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Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

TRI-STATE MEMORIAL HOSPITAL

Clarkston, WA · CCN 501332 · Rates published

20,114 distinct procedures filed
18 distinct payers
905,347 rate rows
2026-07-15 last MRF observed
Data quality

241,672 of 905,347 rate rows are consumer-grade (26.7%)

663,675 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 354,164
professional (physician) fee — not the facility price 291,327
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 10,860
per-diem day rate — not a per-procedure price 6,903
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 168
placeholder amount (≤ $0.02) — excluded from medians 135
exceeds 10× this hospital's gross charge — excluded from medians 118
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/TriStateHealth/910545036_tri-state-memorial-hospital_standardcharges.csv
Found on page https://www.tsh.org/transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-12
Content fingerprint f3b7320415e12539… · 196,821,873 bytes · first seen 2026-07-20

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
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 15 $1,596,530.31 $1,596,530.31 $1,596,530.31 nat. median
$739,258
outlier · 2.2×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 15 $1,548,445.35 $1,548,445.35 $1,548,445.35 nat. median
$646,415
outlier · 2.4×
Q2055
HCPCS 		Idecabtagene Vicleucel Car 15 $1,535,536.30 $1,535,536.30 $1,535,536.30 nat. median
$622,450
outlier · 2.5×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 15 $1,513,990.13 $1,513,990.13 $1,513,990.13 nat. median
$640,950
outlier · 2.4×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 15 $1,491,867.58 $1,491,867.58 $1,491,867.58 nat. median
$608,239
outlier · 2.5×
Q2053
HCPCS 		Brexucabtagene Car Pos T 15 $1,370,792.00 $1,370,792.00 $1,370,792.00 nat. median
$591,721
outlier · 2.3×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $257,184.99 $257,184.99 $257,184.99 nat. median
$249,036
1.0× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 15 $199,703.58 $199,703.58 $199,703.58 nat. median
$63,528
outlier · 3.1×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 15 $193,672.97 $193,672.97 $193,672.97 nat. median
$68,423
outlier · 2.8×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 15 $169,313.99 $169,313.99 $169,313.99 nat. median
$65,720
outlier · 2.6×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $149,795.10 $149,795.10 $149,795.10 nat. median
$110,307
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $148,270.83 $148,270.83 $148,270.83 nat. median
$104,013
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $144,219.75 $144,219.75 $144,219.75 nat. median
$198,418
0.7× median
215
MS_DRG 		Other Heart Assist System Implant 1 $137,871.57 $137,871.57 $137,871.57 nat. median
$93,901
1.5× median
J9226
HCPCS 		Supprelin La Implant 15 $134,682.67 $134,682.67 $134,682.67 nat. median
$55,159
outlier · 2.4×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $126,571.14 $126,571.14 $126,571.14 nat. median
$190,559
0.7× median
7
MS_DRG 		Lung Transplant 1 $106,471.05 $106,471.05 $106,471.05 nat. median
$117,974
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $103,989.81 $103,989.81 $103,989.81 nat. median
$126,695
0.8× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $102,109.35 $102,109.35 $102,109.35 nat. median
$95,038
1.1× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 $85,374.93 $85,374.93 $85,374.93 nat. median
$74,370
1.1× median
J9266
HCPCS 		Pegaspargase Injection 15 $82,395.31 $82,395.31 $82,395.31 nat. median
$33,233
outlier · 2.5×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $78,871.44 $78,871.44 $78,871.44 nat. median
$77,632
1.0× median
266
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 $77,364.84 $77,364.84 $77,364.84 nat. median
$58,280
1.3× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 1 $75,229.56 $75,229.56 $75,229.56 nat. median
$53,927
1.4× median
J9600
HCPCS 		Porfimer Sodium Injection 15 $71,727.34 $71,727.34 $71,727.34 nat. median
$30,131
outlier · 2.4×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $69,491.46 $69,491.46 $69,491.46 nat. median
$59,371
1.2× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $69,174.33 $69,174.33 $69,174.33 nat. median
$90,551
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 1 $65,895.15 $65,895.15 $65,895.15 nat. median
$77,028
0.9× median
21
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 $63,875.19 $63,875.19 $63,875.19 nat. median
$51,514
1.2× median
834
MS_DRG 		Acute Leukemia With Mcc 1 $62,374.17 $62,374.17 $62,374.17 nat. median
$50,371
1.2× median
457
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 $60,755.04 $60,755.04 $60,755.04 nat. median
$55,167
1.1× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 $60,712.26 $60,712.26 $60,712.26 nat. median
$63,873
1.0× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 $60,071.49 $60,071.49 $60,071.49 nat. median
$71,748
0.8× median
790
MS_DRG 		Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 $59,104.29 $59,104.29 $59,104.29 nat. median
$50,870
1.2× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 $58,916.43 $58,916.43 $58,916.43 nat. median
$72,398
0.8× median
901
MS_DRG 		Wound Debridements For Injuries With Mcc 1 $57,996.66 $57,996.66 $57,996.66 nat. median
$39,652
1.5× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 $56,664.90 $56,664.90 $56,664.90 nat. median
$62,031
0.9× median
820
MS_DRG 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 $56,231.52 $56,231.52 $56,231.52 nat. median
$53,856
1.0× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 1 $55,084.83 $55,084.83 $55,084.83 nat. median
$47,429
1.2× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 1 $54,253.41 $54,253.41 $54,253.41 nat. median
$58,251
0.9× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 $54,050.67 $54,050.67 $54,050.67 nat. median
$45,868
1.2× median
653
MS_DRG 		Major Bladder Procedures With Mcc 1 $53,774.46 $53,774.46 $53,774.46 nat. median
$49,999
1.1× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 $53,704.71 $53,704.71 $53,704.71 nat. median
$67,976
0.8× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 1 $53,563.35 $53,563.35 $53,563.35 nat. median
$62,655
0.9× median
A9604
HCPCS 		Sm 153 Lexidronam 15 $52,642.55 $52,642.55 $52,642.55 nat. median
$12,627
outlier · 4.2×
622
MS_DRG 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 $51,260.67 $51,260.67 $51,260.67 nat. median
$33,627
1.5× median
463
MS_DRG 		Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective… 1 $50,979.81 $50,979.81 $50,979.81 nat. median
$49,929
1.0× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 1 $50,711.04 $50,711.04 $50,711.04 nat. median
$57,801
0.9× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 1 $50,216.28 $50,216.28 $50,216.28 nat. median
$55,477
0.9× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 1 $50,191.17 $50,191.17 $50,191.17 nat. median
$61,728
0.8× median

Other procedures at this hospital

Browse this hospital's 20,114 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
             
261 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Cc 2 1 — — $16,038.78 $16,038.78 $16,038.78 2026-06-26
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 2 1 — — $16,075.05 $16,075.05 $16,075.05 2026-06-26
620 MS_DRG O.r. Procedures For Obesity With Cc 2 1 — — $16,075.05 $16,075.05 $16,075.05 2026-06-26
177 MS_DRG Respiratory Infections And Inflammations With Mcc 2 1 — — $16,080.63 $16,080.63 $16,080.63 2026-06-26
895 MS_DRG Alcohol, Drug Abuse Or Dependence With Rehabilitation Therapy 2 1 — — $16,209.90 $16,209.90 $16,209.90 2026-06-26
902 MS_DRG Wound Debridements For Injuries With Cc 2 1 — — $16,265.70 $16,265.70 $16,265.70 2026-06-26
438 MS_DRG Disorders Of Pancreas Except Malignancy With Mcc 2 1 — — $16,389.39 $16,389.39 $16,389.39 2026-06-26
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 2 1 — — $16,399.62 $16,399.62 $16,399.62 2026-06-26
617 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $16,437.75 $16,437.75 $16,437.75 2026-06-26
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 2 1 — — $16,452.63 $16,452.63 $16,452.63 2026-06-26
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 2 1 — — $16,485.18 $16,485.18 $16,485.18 2026-06-26
81554 CPT Pulm Ds Ipf Mrna 190 Gen Alg 25 15 — — $16,499.28 $16,499.28 $16,499.28 2026-06-26
295U OTHER Onc Brst Dux Carc 7 Proteins 25 15 — — $16,576.75 $16,576.75 $16,576.75 2026-06-26
717 MS_DRG Other Male Reproductive System O.r. Procedures Except Malignancy With Cc/mcc 2 1 — — $16,632.12 $16,632.12 $16,632.12 2026-06-26
C1767 HCPCS Neurostimulator Interstim X 25 15 $23,149.00 $22,917.51 $9,259.60 $21,991.55 $16,667.28 2026-06-26
212U OTHER Rare Ds Gen DNA Alys Proband 25 15 — — $16,699.36 $16,699.36 $16,699.36 2026-06-26
265U OTHER Rar Do Whl Gn&mtcdrl DNA Als 25 15 — — $16,701.19 $16,701.19 $16,701.19 2026-06-26
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 2 1 — — $16,728.84 $16,728.84 $16,728.84 2026-06-26
42 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc 2 1 — — $16,737.21 $16,737.21 $16,737.21 2026-06-26
884 MS_DRG Organic Disturbances And Intellectual Disability 2 1 — — $16,752.09 $16,752.09 $16,752.09 2026-06-26
722 MS_DRG Malignancy, Male Reproductive System With Mcc 2 1 — — $16,753.02 $16,753.02 $16,753.02 2026-06-26
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 2 1 — — $16,753.02 $16,753.02 $16,753.02 2026-06-26
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 2 1 — — $16,794.87 $16,794.87 $16,794.87 2026-06-26
769 MS_DRG Postpartum And Post Abortion Diagnoses With O.r. Procedures 2 1 — — $16,881.36 $16,881.36 $16,881.36 2026-06-26
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 2 1 — — $16,936.23 $16,936.23 $16,936.23 2026-06-26
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 2 1 — — $16,958.55 $16,958.55 $16,958.55 2026-06-26
754 MS_DRG Malignancy, Female Reproductive System With Mcc 2 1 — — $16,972.50 $16,972.50 $16,972.50 2026-06-26
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 2 1 — — $17,150.13 $17,150.13 $17,150.13 2026-06-26
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 2 1 — — $17,164.08 $17,164.08 $17,164.08 2026-06-26
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 2 1 — — $17,181.75 $17,181.75 $17,181.75 2026-06-26
709 MS_DRG Penis Procedures With Cc/mcc 2 1 — — $17,182.68 $17,182.68 $17,182.68 2026-06-26
595 MS_DRG Major Skin Disorders With Mcc 2 1 — — $17,363.10 $17,363.10 $17,363.10 2026-06-26
657 MS_DRG Kidney And Ureter Procedures For Neoplasm With Cc 2 1 — — $17,377.98 $17,377.98 $17,377.98 2026-06-26
113 MS_DRG Orbital Procedures With Cc/mcc 2 1 — — $17,383.56 $17,383.56 $17,383.56 2026-06-26
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 2 1 — — $17,529.57 $17,529.57 $17,529.57 2026-06-26
470 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without … 2 1 — — $17,583.51 $17,583.51 $17,583.51 2026-06-26
116 MS_DRG Intraocular Procedures With Cc/mcc 2 1 — — $17,615.13 $17,615.13 $17,615.13 2026-06-26
803 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 2 1 — — $17,659.77 $17,659.77 $17,659.77 2026-06-26
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 2 1 — — $17,669.07 $17,669.07 $17,669.07 2026-06-26
843 MS_DRG Other Myeloproliferative Disorders Or Poorly Differentiated Neoplastic Diagnoses… 2 1 — — $17,670.00 $17,670.00 $17,670.00 2026-06-26
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 2 1 — — $17,673.72 $17,673.72 $17,673.72 2026-06-26
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 2 1 — — $17,729.52 $17,729.52 $17,729.52 2026-06-26
C1772 HCPCS Infusion Pump, Programmable 3 2 — — $8,716.96 $17,825.92 $17,825.92 2026-06-26
421 MS_DRG Hepatobiliary Diagnostic Procedures With Cc 2 1 — — $17,858.79 $17,858.79 $17,858.79 2026-06-26
336 MS_DRG Peritoneal Adhesiolysis With Cc 2 1 — — $17,901.57 $17,901.57 $17,901.57 2026-06-26
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 2 1 — — $17,974.11 $17,974.11 $17,974.11 2026-06-26
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 2 1 — — $18,095.01 $18,095.01 $18,095.01 2026-06-26
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 2 1 — — $18,161.97 $18,161.97 $18,161.97 2026-06-26
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 2 1 — — $18,184.29 $18,184.29 $18,184.29 2026-06-26
75842 CPT Vein X-ray Adrenal Glands 25 15 — — $18,325.72 $18,325.72 $18,325.72 2026-06-26
75893 CPT Venous Sampling By Catheter 25 15 — — $18,325.72 $18,325.72 $18,325.72 2026-06-26
75605 CPT Contrast Exam Thoracic Aorta 25 15 — — $18,325.72 $18,325.72 $18,325.72 2026-06-26
75726 CPT Artery X-rays Abdomen 25 15 — — $18,325.72 $18,325.72 $18,325.72 2026-06-26
75705 CPT Artery X-rays Spine 25 15 — — $18,325.72 $18,325.72 $18,325.72 2026-06-26
75736 CPT Artery X-rays Pelvis 25 15 — — $18,325.72 $18,325.72 $18,325.72 2026-06-26
167 MS_DRG Other Respiratory System O.r. Procedures With Cc 2 1 — — $18,376.80 $18,376.80 $18,376.80 2026-06-26
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 2 1 — — $18,476.31 $18,476.31 $18,476.31 2026-06-26
330 MS_DRG Major Small And Large Bowel Procedures With Cc 2 1 — — $18,735.78 $18,735.78 $18,735.78 2026-06-26
165 MS_DRG Major Chest Procedures Without Cc/mcc 2 1 — — $18,739.50 $18,739.50 $18,739.50 2026-06-26
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 2 1 — — $18,795.30 $18,795.30 $18,795.30 2026-06-26
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 2 1 — — $18,809.25 $18,809.25 $18,809.25 2026-06-26
682 MS_DRG Renal Failure With Mcc 2 1 — — $18,874.35 $18,874.35 $18,874.35 2026-06-26
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 2 1 — — $18,889.23 $18,889.23 $18,889.23 2026-06-26
883 MS_DRG Disorders Of Personality And Impulse Control 2 1 — — $18,938.52 $18,938.52 $18,938.52 2026-06-26
623 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $19,011.06 $19,011.06 $19,011.06 2026-06-26
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 2 1 — — $19,091.04 $19,091.04 $19,091.04 2026-06-26
374 MS_DRG Digestive Malignancy With Mcc 2 1 — — $19,095.69 $19,095.69 $19,095.69 2026-06-26
668 MS_DRG Transurethral Procedures With Mcc 2 1 — — $19,204.50 $19,204.50 $19,204.50 2026-06-26
J0600 HCPCS Edetate Calcium Disodium Inj 25 15 — — $19,244.44 $19,244.44 $19,244.44 2026-06-26
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 1 — — $19,279.83 $19,279.83 $19,279.83 2026-06-26
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 2 1 — — $19,313.31 $19,313.31 $19,313.31 2026-06-26
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 2 1 — — $19,443.51 $19,443.51 $19,443.51 2026-06-26
412 MS_DRG Cholecystectomy With C.d.e. With Cc 2 1 — — $19,464.90 $19,464.90 $19,464.90 2026-06-26
347 MS_DRG Anal And Stomal Procedures With Mcc 2 1 — — $19,483.50 $19,483.50 $19,483.50 2026-06-26
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 2 1 — — $19,489.08 $19,489.08 $19,489.08 2026-06-26
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 2 1 — — $19,521.63 $19,521.63 $19,521.63 2026-06-26
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 2 1 — — $19,583.94 $19,583.94 $19,583.94 2026-06-26
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 2 1 — — $19,658.34 $19,658.34 $19,658.34 2026-06-26
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 2 1 — — $19,702.05 $19,702.05 $19,702.05 2026-06-26
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 2 1 — — $19,734.60 $19,734.60 $19,734.60 2026-06-26
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 2 1 — — $19,903.86 $19,903.86 $19,903.86 2026-06-26
655 MS_DRG Major Bladder Procedures Without Cc/mcc 2 1 — — $19,998.72 $19,998.72 $19,998.72 2026-06-26
503 MS_DRG Foot Procedures With Mcc 2 1 — — $20,108.46 $20,108.46 $20,108.46 2026-06-26
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 2 1 — — $20,130.78 $20,130.78 $20,130.78 2026-06-26
887 MS_DRG Other Mental Disorder Diagnoses 2 1 — — $20,185.65 $20,185.65 $20,185.65 2026-06-26
800 MS_DRG Splenic Procedures With Cc 2 1 — — $20,201.46 $20,201.46 $20,201.46 2026-06-26
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 2 1 — — $20,202.39 $20,202.39 $20,202.39 2026-06-26
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 2 1 — — $20,224.71 $20,224.71 $20,224.71 2026-06-26
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 2 1 — — $20,269.35 $20,269.35 $20,269.35 2026-06-26
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 2 1 — — $20,323.29 $20,323.29 $20,323.29 2026-06-26
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 2 1 — — $20,327.01 $20,327.01 $20,327.01 2026-06-26
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 1 — — $20,349.33 $20,349.33 $20,349.33 2026-06-26
33285 CPT Insj Subq Car Rhythm Mntr 25 15 $28,332.00 $28,048.68 $11,332.80 $26,915.40 $20,399.04 2026-06-26
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 2 1 — — $20,419.08 $20,419.08 $20,419.08 2026-06-26
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $20,513.94 $20,513.94 $20,513.94 2026-06-26
267U OTHER Rare Do Id Opt Gen Mapg&seq 25 15 — — $20,554.96 $20,554.96 $20,554.96 2026-06-26
333 MS_DRG Rectal Resection With Cc 2 1 — — $20,607.87 $20,607.87 $20,607.87 2026-06-26
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 2 1 — — $20,631.12 $20,631.12 $20,631.12 2026-06-26
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 2 1 — — $20,702.73 $20,702.73 $20,702.73 2026-06-26
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $21,072.87 $21,072.87 $21,072.87 2026-06-26
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 1 — — $21,149.13 $21,149.13 $21,149.13 2026-06-26
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 2 1 — — $21,483.00 $21,483.00 $21,483.00 2026-06-26
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 2 1 — — $21,549.03 $21,549.03 $21,549.03 2026-06-26
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 2 1 — — $21,603.90 $21,603.90 $21,603.90 2026-06-26
253 MS_DRG Other Vascular Procedures With Cc 2 1 — — $21,719.22 $21,719.22 $21,719.22 2026-06-26
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 2 1 — — $21,841.98 $21,841.98 $21,841.98 2026-06-26
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 2 1 — — $21,865.23 $21,865.23 $21,865.23 2026-06-26
472 MS_DRG Cervical Spinal Fusion With Cc 2 1 — — $21,929.40 $21,929.40 $21,929.40 2026-06-26
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 2 1 — — $21,935.91 $21,935.91 $21,935.91 2026-06-26
81529 CPT Onc Cutan Mlnma Mrna 31 Gene 25 15 — — $21,938.65 $21,938.65 $21,938.65 2026-06-26
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 2 1 — — $22,293.03 $22,293.03 $22,293.03 2026-06-26
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 2 1 — — $22,300.47 $22,300.47 $22,300.47 2026-06-26
37 MS_DRG Extracranial Procedures With Mcc 2 1 — — $22,455.78 $22,455.78 $22,455.78 2026-06-26
963 MS_DRG Other Multiple Significant Trauma With Mcc 2 1 — — $22,606.44 $22,606.44 $22,606.44 2026-06-26
426U OTHER Genome Ultra-rapid Seq Alys 25 15 — — $23,125.71 $23,125.71 $23,125.71 2026-06-26
94U OTHER Genome Rapid Sequence Alys 25 15 — — $23,125.71 $23,125.71 $23,125.71 2026-06-26
164 MS_DRG Major Chest Procedures With Cc 2 1 — — $23,137.47 $23,137.47 $23,137.47 2026-06-26
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 2 1 — — $23,490.87 $23,490.87 $23,490.87 2026-06-26
35 MS_DRG Carotid Artery Stent Procedures With Cc 2 1 — — $23,575.50 $23,575.50 $23,575.50 2026-06-26
919 MS_DRG Complications Of Treatment With Mcc 2 1 — — $23,610.84 $23,610.84 $23,610.84 2026-06-26
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 2 1 — — $23,622.00 $23,622.00 $23,622.00 2026-06-26
81552 CPT Onc Uveal Mlnma Mrna 15 Gene 25 15 — — $23,716.80 $23,716.80 $23,716.80 2026-06-26
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 2 1 — — $23,744.76 $23,744.76 $23,744.76 2026-06-26
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 2 1 — — $23,746.62 $23,746.62 $23,746.62 2026-06-26
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 1 — — $23,769.87 $23,769.87 $23,769.87 2026-06-26
654 MS_DRG Major Bladder Procedures With Cc 2 1 — — $24,186.51 $24,186.51 $24,186.51 2026-06-26
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 2 1 — — $24,327.87 $24,327.87 $24,327.87 2026-06-26
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 2 1 — — $24,342.75 $24,342.75 $24,342.75 2026-06-26
265 MS_DRG Aicd Lead Procedures 2 1 — — $24,440.40 $24,440.40 $24,440.40 2026-06-26
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 2 1 — — $24,582.69 $24,582.69 $24,582.69 2026-06-26
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $24,607.80 $24,607.80 $24,607.80 2026-06-26
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 1 — — $24,731.49 $24,731.49 $24,731.49 2026-06-26
545 MS_DRG Connective Tissue Disorders With Mcc 2 1 — — $24,891.45 $24,891.45 $24,891.45 2026-06-26
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 2 1 — — $25,013.28 $25,013.28 $25,013.28 2026-06-26
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 1 — — $25,332.27 $25,332.27 $25,332.27 2026-06-26
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 1 — — $25,336.92 $25,336.92 $25,336.92 2026-06-26
548 MS_DRG Septic Arthritis With Mcc 2 1 — — $25,588.02 $25,588.02 $25,588.02 2026-06-26
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 2 1 — — $25,695.90 $25,695.90 $25,695.90 2026-06-26
211U OTHER Onc Pan-tum Dna&rna Gnrj Seq 25 15 — — $25,787.75 $25,787.75 $25,787.75 2026-06-26
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 2 1 — — $25,794.48 $25,794.48 $25,794.48 2026-06-26
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 2 1 — — $25,895.85 $25,895.85 $25,895.85 2026-06-26
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 2 1 — — $25,921.89 $25,921.89 $25,921.89 2026-06-26
315U OTHER Onc Cutan Sq Cll Ca Mrna 40 25 15 — — $25,925.00 $25,925.00 $25,925.00 2026-06-26
77425 CPT Io Rad Tx Deliver By Elctrns 25 15 — — $25,968.74 $25,968.74 $25,968.74 2026-06-26
77424 CPT Io Rad Tx Delivery By X-ray 25 15 — — $25,968.74 $25,968.74 $25,968.74 2026-06-26
77372 CPT Srs Linear Based 25 15 — — $25,968.74 $25,968.74 $25,968.74 2026-06-26
77371 CPT Srs Multisource 25 15 — — $25,968.74 $25,968.74 $25,968.74 2026-06-26
252 MS_DRG Other Vascular Procedures With Mcc 2 1 — — $26,258.55 $26,258.55 $26,258.55 2026-06-26
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $26,272.50 $26,272.50 $26,272.50 2026-06-26
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 2 1 — — $26,310.63 $26,310.63 $26,310.63 2026-06-26
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 1 — — $26,408.28 $26,408.28 $26,408.28 2026-06-26
264 MS_DRG Other Circulatory System O.r. Procedures 2 1 — — $26,806.32 $26,806.32 $26,806.32 2026-06-26
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 1 — — $26,850.96 $26,850.96 $26,850.96 2026-06-26
974 MS_DRG HIV With Major Related Condition With Mcc 2 1 — — $26,871.42 $26,871.42 $26,871.42 2026-06-26
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 1 — — $27,206.22 $27,206.22 $27,206.22 2026-06-26
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 1 — — $27,285.27 $27,285.27 $27,285.27 2026-06-26
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 1 — — $27,312.24 $27,312.24 $27,312.24 2026-06-26
652 MS_DRG Kidney Transplant 2 1 — — $27,459.18 $27,459.18 $27,459.18 2026-06-26
288 MS_DRG Acute And Subacute Endocarditis With Mcc 2 1 — — $27,467.55 $27,467.55 $27,467.55 2026-06-26
791 MS_DRG Prematurity With Major Problems 2 1 — — $27,640.53 $27,640.53 $27,640.53 2026-06-26
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 1 — — $27,828.39 $27,828.39 $27,828.39 2026-06-26
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 1 — — $27,865.59 $27,865.59 $27,865.59 2026-06-26
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 2 1 — — $27,979.05 $27,979.05 $27,979.05 2026-06-26
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 1 — — $27,991.14 $27,991.14 $27,991.14 2026-06-26
441 MS_DRG Disorders Of Liver Except Malignancy, Cirrhosis Or Alcoholic Hepatitis With Mcc 2 1 — — $28,251.54 $28,251.54 $28,251.54 2026-06-26
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 1 — — $28,430.10 $28,430.10 $28,430.10 2026-06-26
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $28,439.40 $28,439.40 $28,439.40 2026-06-26
665 MS_DRG Prostatectomy With Mcc 2 1 — — $28,451.49 $28,451.49 $28,451.49 2026-06-26
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 1 — — $28,910.91 $28,910.91 $28,910.91 2026-06-26
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 1 — — $28,916.49 $28,916.49 $28,916.49 2026-06-26
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 2 1 — — $28,948.11 $28,948.11 $28,948.11 2026-06-26
835 MS_DRG Acute Leukemia With Cc 2 1 — — $28,994.61 $28,994.61 $28,994.61 2026-06-26
662 MS_DRG Minor Bladder Procedures With Mcc 2 1 — — $29,021.58 $29,021.58 $29,021.58 2026-06-26
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 1 — — $29,155.50 $29,155.50 $29,155.50 2026-06-26
500 MS_DRG Soft Tissue Procedures With Mcc 2 1 — — $29,163.87 $29,163.87 $29,163.87 2026-06-26
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 1 — — $29,233.62 $29,233.62 $29,233.62 2026-06-26
619 MS_DRG O.r. Procedures For Obesity With Mcc 2 1 — — $29,281.98 $29,281.98 $29,281.98 2026-06-26
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 1 — — $29,495.88 $29,495.88 $29,495.88 2026-06-26
559 MS_DRG Aftercare, Musculoskeletal System And Connective Tissue With Mcc 2 1 — — $29,739.54 $29,739.54 $29,739.54 2026-06-26
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 2 1 — — $29,810.22 $29,810.22 $29,810.22 2026-06-26
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 1 — — $29,851.14 $29,851.14 $29,851.14 2026-06-26
592 MS_DRG Skin Ulcers With Mcc 2 1 — — $30,307.77 $30,307.77 $30,307.77 2026-06-26
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 1 — — $30,473.31 $30,473.31 $30,473.31 2026-06-26
31 MS_DRG Ventricular Shunt Procedures With Mcc 2 1 — — $30,616.53 $30,616.53 $30,616.53 2026-06-26
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 1 — — $30,686.28 $30,686.28 $30,686.28 2026-06-26
542 MS_DRG Pathological Fractures And Musculoskeletal And Connective Tissue Malignancy With… 2 1 — — $30,772.77 $30,772.77 $30,772.77 2026-06-26
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 1 — — $30,825.78 $30,825.78 $30,825.78 2026-06-26
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 1 — — $30,868.56 $30,868.56 $30,868.56 2026-06-26
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 1 — — $30,929.01 $30,929.01 $30,929.01 2026-06-26
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 1 — — $31,216.38 $31,216.38 $31,216.38 2026-06-26
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 1 — — $31,578.15 $31,578.15 $31,578.15 2026-06-26
949 MS_DRG Aftercare With Cc/mcc 2 1 — — $31,611.63 $31,611.63 $31,611.63 2026-06-26
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 1 — — $32,054.31 $32,054.31 $32,054.31 2026-06-26
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 1 — — $32,387.25 $32,387.25 $32,387.25 2026-06-26
C1820 HCPCS Generator Kit C1820 25 15 $45,000.00 $44,550.00 $18,000.00 $42,750.00 $32,400.00 2026-06-26
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 1 — — $32,493.27 $32,493.27 $32,493.27 2026-06-26
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $32,583.48 $32,583.48 $32,583.48 2026-06-26
10 MS_DRG Pancreas Transplant 2 1 — — $34,081.71 $34,081.71 $34,081.71 2026-06-26
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 1 — — $34,116.12 $34,116.12 $34,116.12 2026-06-26
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 1 — — $34,203.54 $34,203.54 $34,203.54 2026-06-26
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $34,529.04 $34,529.04 $34,529.04 2026-06-26
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 2 1 — — $34,777.35 $34,777.35 $34,777.35 2026-06-26
539 MS_DRG Osteomyelitis With Mcc 2 1 — — $35,239.56 $35,239.56 $35,239.56 2026-06-26
332 MS_DRG Rectal Resection With Mcc 2 1 — — $35,748.27 $35,748.27 $35,748.27 2026-06-26
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 1 — — $36,236.52 $36,236.52 $36,236.52 2026-06-26
81416 CPT Exome Sequence Analysis 25 15 — — $36,600.00 $36,600.00 $36,600.00 2026-06-26
J1412 HCPCS Inj Roctavian Ml 2x10^13vc G 25 15 — — $36,623.83 $36,623.83 $36,623.83 2026-06-26
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 1 — — $36,777.78 $36,777.78 $36,777.78 2026-06-26
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 1 — — $37,193.49 $37,193.49 $37,193.49 2026-06-26
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $37,621.29 $37,621.29 $37,621.29 2026-06-26
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $37,634.31 $37,634.31 $37,634.31 2026-06-26
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 1 — — $37,876.11 $37,876.11 $37,876.11 2026-06-26
245 MS_DRG Aicd Generator Procedures 2 1 — — $38,186.73 $38,186.73 $38,186.73 2026-06-26
570 MS_DRG Skin Debridement With Mcc 2 1 — — $38,219.28 $38,219.28 $38,219.28 2026-06-26
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 1 — — $38,621.04 $38,621.04 $38,621.04 2026-06-26
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $38,667.54 $38,667.54 $38,667.54 2026-06-26
799 MS_DRG Splenic Procedures With Mcc 2 1 — — $39,281.34 $39,281.34 $39,281.34 2026-06-26
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 1 — — $39,466.41 $39,466.41 $39,466.41 2026-06-26
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 1 — — $40,552.65 $40,552.65 $40,552.65 2026-06-26
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $41,057.64 $41,057.64 $41,057.64 2026-06-26
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 1 — — $41,096.70 $41,096.70 $41,096.70 2026-06-26
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 1 — — $41,132.04 $41,132.04 $41,132.04 2026-06-26
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $41,856.51 $41,856.51 $41,856.51 2026-06-26
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 1 — — $41,857.44 $41,857.44 $41,857.44 2026-06-26
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 1 — — $41,958.81 $41,958.81 $41,958.81 2026-06-26
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $42,093.66 $42,093.66 $42,093.66 2026-06-26
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 1 — — $42,168.06 $42,168.06 $42,168.06 2026-06-26
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $42,326.16 $42,326.16 $42,326.16 2026-06-26
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $42,741.87 $42,741.87 $42,741.87 2026-06-26
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 1 — — $42,791.16 $42,791.16 $42,791.16 2026-06-26
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 1 — — $43,606.77 $43,606.77 $43,606.77 2026-06-26
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 2 1 — — $43,614.21 $43,614.21 $43,614.21 2026-06-26
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $43,746.27 $43,746.27 $43,746.27 2026-06-26
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 1 — — $43,913.67 $43,913.67 $43,913.67 2026-06-26
6 MS_DRG Liver Transplant Without Mcc 2 1 — — $44,182.44 $44,182.44 $44,182.44 2026-06-26
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $44,300.55 $44,300.55 $44,300.55 2026-06-26
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $44,342.40 $44,342.40 $44,342.40 2026-06-26
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 1 — — $44,394.48 $44,394.48 $44,394.48 2026-06-26
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 1 — — $44,620.47 $44,620.47 $44,620.47 2026-06-26
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $44,626.98 $44,626.98 $44,626.98 2026-06-26
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 1 — — $45,155.22 $45,155.22 $45,155.22 2026-06-26
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $45,870.39 $45,870.39 $45,870.39 2026-06-26
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 1 — — $46,465.59 $46,465.59 $46,465.59 2026-06-26
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $46,880.37 $46,880.37 $46,880.37 2026-06-26
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $47,628.09 $47,628.09 $47,628.09 2026-06-26
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $48,198.18 $48,198.18 $48,198.18 2026-06-26
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $48,366.51 $48,366.51 $48,366.51 2026-06-26
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 1 — — $48,826.86 $48,826.86 $48,826.86 2026-06-26
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 1 — — $49,407.18 $49,407.18 $49,407.18 2026-06-26
163 MS_DRG Major Chest Procedures With Mcc 2 1 — — $50,045.16 $50,045.16 $50,045.16 2026-06-26
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $50,191.17 $50,191.17 $50,191.17 2026-06-26
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $50,216.28 $50,216.28 $50,216.28 2026-06-26
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $50,711.04 $50,711.04 $50,711.04 2026-06-26
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $50,979.81 $50,979.81 $50,979.81 2026-06-26
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 1 — — $51,260.67 $51,260.67 $51,260.67 2026-06-26
A9604 HCPCS Sm 153 Lexidronam 25 15 — — $52,642.55 $52,642.55 $52,642.55 2026-06-26
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $53,563.35 $53,563.35 $53,563.35 2026-06-26
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $53,704.71 $53,704.71 $53,704.71 2026-06-26
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $53,774.46 $53,774.46 $53,774.46 2026-06-26
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 1 — — $54,050.67 $54,050.67 $54,050.67 2026-06-26
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 1 — — $54,253.41 $54,253.41 $54,253.41 2026-06-26
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $55,084.83 $55,084.83 $55,084.83 2026-06-26
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 1 — — $56,231.52 $56,231.52 $56,231.52 2026-06-26
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $56,664.90 $56,664.90 $56,664.90 2026-06-26
901 MS_DRG Wound Debridements For Injuries With Mcc 2 1 — — $57,996.66 $57,996.66 $57,996.66 2026-06-26
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $58,916.43 $58,916.43 $58,916.43 2026-06-26
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 1 — — $59,104.29 $59,104.29 $59,104.29 2026-06-26
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $60,071.49 $60,071.49 $60,071.49 2026-06-26
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 1 — — $60,712.26 $60,712.26 $60,712.26 2026-06-26
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $60,755.04 $60,755.04 $60,755.04 2026-06-26
834 MS_DRG Acute Leukemia With Mcc 2 1 — — $62,374.17 $62,374.17 $62,374.17 2026-06-26
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $63,875.19 $63,875.19 $63,875.19 2026-06-26
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $65,895.15 $65,895.15 $65,895.15 2026-06-26
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $69,174.33 $69,174.33 $69,174.33 2026-06-26
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $69,491.46 $69,491.46 $69,491.46 2026-06-26
J9600 HCPCS Porfimer Sodium Injection 25 15 — — $71,727.34 $71,727.34 $71,727.34 2026-06-26
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $75,229.56 $75,229.56 $75,229.56 2026-06-26
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 1 — — $77,364.84 $77,364.84 $77,364.84 2026-06-26
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 1 — — $78,871.44 $78,871.44 $78,871.44 2026-06-26
J9266 HCPCS Pegaspargase Injection 25 15 — — $82,395.31 $82,395.31 $82,395.31 2026-06-26
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $85,374.93 $85,374.93 $85,374.93 2026-06-26
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $102,109.35 $102,109.35 $102,109.35 2026-06-26
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $103,989.81 $103,989.81 $103,989.81 2026-06-26
7 MS_DRG Lung Transplant 2 1 — — $106,471.05 $106,471.05 $106,471.05 2026-06-26
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $126,571.14 $126,571.14 $126,571.14 2026-06-26
J9226 HCPCS Supprelin La Implant 25 15 — — $134,682.67 $134,682.67 $134,682.67 2026-06-26
215 MS_DRG Other Heart Assist System Implant 2 1 — — $137,871.57 $137,871.57 $137,871.57 2026-06-26
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 1 — — $144,219.75 $144,219.75 $144,219.75 2026-06-26
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $148,270.83 $148,270.83 $148,270.83 2026-06-26
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $149,795.10 $149,795.10 $149,795.10 2026-06-26
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 25 15 — — $169,313.99 $169,313.99 $169,313.99 2026-06-26
J9029 HCPCS Instill Adstiladrin, Tx Dose 25 15 — — $193,672.97 $193,672.97 $193,672.97 2026-06-26
A9543 HCPCS Y90 Ibritumomab, Rx 25 15 — — $199,703.58 $199,703.58 $199,703.58 2026-06-26
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $257,184.99 $257,184.99 $257,184.99 2026-06-26
Q2053 HCPCS Brexucabtagene Car Pos T 25 15 — — $1,370,792.00 $1,370,792.00 $1,370,792.00 2026-06-26
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 25 15 — — $1,491,867.58 $1,491,867.58 $1,491,867.58 2026-06-26
Q2054 HCPCS Lisocabtagene Mara Car Pos T 25 15 — — $1,513,990.13 $1,513,990.13 $1,513,990.13 2026-06-26
Q2055 HCPCS Idecabtagene Vicleucel Car 25 15 — — $1,535,536.30 $1,535,536.30 $1,535,536.30 2026-06-26
Q2056 HCPCS Ciltacabtagene Car-pos T 25 15 — — $1,548,445.35 $1,548,445.35 $1,548,445.35 2026-06-26
Q2042 HCPCS Tisagenlecleucel Car-pos T 25 15 — — $1,596,530.31 $1,596,530.31 $1,596,530.31 2026-06-26
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