Price Transparencybeta Hospital negotiated rates

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

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Hospital

HCA FLORIDA NORTHSIDE HOSPITAL

Saint Petersburg, FL · CCN 100238 · Rates published

34,459 distinct procedures filed
58 distinct payers
1,489,038 rate rows
2026-07-31 last MRF observed
Data quality

1,459,854 of 1,489,038 rate rows are consumer-grade (98.0%)

29,184 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
per-diem day rate — not a per-procedure price 12,191
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8,148
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 7,765
template filing: same amount across many unrelated codes — excluded 433
placeholder amount (≤ $0.02) — excluded from medians 331
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 195
percent-of-charges filed in the dollar field — excluded from medians 52
exceeds 10× this hospital's gross charge — excluded from medians 44
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 25
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hcah-p-001-delivery.stylelabs.cloud/api/public/content/4d1df53db98440c9805fe2984a700913
Found on page https://www.hcafloridahealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-08-03
Content fingerprint e645fc345b177bdc… · 3,900,072 bytes · first seen 2026-07-31

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 21 $3,672,900.00 $4,407,480.00 $3,856,545.00 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 21 $3,605,000.00 $4,326,000.00 $3,785,250.00 nat. median
$3,646,097
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 23 $5,657.11 $4,821,909.75 $3,491,727.75 nat. median
$3,325,455
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 23 $9,331.39 $4,764,700.00 $3,450,300.00 nat. median
$3,252,508
1.1× median
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 23 $8,288.13 $4,303,600.00 $3,116,400.00 nat. median
$2,939,969
1.1× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 22 $2,388,614.00 $3,463,490.30 $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
$2,511,312
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 22 $529,192.90 $767,329.70 $555,652.55 nat. median
$576,820
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 22 $527,123.40 $764,328.93 $553,479.57 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 22 $526,587.60 $763,552.02 $552,916.98 nat. median
$560,872
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 22 $516,726.10 $749,252.84 $542,562.41 nat. median
$562,201
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 22 $489,456.00 $709,711.20 $513,928.80 nat. median
$533,230
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $513,317.11 $513,317.11 nat. median
$549,535
0.9× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$570,020
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$541,339
0.9× 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
$691,418
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$545,335
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
$631,793
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 22 $460,530.40 $667,769.08 $483,556.92 nat. median
$492,768
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$516,226
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
$610,161
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
$624,417
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$474,767
0.9× 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
$588,565
0.8× 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
$577,541
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 32 $6,771.00 $832,980.61 $295,210.98 nat. median
$370,165
0.8× median
5834
APR_DRG 		Neonate With Ecmo 13 $192,207.00 $288,310.50 $226,804.26 nat. median
$311,018
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 32 $9,780.00 $622,167.61 $220,769.03 nat. median
$261,939
0.8× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $191,752.51 $191,752.51 $191,752.51 nat. median
$214,447
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 30 $9,780.00 $524,012.93 $186,108.86 nat. median
$205,166
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 33 $9,780.00 $654,271.54 $169,892.12 nat. median
$199,832
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $158,224.17 $158,224.17 $158,224.17 nat. median
$292,434
0.5× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $156,515.70 $156,515.70 $156,515.70 nat. median
$75,807
outlier · 2.1×
1908
OTHER 		New Technology - Level 52 22 $147,339.90 $213,642.85 $154,706.89 nat. median
$155,877
1.0× median
1907
OTHER 		New Technology - Level 52 22 $147,339.90 $213,642.85 $154,706.89 nat. median
$155,877
1.0× median
802002
CDM 		Kit Hrt Implant Lvas 7 $16,558.23 $276,973.99 $150,529.35 nat. median
$9,040
outlier · 16.7×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 13 $125,393.00 $188,089.50 $147,963.74 nat. median
$254,667
0.6× median
5833
APR_DRG 		Neonate With Ecmo 13 $124,517.00 $186,775.50 $146,930.06 nat. median
$250,089
0.6× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$85,250
1.7× median
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$85,034
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
$63,643
outlier · 2.2×
1905
OTHER 		New Technology - Level 51 22 $132,847.50 $192,628.88 $139,489.88 nat. median
$140,545
1.0× median
1906
OTHER 		New Technology - Level 51 22 $132,847.50 $192,628.88 $139,489.88 nat. median
$140,545
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 13 $111,047.00 $166,570.50 $131,035.46 nat. median
$243,231
0.5× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$84,819
1.5× median

Other procedures at this hospital

Browse this hospital's 34,459 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
             
9138 OTHER Inj, Hemgenix, Per Tx Dos 24 21 — — $3,672,900.00 $4,407,480.00 $3,856,545.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 24 21 — — $3,605,000.00 $4,326,000.00 $3,785,250.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 26 23 — — $5,657.11 $4,821,909.75 $3,491,727.75 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 26 23 — — $9,331.39 $4,764,700.00 $3,450,300.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 26 23 — — $8,288.13 $4,303,600.00 $3,116,400.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 25 22 — — $2,388,614.00 $3,463,490.30 $2,508,044.70 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 25 22 — — $529,192.90 $767,329.70 $555,652.55 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 25 22 — — $527,123.40 $764,328.93 $553,479.57 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 25 22 — — $526,587.60 $763,552.02 $552,916.98 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 25 22 — — $516,726.10 $749,252.84 $542,562.41 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 25 22 — — $489,456.00 $709,711.20 $513,928.80 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 3 — — $502,693.77 $1,125,423.00 $502,693.77 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
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
9391 OTHER Brexucabtagene Car Pos T 25 22 — — $460,530.40 $667,769.08 $483,556.92 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 3 — — $470,149.30 $1,082,427.24 $470,149.30 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
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 6 3 — — $445,599.57 $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
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 51 32 — — $6,771.00 $832,980.61 $295,210.98 2024-10-01
5834 APR_DRG Neonate With Ecmo 16 13 — — $192,207.00 $288,310.50 $226,804.26 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $191,752.51 $191,752.51 $191,752.51 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 51 30 — — $9,780.00 $524,012.93 $186,108.86 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 54 33 — — $9,780.00 $654,271.54 $169,892.12 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $158,224.17 $158,224.17 $158,224.17 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $156,515.70 $156,515.70 $156,515.70 2024-10-01
1908 OTHER New Technology - Level 52 25 22 — — $147,339.90 $213,642.85 $154,706.89 2024-10-01
1907 OTHER New Technology - Level 52 25 22 — — $147,339.90 $213,642.85 $154,706.89 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 16 13 — — $125,393.00 $188,089.50 $147,963.74 2024-10-01
5833 APR_DRG Neonate With Ecmo 16 13 — — $124,517.00 $186,775.50 $146,930.06 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
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
1905 OTHER New Technology - Level 51 25 22 — — $132,847.50 $192,628.88 $139,489.88 2024-10-01
1906 OTHER New Technology - Level 51 25 22 — — $132,847.50 $192,628.88 $139,489.88 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 16 13 — — $111,047.00 $166,570.50 $131,035.46 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $128,435.86 $128,435.86 $128,435.86 2024-10-01
1904 OTHER New Technology - Level 50 25 22 — — $118,355.10 $171,614.89 $124,272.86 2024-10-01
1903 OTHER New Technology - Level 50 25 22 — — $118,355.10 $171,614.89 $124,272.86 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
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 13 — — $97,644.00 $146,466.00 $115,219.92 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
5832 APR_DRG Neonate With Ecmo 16 13 — — $95,607.00 $143,410.50 $112,816.26 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 53 32 — — $9,780.00 $392,685.68 $112,379.42 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 16 13 — — $95,167.00 $142,750.50 $112,297.06 2024-10-01
1901 OTHER New Technology - Level 49 25 22 — — $103,862.70 $150,600.91 $109,055.84 2024-10-01
1902 OTHER New Technology - Level 49 25 22 — — $103,862.70 $150,600.91 $109,055.84 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 16 13 — — $91,470.00 $137,205.00 $107,934.60 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 16 13 — — $90,217.00 $135,325.50 $106,456.06 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 26 23 — — $96,999.90 $144,999.85 $104,999.90 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 50 31 — — $6,771.00 $368,315.44 $104,280.11 2024-10-01
7 MS_DRG Lung Transplant 50 31 — — $9,780.00 $310,695.25 $104,020.11 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $68,499.00 $102,063.00 $102,063.00 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 1 — — $68,499.00 $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 — — $68,499.00 $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 — — $68,499.00 $102,063.00 $102,063.00 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $100,746.82 $100,746.82 $100,746.82 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 1 — — $67,393.00 $100,416.00 $100,416.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $67,393.00 $100,416.00 $100,416.00 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $100,053.67 $100,053.67 $100,053.67 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 16 13 — — $82,446.00 $123,669.00 $97,286.28 2024-10-01
1599 OTHER New Technology - Level 48 25 22 — — $91,785.68 $133,089.24 $96,374.96 2024-10-01
1585 OTHER New Technology - Level 48 25 22 — — $91,785.68 $133,089.24 $96,374.96 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 16 13 — — $81,552.00 $122,328.00 $96,231.36 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 26 23 — — $88,300.94 $131,996.25 $95,583.49 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 16 13 — — $80,942.00 $121,413.00 $95,511.56 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 16 13 — — $79,657.00 $119,485.50 $93,995.26 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $90,306.37 $90,306.37 $90,306.37 2024-10-01
215 MS_DRG Other Heart Assist System Implant 57 35 — — $10,799.00 $380,257.34 $89,506.75 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 16 13 — — $75,611.00 $113,416.50 $89,220.98 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 52 32 — — $9,780.00 $421,414.16 $89,178.36 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 16 13 — — $75,232.00 $112,848.00 $88,773.76 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 56 35 — — $9,780.00 $351,620.27 $88,166.45 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 16 13 — — $73,863.00 $110,794.50 $87,158.34 2024-10-01
1584 OTHER New Technology - Level 47 25 22 — — $82,124.09 $119,079.93 $86,230.29 2024-10-01
1598 OTHER New Technology - Level 47 25 22 — — $82,124.09 $119,079.93 $86,230.29 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 50 31 — — $9,780.00 $374,358.21 $84,962.67 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $10,799.00 $342,182.31 $84,877.27 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 16 13 — — $71,560.00 $107,340.00 $84,440.80 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $83,910.15 $83,910.15 $83,910.15 2024-10-01
5831 APR_DRG Neonate With Ecmo 16 13 — — $69,493.00 $104,239.50 $82,001.74 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $81,716.22 $81,716.22 $81,716.22 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 16 13 — — $68,321.00 $102,481.50 $80,618.78 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 35 — — $10,799.00 $238,808.75 $79,367.23 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 16 13 — — $67,242.00 $100,863.00 $79,345.56 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 16 13 — — $66,782.00 $100,173.00 $78,802.76 2024-10-01
1583 OTHER New Technology - Level 46 25 22 — — $72,462.48 $105,070.60 $76,085.60 2024-10-01
1597 OTHER New Technology - Level 46 25 22 — — $72,462.48 $105,070.60 $76,085.60 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 16 13 — — $64,392.00 $96,588.00 $75,982.56 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $11,430.00 $75,435.00 $75,435.00 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 56 35 — — $9,780.00 $300,712.10 $73,640.71 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 16 13 — — $62,352.00 $93,528.00 $73,575.36 2024-10-01
007 OTHER Lung Transplant 1 1 — — $72,399.19 $72,399.19 $72,399.19 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 16 13 — — $61,338.00 $92,007.00 $72,378.84 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $72,267.86 $72,267.86 $72,267.86 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
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 16 13 — — $59,125.00 $88,687.50 $69,767.50 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 35 — — $10,799.00 $187,062.91 $69,322.54 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 26 23 — — $63,895.55 $95,513.96 $69,165.29 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 25 22 — — $65,476.58 $94,941.04 $68,750.41 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 56 35 — — $10,799.00 $272,267.64 $68,741.28 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 13 — — $56,946.00 $85,419.00 $67,196.28 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 56 35 — — $10,799.00 $235,720.44 $67,107.92 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $66,882.99 $66,882.99 $66,882.99 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 26 23 — — $13,557.07 $91,864.42 $66,522.51 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 56 35 — — $10,799.00 $202,235.44 $66,302.94 2024-10-01
1582 OTHER New Technology - Level 45 25 22 — — $62,800.88 $91,061.28 $65,940.92 2024-10-01
1596 OTHER New Technology - Level 45 25 22 — — $62,800.88 $91,061.28 $65,940.92 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 34 — — $10,799.00 $206,936.46 $65,675.92 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 16 13 — — $55,523.00 $83,284.50 $65,517.14 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 16 13 — — $54,849.00 $82,273.50 $64,721.82 2024-10-01
10 MS_DRG Pancreas Transplant 50 31 — — $9,780.00 $188,736.32 $63,883.14 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 2 — — $11,430.00 $62,710.00 $62,710.00 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $61,641.70 $61,641.70 $61,641.70 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
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 16 13 — — $51,688.00 $77,532.00 $60,991.84 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
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 16 13 — — $51,226.00 $76,839.00 $60,446.68 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 56 35 — — $9,780.00 $164,865.67 $59,580.90 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 56 35 — — $10,799.00 $229,690.73 $59,485.43 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $59,404.17 $59,404.17 $59,404.17 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $59,268.57 $59,268.57 $59,268.57 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $10,799.00 $231,744.16 $58,675.66 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 16 13 — — $49,247.00 $73,870.50 $58,111.46 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 16 13 — — $48,983.00 $73,474.50 $57,799.94 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 25 22 — — $55,015.23 $79,772.08 $57,765.99 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 13 — — $48,895.00 $73,342.50 $57,696.10 2024-10-01
64 APR_DRG Pancreas Transplant 16 13 — — $48,372.00 $72,558.00 $57,078.96 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 16 13 — — $47,538.00 $71,307.00 $56,094.84 2024-10-01
1581 OTHER New Technology - Level 44 25 22 — — $53,139.28 $77,051.96 $55,796.24 2024-10-01
1595 OTHER New Technology - Level 44 25 22 — — $53,139.28 $77,051.96 $55,796.24 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $37,326.00 $55,615.00 $55,615.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 3 1 — — $37,326.00 $55,615.00 $55,615.00 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 56 35 — — $10,799.00 $218,865.31 $55,476.68 2024-10-01
8514 APR_DRG Gender Related Procedures 16 13 — — $46,902.00 $70,353.00 $55,344.36 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $55,122.12 $55,122.12 $55,122.12 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 35 — — $10,799.00 $238,808.75 $55,003.27 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 16 13 — — $46,525.00 $69,787.50 $54,899.50 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 56 35 — — $9,780.00 $228,430.59 $54,866.04 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 55 35 — — $8,000.00 $68,479.24 $54,783.39 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 16 13 — — $46,203.00 $69,304.50 $54,519.54 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 56 35 — — $10,799.00 $109,888.00 $53,867.58 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 16 13 — — $45,376.00 $68,064.00 $53,543.68 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 3 1 — — $35,851.00 $53,419.00 $53,419.00 2024-10-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 3 1 — — $35,851.00 $53,419.00 $53,419.00 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $53,357.83 $53,357.83 $53,357.83 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 51 30 — — $9,780.00 $147,521.39 $53,162.82 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $53,061.12 $53,061.12 $53,061.12 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 16 13 — — $44,835.00 $67,252.50 $52,905.30 2024-10-01
5244 OTHER Level 4 Blood Product Exc 25 22 — — $50,304.25 $72,941.16 $52,819.46 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 56 35 — — $10,799.00 $162,919.86 $51,583.97 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
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 16 13 — — $43,677.00 $65,515.50 $51,538.86 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 55 35 — — $6,771.00 $142,865.03 $51,518.57 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 16 13 — — $43,560.00 $65,340.00 $51,400.80 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 56 35 — — $9,780.00 $201,948.16 $51,274.63 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 57 35 — — $10,799.00 $293,552.83 $51,108.19 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 56 35 — — $10,799.00 $135,553.57 $50,874.85 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 35 — — $10,799.00 $238,808.75 $50,763.73 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 56 35 — — $9,780.00 $147,161.64 $50,646.42 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $50,561.89 $50,561.89 $50,561.89 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 56 35 — — $10,799.00 $166,429.31 $50,219.08 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 26 23 — — $46,068.21 $68,864.85 $49,867.65 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 16 13 — — $42,035.00 $63,052.50 $49,601.30 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 16 13 — — $41,957.00 $62,935.50 $49,509.26 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 16 13 — — $41,876.00 $62,814.00 $49,413.68 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 16 13 — — $41,730.00 $62,595.00 $49,241.40 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 56 35 — — $10,799.00 $134,281.24 $48,967.56 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 56 35 — — $9,780.00 $136,019.64 $48,858.27 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 50 31 — — $6,771.00 $368,315.44 $48,624.11 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 50 31 — — $6,771.00 $368,315.44 $48,624.11 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $48,368.04 $48,368.04 $48,368.04 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 56 35 — — $10,799.00 $165,642.54 $48,103.74 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 41 29 — — $11,098.00 $58,714.72 $47,911.22 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $47,898.00 $47,898.00 $47,898.00 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 56 35 — — $10,799.00 $145,532.60 $47,712.90 2024-10-01
1142 OTHER Supprelin La Implant 25 22 — — $45,350.21 $65,757.80 $47,617.72 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 56 35 — — $10,799.00 $235,720.44 $47,245.65 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $47,179.63 $47,179.63 $47,179.63 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 16 13 — — $39,878.00 $59,817.00 $47,056.04 2024-10-01
534683 CDM Valve Aorta 29mm 16 10 $98,804.00 $98,804.00 $5,434.22 $90,899.68 $46,931.90 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 56 35 — — $9,780.00 $128,599.95 $46,711.43 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $46,429.88 $46,429.88 $46,429.88 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 16 13 — — $38,906.00 $58,359.00 $45,909.08 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $45,881.13 $45,881.13 $45,881.13 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 56 35 — — $10,799.00 $179,722.76 $45,754.07 2024-10-01
1580 OTHER New Technology - Level 43 25 22 — — $43,477.68 $63,042.64 $45,651.56 2024-10-01
1594 OTHER New Technology - Level 43 25 22 — — $43,477.68 $63,042.64 $45,651.56 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 56 35 — — $10,799.00 $154,082.59 $45,515.80 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 56 35 — — $10,799.00 $178,576.88 $45,469.44 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
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 55 34 — — $10,799.00 $206,936.46 $45,318.96 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $45,050.56 $45,050.56 $45,050.56 2024-10-01
507784 CDM Valve Aor 26mm 16 10 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $44,861.38 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 16 13 — — $37,904.00 $56,856.00 $44,726.72 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 16 13 — — $37,476.00 $56,214.00 $44,221.68 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 55 35 — — $6,771.00 $122,083.69 $44,180.31 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $44,021.66 $44,021.66 $44,021.66 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 50 31 — — $9,780.00 $190,652.64 $43,939.51 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 56 35 — — $9,780.00 $145,610.95 $43,841.82 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 16 13 — — $36,953.00 $55,429.50 $43,604.54 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 56 35 — — $9,780.00 $119,183.41 $43,369.82 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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 56 35 — — $10,799.00 $109,723.00 $42,937.79 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 56 35 — — $9,780.00 $119,167.95 $42,937.08 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 54 34 — — $10,799.00 $156,057.67 $42,705.01 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 56 35 — — $9,780.00 $168,117.11 $42,258.89 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
0207 RC — 15 13 — — $7,500.00 $41,922.50 $41,922.50 2024-10-01
0208 RC — 24 19 — — $7,500.00 $41,922.50 $41,922.50 2024-10-01
4404 APR_DRG Kidney Transplant 16 13 — — $35,422.00 $53,133.00 $41,797.96 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 56 35 — — $10,799.00 $145,614.22 $41,680.94 2024-10-01
8634 APR_DRG Neonatal Aftercare 16 13 — — $35,009.00 $52,513.50 $41,310.62 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 56 35 — — $10,799.00 $81,050.22 $41,210.04 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 56 35 — — $10,799.00 $78,377.00 $41,076.74 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 55 32 — — $9,780.00 $622,167.61 $220,769.03 2026-03-01
802002 CDM Kit Hrt Implant Lvas 13 7 $301,058.69 $301,058.69 $16,558.23 $276,973.99 $150,529.35 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 58 35 — — $10,799.00 $240,568.37 $71,817.96 2026-03-01
719337 CDM Organ Acq Heart 47 21 $386,807.91 $386,807.91 $18,179.97 $355,863.28 $63,436.50 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 54 32 — — $9,780.00 $190,652.64 $63,210.19 2026-03-01
716854 CDM Liver Acquis/cadaver 89 26 $330,623.51 $330,623.51 $15,328.91 $304,173.63 $54,222.26 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 58 35 — — $10,799.00 $240,568.37 $52,091.54 2026-03-01
680173 CDM Ins/repos Sngle Icd+lead 52 20 $281,152.70 $281,152.70 $13,035.26 $258,660.48 $50,607.49 2026-03-01
680174 CDM Ins/repos Lead Dual+gen 52 20 $281,152.70 $281,152.70 $13,035.26 $258,660.48 $50,607.49 2026-03-01
525520 CDM Valve Tavr 23mm 13 7 $98,804.00 $98,804.00 $5,434.22 $90,899.68 $49,402.00 2026-03-01
529563 CDM Valve Tavr 29mm 13 7 $98,804.00 $98,804.00 $5,434.22 $90,899.68 $49,402.00 2026-03-01
527597 CDM Valve Tavr 26mm 13 7 $98,804.00 $98,804.00 $5,434.22 $90,899.68 $49,402.00 2026-03-01
804212 CDM Kit Vlv Aor 18fr 23mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
987847 CDM Valve Aor/pulm 20mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
976231 CDM Kit Aor Vlv 14fr 26mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
987710 CDM Kit Aor Vlv 26mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
515913 CDM Valve Tavr 23mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
976230 CDM Kit Aor Vlv 14fr 23mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
976232 CDM Kit Aor Vlv 14fr 29mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
913745 CDM Valve Aor With Intro 23mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
913744 CDM Valve Aor With Intro 27mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
965615 CDM Valve Xt Sapien 29mm Ta 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
515914 CDM Valve Tavr 29mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
913746 CDM Valve Aor With Intro 25mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
965600 CDM Valve Xt Sapien 26mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
502420 CDM Valve Heart Trnscth 26mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
502418 CDM Valve Heart Trnscth 20mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
502419 CDM Valve Heart Trnscth 23mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
965599 CDM Valve Xt Sapien 23mm 29 11 $94,445.00 $94,445.00 $5,194.48 $86,889.40 $47,222.50 2026-03-01
531856 CDM System Trcsd 1clip 1cath 29 11 $92,992.00 $92,992.00 $5,114.56 $85,552.64 $46,496.00 2026-03-01
532803 CDM Valve Tavr 26mm 13 7 $91,539.00 $91,539.00 $5,034.65 $84,215.88 $45,769.50 2026-03-01
653 MS_DRG Major Bladder Procedures With Mcc 58 35 — — $9,780.00 $123,128.50 $44,990.33 2026-03-01
718282 CDM Aorto Bi Iliac- Rupture 52 20 $247,650.81 $247,650.81 $11,481.99 $227,838.75 $44,577.15 2026-03-01
720324 CDM Tavr Carotid Approach 52 20 $247,650.71 $247,650.71 $11,481.99 $227,838.65 $44,577.13 2026-03-01
705406 CDM Rem/replace Icd Dual Ld 52 20 $244,134.58 $244,134.58 $11,318.97 $224,603.81 $43,944.22 2026-03-01
705405 CDM Rem/replace Icd Sgl Ld 52 20 $244,134.58 $244,134.58 $11,318.97 $224,603.81 $43,944.22 2026-03-01
705408 CDM Rem/replace Icd Multi Ld 52 20 $244,134.58 $244,134.58 $11,318.97 $224,603.81 $43,944.22 2026-03-01
705404 CDM Ins Icd Gen Multi Ld 52 20 $244,134.58 $244,134.58 $11,318.97 $224,603.81 $43,944.22 2026-03-01
705403 CDM Ins Icd Gen Dual Ld 52 20 $244,134.58 $244,134.58 $11,318.97 $224,603.81 $43,944.22 2026-03-01
912730 CDM Valve Aor Tavr 29mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
976664 CDM Valve Tavr 29mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
990105 CDM Valve Tavr 23mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
521213 CDM Valve Tavr Size 34mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
912731 CDM Valve Aor Tavr 34mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
521211 CDM Valve Tavr Sz 26mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
990103 CDM Valve Tavr 29mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
914338 CDM Valve Aor Tavr 23mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
912729 CDM Valve Aor Tavr 26mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
986887 CDM Valve Tavr 34mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
990104 CDM Valve Tavr 26mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
976660 CDM Valve Tavr 23mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
521212 CDM Valve Tavr Sz 29mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
976663 CDM Valve Tavr 26mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
521210 CDM Valve Tavr Sz 23mm 29 11 $87,180.00 $87,180.00 $4,794.90 $80,205.60 $43,590.00 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 58 35 — — $9,780.00 $119,296.06 $43,195.94 2026-03-01
535363 CDM Valve Tavr 29mm 13 7 $84,274.00 $84,274.00 $4,635.07 $77,532.08 $42,137.00 2026-03-01
0916T CPT Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 1 1 — — $41,326.00 $41,326.00 $41,326.00 2026-03-01
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