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

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Hospital

Hca Florida Largo Hospital

Largo, FL · CCN 109812 · Rates published

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 — reasonRows
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⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 24 months old.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 viaDiscovered 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
$738,272
0.7× 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
$646,415
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
$622,245
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
$640,950
0.7× 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
$608,101
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
$591,650
0.7× median
5834
APR_DRG 		Neonate With Ecmo 15 $192,207.00 $288,310.50 $230,648.40 nat. median
$307,273
0.8× median
J7330
HCPCS 		Autologous Cultured Chondrocytes, Implant 1 $156,515.70 $156,515.70 $156,515.70 nat. median
$75,037
outlier · 2.1×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 15 $125,393.00 $188,089.50 $150,471.60 nat. median
$247,214
0.6× median
5833
APR_DRG 		Neonate With Ecmo 15 $124,517.00 $186,775.50 $149,420.40 nat. median
$244,017
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
$63,643
outlier · 2.2×
215
MS_DRG 		Other Heart Assist System Implant 9 $10,799.00 $320,066.00 $136,328.00 nat. median
$93,917
1.5× median
24
APR_DRG 		Heart And/or Lung Transplant 15 $111,047.00 $166,570.50 $133,256.40 nat. median
$241,915
0.6× median
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
$62,038
outlier · 2.0×
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
$90,581
1.4× 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
$59,558
outlier · 2.1×
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
$65,720
1.8× 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
$124,042
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
$72,473
1.6× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 7 $71,998.48 $187,168.93 $115,891.00 nat. median
$77,043
1.5× 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
$58,331
2.0× median
267
MS_DRG 		Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 9 $10,799.00 $177,122.00 $115,231.00 nat. median
$45,888
outlier · 2.5×
5832
APR_DRG 		Neonate With Ecmo 15 $95,607.00 $143,410.50 $114,728.40 nat. median
$159,249
0.7× median
232
MS_DRG 		Coronary Bypass With Ptca Without Mcc 9 $10,799.00 $141,689.00 $114,496.00 nat. median
$57,804
2.0× median
1614
APR_DRG 		Implantable Heart Assist Systems 15 $95,167.00 $142,750.50 $114,200.40 nat. median
$202,993
0.6× median
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
$50,679
outlier · 2.2×
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
$46,557
outlier · 2.4×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 15 $91,470.00 $137,205.00 $109,764.00 nat. median
$154,011
0.7× median
275
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 7 $12,698.00 $156,091.92 $109,425.00 nat. median
$66,649
1.6× median
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
$71,758
1.5× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 15 $90,217.00 $135,325.50 $108,260.40 nat. median
$156,153
0.7× median
228
MS_DRG 		Other Cardiothoracic Procedures With Mcc 8 $10,799.00 $137,939.00 $104,697.00 nat. median
$47,451
outlier · 2.2×
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
$51,613
outlier · 2.0×
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
$34,024
outlier · 3.0×
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
$32,619
outlier · 3.1×
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
$39,629
outlier · 2.6×
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
$47,579
outlier · 2.1×
226
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 $67,393.00 $100,416.00 $100,416.00 nat. median
$38,225
outlier · 2.6×
227
MS_DRG 		Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 $67,393.00 $100,416.00 $100,416.00 nat. median
$31,634
outlier · 3.2×
A9699
HCPCS 		Radiopharmaceutical, Therapeutic, Not Otherwise Classified 1 $100,053.67 $100,053.67 $100,053.67 nat. median
$1,683
outlier · 59.4×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 15 $82,446.00 $123,669.00 $98,935.20 nat. median
$165,000
0.6× median
229
MS_DRG 		Other Cardiothoracic Procedures Without Mcc 8 $10,799.00 $137,939.00 $98,814.00 nat. median
$30,783
outlier · 3.2×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 15 $81,552.00 $122,328.00 $97,862.40 nat. median
$175,429
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
$133,164
0.7× median
235
MS_DRG 		Coronary Bypass Without Cardiac Catheterization With Mcc 9 $10,799.00 $112,866.00 $97,000.00 nat. median
$55,491
1.7× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 15 $79,657.00 $119,485.50 $95,588.40 nat. median
$162,514
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
$40,341
outlier · 2.3×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 15 $75,611.00 $113,416.50 $90,733.20 nat. median
$170,172
0.5× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 15 $75,232.00 $112,848.00 $90,278.40 nat. median
$163,587
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
$151,838
0.6× 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.

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
             
0120 EAPG Car T-cell Immunotherapy 19 15 — — $24,610.00 $36,915.00 $29,532.00 2024-10-01
0207 RC — 13 12 — — $8,000.00 $42,172.50 $42,172.50 2024-10-01
0208 RC — 22 18 — — $7,500.00 $41,922.50 $41,922.50 2024-10-01
0246 EAPG Class IV Therapeutic Radiopharmaceuticals 19 15 — — $23,186.00 $34,779.00 $27,823.20 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
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
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
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
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
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
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
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
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
11 APR_DRG Liver Transplant And/or Intestinal Transplant 19 15 — — $21,971.00 $32,956.50 $26,365.20 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
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
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
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
12 APR_DRG Liver Transplant And/or Intestinal Transplant 19 15 — — $25,269.00 $37,903.50 $30,322.80 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
13 APR_DRG Liver Transplant And/or Intestinal Transplant 19 15 — — $31,456.00 $47,184.00 $37,747.20 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
14 APR_DRG Liver Transplant And/or Intestinal Transplant 19 15 — — $67,242.00 $100,863.00 $80,690.40 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
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 19 15 — — $22,487.00 $33,730.50 $26,984.40 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
1611 APR_DRG Implantable Heart Assist Systems 19 15 — — $49,247.00 $73,870.50 $59,096.40 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 19 15 — — $51,688.00 $77,532.00 $62,025.60 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 19 15 — — $64,392.00 $96,588.00 $77,270.40 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 19 15 — — $95,167.00 $142,750.50 $114,200.40 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
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
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
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
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
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 19 15 — — $31,789.00 $47,683.50 $38,146.80 2024-10-01
1694 APR_DRG Major Abdominal Vascular Procedures 19 15 — — $22,756.00 $34,134.00 $27,307.20 2024-10-01
1782 APR_DRG External Heart Assist Devices 19 15 — — $21,425.00 $32,137.50 $25,710.00 2024-10-01
1783 APR_DRG External Heart Assist Devices 19 15 — — $22,287.00 $33,430.50 $26,744.40 2024-10-01
1784 APR_DRG External Heart Assist Devices 19 15 — — $30,258.00 $45,387.00 $36,309.60 2024-10-01
1794 APR_DRG Defibrillator Implants 19 15 — — $24,521.00 $36,781.50 $29,425.20 2024-10-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 19 15 — — $26,369.00 $39,553.50 $31,642.80 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
204 APR_DRG Open Craniotomy For Trauma 19 15 — — $22,290.00 $33,435.00 $26,748.00 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
21 APR_DRG Heart And/or Lung Transplant 19 15 — — $41,730.00 $62,595.00 $50,076.00 2024-10-01
214 APR_DRG Open Craniotomy Except Trauma 19 15 — — $24,880.00 $37,320.00 $29,856.00 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
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
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
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
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
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
22 APR_DRG Heart And/or Lung Transplant 19 15 — — $45,376.00 $68,064.00 $54,451.20 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
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 19 15 — — $22,906.00 $34,359.00 $27,487.20 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
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
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
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
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
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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 13 8 — — $10,799.00 $137,939.00 $104,697.00 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
23 APR_DRG Heart And/or Lung Transplant 19 15 — — $62,352.00 $93,528.00 $74,822.40 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 7 — — $71,998.48 $187,168.93 $115,891.00 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
2324 APR_DRG Gastric Fundoplication 19 15 — — $23,163.00 $34,744.50 $27,795.60 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
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
234 APR_DRG Spinal Procedures 19 15 — — $22,843.00 $34,264.50 $27,411.60 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
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 15 9 — — $10,799.00 $112,866.00 $94,383.00 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
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
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 15 9 — — $10,799.00 $81,795.00 $45,326.00 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
244 MS_DRG Permanent Cardiac Pacemaker Implant Without Cc/mcc 15 9 — — $10,799.00 $61,663.00 $27,489.19 2024-10-01
245 MS_DRG Aicd Generator Procedures 15 9 — — $10,799.00 $107,937.90 $46,348.45 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
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
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 15 9 — — $10,799.00 $81,505.00 $57,946.00 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
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
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
258 MS_DRG Cardiac Pacemaker Device Replacement With Mcc 15 9 — — $10,799.00 $61,968.48 $29,083.00 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
26 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Cc 15 9 — — $10,799.00 $81,505.00 $57,946.00 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
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 19 15 — — $23,677.00 $35,515.50 $28,412.40 2024-10-01
265 MS_DRG Aicd Lead Procedures 15 9 — — $10,799.00 $99,972.00 $45,326.00 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
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
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
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
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 15 9 — — $10,799.00 $109,723.00 $81,795.00 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
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 15 9 — — $10,799.00 $57,147.00 $37,532.00 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
274 APR_DRG Other Open Craniotomy 19 15 — — $23,321.00 $34,981.50 $27,985.20 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
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
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 15 9 — — $10,799.00 $127,287.00 $39,529.74 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
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
28 MS_DRG Spinal Procedures With Mcc 15 9 — — $10,799.00 $134,281.24 $50,895.00 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
299 MS_DRG Peripheral Vascular Disorders With Mcc 15 9 — — $10,799.00 $70,533.00 $33,493.00 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
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
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
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
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
31 MS_DRG Ventricular Shunt Procedures With Mcc 15 9 — — $10,799.00 $78,377.00 $39,745.00 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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 15 9 — — $10,799.00 $127,238.00 $52,472.00 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
320 MS_DRG Other Endovascular Cardiac Valve Procedures Without Mcc 15 9 — — $10,799.00 $127,238.00 $47,032.00 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
33 MS_DRG Ventricular Shunt Procedures Without Cc/mcc 15 9 — — $10,799.00 $78,377.00 $28,706.00 2024-10-01
33208 CPT Insertion Of New Or Replacement Of Permanent Pacemaker With Transvenous Electrod… 28 15 — — $975.00 $55,286.00 $25,655.00 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
34 MS_DRG Carotid Artery Stent Procedures With Mcc 15 9 — — $10,799.00 $78,377.00 $56,993.00 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
36 MS_DRG Carotid Artery Stent Procedures Without Cc/mcc 15 9 — — $10,799.00 $78,377.00 $53,766.00 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
4403 APR_DRG Kidney Transplant 19 15 — — $21,467.00 $32,200.50 $25,760.40 2024-10-01
4404 APR_DRG Kidney Transplant 19 15 — — $35,422.00 $53,133.00 $42,506.40 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
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
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
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
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
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
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
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
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
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
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
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
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
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
473 MS_DRG Cervical Spinal Fusion Without Cc/mcc 15 9 — — $10,799.00 $74,994.00 $46,489.00 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
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
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
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
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
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
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
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
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
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
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
5831 APR_DRG Neonate With Ecmo 19 15 — — $69,493.00 $104,239.50 $83,391.60 2024-10-01
5832 APR_DRG Neonate With Ecmo 19 15 — — $95,607.00 $143,410.50 $114,728.40 2024-10-01
5833 APR_DRG Neonate With Ecmo 19 15 — — $124,517.00 $186,775.50 $149,420.40 2024-10-01
5834 APR_DRG Neonate With Ecmo 19 15 — — $192,207.00 $288,310.50 $230,648.40 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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
619 MS_DRG O.r. Procedures For Obesity With Mcc 15 9 — — $10,799.00 $50,760.00 $27,266.00 2024-10-01
62 APR_DRG Pancreas Transplant 19 15 — — $27,515.00 $41,272.50 $33,018.00 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
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
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
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
63 APR_DRG Pancreas Transplant 19 15 — — $34,364.00 $51,546.00 $41,236.80 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
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
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
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
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
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
64 APR_DRG Pancreas Transplant 19 15 — — $48,372.00 $72,558.00 $58,046.40 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
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
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
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
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
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
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
69 MS_DRG Transient Ischemia Without Thrombolytic 14 9 — — $6,000.00 $74,994.00 $30,901.00 2024-10-01
6904 APR_DRG Acute Leukemia 19 15 — — $26,010.00 $39,015.00 $31,212.00 2024-10-01
6954 APR_DRG Chemotherapy For Acute Leukemia 19 15 — — $23,049.00 $34,573.50 $27,658.80 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
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
707 MS_DRG Major Male Pelvic Procedures With Cc/mcc 15 9 — — $10,799.00 $39,188.00 $27,410.00 2024-10-01
71 APR_DRG Allogeneic Bone Marrow Transplant 19 15 — — $28,151.00 $42,226.50 $33,781.20 2024-10-01
72 APR_DRG Allogeneic Bone Marrow Transplant 19 15 — — $29,633.00 $44,449.50 $35,559.60 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 19 15 — — $36,953.00 $55,429.50 $44,343.60 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 19 15 — — $75,611.00 $113,416.50 $90,733.20 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
7594 APR_DRG Eating Disorders 19 15 — — $24,554.00 $36,831.00 $29,464.80 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 19 15 — — $37,476.00 $56,214.00 $44,971.20 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
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 19 15 — — $90,217.00 $135,325.50 $108,260.40 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
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
8514 APR_DRG Gender Related Procedures 19 15 — — $46,902.00 $70,353.00 $56,282.40 2024-10-01
8634 APR_DRG Neonatal Aftercare 19 15 — — $35,009.00 $52,513.50 $42,010.80 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
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
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
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
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
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
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
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
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
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
9104 APR_DRG Craniotomy For Multiple Significant Trauma 19 15 — — $26,692.00 $40,038.00 $32,030.40 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
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
914 APR_DRG Other Major Head And Neck Procedures 19 15 — — $25,293.00 $37,939.50 $30,351.60 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
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
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 19 15 — — $32,422.00 $48,633.00 $38,906.40 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
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 19 15 — — $75,232.00 $112,848.00 $90,278.40 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
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
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
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
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
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $100,053.67 $100,053.67 $100,053.67 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
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 2 1 — — $40,208.00 $53,804.00 $47,006.00 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
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
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
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
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $156,515.70 $156,515.70 $156,515.70 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
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 6 3 — — $43,241.44 $94,940.24 $43,241.44 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 2 1 — — $50,561.89 $50,561.89 $50,561.89 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
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
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
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
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
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
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
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