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 PALMS WEST HOSPITAL

Loxahatchee, FL · CCN 100269 · Rates published

28,524 distinct procedures filed
53 distinct payers
824,659 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

780,540 of 824,659 rate rows are consumer-grade (94.7%)

44,119 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 22,381
per-diem day rate — not a per-procedure price 16,088
template filing: same amount across many unrelated codes — excluded 4,686
exceeds 10× this hospital's gross charge — excluded from medians 851
placeholder amount (≤ $0.02) — excluded from medians 113

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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/62-1694178_HCA-FLORIDA-PALMS-WEST-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
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,006,423
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
$2,469,189
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 21 $3,636,171.00 $4,407,480.00 $3,783,087.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 21 $3,568,950.00 $4,326,000.00 $3,713,150.00 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 22 $5,565.76 $3,990,546.00 $3,408,591.38 nat. median
$13,041
outlier · 261.4×
748
OTHER 		Inj, Lovotibeglogene Auto 22 $9,180.70 $3,943,200.00 $3,368,150.00 nat. median
$17,963
outlier · 187.5×
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 $8,154.28 $3,561,600.00 $3,042,200.00 nat. median
$21,896
outlier · 138.9×
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 $2,364,727.86 $2,866,336.80 $2,460,272.42 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,316,955.58 $2,316,955.58 $2,316,955.58 nat. median
$2,457,321
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 21 $523,900.97 $635,031.48 $545,068.69 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 21 $521,852.17 $632,548.08 $542,937.10 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 21 $521,321.72 $631,905.12 $542,385.23 nat. median
$558,082
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 21 $511,558.84 $620,071.32 $532,227.88 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
9035
OTHER 		Axicabtagene Ciloleucel C 21 $484,561.44 $587,347.20 $504,139.68 nat. median
$532,192
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
$754,974
0.7× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$534,091
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 3 $492,271.12 $837,683.55 $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
9391
OTHER 		Brexucabtagene Car Pos T 21 $455,925.10 $552,636.48 $474,346.31 nat. median
$489,450
1.0× 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
$625,184
0.8× 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
$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 $807,075.90 $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 $741,576.00 $435,956.80 nat. median
$620,080
0.7× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 31 $1,870.00 $725,393.41 $305,396.53 nat. median
$370,174
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 34 $1,870.00 $541,808.87 $226,134.10 nat. median
$265,286
0.9× median
5834
APR_DRG 		Neonate With Ecmo 12 $192,207.00 $288,310.50 $225,843.22 nat. median
$309,665
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 33 $1,870.00 $456,331.78 $192,543.57 nat. median
$206,368
0.9× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $188,656.08 $188,656.08 $188,656.08 nat. median
$263,894
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 34 $1,870.00 $555,647.81 $174,046.53 nat. median
$202,986
0.9× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $155,668.99 $155,668.99 $155,668.99 nat. median
$424,868
outlier · 0.4×
1908
OTHER 		New Technology - Level 52 22 $145,866.50 $176,807.88 $153,233.49 nat. median
$152,962
1.0× median
1907
OTHER 		New Technology - Level 52 22 $145,866.50 $176,807.88 $153,233.49 nat. median
$153,199
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 12 $125,393.00 $188,089.50 $147,336.78 nat. median
$246,434
0.6× median
5833
APR_DRG 		Neonate With Ecmo 12 $124,517.00 $186,775.50 $146,307.48 nat. median
$244,017
0.6× 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
1905
OTHER 		New Technology - Level 51 22 $131,519.02 $159,417.00 $138,161.40 nat. median
$137,903
1.0× median
1906
OTHER 		New Technology - Level 51 22 $131,519.02 $159,417.00 $138,161.40 nat. median
$138,020
1.0× median
24
APR_DRG 		Heart And/or Lung Transplant 12 $111,047.00 $166,570.50 $130,480.23 nat. median
$234,738
0.6× median
01905
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median
01906
OTHER 		New Technology - Level 51 1 $128,862.07 $128,862.07 $128,862.07 nat. median
$82,736
1.6× median

Other procedures at this hospital

Browse this hospital's 28,524 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 2 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… 2 1 — — $3,884,946.48 $3,884,946.48 $3,884,946.48 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 25 21 — — $3,636,171.00 $4,407,480.00 $3,783,087.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 25 21 — — $3,568,950.00 $4,326,000.00 $3,713,150.00 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
714 OTHER Inj Delandistrogene Mox R 26 22 — — $5,565.76 $3,990,546.00 $3,408,591.38 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 26 22 — — $9,180.70 $3,943,200.00 $3,368,150.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
746 OTHER Inj, Betibeglogene Autote 26 22 — — $8,154.28 $3,561,600.00 $3,042,200.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 25 21 — — $2,364,727.86 $2,866,336.80 $2,460,272.42 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 25 21 — — $523,900.97 $635,031.48 $545,068.69 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 25 21 — — $521,852.17 $632,548.08 $542,937.10 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 25 21 — — $521,321.72 $631,905.12 $542,385.23 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 25 21 — — $511,558.84 $620,071.32 $532,227.88 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
9035 OTHER Axicabtagene Ciloleucel C 25 21 — — $484,561.44 $587,347.20 $504,139.68 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 6 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
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 6 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
9391 OTHER Brexucabtagene Car Pos T 25 21 — — $455,925.10 $552,636.48 $474,346.31 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
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 6 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… 6 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… 6 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 56 31 — — $1,870.00 $725,393.41 $305,396.53 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 62 34 — — $1,870.00 $541,808.87 $226,134.10 2024-10-01
5834 APR_DRG Neonate With Ecmo 14 12 — — $192,207.00 $288,310.50 $225,843.22 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 59 33 — — $1,870.00 $456,331.78 $192,543.57 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $188,656.08 $188,656.08 $188,656.08 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 62 34 — — $1,870.00 $555,647.81 $174,046.53 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $155,668.99 $155,668.99 $155,668.99 2024-10-01
1908 OTHER New Technology - Level 52 26 22 — — $145,866.50 $176,807.88 $153,233.49 2024-10-01
1907 OTHER New Technology - Level 52 26 22 — — $145,866.50 $176,807.88 $153,233.49 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 12 — — $125,393.00 $188,089.50 $147,336.78 2024-10-01
5833 APR_DRG Neonate With Ecmo 14 12 — — $124,517.00 $186,775.50 $146,307.48 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
1906 OTHER New Technology - Level 51 26 22 — — $131,519.02 $159,417.00 $138,161.40 2024-10-01
1905 OTHER New Technology - Level 51 26 22 — — $131,519.02 $159,417.00 $138,161.40 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 14 12 — — $111,047.00 $166,570.50 $130,480.23 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $128,862.07 $128,862.07 $128,862.07 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $126,361.80 $126,361.80 $126,361.80 2024-10-01
1903 OTHER New Technology - Level 50 26 22 — — $117,171.55 $142,026.12 $123,089.30 2024-10-01
1904 OTHER New Technology - Level 50 26 22 — — $117,171.55 $142,026.12 $123,089.30 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 62 34 — — $1,870.00 $333,492.93 $115,139.90 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
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 12 — — $97,644.00 $146,466.00 $114,731.70 2024-10-01
5832 APR_DRG Neonate With Ecmo 14 12 — — $95,607.00 $143,410.50 $112,338.23 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 14 12 — — $95,167.00 $142,750.50 $111,821.23 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 2 1 — — $108,036.36 $108,036.36 $108,036.36 2024-10-01
1901 OTHER New Technology - Level 49 26 22 — — $102,824.07 $124,635.24 $108,017.21 2024-10-01
1902 OTHER New Technology - Level 49 26 22 — — $102,824.07 $124,635.24 $108,017.21 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 57 32 — — $1,870.00 $312,796.22 $107,902.03 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 12 — — $91,470.00 $137,205.00 $107,477.25 2024-10-01
7 MS_DRG Lung Transplant 61 34 — — $1,870.00 $263,861.60 $106,577.93 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 14 12 — — $90,217.00 $135,325.50 $106,004.98 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 27 23 — — $96,999.90 $119,999.88 $102,999.90 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
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 12 — — $82,446.00 $123,669.00 $96,874.05 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 12 — — $81,552.00 $122,328.00 $95,823.60 2024-10-01
1599 OTHER New Technology - Level 48 26 22 — — $90,867.82 $110,142.82 $95,457.11 2024-10-01
1585 OTHER New Technology - Level 48 26 22 — — $90,867.82 $110,142.82 $95,457.11 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 14 12 — — $80,942.00 $121,413.00 $95,106.85 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 27 23 — — $88,300.94 $109,238.28 $93,762.86 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 12 — — $79,657.00 $119,485.50 $93,596.98 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 3 2 — — $53,789.99 $91,596.09 $91,596.09 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 62 34 — — $1,870.00 $357,890.93 $90,151.99 2024-10-01
215 MS_DRG Other Heart Assist System Implant 66 35 — — $1,870.00 $326,911.00 $89,192.50 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
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 65 35 — — $1,870.00 $298,617.66 $89,031.22 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $88,848.05 $88,848.05 $88,848.05 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 14 12 — — $75,611.00 $113,416.50 $88,842.92 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 12 — — $75,232.00 $112,848.00 $88,397.60 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 61 34 — — $1,870.00 $317,928.12 $87,058.55 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 12 — — $73,863.00 $110,794.50 $86,789.02 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 34 — — $1,870.00 $290,602.36 $86,559.78 2024-10-01
1584 OTHER New Technology - Level 47 26 22 — — $81,302.85 $98,548.91 $85,409.05 2024-10-01
1598 OTHER New Technology - Level 47 26 22 — — $81,302.85 $98,548.91 $85,409.05 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 12 — — $71,560.00 $107,340.00 $84,083.00 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $82,555.13 $82,555.13 $82,555.13 2024-10-01
5831 APR_DRG Neonate With Ecmo 14 12 — — $69,493.00 $104,239.50 $81,654.27 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 1 1 — — $80,396.63 $80,396.63 $80,396.63 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 14 12 — — $68,321.00 $102,481.50 $80,277.18 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 35 — — $1,870.00 $212,735.00 $80,220.00 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $79,660.37 $79,660.37 $79,660.37 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 14 12 — — $67,242.00 $100,863.00 $79,009.35 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 12 — — $66,782.00 $100,173.00 $78,468.85 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 14 12 — — $64,392.00 $96,588.00 $75,660.60 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 62 34 — — $1,870.00 $255,383.29 $75,462.14 2024-10-01
1583 OTHER New Technology - Level 46 26 22 — — $71,737.86 $86,954.98 $75,360.98 2024-10-01
1597 OTHER New Technology - Level 46 26 22 — — $71,737.86 $86,954.98 $75,360.98 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 14 12 — — $62,352.00 $93,528.00 $73,263.60 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 14 12 — — $61,338.00 $92,007.00 $72,072.15 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 66 35 — — $1,870.00 $204,305.52 $71,917.34 2024-10-01
007 OTHER Lung Transplant 1 1 — — $71,230.05 $71,230.05 $71,230.05 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 1 — — $71,100.84 $71,100.84 $71,100.84 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
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 60 33 — — $1,870.00 $162,901.99 $70,157.72 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 12 — — $59,125.00 $88,687.50 $69,471.88 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 62 34 — — $1,870.00 $231,226.50 $69,109.88 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 26 22 — — $64,821.81 $78,571.90 $68,095.65 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 27 23 — — $63,895.55 $79,046.04 $67,847.85 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 12 — — $56,946.00 $85,419.00 $66,911.55 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 60 33 — — $1,870.00 $200,188.36 $66,832.49 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 66 35 — — $1,870.00 $171,750.83 $66,427.84 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $65,802.93 $65,802.93 $65,802.93 2024-10-01
10 MS_DRG Pancreas Transplant 58 33 — — $1,870.00 $160,286.54 $65,468.08 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 64 34 — — $1,870.00 $175,743.23 $65,455.34 2024-10-01
1596 OTHER New Technology - Level 45 26 22 — — $62,172.87 $75,361.06 $65,312.92 2024-10-01
1582 OTHER New Technology - Level 45 26 22 — — $62,172.87 $75,361.06 $65,312.92 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 14 12 — — $55,523.00 $83,284.50 $65,239.52 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 58 33 — — $1,870.00 $161,914.00 $65,097.74 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 26 22 — — $13,338.14 $76,025.72 $64,938.64 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 12 — — $54,849.00 $82,273.50 $64,447.57 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 3 — — $61,600.24 $104,773.89 $61,600.24 2024-10-01
0515T CPT Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including … 2 1 — — $44,716.00 $78,356.00 $61,536.00 2024-10-01
0571T CPT Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S… 2 1 — — $44,716.00 $78,356.00 $61,536.00 2024-10-01
0520T CPT Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L… 2 1 — — $44,716.00 $78,356.00 $61,536.00 2024-10-01
0614T CPT Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator 2 1 — — $44,716.00 $78,356.00 $61,536.00 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 62 34 — — $1,870.00 $143,571.73 $61,362.18 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
1612 APR_DRG Implantable Heart Assist Systems 14 12 — — $51,688.00 $77,532.00 $60,733.40 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $60,646.27 $60,646.27 $60,646.27 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 12 — — $51,226.00 $76,839.00 $60,190.55 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 34 — — $1,870.00 $196,811.46 $60,152.46 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 62 34 — — $1,870.00 $195,067.55 $59,884.95 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $58,444.88 $58,444.88 $58,444.88 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $58,311.47 $58,311.47 $58,311.47 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 14 12 — — $49,247.00 $73,870.50 $57,865.22 2024-10-01
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 12 — — $48,983.00 $73,474.50 $57,555.02 2024-10-01
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 12 — — $48,895.00 $73,342.50 $57,451.62 2024-10-01
64 APR_DRG Pancreas Transplant 14 12 — — $48,372.00 $72,558.00 $56,837.10 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 25 21 — — $54,465.08 $66,018.28 $56,665.69 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 62 34 — — $1,870.00 $193,997.37 $56,232.43 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 63 34 — — $1,870.00 $139,772.00 $56,023.71 2024-10-01
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 12 — — $47,538.00 $71,307.00 $55,857.15 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 62 34 — — $1,870.00 $185,873.95 $55,781.27 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 61 33 — — $1,870.00 $70,878.70 $55,568.90 2024-10-01
1581 OTHER New Technology - Level 44 26 22 — — $52,607.89 $63,767.14 $55,264.85 2024-10-01
1595 OTHER New Technology - Level 44 26 22 — — $52,607.89 $63,767.14 $55,264.85 2024-10-01
8514 APR_DRG Gender Related Procedures 14 12 — — $46,902.00 $70,353.00 $55,109.85 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 35 — — $1,870.00 $212,735.00 $55,088.22 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 59 33 — — $1,870.00 $128,467.63 $55,027.03 2024-10-01
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational 14 12 — — $46,525.00 $69,787.50 $54,666.88 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 14 12 — — $46,203.00 $69,304.50 $54,288.53 2024-10-01
215 OTHER Other Heart Assist System Implant 1 1 — — $54,231.97 $54,231.97 $54,231.97 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 14 12 — — $45,376.00 $68,064.00 $53,316.80 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 61 33 — — $1,870.00 $124,412.68 $52,798.28 2024-10-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 14 12 — — $44,835.00 $67,252.50 $52,681.12 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 66 35 — — $1,870.00 $204,305.52 $52,673.29 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $52,496.18 $52,496.18 $52,496.18 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 62 34 — — $1,870.00 $138,361.61 $52,383.30 2024-10-01
5244 OTHER Level 4 Blood Product Exc 26 22 — — $49,801.21 $65,395.53 $52,316.42 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $52,204.26 $52,204.26 $52,204.26 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 62 34 — — $1,870.00 $124,978.75 $52,166.06 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 62 34 — — $1,870.00 $171,506.85 $51,558.94 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
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 65 35 — — $1,870.00 $249,303.20 $51,434.73 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 14 12 — — $43,677.00 $65,515.50 $51,320.47 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 12 — — $43,560.00 $65,340.00 $51,183.00 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 63 34 — — $1,870.00 $118,045.56 $51,157.23 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 63 34 — — $1,870.00 $141,342.05 $51,021.94 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 66 35 — — $1,870.00 $212,735.00 $50,845.05 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 61 33 — — $1,870.00 $116,937.57 $50,687.91 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 57 32 — — $1,870.00 $312,796.22 $50,332.64 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 57 32 — — $1,870.00 $312,796.22 $50,332.64 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 65 35 — — $1,870.00 $118,451.44 $50,322.70 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 39 28 — — $4,345.00 $60,778.49 $49,595.25 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 14 12 — — $42,035.00 $63,052.50 $49,391.12 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 14 12 — — $41,957.00 $62,935.50 $49,299.48 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 14 12 — — $41,876.00 $62,814.00 $49,204.30 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 14 12 — — $41,730.00 $62,595.00 $49,032.75 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 27 23 — — $46,068.21 $56,991.60 $48,917.79 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 60 33 — — $1,870.00 $140,673.88 $48,856.29 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $48,795.12 $48,795.12 $48,795.12 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 60 33 — — $1,870.00 $123,595.28 $48,571.33 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 62 34 — — $1,870.00 $111,990.07 $47,898.59 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $47,586.97 $47,586.97 $47,586.97 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 60 33 — — $1,870.00 $200,188.36 $47,323.95 2024-10-01
1142 OTHER Supprelin La Implant 26 22 — — $44,896.71 $54,420.25 $47,164.22 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $47,124.50 $47,124.50 $47,124.50 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 34 — — $1,870.00 $152,631.67 $46,913.92 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 14 12 — — $39,878.00 $59,817.00 $46,856.65 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 62 34 — — $1,870.00 $151,658.52 $46,622.32 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 1 1 — — $46,417.74 $46,417.74 $46,417.74 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 62 34 — — $1,870.00 $107,225.31 $46,117.34 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 66 35 — — $1,870.00 $130,856.46 $46,028.91 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 12 — — $38,906.00 $58,359.00 $45,714.55 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $45,680.10 $45,680.10 $45,680.10 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 64 34 — — $1,870.00 $175,743.23 $45,395.62 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 61 33 — — $1,870.00 $106,315.45 $45,282.88 2024-10-01
1580 OTHER New Technology - Level 43 26 22 — — $43,042.90 $52,173.22 $45,216.79 2024-10-01
1594 OTHER New Technology - Level 43 26 22 — — $43,042.90 $52,173.22 $45,216.79 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $45,140.21 $45,140.21 $45,140.21 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 61 34 — — $1,870.00 $161,914.00 $45,041.04 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 62 34 — — $1,870.00 $123,661.82 $44,941.00 2024-10-01
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 62 34 — — $1,870.00 $103,789.76 $44,676.36 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 14 12 — — $37,904.00 $56,856.00 $44,537.20 2024-10-01
834 OTHER Acute Leukemia With Mcc 1 1 — — $44,323.06 $44,323.06 $44,323.06 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 62 34 — — $1,870.00 $103,887.87 $44,274.76 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 62 34 — — $1,870.00 $103,776.30 $44,206.33 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 4 2 — — $6,300.00 $51,722.00 $44,082.00 2024-10-01
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 4 2 — — $6,300.00 $51,722.00 $44,082.00 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 14 12 — — $37,476.00 $56,214.00 $44,034.30 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 63 34 — — $1,870.00 $105,370.00 $43,820.09 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 14 12 — — $36,953.00 $55,429.50 $43,419.78 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $43,310.77 $43,310.77 $43,310.77 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $43,241.44 $72,861.11 $43,241.44 2024-10-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 62 34 — — $1,870.00 $142,775.43 $43,115.09 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 64 34 — — $1,870.00 $132,533.82 $42,779.43 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 62 34 — — $1,870.00 $68,832.86 $42,663.68 2024-10-01
01594 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
01580 OTHER New Technology - Level 43 1 1 — — $42,173.35 $42,173.35 $42,173.35 2024-10-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures 60 33 — — $1,870.00 $123,664.59 $41,918.95 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 62 34 — — $1,870.00 $97,693.87 $41,702.53 2024-10-01
4404 APR_DRG Kidney Transplant 14 12 — — $35,422.00 $53,133.00 $41,620.85 2024-10-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 62 34 — — $1,870.00 $96,208.85 $41,496.69 2024-10-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 62 34 — — $1,870.00 $96,882.11 $41,365.42 2024-10-01
8634 APR_DRG Neonatal Aftercare 14 12 — — $35,009.00 $52,513.50 $41,135.57 2024-10-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 61 33 — — $1,870.00 $96,310.80 $41,128.17 2024-10-01
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 65 35 — — $1,870.00 $187,190.88 $41,035.25 2024-10-01
245 MS_DRG Aicd Generator Procedures 62 33 — — $1,425.00 $93,996.71 $40,769.68 2024-10-01
471 MS_DRG Cervical Spinal Fusion With Mcc 63 34 — — $1,870.00 $66,991.00 $40,730.15 2024-10-01
63 APR_DRG Pancreas Transplant 14 12 — — $34,364.00 $51,546.00 $40,377.70 2024-10-01
6 MS_DRG Liver Transplant Without Mcc 61 34 — — $1,870.00 $317,928.12 $40,265.49 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 14 12 — — $34,228.00 $51,342.00 $40,217.90 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 4 2 — — $6,300.00 $51,638.00 $40,213.00 2024-10-01
249 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent Without Mcc 4 2 — — $6,300.00 $51,638.00 $40,213.00 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 14 12 — — $34,068.00 $51,102.00 $40,029.90 2024-10-01
232 OTHER Coronary Bypass With Ptca Without Mcc 1 1 — — $40,002.39 $40,002.39 $40,002.39 2024-10-01
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $39,998.73 $39,998.73 $39,998.73 2024-10-01
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $39,908.75 $39,908.75 $39,908.75 2024-10-01
466 OTHER Revision Of Hip Or Knee Replacement With Mcc 1 1 — — $39,843.88 $39,843.88 $39,843.88 2024-10-01
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 62 34 — — $1,870.00 $138,361.61 $39,827.34 2024-10-01
461 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 1 1 — — $39,594.34 $39,594.34 $39,594.34 2024-10-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 64 34 — — $1,870.00 $175,743.23 $39,518.79 2024-10-01
799 MS_DRG Splenic Procedures With Mcc 62 34 — — $1,870.00 $91,457.56 $39,503.85 2024-10-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 62 34 — — $1,870.00 $100,370.04 $39,502.23 2024-10-01
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device… 27 23 — — $37,140.82 $45,947.40 $39,438.18 2024-10-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $39,397.64 $39,397.64 $39,397.64 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
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. 62 34 — — $1,870.00 $91,855.75 $39,278.08 2024-10-01
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $39,259.52 $39,259.52 $39,259.52 2024-10-01
L2006 HCPCS Knee Ankle Foot Device, Any Material, Single Or Double Upright, Swing And Stance… 27 23 — — $36,570.46 $45,241.80 $38,832.54 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $38,803.31 $38,803.31 $38,803.31 2024-10-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 62 34 — — $1,870.00 $90,009.09 $38,511.20 2024-10-01
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 58 33 — — $1,870.00 $128,275.26 $38,503.46 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 1 — — $35,664.00 $41,013.00 $38,338.50 2024-10-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 60 33 — — $1,870.00 $105,662.75 $38,330.26 2024-10-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 62 34 — — $1,870.00 $88,325.94 $38,190.34 2024-10-01
006 OTHER Liver Transplant Without Mcc 1 1 — — $38,133.19 $38,133.19 $38,133.19 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 14 12 — — $32,422.00 $48,633.00 $38,095.85 2024-10-01
163 MS_DRG Major Chest Procedures With Mcc 65 35 — — $1,870.00 $88,656.80 $37,949.62 2024-10-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 2 1 — — $27,959.00 $47,788.00 $37,873.50 2024-10-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 62 34 — — $1,870.00 $92,288.21 $37,541.66 2024-10-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 62 34 — — $1,870.00 $92,727.00 $37,488.68 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 14 12 — — $31,789.00 $47,683.50 $37,352.07 2024-10-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 60 33 — — $1,870.00 $140,673.88 $37,226.49 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 14 12 — — $31,574.00 $47,361.00 $37,099.45 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 14 12 — — $31,456.00 $47,184.00 $36,960.80 2024-10-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 65 35 — — $1,870.00 $86,261.92 $36,955.08 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 14 12 — — $31,113.00 $46,669.50 $36,557.78 2024-10-01
901 MS_DRG Wound Debridements For Injuries With Mcc 62 34 — — $1,870.00 $85,219.33 $36,522.11 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 14 12 — — $30,783.00 $46,174.50 $36,170.02 2024-10-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 62 34 — — $1,870.00 $114,781.50 $36,122.90 2024-10-01
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $36,108.09 $36,108.09 $36,108.09 2024-10-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 63 34 — — $1,870.00 $100,228.65 $36,017.36 2024-10-01
017 OTHER Autologous Bone Marrow Transplant Without Cc/mcc 1 1 — — $35,869.53 $35,869.53 $35,869.53 2024-10-01
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $35,813.04 $35,813.04 $35,813.04 2024-10-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 63 34 — — $1,870.00 $86,885.00 $35,741.54 2024-10-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 58 32 — — $1,870.00 $83,228.40 $35,695.32 2024-10-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 60 33 — — $1,870.00 $66,991.00 $35,557.38 2024-10-01
1784 APR_DRG External Heart Assist Devices 14 12 — — $30,258.00 $45,387.00 $35,553.15 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 14 12 — — $30,178.00 $45,267.00 $35,459.15 2024-10-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 14 12 — — $30,089.00 $45,133.50 $35,354.57 2024-10-01
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 14 12 — — $30,025.00 $45,037.50 $35,279.38 2024-10-01
140 MS_DRG Major Head And Neck Procedures With Mcc 62 34 — — $1,870.00 $81,349.04 $35,264.02 2024-10-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 65 35 — — $1,870.00 $82,049.23 $35,205.64 2024-10-01
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