Price Transparencybeta Hospital negotiated rates

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

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Hospital

LONE PEAK HOSPITAL

Draper, UT · CCN 460060 · Rates published

21,067 distinct procedures filed
29 distinct payers
455,780 rate rows
2024-10-01 last MRF observed · ⚠ 21 mo old
Data quality

249,251 of 455,780 rate rows are consumer-grade (54.7%)

206,529 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 203,784
per-diem day rate — not a per-procedure price 2,391
template filing: same amount across many unrelated codes — excluded 256
placeholder amount (≤ $0.02) — excluded from medians 88
exceeds 10× this hospital's gross charge — excluded from medians 10

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 21 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.hcadam.com/api/public/content/65ebdd902aea4b6d9ee5a03ee8ecef72?download=true
Found on page https://www.mountainstar.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint 4a6f843cfa23ee40… · 279,931,915 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 9 $3,202,768.80 $3,709,629.00 $3,672,900.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 9 $3,143,560.00 $3,641,050.00 $3,605,000.00 nat. median
$3,605,000
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 9 $2,899,796.76 $3,358,709.55 $3,325,455.00 nat. median
$13,041
outlier · 255.0×
748
OTHER 		Inj, Lovotibeglogene Auto 9 $2,865,392.00 $3,318,860.00 $3,286,000.00 nat. median
$17,963
outlier · 182.9×
746
OTHER 		Inj, Betibeglogene Autote 9 $2,588,096.00 $2,997,680.00 $2,968,000.00 nat. median
$21,896
outlier · 135.6×
9141
OTHER 		Inj Onase Abepar-xioi Tre 9 $2,082,871.41 $2,412,500.14 $2,388,614.00 nat. median
$2,588,981
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 9 $461,456.21 $534,484.83 $529,192.90 nat. median
$566,531
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 9 $459,651.60 $532,394.63 $527,123.40 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 9 $459,184.39 $531,853.48 $526,587.60 nat. median
$558,082
0.9× median
9413
OTHER 		Lisocabtagene Car Pos T 9 $450,585.16 $521,893.36 $516,726.10 nat. median
$562,201
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 9 $426,805.63 $494,350.56 $489,456.00 nat. median
$532,192
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 9 $401,582.51 $465,135.70 $460,530.40 nat. median
$489,450
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 29 $235,461.70 $1,026,253.41 $454,981.26 nat. median
$370,174
1.2× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $173,187.15 $569,114.14 $323,255.16 nat. median
$265,286
1.2× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 $136,258.04 $593,876.96 $245,799.82 nat. median
$202,976
1.2× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 $146,105.99 $734,221.59 $238,079.97 nat. median
$206,474
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 28 $74,160.16 $292,395.99 $172,758.01 nat. median
$108,660
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 28 $68,835.54 $300,017.85 $159,709.92 nat. median
$102,358
1.6× median
1907
OTHER 		New Technology - Level 52 9 $127,060.17 $147,168.31 $145,711.20 nat. median
$153,199
1.0× median
1908
OTHER 		New Technology - Level 52 9 $127,060.17 $147,168.31 $145,711.20 nat. median
$152,962
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 25 $93,947.70 $409,468.50 $144,846.45 nat. median
$133,161
1.1× median
7
MS_DRG 		Lung Transplant 28 $78,394.56 $246,831.61 $143,490.00 nat. median
$122,708
1.2× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 28 $66,146.85 $230,649.54 $138,549.42 nat. median
$100,136
1.4× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 15 $56,633.21 $246,834.30 $132,339.02 nat. median
$87,428
1.5× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 28 $73,246.61 $260,108.64 $132,224.83 nat. median
$117,357
1.1× median
1906
OTHER 		New Technology - Level 51 9 $114,562.49 $132,692.79 $131,379.00 nat. median
$138,020
1.0× median
1905
OTHER 		New Technology - Level 51 9 $114,562.49 $132,692.79 $131,379.00 nat. median
$137,903
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 29 $65,282.79 $284,533.25 $128,274.00 nat. median
$99,019
1.3× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 $92,321.98 $150,596.13 $122,441.20 nat. median
$62,507
2.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 $62,026.57 $270,341.13 $121,967.46 nat. median
$93,672
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 29 $54,019.29 $235,441.60 $121,477.89 nat. median
$77,570
1.6× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 28 $44,965.80 $195,982.21 $120,474.01 nat. median
$68,886
1.7× median
1903
OTHER 		New Technology - Level 50 9 $102,064.81 $118,217.27 $117,046.80 nat. median
$119,935
1.0× median
1904
OTHER 		New Technology - Level 50 9 $102,064.81 $118,217.27 $117,046.80 nat. median
$120,174
1.0× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 9 $58,932.85 $170,171.43 $116,992.85 nat. median
$63,570
1.8× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 29 $46,222.91 $201,461.29 $110,431.65 nat. median
$72,135
1.5× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 9 $54,565.57 $150,830.71 $108,322.98 nat. median
$54,196
2.0× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 28 $39,689.39 $172,985.12 $106,337.26 nat. median
$59,099
1.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 29 $51,864.24 $226,048.90 $105,889.47 nat. median
$79,312
1.3× median
1902
OTHER 		New Technology - Level 49 9 $89,567.13 $103,741.75 $102,714.60 nat. median
$105,172
1.0× median
1901
OTHER 		New Technology - Level 49 9 $89,567.13 $103,741.75 $102,714.60 nat. median
$105,693
1.0× median
Q0480
HCPCS 		Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 10 $87,199.91 $100,999.90 $99,999.90 nat. median
$111,989
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 $53,872.30 $185,192.91 $99,316.00 nat. median
$81,118
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 $49,282.28 $214,795.48 $97,891.78 nat. median
$74,915
1.3× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 9 $49,267.73 $136,382.27 $97,805.75 nat. median
$49,935
2.0× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 28 $44,944.84 $192,748.24 $97,614.67 nat. median
$64,023
1.5× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 15 $42,387.03 $184,742.72 $97,407.21 nat. median
$65,393
1.5× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 29 $49,847.24 $217,257.86 $96,248.02 nat. median
$73,807
1.3× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 29 $38,922.47 $169,642.52 $94,522.26 nat. median
$64,732
1.5× median
Q2043
HCPCS 		Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 $60,483.01 $122,043.61 $91,267.39 nat. median
$66,682
1.4× median

Other procedures at this hospital

Browse this hospital's 21,067 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
             
9138 OTHER Inj, Hemgenix, Per Tx Dos 12 9 — — $3,202,768.80 $3,709,629.00 $3,672,900.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 12 9 — — $3,143,560.00 $3,641,050.00 $3,605,000.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 12 9 — — $2,899,796.76 $3,358,709.55 $3,325,455.00 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 12 9 — — $2,865,392.00 $3,318,860.00 $3,286,000.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 12 9 — — $2,588,096.00 $2,997,680.00 $2,968,000.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 12 9 — — $2,082,871.41 $2,412,500.14 $2,388,614.00 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 12 9 — — $461,456.21 $534,484.83 $529,192.90 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 12 9 — — $459,651.60 $532,394.63 $527,123.40 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 12 9 — — $459,184.39 $531,853.48 $526,587.60 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 12 9 — — $450,585.16 $521,893.36 $516,726.10 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 12 9 — — $426,805.63 $494,350.56 $489,456.00 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 12 9 — — $401,582.51 $465,135.70 $460,530.40 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 49 29 — — $235,461.70 $1,026,253.41 $454,981.26 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 46 28 — — $173,187.15 $569,114.14 $323,255.16 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 49 29 — — $136,258.04 $593,876.96 $245,799.82 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 36 23 — — $146,105.99 $734,221.59 $238,079.97 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 46 28 — — $74,160.16 $292,395.99 $172,758.01 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 45 28 — — $68,835.54 $300,017.85 $159,709.92 2024-10-01
1907 OTHER New Technology - Level 52 12 9 — — $127,060.17 $147,168.31 $145,711.20 2024-10-01
1908 OTHER New Technology - Level 52 12 9 — — $127,060.17 $147,168.31 $145,711.20 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 25 — — $93,947.70 $409,468.50 $144,846.45 2024-10-01
7 MS_DRG Lung Transplant 45 28 — — $78,394.56 $246,831.61 $143,490.00 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 45 28 — — $66,146.85 $230,649.54 $138,549.42 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 32 15 — — $56,633.21 $246,834.30 $132,339.02 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 45 28 — — $73,246.61 $260,108.64 $132,224.83 2024-10-01
1906 OTHER New Technology - Level 51 12 9 — — $114,562.49 $132,692.79 $131,379.00 2024-10-01
1905 OTHER New Technology - Level 51 12 9 — — $114,562.49 $132,692.79 $131,379.00 2024-10-01
215 MS_DRG Other Heart Assist System Implant 49 29 — — $65,282.79 $284,533.25 $128,274.00 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 7 1 — — $92,321.98 $150,596.13 $122,441.20 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 29 — — $62,026.57 $270,341.13 $121,967.46 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 49 29 — — $54,019.29 $235,441.60 $121,477.89 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 45 28 — — $44,965.80 $195,982.21 $120,474.01 2024-10-01
1904 OTHER New Technology - Level 50 12 9 — — $102,064.81 $118,217.27 $117,046.80 2024-10-01
1903 OTHER New Technology - Level 50 12 9 — — $102,064.81 $118,217.27 $117,046.80 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 20 9 — — $58,932.85 $170,171.43 $116,992.85 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 49 29 — — $46,222.91 $201,461.29 $110,431.65 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 20 9 — — $54,565.57 $150,830.71 $108,322.98 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 45 28 — — $39,689.39 $172,985.12 $106,337.26 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 49 29 — — $51,864.24 $226,048.90 $105,889.47 2024-10-01
1902 OTHER New Technology - Level 49 12 9 — — $89,567.13 $103,741.75 $102,714.60 2024-10-01
1901 OTHER New Technology - Level 49 12 9 — — $89,567.13 $103,741.75 $102,714.60 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 19 10 — — $87,199.91 $100,999.90 $99,999.90 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 29 — — $53,872.30 $185,192.91 $99,316.00 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 29 — — $49,282.28 $214,795.48 $97,891.78 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 20 9 — — $49,267.73 $136,382.27 $97,805.75 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 48 28 — — $44,944.84 $192,748.24 $97,614.67 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 32 15 — — $42,387.03 $184,742.72 $97,407.21 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 49 29 — — $49,847.24 $217,257.86 $96,248.02 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 49 29 — — $38,922.47 $169,642.52 $94,522.26 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 10 2 — — $60,483.01 $122,043.61 $91,267.39 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 12 9 — — $79,379.82 $91,942.22 $91,031.90 2024-10-01
1599 OTHER New Technology - Level 48 12 9 — — $79,152.38 $91,678.79 $90,771.08 2024-10-01
1585 OTHER New Technology - Level 48 12 9 — — $79,152.38 $91,678.79 $90,771.08 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 32 15 — — $33,877.00 $170,369.54 $89,633.48 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 49 29 — — $37,197.51 $171,068.70 $88,264.20 2024-10-01
0424T CPT Insertion Or Replacement Of Neurostimulator System For Treatment Of Central Slee… 11 2 — — $5,528.00 $126,501.15 $86,350.79 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 49 29 — — $51,086.46 $222,658.94 $85,735.19 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 49 29 — — $39,918.83 $173,985.12 $85,624.94 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 49 29 — — $42,558.46 $191,436.27 $85,191.00 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 49 29 — — $43,808.39 $190,937.67 $84,597.13 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 49 29 — — $44,512.68 $194,007.29 $83,080.00 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 45 28 — — $30,564.32 $133,213.75 $81,889.04 2024-10-01
1584 OTHER New Technology - Level 47 12 9 — — $70,820.60 $82,028.44 $81,216.28 2024-10-01
1598 OTHER New Technology - Level 47 12 9 — — $70,820.60 $82,028.44 $81,216.28 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 49 29 — — $16,243.00 $155,960.15 $80,468.83 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 20 9 — — $40,168.33 $122,417.14 $79,741.74 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 29 — — $40,680.63 $177,305.43 $78,768.04 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 49 29 — — $43,526.20 $192,422.34 $78,330.70 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 20 9 — — $38,929.12 $115,195.98 $77,281.65 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 20 9 — — $38,644.33 $106,639.08 $76,716.29 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 49 29 — — $41,298.64 $189,929.32 $75,784.03 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 29 — — $38,622.21 $132,825.73 $75,078.56 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 29 — — $36,407.61 $158,681.58 $74,221.89 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 49 29 — — $37,582.91 $163,804.11 $74,158.71 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 45 28 — — $39,477.21 $140,409.88 $73,901.12 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 13 — — $1,751.00 $113,368.99 $73,477.99 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 49 29 — — $38,017.50 $165,698.25 $72,332.72 2024-10-01
1597 OTHER New Technology - Level 46 12 9 — — $62,488.81 $72,378.09 $71,661.48 2024-10-01
1583 OTHER New Technology - Level 46 12 9 — — $62,488.81 $72,378.09 $71,661.48 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 49 29 — — $38,512.81 $167,857.02 $70,744.84 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 45 28 — — $28,506.42 $124,244.44 $70,289.72 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 49 29 — — $35,183.73 $153,347.35 $69,706.10 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 49 29 — — $30,958.00 $134,929.62 $69,240.80 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 49 29 — — $38,644.46 $168,430.83 $69,148.46 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 32 15 — — $28,534.00 $128,288.99 $69,005.84 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 49 29 — — $36,229.30 $157,904.42 $68,907.91 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 49 29 — — $31,189.36 $135,937.97 $68,010.10 2024-10-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 45 28 — — $26,458.74 $115,319.70 $67,360.85 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 49 29 — — $33,219.78 $144,787.50 $67,340.00 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 49 29 — — $39,739.88 $173,205.18 $67,294.53 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 49 29 — — $34,598.32 $150,795.83 $66,323.82 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 45 28 — — $33,627.52 $114,529.13 $66,009.16 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 12 9 — — $57,440.12 $66,530.42 $65,871.70 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 29 — — $33,518.24 $146,088.33 $65,668.99 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 12 9 — — $57,095.58 $66,131.35 $65,476.58 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 49 29 — — $36,196.71 $157,762.36 $65,243.77 2024-10-01
245 MS_DRG Aicd Generator Procedures 49 29 — — $28,960.18 $126,222.15 $65,125.28 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 49 29 — — $33,147.56 $144,472.74 $64,944.91 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 49 29 — — $32,202.33 $140,352.99 $64,757.81 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 17 13 — — $1,751.00 $99,629.42 $64,572.95 2024-10-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 49 29 — — $25,850.32 $112,667.90 $64,517.63 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 12 9 — — $55,245.36 $63,988.32 $63,354.77 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 49 29 — — $32,318.65 $140,859.95 $63,016.86 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 49 29 — — $31,664.85 $138,010.38 $62,535.76 2024-10-01
1582 OTHER New Technology - Level 45 12 9 — — $54,157.02 $62,727.75 $62,106.68 2024-10-01
1596 OTHER New Technology - Level 45 12 9 — — $54,157.02 $62,727.75 $62,106.68 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 49 29 — — $36,306.50 $158,302.75 $61,518.89 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 49 29 — — $29,575.63 $128,904.58 $61,285.63 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 49 29 — — $32,953.91 $143,628.74 $61,017.57 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 49 29 — — $31,437.33 $137,018.74 $60,984.34 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 49 29 — — $28,957.62 $97,905.00 $60,837.33 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 49 29 — — $30,124.62 $131,297.33 $60,827.61 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 45 26 — — $6,248.00 $141,475.54 $60,468.84 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 49 29 — — $31,950.53 $139,255.50 $60,353.80 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 49 29 — — $28,866.87 $125,815.46 $59,362.44 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 45 28 — — $33,636.66 $94,841.53 $58,991.90 2024-10-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 49 29 — — $24,785.58 $108,027.26 $58,850.97 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 49 29 — — $30,720.26 $133,893.41 $58,509.58 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 17 13 — — $1,751.00 $90,205.44 $58,464.97 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 45 28 — — $30,912.63 $99,352.66 $57,056.56 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 3 1 — — $50,463.32 $65,181.79 $56,771.24 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 49 29 — — $28,301.90 $123,353.08 $56,661.72 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 49 29 — — $28,222.66 $123,007.68 $56,532.00 2024-10-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 49 29 — — $23,758.82 $109,266.81 $56,377.04 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 49 29 — — $30,295.90 $132,043.84 $56,061.56 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 29 — — $29,709.20 $129,486.75 $55,895.08 2024-10-01
10 MS_DRG Pancreas Transplant 45 28 — — $30,763.72 $86,231.64 $55,889.43 2024-10-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 45 28 — — $20,455.03 $89,152.71 $55,144.01 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 12 9 — — $47,973.28 $55,565.38 $55,015.23 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 49 29 — — $28,743.52 $125,277.86 $54,921.98 2024-10-01
0266T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Total… 7 1 — — $41,395.46 $67,524.50 $54,900.36 2024-10-01
0268T CPT Implantation Or Replacement Of Carotid Sinus Baroreflex Activation Device; Pulse… 7 1 — — $41,395.46 $67,524.50 $54,900.36 2024-10-01
131 MS_DRG Cranial/facial Procedures W Cc/mcc 1 1 — — $54,842.89 $54,842.89 $54,842.89 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 49 29 — — $28,771.64 $125,400.42 $54,692.37 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 32 15 — — $23,377.64 $101,890.80 $54,530.67 2024-10-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 49 29 — — $26,309.19 $114,667.89 $53,111.78 2024-10-01
1595 OTHER New Technology - Level 44 12 9 — — $45,825.24 $53,077.40 $52,551.88 2024-10-01
1581 OTHER New Technology - Level 44 12 9 — — $45,825.24 $53,077.40 $52,551.88 2024-10-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 45 28 — — $19,652.33 $85,654.13 $52,528.07 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 49 29 — — $27,876.90 $121,500.72 $52,458.17 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 49 29 — — $26,577.61 $115,837.80 $52,424.15 2024-10-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 49 29 — — $27,345.17 $119,183.19 $52,335.46 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 49 29 — — $27,658.97 $120,550.87 $51,961.51 2024-10-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 49 29 — — $24,843.10 $108,277.96 $51,763.24 2024-10-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 49 29 — — $24,994.56 $108,938.12 $50,854.50 2024-10-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 45 28 — — $18,972.32 $82,690.35 $50,831.33 2024-10-01
332 MS_DRG Rectal Resection With Mcc 49 29 — — $23,342.25 $101,790.53 $50,558.06 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 11 2 — — $6,465.00 $73,775.56 $50,359.84 2024-10-01
0408T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 11 2 — — $9,242.00 $73,775.56 $50,359.84 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 49 29 — — $25,827.31 $112,567.63 $49,929.00 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 13 — — $1,751.00 $76,779.54 $49,763.22 2024-10-01
5244 OTHER Level 4 Blood Product Exc 12 9 — — $43,380.41 $50,245.66 $49,748.18 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 49 29 — — $27,499.19 $119,854.49 $49,520.54 2024-10-01
93613 CPT Intracardiac Electrophysiologic 3-dimensional Mapping (List Separately In Additi… 6 3 — — $8,300.00 $71,218.00 $49,510.50 2024-10-01
93609 CPT Intraventricular And/or Intra-atrial Mapping Of Tachycardia Site(s) With Cathete… 6 3 — — $8,300.00 $71,218.00 $49,510.50 2024-10-01
93621 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 6 3 — — $8,300.00 $71,218.00 $49,510.50 2024-10-01
93622 CPT Comprehensive Electrophysiologic Evaluation Including Insertion And Repositionin… 6 3 — — $8,300.00 $71,218.00 $49,510.50 2024-10-01
93623 CPT Programmed Stimulation And Pacing After Intravenous Drug Infusion (List Separate… 6 3 — — $8,300.00 $71,218.00 $49,510.50 2024-10-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 45 28 — — $18,372.21 $80,074.77 $49,223.49 2024-10-01
140 MS_DRG Major Head And Neck Procedures With Mcc 49 29 — — $24,145.84 $105,238.98 $48,855.00 2024-10-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 49 29 — — $24,933.85 $108,673.50 $48,329.94 2024-10-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 49 29 — — $25,293.66 $110,241.73 $48,185.36 2024-10-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 49 29 — — $24,905.73 $108,550.93 $48,088.24 2024-10-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 49 29 — — $23,771.32 $103,606.67 $47,966.68 2024-10-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 49 29 — — $24,214.22 $105,537.02 $47,854.91 2024-10-01
33264 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 22 9 — — $1,348.00 $73,775.56 $47,793.74 2024-10-01
33270 CPT Insertion Or Replacement Of Permanent Subcutaneous Implantable Defibrillator Sys… 22 9 — — $1,348.00 $73,775.56 $47,793.74 2024-10-01
33249 CPT Insertion Or Replacement Of Permanent Implantable Defibrillator System, With Tra… 22 9 — — $1,568.00 $73,775.56 $47,793.74 2024-10-01
33231 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Multi… 22 9 — — $1,568.00 $73,775.56 $47,793.74 2024-10-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 49 29 — — $22,847.83 $99,581.63 $47,545.11 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 17 13 — — $1,751.00 $72,512.63 $46,997.70 2024-10-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 49 29 — — $24,608.55 $107,255.68 $46,953.46 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 19 10 — — $41,642.36 $48,232.55 $46,799.90 2024-10-01
129 MS_DRG Major Head & Neck Procedures W Cc/mcc Or Major Device 1 1 — — $46,685.69 $46,685.69 $46,685.69 2024-10-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 49 29 — — $25,595.32 $111,556.49 $46,564.69 2024-10-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 49 29 — — $23,111.77 $100,732.04 $46,457.78 2024-10-01
0431T CPT Removal And Replacement Of Neurostimulator System For Treatment Of Central Sleep… 11 2 — — $5,528.00 $67,524.50 $46,092.81 2024-10-01
0427T CPT Insertion Or Replacement Of Neurostimulator System For Treatment Of Central Slee… 11 2 — — $2,265.00 $67,524.50 $46,092.81 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 20 9 — — $23,166.43 $63,146.92 $45,989.74 2024-10-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 48 28 — — $21,402.05 $89,567.75 $45,838.21 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 20 9 — — $23,055.59 $64,702.91 $45,769.71 2024-10-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 49 29 — — $23,243.43 $101,305.85 $45,703.00 2024-10-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 49 29 — — $23,561.64 $103,681.88 $45,593.98 2024-10-01
1142 OTHER Supprelin La Implant 12 9 — — $39,545.38 $45,803.71 $45,350.21 2024-10-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 49 29 — — $22,081.54 $96,241.81 $45,286.61 2024-10-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 49 29 — — $20,810.37 $90,701.45 $45,279.32 2024-10-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 45 28 — — $16,899.72 $73,656.98 $45,278.35 2024-10-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 49 29 — — $25,916.38 $113,030.02 $45,236.80 2024-10-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 49 29 — — $21,926.24 $95,564.93 $45,093.44 2024-10-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 49 29 — — $22,102.63 $96,333.73 $44,931.86 2024-10-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 49 29 — — $25,656.67 $111,823.90 $44,701.03 2024-10-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 48 28 — — $23,345.00 $84,456.36 $44,496.65 2024-10-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 10 2 — — $29,186.56 $59,253.66 $44,311.43 2024-10-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 49 29 — — $22,887.45 $99,754.33 $44,245.44 2024-10-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 49 29 — — $23,152.68 $100,910.31 $44,196.85 2024-10-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 49 29 — — $22,529.55 $98,194.45 $44,080.22 2024-10-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 49 29 — — $24,449.41 $106,562.09 $43,917.42 2024-10-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 49 29 — — $18,351.00 $101,720.89 $43,817.00 2024-10-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 1 1 — — $43,781.73 $43,781.73 $43,781.73 2024-10-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 49 29 — — $18,415.37 $84,690.34 $43,696.63 2024-10-01
93654 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 19 8 — — $3,280.00 $63,349.00 $43,550.00 2024-10-01
93653 CPT Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of … 19 8 — — $3,280.00 $63,349.00 $43,550.00 2024-10-01
93656 CPT Comprehensive Electrophysiologic Evaluation With Transseptal Catheterizations, I… 19 8 — — $3,280.00 $63,349.00 $43,550.00 2024-10-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 49 29 — — $20,155.94 $87,849.10 $43,500.00 2024-10-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 49 29 — — $22,280.94 $97,110.89 $43,463.05 2024-10-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 49 29 — — $23,633.92 $103,007.79 $43,379.07 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 17 13 — — $1,751.00 $66,907.78 $43,365.02 2024-10-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 49 29 — — $21,187.44 $92,344.90 $43,339.13 2024-10-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 49 29 — — $22,088.57 $96,272.45 $43,316.04 2024-10-01
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 11 2 — — $9,242.00 $63,251.15 $43,175.79 2024-10-01
1594 OTHER New Technology - Level 43 12 9 — — $37,493.45 $43,427.05 $42,997.08 2024-10-01
1580 OTHER New Technology - Level 43 12 9 — — $37,493.45 $43,427.05 $42,997.08 2024-10-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 49 29 — — $17,474.91 $76,163.93 $42,901.40 2024-10-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 49 29 — — $20,456.31 $89,158.28 $42,721.96 2024-10-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 49 29 — — $22,126.28 $96,436.80 $42,157.03 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 7 1 — — $31,710.93 $51,727.05 $42,056.34 2024-10-01
570 MS_DRG Skin Debridement With Mcc 49 29 — — $18,675.78 $81,397.88 $41,997.86 2024-10-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 49 29 — — $20,320.82 $88,567.76 $41,807.14 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 34 15 — — $2,975.00 $99,103.65 $41,675.57 2024-10-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 49 29 — — $21,051.95 $91,754.37 $41,423.23 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 19 10 — — $36,492.76 $42,268.00 $41,012.51 2024-10-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 49 29 — — $20,548.98 $89,562.18 $40,998.02 2024-10-01
265 MS_DRG Aicd Lead Procedures 49 29 — — $22,586.43 $98,442.36 $40,887.46 2024-10-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 49 29 — — $21,531.28 $93,843.50 $40,807.28 2024-10-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 20 9 — — $20,447.08 $59,345.67 $40,591.32 2024-10-01
252 MS_DRG Other Vascular Procedures With Mcc 49 29 — — $21,434.14 $93,420.10 $40,403.93 2024-10-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 49 29 — — $21,909.63 $95,492.51 $40,052.82 2024-10-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 49 29 — — $20,711.95 $90,272.48 $39,928.90 2024-10-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 49 29 — — $20,052.40 $87,397.85 $39,909.47 2024-10-01
37 MS_DRG Extracranial Procedures With Mcc 49 29 — — $21,573.46 $94,027.34 $39,845.23 2024-10-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 49 29 — — $21,580.49 $94,057.98 $39,798.91 2024-10-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 49 29 — — $16,184.57 $70,540.00 $39,737.79 2024-10-01
264 MS_DRG Other Circulatory System O.r. Procedures 49 29 — — $20,873.01 $90,974.43 $39,527.99 2024-10-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 49 29 — — $21,766.47 $94,868.56 $39,441.73 2024-10-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 49 29 — — $19,973.15 $87,052.45 $39,125.85 2024-10-01
500 MS_DRG Soft Tissue Procedures With Mcc 49 29 — — $20,724.73 $90,328.19 $38,749.24 2024-10-01
652 MS_DRG Kidney Transplant 45 28 — — $19,201.12 $69,028.27 $38,695.78 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 13 — — $1,751.00 $59,544.24 $38,592.49 2024-10-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 49 29 — — $17,310.66 $75,448.05 $38,489.25 2024-10-01
397 MS_DRG Appendix Procedures With Mcc 45 28 — — $14,358.02 $62,579.04 $38,468.53 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 17 13 — — $1,751.00 $59,164.60 $38,346.43 2024-10-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 49 29 — — $21,360.00 $93,096.98 $38,207.39 2024-10-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 49 29 — — $21,280.75 $92,751.58 $38,171.91 2024-10-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 49 29 — — $18,190.70 $79,283.69 $38,164.87 2024-10-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 49 29 — — $20,205.15 $88,063.58 $38,155.15 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 19 10 — — $33,621.70 $38,942.57 $37,785.86 2024-10-01
22633 CPT Arthrodesis, Combined Posterior Or Posterolateral Technique With Posterior Inter… 16 5 — — $4,000.00 $54,927.00 $37,663.93 2024-10-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 27 19 — — $23,848.02 $64,629.19 $37,570.00 2024-10-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 49 29 — — $21,253.91 $92,634.59 $37,478.46 2024-10-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 49 29 — — $19,135.93 $83,403.44 $37,251.26 2024-10-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 49 29 — — $18,873.26 $82,258.60 $37,200.24 2024-10-01
665 MS_DRG Prostatectomy With Mcc 49 29 — — $19,742.44 $86,046.88 $37,135.65 2024-10-01
472 MS_DRG Cervical Spinal Fusion With Cc 49 29 — — $18,887.96 $82,322.67 $37,099.40 2024-10-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 49 29 — — $17,060.67 $78,461.96 $36,788.00 2024-10-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 49 29 — — $18,846.42 $82,141.61 $36,760.44 2024-10-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 49 29 — — $18,689.20 $81,456.38 $36,749.51 2024-10-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 49 29 — — $17,764.42 $77,425.76 $36,309.72 2024-10-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 49 29 — — $19,181.95 $83,604.00 $36,154.21 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 17 13 — — $1,751.00 $55,699.16 $36,100.37 2024-10-01
662 MS_DRG Minor Bladder Procedures With Mcc 49 29 — — $19,151.91 $83,473.08 $35,896.59 2024-10-01
800 MS_DRG Splenic Procedures With Cc 49 29 — — $18,007.92 $78,487.03 $35,886.93 2024-10-01
0409T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 11 2 — — $6,465.00 $52,482.14 $35,824.76 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 11 2 — — $5,528.00 $52,482.14 $35,824.76 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 11 2 — — $6,578.00 $52,482.14 $35,824.76 2024-10-01
0414T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation System Pul… 11 2 — — $6,465.00 $52,482.14 $35,824.76 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 11 2 — — $5,528.00 $52,482.14 $35,824.76 2024-10-01
22630 CPT Arthrodesis, Posterior Interbody Technique, Including Laminectomy And/or Discect… 16 5 — — $4,000.00 $50,364.55 $35,498.14 2024-10-01
654 MS_DRG Major Bladder Procedures With Cc 49 29 — — $17,495.36 $76,253.06 $35,266.12 2024-10-01
93657 CPT Additional Linear Or Focal Intracardiac Catheter Ablation Of The Left Or Right A… 12 7 — — $960.00 $63,349.00 $35,191.00 2024-10-01
93655 CPT Intracardiac Catheter Ablation Of A Discrete Mechanism Of Arrhythmia Which Is Di… 12 7 — — $960.00 $63,349.00 $35,191.00 2024-10-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 49 29 — — $17,912.69 $78,071.99 $35,125.19 2024-10-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 49 29 — — $18,453.37 $80,428.53 $35,000.05 2024-10-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 20 9 — — $17,387.52 $52,167.33 $34,517.52 2024-10-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 49 29 — — $18,669.39 $81,370.03 $34,505.59 2024-10-01
0775T CPT Arthrodesis, Sacroiliac Joint, Percutaneous, With Image Guidance, Includes Place… 11 2 — — $5,554.00 $50,364.55 $34,379.28 2024-10-01
0809T CPT Arthrodesis, Sacroiliac Joint, Percutaneous Or Minimally Invasive, With Image Gu… 11 2 — — $6,578.00 $50,364.55 $34,379.28 2024-10-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 49 29 — — $17,513.90 $76,333.84 $34,240.74 2024-10-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 49 29 — — $16,111.00 $72,492.64 $34,159.95 2024-10-01
668 MS_DRG Transurethral Procedures With Mcc 49 29 — — $18,009.84 $78,495.39 $34,093.74 2024-10-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 49 29 — — $17,061.41 $74,361.71 $34,046.36 2024-10-01
33263 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 22 9 — — $1,348.00 $64,906.00 $33,999.29 2024-10-01
33262 CPT Removal Of Implantable Defibrillator Pulse Generator With Replacement Of Implant… 22 9 — — $1,348.00 $64,906.00 $33,999.29 2024-10-01
33230 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual … 22 9 — — $1,568.00 $64,906.00 $33,999.29 2024-10-01
33240 CPT Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Singl… 22 9 — — $1,568.00 $64,906.00 $33,999.29 2024-10-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 49 29 — — $17,387.35 $75,782.31 $33,947.00 2024-10-01
974 MS_DRG HIV With Major Related Condition With Mcc 49 29 — — $18,639.35 $81,239.11 $33,939.85 2024-10-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 49 29 — — $17,953.60 $78,250.27 $33,881.13 2024-10-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 45 28 — — $11,653.35 $50,790.81 $33,848.68 2024-10-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 12 9 — — $29,195.34 $33,815.71 $33,480.90 2024-10-01
1579 OTHER New Technology - Level 42 12 9 — — $29,161.67 $33,776.70 $33,442.28 2024-10-01
1593 OTHER New Technology - Level 42 12 9 — — $29,161.67 $33,776.70 $33,442.28 2024-10-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 49 29 — — $17,164.31 $74,810.17 $33,245.00 2024-10-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 49 29 — — $16,087.43 $70,116.61 $32,969.96 2024-10-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 7 1 — — $24,829.76 $40,502.45 $32,930.25 2024-10-01
263 MS_DRG Vein Ligation And Stripping 49 29 — — $18,048.60 $78,695.95 $32,910.73 2024-10-01
C9782 HCPCS Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa… 7 1 — — $24,675.70 $40,251.15 $32,725.94 2024-10-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 49 29 — — $15,590.84 $67,952.27 $32,660.16 2024-10-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 49 29 — — $16,571.86 $72,228.01 $32,624.92 2024-10-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 49 29 — — $15,619.60 $68,077.62 $32,473.06 2024-10-01
132 MS_DRG Cranial/facial Procedures Without Cc/mcc 1 1 — — $32,414.67 $32,414.67 $32,414.67 2024-10-01
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