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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

MEMORIAL HOSPITAL PEMBROKE

Pembroke Pines, FL · CCN 100230 · Rates published

40,479 distinct procedures filed
82 distinct payers
4,013,788 rate rows
2025-07-30 last MRF observed
Data quality

3,119,703 of 4,013,788 rate rows are consumer-grade (77.7%)

894,085 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 878,853
exceeds 10× this hospital's gross charge — excluded from medians 4,383
percent-of-charges filed in the dollar field — excluded from medians 3,962
template filing: same amount across many unrelated codes — excluded 3,551
per-diem day rate — not a per-procedure price 2,701
placeholder amount (≤ $0.02) — excluded from medians 635
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mhs.pt.panaceainc.com/MRFDownload/mhs/pembroke
Found on page https://www.mhs.net/patients-and-visitors/billing/charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-18
Content fingerprint c25e1f13b5557a60… · 156,863,679 bytes · first seen 2026-05-09

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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 18 $3,672,900.00 $4,480,938.00 $4,021,825.50 nat. median
$3,710,000
1.1× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 18 $3,605,000.00 $4,398,100.00 $3,947,475.00 nat. median
$3,710,000
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 18 $3,325,454.76 $4,057,054.81 $3,641,372.96 nat. median
$3,325,455
1.1× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 18 $3,286,000.00 $4,008,920.00 $3,598,170.00 nat. median
$3,286,000
1.1× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 18 $2,968,000.00 $3,620,960.00 $3,249,960.00 nat. median
$3,006,423
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 19 $2,332,000.00 $4,314,200.00 $2,565,200.00 nat. median
$2,448,600
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 28 $10,712.95 $4,418,936.33 $2,388,614.23 nat. median
$2,469,189
1.0× median
Q2042
HCPCS 		Hc Kymriah All 25 Or Less Yrs 69 $6,281.00 $4,918,121.25 $2,316,881.70 nat. median
$754,974
outlier · 3.1×
Q2041
HCPCS 		Hc Yescarta 69 $6,281.00 $4,292,500.00 $2,090,600.00 nat. median
$634,511
outlier · 3.3×
Q2053
HCPCS 		Hc Tecartus 69 $6,281.00 $3,995,000.00 $2,007,800.00 nat. median
$620,080
outlier · 3.2×
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $1,369,153.31 $1,369,153.31 $1,369,153.31 nat. median
$824,563
1.7× median
Q2054
HCPCS 		Hc Lisocabtagene Mara Car Pos T - Breyanzi 69 $6,281.00 $4,922,967.10 $1,158,345.20 nat. median
$674,188
1.7× median
Q2055
HCPCS 		Hc Idecabtagene Vicleucel Car - Abecma 69 $6,281.00 $4,894,820.20 $1,151,722.40 nat. median
$625,184
1.8× median
Q2056
HCPCS 		Hc Ciltacabtagene Car-pos T Carvykti 69 $6,281.00 $4,762,638.40 $1,120,620.80 nat. median
$675,122
1.7× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $494,364.16 $494,364.16 $494,364.16 nat. median
$459,112
1.1× median
AUTOALLOU
CPT 		Autologous/Allogeneic Unrelated 1 $410,617.00 $410,617.00 $410,617.00 —
AUTOALLOR
CPT 		Autologous/Allogeneic Related 1 $368,900.00 $368,900.00 $368,900.00 —
002-P
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc-pediatric 5 $235,278.00 $360,600.00 $338,586.00 —
001-P
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc-pediatric 5 $235,278.00 $360,600.00 $338,586.00 —
AUTOALLO
CPT 		Autologous/allogeneic Stem Cell-tandem 2 $293,266.00 $351,777.00 $322,521.50 —
ALLOUOP
CPT 		Allogeneic Matched/mismatched Unrelated 2 $226,475.70 $414,850.00 $320,662.85 —
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 21 $156,000.00 $1,456,543.76 $309,465.54 nat. median
$370,174
0.8× median
ALLOROP
CPT 		Allogenic Matched/mismatched Related 2 $184,260.45 $414,850.00 $299,555.22 —
002-A
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc-adult 5 $209,136.00 $338,506.00 $283,234.00 —
001-A
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc-adult 5 $209,136.00 $338,506.00 $283,234.00 —
014-U
MS_DRG 		Allogeneic Bone Marrow Transplant-matched/mismatched-unrelated 5 $240,400.00 $309,899.00 $266,648.00 —
AUTOTAN
CPT 		Autologous Stem Cell - Tandem 3 $180,300.00 $255,667.00 $234,518.00 —
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 21 $212,761.35 $1,087,916.08 $232,973.68 nat. median
$265,286
0.9× median
014-R
MS_DRG 		Allogeneic Bone Marrow Transplant-matched/mismatched-related 5 $202,155.00 $269,747.00 $230,049.00 —
5834
APR_DRG 		12 $192,207.36 $297,921.41 $201,817.73 nat. median
$309,665
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 21 $179,621.20 $916,221.98 $196,685.21 nat. median
$206,368
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 21 $162,540.84 $827,731.26 $177,982.22 nat. median
$202,986
0.9× median
027844057-80
CDM 		Hc Heartmate3 Lvad Implant Kit 106524us 51 $682.69 $196,229.37 $146,608.15 nat. median
$146,608
1.0× median
652-P
MS_DRG 		Kidney - Pediatric 2 $114,750.00 $160,910.00 $137,830.00 —
651-P
MS_DRG 		Kidney - Pediatric 2 $114,750.00 $160,910.00 $137,830.00 —
650-P
MS_DRG 		Kidney - Pediatric 2 $114,750.00 $160,910.00 $137,830.00 —
AUTOOP
CPT 		Autologous, Outpatient 2 $125,861.20 $143,031.00 $134,446.10 —
5884
APR_DRG 		12 $125,393.59 $194,360.06 $131,663.27 nat. median
$246,434
0.5× median
5833
APR_DRG 		12 $124,517.93 $193,002.79 $130,743.83 nat. median
$244,017
0.5× median
652-A
MS_DRG 		Kidney - Adult 2 $105,590.00 $148,991.00 $127,290.50 —
651-A
MS_DRG 		Kidney - Adult 2 $105,590.00 $148,991.00 $127,290.50 —
650-A
MS_DRG 		Kidney - Adult 2 $105,590.00 $148,991.00 $127,290.50 —
027800228-80
CDM 		Hc Vad Hmii Sealed Implant Kit Thoratec 106015 51 $682.69 $159,101.25 $118,868.75 nat. median
$118,869
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 21 $108,109.14 $545,728.86 $118,379.51 nat. median
$133,176
0.9× median
0024
APR_DRG 		13 $111,047.26 $172,123.25 $116,599.62 nat. median
$372,987
outlier · 0.3×
081211206-253
CDM 		Hc Organ Acquisition Heart Cadaver Donor 51 $682.69 $157,107.20 $110,899.20 nat. median
$92,416
1.2× median
081211206-255
CDM 		Hc Organ Acquisition Heart Cadaver Donor 51 $682.69 $157,107.20 $110,899.20 nat. median
$92,416
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 21 $100,444.15 $506,017.72 $109,986.35 nat. median
$117,303
0.9× median
7
MS_DRG 		Lung Transplant 21 $100,198.15 $504,743.19 $109,716.98 nat. median
$122,708
0.9× median
0114
APR_DRG 		12 $97,644.18 $151,348.48 $102,526.39 nat. median
$197,700
0.5× median

Other procedures at this hospital

Browse this hospital's 40,479 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
             
5834 APR_DRG — 15 12 — — $192,207.36 $297,921.41 $201,817.73 2025-07-30
5884 APR_DRG — 15 12 — — $125,393.59 $194,360.06 $131,663.27 2025-07-30
5833 APR_DRG — 15 12 — — $124,517.93 $193,002.79 $130,743.83 2025-07-30
0024 APR_DRG — 17 13 — — $111,047.26 $172,123.25 $116,599.62 2025-07-30
0114 APR_DRG — 15 12 — — $97,644.18 $151,348.48 $102,526.39 2025-07-30
5832 APR_DRG — 15 12 — — $95,607.08 $148,190.97 $100,387.43 2025-07-30
1614 APR_DRG — 15 12 — — $95,167.09 $147,508.99 $99,925.44 2025-07-30
6304 APR_DRG — 15 12 — — $91,470.33 $141,779.01 $96,043.85 2025-07-30
8414 APR_DRG — 15 12 — — $90,217.23 $139,836.71 $94,728.09 2025-07-30
6094 APR_DRG — 15 12 — — $82,446.63 $127,792.28 $86,568.96 2025-07-30
5883 APR_DRG — 15 12 — — $81,552.64 $126,406.59 $85,630.27 2025-07-30
6314 APR_DRG — 15 12 — — $80,942.26 $125,460.50 $84,989.37 2025-07-30
5914 APR_DRG — 15 12 — — $79,657.89 $123,469.73 $83,640.78 2025-07-30
0074 APR_DRG — 17 13 — — $75,611.37 $117,197.62 $79,391.94 2025-07-30
0094 APR_DRG — 15 12 — — $75,232.49 $116,610.36 $78,994.11 2025-07-30
5934 APR_DRG — 15 12 — — $73,863.28 $114,488.08 $77,556.44 2025-07-30
5882 APR_DRG — 15 12 — — $71,560.89 $110,919.38 $75,138.93 2025-07-30
5831 APR_DRG — 15 12 — — $69,493.60 $107,715.08 $72,968.28 2025-07-30
6034 APR_DRG — 15 12 — — $68,321.02 $105,897.58 $71,737.07 2025-07-30
0014 APR_DRG — 17 13 — — $67,242.62 $104,226.06 $70,604.75 2025-07-30
0044 APR_DRG — 15 12 — — $66,782.14 $103,512.32 $70,121.25 2025-07-30
1613 APR_DRG — 15 12 — — $64,392.40 $99,808.22 $67,612.02 2025-07-30
0023 APR_DRG — 17 13 — — $62,352.43 $96,646.27 $65,470.05 2025-07-30
5881 APR_DRG — 15 12 — — $61,338.01 $95,073.92 $64,404.91 2025-07-30
5913 APR_DRG — 15 12 — — $59,125.13 $91,643.95 $62,081.39 2025-07-30
0113 APR_DRG — 15 12 — — $56,946.04 $88,266.36 $59,793.34 2025-07-30
1604 APR_DRG — 15 12 — — $55,523.63 $86,061.63 $58,299.81 2025-07-30
6024 APR_DRG — 15 12 — — $54,849.27 $85,016.37 $57,591.73 2025-07-30
1612 APR_DRG — 15 12 — — $51,688.84 $80,117.70 $54,273.28 2025-07-30
5933 APR_DRG — 15 12 — — $51,226.92 $79,401.73 $53,788.27 2025-07-30
1611 APR_DRG — 15 12 — — $49,247.34 $76,333.38 $51,709.71 2025-07-30
5891 APR_DRG — 15 12 — — $48,983.85 $75,924.97 $51,433.04 2025-07-30
0112 APR_DRG — 15 12 — — $48,895.78 $75,788.46 $51,340.57 2025-07-30
0064 APR_DRG — 17 13 — — $48,372.76 $74,977.78 $50,791.40 2025-07-30
5892 APR_DRG — 15 12 — — $47,538.79 $73,685.12 $49,915.73 2025-07-30
8514 APR_DRG — 15 12 — — $46,902.89 $72,699.48 $49,248.03 2025-07-30
5893 APR_DRG — 15 12 — — $46,525.81 $72,115.01 $48,852.10 2025-07-30
8424 APR_DRG — 15 12 — — $46,203.37 $71,615.22 $48,513.54 2025-07-30
0022 APR_DRG — 17 13 — — $45,376.96 $70,334.29 $47,645.81 2025-07-30
5912 APR_DRG — 15 12 — — $44,835.60 $69,495.18 $47,077.38 2025-07-30
6303 APR_DRG — 15 12 — — $43,677.04 $67,699.41 $45,860.89 2025-07-30
0054 APR_DRG — 15 12 — — $43,560.21 $67,518.33 $45,738.22 2025-07-30
6074 APR_DRG — 15 12 — — $42,035.35 $65,154.79 $44,137.12 2025-07-30
5932 APR_DRG — 15 12 — — $41,957.35 $65,033.89 $44,055.22 2025-07-30
0043 APR_DRG — 15 12 — — $41,876.47 $64,908.53 $43,970.29 2025-07-30
0021 APR_DRG — 17 13 — — $41,730.88 $64,682.86 $43,817.42 2025-07-30
3034 APR_DRG — 15 12 — — $39,878.55 $61,811.75 $41,872.48 2025-07-30
6023 APR_DRG — 15 12 — — $38,906.55 $60,305.15 $40,851.88 2025-07-30
1624 APR_DRG — 15 12 — — $37,904.72 $58,752.32 $39,799.96 2025-07-30
0084 APR_DRG — 17 13 — — $37,476.23 $58,088.16 $39,350.04 2025-07-30
0073 APR_DRG — 17 13 — — $36,953.93 $57,278.59 $38,801.63 2025-07-30
4404 APR_DRG — 17 13 — — $35,422.96 $54,905.59 $37,194.11 2025-07-30
8634 APR_DRG — 15 12 — — $35,009.21 $54,264.28 $36,759.67 2025-07-30
0063 APR_DRG — 17 13 — — $34,364.33 $53,264.71 $36,082.55 2025-07-30
6134 APR_DRG — 15 12 — — $34,228.81 $53,054.66 $35,940.25 2025-07-30
6114 APR_DRG — 15 12 — — $34,068.84 $52,806.70 $35,772.28 2025-07-30
0093 APR_DRG — 15 12 — — $32,422.49 $50,254.86 $34,043.61 2025-07-30
5484 APR_DRG — 15 12 — — $32,130.18 $49,801.78 $33,736.69 2025-07-30
1674 APR_DRG — 15 12 — — $31,789.10 $49,273.11 $33,378.56 2025-07-30
1634 APR_DRG — 15 12 — — $31,574.50 $48,940.48 $33,153.23 2025-07-30
0013 APR_DRG — 17 13 — — $31,456.60 $48,757.73 $33,029.43 2025-07-30
6022 APR_DRG — 15 12 — — $31,113.67 $48,226.19 $32,669.35 2025-07-30
6093 APR_DRG — 15 12 — — $30,783.68 $47,714.70 $32,322.86 2025-07-30
1784 APR_DRG — 15 12 — — $30,258.13 $46,900.10 $31,771.04 2025-07-30
6033 APR_DRG — 15 12 — — $30,178.33 $46,776.41 $31,687.25 2025-07-30
0053 APR_DRG — 15 12 — — $30,089.90 $46,639.35 $31,594.40 2025-07-30
6124 APR_DRG — 15 12 — — $30,025.56 $46,539.62 $31,526.84 2025-07-30
8504 APR_DRG — 16 13 — — $29,751.29 $46,114.50 $31,238.85 2025-07-30
0072 APR_DRG — 17 13 — — $29,633.02 $45,931.18 $31,114.67 2025-07-30
1654 APR_DRG — 15 12 — — $29,487.44 $45,705.53 $30,961.81 2025-07-30
6073 APR_DRG — 15 12 — — $29,098.49 $45,102.66 $30,553.41 2025-07-30
8413 APR_DRG — 15 12 — — $28,871.31 $44,750.53 $30,314.88 2025-07-30
6214 APR_DRG — 15 12 — — $28,840.40 $44,702.62 $30,282.42 2025-07-30
6804 APR_DRG — 15 12 — — $28,815.59 $44,664.16 $30,256.37 2025-07-30
850 MS_DRG Acute Leukemia With Other Procedures 24 21 — — $71,445.87 $355,782.00 $78,233.23 2025-07-30
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 24 21 — — $43,978.05 $213,475.38 $48,155.97 2025-07-30
081111207-255 CDM Adult Kidney Transplant Living 79 51 $107,322.00 — $682.69 $91,223.70 $64,393.20 2025-07-30
081111207-253 CDM Adult Kidney Transplant Living 79 51 $107,322.00 — $682.69 $91,223.70 $64,393.20 2025-07-30
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $1,369,153.31 $1,369,153.31 $1,369,153.31 2025-07-30
245 MS_DRG Aicd Generator Procedures 52 38 — — $7,505.00 $188,737.99 $41,751.49 2025-07-30
265 MS_DRG Aicd Lead Procedures 53 39 — — $7,280.00 $137,772.40 $31,421.59 2025-07-30
14 MS_DRG Allogeneic Bone Marrow Transplant 24 21 — — $100,444.15 $506,017.72 $109,986.35 2025-07-30
014-R MS_DRG Allogeneic Bone Marrow Transplant-matched/mismatched-related 5 5 — — $202,155.00 $269,747.00 $230,049.00 2025-07-30
014-U MS_DRG Allogeneic Bone Marrow Transplant-matched/mismatched-unrelated 5 5 — — $240,400.00 $309,899.00 $266,648.00 2025-07-30
ALLOUOP CPT Allogeneic Matched/mismatched Unrelated 2 2 — — $226,475.70 $414,850.00 $320,662.85 2025-07-30
ALLOROP CPT Allogenic Matched/mismatched Related 2 2 — — $184,260.45 $414,850.00 $299,555.22 2025-07-30
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 24 21 — — $40,322.23 $194,535.15 $44,152.85 2025-07-30
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 24 21 — — $36,205.71 $173,208.08 $39,645.26 2025-07-30
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 24 21 — — $31,586.00 $149,274.03 $34,586.67 2025-07-30
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 56 38 — — $31,202.00 $257,516.05 $56,414.62 2025-07-30
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 56 38 — — $31,202.00 $160,694.56 $46,200.00 2025-07-30
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 29 23 — — $47,769.54 $233,118.53 $53,501.88 2025-07-30
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 29 23 — — $47,769.54 $233,118.53 $53,501.88 2025-07-30
AUTOTAN CPT Autologous Stem Cell - Tandem 3 3 — — $180,300.00 $255,667.00 $234,518.00 2025-07-30
AUTOOP CPT Autologous, Outpatient 2 2 — — $125,861.20 $143,031.00 $134,446.10 2025-07-30
AUTOALLOR CPT Autologous/Allogeneic Related 1 1 — — $368,900.00 $368,900.00 $368,900.00 2025-07-30
AUTOALLO CPT Autologous/allogeneic Stem Cell-tandem 2 2 — — $293,266.00 $351,777.00 $322,521.50 2025-07-30
AUTOALLOU CPT Autologous/Allogeneic Unrelated 1 1 — — $410,617.00 $410,617.00 $410,617.00 2025-07-30
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 24 21 — — $29,491.21 $138,421.25 $32,292.88 2025-07-30
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 24 21 — — $29,973.53 $140,920.09 $32,821.01 2025-07-30
J0480 HCPCS Basiliximab 20 Mg Solr 1 Each Vial 225 69 $59,313.82 — $1,116.91 $60,429.61 $36,459.22 2025-07-30
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 37 23 — — $23,112.00 $237,011.63 $50,947.04 2025-07-30
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 24 21 — — $28,874.70 $135,227.21 $31,617.80 2025-07-30
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 24 21 — — $28,410.27 $132,821.06 $31,109.25 2025-07-30
90288 HCPCS Botulism Immune Globulinhuman 100 Mg Solr 1 Each Vial 103 66 $145,111.00 — $1,135.76 $123,344.35 $46,435.52 2025-07-30
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 51 36 — — $37,593.00 $272,941.67 $61,001.77 2025-07-30
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 51 36 — — $37,593.00 $239,240.12 $54,825.25 2025-07-30
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 51 36 — — $37,452.15 $179,665.68 $46,200.00 2025-07-30
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 38 — — $31,202.00 $372,744.78 $73,872.00 2025-07-30
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 38 — — $31,202.00 $249,417.01 $55,478.93 2025-07-30
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 38 — — $31,202.00 $229,773.86 $52,543.22 2025-07-30
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 56 38 — — $31,202.00 $298,837.73 $64,384.12 2025-07-30
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 56 38 — — $31,202.00 $204,569.15 $48,351.92 2025-07-30
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 56 38 — — $31,202.00 $177,375.40 $46,200.00 2025-07-30
34 MS_DRG Carotid Artery Stent Procedures With Mcc 24 21 — — $31,762.67 $150,189.37 $34,780.13 2025-07-30
471 MS_DRG Cervical Spinal Fusion With Mcc 24 21 — — $38,983.36 $187,598.64 $42,686.78 2025-07-30
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 24 21 — — $40,100.83 $193,388.08 $43,910.41 2025-07-30
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 25 21 — — $156,000.00 $1,456,543.76 $309,465.54 2025-07-30
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 24 21 — — $28,893.34 $135,323.76 $31,638.21 2025-07-30
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 26 21 — — $64,950.53 $322,130.65 $71,770.34 2025-07-30
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 26 21 — — $43,554.62 $211,281.65 $48,127.85 2025-07-30
454 MS_DRG Combined Anterior/posterior Spinal Fusion W Cc 2 1 — — $37,276.00 $37,276.00 $37,276.00 2025-07-30
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 49 35 — — $38,331.00 $420,744.21 $73,873.00 2025-07-30
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 27 22 — — $15,000.00 $238,931.14 $52,802.81 2025-07-30
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 56 38 — — $31,202.00 $301,885.00 $65,010.54 2025-07-30
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 56 38 — — $31,202.00 $205,476.76 $48,452.65 2025-07-30
231 MS_DRG Coronary Bypass With Ptca With Mcc 56 38 — — $31,202.00 $327,278.97 $69,571.20 2025-07-30
232 MS_DRG Coronary Bypass With Ptca Without Mcc 56 38 — — $31,202.00 $235,930.21 $53,861.80 2025-07-30
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 56 38 — — $31,202.00 $227,259.57 $52,002.10 2025-07-30
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 55 37 — — $31,202.00 $158,817.53 $46,200.00 2025-07-30
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 51 36 — — $2,045.00 $164,506.55 $30,530.00 2025-07-30
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 24 21 — — $36,113.27 $172,729.17 $39,544.04 2025-07-30
955 MS_DRG Craniotomy For Multiple Significant Trauma 24 21 — — $53,676.70 $263,722.60 $58,775.99 2025-07-30
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 21 — — $45,303.51 $220,342.37 $49,607.35 2025-07-30
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 24 21 — — $31,114.11 $146,829.26 $34,069.95 2025-07-30
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 21 — — $162,540.84 $827,731.26 $177,982.22 2025-07-30
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 53 38 — — $31,202.00 $231,376.68 $53,125.33 2025-07-30
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 53 38 — — $31,202.00 $181,704.92 $46,550.29 2025-07-30
25010021027 NDC Ethacrynic Acid 50 Mg Solr 1 Each Vial 78 52 $76,130.87 — $682.69 $64,711.24 $45,678.52 2025-07-30
0620T HCPCS Evasc Ven Artlz Tibl/prnl Vn 38 28 — — $7,047.29 $64,995.68 $35,132.80 2025-07-30
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 21 — — $179,621.20 $916,221.98 $196,685.21 2025-07-30
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 24 21 — — $35,029.35 $167,113.53 $38,357.15 2025-07-30
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 21 — — $38,212.53 $183,605.13 $41,842.72 2025-07-30
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 24 21 — — $47,090.41 $229,600.07 $51,564.00 2025-07-30
793 MS_DRG Full Term Neonate With Major Problems 24 21 — — $33,863.43 $161,073.05 $37,080.46 2025-07-30
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 24 21 — — $52,562.95 $257,952.48 $57,556.44 2025-07-30
027213347-79 CDM Hc Cannula Perf 180d Dil Circ Bbl H965251960 79 51 $51,171.00 — $682.69 $43,495.35 $30,702.60 2025-07-30
Q2056 HCPCS Hc Ciltacabtagene Car-pos T Carvykti 113 69 — — $6,281.00 $4,762,638.40 $1,120,620.80 2025-07-30
027217127-79 CDM Hc Distractor Surg Ips Kawamoto Ti M Oral/max 60-008-92-09 79 51 $61,520.00 — $682.69 $52,292.00 $36,912.00 2025-07-30
027217126-79 CDM Hc Distractor Surg Ips Kawamoto Ti S Oral/max 60-008-91-09 79 51 $57,620.00 — $682.69 $48,977.00 $34,572.00 2025-07-30
036011262-255 CDM Hc Ep Therapeutic 1st Minute 79 51 $53,750.00 — $682.69 $45,687.50 $32,250.00 2025-07-30
036011262-253 CDM Hc Ep Therapeutic 1st Minute 79 51 $53,750.00 — $682.69 $45,687.50 $32,250.00 2025-07-30
027844057-80 CDM Hc Heartmate3 Lvad Implant Kit 106524us 74 51 $225,551.00 — $682.69 $196,229.37 $146,608.15 2025-07-30
Q2055 HCPCS Hc Idecabtagene Vicleucel Car - Abecma 113 69 — — $6,281.00 $4,894,820.20 $1,151,722.40 2025-07-30
032099915500-255 CDM Hc Ir Fluoro Group 15 79 51 $51,684.00 — $143.00 $43,931.40 $31,010.40 2025-07-30
032099915500-253 CDM Hc Ir Fluoro Group 15 79 51 $51,684.00 — $143.00 $43,931.40 $31,010.40 2025-07-30
C1820 HCPCS Hc Kit Impl Maestro Rechrgable 2400 223 52 $54,884.00 — $682.69 $63,954.00 $33,895.62 2025-07-30
027216466-79 CDM Hc Kit Neurosurgical Visualase 10mm Laser Neurokit-400-t10 79 51 $50,729.00 — $682.69 $43,119.65 $30,437.40 2025-07-30
027843979-80 CDM Hc Kit Nrstm Rns Vagus Nrv Stm Rns-320-k 74 51 $70,851.00 — $682.69 $61,640.37 $46,053.15 2025-07-30
C1822 HCPCS Hc Kit Patient Maestro Rechrgable 2404 223 52 $56,430.00 — $532.95 $79,299.00 $36,679.50 2025-07-30
Q2042 HCPCS Hc Kymriah All 25 Or Less Yrs 176 69 $4,718,700.00 — $6,281.00 $4,918,121.25 $2,316,881.70 2025-07-30
027217132-79 CDM Hc Laser Ablation Visualase 1.65mm 3mm Tip Cath 9735559 79 51 $50,799.00 — $682.69 $43,179.15 $30,479.40 2025-07-30
027216469-79 CDM Hc Laser Ablt Sys L10 Mm .4 Mm Core Tip Visualase 9735560 79 51 $50,801.00 — $682.69 $43,180.85 $30,480.60 2025-07-30
Q2054 HCPCS Hc Lisocabtagene Mara Car Pos T - Breyanzi 113 69 — — $6,281.00 $4,922,967.10 $1,158,345.20 2025-07-30
027216691-79 CDM Hc Matrix Wnd 20cmx25cm Clgn-gag Mwm4101 79 51 $57,670.00 — $682.69 $49,019.50 $34,602.00 2025-07-30
027216116-79 CDM Hc Matrix Wnd W 40 Cm L20 Cm Sgl Use Indiv Packed Mtx-2040 79 51 $63,522.00 — $682.69 $53,993.70 $38,113.20 2025-07-30
081211206-255 CDM Hc Organ Acquisition Heart Cadaver Donor 79 51 $184,832.00 — $682.69 $157,107.20 $110,899.20 2025-07-30
081211206-253 CDM Hc Organ Acquisition Heart Cadaver Donor 79 51 $184,832.00 — $682.69 $157,107.20 $110,899.20 2025-07-30
081211207-253 CDM Hc Organ Acquisition Kidney Cadaver Donor 79 51 $107,322.00 — $682.69 $91,223.70 $64,393.20 2025-07-30
081211207-255 CDM Hc Organ Acquisition Kidney Cadaver Donor 79 51 $107,322.00 — $682.69 $91,223.70 $64,393.20 2025-07-30
48554 HCPCS Hc Organ Acquisition Pancreas Cadaver Donor 155 58 $108,362.00 — $1,694.00 $92,107.70 $64,500.63 2025-07-30
C1759 HCPCS Hc Shunt Ventriclr Backtiseal Kit 223 52 $52,250.00 — $270.98 $73,150.00 $33,962.50 2025-07-30
081538240-253 CDM Hc Stem Cell Acquisition 79 51 $164,806.00 — $682.69 $140,085.10 $98,883.60 2025-07-30
081538240-255 CDM Hc Stem Cell Acquisition 79 51 $164,806.00 — $682.69 $140,085.10 $98,883.60 2025-07-30
027216817-79 CDM Hc System Embl Prot Nav6 190cm .014in 22437-19 79 51 $70,415.00 — $682.69 $59,852.75 $42,249.00 2025-07-30
C1826 HCPCS Hc System Evoke G4 Stimulator 2x60cm Leads Permsys-60-2-g4 75 52 $51,205.00 — $682.69 $51,205.00 $33,283.25 2025-07-30
Q2053 HCPCS Hc Tecartus 176 69 $4,400,000.00 — $6,281.00 $3,995,000.00 $2,007,800.00 2025-07-30
027257598-255 CDM Hc Tray Press Montr 2.5f Cpmsy250 79 51 $114,205.00 — $682.69 $97,074.25 $68,523.00 2025-07-30
027800228-80 CDM Hc Vad Hmii Sealed Implant Kit Thoratec 106015 74 51 $182,875.00 — $682.69 $159,101.25 $118,868.75 2025-07-30
027856109-80 CDM Hc Vad Hw Dvc Vent Asst Kt Pmp 1103 74 51 $156,019.00 — $682.69 $135,736.53 $101,412.35 2025-07-30
Q2041 HCPCS Hc Yescarta 176 69 $4,400,000.00 — $6,281.00 $4,292,500.00 $2,090,600.00 2025-07-30
A9543 HCPCS Hc Zevalin Y-90 Tx Dose Upto 40 Mci 113 69 $304,169.00 — $4,037.00 $258,543.65 $81,517.29 2025-07-30
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 24 21 — — $212,761.35 $1,087,916.08 $232,973.68 2025-07-30
001-A MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc-adult 5 5 — — $209,136.00 $338,506.00 $283,234.00 2025-07-30
001-P MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc-pediatric 5 5 — — $235,278.00 $360,600.00 $338,586.00 2025-07-30
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 24 21 — — $84,922.59 $425,602.85 $92,990.24 2025-07-30
002-A MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc-adult 5 5 — — $209,136.00 $338,506.00 $283,234.00 2025-07-30
002-P MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc-pediatric 5 5 — — $235,278.00 $360,600.00 $338,586.00 2025-07-30
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 24 21 — — $29,084.92 $136,316.35 $31,847.99 2025-07-30
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 24 21 — — $49,919.50 $244,257.11 $54,661.85 2025-07-30
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 38 28 — — $12,436.05 $56,589.24 $30,588.78 2025-07-30
0266T HCPCS Implt/rpl Crtd Sns Dev Total 38 28 — — $12,436.05 $83,565.61 $45,170.60 2025-07-30
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 24 21 — — $40,056.84 $193,160.21 $43,862.24 2025-07-30
J1413 HCPCS Inj Delandistrogene Mox Rokl 20 18 — — $3,325,454.76 $4,057,054.81 $3,641,372.96 2025-07-30
J3399 HCPCS Inj Onase Abepar-xioi Treat 38 28 — — $10,712.95 $4,418,936.33 $2,388,614.23 2025-07-30
J1414 HCPCS Inj, Beqvez, Per Tx Dose 20 18 — — $3,605,000.00 $4,398,100.00 $3,947,475.00 2025-07-30
J3393 HCPCS Inj, Betibeglogene Autotemce 20 18 — — $2,968,000.00 $3,620,960.00 $3,249,960.00 2025-07-30
J3392 HCPCS Inj, Exagamglogene Autotem 22 19 — — $2,332,000.00 $4,314,200.00 $2,565,200.00 2025-07-30
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 20 18 — — $3,672,900.00 $4,480,938.00 $4,021,825.50 2025-07-30
J3394 HCPCS Inj, Lovotibeglogene Autotem 20 18 — — $3,286,000.00 $4,008,920.00 $3,598,170.00 2025-07-30
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 22 19 — — $32,182.77 $59,538.13 $35,401.05 2025-07-30
33276 HCPCS Insj Phrnc Nrv Stim Sys 35 32 — — $546.77 $83,565.61 $45,170.60 2025-07-30
0408T HCPCS Insj/rplc Cardiac Modulj Sys 38 28 — — $5,079.14 $59,538.13 $32,182.77 2025-07-30
0571T HCPCS Insj/rplcmt Icds Ss Eltrd 38 28 — — $14,379.86 $59,538.13 $32,182.77 2025-07-30
J9029 HCPCS Instill Adstiladrin, Tx Dose 39 23 — — $63,354.77 $210,574.58 $77,292.82 2025-07-30
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 24 21 — — $43,978.05 $213,475.38 $48,155.97 2025-07-30
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 24 21 — — $62,866.93 $311,335.80 $68,839.29 2025-07-30
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 24 21 — — $29,091.63 $136,351.11 $31,855.33 2025-07-30
650-A MS_DRG Kidney - Adult 2 2 — — $105,590.00 $148,991.00 $127,290.50 2025-07-30
651-A MS_DRG Kidney - Adult 2 2 — — $105,590.00 $148,991.00 $127,290.50 2025-07-30
652-A MS_DRG Kidney - Adult 2 2 — — $105,590.00 $148,991.00 $127,290.50 2025-07-30
651-P MS_DRG Kidney - Pediatric 2 2 — — $114,750.00 $160,910.00 $137,830.00 2025-07-30
650-P MS_DRG Kidney - Pediatric 2 2 — — $114,750.00 $160,910.00 $137,830.00 2025-07-30
652-P MS_DRG Kidney - Pediatric 2 2 — — $114,750.00 $160,910.00 $137,830.00 2025-07-30
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 27 22 — — $37,119.67 $177,943.14 $41,202.84 2025-07-30
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 27 22 — — $28,660.00 $142,055.00 $31,812.61 2025-07-30
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 38 28 — — $4,001.39 $56,589.24 $30,588.78 2025-07-30
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 24 21 — — $31,268.42 $147,628.73 $34,238.93 2025-07-30
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 24 21 — — $82,162.09 $411,301.13 $89,967.49 2025-07-30
6 MS_DRG Liver Transplant Without Mcc 24 21 — — $38,922.97 $187,285.80 $42,620.66 2025-07-30
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 24 21 — — $29,018.58 $135,972.61 $31,775.35 2025-07-30
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 24 21 — — $29,246.69 $137,154.45 $32,025.13 2025-07-30
7 MS_DRG Lung Transplant 24 21 — — $100,198.15 $504,743.19 $109,716.98 2025-07-30
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 21 — — $46,177.20 $224,868.87 $50,564.04 2025-07-30
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 24 21 — — $37,657.90 $180,731.65 $41,235.40 2025-07-30
653 MS_DRG Major Bladder Procedures With Mcc 24 21 — — $44,330.66 $215,302.20 $48,542.07 2025-07-30
163 MS_DRG Major Chest Procedures With Mcc 24 21 — — $37,133.83 $178,016.52 $40,661.54 2025-07-30
140 MS_DRG Major Head And Neck Procedures With Mcc 24 21 — — $34,301.02 $163,340.16 $37,559.62 2025-07-30
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 24 21 — — $37,004.86 $177,348.36 $40,520.33 2025-07-30
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 21 — — $80,864.96 $404,580.90 $89,355.79 2025-07-30
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 30 23 — — $52,500.00 $274,320.48 $61,015.90 2025-07-30
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 26 21 — — $43,805.10 $212,579.35 $48,404.64 2025-07-30
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 26 21 — — $52,755.29 $258,948.92 $58,294.60 2025-07-30
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 30 23 — — $33,214.86 $157,712.94 $36,370.27 2025-07-30
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 24 21 — — $38,373.56 $184,439.36 $42,019.05 2025-07-30
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 24 21 — — $29,495.68 $138,444.42 $32,297.78 2025-07-30
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 24 21 — — $28,885.13 $135,281.28 $31,629.22 2025-07-30
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 24 21 — — $32,067.57 $151,769.01 $35,114.00 2025-07-30
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $494,364.16 $494,364.16 $494,364.16 2025-07-30
228 MS_DRG Other Cardiothoracic Procedures With Mcc 56 38 — — $31,202.00 $192,465.01 $47,757.00 2025-07-30
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 56 38 — — $25,930.07 $119,971.52 $44,860.61 2025-07-30
264 MS_DRG Other Circulatory System O.r. Procedures 26 21 — — $20,609.00 $134,987.75 $31,278.90 2025-07-30
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 24 21 — — $34,573.12 $164,749.87 $37,857.57 2025-07-30
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 24 21 — — $32,187.60 $152,390.83 $35,245.42 2025-07-30
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 24 21 — — $35,520.62 $169,658.72 $38,895.08 2025-07-30
215 MS_DRG Other Heart Assist System Implant 56 38 — — $31,202.00 $409,192.37 $73,872.00 2025-07-30
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 24 21 — — $33,094.84 $157,091.12 $36,238.85 2025-07-30
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 24 21 — — $34,005.81 $161,810.73 $37,236.36 2025-07-30
271 MS_DRG Other Major Cardiovascular Procedures With Cc 56 38 — — $28,450.52 $133,029.62 $46,200.00 2025-07-30
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 56 38 — — $31,202.00 $198,246.73 $47,757.00 2025-07-30
272 MS_DRG Other Major Cardiovascular Procedures Without Cc/mcc 56 38 — — $21,426.64 $96,639.97 $41,611.50 2025-07-30
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 24 21 — — $32,470.88 $153,858.46 $35,555.62 2025-07-30
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 24 21 — — $33,410.92 $158,728.70 $36,584.96 2025-07-30
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 21 — — $58,417.18 $288,282.33 $63,966.82 2025-07-30
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 24 21 — — $29,497.17 $138,452.15 $32,299.40 2025-07-30
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 24 21 — — $31,476.41 $148,706.29 $34,466.67 2025-07-30
252 MS_DRG Other Vascular Procedures With Mcc 24 21 — — $28,346.16 $132,488.91 $31,039.04 2025-07-30
10 MS_DRG Pancreas Transplant 25 21 — — $62,210.16 $307,933.21 $68,431.18 2025-07-30
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 21 — — $43,243.01 $209,667.25 $47,351.10 2025-07-30
J9266 HCPCS Pegaspargase 750 Unit/ml Soln 5 Ml Vial 111 69 $352,172.33 — $6,281.00 $299,346.48 $70,434.47 2025-07-30
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 50 36 — — $12,182.00 $151,023.61 $31,226.85 2025-07-30
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 24 21 — — $30,893.45 $145,686.05 $33,828.33 2025-07-30
335 MS_DRG Peritoneal Adhesiolysis With Mcc 24 21 — — $29,784.92 $139,942.95 $32,614.49 2025-07-30
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 24 21 — — $36,406.25 $174,247.02 $39,864.85 2025-07-30
791 MS_DRG Prematurity With Major Problems 24 21 — — $33,038.93 $156,801.46 $36,177.63 2025-07-30
665 MS_DRG Prostatectomy With Mcc 24 21 — — $28,370.01 $132,612.50 $31,065.17 2025-07-30
332 MS_DRG Rectal Resection With Mcc 24 21 — — $28,631.67 $133,968.13 $31,351.68 2025-07-30
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 24 21 — — $50,984.78 $249,776.20 $55,828.34 2025-07-30
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 37 23 — — $22,147.00 $132,288.07 $30,710.00 2025-07-30
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 37 23 — — $22,147.00 $196,763.64 $42,790.00 2025-07-30
33287 HCPCS Rmv&rplcmt Phrnc Nrv Stim Pg 35 32 — — $546.77 $56,589.24 $30,588.78 2025-07-30
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 24 21 — — $54,632.40 $268,673.94 $59,822.48 2025-07-30
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 26 21 — — $61,869.48 $306,168.18 $68,365.78 2025-07-30
8 MS_DRG Simultaneous Pancreas/kidney Transplant 26 21 — — $43,335.45 $430,374.00 $47,885.68 2025-07-30
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 26 21 — — $31,937.86 $151,096.99 $35,291.34 2025-07-30
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 26 21 — — $41,166.11 $198,907.16 $45,488.56 2025-07-30
Q2043 HCPCS Sipuleucel-t-lactated Ringers 50 Million Cell/250 Ml Susp 250 Ml Bag 111 69 $172,980.00 — $6,281.00 $147,033.00 $69,192.00 2025-07-30
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 21 — — $42,994.02 $208,377.28 $47,078.46 2025-07-30
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 24 21 — — $28,603.34 $133,821.37 $31,320.66 2025-07-30
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 24 21 — — $48,681.26 $237,842.00 $53,305.99 2025-07-30
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 24 21 — — $30,669.06 $144,523.52 $33,582.62 2025-07-30
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 24 21 — — $31,556.92 $149,123.40 $34,554.83 2025-07-30
187001050 NDC Sodium Benzoate-sodium Phenylacetate 10-10 % Soln 50 Ml Vial 78 52 $142,640.39 — $682.69 $121,244.33 $85,584.23 2025-07-30
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 21 — — $65,909.22 $327,097.44 $72,170.60 2025-07-30
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 37 23 — — $25,593.00 $221,667.11 $48,375.00 2025-07-30
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 24 21 — — $34,963.00 $166,769.80 $38,284.49 2025-07-30
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 24 21 — — $27,796.74 $129,642.47 $30,437.43 2025-07-30
28 MS_DRG Spinal Procedures With Mcc 24 21 — — $48,094.57 $234,802.45 $52,663.56 2025-07-30
799 MS_DRG Splenic Procedures With Mcc 24 21 — — $38,219.24 $183,639.89 $41,850.07 2025-07-30
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 21 — — $40,636.08 $196,161.14 $44,496.51 2025-07-30
J9226 HCPCS Supprelin La Implant 55 31 — — $15,400.68 $150,556.09 $49,885.24 2025-07-30
12 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Cc 24 21 — — $33,365.45 $158,493.10 $36,535.17 2025-07-30
11 MS_DRG Tracheostomy For Face,mouth & Neck Diagnoses W Mcc 24 21 — — $42,998.49 $208,400.45 $47,083.35 2025-07-30
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 24 21 — — $108,109.14 $545,728.86 $118,379.51 2025-07-30
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 24 21 — — $40,071.75 $193,237.45 $43,878.57 2025-07-30
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 24 21 — — $32,127.21 $152,077.99 $35,179.30 2025-07-30
739 MS_DRG Uterine,adnexa Proc For Non-ovarian/adnexal Malig W Mcc 24 21 — — $32,450.00 $153,750.32 $35,532.76 2025-07-30
31 MS_DRG Ventricular Shunt Procedures With Mcc 24 21 — — $34,013.27 $161,849.35 $37,244.54 2025-07-30
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 24 21 — — $43,036.51 $208,597.42 $47,124.98 2025-07-30
901 MS_DRG Wound Debridements For Injuries With Mcc 24 21 — — $35,801.66 $171,114.77 $39,202.82 2025-07-30
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