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

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Hospital

PALESTINE REGIONAL WEST CAMPUS

Palestine, TX · CCN 453089 · Rates published

8,464 distinct procedures filed
32 distinct payers
43,851 rate rows
2026-04-01 last MRF observed
Data quality

15,621 of 43,851 rate rows are consumer-grade (35.6%)

28,230 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 26,661
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,566
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 3
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://url.us.m.mimecastprotect.com/s/2WwrC31JV1u21zZPlswiZNhQvt7C?domain=hospitalpricedisclosure.com
Found on page https://url.us.m.mimecastprotect.com/s/A3KvC1w73wuqyN80oSqfp5hVJ6l8?domain=palestineregional.com
Discovered viaCMS hospital list
Last fetch success · 2026-10-01
Content fingerprint 43c726650880d4d1… · 12,054,239 bytes · first seen 2026-09-21

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
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $103,200.22 $103,200.22 $103,200.22 nat. median
$145,435
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 2 $63,460.44 $111,695.88 $87,578.16 nat. median
$73,023
1.2× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $62,584.70 $62,584.70 $62,584.70 nat. median
$97,418
0.6× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $62,364.81 $62,364.81 $62,364.81 nat. median
$56,428
1.1× median
5232
OTHER 		Level 2 Icd And Similar Procedures 1 $53,683.93 $67,662.43 $60,673.18 nat. median
$32,102
1.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $60,177.63 $60,177.63 $60,177.63 nat. median
$69,822
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $56,474.91 $56,474.91 $56,474.91 nat. median
$59,651
0.9× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $55,896.32 $55,896.32 $55,896.32 nat. median
$2,106
outlier · 26.5×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $53,848.51 $53,848.51 $53,848.51 nat. median
$60,505
0.9× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 $52,147.90 $52,147.90 $52,147.90 nat. median
$44,036
1.2× median
222
MS_DRG 		Description Not Available 1 $46,399.68 $46,399.68 $46,399.68 nat. median
$2,024
outlier · 22.9×
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $44,954.60 $44,954.60 $44,954.60 nat. median
$38,173
1.2× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 1 $44,752.09 $44,752.09 $44,752.09 nat. median
$35,725
1.3× median
224
MS_DRG 		Description Not Available 1 $43,904.29 $43,904.29 $43,904.29 nat. median
$2,024
outlier · 21.7×
834
MS_DRG 		Acute Leukemia With Mcc 1 $43,630.07 $43,630.07 $43,630.07 nat. median
$37,487
1.2× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $43,067.80 $43,067.80 $43,067.80 nat. median
$48,611
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $42,609.90 $42,609.90 $42,609.90 nat. median
$55,923
0.8× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $40,582.99 $42,120.46 $41,351.72 nat. median
$47,121
0.9× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $40,142.49 $40,142.49 $40,142.49 nat. median
$43,803
0.9× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $39,457.02 $39,457.02 $39,457.02 nat. median
$47,458
0.8× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $38,372.19 $38,372.19 $38,372.19 nat. median
$42,674
0.9× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $38,267.69 $38,267.69 $38,267.69 nat. median
$47,340
0.8× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 $37,806.50 $37,806.50 $37,806.50 nat. median
$40,726
0.9× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $37,683.65 $37,683.65 $37,683.65 nat. median
$2,106
outlier · 17.9×
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $37,439.77 $37,439.77 $37,439.77 nat. median
$45,446
0.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $37,378.04 $37,378.04 $37,378.04 nat. median
$52,327
0.7× median
799
MS_DRG 		Splenic Procedures With Mcc 1 $37,362.48 $37,362.48 $37,362.48 nat. median
$32,381
1.2× median
223
MS_DRG 		Description Not Available 1 $37,250.38 $37,250.38 $37,250.38 nat. median
$2,024
outlier · 18.4×
23
MS_DRG 		Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 $37,074.16 $37,074.16 $37,074.16 nat. median
$40,301
0.9× median
22
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 $36,432.30 $36,432.30 $36,432.30 nat. median
$23,282
1.6× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $35,823.78 $35,823.78 $35,823.78 nat. median
$2,106
outlier · 17.0×
226
MS_DRG 		Description Not Available 1 $34,922.07 $34,922.07 $34,922.07 nat. median
$2,024
outlier · 17.3×
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 $34,285.44 $34,285.44 $34,285.44 nat. median
$27,340
1.3× median
826
MS_DRG 		Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r.… 1 $33,460.45 $33,460.45 $33,460.45 nat. median
$32,899
1.0× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 1 $32,637.43 $32,637.43 $32,637.43 nat. median
$41,943
0.8× median
823
MS_DRG 		Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 $32,070.07 $32,070.07 $32,070.07 nat. median
$32,245
1.0× median
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 $32,057.51 $32,057.51 $32,057.51 nat. median
$39,159
0.8× median
239
MS_DRG 		Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 $31,728.52 $31,728.52 $31,728.52 nat. median
$34,615
0.9× median
225
MS_DRG 		Description Not Available 1 $31,434.55 $31,434.55 $31,434.55 nat. median
$2,024
outlier · 15.5×
220
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $30,836.43 $30,836.43 $30,836.43 nat. median
$38,832
0.8× median
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 $30,673.05 $30,673.05 $30,673.05 nat. median
$38,844
0.8× median
270
MS_DRG 		Other Major Cardiovascular Procedures With Mcc 2 $30,528.47 $30,528.71 $30,528.59 nat. median
$37,725
0.8× median
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $30,527.53 $30,527.53 $30,527.53 nat. median
$30,649
1.0× median
34
MS_DRG 		Carotid Artery Stent Procedures With Mcc 1 $29,998.82 $29,998.82 $29,998.82 nat. median
$27,223
1.1× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 $29,941.06 $29,941.06 $29,941.06 nat. median
$34,616
0.9× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $29,685.53 $29,685.53 $29,685.53 nat. median
$43,023
0.7× median
227
MS_DRG 		Description Not Available 1 $29,615.14 $29,615.14 $29,615.14 nat. median
$2,024
outlier · 14.6×
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 $23,609.59 $39,104.57 $29,586.68 nat. median
$34,733
0.9× median
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 $29,510.01 $29,510.01 $29,510.01 nat. median
$24,822
1.2× median
288
MS_DRG 		Acute And Subacute Endocarditis With Mcc 1 $28,707.77 $28,707.77 $28,707.77 nat. median
$18,971
1.5× median

Other procedures at this hospital

Browse this hospital's 8,464 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
             
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $103,200.22 $103,200.22 $103,200.22 2026-04-01
215 MS_DRG Other Heart Assist System Implant 2 2 — — $63,460.44 $111,695.88 $87,578.16 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $62,584.70 $62,584.70 $62,584.70 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $62,364.81 $62,364.81 $62,364.81 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 2 1 — — $53,683.93 $67,662.43 $60,673.18 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $60,177.63 $60,177.63 $60,177.63 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $56,474.91 $56,474.91 $56,474.91 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $55,896.32 $55,896.32 $55,896.32 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $53,848.51 $53,848.51 $53,848.51 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $52,147.90 $52,147.90 $52,147.90 2026-04-01
222 MS_DRG Description Not Available 1 1 — — $46,399.68 $46,399.68 $46,399.68 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $44,954.60 $44,954.60 $44,954.60 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $44,752.09 $44,752.09 $44,752.09 2026-04-01
224 MS_DRG Description Not Available 1 1 — — $43,904.29 $43,904.29 $43,904.29 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $43,630.07 $43,630.07 $43,630.07 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $43,067.80 $43,067.80 $43,067.80 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $42,609.90 $42,609.90 $42,609.90 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 2 — — $40,582.99 $42,120.46 $41,351.72 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 1 1 — — $40,142.49 $40,142.49 $40,142.49 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $39,457.02 $39,457.02 $39,457.02 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $38,372.19 $38,372.19 $38,372.19 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $38,267.69 $38,267.69 $38,267.69 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $37,806.50 $37,806.50 $37,806.50 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $37,683.65 $37,683.65 $37,683.65 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $37,439.77 $37,439.77 $37,439.77 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $37,378.04 $37,378.04 $37,378.04 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 1 1 — — $37,362.48 $37,362.48 $37,362.48 2026-04-01
223 MS_DRG Description Not Available 1 1 — — $37,250.38 $37,250.38 $37,250.38 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $37,074.16 $37,074.16 $37,074.16 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $36,432.30 $36,432.30 $36,432.30 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 1 1 — — $35,823.78 $35,823.78 $35,823.78 2026-04-01
226 MS_DRG Description Not Available 1 1 — — $34,922.07 $34,922.07 $34,922.07 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $34,285.44 $34,285.44 $34,285.44 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $33,460.45 $33,460.45 $33,460.45 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 1 1 — — $32,637.43 $32,637.43 $32,637.43 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 1 1 — — $32,070.07 $32,070.07 $32,070.07 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $32,057.51 $32,057.51 $32,057.51 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $31,728.52 $31,728.52 $31,728.52 2026-04-01
225 MS_DRG Description Not Available 1 1 — — $31,434.55 $31,434.55 $31,434.55 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $30,836.43 $30,836.43 $30,836.43 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $30,673.05 $30,673.05 $30,673.05 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 2 — — $30,528.47 $30,528.71 $30,528.59 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $30,527.53 $30,527.53 $30,527.53 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 1 1 — — $29,998.82 $29,998.82 $29,998.82 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $29,941.06 $29,941.06 $29,941.06 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $29,685.53 $29,685.53 $29,685.53 2026-04-01
227 MS_DRG Description Not Available 1 1 — — $29,615.14 $29,615.14 $29,615.14 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $23,609.59 $39,104.57 $29,586.68 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $29,510.01 $29,510.01 $29,510.01 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 1 1 — — $28,707.77 $28,707.77 $28,707.77 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $28,661.66 $28,661.66 $28,661.66 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 1 1 — — $28,473.59 $28,473.59 $28,473.59 2026-04-01
237 MS_DRG Description Not Available 1 1 — — $28,294.66 $28,294.66 $28,294.66 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $28,096.96 $28,096.96 $28,096.96 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 1 1 — — $28,044.50 $28,044.50 $28,044.50 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $27,811.92 $27,811.92 $27,811.92 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 2 — — $15,326.40 $40,092.54 $27,709.47 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $27,636.12 $27,636.12 $27,636.12 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $27,533.02 $27,533.02 $27,533.02 2026-04-01
245 MS_DRG Aicd Generator Procedures 1 1 — — $27,273.93 $27,273.93 $27,273.93 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 1 1 — — $26,957.50 $26,957.50 $26,957.50 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $26,638.20 $26,638.20 $26,638.20 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
0520T OTHER Rmvl&rplcmt Pg Wcs New Eltrd 1 1 — — $26,547.00 $26,547.00 $26,547.00 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 1 1 — — $26,486.20 $26,486.20 $26,486.20 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 1 — — $18,136.00 $34,149.54 $26,142.77 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $25,770.67 $25,770.67 $25,770.67 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $25,684.45 $25,684.45 $25,684.45 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $25,408.20 $25,408.20 $25,408.20 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $24,969.75 $24,969.75 $24,969.75 2026-04-01
984 MS_DRG Description Not Available 1 1 — — $24,912.06 $24,912.06 $24,912.06 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $24,888.69 $24,888.69 $24,888.69 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 1 1 — — $24,699.50 $24,699.50 $24,699.50 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 1 1 — — $24,375.40 $24,375.40 $24,375.40 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 1 1 — — $24,258.06 $24,258.06 $24,258.06 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 1 — — $23,953.42 $23,953.42 $23,953.42 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $23,943.86 $23,943.86 $23,943.86 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $23,805.46 $23,805.46 $23,805.46 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 2 — — $21,925.78 $25,084.57 $23,505.17 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 1 1 — — $23,364.65 $23,364.65 $23,364.65 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $23,343.93 $23,343.93 $23,343.93 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $23,186.27 $23,186.27 $23,186.27 2026-04-01
398 MS_DRG Appendix Procedures With Cc 1 1 — — $23,024.72 $23,024.72 $23,024.72 2026-04-01
835 MS_DRG Acute Leukemia With Cc 1 1 — — $22,798.54 $22,798.54 $22,798.54 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 5 4 — — $7,182.00 $49,800.76 $22,693.54 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 1 1 — — $22,453.23 $22,453.23 $22,453.23 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $22,371.89 $22,371.89 $22,371.89 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 1 1 — — $22,368.06 $22,368.06 $22,368.06 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 1 1 — — $22,270.16 $22,270.16 $22,270.16 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 2 2 — — $19,793.28 $24,647.49 $22,220.39 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $22,164.29 $22,164.29 $22,164.29 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $22,046.25 $22,046.25 $22,046.25 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $21,937.36 $21,937.36 $21,937.36 2026-04-01
306 MS_DRG Cardiac Congenital And Valvular Disorders With Mcc 1 1 — — $21,717.89 $21,717.89 $21,717.89 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 1 1 — — $21,652.81 $21,652.81 $21,652.81 2026-04-01
230 MS_DRG Description Not Available 1 1 — — $21,589.26 $21,589.26 $21,589.26 2026-04-01
570 MS_DRG Skin Debridement With Mcc 2 2 — — $18,903.98 $24,186.37 $21,545.17 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 2 — — $19,234.99 $23,849.14 $21,542.07 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 1 1 — — $21,533.24 $21,533.24 $21,533.24 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 1 1 — — $21,496.61 $21,496.61 $21,496.61 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 1 1 — — $21,312.80 $21,312.80 $21,312.80 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 1 1 — — $21,226.92 $21,226.92 $21,226.92 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 1 1 — — $21,185.48 $21,185.48 $21,185.48 2026-04-01
246 MS_DRG Description Not Available 1 1 — — $21,171.46 $21,171.46 $21,171.46 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $20,917.33 $20,917.33 $20,917.33 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 — — $8,242.75 $33,519.12 $20,880.94 2026-04-01
248 MS_DRG Description Not Available 1 1 — — $20,836.96 $20,836.96 $20,836.96 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 1 1 — — $20,654.61 $20,654.61 $20,654.61 2026-04-01
332 MS_DRG Rectal Resection With Mcc 1 1 — — $20,633.54 $20,633.54 $20,633.54 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 2 — — $18,131.39 $23,100.48 $20,615.93 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 2 — — $18,809.88 $21,987.11 $20,398.50 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 1 1 — — $20,380.01 $20,380.01 $20,380.01 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 1 1 — — $20,213.66 $20,213.66 $20,213.66 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $20,093.60 $20,093.60 $20,093.60 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 2 — — $18,198.50 $21,887.69 $20,043.10 2026-04-01
9005 OTHER Reteplase Injection 2 2 — — $3,645.58 $36,040.37 $19,842.97 2025-01-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 1 — — $19,831.30 $19,831.30 $19,831.30 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 1 1 — — $19,744.94 $19,744.94 $19,744.94 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 1 1 — — $19,579.68 $19,579.68 $19,579.68 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $19,483.41 $19,483.41 $19,483.41 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 1 1 — — $19,422.65 $19,422.65 $19,422.65 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 1 1 — — $19,241.41 $19,241.41 $19,241.41 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 1 1 — — $19,238.76 $19,238.76 $19,238.76 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 1 1 — — $19,169.35 $19,169.35 $19,169.35 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $19,137.89 $19,137.89 $19,137.89 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 1 1 — — $19,130.42 $19,130.42 $19,130.42 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 1 1 — — $19,070.99 $19,070.99 $19,070.99 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 1 1 — — $18,966.84 $18,966.84 $18,966.84 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $18,966.77 $18,966.77 $18,966.77 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $18,860.03 $18,860.03 $18,860.03 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 1 1 — — $18,770.04 $18,770.04 $18,770.04 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 1 1 — — $18,705.17 $18,705.17 $18,705.17 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $18,535.44 $18,535.44 $18,535.44 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 2 2 — — $16,570.59 $20,211.63 $18,391.11 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 1 1 — — $18,366.90 $18,366.90 $18,366.90 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 1 1 — — $18,296.37 $18,296.37 $18,296.37 2026-04-01
746 MS_DRG Vagina, Cervix And Vulva Procedures With Cc/Mcc 2 2 — — $7,672.83 $28,780.10 $18,226.46 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 1 1 — — $18,204.50 $18,204.50 $18,204.50 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 3 — — $12,554.99 $21,074.90 $18,161.81 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $17,927.48 $17,927.48 $17,927.48 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 4 4 — — $3,926.48 $33,429.08 $17,888.62 2026-04-01
5194 OTHER Level 4 Endovascular Procedures 1 1 — — $17,880.17 $17,880.17 $17,880.17 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 1 1 — — $17,780.78 $17,780.78 $17,780.78 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 2 2 — — $14,752.71 $20,788.11 $17,770.41 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 1 1 — — $17,530.90 $17,530.90 $17,530.90 2026-04-01
0956T OTHER Prt Crn Ch Cr&tun Elt S-sclp 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
0960T OTHER Rpl S-sclp Eltr Ra Rcvr&tlmt 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 1 1 — — $17,441.00 $17,441.00 $17,441.00 2026-04-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 1 1 — — $17,427.26 $17,427.26 $17,427.26 2026-04-01
675 MS_DRG Other Kidney And Urinary Tract Procedures Without Cc/Mcc 2 1 — — $9,973.94 $24,841.55 $17,407.74 2026-04-01
116 MS_DRG Intraocular Procedures With Cc/Mcc 1 1 — — $17,404.84 $17,404.84 $17,404.84 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $17,403.03 $17,403.03 $17,403.03 2026-04-01
503 MS_DRG Foot Procedures With Mcc 1 1 — — $17,309.97 $17,309.97 $17,309.97 2026-04-01
665 MS_DRG Prostatectomy With Mcc 1 1 — — $17,193.19 $17,193.19 $17,193.19 2026-04-01
548 MS_DRG Septic Arthritis With Mcc 1 1 — — $17,136.20 $17,136.20 $17,136.20 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 1 1 — — $17,084.84 $17,084.84 $17,084.84 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 2 2 — — $16,839.99 $17,144.67 $16,992.33 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 1 1 — — $16,933.61 $16,933.61 $16,933.61 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 2 2 — — $13,262.91 $20,392.00 $16,827.46 2026-04-01
241 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe Without Cc… 3 3 — — $9,376.72 $18,199.54 $16,815.81 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 1 1 — — $16,687.99 $16,687.99 $16,687.99 2026-04-01
553 MS_DRG Bone Diseases And Arthropathies With Mcc 1 1 — — $16,675.99 $16,675.99 $16,675.99 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 1 1 — — $16,630.16 $16,630.16 $16,630.16 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 1 1 — — $16,620.95 $16,620.95 $16,620.95 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 1 1 — — $16,593.74 $16,593.74 $16,593.74 2026-04-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 2 2 — — $16,394.65 $16,789.49 $16,592.07 2026-04-01
722 MS_DRG Malignancy, Male Reproductive System With Mcc 1 1 — — $16,578.67 $16,578.67 $16,578.67 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 1 1 — — $16,487.36 $16,487.36 $16,487.36 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 4 4 — — $12,998.10 $17,528.03 $16,447.51 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 4 4 — — $12,289.20 $22,832.51 $16,347.70 2026-04-01
265 MS_DRG Aicd Lead Procedures 1 1 — — $16,328.10 $16,328.10 $16,328.10 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 1 1 — — $16,256.00 $16,256.00 $16,256.00 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 1 1 — — $16,256.00 $16,256.00 $16,256.00 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 1 1 — — $16,256.00 $16,256.00 $16,256.00 2026-04-01
93582 HCPCS Perq Transcath Closure Pda 1 1 — — $16,256.00 $16,256.00 $16,256.00 2026-04-01
93581 HCPCS Percut Closure Vent 1 1 — — $16,256.00 $16,256.00 $16,256.00 2026-04-01
93580 HCPCS Percut Closure Fonta 1 1 — — $16,256.00 $16,256.00 $16,256.00 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $16,175.04 $16,175.04 $16,175.04 2026-04-01
251 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc 1 1 — — $16,161.44 $16,161.44 $16,161.44 2026-04-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 1 1 — — $15,954.04 $15,954.04 $15,954.04 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 1 1 — — $15,953.69 $15,953.69 $15,953.69 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $15,894.40 $15,894.40 $15,894.40 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 6 6 — — $4,000.00 $21,885.34 $15,778.13 2026-04-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 1 1 — — $15,750.83 $15,750.83 $15,750.83 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 1 1 — — $15,690.63 $15,690.63 $15,690.63 2026-04-01
238 MS_DRG Description Not Available 1 1 — — $15,597.15 $15,597.15 $15,597.15 2026-04-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 1 1 — — $15,546.64 $15,546.64 $15,546.64 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $15,290.14 $15,290.14 $15,290.14 2026-04-01
620 MS_DRG O.r. Procedures For Obesity With Cc 1 1 — — $15,284.90 $15,284.90 $15,284.90 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 3 3 — — $12,301.14 $37,317.13 $15,187.97 2026-04-01
800 MS_DRG Splenic Procedures With Cc 1 1 — — $15,179.22 $15,179.22 $15,179.22 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 1 1 — — $15,055.81 $15,055.81 $15,055.81 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 1 1 — — $15,009.51 $15,009.51 $15,009.51 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 1 1 — — $14,999.24 $14,999.24 $14,999.24 2026-04-01
919 MS_DRG Complications Of Treatment With Mcc 2 2 — — $11,057.52 $18,729.38 $14,893.45 2026-04-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 1 1 — — $14,823.09 $14,823.09 $14,823.09 2026-04-01
249 MS_DRG Description Not Available 1 1 — — $14,792.12 $14,792.12 $14,792.12 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 1 1 — — $14,779.00 $14,779.00 $14,779.00 2026-04-01
247 MS_DRG Description Not Available 2 2 — — $13,642.26 $15,835.10 $14,738.68 2026-04-01
717 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/Mcc 1 1 — — $14,635.16 $14,635.16 $14,635.16 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 1 1 — — $14,614.93 $14,614.93 $14,614.93 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 1 1 — — $14,606.70 $14,606.70 $14,606.70 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 1 1 — — $14,606.07 $14,606.07 $14,606.07 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 1 1 — — $14,559.82 $14,559.82 $14,559.82 2026-04-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 1 1 — — $14,509.31 $14,509.31 $14,509.31 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 1 1 — — $14,478.97 $14,478.97 $14,478.97 2026-04-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 1 1 — — $14,428.88 $14,428.88 $14,428.88 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 1 1 — — $14,375.37 $14,375.37 $14,375.37 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 1 1 — — $14,284.06 $14,284.06 $14,284.06 2026-04-01
69930 HCPCS Implant Cochlear Device 2 2 — — $1,976.00 $26,547.00 $14,261.50 2026-04-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 1 1 — — $14,248.83 $14,248.83 $14,248.83 2026-04-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $14,225.53 $14,225.53 $14,225.53 2026-04-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 4 4 — — $9,235.39 $17,420.23 $14,134.69 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 1 1 — — $14,013.88 $14,013.88 $14,013.88 2026-04-01
70 MS_DRG Other Cerebrovascular Disorders With Mcc 8 7 — — $10,679.95 $15,271.65 $13,915.99 2026-04-01
338 MS_DRG Description Not Available 1 1 — — $13,914.40 $13,914.40 $13,914.40 2026-04-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 1 1 — — $13,907.35 $13,907.35 $13,907.35 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 13 10 — — $3,508.86 $19,714.32 $13,904.29 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 1 1 — — $13,889.91 $13,889.91 $13,889.91 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $13,846.17 $13,846.17 $13,846.17 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
61886 HCPCS Implant Neurostim Arrays 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 2 2 — — $1,013.00 $26,547.00 $13,780.00 2026-04-01
836 MS_DRG Acute Leukemia Without Cc/Mcc 1 1 — — $13,741.53 $13,741.53 $13,741.53 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 1 1 — — $13,697.66 $13,697.66 $13,697.66 2026-04-01
124 MS_DRG Other Disorders Of The Eye With Mcc Or Thrombolytic Agent 1 1 — — $13,695.84 $13,695.84 $13,695.84 2026-04-01
259 MS_DRG Cardiac Pacemaker Device Replacement Without Mcc 1 1 — — $13,669.47 $13,669.47 $13,669.47 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 1 1 — — $13,608.78 $13,608.78 $13,608.78 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 1 1 — — $13,516.21 $13,516.21 $13,516.21 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/Mcc 1 1 — — $13,462.49 $13,462.49 $13,462.49 2026-04-01
882 MS_DRG Neuroses Except Depressive 2 2 — — $9,020.69 $17,871.81 $13,446.25 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 1 1 — — $13,434.03 $13,434.03 $13,434.03 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 7 7 — — $9,277.42 $14,964.15 $13,419.27 2026-04-01
595 MS_DRG Major Skin Disorders With Mcc 1 1 — — $13,417.36 $13,417.36 $13,417.36 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 1 1 — — $13,413.87 $13,413.87 $13,413.87 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 1 1 — — $13,357.09 $13,357.09 $13,357.09 2026-04-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $13,312.58 $13,312.58 $13,312.58 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 1 1 — — $13,177.80 $13,177.80 $13,177.80 2026-04-01
337 MS_DRG Peritoneal Adhesiolysis Without Cc/Mcc 3 3 — — $9,679.48 $13,192.41 $13,167.67 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 1 1 — — $13,145.30 $13,145.30 $13,145.30 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 1 1 — — $13,068.63 $13,068.63 $13,068.63 2026-04-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 1 1 — — $13,060.05 $13,060.05 $13,060.05 2026-04-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 1 1 — — $13,055.30 $13,055.30 $13,055.30 2026-04-01
131 MS_DRG Description Not Available 1 1 — — $13,055.03 $13,055.03 $13,055.03 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 1 1 — — $13,039.47 $13,039.47 $13,039.47 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 1 1 — — $13,027.54 $13,027.54 $13,027.54 2026-04-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 6 5 — — $5,760.01 $16,255.08 $13,013.17 2026-04-01
58 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Mcc 1 1 — — $12,970.83 $12,970.83 $12,970.83 2026-04-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 2 2 — — $12,167.47 $13,706.34 $12,936.90 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 1 1 — — $12,916.41 $12,916.41 $12,916.41 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 1 1 — — $12,859.35 $12,859.35 $12,859.35 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 2 — — $4,000.00 $21,663.27 $12,831.64 2026-04-01
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $12,809.12 $12,809.12 $12,809.12 2026-04-01
686 MS_DRG Kidney And Urinary Tract Neoplasms With Mcc 1 1 — — $12,796.08 $12,796.08 $12,796.08 2026-04-01
682 MS_DRG Renal Failure With Mcc 9 7 — — $1,219.76 $16,954.80 $12,788.42 2026-04-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 1 1 — — $12,768.52 $12,768.52 $12,768.52 2026-04-01
333 MS_DRG Rectal Resection With Cc 1 1 — — $12,763.71 $12,763.71 $12,763.71 2026-04-01
180 MS_DRG Respiratory Neoplasms With Mcc 2 2 — — $10,625.15 $14,844.50 $12,734.83 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 7 4 — — $4,458.34 $18,039.81 $12,712.81 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 1 1 — — $12,704.69 $12,704.69 $12,704.69 2026-04-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 3 3 — — $10,190.05 $13,962.69 $12,679.57 2026-04-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 2 1 — — $10,445.10 $14,901.21 $12,673.15 2026-04-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 1 1 — — $12,654.60 $12,654.60 $12,654.60 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 1 1 — — $12,571.17 $12,571.17 $12,571.17 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 1 1 — — $12,569.91 $12,569.91 $12,569.91 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 2 — — $2,310.00 $22,818.57 $12,564.28 2026-04-01
507 MS_DRG Major Shoulder Or Elbow Joint Procedures With Cc/Mcc 2 2 — — $9,891.13 $15,158.12 $12,524.62 2026-04-01
913 MS_DRG Traumatic Injury With Mcc 1 1 — — $12,486.27 $12,486.27 $12,486.27 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 1 1 — — $12,459.83 $12,459.83 $12,459.83 2026-04-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/Mcc 3 3 — — $8,494.12 $16,559.43 $12,451.22 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 2 — — $11,020.12 $17,458.73 $12,437.51 2026-04-01
592 MS_DRG Skin Ulcers With Mcc 1 1 — — $12,401.17 $12,401.17 $12,401.17 2026-04-01
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 1 1 — — $12,367.61 $12,367.61 $12,367.61 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 1 1 — — $12,307.48 $12,307.48 $12,307.48 2026-04-01
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