 2026-09-01
Q0481 HCPCS Dme Pos 5 3 — — $1.00 $62,808.45 $32,764.81 2026-09-01
L5859 HCPCS Dme Pos 5 3 — — $17,196.40 $62,715.27 $32,716.17 2026-09-01
E0766 HCPCS Dme Pos 5 3 — — $1.00 $57,210.38 $29,844.49 2026-09-01
L6955 HCPCS Dme Pos 5 3 — — $15,376.27 $56,077.26 $29,253.41 2026-09-01
L6960 HCPCS Dme Pos 5 3 — — $15,161.77 $55,294.98 $28,845.30 2026-09-01
L7191 HCPCS Dme Pos 5 3 — — $14,235.66 $51,917.45 $27,083.37 2026-09-01
Q0479 HCPCS Dme Pos 5 3 — — $14,192.24 $51,759.10 $27,000.75 2026-09-01
L7186 HCPCS Dme Pos 5 3 — — $13,392.36 $48,841.94 $25,479.00 2026-09-01
L6945 HCPCS Dme Pos 5 3 — — $13,037.57 $47,548.02 $24,804.00 2026-09-01
L6950 HCPCS Dme Pos 5 3 — — $12,253.38 $44,688.08 $23,312.09 2026-09-01
L7190 HCPCS Dme Pos 5 3 — — $11,806.22 $43,057.28 $22,461.36 2026-09-01
L6940 HCPCS Dme Pos 5 3 — — $11,525.09 $42,032.00 $21,926.50 2026-09-01
L6935 HCPCS Dme Pos 5 3 — — $10,349.38 $36,994.18 $19,298.46 2026-09-01
L5857 HCPCS Dme Pos 5 3 — — $10,095.74 $36,819.16 $19,207.17 2026-09-01
L8614 HCPCS Dvc Cochlear Mcd No Charge 5 3 $0.01 — $1.00 $82,737.15 $43,160.85 2026-09-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 3 — — $89,188.29 $715,161.89 $177,542.54 2026-09-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 16 3 — — $33,802.51 $206,490.31 $50,742.07 2026-09-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 16 3 — — $22,389.10 $160,410.40 $39,796.45 2026-09-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 11 3 — — $76,849.19 $719,383.75 $182,570.67 2026-09-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 11 3 — — $12,203.15 $131,211.17 $33,299.82 2026-09-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 16 3 — — $7,338.09 $82,836.70 $20,489.36 2026-09-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 3 — — $14,399.57 $158,085.51 $39,428.01 2026-09-01
37 MS_DRG Extracranial Procedures With Mcc 16 3 — — $9,712.87 $110,924.02 $27,806.64 2026-09-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 3 — — $19,633.92 $20,667.29 $19,633.92 2026-09-01
503 MS_DRG Foot Procedures With Mcc 16 3 — — $6,385.19 $94,043.32 $22,126.47 2026-09-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 11 3 — — $17,510.59 $241,676.95 $51,400.81 2026-09-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 11 3 — — $10,776.29 $108,521.64 $24,476.36 2026-09-01
J7310 HCPCS Ganciclovir 4.5mg Implnt 5 3 $116,432.00 $87,324.00 25% off $16,960.00 $61,853.12 $37,820.80 2026-09-01
V2790 HCPCS Grft Ocular Amnio Membrn 7 4 $20,261.00 $15,195.75 25% off $1.00 $20,261.00 $20,261.00 2026-09-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 11 3 — — $108,538.60 $944,237.29 $216,783.24 2026-09-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 11 3 — — $59,087.14 $381,813.67 $84,807.61 2026-09-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 3 — — $13,087.92 $114,798.83 $28,384.24 2026-09-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 16 3 — — $7,780.47 $97,779.99 $24,324.26 2026-09-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 16 3 — — $12,171.86 $98,127.04 $24,458.96 2026-09-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 15 3 — — $19,201.80 $96,708.52 $24,448.50 2026-09-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 16 3 — — $37,137.20 $206,251.08 $53,566.82 2026-09-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 16 3 — — $15,419.42 $88,864.56 $28,362.03 2026-09-01
974 MS_DRG HIV With Major Related Condition With Mcc 16 3 — — $8,612.61 $97,240.88 $24,515.32 2026-09-01
L8687 HCPCS Imp Nstim Gen Dl Rechrg 5 3 $0.01 — $1.00 $28,970.89 $19,565.75 2026-09-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 3 — — $19,590.94 $166,401.19 $41,530.07 2026-09-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 12 2 — — $15,391.20 $83,962.08 $23,026.69 2026-09-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 2 — — $3,296,000.00 $3,296,000.00 $3,296,000.00 2026-09-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 2 2 — — $2,222,890.60 $2,222,890.60 $2,222,890.60 2026-09-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 2 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2026-09-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 2 2 — — $3,286,000.00 $3,286,000.00 $3,286,000.00 2026-09-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 16 3 — — $34,828.21 $178,369.30 $46,816.23 2026-09-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 3 — — $47,550.05 $265,131.35 $68,277.52 2026-09-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 16 3 — — $21,889.11 $107,059.32 $29,393.94 2026-09-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 16 3 — — $13,978.53 $92,897.73 $22,861.77 2026-09-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 16 3 — — $13,625.91 $107,274.96 $26,564.29 2026-09-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 16 3 — — $10,408.17 $85,613.08 $21,482.82 2026-09-01
652 MS_DRG Kidney Transplant 10 3 — — $22,248.03 $108,814.77 $39,140.07 2026-09-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 10 3 — — $32,387.94 $158,408.97 $40,743.24 2026-09-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 10 3 — — $25,529.26 $124,863.23 $31,159.60 2026-09-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 16 3 — — $13,194.93 $108,733.91 $27,045.03 2026-09-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 16 3 — — $6,403.03 $80,407.36 $19,496.68 2026-09-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 16 3 — — $23,515.68 $126,790.52 $31,976.36 2026-09-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 2 — — $516,726.08 $516,726.08 $516,726.08 2026-09-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 11 3 — — $50,753.76 $347,401.99 $81,957.78 2026-09-01
6 MS_DRG Liver Transplant Without Mcc 11 3 — — $24,114.20 $156,239.08 $37,319.44 2026-09-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 16 3 — — $13,808.36 $122,164.34 $29,489.50 2026-09-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 16 3 — — $3,689.36 $101,648.06 $21,324.56 2026-09-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 17 4 — — $5,103.07 $85,451.35 $19,872.00 2026-09-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 17 4 — — $7,324.64 $123,710.89 $28,468.85 2026-09-01
7 MS_DRG Lung Transplant 10 3 — — $46,554.47 $436,344.04 $105,099.29 2026-09-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 3 — — $21,029.49 $197,608.57 $49,279.73 2026-09-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 16 3 — — $11,934.44 $108,996.72 $26,223.93 2026-09-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 16 3 — — $16,698.92 $154,480.25 $38,135.39 2026-09-01
654 MS_DRG Major Bladder Procedures With Cc 16 3 — — $11,137.10 $94,319.61 $23,091.11 2026-09-01
653 MS_DRG Major Bladder Procedures With Mcc 16 3 — — $19,340.66 $175,087.50 $45,637.88 2026-09-01
164 MS_DRG Major Chest Procedures With Cc 16 3 — — $12,370.98 $85,043.66 $21,042.27 2026-09-01
163 MS_DRG Major Chest Procedures With Mcc 16 3 — — $23,485.85 $151,009.77 $38,710.95 2026-09-01
140 MS_DRG Major Head And Neck Procedures With Mcc 15 3 — — $7,313.53 $143,715.02 $32,547.92 2026-09-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 17 4 — — $17,558.84 $102,200.64 $27,380.95 2026-09-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 16 3 — — $7,297.44 $93,396.40 $20,900.94 2026-09-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 16 3 — — $11,364.87 $80,771.26 $19,666.25 2026-09-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 3 — — $13,556.62 $154,874.47 $37,829.26 2026-09-01
662 MS_DRG Minor Bladder Procedures With Mcc 16 3 — — $8,653.54 $103,154.18 $25,404.53 2026-09-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 16 3 — — $9,155.87 $87,024.86 $22,567.89 2026-09-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 4 — — $20,915.00 $371,348.31 $59,891.53 2026-09-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 4 — — $18,285.72 $243,223.51 $46,793.47 2026-09-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 4 — — $15,869.71 $189,427.67 $40,544.76 2026-09-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 14 4 — — $19,980.69 $225,129.83 $44,943.77 2026-09-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 14 4 — — $12,055.49 $142,889.52 $32,839.51 2026-09-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 3 — — $13,673.28 $157,613.79 $38,404.57 2026-09-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 3 — — $9,871.64 $77,873.57 $19,424.59 2026-09-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 16 3 — — $7,371.13 $106,473.04 $25,900.31 2026-09-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 16 3 — — $9,537.44 $121,695.99 $29,986.92 2026-09-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 3 — — $8,886.29 $115,516.51 $28,573.62 2026-09-01
620 MS_DRG O.r. Procedures For Obesity With Cc 24 6 — — $6,911.49 $53,920.51 $20,245.50 2026-09-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 24 6 — — $12,481.50 $97,288.06 $22,563.94 2026-09-01
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 24 6 — — $5,734.04 $50,824.03 $20,245.50 2026-09-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 16 3 — — $8,365.54 $122,258.68 $26,531.46 2026-09-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 11 3 — — $7,674.63 $130,223.94 $30,242.20 2026-09-01
113 MS_DRG Orbital Procedures With Cc/mcc 16 3 — — $3,860.12 $79,217.96 $19,113.40 2026-09-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 15 3 — — $3,879.71 $76,876.23 $19,510.13 2026-09-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 20 4 — — $26,098.06 $166,697.70 $46,817.09 2026-09-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 20 4 — — $15,658.31 $106,980.00 $36,679.87 2026-09-01
264 MS_DRG Other Circulatory System O.r. Procedures 16 3 — — $8,216.72 $112,558.18 $26,877.31 2026-09-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 3 — — $17,284.58 $148,011.00 $35,482.22 2026-09-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 11 2 — — $21,327.07 $126,237.94 $28,237.85 2026-09-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 16 3 — — $12,691.44 $125,570.80 $33,053.88 2026-09-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 19 4 — — $27,972.86 $150,372.95 $37,567.23 2026-09-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 19 4 — — $14,275.34 $83,182.00 $24,233.52 2026-09-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 16 3 — — $7,242.77 $86,512.71 $21,206.06 2026-09-01
215 MS_DRG Other Heart Assist System Implant 16 3 — — $38,783.06 $335,491.16 $86,432.74 2026-09-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 3 — — $16,789.85 $139,931.18 $33,138.34 2026-09-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 16 3 — — $5,744.86 $78,796.79 $19,475.85 2026-09-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 3 — — $9,165.63 $141,568.71 $33,692.76 2026-09-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 19 4 — — $12,821.55 $119,825.97 $29,456.51 2026-09-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 19 4 — — $29,073.12 $177,779.65 $43,055.60 2026-09-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 19 4 — — $9,217.56 $86,020.78 $21,398.81 2026-09-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 16 3 — — $12,929.73 $92,112.66 $22,635.92 2026-09-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 20 4 — — $13,850.76 $107,379.41 $25,968.03 2026-09-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 3 — — $13,579.42 $129,361.37 $32,036.92 2026-09-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 3 — — $19,047.39 $141,983.15 $33,866.69 2026-09-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 3 — — $25,469.42 $256,744.91 $61,041.28 2026-09-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 16 3 — — $14,563.02 $99,198.51 $21,500.48 2026-09-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 16 3 — — $14,481.44 $134,240.27 $28,973.87 2026-09-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 16 3 — — $10,287.71 $125,938.06 $32,612.04 2026-09-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 16 3 — — $7,807.96 $109,118.02 $26,816.05 2026-09-01
253 MS_DRG Other Vascular Procedures With Cc 16 3 — — $8,913.77 $87,456.15 $21,196.13 2026-09-01
252 MS_DRG Other Vascular Procedures With Mcc 16 3 — — $11,183.88 $117,534.78 $28,176.25 2026-09-01
10 MS_DRG Pancreas Transplant 10 3 — — $18,866.69 $241,778.04 $64,118.87 2026-09-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 16 3 — — $9,896.78 $97,719.34 $23,649.97 2026-09-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 16 3 — — $13,504.57 $184,323.03 $44,881.56 2026-09-01
J9266 HCPCS Pegaspargase Injection 5 3 — — $6,218.44 $94,024.98 $43,969.94 2026-09-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 19 4 — — $14,382.00 $139,004.60 $33,440.89 2026-09-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 19 4 — — $14,382.00 $110,910.54 $26,178.95 2026-09-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 2 2 — — $32,948.87 $42,728.36 $37,838.62 2026-09-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 2 2 — — $28,933.90 $31,958.49 $30,446.19 2026-09-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 18 4 — — $18,435.45 $91,674.64 $32,636.17 2026-09-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 18 4 — — $11,693.46 $59,402.52 $23,025.98 2026-09-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 2 2 — — $20,000.34 $42,053.27 $31,026.81 2026-09-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 2 2 — — $15,057.42 $29,853.53 $22,455.47 2026-09-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 20 4 — — $10,056.13 $73,537.15 $19,587.72 2026-09-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 16 3 — — $18,949.44 $130,099.27 $31,651.51 2026-09-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 16 3 — — $13,411.59 $120,317.90 $29,895.15 2026-09-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 20 4 — — $11,029.21 $71,798.54 $23,697.47 2026-09-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 20 4 — — $12,377.41 $107,578.20 $28,730.24 2026-09-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 20 4 — — $9,884.79 $60,901.91 $21,301.94 2026-09-01
J9600 HCPCS Porfimer Sodium Injection 5 3 — — $19,534.15 $80,931.49 $48,326.78 2026-09-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 16 3 — — $15,950.40 $153,263.90 $37,129.01 2026-09-01
Q4244 HCPCS Procenta, Per 200 Mg 1 1 — — $38,221.51 $38,221.51 $38,221.51 2026-09-01
665 MS_DRG Prostatectomy With Mcc 16 3 — — $5,700.71 $105,165.71 $27,613.01 2026-09-01
849 MS_DRG Radiotherapy 16 3 — — $3,936.73 $91,293.89 $21,344.08 2026-09-01
332 MS_DRG Rectal Resection With Mcc 16 3 — — $12,946.98 $121,995.87 $29,379.89 2026-09-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 16 3 — — $13,335.57 $92,614.70 $22,372.53 2026-09-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 16 3 — — $31,206.39 $216,810.78 $54,777.18 2026-09-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 16 3 — — $18,138.94 $118,825.26 $28,699.21 2026-09-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 16 3 — — $26,519.39 $175,390.75 $42,691.46 2026-09-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 16 3 — — $14,167.12 $92,591.11 $21,978.18 2026-09-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 16 3 — — $24,412.43 $232,886.19 $57,811.75 2026-09-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 16 3 — — $5,927.60 $101,772.73 $23,172.62 2026-09-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 10 3 — — $24,923.53 $188,841.39 $43,757.33 2026-09-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 10 3 — — $27,724.32 $240,393.21 $63,751.35 2026-09-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 14 4 — — $10,262.27 $135,466.73 $32,091.76 2026-09-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 14 4 — — $17,579.60 $179,575.54 $38,456.58 2026-09-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 14 4 — — $8,955.88 $108,845.10 $26,138.42 2026-09-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 12 2 — — $14,949.13 $73,115.98 $25,410.33 2026-09-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 5 3 — — $35,880.08 $194,847.01 $110,718.18 2026-09-01
570 MS_DRG Skin Debridement With Mcc 16 3 — — $11,272.77 $99,097.42 $24,639.40 2026-09-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 16 3 — — $11,840.00 $89,312.69 $22,059.56 2026-09-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 16 3 — — $26,750.08 $165,141.03 $45,698.19 2026-09-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 16 3 — — $11,557.26 $116,965.35 $28,534.74 2026-09-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 3 — — $21,754.91 $220,742.87 $49,262.48 2026-09-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 16 3 — — $13,053.71 $119,923.68 $31,422.90 2026-09-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 16 3 — — $12,041.16 $123,761.43 $31,050.97 2026-09-01
A9604 HCPCS Sm 153 Lexidronam 5 3 — — $7,665.00 $71,260.41 $43,573.00 2026-09-01
500 MS_DRG Soft Tissue Procedures With Mcc 16 3 — — $7,026.98 $106,634.77 $26,622.30 2026-09-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 7 3 — — $15,510.78 $128,679.88 $54,537.40 2026-09-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 4 — — $22,239.69 $283,144.16 $70,177.30 2026-09-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 4 — — $17,605.62 $200,920.69 $49,520.27 2026-09-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 4 — — $13,567.14 $140,591.58 $40,171.21 2026-09-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 7 3 — — $13,158.13 $70,970.58 $30,078.91 2026-09-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 16 3 — — $16,336.65 $114,950.45 $28,173.04 2026-09-01
28 MS_DRG Spinal Procedures With Mcc 16 3 — — $16,809.44 $202,443.66 $50,273.74 2026-09-01
800 MS_DRG Splenic Procedures With Cc 16 3 — — $8,774.30 $94,659.92 $23,805.45 2026-09-01
799 MS_DRG Splenic Procedures With Mcc 16 3 — — $11,957.25 $152,596.76 $40,273.15 2026-09-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 16 3 — — $12,684.13 $82,354.87 $20,451.51 2026-09-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 16 3 — — $15,538.43 $168,045.46 $42,183.64 2026-09-01
J9226 HCPCS Supprelin La Implant 5 3 — — $21,173.64 $162,568.43 $89,458.68 2026-09-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 16 3 — — $5,486.09 $101,759.25 $24,035.13 2026-09-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 16 3 — — $12,715.41 $142,053.90 $33,677.07 2026-09-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 16 3 — — $22,536.47 $183,770.45 $43,566.17 2026-09-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 16 3 — — $9,505.57 $97,099.37 $22,156.35 2026-09-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 3 — — $56,756.21 $466,709.07 $119,681.10 2026-09-01
668 MS_DRG Transurethral Procedures With Mcc 16 3 — — $5,446.33 $98,386.48 $23,817.17 2026-09-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 16 3 — — $13,152.83 $77,011.01 $19,098.15 2026-09-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 3 — — $12,236.19 $187,547.54 $40,236.54 2026-09-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 14 3 — — $8,417.59 $121,514.04 $26,598.52 2026-09-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 14 3 — — $8,414.66 $100,286.82 $25,512.57 2026-09-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 16 3 — — $11,194.11 $90,886.20 $22,161.76 2026-09-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 16 3 — — $6,568.23 $120,718.86 $30,186.92 2026-09-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 16 3 — — $12,299.93 $120,439.20 $32,496.52 2026-09-01
263 MS_DRG Vein Ligation And Stripping 16 3 — — $3,625.33 $103,016.04 $21,779.94 2026-09-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 16 3 — — $12,978.86 $150,965.97 $33,670.19 2026-09-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 3 — — $25,034.05 $192,038.95 $45,746.47 2026-09-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 3 — — $11,404.34 $104,946.70 $24,706.68 2026-09-01
901 MS_DRG Wound Debridements For Injuries With Mcc 16 3 — — $22,483.84 $141,400.24 $36,375.26 2026-09-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 3 — — $36,447.53 $270,331.80 $146,522.57 2026-09-01
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