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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

MEDICAL CITY MENTAL HEALTH AND WELLNESS CENTER

Fort Worth, TX · CCN 454079 · Rates published

14,084 distinct procedures filed
10 distinct payers
134,550 rate rows
2026-03-01 last MRF observed
Data quality

128,915 of 134,550 rate rows are consumer-grade (95.8%)

5,635 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
per-diem day rate — not a per-procedure price 4,242
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 959
template filing: same amount across many unrelated codes — excluded 299
placeholder amount (≤ $0.02) — excluded from medians 122
exceeds 10× this hospital's gross charge — excluded from medians 13
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/46-4027347_MEDICAL-CITY-MENTAL-HEALTH-AND-WELLNESS-CENTER-ALLIANCE_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.medicalcityhealthcare.com/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 4d91401e7477d544… · 71,966,665 bytes · first seen 2026-05-18

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
845
OTHER 		Inj, Atidarsagene Autotem 2 $4,505,000.00 $4,543,292.50 $4,524,146.25 nat. median
$9,966
outlier · 454.0×
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 3 $3,685,267.00 $4,790,847.10 $3,716,591.77 nat. median
$3,746,358
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 4 $3,327,860.00 $4,326,218.00 $3,627,367.40 nat. median
$13,041
outlier · 278.2×
748
OTHER 		Inj, Lovotibeglogene Auto 4 $3,252,508.00 $4,228,260.40 $3,545,233.72 nat. median
$17,963
outlier · 197.4×
908
OTHER 		Topi Adm Prad Zami Per Tr 3 $3,335,820.00 $4,336,566.00 $3,364,174.47 nat. median
$22,747
outlier · 147.9×
906
OTHER 		Inj Elivaldogene Autoteme 3 $3,180,000.00 $4,134,000.00 $3,207,030.00 nat. median
$20,756
outlier · 154.5×
746
OTHER 		Inj, Betibeglogene Autote 4 $2,939,969.00 $3,821,959.70 $3,204,566.21 nat. median
$21,896
outlier · 146.4×
9141
OTHER 		Inj Onase Abepar-xioi Tre 4 $2,588,981.00 $4,634,275.99 $2,988,331.32 nat. median
$2,588,981
1.2× median
824
OTHER 		Inj, Exagamglogene Autote 4 $2,332,000.00 $4,174,280.00 $2,691,711.00 nat. median
$25,250
outlier · 106.6×
9498
OTHER 		Ciltacabtagene Car-pos T 5 $587,649.60 $1,539,641.95 $1,051,892.78 nat. median
$587,650
1.8× median
9194
OTHER 		Tisagenlecleucel Car-pos 5 $566,531.30 $1,484,312.01 $1,014,091.03 nat. median
$566,531
1.8× median
9413
OTHER 		Lisocabtagene Car Pos T 5 $562,201.20 $1,472,967.14 $1,006,340.15 nat. median
$562,201
1.8× median
9422
OTHER 		Idecabtagene Vicleucel Ca 5 $558,081.80 $1,462,174.32 $998,966.42 nat. median
$558,082
1.8× median
9035
OTHER 		Axicabtagene Ciloleucel C 5 $532,192.20 $1,394,343.56 $952,624.04 nat. median
$532,192
1.8× median
2067
OTHER 		Afamitresgene Autoleucel 6 $770,620.00 $2,019,024.40 $920,890.90 nat. median
$786,032
1.2× median
9391
OTHER 		Brexucabtagene Car Pos T 5 $489,450.20 $1,282,359.52 $876,115.86 nat. median
$489,450
1.8× median
831
OTHER 		Obecbtge Autol Up To 400 5 $278,250.00 $729,015.00 $498,067.50 nat. median
$12,362
outlier · 40.3×
897
OTHER 		Revakinagene, Per Implant 5 $265,000.00 $694,300.00 $474,350.00 nat. median
$9,577
outlier · 49.5×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $374,582.33 $374,582.33 $374,582.33 nat. median
$202,976
1.8× median
886
OTHER 		Inj. Remestemcel-l-rknd/ 5 $201,669.00 $528,372.78 $360,987.51 nat. median
$17,985
outlier · 20.1×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 $244,449.51 $244,449.51 $244,449.51 nat. median
$133,161
1.8× median
7
MS_DRG 		Lung Transplant 2 $228,545.13 $228,545.13 $228,545.13 nat. median
$122,708
1.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $194,502.14 $194,502.14 $194,502.14 nat. median
$98,894
2.0× median
1908
OTHER 		New Technology - Level 52 6 $150,194.70 $393,510.11 $179,482.66 nat. median
$152,962
1.2× median
1907
OTHER 		New Technology - Level 52 6 $150,194.70 $393,510.11 $179,482.66 nat. median
$153,199
1.2× median
1905
OTHER 		New Technology - Level 51 6 $135,421.50 $354,804.33 $161,828.69 nat. median
$137,903
1.2× median
1906
OTHER 		New Technology - Level 51 6 $135,421.50 $354,804.33 $161,828.69 nat. median
$138,020
1.2× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $159,001.42 $159,001.42 $159,001.42 nat. median
$82,711
1.9× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $152,822.86 $152,822.86 $152,822.86 nat. median
$83,470
1.8× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $148,303.20 $148,303.20 $148,303.20 nat. median
$81,118
1.8× median
1904
OTHER 		New Technology - Level 50 6 $120,648.30 $316,098.55 $144,174.72 nat. median
$120,174
1.2× median
1903
OTHER 		New Technology - Level 50 6 $120,648.30 $316,098.55 $144,174.72 nat. median
$119,935
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $138,868.58 $138,868.58 $138,868.58 nat. median
$77,570
1.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $134,476.00 $134,476.00 $134,476.00 nat. median
$72,135
1.9× median
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 6 $111,492.00 $292,109.04 $133,232.94 nat. median
$111,989
1.2× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $127,393.85 $127,393.85 $127,393.85 nat. median
$68,090
1.9× median
1902
OTHER 		New Technology - Level 49 6 $105,875.10 $277,392.76 $126,520.74 nat. median
$105,172
1.2× median
1901
OTHER 		New Technology - Level 49 6 $105,875.10 $277,392.76 $126,520.74 nat. median
$105,693
1.2× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $121,979.45 $121,979.45 $121,979.45 nat. median
$66,526
1.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 $121,381.18 $121,381.18 $121,381.18 nat. median
$65,950
1.8× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 2 $118,790.45 $118,790.45 $118,790.45 nat. median
$64,732
1.8× median
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 $118,003.35 $118,003.35 $118,003.35 nat. median
$60,691
1.9× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 $117,916.88 $117,916.88 $117,916.88 nat. median
$63,724
1.9× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 $115,619.11 $115,619.11 $115,619.11 nat. median
$59,793
1.9× median
K1007
HCPCS 		Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 6 $95,081.00 $249,112.22 $113,621.79 nat. median
$96,983
1.2× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $113,559.59 $113,559.59 $113,559.59 nat. median
$62,134
1.8× median
1599
OTHER 		New Technology - Level 48 6 $93,564.09 $245,137.92 $111,809.09 nat. median
$95,288
1.2× median
1585
OTHER 		New Technology - Level 48 6 $93,564.09 $245,137.92 $111,809.09 nat. median
$95,360
1.2× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 2 $108,028.70 $108,028.70 $108,028.70 nat. median
$60,185
1.8× median
28
MS_DRG 		Spinal Procedures With Mcc 2 $106,034.48 $106,034.48 $106,034.48 nat. median
$57,822
1.8× median

Other procedures at this hospital

Browse this hospital's 14,084 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
845 OTHER Inj, Atidarsagene Autotem 2 2 — — $4,505,000.00 $4,543,292.50 $4,524,146.25 2026-03-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 3 3 — — $3,685,267.00 $4,790,847.10 $3,716,591.77 2026-03-01
714 OTHER Inj Delandistrogene Mox R 6 4 — — $3,327,860.00 $4,326,218.00 $3,627,367.40 2026-03-01
748 OTHER Inj, Lovotibeglogene Auto 6 4 — — $3,252,508.00 $4,228,260.40 $3,545,233.72 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 3 3 — — $3,335,820.00 $4,336,566.00 $3,364,174.47 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 3 3 — — $3,180,000.00 $4,134,000.00 $3,207,030.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 6 4 — — $2,939,969.00 $3,821,959.70 $3,204,566.21 2026-03-01
9141 OTHER Inj Onase Abepar-xioi Tre 4 4 — — $2,588,981.00 $4,634,275.99 $2,988,331.32 2026-03-01
824 OTHER Inj, Exagamglogene Autote 4 4 — — $2,332,000.00 $4,174,280.00 $2,691,711.00 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 7 5 — — $587,649.60 $1,539,641.95 $1,051,892.78 2026-03-01
9194 OTHER Tisagenlecleucel Car-pos 7 5 — — $566,531.30 $1,484,312.01 $1,014,091.03 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 7 5 — — $562,201.20 $1,472,967.14 $1,006,340.15 2026-03-01
9422 OTHER Idecabtagene Vicleucel Ca 7 5 — — $558,081.80 $1,462,174.32 $998,966.42 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 7 5 — — $532,192.20 $1,394,343.56 $952,624.04 2026-03-01
2067 OTHER Afamitresgene Autoleucel 10 6 — — $770,620.00 $2,019,024.40 $920,890.90 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 7 5 — — $489,450.20 $1,282,359.52 $876,115.86 2026-03-01
831 OTHER Obecbtge Autol Up To 400 7 5 — — $278,250.00 $729,015.00 $498,067.50 2026-03-01
897 OTHER Revakinagene, Per Implant 7 5 — — $265,000.00 $694,300.00 $474,350.00 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 2 — — $374,582.33 $374,582.33 $374,582.33 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 7 5 — — $201,669.00 $528,372.78 $360,987.51 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 2 — — $244,449.51 $244,449.51 $244,449.51 2026-03-01
7 MS_DRG Lung Transplant 3 2 — — $228,545.13 $228,545.13 $228,545.13 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $194,502.14 $194,502.14 $194,502.14 2026-03-01
1907 OTHER New Technology - Level 52 10 6 — — $150,194.70 $393,510.11 $179,482.66 2026-03-01
1908 OTHER New Technology - Level 52 10 6 — — $150,194.70 $393,510.11 $179,482.66 2026-03-01
1905 OTHER New Technology - Level 51 10 6 — — $135,421.50 $354,804.33 $161,828.69 2026-03-01
1906 OTHER New Technology - Level 51 10 6 — — $135,421.50 $354,804.33 $161,828.69 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 3 2 — — $159,001.42 $159,001.42 $159,001.42 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 3 2 — — $152,822.86 $152,822.86 $152,822.86 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $148,303.20 $148,303.20 $148,303.20 2026-03-01
1904 OTHER New Technology - Level 50 10 6 — — $120,648.30 $316,098.55 $144,174.72 2026-03-01
1903 OTHER New Technology - Level 50 10 6 — — $120,648.30 $316,098.55 $144,174.72 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 2 — — $138,868.58 $138,868.58 $138,868.58 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 2 — — $134,476.00 $134,476.00 $134,476.00 2026-03-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 10 6 — — $111,492.00 $292,109.04 $133,232.94 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $127,393.85 $127,393.85 $127,393.85 2026-03-01
1901 OTHER New Technology - Level 49 10 6 — — $105,875.10 $277,392.76 $126,520.74 2026-03-01
1902 OTHER New Technology - Level 49 10 6 — — $105,875.10 $277,392.76 $126,520.74 2026-03-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 2 — — $121,979.45 $121,979.45 $121,979.45 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 2 — — $121,381.18 $121,381.18 $121,381.18 2026-03-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 2 — — $118,790.45 $118,790.45 $118,790.45 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 3 2 — — $118,003.35 $118,003.35 $118,003.35 2026-03-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 3 2 — — $117,916.88 $117,916.88 $117,916.88 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $115,619.11 $115,619.11 $115,619.11 2026-03-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 10 6 — — $95,081.00 $249,112.22 $113,621.79 2026-03-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 2 — — $113,559.59 $113,559.59 $113,559.59 2026-03-01
1585 OTHER New Technology - Level 48 10 6 — — $93,564.09 $245,137.92 $111,809.09 2026-03-01
1599 OTHER New Technology - Level 48 10 6 — — $93,564.09 $245,137.92 $111,809.09 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 2 — — $108,028.70 $108,028.70 $108,028.70 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 3 2 — — $106,034.48 $106,034.48 $106,034.48 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $105,236.79 $105,236.79 $105,236.79 2026-03-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 2 — — $103,501.99 $103,501.99 $103,501.99 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 2 — — $101,777.78 $101,777.78 $101,777.78 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $101,128.33 $101,128.33 $101,128.33 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 3 2 — — $100,715.37 $100,715.37 $100,715.37 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 2 — — $100,584.78 $100,584.78 $100,584.78 2026-03-01
1584 OTHER New Technology - Level 47 10 6 — — $83,715.29 $219,334.06 $100,039.77 2026-03-01
1598 OTHER New Technology - Level 47 10 6 — — $83,715.29 $219,334.06 $100,039.77 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $99,217.06 $99,217.06 $99,217.06 2026-03-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 2 — — $98,232.30 $98,232.30 $98,232.30 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 2 — — $97,469.90 $97,469.90 $97,469.90 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 7 5 — — $54,404.11 $142,538.77 $97,383.36 2026-03-01
834 MS_DRG Acute Leukemia With Mcc 3 2 — — $96,885.76 $96,885.76 $96,885.76 2026-03-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 2 — — $96,543.38 $96,543.38 $96,543.38 2026-03-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 2 — — $96,253.96 $96,253.96 $96,253.96 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 7 3 — — $75,983.00 $199,754.18 $95,513.00 2026-03-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 3 2 — — $94,056.78 $94,056.78 $94,056.78 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $93,424.98 $93,424.98 $93,424.98 2026-03-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $93,116.14 $93,116.14 $93,116.14 2026-03-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 2 — — $91,864.90 $91,864.90 $91,864.90 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 3 2 — — $91,706.07 $91,706.07 $91,706.07 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 8 3 — — $55,453.00 $148,770.88 $88,350.00 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 3 — — $55,453.00 $191,906.12 $88,350.00 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 3 — — $55,453.00 $172,646.85 $88,350.00 2026-03-01
215 MS_DRG Other Heart Assist System Implant 8 3 — — $55,453.00 $175,721.14 $88,350.00 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 3 — — $55,453.00 $135,506.64 $88,333.41 2026-03-01
1597 OTHER New Technology - Level 46 10 6 — — $73,866.49 $193,530.20 $88,270.46 2026-03-01
1583 OTHER New Technology - Level 46 10 6 — — $73,866.49 $193,530.20 $88,270.46 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 8 3 — — $55,453.00 $134,922.49 $88,187.37 2026-03-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 2 — — $88,017.64 $88,017.64 $88,017.64 2026-03-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 2 — — $87,156.41 $87,156.41 $87,156.41 2026-03-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 2 — — $86,858.16 $86,858.16 $86,858.16 2026-03-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $86,496.38 $86,496.38 $86,496.38 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 8 3 — — $55,453.00 $125,837.30 $85,916.07 2026-03-01
471 MS_DRG Cervical Spinal Fusion With Mcc 3 2 — — $85,216.90 $85,216.90 $85,216.90 2026-03-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 2 — — $84,786.29 $84,786.29 $84,786.29 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 3 — — $55,453.00 $116,040.89 $83,466.97 2026-03-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 3 — — $55,453.00 $116,040.89 $83,466.97 2026-03-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $82,800.89 $82,800.89 $82,800.89 2026-03-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 3 2 — — $82,553.81 $82,553.81 $82,553.81 2026-03-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 10 6 — — $68,801.70 $180,260.45 $82,218.03 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 8 3 — — $55,453.00 $108,154.00 $81,495.25 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 8 3 — — $55,453.00 $106,992.76 $81,204.94 2026-03-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $81,119.03 $81,119.03 $81,119.03 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 8 3 — — $55,453.00 $106,004.48 $80,957.87 2026-03-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 2 — — $80,912.55 $80,912.55 $80,912.55 2026-03-01
245 MS_DRG Aicd Generator Procedures 3 2 — — $80,517.24 $80,517.24 $80,517.24 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 8 3 — — $55,453.00 $103,569.05 $80,349.01 2026-03-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 2 — — $80,275.46 $80,275.46 $80,275.46 2026-03-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $80,240.16 $80,240.16 $80,240.16 2026-03-01
799 MS_DRG Splenic Procedures With Mcc 3 2 — — $79,926.03 $79,926.03 $79,926.03 2026-03-01
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $79,094.81 $79,094.81 $79,094.81 2026-03-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $79,071.86 $79,071.86 $79,071.86 2026-03-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $78,761.26 $78,761.26 $78,761.26 2026-03-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 8 3 — — $55,453.00 $95,513.00 $78,585.00 2026-03-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 8 3 — — $55,453.00 $95,513.00 $78,585.00 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 8 3 — — $55,453.00 $96,405.73 $78,585.00 2026-03-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 3 — — $55,453.00 $95,513.00 $78,585.00 2026-03-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 8 3 — — $55,453.00 $95,513.00 $78,585.00 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 3 — — $55,453.00 $95,513.00 $78,585.00 2026-03-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $77,524.13 $77,524.13 $77,524.13 2026-03-01
717 OTHER Instill Adstiladrin, Tx D 10 6 — — $64,274.79 $168,399.95 $76,808.38 2026-03-01
1596 OTHER New Technology - Level 45 10 6 — — $64,017.69 $167,726.35 $76,501.14 2026-03-01
1582 OTHER New Technology - Level 45 10 6 — — $64,017.69 $167,726.35 $76,501.14 2026-03-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $75,761.10 $75,761.10 $75,761.10 2026-03-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 8 3 — — $55,453.00 $95,513.00 $75,733.00 2026-03-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 8 3 — — $55,453.00 $95,513.00 $75,733.00 2026-03-01
5244 OTHER Level 4 Blood Product Exc 10 6 — — $63,291.86 $165,824.67 $75,633.77 2026-03-01
140 MS_DRG Major Head And Neck Procedures With Mcc 3 2 — — $75,274.01 $75,274.01 $75,274.01 2026-03-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $74,841.64 $74,841.64 $74,841.64 2026-03-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $74,531.03 $74,531.03 $74,531.03 2026-03-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 2 — — $74,403.97 $74,403.97 $74,403.97 2026-03-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $74,366.91 $74,366.91 $74,366.91 2026-03-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $74,149.84 $74,149.84 $74,149.84 2026-03-01
901 MS_DRG Wound Debridements For Injuries With Mcc 3 2 — — $74,061.60 $74,061.60 $74,061.60 2026-03-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 2 — — $73,638.04 $73,638.04 $73,638.04 2026-03-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 2 — — $73,292.14 $73,292.14 $73,292.14 2026-03-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 2 — — $70,953.78 $70,953.78 $70,953.78 2026-03-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 2 — — $70,311.40 $70,311.40 $70,311.40 2026-03-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $69,037.21 $69,037.21 $69,037.21 2026-03-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 2 — — $68,310.11 $68,310.11 $68,310.11 2026-03-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 3 2 — — $68,142.46 $68,142.46 $68,142.46 2026-03-01
1643 OTHER Y90 Ibritumomab, Rx 10 6 — — $56,824.55 $148,880.32 $67,905.34 2026-03-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 2 — — $67,755.97 $67,755.97 $67,755.97 2026-03-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $66,409.42 $66,409.42 $66,409.42 2026-03-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 2 — — $66,120.00 $66,120.00 $66,120.00 2026-03-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 2 — — $65,962.93 $65,962.93 $65,962.93 2026-03-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 2 — — $65,955.87 $65,955.87 $65,955.87 2026-03-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 3 2 — — $65,770.57 $65,770.57 $65,770.57 2026-03-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 2 — — $64,822.87 $64,822.87 $64,822.87 2026-03-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 3 2 — — $64,796.40 $64,796.40 $64,796.40 2026-03-01
1581 OTHER New Technology - Level 44 10 6 — — $54,168.89 $141,922.49 $64,731.82 2026-03-01
1595 OTHER New Technology - Level 44 10 6 — — $54,168.89 $141,922.49 $64,731.82 2026-03-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 2 — — $64,035.77 $64,035.77 $64,035.77 2026-03-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 2 — — $63,986.35 $63,986.35 $63,986.35 2026-03-01
332 MS_DRG Rectal Resection With Mcc 3 2 — — $63,898.11 $63,898.11 $63,898.11 2026-03-01
265 MS_DRG Aicd Lead Procedures 3 2 — — $63,853.99 $63,853.99 $63,853.99 2026-03-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 2 — — $63,741.05 $63,741.05 $63,741.05 2026-03-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 3 2 — — $63,645.75 $63,645.75 $63,645.75 2026-03-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 3 2 — — $63,229.25 $63,229.25 $63,229.25 2026-03-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 2 — — $63,082.78 $63,082.78 $63,082.78 2026-03-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 2 — — $63,019.24 $63,019.24 $63,019.24 2026-03-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $62,925.71 $62,925.71 $62,925.71 2026-03-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 2 — — $62,872.76 $62,872.76 $62,872.76 2026-03-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 3 2 — — $62,812.76 $62,812.76 $62,812.76 2026-03-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 2 — — $62,761.58 $62,761.58 $62,761.58 2026-03-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 2 — — $62,237.44 $62,237.44 $62,237.44 2026-03-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 2 — — $62,110.37 $62,110.37 $62,110.37 2026-03-01
252 MS_DRG Other Vascular Procedures With Mcc 3 2 — — $61,561.52 $61,561.52 $61,561.52 2026-03-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 3 2 — — $61,545.64 $61,545.64 $61,545.64 2026-03-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 2 — — $61,263.27 $61,263.27 $61,263.27 2026-03-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 2 — — $60,966.78 $60,966.78 $60,966.78 2026-03-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $60,504.40 $60,504.40 $60,504.40 2026-03-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 2 — — $60,207.92 $60,207.92 $60,207.92 2026-03-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $60,128.50 $60,128.50 $60,128.50 2026-03-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 10 6 — — $50,007.20 $131,018.86 $59,758.60 2026-03-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 10 6 — — $49,600.80 $129,954.10 $59,272.96 2026-03-01
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $58,954.91 $58,954.91 $58,954.91 2026-03-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 3 2 — — $58,296.64 $58,296.64 $58,296.64 2026-03-01
37 MS_DRG Extracranial Procedures With Mcc 3 2 — — $58,098.98 $58,098.98 $58,098.98 2026-03-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 3 2 — — $57,153.05 $57,153.05 $57,153.05 2026-03-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 3 2 — — $57,089.52 $57,089.52 $57,089.52 2026-03-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $57,010.10 $57,010.10 $57,010.10 2026-03-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 3 2 — — $56,951.86 $56,951.86 $56,951.86 2026-03-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 3 2 — — $56,346.53 $56,346.53 $56,346.53 2026-03-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 3 2 — — $56,242.41 $56,242.41 $56,242.41 2026-03-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 3 2 — — $56,187.70 $56,187.70 $56,187.70 2026-03-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 3 2 — — $56,074.76 $56,074.76 $56,074.76 2026-03-01
500 MS_DRG Soft Tissue Procedures With Mcc 3 2 — — $55,852.39 $55,852.39 $55,852.39 2026-03-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 3 2 — — $55,767.68 $55,767.68 $55,767.68 2026-03-01
665 MS_DRG Prostatectomy With Mcc 3 2 — — $55,082.94 $55,082.94 $55,082.94 2026-03-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 3 2 — — $54,968.23 $54,968.23 $54,968.23 2026-03-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 3 2 — — $54,871.16 $54,871.16 $54,871.16 2026-03-01
662 MS_DRG Minor Bladder Procedures With Mcc 3 2 — — $54,029.35 $54,029.35 $54,029.35 2026-03-01
263 MS_DRG Vein Ligation And Stripping 3 2 — — $53,957.00 $53,957.00 $53,957.00 2026-03-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 3 2 — — $53,529.91 $53,529.91 $53,529.91 2026-03-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 3 2 — — $53,305.78 $53,305.78 $53,305.78 2026-03-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 3 2 — — $53,298.72 $53,298.72 $53,298.72 2026-03-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 3 2 — — $53,240.49 $53,240.49 $53,240.49 2026-03-01
1594 OTHER New Technology - Level 43 10 6 — — $44,320.09 $116,118.64 $52,962.51 2026-03-01
1580 OTHER New Technology - Level 43 10 6 — — $44,320.09 $116,118.64 $52,962.51 2026-03-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 3 2 — — $52,527.51 $52,527.51 $52,527.51 2026-03-01
472 MS_DRG Cervical Spinal Fusion With Cc 3 2 — — $51,992.77 $51,992.77 $51,992.77 2026-03-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 3 2 — — $51,957.48 $51,957.48 $51,957.48 2026-03-01
570 MS_DRG Skin Debridement With Mcc 3 2 — — $51,904.53 $51,904.53 $51,904.53 2026-03-01
1142 OTHER Supprelin La Implant 10 6 — — $43,185.34 $113,145.59 $51,606.48 2026-03-01
668 MS_DRG Transurethral Procedures With Mcc 3 2 — — $51,532.16 $51,532.16 $51,532.16 2026-03-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 3 2 — — $51,396.27 $51,396.27 $51,396.27 2026-03-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 3 2 — — $51,214.50 $51,214.50 $51,214.50 2026-03-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 3 2 — — $51,182.73 $51,182.73 $51,182.73 2026-03-01
974 MS_DRG HIV With Major Related Condition With Mcc 3 2 — — $50,932.13 $50,932.13 $50,932.13 2026-03-01
843 OTHER Pegaspargase Injection 7 5 — — $28,424.06 $74,471.04 $50,879.07 2026-03-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 3 2 — — $50,858.01 $50,858.01 $50,858.01 2026-03-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 3 2 — — $50,653.29 $50,653.29 $50,653.29 2026-03-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 3 2 — — $50,305.62 $50,305.62 $50,305.62 2026-03-01
800 MS_DRG Splenic Procedures With Cc 3 2 — — $49,580.29 $49,580.29 $49,580.29 2026-03-01
654 MS_DRG Major Bladder Procedures With Cc 3 2 — — $49,402.05 $49,402.05 $49,402.05 2026-03-01
503 MS_DRG Foot Procedures With Mcc 3 2 — — $49,257.33 $49,257.33 $49,257.33 2026-03-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 3 2 — — $48,918.49 $48,918.49 $48,918.49 2026-03-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 3 2 — — $48,657.30 $48,657.30 $48,657.30 2026-03-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 3 2 — — $48,509.06 $48,509.06 $48,509.06 2026-03-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 3 2 — — $48,496.70 $48,496.70 $48,496.70 2026-03-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 3 2 — — $48,246.10 $48,246.10 $48,246.10 2026-03-01
849 MS_DRG Radiotherapy 3 2 — — $47,817.26 $47,817.26 $47,817.26 2026-03-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 3 2 — — $47,759.02 $47,759.02 $47,759.02 2026-03-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 3 2 — — $47,603.72 $47,603.72 $47,603.72 2026-03-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 10 6 — — $39,525.60 $103,557.07 $47,233.09 2026-03-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 3 2 — — $46,943.68 $46,943.68 $46,943.68 2026-03-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 3 2 — — $46,779.55 $46,779.55 $46,779.55 2026-03-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 3 2 — — $46,544.84 $46,544.84 $46,544.84 2026-03-01
253 MS_DRG Other Vascular Procedures With Cc 3 2 — — $45,807.15 $45,807.15 $45,807.15 2026-03-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 3 2 — — $45,752.44 $45,752.44 $45,752.44 2026-03-01
77372 CPT Radiation Treatment Delivery, Stereotactic Radiosurgery (srs), Complete Course O… 5 1 — — $31,154.00 $53,660.00 $45,611.00 2026-03-01
G0339 HCPCS Image-guided Robotic Linear Accelerator-based Stereotactic Radiosurgery, Complet… 5 1 — — $31,154.00 $53,660.00 $45,611.00 2026-03-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 3 2 — — $45,581.25 $45,581.25 $45,581.25 2026-03-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 3 2 — — $45,517.72 $45,517.72 $45,517.72 2026-03-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 3 2 — — $45,517.72 $45,517.72 $45,517.72 2026-03-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 3 2 — — $45,313.00 $45,313.00 $45,313.00 2026-03-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 3 2 — — $45,055.34 $45,055.34 $45,055.34 2026-03-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 3 2 — — $44,841.80 $44,841.80 $44,841.80 2026-03-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 3 2 — — $44,757.09 $44,757.09 $44,757.09 2026-03-01
164 MS_DRG Major Chest Procedures With Cc 3 2 — — $44,543.55 $44,543.55 $44,543.55 2026-03-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 3 2 — — $44,524.14 $44,524.14 $44,524.14 2026-03-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 3 2 — — $43,977.05 $43,977.05 $43,977.05 2026-03-01
545 MS_DRG Connective Tissue Disorders With Mcc 3 2 — — $43,797.04 $43,797.04 $43,797.04 2026-03-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 3 2 — — $43,399.96 $43,399.96 $43,399.96 2026-03-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 3 2 — — $43,387.61 $43,387.61 $43,387.61 2026-03-01
856 OTHER Porfimer Sodium Injection 7 5 — — $24,228.42 $63,478.46 $43,368.87 2026-03-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 3 2 — — $43,135.24 $43,135.24 $43,135.24 2026-03-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 3 2 — — $43,084.06 $43,084.06 $43,084.06 2026-03-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 3 2 — — $42,448.73 $42,448.73 $42,448.73 2026-03-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 3 2 — — $42,305.79 $42,305.79 $42,305.79 2026-03-01
397 MS_DRG Appendix Procedures With Mcc 3 2 — — $42,265.20 $42,265.20 $42,265.20 2026-03-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 3 2 — — $42,187.54 $42,187.54 $42,187.54 2026-03-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 3 2 — — $42,115.19 $42,115.19 $42,115.19 2026-03-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 10 6 — — $34,970.10 $91,621.66 $41,789.27 2026-03-01
113 MS_DRG Orbital Procedures With Cc/mcc 3 2 — — $41,492.21 $41,492.21 $41,492.21 2026-03-01
333 MS_DRG Rectal Resection With Cc 3 2 — — $41,335.15 $41,335.15 $41,335.15 2026-03-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 3 2 — — $41,271.61 $41,271.61 $41,271.61 2026-03-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 3 2 — — $41,241.61 $41,241.61 $41,241.61 2026-03-01
1579 OTHER New Technology - Level 42 10 6 — — $34,471.29 $90,314.78 $41,193.19 2026-03-01
1593 OTHER New Technology - Level 42 10 6 — — $34,471.29 $90,314.78 $41,193.19 2026-03-01
709 MS_DRG Penis Procedures With Cc/mcc 3 2 — — $41,068.66 $41,068.66 $41,068.66 2026-03-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 3 2 — — $41,040.42 $41,040.42 $41,040.42 2026-03-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 3 2 — — $40,788.06 $40,788.06 $40,788.06 2026-03-01
347 MS_DRG Anal And Stomal Procedures With Mcc 3 2 — — $40,512.75 $40,512.75 $40,512.75 2026-03-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 3 2 — — $40,500.40 $40,500.40 $40,500.40 2026-03-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 3 2 — — $40,336.27 $40,336.27 $40,336.27 2026-03-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 3 2 — — $40,265.68 $40,265.68 $40,265.68 2026-03-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 3 2 — — $40,161.55 $40,161.55 $40,161.55 2026-03-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 3 2 — — $40,094.49 $40,094.49 $40,094.49 2026-03-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 3 2 — — $39,983.31 $39,983.31 $39,983.31 2026-03-01
5166 OTHER Cochlear Implant Procedur 10 6 — — $33,176.95 $86,923.61 $39,646.46 2026-03-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 3 2 — — $39,506.81 $39,506.81 $39,506.81 2026-03-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 3 2 — — $39,483.87 $39,483.87 $39,483.87 2026-03-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 3 2 — — $39,171.50 $39,171.50 $39,171.50 2026-03-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 3 2 — — $38,965.02 $38,965.02 $38,965.02 2026-03-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 3 2 — — $38,802.66 $38,802.66 $38,802.66 2026-03-01
30 MS_DRG Spinal Procedures Without Cc/mcc 3 2 — — $38,740.89 $38,740.89 $38,740.89 2026-03-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 3 2 — — $38,680.89 $38,680.89 $38,680.89 2026-03-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 3 2 — — $38,612.06 $38,612.06 $38,612.06 2026-03-01
141 MS_DRG Major Head And Neck Procedures With Cc 3 2 — — $38,492.05 $38,492.05 $38,492.05 2026-03-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 3 2 — — $38,451.46 $38,451.46 $38,451.46 2026-03-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $38,424.99 $38,424.99 $38,424.99 2026-03-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 8 3 — — $24,051.00 $50,956.84 $38,320.00 2026-03-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 3 2 — — $38,296.16 $38,296.16 $38,296.16 2026-03-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 3 2 — — $37,793.19 $37,793.19 $37,793.19 2026-03-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 3 2 — — $37,779.07 $37,779.07 $37,779.07 2026-03-01
374 MS_DRG Digestive Malignancy With Mcc 3 2 — — $37,743.78 $37,743.78 $37,743.78 2026-03-01
5232 OTHER Level 2 Icd And Similar P 10 6 — — $31,583.85 $82,749.69 $37,742.70 2026-03-01
32 MS_DRG Ventricular Shunt Procedures With Cc 3 2 — — $37,607.89 $37,607.89 $37,607.89 2026-03-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 3 2 — — $37,606.12 $37,606.12 $37,606.12 2026-03-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 3 2 — — $37,590.24 $37,590.24 $37,590.24 2026-03-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 3 2 — — $37,532.00 $37,532.00 $37,532.00 2026-03-01
595 MS_DRG Major Skin Disorders With Mcc 3 2 — — $37,426.11 $37,426.11 $37,426.11 2026-03-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 3 2 — — $37,373.17 $37,373.17 $37,373.17 2026-03-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 3 2 — — $37,367.88 $37,367.88 $37,367.88 2026-03-01
655 MS_DRG Major Bladder Procedures Without Cc/mcc 3 2 — — $37,353.76 $37,353.76 $37,353.76 2026-03-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 3 2 — — $37,214.34 $37,214.34 $37,214.34 2026-03-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 3 2 — — $37,104.92 $37,104.92 $37,104.92 2026-03-01
5465 OTHER Level 5 Neurostimulator A 10 6 — — $31,049.39 $81,349.40 $37,104.02 2026-03-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 3 2 — — $36,963.74 $36,963.74 $36,963.74 2026-03-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 3 2 — — $36,940.79 $36,940.79 $36,940.79 2026-03-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 3 2 — — $36,903.73 $36,903.73 $36,903.73 2026-03-01
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 3 2 — — $36,838.44 $36,838.44 $36,838.44 2026-03-01
835 MS_DRG Acute Leukemia With Cc 3 2 — — $36,810.20 $36,810.20 $36,810.20 2026-03-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 3 2 — — $36,799.61 $36,799.61 $36,799.61 2026-03-01
711 MS_DRG Testes Procedures With Cc/mcc 3 2 — — $36,774.90 $36,774.90 $36,774.90 2026-03-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 3 2 — — $36,697.25 $36,697.25 $36,697.25 2026-03-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 3 2 — — $36,674.31 $36,674.31 $36,674.31 2026-03-01
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