Price Transparency 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

LOS ROBLES HOSPITAL & MEDICAL CENTER

Thousand Oaks, CA · CCN 050549 · Rates published

32,019 distinct procedures filed
38 distinct payers
648,894 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

286,230 of 648,894 rate rows are consumer-grade (44.1%)

362,664 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 318,805
template filing: same amount across many unrelated codes — excluded 27,307
per-diem day rate — not a per-procedure price 16,393
placeholder amount (≤ $0.02) — excluded from medians 111
exceeds 10× this hospital's gross charge — excluded from medians 48

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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://core.secure.ehc.com/src/util/json-detail-price-list/95-2321136_los-robles-hospital-and-medical-center_standardcharges.json
Found on page https://losrobleshospital.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 1416f01f2c67f89b… · 491,487,451 bytes · first seen 2026-05-08

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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,006,423
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,469,189
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 17 $3,636,171.00 $4,774,770.00 $3,709,629.00 nat. median
$3,746,358
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,672,900.00 $3,672,900.00 $3,672,900.00 nat. median
$3,574,709
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 17 $3,568,950.00 $4,686,500.00 $3,641,050.00 nat. median
$3,605,000
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,496,850
1.0× median
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,325,455.00 $3,325,455.00 $3,325,455.00 nat. median
$3,228,024
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 18 $8,469.42 $4,323,091.50 $3,325,455.00 nat. median
$13,041
outlier · 255.0×
748
OTHER 		Inj, Lovotibeglogene Auto 18 $13,970.28 $4,271,800.00 $3,286,000.00 nat. median
$17,963
outlier · 182.9×
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,286,000.00 $3,286,000.00 $3,286,000.00 nat. median
$3,187,420
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$2,878,960
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 18 $12,408.39 $3,858,400.00 $2,968,000.00 nat. median
$21,896
outlier · 135.6×
9141
OTHER 		Inj Onase Abepar-xioi Tre 17 $2,364,727.86 $3,105,198.20 $2,412,500.14 nat. median
$2,588,981
0.9× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,388,614.00 $2,388,614.00 $2,388,614.00 nat. median
$2,457,321
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 17 $523,900.97 $687,950.77 $534,484.83 nat. median
$566,531
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 17 $521,852.17 $685,260.42 $532,394.64 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 17 $521,321.72 $684,563.88 $531,853.47 nat. median
$558,082
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $529,192.90 $529,192.90 $529,192.90 nat. median
$538,205
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 $92,985.20 $837,683.55 $527,123.43 nat. median
$675,122
0.8× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $527,123.40 $527,123.40 $527,123.40 nat. median
$554,552
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $526,587.60 $526,587.60 $526,587.60 nat. median
$530,178
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 $106,631.80 $830,699.97 $526,587.59 nat. median
$625,184
0.8× median
9413
OTHER 		Lisocabtagene Car Pos T 17 $511,558.84 $671,743.93 $521,893.36 nat. median
$562,201
0.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 $3,135.00 $863,696.72 $518,241.00 nat. median
$754,974
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $516,726.10 $516,726.10 $516,726.10 nat. median
$534,091
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 $104,247.00 $819,043.85 $516,726.08 nat. median
$674,188
0.8× median
9035
OTHER 		Axicabtagene Ciloleucel C 17 $484,561.44 $636,292.80 $494,350.56 nat. median
$532,192
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $489,456.00 $489,456.00 $489,456.00 nat. median
$505,583
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 $98,876.80 $807,075.90 $489,455.96 nat. median
$634,511
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 17 $455,925.10 $598,689.52 $465,135.71 nat. median
$489,450
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 $98,876.80 $741,576.00 $460,530.40 nat. median
$620,080
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $460,530.40 $460,530.40 $460,530.40 nat. median
$464,978
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 25 $313,316.24 $587,467.95 $391,645.30 nat. median
$370,174
1.1× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 27 $8,580.00 $438,864.60 $292,576.40 nat. median
$265,286
1.1× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $287,078.20 $287,078.20 $287,078.20 nat. median
$263,894
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 25 $8,580.00 $384,542.00 $246,449.90 nat. median
$206,368
1.2× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $236,881.80 $236,881.80 $236,881.80 nat. median
$424,868
0.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 27 $7,763.00 $528,616.00 $222,651.70 nat. median
$202,986
1.1× median
1908
OTHER 		New Technology - Level 52 17 $197,980.20 $259,974.00 $201,979.80 nat. median
$152,962
1.3× median
1907
OTHER 		New Technology - Level 52 17 $197,980.20 $259,974.00 $201,979.80 nat. median
$153,199
1.3× median
01908
OTHER 		New Technology - Level 52 1 $199,980.00 $199,980.00 $199,980.00 nat. median
$82,736
outlier · 2.4×
01907
OTHER 		New Technology - Level 52 1 $199,980.00 $199,980.00 $199,980.00 nat. median
$84,819
outlier · 2.4×
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $192,285.00 $192,285.00 $192,285.00 nat. median
$218,232
0.9× median
1905
OTHER 		New Technology - Level 51 17 $178,506.80 $234,402.87 $182,113.00 nat. median
$137,903
1.3× median
1906
OTHER 		New Technology - Level 51 17 $178,506.80 $234,402.87 $182,113.00 nat. median
$138,020
1.3× median
01905
OTHER 		New Technology - Level 51 1 $180,309.90 $180,309.90 $180,309.90 nat. median
$82,736
outlier · 2.2×
01906
OTHER 		New Technology - Level 51 1 $180,309.90 $180,309.90 $180,309.90 nat. median
$82,736
outlier · 2.2×
1904
OTHER 		New Technology - Level 50 17 $159,033.40 $208,831.74 $162,246.20 nat. median
$120,174
1.4× median
1903
OTHER 		New Technology - Level 50 17 $159,033.40 $208,831.74 $162,246.20 nat. median
$119,935
1.4× median
01903
OTHER 		New Technology - Level 50 1 $160,639.80 $160,639.80 $160,639.80 nat. median
$84,819
1.9× median

Other procedures at this hospital

Browse this hospital's 32,019 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
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 22 17 — — $3,636,171.00 $4,774,770.00 $3,709,629.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,672,900.00 $3,672,900.00 $3,672,900.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 22 17 — — $3,568,950.00 $4,686,500.00 $3,641,050.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 23 18 — — $8,469.42 $4,323,091.50 $3,325,455.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,325,455.00 $3,325,455.00 $3,325,455.00 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,286,000.00 $3,286,000.00 $3,286,000.00 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 23 18 — — $13,970.28 $4,271,800.00 $3,286,000.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 23 18 — — $12,408.39 $3,858,400.00 $2,968,000.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 22 17 — — $2,364,727.86 $3,105,198.20 $2,412,500.14 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,388,614.00 $2,388,614.00 $2,388,614.00 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 22 17 — — $523,900.97 $687,950.77 $534,484.83 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 22 17 — — $521,852.17 $685,260.42 $532,394.64 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 22 17 — — $521,321.72 $684,563.88 $531,853.47 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $529,192.90 $529,192.90 $529,192.90 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 7 5 — — $92,985.20 $837,683.55 $527,123.43 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $527,123.40 $527,123.40 $527,123.40 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $526,587.60 $526,587.60 $526,587.60 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 5 — — $106,631.80 $830,699.97 $526,587.59 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 22 17 — — $511,558.84 $671,743.93 $521,893.36 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 9 6 — — $3,135.00 $863,696.72 $518,241.00 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $516,726.10 $516,726.10 $516,726.10 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 7 5 — — $104,247.00 $819,043.85 $516,726.08 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 22 17 — — $484,561.44 $636,292.80 $494,350.56 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $489,456.00 $489,456.00 $489,456.00 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 7 5 — — $98,876.80 $807,075.90 $489,455.96 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 22 17 — — $455,925.10 $598,689.52 $465,135.71 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $460,530.40 $460,530.40 $460,530.40 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 5 — — $98,876.80 $741,576.00 $460,530.40 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 25 — — $313,316.24 $587,467.95 $391,645.30 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 35 27 — — $8,580.00 $438,864.60 $292,576.40 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $287,078.20 $287,078.20 $287,078.20 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 33 25 — — $8,580.00 $384,542.00 $246,449.90 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $236,881.80 $236,881.80 $236,881.80 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 37 27 — — $7,763.00 $528,616.00 $222,651.70 2024-10-01
1907 OTHER New Technology - Level 52 22 17 — — $197,980.20 $259,974.00 $201,979.80 2024-10-01
1908 OTHER New Technology - Level 52 22 17 — — $197,980.20 $259,974.00 $201,979.80 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $199,980.00 $199,980.00 $199,980.00 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $199,980.00 $199,980.00 $199,980.00 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $192,285.00 $192,285.00 $192,285.00 2024-10-01
1905 OTHER New Technology - Level 51 22 17 — — $178,506.80 $234,402.87 $182,113.00 2024-10-01
1906 OTHER New Technology - Level 51 22 17 — — $178,506.80 $234,402.87 $182,113.00 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $180,309.90 $180,309.90 $180,309.90 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $180,309.90 $180,309.90 $180,309.90 2024-10-01
1903 OTHER New Technology - Level 50 22 17 — — $159,033.40 $208,831.74 $162,246.20 2024-10-01
1904 OTHER New Technology - Level 50 22 17 — — $159,033.40 $208,831.74 $162,246.20 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $160,639.80 $160,639.80 $160,639.80 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $160,639.80 $160,639.80 $160,639.80 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 37 27 — — $7,763.00 $358,475.00 $146,863.00 2024-10-01
1902 OTHER New Technology - Level 49 22 17 — — $139,560.00 $183,260.61 $142,379.40 2024-10-01
1901 OTHER New Technology - Level 49 22 17 — — $139,560.00 $183,260.61 $142,379.40 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $140,969.70 $140,969.70 $140,969.70 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $140,969.70 $140,969.70 $140,969.70 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 32 25 — — $108,560.91 $204,284.85 $136,189.90 2024-10-01
7 MS_DRG Lung Transplant 33 26 — — $8,580.00 $203,770.95 $135,847.30 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $135,200.20 $135,200.20 $135,200.20 2024-10-01
1599 OTHER New Technology - Level 48 22 17 — — $123,332.22 $161,951.40 $125,823.78 2024-10-01
1585 OTHER New Technology - Level 48 22 17 — — $123,332.22 $161,951.40 $125,823.78 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $125,624.30 $125,624.30 $125,624.30 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $124,578.00 $124,578.00 $124,578.00 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $124,578.00 $124,578.00 $124,578.00 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $122,339.70 $122,339.70 $122,339.70 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 4 2 — — $79,763.85 $199,409.63 $120,116.70 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 7 5 — — $29,124.00 $129,277.00 $117,153.98 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 35 27 — — $8,580.00 $241,600.00 $114,586.10 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 33 26 — — $8,580.00 $169,907.85 $113,271.90 2024-10-01
1584 OTHER New Technology - Level 47 22 17 — — $110,349.95 $144,903.98 $112,579.24 2024-10-01
1598 OTHER New Technology - Level 47 22 17 — — $110,349.95 $144,903.98 $112,579.24 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $111,464.60 $111,464.60 $111,464.60 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $111,464.60 $111,464.60 $111,464.60 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 33 26 — — $8,580.00 $166,100.85 $110,733.90 2024-10-01
215 MS_DRG Other Heart Assist System Implant 40 28 — — $7,763.00 $229,302.00 $110,169.20 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 23 — — $8,580.00 $163,500.60 $109,000.40 2024-10-01
007 OTHER Lung Transplant 1 1 — — $108,390.90 $108,390.90 $108,390.90 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $108,194.30 $108,194.30 $108,194.30 2024-10-01
A9543 HCPCS Y90 Ibritum Tiu Tx 40mci 6 4 $278,837.37 $278,837.37 $67,947.00 $393,786.06 $108,036.36 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 43 28 — — $7,763.00 $206,983.00 $100,372.10 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $100,132.40 $100,132.40 $100,132.40 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 23 18 — — $98,999.90 $129,999.87 $99,999.90 2024-10-01
1583 OTHER New Technology - Level 46 22 17 — — $97,367.65 $127,856.51 $99,334.67 2024-10-01
1597 OTHER New Technology - Level 46 22 17 — — $97,367.65 $127,856.51 $99,334.67 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $98,351.16 $98,351.16 $98,351.16 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $98,351.16 $98,351.16 $98,351.16 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 2 — — $74,261.36 $97,981.51 $97,981.51 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 30 23 — — $8,580.00 $143,721.12 $95,814.08 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $92,285.55 $92,285.55 $92,285.55 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 23 18 — — $90,121.58 $118,341.47 $91,031.90 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 2 — — $68,758.15 $90,720.49 $90,720.49 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 54 32 — — $7,763.00 $162,770.00 $89,917.44 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $88,935.67 $88,935.67 $88,935.67 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $88,732.67 $88,732.67 $88,732.67 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 28 — — $7,763.00 $132,156.78 $88,104.52 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 30 23 — — $8,580.00 $130,154.40 $86,769.60 2024-10-01
1596 OTHER New Technology - Level 45 22 17 — — $84,385.38 $110,809.09 $86,090.14 2024-10-01
1582 OTHER New Technology - Level 45 22 17 — — $84,385.38 $110,809.09 $86,090.14 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $85,237.76 $85,237.76 $85,237.76 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $85,237.76 $85,237.76 $85,237.76 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 7 5 — — $29,124.00 $96,757.00 $84,882.50 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 42 28 — — $7,763.00 $163,180.00 $83,868.27 2024-10-01
10 MS_DRG Pancreas Transplant 33 26 — — $8,580.00 $124,433.74 $82,955.83 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 54 32 — — $7,763.00 $123,288.00 $82,954.73 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $82,524.90 $82,524.90 $82,524.90 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 33 26 — — $8,580.00 $123,719.05 $82,479.37 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 32 — — $7,763.00 $174,511.00 $82,120.40 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $79,883.53 $79,883.53 $79,883.53 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $79,439.32 $79,439.32 $79,439.32 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 7 5 — — $29,124.00 $89,229.00 $77,945.25 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 35 27 — — $8,580.00 $119,563.00 $77,673.22 2024-10-01
A9699 HCPCS Noc Therapeutic Radiophm 2 1 $682.02 $682.02 $76,785.37 $76,785.37 $76,785.37 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 23 — — $8,580.00 $110,826.54 $73,884.36 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 36 27 — — $8,580.00 $170,184.00 $73,550.11 2024-10-01
1581 OTHER New Technology - Level 44 22 17 — — $71,403.12 $93,761.67 $72,845.61 2024-10-01
1595 OTHER New Technology - Level 44 22 17 — — $71,403.12 $93,761.67 $72,845.61 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $72,413.18 $72,413.18 $72,413.18 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 34 26 — — $8,536.00 $108,612.39 $72,408.26 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $72,124.36 $72,124.36 $72,124.36 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $72,124.36 $72,124.36 $72,124.36 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $71,709.45 $71,709.45 $71,709.45 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 35 27 — — $8,580.00 $112,671.00 $71,073.33 2024-10-01
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 3 2 — — $16,565.00 $79,827.00 $70,940.00 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 53 32 — — $7,763.00 $125,120.00 $70,793.30 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $70,633.96 $70,633.96 $70,633.96 2024-10-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $70,373.85 $70,373.85 $70,373.85 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 30 23 — — $8,580.00 $104,683.90 $69,789.27 2024-10-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $69,651.08 $69,651.08 $69,651.08 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 33 25 — — $8,580.00 $104,283.74 $69,522.49 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $69,511.49 $69,511.49 $69,511.49 2024-10-01
5244 OTHER Level 4 Blood Product Exc 22 17 — — $67,593.69 $88,759.38 $68,959.21 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $68,689.95 $68,689.95 $68,689.95 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $68,276.45 $68,276.45 $68,276.45 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $67,446.48 $67,446.48 $67,446.48 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 34 26 — — $8,536.00 $101,001.45 $67,334.30 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 43 28 — — $7,763.00 $195,148.00 $67,227.38 2024-10-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $67,113.32 $67,113.32 $67,113.32 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 2 — — $50,616.17 $66,783.70 $66,783.70 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 22 17 — — $64,821.81 $85,119.55 $66,131.35 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $65,906.08 $65,906.08 $65,906.08 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 23 18 — — $65,212.98 $85,633.21 $65,871.70 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 35 27 — — $8,580.00 $100,263.00 $65,841.59 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $65,476.58 $65,476.58 $65,476.58 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 54 32 — — $7,763.00 $162,770.00 $64,875.64 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 2 — — $49,054.63 $64,723.39 $64,723.39 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 36 27 — — $8,580.00 $115,723.00 $64,493.17 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 30 23 — — $8,580.00 $104,321.00 $64,410.12 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 35 27 — — $8,580.00 $96,176.10 $64,117.40 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 41 28 — — $23,276.00 $99,474.00 $63,898.37 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 4 3 — — $48,500.00 $81,912.32 $63,644.25 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 50 32 — — $7,763.00 $274,778.00 $63,627.30 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 23 18 — — $20,296.68 $82,361.20 $63,354.77 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 7 5 — — $16,500.00 $104,773.89 $63,354.77 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $63,354.77 $63,354.77 $63,354.77 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 42 28 — — $7,763.00 $94,950.69 $63,300.46 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 32 25 — — $50,278.30 $94,271.81 $62,847.87 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 32 25 — — $42,385.60 $94,271.81 $62,847.87 2024-10-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $62,582.76 $62,582.76 $62,582.76 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 54 32 — — $7,763.00 $123,288.00 $62,498.62 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 43 28 — — $7,763.00 $206,983.00 $61,951.00 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 30 24 — — $49,526.75 $92,862.66 $61,908.44 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 7 5 — — $29,124.00 $67,190.00 $61,272.04 2024-10-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 2 2 — — $60,927.09 $60,927.09 $60,927.09 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $60,871.71 $60,871.71 $60,871.71 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $60,866.14 $60,866.14 $60,866.14 2024-10-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $60,751.60 $60,751.60 $60,751.60 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $60,729.22 $60,729.22 $60,729.22 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 34 27 — — $8,580.00 $119,879.97 $60,630.61 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $60,630.50 $60,630.50 $60,630.50 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 39 26 — — $7,763.00 $135,959.00 $60,602.30 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $60,250.78 $60,250.78 $60,250.78 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $59,951.46 $59,951.46 $59,951.46 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 28 — — $7,763.00 $107,980.00 $59,770.07 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $59,741.29 $59,741.29 $59,741.29 2024-10-01
1594 OTHER New Technology - Level 43 22 17 — — $58,420.85 $76,714.25 $59,601.07 2024-10-01
1580 OTHER New Technology - Level 43 22 17 — — $58,420.85 $76,714.25 $59,601.07 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $59,010.96 $59,010.96 $59,010.96 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $59,010.96 $59,010.96 $59,010.96 2024-10-01
B0105 OTHER Stroke; M > 34.25 & M < 38.85 2 2 — — $59,005.87 $59,005.87 $59,005.87 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 9 6 — — $55,015.22 $335,189.81 $58,768.60 2024-10-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $58,204.60 $58,204.60 $58,204.60 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 42 28 — — $7,763.00 $163,180.00 $58,148.26 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 35 27 — — $8,580.00 $87,089.06 $58,059.37 2024-10-01
006 OTHER Liver Transplant Without Mcc 1 1 — — $58,027.35 $58,027.35 $58,027.35 2024-10-01
B1903 OTHER Guillian Barre; M < 18.05 2 2 — — $57,992.15 $57,992.15 $57,992.15 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 33 26 — — $8,536.00 $124,668.32 $57,568.38 2024-10-01
B0604 OTHER Neurological; M < 25.85 2 2 — — $57,507.23 $57,507.23 $57,507.23 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 23 — — $8,580.00 $86,014.68 $57,343.12 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 30 23 — — $8,580.00 $85,468.15 $56,978.77 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 33 26 — — $8,580.00 $85,011.93 $56,674.62 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 35 27 — — $8,580.00 $84,818.85 $56,545.90 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 54 32 — — $7,763.00 $123,288.00 $56,528.01 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 32 — — $7,763.00 $164,532.00 $56,278.13 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 35 27 — — $8,580.00 $84,387.54 $56,258.36 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 35 27 — — $8,580.00 $84,308.13 $56,205.42 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 35 27 — — $8,580.00 $84,297.24 $56,198.16 2024-10-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 2 2 — — $55,964.71 $55,964.71 $55,964.71 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 22 17 — — $54,465.08 $71,519.80 $55,565.38 2024-10-01
A0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $55,202.69 $55,202.69 $55,202.69 2024-10-01
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days 2 2 — — $55,036.43 $55,036.43 $55,036.43 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $55,015.23 $55,015.23 $55,015.23 2024-10-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $54,945.75 $54,945.75 $54,945.75 2024-10-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $54,582.74 $54,582.74 $54,582.74 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 53 32 — — $7,763.00 $123,288.00 $54,546.99 2024-10-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $54,496.76 $54,496.76 $54,496.76 2024-10-01
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $54,186.66 $54,186.66 $54,186.66 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 54 32 — — $7,763.00 $127,343.00 $53,774.00 2024-10-01
B0704 OTHER Fracture Of Lower Extremity; M < 28.15 2 2 — — $53,741.00 $53,741.00 $53,741.00 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 30 23 — — $8,580.00 $80,479.31 $53,652.87 2024-10-01
B2102 OTHER Burns; M=12-45 2 2 — — $53,517.01 $53,517.01 $53,517.01 2024-10-01
D0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $53,189.11 $53,189.11 $53,189.11 2024-10-01
B1004 OTHER Amputation, Lower Extremity; M=39-45 2 2 — — $53,136.00 $53,136.00 $53,136.00 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 42 28 — — $10,000.00 $79,616.68 $53,077.79 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 35 27 — — $8,580.00 $79,373.79 $52,915.86 2024-10-01
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $52,616.44 $52,616.44 $52,616.44 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 4 3 — — $48,500.00 $64,249.90 $52,535.36 2024-10-01
B1504 OTHER Pulmonary; M < 29.15 2 2 — — $52,519.45 $52,519.45 $52,519.45 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 35 27 — — $8,580.00 $78,716.70 $52,477.80 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 33 26 — — $8,536.00 $121,336.32 $52,169.50 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 33 26 — — $8,580.00 $78,193.53 $52,129.02 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 35 27 — — $8,580.00 $78,171.74 $52,114.49 2024-10-01
B1704 OTHER Major Multiple Trauma,no Brain Or Spinal Cord Inju 2 2 — — $51,593.48 $51,593.48 $51,593.48 2024-10-01
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $51,496.36 $51,496.36 $51,496.36 2024-10-01
B2005 OTHER Miscellaneous; M=12-32 And A Tm81 2 2 — — $51,290.98 $51,290.98 $51,290.98 2024-10-01
D0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $51,191.69 $51,191.69 $51,191.69 2024-10-01
C0105 OTHER Stroke; M > 34.25 & M < 38.85 2 2 — — $51,173.21 $51,173.21 $51,173.21 2024-10-01
228 OTHER Other Cardiothoracic Procedures With Mcc 1 1 — — $51,119.82 $51,119.82 $51,119.82 2024-10-01
323 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 1 1 — — $51,080.82 $51,080.82 $51,080.82 2024-10-01
245 MS_DRG Aicd Generator Procedures 42 28 — — $7,763.00 $77,497.00 $50,920.74 2024-10-01
A0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $50,688.29 $50,688.29 $50,688.29 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 42 28 — — $7,763.00 $75,921.78 $50,614.52 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 33 26 — — $8,580.00 $75,795.65 $50,530.43 2024-10-01
B1204 OTHER Osteoarthritis; M=39-47 2 2 — — $50,425.05 $50,425.05 $50,425.05 2024-10-01
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $50,338.08 $50,338.08 $50,338.08 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 32 — — $7,763.00 $182,451.00 $50,260.15 2024-10-01
576 OTHER Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc* 1 1 — — $50,217.87 $50,217.87 $50,217.87 2024-10-01
C0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 2 2 — — $50,180.28 $50,180.28 $50,180.28 2024-10-01
B0504 OTHER Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 2 2 — — $50,124.86 $50,124.86 $50,124.86 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 50 32 — — $7,763.00 $206,318.00 $50,031.87 2024-10-01
B0304 OTHER Nontraumatic Brain Injury; M < 26.15 2 2 — — $49,926.27 $49,926.27 $49,926.27 2024-10-01
C0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 2 2 — — $49,769.25 $49,769.25 $49,769.25 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 34 27 — — $8,580.00 $115,918.99 $49,765.39 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 35 27 — — $8,580.00 $74,325.78 $49,550.52 2024-10-01
B1404 OTHER Cardiac; M < 31.15 2 2 — — $49,549.88 $49,549.88 $49,549.88 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 35 27 — — $8,580.00 $74,322.67 $49,548.45 2024-10-01
023 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $49,471.16 $49,471.16 $49,471.16 2024-10-01
B0904 OTHER Other Orthopedic; M < 24.15 2 2 — — $49,452.89 $49,452.89 $49,452.89 2024-10-01
B1304 OTHER Rheumatoid, Other Arthritis; M=12-35 2 2 — — $49,452.89 $49,452.89 $49,452.89 2024-10-01
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $49,200.49 $49,200.49 $49,200.49 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 9 6 — — $44,578.80 $272,131.25 $49,032.50 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 36 27 — — $8,580.00 $115,723.00 $48,973.49 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 34 27 — — $8,580.00 $97,534.36 $48,768.87 2024-10-01
456 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $48,723.64 $48,723.64 $48,723.64 2024-10-01
B2004 OTHER Miscellaneous; M < 27.85 2 2 — — $48,660.85 $48,660.85 $48,660.85 2024-10-01
454 OTHER Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $48,573.18 $48,573.18 $48,573.18 2024-10-01
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $48,563.63 $48,563.63 $48,563.63 2024-10-01
238 MS_DRG Major Cardiovasc Procedures Without Mcc 2 2 — — $48,500.00 $48,500.00 $48,500.00 2024-10-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 2 2 — — $48,500.00 $48,500.00 $48,500.00 2024-10-01
237 MS_DRG Major Cardiovasc Procedures W Mcc 2 2 — — $48,500.00 $48,500.00 $48,500.00 2024-10-01
D0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 2 2 — — $48,312.17 $48,312.17 $48,312.17 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 7 5 — — $29,124.00 $53,364.00 $48,193.50 2024-10-01
B1203 OTHER Osteoarthritis; M < 30.75 2 2 — — $48,085.87 $48,085.87 $48,085.87 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 35 27 — — $8,580.00 $72,058.69 $48,039.13 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 33 26 — — $8,580.00 $72,029.12 $48,019.41 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 35 27 — — $8,580.00 $71,790.87 $47,860.58 2024-10-01
653 OTHER Major Bladder Procedures With Mcc 1 1 — — $47,836.82 $47,836.82 $47,836.82 2024-10-01
B0805 OTHER Replacement Of Lower Extremity Joint; M > 22.05 & 2 2 — — $47,598.64 $47,598.64 $47,598.64 2024-10-01
B0204 OTHER Traumatic Brain Injury; M > 40.65 & M < 44.25 2 2 — — $47,564.00 $47,564.00 $47,564.00 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 39 26 — — $7,763.00 $96,614.00 $47,550.40 2024-10-01
B0104 OTHER Stroke; M > 38.85 & M < 44.45 2 2 — — $47,187.61 $47,187.61 $47,187.61 2024-10-01
A0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $47,173.76 $47,173.76 $47,173.76 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 35 27 — — $8,580.00 $70,539.00 $47,026.00 2024-10-01
408 OTHER Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $46,969.10 $46,969.10 $46,969.10 2024-10-01
D0105 OTHER Stroke; M > 34.25 & M < 38.85 2 2 — — $46,762.73 $46,762.73 $46,762.73 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 54 32 — — $7,763.00 $123,288.00 $46,761.48 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 35 27 — — $8,580.00 $70,120.14 $46,746.76 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 48 31 — — $7,763.00 $123,288.00 $46,708.66 2024-10-01
008 OTHER Simultaneous Pancreas And Kidney Transplant 1 1 — — $46,494.64 $46,494.64 $46,494.64 2024-10-01
011 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $46,477.92 $46,477.92 $46,477.92 2024-10-01
1579 OTHER New Technology - Level 42 22 17 — — $45,438.57 $59,666.82 $46,356.53 2024-10-01
1593 OTHER New Technology - Level 42 22 17 — — $45,438.57 $59,666.82 $46,356.53 2024-10-01
B1103 OTHER Amputation, Non-lower Extremity; M=12-37 2 2 — — $46,312.44 $46,312.44 $46,312.44 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 35 27 — — $8,580.00 $69,276.21 $46,184.14 2024-10-01
B1804 OTHER Major Multiple Trauma With Brain Or Spinal Code In 2 2 — — $46,150.80 $46,150.80 $46,150.80 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 23 18 — — $45,643.75 $59,936.24 $46,104.80 2024-10-01
01579 OTHER New Technology - Level 42 1 1 — — $45,897.55 $45,897.55 $45,897.55 2024-10-01
01593 OTHER New Technology - Level 42 1 1 — — $45,897.55 $45,897.55 $45,897.55 2024-10-01
B0603 OTHER Neurological; M > 25.85 & M < 37.35 2 2 — — $45,855.23 $45,855.23 $45,855.23 2024-10-01
Q4244 HCPCS Procenta, Per 200 Mg 2 1 — — $26,200.65 $65,501.63 $45,851.14 2024-10-01
1142 OTHER Supprelin La Implant 22 17 — — $44,896.71 $58,955.27 $45,803.71 2024-10-01
B1703 OTHER Maj Mult Trauma No Brain Or Spinal Cord Injury; M 2 2 — — $45,582.75 $45,582.75 $45,582.75 2024-10-01
D0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 2 2 — — $45,578.13 $45,578.13 $45,578.13 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 53 32 — — $7,763.00 $123,288.00 $45,552.68 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $45,350.21 $45,350.21 $45,350.21 2024-10-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 32 24 — — $8,536.00 $67,664.65 $45,109.77 2024-10-01
B0403 OTHER Traumatic Spinal Cord Injury; M > 16.05 & M < 30.3 2 2 — — $45,072.42 $45,072.42 $45,072.42 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 42 28 — — $7,763.00 $107,980.00 $45,016.34 2024-10-01
C1903 OTHER Guillian Barre; M < 18.05 2 2 — — $44,582.88 $44,582.88 $44,582.88 2024-10-01
A0105 OTHER Stroke; M > 34.25 & M < 38.85 2 2 — — $44,566.72 $44,566.72 $44,566.72 2024-10-01
317 OTHER Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 1 — — $44,530.73 $44,530.73 $44,530.73 2024-10-01
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