Price Transparencybeta Hospital negotiated rates

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

BANNER GATEWAY MEDICAL CENTER

Gilbert, AZ · CCN 030122 · Rates published

7,540 distinct procedures filed
31 distinct payers
264,153 rate rows
2026-05-01 last MRF observed
Data quality

259,140 of 264,153 rate rows are consumer-grade (98.1%)

5,013 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
per-diem day rate — not a per-procedure price 3,631
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 996
exceeds 10× this hospital's gross charge — excluded from medians 352
placeholder amount (≤ $0.02) — excluded from medians 34
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://images.pricetransparency.healthcare/public-mrfs/banner/900220728_banner-gateway-medical-center_standardcharges.csv
Found on page https://www.bannerhealth.com/patients/billing/pricing-resources/hospital-price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-16
Content fingerprint 82acef8e7867b0a8… · 127,432,401 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
J9999
HCPCS 		Lifileucel Til/dose 7.5b-72b Snij 13 $4.73 $2,819,628.00 $1,597,789.20 nat. median
$1,829
outlier · 873.6×
Q2057
HCPCS 		Afamitres Tcr-t/dose 2.68b-10b Sniv 28 $80,560.98 $3,980,328.00 $821,342.21 nat. median
$824,563
1.0× median
Q2042
HCPCS 		Tisagenlecl Car-t/<=600m/dose Adult 28 $4.73 $3,185,922.52 $408,858.00 nat. median
$753,246
0.5× median
Q2056
HCPCS 		Ciltacabt Car-t/<=100m/dose 30ml Ij 28 $4.73 $2,858,298.90 $405,756.74 nat. median
$674,867
0.6× median
Q2055
HCPCS 		Idecabt Car-t/<=510m/dose 250ml Ij 28 $4.73 $2,892,555.60 $387,752.24 nat. median
$625,184
0.6× median
Q2054
HCPCS 		Lisocabtag Mar Car-t/<=110m/dose Ij 28 $4.73 $2,909,188.50 $379,082.81 nat. median
$673,137
0.6× median
Q2041
HCPCS 		Axicabtag Cil Car-t/<=200m/dose 28 $4.73 $2,751,670.50 $359,552.00 nat. median
$634,303
0.6× median
Q2053
HCPCS 		Brexucabtag Car-t/<=200m/dose Spij 28 $4.73 $2,529,495.00 $359,552.00 nat. median
$619,808
0.6× median
18
MS_DRG 		Ms-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 $155,615.67 $1,141,377.89 $317,284.93 nat. median
$370,174
0.9× median
Q2058
HCPCS 		Obecabtagn Car-t/10<=400m/inf 1st 28 $40,372.50 $1,437,189.00 $270,375.00 nat. median
$324,450
0.8× median
1
MS_DRG 		Ms-DRG 42.00: Heart Transplant Or Implant Of Heart Assist System With Mcc 21 $237,430.97 $852,513.60 $249,302.52 nat. median
$265,286
0.9× median
14
MS_DRG 		Ms-DRG 42.00: Allogeneic Bone Marrow Transplant 21 $111,377.27 $443,836.00 $231,033.00 nat. median
$117,357
2.0× median
5834
APR_DRG 		Apr-DRG 38.00: Neonate With Ecmo 5 $222,713.21 $222,713.21 $222,713.21 nat. median
$309,665
0.7× median
927
MS_DRG 		Ms-DRG 42.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Ski… 22 $200,237.74 $717,970.54 $215,255.57 nat. median
$206,474
1.0× median
3
MS_DRG 		Ms-DRG 42.00: Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Exce… 21 $181,068.44 $648,627.37 $199,175.28 nat. median
$202,976
1.0× median
5833
APR_DRG 		Apr-DRG 38.00: Neonate With Ecmo 5 $178,924.31 $178,924.31 $178,924.31 nat. median
$244,017
0.7× median
5884
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 $176,411.83 $176,411.83 $176,411.83 nat. median
$246,434
0.7× median
24
APR_DRG 		Apr-DRG 38.00: Heart And/Or Lung Transplant 5 $154,995.95 $154,995.95 $154,995.95 nat. median
$234,729
0.7× median
1614
APR_DRG 		Apr-DRG 38.00: Implantable Heart Assist Systems 5 $136,571.11 $136,571.11 $136,571.11 nat. median
$207,730
0.7× median
4
MS_DRG 		Ms-DRG 42.00: Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face,… 21 $119,979.68 $427,644.45 $131,977.65 nat. median
$133,161
1.0× median
16
MS_DRG 		Ms-DRG 42.00: Autologous Bone Marrow Transplant With Cc/mcc 21 $52,260.48 $443,836.00 $131,869.08 nat. median
$56,918
outlier · 2.3×
17
MS_DRG 		Ms-DRG 42.00: Autologous Bone Marrow Transplant Without Cc/mcc 21 $52,260.48 $443,836.00 $128,480.17 nat. median
$53,807
outlier · 2.4×
8414
APR_DRG 		Apr-DRG 38.00: Extensive Third Degree Burns With Skin Graft 5 $122,931.95 $122,931.95 $122,931.95 nat. median
$160,267
0.8× median
6312193
CDM 		Fix Extrnl Lw/up/pelvic Lvl 34 14 $35,345.42 $183,963.00 $122,642.00 nat. median
$122,642
1.0× median
5832
APR_DRG 		Apr-DRG 38.00: Neonate With Ecmo 5 $121,376.61 $121,376.61 $121,376.61 nat. median
$156,126
0.8× median
5914
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 $120,419.47 $120,419.47 $120,419.47 nat. median
$164,289
0.7× median
6094
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 $117,966.81 $117,966.81 $117,966.81 nat. median
$162,982
0.7× median
74
APR_DRG 		Apr-DRG 38.00: Allogeneic Bone Marrow Transplant 5 $117,548.07 $226,333.00 $117,548.07 nat. median
$187,061
0.6× median
7
MS_DRG 		Ms-DRG 42.00: Lung Transplant 21 $111,101.17 $395,527.23 $116,656.23 nat. median
$122,708
1.0× median
6312185
CDM 		Fix Extrnl Lw/up/pelvic Lvl 33 14 $32,820.79 $170,823.00 $113,882.00 nat. median
$113,882
1.0× median
5883
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 $107,557.98 $107,557.98 $107,557.98 nat. median
$182,665
0.6× median
94
APR_DRG 		Apr-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo) 5 $106,182.10 $106,182.10 $106,182.10 nat. median
$164,834
0.6× median
6314
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 $105,165.14 $105,165.14 $105,165.14 nat. median
$122,924
0.9× median
6310122
CDM 		Fix Extrnl Lw/up/pelvic Lvl 32 14 $30,296.16 $157,683.00 $105,122.00 nat. median
$105,122
1.0× median
6304
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 5 $101,336.60 $101,336.60 $101,336.60 nat. median
$150,721
0.7× median
14
APR_DRG 		Apr-DRG 38.00: Liver Transplant And/Or Intestinal Transplant 5 $100,439.29 $100,439.29 $100,439.29 nat. median
$129,535
0.8× median
5934
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 $100,020.54 $100,020.54 $100,020.54 nat. median
$151,838
0.7× median
212
MS_DRG 		Ms-DRG 42.00: Concomitant Aortic And Mitral Valve Procedures 22 $92,904.89 $329,703.88 $99,872.76 nat. median
$102,358
1.0× median
2
MS_DRG 		Ms-DRG 42.00: Heart Transplant Or Implant Of Heart Assist System Without Mcc 21 $93,957.39 $385,061.63 $98,655.26 nat. median
$108,660
0.9× median
215
MS_DRG 		Ms-DRG 42.00: Other Heart Assist System Implant 22 $90,402.47 $364,666.54 $97,182.65 nat. median
$99,019
1.0× median
6310114
CDM 		Fix Extrnl Lw/up/pelvic Lvl 31 14 $27,771.53 $144,543.00 $96,362.00 nat. median
$94,627
1.0× median
426
MS_DRG 		Ms-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 22 $89,403.52 $317,037.98 $96,108.79 nat. median
$98,894
1.0× median
5831
APR_DRG 		Apr-DRG 38.00: Neonate With Ecmo 5 $95,892.90 $95,892.90 $95,892.90 nat. median
$144,745
0.7× median
5
MS_DRG 		Ms-DRG 42.00: Liver Transplant With Mcc Or Intestinal Transplant 21 $90,859.28 $322,304.09 $95,402.24 nat. median
$100,136
1.0× median
1613
APR_DRG 		Apr-DRG 38.00: Implantable Heart Assist Systems 5 $95,234.87 $95,234.87 $95,234.87 nat. median
$119,796
0.8× median
6034
APR_DRG 		Apr-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant… 5 $93,679.53 $93,679.53 $93,679.53 nat. median
$109,499
0.9× median
44
APR_DRG 		Apr-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 $93,260.78 $93,260.78 $93,260.78 nat. median
$105,658
0.9× median
216
MS_DRG 		Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 22 $82,507.02 $292,090.54 $88,695.04 nat. median
$93,672
0.9× median
6310106
CDM 		Fix Extrnl Lw/up/pelvic Lvl 30 14 $25,246.90 $131,403.00 $87,602.00 nat. median
$86,025
1.0× median
850
MS_DRG 		Ms-DRG 42.00: Acute Leukemia With Other Procedures 22 $78,832.45 $278,798.15 $84,744.89 nat. median
$83,470
1.0× median

Other procedures at this hospital

Browse this hospital's 7,540 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
             
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $44,222.15 $44,222.15 $44,222.15 2026-05-01
012 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $32,803.41 $32,803.41 $32,803.41 2026-05-01
1 MS_DRG Ms-DRG 42.00: Heart Transplant Or Implant Of Heart Assist System With Mcc 39 21 — $399,562.44 $237,430.97 $852,513.60 $249,302.52 2026-05-01
10 MS_DRG Ms-DRG 42.00: Pancreas Transplant 39 21 — — $68,467.21 $241,302.85 $71,890.57 2026-05-01
11 MS_DRG Ms-DRG 42.00: Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Wi… 43 21 — $76,022.88 $46,905.93 $177,983.76 $51,596.52 2026-05-01
11 APR_DRG Apr-DRG 38.00: Liver Transplant And/Or Intestinal Transplant 5 5 — — $39,960.36 $39,960.36 $39,960.36 2026-05-01
12 APR_DRG Apr-DRG 38.00: Liver Transplant And/Or Intestinal Transplant 5 5 — — $39,960.36 $39,960.36 $39,960.36 2026-05-01
12 MS_DRG Ms-DRG 42.00: Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Wi… 43 21 — $59,051.91 $36,094.75 $135,360.54 $39,704.22 2026-05-01
1204 APR_DRG Apr-DRG 38.00: Major Respiratory And Chest Procedures 5 5 — — $32,422.93 $32,422.93 $32,422.93 2026-05-01
13 APR_DRG Apr-DRG 38.00: Liver Transplant And/Or Intestinal Transplant 5 5 — — $47,318.33 $47,318.33 $47,318.33 2026-05-01
14 MS_DRG Ms-DRG 42.00: Allogeneic Bone Marrow Transplant 59 21 — $168,987.24 $111,377.27 $443,836.00 $231,033.00 2026-05-01
14 APR_DRG Apr-DRG 38.00: Liver Transplant And/Or Intestinal Transplant 5 5 — — $100,439.29 $100,439.29 $100,439.29 2026-05-01
140 MS_DRG Ms-DRG 42.00: Major Head And Neck Procedures With Mcc 44 22 — $55,704.89 $37,144.75 $127,996.74 $39,930.60 2026-05-01
16 MS_DRG Ms-DRG 42.00: Autologous Bone Marrow Transplant With Cc/mcc 52 21 — $91,077.06 $52,260.48 $443,836.00 $131,869.08 2026-05-01
1604 APR_DRG Apr-DRG 38.00: Major Cardiothoracic Repair Of Heart Anomaly 5 5 — — $64,546.75 $64,546.75 $64,546.75 2026-05-01
1611 APR_DRG Apr-DRG 38.00: Implantable Heart Assist Systems 5 5 — — $66,700.30 $66,700.30 $66,700.30 2026-05-01
1612 APR_DRG Apr-DRG 38.00: Implantable Heart Assist Systems 5 5 — — $66,700.30 $66,700.30 $66,700.30 2026-05-01
1613 APR_DRG Apr-DRG 38.00: Implantable Heart Assist Systems 5 5 — — $95,234.87 $95,234.87 $95,234.87 2026-05-01
1614 APR_DRG Apr-DRG 38.00: Implantable Heart Assist Systems 5 5 — — $136,571.11 $136,571.11 $136,571.11 2026-05-01
1623 APR_DRG Apr-DRG 38.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $36,550.57 $36,550.57 $36,550.57 2026-05-01
1624 APR_DRG Apr-DRG 38.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 5 5 — — $56,291.47 $56,291.47 $56,291.47 2026-05-01
163 MS_DRG Ms-DRG 42.00: Major Chest Procedures With Mcc 44 22 — $69,505.79 $40,324.00 $139,497.44 $43,348.30 2026-05-01
163 OTHER Major Chest Procedures With Mcc 1 1 — — $36,761.39 $36,761.39 $36,761.39 2026-05-01
1634 APR_DRG Apr-DRG 38.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnos… 5 5 — — $46,839.76 $46,839.76 $46,839.76 2026-05-01
1654 APR_DRG Apr-DRG 38.00: Coronary Bypass With Ami Or Complex Principal Diagnosis 5 5 — — $43,250.51 $43,250.51 $43,250.51 2026-05-01
166 MS_DRG Ms-DRG 42.00: Other Respiratory System O.r. Procedures With Mcc 44 22 — $59,833.37 $33,974.69 $116,529.33 $36,522.79 2026-05-01
1664 APR_DRG Apr-DRG 38.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis 5 5 — — $37,268.42 $37,268.42 $37,268.42 2026-05-01
1674 APR_DRG Apr-DRG 38.00: Other Cardiothoracic And Thoracic Vascular Procedures 5 5 — — $45,344.24 $45,344.24 $45,344.24 2026-05-01
1694 APR_DRG Apr-DRG 38.00: Major Abdominal Vascular Procedures 5 5 — — $36,430.93 $36,430.93 $36,430.93 2026-05-01
17 MS_DRG Ms-DRG 42.00: Autologous Bone Marrow Transplant Without Cc/mcc 51 21 — $91,077.06 $52,260.48 $443,836.00 $128,480.17 2026-05-01
1783 APR_DRG Apr-DRG 38.00: External Heart Assist Systems 5 5 — — $33,200.60 $33,200.60 $33,200.60 2026-05-01
1784 APR_DRG Apr-DRG 38.00: External Heart Assist Systems 5 5 — — $47,318.33 $47,318.33 $47,318.33 2026-05-01
1794 APR_DRG Apr-DRG 38.00: Defibrillator Implants 5 5 — — $37,088.96 $37,088.96 $37,088.96 2026-05-01
18 MS_DRG Ms-DRG 42.00: Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 31 17 — $543,233.29 $155,615.67 $1,141,377.89 $317,284.93 2026-05-01
1834 APR_DRG Apr-DRG 38.00: Percutaneous Structural Cardiac Procedures 5 5 — — $41,695.17 $41,695.17 $41,695.17 2026-05-01
19 MS_DRG Ms-DRG 42.00: Simultaneous Pancreas And Kidney Transplant With Hemodialysis 38 21 — $117,867.90 $68,084.87 $264,309.83 $69,786.99 2026-05-01
2 MS_DRG Ms-DRG 42.00: Heart Transplant Or Implant Of Heart Assist System Without Mcc 39 21 — $180,532.22 $93,957.39 $385,061.63 $98,655.26 2026-05-01
20 MS_DRG Ms-DRG 42.00: Intracranial Vascular Procedures With Principal Diagnosis Hemorrha… 44 22 — $124,620.90 $69,204.29 $288,226.28 $74,394.61 2026-05-01
204 APR_DRG Apr-DRG 38.00: Open Craniotomy For Trauma 5 5 — — $34,217.55 $34,217.55 $34,217.55 2026-05-01
207 MS_DRG Ms-DRG 42.00: Respiratory System Diagnosis With Ventilator Support >96 Hours 44 22 — $101,855.32 $55,868.95 $195,729.81 $60,059.12 2026-05-01
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $51,309.21 $51,309.21 $51,309.21 2026-05-01
21 APR_DRG Apr-DRG 38.00: Heart And/Or Lung Transplant 5 5 — — $52,821.85 $52,821.85 $52,821.85 2026-05-01
21 MS_DRG Ms-DRG 42.00: Intracranial Vascular Procedures With Principal Diagnosis Hemorrha… 44 22 — $90,546.25 $48,005.29 $250,631.18 $51,605.68 2026-05-01
212 MS_DRG Ms-DRG 42.00: Concomitant Aortic And Mitral Valve Procedures 44 22 — $158,813.50 $92,904.89 $329,703.88 $99,872.76 2026-05-01
214 APR_DRG Apr-DRG 38.00: Open Craniotomy Except Trauma 5 5 — — $38,225.56 $38,225.56 $38,225.56 2026-05-01
215 MS_DRG Ms-DRG 42.00: Other Heart Assist System Implant 44 22 — $150,615.53 $90,402.47 $364,666.54 $97,182.65 2026-05-01
216 MS_DRG Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 44 22 — $143,095.81 $82,507.02 $292,090.54 $88,695.04 2026-05-01
217 MS_DRG Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 44 22 — $93,849.03 $55,791.14 $195,448.34 $59,975.47 2026-05-01
218 MS_DRG Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures With Cardi… 44 22 — $83,999.68 $51,535.95 $180,055.56 $55,401.15 2026-05-01
219 MS_DRG Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures Without Ca… 44 22 — $113,695.19 $66,496.91 $234,175.44 $71,484.18 2026-05-01
22 APR_DRG Apr-DRG 38.00: Heart And/Or Lung Transplant 5 5 — — $68,315.47 $68,315.47 $68,315.47 2026-05-01
22 MS_DRG Ms-DRG 42.00: Intracranial Vascular Procedures With Principal Diagnosis Hemorrha… 44 22 — $57,842.85 $31,298.23 $209,739.30 $33,645.60 2026-05-01
220 MS_DRG Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures Without Ca… 44 22 — $77,335.14 $46,075.97 $160,304.63 $49,531.67 2026-05-01
2204 APR_DRG Apr-DRG 38.00: Major Stomach, Esophageal And Duodenal Procedures 5 5 — — $34,097.91 $34,097.91 $34,097.91 2026-05-01
221 MS_DRG Ms-DRG 42.00: Cardiac Valve And Other Major Cardiothoracic Procedures Without Ca… 44 22 — $68,547.39 $40,185.12 $150,439.73 $43,199.00 2026-05-01
224 APR_DRG Apr-DRG 38.00: Ventricular Shunt Procedures 5 5 — — $34,157.73 $34,157.73 $34,157.73 2026-05-01
228 MS_DRG Ms-DRG 42.00: Other Cardiothoracic Procedures With Mcc 44 22 — $74,297.77 $43,453.92 $185,424.53 $46,712.96 2026-05-01
23 APR_DRG Apr-DRG 38.00: Heart And/Or Lung Transplant 5 5 — — $81,476.07 $81,476.07 $81,476.07 2026-05-01
23 MS_DRG Ms-DRG 42.00: Craniotomy With Major Device Implant Or Acute Complex Cns Principa… 44 22 — $83,586.83 $49,492.85 $172,664.85 $53,204.82 2026-05-01
231 MS_DRG Ms-DRG 42.00: Coronary Bypass With Ptca With Mcc 44 22 — $119,651.99 $72,657.98 $256,462.58 $78,107.33 2026-05-01
232 MS_DRG Ms-DRG 42.00: Coronary Bypass With Ptca Without Mcc 44 22 — $87,715.30 $52,869.56 $184,879.81 $56,834.78 2026-05-01
2324 APR_DRG Apr-DRG 38.00: Gastric Fundoplication 5 5 — — $39,481.79 $39,481.79 $39,481.79 2026-05-01
233 MS_DRG Ms-DRG 42.00: Coronary Bypass With Cardiac Catheterization Or Open Ablation With… 44 22 — $115,007.46 $67,157.01 $236,563.35 $72,193.79 2026-05-01
234 MS_DRG Ms-DRG 42.00: Coronary Bypass With Cardiac Catheterization Or Open Ablation With… 44 22 — $76,642.15 $46,272.59 $161,015.85 $49,743.04 2026-05-01
234 APR_DRG Apr-DRG 38.00: Spinal Procedures 5 5 — — $34,636.30 $34,636.30 $34,636.30 2026-05-01
235 MS_DRG Ms-DRG 42.00: Coronary Bypass Without Cardiac Catheterization With Mcc 44 22 — $86,712.67 $50,991.29 $178,085.31 $54,815.63 2026-05-01
236 MS_DRG Ms-DRG 42.00: Coronary Bypass Without Cardiac Catheterization Without Mcc 44 22 — $59,582.71 $36,165.03 $124,452.71 $38,877.40 2026-05-01
239 MS_DRG Ms-DRG 42.00: Amputation For Circulatory System Disorders Except Upper Limb And … 44 22 — $70,877.03 $43,902.36 $152,441.78 $47,195.04 2026-05-01
24 APR_DRG Apr-DRG 38.00: Heart And/Or Lung Transplant 5 5 — — $154,995.95 $154,995.95 $154,995.95 2026-05-01
24 MS_DRG Ms-DRG 42.00: Craniotomy With Major Device Implant Or Acute Complex Cns Principa… 44 22 — $55,867.08 $33,568.08 $125,281.69 $36,085.68 2026-05-01
242 MS_DRG Ms-DRG 42.00: Permanent Cardiac Pacemaker Implant With Mcc 44 22 — $50,942.40 $30,140.32 $102,658.88 $32,400.85 2026-05-01
245 MS_DRG Ms-DRG 42.00: Aicd Generator Procedures 44 22 — $66,807.54 $42,646.55 $147,899.00 $45,845.04 2026-05-01
25 MS_DRG Ms-DRG 42.00: Craniotomy And Endovascular Intracranial Procedures With Mcc 44 22 — $65,111.91 $39,178.64 $167,542.28 $42,117.04 2026-05-01
252 MS_DRG Ms-DRG 42.00: Other Vascular Procedures With Mcc 44 22 — $49,453.21 $30,461.60 $103,821.06 $32,746.22 2026-05-01
2604 APR_DRG Apr-DRG 38.00: Major Pancreas, Liver And Shunt Procedures 5 5 — — $40,199.64 $40,199.64 $40,199.64 2026-05-01
264 MS_DRG Ms-DRG 42.00: Other Circulatory System O.r. Procedures 44 22 — $48,155.69 $31,002.91 $105,779.20 $33,328.13 2026-05-01
265 MS_DRG Ms-DRG 42.00: Aicd Lead Procedures 44 22 — $52,107.22 $31,606.13 $107,961.31 $33,976.59 2026-05-01
266 MS_DRG Ms-DRG 42.00: Endovascular Cardiac Valve Replacement And Supplement Procedures W… 44 22 — $92,094.43 $51,883.15 $225,871.46 $55,774.38 2026-05-01
267 MS_DRG Ms-DRG 42.00: Endovascular Cardiac Valve Replacement And Supplement Procedures W… 44 22 — $71,953.38 $41,123.01 $207,942.60 $44,207.24 2026-05-01
268 MS_DRG Ms-DRG 42.00: Aortic And Heart Assist Procedures Except Pulsation Balloon With M… 44 22 — $101,073.86 $57,545.59 $201,794.91 $61,861.51 2026-05-01
269 MS_DRG Ms-DRG 42.00: Aortic And Heart Assist Procedures Except Pulsation Balloon Withou… 44 22 — $61,322.57 $36,571.64 $125,923.59 $39,314.51 2026-05-01
270 MS_DRG Ms-DRG 42.00: Other Major Cardiovascular Procedures With Mcc 44 22 — $74,563.17 $44,706.38 $155,350.24 $48,059.36 2026-05-01
271 MS_DRG Ms-DRG 42.00: Other Major Cardiovascular Procedures With Cc 44 22 — $50,957.15 $30,578.73 $104,244.77 $32,872.13 2026-05-01
273 MS_DRG Ms-DRG 42.00: Percutaneous And Other Intracardiac Procedures With Mcc 44 22 — $57,459.49 $34,476.67 $118,345.23 $37,062.42 2026-05-01
274 APR_DRG Apr-DRG 38.00: Other Open Craniotomy 5 5 — — $34,995.23 $34,995.23 $34,995.23 2026-05-01
275 MS_DRG Ms-DRG 42.00: Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 44 22 — $103,742.62 $60,887.17 $258,368.85 $65,453.71 2026-05-01
276 MS_DRG Ms-DRG 42.00: Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimu… 44 22 — $91,563.63 $53,586.57 $187,473.52 $57,605.57 2026-05-01
277 MS_DRG Ms-DRG 42.00: Cardiac Defibrillator Implant Without Mcc 44 22 — $70,508.42 $40,681.26 $140,789.75 $43,732.35 2026-05-01
278 MS_DRG Ms-DRG 42.00: Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascul… 44 22 — $65,760.67 $43,621.23 $151,424.87 $45,802.29 2026-05-01
2793750 CDM Fix Extrnl Lw/up/pelvic Lvl 21 25 14 $70,084.00 $12,965.54 82% off $10,099.10 $52,563.00 $35,042.00 2026-05-01
2793768 CDM Fix Extrnl Lw/up/pelvic Lvl 22 25 14 $78,844.00 $14,586.14 82% off $11,361.42 $59,133.00 $39,422.00 2026-05-01
2793776 CDM Fix Extrnl Lw/up/pelvic Lvl 23 25 14 $87,604.00 $16,206.74 82% off $12,623.74 $65,703.00 $43,802.00 2026-05-01
2793784 CDM Fix Extrnl Lw/up/pelvic Lvl 24 25 14 $96,364.00 $17,827.34 82% off $13,886.05 $72,273.00 $48,182.00 2026-05-01
2793792 CDM Fix Extrnl Lw/up/pelvic Lvl 25 25 14 $105,124.00 $19,447.94 82% off $15,148.37 $78,843.00 $52,562.00 2026-05-01
2793800 CDM Fix Extrnl Lw/up/pelvic Lvl 26 25 14 $116,512.00 $21,554.72 82% off $16,789.38 $87,384.00 $58,256.00 2026-05-01
2793818 CDM Fix Extrnl Lw/up/pelvic Lvl 27 25 14 $131,404.00 $24,309.74 82% off $18,935.32 $98,553.00 $65,702.00 2026-05-01
2793826 CDM Fix Extrnl Lw/up/pelvic Lvl 28 25 14 $142,354.00 $26,335.49 82% off $20,513.21 $106,765.50 $71,177.00 2026-05-01
28 MS_DRG Ms-DRG 42.00: Spinal Procedures With Mcc 44 22 — $88,850.63 $52,625.25 $183,996.07 $56,572.15 2026-05-01
3 MS_DRG Ms-DRG 42.00: Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Exce… 43 21 — $314,353.71 $181,068.44 $648,627.37 $199,175.28 2026-05-01
3033 APR_DRG Apr-DRG 38.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $43,549.62 $43,549.62 $43,549.62 2026-05-01
3034 APR_DRG Apr-DRG 38.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back 5 5 — — $56,650.39 $56,650.39 $56,650.39 2026-05-01
3044 APR_DRG Apr-DRG 38.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 5 5 — — $40,558.57 $40,558.57 $40,558.57 2026-05-01
31 MS_DRG Ms-DRG 42.00: Ventricular Shunt Procedures With Mcc 44 22 — $60,703.29 $36,821.80 $126,828.51 $39,583.43 2026-05-01
3124 APR_DRG Apr-DRG 38.00: Skin Graft, Except Hand, For Musculoskeletal And Connective Tissu… 5 5 — — $40,199.64 $40,199.64 $40,199.64 2026-05-01
317 MS_DRG Ms-DRG 42.00: Concomitant Left Atrial Appendage Closure And Cardiac Ablation 44 22 — — $53,519.63 $187,231.40 $57,533.60 2026-05-01
319 MS_DRG Ms-DRG 42.00: Other Endovascular Cardiac Valve Procedures With Mcc 44 22 — $64,315.71 $38,513.51 $152,278.80 $41,402.03 2026-05-01
323 MS_DRG Ms-DRG 42.00: Coronary Intravascular Lithotripsy With Intraluminal Device With M… 44 22 — $61,042.42 $37,397.41 $128,910.74 $40,202.21 2026-05-01
326 MS_DRG Ms-DRG 42.00: Stomach, Esophageal And Duodenal Procedures With Mcc 44 22 — $74,887.55 $44,254.59 $153,715.93 $47,573.68 2026-05-01
329 MS_DRG Ms-DRG 42.00: Major Small And Large Bowel Procedures With Mcc 44 22 — $66,601.11 $40,179.27 $138,973.85 $43,192.71 2026-05-01
332 MS_DRG Ms-DRG 42.00: Rectal Resection With Mcc 44 22 — $53,876.57 $30,782.03 $114,415.07 $33,090.68 2026-05-01
335 MS_DRG Ms-DRG 42.00: Peritoneal Adhesiolysis With Mcc 44 22 — $52,711.75 $32,076.32 $109,662.20 $34,482.04 2026-05-01
34 MS_DRG Ms-DRG 42.00: Carotid Artery Stent Procedures With Mcc 44 22 — $57,518.47 $34,295.96 $117,691.51 $36,868.16 2026-05-01
356 MS_DRG Ms-DRG 42.00: Other Digestive System O.r. Procedures With Mcc 44 22 — $63,091.91 $37,450.12 $129,101.41 $40,258.88 2026-05-01
356 OTHER Other Digestive System O.r. Procedures With Mcc 1 1 — — $34,071.85 $34,071.85 $34,071.85 2026-05-01
3614 APR_DRG Apr-DRG 38.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses 5 5 — — $33,918.45 $33,918.45 $33,918.45 2026-05-01
38240 CPT Transplant Hpc Allogenic/donor 52 28 $14,418.00 $2,350.13 84% off $2,440.42 $104,007.88 $63,035.08 2026-05-01
4 MS_DRG Ms-DRG 42.00: Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face,… 43 21 — $216,744.82 $119,979.68 $427,644.45 $131,977.65 2026-05-01
40 MS_DRG Ms-DRG 42.00: Peripheral, Cranial Nerve And Other Nervous System Procedures With… 44 22 — $56,781.24 $33,320.42 $114,162.61 $35,819.45 2026-05-01
402 MS_DRG Ms-DRG 42.00: Single Level Combined Anterior And Posterior Spinal Fusion Except … 44 22 — — $34,492.56 $145,770.00 $37,079.51 2026-05-01
405 MS_DRG Ms-DRG 42.00: Pancreas, Liver And Shunt Procedures With Mcc 44 22 — $81,168.72 $47,180.35 $179,065.67 $50,718.88 2026-05-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $43,409.99 $43,409.99 $43,409.99 2026-05-01
408 MS_DRG Ms-DRG 42.00: Biliary Tract Procedures Except Only Cholecystectomy With Or Witho… 44 22 — $54,879.20 $31,054.78 $115,490.38 $33,383.89 2026-05-01
41 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $37,627.35 $37,627.35 $37,627.35 2026-05-01
414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $46,605.33 $46,605.33 $46,605.33 2026-05-01
414 MS_DRG Ms-DRG 42.00: Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 44 22 — $51,974.52 $31,075.69 $106,042.51 $33,406.37 2026-05-01
42 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $44,686.21 $44,686.21 $44,686.21 2026-05-01
420 MS_DRG Ms-DRG 42.00: Hepatobiliary Diagnostic Procedures With Mcc 44 22 — $47,197.29 $31,290.72 $116,420.56 $33,637.53 2026-05-01
423 MS_DRG Ms-DRG 42.00: Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 44 22 — $57,665.92 $35,791.05 $123,099.86 $38,475.38 2026-05-01
426 MS_DRG Ms-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 44 22 — — $89,403.52 $317,037.98 $96,108.79 2026-05-01
427 MS_DRG Ms-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 44 22 — — $61,185.85 $214,963.22 $65,774.79 2026-05-01
428 MS_DRG Ms-DRG 42.00: Multiple Level Combined Anterior And Posterior Spinal Fusion Excep… 44 22 — — $47,811.18 $170,063.59 $51,397.02 2026-05-01
429 MS_DRG Ms-DRG 42.00: Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 44 22 — — $71,542.74 $252,428.26 $76,908.45 2026-05-01
43 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $63,769.08 $63,769.08 $63,769.08 2026-05-01
430 MS_DRG Ms-DRG 42.00: Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 44 22 — — $47,530.07 $170,063.59 $51,094.82 2026-05-01
44 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure 5 5 — — $93,260.78 $93,260.78 $93,260.78 2026-05-01
4403 APR_DRG Apr-DRG 38.00: Kidney Transplant 5 5 — — $32,363.11 $32,363.11 $32,363.11 2026-05-01
4404 APR_DRG Apr-DRG 38.00: Kidney Transplant 5 5 — — $49,770.99 $49,770.99 $49,770.99 2026-05-01
4414 APR_DRG Apr-DRG 38.00: Major Bladder Procedures 5 5 — — $33,559.52 $33,559.52 $33,559.52 2026-05-01
447 MS_DRG Ms-DRG 42.00: Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-ma… 44 22 — — $57,855.99 $202,917.75 $62,195.19 2026-05-01
448 MS_DRG Ms-DRG 42.00: Multiple Level Spinal Fusion Except Cervical Without Mcc 44 22 — — $35,925.74 $123,587.13 $38,620.17 2026-05-01
450 MS_DRG Ms-DRG 42.00: Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made… 37 22 — — $44,849.44 $155,867.78 $44,849.44 2026-05-01
456 MS_DRG Ms-DRG 42.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 44 22 — $124,281.77 $72,618.67 $256,320.34 $78,065.07 2026-05-01
457 MS_DRG Ms-DRG 42.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 44 22 — $89,573.11 $49,779.81 $173,702.94 $53,513.29 2026-05-01
458 MS_DRG Ms-DRG 42.00: Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, I… 44 22 — $66,807.54 $37,887.69 $130,684.27 $40,729.26 2026-05-01
461 MS_DRG Ms-DRG 42.00: Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Wi… 44 22 — $100,543.06 $53,103.82 $185,727.23 $57,086.60 2026-05-01
463 MS_DRG Ms-DRG 42.00: Wound Debridement And Skin Graft Except Hand For Musculoskeletal A… 44 22 — $83,513.11 $46,948.60 $163,461.27 $50,469.74 2026-05-01
466 MS_DRG Ms-DRG 42.00: Revision Of Hip Or Knee Replacement With Mcc 44 22 — $76,479.96 $44,385.10 $154,188.07 $47,713.99 2026-05-01
467 MS_DRG Ms-DRG 42.00: Revision Of Hip Or Knee Replacement With Cc 44 22 — $51,399.49 $30,418.09 $103,663.68 $32,699.44 2026-05-01
471 MS_DRG Ms-DRG 42.00: Cervical Spinal Fusion With Mcc 44 22 — $72,528.42 $42,399.74 $147,006.18 $45,579.72 2026-05-01
474 MS_DRG Ms-DRG 42.00: Amputation For Musculoskeletal System And Connective Tissue Disord… 44 22 — $63,445.78 $39,282.38 $135,729.45 $42,228.56 2026-05-01
477 MS_DRG Ms-DRG 42.00: Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 44 22 — $49,674.37 $30,533.55 $104,081.34 $32,823.57 2026-05-01
492 MS_DRG Ms-DRG 42.00: Lower Extremity And Humerus Procedures Except Hip, Foot And Femur … 44 22 — $51,045.62 $31,472.26 $107,477.07 $33,832.68 2026-05-01
495 MS_DRG Ms-DRG 42.00: Local Excision And Removal Of Internal Fixation Devices Except Hip… 44 22 — $52,800.22 $31,216.24 $106,550.96 $33,557.46 2026-05-01
5 MS_DRG Ms-DRG 42.00: Liver Transplant With Mcc Or Intestinal Transplant 39 21 — $152,606.05 $90,859.28 $322,304.09 $95,402.24 2026-05-01
518 MS_DRG Ms-DRG 42.00: Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Dev… 44 22 — $53,847.08 $31,746.68 $108,469.76 $33,334.01 2026-05-01
52 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $33,858.63 $33,858.63 $33,858.63 2026-05-01
53 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $43,011.23 $43,011.23 $43,011.23 2026-05-01
54 APR_DRG Apr-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure 5 5 — — $61,196.78 $61,196.78 $61,196.78 2026-05-01
573 MS_DRG Ms-DRG 42.00: Skin Graft For Skin Ulcer Or Cellulitis With Mcc 44 22 — $91,681.58 $49,692.48 $186,377.92 $55,947.89 2026-05-01
574 MS_DRG Ms-DRG 42.00: Skin Graft For Skin Ulcer Or Cellulitis With Cc 44 22 — $50,219.92 $30,750.24 $104,865.20 $33,056.51 2026-05-01
576 MS_DRG Ms-DRG 42.00: Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 44 22 — $83,793.25 $46,900.90 $163,288.75 $49,967.73 2026-05-01
5831 APR_DRG Apr-DRG 38.00: Neonate With Ecmo 5 5 — — $95,892.90 $95,892.90 $95,892.90 2026-05-01
5832 APR_DRG Apr-DRG 38.00: Neonate With Ecmo 5 5 — — $121,376.61 $121,376.61 $121,376.61 2026-05-01
5833 APR_DRG Apr-DRG 38.00: Neonate With Ecmo 5 5 — — $178,924.31 $178,924.31 $178,924.31 2026-05-01
5834 APR_DRG Apr-DRG 38.00: Neonate With Ecmo 5 5 — — $222,713.21 $222,713.21 $222,713.21 2026-05-01
5881 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $51,924.54 $51,924.54 $51,924.54 2026-05-01
5882 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $51,924.54 $51,924.54 $51,924.54 2026-05-01
5883 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $107,557.98 $107,557.98 $107,557.98 2026-05-01
5884 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure 5 5 — — $176,411.83 $176,411.83 $176,411.83 2026-05-01
5891 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 5 — — $74,417.20 $74,417.20 $74,417.20 2026-05-01
5892 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 5 — — $71,785.08 $71,785.08 $71,785.08 2026-05-01
5893 APR_DRG Apr-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams A… 5 5 — — $65,264.60 $65,264.60 $65,264.60 2026-05-01
5911 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $46,660.30 $46,660.30 $46,660.30 2026-05-01
5912 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $64,786.03 $64,786.03 $64,786.03 2026-05-01
5913 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $71,605.62 $71,605.62 $71,605.62 2026-05-01
5914 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure 5 5 — — $120,419.47 $120,419.47 $120,419.47 2026-05-01
5932 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $60,000.36 $60,000.36 $60,000.36 2026-05-01
5933 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $69,272.60 $69,272.60 $69,272.60 2026-05-01
5934 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure 5 5 — — $100,020.54 $100,020.54 $100,020.54 2026-05-01
6 MS_DRG Ms-DRG 42.00: Liver Transplant Without Mcc 39 21 — $71,319.37 $42,331.96 $260,000.00 $44,448.56 2026-05-01
6022 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $47,258.51 $47,258.51 $47,258.51 2026-05-01
6023 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $52,762.03 $52,762.03 $52,762.03 2026-05-01
6024 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Sy… 5 5 — — $77,408.24 $77,408.24 $77,408.24 2026-05-01
6033 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 5 5 — — $45,164.78 $45,164.78 $45,164.78 2026-05-01
6034 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant … 5 5 — — $93,679.53 $93,679.53 $93,679.53 2026-05-01
6072 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 5 5 — — $33,200.60 $33,200.60 $33,200.60 2026-05-01
6073 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 5 5 — — $41,396.06 $41,396.06 $41,396.06 2026-05-01
6074 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Sy… 5 5 — — $64,486.93 $64,486.93 $64,486.93 2026-05-01
6083 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant … 5 5 — — $35,174.69 $35,174.69 $35,174.69 2026-05-01
6084 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant … 5 5 — — $57,128.96 $57,128.96 $57,128.96 2026-05-01
6093 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $47,198.69 $47,198.69 $47,198.69 2026-05-01
6094 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure 5 5 — — $117,966.81 $117,966.81 $117,966.81 2026-05-01
61 APR_DRG Apr-DRG 38.00: Pancreas Transplant 5 5 — — $44,746.03 $44,746.03 $44,746.03 2026-05-01
6114 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly 5 5 — — $51,984.36 $51,984.36 $51,984.36 2026-05-01
6124 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Sy… 5 5 — — $42,652.30 $42,652.30 $42,652.30 2026-05-01
6134 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal… 5 5 — — $42,891.59 $42,891.59 $42,891.59 2026-05-01
6144 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Signif… 5 5 — — $33,439.88 $33,439.88 $33,439.88 2026-05-01
616 MS_DRG Ms-DRG 42.00: Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic … 44 22 — $58,358.91 $34,097.67 $116,974.23 $36,655.00 2026-05-01
62 APR_DRG Apr-DRG 38.00: Pancreas Transplant 5 5 — — $44,746.03 $44,746.03 $44,746.03 2026-05-01
6214 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly 5 5 — — $40,319.29 $40,319.29 $40,319.29 2026-05-01
622 MS_DRG Ms-DRG 42.00: Skin Grafts And Wound Debridement For Endocrine, Nutritional And M… 44 22 — $56,412.63 $33,068.59 $113,251.63 $35,548.74 2026-05-01
6234 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal… 5 5 — — $36,311.29 $36,311.29 $36,311.29 2026-05-01
6254 APR_DRG Apr-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condi… 5 5 — — $44,028.18 $44,028.18 $44,028.18 2026-05-01
628 MS_DRG Ms-DRG 42.00: Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mc… 44 22 — $59,199.35 $34,772.85 $119,416.61 $37,380.82 2026-05-01
63 APR_DRG Apr-DRG 38.00: Pancreas Transplant 5 5 — — $49,950.45 $49,950.45 $49,950.45 2026-05-01
6303 APR_DRG Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 5 5 — — $50,608.48 $50,608.48 $50,608.48 2026-05-01
6304 APR_DRG Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Proce… 5 5 — — $101,336.60 $101,336.60 $101,336.60 2026-05-01
6310098 CDM Fix Extrnl Lw/up/pelvic Lvl 29 25 14 $157,684.00 $29,171.54 82% off $22,722.26 $118,263.00 $78,842.00 2026-05-01
6310106 CDM Fix Extrnl Lw/up/pelvic Lvl 30 25 14 $175,204.00 $32,412.74 82% off $25,246.90 $131,403.00 $87,602.00 2026-05-01
6310114 CDM Fix Extrnl Lw/up/pelvic Lvl 31 25 14 $192,724.00 $35,653.94 82% off $27,771.53 $144,543.00 $96,362.00 2026-05-01
6310122 CDM Fix Extrnl Lw/up/pelvic Lvl 32 25 14 $210,244.00 $38,895.14 82% off $30,296.16 $157,683.00 $105,122.00 2026-05-01
6312185 CDM Fix Extrnl Lw/up/pelvic Lvl 33 25 14 $227,764.00 $42,136.34 82% off $32,820.79 $170,823.00 $113,882.00 2026-05-01
6312193 CDM Fix Extrnl Lw/up/pelvic Lvl 34 25 14 $245,284.00 $45,377.54 82% off $35,345.42 $183,963.00 $122,642.00 2026-05-01
6313 APR_DRG Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $35,055.05 $35,055.05 $35,055.05 2026-05-01
6314 APR_DRG Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure 5 5 — — $105,165.14 $105,165.14 $105,165.14 2026-05-01
6334 APR_DRG Apr-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Anomaly 5 5 — — $39,661.26 $39,661.26 $39,661.26 2026-05-01
64 APR_DRG Apr-DRG 38.00: Pancreas Transplant 5 5 — — $83,031.41 $83,031.41 $83,031.41 2026-05-01
650 MS_DRG Ms-DRG 42.00: Kidney Transplant With Hemodialysis With Mcc 40 22 — $66,320.97 $40,308.11 $145,000.00 $42,323.52 2026-05-01
651 MS_DRG Ms-DRG 42.00: Kidney Transplant With Hemodialysis Without Mcc 40 22 — $50,986.64 $30,813.82 $145,000.00 $32,354.51 2026-05-01
6514 APR_DRG Apr-DRG 38.00: Other Procedures Of Blood And Blood-forming Organs 5 5 — — $39,541.61 $39,541.61 $39,541.61 2026-05-01
653 MS_DRG Ms-DRG 42.00: Major Bladder Procedures With Mcc 44 22 — $79,826.97 $48,401.02 $168,715.27 $52,031.10 2026-05-01
665 MS_DRG Ms-DRG 42.00: Prostatectomy With Mcc 44 22 — $45,545.90 $30,488.37 $113,257.30 $32,775.00 2026-05-01
673 MS_DRG Ms-DRG 42.00: Other Kidney And Urinary Tract Procedures With Mcc 44 22 — $54,525.33 $35,746.25 $126,798.24 $38,285.96 2026-05-01
673 OTHER Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $33,476.01 $33,476.01 $33,476.01 2026-05-01
6804 APR_DRG Apr-DRG 38.00: Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neopl… 5 5 — — $43,669.26 $43,669.26 $43,669.26 2026-05-01
6814 APR_DRG Apr-DRG 38.00: Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neop… 5 5 — — $38,584.48 $38,584.48 $38,584.48 2026-05-01
6904 APR_DRG Apr-DRG 38.00: Acute Leukemia 5 5 — — $41,396.06 $41,396.06 $41,396.06 2026-05-01
6954 APR_DRG Apr-DRG 38.00: Chemotherapy For Acute Leukemia 5 5 — — $37,746.99 $37,746.99 $37,746.99 2026-05-01
7 MS_DRG Ms-DRG 42.00: Lung Transplant 39 21 — $180,856.60 $111,101.17 $395,527.23 $116,656.23 2026-05-01
71 APR_DRG Apr-DRG 38.00: Allogeneic Bone Marrow Transplant 8 5 — — $34,696.12 $226,333.00 $34,696.12 2026-05-01
72 APR_DRG Apr-DRG 38.00: Allogeneic Bone Marrow Transplant 8 5 — — $50,249.56 $226,333.00 $50,249.56 2026-05-01
73 APR_DRG Apr-DRG 38.00: Allogeneic Bone Marrow Transplant 8 5 — — $60,478.93 $226,333.00 $60,478.93 2026-05-01
736 MS_DRG Ms-DRG 42.00: Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy Wi… 44 22 — $57,312.05 $34,705.08 $129,881.74 $37,307.96 2026-05-01
739 MS_DRG Ms-DRG 42.00: Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Mali… 44 22 — $53,316.28 $35,067.35 $131,309.99 $37,697.40 2026-05-01
74 APR_DRG Apr-DRG 38.00: Allogeneic Bone Marrow Transplant 8 5 — — $117,548.07 $226,333.00 $117,548.07 2026-05-01
790 MS_DRG Ms-DRG 42.00: Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 41 22 — $88,467.27 $51,498.30 $179,919.37 $54,073.21 2026-05-01
791 MS_DRG Ms-DRG 42.00: Prematurity With Major Problems 41 22 — $60,423.15 $35,728.29 $122,872.87 $37,514.70 2026-05-01
793 MS_DRG Ms-DRG 42.00: Full Term Neonate With Major Problems 41 22 — $62,059.79 $16,672.31 $126,220.18 $36,653.63 2026-05-01
799 MS_DRG Ms-DRG 42.00: Splenic Procedures With Mcc 44 22 — $73,059.22 $41,542.17 $143,904.02 $44,657.83 2026-05-01
8 MS_DRG Ms-DRG 42.00: Simultaneous Pancreas And Kidney Transplant 38 21 — $77,585.80 $47,284.09 $222,879.79 $48,466.19 2026-05-01
802 MS_DRG Ms-DRG 42.00: Other O.r. Procedures Of The Blood And Blood Forming Organs With M… 44 22 — $50,588.54 $31,753.37 $108,493.97 $34,134.88 2026-05-01
820 MS_DRG Ms-DRG 42.00: Lymphoma And Leukemia With Major O.r. Procedures With Mcc 44 22 — $89,160.27 $50,473.40 $192,048.57 $54,258.90 2026-05-01
823 MS_DRG Ms-DRG 42.00: Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 44 22 — $66,379.94 $40,912.18 $154,353.31 $43,980.60 2026-05-01
826 MS_DRG Ms-DRG 42.00: Myeloproliferative Disorders Or Poorly Differentiated Neoplasms Wi… 44 22 — $68,237.76 $41,715.36 $157,519.87 $44,844.01 2026-05-01
83 APR_DRG Apr-DRG 38.00: Autologous Bone Marrow Transplant Or T-cell Immunotherapy 7 5 — — $33,200.60 $226,333.00 $33,200.60 2026-05-01
834 MS_DRG Ms-DRG 42.00: Acute Leukemia With Mcc 44 22 — $82,554.71 $48,005.29 $182,317.99 $51,605.68 2026-05-01
834 OTHER Acute Leukemia Age >17 With Mcc 1 1 — — $45,105.52 $45,105.52 $45,105.52 2026-05-01
837 MS_DRG Ms-DRG 42.00: Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With Hi… 44 22 — $71,422.58 $43,653.87 $165,162.49 $46,927.91 2026-05-01
837 OTHER Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $40,032.40 $40,032.40 $40,032.40 2026-05-01
84 APR_DRG Apr-DRG 38.00: Autologous Bone Marrow Transplant Or T-cell Immunotherapy 7 5 — — $53,001.32 $226,333.00 $53,001.32 2026-05-01
8413 APR_DRG Apr-DRG 38.00: Extensive Third Degree Burns With Skin Graft 5 5 — — $48,873.68 $48,873.68 $48,873.68 2026-05-01
8414 APR_DRG Apr-DRG 38.00: Extensive Third Degree Burns With Skin Graft 5 5 — — $122,931.95 $122,931.95 $122,931.95 2026-05-01
8424 APR_DRG Apr-DRG 38.00: Burns With Skin Graft Except Extensive Third Degree Burns 5 5 — — $61,136.96 $61,136.96 $61,136.96 2026-05-01
850 MS_DRG Ms-DRG 42.00: Acute Leukemia With Other Procedures 44 22 — — $78,832.45 $278,798.15 $84,744.89 2026-05-01
8504 APR_DRG Apr-DRG 38.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Co… 5 5 — — $38,105.91 $38,105.91 $38,105.91 2026-05-01
853 MS_DRG Ms-DRG 42.00: Infectious And Parasitic Diseases With O.r. Procedures With Mcc 44 22 — $73,707.98 $43,604.50 $151,364.34 $46,874.83 2026-05-01
853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $40,633.74 $40,633.74 $40,633.74 2026-05-01
856 MS_DRG Ms-DRG 42.00: Postoperative Or Post-traumatic Infections With O.r. Procedures Wi… 44 22 — $65,288.85 $39,507.44 $136,543.57 $42,470.49 2026-05-01
8634 APR_DRG Apr-DRG 38.00: Neonatal Aftercare 5 5 — — $61,495.89 $61,495.89 $61,495.89 2026-05-01
870 MS_DRG Ms-DRG 42.00: Septicemia Or Severe Sepsis With Mv >96 Hours 44 22 — $102,695.76 $59,962.68 $210,538.47 $64,459.88 2026-05-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $56,062.65 $56,062.65 $56,062.65 2026-05-01
876 MS_DRG Ms-DRG 42.00: O.r. Procedures With Principal Diagnosis Of Mental Illness 43 22 — $55,026.64 $34,638.15 $118,929.34 $38,101.96 2026-05-01
894 APR_DRG Apr-DRG 38.00: Major Cranial Or Facial Bone Procedures 5 5 — — $36,311.29 $36,311.29 $36,311.29 2026-05-01
901 MS_DRG Ms-DRG 42.00: Wound Debridements For Injuries With Mcc 44 22 — $63,814.39 $38,828.92 $134,089.08 $41,741.09 2026-05-01
904 MS_DRG Ms-DRG 42.00: Skin Grafts For Injuries With Cc/mcc 44 22 — $48,008.24 $34,065.04 $116,856.19 $36,619.92 2026-05-01
907 MS_DRG Ms-DRG 42.00: Other O.r. Procedures For Injuries With Mcc 44 22 — $54,849.71 $35,090.78 $120,566.68 $37,722.59 2026-05-01
9104 APR_DRG Apr-DRG 38.00: Craniotomy For Multiple Significant Trauma 5 5 — — $42,712.12 $42,712.12 $42,712.12 2026-05-01
9114 APR_DRG Apr-DRG 38.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significa… 5 5 — — $41,934.45 $41,934.45 $41,934.45 2026-05-01
9124 APR_DRG Apr-DRG 38.00: Musculoskeletal And Other Procedures For Multiple Significant Tra… 5 5 — — $39,362.15 $39,362.15 $39,362.15 2026-05-01
914 APR_DRG Apr-DRG 38.00: Other Major Head And Neck Procedures 5 5 — — $36,490.75 $36,490.75 $36,490.75 2026-05-01
927 MS_DRG Ms-DRG 42.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Ski… 44 22 — $388,651.48 $200,237.74 $717,970.54 $215,255.57 2026-05-01
928 MS_DRG Ms-DRG 42.00: Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/m… 44 22 — $102,032.26 $57,640.13 $202,136.91 $61,963.14 2026-05-01
93 APR_DRG Apr-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo) 5 5 — — $47,019.23 $47,019.23 $47,019.23 2026-05-01
933 MS_DRG Ms-DRG 42.00: Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without … 44 22 — — $37,962.15 $130,953.63 $40,809.31 2026-05-01
94 APR_DRG Apr-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo) 5 5 — — $106,182.10 $106,182.10 $106,182.10 2026-05-01
94 MS_DRG Ms-DRG 42.00: Bacterial And Tuberculous Infections Of Nervous System With Mcc 44 22 — $53,419.49 $32,288.00 $110,427.91 $34,709.60 2026-05-01
9504 APR_DRG Apr-DRG 38.00: Extensive O.r. Procedure Unrelated To Principal Diagnosis 5 5 — — $33,858.63 $33,858.63 $33,858.63 2026-05-01
955 MS_DRG Ms-DRG 42.00: Craniotomy For Multiple Significant Trauma 44 22 — $89,794.28 $58,890.09 $206,658.50 $63,306.85 2026-05-01
956 MS_DRG Ms-DRG 42.00: Limb Reattachment, Hip And Femur Procedures For Multiple Significa… 44 22 — $57,179.35 $33,741.26 $116,548.20 $36,271.85 2026-05-01
957 MS_DRG Ms-DRG 42.00: Other O.r. Procedures For Multiple Significant Trauma With Mcc 44 22 — $106,647.30 $64,210.34 $225,904.01 $69,026.11 2026-05-01
958 MS_DRG Ms-DRG 42.00: Other O.r. Procedures For Multiple Significant Trauma With Cc 44 22 — $59,641.69 $36,145.78 $124,383.10 $38,856.71 2026-05-01
969 MS_DRG Ms-DRG 42.00: HIV With Extensive O.r. Procedures With Mcc 44 22 — $101,339.26 $54,673.38 $191,404.94 $58,773.89 2026-05-01
97 MS_DRG Ms-DRG 42.00: Non-bacterial Infection Of Nervous System Except Viral Meningitis … 44 22 — $53,625.91 $31,751.70 $108,487.92 $34,133.08 2026-05-01
981 MS_DRG Ms-DRG 42.00: Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mc… 44 22 — $69,712.21 $41,534.64 $143,876.78 $44,649.74 2026-05-01
987 MS_DRG Ms-DRG 42.00: Non-extensive O.r. Procedures Unrelated To Principal Diagnosis Wit… 44 22 — $49,792.33 $31,066.49 $106,009.22 $33,396.47 2026-05-01
A9543 HCPCS Rrx Yttr90 Zev Thr/0-40mci Dose 53 28 $96,210.00 $50,510.25 48% off $32,326.56 $350,571.48 $56,824.55 2026-05-01
C1721 HCPCS Imp Icd Chamber Dual Lvl 01 151 17 $87,604.00 $30,193.59 66% off $8,760.00 $98,553.00 $35,041.60 2026-05-01
C1722 HCPCS Imp Icd Chamber Sgl Lvl 01 122 17 $65,704.00 $22,645.54 66% off $8,760.00 $82,128.00 $32,358.22 2026-05-01
C1767 HCPCS Imp Generator Neurostim Lvl 01 238 17 $87,604.00 $26,281.20 70% off $5,694.00 $131,403.00 $37,987.40 2026-05-01
C1882 HCPCS Imp Icd Chamber Non Sgl/dual Lvl 01 180 17 $78,840.00 $23,652.00 70% off $12,264.00 $91,983.00 $37,632.96 2026-05-01
J9999 HCPCS Lifileucel Til/dose 7.5b-72b Snij 26 13 $3,759,504.00 $1,295,750.65 66% off $4.73 $2,819,628.00 $1,597,789.20 2026-05-01
L8614 HCPCS Imp Dev Cochlear Int&ext Cmp Lvl 01 251 17 $109,504.00 $32,851.20 70% off $10,074.00 $164,253.00 $54,752.00 2026-05-01
Q2041 HCPCS Axicabtag Cil Car-t/<=200m/dose 80 28 $3,668,894.00 $1,264,521.01 66% off $4.73 $2,751,670.50 $359,552.00 2026-05-01
Q2042 HCPCS Tisagenlecl Car-t/<=600m/dose Adult 110 28 $3,335,729.60 $1,149,692.56 66% off $4.73 $3,185,922.52 $408,858.00 2026-05-01
Q2053 HCPCS Brexucabtag Car-t/<=200m/dose Spij 80 28 $3,372,660.00 $1,162,421.00 66% off $4.73 $2,529,495.00 $359,552.00 2026-05-01
Q2054 HCPCS Lisocabtag Mar Car-t/<=110m/dose Ij 80 28 $3,878,918.00 $1,336,907.88 66% off $4.73 $2,909,188.50 $379,082.81 2026-05-01
Q2055 HCPCS Idecabt Car-t/<=510m/dose 250ml Ij 80 28 $3,856,740.80 $1,329,264.28 66% off $4.73 $2,892,555.60 $387,752.24 2026-05-01
Q2056 HCPCS Ciltacabt Car-t/<=100m/dose 30ml Ij 80 28 $3,811,065.20 $1,313,521.73 66% off $4.73 $2,858,298.90 $405,756.74 2026-05-01
Q2057 HCPCS Afamitres Tcr-t/dose 2.68b-10b Sniv 60 28 $559,063.00 $1,829,146.46 $80,560.98 $3,980,328.00 $821,342.21 2026-05-01
Q2058 HCPCS Obecabtagn Car-t/10<=400m/inf 1st 72 28 $1,916,252.00 $660,455.41 66% off $40,372.50 $1,437,189.00 $270,375.00 2026-05-01
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