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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

ASPIRUS WAUSAU HOSPITAL

Wausau, WI · CCN 520030 · Rates published

18,536 distinct procedures filed
32 distinct payers
452,195 rate rows
2026-07-31 last MRF observed
Data quality

349,726 of 452,195 rate rows are consumer-grade (77.3%)

102,469 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
professional (physician) fee — not the facility price 54,673
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 37,599
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,779
placeholder amount (≤ $0.02) — excluded from medians 349
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 29
exceeds 10× this hospital's gross charge — excluded from medians 25
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 15
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.aspirus.org/Uploads/Public/Documents/PriceEstimate/TransparencyFY26/391138241_aspirus-wausau-hospital_standardcharges.json
Found on page https://www.aspirus.org/price-estimate
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-11
Content fingerprint 08e4dc13475500cc… · 164,301,855 bytes · first seen 2026-05-06

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 4 $4,505,000.00 $4,730,250.00 $4,617,625.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 4 $3,691,450.00 $3,876,022.50 $3,783,736.25 nat. median
$3,703,693
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 4 $3,335,820.00 $3,502,611.00 $3,419,215.50 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 4 $3,321,376.38 $3,487,445.20 $3,404,410.79 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 4 $3,245,381.39 $3,407,650.46 $3,326,515.92 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 4 $3,180,000.00 $3,339,000.00 $3,259,500.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 5 $2,938,320.00 $4,850,948.67 $3,026,469.60 nat. median
$2,994,107
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,587,087.26 $4,271,819.03 $2,664,699.87 nat. median
$2,466,282
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 5 $2,332,000.00 $3,847,800.00 $2,401,960.00 nat. median
$2,401,960
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $770,620.00 $1,271,523.00 $944,009.50 nat. median
$809,217
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 $317,962.27 $1,118,391.34 $828,091.08 nat. median
$359,358
outlier · 2.3×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 7 $614,180.81 $4,606,356.06 $767,726.01 nat. median
$738,272
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 7 $588,494.81 $4,413,711.06 $735,618.51 nat. median
$646,415
1.1× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 7 $562,260.84 $4,216,956.27 $702,826.04 nat. median
$640,950
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 7 $559,781.08 $4,198,358.11 $699,726.35 nat. median
$622,245
1.1× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 7 $531,849.12 $3,988,868.38 $664,811.40 nat. median
$608,101
1.1× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 7 $489,290.60 $3,669,679.51 $611,613.25 nat. median
$591,650
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 8 $204,310.86 $725,790.99 $473,270.57 nat. median
$249,124
1.9× median
MS DRG V38 (FY2021) 003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 $397,260.90 $691,376.81 $417,808.88 nat. median
$417,809
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 $157,401.99 $552,956.60 $409,425.94 nat. median
$198,433
outlier · 2.1×
MS DRG V38 (FY2021) 004
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 7 $333,582.62 $368,091.17 $345,085.47 nat. median
$345,085
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 10 $76,935.69 $740,854.97 $333,756.23 nat. median
$190,557
1.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 5 $278,250.00 $2,086,875.00 $289,380.00 nat. median
$319,951
0.9× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 7 $202,713.58 $1,520,351.88 $253,391.98 nat. median
$209,753
1.2× median
7
MS_DRG 		Lung Transplant 8 $95,624.05 $335,397.23 $248,338.34 nat. median
$117,894
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 8 $88,767.68 $311,251.59 $230,460.18 nat. median
$110,192
outlier · 2.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 8 $83,721.93 $293,482.29 $217,303.24 nat. median
$103,967
outlier · 2.1×
209
MS_DRG 		Complex Aortic Arch Procedures 8 $83,626.32 $293,145.60 $217,053.95 nat. median
$92,655
outlier · 2.3×
MS DRG V38 (FY2021) 457
OTHER 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 $190,851.83 $210,595.12 $197,432.93 nat. median
$197,433
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 11 $48,944.05 $595,005.93 $191,899.79 nat. median
$126,722
1.5× median
MS DRG V38 (FY2021) 216
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 $172,532.57 $197,481.43 $181,456.67 nat. median
$181,457
1.0× median
MS DRG V38 (FY2021) 456
OTHER 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 $170,540.78 $188,182.92 $176,421.49 nat. median
$176,421
1.0× median
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 $66,643.88 $233,339.63 $172,771.78 nat. median
$78,037
outlier · 2.2×
MS DRG V38 (FY2021) 219
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 $73,392.89 $179,188.68 $167,989.39 nat. median
$167,989
1.0× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 $62,185.73 $254,167.46 $167,968.88 nat. median
$77,696
outlier · 2.2×
MS DRG V38 (FY2021) 231
OTHER 		Coronary Bypass With Ptca With McC 7 $156,299.37 $172,468.27 $161,689.01 nat. median
$161,689
1.0× median
9309
OTHER 		Inj. Tagraxofusp-erzs 10 Mcg 1 $161,668.05 $161,668.05 $161,668.05 nat. median
$359
outlier · 449.9×
215
MS_DRG 		Other Heart Assist System Implant 8 $73,611.30 $257,876.34 $156,558.77 nat. median
$93,917
1.7× median
MS DRG V38 (FY2021) 459
OTHER 		Spinal Fusion Except Cervical With McC 7 $151,000.29 $166,621.01 $156,207.20 nat. median
$156,207
1.0× median
MS DRG V38 (FY2021) 856
OTHER 		Postoperative Or Post-traumatic Infections With O.r. Procedures With McC 7 $149,510.67 $164,977.29 $154,666.21 nat. median
$154,666
1.0× median
MS DRG V38 (FY2021) 217
OTHER 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 7 $146,316.49 $161,452.68 $151,361.88 nat. median
$151,362
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 8 $74,455.76 $281,628.32 $150,804.11 nat. median
$97,414
1.5× median
MS DRG V38 (FY2021) 232
OTHER 		Coronary Bypass With Ptca Without McC 7 $142,418.89 $157,151.88 $147,329.88 nat. median
$147,330
1.0× median
MS DRG V38 (FY2021) 870
OTHER 		Septicemia Or Severe Sepsis With Mv >96 Hours 7 $139,931.81 $154,407.51 $144,757.04 nat. median
$144,757
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 10 $42,702.07 $267,031.64 $142,843.52 nat. median
$94,964
1.5× median
MS DRG V38 (FY2021) 471
OTHER 		Cervical Spinal Fusion With McC 7 $137,279.42 $151,480.74 $142,013.20 nat. median
$142,013
1.0× median
MS DRG V38 (FY2021) 957
OTHER 		Other O.r. Procedures For Multiple Significant Trauma With McC 9 $38,592.26 $147,311.59 $138,104.61 nat. median
$138,105
1.0× median
MS DRG V38 (FY2021) 207
OTHER 		Respiratory System Diagnosis With Ventilator Support >96 Hours 8 $131,183.52 $199,665.46 $137,968.88 nat. median
$137,969
1.0× median
10
MS_DRG 		Pancreas Transplant 8 $53,156.91 $185,843.45 $137,604.17 nat. median
$64,903
outlier · 2.1×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 8 $53,134.85 $185,765.76 $137,546.64 nat. median
$61,329
outlier · 2.2×

Other procedures at this hospital

Browse this hospital's 18,536 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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 28 8 — — $204,310.86 $725,790.99 $473,270.57 2026-04-01
10 MS_DRG Pancreas Transplant 27 8 — — $53,156.91 $185,843.45 $137,604.17 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 31 8 — — $39,250.91 $141,255.74 $79,628.77 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 29 8 — — $27,313.49 $109,190.18 $61,552.76 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 27 8 — — $21,578.48 $74,635.74 $55,262.58 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 27 8 — — $88,767.68 $311,251.59 $230,460.18 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 27 8 — — $43,993.51 $153,573.30 $113,710.36 2026-04-01
162 MS_DRG Inguinal & Femoral Hernia Procedures Age >17 Without Cc 3 3 $66,964.01 $43,526.61 35% off $60,419.47 $72,065.86 $66,964.01 2026-07-31
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 27 8 — — $40,335.50 $140,691.14 $104,172.01 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 27 8 — — $317,962.27 $1,118,391.34 $828,091.08 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 27 8 — — $52,854.65 $184,779.01 $136,816.01 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 27 8 — — $83,721.93 $293,482.29 $217,303.24 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 28 8 — — $9,697.62 $203,794.05 $132,889.12 2026-04-01
2038 OTHER Gen, Neuro, Clo Loop, Rechg 3 3 — — $46,261.47 $85,680.04 $83,561.47 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 27 8 — — $83,626.32 $293,145.60 $217,053.95 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 29 8 — — $19,651.87 $137,104.13 $77,288.42 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 32 8 — — $74,455.76 $281,628.32 $150,804.11 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 28 8 — — $42,338.57 $147,803.00 $96,378.73 2026-04-01
215 MS_DRG Other Heart Assist System Implant 30 8 — — $73,611.30 $257,876.34 $156,558.77 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 36 8 — — $69,433.09 $253,364.74 $121,154.35 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 30 8 — — $12,691.93 $170,293.69 $81,431.31 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 28 8 — — $12,691.93 $170,293.69 $88,425.46 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 9 — — $48,328.53 $312,921.05 $92,724.32 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 27 8 — — $23,752.40 $82,291.48 $60,931.13 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 63 10 — — $12,691.93 $138,114.19 $64,403.80 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 32 8 — — $12,691.93 $130,536.14 $61,487.69 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 40 9 — — $9,074.96 $148,409.04 $54,702.02 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 37 8 — — $551.95 $218,325.98 $64,252.04 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 31 8 — — $40,294.54 $160,513.28 $88,512.75 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 56 12 — — $10,849.86 $198,003.03 $65,433.94 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 40 9 — — $12,691.93 $151,990.87 $70,975.91 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 35 8 — — $32,684.53 $127,467.11 $51,718.98 2026-04-01
245 MS_DRG Aicd Generator Procedures 30 9 $5,241.26 $3,406.82 35% off $5,241.26 $176,157.66 $77,050.29 2026-07-31
265 MS_DRG Aicd Lead Procedures 30 8 — — $22,513.78 $93,707.76 $51,476.10 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 36 8 — — $45,419.59 $178,130.73 $112,631.90 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 34 8 — — $23,099.13 $184,670.23 $100,368.38 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 34 8 — — $41,751.32 $155,564.93 $101,440.09 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 37 8 — — $32,954.01 $119,614.53 $67,429.18 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 31 9 — — $21,843.46 $144,159.01 $77,115.14 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 32 8 — — $27,026.69 $155,608.96 $65,020.10 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 42 10 — — $76,935.69 $740,854.97 $333,756.23 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 27 8 — — $33,335.72 $116,040.47 $85,919.91 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 28 8 — — $33,206.29 $115,584.65 $75,369.92 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 28 8 — — $16,681.77 $83,146.15 $54,217.57 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 39 8 — — $8,882.74 $129,168.67 $69,096.34 2026-04-01
332 MS_DRG Rectal Resection With Mcc 27 8 — — $27,012.54 $93,772.51 $69,432.03 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 27 8 — — $28,851.10 $100,247.26 $74,226.13 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 28 8 — — $765.81 $89,056.30 $58,071.43 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 47 11 $244,323.06 $158,809.99 35% off $48,944.05 $595,005.93 $191,899.79 2026-07-31
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 44 9 — — $13,689.95 $104,126.93 $56,003.00 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 33 8 — — $1,218.33 $141,680.48 $75,789.29 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 29 8 — — $26,607.32 $92,345.47 $52,057.05 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 28 8 — — $24,678.30 $85,552.17 $63,309.68 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 32 9 $8,216.29 $5,340.59 35% off $8,216.29 $107,558.55 $59,084.69 2026-07-31
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 32 9 $3,245.09 $2,109.31 35% off $105.67 $285,438.06 $119,099.63 2026-07-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 35 8 — — $5,043.68 $186,954.52 $100,007.78 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 34 8 — — $1,243.52 $145,604.18 $75,560.31 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 27 8 — — $66,643.88 $233,339.63 $172,771.78 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 27 8 — — $42,797.71 $149,362.12 $110,592.27 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 29 8 — — $47,945.87 $173,046.76 $97,550.02 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 27 8 — — $39,580.22 $138,031.31 $102,202.59 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 3 — — $43,320.61 $75,076.99 $71,042.60 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 8 — — $62,185.73 $254,167.46 $167,968.88 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 30 8 — — $40,835.49 $155,282.47 $119,191.67 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 28 8 — — $31,071.35 $108,066.17 $78,350.17 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 3 — — $44,584.24 $116,293.04 $97,930.89 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 15 10 — — $25,516.05 $81,020.85 $51,980.62 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 28 8 — — $5,988.91 $143,040.18 $93,273.01 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 33 8 — — $1,075.39 $125,058.50 $54,210.94 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 31 8 — — $29,644.21 $111,181.82 $59,474.61 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 28 8 — — $23,822.79 $93,902.00 $61,231.20 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 31 10 $62,594.93 $40,686.70 35% off $42,702.07 $267,031.64 $142,843.52 2026-07-31
503 MS_DRG Foot Procedures With Mcc 32 8 — — $17,448.94 $72,286.70 $55,789.08 2026-04-01
5092 OTHER Level 2 Breast/Lymphatic Surgery And Related Procedures 1 1 — — $95,512.53 $95,512.53 $95,512.53 2025-07-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 31 8 — — $832.33 $96,792.33 $54,563.83 2026-04-01
570 MS_DRG Skin Debridement With Mcc 31 8 — — $21,369.67 $76,171.55 $56,399.74 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 30 8 — — $31,519.93 $169,674.71 $93,206.70 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 28 8 — — $36,429.66 $126,936.18 $82,771.98 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 27 8 — — $24,201.74 $83,873.91 $62,102.80 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 27 8 — — $34,486.67 $120,093.66 $88,921.01 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 28 9 — — $26,032.22 $90,320.17 $58,895.57 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 30 8 — — $25,940.01 $96,520.39 $53,021.15 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 27 8 — — $34,960.28 $121,761.56 $90,155.97 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 27 8 — — $27,638.38 $95,976.51 $71,063.94 2026-04-01
652 MS_DRG Kidney Transplant 27 8 — — $24,135.55 $83,640.82 $61,930.22 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 29 8 — — $38,600.64 $134,581.56 $75,866.40 2026-04-01
665 MS_DRG Prostatectomy With Mcc 28 8 — — $22,359.80 $80,835.96 $52,711.15 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 38 8 — — $946.54 $108,817.24 $57,916.88 2026-04-01
7 MS_DRG Lung Transplant 27 8 — — $95,624.05 $335,397.23 $248,338.34 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 27 8 — — $26,672.77 $92,575.98 $68,546.08 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 27 8 — — $26,733.81 $92,790.94 $68,705.24 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 47 12 — — $13,935.00 $387,186.73 $98,144.00 2026-04-01
791 MS_DRG Prematurity With Major Problems 37 9 — — $7,350.00 $105,124.04 $50,963.00 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 31 8 — — $33,691.67 $117,293.98 $69,039.49 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 27 8 — — $41,602.64 $145,153.54 $107,476.11 2026-04-01
800 MS_DRG Splenic Procedures With Cc 27 8 — — $21,046.03 $72,760.65 $53,874.21 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 30 8 — — $25,410.78 $103,184.21 $56,681.75 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 31 8 — — $1,306.14 $151,892.46 $108,183.45 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 37 8 — — $23,824.96 $118,741.74 $63,518.64 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 29 8 — — $34,122.70 $121,150.34 $89,703.41 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 30 8 — — $35,127.18 $124,426.57 $68,350.73 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 29 8 — — $13,784.29 $224,272.39 $126,426.97 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 42 8 — — $847.00 $117,806.78 $53,208.68 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 50 9 — — $47,495.40 $223,737.82 $54,236.68 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 27 8 — — $28,808.45 $100,097.05 $74,114.91 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 27 8 — — $31,247.85 $108,687.74 $80,475.72 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 28 8 — — $27,397.90 $95,129.62 $70,433.34 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 8 — — $157,401.99 $552,956.60 $409,425.94 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 27 8 — — $53,134.85 $185,765.76 $137,546.64 2026-04-01
9284 OTHER Ipilimumab Injection 2 2 — — $47,095.71 $93,723.22 $70,409.46 2025-07-01
9287 OTHER Brentuximab Vedotin Inj 1 1 — — $59,164.64 $59,164.64 $59,164.64 2025-07-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 27 8 — — $24,071.57 $83,415.50 $61,763.38 2026-04-01
9309 OTHER Inj. Tagraxofusp-erzs 10 Mcg 1 1 — — $161,668.05 $161,668.05 $161,668.05 2025-07-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 27 8 — — $29,023.93 $100,855.89 $74,676.78 2026-04-01
93609 HCPCS Map Tachycardia Add-on 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93613 HCPCS Electrophys Map 3d Add-on 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93621 HCPCS Electrophysiology Evaluation 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93622 HCPCS Electrophysiology Evaluation 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93623 HCPCS Stimulation Pacing Heart 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93631 HCPCS Heart Pacing Mapping 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93655 HCPCS Ablate Arrhythmia Add On 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
93657 HCPCS Tx L/r Atrial Fib Addl 5 1 — — $31,256.00 $55,399.00 $55,399.00 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 28 8 — — $27,069.90 $93,974.52 $72,527.20 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 28 8 — — $49,887.21 $174,328.76 $134,542.61 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 48 9 — — $14,510.87 $97,457.94 $53,536.17 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 47 8 — — $1,697.02 $276,338.37 $111,249.02 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 42 11 — — $28,281.70 $190,633.88 $81,387.67 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 27 8 — — $22,036.65 $76,249.25 $56,457.27 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 27 8 — — $45,402.58 $158,535.55 $117,384.56 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 33 8 — — $15,209.50 $93,542.01 $52,731.56 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 5 — — $56,824.55 $426,184.12 $59,097.54 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $77,046.96 $77,046.96 $77,046.96 2026-04-01
C1825 HCPCS Impl Neurstm Sys Ipg 2102 Ld 1036 Csl Strl Barostim Neo 12 12 $61,250.00 $39,812.50 35% off $37,362.50 $61,250.00 $55,125.00 2026-07-31
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 4 — — $3,691,450.00 $3,876,022.50 $3,783,736.25 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 4 4 — — $3,321,376.38 $3,487,445.20 $3,404,410.79 2026-04-01
J3387 HCPCS Inj Elivaldogene Autotemecel 4 4 — — $3,180,000.00 $3,339,000.00 $3,259,500.00 2026-04-01
J3389 HCPCS Topi Adm Prad Zami Per Treat 4 4 — — $3,335,820.00 $3,502,611.00 $3,419,215.50 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 4 4 — — $4,505,000.00 $4,730,250.00 $4,617,625.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 5 5 — — $2,332,000.00 $3,847,800.00 $2,401,960.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 5 5 — — $2,938,320.00 $4,850,948.67 $3,026,469.60 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 4 4 — — $3,245,381.39 $3,407,650.46 $3,326,515.92 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 5 5 — — $2,587,087.26 $4,271,819.03 $2,664,699.87 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 11 7 — — $202,713.58 $1,520,351.88 $253,391.98 2026-04-01
J7330 HCPCS Gft Atlgs Clgn Membr Cult Chondrocytes On Prcn 13 13 $69,820.00 $45,383.00 35% off $42,590.20 $138,148.31 $62,838.00 2026-07-31
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 11 7 — — $64,282.30 $482,117.24 $80,352.87 2026-04-01
J9226 HCPCS Supprelin La Implant 11 7 — — $41,173.43 $308,800.70 $51,466.78 2026-04-01
J9600 HCPCS Porfimer Sodium 75 Mg IV Solr 13 13 $61,864.17 $40,211.71 35% off $3,004.74 $59,389.60 $53,821.83 2026-07-31
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 5 4 — — $68,801.71 $516,012.83 $70,865.76 2026-04-01
MS DRG V38 (FY2021) 003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 8 8 $456,621.72 $296,804.12 35% off $397,260.90 $691,376.81 $417,808.88 2026-07-31
MS DRG V38 (FY2021) 004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 7 7 $383,428.30 $249,228.40 35% off $333,582.62 $368,091.17 $345,085.47 2026-07-31
MS DRG V38 (FY2021) 023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 7 7 $152,594.68 $99,186.54 35% off $132,757.37 $146,490.89 $137,335.21 2026-07-31
MS DRG V38 (FY2021) 025 OTHER Craniotomy And Endovascular Intracranial Procedures With McC 8 8 $78,986.74 $51,341.38 35% off $60,579.64 $75,827.27 $71,088.07 2026-07-31
MS DRG V38 (FY2021) 031 OTHER Ventricular Shunt Procedures With McC 7 7 $65,148.64 $42,346.62 35% off $56,679.32 $62,542.69 $58,633.78 2026-07-31
MS DRG V38 (FY2021) 034 OTHER Carotid Artery Stent Procedures With McC 7 7 $86,822.91 $56,434.89 35% off $75,535.93 $83,349.99 $78,140.62 2026-07-31
MS DRG V38 (FY2021) 040 OTHER Peripheral, Cranial Nerve And Other Nervous System Procedures With McC 8 8 $102,059.77 $66,338.85 35% off $37,650.00 $97,977.38 $91,853.79 2026-07-31
MS DRG V38 (FY2021) 063 OTHER Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 8 8 $57,331.98 $37,265.79 35% off $26,231.71 $55,038.70 $51,598.78 2026-07-31
MS DRG V38 (FY2021) 075 OTHER Viral Meningitis With Cc/McC 7 7 $63,163.15 $41,056.05 35% off $54,951.94 $60,636.62 $56,846.84 2026-07-31
MS DRG V38 (FY2021) 094 OTHER Bacterial And Tuberculous Infections Of Nervous System With McC 7 7 $140,772.18 $91,501.92 35% off $122,471.80 $135,141.29 $126,694.96 2026-07-31
MS DRG V38 (FY2021) 095 OTHER Bacterial And Tuberculous Infections Of Nervous System With Cc 7 7 $95,154.00 $61,850.10 35% off $82,783.98 $91,347.84 $85,638.60 2026-07-31
MS DRG V38 (FY2021) 096 OTHER Bacterial And Tuberculous Infections Of Nervous System Without Cc/McC 7 7 $95,746.98 $62,235.54 35% off $83,299.87 $91,917.10 $86,172.28 2026-07-31
MS DRG V38 (FY2021) 135 OTHER Sinus And Mastoid Procedures With Cc/McC 7 7 $107,926.67 $70,152.34 35% off $93,896.20 $103,609.60 $97,134.00 2026-07-31
MS DRG V38 (FY2021) 140 OTHER Major Head And Neck Procedures With McC 7 7 $118,650.24 $77,122.66 35% off $103,225.71 $113,904.23 $106,785.22 2026-07-31
MS DRG V38 (FY2021) 154 OTHER Other Ear, Nose, Mouth And Throat Diagnoses With McC 7 7 $66,462.34 $43,200.52 35% off $57,822.24 $63,803.85 $59,816.11 2026-07-31
MS DRG V38 (FY2021) 163 OTHER Major Chest Procedures With McC 8 8 $128,884.05 $83,774.63 35% off $71,370.59 $123,728.69 $115,995.65 2026-07-31
MS DRG V38 (FY2021) 164 OTHER Major Chest Procedures With Cc 9 9 $61,267.61 $39,823.95 35% off $39,397.98 $58,816.91 $55,140.85 2026-07-31
MS DRG V38 (FY2021) 165 OTHER Major Chest Procedures Without Cc/McC 8 8 $59,611.32 $38,747.36 35% off $36,626.67 $57,226.87 $53,650.19 2026-07-31
MS DRG V38 (FY2021) 166 OTHER Other Respiratory System O.r. Procedures With McC 9 9 $97,553.69 $63,409.90 35% off $59,588.08 $163,373.87 $87,798.32 2026-07-31
MS DRG V38 (FY2021) 167 OTHER Other Respiratory System O.r. Procedures With Cc 8 8 $58,086.77 $37,756.40 35% off $32,974.70 $55,763.30 $52,278.09 2026-07-31
MS DRG V38 (FY2021) 207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 8 8 $150,785.66 $98,010.68 35% off $131,183.52 $199,665.46 $137,968.88 2026-07-31
MS DRG V38 (FY2021) 215 OTHER Other Heart Assist System Implant 7 7 $146,290.39 $95,088.75 35% off $127,272.64 $140,438.77 $131,661.35 2026-07-31
MS DRG V38 (FY2021) 216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 8 8 $198,313.30 $128,903.65 35% off $172,532.57 $197,481.43 $181,456.67 2026-07-31
MS DRG V38 (FY2021) 217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 7 7 $168,179.87 $109,316.92 35% off $146,316.49 $161,452.68 $151,361.88 2026-07-31
MS DRG V38 (FY2021) 219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 9 9 $186,654.88 $121,325.67 35% off $73,392.89 $179,188.68 $167,989.39 2026-07-31
MS DRG V38 (FY2021) 220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 8 $101,862.64 $66,210.72 35% off $88,620.50 $102,240.63 $93,204.32 2026-07-31
MS DRG V38 (FY2021) 221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 8 8 $100,239.98 $65,155.99 35% off $73,398.23 $96,230.38 $90,215.98 2026-07-31
MS DRG V38 (FY2021) 222 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 7 7 $151,774.27 $98,653.28 35% off $132,043.61 $145,703.30 $136,596.84 2026-07-31
MS DRG V38 (FY2021) 223 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 7 7 $71,261.51 $46,319.98 35% off $61,997.51 $68,411.05 $64,135.36 2026-07-31
MS DRG V38 (FY2021) 224 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 7 7 $81,057.38 $52,687.30 35% off $70,519.92 $77,815.08 $72,951.64 2026-07-31
MS DRG V38 (FY2021) 225 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 7 7 $94,389.39 $61,353.10 35% off $82,118.77 $90,613.81 $84,950.45 2026-07-31
MS DRG V38 (FY2021) 226 OTHER Cardiac Defibrillator Implant Without Cardiac Catheterization With McC 7 7 $109,370.22 $71,090.64 35% off $95,152.09 $104,995.41 $98,433.20 2026-07-31
MS DRG V38 (FY2021) 228 OTHER Other Cardiothoracic Procedures With McC 7 7 $111,797.69 $72,668.50 35% off $97,263.99 $107,325.78 $100,617.92 2026-07-31
MS DRG V38 (FY2021) 229 OTHER Other Cardiothoracic Procedures Without McC 7 7 $95,616.49 $62,150.72 35% off $83,186.35 $91,791.83 $86,054.84 2026-07-31
MS DRG V38 (FY2021) 231 OTHER Coronary Bypass With Ptca With McC 7 7 $179,654.45 $116,775.39 35% off $156,299.37 $172,468.27 $161,689.01 2026-07-31
MS DRG V38 (FY2021) 232 OTHER Coronary Bypass With Ptca Without McC 7 7 $163,699.87 $106,404.92 35% off $142,418.89 $157,151.88 $147,329.88 2026-07-31
MS DRG V38 (FY2021) 233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With McC 8 8 $140,768.37 $91,499.44 35% off $120,633.72 $135,137.64 $126,691.53 2026-07-31
MS DRG V38 (FY2021) 234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without McC 9 9 $123,422.97 $80,224.93 35% off $51,379.08 $119,677.41 $111,080.67 2026-07-31
MS DRG V38 (FY2021) 235 OTHER Coronary Bypass Without Cardiac Catheterization With McC 8 8 $93,185.68 $60,570.69 35% off $81,071.54 $102,803.53 $85,264.89 2026-07-31
MS DRG V38 (FY2021) 236 OTHER Coronary Bypass Without Cardiac Catheterization Without McC 9 9 $83,777.82 $54,455.58 35% off $33,922.39 $80,426.71 $75,400.04 2026-07-31
MS DRG V38 (FY2021) 239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With McC 7 7 $129,790.72 $84,363.97 35% off $112,917.93 $124,599.09 $116,811.65 2026-07-31
MS DRG V38 (FY2021) 242 OTHER Permanent Cardiac Pacemaker Implant With McC 8 8 $68,890.72 $44,778.97 35% off $59,934.93 $72,064.53 $63,035.01 2026-07-31
MS DRG V38 (FY2021) 246 OTHER Percutaneous Cardiovascular Procedures With Drug-eluting Stent With McC Or 4+ Ar… 9 9 $69,024.65 $44,866.02 35% off $37,366.50 $66,263.66 $62,122.19 2026-07-31
MS DRG V38 (FY2021) 248 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With McC Or 4… 9 9 $65,368.61 $42,489.60 35% off $32,400.00 $62,753.87 $58,831.75 2026-07-31
MS DRG V38 (FY2021) 249 OTHER Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without McC 8 8 $62,650.65 $40,722.92 35% off $36,083.59 $60,144.62 $56,385.59 2026-07-31
MS DRG V38 (FY2021) 252 OTHER Other Vascular Procedures With McC 8 8 $98,466.67 $64,003.34 35% off $40,708.67 $94,528.00 $88,620.00 2026-07-31
MS DRG V38 (FY2021) 263 OTHER Vein Ligation And Stripping 7 7 $82,249.01 $53,461.86 35% off $71,556.64 $78,959.05 $74,024.11 2026-07-31
MS DRG V38 (FY2021) 264 OTHER Other Circulatory System O.r. Procedures 7 7 $67,696.61 $44,002.80 35% off $58,896.05 $64,988.75 $60,926.95 2026-07-31
MS DRG V38 (FY2021) 266 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures With McC 8 8 $104,771.75 $68,101.64 35% off $91,151.42 $102,818.38 $95,866.15 2026-07-31
MS DRG V38 (FY2021) 267 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Without McC 7 7 $102,170.46 $66,410.80 35% off $88,888.30 $98,083.64 $91,953.41 2026-07-31
MS DRG V38 (FY2021) 268 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With McC 8 8 $101,212.72 $65,788.27 35% off $61,962.22 $97,164.21 $91,091.45 2026-07-31
MS DRG V38 (FY2021) 269 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without McC 8 8 $66,854.26 $43,455.27 35% off $39,031.83 $64,180.09 $60,168.83 2026-07-31
MS DRG V38 (FY2021) 270 OTHER Other Major Cardiovascular Procedures With McC 9 9 $90,785.28 $59,010.43 35% off $61,194.28 $90,895.42 $81,706.75 2026-07-31
MS DRG V38 (FY2021) 271 OTHER Other Major Cardiovascular Procedures With Cc 8 8 $67,120.22 $43,628.14 35% off $58,394.59 $67,491.42 $61,415.00 2026-07-31
MS DRG V38 (FY2021) 272 OTHER Other Major Cardiovascular Procedures Without Cc/McC 8 8 $69,255.40 $45,016.01 35% off $39,388.74 $66,485.18 $62,329.86 2026-07-31
MS DRG V38 (FY2021) 273 OTHER Percutaneous And Other Intracardiac Procedures With McC 8 8 $89,523.66 $58,190.38 35% off $72,652.78 $85,942.71 $80,571.29 2026-07-31
MS DRG V38 (FY2021) 274 OTHER Percutaneous And Other Intracardiac Procedures Without McC 8 8 $63,386.91 $41,201.49 35% off $55,146.61 $62,737.61 $57,999.03 2026-07-31
MS DRG V38 (FY2021) 285 OTHER Acute Myocardial Infarction, Expired Without Cc/McC 7 7 $101,955.22 $66,270.89 35% off $88,701.04 $97,877.01 $91,759.70 2026-07-31
MS DRG V38 (FY2021) 288 OTHER Acute And Subacute Endocarditis With McC 7 7 $67,592.03 $43,934.82 35% off $58,805.07 $64,888.35 $60,832.83 2026-07-31
MS DRG V38 (FY2021) 319 OTHER Other Endovascular Cardiac Valve Procedures With McC 7 7 $125,691.29 $81,699.34 35% off $109,351.42 $120,663.64 $113,122.16 2026-07-31
MS DRG V38 (FY2021) 320 OTHER Other Endovascular Cardiac Valve Procedures Without McC 7 7 $89,170.03 $57,960.52 35% off $77,577.93 $85,603.23 $80,253.03 2026-07-31
MS DRG V38 (FY2021) 326 OTHER Stomach, Esophageal And Duodenal Procedures With McC 7 7 $100,731.22 $65,475.29 35% off $87,636.16 $96,701.97 $90,658.10 2026-07-31
MS DRG V38 (FY2021) 329 OTHER Major Small And Large Bowel Procedures With McC 9 9 $83,497.09 $54,273.11 35% off $27,667.30 $80,157.21 $75,147.38 2026-07-31
MS DRG V38 (FY2021) 335 OTHER Peritoneal Adhesiolysis With McC 7 7 $69,091.33 $44,909.36 35% off $60,109.46 $66,327.68 $62,182.20 2026-07-31
MS DRG V38 (FY2021) 356 OTHER Other Digestive System O.r. Procedures With McC 7 7 $74,717.26 $48,566.22 35% off $65,004.02 $71,728.57 $67,245.53 2026-07-31
MS DRG V38 (FY2021) 405 OTHER Pancreas, Liver And Shunt Procedures With McC 9 9 $115,366.17 $74,988.01 35% off $80,668.25 $110,751.52 $103,829.55 2026-07-31
MS DRG V38 (FY2021) 406 OTHER Pancreas, Liver And Shunt Procedures With Cc 7 7 $66,951.34 $43,518.37 35% off $58,247.67 $64,273.29 $60,256.21 2026-07-31
MS DRG V38 (FY2021) 407 OTHER Pancreas, Liver And Shunt Procedures Without Cc/McC 7 7 $59,841.13 $38,896.73 35% off $52,061.78 $57,447.48 $53,857.02 2026-07-31
MS DRG V38 (FY2021) 409 OTHER Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 8 8 $60,261.60 $39,170.04 35% off $40,395.48 $57,851.14 $54,235.44 2026-07-31
MS DRG V38 (FY2021) 411 OTHER Cholecystectomy With C.d.e. With McC 7 7 $78,162.36 $50,805.53 35% off $68,001.25 $75,035.87 $70,346.12 2026-07-31
MS DRG V38 (FY2021) 413 OTHER Cholecystectomy With C.d.e. Without Cc/McC 7 7 $85,872.14 $55,816.89 35% off $74,708.76 $82,437.25 $77,284.93 2026-07-31
MS DRG V38 (FY2021) 414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With McC 7 7 $74,042.51 $48,127.63 35% off $64,416.98 $71,080.81 $66,638.26 2026-07-31
MS DRG V38 (FY2021) 420 OTHER Hepatobiliary Diagnostic Procedures With McC 7 7 $58,723.73 $38,170.42 35% off $51,089.65 $56,374.78 $52,851.36 2026-07-31
MS DRG V38 (FY2021) 424 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 7 7 $68,184.39 $44,319.85 35% off $59,320.42 $65,457.01 $61,365.95 2026-07-31
MS DRG V38 (FY2021) 453 OTHER Combined Anterior And Posterior Spinal Fusion With McC 7 7 $134,144.99 $87,194.24 35% off $116,706.14 $128,779.19 $120,730.49 2026-07-31
MS DRG V38 (FY2021) 454 OTHER Combined Anterior And Posterior Spinal Fusion With Cc 8 8 $113,286.00 $73,635.90 35% off $63,650.65 $108,754.56 $101,957.40 2026-07-31
MS DRG V38 (FY2021) 455 OTHER Combined Anterior And Posterior Spinal Fusion Without Cc/McC 9 9 $88,895.34 $57,781.97 35% off $77,338.95 $90,711.84 $82,672.67 2026-07-31
MS DRG V38 (FY2021) 456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 7 $196,023.88 $127,415.52 35% off $170,540.78 $188,182.92 $176,421.49 2026-07-31
MS DRG V38 (FY2021) 457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 7 $219,369.92 $142,590.45 35% off $190,851.83 $210,595.12 $197,432.93 2026-07-31
MS DRG V38 (FY2021) 458 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 7 7 $62,078.29 $40,350.89 35% off $54,008.11 $59,595.16 $55,870.46 2026-07-31
MS DRG V38 (FY2021) 459 OTHER Spinal Fusion Except Cervical With McC 7 7 $173,563.55 $112,816.31 35% off $151,000.29 $166,621.01 $156,207.20 2026-07-31
MS DRG V38 (FY2021) 460 OTHER Spinal Fusion Except Cervical Without McC 10 10 $95,112.14 $61,822.89 35% off $71,319.54 $107,387.64 $85,600.93 2026-07-31
MS DRG V38 (FY2021) 462 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without McC 7 7 $93,191.48 $60,574.46 35% off $81,076.59 $89,463.82 $83,872.33 2026-07-31
MS DRG V38 (FY2021) 463 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 7 7 $109,439.38 $71,135.60 35% off $95,212.26 $105,061.80 $98,495.44 2026-07-31
MS DRG V38 (FY2021) 466 OTHER Revision Of Hip Or Knee Replacement With McC 8 8 $98,047.26 $63,730.72 35% off $40,549.67 $94,125.37 $88,242.53 2026-07-31
MS DRG V38 (FY2021) 467 OTHER Revision Of Hip Or Knee Replacement With Cc 8 8 $67,070.75 $43,595.99 35% off $58,351.55 $73,058.37 $61,369.74 2026-07-31
MS DRG V38 (FY2021) 471 OTHER Cervical Spinal Fusion With McC 7 7 $157,792.44 $102,565.09 35% off $137,279.42 $151,480.74 $142,013.20 2026-07-31
MS DRG V38 (FY2021) 472 OTHER Cervical Spinal Fusion With Cc 8 8 $87,408.48 $56,815.51 35% off $57,808.68 $83,912.14 $78,667.63 2026-07-31
MS DRG V38 (FY2021) 473 OTHER Cervical Spinal Fusion Without Cc/McC 7 7 $76,275.42 $49,579.02 35% off $66,359.62 $73,224.40 $68,647.88 2026-07-31
MS DRG V38 (FY2021) 474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With McC 7 7 $65,752.18 $42,738.92 35% off $57,204.40 $63,122.09 $59,176.96 2026-07-31
MS DRG V38 (FY2021) 477 OTHER Biopsies Of Musculoskeletal System And Connective Tissue With McC 7 7 $74,226.94 $48,247.51 35% off $64,577.44 $71,257.86 $66,804.25 2026-07-31
MS DRG V38 (FY2021) 479 OTHER Biopsies Of Musculoskeletal System And Connective Tissue Without Cc/McC 7 7 $110,109.34 $71,571.07 35% off $95,795.13 $105,704.97 $99,098.41 2026-07-31
MS DRG V38 (FY2021) 503 OTHER Foot Procedures With McC 7 7 $108,972.10 $70,831.87 35% off $94,805.73 $104,613.22 $98,074.89 2026-07-31
MS DRG V38 (FY2021) 510 OTHER Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With McC 7 7 $68,936.23 $44,808.55 35% off $59,974.52 $66,178.78 $62,042.61 2026-07-31
MS DRG V38 (FY2021) 518 OTHER Back And Neck Procedures Except Spinal Fusion With McC Or Disc Device Or Neurost… 7 7 $109,214.49 $70,989.42 35% off $95,016.61 $104,845.91 $98,293.04 2026-07-31
MS DRG V38 (FY2021) 539 OTHER Osteomyelitis With McC 7 7 $78,318.41 $50,906.97 35% off $68,137.02 $75,185.67 $70,486.57 2026-07-31
MS DRG V38 (FY2021) 571 OTHER Skin Debridement With Cc 7 7 $56,587.33 $36,781.76 35% off $49,230.98 $54,323.84 $50,928.60 2026-07-31
MS DRG V38 (FY2021) 573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With McC 7 7 $112,365.87 $73,037.82 35% off $97,758.31 $107,871.24 $101,129.28 2026-07-31
MS DRG V38 (FY2021) 597 OTHER Malignant Breast Disorders With McC 7 7 $121,903.36 $79,237.18 35% off $106,055.92 $117,027.23 $109,713.02 2026-07-31
MS DRG V38 (FY2021) 604 OTHER Trauma To The Skin, Subcutaneous Tissue And Breast With McC 7 7 $146,574.42 $95,273.37 35% off $127,519.75 $140,711.44 $131,916.98 2026-07-31
MS DRG V38 (FY2021) 616 OTHER Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 7 7 $59,641.61 $38,767.05 35% off $51,888.20 $57,255.95 $53,677.45 2026-07-31
MS DRG V38 (FY2021) 622 OTHER Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 7 7 $73,817.34 $47,981.27 35% off $64,221.09 $70,864.65 $66,435.61 2026-07-31
MS DRG V38 (FY2021) 625 OTHER Thyroid, Parathyroid And Thyroglossal Procedures With McC 7 7 $96,156.92 $62,502.00 35% off $83,656.52 $92,310.64 $86,541.23 2026-07-31
MS DRG V38 (FY2021) 628 OTHER Other Endocrine, Nutritional And Metabolic O.r. Procedures With McC 7 7 $62,039.12 $40,325.43 35% off $53,974.03 $59,557.56 $55,835.21 2026-07-31
MS DRG V38 (FY2021) 653 OTHER Major Bladder Procedures With McC 7 7 $69,140.51 $44,941.33 35% off $60,152.24 $66,374.89 $62,226.46 2026-07-31
MS DRG V38 (FY2021) 654 OTHER Major Bladder Procedures With Cc 7 7 $77,016.87 $50,060.97 35% off $67,004.68 $73,936.20 $69,315.18 2026-07-31
MS DRG V38 (FY2021) 662 OTHER Minor Bladder Procedures With McC 7 7 $57,882.96 $37,623.92 35% off $50,358.18 $55,567.64 $52,094.66 2026-07-31
MS DRG V38 (FY2021) 668 OTHER Transurethral Procedures With McC 7 7 $64,447.71 $41,891.01 35% off $56,069.51 $61,869.80 $58,002.94 2026-07-31
MS DRG V38 (FY2021) 673 OTHER Other Kidney And Urinary Tract Procedures With McC 7 7 $64,845.39 $42,149.50 35% off $56,415.49 $62,251.57 $58,360.85 2026-07-31
MS DRG V38 (FY2021) 674 OTHER Other Kidney And Urinary Tract Procedures With Cc 7 7 $57,915.91 $37,645.34 35% off $50,386.84 $55,599.27 $52,124.32 2026-07-31
MS DRG V38 (FY2021) 693 OTHER Urinary Stones With McC 7 7 $75,893.72 $49,330.92 35% off $66,027.54 $72,857.97 $68,304.35 2026-07-31
MS DRG V38 (FY2021) 725 OTHER Benign Prostatic Hypertrophy With McC 7 7 $104,557.68 $67,962.49 35% off $90,965.18 $100,375.37 $94,101.91 2026-07-31
MS DRG V38 (FY2021) 734 OTHER Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/McC 7 7 $74,022.32 $48,114.51 35% off $64,399.42 $71,061.43 $66,620.09 2026-07-31
MS DRG V38 (FY2021) 739 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 7 7 $141,634.68 $92,062.54 35% off $123,222.17 $135,969.29 $127,471.21 2026-07-31
MS DRG V38 (FY2021) 740 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Cc 7 7 $66,609.23 $43,296.00 35% off $57,950.03 $63,944.86 $59,948.31 2026-07-31
MS DRG V38 (FY2021) 749 OTHER Other Female Reproductive System O.r. Procedures With Cc/McC 7 7 $75,605.74 $49,143.73 35% off $65,776.99 $72,581.51 $68,045.17 2026-07-31
MS DRG V38 (FY2021) 790 OTHER Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 8 8 $119,735.12 $77,827.83 35% off $93,485.21 $114,945.72 $107,761.61 2026-07-31
MS DRG V38 (FY2021) 791 OTHER Prematurity With Major Problems 10 10 $86,797.58 $56,418.43 35% off $15,770.00 $83,325.68 $78,117.82 2026-07-31
MS DRG V38 (FY2021) 799 OTHER Splenectomy With McC 9 9 $82,343.02 $53,522.96 35% off $55,361.23 $79,049.30 $74,108.72 2026-07-31
MS DRG V38 (FY2021) 802 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With McC 8 8 $58,474.14 $38,008.19 35% off $13,038.31 $56,135.17 $52,626.73 2026-07-31
MS DRG V38 (FY2021) 804 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs Without Cc/McC 7 7 $58,064.39 $37,741.85 35% off $50,516.02 $55,741.81 $52,257.95 2026-07-31
MS DRG V38 (FY2021) 821 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Cc 7 7 $64,018.82 $41,612.23 35% off $55,696.37 $61,458.07 $57,616.94 2026-07-31
MS DRG V38 (FY2021) 823 OTHER Lymphoma And Non-acute Leukemia With Other Procedures With McC 7 7 $149,485.03 $97,165.27 35% off $130,051.98 $143,505.63 $134,536.53 2026-07-31
MS DRG V38 (FY2021) 826 OTHER Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 7 7 $109,881.02 $71,422.66 35% off $95,596.49 $105,485.78 $98,892.92 2026-07-31
MS DRG V38 (FY2021) 829 OTHER Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 8 8 $135,979.97 $88,386.98 35% off $91,622.08 $130,540.77 $122,381.97 2026-07-31
MS DRG V38 (FY2021) 834 OTHER Acute Leukemia Without Major O.r. Procedures With McC 7 7 $92,009.38 $59,806.10 35% off $80,048.16 $88,329.00 $82,808.44 2026-07-31
MS DRG V38 (FY2021) 840 OTHER Lymphoma And Non-acute Leukemia With McC 8 8 $79,310.32 $51,551.71 35% off $60,885.42 $76,137.91 $71,379.29 2026-07-31
MS DRG V38 (FY2021) 849 OTHER Radiotherapy 7 7 $73,075.18 $47,498.87 35% off $63,575.41 $70,152.17 $65,767.66 2026-07-31
MS DRG V38 (FY2021) 853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With McC 9 9 $86,039.92 $55,925.95 35% off $74,315.50 $173,144.07 $77,435.93 2026-07-31
MS DRG V38 (FY2021) 856 OTHER Postoperative Or Post-traumatic Infections With O.r. Procedures With McC 7 7 $171,851.34 $111,703.37 35% off $149,510.67 $164,977.29 $154,666.21 2026-07-31
MS DRG V38 (FY2021) 870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 7 7 $160,841.16 $104,546.75 35% off $139,931.81 $154,407.51 $144,757.04 2026-07-31
MS DRG V38 (FY2021) 886 OTHER Behavioral And Developmental Disorders 7 7 $83,574.37 $54,323.34 35% off $72,709.70 $80,231.40 $75,216.93 2026-07-31
MS DRG V38 (FY2021) 901 OTHER Wound Debridements For Injuries With McC 7 7 $88,547.18 $57,555.67 35% off $77,036.05 $85,005.29 $79,692.46 2026-07-31
MS DRG V38 (FY2021) 904 OTHER Skin Grafts For Injuries With Cc/McC 7 7 $91,056.23 $59,186.55 35% off $79,218.92 $87,413.98 $81,950.61 2026-07-31
MS DRG V38 (FY2021) 907 OTHER Other O.r. Procedures For Injuries With McC 7 7 $71,022.43 $46,164.58 35% off $61,789.51 $68,181.53 $63,920.19 2026-07-31
MS DRG V38 (FY2021) 922 OTHER Other Injury, Poisoning And Toxic Effect Diagnoses With McC 7 7 $72,250.49 $46,962.82 35% off $62,857.93 $69,360.47 $65,025.44 2026-07-31
MS DRG V38 (FY2021) 955 OTHER Craniotomy For Multiple Significant Trauma 7 7 $80,534.84 $52,347.65 35% off $70,065.31 $77,313.45 $72,481.36 2026-07-31
MS DRG V38 (FY2021) 956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 7 7 $67,867.40 $44,113.81 35% off $59,044.64 $65,152.70 $61,080.66 2026-07-31
MS DRG V38 (FY2021) 957 OTHER Other O.r. Procedures For Multiple Significant Trauma With McC 9 9 $153,449.57 $99,742.22 35% off $38,592.26 $147,311.59 $138,104.61 2026-07-31
MS DRG V38 (FY2021) 958 OTHER Other O.r. Procedures For Multiple Significant Trauma With Cc 8 8 $86,650.40 $56,322.76 35% off $61,716.61 $83,184.38 $77,985.36 2026-07-31
MS DRG V38 (FY2021) 981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With McC 7 7 $85,324.98 $55,461.24 35% off $74,232.73 $81,911.98 $76,792.48 2026-07-31
MS DRG V38 (FY2021) 987 OTHER Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With McC 7 7 $71,938.52 $46,760.04 35% off $62,586.51 $69,060.98 $64,744.67 2026-07-31
Q0480 HCPCS Driver Pneumatic Vad, Rep 5 4 — — $110,901.76 $831,763.20 $114,228.81 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 11 7 — — $531,849.12 $3,988,868.38 $664,811.40 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 7 — — $614,180.81 $4,606,356.06 $767,726.01 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 11 7 — — $56,269.19 $422,018.94 $70,336.49 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 11 7 — — $489,290.60 $3,669,679.51 $611,613.25 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 11 7 — — $562,260.84 $4,216,956.27 $702,826.04 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 11 7 — — $559,781.08 $4,198,358.11 $699,726.35 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 11 7 — — $588,494.81 $4,413,711.06 $735,618.51 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 10 7 — — $770,620.00 $1,271,523.00 $944,009.50 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 6 5 — — $278,250.00 $2,086,875.00 $289,380.00 2026-04-01
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