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

HCA FLORIDA NORTH FLORIDA HOSPITAL

Gainesville, FL · CCN 100204 · Rates published

35,855 distinct procedures filed
82 distinct payers
1,524,430 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

1,373,583 of 1,524,430 rate rows are consumer-grade (90.1%)

150,847 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 98,555
per-diem day rate — not a per-procedure price 24,905
template filing: same amount across many unrelated codes — excluded 23,620
exceeds 10× this hospital's gross charge — excluded from medians 3,572
placeholder amount (≤ $0.02) — excluded from medians 195

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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://www.hcadam.com/api/public/content/cc75972a7232413aa66226b9b75974a0?download=true
Found on page https://www.hcafloridahealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 0be8e73114a03c82… · 401,411,436 bytes · first seen 2026-05-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,004,655
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,468,984
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 30 $3,489,255.00 $4,407,480.00 $3,746,358.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 30 $3,424,750.00 $4,326,000.00 $3,677,100.00 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 30 $5,549.91 $3,990,546.00 $3,391,964.10 nat. median
$13,041
outlier · 260.1×
748
OTHER 		Inj, Lovotibeglogene Auto 30 $9,154.57 $3,943,200.00 $3,351,720.00 nat. median
$17,963
outlier · 186.6×
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 30 $8,131.07 $3,561,600.00 $3,027,360.00 nat. median
$21,896
outlier · 138.3×
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 30 $2,269,183.30 $2,866,336.80 $2,436,386.28 nat. median
$2,588,981
0.9× 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 30 $502,733.26 $635,031.48 $539,776.76 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 30 $500,767.23 $632,548.08 $537,665.87 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 30 $500,258.22 $631,905.12 $537,119.35 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 30 $490,889.79 $620,071.32 $527,060.62 nat. median
$562,201
0.9× 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
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $1,570,357.68 $502,693.77 nat. median
$753,246
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
9035
OTHER 		Axicabtagene Ciloleucel C 30 $464,983.20 $587,347.20 $499,245.12 nat. median
$532,192
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $1,523,061.00 $492,271.12 nat. median
$674,867
0.7× 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 $1,510,363.59 $470,149.30 nat. median
$625,184
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 30 $437,503.88 $552,636.48 $469,741.01 nat. median
$489,450
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $1,489,170.63 $459,839.17 nat. median
$673,137
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 $1,467,410.73 $445,599.57 nat. median
$634,303
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $1,348,320.00 $435,956.80 nat. median
$619,808
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 43 $1,324.00 $1,652,159.28 $300,332.78 nat. median
$370,174
0.8× median
5834
APR_DRG 		Neonate With Ecmo 20 $182,596.65 $288,310.50 $230,648.40 nat. median
$309,665
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 46 $1,870.00 $1,234,026.32 $224,670.81 nat. median
$265,286
0.8× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $188,119.08 $213,607.29 $200,863.18 nat. median
$263,894
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 45 $1,870.00 $1,039,343.31 $190,835.52 nat. median
$206,474
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 46 $1,870.00 $938,899.92 $172,946.17 nat. median
$202,976
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $155,226.00 $176,257.54 $165,741.77 nat. median
$424,868
outlier · 0.4×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 20 $119,123.35 $188,089.50 $150,471.60 nat. median
$246,434
0.6× median
1907
OTHER 		New Technology - Level 52 32 $132,605.91 $176,807.88 $150,286.70 nat. median
$153,199
1.0× median
1908
OTHER 		New Technology - Level 52 32 $132,605.91 $176,807.88 $150,286.70 nat. median
$152,962
1.0× median
5833
APR_DRG 		Neonate With Ecmo 20 $118,291.15 $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
1906
OTHER 		New Technology - Level 51 32 $119,562.75 $159,417.00 $135,504.45 nat. median
$138,020
1.0× median
1905
OTHER 		New Technology - Level 51 32 $119,562.75 $159,417.00 $135,504.45 nat. median
$137,903
1.0× median
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $126,002.13 $143,074.22 $134,538.17 nat. median
$218,232
0.6× median
24
APR_DRG 		Heart And/or Lung Transplant 20 $105,494.65 $166,570.50 $133,256.40 nat. median
$234,729
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 35,855 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 2 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 47 30 — — $3,489,255.00 $4,407,480.00 $3,746,358.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 47 30 — — $3,424,750.00 $4,326,000.00 $3,677,100.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 2 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 2 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 49 30 — — $5,549.91 $3,990,546.00 $3,391,964.10 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 49 30 — — $9,154.57 $3,943,200.00 $3,351,720.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 2 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 2 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 49 30 — — $8,131.07 $3,561,600.00 $3,027,360.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 2 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 47 30 — — $2,269,183.30 $2,866,336.80 $2,436,386.28 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 2 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 47 30 — — $502,733.26 $635,031.48 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 47 30 — — $500,767.23 $632,548.08 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 47 30 — — $500,258.22 $631,905.12 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 47 30 — — $490,889.79 $620,071.32 $527,060.62 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 2 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 2 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 2 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 11 3 — — $502,693.77 $1,570,357.68 $502,693.77 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 2 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 47 30 — — $464,983.20 $587,347.20 $499,245.12 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 3 — — $492,271.12 $1,523,061.00 $492,271.12 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 2 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 10 3 — — $470,149.30 $1,510,363.59 $470,149.30 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 47 30 — — $437,503.88 $552,636.48 $469,741.01 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 3 — — $459,839.17 $1,489,170.63 $459,839.17 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 2 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 11 3 — — $445,599.57 $1,467,410.73 $445,599.57 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 3 — — $435,956.80 $1,348,320.00 $435,956.80 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 102 43 — — $1,324.00 $1,652,159.28 $300,332.78 2024-10-01
5834 APR_DRG Neonate With Ecmo 32 20 — — $182,596.65 $288,310.50 $230,648.40 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 109 46 — — $1,870.00 $1,234,026.32 $224,670.81 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $188,119.08 $213,607.29 $200,863.18 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 106 45 — — $1,870.00 $1,039,343.31 $190,835.52 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 109 46 — — $1,870.00 $938,899.92 $172,946.17 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 1 — — $155,226.00 $176,257.54 $165,741.77 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 32 20 — — $119,123.35 $188,089.50 $150,471.60 2024-10-01
1907 OTHER New Technology - Level 52 51 32 — — $132,605.91 $176,807.88 $150,286.70 2024-10-01
1908 OTHER New Technology - Level 52 51 32 — — $132,605.91 $176,807.88 $150,286.70 2024-10-01
5833 APR_DRG Neonate With Ecmo 32 20 — — $118,291.15 $186,775.50 $149,420.40 2024-10-01
01907 OTHER New Technology - Level 52 2 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
01908 OTHER New Technology - Level 52 2 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
1906 OTHER New Technology - Level 51 51 32 — — $119,562.75 $159,417.00 $135,504.45 2024-10-01
1905 OTHER New Technology - Level 51 51 32 — — $119,562.75 $159,417.00 $135,504.45 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 1 — — $126,002.13 $143,074.22 $134,538.17 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 32 20 — — $105,494.65 $166,570.50 $133,256.40 2024-10-01
01906 OTHER New Technology - Level 51 2 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01905 OTHER New Technology - Level 51 2 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
1904 OTHER New Technology - Level 50 51 32 — — $106,519.59 $142,026.12 $120,722.20 2024-10-01
1903 OTHER New Technology - Level 50 51 32 — — $106,519.59 $142,026.12 $120,722.20 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 3 1 — — $120,116.70 $218,394.00 $120,116.70 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 20 — — $92,761.80 $146,466.00 $117,172.80 2024-10-01
01904 OTHER New Technology - Level 50 2 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01903 OTHER New Technology - Level 50 2 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
5832 APR_DRG Neonate With Ecmo 32 20 — — $90,826.65 $143,410.50 $114,728.40 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 109 46 — — $1,870.00 $619,024.13 $114,496.55 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 32 20 — — $90,408.65 $142,750.50 $114,200.40 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 5 3 — — $13,300.00 $144,551.00 $109,862.00 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 32 20 — — $86,896.50 $137,205.00 $109,764.00 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 32 20 — — $85,706.15 $135,325.50 $108,260.40 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 3 1 — — $108,036.36 $196,429.74 $108,036.36 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 104 44 — — $1,324.00 $573,976.63 $107,296.90 2024-10-01
7 MS_DRG Lung Transplant 107 46 — — $1,870.00 $572,530.83 $106,001.01 2024-10-01
1902 OTHER New Technology - Level 49 51 32 — — $93,476.43 $124,635.24 $105,939.95 2024-10-01
1901 OTHER New Technology - Level 49 51 32 — — $93,476.43 $124,635.24 $105,939.95 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 5 3 — — $13,300.00 $135,758.00 $102,472.00 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 53 32 — — $89,999.91 $119,999.88 $101,999.90 2024-10-01
01902 OTHER New Technology - Level 49 2 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
01901 OTHER New Technology - Level 49 2 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 32 20 — — $78,323.70 $123,669.00 $98,935.20 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 32 20 — — $77,474.40 $122,328.00 $97,862.40 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 32 20 — — $76,894.90 $121,413.00 $97,130.40 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 32 20 — — $75,674.15 $119,485.50 $95,588.40 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 1 — — $88,595.16 $100,598.89 $94,597.02 2024-10-01
1599 OTHER New Technology - Level 48 51 32 — — $82,607.11 $110,142.82 $93,621.39 2024-10-01
1585 OTHER New Technology - Level 48 51 32 — — $82,607.11 $110,142.82 $93,621.39 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 53 32 — — $81,928.71 $109,238.28 $92,852.54 2024-10-01
215 MS_DRG Other Heart Assist System Implant 113 48 — — $1,480.00 $464,153.09 $92,125.45 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 5 2 — — $53,789.99 $166,538.34 $91,596.09 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 32 20 — — $71,830.45 $113,416.50 $90,733.20 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 109 46 — — $1,870.00 $482,795.10 $90,473.85 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 32 20 — — $71,470.40 $112,848.00 $90,278.40 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 113 47 — — $1,870.00 $477,248.50 $89,450.50 2024-10-01
01585 OTHER New Technology - Level 48 2 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01599 OTHER New Technology - Level 48 2 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 32 20 — — $70,169.85 $110,794.50 $88,635.60 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 2 1 — — $82,320.15 $93,473.70 $87,896.92 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 107 46 — — $1,870.00 $466,536.46 $87,474.13 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 108 46 — — $1,870.00 $459,219.86 $86,678.26 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 32 20 — — $67,982.00 $107,340.00 $85,872.00 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 1 — — $80,167.78 $91,029.73 $85,598.76 2024-10-01
1584 OTHER New Technology - Level 47 51 32 — — $73,911.68 $98,548.91 $83,766.57 2024-10-01
1598 OTHER New Technology - Level 47 51 32 — — $73,911.68 $98,548.91 $83,766.57 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 3 — — $75,543.00 $122,728.00 $83,505.00 2024-10-01
5831 APR_DRG Neonate With Ecmo 32 20 — — $66,018.35 $104,239.50 $83,391.60 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 32 20 — — $64,904.95 $102,481.50 $81,985.20 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 113 48 — — $1,480.00 $219,397.00 $80,932.39 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 32 20 — — $63,879.90 $100,863.00 $80,690.40 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 32 20 — — $63,442.90 $100,173.00 $80,138.40 2024-10-01
01598 OTHER New Technology - Level 47 2 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01584 OTHER New Technology - Level 47 2 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 32 20 — — $61,172.40 $96,588.00 $77,270.40 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 3 1 — — $76,785.37 $139,609.77 $76,785.37 2024-10-01
007 OTHER Lung Transplant 2 1 — — $71,027.31 $80,650.80 $75,839.05 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $70,898.46 $80,504.49 $75,701.48 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 110 46 — — $1,870.00 $403,565.48 $75,648.26 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 32 20 — — $59,234.40 $93,528.00 $74,822.40 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 113 48 — — $1,480.00 $371,236.60 $74,525.59 2024-10-01
1597 OTHER New Technology - Level 46 51 32 — — $65,216.23 $86,954.98 $73,911.73 2024-10-01
1583 OTHER New Technology - Level 46 51 32 — — $65,216.23 $86,954.98 $73,911.73 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 32 20 — — $58,271.10 $92,007.00 $73,605.60 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 32 20 — — $56,168.75 $88,687.50 $70,950.00 2024-10-01
01583 OTHER New Technology - Level 46 2 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01597 OTHER New Technology - Level 46 2 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 1 — — $65,615.63 $74,505.89 $70,060.76 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 104 46 — — $1,870.00 $371,026.30 $69,852.49 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 108 46 — — $1,870.00 $365,392.08 $69,161.98 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 20 — — $54,098.70 $85,419.00 $68,335.20 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 111 48 — — $1,480.00 $173,955.00 $68,101.70 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 106 46 — — $1,870.00 $353,146.63 $67,833.57 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 109 48 — — $1,480.00 $173,955.00 $67,627.51 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 53 32 — — $59,284.53 $79,046.04 $67,189.13 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 3 1 — — $53,616.00 $76,506.00 $67,143.00 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 3 1 — — $53,616.00 $76,506.00 $67,143.00 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 3 1 — — $53,616.00 $76,506.00 $67,143.00 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 3 1 — — $53,616.00 $76,506.00 $67,143.00 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 51 32 — — $58,928.92 $78,571.90 $66,786.11 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 32 20 — — $52,746.85 $83,284.50 $66,627.60 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 32 20 — — $52,106.55 $82,273.50 $65,818.80 2024-10-01
10 MS_DRG Pancreas Transplant 104 45 — — $1,870.00 $349,295.55 $65,252.82 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 104 45 — — $1,870.00 $347,284.58 $64,881.13 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 49 30 — — $13,300.17 $76,025.72 $64,621.87 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $60,473.66 $68,667.23 $64,570.44 2024-10-01
1596 OTHER New Technology - Level 45 51 32 — — $56,520.79 $75,361.06 $64,056.90 2024-10-01
1582 OTHER New Technology - Level 45 51 32 — — $56,520.79 $75,361.06 $64,056.90 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 2 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $58,278.52 $66,174.68 $62,226.60 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $58,145.50 $66,023.63 $62,084.57 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 32 20 — — $49,103.60 $77,532.00 $62,025.60 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 108 46 — — $1,870.00 $309,597.50 $61,758.88 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 11 3 — — $61,600.24 $190,497.99 $61,600.24 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 32 20 — — $48,664.70 $76,839.00 $61,471.20 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 2 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 110 46 — — $1,870.00 $326,999.62 $60,983.46 2024-10-01
01582 OTHER New Technology - Level 45 2 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
01596 OTHER New Technology - Level 45 2 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 108 46 — — $1,870.00 $311,008.24 $60,875.00 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 32 20 — — $46,784.65 $73,870.50 $59,096.40 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 32 20 — — $46,533.85 $73,474.50 $58,779.60 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 20 — — $46,450.25 $73,342.50 $58,674.00 2024-10-01
64 APR_DRG Pancreas Transplant 32 20 — — $45,953.40 $72,558.00 $58,046.40 2024-10-01
215 OTHER Other Heart Assist System Implant 2 1 — — $54,077.62 $61,404.59 $57,741.10 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 108 46 — — $1,870.00 $168,697.78 $57,524.35 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 107 47 — — $1,870.00 $173,955.00 $57,417.79 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 32 20 — — $45,161.10 $71,307.00 $57,045.60 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 113 48 — — $1,480.00 $219,397.00 $56,919.70 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 110 46 — — $1,870.00 $299,143.95 $56,318.13 2024-10-01
8514 APR_DRG Gender Related Procedures 32 20 — — $44,556.90 $70,353.00 $56,282.40 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 47 30 — — $52,264.47 $66,018.28 $56,115.53 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 107 45 — — $1,870.00 $121,343.32 $55,967.31 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $52,346.76 $59,439.21 $55,892.99 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 32 20 — — $44,198.75 $69,787.50 $55,830.00 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $52,055.67 $59,108.70 $55,582.18 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 32 20 — — $43,892.85 $69,304.50 $55,443.60 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 106 45 — — $1,870.00 $292,598.44 $54,716.89 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 32 20 — — $43,107.20 $68,064.00 $54,451.20 2024-10-01
1595 OTHER New Technology - Level 44 51 32 — — $47,825.35 $63,767.14 $54,202.07 2024-10-01
1581 OTHER New Technology - Level 44 51 32 — — $47,825.35 $63,767.14 $54,202.07 2024-10-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $53,436.86 $54,772.78 $54,104.82 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 113 48 — — $1,480.00 $267,616.84 $53,870.98 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 32 20 — — $42,593.25 $67,252.50 $53,802.00 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 108 46 — — $1,870.00 $271,371.53 $53,622.32 2024-10-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $52,888.04 $54,210.25 $53,549.15 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 2 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 111 47 — — $1,870.00 $252,754.00 $53,364.53 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 110 45 — — $1,324.00 $283,362.87 $52,646.30 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 113 48 — — $1,480.00 $219,397.00 $52,480.67 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 32 20 — — $41,493.15 $65,515.50 $52,412.40 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 32 20 — — $41,382.00 $65,340.00 $52,272.00 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 8 3 — — $35,664.00 $83,213.00 $52,186.50 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 108 47 — — $1,480.00 $173,955.00 $51,910.40 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 110 46 — — $1,870.00 $277,062.71 $51,775.74 2024-10-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $50,961.05 $52,235.08 $51,598.07 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 70 40 — — $4,345.00 $139,752.79 $51,593.24 2024-10-01
01595 OTHER New Technology - Level 44 2 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
01581 OTHER New Technology - Level 44 2 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 107 45 — — $1,870.00 $266,337.53 $51,509.28 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 110 46 — — $1,870.00 $271,021.03 $51,401.51 2024-10-01
5244 OTHER Level 4 Blood Product Exc 51 32 — — $45,273.83 $65,395.53 $51,310.33 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 109 47 — — $1,870.00 $268,861.10 $51,003.00 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $47,451.52 $53,880.73 $50,666.12 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 12 4 — — $1,480.00 $94,194.00 $50,606.50 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 12 4 — — $1,480.00 $94,194.00 $50,606.50 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 32 20 — — $39,933.25 $63,052.50 $50,442.00 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 32 20 — — $39,859.15 $62,935.50 $50,348.40 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 32 20 — — $39,782.20 $62,814.00 $50,251.20 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 104 44 — — $1,324.00 $283,891.48 $50,184.97 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 104 44 — — $1,324.00 $283,891.48 $50,184.97 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 1 — — $46,990.38 $53,357.10 $50,173.74 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 104 46 — — $1,870.00 $251,437.07 $50,144.41 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 12 4 — — $1,480.00 $92,544.00 $50,108.50 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 12 4 — — $1,480.00 $92,544.00 $50,108.50 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 32 20 — — $39,643.50 $62,595.00 $50,076.00 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 106 46 — — $1,870.00 $249,934.32 $49,847.83 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 113 47 — — $1,870.00 $269,785.53 $49,697.40 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $46,285.62 $52,556.86 $49,421.24 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 106 46 — — $1,870.00 $242,162.07 $48,797.06 2024-10-01
05244 OTHER Level 4 Blood Product Exc 2 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 1 — — $45,550.08 $51,721.66 $48,635.87 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 53 32 — — $42,743.70 $56,991.60 $48,442.86 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 108 46 — — $1,870.00 $241,193.82 $48,122.83 2024-10-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $47,520.86 $48,708.88 $48,114.87 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $45,011.73 $51,110.38 $48,061.06 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 32 20 — — $37,884.10 $59,817.00 $47,853.60 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 108 46 — — $1,870.00 $239,656.02 $47,819.34 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 110 46 — — $1,870.00 $255,069.08 $47,720.40 2024-10-01
834 OTHER Acute Leukemia With Mcc 2 1 — — $44,196.91 $50,185.14 $47,191.03 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 111 48 — — $1,480.00 $173,955.00 $46,985.82 2024-10-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 2 2 — — $46,263.67 $47,420.26 $46,841.96 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 109 48 — — $1,480.00 $173,955.00 $46,779.72 2024-10-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $46,130.41 $47,283.67 $46,707.04 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 32 20 — — $36,960.70 $58,359.00 $46,687.20 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 12 4 — — $1,480.00 $92,544.00 $46,593.50 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 12 4 — — $1,480.00 $92,544.00 $46,593.50 2024-10-01
1142 OTHER Supprelin La Implant 51 32 — — $40,815.19 $54,420.25 $46,257.21 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 1 — — $43,187.49 $49,038.97 $46,113.23 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 110 46 — — $1,870.00 $244,216.85 $45,719.39 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 32 20 — — $36,008.80 $56,856.00 $45,484.80 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 107 46 — — $1,870.00 $238,372.33 $45,377.82 2024-10-01
B0105 OTHER Stroke; M > 34.25 & M < 38.85 2 2 — — $44,804.83 $45,924.95 $45,364.89 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 107 47 — — $1,870.00 $173,955.00 $45,351.86 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 110 45 — — $1,324.00 $242,144.54 $45,187.75 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 110 46 — — $1,870.00 $237,829.06 $45,059.90 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 32 20 — — $35,602.20 $56,214.00 $44,971.20 2024-10-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $44,196.40 $45,301.31 $44,748.85 2024-10-01
B1903 OTHER Guillian Barre; M < 18.05 2 2 — — $44,035.09 $45,135.96 $44,585.52 2024-10-01
1580 OTHER New Technology - Level 43 51 32 — — $39,129.91 $52,173.22 $44,347.23 2024-10-01
1594 OTHER New Technology - Level 43 51 32 — — $39,129.91 $52,173.22 $44,347.23 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 32 20 — — $35,105.35 $55,429.50 $44,343.60 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 110 46 — — $1,870.00 $236,392.03 $44,276.60 2024-10-01
B0604 OTHER Neurological; M < 25.85 2 2 — — $43,666.87 $44,758.54 $44,212.71 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 110 46 — — $1,870.00 $236,615.47 $44,187.26 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 109 48 — — $1,480.00 $173,955.00 $44,080.88 2024-10-01
01142 OTHER Supprelin La Implant 2 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 110 46 — — $1,870.00 $236,361.36 $43,924.91 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 108 46 — — $1,870.00 $94,743.00 $43,314.29 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 11 3 — — $43,241.44 $132,474.75 $43,241.44 2024-10-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 2 2 — — $42,495.60 $43,557.99 $43,026.79 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 110 46 — — $1,870.00 $129,581.90 $43,024.76 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 104 46 — — $1,870.00 $219,187.05 $42,642.72 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 2 1 — — $39,888.53 $45,293.03 $42,590.78 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $39,884.88 $45,288.88 $42,586.88 2024-10-01
4404 APR_DRG Kidney Transplant 32 20 — — $33,650.90 $53,133.00 $42,506.40 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 2 1 — — $39,795.15 $45,187.00 $42,491.07 2024-10-01
A0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $41,916.97 $42,964.89 $42,440.93 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $39,730.47 $45,113.56 $42,422.01 2024-10-01
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days 2 2 — — $41,790.73 $42,835.49 $42,313.11 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 111 47 — — $1,870.00 $189,782.00 $42,228.59 2024-10-01
01594 OTHER New Technology - Level 43 2 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01580 OTHER New Technology - Level 43 2 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 109 47 — — $1,870.00 $89,055.00 $42,158.00 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 1 — — $39,481.64 $44,831.01 $42,156.32 2024-10-01
8634 APR_DRG Neonatal Aftercare 32 20 — — $33,258.55 $52,513.50 $42,010.80 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 1 — — $39,285.49 $44,608.29 $41,946.89 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $39,147.78 $44,451.91 $41,799.85 2024-10-01
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $41,145.47 $42,174.11 $41,659.79 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 110 46 — — $1,870.00 $222,508.00 $41,634.48 2024-10-01
B0704 OTHER Fracture Of Lower Extremity; M < 28.15 2 2 — — $40,807.06 $41,827.24 $41,317.15 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 110 46 — — $1,870.00 $220,659.14 $41,274.43 2024-10-01
63 APR_DRG Pancreas Transplant 32 20 — — $32,645.80 $51,546.00 $41,236.80 2024-10-01
245 MS_DRG Aicd Generator Procedures 108 47 — — $1,480.00 $214,087.34 $41,211.94 2024-10-01
B2102 OTHER Burns; M=12-45 2 2 — — $40,636.98 $41,652.91 $41,144.95 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 110 46 — — $1,870.00 $219,125.72 $41,122.99 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 32 20 — — $32,516.60 $51,342.00 $41,073.60 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 110 45 — — $1,324.00 $219,357.92 $41,064.48 2024-10-01
D0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $40,388.00 $41,397.70 $40,892.85 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 32 20 — — $32,364.60 $51,102.00 $40,881.60 2024-10-01
B1004 OTHER Amputation, Lower Extremity; M=39-45 2 2 — — $40,347.67 $41,356.36 $40,852.01 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 108 46 — — $1,870.00 $203,822.19 $40,747.27 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 109 48 — — $1,480.00 $173,955.00 $40,741.38 2024-10-01
006 OTHER Liver Transplant Without Mcc 2 1 — — $38,024.65 $43,176.61 $40,600.63 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 107 46 — — $1,870.00 $288,549.15 $40,593.30 2024-10-01
B1504 OTHER Pulmonary; M < 29.15 2 2 — — $39,879.51 $40,876.50 $40,378.01 2024-10-01
B1704 OTHER Major Multiple Trauma,no Brain Or Spinal Cord Inju 2 2 — — $39,176.39 $40,155.80 $39,666.10 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 106 46 — — $1,870.00 $95,898.71 $39,581.04 2024-10-01
B2005 OTHER Miscellaneous; M=12-32 And A Tm81 2 2 — — $38,946.70 $39,920.36 $39,433.53 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 3 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
D0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $38,871.30 $39,843.08 $39,357.19 2024-10-01
C0105 OTHER Stroke; M > 34.25 & M < 38.85 2 2 — — $38,857.27 $39,828.71 $39,342.99 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 110 46 — — $1,870.00 $209,211.06 $39,228.38 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 110 46 — — $1,870.00 $208,304.15 $39,160.01 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 110 46 — — $1,870.00 $208,295.39 $39,158.43 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 53 32 — — $34,460.55 $45,947.40 $39,055.29 2024-10-01
A0106 OTHER Stroke; M > 30.05 & M < 34.25 2 2 — — $38,489.06 $39,451.28 $38,970.17 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 32 20 — — $30,800.90 $48,633.00 $38,906.40 2024-10-01
J9600 HCPCS Porfimer Na 75 Mg Inj 3 1 $110,658.21 $110,658.21 $38,803.31 $70,551.48 $38,803.31 2024-10-01
B1204 OTHER Osteoarthritis; M=39-47 2 2 — — $38,289.17 $39,246.40 $38,767.79 2024-10-01
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