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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

HCA FLORIDA GULF COAST HOSPITAL

Panama City, FL · CCN 100242 · Rates published

31,335 distinct procedures filed
41 distinct payers
816,033 rate rows
2026-07-31 last MRF observed
Data quality

762,904 of 816,033 rate rows are consumer-grade (93.5%)

53,129 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
template filing: same amount across many unrelated codes — excluded 20,419
per-diem day rate — not a per-procedure price 10,021
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,855
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8,217
exceeds 10× this hospital's gross charge — excluded from medians 3,903
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 443
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 160
placeholder amount (≤ $0.02) — excluded from medians 85
percent-of-charges filed in the dollar field — excluded from medians 26
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hcah-p-001-delivery.stylelabs.cloud/api/public/content/2b5c8e86d4ab49e4b801e2d576b69434
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 · 2026-08-11
Content fingerprint 3199d51e1a14d3e0… · 1,596,033 bytes · first seen 2026-07-30

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$2,997,086
1.6× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 $3,884,946.48 $3,884,946.48 $3,884,946.48 nat. median
$2,460,273
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 18 $3,599,442.00 $4,407,480.00 $3,746,358.00 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 18 $3,532,900.00 $4,326,000.00 $3,677,100.00 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 18 $5,280.60 $3,990,546.00 $3,391,964.10 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 18 $8,710.34 $3,943,200.00 $3,351,720.00 nat. median
$3,252,508
1.0× median
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,225,691.35 $3,225,691.35 nat. median
$3,228,024
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 18 $7,736.51 $3,561,600.00 $3,027,360.00 nat. median
$2,939,969
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 18 $2,340,841.72 $2,866,336.80 $2,436,386.28 nat. median
$2,588,981
0.9× 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 18 $518,609.04 $635,031.48 $539,776.76 nat. median
$576,820
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 18 $516,580.93 $632,548.08 $537,665.87 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 18 $516,055.85 $631,905.12 $537,119.35 nat. median
$560,872
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 18 $506,391.58 $620,071.32 $527,060.62 nat. median
$562,201
0.9× 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 $863,696.72 $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
9035
OTHER 		Axicabtagene Ciloleucel C 18 $479,666.88 $587,347.20 $499,245.12 nat. median
$533,230
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $837,683.55 $492,271.12 nat. median
$631,793
0.8× 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 $830,699.97 $470,149.30 nat. median
$610,161
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 18 $451,319.79 $552,636.48 $469,741.01 nat. median
$492,768
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $819,043.85 $459,839.17 nat. median
$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 $807,075.90 $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 $741,576.00 $435,956.80 nat. median
$577,541
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 $2,701.00 $1,658,155.20 $281,590.40 nat. median
$370,165
0.8× median
5834
APR_DRG 		Neonate With Ecmo 10 $192,207.00 $288,310.50 $230,648.40 nat. median
$311,018
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 23 $2,837.00 $1,238,504.77 $214,732.44 nat. median
$261,939
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 22 $2,837.00 $1,043,115.24 $184,086.22 nat. median
$205,166
0.9× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $178,990.51 $178,990.51 $178,990.51 nat. median
$214,447
0.8× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 22 $2,837.00 $942,307.32 $166,374.02 nat. median
$199,832
0.8× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 10 $125,393.00 $188,089.50 $150,471.60 nat. median
$254,667
0.6× median
1908
OTHER 		New Technology - Level 52 18 $144,393.10 $176,807.88 $150,286.70 nat. median
$155,877
1.0× median
1907
OTHER 		New Technology - Level 52 18 $144,393.10 $176,807.88 $150,286.70 nat. median
$155,877
1.0× median
5833
APR_DRG 		Neonate With Ecmo 10 $124,517.00 $186,775.50 $149,420.40 nat. median
$250,089
0.6× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $147,693.56 $147,693.56 $147,693.56 nat. median
$292,434
0.5× 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
1906
OTHER 		New Technology - Level 51 18 $130,190.55 $159,417.00 $135,504.45 nat. median
$140,545
1.0× median
1905
OTHER 		New Technology - Level 51 18 $130,190.55 $159,417.00 $135,504.45 nat. median
$140,545
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 10 $111,047.00 $166,570.50 $133,256.40 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
01906
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$85,250
1.5× median

Other procedures at this hospital

Browse this hospital's 31,335 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 1 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 21 18 — — $3,599,442.00 $4,407,480.00 $3,746,358.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 21 18 — — $3,532,900.00 $4,326,000.00 $3,677,100.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 22 18 — — $5,280.60 $3,990,546.00 $3,391,964.10 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 22 18 — — $8,710.34 $3,943,200.00 $3,351,720.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 22 18 — — $7,736.51 $3,561,600.00 $3,027,360.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 21 18 — — $2,340,841.72 $2,866,336.80 $2,436,386.28 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 21 18 — — $518,609.04 $635,031.48 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 21 18 — — $516,580.93 $632,548.08 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 21 18 — — $516,055.85 $631,905.12 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 21 18 — — $506,391.58 $620,071.32 $527,060.62 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 5 3 — — $502,693.77 $863,696.72 $502,693.77 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 21 18 — — $479,666.88 $587,347.20 $499,245.12 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 5 3 — — $492,271.12 $837,683.55 $492,271.12 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 5 3 — — $470,149.30 $830,699.97 $470,149.30 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 21 18 — — $451,319.79 $552,636.48 $469,741.01 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 5 3 — — $459,839.17 $819,043.85 $459,839.17 2024-10-01
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… 5 3 — — $445,599.57 $807,075.90 $445,599.57 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 5 3 — — $435,956.80 $741,576.00 $435,956.80 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 42 22 — — $2,701.00 $1,658,155.20 $281,590.40 2024-10-01
5834 APR_DRG Neonate With Ecmo 12 10 — — $192,207.00 $288,310.50 $230,648.40 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 45 23 — — $2,837.00 $1,238,504.77 $214,732.44 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 44 22 — — $2,837.00 $1,043,115.24 $184,086.22 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $178,990.51 $178,990.51 $178,990.51 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 44 22 — — $2,837.00 $942,307.32 $166,374.02 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $125,393.00 $188,089.50 $150,471.60 2024-10-01
1908 OTHER New Technology - Level 52 21 18 — — $144,393.10 $176,807.88 $150,286.70 2024-10-01
1907 OTHER New Technology - Level 52 21 18 — — $144,393.10 $176,807.88 $150,286.70 2024-10-01
5833 APR_DRG Neonate With Ecmo 12 10 — — $124,517.00 $186,775.50 $149,420.40 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $147,693.56 $147,693.56 $147,693.56 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $142,919.70 $142,919.70 $142,919.70 2024-10-01
1905 OTHER New Technology - Level 51 21 18 — — $130,190.55 $159,417.00 $135,504.45 2024-10-01
1906 OTHER New Technology - Level 51 21 18 — — $130,190.55 $159,417.00 $135,504.45 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 12 10 — — $111,047.00 $166,570.50 $133,256.40 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
1904 OTHER New Technology - Level 50 21 18 — — $115,988.00 $142,026.12 $120,722.20 2024-10-01
1903 OTHER New Technology - Level 50 21 18 — — $115,988.00 $142,026.12 $120,722.20 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 1 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $119,887.93 $119,887.93 $119,887.93 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 10 — — $97,644.00 $146,466.00 $117,172.80 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
5832 APR_DRG Neonate With Ecmo 12 10 — — $95,607.00 $143,410.50 $114,728.40 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 12 10 — — $95,167.00 $142,750.50 $114,200.40 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 44 22 — — $2,837.00 $621,270.66 $109,967.22 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 10 — — $91,470.00 $137,205.00 $109,764.00 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 12 10 — — $90,217.00 $135,325.50 $108,260.40 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 1 — — $108,036.36 $108,036.36 $108,036.36 2024-10-01
1902 OTHER New Technology - Level 49 21 18 — — $101,785.45 $124,635.24 $105,939.95 2024-10-01
1901 OTHER New Technology - Level 49 21 18 — — $101,785.45 $124,635.24 $105,939.95 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 42 22 — — $2,701.00 $576,059.67 $103,252.79 2024-10-01
7 MS_DRG Lung Transplant 42 22 — — $2,837.00 $574,608.63 $102,994.77 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 22 18 — — $96,999.90 $119,999.88 $101,999.90 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
459 MS_DRG Spinal Fusion Except Cervical With Mcc 6 3 — — $6,740.00 $118,877.00 $100,123.50 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 4 2 — — $6,740.00 $162,536.00 $99,300.00 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 12 10 — — $82,446.00 $123,669.00 $98,935.20 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $81,552.00 $122,328.00 $97,862.40 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 12 10 — — $80,942.00 $121,413.00 $97,130.40 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 10 — — $79,657.00 $119,485.50 $95,588.40 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 4 2 — — $6,740.00 $115,548.00 $94,536.00 2024-10-01
1599 OTHER New Technology - Level 48 21 18 — — $89,949.97 $110,142.82 $93,621.39 2024-10-01
1585 OTHER New Technology - Level 48 21 18 — — $89,949.97 $110,142.82 $93,621.39 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 22 18 — — $88,300.94 $109,238.28 $92,852.54 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 12 10 — — $75,611.00 $113,416.50 $90,733.20 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 10 — — $75,232.00 $112,848.00 $90,278.40 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 10 — — $73,863.00 $110,794.50 $88,635.60 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 2 — — $6,740.00 $120,210.00 $87,610.00 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 5 2 — — $6,740.00 $90,620.00 $87,610.00 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 45 23 — — $2,837.00 $484,547.23 $86,980.14 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 43 23 — — $2,837.00 $478,980.50 $85,990.28 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $71,560.00 $107,340.00 $85,872.00 2024-10-01
215 MS_DRG Other Heart Assist System Implant 45 24 — — $6,740.00 $465,837.57 $85,644.95 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 2 — — $6,740.00 $106,940.00 $85,547.00 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 5 2 — — $6,740.00 $85,547.00 $84,910.00 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $84,296.07 $84,296.07 $84,296.07 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 42 22 — — $2,837.00 $468,229.59 $84,078.55 2024-10-01
1598 OTHER New Technology - Level 47 21 18 — — $80,481.61 $98,548.91 $83,766.57 2024-10-01
1584 OTHER New Technology - Level 47 21 18 — — $80,481.61 $98,548.91 $83,766.57 2024-10-01
5831 APR_DRG Neonate With Ecmo 12 10 — — $69,493.00 $104,239.50 $83,391.60 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 23 — — $10,799.00 $460,886.43 $82,772.80 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 12 10 — — $68,321.00 $102,481.50 $81,985.20 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 12 10 — — $67,242.00 $100,863.00 $80,690.40 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 10 — — $66,782.00 $100,173.00 $80,138.40 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 5 2 — — $6,740.00 $90,990.00 $79,989.00 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 — — $78,325.54 $78,325.54 $78,325.54 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 43 24 — — $6,740.00 $178,181.21 $77,726.58 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 12 10 — — $64,392.00 $96,588.00 $77,270.40 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $76,277.63 $76,277.63 $76,277.63 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 1 — — $6,740.00 $144,790.00 $75,765.00 2024-10-01
0207 RC — 11 10 — — $11,700.00 $75,194.50 $75,194.50 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 12 10 — — $62,352.00 $93,528.00 $74,822.40 2024-10-01
1597 OTHER New Technology - Level 46 21 18 — — $71,013.23 $86,954.98 $73,911.73 2024-10-01
1583 OTHER New Technology - Level 46 21 18 — — $71,013.23 $86,954.98 $73,911.73 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 12 10 — — $61,338.00 $92,007.00 $73,605.60 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 5 2 — — $6,740.00 $79,989.00 $73,250.00 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 45 23 — — $2,837.00 $405,030.07 $72,840.47 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 2 2 — — $53,789.99 $91,596.09 $72,693.04 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 6 3 — — $6,740.00 $118,877.00 $72,161.00 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 10 — — $59,125.00 $88,687.50 $70,950.00 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $70,288.61 $70,288.61 $70,288.61 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 45 24 — — $6,740.00 $372,583.87 $68,667.86 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 10 — — $56,946.00 $85,419.00 $68,335.20 2024-10-01
007 OTHER Lung Transplant 1 1 — — $67,580.69 $67,580.69 $67,580.69 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $67,458.10 $67,458.10 $67,458.10 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 22 18 — — $63,895.55 $79,046.04 $67,189.13 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 43 24 — — $6,740.00 $372,372.81 $67,033.40 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 21 18 — — $64,167.05 $78,571.90 $66,786.11 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 12 10 — — $55,523.00 $83,284.50 $66,627.60 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 43 23 — — $10,799.00 $366,718.14 $66,027.90 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $54,849.00 $82,273.50 $65,818.80 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 22 18 — — $12,654.78 $76,025.72 $64,621.87 2024-10-01
1596 OTHER New Technology - Level 45 21 18 — — $61,544.86 $75,361.06 $64,056.90 2024-10-01
1582 OTHER New Technology - Level 45 21 18 — — $61,544.86 $75,361.06 $64,056.90 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 45 24 — — $6,740.00 $354,428.25 $63,842.51 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 45 24 — — $6,740.00 $173,955.00 $63,403.74 2024-10-01
10 MS_DRG Pancreas Transplant 42 22 — — $2,837.00 $350,563.19 $63,155.23 2024-10-01
817682 CDM Insrt Aicd Only Mult Ld 26 16 $141,517.35 $141,517.35 $8,349.52 $148,593.22 $62,904.46 2024-10-01
817681 CDM Insrt Aicd Only Dual Ld 26 16 $141,517.35 $141,517.35 $8,349.52 $148,593.22 $62,904.46 2024-10-01
806528 CDM Insert/replace Aicd 26 16 $141,517.35 $141,517.35 $8,349.52 $148,593.22 $62,904.46 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 43 23 — — $2,837.00 $348,544.93 $62,796.35 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 24 — — $6,740.00 $173,965.00 $62,772.95 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $62,431.63 $62,431.63 $62,431.63 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 12 10 — — $51,688.00 $77,532.00 $62,025.60 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 5 3 — — $61,600.24 $104,773.89 $61,600.24 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 10 — — $51,226.00 $76,839.00 $61,471.20 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
812856 CDM Ins Icd Generator 26 16 $137,842.80 $137,842.80 $8,132.73 $144,734.94 $61,271.12 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
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 45 23 — — $2,837.00 $328,186.35 $59,176.20 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 12 10 — — $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 12 10 — — $48,983.00 $73,474.50 $58,779.60 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 10 — — $48,895.00 $73,342.50 $58,674.00 2024-10-01
64 APR_DRG Pancreas Transplant 12 10 — — $48,372.00 $72,558.00 $58,046.40 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $57,539.16 $57,539.16 $57,539.16 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 10 — — $47,538.00 $71,307.00 $57,045.60 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 41 23 — — $10,555.00 $310,721.07 $56,604.55 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 23 — — $10,799.00 $312,136.94 $56,322.32 2024-10-01
8514 APR_DRG Gender Related Procedures 12 10 — — $46,902.00 $70,353.00 $56,282.40 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 21 18 — — $53,914.93 $66,018.28 $56,115.53 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 12 10 — — $46,525.00 $69,787.50 $55,830.00 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $55,450.54 $55,450.54 $55,450.54 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 12 10 — — $46,203.00 $69,304.50 $55,443.60 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $55,323.98 $55,323.98 $55,323.98 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 12 10 — — $45,376.00 $68,064.00 $54,451.20 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 45 23 — — $2,837.00 $300,229.59 $54,204.97 2024-10-01
1581 OTHER New Technology - Level 44 21 18 — — $52,076.49 $63,767.14 $54,202.07 2024-10-01
1595 OTHER New Technology - Level 44 21 18 — — $52,076.49 $63,767.14 $54,202.07 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 12 10 — — $44,835.00 $67,252.50 $53,802.00 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 43 23 — — $10,799.00 $173,955.00 $53,452.75 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 43 23 — — $10,799.00 $163,300.90 $53,237.77 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 43 24 — — $6,740.00 $178,181.21 $52,529.69 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 12 10 — — $43,677.00 $65,515.50 $52,412.40 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 44 22 — — $2,837.00 $293,660.32 $52,405.43 2024-10-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 5 4 — — $42,732.34 $54,750.81 $52,347.12 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 12 10 — — $43,560.00 $65,340.00 $52,272.00 2024-10-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 5 4 — — $42,293.46 $54,188.50 $51,809.49 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $51,545.10 $51,545.10 $51,545.10 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 43 23 — — $10,799.00 $90,407.00 $51,529.77 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $51,453.49 $51,453.49 $51,453.49 2024-10-01
5244 OTHER Level 4 Blood Product Exc 21 18 — — $49,298.17 $60,365.10 $51,310.33 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $42,035.00 $63,052.50 $50,442.00 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 12 10 — — $41,957.00 $62,935.50 $50,348.40 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 45 23 — — $2,837.00 $278,068.21 $50,264.25 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 12 10 — — $41,876.00 $62,814.00 $50,251.20 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 12 10 — — $41,730.00 $62,595.00 $50,076.00 2024-10-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 5 4 — — $40,752.49 $52,214.12 $49,921.79 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $49,806.62 $49,806.62 $49,806.62 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 45 24 — — $6,740.00 $268,588.06 $49,735.13 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $49,529.65 $49,529.65 $49,529.65 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 45 23 — — $2,701.00 $284,391.24 $49,430.95 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 45 24 — — $6,740.00 $269,836.84 $49,265.32 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 43 23 — — $10,555.00 $272,356.37 $49,248.58 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 45 23 — — $2,837.00 $272,004.61 $49,186.03 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 41 23 — — $10,799.00 $219,027.14 $48,791.34 2024-10-01
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 3 1 — — $20,167.00 $48,710.00 $48,710.00 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 43 24 — — $6,740.00 $178,181.21 $48,460.73 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 22 18 — — $46,068.21 $56,991.60 $48,442.86 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 45 24 — — $6,740.00 $267,304.11 $48,350.19 2024-10-01
816119 CDM Elec Insert Dual Ppm/icd 26 16 $108,426.45 $108,426.45 $6,397.16 $113,847.77 $48,195.56 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 42 22 — — $2,701.00 $274,809.39 $48,009.29 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 42 22 — — $2,701.00 $274,809.39 $48,009.29 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 45 24 — — $6,740.00 $173,955.00 $47,938.00 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 12 10 — — $39,878.00 $59,817.00 $47,853.60 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 29 19 — — $43,292.29 $135,281.90 $47,301.67 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 12 10 — — $38,906.00 $58,359.00 $46,687.20 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 45 23 — — $2,837.00 $270,764.62 $46,633.84 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 43 24 — — $6,740.00 $252,349.57 $46,561.30 2024-10-01
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 5 4 — — $38,001.44 $48,689.35 $46,551.76 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 45 24 — — $6,740.00 $250,841.36 $46,504.30 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 45 23 — — $2,837.00 $255,994.76 $46,339.18 2024-10-01
1142 OTHER Supprelin La Implant 21 18 — — $44,443.21 $54,420.25 $46,257.21 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 12 10 — — $37,904.00 $56,856.00 $45,484.80 2024-10-01
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 5 4 — — $36,996.09 $47,401.24 $45,320.21 2024-10-01
D0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 5 4 — — $36,889.52 $47,264.70 $45,189.67 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $45,148.93 $45,148.93 $45,148.93 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 45 24 — — $6,740.00 $243,040.91 $45,084.20 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 12 10 — — $37,476.00 $56,214.00 $44,971.20 2024-10-01
824435 CDM Intro Cath Dialysis Circ 26 16 $101,160.00 $101,160.00 $5,968.44 $106,218.00 $44,965.62 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $44,710.16 $44,710.16 $44,710.16 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 45 23 — — $2,837.00 $245,103.15 $44,402.44 2024-10-01
1594 OTHER New Technology - Level 43 21 18 — — $42,608.13 $52,173.22 $44,347.23 2024-10-01
1580 OTHER New Technology - Level 43 21 18 — — $42,608.13 $52,173.22 $44,347.23 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 12 10 — — $36,953.00 $55,429.50 $44,343.60 2024-10-01
824440 CDM Stent Plm Ctr Dialys Seg 26 16 $99,727.45 $99,727.45 $5,883.92 $104,713.82 $44,328.85 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 43 23 — — $10,799.00 $242,069.15 $44,280.67 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $44,039.60 $44,039.60 $44,039.60 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 43 23 — — $10,799.00 $240,525.77 $44,003.62 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 5 4 — — $35,829.49 $45,906.53 $43,891.12 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 45 24 — — $6,740.00 $173,955.00 $43,423.96 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 42 22 — — $2,837.00 $239,237.42 $43,359.39 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $43,339.76 $43,339.76 $43,339.76 2024-10-01
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 5 4 — — $35,342.94 $45,283.14 $43,295.10 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 45 23 — — $2,837.00 $238,692.18 $43,262.45 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 5 3 — — $43,241.44 $72,861.11 $43,241.44 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 43 24 — — $6,740.00 $173,965.00 $43,235.04 2024-10-01
B1903 HCPCS Guillian Barre; M < 18.05 5 4 — — $35,213.94 $45,117.86 $43,137.08 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 45 23 — — $2,837.00 $237,249.93 $43,005.98 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $42,827.53 $42,827.53 $42,827.53 2024-10-01
B0604 HCPCS Neurological; M < 25.85 5 4 — — $34,919.48 $44,740.59 $42,776.37 2024-10-01
4404 APR_DRG Kidney Transplant 12 10 — — $35,422.00 $53,133.00 $42,506.40 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 45 23 — — $2,701.00 $243,023.32 $42,355.17 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 — — $42,052.24 $42,052.24 $42,052.24 2024-10-01
8634 APR_DRG Neonatal Aftercare 12 10 — — $35,009.00 $52,513.50 $42,010.80 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 43 23 — — $10,799.00 $173,955.00 $41,926.21 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 47 24 — — $2,837.00 $237,474.18 $41,770.92 2024-10-01
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 5 4 — — $33,982.84 $43,540.51 $41,628.98 2024-10-01
63 APR_DRG Pancreas Transplant 12 10 — — $34,364.00 $51,546.00 $41,236.80 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $41,091.81 $41,091.81 $41,091.81 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 45 23 — — $2,837.00 $125,436.39 $41,083.32 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 12 10 — — $34,228.00 $51,342.00 $41,073.60 2024-10-01
A0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 5 4 — — $33,520.13 $42,947.66 $41,062.15 2024-10-01
A5104 HCPCS Expired, Not Orthopedic, Length Of Stay Is 16 Days 5 4 — — $33,419.17 $42,818.31 $40,938.48 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 12 10 — — $34,068.00 $51,102.00 $40,881.60 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 45 24 — — $6,740.00 $173,955.00 $40,726.26 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 45 24 — — $6,740.00 $78,826.00 $40,650.15 2024-10-01
824438 CDM Thrmbc/nfs Dialysis Circ 26 16 $91,334.20 $91,334.20 $5,388.72 $95,900.91 $40,598.05 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 43 23 — — $10,555.00 $219,982.52 $40,315.85 2024-10-01
C0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 5 4 — — $32,903.17 $42,157.19 $40,306.39 2024-10-01
817684 CDM Rem/repl Aicd Dual Ld 26 16 $90,294.30 $90,294.30 $5,327.36 $94,809.01 $40,135.82 2024-10-01
817683 CDM Rem/repl Aicd Sing Ld 26 16 $90,294.30 $90,294.30 $5,327.36 $94,809.01 $40,135.82 2024-10-01
817685 CDM Rem/repl Aicd Mult Ld 26 16 $90,294.30 $90,294.30 $5,327.36 $94,809.01 $40,135.82 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 45 23 — — $2,837.00 $237,219.15 $40,133.81 2024-10-01
237 MS_DRG Major Cardiovasc Procedures W Mcc 2 1 — — $6,740.00 $73,210.00 $39,975.00 2024-10-01
B0704 HCPCS Fracture Of Lower Extremity; M < 28.15 5 4 — — $32,632.56 $41,810.46 $39,974.88 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 45 23 — — $2,837.00 $219,920.96 $39,924.56 2024-10-01
B2102 HCPCS Burns; M=12-45 5 4 — — $32,496.55 $41,636.20 $39,808.27 2024-10-01
4A020N7 OTHER Measurement Of Cardiac Sampling And Pressure, Left Heart, Open Approach 2 1 — — $39,626.00 $39,626.00 $39,626.00 2024-10-01
4A023N7 OTHER Measurement Of Cardiac Sampling And Pressure, Left Heart, Percutaneous Approach 2 1 — — $39,626.00 $39,626.00 $39,626.00 2024-10-01
4A023N8 OTHER Measurement Of Cardiac Sampling And Pressure, Bilateral, Percutaneous Approach 2 1 — — $39,626.00 $39,626.00 $39,626.00 2024-10-01
4A020N8 OTHER Measurement Of Cardiac Sampling And Pressure, Bilateral, Open Approach 2 1 — — $39,626.00 $39,626.00 $39,626.00 2024-10-01
4A020N6 OTHER Measurement Of Cardiac Sampling And Pressure, Right Heart, Open Approach 2 1 — — $39,626.00 $39,626.00 $39,626.00 2024-10-01
4A023N6 OTHER Measurement Of Cardiac Sampling And Pressure, Right Heart, Percutaneous Approach… 2 1 — — $39,626.00 $39,626.00 $39,626.00 2024-10-01
D0106 HCPCS Stroke; M > 30.05 & M < 34.25 5 4 — — $32,297.44 $41,381.09 $39,564.36 2024-10-01
B1004 HCPCS Amputation, Lower Extremity; M=39-45 5 4 — — $32,265.19 $41,339.77 $39,524.86 2024-10-01
245 MS_DRG Aicd Generator Procedures 45 24 — — $6,740.00 $214,864.29 $39,397.06 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 1 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 45 24 — — $6,740.00 $75,871.00 $39,164.21 2024-10-01
B1504 HCPCS Pulmonary; M < 29.15 5 4 — — $31,890.81 $40,860.10 $39,066.24 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 22 18 — — $37,140.82 $45,947.40 $39,055.29 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 45 23 — — $2,837.00 $223,315.52 $38,984.25 2024-10-01
816107 CDM Archuplasty 26 16 $87,646.75 $87,646.75 $5,171.16 $92,029.09 $38,958.98 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 12 10 — — $32,422.00 $48,633.00 $38,906.40 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 1 1 — — $38,803.31 $38,803.31 $38,803.31 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 42 22 — — $2,837.00 $279,318.06 $38,731.40 2024-10-01
817003 CDM Stent Ather Tibperon Add 26 16 $87,082.20 $87,082.20 $5,137.85 $91,436.31 $38,708.04 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 45 23 — — $2,837.00 $221,459.94 $38,666.86 2024-10-01
816999 CDM Stent Ather Fem Pop 26 16 $86,729.15 $86,729.15 $5,117.02 $91,065.61 $38,551.11 2024-10-01
817001 CDM Stent Ather Tibperoneal 26 16 $86,729.15 $86,729.15 $5,117.02 $91,065.61 $38,551.11 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 41 23 — — $10,799.00 $173,965.00 $38,496.85 2024-10-01
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