Price Transparency Hospital negotiated rates

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

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Hospital

SAVANNAH HEALTH SERVICES LLC DBA MEMORIAL HEALTH UNIVERSITY MEDICAL CENTER

Savannah, GA · CCN 110036 · Rates published

32,428 distinct procedures filed
36 distinct payers
676,094 rate rows
2024-10-01 last MRF observed · ⚠ 20 mo old
Data quality

351,475 of 676,094 rate rows are consumer-grade (52.0%)

324,619 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 317,351
per-diem day rate — not a per-procedure price 5,689
template filing: same amount across many unrelated codes — excluded 1,442
placeholder amount (≤ $0.02) — excluded from medians 118
exceeds 10× this hospital's gross charge — excluded from medians 19

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 20 months old.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

Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://core.secure.ehc.com/src/util/json-detail-price-list/82-1969974_memorial-health-university-medical-center_standardcharges.json
Found on page https://memorialhealth.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint 4206d36f12e7c2f7… · 438,911,922 bytes · first seen 2026-05-05

Top 50 most expensive offerings

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

Code Description Payers Min $ Max $ Avg median vs national
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 1 $4,897,200.00 $4,897,200.00 $4,897,200.00 nat. median
$3,006,423
1.6× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 3 $465,980.20 $4,111,590.00 $3,994,116.00 nat. median
$3,710,000
1.1× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 14 $3,672,900.00 $3,856,545.00 $3,746,358.00 nat. median
$3,746,358
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 14 $3,605,000.00 $3,785,250.00 $3,677,100.00 nat. median
$3,605,000
1.0× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,562,713.00 $3,562,713.00 $3,562,713.00 nat. median
$3,574,709
1.0× median
00773
OTHER 		Inj, Beqvez, Per Tx Dose 1 $3,496,850.00 $3,496,850.00 $3,496,850.00 nat. median
$3,496,850
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 15 $5,488.33 $3,491,727.75 $3,391,964.10 nat. median
$13,041
outlier · 260.1×
748
OTHER 		Inj, Lovotibeglogene Auto 15 $9,052.99 $3,450,300.00 $3,351,720.00 nat. median
$17,963
outlier · 186.6×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,225,691.35 $3,225,691.35 $3,225,691.35 nat. median
$3,228,024
1.0× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,187,420.00 $3,187,420.00 $3,187,420.00 nat. median
$3,187,420
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 16 $8,040.85 $4,986,240.00 $3,027,360.00 nat. median
$21,896
outlier · 138.3×
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,878,960.00 $2,878,960.00 $2,878,960.00 nat. median
$2,878,960
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 6 $31,607.91 $3,884,946.48 $2,648,347.96 nat. median
$2,469,189
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 15 $2,388,614.00 $4,012,871.52 $2,436,386.28 nat. median
$2,588,981
0.9× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,316,955.58 $2,316,955.58 $2,316,955.58 nat. median
$2,457,321
0.9× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 $426,039.04 $3,651,763.20 $2,038,901.12 nat. median
$3,325,455
0.6× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 9 $73,428.36 $1,292,595.50 $683,011.93 nat. median
$754,974
0.9× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 9 $66,087.96 $1,198,462.58 $632,275.27 nat. median
$674,188
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 $68,614.69 $1,136,715.72 $602,665.20 nat. median
$634,511
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 8 $67,592.00 $1,282,791.58 $595,823.34 nat. median
$675,122
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 8 $67,028.42 $1,225,870.24 $574,529.28 nat. median
$625,184
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 15 $529,192.90 $889,044.07 $539,776.76 nat. median
$566,531
1.0× median
9498
OTHER 		Ciltacabtagene Car-pos T 15 $527,123.40 $885,567.31 $537,665.87 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 15 $526,587.60 $884,667.17 $537,119.35 nat. median
$558,082
1.0× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 8 $59,837.13 $1,136,715.72 $527,975.14 nat. median
$620,080
0.9× median
9413
OTHER 		Lisocabtagene Car Pos T 15 $516,726.10 $868,099.85 $527,060.62 nat. median
$562,201
0.9× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $513,317.11 $513,317.11 $513,317.11 nat. median
$538,205
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $511,309.70 $511,309.70 $511,309.70 nat. median
$554,552
0.9× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $510,789.97 $510,789.97 $510,789.97 nat. median
$530,178
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $501,224.32 $501,224.32 $501,224.32 nat. median
$534,091
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 15 $489,456.00 $822,286.08 $499,245.12 nat. median
$532,192
0.9× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $474,772.32 $474,772.32 $474,772.32 nat. median
$505,583
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 15 $460,530.40 $773,691.07 $469,741.01 nat. median
$489,450
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $446,714.49 $446,714.49 $446,714.49 nat. median
$464,978
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 24 $5,044.14 $756,808.20 $280,826.60 nat. median
$370,174
0.8× median
1614
APR_DRG 		Implantable Heart Assist Systems 6 $205,687.58 $242,263.35 $230,727.00 nat. median
$207,730
1.1× median
5834
APR_DRG 		Neonate With Ecmo 6 $220,362.00 $260,336.33 $228,074.67 nat. median
$309,665
0.7× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 23 $5,044.14 $512,825.64 $210,145.40 nat. median
$265,286
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $198,638.00 $208,569.90 $200,624.38 nat. median
$164,834
1.2× median
001
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $186,031.74 $201,374.57 $193,703.15 nat. median
$263,894
0.7× median
34
APR_DRG 		Bone Marrow Transplant 2 $187,490.42 $196,864.94 $192,177.68 nat. median
$209,067
0.9× median
5833
APR_DRG 		Neonate With Ecmo 6 $174,500.00 $187,228.22 $178,151.29 nat. median
$244,017
0.7× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 $5,044.14 $260,641.35 $175,498.51 nat. median
$206,368
0.9× median
1613
APR_DRG 		Implantable Heart Assist Systems 6 $86,529.13 $177,411.15 $168,963.00 nat. median
$119,796
1.4× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 6 $162,857.00 $234,146.32 $168,556.99 nat. median
$246,434
0.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 6 $145,741.94 $174,578.25 $166,265.00 nat. median
$105,658
1.6× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 $115,349.19 $174,429.15 $166,123.00 nat. median
$150,721
1.1× median
018
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $153,503.57 $166,163.65 $159,833.61 nat. median
$424,868
outlier · 0.4×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 27 $5,044.14 $276,577.68 $158,685.95 nat. median
$202,986
0.8× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 6 $82,554.24 $191,683.20 $147,164.11 nat. median
$87,411
1.7× median

Other procedures at this hospital

Browse this hospital's 32,428 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
             
215 MS_DRG Other Heart Assist System Implant 54 28 — — $5,044.14 $248,647.20 $82,358.93 2024-10-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 28 — — $5,044.14 $175,704.83 $73,373.97 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 54 28 — — $5,044.14 $154,275.19 $66,141.43 2024-10-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 54 28 — — $5,044.14 $147,337.15 $64,504.82 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 54 28 — — $5,044.14 $194,792.50 $61,541.46 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 54 28 — — $5,044.14 $162,162.72 $61,070.08 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 54 28 — — $5,044.14 $204,851.00 $60,462.38 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 54 28 — — $5,044.14 $152,385.00 $51,172.12 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 28 — — $5,044.14 $173,077.00 $50,594.23 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 54 28 — — $5,044.14 $143,666.00 $48,159.27 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 54 28 — — $5,044.14 $134,321.46 $47,223.97 2024-10-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 54 28 — — $5,044.14 $148,336.00 $47,035.37 2024-10-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 54 28 — — $5,044.14 $173,077.00 $46,945.55 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 54 28 — — $5,044.14 $123,063.10 $46,567.03 2024-10-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 54 28 — — $5,044.14 $125,418.62 $45,341.83 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 54 28 — — $5,044.14 $110,808.70 $45,127.87 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 54 28 — — $5,044.14 $120,004.05 $44,867.62 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 54 28 — — $5,044.14 $142,152.27 $43,521.60 2024-10-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 51 27 — — $5,044.14 $260,641.35 $175,498.51 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 51 27 — — $5,044.14 $276,577.68 $158,685.95 2024-10-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 51 27 — — $5,044.14 $171,455.01 $105,144.23 2024-10-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 51 27 — — $5,044.14 $89,909.79 $51,506.24 2024-10-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 50 27 — — $5,044.14 $155,161.05 $58,076.18 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 50 27 — — $5,044.14 $141,038.37 $52,368.09 2024-10-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 50 27 — — $5,044.14 $151,750.25 $48,380.02 2024-10-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 50 27 — — $5,044.14 $122,916.53 $47,149.89 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 50 27 — — $5,044.14 $105,999.33 $44,881.14 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 50 27 — — $5,044.14 $116,346.18 $43,037.69 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 50 27 — — $5,044.14 $100,628.27 $42,685.67 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 49 26 — — $5,044.14 $347,277.00 $84,787.59 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 49 25 — — $5,044.14 $142,187.86 $53,065.04 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 48 28 — — $5,044.14 $141,574.00 $54,143.82 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 48 28 — — $5,044.14 $115,068.00 $47,650.42 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 46 27 — — $5,044.14 $238,528.09 $99,053.60 2024-10-01
7 MS_DRG Lung Transplant 46 27 — — $5,044.14 $237,927.26 $98,326.01 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 46 27 — — $5,044.14 $193,879.06 $80,802.86 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 46 26 — — $5,044.14 $190,600.00 $79,171.91 2024-10-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 46 26 — — $5,044.14 $151,757.00 $63,311.24 2024-10-01
10 MS_DRG Pancreas Transplant 46 27 — — $5,044.14 $145,157.13 $60,590.27 2024-10-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 46 26 — — $5,044.14 $129,234.00 $54,118.18 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 46 26 — — $5,044.14 $121,992.00 $51,196.51 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 46 27 — — $5,044.14 $109,888.35 $46,470.82 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 46 27 — — $5,044.14 $109,888.35 $46,244.13 2024-10-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 45 24 — — $5,044.14 $137,476.81 $49,445.00 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 44 23 — — $5,044.14 $512,825.64 $210,145.40 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 44 27 — — $5,044.14 $198,330.67 $82,219.47 2024-10-01
850 MS_DRG Acute Leukemia With Other Procedures 42 25 — — $5,044.14 $167,710.14 $69,764.07 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 42 25 — — $5,044.14 $112,628.50 $47,358.73 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 40 27 — — $5,044.14 $144,321.43 $60,250.34 2024-10-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 37 24 — — $5,044.14 $756,808.20 $280,826.60 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 33 21 — — $5,044.14 $77,701.06 $45,573.90 2024-10-01
746 OTHER Inj, Betibeglogene Autote 23 16 — — $8,040.85 $4,986,240.00 $3,027,360.00 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 23 16 — — $13,152.60 $106,436.01 $64,621.87 2024-10-01
714 OTHER Inj Delandistrogene Mox R 22 15 — — $5,488.33 $3,491,727.75 $3,391,964.10 2024-10-01
748 OTHER Inj, Lovotibeglogene Auto 22 15 — — $9,052.99 $3,450,300.00 $3,351,720.00 2024-10-01
Q0480 HCPCS Driver For Use With Pneumatic Ventricular Assist Device, Replacement Only 22 15 — — $96,999.90 $167,999.83 $101,999.90 2024-10-01
K1007 HCPCS Bilateral Hip, Knee, Ankle, Foot Device, Powered, Includes Pelvic Component, Sin… 22 15 — — $88,300.94 $152,933.59 $92,852.54 2024-10-01
L8702 HCPCS Powered Upper Extremity Range Of Motion Assist Device, Elbow, Wrist, Hand, Finge… 22 15 — — $63,895.55 $110,664.46 $67,189.13 2024-10-01
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 22 15 — — $46,068.21 $79,788.24 $48,442.86 2024-10-01
9141 OTHER Inj Onase Abepar-xioi Tre 21 15 — — $2,388,614.00 $4,012,871.52 $2,436,386.28 2024-10-01
9194 OTHER Tisagenlecleucel Car-pos 21 15 — — $529,192.90 $889,044.07 $539,776.76 2024-10-01
9498 OTHER Ciltacabtagene Car-pos T 21 15 — — $527,123.40 $885,567.31 $537,665.87 2024-10-01
9422 OTHER Idecabtagene Vicleucel Ca 21 15 — — $526,587.60 $884,667.17 $537,119.35 2024-10-01
9413 OTHER Lisocabtagene Car Pos T 21 15 — — $516,726.10 $868,099.85 $527,060.62 2024-10-01
9035 OTHER Axicabtagene Ciloleucel C 21 15 — — $489,456.00 $822,286.08 $499,245.12 2024-10-01
9391 OTHER Brexucabtagene Car Pos T 21 15 — — $460,530.40 $773,691.07 $469,741.01 2024-10-01
1907 OTHER New Technology - Level 52 21 15 — — $137,485.30 $230,975.30 $140,235.01 2024-10-01
1908 OTHER New Technology - Level 52 21 15 — — $137,485.30 $230,975.30 $140,235.01 2024-10-01
1905 OTHER New Technology - Level 51 21 15 — — $123,962.20 $208,256.50 $126,441.44 2024-10-01
1906 OTHER New Technology - Level 51 21 15 — — $123,962.20 $208,256.50 $126,441.44 2024-10-01
1904 OTHER New Technology - Level 50 21 15 — — $110,439.10 $185,537.69 $112,647.88 2024-10-01
1903 OTHER New Technology - Level 50 21 15 — — $110,439.10 $185,537.69 $112,647.88 2024-10-01
1901 OTHER New Technology - Level 49 21 15 — — $96,916.00 $162,818.88 $98,854.32 2024-10-01
1902 OTHER New Technology - Level 49 21 15 — — $96,916.00 $162,818.88 $98,854.32 2024-10-01
1599 OTHER New Technology - Level 48 21 15 — — $85,646.75 $143,886.54 $87,359.68 2024-10-01
1585 OTHER New Technology - Level 48 21 15 — — $85,646.75 $143,886.54 $87,359.68 2024-10-01
1598 OTHER New Technology - Level 47 21 15 — — $76,631.35 $128,740.67 $78,163.98 2024-10-01
1584 OTHER New Technology - Level 47 21 15 — — $76,631.35 $128,740.67 $78,163.98 2024-10-01
1583 OTHER New Technology - Level 46 21 15 — — $67,615.95 $113,594.80 $68,968.27 2024-10-01
1597 OTHER New Technology - Level 46 21 15 — — $67,615.95 $113,594.80 $68,968.27 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 21 15 — — $65,476.58 $110,000.65 $66,786.11 2024-10-01
1582 OTHER New Technology - Level 45 21 15 — — $58,600.55 $98,448.92 $59,772.56 2024-10-01
1596 OTHER New Technology - Level 45 21 15 — — $58,600.55 $98,448.92 $59,772.56 2024-10-01
9273 OTHER Sipuleucel-t Auto Cd54+ 21 15 — — $55,015.23 $92,425.59 $56,115.53 2024-10-01
1595 OTHER New Technology - Level 44 21 15 — — $49,585.15 $83,303.05 $50,576.85 2024-10-01
1581 OTHER New Technology - Level 44 21 15 — — $49,585.15 $83,303.05 $50,576.85 2024-10-01
5244 OTHER Level 4 Blood Product Exc 21 15 — — $46,939.73 $78,858.75 $47,878.52 2024-10-01
1142 OTHER Supprelin La Implant 21 15 — — $45,350.21 $76,188.35 $46,257.21 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 20 14 — — $3,672,900.00 $3,856,545.00 $3,746,358.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 20 14 — — $3,605,000.00 $3,785,250.00 $3,677,100.00 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 11 9 — — $73,428.36 $1,292,595.50 $683,011.93 2024-10-01
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 11 9 — — $66,087.96 $1,198,462.58 $632,275.27 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 11 6 — — $82,554.24 $191,683.20 $147,164.11 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 11 6 — — $56,979.84 $127,531.26 $103,897.06 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 11 6 — — $58,344.82 $138,881.75 $84,272.00 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 11 6 — — $42,906.24 $100,251.14 $79,738.79 2024-10-01
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 11 6 — — $34,077.12 $78,852.51 $51,134.84 2024-10-01
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 10 8 — — $68,614.69 $1,136,715.72 $602,665.20 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 10 9 — — $7,390.73 $135,125.34 $63,055.79 2024-10-01
J9226 HCPCS Supprelin La 50 Mg Imp 10 9 $342,004.00 $342,004.00 $5,879.08 $112,740.18 $53,009.98 2024-10-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 9 8 — — $67,592.00 $1,282,791.58 $595,823.34 2024-10-01
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 9 8 — — $67,028.42 $1,225,870.24 $574,529.28 2024-10-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 9 8 — — $59,837.13 $1,136,715.72 $527,975.14 2024-10-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 8 3 — — $26,490.71 $55,621.80 $44,364.38 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 7 6 — — $31,607.91 $3,884,946.48 $2,648,347.96 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 7 6 — — $8,454.12 $156,303.14 $104,773.89 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 6 6 — — $205,687.58 $242,263.35 $230,727.00 2024-10-01
5834 APR_DRG Neonate With Ecmo 6 6 — — $220,362.00 $260,336.33 $228,074.67 2024-10-01
5833 APR_DRG Neonate With Ecmo 6 6 — — $174,500.00 $187,228.22 $178,151.29 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 6 6 — — $86,529.13 $177,411.15 $168,963.00 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $162,857.00 $234,146.32 $168,556.99 2024-10-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $145,741.94 $174,578.25 $166,265.00 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $115,349.19 $174,429.15 $166,123.00 2024-10-01
24 APR_DRG Heart And/or Lung Transplant 6 6 — — $130,982.00 $195,394.09 $135,566.37 2024-10-01
5832 APR_DRG Neonate With Ecmo 6 6 — — $128,710.00 $170,206.98 $133,214.85 2024-10-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $121,894.00 $171,998.80 $126,160.29 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $119,339.00 $142,963.27 $123,515.86 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $116,428.00 $154,437.21 $120,502.98 2024-10-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 6 2 — — $75,934.28 $133,438.48 $118,119.98 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $113,091.00 $128,749.73 $117,049.18 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $98,722.67 $121,056.60 $115,292.00 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $72,082.56 $119,714.70 $114,014.00 2024-10-01
5831 APR_DRG Neonate With Ecmo 6 6 — — $102,657.49 $116,808.30 $111,246.00 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 6 6 — — $54,563.68 $111,589.80 $106,276.00 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 2 — — $67,869.14 $119,265.70 $105,574.20 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $98,822.00 $132,337.70 $102,280.77 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 6 6 — — $41,270.91 $105,999.60 $100,952.00 2024-10-01
64 APR_DRG Pancreas Transplant 6 6 — — $94,136.00 $151,021.07 $97,430.76 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 6 2 — — $62,161.68 $109,236.04 $96,695.93 2024-10-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $72,818.48 $99,513.75 $94,775.00 2024-10-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $69,098.77 $94,519.95 $90,019.00 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $86,540.00 $166,135.93 $89,568.90 2024-10-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $86,540.00 $95,530.75 $89,568.90 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 6 2 — — $57,071.05 $100,290.33 $88,777.17 2024-10-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $53,777.34 $92,134.35 $87,747.00 2024-10-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $77,458.34 $90,867.00 $86,540.00 2024-10-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $85,221.98 $89,599.65 $86,186.33 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 6 6 — — $81,925.00 $130,280.02 $84,792.38 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $81,641.00 $104,813.00 $84,498.43 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $79,157.00 $95,349.20 $81,927.49 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $78,589.00 $105,183.69 $81,339.61 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 6 2 — — $52,199.69 $91,729.95 $81,199.51 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $74,613.00 $104,098.65 $77,224.45 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 6 2 — — $48,861.50 $85,863.78 $76,006.76 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $49,825.01 $78,790.95 $75,039.00 2024-10-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 6 6 — — $40,889.05 $77,896.35 $74,187.00 2024-10-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 6 — — $61,849.75 $76,629.00 $72,980.00 2024-10-01
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 6 6 — — $48,305.84 $76,032.60 $72,412.00 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $69,928.00 $113,185.29 $72,375.48 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $67,940.00 $99,943.31 $70,317.90 2024-10-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $67,301.00 $77,934.58 $69,656.54 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $66,662.00 $95,407.55 $68,995.17 2024-10-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 6 — — $63,254.00 $86,832.09 $65,467.89 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $62,970.00 $83,854.73 $65,173.95 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 6 6 — — $62,615.00 $88,188.39 $64,806.53 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 6 6 — — $62,615.00 $104,473.66 $64,806.53 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $61,124.00 $114,277.89 $63,263.34 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 6 6 — — $60,982.00 $102,725.07 $63,116.37 2024-10-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $53,431.51 $65,074.80 $61,976.00 2024-10-01
214 APR_DRG Open Craniotomy Except Trauma 6 6 — — $59,421.00 $68,063.34 $61,500.74 2024-10-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $57,930.00 $63,444.37 $59,755.90 2024-10-01
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 6 2 — — $38,345.08 $67,383.40 $59,647.90 2024-10-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 6 6 — — $52,053.34 $62,615.70 $59,634.00 2024-10-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 6 6 — — $53,741.00 $74,443.87 $55,621.93 2024-10-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 6 — — $49,552.26 $57,546.30 $54,806.00 2024-10-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $51,398.00 $72,950.33 $53,196.93 2024-10-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 6 — — $51,114.00 $77,028.94 $52,902.99 2024-10-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 6 6 — — $50,689.00 $64,418.09 $52,463.11 2024-10-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 6 — — $37,499.73 $54,489.75 $51,895.00 2024-10-01
4404 APR_DRG Kidney Transplant 6 6 — — $50,121.00 $107,175.44 $51,875.24 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $49,482.00 $85,925.37 $51,213.87 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 6 6 — — $49,340.00 $78,463.05 $51,066.90 2024-10-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $49,340.00 $55,974.48 $51,066.90 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 6 — — $49,340.00 $56,673.70 $51,066.90 2024-10-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $49,198.00 $59,895.31 $50,919.93 2024-10-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $49,198.00 $83,808.26 $50,919.93 2024-10-01
63 APR_DRG Pancreas Transplant 6 6 — — $48,985.00 $98,326.56 $50,699.47 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $48,630.00 $70,932.63 $50,332.05 2024-10-01
8634 APR_DRG Neonatal Aftercare 6 6 — — $48,346.00 $66,404.44 $50,038.11 2024-10-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $48,062.00 $54,050.81 $49,744.17 2024-10-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $48,414.94 $51,657.90 $49,689.98 2024-10-01
4403 APR_DRG Kidney Transplant 6 6 — — $47,920.00 $65,449.09 $49,597.20 2024-10-01
914 APR_DRG Other Major Head And Neck Procedures 6 6 — — $46,997.00 $68,343.24 $48,641.90 2024-10-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 6 — — $46,287.00 $52,768.00 $47,907.04 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $46,145.00 $70,880.76 $47,760.07 2024-10-01
11 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $45,861.00 $80,879.52 $47,466.14 2024-10-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 6 6 — — $45,648.00 $53,366.72 $47,245.68 2024-10-01
984 MS_DRG Prostatic O.r. Procedure Unrelated To Principal Diagnosis W Mcc 6 2 — — $30,167.63 $53,013.24 $46,927.41 2024-10-01
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $45,222.00 $66,877.80 $46,804.77 2024-10-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 6 6 — — $44,938.00 $76,889.53 $46,510.83 2024-10-01
913 APR_DRG Other Major Head And Neck Procedures 6 6 — — $37,017.01 $48,750.45 $46,429.00 2024-10-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $44,725.00 $69,238.08 $46,290.38 2024-10-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 6 6 — — $44,654.00 $62,266.39 $46,216.89 2024-10-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 6 — — $44,157.00 $88,253.23 $45,702.49 2024-10-01
6904 APR_DRG Acute Leukemia 6 6 — — $43,873.00 $56,740.70 $45,408.56 2024-10-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $43,660.00 $68,450.23 $45,188.10 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 6 2 — — $28,964.27 $50,898.60 $45,055.54 2024-10-01
62 APR_DRG Pancreas Transplant 6 6 — — $43,518.00 $91,682.33 $45,041.13 2024-10-01
61 APR_DRG Pancreas Transplant 6 6 — — $43,518.00 $81,420.96 $45,041.13 2024-10-01
893 APR_DRG Major Cranial Or Facial Bone Procedures 6 6 — — $33,385.81 $46,886.70 $44,654.00 2024-10-01
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 6 — — $42,950.00 $57,551.24 $44,453.25 2024-10-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $43,447.00 $45,957.34 $44,042.42 2024-10-01
6903 APR_DRG Acute Leukemia 6 6 — — $24,238.86 $46,066.65 $43,873.00 2024-10-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 6 — — $42,311.00 $71,638.34 $43,791.89 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 6 2 — — $27,361.59 $48,082.21 $42,562.46 2024-10-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 6 — — $41,104.00 $65,301.04 $42,542.64 2024-10-01
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $198,638.00 $208,569.90 $200,624.38 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 4 3 — — $108,036.36 $165,601.38 $135,129.06 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $113,659.00 $119,341.95 $114,795.59 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $104,927.00 $110,173.35 $105,976.27 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $57,646.00 $60,528.30 $58,222.46 2024-10-01
84 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $56,155.00 $58,962.75 $56,716.55 2024-10-01
83 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $56,155.00 $58,962.75 $56,716.55 2024-10-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $55,942.00 $58,739.10 $56,501.42 2024-10-01
1784 APR_DRG External Heart Assist Devices 4 4 — — $53,528.00 $56,204.40 $54,063.28 2024-10-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $48,843.00 $51,285.15 $49,331.43 2024-10-01
1794 APR_DRG Defibrillator Implants 4 4 — — $47,991.00 $50,390.55 $48,470.91 2024-10-01
1824 APR_DRG Other Peripheral Vascular And Related Procedures 4 4 — — $47,778.00 $50,166.90 $48,255.78 2024-10-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 4 — — $47,636.00 $50,017.80 $48,112.36 2024-10-01
72 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $47,210.00 $49,570.50 $47,682.10 2024-10-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 4 4 — — $45,790.00 $48,079.50 $46,247.90 2024-10-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 4 4 — — $44,867.00 $47,110.35 $45,315.67 2024-10-01
71 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $44,867.00 $47,110.35 $45,315.67 2024-10-01
1783 APR_DRG External Heart Assist Devices 4 4 — — $43,731.00 $45,917.55 $44,168.31 2024-10-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 3 3 — — $465,980.20 $4,111,590.00 $3,994,116.00 2024-10-01
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 2 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 2 — — $426,039.04 $3,651,763.20 $2,038,901.12 2024-10-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $186,031.74 $201,374.57 $193,703.15 2024-10-01
34 APR_DRG Bone Marrow Transplant 2 2 — — $187,490.42 $196,864.94 $192,177.68 2024-10-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $153,503.57 $166,163.65 $159,833.61 2024-10-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 — — $124,604.07 $134,880.69 $129,742.38 2024-10-01
J7330 HCPCS Autologous Cultured Chondrocytes, Implant 2 1 — — $120,116.70 $120,116.70 $120,116.70 2024-10-01
33 APR_DRG Bone Marrow Transplant 2 2 — — $104,327.97 $109,544.37 $106,936.17 2024-10-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 — — $87,612.15 $94,837.89 $91,225.02 2024-10-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 — — $81,406.75 $88,120.70 $84,763.73 2024-10-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $79,278.27 $85,816.69 $82,547.48 2024-10-01
A9699 HCPCS Radiopharmaceutical, Therapeutic, Not Otherwise Classified 2 1 — — $76,785.37 $76,785.37 $76,785.37 2024-10-01
904 APR_DRG Major Larynx & Trachea Procedures 2 2 — — $73,532.78 $77,209.42 $75,371.10 2024-10-01
007 OTHER Lung Transplant 2 2 — — $70,239.21 $76,032.14 $73,135.68 2024-10-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $70,111.79 $75,894.21 $73,003.00 2024-10-01
955 OTHER Craniotomy For Multiple Significant Trauma 2 2 — — $64,887.58 $70,239.13 $67,563.36 2024-10-01
32 APR_DRG Bone Marrow Transplant 2 2 — — $64,496.98 $67,721.83 $66,109.40 2024-10-01
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $59,802.66 $64,734.84 $62,268.75 2024-10-01
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $57,631.88 $62,385.03 $60,008.46 2024-10-01
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 2 2 — — $57,500.34 $62,242.64 $59,871.49 2024-10-01
2214 APR_DRG Major Small & Large Bowel Procedures 2 2 — — $56,969.04 $59,817.49 $58,393.26 2024-10-01
215 OTHER Other Heart Assist System Implant 2 2 — — $53,477.59 $57,888.12 $55,682.85 2024-10-01
1734 APR_DRG Other Vascular Procedures 2 2 — — $54,078.91 $56,782.85 $55,430.88 2024-10-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $51,765.93 $56,035.29 $53,900.61 2024-10-01
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $51,478.07 $55,723.69 $53,600.88 2024-10-01
7914 APR_DRG O.r. Procedure For Other Complications Of Treatment 2 2 — — $50,753.40 $53,291.07 $52,022.24 2024-10-01
6934 APR_DRG Chemotherapy 2 2 — — $50,518.73 $53,044.66 $51,781.70 2024-10-01
2624 APR_DRG Cholecystectomy Except Laparoscopic 2 2 — — $47,718.13 $50,104.04 $48,911.08 2024-10-01
021 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 2 — — $46,925.01 $50,795.12 $48,860.07 2024-10-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 2 — — $46,468.98 $50,301.48 $48,385.23 2024-10-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $45,772.05 $49,547.06 $47,659.56 2024-10-01
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $45,044.68 $48,759.70 $46,902.19 2024-10-01
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $44,512.29 $48,183.41 $46,347.85 2024-10-01
3024 APR_DRG Knee Joint Replacement 2 2 — — $44,739.48 $46,976.46 $45,857.97 2024-10-01
5464 APR_DRG Other O.r. Proc For Obstetric Diagnoses Except Delivery Diagnoses 2 2 — — $44,645.82 $46,878.11 $45,761.96 2024-10-01
834 OTHER Acute Leukemia With Mcc 2 2 — — $43,706.51 $47,311.17 $45,508.84 2024-10-01
31 APR_DRG Bone Marrow Transplant 2 2 — — $43,642.30 $45,824.42 $44,733.36 2024-10-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $42,708.30 $46,230.64 $44,469.47 2024-10-01
704 APR_DRG Orbital Procedures 2 2 — — $42,352.65 $44,470.28 $43,411.46 2024-10-01
4814 APR_DRG Penis Procedures 2 2 — — $42,346.47 $44,463.80 $43,405.14 2024-10-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,562,713.00 $3,562,713.00 $3,562,713.00 2024-10-01
00773 OTHER Inj, Beqvez, Per Tx Dose 1 1 — — $3,496,850.00 $3,496,850.00 $3,496,850.00 2024-10-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,225,691.35 $3,225,691.35 $3,225,691.35 2024-10-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,187,420.00 $3,187,420.00 $3,187,420.00 2024-10-01
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,878,960.00 $2,878,960.00 $2,878,960.00 2024-10-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,316,955.58 $2,316,955.58 $2,316,955.58 2024-10-01
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $513,317.11 $513,317.11 $513,317.11 2024-10-01
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $511,309.70 $511,309.70 $511,309.70 2024-10-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $510,789.97 $510,789.97 $510,789.97 2024-10-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $501,224.32 $501,224.32 $501,224.32 2024-10-01
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $474,772.32 $474,772.32 $474,772.32 2024-10-01
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $446,714.49 $446,714.49 $446,714.49 2024-10-01
01907 OTHER New Technology - Level 52 1 1 — — $133,360.74 $133,360.74 $133,360.74 2024-10-01
01908 OTHER New Technology - Level 52 1 1 — — $133,360.74 $133,360.74 $133,360.74 2024-10-01
01905 OTHER New Technology - Level 51 1 1 — — $120,243.33 $120,243.33 $120,243.33 2024-10-01
01906 OTHER New Technology - Level 51 1 1 — — $120,243.33 $120,243.33 $120,243.33 2024-10-01
01903 OTHER New Technology - Level 50 1 1 — — $107,125.93 $107,125.93 $107,125.93 2024-10-01
01904 OTHER New Technology - Level 50 1 1 — — $107,125.93 $107,125.93 $107,125.93 2024-10-01
01901 OTHER New Technology - Level 49 1 1 — — $94,008.52 $94,008.52 $94,008.52 2024-10-01
01902 OTHER New Technology - Level 49 1 1 — — $94,008.52 $94,008.52 $94,008.52 2024-10-01
01599 OTHER New Technology - Level 48 1 1 — — $83,077.35 $83,077.35 $83,077.35 2024-10-01
01585 OTHER New Technology - Level 48 1 1 — — $83,077.35 $83,077.35 $83,077.35 2024-10-01
01598 OTHER New Technology - Level 47 1 1 — — $74,332.41 $74,332.41 $74,332.41 2024-10-01
01584 OTHER New Technology - Level 47 1 1 — — $74,332.41 $74,332.41 $74,332.41 2024-10-01
01597 OTHER New Technology - Level 46 1 1 — — $65,587.47 $65,587.47 $65,587.47 2024-10-01
01583 OTHER New Technology - Level 46 1 1 — — $65,587.47 $65,587.47 $65,587.47 2024-10-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $63,512.28 $63,512.28 $63,512.28 2024-10-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $61,454.13 $61,454.13 $61,454.13 2024-10-01
01582 OTHER New Technology - Level 45 1 1 — — $56,842.53 $56,842.53 $56,842.53 2024-10-01
01596 OTHER New Technology - Level 45 1 1 — — $56,842.53 $56,842.53 $56,842.53 2024-10-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $53,364.77 $53,364.77 $53,364.77 2024-10-01
01595 OTHER New Technology - Level 44 1 1 — — $48,097.60 $48,097.60 $48,097.60 2024-10-01
01581 OTHER New Technology - Level 44 1 1 — — $48,097.60 $48,097.60 $48,097.60 2024-10-01
05244 OTHER Level 4 Blood Product Exc 1 1 — — $45,531.54 $45,531.54 $45,531.54 2024-10-01
01142 OTHER Supprelin La Implant 1 1 — — $43,989.70 $43,989.70 $43,989.70 2024-10-01
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