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

PROV SACRED HRT MED CTR & CHILDS HOSP.

Spokane, WA · CCN 500054 · Rates published

15,356 distinct procedures filed
14 distinct payers
283,413 rate rows
2026-04-01 last MRF observed
Data quality

222,652 of 283,413 rate rows are consumer-grade (78.6%)

60,761 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 60,702
placeholder amount (≤ $0.02) — excluded from medians 59
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://pricetransparency.providence.org/wamt/live/364640211_providence-sacred-hrt-med-center-and-childs-hosp_standardcharges.json
Found on page https://www.providence.org/billing-support/pricing-transparency
Discovered viaDiscovered by HANK
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-19
Content fingerprint c2f4146516f40861… · 219,342,480 bytes · first seen 2026-05-15

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 $2,893,800.00 $4,429,740.00 $3,844,554.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $2,570,880.00 $3,985,651.65 $3,454,231.43 nat. median
$3,325,455
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 10 $1,796,172.04 $4,786,111.43 $2,716,441.62 nat. median
$2,469,189
1.1× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 11 $398,636.55 $2,037,540.68 $862,793.79 nat. median
$754,974
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 10 $395,612.82 $1,952,327.55 $676,769.03 nat. median
$675,122
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $369,605.74 $1,865,296.52 $646,599.96 nat. median
$674,188
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $378,058.43 $1,857,069.95 $643,748.24 nat. median
$625,184
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 11 $350,563.20 $1,764,405.85 $638,218.94 nat. median
$634,511
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 12 $388,261.34 $1,017,496.62 $624,189.02 nat. median
$370,174
1.7× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $350,563.20 $1,623,218.26 $562,684.19 nat. median
$620,080
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $192,728.07 $759,985.80 $416,502.17 nat. median
$265,286
1.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $177,337.76 $578,229.66 $333,512.45 nat. median
$202,986
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $192,249.56 $702,248.49 $324,901.76 nat. median
$206,368
1.6× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 4 $78,290.00 $236,085.42 $199,452.39 nat. median
$87,411
outlier · 2.3×
7
MS_DRG 		Lung Transplant 12 $116,831.13 $352,598.08 $197,444.61 nat. median
$122,708
1.6× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 12 $108,460.88 $353,488.48 $183,298.89 nat. median
$117,303
1.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 $97,900.21 $391,637.40 $178,164.34 nat. median
$133,176
1.3× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 11 $108,243.35 $359,096.58 $175,291.35 nat. median
$111,989
1.6× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 12 $102,301.03 $326,207.31 $172,888.74 nat. median
$108,660
1.6× median
215
MS_DRG 		Other Heart Assist System Implant 12 $89,957.99 $285,852.70 $152,029.00 nat. median
$99,019
1.5× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $80,220.00 $264,378.25 $149,385.88 nat. median
$93,672
1.6× median
459
MS_DRG 		Spinal Fusion Except Cervical With Mcc 4 $63,718.00 $176,697.74 $149,279.81 nat. median
$65,381
outlier · 2.3×
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 4 $78,290.00 $162,950.46 $137,665.68 nat. median
$62,270
outlier · 2.2×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $79,841.00 $178,406.44 $129,123.72 nat. median
$63,570
outlier · 2.0×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 12 $76,009.67 $228,499.77 $128,456.34 nat. median
$81,118
1.6× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $123,756.60 $123,756.60 $123,756.60 nat. median
$76,377
1.6× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 11 $95,905.11 $293,917.62 $120,896.10 nat. median
$102,358
1.2× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $74,066.00 $165,185.45 $119,625.73 nat. median
$54,196
outlier · 2.2×
L8702
HCPCS 		Pow Ue Rom Dev Ewhf Uprt Cus 10 $68,801.71 $228,249.21 $116,274.89 nat. median
$70,825
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 12 $82,192.90 $287,320.53 $114,344.98 nat. median
$100,136
1.1× median
38240
HCPCS 		Transplt Allo Hct/donor 11 $5,419.00 $232,534.73 $112,908.95 nat. median
$15,912
outlier · 7.1×
209
MS_DRG 		Complex Aortic Arch Procedures 11 $102,184.32 $189,040.99 $110,359.07 nat. median
$98,017
1.1× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 12 $64,618.30 $213,878.22 $109,204.93 nat. median
$71,240
1.5× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 12 $8,244.86 $282,814.53 $107,473.45 nat. median
$98,905
1.1× median
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 $62,597.00 $149,147.37 $105,872.18 nat. median
$49,935
outlier · 2.1×
455
MS_DRG 		Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 4 $78,028.08 $122,702.40 $103,662.84 nat. median
$48,483
outlier · 2.1×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 $23,258.29 $366,863.88 $103,155.20 nat. median
$77,576
1.3× median
223
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $79,841.00 $121,600.93 $100,720.96 nat. median
$44,728
outlier · 2.3×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 12 $59,382.30 $166,149.76 $100,356.09 nat. median
$59,793
1.7× median
225
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 $74,066.00 $117,849.47 $95,957.74 nat. median
$48,649
2.0× median
J9029
HCPCS 		Inj, Adstiladrin, Per Tx Dos 10 $48,204.00 $213,256.09 $95,249.00 nat. median
$69,774
1.4× median
0266T
HCPCS 		Implt/rpl Crtd Sns Dev Total 4 $5,419.00 $124,601.88 $94,870.70 nat. median
$42,941
outlier · 2.2×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 12 $60,575.65 $184,354.65 $93,867.74 nat. median
$64,027
1.5× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 12 $55,520.83 $183,099.81 $93,830.20 nat. median
$60,185
1.6× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 12 $53,800.63 $164,567.63 $90,923.06 nat. median
$56,920
1.6× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 12 $59,596.87 $174,233.57 $90,469.36 nat. median
$64,510
1.4× median
0424T
HCPCS 		Insj/rplc Nstim Apnea Compl 1 $90,268.09 $90,268.09 $90,268.09 nat. median
$24,752
outlier · 3.6×
0427T
HCPCS 		Insj/rplc Nstim Apnea Pls Gn 1 $90,268.09 $90,268.09 $90,268.09 nat. median
$15,886
outlier · 5.7×
0431T
HCPCS 		Rmvl/rplc Nstim Apnea Pls Gn 1 $90,268.09 $90,268.09 $90,268.09 nat. median
$18,872
outlier · 4.8×
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 $62,597.00 $116,987.33 $89,792.17 nat. median
$39,020
outlier · 2.3×

Other procedures at this hospital

Browse this hospital's 15,356 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 10 8 — — $2,893,800.00 $4,429,740.00 $3,844,554.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 9 7 — — $2,570,880.00 $3,985,651.65 $3,454,231.43 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 13 10 — — $1,796,172.04 $4,786,111.43 $2,716,441.62 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 18 11 — — $398,636.55 $2,037,540.68 $862,793.79 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 18 10 — — $395,612.82 $1,952,327.55 $676,769.03 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 18 10 — — $369,605.74 $1,865,296.52 $646,599.96 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 18 10 — — $378,058.43 $1,857,069.95 $643,748.24 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 19 11 — — $350,563.20 $1,764,405.85 $638,218.94 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 25 12 — — $388,261.34 $1,017,496.62 $624,189.02 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 18 10 — — $350,563.20 $1,623,218.26 $562,684.19 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 31 12 — — $192,728.07 $759,985.80 $416,502.17 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 32 12 — — $177,337.76 $578,229.66 $333,512.45 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 25 12 — — $192,249.56 $702,248.49 $324,901.76 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 5 4 — — $78,290.00 $236,085.42 $199,452.39 2026-04-01
7 MS_DRG Lung Transplant 25 12 — — $116,831.13 $352,598.08 $197,444.61 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 25 12 — — $108,460.88 $353,488.48 $183,298.89 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 29 13 — — $97,900.21 $391,637.40 $178,164.34 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 16 11 — — $108,243.35 $359,096.58 $175,291.35 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 25 12 — — $102,301.03 $326,207.31 $172,888.74 2026-04-01
215 MS_DRG Other Heart Assist System Implant 27 12 — — $89,957.99 $285,852.70 $152,029.00 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 12 — — $80,220.00 $264,378.25 $149,385.88 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 5 4 — — $63,718.00 $176,697.74 $149,279.81 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 5 4 — — $78,290.00 $162,950.46 $137,665.68 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $79,841.00 $178,406.44 $129,123.72 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 12 — — $76,009.67 $228,499.77 $128,456.34 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $123,756.60 $123,756.60 $123,756.60 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 26 11 — — $95,905.11 $293,917.62 $120,896.10 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $74,066.00 $165,185.45 $119,625.73 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 15 10 — — $68,801.71 $228,249.21 $116,274.89 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 28 12 — — $82,192.90 $287,320.53 $114,344.98 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 20 11 — — $5,419.00 $232,534.73 $112,908.95 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 15 11 — — $102,184.32 $189,040.99 $110,359.07 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 25 12 — — $64,618.30 $213,878.22 $109,204.93 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 12 — — $8,244.86 $282,814.53 $107,473.45 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 2 — — $62,597.00 $149,147.37 $105,872.18 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 5 4 — — $78,028.08 $122,702.40 $103,662.84 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 41 13 — — $23,258.29 $366,863.88 $103,155.20 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $79,841.00 $121,600.93 $100,720.96 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 25 12 — — $59,382.30 $166,149.76 $100,356.09 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $74,066.00 $117,849.47 $95,957.74 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 19 10 — — $48,204.00 $213,256.09 $95,249.00 2026-04-01
0266T HCPCS Implt/rpl Crtd Sns Dev Total 5 4 — — $5,419.00 $124,601.88 $94,870.70 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 26 12 — — $60,575.65 $184,354.65 $93,867.74 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 25 12 — — $55,520.83 $183,099.81 $93,830.20 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 25 12 — — $53,800.63 $164,567.63 $90,923.06 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 12 — — $59,596.87 $174,233.57 $90,469.36 2026-04-01
0424T HCPCS Insj/rplc Nstim Apnea Compl 1 1 — — $90,268.09 $90,268.09 $90,268.09 2026-04-01
0431T HCPCS Rmvl/rplc Nstim Apnea Pls Gn 1 1 — — $90,268.09 $90,268.09 $90,268.09 2026-04-01
0427T HCPCS Insj/rplc Nstim Apnea Pls Gn 1 1 — — $90,268.09 $90,268.09 $90,268.09 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 2 — — $62,597.00 $116,987.33 $89,792.17 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 21 11 — — $81,452.17 $225,029.88 $89,597.39 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 22 11 — — $41,672.79 $186,672.66 $89,182.05 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 12 — — $59,596.87 $160,518.62 $88,366.74 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 26 12 — — $60,995.65 $184,230.40 $88,138.71 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 28 12 — — $45,823.86 $156,306.20 $86,991.88 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 20 11 — — $51,071.73 $188,515.06 $86,746.76 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 42 13 — — $47,400.03 $212,983.79 $86,493.38 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 24 11 — — $6,815.11 $248,539.30 $86,139.84 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 25 12 — — $50,881.87 $146,803.67 $85,990.36 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 20 10 — — $5,419.00 $162,832.34 $85,649.74 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 33 13 — — $17,113.52 $228,629.28 $83,872.35 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 25 12 — — $49,334.95 $164,567.63 $83,376.07 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 35 13 — — $56,587.36 $201,385.55 $82,770.43 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 5 4 — — $38,076.00 $97,453.77 $82,332.01 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 36 13 — — $20,883.36 $217,441.14 $81,936.42 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 28 13 — — $35,787.03 $164,814.15 $81,685.28 2026-04-01
10 MS_DRG Pancreas Transplant 25 12 — — $64,987.30 $215,116.69 $81,552.01 2026-04-01
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 5 4 — — $5,419.00 $90,268.09 $80,600.30 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 25 12 — — $47,217.02 $150,403.06 $79,796.76 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 28 12 — — $51,876.18 $164,026.28 $78,761.62 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 11 — — $60,449.38 $191,537.12 $78,639.96 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 12 — — $50,769.83 $161,858.14 $78,175.22 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 16 11 — — $48,155.50 $159,755.55 $77,983.95 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 26 12 — — $44,566.70 $151,409.15 $77,768.89 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 25 11 — — $50,537.11 $134,988.25 $75,568.10 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 42 13 — — $10,538.37 $210,902.10 $75,564.88 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 31 12 — — $37,205.76 $182,622.92 $74,776.36 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 16 11 — — $44,853.57 $148,801.42 $72,636.73 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 33 12 — — $16,288.02 $128,280.52 $72,140.51 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 39 12 — — $45,479.80 $139,290.46 $72,028.22 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 32 13 — — $28,431.95 $187,700.28 $72,010.69 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 25 12 — — $42,561.00 $128,844.45 $71,928.09 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 20 11 — — $5,419.00 $162,832.34 $71,487.27 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 25 12 — — $42,194.69 $130,833.02 $71,309.03 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 31 11 — — $11,933.66 $190,668.30 $71,038.66 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 12 — — $39,947.18 $123,909.44 $70,257.88 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 27 12 — — $36,881.66 $113,062.67 $68,934.46 2026-04-01
J9226 HCPCS Supprelin La Implant 22 11 — — $34,769.23 $136,592.57 $67,910.24 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 34 13 — — $10,749.89 $223,276.00 $67,084.74 2026-04-01
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 20 10 — — $5,419.00 $162,832.34 $66,908.82 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 24 11 — — $30,430.02 $180,892.72 $66,606.36 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 26 12 — — $14,349.45 $166,910.65 $66,048.80 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 29 11 — — $53,692.88 $167,126.51 $65,389.26 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 12 — — $38,025.28 $120,714.90 $64,262.72 2026-04-01
69930 HCPCS Implant Cochlear Device 20 11 — — $17,902.00 $121,892.33 $64,115.32 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 39 13 — — $2,555.04 $177,908.93 $63,902.48 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 27 12 — — $2,371.28 $161,096.18 $63,861.55 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 34 12 — — $42,481.79 $404,526.81 $63,718.21 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 26 12 — — $32,320.29 $135,093.48 $63,141.76 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 40 13 — — $22,079.59 $152,921.03 $63,089.00 2026-04-01
90288 HCPCS Botulism Ig IV 1 1 — — $63,030.00 $63,030.00 $63,030.00 2026-04-01
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 21 11 — — $5,419.00 $116,039.30 $62,960.41 2026-04-01
0408T HCPCS Insj/rplc Cardiac Modulj Sys 21 11 — — $5,419.00 $116,039.30 $62,960.41 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 23 11 — — $52,340.80 $147,594.24 $62,808.96 2026-04-01
0316T HCPCS Replc Vagus Nerve Pls Gen 2 2 — — $33,603.00 $90,268.09 $61,935.54 2026-04-01
0312T HCPCS Laps Impltj Nstim Vagus 2 2 — — $33,603.00 $90,268.09 $61,935.54 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 1 1 — — $61,899.11 $61,899.11 $61,899.11 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 26 12 — — $35,262.73 $106,023.07 $61,406.54 2026-04-01
33270 HCPCS Ins/rep Subq Defibrillator 20 11 — — $5,419.00 $116,039.30 $61,036.62 2026-04-01
33231 HCPCS Insrt Pulse Gen W/mult Leads 20 11 — — $5,419.00 $116,039.30 $61,036.62 2026-04-01
33264 HCPCS Rmvl & Rplcmt Dfb Gen Mlt Ld 20 11 — — $5,419.00 $116,039.30 $61,036.62 2026-04-01
33249 HCPCS Insj/rplcmt Defib W/lead(s) 20 11 — — $5,419.00 $116,039.30 $61,036.62 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 34 12 — — $44,538.86 $166,408.60 $60,587.19 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 27 12 — — $21,750.18 $181,658.48 $60,179.11 2026-04-01
61886 HCPCS Implant Neurostim Arrays 20 11 — — $9,231.00 $114,075.67 $60,003.75 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 20 11 — — $8,066.00 $114,075.67 $60,003.75 2026-04-01
0426T HCPCS Insj/rplc Nstim Apnea Stm Ld 1 1 — — $59,766.20 $59,766.20 $59,766.20 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 34 12 — — $25,458.32 $121,723.90 $59,765.99 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 27 12 — — $35,314.80 $104,924.90 $59,682.01 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 28 12 — — $31,376.08 $135,894.84 $59,615.40 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 37 12 — — $40,016.74 $149,171.16 $59,613.49 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 29 12 — — $48,025.27 $145,584.08 $59,436.80 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 15 10 — — $34,970.13 $116,013.17 $59,099.52 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 26 12 — — $39,499.72 $118,518.44 $58,712.68 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 25 12 — — $36,332.91 $96,719.68 $58,124.61 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 15 10 — — $34,386.10 $114,075.67 $58,112.52 2026-04-01
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 19 10 — — $5,419.00 $114,075.67 $58,112.52 2026-04-01
C8007 HCPCS Opn Mplnt Hpgls Ns Ary Ps Gn 15 10 — — $34,386.10 $114,075.67 $58,112.52 2026-04-01
C8011 HCPCS Opn Mplnt Hpgls Ns Ary Rec 15 10 — — $34,386.10 $114,075.67 $58,112.52 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 19 10 — — $5,419.00 $114,075.67 $58,112.52 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 35 13 — — $17,388.58 $103,323.00 $58,047.88 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 33 12 — — $1,552.32 $107,482.80 $57,440.90 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 44 12 — — $22,524.56 $154,430.09 $57,211.45 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 35 13 — — $1,445.60 $150,892.30 $56,907.27 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 30 12 — — $38,400.64 $120,998.08 $56,507.22 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 41 13 — — $27,838.67 $123,898.65 $56,258.28 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 11 — — $46,930.50 $162,312.76 $56,141.89 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 30 12 — — $21,742.36 $98,441.13 $56,120.61 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 38 13 — — $1,774.25 $136,110.57 $56,049.81 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 30 12 — — $31,342.75 $124,306.07 $55,990.35 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 27 12 — — $33,115.18 $95,410.33 $55,964.65 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 15 11 — — $51,800.32 $95,830.59 $55,944.35 2026-04-01
265 MS_DRG Aicd Lead Procedures 25 12 — — $33,047.84 $96,242.10 $55,850.85 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 20 11 — — $5,419.00 $106,037.48 $55,775.67 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 26 12 — — $37,399.78 $110,717.94 $55,509.57 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 32 13 — — $27,489.58 $163,619.18 $55,305.21 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 27 12 — — $1,445.25 $106,236.23 $55,187.80 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 26 12 — — $31,579.03 $141,535.71 $55,105.40 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 27 12 — — $31,092.70 $187,109.41 $55,052.75 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 25 12 — — $32,548.66 $94,534.14 $55,007.24 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 35 12 — — $46.03 $143,541.54 $54,568.67 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 28 12 — — $36,665.46 $105,499.62 $54,335.48 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 32 12 — — $21,212.95 $113,054.58 $54,297.14 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 25 12 — — $33,140.31 $85,662.02 $53,954.60 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 27 12 — — $31,873.51 $105,441.04 $53,866.23 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 27 12 — — $27,858.62 $93,484.54 $53,623.46 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 35 12 — — $36,528.74 $110,944.59 $53,304.69 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 21 11 — — $48,412.90 $138,949.21 $53,254.19 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 28 11 — — $28,076.41 $114,921.73 $52,916.74 2026-04-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 1 1 — — $52,636.96 $52,636.96 $52,636.96 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 33 13 — — $6,904.94 $197,662.76 $52,027.60 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 2 2 — — $33,651.00 $69,795.82 $51,723.41 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 25 12 — — $35,525.79 $116,743.02 $51,368.14 2026-04-01
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 18 10 — — $5,419.00 $116,039.30 $50,543.22 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 32 12 — — $43,497.25 $131,052.00 $50,503.16 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 20 11 — — $8,066.00 $114,075.67 $50,361.08 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 2 2 — — $29,990.00 $70,131.35 $50,060.68 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 25 12 — — $29,536.52 $87,758.75 $49,916.72 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 37 14 — — $868.84 $137,033.48 $49,874.66 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 15 10 — — $29,510.19 $97,899.86 $49,872.22 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 25 12 — — $29,479.96 $85,808.16 $49,821.13 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 41 12 — — $36,232.55 $120,671.60 $49,660.76 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 27 12 — — $41,129.98 $132,000.45 $49,468.99 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 29 12 — — $18,947.39 $84,228.68 $49,306.76 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 25 12 — — $29,147.77 $87,899.26 $49,259.73 2026-04-01
93653 HCPCS Ep & Ablate Supravent Arrhyt 19 11 — — $29,126.58 $96,627.22 $49,223.91 2026-04-01
93656 HCPCS Tx Atrial Fib Pulm Vein Isol 19 11 — — $29,126.58 $96,627.22 $49,223.91 2026-04-01
93654 HCPCS Ep & Ablate Ventric Tachy 19 11 — — $29,126.58 $96,627.22 $49,223.91 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 26 12 — — $29,540.81 $106,954.31 $49,163.03 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 42 13 — — $1,932.30 $539,478.45 $48,943.71 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 28 12 — — $10,832.15 $93,686.90 $48,890.59 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 33 13 — — $15,601.86 $93,175.95 $48,739.30 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 10 8 — — $9,225.79 $84,646.58 $48,353.60 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 30 13 — — $23,951.55 $97,780.07 $48,319.77 2026-04-01
665 MS_DRG Prostatectomy With Mcc 25 12 — — $28,585.74 $92,640.00 $48,309.90 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 31 12 — — $26,327.58 $79,963.30 $48,211.27 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 28 12 — — $18,085.55 $126,254.17 $47,984.94 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 26 12 — — $33,540.74 $104,174.80 $47,707.71 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 30 13 — — $1,460.34 $96,894.29 $47,671.10 2026-04-01
791 MS_DRG Prematurity With Major Problems 30 12 — — $27,308.80 $109,549.62 $47,608.00 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 26 12 — — $32,730.02 $107,407.25 $47,294.88 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 30 12 — — $1,617.67 $84,023.54 $47,247.66 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 34 12 — — $5,526.00 $130,018.29 $47,203.74 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 16 11 — — $28,851.23 $95,713.76 $46,722.24 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 25 12 — — $30,220.65 $81,002.34 $46,518.80 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 16 11 — — $28,715.00 $95,261.82 $46,501.62 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 26 12 — — $27,681.65 $77,114.56 $46,437.20 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 27 11 — — $41,315.40 $127,412.70 $46,231.46 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 25 12 — — $28,773.38 $75,695.30 $45,889.10 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 29 12 — — $38,240.75 $119,535.66 $45,888.90 2026-04-01
0870T HCPCS Imp Subq Prtl Ascts Pmp Sys 17 10 — — $5,419.00 $126,647.78 $45,810.89 2026-04-01
245 MS_DRG Aicd Generator Procedures 29 13 — — $7,874.00 $131,847.54 $45,677.42 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 29 13 — — $9,296.78 $212,952.68 $45,419.17 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 25 12 — — $26,779.36 $78,682.21 $45,257.12 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 25 12 — — $26,617.75 $79,132.81 $44,984.00 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 20 11 — — $5,419.00 $99,509.36 $44,721.84 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 30 13 — — $6,957.58 $114,106.88 $44,686.18 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 25 12 — — $26,436.39 $71,552.42 $44,677.50 2026-04-01
0614T HCPCS Rmvl&rplcmt Ss Impl Dfb Pg 21 11 — — $5,419.00 $82,230.72 $44,616.61 2026-04-01
0409T HCPCS Insj/rplc Car Modulj Pls Gn 21 11 — — $5,419.00 $82,230.72 $44,616.61 2026-04-01
0414T HCPCS Rmvl & Rpl Car Modulj Pls Gn 21 11 — — $5,419.00 $82,230.72 $44,616.61 2026-04-01
9513 OTHER Plasma, Frz Between 8-24hour 1 1 — — $44,522.60 $44,522.60 $44,522.60 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 35 13 — — $25,303.38 $108,107.91 $44,170.39 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 25 12 — — $26,486.67 $73,563.72 $44,091.56 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 32 12 — — $21,313.39 $115,089.02 $44,002.48 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 35 12 — — $33,439.91 $106,017.67 $43,991.66 2026-04-01
61891 HCPCS Rev/rplcmt Sk-mnt Crnl Nstm 19 10 — — $5,419.00 $114,075.67 $43,941.17 2026-04-01
800 MS_DRG Splenic Procedures With Cc 27 12 — — $25,317.84 $78,614.76 $43,578.98 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 32 13 — — $14,314.95 $91,334.10 $43,471.76 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 25 12 — — $25,695.70 $76,140.51 $43,425.73 2026-04-01
33263 HCPCS Rmvl & Rplcmt Dfb Gen 2 Lead 20 11 — — $5,419.00 $82,230.72 $43,253.32 2026-04-01
33262 HCPCS Rmvl& Replc Pulse Gen 1 Lead 20 11 — — $5,419.00 $82,230.72 $43,253.32 2026-04-01
33240 HCPCS Insrt Pulse Gen W/singl Lead 20 11 — — $5,419.00 $82,230.72 $43,253.32 2026-04-01
33230 HCPCS Insrt Pulse Gen W/dual Leads 20 11 — — $5,419.00 $82,230.72 $43,253.32 2026-04-01
0515T HCPCS Insj Wcs Lv Compl Sys 20 11 — — $5,419.00 $82,230.72 $43,253.32 2026-04-01
J9266 HCPCS Pegaspargase Injection 22 11 — — $20,109.54 $94,296.62 $42,936.57 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 25 12 — — $26,995.73 $71,332.31 $42,903.92 2026-04-01
21243 HCPCS Reconstruction Of Jaw Joint 20 11 — — $12,967.00 $100,309.87 $42,903.26 2026-04-01
20696 HCPCS Comp Multiplane Ext Fixation 20 11 — — $18,229.00 $100,309.87 $42,903.26 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 31 12 — — $29,432.92 $112,255.91 $42,327.53 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 29 13 — — $35,039.79 $110,882.53 $42,235.68 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 28 11 — — $34,959.96 $112,972.75 $42,114.96 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 25 12 — — $24,859.85 $73,695.94 $42,013.15 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 25 12 — — $24,780.84 $73,196.23 $41,879.62 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 26 12 — — $26,911.20 $86,394.68 $41,872.04 2026-04-01
69715 HCPCS Temple Bne Implnt W/Stimulat 2 2 — — $33,603.00 $49,432.85 $41,517.93 2026-04-01
G2171 HCPCS Avf Use Magnetic/art/ven 2 2 — — $33,603.00 $49,413.91 $41,508.46 2026-04-01
G2170 HCPCS Avf By Tissue W Thermal E 2 2 — — $33,603.00 $49,413.91 $41,508.46 2026-04-01
0909T HCPCS Rplcmt Int Nstim Sys Vgs Nrv 17 10 — — $5,419.00 $114,075.67 $41,263.32 2026-04-01
0908T HCPCS Opn Imp Int Nstm Sys Vgs Nrv 17 10 — — $5,419.00 $114,075.67 $41,263.32 2026-04-01
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 17 10 — — $5,419.00 $114,075.67 $41,263.32 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 32 13 — — $26,746.69 $94,517.95 $41,191.49 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 38 13 — — $13,053.00 $102,569.37 $41,037.40 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 25 12 — — $24,242.16 $74,054.10 $40,969.25 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 28 13 — — $8,570.60 $69,840.21 $40,890.43 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 30 13 — — $24,364.19 $101,921.64 $40,854.82 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 26 12 — — $8,097.34 $84,167.65 $40,531.89 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 34 12 — — $22,084.08 $67,947.76 $40,525.95 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 32 13 — — $10,683.34 $102,585.02 $40,513.93 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 28 13 — — $14,820.54 $94,299.39 $40,433.85 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 27 12 — — $7,411.47 $64,675.85 $40,086.17 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 32 12 — — $25,893.55 $95,813.08 $40,018.89 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 37 13 — — $6,584.04 $112,531.13 $39,898.26 2026-04-01
54416 HCPCS Remv/repl Penis Contain Pros 20 11 — — $9,231.00 $76,620.96 $39,775.57 2026-04-01
54405 HCPCS Insert Multi-comp Penis Pros 20 11 — — $9,231.00 $76,620.96 $39,775.57 2026-04-01
54401 HCPCS Insert Self-contd Prosthesis 20 11 — — $9,231.00 $76,620.96 $39,775.57 2026-04-01
54410 HCPCS Remove/replace Penis Prosth 20 11 — — $9,231.00 $76,620.96 $39,775.57 2026-04-01
54411 HCPCS Remov/replc Penis Pros Comp 20 11 — — $5,419.00 $76,620.96 $39,775.57 2026-04-01
53444 HCPCS Insert Tandem Cuff 20 11 — — $8,066.00 $76,620.96 $39,775.57 2026-04-01
53445 HCPCS Insert Uro/ves Nck Sphincter 20 11 — — $6,022.00 $76,620.96 $39,775.57 2026-04-01
53447 HCPCS Remove/replace Ur Sphincter 20 11 — — $6,022.00 $76,620.96 $39,775.57 2026-04-01
332 MS_DRG Rectal Resection With Mcc 27 12 — — $29,721.54 $97,357.86 $39,684.35 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 27 12 — — $22,529.71 $69,726.88 $39,505.05 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 32 12 — — $749.04 $89,042.89 $39,474.87 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 24 11 — — $27,285.72 $82,791.57 $39,427.87 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 30 13 — — $7,794.09 $89,086.47 $39,330.71 2026-04-01
0823T HCPCS Tcat Ins 1chmbr Ldls Pm Ra 19 10 — — $5,419.00 $82,230.72 $39,139.73 2026-04-01
0796T HCPCS Tcat Ins 2chmbr Ldls Pm Ra 19 10 — — $5,419.00 $82,230.72 $39,139.73 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 25 12 — — $22,935.85 $65,291.04 $38,761.59 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 27 12 — — $22,844.27 $68,175.42 $38,606.82 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 27 12 — — $17,680.99 $63,506.54 $38,265.42 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 29 12 — — $11,955.77 $66,232.01 $38,254.81 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 28 12 — — $26,861.13 $69,562.26 $38,049.01 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 31 12 — — $20,193.97 $65,555.31 $37,993.84 2026-04-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 1 1 — — $37,943.35 $37,943.35 $37,943.35 2026-04-01
570 MS_DRG Skin Debridement With Mcc 27 12 — — $26,968.79 $81,226.61 $37,869.55 2026-04-01
64590 HCPCS Insrt/redo Pn/gastr Stimul 20 11 — — $8,066.00 $71,718.92 $37,724.12 2026-04-01
64580 HCPCS Implant Neuroelectrodes 20 11 — — $6,022.00 $71,718.92 $37,724.12 2026-04-01
63655 HCPCS Implant Neuroelectrodes 20 11 — — $21,618.41 $71,718.92 $37,724.12 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 31 13 — — $1,511.08 $97,291.26 $37,528.84 2026-04-01
33221 HCPCS Insert Pulse Gen Mult Leads 20 11 — — $5,419.00 $71,207.20 $37,454.96 2026-04-01
33229 HCPCS Remv&replc Pm Gen Mult Leads 20 11 — — $5,419.00 $71,207.20 $37,454.96 2026-04-01
33274 HCPCS Tcat Insj/rpl Perm Ldls Pm 20 11 — — $5,419.00 $71,207.20 $37,454.96 2026-04-01
22630 HCPCS Lumbar Spine Fusion 19 10 — — $5,419.00 $100,309.87 $37,434.06 2026-04-01
27702 HCPCS Reconstruct Ankle Joint 19 10 — — $5,419.00 $100,309.87 $37,434.06 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 36 13 — — $28,681.83 $92,936.80 $37,365.91 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 30 12 — — $30,194.45 $92,882.00 $37,257.27 2026-04-01
22633 HCPCS Lumbar Spine Fusion Combined 20 11 — — $5,419.00 $100,309.87 $37,163.13 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 29 12 — — $20,417.16 $64,122.72 $37,160.84 2026-04-01
503 MS_DRG Foot Procedures With Mcc 26 12 — — $24,951.15 $71,451.18 $37,023.91 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 30 13 — — $20,272.06 $61,782.80 $36,996.51 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 27 12 — — $20,705.05 $64,675.85 $36,928.48 2026-04-01
C9752 HCPCS Intraosseous Des Lumb/sacrum 1 1 — — $36,892.20 $36,892.20 $36,892.20 2026-04-01
5166 OTHER Cochlear Implant Procedure 11 9 — — $28,730.96 $119,913.90 $36,879.88 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 30 12 — — $23,497.58 $258,542.16 $36,598.39 2026-04-01
0816T HCPCS Opn Insj/rplcmt Ins Ptn Subq 19 10 — — $5,419.00 $71,718.92 $36,535.11 2026-04-01
0817T HCPCS Opn Insj/rplcmt Ins Ptn Subf 19 10 — — $5,419.00 $71,718.92 $36,535.11 2026-04-01
Q0483 HCPCS Monitor Elec Vad, Rep 16 11 — — $22,533.92 $74,756.13 $36,491.86 2026-04-01
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 27 12 — — $21,544.25 $67,583.88 $36,409.78 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 28 12 — — $20,855.74 $59,488.92 $36,358.02 2026-04-01
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