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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

WEST ALLIS MEMORIAL HOSPITAL

West Allis, WI · CCN 520139 · Rates published

12,110 distinct procedures filed
18 distinct payers
787,458 rate rows
2025-11-21 last MRF observed
Data quality

718,796 of 787,458 rate rows are consumer-grade (91.3%)

68,662 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 48,258
template filing: same amount across many unrelated codes — excluded 14,728
exceeds 10× this hospital's gross charge — excluded from medians 3,154
placeholder amount (≤ $0.02) — excluded from medians 1,002
percent-of-charges filed in the dollar field — excluded from medians 824
per-diem day rate — not a per-procedure price 696
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11259/391022464_aurora-west-allis-medical-center_standardcharges.csv
Found on page https://www.aurorahealthcare.org/patients-visitors/billing-payment/health-care-costs
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint a571699838d3b60a… · 137,165,528 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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 1 $3,710,000.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,321,781.51 $3,321,781.51 $3,321,781.51 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 1 $3,193,000.00 $3,193,000.00 $3,193,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,403,458.75 $2,403,458.75 $2,403,458.75 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 $620,149.28 $914,761.68 $758,574.12 nat. median
$370,174
outlier · 2.0×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $529,192.86 $1,380,122.16 $724,994.21 nat. median
$753,246
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $527,123.43 $1,345,216.74 $722,159.10 nat. median
$674,867
1.1× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $526,587.59 $1,289,082.32 $692,617.59 nat. median
$625,184
1.1× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $516,485.97 $1,260,225.76 $677,113.10 nat. median
$673,137
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $489,455.96 $1,194,421.85 $641,756.98 nat. median
$634,303
1.0× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $460,530.40 $1,190,845.68 $630,926.65 nat. median
$619,808
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 15 $463,199.53 $683,250.28 $566,591.27 nat. median
$265,286
outlier · 2.1×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 15 $390,097.72 $575,420.24 $477,172.27 nat. median
$206,474
outlier · 2.3×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 15 $352,421.23 $519,844.89 $431,085.92 nat. median
$202,976
outlier · 2.1×
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 15 $232,353.72 $342,737.28 $284,217.89 nat. median
$133,161
outlier · 2.1×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 15 $215,446.00 $317,797.26 $263,536.16 nat. median
$117,357
outlier · 2.2×
7
MS_DRG 		Lung Transplant 15 $214,903.35 $316,996.81 $262,872.38 nat. median
$122,708
outlier · 2.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 $181,207.95 $267,293.84 $221,655.76 nat. median
$108,660
outlier · 2.0×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 15 $179,139.29 $264,242.44 $219,125.35 nat. median
$102,358
outlier · 2.1×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 15 $175,118.73 $258,311.85 $214,207.35 nat. median
$100,136
outlier · 2.1×
215
MS_DRG 		Other Heart Assist System Implant 15 $174,220.89 $256,987.47 $213,109.11 nat. median
$99,019
outlier · 2.2×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $172,257.48 $254,091.30 $210,707.43 nat. median
$98,894
outlier · 2.1×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $158,702.69 $234,097.08 $194,127.05 nat. median
$93,672
outlier · 2.1×
850
MS_DRG 		Acute Leukemia With Other Procedures 15 $151,480.48 $223,443.85 $185,292.76 nat. median
$83,470
outlier · 2.2×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 15 $139,344.81 $205,542.92 $170,448.26 nat. median
$79,312
outlier · 2.1×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 $139,267.52 $205,428.92 $170,353.72 nat. median
$81,118
outlier · 2.1×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 $137,152.83 $202,309.59 $167,767.00 nat. median
$82,711
outlier · 2.0×
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 $132,556.73 $195,530.04 $162,144.99 nat. median
$77,570
outlier · 2.1×
10
MS_DRG 		Pancreas Transplant 15 $131,108.01 $193,393.09 $160,372.91 nat. median
$68,884
outlier · 2.3×
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 15 $130,356.52 $192,284.59 $159,453.67 nat. median
$71,271
outlier · 2.2×
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 15 $128,532.88 $189,594.60 $157,222.98 nat. median
$73,807
outlier · 2.1×
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 $127,235.45 $187,680.80 $155,635.95 nat. median
$74,915
outlier · 2.1×
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 15 $122,741.30 $181,051.64 $150,138.65 nat. median
$72,135
outlier · 2.1×
427
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 $116,796.80 $172,283.09 $142,867.26 nat. median
$68,090
outlier · 2.1×
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 15 $116,209.75 $171,417.15 $142,149.17 nat. median
$68,886
outlier · 2.1×
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 15 $114,392.69 $168,736.86 $139,926.52 nat. median
$66,526
outlier · 2.1×
955
MS_DRG 		Craniotomy For Multiple Significant Trauma 15 $112,284.57 $165,627.24 $137,347.84 nat. median
$64,732
outlier · 2.1×
447
MS_DRG 		Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 15 $110,252.09 $162,629.20 $134,861.69 nat. median
$63,724
outlier · 2.1×
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 15 $109,827.83 $162,003.40 $134,342.73 nat. median
$64,023
outlier · 2.1×
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 15 $109,642.01 $161,729.31 $134,115.44 nat. median
$65,950
outlier · 2.0×
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 15 $106,346.64 $156,868.40 $130,084.49 nat. median
$62,134
outlier · 2.1×
217
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 $106,193.71 $156,642.82 $129,897.43 nat. median
$64,508
outlier · 2.0×
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 15 $103,996.79 $153,402.22 $127,210.13 nat. median
$60,185
outlier · 2.1×
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 15 $101,860.71 $150,251.37 $124,597.26 nat. median
$59,099
outlier · 2.1×
317
MS_DRG 		Concomitant Left Atrial Appendage Closure And Cardiac Ablation 15 $101,729.16 $150,057.32 $124,436.35 nat. median
$60,691
outlier · 2.1×
573
MS_DRG 		Skin Graft For Skin Ulcer Or Cellulitis With Mcc 15 $101,265.44 $149,373.30 $123,869.11 nat. median
$59,793
outlier · 2.1×
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 15 $100,451.46 $148,172.63 $122,873.45 nat. median
$59,898
outlier · 2.1×

Other procedures at this hospital

Browse this hospital's 12,110 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 48 15 — — $463,199.53 $683,250.28 $566,591.27 2025-11-21
10 MS_DRG Pancreas Transplant 48 15 — — $131,108.01 $193,393.09 $160,372.91 2025-11-21
100 MS_DRG Seizures With Mcc 48 15 — — $32,646.27 $48,155.44 $39,933.32 2025-11-21
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 48 15 — — $88,730.18 $130,882.95 $108,535.83 2025-11-21
113 MS_DRG Orbital Procedures With Cc/mcc 48 15 — — $37,107.53 $54,736.09 $45,390.38 2025-11-21
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 48 15 — — $67,481.24 $99,539.35 $82,543.88 2025-11-21
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 48 15 — — $43,576.60 $64,278.40 $53,303.43 2025-11-21
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 48 15 — — $39,648.13 $58,483.64 $48,498.07 2025-11-21
14 MS_DRG Allogeneic Bone Marrow Transplant 48 15 — — $215,446.00 $317,797.26 $263,536.16 2025-11-21
140 MS_DRG Major Head And Neck Procedures With Mcc 48 15 — — $69,544.96 $102,583.48 $85,068.24 2025-11-21
141 MS_DRG Major Head And Neck Procedures With Cc 48 15 — — $35,329.93 $52,114.02 $43,216.01 2025-11-21
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 48 15 — — $54,296.44 $80,090.89 $66,416.07 2025-11-21
146 MS_DRG Ear, Nose, Mouth And Throat Malignancy With Mcc 48 15 — — $37,724.18 $55,645.69 $46,144.68 2025-11-21
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 48 15 — — $99,254.34 $146,406.79 $121,409.11 2025-11-21
163 MS_DRG Major Chest Procedures With Mcc 48 15 — — $75,793.68 $111,800.76 $92,711.75 2025-11-21
164 MS_DRG Major Chest Procedures With Cc 48 15 — — $41,389.55 $61,052.35 $50,628.19 2025-11-21
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 48 15 — — $63,314.33 $93,392.88 $77,446.86 2025-11-21
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 48 15 — — $99,254.34 $146,406.79 $121,409.11 2025-11-21
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 48 15 — — $50,460.06 $74,431.96 $61,723.36 2025-11-21
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 48 15 — — $620,149.28 $914,761.68 $758,574.12 2025-11-21
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 48 15 — — $130,356.52 $192,284.59 $159,453.67 2025-11-21
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 48 15 — — $181,207.95 $267,293.84 $221,655.76 2025-11-21
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 48 15 — — $132,556.73 $195,530.04 $162,144.99 2025-11-21
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 48 15 — — $106,346.64 $156,868.40 $130,084.49 2025-11-21
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 48 15 — — $44,132.41 $65,098.25 $53,983.29 2025-11-21
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 48 15 — — $90,890.92 $134,070.19 $111,178.88 2025-11-21
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 48 15 — — $179,139.29 $264,242.44 $219,125.35 2025-11-21
215 MS_DRG Other Heart Assist System Implant 48 15 — — $174,220.89 $256,987.47 $213,109.11 2025-11-21
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 48 15 — — $158,702.69 $234,097.08 $194,127.05 2025-11-21
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 48 15 — — $106,193.71 $156,642.82 $129,897.43 2025-11-21
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 48 15 — — $97,830.29 $144,306.22 $119,667.20 2025-11-21
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 48 15 — — $127,235.45 $187,680.80 $155,635.95 2025-11-21
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 48 15 — — $58,053.90 $85,633.38 $71,012.23 2025-11-21
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 48 15 — — $87,098.93 $128,476.76 $106,540.48 2025-11-21
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 48 15 — — $75,520.71 $111,398.11 $92,377.85 2025-11-21
228 MS_DRG Other Cardiothoracic Procedures With Mcc 48 15 — — $81,945.39 $120,874.92 $100,236.58 2025-11-21
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 48 15 — — $51,080.00 $75,346.41 $62,481.67 2025-11-21
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 48 15 — — $93,814.66 $138,382.91 $114,755.24 2025-11-21
231 MS_DRG Coronary Bypass With Ptca With Mcc 48 15 — — $139,344.81 $205,542.92 $170,448.26 2025-11-21
232 MS_DRG Coronary Bypass With Ptca Without Mcc 48 15 — — $100,451.46 $148,172.63 $122,873.45 2025-11-21
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 48 15 — — $128,532.88 $189,594.60 $157,222.98 2025-11-21
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 48 15 — — $87,485.37 $129,046.77 $107,013.16 2025-11-21
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 48 15 — — $96,759.78 $142,727.16 $118,357.74 2025-11-21
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 48 15 — — $67,619.37 $99,743.10 $82,712.84 2025-11-21
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 48 15 — — $82,826.78 $122,175.05 $101,314.73 2025-11-21
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 48 15 — — $62,515.15 $92,214.04 $76,469.29 2025-11-21
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 48 15 — — $47,888.22 $70,638.32 $58,577.44 2025-11-21
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 48 15 — — $55,778.05 $82,276.35 $68,228.39 2025-11-21
243 MS_DRG Permanent Cardiac Pacemaker Implant With Cc 48 15 — — $37,045.04 $54,643.92 $45,313.95 2025-11-21
245 MS_DRG Aicd Generator Procedures 48 15 — — $80,358.54 $118,534.22 $98,295.54 2025-11-21
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 48 15 — — $73,542.50 $108,480.11 $89,958.08 2025-11-21
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 48 15 — — $38,028.39 $56,094.43 $46,516.79 2025-11-21
252 MS_DRG Other Vascular Procedures With Mcc 48 15 — — $56,409.50 $83,207.78 $69,000.78 2025-11-21
253 MS_DRG Other Vascular Procedures With Cc 48 15 — — $41,981.53 $61,925.57 $51,352.32 2025-11-21
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 48 15 — — $43,025.73 $63,465.82 $52,629.59 2025-11-21
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 48 15 — — $46,133.64 $68,050.21 $56,431.23 2025-11-21
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 48 15 — — $50,295.62 $74,189.40 $61,522.21 2025-11-21
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 48 15 — — $56,011.55 $82,620.79 $68,514.01 2025-11-21
263 MS_DRG Vein Ligation And Stripping 48 15 — — $44,104.45 $65,057.02 $53,949.10 2025-11-21
264 MS_DRG Other Circulatory System O.r. Procedures 48 15 — — $57,473.42 $84,777.15 $70,302.19 2025-11-21
265 MS_DRG Aicd Lead Procedures 48 15 — — $58,659.04 $86,526.00 $71,752.44 2025-11-21
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 48 15 — — $98,512.72 $145,312.84 $120,501.95 2025-11-21
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 48 15 — — $77,364.09 $114,117.20 $94,632.69 2025-11-21
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 48 15 — — $109,642.01 $161,729.31 $134,115.44 2025-11-21
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 48 15 — — $68,418.55 $100,921.94 $83,690.40 2025-11-21
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 48 15 — — $40,580.50 $59,858.96 $49,638.57 2025-11-21
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 48 15 — — $84,407.05 $124,506.05 $103,247.73 2025-11-21
271 MS_DRG Other Major Cardiovascular Procedures With Cc 48 15 — — $56,639.71 $83,547.37 $69,282.39 2025-11-21
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 48 15 — — $41,146.18 $60,693.36 $50,330.50 2025-11-21
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 48 15 — — $64,300.97 $94,848.24 $78,653.73 2025-11-21
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 48 15 — — $51,321.72 $75,702.98 $62,777.35 2025-11-21
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 48 15 — — $116,209.75 $171,417.15 $142,149.17 2025-11-21
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 48 15 — — $101,860.71 $150,251.37 $124,597.26 2025-11-21
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 48 15 — — $76,495.84 $112,836.49 $93,570.64 2025-11-21
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 48 15 — — $82,274.27 $121,360.04 $100,638.88 2025-11-21
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 48 15 — — $52,693.15 $77,725.93 $64,454.90 2025-11-21
28 MS_DRG Spinal Procedures With Mcc 48 15 — — $99,971.30 $147,464.35 $122,286.11 2025-11-21
286 MS_DRG Circulatory Disorders Except Ami, With Cardiac Catheterization With Mcc 48 15 — — $36,395.51 $53,685.80 $44,519.42 2025-11-21
288 MS_DRG Acute And Subacute Endocarditis With Mcc 48 15 — — $44,916.79 $66,255.26 $54,942.76 2025-11-21
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 48 15 — — $55,197.57 $81,420.12 $67,518.35 2025-11-21
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 48 15 — — $352,421.23 $519,844.89 $431,085.92 2025-11-21
30 MS_DRG Spinal Procedures Without Cc/mcc 48 15 — — $36,594.48 $53,979.30 $44,762.81 2025-11-21
31 MS_DRG Ventricular Shunt Procedures With Mcc 48 15 — — $68,910.23 $101,647.19 $84,291.82 2025-11-21
314 MS_DRG Other Circulatory System Diagnoses With Mcc 48 15 — — $35,412.15 $52,235.30 $43,316.58 2025-11-21
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 48 15 — — $101,729.16 $150,057.32 $124,436.35 2025-11-21
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 48 15 — — $72,235.20 $106,551.76 $88,358.98 2025-11-21
32 MS_DRG Ventricular Shunt Procedures With Cc 48 15 — — $35,117.81 $51,801.11 $42,956.52 2025-11-21
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 48 15 — — $38,064.57 $56,147.79 $46,561.04 2025-11-21
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 48 15 — — $46,812.78 $69,051.98 $57,261.96 2025-11-21
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 48 15 — — $70,041.57 $103,316.01 $85,675.70 2025-11-21
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 48 15 — — $52,540.22 $77,500.35 $64,267.84 2025-11-21
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 48 15 — — $47,064.37 $69,423.10 $57,569.71 2025-11-21
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 48 15 — — $83,519.08 $123,196.22 $102,161.54 2025-11-21
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 48 15 — — $39,927.68 $58,895.99 $48,840.02 2025-11-21
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 48 15 — — $75,509.20 $111,381.13 $92,363.77 2025-11-21
330 MS_DRG Major Small And Large Bowel Procedures With Cc 48 15 — — $38,868.68 $57,333.91 $47,544.65 2025-11-21
332 MS_DRG Rectal Resection With Mcc 48 15 — — $57,039.30 $84,136.79 $69,771.17 2025-11-21
333 MS_DRG Rectal Resection With Cc 48 15 — — $34,948.43 $51,551.28 $42,749.35 2025-11-21
335 MS_DRG Peritoneal Adhesiolysis With Mcc 48 15 — — $59,583.19 $87,889.19 $72,882.88 2025-11-21
336 MS_DRG Peritoneal Adhesiolysis With Cc 48 15 — — $34,734.66 $51,235.95 $42,487.86 2025-11-21
34 MS_DRG Carotid Artery Stent Procedures With Mcc 48 15 — — $63,945.78 $94,324.31 $78,219.26 2025-11-21
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 48 15 — — $44,308.36 $65,357.79 $54,198.53 2025-11-21
347 MS_DRG Anal And Stomal Procedures With Mcc 48 15 — — $38,919.66 $57,409.10 $47,607.00 2025-11-21
35 MS_DRG Carotid Artery Stent Procedures With Cc 48 15 — — $37,406.81 $55,177.55 $45,756.46 2025-11-21
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 48 15 — — $39,773.10 $58,667.99 $48,650.94 2025-11-21
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 48 15 — — $48,230.25 $71,142.85 $58,995.83 2025-11-21
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 48 15 — — $70,145.17 $103,468.82 $85,802.43 2025-11-21
357 MS_DRG Other Digestive System O.r. Procedures With Cc 48 15 — — $37,031.89 $54,624.51 $45,297.85 2025-11-21
37 MS_DRG Extracranial Procedures With Mcc 48 15 — — $54,608.88 $80,551.75 $66,798.24 2025-11-21
374 MS_DRG Digestive Malignancy With Mcc 48 15 — — $34,719.86 $51,214.12 $42,469.76 2025-11-21
397 MS_DRG Appendix Procedures With Mcc 48 15 — — $40,744.94 $60,101.52 $49,839.71 2025-11-21
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And … 48 15 — — $232,353.72 $342,737.28 $284,217.89 2025-11-21
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 48 15 — — $62,028.41 $91,496.06 $75,873.90 2025-11-21
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 48 15 — — $64,332.22 $94,894.32 $78,691.95 2025-11-21
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 48 15 — — $89,269.54 $131,678.55 $109,195.58 2025-11-21
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 48 15 — — $46,181.33 $68,120.55 $56,489.57 2025-11-21
407 MS_DRG Pancreas, Liver And Shunt Procedures Without Cc/mcc 48 15 — — $35,121.10 $51,805.96 $42,960.55 2025-11-21
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 48 15 — — $57,575.38 $84,927.53 $70,426.90 2025-11-21
409 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 48 15 — — $34,474.85 $50,852.70 $42,170.05 2025-11-21
41 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe… 48 15 — — $37,133.84 $54,774.90 $45,422.56 2025-11-21
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 48 15 — — $44,997.36 $66,374.12 $55,041.32 2025-11-21
412 MS_DRG Cholecystectomy With C.d.e. With Cc 48 15 — — $35,052.03 $51,704.09 $42,876.07 2025-11-21
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 48 15 — — $57,616.49 $84,988.17 $70,477.18 2025-11-21
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 48 15 — — $39,079.17 $57,644.38 $47,802.11 2025-11-21
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 48 15 — — $58,039.10 $85,611.55 $70,994.13 2025-11-21
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 48 15 — — $66,884.33 $98,658.85 $81,813.72 2025-11-21
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 48 15 — — $37,546.59 $55,383.72 $45,927.43 2025-11-21
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 48 15 — — $172,257.48 $254,091.30 $210,707.43 2025-11-21
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 48 15 — — $116,796.80 $172,283.09 $142,867.26 2025-11-21
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 48 15 — — $90,509.42 $133,507.45 $110,712.22 2025-11-21
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 48 15 — — $137,152.83 $202,309.59 $167,767.00 2025-11-21
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 48 15 — — $89,956.90 $132,692.45 $110,036.38 2025-11-21
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 48 15 — — $110,252.09 $162,629.20 $134,861.69 2025-11-21
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 48 15 — — $67,149.07 $99,049.38 $82,137.57 2025-11-21
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 48 15 — — $84,688.24 $124,920.83 $103,591.69 2025-11-21
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 48 15 — — $50,746.18 $74,854.02 $62,073.35 2025-11-21
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 48 15 — — $139,267.52 $205,428.92 $170,353.72 2025-11-21
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 48 15 — — $94,378.69 $139,214.89 $115,445.16 2025-11-21
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 48 15 — — $71,005.19 $104,737.41 $86,854.41 2025-11-21
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 48 15 — — $84,391.90 $148,851.80 $109,945.12 2025-11-21
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 48 15 — — $39,382.98 $69,464.33 $51,307.85 2025-11-21
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 48 15 — — $88,814.04 $131,006.66 $108,638.42 2025-11-21
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 48 15 — — $48,486.78 $71,521.24 $59,309.62 2025-11-21
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 48 15 — — $70,060.94 $123,574.62 $91,274.86 2025-11-21
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 48 15 — — $47,103.35 $83,081.65 $61,365.89 2025-11-21
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 48 15 — — $36,075.62 $63,630.76 $46,999.04 2025-11-21
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 48 15 — — $44,951.16 $79,285.59 $58,562.03 2025-11-21
471 MS_DRG Cervical Spinal Fusion With Mcc 48 15 — — $79,873.44 $117,818.67 $97,702.16 2025-11-21
472 MS_DRG Cervical Spinal Fusion With Cc 48 15 — — $47,641.56 $70,274.48 $58,275.73 2025-11-21
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 48 15 — — $38,929.53 $57,423.65 $47,619.07 2025-11-21
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 48 15 — — $73,746.41 $108,780.88 $90,207.50 2025-11-21
475 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Cc 48 15 — — $35,474.64 $52,327.47 $43,393.01 2025-11-21
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 48 15 — — $56,550.92 $83,416.38 $69,173.76 2025-11-21
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 48 15 — — $38,455.94 $56,725.08 $47,039.77 2025-11-21
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 48 15 — — $48,361.80 $71,336.90 $59,156.75 2025-11-21
481 MS_DRG Hip And Femur Procedures Except Major Joint With Cc 48 15 — — $34,119.66 $50,328.77 $41,735.57 2025-11-21
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 48 15 — — $35,042.85 $61,809.14 $47,041.04 2025-11-21
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 48 15 — — $52,938.17 $78,087.34 $64,754.61 2025-11-21
486 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Cc 48 15 — — $34,876.08 $51,444.55 $42,660.84 2025-11-21
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 48 15 — — $58,395.93 $86,137.91 $71,430.61 2025-11-21
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 48 15 — — $39,482.04 $58,238.66 $48,294.92 2025-11-21
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 48 15 — — $57,892.75 $85,395.67 $70,815.11 2025-11-21
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 48 15 — — $41,519.46 $61,243.97 $50,787.10 2025-11-21
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 48 15 — — $175,118.73 $258,311.85 $214,207.35 2025-11-21
500 MS_DRG Soft Tissue Procedures With Mcc 48 15 — — $52,106.10 $76,859.99 $63,736.82 2025-11-21
503 MS_DRG Foot Procedures With Mcc 48 15 — — $43,520.69 $64,195.93 $53,235.04 2025-11-21
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 48 15 — — $46,998.60 $69,326.07 $57,489.26 2025-11-21
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 48 15 — — $50,851.43 $75,009.25 $62,202.08 2025-11-21
516 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 48 15 — — $33,080.39 $48,795.80 $40,464.34 2025-11-21
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 48 15 — — $58,935.30 $86,933.50 $72,090.37 2025-11-21
52 MS_DRG Spinal Disorders And Injuries With Cc/mcc 48 15 — — $33,093.55 $48,815.20 $40,480.43 2025-11-21
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 48 15 — — $40,082.95 $70,698.96 $52,219.76 2025-11-21
539 MS_DRG Osteomyelitis With Mcc 48 15 — — $33,256.35 $49,055.33 $40,679.57 2025-11-21
545 MS_DRG Connective Tissue Disorders With Mcc 48 15 — — $41,552.34 $61,292.49 $50,827.33 2025-11-21
548 MS_DRG Septic Arthritis With Mcc 48 15 — — $33,128.08 $48,866.14 $40,522.67 2025-11-21
56 MS_DRG Degenerative Nervous System Disorders With Mcc 48 15 — — $41,177.42 $60,739.45 $50,368.72 2025-11-21
570 MS_DRG Skin Debridement With Mcc 48 15 — — $49,499.73 $73,015.41 $60,548.67 2025-11-21
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 48 15 — — $101,265.44 $149,373.30 $123,869.11 2025-11-21
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 48 15 — — $56,976.82 $84,044.61 $69,694.73 2025-11-21
575 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis Without Cc/mcc 48 15 — — $32,833.73 $48,431.96 $40,162.62 2025-11-21
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 48 15 — — $88,720.31 $130,868.40 $108,523.76 2025-11-21
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 48 15 — — $43,787.08 $64,588.88 $53,560.90 2025-11-21
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 48 15 — — $53,597.57 $79,060.01 $65,561.20 2025-11-21
584 MS_DRG Breast Biopsy, Local Excision And Other Breast Procedures With Cc/mcc 48 15 — — $33,667.45 $49,661.73 $41,182.43 2025-11-21
592 MS_DRG Skin Ulcers With Mcc 48 15 — — $33,813.80 $49,877.61 $41,361.44 2025-11-21
595 MS_DRG Major Skin Disorders With Mcc 48 15 — — $34,780.70 $51,303.87 $42,544.18 2025-11-21
6 MS_DRG Liver Transplant Without Mcc 48 15 — — $79,740.24 $117,622.20 $97,539.23 2025-11-21
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 48 15 — — $44,454.71 $65,573.67 $54,377.54 2025-11-21
614 MS_DRG Adrenal And Pituitary Procedures With Cc/mcc 48 15 — — $37,475.88 $55,279.42 $45,840.94 2025-11-21
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 48 15 — — $63,556.06 $93,749.44 $77,742.54 2025-11-21
619 MS_DRG O.r. Procedures For Obesity With Mcc 48 15 — — $44,834.57 $66,133.98 $50,332.56 2025-11-21
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 48 15 — — $61,533.45 $90,765.95 $75,268.46 2025-11-21
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 48 15 — — $47,146.59 $69,544.38 $57,670.29 2025-11-21
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 48 15 — — $64,883.09 $95,706.90 $79,365.79 2025-11-21
629 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 48 15 — — $36,984.20 $54,554.17 $45,239.53 2025-11-21
64 MS_DRG Intracranial Hemorrhage Or Cerebral Infarction With Mcc 48 15 — — $32,710.40 $48,250.04 $40,011.76 2025-11-21
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 48 15 — — $75,762.44 $111,754.67 $92,673.54 2025-11-21
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 48 15 — — $57,101.79 $84,228.96 $69,847.61 2025-11-21
652 MS_DRG Kidney Transplant 48 15 — — $50,506.10 $74,499.88 $61,779.68 2025-11-21
653 MS_DRG Major Bladder Procedures With Mcc 48 15 — — $91,668.72 $135,217.50 $112,130.29 2025-11-21
654 MS_DRG Major Bladder Procedures With Cc 48 15 — — $46,406.61 $68,452.86 $56,765.13 2025-11-21
655 MS_DRG Major Bladder Procedures Without Cc/mcc 48 15 — — $34,159.12 $50,386.99 $41,783.85 2025-11-21
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 48 15 — — $53,574.55 $79,026.05 $65,533.04 2025-11-21
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 48 15 — — $42,496.23 $62,684.78 $51,981.90 2025-11-21
662 MS_DRG Minor Bladder Procedures With Mcc 48 15 — — $51,298.70 $75,669.02 $62,749.19 2025-11-21
665 MS_DRG Prostatectomy With Mcc 48 15 — — $56,462.12 $83,285.40 $69,065.15 2025-11-21
668 MS_DRG Transurethral Procedures With Mcc 48 15 — — $47,955.64 $70,737.77 $58,659.92 2025-11-21
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 48 15 — — $68,893.78 $101,622.94 $84,271.71 2025-11-21
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 48 15 — — $37,959.33 $55,992.55 $46,432.32 2025-11-21
7 MS_DRG Lung Transplant 48 15 — — $214,903.35 $316,996.81 $262,872.38 2025-11-21
709 MS_DRG Penis Procedures With Cc/mcc 48 15 — — $36,951.31 $54,505.66 $45,199.29 2025-11-21
715 MS_DRG Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 48 15 — — $37,135.49 $54,777.32 $45,424.57 2025-11-21
734 MS_DRG Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 48 15 — — $34,578.44 $51,005.52 $42,296.77 2025-11-21
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 48 15 — — $64,749.89 $95,510.43 $79,202.86 2025-11-21
737 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Cc 48 15 — — $32,861.69 $48,473.19 $40,196.82 2025-11-21
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 48 15 — — $65,461.92 $96,560.71 $80,073.81 2025-11-21
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 48 15 — — $42,566.94 $62,789.08 $52,068.39 2025-11-21
799 MS_DRG Splenic Procedures With Mcc 48 15 — — $78,187.93 $115,332.43 $95,640.42 2025-11-21
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 48 15 — — $89,473.45 $131,979.32 $109,445.01 2025-11-21
80 MS_DRG Nontraumatic Stupor And Coma With Mcc 48 15 — — $32,687.38 $48,216.08 $39,983.60 2025-11-21
800 MS_DRG Splenic Procedures With Cc 48 15 — — $47,914.53 $70,677.13 $58,609.63 2025-11-21
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 48 15 — — $58,948.45 $86,952.91 $72,106.46 2025-11-21
808 MS_DRG Major Hematological And Immunological Diagnoses Except Sickle Cell Crisis And Co… 48 15 — — $37,661.69 $55,553.52 $46,068.24 2025-11-21
814 MS_DRG Reticuloendothelial And Immunity Disorders With Mcc 48 15 — — $34,376.18 $50,707.17 $42,049.36 2025-11-21
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 48 15 — — $41,687.18 $61,491.39 $50,992.27 2025-11-21
82 MS_DRG Traumatic Stupor And Coma >1 Hour With Mcc 48 15 — — $38,153.37 $56,278.77 $46,669.66 2025-11-21
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 48 15 — — $95,741.90 $141,225.71 $117,112.65 2025-11-21
821 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Cc 48 15 — — $36,709.59 $54,149.09 $44,903.61 2025-11-21
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 48 15 — — $76,949.70 $113,505.95 $94,125.80 2025-11-21
824 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Cc 48 15 — — $36,166.93 $53,348.65 $44,239.83 2025-11-21
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 48 15 — — $78,528.32 $115,834.53 $96,056.79 2025-11-21
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 48 15 — — $38,806.20 $57,241.73 $47,468.21 2025-11-21
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 48 15 — — $50,710.01 $74,800.65 $62,029.10 2025-11-21
834 MS_DRG Acute Leukemia With Mcc 48 15 — — $90,890.92 $134,070.19 $111,178.88 2025-11-21
835 MS_DRG Acute Leukemia With Cc 48 15 — — $35,122.74 $51,808.39 $42,962.56 2025-11-21
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 48 15 — — $82,338.40 $121,454.64 $100,717.32 2025-11-21
838 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis With Cc Or High Dose Che… 48 15 — — $33,351.72 $49,196.02 $40,796.23 2025-11-21
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 48 15 — — $52,439.92 $77,352.38 $64,145.14 2025-11-21
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 48 15 — — $41,994.69 $61,944.97 $51,368.41 2025-11-21
849 MS_DRG Radiotherapy 48 15 — — $43,923.57 $64,790.20 $53,727.84 2025-11-21
85 MS_DRG Traumatic Stupor And Coma <1 Hour With Mcc 48 15 — — $37,262.10 $54,964.10 $45,579.46 2025-11-21
850 MS_DRG Acute Leukemia With Other Procedures 48 15 — — $151,480.48 $223,443.85 $185,292.76 2025-11-21
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 48 15 — — $82,241.38 $121,311.53 $100,598.65 2025-11-21
854 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Cc 48 15 — — $32,856.76 $48,465.91 $40,190.79 2025-11-21
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 48 15 — — $74,188.75 $109,433.37 $90,748.57 2025-11-21
857 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Cc 48 15 — — $35,829.83 $52,851.40 $43,827.49 2025-11-21
867 MS_DRG Other Infectious And Parasitic Diseases Diagnoses With Mcc 48 15 — — $35,260.87 $52,012.14 $43,131.52 2025-11-21
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 48 15 — — $114,392.69 $168,736.86 $139,926.52 2025-11-21
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 48 15 — — $64,618.34 $95,316.38 $79,041.94 2025-11-21
901 MS_DRG Wound Debridements For Injuries With Mcc 48 15 — — $72,855.14 $107,466.21 $89,117.29 2025-11-21
90288 CPT Botulism Ig IV 4 2 — — $48,705.00 $73,057.50 $60,881.25 2025-11-21
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 48 15 — — $63,491.93 $93,654.84 $77,664.10 2025-11-21
906 MS_DRG Hand Procedures For Injuries 48 15 — — $35,889.03 $52,938.72 $43,899.90 2025-11-21
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 48 15 — — $65,507.96 $96,628.63 $80,130.14 2025-11-21
908 MS_DRG Other O.r. Procedures For Injuries With Cc 48 15 — — $33,169.19 $48,926.78 $40,572.96 2025-11-21
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 48 15 — — $390,097.72 $575,420.24 $477,172.27 2025-11-21
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 48 15 — — $109,827.83 $162,003.40 $134,342.73 2025-11-21
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 48 15 — — $52,298.50 $77,143.78 $63,972.15 2025-11-21
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 48 15 — — $71,151.54 $104,953.29 $87,033.43 2025-11-21
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 48 15 — — $35,285.54 $52,048.52 $43,161.69 2025-11-21
935 MS_DRG Non-extensive Burns 48 15 — — $36,117.60 $53,275.88 $44,179.49 2025-11-21
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 48 15 — — $52,193.26 $76,988.54 $63,843.43 2025-11-21
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 48 15 — — $59,999.22 $88,502.87 $73,391.77 2025-11-21
940 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Cc 48 15 — — $34,719.86 $51,214.12 $42,469.76 2025-11-21
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 48 15 — — $39,419.56 $58,146.48 $48,218.48 2025-11-21
955 MS_DRG Craniotomy For Multiple Significant Trauma 48 15 — — $112,284.57 $165,627.24 $137,347.84 2025-11-21
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 48 15 — — $62,855.55 $92,716.13 $76,885.67 2025-11-21
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 48 15 — — $122,741.30 $181,051.64 $150,138.65 2025-11-21
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 48 15 — — $67,581.55 $99,687.31 $82,666.58 2025-11-21
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 48 15 — — $43,476.29 $64,130.44 $53,180.72 2025-11-21
96 MS_DRG Bacterial And Tuberculous Infections Of Nervous System Without Cc/mcc 48 15 — — $39,419.56 $58,146.48 $48,218.48 2025-11-21
963 MS_DRG Other Multiple Significant Trauma With Mcc 48 15 — — $44,673.41 $65,896.28 $54,645.07 2025-11-21
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 48 15 — — $103,996.79 $153,402.22 $127,210.13 2025-11-21
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 48 15 — — $58,945.16 $86,948.06 $72,102.43 2025-11-21
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 48 15 — — $43,630.87 $64,358.44 $53,369.80 2025-11-21
974 MS_DRG HIV With Major Related Condition With Mcc 48 15 — — $49,105.07 $72,433.27 $60,065.92 2025-11-21
98 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 48 15 — — $35,671.97 $52,618.54 $43,634.38 2025-11-21
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 48 15 — — $78,173.13 $115,310.60 $95,622.32 2025-11-21
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 48 15 — — $40,259.85 $59,385.96 $49,246.33 2025-11-21
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 48 15 — — $57,598.40 $84,961.49 $70,455.06 2025-11-21
A9543 HCPCS Y90 Ibritumomab, Rx 16 4 — — $56,824.55 $99,234.09 $59,544.54 2025-11-21
C1767 HCPCS 3000817 - Nrstm Impl Axonics Snm Sys Strl Lf 178 18 $63,461.44 $31,730.72 50% off $30,494.11 $53,942.22 $43,921.56 2025-11-21
C2622 HCPCS 1126517 - Prosthesis Penl Tactra 11mm 16-25cm Malleable Strl Lf 114 18 $57,833.20 $28,916.60 50% off $28,106.94 $49,158.22 $41,929.07 2025-11-21
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2025-11-21
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 1 — — $3,321,781.51 $3,321,781.51 $3,321,781.51 2025-11-21
J1414 HCPCS Inj, Beqvez, Per Tx Dose 8 1 — — $3,710,000.00 $3,710,000.00 $3,710,000.00 2025-11-21
J3392 HCPCS Inj, Exagamglogene Autotem 8 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2025-11-21
J3393 HCPCS Inj, Betibeglogene Autotemce 8 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2025-11-21
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 1 — — $3,193,000.00 $3,193,000.00 $3,193,000.00 2025-11-21
J3399 HCPCS Inj Onase Abepar-xioi Treat 8 1 — — $2,403,458.75 $2,403,458.75 $2,403,458.75 2025-11-21
J7330 HCPCS Cultured Chondrocytes Implnt 8 3 — — $58,238.40 $92,817.45 $72,404.20 2025-11-21
J9029 HCPCS Instill Adstiladrin, Tx Dose 38 12 — — $63,235.61 $154,700.98 $77,382.19 2025-11-21
J9226 HCPCS Supprelin La Implant 40 13 — — $45,212.04 $110,438.78 $54,748.24 2025-11-21
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 30 9 — — $489,455.96 $1,194,421.85 $641,756.98 2025-11-21
Q2042 HCPCS Tisagenlecleucel Car-pos T 30 9 — — $529,192.86 $1,380,122.16 $724,994.21 2025-11-21
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 40 13 — — $55,015.23 $135,509.06 $68,258.98 2025-11-21
Q2053 HCPCS Brexucabtagene Car Pos T 30 9 — — $460,530.40 $1,190,845.68 $630,926.65 2025-11-21
Q2054 HCPCS Lisocabtagene Mara Car Pos T 30 9 — — $516,485.97 $1,260,225.76 $677,113.10 2025-11-21
Q2055 HCPCS Idecabtagene Vicleucel Car 30 9 — — $526,587.59 $1,289,082.32 $692,617.59 2025-11-21
Q2056 HCPCS Ciltacabtagene Car-pos T 30 9 — — $527,123.43 $1,345,216.74 $722,159.10 2025-11-21
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