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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

BON SECOURS RICHMOND COMMUNITY HOSPITAL

Richmond, VA · CCN 490094 · Rates published

186 distinct procedures filed
32 distinct payers
18,005 rate rows
2026-04-01 last MRF observed
Data quality

4,663 of 18,005 rate rows are consumer-grade (25.9%)

13,342 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 13,342
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.bonsecours.com/-/media/bon-secours/patients-and-visitors/corporate/pricing/540647482_bon-secours-richmond-community-hospital-llc_standardcharges.ashx
Found on page https://www.bonsecours.com/patient-resources/estimate-your-cost
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-22
Content fingerprint cce4b6c77dfd60d3… · 4,874,781 bytes · first seen 2026-05-05

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
95
MS_DRG 		Bacterial And Tuberculous Infections Of Nervous System With Cc 25 $24,806.68 $86,261.34 $57,485.21 nat. median
$23,602
outlier · 2.4×
867
MS_DRG 		Other Infectious And Parasitic Diseases Diagnoses With Mcc 25 $21,076.80 $70,007.07 $46,653.25 nat. median
$20,262
outlier · 2.3×
64
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Mcc 25 $20,445.93 $67,257.90 $44,821.17 nat. median
$19,252
outlier · 2.3×
854
MS_DRG 		Infectious And Parasitic Diseases With O.r. Procedures With Cc 25 $20,346.92 $66,826.45 $44,533.65 nat. median
$19,218
outlier · 2.3×
871
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 25 $19,920.22 $64,966.91 $43,294.44 nat. median
$18,642
outlier · 2.3×
91
MS_DRG 		Other Disorders Of Nervous System With Mcc 25 $18,490.42 $58,736.11 $39,142.18 nat. median
$17,061
outlier · 2.3×
58
MS_DRG 		Multiple Sclerosis And Cerebellar Ataxia With Mcc 25 $18,132.01 $57,174.23 $38,101.33 nat. median
$16,817
outlier · 2.3×
551
MS_DRG 		Medical Back Problems With Mcc 25 $17,875.67 $56,057.16 $37,356.91 nat. median
$16,101
outlier · 2.3×
698
MS_DRG 		Other Kidney And Urinary Tract Diagnoses With Mcc 25 $17,709.13 $55,331.41 $36,873.27 nat. median
$15,903
outlier · 2.3×
299
MS_DRG 		Peripheral Vascular Disorders With Mcc 10 $7,252.00 $39,283.42 $36,389.61 nat. median
$15,759
outlier · 2.3×
438
MS_DRG 		Disorders Of Pancreas Except Malignancy With Mcc 25 $17,508.35 $54,522.04 $36,333.90 nat. median
$15,974
outlier · 2.3×
280
MS_DRG 		Acute Myocardial Infarction, Discharged Alive With Mcc 21 $17,228.03 $53,649.12 $36,190.10 nat. median
$15,657
outlier · 2.3×
917
MS_DRG 		Poisoning And Toxic Effects Of Drugs With Mcc 25 $16,844.62 $52,455.14 $34,956.50 nat. median
$14,580
outlier · 2.4×
154
MS_DRG 		Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 25 $16,791.99 $52,291.26 $34,847.29 nat. median
$15,312
outlier · 2.3×
177
MS_DRG 		Respiratory Infections And Inflammations With Mcc 25 $16,783.40 $52,264.50 $34,829.46 nat. median
$15,388
outlier · 2.3×
813
MS_DRG 		Coagulation Disorders 25 $16,381.72 $51,013.66 $33,995.89 nat. median
$14,889
outlier · 2.3×
606
MS_DRG 		Minor Skin Disorders With Mcc 25 $16,251.77 $50,608.97 $33,726.21 nat. median
$14,907
outlier · 2.3×
682
MS_DRG 		Renal Failure With Mcc 17 $15,905.94 $49,532.05 $32,604.22 nat. median
$14,434
outlier · 2.3×
289
MS_DRG 		Acute And Subacute Endocarditis With Cc 14 $18,112.07 $57,087.27 $32,318.44 nat. median
$16,321
2.0× median
602
MS_DRG 		Cellulitis With Mcc 22 $15,264.76 $47,535.38 $32,065.95 nat. median
$14,020
outlier · 2.3×
637
MS_DRG 		Diabetes With Mcc 25 $15,430.16 $48,050.43 $32,021.17 nat. median
$13,965
outlier · 2.3×
757
MS_DRG 		Infections, Female Reproductive System With Mcc 25 $15,378.61 $47,889.90 $31,914.19 nat. median
$14,012
outlier · 2.3×
811
MS_DRG 		Red Blood Cell Disorders With Mcc 25 $15,082.18 $46,966.81 $31,299.03 nat. median
$13,626
outlier · 2.3×
885
MS_DRG 		Psychoses 25 $1,667.00 $46,715.98 $31,131.88 nat. median
$12,319
outlier · 2.5×
951
MS_DRG 		Other Factors Influencing Health Status 25 $1,667.00 $46,715.98 $31,131.88 nat. median
$6,227
outlier · 5.0×
393
MS_DRG 		Other Digestive System Diagnoses With Mcc 20 $17,176.48 $38,479.80 $30,281.15 nat. median
$15,616
1.9× median
640
MS_DRG 		Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 25 $14,344.34 $44,669.14 $29,767.85 nat. median
$12,850
outlier · 2.3×
57
MS_DRG 		Degenerative Nervous System Disorders Without Mcc 17 $13,914.74 $43,331.34 $29,230.03 nat. median
$12,554
outlier · 2.3×
975
MS_DRG 		HIV With Major Related Condition With Cc 25 $13,908.30 $43,311.28 $28,862.97 nat. median
$13,405
outlier · 2.2×
291
MS_DRG 		Heart Failure And Shock With Mcc 25 $13,788.01 $42,936.69 $28,613.33 nat. median
$12,770
outlier · 2.2×
391
MS_DRG 		Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 25 $13,621.54 $42,418.29 $28,267.87 nat. median
$12,539
outlier · 2.3×
189
MS_DRG 		Pulmonary Edema And Respiratory Failure 25 $13,268.20 $41,317.95 $27,534.60 nat. median
$12,282
outlier · 2.2×
604
MS_DRG 		Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 21 $15,810.35 $49,234.38 $27,185.27 nat. median
$14,404
1.9× median
304
MS_DRG 		Hypertension With Mcc 25 $12,780.60 $39,799.55 $26,522.72 nat. median
$11,828
outlier · 2.2×
725
MS_DRG 		Benign Prostatic Hypertrophy With Mcc 24 $12,567.95 $39,137.34 $26,400.88 nat. median
$12,126
outlier · 2.2×
344
MS_DRG 		Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections,extreme 6 $17,699.59 $27,150.12 $25,857.25 nat. median
$24,575
1.1× median
193
MS_DRG 		Simple Pneumonia And Pleurisy With Mcc 28 $14,116.66 $43,960.11 $24,886.85 nat. median
$12,868
1.9× median
445
MS_DRG 		Disorders Of The Biliary Tract With Cc 6 $13,411.32 $24,690.76 $24,690.76 nat. median
$11,041
outlier · 2.2×
190
MS_DRG 		Chronic Obstructive Pulmonary Disease With Mcc 25 $11,896.70 $37,047.03 $24,688.42 nat. median
$11,062
outlier · 2.2×
887
MS_DRG 		Other Mental Disorder Diagnoses 19 $3,954.00 $35,816.25 $24,160.57 nat. median
$10,457
outlier · 2.3×
882
MS_DRG 		Neuroses Except Depressive 25 $1,667.00 $35,913.24 $23,932.85 nat. median
$9,342
outlier · 2.6×
433
MS_DRG 		Cirrhosis And Alcoholic Hepatitis With Cc 25 $11,343.59 $35,324.61 $23,540.58 nat. median
$10,764
outlier · 2.2×
74
MS_DRG 		Cranial And Peripheral Nerve Disorders Without Mcc 25 $11,070.79 $34,475.11 $22,974.47 nat. median
$10,485
outlier · 2.2×
92
MS_DRG 		Other Disorders Of Nervous System With Cc 18 $6,778.31 $23,851.69 $22,869.72 nat. median
$10,605
outlier · 2.2×
872
MS_DRG 		Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 25 $10,990.24 $34,224.27 $22,807.31 nat. median
$10,401
outlier · 2.2×
923
MS_DRG 		Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 25 $10,930.10 $34,036.98 $22,682.50 nat. median
$10,193
outlier · 2.2×
815
MS_DRG 		Reticuloendothelial And Immunity Disorders With Cc 25 $10,890.36 $33,913.23 $22,600.03 nat. median
$10,367
outlier · 2.2×
65
MS_DRG 		Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 25 $10,850.62 $33,789.48 $22,517.57 nat. median
$10,473
outlier · 2.2×
178
MS_DRG 		Respiratory Infections And Inflammations With Cc 25 $10,482.24 $32,642.32 $21,753.09 nat. median
$10,198
outlier · 2.1×
315
MS_DRG 		Other Circulatory System Diagnoses With Cc 22 $10,345.84 $23,177.38 $21,733.01 nat. median
$9,952
outlier · 2.2×

Other procedures at this hospital

Browse this hospital's 186 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
             
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 44 25 — — $24,806.68 $86,261.34 $57,485.21 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 44 25 — — $21,076.80 $70,007.07 $46,653.25 2026-04-01
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 44 25 — — $20,445.93 $67,257.90 $44,821.17 2026-04-01
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 44 25 — — $20,346.92 $66,826.45 $44,533.65 2026-04-01
871 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc 44 25 — — $19,920.22 $64,966.91 $43,294.44 2026-04-01
91 MS_DRG Other Disorders Of Nervous System With Mcc 44 25 — — $18,490.42 $58,736.11 $39,142.18 2026-04-01
58 MS_DRG Multiple Sclerosis And Cerebellar Ataxia With Mcc 44 25 — — $18,132.01 $57,174.23 $38,101.33 2026-04-01
551 MS_DRG Medical Back Problems With Mcc 44 25 — — $17,875.67 $56,057.16 $37,356.91 2026-04-01
698 MS_DRG Other Kidney And Urinary Tract Diagnoses With Mcc 44 25 — — $17,709.13 $55,331.41 $36,873.27 2026-04-01
299 MS_DRG Peripheral Vascular Disorders With Mcc 12 10 — — $7,252.00 $39,283.42 $36,389.61 2026-04-01
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 44 25 — — $17,508.35 $54,522.04 $36,333.90 2026-04-01
280 MS_DRG Acute Myocardial Infarction, Discharged Alive With Mcc 32 21 — — $17,228.03 $53,649.12 $36,190.10 2026-04-01
917 MS_DRG Poisoning And Toxic Effects Of Drugs With Mcc 44 25 — — $16,844.62 $52,455.14 $34,956.50 2026-04-01
154 MS_DRG Other Ear, Nose, Mouth And Throat Diagnoses With Mcc 44 25 — — $16,791.99 $52,291.26 $34,847.29 2026-04-01
177 MS_DRG Respiratory Infections And Inflammations With Mcc 44 25 — — $16,783.40 $52,264.50 $34,829.46 2026-04-01
813 MS_DRG Coagulation Disorders 44 25 — — $16,381.72 $51,013.66 $33,995.89 2026-04-01
606 MS_DRG Minor Skin Disorders With Mcc 44 25 — — $16,251.77 $50,608.97 $33,726.21 2026-04-01
682 MS_DRG Renal Failure With Mcc 27 17 — — $15,905.94 $49,532.05 $32,604.22 2026-04-01
289 MS_DRG Acute And Subacute Endocarditis With Cc 23 14 — — $18,112.07 $57,087.27 $32,318.44 2026-04-01
602 MS_DRG Cellulitis With Mcc 36 22 — — $15,264.76 $47,535.38 $32,065.95 2026-04-01
637 MS_DRG Diabetes With Mcc 44 25 — — $15,430.16 $48,050.43 $32,021.17 2026-04-01
757 MS_DRG Infections, Female Reproductive System With Mcc 44 25 — — $15,378.61 $47,889.90 $31,914.19 2026-04-01
811 MS_DRG Red Blood Cell Disorders With Mcc 44 25 — — $15,082.18 $46,966.81 $31,299.03 2026-04-01
885 MS_DRG Psychoses 44 25 — — $1,667.00 $46,715.98 $31,131.88 2026-04-01
951 MS_DRG Other Factors Influencing Health Status 44 25 — — $1,667.00 $46,715.98 $31,131.88 2026-04-01
393 MS_DRG Other Digestive System Diagnoses With Mcc 33 20 — — $17,176.48 $38,479.80 $30,281.15 2026-04-01
640 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes With M… 44 25 — — $14,344.34 $44,669.14 $29,767.85 2026-04-01
57 MS_DRG Degenerative Nervous System Disorders Without Mcc 20 17 — — $13,914.74 $43,331.34 $29,230.03 2026-04-01
975 MS_DRG HIV With Major Related Condition With Cc 44 25 — — $13,908.30 $43,311.28 $28,862.97 2026-04-01
291 MS_DRG Heart Failure And Shock With Mcc 44 25 — — $13,788.01 $42,936.69 $28,613.33 2026-04-01
391 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders With Mcc 44 25 — — $13,621.54 $42,418.29 $28,267.87 2026-04-01
189 MS_DRG Pulmonary Edema And Respiratory Failure 44 25 — — $13,268.20 $41,317.95 $27,534.60 2026-04-01
604 MS_DRG Trauma To The Skin, Subcutaneous Tissue And Breast With Mcc 28 21 — — $15,810.35 $49,234.38 $27,185.27 2026-04-01
304 MS_DRG Hypertension With Mcc 44 25 — — $12,780.60 $39,799.55 $26,522.72 2026-04-01
725 MS_DRG Benign Prostatic Hypertrophy With Mcc 38 24 — — $12,567.95 $39,137.34 $26,400.88 2026-04-01
344 MS_DRG Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections,extreme 6 6 — — $17,699.59 $27,150.12 $25,857.25 2026-04-01
193 MS_DRG Simple Pneumonia And Pleurisy With Mcc 47 28 — — $14,116.66 $43,960.11 $24,886.85 2026-04-01
445 MS_DRG Disorders Of The Biliary Tract With Cc 6 6 — — $13,411.32 $24,690.76 $24,690.76 2026-04-01
190 MS_DRG Chronic Obstructive Pulmonary Disease With Mcc 44 25 — — $11,896.70 $37,047.03 $24,688.42 2026-04-01
887 MS_DRG Other Mental Disorder Diagnoses 32 19 — — $3,954.00 $35,816.25 $24,160.57 2026-04-01
882 MS_DRG Neuroses Except Depressive 44 25 — — $1,667.00 $35,913.24 $23,932.85 2026-04-01
433 MS_DRG Cirrhosis And Alcoholic Hepatitis With Cc 44 25 — — $11,343.59 $35,324.61 $23,540.58 2026-04-01
74 MS_DRG Cranial And Peripheral Nerve Disorders Without Mcc 44 25 — — $11,070.79 $34,475.11 $22,974.47 2026-04-01
92 MS_DRG Other Disorders Of Nervous System With Cc 24 18 — — $6,778.31 $23,851.69 $22,869.72 2026-04-01
872 MS_DRG Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc 44 25 — — $10,990.24 $34,224.27 $22,807.31 2026-04-01
923 MS_DRG Other Injury, Poisoning And Toxic Effect Diagnoses Without Mcc 44 25 — — $10,930.10 $34,036.98 $22,682.50 2026-04-01
815 MS_DRG Reticuloendothelial And Immunity Disorders With Cc 44 25 — — $10,890.36 $33,913.23 $22,600.03 2026-04-01
65 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours 44 25 — — $10,850.62 $33,789.48 $22,517.57 2026-04-01
178 MS_DRG Respiratory Infections And Inflammations With Cc 44 25 — — $10,482.24 $32,642.32 $21,753.09 2026-04-01
315 MS_DRG Other Circulatory System Diagnoses With Cc 34 22 — — $10,345.84 $23,177.38 $21,733.01 2026-04-01
202 MS_DRG Bronchitis And Asthma With Cc/mcc 44 25 — — $10,430.69 $32,481.78 $21,646.11 2026-04-01
394 MS_DRG Other Digestive System Diagnoses With Cc 32 21 — — $10,049.42 $22,513.32 $21,110.33 2026-04-01
101 MS_DRG Seizures Without Mcc 26 18 — — $6,393.41 $22,176.47 $20,542.85 2026-04-01
60 MS_DRG Multiple Sclerosis And Cerebellar Ataxia Without Cc/mcc 44 25 — — $9,878.65 $30,762.71 $20,500.51 2026-04-01
281 MS_DRG Acute Myocardial Infarction, Discharged Alive With Cc 44 25 — — $9,871.13 $30,739.30 $20,484.90 2026-04-01
638 MS_DRG Diabetes With Cc 31 19 — — $11,890.20 $29,973.41 $20,219.17 2026-04-01
883 MS_DRG Disorders Of Personality And Impulse Control 44 25 — — $1,667.00 $65,762.90 $20,102.88 2026-04-01
866 MS_DRG Viral Illness Without Mcc 31 19 — — $3,954.00 $29,592.14 $19,961.97 2026-04-01
312 MS_DRG Syncope And Collapse 25 17 — — $6,043.81 $29,140.63 $19,657.40 2026-04-01
683 MS_DRG Renal Failure With Cc 44 25 — — $9,406.09 $29,291.13 $19,519.83 2026-04-01
558 MS_DRG Tendonitis, Myositis And Bursitis Without Mcc 25 19 — — $5,991.78 $28,889.79 $19,488.19 2026-04-01
603 MS_DRG Cellulitis Without Mcc 44 25 — — $9,353.47 $29,127.25 $19,410.61 2026-04-01
918 MS_DRG Poisoning And Toxic Effects Of Drugs Without Mcc 44 25 — — $9,205.25 $28,665.71 $19,103.04 2026-04-01
385 MS_DRG Inflammatory Bowel Disease With Mcc 36 23 — — $4,300.00 $52,920.02 $18,881.43 2026-04-01
384 MS_DRG Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue,major 2 2 — — $18,341.19 $19,258.25 $18,799.72 2026-04-01
439 MS_DRG Disorders Of Pancreas Except Malignancy With Cc 44 25 — — $9,034.49 $28,133.93 $18,748.67 2026-04-01
103 MS_DRG Headaches Without Mcc 23 16 — — $8,981.86 $28,434.94 $18,717.15 2026-04-01
556 MS_DRG Signs And Symptoms Of Musculoskeletal System And Connective Tissue Without Mcc 44 25 — — $8,920.64 $27,779.42 $18,512.42 2026-04-01
554 MS_DRG Bone Diseases And Arthropathies Without Mcc 44 25 — — $8,915.27 $27,762.69 $18,501.27 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 30 21 — — $2,062.00 $58,364.87 $18,405.22 2026-04-01
552 MS_DRG Medical Back Problems Without Mcc 33 23 — — $12,389.81 $32,150.68 $18,201.25 2026-04-01
728 MS_DRG Inflammation Of The Male Reproductive System Without Mcc 44 25 — — $8,712.29 $27,130.58 $18,080.03 2026-04-01
690 MS_DRG Kidney And Urinary Tract Infections Without Mcc 44 25 — — $8,694.03 $27,073.73 $18,042.14 2026-04-01
69 MS_DRG Transient Ischemia Without Thrombolytic 22 17 — — $11,142.68 $26,715.87 $18,021.73 2026-04-01
948 MS_DRG Signs And Symptoms Without Mcc 44 25 — — $8,597.37 $26,772.72 $17,841.54 2026-04-01
93 MS_DRG Other Disorders Of Nervous System Without Cc/mcc 44 25 — — $8,552.26 $26,632.25 $17,747.93 2026-04-01
389 MS_DRG Gastrointestinal Obstruction With Cc 44 25 — — $8,482.45 $26,414.86 $17,603.07 2026-04-01
884 MS_DRG Organic Disturbances And Intellectual Disability 44 25 — — $1,667.00 $53,809.66 $17,359.94 2026-04-01
641 MS_DRG Miscellaneous Disorders Of Nutrition, Metabolism, Fluids And Electrolytes Withou… 44 25 — — $8,357.87 $26,026.90 $17,344.52 2026-04-01
645 MS_DRG Endocrine Disorders Without Cc/mcc 38 23 — — $8,251.54 $18,485.61 $17,333.62 2026-04-01
305 MS_DRG Hypertension Without Mcc 44 25 — — $8,109.77 $25,254.32 $16,829.67 2026-04-01
149 MS_DRG Dysequilibrium 38 21 — — $8,072.18 $18,083.80 $16,751.66 2026-04-01
309 MS_DRG Cardiac Arrhythmia And Conduction Disorders With Cc 25 17 — — $3,954.00 $17,101.35 $16,598.13 2026-04-01
373 MS_DRG Major Gastrointestinal Disorders And Peritoneal Infections Without Cc/mcc 28 21 — — $5,031.76 $24,261.00 $16,365.75 2026-04-01
313 MS_DRG Chest Pain 24 19 — — $8,556.83 $23,859.66 $16,095.02 2026-04-01
301 MS_DRG Peripheral Vascular Disorders Without Cc/mcc 29 19 — — $4,948.53 $23,859.66 $16,095.02 2026-04-01
191 MS_DRG Chronic Obstructive Pulmonary Disease With Cc 25 15 — — $9,575.90 $20,670.29 $15,961.36 2026-04-01
392 MS_DRG Esophagitis, Gastroenteritis And Miscellaneous Digestive Disorders Without Mcc 24 18 — — $4,300.00 $18,774.33 $15,611.85 2026-04-01
565 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses With Cc 16 11 — — $10,465.06 $21,983.44 $15,469.82 2026-04-01
66 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc 44 25 — — $7,350.46 $22,889.76 $15,253.91 2026-04-01
395 MS_DRG Other Digestive System Diagnoses Without Cc/mcc 44 25 — — $6,970.26 $21,705.81 $14,464.92 2026-04-01
192 MS_DRG Chronic Obstructive Pulmonary Disease Without Cc/mcc 44 25 — — $6,895.08 $21,471.69 $14,308.90 2026-04-01
440 MS_DRG Disorders Of Pancreas Except Malignancy Without Cc/mcc 44 25 — — $6,673.84 $20,782.72 $13,849.76 2026-04-01
639 MS_DRG Diabetes Without Cc/mcc 44 25 — — $6,671.69 $20,776.03 $13,845.31 2026-04-01
661 MS_DRG Coagulation And Platelet Disorders,minor 7 6 — — $13,703.53 $14,388.70 $13,703.53 2026-04-01
832 MS_DRG Other Antepartum Diagnoses Without O.r. Procedures With Cc 23 20 — — $7,749.98 $16,773.59 $13,662.77 2026-04-01
720 MS_DRG Septicemia And Disseminated Infections,extreme 21 6 — — $9,098.08 $30,038.63 $13,457.43 2026-04-01
469 MS_DRG Acute Kidney Injury,major 4 4 — — $12,987.23 $13,636.59 $13,311.91 2026-04-01
195 MS_DRG Simple Pneumonia And Pleurisy Without Cc/mcc 34 21 — — $6,750.09 $21,020.18 $12,868.23 2026-04-01
364 MS_DRG Other Skin, Subcutaneous Tissue And Related Procedures,moderate 7 6 — — $12,848.06 $13,490.47 $12,848.06 2026-04-01
52 MS_DRG Alteration In Consciousness,major 7 6 — — $12,667.88 $13,301.28 $12,667.88 2026-04-01
880 MS_DRG Acute Adjustment Reaction And Psychosocial Dysfunction 44 25 — — $1,667.00 $32,113.89 $12,381.38 2026-04-01
203 MS_DRG Bronchitis And Asthma Without Cc/mcc 34 25 — — $6,276.81 $16,120.47 $12,372.89 2026-04-01
194 MS_DRG Simple Pneumonia And Pleurisy With Cc 63 31 — — $6,146.44 $26,953.33 $12,322.19 2026-04-01
881 MS_DRG Depressive Neuroses 44 25 — — $1,667.00 $31,468.40 $12,233.25 2026-04-01
133 MS_DRG Respiratory Failure,major 14 6 — — $8,673.29 $15,902.16 $12,125.94 2026-04-01
897 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy Without Mcc 37 21 — — $2,062.00 $21,240.52 $11,787.35 2026-04-01
383 MS_DRG Cellulitis And Other Skin Infections,major 14 6 — — $9,301.70 $14,137.99 $11,615.77 2026-04-01
48 MS_DRG Peripheral, Cranial And Autonomic Nerve Disorders,moderate 4 3 — — $10,907.16 $11,452.51 $11,179.83 2026-04-01
894 MS_DRG Alcohol, Drug Abuse Or Dependence, Left Ama 51 31 — — $2,062.00 $20,632.22 $11,104.20 2026-04-01
254 MS_DRG Other Digestive System Diagnoses,moderate 7 6 — — $10,593.68 $11,123.36 $10,593.68 2026-04-01
282 MS_DRG Acute Myocardial Infarction, Discharged Alive Without Cc/mcc 58 31 — — $6,120.07 $24,184.08 $10,561.70 2026-04-01
812 MS_DRG Red Blood Cell Disorders Without Mcc 48 23 — — $3,522.92 $22,205.34 $10,515.23 2026-04-01
176 MS_DRG Pulmonary Embolism Without Mcc 25 17 — — $5,387.77 $27,277.74 $10,058.67 2026-04-01
113 MS_DRG Infections Of Upper Respiratory Tract,major 8 6 — — $6,634.24 $10,134.38 $9,651.79 2026-04-01
204 MS_DRG Respiratory Signs And Symptoms 38 26 — — $5,625.53 $19,512.98 $9,239.69 2026-04-01
43 MS_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies,mi… 7 6 — — $9,174.26 $9,632.97 $9,174.26 2026-04-01
710 MS_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure,minor 7 6 — — $8,901.79 $9,346.88 $8,901.79 2026-04-01
45 MS_DRG Cva And Precerebral Occlusion With Infarction,minor 14 6 — — $7,167.44 $10,769.61 $8,891.29 2026-04-01
425 MS_DRG Other Non-hypovolemic Electrolyte Disorders,moderate 7 6 — — $8,567.81 $8,996.20 $8,567.81 2026-04-01
775 MS_DRG Alcohol Abuse And Dependence,major 14 6 — — $4,973.11 $12,429.19 $8,529.55 2026-04-01
54 MS_DRG Migraine And Other Headaches,moderate 11 6 — — $7,382.76 $8,510.18 $8,104.93 2026-04-01
201 MS_DRG Cardiac Arrhythmia And Conduction Disorders,moderate 7 6 — — $7,766.55 $8,154.88 $7,766.55 2026-04-01
463 MS_DRG Kidney And Urinary Tract Infections,moderate 11 6 — — $5,793.42 $7,842.65 $7,469.19 2026-04-01
422 MS_DRG Hypovolemia And Related Electrolyte Disorders,moderate 5 5 — — $7,460.40 $7,833.42 $7,460.40 2026-04-01
138 MS_DRG Bronchiolitis And Rsv Pneumonia,moderate 5 5 — — $7,401.81 $7,771.90 $7,401.81 2026-04-01
351 MS_DRG Other Musculoskeletal System And Connective Tissue Diagnoses,minor 8 5 — — $6,580.04 $7,817.83 $7,363.43 2026-04-01
426 MS_DRG Non-hypovolemic Sodium Disorders,minor 14 6 — — $5,641.07 $8,966.98 $7,231.56 2026-04-01
140 MS_DRG Chronic Obstructive Pulmonary Disease,minor 14 6 — — $6,572.71 $7,834.96 $7,181.61 2026-04-01
244 MS_DRG Diverticulitis And Diverticulosis,minor 12 5 — — $6,380.82 $8,025.68 $7,171.68 2026-04-01
139 MS_DRG Other Pneumonia,major 21 6 — — $5,979.45 $10,545.05 $7,170.37 2026-04-01
28119 CPT Ostectomy Calcaneus Spur W/wo Plntar Fascial Rls|LEFT Side 4 3 — — $7,079.78 $7,221.37 $7,150.57 2026-04-01
27650 CPT Repair Primary Open/Prq Ruptured Achilles Tendon|LEFT Side 4 3 — — $7,079.78 $7,221.37 $7,150.57 2026-04-01
28296 CPT Corrj Hallux Valgus W/Sesmdc W/Dist Metar Osteot|LEFT Foot, Great Toe 4 2 — — $7,079.78 $7,079.78 $7,079.78 2026-04-01
249 MS_DRG Other Gastroenteritis, Nausea And Vomiting,major 21 6 — — $6,017.54 $12,907.53 $6,987.26 2026-04-01
420 MS_DRG Diabetes,minor 19 6 — — $6,703.08 $11,621.71 $6,782.18 2026-04-01
817 MS_DRG Intentional Self-harm And Attempted Suicide,minor 14 6 — — $5,668.90 $7,804.20 $6,692.46 2026-04-01
141 MS_DRG Asthma,major 19 6 — — $5,307.09 $7,781.12 $6,622.52 2026-04-01
251 MS_DRG Abdominal Pain,moderate 5 5 — — $6,565.39 $6,893.66 $6,565.39 2026-04-01
207 MS_DRG Other Circulatory System Diagnoses,minor 7 6 — — $6,555.13 $6,882.89 $6,555.13 2026-04-01
816 MS_DRG Toxic Effects Of Non-medicinal Substances,moderate 6 6 — — $6,432.09 $6,753.70 $6,432.09 2026-04-01
199 MS_DRG Hypertension,minor 14 6 — — $5,192.83 $7,345.85 $6,224.26 2026-04-01
776 MS_DRG Other Drug Abuse And Dependence,moderate 7 6 — — $6,221.15 $6,532.21 $6,221.15 2026-04-01
197 MS_DRG Peripheral And Other Vascular Disorders,minor 5 4 — — $6,092.24 $6,396.86 $6,092.24 2026-04-01
53 MS_DRG Seizure,minor 7 6 — — $5,998.50 $6,298.43 $5,998.50 2026-04-01
111 MS_DRG Vertigo And Other Labyrinth Disorders,minor 4 4 — — $5,611.77 $5,892.36 $5,752.07 2026-04-01
134 MS_DRG Pulmonary Embolism,minor 11 5 — — $5,077.12 $8,619.37 $5,330.97 2026-04-01
49505 CPT Rpr 1st Ingun Hrna Age 5 Yrs/> Reducible|LEFT Side 6 3 — — $3,493.34 $3,563.21 $3,528.28 2026-04-01
G0330 HCPCS Facility Svs Dental Rehab 3 2 — — $3,234.84 $3,299.54 $3,299.54 2026-04-01
28285 CPT Correction Hammertoe|LEFT Foot, Fifth Digit 17 3 — — $3,192.44 $7,221.37 $3,256.29 2026-04-01
11750 CPT Hc Removal Of Nail Bed|RIGHT Foot, Great Toe 4 3 — — $3,192.44 $3,256.29 $3,224.36 2026-04-01
28118 CPT Ostectomy Calcaneus|LEFT Side 1 1 — — $3,192.44 $3,192.44 $3,192.44 2026-04-01
28825 CPT Amputation Toe Interphalangeal Joint|RIGHT Foot, Second Digit 6 3 — — $3,192.44 $3,256.29 $3,192.44 2026-04-01
28289 CPT Hallux Rigidus W/Cheilectomy 1st Mp Jt Without Implt|RIGHT Foot, Great Toe 5 2 — — $3,192.44 $3,256.29 $3,192.44 2026-04-01
11471 CPT Excision H/p/p/u Complex Repair 2 2 — — $2,834.09 $2,890.77 $2,862.43 2026-04-01
15271 CPT Hc App Skin Sub T/a/L Tot <100 1st 25 3 2 — — $2,834.09 $2,890.77 $2,834.09 2026-04-01
11771 CPT Excision Pilonidal Cyst/Sinus Extensive 3 2 — — $2,834.09 $2,834.09 $2,834.09 2026-04-01
28043 CPT Excision Tumor Soft Tissue Foot/Toe Subq <1.5cm|LEFT Foot, Great Toe 4 3 — — $1,611.44 $1,643.67 $1,627.56 2026-04-01
27327 CPT Hc Exc Thigh/Knee Les Sc < 3 Cm|RIGHT Side 2 2 — — $1,611.44 $1,643.67 $1,627.56 2026-04-01
12041 CPT Hc Lyr Clos Nk Hnd Ft <2.6cm 2 2 — — $1,611.44 $1,643.67 $1,627.56 2026-04-01
11422 CPT Hc Excis Benign Lesion 1.1-2.0 Cm; Scalp/Neck/Hands/Feet/Genit 4 2 — — $1,611.44 $1,643.67 $1,611.44 2026-04-01
21931 CPT Excision Tumor Soft Tis Back/Flank Subq 3 Cm/> 7 3 — — $1,611.44 $1,643.67 $1,611.44 2026-04-01
21555 CPT Exc Tumor Soft Tissue Neck/Ant Thorax Subq <3cm 4 3 — — $1,611.44 $1,643.67 $1,611.44 2026-04-01
21011 CPT Excision Tumor Soft Tiss Face/Scalp Subq <2cm 2 2 — — $1,611.44 $1,611.44 $1,611.44 2026-04-01
11406 CPT Hc Excis Benign Les > 4.0cm 3 2 — — $1,611.44 $1,611.44 $1,611.44 2026-04-01
23075 CPT Excision Tumor Soft Tissue Shoulder Subq <3cm 3 3 — — $1,611.44 $1,643.67 $1,611.44 2026-04-01
12042 CPT Hc Lyr Clos Nk Hnd Ft 2.6-5 Cm 3 2 — — $1,611.44 $1,611.44 $1,611.44 2026-04-01
12032 CPT Hc Lyr Clos Sc Tk Ext 2.6-7 Cm 6 3 — — $1,611.44 $1,643.67 $1,611.44 2026-04-01
11423 CPT Hc Exc Benign Lesion 2.1-3.0cm; Scalp/Neck/Hands/Feet/Genit 3 3 — — $1,611.44 $1,643.67 $1,611.44 2026-04-01
751 MS_DRG Major Depressive Disorders And Other Or Unspecified Psychoses,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
754 MS_DRG Depression Except Major Depressive Disorder,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
752 MS_DRG Disorders Of Personality And Impulse Control,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
753 MS_DRG Bipolar Disorders,major 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
773 MS_DRG Opioid Abuse And Dependence,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
770 MS_DRG Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
760 MS_DRG Other Mental Health Disorders,minor 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
755 MS_DRG Adjustment Disorders And Neuroses Except Depressive Diagnoses,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
750 MS_DRG Schizophrenia,moderate 7 6 — — $1,287.43 $1,351.80 $1,287.43 2026-04-01
45385 CPT Colsc Flx W/Rmvl Of Tumor Polyp Lesion Snare Tq|PREVENTIVE Services 8 3 — — $1,167.54 $1,190.90 $1,167.54 2026-04-01
45380 CPT Colonoscopy W/Biopsy Single/Multiple|COLORECTAL Cancer Screen 24 3 — — $1,167.54 $1,190.90 $1,167.54 2026-04-01
G0121 HCPCS Colon Ca Scrn Not Hi Rsk Ind 3 2 — — $907.35 $925.49 $925.49 2026-04-01
45378 CPT Colonoscopy Flx Dx W/Collj Spec When Pfrmd|PREVENTIVE Services 5 3 — — $907.35 $925.49 $907.35 2026-04-01
43239 CPT Egd Transoral Biopsy Single/Multiple 11 3 — — $884.93 $902.63 $884.93 2026-04-01
96413 CPT Hc Chemo Infusion 1st Hour Chemo|UNUSUAL Non-overlapping Service 5 3 — — $322.27 $328.72 $322.27 2026-04-01
41899 CPT Hc Dental Surgery Procedure 7 3 — — $231.09 $235.71 $231.09 2026-04-01
Q5104 HCPCS Hc Injection, Renflexis|PBB Charge|jz Modifier - Single-dose Pkgs With No Document… 31 3 — — $27.75 $28.31 $27.75 2026-04-01
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