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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 CAREPLEX HOSPITAL

Hampton, VA · CCN 490093 · Rates published

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You selected 45378 (HCPCS)

Diagnostic colonoscopy

This hospital’s price: $2,848 across 4 payers · range $925-$5,790

Source: https://www.sentara.com/Documents/s/sentaracareplexhospitalstandardchargesxlsx-1395308 · 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.

11,916 distinct procedures filed
15 distinct payers
125,730 rate rows
2026-04-01 last MRF observed
Data quality

91,131 of 125,730 rate rows are consumer-grade (72.5%)

34,599 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 34,591
placeholder amount (≤ $0.02) — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.sentara.com/Documents/s/sentaracareplexhospitalstandardchargesxlsx-1395308
Found on page https://www.sentara.com/billing/estimating-hospital-charges
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint 71774a24faf4d1fe… · 34,725,548 bytes · first seen 2026-05-06

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 $0.03 $4,730,250.00 $4,595,100.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $0.03 $3,869,530.00 $3,758,972.00 nat. median
$3,685,267
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.03 $3,482,285.72 $3,382,791.84 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $0.03 $3,410,868.00 $3,313,414.63 nat. median
$3,248,446
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $0.03 $3,093,027.00 $3,004,654.80 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $0.03 $2,577,866.14 $2,504,212.82 nat. median
$2,455,111
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $0.03 $2,448,600.00 $2,378,640.00 nat. median
$2,332,000
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 4 $316,326.22 $1,091,833.92 $882,829.17 nat. median
$168,055
outlier · 5.3×
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $0.03 $809,151.00 $786,032.40 nat. median
$813,967
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $0.03 $621,312.51 $603,560.73 nat. median
$621,313
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $0.03 $594,162.39 $577,186.32 nat. median
$599,737
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $0.03 $590,665.09 $573,788.95 nat. median
$579,571
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $205,833.66 $708,556.29 $572,920.61 nat. median
$186,516
outlier · 3.1×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $0.03 $585,183.83 $568,464.29 nat. median
$574,037
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $0.03 $559,891.68 $543,894.77 nat. median
$562,501
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $0.03 $513,769.84 $499,090.70 nat. median
$513,770
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $157,191.55 $539,826.04 $436,489.62 nat. median
$131,925
outlier · 3.3×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 $156,278.24 $536,657.96 $433,927.98 nat. median
$145,435
outlier · 3.0×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 $102,530.94 $395,043.12 $289,044.09 nat. median
$97,418
outlier · 3.0×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 4 $0.03 $972,967.79 $289,032.19 nat. median
$286,598
1.0× median
7
MS_DRG 		Lung Transplant 4 $95,962.13 $327,432.86 $264,753.89 nat. median
$70,649
outlier · 3.7×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $89,166.65 $303,860.58 $245,693.95 nat. median
$72,715
outlier · 3.4×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $84,165.69 $286,513.23 $231,667.32 nat. median
$65,418
outlier · 3.5×
209
MS_DRG 		Complex Aortic Arch Procedures 4 $84,070.93 $286,184.54 $231,401.54 nat. median
$2,110
outlier · 109.6×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $80,829.53 $274,940.74 $222,310.10 nat. median
$74,509
outlier · 3.0×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 4 $8,749.06 $278,660.02 $216,186.35 nat. median
$2,736
outlier · 79.0×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $199,213.13 $224,051.64 $211,632.39 nat. median
$2,106
outlier · 100.5×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $76,721.48 $260,690.68 $210,787.86 nat. median
$69,922
outlier · 3.0×
215
MS_DRG 		Other Heart Assist System Implant 4 $74,144.83 $251,752.79 $203,560.91 nat. median
$73,023
outlier · 2.8×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $72,875.09 $247,348.32 $199,999.57 nat. median
$69,822
outlier · 2.9×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 4 $67,239.28 $227,798.73 $184,192.26 nat. median
$2,596
outlier · 71.0×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $172,128.02 $193,589.47 $182,858.74 nat. median
$2,024
outlier · 90.3×
850
MS_DRG 		Acute Leukemia With Other Procedures 4 $62,123.94 $218,946.80 $175,562.70 nat. median
$2,633
outlier · 66.7×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $62,820.71 $212,471.57 $171,799.11 nat. median
$59,651
outlier · 2.9×
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $159,372.31 $179,243.33 $169,307.82 nat. median
$2,024
outlier · 83.7×
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $57,961.04 $198,700.65 $161,097.60 nat. median
$65,477
outlier · 2.5×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 $58,924.03 $198,954.74 $160,869.74 nat. median
$56,428
outlier · 2.9×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 4 $16,990.45 $213,141.59 $159,805.61 nat. median
$60,505
outlier · 2.6×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $149,100.74 $167,691.07 $158,395.90 nat. median
$2,106
outlier · 75.2×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 $57,535.49 $194,138.14 $156,975.17 nat. median
$55,923
outlier · 2.8×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 $57,109.81 $192,661.55 $155,781.23 nat. median
$52,327
outlier · 3.0×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 $14,667.57 $193,301.24 $154,998.78 nat. median
$55,935
outlier · 2.8×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $143,898.63 $161,840.36 $152,869.49 nat. median
$2,024
outlier · 75.5×
10
MS_DRG 		Pancreas Transplant 4 $53,872.05 $181,430.40 $146,700.01 nat. median
$23,080
outlier · 6.4×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 4 $53,850.20 $181,354.55 $146,638.68 nat. median
$37,013
outlier · 4.0×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $137,500.54 $154,644.53 $146,072.54 nat. median
$2,106
outlier · 69.4×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 $53,572.48 $180,391.23 $145,859.76 nat. median
$45,605
outlier · 3.2×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 $50,511.98 $180,285.03 $145,773.90 nat. median
$51,518
outlier · 2.8×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 $51,701.40 $173,900.82 $140,611.79 nat. median
$49,569
outlier · 2.8×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 4 $50,631.39 $170,189.13 $137,610.61 nat. median
$47,340
outlier · 2.9×

Other procedures at this hospital

Browse this hospital's 11,916 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 7 4 — — $0.03 $4,730,250.00 $4,595,100.00 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 4 — — $0.03 $3,869,530.00 $3,758,972.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 4 — — $0.03 $3,482,285.72 $3,382,791.84 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 4 — — $0.03 $3,410,868.00 $3,313,414.63 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 7 4 — — $0.03 $3,093,027.00 $3,004,654.80 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 7 4 — — $0.03 $2,577,866.14 $2,504,212.82 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 7 4 — — $0.03 $2,448,600.00 $2,378,640.00 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 4 — — $316,326.22 $1,091,833.92 $882,829.17 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 7 4 — — $0.03 $809,151.00 $786,032.40 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 7 4 — — $0.03 $621,312.51 $603,560.73 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 7 4 — — $0.03 $594,162.39 $577,186.32 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 4 — — $0.03 $590,665.09 $573,788.95 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 12 4 — — $205,833.66 $708,556.29 $572,920.61 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 7 4 — — $0.03 $585,183.83 $568,464.29 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 7 4 — — $0.03 $559,891.68 $543,894.77 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 7 4 — — $0.03 $513,769.84 $499,090.70 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 4 — — $157,191.55 $539,826.04 $436,489.62 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 4 — — $156,278.24 $536,657.96 $433,927.98 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 4 — — $102,530.94 $395,043.12 $289,044.09 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 10 4 — — $0.03 $972,967.79 $289,032.19 2026-04-01
7 MS_DRG Lung Transplant 12 4 — — $95,962.13 $327,432.86 $264,753.89 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 12 4 — — $89,166.65 $303,860.58 $245,693.95 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 4 — — $84,165.69 $286,513.23 $231,667.32 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 12 4 — — $84,070.93 $286,184.54 $231,401.54 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 12 4 — — $80,829.53 $274,940.74 $222,310.10 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 4 — — $8,749.06 $278,660.02 $216,186.35 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $199,213.13 $224,051.64 $211,632.39 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 12 4 — — $76,721.48 $260,690.68 $210,787.86 2026-04-01
215 MS_DRG Other Heart Assist System Implant 12 4 — — $74,144.83 $251,752.79 $203,560.91 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 4 — — $72,875.09 $247,348.32 $199,999.57 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 12 4 — — $67,239.28 $227,798.73 $184,192.26 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $172,128.02 $193,589.47 $182,858.74 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 13 4 — — $62,123.94 $218,946.80 $175,562.70 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 4 — — $62,820.71 $212,471.57 $171,799.11 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $159,372.31 $179,243.33 $169,307.82 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 10 4 — — $57,961.04 $198,700.65 $161,097.60 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 12 4 — — $58,924.03 $198,954.74 $160,869.74 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 15 4 — — $16,990.45 $213,141.59 $159,805.61 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 1 — — $149,100.74 $167,691.07 $158,395.90 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 4 — — $57,535.49 $194,138.14 $156,975.17 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 12 4 — — $57,109.81 $192,661.55 $155,781.23 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 4 — — $14,667.57 $193,301.24 $154,998.78 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 1 — — $143,898.63 $161,840.36 $152,869.49 2026-04-01
10 MS_DRG Pancreas Transplant 12 4 — — $53,872.05 $181,430.40 $146,700.01 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 12 4 — — $53,850.20 $181,354.55 $146,638.68 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $137,500.54 $154,644.53 $146,072.54 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 4 — — $53,572.48 $180,391.23 $145,859.76 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 4 — — $50,511.98 $180,285.03 $145,773.90 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 12 4 — — $51,701.40 $173,900.82 $140,611.79 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 12 4 — — $50,631.39 $170,189.13 $137,610.61 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 4 — — $18,681.54 $182,515.08 $136,983.66 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 12 4 — — $50,270.59 $168,937.57 $136,598.63 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 13 4 — — $29,875.14 $169,061.47 $135,562.10 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 4 — — $49,495.77 $166,249.89 $134,425.43 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 4 — — $49,495.77 $166,249.89 $134,425.43 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 4 — — $49,321.56 $165,645.60 $133,936.82 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 12 4 — — $46,238.33 $154,950.47 $125,289.01 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 12 4 — — $46,186.58 $154,770.95 $125,143.86 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 1 — — $117,321.59 $131,949.61 $124,635.60 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 12 4 — — $45,758.72 $153,286.78 $123,943.79 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 13 4 — — $43,034.36 $151,913.86 $121,812.27 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 4 — — $42,810.06 $151,870.87 $121,777.81 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 19 5 — — $27,127.05 $174,757.95 $121,460.68 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 12 4 — — $44,790.02 $149,926.53 $121,226.79 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 4 — — $45,033.47 $150,771.02 $120,895.89 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 1 — — $113,702.15 $127,878.89 $120,790.52 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 12 4 — — $44,344.66 $148,381.68 $119,977.66 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 1 — — $112,870.36 $126,943.38 $119,906.87 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 12 4 — — $44,316.97 $148,285.60 $119,899.98 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 4 — — $43,336.61 $144,884.91 $117,150.25 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 13 4 — — $43,604.84 $145,815.36 $116,922.19 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 12 4 — — $43,166.04 $144,293.26 $116,671.86 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 4 — — $17,373.03 $150,275.45 $116,584.73 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 12 4 — — $42,420.38 $141,706.71 $114,580.44 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 4 — — $37,342.26 $140,735.80 $112,849.14 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 4 — — $15,147.74 $139,643.53 $111,973.30 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 12 4 — — $41,323.39 $137,901.46 $111,503.62 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 12 4 — — $41,164.50 $137,350.27 $111,057.94 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 13 4 — — $29,373.30 $138,316.12 $110,908.92 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 2 1 — — $103,538.49 $116,447.99 $109,993.24 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 4 — — $40,439.25 $134,834.52 $109,023.76 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 12 4 — — $40,415.92 $134,753.61 $108,958.34 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 4 — — $28,045.51 $133,848.44 $107,326.50 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 14 4 — — $7,764.61 $138,118.91 $107,153.59 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 4 — — $40,662.96 $142,146.65 $106,576.25 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 12 4 — — $39,445.03 $131,385.78 $106,235.20 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 19 4 — — $14,925.79 $162,694.95 $105,034.81 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 15 4 — — $25,322.39 $138,806.63 $104,072.03 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 12 4 — — $38,306.50 $127,436.42 $103,041.85 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 14 4 — — $21,247.74 $131,613.33 $102,106.52 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 4 — — $37,630.07 $125,090.06 $100,303.59 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 13 4 — — $36,801.66 $123,921.94 $99,366.93 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 12 4 — — $36,587.03 $121,471.92 $98,219.11 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 12 4 — — $36,269.96 $120,372.07 $97,329.80 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 14 4 — — $31,820.58 $124,440.26 $96,541.61 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 9 4 — — $31,238.15 $138,244.00 $96,123.75 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 9 4 — — $31,238.15 $138,244.00 $96,123.75 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 9 4 — — $31,238.15 $138,244.00 $96,123.75 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 9 4 — — $31,238.15 $138,244.00 $96,123.75 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 12 4 — — $35,837.00 $118,870.20 $96,115.42 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 21 4 — — $11,695.19 $146,904.21 $96,102.09 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 12 4 — — $35,664.97 $118,273.50 $95,632.95 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 12 4 — — $35,367.58 $117,241.91 $94,798.83 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 14 5 — — $35,686.43 $122,088.85 $94,717.36 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 13 4 — — $33,822.43 $116,774.15 $93,635.47 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 14 4 — — $19,186.89 $114,958.76 $92,952.74 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 13 4 — — $33,127.91 $115,922.08 $92,952.24 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 12 4 — — $34,579.65 $114,508.71 $92,588.83 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 23 4 — — $5,785.60 $124,867.56 $91,873.92 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 12 4 — — $34,226.86 $113,284.96 $91,599.35 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 12 4 — — $34,098.58 $112,839.96 $91,239.52 2026-04-01
245 MS_DRG Aicd Generator Procedures 14 4 — — $8,953.16 $115,355.72 $89,493.76 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 4 — — $29,869.69 $111,067.56 $88,881.72 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 13 4 — — $32,280.74 $109,413.98 $87,733.71 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $82,233.25 $92,486.34 $87,359.79 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 12 4 — — $32,298.93 $106,597.34 $86,191.90 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 12 4 — — $32,283.63 $106,544.25 $86,148.97 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 5 — — $31,982.60 $105,500.02 $86,013.98 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 12 4 — — $32,157.53 $106,106.83 $85,795.29 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 12 4 — — $32,100.68 $105,909.62 $85,635.82 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 13 4 — — $31,455.03 $106,779.39 $85,621.16 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 12 4 — — $31,839.73 $105,004.45 $84,903.93 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 14 4 — — $31,971.88 $108,541.68 $84,207.38 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 20 4 — — $12,027.37 $113,317.83 $83,533.77 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 19 5 — — $24,118.59 $163,306.16 $83,505.67 2026-04-01
791 MS_DRG Prematurity With Major Problems 12 4 — — $31,154.57 $102,627.76 $82,982.20 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 12 4 — — $30,608.63 $100,733.98 $81,450.94 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 15 4 — — $10,230.25 $107,843.85 $80,857.29 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 12 4 — — $30,082.36 $98,908.48 $79,974.89 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 12 4 — — $29,953.35 $98,460.95 $79,613.02 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 12 4 — — $29,782.06 $97,866.78 $79,132.59 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 20 5 — — $28,001.59 $107,224.39 $79,106.78 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 15 4 — — $11,167.60 $105,424.17 $79,043.11 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 12 4 — — $29,739.78 $97,720.13 $79,014.01 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 12 4 — — $29,712.81 $97,626.58 $78,938.38 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 15 5 — — $31,639.29 $104,309.14 $78,291.45 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 12 4 — — $28,997.04 $95,143.69 $76,930.77 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 13 4 — — $2,713.84 $94,729.03 $75,958.57 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 12 4 — — $28,580.11 $93,697.45 $75,761.38 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 4 — — $29,553.18 $97,072.86 $75,309.79 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 12 4 — — $28,341.76 $92,870.66 $75,092.85 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 20 5 — — $27,671.30 $101,654.32 $75,076.24 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 12 4 — — $28,016.68 $91,742.99 $74,181.05 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 14 4 — — $11,399.29 $94,493.89 $74,070.87 2026-04-01
332 MS_DRG Rectal Resection With Mcc 12 4 — — $27,959.82 $91,545.78 $74,021.59 2026-04-01
265 MS_DRG Aicd Lead Procedures 12 4 — — $27,941.59 $91,482.57 $73,970.48 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 13 4 — — $18,449.61 $91,672.20 $73,507.44 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 12 4 — — $27,683.56 $90,587.52 $73,246.76 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 14 4 — — $26,683.63 $94,228.41 $73,103.04 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 12 4 — — $27,623.07 $90,377.66 $73,077.08 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 12 4 — — $27,558.20 $90,152.63 $72,895.12 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 12 4 — — $27,536.33 $90,076.78 $72,833.79 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 14 4 — — $27,894.95 $91,320.75 $72,804.73 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 14 4 — — $21,848.12 $92,832.73 $72,020.27 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 12 4 — — $27,221.45 $88,984.51 $71,950.62 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 2 1 — — $67,663.31 $76,099.78 $71,881.54 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 2 1 — — $67,339.59 $75,735.69 $71,537.64 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 16 5 — — $26,623.09 $115,009.33 $70,378.55 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 13 4 — — $24,718.06 $87,346.11 $70,038.56 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 14 4 — — $25,827.95 $89,990.81 $69,815.49 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 12 4 — — $26,435.70 $86,258.89 $69,746.75 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 13 4 — — $23,890.28 $86,683.67 $69,507.38 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 18 5 — — $10,520.51 $94,504.01 $69,333.11 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 10 4 — — $24,712.99 $84,720.48 $68,687.57 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 17 4 — — $24,637.29 $90,286.64 $68,596.28 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 14 4 — — $26,326.38 $88,175.42 $68,407.10 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 15 4 — — $14,397.69 $91,184.22 $68,366.52 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 9 4 — — $22,136.77 $138,244.00 $68,117.66 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 9 4 — — $22,136.77 $138,244.00 $68,117.66 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 9 4 — — $22,136.77 $138,244.00 $68,117.66 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 9 4 — — $22,136.77 $138,244.00 $68,117.66 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 14 4 — — $17,052.45 $87,770.88 $68,093.24 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 13 4 — — $25,646.31 $83,520.64 $66,971.10 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 17 4 — — $23,848.85 $89,166.55 $66,853.76 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 7 4 — — $64,609.13 $193,464.70 $66,509.40 2026-04-01
652 MS_DRG Kidney Transplant 12 4 — — $25,108.38 $81,654.68 $66,023.90 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 13 4 — — $25,278.21 $82,243.80 $65,947.27 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 12 4 — — $25,044.97 $81,434.71 $65,846.04 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 13 4 — — $22,374.85 $81,882.23 $65,657.35 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 12 4 — — $24,969.16 $81,171.75 $65,633.42 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 13 4 — — $23,294.58 $81,594.00 $65,426.23 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 15 4 — — $14,310.45 $86,941.56 $65,185.54 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 12 4 — — $24,775.28 $80,499.20 $65,089.61 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 12 4 — — $24,728.62 $80,337.38 $64,958.76 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 20 4 — — $24,150.38 $133,277.35 $64,923.26 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 19 4 — — $32,933.31 $116,217.91 $64,709.36 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 13 4 — — $20,918.45 $80,577.58 $64,611.21 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 12 4 — — $24,536.20 $79,669.88 $64,419.04 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 9 4 — — $21,401.00 $214,600.72 $64,286.82 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 12 4 — — $24,471.33 $79,444.86 $64,237.10 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 13 4 — — $14,821.34 $80,018.80 $64,163.16 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 4 — — $18,234.97 $79,631.96 $63,852.96 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 15 4 — — $22,988.51 $83,237.46 $63,814.07 2026-04-01
665 MS_DRG Prostatectomy With Mcc 12 4 — — $24,318.98 $78,916.42 $63,809.82 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 2 1 — — $59,720.78 $67,166.95 $63,443.86 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 15 4 — — $24,676.56 $84,463.73 $63,327.75 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 13 4 — — $24,271.61 $78,752.07 $63,147.43 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 13 4 — — $22,480.06 $78,613.01 $63,035.92 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 16 4 — — $13,537.51 $80,726.76 $62,628.37 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 17 4 — — $3,067.71 $83,227.34 $62,400.76 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 20 4 — — $20,852.11 $81,677.43 $61,777.15 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 12 4 — — $23,582.07 $76,360.21 $61,742.93 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 12 4 — — $23,558.02 $76,276.77 $61,675.46 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 13 4 — — $19,209.26 $76,370.32 $61,237.62 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 12 4 — — $23,028.11 $74,438.62 $60,189.18 2026-04-01
570 MS_DRG Skin Debridement With Mcc 12 4 — — $23,006.24 $74,362.77 $60,127.85 2026-04-01
263 MS_DRG Vein Ligation And Stripping 14 4 — — $12,725.14 $77,303.30 $59,972.43 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 17 4 — — $21,586.62 $79,897.44 $59,904.12 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 18 4 — — $21,804.79 $235,219.36 $59,693.87 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 13 4 — — $22,614.83 $73,005.02 $59,520.86 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 12 4 — — $22,721.24 $73,374.17 $59,328.49 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 12 4 — — $22,708.13 $73,328.66 $59,291.68 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 13 4 — — $955.68 $73,829.28 $59,200.08 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 12 4 — — $22,574.01 $72,863.43 $58,915.52 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 14 4 — — $23,263.55 $75,255.30 $58,383.57 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 7 4 — — $56,377.77 $170,635.21 $58,035.94 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 2 1 — — $54,429.00 $60,970.00 $57,699.50 2026-04-01
800 MS_DRG Splenic Procedures With Cc 12 4 — — $22,046.29 $71,032.87 $57,435.38 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 13 4 — — $20,452.23 $70,777.50 $56,753.01 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 12 4 — — $21,772.95 $70,084.72 $56,668.72 2026-04-01
503 MS_DRG Foot Procedures With Mcc 13 4 — — $17,714.31 $70,570.17 $56,586.76 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 12 4 — — $21,665.08 $69,710.52 $56,366.15 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 12 4 — — $21,495.25 $69,121.40 $55,889.81 2026-04-01
849 MS_DRG Radiotherapy 12 4 — — $21,318.12 $68,507.00 $55,393.01 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 12 4 — — $21,294.07 $68,423.56 $55,325.56 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 15 4 — — $18,072.28 $73,634.59 $55,208.47 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 12 4 — — $21,229.93 $68,201.06 $55,145.64 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 17 5 — — $7,578.36 $98,116.49 $54,709.90 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 9 4 — — $28,545.63 $97,859.45 $54,429.00 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 9 4 — — $22,136.77 $75,888.76 $54,429.00 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 9 4 — — $26,788.24 $91,834.79 $54,429.00 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 9 4 — — $43,834.99 $150,274.05 $54,429.00 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 9 4 — — $31,238.15 $107,089.88 $54,429.00 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 9 4 — — $31,238.15 $107,089.88 $54,429.00 2026-04-01
0614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 9 4 — — $22,136.77 $75,888.76 $54,429.00 2026-04-01
69930 HCPCS Implant Cochlear Device 9 4 — — $32,813.81 $112,491.50 $54,429.00 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 9 4 — — $22,136.77 $75,888.76 $54,429.00 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 9 4 — — $31,238.15 $107,089.88 $54,429.00 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 9 4 — — $22,136.77 $75,888.76 $54,429.00 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 9 4 — — $22,136.77 $75,888.76 $54,429.00 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 9 4 — — $22,136.77 $75,888.76 $54,429.00 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 9 4 — — $43,834.99 $150,274.05 $54,429.00 2026-04-01
61886 HCPCS Implant Neurostim Arrays 9 4 — — $30,709.54 $105,277.69 $54,429.00 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 15 4 — — $18,589.15 $72,570.14 $54,410.38 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 14 4 — — $20,889.54 $67,020.30 $54,190.91 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 2 1 — — $50,784.58 $57,116.56 $53,950.57 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 13 4 — — $16,383.70 $67,255.44 $53,928.84 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 13 4 — — $18,738.13 $66,684.02 $53,470.65 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 17 4 — — $20,223.31 $74,489.19 $53,058.48 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 12 4 — — $20,465.32 $65,548.77 $53,001.07 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 12 4 — — $20,368.37 $65,212.49 $52,729.16 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 12 4 — — $20,368.37 $65,212.49 $52,729.16 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 12 4 — — $20,283.82 $64,919.20 $52,492.01 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 23 5 — — $19,919.51 $68,792.71 $51,578.21 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 12 4 — — $19,958.00 $63,789.00 $51,578.16 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 20 6 — — $29,793.84 $106,233.25 $50,959.40 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 12 4 — — $19,657.71 $62,747.30 $50,735.88 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 14 4 — — $18,132.92 $65,303.52 $50,662.92 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 19 4 — — $11,296.25 $69,480.43 $50,550.05 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 12 4 — — $19,463.81 $62,074.75 $50,192.07 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 12 4 — — $19,363.23 $61,725.83 $49,909.94 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 14 4 — — $18,078.59 $64,244.12 $49,841.02 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 12 4 — — $19,224.01 $61,242.90 $49,519.46 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 15 4 — — $16,312.65 $62,160.71 $49,438.52 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 12 4 — — $19,166.42 $61,043.16 $49,357.95 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 21 5 — — $6,751.70 $101,600.99 $49,204.79 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 12 4 — — $19,100.83 $60,815.61 $49,173.95 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 15 4 — — $13,435.97 $61,799.15 $49,030.62 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 12 4 — — $19,025.02 $60,552.65 $48,961.33 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 16 5 — — $19,056.83 $63,816.82 $48,897.89 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 14 4 — — $18,270.41 $63,005.20 $48,879.86 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 12 4 — — $18,992.95 $60,441.40 $48,871.38 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 15 4 — — $17,087.36 $64,122.75 $48,483.39 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 15 4 — — $4,994.58 $64,550.05 $48,397.22 2026-04-01
33968 HCPCS Remove Aortic Assist Device 2 1 — — $45,353.00 $50,815.00 $48,084.00 2026-04-01
33967 HCPCS Insert I-aort Percut Device 2 1 — — $45,353.00 $50,815.00 $48,084.00 2026-04-01
0268T OTHER Implt/rpl Crtd Sns Dev Gen 2 1 — — $45,353.00 $50,815.00 $48,084.00 2026-04-01
0266T OTHER Implt/rpl Crtd Sns Dev Total 2 1 — — $45,353.00 $50,815.00 $48,084.00 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 2 1 — — $45,353.00 $50,815.00 $48,084.00 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 2 1 — — $45,353.00 $50,815.00 $48,084.00 2026-04-01
792 MS_DRG Prematurity Without Major Problems 14 4 — — $6,110.35 $61,925.57 $48,042.28 2026-04-01
333 MS_DRG Rectal Resection With Cc 12 4 — — $18,640.89 $59,220.18 $47,883.93 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 12 4 — — $18,602.26 $59,086.18 $47,775.58 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 12 4 — — $18,530.83 $58,838.40 $47,575.24 2026-04-01
J9226 HCPCS Supprelin La Implant 7 4 — — $45,921.06 $138,959.19 $47,271.68 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 12 4 — — $18,414.94 $58,436.38 $47,250.18 2026-04-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 12 4 — — $18,296.13 $58,024.25 $46,916.93 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 14 5 — — $15,545.99 $58,797.94 $46,764.81 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 13 4 — — $7,973.52 $58,041.95 $46,540.99 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 12 4 — — $18,128.48 $57,442.72 $46,446.72 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 14 4 — — $6,849.40 $59,445.21 $46,118.00 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 18 5 — — $15,815.42 $60,337.74 $46,050.88 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 4 — — $2,416.52 $86,145.12 $45,883.93 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 16 5 — — $16,044.78 $59,129.16 $45,872.81 2026-04-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 12 4 — — $17,885.75 $56,600.76 $45,765.94 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 12 4 — — $17,876.28 $56,567.89 $45,739.36 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 2 1 — — $42,927.47 $48,279.80 $45,603.64 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 14 4 — — $16,615.88 $58,737.26 $45,568.77 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 12 4 — — $17,747.27 $56,120.37 $45,377.50 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 9 4 — — $18,243.62 $62,542.33 $45,353.00 2026-04-01
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