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

COVENANT HOSPITAL LEVELLAND

Levelland, TX · CCN 450755 · Rates published

15,160 distinct procedures filed
17 distinct payers
353,834 rate rows
2026-04-01 last MRF observed
Data quality

262,358 of 353,834 rate rows are consumer-grade (74.1%)

91,476 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 91,050
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 388
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 24
placeholder amount (≤ $0.02) — excluded from medians 14
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/txnm/live/752246348_covenant-hospital-levelland_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-03
Content fingerprint 6bbea8a4131a2088… · 174,893,973 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $1,776,904.50 $1,791,273.00 $1,776,904.50 nat. median
$2,313,353
0.8× median
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 1 $1,674,137.50 $1,687,675.00 $1,674,137.50 nat. median
$6
outlier · 291661.6×
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.04 $3,504,052.08 $1,610,867.56 nat. median
$3,325,455
outlier · 0.5×
C9081
HCPCS 		Idecabtagene Car Pos T 1 $1,603,035.35 $1,615,997.90 $1,603,035.35 nat. median
$422,856
outlier · 3.8×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $1,567,879.39 $1,580,557.66 $1,567,879.39 nat. median
$1,000,529
1.6× median
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $1,425,344.90 $1,436,870.60 $1,425,344.90 nat. median
$1,000,529
1.4× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $570,839.96 $1,732,143.60 $1,169,555.71 nat. median
$599,737
2.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $542,987.65 $1,562,654.28 $1,070,344.33 nat. median
$574,037
1.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $545,393.01 $1,528,383.91 $1,054,654.67 nat. median
$579,571
1.8× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $595,755.38 $1,436,870.60 $1,036,652.82 nat. median
$621,313
1.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $474,611.88 $1,389,439.92 $947,248.13 nat. median
$513,770
1.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $515,893.64 $1,325,269.00 $937,869.66 nat. median
$562,501
1.7× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 $257,786.93 $762,812.81 $344,638.21 nat. median
$168,055
outlier · 2.1×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $62,353.83 $598,400.00 $330,708.92 nat. median
$66,211
outlier · 5.0×
0100T
OTHER 		Prosth Retina Receive&Gen 3 $8,624.00 $841,802.76 $281,288.95 nat. median
$66,159
outlier · 4.3×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $192,545.51 $410,554.57 $216,044.96 nat. median
$186,516
1.2× median
C9074
HCPCS 		Injection, Lumasiran 1 $204,050.00 $205,700.00 $204,050.00 nat. median
$297
outlier · 687.4×
C9031
HCPCS 		Lutetium Lu 177 Dotatate, Tx 1 $186,798.50 $188,309.00 $186,798.50 —
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $146,496.85 $441,427.96 $174,800.81 nat. median
$145,435
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $162,169.06 $345,784.48 $167,002.35 nat. median
$131,925
1.3× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $131,651.74 $184,184.64 $153,473.31 nat. median
$2,106
outlier · 72.9×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $54,581.12 $227,721.83 $142,629.59 nat. median
$63,499
outlier · 2.2×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $141,644.09 $142,789.46 $141,644.09 nat. median
$92,809
1.5× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $55,119.81 $203,962.06 $131,137.95 nat. median
$65,477
outlier · 2.0×
33264
HCPCS 		Rmvl & Rplcmt Dfb Gen Mlt Ld 5 $5,619.00 $178,200.17 $119,768.60 nat. median
$32,779
outlier · 3.7×
33270
HCPCS 		Ins/rep Subq Defibrillator 5 $5,619.00 $178,200.17 $119,768.60 nat. median
$32,475
outlier · 3.7×
33231
HCPCS 		Insrt Pulse Gen W/mult Leads 5 $5,619.00 $178,200.17 $119,768.60 nat. median
$31,377
outlier · 3.8×
33249
HCPCS 		Insj/rplcmt Defib W/lead(s) 5 $8,624.00 $178,200.17 $119,768.60 nat. median
$32,069
outlier · 3.7×
69930
HCPCS 		Implant Cochlear Device 6 $3,300.00 $182,757.93 $118,527.79 nat. median
$23,645
outlier · 5.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 8 $96,586.53 $304,357.40 $117,766.01 nat. median
$97,418
1.2× median
C9741
HCPCS 		Impl Pressure Sensor W/angio 2 $10,947.74 $180,109.71 $116,810.28 nat. median
$6,326
outlier · 18.5×
0424T
OTHER 		Insj/rplc Nstim Apnea Compl 2 $104,245.09 $160,735.44 $115,310.21 nat. median
$14,049
outlier · 8.2×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $11,759.00 $158,526.73 $115,096.50 nat. median
$2,024
outlier · 56.9×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $98,534.52 $137,852.69 $114,866.85 nat. median
$2,106
outlier · 54.6×
0283T
OTHER 		Periph Field Stimul Perm 2 $93,661.36 $144,416.39 $111,172.85 nat. median
$5,538
outlier · 20.1×
64568
HCPCS 		Inc For Vagus N Elect Impl 5 $4,837.00 $160,735.44 $107,708.97 nat. median
$27,905
outlier · 3.9×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $11,759.00 $146,778.94 $106,567.16 nat. median
$2,024
outlier · 52.7×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $90,868.43 $127,127.60 $105,930.08 nat. median
$2,106
outlier · 50.3×
7
MS_DRG 		Lung Transplant 8 $89,332.16 $190,478.23 $105,268.81 nat. median
$70,649
1.5× median
63685
HCPCS 		Insrt/redo Spine N Generator 6 $2,150.00 $160,735.44 $104,245.09 nat. median
$21,812
outlier · 4.8×
0316T
OTHER 		Replc Vagus Nerve Pls Gen 2 $72,689.36 $160,735.44 $104,245.09 nat. median
$9,247
outlier · 11.3×
61886
HCPCS 		Implant Neurostim Arrays 6 $2,300.00 $160,735.44 $104,245.09 nat. median
$23,007
outlier · 4.5×
0427T
OTHER 		Insj/rplc Nstim Apnea Pls Gn 2 $73,765.84 $160,735.44 $104,245.09 nat. median
$9,247
outlier · 11.3×
0268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 2 $72,689.36 $160,735.44 $104,245.09 nat. median
$22,046
outlier · 4.7×
0312T
OTHER 		Laps Impltj Nstim Vagus 2 $13,214.51 $160,735.44 $104,245.09 nat. median
$14,049
outlier · 7.4×
0266T
OTHER 		Implt/rpl Crtd Sns Dev Total 2 $13,214.51 $160,735.44 $104,245.09 nat. median
$44,339
outlier · 2.4×
0431T
OTHER 		Rmvl/rplc Nstim Apnea Pls Gn 2 $73,765.84 $160,735.44 $104,245.09 nat. median
$9,247
outlier · 11.3×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $89,557.75 $190,959.24 $98,417.37 nat. median
$72,715
1.4× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 $11,759.00 $132,527.98 $96,220.41 nat. median
$2,024
outlier · 47.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $74,465.23 $223,002.87 $94,737.23 nat. median
$74,509
1.3× median

Other procedures at this hospital

Browse this hospital's 15,160 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
             
C9098 HCPCS Ciltacabtagene Car Pos T 8 1 — — $1,776,904.50 $1,791,273.00 $1,776,904.50 2026-04-01
Q2040 HCPCS Tisagenlecleucel Car-pos T 8 1 — — $1,674,137.50 $1,687,675.00 $1,674,137.50 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 16 4 — — $0.04 $3,504,052.08 $1,610,867.56 2026-04-01
C9081 HCPCS Idecabtagene Car Pos T 8 1 — — $1,603,035.35 $1,615,997.90 $1,603,035.35 2026-04-01
C9076 HCPCS Lisocabtagene Car Pos T 8 1 — — $1,567,879.39 $1,580,557.66 $1,567,879.39 2026-04-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 8 1 — — $1,425,344.90 $1,436,870.60 $1,425,344.90 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 16 4 — — $570,839.96 $1,732,143.60 $1,169,555.71 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 16 4 — — $542,987.65 $1,562,654.28 $1,070,344.33 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 16 4 — — $545,393.01 $1,528,383.91 $1,054,654.67 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 16 4 — — $595,755.38 $1,436,870.60 $1,036,652.82 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 16 4 — — $474,611.88 $1,389,439.92 $947,248.13 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 16 4 — — $515,893.64 $1,325,269.00 $937,869.66 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 36 8 — — $257,786.93 $762,812.81 $344,638.21 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 16 4 — — $62,353.83 $598,400.00 $330,708.92 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 16 3 — — $8,624.00 $841,802.76 $281,288.95 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 28 8 — — $192,545.51 $410,554.57 $216,044.96 2026-04-01
C9074 HCPCS Injection, Lumasiran 8 1 — — $204,050.00 $205,700.00 $204,050.00 2026-04-01
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 8 1 — — $186,798.50 $188,309.00 $186,798.50 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 36 8 — — $146,496.85 $441,427.96 $174,800.81 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 8 — — $162,169.06 $345,784.48 $167,002.35 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 8 1 — — $131,651.74 $184,184.64 $153,473.31 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 16 4 — — $54,581.12 $227,721.83 $142,629.59 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 8 1 — — $141,644.09 $142,789.46 $141,644.09 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 16 4 — — $55,119.81 $203,962.06 $131,137.95 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 24 5 — — $5,619.00 $178,200.17 $119,768.60 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 24 5 — — $8,624.00 $178,200.17 $119,768.60 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 24 5 — — $5,619.00 $178,200.17 $119,768.60 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 24 5 — — $5,619.00 $178,200.17 $119,768.60 2026-04-01
69930 HCPCS Implant Cochlear Device 26 6 — — $3,300.00 $182,757.93 $118,527.79 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 36 8 — — $96,586.53 $304,357.40 $117,766.01 2026-04-01
C9741 HCPCS Impl Pressure Sensor W/angio 14 2 — — $10,947.74 $180,109.71 $116,810.28 2026-04-01
0424T OTHER Insj/rplc Nstim Apnea Compl 14 2 — — $104,245.09 $160,735.44 $115,310.21 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 10 2 — — $11,759.00 $158,526.73 $115,096.50 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 8 1 — — $98,534.52 $137,852.69 $114,866.85 2026-04-01
0283T OTHER Periph Field Stimul Perm 14 2 — — $93,661.36 $144,416.39 $111,172.85 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 24 5 — — $4,837.00 $160,735.44 $107,708.97 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 10 2 — — $11,759.00 $146,778.94 $106,567.16 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 8 1 — — $90,868.43 $127,127.60 $105,930.08 2026-04-01
7 MS_DRG Lung Transplant 28 8 — — $89,332.16 $190,478.23 $105,268.81 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 14 2 — — $13,214.51 $160,735.44 $104,245.09 2026-04-01
0431T OTHER Rmvl/rplc Nstim Apnea Pls Gn 14 2 — — $73,765.84 $160,735.44 $104,245.09 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 26 6 — — $2,150.00 $160,735.44 $104,245.09 2026-04-01
0427T OTHER Insj/rplc Nstim Apnea Pls Gn 14 2 — — $73,765.84 $160,735.44 $104,245.09 2026-04-01
0316T OTHER Replc Vagus Nerve Pls Gen 14 2 — — $72,689.36 $160,735.44 $104,245.09 2026-04-01
61886 HCPCS Implant Neurostim Arrays 26 6 — — $2,300.00 $160,735.44 $104,245.09 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 14 2 — — $72,689.36 $160,735.44 $104,245.09 2026-04-01
0312T OTHER Laps Impltj Nstim Vagus 14 2 — — $13,214.51 $160,735.44 $104,245.09 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 28 8 — — $89,557.75 $190,959.24 $98,417.37 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 10 2 — — $11,759.00 $132,527.98 $96,220.41 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 36 8 — — $74,465.23 $223,002.87 $94,737.23 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 8 — — $75,330.67 $160,623.59 $93,375.24 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 18 7 — — $91,414.11 $98,410.08 $93,279.70 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 8 — — $71,652.22 $152,780.22 $91,092.65 2026-04-01
J9226 HCPCS Supprelin La Implant 16 4 — — $39,938.22 $137,441.33 $89,888.41 2026-04-01
215 MS_DRG Other Heart Assist System Implant 38 8 — — $11,759.00 $211,493.19 $87,435.47 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 8 — — $65,970.13 $200,944.21 $86,296.25 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 28 8 — — $72,793.83 $155,214.42 $85,869.74 2026-04-01
0809T OTHER Arthrd Si Jt Prq Tfx&implt 8 1 — — $78,393.52 $120,874.92 $85,400.76 2026-04-01
0775T OTHER Arthrd Si Jt Prq Iartic Impl 8 1 — — $78,393.52 $120,874.92 $85,400.76 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 8 1 — — $84,700.00 $89,320.00 $84,700.00 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 24 5 — — $8,624.00 $125,375.15 $84,264.82 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 24 5 — — $5,619.00 $125,375.15 $84,264.82 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 24 5 — — $5,619.00 $125,375.15 $84,264.82 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 24 5 — — $8,624.00 $125,375.15 $84,264.82 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 24 5 — — $5,619.00 $125,375.15 $84,264.82 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 24 5 — — $8,624.00 $125,375.15 $84,264.82 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 24 5 — — $8,624.00 $125,375.15 $84,264.82 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 8 1 — — $80,400.15 $81,050.29 $80,400.15 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 8 1 — — $68,424.32 $95,727.63 $79,765.80 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 10 2 — — $11,759.00 $108,051.02 $78,449.19 2026-04-01
0308T OTHER Insj Ocular Telescope Prosth 24 5 — — $4,837.00 $122,912.70 $76,706.55 2026-04-01
0426T OTHER Insj/rplc Nstim Apnea Stm Ld 14 2 — — $69,020.32 $106,422.40 $76,346.50 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 28 8 — — $57,012.24 $121,564.17 $76,309.47 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 10 2 — — $11,759.00 $104,717.58 $76,028.99 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 36 8 — — $57,924.16 $168,021.85 $75,831.85 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 8 — — $57,891.35 $175,205.50 $75,626.89 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 10 2 — — $11,759.00 $103,951.51 $75,472.79 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 28 8 — — $62,968.45 $134,264.28 $73,736.59 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 36 8 — — $55,101.58 $175,003.43 $71,491.86 2026-04-01
63655 HCPCS Implant Neuroelectrodes 24 5 — — $7,837.00 $106,422.40 $70,854.84 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 8 — — $52,890.13 $160,277.68 $70,018.39 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 36 8 — — $53,428.81 $161,487.48 $69,762.37 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 36 8 — — $51,021.85 $149,745.91 $69,566.67 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 26 6 — — $2,150.00 $106,422.40 $69,020.32 2026-04-01
64580 HCPCS Implant Neuroelectrodes 26 6 — — $1,000.00 $106,422.40 $69,020.32 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 26 6 — — $2,150.00 $106,422.40 $69,020.32 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 24 5 — — $5,619.00 $101,088.97 $67,640.94 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 24 5 — — $5,619.00 $101,088.97 $67,640.94 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 36 8 — — $48,306.59 $145,673.32 $65,780.49 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 24 5 — — $7,187.00 $206,646.06 $64,767.44 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 36 8 — — $47,554.63 $144,205.36 $64,089.67 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 36 8 — — $45,576.98 $141,923.72 $63,827.46 2026-04-01
0387T OTHER Leadless C Pm Ins/rpl Ventr 14 2 — — $57,353.00 $88,432.55 $63,440.74 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 8 1 — — $54,344.56 $76,029.63 $63,352.29 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 8 — — $48,526.71 $103,470.94 $63,147.46 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 16 3 — — $6,794.00 $87,988.63 $63,104.93 2026-04-01
37230 HCPCS Tib/per Revasc W/stent 16 3 — — $6,794.00 $87,988.63 $63,104.93 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 16 3 — — $6,794.00 $87,988.63 $63,104.93 2026-04-01
37229 HCPCS Tib/per Revasc W/ather 16 3 — — $6,794.00 $87,988.63 $63,104.93 2026-04-01
10 MS_DRG Pancreas Transplant 28 8 — — $54,500.69 $116,208.94 $62,832.19 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 28 8 — — $45,654.23 $97,346.08 $62,810.15 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 36 8 — — $46,675.52 $126,095.06 $62,692.00 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 28 8 — — $54,186.92 $115,539.90 $62,530.15 2026-04-01
C9746 HCPCS Trans Imp Balloon Cont 14 2 — — $56,198.20 $86,651.97 $62,163.37 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 8 — — $40,668.05 $117,947.81 $61,486.91 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 8 — — $44,142.79 $131,790.89 $61,486.91 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 36 8 — — $42,094.72 $128,743.18 $61,302.05 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 36 8 — — $44,213.20 $143,027.27 $60,399.40 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 26 6 — — $1,000.00 $97,008.26 $59,377.84 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 26 6 — — $2,300.00 $97,008.26 $59,377.84 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 26 6 — — $2,300.00 $97,008.26 $59,377.84 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 26 6 — — $1,000.00 $97,008.26 $59,377.84 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 26 6 — — $2,300.00 $97,008.26 $59,377.84 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 26 6 — — $2,300.00 $97,008.26 $59,377.84 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 28 8 — — $42,287.50 $90,167.38 $59,237.08 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 28 8 — — $45,829.91 $97,720.69 $59,201.07 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 24 5 — — $7,187.00 $88,022.36 $59,159.96 2026-04-01
C9602 HCPCS Perc D-e Cor Stent Ather S 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
0238T OTHER Trluml Perip Athrc Iliac Art 24 5 — — $8,624.00 $87,988.63 $59,137.29 2026-04-01
93580 HCPCS Transcath Closure Of Asd 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
92933 HCPCS Prq Card Stent/ath/angio 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 24 5 — — $8,624.00 $87,988.63 $59,137.29 2026-04-01
93581 HCPCS Transcath Closure Of Vsd 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 24 5 — — $7,837.00 $87,988.63 $59,137.29 2026-04-01
62362 HCPCS Implant Spine Infusion Pump 26 6 — — $2,150.00 $91,170.75 $59,128.86 2026-04-01
62361 HCPCS Implant Spine Infusion Pump 26 6 — — $2,150.00 $91,170.75 $59,128.86 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 8 1 — — $59,122.56 $59,600.64 $59,122.56 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 36 8 — — $40,950.37 $129,322.91 $58,030.24 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 36 8 — — $43,230.18 $142,294.33 $57,975.32 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 36 8 — — $41,756.34 $123,163.29 $57,521.29 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 36 8 — — $41,556.73 $125,252.79 $57,101.29 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 36 8 — — $42,342.18 $128,579.61 $57,088.14 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 8 — — $39,231.80 $126,275.41 $56,751.68 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 16 1 — — $38,096.53 $87,988.63 $56,666.59 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 16 1 — — $38,096.53 $87,988.63 $56,666.59 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 36 8 — — $40,221.66 $121,755.38 $56,020.74 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 36 8 — — $39,798.51 $125,194.41 $55,991.35 2026-04-01
69715 HCPCS Temple Bne Implnt W/Stimulat 16 3 — — $6,200.00 $88,022.36 $55,762.37 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 8 — — $38,997.33 $117,370.15 $54,951.01 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 36 8 — — $36,919.19 $117,264.56 $54,712.79 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 28 8 — — $40,640.02 $86,654.56 $53,776.79 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 36 8 — — $34,199.82 $92,350.73 $53,681.74 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 28 8 — — $41,258.68 $87,973.69 $53,675.38 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 36 8 — — $41,950.48 $141,174.21 $53,347.60 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 36 8 — — $37,781.89 $115,924.97 $53,091.57 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 36 8 — — $37,108.54 $113,982.88 $52,941.52 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 38 5 — — $2,550.51 $112,802.69 $52,927.35 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 36 8 — — $36,366.84 $107,620.36 $52,881.19 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 36 8 — — $36,884.32 $106,759.05 $52,814.67 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 28 8 — — $37,393.60 $79,732.40 $52,480.44 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 18 7 — — $50,997.27 $54,900.12 $52,038.03 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 36 8 — — $36,205.51 $109,009.27 $51,876.44 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 36 8 — — $37,784.62 $127,155.14 $51,574.79 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 36 8 — — $35,087.82 $104,701.02 $51,439.43 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 8 — — $37,633.55 $80,244.02 $51,414.10 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 28 8 — — $37,193.31 $79,305.32 $51,286.23 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 36 8 — — $34,824.63 $107,386.40 $50,891.03 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 36 8 — — $38,105.23 $112,086.34 $50,821.41 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 28 8 — — $41,258.68 $87,973.69 $50,020.00 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 38 8 — — $8,628.00 $96,621.38 $49,495.39 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 28 8 — — $35,203.35 $75,062.23 $49,265.26 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 36 8 — — $34,717.99 $105,158.59 $49,204.85 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 36 8 — — $34,190.25 $103,508.43 $48,827.39 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 38 8 — — $8,050.00 $104,324.19 $48,779.31 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 36 8 — — $34,429.51 $99,522.80 $48,696.67 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 36 8 — — $36,879.54 $117,666.23 $48,538.10 2026-04-01
24371 HCPCS Revise Reconst Elbow Joint 24 5 — — $8,624.00 $88,022.36 $47,999.71 2026-04-01
27279 HCPCS Arthrodesis Sacroiliac Joint 24 5 — — $7,187.00 $88,022.36 $47,999.71 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 36 8 — — $33,202.45 $101,845.85 $47,977.33 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 36 8 — — $34,226.48 $98,483.43 $47,788.60 2026-04-01
J9266 HCPCS Pegaspargase Injection 16 4 — — $27,571.34 $65,529.25 $47,495.49 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 36 8 — — $32,159.28 $101,042.52 $47,452.14 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 8 — — $32,500.39 $98,148.01 $46,918.43 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 36 8 — — $32,643.27 $90,868.28 $46,810.15 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 24 4 — — $26,228.94 $69,002.76 $46,689.37 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 18 4 — — $6,794.00 $88,673.28 $46,680.79 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 18 4 — — $5,619.00 $248,402.76 $46,680.79 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 8 1 — — $42,604.54 $65,691.92 $46,412.77 2026-04-01
69718 HCPCS Revise Temple Bone Implant 16 3 — — $6,200.00 $65,691.92 $46,412.77 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 36 8 — — $31,802.44 $99,017.61 $46,351.48 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 36 8 — — $31,388.86 $93,518.47 $46,181.32 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 36 8 — — $31,987.01 $93,209.97 $46,090.82 2026-04-01
245 MS_DRG Aicd Generator Procedures 36 8 — — $33,404.11 $93,820.76 $45,917.56 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 36 8 — — $30,839.25 $91,688.18 $45,811.58 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 36 8 — — $30,570.59 $91,431.45 $45,796.12 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 36 8 — — $32,501.76 $102,582.94 $45,658.44 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 36 8 — — $31,506.44 $97,593.13 $45,294.14 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 36 8 — — $28,644.89 $85,232.49 $45,284.07 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 10 2 — — $13,952.00 $62,316.66 $45,244.29 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 36 8 — — $30,027.13 $90,311.33 $45,147.95 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 10 2 — — $13,508.00 $62,018.51 $45,027.83 2026-04-01
0398T OTHER Mrgfus Strtctc Les Abltj 22 2 — — $13,214.51 $69,002.76 $44,751.79 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 28 8 — — $31,493.45 $67,151.82 $44,648.64 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 36 8 — — $29,158.27 $88,588.71 $44,605.74 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 8 1 — — $33,767.78 $55,001.73 $44,561.04 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 28 8 — — $33,147.08 $70,677.76 $44,175.37 2026-04-01
22869 HCPCS Insj Stablj Dev Without Dcmprn 24 5 — — $4,837.00 $78,259.20 $44,151.64 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 36 8 — — $29,115.89 $85,716.98 $44,099.89 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 36 8 — — $30,655.36 $89,087.69 $43,833.04 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 36 8 — — $28,909.44 $78,223.99 $43,619.56 2026-04-01
0171T OTHER Lumbar Spine Proces Distract 14 2 — — $36,601.92 $56,436.48 $43,445.24 2026-04-01
25446 HCPCS Wrist Replacement 26 6 — — $3,300.00 $88,022.36 $43,445.24 2026-04-01
25442 HCPCS Reconstruct Wrist Joint 26 6 — — $2,750.00 $88,022.36 $43,445.24 2026-04-01
24363 HCPCS Replace Elbow Joint 26 6 — — $3,300.00 $88,022.36 $43,445.24 2026-04-01
24361 HCPCS Reconstruct Elbow Joint 26 6 — — $2,750.00 $88,022.36 $43,445.24 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 36 8 — — $28,050.84 $82,919.79 $43,238.22 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 36 8 — — $28,092.54 $83,745.91 $43,221.99 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 38 8 — — $8,050.00 $86,102.09 $43,191.08 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 36 8 — — $28,642.84 $76,565.56 $43,126.85 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 36 8 — — $30,284.85 $89,605.30 $43,088.17 2026-04-01
24370 HCPCS Revise Reconst Elbow Joint 24 5 — — $7,187.00 $65,691.92 $43,024.89 2026-04-01
27415 HCPCS Osteochondral Knee Allograft 24 5 — — $5,619.00 $65,691.92 $43,024.89 2026-04-01
22554 HCPCS Neck Spine Fusion 24 5 — — $7,837.00 $65,691.92 $43,024.89 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 38 8 — — $8,628.00 $83,671.37 $42,925.64 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 36 8 — — $29,515.80 $94,177.06 $42,902.54 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 36 8 — — $27,802.70 $80,973.56 $42,750.94 2026-04-01
28715 HCPCS Fusion Of Foot Bones 26 6 — — $2,600.00 $65,691.92 $42,604.54 2026-04-01
69714 HCPCS Implant Temple Bone W/Stimul 26 6 — — $6,200.00 $65,691.92 $42,604.54 2026-04-01
24435 HCPCS Repair Humerus With Graft 26 6 — — $2,600.00 $65,691.92 $42,604.54 2026-04-01
25441 HCPCS Reconstruct Wrist Joint 26 6 — — $2,750.00 $65,691.92 $42,604.54 2026-04-01
24365 HCPCS Reconstruct Head Of Radius 26 6 — — $2,750.00 $65,691.92 $42,604.54 2026-04-01
24366 HCPCS Reconstruct Head Of Radius 26 6 — — $2,750.00 $65,691.92 $42,604.54 2026-04-01
24498 HCPCS Reinforce Humerus 26 6 — — $2,300.00 $65,691.92 $42,604.54 2026-04-01
27428 HCPCS Reconstruction Knee 26 6 — — $2,600.00 $65,691.92 $42,604.54 2026-04-01
25444 HCPCS Reconstruct Wrist Joint 26 6 — — $2,750.00 $65,691.92 $42,604.54 2026-04-01
27438 HCPCS Revise Kneecap With Implant 26 6 — — $2,750.00 $65,691.92 $42,604.54 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 38 8 — — $8,909.00 $80,685.77 $42,437.19 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 8 1 — — $39,557.40 $48,278.72 $41,893.47 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 28 8 — — $27,912.76 $59,516.89 $41,263.71 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 36 8 — — $25,986.37 $78,445.53 $40,886.07 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 28 8 — — $28,510.22 $60,790.83 $40,740.46 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 36 8 — — $26,581.79 $80,776.87 $40,567.40 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 36 8 — — $25,784.02 $79,723.00 $40,493.93 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 36 8 — — $24,504.33 $70,194.75 $40,361.66 2026-04-01
0302T OTHER Icar Ischm Mntrng Sys Compl 14 2 — — $33,986.55 $52,403.84 $40,340.88 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 36 8 — — $27,231.21 $77,010.70 $40,324.52 2026-04-01
37221 HCPCS Iliac Revasc W/stent 16 3 — — $6,794.00 $54,694.81 $40,074.81 2026-04-01
37225 HCPCS Fem/popl Revas W/ather 16 3 — — $6,794.00 $54,694.81 $40,074.81 2026-04-01
37226 HCPCS Fem/popl Revasc W/stent 16 3 — — $6,794.00 $54,694.81 $40,074.81 2026-04-01
37228 HCPCS Tib/per Revasc W/tla 16 3 — — $6,794.00 $54,694.81 $40,074.81 2026-04-01
791 MS_DRG Prematurity With Major Problems 28 8 — — $27,754.84 $59,180.18 $39,927.66 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 36 8 — — $26,128.56 $80,296.52 $39,734.37 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 28 8 — — $26,860.01 $57,272.18 $39,644.73 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 36 8 — — $26,325.44 $84,015.07 $39,538.68 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 36 8 — — $24,498.86 $75,902.85 $39,533.79 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 36 8 — — $26,976.91 $83,118.56 $39,454.38 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 36 8 — — $26,393.11 $67,418.27 $39,039.01 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 36 8 — — $24,274.64 $71,681.34 $38,906.50 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 28 8 — — $29,577.32 $63,066.15 $38,716.55 2026-04-01
265 MS_DRG Aicd Lead Procedures 36 8 — — $24,383.33 $73,172.07 $38,614.37 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 36 8 — — $22,570.42 $68,855.17 $38,572.65 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 36 8 — — $24,505.69 $75,300.51 $38,564.87 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 36 8 — — $24,064.77 $74,147.26 $38,561.35 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 28 8 — — $26,861.38 $57,275.09 $38,501.23 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 36 8 — — $27,212.07 $74,873.99 $38,340.55 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 36 8 — — $26,915.38 $80,482.86 $38,276.36 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 32 5 — — $2,539.65 $112,802.69 $38,270.70 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 32 5 — — $1,908.99 $112,802.69 $38,270.70 2026-04-01
332 MS_DRG Rectal Resection With Mcc 36 8 — — $23,710.67 $75,107.95 $38,258.50 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 38 8 — — $25,593.98 $79,207.46 $38,248.66 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 36 8 — — $24,772.98 $74,018.89 $38,248.51 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 36 8 — — $23,933.52 $77,066.61 $38,207.51 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 36 8 — — $23,950.61 $72,987.80 $38,184.32 2026-04-01
33214 HCPCS Upgrade Of Pacemaker System 24 5 — — $8,624.00 $56,590.71 $38,034.70 2026-04-01
33208 HCPCS Insrt Heart Pm Atrial & Vent 24 5 — — $8,624.00 $56,590.71 $38,034.70 2026-04-01
33224 HCPCS Insert Pacing Lead & Connect 24 5 — — $5,619.00 $56,590.71 $38,034.70 2026-04-01
33206 HCPCS Insert Heart Pm Atrial 24 5 — — $8,624.00 $56,590.71 $38,034.70 2026-04-01
33207 HCPCS Insert Heart Pm Ventricular 24 5 — — $8,624.00 $56,590.71 $38,034.70 2026-04-01
33228 HCPCS Remv&replc Pm Gen Dual Lead 24 5 — — $5,619.00 $56,590.71 $38,034.70 2026-04-01
C9750 HCPCS Ins/rem-replace Compl Iims 8 1 — — $34,897.80 $53,808.90 $38,017.16 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 8 1 — — $28,715.01 $46,771.66 $37,893.24 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 36 8 — — $24,940.46 $75,006.50 $37,850.18 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 38 8 — — $8,050.00 $71,559.19 $37,711.19 2026-04-01
C9754 HCPCS Perc Av Fistula, Direct 8 1 — — $34,615.16 $53,373.10 $37,709.26 2026-04-01
C9755 HCPCS Rf Magnetic-guide Av Fistula 8 1 — — $34,615.16 $53,373.10 $37,709.26 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 36 8 — — $21,696.10 $66,571.45 $37,683.03 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 36 8 — — $23,412.62 $72,182.39 $37,656.76 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 36 8 — — $26,420.46 $81,942.54 $37,602.65 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 36 8 — — $23,448.85 $69,439.04 $37,538.01 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 36 8 — — $21,903.91 $66,267.09 $37,516.56 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 38 8 — — $804.37 $70,515.68 $37,389.88 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 36 8 — — $23,507.64 $69,753.75 $37,348.96 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 8 — — $23,735.96 $50,610.93 $37,332.01 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 36 8 — — $23,946.51 $69,913.17 $37,146.31 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 36 8 — — $22,945.03 $71,255.31 $37,016.37 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 38 8 — — $12,266.50 $66,271.24 $36,893.71 2026-04-01
36905 HCPCS Thrmbc/nfs Dialysis Circuit 24 5 — — $8,624.00 $54,694.81 $36,760.46 2026-04-01
C9604 HCPCS Perc D-e Cor Revasc T Cabg S 24 5 — — $7,837.00 $54,694.81 $36,760.46 2026-04-01
C9600 HCPCS Perc Drug-el Cor Stent Sing 24 5 — — $7,837.00 $54,694.81 $36,760.46 2026-04-01
92990 HCPCS Revision Of Pulmonary Valve 24 5 — — $8,624.00 $54,694.81 $36,760.46 2026-04-01
92928 HCPCS Prq Card Stent W/angio 1 Vsl 24 5 — — $7,837.00 $54,694.81 $36,760.46 2026-04-01
36903 HCPCS Intro Cath Dialysis Circuit 24 5 — — $8,624.00 $54,694.81 $36,760.46 2026-04-01
0234T OTHER Trluml Perip Athrc Renal Art 24 5 — — $5,619.00 $54,694.81 $36,760.46 2026-04-01
37242 HCPCS Vasc Embolize/occlude Artery 24 5 — — $5,619.00 $54,694.81 $36,760.46 2026-04-01
92937 HCPCS Prq Revasc Byp Graft 1 Vsl 24 5 — — $7,837.00 $54,694.81 $36,760.46 2026-04-01
37238 HCPCS Open/perq Place Stent Same 24 5 — — $5,619.00 $54,694.81 $36,760.46 2026-04-01
37236 HCPCS Open/perq Place Stent 1st 24 5 — — $5,619.00 $54,694.81 $36,760.46 2026-04-01
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