Price Transparency 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

Western Peaks Specialty Hospital

Bountiful, UT · CCN 462003 · Rates published

859 distinct procedures filed
17 distinct payers
7,677 rate rows
2024-06-28 last MRF observed · ⚠ 24 mo old
Data quality

7,445 of 7,677 rate rows are consumer-grade (97.0%)

232 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 195
per-diem day rate — not a per-procedure price 36
placeholder amount (≤ $0.02) — excluded from medians 1

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 24 months old.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://images.pricetransparency.healthcare/western-peaks-specialty-hospital/87-0257692_southdaviscommunityhospital_standardcharges.csv
Found on page https://pricetransparency.healthcare/western-peaks-specialty-hospital/charges/
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 18af2d4595aeb540… · 3,745,206 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
164
MS_DRG 		Ms-ltc-DRG 164: Major Chest Procedures With Cc 10 $106,499.06 $118,332.29 $118,332.29 nat. median
$25,707
outlier · 4.6×
163
MS_DRG 		Ms-ltc-DRG 163: Major Chest Procedures With Mcc 10 $106,499.06 $118,332.29 $118,332.29 nat. median
$44,938
outlier · 2.6×
165
MS_DRG 		Ms-ltc-DRG 165: Major Chest Procedures Without Cc/mcc 10 $106,499.06 $118,332.29 $118,332.29 nat. median
$19,862
outlier · 6.0×
981
MS_DRG 		Ms-ltc-DRG 981: Extensive O.r. Procedures Unrelated To Principal Diagnosis With… 10 $99,655.65 $110,728.50 $110,728.50 nat. median
$46,084
outlier · 2.4×
987
MS_DRG 		Ms-ltc-DRG 987: Non-extensive O.r. Procedures Unrelated To Principal Diagnosis W… 10 $95,811.76 $106,457.51 $106,457.51 nat. median
$33,847
outlier · 3.1×
140
MS_DRG 		Ms-ltc-DRG 140: Major Head And Neck Procedures With Mcc 10 $93,278.66 $103,642.95 $103,642.95 nat. median
$40,208
outlier · 2.6×
166
MS_DRG 		Ms-ltc-DRG 166: Other Respiratory System O.r. Procedures With Mcc 10 $93,278.66 $103,642.95 $103,642.95 nat. median
$37,476
outlier · 2.8×
870
MS_DRG 		Ms-ltc-DRG 870: Septicemia Or Severe Sepsis With Mv >96 Hours 10 $82,064.63 $91,182.92 $91,182.92 nat. median
$66,526
1.4× median
207
MS_DRG 		Ms-ltc-DRG 207: Respiratory System Diagnosis With Ventilator Support >96 Hours 10 $77,625.66 $86,250.73 $86,250.73 nat. median
$62,134
1.4× median
853
MS_DRG 		Ms-ltc-DRG 853: Infectious And Parasitic Diseases With O.r. Procedures With Mcc 10 $68,108.42 $75,676.02 $75,676.02 nat. median
$48,170
1.6× median
574
MS_DRG 		Ms-ltc-DRG 574: Skin Graft For Skin Ulcer Or Cellulitis With Cc* 10 $62,459.18 $69,399.09 $69,399.09 nat. median
$33,675
outlier · 2.1×
573
MS_DRG 		Ms-ltc-DRG 573: Skin Graft For Skin Ulcer Or Cellulitis With Mcc* 10 $62,459.18 $69,399.09 $69,399.09 nat. median
$59,793
1.2× median
483
MS_DRG 		Ms-ltc-DRG 483: Major Joint Or Limb Reattachment Procedures Of Upper Extremities 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$26,699
outlier · 2.6×
405
MS_DRG 		Ms-ltc-DRG 405: Pancreas, Liver And Shunt Procedures With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$52,836
1.3× median
488
MS_DRG 		Ms-ltc-DRG 488: Knee Procedures Without Principal Diagnosis Of Infection With Cc… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$19,302
outlier · 3.6×
435
MS_DRG 		Ms-ltc-DRG 435: Malignancy Of Hepatobiliary System Or Pancreas With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$18,499
outlier · 3.8×
306
MS_DRG 		Ms-ltc-DRG 306: Cardiac Congenital And Valvular Disorders With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$15,866
outlier · 4.4×
482
MS_DRG 		Ms-ltc-DRG 482: Hip And Femur Procedures Except Major Joint Without Cc/mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$17,028
outlier · 4.1×
489
MS_DRG 		Ms-ltc-DRG 489: Knee Procedures Without Principal Diagnosis Of Infection Without… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$12,955
outlier · 5.4×
344
MS_DRG 		Ms-ltc-DRG 344: Minor Small And Large Bowel Procedures With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$25,892
outlier · 2.7×
330
MS_DRG 		Ms-ltc-DRG 330: Major Small And Large Bowel Procedures With Cc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$24,346
outlier · 2.8×
469
MS_DRG 		Ms-ltc-DRG 469: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Ex… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$31,075
outlier · 2.2×
275
MS_DRG 		Ms-ltc-DRG 275: Cardiac Defibrillator Implant With Cardiac Catheterization And M… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$68,887
1.0× median
272
MS_DRG 		Ms-ltc-DRG 272: Other Major Cardiovascular Procedures Without Cc/mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$26,293
outlier · 2.6×
277
MS_DRG 		Ms-ltc-DRG 277: Cardiac Defibrillator Implant Without Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$46,109
1.5× median
276
MS_DRG 		Ms-ltc-DRG 276: Cardiac Defibrillator Implant With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$59,099
1.2× median
259
MS_DRG 		Ms-ltc-DRG 259: Cardiac Pacemaker Device Replacement Without Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$20,037
outlier · 3.5×
287
MS_DRG 		Ms-ltc-DRG 287: Circulatory Disorders Except Ami, With Cardiac Catheterization W… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$12,026
outlier · 5.8×
286
MS_DRG 		Ms-ltc-DRG 286: Circulatory Disorders Except Ami, With Cardiac Catheterization W… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$22,019
outlier · 3.2×
307
MS_DRG 		Ms-ltc-DRG 307: Cardiac Congenital And Valvular Disorders Without Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$10,131
outlier · 6.8×
456
MS_DRG 		Ms-ltc-DRG 456: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy,… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$81,118
0.9× median
470
MS_DRG 		Ms-ltc-DRG 470: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Ex… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$20,059
outlier · 3.5×
480
MS_DRG 		Ms-ltc-DRG 480: Hip And Femur Procedures Except Major Joint With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$29,218
outlier · 2.4×
252
MS_DRG 		Ms-ltc-DRG 252: Other Vascular Procedures With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$34,043
outlier · 2.0×
244
MS_DRG 		Ms-ltc-DRG 244: Permanent Cardiac Pacemaker Implant Without Cc/mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$19,105
outlier · 3.6×
243
MS_DRG 		Ms-ltc-DRG 243: Permanent Cardiac Pacemaker Implant With Cc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$22,669
outlier · 3.1×
253
MS_DRG 		Ms-ltc-DRG 253: Other Vascular Procedures With Cc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$26,081
outlier · 2.7×
254
MS_DRG 		Ms-ltc-DRG 254: Other Vascular Procedures Without Cc/mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$18,438
outlier · 3.8×
231
MS_DRG 		Ms-ltc-DRG 231: Coronary Bypass With Ptca With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$79,312
0.9× median
268
MS_DRG 		Ms-ltc-DRG 268: Aortic And Heart Assist Procedures Except Pulsation Balloon With… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$65,950
1.1× median
255
MS_DRG 		Ms-ltc-DRG 255: Upper Limb And Toe Amputation For Circulatory System Disorders W… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$26,350
outlier · 2.6×
258
MS_DRG 		Ms-ltc-DRG 258: Cardiac Pacemaker Device Replacement With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$29,995
outlier · 2.3×
265
MS_DRG 		Ms-ltc-DRG 265: Aicd Lead Procedures 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$35,445
2.0× median
329
MS_DRG 		Ms-ltc-DRG 329: Major Small And Large Bowel Procedures With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$44,810
1.5× median
240
MS_DRG 		Ms-ltc-DRG 240: Amputation For Circulatory System Disorders Except Upper Limb An… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$28,136
outlier · 2.5×
241
MS_DRG 		Ms-ltc-DRG 241: Amputation For Circulatory System Disorders Except Upper Limb An… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$15,000
outlier · 4.6×
233
MS_DRG 		Ms-ltc-DRG 233: Coronary Bypass With Cardiac Catheterization Or Open Ablation Wi… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$73,807
0.9× median
270
MS_DRG 		Ms-ltc-DRG 270: Other Major Cardiovascular Procedures With Mcc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$51,307
1.4× median
271
MS_DRG 		Ms-ltc-DRG 271: Other Major Cardiovascular Procedures With Cc 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$35,597
1.9× median
239
MS_DRG 		Ms-ltc-DRG 239: Amputation For Circulatory System Disorders Except Upper Limb An… 10 $62,443.10 $69,381.22 $69,381.22 nat. median
$47,740
1.5× median

Other procedures at this hospital

Browse this hospital's 859 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
             
163 MS_DRG Ms-ltc-DRG 163: Major Chest Procedures With Mcc 10 10 — — $106,499.06 $118,332.29 $118,332.29 2024-06-28
164 MS_DRG Ms-ltc-DRG 164: Major Chest Procedures With Cc 10 10 — — $106,499.06 $118,332.29 $118,332.29 2024-06-28
165 MS_DRG Ms-ltc-DRG 165: Major Chest Procedures Without Cc/mcc 10 10 — — $106,499.06 $118,332.29 $118,332.29 2024-06-28
981 MS_DRG Ms-ltc-DRG 981: Extensive O.r. Procedures Unrelated To Principal Diagnosis With … 10 10 — — $99,655.65 $110,728.50 $110,728.50 2024-06-28
987 MS_DRG Ms-ltc-DRG 987: Non-extensive O.r. Procedures Unrelated To Principal Diagnosis W… 10 10 — — $95,811.76 $106,457.51 $106,457.51 2024-06-28
166 MS_DRG Ms-ltc-DRG 166: Other Respiratory System O.r. Procedures With Mcc 10 10 — — $93,278.66 $103,642.95 $103,642.95 2024-06-28
140 MS_DRG Ms-ltc-DRG 140: Major Head And Neck Procedures With Mcc 10 10 — — $93,278.66 $103,642.95 $103,642.95 2024-06-28
870 MS_DRG Ms-ltc-DRG 870: Septicemia Or Severe Sepsis With Mv >96 Hours 10 10 — — $82,064.63 $91,182.92 $91,182.92 2024-06-28
207 MS_DRG Ms-ltc-DRG 207: Respiratory System Diagnosis With Ventilator Support >96 Hours 10 10 — — $77,625.66 $86,250.73 $86,250.73 2024-06-28
853 MS_DRG Ms-ltc-DRG 853: Infectious And Parasitic Diseases With O.r. Procedures With Mcc 10 10 — — $68,108.42 $75,676.02 $75,676.02 2024-06-28
574 MS_DRG Ms-ltc-DRG 574: Skin Graft For Skin Ulcer Or Cellulitis With Cc* 10 10 — — $62,459.18 $69,399.09 $69,399.09 2024-06-28
573 MS_DRG Ms-ltc-DRG 573: Skin Graft For Skin Ulcer Or Cellulitis With Mcc* 10 10 — — $62,459.18 $69,399.09 $69,399.09 2024-06-28
456 MS_DRG Ms-ltc-DRG 456: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy,… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
743 MS_DRG Ms-ltc-DRG 743: Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
749 MS_DRG Ms-ltc-DRG 749: Other Female Reproductive System O.r. Procedures With Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
659 MS_DRG Ms-ltc-DRG 659: Kidney And Ureter Procedures For Non-neoplasm With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
243 MS_DRG Ms-ltc-DRG 243: Permanent Cardiac Pacemaker Implant With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
344 MS_DRG Ms-ltc-DRG 344: Minor Small And Large Bowel Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
253 MS_DRG Ms-ltc-DRG 253: Other Vascular Procedures With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
503 MS_DRG Ms-ltc-DRG 503: Foot Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
576 MS_DRG Ms-ltc-DRG 576: Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc* 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
504 MS_DRG Ms-ltc-DRG 504: Foot Procedures With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
855 MS_DRG Ms-ltc-DRG 855: Infectious And Parasitic Diseases With O.r. Procedures Without C… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
474 MS_DRG Ms-ltc-DRG 474: Amputation For Musculoskeletal System And Connective Tissue Diso… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
494 MS_DRG Ms-ltc-DRG 494: Lower Extremity And Humerus Procedures Except Hip, Foot And Femu… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
481 MS_DRG Ms-ltc-DRG 481: Hip And Femur Procedures Except Major Joint With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
287 MS_DRG Ms-ltc-DRG 287: Circulatory Disorders Except Ami, With Cardiac Catheterization W… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
275 MS_DRG Ms-ltc-DRG 275: Cardiac Defibrillator Implant With Cardiac Catheterization And M… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
496 MS_DRG Ms-ltc-DRG 496: Local Excision And Removal Of Internal Fixation Devices Except H… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
665 MS_DRG Ms-ltc-DRG 665: Prostatectomy With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
518 MS_DRG Ms-ltc-DRG 518: Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc D… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
307 MS_DRG Ms-ltc-DRG 307: Cardiac Congenital And Valvular Disorders Without Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
254 MS_DRG Ms-ltc-DRG 254: Other Vascular Procedures Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
662 MS_DRG Ms-ltc-DRG 662: Minor Bladder Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
435 MS_DRG Ms-ltc-DRG 435: Malignancy Of Hepatobiliary System Or Pancreas With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
711 MS_DRG Ms-ltc-DRG 711: Testes Procedures With Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
240 MS_DRG Ms-ltc-DRG 240: Amputation For Circulatory System Disorders Except Upper Limb An… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
492 MS_DRG Ms-ltc-DRG 492: Lower Extremity And Humerus Procedures Except Hip, Foot And Femu… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
555 MS_DRG Ms-ltc-DRG 555: Signs And Symptoms Of Musculoskeletal System And Connective Tiss… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
750 MS_DRG Ms-ltc-DRG 750: Other Female Reproductive System O.r. Procedures Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
306 MS_DRG Ms-ltc-DRG 306: Cardiac Congenital And Valvular Disorders With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
475 MS_DRG Ms-ltc-DRG 475: Amputation For Musculoskeletal System And Connective Tissue Diso… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
628 MS_DRG Ms-ltc-DRG 628: Other Endocrine, Nutritional And Metabolic O.r. Procedures With … 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
553 MS_DRG Ms-ltc-DRG 553: Bone Diseases And Arthropathies With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
271 MS_DRG Ms-ltc-DRG 271: Other Major Cardiovascular Procedures With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
616 MS_DRG Ms-ltc-DRG 616: Amputation Of Lower Limb For Endocrine, Nutritional And Metaboli… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
748 MS_DRG Ms-ltc-DRG 748: Female Reproductive System Reconstructive Procedures 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
268 MS_DRG Ms-ltc-DRG 268: Aortic And Heart Assist Procedures Except Pulsation Balloon With… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
653 MS_DRG Ms-ltc-DRG 653: Major Bladder Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
617 MS_DRG Ms-ltc-DRG 617: Amputation Of Lower Limb For Endocrine, Nutritional And Metaboli… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
330 MS_DRG Ms-ltc-DRG 330: Major Small And Large Bowel Procedures With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
505 MS_DRG Ms-ltc-DRG 505: Foot Procedures Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
276 MS_DRG Ms-ltc-DRG 276: Cardiac Defibrillator Implant With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
255 MS_DRG Ms-ltc-DRG 255: Upper Limb And Toe Amputation For Circulatory System Disorders W… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
746 MS_DRG Ms-ltc-DRG 746: Vagina, Cervix And Vulva Procedures With Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
277 MS_DRG Ms-ltc-DRG 277: Cardiac Defibrillator Implant Without Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
577 MS_DRG Ms-ltc-DRG 577: Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
329 MS_DRG Ms-ltc-DRG 329: Major Small And Large Bowel Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
735 MS_DRG Ms-ltc-DRG 735: Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
405 MS_DRG Ms-ltc-DRG 405: Pancreas, Liver And Shunt Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
497 MS_DRG Ms-ltc-DRG 497: Local Excision And Removal Of Internal Fixation Devices Except H… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
235 MS_DRG Ms-ltc-DRG 235: Coronary Bypass Without Cardiac Catheterization With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
272 MS_DRG Ms-ltc-DRG 272: Other Major Cardiovascular Procedures Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
244 MS_DRG Ms-ltc-DRG 244: Permanent Cardiac Pacemaker Implant Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
469 MS_DRG Ms-ltc-DRG 469: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Ex… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
483 MS_DRG Ms-ltc-DRG 483: Major Joint Or Limb Reattachment Procedures Of Upper Extremities 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
736 MS_DRG Ms-ltc-DRG 736: Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy … 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
258 MS_DRG Ms-ltc-DRG 258: Cardiac Pacemaker Device Replacement With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
252 MS_DRG Ms-ltc-DRG 252: Other Vascular Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
242 MS_DRG Ms-ltc-DRG 242: Permanent Cardiac Pacemaker Implant With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
241 MS_DRG Ms-ltc-DRG 241: Amputation For Circulatory System Disorders Except Upper Limb An… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
738 MS_DRG Ms-ltc-DRG 738: Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy … 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
734 MS_DRG Ms-ltc-DRG 734: Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
259 MS_DRG Ms-ltc-DRG 259: Cardiac Pacemaker Device Replacement Without Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
619 MS_DRG Ms-ltc-DRG 619: O.r. Procedures For Obesity With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
470 MS_DRG Ms-ltc-DRG 470: Major Hip And Knee Joint Replacement Or Reattachment Of Lower Ex… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
578 MS_DRG Ms-ltc-DRG 578: Skin Graft Except For Skin Ulcer Or Cellulitis Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
480 MS_DRG Ms-ltc-DRG 480: Hip And Femur Procedures Except Major Joint With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
286 MS_DRG Ms-ltc-DRG 286: Circulatory Disorders Except Ami, With Cardiac Catheterization W… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
488 MS_DRG Ms-ltc-DRG 488: Knee Procedures Without Principal Diagnosis Of Infection With Cc… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
495 MS_DRG Ms-ltc-DRG 495: Local Excision And Removal Of Internal Fixation Devices Except H… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
489 MS_DRG Ms-ltc-DRG 489: Knee Procedures Without Principal Diagnosis Of Infection Without… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
739 MS_DRG Ms-ltc-DRG 739: Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Ma… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
493 MS_DRG Ms-ltc-DRG 493: Lower Extremity And Humerus Procedures Except Hip, Foot And Femu… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
233 MS_DRG Ms-ltc-DRG 233: Coronary Bypass With Cardiac Catheterization Or Open Ablation Wi… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
270 MS_DRG Ms-ltc-DRG 270: Other Major Cardiovascular Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
742 MS_DRG Ms-ltc-DRG 742: Uterine And Adnexa Procedures For Non-malignancy With Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
231 MS_DRG Ms-ltc-DRG 231: Coronary Bypass With Ptca With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
854 MS_DRG Ms-ltc-DRG 854: Infectious And Parasitic Diseases With O.r. Procedures With Cc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
747 MS_DRG Ms-ltc-DRG 747: Vagina, Cervix And Vulva Procedures Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
843 MS_DRG Ms-ltc-DRG 843: Other Myeloproliferative Disorders Or Poorly Differentiated Neop… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
265 MS_DRG Ms-ltc-DRG 265: Aicd Lead Procedures 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
618 MS_DRG Ms-ltc-DRG 618: Amputation Of Lower Limb For Endocrine, Nutritional And Metaboli… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
625 MS_DRG Ms-ltc-DRG 625: Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
239 MS_DRG Ms-ltc-DRG 239: Amputation For Circulatory System Disorders Except Upper Limb An… 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
482 MS_DRG Ms-ltc-DRG 482: Hip And Femur Procedures Except Major Joint Without Cc/mcc 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
737 MS_DRG Ms-ltc-DRG 737: Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy … 10 10 — — $62,443.10 $69,381.22 $69,381.22 2024-06-28
579 MS_DRG Ms-ltc-DRG 579: Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 10 10 — — $60,931.28 $67,701.42 $67,701.42 2024-06-28
143 MS_DRG Ms-ltc-DRG 143: Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
141 MS_DRG Ms-ltc-DRG 141: Major Head And Neck Procedures With Cc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
135 MS_DRG Ms-ltc-DRG 135: Sinus And Mastoid Procedures With Cc/mcc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
113 MS_DRG Ms-ltc-DRG 113: Orbital Procedures With Cc/mcc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
116 MS_DRG Ms-ltc-DRG 116: Intraocular Procedures With Cc/mcc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
137 MS_DRG Ms-ltc-DRG 137: Mouth Procedures With Cc/mcc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
167 MS_DRG Ms-ltc-DRG 167: Other Respiratory System O.r. Procedures With Cc 10 10 — — $60,834.78 $67,594.20 $67,594.20 2024-06-28
620 MS_DRG Ms-ltc-DRG 620: O.r. Procedures For Obesity With Cc 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
357 MS_DRG Ms-ltc-DRG 357: Other Digestive System O.r. Procedures With Cc* 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
801 MS_DRG Ms-ltc-DRG 801: Splenic Procedures Without Cc/mcc 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
356 MS_DRG Ms-ltc-DRG 356: Other Digestive System O.r. Procedures With Mcc* 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
800 MS_DRG Ms-ltc-DRG 800: Splenic Procedures With Cc 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
799 MS_DRG Ms-ltc-DRG 799: Splenic Procedures With Mcc 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
358 MS_DRG Ms-ltc-DRG 358: Other Digestive System O.r. Procedures Without Cc/mcc 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
621 MS_DRG Ms-ltc-DRG 621: O.r. Procedures For Obesity Without Cc/mcc 10 10 — — $59,897.93 $66,553.26 $66,553.26 2024-06-28
205 MS_DRG Ms-ltc-DRG 205: Other Respiratory System Diagnoses With Mcc 10 10 — — $58,908.82 $65,454.24 $65,454.24 2024-06-28
622 MS_DRG Ms-ltc-DRG 622: Skin Grafts And Wound Debridement For Endocrine, Nutritional And… 10 10 — — $56,966.76 $63,296.40 $63,296.40 2024-06-28
500 MS_DRG Ms-ltc-DRG 500: Soft Tissue Procedures With Mcc 10 10 — — $55,326.28 $61,473.64 $61,473.64 2024-06-28
463 MS_DRG Ms-ltc-DRG 463: Wound Debridement And Skin Graft Except Hand For Musculoskeletal… 10 10 — — $55,265.97 $61,406.63 $61,406.63 2024-06-28
820 MS_DRG Ms-ltc-DRG 820: Lymphoma And Leukemia With Major O.r. Procedures With Mcc 10 10 — — $54,489.95 $60,544.39 $60,544.39 2024-06-28
826 MS_DRG Ms-ltc-DRG 826: Myeloproliferative Disorders Or Poorly Differentiated Neoplasms … 10 10 — — $54,489.95 $60,544.39 $60,544.39 2024-06-28
907 MS_DRG Ms-ltc-DRG 907: Other O.r. Procedures For Injuries With Mcc 10 10 — — $54,489.95 $60,544.39 $60,544.39 2024-06-28
856 MS_DRG Ms-ltc-DRG 856: Postoperative Or Post-traumatic Infections With O.r. Procedures … 10 10 — — $53,573.20 $59,525.78 $59,525.78 2024-06-28
941 MS_DRG Ms-ltc-DRG 941: O.r. Procedures With Diagnoses Of Other Contact With Health Serv… 10 10 — — $53,247.52 $59,163.91 $59,163.91 2024-06-28
939 MS_DRG Ms-ltc-DRG 939: O.r. Procedures With Diagnoses Of Other Contact With Health Serv… 10 10 — — $53,247.52 $59,163.91 $59,163.91 2024-06-28
940 MS_DRG Ms-ltc-DRG 940: O.r. Procedures With Diagnoses Of Other Contact With Health Serv… 10 10 — — $53,247.52 $59,163.91 $59,163.91 2024-06-28
570 MS_DRG Ms-ltc-DRG 570: Skin Debridement With Mcc 10 10 — — $52,885.65 $58,761.83 $58,761.83 2024-06-28
673 MS_DRG Ms-ltc-DRG 673: Other Kidney And Urinary Tract Procedures With Mcc 10 10 — — $52,688.63 $58,542.92 $58,542.92 2024-06-28
902 MS_DRG Ms-ltc-DRG 902: Wound Debridements For Injuries With Cc* 10 10 — — $51,980.97 $57,756.63 $57,756.63 2024-06-28
901 MS_DRG Ms-ltc-DRG 901: Wound Debridements For Injuries With Mcc* 10 10 — — $51,980.97 $57,756.63 $57,756.63 2024-06-28
974 MS_DRG Ms-ltc-DRG 974: HIV With Major Related Condition With Mcc 10 10 — — $51,188.87 $56,876.52 $56,876.52 2024-06-28
857 MS_DRG Ms-ltc-DRG 857: Postoperative Or Post-traumatic Infections With O.r. Procedures … 10 10 — — $50,191.70 $55,768.56 $55,768.56 2024-06-28
982 MS_DRG Ms-ltc-DRG 982: Extensive O.r. Procedures Unrelated To Principal Diagnosis With … 10 10 — — $49,749.42 $55,277.13 $55,277.13 2024-06-28
279 MS_DRG Ms-ltc-DRG 279: Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vasc… 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
261 MS_DRG Ms-ltc-DRG 261: Cardiac Pacemaker Revision Except Device Replacement With Cc 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
262 MS_DRG Ms-ltc-DRG 262: Cardiac Pacemaker Revision Except Device Replacement Without Cc/… 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
278 MS_DRG Ms-ltc-DRG 278: Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vasc… 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
263 MS_DRG Ms-ltc-DRG 263: Vein Ligation And Stripping 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
264 MS_DRG Ms-ltc-DRG 264: Other Circulatory System O.r. Procedures 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
245 MS_DRG Ms-ltc-DRG 245: Aicd Generator Procedures 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
260 MS_DRG Ms-ltc-DRG 260: Cardiac Pacemaker Revision Except Device Replacement With Mcc 10 10 — — $48,792.46 $54,213.85 $54,213.85 2024-06-28
580 MS_DRG Ms-ltc-DRG 580: Other Skin, Subcutaneous Tissue And Breast Procedures With Cc 10 10 — — $48,699.99 $54,111.10 $54,111.10 2024-06-28
516 MS_DRG Ms-ltc-DRG 516: Other Musculoskeletal System And Connective Tissue O.r. Procedur… 10 10 — — $47,083.63 $52,315.14 $52,315.14 2024-06-28
515 MS_DRG Ms-ltc-DRG 515: Other Musculoskeletal System And Connective Tissue O.r. Procedur… 10 10 — — $47,083.63 $52,315.14 $52,315.14 2024-06-28
606 MS_DRG Ms-ltc-DRG 606: Minor Skin Disorders With Mcc 10 10 — — $45,873.36 $50,970.40 $50,970.40 2024-06-28
393 MS_DRG Ms-ltc-DRG 393: Other Digestive System Diagnoses With Mcc 10 10 — — $45,358.70 $50,398.56 $50,398.56 2024-06-28
919 MS_DRG Ms-ltc-DRG 919: Complications Of Treatment With Mcc 10 10 — — $43,822.76 $48,691.95 $48,691.95 2024-06-28
464 MS_DRG Ms-ltc-DRG 464: Wound Debridement And Skin Graft Except Hand For Musculoskeletal… 10 10 — — $42,837.65 $47,597.39 $47,597.39 2024-06-28
208 MS_DRG Ms-ltc-DRG 208: Respiratory System Diagnosis With Ventilator Support <=96 Hours 10 10 — — $42,817.55 $47,575.06 $47,575.06 2024-06-28
956 MS_DRG Ms-ltc-DRG 956: Limb Reattachment, Hip And Femur Procedures For Multiple Signifi… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
958 MS_DRG Ms-ltc-DRG 958: Other O.r. Procedures For Multiple Significant Trauma With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
959 MS_DRG Ms-ltc-DRG 959: Other O.r. Procedures For Multiple Significant Trauma Without Cc… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
955 MS_DRG Ms-ltc-DRG 955: Craniotomy For Multiple Significant Trauma 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
988 MS_DRG Ms-ltc-DRG 988: Non-extensive O.r. Procedures Unrelated To Principal Diagnosis W… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
970 MS_DRG Ms-ltc-DRG 970: HIV With Extensive O.r. Procedures Without Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
935 MS_DRG Ms-ltc-DRG 935: Non-extensive Burns 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
963 MS_DRG Ms-ltc-DRG 963: Other Multiple Significant Trauma With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
545 MS_DRG Ms-ltc-DRG 545: Connective Tissue Disorders With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
905 MS_DRG Ms-ltc-DRG 905: Skin Grafts For Injuries Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
908 MS_DRG Ms-ltc-DRG 908: Other O.r. Procedures For Injuries With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
964 MS_DRG Ms-ltc-DRG 964: Other Multiple Significant Trauma With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
909 MS_DRG Ms-ltc-DRG 909: Other O.r. Procedures For Injuries Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
173 MS_DRG Ms-ltc-DRG 173: Ultrasound Accelerated And Other Thrombolysis With Principal Dia… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
321 MS_DRG Ms-ltc-DRG 321: Percutaneous Cardiovascular Procedures With Intraluminal Device … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
326 MS_DRG Ms-ltc-DRG 326: Stomach, Esophageal And Duodenal Procedures With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
626 MS_DRG Ms-ltc-DRG 626: Thyroid, Parathyroid And Thyroglossal Procedures With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
687 MS_DRG Ms-ltc-DRG 687: Kidney And Urinary Tract Neoplasms With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
903 MS_DRG Ms-ltc-DRG 903: Wound Debridements For Injuries Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
228 MS_DRG Ms-ltc-DRG 228: Other Cardiothoracic Procedures With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
154 MS_DRG Ms-ltc-DRG 154: Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
217 MS_DRG Ms-ltc-DRG 217: Cardiac Valve And Other Major Cardiothoracic Procedures With Car… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
466 MS_DRG Ms-ltc-DRG 466: Revision Of Hip Or Knee Replacement With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
232 MS_DRG Ms-ltc-DRG 232: Coronary Bypass With Ptca Without Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
865 MS_DRG Ms-ltc-DRG 865: Viral Illness With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
323 MS_DRG Ms-ltc-DRG 323: Coronary Intravascular Lithotripsy With Intraluminal Device With… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
717 MS_DRG Ms-ltc-DRG 717: Other Male Reproductive System O.r. Procedures Except Malignancy… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
144 MS_DRG Ms-ltc-DRG 144: Other Ear, Nose, Mouth And Throat O.r. Procedures With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
142 MS_DRG Ms-ltc-DRG 142: Major Head And Neck Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
597 MS_DRG Ms-ltc-DRG 597: Malignant Breast Disorders With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
218 MS_DRG Ms-ltc-DRG 218: Cardiac Valve And Other Major Cardiothoracic Procedures With Car… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
138 MS_DRG Ms-ltc-DRG 138: Mouth Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
513 MS_DRG Ms-ltc-DRG 513: Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
136 MS_DRG Ms-ltc-DRG 136: Sinus And Mastoid Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
477 MS_DRG Ms-ltc-DRG 477: Biopsies Of Musculoskeletal System And Connective Tissue With Mc… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
514 MS_DRG Ms-ltc-DRG 514: Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
117 MS_DRG Ms-ltc-DRG 117: Intraocular Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
324 MS_DRG Ms-ltc-DRG 324: Coronary Intravascular Lithotripsy With Intraluminal Device With… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
115 MS_DRG Ms-ltc-DRG 115: Extraocular Procedures Except Orbit 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
114 MS_DRG Ms-ltc-DRG 114: Orbital Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
554 MS_DRG Ms-ltc-DRG 554: Bone Diseases And Arthropathies Without Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
983 MS_DRG Ms-ltc-DRG 983: Extensive O.r. Procedures Unrelated To Principal Diagnosis Witho… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
266 MS_DRG Ms-ltc-DRG 266: Endovascular Cardiac Valve Replacement And Supplement Procedures… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
102 MS_DRG Ms-ltc-DRG 102: Headaches With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
320 MS_DRG Ms-ltc-DRG 320: Other Endovascular Cardiac Valve Procedures Without Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
100 MS_DRG Ms-ltc-DRG 100: Seizures With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
506 MS_DRG Ms-ltc-DRG 506: Major Thumb Or Joint Procedures 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
828 MS_DRG Ms-ltc-DRG 828: Myeloproliferative Disorders Or Poorly Differentiated Neoplasms … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
827 MS_DRG Ms-ltc-DRG 827: Myeloproliferative Disorders Or Poorly Differentiated Neoplasms … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
465 MS_DRG Ms-ltc-DRG 465: Wound Debridement And Skin Graft Except Hand For Musculoskeletal… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
840 MS_DRG Ms-ltc-DRG 840: Lymphoma And Non-acute Leukemia With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
212 MS_DRG Ms-ltc-DRG 212: Concomitant Aortic And Mitral Valve Procedures 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
423 MS_DRG Ms-ltc-DRG 423: Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
821 MS_DRG Ms-ltc-DRG 821: Lymphoma And Leukemia With Major O.r. Procedures With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
269 MS_DRG Ms-ltc-DRG 269: Aortic And Heart Assist Procedures Except Pulsation Balloon With… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
811 MS_DRG Ms-ltc-DRG 811: Red Blood Cell Disorders With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
139 MS_DRG Ms-ltc-DRG 139: Salivary Gland Procedures 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
368 MS_DRG Ms-ltc-DRG 368: Major Esophageal Disorders With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
501 MS_DRG Ms-ltc-DRG 501: Soft Tissue Procedures With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
822 MS_DRG Ms-ltc-DRG 822: Lymphoma And Leukemia With Major O.r. Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
808 MS_DRG Ms-ltc-DRG 808: Major Hematological And Immunological Diagnoses Except Sickle Ce… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
965 MS_DRG Ms-ltc-DRG 965: Other Multiple Significant Trauma Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
145 MS_DRG Ms-ltc-DRG 145: Other Ear, Nose, Mouth And Throat O.r. Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
499 MS_DRG Ms-ltc-DRG 499: Local Excision And Removal Of Internal Fixation Devices Of Hip A… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
686 MS_DRG Ms-ltc-DRG 686: Kidney And Urinary Tract Neoplasms With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
740 MS_DRG Ms-ltc-DRG 740: Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Ma… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
629 MS_DRG Ms-ltc-DRG 629: Other Endocrine, Nutritional And Metabolic O.r. Procedures With … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
798 MS_DRG Ms-ltc-DRG 798: Vaginal Delivery With Sterilization And/or D&c Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
267 MS_DRG Ms-ltc-DRG 267: Endovascular Cardiac Valve Replacement And Supplement Procedures… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
796 MS_DRG Ms-ltc-DRG 796: Vaginal Delivery With Sterilization And/or D&c With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
797 MS_DRG Ms-ltc-DRG 797: Vaginal Delivery With Sterilization And/or D&c With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
788 MS_DRG Ms-ltc-DRG 788: Cesarean Section Without Sterilization Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
786 MS_DRG Ms-ltc-DRG 786: Cesarean Section Without Sterilization With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
785 MS_DRG Ms-ltc-DRG 785: Cesarean Section With Sterilization Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
157 MS_DRG Ms-ltc-DRG 157: Dental And Oral Diseases With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
787 MS_DRG Ms-ltc-DRG 787: Cesarean Section Without Sterilization With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
783 MS_DRG Ms-ltc-DRG 783: Cesarean Section With Sterilization With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
251 MS_DRG Ms-ltc-DRG 251: Percutaneous Cardiovascular Procedures Without Intraluminal Devi… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
250 MS_DRG Ms-ltc-DRG 250: Percutaneous Cardiovascular Procedures Without Intraluminal Devi… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
784 MS_DRG Ms-ltc-DRG 784: Cesarean Section With Sterilization With Cc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
236 MS_DRG Ms-ltc-DRG 236: Coronary Bypass Without Cardiac Catheterization Without Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
234 MS_DRG Ms-ltc-DRG 234: Coronary Bypass With Cardiac Catheterization Or Open Ablation Wi… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
168 MS_DRG Ms-ltc-DRG 168: Other Respiratory System O.r. Procedures Without Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
768 MS_DRG Ms-ltc-DRG 768: Vaginal Delivery With O.r. Procedures Except Sterilization And/o… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
969 MS_DRG Ms-ltc-DRG 969: HIV With Extensive O.r. Procedures With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
229 MS_DRG Ms-ltc-DRG 229: Other Cardiothoracic Procedures Without Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
904 MS_DRG Ms-ltc-DRG 904: Skin Grafts For Injuries With Cc/mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
769 MS_DRG Ms-ltc-DRG 769: Postpartum And Post Abortion Diagnoses With O.r. Procedures 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
319 MS_DRG Ms-ltc-DRG 319: Other Endovascular Cardiac Valve Procedures With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
221 MS_DRG Ms-ltc-DRG 221: Cardiac Valve And Other Major Cardiothoracic Procedures Without … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
220 MS_DRG Ms-ltc-DRG 220: Cardiac Valve And Other Major Cardiothoracic Procedures Without … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
219 MS_DRG Ms-ltc-DRG 219: Cardiac Valve And Other Major Cardiothoracic Procedures Without … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
322 MS_DRG Ms-ltc-DRG 322: Percutaneous Cardiovascular Procedures With Intraluminal Device … 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
485 MS_DRG Ms-ltc-DRG 485: Knee Procedures With Principal Diagnosis Of Infection With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
216 MS_DRG Ms-ltc-DRG 216: Cardiac Valve And Other Major Cardiothoracic Procedures With Car… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
215 MS_DRG Ms-ltc-DRG 215: Other Heart Assist System Implant 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
417 MS_DRG Ms-ltc-DRG 417: Laparoscopic Cholecystectomy Without C.d.e. With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
498 MS_DRG Ms-ltc-DRG 498: Local Excision And Removal Of Internal Fixation Devices Of Hip A… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
510 MS_DRG Ms-ltc-DRG 510: Shoulder, Elbow Or Forearm Procedures, Except Major Joint Proced… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
204 MS_DRG Ms-ltc-DRG 204: Respiratory Signs And Symptoms 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
325 MS_DRG Ms-ltc-DRG 325: Coronary Intravascular Lithotripsy Without Intraluminal Device 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
199 MS_DRG Ms-ltc-DRG 199: Pneumothorax With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
757 MS_DRG Ms-ltc-DRG 757: Infections, Female Reproductive System With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
989 MS_DRG Ms-ltc-DRG 989: Non-extensive O.r. Procedures Unrelated To Principal Diagnosis W… 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
957 MS_DRG Ms-ltc-DRG 957: Other O.r. Procedures For Multiple Significant Trauma With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
196 MS_DRG Ms-ltc-DRG 196: Interstitial Lung Disease With Mcc 10 10 — — $41,788.22 $46,431.36 $46,431.36 2024-06-28
288 MS_DRG Ms-ltc-DRG 288: Acute And Subacute Endocarditis With Mcc 10 10 — — $41,764.10 $46,404.56 $46,404.56 2024-06-28
867 MS_DRG Ms-ltc-DRG 867: Other Infectious And Parasitic Diseases Diagnoses With Mcc 10 10 — — $41,165.00 $45,738.89 $45,738.89 2024-06-28
388 MS_DRG Ms-ltc-DRG 388: Gastrointestinal Obstruction With Mcc 10 10 — — $40,887.57 $45,430.63 $45,430.63 2024-06-28
623 MS_DRG Ms-ltc-DRG 623: Skin Grafts And Wound Debridement For Endocrine, Nutritional And… 10 10 — — $40,807.15 $45,341.28 $45,341.28 2024-06-28
438 MS_DRG Ms-ltc-DRG 438: Disorders Of Pancreas Except Malignancy With Mcc 10 10 — — $40,766.94 $45,296.60 $45,296.60 2024-06-28
575 MS_DRG Ms-ltc-DRG 575: Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 10 10 — — $40,674.46 $45,193.85 $45,193.85 2024-06-28
557 MS_DRG Ms-ltc-DRG 557: Tendonitis, Myositis And Bursitis With Mcc 10 10 — — $40,674.46 $45,193.85 $45,193.85 2024-06-28
539 MS_DRG Ms-ltc-DRG 539: Osteomyelitis With Mcc 10 10 — — $38,877.16 $43,196.85 $43,196.85 2024-06-28
353 MS_DRG Ms-ltc-DRG 353: Hernia Procedures Except Inguinal And Femoral With Mcc 10 10 — — $38,828.92 $43,143.24 $43,143.24 2024-06-28
347 MS_DRG Ms-ltc-DRG 347: Anal And Stomal Procedures With Mcc 10 10 — — $38,828.92 $43,143.24 $43,143.24 2024-06-28
335 MS_DRG Ms-ltc-DRG 335: Peritoneal Adhesiolysis With Mcc 10 10 — — $38,828.92 $43,143.24 $43,143.24 2024-06-28
397 MS_DRG Ms-ltc-DRG 397: Appendix Procedures With Mcc 10 10 — — $38,828.92 $43,143.24 $43,143.24 2024-06-28
371 MS_DRG Ms-ltc-DRG 371: Major Gastrointestinal Disorders And Peritoneal Infections With … 10 10 — — $38,828.92 $43,143.24 $43,143.24 2024-06-28
350 MS_DRG Ms-ltc-DRG 350: Inguinal And Femoral Hernia Procedures With Mcc 10 10 — — $38,828.92 $43,143.24 $43,143.24 2024-06-28
585 MS_DRG Ms-ltc-DRG 585: Breast Biopsy, Local Excision And Other Breast Procedures Withou… 10 10 — — $38,056.91 $42,285.46 $42,285.46 2024-06-28
584 MS_DRG Ms-ltc-DRG 584: Breast Biopsy, Local Excision And Other Breast Procedures With C… 10 10 — — $38,056.91 $42,285.46 $42,285.46 2024-06-28
582 MS_DRG Ms-ltc-DRG 582: Mastectomy For Malignancy With Cc/mcc 10 10 — — $38,056.91 $42,285.46 $42,285.46 2024-06-28
583 MS_DRG Ms-ltc-DRG 583: Mastectomy For Malignancy Without Cc/mcc 10 10 — — $38,056.91 $42,285.46 $42,285.46 2024-06-28
581 MS_DRG Ms-ltc-DRG 581: Other Skin, Subcutaneous Tissue And Breast Procedures Without Cc… 10 10 — — $38,056.91 $42,285.46 $42,285.46 2024-06-28
571 MS_DRG Ms-ltc-DRG 571: Skin Debridement With Cc 10 10 — — $38,056.91 $42,285.46 $42,285.46 2024-06-28
189 MS_DRG Ms-ltc-DRG 189: Pulmonary Edema And Respiratory Failure 10 10 — — $37,859.90 $42,066.55 $42,066.55 2024-06-28
592 MS_DRG Ms-ltc-DRG 592: Skin Ulcers With Mcc 10 10 — — $37,691.03 $41,878.92 $41,878.92 2024-06-28
637 MS_DRG Ms-ltc-DRG 637: Diabetes With Mcc 10 10 — — $37,542.26 $41,713.62 $41,713.62 2024-06-28
551 MS_DRG Ms-ltc-DRG 551: Medical Back Problems With Mcc* 10 10 — — $37,469.88 $41,633.20 $41,633.20 2024-06-28
862 MS_DRG Ms-ltc-DRG 862: Postoperative And Post-traumatic Infections With Mcc 10 10 — — $37,196.47 $41,329.41 $41,329.41 2024-06-28
871 MS_DRG Ms-ltc-DRG 871: Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 10 10 — — $36,677.78 $40,753.09 $40,753.09 2024-06-28
552 MS_DRG Ms-ltc-DRG 552: Medical Back Problems Without Mcc* 10 10 — — $36,533.03 $40,592.26 $40,592.26 2024-06-28
708 MS_DRG Ms-ltc-DRG 708: Major Male Pelvic Procedures Without Cc/mcc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
709 MS_DRG Ms-ltc-DRG 709: Penis Procedures With Cc/mcc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
713 MS_DRG Ms-ltc-DRG 713: Transurethral Prostatectomy With Cc/mcc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
707 MS_DRG Ms-ltc-DRG 707: Major Male Pelvic Procedures With Cc/mcc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
727 MS_DRG Ms-ltc-DRG 727: Inflammation Of The Male Reproductive System With Mcc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
722 MS_DRG Ms-ltc-DRG 722: Malignancy, Male Reproductive System With Mcc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
723 MS_DRG Ms-ltc-DRG 723: Malignancy, Male Reproductive System With Cc 10 10 — — $36,275.71 $40,306.34 $40,306.34 2024-06-28
698 MS_DRG Ms-ltc-DRG 698: Other Kidney And Urinary Tract Diagnoses With Mcc 10 10 — — $36,227.45 $40,252.72 $40,252.72 2024-06-28
559 MS_DRG Ms-ltc-DRG 559: Aftercare, Musculoskeletal System And Connective Tissue With Mcc 10 10 — — $36,203.33 $40,225.92 $40,225.92 2024-06-28
314 MS_DRG Ms-ltc-DRG 314: Other Circulatory System Diagnoses With Mcc 10 10 — — $36,006.31 $40,007.01 $40,007.01 2024-06-28
461 MS_DRG Ms-ltc-DRG 461: Bilateral Or Multiple Major Joint Procedures Of Lower Extremity … 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
459 MS_DRG Ms-ltc-DRG 459: Spinal Fusion Except Cervical With Mcc 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
502 MS_DRG Ms-ltc-DRG 502: Soft Tissue Procedures Without Cc/mcc 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
564 MS_DRG Ms-ltc-DRG 564: Other Musculoskeletal System And Connective Tissue Diagnoses Wit… 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
478 MS_DRG Ms-ltc-DRG 478: Biopsies Of Musculoskeletal System And Connective Tissue With Cc 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
453 MS_DRG Ms-ltc-DRG 453: Combined Anterior And Posterior Spinal Fusion With Mcc 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
479 MS_DRG Ms-ltc-DRG 479: Biopsies Of Musculoskeletal System And Connective Tissue Without… 10 10 — — $35,266.48 $39,184.98 $39,184.98 2024-06-28
186 MS_DRG Ms-ltc-DRG 186: Pleural Effusion With Mcc 10 10 — — $34,719.65 $38,577.39 $38,577.39 2024-06-28
444 MS_DRG Ms-ltc-DRG 444: Disorders Of The Biliary Tract With Mcc* 10 10 — — $34,160.76 $37,956.40 $37,956.40 2024-06-28
299 MS_DRG Ms-ltc-DRG 299: Peripheral Vascular Disorders With Mcc 10 10 — — $34,056.22 $37,840.24 $37,840.24 2024-06-28
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