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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

BAYLOR SCOTT AND WHITE SURGICAL HOSPITAL AT SHERMA

Sherman, TX · CCN 670076 · Rates published

14,071 distinct procedures filed
2 distinct payers
250,722 rate rows
2026-04-01 last MRF observed
Data quality

214,902 of 250,722 rate rows are consumer-grade (85.7%)

35,820 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 35,526
exceeds 10× this hospital's gross charge — excluded from medians 270
placeholder amount (≤ $0.02) — excluded from medians 24
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/USPI/611762781_baylor-scott-&-white-surgical-hospital-at-sherman_standardcharges.json
Found on page https://baylorsherman.com/hospital-pricing-information/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-18
Content fingerprint 038a2a7750cd0973… · 23,814,278 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 2 $3,494,311.16 $4,229,400.00 $3,861,855.58 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $3,193,324.48 $3,193,324.48 $3,193,324.48 nat. median
$3,325,455
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 2 $2,173,075.91 $3,417,016.24 $2,795,046.08 nat. median
$2,468,984
1.1× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $485,270.26 $745,536.97 $615,403.61 nat. median
$674,867
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $463,463.74 $725,180.49 $594,322.11 nat. median
$625,184
1.0× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $453,299.58 $710,187.64 $581,743.61 nat. median
$673,137
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $439,263.27 $674,012.78 $556,638.03 nat. median
$634,303
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $429,757.20 $674,160.00 $551,958.60 nat. median
$619,808
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $495,544.81 $495,544.81 $495,544.81 nat. median
$753,246
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $183,739.04 $319,005.00 $251,372.02 nat. median
$265,286
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $178,722.23 $310,295.00 $244,508.61 nat. median
$206,474
1.2× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $212,967.52 $433,712.00 $240,550.48 nat. median
$370,174
0.6× median
Q0480
HCPCS 		Dme Pos 1 $149,999.94 $149,999.94 $149,999.94 nat. median
$111,989
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 $119,236.99 $250,983.00 $137,028.56 nat. median
$202,976
0.7× median
7
MS_DRG 		Lung Transplant 2 $83,170.96 $144,400.00 $113,785.48 nat. median
$122,708
0.9× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $83,019.76 $144,138.00 $113,578.88 nat. median
$108,660
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $77,709.36 $134,918.00 $106,313.68 nat. median
$117,357
0.9× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $73,029.53 $126,793.00 $99,911.26 nat. median
$102,358
1.0× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $70,177.02 $121,840.00 $96,008.51 nat. median
$100,136
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 $80,907.18 $173,048.00 $93,770.43 nat. median
$133,161
0.7× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 $54,199.04 $94,099.00 $74,149.02 nat. median
$71,271
1.0× median
L7180
HCPCS 		Dme Pos 1 $69,996.44 $69,996.44 $69,996.44 nat. median
$49,027
1.4× median
L7181
HCPCS 		Dme Pos 1 $69,427.70 $69,427.70 $69,427.70 nat. median
$50,598
1.4× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 2 $62,609.10 $74,643.30 $68,626.20 nat. median
$62,507
1.1× median
215
MS_DRG 		Other Heart Assist System Implant 2 $60,706.45 $120,249.00 $67,595.24 nat. median
$99,019
0.7× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 $47,705.46 $82,825.00 $65,265.23 nat. median
$68,886
0.9× median
928
MS_DRG 		Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 $46,918.25 $81,459.00 $64,188.62 nat. median
$64,023
1.0× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $57,399.27 $114,251.00 $64,072.07 nat. median
$93,672
0.7× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 1 $60,724.24 $60,724.24 $60,724.24 nat. median
$69,774
0.9× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 $54,815.04 $99,502.00 $59,531.82 nat. median
$77,570
0.8× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 2 $53,940.08 $104,316.00 $59,332.65 nat. median
$87,428
0.7× median
276
MS_DRG 		Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 $42,107.57 $73,106.00 $57,606.79 nat. median
$59,099
1.0× median
17
MS_DRG 		Autologous Bone Marrow Transplant Without Cc/mcc 2 $41,882.46 $72,716.00 $57,299.23 nat. median
$53,807
1.1× median
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 2 $41,882.46 $72,716.00 $57,299.23 nat. median
$56,918
1.0× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 2 $53,025.03 $60,959.08 $56,992.06 nat. median
$66,682
0.9× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $49,782.69 $99,231.00 $55,610.52 nat. median
$81,118
0.7× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $49,452.73 $95,532.00 $54,366.15 nat. median
$79,312
0.7× median
219
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 $47,891.94 $90,776.00 $52,148.96 nat. median
$74,915
0.7× median
233
MS_DRG 		Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 $45,632.95 $91,817.00 $51,221.97 nat. median
$73,807
0.7× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $45,112.69 $73,120.53 $48,994.58 nat. median
$63,570
0.8× median
8
MS_DRG 		Simultaneous Pancreas And Kidney Transplant 2 $35,676.37 $61,941.00 $48,808.68 nat. median
$53,167
0.9× median
957
MS_DRG 		Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 $43,662.67 $85,141.00 $48,229.48 nat. median
$72,135
0.7× median
J9226
HCPCS 		Supprelin La Implant 2 $42,626.47 $50,952.42 $46,789.44 nat. median
$60,368
0.8× median
969
MS_DRG 		HIV With Extensive O.r. Procedures With Mcc 2 $42,702.86 $80,904.00 $46,488.15 nat. median
$60,185
0.8× median
268
MS_DRG 		Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 $40,777.35 $80,694.00 $45,381.86 nat. median
$65,950
0.7× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $41,769.57 $67,701.86 $45,363.79 nat. median
$54,196
0.8× median
870
MS_DRG 		Septicemia Or Severe Sepsis With Mv >96 Hours 2 $40,011.98 $81,991.00 $45,339.85 nat. median
$66,526
0.7× median
6
MS_DRG 		Liver Transplant Without Mcc 2 $32,796.06 $56,940.00 $44,868.03 nat. median
$46,260
1.0× median
10
MS_DRG 		Pancreas Transplant 2 $32,638.08 $56,666.00 $44,652.04 nat. median
$68,884
0.6× median
207
MS_DRG 		Respiratory System Diagnosis With Ventilator Support >96 Hours 2 $38,686.28 $81,321.00 $44,427.06 nat. median
$62,134
0.7× median

Other procedures at this hospital

Browse this hospital's 14,071 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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 4 2 — — $183,739.04 $319,005.00 $251,372.02 2026-04-01
10 MS_DRG Pancreas Transplant 4 2 — — $32,638.08 $56,666.00 $44,652.04 2026-04-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 24 2 — — $30,433.36 $60,700.00 $34,006.92 2026-04-01
113 MS_DRG Orbital Procedures With Cc/mcc 24 2 — — $13,229.31 $29,516.00 $15,684.07 2026-04-01
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 24 2 — — $23,034.77 $47,146.00 $26,085.83 2026-04-01
13 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 24 2 — — $16,664.34 $31,616.00 $18,154.19 2026-04-01
135 MS_DRG Sinus And Mastoid Procedures With Cc/mcc 24 2 — — $14,439.52 $31,221.00 $16,832.15 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 4 2 — — $77,709.36 $134,918.00 $106,313.68 2026-04-01
140 MS_DRG Major Head And Neck Procedures With Mcc 24 2 — — $24,488.92 $44,476.00 $26,596.16 2026-04-01
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 24 2 — — $18,692.96 $39,149.00 $21,425.17 2026-04-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 4 2 — — $41,882.46 $72,716.00 $57,299.23 2026-04-01
163 MS_DRG Major Chest Procedures With Mcc 24 2 — — $28,539.08 $55,488.00 $31,477.44 2026-04-01
164 MS_DRG Major Chest Procedures With Cc 24 2 — — $15,217.27 $30,023.00 $16,909.70 2026-04-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 24 2 — — $21,598.89 $47,768.00 $25,485.46 2026-04-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 4 2 — — $41,882.46 $72,716.00 $57,299.23 2026-04-01
173 MS_DRG Ultrasound Accelerated And Other Thrombolysis With Principal Diagnosis Pulmonary… 4 2 — — $20,849.69 $36,199.00 $28,524.35 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 2 — — $212,967.52 $433,712.00 $240,550.48 2026-04-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 2 — — $54,199.04 $94,099.00 $74,149.02 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 2 — — $83,019.76 $144,138.00 $113,578.88 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 2 — — $54,815.04 $99,502.00 $59,531.82 2026-04-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 24 2 — — $38,686.28 $81,321.00 $44,427.06 2026-04-01
208 MS_DRG Respiratory System Diagnosis With Ventilator Support <=96 Hours 24 2 — — $15,319.79 $31,829.00 $17,485.43 2026-04-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 24 2 — — $40,001.97 $72,297.00 $43,444.09 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 4 2 — — $73,029.53 $126,793.00 $99,911.26 2026-04-01
215 MS_DRG Other Heart Assist System Implant 24 2 — — $60,706.45 $120,249.00 $67,595.24 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 2 — — $57,399.27 $114,251.00 $64,072.07 2026-04-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 2 — — $37,407.13 $74,932.00 $41,892.59 2026-04-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 24 2 — — $34,990.82 $67,062.00 $38,313.79 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 2 — — $47,891.94 $90,776.00 $52,148.96 2026-04-01
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 24 2 — — $23,573.38 $41,623.68 $27,890.04 2026-04-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 2 — — $32,023.61 $61,739.00 $35,169.82 2026-04-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 24 2 — — $27,878.59 $54,723.00 $30,898.41 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 20 1 — — $45,112.69 $73,120.53 $48,994.58 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 20 1 — — $30,748.58 $49,838.59 $33,394.46 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 20 1 — — $41,769.57 $67,701.86 $45,363.79 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 20 1 — — $29,799.97 $48,301.04 $32,364.22 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 20 1 — — $37,714.10 $61,128.60 $40,959.36 2026-04-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 20 1 — — $29,581.96 $47,947.69 $32,127.46 2026-04-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 24 2 — — $29,037.54 $59,316.00 $32,850.26 2026-04-01
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 24 2 — — $19,448.90 $37,430.00 $21,340.69 2026-04-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 2 — — $33,769.41 $66,733.00 $37,555.95 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 24 2 — — $49,452.73 $95,532.00 $54,366.15 2026-04-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 24 2 — — $34,514.16 $70,027.00 $38,908.94 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 24 2 — — $45,632.95 $91,817.00 $51,221.97 2026-04-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 24 2 — — $30,557.68 $61,190.00 $34,215.46 2026-04-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 24 2 — — $35,293.08 $69,226.00 $39,101.38 2026-04-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 24 2 — — $24,029.93 $47,573.00 $26,749.29 2026-04-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 24 2 — — $27,398.39 $56,586.00 $31,173.98 2026-04-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 2 — — $23,266.33 $44,602.00 $25,478.96 2026-04-01
240 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Cc 24 2 — — $15,992.07 $33,070.00 $18,207.82 2026-04-01
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 24 2 — — $20,465.86 $40,673.00 $22,826.92 2026-04-01
245 MS_DRG Aicd Generator Procedures 24 2 — — $28,729.39 $53,344.00 $31,201.52 2026-04-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 20 1 — — $17,648.90 $28,606.07 $19,167.56 2026-04-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 20 1 — — $17,733.74 $28,743.59 $19,259.71 2026-04-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 24 2 — — $26,752.63 $51,985.00 $29,498.43 2026-04-01
250 MS_DRG Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 24 2 — — $14,256.87 $27,674.00 $15,711.50 2026-04-01
252 MS_DRG Other Vascular Procedures With Mcc 24 2 — — $19,698.72 $39,481.00 $22,066.92 2026-04-01
253 MS_DRG Other Vascular Procedures With Cc 24 2 — — $15,755.21 $30,032.00 $17,204.19 2026-04-01
255 MS_DRG Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 24 2 — — $15,116.52 $32,342.00 $17,522.85 2026-04-01
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 24 2 — — $16,799.86 $31,886.00 $18,305.42 2026-04-01
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 24 2 — — $17,814.46 $34,764.00 $19,685.28 2026-04-01
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 24 2 — — $20,613.75 $39,027.00 $22,432.94 2026-04-01
263 MS_DRG Vein Ligation And Stripping 24 2 — — $16,415.11 $33,258.00 $18,491.78 2026-04-01
264 MS_DRG Other Circulatory System O.r. Procedures 24 2 — — $19,500.75 $38,447.00 $21,661.76 2026-04-01
265 MS_DRG Aicd Lead Procedures 24 2 — — $19,927.33 $41,603.00 $22,802.32 2026-04-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 24 2 — — $38,891.32 $73,529.00 $42,294.43 2026-04-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 24 2 — — $30,406.26 $57,450.00 $33,056.17 2026-04-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 24 2 — — $40,777.35 $80,694.00 $45,381.86 2026-04-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 24 2 — — $25,195.96 $48,955.00 $27,780.48 2026-04-01
27 MS_DRG Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc 24 2 — — $14,702.90 $28,640.00 $16,232.03 2026-04-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 24 2 — — $30,123.44 $59,530.00 $33,501.64 2026-04-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 24 2 — — $20,526.55 $40,686.00 $22,863.61 2026-04-01
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 24 2 — — $15,297.99 $28,718.00 $16,614.36 2026-04-01
27278 CPT Arthrodesis Sacroiliac Jt. Percut. Or Min. Inv. W/image W/intra-articular Implan… 2 1 $43,475.00 $26,085.00 40% off $16,978.66 $16,978.66 $16,978.66 2026-04-01
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 24 2 — — $23,644.60 $45,875.00 $26,051.18 2026-04-01
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 24 2 — — $19,794.17 $38,151.00 $21,735.66 2026-04-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 2 — — $47,705.46 $82,825.00 $65,265.23 2026-04-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 2 — — $42,107.57 $73,106.00 $57,606.79 2026-04-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 4 2 — — $32,426.53 $56,298.00 $44,362.26 2026-04-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 2 — — $30,243.25 $52,508.00 $41,375.62 2026-04-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 2 — — $21,701.31 $37,677.00 $29,689.15 2026-04-01
28 MS_DRG Spinal Procedures With Mcc 24 2 — — $34,630.23 $70,939.00 $39,234.71 2026-04-01
288 MS_DRG Acute And Subacute Endocarditis With Mcc 24 2 — — $15,887.78 $30,525.00 $17,418.22 2026-04-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 24 2 — — $20,136.50 $40,357.00 $22,556.88 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 2 — — $119,236.99 $250,983.00 $137,028.56 2026-04-01
30 MS_DRG Spinal Procedures Without Cc/mcc 24 2 — — $13,794.35 $27,299.00 $15,352.53 2026-04-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 24 2 — — $24,280.93 $48,461.00 $27,141.22 2026-04-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 24 2 — — $25,374.49 $51,348.00 $28,566.65 2026-04-01
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 24 2 — — $14,561.49 $26,204.00 $15,814.49 2026-04-01
321 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A… 4 2 — — $19,491.58 $33,841.00 $26,666.29 2026-04-01
322 MS_DRG Percutaneous Cardiovascular Procedures With Intraluminal Device Without Mcc 4 2 — — $12,363.36 $21,465.00 $16,914.18 2026-04-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 4 2 — — $28,070.81 $48,736.00 $38,403.40 2026-04-01
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 4 2 — — $20,128.26 $34,946.00 $27,537.13 2026-04-01
325 MS_DRG Coronary Intravascular Lithotripsy Without Intraluminal Device 4 2 — — $17,929.38 $31,129.00 $24,529.19 2026-04-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 2 — — $30,159.97 $59,790.00 $33,596.39 2026-04-01
327 MS_DRG Stomach, Esophageal And Duodenal Procedures With Cc 24 2 — — $15,091.18 $29,399.00 $16,661.55 2026-04-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 24 2 — — $27,240.48 $53,172.00 $30,105.08 2026-04-01
330 MS_DRG Major Small And Large Bowel Procedures With Cc 24 2 — — $14,467.22 $27,924.00 $15,897.93 2026-04-01
332 MS_DRG Rectal Resection With Mcc 24 2 — — $23,923.29 $42,704.00 $25,981.86 2026-04-01
33276 CPT Insj Phrnc Nrv Stim Sys 2 1 — — $43,029.75 $43,029.75 $43,029.75 2026-04-01
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 2 1 — — $28,290.59 $28,290.59 $28,290.59 2026-04-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 24 2 — — $21,704.95 $42,085.00 $23,906.26 2026-04-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 20 1 — — $15,652.10 $25,369.58 $16,998.94 2026-04-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 24 2 — — $23,564.46 $45,927.00 $26,022.58 2026-04-01
344 MS_DRG Minor Small And Large Bowel Procedures With Mcc 24 2 — — $15,510.69 $32,260.00 $17,713.17 2026-04-01
347 MS_DRG Anal And Stomal Procedures With Mcc 24 2 — — $14,955.07 $30,008.00 $16,762.92 2026-04-01
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 24 2 — — $13,887.44 $28,253.00 $15,677.69 2026-04-01
353 MS_DRG Hernia Procedures Except Inguinal And Femoral With Mcc 24 2 — — $16,897.08 $34,425.00 $19,089.47 2026-04-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 24 2 — — $24,878.97 $50,369.00 $28,015.51 2026-04-01
37 MS_DRG Extracranial Procedures With Mcc 24 2 — — $19,873.72 $39,738.00 $22,235.86 2026-04-01
397 MS_DRG Appendix Procedures With Mcc 4 2 — — $15,232.82 $26,447.00 $20,839.91 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 24 2 — — $80,907.18 $173,048.00 $93,770.43 2026-04-01
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 24 2 — — $22,321.25 $45,328.00 $25,174.93 2026-04-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 2 — — $32,652.87 $64,807.00 $36,395.01 2026-04-01
406 MS_DRG Pancreas, Liver And Shunt Procedures With Cc 24 2 — — $17,261.79 $33,990.00 $19,162.42 2026-04-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 24 2 — — $21,620.69 $43,818.00 $24,359.54 2026-04-01
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 24 2 — — $19,530.91 $33,909.00 $21,617.10 2026-04-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 24 2 — — $20,826.45 $41,499.00 $23,260.39 2026-04-01
417 MS_DRG Laparoscopic Cholecystectomy Without C.d.e. With Mcc 24 2 — — $14,009.41 $27,285.00 $15,465.24 2026-04-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 24 2 — — $19,214.99 $37,680.00 $21,285.54 2026-04-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 24 2 — — $23,166.75 $46,039.00 $25,838.82 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 24 2 — — $53,940.08 $104,316.00 $59,332.65 2026-04-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 24 2 — — $35,887.58 $72,001.00 $40,223.28 2026-04-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 24 2 — — $28,210.90 $54,217.00 $30,933.08 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 2 — — $49,782.69 $99,231.00 $55,610.52 2026-04-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 2 — — $35,568.83 $71,518.00 $39,911.18 2026-04-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 2 — — $28,358.79 $53,339.00 $30,799.03 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 24 2 — — $39,081.64 $78,075.00 $43,707.07 2026-04-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 24 2 — — $22,189.27 $43,061.00 $24,450.31 2026-04-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 24 2 — — $37,798.36 $80,267.00 $43,641.47 2026-04-01
462 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 24 2 — — $17,591.16 $33,507.00 $19,201.93 2026-04-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 2 — — $30,883.51 $66,673.00 $35,971.54 2026-04-01
464 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 2 — — $17,600.58 $35,332.00 $19,732.88 2026-04-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 24 2 — — $30,904.13 $61,057.00 $34,365.28 2026-04-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 24 2 — — $21,363.80 $41,041.00 $23,420.30 2026-04-01
468 MS_DRG Revision Of Hip Or Knee Replacement Without Cc/mcc 24 2 — — $16,434.56 $31,427.00 $17,974.83 2026-04-01
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 24 2 — — $19,039.41 $39,198.00 $21,627.53 2026-04-01
471 MS_DRG Cervical Spinal Fusion With Mcc 24 2 — — $29,678.00 $57,906.00 $32,792.25 2026-04-01
472 MS_DRG Cervical Spinal Fusion With Cc 24 2 — — $18,094.33 $34,791.00 $19,845.04 2026-04-01
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 24 2 — — $14,936.81 $28,966.00 $16,452.96 2026-04-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 2 — — $24,138.93 $50,653.00 $27,695.36 2026-04-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 24 2 — — $20,049.30 $39,660.00 $22,308.83 2026-04-01
478 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Cc 24 2 — — $13,839.72 $28,061.00 $15,596.51 2026-04-01
480 MS_DRG Hip And Femur Procedures Except Major Joint With Mcc 24 2 — — $17,475.67 $34,714.00 $19,487.06 2026-04-01
483 MS_DRG Major Joint Or Limb Reattachment Procedures Of Upper Extremities 24 2 — — $13,890.98 $29,244.00 $15,965.06 2026-04-01
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 24 2 — — $19,154.89 $38,777.00 $21,568.88 2026-04-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 24 2 — — $20,538.92 $40,756.00 $22,890.33 2026-04-01
493 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Cc 24 2 — — $13,998.21 $28,273.00 $15,743.60 2026-04-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 24 2 — — $21,885.24 $42,158.00 $24,025.19 2026-04-01
498 MS_DRG Local Excision And Removal Of Internal Fixation Devices Of Hip And Femur With Cc… 24 2 — — $15,101.79 $30,737.00 $17,052.43 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 2 — — $70,177.02 $121,840.00 $96,008.51 2026-04-01
500 MS_DRG Soft Tissue Procedures With Mcc 24 2 — — $18,880.91 $38,174.00 $21,246.52 2026-04-01
503 MS_DRG Foot Procedures With Mcc 24 2 — — $14,926.20 $31,571.00 $17,197.46 2026-04-01
510 MS_DRG Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc 24 2 — — $17,016.69 $32,027.00 $18,480.95 2026-04-01
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 24 2 — — $18,370.08 $37,217.00 $20,693.50 2026-04-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 24 2 — — $21,963.61 $42,989.00 $24,307.08 2026-04-01
521 MS_DRG Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc 24 2 — — $17,789.13 $35,248.00 $19,810.85 2026-04-01
545 MS_DRG Connective Tissue Disorders With Mcc 24 2 — — $14,780.67 $29,350.00 $16,478.69 2026-04-01
570 MS_DRG Skin Debridement With Mcc 24 2 — — $17,187.55 $34,400.00 $19,240.08 2026-04-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 24 2 — — $34,588.99 $73,199.00 $39,863.23 2026-04-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 24 2 — — $21,238.30 $40,093.00 $23,079.25 2026-04-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 2 — — $33,283.91 $66,901.00 $37,340.79 2026-04-01
577 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Cc 24 2 — — $15,429.38 $31,185.00 $17,359.50 2026-04-01
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 24 2 — — $18,569.82 $39,344.00 $21,414.57 2026-04-01
6 MS_DRG Liver Transplant Without Mcc 4 2 — — $32,796.06 $56,940.00 $44,868.03 2026-04-01
61 MS_DRG Ischemic Stroke, Precerebral Occlusion Or Transient Ischemia With Thrombolytic A… 24 2 — — $17,278.88 $32,995.00 $18,884.89 2026-04-01
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 24 2 — — $22,180.43 $46,590.00 $25,461.89 2026-04-01
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 2 1 — — $19,930.05 $19,930.05 $19,930.05 2026-04-01
619 MS_DRG O.r. Procedures For Obesity With Mcc 22 1 — — $17,037.90 $27,615.74 $18,503.99 2026-04-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 24 2 — — $21,335.52 $45,035.00 $24,555.24 2026-04-01
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 24 2 — — $16,952.46 $34,388.00 $19,109.03 2026-04-01
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 24 2 — — $21,475.16 $47,259.00 $25,271.47 2026-04-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 2 — — $30,494.80 $52,945.00 $41,719.90 2026-04-01
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 4 2 — — $23,449.30 $40,712.00 $32,080.65 2026-04-01
652 MS_DRG Kidney Transplant 4 2 — — $20,371.00 $35,368.00 $27,869.50 2026-04-01
653 MS_DRG Major Bladder Procedures With Mcc 24 2 — — $32,740.08 $63,729.00 $36,131.82 2026-04-01
654 MS_DRG Major Bladder Procedures With Cc 24 2 — — $16,748.01 $32,226.00 $18,375.24 2026-04-01
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 24 2 — — $19,474.83 $36,936.00 $21,212.38 2026-04-01
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 24 2 — — $15,183.09 $30,477.00 $17,021.67 2026-04-01
662 MS_DRG Minor Bladder Procedures With Mcc 24 2 — — $17,904.02 $35,277.00 $19,881.72 2026-04-01
665 MS_DRG Prostatectomy With Mcc 24 2 — — $18,031.29 $36,365.00 $20,264.08 2026-04-01
668 MS_DRG Transurethral Procedures With Mcc 24 2 — — $16,632.53 $33,173.00 $18,585.44 2026-04-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 24 2 — — $20,586.65 $43,533.00 $23,716.00 2026-04-01
674 MS_DRG Other Kidney And Urinary Tract Procedures With Cc 24 2 — — $13,966.99 $28,043.00 $15,660.53 2026-04-01
7 MS_DRG Lung Transplant 4 2 — — $83,170.96 $144,400.00 $113,785.48 2026-04-01
709 MS_DRG Penis Procedures With Cc/mcc 24 2 — — $14,211.50 $24,957.00 $15,434.39 2026-04-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 24 2 — — $25,130.56 $45,760.00 $27,293.01 2026-04-01
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 24 2 — — $22,992.35 $42,571.00 $24,970.82 2026-04-01
749 MS_DRG Other Female Reproductive System O.r. Procedures With Cc/mcc 24 2 — — $14,884.37 $29,632.00 $16,616.37 2026-04-01
77371 CPT Srs Multisource 22 2 — — $7,094.70 $41,912.17 $28,081.16 2026-04-01
783 MS_DRG Cesarean Section With Sterilization With Mcc 4 2 — — $12,013.49 $20,858.00 $16,435.74 2026-04-01
786 MS_DRG Cesarean Section Without Sterilization With Mcc 4 2 — — $11,862.29 $20,595.00 $16,228.65 2026-04-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 2 — — $0.70 $40,683.01 $20,341.86 2026-04-01
799 MS_DRG Splenic Procedures With Mcc 24 2 — — $30,683.77 $58,326.00 $33,459.09 2026-04-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 2 — — $35,676.37 $61,941.00 $48,808.68 2026-04-01
800 MS_DRG Splenic Procedures With Cc 24 2 — — $15,663.88 $33,170.00 $18,058.42 2026-04-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 24 2 — — $22,460.30 $39,911.00 $24,392.99 2026-04-01
816T CPT Opn Insj/rplcmt Ins Ptn Subq 2 1 — — $19,930.05 $19,930.05 $19,930.05 2026-04-01
817 MS_DRG Other Antepartum Diagnoses With O.r. Procedures With Mcc 24 2 — — $15,289.78 $29,889.59 $20,027.59 2026-04-01
817T CPT Opn Insj/rplcmt Ins Ptn Subf 2 1 — — $19,930.05 $19,930.05 $19,930.05 2026-04-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 2 — — $31,331.30 $71,182.00 $37,513.15 2026-04-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 2 — — $25,491.15 $52,996.00 $29,104.63 2026-04-01
823T CPT Tcat Ins 1chmbr Ldls Pm Ra 2 1 — — $17,752.30 $17,752.30 $17,752.30 2026-04-01
825T CPT Tcat Rmv&rpl1chmb Ldls Pm Ra 2 1 — — $17,752.30 $17,752.30 $17,752.30 2026-04-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 24 2 — — $29,757.77 $51,665.00 $32,903.02 2026-04-01
827 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 24 2 — — $14,345.25 $27,278.00 $15,645.58 2026-04-01
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 24 2 — — $18,646.41 $37,127.00 $20,817.46 2026-04-01
834 MS_DRG Acute Leukemia With Mcc 24 2 — — $32,582.76 $65,911.00 $36,674.93 2026-04-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 24 2 — — $31,711.92 $55,995.00 $34,440.70 2026-04-01
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 24 2 — — $18,306.44 $36,790.00 $20,535.88 2026-04-01
846 MS_DRG Chemotherapy Without Acute Leukemia As Secondary Diagnosis With Mcc 24 2 — — $14,193.83 $28,771.00 $15,993.23 2026-04-01
849 MS_DRG Radiotherapy 24 2 — — $13,780.80 $31,683.00 $16,607.68 2026-04-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 24 2 — — $28,876.69 $58,852.00 $32,629.35 2026-04-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 24 2 — — $25,999.63 $52,131.00 $29,131.57 2026-04-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 24 2 — — $40,011.98 $81,991.00 $45,339.85 2026-04-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 4 2 — — $25,301.02 $43,927.00 $34,614.01 2026-04-01
883 MS_DRG Disorders Of Personality And Impulse Control 4 2 — — $12,715.94 $22,077.00 $17,396.47 2026-04-01
884 MS_DRG Organic Disturbances And Intellectual Disability 4 2 — — $11,912.46 $20,682.00 $16,297.23 2026-04-01
886 MS_DRG Behavioral And Developmental Disorders 4 2 — — $11,402.58 $19,797.00 $15,599.79 2026-04-01
896 MS_DRG Alcohol, Drug Abuse Or Dependence Without Rehabilitation Therapy With Mcc 4 2 — — $12,056.21 $20,932.00 $16,494.10 2026-04-01
901 MS_DRG Wound Debridements For Injuries With Mcc 24 2 — — $25,916.55 $50,947.00 $28,745.40 2026-04-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 24 2 — — $20,927.79 $38,332.00 $22,728.61 2026-04-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 24 2 — — $22,776.70 $43,786.00 $24,978.14 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 2 — — $178,722.23 $310,295.00 $244,508.61 2026-04-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 4 2 — — $46,918.25 $81,459.00 $64,188.62 2026-04-01
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 4 2 — — $21,802.34 $37,853.00 $29,827.67 2026-04-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 4 2 — — $20,558.14 $35,693.00 $28,125.57 2026-04-01
934 MS_DRG Full Thickness Burn Without Skin Graft Or Inhalation Injury 4 2 — — $14,187.96 $24,633.00 $19,410.48 2026-04-01
935 MS_DRG Non-extensive Burns 4 2 — — $13,839.45 $24,028.00 $18,933.72 2026-04-01
93590 CPT Perq Transcath Cls Mitral 4 2 — — $15,975.63 $29,201.92 $22,588.77 2026-04-01
93591 CPT Perq Transcath Cls Aortic 4 2 — — $15,975.63 $29,201.92 $22,588.77 2026-04-01
93653 CPT Compre Ep Eval Tx Svt 4 2 — — $21,638.17 $39,918.19 $30,778.18 2026-04-01
93654 CPT Compre Ep Eval Tx Vt 4 2 — — $21,638.17 $39,918.19 $30,778.18 2026-04-01
93656 CPT Compre Ep Eval Abltj Atr Fib 4 2 — — $21,638.17 $39,918.19 $30,778.18 2026-04-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 24 2 — — $18,248.11 $37,851.00 $20,809.66 2026-04-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 24 2 — — $21,055.06 $42,646.00 $23,715.07 2026-04-01
95 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Cc 24 2 — — $15,064.67 $28,067.00 $16,360.96 2026-04-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 24 2 — — $39,688.51 $71,694.00 $43,103.66 2026-04-01
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 24 2 — — $22,414.35 $45,654.00 $25,319.39 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 2 — — $43,662.67 $85,141.00 $48,229.48 2026-04-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 24 2 — — $24,572.59 $47,615.00 $27,056.17 2026-04-01
959 MS_DRG Other O.r. Procedures For Multiple Significant Trauma Without Cc/mcc 24 2 — — $15,134.78 $29,811.00 $16,803.89 2026-04-01
963 MS_DRG Other Multiple Significant Trauma With Mcc 24 2 — — $16,339.69 $32,188.00 $18,142.67 2026-04-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 24 2 — — $42,702.86 $80,904.00 $46,488.15 2026-04-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 24 2 — — $22,909.27 $42,814.00 $24,880.59 2026-04-01
970 MS_DRG HIV With Extensive O.r. Procedures Without Mcc 24 2 — — $16,302.77 $29,494.22 $19,762.67 2026-04-01
974 MS_DRG HIV With Major Related Condition With Mcc 24 2 — — $16,927.72 $34,333.00 $19,079.67 2026-04-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 2 — — $26,987.72 $55,804.00 $30,725.86 2026-04-01
982 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 24 2 — — $14,778.31 $29,265.00 $16,453.01 2026-04-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 2 — — $19,552.01 $39,751.00 $22,064.89 2026-04-01
A0430 HCPCS Fixed Wing Air Transport 2 1 — — $24,211.32 $24,211.32 $24,211.32 2026-04-01
A0431 HCPCS Rotary Wing Air Transport 2 1 — — $28,149.36 $28,149.36 $28,149.36 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 4 2 — — $62,609.10 $74,643.30 $68,626.20 2026-04-01
A9604 HCPCS Sm 153 Lexidronam 4 2 — — $16,503.97 $19,676.23 $18,090.10 2026-04-01
C2616 HCPCS Brachytx, Non-str,yttrium-90 4 2 — — $16,424.76 $29,936.59 $23,180.67 2026-04-01
C9734 HCPCS U/s Trtmt, Not Leiomyomata 4 2 — — $11,990.65 $22,181.74 $17,086.19 2026-04-01
C9760 HCPCS Non-blind Interatrial Shunt 2 1 — — $26,296.14 $26,296.14 $26,296.14 2026-04-01
C9790 HCPCS Kidney Histotripsy W/image 2 1 — — $16,734.08 $16,734.08 $16,734.08 2026-04-01
C9797 HCPCS Vasc Emb/occ W/prs Cath 2 1 — — $15,975.63 $15,975.63 $15,975.63 2026-04-01
E0766 HCPCS Dme Pos 2 1 — — $22,934.16 $22,934.16 $22,934.16 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 4 2 — — $3,494,311.16 $4,229,400.00 $3,861,855.58 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 1 — — $3,193,324.48 $3,193,324.48 $3,193,324.48 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 4 2 — — $2,173,075.91 $3,417,016.24 $2,795,046.08 2026-04-01
J9029 HCPCS Instill Adstiladrin, Tx Dose 2 1 — — $60,724.24 $60,724.24 $60,724.24 2026-04-01
J9226 HCPCS Supprelin La Implant 4 2 — — $42,626.47 $50,952.42 $46,789.44 2026-04-01
J9266 HCPCS Pegaspargase Injection 4 2 — — $24,652.38 $29,390.86 $27,021.62 2026-04-01
J9600 HCPCS Porfimer Sodium Injection 4 2 — — $22,155.81 $25,638.62 $23,897.22 2026-04-01
L5856 HCPCS Dme Pos 2 1 — — $41,596.01 $41,596.01 $41,596.01 2026-04-01
L5858 HCPCS Dme Pos 2 1 — — $32,203.43 $32,203.43 $32,203.43 2026-04-01
L5859 HCPCS Dme Pos 2 1 — — $25,140.93 $25,140.93 $25,140.93 2026-04-01
L5973 HCPCS Dme Pos 2 1 — — $29,811.35 $29,811.35 $29,811.35 2026-04-01
L5991 HCPCS Dme Pos 2 1 — — $16,453.86 $16,453.86 $16,453.86 2026-04-01
L6880 HCPCS Dme Pos 2 1 — — $41,399.55 $41,399.55 $41,399.55 2026-04-01
L6940 HCPCS Dme Pos 2 1 — — $16,849.55 $16,849.55 $16,849.55 2026-04-01
L6945 HCPCS Dme Pos 2 1 — — $19,060.77 $19,060.77 $19,060.77 2026-04-01
L6950 HCPCS Dme Pos 2 1 — — $17,914.31 $17,914.31 $17,914.31 2026-04-01
L6955 HCPCS Dme Pos 2 1 — — $22,479.93 $22,479.93 $22,479.93 2026-04-01
L6960 HCPCS Dme Pos 2 1 — — $22,166.33 $22,166.33 $22,166.33 2026-04-01
L6965 HCPCS Dme Pos 2 1 — — $32,381.85 $32,381.85 $32,381.85 2026-04-01
L6970 HCPCS Dme Pos 2 1 — — $32,913.95 $32,913.95 $32,913.95 2026-04-01
L6975 HCPCS Dme Pos 2 1 — — $33,090.60 $33,090.60 $33,090.60 2026-04-01
L7180 HCPCS Dme Pos 2 1 — — $69,996.44 $69,996.44 $69,996.44 2026-04-01
L7181 HCPCS Dme Pos 2 1 — — $69,427.70 $69,427.70 $69,427.70 2026-04-01
L7186 HCPCS Dme Pos 2 1 — — $19,579.47 $19,579.47 $19,579.47 2026-04-01
L7190 HCPCS Dme Pos 2 1 — — $17,260.56 $17,260.56 $17,260.56 2026-04-01
L7191 HCPCS Dme Pos 2 1 — — $20,812.37 $20,812.37 $20,812.37 2026-04-01
L8685 HCPCS Implt Nrostm Pls Gen Sng Rec 2 1 — — $18,447.68 $18,447.68 $18,447.68 2026-04-01
L8687 HCPCS Implt Nrostm Pls Gen Dua Rec 2 1 — — $24,007.82 $24,007.82 $24,007.82 2026-04-01
Q0479 HCPCS Dme Pos 2 1 — — $20,748.89 $20,748.89 $20,748.89 2026-04-01
Q0480 HCPCS Dme Pos 2 1 — — $149,999.94 $149,999.94 $149,999.94 2026-04-01
Q0481 HCPCS Dme Pos 2 1 — — $25,178.30 $25,178.30 $25,178.30 2026-04-01
Q0483 HCPCS Dme Pos 2 1 — — $32,488.02 $32,488.02 $32,488.02 2026-04-01
Q0489 HCPCS Dme Pos 2 1 — — $28,165.38 $28,165.38 $28,165.38 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 4 2 — — $439,263.27 $674,012.78 $556,638.03 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 1 — — $495,544.81 $495,544.81 $495,544.81 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 4 2 — — $53,025.03 $60,959.08 $56,992.06 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 4 2 — — $429,757.20 $674,160.00 $551,958.60 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 4 2 — — $453,299.58 $710,187.64 $581,743.61 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 4 2 — — $463,463.74 $725,180.49 $594,322.11 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 4 2 — — $485,270.26 $745,536.97 $615,403.61 2026-04-01
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