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

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Hospital

SENTARA HALIFAX REGIONAL HOSPITAL

South Boston, VA · CCN 490013 · Rates published

Your selected procedure

You selected 45378 (HCPCS)

Diagnostic colonoscopy

This hospital’s price: $960 across 4 payers · range $933-$3,249

Source: https://www.sentara.com/Documents/s/sentarahalifaxregionalhospitalstandardchargesxlsx-1395297 · observed 2026-04-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

8,826 distinct procedures filed
15 distinct payers
88,993 rate rows
2026-04-01 last MRF observed
Data quality

64,164 of 88,993 rate rows are consumer-grade (72.1%)

24,829 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 22,088
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,667
placeholder amount (≤ $0.02) — excluded from medians 74
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.sentara.com/Documents/s/sentarahalifaxregionalhospitalstandardchargesxlsx-1395297
Found on page https://www.sentara.com/billing/estimating-hospital-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 4078a641155ca0e8… · 19,845,788 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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 4 $4,595,100.00 $4,730,250.00 $4,679,568.75 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $3,765,279.00 $3,876,022.50 $3,834,493.69 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,387,803.91 $3,487,445.20 $3,450,079.71 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,310,289.02 $3,407,650.46 $3,371,139.92 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $2,997,086.40 $3,085,236.00 $3,052,179.90 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $2,638,829.00 $2,716,441.62 $2,687,336.88 nat. median
$2,455,111
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $2,378,640.00 $2,448,600.00 $2,422,365.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $786,032.40 $809,151.00 $800,481.52 nat. median
$813,967
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $626,464.42 $644,889.85 $637,980.31 nat. median
$621,313
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $600,264.70 $617,919.55 $611,298.98 nat. median
$599,737
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $573,506.05 $590,373.88 $584,048.45 nat. median
$579,571
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $570,976.70 $587,770.14 $581,472.59 nat. median
$574,037
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $542,486.10 $558,441.57 $552,458.27 nat. median
$562,501
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $499,076.41 $513,755.13 $508,250.61 nat. median
$513,770
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 $315,655.79 $324,939.78 $321,458.29 nat. median
$168,055
1.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 4 $283,815.00 $988,580.00 $292,162.50 nat. median
$286,598
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $205,076.59 $211,108.25 $208,846.38 nat. median
$186,516
1.1× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $155,482.31 $237,471.29 $159,674.24 nat. median
$145,435
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $156,396.33 $160,996.23 $159,271.27 nat. median
$131,925
1.2× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $57,961.04 $201,888.99 $115,637.96 nat. median
$65,477
1.8× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $101,692.86 $104,683.82 $103,562.21 nat. median
$97,418
1.1× median
7
MS_DRG 		Lung Transplant 4 $95,118.90 $97,916.51 $96,867.40 nat. median
$70,649
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $88,318.08 $90,915.67 $89,941.57 nat. median
$72,715
1.2× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $83,313.20 $85,763.59 $84,844.70 nat. median
$65,418
1.3× median
209
MS_DRG 		Complex Aortic Arch Procedures 4 $83,218.37 $85,665.97 $84,748.12 nat. median
$2,110
outlier · 40.2×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $7,116.46 $83,431.23 $81,444.77 nat. median
$2,736
outlier · 29.8×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $79,974.44 $82,326.63 $81,444.55 nat. median
$74,509
1.1× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $75,863.15 $78,094.42 $77,257.70 nat. median
$69,922
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 4 $73,284.49 $75,439.92 $74,631.64 nat. median
$73,023
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $72,013.75 $74,131.81 $73,337.54 nat. median
$69,822
1.1× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 $66,373.52 $68,325.68 $67,593.62 nat. median
$2,596
outlier · 26.0×
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 4 $65,567.94 $138,279.69 $67,496.41 nat. median
$66,211
1.0× median
850
MS_DRG 		Acute Leukemia With Other Procedures 4 $63,819.66 $65,696.70 $64,992.81 nat. median
$2,633
outlier · 24.7×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 4 $19,504.74 $63,972.58 $63,287.16 nat. median
$60,505
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $61,951.48 $63,773.59 $63,090.30 nat. median
$59,651
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 $58,051.76 $59,759.16 $59,118.88 nat. median
$56,428
1.0× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 4 $57,394.58 $121,962.21 $59,082.65 nat. median
$63,499
0.9× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 $56,662.12 $58,328.66 $57,703.71 nat. median
$55,923
1.0× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 $56,420.67 $58,080.10 $57,457.81 nat. median
$55,935
1.0× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 $56,236.11 $57,890.11 $57,269.86 nat. median
$52,327
1.1× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $53,308.76 $54,876.66 $54,288.70 nat. median
$9,905
outlier · 5.5×
10
MS_DRG 		Pancreas Transplant 4 $52,995.82 $54,554.52 $53,970.01 nat. median
$23,080
outlier · 2.3×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 $52,973.93 $54,531.99 $53,947.72 nat. median
$37,013
1.5× median
5116
OTHER 		Level 6 Musculoskeletal Procedures 2 $18,965.58 $57,793.95 $53,899.03 nat. median
$18,185
outlier · 3.0×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 $52,696.00 $54,245.89 $53,664.68 nat. median
$45,605
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 $52,665.37 $54,214.36 $53,633.49 nat. median
$51,518
1.0× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 4 $51,070.76 $52,572.84 $52,009.56 nat. median
$48,611
1.1× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $50,823.47 $52,318.28 $51,757.72 nat. median
$49,569
1.0× median
J9600
HCPCS 		Porfimer Sodium Injection 1 $47,487.70 $52,817.96 $51,121.97 nat. median
$26,416
1.9× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 4 $49,752.61 $51,215.92 $50,667.18 nat. median
$47,340
1.1× median

Other procedures at this hospital

Browse this hospital's 8,826 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 4 4 — — $4,595,100.00 $4,730,250.00 $4,679,568.75 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 4 — — $3,765,279.00 $3,876,022.50 $3,834,493.69 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 4 — — $3,387,803.91 $3,487,445.20 $3,450,079.71 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $3,310,289.02 $3,407,650.46 $3,371,139.92 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 4 4 — — $2,997,086.40 $3,085,236.00 $3,052,179.90 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 4 — — $2,638,829.00 $2,716,441.62 $2,687,336.88 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 4 — — $2,378,640.00 $2,448,600.00 $2,422,365.00 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 4 4 — — $786,032.40 $809,151.00 $800,481.52 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 4 4 — — $626,464.42 $644,889.85 $637,980.31 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 4 4 — — $600,264.70 $617,919.55 $611,298.98 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 4 — — $573,506.05 $590,373.88 $584,048.45 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 4 4 — — $570,976.70 $587,770.14 $581,472.59 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 4 — — $542,486.10 $558,441.57 $552,458.27 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 4 — — $499,076.41 $513,755.13 $508,250.61 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 4 — — $315,655.79 $324,939.78 $321,458.29 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 7 4 — — $283,815.00 $988,580.00 $292,162.50 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 4 — — $205,076.59 $211,108.25 $208,846.38 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 4 — — $155,482.31 $237,471.29 $159,674.24 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 4 — — $156,396.33 $160,996.23 $159,271.27 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 10 4 — — $57,961.04 $201,888.99 $115,637.96 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 4 — — $101,692.86 $104,683.82 $103,562.21 2026-04-01
7 MS_DRG Lung Transplant 4 4 — — $95,118.90 $97,916.51 $96,867.40 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 4 4 — — $88,318.08 $90,915.67 $89,941.57 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 4 — — $83,313.20 $85,763.59 $84,844.70 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 4 4 — — $83,218.37 $85,665.97 $84,748.12 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 6 4 — — $7,116.46 $83,431.23 $81,444.77 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 4 4 — — $79,974.44 $82,326.63 $81,444.55 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 4 — — $75,863.15 $78,094.42 $77,257.70 2026-04-01
215 MS_DRG Other Heart Assist System Implant 4 4 — — $73,284.49 $75,439.92 $74,631.64 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $72,013.75 $74,131.81 $73,337.54 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 4 — — $66,373.52 $68,325.68 $67,593.62 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 7 4 — — $65,567.94 $138,279.69 $67,496.41 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 4 4 — — $63,819.66 $65,696.70 $64,992.81 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 6 4 — — $19,504.74 $63,972.58 $63,287.16 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 4 — — $61,951.48 $63,773.59 $63,090.30 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 4 — — $58,051.76 $59,759.16 $59,118.88 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 7 4 — — $57,394.58 $121,962.21 $59,082.65 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 4 — — $56,662.12 $58,328.66 $57,703.71 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 4 — — $56,420.67 $58,080.10 $57,457.81 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 4 — — $56,236.11 $57,890.11 $57,269.86 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 4 — — $53,308.76 $54,876.66 $54,288.70 2026-04-01
10 MS_DRG Pancreas Transplant 4 4 — — $52,995.82 $54,554.52 $53,970.01 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 4 — — $52,973.93 $54,531.99 $53,947.72 2026-04-01
5116 OTHER Level 6 Musculoskeletal Procedures 3 2 — — $18,965.58 $57,793.95 $53,899.03 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 4 — — $52,696.00 $54,245.89 $53,664.68 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 4 — — $52,665.37 $54,214.36 $53,633.49 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 4 4 — — $51,070.76 $52,572.84 $52,009.56 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 4 — — $50,823.47 $52,318.28 $51,757.72 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 3 1 — — $47,487.70 $52,817.96 $51,121.97 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $49,752.61 $51,215.92 $50,667.18 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 4 4 — — $49,391.52 $50,844.21 $50,299.46 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 4 — — $13,512.32 $50,881.00 $49,911.84 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $48,616.10 $50,045.98 $49,509.78 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $48,616.10 $50,045.98 $49,509.78 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 4 — — $48,441.76 $49,866.52 $49,332.24 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 5 4 — — $47,590.47 $51,516.82 $48,873.54 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 4 — — $45,356.11 $46,690.11 $46,189.85 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 4 4 — — $45,304.32 $46,636.80 $46,137.12 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 4 — — $44,876.12 $46,196.01 $45,701.05 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 4 4 — — $44,480.02 $45,788.25 $45,297.67 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 4 — — $44,467.61 $45,775.48 $45,285.04 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 4 — — $44,150.30 $45,448.84 $44,961.89 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 4 — — $44,007.33 $45,301.66 $44,816.29 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 4 4 — — $43,906.65 $45,198.03 $44,713.76 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 4 4 — — $43,460.96 $44,739.22 $44,259.87 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 4 — — $43,433.23 $44,710.68 $44,231.64 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 4 4 — — $42,720.55 $43,977.03 $43,505.85 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 4 — — $42,452.10 $43,700.70 $43,232.48 2026-04-01
J9226 HCPCS Supprelin La Implant 7 4 — — $41,996.90 $99,321.65 $43,232.10 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 4 4 — — $42,281.41 $43,524.98 $43,058.64 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 6 4 — — $7,125.01 $43,469.41 $42,434.43 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 4 — — $41,662.08 $42,887.44 $42,427.93 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 4 — — $41,535.16 $42,756.79 $42,298.68 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 4 — — $41,255.04 $42,468.43 $42,013.40 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 4 4 — — $40,939.91 $42,144.03 $41,692.49 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 4 4 — — $40,698.46 $41,895.47 $41,446.59 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 4 4 — — $40,500.05 $41,691.23 $41,244.54 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 4 — — $40,437.31 $41,626.64 $41,180.64 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 4 4 — — $40,278.29 $41,462.95 $41,018.70 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 5 4 — — $17,992.82 $41,749.80 $40,954.56 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 4 — — $39,552.47 $40,715.78 $40,279.54 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 4 4 — — $39,529.12 $40,691.74 $40,255.76 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 4 — — $39,267.98 $40,422.92 $39,989.82 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 5 4 — — $3,517.26 $40,291.50 $39,524.05 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 4 4 — — $38,557.48 $39,691.52 $39,266.25 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 6 4 — — $12,163.15 $39,759.10 $38,812.46 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 4 — — $37,418.05 $38,518.58 $38,105.88 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 7 4 — — $15,680.32 $40,025.04 $37,604.01 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 4 4 — — $36,741.10 $37,821.72 $37,416.49 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 4 — — $36,404.09 $37,474.79 $37,073.28 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 11 4 — — $10,723.81 $71,224.27 $37,036.48 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 5 4 — — $30,508.92 $37,628.73 $36,912.00 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 4 4 — — $35,875.23 $36,930.38 $36,534.69 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 4 — — $35,697.24 $36,747.15 $36,353.43 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 4 4 — — $35,379.91 $36,420.50 $36,030.28 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 4 — — $34,946.62 $35,974.46 $35,589.02 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 4 — — $34,876.58 $35,902.37 $35,517.69 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 4 4 — — $34,774.46 $35,797.24 $35,413.70 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 9 4 — — $34,181.40 $76,043.79 $35,186.74 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 4 4 — — $34,476.84 $35,490.86 $35,110.60 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 4 4 — — $34,341.88 $35,351.94 $34,973.17 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 4 — — $34,096.05 $35,098.88 $34,722.82 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 4 4 — — $33,832.72 $34,827.80 $34,454.64 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 4 4 — — $33,818.13 $34,812.78 $34,439.79 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 4 4 — — $33,688.28 $34,679.12 $34,307.56 2026-04-01
245 MS_DRG Aicd Generator Procedures 5 4 — — $6,457.71 $34,930.68 $34,265.33 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 4 4 — — $33,344.71 $34,325.43 $33,957.67 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 4 4 — — $33,335.22 $34,315.67 $33,948.01 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 4 4 — — $33,206.83 $34,183.51 $33,817.26 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 4 — — $32,695.48 $33,657.11 $33,296.49 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 4 4 — — $32,218.40 $33,166.00 $32,810.65 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 7 4 — — $31,485.44 $109,669.59 $32,411.48 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 5 4 — — $31,048.03 $32,906.94 $32,280.14 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 4 4 — — $31,586.69 $32,515.71 $32,167.33 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 4 — — $31,458.30 $32,383.54 $32,036.57 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 4 — — $31,405.78 $32,329.48 $31,983.09 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 4 4 — — $31,390.46 $32,313.71 $31,967.49 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 4 4 — — $31,300.74 $32,221.35 $31,876.12 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 4 4 — — $31,264.26 $32,183.80 $31,838.97 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 4 4 — — $31,207.36 $32,125.22 $31,781.02 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 7 4 — — $9,514.20 $32,699.69 $31,765.41 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 4 — — $31,089.19 $32,003.58 $31,660.69 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 4 4 — — $31,067.30 $31,981.05 $31,638.39 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 4 4 — — $30,745.62 $31,649.90 $31,310.79 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 5 4 — — $14,754.45 $31,856.40 $31,249.61 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 2 2 — — $28,708.85 $33,277.80 $30,993.33 2026-04-01
791 MS_DRG Prematurity With Major Problems 4 4 — — $30,260.51 $31,150.53 $30,816.78 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 4 — — $29,979.67 $30,861.42 $30,530.76 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 4 4 — — $29,714.14 $30,588.09 $30,260.36 2026-04-01
J9266 HCPCS Pegaspargase Injection 7 4 — — $28,992.54 $61,964.45 $29,845.26 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 4 — — $29,187.47 $30,045.93 $29,724.01 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 4 4 — — $29,058.35 $29,913.01 $29,592.51 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 4 4 — — $28,886.93 $29,736.55 $29,417.94 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 4 4 — — $28,844.62 $29,692.99 $29,374.85 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 4 4 — — $28,817.63 $29,665.21 $29,347.37 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 4 4 — — $28,657.88 $29,500.76 $29,184.68 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 5 4 — — $27,916.74 $33,663.73 $28,669.39 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 6 4 — — $25,626.51 $29,313.15 $28,617.86 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 4 4 — — $27,913.82 $28,734.81 $28,426.94 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 4 4 — — $27,837.23 $28,655.97 $28,348.94 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 4 4 — — $27,684.03 $28,498.27 $28,192.93 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 6 4 — — $4,292.20 $28,804.65 $28,118.83 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 4 4 — — $27,445.50 $28,252.72 $27,950.01 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 4 4 — — $27,434.56 $28,241.46 $27,938.88 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 4 4 — — $27,120.16 $27,917.81 $27,618.69 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 4 — — $27,099.74 $27,896.79 $27,597.89 2026-04-01
332 MS_DRG Rectal Resection With Mcc 4 4 — — $27,063.26 $27,859.24 $27,560.75 2026-04-01
265 MS_DRG Aicd Lead Procedures 4 4 — — $27,045.02 $27,840.47 $27,542.17 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 4 4 — — $26,998.34 $27,792.41 $27,494.64 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 4 — — $26,958.95 $27,751.86 $27,454.51 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 4 4 — — $26,786.79 $27,574.64 $27,279.19 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 4 4 — — $26,726.24 $27,512.31 $27,217.53 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 6 4 — — $24,234.07 $33,221.31 $27,190.79 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 4 4 — — $26,661.32 $27,445.48 $27,151.42 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 4 4 — — $26,639.44 $27,422.96 $27,129.14 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 4 4 — — $26,614.64 $27,397.42 $27,103.88 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 4 4 — — $26,593.48 $27,375.64 $27,082.33 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 4 4 — — $26,376.83 $27,152.62 $26,861.70 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 4 4 — — $26,324.31 $27,098.56 $26,808.22 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 4 4 — — $26,097.44 $26,865.02 $26,577.17 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 4 — — $26,090.89 $26,858.26 $26,570.50 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 4 4 — — $25,974.17 $26,738.11 $26,451.64 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 4 4 — — $25,851.61 $26,611.96 $26,326.83 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 4 4 — — $25,734.91 $26,491.82 $26,207.97 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 4 4 — — $25,537.94 $26,289.06 $26,007.40 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 7 4 — — $21,318.93 $28,216.40 $25,912.07 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 7 4 — — $6,461.89 $26,255.27 $25,505.12 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 4 4 — — $24,747.93 $25,475.81 $25,202.86 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 6 4 — — $22,903.77 $25,755.90 $25,142.67 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 4 4 — — $24,666.23 $25,391.71 $25,119.65 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 4 4 — — $24,663.31 $25,388.71 $25,116.68 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 4 4 — — $24,379.55 $25,096.60 $24,827.71 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 4 4 — — $24,275.24 $24,989.21 $24,721.47 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 4 4 — — $24,248.98 $24,962.19 $24,694.74 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 4 4 — — $24,216.15 $24,928.39 $24,661.29 2026-04-01
652 MS_DRG Kidney Transplant 4 4 — — $24,209.59 $24,921.63 $24,654.62 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 4 4 — — $24,192.07 $24,903.61 $24,636.78 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 4 4 — — $24,146.12 $24,856.30 $24,589.99 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 5 4 — — $23,941.87 $27,077.03 $24,587.36 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 5 4 — — $23,898.83 $72,925.33 $24,543.17 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 4 4 — — $23,876.22 $24,578.46 $24,315.12 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 5 4 — — $15,859.77 $24,778.20 $24,306.24 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 5 4 — — $23,636.95 $25,725.61 $24,274.22 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 4 4 — — $23,829.54 $24,530.40 $24,267.58 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 4 4 — — $23,737.62 $24,435.79 $24,173.98 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 4 4 — — $23,702.61 $24,399.74 $24,138.32 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 4 4 — — $23,626.02 $24,320.90 $24,060.32 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 4 4 — — $23,572.03 $24,265.32 $24,005.33 2026-04-01
665 MS_DRG Prostatectomy With Mcc 4 4 — — $23,419.58 $24,108.39 $23,850.08 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 4 4 — — $23,332.04 $24,018.28 $23,760.94 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 5 4 — — $22,975.24 $24,059.57 $23,601.30 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 5 4 — — $16,861.73 $23,660.08 $23,209.41 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 4 4 — — $22,685.00 $23,352.21 $23,102.01 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 4 4 — — $22,682.08 $23,349.20 $23,099.03 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 4 4 — — $22,658.00 $23,324.42 $23,074.51 2026-04-01
263 MS_DRG Vein Ligation And Stripping 6 4 — — $9,791.12 $23,629.29 $23,066.69 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0796T OTHER Tcat Ins 2chmbr Ldls Pm Ra 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
0823T OTHER Tcat Ins 1chmbr Ldls Pm Ra 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 7 4 — — $22,312.01 $77,716.86 $22,968.25 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 6 4 — — $6,884.78 $23,447.57 $22,889.29 2026-04-01
0888T OTHER Histotripsy Mal Renal Tissue 8 4 — — $17,182.19 $59,848.73 $22,844.17 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 4 4 — — $22,363.31 $23,021.05 $22,774.40 2026-04-01
570 MS_DRG Skin Debridement With Mcc 5 4 — — $22,105.81 $23,049.08 $22,701.80 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 4 4 — — $22,142.27 $22,793.52 $22,549.30 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 4 4 — — $22,127.69 $22,778.50 $22,534.44 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 4 4 — — $21,951.89 $22,597.53 $22,355.42 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 4 4 — — $21,895.72 $22,539.71 $22,298.21 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 4 4 — — $21,820.58 $22,462.37 $22,221.69 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 4 4 — — $21,807.45 $22,448.84 $22,208.32 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 4 4 — — $21,714.08 $22,352.73 $22,113.23 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 4 4 — — $21,673.23 $22,310.67 $22,071.63 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 7 4 — — $20,690.52 $22,440.95 $21,975.75 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 5 4 — — $1,425.53 $22,342.22 $21,916.65 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 6 4 — — $20,940.61 $22,075.64 $21,691.29 2026-04-01
800 MS_DRG Splenic Procedures With Cc 4 4 — — $21,145.09 $21,767.00 $21,533.78 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 4 4 — — $21,071.42 $21,691.16 $21,458.76 2026-04-01
503 MS_DRG Foot Procedures With Mcc 4 4 — — $21,011.60 $21,629.59 $21,397.85 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 4 4 — — $20,871.55 $21,485.42 $21,255.21 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 4 4 — — $20,763.58 $21,374.27 $21,145.26 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 6 4 — — $18,286.02 $77,081.87 $21,082.86 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 4 4 — — $20,697.20 $21,305.94 $21,077.66 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 5 4 — — $20,498.79 $23,832.43 $21,051.45 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 4 4 — — $20,593.62 $21,199.31 $20,972.17 2026-04-01
849 MS_DRG Radiotherapy 4 4 — — $20,416.36 $21,016.84 $20,791.66 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 4 4 — — $20,392.29 $20,992.06 $20,767.15 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 4 4 — — $20,328.09 $20,925.98 $20,701.77 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 4 4 — — $20,055.27 $20,645.13 $20,423.93 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 4 4 — — $19,987.43 $20,575.30 $20,354.85 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 4 4 — — $19,890.41 $20,475.42 $20,256.04 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 4 4 — — $19,585.49 $20,161.53 $19,945.51 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 4 4 — — $19,562.88 $20,138.25 $19,922.49 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0803T OTHER Tcat Rmv&rpl2chmb Ldls Pm Rv 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0795T OTHER Tcat Ins 2chmbr Ldls Pm Cmpl 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0525T OTHER Insj/rplcmt Compl Iims 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0802T OTHER Tcat Rmv&rpl2chmb Ldls Pm Ra 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0801T OTHER Tcat Rmv&rpl 2chmbr Ldls Pm 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0825T OTHER Tcat Rmv&rpl1chmb Ldls Pm Ra 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
0797T OTHER Tcat Ins 2chmbr Ldls Pm Rv 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 7 4 — — $19,320.95 $67,298.45 $19,889.22 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 4 4 — — $19,465.86 $20,038.39 $19,823.69 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 4 4 — — $19,465.86 $20,038.39 $19,823.69 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 4 4 — — $19,381.24 $19,951.28 $19,737.52 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 5 4 — — $16,863.73 $20,065.42 $19,683.22 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 4 4 — — $19,274.74 $19,841.64 $19,629.05 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 4 4 — — $19,186.48 $19,750.78 $19,539.17 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 4 4 — — $19,063.20 $19,623.88 $19,413.62 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 4 4 — — $19,055.17 $19,615.62 $19,405.45 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 5 4 — — $17,593.19 $19,714.74 $19,339.22 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 1 1 — — $19,244.72 $19,244.72 $19,244.72 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 4 4 — — $18,829.04 $19,382.83 $19,175.16 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 4 4 — — $18,754.63 $19,306.23 $19,099.39 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 4 4 — — $18,590.50 $19,137.28 $18,932.24 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 4 4 — — $18,585.39 $19,132.02 $18,927.03 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 1 1 — — $18,903.57 $18,903.57 $18,903.57 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 4 4 — — $18,560.59 $19,106.49 $18,901.78 2026-04-01
792 MS_DRG Prematurity Without Major Problems 4 4 — — $18,517.55 $19,062.18 $18,857.94 2026-04-01
0686T OTHER Histotripsy Mal Hepatcel Tis 8 4 — — $17,182.19 $59,848.73 $18,844.17 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 4 4 — — $18,481.08 $19,024.65 $18,820.81 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 4 4 — — $18,459.93 $19,002.87 $18,799.26 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 4 4 — — $18,320.60 $18,859.44 $18,657.38 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 5 4 — — $18,121.45 $21,948.37 $18,610.02 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 4 4 — — $18,262.97 $18,800.11 $18,598.68 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 4 4 — — $18,197.32 $18,732.54 $18,531.83 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 4 4 — — $18,089.35 $18,621.39 $18,421.88 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 7 4 — — $15,760.90 $45,827.41 $18,316.06 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 5 4 — — $17,225.13 $18,590.61 $18,236.50 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 5 4 — — $17,710.76 $42,857.09 $18,188.26 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 4 4 — — $17,801.95 $18,325.53 $18,129.19 2026-04-01
23472 HCPCS Reconstruct Shoulder Joint 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27487 HCPCS Revise/replace Knee Joint 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
0790T OTHER Revj Rplcmt/rmvl Vrt Tethrg 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27290 HCPCS Amputation Of Leg At Hip 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27295 HCPCS Amputation Of Leg At Hip 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27703 HCPCS Reconstruction Ankle Joint 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27278 HCPCS Arthrd Si Jt Prq Wo Tfxj Dev 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27279 HCPCS Arthrodesis Sacroiliac Joint 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
27280 HCPCS Fusion Of Sacroiliac Joint 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
20802 HCPCS Replantation Arm Complete 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
22867 HCPCS Insj Stablj Dev W/dcmprn 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
0656T OTHER Vrt Bdy Tethering Ant 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
22862 HCPCS Revise Lumbar Artif Disc 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
20982 HCPCS Ablate Bone Tumor(s) Perq 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
22861 HCPCS Revise Cerv Artific Disc 7 4 — — $17,587.76 $61,261.42 $18,105.05 2026-04-01
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