Price Transparencybeta Hospital negotiated rates

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

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Hospital

HOUSTON METHODIST CLEAR LAKE HOSPITAL

Nassau Bay, TX · CCN 450709 · Rates published

15,508 distinct procedures filed
23 distinct payers
255,921 rate rows
2026-04-01 last MRF observed
Data quality

205,799 of 255,921 rate rows are consumer-grade (80.4%)

50,122 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 49,010
template filing: same amount across many unrelated codes — excluded 1,066
placeholder amount (≤ $0.02) — excluded from medians 46
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.houstonmethodist.org/-/media/files/patient-resources/464389870_houston-methodist-clear-lake-hospital_standardcharges.ashx
Found on page https://www.houstonmethodist.org/for-patients/patient-resources/billing-insurance/pricing-transparency/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 18a206d1e78078bd… · 64,090,063 bytes · first seen 2026-05-04

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 7 $3,685,266.67 $4,053,793.33 $3,795,824.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,316,462.59 $3,648,108.85 $3,415,956.47 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,248,445.72 $3,573,290.29 $3,345,899.09 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,945,740.00 $4,801,556.20 $3,063,569.60 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 8 $2,455,110.60 $4,910,221.21 $2,602,417.25 nat. median
$2,468,984
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 8 $2,332,000.00 $4,664,000.00 $2,471,920.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 8 $770,620.00 $4,558,217.30 $816,857.20 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 8 $591,726.20 $3,423,431.17 $627,229.78 nat. median
$753,246
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 8 $565,868.94 $3,271,996.41 $599,821.08 nat. median
$674,867
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 8 $562,538.19 $3,054,756.15 $596,290.47 nat. median
$673,137
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 8 $557,317.93 $3,120,886.85 $590,757.01 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 8 $533,230.17 $2,974,302.92 $565,223.98 nat. median
$634,303
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 8 $489,304.61 $2,894,796.03 $518,662.89 nat. median
$619,808
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 14 $316,713.50 $633,427.00 $338,883.44 nat. median
$370,174
0.9× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $267,482.51 $267,482.51 $267,482.51 nat. median
$21,806
outlier · 12.3×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $206,078.48 $426,580.74 $220,503.97 nat. median
$265,286
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 15 $156,459.16 $324,560.15 $169,758.19 nat. median
$202,976
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $157,373.64 $359,258.08 $168,389.79 nat. median
$206,474
0.8× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $148,898.10 $467,204.56 $157,775.33 nat. median
$76,329
outlier · 2.1×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 8 $111,492.17 $222,984.34 $118,181.70 nat. median
$111,989
1.1× median
90288
HCPCS 		Botulism Ig IV 1 $114,456.75 $121,762.50 $114,456.75 nat. median
$55,037
outlier · 2.1×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $102,642.55 $223,660.50 $112,906.80 nat. median
$133,161
0.8× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $89,668.51 $134,826.20 $112,247.36 nat. median
$87,428
1.3× median
5463
OTHER 		Level 3 Neurostimulator And Related Procedures 1 $105,346.84 $105,346.84 $105,346.84 nat. median
$12,334
outlier · 8.5×
230
MS_DRG 		Other Cardiothoracic Procedures Without Cc/mcc 1 $104,476.71 $104,476.71 $104,476.71 nat. median
$29,847
outlier · 3.5×
7
MS_DRG 		Lung Transplant 14 $96,065.28 $192,130.56 $102,789.85 nat. median
$122,708
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $89,261.02 $178,522.04 $95,509.29 nat. median
$117,357
0.8× median
5465
OTHER 		Level 5 Neurostimulator And Related Procedures 6 $29,270.95 $184,131.83 $93,052.41 nat. median
$31,444
outlier · 3.0×
A9543
HCPCS 		Y90 Ibritumomab, Rx 8 $56,824.55 $336,117.21 $92,624.01 nat. median
$62,507
1.5× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $84,253.62 $168,507.24 $90,151.37 nat. median
$108,660
0.8× median
209
MS_DRG 		Complex Aortic Arch Procedures 14 $84,158.74 $168,317.48 $90,049.85 nat. median
$98,047
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 16 $9,936.00 $171,746.00 $89,004.48 nat. median
$102,358
0.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $500.00 $163,973.50 $87,725.82 nat. median
$98,894
0.9× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 8 $63,342.28 $624,000.00 $86,462.21 nat. median
$69,774
1.2× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $67,112.24 $100,910.44 $84,011.34 nat. median
$65,393
1.3× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $76,799.81 $153,599.62 $82,175.80 nat. median
$100,136
0.8× median
215
MS_DRG 		Other Heart Assist System Implant 16 $34,387.00 $171,746.00 $81,641.82 nat. median
$99,019
0.8× median
J9226
HCPCS 		Supprelin La Implant 8 $45,020.65 $267,429.22 $80,586.96 nat. median
$60,368
1.3× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $154.71 $171,746.00 $80,243.32 nat. median
$93,672
0.9× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $61,890.84 $93,059.50 $77,475.17 nat. median
$62,372
1.2× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 8 $55,272.32 $337,256.15 $75,446.73 nat. median
$66,682
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $67,305.38 $134,610.76 $74,035.92 nat. median
$82,711
0.9× median
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 8 $68,801.71 $137,603.42 $72,929.82 nat. median
$70,825
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $64,750.23 $139,505.01 $71,225.25 nat. median
$83,470
0.9× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 16 $9,936.00 $143,487.00 $69,381.98 nat. median
$79,312
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 $62,881.12 $146,075.79 $69,169.23 nat. median
$81,118
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 $48,674.00 $195,055.00 $64,877.36 nat. median
$77,570
0.8× median
38240
HCPCS 		Transplt Allo Hct/donor 8 $7,316.00 $126,375.50 $64,293.53 nat. median
$15,979
outlier · 4.0×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 $9,936.00 $143,487.00 $63,347.99 nat. median
$74,915
0.8× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 $9,936.00 $118,670.91 $63,082.26 nat. median
$73,807
0.9× median

Other procedures at this hospital

Browse this hospital's 15,508 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
             
0408T HCPCS Insj/rplc Cardiac Modulj Sys 13 8 — — $7,665.00 $63,063.80 $33,108.49 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 13 8 — — $7,665.00 $46,334.30 $23,462.18 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 13 8 — — $7,665.00 $46,334.30 $23,462.18 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 13 8 — — $7,665.00 $46,334.30 $23,462.18 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 13 8 — — $7,665.00 $65,856.59 $33,108.49 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 15 8 — — $7,316.00 $46,334.30 $23,015.29 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 13 8 — — $9,317.12 $88,494.38 $45,574.61 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 13 8 — — $627.00 $61,996.63 $31,928.26 2026-04-01
0686T HCPCS Histotripsy Mal Hepatcel Tis 12 8 — — $7,250.29 $68,829.18 $35,791.18 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 15 8 — — $2,110.15 $61,996.63 $31,618.28 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 15 8 — — $2,110.15 $61,996.63 $31,618.28 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 15 8 — — $7,316.00 $65,405.62 $32,477.86 2026-04-01
0916T HCPCS Insj Perm Ccm-d Sys Pg Only 15 8 — — $7,316.00 $45,790.23 $23,015.29 2026-04-01
0923T HCPCS Rmvl&rplcmt Perm Ccm-d Pg 15 8 — — $7,316.00 $45,790.23 $23,015.29 2026-04-01
0956T HCPCS Prt Crn Ch Cr&tun Elt S-sclp 12 8 — — $7,316.00 $54,515.34 $28,347.97 2026-04-01
0960T HCPCS Rpl S-sclp Eltr Ra Rcvr&tlmt 12 8 — — $7,316.00 $54,515.34 $28,347.97 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 28 15 — — $206,078.48 $426,580.74 $220,503.97 2026-04-01
10 MS_DRG Pancreas Transplant 27 14 — — $53,920.93 $107,841.86 $57,695.40 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 33 15 — — $41,356.08 $82,712.16 $45,491.69 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 33 15 — — $32,319.99 $64,639.98 $35,551.99 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 33 15 — — $22,582.53 $45,165.06 $24,840.78 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 27 14 — — $89,261.02 $178,522.04 $95,509.29 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 35 16 — — $8,710.22 $65,359.60 $35,947.78 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 34 15 — — $23,281.83 $57,788.28 $31,783.55 2026-04-01
1475 OTHER Golimumab For IV Use 1mg 1 1 — — $57,459.15 $57,459.15 $57,459.15 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 27 14 — — $44,827.18 $89,654.36 $47,965.08 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 36 15 — — $33,048.57 $94,420.00 $37,685.88 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 33 15 — — $28,829.19 $61,739.43 $31,712.11 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 27 14 — — $41,196.98 $82,393.96 $44,080.77 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 38 15 — — $23,106.76 $69,026.31 $25,600.25 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 28 14 — — $316,713.50 $633,427.00 $338,883.44 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 27 14 — — $53,620.97 $107,241.94 $57,374.44 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 15 — — $84,253.62 $168,507.24 $90,151.37 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 35 16 — — $48,674.00 $195,055.00 $64,877.36 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 19 9 — — $7,316.00 $54,515.34 $27,666.53 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 41 16 — — $30,949.76 $330,643.18 $53,364.14 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 43 16 — — $13,852.70 $166,748.30 $23,123.90 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 27 14 — — $84,158.74 $168,317.48 $90,049.85 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 35 16 — — $40,186.16 $195,055.00 $44,204.78 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 38 16 — — $9,936.00 $171,746.00 $89,004.48 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 21 11 — — $3,532.83 $54,515.34 $27,257.67 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 27 14 — — $43,201.11 $86,402.22 $46,225.19 2026-04-01
215 MS_DRG Other Heart Assist System Implant 33 16 — — $34,387.00 $171,746.00 $81,641.82 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 39 16 — — $154.71 $171,746.00 $80,243.32 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 38 16 — — $9,936.00 $171,746.00 $54,492.90 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 38 16 — — $9,936.00 $171,746.00 $54,492.90 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 39 16 — — $9,936.00 $143,487.00 $63,347.99 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 35 16 — — $24,739.92 $195,055.00 $27,213.91 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 16 — — $9,936.00 $143,487.00 $44,517.87 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 16 — — $9,936.00 $143,487.00 $42,168.83 2026-04-01
22103 HCPCS Remove Extra Spine Segment 5 2 — — $7,316.00 $27,166.00 $25,663.00 2026-04-01
22558 HCPCS Lumbar Spine Fusion 18 8 — — $929.96 $54,515.34 $27,462.10 2026-04-01
22630 HCPCS Lumbar Spine Fusion 18 8 — — $957.34 $54,515.34 $27,462.10 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 15 8 — — $6,902.41 $54,515.34 $27,802.82 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 41 16 — — $9,936.00 $163,050.00 $41,423.81 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 38 16 — — $9,936.00 $163,050.00 $26,989.93 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 35 16 — — $43,371.89 $123,913.00 $47,709.08 2026-04-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 1 1 — — $104,476.71 $104,476.71 $104,476.71 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 38 16 — — $9,936.00 $143,487.00 $69,381.98 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 38 16 — — $9,936.00 $143,487.00 $50,376.84 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 38 16 — — $9,936.00 $118,670.91 $63,082.26 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 38 16 — — $9,936.00 $117,934.00 $45,560.74 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 38 16 — — $9,936.00 $104,352.00 $48,819.38 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 38 16 — — $9,936.00 $104,352.00 $35,333.63 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 35 15 — — $7,754.97 $76,278.81 $41,217.48 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 16 — — $28,327.39 $126,913.00 $33,110.62 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 38 16 — — $7,754.97 $44,708.18 $24,254.19 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 42 15 — — $9,936.00 $74,663.60 $26,964.76 2026-04-01
245 MS_DRG Aicd Generator Procedures 37 15 — — $7,754.97 $74,005.70 $37,287.51 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 35 16 — — $34,733.56 $123,913.00 $38,206.92 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 41 16 — — $7,754.97 $54,017.96 $28,899.61 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 34 15 — — $7,754.97 $42,473.42 $23,360.38 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 36 15 — — $7,754.97 $48,964.58 $26,563.28 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 35 16 — — $24,242.17 $123,913.00 $26,666.39 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 36 15 — — $7,754.97 $51,583.49 $27,439.89 2026-04-01
263 MS_DRG Vein Ligation And Stripping 34 15 — — $7,754.97 $47,728.24 $26,250.53 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 37 16 — — $7,754.97 $52,929.79 $27,964.63 2026-04-01
265 MS_DRG Aicd Lead Procedures 35 15 — — $7,754.97 $55,914.08 $30,752.74 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 38 16 — — $9,936.00 $171,746.00 $50,905.10 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 38 16 — — $9,936.00 $171,746.00 $39,925.75 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 40 16 — — $9,936.00 $110,874.00 $56,787.12 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 40 16 — — $9,936.00 $78,266.00 $34,660.29 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 41 16 — — $9,936.00 $110,874.00 $42,862.53 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 42 16 — — $9,936.00 $78,266.00 $29,843.22 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 43 15 — — $9,936.00 $115,194.52 $34,825.44 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 43 15 — — $9,936.00 $53,335.89 $28,131.53 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 40 15 — — $9,936.00 $262,128.75 $58,949.35 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 40 16 — — $9,936.00 $106,629.85 $49,246.43 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 39 15 — — $9,936.00 $131,795.08 $38,783.34 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 18 8 — — $579.21 $54,515.34 $27,462.10 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 36 16 — — $7,754.97 $84,348.46 $45,763.22 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 35 15 — — $7,754.97 $55,741.82 $30,658.00 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 33 15 — — $45,400.83 $92,067.95 $49,940.91 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 35 15 — — $4,308.32 $42,601.88 $23,431.03 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 33 15 — — $26,449.20 $52,898.40 $29,094.12 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 30 15 — — $156,459.16 $324,560.15 $169,758.19 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 34 15 — — $34,250.41 $68,500.82 $37,675.45 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 32 15 — — $50,350.58 $100,701.16 $55,385.64 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 38 15 — — $9,936.00 $68,243.92 $37,022.33 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 47 16 — — $9,936.00 $112,102.79 $23,548.24 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 38 15 — — $9,936.00 $66,266.06 $35,949.33 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 41 15 — — $9,936.00 $53,086.73 $27,001.96 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 36 15 — — $9,936.00 $49,961.54 $27,118.26 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 16 — — $37,949.94 $90,462.63 $41,744.93 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 39 15 — — $8,562.41 $128,696.91 $38,606.72 2026-04-01
332 MS_DRG Rectal Resection With Mcc 33 15 — — $27,975.28 $55,950.56 $30,772.81 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 15 8 — — $7,316.00 $46,334.30 $23,015.29 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 15 8 — — $7,316.00 $65,856.59 $32,477.86 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 18 8 — — $7,316.00 $65,856.59 $32,083.71 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 15 8 — — $7,316.00 $46,334.30 $23,015.29 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 15 8 — — $7,316.00 $46,334.30 $23,015.29 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 15 8 — — $7,316.00 $65,856.59 $32,477.86 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 15 8 — — $7,316.00 $65,856.59 $32,477.86 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 15 8 — — $7,316.00 $91,801.02 $45,574.61 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 15 8 — — $7,316.00 $61,996.63 $31,928.26 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 15 8 — — $7,316.00 $58,183.92 $29,678.48 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 34 15 — — $27,611.82 $55,223.64 $30,373.00 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 35 15 — — $28,530.41 $59,599.74 $32,779.86 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 35 15 — — $21,892.61 $208,901.74 $25,002.95 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 34 15 — — $11,921.05 $67,220.68 $36,971.37 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 27 14 — — $26,646.25 $53,292.50 $28,511.49 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 34 15 — — $23,282.01 $51,359.75 $28,134.74 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 18 8 — — $7,316.00 $126,375.50 $64,293.53 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 32 16 — — $102,642.55 $223,660.50 $112,906.80 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 33 15 — — $29,730.54 $59,461.08 $32,703.59 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 33 15 — — $30,893.16 $159,689.87 $33,982.48 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 34 15 — — $41,475.78 $83,761.62 $45,623.36 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 33 15 — — $22,716.82 $45,433.64 $24,988.50 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 33 15 — — $27,573.14 $56,633.27 $30,330.45 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 34 15 — — $4,869.65 $51,317.56 $28,224.66 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 33 15 — — $27,551.25 $55,102.50 $30,306.38 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 36 15 — — $7,037.93 $53,450.75 $28,661.74 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 34 15 — — $31,860.20 $63,720.40 $35,046.22 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 33 15 — — $500.00 $163,973.50 $87,725.82 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 34 15 — — $54,234.03 $425,265.18 $58,843.92 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 31 15 — — $42,581.48 $85,162.96 $46,839.63 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 31 15 — — $67,305.38 $134,610.76 $74,035.92 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 32 15 — — $43,640.47 $87,280.94 $48,004.52 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 32 15 — — $250.00 $101,535.98 $54,591.57 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 31 15 — — $32,500.99 $65,001.98 $35,751.09 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 32 15 — — $39,606.93 $80,894.88 $43,885.47 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 31 15 — — $25,126.73 $50,253.46 $27,639.40 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $89,668.51 $134,826.20 $112,247.36 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $61,890.84 $93,059.50 $77,475.17 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 1 — — $46,604.07 $70,074.20 $58,339.13 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 35 15 — — $62,881.12 $146,075.79 $69,169.23 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 33 15 — — $45,070.95 $92,435.69 $49,578.04 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 33 15 — — $32,003.24 $68,939.17 $35,203.56 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $67,112.24 $100,910.44 $84,011.34 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $37,014.29 $55,654.95 $46,334.62 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 33 15 — — $41,858.94 $103,743.48 $46,044.83 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 34 15 — — $20,963.75 $43,369.39 $23,060.13 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 37 16 — — $627.65 $89,909.45 $47,461.81 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 35 15 — — $22,846.55 $48,564.62 $26,710.54 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 37 16 — — $31,115.49 $88,050.00 $43,495.08 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 41 17 — — $6,234.41 $88,050.00 $32,596.34 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 41 16 — — $20,259.15 $127,136.53 $23,766.61 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 38 16 — — $491.42 $88,050.00 $26,056.25 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 33 15 — — $36,791.69 $74,842.59 $40,470.86 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 34 15 — — $23,051.81 $46,103.62 $25,356.99 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 34 15 — — $32,881.24 $67,916.30 $36,169.36 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 35 15 — — $20,661.21 $53,526.04 $29,439.32 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 41 16 — — $21,626.16 $50,981.21 $25,085.64 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 34 15 — — $19,711.27 $43,560.88 $23,958.48 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 33 15 — — $25,102.65 $50,205.30 $27,612.92 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 34 15 — — $26,042.84 $56,693.54 $31,181.45 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 33 15 — — $28,011.77 $56,023.54 $30,812.95 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 33 15 — — $23,567.81 $47,135.62 $25,924.59 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 14 — — $76,799.81 $153,599.62 $82,175.80 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 33 15 — — $24,647.96 $49,339.20 $27,112.76 2026-04-01
503 MS_DRG Foot Procedures With Mcc 34 15 — — $20,776.79 $43,841.14 $24,112.63 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 33 15 — — $23,594.81 $47,189.62 $25,954.29 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 34 15 — — $24,809.26 $58,086.64 $27,290.19 2026-04-01
5166 OTHER Cochlear Implant Procedure 1 1 — — $31,227.16 $31,227.16 $31,227.16 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 36 16 — — $25,707.00 $57,652.54 $31,708.90 2026-04-01
5200 OTHER Implantation Wireless Pa Pressure Monitor 2 1 — — $28,017.27 $28,505.41 $28,261.34 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 38 17 — — $21,983.02 $88,050.00 $24,747.66 2026-04-01
5213 OTHER Level 3 Electrophysiologic Procedures 16 8 — — $14,956.11 $47,178.32 $24,160.95 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 2 2 — — $18,724.02 $105,813.25 $62,268.63 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 8 6 — — $350.00 $156,196.11 $31,592.90 2026-04-01
5432 OTHER Level 2 Nerve Procedures 2 2 — — $6,156.74 $43,400.69 $24,778.72 2026-04-01
5463 OTHER Level 3 Neurostimulator And Related Procedures 1 1 — — $105,346.84 $105,346.84 $105,346.84 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 9 6 — — $29,270.95 $184,131.83 $93,052.41 2026-04-01
570 MS_DRG Skin Debridement With Mcc 33 15 — — $23,015.32 $46,030.64 $25,316.85 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 34 15 — — $20,275.71 $98,729.14 $54,301.03 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 33 15 — — $26,885.64 $53,771.28 $29,574.20 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 33 15 — — $37,320.82 $86,468.37 $41,052.90 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 36 15 — — $24,070.89 $50,851.57 $27,704.44 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 27 14 — — $35,392.60 $70,785.20 $37,870.08 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 37 16 — — $14,868.66 $55,441.00 $23,839.66 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 34 15 — — $27,002.41 $60,216.41 $29,702.65 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 21 11 — — $2,214.47 $61,996.63 $30,998.31 2026-04-01
61886 HCPCS Implant Neurostim Arrays 21 11 — — $2,537.60 $61,996.63 $30,998.31 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 15 8 — — $7,316.00 $61,996.63 $31,928.26 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 38 15 — — $17,547.00 $55,560.13 $24,885.74 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 35 15 — — $16,913.45 $112,185.13 $30,279.07 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 34 16 — — $12,978.53 $47,183.78 $25,951.08 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 33 15 — — $28,749.64 $61,080.62 $31,624.60 2026-04-01
63035 HCPCS Spinal Disk Surgery Add-on 5 2 — — $7,316.00 $27,166.00 $25,663.00 2026-04-01
63048 HCPCS Remove Spinal Lamina Add-on 5 2 — — $7,316.00 $27,166.00 $25,663.00 2026-04-01
63052 HCPCS Lam Facetc/frmt Arthrd Lum 1 5 2 — — $7,316.00 $27,166.00 $25,663.00 2026-04-01
63053 HCPCS Lam Factc/frmt Arthrd Lum Ea 5 2 — — $7,316.00 $27,166.00 $25,663.00 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 21 11 — — $2,214.47 $61,996.63 $30,998.31 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 15 8 — — $7,316.00 $88,494.38 $45,574.61 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 15 8 — — $7,316.00 $61,996.63 $31,928.26 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 10 8 — — $30,998.31 $61,996.63 $32,858.21 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 14 — — $24,671.24 $71,725.22 $38,014.36 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 27 14 — — $28,596.37 $57,192.74 $30,598.12 2026-04-01
652 MS_DRG Kidney Transplant 27 14 — — $25,120.17 $50,240.34 $26,878.58 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 33 15 — — $39,475.30 $84,421.74 $43,422.83 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 34 15 — — $15,802.51 $43,960.82 $24,178.45 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 34 15 — — $24,432.39 $49,573.26 $27,265.29 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 35 16 — — $7,088.25 $47,788.08 $26,283.44 2026-04-01
665 MS_DRG Prostatectomy With Mcc 34 15 — — $13,608.85 $51,998.44 $26,762.72 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 33 15 — — $22,861.32 $45,722.64 $25,147.45 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 38 16 — — $11,834.19 $64,429.80 $35,404.69 2026-04-01
69930 HCPCS Implant Cochlear Device 21 11 — — $4,704.68 $67,540.97 $33,122.37 2026-04-01
7 MS_DRG Lung Transplant 27 14 — — $96,065.28 $192,130.56 $102,789.85 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 33 15 — — $27,638.10 $59,631.01 $30,401.91 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 33 15 — — $27,698.67 $60,286.75 $30,468.54 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 33 14 — — $6,848.19 $115,825.69 $47,174.30 2026-04-01
791 MS_DRG Prematurity With Major Problems 32 14 — — $2,703.85 $62,348.30 $32,732.86 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 37 15 — — $1,839.60 $63,962.70 $32,940.79 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 33 15 — — $34,603.65 $75,384.24 $38,064.02 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 27 14 — — $42,454.49 $84,908.98 $45,426.30 2026-04-01
800 MS_DRG Splenic Procedures With Cc 33 15 — — $22,054.13 $44,126.59 $24,259.54 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 33 15 — — $30,627.50 $61,255.00 $33,690.25 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 33 15 — — $44,353.52 $92,000.54 $48,788.87 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 34 15 — — $35,011.62 $70,866.35 $38,512.78 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 33 15 — — $35,690.37 $72,320.17 $39,259.41 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 33 15 — — $24,612.93 $49,225.86 $27,074.22 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 33 15 — — $41,617.37 $85,188.79 $45,779.11 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 33 15 — — $36,613.61 $75,829.04 $40,274.97 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 37 15 — — $8,643.75 $50,319.16 $27,675.54 2026-04-01
849 MS_DRG Radiotherapy 33 15 — — $21,325.02 $42,650.04 $23,457.52 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 31 15 — — $64,750.23 $139,505.01 $71,225.25 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 49 17 — — $27,014.35 $231,081.52 $41,353.16 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 36 15 — — $15,322.23 $214,444.83 $38,222.97 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 43 16 — — $46,861.08 $180,923.92 $57,194.39 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 31 15 — — $29,757.54 $59,515.08 $32,733.29 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 34 15 — — $32,178.40 $67,095.49 $35,396.24 2026-04-01
90288 HCPCS Botulism Ig IV 3 1 — — $114,456.75 $121,762.50 $114,456.75 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 33 15 — — $28,357.72 $58,472.50 $31,193.49 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 37 15 — — $21,170.53 $60,329.15 $31,640.65 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 15 — — $157,373.64 $359,258.08 $168,389.79 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 31 15 — — $53,899.04 $107,798.08 $59,288.94 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 31 15 — — $25,056.67 $50,113.34 $27,562.34 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 31 15 — — $29,971.38 $65,526.57 $32,968.52 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 15 8 — — $11,852.46 $63,758.04 $28,094.95 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 15 8 — — $11,852.46 $63,758.04 $28,094.95 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 15 8 — — $11,852.46 $63,758.04 $28,094.95 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 34 15 — — $23,830.61 $56,064.42 $30,835.43 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 34 15 — — $27,235.96 $264,376.00 $29,959.56 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 33 15 — — $50,676.08 $103,407.78 $55,743.69 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 35 15 — — $16,499.78 $59,006.81 $31,915.22 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 33 15 — — $57,162.86 $114,325.72 $62,879.15 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 33 15 — — $32,304.67 $64,609.34 $35,535.14 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 33 15 — — $23,037.21 $46,074.42 $25,340.93 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 34 16 — — $21,502.37 $43,004.74 $23,652.61 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 33 15 — — $46,225.55 $104,566.61 $50,848.11 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 34 15 — — $26,729.86 $55,820.66 $30,701.36 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 36 15 — — $20,896.19 $60,315.01 $24,874.50 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 15 — — $35,792.55 $110,711.05 $42,056.25 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 33 15 — — $26,571.81 $53,143.62 $29,228.99 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 15 8 — — $56,824.55 $336,117.21 $92,624.01 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $267,482.51 $267,482.51 $267,482.51 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 17 8 — — $7,250.29 $54,080.28 $27,851.35 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 7 — — $3,685,266.67 $4,053,793.33 $3,795,824.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 7 — — $3,316,462.59 $3,648,108.85 $3,415,956.47 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 10 8 — — $2,332,000.00 $4,664,000.00 $2,471,920.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 8 7 — — $2,945,740.00 $4,801,556.20 $3,063,569.60 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 7 — — $3,248,445.72 $3,573,290.29 $3,345,899.09 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 10 8 — — $2,455,110.60 $4,910,221.21 $2,602,417.25 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 5 3 — — $24,279.71 $62,150.40 $39,856.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 5 3 — — $148,898.10 $467,204.56 $157,775.33 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 16 8 — — $63,342.28 $624,000.00 $86,462.21 2026-04-01
J9226 HCPCS Supprelin La Implant 18 8 — — $45,020.65 $267,429.22 $80,586.96 2026-04-01
J9266 HCPCS Pegaspargase Injection 18 8 — — $28,424.06 $160,122.18 $50,879.07 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 15 8 — — $24,228.42 $143,311.10 $39,492.32 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 10 8 — — $29,717.20 $59,434.40 $31,500.23 2026-04-01
L5858 HCPCS Stance Phase Only 10 8 — — $23,006.91 $46,013.82 $24,387.32 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 10 8 — — $29,510.19 $59,020.38 $31,280.80 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 10 8 — — $29,576.84 $59,153.68 $31,351.45 2026-04-01
L6965 HCPCS Shldr Disartic Myoelectronic 10 8 — — $23,134.38 $46,268.76 $24,522.44 2026-04-01
L6970 HCPCS Interscapular-thor Switch CT 10 8 — — $23,514.53 $47,029.06 $24,925.40 2026-04-01
L6975 HCPCS Interscap-thor Myoelectronic 10 8 — — $23,640.73 $47,281.46 $25,059.18 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 10 8 — — $50,007.15 $100,014.30 $53,007.58 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 10 8 — — $49,600.83 $99,201.66 $52,576.88 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 10 8 — — $34,970.13 $69,940.26 $37,068.34 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 10 8 — — $68,801.71 $137,603.42 $72,929.82 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 10 8 — — $111,492.17 $222,984.34 $118,181.70 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 10 8 — — $23,210.23 $46,420.46 $24,602.85 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 12 8 — — $533,230.17 $2,974,302.92 $565,223.98 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 12 8 — — $591,726.20 $3,423,431.17 $627,229.78 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 16 8 — — $55,272.32 $337,256.15 $75,446.73 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 12 8 — — $489,304.61 $2,894,796.03 $518,662.89 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 12 8 — — $562,538.19 $3,054,756.15 $596,290.47 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 12 8 — — $557,317.93 $3,120,886.85 $590,757.01 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 12 8 — — $565,868.94 $3,271,996.41 $599,821.08 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 12 8 — — $770,620.00 $4,558,217.30 $816,857.20 2026-04-01
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