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 →

Export CSV
Hospital

HCA FLORIDA NORTH FLORIDA HOSPITAL

Gainesville, FL · CCN 100204 · Rates published

Your selected procedure

You selected 45378 (CPT)

Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)

This hospital’s price: $2,280 across 23 payers · range $1,220-$14,520

Source: https://www.hcadam.com/api/public/content/cc75972a7232413aa66226b9b75974a0?download=true · observed 2024-10-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

29,413 distinct procedures filed
82 distinct payers
1,595,992 rate rows
2024-10-01 last MRF observed · ⚠ 24 mo old
Data quality

1,450,028 of 1,595,992 rate rows are consumer-grade (90.9%)

145,964 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 72,876
per-diem day rate — not a per-procedure price 24,905
template filing: same amount across many unrelated codes — excluded 23,534
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 19,882
exceeds 10× this hospital's gross charge — excluded from medians 3,572
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 582
percent-of-charges filed in the dollar field — excluded from medians 354
placeholder amount (≤ $0.02) — excluded from medians 195
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 64

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 24 months old.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 Latest re-check couldn't be parsed — showing last good data · 2026-09-21
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
$2,968,000
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
$2,455,111
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 23 $3,489,255.00 $4,407,480.00 $3,746,358.00 nat. median
$3,765,001
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 23 $3,424,750.00 $4,326,000.00 $3,677,100.00 nat. median
$3,677,100
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
$3,562,713
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 24 $5,549.91 $3,990,546.00 $3,391,964.10 nat. median
$3,391,964
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 24 $9,154.57 $3,943,200.00 $3,351,720.00 nat. median
$3,351,720
1.0× median
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,225,691.35 $3,225,691.35 nat. median
$3,225,691
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 24 $8,131.07 $3,561,600.00 $3,027,360.00 nat. median
$3,001,835
1.0× median
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 23 $2,269,183.30 $2,866,336.80 $2,436,386.28 nat. median
$2,508,045
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
$2,316,956
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 23 $502,733.26 $635,031.48 $539,776.76 nat. median
$555,653
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 23 $500,767.23 $632,548.08 $537,665.87 nat. median
$553,480
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 23 $500,258.22 $631,905.12 $537,119.35 nat. median
$552,917
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 23 $490,889.79 $620,071.32 $527,060.62 nat. median
$542,562
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $513,317.11 $513,317.11 nat. median
$513,317
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$511,310
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$510,790
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $863,696.72 $502,693.77 nat. median
$621,313
0.8× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$501,224
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 23 $464,983.20 $587,347.20 $499,245.12 nat. median
$513,929
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $837,683.55 $492,271.12 nat. median
$599,737
0.8× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$474,772
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $830,699.97 $470,149.30 nat. median
$574,037
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 23 $437,503.88 $552,636.48 $469,741.01 nat. median
$483,557
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $819,043.85 $459,839.17 nat. median
$579,571
0.8× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$446,714
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $807,075.90 $445,599.57 nat. median
$562,501
0.8× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $741,576.00 $435,956.80 nat. median
$513,770
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 $1,870.00 $725,393.41 $297,388.34 nat. median
$168,055
1.8× median
5834
APR_DRG 		Neonate With Ecmo 14 $182,596.65 $288,310.50 $230,648.40 nat. median
$390,362
0.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 35 $1,870.00 $541,808.87 $220,265.50 nat. median
$186,516
1.2× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $188,119.08 $188,119.08 $188,119.08 nat. median
$177,883
1.1× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 34 $1,870.00 $456,331.78 $185,728.00 nat. median
$131,925
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 35 $1,870.00 $412,231.33 $167,908.90 nat. median
$145,435
1.2× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $155,226.00 $155,226.00 $155,226.00 nat. median
$149,977
1.0× median
1907
OTHER 		New Technology - Level 52 24 $139,972.90 $176,807.88 $151,023.40 nat. median
$149,948
1.0× median
1908
OTHER 		New Technology - Level 52 24 $139,972.90 $176,807.88 $151,023.40 nat. median
$149,948
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 14 $119,123.35 $188,089.50 $150,471.60 nat. median
$286,698
0.5× median
5833
APR_DRG 		Neonate With Ecmo 14 $118,291.15 $186,775.50 $149,420.40 nat. median
$268,208
0.6× median
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$145,788
1.0× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$145,788
1.0× median
1905
OTHER 		New Technology - Level 51 24 $126,205.13 $159,417.00 $136,168.69 nat. median
$135,199
1.0× median
1906
OTHER 		New Technology - Level 51 24 $126,205.13 $159,417.00 $136,168.69 nat. median
$135,199
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 14 $105,494.65 $166,570.50 $133,256.40 nat. median
$225,531
0.6× median
01906
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$131,449
1.0× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$131,449
1.0× median

Other procedures at this hospital

Browse this hospital's 29,413 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 27 23 — — $3,489,255.00 $4,407,480.00 $3,746,358.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 27 23 — — $3,424,750.00 $4,326,000.00 $3,677,100.00 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
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 28 24 — — $5,549.91 $3,990,546.00 $3,391,964.10 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 28 24 — — $9,154.57 $3,943,200.00 $3,351,720.00 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
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 28 24 — — $8,131.07 $3,561,600.00 $3,027,360.00 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
9141 OTHER Inj Onase Abepar-xioi Tre 27 23 — — $2,269,183.30 $2,866,336.80 $2,436,386.28 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
9194 OTHER Tisagenlecleucel Car-pos 27 23 — — $502,733.26 $635,031.48 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 27 23 — — $500,767.23 $632,548.08 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 27 23 — — $500,258.22 $631,905.12 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 27 23 — — $490,889.79 $620,071.32 $527,060.62 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 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… 6 3 — — $502,693.77 $863,696.72 $502,693.77 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 27 23 — — $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… 6 3 — — $492,271.12 $837,683.55 $492,271.12 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 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 (… 5 3 — — $470,149.30 $830,699.97 $470,149.30 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 27 23 — — $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… 6 3 — — $459,839.17 $819,043.85 $459,839.17 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 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… 6 3 — — $445,599.57 $807,075.90 $445,599.57 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 6 3 — — $435,956.80 $741,576.00 $435,956.80 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 50 32 — — $1,870.00 $725,393.41 $297,388.34 2024-10-01
5834 APR_DRG Neonate With Ecmo 17 14 — — $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 56 35 — — $1,870.00 $541,808.87 $220,265.50 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $188,119.08 $188,119.08 $188,119.08 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 53 34 — — $1,870.00 $456,331.78 $185,728.00 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 56 35 — — $1,870.00 $412,231.33 $167,908.90 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $155,226.00 $155,226.00 $155,226.00 2024-10-01
1907 OTHER New Technology - Level 52 28 24 — — $139,972.90 $176,807.88 $151,023.40 2024-10-01
1908 OTHER New Technology - Level 52 28 24 — — $139,972.90 $176,807.88 $151,023.40 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 17 14 — — $119,123.35 $188,089.50 $150,471.60 2024-10-01
5833 APR_DRG Neonate With Ecmo 17 14 — — $118,291.15 $186,775.50 $149,420.40 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
1906 OTHER New Technology - Level 51 28 24 — — $126,205.13 $159,417.00 $136,168.69 2024-10-01
1905 OTHER New Technology - Level 51 28 24 — — $126,205.13 $159,417.00 $136,168.69 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 17 14 — — $105,494.65 $166,570.50 $133,256.40 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $126,002.13 $126,002.13 $126,002.13 2024-10-01
1904 OTHER New Technology - Level 50 28 24 — — $112,437.35 $142,026.12 $121,313.98 2024-10-01
1903 OTHER New Technology - Level 50 28 24 — — $112,437.35 $142,026.12 $121,313.98 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 14 — — $92,761.80 $146,466.00 $117,172.80 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
5832 APR_DRG Neonate With Ecmo 17 14 — — $90,826.65 $143,410.50 $114,728.40 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 17 14 — — $90,408.65 $142,750.50 $114,200.40 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 56 35 — — $1,870.00 $271,787.37 $111,161.70 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 17 14 — — $86,896.50 $137,205.00 $109,764.00 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 17 14 — — $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… 2 1 — — $108,036.36 $108,036.36 $108,036.36 2024-10-01
1902 OTHER New Technology - Level 49 28 24 — — $98,669.56 $124,635.24 $106,459.26 2024-10-01
1901 OTHER New Technology - Level 49 28 24 — — $98,669.56 $124,635.24 $106,459.26 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 51 33 — — $1,870.00 $252,008.91 $104,201.80 2024-10-01
7 MS_DRG Lung Transplant 55 35 — — $1,870.00 $251,374.12 $102,913.60 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 29 25 — — $94,999.90 $119,999.88 $101,999.90 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
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 17 14 — — $78,323.70 $123,669.00 $98,935.20 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 17 14 — — $77,474.40 $122,328.00 $97,862.40 2024-10-01
594797 CDM Revas Fempp Stnt/ath/ang 27 24 $215,868.00 $215,868.00 $550.00 $313,008.60 $97,140.60 2024-10-01
791688 CDM Endo Rpr Aaa W/one Limb 27 24 $215,868.00 $215,868.00 $550.00 $313,008.60 $97,140.60 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 17 14 — — $76,894.90 $121,413.00 $97,130.40 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 17 14 — — $75,674.15 $119,485.50 $95,588.40 2024-10-01
594884 CDM Revas Tib Stnt/ath/ang 1 27 24 $212,324.00 $212,324.00 $550.00 $307,869.80 $95,545.80 2024-10-01
1599 OTHER New Technology - Level 48 28 24 — — $87,196.40 $110,142.82 $94,080.32 2024-10-01
1585 OTHER New Technology - Level 48 28 24 — — $87,196.40 $110,142.82 $94,080.32 2024-10-01
594888 CDM Revas Tib St/ath/ang Ea+ 27 24 $207,255.00 $207,255.00 $550.00 $300,519.75 $93,264.75 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 29 25 — — $86,480.30 $109,238.28 $92,852.54 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 3 2 — — $53,789.99 $91,596.09 $91,596.09 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 17 14 — — $71,830.45 $113,416.50 $90,733.20 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 17 14 — — $71,470.40 $112,848.00 $90,278.40 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01585 OTHER New Technology - Level 48 1 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 17 14 — — $70,169.85 $110,794.50 $88,635.60 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $88,595.16 $88,595.16 $88,595.16 2024-10-01
215 MS_DRG Other Heart Assist System Implant 61 37 — — $1,480.00 $337,152.00 $87,034.40 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 56 35 — — $1,870.00 $266,182.00 $86,994.09 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 59 36 — — $1,870.00 $209,539.67 $86,010.10 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 17 14 — — $67,982.00 $107,340.00 $85,872.00 2024-10-01
1584 OTHER New Technology - Level 47 28 24 — — $78,017.89 $98,548.91 $84,177.19 2024-10-01
1598 OTHER New Technology - Level 47 28 24 — — $78,017.89 $98,548.91 $84,177.19 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 55 35 — — $1,870.00 $204,836.47 $84,109.74 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $1,870.00 $217,828.00 $83,639.87 2024-10-01
5831 APR_DRG Neonate With Ecmo 17 14 — — $66,018.35 $104,239.50 $83,391.60 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $82,320.15 $82,320.15 $82,320.15 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 17 14 — — $64,904.95 $102,481.50 $81,985.20 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 17 14 — — $63,879.90 $100,863.00 $80,690.40 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $80,167.78 $80,167.78 $80,167.78 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 17 14 — — $63,442.90 $100,173.00 $80,138.40 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
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 55 35 — — $26,750.00 $219,397.00 $79,405.36 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 17 14 — — $61,172.40 $96,588.00 $77,270.40 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 17 14 — — $59,234.40 $93,528.00 $74,822.40 2024-10-01
1583 OTHER New Technology - Level 46 28 24 — — $68,839.36 $86,954.98 $74,274.04 2024-10-01
1597 OTHER New Technology - Level 46 28 24 — — $68,839.36 $86,954.98 $74,274.04 2024-10-01
594796 CDM Revas Fempop W/stnt&ang 27 24 $164,193.00 $164,193.00 $550.00 $238,079.85 $73,886.85 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 17 14 — — $58,271.10 $92,007.00 $73,605.60 2024-10-01
594791 CDM Revas Iliac Tla/stnt Ini 27 24 $163,102.00 $163,102.00 $550.00 $236,497.90 $73,395.90 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 56 35 — — $1,870.00 $177,188.57 $72,938.44 2024-10-01
594833 CDM Revas Tibp Stnt&ang Ini 27 24 $160,640.00 $160,640.00 $550.00 $232,928.00 $72,288.00 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 55 35 — — $26,000.00 $162,994.32 $71,235.36 2024-10-01
594793 CDM Revas Iliac/tla/stnt Ea+ 27 24 $158,028.00 $158,028.00 $550.00 $229,140.60 $71,112.60 2024-10-01
007 OTHER Lung Transplant 1 1 — — $71,027.31 $71,027.31 $71,027.31 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 17 14 — — $56,168.75 $88,687.50 $70,950.00 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $70,898.46 $70,898.46 $70,898.46 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 51 32 — — $29,911.00 $162,901.99 $68,509.18 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 14 — — $54,098.70 $85,419.00 $68,335.20 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 29 25 — — $62,578.11 $79,046.04 $67,189.13 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 28 24 — — $62,202.75 $78,571.90 $67,113.49 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 56 35 — — $1,870.00 $173,436.00 $66,909.49 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 17 14 — — $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… 17 14 — — $52,106.55 $82,273.50 $65,818.80 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 55 35 — — $25,000.00 $107,059.00 $65,817.54 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $65,615.63 $65,615.63 $65,615.63 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 54 34 — — $1,870.00 $155,051.78 $65,273.81 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 2 1 — — $53,616.00 $76,506.00 $65,061.00 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 2 1 — — $53,616.00 $76,506.00 $65,061.00 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 2 1 — — $53,616.00 $76,506.00 $65,061.00 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 2 1 — — $53,616.00 $76,506.00 $65,061.00 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 28 24 — — $13,300.17 $76,025.72 $64,621.87 2024-10-01
1596 OTHER New Technology - Level 45 28 24 — — $59,660.84 $75,361.06 $64,370.90 2024-10-01
1582 OTHER New Technology - Level 45 28 24 — — $59,660.84 $75,361.06 $64,370.90 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 53 34 — — $25,750.00 $133,097.00 $63,938.73 2024-10-01
10 MS_DRG Pancreas Transplant 52 34 — — $1,870.00 $153,360.93 $63,627.29 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 52 34 — — $1,870.00 $152,478.00 $63,268.75 2024-10-01
594692 CDM Cth Plc/inj R&lhc/l Vent 27 24 $139,195.00 $139,195.00 $550.00 $201,832.75 $62,637.75 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 17 14 — — $49,103.60 $77,532.00 $62,025.60 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $61,600.24 $104,773.89 $61,600.24 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 17 14 — — $48,664.70 $76,839.00 $61,471.20 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 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
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $60,473.66 $60,473.66 $60,473.66 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 56 35 — — $1,870.00 $143,571.73 $59,355.35 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 17 14 — — $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 17 14 — — $46,533.85 $73,474.50 $58,779.60 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 17 14 — — $46,450.25 $73,342.50 $58,674.00 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 54 34 — — $12,867.00 $135,931.19 $58,518.88 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $58,278.52 $58,278.52 $58,278.52 2024-10-01
594795 CDM Revas Fempop W/ath&ang 27 24 $129,410.00 $129,410.00 $550.00 $187,644.50 $58,234.50 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $1,870.00 $147,695.00 $58,213.97 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $58,145.50 $58,145.50 $58,145.50 2024-10-01
64 APR_DRG Pancreas Transplant 17 14 — — $45,953.40 $72,558.00 $58,046.40 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 17 14 — — $45,161.10 $71,307.00 $57,045.60 2024-10-01
594799 CDM Revas Tibper/ath/ang Ini 27 24 $125,859.00 $125,859.00 $550.00 $182,495.55 $56,636.55 2024-10-01
8514 APR_DRG Gender Related Procedures 17 14 — — $44,556.90 $70,353.00 $56,282.40 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 27 23 — — $52,264.47 $66,018.28 $56,115.53 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 17 14 — — $44,198.75 $69,787.50 $55,830.00 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 17 14 — — $43,892.85 $69,304.50 $55,443.60 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 55 34 — — $1,870.00 $69,266.48 $55,413.18 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 53 34 — — $12,867.00 $144,804.00 $55,291.20 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 54 34 — — $11,768.00 $139,419.00 $55,055.77 2024-10-01
116137 CDM Transcath Plc V/c Stent 27 24 $121,342.00 $121,342.00 $550.00 $175,945.90 $54,603.90 2024-10-01
791462 CDM Place Stent Carot/inom 27 24 $121,342.00 $121,342.00 $550.00 $175,945.90 $54,603.90 2024-10-01
792722 CDM Perc Mech Thrmb Stnt Plc 27 24 $121,292.00 $121,292.00 $550.00 $175,873.40 $54,581.40 2024-10-01
1581 OTHER New Technology - Level 44 28 24 — — $50,482.32 $63,767.14 $54,467.76 2024-10-01
1595 OTHER New Technology - Level 44 28 24 — — $50,482.32 $63,767.14 $54,467.76 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 17 14 — — $43,107.20 $68,064.00 $54,451.20 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 56 35 — — $1,870.00 $131,341.48 $54,413.65 2024-10-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $53,436.86 $54,772.78 $54,104.82 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $54,077.62 $54,077.62 $54,077.62 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 17 14 — — $42,593.25 $67,252.50 $53,802.00 2024-10-01
594886 CDM Revas Tibp/ath/ang Ea Ad 27 24 $119,335.00 $119,335.00 $550.00 $173,035.75 $53,700.75 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 37 — — $12,867.00 $219,397.00 $53,595.32 2024-10-01
B0505 HCPCS 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+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 53 34 — — $1,870.00 $128,467.63 $53,252.45 2024-10-01
935054 CDM Kit Cath Rt Heart 44 28 $244,319.00 $244,319.00 $550.00 $354,262.55 $52,528.58 2024-10-01
925872 CDM Pump Heart 85mm X 21fr 44 28 $244,319.00 $244,319.00 $550.00 $354,262.55 $52,528.58 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 17 14 — — $41,493.15 $65,515.50 $52,412.40 2024-10-01
594686 CDM Cath Hrt R&l/inj L Vent 27 24 $116,428.00 $116,428.00 $550.00 $168,820.60 $52,392.60 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $52,346.76 $52,346.76 $52,346.76 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 17 14 — — $41,382.00 $65,340.00 $52,272.00 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $52,055.67 $52,055.67 $52,055.67 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 55 34 — — $1,870.00 $124,412.68 $51,614.02 2024-10-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 2 2 — — $50,961.05 $52,235.08 $51,598.07 2024-10-01
5244 OTHER Level 4 Blood Product Exc 28 24 — — $47,789.04 $65,395.53 $51,561.85 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
232 MS_DRG Coronary Bypass With Ptca Without Mcc 58 37 — — $11,000.00 $131,382.00 $51,261.64 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 54 34 — — $11,768.00 $119,147.78 $51,218.74 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 56 35 — — $1,870.00 $121,646.54 $50,496.34 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 17 14 — — $39,933.25 $63,052.50 $50,442.00 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 17 14 — — $39,859.15 $62,935.50 $50,348.40 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 56 35 — — $11,000.00 $252,754.00 $50,299.45 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 17 14 — — $39,782.20 $62,814.00 $50,251.20 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 56 35 — — $1,870.00 $118,993.90 $50,165.90 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 17 14 — — $39,643.50 $62,595.00 $50,076.00 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 57 35 — — $1,870.00 $118,045.56 $50,022.18 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 55 34 — — $1,870.00 $116,937.57 $49,929.00 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 53 35 — — $11,768.00 $118,451.44 $49,697.40 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 37 — — $12,867.00 $219,397.00 $49,660.00 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 56 36 — — $12,867.00 $96,217.00 $49,429.49 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 34 29 — — $4,345.00 $59,439.22 $48,859.04 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 51 33 — — $1,870.00 $116,098.88 $48,737.33 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 51 33 — — $1,870.00 $116,098.88 $48,737.33 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 29 25 — — $45,118.35 $56,991.60 $48,442.86 2024-10-01
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $47,520.86 $48,708.88 $48,114.87 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 17 14 — — $37,884.10 $59,817.00 $47,853.60 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 52 33 — — $12,867.00 $138,724.00 $47,788.26 2024-10-01
792721 CDM Perc Mech Thrmbty W Ta 27 24 $106,167.00 $106,167.00 $550.00 $153,942.15 $47,775.15 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 54 34 — — $1,870.00 $109,735.61 $47,511.01 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $47,451.52 $47,451.52 $47,451.52 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $46,990.38 $46,990.38 $46,990.38 2024-10-01
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 2 2 — — $46,263.67 $47,420.26 $46,841.96 2024-10-01
594690 CDM Cth Plc/inj Lhc & L Vent 27 24 $103,865.00 $103,865.00 $550.00 $150,604.25 $46,739.25 2024-10-01
594691 CDM Cth Plc/inj Lhc W Graft 27 24 $103,865.00 $103,865.00 $550.00 $150,604.25 $46,739.25 2024-10-01
D0404 HCPCS 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… 17 14 — — $36,960.70 $58,359.00 $46,687.20 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 56 35 — — $1,870.00 $111,990.07 $46,594.59 2024-10-01
1142 OTHER Supprelin La Implant 28 24 — — $43,082.70 $54,420.25 $46,483.96 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $46,285.62 $46,285.62 $46,285.62 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 54 34 — — $1,870.00 $109,612.00 $46,077.02 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $1,870.00 $114,454.00 $45,677.71 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $45,550.08 $45,550.08 $45,550.08 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 17 14 — — $36,008.80 $56,856.00 $45,484.80 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 56 35 — — $1,870.00 $113,755.00 $45,395.36 2024-10-01
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 2 2 — — $44,804.83 $45,924.95 $45,364.89 2024-10-01
C2642 HCPCS Brachytx Strnd Cesium131 29 13 $61,480.00 $61,480.00 $550.00 $76,789.00 $45,170.00 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 53 34 — — $9,732.00 $107,225.31 $45,116.05 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $45,011.73 $45,011.73 $45,011.73 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 17 14 — — $35,602.20 $56,214.00 $44,971.20 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 58 37 — — $11,000.00 $107,059.00 $44,827.47 2024-10-01
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 2 2 — — $44,196.40 $45,301.31 $44,748.85 2024-10-01
B1903 HCPCS Guillian Barre; M < 18.05 2 2 — — $44,035.09 $45,135.96 $44,585.52 2024-10-01
1594 OTHER New Technology - Level 43 28 24 — — $41,303.80 $52,173.22 $44,564.62 2024-10-01
1580 OTHER New Technology - Level 43 28 24 — — $41,303.80 $52,173.22 $44,564.62 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 17 14 — — $35,105.35 $55,429.50 $44,343.60 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 55 34 — — $1,870.00 $106,315.45 $44,301.72 2024-10-01
B0604 HCPCS Neurological; M < 25.85 2 2 — — $43,666.87 $44,758.54 $44,212.71 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 56 36 — — $11,000.00 $133,097.00 $44,209.78 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $44,196.91 $44,196.91 $44,196.91 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 53 34 — — $9,732.00 $104,420.70 $43,971.50 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 55 35 — — $1,870.00 $104,659.23 $43,632.52 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 56 35 — — $1,870.00 $103,887.87 $43,320.84 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 54 34 — — $11,000.00 $109,161.00 $43,300.54 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 56 35 — — $1,870.00 $103,789.76 $43,281.21 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 56 35 — — $1,870.00 $103,776.30 $43,275.77 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $43,241.44 $72,861.11 $43,241.44 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $43,187.49 $43,187.49 $43,187.49 2024-10-01
792593 CDM Imp/repl Inf Dev 27 24 $95,828.00 $95,828.00 $550.00 $138,950.60 $43,122.60 2024-10-01
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 2 2 — — $42,495.60 $43,557.99 $43,026.79 2024-10-01
4404 APR_DRG Kidney Transplant 17 14 — — $33,650.90 $53,133.00 $42,506.40 2024-10-01
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 2 2 — — $41,916.97 $42,964.89 $42,440.93 2024-10-01
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days 2 2 — — $41,790.73 $42,835.49 $42,313.11 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 53 34 — — $11,768.00 $107,092.00 $42,197.36 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 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 56 35 — — $1,870.00 $54,804.00 $42,065.21 2024-10-01
8634 APR_DRG Neonatal Aftercare 17 14 — — $33,258.55 $52,513.50 $42,010.80 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 59 36 — — $1,480.00 $114,764.00 $41,676.47 2024-10-01
C0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 2 2 — — $41,145.47 $42,174.11 $41,659.79 2024-10-01
B0704 HCPCS Fracture Of Lower Extremity; M < 28.15 2 2 — — $40,807.06 $41,827.24 $41,317.15 2024-10-01
63 APR_DRG Pancreas Transplant 17 14 — — $32,645.80 $51,546.00 $41,236.80 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 53 34 — — $9,732.00 $97,693.87 $41,226.30 2024-10-01
B2102 HCPCS Burns; M=12-45 2 2 — — $40,636.98 $41,652.91 $41,144.95 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 17 14 — — $32,516.60 $51,342.00 $41,073.60 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 54 34 — — $1,870.00 $96,235.78 $41,003.65 2024-10-01
D0106 HCPCS 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 17 14 — — $32,364.60 $51,102.00 $40,881.60 2024-10-01
B1004 HCPCS Amputation, Lower Extremity; M=39-45 2 2 — — $40,347.67 $41,356.36 $40,852.01 2024-10-01
594685 CDM Cath Hrt Lt/inj L Vent 27 24 $90,662.00 $90,662.00 $550.00 $131,459.90 $40,797.90 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 56 35 — — $1,870.00 $96,882.11 $40,490.13 2024-10-01
B1504 HCPCS Pulmonary; M < 29.15 2 2 — — $39,879.51 $40,876.50 $40,378.01 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 55 34 — — $1,870.00 $96,310.80 $40,259.29 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 56 35 — — $1,870.00 $96,208.85 $40,218.09 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 54 34 — — $11,000.00 $66,991.00 $40,212.42 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 56 35 — — $11,000.00 $189,782.00 $40,183.44 2024-10-01
790765 CDM Vasc Embol Tum/org/inf 27 24 $88,946.00 $88,946.00 $550.00 $128,971.70 $40,025.70 2024-10-01
790763 CDM Vasc Emboliz Arterial 27 24 $88,946.00 $88,946.00 $550.00 $128,971.70 $40,025.70 2024-10-01
790761 CDM Vasc Emboliz Venous 27 24 $88,946.00 $88,946.00 $550.00 $128,971.70 $40,025.70 2024-10-01
792939 CDM Embo Dialysis Circuit 27 24 $88,946.00 $88,946.00 $550.00 $128,971.70 $40,025.70 2024-10-01
790767 CDM Vasc Embol Art Ven Hem 27 24 $88,946.00 $88,946.00 $550.00 $128,971.70 $40,025.70 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $39,888.53 $39,888.53 $39,888.53 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $39,884.88 $39,884.88 $39,884.88 2024-10-01
121641 CDM Aortic Balloon Removal 27 24 $88,584.00 $88,584.00 $550.00 $128,446.80 $39,862.80 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $39,795.15 $39,795.15 $39,795.15 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $39,730.47 $39,730.47 $39,730.47 2024-10-01
245 MS_DRG Aicd Generator Procedures 56 35 — — $1,480.00 $93,996.71 $39,717.51 2024-10-01
B1704 HCPCS Major Multiple Trauma,no Brain Or Spinal Cord Inju 2 2 — — $39,176.39 $40,155.80 $39,666.10 2024-10-01
See an error in this hospital's data? Submit a correction