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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 PRINCESS ANNE HOSPITAL

Virginia Beach, VA · CCN 490119 · Rates published

13,217 distinct procedures filed
14 distinct payers
139,207 rate rows
2026-04-01 last MRF observed
Data quality

103,793 of 139,207 rate rows are consumer-grade (74.6%)

35,414 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 29,030
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,376
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/sentara-princess-anne-hospital_standardcharges
Found on page https://www.sentara.com/billing/estimating-hospital-charges
Discovered viaDiscovered by HANK
Last fetch success · 2026-11-02
Content fingerprint f02c33b517d4b338… · 30,697,095 bytes · first seen 2026-11-02

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 $3,876,022.50 $3,765,279.00 nat. median
$3,691,450
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $0.03 $3,466,624.00 $3,367,577.60 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $0.03 $3,397,064.46 $3,300,005.48 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 4 $0.03 $3,071,379.46 $2,983,625.76 nat. median
$2,988,866
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $0.03 $2,813,807.90 $2,733,413.39 nat. median
$2,468,984
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $0.03 $2,434,608.00 $2,365,047.77 nat. median
$2,401,960
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 5 $334,739.11 $1,091,833.92 $832,046.19 nat. median
$360,840
outlier · 2.3×
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $0.03 $854,665.74 $830,246.72 nat. median
$813,967
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 4 $0.03 $657,631.63 $638,842.15 nat. median
$739,658
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 4 $0.03 $623,817.87 $605,994.50 nat. median
$646,415
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 4 $0.03 $619,339.11 $601,643.71 nat. median
$637,620
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 4 $0.03 $606,840.42 $589,502.12 nat. median
$606,840
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 4 $0.03 $604,642.99 $587,367.47 nat. median
$621,967
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 4 $0.03 $558,970.38 $542,999.80 nat. median
$589,050
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 5 $208,309.21 $708,556.29 $539,964.51 nat. median
$247,881
outlier · 2.2×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 5 $206,460.73 $539,826.04 $411,381.43 nat. median
$197,661
outlier · 2.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 5 $157,802.98 $536,657.96 $408,967.15 nat. median
$190,169
outlier · 2.2×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 4 $0.03 $308,411.99 $299,600.22 nat. median
$319,951
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 5 $100,787.72 $350,218.80 $255,045.83 nat. median
$126,179
outlier · 2.0×
7
MS_DRG 		Lung Transplant 5 $110,303.86 $327,432.86 $249,524.45 nat. median
$118,005
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 5 $87,447.76 $303,860.58 $231,560.90 nat. median
$109,831
outlier · 2.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 5 $81,623.40 $286,513.23 $218,341.12 nat. median
$103,967
outlier · 2.1×
209
MS_DRG 		Complex Aortic Arch Procedures 5 $85,423.48 $286,184.54 $218,090.64 nat. median
$92,852
outlier · 2.3×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 1 $199,213.13 $224,051.64 $211,632.39 nat. median
$70,523
outlier · 3.0×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 5 $84,870.12 $274,940.74 $209,522.16 nat. median
$97,040
outlier · 2.2×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 5 $77,693.51 $260,690.68 $198,662.71 nat. median
$94,857
outlier · 2.1×
215
MS_DRG 		Other Heart Assist System Implant 5 $75,227.14 $251,752.79 $191,851.48 nat. median
$93,502
outlier · 2.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 5 $73,303.74 $247,348.32 $188,494.99 nat. median
$90,525
outlier · 2.1×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 5 $65,581.93 $227,798.73 $173,596.97 nat. median
$77,824
outlier · 2.2×
850
MS_DRG 		Acute Leukemia With Other Procedures 5 $20,958.13 $218,946.80 $164,798.94 nat. median
$77,888
outlier · 2.1×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 5 $56,530.88 $212,471.57 $161,916.71 nat. median
$77,632
outlier · 2.1×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 5 $20,287.75 $213,141.59 $160,429.43 nat. median
$76,974
outlier · 2.1×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $8,758.01 $278,660.02 $158,867.14 nat. median
$93,061
1.7× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 1 $149,100.74 $167,691.07 $158,395.90 nat. median
$52,712
outlier · 3.0×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 5 $59,040.28 $198,954.74 $151,616.04 nat. median
$74,251
outlier · 2.0×
A9543
HCPCS 		Y90 Ibritumomab, Rx 4 $76,245.12 $259,497.99 $148,880.32 nat. median
$64,212
outlier · 2.3×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 5 $56,674.04 $194,138.14 $147,945.48 nat. median
$72,172
outlier · 2.0×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 5 $56,004.97 $192,661.55 $146,820.23 nat. median
$67,825
outlier · 2.2×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 5 $14,735.25 $193,301.24 $146,401.76 nat. median
$71,682
outlier · 2.0×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 1 $137,500.54 $154,644.53 $146,072.54 nat. median
$49,451
outlier · 3.0×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 $53,089.07 $678,558.17 $141,927.05 nat. median
$66,583
outlier · 2.1×
10
MS_DRG 		Pancreas Or Islet Cell Transplant 5 $55,800.98 $181,430.40 $138,261.39 nat. median
$64,557
outlier · 2.1×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 5 $56,703.71 $181,354.55 $138,203.58 nat. median
$61,444
outlier · 2.2×
19
MS_DRG 		Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis 5 $55,974.55 $180,391.23 $137,469.47 nat. median
$66,279
outlier · 2.1×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 5 $49,715.51 $219,321.85 $137,377.18 nat. median
$63,362
outlier · 2.2×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 5 $53,152.86 $173,900.82 $132,523.38 nat. median
$63,879
outlier · 2.1×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 5 $48,405.55 $170,189.13 $129,694.83 nat. median
$61,572
outlier · 2.1×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 5 $44,933.22 $169,061.47 $128,043.13 nat. median
$57,541
outlier · 2.2×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc 5 $47,046.34 $168,937.57 $127,949.30 nat. median
$60,366
outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 13,217 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 14 5 — — $19,511.47 $68,423.56 $51,822.38 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 13 5 — — $40,854.36 $138,806.63 $105,779.39 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 15 5 — — $20,958.13 $218,946.80 $164,798.94 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 7 4 — — $0.03 $854,665.74 $830,246.72 2026-04-01
245 MS_DRG Aicd Generator Procedures 15 5 — — $8,962.31 $115,355.72 $86,827.03 2026-04-01
265 MS_DRG Aicd Lead Procedures 13 5 — — $24,154.94 $91,482.57 $69,715.48 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 13 5 — — $87,447.76 $303,860.58 $231,560.90 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 15 5 — — $33,332.57 $124,440.26 $93,664.87 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc O… 13 5 — — $31,253.65 $108,541.68 $82,715.60 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 14 5 — — $23,330.08 $88,175.42 $66,781.96 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 13 5 — — $53,152.86 $173,900.82 $132,523.38 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 13 5 — — $31,589.68 $106,779.39 $81,372.62 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 13 5 — — $17,677.07 $60,552.65 $46,144.93 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 13 5 — — $44,606.96 $149,926.53 $114,253.46 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 13 5 — — $36,265.77 $137,350.27 $104,669.56 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 7 4 — — $0.03 $606,840.42 $589,502.12 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 14 5 — — $27,673.88 $380,364.34 $74,389.09 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 15 5 — — $17,429.32 $65,212.49 $49,084.76 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 13 5 — — $25,301.70 $88,984.51 $67,811.80 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 13 5 — — $17,218.66 $65,212.49 $49,696.03 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 4 4 — — $96,982.65 $99,835.08 $98,765.42 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 13 5 — — $36,871.06 $139,643.53 $106,417.16 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 13 5 — — $21,160.41 $67,255.44 $51,252.88 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 13 5 — — $24,641.53 $90,152.63 $68,701.98 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 17 5 — — $13,134.16 $62,178.41 $45,094.00 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc Or Insertion O… 15 5 — — $20,733.43 $87,346.11 $65,744.49 2026-04-01
C9782 HCPCS Blind Myocar Trpl Bon Marrow 9 4 — — $17,047.24 $58,019.76 $45,353.00 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 7 4 — — $0.03 $558,970.38 $542,999.80 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 14 5 — — $53,089.07 $678,558.17 $141,927.05 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 13 5 — — $46,005.93 $151,870.87 $115,735.17 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 13 5 — — $34,796.33 $116,774.15 $88,989.26 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 9 4 — — $55,913.67 $79,444.86 $67,042.99 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 10 4 — — $39,160.42 $82,243.80 $68,110.38 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 5 — — $73,303.74 $247,348.32 $188,494.99 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 5 — — $50,478.79 $166,249.89 $126,692.88 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 5 — — $50,478.79 $166,249.89 $126,692.88 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 5 — — $56,674.04 $194,138.14 $147,945.48 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 5 — — $40,843.23 $134,834.52 $102,752.39 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 5 — — $34,962.49 $127,436.42 $97,114.57 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 13 5 — — $17,841.75 $60,441.40 $46,060.15 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 13 5 — — $28,866.64 $97,866.78 $74,580.65 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 22 5 — — $19,689.30 $125,547.08 $55,240.37 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 16 5 — — $33,489.07 $122,088.85 $92,467.19 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 17 5 — — $16,753.70 $61,725.83 $46,466.57 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 14 5 — — $14,586.61 $62,074.75 $47,013.94 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 13 5 — — $34,940.23 $121,471.92 $92,569.25 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 13 5 — — $18,760.05 $65,548.77 $49,952.29 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 13 5 — — $334,739.11 $1,091,833.92 $832,046.19 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 13 5 — — $27,019.64 $90,076.78 $68,644.18 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 13 5 — — $22,052.76 $83,520.64 $63,647.98 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 7 4 — — $0.03 $623,817.87 $605,994.50 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 13 5 — — $65,581.93 $227,798.73 $173,596.97 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 14 5 — — $37,447.63 $145,815.36 $110,437.08 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
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
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
209 MS_DRG Complex Aortic Arch Procedures 13 5 — — $85,423.48 $286,184.54 $218,090.64 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 5 — — $84,870.12 $274,940.74 $209,522.16 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 5 — — $44,933.22 $169,061.47 $128,043.13 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 15 5 — — $7,742.45 $62,747.30 $47,229.23 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 5 — — $14,735.25 $193,301.24 $146,401.76 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 13 5 — — $40,827.65 $138,118.91 $105,255.30 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 15 5 — — $20,287.75 $213,141.59 $160,429.43 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 13 5 — — $46,192.86 $153,286.78 $116,814.18 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 13 5 — — $43,411.96 $148,381.68 $113,076.18 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 13 5 — — $32,175.67 $105,909.62 $80,709.80 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 14 5 — — $17,048.06 $109,413.98 $82,867.54 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 13 5 — — $23,669.07 $79,669.88 $60,713.47 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 13 5 — — $24,740.93 $81,171.75 $61,857.99 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 13 5 — — $23,668.34 $78,613.01 $59,908.07 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 13 5 — — $34,205.15 $114,958.76 $87,605.82 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 13 5 — — $19,532.98 $63,789.00 $48,611.24 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 13 5 — — $48,405.55 $170,189.13 $129,694.83 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 5 — — $42,593.80 $144,884.91 $110,411.42 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 13 5 — — $29,440.77 $98,908.48 $75,374.49 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 4 — — $110,408.22 $113,655.52 $112,437.78 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 5 — — $157,802.98 $536,657.96 $408,967.15 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 4 4 — — $49,118.61 $50,563.28 $50,021.53 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 4 4 — — $43,600.26 $44,882.62 $44,401.73 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 13 5 — — $43,374.88 $144,293.26 $109,960.55 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 13 5 — — $44,041.73 $154,950.47 $118,082.01 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 13 5 — — $35,019.61 $120,372.07 $91,731.09 2026-04-01
0620T OTHER Evasc Ven Artlz Tibl/prnl Vn 9 4 — — $31,497.00 $149,191.07 $45,016.81 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 5 — — $206,460.73 $539,826.04 $411,381.43 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 13 5 — — $25,997.48 $98,460.95 $75,033.45 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 21 5 — — $412.17 $62,160.71 $47,370.38 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 18 5 — — $32,437.60 $118,627.47 $86,390.11 2026-04-01
524 MS_DRG Extensive Or Complex Spinal Fusion Procedures Except Cervical With Cc 4 4 — — $72,932.11 $75,077.17 $74,272.77 2026-04-01
523 MS_DRG Extensive Or Complex Spinal Fusion Procedures Except Cervical With Mcc 4 4 — — $101,906.30 $104,903.55 $103,779.58 2026-04-01
525 MS_DRG Extensive Or Complex Spinal Fusion Procedures Except Cervical Without Cc/Mcc 4 4 — — $54,111.97 $55,703.50 $55,106.68 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 14 5 — — $24,042.48 $83,237.46 $63,042.07 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 25 6 — — $20,844.23 $235,949.37 $83,751.45 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 3 2 — — $5,220.00 $50,815.00 $45,353.00 2026-04-01
503 MS_DRG Foot Procedures With Mcc 15 5 — — $17,816.89 $70,570.17 $53,117.42 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 13 5 — — $56,703.71 $181,354.55 $138,203.58 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 14 5 — — $22,386.55 $81,434.71 $61,676.71 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 5 — — $208,309.21 $708,556.29 $539,964.51 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 5 — — $81,623.40 $286,513.23 $218,341.12 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 16 5 — — $6,747.53 $86,145.12 $62,734.93 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 15 5 — — $19,590.38 $73,374.17 $55,227.96 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc Or Insertion Of Antibiotic-… 18 5 — — $15,646.52 $73,634.59 $49,020.77 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 16 5 — — $17,197.56 $72,570.14 $54,962.90 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 13 5 — — $53,217.40 $154,770.95 $117,945.21 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 13 5 — — $23,332.31 $66,684.02 $50,817.42 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 16 5 — — $22,615.02 $72,969.62 $54,436.04 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 7 4 — — $0.03 $604,642.99 $587,367.47 2026-04-01
0870T OTHER Imp Subq Prtl Ascts Pmp Sys 9 4 — — $5,169.00 $149,191.07 $45,016.81 2026-04-01
69930 HCPCS Implant Cochlear Device 10 5 — — $10,181.00 $111,680.81 $44,103.96 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
64568 HCPCS Inc For Vagus N Elect Impl 10 5 — — $5,220.00 $149,191.07 $49,776.62 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 25 5 — — $13,801.00 $147,718.19 $81,576.15 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 13 5 — — $19,114.62 $63,005.20 $48,013.93 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 4 — — $0.03 $3,466,624.00 $3,367,577.60 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 7 4 — — $0.03 $2,813,807.90 $2,733,413.39 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 7 4 — — $66,504.57 $178,875.56 $68,460.59 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 7 4 — — $0.03 $4,730,250.00 $4,595,100.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 7 4 — — $0.03 $3,071,379.46 $2,983,625.76 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 7 4 — — $0.03 $2,434,608.00 $2,365,047.77 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 4 — — $0.03 $3,876,022.50 $3,765,279.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 4 — — $0.03 $3,397,064.46 $3,300,005.48 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 10 5 — — $5,220.00 $138,244.00 $63,798.30 2026-04-01
33967 HCPCS Insert I-aort Percut Device 3 2 — — $5,220.00 $50,815.00 $45,353.00 2026-04-01
0916T OTHER Insj Perm Ccm-d Sys Pg Only 9 4 — — $22,136.77 $75,341.85 $54,429.00 2026-04-01
0915T OTHER Insj Perm Ccm-d Sys Pg&eltrd 9 4 — — $31,238.15 $106,318.11 $54,429.00 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 9 4 — — $43,834.99 $149,191.07 $54,429.00 2026-04-01
0515T OTHER Insj Wcs Lv Compl Sys 9 4 — — $22,136.77 $75,341.85 $54,429.00 2026-04-01
0409T OTHER Insj/rplc Car Modulj Pls Gn 9 4 — — $22,136.77 $75,341.85 $54,429.00 2026-04-01
0408T OTHER Insj/rplc Cardiac Modulj Sys 9 4 — — $31,238.15 $106,318.11 $54,429.00 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 10 5 — — $5,220.00 $138,244.00 $63,798.30 2026-04-01
0571T OTHER Insj/rplcmt Icds Ss Eltrd 9 4 — — $31,238.15 $106,318.11 $54,429.00 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 10 5 — — $5,220.00 $138,244.00 $45,210.38 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 10 5 — — $5,220.00 $138,244.00 $63,798.30 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 10 5 — — $5,220.00 $138,244.00 $45,210.38 2026-04-01
C9758 HCPCS Interatrial Shunt Ide 9 4 — — $17,047.24 $58,019.76 $45,353.00 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 13 5 — — $40,576.94 $133,848.44 $102,000.94 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 5 — — $59,040.28 $198,954.74 $151,616.04 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 13 5 — — $24,863.32 $80,337.38 $61,222.14 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 15 5 — — $18,423.71 $69,710.52 $52,470.37 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 13 5 — — $24,316.64 $80,499.20 $61,345.46 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 19 5 — — $17,110.91 $64,244.12 $48,355.87 2026-04-01
652 MS_DRG Kidney Transplant 13 5 — — $23,583.77 $81,654.68 $62,226.01 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 13 5 — — $34,804.49 $118,870.20 $90,586.58 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 13 5 — — $27,949.07 $93,697.45 $71,403.35 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 10 4 — — $22,185.83 $81,594.00 $67,572.24 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 22 5 — — $14,870.22 $60,337.74 $44,286.58 2026-04-01
0674T OTHER Laps Insj Nw/rpcmt Prm Isdss 9 4 — — $30,709.54 $104,518.98 $45,353.00 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 1 1 — — $69,723.94 $69,723.94 $69,723.94 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 14 5 — — $25,236.95 $95,143.69 $72,059.57 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 7 4 — — $0.03 $619,339.11 $601,643.71 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 5 — — $77,693.51 $260,690.68 $198,662.71 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 13 5 — — $33,939.59 $117,241.91 $89,345.72 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 14 5 — — $24,745.38 $91,672.20 $69,430.35 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 13 5 — — $23,651.27 $76,276.77 $58,127.70 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 22 5 — — $965.90 $64,122.75 $47,500.47 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc Or In… 19 5 — — $21,808.30 $92,832.73 $65,336.12 2026-04-01
7 MS_DRG Lung Transplant 13 5 — — $110,303.86 $327,432.86 $249,524.45 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 13 5 — — $46,326.38 $148,285.60 $113,002.97 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 17 5 — — $80.75 $81,791.21 $61,563.38 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 14 5 — — $34,159.16 $115,922.08 $87,796.63 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 13 5 — — $20,914.89 $70,777.50 $53,936.91 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 14 5 — — $38,678.00 $131,385.78 $103,431.74 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 14 5 — — $18,656.21 $63,816.82 $48,777.46 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 17 5 — — $31,266.15 $113,317.83 $79,753.63 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 17 5 — — $3,182.31 $107,843.85 $75,901.01 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 19 5 — — $7,410.51 $76,691.43 $57,724.83 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 22 5 — — $22,761.73 $156,539.79 $87,810.99 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 17 5 — — $9,278.69 $77,406.97 $54,479.39 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 16 5 — — $17,609.14 $65,303.52 $47,557.10 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 18 5 — — $8,758.01 $278,660.02 $158,867.14 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 5 — — $49,715.51 $219,321.85 $137,377.18 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 21 5 — — $36,592.67 $142,146.65 $100,043.49 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc 14 5 — — $47,046.34 $168,937.57 $127,949.30 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 22 5 — — $28,033.69 $142,258.64 $81,209.20 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 13 5 — — $35,278.48 $118,273.50 $90,131.85 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 14 5 — — $14,731.00 $58,436.38 $44,258.32 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 13 5 — — $23,193.60 $79,897.44 $60,886.88 2026-04-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 14 5 — — $16,846.29 $58,024.25 $43,946.18 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 14 5 — — $28,341.46 $91,320.75 $69,164.17 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 15 5 — — $22,846.07 $86,683.67 $65,245.88 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 13 5 — — $19,276.33 $73,005.02 $55,634.42 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 14 5 — — $15,660.95 $59,086.18 $44,750.46 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 13 5 — — $24,223.92 $91,742.99 $69,913.94 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 13 5 — — $27,299.29 $97,720.13 $74,468.89 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 7 4 — — $0.03 $308,411.99 $299,600.22 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 9 4 — — $30,709.54 $104,518.98 $45,353.00 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 14 5 — — $9,602.47 $59,445.21 $45,022.38 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 5 — — $36,836.20 $125,090.06 $95,326.50 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 13 5 — — $25,519.79 $79,631.96 $60,684.57 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 11 4 — — $34,887.94 $84,463.73 $68,619.26 2026-04-01
357 MS_DRG Other Digestive System O.r. Procedures With Cc 15 5 — — $16,945.69 $58,797.94 $44,807.73 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 5 — — $28,741.69 $111,067.56 $80,884.63 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 15 5 — — $1,794.47 $94,729.03 $71,301.54 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc Or Insertion… 13 5 — — $27,462.47 $94,228.41 $71,807.98 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 13 5 — — $31,646.79 $112,839.96 $85,991.16 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 13 5 — — $16,057.79 $60,815.61 $46,345.32 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 13 5 — — $18,326.12 $64,919.20 $49,472.52 2026-04-01
215 MS_DRG Other Heart Assist System Implant 13 5 — — $75,227.14 $251,752.79 $191,851.48 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 14 5 — — $15,862.06 $105,004.45 $79,527.87 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 16 5 — — $15,642.36 $113,631.21 $44,783.02 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 5 — — $28,903.28 $106,233.25 $77,364.06 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 20 5 — — $23,686.25 $89,917.49 $67,050.98 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 22 5 — — $35,887.93 $165,035.48 $95,613.06 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 15 5 — — $18,435.90 $64,550.05 $49,191.20 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 13 5 — — $19,553.75 $69,121.40 $52,674.86 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 14 5 — — $21,008.17 $80,577.58 $61,027.54 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 18 5 — — $26,364.43 $97,072.86 $70,693.03 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 13 5 — — $30,227.05 $106,544.25 $81,193.43 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 5 — — $56,004.97 $192,661.55 $146,820.23 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 13 5 — — $20,111.55 $74,438.62 $56,726.92 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 13 5 — — $27,446.89 $100,733.98 $76,765.64 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 16 5 — — $26,092.25 $94,504.01 $68,822.27 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 14 5 — — $21,866.22 $81,882.23 $62,015.65 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 14 5 — — $16,503.01 $88,198.18 $66,799.20 2026-04-01
10 MS_DRG Pancreas Or Islet Cell Transplant 13 5 — — $55,800.98 $181,430.40 $138,261.39 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 13 5 — — $21,867.32 $73,328.66 $55,881.05 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 14 5 — — $18,788.14 $138,316.12 $104,757.34 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 13 5 — — $15,535.59 $58,838.40 $44,838.56 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 13 5 — — $31,884.15 $104,309.14 $79,490.13 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 13 5 — — $24,715.71 $83,227.34 $63,424.48 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 15 5 — — $20,136.78 $68,792.71 $52,424.37 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 13 5 — — $25,060.64 $86,941.56 $66,254.94 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 13 5 — — $17,356.63 $61,043.16 $46,518.73 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 13 5 — — $19,422.45 $61,242.90 $46,670.95 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 14 5 — — $26,392.77 $97,626.58 $73,940.05 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 15 5 — — $23,310.93 $90,286.64 $67,957.80 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 16 5 — — $14,018.83 $80,726.76 $58,789.03 2026-04-01
93591 HCPCS Perq Transcath Cls Aortic 9 4 — — $18,243.62 $62,091.61 $45,353.00 2026-04-01
93590 HCPCS Perq Transcath Cls Mitral 9 4 — — $18,243.62 $62,091.61 $45,353.00 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 3 1 — — $61,297.90 $68,324.14 $65,659.02 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 17 5 — — $25,823.66 $115,009.33 $80,944.12 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 4 4 — — $70,177.74 $72,241.80 $71,467.77 2026-04-01
791 MS_DRG Prematurity With Major Problems 18 5 — — $7,863.63 $102,627.76 $63,043.43 2026-04-01
665 MS_DRG Prostatectomy With Mcc 13 5 — — $24,118.58 $78,916.42 $60,139.28 2026-04-01
0100T OTHER Prosth Retina Receive&Gen 3 2 — — $13,700.00 $60,970.00 $54,429.00 2026-04-01
849 MS_DRG Radiotherapy 13 5 — — $19,171.74 $68,507.00 $52,206.65 2026-04-01
333 MS_DRG Rectal Resection With Cc 13 5 — — $15,785.56 $59,220.18 $45,129.51 2026-04-01
332 MS_DRG Rectal Resection With Mcc 13 5 — — $28,090.75 $91,545.78 $69,763.65 2026-04-01
33968 HCPCS Remove Aortic Assist Device 3 2 — — $5,220.00 $50,815.00 $45,353.00 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 21 5 — — $18,291.01 $69,498.13 $52,310.51 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 19 5 — — $14,994.66 $162,694.95 $114,505.49 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 10 4 — — $23,650.58 $89,166.55 $73,843.48 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 14 4 — — $12,700.79 $131,613.33 $99,680.81 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 11 4 — — $88.10 $69,480.43 $56,446.67 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 9 4 — — $30,709.54 $104,518.98 $45,353.00 2026-04-01
0414T OTHER Rmvl & Rpl Car Modulj Pls Gn 9 4 — — $22,136.77 $75,341.85 $54,429.00 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 10 5 — — $5,220.00 $138,244.00 $45,210.38 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 10 5 — — $5,220.00 $138,244.00 $63,798.30 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 10 5 — — $5,220.00 $138,244.00 $45,210.38 2026-04-01
0923T OTHER Rmvl&rplcmt Perm Ccm-d Pg 9 4 — — $22,136.77 $75,341.85 $54,429.00 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 20 5 — — $40,214.92 $245,872.59 $127,266.98 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 13 5 — — $23,203.98 $76,370.32 $58,198.99 2026-04-01
8 MS_DRG Simultaneous Pancreas, Islet Cell And Kidney Transplant 13 5 — — $40,887.73 $141,706.71 $107,989.43 2026-04-01
19 MS_DRG Simultaneous Pancreas, Islet Cell And Kidney Transplant With Hemodialysis 13 5 — — $55,974.55 $180,391.23 $137,469.47 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 24 5 — — $25,745.39 $101,654.32 $76,720.79 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc 15 5 — — $36,046.81 $134,753.61 $101,427.62 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 23 5 — — $20,780.99 $81,677.43 $59,103.91 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 7 4 — — $56,776.39 $157,767.64 $58,446.29 2026-04-01
570 MS_DRG Skin Debridement With Mcc 14 5 — — $16,969.63 $74,362.77 $56,320.59 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 14 5 — — $17,941.83 $67,020.30 $50,759.58 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 14 5 — — $36,860.39 $123,921.94 $93,855.53 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 16 5 — — $19,029.00 $87,770.88 $63,918.89 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 13 5 — — $47,137.13 $165,645.60 $126,232.38 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 18 6 — — $18,016.26 $89,990.81 $51,898.89 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 15 5 — — $27,515.89 $92,870.66 $70,773.29 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 13 5 — — $24,924.15 $80,018.80 $60,979.37 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
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 13 5 — — $56,530.88 $212,471.57 $161,916.71 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 13 5 — — $39,809.20 $150,771.02 $114,897.01 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Or Infection Wi… 13 5 — — $29,945.91 $105,500.02 $80,397.66 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
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 19 5 — — $21,856.66 $86,258.89 $65,734.71 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 14 5 — — $45,617.99 $151,913.86 $115,055.94 2026-04-01
800 MS_DRG Splenic Procedures With Cc 13 5 — — $23,356.79 $71,032.87 $54,131.52 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 13 5 — — $35,944.60 $114,508.71 $87,262.85 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 15 5 — — $18,159.22 $61,799.15 $46,515.57 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 17 5 — — $24,791.44 $126,101.42 $94,915.21 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 9 4 — — $18,243.62 $62,091.61 $45,353.00 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 15 6 — — $3,289.62 $76,360.21 $57,475.52 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 3 2 — — $5,220.00 $50,815.00 $45,353.00 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 7 4 — — $0.03 $657,631.63 $638,842.15 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 13 5 — — $32,482.76 $106,597.34 $81,233.89 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 13 5 — — $41,634.70 $137,901.46 $105,089.60 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 13 5 — — $20,247.30 $72,863.43 $55,526.52 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 5 — — $100,787.72 $350,218.80 $255,045.83 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 10 5 — — $5,220.00 $213,054.15 $63,749.82 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 13 5 — — $21,302.83 $73,829.28 $56,262.56 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 13 5 — — $47,088.17 $140,735.80 $107,249.54 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 15 5 — — $6,820.39 $91,184.22 $68,633.40 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 13 5 — — $21,916.28 $75,255.30 $57,349.28 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 13 5 — — $20,986.84 $68,201.06 $51,973.50 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 9 4 — — $63,755.93 $90,587.52 $76,446.20 2026-04-01
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 9 4 — — $36,668.38 $52,100.21 $43,967.02 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 9 4 — — $63,608.23 $90,377.66 $76,269.11 2026-04-01
263 MS_DRG Vein Ligation And Stripping 16 5 — — $12,783.87 $77,303.30 $56,295.90 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 13 5 — — $31,597.09 $113,284.96 $86,330.27 2026-04-01
463 MS_DRG Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective T… 20 6 — — $2,768.53 $144,106.16 $70,365.69 2026-04-01
464 MS_DRG Wound Debridement Or Skin Graft Except Hand For Musculoskeletal And Connective T… 16 5 — — $8,640.51 $78,752.07 $57,350.97 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 14 5 — — $33,186.70 $106,106.83 $80,362.79 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 10 4 — — $76,245.12 $259,497.99 $148,880.32 2026-04-01
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