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

MARION COMMUNTIY HOSPITAL

Ocala, FL · CCN 100212 · Rates published

27,150 distinct procedures filed
49 distinct payers
700,191 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

615,013 of 700,191 rate rows are consumer-grade (87.8%)

85,178 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 55,264
template filing: same amount across many unrelated codes — excluded 17,583
per-diem day rate — not a per-procedure price 8,536
exceeds 10× this hospital's gross charge — excluded from medians 3,686
placeholder amount (≤ $0.02) — excluded from medians 109

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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/59-1479652_HCA-FLORIDA-WEST-MARION-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 Latest re-check couldn't be parsed — showing last good data · 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
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 21 $3,672,900.00 $4,407,480.00 $3,801,451.50 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 21 $3,605,000.00 $4,326,000.00 $3,731,175.00 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 21 $6,119.69 $3,990,546.00 $3,391,964.10 nat. median
$13,041
outlier · 260.1×
748
OTHER 		Inj, Lovotibeglogene Auto 21 $10,094.41 $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 21 $8,965.84 $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 21 $2,388,614.00 $2,866,336.80 $2,472,215.49 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 24 $529,192.90 $1,111,305.09 $560,944.47 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 24 $527,123.40 $1,106,959.14 $558,750.80 nat. median
$587,650
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 24 $526,587.60 $1,105,833.96 $558,182.86 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 24 $516,726.10 $1,085,124.81 $547,729.67 nat. median
$562,201
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 24 $489,456.00 $1,027,857.60 $518,823.36 nat. median
$532,192
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
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
$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
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
$674,867
0.7× median
9391
OTHER 		Brexucabtagene Car Pos T 24 $460,530.40 $967,113.84 $488,162.22 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 $830,699.97 $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 $819,043.85 $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 $807,075.90 $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 $741,576.00 $435,956.80 nat. median
$619,808
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 29 $1,376.00 $1,652,159.28 $316,415.93 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 30 $2,837.00 $1,234,026.32 $236,489.65 nat. median
$265,286
0.9× median
5834
APR_DRG 		Neonate With Ecmo 9 $211,427.70 $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 $207,432.07 $207,432.07 $207,432.07 nat. median
$263,894
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 $2,837.00 $1,039,343.31 $200,252.82 nat. median
$206,474
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 $2,837.00 $938,899.92 $185,372.57 nat. median
$202,976
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $171,162.13 $171,162.13 $171,162.13 nat. median
$424,868
outlier · 0.4×
1907
OTHER 		New Technology - Level 52 24 $147,339.90 $353,615.76 $156,180.29 nat. median
$153,199
1.0× median
1908
OTHER 		New Technology - Level 52 24 $147,339.90 $353,615.76 $156,180.29 nat. median
$152,962
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 9 $137,932.30 $188,089.50 $150,471.60 nat. median
$246,434
0.6× median
5833
APR_DRG 		Neonate With Ecmo 9 $136,968.70 $186,775.50 $149,420.40 nat. median
$244,017
0.6× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$82,736
1.7× median
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$84,819
1.7× median
1905
OTHER 		New Technology - Level 51 24 $132,847.50 $318,834.00 $140,818.35 nat. median
$137,903
1.0× median
1906
OTHER 		New Technology - Level 51 24 $132,847.50 $318,834.00 $140,818.35 nat. median
$138,020
1.0× median
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $138,938.05 $138,938.05 $138,938.05 nat. median
$218,232
0.6× median
24
APR_DRG 		Heart And/or Lung Transplant 9 $122,151.70 $166,570.50 $133,256.40 nat. median
$234,729
0.6× median
01906
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 27,150 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
             
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $207,432.07 $207,432.07 $207,432.07 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $78,177.19 $78,177.19 $78,177.19 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $138,938.05 $138,938.05 $138,938.05 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $97,690.74 $97,690.74 $97,690.74 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $64,261.64 $64,261.64 $64,261.64 2024-10-01
006 OTHER Liver Transplant Without Mcc 1 1 — — $41,928.42 $41,928.42 $41,928.42 2024-10-01
007 OTHER Lung Transplant 1 1 — — $78,319.26 $78,319.26 $78,319.26 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
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 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
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 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
0100T CPT Placement Of A Subconjunctival Retinal Prosthesis Receiver And Pulse Generator, … 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $90,771.47 $90,771.47 $90,771.47 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $39,439.47 $39,439.47 $39,439.47 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $171,162.13 $171,162.13 $171,162.13 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $51,037.49 $51,037.49 $51,037.49 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 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
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
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
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $66,682.14 $66,682.14 $66,682.14 2024-10-01
0207 RC — 12 10 — — $11,700.00 $55,381.00 $55,381.00 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $52,323.09 $52,323.09 $52,323.09 2024-10-01
0409T CPT Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I… 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
0414T CPT Removal And Replacement Of Permanent Cardiac Contractility Modulation System Pul… 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 1 1 — — $41,975.00 $41,975.00 $41,975.00 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 1 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 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
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 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
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 58 30 — — $2,837.00 $1,234,026.32 $236,489.65 2024-10-01
10 MS_DRG Pancreas Transplant 57 30 — — $2,837.00 $349,295.55 $68,033.66 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 59 30 — — $2,837.00 $236,392.03 $46,240.54 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 9 — — $53,784.50 $73,342.50 $58,674.00 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 9 — — $62,640.60 $85,419.00 $68,335.20 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 11 9 — — $107,408.40 $146,466.00 $117,172.80 2024-10-01
1142 OTHER Supprelin La Implant 29 24 — — $45,350.21 $108,840.50 $48,071.22 2024-10-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 3 1 — — $20,167.00 $48,710.00 $48,710.00 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 58 30 — — $1,376.00 $573,976.63 $113,565.69 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 11 9 — — $73,966.20 $100,863.00 $80,690.40 2024-10-01
1580 OTHER New Technology - Level 43 29 24 — — $43,477.68 $104,346.43 $46,086.34 2024-10-01
1581 OTHER New Technology - Level 44 29 24 — — $53,139.28 $127,534.27 $56,327.64 2024-10-01
1582 OTHER New Technology - Level 45 29 24 — — $62,800.88 $150,722.11 $66,568.93 2024-10-01
1583 OTHER New Technology - Level 46 29 24 — — $72,462.48 $173,909.95 $76,810.23 2024-10-01
1584 OTHER New Technology - Level 47 29 24 — — $82,124.09 $197,097.82 $87,051.54 2024-10-01
1585 OTHER New Technology - Level 48 29 24 — — $91,785.68 $220,285.63 $97,292.82 2024-10-01
1594 OTHER New Technology - Level 43 29 24 — — $43,477.68 $104,346.43 $46,086.34 2024-10-01
1595 OTHER New Technology - Level 44 29 24 — — $53,139.28 $127,534.27 $56,327.64 2024-10-01
1596 OTHER New Technology - Level 45 29 24 — — $62,800.88 $150,722.11 $66,568.93 2024-10-01
1597 OTHER New Technology - Level 46 29 24 — — $72,462.48 $173,909.95 $76,810.23 2024-10-01
1598 OTHER New Technology - Level 47 29 24 — — $82,124.09 $197,097.82 $87,051.54 2024-10-01
1599 OTHER New Technology - Level 48 29 24 — — $91,785.68 $220,285.63 $97,292.82 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 58 30 — — $1,376.00 $283,891.48 $52,654.99 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 11 9 — — $61,075.30 $83,284.50 $66,627.60 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 11 9 — — $54,171.70 $73,870.50 $59,096.40 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 11 9 — — $56,856.80 $77,532.00 $62,025.60 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 11 9 — — $70,831.20 $96,588.00 $77,270.40 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 11 9 — — $104,683.70 $142,750.50 $114,200.40 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 11 9 — — $41,694.40 $56,856.00 $45,484.80 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 59 30 — — $2,837.00 $201,925.13 $39,587.59 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 29 24 — — $65,476.58 $157,143.79 $69,405.17 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 58 30 — — $1,376.00 $283,891.48 $52,654.99 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 57 29 — — $1,376.00 $1,652,159.28 $316,415.93 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 57 30 — — $2,837.00 $347,284.58 $67,645.50 2024-10-01
1901 OTHER New Technology - Level 49 29 24 — — $103,862.70 $249,270.48 $110,094.46 2024-10-01
1902 OTHER New Technology - Level 49 29 24 — — $103,862.70 $249,270.48 $110,094.46 2024-10-01
1903 OTHER New Technology - Level 50 29 24 — — $118,355.10 $284,052.24 $125,456.41 2024-10-01
1904 OTHER New Technology - Level 50 29 24 — — $118,355.10 $284,052.24 $125,456.41 2024-10-01
1905 OTHER New Technology - Level 51 29 24 — — $132,847.50 $318,834.00 $140,818.35 2024-10-01
1906 OTHER New Technology - Level 51 29 24 — — $132,847.50 $318,834.00 $140,818.35 2024-10-01
1907 OTHER New Technology - Level 52 29 24 — — $147,339.90 $353,615.76 $156,180.29 2024-10-01
1908 OTHER New Technology - Level 52 29 24 — — $147,339.90 $353,615.76 $156,180.29 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 58 30 — — $2,837.00 $482,795.10 $95,623.72 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 57 30 — — $10,799.00 $353,146.63 $70,112.49 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 60 30 — — $1,376.00 $283,362.87 $54,635.85 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 57 30 — — $10,799.00 $242,162.07 $50,572.56 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 11 9 — — $45,903.00 $62,595.00 $50,076.00 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 59 30 — — $2,837.00 $477,248.50 $94,532.31 2024-10-01
215 MS_DRG Other Heart Assist System Implant 57 30 — — $10,799.00 $464,153.09 $96,334.33 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $59,629.45 $59,629.45 $59,629.45 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 30 — — $10,799.00 $191,586.29 $84,617.28 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $57,720.89 $57,720.89 $57,720.89 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 30 — — $10,799.00 $184,069.86 $61,117.22 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $57,399.92 $57,399.92 $57,399.92 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 30 — — $10,799.00 $184,069.86 $56,853.95 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 30 — — $10,799.00 $173,955.00 $67,964.77 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $43,979.63 $43,979.63 $43,979.63 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 11 9 — — $49,913.60 $68,064.00 $54,451.20 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 30 — — $10,799.00 $173,955.00 $50,249.41 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 30 — — $10,799.00 $173,955.00 $43,660.02 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $71,038.00 $87,168.00 $87,168.00 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $71,038.00 $87,168.00 $87,168.00 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $69,717.00 $85,547.00 $85,547.00 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $69,717.00 $85,547.00 $85,547.00 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $65,187.00 $79,989.00 $79,989.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $65,187.00 $79,989.00 $79,989.00 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 55 30 — — $10,799.00 $173,955.00 $47,316.01 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 11 9 — — $68,587.20 $93,528.00 $74,822.40 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 57 30 — — $10,799.00 $249,934.32 $50,277.47 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 57 30 — — $10,799.00 $371,236.60 $78,899.88 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $51,814.61 $51,814.61 $51,814.61 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 57 30 — — $10,799.00 $267,616.84 $58,268.00 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $43,983.65 $43,983.65 $43,983.65 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 55 30 — — $10,799.00 $173,955.00 $68,650.58 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $43,318.71 $43,318.71 $43,318.71 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 55 30 — — $10,799.00 $173,955.00 $50,470.31 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 55 30 — — $10,799.00 $173,955.00 $53,792.29 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 55 30 — — $10,799.00 $173,955.00 $38,706.88 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 59 30 — — $2,837.00 $220,659.14 $42,784.26 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 11 9 — — $122,151.70 $166,570.50 $133,256.40 2024-10-01
245 MS_DRG Aicd Generator Procedures 57 30 — — $10,799.00 $214,087.34 $42,749.47 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $31,488.00 $38,638.00 $38,638.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 3 1 — — $31,488.00 $38,638.00 $38,638.00 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 57 30 — — $10,799.00 $95,898.71 $39,922.28 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 57 30 — — $10,799.00 $226,265.70 $57,243.91 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 57 30 — — $10,799.00 $173,955.00 $45,101.46 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 55 30 — — $10,799.00 $173,955.00 $58,100.87 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 55 30 — — $10,799.00 $173,955.00 $45,300.18 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 57 30 — — $10,799.00 $309,597.50 $62,129.36 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 57 30 — — $9,905.00 $271,371.53 $54,535.90 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 57 30 — — $9,905.00 $203,822.19 $41,117.47 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 55 30 — — $10,799.00 $219,187.05 $44,169.65 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 57 30 — — $10,799.00 $266,337.53 $53,030.86 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 58 29 — — $2,837.00 $938,899.92 $185,372.57 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 11 9 — — $43,865.80 $59,817.00 $47,853.60 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 59 30 — — $2,837.00 $271,021.03 $53,952.44 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 57 30 — — $10,799.00 $118,877.00 $38,490.70 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 59 30 — — $2,837.00 $222,508.00 $43,137.67 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 59 30 — — $2,837.00 $201,171.56 $39,825.07 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 58 29 — — $2,837.00 $619,024.13 $121,846.79 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 59 30 — — $2,837.00 $237,829.06 $47,421.18 2024-10-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $39,377.35 $39,377.35 $39,377.35 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $47,621.30 $47,621.30 $47,621.30 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 57 30 — — $9,905.00 $459,219.86 $90,984.77 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 57 30 — — $9,905.00 $311,008.24 $61,820.82 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 57 30 — — $9,905.00 $241,193.82 $48,541.22 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 57 30 — — $9,905.00 $365,392.08 $72,522.05 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 11 9 — — $46,063.60 $62,814.00 $50,251.20 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 57 30 — — $9,905.00 $239,656.02 $48,235.73 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 11 9 — — $73,460.20 $100,173.00 $80,138.40 2024-10-01
4404 APR_DRG Kidney Transplant 11 9 — — $38,964.20 $53,133.00 $42,506.40 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 57 30 — — $9,905.00 $168,697.78 $58,419.85 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 59 30 — — $2,837.00 $129,581.90 $45,018.51 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $64,114.95 $64,114.95 $64,114.95 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 1 — — $77,347.00 $102,472.00 $89,909.50 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 2 1 — — $108,491.00 $144,551.00 $126,521.00 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 55 30 — — $10,799.00 $371,026.30 $73,089.53 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 55 30 — — $10,799.00 $251,437.07 $50,575.99 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 55 30 — — $10,799.00 $189,167.07 $39,648.04 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 4 2 — — $75,543.00 $122,728.00 $83,213.00 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 4 2 — — $43,053.00 $83,213.00 $70,272.50 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 57 30 — — $10,799.00 $268,861.10 $53,527.43 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $43,534.99 $43,534.99 $43,534.99 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 59 30 — — $2,837.00 $236,615.47 $45,834.31 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $43,809.36 $43,809.36 $43,809.36 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 57 30 — — $10,799.00 $101,807.78 $43,692.51 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 57 30 — — $10,799.00 $97,131.77 $42,495.15 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 59 30 — — $2,837.00 $196,470.53 $38,160.60 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 57 30 — — $2,837.00 $466,536.46 $92,424.47 2024-10-01
5244 OTHER Level 4 Blood Product Exc 29 24 — — $50,304.25 $120,730.20 $53,322.51 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 11 9 — — $47,916.00 $65,340.00 $52,272.00 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 59 30 — — $2,837.00 $269,785.53 $52,174.79 2024-10-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $39,701.77 $39,701.77 $39,701.77 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 59 30 — — $2,837.00 $236,361.36 $45,561.30 2024-10-01
5831 APR_DRG Neonate With Ecmo 11 9 — — $76,442.30 $104,239.50 $83,391.60 2024-10-01
5832 APR_DRG Neonate With Ecmo 11 9 — — $105,167.70 $143,410.50 $114,728.40 2024-10-01
5833 APR_DRG Neonate With Ecmo 11 9 — — $136,968.70 $186,775.50 $149,420.40 2024-10-01
5834 APR_DRG Neonate With Ecmo 11 9 — — $211,427.70 $288,310.50 $230,648.40 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 9 — — $67,471.80 $92,007.00 $73,605.60 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 9 — — $78,716.00 $107,340.00 $85,872.00 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 9 — — $89,707.20 $122,328.00 $97,862.40 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 11 9 — — $137,932.30 $188,089.50 $150,471.60 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 11 9 — — $53,881.30 $73,474.50 $58,779.60 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 11 9 — — $52,291.80 $71,307.00 $57,045.60 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 11 9 — — $51,177.50 $69,787.50 $55,830.00 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 11 9 — — $49,318.50 $67,252.50 $53,802.00 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 11 9 — — $65,037.50 $88,687.50 $70,950.00 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 11 9 — — $87,622.70 $119,485.50 $95,588.40 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 11 9 — — $46,152.70 $62,935.50 $50,348.40 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 11 9 — — $56,348.60 $76,839.00 $61,471.20 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 11 9 — — $81,249.30 $110,794.50 $88,635.60 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 57 30 — — $2,837.00 $288,549.15 $42,425.32 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 11 9 — — $42,796.60 $58,359.00 $46,687.20 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 11 9 — — $60,333.90 $82,273.50 $65,818.80 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 11 9 — — $75,153.10 $102,481.50 $81,985.20 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 11 9 — — $46,238.50 $63,052.50 $50,442.00 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 11 9 — — $90,690.60 $123,669.00 $98,935.20 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 11 9 — — $37,474.80 $51,102.00 $40,881.60 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 11 9 — — $37,650.80 $51,342.00 $41,073.60 2024-10-01
63 APR_DRG Pancreas Transplant 11 9 — — $37,800.40 $51,546.00 $41,236.80 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 11 9 — — $48,044.70 $65,515.50 $52,412.40 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 11 9 — — $100,617.00 $137,205.00 $109,764.00 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 11 9 — — $89,036.20 $121,413.00 $97,130.40 2024-10-01
64 APR_DRG Pancreas Transplant 11 9 — — $53,209.20 $72,558.00 $58,046.40 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 57 30 — — $2,837.00 $201,841.88 $40,339.91 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $88,398.15 $88,398.15 $88,398.15 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 59 30 — — $2,837.00 $244,216.85 $47,750.92 2024-10-01
7 MS_DRG Lung Transplant 57 30 — — $2,837.00 $572,530.83 $111,123.51 2024-10-01
714 OTHER Inj Delandistrogene Mox R 25 21 — — $6,119.69 $3,990,546.00 $3,391,964.10 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 28 24 — — $14,665.62 $133,045.02 $66,839.29 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 11 9 — — $40,648.30 $55,429.50 $44,343.60 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 11 9 — — $83,172.10 $113,416.50 $90,733.20 2024-10-01
746 OTHER Inj, Betibeglogene Autote 25 21 — — $8,965.84 $3,561,600.00 $3,027,360.00 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 25 21 — — $10,094.41 $3,943,200.00 $3,351,720.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 24 21 — — $3,605,000.00 $4,326,000.00 $3,731,175.00 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 41 26 — — $47,280.16 $139,752.79 $52,368.83 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 59 30 — — $2,837.00 $208,304.15 $40,818.90 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 57 30 — — $2,837.00 $238,372.33 $47,528.08 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 59 30 — — $2,837.00 $255,069.08 $49,361.73 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 59 30 — — $2,837.00 $205,005.11 $39,791.99 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 59 30 — — $2,837.00 $209,211.06 $40,595.96 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $48,734.34 $48,734.34 $48,734.34 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 60 30 — — $1,376.00 $242,144.54 $46,776.27 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 60 30 — — $1,376.00 $219,357.92 $42,431.27 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 11 9 — — $41,223.60 $56,214.00 $44,971.20 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 11 9 — — $99,238.70 $135,325.50 $108,260.40 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 11 9 — — $50,823.30 $69,304.50 $55,443.60 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 59 30 — — $2,837.00 $403,565.48 $80,033.53 2024-10-01
8514 APR_DRG Gender Related Procedures 11 9 — — $51,592.20 $70,353.00 $56,282.40 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 59 30 — — $2,837.00 $219,125.72 $42,907.72 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 59 30 — — $2,837.00 $197,649.08 $38,762.21 2024-10-01
8634 APR_DRG Neonatal Aftercare 11 9 — — $38,509.90 $52,513.50 $42,010.80 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 57 30 — — $10,236.00 $138,502.68 $58,575.09 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $43,166.85 $43,166.85 $43,166.85 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 27 24 — — $489,456.00 $1,027,857.60 $518,823.36 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 24 21 — — $3,672,900.00 $4,407,480.00 $3,801,451.50 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 24 21 — — $2,388,614.00 $2,866,336.80 $2,472,215.49 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 27 24 — — $529,192.90 $1,111,305.09 $560,944.47 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 58 29 — — $2,837.00 $1,039,343.31 $200,252.82 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 27 24 — — $55,015.23 $115,531.98 $58,316.14 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 58 29 — — $2,837.00 $292,598.44 $56,812.60 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 11 9 — — $35,664.20 $48,633.00 $38,906.40 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 27 24 — — $460,530.40 $967,113.84 $488,162.22 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 11 9 — — $82,755.20 $112,848.00 $90,278.40 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 27 24 — — $516,726.10 $1,085,124.81 $547,729.67 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 27 24 — — $526,587.60 $1,105,833.96 $558,182.86 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 27 24 — — $527,123.40 $1,106,959.14 $558,750.80 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $72,352.01 $72,352.01 $72,352.01 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 59 30 — — $2,837.00 $299,143.95 $59,486.26 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $50,226.44 $50,226.44 $50,226.44 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 59 30 — — $2,837.00 $326,999.62 $63,730.00 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $49,632.82 $49,632.82 $49,632.82 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 59 30 — — $2,837.00 $277,062.71 $54,090.97 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $43,880.70 $43,880.70 $43,880.70 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 59 30 — — $2,837.00 $208,295.39 $40,817.21 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 1 — — $108,036.36 $108,036.36 $108,036.36 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
B0105 OTHER Stroke; M > 34.25 & M < 38.85 4 3 — — $35,924.13 $45,803.27 $40,414.65 2024-10-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 4 3 — — $40,860.14 $52,096.67 $45,967.65 2024-10-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 4 3 — — $37,093.82 $47,294.62 $41,730.54 2024-10-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 4 3 — — $42,845.22 $54,627.66 $48,200.88 2024-10-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 4 3 — — $34,072.61 $43,442.57 $38,331.68 2024-10-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 4 3 — — $42,405.18 $54,066.61 $47,705.83 2024-10-01
B0604 OTHER Neurological; M < 25.85 4 3 — — $35,011.73 $44,639.95 $39,388.20 2024-10-01
B1903 OTHER Guillian Barre; M < 18.05 4 3 — — $35,306.96 $45,016.37 $39,720.33 2024-10-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 4 3 — — $35,436.30 $45,181.28 $39,865.84 2024-10-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 4 3 — — $38,101.82 $48,579.83 $42,864.55 2024-10-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 4 3 — — $36,986.97 $47,158.39 $41,610.34 2024-10-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 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… 1 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 3 — — $61,600.24 $104,773.89 $61,600.24 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 5 3 — — $43,241.44 $72,861.11 $43,241.44 2024-10-01
J9600 HCPCS Porfimer Na 75 Mg Inj 1 1 $43,300.00 $43,300.00 $38,803.31 $38,803.31 $38,803.31 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 5 3 — — $445,599.57 $807,075.90 $445,599.57 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 3 — — $502,693.77 $863,696.72 $502,693.77 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 2 — — $53,789.99 $91,596.09 $72,693.04 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 3 — — $435,956.80 $741,576.00 $435,956.80 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 3 — — $459,839.17 $819,043.85 $459,839.17 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
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 3 — — $492,271.12 $837,683.55 $492,271.12 2024-10-01
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