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

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This hospital’s price: $447 across 5 payers · range $283-$579

Source: https://pricetransparency.providence.org/txnm/live/752246348_covenant-hospital-levelland_standardcharges.json · observed 2026-04-01

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

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
$31,873
outlier · 55.7×
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 1 $1,674,137.50 $1,687,675.00 $1,674,137.50 nat. median
$10,345
outlier · 161.8×
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.04 $3,504,052.08 $1,610,867.56 nat. median
$3,324,572
outlier · 0.5×
C9081
HCPCS 		Idecabtagene Car Pos T 1 $1,603,035.35 $1,615,997.90 $1,603,035.35 nat. median
$27,427
outlier · 58.4×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $1,567,879.39 $1,580,557.66 $1,567,879.39 nat. median
$27,935
outlier · 56.1×
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $1,425,344.90 $1,436,870.60 $1,425,344.90 nat. median
$27,071
outlier · 52.7×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $570,839.96 $1,732,143.60 $1,169,555.71 nat. median
$646,415
1.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $542,987.65 $1,562,654.28 $1,070,344.33 nat. median
$622,245
1.7× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $545,393.01 $1,528,383.91 $1,054,654.67 nat. median
$640,950
1.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $595,755.38 $1,436,870.60 $1,036,652.82 nat. median
$738,272
1.4× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $474,611.88 $1,389,439.92 $947,248.13 nat. median
$591,650
1.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $515,893.64 $1,325,269.00 $937,869.66 nat. median
$608,101
1.5× 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
$359,358
1.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $62,353.83 $598,400.00 $330,708.92 nat. median
$68,423
outlier · 4.8×
0100T
OTHER 		Prosth Retina Receive&Gen 3 $8,624.00 $841,802.76 $281,288.95 nat. median
$5,128
outlier · 54.9×
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
$249,124
0.9× median
C9074
HCPCS 		Injection, Lumasiran 1 $204,050.00 $205,700.00 $204,050.00 nat. median
$501
outlier · 407.1×
C9031
HCPCS 		Lutetium Lu 177 Dotatate, Tx 1 $186,798.50 $188,309.00 $186,798.50 nat. median
$524
outlier · 356.7×
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
$190,557
0.9× 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
$198,433
0.8× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $131,651.74 $184,184.64 $153,473.31 nat. median
$71,201
outlier · 2.2×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $54,581.12 $227,721.83 $142,629.59 nat. median
$65,720
outlier · 2.2×
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $141,644.09 $142,789.46 $141,644.09 nat. median
$75,037
1.9× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $55,119.81 $203,962.06 $131,137.95 nat. median
$63,643
outlier · 2.1×
33264
HCPCS 		Rmvl & Rplcmt Dfb Gen Mlt Ld 5 $5,619.00 $178,200.17 $119,768.60 nat. median
$31,564
outlier · 3.8×
33270
HCPCS 		Ins/rep Subq Defibrillator 5 $5,619.00 $178,200.17 $119,768.60 nat. median
$32,113
outlier · 3.7×
33231
HCPCS 		Insrt Pulse Gen W/mult Leads 5 $5,619.00 $178,200.17 $119,768.60 nat. median
$30,121
outlier · 4.0×
33249
HCPCS 		Insj/rplcmt Defib W/lead(s) 5 $8,624.00 $178,200.17 $119,768.60 nat. median
$31,584
outlier · 3.8×
69930
HCPCS 		Implant Cochlear Device 6 $3,300.00 $182,757.93 $118,527.79 nat. median
$29,205
outlier · 4.1×
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
$126,722
0.9× median
C9741
HCPCS 		Impl Pressure Sensor W/angio 2 $10,947.74 $180,109.71 $116,810.28 nat. median
$12,039
outlier · 9.7×
0424T
OTHER 		Insj/rplc Nstim Apnea Compl 2 $104,245.09 $160,735.44 $115,310.21 nat. median
$22,425
outlier · 5.1×
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
$47,579
outlier · 2.4×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $98,534.52 $137,852.69 $114,866.85 nat. median
$52,841
outlier · 2.2×
0283T
OTHER 		Periph Field Stimul Perm 2 $93,661.36 $144,416.39 $111,172.85 nat. median
$14,059
outlier · 7.9×
64568
HCPCS 		Inc For Vagus N Elect Impl 5 $4,837.00 $160,735.44 $107,708.97 nat. median
$27,679
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
$39,629
outlier · 2.7×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $90,868.43 $127,127.60 $105,930.08 nat. median
$49,639
outlier · 2.1×
7
MS_DRG 		Lung Transplant 8 $89,332.16 $190,478.23 $105,268.81 nat. median
$117,894
0.9× median
63685
HCPCS 		Insrt/redo Spine N Generator 6 $2,150.00 $160,735.44 $104,245.09 nat. median
$21,040
outlier · 5.0×
0316T
OTHER 		Replc Vagus Nerve Pls Gen 2 $72,689.36 $160,735.44 $104,245.09 nat. median
$14,923
outlier · 7.0×
61886
HCPCS 		Implant Neurostim Arrays 6 $2,300.00 $160,735.44 $104,245.09 nat. median
$27,176
outlier · 3.8×
0427T
OTHER 		Insj/rplc Nstim Apnea Pls Gn 2 $73,765.84 $160,735.44 $104,245.09 nat. median
$22,408
outlier · 4.7×
0268T
OTHER 		Implt/rpl Crtd Sns Dev Gen 2 $72,689.36 $160,735.44 $104,245.09 nat. median
$28,036
outlier · 3.7×
0312T
OTHER 		Laps Impltj Nstim Vagus 2 $13,214.51 $160,735.44 $104,245.09 nat. median
$18,162
outlier · 5.7×
0266T
OTHER 		Implt/rpl Crtd Sns Dev Total 2 $13,214.51 $160,735.44 $104,245.09 nat. median
$39,035
outlier · 2.7×
0431T
OTHER 		Rmvl/rplc Nstim Apnea Pls Gn 2 $73,765.84 $160,735.44 $104,245.09 nat. median
$22,408
outlier · 4.7×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $89,557.75 $190,959.24 $98,417.37 nat. median
$110,192
0.9× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 $11,759.00 $132,527.98 $96,220.41 nat. median
$38,225
outlier · 2.5×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $74,465.23 $223,002.87 $94,737.23 nat. median
$97,414
1.0× 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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