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 SOUTH SHORE HOSPITAL

Sun City Center, FL · CCN 100259 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $4,991 across 34 payers · range $2,597-$15,957

Source: https://www.hcadam.com/api/public/content/cec6d0aaac0b427683f8fd4dfdc681c1?download=true · observed 2024-10-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

51,038 distinct procedures filed
50 distinct payers
1,163,495 rate rows
2026-07-31 last MRF observed
Data quality

1,120,822 of 1,163,495 rate rows are consumer-grade (96.3%)

42,673 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 20,855
per-diem day rate — not a per-procedure price 11,391
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 7,729
template filing: same amount across many unrelated codes — excluded 2,145
percent-of-charges filed in the dollar field — excluded from medians 217
placeholder amount (≤ $0.02) — excluded from medians 190
exceeds 10× this hospital's gross charge — excluded from medians 70
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 49
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 27
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/59-2822337_HCA-FLORIDA-SOUTH-SHORE-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 not_modified · 2026-08-11

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 20 $3,672,900.00 $4,187,106.00 $3,856,545.00 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 20 $3,605,000.00 $4,109,700.00 $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 22 $5,280.60 $4,821,909.75 $3,491,727.75 nat. median
$3,325,455
1.1× median
748
OTHER 		Inj, Lovotibeglogene Auto 22 $8,710.34 $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 22 $7,736.51 $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 21 $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 21 $529,192.90 $767,329.70 $555,652.55 nat. median
$576,820
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 21 $527,123.40 $764,328.93 $553,479.57 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 21 $526,587.60 $763,552.02 $552,916.98 nat. median
$560,872
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 21 $516,726.10 $749,252.84 $542,562.41 nat. median
$562,201
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 21 $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 21 $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 $271,218.23 nat. median
$370,165
0.7× 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 $202,577.62 nat. median
$261,939
0.8× 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
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 $9,000.00 $524,012.93 $168,929.20 nat. median
$205,166
0.8× 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 21 $147,339.90 $213,642.85 $154,706.89 nat. median
$155,877
1.0× median
1907
OTHER 		New Technology - Level 52 21 $147,339.90 $213,642.85 $154,706.89 nat. median
$155,877
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 32 $9,000.00 $614,950.32 $154,129.74 nat. median
$199,832
0.8× median
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
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
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×
1906
OTHER 		New Technology - Level 51 21 $132,847.50 $192,628.88 $139,489.88 nat. median
$140,545
1.0× median
1905
OTHER 		New Technology - Level 51 21 $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
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 51,038 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 23 20 — — $3,672,900.00 $4,187,106.00 $3,856,545.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 23 20 — — $3,605,000.00 $4,109,700.00 $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 25 22 — — $5,280.60 $4,821,909.75 $3,491,727.75 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 25 22 — — $8,710.34 $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 25 22 — — $7,736.51 $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 24 21 — — $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 24 21 — — $529,192.90 $767,329.70 $555,652.55 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 24 21 — — $527,123.40 $764,328.93 $553,479.57 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 24 21 — — $526,587.60 $763,552.02 $552,916.98 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 24 21 — — $516,726.10 $749,252.84 $542,562.41 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 24 21 — — $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 24 21 — — $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 $271,218.23 2024-10-01
5834 APR_DRG Neonate With Ecmo 16 13 — — $192,207.00 $288,310.50 $226,804.26 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 52 32 — — $9,780.00 $622,167.61 $202,577.62 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
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 50 29 — — $9,000.00 $524,012.93 $168,929.20 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $156,515.70 $156,515.70 $156,515.70 2024-10-01
1907 OTHER New Technology - Level 52 24 21 — — $147,339.90 $213,642.85 $154,706.89 2024-10-01
1908 OTHER New Technology - Level 52 24 21 — — $147,339.90 $213,642.85 $154,706.89 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 53 32 — — $9,000.00 $614,950.32 $154,129.74 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
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
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 24 21 — — $132,847.50 $192,628.88 $139,489.88 2024-10-01
1906 OTHER New Technology - Level 51 24 21 — — $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
1903 OTHER New Technology - Level 50 24 21 — — $118,355.10 $171,614.89 $124,272.86 2024-10-01
1904 OTHER New Technology - Level 50 24 21 — — $118,355.10 $171,614.89 $124,272.86 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
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
1614 APR_DRG Implantable Heart Assist Systems 16 13 — — $95,167.00 $142,750.50 $112,297.06 2024-10-01
1902 OTHER New Technology - Level 49 24 21 — — $103,862.70 $150,600.91 $109,055.84 2024-10-01
1901 OTHER New Technology - Level 49 24 21 — — $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 25 22 — — $96,999.90 $144,999.85 $104,999.90 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
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
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
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 53 32 — — $9,000.00 $369,085.56 $101,618.93 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
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
14 MS_DRG Allogeneic Bone Marrow Transplant 50 31 — — $6,771.00 $346,179.96 $96,556.21 2024-10-01
1599 OTHER New Technology - Level 48 24 21 — — $91,785.68 $133,089.24 $96,374.96 2024-10-01
1585 OTHER New Technology - Level 48 24 21 — — $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… 25 22 — — $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
7 MS_DRG Lung Transplant 50 31 — — $9,780.00 $292,022.70 $93,986.59 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 16 13 — — $75,611.00 $113,416.50 $89,220.98 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
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
1598 OTHER New Technology - Level 47 24 21 — — $82,124.09 $119,079.93 $86,230.29 2024-10-01
1584 OTHER New Technology - Level 47 24 21 — — $82,124.09 $119,079.93 $86,230.29 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
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
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 52 32 — — $9,780.00 $396,087.48 $82,786.77 2024-10-01
5831 APR_DRG Neonate With Ecmo 16 13 — — $69,493.00 $104,239.50 $82,001.74 2024-10-01
215 MS_DRG Other Heart Assist System Implant 56 34 — — $10,799.00 $357,404.16 $81,476.17 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 55 34 — — $9,000.00 $330,488.16 $81,447.83 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
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
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
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 50 31 — — $9,780.00 $351,859.56 $78,482.27 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 34 — — $10,799.00 $321,617.41 $78,371.03 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $78,325.54 $78,325.54 $78,325.54 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
1597 OTHER New Technology - Level 46 24 21 — — $72,462.48 $105,070.60 $76,085.60 2024-10-01
1583 OTHER New Technology - Level 46 24 21 — — $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
23 APR_DRG Heart And/or Lung Transplant 16 13 — — $62,352.00 $93,528.00 $73,575.36 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 34 — — $10,799.00 $224,456.53 $73,530.55 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
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
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 25 22 — — $63,895.55 $95,513.96 $69,165.29 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 24 21 — — $65,476.58 $94,941.04 $68,750.41 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
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
717 OTHER Instill Adstiladrin, Tx D 25 22 — — $12,654.78 $91,864.42 $66,522.51 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 55 34 — — $9,000.00 $282,639.53 $66,249.25 2024-10-01
1596 OTHER New Technology - Level 45 24 21 — — $62,800.88 $91,061.28 $65,940.92 2024-10-01
1582 OTHER New Technology - Level 45 24 21 — — $62,800.88 $91,061.28 $65,940.92 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 55 34 — — $10,799.00 $226,110.40 $65,165.87 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
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 65 39 — — $10,799.00 $187,062.91 $63,922.87 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 55 34 — — $10,799.00 $255,904.56 $62,952.16 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
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $62,431.63 $62,431.63 $62,431.63 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
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 55 34 — — $10,799.00 $221,553.82 $61,416.42 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
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 65 39 — — $10,799.00 $190,081.24 $60,665.06 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
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 64 38 — — $10,799.00 $194,499.74 $59,777.96 2024-10-01
10 MS_DRG Pancreas Transplant 59 37 — — $9,780.00 $177,393.41 $59,611.22 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 59 37 — — $9,780.00 $179,194.56 $59,268.02 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+ 24 21 — — $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
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
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
1595 OTHER New Technology - Level 44 24 21 — — $53,139.28 $77,051.96 $55,796.24 2024-10-01
1581 OTHER New Technology - Level 44 24 21 — — $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
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $55,450.54 $55,450.54 $55,450.54 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 65 39 — — $10,799.00 $215,886.49 $55,352.31 2024-10-01
8514 APR_DRG Gender Related Procedures 16 13 — — $46,902.00 $70,353.00 $55,344.36 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
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
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
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 65 39 — — $9,000.00 $164,865.67 $54,211.70 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 55 34 — — $10,799.00 $217,816.51 $53,582.55 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
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 24 21 — — $50,304.25 $72,941.16 $52,819.46 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 65 39 — — $10,799.00 $205,711.67 $51,559.59 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
215 OTHER Other Heart Assist System Implant 1 1 — — $51,453.49 $51,453.49 $51,453.49 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
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 65 39 — — $10,799.00 $109,888.00 $51,275.03 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $50,561.89 $50,561.89 $50,561.89 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 34 — — $10,799.00 $224,456.53 $50,351.28 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 25 22 — — $46,068.21 $68,864.85 $49,867.65 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
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
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
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
955 MS_DRG Craniotomy For Multiple Significant Trauma 55 34 — — $9,000.00 $214,702.08 $49,107.43 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 64 39 — — $8,000.00 $65,982.40 $48,793.93 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 65 39 — — $9,000.00 $147,521.39 $48,508.50 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 65 39 — — $10,799.00 $153,128.50 $48,076.89 2024-10-01
1142 OTHER Supprelin La Implant 24 21 — — $45,350.21 $65,757.80 $47,617.72 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 65 39 — — $9,780.00 $189,811.22 $47,574.29 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 55 34 — — $10,799.00 $226,110.40 $47,411.71 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
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 2 1 — — $40,208.00 $53,804.00 $47,006.00 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 56 34 — — $10,799.00 $275,910.53 $46,709.87 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 56 34 — — $10,799.00 $224,456.53 $46,387.83 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 65 39 — — $10,799.00 $135,553.57 $46,321.16 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 54 34 — — $6,771.00 $142,865.03 $46,286.53 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 59 37 — — $6,771.00 $346,179.96 $45,987.07 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 59 37 — — $6,771.00 $346,179.96 $45,987.07 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 65 39 — — $9,000.00 $139,688.63 $45,932.90 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
28 MS_DRG Spinal Procedures With Mcc 65 39 — — $10,799.00 $134,281.24 $45,886.38 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 65 39 — — $10,799.00 $156,427.03 $45,669.17 2024-10-01
1594 OTHER New Technology - Level 43 24 21 — — $43,477.68 $63,042.64 $45,651.56 2024-10-01
1580 OTHER New Technology - Level 43 24 21 — — $43,477.68 $63,042.64 $45,651.56 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
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
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 65 39 — — $10,799.00 $155,687.55 $44,924.31 2024-10-01
976232 CDM Kit Aor Vlv 14fr 29mm 16 10 $94,445.00 $94,445.00 $4,816.69 $86,889.40 $44,861.38 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 64 38 — — $10,799.00 $194,499.74 $44,847.32 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
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $44,710.16 $44,710.16 $44,710.16 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 65 39 — — $9,000.00 $136,019.64 $44,287.95 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 16 13 — — $37,476.00 $56,214.00 $44,221.68 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
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 65 39 — — $10,799.00 $136,786.20 $43,872.80 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 16 13 — — $36,953.00 $55,429.50 $43,604.54 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
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $43,241.44 $94,940.24 $43,241.44 2024-10-01
707410 CDM Insert Perc Vad/arterial 22 14 $206,474.40 $206,474.40 $10,530.19 $189,956.45 $42,946.68 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
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 50 33 — — $11,098.00 $54,201.00 $42,545.79 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 55 34 — — $10,799.00 $221,553.82 $42,508.48 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 65 39 — — $10,799.00 $168,921.56 $42,338.51 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 — 14 12 — — $8,000.00 $42,172.50 $42,172.50 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 65 39 — — $10,799.00 $167,844.55 $42,068.57 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $42,052.24 $42,052.24 $42,052.24 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 63 38 — — $10,799.00 $146,678.73 $42,047.40 2024-10-01
0208 RC — 23 18 — — $7,500.00 $41,922.50 $41,922.50 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 65 39 — — $9,000.00 $128,599.95 $41,872.11 2024-10-01
4404 APR_DRG Kidney Transplant 16 13 — — $35,422.00 $53,133.00 $41,797.96 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 65 39 — — $10,799.00 $144,822.34 $41,789.11 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 59 37 — — $9,780.00 $179,194.56 $41,455.79 2024-10-01
912729 CDM Valve Aor Tavr 26mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
976660 CDM Valve Tavr 23mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
912731 CDM Valve Aor Tavr 34mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
912730 CDM Valve Aor Tavr 29mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
986887 CDM Valve Tavr 34mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
976663 CDM Valve Tavr 26mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
976664 CDM Valve Tavr 29mm 16 10 $87,180.00 $87,180.00 $4,446.18 $80,205.60 $41,410.50 2024-10-01
G0448 HCPCS Insertion Or Replacement Of A Permanent Pacing Cardioverter-defibrillator System… 12 5 — — $5,395.00 $59,261.00 $41,361.50 2024-10-01
8634 APR_DRG Neonatal Aftercare 16 13 — — $35,009.00 $52,513.50 $41,310.62 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
63 APR_DRG Pancreas Transplant 16 13 — — $34,364.00 $51,546.00 $40,549.52 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 16 13 — — $34,228.00 $51,342.00 $40,389.04 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 25 22 — — $37,140.82 $55,519.78 $40,203.97 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 16 13 — — $34,068.00 $51,102.00 $40,200.24 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 65 39 — — $9,000.00 $123,128.50 $40,090.61 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 66 39 — — $10,799.00 $207,169.16 $40,086.56 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 65 39 — — $10,799.00 $109,723.00 $39,840.02 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 64 39 — — $6,771.00 $122,083.69 $39,750.42 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 65 39 — — $9,780.00 $158,013.39 $39,604.49 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 25 22 — — $36,570.46 $54,667.17 $39,586.58 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 65 39 — — $9,000.00 $136,859.85 $39,491.50 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
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 64 38 — — $10,799.00 $194,499.74 $38,886.08 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 65 39 — — $9,780.00 $119,296.06 $38,842.76 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 65 39 — — $10,799.00 $136,862.91 $38,831.75 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 65 39 — — $9,000.00 $119,183.41 $38,806.09 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 65 39 — — $9,000.00 $119,167.95 $38,801.05 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 65 39 — — $10,799.00 $76,179.17 $38,452.90 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 16 13 — — $32,422.00 $48,633.00 $38,257.96 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 65 39 — — $10,799.00 $78,377.00 $38,045.17 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $37,952.93 $37,952.93 $37,952.93 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $37,949.46 $37,949.46 $37,949.46 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $37,864.09 $37,864.09 $37,864.09 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $37,802.54 $37,802.54 $37,802.54 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $37,565.78 $37,565.78 $37,565.78 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 16 13 — — $31,789.00 $47,683.50 $37,511.02 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $37,379.15 $37,379.15 $37,379.15 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 16 13 — — $31,574.00 $47,361.00 $37,257.32 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $37,248.13 $37,248.13 $37,248.13 2024-10-01
245 MS_DRG Aicd Generator Procedures 65 39 — — $10,799.00 $107,937.90 $37,232.34 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 16 13 — — $31,456.00 $47,184.00 $37,118.08 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
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 16 13 — — $31,113.00 $46,669.50 $36,713.34 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 65 39 — — $9,000.00 $112,183.40 $36,526.88 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 65 39 — — $9,000.00 $110,478.13 $36,327.81 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 16 13 — — $30,783.00 $46,174.50 $36,323.94 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 65 39 — — $9,000.00 $111,251.25 $36,223.38 2024-10-01
006 OTHER Liver Transplant Without Mcc 1 1 — — $36,179.50 $36,179.50 $36,179.50 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 65 39 — — $10,799.00 $153,128.50 $36,109.67 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 64 39 — — $6,771.00 $110,595.21 $36,009.76 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 50 31 — — $9,780.00 $351,859.56 $35,737.35 2024-10-01
1784 APR_DRG External Heart Assist Devices 16 13 — — $30,258.00 $45,387.00 $35,704.44 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 16 13 — — $30,178.00 $45,267.00 $35,610.04 2024-10-01
1579 OTHER New Technology - Level 42 24 21 — — $33,816.08 $49,033.32 $35,506.88 2024-10-01
1593 OTHER New Technology - Level 42 24 21 — — $33,816.08 $49,033.32 $35,506.88 2024-10-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 16 13 — — $30,089.00 $45,133.50 $35,505.02 2024-10-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 16 13 — — $30,025.00 $45,037.50 $35,429.50 2024-10-01
L8701 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand With S… 25 22 — — $32,476.47 $48,547.31 $35,154.94 2024-10-01
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 16 13 — — $29,751.00 $44,626.50 $35,106.18 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 59 37 — — $9,780.00 $141,965.66 $35,102.71 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 65 39 — — $10,799.00 $116,939.79 $35,029.45 2024-10-01
72 APR_DRG Allogeneic Bone Marrow Transplant 16 13 — — $29,633.00 $44,449.50 $34,966.94 2024-10-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 16 13 — — $29,487.00 $44,230.50 $34,794.66 2024-10-01
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