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

NORTHERN COCHISE COMMUNITY HOSPITAL, INC.

Willcox, AZ · CCN 031302 · Rates published

12,858 distinct procedures filed
4 distinct payers
28,927 rate rows
2025-03-28 last MRF observed · ⚠ 16 mo old
Data quality

28,655 of 28,927 rate rows are consumer-grade (99.1%)

272 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 204
exceeds 10× this hospital's gross charge — excluded from medians 26
placeholder amount (≤ $0.02) — excluded from medians 22
percent-of-charges filed in the dollar field — excluded from medians 12
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 16 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/9275/860208451_northern-cochise-community-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/NorthernCochiseHospital/9275
Discovered viaPublic MRF directory
Last fetch not_modified · 2026-05-15
Content fingerprint 5202686f344eb61a… · 12,749,323 bytes · first seen 2026-05-06

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
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $2,636,800.00 $2,636,800.00 $2,636,800.00 nat. median
$3,325,455
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 1 $394,320.00 $394,320.00 $394,320.00 nat. median
$674,867
0.6× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 1 $380,939.46 $380,939.46 $380,939.46 nat. median
$753,246
0.5× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 1 $355,736.00 $355,736.00 $355,736.00 nat. median
$625,184
0.6× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 1 $348,812.99 $348,812.99 $348,812.99 nat. median
$619,808
0.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 1 $347,966.42 $347,966.42 $347,966.42 nat. median
$634,303
0.5× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 1 $347,934.40 $347,934.40 $347,934.40 nat. median
$673,137
0.5× median
5834
APR_DRG 		Neonate With Ecmo 1 $261,126.31 $261,126.31 $261,126.31 nat. median
$309,665
0.8× median
5833
APR_DRG 		Neonate With Ecmo 1 $209,775.41 $209,775.41 $209,775.41 nat. median
$244,017
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $206,843.56 $206,843.56 $206,843.56 nat. median
$246,434
0.8× median
24
APR_DRG 		Heart And/Or Lung Transplant 1 $181,701.18 $181,701.18 $181,701.18 nat. median
$234,729
0.8× median
1614
APR_DRG 		Implantable Heart Assist Systems 1 $160,146.45 $160,146.45 $160,146.45 nat. median
$207,730
0.8× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 1 $144,168.56 $144,168.56 $144,168.56 nat. median
$160,267
0.9× median
5832
APR_DRG 		Neonate With Ecmo 1 $142,335.80 $142,335.80 $142,335.80 nat. median
$156,126
0.9× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $141,221.98 $141,221.98 $141,221.98 nat. median
$164,289
0.9× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 $138,340.63 $138,340.63 $138,340.63 nat. median
$162,982
0.8× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $137,807.56 $137,807.56 $137,807.56 nat. median
$187,061
0.7× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $126,083.66 $126,083.66 $126,083.66 nat. median
$182,665
0.7× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo) 1 $124,520.24 $124,520.24 $124,520.24 nat. median
$164,834
0.8× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 $123,339.09 $123,339.09 $123,339.09 nat. median
$122,924
1.0× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $118,789.10 $118,789.10 $118,789.10 nat. median
$150,721
0.8× median
14
APR_DRG 		Liver Transplant And/Or Intestinal Transplant 1 $117,754.54 $117,754.54 $117,754.54 nat. median
$129,535
0.9× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $117,243.92 $117,243.92 $117,243.92 nat. median
$151,838
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $116,303.46 $116,303.46 $116,303.46 nat. median
$265,286
outlier · 0.4×
5831
APR_DRG 		Neonate With Ecmo 1 $112,462.48 $112,462.48 $112,462.48 nat. median
$144,745
0.8× median
1613
APR_DRG 		Implantable Heart Assist Systems 1 $111,650.96 $111,650.96 $111,650.96 nat. median
$119,796
0.9× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 $109,833.63 $109,833.63 $109,833.63 nat. median
$109,499
1.0× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $109,327.92 $109,327.92 $109,327.92 nat. median
$105,658
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 1 $103,844.37 $103,844.37 $103,844.37 nat. median
$202,976
0.5× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 1 $101,631.03 $101,631.03 $101,631.03 nat. median
$206,474
outlier · 0.5×
64
APR_DRG 		Pancreas Transplant 1 $97,322.06 $97,322.06 $97,322.06 nat. median
$91,009
1.1× median
23
APR_DRG 		Heart And/Or Lung Transplant 1 $95,511.04 $95,511.04 $95,511.04 nat. median
$93,528
1.0× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $90,728.90 $90,728.90 $90,728.90 nat. median
$118,620
0.8× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $87,221.90 $87,221.90 $87,221.90 nat. median
$93,370
0.9× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $84,136.44 $84,136.44 $84,136.44 nat. median
$89,796
0.9× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $83,928.82 $83,928.82 $83,928.82 nat. median
$102,919
0.8× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $81,892.04 $81,892.04 $81,892.04 nat. median
$108,660
0.8× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $81,194.06 $81,194.06 $81,194.06 nat. median
$108,996
0.7× median
22
APR_DRG 		Heart And/Or Lung Transplant 1 $80,073.23 $80,073.23 $80,073.23 nat. median
$77,804
1.0× median
1611
APR_DRG 		Implantable Heart Assist Systems 1 $78,199.79 $78,199.79 $78,199.79 nat. median
$76,806
1.0× median
1612
APR_DRG 		Implantable Heart Assist Systems 1 $78,199.79 $78,199.79 $78,199.79 nat. median
$85,444
0.9× median
215
MS_DRG 		Other Heart Assist System Implant 1 $77,554.57 $77,554.57 $77,554.57 nat. median
$99,019
0.8× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $76,487.67 $76,487.67 $76,487.67 nat. median
$69,788
1.1× median
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 1 $76,199.20 $76,199.20 $76,199.20 nat. median
$69,774
1.1× median
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $75,926.55 $75,926.55 $75,926.55 nat. median
$81,294
0.9× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 1 $75,687.37 $75,687.37 $75,687.37 nat. median
$97,957
0.8× median
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 $75,637.57 $75,637.57 $75,637.57 nat. median
$95,507
0.8× median
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $74,757.32 $74,757.32 $74,757.32 nat. median
$69,926
1.1× median
8634
APR_DRG 		Neonatal Aftercare 1 $72,106.73 $72,106.73 $72,106.73 nat. median
$69,502
1.0× median
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 $71,753.92 $71,753.92 $71,753.92 nat. median
$68,217
1.1× median

Other procedures at this hospital

Browse this hospital's 12,858 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $116,303.46 $116,303.46 $116,303.46 2025-03-28
10 MS_DRG Pancreas Transplant 1 1 — — $36,532.85 $36,532.85 $36,532.85 2025-03-28
11 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $46,835.28 $46,835.28 $46,835.28 2025-03-28
12 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $46,835.28 $46,835.28 $46,835.28 2025-03-28
1204 APR_DRG Major Respiratory And Chest Procedures 1 1 — — $37,990.63 $37,990.63 $37,990.63 2025-03-28
1214 APR_DRG Other Respiratory And Chest Procedures 1 1 — — $31,089.56 $31,089.56 $31,089.56 2025-03-28
13 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $55,504.59 $55,504.59 $55,504.59 2025-03-28
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $35,760.18 $35,760.18 $35,760.18 2025-03-28
14 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $117,754.54 $117,754.54 $117,754.54 2025-03-28
14 MS_DRG Allogeneic Bone Marrow Transplant 1 1 — — $58,258.98 $58,258.98 $58,258.98 2025-03-28
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 1 1 — — $44,127.26 $44,127.26 $44,127.26 2025-03-28
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $35,903.96 $35,903.96 $35,903.96 2025-03-28
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $75,687.37 $75,687.37 $75,687.37 2025-03-28
1611 APR_DRG Implantable Heart Assist Systems 1 1 — — $78,199.79 $78,199.79 $78,199.79 2025-03-28
1612 APR_DRG Implantable Heart Assist Systems 1 1 — — $78,199.79 $78,199.79 $78,199.79 2025-03-28
1613 APR_DRG Implantable Heart Assist Systems 1 1 — — $111,650.96 $111,650.96 $111,650.96 2025-03-28
1614 APR_DRG Implantable Heart Assist Systems 1 1 — — $160,146.45 $160,146.45 $160,146.45 2025-03-28
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $27,620.43 $27,620.43 $27,620.43 2025-03-28
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $31,918.61 $31,918.61 $31,918.61 2025-03-28
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $42,829.59 $42,829.59 $42,829.59 2025-03-28
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $66,036.11 $66,036.11 $66,036.11 2025-03-28
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $34,985.83 $34,985.83 $34,985.83 2025-03-28
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $54,932.95 $54,932.95 $54,932.95 2025-03-28
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $27,271.13 $27,271.13 $27,271.13 2025-03-28
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $34,605.67 $34,605.67 $34,605.67 2025-03-28
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $50,697.89 $50,697.89 $50,697.89 2025-03-28
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $28,395.48 $28,395.48 $28,395.48 2025-03-28
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $43,690.21 $43,690.21 $43,690.21 2025-03-28
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $30,500.38 $30,500.38 $30,500.38 2025-03-28
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $53,164.02 $53,164.02 $53,164.02 2025-03-28
1694 APR_DRG Major Abdominal Vascular Procedures 1 1 — — $42,746.82 $42,746.82 $42,746.82 2025-03-28
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $30,214.53 $30,214.53 $30,214.53 2025-03-28
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 1 1 — — $30,224.73 $30,224.73 $30,224.73 2025-03-28
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 1 1 — — $28,128.95 $28,128.95 $28,128.95 2025-03-28
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 1 1 — — $36,653.06 $36,653.06 $36,653.06 2025-03-28
1781 APR_DRG External Heart Assist Systems 1 1 — — $29,471.43 $29,471.43 $29,471.43 2025-03-28
1782 APR_DRG External Heart Assist Systems 1 1 — — $33,150.97 $33,150.97 $33,150.97 2025-03-28
1783 APR_DRG External Heart Assist Systems 1 1 — — $38,914.37 $38,914.37 $38,914.37 2025-03-28
1784 APR_DRG External Heart Assist Systems 1 1 — — $55,484.95 $55,484.95 $55,484.95 2025-03-28
1793 APR_DRG Defibrillator Implants 1 1 — — $32,110.79 $32,110.79 $32,110.79 2025-03-28
1794 APR_DRG Defibrillator Implants 1 1 — — $43,469.97 $43,469.97 $43,469.97 2025-03-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $44,127.26 $44,127.26 $44,127.26 2025-03-28
1804 APR_DRG Other Circulatory System Procedures 1 1 — — $27,915.72 $27,915.72 $27,915.72 2025-03-28
1814 APR_DRG Lower Extremity Arterial Procedures 1 1 — — $37,239.43 $37,239.43 $37,239.43 2025-03-28
1824 APR_DRG Other Peripheral Vascular Procedures 1 1 — — $31,432.54 $31,432.54 $31,432.54 2025-03-28
1831 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $26,889.57 $26,889.57 $26,889.57 2025-03-28
1832 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $28,283.25 $28,283.25 $28,283.25 2025-03-28
1833 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $33,632.13 $33,632.13 $33,632.13 2025-03-28
1834 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $48,903.71 $48,903.71 $48,903.71 2025-03-28
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $56,211.45 $56,211.45 $56,211.45 2025-03-28
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $81,892.04 $81,892.04 $81,892.04 2025-03-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $61,297.82 $61,297.82 $61,297.82 2025-03-28
204 APR_DRG Open Craniotomy For Trauma 1 1 — — $40,117.98 $40,117.98 $40,117.98 2025-03-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 1 1 — — $34,709.72 $34,709.72 $34,709.72 2025-03-28
21 APR_DRG Heart And/Or Lung Transplant 1 1 — — $61,900.65 $61,900.65 $61,900.65 2025-03-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $53,302.38 $53,302.38 $53,302.38 2025-03-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $37,711.62 $37,711.62 $37,711.62 2025-03-28
213 APR_DRG Open Craniotomy Except Trauma 1 1 — — $27,410.01 $27,410.01 $27,410.01 2025-03-28
214 APR_DRG Open Craniotomy Except Trauma 1 1 — — $44,853.13 $44,853.13 $44,853.13 2025-03-28
215 MS_DRG Other Heart Assist System Implant 1 1 — — $77,554.57 $77,554.57 $77,554.57 2025-03-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $50,877.25 $50,877.25 $50,877.25 2025-03-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $41,456.10 $41,456.10 $41,456.10 2025-03-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $37,509.75 $37,509.75 $37,509.75 2025-03-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $43,953.33 $43,953.33 $43,953.33 2025-03-28
22 APR_DRG Heart And/Or Lung Transplant 1 1 — — $80,073.23 $80,073.23 $80,073.23 2025-03-28
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $44,605.80 $44,605.80 $44,605.80 2025-03-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $33,738.22 $33,738.22 $33,738.22 2025-03-28
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 1 1 — — $40,004.35 $40,004.35 $40,004.35 2025-03-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $31,994.40 $31,994.40 $31,994.40 2025-03-28
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 1 1 — — $27,475.94 $27,475.94 $27,475.94 2025-03-28
2234 APR_DRG Other Small And Large Bowel Procedures 1 1 — — $27,320.93 $27,320.93 $27,320.93 2025-03-28
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $40,079.40 $40,079.40 $40,079.40 2025-03-28
2264 APR_DRG Anal Procedures 1 1 — — $26,716.33 $26,716.33 $26,716.33 2025-03-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 1 1 — — $39,434.71 $39,434.71 $39,434.71 2025-03-28
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 1 1 — — $31,121.14 $31,121.14 $31,121.14 2025-03-28
2294 APR_DRG Other Digestive System And Abdominal Procedures 1 1 — — $27,182.06 $27,182.06 $27,182.06 2025-03-28
23 APR_DRG Heart And/Or Lung Transplant 1 1 — — $95,511.04 $95,511.04 $95,511.04 2025-03-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $32,152.11 $32,152.11 $32,152.11 2025-03-28
2304 APR_DRG Major Small Bowel Procedures 1 1 — — $34,522.21 $34,522.21 $34,522.21 2025-03-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 1 1 — — $43,795.62 $43,795.62 $43,795.62 2025-03-28
2314 APR_DRG Major Large Bowel Procedures 1 1 — — $30,310.30 $30,310.30 $30,310.30 2025-03-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 1 1 — — $37,167.29 $37,167.29 $37,167.29 2025-03-28
2324 APR_DRG Gastric Fundoplication 1 1 — — $46,303.62 $46,303.62 $46,303.62 2025-03-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $41,672.39 $41,672.39 $41,672.39 2025-03-28
234 APR_DRG Spinal Procedures 1 1 — — $40,597.73 $40,597.73 $40,597.73 2025-03-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $31,799.74 $31,799.74 $31,799.74 2025-03-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $32,680.22 $32,680.22 $32,680.22 2025-03-28
24 APR_DRG Heart And/Or Lung Transplant 1 1 — — $181,701.18 $181,701.18 $181,701.18 2025-03-28
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $26,643.98 $26,643.98 $26,643.98 2025-03-28
244 APR_DRG Open Extracranial Vascular Procedures 1 1 — — $28,182.25 $28,182.25 $28,182.25 2025-03-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 1 1 — — $35,631.65 $35,631.65 $35,631.65 2025-03-28
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 1 1 — — $47,113.04 $47,113.04 $47,113.04 2025-03-28
2614 APR_DRG Major Biliary Tract Procedures 1 1 — — $37,024.10 $37,024.10 $37,024.10 2025-03-28
264 APR_DRG Other Nervous System And Related Procedures 1 1 — — $34,264.79 $34,264.79 $34,264.79 2025-03-28
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 1 1 — — $27,123.14 $27,123.14 $27,123.14 2025-03-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $48,036.66 $48,036.66 $48,036.66 2025-03-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $44,223.69 $44,223.69 $44,223.69 2025-03-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $30,482.19 $30,482.19 $30,482.19 2025-03-28
274 APR_DRG Other Open Craniotomy 1 1 — — $41,005.25 $41,005.25 $41,005.25 2025-03-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $54,947.97 $54,947.97 $54,947.97 2025-03-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 1 — — $33,179.48 $33,179.48 $33,179.48 2025-03-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $28,632.03 $28,632.03 $28,632.03 2025-03-28
28 MS_DRG Spinal Procedures With Mcc 1 1 — — $30,368.64 $30,368.64 $30,368.64 2025-03-28
294 APR_DRG Other Percutaneous Intracranial Procedures 1 1 — — $32,208.99 $32,208.99 $32,208.99 2025-03-28
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 1 1 — — $103,844.37 $103,844.37 $103,844.37 2025-03-28
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $27,633.76 $27,633.76 $27,633.76 2025-03-28
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $35,683.73 $35,683.73 $35,683.73 2025-03-28
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $51,028.95 $51,028.95 $51,028.95 2025-03-28
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $66,449.23 $66,449.23 $66,449.23 2025-03-28
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 1 1 — — $36,903.46 $36,903.46 $36,903.46 2025-03-28
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $32,927.92 $32,927.92 $32,927.92 2025-03-28
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $47,588.59 $47,588.59 $47,588.59 2025-03-28
3054 APR_DRG Amputation Of Lower Limb Except Toes 1 1 — — $29,803.89 $29,803.89 $29,803.89 2025-03-28
3094 APR_DRG Other Significant Hip And Femur Surgery 1 1 — — $29,232.95 $29,232.95 $29,232.95 2025-03-28
3104 APR_DRG Intervertebral Disc Excision And Decompression 1 1 — — $26,829.25 $26,829.25 $26,829.25 2025-03-28
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $47,114.44 $47,114.44 $47,114.44 2025-03-28
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 1 1 — — $28,088.97 $28,088.97 $28,088.97 2025-03-28
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 1 1 — — $29,141.77 $29,141.77 $29,141.77 2025-03-28
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 1 1 — — $27,861.71 $27,861.71 $27,861.71 2025-03-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 1 1 — — $32,385.52 $32,385.52 $32,385.52 2025-03-28
3214 APR_DRG Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or… 1 1 — — $35,817.69 $35,817.69 $35,817.69 2025-03-28
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 1 1 — — $28,854.19 $28,854.19 $28,854.19 2025-03-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 1 1 — — $26,837.74 $26,837.74 $26,837.74 2025-03-28
33276 CPT Insj Phrnc Nrv Stim Sys 1 1 — — $32,625.36 $32,625.36 $32,625.36 2025-03-28
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 1 1 — — $39,763.07 $39,763.07 $39,763.07 2025-03-28
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 1 1 — — $62,756.86 $62,756.86 $62,756.86 2025-03-28
4014 APR_DRG Adrenal Procedures 1 1 — — $27,535.56 $27,535.56 $27,535.56 2025-03-28
4034 APR_DRG Procedures For Obesity 1 1 — — $29,636.25 $29,636.25 $29,636.25 2025-03-28
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 1 1 — — $31,813.40 $31,813.40 $31,813.40 2025-03-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $27,392.88 $27,392.88 $27,392.88 2025-03-28
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 1 1 — — $35,614.99 $35,614.99 $35,614.99 2025-03-28
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $44,109.64 $44,109.64 $44,109.64 2025-03-28
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $52,364.42 $52,364.42 $52,364.42 2025-03-28
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $74,757.32 $74,757.32 $74,757.32 2025-03-28
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $109,327.92 $109,327.92 $109,327.92 2025-03-28
4401 APR_DRG Kidney Transplant 1 1 — — $30,772.52 $30,772.52 $30,772.52 2025-03-28
4402 APR_DRG Kidney Transplant 1 1 — — $32,709.79 $32,709.79 $32,709.79 2025-03-28
4403 APR_DRG Kidney Transplant 1 1 — — $37,932.41 $37,932.41 $37,932.41 2025-03-28
4404 APR_DRG Kidney Transplant 1 1 — — $58,385.24 $58,385.24 $58,385.24 2025-03-28
4414 APR_DRG Major Bladder Procedures 1 1 — — $39,319.78 $39,319.78 $39,319.78 2025-03-28
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 1 1 — — $27,622.53 $27,622.53 $27,622.53 2025-03-28
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 1 1 — — $26,944.28 $26,944.28 $26,944.28 2025-03-28
4444 APR_DRG Renal Dialysis Access Device Procedures And Vessel Repair 1 1 — — $29,825.63 $29,825.63 $29,825.63 2025-03-28
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 1 1 — — $32,618.61 $32,618.61 $32,618.61 2025-03-28
453 MS_DRG Inpatient Ms-DRG 1 1 — — $42,961.11 $42,961.11 $42,961.11 2025-03-28
454 MS_DRG Inpatient Ms-DRG 1 1 — — $39,753.73 $39,753.73 $39,753.73 2025-03-28
455 MS_DRG Inpatient Ms-DRG 1 1 — — $34,445.67 $34,445.67 $34,445.67 2025-03-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $37,565.62 $37,565.62 $37,565.62 2025-03-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $30,338.00 $30,338.00 $30,338.00 2025-03-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $27,444.24 $27,444.24 $27,444.24 2025-03-28
459 MS_DRG Inpatient Ms-DRG 1 1 — — $27,011.67 $27,011.67 $27,011.67 2025-03-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $31,156.29 $31,156.29 $31,156.29 2025-03-28
4804 APR_DRG Major Male Pelvic Procedures 1 1 — — $31,941.76 $31,941.76 $31,941.76 2025-03-28
4844 APR_DRG Other Male Reproductive System And Related Procedures 1 1 — — $27,039.67 $27,039.67 $27,039.67 2025-03-28
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 1 1 — — $27,128.05 $27,128.05 $27,128.05 2025-03-28
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $58,911.44 $58,911.44 $58,911.44 2025-03-28
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 1 1 — — $28,429.85 $28,429.85 $28,429.85 2025-03-28
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $29,144.57 $29,144.57 $29,144.57 2025-03-28
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 1 1 — — $34,134.33 $34,134.33 $34,134.33 2025-03-28
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 1 1 — — $30,793.56 $30,793.56 $30,793.56 2025-03-28
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 1 1 — — $27,193.98 $27,193.98 $27,193.98 2025-03-28
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $39,671.18 $39,671.18 $39,671.18 2025-03-28
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $50,436.27 $50,436.27 $50,436.27 2025-03-28
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $71,753.92 $71,753.92 $71,753.92 2025-03-28
5484 APR_DRG Postpartum And Post Abortion Diagnosis With O.r. Procedure 1 1 — — $32,425.02 $32,425.02 $32,425.02 2025-03-28
5831 APR_DRG Neonate With Ecmo 1 1 — — $112,462.48 $112,462.48 $112,462.48 2025-03-28
5832 APR_DRG Neonate With Ecmo 1 1 — — $142,335.80 $142,335.80 $142,335.80 2025-03-28
5833 APR_DRG Neonate With Ecmo 1 1 — — $209,775.41 $209,775.41 $209,775.41 2025-03-28
5834 APR_DRG Neonate With Ecmo 1 1 — — $261,126.31 $261,126.31 $261,126.31 2025-03-28
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $60,868.89 $60,868.89 $60,868.89 2025-03-28
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $60,868.89 $60,868.89 $60,868.89 2025-03-28
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $126,083.66 $126,083.66 $126,083.66 2025-03-28
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $206,843.56 $206,843.56 $206,843.56 2025-03-28
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $87,221.90 $87,221.90 $87,221.90 2025-03-28
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $84,136.44 $84,136.44 $84,136.44 2025-03-28
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $76,487.67 $76,487.67 $76,487.67 2025-03-28
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $54,742.87 $54,742.87 $54,742.87 2025-03-28
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $75,926.55 $75,926.55 $75,926.55 2025-03-28
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $83,928.82 $83,928.82 $83,928.82 2025-03-28
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $141,221.98 $141,221.98 $141,221.98 2025-03-28
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $70,334.29 $70,334.29 $70,334.29 2025-03-28
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $81,194.06 $81,194.06 $81,194.06 2025-03-28
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $117,243.92 $117,243.92 $117,243.92 2025-03-28
6 MS_DRG Liver Transplant Without Mcc 1 1 — — $40,281.84 $40,281.84 $40,281.84 2025-03-28
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $55,438.66 $55,438.66 $55,438.66 2025-03-28
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $61,856.47 $61,856.47 $61,856.47 2025-03-28
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $90,728.90 $90,728.90 $90,728.90 2025-03-28
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $34,533.43 $34,533.43 $34,533.43 2025-03-28
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $52,950.79 $52,950.79 $52,950.79 2025-03-28
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $109,833.63 $109,833.63 $109,833.63 2025-03-28
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $38,935.42 $38,935.42 $38,935.42 2025-03-28
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $48,520.75 $48,520.75 $48,520.75 2025-03-28
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $75,637.57 $75,637.57 $75,637.57 2025-03-28
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $28,194.88 $28,194.88 $28,194.88 2025-03-28
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $41,263.36 $41,263.36 $41,263.36 2025-03-28
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $67,001.94 $67,001.94 $67,001.94 2025-03-28
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $37,504.56 $37,504.56 $37,504.56 2025-03-28
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $37,504.56 $37,504.56 $37,504.56 2025-03-28
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $55,323.63 $55,323.63 $55,323.63 2025-03-28
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $138,340.63 $138,340.63 $138,340.63 2025-03-28
61 APR_DRG Pancreas Transplant 1 1 — — $52,492.07 $52,492.07 $52,492.07 2025-03-28
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $35,147.15 $35,147.15 $35,147.15 2025-03-28
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $60,961.48 $60,961.48 $60,961.48 2025-03-28
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $33,076.62 $33,076.62 $33,076.62 2025-03-28
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $50,039.98 $50,039.98 $50,039.98 2025-03-28
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $31,431.14 $31,431.14 $31,431.14 2025-03-28
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $50,289.68 $50,289.68 $50,289.68 2025-03-28
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $28,286.76 $28,286.76 $28,286.76 2025-03-28
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $39,212.47 $39,212.47 $39,212.47 2025-03-28
62 APR_DRG Pancreas Transplant 1 1 — — $52,492.07 $52,492.07 $52,492.07 2025-03-28
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 1 1 — — $27,217.83 $27,217.83 $27,217.83 2025-03-28
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 1 1 — — $47,287.69 $47,287.69 $47,287.69 2025-03-28
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $36,513.48 $36,513.48 $36,513.48 2025-03-28
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 1 1 — — $42,547.63 $42,547.63 $42,547.63 2025-03-28
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 1 1 — — $51,634.96 $51,634.96 $51,634.96 2025-03-28
63 APR_DRG Pancreas Transplant 1 1 — — $58,558.48 $58,558.48 $58,558.48 2025-03-28
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $33,012.09 $33,012.09 $33,012.09 2025-03-28
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $59,310.38 $59,310.38 $59,310.38 2025-03-28
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $118,789.10 $118,789.10 $118,789.10 2025-03-28
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $41,104.14 $41,104.14 $41,104.14 2025-03-28
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $123,339.09 $123,339.09 $123,339.09 2025-03-28
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 1 1 — — $46,523.16 $46,523.16 $46,523.16 2025-03-28
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 1 1 — — $31,339.25 $31,339.25 $31,339.25 2025-03-28
6364 APR_DRG Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection 1 1 — — $29,347.98 $29,347.98 $29,347.98 2025-03-28
64 APR_DRG Pancreas Transplant 1 1 — — $97,322.06 $97,322.06 $97,322.06 2025-03-28
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 1 1 — — $28,445.48 $28,445.48 $28,445.48 2025-03-28
6504 APR_DRG Splenectomy 1 1 — — $28,723.73 $28,723.73 $28,723.73 2025-03-28
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 1 1 — — $46,387.79 $46,387.79 $46,387.79 2025-03-28
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $51,210.62 $51,210.62 $51,210.62 2025-03-28
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $45,273.97 $45,273.97 $45,273.97 2025-03-28
6903 APR_DRG Acute Leukemia 1 1 — — $30,254.19 $30,254.19 $30,254.19 2025-03-28
6904 APR_DRG Acute Leukemia 1 1 — — $48,504.62 $48,504.62 $48,504.62 2025-03-28
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 1 1 — — $28,128.24 $28,128.24 $28,128.24 2025-03-28
6954 APR_DRG Chemotherapy For Acute Leukemia 1 1 — — $44,263.25 $44,263.25 $44,263.25 2025-03-28
7 MS_DRG Lung Transplant 1 1 — — $56,917.99 $56,917.99 $56,917.99 2025-03-28
71 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $40,658.05 $40,658.05 $40,658.05 2025-03-28
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 1 1 — — $33,463.79 $33,463.79 $33,463.79 2025-03-28
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 1 1 — — $33,120.81 $33,120.81 $33,120.81 2025-03-28
72 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $58,909.18 $58,909.18 $58,909.18 2025-03-28
73 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $70,931.88 $70,931.88 $70,931.88 2025-03-28
734 APR_DRG Orbit And Eye Procedures 1 1 — — $28,755.30 $28,755.30 $28,755.30 2025-03-28
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $137,807.56 $137,807.56 $137,807.56 2025-03-28
7594 APR_DRG Eating Disorders 1 1 — — $28,590.47 $28,590.47 $28,590.47 2025-03-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 1 1 — — $35,460.42 $35,460.42 $35,460.42 2025-03-28
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $35,671.10 $35,671.10 $35,671.10 2025-03-28
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $28,319.02 $28,319.02 $28,319.02 2025-03-28
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 1 1 — — $47,400.42 $47,400.42 $47,400.42 2025-03-28
81 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $27,684.26 $27,684.26 $27,684.26 2025-03-28
82 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $33,226.72 $33,226.72 $33,226.72 2025-03-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $29,204.29 $29,204.29 $29,204.29 2025-03-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $26,912.54 $26,912.54 $26,912.54 2025-03-28
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $38,943.83 $38,943.83 $38,943.83 2025-03-28
834 MS_DRG Acute Leukemia With Mcc 1 1 — — $27,363.14 $27,363.14 $27,363.14 2025-03-28
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $62,166.48 $62,166.48 $62,166.48 2025-03-28
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $37,216.28 $37,216.28 $37,216.28 2025-03-28
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $37,216.28 $37,216.28 $37,216.28 2025-03-28
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $57,269.31 $57,269.31 $57,269.31 2025-03-28
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $144,168.56 $144,168.56 $144,168.56 2025-03-28
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $29,190.87 $29,190.87 $29,190.87 2025-03-28
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $71,693.60 $71,693.60 $71,693.60 2025-03-28
8434 APR_DRG Extensive Third Degree Burns Without Skin Graft 1 1 — — $35,683.02 $35,683.02 $35,683.02 2025-03-28
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 1 1 — — $44,695.31 $44,695.31 $44,695.31 2025-03-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $28,684.29 $28,684.29 $28,684.29 2025-03-28
8633 APR_DRG Neonatal Aftercare 1 1 — — $27,689.17 $27,689.17 $27,689.17 2025-03-28
8634 APR_DRG Neonatal Aftercare 1 1 — — $72,106.73 $72,106.73 $72,106.73 2025-03-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 1 1 — — $39,430.20 $39,430.20 $39,430.20 2025-03-28
894 APR_DRG Major Cranial Or Facial Bone Procedures 1 1 — — $42,543.42 $42,543.42 $42,543.42 2025-03-28
91 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $32,993.15 $32,993.15 $32,993.15 2025-03-28
9103 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $28,854.89 $28,854.89 $28,854.89 2025-03-28
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $50,111.52 $50,111.52 $50,111.52 2025-03-28
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 1 1 — — $49,192.69 $49,192.69 $49,192.69 2025-03-28
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $46,137.39 $46,137.39 $46,137.39 2025-03-28
914 APR_DRG Other Major Head And Neck Procedures 1 1 — — $42,771.37 $42,771.37 $42,771.37 2025-03-28
92 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $32,993.15 $32,993.15 $32,993.15 2025-03-28
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 1 1 — — $32,267.91 $32,267.91 $32,267.91 2025-03-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 1 1 — — $101,631.03 $101,631.03 $101,631.03 2025-03-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 1 1 — — $32,554.95 $32,554.95 $32,554.95 2025-03-28
93 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $55,111.80 $55,111.80 $55,111.80 2025-03-28
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $124,520.24 $124,520.24 $124,520.24 2025-03-28
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $39,678.20 $39,678.20 $39,678.20 2025-03-28
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $29,766.71 $29,766.71 $29,766.71 2025-03-28
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $27,511.01 $27,511.01 $27,511.01 2025-03-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $40,006.07 $40,006.07 $40,006.07 2025-03-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $32,175.54 $32,175.54 $32,175.54 2025-03-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 1 1 — — $28,334.63 $28,334.63 $28,334.63 2025-03-28
984 APR_DRG Other Ear, Nose, Mouth And Throat Procedures 1 1 — — $27,722.13 $27,722.13 $27,722.13 2025-03-28
A9543 HCPCS Y90 Ibritumomab, Rx 1 1 — — $52,381.27 $52,381.27 $52,381.27 2025-03-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $2,636,800.00 $2,636,800.00 $2,636,800.00 2025-03-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 1 1 — — $76,199.20 $76,199.20 $76,199.20 2025-03-28
J9226 HCPCS Supprelin La Implant 2 2 — — $43,778.64 $54,093.86 $48,936.25 2025-03-28
L7180 HCPCS Electronic Elbow Sequential 1 1 — — $28,032.50 $28,032.50 $28,032.50 2025-03-28
L7181 HCPCS Electronic Elbo Simultaneous 1 1 — — $30,433.14 $30,433.14 $30,433.14 2025-03-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $68,407.23 $68,407.23 $68,407.23 2025-03-28
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 1 1 — — $347,966.42 $347,966.42 $347,966.42 2025-03-28
Q2042 HCPCS Tisagenlecleucel Car-pos T 1 1 — — $380,939.46 $380,939.46 $380,939.46 2025-03-28
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $43,185.17 $43,185.17 $43,185.17 2025-03-28
Q2053 HCPCS Brexucabtagene Car Pos T 1 1 — — $348,812.99 $348,812.99 $348,812.99 2025-03-28
Q2054 HCPCS Lisocabtagene Mara Car Pos T 1 1 — — $347,934.40 $347,934.40 $347,934.40 2025-03-28
Q2055 HCPCS Idecabtagene Vicleucel Car 1 1 — — $355,736.00 $355,736.00 $355,736.00 2025-03-28
Q2056 HCPCS Ciltacabtagene Car-pos T 1 1 — — $394,320.00 $394,320.00 $394,320.00 2025-03-28
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