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

ST ELIZABETH HOSPITAL

Fort Morgan, CO · CCN 060044 · Rates published

13,154 distinct procedures filed
9 distinct payers
103,565 rate rows
2024-12-02 last MRF observed · ⚠ 18 mo old
Data quality

103,282 of 103,565 rate rows are consumer-grade (99.7%)

283 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 255
exceeds 10× this hospital's gross charge — excluded from medians 16
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 9
placeholder amount (≤ $0.02) — excluded from medians 3

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old.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/10547/840405257_commonspirit-health-st-elizabeth_standardcharges.csv
Found on page https://www.mountain.commonspirit.org/price-transparency
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 4b491999cf5ed36c… · 129,777,967 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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 $373,185.74 $373,185.74 $373,185.74 nat. median
$370,174
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 4 $274,486.15 $274,486.15 $274,486.15 nat. median
$265,286
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 4 $266,991.59 $266,991.59 $266,991.59 nat. median
$206,368
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 4 $215,956.81 $215,956.81 $215,956.81 nat. median
$202,986
1.1× median
5834
APR_DRG 		Neonate With Ecmo 1 $209,047.88 $209,047.88 $209,047.88 nat. median
$309,665
0.7× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $188,017.35 $188,017.35 $188,017.35 nat. median
$246,434
0.8× median
24
APR_DRG 		Heart And/or Lung Transplant 1 $163,775.02 $163,775.02 $163,775.02 nat. median
$234,738
0.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 1 $163,355.43 $163,355.43 $163,355.43 nat. median
$207,730
0.8× median
34
APR_DRG 		Bone Marrow Transplant 1 $154,395.16 $154,395.16 $154,395.16 nat. median
$209,067
0.7× median
5833
APR_DRG 		Neonate With Ecmo 1 $150,342.81 $150,342.81 $150,342.81 nat. median
$244,017
0.6× median
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 4 $148,898.71 $148,898.71 $148,898.71 nat. median
$133,176
1.1× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 1 $139,119.24 $139,119.24 $139,119.24 nat. median
$105,658
1.3× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 1 $137,825.64 $137,825.64 $137,825.64 nat. median
$160,267
0.9× median
5832
APR_DRG 		Neonate With Ecmo 1 $136,674.85 $136,674.85 $136,674.85 nat. median
$156,126
0.9× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $133,113.16 $133,113.16 $133,113.16 nat. median
$129,535
1.0× median
7
MS_DRG 		Lung Transplant 4 $124,248.37 $124,248.37 $124,248.37 nat. median
$122,708
1.0× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 $124,022.49 $124,022.49 $124,022.49 nat. median
$108,660
1.1× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 1 $124,012.12 $124,012.12 $124,012.12 nat. median
$182,736
0.7× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 4 $116,089.33 $116,089.33 $116,089.33 nat. median
$117,303
1.0× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 1 $114,798.32 $114,798.32 $114,798.32 nat. median
$164,279
0.7× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 4 $109,098.18 $109,098.18 $109,098.18 nat. median
$102,358
1.1× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 1 $106,265.84 $106,265.84 $106,265.84 nat. median
$151,838
0.7× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 4 $104,836.84 $104,836.84 $104,836.84 nat. median
$100,136
1.0× median
215
MS_DRG 		Other Heart Assist System Implant 4 $103,467.38 $103,467.38 $103,467.38 nat. median
$99,019
1.0× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 $103,384.77 $103,384.77 $103,384.77 nat. median
$162,982
0.6× median
64
APR_DRG 		Pancreas Transplant 1 $102,350.16 $102,350.16 $102,350.16 nat. median
$91,748
1.1× median
9104
APR_DRG 		Craniotomy For Multiple Significant Trauma 1 $101,877.96 $101,877.96 $101,877.96 nat. median
$57,769
1.8× median
23
APR_DRG 		Heart And/or Lung Transplant 1 $100,363.62 $100,363.62 $100,363.62 nat. median
$93,528
1.1× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $100,203.03 $100,203.03 $100,203.03 nat. median
$93,260
1.1× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 $98,306.57 $98,306.57 $98,306.57 nat. median
$93,672
1.0× median
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 $97,973.21 $97,973.21 $97,973.21 nat. median
$68,217
1.4× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 $97,255.68 $97,255.68 $97,255.68 nat. median
$150,721
0.6× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $91,094.47 $91,094.47 $91,094.47 nat. median
$89,790
1.0× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $90,886.73 $90,886.73 $90,886.73 nat. median
$118,620
0.8× median
453
MS_DRG 		DRG 4 $89,758.57 $89,758.57 $89,758.57 nat. median
$87,411
1.0× median
5831
APR_DRG 		Neonate With Ecmo 1 $86,554.88 $86,554.88 $86,554.88 nat. median
$145,122
0.6× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 $85,615.74 $85,615.74 $85,615.74 nat. median
$77,576
1.1× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 $85,382.77 $85,382.77 $85,382.77 nat. median
$81,118
1.1× median
9114
APR_DRG 		Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 1 $85,187.47 $85,187.47 $85,187.47 nat. median
$52,039
1.6× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 $83,590.45 $83,590.45 $83,590.45 nat. median
$122,924
0.7× median
4404
APR_DRG 		Kidney Transplant 1 $83,230.32 $83,230.32 $83,230.32 nat. median
$79,034
1.1× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $83,223.27 $83,223.27 $83,223.27 nat. median
$66,682
1.2× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $82,813.47 $82,813.47 $82,813.47 nat. median
$69,788
1.2× median
9124
APR_DRG 		Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 $82,446.50 $82,446.50 $82,446.50 nat. median
$55,151
1.5× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 4 $82,200.19 $82,200.19 $82,200.19 nat. median
$79,312
1.0× median
3034
APR_DRG 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 $81,397.54 $81,397.54 $81,397.54 nat. median
$84,162
1.0× median
33
APR_DRG 		Bone Marrow Transplant 1 $81,341.50 $81,341.50 $81,341.50 nat. median
$113,142
0.7× median
19
MS_DRG 		Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 $80,967.47 $80,967.47 $80,967.47 nat. median
$71,240
1.1× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 1 $80,114.18 $80,114.18 $80,114.18 nat. median
$97,957
0.8× median
1624
APR_DRG 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 $79,091.87 $79,091.87 $79,091.87 nat. median
$81,790
1.0× median

Other procedures at this hospital

Browse this hospital's 13,154 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $373,185.74 $373,185.74 $373,185.74 2024-12-02
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 4 4 — — $274,486.15 $274,486.15 $274,486.15 2024-12-02
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 4 4 — — $266,991.59 $266,991.59 $266,991.59 2024-12-02
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 4 4 — — $215,956.81 $215,956.81 $215,956.81 2024-12-02
5834 APR_DRG Neonate With Ecmo 1 1 — — $209,047.88 $209,047.88 $209,047.88 2024-12-02
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $188,017.35 $188,017.35 $188,017.35 2024-12-02
24 APR_DRG Heart And/or Lung Transplant 1 1 — — $163,775.02 $163,775.02 $163,775.02 2024-12-02
1614 APR_DRG Implantable Heart Assist Systems 1 1 — — $163,355.43 $163,355.43 $163,355.43 2024-12-02
34 APR_DRG Bone Marrow Transplant 1 1 — — $154,395.16 $154,395.16 $154,395.16 2024-12-02
5833 APR_DRG Neonate With Ecmo 1 1 — — $150,342.81 $150,342.81 $150,342.81 2024-12-02
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 4 4 — — $148,898.71 $148,898.71 $148,898.71 2024-12-02
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $139,119.24 $139,119.24 $139,119.24 2024-12-02
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $137,825.64 $137,825.64 $137,825.64 2024-12-02
5832 APR_DRG Neonate With Ecmo 1 1 — — $136,674.85 $136,674.85 $136,674.85 2024-12-02
14 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $133,113.16 $133,113.16 $133,113.16 2024-12-02
7 MS_DRG Lung Transplant 4 4 — — $124,248.37 $124,248.37 $124,248.37 2024-12-02
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 4 4 — — $124,022.49 $124,022.49 $124,022.49 2024-12-02
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $124,012.12 $124,012.12 $124,012.12 2024-12-02
14 MS_DRG Allogeneic Bone Marrow Transplant 4 4 — — $116,089.33 $116,089.33 $116,089.33 2024-12-02
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $114,798.32 $114,798.32 $114,798.32 2024-12-02
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 4 4 — — $109,098.18 $109,098.18 $109,098.18 2024-12-02
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $106,265.84 $106,265.84 $106,265.84 2024-12-02
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 4 4 — — $104,836.84 $104,836.84 $104,836.84 2024-12-02
215 MS_DRG Other Heart Assist System Implant 4 4 — — $103,467.38 $103,467.38 $103,467.38 2024-12-02
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $103,384.77 $103,384.77 $103,384.77 2024-12-02
64 APR_DRG Pancreas Transplant 1 1 — — $102,350.16 $102,350.16 $102,350.16 2024-12-02
9104 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $101,877.96 $101,877.96 $101,877.96 2024-12-02
23 APR_DRG Heart And/or Lung Transplant 1 1 — — $100,363.62 $100,363.62 $100,363.62 2024-12-02
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $100,203.03 $100,203.03 $100,203.03 2024-12-02
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $98,306.57 $98,306.57 $98,306.57 2024-12-02
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $97,973.21 $97,973.21 $97,973.21 2024-12-02
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $97,255.68 $97,255.68 $97,255.68 2024-12-02
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $91,094.47 $91,094.47 $91,094.47 2024-12-02
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $90,886.73 $90,886.73 $90,886.73 2024-12-02
453 MS_DRG DRG 4 4 — — $89,758.57 $89,758.57 $89,758.57 2024-12-02
5831 APR_DRG Neonate With Ecmo 1 1 — — $86,554.88 $86,554.88 $86,554.88 2024-12-02
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 4 — — $85,615.74 $85,615.74 $85,615.74 2024-12-02
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 4 — — $85,382.77 $85,382.77 $85,382.77 2024-12-02
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 1 1 — — $85,187.47 $85,187.47 $85,187.47 2024-12-02
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 1 1 — — $83,590.45 $83,590.45 $83,590.45 2024-12-02
4404 APR_DRG Kidney Transplant 1 1 — — $83,230.32 $83,230.32 $83,230.32 2024-12-02
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $83,223.27 $83,223.27 $83,223.27 2024-12-02
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 1 1 — — $82,813.47 $82,813.47 $82,813.47 2024-12-02
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $82,446.50 $82,446.50 $82,446.50 2024-12-02
231 MS_DRG Coronary Bypass With Ptca With Mcc 4 4 — — $82,200.19 $82,200.19 $82,200.19 2024-12-02
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $81,397.54 $81,397.54 $81,397.54 2024-12-02
33 APR_DRG Bone Marrow Transplant 1 1 — — $81,341.50 $81,341.50 $81,341.50 2024-12-02
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 4 — — $80,967.47 $80,967.47 $80,967.47 2024-12-02
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $80,114.18 $80,114.18 $80,114.18 2024-12-02
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $79,091.87 $79,091.87 $79,091.87 2024-12-02
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 4 — — $79,003.42 $79,003.42 $79,003.42 2024-12-02
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 4 — — $78,108.01 $78,108.01 $78,108.01 2024-12-02
22 APR_DRG Heart And/or Lung Transplant 1 1 — — $77,804.41 $77,804.41 $77,804.41 2024-12-02
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $77,302.14 $77,302.14 $77,302.14 2024-12-02
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $76,611.25 $76,611.25 $76,611.25 2024-12-02
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 1 1 — — $76,071.40 $76,071.40 $76,071.40 2024-12-02
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 1 1 — — $73,603.09 $73,603.09 $73,603.09 2024-12-02
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 4 4 — — $73,259.18 $73,259.18 $73,259.18 2024-12-02
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $71,854.36 $71,854.36 $71,854.36 2024-12-02
8634 APR_DRG Neonatal Aftercare 1 1 — — $71,695.82 $71,695.82 $71,695.82 2024-12-02
J9269 HCPCS Tagraxofusp-erzs 1,000 Mcg/ml Intravenous Solution 12 9 $108,194.38 $108,194.38 $467.21 $104,948.55 $71,408.29 2024-12-02
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 4 4 — — $71,266.77 $71,266.77 $71,266.77 2024-12-02
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 4 4 — — $70,548.61 $70,548.61 $70,548.61 2024-12-02
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 1 1 — — $70,519.75 $70,519.75 $70,519.75 2024-12-02
13 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $70,167.13 $70,167.13 $70,167.13 2024-12-02
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 4 4 — — $70,090.77 $70,090.77 $70,090.77 2024-12-02
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 4 4 — — $69,972.26 $69,972.26 $69,972.26 2024-12-02
21 APR_DRG Heart And/or Lung Transplant 1 1 — — $69,866.45 $69,866.45 $69,866.45 2024-12-02
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 4 4 — — $69,613.69 $69,613.69 $69,613.69 2024-12-02
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 4 — — $69,432.38 $69,432.38 $69,432.38 2024-12-02
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 4 4 — — $69,065.70 $69,065.70 $69,065.70 2024-12-02
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $68,997.21 $68,997.21 $68,997.21 2024-12-02
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 1 1 — — $68,082.19 $68,082.19 $68,082.19 2024-12-02
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $67,334.59 $67,334.59 $67,334.59 2024-12-02
459 MS_DRG DRG 4 4 — — $67,179.65 $67,179.65 $67,179.65 2024-12-02
63 APR_DRG Pancreas Transplant 1 1 — — $66,017.75 $66,017.75 $66,017.75 2024-12-02
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $64,475.17 $64,475.17 $64,475.17 2024-12-02
J3357 HCPCS Ustekinumab 90 Mg/ml Subcutaneous Syringe 12 9 $97,449.98 $97,449.98 $263.78 $94,526.48 $64,316.99 2024-12-02
62 APR_DRG Pancreas Transplant 1 1 — — $64,051.02 $64,051.02 $64,051.02 2024-12-02
J9226 HCPCS Supprelin La Implant 1 1 — — $63,876.90 $63,876.90 $63,876.90 2024-12-02
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 4 — — $63,267.77 $63,267.77 $63,267.77 2024-12-02
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 4 — — $62,984.15 $62,984.15 $62,984.15 2024-12-02
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 4 4 — — $62,904.13 $62,904.13 $62,904.13 2024-12-02
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 4 4 — — $62,567.84 $62,567.84 $62,567.84 2024-12-02
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 4 4 — — $62,567.84 $62,567.84 $62,567.84 2024-12-02
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 4 — — $62,207.25 $62,207.25 $62,207.25 2024-12-02
454 MS_DRG DRG 4 4 — — $61,953.00 $61,953.00 $61,953.00 2024-12-02
955 MS_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $61,688.63 $61,688.63 $61,688.63 2024-12-02
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 4 — — $61,537.71 $61,537.71 $61,537.71 2024-12-02
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $61,396.16 $61,396.16 $61,396.16 2024-12-02
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 4 — — $61,248.01 $61,248.01 $61,248.01 2024-12-02
214 APR_DRG Open Craniotomy Except Trauma 1 1 — — $61,126.23 $61,126.23 $61,126.23 2024-12-02
28 MS_DRG Spinal Procedures With Mcc 4 4 — — $61,039.35 $61,039.35 $61,039.35 2024-12-02
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 1 1 — — $60,831.70 $60,831.70 $60,831.70 2024-12-02
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 4 4 — — $60,775.99 $60,775.99 $60,775.99 2024-12-02
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $60,775.66 $60,775.66 $60,775.66 2024-12-02
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 4 — — $60,254.34 $60,254.34 $60,254.34 2024-12-02
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $59,567.47 $59,567.47 $59,567.47 2024-12-02
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 4 4 — — $59,565.56 $59,565.56 $59,565.56 2024-12-02
4014 APR_DRG Adrenal Procedures 1 1 — — $58,830.81 $58,830.81 $58,830.81 2024-12-02
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 1 1 — — $58,605.98 $58,605.98 $58,605.98 2024-12-02
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 4 — — $57,702.81 $57,702.81 $57,702.81 2024-12-02
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 4 — — $57,565.05 $57,565.05 $57,565.05 2024-12-02
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 4 — — $57,420.20 $57,420.20 $57,420.20 2024-12-02
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 4 4 — — $57,368.54 $57,368.54 $57,368.54 2024-12-02
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 1 1 — — $56,958.39 $56,958.39 $56,958.39 2024-12-02
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $56,916.70 $56,916.70 $56,916.70 2024-12-02
834 MS_DRG Acute Leukemia With Mcc 4 4 — — $56,713.19 $56,713.19 $56,713.19 2024-12-02
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $56,465.00 $56,465.00 $56,465.00 2024-12-02
12 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $56,306.46 $56,306.46 $56,306.46 2024-12-02
6904 APR_DRG Acute Leukemia 1 1 — — $56,231.29 $56,231.29 $56,231.29 2024-12-02
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 4 4 — — $55,763.07 $55,763.07 $55,763.07 2024-12-02
904 APR_DRG Major Larynx & Trachea Procedures 1 1 — — $55,734.48 $55,734.48 $55,734.48 2024-12-02
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 1 1 — — $55,632.66 $55,632.66 $55,632.66 2024-12-02
224 APR_DRG Ventricular Shunt Procedures 1 1 — — $55,560.91 $55,560.91 $55,560.91 2024-12-02
1694 APR_DRG Major Abdominal Vascular Procedures 1 1 — — $55,315.58 $55,315.58 $55,315.58 2024-12-02
653 MS_DRG Major Bladder Procedures With Mcc 4 4 — — $54,835.24 $54,835.24 $54,835.24 2024-12-02
J9281 HCPCS Mitomycin 40 Mg X 2 Intra-pyelocalyceal Kit 12 9 $82,845.00 $82,845.00 $430.89 $80,359.65 $54,677.70 2024-12-02
234 APR_DRG Spinal Procedures 1 1 — — $54,394.41 $54,394.41 $54,394.41 2024-12-02
1613 APR_DRG Implantable Heart Assist Systems 1 1 — — $54,183.93 $54,183.93 $54,183.93 2024-12-02
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $54,060.93 $54,060.93 $54,060.93 2024-12-02
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $53,981.66 $53,981.66 $53,981.66 2024-12-02
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 1 1 — — $53,959.10 $53,959.10 $53,959.10 2024-12-02
A9543 HCPCS Y-90 Zevalin 13 9 $70,810.44 $70,810.44 $24,783.65 $68,686.13 $53,780.53 2024-12-02
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $53,702.16 $53,702.16 $53,702.16 2024-12-02
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 4 4 — — $53,296.62 $53,296.62 $53,296.62 2024-12-02
204 APR_DRG Open Craniotomy For Trauma 1 1 — — $53,197.84 $53,197.84 $53,197.84 2024-12-02
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 4 — — $53,123.41 $53,123.41 $53,123.41 2024-12-02
C2616 HCPCS Yttrium-90 Brachytx Src Non-stranded 12 9 $79,875.00 $79,875.00 $27,956.25 $77,478.75 $52,717.50 2024-12-02
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 4 4 — — $52,650.38 $52,650.38 $52,650.38 2024-12-02
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $52,644.31 $52,644.31 $52,644.31 2024-12-02
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 4 4 — — $52,535.92 $52,535.92 $52,535.92 2024-12-02
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $52,435.89 $52,435.89 $52,435.89 2024-12-02
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 4 — — $52,229.01 $52,229.01 $52,229.01 2024-12-02
894 APR_DRG Major Cranial Or Facial Bone Procedures 1 1 — — $51,966.42 $51,966.42 $51,966.42 2024-12-02
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 1 1 — — $51,938.40 $51,938.40 $51,938.40 2024-12-02
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 4 4 — — $51,446.02 $51,446.02 $51,446.02 2024-12-02
11 APR_DRG Liver Transplant And/or Intestinal Transplant 1 1 — — $51,439.54 $51,439.54 $51,439.54 2024-12-02
4034 APR_DRG Procedures For Obesity 1 1 — — $51,231.80 $51,231.80 $51,231.80 2024-12-02
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 4 4 — — $51,222.17 $51,222.17 $51,222.17 2024-12-02
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 1 1 — — $51,212.66 $51,212.66 $51,212.66 2024-12-02
228 MS_DRG Other Cardiothoracic Procedures With Mcc 4 4 — — $51,037.82 $51,037.82 $51,037.82 2024-12-02
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $50,945.47 $50,945.47 $50,945.47 2024-12-02
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 1 1 — — $50,818.36 $50,818.36 $50,818.36 2024-12-02
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 4 — — $50,638.73 $50,638.73 $50,638.73 2024-12-02
799 MS_DRG Splenic Procedures With Mcc 4 4 — — $50,185.95 $50,185.95 $50,185.95 2024-12-02
471 MS_DRG Cervical Spinal Fusion With Mcc 4 4 — — $49,825.36 $49,825.36 $49,825.36 2024-12-02
9103 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $49,702.43 $49,702.43 $49,702.43 2024-12-02
32 APR_DRG Bone Marrow Transplant 1 1 — — $49,472.14 $49,472.14 $49,472.14 2024-12-02
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 4 4 — — $49,432.34 $49,432.34 $49,432.34 2024-12-02
6 MS_DRG Liver Transplant Without Mcc 4 4 — — $48,993.75 $48,993.75 $48,993.75 2024-12-02
61 APR_DRG Pancreas Transplant 1 1 — — $48,898.11 $48,898.11 $48,898.11 2024-12-02
10 MS_DRG Pancreas Transplant 4 4 — — $48,757.74 $48,757.74 $48,757.74 2024-12-02
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 4 4 — — $48,688.86 $48,688.86 $48,688.86 2024-12-02
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 1 1 — — $48,680.12 $48,680.12 $48,680.12 2024-12-02
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 4 4 — — $48,441.71 $48,441.71 $48,441.71 2024-12-02
914 APR_DRG Other Major Head And Neck Procedures 1 1 — — $48,348.69 $48,348.69 $48,348.69 2024-12-02
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 1 1 — — $48,312.47 $48,312.47 $48,312.47 2024-12-02
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 4 — — $48,180.38 $48,180.38 $48,180.38 2024-12-02
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $48,177.37 $48,177.37 $48,177.37 2024-12-02
4414 APR_DRG Major Bladder Procedures 1 1 — — $48,045.96 $48,045.96 $48,045.96 2024-12-02
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 4 — — $48,016.29 $48,016.29 $48,016.29 2024-12-02
4403 APR_DRG Kidney Transplant 1 1 — — $47,972.15 $47,972.15 $47,972.15 2024-12-02
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 1 1 — — $47,892.88 $47,892.88 $47,892.88 2024-12-02
9304 APR_DRG Multiple Significant Trauma Without O.r. Procedure 1 1 — — $47,829.33 $47,829.33 $47,829.33 2024-12-02
163 MS_DRG Major Chest Procedures With Mcc 4 4 — — $47,744.83 $47,744.83 $47,744.83 2024-12-02
120 EAPG Immunotherapy 1 1 — — $47,701.99 $47,701.99 $47,701.99 2024-12-02
244 APR_DRG Open Extracranial Vascular Procedures 1 1 — — $47,094.03 $47,094.03 $47,094.03 2024-12-02
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 4 — — $47,086.43 $47,086.43 $47,086.43 2024-12-02
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 1 1 — — $46,833.67 $46,833.67 $46,833.67 2024-12-02
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 1 1 — — $46,765.33 $46,765.33 $46,765.33 2024-12-02
455 MS_DRG DRG 4 4 — — $46,650.88 $46,650.88 $46,650.88 2024-12-02
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 1 1 — — $46,606.79 $46,606.79 $46,606.79 2024-12-02
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 1 1 — — $46,470.12 $46,470.12 $46,470.12 2024-12-02
1204 APR_DRG Major Respiratory And Chest Procedures 1 1 — — $46,029.35 $46,029.35 $46,029.35 2024-12-02
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $45,967.16 $45,967.16 $45,967.16 2024-12-02
245 MS_DRG Aicd Generator Procedures 4 4 — — $45,899.29 $45,899.29 $45,899.29 2024-12-02
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 4 — — $45,895.24 $45,895.24 $45,895.24 2024-12-02
8444 APR_DRG Partial Thickness Burns Without Skin Graft 1 1 — — $45,881.06 $45,881.06 $45,881.06 2024-12-02
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 4 — — $45,751.41 $45,751.41 $45,751.41 2024-12-02
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 1 1 — — $45,719.10 $45,719.10 $45,719.10 2024-12-02
6934 APR_DRG Chemotherapy 1 1 — — $45,633.00 $45,633.00 $45,633.00 2024-12-02
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 4 — — $45,600.48 $45,600.48 $45,600.48 2024-12-02
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 4 — — $45,555.91 $45,555.91 $45,555.91 2024-12-02
J2350 HCPCS Ocrelizumab 30 Mg/ml Intravenous Solution 12 9 $69,000.33 $69,000.33 $91.34 $66,930.32 $45,540.22 2024-12-02
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $45,508.63 $45,508.63 $45,508.63 2024-12-02
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 1 1 — — $45,341.88 $45,341.88 $45,341.88 2024-12-02
264 APR_DRG Other Nervous System And Related Procedures 1 1 — — $45,208.63 $45,208.63 $45,208.63 2024-12-02
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 4 4 — — $45,180.12 $45,180.12 $45,180.12 2024-12-02
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 1 1 — — $45,050.09 $45,050.09 $45,050.09 2024-12-02
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 4 4 — — $44,855.99 $44,855.99 $44,855.99 2024-12-02
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 4 4 — — $44,730.39 $44,730.39 $44,730.39 2024-12-02
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 4 4 — — $44,454.87 $44,454.87 $44,454.87 2024-12-02
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 4 4 — — $44,182.40 $44,182.40 $44,182.40 2024-12-02
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 1 1 — — $44,085.86 $44,085.86 $44,085.86 2024-12-02
J7311 HCPCS Fluocinolone 0.59 Mg Intravitreal Implant 12 9 $66,587.50 $66,587.50 $502.24 $64,589.88 $43,947.75 2024-12-02
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 1 1 — — $43,886.32 $43,886.32 $43,886.32 2024-12-02
901 MS_DRG Wound Debridements For Injuries With Mcc 4 4 — — $43,836.99 $43,836.99 $43,836.99 2024-12-02
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 1 1 — — $43,771.51 $43,771.51 $43,771.51 2024-12-02
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 1 1 — — $43,698.39 $43,698.39 $43,698.39 2024-12-02
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 1 1 — — $43,641.68 $43,641.68 $43,641.68 2024-12-02
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $43,628.69 $43,628.69 $43,628.69 2024-12-02
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 4 — — $43,583.77 $43,583.77 $43,583.77 2024-12-02
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 4 — — $43,339.65 $43,339.65 $43,339.65 2024-12-02
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 1 1 — — $42,975.40 $42,975.40 $42,975.40 2024-12-02
J9266 HCPCS Pegaspargase 750 Unit/ml Injection Solution 12 9 $65,104.83 $65,104.83 $22,786.69 $63,151.69 $42,969.19 2024-12-02
J2507 HCPCS Pegloticase 8 Mg/ml Intravenous Solution 17 9 $65,041.27 $65,041.27 $4,696.95 $97,204.28 $42,927.24 2024-12-02
1214 APR_DRG Other Respiratory And Chest Procedures 1 1 — — $42,713.67 $42,713.67 $42,713.67 2024-12-02
793 MS_DRG Full Term Neonate With Major Problems 4 4 — — $42,636.69 $42,636.69 $42,636.69 2024-12-02
6504 APR_DRG Splenic Procedures 1 1 — — $42,464.92 $42,464.92 $42,464.92 2024-12-02
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 1 1 — — $42,371.98 $42,371.98 $42,371.98 2024-12-02
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 1 1 — — $42,192.26 $42,192.26 $42,192.26 2024-12-02
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 4 — — $42,123.14 $42,123.14 $42,123.14 2024-12-02
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 1 1 — — $42,009.80 $42,009.80 $42,009.80 2024-12-02
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 4 4 — — $41,934.74 $41,934.74 $41,934.74 2024-12-02
2614 APR_DRG Major Biliary Tract Procedures 1 1 — — $41,886.80 $41,886.80 $41,886.80 2024-12-02
31 MS_DRG Ventricular Shunt Procedures With Mcc 4 4 — — $41,697.72 $41,697.72 $41,697.72 2024-12-02
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $41,633.27 $41,633.27 $41,633.27 2024-12-02
791 MS_DRG Prematurity With Major Problems 4 4 — — $41,506.27 $41,506.27 $41,506.27 2024-12-02
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 1 1 — — $41,437.83 $41,437.83 $41,437.83 2024-12-02
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $41,207.53 $41,207.53 $41,207.53 2024-12-02
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 1 1 — — $41,205.48 $41,205.48 $41,205.48 2024-12-02
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 4 — — $41,102.12 $41,102.12 $41,102.12 2024-12-02
7724 APR_DRG Alcohol And Drug Dependence With Rehabilitation And/or Detoxification Therapy 1 1 — — $41,046.26 $41,046.26 $41,046.26 2024-12-02
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $41,042.16 $41,042.16 $41,042.16 2024-12-02
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 4 4 — — $40,970.44 $40,970.44 $40,970.44 2024-12-02
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $40,962.20 $40,962.20 $40,962.20 2024-12-02
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 4 4 — — $40,933.98 $40,933.98 $40,933.98 2024-12-02
2214 APR_DRG Major Small & Large Bowel Procedures 1 1 — — $40,843.30 $40,843.30 $40,843.30 2024-12-02
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 1 1 — — $40,728.49 $40,728.49 $40,728.49 2024-12-02
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 4 4 — — $40,663.53 $40,663.53 $40,663.53 2024-12-02
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 1 — — $40,615.74 $40,615.74 $40,615.74 2024-12-02
246 EAPG Class IV Therapeutic Radiopharmaceuticals 1 1 — — $40,566.75 $40,566.75 $40,566.75 2024-12-02
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 4 — — $40,566.29 $40,566.29 $40,566.29 2024-12-02
2234 APR_DRG Other Small And Large Bowel Procedures 1 1 — — $40,473.60 $40,473.60 $40,473.60 2024-12-02
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 1 1 — — $40,423.71 $40,423.71 $40,423.71 2024-12-02
4402 APR_DRG Kidney Transplant 1 1 — — $40,254.92 $40,254.92 $40,254.92 2024-12-02
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 4 — — $40,088.19 $40,088.19 $40,088.19 2024-12-02
2294 APR_DRG Other Digestive System And Abdominal Procedures 1 1 — — $39,855.16 $39,855.16 $39,855.16 2024-12-02
J3245 HCPCS Tildrakizumab-asmn 100 Mg/ml Subcutaneous Syringe 12 9 $60,331.15 $60,331.15 $209.35 $58,521.22 $39,818.56 2024-12-02
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 1 1 — — $39,663.81 $39,663.81 $39,663.81 2024-12-02
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 4 — — $39,614.15 $39,614.15 $39,614.15 2024-12-02
4834 APR_DRG Penis, Testes And Scrotal Procedures 1 1 — — $39,553.11 $39,553.11 $39,553.11 2024-12-02
34 MS_DRG Carotid Artery Stent Procedures With Mcc 4 4 — — $39,517.92 $39,517.92 $39,517.92 2024-12-02
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 4 4 — — $39,473.35 $39,473.35 $39,473.35 2024-12-02
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 1 1 — — $39,378.85 $39,378.85 $39,378.85 2024-12-02
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 4 4 — — $39,374.08 $39,374.08 $39,374.08 2024-12-02
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 4 4 — — $39,282.92 $39,282.92 $39,282.92 2024-12-02
9123 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 1 1 — — $39,204.59 $39,204.59 $39,204.59 2024-12-02
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 1 1 — — $39,095.25 $39,095.25 $39,095.25 2024-12-02
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 4 4 — — $39,002.34 $39,002.34 $39,002.34 2024-12-02
1734 APR_DRG Other Vascular Procedures 1 1 — — $38,839.68 $38,839.68 $38,839.68 2024-12-02
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 4 4 — — $38,750.13 $38,750.13 $38,750.13 2024-12-02
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 1 1 — — $38,715.30 $38,715.30 $38,715.30 2024-12-02
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 1 1 — — $38,662.00 $38,662.00 $38,662.00 2024-12-02
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 4 — — $38,377.38 $38,377.38 $38,377.38 2024-12-02
5144 APR_DRG Female Reproductive System Reconstructive Procedures 1 1 — — $38,276.58 $38,276.58 $38,276.58 2024-12-02
140 MS_DRG Major Head And Neck Procedures With Mcc 4 4 — — $38,268.99 $38,268.99 $38,268.99 2024-12-02
5184 APR_DRG Other Female Reproductive System And Related Procedures 1 1 — — $38,018.96 $38,018.96 $38,018.96 2024-12-02
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 4 4 — — $37,796.97 $37,796.97 $37,796.97 2024-12-02
3624 APR_DRG Mastectomy Procedures 1 1 — — $37,774.31 $37,774.31 $37,774.31 2024-12-02
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 1 1 — — $37,733.99 $37,733.99 $37,733.99 2024-12-02
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 4 4 — — $37,702.77 $37,702.77 $37,702.77 2024-12-02
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 4 4 — — $37,675.42 $37,675.42 $37,675.42 2024-12-02
2624 APR_DRG Cholecystectomy Except Laparoscopic 1 1 — — $37,512.58 $37,512.58 $37,512.58 2024-12-02
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 1 1 — — $37,469.53 $37,469.53 $37,469.53 2024-12-02
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 4 4 — — $37,457.65 $37,457.65 $37,457.65 2024-12-02
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 1 1 — — $37,233.77 $37,233.77 $37,233.77 2024-12-02
3054 APR_DRG Amputation Of Lower Limb Except Toes 1 1 — — $37,086.16 $37,086.16 $37,086.16 2024-12-02
460 MS_DRG DRG 4 4 — — $37,051.47 $37,051.47 $37,051.47 2024-12-02
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 4 4 — — $36,989.68 $36,989.68 $36,989.68 2024-12-02
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 1 1 — — $36,903.02 $36,903.02 $36,903.02 2024-12-02
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 4 4 — — $36,838.76 $36,838.76 $36,838.76 2024-12-02
J3241 HCPCS Teprotumumab-trbw 500 Mg Intravenous Solution 12 9 $55,721.05 $55,721.05 $485.27 $54,049.42 $36,775.89 2024-12-02
332 MS_DRG Rectal Resection With Mcc 4 4 — — $36,744.55 $36,744.55 $36,744.55 2024-12-02
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 4 4 — — $36,694.92 $36,694.92 $36,694.92 2024-12-02
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 4 4 — — $36,630.09 $36,630.09 $36,630.09 2024-12-02
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 1 1 — — $36,577.74 $36,577.74 $36,577.74 2024-12-02
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 1 1 — — $36,534.01 $36,534.01 $36,534.01 2024-12-02
4814 APR_DRG Penis Procedures 1 1 — — $36,530.59 $36,530.59 $36,530.59 2024-12-02
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 1 1 — — $36,503.94 $36,503.94 $36,503.94 2024-12-02
4804 APR_DRG Major Male Pelvic Procedures 1 1 — — $36,411.00 $36,411.00 $36,411.00 2024-12-02
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 1 1 — — $36,382.30 $36,382.30 $36,382.30 2024-12-02
3094 APR_DRG Other Significant Hip And Femur Surgery 1 1 — — $36,376.83 $36,376.83 $36,376.83 2024-12-02
4401 APR_DRG Kidney Transplant 1 1 — — $36,332.41 $36,332.41 $36,332.41 2024-12-02
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 4 4 — — $36,274.56 $36,274.56 $36,274.56 2024-12-02
335 MS_DRG Peritoneal Adhesiolysis With Mcc 4 4 — — $36,211.76 $36,211.76 $36,211.76 2024-12-02
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 1 1 — — $36,117.84 $36,117.84 $36,117.84 2024-12-02
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 1 1 — — $35,944.95 $35,944.95 $35,944.95 2024-12-02
265 MS_DRG Aicd Lead Procedures 4 4 — — $35,797.48 $35,797.48 $35,797.48 2024-12-02
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 4 4 — — $35,707.33 $35,707.33 $35,707.33 2024-12-02
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 1 1 — — $35,623.77 $35,623.77 $35,623.77 2024-12-02
31 APR_DRG Bone Marrow Transplant 1 1 — — $35,582.76 $35,582.76 $35,582.76 2024-12-02
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 1 1 — — $35,528.78 $35,528.78 $35,528.78 2024-12-02
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 4 4 — — $35,313.30 $35,313.30 $35,313.30 2024-12-02
1804 APR_DRG Other Circulatory System Procedures 1 1 — — $35,298.48 $35,298.48 $35,298.48 2024-12-02
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 4 4 — — $35,216.06 $35,216.06 $35,216.06 2024-12-02
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 1 1 — — $35,212.38 $35,212.38 $35,212.38 2024-12-02
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 1 1 — — $35,194.61 $35,194.61 $35,194.61 2024-12-02
9102 APR_DRG Craniotomy For Multiple Significant Trauma 1 1 — — $35,153.61 $35,153.61 $35,153.61 2024-12-02
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