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

LAC/RANCHO LOS AMIGOS NATIONAL REHABILITATION CTR

Downey, CA · CCN 050717 · Rates published

22,273 distinct procedures filed
4 distinct payers
214,876 rate rows
2026-07-15 last MRF observed
Data quality

210,321 of 214,876 rate rows are consumer-grade (97.9%)

4,555 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
template filing: same amount across many unrelated codes — excluded 3,887
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 314
placeholder amount (≤ $0.02) — excluded from medians 309
per-diem day rate — not a per-procedure price 45
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://file.lacounty.gov/SDSInter/dhs/1157356_956000927_RanchoLosAmigosNationalRehab.CenterCenter_standardcharges.csv
Found on page https://dhs.lacounty.gov/patient-information/get-coverage/hospital-price-transparency/
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint 2a04fb3c79a3e330… · 51,057,031 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1411
HCPCS 		"inj, Hemgenix, Per Tx Dose" 3 $4,325,397.49 $4,974,207.11 $4,325,397.49 nat. median
$3,703,693
1.2× median
J1413
HCPCS 		"inj Delandistrogene Mox Rokl" 3 $3,892,532.14 $4,476,411.96 $3,892,532.14 nat. median
$3,324,572
1.2× median
J3394
HCPCS 		"inj, Lovotibeglogene Autotem" 3 $3,812,700.74 $4,384,605.85 $3,812,700.74 nat. median
$3,286,000
1.2× median
J3393
HCPCS 		"inj, Betibeglogene Autotemce" 3 $3,457,415.04 $3,976,027.30 $3,457,415.04 nat. median
$2,994,107
1.2× median
J3399
HCPCS 		"inj Onase Abepar-xioi Treat" 3 $2,881,563.32 $3,313,797.82 $2,881,563.32 nat. median
$2,466,282
1.2× median
J3392
HCPCS 		"inj, Exagamglogene Autotem" 3 $2,737,068.40 $4,926,723.12 $2,737,068.40 nat. median
$2,401,960
1.1× median
6024
APR_DRG 		"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 1 $935,686.66 $1,173,861.45 $1,105,811.51 nat. median
$118,589
outlier · 9.3×
6074
APR_DRG 		"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 1 $769,282.77 $965,100.20 $909,152.36 nat. median
$96,883
outlier · 9.4×
6023
APR_DRG 		"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 1 $765,551.22 $960,418.80 $904,742.35 nat. median
$88,157
outlier · 10.3×
6073
APR_DRG 		"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 1 $618,154.91 $775,503.43 $730,546.71 nat. median
$69,181
outlier · 10.6×
6022
APR_DRG 		"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 1 $617,455.25 $774,625.67 $729,719.84 nat. median
$70,021
outlier · 10.4×
44
APR_DRG 		"tracheostomy With Mv >96 Hours With Extensive Procedure" 1 $544,456.76 $683,045.75 $643,448.90 nat. median
$122,016
outlier · 5.3×
6124
APR_DRG 		"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 1 $524,749.50 $658,322.10 $620,158.50 nat. median
$66,709
outlier · 9.3×
7404
APR_DRG 		"mental Illness Diagnosis With O.r. Procedure" 1 $488,017.04 $612,239.55 $576,747.41 nat. median
$35,154
outlier · 16.4×
1614
APR_DRG 		"implantable Heart Assist Systems" 1 $476,822.38 $598,195.35 $563,517.36 nat. median
$202,993
outlier · 2.8×
6021
APR_DRG 		"neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 1 $475,423.05 $596,439.82 $561,863.60 nat. median
$31,231
outlier · 18.0×
6072
APR_DRG 		"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 1 $471,225.05 $591,173.25 $556,902.33 nat. median
$52,066
outlier · 10.7×
18
MS_DRG 		"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies" 3 $550,703.91 $991,267.04 $550,703.91 nat. median
$359,358
1.5× median
54
APR_DRG 		"tracheostomy With Mv >96 Hours Without Extensive Procedure" 1 $462,129.39 $579,762.33 $546,152.92 nat. median
$81,668
outlier · 6.7×
6123
APR_DRG 		"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 1 $427,262.70 $536,020.48 $504,946.83 nat. median
$46,627
outlier · 10.8×
94
APR_DRG 		"extracorporeal Membrane Oxygenation (ecmo)" 1 $405,573.06 $508,809.84 $479,313.61 nat. median
$163,587
outlier · 2.9×
B0406
HCPCS 		"traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50.,comorbidi" 3 $400,779.48 $721,403.07 $460,896.41 nat. median
$60,970
outlier · 7.6×
43
APR_DRG 		"tracheostomy With Mv >96 Hours With Extensive Procedure" 1 $384,699.69 $482,623.25 $454,645.09 nat. median
$74,757
outlier · 6.1×
7594
APR_DRG 		"eating Disorders" 1 $354,614.05 $444,879.45 $419,089.33 nat. median
$27,181
outlier · 15.4×
114
APR_DRG 		"chimeric Antigen Receptor (car) T-cell And Other Immunotherapies" 1 $353,681.16 $443,709.10 $417,986.83 nat. median
$124,042
outlier · 3.4×
1604
APR_DRG 		"major Cardiothoracic Repair Of Heart Anomaly" 1 $351,698.78 $441,222.10 $415,644.01 nat. median
$98,624
outlier · 4.2×
53
APR_DRG 		"tracheostomy With Mv >96 Hours Without Extensive Procedure" 1 $349,949.61 $439,027.69 $413,576.81 nat. median
$50,489
outlier · 8.2×
1613
APR_DRG 		"implantable Heart Assist Systems" 1 $347,500.78 $435,955.52 $410,682.74 nat. median
$120,517
outlier · 3.4×
6071
APR_DRG 		"neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 1 $345,051.95 $432,883.35 $407,788.67 nat. median
$31,928
outlier · 12.8×
C1904
HCPCS 		"guillain-barr� M <38.50.,comorbidity In Tier 2" 3 $337,741.58 $607,934.85 $388,402.82 nat. median
$54,675
outlier · 7.1×
7614
APR_DRG 		"schizoaffective Disorders" 1 $316,715.48 $397,333.96 $374,300.11 nat. median
$18,687
outlier · 20.0×
4284
APR_DRG 		"genetic Disorders" 1 $308,319.48 $386,800.81 $364,377.57 nat. median
$41,157
outlier · 8.9×
6122
APR_DRG 		"neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 1 $305,754.04 $383,582.34 $361,345.69 nat. median
$33,469
outlier · 10.8×
7584
APR_DRG 		"disorders Of Impulse Control & Development" 1 $297,941.11 $373,780.66 $352,112.22 nat. median
$14,512
outlier · 24.3×
7574
APR_DRG 		"organic Mental Health Conditions And Disturbances" 1 $282,898.29 $354,908.76 $334,334.34 nat. median
$16,531
outlier · 20.2×
6224
APR_DRG 		"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe… 1 $281,382.34 $353,006.94 $332,542.77 nat. median
$41,260
outlier · 8.1×
3
MS_DRG 		"ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mout… 3 $331,190.91 $596,143.64 $331,190.91 nat. median
$190,557
1.7× median
6954
APR_DRG 		"chemotherapy For Acute Leukemia" 1 $266,805.97 $334,720.21 $315,316.14 nat. median
$49,041
outlier · 6.4×
6223
APR_DRG 		"neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe… 1 $265,639.86 $333,257.28 $313,938.01 nat. median
$26,136
outlier · 12.0×
3614
APR_DRG 		"skin Graft For Skin And Subcutaneous Tissue Diagnoses" 1 $262,957.81 $329,892.52 $310,768.32 nat. median
$47,197
outlier · 6.6×
J3403
HCPCS 		"revakinagene, Per Implant" 3 $302,227.75 $604,455.50 $302,227.75 nat. median
$265,000
1.1× median
52
APR_DRG 		"tracheostomy With Mv >96 Hours Without Extensive Procedure" 1 $253,862.15 $318,481.60 $300,018.90 nat. median
$42,392
outlier · 7.1×
6904
APR_DRG 		"acute Leukemia" 1 $253,512.31 $318,042.72 $299,605.46 nat. median
$58,121
outlier · 5.2×
7514
APR_DRG 		"depressive Disorders" 1 $248,148.21 $311,313.21 $293,266.06 nat. median
$14,895
outlier · 19.7×
914
APR_DRG 		"other Major Head And Neck Procedures" 1 $247,331.93 $310,289.15 $292,301.37 nat. median
$47,294
outlier · 6.2×
6804
APR_DRG 		"major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms" 1 $245,582.77 $308,094.74 $290,234.18 nat. median
$64,490
outlier · 4.5×
B0404
HCPCS 		"traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 1" 3 $250,141.67 $450,255.01 $287,662.93 nat. median
$60,006
outlier · 4.8×
6814
APR_DRG 		"other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms" 1 $242,667.49 $304,437.40 $286,788.85 nat. median
$68,108
outlier · 4.2×
3124
APR_DRG 		"skin Graft For Musculoskeletal And Connective Tissue Diagnoses" 1 $242,434.27 $304,144.81 $286,513.23 nat. median
$50,614
outlier · 5.7×
A1904
HCPCS 		"guillain-barr� M <38.50.,without Comorbidities" 3 $247,996.40 $446,393.52 $285,195.86 nat. median
$49,305
outlier · 5.8×

Other procedures at this hospital

Browse this hospital's 22,273 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
             
1104 APR_DRG "ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies" 5 1 — — $136,901.31 $171,748.92 $161,792.46 2026-07-15
112 APR_DRG "chimeric Antigen Receptor (car) T-cell And Other Immunotherapies" 5 1 — — $129,904.65 $162,971.29 $153,523.68 2026-07-15
113 APR_DRG "chimeric Antigen Receptor (car) T-cell And Other Immunotherapies" 5 1 — — $179,930.77 $225,731.33 $212,645.46 2026-07-15
114 APR_DRG "chimeric Antigen Receptor (car) T-cell And Other Immunotherapies" 5 1 — — $353,681.16 $443,709.10 $417,986.83 2026-07-15
1144 APR_DRG "dental Diseases And Disorders" 5 1 — — $154,043.13 $193,254.11 $182,050.97 2026-07-15
1204 APR_DRG "major Respiratory And Chest Procedures" 5 1 — — $185,877.93 $233,192.32 $219,673.92 2026-07-15
1214 APR_DRG "other Respiratory And Chest Procedures" 5 1 — — $196,722.76 $246,797.64 $232,490.53 2026-07-15
1302 APR_DRG "respiratory System Diagnosis With Ventilator Support > 96 Hours" 5 1 — — $155,209.24 $194,717.05 $183,429.10 2026-07-15
1303 APR_DRG "respiratory System Diagnosis With Ventilator Support > 96 Hours" 5 1 — — $182,146.38 $228,510.92 $215,263.91 2026-07-15
1304 APR_DRG "respiratory System Diagnosis With Ventilator Support > 96 Hours" 5 1 — — $222,610.40 $279,274.86 $263,085.02 2026-07-15
1313 APR_DRG "cystic Fibrosis - Pulmonary Disease" 5 1 — — $123,141.22 $154,486.25 $145,530.53 2026-07-15
1314 APR_DRG "cystic Fibrosis - Pulmonary Disease" 5 1 — — $128,388.71 $161,069.47 $151,732.11 2026-07-15
1603 APR_DRG "major Cardiothoracic Repair Of Heart Anomaly" 5 1 — — $128,738.54 $161,508.36 $152,145.55 2026-07-15
1604 APR_DRG "major Cardiothoracic Repair Of Heart Anomaly" 5 1 — — $351,698.78 $441,222.10 $415,644.01 2026-07-15
1612 APR_DRG "implantable Heart Assist Systems" 5 1 — — $196,023.09 $245,919.88 $231,663.65 2026-07-15
1613 APR_DRG "implantable Heart Assist Systems" 5 1 — — $347,500.78 $435,955.52 $410,682.74 2026-07-15
1614 APR_DRG "implantable Heart Assist Systems" 5 1 — — $476,822.38 $598,195.35 $563,517.36 2026-07-15
1623 APR_DRG "cardiac Valve Procedures With Ami Or Complex Principal Diagnosis" 5 1 — — $157,891.29 $198,081.81 $186,598.80 2026-07-15
1624 APR_DRG "cardiac Valve Procedures With Ami Or Complex Principal Diagnosis" 5 1 — — $231,939.28 $290,978.37 $274,110.06 2026-07-15
1633 APR_DRG "cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis" 5 1 — — $122,558.16 $153,754.78 $144,841.46 2026-07-15
1634 APR_DRG "cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis" 5 1 — — $191,825.10 $240,653.30 $226,702.39 2026-07-15
1653 APR_DRG "coronary Bypass With Ami Or Complex Principal Diagnosis" 5 1 — — $135,035.54 $169,408.22 $159,587.45 2026-07-15
1654 APR_DRG "coronary Bypass With Ami Or Complex Principal Diagnosis" 5 1 — — $190,775.60 $239,336.66 $225,462.07 2026-07-15
1664 APR_DRG "coronary Bypass Without Ami Or Complex Principal Diagnosis" 5 1 — — $170,368.67 $213,735.24 $201,344.79 2026-07-15
1674 APR_DRG "other Cardiothoracic And Thoracic Circulatory Procedures" 5 1 — — $179,114.50 $224,707.28 $211,680.77 2026-07-15
1694 APR_DRG "major Abdominal Vascular Procedures" 5 1 — — $150,194.97 $188,426.41 $177,503.14 2026-07-15
1704 APR_DRG "permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock" 5 1 — — $155,209.24 $194,717.05 $183,429.10 2026-07-15
1714 APR_DRG "permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock" 5 1 — — $136,085.04 $170,724.86 $160,827.77 2026-07-15
1754 APR_DRG "percutaneous Cardiac Intervention Without Ami" 5 1 — — $127,805.66 $160,338.00 $151,043.05 2026-07-15
1764 APR_DRG "insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices" 5 1 — — $128,155.49 $160,776.89 $151,456.49 2026-07-15
1784 APR_DRG "external Heart Assist Devices" 5 1 — — $122,324.94 $153,462.20 $144,565.84 2026-07-15
1794 APR_DRG "defibrillator Implants" 5 1 — — $158,241.13 $198,520.69 $187,012.24 2026-07-15
18 MS_DRG "chimeric Antigen Receptor (car) T-cell And Other Immunotherapies" 8 3 — — $550,703.91 $991,267.04 $550,703.91 2026-07-15
1804 APR_DRG "other Circulatory System Procedures" 5 1 — — $171,884.61 $215,637.06 $203,136.36 2026-07-15
1814 APR_DRG "lower Extremity Vascular Procedures" 5 1 — — $169,435.78 $212,564.89 $200,242.29 2026-07-15
1824 APR_DRG "other Peripheral Vascular And Related Procedures" 5 1 — — $141,565.75 $177,600.67 $167,304.98 2026-07-15
1834 APR_DRG "percutaneous Structural Cardiac Procedures" 5 1 — — $154,043.13 $193,254.11 $182,050.97 2026-07-15
1924 APR_DRG "cardiac Catheterization For Other Non-coronary Conditions" 5 1 — — $140,516.26 $176,284.03 $166,064.67 2026-07-15
1933 APR_DRG "acute And Subacute Endocarditis" 5 1 — — $131,770.43 $165,311.99 $155,728.69 2026-07-15
1934 APR_DRG "acute And Subacute Endocarditis" 5 1 — — $168,736.12 $211,687.13 $199,415.41 2026-07-15
1944 APR_DRG "heart Failure" 5 1 — — $129,088.38 $161,947.24 $152,558.99 2026-07-15
20 MS_DRG "intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc" 8 3 — — $155,821.16 $280,478.09 $155,821.16 2026-07-15
209 MS_DRG "complex Aortic Arch Procedures" 8 3 — — $191,430.99 $344,575.78 $191,430.99 2026-07-15
212 MS_DRG "concomitant Aortic And Mitral Valve Procedures" 8 3 — — $193,252.53 $347,854.55 $193,252.53 2026-07-15
215 MS_DRG "other Heart Assist System Implant" 8 3 — — $172,251.46 $310,052.63 $172,251.46 2026-07-15
216 MS_DRG "cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriz… 8 3 — — $178,429.07 $321,172.33 $178,429.07 2026-07-15
219 MS_DRG "cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Cathete… 8 3 — — $149,649.48 $269,369.06 $149,649.48 2026-07-15
2203 APR_DRG "major Stomach, Esophageal And Duodenal Procedures" 5 1 — — $127,105.99 $159,460.24 $150,216.17 2026-07-15
2204 APR_DRG "major Stomach, Esophageal And Duodenal Procedures" 5 1 — — $213,864.57 $268,302.83 $252,749.04 2026-07-15
2224 APR_DRG "other Stomach, Esophageal And Duodenal Procedures" 5 1 — — $167,570.01 $210,224.19 $198,037.28 2026-07-15
2234 APR_DRG "other Small And Large Bowel Procedures" 5 1 — — $168,036.45 $210,809.37 $198,588.53 2026-07-15
224 APR_DRG "ventricular Shunt Procedures" 5 1 — — $197,305.81 $247,529.11 $233,179.60 2026-07-15
2243 APR_DRG "peritoneal Adhesiolysis" 5 1 — — $122,907.99 $154,193.67 $145,254.90 2026-07-15
2244 APR_DRG "peritoneal Adhesiolysis" 5 1 — — $176,315.83 $221,196.23 $208,373.26 2026-07-15
2264 APR_DRG "anal And Perineal Procedures" 5 1 — — $145,763.75 $182,867.25 $172,266.25 2026-07-15
2274 APR_DRG "hernia Procedures Except Inguinal, Femoral And Umbilical" 5 1 — — $172,351.06 $216,222.24 $203,687.61 2026-07-15
2284 APR_DRG "inguinal, Femoral And Umbilical Hernia Procedures" 5 1 — — $140,516.26 $176,284.03 $166,064.67 2026-07-15
2294 APR_DRG "other Digestive System And Abdominal Procedures" 5 1 — — $146,230.19 $183,452.43 $172,817.50 2026-07-15
2303 APR_DRG "major Small Bowel Procedures" 5 1 — — $136,085.04 $170,724.86 $160,827.77 2026-07-15
2304 APR_DRG "major Small Bowel Procedures" 5 1 — — $204,419.08 $256,453.03 $241,586.19 2026-07-15
231 MS_DRG "coronary Bypass With Ptca With Mcc" 8 3 — — $160,700.42 $289,260.76 $160,700.42 2026-07-15
2314 APR_DRG "major Large Bowel Procedures" 5 1 — — $180,980.27 $227,047.98 $213,885.78 2026-07-15
2323 APR_DRG "gastric Fundoplication" 5 1 — — $125,356.83 $157,265.84 $148,148.98 2026-07-15
2324 APR_DRG "gastric Fundoplication" 5 1 — — $186,577.60 $234,070.08 $220,500.80 2026-07-15
233 MS_DRG "coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc" 8 3 — — $151,985.95 $273,574.71 $151,985.95 2026-07-15
233 APR_DRG "spinal Procedures" 5 1 — — $122,907.99 $154,193.67 $145,254.90 2026-07-15
2334 APR_DRG "appendectomy With Complex Principal Diagnosis" 5 1 — — $135,385.37 $169,847.10 $160,000.89 2026-07-15
234 APR_DRG "spinal Procedures" 5 1 — — $212,115.41 $266,108.42 $250,681.85 2026-07-15
2404 APR_DRG "digestive Malignancy" 5 1 — — $122,441.55 $153,608.49 $144,703.65 2026-07-15
244 APR_DRG "open Extracranial Vascular Procedures" 5 1 — — $143,548.14 $180,087.67 $169,647.80 2026-07-15
2454 APR_DRG "inflammatory Bowel Disease" 5 1 — — $132,819.93 $166,628.64 $156,969.01 2026-07-15
2484 APR_DRG "major Gastrointestinal And Peritoneal Infections" 5 1 — — $127,922.27 $160,484.30 $151,180.86 2026-07-15
2524 APR_DRG "malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure" 5 1 — — $128,738.54 $161,508.36 $152,145.55 2026-07-15
2604 APR_DRG "major Pancreas, Liver And Shunt Procedures" 5 1 — — $193,690.87 $242,994.00 $228,907.39 2026-07-15
2614 APR_DRG "major Biliary Tract Procedures" 5 1 — — $231,706.06 $290,685.78 $273,834.43 2026-07-15
2634 APR_DRG "cholecystectomy" 5 1 — — $142,382.03 $178,624.73 $168,269.67 2026-07-15
264 APR_DRG "other Nervous System And Related Procedures" 5 1 — — $204,302.47 $256,306.74 $241,448.38 2026-07-15
2644 APR_DRG "other Hepatobiliary, Pancreas And Abdominal Procedures" 5 1 — — $178,997.89 $224,560.98 $211,542.96 2026-07-15
274 APR_DRG "other Open Craniotomy" 5 1 — — $177,948.39 $223,244.34 $210,302.64 2026-07-15
2804 APR_DRG "alcoholic Liver Disease" 5 1 — — $128,738.54 $161,508.36 $152,145.55 2026-07-15
2824 APR_DRG "disorders Of Pancreas Except Malignancy" 5 1 — — $146,346.81 $183,598.72 $172,955.32 2026-07-15
294 APR_DRG "other Percutaneous Intracranial Procedures" 5 1 — — $163,488.62 $205,103.91 $193,213.83 2026-07-15
2994 APR_DRG "multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical" 5 1 — — $182,146.38 $228,510.92 $215,263.91 2026-07-15
3 MS_DRG "ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mout… 8 3 — — $331,190.91 $596,143.64 $331,190.91 2026-07-15
3004 APR_DRG "single Level Combined Anterior And Posterior Spinal Fusion Except Cervical" 5 1 — — $162,788.96 $204,226.14 $192,386.95 2026-07-15
3034 APR_DRG "dorsal And Lumbar Fusion Procedure For Curvature Of Back" 5 1 — — $207,917.41 $260,841.85 $245,720.58 2026-07-15
304 APR_DRG "percutaneous Intracranial And Extracranial Vascular Procedures" 5 1 — — $129,438.21 $162,386.12 $152,972.43 2026-07-15
3044 APR_DRG "dorsal And Lumbar Fusion Procedure Except For Curvature Of Back" 5 1 — — $190,425.76 $238,897.78 $225,048.63 2026-07-15
3053 APR_DRG "amputation Of Lower Limb Except Toes" 5 1 — — $126,639.55 $158,875.07 $149,664.92 2026-07-15
3054 APR_DRG "amputation Of Lower Limb Except Toes" 5 1 — — $194,740.37 $244,310.65 $230,147.71 2026-07-15
3084 APR_DRG "hip And Femur Fracture Repair" 5 1 — — $123,957.49 $155,510.31 $146,495.22 2026-07-15
3094 APR_DRG "other Significant Hip And Femur Surgery" 5 1 — — $160,923.18 $201,885.44 $190,181.94 2026-07-15
3104 APR_DRG "vertebral And Intervertebral Spinal Procedures Including Disc Procedures" 5 1 — — $177,015.50 $222,073.99 $209,200.13 2026-07-15
3123 APR_DRG "skin Graft For Musculoskeletal And Connective Tissue Diagnoses" 5 1 — — $155,442.46 $195,009.64 $183,704.73 2026-07-15
3124 APR_DRG "skin Graft For Musculoskeletal And Connective Tissue Diagnoses" 5 1 — — $242,434.27 $304,144.81 $286,513.23 2026-07-15
3134 APR_DRG "knee And Lower Leg Procedures Except Foot" 5 1 — — $162,439.12 $203,787.26 $191,973.51 2026-07-15
3144 APR_DRG "foot And Toe Procedures" 5 1 — — $157,658.07 $197,789.22 $186,323.18 2026-07-15
3154 APR_DRG "shoulder, Upper Arm And Forearm Procedures Except Joint Replacement" 5 1 — — $146,230.19 $183,452.43 $172,817.50 2026-07-15
3164 APR_DRG "hand And Wrist Procedures" 5 1 — — $152,877.02 $191,791.17 $180,672.84 2026-07-15
3174 APR_DRG "tendon, Muscle And Other Soft Tissue Procedures" 5 1 — — $172,117.84 $215,929.65 $203,411.99 2026-07-15
3204 APR_DRG "other Musculoskeletal System And Connective Tissue Procedures" 5 1 — — $166,287.29 $208,614.96 $196,521.34 2026-07-15
3214 APR_DRG "spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures" 5 1 — — $181,913.16 $228,218.33 $214,988.28 2026-07-15
3224 APR_DRG "shoulder And Elbow Joint Replacement" 5 1 — — $124,890.38 $156,680.66 $147,597.72 2026-07-15
3234 APR_DRG "non-elective Or Complex Hip Joint Replacement" 5 1 — — $140,866.09 $176,722.91 $166,478.10 2026-07-15
3254 APR_DRG "non-elective Or Complex Knee Joint Replacement" 5 1 — — $134,219.26 $168,384.16 $158,622.76 2026-07-15
3434 APR_DRG "musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Mal… 5 1 — — $141,915.59 $178,039.55 $167,718.42 2026-07-15
3444 APR_DRG "osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections" 5 1 — — $158,241.13 $198,520.69 $187,012.24 2026-07-15
3464 APR_DRG "connective Tissue Disorders" 5 1 — — $143,897.97 $180,526.55 $170,061.24 2026-07-15
3494 APR_DRG "malfunction, Reaction, Complication Of Orthopedic Device Or Procedure" 5 1 — — $125,123.60 $156,973.25 $147,873.35 2026-07-15
3613 APR_DRG "skin Graft For Skin And Subcutaneous Tissue Diagnoses" 5 1 — — $150,661.41 $189,011.59 $178,054.40 2026-07-15
3614 APR_DRG "skin Graft For Skin And Subcutaneous Tissue Diagnoses" 5 1 — — $262,957.81 $329,892.52 $310,768.32 2026-07-15
3634 APR_DRG "breast Procedures Except Mastectomy" 5 1 — — $175,499.56 $220,172.17 $207,408.57 2026-07-15
3644 APR_DRG "other Skin, Subcutaneous Tissue And Related Procedures" 5 1 — — $166,403.90 $208,761.25 $196,659.15 2026-07-15
3804 APR_DRG "skin Ulcers" 5 1 — — $132,819.93 $166,628.64 $156,969.01 2026-07-15
3814 APR_DRG "major Skin Disorders" 5 1 — — $144,131.20 $180,819.14 $170,336.87 2026-07-15
3834 APR_DRG "cellulitis And Other Skin Infections" 5 1 — — $125,123.60 $156,973.25 $147,873.35 2026-07-15
4 MS_DRG "tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Ne… 8 3 — — $242,541.22 $436,574.20 $242,541.22 2026-07-15
4014 APR_DRG "adrenal Procedures" 5 1 — — $209,433.36 $262,743.66 $247,512.15 2026-07-15
403 APR_DRG "spinal Disorders And Injuries" 5 1 — — $159,290.63 $199,837.33 $188,252.56 2026-07-15
4034 APR_DRG "procedures For Obesity" 5 1 — — $153,110.24 $192,083.76 $180,948.47 2026-07-15
404 APR_DRG "spinal Disorders And Injuries" 5 1 — — $182,612.83 $229,096.09 $215,815.16 2026-07-15
4044 APR_DRG "thyroid, Parathyroid And Thyroglossal Procedures" 5 1 — — $170,018.84 $213,296.36 $200,931.35 2026-07-15
4054 APR_DRG "other Procedures For Endocrine, Nutritional And Metabolic Disorders" 5 1 — — $227,624.67 $285,565.50 $269,010.98 2026-07-15
41 APR_DRG "tracheostomy With Mv >96 Hours With Extensive Procedure" 5 1 — — $194,390.54 $243,871.76 $229,734.27 2026-07-15
42 APR_DRG "tracheostomy With Mv >96 Hours With Extensive Procedure" 5 1 — — $235,437.61 $295,367.18 $278,244.45 2026-07-15
4214 APR_DRG "malnutrition, Failure To Thrive And Other Nutritional Disorders" 5 1 — — $145,530.53 $182,574.66 $171,990.62 2026-07-15
423 APR_DRG "degenerative Nervous System Disorders Except Multiple Sclerosis" 5 1 — — $122,441.55 $153,608.49 $144,703.65 2026-07-15
4234 APR_DRG "inborn Errors Of Metabolism" 5 1 — — $163,022.18 $204,518.73 $192,662.57 2026-07-15
424 APR_DRG "degenerative Nervous System Disorders Except Multiple Sclerosis" 5 1 — — $152,760.41 $191,644.88 $180,535.03 2026-07-15
4244 APR_DRG "other Endocrine Disorders" 5 1 — — $123,024.61 $154,339.96 $145,392.72 2026-07-15
426 MS_DRG "multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wi… 8 3 — — $185,421.95 $333,759.51 $185,421.95 2026-07-15
4274 APR_DRG "thyroid Disorders" 5 1 — — $128,272.10 $160,923.18 $151,594.30 2026-07-15
4283 APR_DRG "genetic Disorders" 5 1 — — $199,288.20 $250,016.10 $235,522.42 2026-07-15
4284 APR_DRG "genetic Disorders" 5 1 — — $308,319.48 $386,800.81 $364,377.57 2026-07-15
429 MS_DRG "combined Anterior And Posterior Cervical Spinal Fusion With Mcc" 8 3 — — $167,138.27 $300,848.89 $167,138.27 2026-07-15
43 APR_DRG "tracheostomy With Mv >96 Hours With Extensive Procedure" 5 1 — — $384,699.69 $482,623.25 $454,645.09 2026-07-15
433 APR_DRG "multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies" 5 1 — — $128,621.93 $161,362.06 $152,007.74 2026-07-15
434 APR_DRG "multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies" 5 1 — — $201,387.20 $252,649.39 $238,003.05 2026-07-15
44 APR_DRG "tracheostomy With Mv >96 Hours With Extensive Procedure" 5 1 — — $544,456.76 $683,045.75 $643,448.90 2026-07-15
4414 APR_DRG "major Bladder Procedures" 5 1 — — $202,669.92 $254,258.62 $239,518.99 2026-07-15
4424 APR_DRG "kidney And Urinary Tract Procedures For Malignancy" 5 1 — — $149,028.86 $186,963.48 $176,125.01 2026-07-15
4434 APR_DRG "kidney And Urinary Tract Procedures For Non-malignancy" 5 1 — — $162,905.57 $204,372.44 $192,524.76 2026-07-15
4444 APR_DRG "renal Dialysis Access Device Procedures" 5 1 — — $182,379.60 $228,803.50 $215,539.53 2026-07-15
4454 APR_DRG "other Bladder Procedures" 5 1 — — $161,739.46 $202,909.50 $191,146.63 2026-07-15
4464 APR_DRG "urethral And Transurethral Procedures" 5 1 — — $147,396.30 $184,915.36 $174,195.63 2026-07-15
4474 APR_DRG "other Kidney, Urinary Tract And Related Non-percutaneous Procedures" 5 1 — — $219,345.29 $275,178.64 $259,226.25 2026-07-15
4484 APR_DRG "other Kidney, Urinary Tract And Related Percutaneous Procedures" 5 1 — — $163,138.79 $204,665.03 $192,800.39 2026-07-15
456 MS_DRG "spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or E… 8 3 — — $160,406.12 $288,731.02 $160,406.12 2026-07-15
4614 APR_DRG "kidney And Urinary Tract Malignancy" 5 1 — — $122,791.38 $154,047.37 $145,117.09 2026-07-15
4624 APR_DRG "nephritis And Nephrosis" 5 1 — — $157,075.02 $197,057.75 $185,634.11 2026-07-15
4694 APR_DRG "acute Kidney Injury" 5 1 — — $131,070.76 $164,434.23 $154,901.81 2026-07-15
4824 APR_DRG "transurethral Prostatectomy" 5 1 — — $131,420.60 $164,873.11 $155,315.25 2026-07-15
4834 APR_DRG "penis, Testes And Scrotal Procedures" 5 1 — — $173,750.39 $217,977.76 $205,341.37 2026-07-15
484 APR_DRG "peripheral, Cranial And Autonomic Nerve Disorders" 5 1 — — $146,580.03 $183,891.31 $173,230.94 2026-07-15
4844 APR_DRG "other Male Reproductive System And Related Procedures" 5 1 — — $207,334.36 $260,110.38 $245,031.51 2026-07-15
4854 APR_DRG "prostatectomy Procedures" 5 1 — — $187,277.27 $234,947.84 $221,327.68 2026-07-15
493 APR_DRG "bacterial And Tuberculous Infections Of Nervous System" 5 1 — — $146,696.64 $184,037.60 $173,368.75 2026-07-15
494 APR_DRG "bacterial And Tuberculous Infections Of Nervous System" 5 1 — — $196,839.37 $246,943.93 $232,628.34 2026-07-15
5004 APR_DRG "malignancy, Male Reproductive System" 5 1 — — $122,907.99 $154,193.67 $145,254.90 2026-07-15
503 APR_DRG "non-bacterial Infections Of Nervous System Except Viral Meningitis" 5 1 — — $122,324.94 $153,462.20 $144,565.84 2026-07-15
504 APR_DRG "non-bacterial Infections Of Nervous System Except Viral Meningitis" 5 1 — — $182,729.44 $229,242.38 $215,952.97 2026-07-15
51 APR_DRG "tracheostomy With Mv >96 Hours Without Extensive Procedure" 5 1 — — $139,933.20 $175,552.56 $165,375.60 2026-07-15
5114 APR_DRG "uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy" 5 1 — — $180,397.22 $226,316.51 $213,196.71 2026-07-15
5124 APR_DRG "uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy" 5 1 — — $183,545.71 $230,266.44 $216,917.66 2026-07-15
5134 APR_DRG "uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma" 5 1 — — $162,788.96 $204,226.14 $192,386.95 2026-07-15
514 APR_DRG "viral Meningitis" 5 1 — — $130,604.32 $163,849.06 $154,350.56 2026-07-15
5144 APR_DRG "female Reproductive System Reconstructive Procedures" 5 1 — — $139,933.20 $175,552.56 $165,375.60 2026-07-15
5184 APR_DRG "other Female Reproductive System And Related Procedures" 5 1 — — $170,835.12 $214,320.42 $201,896.05 2026-07-15
5194 APR_DRG "uterine And Adnexa Procedures For Leiomyoma" 5 1 — — $139,116.92 $174,528.50 $164,410.91 2026-07-15
52 APR_DRG "tracheostomy With Mv >96 Hours Without Extensive Procedure" 5 1 — — $253,862.15 $318,481.60 $300,018.90 2026-07-15
5204 APR_DRG "other GYN Procedures For Malignancy" 5 1 — — $199,521.42 $250,308.69 $235,798.04 2026-07-15
53 APR_DRG "tracheostomy With Mv >96 Hours Without Extensive Procedure" 5 1 — — $349,949.61 $439,027.69 $413,576.81 2026-07-15
54 APR_DRG "tracheostomy With Mv >96 Hours Without Extensive Procedure" 5 1 — — $462,129.39 $579,762.33 $546,152.92 2026-07-15
573 MS_DRG "skin Graft For Skin Ulcer Or Cellulitis With Mcc" 8 3 — — $146,598.94 $263,878.09 $146,598.94 2026-07-15
583 APR_DRG "other Disorders Of Nervous System" 5 1 — — $150,661.41 $189,011.59 $178,054.40 2026-07-15
584 APR_DRG "other Disorders Of Nervous System" 5 1 — — $170,485.28 $213,881.54 $201,482.61 2026-07-15
6021 APR_DRG "neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $475,423.05 $596,439.82 $561,863.60 2026-07-15
6022 APR_DRG "neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $617,455.25 $774,625.67 $729,719.84 2026-07-15
6023 APR_DRG "neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $765,551.22 $960,418.80 $904,742.35 2026-07-15
6024 APR_DRG "neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $935,686.66 $1,173,861.45 $1,105,811.51 2026-07-15
6071 APR_DRG "neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $345,051.95 $432,883.35 $407,788.67 2026-07-15
6072 APR_DRG "neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $471,225.05 $591,173.25 $556,902.33 2026-07-15
6073 APR_DRG "neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $618,154.91 $775,503.43 $730,546.71 2026-07-15
6074 APR_DRG "neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $769,282.77 $965,100.20 $909,152.36 2026-07-15
6121 APR_DRG "neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $209,549.97 $262,889.96 $247,649.96 2026-07-15
6122 APR_DRG "neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $305,754.04 $383,582.34 $361,345.69 2026-07-15
6123 APR_DRG "neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $427,262.70 $536,020.48 $504,946.83 2026-07-15
6124 APR_DRG "neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $524,749.50 $658,322.10 $620,158.50 2026-07-15
6221 APR_DRG "neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $126,522.94 $158,728.77 $149,527.11 2026-07-15
6222 APR_DRG "neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $186,927.43 $234,508.96 $220,914.24 2026-07-15
6223 APR_DRG "neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $265,639.86 $333,257.28 $313,938.01 2026-07-15
6224 APR_DRG "neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Othe… 5 1 — — $281,382.34 $353,006.94 $332,542.77 2026-07-15
6343 APR_DRG "neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other M… 5 1 — — $159,523.85 $200,129.92 $188,528.18 2026-07-15
6344 APR_DRG "neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other M… 5 1 — — $225,059.23 $282,347.03 $265,979.09 2026-07-15
6504 APR_DRG "splenic Procedures" 5 1 — — $133,169.76 $167,067.52 $157,382.45 2026-07-15
6514 APR_DRG "other Procedures Of Blood And Blood-forming Organs" 5 1 — — $195,323.43 $245,042.12 $230,836.78 2026-07-15
6604 APR_DRG "major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagul… 5 1 — — $122,907.99 $154,193.67 $145,254.90 2026-07-15
6624 APR_DRG "sickle Cell Anemia Crisis" 5 1 — — $129,321.60 $162,239.82 $152,834.62 2026-07-15
6803 APR_DRG "major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms" 5 1 — — $127,922.27 $160,484.30 $151,180.86 2026-07-15
6804 APR_DRG "major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms" 5 1 — — $245,582.77 $308,094.74 $290,234.18 2026-07-15
6814 APR_DRG "other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms" 5 1 — — $242,667.49 $304,437.40 $286,788.85 2026-07-15
6903 APR_DRG "acute Leukemia" 5 1 — — $185,877.93 $233,192.32 $219,673.92 2026-07-15
6904 APR_DRG "acute Leukemia" 5 1 — — $253,512.31 $318,042.72 $299,605.46 2026-07-15
6914 APR_DRG "lymphoma, Myeloma And Non-acute Leukemia" 5 1 — — $169,552.39 $212,711.19 $200,380.10 2026-07-15
6924 APR_DRG "radiotherapy" 5 1 — — $159,757.07 $200,422.51 $188,803.81 2026-07-15
6944 APR_DRG "lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior" 5 1 — — $122,674.77 $153,901.08 $144,979.28 2026-07-15
6953 APR_DRG "chemotherapy For Acute Leukemia" 5 1 — — $142,498.64 $178,771.02 $168,407.49 2026-07-15
6954 APR_DRG "chemotherapy For Acute Leukemia" 5 1 — — $266,805.97 $334,720.21 $315,316.14 2026-07-15
6964 APR_DRG "other Chemotherapy" 5 1 — — $129,788.04 $162,825.00 $153,385.87 2026-07-15
7103 APR_DRG "infectious And Parasitic Diseases Including HIV With O.r. Procedure" 5 1 — — $137,600.98 $172,626.68 $162,619.34 2026-07-15
7104 APR_DRG "infectious And Parasitic Diseases Including HIV With O.r. Procedure" 5 1 — — $184,595.21 $231,583.09 $218,157.98 2026-07-15
7244 APR_DRG "other Infectious And Parasitic Diseases" 5 1 — — $138,300.65 $173,504.45 $163,446.22 2026-07-15
734 APR_DRG "orbit And Eye Procedures" 5 1 — — $185,994.55 $233,338.61 $219,811.74 2026-07-15
7402 APR_DRG "mental Illness Diagnosis With O.r. Procedure" 5 1 — — $147,629.53 $185,207.95 $174,471.26 2026-07-15
7403 APR_DRG "mental Illness Diagnosis With O.r. Procedure" 5 1 — — $227,041.62 $284,834.03 $268,321.91 2026-07-15
7404 APR_DRG "mental Illness Diagnosis With O.r. Procedure" 5 1 — — $488,017.04 $612,239.55 $576,747.41 2026-07-15
7513 APR_DRG "depressive Disorders" 5 1 — — $130,021.27 $163,117.59 $153,661.50 2026-07-15
7514 APR_DRG "depressive Disorders" 5 1 — — $248,148.21 $311,313.21 $293,266.06 2026-07-15
7523 APR_DRG "personality Disorders" 5 1 — — $147,163.08 $184,622.78 $173,920.01 2026-07-15
7524 APR_DRG "personality Disorders" 5 1 — — $147,163.08 $184,622.78 $173,920.01 2026-07-15
7533 APR_DRG "bipolar Disorders" 5 1 — — $140,516.26 $176,284.03 $166,064.67 2026-07-15
7534 APR_DRG "bipolar Disorders" 5 1 — — $233,805.06 $293,319.07 $276,315.07 2026-07-15
7573 APR_DRG "organic Mental Health Conditions And Disturbances" 5 1 — — $129,204.99 $162,093.53 $152,696.80 2026-07-15
7574 APR_DRG "organic Mental Health Conditions And Disturbances" 5 1 — — $282,898.29 $354,908.76 $334,334.34 2026-07-15
7583 APR_DRG "disorders Of Impulse Control & Development" 5 1 — — $135,385.37 $169,847.10 $160,000.89 2026-07-15
7584 APR_DRG "disorders Of Impulse Control & Development" 5 1 — — $297,941.11 $373,780.66 $352,112.22 2026-07-15
7591 APR_DRG "eating Disorders" 5 1 — — $123,024.61 $154,339.96 $145,392.72 2026-07-15
7592 APR_DRG "eating Disorders" 5 1 — — $134,452.48 $168,676.75 $158,898.39 2026-07-15
7593 APR_DRG "eating Disorders" 5 1 — — $192,991.21 $242,116.24 $228,080.52 2026-07-15
7594 APR_DRG "eating Disorders" 5 1 — — $354,614.05 $444,879.45 $419,089.33 2026-07-15
7612 APR_DRG "schizoaffective Disorders" 5 1 — — $125,706.66 $157,704.72 $148,562.41 2026-07-15
7613 APR_DRG "schizoaffective Disorders" 5 1 — — $218,062.57 $273,569.41 $257,710.31 2026-07-15
7614 APR_DRG "schizoaffective Disorders" 5 1 — — $316,715.48 $397,333.96 $374,300.11 2026-07-15
7754 APR_DRG "alcohol Abuse And Dependence" 5 1 — — $145,413.92 $182,428.37 $171,852.81 2026-07-15
7924 APR_DRG "extensive O.r. Procedures For Other Complications Of Treatment" 5 1 — — $184,711.82 $231,729.38 $218,295.79 2026-07-15
7934 APR_DRG "moderately Extensive O.r. Procedures For Other Complications Of Treatment" 5 1 — — $165,237.79 $207,298.31 $195,281.02 2026-07-15
7944 APR_DRG "non-extensive O.r. Procedures For Other Complications Of Treatment" 5 1 — — $153,226.85 $192,230.05 $181,086.28 2026-07-15
850 MS_DRG "acute Leukemia With Other Procedures" 8 3 — — $178,122.57 $320,620.63 $178,122.57 2026-07-15
8614 APR_DRG "signs, Symptoms And Other Factors Influencing Health Status" 5 1 — — $134,569.09 $168,823.05 $159,036.20 2026-07-15
8623 APR_DRG "other Aftercare And Convalescence" 5 1 — — $122,791.38 $154,047.37 $145,117.09 2026-07-15
8624 APR_DRG "other Aftercare And Convalescence" 5 1 — — $122,791.38 $154,047.37 $145,117.09 2026-07-15
870 MS_DRG "septicemia Or Severe Sepsis With Mv >96 Hours" 8 3 — — $147,897.29 $266,215.12 $147,897.29 2026-07-15
8904 APR_DRG "hiv With Multiple Major HIV Related Conditions" 5 1 — — $169,085.95 $212,126.01 $199,828.85 2026-07-15
8924 APR_DRG "hiv With Major HIV Related Condition" 5 1 — — $125,240.21 $157,119.54 $148,011.16 2026-07-15
894 APR_DRG "major Cranial Or Facial Bone Procedures" 5 1 — — $193,107.82 $242,262.53 $228,218.33 2026-07-15
913 APR_DRG "other Major Head And Neck Procedures" 5 1 — — $139,816.59 $175,406.27 $165,237.79 2026-07-15
914 APR_DRG "other Major Head And Neck Procedures" 5 1 — — $247,331.93 $310,289.15 $292,301.37 2026-07-15
924 APR_DRG "facial Bone Procedures Except Major Cranial Or Facial Bone Procedures" 5 1 — — $195,789.87 $245,627.29 $231,388.03 2026-07-15
93 APR_DRG "extracorporeal Membrane Oxygenation (ecmo)" 5 1 — — $239,169.16 $300,048.58 $282,654.46 2026-07-15
94 APR_DRG "extracorporeal Membrane Oxygenation (ecmo)" 5 1 — — $405,573.06 $508,809.84 $479,313.61 2026-07-15
9503 APR_DRG "extensive O.r. Procedure Unrelated To Principal Diagnosis" 5 1 — — $125,823.27 $157,851.01 $148,700.23 2026-07-15
9504 APR_DRG "extensive O.r. Procedure Unrelated To Principal Diagnosis" 5 1 — — $216,779.85 $271,960.17 $256,194.37 2026-07-15
9514 APR_DRG "moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis" 5 1 — — $195,206.81 $244,895.82 $230,698.96 2026-07-15
9524 APR_DRG "non-extensive O.r. Procedure Unrelated To Principal Diagnosis" 5 1 — — $189,609.49 $237,873.72 $224,083.94 2026-07-15
984 APR_DRG "other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures" 5 1 — — $185,644.71 $232,899.73 $219,398.30 2026-07-15
A0205 HCPCS "traumatic Brain Injury M <35.50.,without Comorbidities" 5 3 — — $128,472.08 $231,249.74 $147,742.89 2026-07-15
A0404 HCPCS "traumatic Spinal Cord Injury M <31.50 And A <61.50.,without Comorbidities" 5 3 — — $158,893.81 $286,008.86 $182,727.88 2026-07-15
A0405 HCPCS "traumatic Spinal Cord Injury M >=31.50 And M <41.50.,without Comorbidities" 5 3 — — $163,028.75 $293,451.74 $187,483.06 2026-07-15
A1806 HCPCS "major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50.,without Com" 5 3 — — $181,983.72 $327,570.70 $209,281.28 2026-07-15
A1904 HCPCS "guillain-barr� M <38.50.,without Comorbidities" 5 3 — — $247,996.40 $446,393.52 $285,195.86 2026-07-15
B0205 HCPCS "traumatic Brain Injury M <35.50.,comorbidity In Tier 1" 5 3 — — $196,196.55 $353,153.78 $225,626.03 2026-07-15
B0404 HCPCS "traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 1" 5 3 — — $250,141.67 $450,255.01 $287,662.93 2026-07-15
B0406 HCPCS "traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50.,comorbidi" 5 3 — — $400,779.48 $721,403.07 $460,896.41 2026-07-15
B0505 HCPCS "non-traumatic Spinal Cord Injury M <39.50.,comorbidity In Tier 1" 5 3 — — $135,109.44 $243,197.00 $155,375.86 2026-07-15
B0704 HCPCS "fracture Of Lower Extremity M <41.50.,comorbidity In Tier 1" 5 3 — — $128,086.88 $230,556.38 $147,299.91 2026-07-15
B1806 HCPCS "major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50.,comorbidity" 5 3 — — $161,887.21 $291,396.98 $186,170.29 2026-07-15
C0205 HCPCS "traumatic Brain Injury M <35.50.,comorbidity In Tier 2" 5 3 — — $181,625.20 $326,925.35 $208,868.98 2026-07-15
C0404 HCPCS "traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 2" 5 3 — — $195,448.61 $351,807.51 $224,765.91 2026-07-15
C0405 HCPCS "traumatic Spinal Cord Injury M >=31.50 And M <41.50.,comorbidity In Tier 2" 5 3 — — $167,521.98 $301,539.55 $192,650.27 2026-07-15
C0406 HCPCS "traumatic Spinal Cord Injury M >=24.50 And M <31.50 And A >=61.50.,comorbidi" 5 3 — — $209,204.18 $376,567.52 $240,584.80 2026-07-15
C0407 HCPCS "traumatic Spinal Cord Injury M <24.50 And A >=61.50.,comorbidity In Tier 2" 5 3 — — $183,538.10 $330,368.58 $211,068.82 2026-07-15
C0502 HCPCS "non-traumatic Spinal Cord Injury M >=53.50 And M <60.50.,comorbidity In Tier" 5 3 — — $139,492.60 $251,086.67 $160,416.49 2026-07-15
C0504 HCPCS "non-traumatic Spinal Cord Injury M >=39.50 And M <48.50.,comorbidity In Tier" 5 3 — — $128,940.78 $232,093.40 $148,281.89 2026-07-15
C1705 HCPCS "major Multiple Trauma Without Brain Or Spinal Cord Injury M <36.50.,comorbid" 5 3 — — $139,638.26 $251,348.87 $160,584.00 2026-07-15
C1805 HCPCS "major Multiple Trauma With Brain Or Spinal Cord Injury M >=30.50 And M <40.5" 5 3 — — $131,786.62 $237,215.91 $151,554.61 2026-07-15
C1904 HCPCS "guillain-barr� M <38.50.,comorbidity In Tier 2" 5 3 — — $337,741.58 $607,934.85 $388,402.82 2026-07-15
D0404 HCPCS "traumatic Spinal Cord Injury M <31.50 And A <61.50.,comorbidity In Tier 3" 5 3 — — $131,324.80 $236,384.63 $151,023.52 2026-07-15
D0405 HCPCS "traumatic Spinal Cord Injury M >=31.50 And M <41.50.,comorbidity In Tier 3" 5 3 — — $178,532.13 $321,357.83 $205,311.95 2026-07-15
D0407 HCPCS "traumatic Spinal Cord Injury M <24.50 And A >=61.50.,comorbidity In Tier 3" 5 3 — — $210,084.95 $378,152.91 $241,597.69 2026-07-15
D0505 HCPCS "non-traumatic Spinal Cord Injury M <39.50.,comorbidity In Tier 3" 5 3 — — $128,957.90 $232,124.21 $148,301.58 2026-07-15
D1806 HCPCS "major Multiple Trauma With Brain Or Spinal Cord Injury M <30.50.,comorbidity" 5 3 — — $169,830.62 $305,695.11 $195,305.21 2026-07-15
D1904 HCPCS "guillain-barr� M <38.50.,comorbidity In Tier 3" 5 3 — — $158,338.04 $285,008.48 $182,088.75 2026-07-15
D2005 HCPCS "miscellaneous M <46.50 And A <77.50.,comorbidity In Tier 3" 5 3 — — $137,210.35 $246,978.63 $157,791.90 2026-07-15
D2102 HCPCS "burns M <52.50.,comorbidity In Tier 3" 5 3 — — $132,870.26 $239,166.47 $152,800.80 2026-07-15
J1411 HCPCS "inj, Hemgenix, Per Tx Dose" 5 3 — — $4,325,397.49 $4,974,207.11 $4,325,397.49 2026-07-15
J1413 HCPCS "inj Delandistrogene Mox Rokl" 5 3 — — $3,892,532.14 $4,476,411.96 $3,892,532.14 2026-07-15
J3392 HCPCS "inj, Exagamglogene Autotem" 6 3 — — $2,737,068.40 $4,926,723.12 $2,737,068.40 2026-07-15
J3393 HCPCS "inj, Betibeglogene Autotemce" 5 3 — — $3,457,415.04 $3,976,027.30 $3,457,415.04 2026-07-15
J3394 HCPCS "inj, Lovotibeglogene Autotem" 5 3 — — $3,812,700.74 $4,384,605.85 $3,812,700.74 2026-07-15
J3399 HCPCS "inj Onase Abepar-xioi Treat" 5 3 — — $2,881,563.32 $3,313,797.82 $2,881,563.32 2026-07-15
J3402 HCPCS "inj. Remestemcel-l-rknd/ Td" 7 3 — — $241,359.67 $482,719.34 $241,359.67 2026-07-15
J3403 HCPCS "revakinagene, Per Implant" 7 3 — — $302,227.75 $604,455.50 $302,227.75 2026-07-15
Q2041 HCPCS "axicabtagene Ciloleucel Car+" 15 4 — — $129,829.46 $1,251,704.50 $183,925.06 2026-07-15
Q2042 HCPCS "tisagenlecleucel Car-pos T" 15 4 — — $149,434.07 $1,389,018.08 $211,698.27 2026-07-15
Q2053 HCPCS "brexucabtagene Car Pos T" 15 4 — — $151,630.74 $1,148,593.64 $214,810.21 2026-07-15
Q2054 HCPCS "lisocabtagene Mara Car Pos T" 15 4 — — $133,341.26 $1,320,502.14 $188,900.12 2026-07-15
Q2055 HCPCS "idecabtagene Vicleucel Car" 15 4 — — $136,227.91 $1,308,248.12 $192,989.53 2026-07-15
Q2056 HCPCS "ciltacabtagene Car-pos T" 15 4 — — $142,823.89 $1,328,320.76 $202,333.84 2026-07-15
Q2057 HCPCS "afamitresgene Autoleucel" 15 4 — — $140,779.19 $1,808,953.38 $199,437.18 2026-07-15
Q2058 HCPCS "obecbtge Autol Up To 400 Mil" 15 4 — — $135,550.80 $653,164.06 $192,030.30 2026-07-15
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