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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

AURORA MEDICAL CTR MANITOWOC COUNTY

Two Rivers, WI · CCN 520034 · Rates published

14,980 distinct procedures filed
18 distinct payers
360,931 rate rows
2026-11-04 last MRF observed
Data quality

357,300 of 360,931 rate rows are consumer-grade (99.0%)

3,631 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
template filing: same amount across many unrelated codes — excluded 1,833
exceeds 10× this hospital's gross charge — excluded from medians 615
placeholder amount (≤ $0.02) — excluded from medians 398
percent-of-charges filed in the dollar field — excluded from medians 370
per-diem day rate — not a per-procedure price 348
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 63
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11248/391211629_aurora-medical-center-manitowoc_standardcharges.csv
Found on page https://www.aurorahealthcare.org/patients-visitors/billing-payment/health-care-costs
Discovered viaDiscovered by HANK
Last fetch success · 2026-11-05
Content fingerprint db04fe21ebe60a28… · 112,662,721 bytes · first seen 2026-11-05

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 		Pharmacy 1 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Pharmacy 1 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,691,450
1.0× median
J3389
HCPCS 		Pharmacy 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Pharmacy 1 $3,327,859.73 $3,327,859.73 $3,327,859.73 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Pharmacy 1 $3,252,508.08 $3,252,508.08 $3,252,508.08 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Pharmacy 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Pharmacy 1 $2,939,968.89 $2,939,968.89 $2,939,968.89 nat. median
$2,983,626
1.0× median
J3405
HCPCS 		Dme 1 $2,664,228.59 $2,664,228.59 $2,664,228.59 nat. median
$2,664,229
1.0× median
J3392
HCPCS 		Pharmacy 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,401,960
1.0× median
Q2057
HCPCS 		Pharmacy 7 $770,620.00 $1,770,037.08 $969,439.96 nat. median
$813,967
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 $649,382.95 $983,272.36 $823,409.63 nat. median
$360,195
outlier · 2.3×
Q2056
HCPCS 		Pharmacy 10 $565,868.95 $1,349,772.30 $769,181.91 nat. median
$646,415
1.2× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 10 $566,531.30 $1,380,122.16 $764,817.26 nat. median
$739,658
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $557,317.93 $1,289,082.32 $733,659.03 nat. median
$621,967
1.2× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 10 $557,485.91 $1,291,320.03 $718,112.99 nat. median
$637,620
1.1× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 10 $528,376.24 $1,222,392.36 $699,200.03 nat. median
$607,251
1.2× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 10 $489,304.61 $1,190,845.68 $660,757.77 nat. median
$589,091
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $421,423.41 $638,104.20 $534,359.73 nat. median
$247,805
outlier · 2.2×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 $321,068.82 $4,545,820.36 $407,111.33 nat. median
$197,664
outlier · 2.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 16 $319,184.56 $4,519,142.23 $404,722.11 nat. median
$190,274
outlier · 2.1×
J3403
HCPCS 		Pharmacy 6 $250,000.00 $608,678.50 $345,560.00 nat. median
$265,000
1.3× median
Q2058
HCPCS 		Pharmacy 1 $278,250.00 $278,250.00 $278,250.00 nat. median
$319,951
0.9× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 16 $208,297.35 $2,949,156.98 $264,118.50 nat. median
$126,240
outlier · 2.1×
J3402
HCPCS 		Pharmacy 7 $201,669.02 $463,213.57 $253,699.63 nat. median
$209,753
1.2× median
7
MS_DRG 		Lung Transplant 16 $194,745.11 $2,757,278.88 $246,934.41 nat. median
$117,943
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 16 $180,725.18 $2,558,779.16 $229,157.32 nat. median
$109,875
outlier · 2.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 $170,407.61 $2,412,698.87 $216,074.76 nat. median
$103,911
outlier · 2.1×
209
MS_DRG 		Other Inpatient Ms-DRG 16 $170,212.11 $2,409,930.98 $215,826.88 nat. median
$92,760
outlier · 2.3×
426
MS_DRG 		Other Inpatient Ms-DRG 16 $165,736.81 $2,346,567.78 $210,152.24 nat. median
$93,094
outlier · 2.3×
212
MS_DRG 		Other Inpatient Ms-DRG 16 $163,524.72 $2,315,248.13 $207,347.34 nat. median
$97,029
outlier · 2.1×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 16 $155,049.30 $2,195,249.80 $196,600.61 nat. median
$94,844
outlier · 2.1×
215
MS_DRG 		Other Heart Assist System Implant 16 $149,733.37 $2,119,984.70 $189,860.08 nat. median
$93,531
outlier · 2.0×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $147,113.75 $2,082,895.08 $186,538.43 nat. median
$90,525
outlier · 2.1×
429
MS_DRG 		Other Inpatient Ms-DRG 16 $135,486.36 $1,918,269.97 $171,795.05 nat. median
$77,933
outlier · 2.2×
850
MS_DRG 		Other Inpatient Ms-DRG 16 $130,221.56 $1,843,728.78 $165,119.35 nat. median
$78,028
outlier · 2.1×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 16 $126,768.84 $1,794,843.73 $160,741.33 nat. median
$76,979
outlier · 2.1×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 $126,370.33 $1,789,201.51 $160,236.03 nat. median
$77,595
outlier · 2.1×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 $118,331.01 $1,675,377.68 $150,042.28 nat. median
$74,260
outlier · 2.0×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 $115,466.28 $1,634,817.57 $146,409.82 nat. median
$72,153
outlier · 2.0×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 $114,968.52 $1,627,770.11 $145,778.67 nat. median
$71,672
outlier · 2.0×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 $114,588.06 $1,622,383.39 $145,296.25 nat. median
$67,850
outlier · 2.1×
427
MS_DRG 		Other Inpatient Ms-DRG 16 $108,553.31 $1,536,941.00 $137,644.26 nat. median
$63,446
outlier · 2.2×
10
MS_DRG 		Pancreas Transplant 16 $107,908.18 $1,527,806.99 $136,826.25 nat. median
$64,615
outlier · 2.1×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 16 $107,863.06 $1,527,168.25 $136,769.04 nat. median
$61,444
outlier · 2.2×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 $107,290.11 $1,519,056.22 $136,042.55 nat. median
$66,332
outlier · 2.1×
275
MS_DRG 		Other Inpatient Ms-DRG 16 $107,226.96 $1,518,161.99 $135,962.47 nat. median
$66,553
outlier · 2.0×
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 1 $132,128.29 $132,128.29 $132,128.29 nat. median
$111,503
1.2× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 16 $103,939.65 $1,471,618.99 $131,794.20 nat. median
$62,605
outlier · 2.1×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 $103,429.86 $1,464,401.20 $131,147.80 nat. median
$63,874
outlier · 2.1×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 16 $101,222.28 $1,433,145.43 $128,348.61 nat. median
$61,601
outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 14,980 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
             
288 MS_DRG Acute And Subacute Endocarditis With Mcc 25 16 — — $40,695.84 $576,187.87 $51,601.82 2026-11-04
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 25 16 — — $82,557.12 $1,168,876.57 $104,681.41 2026-11-04
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 25 16 — — $32,960.29 $466,664.91 $41,793.24 2026-11-04
245 MS_DRG Aicd Generator Procedures 25 16 — — $68,609.37 $971,398.83 $86,995.84 2026-11-04
265 MS_DRG Aicd Lead Procedures 25 16 — — $54,410.49 $770,365.43 $68,991.84 2026-11-04
14 MS_DRG Allogeneic Bone Marrow Transplant 25 16 — — $180,725.18 $2,558,779.16 $229,157.32 2026-11-04
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 25 16 — — $42,865.82 $606,911.36 $54,353.33 2026-11-04
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 25 16 — — $74,012.52 $1,047,898.83 $93,846.98 2026-11-04
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 25 16 — — $34,221.98 $484,528.39 $43,393.05 2026-11-04
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 25 16 — — $64,556.63 $914,018.51 $81,857.02 2026-11-04
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 25 16 — — $52,443.52 $742,516.28 $66,497.74 2026-11-04
347 MS_DRG Anal And Stomal Procedures With Mcc 25 16 — — $34,521.23 $488,765.38 $43,772.50 2026-11-04
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 25 16 — — $103,429.86 $1,464,401.20 $131,147.80 2026-11-04
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 25 16 — — $63,508.48 $899,178.40 $80,527.98 2026-11-04
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 25 16 — — $89,170.83 $1,262,516.15 $113,067.52 2026-11-04
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 25 16 — — $81,690.93 $1,156,612.72 $103,583.10 2026-11-04
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 15 10 — — $528,376.24 $1,222,392.36 $699,200.03 2026-11-04
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 25 16 — — $56,201.52 $795,723.49 $71,262.84 2026-11-04
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 25 16 — — $38,786.01 $549,147.79 $49,180.19 2026-11-04
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 25 16 — — $52,924.74 $749,329.53 $67,107.92 2026-11-04
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 25 16 — — $38,786.01 $549,147.79 $49,180.19 2026-11-04
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $114,097.24 $114,097.24 $114,097.24 2026-11-04
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 25 16 — — $78,266.43 $125,758.71 $95,001.12 2026-11-04
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 25 16 — — $37,694.86 $60,568.20 $45,754.66 2026-11-04
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 25 16 — — $53,619.49 $759,166.16 $67,988.86 2026-11-04
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 25 16 — — $32,742.24 $463,577.65 $41,516.76 2026-11-04
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 25 16 — — $36,981.45 $523,598.11 $46,892.03 2026-11-04
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 25 16 — — $51,950.27 $735,532.70 $65,872.31 2026-11-04
90288 CPT Botulism Ig IV 1 1 — — $91,450.01 $91,450.01 $91,450.01 2026-11-04
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 25 16 — — $32,191.85 $455,785.00 $40,818.87 2026-11-04
Q2053 HCPCS Brexucabtagene Car Pos T 15 10 — — $489,304.61 $1,190,845.68 $660,757.77 2026-11-04
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 25 16 — — $47,250.90 $668,997.08 $59,913.56 2026-11-04
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 25 16 — — $48,915.61 $692,566.66 $62,024.39 2026-11-04
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 16 — — $147,113.75 $2,082,895.08 $186,538.43 2026-11-04
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 16 — — $98,879.36 $1,399,973.42 $125,377.82 2026-11-04
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 25 16 — — $98,879.36 $1,399,973.42 $125,377.82 2026-11-04
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 25 16 — — $115,466.28 $1,634,817.57 $146,409.82 2026-11-04
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 25 16 — — $80,194.65 $1,135,427.78 $101,685.83 2026-11-04
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 25 16 — — $75,794.53 $1,073,129.14 $96,106.53 2026-11-04
35 MS_DRG Carotid Artery Stent Procedures With Cc 25 16 — — $35,948.34 $508,970.92 $45,582.05 2026-11-04
34 MS_DRG Carotid Artery Stent Procedures With Mcc 25 16 — — $58,207.59 $824,126.22 $73,806.51 2026-11-04
472 MS_DRG Cervical Spinal Fusion With Cc 25 16 — — $44,303.45 $627,265.94 $56,176.23 2026-11-04
471 MS_DRG Cervical Spinal Fusion With Mcc 25 16 — — $72,613.99 $1,028,097.83 $92,073.65 2026-11-04
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 25 16 — — $36,712.27 $519,786.95 $46,550.71 2026-11-04
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 25 16 — — $72,247.06 $1,022,902.73 $91,608.39 2026-11-04
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 25 16 — — $38,986.02 $551,979.55 $49,433.79 2026-11-04
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 15 — — $649,382.95 $983,272.36 $823,409.63 2026-11-04
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 25 16 — — $53,574.38 $758,527.42 $67,931.66 2026-11-04
412 MS_DRG Cholecystectomy With C.d.e. With Cc 25 16 — — $31,617.40 $447,651.69 $40,090.47 2026-11-04
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 25 16 — — $49,675.03 $703,318.82 $62,987.32 2026-11-04
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 25 16 — — $33,276.09 $471,136.10 $42,193.67 2026-11-04
545 MS_DRG Connective Tissue Disorders With Mcc 25 16 — — $37,319.80 $528,388.67 $47,321.06 2026-11-04
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 25 16 — — $114,968.52 $1,627,770.11 $145,778.67 2026-11-04
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 25 16 — — $82,148.08 $1,163,085.31 $104,162.76 2026-11-04
231 MS_DRG Coronary Bypass With Ptca With Mcc 25 16 — — $126,768.84 $1,794,843.73 $160,741.33 2026-11-04
232 MS_DRG Coronary Bypass With Ptca Without Mcc 25 16 — — $91,169.38 $1,290,812.42 $115,601.66 2026-11-04
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 25 16 — — $88,252.01 $1,249,507.10 $111,902.46 2026-11-04
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 25 16 — — $62,991.17 $891,854.16 $79,872.04 2026-11-04
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 25 16 — — $46,756.15 $661,992.21 $59,286.23 2026-11-04
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 25 16 — — $68,373.27 $968,056.08 $86,696.48 2026-11-04
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 25 16 — — $37,939.37 $537,160.73 $48,106.66 2026-11-04
955 MS_DRG Craniotomy For Multiple Significant Trauma 25 16 — — $101,222.28 $1,433,145.43 $128,348.61 2026-11-04
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 25 16 — — $86,172.25 $1,220,061.09 $109,265.36 2026-11-04
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 25 16 — — $58,827.15 $832,898.28 $74,592.11 2026-11-04
J7330 HCPCS Cultured Chondrocytes Implnt 7 4 — — $69,772.00 $149,367.18 $83,726.25 2026-11-04
56 MS_DRG Degenerative Nervous System Disorders With Mcc 25 16 — — $34,934.78 $494,620.51 $44,296.87 2026-11-04
374 MS_DRG Digestive Malignancy With Mcc 25 16 — — $32,161.77 $455,359.17 $40,780.73 2026-11-04
J3405 HCPCS Dme 1 1 — — $2,664,228.59 $2,664,228.59 $2,664,228.59 2026-11-04
J2789 HCPCS Dme 1 1 — — $40,427.50 $40,427.50 $40,427.50 2026-11-04
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $132,128.29 $132,128.29 $132,128.29 2026-11-04
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 25 16 — — $31,841.46 $450,824.10 $40,374.58 2026-11-04
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 25 16 — — $319,184.56 $4,519,142.23 $404,722.11 2026-11-04
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $58,766.81 $58,766.81 $58,766.81 2026-11-04
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $53,323.46 $53,323.46 $53,323.46 2026-11-04
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 25 16 — — $92,158.88 $1,304,822.16 $116,856.33 2026-11-04
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 25 16 — — $71,592.91 $1,013,640.97 $90,778.93 2026-11-04
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $41,964.16 $41,964.16 $41,964.16 2026-11-04
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $82,562.05 $82,562.05 $82,562.05 2026-11-04
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 25 16 — — $321,068.82 $4,545,820.36 $407,111.33 2026-11-04
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 25 16 — — $58,560.98 $829,129.70 $74,254.61 2026-11-04
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 25 16 — — $36,970.92 $523,449.07 $46,878.68 2026-11-04
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 16 — — $70,555.29 $998,949.91 $89,463.24 2026-11-04
37 MS_DRG Extracranial Procedures With Mcc 25 16 — — $49,506.60 $700,934.18 $62,773.76 2026-11-04
503 MS_DRG Foot Procedures With Mcc 25 16 — — $41,972.56 $594,264.27 $53,220.69 2026-11-04
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 25 16 — — $107,863.06 $1,527,168.25 $136,769.04 2026-11-04
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 25 16 — — $48,434.39 $685,753.41 $61,414.21 2026-11-04
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 25 16 — — $33,243.00 $470,667.69 $42,151.72 2026-11-04
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 24 15 — — $421,423.41 $638,104.20 $534,359.73 2026-11-04
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 25 16 — — $170,407.61 $2,412,698.87 $216,074.76 2026-11-04
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 25 16 — — $51,235.97 $725,419.29 $64,966.58 2026-11-04
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 25 16 — — $43,640.28 $617,876.43 $55,335.34 2026-11-04
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 25 16 — — $31,497.09 $445,948.37 $39,937.93 2026-11-04
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 25 16 — — $43,795.17 $620,069.44 $55,531.74 2026-11-04
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 25 16 — — $40,673.60 $65,354.45 $49,370.31 2026-11-04
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 25 16 — — $92,052.11 $1,303,310.47 $116,720.95 2026-11-04
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 25 16 — — $39,661.22 $561,539.38 $50,289.94 2026-11-04
974 MS_DRG HIV With Major Related Condition With Mcc 25 16 — — $43,399.67 $614,469.80 $55,030.25 2026-11-04
Q2055 HCPCS Idecabtagene Vicleucel Car 15 10 — — $557,317.93 $1,289,082.32 $733,659.03 2026-11-04
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 25 16 — — $74,266.67 $1,051,497.08 $94,169.22 2026-11-04
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 25 16 — — $37,473.19 $530,560.40 $47,515.55 2026-11-04
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 25 16 — — $79,608.16 $1,127,124.13 $100,942.18 2026-11-04
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 25 16 — — $118,331.01 $1,675,377.68 $150,042.28 2026-11-04
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 25 16 — — $47,781.74 $676,512.94 $60,586.66 2026-11-04
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 25 16 — — $41,461.27 $587,025.19 $52,572.38 2026-11-04
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 25 16 — — $47,877.98 $677,875.59 $60,708.70 2026-11-04
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 25 16 — — $38,210.05 $540,993.18 $48,449.88 2026-11-04
652 MS_DRG Kidney Transplant 25 16 — — $48,565.22 $687,605.76 $61,580.11 2026-11-04
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 25 16 — — $70,699.65 $1,000,993.88 $89,646.30 2026-11-04
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 25 16 — — $55,727.82 $789,016.70 $70,662.19 2026-11-04
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 25 16 — — $48,529.13 $687,094.77 $61,534.34 2026-11-04
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 25 16 — — $35,886.68 $508,097.97 $45,503.88 2026-11-04
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 25 16 — — $56,587.99 $801,195.38 $71,752.88 2026-11-04
Q2054 HCPCS Lisocabtagene Mara Car Pos T 15 10 — — $557,485.91 $1,291,320.03 $718,112.99 2026-11-04
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 25 16 — — $155,049.30 $2,195,249.80 $196,600.61 2026-11-04
6 MS_DRG Liver Transplant Without Mcc 25 16 — — $69,731.21 $987,282.22 $88,418.32 2026-11-04
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 25 16 — — $54,523.28 $771,962.29 $69,134.85 2026-11-04
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 25 16 — — $45,366.64 $642,318.96 $57,524.34 2026-11-04
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 25 16 — — $38,137.87 $539,971.20 $48,358.35 2026-11-04
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 25 16 — — $55,213.52 $781,735.04 $70,010.07 2026-11-04
7 MS_DRG Lung Transplant 25 16 — — $194,745.11 $2,757,278.88 $246,934.41 2026-11-04
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 25 16 — — $33,664.07 $476,629.28 $42,685.62 2026-11-04
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 25 16 — — $88,194.86 $1,248,698.03 $111,830.01 2026-11-04
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 25 16 — — $48,646.43 $688,755.50 $61,683.07 2026-11-04
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 25 16 — — $34,070.09 $482,377.96 $43,200.46 2026-11-04
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 25 16 — — $68,946.22 $976,168.11 $87,422.97 2026-11-04
654 MS_DRG Major Bladder Procedures With Cc 25 16 — — $42,095.87 $596,010.16 $53,377.05 2026-11-04
653 MS_DRG Major Bladder Procedures With Mcc 25 16 — — $78,143.46 $1,106,386.31 $99,084.96 2026-11-04
655 MS_DRG Major Bladder Procedures Without Cc/mcc 25 16 — — $31,829.43 $450,653.77 $40,359.33 2026-11-04
164 MS_DRG Major Chest Procedures With Cc 25 16 — — $37,955.91 $537,394.94 $48,127.63 2026-11-04
163 MS_DRG Major Chest Procedures With Mcc 25 16 — — $67,397.31 $954,237.97 $85,458.96 2026-11-04
141 MS_DRG Major Head And Neck Procedures With Cc 25 16 — — $32,799.38 $464,386.73 $41,589.21 2026-11-04
140 MS_DRG Major Head And Neck Procedures With Mcc 25 16 — — $64,141.58 $908,142.08 $81,330.74 2026-11-04
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 25 16 — — $33,202.40 $470,092.82 $42,100.24 2026-11-04
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 25 16 — — $42,983.48 $69,065.96 $52,174.07 2026-11-04
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 25 16 — — $39,280.59 $590,176.32 $51,756.92 2026-11-04
595 MS_DRG Major Skin Disorders With Mcc 25 16 — — $31,891.09 $451,526.72 $40,437.51 2026-11-04
330 MS_DRG Major Small And Large Bowel Procedures With Cc 25 16 — — $36,049.09 $510,397.44 $45,709.81 2026-11-04
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 25 16 — — $69,122.17 $978,659.20 $87,646.06 2026-11-04
662 MS_DRG Minor Bladder Procedures With Mcc 25 16 — — $46,038.84 $651,836.21 $58,376.68 2026-11-04
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 25 16 — — $38,840.15 $549,914.28 $49,248.83 2026-11-04
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 25 16 — — $70,344.76 $995,969.11 $89,196.29 2026-11-04
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 25 16 — — $34,755.83 $492,086.84 $44,069.96 2026-11-04
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 25 16 — — $47,520.08 $672,808.24 $60,254.88 2026-11-04
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 25 16 — — $34,510.71 $488,616.34 $43,759.15 2026-11-04
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 25 16 — — $54,314.25 $769,002.79 $68,869.80 2026-11-04
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 16 — — $51,556.28 $729,954.36 $65,372.73 2026-11-04
619 MS_DRG O.r. Procedures For Obesity With Mcc 25 16 — — $43,420.72 $614,767.88 $54,736.44 2026-11-04
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 25 16 — — $35,142.30 $497,558.73 $44,560.01 2026-11-04
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 25 16 — — $54,565.38 $772,558.45 $69,188.24 2026-11-04
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 25 16 — — $58,120.37 $822,891.32 $73,695.91 2026-11-04
113 MS_DRG Orbital Procedures With Cc/mcc 25 16 — — $35,355.84 $500,582.11 $44,830.77 2026-11-04
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 25 16 — — $34,310.70 $485,784.58 $43,505.55 2026-11-04
228 MS_DRG Other Cardiothoracic Procedures With Mcc 25 16 — — $74,399.00 $1,053,370.72 $94,337.02 2026-11-04
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 25 16 — — $47,362.18 $670,572.64 $60,054.67 2026-11-04
264 MS_DRG Other Circulatory System O.r. Procedures 25 16 — — $50,235.94 $711,260.51 $63,698.56 2026-11-04
357 MS_DRG Other Digestive System O.r. Procedures With Cc 25 16 — — $34,970.87 $495,131.51 $44,342.63 2026-11-04
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 25 16 — — $66,058.93 $935,288.62 $83,761.91 2026-11-04
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 25 16 — — $56,341.37 $797,703.59 $71,440.17 2026-11-04
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 25 16 — — $32,764.79 $463,897.02 $41,545.36 2026-11-04
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 25 16 — — $56,043.62 $793,487.90 $71,062.62 2026-11-04
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 25 16 — — $67,113.09 $950,213.89 $85,098.58 2026-11-04
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 25 16 — — $36,170.90 $512,122.04 $45,864.26 2026-11-04
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 25 16 — — $38,611.57 $546,677.99 $48,959.00 2026-11-04
215 MS_DRG Other Heart Assist System Implant 25 16 — — $149,733.37 $2,119,984.70 $189,860.08 2026-11-04
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 25 16 — — $32,901.64 $465,834.54 $41,718.88 2026-11-04
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 25 16 — — $62,452.81 $884,231.84 $79,189.40 2026-11-04
209 MS_DRG Other Inpatient Ms-DRG 25 16 — — $170,212.11 $2,409,930.98 $215,826.88 2026-11-04
426 MS_DRG Other Inpatient Ms-DRG 25 16 — — $165,736.81 $2,346,567.78 $210,152.24 2026-11-04
212 MS_DRG Other Inpatient Ms-DRG 25 16 — — $163,524.72 $2,315,248.13 $207,347.34 2026-11-04
429 MS_DRG Other Inpatient Ms-DRG 25 16 — — $135,486.36 $1,918,269.97 $171,795.05 2026-11-04
850 MS_DRG Other Inpatient Ms-DRG 25 16 — — $130,221.56 $1,843,728.78 $165,119.35 2026-11-04
427 MS_DRG Other Inpatient Ms-DRG 25 16 — — $108,553.31 $1,536,941.00 $137,644.26 2026-11-04
275 MS_DRG Other Inpatient Ms-DRG 25 16 — — $107,226.96 $1,518,161.99 $135,962.47 2026-11-04
317 MS_DRG Other Inpatient Ms-DRG 25 16 — — $100,551.59 $1,423,649.46 $127,498.18 2026-11-04
447 MS_DRG Other Inpatient Ms-DRG 25 16 — — $100,477.90 $1,422,606.18 $127,404.75 2026-11-04
276 MS_DRG Other Inpatient Ms-DRG 25 16 — — $90,327.25 $1,278,889.23 $114,533.85 2026-11-04
430 MS_DRG Other Inpatient Ms-DRG 25 16 — — $86,725.65 $1,227,896.33 $109,967.06 2026-11-04
213 MS_DRG Other Inpatient Ms-DRG 25 16 — — $85,820.36 $1,215,078.91 $108,819.17 2026-11-04
428 MS_DRG Other Inpatient Ms-DRG 25 16 — — $84,543.64 $1,197,002.51 $107,200.30 2026-11-04
278 MS_DRG Other Inpatient Ms-DRG 25 16 — — $83,704.52 $1,185,121.91 $106,136.30 2026-11-04
450 MS_DRG Other Inpatient Ms-DRG 25 16 — — $80,146.52 $1,134,746.45 $101,624.81 2026-11-04
277 MS_DRG Other Inpatient Ms-DRG 25 16 — — $69,453.00 $983,343.31 $88,065.56 2026-11-04
323 MS_DRG Other Inpatient Ms-DRG 25 16 — — $65,075.44 $921,364.04 $82,514.86 2026-11-04
448 MS_DRG Other Inpatient Ms-DRG 25 16 — — $63,773.15 $902,925.69 $80,863.57 2026-11-04
402 MS_DRG Other Inpatient Ms-DRG 25 16 — — $60,460.28 $856,020.74 $76,662.89 2026-11-04
279 MS_DRG Other Inpatient Ms-DRG 25 16 — — $54,233.04 $767,853.05 $68,766.84 2026-11-04
359 MS_DRG Other Inpatient Ms-DRG 25 16 — — $51,709.67 $732,126.08 $65,567.22 2026-11-04
451 MS_DRG Other Inpatient Ms-DRG 25 16 — — $48,578.76 $687,797.39 $61,597.27 2026-11-04
325 MS_DRG Other Inpatient Ms-DRG 25 16 — — $48,278.00 $683,539.11 $61,215.91 2026-11-04
324 MS_DRG Other Inpatient Ms-DRG 25 16 — — $47,384.74 $670,892.01 $60,083.27 2026-11-04
173 MS_DRG Other Inpatient Ms-DRG 25 16 — — $44,759.10 $633,717.23 $56,754.00 2026-11-04
321 MS_DRG Other Inpatient Ms-DRG 25 16 — — $40,915.39 $579,296.41 $51,880.21 2026-11-04
318 MS_DRG Other Inpatient Ms-DRG 25 16 — — $36,425.04 $515,720.29 $46,186.51 2026-11-04
360 MS_DRG Other Inpatient Ms-DRG 25 16 — — $36,306.24 $514,038.27 $46,035.87 2026-11-04
397 MS_DRG Other Inpatient Ms-DRG 25 16 — — $36,014.51 $509,907.74 $45,665.95 2026-11-04
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 25 16 — — $35,167.87 $497,920.68 $44,592.42 2026-11-04
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 25 16 — — $63,183.66 $894,579.46 $80,116.11 2026-11-04
271 MS_DRG Other Major Cardiovascular Procedures With Cc 25 16 — — $53,479.64 $757,186.06 $67,811.53 2026-11-04
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 25 16 — — $79,345.00 $1,123,398.14 $100,608.49 2026-11-04
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 25 16 — — $38,392.01 $543,569.44 $48,680.60 2026-11-04
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 25 16 — — $33,644.52 $476,352.49 $42,660.84 2026-11-04
963 MS_DRG Other Multiple Significant Trauma With Mcc 25 16 — — $41,110.88 $582,064.29 $52,128.10 2026-11-04
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 25 16 — — $47,924.60 $678,535.63 $60,767.81 2026-11-04
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 25 16 — — $57,735.39 $817,440.72 $73,207.77 2026-11-04
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 25 16 — — $63,368.63 $897,198.30 $80,350.65 2026-11-04
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 25 16 — — $114,588.06 $1,622,383.39 $145,296.25 2026-11-04
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 25 16 — — $44,273.38 $626,840.11 $56,138.10 2026-11-04
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 25 16 — — $59,912.90 $848,270.67 $75,968.82 2026-11-04
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 25 16 — — $56,207.53 $795,808.66 $71,270.46 2026-11-04
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 25 16 — — $48,700.56 $689,521.99 $61,751.72 2026-11-04
253 MS_DRG Other Vascular Procedures With Cc 25 16 — — $39,032.63 $552,639.58 $49,492.90 2026-11-04
252 MS_DRG Other Vascular Procedures With Mcc 25 16 — — $52,457.06 $742,707.91 $66,514.90 2026-11-04
10 MS_DRG Pancreas Transplant 25 16 — — $107,908.18 $1,527,806.99 $136,826.25 2026-11-04
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 25 16 — — $43,613.21 $617,493.18 $55,301.01 2026-11-04
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 25 16 — — $82,265.38 $1,164,746.04 $104,311.49 2026-11-04
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 25 16 — — $33,378.34 $472,583.91 $42,323.33 2026-11-04
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 25 16 — — $32,030.94 $453,506.82 $40,614.84 2026-11-04
709 MS_DRG Penis Procedures With Cc/mcc 25 16 — — $34,994.93 $495,472.17 $44,373.14 2026-11-04
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 25 16 — — $62,039.27 $878,376.71 $78,665.03 2026-11-04
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 25 16 — — $49,500.58 $700,849.01 $62,766.14 2026-11-04
250 MS_DRG Percutaneous Cardiovascular Procedures Without Coronary Artery Stent With Mcc 25 16 — — $32,820.44 $464,684.81 $41,615.91 2026-11-04
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 25 16 — — $33,064.05 $468,134.01 $41,924.81 2026-11-04
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 25 16 — — $58,064.73 $822,103.54 $73,625.36 2026-11-04
336 MS_DRG Peritoneal Adhesiolysis With Cc 25 16 — — $31,710.63 $448,971.75 $40,208.69 2026-11-04
335 MS_DRG Peritoneal Adhesiolysis With Mcc 25 16 — — $53,699.19 $760,294.60 $68,089.92 2026-11-04
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 25 16 — — $32,044.47 $453,698.44 $40,632.00 2026-11-04
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 25 16 — — $48,013.33 $679,791.82 $60,880.31 2026-11-04
J3391 HCPCS Pharmacy 3 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-11-04
J1411 HCPCS Pharmacy 3 1 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-11-04
J3389 HCPCS Pharmacy 3 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-11-04
J1413 HCPCS Pharmacy 3 1 — — $3,327,859.73 $3,327,859.73 $3,327,859.73 2026-11-04
J3394 HCPCS Pharmacy 3 1 — — $3,252,508.08 $3,252,508.08 $3,252,508.08 2026-11-04
J3387 HCPCS Pharmacy 3 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-11-04
J3393 HCPCS Pharmacy 3 1 — — $2,939,968.89 $2,939,968.89 $2,939,968.89 2026-11-04
J3392 HCPCS Pharmacy 3 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-11-04
Q2057 HCPCS Pharmacy 11 7 — — $770,620.00 $1,770,037.08 $969,439.96 2026-11-04
Q2056 HCPCS Pharmacy 15 10 — — $565,868.95 $1,349,772.30 $769,181.91 2026-11-04
J3403 HCPCS Pharmacy 8 6 — — $250,000.00 $608,678.50 $345,560.00 2026-11-04
Q2058 HCPCS Pharmacy 3 1 — — $278,250.00 $278,250.00 $278,250.00 2026-11-04
J3402 HCPCS Pharmacy 11 7 — — $201,669.02 $463,213.57 $253,699.63 2026-11-04
J3404 HCPCS Pharmacy 2 1 — — $115,000.00 $138,000.00 $126,500.00 2026-11-04
J9183 HCPCS Pharmacy 3 2 — — $73,088.26 $113,469.52 $87,705.91 2026-11-04
J9029 HCPCS Pharmacy 18 12 — — $63,342.28 $154,700.98 $86,783.51 2026-11-04
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 25 16 — — $32,203.88 $455,955.33 $40,834.12 2026-11-04
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 25 16 — — $68,403.35 $968,481.91 $86,734.61 2026-11-04
665 MS_DRG Prostatectomy With Mcc 25 16 — — $46,936.61 $664,547.18 $59,515.04 2026-11-04
A9699 HCPCS Radiopharm Rx Agent Noc 4 2 — — $46,695.13 $61,932.02 $46,695.13 2026-11-04
849 MS_DRG Radiotherapy 25 16 — — $40,745.46 $576,890.48 $51,664.75 2026-11-04
333 MS_DRG Rectal Resection With Cc 25 16 — — $35,222.00 $498,687.17 $44,661.07 2026-11-04
332 MS_DRG Rectal Resection With Mcc 25 16 — — $54,448.09 $770,897.72 $69,039.51 2026-11-04
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 25 16 — — $96,765.02 $1,370,037.72 $122,696.86 2026-11-04
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 25 16 — — $41,334.95 $585,236.71 $52,412.21 2026-11-04
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 25 16 — — $31,981.31 $452,804.20 $40,551.92 2026-11-04
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 25 16 — — $49,975.45 $80,300.68 $60,661.05 2026-11-04
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 25 16 — — $73,765.72 $118,526.96 $89,538.09 2026-11-04
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 25 16 — — $38,941.91 $62,571.96 $47,268.35 2026-11-04
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 25 16 — — $103,939.65 $1,471,618.99 $131,794.20 2026-11-04
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 25 16 — — $45,422.28 $643,106.74 $57,594.89 2026-11-04
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 25 16 — — $84,281.97 $1,193,297.80 $106,868.51 2026-11-04
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 25 16 — — $107,290.11 $1,519,056.22 $136,042.55 2026-11-04
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 25 16 — — $32,632.46 $462,023.38 $41,377.56 2026-11-04
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 19 13 — — $54,404.11 $135,509.06 $73,445.55 2026-11-04
570 MS_DRG Skin Debridement With Mcc 25 16 — — $44,228.26 $626,201.37 $56,080.89 2026-11-04
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 25 16 — — $39,861.23 $564,371.14 $50,543.55 2026-11-04
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 25 16 — — $73,704.25 $1,043,534.10 $93,456.08 2026-11-04
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 25 16 — — $52,202.91 $739,109.66 $66,192.66 2026-11-04
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 25 16 — — $98,519.95 $1,394,884.78 $124,922.10 2026-11-04
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 25 16 — — $53,523.25 $757,803.51 $67,866.83 2026-11-04
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 25 16 — — $55,236.08 $782,054.41 $70,038.67 2026-11-04
500 MS_DRG Soft Tissue Procedures With Mcc 25 16 — — $47,592.26 $673,830.23 $60,346.41 2026-11-04
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 16 — — $126,370.33 $1,789,201.51 $160,236.03 2026-11-04
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 16 — — $89,673.10 $1,269,627.47 $113,704.39 2026-11-04
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 25 16 — — $62,747.56 $888,404.96 $79,563.14 2026-11-04
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 25 16 — — $51,303.64 $726,377.40 $65,052.39 2026-11-04
28 MS_DRG Spinal Procedures With Mcc 25 16 — — $90,352.82 $1,279,251.19 $114,566.26 2026-11-04
30 MS_DRG Spinal Procedures Without Cc/mcc 25 16 — — $33,011.42 $467,388.81 $41,858.07 2026-11-04
800 MS_DRG Splenectomy With Cc 25 16 — — $42,247.76 $598,160.59 $53,569.64 2026-11-04
799 MS_DRG Splenectomy With Mcc 25 16 — — $68,105.60 $964,266.21 $86,357.07 2026-11-04
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 25 16 — — $36,755.88 $520,404.40 $46,606.01 2026-11-04
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 25 16 — — $75,000.52 $1,061,887.28 $95,099.74 2026-11-04
J9226 HCPCS Supprelin La Implant 19 13 — — $41,173.43 $110,438.78 $58,300.21 2026-11-04
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 25 16 — — $45,416.26 $643,021.57 $57,587.27 2026-11-04
Q2042 HCPCS Tisagenlecleucel Car-pos T 15 10 — — $566,531.30 $1,380,122.16 $764,817.26 2026-11-04
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 25 16 — — $63,400.21 $897,645.42 $80,390.69 2026-11-04
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 25 16 — — $82,018.76 $1,161,254.25 $103,998.78 2026-11-04
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 25 16 — — $43,336.51 $613,575.57 $54,950.16 2026-11-04
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 25 16 — — $208,297.35 $2,949,156.98 $264,118.50 2026-11-04
668 MS_DRG Transurethral Procedures With Mcc 25 16 — — $43,910.96 $621,708.88 $55,678.56 2026-11-04
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 25 16 — — $34,370.85 $486,636.24 $43,581.82 2026-11-04
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 25 16 — — $34,164.83 $483,719.32 $43,320.59 2026-11-04
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 25 16 — — $40,563.50 $574,314.22 $51,434.02 2026-11-04
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 25 16 — — $53,878.15 $762,828.28 $68,316.83 2026-11-04
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 25 16 — — $53,753.33 $761,061.09 $68,158.57 2026-11-04
263 MS_DRG Vein Ligation And Stripping 25 16 — — $45,977.18 $650,963.26 $58,298.50 2026-11-04
32 MS_DRG Ventricular Shunt Procedures With Cc 25 16 — — $32,045.98 $453,719.73 $40,633.91 2026-11-04
31 MS_DRG Ventricular Shunt Procedures With Mcc 25 16 — — $67,377.76 $953,961.18 $85,434.17 2026-11-04
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 25 16 — — $85,709.08 $1,213,503.34 $108,678.07 2026-11-04
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 25 16 — — $46,838.86 $663,163.24 $59,391.10 2026-11-04
901 MS_DRG Wound Debridements For Injuries With Mcc 27 16 — — $709.00 $893,514.89 $80,020.77 2026-11-04
A9543 HCPCS Y90 Ibritumomab, Rx 6 3 — — $56,824.55 $107,375.31 $62,315.63 2026-11-04
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