FINAL NEW TECHNOLOGY ADD-ON PAYMENTS THRESHOLDS1 FOR APPLICATIONS FOR FY 2027									
MS?DRG	Threshold								
001	"$910,448"								
002	"$414,837"								
003	"$615,713"								
004	"$388,072"								
005	"$362,215"								
006	"$214,859"								
007	"$494,673"								
008	"$245,363"								
010	"$152,606"								
011	"$191,319"								
012	"$167,799"								
013	"$119,624"								
014	"$362,653"								
016	"$190,128"								
017	"$133,316"								
018	"$1,885,660"								
019	"$274,047"								
020	"$270,114"								
021	"$187,469"								
022	"$125,592"								
023	"$202,377"								
024	"$152,296"								
025	"$168,654"								
026	"$126,143"								
027	"$111,432"								
028	"$203,573"								
029	"$131,579"								
030	"$97,242"								
031	"$149,940"								
032	"$96,543"								
033	"$83,392"								
034	"$153,090"								
035	"$105,441"								
036	"$90,635"								
037	"$132,298"								
038	"$84,053"								
039	"$70,076"								
040	"$141,272"								
041	"$103,646"								
042	"$88,255"								
052	"$77,422"								
053	"$54,679"								
054	"$66,780"								
055	"$57,182"								
056	"$74,792"								
057	"$56,822"								
058	"$69,591"								
059	"$60,985"								
060	"$53,361"								
061	"$126,124"								
062	"$99,738"								
063	"$87,543"								
064	"$82,400"								
065	"$60,989"								
066	"$50,225"								
067	"$73,788"								
068	"$57,917"								
069	"$58,123"								
070	"$69,910"								
071	"$56,732"								
072	"$50,828"								
073	"$66,631"								
074	"$55,983"								
075	"$81,363"								
076	"$47,217"								
080	"$73,230"								
081	"$52,493"								
082	"$88,135"								
083	"$67,619"								
084	"$55,507"								
085	"$87,397"								
086	"$66,373"								
087	"$55,152"								
088	"$70,391"								
089	"$63,781"								
090	"$54,528"								
091	"$71,243"								
092	"$56,294"								
093	"$51,565"								
094	"$118,731"								
095	"$103,635"								
096	"$103,635"								
097	"$127,845"								
098	"$91,586"								
099	"$71,256"								
100	"$76,892"								
101	"$53,123"								
102	"$62,462"								
103	"$55,233"								
113	"$99,610"								
114	"$67,397"								
115	"$74,690"								
116	"$77,735"								
117	"$62,285"								
121	"$52,552"								
122	"$35,546"								
123	"$56,134"								
124	"$64,051"								
125	"$48,890"								
135	"$92,478"								
136	"$63,398"								
137	"$65,213"								
138	"$54,917"								
139	"$67,348"								
140	"$161,486"								
141	"$100,354"								
142	"$82,672"								
143	"$128,086"								
144	"$82,207"								
145	"$66,618"								
146	"$77,522"								
147	"$57,813"								
148	"$46,534"								
149	"$51,750"								
150	"$58,985"								
151	"$39,131"								
152	"$56,625"								
153	"$42,472"								
154	"$66,998"								
155	"$52,232"								
156	"$42,966"								
157	"$69,813"								
158	"$50,818"								
159	"$42,641"								
163	"$162,818"								
164	"$111,396"								
165	"$94,378"								
166	"$128,568"								
167	"$85,365"								
168	"$74,223"								
173	"$133,577"								
175	"$65,068"								
176	"$48,675"								
177	"$67,593"								
178	"$51,907"								
179	"$41,617"								
180	"$75,703"								
181	"$58,265"								
182	"$48,639"								
183	"$69,575"								
184	"$58,824"								
185	"$48,389"								
186	"$68,618"								
187	"$54,974"								
188	"$44,141"								
189	"$59,711"								
190	"$56,122"								
191	"$46,652"								
192	"$36,738"								
193	"$62,111"								
194	"$45,638"								
195	"$36,775"								
196	"$72,014"								
197	"$52,455"								
198	"$43,214"								
199	"$73,421"								
200	"$56,697"								
201	"$40,264"								
202	"$52,620"								
203	"$37,731"								
204	"$50,208"								
205	"$70,801"								
206	"$52,523"								
207	"$213,314"								
208	"$108,084"								
209	"$402,058"								
212	"$416,866"								
213	"$207,071"								
215	"$355,618"								
216	"$367,759"								
217	"$269,365"								
218	"$269,365"								
219	"$288,708"								
220	"$220,566"								
221	"$196,817"								
228	"$190,954"								
229	"$138,573"								
231	"$353,954"								
232	"$271,055"								
233	"$302,555"								
234	"$237,661"								
235	"$231,908"								
236	"$184,585"								
239	"$152,028"								
240	"$103,585"								
241	"$65,903"								
242	"$132,404"								
243	"$103,178"								
244	"$93,231"								
245	"$182,655"								
250	"$114,434"								
251	"$93,654"								
252	"$129,808"								
253	"$113,158"								
254	"$87,013"								
255	"$99,620"								
256	"$73,142"								
257	"$56,254"								
258	"$120,533"								
259	"$102,175"								
260	"$128,084"								
261	"$91,369"								
262	"$84,480"								
263	"$125,920"								
264	"$109,387"								
265	"$136,680"								
266	"$228,208"								
267	"$188,033"								
268	"$250,960"								
269	"$163,520"								
270	"$190,072"								
271	"$141,835"								
272	"$108,867"								
273	"$171,289"								
274	"$139,576"								
275	"$292,183"								
276	"$236,093"								
277	"$198,429"								
278	"$203,257"								
279	"$150,373"								
280	"$70,499"								
281	"$56,854"								
282	"$51,880"								
283	"$77,790"								
284	"$45,277"								
285	"$35,347"								
286	"$95,735"								
287	"$69,361"								
288	"$93,995"								
289	"$71,416"								
290	"$53,674"								
291	"$58,217"								
292	"$44,823"								
293	"$32,842"								
296	"$73,779"								
297	"$42,154"								
298	"$29,629"								
299	"$66,440"								
300	"$53,226"								
301	"$42,205"								
302	"$56,539"								
303	"$41,452"								
304	"$59,034"								
305	"$48,199"								
306	"$62,778"								
307	"$50,626"								
308	"$58,929"								
309	"$42,656"								
310	"$34,363"								
311	"$44,732"								
312	"$52,749"								
313	"$47,239"								
314	"$76,468"								
315	"$52,722"								
316	"$43,013"								
317	"$263,647"								
318	"$121,444"								
319	"$166,680"								
320	"$109,628"								
321	"$140,967"								
322	"$110,462"								
323	"$196,517"								
324	"$158,841"								
325	"$146,289"								
326	"$165,936"								
327	"$106,300"								
328	"$82,789"								
329	"$160,859"								
330	"$106,045"								
331	"$85,124"								
332	"$132,233"								
333	"$102,267"								
334	"$82,086"								
335	"$135,171"								
336	"$97,082"								
337	"$80,725"								
344	"$101,332"								
345	"$73,842"								
346	"$67,158"								
347	"$93,707"								
348	"$68,134"								
349	"$54,372"								
350	"$106,995"								
351	"$81,767"								
352	"$69,873"								
353	"$116,687"								
354	"$84,585"								
355	"$73,857"								
356	"$156,165"								
357	"$103,103"								
358	"$74,555"								
359	"$162,967"								
360	"$128,592"								
368	"$72,143"								
369	"$57,619"								
370	"$45,788"								
371	"$71,119"								
372	"$54,620"								
373	"$41,868"								
374	"$80,496"								
375	"$61,131"								
376	"$54,154"								
377	"$76,988"								
378	"$56,078"								
379	"$39,985"								
380	"$80,835"								
381	"$59,520"								
382	"$49,934"								
383	"$68,528"								
384	"$55,666"								
385	"$68,663"								
386	"$54,400"								
387	"$41,247"								
388	"$64,096"								
389	"$45,738"								
390	"$33,670"								
391	"$61,301"								
392	"$47,541"								
393	"$67,849"								
394	"$52,569"								
395	"$41,084"								
397	"$105,830"								
398	"$81,471"								
399	"$69,889"								
402	"$159,239"								
405	"$188,687"								
406	"$126,019"								
407	"$103,087"								
408	"$134,756"								
409	"$99,918"								
410	"$85,899"								
411	"$135,254"								
412	"$106,186"								
413	"$91,074"								
414	"$133,680"								
415	"$97,421"								
416	"$74,156"								
417	"$111,016"								
418	"$91,498"								
419	"$79,934"								
420	"$126,812"								
421	"$85,212"								
422	"$73,608"								
423	"$152,026"								
424	"$99,034"								
425	"$75,745"								
426	"$357,198"								
427	"$247,609"								
428	"$207,675"								
429	"$324,217"								
430	"$217,810"								
432	"$79,826"								
433	"$57,565"								
434	"$44,192"								
435	"$79,849"								
436	"$60,621"								
437	"$54,018"								
438	"$70,642"								
439	"$50,973"								
440	"$40,317"								
441	"$71,665"								
442	"$52,992"								
443	"$43,280"								
444	"$74,984"								
445	"$61,010"								
446	"$53,930"								
447	"$236,632"								
448	"$161,042"								
450	"$198,482"								
451	"$131,982"								
456	"$295,750"								
457	"$213,551"								
458	"$158,517"								
461	"$205,539"								
462	"$118,547"								
463	"$156,996"								
464	"$110,609"								
465	"$80,881"								
466	"$179,633"								
467	"$134,512"								
468	"$113,147"								
469	"$119,657"								
470	"$90,138"								
471	"$181,395"								
472	"$126,160"								
473	"$109,494"								
474	"$136,297"								
475	"$89,882"								
476	"$62,439"								
477	"$128,085"								
478	"$104,217"								
479	"$88,679"								
480	"$119,224"								
481	"$97,367"								
482	"$81,768"								
483	"$116,772"								
485	"$129,298"								
486	"$94,940"								
487	"$79,347"								
488	"$75,921"								
489	"$65,612"								
492	"$141,107"								
493	"$109,556"								
494	"$92,521"								
495	"$135,673"								
496	"$81,918"								
497	"$63,728"								
498	"$123,464"								
499	"$92,091"								
500	"$113,418"								
501	"$79,813"								
502	"$69,551"								
503	"$106,348"								
504	"$81,519"								
505	"$79,687"								
506	"$63,734"								
507	"$85,477"								
508	"$70,675"								
510	"$123,427"								
511	"$98,001"								
512	"$84,709"								
513	"$73,794"								
514	"$58,968"								
515	"$124,095"								
516	"$95,022"								
517	"$78,726"								
518	"$142,091"								
519	"$93,128"								
520	"$78,774"								
521	"$121,961"								
522	"$101,090"								
533	"$64,390"								
534	"$42,606"								
535	"$59,612"								
536	"$43,955"								
537	"$51,693"								
538	"$40,739"								
539	"$71,273"								
540	"$57,804"								
541	"$41,668"								
542	"$70,614"								
543	"$54,513"								
544	"$42,037"								
545	"$80,524"								
546	"$56,081"								
547	"$47,912"								
548	"$76,508"								
549	"$58,148"								
550	"$49,232"								
551	"$71,630"								
552	"$54,701"								
553	"$58,540"								
554	"$42,570"								
555	"$60,476"								
556	"$46,400"								
557	"$66,493"								
558	"$48,929"								
559	"$68,554"								
560	"$52,650"								
561	"$39,611"								
562	"$63,948"								
563	"$48,824"								
564	"$68,518"								
565	"$54,400"								
566	"$45,053"								
570	"$95,862"								
571	"$71,475"								
572	"$59,162"								
573	"$167,778"								
574	"$113,693"								
575	"$74,150"								
576	"$169,281"								
577	"$106,005"								
578	"$79,076"								
579	"$107,870"								
580	"$76,349"								
581	"$72,619"								
582	"$91,354"								
583	"$83,635"								
584	"$92,827"								
585	"$91,114"								
592	"$67,469"								
593	"$52,641"								
594	"$39,734"								
595	"$70,878"								
596	"$50,903"								
597	"$70,955"								
598	"$56,425"								
599	"$45,676"								
600	"$51,843"								
601	"$32,818"								
602	"$60,989"								
603	"$43,071"								
604	"$68,072"								
605	"$53,188"								
606	"$62,222"								
607	"$45,591"								
614	"$100,161"								
615	"$80,960"								
616	"$118,097"								
617	"$80,975"								
618	"$67,812"								
619	"$107,099"								
620	"$82,057"								
621	"$77,401"								
622	"$109,588"								
623	"$73,020"								
624	"$60,963"								
625	"$122,012"								
626	"$82,326"								
627	"$77,646"								
628	"$125,678"								
629	"$89,223"								
630	"$72,387"								
637	"$63,553"								
638	"$47,637"								
639	"$35,816"								
640	"$59,360"								
641	"$43,430"								
642	"$59,504"								
643	"$68,632"								
644	"$53,569"								
645	"$42,799"								
650	"$194,343"								
651	"$163,627"								
652	"$153,144"								
653	"$182,929"								
654	"$127,208"								
655	"$102,829"								
656	"$129,129"								
657	"$93,646"								
658	"$84,661"								
659	"$98,978"								
660	"$69,777"								
661	"$63,056"								
662	"$114,303"								
663	"$74,002"								
664	"$61,571"								
665	"$120,035"								
666	"$80,434"								
667	"$63,530"								
668	"$112,973"								
669	"$76,140"								
670	"$59,199"								
671	"$81,905"								
672	"$63,993"								
673	"$141,518"								
674	"$93,921"								
675	"$77,038"								
682	"$63,721"								
683	"$48,008"								
684	"$35,289"								
686	"$74,153"								
687	"$54,919"								
688	"$44,831"								
689	"$56,529"								
690	"$44,596"								
693	"$62,951"								
694	"$48,396"								
695	"$55,210"								
696	"$38,148"								
697	"$55,511"								
698	"$67,439"								
699	"$51,839"								
700	"$38,584"								
707	"$100,496"								
708	"$86,470"								
709	"$90,003"								
710	"$68,962"								
711	"$85,273"								
712	"$63,286"								
713	"$73,184"								
714	"$61,180"								
715	"$94,877"								
716	"$77,565"								
717	"$84,735"								
718	"$71,688"								
722	"$73,591"								
723	"$56,565"								
724	"$39,571"								
725	"$56,731"								
726	"$40,071"								
727	"$64,908"								
728	"$44,619"								
729	"$53,334"								
730	"$39,487"								
734	"$102,344"								
735	"$78,416"								
736	"$142,098"								
737	"$101,589"								
738	"$81,781"								
739	"$140,989"								
740	"$93,605"								
741	"$81,816"								
742	"$88,926"								
743	"$70,355"								
744	"$83,406"								
745	"$60,864"								
746	"$77,128"								
747	"$56,131"								
748	"$71,054"								
749	"$107,247"								
750	"$79,622"								
754	"$73,241"								
755	"$56,083"								
756	"$52,585"								
757	"$63,701"								
758	"$52,554"								
759	"$37,863"								
760	"$53,101"								
761	"$38,729"								
768	"$44,661"								
769	"$62,695"								
770	"$56,005"								
776	"$33,211"								
779	"$37,126"								
783	"$73,003"								
784	"$51,820"								
785	"$46,589"								
786	"$65,644"								
787	"$53,076"								
788	"$45,270"								
794	"$31,698"								
796	"$52,498"								
797	"$48,630"								
798	"$46,980"								
799	"$177,124"								
800	"$122,959"								
801	"$88,319"								
802	"$129,424"								
803	"$84,327"								
804	"$74,718"								
805	"$41,470"								
806	"$28,367"								
807	"$25,274"								
808	"$82,668"								
809	"$59,927"								
810	"$54,440"								
811	"$65,580"								
812	"$51,018"								
813	"$65,158"								
814	"$77,321"								
815	"$54,938"								
816	"$43,058"								
817	"$71,121"								
818	"$57,873"								
819	"$50,398"								
820	"$200,658"								
821	"$97,243"								
822	"$71,154"								
823	"$161,414"								
824	"$100,772"								
825	"$74,844"								
826	"$174,166"								
827	"$106,189"								
828	"$86,435"								
829	"$114,786"								
830	"$80,562"								
831	"$51,161"								
832	"$32,435"								
833	"$24,781"								
834	"$149,709"								
835	"$77,397"								
836	"$59,223"								
837	"$125,274"								
838	"$73,567"								
839	"$60,960"								
840	"$102,896"								
841	"$69,750"								
842	"$54,952"								
843	"$78,907"								
844	"$60,308"								
845	"$51,519"								
846	"$84,860"								
847	"$58,765"								
848	"$41,829"								
849	"$93,726"								
850	"$242,777"								
853	"$161,133"								
854	"$89,059"								
855	"$73,606"								
856	"$143,172"								
857	"$86,774"								
858	"$68,170"								
862	"$71,992"								
863	"$50,913"								
864	"$52,104"								
865	"$62,851"								
866	"$47,019"								
867	"$76,374"								
868	"$53,232"								
869	"$41,479"								
870	"$233,247"								
871	"$78,382"								
872	"$55,747"								
876	"$107,174"								
880	"$50,887"								
881	"$36,189"								
882	"$43,358"								
883	"$47,635"								
884	"$58,032"								
885	"$46,655"								
886	"$55,717"								
887	"$54,404"								
894	"$32,719"								
895	"$46,963"								
896	"$69,147"								
897	"$44,114"								
901	"$128,714"								
902	"$79,662"								
903	"$62,597"								
904	"$121,211"								
905	"$71,777"								
906	"$76,895"								
907	"$133,661"								
908	"$85,834"								
909	"$67,848"								
913	"$70,364"								
914	"$52,854"								
915	"$70,242"								
916	"$36,487"								
917	"$65,563"								
918	"$45,630"								
919	"$72,288"								
920	"$52,967"								
921	"$40,347"								
922	"$69,594"								
923	"$51,125"								
927	"$543,543"								
928	"$191,271"								
929	"$108,726"								
933	"$108,395"								
934	"$66,004"								
935	"$64,409"								
939	"$120,644"								
940	"$98,753"								
941	"$89,676"								
945	"$67,495"								
946	"$62,632"								
947	"$56,919"								
948	"$44,128"								
949	"$47,523"								
950	"$29,043"								
951	"$29,601"								
955	"$250,315"								
956	"$135,268"								
957	"$270,653"								
958	"$163,950"								
959	"$112,599"								
963	"$102,401"								
964	"$71,111"								
965	"$54,997"								
969	"$197,482"								
970	"$110,366"								
974	"$98,298"								
975	"$61,450"								
976	"$50,141"								
977	"$58,934"								
981	"$153,743"								
982	"$101,729"								
983	"$82,487"								
987	"$118,407"								
988	"$76,859"								
989	"$65,035"								
1Geometric mean plus the lesser of .75 of the national adjusted operating standardized payment amount (increased to reflect the difference between costs and charges) or .75 of one standard deviation of mean charges by Medicare Severity Diagnosis Related Group (MS-DRG)									
