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

Kpc Promise Hospital Of Wichita Falls Llc

Wichita Falls, TX · CCN 452068 · Rates published

314 distinct procedures filed
45 distinct payers
10,154 rate rows
2025-05-01 last MRF observed · ⚠ 14 mo old
Data quality

6 of 10,154 rate rows are consumer-grade (0.1%)

10,148 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 9,906
per-diem day rate — not a per-procedure price 240
percent-of-charges filed in the dollar field — excluded from medians 2

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 14 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://wichitafalls.kpcph.com/wp-content/uploads/sites/10/2025/05/83-4295134_Highcrest-Hospital-of-Wichita-Falls_standardcharges.csv
Found on page https://wichitafalls.kpcph.com/cms-price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint a9b8a840df4c63fc… · 1,202,530 bytes · first seen 2026-05-06

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
0801
RC 		1 $500.00 $500.00 $500.00 nat. median
$1,315
outlier · 0.4×
0802
RC 		1 $500.00 $500.00 $500.00 nat. median
$1,174
outlier · 0.4×
121
MS_DRG 		Acute Major Eye Infections W Cc/Mcc 0 — — — nat. median
$12,356
147
MS_DRG 		Ear, Nose, Mouth & Throat Malignancy W Cc 0 — — — nat. median
$13,304
148
MS_DRG 		Ear, Nose, Mouth & Throat Malignancy Without Cc/Mcc 0 — — — nat. median
$9,128
152
MS_DRG 		Otitis Media & Uri W Mcc 0 — — — nat. median
$12,253
154
MS_DRG 		Nasal Trauma & Deformity W Mcc 0 — — — nat. median
$16,089
176
MS_DRG 		Pulmonary Embolism Without Mcc 0 — — — nat. median
$9,177
157
MS_DRG 		Dental & Oral Diseases W Mcc 0 — — — nat. median
$17,221
158
MS_DRG 		Dental & Oral Diseases W Cc 0 — — — nat. median
$10,106
163
MS_DRG 		Major Chest Procedures W Mcc 0 — — — nat. median
$44,937
166
MS_DRG 		Other Resp System O.r. Procedures W Mcc 0 — — — nat. median
$37,476
167
MS_DRG 		Other Resp System O.r. Procedures W Cc 0 — — — nat. median
$18,895
168
MS_DRG 		Other Resp System O.r. Procedures Without Cc/Mcc 0 — — — nat. median
$14,494
201
MS_DRG 		Pneumothorax Without Cc/Mcc 0 — — — nat. median
$7,992
200
MS_DRG 		Pneumothorax W Cc 0 — — — nat. median
$11,694
177
MS_DRG 		Respiratory Infections & Inflammations W Mcc 0 — — — nat. median
$16,234
178
MS_DRG 		Respiratory Infections & Inflammations W Cc 0 — — — nat. median
$10,873
179
MS_DRG 		Respiratory Infections & Inflammations Without Cc/Mcc 0 — — — nat. median
$8,705
186
MS_DRG 		Pleural Effusion W Mcc 0 — — — nat. median
$15,980
187
MS_DRG 		Pleural Effusion W Cc 0 — — — nat. median
$10,854
189
MS_DRG 		Pulmonary Edema & Respiratory Failure 0 — — — nat. median
$13,017
190
MS_DRG 		Chronic Obstructive Pulmonary Disease W Mcc 0 — — — nat. median
$11,699
191
MS_DRG 		Chronic Obstructive Pulmonary Disease W Cc 0 — — — nat. median
$9,406
192
MS_DRG 		Chronic Obstructive Pulmonary Disease Without Cc/Mcc 0 — — — nat. median
$7,581
193
MS_DRG 		Simple Pneumonia & Pleurisy W Mcc 0 — — — nat. median
$13,648
194
MS_DRG 		Simple Pneumonia & Pleurisy W Cc 0 — — — nat. median
$9,125
195
MS_DRG 		Simple Pneumonia & Pleurisy Without Cc/Mcc 0 — — — nat. median
$7,338
196
MS_DRG 		Interstitial Lung Disease W Mcc 0 — — — nat. median
$18,723
199
MS_DRG 		Pneumothorax W Mcc 0 — — — nat. median
$17,612
175
MS_DRG 		Pulmonary Embolism W Mcc 0 — — — nat. median
$14,623
153
MS_DRG 		Otitis Media & Uri Without Mcc 0 — — — nat. median
$8,180
202
MS_DRG 		Bronchitis & Asthma W Cc/Mcc 0 — — — nat. median
$10,377
204
MS_DRG 		Respiratory Signs & Symptoms 0 — — — nat. median
$8,989
205
MS_DRG 		Other Respiratory System Diagnoses W Mcc 0 — — — nat. median
$18,292
206
MS_DRG 		Other Respiratory System Diagnoses Without Mcc 0 — — — nat. median
$10,000
207
MS_DRG 		Respiratory System Diagnosis W Ventilator Support 96+ Hours 0 — — — nat. median
$62,134
208
MS_DRG 		Respiratory System Diagnosis W Ventilator Support <96 Hours 0 — — — nat. median
$26,748
239
MS_DRG 		Amputation For Circ Sys Disorders Exc Upper Limb & Toe W Mcc 0 — — — nat. median
$47,740
242
MS_DRG 		Permanent Cardiac Pacemaker Implant W Mcc 0 — — — nat. median
$32,825
253
MS_DRG 		Other Vascular Procedures W Cc 0 — — — nat. median
$26,079
264
MS_DRG 		Other Circulatory System O.r. Procedures 0 — — — nat. median
$33,061
270
MS_DRG 		Other Major Cardiovascular Procedures W Mcc 0 — — — nat. median
$51,307
271
MS_DRG 		Other Major Cardiovascular Procedures W Cc 0 — — — nat. median
$35,597
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive W Mcc 0 — — — nat. median
$16,529
281
MS_DRG 		Acute Myocardial Infarction, Discharged Alive W Cc 0 — — — nat. median
$10,381
282
MS_DRG 		Acute Myocardia Infarction, Discharged Alive Without Cc/Mcc 0 — — — nat. median
$8,518
283
MS_DRG 		Acute Myocardial Infarction, Expired W Mcc 0 — — — nat. median
$19,748
286
MS_DRG 		Circulatory Disorders Except Ami, W Card Cath W Mcc 0 — — — nat. median
$22,019
146
MS_DRG 		Ear, Nose, Mouth & Throat Malignancy W Mcc 0 — — — nat. median
$21,758

Other procedures at this hospital

Browse this hospital's 314 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
             
0801 RC — 2 1 $1,817.00 $1,817.00 $500.00 $500.00 $500.00 2025-05-01
0802 RC — 2 1 $1,786.00 $1,786.00 $500.00 $500.00 $500.00 2025-05-01
121 MS_DRG Acute Major Eye Infections W Cc/Mcc 0 0 — — — — — 2025-05-01
146 MS_DRG Ear, Nose, Mouth & Throat Malignancy W Mcc 0 0 — — — — — 2025-05-01
147 MS_DRG Ear, Nose, Mouth & Throat Malignancy W Cc 0 0 — — — — — 2025-05-01
148 MS_DRG Ear, Nose, Mouth & Throat Malignancy Without Cc/Mcc 0 0 — — — — — 2025-05-01
152 MS_DRG Otitis Media & Uri W Mcc 0 0 — — — — — 2025-05-01
153 MS_DRG Otitis Media & Uri Without Mcc 0 0 — — — — — 2025-05-01
154 MS_DRG Nasal Trauma & Deformity W Mcc 0 0 — — — — — 2025-05-01
157 MS_DRG Dental & Oral Diseases W Mcc 0 0 — — — — — 2025-05-01
158 MS_DRG Dental & Oral Diseases W Cc 0 0 — — — — — 2025-05-01
163 MS_DRG Major Chest Procedures W Mcc 0 0 — — — — — 2025-05-01
166 MS_DRG Other Resp System O.r. Procedures W Mcc 0 0 — — — — — 2025-05-01
167 MS_DRG Other Resp System O.r. Procedures W Cc 0 0 — — — — — 2025-05-01
168 MS_DRG Other Resp System O.r. Procedures Without Cc/Mcc 0 0 — — — — — 2025-05-01
175 MS_DRG Pulmonary Embolism W Mcc 0 0 — — — — — 2025-05-01
176 MS_DRG Pulmonary Embolism Without Mcc 0 0 — — — — — 2025-05-01
177 MS_DRG Respiratory Infections & Inflammations W Mcc 0 0 — — — — — 2025-05-01
178 MS_DRG Respiratory Infections & Inflammations W Cc 0 0 — — — — — 2025-05-01
179 MS_DRG Respiratory Infections & Inflammations Without Cc/Mcc 0 0 — — — — — 2025-05-01
186 MS_DRG Pleural Effusion W Mcc 0 0 — — — — — 2025-05-01
187 MS_DRG Pleural Effusion W Cc 0 0 — — — — — 2025-05-01
189 MS_DRG Pulmonary Edema & Respiratory Failure 0 0 — — — — — 2025-05-01
190 MS_DRG Chronic Obstructive Pulmonary Disease W Mcc 0 0 — — — — — 2025-05-01
191 MS_DRG Chronic Obstructive Pulmonary Disease W Cc 0 0 — — — — — 2025-05-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/Mcc 0 0 — — — — — 2025-05-01
193 MS_DRG Simple Pneumonia & Pleurisy W Mcc 0 0 — — — — — 2025-05-01
194 MS_DRG Simple Pneumonia & Pleurisy W Cc 0 0 — — — — — 2025-05-01
195 MS_DRG Simple Pneumonia & Pleurisy Without Cc/Mcc 0 0 — — — — — 2025-05-01
196 MS_DRG Interstitial Lung Disease W Mcc 0 0 — — — — — 2025-05-01
199 MS_DRG Pneumothorax W Mcc 0 0 — — — — — 2025-05-01
200 MS_DRG Pneumothorax W Cc 0 0 — — — — — 2025-05-01
201 MS_DRG Pneumothorax Without Cc/Mcc 0 0 — — — — — 2025-05-01
202 MS_DRG Bronchitis & Asthma W Cc/Mcc 0 0 — — — — — 2025-05-01
204 MS_DRG Respiratory Signs & Symptoms 0 0 — — — — — 2025-05-01
205 MS_DRG Other Respiratory System Diagnoses W Mcc 0 0 — — — — — 2025-05-01
206 MS_DRG Other Respiratory System Diagnoses Without Mcc 0 0 — — — — — 2025-05-01
207 MS_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 0 0 — — — — — 2025-05-01
208 MS_DRG Respiratory System Diagnosis W Ventilator Support <96 Hours 0 0 — — — — — 2025-05-01
239 MS_DRG Amputation For Circ Sys Disorders Exc Upper Limb & Toe W Mcc 0 0 — — — — — 2025-05-01
242 MS_DRG Permanent Cardiac Pacemaker Implant W Mcc 0 0 — — — — — 2025-05-01
253 MS_DRG Other Vascular Procedures W Cc 0 0 — — — — — 2025-05-01
264 MS_DRG Other Circulatory System O.r. Procedures 0 0 — — — — — 2025-05-01
270 MS_DRG Other Major Cardiovascular Procedures W Mcc 0 0 — — — — — 2025-05-01
271 MS_DRG Other Major Cardiovascular Procedures W Cc 0 0 — — — — — 2025-05-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive W Mcc 0 0 — — — — — 2025-05-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive W Cc 0 0 — — — — — 2025-05-01
282 MS_DRG Acute Myocardia Infarction, Discharged Alive Without Cc/Mcc 0 0 — — — — — 2025-05-01
283 MS_DRG Acute Myocardial Infarction, Expired W Mcc 0 0 — — — — — 2025-05-01
286 MS_DRG Circulatory Disorders Except Ami, W Card Cath W Mcc 0 0 — — — — — 2025-05-01
288 MS_DRG Acute & Subacute Endocarditis W Mcc 0 0 — — — — — 2025-05-01
289 MS_DRG Acute & Subacute Endocarditis W Cc 0 0 — — — — — 2025-05-01
291 MS_DRG Heart Failure & Shock W Mcc 0 0 — — — — — 2025-05-01
292 MS_DRG Heart Failure & Shock W Cc 0 0 — — — — — 2025-05-01
293 MS_DRG Heart Failure & Shock Without Cc/Mcc 0 0 — — — — — 2025-05-01
299 MS_DRG Peripheral Vascular Disorders W Mcc 0 0 — — — — — 2025-05-01
3 MS_DRG Ecmo Or Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck W Maj O. 0 0 — — — — — 2025-05-01
300 MS_DRG Peripheral Vascular Disorders W Cc 0 0 — — — — — 2025-05-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/Mcc 0 0 — — — — — 2025-05-01
302 MS_DRG Atherosclerosis W Mcc 0 0 — — — — — 2025-05-01
303 MS_DRG Atherosclerosis Without Mcc 0 0 — — — — — 2025-05-01
306 MS_DRG Cardiac Congenital & Valvular Disorders W Mcc 0 0 — — — — — 2025-05-01
307 MS_DRG Cardiac Congenital & Valvular Disorders Without Mcc 0 0 — — — — — 2025-05-01
308 MS_DRG Cardiac Arrhythmia & Conduction Disorders W Mcc 0 0 — — — — — 2025-05-01
309 MS_DRG Cardiac Arrhythmia & Conduction Disorders W Cc 0 0 — — — — — 2025-05-01
312 MS_DRG Syncope & Collapse 0 0 — — — — — 2025-05-01
314 MS_DRG Other Circulatory System Diagnoses W Mcc 0 0 — — — — — 2025-05-01
315 MS_DRG Other Circulatory System Diagnoses W Cc 0 0 — — — — — 2025-05-01
316 MS_DRG Other Circulatory System Diagnoses Without Cc/Mcc 0 0 — — — — — 2025-05-01
329 MS_DRG Major Small & Large Bowel Procedures W Mcc 0 0 — — — — — 2025-05-01
356 MS_DRG Other Digestive System O.r. Procedures W Mcc 0 0 — — — — — 2025-05-01
357 MS_DRG Other Digestive System O.r. Procedures W Cc 0 0 — — — — — 2025-05-01
368 MS_DRG Major Esophageal Disorders W Mcc 0 0 — — — — — 2025-05-01
369 MS_DRG Major Esophageal Disorders W Cc 0 0 — — — — — 2025-05-01
371 MS_DRG Major Gastrointestinal Disorders & Peritoneal Infections W Mcc 0 0 — — — — — 2025-05-01
372 MS_DRG Major Gastrointestinal Disorders & Peritoneal Infections W Cc 0 0 — — — — — 2025-05-01
373 MS_DRG Major Gastrointestinal Disorders & Peritoneal Infections Without Cc/M 0 0 — — — — — 2025-05-01
374 MS_DRG Digestive Malignancy W Mcc 0 0 — — — — — 2025-05-01
375 MS_DRG Digestive Malignancy W Cc 0 0 — — — — — 2025-05-01
377 MS_DRG G.i. Hemorrhage W Mcc 0 0 — — — — — 2025-05-01
378 MS_DRG G.i. Hemorrhage W Cc 0 0 — — — — — 2025-05-01
380 MS_DRG Complicated Peptic Ulcer W Mcc 0 0 — — — — — 2025-05-01
381 MS_DRG Complicated Peptic Ulcer W Cc 0 0 — — — — — 2025-05-01
383 MS_DRG Uncomplicated Peptic Ulcer W Mcc 0 0 — — — — — 2025-05-01
385 MS_DRG Inflammatory Bowel Disease W Mcc 0 0 — — — — — 2025-05-01
386 MS_DRG Inflammatory Bowel Disease W Cc 0 0 — — — — — 2025-05-01
388 MS_DRG G.i. Obstruction W Mcc 0 0 — — — — — 2025-05-01
389 MS_DRG G.i. Obstruction W Cc 0 0 — — — — — 2025-05-01
391 MS_DRG Esophagitis, Gastroent & Misc Digest Disorders W Mcc 0 0 — — — — — 2025-05-01
392 MS_DRG Esophagitis, Gastroent & Misc Digest Disorders Without Mcc 0 0 — — — — — 2025-05-01
393 MS_DRG Other Digestive System Diagnoses W Mcc 0 0 — — — — — 2025-05-01
394 MS_DRG Other Digestive System Diagnoses W Cc 0 0 — — — — — 2025-05-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/Mcc 0 0 — — — — — 2025-05-01
4 MS_DRG Trach W Mv 96+ Hrs Or Pdx Exc Face, Mouth & Neck Without Maj O.r. 0 0 — — — — — 2025-05-01
40 MS_DRG Periph/Cranial Nerve & Other Nerv Syst Proc W Mcc 0 0 — — — — — 2025-05-01
41 MS_DRG Periph/Cranial Nerve & Other Nerv Syst Proc W Cc Or Periph Neuros 0 0 — — — — — 2025-05-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures W Mcc 0 0 — — — — — 2025-05-01
432 MS_DRG Cirrhosis & Alcoholic Hepatitis W Mcc 0 0 — — — — — 2025-05-01
433 MS_DRG Cirrhosis & Alcoholic Hepatitis W Cc 0 0 — — — — — 2025-05-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas W Mcc 0 0 — — — — — 2025-05-01
438 MS_DRG Disorders Of Pancreas Except Malignancy W Mcc 0 0 — — — — — 2025-05-01
439 MS_DRG Disorders Of Pancreas Except Malignancy W Cc 0 0 — — — — — 2025-05-01
441 MS_DRG Disorders Of Liver Except Malig,cirr,alc Hepa W Mcc 0 0 — — — — — 2025-05-01
442 MS_DRG Disorders Of Liver Except Malig,cirr,alc Hepa W Cc 0 0 — — — — — 2025-05-01
443 MS_DRG Disorders Of Liver Except Malig,cirr,alc Hepa Without Cc/Mcc 0 0 — — — — — 2025-05-01
444 MS_DRG Disorders Of The Biliary Tract W Mcc 0 0 — — — — — 2025-05-01
445 MS_DRG Disorders Of The Biliary Tract W Cc 0 0 — — — — — 2025-05-01
463 MS_DRG Wnd Debrid & Skn Grft Exc Hand, For Musculo-conn Tiss Dis W Mcc 0 0 — — — — — 2025-05-01
464 MS_DRG Wnd Debrid & Skn Grft Exc Hand, For Musculo-conn Tiss Dis W Cc 0 0 — — — — — 2025-05-01
465 MS_DRG Wnd Debrid & Skn Grft Exc Hand, For Musculo-conn Tiss Dis Without Cc/ 0 0 — — — — — 2025-05-01
466 MS_DRG Revision Of Hip Or Knee Replacement W Mcc 0 0 — — — — — 2025-05-01
467 MS_DRG Revision Of Hip Or Knee Replacement W Cc 0 0 — — — — — 2025-05-01
474 MS_DRG Amputation For Musculoskeletal Sys & Conn Tissue Dis W Mcc 0 0 — — — — — 2025-05-01
477 MS_DRG Biopsies Of Musculoskeletal System & Connective Tissue W Mcc 0 0 — — — — — 2025-05-01
481 MS_DRG Hip & Femur Procedures Except Major Joint W Cc 0 0 — — — — — 2025-05-01
492 MS_DRG Lower Extrem & Humer Proc Except Hip,foot,femur W Mcc 0 0 — — — — — 2025-05-01
495 MS_DRG Local Excision & Removal Int Fix Devices Exc Hip & Femur W Mcc 0 0 — — — — — 2025-05-01
498 MS_DRG Local Excision & Removal Int Fix Devices Of Hip & Femur W Cc/Mcc 0 0 — — — — — 2025-05-01
499 MS_DRG Local Excision & Removal Int Fix Devices Of Hip & Femur Without Cc/Mc 0 0 — — — — — 2025-05-01
500 MS_DRG Soft Tissue Procedures W Mcc 0 0 — — — — — 2025-05-01
501 MS_DRG Soft Tissue Procedures W Cc 0 0 — — — — — 2025-05-01
502 MS_DRG Soft Tissue Procedures Without Cc/Mcc 0 0 — — — — — 2025-05-01
503 MS_DRG Foot Procedures W Mcc 0 0 — — — — — 2025-05-01
513 MS_DRG Hand Or Wrist Proc, Except Major Thumb Or Joint Proc W Cc/Mcc 0 0 — — — — — 2025-05-01
515 MS_DRG Other Musculoskelet Sys & Conn Tiss O.r. Proc W Mcc 0 0 — — — — — 2025-05-01
52 MS_DRG Spinal Disorders & Injuries W Cc/Mcc 0 0 — — — — — 2025-05-01
533 MS_DRG Fractures Of Femur W Mcc 0 0 — — — — — 2025-05-01
535 MS_DRG Fractures Of Hip & Pelvis W Mcc 0 0 — — — — — 2025-05-01
539 MS_DRG Osteomyelitis W Mcc 0 0 — — — — — 2025-05-01
54 MS_DRG Nervous System Neoplasms W Mcc 0 0 — — — — — 2025-05-01
540 MS_DRG Osteomyelitis W Cc 0 0 — — — — — 2025-05-01
541 MS_DRG Osteomyelitis Without Cc/Mcc 0 0 — — — — — 2025-05-01
542 MS_DRG Pathological Fractures & Musculoskelet & Conn Tiss Malig W Mcc 0 0 — — — — — 2025-05-01
545 MS_DRG Connective Tissue Disorders W Mcc 0 0 — — — — — 2025-05-01
548 MS_DRG Septic Arthritis W Mcc 0 0 — — — — — 2025-05-01
549 MS_DRG Septic Arthritis W Cc 0 0 — — — — — 2025-05-01
55 MS_DRG Nervous System Neoplasms Without Mcc 0 0 — — — — — 2025-05-01
551 MS_DRG Medical Back Problems W Mcc 0 0 — — — — — 2025-05-01
552 MS_DRG Medical Back Problems Without Mcc 0 0 — — — — — 2025-05-01
553 MS_DRG Bone Diseases & Arthropathies W Mcc 0 0 — — — — — 2025-05-01
554 MS_DRG Bone Diseases & Arthropathies Without Mcc 0 0 — — — — — 2025-05-01
555 MS_DRG Signs & Symptoms Of Musculoskeletal System & Conn Tissue W Mcc 0 0 — — — — — 2025-05-01
557 MS_DRG Tendonitis, Myositis & Bursitis W Mcc 0 0 — — — — — 2025-05-01
558 MS_DRG Tendonitis, Myositis & Bursitis Without Mcc 0 0 — — — — — 2025-05-01
559 MS_DRG Aftercare, Musculoskeletal System & Connective Tissue W Mcc 0 0 — — — — — 2025-05-01
56 MS_DRG Degenerative Nervous System Disorders W Mcc 0 0 — — — — — 2025-05-01
560 MS_DRG Aftercare, Musculoskeletal System & Connective Tissue W Cc 0 0 — — — — — 2025-05-01
561 MS_DRG Aftercare, Musculoskeletal System & Connective Tissue Without Cc/Mcc 0 0 — — — — — 2025-05-01
562 MS_DRG Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh W Mcc 0 0 — — — — — 2025-05-01
563 MS_DRG Fx, Sprn, Strn & Disl Except Femur, Hip, Pelvis & Thigh Without Mcc 0 0 — — — — — 2025-05-01
564 MS_DRG Other Musculoskeletal Sys & Connective Tissue Diagnoses W Mcc 0 0 — — — — — 2025-05-01
565 MS_DRG Other Musculoskeletal Sys & Connective Tissue Diagnoses W Cc 0 0 — — — — — 2025-05-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 0 0 — — — — — 2025-05-01
570 MS_DRG Skin Debridement W Mcc 0 0 — — — — — 2025-05-01
571 MS_DRG Skin Debridement W Cc 0 0 — — — — — 2025-05-01
572 MS_DRG Skin Debridement Without Cc/Mcc 0 0 — — — — — 2025-05-01
573 MS_DRG Skin Graft &/or Debrid For Skn Ulcer Or Cellulitis W Mcc 0 0 — — — — — 2025-05-01
574 MS_DRG Skin Graft &/or Debrid For Skn Ulcer Or Cellulitis W Cc 0 0 — — — — — 2025-05-01
576 MS_DRG Skin Graft &/or Debrid Exc For Skin Ulcer Or Cellulitis W Mcc 0 0 — — — — — 2025-05-01
577 MS_DRG Skin Graft &/or Debrid Exc For Skin Ulcer Or Cellulitis W Cc 0 0 — — — — — 2025-05-01
579 MS_DRG Other Skin, Subcut Tiss & Breast Proc W Mcc 0 0 — — — — — 2025-05-01
580 MS_DRG Other Skin, Subcut Tiss & Breast Proc W Cc 0 0 — — — — — 2025-05-01
59 MS_DRG Multiple Sclerosis & Cerebellar Ataxia W Cc 0 0 — — — — — 2025-05-01
592 MS_DRG Skin Ulcers W Mcc 0 0 — — — — — 2025-05-01
593 MS_DRG Skin Ulcers W Cc 0 0 — — — — — 2025-05-01
594 MS_DRG Skin Ulcers Without Cc/Mcc 0 0 — — — — — 2025-05-01
595 MS_DRG Major Skin Disorders W Mcc 0 0 — — — — — 2025-05-01
60 MS_DRG Multiple Sclerosis & Cerebellar Ataxia Without Cc/Mcc 0 0 — — — — — 2025-05-01
602 MS_DRG Cellulitis W Mcc 0 0 — — — — — 2025-05-01
603 MS_DRG Cellulitis Without Mcc 0 0 — — — — — 2025-05-01
604 MS_DRG Trauma To The Skin, Subcut Tiss & Breast W Mcc 0 0 — — — — — 2025-05-01
605 MS_DRG Trauma To The Skin, Subcut Tiss & Breast Without Mcc 0 0 — — — — — 2025-05-01
606 MS_DRG Minor Skin Disorders W Mcc 0 0 — — — — — 2025-05-01
607 MS_DRG Minor Skin Disorders Without Mcc 0 0 — — — — — 2025-05-01
616 MS_DRG Amputat Of Lower Limb For Endocrine,nutrit,& Metabol Dis W Mcc 0 0 — — — — — 2025-05-01
617 MS_DRG Amputat Of Lower Limb For Endocrine,nutrit,& Metabol Dis W Cc 0 0 — — — — — 2025-05-01
622 MS_DRG Skin Grafts & Wound Debrid For Endoc, Nutrit & Metab Dis W Mcc 0 0 — — — — — 2025-05-01
623 MS_DRG Skin Grafts & Wound Debrid For Endoc, Nutrit & Metab Dis W Cc 0 0 — — — — — 2025-05-01
624 MS_DRG Skin Grafts & Wound Debrid For Endoc, Nutrit & Metab Dis Without Cc/M 0 0 — — — — — 2025-05-01
628 MS_DRG Other Endocrine, Nutrit & Metab O.r. Proc W Mcc 0 0 — — — — — 2025-05-01
629 MS_DRG Other Endocrine, Nutrit & Metab O.r. Proc W Cc 0 0 — — — — — 2025-05-01
637 MS_DRG Diabetes W Mcc 0 0 — — — — — 2025-05-01
638 MS_DRG Diabetes W Cc 0 0 — — — — — 2025-05-01
639 MS_DRG Diabetes Without Cc/Mcc 0 0 — — — — — 2025-05-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction W Mcc 0 0 — — — — — 2025-05-01
640 MS_DRG Nutritional & Misc Metabolic Disorders W Mcc 0 0 — — — — — 2025-05-01
641 MS_DRG Nutritional & Misc Metabolic Disorders Without Mcc 0 0 — — — — — 2025-05-01
643 MS_DRG Endocrine Disorders W Mcc 0 0 — — — — — 2025-05-01
644 MS_DRG Endocrine Disorders W Cc 0 0 — — — — — 2025-05-01
645 MS_DRG Endocrine Disorders Without Cc/Mcc 0 0 — — — — — 2025-05-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction W Cc 0 0 — — — — — 2025-05-01
673 MS_DRG Other Kidney & Urinary Tract Procedures W Mcc 0 0 — — — — — 2025-05-01
674 MS_DRG Other Kidney & Urinary Tract Procedures W Cc 0 0 — — — — — 2025-05-01
675 MS_DRG Other Kidney & Urinary Tract Procedures Without Cc/Mcc 0 0 — — — — — 2025-05-01
682 MS_DRG Renal Failure W Mcc 0 0 — — — — — 2025-05-01
683 MS_DRG Renal Failure W Cc 0 0 — — — — — 2025-05-01
684 MS_DRG Renal Failure Without Cc/Mcc 0 0 — — — — — 2025-05-01
689 MS_DRG Kidney & Urinary Tract Infections W Mcc 0 0 — — — — — 2025-05-01
690 MS_DRG Kidney & Urinary Tract Infections Without Mcc 0 0 — — — — — 2025-05-01
693 MS_DRG Urinary Stones Without Esw Lithotripsy W Mcc 0 0 — — — — — 2025-05-01
694 MS_DRG Urinary Stones Without Esw Lithotripsy Without Mcc 0 0 — — — — — 2025-05-01
695 MS_DRG Kidney & Urinary Tract Signs & Symptoms W Mcc 0 0 — — — — — 2025-05-01
697 MS_DRG Urethral Stricture 0 0 — — — — — 2025-05-01
698 MS_DRG Other Kidney & Urinary Tract Diagnoses W Mcc 0 0 — — — — — 2025-05-01
699 MS_DRG Other Kidney & Urinary Tract Diagnoses W Cc 0 0 — — — — — 2025-05-01
70 MS_DRG Nonspecific Cerebrovascular Disorders W Mcc 0 0 — — — — — 2025-05-01
71 MS_DRG Nonspecific Cerebrovascular Disorders W Cc 0 0 — — — — — 2025-05-01
717 MS_DRG Other Male Reproductive System O.r. Proc Exc Malignancy W Cc/Mcc 0 0 — — — — — 2025-05-01
727 MS_DRG Inflammation Of The Male Reproductive System W Mcc 0 0 — — — — — 2025-05-01
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 0 0 — — — — — 2025-05-01
729 MS_DRG Other Male Reproductive System Diagnoses W Cc/Mcc 0 0 — — — — — 2025-05-01
73 MS_DRG Cranial & Peripheral Nerve Disorders W Mcc 0 0 — — — — — 2025-05-01
74 MS_DRG Cranial & Peripheral Nerve Disorders Without Mcc 0 0 — — — — — 2025-05-01
754 MS_DRG Malignancy, Female Reproductive System W Mcc 0 0 — — — — — 2025-05-01
757 MS_DRG Infections, Female Reproductive System W Mcc 0 0 — — — — — 2025-05-01
758 MS_DRG Infections, Female Reproductive System W Cc 0 0 — — — — — 2025-05-01
759 MS_DRG Infections, Female Reproductive System Without Cc/Mcc 0 0 — — — — — 2025-05-01
760 MS_DRG Menstrual & Other Female Reproductive System Disorders W Cc/Mcc 0 0 — — — — — 2025-05-01
776 MS_DRG Postpartum & Post Abortion Diagnoses Without O.r. Procedure 0 0 — — — — — 2025-05-01
80 MS_DRG Nontraumatic Stupor & Coma W Mcc 0 0 — — — — — 2025-05-01
808 MS_DRG Major Hematol/Immun Diag Exc Sickle Cell Crisis & Coagul W Mcc 0 0 — — — — — 2025-05-01
809 MS_DRG Major Hematol/Immun Diag Exc Sickle Cell Crisis & Coagul W Cc 0 0 — — — — — 2025-05-01
811 MS_DRG Red Blood Cell Disorders W Mcc 0 0 — — — — — 2025-05-01
814 MS_DRG Reticuloendothelial & Immunity Disorders W Mcc 0 0 — — — — — 2025-05-01
815 MS_DRG Reticuloendothelial & Immunity Disorders W Cc 0 0 — — — — — 2025-05-01
82 MS_DRG Traumatic Stupor & Coma, Coma >1 Hr W Mcc 0 0 — — — — — 2025-05-01
83 MS_DRG Traumatic Stupor & Coma, Coma >1 Hr W Cc 0 0 — — — — — 2025-05-01
84 MS_DRG Traumatic Stupor & Coma, Coma >1 Hr Without Cc/Mcc 0 0 — — — — — 2025-05-01
840 MS_DRG Lymphoma & Non-acute Leukemia W Mcc 0 0 — — — — — 2025-05-01
841 MS_DRG Lymphoma & Non-acute Leukemia W Cc 0 0 — — — — — 2025-05-01
843 MS_DRG Other Myeloprolif Dis Or Poorly Diff Neopl Diag W Mcc 0 0 — — — — — 2025-05-01
845 MS_DRG Other Myeloprolif Dis Or Poorly Diff Neopl Diag Without Cc/Mcc 0 0 — — — — — 2025-05-01
85 MS_DRG Traumatic Stupor & Coma, Coma <1 Hr W Mcc 0 0 — — — — — 2025-05-01
853 MS_DRG Infectious & Parasitic Diseases W O.r. Procedure W Mcc 0 0 — — — — — 2025-05-01
856 MS_DRG Postoperative Or Post-traumatic Infections W O.r. Proc W Mcc 0 0 — — — — — 2025-05-01
862 MS_DRG Postoperative & Post-traumatic Infections W Mcc 0 0 — — — — — 2025-05-01
863 MS_DRG Postoperative & Post-traumatic Infections Without Mcc 0 0 — — — — — 2025-05-01
866 MS_DRG Viral Illness Without Mcc 0 0 — — — — — 2025-05-01
867 MS_DRG Other Infectious & Parasitic Diseases Diagnoses W Mcc 0 0 — — — — — 2025-05-01
868 MS_DRG Other Infectious & Parasitic Diseases Diagnoses W Cc 0 0 — — — — — 2025-05-01
869 MS_DRG Other Infectious & Parasitic Diseases Diagnoses Without Cc/Mcc 0 0 — — — — — 2025-05-01
870 MS_DRG Septicemia W Mv 96+ Hours 0 0 — — — — — 2025-05-01
871 MS_DRG Septicemia Without Mv 96+ Hours W Mcc 0 0 — — — — — 2025-05-01
872 MS_DRG Septicemia Without Mv 96+ Hours Without Mcc 0 0 — — — — — 2025-05-01
880 MS_DRG Acute Adjustment Reaction & Psychosocial Dysfunction 0 0 — — — — — 2025-05-01
887 MS_DRG Other Mental Disorder Diagnoses 0 0 — — — — — 2025-05-01
896 MS_DRG Alcohol/Drug Abuse Or Dependence Without Rehabilitation Therapy W Mcc 0 0 — — — — — 2025-05-01
897 MS_DRG Alcohol/Drug Abuse Or Dependence Without Rehabilitation Therapy Without M 0 0 — — — — — 2025-05-01
901 MS_DRG Wound Debridements For Injuries W Mcc 0 0 — — — — — 2025-05-01
902 MS_DRG Wound Debridements For Injuries W Cc 0 0 — — — — — 2025-05-01
906 MS_DRG Hand Procedures For Injuries 0 0 — — — — — 2025-05-01
907 MS_DRG Other O.r. Procedures For Injuries W Mcc 0 0 — — — — — 2025-05-01
91 MS_DRG Other Disorders Of Nervous System W Mcc 0 0 — — — — — 2025-05-01
913 MS_DRG Traumatic Injury W Mcc 0 0 — — — — — 2025-05-01
914 MS_DRG Traumatic Injury Without Mcc 0 0 — — — — — 2025-05-01
917 MS_DRG Poisoning & Toxic Effects Of Drugs W Mcc 0 0 — — — — — 2025-05-01
919 MS_DRG Complications Of Treatment W Mcc 0 0 — — — — — 2025-05-01
92 MS_DRG Other Disorders Of Nervous System W Cc 0 0 — — — — — 2025-05-01
920 MS_DRG Complications Of Treatment W Cc 0 0 — — — — — 2025-05-01
921 MS_DRG Complications Of Treatment Without Cc/Mcc 0 0 — — — — — 2025-05-01
922 MS_DRG Other Injury, Poisoning & Toxic Effect Diag W Mcc 0 0 — — — — — 2025-05-01
923 MS_DRG Other Injury, Poisoning & Toxic Effect Diag Without Mcc 0 0 — — — — — 2025-05-01
928 MS_DRG Full Thickness Burn W Skin Graft Or Inhal Inj W Cc/Mcc 0 0 — — — — — 2025-05-01
93 MS_DRG Other Disorders Of Nervous System Without Cc/Mcc 0 0 — — — — — 2025-05-01
933 MS_DRG Extensive Burns Or Full Thickness Burns W Mv 96+ Hrs Without Skin Gra 0 0 — — — — — 2025-05-01
934 MS_DRG Full Thickness Burn Without Skin Grft Or Inhal Inj 0 0 — — — — — 2025-05-01
935 MS_DRG Non-extensive Burns 0 0 — — — — — 2025-05-01
939 MS_DRG O.r. Proc W Diagnoses Of Other Contact W Health Services W Mcc 0 0 — — — — — 2025-05-01
94 MS_DRG Bacterial & Tuberculous Infections Of Nervous System W Mcc 0 0 — — — — — 2025-05-01
940 MS_DRG O.r. Proc W Diagnoses Of Other Contact W Health Services W Cc 0 0 — — — — — 2025-05-01
947 MS_DRG Signs & Symptoms W Mcc 0 0 — — — — — 2025-05-01
948 MS_DRG Signs & Symptoms Without Mcc 0 0 — — — — — 2025-05-01
949 MS_DRG Aftercare W Cc/Mcc 0 0 — — — — — 2025-05-01
95 MS_DRG Bacterial & Tuberculous Infections Of Nervous System W Cc 0 0 — — — — — 2025-05-01
950 MS_DRG Aftercare Without Cc/Mcc 0 0 — — — — — 2025-05-01
951 MS_DRG Other Factors Influencing Health Status 0 0 — — — — — 2025-05-01
96 MS_DRG Bacterial & Tuberculous Infections Of Nervous System Without Cc/Mcc 0 0 — — — — — 2025-05-01
963 MS_DRG Other Multiple Significant Trauma W Mcc 0 0 — — — — — 2025-05-01
964 MS_DRG Other Multiple Significant Trauma W Cc 0 0 — — — — — 2025-05-01
97 MS_DRG Non-bacterial Infect Of Nervous Sys Exc Viral Meningitis W Mcc 0 0 — — — — — 2025-05-01
974 MS_DRG HIV W Major Related Condition W Mcc 0 0 — — — — — 2025-05-01
975 MS_DRG HIV W Major Related Condition W Cc 0 0 — — — — — 2025-05-01
98 MS_DRG Non-bacterial Infect Of Nervous Sys Exc Viral Meningitis W Cc 0 0 — — — — — 2025-05-01
981 MS_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis W Mcc 0 0 — — — — — 2025-05-01
982 MS_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis W Cc 0 0 — — — — — 2025-05-01
983 MS_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis Without Cc/ 0 0 — — — — — 2025-05-01
987 MS_DRG Non-extensive O.r. Proc Unrelated To Principal Diagnosis W Mcc 0 0 — — — — — 2025-05-01
0636 RC — 0 0 $1,466.16 $1,466.16 — — — 2025-05-01
,270,RC,IMB-0496,LOCAL,,inpatient,,,39.72,39.72,,,,,,,,,, WALKER OTHER Immobilizer,knee,cut-away,19" 0 0 — — — — — 2025-05-01
,270,RC,IMB-0565,LOCAL,,inpatient,,,47.96,47.96,,,,,,,,,, POUCH OTHER Pouch,eakin,fistula,6.9 X4.3" 0 0 — — — — — 2025-05-01
27-48" OTHER Binder, Abdominal, 12"h 0 0 — $28.68 — — — 2025-05-01
27-48""" OTHER Binder, Abdominal, 9"h 0 0 — $27.96 — — — 2025-05-01
4-PANEL OTHER Binder,abdominal,12" 0 0 — — — — — 2025-05-01
4-PANL OTHER Binder,abdominal12" 0 0 — — — — — 2025-05-01
4-PANL" OTHER Binder, Abdominal, 12" 0 0 — $32.80 — — — 2025-05-01
AD" OTHER Collar,trach,adjustable,19" 0 0 — $22.92 — — — 2025-05-01
HYDROFERA" OTHER Dressing,foam,4"x4"" 0 0 — $34.60 — — — 2025-05-01
L" OTHER Splint,wrist,forearm,dlx,10" 0 0 — $27.52 — — — 2025-05-01
LF OTHER Set,iv,extension,18" 0 0 — — — — — 2025-05-01
MODIFIED OTHER Needle,2.75" 0 0 — — — — — 2025-05-01
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