Price Transparency Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

Export CSV
Hospital

HCA FLORIDA FAWCETT HOSPITAL

Port Charlotte, FL · CCN 100236 · Rates published

30,796 distinct procedures filed
43 distinct payers
743,589 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

367,412 of 743,589 rate rows are consumer-grade (49.4%)

376,177 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 361,864
per-diem day rate — not a per-procedure price 12,016
template filing: same amount across many unrelated codes — excluded 2,146
placeholder amount (≤ $0.02) — excluded from medians 89
exceeds 10× this hospital's gross charge — excluded from medians 62

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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/65-0252846_HCA-FLORIDA-FAWCETT-HOSPITAL_standardcharges.json?si=pt-json-access-policy&spr=https&sv=2024-11-04&sr=c&sig=o5IofreS%2F7ETlsnhPakPWCwHVVUZRobywQ5wUKGjVuQ%3D
Found on page https://www.hcafloridahealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaCMS hospital list
Last fetch success · 2026-06-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 16 $3,672,900.00 $4,040,190.00 $3,856,545.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 16 $3,605,000.00 $3,965,500.00 $3,785,250.00 nat. median
$3,605,000
1.1× 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 17 $5,283.24 $3,658,000.50 $3,491,727.75 nat. median
$13,041
outlier · 267.7×
748
OTHER 		Inj, Lovotibeglogene Auto 17 $8,714.69 $3,614,600.00 $3,450,300.00 nat. median
$17,963
outlier · 192.1×
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 17 $7,740.38 $3,264,800.00 $3,116,400.00 nat. median
$21,896
outlier · 142.3×
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 16 $2,388,614.00 $2,627,475.40 $2,508,044.70 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 16 $529,192.90 $582,112.19 $555,652.55 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 16 $527,123.40 $579,835.74 $553,479.57 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 16 $526,587.60 $579,246.36 $552,916.98 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 16 $516,726.10 $568,398.71 $542,562.41 nat. median
$562,201
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 16 $489,456.00 $538,401.60 $513,928.80 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 $1,125,423.00 $502,693.77 nat. median
$754,974
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$534,091
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $1,091,527.05 $492,271.12 nat. median
$675,122
0.7× median
9391
OTHER 		Brexucabtagene Car Pos T 16 $460,530.40 $506,583.44 $483,556.92 nat. median
$489,450
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$505,583
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $1,082,427.24 $470,149.30 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $1,067,238.95 $459,839.17 nat. median
$674,188
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$464,978
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $1,051,644.36 $445,599.57 nat. median
$634,511
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $966,296.00 $435,956.80 nat. median
$620,080
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $6,771.00 $961,233.00 $269,673.23 nat. median
$370,174
0.7× median
5834
APR_DRG 		Neonate With Ecmo 12 $192,207.00 $288,310.50 $230,648.40 nat. median
$309,665
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 25 $9,746.00 $717,961.54 $201,423.59 nat. median
$265,286
0.8× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $179,080.04 $179,080.04 $179,080.04 nat. median
$263,894
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 24 $9,000.00 $604,694.17 $169,646.47 nat. median
$206,368
0.8× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $156,515.70 $156,515.70 $156,515.70 nat. median
$76,377
outlier · 2.0×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 24 $9,000.00 $611,222.62 $154,768.99 nat. median
$202,986
0.8× median
1908
OTHER 		New Technology - Level 52 16 $147,339.90 $162,073.89 $154,706.89 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 16 $147,339.90 $162,073.89 $154,706.89 nat. median
$153,199
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 12 $125,393.00 $188,089.50 $150,471.60 nat. median
$246,434
0.6× median
5833
APR_DRG 		Neonate With Ecmo 12 $124,517.00 $186,775.50 $149,420.40 nat. median
$244,017
0.6× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $147,767.38 $147,767.38 $147,767.38 nat. median
$424,868
outlier · 0.3×
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$84,819
1.7× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$82,736
1.7× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 $140,774.65 $140,774.65 $140,774.65 nat. median
$62,507
outlier · 2.3×
1905
OTHER 		New Technology - Level 51 16 $132,847.50 $146,132.25 $139,489.88 nat. median
$137,903
1.0× median
1906
OTHER 		New Technology - Level 51 16 $132,847.50 $146,132.25 $139,489.88 nat. median
$138,020
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 12 $111,047.00 $166,570.50 $133,256.40 nat. median
$234,738
0.6× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median
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 30,796 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
             
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
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
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 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
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
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $179,080.04 $179,080.04 $179,080.04 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $147,767.38 $147,767.38 $147,767.38 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
01906 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $119,947.87 $119,947.87 $119,947.87 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
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
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $84,338.21 $84,338.21 $84,338.21 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $78,364.71 $78,364.71 $78,364.71 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $76,315.77 $76,315.77 $76,315.77 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
007 OTHER Lung Transplant 1 1 — — $67,614.48 $67,614.48 $67,614.48 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $67,491.82 $67,491.82 $67,491.82 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $62,462.84 $62,462.84 $62,462.84 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 — — $57,567.93 $57,567.93 $57,567.93 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $55,478.27 $55,478.27 $55,478.27 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $55,351.63 $55,351.63 $55,351.63 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 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
215 OTHER Other Heart Assist System Implant 1 1 — — $51,479.22 $51,479.22 $51,479.22 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $49,831.52 $49,831.52 $49,831.52 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $49,554.43 $49,554.43 $49,554.43 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $45,171.50 $45,171.50 $45,171.50 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $44,732.51 $44,732.51 $44,732.51 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $44,061.62 $44,061.62 $44,061.62 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $43,361.42 $43,361.42 $43,361.42 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $42,848.94 $42,848.94 $42,848.94 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $42,073.26 $42,073.26 $42,073.26 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $41,112.36 $41,112.36 $41,112.36 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $37,971.91 $37,971.91 $37,971.91 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $37,968.43 $37,968.43 $37,968.43 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $37,883.02 $37,883.02 $37,883.02 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $37,821.44 $37,821.44 $37,821.44 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $37,584.57 $37,584.57 $37,584.57 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $37,397.85 $37,397.85 $37,397.85 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $37,266.75 $37,266.75 $37,266.75 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $156,515.70 $156,515.70 $156,515.70 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 1 — — $140,774.65 $140,774.65 $140,774.65 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $100,053.67 $100,053.67 $100,053.67 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $50,561.89 $50,561.89 $50,561.89 2024-10-01
C2616 HCPCS Brachytx Ns Yttrium 90 2 1 $47,949.00 $47,949.00 $40,208.00 $53,804.00 $47,006.00 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 2 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 2 1 — — $37,108.68 $37,108.68 $37,108.68 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 3 2 — — $53,789.99 $119,352.48 $119,352.48 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $63,606.00 $102,063.00 $102,063.00 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $63,606.00 $102,063.00 $102,063.00 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $63,606.00 $102,063.00 $102,063.00 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $63,606.00 $102,063.00 $102,063.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $62,579.00 $100,416.00 $100,416.00 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $62,579.00 $100,416.00 $100,416.00 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $10,614.00 $75,435.00 $75,435.00 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 2 — — $10,614.00 $62,710.00 $62,710.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 3 1 — — $34,659.00 $55,615.00 $55,615.00 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $34,659.00 $55,615.00 $55,615.00 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 3 1 — — $33,290.00 $53,419.00 $53,419.00 2024-10-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 3 1 — — $33,290.00 $53,419.00 $53,419.00 2024-10-01
0294T CPT HInsertion Of Left Atrial Hemodynamic Monitor; Pressure Sensor Lead At Time Of I… 3 1 — — $19,926.00 $49,364.00 $45,326.00 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 3 — — $470,149.30 $1,082,427.24 $470,149.30 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 3 — — $502,693.77 $1,125,423.00 $502,693.77 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 6 3 — — $492,271.12 $1,091,527.05 $492,271.12 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 6 3 — — $459,839.17 $1,067,238.95 $459,839.17 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 6 3 — — $445,599.57 $1,051,644.36 $445,599.57 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 6 3 — — $435,956.80 $966,296.00 $435,956.80 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $61,600.24 $136,523.56 $61,600.24 2024-10-01
B0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 6 — — $42,922.73 $54,189.95 $53,653.41 2024-10-01
B0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 6 6 — — $42,481.90 $53,633.40 $53,102.37 2024-10-01
B0106 OTHER Stroke; M > 30.05 & M < 34.25 6 6 — — $40,934.05 $51,679.24 $51,167.57 2024-10-01
C0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 6 — — $38,170.75 $48,190.57 $47,713.44 2024-10-01
B0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 6 6 — — $37,160.92 $46,915.66 $46,451.15 2024-10-01
D0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 6 — — $37,053.88 $46,780.53 $46,317.35 2024-10-01
B0105 OTHER Stroke; M > 34.25 & M < 38.85 6 6 — — $35,989.12 $45,436.27 $44,986.40 2024-10-01
C0106 OTHER Stroke; M > 30.05 & M < 34.25 6 6 — — $35,500.40 $44,819.26 $44,375.51 2024-10-01
B1903 OTHER Guillian Barre; M < 18.05 6 6 — — $35,370.83 $44,655.67 $44,213.54 2024-10-01
B0604 OTHER Neurological; M < 25.85 6 6 — — $35,075.06 $44,282.27 $43,843.83 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $43,241.44 $94,940.24 $43,241.44 2024-10-01
B0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 6 6 — — $34,134.25 $43,094.49 $42,667.81 2024-10-01
A0404 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 6 6 — — $33,669.47 $42,507.71 $42,086.84 2024-10-01
A5104 OTHER Expired, Not Orthopedic, Length Of Stay Is 16 Days 6 6 — — $33,568.06 $42,379.68 $41,960.08 2024-10-01
C0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 6 6 — — $33,049.77 $41,725.33 $41,312.21 2024-10-01
B0704 OTHER Fracture Of Lower Extremity; M < 28.15 6 6 — — $32,777.95 $41,382.16 $40,972.43 2024-10-01
B2102 OTHER Burns; M=12-45 6 6 — — $32,641.33 $41,209.68 $40,801.66 2024-10-01
D0106 OTHER Stroke; M > 30.05 & M < 34.25 6 6 — — $32,441.34 $40,957.19 $40,551.67 2024-10-01
B1004 OTHER Amputation, Lower Extremity; M=39-45 6 6 — — $32,408.94 $40,916.29 $40,511.18 2024-10-01
B1504 OTHER Pulmonary; M < 29.15 6 6 — — $32,032.90 $40,441.53 $40,041.12 2024-10-01
B1704 OTHER Major Multiple Trauma,no Brain Or Spinal Cord Inju 6 6 — — $31,468.12 $39,728.51 $39,335.16 2024-10-01
B2005 OTHER Miscellaneous; M=12-32 And A Tm81 6 6 — — $31,283.62 $39,495.57 $39,104.53 2024-10-01
D0505 OTHER Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 6 6 — — $31,223.06 $39,419.11 $39,028.83 2024-10-01
C0105 OTHER Stroke; M > 34.25 & M < 38.85 6 6 — — $31,211.79 $39,404.89 $39,014.74 2024-10-01
A0106 OTHER Stroke; M > 30.05 & M < 34.25 6 6 — — $30,916.03 $39,031.48 $38,645.03 2024-10-01
B1204 OTHER Osteoarthritis; M=39-47 6 6 — — $30,755.47 $38,828.78 $38,444.34 2024-10-01
C0205 OTHER Traumatic Brain Injury; M > 28.75 & M < 40.65 6 6 — — $30,606.18 $38,640.30 $38,257.72 2024-10-01
B0504 OTHER Nontraumatic Spinal Cord Injury; M > 29.25 & M < 3 6 6 — — $30,572.38 $38,597.62 $38,215.47 2024-10-01
B0304 OTHER Nontraumatic Brain Injury; M < 26.15 6 6 — — $30,451.25 $38,444.71 $38,064.06 2024-10-01
C0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 6 6 — — $30,355.48 $38,323.79 $37,944.35 2024-10-01
B1404 OTHER Cardiac; M < 31.15 6 6 — — $30,221.68 $38,154.87 $37,777.10 2024-10-01
B1304 OTHER Rheumatoid, Other Arthritis; M=12-35 6 6 — — $30,162.53 $38,080.19 $37,703.16 2024-10-01
B0904 OTHER Other Orthopedic; M < 24.15 6 6 — — $30,162.53 $38,080.19 $37,703.16 2024-10-01
B2004 OTHER Miscellaneous; M < 27.85 6 6 — — $29,679.44 $37,470.30 $37,099.30 2024-10-01
D0405 OTHER Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 6 6 — — $29,466.77 $37,201.80 $36,833.47 2024-10-01
G0448 HCPCS Insertion Or Replacement Of A Permanent Pacing Cardioverter-defibrillator System… 12 5 — — $5,395.00 $59,261.00 $39,229.50 2024-10-01
5834 APR_DRG Neonate With Ecmo 15 12 — — $192,207.00 $288,310.50 $230,648.40 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $125,393.00 $188,089.50 $150,471.60 2024-10-01
5833 APR_DRG Neonate With Ecmo 15 12 — — $124,517.00 $186,775.50 $149,420.40 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 15 12 — — $111,047.00 $166,570.50 $133,256.40 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 12 — — $97,644.00 $146,466.00 $117,172.80 2024-10-01
5832 APR_DRG Neonate With Ecmo 15 12 — — $95,607.00 $143,410.50 $114,728.40 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 15 12 — — $95,167.00 $142,750.50 $114,200.40 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 12 — — $91,470.00 $137,205.00 $109,764.00 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 15 12 — — $90,217.00 $135,325.50 $108,260.40 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 15 12 — — $82,446.00 $123,669.00 $98,935.20 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $81,552.00 $122,328.00 $97,862.40 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 15 12 — — $80,942.00 $121,413.00 $97,130.40 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 12 — — $79,657.00 $119,485.50 $95,588.40 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 15 12 — — $75,611.00 $113,416.50 $90,733.20 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 12 — — $75,232.00 $112,848.00 $90,278.40 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 12 — — $73,863.00 $110,794.50 $88,635.60 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $71,560.00 $107,340.00 $85,872.00 2024-10-01
5831 APR_DRG Neonate With Ecmo 15 12 — — $69,493.00 $104,239.50 $83,391.60 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 15 12 — — $68,321.00 $102,481.50 $81,985.20 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 15 12 — — $67,242.00 $100,863.00 $80,690.40 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 12 — — $66,782.00 $100,173.00 $80,138.40 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 15 12 — — $64,392.00 $96,588.00 $77,270.40 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 15 12 — — $62,352.00 $93,528.00 $74,822.40 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $61,338.00 $92,007.00 $73,605.60 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 12 — — $59,125.00 $88,687.50 $70,950.00 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 12 — — $56,946.00 $85,419.00 $68,335.20 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 15 12 — — $55,523.00 $83,284.50 $66,627.60 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $54,849.00 $82,273.50 $65,818.80 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 15 12 — — $51,688.00 $77,532.00 $62,025.60 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 12 — — $51,226.00 $76,839.00 $61,471.20 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 15 12 — — $49,247.00 $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 15 12 — — $48,983.00 $73,474.50 $58,779.60 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 12 — — $48,895.00 $73,342.50 $58,674.00 2024-10-01
64 APR_DRG Pancreas Transplant 15 12 — — $48,372.00 $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 15 12 — — $47,538.00 $71,307.00 $57,045.60 2024-10-01
8514 APR_DRG Gender Related Procedures 15 12 — — $46,902.00 $70,353.00 $56,282.40 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 12 — — $46,525.00 $69,787.50 $55,830.00 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 15 12 — — $46,203.00 $69,304.50 $55,443.60 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 15 12 — — $45,376.00 $68,064.00 $54,451.20 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 12 — — $44,835.00 $67,252.50 $53,802.00 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 12 — — $43,677.00 $65,515.50 $52,412.40 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 15 12 — — $43,560.00 $65,340.00 $52,272.00 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $42,035.00 $63,052.50 $50,442.00 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 12 — — $41,957.00 $62,935.50 $50,348.40 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 12 — — $41,876.00 $62,814.00 $50,251.20 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 15 12 — — $41,730.00 $62,595.00 $50,076.00 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 15 12 — — $39,878.00 $59,817.00 $47,853.60 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $38,906.00 $58,359.00 $46,687.20 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 15 12 — — $37,904.00 $56,856.00 $45,484.80 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 15 12 — — $37,476.00 $56,214.00 $44,971.20 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 15 12 — — $36,953.00 $55,429.50 $44,343.60 2024-10-01
4404 APR_DRG Kidney Transplant 15 12 — — $35,422.00 $53,133.00 $42,506.40 2024-10-01
8634 APR_DRG Neonatal Aftercare 15 12 — — $35,009.00 $52,513.50 $42,010.80 2024-10-01
63 APR_DRG Pancreas Transplant 15 12 — — $34,364.00 $51,546.00 $41,236.80 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 15 12 — — $34,228.00 $51,342.00 $41,073.60 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 15 12 — — $34,068.00 $51,102.00 $40,881.60 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 12 — — $32,422.00 $48,633.00 $38,906.40 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 15 12 — — $31,789.00 $47,683.50 $38,146.80 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 15 12 — — $31,574.00 $47,361.00 $37,888.80 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 15 12 — — $31,456.00 $47,184.00 $37,747.20 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $31,113.00 $46,669.50 $37,335.60 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 15 12 — — $30,783.00 $46,174.50 $36,939.60 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 18 16 — — $3,672,900.00 $4,040,190.00 $3,856,545.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 18 16 — — $3,605,000.00 $3,965,500.00 $3,785,250.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 18 16 — — $2,388,614.00 $2,627,475.40 $2,508,044.70 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 18 16 — — $529,192.90 $582,112.19 $555,652.55 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 18 16 — — $527,123.40 $579,835.74 $553,479.57 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 18 16 — — $526,587.60 $579,246.36 $552,916.98 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 18 16 — — $516,726.10 $568,398.71 $542,562.41 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 18 16 — — $489,456.00 $538,401.60 $513,928.80 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 18 16 — — $460,530.40 $506,583.44 $483,556.92 2024-10-01
1907 OTHER New Technology - Level 52 18 16 — — $147,339.90 $162,073.89 $154,706.89 2024-10-01
1908 OTHER New Technology - Level 52 18 16 — — $147,339.90 $162,073.89 $154,706.89 2024-10-01
1906 OTHER New Technology - Level 51 18 16 — — $132,847.50 $146,132.25 $139,489.88 2024-10-01
1905 OTHER New Technology - Level 51 18 16 — — $132,847.50 $146,132.25 $139,489.88 2024-10-01
1904 OTHER New Technology - Level 50 18 16 — — $118,355.10 $130,190.61 $124,272.86 2024-10-01
1903 OTHER New Technology - Level 50 18 16 — — $118,355.10 $130,190.61 $124,272.86 2024-10-01
1901 OTHER New Technology - Level 49 18 16 — — $103,862.70 $114,248.97 $109,055.84 2024-10-01
1902 OTHER New Technology - Level 49 18 16 — — $103,862.70 $114,248.97 $109,055.84 2024-10-01
1585 OTHER New Technology - Level 48 18 16 — — $91,785.68 $100,964.25 $96,374.96 2024-10-01
1599 OTHER New Technology - Level 48 18 16 — — $91,785.68 $100,964.25 $96,374.96 2024-10-01
1598 OTHER New Technology - Level 47 18 16 — — $82,124.09 $90,336.50 $86,230.29 2024-10-01
1584 OTHER New Technology - Level 47 18 16 — — $82,124.09 $90,336.50 $86,230.29 2024-10-01
1597 OTHER New Technology - Level 46 18 16 — — $72,462.48 $79,708.73 $76,085.60 2024-10-01
1583 OTHER New Technology - Level 46 18 16 — — $72,462.48 $79,708.73 $76,085.60 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 18 16 — — $65,476.58 $72,024.24 $68,750.41 2024-10-01
1596 OTHER New Technology - Level 45 18 16 — — $62,800.88 $69,080.97 $65,940.92 2024-10-01
1582 OTHER New Technology - Level 45 18 16 — — $62,800.88 $69,080.97 $65,940.92 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 18 16 — — $55,015.23 $60,516.75 $57,765.99 2024-10-01
1581 OTHER New Technology - Level 44 18 16 — — $53,139.28 $58,453.21 $55,796.24 2024-10-01
1595 OTHER New Technology - Level 44 18 16 — — $53,139.28 $58,453.21 $55,796.24 2024-10-01
5244 OTHER Level 4 Blood Product Exc 18 16 — — $50,304.25 $55,334.68 $52,819.46 2024-10-01
1142 OTHER Supprelin La Implant 18 16 — — $45,350.21 $49,885.23 $47,617.72 2024-10-01
1594 OTHER New Technology - Level 43 18 16 — — $43,477.68 $47,825.45 $45,651.56 2024-10-01
1580 OTHER New Technology - Level 43 18 16 — — $43,477.68 $47,825.45 $45,651.56 2024-10-01
714 OTHER Inj Delandistrogene Mox R 19 17 — — $5,283.24 $3,658,000.50 $3,491,727.75 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 19 17 — — $8,714.69 $3,614,600.00 $3,450,300.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 19 17 — — $7,740.38 $3,264,800.00 $3,116,400.00 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 19 17 — — $96,999.90 $109,999.89 $104,999.90 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 19 17 — — $88,300.94 $100,135.09 $95,583.49 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 19 17 — — $63,895.55 $72,458.87 $69,165.29 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 19 17 — — $12,661.11 $69,690.25 $66,522.51 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 19 17 — — $46,068.21 $52,242.30 $49,867.65 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 19 17 — — $37,140.82 $42,118.45 $40,203.97 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 19 17 — — $36,570.46 $41,471.65 $39,586.58 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 42 25 — — $11,098.00 $54,201.00 $42,114.01 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 43 24 — — $6,771.00 $961,233.00 $269,673.23 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 43 24 — — $6,771.00 $344,081.49 $94,614.76 2024-10-01
7 MS_DRG Lung Transplant 43 24 — — $9,746.00 $333,100.77 $94,376.43 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 43 24 — — $9,746.00 $349,726.67 $76,904.24 2024-10-01
10 MS_DRG Pancreas Transplant 43 24 — — $9,746.00 $203,221.57 $57,578.15 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 43 24 — — $9,746.00 $202,051.58 $57,246.66 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 43 24 — — $6,771.00 $344,081.49 $43,588.40 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 43 24 — — $6,771.00 $344,081.49 $43,588.40 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 43 24 — — $9,746.00 $178,108.32 $39,293.48 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 45 25 — — $9,746.00 $717,961.54 $201,423.59 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 45 24 — — $9,000.00 $604,694.17 $169,646.47 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 45 24 — — $9,000.00 $611,222.62 $154,768.99 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 45 24 — — $9,000.00 $366,848.24 $102,040.39 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 45 25 — — $9,746.00 $393,686.48 $80,364.56 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 45 24 — — $9,000.00 $170,234.96 $47,759.29 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 46 26 — — $6,771.00 $164,861.67 $45,816.77 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 46 26 — — $6,771.00 $140,880.68 $39,152.21 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 47 26 — — $9,000.00 $328,484.81 $78,670.02 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 47 26 — — $9,746.00 $319,667.84 $75,698.16 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 47 26 — — $9,000.00 $280,926.23 $66,524.05 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 47 26 — — $10,614.00 $215,864.61 $61,759.88 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 47 26 — — $9,746.00 $254,353.32 $60,822.03 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 47 26 — — $10,799.00 $220,210.81 $59,983.00 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 47 26 — — $9,000.00 $190,249.71 $53,374.42 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 47 26 — — $9,746.00 $216,496.15 $51,769.46 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 47 26 — — $9,000.00 $213,400.61 $49,311.12 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 47 26 — — $9,746.00 $204,464.69 $48,892.44 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 47 26 — — $10,799.00 $109,888.00 $48,622.61 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 47 26 — — $9,000.00 $161,196.21 $45,671.23 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 47 26 — — $9,746.00 $157,885.06 $45,171.66 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 47 26 — — $9,746.00 $188,660.63 $45,113.31 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 47 26 — — $10,799.00 $154,956.26 $43,903.29 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 47 26 — — $9,000.00 $156,962.32 $43,599.66 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 47 26 — — $9,000.00 $148,400.23 $41,633.57 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 47 26 — — $10,799.00 $220,210.81 $41,483.61 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 47 26 — — $9,746.00 $167,897.59 $40,148.37 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 47 26 — — $9,746.00 $166,827.11 $39,892.39 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 47 26 — — $9,000.00 $142,086.36 $39,862.23 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 47 26 — — $9,000.00 $138,369.92 $39,203.93 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 47 26 — — $9,000.00 $137,533.84 $38,585.02 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 47 26 — — $9,746.00 $137,663.84 $38,277.34 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 47 26 — — $9,000.00 $137,516.00 $38,198.03 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 47 26 — — $10,799.00 $107,140.00 $38,159.37 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 47 26 — — $9,746.00 $157,055.55 $37,191.16 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 48 27 — — $10,799.00 $224,739.76 $63,594.73 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 48 27 — — $10,799.00 $224,739.76 $46,492.88 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 48 26 — — $10,799.00 $274,238.02 $46,443.78 2024-10-01
215 MS_DRG Other Heart Assist System Implant 49 27 — — $6,000.00 $355,237.65 $79,511.81 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 27 — — $10,799.00 $223,095.92 $72,428.38 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 27 — — $10,799.00 $223,095.92 $49,835.84 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 49 27 — — $10,799.00 $223,095.92 $45,912.97 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 56 31 — — $10,799.00 $145,789.59 $43,220.42 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 31 — — $10,799.00 $193,320.72 $64,256.42 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 57 32 — — $8,000.00 $61,568.47 $47,777.14 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 31 — — $10,799.00 $193,320.72 $45,002.66 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 31 — — $10,799.00 $193,320.72 $39,020.77 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 58 32 — — $10,799.00 $188,929.01 $62,796.69 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 58 32 — — $9,746.00 $214,577.83 $57,163.41 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 58 32 — — $10,799.00 $155,478.80 $50,836.54 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 58 32 — — $10,799.00 $143,944.46 $46,783.88 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 58 32 — — $10,614.00 $154,743.80 $46,424.79 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 58 32 — — $10,799.00 $156,424.48 $46,187.64 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 58 32 — — $10,799.00 $145,412.80 $45,189.73 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 58 32 — — $10,799.00 $116,230.93 $38,315.85 2024-10-01
See an error in this hospital's data? Submit a correction