Price Transparency Hospital negotiated rates

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

PROVIDENCE REGIONAL MEDICAL CENTER EVERETT

Everett, WA · CCN 500014 · Rates published

15,941 distinct procedures filed
16 distinct payers
569,504 rate rows
2026-04-01 last MRF observed
Data quality

454,412 of 569,504 rate rows are consumer-grade (79.8%)

115,092 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 114,656
template filing: same amount across many unrelated codes — excluded 274
placeholder amount (≤ $0.02) — excluded from medians 162
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/wamt/live/352346161_providence-regional-medical-center-everett_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-17
Content fingerprint b7d7ee544c298a35… · 218,857,959 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,153,500.00 $4,429,740.00 $3,844,554.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 6 $2,801,600.00 $4,982,064.57 $3,470,838.32 nat. median
$3,325,455
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 9 $1,957,366.97 $4,786,111.43 $2,755,247.93 nat. median
$2,469,189
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $434,411.62 $1,424,899.47 $675,598.89 nat. median
$754,974
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 14 $386,720.03 $1,155,817.63 $657,424.05 nat. median
$370,174
1.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $431,116.53 $1,365,307.95 $635,574.39 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $402,775.49 $1,304,445.14 $607,241.70 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $411,986.76 $1,298,692.11 $604,563.57 nat. median
$625,184
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $382,024.00 $1,233,889.95 $579,715.54 nat. median
$634,511
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $382,024.00 $1,135,154.19 $528,433.85 nat. median
$620,080
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $86,381.49 $863,300.16 $401,977.28 nat. median
$265,286
1.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $191,591.60 $757,338.17 $325,705.72 nat. median
$206,368
1.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 14 $190,471.72 $656,835.63 $323,801.92 nat. median
$202,986
1.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 7 $165,619.57 $271,601.91 $211,787.46 nat. median
$87,411
outlier · 2.4×
7
MS_DRG 		Lung Transplant 14 $116,513.05 $400,531.14 $198,072.18 nat. median
$122,708
1.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $108,180.52 $401,542.59 $183,906.89 nat. median
$117,303
1.6× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 7 $143,101.85 $234,674.79 $178,199.71 nat. median
$63,570
outlier · 2.8×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $102,048.43 $351,797.48 $173,482.33 nat. median
$108,660
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 14 $52,474.47 $433,056.92 $172,715.02 nat. median
$133,176
1.3× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 7 $132,497.15 $217,283.98 $164,994.04 nat. median
$54,196
outlier · 3.0×
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 7 $123,957.69 $203,280.00 $154,376.44 nat. median
$65,381
outlier · 2.4×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 $69,242.58 $295,784.76 $149,946.95 nat. median
$93,672
1.6× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 7 $119,632.82 $196,187.59 $148,974.55 nat. median
$49,935
outlier · 3.0×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $92,920.46 $326,379.59 $148,672.74 nat. median
$100,136
1.5× median
5244
OTHER 		Level 4 Blood Product Exchange And Related Services 1 $124,578.72 $159,395.37 $148,237.70 nat. median
$63,188
outlier · 2.3×
215
MS_DRG 		Other Heart Assist System Implant 14 $56,722.49 $324,712.23 $143,617.63 nat. median
$99,019
1.5× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 7 $114,313.65 $187,464.60 $141,759.61 nat. median
$62,270
outlier · 2.3×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $74,384.20 $259,562.59 $136,576.01 nat. median
$81,118
1.7× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 10 $108,243.35 $251,124.57 $129,892.02 nat. median
$111,989
1.2× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $3,067.03 $247,054.33 $129,752.96 nat. median
$77,576
1.7× median
1580
OTHER 		New Technology - Level 43 ($40,001-$50,000) 1 $107,672.70 $137,764.53 $128,121.01 nat. median
$45,289
outlier · 2.8×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 13 $97,957.69 $333,873.52 $127,345.00 nat. median
$102,358
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 14 $55,980.96 $237,154.38 $126,645.69 nat. median
$74,915
1.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 $60,546.71 $260,000.00 $126,105.79 nat. median
$73,807
1.7× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $123,756.60 $123,756.60 $123,756.60 nat. median
$76,377
1.6× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 7 $97,537.50 $159,953.16 $121,770.60 nat. median
$44,728
outlier · 2.7×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 7 $94,528.41 $155,018.51 $117,973.80 nat. median
$48,649
outlier · 2.4×
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 7 $93,836.88 $153,884.46 $116,851.77 nat. median
$39,020
outlier · 3.0×
0427T
HCPCS 		Insj/rplc Nstim Apnea Pls Gn 1 $110,360.02 $110,360.02 $110,360.02 nat. median
$15,886
outlier · 6.9×
0424T
HCPCS 		Insj/rplc Nstim Apnea Compl 1 $110,360.02 $110,360.02 $110,360.02 nat. median
$24,752
outlier · 4.5×
0431T
HCPCS 		Rmvl/rplc Nstim Apnea Pls Gn 1 $110,360.02 $110,360.02 $110,360.02 nat. median
$18,872
outlier · 5.8×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 14 $64,876.05 $204,696.03 $110,289.29 nat. median
$64,027
1.7× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 $36,981.69 $228,762.41 $110,196.70 nat. median
$72,138
1.5× median
209
MS_DRG 		Complex Aortic Arch Procedures 12 $76,495.27 $188,574.64 $110,086.82 nat. median
$98,017
1.1× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 7 $86,078.66 $141,161.64 $110,073.84 nat. median
$48,483
outlier · 2.3×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 $64,535.52 $242,953.36 $109,710.39 nat. median
$71,240
1.5× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 $4,879.19 $321,261.04 $109,199.65 nat. median
$98,905
1.1× median
38240
HCPCS 		Transplt Allo Hct/donor 11 $7,246.00 $222,158.94 $107,447.96 nat. median
$15,912
outlier · 6.8×
0266T
HCPCS 		Implt/rpl Crtd Sns Dev Total 3 $7,246.00 $119,430.38 $104,809.20 nat. median
$42,941
outlier · 2.4×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 13 $2,779.22 $236,745.59 $103,196.78 nat. median
$68,887
1.5× median

Other procedures at this hospital

Browse this hospital's 15,941 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
             
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 64 14 — — $22.44 $78,267.84 $38,304.06 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 74 14 — — $200.00 $208,961.72 $43,360.59 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 80 14 — — $822.95 $77,139.92 $39,657.28 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 68 14 — — $846.35 $274,656.29 $40,319.73 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 66 14 — — $870.61 $81,608.69 $39,136.32 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 74 14 — — $1,008.26 $94,512.34 $46,419.41 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 68 14 — — $1,065.55 $83,263.79 $40,324.67 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 74 14 — — $1,121.58 $105,135.63 $47,919.51 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 76 14 — — $1,122.54 $138,584.96 $64,027.28 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 74 14 — — $1,327.99 $108,169.98 $46,830.92 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 72 14 — — $1,455.54 $130,734.51 $64,048.64 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 90 14 — — $1,523.04 $157,985.53 $66,961.58 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 62 14 — — $1,561.37 $146,359.88 $68,124.19 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 102 14 — — $1,635.19 $286,326.71 $67,362.83 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 72 14 — — $1,637.66 $157,820.79 $61,314.45 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 78 14 — — $1,646.08 $127,516.26 $61,623.34 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 64 14 — — $2,040.36 $132,337.51 $64,705.98 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 68 14 — — $2,232.54 $209,275.14 $97,486.72 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 56 13 — — $2,604.29 $205,483.73 $65,930.60 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 56 13 — — $2,606.20 $189,600.90 $65,978.33 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 66 14 — — $2,680.80 $204,349.68 $99,585.98 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 66 13 — — $2,779.22 $236,745.59 $103,196.78 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 78 14 — — $3,008.71 $114,753.60 $48,870.03 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 68 14 — — $3,067.03 $247,054.33 $129,752.96 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 86 14 — — $3,734.26 $127,828.89 $39,937.31 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 60 13 — — $4,879.19 $321,261.04 $109,199.65 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 70 14 — — $5,087.62 $101,197.11 $51,382.38 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 78 14 — — $5,104.02 $156,140.30 $52,022.41 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 68 14 — — $5,722.64 $95,609.61 $43,604.25 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 78 14 — — $5,809.31 $221,304.79 $93,248.16 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 74 14 — — $5,973.65 $165,531.46 $56,880.09 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 82 14 — — $6,259.44 $80,404.15 $40,527.73 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 42 11 — — $6,914.00 $155,566.70 $65,258.99 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 42 11 — — $6,914.00 $110,360.02 $52,711.26 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 40 10 — — $6,914.00 $108,985.57 $47,440.14 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 42 11 — — $6,914.00 $108,985.57 $45,973.40 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 36 10 — — $6,914.00 $120,996.70 $44,865.71 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 36 10 — — $6,914.00 $108,985.57 $40,411.96 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 36 10 — — $6,914.00 $108,985.57 $40,411.96 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 64 13 — — $7,007.41 $217,575.16 $71,814.91 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 42 11 — — $7,246.00 $222,158.94 $107,447.96 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 8 3 — — $7,246.00 $119,430.38 $104,809.20 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 8 3 — — $7,246.00 $110,360.02 $71,890.19 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 40 10 — — $7,246.00 $155,566.70 $67,716.35 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 40 10 — — $7,246.00 $155,566.70 $60,425.32 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 42 11 — — $7,246.00 $122,351.21 $53,618.60 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 42 11 — — $7,246.00 $122,351.21 $53,618.60 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 42 11 — — $7,246.00 $122,351.21 $53,618.60 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 42 11 — — $7,246.00 $122,351.21 $53,618.60 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 42 11 — — $7,246.00 $122,351.21 $53,618.60 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 42 11 — — $7,246.00 $110,861.58 $53,618.60 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 42 11 — — $7,246.00 $108,096.60 $48,997.03 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 40 10 — — $7,246.00 $108,985.57 $47,440.14 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 42 11 — — $7,246.00 $95,069.21 $45,980.56 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 40 10 — — $7,246.00 $108,985.57 $44,071.21 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 36 10 — — $7,246.00 $110,861.58 $41,107.59 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 36 10 — — $7,246.00 $108,985.57 $40,411.96 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 42 11 — — $7,246.00 $95,834.00 $39,165.35 2026-04-01
22630 HCPCS Lumbar Spine Fusion 40 10 — — $7,246.00 $95,834.00 $38,122.85 2026-04-01
245 MS_DRG Aicd Generator Procedures 68 14 — — $7,470.94 $149,771.23 $64,396.64 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 62 14 — — $7,568.31 $87,769.34 $39,269.31 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 26 8 — — $7,613.66 $74,666.68 $40,173.46 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 74 14 — — $7,727.64 $97,755.11 $45,563.03 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 82 14 — — $7,795.37 $78,246.39 $38,348.38 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 50 13 — — $8,128.96 $282,326.35 $85,980.93 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 76 14 — — $8,234.93 $129,618.85 $42,779.95 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 62 14 — — $8,989.07 $195,909.14 $80,210.69 2026-04-01
61886 HCPCS Implant Neurostim Arrays 42 11 — — $9,161.00 $110,360.02 $52,711.26 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 68 14 — — $9,402.94 $109,843.47 $54,674.88 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 80 14 — — $9,457.63 $76,978.32 $39,640.57 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 80 14 — — $9,935.49 $116,512.91 $55,385.08 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 66 14 — — $10,260.64 $152,725.89 $71,979.52 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 42 11 — — $10,334.00 $95,834.00 $39,165.35 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 62 14 — — $11,201.71 $165,353.69 $71,318.85 2026-04-01
791 MS_DRG Prematurity With Major Problems 78 14 — — $11,959.91 $213,367.01 $59,275.25 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 80 14 — — $12,076.09 $141,262.79 $63,280.07 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 68 14 — — $12,283.56 $97,114.53 $45,035.29 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 42 11 — — $12,522.00 $95,834.00 $39,165.35 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 62 14 — — $12,995.43 $91,520.90 $42,501.15 2026-04-01
69930 HCPCS Implant Cochlear Device 42 11 — — $13,551.00 $125,480.53 $56,323.12 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 40 10 — — $13,551.00 $92,315.67 $46,137.10 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 40 10 — — $13,551.00 $92,315.67 $46,137.10 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 40 10 — — $13,551.00 $92,315.67 $46,137.10 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 86 14 — — $13,693.01 $89,258.93 $41,993.50 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 74 14 — — $13,918.52 $138,271.35 $66,278.05 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 72 14 — — $13,975.09 $259,709.71 $98,946.12 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 66 14 — — $14,380.76 $115,605.67 $56,446.67 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 70 14 — — $14,731.51 $107,118.69 $49,002.02 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 70 14 — — $14,803.23 $156,870.05 $46,269.25 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 62 14 — — $15,766.40 $89,378.47 $42,987.36 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 80 14 — — $16,319.57 $174,849.06 $88,373.57 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 70 14 — — $16,736.97 $89,332.49 $42,275.22 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 70 14 — — $17,391.58 $166,380.46 $79,459.94 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 70 14 — — $17,796.84 $94,775.93 $46,804.08 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 66 14 — — $17,813.89 $153,458.42 $69,933.17 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 64 14 — — $17,943.32 $112,707.02 $46,668.22 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 76 14 — — $18,375.73 $93,739.96 $45,692.96 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 68 14 — — $19,014.36 $111,072.54 $50,661.11 2026-04-01
5231 OTHER Level 1 Icd And Similar Procedures 24 5 — — $19,428.23 $68,754.91 $53,721.90 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 82 14 — — $19,708.76 $145,719.30 $64,054.12 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 70 14 — — $19,708.76 $99,891.42 $47,541.97 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 66 14 — — $20,304.09 $106,193.06 $50,872.48 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 64 14 — — $20,870.70 $107,308.72 $55,483.28 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 72 14 — — $20,888.14 $176,454.70 $72,389.57 2026-04-01
5224 OTHER Level 4 Pacemaker And Similar Procedures 18 5 — — $21,344.45 $56,835.96 $44,421.31 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 62 14 — — $21,425.89 $72,324.81 $38,566.60 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 68 14 — — $21,436.14 $102,876.73 $51,845.08 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 62 14 — — $21,937.70 $87,356.77 $48,468.61 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 70 14 — — $22,120.57 $77,443.36 $41,309.55 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 88 14 — — $22,477.19 $290,448.00 $86,223.92 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 68 14 — — $22,498.98 $111,674.36 $53,398.67 2026-04-01
503 MS_DRG Foot Procedures With Mcc 64 14 — — $22,688.40 $81,115.23 $41,144.06 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 66 14 — — $22,906.12 $73,468.05 $42,878.11 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 60 14 — — $23,040.91 $74,166.87 $39,169.55 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 66 14 — — $23,498.87 $78,099.27 $40,869.50 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 64 14 — — $23,807.66 $89,890.32 $42,729.95 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 64 14 — — $23,821.17 $73,468.05 $42,827.36 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 68 14 — — $23,830.37 $90,374.59 $48,632.32 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 84 14 — — $23,991.83 $213,216.73 $96,908.17 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 78 14 — — $24,128.79 $476,387.45 $55,042.40 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 60 14 — — $24,341.33 $81,320.58 $41,380.26 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 8 2 — — $24,482.58 $63,808.27 $54,606.18 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 62 14 — — $24,504.35 $80,189.60 $39,804.14 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 64 14 — — $24,620.89 $77,382.06 $44,371.62 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 64 13 — — $24,624.56 $130,544.48 $43,390.47 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 62 14 — — $24,956.24 $122,182.62 $44,921.23 2026-04-01
849 MS_DRG Radiotherapy 60 14 — — $24,985.74 $81,863.09 $42,475.76 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 64 14 — — $25,300.77 $91,341.82 $47,201.06 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 62 14 — — $25,788.33 $86,491.24 $41,261.33 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 68 14 — — $25,840.55 $86,071.33 $48,709.51 2026-04-01
800 MS_DRG Splenic Procedures With Cc 60 14 — — $25,878.60 $89,301.84 $43,993.62 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 72 14 — — $26,374.67 $94,649.07 $41,537.33 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 62 14 — — $26,525.69 $110,816.98 $47,746.24 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 60 14 — — $26,575.74 $83,564.16 $45,178.76 2026-04-01
570 MS_DRG Skin Debridement With Mcc 64 14 — — $27,055.68 $92,268.76 $43,289.09 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 62 14 — — $27,082.50 $81,029.41 $43,332.00 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 60 13 — — $27,371.18 $106,750.46 $42,425.33 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 78 14 — — $27,392.44 $118,033.15 $54,680.61 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 82 14 — — $28,372.76 $95,652.52 $48,302.74 2026-04-01
665 MS_DRG Prostatectomy With Mcc 62 14 — — $28,665.35 $105,233.71 $45,864.56 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 60 14 — — $28,852.14 $85,985.51 $49,048.63 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 72 14 — — $29,089.16 $151,084.29 $57,093.82 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 60 14 — — $29,224.84 $99,848.51 $49,682.22 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 68 14 — — $29,351.54 $101,779.46 $48,308.45 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 60 14 — — $29,555.53 $97,473.13 $50,244.40 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 62 14 — — $29,611.84 $98,803.34 $47,378.94 2026-04-01
652 MS_DRG Kidney Transplant 60 14 — — $29,633.29 $94,132.28 $50,376.59 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 74 14 — — $29,817.96 $225,000.00 $89,266.95 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 60 14 — — $29,841.54 $104,418.42 $50,730.61 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 82 14 — — $29,874.04 $105,570.86 $48,831.15 2026-04-01
2616 OTHER Brachytx, Non-str,yttrium-90 12 3 — — $30,653.84 $87,379.63 $45,002.07 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 74 14 — — $31,359.90 $104,973.19 $58,119.57 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 62 14 — — $31,645.14 $105,399.22 $50,632.22 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 64 14 — — $31,685.46 $145,725.43 $65,994.90 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 78 14 — — $31,855.27 $174,182.96 $61,131.41 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 70 14 — — $31,938.30 $118,459.19 $51,101.28 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 68 14 — — $32,061.91 $154,368.73 $71,612.00 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 64 14 — — $32,224.30 $111,823.46 $51,558.88 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 72 14 — — $32,291.34 $143,417.48 $64,706.95 2026-04-01
5200 OTHER Implantation Wireless Pa Pressure Monitor 10 3 — — $32,482.32 $84,777.73 $66,259.77 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 60 14 — — $32,610.41 $107,385.34 $55,437.70 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 76 14 — — $32,692.13 $157,320.32 $76,682.85 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 60 14 — — $32,716.76 $120,678.25 $55,618.49 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 60 14 — — $32,790.94 $122,008.46 $55,744.60 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 62 14 — — $33,050.14 $109,874.12 $52,880.22 2026-04-01
265 MS_DRG Aicd Lead Procedures 60 14 — — $33,107.34 $109,325.49 $56,282.47 2026-04-01
332 MS_DRG Rectal Resection With Mcc 60 14 — — $33,129.68 $106,309.53 $56,320.46 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 60 14 — — $33,174.37 $107,897.20 $56,396.43 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 62 14 — — $33,199.39 $97,276.97 $53,119.02 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 64 14 — — $33,598.01 $118,336.59 $57,116.62 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 60 14 — — $33,890.27 $106,422.93 $57,613.46 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 26 7 — — $33,954.12 $55,681.86 $42,281.88 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 66 14 — — $34,077.96 $120,954.10 $54,524.74 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 64 14 — — $34,410.10 $120,436.11 $60,030.81 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 30 9 — — $35,140.84 $108,985.57 $52,711.26 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 30 9 — — $35,140.84 $108,985.57 $52,711.26 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 30 9 — — $35,140.84 $108,985.57 $52,711.26 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 72 14 — — $35,146.27 $125,956.18 $59,568.77 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 60 14 — — $35,364.08 $119,182.53 $60,118.93 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 60 14 — — $35,574.11 $132,613.36 $56,918.58 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 64 13 — — $35,617.47 $175,733.53 $47,713.81 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 26 7 — — $35,688.56 $58,526.18 $44,441.70 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 76 14 — — $35,721.33 $119,841.50 $68,695.51 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 64 14 — — $35,933.43 $125,769.21 $61,520.38 2026-04-01
5495 OTHER Level 5 Intraocular Procedures 6 1 — — $35,982.43 $46,038.62 $42,815.92 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 60 14 — — $36,377.61 $109,867.99 $61,841.94 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 66 14 — — $36,845.38 $124,656.62 $60,619.47 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 70 14 — — $36,981.69 $228,762.41 $110,196.70 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 58 13 — — $37,142.22 $142,056.80 $42,539.08 2026-04-01
J9226 HCPCS Supprelin La Implant 38 11 — — $37,889.54 $99,575.96 $49,408.11 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 64 14 — — $38,276.85 $135,785.63 $61,242.96 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 72 14 — — $39,100.23 $320,522.15 $84,720.95 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 66 14 — — $39,137.54 $137,446.86 $62,620.06 2026-04-01
5496 OTHER Level 6 Intraocular Procedures 12 1 — — $39,279.62 $50,606.14 $46,901.49 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 82 14 — — $40,261.40 $147,806.50 $76,600.92 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 78 14 — — $40,391.10 $210,000.00 $95,796.94 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 60 14 — — $40,656.93 $134,630.13 $69,116.78 2026-04-01
5471 OTHER Implantation Of Drug Infusion Device 6 1 — — $40,657.67 $52,020.47 $48,379.04 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 62 14 — — $40,814.23 $128,432.70 $73,465.61 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 66 14 — — $41,695.90 $176,667.32 $73,306.58 2026-04-01
1576 OTHER New Technology - Level 39 ($15,001-$20,000) 6 1 — — $41,873.45 $53,576.03 $49,825.71 2026-04-01
1590 OTHER New Technology - Level 39 ($15,001-$20,000) 6 1 — — $41,873.45 $53,576.03 $49,825.71 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 60 13 — — $42,047.62 $142,589.93 $54,661.90 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 60 14 — — $42,212.97 $148,618.79 $71,762.05 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 26 7 — — $42,220.71 $69,238.35 $52,575.97 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 76 14 — — $42,452.20 $144,189.86 $67,145.13 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 76 14 — — $42,706.95 $190,000.00 $82,333.98 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 60 14 — — $42,788.55 $141,204.55 $72,740.54 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 76 14 — — $42,874.53 $183,605.76 $88,868.02 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 62 14 — — $43,926.30 $148,867.05 $70,282.08 2026-04-01
1142 OTHER Supprelin La Implant 6 1 — — $44,158.25 $66,237.38 $61,600.76 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 70 14 — — $44,506.74 $155,662.16 $72,551.52 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 26 10 — — $44,853.57 $104,060.28 $53,824.28 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 2 1 — — $45,103.69 $45,103.69 $45,103.69 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 38 11 — — $45,412.66 $137,701.68 $67,523.03 2026-04-01
5378 OTHER Level 8 Urology And Related Services 6 1 — — $45,986.50 $58,838.58 $54,719.88 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 56 13 — — $46,786.45 $194,384.28 $65,673.12 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 62 14 — — $47,212.66 $170,849.23 $75,540.26 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 50 13 — — $47,759.96 $157,838.31 $53,243.46 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 26 10 — — $48,155.50 $111,720.76 $57,786.60 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 60 14 — — $49,321.04 $184,988.08 $83,845.76 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 60 14 — — $49,515.88 $165,375.14 $84,176.99 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 26 7 — — $49,649.99 $81,421.73 $61,827.38 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 30 9 — — $50,160.26 $155,566.70 $75,240.39 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 54 13 — — $50,316.47 $168,734.38 $56,118.16 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 60 14 — — $50,860.99 $166,760.52 $86,463.68 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 34 12 — — $51,775.31 $95,784.32 $55,917.33 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 48 13 — — $52,313.35 $167,658.57 $57,544.69 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 64 14 — — $52,463.25 $175,900.35 $91,910.71 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 74 14 — — $52,474.47 $433,056.92 $172,715.02 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 32 9 — — $52,530.00 $149,134.93 $73,924.64 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 62 14 — — $53,186.56 $178,441.24 $85,098.50 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 60 14 — — $53,766.61 $184,988.08 $91,403.24 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 66 14 — — $53,777.95 $186,324.42 $98,044.38 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 54 13 — — $54,453.91 $189,846.10 $59,899.30 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 60 14 — — $54,954.41 $187,219.40 $93,422.50 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 60 14 — — $55,479.05 $197,463.54 $94,314.38 2026-04-01
9273 OTHER Sipuleucel-t Auto Cd54+ 6 1 — — $55,512.78 $83,269.17 $77,440.33 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 38 10 — — $55,655.09 $176,235.29 $77,460.03 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 88 14 — — $55,980.96 $237,154.38 $126,645.69 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 26 7 — — $55,984.03 $91,809.01 $69,714.94 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 26 7 — — $56,253.16 $92,250.37 $70,050.09 2026-04-01
215 MS_DRG Other Heart Assist System Implant 70 14 — — $56,722.49 $324,712.23 $143,617.63 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 8 2 — — $56,943.90 $90,575.47 $77,513.15 2026-04-01
999 MS_DRG Ungroupable 2 1 — — $56,964.06 $56,964.06 $56,964.06 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 60 14 — — $59,323.11 $188,736.57 $100,849.29 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 60 14 — — $59,536.72 $182,339.92 $101,212.43 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 60 14 — — $59,536.72 $197,919.31 $101,212.43 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 76 14 — — $60,546.71 $260,000.00 $126,105.79 2026-04-01
2050 OTHER Cath Coronary Drug-delivery 2 1 — — $60,811.01 $60,811.01 $60,811.01 2026-04-01
90288 HCPCS Botulism Ig IV 2 1 — — $63,030.00 $63,030.00 $63,030.00 2026-04-01
0717 OTHER Instill Adstiladrin, Tx Dose 6 1 — — $63,499.33 $95,249.00 $88,581.57 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 60 14 — — $64,535.52 $242,953.36 $109,710.39 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 60 14 — — $64,876.05 $204,696.03 $110,289.29 2026-04-01
10 MS_DRG Pancreas Transplant 60 14 — — $64,902.86 $244,360.19 $96,883.76 2026-04-01
1643 OTHER Y90 Ibritumomab, Rx 6 1 — — $65,476.58 $98,214.87 $91,339.83 2026-04-01
1578 OTHER New Technology - Level 41 ($25,001-$30,000) 6 1 — — $65,800.45 $84,190.03 $78,296.73 2026-04-01
1592 OTHER New Technology - Level 41 ($25,001-$30,000) 6 1 — — $65,800.45 $84,190.03 $78,296.73 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 26 7 — — $68,366.15 $112,114.64 $87,423.81 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 72 14 — — $69,242.58 $295,784.76 $149,946.95 2026-04-01
0426T HCPCS Insj/rplc Nstim Apnea Stm Ld 2 1 — — $73,069.00 $73,069.00 $73,069.00 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 66 14 — — $74,384.20 $259,562.59 $136,576.01 2026-04-01
5166 OTHER Cochlear Implant Procedure 6 1 — — $76,450.11 $97,816.02 $90,968.89 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 36 12 — — $76,495.27 $188,574.64 $110,086.82 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 46 13 — — $81,293.53 $255,621.00 $89,422.88 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 26 7 — — $86,078.66 $141,161.64 $110,073.84 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 62 14 — — $86,381.49 $863,300.16 $401,977.28 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 62 14 — — $92,920.46 $326,379.59 $148,672.74 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 26 7 — — $93,836.88 $153,884.46 $116,851.77 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 26 7 — — $94,528.41 $155,018.51 $117,973.80 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 26 7 — — $97,537.50 $159,953.16 $121,770.60 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 52 13 — — $97,957.69 $333,873.52 $127,345.00 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 60 14 — — $102,048.43 $351,797.48 $173,482.33 2026-04-01
1580 OTHER New Technology - Level 43 ($40,001-$50,000) 6 1 — — $107,672.70 $137,764.53 $128,121.01 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 60 14 — — $108,180.52 $401,542.59 $183,906.89 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 26 10 — — $108,243.35 $251,124.57 $129,892.02 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 2 1 — — $110,360.02 $110,360.02 $110,360.02 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 2 1 — — $110,360.02 $110,360.02 $110,360.02 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 2 1 — — $110,360.02 $110,360.02 $110,360.02 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 26 7 — — $114,313.65 $187,464.60 $141,759.61 2026-04-01
7 MS_DRG Lung Transplant 60 14 — — $116,513.05 $400,531.14 $198,072.18 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 26 7 — — $119,632.82 $196,187.59 $148,974.55 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 4 1 — — $123,756.60 $123,756.60 $123,756.60 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 26 7 — — $123,957.69 $203,280.00 $154,376.44 2026-04-01
5244 OTHER Level 4 Blood Product Exchange And Related Services 6 1 — — $124,578.72 $159,395.37 $148,237.70 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 26 7 — — $132,497.15 $217,283.98 $164,994.04 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 26 7 — — $143,101.85 $234,674.79 $178,199.71 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 26 7 — — $165,619.57 $271,601.91 $211,787.46 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 72 14 — — $190,471.72 $656,835.63 $323,801.92 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 60 14 — — $191,591.60 $757,338.17 $325,705.72 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 32 10 — — $382,024.00 $1,233,889.95 $579,715.54 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 30 9 — — $382,024.00 $1,135,154.19 $528,433.85 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 60 14 — — $386,720.03 $1,155,817.63 $657,424.05 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 30 9 — — $402,775.49 $1,304,445.14 $607,241.70 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 30 9 — — $411,986.76 $1,298,692.11 $604,563.57 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 30 9 — — $431,116.53 $1,365,307.95 $635,574.39 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 30 10 — — $434,411.62 $1,424,899.47 $675,598.89 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 28 9 — — $1,957,366.97 $4,786,111.43 $2,755,247.93 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 20 6 — — $2,801,600.00 $4,982,064.57 $3,470,838.32 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 20 7 — — $3,153,500.00 $4,429,740.00 $3,844,554.00 2026-04-01
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