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

SWEDISH EDMONDS HOSPITAL

Edmonds, WA · CCN 500026 · Rates published

14,923 distinct procedures filed
16 distinct payers
303,505 rate rows
2026-04-01 last MRF observed
Data quality

246,872 of 303,505 rate rows are consumer-grade (81.3%)

56,633 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 56,567
placeholder amount (≤ $0.02) — excluded from medians 66
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/swedish/live/272305304_swedish-edmonds-hospital_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint e7cf6376d5c10918… · 203,649,504 bytes · first seen 2026-05-08

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 8 $3,691,450.00 $4,429,740.00 $3,876,022.50 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,321,376.38 $4,982,064.57 $3,520,658.96 nat. median
$3,325,455
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 12 $2,479,853.20 $4,786,111.43 $2,975,150.34 nat. median
$2,468,984
1.2× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 12 $614,180.81 $1,560,019.25 $919,930.49 nat. median
$753,246
1.2× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 12 $494,384.00 $1,350,896.76 $742,708.44 nat. median
$634,303
1.2× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 11 $542,190.00 $1,494,776.81 $741,101.77 nat. median
$674,867
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 11 $502,980.50 $1,421,843.95 $706,656.73 nat. median
$625,184
1.1× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 11 $499,938.24 $1,428,142.52 $699,854.44 nat. median
$673,137
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 11 $489,290.60 $1,242,798.13 $637,395.96 nat. median
$619,808
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 14 $364,777.87 $1,114,028.12 $583,644.59 nat. median
$370,174
1.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 14 $237,085.50 $860,080.96 $379,336.80 nat. median
$265,286
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 14 $180,871.51 $673,419.12 $289,394.42 nat. median
$206,474
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 14 $179,816.04 $608,339.09 $287,705.66 nat. median
$202,976
1.4× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 7 $153,031.64 $273,315.44 $197,542.00 nat. median
$87,428
outlier · 2.3×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 14 $117,702.16 $401,082.76 $188,323.46 nat. median
$133,161
1.4× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 7 $127,987.73 $278,194.90 $185,442.85 nat. median
$63,570
outlier · 2.9×
7
MS_DRG 		Lung Transplant 14 $110,110.82 $370,958.48 $176,177.31 nat. median
$122,708
1.4× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 7 $118,503.07 $257,578.99 $171,700.42 nat. median
$54,196
outlier · 3.2×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 14 $102,257.51 $371,895.25 $163,612.02 nat. median
$117,357
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 $96,478.09 $445,315.56 $154,364.94 nat. median
$108,660
1.4× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 7 $110,877.23 $200,301.42 $144,770.25 nat. median
$65,393
outlier · 2.2×
0427T
HCPCS 		Insj/rplc Nstim Apnea Pls Gn 1 $140,934.70 $147,340.82 $144,137.76 nat. median
$15,886
outlier · 9.1×
0431T
HCPCS 		Rmvl/rplc Nstim Apnea Pls Gn 1 $140,934.70 $147,340.82 $144,137.76 nat. median
$18,872
outlier · 7.6×
0424T
HCPCS 		Insj/rplc Nstim Apnea Compl 1 $140,934.70 $147,340.82 $144,137.76 nat. median
$24,752
outlier · 5.8×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 7 $106,997.44 $195,289.06 $141,147.50 nat. median
$49,935
outlier · 2.8×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 14 $87,875.07 $304,460.55 $140,600.11 nat. median
$100,136
1.4× median
0266T
HCPCS 		Implt/rpl Crtd Sns Dev Total 4 $7,277.00 $147,340.82 $134,146.49 nat. median
$42,941
outlier · 3.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 $83,429.94 $298,639.06 $133,487.90 nat. median
$93,672
1.4× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 7 $101,815.48 $181,251.45 $131,001.65 nat. median
$62,372
outlier · 2.1×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 12 $108,243.35 $397,069.20 $129,892.02 nat. median
$111,989
1.2× median
215
MS_DRG 		Other Heart Assist System Implant 14 $37,856.94 $314,080.72 $127,346.00 nat. median
$99,019
1.3× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 7 $87,235.79 $189,616.25 $126,396.91 nat. median
$44,728
outlier · 2.8×
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 7 $84,544.51 $183,766.47 $122,497.49 nat. median
$48,704
outlier · 2.5×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 $71,810.44 $255,824.20 $114,896.70 nat. median
$81,118
1.4× median
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 7 $83,926.02 $155,044.34 $112,060.15 nat. median
$39,020
outlier · 2.9×
38240
HCPCS 		Transplt Allo Hct/donor 12 $3,304.00 $257,920.55 $111,029.56 nat. median
$15,979
outlier · 6.9×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 $67,307.19 $307,494.74 $107,691.50 nat. median
$77,570
1.4× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 13 $92,622.61 $309,222.43 $106,516.00 nat. median
$102,358
1.0× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 14 $65,702.50 $239,689.43 $105,124.00 nat. median
$74,915
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 $65,423.68 $235,664.66 $104,677.89 nat. median
$73,807
1.4× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 $65,210.56 $220,749.51 $104,336.90 nat. median
$72,135
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 13 $96,368.58 $202,374.02 $104,078.07 nat. median
$98,047
1.1× median
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 7 $80,036.21 $142,229.33 $102,797.95 nat. median
$48,483
outlier · 2.1×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 $6,096.95 $297,541.18 $101,370.66 nat. median
$98,894
1.0× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 14 $61,443.53 $194,295.51 $98,309.65 nat. median
$64,023
1.5× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 $61,122.59 $225,015.23 $97,796.14 nat. median
$71,271
1.4× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 14 $18,463.26 $259,271.88 $97,245.45 nat. median
$79,312
1.2× median
0426T
HCPCS 		Insj/rplc Nstim Apnea Stm Ld 1 $93,312.39 $97,553.87 $95,433.13 nat. median
$13,244
outlier · 7.2×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 $58,960.25 $207,137.29 $94,336.40 nat. median
$65,950
1.4× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 14 $57,723.67 $193,823.60 $92,357.87 nat. median
$64,732
1.4× median

Other procedures at this hospital

Browse this hospital's 14,923 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
             
0266T HCPCS Implt/rpl Crtd Sns Dev Total 7 4 — — $7,277.00 $147,340.82 $134,146.49 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 7 4 — — $7,277.00 $147,340.82 $88,196.73 2026-04-01
0312T HCPCS Laps Impltj Nstim Vagus 4 2 — — $4,912.00 $147,340.82 $73,562.85 2026-04-01
0316T HCPCS Replc Vagus Nerve Pls Gen 4 2 — — $4,912.00 $147,340.82 $73,562.85 2026-04-01
0398T HCPCS Mrgfus Strtctc Les Abltj 6 3 — — $34,077.51 $62,502.50 $39,638.94 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 24 12 — — $4,633.00 $128,707.31 $55,405.88 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 24 12 — — $4,633.00 $114,927.22 $39,263.12 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 24 12 — — $4,633.00 $114,927.22 $39,263.12 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 2 1 — — $140,934.70 $147,340.82 $144,137.76 2026-04-01
0426T HCPCS Insj/rplc Nstim Apnea Stm Ld 2 1 — — $93,312.39 $97,553.87 $95,433.13 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 2 1 — — $140,934.70 $147,340.82 $144,137.76 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 2 1 — — $140,934.70 $147,340.82 $144,137.76 2026-04-01
0453T HCPCS Insj/rplcmt Mech-elec Ntrfce 2 1 — — $36,986.55 $38,667.76 $37,827.15 2026-04-01
0454T HCPCS Insj/rplcmt Subq Electrode 2 1 — — $36,986.55 $38,667.76 $37,827.15 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 24 12 — — $2,836.00 $114,927.22 $39,263.12 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 24 12 — — $4,633.00 $163,350.16 $55,405.88 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 24 12 — — $3,294.00 $114,927.22 $39,263.12 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 22 11 — — $2,836.00 $180,608.75 $66,198.78 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 18 11 — — $2,443.00 $126,529.31 $38,303.51 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 18 11 — — $2,225.00 $140,473.92 $42,524.88 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 18 11 — — $2,225.00 $126,529.31 $38,303.51 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 18 11 — — $2,225.00 $126,529.31 $38,303.51 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 20 11 — — $4,633.00 $128,707.31 $41,107.59 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 31 14 — — $237,085.50 $860,080.96 $379,336.80 2026-04-01
10 MS_DRG Pancreas Transplant 31 14 — — $61,468.80 $226,318.20 $77,387.58 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 31 14 — — $46,966.75 $153,164.90 $75,146.80 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 31 14 — — $36,537.50 $116,483.22 $58,460.00 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 31 14 — — $25,298.74 $81,024.88 $40,477.98 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 31 14 — — $102,257.51 $371,895.25 $163,612.02 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 33 14 — — $8,512.49 $120,048.62 $55,429.17 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 33 14 — — $10,523.54 $93,725.36 $48,875.19 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 31 14 — — $50,973.01 $200,384.72 $81,556.82 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 31 14 — — $38,776.49 $148,937.28 $62,042.38 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 34 14 — — $26,484.24 $110,762.95 $50,388.16 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 31 14 — — $46,783.11 $171,329.74 $73,050.59 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 31 14 — — $364,777.87 $1,114,028.12 $583,644.59 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 31 14 — — $61,122.59 $225,015.23 $97,796.14 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 31 14 — — $96,478.09 $445,315.56 $154,364.94 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 31 14 — — $67,307.19 $307,494.74 $107,691.50 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 24 12 — — $2,443.00 $111,260.70 $46,485.66 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 37 14 — — $7,294.74 $183,598.60 $66,272.30 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 20 13 — — $96,368.58 $202,374.02 $104,078.07 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 31 14 — — $45,616.44 $224,396.49 $72,986.30 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 13 — — $92,622.61 $309,222.43 $106,516.00 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 24 12 — — $3,304.00 $111,260.70 $46,485.66 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 20 13 — — $49,096.23 $103,102.08 $53,023.93 2026-04-01
215 MS_DRG Other Heart Assist System Implant 33 14 — — $37,856.94 $314,080.72 $127,346.00 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 31 14 — — $83,429.94 $298,639.06 $133,487.90 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 31 14 — — $56,411.28 $192,864.67 $90,258.05 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 31 14 — — $56,411.28 $181,733.35 $90,258.05 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 31 14 — — $65,702.50 $239,689.43 $105,124.00 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 31 14 — — $27,788.76 $144,058.77 $44,462.02 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 31 14 — — $45,944.96 $160,791.46 $73,511.94 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 31 14 — — $43,480.22 $136,238.29 $69,568.35 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 11 7 — — $127,987.73 $278,194.90 $185,442.85 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 11 7 — — $87,235.79 $189,616.25 $126,396.91 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 11 7 — — $118,503.07 $257,578.99 $171,700.42 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 11 7 — — $84,544.51 $183,766.47 $122,497.49 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 11 7 — — $106,997.44 $195,289.06 $141,147.50 2026-04-01
22630 HCPCS Lumbar Spine Fusion 22 11 — — $3,294.00 $111,260.70 $41,715.41 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 24 12 — — $3,294.00 $111,260.70 $46,485.66 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 11 7 — — $83,926.02 $155,044.34 $112,060.15 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 32 14 — — $42,698.51 $158,560.43 $66,182.69 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 33 14 — — $15,302.17 $102,365.38 $44,085.98 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 31 14 — — $49,293.34 $168,722.01 $78,869.34 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 34 14 — — $18,463.26 $259,271.88 $97,245.45 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 31 14 — — $52,092.50 $177,107.69 $83,348.00 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 31 14 — — $65,423.68 $235,664.66 $104,677.89 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 31 14 — — $47,039.19 $158,729.99 $75,262.70 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 31 14 — — $50,458.32 $181,578.66 $80,733.31 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 31 14 — — $36,308.38 $121,873.46 $58,093.41 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 31 14 — — $42,482.03 $143,261.55 $67,971.25 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 31 14 — — $33,975.88 $117,173.43 $54,361.41 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 37 14 — — $11,103.02 $110,884.92 $41,877.72 2026-04-01
245 MS_DRG Aicd Generator Procedures 33 14 — — $11,633.77 $161,163.30 $59,183.14 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 9 6 — — $54,147.85 $92,938.55 $72,548.59 2026-04-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 9 6 — — $34,518.03 $58,696.78 $46,248.09 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 11 7 — — $50,311.82 $94,065.96 $67,987.30 2026-04-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 11 7 — — $30,367.96 $55,736.95 $40,284.55 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 31 14 — — $39,323.18 $133,784.16 $62,917.09 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 33 14 — — $8,023.53 $98,929.60 $45,611.48 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 31 14 — — $23,745.43 $75,417.57 $37,992.69 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 31 14 — — $27,491.40 $94,241.47 $43,986.24 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 31 14 — — $27,214.27 $91,085.31 $43,542.83 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 32 14 — — $28,423.90 $106,116.47 $44,057.04 2026-04-01
263 MS_DRG Vein Ligation And Stripping 33 14 — — $13,942.36 $76,131.10 $40,166.90 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 35 14 — — $16,597.91 $99,209.73 $42,477.20 2026-04-01
265 MS_DRG Aicd Lead Procedures 31 14 — — $31,501.88 $101,253.59 $50,403.01 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 31 14 — — $52,646.77 $209,653.88 $84,234.83 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 31 14 — — $41,126.67 $166,523.71 $65,802.67 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 31 14 — — $58,960.25 $207,137.29 $94,336.40 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 31 14 — — $36,598.15 $128,361.28 $58,557.04 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 37 14 — — $14,499.71 $154,297.69 $63,000.00 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 31 14 — — $30,980.46 $106,059.95 $49,568.74 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 31 14 — — $35,775.16 $113,832.84 $57,240.26 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 31 14 — — $28,751.57 $97,766.49 $46,002.51 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 26 13 — — $61,087.21 $200,596.74 $70,250.29 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 26 13 — — $51,620.78 $175,829.08 $59,363.90 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 26 13 — — $39,927.99 $132,062.00 $45,917.19 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 22 11 — — $3,294.00 $111,260.70 $41,715.41 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 26 13 — — $47,911.03 $142,017.32 $55,097.68 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 31 14 — — $51,635.10 $173,219.76 $82,616.16 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 31 14 — — $23,819.56 $79,882.59 $38,111.30 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 31 14 — — $29,761.56 $98,069.91 $47,618.50 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 31 14 — — $179,816.04 $608,339.09 $287,705.66 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 31 14 — — $38,765.54 $130,044.96 $62,024.86 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 26 13 — — $14,073.81 $175,601.98 $62,509.30 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 31 14 — — $38,617.28 $128,444.57 $61,787.65 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 32 13 — — $19,879.79 $120,911.59 $41,223.48 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 34 14 — — $31,369.24 $158,143.98 $66,704.96 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 39 14 — — $39,044.61 $145,349.79 $45,514.27 2026-04-01
332 MS_DRG Rectal Resection With Mcc 31 14 — — $31,522.93 $123,792.14 $50,436.69 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 24 12 — — $2,443.00 $114,927.22 $39,263.12 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 24 12 — — $2,443.00 $163,350.16 $55,405.88 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 24 12 — — $4,633.00 $114,927.22 $39,263.12 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 24 12 — — $4,633.00 $163,350.16 $55,405.88 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 24 12 — — $2,443.00 $114,927.22 $39,263.12 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 24 12 — — $2,443.00 $114,927.22 $39,263.12 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 24 12 — — $2,443.00 $163,350.16 $55,405.88 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 24 12 — — $2,443.00 $163,350.16 $55,405.88 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 22 11 — — $2,443.00 $180,608.75 $67,716.35 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 22 11 — — $2,443.00 $126,529.31 $47,440.14 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 24 12 — — $4,633.00 $144,318.94 $50,630.26 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 34 14 — — $15,183.88 $116,414.88 $48,210.33 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 11 7 — — $44,406.05 $83,211.28 $60,141.95 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 11 7 — — $27,220.33 $50,492.56 $36,494.10 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 31 14 — — $33,628.83 $118,336.54 $53,806.13 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 11 7 — — $37,761.44 $69,084.43 $49,931.60 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 33 14 — — $25,468.90 $89,981.70 $38,203.35 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 32 14 — — $38,026.79 $128,144.13 $60,842.86 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 31 14 — — $28,754.94 $97,498.77 $46,007.90 2026-04-01
37225 HCPCS Fem/popl Revas W/ather 9 5 — — $2,836.00 $52,246.90 $45,614.30 2026-04-01
37227 HCPCS Fem/popl Revasc Stnt & Ather 9 5 — — $2,836.00 $80,656.25 $45,614.30 2026-04-01
37229 HCPCS Tib/per Revasc W/ather 9 5 — — $2,836.00 $80,656.25 $45,614.30 2026-04-01
37230 HCPCS Tib/per Revasc W/stent 9 5 — — $2,836.00 $80,656.25 $45,614.30 2026-04-01
37231 HCPCS Tib/per Revasc Stent & Ather 9 5 — — $2,836.00 $80,656.25 $45,614.30 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 24 12 — — $3,304.00 $257,920.55 $111,029.56 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 35 14 — — $117,702.16 $401,082.76 $188,323.46 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 31 14 — — $33,548.81 $114,966.21 $53,678.10 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 24 13 — — $34,890.69 $111,538.20 $38,379.76 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 32 14 — — $45,652.39 $170,676.39 $73,012.58 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 31 14 — — $25,453.74 $85,698.13 $40,725.98 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 31 14 — — $31,058.80 $111,637.52 $49,694.08 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 32 14 — — $16,894.29 $111,655.36 $44,716.40 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 31 14 — — $31,033.52 $107,931.04 $49,653.63 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 31 14 — — $36,006.81 $124,517.97 $57,610.90 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 28 13 — — $6,096.95 $297,541.18 $101,370.66 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 13 — — $5,286.90 $201,510.80 $67,394.89 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 13 — — $48,381.07 $156,276.11 $53,219.18 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 24 13 — — $76,916.82 $236,747.58 $84,608.50 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 24 13 — — $49,603.33 $155,279.73 $54,563.66 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 24 13 — — $57,306.70 $190,312.13 $63,037.37 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 24 13 — — $36,746.40 $115,909.80 $40,421.04 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 24 13 — — $45,918.01 $146,184.53 $50,509.81 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 11 7 — — $153,031.64 $273,315.44 $197,542.00 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 11 7 — — $101,815.48 $181,251.45 $131,001.65 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 11 7 — — $80,036.21 $142,229.33 $102,797.95 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 14 — — $71,810.44 $255,824.20 $114,896.70 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 14 — — $51,254.35 $193,233.54 $82,006.96 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 31 14 — — $36,171.91 $148,961.08 $57,875.06 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 11 7 — — $110,877.23 $200,301.42 $144,770.25 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 11 7 — — $62,952.46 $116,926.53 $84,510.05 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 31 14 — — $47,547.13 $180,912.33 $76,075.41 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 31 14 — — $23,430.39 $93,447.23 $37,488.62 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 38 14 — — $5,072.74 $159,750.31 $56,388.99 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 32 14 — — $27,260.60 $88,524.10 $43,616.96 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 34 14 — — $15,466.07 $159,018.54 $60,576.93 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 35 14 — — $28,075.94 $106,419.89 $46,095.40 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 32 14 — — $23,687.33 $83,362.99 $37,466.08 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 31 14 — — $41,698.63 $149,321.02 $66,717.81 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 31 14 — — $25,840.38 $90,838.41 $41,344.61 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 32 14 — — $34,320.29 $127,298.66 $57,637.17 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 34 14 — — $21,783.38 $99,917.20 $45,110.63 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 33 14 — — $20,899.35 $72,332.91 $36,559.48 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 31 14 — — $28,207.41 $101,425.37 $45,131.86 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 31 14 — — $31,951.70 $103,222.09 $51,122.72 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 31 14 — — $31,565.05 $108,335.60 $50,504.08 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 31 14 — — $26,435.93 $76,857.32 $42,297.49 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 33 14 — — $87,875.07 $304,460.55 $140,600.11 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 32 14 — — $27,682.62 $94,878.06 $44,292.19 2026-04-01
503 MS_DRG Foot Procedures With Mcc 31 14 — — $24,534.72 $78,549.93 $39,255.55 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 31 14 — — $26,467.10 $81,616.84 $42,347.36 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 31 14 — — $27,868.78 $93,423.43 $44,590.05 2026-04-01
5166 OTHER Cochlear Implant Procedure 1 1 — — $37,289.88 $37,289.88 $37,289.88 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 31 14 — — $32,505.13 $106,699.51 $52,008.21 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 33 14 — — $18,120.11 $91,210.25 $37,801.54 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 1 1 — — $38,640.94 $38,640.94 $38,640.94 2026-04-01
53444 HCPCS Insert Tandem Cuff 24 12 — — $2,225.00 $88,924.24 $36,584.60 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 24 12 — — $1,638.00 $88,924.24 $36,584.60 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 24 12 — — $1,638.00 $88,924.24 $36,584.60 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 24 12 — — $2,443.00 $88,924.24 $36,584.60 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 24 12 — — $2,443.00 $88,924.24 $36,584.60 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 24 12 — — $2,443.00 $88,924.24 $36,584.60 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 24 12 — — $3,304.00 $88,924.24 $36,584.60 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 24 12 — — $2,443.00 $88,924.24 $36,584.60 2026-04-01
5464 OTHER Level 4 Neurostimulator And Related Procedures 4 4 — — $25,848.66 $81,995.41 $55,647.78 2026-04-01
570 MS_DRG Skin Debridement With Mcc 32 14 — — $25,105.74 $85,456.22 $39,987.31 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 32 14 — — $42,770.85 $174,801.47 $87,125.42 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 31 14 — — $30,265.29 $98,352.44 $48,424.46 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 31 14 — — $42,309.34 $153,145.03 $67,694.94 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 31 14 — — $23,352.05 $75,842.95 $37,363.28 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 33 14 — — $26,200.23 $93,551.34 $42,455.16 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 31 14 — — $40,083.83 $139,703.81 $64,134.13 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 34 14 — — $14,224.50 $86,004.53 $37,584.90 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 32 14 — — $30,400.07 $117,982.55 $47,120.10 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 24 12 — — $2,225.00 $126,529.31 $53,718.09 2026-04-01
61886 HCPCS Implant Neurostim Arrays 24 12 — — $2,443.00 $147,340.82 $54,468.30 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 22 11 — — $2,443.00 $126,529.31 $47,440.14 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 31 14 — — $25,345.92 $91,076.39 $40,553.47 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 34 14 — — $20,302.17 $107,532.43 $48,057.57 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 31 14 — — $32,416.68 $112,023.62 $51,866.69 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 24 12 — — $2,225.00 $147,340.82 $54,468.30 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 24 12 — — $2,225.00 $180,608.75 $76,461.04 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 22 11 — — $2,225.00 $126,529.31 $47,440.14 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 15 11 — — $35,140.84 $126,529.31 $42,169.01 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 31 14 — — $40,626.31 $134,477.26 $65,002.10 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 31 14 — — $32,239.78 $110,016.30 $51,583.65 2026-04-01
652 MS_DRG Kidney Transplant 31 14 — — $28,227.63 $94,747.17 $45,164.21 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 32 14 — — $44,795.99 $162,394.82 $71,318.10 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 32 14 — — $24,603.80 $86,349.59 $38,135.89 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 31 14 — — $27,842.67 $97,718.90 $44,548.27 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 31 14 — — $26,812.46 $88,550.41 $42,899.94 2026-04-01
665 MS_DRG Prostatectomy With Mcc 31 14 — — $27,315.35 $97,463.93 $43,704.56 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 31 14 — — $25,620.52 $83,479.01 $40,992.83 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 34 14 — — $34,973.74 $118,941.53 $56,445.11 2026-04-01
69715 HCPCS Temple Bne Implnt W/Stimulat 4 2 — — $4,912.00 $80,687.16 $41,685.01 2026-04-01
69930 HCPCS Implant Cochlear Device 24 12 — — $4,633.00 $167,528.10 $58,200.56 2026-04-01
7 MS_DRG Lung Transplant 31 14 — — $110,110.82 $370,958.48 $176,177.31 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 31 14 — — $31,133.76 $126,743.04 $49,814.02 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 31 14 — — $31,203.68 $113,752.53 $49,925.89 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 40 14 — — $12,198.88 $168,760.72 $68,970.49 2026-04-01
791 MS_DRG Prematurity With Major Problems 35 14 — — $8,411.57 $115,254.06 $56,343.98 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 41 14 — — $4,206.00 $118,390.82 $37,953.97 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 31 14 — — $39,173.24 $153,119.71 $62,677.18 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 31 14 — — $48,234.50 $161,624.38 $77,175.20 2026-04-01
800 MS_DRG Splenic Procedures With Cc 31 14 — — $24,688.88 $87,869.66 $39,502.21 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 31 14 — — $34,584.07 $110,411.94 $55,334.51 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 32 14 — — $20,913.12 $169,311.00 $78,160.78 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 32 14 — — $37,605.54 $133,915.04 $61,448.38 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 31 14 — — $40,427.51 $150,058.74 $64,684.02 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 32 14 — — $27,642.19 $95,440.27 $44,227.50 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 33 14 — — $30,935.47 $180,034.79 $70,902.46 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 31 14 — — $41,493.10 $169,537.08 $66,388.96 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 36 14 — — $26,686.36 $95,800.21 $38,168.70 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 31 14 — — $22,861.80 $79,510.76 $36,578.88 2026-04-01
849 MS_DRG Radiotherapy 31 14 — — $23,847.36 $75,818.84 $38,155.78 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 25 13 — — $2,673.66 $261,481.17 $81,364.49 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 45 14 — — $4,033.44 $308,856.04 $63,936.58 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 32 14 — — $39,340.03 $138,737.03 $60,977.04 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 36 14 — — $34,836.92 $197,474.17 $68,853.13 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 33 14 — — $27,828.60 $111,543.88 $53,429.35 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 31 14 — — $36,374.08 $126,981.02 $58,198.53 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $63,030.00 $63,030.00 $63,030.00 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 31 14 — — $31,964.33 $110,867.07 $51,142.93 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 32 14 — — $17,857.70 $117,447.11 $51,714.71 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 14 — — $180,871.51 $673,419.12 $289,394.42 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 31 14 — — $61,443.53 $194,295.51 $98,309.65 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 31 14 — — $28,154.34 $90,276.34 $45,046.94 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 31 14 — — $33,826.79 $122,822.03 $50,699.63 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 23 12 — — $4,633.00 $107,176.01 $47,625.39 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 23 12 — — $4,633.00 $107,176.01 $47,625.39 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 23 12 — — $4,633.00 $107,176.01 $47,625.39 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 31 14 — — $31,588.64 $100,384.23 $50,541.82 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 31 14 — — $30,669.63 $108,216.61 $49,071.41 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 31 14 — — $57,723.67 $193,823.60 $92,357.87 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 33 14 — — $2,915.91 $114,525.95 $49,082.42 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 31 14 — — $65,210.56 $220,749.51 $104,336.90 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 31 14 — — $36,519.81 $125,106.96 $58,431.70 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 31 14 — — $25,823.53 $81,390.77 $41,317.65 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 31 14 — — $24,052.05 $81,206.34 $38,483.28 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 31 14 — — $52,586.97 $179,516.55 $84,139.15 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 33 14 — — $12,836.46 $111,860.62 $47,171.94 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 31 14 — — $23,240.02 $88,904.86 $37,184.03 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 34 14 — — $25,334.12 $191,845.27 $39,267.88 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 34 14 — — $40,545.44 $137,267.53 $62,845.43 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 33 14 — — $28,769.12 $99,439.66 $44,854.62 2026-04-01
999 MS_DRG Ungroupable 1 1 — — $50,494.07 $50,494.07 $50,494.07 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 22 12 — — $56,824.55 $204,604.43 $81,904.36 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 15 11 — — $35,140.84 $126,529.31 $42,169.01 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 15 11 — — $35,140.84 $126,529.31 $42,169.01 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 2 1 — — $57,599.44 $60,217.59 $58,908.51 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 24 12 — — $4,912.00 $110,372.79 $47,513.24 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 4 2 — — $4,912.00 $80,656.25 $41,670.22 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 4 2 — — $4,912.00 $80,656.25 $41,670.22 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 9 8 — — $3,691,450.00 $4,429,740.00 $3,876,022.50 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 9 7 — — $3,321,376.38 $4,982,064.57 $3,520,658.96 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 16 12 — — $2,479,853.20 $4,786,111.43 $2,975,150.34 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 19 11 — — $64,282.30 $163,277.04 $77,138.76 2026-04-01
J9226 HCPCS Supprelin La Implant 23 12 — — $41,173.43 $104,580.50 $61,760.14 2026-04-01
J9266 HCPCS Pegaspargase Injection 23 12 — — $28,338.71 $72,197.11 $39,445.63 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 15 12 — — $44,853.57 $164,536.38 $53,824.28 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 15 12 — — $48,155.50 $176,648.90 $57,786.60 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 15 12 — — $108,243.35 $397,069.20 $129,892.02 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 20 12 — — $494,384.00 $1,350,896.76 $742,708.44 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 19 12 — — $614,180.81 $1,560,019.25 $919,930.49 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 23 12 — — $56,269.19 $142,923.75 $81,742.78 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 18 11 — — $489,290.60 $1,242,798.13 $637,395.96 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 18 11 — — $499,938.24 $1,428,142.52 $699,854.44 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 18 11 — — $502,980.50 $1,421,843.95 $706,656.73 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 18 11 — — $542,190.00 $1,494,776.81 $741,101.77 2026-04-01
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