Hospital

Hca Florida Largo Hospital

Largo, FL · CCN 109812 · Rates published

Your selected procedure

You selected 788 (MS_DRG)

CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC

This hospital’s price: $16,828 across 9 payers · range $9,322-$21,102

Source: https://www.hcadam.com/api/public/content/9ee5da97a90841b590bffc73655500cf?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.

45,140 distinct procedures filed

59 distinct payers

1,351,836 rate rows

2024-10-01 last MRF observed · ⚠ 24 mo old

Data quality

1,328,090 of 1,351,836 rate rows are consumer-grade (98.2%)

23,746 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 — reason	Rows
per-diem day rate — not a per-procedure price	8,514
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only	8,507
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	5,421
template filing: same amount across many unrelated codes — excluded	531
percent-of-charges filed in the dollar field — excluded from medians	400
placeholder amount (≤ $0.02) — excluded from medians	195
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	104
exceeds 10× this hospital's gross charge — excluded from medians	46
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings	28

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 24 months old.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://www.hcadam.com/api/public/content/9ee5da97a90841b590bffc73655500cf?download=true
Found on page	https://www.hcafloridahealthcare.com/patient-resources/patient-financial-resources/pricing-transparency-cms-required-file-of-standard-charges
Discovered via	Discovered by HANK
Last fetch	not_modified · 2026-09-20
Content fingerprint	f6d49b8922568a93… · 638,712,035 bytes · first seen 2026-05-08

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
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 $621,313 0.8× 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 $599,737 0.8× 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 $574,037 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 $579,571 0.8× 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 $562,501 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 $513,770 0.8× median
5834 APR_DRG	Neonate With Ecmo	15	$192,207.00	$288,310.50	$230,648.40	nat. median $390,362 0.6× median
J7330 HCPCS	Autologous Cultured Chondrocytes, Implant	1	$156,515.70	$156,515.70	$156,515.70	nat. median $92,809 1.7× median
5884 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	15	$125,393.00	$188,089.50	$150,471.60	nat. median $286,698 0.5× median
5833 APR_DRG	Neonate With Ecmo	15	$124,517.00	$186,775.50	$149,420.40	nat. median $268,208 0.6× 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 $65,477 outlier · 2.2×
215 MS_DRG	Other Heart Assist System Implant	9	$10,799.00	$320,066.00	$136,328.00	nat. median $73,023 1.9× median
24 APR_DRG	Heart And/or Lung Transplant	15	$111,047.00	$166,570.50	$133,256.40	nat. median $225,531 0.6× median
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	7	$77,336.00	$183,631.00	$125,614.00	nat. median $69,822 1.8× median
218 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	7	$50,549.50	$173,239.00	$125,614.00	nat. median $45,446 outlier · 2.8×
217 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	7	$54,868.53	$178,437.00	$125,614.00	nat. median $47,458 outlier · 2.6×
Q2043 HCPCS	Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm…	2	$53,789.99	$119,352.48	$119,352.48	nat. median $63,499 1.9× median
114 APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	15	$97,644.00	$146,466.00	$117,172.80	nat. median $135,803 0.9× median
219 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	6	$65,741.29	$147,232.00	$116,330.00	nat. median $55,923 outlier · 2.1×
231 MS_DRG	Coronary Bypass With Ptca With Mcc	7	$71,998.48	$187,168.93	$115,891.00	nat. median $60,505 1.9× median
266 MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	9	$10,799.00	$233,623.00	$115,231.00	nat. median $44,036 outlier · 2.6×
267 MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	9	$10,799.00	$177,122.00	$115,231.00	nat. median $34,616 outlier · 3.3×
5832 APR_DRG	Neonate With Ecmo	15	$95,607.00	$143,410.50	$114,728.40	nat. median $201,678 0.6× median
232 MS_DRG	Coronary Bypass With Ptca Without Mcc	9	$10,799.00	$141,689.00	$114,496.00	nat. median $43,803 outlier · 2.6×
1614 APR_DRG	Implantable Heart Assist Systems	15	$95,167.00	$142,750.50	$114,200.40	nat. median $202,242 0.6× median
221 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	8	$10,799.00	$138,900.00	$112,640.00	nat. median $35,297 outlier · 3.2×
220 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	8	$10,799.00	$143,065.00	$112,640.00	nat. median $38,832 outlier · 2.9×
6304 APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	15	$91,470.00	$137,205.00	$109,764.00	nat. median $187,567 0.6× median
275 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	7	$12,698.00	$156,091.92	$109,425.00	nat. median $51,518 outlier · 2.1×
233 MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	7	$66,410.85	$121,395.00	$109,060.00	nat. median $55,935 1.9× median
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft	15	$90,217.00	$135,325.50	$108,260.40	nat. median $173,018 0.6× median
228 MS_DRG	Other Cardiothoracic Procedures With Mcc	8	$10,799.00	$137,939.00	$104,697.00	nat. median $35,725 outlier · 2.9×
234 MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	9	$10,799.00	$117,567.00	$104,245.00	nat. median $39,159 outlier · 2.7×
222 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	1	$68,499.00	$102,063.00	$102,063.00	nat. median $2,024 outlier · 50.4×
223 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock…	1	$68,499.00	$102,063.00	$102,063.00	nat. median $2,024 outlier · 50.4×
224 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	1	$68,499.00	$102,063.00	$102,063.00	nat. median $2,024 outlier · 50.4×
225 MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	1	$68,499.00	$102,063.00	$102,063.00	nat. median $2,024 outlier · 50.4×
226 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc	1	$67,393.00	$100,416.00	$100,416.00	nat. median $2,024 outlier · 49.6×
227 MS_DRG	Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc	1	$67,393.00	$100,416.00	$100,416.00	nat. median $2,024 outlier · 49.6×
A9699 HCPCS	Radiopharmaceutical, Therapeutic, Not Otherwise Classified	1	$100,053.67	$100,053.67	$100,053.67	nat. median $7,098 outlier · 14.1×
6094 APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	15	$82,446.00	$123,669.00	$98,935.20	nat. median $198,578 outlier · 0.5×
229 MS_DRG	Other Cardiothoracic Procedures Without Mcc	8	$10,799.00	$137,939.00	$98,814.00	nat. median $22,934 outlier · 4.3×
5883 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	15	$81,552.00	$122,328.00	$97,862.40	nat. median $173,134 0.6× median
6314 APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	15	$80,942.00	$121,413.00	$97,130.40	nat. median $181,762 0.5× median
235 MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	9	$10,799.00	$112,866.00	$97,000.00	nat. median $43,023 outlier · 2.3×
5914 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	15	$79,657.00	$119,485.50	$95,588.40	nat. median $171,497 0.6× median
236 MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	9	$10,799.00	$112,866.00	$94,383.00	nat. median $30,358 outlier · 3.1×
74 APR_DRG	Allogeneic Bone Marrow Transplant	15	$75,611.00	$113,416.50	$90,733.20	nat. median $149,836 0.6× median
94 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	15	$75,232.00	$112,848.00	$90,278.40	nat. median $152,792 0.6× median
5934 APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	15	$73,863.00	$110,794.50	$88,635.60	nat. median $168,439 0.5× median

Other procedures at this hospital

Browse this hospital's 45,140 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

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
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
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
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
5834	APR_DRG	Neonate With Ecmo	19	15	—	—	$192,207.00	$288,310.50	$230,648.40	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	19	15	—	—	$125,393.00	$188,089.50	$150,471.60	2024-10-01
5833	APR_DRG	Neonate With Ecmo	19	15	—	—	$124,517.00	$186,775.50	$149,420.40	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
215	MS_DRG	Other Heart Assist System Implant	15	9	—	—	$10,799.00	$320,066.00	$136,328.00	2024-10-01
24	APR_DRG	Heart And/or Lung Transplant	19	15	—	—	$111,047.00	$166,570.50	$133,256.40	2024-10-01
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	7	—	—	$77,336.00	$183,631.00	$125,614.00	2024-10-01
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	7	—	—	$50,549.50	$173,239.00	$125,614.00	2024-10-01
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	13	7	—	—	$54,868.53	$178,437.00	$125,614.00	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	19	15	—	—	$97,644.00	$146,466.00	$117,172.80	2024-10-01
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	11	6	—	—	$65,741.29	$147,232.00	$116,330.00	2024-10-01
231	MS_DRG	Coronary Bypass With Ptca With Mcc	13	7	—	—	$71,998.48	$187,168.93	$115,891.00	2024-10-01
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	15	9	—	—	$10,799.00	$233,623.00	$115,231.00	2024-10-01
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	15	9	—	—	$10,799.00	$177,122.00	$115,231.00	2024-10-01
5832	APR_DRG	Neonate With Ecmo	19	15	—	—	$95,607.00	$143,410.50	$114,728.40	2024-10-01
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	15	9	—	—	$10,799.00	$141,689.00	$114,496.00	2024-10-01
1614	APR_DRG	Implantable Heart Assist Systems	19	15	—	—	$95,167.00	$142,750.50	$114,200.40	2024-10-01
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	8	—	—	$10,799.00	$138,900.00	$112,640.00	2024-10-01
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	13	8	—	—	$10,799.00	$143,065.00	$112,640.00	2024-10-01
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	19	15	—	—	$91,470.00	$137,205.00	$109,764.00	2024-10-01
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	13	7	—	—	$12,698.00	$156,091.92	$109,425.00	2024-10-01
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	13	7	—	—	$66,410.85	$121,395.00	$109,060.00	2024-10-01
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	19	15	—	—	$90,217.00	$135,325.50	$108,260.40	2024-10-01
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	13	8	—	—	$10,799.00	$137,939.00	$104,697.00	2024-10-01
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	15	9	—	—	$10,799.00	$117,567.00	$104,245.00	2024-10-01
224	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh…	3	1	—	—	$68,499.00	$102,063.00	$102,063.00	2024-10-01
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
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
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	19	15	—	—	$82,446.00	$123,669.00	$98,935.20	2024-10-01
229	MS_DRG	Other Cardiothoracic Procedures Without Mcc	13	8	—	—	$10,799.00	$137,939.00	$98,814.00	2024-10-01
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	19	15	—	—	$81,552.00	$122,328.00	$97,862.40	2024-10-01
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	19	15	—	—	$80,942.00	$121,413.00	$97,130.40	2024-10-01
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	15	9	—	—	$10,799.00	$112,866.00	$97,000.00	2024-10-01
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	19	15	—	—	$79,657.00	$119,485.50	$95,588.40	2024-10-01
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	15	9	—	—	$10,799.00	$112,866.00	$94,383.00	2024-10-01
74	APR_DRG	Allogeneic Bone Marrow Transplant	19	15	—	—	$75,611.00	$113,416.50	$90,733.20	2024-10-01
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	19	15	—	—	$75,232.00	$112,848.00	$90,278.40	2024-10-01
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	19	15	—	—	$73,863.00	$110,794.50	$88,635.60	2024-10-01
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	19	15	—	—	$71,560.00	$107,340.00	$85,872.00	2024-10-01
5831	APR_DRG	Neonate With Ecmo	19	15	—	—	$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	19	15	—	—	$68,321.00	$102,481.50	$81,985.20	2024-10-01
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	13	7	—	—	$54,135.00	$109,888.00	$81,795.00	2024-10-01
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	15	9	—	—	$10,799.00	$109,723.00	$81,795.00	2024-10-01
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	19	15	—	—	$67,242.00	$100,863.00	$80,690.40	2024-10-01
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	19	15	—	—	$66,782.00	$100,173.00	$80,138.40	2024-10-01
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	12	7	—	—	$17,032.00	$187,062.91	$78,524.00	2024-10-01
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	15	9	—	—	$10,799.00	$109,723.00	$77,639.00	2024-10-01
272	MS_DRG	Other Major Cardiovascular Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$109,723.00	$77,639.00	2024-10-01
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	15	9	—	—	$10,799.00	$109,723.00	$77,639.00	2024-10-01
1613	APR_DRG	Implantable Heart Assist Systems	19	15	—	—	$64,392.00	$96,588.00	$77,270.40	2024-10-01
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	15	9	—	—	$10,799.00	$178,048.38	$74,994.00	2024-10-01
23	APR_DRG	Heart And/or Lung Transplant	19	15	—	—	$62,352.00	$93,528.00	$74,822.40	2024-10-01
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	19	15	—	—	$61,338.00	$92,007.00	$73,605.60	2024-10-01
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	19	15	—	—	$59,125.00	$88,687.50	$70,950.00	2024-10-01
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	9	—	—	$10,799.00	$126,768.77	$68,861.00	2024-10-01
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	15	9	—	—	$10,799.00	$184,222.26	$68,861.00	2024-10-01
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	15	9	—	—	$10,799.00	$146,695.00	$68,861.00	2024-10-01
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	15	9	—	—	$10,799.00	$231,528.06	$68,861.00	2024-10-01
113	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	15	—	—	$56,946.00	$85,419.00	$68,335.20	2024-10-01
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	19	15	—	—	$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…	19	15	—	—	$54,849.00	$82,273.50	$65,818.80	2024-10-01
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	15	9	—	—	$10,799.00	$114,078.00	$65,767.21	2024-10-01
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	13	7	—	—	$12,698.00	$147,486.00	$63,589.34	2024-10-01
1612	APR_DRG	Implantable Heart Assist Systems	19	15	—	—	$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	19	15	—	—	$51,226.00	$76,839.00	$61,471.20	2024-10-01
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	15	9	—	—	$10,799.00	$156,803.18	$60,317.65	2024-10-01
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	15	9	—	—	$10,799.00	$126,011.12	$59,983.00	2024-10-01
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	15	9	—	—	$10,799.00	$142,424.00	$59,983.00	2024-10-01
1611	APR_DRG	Implantable Heart Assist Systems	19	15	—	—	$49,247.00	$73,870.50	$59,096.40	2024-10-01
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	19	15	—	—	$48,983.00	$73,474.50	$58,779.60	2024-10-01
112	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	15	—	—	$48,895.00	$73,342.50	$58,674.00	2024-10-01
64	APR_DRG	Pancreas Transplant	19	15	—	—	$48,372.00	$72,558.00	$58,046.40	2024-10-01
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	15	9	—	—	$10,799.00	$135,553.57	$58,039.00	2024-10-01
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	15	9	—	—	$10,799.00	$81,505.00	$57,946.00	2024-10-01
27	MS_DRG	Craniotomy And Endovascular Intracranial Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$81,505.00	$57,946.00	2024-10-01
26	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Cc	15	9	—	—	$10,799.00	$81,505.00	$57,946.00	2024-10-01
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	15	9	—	—	$10,799.00	$105,716.00	$57,902.92	2024-10-01
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	19	15	—	—	$47,538.00	$71,307.00	$57,045.60	2024-10-01
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	15	9	—	—	$10,799.00	$78,377.00	$56,993.00	2024-10-01
8514	APR_DRG	Gender Related Procedures	19	15	—	—	$46,902.00	$70,353.00	$56,282.40	2024-10-01
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational	19	15	—	—	$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	—	—	$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
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	19	15	—	—	$46,203.00	$69,304.50	$55,443.60	2024-10-01
35	MS_DRG	Carotid Artery Stent Procedures With Cc	15	9	—	—	$10,799.00	$78,377.00	$55,378.00	2024-10-01
22	APR_DRG	Heart And/or Lung Transplant	19	15	—	—	$45,376.00	$68,064.00	$54,451.20	2024-10-01
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	19	15	—	—	$44,835.00	$67,252.50	$53,802.00	2024-10-01
36	MS_DRG	Carotid Artery Stent Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$78,377.00	$53,766.00	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
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	15	9	—	—	$10,799.00	$136,819.27	$52,630.42	2024-10-01
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	15	9	—	—	$10,799.00	$127,238.00	$52,472.00	2024-10-01
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	19	15	—	—	$43,677.00	$65,515.50	$52,412.40	2024-10-01
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	19	15	—	—	$43,560.00	$65,340.00	$52,272.00	2024-10-01
28	MS_DRG	Spinal Procedures With Mcc	15	9	—	—	$10,799.00	$134,281.24	$50,895.00	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…	19	15	—	—	$42,035.00	$63,052.50	$50,442.00	2024-10-01
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	19	15	—	—	$41,957.00	$62,935.50	$50,348.40	2024-10-01
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	19	15	—	—	$41,876.00	$62,814.00	$50,251.20	2024-10-01
21	APR_DRG	Heart And/or Lung Transplant	19	15	—	—	$41,730.00	$62,595.00	$50,076.00	2024-10-01
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	15	9	—	—	$10,799.00	$74,994.00	$49,076.00	2024-10-01
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	15	9	—	—	$10,799.00	$65,833.00	$48,319.44	2024-10-01
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	19	15	—	—	$39,878.00	$59,817.00	$47,853.60	2024-10-01
0294T	CPT	HInsertion Of Left Atrial Hemodynamic Monitor; Pressure Sensor Lead At Time Of I…	2	1	—	—	$45,326.00	$49,364.00	$47,345.00	2024-10-01
320	MS_DRG	Other Endovascular Cardiac Valve Procedures Without Mcc	15	9	—	—	$10,799.00	$127,238.00	$47,032.00	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
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	15	9	—	—	$10,799.00	$121,604.36	$46,777.68	2024-10-01
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	19	15	—	—	$38,906.00	$58,359.00	$46,687.20	2024-10-01
473	MS_DRG	Cervical Spinal Fusion Without Cc/mcc	15	9	—	—	$10,799.00	$74,994.00	$46,489.00	2024-10-01
471	MS_DRG	Cervical Spinal Fusion With Mcc	15	9	—	—	$10,799.00	$78,377.00	$46,489.00	2024-10-01
472	MS_DRG	Cervical Spinal Fusion With Cc	15	9	—	—	$10,799.00	$78,377.00	$46,489.00	2024-10-01
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	15	9	—	—	$10,799.00	$120,829.04	$46,479.44	2024-10-01
245	MS_DRG	Aicd Generator Procedures	15	9	—	—	$10,799.00	$107,937.90	$46,348.45	2024-10-01
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	19	15	—	—	$37,904.00	$56,856.00	$45,484.80	2024-10-01
242	MS_DRG	Permanent Cardiac Pacemaker Implant With Mcc	15	9	—	—	$10,799.00	$81,795.00	$45,326.00	2024-10-01
265	MS_DRG	Aicd Lead Procedures	15	9	—	—	$10,799.00	$99,972.00	$45,326.00	2024-10-01
84	APR_DRG	Autologous Bone Marrow Transplant	19	15	—	—	$37,476.00	$56,214.00	$44,971.20	2024-10-01
900549	CDM	Dont Use-set Ventricular	35	22	$188,775.00	$188,775.00	$9,627.52	$188,775.00	$44,928.45	2024-10-01
73	APR_DRG	Allogeneic Bone Marrow Transplant	19	15	—	—	$36,953.00	$55,429.50	$44,343.60	2024-10-01
462	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc	15	9	—	—	$10,799.00	$69,981.00	$43,618.36	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
G0448	HCPCS	Insertion Or Replacement Of A Permanent Pacing Cardioverter-defibrillator System…	11	5	—	—	$5,395.00	$55,286.00	$42,950.00	2024-10-01
29	MS_DRG	Spinal Procedures With Cc Or Spinal Neurostimulators	15	9	—	—	$10,799.00	$74,994.00	$42,798.00	2024-10-01
704267	CDM	Trial Spinal Cord Stim	19	12	$85,234.28	$85,234.28	$6,903.98	$85,234.28	$42,617.14	2024-10-01
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures	15	9	—	—	$10,799.00	$110,509.06	$42,509.64	2024-10-01
4404	APR_DRG	Kidney Transplant	19	15	—	—	$35,422.00	$53,133.00	$42,506.40	2024-10-01
0207	RC	—	13	12	—	—	$8,000.00	$42,172.50	$42,172.50	2024-10-01
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	14	9	—	—	$6,000.00	$65,982.40	$42,021.50	2024-10-01
8634	APR_DRG	Neonatal Aftercare	19	15	—	—	$35,009.00	$52,513.50	$42,010.80	2024-10-01
0208	RC	—	22	18	—	—	$7,500.00	$41,922.50	$41,922.50	2024-10-01
37	MS_DRG	Extracranial Procedures With Mcc	15	9	—	—	$10,799.00	$74,994.00	$41,813.00	2024-10-01
38	MS_DRG	Extracranial Procedures With Cc	15	9	—	—	$10,799.00	$74,994.00	$41,813.00	2024-10-01
39	MS_DRG	Extracranial Procedures Without Cc/mcc	15	9	—	—	$9,671.29	$74,994.00	$41,813.00	2024-10-01
482	MS_DRG	Hip And Femur Procedures Except Major Joint Without Cc/mcc	15	9	—	—	$10,799.00	$55,248.00	$41,807.00	2024-10-01
480	MS_DRG	Hip And Femur Procedures Except Major Joint With Mcc	15	9	—	—	$10,799.00	$55,248.00	$41,807.00	2024-10-01
481	MS_DRG	Hip And Femur Procedures Except Major Joint With Cc	15	9	—	—	$10,799.00	$55,248.00	$41,807.00	2024-10-01
515	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc	15	9	—	—	$10,799.00	$68,303.61	$41,478.00	2024-10-01
30	MS_DRG	Spinal Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$74,994.00	$41,406.00	2024-10-01
63	APR_DRG	Pancreas Transplant	19	15	—	—	$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	19	15	—	—	$34,228.00	$51,342.00	$41,073.60	2024-10-01
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	15	9	—	—	$10,799.00	$65,833.00	$40,937.00	2024-10-01
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	19	15	—	—	$34,068.00	$51,102.00	$40,881.60	2024-10-01
31	MS_DRG	Ventricular Shunt Procedures With Mcc	15	9	—	—	$10,799.00	$78,377.00	$39,745.00	2024-10-01
279	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures	15	9	—	—	$10,799.00	$81,795.00	$39,666.00	2024-10-01
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	15	9	—	—	$10,799.00	$127,287.00	$39,529.74	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
704452	CDM	Trial Spinal Cord Stim	19	12	$77,813.59	$77,813.59	$6,302.90	$77,813.59	$38,906.79	2024-10-01
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	19	15	—	—	$32,422.00	$48,633.00	$38,906.40	2024-10-01
252	MS_DRG	Other Vascular Procedures With Mcc	15	9	—	—	$10,799.00	$70,533.00	$38,363.00	2024-10-01
253	MS_DRG	Other Vascular Procedures With Cc	15	9	—	—	$10,799.00	$70,533.00	$38,363.00	2024-10-01
254	MS_DRG	Other Vascular Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$70,533.00	$38,363.00	2024-10-01
1674	APR_DRG	Other Cardiothoracic And Thoracic Circulatory Procedures	19	15	—	—	$31,789.00	$47,683.50	$38,146.80	2024-10-01
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	19	15	—	—	$31,574.00	$47,361.00	$37,888.80	2024-10-01
886382	CDM	Blood Pump Cannula 32f	17	12	$75,510.00	$75,510.00	$6,116.31	$75,510.00	$37,755.00	2024-10-01
13	APR_DRG	Liver Transplant And/or Intestinal Transplant	19	15	—	—	$31,456.00	$47,184.00	$37,747.20	2024-10-01
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	15	9	—	—	$10,799.00	$57,147.00	$37,532.00	2024-10-01
468	MS_DRG	Revision Of Hip Or Knee Replacement Without Cc/mcc	15	9	—	—	$10,799.00	$65,833.00	$37,478.00	2024-10-01
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	19	15	—	—	$31,113.00	$46,669.50	$37,335.60	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
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	19	15	—	—	$30,783.00	$46,174.50	$36,939.60	2024-10-01
41	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Cc Or Periphe…	15	9	—	—	$10,799.00	$68,978.00	$36,645.00	2024-10-01
1784	APR_DRG	External Heart Assist Devices	19	15	—	—	$30,258.00	$45,387.00	$36,309.60	2024-10-01
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	19	15	—	—	$30,178.00	$45,267.00	$36,213.60	2024-10-01
53	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	19	15	—	—	$30,089.00	$45,133.50	$36,106.80	2024-10-01
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	19	15	—	—	$30,025.00	$45,037.50	$36,030.00	2024-10-01
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	19	15	—	—	$29,751.00	$44,626.50	$35,701.20	2024-10-01
72	APR_DRG	Allogeneic Bone Marrow Transplant	19	15	—	—	$29,633.00	$44,449.50	$35,559.60	2024-10-01
1654	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	19	15	—	—	$29,487.00	$44,230.50	$35,384.40	2024-10-01
42	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$68,978.00	$35,237.00	2024-10-01
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	19	15	—	—	$29,098.00	$43,647.00	$34,917.60	2024-10-01
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	15	9	—	—	$10,799.00	$101,893.00	$34,694.95	2024-10-01
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	19	15	—	—	$28,871.00	$43,306.50	$34,645.20	2024-10-01
6214	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	19	15	—	—	$28,840.00	$43,260.00	$34,608.00	2024-10-01
6804	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	19	15	—	—	$28,815.00	$43,222.50	$34,578.00	2024-10-01
0614T	CPT	Removal And Replacement Of Substernal Implantable Defibrillator Pulse Generator	2	1	—	—	$29,476.00	$39,443.00	$34,459.50	2024-10-01
0571T	CPT	Insertion Or Replacement Of Implantable Cardioverter-defibrillator System With S…	2	1	—	—	$29,476.00	$39,443.00	$34,459.50	2024-10-01
0520T	CPT	Removal And Replacement Of Pulse Generator For Wireless Cardiac Stimulator For L…	2	1	—	—	$29,476.00	$39,443.00	$34,459.50	2024-10-01
0515T	CPT	Insertion Of Wireless Cardiac Stimulator For Left Ventricular Pacing, Including …	2	1	—	—	$29,476.00	$39,443.00	$34,459.50	2024-10-01
243	MS_DRG	Permanent Cardiac Pacemaker Implant With Cc	15	9	—	—	$10,799.00	$81,795.00	$34,313.13	2024-10-01
6334	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Anomaly	19	15	—	—	$28,549.00	$42,823.50	$34,258.80	2024-10-01
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	15	9	—	—	$10,799.00	$74,994.00	$33,992.34	2024-10-01
927543	CDM	Cap Tor Spn Thoracic L1	17	12	$67,959.00	$67,959.00	$5,504.68	$67,959.00	$33,979.50	2024-10-01
867144	CDM	Aicd Endotak W Lead8210	17	12	$67,650.00	$67,650.00	$5,479.65	$67,650.00	$33,825.00	2024-10-01
71	APR_DRG	Allogeneic Bone Marrow Transplant	19	15	—	—	$28,151.00	$42,226.50	$33,781.20	2024-10-01
274	MS_DRG	Percutaneous And Other Intracardiac Procedures Without Mcc	15	9	—	—	$10,799.00	$57,147.00	$33,621.00	2024-10-01
3044	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	19	15	—	—	$27,960.00	$41,940.00	$33,552.00	2024-10-01
299	MS_DRG	Peripheral Vascular Disorders With Mcc	15	9	—	—	$10,799.00	$70,533.00	$33,493.00	2024-10-01
300	MS_DRG	Peripheral Vascular Disorders With Cc	15	9	—	—	$9,096.04	$70,533.00	$33,493.00	2024-10-01
301	MS_DRG	Peripheral Vascular Disorders Without Cc/mcc	15	9	—	—	$6,060.91	$70,533.00	$33,493.00	2024-10-01
250	MS_DRG	Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc	15	9	—	—	$10,799.00	$57,147.00	$33,474.00	2024-10-01
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	15	9	—	—	$10,799.00	$86,792.10	$33,386.41	2024-10-01
865744	CDM	Aicd Endotak 8211	17	12	$66,550.00	$66,550.00	$5,390.55	$66,550.00	$33,275.00	2024-10-01
62	APR_DRG	Pancreas Transplant	19	15	—	—	$27,515.00	$41,272.50	$33,018.00	2024-10-01
865741	CDM	Aicd Cpi 8140	17	12	$65,725.00	$65,725.00	$5,323.73	$65,725.00	$32,862.50	2024-10-01
865742	CDM	Aicd Cpi 8150	17	12	$65,725.00	$65,725.00	$5,323.73	$65,725.00	$32,862.50	2024-10-01
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	19	15	—	—	$27,175.00	$40,762.50	$32,610.00	2024-10-01
5911	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	19	15	—	—	$26,951.00	$40,426.50	$32,341.20	2024-10-01
470	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity Without	15	9	—	—	$10,799.00	$65,833.00	$32,167.00	2024-10-01
469	MS_DRG	Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc…	15	9	—	—	$10,799.00	$65,833.00	$32,167.00	2024-10-01
522	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture Without Mcc	15	9	—	—	$10,799.00	$55,248.00	$32,167.00	2024-10-01
521	MS_DRG	Hip Replacement With Principal Diagnosis Of Hip Fracture With Mcc	15	9	—	—	$10,799.00	$64,380.60	$32,167.00	2024-10-01
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	19	15	—	—	$26,692.00	$40,038.00	$32,030.40	2024-10-01
6084	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	19	15	—	—	$26,558.00	$39,837.00	$31,869.60	2024-10-01
251	MS_DRG	Percutaneous Cardiovascular Procedures Without Intraluminal Device Without Mcc	15	9	—	—	$10,799.00	$57,147.00	$31,811.00	2024-10-01
519	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Cc	15	9	—	—	$10,799.00	$74,994.00	$31,811.00	2024-10-01
520	MS_DRG	Back And Neck Procedures Except Spinal Fusion Without Cc/mcc	15	9	—	—	$10,799.00	$74,994.00	$31,811.00	2024-10-01
133	MS_DRG	Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc	2	1	—	—	$27,401.00	$36,060.00	$31,730.50	2024-10-01
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	19	15	—	—	$26,369.00	$39,553.50	$31,642.80	2024-10-01
6814	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	19	15	—	—	$26,256.00	$39,384.00	$31,507.20	2024-10-01
3124	APR_DRG	Skin Graft For Musculoskeletal And Connective Tissue Diagnoses	19	15	—	—	$26,183.00	$39,274.50	$31,419.60	2024-10-01
7404	APR_DRG	Mental Illness Diagnosis With O.r. Procedure	19	15	—	—	$26,149.00	$39,223.50	$31,378.80	2024-10-01
6904	APR_DRG	Acute Leukemia	19	15	—	—	$26,010.00	$39,015.00	$31,212.00	2024-10-01
42	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	19	15	—	—	$25,840.00	$38,760.00	$31,008.00	2024-10-01
1664	APR_DRG	Coronary Bypass Without Ami Or Complex Principal Diagnosis	19	15	—	—	$25,822.00	$38,733.00	$30,986.40	2024-10-01
66	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction Without Cc/mcc	14	9	—	—	$5,848.49	$74,994.00	$30,901.00	2024-10-01
67	MS_DRG	Nonspecific Cva And Precerebral Occlusion Without Infarction With Mcc	14	9	—	—	$6,000.00	$74,994.00	$30,901.00	2024-10-01
65	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Cc Or Tpa In 24 Hours	14	9	—	—	$6,000.00	$74,994.00	$30,901.00	2024-10-01
69	MS_DRG	Transient Ischemia Without Thrombolytic	14	9	—	—	$6,000.00	$74,994.00	$30,901.00	2024-10-01
68	MS_DRG	Nonspecific Cva And Precerebral Occlusion Without Infarction Without Mcc	14	9	—	—	$6,000.00	$74,994.00	$30,901.00	2024-10-01
64	MS_DRG	Intracranial Hemorrhage Or Cerebral Infarction With Mcc	14	9	—	—	$6,000.00	$74,994.00	$30,901.00	2024-10-01
516	MS_DRG	Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc	15	9	—	—	$10,799.00	$51,391.00	$30,640.69	2024-10-01
3614	APR_DRG	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	19	15	—	—	$25,369.00	$38,053.50	$30,442.80	2024-10-01
914	APR_DRG	Other Major Head And Neck Procedures	19	15	—	—	$25,293.00	$37,939.50	$30,351.60	2024-10-01
12	APR_DRG	Liver Transplant And/or Intestinal Transplant	19	15	—	—	$25,269.00	$37,903.50	$30,322.80	2024-10-01
32	MS_DRG	Ventricular Shunt Procedures With Cc	15	9	—	—	$10,799.00	$78,377.00	$30,124.00	2024-10-01
9114	APR_DRG	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	19	15	—	—	$25,033.00	$37,549.50	$30,039.60	2024-10-01
6302	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	19	15	—	—	$24,994.00	$37,491.00	$29,992.80	2024-10-01
214	APR_DRG	Open Craniotomy Except Trauma	19	15	—	—	$24,880.00	$37,320.00	$29,856.00	2024-10-01
872	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours Without Mcc	14	9	—	—	$6,000.00	$54,860.00	$29,737.00	2024-10-01
871	MS_DRG	Septicemia Or Severe Sepsis Without Mv >96 Hours With Mcc	14	9	—	—	$6,000.00	$54,860.00	$29,737.00	2024-10-01
0120	EAPG	Car T-cell Immunotherapy	19	15	—	—	$24,610.00	$36,915.00	$29,532.00	2024-10-01
0409T	CPT	Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I…	3	2	—	—	$14,841.00	$39,443.00	$29,476.00	2024-10-01
0414T	CPT	Removal And Replacement Of Permanent Cardiac Contractility Modulation System Pul…	3	2	—	—	$14,841.00	$39,443.00	$29,476.00	2024-10-01
7594	APR_DRG	Eating Disorders	19	15	—	—	$24,554.00	$36,831.00	$29,464.80	2024-10-01
1794	APR_DRG	Defibrillator Implants	19	15	—	—	$24,521.00	$36,781.50	$29,425.20	2024-10-01
C1882	HCPCS	Aicd Bi-v Dc H227	289	12	$52,525.00	$52,525.00	$3,501.37	$72,650.00	$29,423.25	2024-10-01
6144	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition…	19	15	—	—	$24,513.00	$36,769.50	$29,415.60	2024-10-01
6313	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	19	15	—	—	$24,305.00	$36,457.50	$29,166.00	2024-10-01
258	MS_DRG	Cardiac Pacemaker Device Replacement With Mcc	15	9	—	—	$10,799.00	$61,968.48	$29,083.00	2024-10-01
1623	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	19	15	—	—	$24,215.00	$36,322.50	$29,058.00	2024-10-01
260	MS_DRG	Cardiac Pacemaker Revision Except Device Replacement With Mcc	15	9	—	—	$10,799.00	$75,252.81	$28,947.58	2024-10-01
6254	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Other Significant Condition	19	15	—	—	$23,982.00	$35,973.00	$28,778.40	2024-10-01
33	MS_DRG	Ventricular Shunt Procedures Without Cc/mcc	15	9	—	—	$10,799.00	$78,377.00	$28,706.00	2024-10-01
1204	APR_DRG	Major Respiratory And Chest Procedures	19	15	—	—	$23,868.00	$35,802.00	$28,641.60	2024-10-01
2604	APR_DRG	Major Pancreas, Liver And Shunt Procedures	19	15	—	—	$23,677.00	$35,515.50	$28,412.40	2024-10-01
949181	CDM	Stent Thoracic 40x40x200	17	12	$56,652.47	$56,652.47	$4,588.85	$56,652.47	$28,326.24	2024-10-01
0686T	CPT	Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant…	2	1	—	—	$28,126.13	$28,126.13	$28,126.13	2024-10-01
321	MS_DRG	Percutaneous Cardiovascular Procedures With Intraluminal Device With Mcc Or 4+ A…	15	9	—	—	$10,799.00	$72,105.00	$28,103.00	2024-10-01
9124	APR_DRG	Musculoskeletal And Other Procedures For Multiple Significant Trauma	19	15	—	—	$23,409.00	$35,113.50	$28,090.80	2024-10-01
143	MS_DRG	Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc	15	9	—	—	$8,000.00	$72,931.25	$28,054.54	2024-10-01
274	APR_DRG	Other Open Craniotomy	19	15	—	—	$23,321.00	$34,981.50	$27,985.20	2024-10-01
933842	CDM	Heart Pump Impella 5.0	35	22	$117,460.00	$117,460.00	$5,990.46	$117,460.00	$27,955.48	2024-10-01
0246	EAPG	Class IV Therapeutic Radiopharmaceuticals	19	15	—	—	$23,186.00	$34,779.00	$27,823.20	2024-10-01
2324	APR_DRG	Gastric Fundoplication	19	15	—	—	$23,163.00	$34,744.50	$27,795.60	2024-10-01
6954	APR_DRG	Chemotherapy For Acute Leukemia	19	15	—	—	$23,049.00	$34,573.50	$27,658.80	2024-10-01
675297	CDM	Trial Spinal Cord Stim	19	12	$55,088.76	$55,088.76	$4,462.19	$55,088.76	$27,544.38	2024-10-01
41	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	19	15	—	—	$22,931.00	$34,396.50	$27,517.20	2024-10-01
244	MS_DRG	Permanent Cardiac Pacemaker Implant Without Cc/mcc	15	9	—	—	$10,799.00	$61,663.00	$27,489.19	2024-10-01
2204	APR_DRG	Major Stomach, Esophageal And Duodenal Procedures	19	15	—	—	$22,906.00	$34,359.00	$27,487.20	2024-10-01
234	APR_DRG	Spinal Procedures	19	15	—	—	$22,843.00	$34,264.50	$27,411.60	2024-10-01
707	MS_DRG	Major Male Pelvic Procedures With Cc/mcc	15	9	—	—	$10,799.00	$39,188.00	$27,410.00	2024-10-01
1694	APR_DRG	Major Abdominal Vascular Procedures	19	15	—	—	$22,756.00	$34,134.00	$27,307.20	2024-10-01
621	MS_DRG	O.r. Procedures For Obesity Without Cc/mcc	15	9	—	—	$10,799.00	$50,760.00	$27,266.00	2024-10-01
619	MS_DRG	O.r. Procedures For Obesity With Mcc	15	9	—	—	$10,799.00	$50,760.00	$27,266.00	2024-10-01
620	MS_DRG	O.r. Procedures For Obesity With Cc	15	9	—	—	$10,799.00	$50,760.00	$27,266.00	2024-10-01
510	MS_DRG	Shoulder, Elbow Or Forearm Procedures, Except Major Joint Procedures With Mcc	15	9	—	—	$10,799.00	$63,130.36	$27,108.13	2024-10-01
1603	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	19	15	—	—	$22,487.00	$33,730.50	$26,984.40	2024-10-01
865619	CDM	Aicd Ventak Av 11 Ddd182	17	12	$53,625.00	$53,625.00	$4,343.63	$53,625.00	$26,812.50	2024-10-01
865617	CDM	Aicd Ventak Av 11 Dd1820	17	12	$53,625.00	$53,625.00	$4,343.63	$53,625.00	$26,812.50	2024-10-01
33230	CPT	Insertion Of Implantable Defibrillator Pulse Generator Only; With Existing Dual …	28	15	—	—	$9.50	$77,816.00	$26,767.00	2024-10-01
111	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	19	15	—	—	$22,296.00	$33,444.00	$26,755.20	2024-10-01
204	APR_DRG	Open Craniotomy For Trauma	19	15	—	—	$22,290.00	$33,435.00	$26,748.00	2024-10-01
1783	APR_DRG	External Heart Assist Devices	19	15	—	—	$22,287.00	$33,430.50	$26,744.40	2024-10-01
259	MS_DRG	Cardiac Pacemaker Device Replacement Without Mcc	15	9	—	—	$10,799.00	$49,364.00	$26,501.00	2024-10-01
9504	APR_DRG	Extensive O.r. Procedure Unrelated To Principal Diagnosis	19	15	—	—	$22,001.00	$33,001.50	$26,401.20	2024-10-01
11	APR_DRG	Liver Transplant And/or Intestinal Transplant	19	15	—	—	$21,971.00	$32,956.50	$26,365.20	2024-10-01
451	MS_DRG	Single Level Spinal Fusion Except Cervical Without Mcc	15	9	—	—	$10,799.00	$101,893.00	$26,220.04	2024-10-01
942572	CDM	Dont Use-stent Aaa Thr 4	17	12	$52,235.35	$52,235.35	$4,231.06	$52,235.35	$26,117.67	2024-10-01
C9760	HCPCS	Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; …	5	2	—	—	$17,497.00	$39,443.00	$26,069.00	2024-10-01
0408T	CPT	Insertion Or Replacement Of Permanent Cardiac Contractility Modulation System, I…	7	4	—	—	$14,841.00	$39,443.00	$26,069.00	2024-10-01
C9758	HCPCS	Blinded Procedure For Nyha Class Iii/iv Heart Failure; Transcatheter Implantatio…	5	2	—	—	$17,497.00	$29,000.00	$26,069.00	2024-10-01
J1412	HCPCS	Injection, Valoctocogene Roxaparvovec-rvox, Per Ml, Containing Nominal 2 X 10°13…	2	1	—	—	$25,816.79	$25,816.79	$25,816.79	2024-10-01
6072	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	19	15	—	—	$21,491.00	$32,236.50	$25,789.20	2024-10-01
4403	APR_DRG	Kidney Transplant	19	15	—	—	$21,467.00	$32,200.50	$25,760.40	2024-10-01
924	APR_DRG	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	19	15	—	—	$21,454.00	$32,181.00	$25,744.80	2024-10-01
1782	APR_DRG	External Heart Assist Devices	19	15	—	—	$21,425.00	$32,137.50	$25,710.00	2024-10-01
33214	CPT	Upgrade Of Implanted Pacemaker System, Conversion Of Single Chamber System To Du…	28	15	—	—	$504.45	$55,286.00	$25,655.00	2024-10-01

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