Price Transparency Hospital negotiated rates

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

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Hospital

HCA FLORIDA OAK HILL HOSPITAL

Brooksville, FL · CCN 100264 · Rates published

29,590 distinct procedures filed
45 distinct payers
713,935 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

360,669 of 713,935 rate rows are consumer-grade (50.5%)

353,266 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 339,618
per-diem day rate — not a per-procedure price 11,362
template filing: same amount across many unrelated codes — excluded 2,146
placeholder amount (≤ $0.02) — excluded from medians 101
exceeds 10× this hospital's gross charge — excluded from medians 39

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://stctrprodsnsvc00455826e6.blob.core.windows.net/pt-final-posting-files/62-1113740_HCA-FLORIDA-OAK-HILL-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 Latest re-check couldn't be parsed — showing last good data · 2026-06-08

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 20 $3,672,900.00 $4,187,106.00 $3,746,358.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 20 $3,605,000.00 $4,109,700.00 $3,677,100.00 nat. median
$3,605,000
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 21 $6,372.10 $3,791,018.70 $3,391,964.10 nat. median
$13,041
outlier · 260.1×
748
OTHER 		Inj, Lovotibeglogene Auto 21 $10,510.76 $3,746,040.00 $3,351,720.00 nat. median
$17,963
outlier · 186.6×
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 21 $9,335.65 $3,383,520.00 $3,027,360.00 nat. median
$21,896
outlier · 138.3×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 20 $2,388,614.00 $2,723,019.96 $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
$2,457,321
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 20 $529,192.90 $603,279.91 $539,776.76 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 20 $527,123.40 $600,920.68 $537,665.87 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 20 $526,587.60 $600,309.86 $537,119.35 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 20 $516,726.10 $589,067.75 $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
$538,205
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$554,552
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$530,178
1.0× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 3 $502,693.77 $1,125,423.00 $502,693.77 nat. median
$754,974
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$534,091
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 20 $489,456.00 $557,979.84 $499,245.12 nat. median
$532,192
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $1,091,527.05 $492,271.12 nat. median
$675,122
0.7× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$505,583
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 3 $470,149.30 $1,082,427.24 $470,149.30 nat. median
$625,184
0.8× median
9391
OTHER 		Brexucabtagene Car Pos T 20 $460,530.40 $525,004.66 $469,741.01 nat. median
$489,450
1.0× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 3 $459,839.17 $1,067,238.95 $459,839.17 nat. median
$674,188
0.7× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$464,978
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 3 $445,599.57 $1,051,644.36 $445,599.57 nat. median
$634,511
0.7× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 3 $435,956.80 $966,296.00 $435,956.80 nat. median
$620,080
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 27 $7,387.00 $961,233.00 $327,160.00 nat. median
$370,174
0.9× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 28 $10,670.00 $717,961.54 $244,467.20 nat. median
$265,286
0.9× median
5834
APR_DRG 		Neonate With Ecmo 12 $192,207.00 $288,310.50 $230,648.40 nat. median
$309,665
0.7× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $215,987.86 $215,987.86 $215,987.86 nat. median
$263,894
0.8× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 28 $10,670.00 $604,694.17 $205,965.40 nat. median
$206,368
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 28 $10,670.00 $689,263.83 $187,962.01 nat. median
$202,986
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $178,221.79 $178,221.79 $178,221.79 nat. median
$424,868
outlier · 0.4×
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $156,515.70 $156,515.70 $156,515.70 nat. median
$76,377
outlier · 2.0×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 12 $125,393.00 $188,089.50 $150,471.60 nat. median
$246,434
0.6× median
1908
OTHER 		New Technology - Level 52 20 $147,339.90 $167,967.49 $150,286.70 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 20 $147,339.90 $167,967.49 $150,286.70 nat. median
$153,199
1.0× median
5833
APR_DRG 		Neonate With Ecmo 12 $124,517.00 $186,775.50 $149,420.40 nat. median
$244,017
0.6× median
003
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $144,668.71 $144,668.71 $144,668.71 nat. median
$218,232
0.7× median
01907
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$84,819
1.7× median
01908
OTHER 		New Technology - Level 52 1 $142,919.70 $142,919.70 $142,919.70 nat. median
$82,736
1.7× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 1 $140,774.65 $140,774.65 $140,774.65 nat. median
$62,507
outlier · 2.3×
1906
OTHER 		New Technology - Level 51 20 $132,847.50 $151,446.15 $135,504.45 nat. median
$138,020
1.0× median
1905
OTHER 		New Technology - Level 51 20 $132,847.50 $151,446.15 $135,504.45 nat. median
$137,903
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 12 $111,047.00 $166,570.50 $133,256.40 nat. median
$234,738
0.6× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median

Other procedures at this hospital

Browse this hospital's 29,590 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 22 20 — — $3,672,900.00 $4,187,106.00 $3,746,358.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 22 20 — — $3,605,000.00 $4,109,700.00 $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 23 21 — — $6,372.10 $3,791,018.70 $3,391,964.10 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 23 21 — — $10,510.76 $3,746,040.00 $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 23 21 — — $9,335.65 $3,383,520.00 $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 22 20 — — $2,388,614.00 $2,723,019.96 $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 22 20 — — $529,192.90 $603,279.91 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 22 20 — — $527,123.40 $600,920.68 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 22 20 — — $526,587.60 $600,309.86 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 22 20 — — $516,726.10 $589,067.75 $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… 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
9035 OTHER Axicabtagene Ciloleucel C 22 20 — — $489,456.00 $557,979.84 $499,245.12 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
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
9391 OTHER Brexucabtagene Car Pos T 22 20 — — $460,530.40 $525,004.66 $469,741.01 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 46 27 — — $7,387.00 $961,233.00 $327,160.00 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 48 28 — — $10,670.00 $717,961.54 $244,467.20 2024-10-01
5834 APR_DRG Neonate With Ecmo 15 12 — — $192,207.00 $288,310.50 $230,648.40 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $215,987.86 $215,987.86 $215,987.86 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 49 28 — — $10,670.00 $604,694.17 $205,965.40 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 49 28 — — $10,670.00 $689,263.83 $187,962.01 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $178,221.79 $178,221.79 $178,221.79 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $156,515.70 $156,515.70 $156,515.70 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $125,393.00 $188,089.50 $150,471.60 2024-10-01
1907 OTHER New Technology - Level 52 22 20 — — $147,339.90 $167,967.49 $150,286.70 2024-10-01
1908 OTHER New Technology - Level 52 22 20 — — $147,339.90 $167,967.49 $150,286.70 2024-10-01
5833 APR_DRG Neonate With Ecmo 15 12 — — $124,517.00 $186,775.50 $149,420.40 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $144,668.71 $144,668.71 $144,668.71 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
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
1906 OTHER New Technology - Level 51 22 20 — — $132,847.50 $151,446.15 $135,504.45 2024-10-01
1905 OTHER New Technology - Level 51 22 20 — — $132,847.50 $151,446.15 $135,504.45 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 15 12 — — $111,047.00 $166,570.50 $133,256.40 2024-10-01
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
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 49 28 — — $10,670.00 $413,687.61 $122,840.20 2024-10-01
1904 OTHER New Technology - Level 50 22 20 — — $118,355.10 $134,924.81 $120,722.20 2024-10-01
1903 OTHER New Technology - Level 50 22 20 — — $118,355.10 $134,924.81 $120,722.20 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 15 12 — — $97,644.00 $146,466.00 $117,172.80 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $114,804.45 $114,804.45 $114,804.45 2024-10-01
5832 APR_DRG Neonate With Ecmo 15 12 — — $95,607.00 $143,410.50 $114,728.40 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 46 27 — — $7,387.00 $388,013.98 $114,500.96 2024-10-01
7 MS_DRG Lung Transplant 46 27 — — $10,670.00 $333,100.77 $114,213.62 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 15 12 — — $95,167.00 $142,750.50 $114,200.40 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 12 — — $91,470.00 $137,205.00 $109,764.00 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 15 12 — — $90,217.00 $135,325.50 $108,260.40 2024-10-01
1901 OTHER New Technology - Level 49 22 20 — — $103,862.70 $118,403.48 $105,939.95 2024-10-01
1902 OTHER New Technology - Level 49 22 20 — — $103,862.70 $118,403.48 $105,939.95 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 1 — — $56,756.00 $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 — — $56,756.00 $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 — — $56,756.00 $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 — — $56,756.00 $102,063.00 $102,063.00 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 23 21 — — $96,999.90 $113,999.89 $101,999.90 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $101,720.02 $101,720.02 $101,720.02 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 — — $55,840.00 $100,416.00 $100,416.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 1 — — $55,840.00 $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 15 12 — — $82,446.00 $123,669.00 $98,935.20 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $81,552.00 $122,328.00 $97,862.40 2024-10-01
215 MS_DRG Other Heart Assist System Implant 51 29 — — $10,799.00 $400,594.58 $97,744.62 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 15 12 — — $80,942.00 $121,413.00 $97,130.40 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 48 28 — — $10,670.00 $443,952.57 $96,857.66 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 50 29 — — $10,670.00 $370,425.91 $95,749.76 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 12 — — $79,657.00 $119,485.50 $95,588.40 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $94,515.43 $94,515.43 $94,515.43 2024-10-01
1599 OTHER New Technology - Level 48 22 20 — — $91,785.68 $104,635.68 $93,621.39 2024-10-01
1585 OTHER New Technology - Level 48 22 20 — — $91,785.68 $104,635.68 $93,621.39 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 46 27 — — $10,670.00 $394,379.94 $93,610.09 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 23 21 — — $88,300.94 $103,776.37 $92,852.54 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 29 — — $10,799.00 $360,483.19 $92,148.63 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $92,044.22 $92,044.22 $92,044.22 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 15 12 — — $75,611.00 $113,416.50 $90,733.20 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 12 — — $75,232.00 $112,848.00 $90,278.40 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $89,032.11 $89,032.11 $89,032.11 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 12 — — $73,863.00 $110,794.50 $88,635.60 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $71,560.00 $107,340.00 $85,872.00 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 29 — — $10,799.00 $251,580.92 $84,874.64 2024-10-01
1584 OTHER New Technology - Level 47 22 20 — — $82,124.09 $93,621.46 $83,766.57 2024-10-01
1598 OTHER New Technology - Level 47 22 20 — — $82,124.09 $93,621.46 $83,766.57 2024-10-01
5831 APR_DRG Neonate With Ecmo 15 12 — — $69,493.00 $104,239.50 $83,391.60 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 15 12 — — $68,321.00 $102,481.50 $81,985.20 2024-10-01
007 OTHER Lung Transplant 1 1 — — $81,549.62 $81,549.62 $81,549.62 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $81,401.68 $81,401.68 $81,401.68 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 50 29 — — $10,670.00 $316,795.03 $81,032.00 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 15 12 — — $67,242.00 $100,863.00 $80,690.40 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 12 — — $66,782.00 $100,173.00 $80,138.40 2024-10-01
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
1613 APR_DRG Implantable Heart Assist Systems 15 12 — — $64,392.00 $96,588.00 $77,270.40 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $9,472.00 $75,435.00 $75,435.00 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $75,336.24 $75,336.24 $75,336.24 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 15 12 — — $62,352.00 $93,528.00 $74,822.40 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 50 29 — — $10,799.00 $253,434.65 $74,574.48 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 50 29 — — $9,472.00 $215,864.61 $74,532.48 2024-10-01
1597 OTHER New Technology - Level 46 22 20 — — $72,462.48 $82,607.23 $73,911.73 2024-10-01
1583 OTHER New Technology - Level 46 22 20 — — $72,462.48 $82,607.23 $73,911.73 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 15 12 — — $61,338.00 $92,007.00 $73,605.60 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 50 29 — — $10,799.00 $286,829.28 $73,407.07 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 50 29 — — $10,799.00 $248,327.44 $70,961.11 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 12 — — $59,125.00 $88,687.50 $70,950.00 2024-10-01
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
10 MS_DRG Pancreas Transplant 46 27 — — $10,670.00 $203,221.57 $69,844.40 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 46 27 — — $10,670.00 $202,051.58 $69,444.70 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $69,432.50 $69,432.50 $69,432.50 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 50 29 — — $10,799.00 $213,051.56 $68,819.68 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 12 — — $56,946.00 $85,419.00 $68,335.20 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 28 — — $10,799.00 $218,004.01 $68,130.10 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 23 21 — — $63,895.55 $75,093.74 $67,189.13 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $66,912.17 $66,912.17 $66,912.17 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 22 20 — — $65,476.58 $74,643.30 $66,786.11 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $66,759.44 $66,759.44 $66,759.44 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 15 12 — — $55,523.00 $83,284.50 $66,627.60 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $54,849.00 $82,273.50 $65,818.80 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 50 29 — — $10,670.00 $190,249.71 $65,087.52 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 23 21 — — $15,270.53 $72,224.44 $64,621.87 2024-10-01
1596 OTHER New Technology - Level 45 22 20 — — $62,800.88 $71,593.00 $64,056.90 2024-10-01
1582 OTHER New Technology - Level 45 22 20 — — $62,800.88 $71,593.00 $64,056.90 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 50 29 — — $10,799.00 $241,975.23 $63,803.57 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 — — $9,472.00 $62,710.00 $62,710.00 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 29 — — $10,799.00 $244,138.49 $62,544.20 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $62,088.92 $62,088.92 $62,088.92 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 15 12 — — $51,688.00 $77,532.00 $62,025.60 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
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 12 — — $51,226.00 $76,839.00 $61,471.20 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $60,916.85 $60,916.85 $60,916.85 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 29 — — $10,799.00 $251,580.92 $60,877.85 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 50 29 — — $10,670.00 $240,647.70 $60,174.38 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $60,101.65 $60,101.65 $60,101.65 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $59,767.43 $59,767.43 $59,767.43 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 15 12 — — $49,247.00 $73,870.50 $59,096.40 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 50 29 — — $10,799.00 $230,570.85 $59,091.86 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 49 29 — — $10,000.00 $75,866.07 $58,872.07 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 12 — — $48,983.00 $73,474.50 $58,779.60 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 50 29 — — $10,799.00 $113,899.43 $58,768.06 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 12 — — $48,895.00 $73,342.50 $58,674.00 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 49 28 — — $10,670.00 $170,234.96 $58,284.11 2024-10-01
64 APR_DRG Pancreas Transplant 15 12 — — $48,372.00 $72,558.00 $58,046.40 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 50 29 — — $10,799.00 $253,434.65 $57,077.63 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 12 — — $47,538.00 $71,307.00 $57,045.60 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 51 29 — — $10,799.00 $309,252.86 $56,507.79 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 49 29 — — $7,387.00 $164,861.67 $56,457.62 2024-10-01
8514 APR_DRG Gender Related Procedures 15 12 — — $46,902.00 $70,353.00 $56,282.40 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 51 29 — — $10,799.00 $251,580.92 $56,121.31 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 22 20 — — $55,015.23 $62,717.36 $56,115.53 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 15 12 — — $46,525.00 $69,787.50 $55,830.00 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 3 1 — — $30,928.00 $55,615.00 $55,615.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 3 1 — — $30,928.00 $55,615.00 $55,615.00 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 15 12 — — $46,203.00 $69,304.50 $55,443.60 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 50 29 — — $10,670.00 $161,196.21 $55,211.66 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 50 29 — — $10,799.00 $171,633.28 $54,897.42 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 50 29 — — $10,670.00 $212,748.91 $54,556.99 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $54,481.21 $54,481.21 $54,481.21 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 15 12 — — $45,376.00 $68,064.00 $54,451.20 2024-10-01
1581 OTHER New Technology - Level 44 22 20 — — $53,139.28 $60,578.78 $54,202.07 2024-10-01
1595 OTHER New Technology - Level 44 22 20 — — $53,139.28 $60,578.78 $54,202.07 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 50 29 — — $10,799.00 $156,424.48 $54,125.55 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $53,951.75 $53,951.75 $53,951.75 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 15 12 — — $44,835.00 $67,252.50 $53,802.00 2024-10-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 3 1 — — $29,705.00 $53,419.00 $53,419.00 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 3 1 — — $29,705.00 $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
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 46 27 — — $7,387.00 $388,013.98 $53,239.93 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 46 27 — — $7,387.00 $388,013.98 $53,239.93 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 50 29 — — $10,670.00 $156,962.32 $53,234.76 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $53,142.58 $53,142.58 $53,142.58 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 50 29 — — $10,799.00 $154,956.26 $53,090.57 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 12 — — $43,677.00 $65,515.50 $52,412.40 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $52,298.08 $52,298.08 $52,298.08 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 15 12 — — $43,560.00 $65,340.00 $52,272.00 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 50 29 — — $10,799.00 $175,330.42 $52,169.37 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 36 24 — — $11,098.00 $64,910.83 $51,928.66 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $51,679.98 $51,679.98 $51,679.98 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
5244 OTHER Level 4 Blood Product Exc 22 20 — — $50,304.25 $57,346.84 $51,310.33 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 50 29 — — $10,799.00 $248,327.44 $51,208.04 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $50,744.43 $50,744.43 $50,744.43 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 50 29 — — $9,472.00 $174,501.57 $50,645.20 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 50 29 — — $10,799.00 $153,316.10 $50,594.27 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $50,561.89 $50,561.89 $50,561.89 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $42,035.00 $63,052.50 $50,442.00 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 50 29 — — $10,670.00 $148,400.23 $50,353.43 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 15 12 — — $41,957.00 $62,935.50 $50,348.40 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 15 12 — — $41,876.00 $62,814.00 $50,251.20 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 15 12 — — $41,730.00 $62,595.00 $50,076.00 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 28 — — $10,799.00 $218,004.01 $50,012.60 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $49,585.49 $49,585.49 $49,585.49 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 50 29 — — $10,799.00 $189,334.84 $48,599.17 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 23 21 — — $46,068.21 $54,142.02 $48,442.86 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 49 29 — — $7,387.00 $140,880.68 $48,306.01 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 50 29 — — $10,799.00 $188,127.68 $48,292.00 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 50 29 — — $10,670.00 $142,086.36 $48,228.68 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 46 27 — — $10,670.00 $200,849.28 $48,035.59 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 15 12 — — $39,878.00 $59,817.00 $47,853.60 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 50 29 — — $10,670.00 $153,398.64 $47,452.55 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 50 29 — — $10,799.00 $162,323.36 $47,210.13 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
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 50 29 — — $10,670.00 $137,533.84 $46,885.45 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 50 29 — — $10,670.00 $137,663.84 $46,740.42 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 50 29 — — $10,670.00 $137,516.00 $46,690.67 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 15 12 — — $38,906.00 $58,359.00 $46,687.20 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 48 28 — — $10,799.00 $164,404.08 $46,271.74 2024-10-01
1142 OTHER Supprelin La Implant 22 20 — — $45,350.21 $51,699.24 $46,257.21 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $45,797.80 $45,797.80 $45,797.80 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $45,793.61 $45,793.61 $45,793.61 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $45,690.60 $45,690.60 $45,690.60 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $45,616.33 $45,616.33 $45,616.33 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 50 29 — — $10,670.00 $177,108.48 $45,488.12 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 15 12 — — $37,904.00 $56,856.00 $45,484.80 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 50 29 — — $10,799.00 $113,899.43 $45,340.21 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $45,330.63 $45,330.63 $45,330.63 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
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $45,105.44 $45,105.44 $45,105.44 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 50 29 — — $10,799.00 $85,385.02 $45,003.30 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 15 12 — — $37,476.00 $56,214.00 $44,971.20 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $44,947.32 $44,947.32 $44,947.32 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 50 29 — — $10,799.00 $79,957.96 $44,839.21 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 51 29 — — $10,799.00 $232,204.47 $44,473.76 2024-10-01
1580 OTHER New Technology - Level 43 22 20 — — $43,477.68 $49,564.56 $44,347.23 2024-10-01
1594 OTHER New Technology - Level 43 22 20 — — $43,477.68 $49,564.56 $44,347.23 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 15 12 — — $36,953.00 $55,429.50 $44,343.60 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 50 29 — — $10,799.00 $153,402.08 $44,203.44 2024-10-01
0207 RC — 12 10 — — $11,700.00 $44,022.50 $44,022.50 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 50 29 — — $10,670.00 $129,456.06 $43,978.32 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 49 29 — — $7,387.00 $127,623.33 $43,799.57 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 50 29 — — $10,670.00 $127,488.24 $43,753.65 2024-10-01
006 OTHER Liver Transplant Without Mcc 1 1 — — $43,657.80 $43,657.80 $43,657.80 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 50 29 — — $10,670.00 $128,380.39 $43,616.34 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 49 28 — — $10,799.00 $218,004.01 $43,424.76 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
245 MS_DRG Aicd Generator Procedures 50 29 — — $10,799.00 $124,556.88 $43,184.80 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 46 27 — — $10,670.00 $394,379.94 $42,855.75 2024-10-01
4404 APR_DRG Kidney Transplant 15 12 — — $35,422.00 $53,133.00 $42,506.40 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
8634 APR_DRG Neonatal Aftercare 15 12 — — $35,009.00 $52,513.50 $42,010.80 2024-10-01
0208 RC — 21 16 — — $7,500.00 $41,922.50 $41,922.50 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 50 29 — — $10,670.00 $121,192.21 $41,613.50 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 50 29 — — $10,670.00 $124,505.92 $41,611.77 2024-10-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 50 29 — — $10,670.00 $121,719.85 $41,374.93 2024-10-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $41,339.30 $41,339.30 $41,339.30 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 50 29 — — $10,799.00 $171,633.28 $41,338.03 2024-10-01
63 APR_DRG Pancreas Transplant 15 12 — — $34,364.00 $51,546.00 $41,236.80 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 15 12 — — $34,228.00 $51,342.00 $41,073.60 2024-10-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $41,066.19 $41,066.19 $41,066.19 2024-10-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $41,001.51 $41,001.51 $41,001.51 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 15 12 — — $34,068.00 $51,102.00 $40,881.60 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 46 27 — — $10,670.00 $159,121.47 $40,738.83 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 50 29 — — $10,670.00 $119,272.81 $40,551.45 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 50 29 — — $10,670.00 $117,480.86 $40,351.95 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 50 29 — — $10,670.00 $117,042.43 $40,202.91 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 50 29 — — $10,799.00 $131,071.35 $39,753.26 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 50 29 — — $9,472.00 $174,501.57 $39,720.27 2024-10-01
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $39,586.82 $39,586.82 $39,586.82 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 50 29 — — $10,670.00 $114,993.04 $39,506.29 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
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 23 21 — — $37,140.82 $43,650.03 $39,055.29 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 15 12 — — $32,422.00 $48,633.00 $38,906.40 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 50 29 — — $10,670.00 $114,307.36 $38,880.48 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 50 29 — — $10,799.00 $127,238.00 $38,861.71 2024-10-01
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $38,744.11 $38,744.11 $38,744.11 2024-10-01
228 OTHER Other Cardiothoracic Procedures With Mcc 1 1 — — $38,460.81 $38,460.81 $38,460.81 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 23 21 — — $36,570.46 $42,979.71 $38,455.53 2024-10-01
323 OTHER Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 1 1 — — $38,431.47 $38,431.47 $38,431.47 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 50 29 — — $10,670.00 $112,925.80 $38,415.55 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 15 12 — — $31,789.00 $47,683.50 $38,146.80 2024-10-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 48 28 — — $7,387.00 $110,287.58 $37,906.81 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 15 12 — — $31,574.00 $47,361.00 $37,888.80 2024-10-01
218 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $37,872.66 $37,872.66 $37,872.66 2024-10-01
576 OTHER Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc* 1 1 — — $37,782.22 $37,782.22 $37,782.22 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 15 12 — — $31,456.00 $47,184.00 $37,747.20 2024-10-01
G0448 HCPCS Insertion Or Replacement Of A Permanent Pacing Cardioverter-defibrillator System… 12 5 — — $5,395.00 $60,908.00 $37,698.50 2024-10-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 50 29 — — $10,799.00 $142,382.88 $37,695.17 2024-10-01
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