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Hospital

MARY IMMACULATE HOSPITAL

Newport News, VA · CCN 490041 · Rates published

859 distinct procedures filed
31 distinct payers
32,647 rate rows
2026-04-01 last MRF observed
Data quality

18,278 of 32,647 rate rows are consumer-grade (56.0%)

14,369 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 14,369
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.bonsecours.com/-/media/bon-secours/patients-and-visitors/corporate/pricing/540548200_mary-immaculate-hospital-llc_standardcharges.ashx
Found on page https://www.bonsecours.com/patient-resources/estimate-your-cost
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-17
Content fingerprint 6a487c0e898a781b… · 9,274,572 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
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $151,559.78 $339,016.00 $245,287.89 nat. median
$202,986
1.2× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 $52,113.38 $297,052.00 $105,146.13 nat. median
$68,090
1.5× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 23 $5,683.00 $137,318.67 $103,861.41 nat. median
$68,887
1.5× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 7 $49,935.11 $133,108.83 $100,677.28 nat. median
$66,526
1.5× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 $5,683.00 $128,675.59 $97,324.19 nat. median
$63,738
1.5× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 19 $5,683.00 $123,920.74 $93,727.84 nat. median
$62,134
1.5× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 $43,199.38 $248,167.00 $86,858.51 nat. median
$58,024
1.5× median
653
MS_DRG 		Major Bladder Procedures With Mcc 23 $37,755.82 $100,073.31 $75,690.76 nat. median
$51,418
1.5× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 29 $5,492.45 $109,762.11 $75,227.70 nat. median
$52,753
1.4× median
326
MS_DRG 		Stomach, Esophageal And Duodenal Procedures With Mcc 23 $36,271.93 $96,048.35 $72,646.47 nat. median
$48,178
1.5× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 24 $5,683.00 $95,278.02 $72,063.83 nat. median
$50,673
1.4× median
853
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 24 $5,683.00 $95,108.55 $71,935.65 nat. median
$48,170
1.5× median
239
MS_DRG 		Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 23 $35,805.45 $94,783.08 $71,689.48 nat. median
$47,740
1.5× median
576
MS_DRG 		Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 $3,099.00 $94,388.29 $71,390.88 nat. median
$49,171
1.5× median
981
MS_DRG 		Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 $5,683.00 $90,355.62 $68,340.76 nat. median
$46,084
1.5× median
277
MS_DRG 		Cardiac Defibrillator Implant Without Mcc 20 $33,652.76 $88,944.00 $67,273.07 nat. median
$46,109
1.5× median
329
MS_DRG 		Major Small And Large Bowel Procedures With Mcc 23 $33,496.55 $88,520.32 $66,952.62 nat. median
$44,810
1.5× median
856
MS_DRG 		Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 23 $33,157.18 $87,599.77 $66,256.36 nat. median
$43,966
1.5× median
163
MS_DRG 		Major Chest Procedures With Mcc 24 $5,683.00 $86,311.40 $65,281.90 nat. median
$44,938
1.5× median
448
MS_DRG 		Multiple Level Spinal Fusion Except Cervical Without Mcc 23 $30,971.09 $109,796.00 $61,771.49 nat. median
$41,169
1.5× median
673
MS_DRG 		Other Kidney And Urinary Tract Procedures With Mcc 24 $3,099.00 $80,915.25 $61,200.51 nat. median
$40,457
1.5× median
458
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 $30,486.88 $182,742.00 $60,778.09 nat. median
$42,730
1.4× median
402
MS_DRG 		Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 22 $29,406.97 $200,791.00 $58,562.60 nat. median
$39,420
1.5× median
231
MS_DRG 		Major Large Bowel Procedures,extreme 6 $57,638.17 $60,520.08 $57,638.17 nat. median
$79,312
0.7× median
323
MS_DRG 		Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 29 $19,168.75 $83,337.93 $57,117.35 nat. median
$41,311
1.4× median
907
MS_DRG 		Other O.r. Procedures For Injuries With Mcc 23 $28,120.46 $73,938.01 $55,923.24 nat. median
$38,112
1.5× median
956
MS_DRG 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 20 $5,683.00 $72,468.61 $54,811.86 nat. median
$37,664
1.5× median
814
MS_DRG 		Reticuloendothelial And Immunity Disorders With Mcc 23 $27,321.71 $71,771.46 $54,284.57 nat. median
$20,889
outlier · 2.6×
628
MS_DRG 		Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 24 $3,099.00 $71,771.46 $54,284.57 nat. median
$37,237
1.5× median
904
MS_DRG 		Skin Grafts For Injuries With Cc/mcc 23 $26,940.44 $70,737.29 $53,502.37 nat. median
$36,505
1.5× median
939
MS_DRG 		O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 23 $26,623.79 $69,878.38 $52,852.73 nat. median
$33,732
1.6× median
279
MS_DRG 		Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures… 22 $26,466.89 $69,452.77 $52,530.82 nat. median
$33,736
1.6× median
616
MS_DRG 		Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 23 $25,621.97 $67,161.05 $50,797.47 nat. median
$35,856
1.4× median
574
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Cc 24 $3,099.00 $66,852.92 $50,564.41 nat. median
$33,675
1.5× median
321
MS_DRG 		Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 23 $20,179.14 $91,507.00 $50,554.00 nat. median
$28,170
1.8× median
477
MS_DRG 		Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 24 $3,099.00 $66,529.38 $50,319.70 nat. median
$33,771
1.5× median
29
MS_DRG 		Spinal Procedures With Cc Or Spinal Neurostimulators 23 $25,083.79 $65,701.28 $49,693.37 nat. median
$33,835
1.5× median
264
MS_DRG 		Other Circulatory System O.r. Procedures 23 $5,683.00 $64,333.94 $48,659.18 nat. median
$33,061
1.5× median
608
MS_DRG 		Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,moder… 6 $47,985.06 $50,384.31 $47,985.06 nat. median
$36,076
1.3× median
612
MS_DRG 		Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 $46,290.80 $48,605.34 $47,679.52 nat. median
$50,031
1.0× median
451
MS_DRG 		Single Level Spinal Fusion Except Cervical Without Mcc 23 $23,797.29 $109,796.00 $47,054.01 nat. median
$31,723
1.5× median
485
MS_DRG 		Knee Procedures With Principal Diagnosis Of Infection With Mcc 23 $23,773.86 $62,148.14 $47,005.94 nat. median
$32,031
1.5× median
242
MS_DRG 		Permanent Cardiac Pacemaker Implant With Mcc 24 $5,683.00 $61,487.58 $46,506.32 nat. median
$32,829
1.4× median
360
MS_DRG 		Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 24 $5,683.00 $91,507.00 $46,495.07 nat. median
$22,939
outlier · 2.0×
665
MS_DRG 		Prostatectomy With Mcc 24 $5,683.00 $60,108.69 $45,463.40 nat. median
$31,502
1.4× median
464
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 23 $22,975.82 $59,983.52 $45,368.72 nat. median
$30,264
1.5× median
467
MS_DRG 		Revision Of Hip Or Knee Replacement With Cc 18 $25,900.29 $67,915.97 $44,857.00 nat. median
$34,721
1.3× median
472
MS_DRG 		Cervical Spinal Fusion With Cc 23 $21,778.77 $59,807.00 $43,414.44 nat. median
$29,860
1.5× median
480
MS_DRG 		Hip And Femur Procedures Except Major Joint With Mcc 23 $21,538.78 $56,085.66 $42,420.56 nat. median
$29,218
1.5× median
974
MS_DRG 		HIV With Major Related Condition With Mcc 24 $5,683.00 $55,579.17 $42,037.48 nat. median
$29,015
1.4× 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
             
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $151,559.78 $339,016.00 $245,287.89 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 39 22 — — $52,113.38 $297,052.00 $105,146.13 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 42 23 — — $5,683.00 $137,318.67 $103,861.41 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 7 7 — — $49,935.11 $133,108.83 $100,677.28 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 40 23 — — $5,683.00 $128,675.59 $97,324.19 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 31 19 — — $5,683.00 $123,920.74 $93,727.84 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 39 22 — — $43,199.38 $248,167.00 $86,858.51 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 40 23 — — $37,755.82 $100,073.31 $75,690.76 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 47 29 — — $5,492.45 $109,762.11 $75,227.70 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 40 23 — — $36,271.93 $96,048.35 $72,646.47 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 43 24 — — $5,683.00 $95,278.02 $72,063.83 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 42 24 — — $5,683.00 $95,108.55 $71,935.65 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 40 23 — — $35,805.45 $94,783.08 $71,689.48 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 43 24 — — $3,099.00 $94,388.29 $71,390.88 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 43 24 — — $5,683.00 $90,355.62 $68,340.76 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 36 20 — — $33,652.76 $88,944.00 $67,273.07 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 40 23 — — $33,496.55 $88,520.32 $66,952.62 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 40 23 — — $33,157.18 $87,599.77 $66,256.36 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 43 24 — — $5,683.00 $86,311.40 $65,281.90 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 40 23 — — $30,971.09 $109,796.00 $61,771.49 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 43 24 — — $3,099.00 $80,915.25 $61,200.51 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 39 22 — — $30,486.88 $182,742.00 $60,778.09 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 39 22 — — $29,406.97 $200,791.00 $58,562.60 2026-04-01
231 MS_DRG Major Large Bowel Procedures,extreme 7 6 — — $57,638.17 $60,520.08 $57,638.17 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 47 29 — — $19,168.75 $83,337.93 $57,117.35 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 40 23 — — $28,120.46 $73,938.01 $55,923.24 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 34 20 — — $5,683.00 $72,468.61 $54,811.86 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 43 24 — — $3,099.00 $71,771.46 $54,284.57 2026-04-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 40 23 — — $27,321.71 $71,771.46 $54,284.57 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 40 23 — — $26,940.44 $70,737.29 $53,502.37 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 40 23 — — $26,623.79 $69,878.38 $52,852.73 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 39 22 — — $26,466.89 $69,452.77 $52,530.82 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 40 23 — — $25,621.97 $67,161.05 $50,797.47 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 43 24 — — $3,099.00 $66,852.92 $50,564.41 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 40 23 — — $20,179.14 $91,507.00 $50,554.00 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 43 24 — — $3,099.00 $66,529.38 $50,319.70 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 40 23 — — $25,083.79 $65,701.28 $49,693.37 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 41 23 — — $5,683.00 $64,333.94 $48,659.18 2026-04-01
608 MS_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,moder… 7 6 — — $47,985.06 $50,384.31 $47,985.06 2026-04-01
612 MS_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $46,290.80 $48,605.34 $47,679.52 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 40 23 — — $23,797.29 $109,796.00 $47,054.01 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 40 23 — — $23,773.86 $62,148.14 $47,005.94 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 43 24 — — $5,683.00 $61,487.58 $46,506.32 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 43 24 — — $5,683.00 $91,507.00 $46,495.07 2026-04-01
665 MS_DRG Prostatectomy With Mcc 43 24 — — $5,683.00 $60,108.69 $45,463.40 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 40 23 — — $22,975.82 $59,983.52 $45,368.72 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 32 18 — — $25,900.29 $67,915.97 $44,857.00 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 40 23 — — $21,778.77 $59,807.00 $43,414.44 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 40 23 — — $21,538.78 $56,085.66 $42,420.56 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 43 24 — — $5,683.00 $55,579.17 $42,037.48 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 40 23 — — $21,239.88 $55,274.89 $41,807.33 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 27 19 — — $2.42 $44,738.72 $41,753.08 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 45 28 — — $8,836.54 $53,381.80 $40,375.50 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 7 5 — — $20,436.88 $53,096.78 $40,159.92 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 42 23 — — $5,683.00 $52,935.01 $40,037.56 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 40 23 — — $18,194.71 $59,807.00 $39,737.99 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 42 23 — — $5,683.00 $51,047.71 $38,610.10 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 42 27 — — $12,102.85 $100,246.63 $37,819.72 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 42 23 — — $5,683.00 $49,670.75 $37,568.63 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 43 24 — — $5,683.00 $83,580.00 $37,187.00 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 43 24 — — $3,099.00 $48,933.16 $37,010.75 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 43 24 — — $3,099.00 $47,359.77 $35,820.71 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 40 23 — — $18,316.81 $47,346.28 $35,810.51 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 40 23 — — $18,215.29 $47,070.89 $35,602.22 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 40 23 — — $17,881.58 $46,165.76 $34,917.62 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 40 23 — — $17,865.26 $46,121.46 $34,884.11 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 40 23 — — $17,804.92 $45,957.77 $34,760.30 2026-04-01
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 40 23 — — $14,556.68 $44,857.00 $34,475.00 2026-04-01
333 MS_DRG Rectal Resection With Cc 40 23 — — $17,491.10 $45,106.56 $34,116.49 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 43 24 — — $3,099.00 $45,037.23 $34,064.05 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 43 24 — — $3,099.00 $45,004.49 $34,039.29 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 31 18 — — $13,378.79 $91,507.00 $33,952.21 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 47 29 — — $10,814.10 $52,921.53 $32,927.00 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 11 — — $32,050.29 $84,597.42 $32,370.79 2026-04-01
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 43 24 — — $3,099.00 $42,614.54 $32,231.64 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 39 22 — — $16,472.25 $42,343.00 $32,026.26 2026-04-01
522 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc 40 23 — — $15,897.15 $44,857.00 $31,886.71 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 43 24 — — $5,683.00 $42,031.02 $31,790.30 2026-04-01
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 40 23 — — $16,330.96 $41,959.77 $31,736.40 2026-04-01
325 MS_DRG Non-elective Or Complex Knee Joint Replacement,major 12 6 — — $26,061.05 $33,096.19 $31,520.19 2026-04-01
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 43 24 — — $3,099.00 $41,241.44 $31,193.09 2026-04-01
374 MS_DRG Digestive Malignancy With Mcc 43 24 — — $3,099.00 $41,187.51 $31,152.30 2026-04-01
336 MS_DRG Peritoneal Adhesiolysis With Cc 40 23 — — $15,833.25 $40,609.77 $30,715.32 2026-04-01
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 40 23 — — $15,732.43 $40,336.30 $30,508.49 2026-04-01
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 40 23 — — $15,708.30 $40,270.82 $30,458.96 2026-04-01
511 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Cc 43 24 — — $3,099.00 $40,045.50 $30,288.54 2026-04-01
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 40 23 — — $15,615.99 $40,020.47 $30,269.60 2026-04-01
63685 CPT Insj/Rplcmt Spinal Npg/Rcvr Pocket Crtj&Connj 7 3 — — $30,107.39 $30,709.54 $30,107.39 2026-04-01
63655 CPT Surg Implnt Neuroelect,Epidural 6 3 — — $30,107.39 $30,709.54 $30,107.39 2026-04-01
64582 CPT Open Impltj Hpglsl Nrv Nstim Ra Pg&Respir Sensor 5 3 — — $30,107.39 $30,709.54 $30,107.39 2026-04-01
941 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services Without Cc/… 40 23 — — $15,258.16 $39,049.85 $29,535.48 2026-04-01
710 MS_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure,extreme 19 6 — — $14,206.78 $65,196.45 $29,436.19 2026-04-01
622 MS_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 7 6 — — $29,345.42 $30,812.69 $29,345.42 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 43 24 — — $3,099.00 $38,728.24 $29,292.23 2026-04-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 43 24 — — $3,099.00 $38,479.81 $29,104.32 2026-04-01
908 MS_DRG Other O.r. Procedures For Injuries With Cc 43 24 — — $3,099.00 $38,423.96 $29,062.08 2026-04-01
283 MS_DRG Acute Myocardial Infarction, Expired With Mcc 43 24 — — $3,099.00 $38,146.64 $28,852.33 2026-04-01
432 MS_DRG Cirrhosis And Alcoholic Hepatitis With Mcc 43 24 — — $5,683.00 $37,903.99 $28,668.80 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 43 24 — — $3,099.00 $37,409.05 $28,294.46 2026-04-01
592 MS_DRG Skin Ulcers With Mcc 43 24 — — $3,099.00 $37,270.39 $28,189.58 2026-04-01
196 MS_DRG Interstitial Lung Disease With Mcc 42 24 — — $5,683.00 $36,344.08 $27,488.96 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 54 29 — — $8,119.95 $72,152.77 $27,462.28 2026-04-01
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 43 24 — — $3,099.00 $36,018.61 $27,242.79 2026-04-01
504 MS_DRG Foot Procedures With Cc 43 24 — — $3,099.00 $35,997.43 $27,226.77 2026-04-01
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 43 24 — — $3,099.00 $35,914.62 $27,164.13 2026-04-01
63053 CPT Lam Facetec/Foramot DRG Arthrd Lmbr Ea Addl Sgm 2 1 — — $27,003.74 $27,003.74 $27,003.74 2026-04-01
20939 CPT Bone Marrow Aspiration Bone Grfg Spi Surg Only|SEPARATE Structure|right Side 1 1 — — $27,003.74 $27,003.74 $27,003.74 2026-04-01
682 MS_DRG Renal Failure With Mcc 21 18 — — $3,099.00 $28,923.89 $26,993.65 2026-04-01
686 MS_DRG Kidney And Urinary Tract Neoplasms With Mcc 12 10 — — $5,683.00 $33,059.54 $26,792.70 2026-04-01
435 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Mcc 43 24 — — $3,099.00 $35,371.54 $26,753.37 2026-04-01
22840 CPT Posterior Non-segmental Instrumentation 2 2 — — $26,474.25 $27,003.74 $26,739.00 2026-04-01
22630 CPT Arthrodesis Posterior Interbody 1 Ntrspc Lumbar 4 3 — — $26,474.25 $27,003.74 $26,739.00 2026-04-01
919 MS_DRG Complications Of Treatment With Mcc 43 24 — — $3,099.00 $35,257.91 $26,667.43 2026-04-01
377 MS_DRG Gastrointestinal Hemorrhage With Mcc 43 24 — — $3,099.00 $35,203.99 $26,626.65 2026-04-01
862 MS_DRG Postoperative And Post-traumatic Infections With Mcc 43 24 — — $3,099.00 $35,121.18 $26,564.01 2026-04-01
63052 CPT Lam Facetec/Foramot DRG Arthrd Lumbar 1 Vrt Sgm 3 1 — — $26,474.25 $26,474.25 $26,474.25 2026-04-01
20930 CPT Allograft For Spine Surgery Only Morselized 5 2 — — $26,474.25 $26,474.25 $26,474.25 2026-04-01
C7505 CPT Perq Ls&cvt Inj Vert Bodies 6 3 — — $26,474.25 $27,003.74 $26,474.25 2026-04-01
22853 CPT Insj Biomchn Dev Intervertebral Dsc Spc W/Arthrd 6 3 — — $26,474.25 $27,003.74 $26,474.25 2026-04-01
22634 CPT Arthrodesis Cmbn Tq 1ntrspc Each Additional 1 1 — — $26,474.25 $26,474.25 $26,474.25 2026-04-01
22632 CPT Arthrodesis Posterior Interbody 1 Ntrspc Ea Addl 3 3 — — $26,474.25 $27,003.74 $26,474.25 2026-04-01
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 16 12 — — $13,598.18 $32,241.76 $26,129.95 2026-04-01
371 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Mcc 43 24 — — $3,099.00 $34,146.71 $25,826.97 2026-04-01
488 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection With Cc/mcc 43 24 — — $3,099.00 $34,065.83 $25,765.80 2026-04-01
62 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 43 24 — — $5,683.00 $33,840.51 $25,595.38 2026-04-01
501 MS_DRG Soft Tissue Procedures With Cc 40 23 — — $13,272.99 $33,665.26 $25,462.82 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 43 24 — — $5,683.00 $33,607.48 $25,419.13 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 24 17 — — $13,246.69 $35,105.77 $25,306.41 2026-04-01
621 MS_DRG O.r. Procedures For Obesity Without Cc/mcc 20 15 — — $11,571.14 $30,982.00 $24,937.61 2026-04-01
828 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 40 23 — — $12,958.48 $32,812.12 $24,817.55 2026-04-01
349 MS_DRG Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure,major 7 6 — — $24,657.04 $25,889.90 $24,657.04 2026-04-01
418 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Cc 40 23 — — $12,871.86 $32,577.17 $24,639.85 2026-04-01
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 43 24 — — $3,099.00 $32,542.51 $24,613.63 2026-04-01
571 MS_DRG Skin Debridement With Cc 43 24 — — $3,099.00 $32,536.73 $24,609.26 2026-04-01
419 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. Without Cc/mcc 26 17 — — $10,558.68 $26,302.85 $24,547.52 2026-04-01
331 MS_DRG Major Small And Large Bowel Procedures Without Cc/mcc 40 23 — — $12,810.08 $32,409.62 $24,513.12 2026-04-01
354 MS_DRG Hernia Procedures Except Inguinal And Femoral With Cc 40 23 — — $12,806.53 $32,400.00 $24,505.84 2026-04-01
551 MS_DRG Medical Back Problems With Mcc 43 24 — — $3,099.00 $32,278.67 $24,414.07 2026-04-01
444 MS_DRG Disorders Of The Biliary Tract With Mcc 43 24 — — $3,099.00 $32,178.53 $24,338.33 2026-04-01
70 MS_DRG Other Cerebrovascular Disorders With Mcc 21 13 — — $12,681.57 $32,061.05 $24,249.48 2026-04-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 43 24 — — $3,099.00 $31,860.77 $24,097.99 2026-04-01
133 MS_DRG Respiratory Failure,extreme 7 6 — — $23,987.67 $25,187.05 $23,987.67 2026-04-01
988 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 43 24 — — $3,099.00 $31,652.78 $23,940.68 2026-04-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 43 24 — — $5,683.00 $31,442.86 $23,781.91 2026-04-01
482 MS_DRG Hip And Femur Procedures Except Major Joint Without Cc/mcc 43 24 — — $3,099.00 $31,410.12 $23,757.15 2026-04-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 43 24 — — $5,683.00 $31,394.72 $23,745.49 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 50 30 — — $5,683.00 $60,682.59 $23,698.22 2026-04-01
230 MS_DRG Major Small Bowel Procedures,moderate 11 6 — — $22,539.21 $79,450.10 $23,666.17 2026-04-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 57 30 — — $3,099.00 $33,613.84 $23,365.32 2026-04-01
328 MS_DRG Stomach, Esophageal And Duodenal Procedures Without Cc/mcc 40 23 — — $12,237.82 $30,857.41 $23,339.10 2026-04-01
620 MS_DRG O.r. Procedures For Obesity With Cc 40 23 — — $12,223.62 $30,982.00 $23,309.97 2026-04-01
949 MS_DRG Aftercare With Cc/mcc 43 24 — — $3,099.00 $30,799.64 $23,295.40 2026-04-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 43 24 — — $3,099.00 $30,799.64 $23,295.40 2026-04-01
513 MS_DRG Hand Or Wrist Procedures, Except Major Thumb Or Joint Procedures With Cc/mcc 43 24 — — $3,099.00 $30,318.18 $22,931.25 2026-04-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 43 24 — — $1.63 $30,204.56 $22,845.31 2026-04-01
487 MS_DRG Knee Procedures With Principal Diagnosis Of Infection Without Cc/mcc 43 24 — — $3,099.00 $30,162.19 $22,813.27 2026-04-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 43 24 — — $5,683.00 $30,110.20 $22,773.94 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 43 24 — — $3,099.00 $30,094.79 $22,762.29 2026-04-01
296 MS_DRG Cardiac Arrest, Unexplained With Mcc 43 24 — — $5,683.00 $30,079.38 $22,750.64 2026-04-01
186 MS_DRG Pleural Effusion With Mcc 43 24 — — $3,099.00 $30,013.90 $22,701.11 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 11 10 — — $22,171.42 $55,579.71 $22,614.72 2026-04-01
669 MS_DRG Transurethral Procedures With Cc 43 24 — — $3,099.00 $29,888.73 $22,606.43 2026-04-01
564 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Mcc 43 24 — — $5,683.00 $29,726.96 $22,484.08 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 61 29 — — $5,348.03 $58,413.97 $22,397.17 2026-04-01
964 MS_DRG Other Multiple Significant Trauma With Cc 43 24 — — $3,099.00 $29,515.12 $22,323.85 2026-04-01
183 MS_DRG Major Chest Trauma With Mcc 43 24 — — $3,099.00 $29,463.12 $22,284.52 2026-04-01
813 MS_DRG Coagulation Disorders 43 24 — — $3,099.00 $29,374.53 $22,217.52 2026-04-01
614 MS_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 14 6 — — $17,650.85 $26,579.61 $21,923.65 2026-04-01
713 MS_DRG Transurethral Prostatectomy With Cc/mcc 40 23 — — $11,535.64 $28,952.78 $21,898.52 2026-04-01
22842 CPT Posterior Segmental Instrumentation 3-6 Vrt Seg 2 2 — — $17,107.48 $26,474.25 $21,790.86 2026-04-01
388 MS_DRG Gastrointestinal Obstruction With Mcc 43 24 — — $3,099.00 $28,440.51 $21,511.07 2026-04-01
67 MS_DRG Precerebral Occlusion Without Infarction With Mcc 43 24 — — $3,099.00 $28,284.52 $21,393.08 2026-04-01
892 MS_DRG HIV With Major HIV Related Condition,extreme 7 6 — — $21,297.68 $22,362.57 $21,297.68 2026-04-01
637 MS_DRG Diabetes With Mcc 43 24 — — $3,099.00 $27,668.26 $20,926.97 2026-04-01
562 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 43 24 — — $3,099.00 $27,439.08 $20,753.64 2026-04-01
642 MS_DRG Inborn And Other Disorders Of Metabolism 43 24 — — $3,099.00 $27,387.09 $20,714.31 2026-04-01
115 MS_DRG Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses,extreme 7 6 — — $20,547.77 $21,575.15 $20,547.77 2026-04-01
811 MS_DRG Red Blood Cell Disorders With Mcc 43 24 — — $3,099.00 $27,044.29 $20,455.03 2026-04-01
858 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures Without Cc/mcc 43 24 — — $3,099.00 $26,824.75 $20,288.98 2026-04-01
54405 CPT Insj Multi-component Inflatable Penile Prosth 4 3 — — $20,222.16 $20,626.61 $20,222.16 2026-04-01
804 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs Without Cc/mcc 43 24 — — $3,099.00 $26,114.12 $19,751.50 2026-04-01
825 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures Without Cc/mcc 40 23 — — $10,442.25 $25,987.02 $19,655.36 2026-04-01
502 MS_DRG Soft Tissue Procedures Without Cc/mcc 43 24 — — $3,099.00 $25,919.61 $19,604.38 2026-04-01
355 MS_DRG Hernia Procedures Except Inguinal And Femoral Without Cc/mcc 40 23 — — $10,411.01 $25,902.28 $19,591.27 2026-04-01
718 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy Without Cc/mcc 35 22 — — $3,099.00 $25,865.69 $19,563.59 2026-04-01
660 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Cc 43 24 — — $3,099.00 $25,453.56 $19,251.88 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 43 24 — — $5,683.00 $25,312.98 $19,145.55 2026-04-01
64581 CPT Open Implantation Nea Sacral Nerve 7 3 — — $18,928.40 $19,306.96 $18,928.40 2026-04-01
64561 CPT Hc Prq Impltj Neurostim Eltrd Sacral Nrve W/Imaging 17 3 — — $6,218.03 $19,306.96 $18,928.40 2026-04-01
64590 CPT Implant Neurostim/Receiver 7 3 — — $18,928.40 $19,306.96 $18,928.40 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 43 24 — — $1.35 $24,950.92 $18,871.71 2026-04-01
465 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 54 30 — — $3,099.00 $35,121.18 $18,816.33 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 43 24 — — $5,683.00 $24,723.68 $18,699.83 2026-04-01
947 MS_DRG Signs And Symptoms With Mcc 43 24 — — $1.32 $24,446.36 $18,490.08 2026-04-01
314 MS_DRG Other Circulatory System Diagnoses With Mcc 50 30 — — $5,683.00 $40,157.20 $18,330.71 2026-04-01
59 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Cc 43 24 — — $3,099.00 $23,897.50 $18,074.95 2026-04-01
743 MS_DRG Uterine And Adnexa Procedures For Non-malignancy Without Cc/mcc 43 24 — — $3,099.00 $23,893.65 $18,072.04 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 43 24 — — $5,683.00 $23,791.58 $17,994.84 2026-04-01
347 MS_DRG Other Back And Neck Disorders, Fractures And Injuries,extreme 14 6 — — $10,321.10 $26,134.87 $17,863.75 2026-04-01
380 MS_DRG Complicated Peptic Ulcer With Mcc 57 30 — — $3,099.00 $37,788.44 $17,714.74 2026-04-01
62362 CPT Impltj/Rplcmt Ithcl/Edrl Drug Nfs Prgrbl Pump 7 3 — — $17,585.60 $17,937.31 $17,585.60 2026-04-01
549 MS_DRG Septic Arthritis With Cc 43 24 — — $3,099.00 $23,248.50 $17,584.08 2026-04-01
831 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Mcc 43 24 — — $3,099.00 $23,157.99 $17,515.62 2026-04-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 28 20 — — $7,779.74 $18,513.60 $17,512.89 2026-04-01
989 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Without Cc/mcc 28 21 — — $9,375.85 $22,784.80 $17,467.55 2026-04-01
302 MS_DRG Atherosclerosis With Mcc 43 24 — — $3,099.00 $23,044.36 $17,429.68 2026-04-01
20936 CPT Autograft Spine Surgery Local From Same Incision 4 3 — — $17,107.48 $17,449.63 $17,278.56 2026-04-01
346 MS_DRG Minor Small And Large Bowel Procedures Without Cc/mcc 43 24 — — $3,099.00 $22,844.08 $17,278.19 2026-04-01
152 MS_DRG Otitis Media And Uri With Mcc 43 24 — — $3,099.00 $22,767.04 $17,219.93 2026-04-01
27279 CPT Arthrodesis Si Joint Percutaneous/Min Invasive|RIGHT Side 12 3 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
24340 CPT Tenodesis Biceps Tendon Elbow Separate Procedure 7 3 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
23472 CPT Arthroplasty Glenohumeral Joint Total Shoulder 15 3 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
22858 CPT Total Disc Arthrp Ant 2nd Level Cervical 4 3 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
22856 CPT Total Disc Arthrp Ant Single Interspace Cervical 4 3 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
63035 CPT Lamnotmy W/Dcmprsn Nrv Each Addl Crvcl/Lmbr 6 3 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
22614 CPT Arthrodesis Pst/Pstlat Tq 1ntrspc Ea Addl Ntrspc 3 2 — — $17,107.48 $17,107.48 $17,107.48 2026-04-01
22612 CPT Arthrodesis Posterior/Pstlat Tq 1ntrspc Lumbar 3 2 — — $17,107.48 $17,449.63 $17,107.48 2026-04-01
27487 CPT Revj Tot Knee Arthrp Fem&Entire Tibial Compone|RIGHT Side 3 2 — — $17,107.48 $17,107.48 $17,107.48 2026-04-01
352 MS_DRG Inguinal And Femoral Hernia Procedures Without Cc/mcc 43 24 — — $3,099.00 $22,489.73 $17,010.17 2026-04-01
689 MS_DRG Kidney And Urinary Tract Infections With Mcc 43 24 — — $3,099.00 $22,345.29 $16,900.93 2026-04-01
199 MS_DRG Pneumothorax With Mcc 57 30 — — $5,683.00 $33,973.39 $16,828.72 2026-04-01
344 MS_DRG Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections,major 12 6 — — $10,575.23 $17,619.12 $16,780.11 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 16 12 — — $15,627.08 $44,383.42 $16,721.80 2026-04-01
436 MS_DRG Malignancy Of Hepatobiliary System Or Pancreas With Cc 43 24 — — $3,099.00 $21,782.95 $16,475.60 2026-04-01
263 MS_DRG Cholecystectomy,major 13 6 — — $9,730.88 $17,124.80 $16,309.34 2026-04-01
785 MS_DRG Cesarean Section With Sterilization Without Cc/mcc 35 20 — — $7,661.90 $16,688.00 $16,278.00 2026-04-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 35 20 — — $12,255.00 $16,688.00 $16,278.00 2026-04-01
175 MS_DRG Pulmonary Embolism With Mcc Or Acute Cor Pulmonale 50 30 — — $3,099.00 $26,453.06 $16,273.23 2026-04-01
787 MS_DRG Cesarean Section Without Sterilization With Cc 42 24 — — $8,790.79 $21,507.56 $16,272.65 2026-04-01
489 MS_DRG Knee Procedures Without Principal Diagnosis Of Infection Without Cc/mcc 43 24 — — $3,099.00 $21,507.56 $16,267.31 2026-04-01
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 57 30 — — $5,204.99 $41,037.30 $15,990.87 2026-04-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 43 24 — — $3,099.00 $21,076.17 $15,941.03 2026-04-01
308 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Mcc 19 13 — — $8,274.98 $23,223.46 $15,916.67 2026-04-01
315 MS_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement,moderate 7 6 — — $15,837.17 $16,629.02 $15,837.17 2026-04-01
381 MS_DRG Complicated Peptic Ulcer With Cc 34 19 — — $3,099.00 $20,866.26 $15,782.26 2026-04-01
181 MS_DRG Respiratory Neoplasms With Cc 43 24 — — $3,099.00 $20,625.53 $15,600.19 2026-04-01
287 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization Without Mcc 43 24 — — $3,099.00 $35,885.00 $15,587.08 2026-04-01
300 MS_DRG Peripheral Vascular Disorders With Cc 43 24 — — $3,099.00 $20,558.13 $15,549.21 2026-04-01
184 MS_DRG Major Chest Trauma With Cc 43 24 — — $3,099.00 $20,492.65 $15,499.68 2026-04-01
174 MS_DRG Percutaneous Cardiac Intervention With Ami,minor 14 6 — — $14,101.25 $16,777.75 $15,392.56 2026-04-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 43 24 — — $3,099.00 $20,340.51 $15,384.61 2026-04-01
810 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 43 24 — — $3,099.00 $20,155.63 $15,244.78 2026-04-01
602 MS_DRG Cellulitis With Mcc 26 18 — — $3,099.00 $28,294.15 $15,200.80 2026-04-01
600 MS_DRG Non-malignant Breast Disorders With Cc/mcc 43 24 — — $3,099.00 $20,059.34 $15,171.95 2026-04-01
788 MS_DRG Cesarean Section Without Sterilization Without Cc/mcc 42 24 — — $7,669.00 $18,464.76 $15,121.94 2026-04-01
399 MS_DRG Appendix Procedures Without Cc/mcc 35 21 — — $3,099.00 $22,044.86 $15,108.90 2026-04-01
494 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Without Cc/mcc 31 19 — — $3,099.00 $37,080.12 $15,107.64 2026-04-01
661 MS_DRG Kidney And Ureter Procedures For Non-neoplasm Without Cc/mcc 43 24 — — $3,099.00 $19,939.94 $15,081.64 2026-04-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 43 24 — — $3,099.00 $19,851.35 $15,014.63 2026-04-01
543 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 43 24 — — $3,099.00 $19,797.43 $14,973.85 2026-04-01
71 MS_DRG Other Cerebrovascular Disorders With Cc 43 24 — — $3,099.00 $19,758.91 $14,944.72 2026-04-01
644 MS_DRG Endocrine Disorders With Cc 43 24 — — $3,099.00 $19,739.66 $14,930.15 2026-04-01
155 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Cc 18 15 — — $3,099.00 $17,650.14 $14,910.99 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 43 24 — — $3,099.00 $19,706.92 $14,905.39 2026-04-01
92 MS_DRG Other Disorders Of Nervous System With Cc 43 24 — — $3,099.00 $19,701.14 $14,901.02 2026-04-01
372 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections With Cc 43 24 — — $3,099.00 $19,662.62 $14,871.89 2026-04-01
539 MS_DRG Osteomyelitis With Mcc 42 24 — — $6,663.16 $37,424.30 $14,846.36 2026-04-01
699 MS_DRG Other Kidney And Urinary Tract Diagnoses With Cc 43 24 — — $3,099.00 $19,547.07 $14,784.49 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 43 24 — — $3,099.00 $19,456.56 $14,716.03 2026-04-01
863 MS_DRG Postoperative And Post-traumatic Infections Without Mcc 43 24 — — $3,099.00 $19,217.76 $14,535.41 2026-04-01
386 MS_DRG Inflammatory Bowel Disease With Cc 21 15 — — $7,355.40 $19,113.76 $14,456.76 2026-04-01
378 MS_DRG Gastrointestinal Hemorrhage With Cc 43 24 — — $3,099.00 $18,886.52 $14,284.88 2026-04-01
43 MS_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies,mo… 7 6 — — $14,235.96 $14,947.75 $14,235.96 2026-04-01
670 MS_DRG Transurethral Procedures Without Cc/mcc 43 24 — — $3,099.00 $18,821.04 $14,235.35 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 43 24 — — $3,099.00 $18,796.00 $14,216.42 2026-04-01
202 MS_DRG Bronchitis And Asthma With Cc/mcc 43 24 — — $3,099.00 $18,703.56 $14,146.50 2026-04-01
920 MS_DRG Complications Of Treatment With Cc 28 19 — — $3,099.00 $18,773.83 $14,103.23 2026-04-01
442 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Cc 43 24 — — $3,099.00 $18,589.94 $14,060.56 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 30 19 — — $3,099.00 $18,561.05 $14,038.71 2026-04-01
220 MS_DRG Major Stomach, Esophageal And Duodenal Procedures,minor 7 6 — — $13,988.76 $14,688.20 $13,988.76 2026-04-01
197 MS_DRG Interstitial Lung Disease With Cc 43 24 — — $3,099.00 $18,277.96 $13,824.59 2026-04-01
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 31 23 — — $6,049.34 $32,486.20 $13,694.74 2026-04-01
227 MS_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical,moderate 7 6 — — $13,481.87 $14,155.96 $13,481.87 2026-04-01
19357 CPT Tissue Expander Placement Breast Reconstruction|RIGHT Side 9 3 — — $13,445.87 $13,714.78 $13,445.87 2026-04-01
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 57 30 — — $5,683.00 $34,019.61 $13,403.64 2026-04-01
60 MS_DRG Multiple Sclerosis And Cerebellar Ataxia Without Cc/mcc 19 15 — — $7,392.10 $17,713.69 $13,397.81 2026-04-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 43 24 — — $3,099.00 $17,700.21 $13,387.61 2026-04-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 43 24 — — $3,099.00 $17,682.88 $13,374.50 2026-04-01
605 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast Without Mcc 43 24 — — $3,099.00 $17,640.51 $13,342.46 2026-04-01
307 MS_DRG Cardiac Congenital And Valvular Disorders Without Mcc 43 24 — — $3,099.00 $17,586.59 $13,301.67 2026-04-01
607 MS_DRG Minor Skin Disorders Without Mcc 43 24 — — $3,099.00 $17,455.63 $13,202.62 2026-04-01
101 MS_DRG Seizures Without Mcc 43 24 — — $3,099.00 $17,382.45 $13,147.27 2026-04-01
722 MS_DRG Fever And Inflammatory Conditions,major 7 6 — — $13,076.35 $13,730.17 $13,076.35 2026-04-01
638 MS_DRG Diabetes With Cc 43 24 — — $3,099.00 $17,259.20 $13,054.05 2026-04-01
563 MS_DRG Fracture, Sprain, Strain And Dislocation Except Femur, Hip, Pelvis And Thigh Wit… 43 24 — — $3,099.00 $17,245.72 $13,043.85 2026-04-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 43 24 — — $3,099.00 $17,201.42 $13,010.35 2026-04-01
45 MS_DRG Cva And Precerebral Occlusion With Infarction,major 14 6 — — $9,723.94 $16,532.78 $12,977.83 2026-04-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 29 10 — — $5,802.15 $15,000.00 $12,935.00 2026-04-01
864 MS_DRG Fever And Inflammatory Conditions 43 24 — — $3,099.00 $17,095.50 $12,930.24 2026-04-01
914 MS_DRG Traumatic Injury Without Mcc 43 24 — — $3,099.00 $17,053.14 $12,898.19 2026-04-01
376 MS_DRG Digestive Malignancy Without Cc/mcc 19 16 — — $6,610.67 $17,004.99 $12,861.78 2026-04-01
28297 CPT Corrj Hallux Valgus W/Sesmdc W/1metar Medial Cnf|RIGHT Foot, Great Toe 3 2 — — $12,526.51 $12,777.04 $12,777.04 2026-04-01
683 MS_DRG Renal Failure With Cc 43 24 — — $3,099.00 $16,866.33 $12,756.90 2026-04-01
312 MS_DRG Syncope And Collapse 43 24 — — $3,099.00 $16,785.45 $12,695.73 2026-04-01
603 MS_DRG Cellulitis Without Mcc 43 24 — — $3,099.00 $16,771.97 $12,685.53 2026-04-01
27138 CPT Revj Tot Hip Arthrp Fem Only W/wo Algrft|RIGHT Side 4 3 — — $12,526.51 $12,777.04 $12,651.78 2026-04-01
27784 CPT Open Treatment Proximal Fibula/Shaft Fracture|RIGHT Side 4 3 — — $12,526.51 $12,777.04 $12,651.78 2026-04-01
68 MS_DRG Precerebral Occlusion Without Infarction Without Mcc 23 16 — — $3,099.00 $16,423.60 $12,590.85 2026-04-01
292 MS_DRG Heart Failure And Shock With Cc 21 15 — — $6,611.32 $16,585.16 $12,544.24 2026-04-01
20931 CPT Allograft For Spine Surgery Only Structural 3 2 — — $12,526.51 $12,526.51 $12,526.51 2026-04-01
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