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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

COVENANT CHILDRENS HOSPITAL

Lubbock, TX · CCN 453306 · Rates published

15,215 distinct procedures filed
18 distinct payers
169,658 rate rows
2026-04-01 last MRF observed
Data quality

111,156 of 169,658 rate rows are consumer-grade (65.5%)

58,502 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 58,496
placeholder amount (≤ $0.02) — excluded from medians 6
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/txnm/live/752428911_covenant-childrens-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 5466f6c8a5c9d488… · 187,714,932 bytes · first seen 2026-05-08

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
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $2,697,170.00 $2,697,170.00 $2,697,170.00 nat. median
$824,563
outlier · 3.3×
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $1,791,273.00 $1,810,431.00 $1,791,273.00 nat. median
$57,174
outlier · 31.3×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $1,732,143.60 $1,936,825.91 $1,750,669.20 nat. median
$674,867
outlier · 2.6×
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 2 $1,687,675.00 $2,179,474.34 $1,696,700.00 nat. median
$25,594
outlier · 66.3×
C9081
HCPCS 		Idecabtagene Car Pos T 1 $1,615,997.90 $1,633,281.30 $1,615,997.90 nat. median
$30,475
outlier · 53.0×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $1,580,557.66 $1,597,462.02 $1,580,557.66 nat. median
$30,475
outlier · 51.9×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $1,562,654.28 $1,894,411.57 $1,579,367.16 nat. median
$625,184
outlier · 2.5×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $1,528,383.91 $1,895,724.80 $1,544,730.26 nat. median
$673,137
outlier · 2.3×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $1,436,870.60 $2,024,136.03 $1,533,965.45 nat. median
$753,246
outlier · 2.0×
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $1,389,439.92 $1,794,331.64 $1,483,329.69 nat. median
$619,808
outlier · 2.4×
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 2 $1,436,870.60 $1,855,583.93 $1,444,554.40 nat. median
$29,278
outlier · 49.3×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $1,325,269.00 $1,865,767.67 $1,414,822.50 nat. median
$634,303
outlier · 2.2×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 5 $418,691.07 $899,425.98 $709,406.19 nat. median
$370,174
1.9× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 3 $222,008.69 $604,800.00 $598,400.00 nat. median
$69,774
outlier · 8.6×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 7 $29,162.88 $803,683.02 $426,469.96 nat. median
$202,976
outlier · 2.1×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $312,727.60 $671,796.81 $411,681.93 nat. median
$265,286
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $263,390.93 $565,812.50 $346,733.98 nat. median
$206,474
1.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $125,326.28 $336,993.16 $247,656.16 nat. median
$133,161
1.9× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $195,810.90 $294,081.44 $227,721.83 nat. median
$66,682
outlier · 3.4×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $120,944.56 $259,811.33 $207,389.83 nat. median
$102,358
outlier · 2.0×
C9074
HCPCS 		Injection, Lumasiran 2 $205,700.00 $265,642.30 $206,800.00 nat. median
$9,821
outlier · 21.1×
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $203,962.06 $263,397.91 $205,052.77 nat. median
$62,507
outlier · 3.3×
215
MS_DRG 		Other Heart Assist System Implant 5 $117,625.92 $252,682.26 $196,685.97 nat. median
$99,019
2.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $145,457.46 $312,469.57 $191,483.60 nat. median
$117,357
1.6× median
7
MS_DRG 		Lung Transplant 4 $145,091.06 $311,682.48 $191,001.28 nat. median
$122,708
1.6× median
C9031
HCPCS 		Lutetium Lu 177 Dotatate, Tx 2 $188,309.00 $243,183.45 $189,316.00 nat. median
$664
outlier · 285.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $112,788.37 $230,171.69 $186,875.55 nat. median
$93,672
2.0× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $162,314.26 $226,089.76 $175,739.29 nat. median
$87,428
outlier · 2.0×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 6 $118,229.92 $253,979.76 $168,262.68 nat. median
$100,136
1.7× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $141,700.70 $171,293.46 $161,416.44 nat. median
$63,570
outlier · 2.5×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $122,350.19 $262,830.86 $161,064.65 nat. median
$108,660
1.5× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 $98,976.17 $215,067.71 $159,905.72 nat. median
$81,118
2.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 6 $31,322.12 $192,250.99 $156,203.00 nat. median
$77,570
outlier · 2.0×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $131,199.82 $158,599.58 $149,454.52 nat. median
$54,196
outlier · 2.8×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $3,377.55 $249,996.64 $148,187.60 nat. median
$98,894
1.5× median
J9226
HCPCS 		Supprelin La Implant 4 $137,441.33 $177,492.62 $146,728.77 nat. median
$60,368
outlier · 2.4×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $90,425.65 $196,743.56 $146,281.46 nat. median
$74,915
2.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $142,789.46 $256,139.76 $144,316.62 nat. median
$76,329
1.9× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $82,868.42 $178,016.71 $139,261.79 nat. median
$72,135
1.9× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 $78,458.36 $168,543.09 $135,474.33 nat. median
$68,886
2.0× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $118,461.46 $143,200.93 $134,943.77 nat. median
$49,935
outlier · 2.7×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 7 $20,648.41 $202,099.06 $133,891.50 nat. median
$79,312
1.7× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 10 $71,809.97 $545,440.69 $132,707.17 nat. median
$62,134
outlier · 2.1×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 $74,024.99 $159,019.39 $131,987.24 nat. median
$65,950
outlier · 2.0×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $121,483.84 $169,216.50 $131,531.77 nat. median
$65,393
outlier · 2.0×
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 5 $70,213.38 $153,753.81 $130,850.28 nat. median
$60,185
outlier · 2.2×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 5 $68,134.92 $152,543.48 $128,358.79 nat. median
$55,736
outlier · 2.3×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 $97,473.17 $198,917.34 $127,573.02 nat. median
$82,711
1.5× median
850
MS_DRG 		Acute Leukemia With Other Procedures 6 $36,727.60 $219,698.72 $123,614.45 nat. median
$83,470
1.5× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 7 $23,926.79 $186,414.65 $123,500.50 nat. median
$73,807
1.7× median

Other procedures at this hospital

Browse this hospital's 15,215 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
             
0266T HCPCS Implt/rpl Crtd Sns Dev Total 7 2 — — $3,669.79 $73,379.22 $62,022.92 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 7 2 — — $20,186.50 $73,379.22 $62,022.92 2026-04-01
0283T HCPCS Periph Field Stimul Perm 7 2 — — $30,873.72 $65,929.22 $55,725.89 2026-04-01
0312T HCPCS Laps Impltj Nstim Vagus 7 2 — — $3,669.79 $73,379.22 $62,022.92 2026-04-01
0316T HCPCS Replc Vagus Nerve Pls Gen 7 2 — — $20,186.50 $73,379.22 $62,022.92 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 7 2 — — $31,541.65 $73,379.22 $62,022.92 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 7 2 — — $20,485.45 $73,379.22 $62,022.92 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 7 2 — — $20,485.45 $73,379.22 $62,022.92 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 7 2 — — $6,355.00 $57,236.48 $48,378.46 2026-04-01
0520T HCPCS Rmvl&rplcmt Pg Wcs New Eltrd 7 2 — — $6,355.00 $57,236.48 $48,378.46 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 7 2 — — $8,068.00 $81,352.25 $68,762.02 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 7 2 — — $7,334.00 $57,236.48 $48,378.46 2026-04-01
0775T HCPCS Arthrd Si Jt Prq Iartic Impl 4 1 — — $46,641.95 $55,182.03 $46,641.95 2026-04-01
0809T HCPCS Arthrd Si Jt Prq Tfx&implt 4 1 — — $46,641.95 $55,182.03 $46,641.95 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 7 2 — — $4,524.00 $52,523.96 $44,395.25 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 7 2 — — $4,524.00 $52,523.96 $44,395.25 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 6 4 — — $312,727.60 $671,796.81 $411,681.93 2026-04-01
10 MS_DRG Pancreas Transplant 6 4 — — $88,518.66 $190,154.48 $116,528.04 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 10 5 — — $59,906.59 $128,690.46 $99,284.55 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 10 5 — — $45,559.48 $97,870.19 $77,114.35 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 10 5 — — $29,420.36 $63,200.38 $51,713.15 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 10 5 — — $26,767.89 $59,332.78 $50,181.12 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 6 4 — — $145,457.46 $312,469.57 $191,483.60 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 10 5 — — $46,953.99 $100,865.88 $72,747.32 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 10 5 — — $36,658.31 $78,748.85 $64,034.43 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 6 4 — — $67,011.31 $143,952.71 $88,215.26 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 10 5 — — $51,171.97 $109,926.87 $90,760.37 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 11 5 — — $27,943.68 $60,028.20 $51,015.65 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 11 5 — — $42,757.11 $202,193.00 $81,168.17 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 6 4 — — $67,011.31 $143,952.71 $88,215.26 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 10 5 — — $34,068.02 $73,184.41 $59,209.13 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 10 5 — — $418,691.07 $899,425.98 $709,406.19 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 6 4 — — $88,009.04 $189,059.72 $115,857.17 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 6 4 — — $122,350.19 $262,830.86 $161,064.65 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 6 — — $31,322.12 $192,250.99 $156,203.00 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 18 10 — — $71,809.97 $545,440.69 $132,707.17 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 18 9 — — $18,603.66 $80,667.85 $50,929.23 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 12 6 — — $52,936.63 $137,395.40 $100,498.96 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 10 5 — — $120,944.56 $259,811.33 $207,389.83 2026-04-01
215 MS_DRG Other Heart Assist System Implant 10 5 — — $117,625.92 $252,682.26 $196,685.97 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 5 — — $112,788.37 $230,171.69 $186,875.55 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 5 — — $75,470.41 $154,015.45 $122,563.86 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 5 — — $69,529.69 $141,891.98 $109,689.96 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 5 — — $90,425.65 $196,743.56 $146,281.46 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 13 6 — — $22,473.28 $84,203.57 $55,785.23 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 5 — — $61,900.14 $133,810.72 $99,490.07 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 10 5 — — $53,672.18 $118,604.38 $88,183.95 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 1 — — $141,700.70 $171,293.46 $161,416.44 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 4 1 — — $96,582.48 $116,752.76 $110,020.64 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 1 — — $131,199.82 $158,599.58 $149,454.52 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 4 1 — — $93,602.85 $113,150.86 $106,626.43 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 1 — — $118,461.46 $143,200.93 $134,943.77 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 4 1 — — $92,918.09 $112,323.10 $105,846.39 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 11 5 — — $25,025.06 $118,847.15 $93,251.22 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 11 6 — — $34,486.59 $110,899.18 $63,601.54 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 6 — — $33,669.63 $136,062.80 $104,912.48 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 7 — — $20,648.41 $202,099.06 $133,891.50 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 11 6 — — $23,448.48 $145,689.06 $110,090.74 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 7 — — $23,926.79 $186,414.65 $123,500.50 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 12 6 — — $11,275.21 $126,884.93 $90,129.67 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 10 5 — — $65,327.01 $140,334.51 $113,230.95 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 10 5 — — $45,652.74 $98,070.54 $77,813.30 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 10 5 — — $55,919.55 $120,125.56 $92,554.93 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 11 5 — — $42,206.41 $90,667.19 $75,787.37 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 10 5 — — $32,331.53 $69,454.11 $54,091.15 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 10 5 — — $37,660.90 $80,902.59 $66,527.96 2026-04-01
245 MS_DRG Aicd Generator Procedures 12 6 — — $15,465.27 $116,547.91 $80,538.05 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 4 1 — — $55,435.87 $67,013.09 $63,149.02 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 4 1 — — $55,702.37 $67,335.25 $63,452.60 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 13 7 — — $49,651.99 $173,042.84 $92,760.22 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 10 5 — — $25,677.58 $55,160.21 $45,264.65 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 12 7 — — $9,506.96 $81,813.70 $58,135.35 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 10 5 — — $28,344.49 $60,889.22 $49,121.43 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 10 5 — — $29,048.41 $62,401.37 $52,901.18 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 10 5 — — $31,147.96 $66,911.60 $52,154.10 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 15 8 — — $22,153.13 $183,884.88 $59,070.86 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 10 5 — — $37,825.22 $81,255.59 $63,834.18 2026-04-01
263 MS_DRG Vein Ligation And Stripping 11 6 — — $18,078.53 $63,966.00 $52,285.98 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 10 5 — — $38,803.39 $83,356.86 $62,886.83 2026-04-01
265 MS_DRG Aicd Lead Procedures 10 5 — — $39,602.79 $85,074.13 $68,049.10 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 10 5 — — $66,510.57 $142,877.03 $120,268.65 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 10 5 — — $52,232.29 $112,204.64 $93,968.25 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 10 5 — — $74,024.99 $159,019.39 $131,987.24 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 10 5 — — $46,192.34 $99,229.70 $80,073.85 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 12 7 — — $27,397.42 $174,152.27 $50,575.57 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 10 5 — — $56,988.76 $122,422.41 $97,370.61 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 10 5 — — $38,242.69 $82,152.38 $66,549.13 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 10 5 — — $27,779.36 $59,675.20 $46,972.57 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 10 5 — — $43,412.18 $93,257.41 $75,036.74 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 10 5 — — $34,649.81 $74,434.20 $62,401.60 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 10 5 — — $78,458.36 $168,543.09 $135,474.33 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 10 5 — — $68,771.11 $147,733.09 $119,577.40 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 10 5 — — $51,652.73 $110,959.62 $92,085.12 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 5 — — $55,546.50 $119,324.17 $85,885.00 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 10 5 — — $35,575.78 $76,423.37 $61,627.55 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 10 5 — — $71,049.06 $153,749.92 $114,315.12 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 10 5 — — $30,325.24 $65,144.24 $49,928.21 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 14 7 — — $20,644.00 $134,933.16 $67,988.07 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 7 — — $29,162.88 $803,683.02 $426,469.96 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 10 5 — — $26,006.87 $59,166.97 $43,991.43 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 11 6 — — $46,524.31 $99,942.85 $76,185.92 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 6 4 — — $68,682.29 $147,542.29 $90,414.98 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 10 5 — — $48,769.31 $104,765.52 $83,988.38 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 10 5 — — $31,606.51 $67,896.64 $55,352.35 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 10 5 — — $47,289.30 $101,586.18 $79,715.70 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 10 5 — — $35,473.64 $76,203.95 $57,160.40 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 10 5 — — $31,776.39 $68,261.56 $50,915.99 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 13 6 — — $56,388.10 $217,952.65 $101,595.24 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 14 7 — — $16,867.06 $66,109.54 $50,800.59 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 8 — — $17,187.31 $651,499.91 $86,970.99 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 15 7 — — $14,462.10 $95,938.51 $47,284.26 2026-04-01
332 MS_DRG Rectal Resection With Mcc 10 5 — — $38,510.27 $82,727.19 $69,849.43 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 10 3 — — $5,260.00 $81,352.25 $53,765.08 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 10 3 — — $8,068.00 $81,352.25 $53,765.08 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 10 3 — — $5,260.00 $81,352.25 $53,765.08 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 10 3 — — $5,260.00 $81,352.25 $53,765.08 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 7 2 — — $5,260.00 $113,401.26 $95,851.07 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 7 2 — — $5,260.00 $74,557.45 $63,018.80 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 7 2 — — $8,068.00 $71,874.26 $60,750.86 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 10 5 — — $40,235.65 $86,433.64 $68,836.63 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 4 1 — — $49,163.85 $59,431.22 $56,004.33 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 10 5 — — $43,173.47 $92,744.61 $75,121.46 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 4 1 — — $41,807.31 $50,538.35 $47,624.24 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 12 6 — — $16,971.98 $64,264.13 $46,645.93 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 10 5 — — $26,276.03 $57,028.47 $48,756.89 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 10 5 — — $25,254.57 $54,251.48 $44,276.88 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 11 5 — — $26,866.70 $57,714.65 $44,416.80 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 10 5 — — $32,562.47 $69,950.21 $56,307.39 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 11 5 — — $47,358.14 $101,734.06 $85,586.84 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 11 5 — — $25,002.53 $53,710.07 $43,942.59 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 10 5 — — $36,869.27 $79,202.02 $64,997.18 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 12 5 — — $125,326.28 $336,993.16 $247,656.16 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 7 — — $13,298.13 $89,961.20 $65,430.44 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 6 4 — — $45,922.25 $93,715.35 $60,103.10 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 10 5 — — $60,270.77 $129,472.77 $106,002.63 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 10 5 — — $31,179.05 $66,978.38 $55,596.89 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 10 5 — — $38,872.22 $83,504.74 $71,670.96 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 10 5 — — $30,381.87 $65,265.88 $55,464.03 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 10 5 — — $38,899.98 $83,564.36 $67,877.73 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 10 5 — — $27,775.18 $59,136.35 $43,968.67 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 15 7 — — $3,607.04 $84,174.95 $47,399.77 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 11 6 — — $41,383.14 $97,004.40 $72,379.03 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 7 5 — — $3,377.55 $249,996.64 $148,187.60 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 5 — — $9,186.65 $169,311.09 $97,773.52 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 4 — — $64,341.64 $131,304.53 $84,210.43 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 6 4 — — $97,473.17 $198,917.34 $127,573.02 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 6 4 — — $63,931.41 $130,467.36 $83,673.52 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 6 4 — — $78,354.87 $159,901.87 $102,550.96 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 6 4 — — $47,722.11 $97,388.40 $62,458.77 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 6 4 — — $60,186.76 $122,825.49 $78,772.51 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 7 5 — — $11,532.83 $73,599.42 $43,626.67 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 4 1 — — $162,314.26 $226,089.76 $175,739.29 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 4 1 — — $112,032.27 $156,051.28 $121,298.46 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 4 1 — — $84,360.78 $117,507.28 $91,338.26 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 5 — — $98,976.17 $215,067.71 $159,905.72 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 5 — — $67,074.16 $155,005.20 $115,248.44 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 10 5 — — $50,462.82 $115,603.93 $85,953.07 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 1 — — $121,483.84 $169,216.50 $131,531.77 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 4 1 — — $67,001.75 $93,327.66 $72,543.47 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 10 5 — — $68,134.92 $152,543.48 $128,358.79 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 12 6 — — $20,222.35 $68,299.72 $48,962.67 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 14 6 — — $3,579.78 $128,812.10 $78,936.99 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 10 5 — — $32,737.89 $70,327.06 $57,791.96 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 10 5 — — $56,561.30 $121,504.15 $99,867.99 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 10 5 — — $38,026.19 $81,687.29 $67,128.71 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 12 6 — — $14,942.00 $62,565.94 $45,428.25 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 10 5 — — $36,289.70 $77,956.99 $64,115.30 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 10 5 — — $53,926.59 $115,844.31 $94,715.35 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 10 5 — — $32,164.99 $69,096.35 $56,906.23 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 11 5 — — $26,282.69 $56,460.09 $45,538.32 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 10 5 — — $49,789.67 $106,957.42 $82,850.42 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 11 6 — — $38,180.51 $99,915.18 $67,390.11 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 10 5 — — $25,962.93 $55,773.18 $45,898.15 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 10 5 — — $32,653.51 $70,145.79 $56,781.07 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 11 5 — — $28,291.20 $60,774.73 $45,975.09 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 10 5 — — $35,791.18 $76,886.08 $63,425.97 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 10 5 — — $39,426.26 $84,694.90 $66,662.74 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 11 5 — — $26,657.97 $61,276.97 $47,128.56 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 10 5 — — $39,085.40 $83,962.68 $68,956.01 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 10 5 — — $28,031.39 $60,216.62 $50,274.81 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 9 6 — — $118,229.92 $253,979.76 $168,262.68 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 11 5 — — $4,931.12 $75,571.89 $60,014.50 2026-04-01
503 MS_DRG Foot Procedures With Mcc 10 5 — — $29,383.72 $63,121.67 $51,639.99 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 10 5 — — $31,731.97 $68,166.16 $52,385.15 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 10 5 — — $34,332.26 $73,752.06 $60,874.68 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 11 6 — — $19,220.97 $93,172.03 $66,890.02 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 10 5 — — $32,360.40 $69,516.12 $57,653.32 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 10 5 — — $28,053.60 $60,264.32 $48,006.57 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 10 5 — — $27,801.56 $59,722.90 $46,096.47 2026-04-01
5661 OTHER Therapeutic Nuclear Medicine 7 4 — — $6,147.23 $176,043.50 $50,269.26 2026-04-01
570 MS_DRG Skin Debridement With Mcc 10 5 — — $33,424.05 $71,801.05 $56,266.96 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 10 5 — — $68,369.19 $146,869.69 $119,729.51 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 10 5 — — $38,468.08 $82,636.56 $65,578.68 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 10 5 — — $59,898.82 $128,673.76 $109,428.09 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 10 5 — — $29,562.48 $63,505.67 $51,008.42 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 10 5 — — $36,185.33 $77,732.79 $64,354.07 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 6 4 — — $53,836.66 $115,651.11 $70,871.84 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 10 5 — — $30,013.25 $64,474.02 $53,967.92 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 10 5 — — $42,911.44 $92,181.73 $76,205.51 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 7 2 — — $5,260.00 $52,523.96 $44,395.25 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 13 7 — — $31,905.58 $89,298.14 $59,160.40 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 14 7 — — $18,552.61 $68,378.43 $49,681.82 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 10 5 — — $43,815.22 $94,123.20 $77,299.20 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 10 3 — — $4,524.00 $73,379.22 $45,642.25 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 7 2 — — $4,524.00 $75,759.97 $64,035.21 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 7 4 — — $19,694.77 $109,881.56 $61,875.42 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 6 4 — — $38,551.35 $82,815.44 $50,749.90 2026-04-01
652 MS_DRG Kidney Transplant 6 4 — — $34,099.10 $73,251.19 $44,888.86 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 10 5 — — $61,889.56 $132,950.24 $104,238.87 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 13 7 — — $31,331.16 $69,819.99 $54,758.21 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 10 5 — — $36,169.79 $77,699.40 $60,414.49 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 10 5 — — $28,692.01 $61,635.75 $49,849.27 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 10 5 — — $34,634.26 $74,400.81 $57,701.46 2026-04-01
665 MS_DRG Prostatectomy With Mcc 10 5 — — $38,120.56 $81,890.02 $59,480.62 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 10 5 — — $32,377.05 $69,551.90 $54,260.59 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 10 5 — — $46,520.98 $99,935.69 $71,204.99 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 10 5 — — $25,628.73 $55,055.26 $45,869.26 2026-04-01
7 MS_DRG Lung Transplant 6 4 — — $145,091.06 $311,682.48 $191,001.28 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 10 5 — — $43,715.29 $93,908.54 $74,848.04 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 10 5 — — $44,197.15 $94,943.68 $69,631.86 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 10 5 — — $28,738.64 $61,735.93 $48,468.68 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 24 11 — — $6,384.51 $2,533,801.66 $84,768.05 2026-04-01
791 MS_DRG Prematurity With Major Problems 16 9 — — $12,776.78 $531,347.83 $60,601.82 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 22 11 — — $2,354.00 $322,904.85 $51,114.58 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 10 5 — — $52,788.55 $113,399.58 $95,400.82 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 6 4 — — $60,408.44 $129,768.52 $79,523.08 2026-04-01
800 MS_DRG Splenic Procedures With Cc 10 5 — — $32,349.29 $69,492.27 $54,254.81 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 10 5 — — $39,799.31 $85,496.29 $65,280.22 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 13 6 — — $24,688.24 $54,628.33 $43,808.57 2026-04-01
81280 HCPCS Long Qt Synd Gene Full Seq 4 1 — — $45,267.79 $50,978.17 $50,303.31 2026-04-01
81416 HCPCS Exome Sequence Analysis 5 2 — — $26,208.00 $58,920.00 $57,360.00 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 5 — — $64,639.74 $138,858.14 $116,429.21 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 10 5 — — $51,952.50 $111,603.60 $86,684.08 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 5 — — $53,018.38 $113,893.30 $84,506.35 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 10 5 — — $26,199.42 $56,281.20 $44,617.68 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 12 5 — — $9,496.29 $73,546.94 $60,726.42 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 11 5 — — $61,364.40 $131,822.09 $111,996.80 2026-04-01
835 MS_DRG Acute Leukemia With Cc 11 5 — — $23,713.49 $72,139.24 $44,716.71 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 5 — — $52,302.90 $119,417.19 $83,572.40 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 10 5 — — $35,411.46 $76,070.38 $60,175.73 2026-04-01
849 MS_DRG Radiotherapy 10 5 — — $29,654.63 $63,703.64 $51,822.90 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 11 5 — — $25,157.97 $54,043.98 $45,462.82 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 8 6 — — $36,727.60 $219,698.72 $123,614.45 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 10 5 — — $55,530.95 $119,290.78 $96,261.52 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 11 5 — — $50,088.33 $107,599.02 $81,956.40 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 13 6 — — $47,538.56 $165,919.48 $109,922.37 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 6 4 — — $43,627.58 $93,720.12 $57,432.37 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 10 5 — — $49,187.89 $105,664.70 $83,331.79 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 10 5 — — $42,867.03 $92,086.33 $63,070.68 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 11 6 — — $17,215.67 $95,010.46 $68,836.79 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 6 4 — — $263,390.93 $565,812.50 $346,733.98 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 6 4 — — $74,150.45 $159,288.90 $97,613.39 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 6 4 — — $35,309.32 $75,850.95 $46,482.01 2026-04-01
9312 OTHER Inj., Ravulizumab-cwvz 10 Mg 1 1 — — $69,025.21 $69,025.21 $69,025.21 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 6 4 — — $48,038.74 $103,196.12 $63,239.32 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 10 5 — — $35,238.26 $75,698.30 $61,910.60 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 11 5 — — $40,507.67 $87,017.99 $67,045.31 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 11 6 — — $20,272.67 $57,170.85 $44,124.39 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 14 8 — — $29,494.78 $285,741.15 $117,266.80 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 12 6 — — $29,570.39 $91,163.29 $66,084.96 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 5 — — $82,868.42 $178,016.71 $139,261.79 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 11 5 — — $45,627.20 $98,015.68 $80,908.13 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 12 7 — — $29,352.63 $90,716.23 $48,761.36 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 11 5 — — $26,613.56 $57,170.85 $43,600.54 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 10 5 — — $30,162.03 $64,793.63 $52,648.94 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 10 5 — — $70,213.38 $153,753.81 $130,850.28 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 10 5 — — $39,801.53 $85,501.06 $70,028.51 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 10 5 — — $29,458.11 $63,281.47 $46,296.72 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 10 5 — — $33,153.14 $71,219.09 $56,157.21 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 7 — — $52,786.33 $139,382.33 $87,730.58 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 11 6 — — $9,508.45 $58,399.17 $46,008.40 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 10 5 — — $38,893.32 $83,550.05 $65,018.36 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 2 — — $203,962.06 $263,397.91 $205,052.77 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 6 2 — — $56,686.32 $73,205.08 $56,989.46 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 4 1 — — $66,998.95 $83,919.61 $74,775.62 2026-04-01
C9031 HCPCS Lutetium Lu 177 Dotatate, Tx 6 2 — — $188,309.00 $243,183.45 $189,316.00 2026-04-01
C9073 HCPCS Brexucabtagene Autoleucel Ca 6 2 — — $1,436,870.60 $1,855,583.93 $1,444,554.40 2026-04-01
C9074 HCPCS Injection, Lumasiran 6 2 — — $205,700.00 $265,642.30 $206,800.00 2026-04-01
C9076 HCPCS Lisocabtagene Car Pos T 4 1 — — $1,580,557.66 $1,597,462.02 $1,580,557.66 2026-04-01
C9081 HCPCS Idecabtagene Car Pos T 4 1 — — $1,615,997.90 $1,633,281.30 $1,615,997.90 2026-04-01
C9098 HCPCS Ciltacabtagene Car Pos T 4 1 — — $1,791,273.00 $1,810,431.00 $1,791,273.00 2026-04-01
C9741 HCPCS Impl Pressure Sensor W/angio 7 2 — — $3,040.29 $82,224.00 $69,498.85 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 8 1 — — $33,952.14 $83,047.24 $47,262.01 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 8 1 — — $33,952.14 $83,047.24 $47,262.01 2026-04-01
J7310 HCPCS Ganciclovir Long Act Implant 7 3 — — $15,789.91 $76,968.65 $59,600.64 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 7 3 — — $142,789.46 $256,139.76 $144,316.62 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 7 3 — — $222,008.69 $604,800.00 $598,400.00 2026-04-01
J9226 HCPCS Supprelin La Implant 9 4 — — $137,441.33 $177,492.62 $146,728.77 2026-04-01
J9266 HCPCS Pegaspargase Injection 9 4 — — $65,529.25 $99,484.21 $69,957.31 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 7 3 — — $81,050.29 $104,668.86 $81,917.14 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 4 1 — — $88,550.00 $92,400.00 $88,550.00 2026-04-01
Q2040 HCPCS Tisagenlecleucel Car-pos T 6 2 — — $1,687,675.00 $2,179,474.34 $1,696,700.00 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 9 4 — — $1,325,269.00 $1,865,767.67 $1,414,822.50 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 9 4 — — $1,436,870.60 $2,024,136.03 $1,533,965.45 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 9 4 — — $195,810.90 $294,081.44 $227,721.83 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 9 4 — — $1,389,439.92 $1,794,331.64 $1,483,329.69 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 3 — — $1,528,383.91 $1,895,724.80 $1,544,730.26 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 7 3 — — $1,562,654.28 $1,894,411.57 $1,579,367.16 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 7 3 — — $1,732,143.60 $1,936,825.91 $1,750,669.20 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 2 1 — — $2,697,170.00 $2,697,170.00 $2,697,170.00 2026-04-01
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