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 →

Export CSV
Hospital

HCA FLORIDA TRINITY HOSPITAL

Trinity, FL · CCN 100191 · Rates published

30,724 distinct procedures filed
60 distinct payers
828,997 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

405,876 of 828,997 rate rows are consumer-grade (49.0%)

423,121 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 408,284
per-diem day rate — not a per-procedure price 12,364
template filing: same amount across many unrelated codes — excluded 2,146
exceeds 10× this hospital's gross charge — excluded from medians 211
placeholder amount (≤ $0.02) — excluded from medians 116

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/59-2047041_HCA-FLORIDA-TRINITY-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.hcafloridahealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaCMS hospital list
Last fetch success · 2026-06-08

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
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 24 $3,672,900.00 $4,187,106.00 $3,783,087.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 24 $3,605,000.00 $4,109,700.00 $3,713,150.00 nat. median
$3,605,000
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,562,713.00 $3,562,713.00 $3,562,713.00 nat. median
$3,574,709
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,496,850.00 $3,496,850.00 $3,496,850.00 nat. median
$3,496,850
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 26 $5,896.85 $4,821,909.75 $3,425,218.65 nat. median
$13,041
outlier · 262.6×
748
OTHER 		Inj, Lovotibeglogene Auto 26 $9,726.84 $4,764,700.00 $3,384,580.00 nat. median
$17,963
outlier · 188.4×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,225,691.35 $3,225,691.35 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,187,420.00 $3,187,420.00 $3,187,420.00 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 26 $8,639.36 $4,303,600.00 $3,057,040.00 nat. median
$21,896
outlier · 139.6×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 25 $2,388,614.00 $3,463,490.30 $2,484,158.56 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,316,955.58 $2,316,955.58 $2,316,955.58 nat. median
$2,457,321
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 25 $529,192.90 $767,329.70 $550,360.62 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 25 $527,123.40 $764,328.93 $548,208.33 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 25 $526,587.60 $763,552.02 $547,651.10 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 25 $516,726.10 $749,252.84 $537,395.15 nat. median
$562,201
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $513,317.11 $513,317.11 nat. median
$538,205
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$554,552
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$530,178
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 25 $489,456.00 $709,711.20 $509,034.24 nat. median
$532,192
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $1,125,423.00 $502,693.77 nat. median
$754,974
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$534,091
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $1,091,527.05 $492,271.12 nat. median
$675,122
0.7× median
9391
OTHER 		Brexucabtagene Car Pos T 25 $460,530.40 $667,769.08 $478,951.61 nat. median
$489,450
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$505,583
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $1,082,427.24 $470,149.30 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $1,067,238.95 $459,839.17 nat. median
$674,188
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$464,978
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $1,051,644.36 $445,599.57 nat. median
$634,511
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $966,296.00 $435,956.80 nat. median
$620,080
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 33 $7,387.00 $832,980.61 $315,415.43 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 33 $10,670.00 $622,167.61 $237,064.37 nat. median
$265,286
0.9× median
5834
APR_DRG 		Neonate With Ecmo 14 $192,207.00 $288,310.50 $230,648.40 nat. median
$309,665
0.7× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $199,878.68 $199,878.68 $199,878.68 nat. median
$263,894
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 31 $10,670.00 $524,012.93 $197,874.70 nat. median
$206,368
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 $10,670.00 $689,263.83 $180,655.17 nat. median
$202,986
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $164,929.39 $164,929.39 $164,929.39 nat. median
$424,868
outlier · 0.4×
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $156,515.70 $156,515.70 $156,515.70 nat. median
$76,377
outlier · 2.0×
1908
OTHER 		New Technology - Level 52 25 $147,339.90 $213,642.85 $153,233.49 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 25 $147,339.90 $213,642.85 $153,233.49 nat. median
$153,199
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 14 $125,393.00 $188,089.50 $150,471.60 nat. median
$246,434
0.6× median
5833
APR_DRG 		Neonate With Ecmo 14 $124,517.00 $186,775.50 $149,420.40 nat. median
$244,017
0.6× median
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$84,819
1.7× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$82,736
1.7× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 $140,774.65 $140,774.65 $140,774.65 nat. median
$62,507
outlier · 2.3×
1906
OTHER 		New Technology - Level 51 25 $132,847.50 $192,628.88 $138,161.40 nat. median
$138,020
1.0× median
1905
OTHER 		New Technology - Level 51 25 $132,847.50 $192,628.88 $138,161.40 nat. median
$137,903
1.0× median
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $133,878.82 $133,878.82 $133,878.82 nat. median
$218,232
0.6× median
24
APR_DRG 		Heart And/or Lung Transplant 14 $111,047.00 $166,570.50 $133,256.40 nat. median
$234,738
0.6× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median

Other procedures at this hospital

Browse this hospital's 30,724 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
             
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $36,634.29 $36,634.29 $36,634.29 2024-10-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 56 35 — — $10,670.00 $94,959.75 $36,733.54 2024-10-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 56 35 — — $10,799.00 $142,382.88 $36,864.37 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 18 14 — — $30,783.00 $46,174.50 $36,939.60 2024-10-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 51 31 — — $7,387.00 $95,572.48 $37,059.04 2024-10-01
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 2 1 — — $37,108.68 $37,108.68 $37,108.68 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 56 35 — — $10,799.00 $124,330.52 $37,217.52 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 18 14 — — $31,113.00 $46,669.50 $37,335.60 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 18 14 — — $31,456.00 $47,184.00 $37,747.20 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 18 14 — — $31,574.00 $47,361.00 $37,888.80 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 56 35 — — $10,670.00 $97,858.69 $37,917.17 2024-10-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $37,943.47 $37,943.47 $37,943.47 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 56 35 — — $10,799.00 $127,238.00 $37,980.64 2024-10-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $38,003.33 $38,003.33 $38,003.33 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 18 14 — — $31,789.00 $47,683.50 $38,146.80 2024-10-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $38,256.07 $38,256.07 $38,256.07 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 56 35 — — $10,670.00 $99,055.91 $38,366.55 2024-10-01
G0448 HCPCS Insertion Or Replacement Of A Permanent Pacing Cardioverter-defibrillator System… 12 5 — — $5,395.00 $60,908.00 $38,410.00 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 56 35 — — $10,670.00 $114,480.65 $38,782.53 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 29 26 — — $36,570.46 $54,667.17 $38,832.54 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 18 14 — — $32,422.00 $48,633.00 $38,906.40 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 35 — — $9,472.00 $174,501.57 $39,018.55 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 2 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 29 26 — — $37,140.82 $55,519.78 $39,438.18 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 56 35 — — $10,670.00 $102,405.62 $39,595.79 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 56 35 — — $10,670.00 $101,426.06 $39,648.75 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 52 33 — — $10,670.00 $159,121.47 $39,776.87 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 56 35 — — $10,670.00 $103,358.85 $39,981.66 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 56 35 — — $10,799.00 $131,071.35 $40,176.93 2024-10-01
006 OTHER Liver Transplant Without Mcc 1 1 — — $40,401.64 $40,401.64 $40,401.64 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 56 35 — — $10,670.00 $105,479.39 $40,777.61 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 56 35 — — $10,670.00 $124,505.92 $40,807.34 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 56 35 — — $10,670.00 $111,732.73 $40,809.01 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 18 14 — — $34,068.00 $51,102.00 $40,881.60 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 18 14 — — $34,228.00 $51,342.00 $41,073.60 2024-10-01
63 APR_DRG Pancreas Transplant 18 14 — — $34,364.00 $51,546.00 $41,236.80 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $41,594.99 $41,594.99 $41,594.99 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $41,741.31 $41,741.31 $41,741.31 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 56 35 — — $10,799.00 $171,633.28 $41,745.69 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 51 32 — — $10,670.00 $394,379.94 $41,802.56 2024-10-01
0208 RC — 23 18 — — $7,500.00 $41,922.50 $41,922.50 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $41,949.71 $41,949.71 $41,949.71 2024-10-01
8634 APR_DRG Neonatal Aftercare 18 14 — — $35,009.00 $52,513.50 $42,010.80 2024-10-01
245 MS_DRG Aicd Generator Procedures 56 35 — — $10,799.00 $107,937.90 $42,117.41 2024-10-01
0207 RC — 14 12 — — $8,000.00 $42,172.50 $42,172.50 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $42,214.10 $42,214.10 $42,214.10 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $42,282.82 $42,282.82 $42,282.82 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $42,378.16 $42,378.16 $42,378.16 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $42,382.04 $42,382.04 $42,382.04 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 34 — — $10,799.00 $218,004.01 $42,402.05 2024-10-01
4404 APR_DRG Kidney Transplant 18 14 — — $35,422.00 $53,133.00 $42,506.40 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 55 35 — — $7,387.00 $110,595.21 $42,697.84 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 56 35 — — $10,670.00 $114,480.65 $42,867.16 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 56 35 — — $10,670.00 $111,251.25 $42,944.08 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 56 35 — — $10,799.00 $153,402.08 $43,163.40 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $43,241.44 $94,940.24 $43,241.44 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 56 35 — — $10,670.00 $112,183.40 $43,293.97 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 57 35 — — $10,799.00 $232,204.47 $43,405.85 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 56 35 — — $10,799.00 $79,957.96 $43,735.89 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 56 35 — — $10,799.00 $85,385.02 $43,857.54 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 56 35 — — $10,670.00 $177,108.48 $44,321.47 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 18 14 — — $36,953.00 $55,429.50 $44,343.60 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 18 14 — — $37,476.00 $56,214.00 $44,971.20 2024-10-01
1594 OTHER New Technology - Level 43 28 25 — — $43,477.68 $63,042.64 $45,216.79 2024-10-01
1580 OTHER New Technology - Level 43 28 25 — — $43,477.68 $63,042.64 $45,216.79 2024-10-01
0294T CPT HInsertion Of Left Atrial Hemodynamic Monitor; Pressure Sensor Lead At Time Of I… 3 1 — — $19,926.00 $49,364.00 $45,326.00 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 56 35 — — $10,799.00 $113,899.43 $45,326.10 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 54 34 — — $10,799.00 $164,404.08 $45,474.65 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 18 14 — — $37,904.00 $56,856.00 $45,484.80 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $45,887.23 $45,887.23 $45,887.23 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 56 35 — — $10,670.00 $119,167.95 $45,915.62 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 56 35 — — $10,670.00 $119,183.41 $45,921.43 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 56 35 — — $10,670.00 $119,296.06 $45,963.71 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 56 35 — — $10,670.00 $153,398.64 $46,424.35 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 18 14 — — $38,906.00 $58,359.00 $46,687.20 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 51 32 — — $10,670.00 $200,849.28 $46,759.15 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $46,959.74 $46,959.74 $46,959.74 2024-10-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 2 1 — — $40,208.00 $53,804.00 $47,006.00 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 55 35 — — $7,387.00 $122,083.69 $47,010.05 2024-10-01
1142 OTHER Supprelin La Implant 28 25 — — $45,350.21 $65,757.80 $47,164.22 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 56 35 — — $10,670.00 $123,128.50 $47,402.23 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 56 35 — — $10,799.00 $162,323.36 $47,558.48 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $47,825.50 $47,825.50 $47,825.50 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 18 14 — — $39,878.00 $59,817.00 $47,853.60 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 56 35 — — $10,799.00 $188,127.68 $48,167.99 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $48,397.50 $48,397.50 $48,397.50 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $10,799.00 $189,334.84 $48,469.19 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 34 — — $10,799.00 $218,004.01 $48,705.97 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 29 26 — — $46,068.21 $68,864.85 $48,917.79 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $49,179.02 $49,179.02 $49,179.02 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 56 35 — — $10,670.00 $128,599.95 $49,455.94 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 35 — — $9,472.00 $174,501.57 $49,500.14 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $49,927.84 $49,927.84 $49,927.84 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 18 14 — — $41,730.00 $62,595.00 $50,076.00 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 18 14 — — $41,876.00 $62,814.00 $50,251.20 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 56 35 — — $10,799.00 $248,327.44 $50,304.31 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 18 14 — — $41,957.00 $62,935.50 $50,348.40 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $50,417.81 $50,417.81 $50,417.81 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 18 14 — — $42,035.00 $63,052.50 $50,442.00 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $50,561.89 $50,561.89 $50,561.89 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 56 35 — — $10,799.00 $153,316.10 $50,908.43 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 41 29 — — $11,098.00 $63,095.73 $50,981.35 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 51 32 — — $7,387.00 $388,013.98 $51,739.20 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 51 32 — — $7,387.00 $388,013.98 $51,739.20 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 56 35 — — $10,799.00 $134,281.24 $51,879.21 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 56 35 — — $10,670.00 $136,019.64 $52,240.93 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 18 14 — — $43,560.00 $65,340.00 $52,272.00 2024-10-01
5244 OTHER Level 4 Blood Product Exc 28 25 — — $50,304.25 $72,941.16 $52,316.42 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 18 14 — — $43,677.00 $65,515.50 $52,412.40 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 56 35 — — $10,799.00 $175,330.42 $52,467.62 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 56 35 — — $10,799.00 $135,553.57 $52,684.56 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 56 35 — — $10,670.00 $212,748.91 $53,119.24 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 3 1 — — $29,705.00 $53,419.00 $53,419.00 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 3 1 — — $29,705.00 $53,419.00 $53,419.00 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 18 14 — — $44,835.00 $67,252.50 $53,802.00 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 56 35 — — $10,670.00 $155,032.26 $53,944.22 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 18 14 — — $45,376.00 $68,064.00 $54,451.20 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 35 — — $10,799.00 $251,580.92 $54,551.42 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 55 35 — — $7,387.00 $142,865.03 $54,810.36 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 57 35 — — $10,799.00 $309,252.86 $54,921.24 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 56 35 — — $10,799.00 $171,633.28 $55,168.12 2024-10-01
1581 OTHER New Technology - Level 44 28 25 — — $53,139.28 $77,051.96 $55,264.85 2024-10-01
1595 OTHER New Technology - Level 44 28 25 — — $53,139.28 $77,051.96 $55,264.85 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $55,309.77 $55,309.77 $55,309.77 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 18 14 — — $46,203.00 $69,304.50 $55,443.60 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $30,928.00 $55,615.00 $55,615.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 3 1 — — $30,928.00 $55,615.00 $55,615.00 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $55,619.05 $55,619.05 $55,619.05 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 18 14 — — $46,525.00 $69,787.50 $55,830.00 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 56 35 — — $10,799.00 $253,434.65 $55,976.96 2024-10-01
8514 APR_DRG Gender Related Procedures 18 14 — — $46,902.00 $70,353.00 $56,282.40 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 52 31 — — $10,670.00 $147,521.39 $56,558.13 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 56 35 — — $10,799.00 $113,899.43 $57,029.08 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 18 14 — — $47,538.00 $71,307.00 $57,045.60 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 28 25 — — $55,015.23 $79,772.08 $57,215.84 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $57,458.11 $57,458.11 $57,458.11 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 56 35 — — $10,799.00 $230,570.85 $57,622.77 2024-10-01
64 APR_DRG Pancreas Transplant 18 14 — — $48,372.00 $72,558.00 $58,046.40 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 56 35 — — $10,670.00 $240,647.70 $58,374.79 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 14 — — $48,895.00 $73,342.50 $58,674.00 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 18 14 — — $48,983.00 $73,474.50 $58,779.60 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 55 35 — — $10,000.00 $73,578.82 $58,863.06 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 18 14 — — $49,247.00 $73,870.50 $59,096.40 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 35 — — $10,799.00 $251,580.92 $59,102.96 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 18 14 — — $51,226.00 $76,839.00 $61,471.20 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $61,600.24 $136,523.56 $61,600.24 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $61,780.29 $61,780.29 $61,780.29 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $61,921.62 $61,921.62 $61,921.62 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 18 14 — — $51,688.00 $77,532.00 $62,025.60 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $10,799.00 $244,138.49 $62,143.53 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 2 — — $9,472.00 $62,710.00 $62,710.00 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 56 35 — — $10,799.00 $241,975.23 $62,763.84 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 56 35 — — $10,670.00 $170,594.64 $63,559.04 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $64,253.98 $64,253.98 $64,253.98 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 29 26 — — $14,131.60 $91,864.42 $65,255.41 2024-10-01
1582 OTHER New Technology - Level 45 28 25 — — $62,800.88 $91,061.28 $65,312.92 2024-10-01
1596 OTHER New Technology - Level 45 28 25 — — $62,800.88 $91,061.28 $65,312.92 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 18 14 — — $54,849.00 $82,273.50 $65,818.80 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 18 14 — — $55,523.00 $83,284.50 $66,627.60 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 34 — — $10,799.00 $218,004.01 $66,640.98 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 52 33 — — $10,670.00 $200,849.28 $67,576.19 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 29 26 — — $63,895.55 $95,513.96 $67,847.85 2024-10-01
10 MS_DRG Pancreas Transplant 51 32 — — $10,670.00 $198,830.47 $67,960.57 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 28 25 — — $65,476.58 $94,941.04 $68,095.65 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 56 35 — — $10,799.00 $213,051.56 $68,297.20 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 14 — — $56,946.00 $85,419.00 $68,335.20 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $69,717.39 $69,717.39 $69,717.39 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 56 35 — — $10,799.00 $248,327.44 $69,988.31 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 18 14 — — $59,125.00 $88,687.50 $70,950.00 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 56 35 — — $10,799.00 $286,829.28 $71,037.19 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 35 — — $9,472.00 $187,062.91 $72,114.09 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 18 14 — — $61,338.00 $92,007.00 $73,605.60 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 56 35 — — $10,799.00 $253,434.65 $73,940.27 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 18 14 — — $62,352.00 $93,528.00 $74,822.40 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $75,330.46 $75,330.46 $75,330.46 2024-10-01
1583 OTHER New Technology - Level 46 28 25 — — $72,462.48 $105,070.60 $75,360.98 2024-10-01
1597 OTHER New Technology - Level 46 28 25 — — $72,462.48 $105,070.60 $75,360.98 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $9,472.00 $75,435.00 $75,435.00 2024-10-01
007 OTHER Lung Transplant 1 1 — — $75,467.36 $75,467.36 $75,467.36 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 18 14 — — $64,392.00 $96,588.00 $77,270.40 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 56 35 — — $10,670.00 $316,795.03 $78,333.49 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 18 14 — — $66,782.00 $100,173.00 $80,138.40 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 18 14 — — $67,242.00 $100,863.00 $80,690.40 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 18 14 — — $68,321.00 $102,481.50 $81,985.20 2024-10-01
5831 APR_DRG Neonate With Ecmo 18 14 — — $69,493.00 $104,239.50 $83,391.60 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $85,179.23 $85,179.23 $85,179.23 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 35 — — $10,799.00 $251,580.92 $85,258.48 2024-10-01
1584 OTHER New Technology - Level 47 28 25 — — $82,124.09 $119,079.93 $85,409.05 2024-10-01
1598 OTHER New Technology - Level 47 28 25 — — $82,124.09 $119,079.93 $85,409.05 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 18 14 — — $71,560.00 $107,340.00 $85,872.00 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $87,466.13 $87,466.13 $87,466.13 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 18 14 — — $73,863.00 $110,794.50 $88,635.60 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $10,799.00 $360,483.19 $88,971.04 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 18 14 — — $75,232.00 $112,848.00 $90,278.40 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 51 32 — — $10,670.00 $394,379.94 $90,369.52 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 18 14 — — $75,611.00 $113,416.50 $90,733.20 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 56 35 — — $10,670.00 $370,425.91 $92,416.97 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 53 33 — — $10,670.00 $443,952.57 $93,634.39 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 29 26 — — $88,300.94 $131,996.25 $93,762.86 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $94,133.42 $94,133.42 $94,133.42 2024-10-01
215 MS_DRG Other Heart Assist System Implant 57 35 — — $10,799.00 $400,594.58 $94,838.60 2024-10-01
1599 OTHER New Technology - Level 48 28 25 — — $91,785.68 $133,089.24 $95,457.11 2024-10-01
1585 OTHER New Technology - Level 48 28 25 — — $91,785.68 $133,089.24 $95,457.11 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 18 14 — — $79,657.00 $119,485.50 $95,588.40 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 18 14 — — $80,942.00 $121,413.00 $97,130.40 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 18 14 — — $81,552.00 $122,328.00 $97,862.40 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 18 14 — — $82,446.00 $123,669.00 $98,935.20 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $100,053.67 $100,053.67 $100,053.67 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $55,840.00 $100,416.00 $100,416.00 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $55,840.00 $100,416.00 $100,416.00 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $56,756.00 $102,063.00 $102,063.00 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $56,756.00 $102,063.00 $102,063.00 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $56,756.00 $102,063.00 $102,063.00 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $56,756.00 $102,063.00 $102,063.00 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 29 26 — — $96,999.90 $144,999.85 $102,999.90 2024-10-01
1901 OTHER New Technology - Level 49 28 25 — — $103,862.70 $150,600.91 $108,017.21 2024-10-01
1902 OTHER New Technology - Level 49 28 25 — — $103,862.70 $150,600.91 $108,017.21 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 18 14 — — $90,217.00 $135,325.50 $108,260.40 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 18 14 — — $91,470.00 $137,205.00 $109,764.00 2024-10-01
7 MS_DRG Lung Transplant 51 32 — — $10,670.00 $327,312.10 $110,628.84 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 51 32 — — $7,387.00 $388,013.98 $110,905.17 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 18 14 — — $95,167.00 $142,750.50 $114,200.40 2024-10-01
5832 APR_DRG Neonate With Ecmo 18 14 — — $95,607.00 $143,410.50 $114,728.40 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 14 — — $97,644.00 $146,466.00 $117,172.80 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 54 33 — — $10,670.00 $413,687.61 $118,923.76 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 3 2 — — $53,789.99 $119,352.48 $119,352.48 2024-10-01
1903 OTHER New Technology - Level 50 28 25 — — $118,355.10 $171,614.89 $123,089.30 2024-10-01
1904 OTHER New Technology - Level 50 28 25 — — $118,355.10 $171,614.89 $123,089.30 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 18 14 — — $111,047.00 $166,570.50 $133,256.40 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $133,878.82 $133,878.82 $133,878.82 2024-10-01
1905 OTHER New Technology - Level 51 28 25 — — $132,847.50 $192,628.88 $138,161.40 2024-10-01
1906 OTHER New Technology - Level 51 28 25 — — $132,847.50 $192,628.88 $138,161.40 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 1 — — $140,774.65 $140,774.65 $140,774.65 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
5833 APR_DRG Neonate With Ecmo 18 14 — — $124,517.00 $186,775.50 $149,420.40 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 18 14 — — $125,393.00 $188,089.50 $150,471.60 2024-10-01
1907 OTHER New Technology - Level 52 28 25 — — $147,339.90 $213,642.85 $153,233.49 2024-10-01
1908 OTHER New Technology - Level 52 28 25 — — $147,339.90 $213,642.85 $153,233.49 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $156,515.70 $156,515.70 $156,515.70 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $164,929.39 $164,929.39 $164,929.39 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 54 33 — — $10,670.00 $689,263.83 $180,655.17 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 52 31 — — $10,670.00 $524,012.93 $197,874.70 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $199,878.68 $199,878.68 $199,878.68 2024-10-01
5834 APR_DRG Neonate With Ecmo 18 14 — — $192,207.00 $288,310.50 $230,648.40 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 53 33 — — $10,670.00 $622,167.61 $237,064.37 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 52 33 — — $7,387.00 $832,980.61 $315,415.43 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 6 3 — — $435,956.80 $966,296.00 $435,956.80 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 6 3 — — $445,599.57 $1,051,644.36 $445,599.57 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 6 3 — — $459,839.17 $1,067,238.95 $459,839.17 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 3 — — $470,149.30 $1,082,427.24 $470,149.30 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 28 25 — — $460,530.40 $667,769.08 $478,951.61 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 6 3 — — $492,271.12 $1,091,527.05 $492,271.12 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 3 — — $502,693.77 $1,125,423.00 $502,693.77 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 28 25 — — $489,456.00 $709,711.20 $509,034.24 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 28 25 — — $516,726.10 $749,252.84 $537,395.15 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 28 25 — — $526,587.60 $763,552.02 $547,651.10 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 28 25 — — $527,123.40 $764,328.93 $548,208.33 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 28 25 — — $529,192.90 $767,329.70 $550,360.62 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 28 25 — — $2,388,614.00 $3,463,490.30 $2,484,158.56 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 29 26 — — $8,639.36 $4,303,600.00 $3,057,040.00 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 29 26 — — $9,726.84 $4,764,700.00 $3,384,580.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 29 26 — — $5,896.85 $4,821,909.75 $3,425,218.65 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 27 24 — — $3,605,000.00 $4,109,700.00 $3,713,150.00 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 27 24 — — $3,672,900.00 $4,187,106.00 $3,783,087.00 2024-10-01
See an error in this hospital's data? Submit a correction