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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

RIVERSIDE SHORE MEMORIAL HOSPITAL

Onancock, VA · CCN 490037 · Rates published

21,499 distinct procedures filed
10 distinct payers
575,164 rate rows
2026-01-02 last MRF observed
Data quality

552,190 of 575,164 rate rows are consumer-grade (96.0%)

22,974 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 10,312
template filing: same amount across many unrelated codes — excluded 3,880
placeholder amount (≤ $0.02) — excluded from medians 3,854
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 2,932
exceeds 10× this hospital's gross charge — excluded from medians 1,858
per-diem day rate — not a per-procedure price 114
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 24
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://riverside.pt.panaceainc.com/MRFDownload/riverside/RSMH
Found on page https://www.riversideonline.com/patients-and-visitors/paying-for-healthcare-services
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-18
Content fingerprint ffa2c07e018224c5… · 110,967,211 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $52,100.68 $4,596,375.00 $4,421,275.00 nat. median
$4,505,000
1.0× median
C9172
HCPCS 		Inj, Beqvez, Per Tx Dose 6 $32,603.97 $3,895,500.00 $3,710,000.00 nat. median
$3,605,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $32,603.97 $3,869,530.00 $3,685,266.67 nat. median
$3,703,693
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $32,603.97 $3,490,800.50 $3,320,517.25 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $52,100.68 $4,864,830.00 $3,261,355.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $52,100.68 $4,394,040.00 $2,950,686.67 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,452,115.60 $4,545,204.82 $2,525,679.07 nat. median
$2,466,282
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $52,100.68 $3,452,460.00 $2,332,000.00 nat. median
$2,401,960
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 6 $52,100.68 $1,140,881.10 $778,326.20 nat. median
$809,217
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $52,100.68 $1,036,481.36 $589,891.07 nat. median
$738,272
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $52,100.68 $1,014,991.10 $565,157.68 nat. median
$646,415
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $52,100.68 $948,121.24 $552,468.37 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $52,100.68 $969,380.60 $552,085.66 nat. median
$622,245
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $52,100.68 $918,762.90 $533,230.17 nat. median
$608,101
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $52,100.68 $898,880.00 $489,720.00 nat. median
$591,650
0.8× median
5831
APR_DRG 		Neonate With Ecmo 5 $183,326.28 $508,848.07 $366,597.75 nat. median
$146,591
outlier · 2.5×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 5 $55,436.09 $466,015.30 $318,520.08 nat. median
$93,998
outlier · 3.4×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $52,100.68 $283,893.75 $273,078.75 nat. median
$319,951
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 9 $215,099.48 $505,295.64 $229,430.02 nat. median
$198,433
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $177,025.88 $232,040.07 $207,490.67 nat. median
$97,414
outlier · 2.1×
1611
APR_DRG 		Implantable Heart Assist Systems 5 $149,103.65 $348,169.01 $160,800.02 nat. median
$76,852
outlier · 2.1×
111
APR_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 6 $59,949.95 $315,585.36 $153,605.35 nat. median
$34,378
outlier · 4.5×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization With Mcc 5 $127,016.50 $166,489.32 $148,875.07 nat. median
$71,758
outlier · 2.1×
5911
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $88,501.21 $265,820.75 $138,770.40 nat. median
$37,270
outlier · 3.7×
6091
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $55,547.01 $300,804.96 $138,401.65 nat. median
$33,663
outlier · 4.1×
5931
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $33,541.43 $232,050.56 $130,402.63 nat. median
$32,930
outlier · 4.0×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 5 $120,964.75 $359,488.32 $127,012.99 nat. median
$120,505
1.1× median
6021
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 5 $30,063.71 $156,554.72 $120,872.10 nat. median
$31,231
outlier · 3.9×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 5 $100,659.00 $131,940.72 $117,981.64 nat. median
$56,686
outlier · 2.1×
461
MS_DRG 		Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 5 $99,721.38 $130,711.71 $116,882.65 nat. median
$53,342
outlier · 2.2×
266
MS_DRG 		Endovascular Cardiac Valve Replacement W Mcc 5 $97,350.50 $127,604.04 $114,103.77 nat. median
$58,331
2.0× median
6301
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 5 $39,126.67 $315,108.58 $110,369.61 nat. median
$24,196
outlier · 4.6×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $106,120.90 $106,120.90 $106,120.90 nat. median
$111,503
1.0× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 3 $45,737.00 $106,594.08 $103,294.46 nat. median
$75,037
1.4× median
234
MS_DRG 		Coronary Bypass With Cardiac Catheterization Without Mcc 5 $86,453.25 $113,320.26 $101,331.19 nat. median
$51,613
2.0× median
41
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 5 $68,567.92 $202,103.24 $97,929.17 nat. median
$42,769
outlier · 2.3×
91
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 5 $60,182.23 $210,594.44 $97,127.01 nat. median
$46,507
outlier · 2.1×
8411
APR_DRG 		Extensive Third Degree Burns With Skin Graft 5 $61,014.80 $295,048.71 $93,893.32 nat. median
$31,407
outlier · 3.0×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 1 $93,216.70 $93,216.70 $93,216.70 nat. median
$97,020
1.0× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement Without Mcc 5 $76,451.38 $100,210.11 $89,608.07 nat. median
$45,888
2.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 9 $69,140.24 $171,701.43 $89,102.26 nat. median
$74,460
1.2× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 7 $57,593.14 $150,527.10 $87,655.77 nat. median
$66,649
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 9 $76,800.17 $225,669.24 $86,846.30 nat. median
$93,917
0.9× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $74,342.03 $205,568.43 $82,527.10 nat. median
$90,581
0.9× median
6031
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 5 $28,655.66 $207,590.94 $79,524.80 nat. median
$14,366
outlier · 5.5×
6311
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $12,138.75 $251,340.37 $77,793.77 nat. median
$9,481
outlier · 8.2×
6071
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 5 $45,393.10 $122,792.74 $77,170.88 nat. median
$31,928
outlier · 2.4×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 9 $52,127.71 $137,553.27 $76,699.15 nat. median
$62,038
1.2× median
51
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 $46,097.78 $147,309.91 $75,824.78 nat. median
$34,315
outlier · 2.2×
739
MS_DRG 		Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 5 $64,689.63 $84,793.17 $75,822.21 nat. median
$34,656
outlier · 2.2×

Other procedures at this hospital

Browse this hospital's 21,499 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
0266T OTHER Implt/rpl Crtd Sns Dev Total 26 8 — — $26,327.72 $45,115.75 $41,325.75 2026-01-02
0268T OTHER Implt/rpl Crtd Sns Dev Gen 30 8 — — $24,996.65 $120,614.15 $29,096.79 2026-01-02
0408T OTHER Insj/rplc Cardiac Modulj Sys 26 6 — — $10,752.78 $126,899.40 $31,225.30 2026-01-02
0409T OTHER Insj/rplc Car Modulj Pls Gn 26 6 — — $21,432.07 $88,841.80 $30,442.86 2026-01-02
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 26 6 — — $21,432.07 $88,841.80 $30,442.86 2026-01-02
0451T OTHER Insj/rplcmt Aortic Ventr Sys 10 5 — — $42,861.43 $45,004.50 $42,861.43 2026-01-02
0452T OTHER Insj/rplcmt Dev Vasc Seal 10 5 — — $42,861.43 $45,004.50 $42,861.43 2026-01-02
0453T OTHER Insj/rplcmt Mech-elec Ntrfce 10 5 — — $42,861.43 $45,004.50 $42,861.43 2026-01-02
0454T OTHER Insj/rplcmt Subq Electrode 10 5 — — $42,861.43 $45,004.50 $42,861.43 2026-01-02
0459T OTHER Relocaj Rplcmt Aortic Ventr 10 5 — — $42,861.43 $45,004.50 $42,861.43 2026-01-02
0571T OTHER Insj/rplcmt Icds Ss Eltrd 26 6 — — $30,442.86 $126,899.40 $31,531.43 2026-01-02
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 26 6 — — $21,432.07 $88,841.80 $30,442.86 2026-01-02
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 22 6 — — $14,919.44 $35,090.14 $33,419.18 2026-01-02
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 26 6 — — $8,471.12 $120,614.15 $29,678.73 2026-01-02
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 26 6 — — $30,442.86 $126,899.40 $31,531.43 2026-01-02
0916T OTHER Insj Perm Ccm-d Sys Pg Only 26 6 — — $21,432.07 $88,841.80 $30,442.86 2026-01-02
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 26 6 — — $21,432.07 $88,841.80 $30,442.86 2026-01-02
0951T OTHER Tot Impl Amei 1st Plmt 10 5 — — $33,072.62 $34,726.25 $33,072.62 2026-01-02
0952T OTHER Tot Impl Amei Rev/rplc Mstdc 10 5 — — $33,072.62 $34,726.25 $33,072.62 2026-01-02
1101 APR_DRG Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies 40 5 — — $11,128.71 $40,754.15 $30,089.03 2026-01-02
111 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 52 6 — — $59,949.95 $315,585.36 $153,605.35 2026-01-02
1301 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 40 5 — — $36,330.14 $76,328.92 $45,361.58 2026-01-02
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 24 7 — — $21,860.38 $51,356.43 $31,066.89 2026-01-02
140 MS_DRG Major Head And Neck Procedures With Mcc 24 7 — — $31,038.72 $90,081.96 $50,657.58 2026-01-02
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 24 7 — — $27,350.27 $70,330.47 $41,186.83 2026-01-02
1601 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 40 5 — — $26,204.94 $279,654.40 $49,395.58 2026-01-02
1611 APR_DRG Implantable Heart Assist Systems 40 5 — — $149,103.65 $348,169.01 $160,800.02 2026-01-02
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 40 5 — — $46,409.66 $100,630.97 $63,764.03 2026-01-02
163 MS_DRG Major Chest Procedures With Mcc 28 9 — — $27,700.37 $98,175.96 $40,210.81 2026-01-02
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 40 5 — — $33,601.46 $88,570.38 $47,828.39 2026-01-02
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 40 5 — — $31,898.49 $69,139.43 $41,420.21 2026-01-02
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 28 9 — — $33,318.63 $82,011.39 $41,517.41 2026-01-02
1661 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 40 5 — — $25,023.95 $51,071.84 $36,644.86 2026-01-02
1671 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 40 5 — — $24,314.05 $77,368.91 $41,854.79 2026-01-02
1691 APR_DRG Major Abdominal Vascular Procedures 40 5 — — $27,773.50 $78,799.41 $33,750.58 2026-01-02
1701 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 40 5 — — $22,237.85 $54,926.24 $30,715.34 2026-01-02
1761 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 40 5 — — $18,608.75 $61,329.23 $30,554.93 2026-01-02
1771 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 40 5 — — $14,646.89 $83,227.93 $48,975.08 2026-01-02
1781 APR_DRG External Heart Assist Systems 40 5 — — $52,783.10 $74,850.46 $67,619.21 2026-01-02
1791 APR_DRG Defibrillator Implants 40 5 — — $35,498.88 $67,025.19 $48,560.40 2026-01-02
1831 APR_DRG Percutaneous Structural Cardiac Procedures 40 5 — — $38,732.57 $80,125.77 $45,836.20 2026-01-02
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 28 9 — — $69,140.24 $171,701.43 $89,102.26 2026-01-02
201 APR_DRG Open Craniotomy For Trauma 40 5 — — $25,157.05 $92,764.59 $34,878.14 2026-01-02
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 28 9 — — $48,966.45 $137,751.36 $58,813.46 2026-01-02
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 28 9 — — $50,302.64 $117,731.49 $69,915.36 2026-01-02
211 APR_DRG Open Craniotomy Except Trauma 40 5 — — $22,591.50 $73,067.82 $36,967.39 2026-01-02
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 5 — — $177,025.88 $232,040.07 $207,490.67 2026-01-02
215 MS_DRG Other Heart Assist System Implant 28 9 — — $76,800.17 $225,669.24 $86,846.30 2026-01-02
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 9 — — $74,342.03 $205,568.43 $82,527.10 2026-01-02
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 9 — — $52,127.71 $137,553.27 $76,699.15 2026-01-02
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 9 — — $46,677.76 $126,720.09 $49,684.48 2026-01-02
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 9 — — $56,643.87 $164,808.75 $65,622.46 2026-01-02
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 28 9 — — $28,581.92 $75,197.52 $33,910.44 2026-01-02
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 9 — — $39,242.06 $112,819.71 $44,712.27 2026-01-02
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 9 — — $30,065.89 $97,822.38 $39,659.79 2026-01-02
228 MS_DRG Other Cardiothoracic Procedures With Mcc 28 9 — — $41,314.22 $106,144.29 $49,356.50 2026-01-02
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 28 9 — — $26,160.18 $66,164.19 $32,799.03 2026-01-02
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 28 9 — — $46,039.36 $121,518.63 $49,131.46 2026-01-02
231 MS_DRG Coronary Bypass With Ptca With Mcc 28 9 — — $66,391.63 $180,494.07 $70,724.02 2026-01-02
231 APR_DRG Spinal Procedures 40 5 — — $15,255.00 $75,495.83 $31,929.48 2026-01-02
232 MS_DRG Coronary Bypass With Ptca Without Mcc 28 9 — — $48,731.07 $130,115.31 $58,772.01 2026-01-02
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 12 5 — — $127,016.50 $166,489.32 $148,875.07 2026-01-02
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 12 5 — — $86,453.25 $113,320.26 $101,331.19 2026-01-02
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 28 9 — — $45,787.46 $125,333.46 $50,103.85 2026-01-02
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 28 9 — — $33,183.32 $87,587.73 $36,437.64 2026-01-02
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 28 9 — — $32,009.88 $107,285.97 $41,000.90 2026-01-02
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 28 9 — — $31,125.94 $80,976.21 $35,046.46 2026-01-02
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 28 9 — — $26,863.94 $72,249.60 $29,542.10 2026-01-02
245 MS_DRG Aicd Generator Procedures 28 9 — — $37,179.08 $104,088.84 $39,547.49 2026-01-02
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 24 7 — — $36,238.42 $95,259.99 $55,362.61 2026-01-02
252 MS_DRG Other Vascular Procedures With Mcc 28 9 — — $27,580.13 $73,067.52 $36,617.50 2026-01-02
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 24 7 — — $24,313.92 $65,148.18 $37,615.93 2026-01-02
264 MS_DRG Other Circulatory System O.r. Procedures 28 9 — — $26,864.45 $74,445.63 $30,853.67 2026-01-02
2641 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 40 5 — — $12,960.88 $43,069.81 $29,123.88 2026-01-02
265 MS_DRG Aicd Lead Procedures 28 9 — — $29,049.81 $75,981.36 $30,871.68 2026-01-02
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 12 5 — — $97,350.50 $127,604.04 $114,103.77 2026-01-02
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 12 5 — — $76,451.38 $100,210.11 $89,608.07 2026-01-02
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 28 9 — — $38,620.48 $142,019.88 $58,361.62 2026-01-02
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 28 9 — — $29,671.02 $88,622.91 $35,505.89 2026-01-02
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 24 7 — — $20,073.62 $52,564.14 $30,589.53 2026-01-02
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 28 9 — — $34,872.52 $109,332.90 $43,121.08 2026-01-02
271 APR_DRG Other Open Craniotomy 40 5 — — $20,301.29 $73,878.98 $31,880.68 2026-01-02
271 MS_DRG Other Major Cardiovascular Procedures With Cc 28 9 — — $27,746.30 $73,365.72 $29,830.74 2026-01-02
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 12 5 — — $63,542.38 $83,289.39 $74,477.53 2026-01-02
274 MS_DRG Percutaneous Intracardiac Procedures Without Mcc 12 5 — — $50,716.25 $66,477.30 $59,444.12 2026-01-02
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 24 7 — — $57,593.14 $150,527.10 $87,655.77 2026-01-02
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 12 5 — — $100,659.00 $131,940.72 $117,981.64 2026-01-02
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 24 7 — — $39,225.05 $99,085.47 $58,389.84 2026-01-02
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 7 — — $36,600.34 $106,570.29 $59,867.00 2026-01-02
27800571-19-4409 CDM C-defib,dual Chamber Implant 44 10 $65,841.60 $32,920.80 50% off $13,695.05 $47,636.40 $30,665.72 2026-01-02
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 7 — — $26,331.36 $68,253.72 $39,859.71 2026-01-02
28 MS_DRG Spinal Procedures With Mcc 28 9 — — $31,578.71 $129,493.35 $51,337.30 2026-01-02
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 28 9 — — $19,887.37 $71,497.71 $29,314.06 2026-01-02
291 APR_DRG Other Percutaneous Intracranial Procedures 40 5 — — $20,114.68 $58,849.15 $31,328.06 2026-01-02
301 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 40 5 — — $19,026.34 $54,175.36 $30,198.61 2026-01-02
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 40 5 — — $48,915.19 $106,403.66 $54,163.75 2026-01-02
3041 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 40 5 — — $27,643.01 $93,483.95 $41,920.73 2026-01-02
31 MS_DRG Ventricular Shunt Procedures With Mcc 24 7 — — $33,797.93 $89,259.78 $51,792.54 2026-01-02
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 28 9 — — $35,797.44 $93,566.64 $38,072.74 2026-01-02
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mmc Or 4+ A… 12 5 — — $46,260.50 $60,636.84 $54,221.57 2026-01-02
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 28 9 — — $33,988.67 $90,725.22 $49,318.83 2026-01-02
3251 APR_DRG Non-elective Or Complex Knee Joint Replacement 40 5 — — $24,488.91 $56,044.33 $29,618.72 2026-01-02
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 7 — — $41,642.72 $108,182.70 $63,129.31 2026-01-02
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 24 7 — — $20,599.38 $51,718.53 $30,542.99 2026-01-02
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 28 9 — — $33,694.57 $97,807.47 $38,542.47 2026-01-02
332 MS_DRG Rectal Resection With Mcc 28 9 — — $29,811.95 $73,883.31 $31,802.99 2026-01-02
33276 HCPCS Insj Phrnc Nrv Stim Sys 30 8 — — $535.94 $45,115.75 $38,019.69 2026-01-02
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 30 8 — — $24,996.65 $120,614.15 $29,096.79 2026-01-02
335 MS_DRG Peritoneal Adhesiolysis With Mcc 28 9 — — $20,937.89 $77,178.42 $30,558.53 2026-01-02
33975 HCPCS Implant Ventricular Device 18 5 — — $1,190.19 $45,004.50 $42,861.43 2026-01-02
33979 HCPCS Insert Intracorporeal Device 14 5 — — $1,768.15 $45,004.50 $42,861.43 2026-01-02
33981 HCPCS Replace Vad Pump Ext 14 5 — — $752.38 $45,004.50 $42,861.43 2026-01-02
33982 HCPCS Replace Vad Intra Without Bp 14 5 — — $1,768.89 $45,004.50 $42,861.43 2026-01-02
33983 HCPCS Replace Vad Intra W/bp 14 5 — — $2,080.76 $45,004.50 $42,861.43 2026-01-02
33991 HCPCS Insj Perq Vad L Hrt Artl&ven 14 5 — — $412.87 $45,004.50 $42,861.43 2026-01-02
34 MS_DRG Carotid Artery Stent Procedures With Mcc 28 9 — — $24,922.92 $82,829.31 $33,325.52 2026-01-02
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 24 7 — — $19,805.44 $51,518.31 $30,049.79 2026-01-02
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 24 7 — — $24,079.16 $62,472.90 $36,472.18 2026-01-02
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 28 9 — — $28,159.69 $90,859.41 $36,524.02 2026-01-02
36100032-19-2275 CDM Ins Pulse Gen W Exist Dual Leads 42 10 $87,472.67 $43,736.34 50% off $5,087.00 $87,472.67 $30,442.86 2026-01-02
36100033-19-2274 CDM Inspulse Gen W Exist Multiple Leads 42 10 $87,472.67 $43,736.34 50% off $5,087.00 $87,472.67 $31,531.43 2026-01-02
36100037-19-2270 CDM Ins Defib Pls Gen W Existing Sgl Lead 42 10 $83,536.76 $41,768.38 50% off $13,680.00 $83,536.76 $30,442.86 2026-01-02
36100040-19-2267 CDM Ins/Rplcmt Icd Sngl/Dual Implant 42 10 $110,632.25 $55,316.13 50% off $13,680.00 $110,632.25 $31,531.43 2026-01-02
36100041-19-2266 CDM Icd Single Gen Change 42 10 $85,971.71 $42,985.86 50% off $5,087.00 $85,971.71 $30,442.86 2026-01-02
36100042-19-2265 CDM Icd Dual Gen Change 42 10 $85,971.71 $42,985.86 50% off $5,087.00 $85,971.71 $30,442.86 2026-01-02
36100043-19-2264 CDM Icd Biv Gen Change 42 10 $85,971.71 $42,985.86 50% off $5,087.00 $85,971.71 $31,531.43 2026-01-02
36100044-19-2263 CDM Ins/Rpl Subq Defib With Electrodes 42 10 $104,570.52 $52,285.26 50% off $5,087.00 $104,570.52 $31,531.43 2026-01-02
37 MS_DRG Extracranial Procedures With Mcc 28 9 — — $27,757.83 $70,735.17 $29,492.58 2026-01-02
38240 HCPCS Transplt Allo Hct/donor 30 8 — — $5,678.13 $234,084.74 $56,470.28 2026-01-02
398 MS_DRG Appendix Procedures Without Mcc/cc 12 5 — — $24,589.50 $32,231.16 $28,821.17 2026-01-02
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 28 9 — — $25,583.02 $80,345.73 $32,894.03 2026-01-02
4011 APR_DRG Adrenal Procedures 40 5 — — $10,630.22 $74,801.13 $32,080.36 2026-01-02
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 28 9 — — $45,116.79 $115,631.31 $52,616.96 2026-01-02
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 28 9 — — $30,583.06 $74,577.69 $45,348.95 2026-01-02
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 40 5 — — $68,567.92 $202,103.24 $97,929.17 2026-01-02
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 28 9 — — $28,977.26 $74,630.94 $30,794.17 2026-01-02
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 28 9 — — $32,121.21 $86,635.62 $63,632.72 2026-01-02
4401 APR_DRG Kidney Transplant 66 8 — — $24,732.08 $111,387.11 $63,270.84 2026-01-02
4411 APR_DRG Major Bladder Procedures 40 5 — — $15,724.79 $81,161.65 $29,322.49 2026-01-02
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 9 — — $45,343.70 $180,393.96 $71,710.87 2026-01-02
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 9 — — $47,924.07 $122,249.22 $51,884.03 2026-01-02
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 9 — — $36,257.92 $91,973.40 $39,005.04 2026-01-02
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 12 5 — — $99,721.38 $130,711.71 $116,882.65 2026-01-02
462 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity Without Mcc 12 5 — — $46,536.75 $60,998.94 $54,545.36 2026-01-02
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 28 9 — — $40,703.76 $115,041.30 $48,265.12 2026-01-02
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 28 9 — — $42,519.80 $108,514.98 $58,539.12 2026-01-02
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 28 9 — — $27,784.82 $72,956.76 $29,980.25 2026-01-02
469 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity W Mcc 12 5 — — $53,116.38 $69,623.31 $62,257.29 2026-01-02
470 MS_DRG Major Joint Replacement Or Reattachment Of Lower Extremity Without Mcc 12 5 — — $30,639.38 $40,161.15 $35,912.18 2026-01-02
471 MS_DRG Cervical Spinal Fusion With Mcc 28 9 — — $30,913.43 $103,460.49 $41,952.06 2026-01-02
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 28 9 — — $35,315.70 $95,524.11 $37,558.62 2026-01-02
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 28 9 — — $23,710.89 $73,250.70 $28,812.19 2026-01-02
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 24 7 — — $24,279.68 $62,643.30 $36,642.46 2026-01-02
483 MS_DRG Major Joint/limb Reattachment Procedure Of Upper Extremities 12 5 — — $41,408.25 $54,276.66 $48,534.29 2026-01-02
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 28 9 — — $27,087.68 $68,571.09 $28,782.62 2026-01-02
491 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 40 5 — — $11,187.43 $56,240.27 $29,568.22 2026-01-02
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 24 7 — — $28,462.92 $75,640.56 $43,796.54 2026-01-02
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 24 7 — — $19,819.30 $51,141.30 $29,913.26 2026-01-02
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 28 9 — — $29,433.73 $74,988.78 $31,281.10 2026-01-02
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 40 5 — — $46,097.78 $147,309.91 $75,824.78 2026-01-02
510 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Mcc 12 5 — — $46,444.13 $60,877.53 $54,436.80 2026-01-02
511 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc W Cc 12 5 — — $31,869.50 $41,773.56 $37,354.00 2026-01-02
512 MS_DRG Shoulder,elbow Or Forearm Proc,exc Major Joint Proc Without Cc/mcc 12 5 — — $26,126.75 $34,246.14 $30,622.97 2026-01-02
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 28 9 — — $26,615.02 $76,339.20 $31,209.58 2026-01-02
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 28 9 — — $16,092.54 $42,866.25 $32,356.51 2026-01-02
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 28 9 — — $50,927.84 $131,169.66 $54,220.48 2026-01-02
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 28 9 — — $13,782.76 $73,802.37 $29,124.16 2026-01-02
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 28 9 — — $46,566.91 $114,919.89 $49,566.15 2026-01-02
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 28 9 — — $20,291.87 $69,425.22 $28,585.01 2026-01-02
5831 APR_DRG Neonate With Ecmo 40 5 — — $183,326.28 $508,848.07 $366,597.75 2026-01-02
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 30 5 — — $120,964.75 $359,488.32 $127,012.99 2026-01-02
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 40 5 — — $55,436.09 $466,015.30 $318,520.08 2026-01-02
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 40 5 — — $88,501.21 $265,820.75 $138,770.40 2026-01-02
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 40 5 — — $33,541.43 $232,050.56 $130,402.63 2026-01-02
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 40 5 — — $30,063.71 $156,554.72 $120,872.10 2026-01-02
6031 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 40 5 — — $28,655.66 $207,590.94 $79,524.80 2026-01-02
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 40 5 — — $45,393.10 $122,792.74 $77,170.88 2026-01-02
6081 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 40 5 — — $23,955.18 $88,018.18 $55,685.10 2026-01-02
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 30 5 — — $55,547.01 $300,804.96 $138,401.65 2026-01-02
6111 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 40 5 — — $18,459.99 $98,564.69 $52,069.84 2026-01-02
6121 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 40 5 — — $33,014.23 $114,851.01 $58,633.01 2026-01-02
6131 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 40 5 — — $20,821.97 $116,341.79 $48,277.94 2026-01-02
6141 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 40 5 — — $16,586.06 $77,048.28 $36,107.90 2026-01-02
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 28 9 — — $32,502.69 $82,324.50 $40,485.16 2026-01-02
61886 HCPCS Implant Neurostim Arrays 30 8 — — $24,996.65 $120,614.15 $29,096.79 2026-01-02
6211 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 40 5 — — $11,953.45 $84,750.23 $32,865.14 2026-01-02
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 28 9 — — $31,425.91 $79,704.60 $33,407.28 2026-01-02
6221 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 40 5 — — $15,650.40 $43,909.75 $32,592.43 2026-01-02
6231 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 40 5 — — $12,582.44 $64,872.59 $36,918.35 2026-01-02
6251 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 40 5 — — $13,443.71 $93,023.56 $31,414.38 2026-01-02
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 28 9 — — $32,965.68 $84,043.41 $35,050.65 2026-01-02
6301 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 40 5 — — $39,126.67 $315,108.58 $110,369.61 2026-01-02
6311 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 40 5 — — $12,138.75 $251,340.37 $77,793.77 2026-01-02
63685 HCPCS Ins/rplc Spi Npg/rcvr Pocket 30 8 — — $24,996.65 $120,614.15 $29,096.79 2026-01-02
64568 HCPCS Opn Impltj Crnl Nrv Nea&pg 30 8 — — $24,996.65 $120,614.15 $29,096.79 2026-01-02
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 30 8 — — $24,996.65 $120,614.15 $29,096.79 2026-01-02
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 22 6 — — $36,902.75 $98,135.49 $38,747.89 2026-01-02
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 22 6 — — $28,432.76 $73,964.25 $29,854.40 2026-01-02
653 MS_DRG Major Bladder Procedures With Mcc 28 9 — — $44,370.14 $118,738.98 $47,221.87 2026-01-02
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 28 9 — — $27,635.91 $89,238.48 $31,601.23 2026-01-02
6901 APR_DRG Acute Leukemia 40 5 — — $14,808.70 $100,757.02 $42,262.56 2026-01-02
69930 HCPCS Implant Cochlear Device 30 8 — — $26,994.86 $125,895.04 $31,889.28 2026-01-02
70 MS_DRG Other Cerebrovascular Disorders With Mcc 12 5 — — $28,255.50 $37,036.44 $33,118.06 2026-01-02
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 28 9 — — $31,928.02 $83,870.88 $33,943.24 2026-01-02
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 12 5 — — $64,689.63 $84,793.17 $75,822.21 2026-01-02
740 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Cc 12 5 — — $29,547.38 $38,729.79 $34,632.25 2026-01-02
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 24 7 — — $49,150.86 $126,624.24 $74,105.70 2026-01-02
791 MS_DRG Prematurity With Major Problems 24 7 — — $33,643.87 $86,475.87 $50,649.72 2026-01-02
792 MS_DRG Prematurity Without Major Problems 24 7 — — $20,396.41 $52,178.61 $30,611.93 2026-01-02
793 MS_DRG Full Term Neonate With Major Problems 24 7 — — $34,553.55 $88,831.65 $52,025.93 2026-01-02
799 MS_DRG Splenic Procedures With Mcc 24 7 — — $40,628.70 $101,277.24 $59,962.82 2026-01-02
800 MS_DRG Splenic Procedures With Cc 24 7 — — $23,210.23 $62,063.94 $35,860.00 2026-01-02
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 28 9 — — $27,877.65 $76,356.24 $42,771.79 2026-01-02
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 28 9 — — $46,455.71 $124,014.99 $51,511.94 2026-01-02
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 28 9 — — $34,899.94 $99,673.35 $38,416.17 2026-01-02
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 28 9 — — $36,016.71 $101,718.15 $41,465.15 2026-01-02
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 24 7 — — $45,881.38 $117,731.49 $68,997.04 2026-01-02
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 28 9 — — $34,266.51 $106,653.36 $40,575.34 2026-01-02
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 28 9 — — $25,716.75 $67,925.70 $32,100.36 2026-01-02
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 30 5 — — $61,014.80 $295,048.71 $93,893.32 2026-01-02
8421 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 40 5 — — $17,089.78 $145,413.54 $36,471.27 2026-01-02
8501 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 40 5 — — $18,766.65 $107,920.48 $39,436.27 2026-01-02
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 28 9 — — $37,210.65 $106,527.69 $42,632.78 2026-01-02
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 28 9 — — $23,503.45 $96,097.08 $37,793.09 2026-01-02
8631 APR_DRG Neonatal Aftercare 40 5 — — $13,745.16 $99,569.05 $41,298.56 2026-01-02
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 28 9 — — $55,597.05 $148,173.45 $59,815.04 2026-01-02
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 14 6 — — $30,658.87 $74,662.40 $31,578.64 2026-01-02
8901 APR_DRG HIV With Multiple Major HIV Related Conditions 40 5 — — $10,812.91 $92,675.53 $36,662.71 2026-01-02
891 APR_DRG Major Cranial Or Facial Bone Procedures 40 5 — — $19,522.23 $69,749.17 $33,870.71 2026-01-02
896 MS_DRG Alcohol/drug Abuse Or Dependence Without Rehabilitation Therapy W Mcc 6 3 — — $33,710.54 $37,931.04 $34,000.81 2026-01-02
901 MS_DRG Wound Debridements For Injuries With Mcc 28 9 — — $35,519.48 $94,369.65 $37,776.30 2026-01-02
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 28 9 — — $27,798.89 $84,852.81 $31,783.49 2026-01-02
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 30 5 — — $60,182.23 $210,594.44 $97,127.01 2026-01-02
9101 APR_DRG Craniotomy For Multiple Significant Trauma 58 9 — — $33,691.50 $145,442.79 $51,874.78 2026-01-02
911 APR_DRG Other Major Head And Neck Procedures 40 5 — — $17,464.30 $74,542.16 $34,454.71 2026-01-02
9121 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 40 5 — — $20,972.04 $73,455.59 $31,229.66 2026-01-02
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 9 — — $215,099.48 $505,295.64 $229,430.02 2026-01-02
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 28 9 — — $35,111.08 $142,260.57 $58,912.65 2026-01-02
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 28 9 — — $23,828.68 $77,717.31 $30,962.89 2026-01-02
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 28 9 — — $31,854.66 $81,417.12 $63,401.75 2026-01-02
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 28 9 — — $59,196.50 $158,987.46 $66,320.56 2026-01-02
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 28 9 — — $33,212.67 $87,538.74 $35,778.01 2026-01-02
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 28 9 — — $56,262.85 $134,707.59 $59,914.20 2026-01-02
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 28 9 — — $28,047.08 $76,351.98 $31,083.27 2026-01-02
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 28 9 — — $38,592.33 $101,258.07 $41,155.85 2026-01-02
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 28 9 — — $27,766.80 $74,607.51 $30,556.99 2026-01-02
A9543 HCPCS Y90 Ibritumomab, Rx 32 7 — — $49,086.98 $130,953.16 $58,245.17 2026-01-02
A9545 HCPCS I131 Tositumomab, Rx 2 1 — — $45,605.41 $45,605.41 $45,605.41 2026-01-02
C9073 HCPCS Brexucabtagene Autoleucel Ca 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
C9076 HCPCS Lisocabtagene Car Pos T 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
C9081 HCPCS Idecabtagene Car Pos T 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
C9085 HCPCS Inj Avalglucosid Alfa-ngpt 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
C9098 HCPCS Ciltacabtagene Car Pos T 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
C9146 HCPCS Inj, Elahere, 1 Mg 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
C9149 HCPCS Inj, Teplizumab-mzwv, 5 Mcg 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
C9172 HCPCS Inj, Beqvez, Per Tx Dose 22 6 — — $32,603.97 $3,895,500.00 $3,710,000.00 2026-01-02
C9301 HCPCS Obecabtagene Car Pos T 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
C9304 HCPCS Inj Marstacimab, 0.5 Mg 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
C9309 HCPCS Inj Onase Abepar-brve Treat 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
G0448 HCPCS Place Perm Pacing Cardiovert 10 5 — — $30,442.86 $31,965.00 $30,442.86 2026-01-02
J1300 HCPCS Eculizumab Injection 14 5 — — $451.40 $34,234.17 $32,603.97 2026-01-02
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 24 7 — — $32,603.97 $3,869,530.00 $3,685,266.67 2026-01-02
J1413 HCPCS Inj Delandistrogene Mox Rokl 24 7 — — $32,603.97 $3,490,800.50 $3,320,517.25 2026-01-02
J3387 HCPCS Inj Elivaldogene Autotemecel 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
J3389 HCPCS Topi Adm Prad Zami Per Treat 10 5 — — $52,100.68 $54,705.71 $52,100.68 2026-01-02
J3391 HCPCS Inj, Atidarsagene Autotemcel 24 7 — — $52,100.68 $4,596,375.00 $4,421,275.00 2026-01-02
J3392 HCPCS Inj, Exagamglogene Autotem 26 7 — — $52,100.68 $3,452,460.00 $2,332,000.00 2026-01-02
J3393 HCPCS Inj, Betibeglogene Autotemce 26 7 — — $52,100.68 $4,394,040.00 $2,950,686.67 2026-01-02
J3394 HCPCS Inj, Lovotibeglogene Autotem 26 7 — — $52,100.68 $4,864,830.00 $3,261,355.00 2026-01-02
J3399 HCPCS Inj Onase Abepar-xioi Treat 16 7 — — $2,452,115.60 $4,545,204.82 $2,525,679.07 2026-01-02
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 12 6 — — $52,100.68 $205,640.00 $52,757.15 2026-01-02
J3403 HCPCS Revakinagene, Per Implant 12 6 — — $52,100.68 $257,500.00 $52,757.15 2026-01-02
J3404 HCPCS Inj Zopap Imad-drba 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
J7174 HCPCS Injection Fitusiran 0.04 Mg 12 6 — — $133.25 $34,234.17 $32,603.97 2026-01-02
J7330 HCPCS Cultured Chondrocytes Implnt 6 3 — — $45,737.00 $106,594.08 $103,294.46 2026-01-02
J9029 HCPCS Instill Adstiladrin, Tx Dose 32 7 — — $32,603.97 $127,010.80 $65,016.82 2026-01-02
J9183 HCPCS Gemcit Intraves Sys, 225 Mg 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
J9226 HCPCS Supprelin La Implant 36 8 — — $32,603.97 $90,981.66 $46,927.20 2026-01-02
J9266 HCPCS Pegaspargase Injection 26 8 — — $28,424.06 $53,472.66 $29,845.26 2026-01-02
J9376 HCPCS Inj Pozelimab-bbfg, 1 Mg 14 6 — — $91.73 $34,234.17 $32,603.97 2026-01-02
J9600 HCPCS Porfimer Sodium Injection 34 7 — — $24,228.42 $47,699.28 $32,603.97 2026-01-02
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 4 1 — — $93,216.70 $93,216.70 $93,216.70 2026-01-02
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 4 1 — — $37,828.21 $37,828.21 $37,828.21 2026-01-02
L6700 HCPCS Ue Add Ext Power Myoel 4 1 — — $28,931.56 $28,931.56 $28,931.56 2026-01-02
L7180 HCPCS Electronic Elbow Sequential 4 1 — — $41,907.21 $41,907.21 $41,907.21 2026-01-02
L7181 HCPCS Electronic Elbo Simultaneous 4 1 — — $47,211.27 $47,211.27 $47,211.27 2026-01-02
L8701 HCPCS Ewh S/d Uprt Micro Sensor 4 1 — — $34,284.44 $34,284.44 $34,284.44 2026-01-02
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 4 1 — — $67,452.66 $67,452.66 $67,452.66 2026-01-02
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 1 — — $106,120.90 $106,120.90 $106,120.90 2026-01-02
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 26 7 — — $52,100.68 $918,762.90 $533,230.17 2026-01-02
Q2042 HCPCS Tisagenlecleucel Car-pos T 26 7 — — $52,100.68 $1,036,481.36 $589,891.07 2026-01-02
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 34 8 — — $32,603.97 $110,907.14 $57,624.35 2026-01-02
Q2053 HCPCS Brexucabtagene Car Pos T 26 7 — — $52,100.68 $898,880.00 $489,720.00 2026-01-02
Q2054 HCPCS Lisocabtagene Mara Car Pos T 26 7 — — $52,100.68 $948,121.24 $552,468.37 2026-01-02
Q2055 HCPCS Idecabtagene Vicleucel Car 26 7 — — $52,100.68 $969,380.60 $552,085.66 2026-01-02
Q2056 HCPCS Ciltacabtagene Car-pos T 28 7 — — $52,100.68 $1,014,991.10 $565,157.68 2026-01-02
Q2057 HCPCS Afamitresgene Autoleucel 24 6 — — $52,100.68 $1,140,881.10 $778,326.20 2026-01-02
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 24 7 — — $52,100.68 $283,893.75 $273,078.75 2026-01-02
Q5139 HCPCS Inj, Eculizumab-aeeb, 10 Mg 10 5 — — $32,603.97 $34,234.17 $32,603.97 2026-01-02
S2235 HCPCS Implant Auditory Brain Imp 10 5 — — $33,072.62 $34,726.25 $33,072.62 2026-01-02
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