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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

SSM HEALTH ST AGNES HOSPITAL-FOND DU LAC

Fond Du Lac, WI · CCN 520088 · Rates published

6,256 distinct procedures filed
26 distinct payers
87,020 rate rows
2026-04-01 last MRF observed
Data quality

51,002 of 87,020 rate rows are consumer-grade (58.6%)

36,018 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 35,989
template filing: same amount across many unrelated codes — excluded 27
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1
placeholder amount (≤ $0.02) — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hospitalpricedisclosure.com/download.aspx?pi=PjFhO32dAPBRj2MaHOd4Xg*-*&f=p22CpYLrWLxCnt4HoK7iZA*-*
Found on page https://www.ssmhealth.com/resources/pay-my-bill/price-estimate/price-transparency#machinefiles
Discovered viaDiscovered by HANK
Last fetch success · 2026-08-03
Content fingerprint 7d1b68f1c0757447… · 38,634,205 bytes · first seen 2026-05-09

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 3 $2,763,950.00 $3,758,972.00 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 3 $2,487,346.94 $3,382,791.84 $3,316,462.59 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 3 $2,436,334.29 $3,313,414.63 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 3 $2,209,305.00 $3,004,654.80 $2,945,740.00 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 4 $1,841,332.95 $4,738,363.47 $2,479,661.71 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 4 $1,749,000.00 $4,500,760.00 $2,355,320.00 nat. median
$2,405,851
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 16 $237,145.34 $888,350.52 $577,777.44 nat. median
$370,165
1.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $153,897.78 $576,503.75 $374,954.32 nat. median
$261,939
1.4× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 16 $117,249.73 $439,219.50 $285,665.53 nat. median
$205,166
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 16 $116,561.62 $436,641.84 $277,774.19 nat. median
$199,832
1.4× median
J7330
HCPCS 		Cultured Chondrocytes Implnt 1 $198,192.56 $198,192.56 $198,192.56 nat. median
$75,807
outlier · 2.6×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 16 $76,067.20 $284,949.06 $185,329.03 nat. median
$132,706
1.4× median
7
MS_DRG 		Lung Transplant 16 $71,118.12 $266,409.70 $173,271.15 nat. median
$122,690
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 16 $65,998.24 $247,230.56 $160,797.16 nat. median
$114,305
1.4× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 $62,230.42 $233,116.20 $151,617.27 nat. median
$108,240
1.4× median
209
MS_DRG 		Complex Aortic Arch Procedures 16 $62,159.02 $232,848.77 $151,443.34 nat. median
$96,134
1.6× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 $60,524.71 $226,726.58 $147,461.51 nat. median
$96,835
1.5× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 16 $59,716.88 $223,700.46 $145,493.34 nat. median
$100,978
1.4× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 16 $56,621.78 $212,106.16 $137,952.48 nat. median
$99,646
1.4× median
215
MS_DRG 		Other Heart Assist System Implant 16 $54,680.48 $204,834.01 $135,201.36 nat. median
$98,002
1.4× median
A9699
HCPCS 		Radiopharm Rx Agent Noc 1 $123,114.30 $123,114.30 $123,114.30 nat. median
$4,125
outlier · 29.8×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 $49,477.68 $185,344.23 $120,546.70 nat. median
$81,124
1.5× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $53,723.83 $201,250.39 $117,413.17 nat. median
$92,900
1.3× median
850
MS_DRG 		Acute Leukemia With Other Procedures 16 $47,555.05 $178,142.02 $115,862.43 nat. median
$81,364
1.4× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 16 $46,294.16 $173,418.72 $112,790.42 nat. median
$79,040
1.4× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 $46,148.63 $172,873.57 $112,435.86 nat. median
$80,459
1.4× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 4 $83,176.32 $214,040.40 $112,010.78 nat. median
$111,503
1.0× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 $43,212.79 $161,875.85 $105,283.01 nat. median
$77,385
1.4× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 $41,984.85 $252,519.86 $102,291.29 nat. median
$73,475
1.4× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 $41,845.91 $156,755.52 $101,952.77 nat. median
$71,485
1.4× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 $42,166.63 $159,164.48 $100,485.91 nat. median
$74,472
1.3× median
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 $39,642.11 $148,500.03 $96,583.46 nat. median
$66,640
1.4× median
10
MS_DRG 		Pancreas Transplant 16 $39,406.52 $147,617.50 $96,009.47 nat. median
$67,750
1.4× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 16 $39,390.04 $147,555.78 $95,969.32 nat. median
$62,911
1.5× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 $39,180.81 $146,771.99 $95,459.55 nat. median
$69,153
1.4× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 $39,157.75 $146,685.59 $95,403.36 nat. median
$68,581
1.4× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 16 $37,957.27 $164,923.34 $92,478.54 nat. median
$65,958
1.4× median
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 16 $36,964.93 $138,471.25 $90,060.81 nat. median
$64,357
1.4× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 $37,771.10 $141,491.20 $90,011.08 nat. median
$65,792
1.4× median
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 16 $36,693.09 $137,452.94 $89,398.51 nat. median
$62,262
1.4× median
218
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $36,109.33 $135,266.15 $87,976.23 nat. median
$60,895
1.4× median
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 $35,978.07 $134,774.48 $87,656.46 nat. median
$59,159
1.5× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 16 $35,337.20 $132,373.75 $86,095.03 nat. median
$62,218
1.4× median
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 $36,109.33 $135,266.15 $86,050.95 nat. median
$63,840
1.3× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 16 $33,616.11 $125,926.53 $81,901.80 nat. median
$60,294
1.4× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 16 $33,293.75 $124,718.96 $81,116.41 nat. median
$59,257
1.4× median
28
MS_DRG 		Spinal Procedures With Mcc 16 $32,995.55 $123,601.91 $80,389.88 nat. median
$56,970
1.4× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 16 $32,986.22 $123,566.93 $80,367.13 nat. median
$58,419
1.4× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/Mcc 16 $32,563.90 $121,984.96 $79,338.23 nat. median
$55,867
1.4× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 16 $32,228.37 $128,109.29 $78,520.73 nat. median
$57,082
1.4× median

Other procedures at this hospital

Browse this hospital's 6,256 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 3 3 — — $2,763,950.00 $3,758,972.00 $3,685,266.67 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 3 3 — — $2,487,346.94 $3,382,791.84 $3,316,462.59 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 3 3 — — $2,436,334.29 $3,313,414.63 $3,248,445.72 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 3 3 — — $2,209,305.00 $3,004,654.80 $2,945,740.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 4 — — $1,841,332.95 $4,738,363.47 $2,479,661.71 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 4 4 — — $1,749,000.00 $4,500,760.00 $2,355,320.00 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 20 16 — — $237,145.34 $888,350.52 $577,777.44 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 20 16 — — $153,897.78 $576,503.75 $374,954.32 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 20 16 — — $117,249.73 $439,219.50 $285,665.53 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 16 — — $116,561.62 $436,641.84 $277,774.19 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $198,192.56 $198,192.56 $198,192.56 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 20 16 — — $76,067.20 $284,949.06 $185,329.03 2026-04-01
7 MS_DRG Lung Transplant 20 16 — — $71,118.12 $266,409.70 $173,271.15 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 20 16 — — $65,998.24 $247,230.56 $160,797.16 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 20 16 — — $62,230.42 $233,116.20 $151,617.27 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 20 16 — — $62,159.02 $232,848.77 $151,443.34 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 20 16 — — $60,524.71 $226,726.58 $147,461.51 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 20 16 — — $59,716.88 $223,700.46 $145,493.34 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 20 16 — — $56,621.78 $212,106.16 $137,952.48 2026-04-01
215 MS_DRG Other Heart Assist System Implant 23 16 — — $54,680.48 $204,834.01 $135,201.36 2026-04-01
A9699 HCPCS Radiopharm Rx Agent Noc 1 1 — — $123,114.30 $123,114.30 $123,114.30 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 20 16 — — $49,477.68 $185,344.23 $120,546.70 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 16 — — $53,723.83 $201,250.39 $117,413.17 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 20 16 — — $47,555.05 $178,142.02 $115,862.43 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 20 16 — — $46,294.16 $173,418.72 $112,790.42 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 20 16 — — $46,148.63 $172,873.57 $112,435.86 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 4 4 — — $83,176.32 $214,040.40 $112,010.78 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 20 16 — — $43,212.79 $161,875.85 $105,283.01 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 16 — — $41,984.85 $252,519.86 $102,291.29 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 20 16 — — $41,845.91 $156,755.52 $101,952.77 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 16 — — $42,166.63 $159,164.48 $100,485.91 2026-04-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 16 — — $39,642.11 $148,500.03 $96,583.46 2026-04-01
10 MS_DRG Pancreas Transplant 20 16 — — $39,406.52 $147,617.50 $96,009.47 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/Mcc 20 16 — — $39,390.04 $147,555.78 $95,969.32 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 20 16 — — $39,180.81 $146,771.99 $95,459.55 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 22 16 — — $39,157.75 $146,685.59 $95,403.36 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 24 16 — — $37,957.27 $164,923.34 $92,478.54 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 20 16 — — $36,964.93 $138,471.25 $90,060.81 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 21 16 — — $37,771.10 $141,491.20 $90,011.08 2026-04-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 20 16 — — $36,693.09 $137,452.94 $89,398.51 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 20 16 — — $36,109.33 $135,266.15 $87,976.23 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 20 16 — — $35,978.07 $134,774.48 $87,656.46 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 20 16 — — $35,337.20 $132,373.75 $86,095.03 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 21 16 — — $36,109.33 $135,266.15 $86,050.95 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 20 16 — — $33,616.11 $125,926.53 $81,901.80 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 20 16 — — $33,293.75 $124,718.96 $81,116.41 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 20 16 — — $32,995.55 $123,601.91 $80,389.88 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 20 16 — — $32,986.22 $123,566.93 $80,367.13 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/Mcc 20 16 — — $32,563.90 $121,984.96 $79,338.23 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 22 16 — — $32,228.37 $128,109.29 $78,520.73 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 20 16 — — $32,207.50 $120,649.84 $78,469.88 2026-04-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 20 16 — — $31,670.96 $118,639.97 $77,162.67 2026-04-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 20 16 — — $31,340.36 $117,401.55 $76,357.21 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 16 — — $31,299.73 $117,249.32 $76,258.20 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 21 16 — — $31,468.87 $117,882.93 $74,992.44 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 20 16 — — $30,778.57 $115,297.05 $74,988.45 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 20 16 — — $30,330.45 $113,618.38 $73,896.67 2026-04-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 26 16 — — $36,720.00 $137,553.74 $73,711.01 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 20 16 — — $30,148.67 $112,937.45 $73,453.79 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 20 16 — — $30,042.14 $112,538.36 $73,194.22 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 20 16 — — $29,952.07 $112,200.98 $72,974.79 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 21 16 — — $30,567.69 $114,507.09 $72,844.86 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/Mcc 20 16 — — $29,832.35 $111,752.52 $72,683.11 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 22 16 — — $32,747.33 $122,672.06 $71,569.12 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 25 17 — — $29,999.30 $112,377.90 $71,490.35 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 28 16 — — $29,285.93 $115,363.96 $71,351.82 2026-04-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 20 16 — — $29,268.36 $109,639.79 $71,309.01 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 20 16 — — $29,071.76 $108,903.31 $70,830.01 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/Mcc 1 1 — — $70,401.20 $70,401.20 $70,401.20 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 20 16 — — $28,586.30 $107,084.76 $69,647.24 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 20 16 — — $28,536.87 $106,899.61 $69,526.82 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 4 4 — — $51,601.28 $132,787.30 $69,489.73 2026-04-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 22 16 — — $30,874.12 $115,655.00 $67,475.24 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 20 16 — — $27,679.07 $103,686.29 $67,436.90 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 23 16 — — $33,655.10 $126,072.59 $66,903.74 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 20 16 — — $26,915.73 $100,826.80 $65,577.10 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 21 16 — — $27,389.12 $102,600.09 $65,270.10 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 20 16 — — $26,517.58 $99,335.34 $64,607.06 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 20 16 — — $26,383.59 $98,833.39 $64,280.60 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 26 16 — — $4,662.06 $108,543.30 $63,326.15 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 20 16 — — $25,818.50 $96,716.54 $62,903.82 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 16 — — $25,688.90 $96,231.05 $62,588.06 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 20 16 — — $25,464.83 $95,391.71 $62,042.15 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 27 17 — — $24,612.53 $92,198.96 $61,277.90 2026-04-01
245 MS_DRG Aicd Generator Procedures 20 16 — — $25,055.16 $93,857.05 $61,044.02 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 20 16 — — $24,871.18 $93,167.90 $60,595.79 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 27 16 — — $90.00 $94,558.55 $60,154.40 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 23 16 — — $25,178.18 $218,452.19 $60,001.28 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 20 16 — — $24,605.39 $92,172.22 $59,948.21 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 21 16 — — $24,968.94 $93,534.08 $59,502.66 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 22 16 — — $27,028.31 $101,248.52 $59,070.24 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 21 16 — — $24,508.74 $91,810.15 $58,405.97 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 5 5 — — $42,618.41 $154,704.84 $57,961.04 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 20 16 — — $23,575.16 $88,312.94 $57,438.17 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 20 16 — — $23,423.59 $87,745.15 $57,068.88 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 21 16 — — $22,914.51 $85,838.14 $57,050.33 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 21 16 — — $22,806.87 $85,434.93 $56,547.54 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 20 16 — — $23,152.84 $86,730.96 $56,409.26 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 20 16 — — $23,141.32 $86,687.76 $56,381.16 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 20 16 — — $23,046.31 $86,331.87 $56,149.69 2026-04-01
0424T CPT Insj/rplc Nstim Apnea Compl 3 1 — — $54,996.00 $54,996.00 $54,996.00 2026-04-01
0100T CPT Prosth Retina Receive&Gen 4 2 — — $51,942.00 $54,996.00 $54,996.00 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 23 16 — — $23,073.76 $86,434.73 $54,986.34 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 25 16 — — $23,003.48 $86,171.41 $54,818.83 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 22 16 — — $24,979.92 $93,575.22 $54,593.50 2026-04-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 24 16 — — $22,079.23 $82,709.16 $53,793.51 2026-04-01
0571T CPT Insj/rplcmt Icds Ss Eltrd 8 6 — — $23,285.27 $59,920.75 $53,469.00 2026-04-01
0408T CPT Insj/rplc Cardiac Modulj Sys 8 6 — — $23,285.27 $59,920.75 $53,469.00 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 20 16 — — $21,879.33 $81,960.35 $53,306.49 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 22 17 — — $9,657.84 $90,368.07 $52,722.38 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 20 16 — — $21,482.84 $80,475.06 $52,340.46 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 20 16 — — $21,385.63 $80,110.94 $52,103.64 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 20 16 — — $21,256.57 $79,627.50 $51,789.21 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 20 16 — — $21,204.40 $79,432.07 $51,662.10 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 23 16 — — $25,363.24 $95,011.14 $50,420.16 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 21 16 — — $21,084.14 $78,981.54 $50,244.92 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 20 16 — — $20,575.06 $77,074.53 $50,128.78 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 22 16 — — $20,523.99 $76,883.21 $50,004.35 2026-04-01
L7181 HCPCS Electronic Elbo Simultaneous 4 4 — — $37,003.64 $95,222.69 $49,831.56 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 20 16 — — $20,351.00 $76,235.20 $49,582.88 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/Mcc 20 16 — — $20,171.42 $75,562.50 $49,145.36 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 20 16 — — $20,163.19 $75,531.64 $49,125.29 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 20 16 — — $19,926.50 $74,644.99 $48,548.62 2026-04-01
332 MS_DRG Rectal Resection With Mcc 20 16 — — $19,883.66 $74,484.53 $48,444.26 2026-04-01
265 MS_DRG Aicd Lead Procedures 20 16 — — $19,869.93 $74,433.10 $48,410.81 2026-04-01
L7180 HCPCS Electronic Elbow Sequential 4 4 — — $35,939.99 $92,485.58 $48,399.19 2026-04-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 24 16 — — $23,289.04 $87,241.14 $48,393.56 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 20 16 — — $19,834.78 $74,301.44 $48,325.18 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 20 16 — — $19,805.13 $74,190.36 $48,252.93 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 21 16 — — $19,366.90 $72,548.72 $48,217.83 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 32 16 — — $17,873.56 $109,667.68 $48,006.01 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 20 16 — — $19,675.52 $73,704.86 $47,937.17 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 20 16 — — $19,629.94 $73,534.11 $47,826.11 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 20 16 — — $19,581.07 $73,351.02 $47,707.04 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 20 16 — — $19,564.60 $73,289.31 $47,666.90 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 21 16 — — $19,911.12 $74,587.39 $47,449.54 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 23 16 — — $23,764.62 $89,022.67 $47,242.23 2026-04-01
0414T CPT Rmvl & Rpl Car Modulj Pls Gn 8 6 — — $16,501.00 $54,996.00 $47,202.29 2026-04-01
0409T CPT Insj/rplc Car Modulj Pls Gn 8 6 — — $16,501.00 $54,996.00 $47,202.29 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 20 16 — — $19,327.36 $72,400.60 $47,088.88 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 21 16 — — $19,545.92 $73,219.36 $46,579.25 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 25 16 — — $19,530.00 $73,159.71 $46,541.30 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 20 16 — — $19,063.76 $71,413.15 $46,446.65 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 24 16 — — $7,249.09 $101,777.22 $46,305.64 2026-04-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 20 16 — — $18,883.63 $70,738.40 $46,007.80 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 24 16 — — $17,212.43 $70,182.96 $45,646.54 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 20 16 — — $18,710.64 $70,090.38 $45,586.33 2026-04-01
5465 OTHER Level 5 Neurostimulator And Related Procedures 2 2 — — $30,578.20 $60,388.77 $45,483.49 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 21 16 — — $280.07 $71,067.55 $45,210.35 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 22 16 — — $20,665.12 $77,411.91 $45,163.52 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 24 16 — — $26,144.71 $97,938.51 $44,967.04 2026-04-01
0431T CPT Rmvl/rplc Nstim Apnea Pls Gn 3 1 — — $44,873.00 $44,873.00 $44,873.00 2026-04-01
0268T CPT Implt/rpl Crtd Sns Dev Gen 4 2 — — $43,285.00 $44,873.00 $44,873.00 2026-04-01
0427T CPT Insj/rplc Nstim Apnea Pls Gn 3 1 — — $44,873.00 $44,873.00 $44,873.00 2026-04-01
0266T CPT Implt/rpl Crtd Sns Dev Total 4 2 — — $43,285.00 $44,873.00 $44,873.00 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 22 16 — — $20,526.19 $76,891.44 $44,859.88 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 22 16 — — $20,466.32 $76,667.21 $44,729.06 2026-04-01
64568 HCPCS Inc For Vagus N Elect Impl 11 6 — — $8,923.00 $84,083.89 $44,438.12 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 25 16 — — $5,147.55 $122,268.85 $44,389.98 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 20 16 — — $18,140.61 $67,955.03 $44,197.51 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 20 16 — — $18,079.10 $67,724.62 $44,047.65 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 20 16 — — $17,863.28 $66,916.15 $43,521.83 2026-04-01
652 MS_DRG Kidney Transplant 20 16 — — $17,735.32 $66,436.82 $43,210.08 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 20 16 — — $17,722.14 $66,387.45 $43,177.97 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/Mcc 20 16 — — $17,687.54 $66,257.85 $43,093.68 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 25 17 — — $25,765.78 $96,519.05 $43,059.30 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 20 16 — — $17,630.43 $66,043.90 $42,954.53 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 22 16 — — $19,610.18 $73,460.05 $42,857.94 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 31 16 — — $18,076.90 $67,716.39 $42,672.22 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 20 16 — — $17,449.21 $65,365.03 $42,512.99 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 22 16 — — $17,353.65 $65,007.08 $42,280.18 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 23 16 — — $4,968.27 $79,508.18 $42,193.11 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 20 16 — — $17,255.35 $64,638.84 $42,040.68 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 22 17 — — $17,133.52 $71,742.30 $41,855.77 2026-04-01
665 MS_DRG Prostatectomy With Mcc 20 16 — — $17,140.57 $64,208.89 $41,761.04 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 21 16 — — $17,501.38 $65,560.46 $41,706.96 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 20 16 — — $17,104.88 $64,075.17 $41,674.08 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 22 16 — — $17,074.67 $63,962.03 $41,600.49 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 21 16 — — $17,380.01 $65,105.82 $41,417.74 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 24 16 — — $22,655.85 $84,869.21 $41,280.85 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 22 16 — — $18,827.61 $70,528.56 $41,147.65 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 20 16 — — $16,585.36 $62,129.07 $40,408.35 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 20 16 — — $16,567.24 $62,061.19 $40,364.19 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 22 16 — — $18,345.44 $68,722.36 $40,093.88 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 21 16 — — $16,812.72 $62,980.75 $40,065.85 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 21 16 — — $16,657.31 $62,398.57 $39,695.49 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 21 16 — — $16,587.56 $62,137.30 $39,529.28 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/Mcc 20 16 — — $16,168.00 $60,565.61 $39,391.49 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 24 17 — — $21,554.33 $86,879.08 $39,190.60 2026-04-01
36906 HCPCS Thrmbc/nfs Dialysis Circuit 8 6 — — $13,599.00 $44,873.00 $39,139.88 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 22 16 — — $17,784.75 $66,621.97 $38,868.47 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 20 16 — — $15,936.80 $59,699.54 $38,828.19 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 22 16 — — $17,764.98 $66,547.91 $38,825.27 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 20 16 — — $15,926.92 $59,662.51 $38,804.11 2026-04-01
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 26 16 — — $17,740.27 $66,455.34 $38,771.26 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 20 16 — — $15,856.63 $59,399.19 $38,632.85 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/Mcc 20 16 — — $15,825.87 $59,283.99 $38,557.93 2026-04-01
570 MS_DRG Skin Debridement With Mcc 21 16 — — $16,151.53 $60,503.90 $38,490.18 2026-04-01
33276 HCPCS Insj Phrnc Nrv Stim Sys 8 5 — — $8,923.00 $84,083.89 $38,120.93 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 21 16 — — $15,848.93 $59,370.39 $37,769.08 2026-04-01
800 MS_DRG Splenic Procedures With Cc 20 16 — — $15,428.27 $57,794.58 $37,589.23 2026-04-01
0308T CPT Insj Ocular Telescope Prosth 8 6 — — $12,211.17 $44,873.00 $37,354.21 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 21 16 — — $15,653.98 $58,640.09 $37,304.49 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/Mcc 20 16 — — $15,091.09 $56,531.47 $36,767.71 2026-04-01
263 MS_DRG Vein Ligation And Stripping 22 17 — — $16,790.20 $62,896.40 $36,694.92 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 23 16 — — $15,372.81 $57,586.81 $36,634.44 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 20 16 — — $15,013.10 $56,239.35 $36,577.71 2026-04-01
503 MS_DRG Foot Procedures With Mcc 21 17 — — $12,654.85 $57,418.12 $36,527.13 2026-04-01
849 MS_DRG Radiotherapy 20 16 — — $14,879.66 $55,739.45 $36,252.59 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 20 16 — — $14,861.54 $55,671.57 $36,208.43 2026-04-01
0520T CPT Rmvl&rplcmt Pg Wcs New Eltrd 8 6 — — $7,753.63 $54,996.00 $35,947.33 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 24 16 — — $16,345.38 $61,230.08 $35,722.76 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 20 16 — — $14,607.82 $54,721.15 $35,590.28 2026-04-01
L8701 HCPCS Pow Ue Rom Dev Ewh Uprt Cust 4 4 — — $26,227.60 $67,492.35 $35,319.83 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 21 16 — — $14,813.20 $55,490.54 $35,300.87 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 20 16 — — $14,483.71 $54,256.22 $35,287.90 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 22 16 — — $11,989.84 $60,069.83 $35,045.84 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 22 16 — — $15,993.37 $59,911.43 $34,953.43 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 23 17 — — $17,484.35 $65,496.69 $34,757.54 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 21 16 — — $14,556.75 $54,529.83 $34,689.71 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 20 16 — — $14,237.13 $53,332.55 $34,687.15 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 20 16 — — $14,183.86 $53,133.00 $34,557.36 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 20 16 — — $14,164.10 $53,058.94 $34,509.19 2026-04-01
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/Mcc 20 16 — — $14,164.10 $53,058.94 $34,509.19 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/Mcc 21 16 — — $13,854.92 $51,900.75 $34,494.63 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 24 17 — — $15,762.16 $62,447.30 $34,448.14 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 25 16 — — $17,295.99 $107,461.25 $34,383.09 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/Mcc 20 16 — — $14,100.39 $52,820.31 $34,353.99 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/Mcc 20 16 — — $14,020.22 $52,519.96 $34,158.64 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 21 16 — — $13,628.66 $51,053.18 $33,931.32 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 24 17 — — $15,222.34 $57,023.14 $33,268.35 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 22 16 — — $10,496.09 $56,718.68 $33,090.71 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 20 16 — — $13,422.72 $50,281.74 $32,702.92 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/Mcc 20 16 — — $13,406.80 $50,222.08 $32,664.12 2026-04-01
318 MS_DRG Percutaneous Coronary Atherectomy Without Intraluminal Device 20 16 — — $13,301.90 $49,829.16 $32,408.57 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 24 16 — — $19,156.57 $71,760.82 $32,333.95 2026-04-01
360 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device Without Mcc 22 16 — — $13,258.52 $49,666.64 $32,302.86 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 20 16 — — $13,209.10 $49,481.49 $32,182.44 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 23 16 — — $16,178.98 $60,606.76 $32,162.57 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 21 16 — — $13,482.58 $50,505.97 $32,129.89 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 20 16 — — $13,151.98 $49,267.55 $32,043.29 2026-04-01
5232 OTHER Level 2 Icd And Similar Procedures 9 6 — — $89.47 $65,506.25 $32,000.51 2026-04-01
56 MS_DRG Degenerative Nervous System Disorders With Mcc 23 16 — — $12,757.68 $108,927.90 $31,762.84 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 26 16 — — $17,304.22 $64,821.93 $31,742.89 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 24 16 — — $17,533.78 $65,681.83 $31,553.51 2026-04-01
113 MS_DRG Orbital Procedures With Cc/Mcc 20 16 — — $12,911.44 $48,366.50 $31,457.26 2026-04-01
5094 OTHER Level 4 Breast/Lymphatic Surgery And Related Procedures 10 7 — — $6,178.64 $64,812.39 $31,379.84 2026-04-01
333 MS_DRG Rectal Resection With Cc 20 16 — — $12,862.57 $48,183.41 $31,338.18 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 20 16 — — $12,842.80 $48,109.35 $31,290.01 2026-04-01
35 MS_DRG Carotid Artery Stent Procedures With Cc 21 16 — — $13,127.82 $49,177.03 $31,284.47 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 25 16 — — $10,226.44 $49,092.69 $31,230.82 2026-04-01
709 MS_DRG Penis Procedures With Cc/Mcc 20 16 — — $12,779.65 $47,872.78 $31,136.14 2026-04-01
64582 HCPCS Opn Mpltj Hpglsl Nstm Ary Pg 11 6 — — $8,923.00 $58,906.76 $31,132.07 2026-04-01
63685 HCPCS Insrt/redo Spine N Generator 11 6 — — $8,923.00 $58,906.76 $31,132.07 2026-04-01
61886 HCPCS Implant Neurostim Arrays 11 6 — — $8,923.00 $58,906.76 $31,132.07 2026-04-01
61885 HCPCS Insrt/redo Neurostim 1 Array 11 6 — — $8,923.00 $58,906.76 $31,132.07 2026-04-01
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 21 16 — — $12,441.91 $46,607.61 $30,976.67 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 20 16 — — $12,692.33 $47,545.68 $30,923.40 2026-04-01
64656 HCPCS Revj/rplcmt Bat Mod Sys Pg 4 4 — — $22,891.23 $58,906.76 $30,826.85 2026-04-01
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 4 4 — — $22,891.23 $58,906.76 $30,826.85 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 20 16 — — $12,606.66 $47,224.76 $30,714.68 2026-04-01
793 MS_DRG Full Term Neonate With Major Problems 28 16 — — $3,846.11 $85,776.43 $30,530.71 2026-04-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 20 16 — — $12,529.78 $46,936.76 $30,527.36 2026-04-01
791 MS_DRG Prematurity With Major Problems 25 16 — — $4,763.91 $83,501.18 $30,315.29 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 26 16 — — $13,860.95 $51,923.37 $30,293.05 2026-04-01
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 8 6 — — $26,827.00 $84,083.89 $30,129.04 2026-04-01
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 21 16 — — $12,602.81 $47,210.36 $30,033.36 2026-04-01
655 MS_DRG Major Bladder Procedures Without Cc/Mcc 22 16 — — $11,623.65 $43,542.40 $29,967.85 2026-04-01
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 20 16 — — $12,293.63 $46,052.17 $29,952.03 2026-04-01
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/Mcc 20 16 — — $12,286.49 $46,025.42 $29,934.64 2026-04-01
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 21 16 — — $12,551.74 $47,019.04 $29,911.65 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 22 16 — — $11,679.55 $51,263.02 $29,907.78 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 33 17 — — $14,941.71 $56,856.23 $29,901.75 2026-04-01
L5856 HCPCS Elec Knee-shin Swing/stance 4 4 — — $22,169.84 $57,050.38 $29,855.38 2026-04-01
L6700 HCPCS Ue Add Ext Power Myoel 4 4 — — $22,132.64 $56,954.67 $29,805.29 2026-04-01
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 21 16 — — $12,497.38 $46,815.38 $29,782.09 2026-04-01
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 23 16 — — $12,476.50 $46,737.21 $29,732.36 2026-04-01
L6880 HCPCS Elec Hand Ind Art Digits 4 4 — — $22,065.16 $56,781.01 $29,714.41 2026-04-01
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/Mcc 20 16 — — $12,189.29 $45,661.30 $29,697.82 2026-04-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 20 16 — — $12,139.87 $45,476.15 $29,577.39 2026-04-01
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 22 16 — — $12,125.04 $45,420.61 $29,541.28 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 22 16 — — $13,505.09 $50,590.32 $29,515.32 2026-04-01
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 22 16 — — $12,074.52 $59,948.66 $29,418.18 2026-04-01
141 MS_DRG Major Head And Neck Procedures With Cc 20 16 — — $11,977.86 $44,869.28 $29,182.69 2026-04-01
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 20 16 — — $11,957.00 $44,791.11 $29,131.85 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/Mcc 20 16 — — $11,916.91 $44,640.94 $29,034.18 2026-04-01
33289 HCPCS Tcat Impl Wrls P-art Prs Snr 11 6 — — $8,923.00 $54,996.00 $28,938.39 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/Mcc 21 16 — — $12,055.30 $45,159.35 $28,728.58 2026-04-01
614 MS_DRG Adrenal And Pituitary Procedures With Cc/Mcc 21 16 — — $12,036.62 $45,089.40 $28,684.09 2026-04-01
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/Mcc 20 16 — — $11,756.00 $44,038.18 $28,642.15 2026-04-01
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 21 16 — — $12,015.21 $45,009.17 $28,633.05 2026-04-01
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 21 16 — — $11,495.14 $43,061.02 $28,619.51 2026-04-01
5200 OTHER Implantation Wireless Pa Pressure Monitor 4 4 — — $7,790.71 $28,754.69 $28,583.19 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 21 16 — — $11,985.56 $44,898.08 $28,562.38 2026-04-01
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/Mcc 20 16 — — $11,697.24 $43,818.06 $28,498.99 2026-04-01
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 20 16 — — $11,679.12 $43,750.17 $28,454.83 2026-04-01
595 MS_DRG Major Skin Disorders With Mcc 20 16 — — $11,646.16 $43,626.74 $28,374.55 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 25 16 — — $14,254.16 $53,396.32 $28,336.17 2026-04-01
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 20 16 — — $11,628.04 $43,558.86 $28,330.40 2026-04-01
412 MS_DRG Cholecystectomy With C.d.e. With Cc 20 16 — — $11,546.22 $43,252.34 $28,131.04 2026-04-01
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