Price Transparencybeta 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

FAIRVIEW PARK HOSPITAL

Dublin, GA · CCN 110125 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $3,870 across 25 payers · range $1,379-$10,977

Source: https://core.secure.ehc.com/src/util/json-detail-price-list/62-1817469_fairview-park-hospital_standardcharges.json · observed 2026-03-01

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.

29,633 distinct procedures filed
56 distinct payers
786,578 rate rows
2026-07-31 last MRF observed
Data quality

723,681 of 786,578 rate rows are consumer-grade (92.0%)

62,897 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 39,632
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 11,565
per-diem day rate — not a per-procedure price 7,358
template filing: same amount across many unrelated codes — excluded 4,087
placeholder amount (≤ $0.02) — excluded from medians 88
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 81
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 60
exceeds 10× this hospital's gross charge — excluded from medians 26
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://core.secure.ehc.com/src/util/json-detail-price-list/62-1817469_fairview-park-hospital_standardcharges.json
Found on page https://fairviewparkhospital.com/about/legal/pricing-transparency-cms-required-file-of-standard-charges.dot
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-03
Content fingerprint aaf2c7322d670c4d… · 480,824,354 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
845
OTHER 		Inj, Atidarsagene Autotem 16 $4,699.51 $4,730,250.00 $4,550,050.00 nat. median
$17,156
outlier · 265.2×
00845
OTHER 		Inj, Atidarsagene Autotem 1 $4,369,850.00 $4,369,850.00 $4,369,850.00 nat. median
$4,414,900
1.0× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 3 $3,915,800.00 $4,111,590.00 $3,994,116.00 nat. median
$3,705,478
1.1× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 15 $3,574,708.99 $3,869,530.35 $3,722,119.67 nat. median
$3,758,972
1.0× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 $3,580,160.00 $3,651,763.20 $3,615,961.60 nat. median
$3,324,572
1.1× median
09138
OTHER 		Inj, Hemgenix, Per Tx Dos 1 $3,574,708.99 $3,574,708.99 $3,574,708.99 nat. median
$3,574,709
1.0× median
J3394
HCPCS 		Injection, Lovotibeglogene Autotemcel, Per Treatment 2 $3,468,280.00 $3,537,645.60 $3,502,962.80 nat. median
$3,286,000
1.1× median
908
OTHER 		Topi Adm Prad Zami Per Tr 16 $8,509.13 $3,502,611.00 $3,369,178.20 nat. median
$30,519
outlier · 110.4×
714
OTHER 		Inj Delandistrogene Mox R 17 $5,527.26 $4,991,790.00 $3,361,138.60 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 17 $10,521.08 $4,878,762.00 $3,285,033.08 nat. median
$3,252,508
1.0× median
00908
OTHER 		Topi Adm Prad Zami Per Tr 1 $3,235,745.40 $3,235,745.40 $3,235,745.40 nat. median
$14,890
outlier · 217.3×
00714
OTHER 		Inj Delandistrogene Mox R 1 $3,228,024.20 $3,228,024.20 $3,228,024.20 nat. median
$3,228,024
1.0× median
906
OTHER 		Inj Elivaldogene Autoteme 17 $7,518.82 $4,770,000.00 $3,211,800.00 nat. median
$25,059
outlier · 128.2×
J3393
HCPCS 		Injection, Betibeglogene Autotemcel, Per Treatment 3 $3,132,640.00 $4,698,960.00 $3,195,292.80 nat. median
$2,994,107
1.1× median
00748
OTHER 		Inj, Lovotibeglogene Auto 1 $3,154,932.76 $3,154,932.76 $3,154,932.76 nat. median
$3,187,420
1.0× median
00906
OTHER 		Inj Elivaldogene Autoteme 1 $3,084,600.00 $3,084,600.00 $3,084,600.00 nat. median
$3,084,600
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 17 $9,732.11 $4,409,953.50 $2,969,368.69 nat. median
$2,939,969
1.0× median
00746
OTHER 		Inj, Betibeglogene Autote 1 $2,851,769.93 $2,851,769.93 $2,851,769.93 nat. median
$2,878,960
1.0× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 $2,648,347.96 $4,013,760.50 $2,702,598.74 nat. median
$2,467,386
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 16 $2,511,311.57 $3,883,471.50 $2,614,870.81 nat. median
$2,588,981
1.0× median
09141
OTHER 		Inj Onase Abepar-xioi Tre 1 $2,511,311.57 $2,511,311.57 $2,511,311.57 nat. median
$2,511,312
1.0× median
J3392
HCPCS 		Injection, Exagamglogene Autotemcel, Per Treatment 3 $2,461,360.00 $3,692,040.00 $2,510,587.20 nat. median
$2,401,965
1.0× median
824
OTHER 		Inj, Exagamglogene Autote 17 $11,396.05 $3,498,000.00 $2,355,320.00 nat. median
$2,285,360
1.0× median
00824
OTHER 		Inj, Exagamglogene Autote 1 $2,262,040.00 $2,262,040.00 $2,262,040.00 nat. median
$2,285,360
1.0× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 $536,573.93 $1,444,178.39 $1,263,446.58 nat. median
$646,415
2.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 $511,793.34 $1,383,914.41 $1,199,875.72 nat. median
$622,450
1.9× median
Q2057
HCPCS 		Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 4 $908,406.86 $1,656,833.00 $1,144,592.65 nat. median
$813,967
1.4× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 $474,717.03 $1,278,450.93 $1,052,317.93 nat. median
$591,721
1.8× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 12 $561,407.87 $1,481,651.65 $1,021,529.76 nat. median
$739,258
1.4× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 12 $500,948.74 $1,352,935.00 $926,941.87 nat. median
$640,950
1.4× median
Q2041
HCPCS 		Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 12 $487,755.77 $1,282,290.17 $885,022.97 nat. median
$608,239
1.5× median
2067
OTHER 		Afamitresgene Autoleucel 16 $747,501.40 $1,155,930.00 $778,326.20 nat. median
$793,739
1.0× median
Q2058
HCPCS 		Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells,… 1 $598,237.50 $598,237.50 $598,237.50 nat. median
$319,951
1.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 16 $570,020.11 $881,474.40 $593,526.10 nat. median
$587,650
1.0× median
9194
OTHER 		Tisagenlecleucel Car-pos 16 $549,535.36 $849,796.95 $572,196.61 nat. median
$577,163
1.0× median
09498
OTHER 		Ciltacabtagene Car-pos T 1 $570,020.11 $570,020.11 $570,020.11 nat. median
$570,020
1.0× median
9413
OTHER 		Lisocabtagene Car Pos T 16 $545,335.16 $843,301.80 $567,823.21 nat. median
$562,201
1.0× median
9422
OTHER 		Idecabtagene Vicleucel Ca 16 $541,339.35 $837,122.70 $563,662.62 nat. median
$563,449
1.0× median
09194
OTHER 		Tisagenlecleucel Car-pos 1 $549,535.36 $549,535.36 $549,535.36 nat. median
$549,535
1.0× median
09413
OTHER 		Lisocabtagene Car Pos T 1 $545,335.16 $545,335.16 $545,335.16 nat. median
$545,335
1.0× median
09422
OTHER 		Idecabtagene Vicleucel Ca 1 $541,339.35 $541,339.35 $541,339.35 nat. median
$541,339
1.0× median
9035
OTHER 		Axicabtagene Ciloleucel C 16 $516,226.43 $798,288.30 $537,514.12 nat. median
$533,230
1.0× median
09035
OTHER 		Axicabtagene Ciloleucel C 1 $516,226.43 $516,226.43 $516,226.43 nat. median
$516,226
1.0× median
9391
OTHER 		Brexucabtagene Car Pos T 16 $474,766.69 $734,175.30 $494,344.70 nat. median
$492,768
1.0× median
09391
OTHER 		Brexucabtagene Car Pos T 1 $474,766.69 $474,766.69 $474,766.69 nat. median
$474,767
1.0× median
J3402
HCPCS 		Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 $433,588.39 $433,588.39 $433,588.39 nat. median
$209,753
outlier · 2.1×
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 31 $9,769.54 $949,373.86 $296,633.82 nat. median
$359,454
0.8× median
831
OTHER 		Obecbtge Autol Up To 400 17 $3,218.02 $417,375.00 $281,032.50 nat. median
$23,596
outlier · 11.9×
00831
OTHER 		Obecbtge Autol Up To 400 1 $269,902.50 $269,902.50 $269,902.50 nat. median
$272,685
1.0× median
897
OTHER 		Revakinagene, Per Implant 16 $257,050.00 $397,500.00 $267,650.00 nat. median
$26,484
outlier · 10.1×

Other procedures at this hospital

Browse this hospital's 29,633 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
             
845 OTHER Inj, Atidarsagene Autotem 21 16 $17,128.44 — $4,699.51 $4,730,250.00 $4,550,050.00 2026-07-31
00845 OTHER Inj, Atidarsagene Autotem 1 1 — — $4,369,850.00 $4,369,850.00 $4,369,850.00 2026-03-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 3 3 — — $3,915,800.00 $4,111,590.00 $3,994,116.00 2026-07-31
9138 OTHER Inj, Hemgenix, Per Tx Dos 19 15 — — $3,574,708.99 $3,869,530.35 $3,722,119.67 2026-03-01
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 2 2 — — $3,580,160.00 $3,651,763.20 $3,615,961.60 2026-03-01
09138 OTHER Inj, Hemgenix, Per Tx Dos 1 1 — — $3,574,708.99 $3,574,708.99 $3,574,708.99 2026-03-01
J3394 HCPCS Injection, Lovotibeglogene Autotemcel, Per Treatment 2 2 — — $3,468,280.00 $3,537,645.60 $3,502,962.80 2026-03-01
908 OTHER Topi Adm Prad Zami Per Tr 21 16 $41,661.32 — $8,509.13 $3,502,611.00 $3,369,178.20 2026-07-31
714 OTHER Inj Delandistrogene Mox R 22 17 $19,440.00 — $5,527.26 $4,991,790.00 $3,361,138.60 2026-07-31
748 OTHER Inj, Lovotibeglogene Auto 22 17 $28,710.15 — $10,521.08 $4,878,762.00 $3,285,033.08 2026-07-31
00908 OTHER Topi Adm Prad Zami Per Tr 1 1 — — $3,235,745.40 $3,235,745.40 $3,235,745.40 2026-03-01
00714 OTHER Inj Delandistrogene Mox R 1 1 — — $3,228,024.20 $3,228,024.20 $3,228,024.20 2026-03-01
906 OTHER Inj Elivaldogene Autoteme 22 17 $36,217.90 — $7,518.82 $4,770,000.00 $3,211,800.00 2026-07-31
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 3 3 — — $3,132,640.00 $4,698,960.00 $3,195,292.80 2026-03-01
00748 OTHER Inj, Lovotibeglogene Auto 1 1 — — $3,154,932.76 $3,154,932.76 $3,154,932.76 2026-03-01
00906 OTHER Inj Elivaldogene Autoteme 1 1 — — $3,084,600.00 $3,084,600.00 $3,084,600.00 2026-03-01
746 OTHER Inj, Betibeglogene Autote 22 17 $31,671.92 — $9,732.11 $4,409,953.50 $2,969,368.69 2026-07-31
00746 OTHER Inj, Betibeglogene Autote 1 1 — — $2,851,769.93 $2,851,769.93 $2,851,769.93 2026-03-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 4 4 — — $2,648,347.96 $4,013,760.50 $2,702,598.74 2026-07-31
9141 OTHER Inj Onase Abepar-xioi Tre 20 16 — — $2,511,311.57 $3,883,471.50 $2,614,870.81 2026-03-01
09141 OTHER Inj Onase Abepar-xioi Tre 1 1 — — $2,511,311.57 $2,511,311.57 $2,511,311.57 2026-03-01
J3392 HCPCS Injection, Exagamglogene Autotemcel, Per Treatment 3 3 — — $2,461,360.00 $3,692,040.00 $2,510,587.20 2026-03-01
824 OTHER Inj, Exagamglogene Autote 22 17 $46,397.72 — $11,396.05 $3,498,000.00 $2,355,320.00 2026-07-31
00824 OTHER Inj, Exagamglogene Autote 1 1 — — $2,262,040.00 $2,262,040.00 $2,262,040.00 2026-03-01
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 11 11 $1,059,735.00 — $536,573.93 $1,444,178.39 $1,263,446.58 2026-07-31
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 11 11 $1,091,486.98 — $511,793.34 $1,383,914.41 $1,199,875.72 2026-07-31
Q2057 HCPCS Afamitresgene Autoleucel, Including Leukapheresis And Dose Preparation Procedure… 4 4 — — $908,406.86 $1,656,833.00 $1,144,592.65 2026-03-01
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 11 11 $1,004,324.14 — $474,717.03 $1,278,450.93 $1,052,317.93 2026-07-31
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 16 12 $1,053,942.97 — $561,407.87 $1,481,651.65 $1,021,529.76 2026-07-31
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 16 12 $1,067,549.72 — $500,948.74 $1,352,935.00 $926,941.87 2026-07-31
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 16 12 $1,011,089.01 — $487,755.77 $1,282,290.17 $885,022.97 2026-07-31
2067 OTHER Afamitresgene Autoleucel 20 16 — — $747,501.40 $1,155,930.00 $778,326.20 2026-03-01
Q2058 HCPCS Obecabtagene Autoleucel, 10 Up To 400 Million Cd19 Car-positive Viable T Cells, … 1 1 — — $598,237.50 $598,237.50 $598,237.50 2026-03-01
9498 OTHER Ciltacabtagene Car-pos T 20 16 $838,162.50 — $570,020.11 $881,474.40 $593,526.10 2026-07-31
9194 OTHER Tisagenlecleucel Car-pos 20 16 $794,249.05 — $549,535.36 $849,796.95 $572,196.61 2026-07-31
09498 OTHER Ciltacabtagene Car-pos T 1 1 — — $570,020.11 $570,020.11 $570,020.11 2026-03-01
9413 OTHER Lisocabtagene Car Pos T 20 16 $761,106.50 — $545,335.16 $843,301.80 $567,823.21 2026-07-31
9422 OTHER Idecabtagene Vicleucel Ca 20 16 $778,172.50 — $541,339.35 $837,122.70 $563,662.62 2026-07-31
09194 OTHER Tisagenlecleucel Car-pos 1 1 — — $549,535.36 $549,535.36 $549,535.36 2026-03-01
09413 OTHER Lisocabtagene Car Pos T 1 1 — — $545,335.16 $545,335.16 $545,335.16 2026-03-01
09422 OTHER Idecabtagene Vicleucel Ca 1 1 — — $541,339.35 $541,339.35 $541,339.35 2026-03-01
9035 OTHER Axicabtagene Ciloleucel C 20 16 $740,048.35 — $516,226.43 $798,288.30 $537,514.12 2026-07-31
09035 OTHER Axicabtagene Ciloleucel C 1 1 — — $516,226.43 $516,226.43 $516,226.43 2026-03-01
9391 OTHER Brexucabtagene Car Pos T 20 16 $740,145.00 — $474,766.69 $734,175.30 $494,344.70 2026-07-31
09391 OTHER Brexucabtagene Car Pos T 1 1 — — $474,766.69 $474,766.69 $474,766.69 2026-03-01
J3402 HCPCS Injection, Remestemcel-l-rknd, Per Therapeutic Dose 1 1 — — $433,588.39 $433,588.39 $433,588.39 2026-03-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 56 31 — — $9,769.54 $949,373.86 $296,633.82 2026-03-01
831 OTHER Obecbtge Autol Up To 400 22 17 $24,204.69 — $3,218.02 $417,375.00 $281,032.50 2026-07-31
00831 OTHER Obecbtge Autol Up To 400 1 1 — — $269,902.50 $269,902.50 $269,902.50 2026-03-01
897 OTHER Revakinagene, Per Implant 20 16 $17,245.94 — $257,050.00 $397,500.00 $267,650.00 2026-07-31
00897 OTHER Revakinagene, Per Implant 1 1 — — $257,050.00 $257,050.00 $257,050.00 2026-03-01
1614 APR_DRG Implantable Heart Assist Systems 6 6 — — $206,596.00 $309,894.00 $206,596.00 2026-03-01
886 OTHER Inj. Remestemcel-l-rknd/ 22 17 $27,652.66 — $7,041.56 $302,503.50 $203,685.69 2026-07-31
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 56 30 — — $9,769.54 $616,105.44 $197,647.62 2026-03-01
018 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 $732,242.47 — $189,741.31 $205,390.08 $197,565.70 2026-07-31
5834 APR_DRG Neonate With Ecmo 6 6 — — $197,315.07 $295,972.60 $197,315.07 2026-03-01
00886 OTHER Inj. Remestemcel-l-rknd/ 1 1 — — $195,618.93 $195,618.93 $195,618.93 2026-03-01
J7330 HCPCS $134,810.16 1 1 $134,810.16 — $180,011.44 $180,011.44 $180,011.44 2026-07-31
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $177,863.26 $266,794.89 $177,863.26 2026-03-01
001 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 $570,193.83 — $166,785.68 $180,541.20 $173,663.44 2026-07-31
5833 APR_DRG Neonate With Ecmo 6 6 — — $156,250.14 $234,375.21 $156,250.14 2026-03-01
1613 APR_DRG Implantable Heart Assist Systems 6 6 — — $151,291.84 $226,937.76 $151,291.84 2026-03-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $148,876.26 $223,314.39 $148,876.26 2026-03-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 10 10 — — $61,338.53 $166,081.64 $148,814.58 2026-03-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $148,749.12 $223,123.68 $148,749.12 2026-03-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 57 30 — — $9,769.54 $466,636.02 $147,265.44 2026-03-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 57 30 — — $9,769.54 $469,390.74 $146,715.19 2026-03-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 6 6 $146,769.98 — $122,172.78 $148,851.91 $145,874.87 2026-07-31
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $145,824.99 $218,737.48 $145,824.99 2026-03-01
1908 OTHER New Technology - Level 52 20 16 $244,009.95 — $129,704.04 $200,573.25 $135,052.65 2026-07-31
1907 OTHER New Technology - Level 52 20 16 $244,009.95 — $129,704.04 $200,573.25 $135,052.65 2026-07-31
01908 OTHER New Technology - Level 52 1 1 — — $134,425.80 $134,425.80 $134,425.80 2026-03-01
01907 OTHER New Technology - Level 52 1 1 — — $134,425.80 $134,425.80 $134,425.80 2026-03-01
003 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 2 2 $409,970.46 — $117,553.91 $127,249.08 $122,401.49 2026-07-31
1905 OTHER New Technology - Level 51 20 16 $220,009.05 — $116,946.30 $180,844.80 $121,768.83 2026-07-31
1906 OTHER New Technology - Level 51 20 16 $220,009.05 — $116,946.30 $180,844.80 $121,768.83 2026-07-31
01906 OTHER New Technology - Level 51 1 1 — — $121,203.63 $121,203.63 $121,203.63 2026-03-01
01905 OTHER New Technology - Level 51 1 1 — — $121,203.63 $121,203.63 $121,203.63 2026-03-01
24 APR_DRG Heart And/or Lung Transplant 6 6 — — $117,282.96 $175,924.44 $117,282.96 2026-03-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 11 11 $128,674.01 — $55,306.59 $145,477.86 $116,968.84 2026-07-31
5832 APR_DRG Neonate With Ecmo 6 6 — — $115,248.78 $172,873.17 $115,248.78 2026-03-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 6 6 — — $109,146.26 $163,719.39 $109,146.26 2026-03-01
1904 OTHER New Technology - Level 50 20 16 $196,008.15 — $104,188.57 $161,116.35 $108,485.01 2026-07-31
1903 OTHER New Technology - Level 50 20 16 $196,008.15 — $104,188.57 $161,116.35 $108,485.01 2026-07-31
01904 OTHER New Technology - Level 50 1 1 — — $107,981.47 $107,981.47 $107,981.47 2026-03-01
01903 OTHER New Technology - Level 50 1 1 — — $107,981.47 $107,981.47 $107,981.47 2026-03-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $106,857.81 $160,286.71 $106,857.81 2026-03-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $104,251.52 $156,377.28 $104,251.52 2026-03-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $103,234.43 $154,851.64 $103,234.43 2026-03-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $102,090.21 $153,135.32 $102,090.21 2026-03-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $101,772.37 $152,658.55 $101,772.37 2026-03-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $101,263.82 $151,895.73 $101,263.82 2026-03-01
A9699 HCPCS $101,856.21 1 1 $101,856.21 — $100,394.53 $100,394.53 $100,394.53 2026-07-31
5831 APR_DRG Neonate With Ecmo 6 6 — — $99,611.06 $149,416.59 $99,611.06 2026-03-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 57 30 — — $9,769.54 $304,523.03 $96,628.39 2026-03-01
004 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 2 2 $278,181.72 — $91,800.29 $99,371.44 $95,585.86 2026-07-31
1901 OTHER New Technology - Level 49 20 16 $172,007.25 — $91,430.83 $141,387.89 $95,201.18 2026-07-31
1902 OTHER New Technology - Level 49 20 16 $172,007.25 — $91,430.83 $141,387.89 $95,201.18 2026-07-31
1612 APR_DRG Implantable Heart Assist Systems 6 6 — — $95,161.30 $142,741.95 $95,161.30 2026-03-01
01902 OTHER New Technology - Level 49 1 1 — — $94,759.31 $94,759.31 $94,759.31 2026-03-01
01901 OTHER New Technology - Level 49 1 1 — — $94,759.31 $94,759.31 $94,759.31 2026-03-01
74 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $93,953.50 $140,930.25 $93,953.50 2026-03-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 11 11 $106,633.54 — $43,855.64 $118,563.29 $92,848.48 2026-07-31
7 MS_DRG Lung Transplant 56 31 — — $9,769.54 $284,710.15 $92,162.36 2026-03-01
1611 APR_DRG Implantable Heart Assist Systems 6 6 — — $90,393.70 $135,590.55 $90,393.70 2026-03-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $88,486.66 $132,729.99 $88,486.66 2026-03-01
651 OTHER Kidney Transplant With Hemodialysis Without Mcc 2 2 $81,231.10 — $82,272.01 $89,057.34 $85,664.67 2026-07-31
14 MS_DRG Allogeneic Bone Marrow Transplant 56 31 — — $9,769.54 $264,213.53 $85,638.17 2026-03-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $84,863.28 $127,294.92 $84,863.28 2026-03-01
64 APR_DRG Pancreas Transplant 6 6 — — $84,291.17 $126,436.76 $84,291.17 2026-03-01
1585 OTHER New Technology - Level 48 20 16 $152,006.50 — $80,799.39 $124,947.51 $84,131.32 2026-07-31
1599 OTHER New Technology - Level 48 20 16 $152,006.50 — $80,799.39 $124,947.51 $84,131.32 2026-07-31
01599 OTHER New Technology - Level 48 1 1 — — $83,740.84 $83,740.84 $83,740.84 2026-03-01
01585 OTHER New Technology - Level 48 1 1 — — $83,740.84 $83,740.84 $83,740.84 2026-03-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 56 30 — — $9,769.54 $253,707.00 $80,836.86 2026-03-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 6 — — $80,604.22 $120,906.33 $80,604.22 2026-03-01
215 MS_DRG Other Heart Assist System Implant 62 32 — — $9,769.54 $222,926.00 $80,300.35 2026-03-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 6 — — $78,570.05 $117,855.08 $78,570.05 2026-03-01
209 MS_DRG Complex Aortic Arch Procedures 49 25 — — $9,769.54 $248,843.82 $78,481.99 2026-03-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 57 31 — — $55,605.10 $215,074.86 $78,250.00 2026-03-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $77,489.39 $116,234.08 $77,489.39 2026-03-01
13 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $77,489.39 $116,234.08 $77,489.39 2026-03-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $77,489.39 $116,234.08 $77,489.39 2026-03-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 32 — — $9,769.54 $242,301.08 $76,457.77 2026-03-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $76,408.74 $114,613.11 $76,408.74 2026-03-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 58 31 — — $9,769.54 $239,067.09 $75,820.01 2026-03-01
1598 OTHER New Technology - Level 47 20 16 $136,005.90 — $72,294.24 $111,795.21 $75,275.44 2026-07-31
1584 OTHER New Technology - Level 47 20 16 $136,005.90 — $72,294.24 $111,795.21 $75,275.44 2026-07-31
01598 OTHER New Technology - Level 47 1 1 — — $74,926.05 $74,926.05 $74,926.05 2026-03-01
01584 OTHER New Technology - Level 47 1 1 — — $74,926.05 $74,926.05 $74,926.05 2026-03-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 56 31 — — $9,769.54 $226,676.34 $73,689.84 2026-03-01
007 OTHER Lung Transplant 2 2 $247,299.88 — $70,554.80 $76,373.76 $73,464.28 2026-07-31
23 APR_DRG Heart And/or Lung Transplant 6 6 — — $73,357.47 $110,036.21 $73,357.47 2026-03-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 6 — — $73,103.20 $109,654.80 $73,103.20 2026-03-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 57 31 — — $48,084.15 $185,331.35 $71,042.00 2026-03-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $70,878.32 $106,317.48 $70,878.32 2026-03-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $70,369.78 $105,554.67 $70,369.78 2026-03-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 6 — — $67,191.38 $100,787.07 $67,191.38 2026-03-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 6 — — $66,809.97 $100,214.96 $66,809.97 2026-03-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 57 31 — — $43,721.91 $168,079.72 $66,470.67 2026-03-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 6 6 — — $66,428.56 $99,642.84 $66,428.56 2026-03-01
1583 OTHER New Technology - Level 46 20 16 $120,005.30 — $63,789.08 $98,642.91 $66,419.56 2026-07-31
1597 OTHER New Technology - Level 46 20 16 $120,005.30 — $63,789.08 $98,642.91 $66,419.56 2026-07-31
01597 OTHER New Technology - Level 46 1 1 — — $66,111.27 $66,111.27 $66,111.27 2026-03-01
01583 OTHER New Technology - Level 46 1 1 — — $66,111.27 $66,111.27 $66,111.27 2026-03-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 6 — — $65,347.90 $98,021.85 $65,347.90 2026-03-01
002 OTHER Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 $374,964.00 — $62,532.38 $67,689.69 $65,111.04 2026-07-31
717 OTHER Instill Adstiladrin, Tx D 22 17 $35,863.37 — $10,432.58 $96,412.18 $64,917.54 2026-07-31
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 6 6 — — $64,839.36 $97,259.04 $64,839.36 2026-03-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 57 31 — — $43,905.92 $168,807.43 $64,567.52 2026-03-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 62 32 — — $9,769.54 $198,076.06 $62,775.36 2026-03-01
014 OTHER Allogeneic Bone Marrow Transplant 2 2 $234,362.80 — $60,225.13 $65,192.15 $62,708.64 2026-07-31
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $62,614.48 $93,921.72 $62,614.48 2026-03-01
00717 OTHER Instill Adstiladrin, Tx D 1 1 — — $62,346.55 $62,346.55 $62,346.55 2026-03-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 11 7 $53,648.60 — $52,091.10 $63,466.35 $62,197.03 2026-07-31
005 OTHER Liver Transplant With Mcc Or Intestinal Transplant 2 2 $290,084.25 — $59,590.77 $64,505.47 $62,048.12 2026-07-31
806368 CDM Ins/repos Sgl Icd+lead 31 20 $178,052.00 $178,052.00 $23,858.97 $160,246.80 $61,249.89 2026-03-01
812898 CDM Ins/repos Dual Icd+lead 31 20 $178,052.00 $178,052.00 $23,858.97 $160,246.80 $61,249.89 2026-03-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $60,834.58 $91,251.87 $60,834.58 2026-03-01
850 MS_DRG Acute Leukemia With Other Procedures 58 31 — — $9,769.54 $190,379.11 $60,684.41 2026-03-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $60,262.46 $90,393.69 $60,262.46 2026-03-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 6 — — $59,690.35 $89,535.52 $59,690.35 2026-03-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 62 32 — — $9,769.54 $172,995.57 $59,518.77 2026-03-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 58 32 — — $12,892.00 $156,761.84 $59,387.67 2026-03-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 57 31 — — $41,698.00 $184,748.75 $59,216.09 2026-03-01
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 $79,653.85 — $55,846.77 $60,452.69 $58,149.73 2026-07-31
1596 OTHER New Technology - Level 45 20 16 $104,004.70 — $55,283.93 $85,490.61 $57,563.68 2026-07-31
1582 OTHER New Technology - Level 45 20 16 $104,004.70 — $55,283.93 $85,490.61 $57,563.68 2026-07-31
1643 OTHER Y90 Ibritumomab, Rx 20 16 $104,639.20 — $55,119.81 $85,236.83 $57,392.80 2026-07-31
01596 OTHER New Technology - Level 45 1 1 — — $57,296.49 $57,296.49 $57,296.49 2026-03-01
01582 OTHER New Technology - Level 45 1 1 — — $57,296.49 $57,296.49 $57,296.49 2026-03-01
5244 OTHER Level 4 Blood Product Exc 20 16 $65,645.63 — $54,657.11 $84,521.31 $56,911.02 2026-07-31
05244 OTHER Level 4 Blood Product Exc 1 1 — — $56,646.87 $56,646.87 $56,646.87 2026-03-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 6 — — $56,639.09 $84,958.63 $56,639.09 2026-03-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $56,384.82 $84,577.23 $56,384.82 2026-03-01
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 $82,996.48 — $53,939.72 $58,388.36 $56,164.04 2026-07-31
21 APR_DRG Heart And/or Lung Transplant 6 6 — — $56,066.98 $84,100.47 $56,066.98 2026-03-01
22 APR_DRG Heart And/or Lung Transplant 6 6 — — $56,066.98 $84,100.47 $56,066.98 2026-03-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 6 — — $55,494.86 $83,242.29 $55,494.86 2026-03-01
01643 OTHER Y90 Ibritumomab, Rx 1 1 — — $55,119.81 $55,119.81 $55,119.81 2026-03-01
9273 OTHER Sipuleucel-t Auto Cd54+ 20 16 $93,634.68 — $52,771.99 $81,606.17 $54,948.15 2026-07-31
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 59 32 — — $11,883.60 $144,557.97 $54,917.98 2026-03-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 58 31 — — $9,769.54 $167,523.50 $54,861.11 2026-03-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $54,732.05 $82,098.08 $54,732.05 2026-03-01
817684 CDM Rem/repl Aicd Dual Ld 31 20 $158,877.00 $158,877.00 $21,289.52 $142,989.30 $54,653.69 2026-03-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 6 6 — — $54,604.91 $81,907.37 $54,604.91 2026-03-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 32 — — $9,769.54 $158,700.92 $54,312.87 2026-03-01
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 $197,354.92 — $51,829.34 $56,103.93 $53,966.63 2026-07-31
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 6 6 — — $53,397.12 $80,095.68 $53,397.12 2026-03-01
214 APR_DRG Open Craniotomy Except Trauma 6 6 — — $53,206.42 $79,809.63 $53,206.42 2026-03-01
09273 OTHER Sipuleucel-t Auto Cd54+ 1 1 — — $52,771.99 $52,771.99 $52,771.99 2026-03-01
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $51,871.49 $77,807.24 $51,871.49 2026-03-01
429 OTHER Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 $10,316.95 — $49,717.97 $53,818.42 $51,768.19 2026-07-31
10 MS_DRG Pancreas Transplant 56 31 — — $9,769.54 $157,757.76 $51,752.61 2026-03-01
73 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $51,617.22 $77,425.83 $51,617.22 2026-03-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 56 31 — — $9,769.54 $156,854.18 $51,465.00 2026-03-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 59 32 — — $11,883.60 $144,557.97 $51,287.34 2026-03-01
B0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 4 3 $52,630.91 — $50,120.57 $52,219.60 $51,195.68 2026-07-31
020 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 $188,469.60 — $49,145.25 $53,198.47 $51,171.86 2026-07-31
817683 CDM Rem/repl Aicd Sing Ld 31 20 $148,691.00 $148,691.00 $19,924.59 $133,821.90 $51,149.70 2026-03-01
817685 CDM Rem/repl Aicd Mult Ld 31 20 $148,691.00 $148,691.00 $19,924.59 $133,821.90 $51,149.70 2026-03-01
B0505 HCPCS Nontraumatic Spinal Cord Injury; M > 23.75 & M < 2 4 3 $49,572.89 — $49,295.36 $51,359.82 $50,352.76 2026-07-31
83 APR_DRG Autologous Bone Marrow Transplant 6 6 — — $50,282.29 $75,423.43 $50,282.29 2026-03-01
84 APR_DRG Autologous Bone Marrow Transplant 6 6 — — $50,282.29 $75,423.43 $50,282.29 2026-03-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 57 30 — — $9,769.54 $157,691.81 $50,281.20 2026-03-01
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 6 6 — — $50,091.58 $75,137.37 $50,091.58 2026-03-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 60 32 — — $11,082.50 $132,055.10 $49,695.40 2026-03-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 58 32 — — $12,892.00 $151,210.63 $49,668.63 2026-03-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 60 32 — — $11,082.50 $133,286.26 $49,588.88 2026-03-01
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 60 32 — — $11,082.50 $137,208.00 $49,373.64 2026-03-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 6 — — $49,074.50 $73,611.75 $49,074.50 2026-03-01
1581 OTHER New Technology - Level 44 20 16 $88,004.10 — $46,778.77 $72,338.31 $48,707.80 2026-07-31
1595 OTHER New Technology - Level 44 20 16 $88,004.10 — $46,778.77 $72,338.31 $48,707.80 2026-07-31
955 MS_DRG Craniotomy For Multiple Significant Trauma 58 31 — — $9,769.54 $147,983.23 $48,641.32 2026-03-01
J9266 HCPCS Injection, Pegaspargase, Per Single Dose Vial 16 12 $52,923.75 — $26,258.38 $70,911.25 $48,584.82 2026-07-31
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 62 32 — — $9,769.54 $151,955.92 $48,506.63 2026-03-01
01595 OTHER New Technology - Level 44 1 1 — — $48,481.73 $48,481.73 $48,481.73 2026-03-01
01581 OTHER New Technology - Level 44 1 1 — — $48,481.73 $48,481.73 $48,481.73 2026-03-01
231 OTHER Coronary Bypass With Ptca With Mcc 2 2 $170,032.47 — $46,518.84 $50,355.45 $48,437.14 2026-07-31
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 58 32 — — $12,892.00 $146,894.98 $48,294.93 2026-03-01
275 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 $47,327.17 — $46,368.71 $50,192.93 $48,280.82 2026-07-31
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 6 6 — — $48,120.98 $72,181.47 $48,120.98 2026-03-01
1784 APR_DRG External Heart Assist Devices 6 6 — — $47,930.27 $71,895.40 $47,930.27 2026-03-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 58 31 — — $9,769.54 $147,002.70 $47,926.50 2026-03-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 56 31 — — $11,082.50 $144,032.53 $47,352.25 2026-03-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 6 — — $46,468.21 $69,702.32 $46,468.21 2026-03-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 6 — — $46,023.23 $69,034.85 $46,023.23 2026-03-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 60 32 — — $11,082.50 $129,021.17 $45,918.30 2026-03-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 6 — — $45,768.96 $68,653.44 $45,768.96 2026-03-01
B0106 HCPCS Stroke; M > 30.05 & M < 34.25 4 3 $47,962.88 — $44,692.75 $46,564.46 $45,651.43 2026-07-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 58 31 — — $9,769.54 $141,466.88 $45,479.11 2026-03-01
28 MS_DRG Spinal Procedures With Mcc 62 32 — — $9,769.54 $132,092.48 $45,460.42 2026-03-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 6 6 — — $45,387.55 $68,081.33 $45,387.55 2026-03-01
850 OTHER Acute Leukemia With Other Procedures 2 2 $582.71 — $43,582.70 $47,177.15 $45,379.93 2026-07-31
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 6 6 $43,601.58 — $12,360.00 $45,802.22 $44,886.18 2026-07-31
4404 APR_DRG Kidney Transplant 6 6 — — $44,879.01 $67,318.51 $44,879.01 2026-03-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 62 32 — — $9,769.54 $131,098.75 $44,501.82 2026-03-01
B1903 HCPCS Guillian Barre; M < 18.05 4 3 $34,827.29 — $43,544.07 $45,367.68 $44,478.11 2026-07-31
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $44,306.90 $66,460.35 $44,306.90 2026-03-01
806366 CDM Ins Single Chamber Icd 31 20 $128,739.00 $128,739.00 $17,251.03 $115,865.10 $44,286.22 2026-03-01
817681 CDM Insrt Aicd Only Dual Ld 31 20 $128,739.00 $128,739.00 $17,251.03 $115,865.10 $44,286.22 2026-03-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 6 — — $44,179.76 $66,269.64 $44,179.76 2026-03-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 6 6 — — $44,179.76 $66,269.64 $44,179.76 2026-03-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 6 — — $44,179.76 $66,269.64 $44,179.76 2026-03-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $44,052.62 $66,078.93 $44,052.62 2026-03-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $44,052.62 $66,078.93 $44,052.62 2026-03-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 6 — — $44,052.62 $66,078.93 $44,052.62 2026-03-01
B0205 HCPCS Traumatic Brain Injury; M > 28.75 & M < 40.65 4 3 $45,137.02 — $42,993.40 $44,793.94 $43,915.63 2026-07-31
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 $150,124.58 — $42,137.00 $45,612.22 $43,874.61 2026-07-31
63 APR_DRG Pancreas Transplant 6 6 — — $43,861.92 $65,792.88 $43,861.92 2026-03-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 62 32 — — $9,769.54 $126,789.69 $43,804.54 2026-03-01
806428 CDM Ins Pacing Elec Lv Pac 31 20 $127,314.00 $127,314.00 $17,060.08 $114,582.60 $43,796.02 2026-03-01
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 6 — — $43,734.78 $65,602.17 $43,734.78 2026-03-01
1142 OTHER Supprelin La Implant 20 16 $66,970.62 — $41,889.78 $64,778.01 $43,617.19 2026-07-31
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 6 — — $43,544.08 $65,316.12 $43,544.08 2026-03-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 62 32 — — $9,769.54 $125,980.65 $43,537.78 2026-03-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 62 32 — — $9,769.54 $123,599.67 $43,468.85 2026-03-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 58 31 — — $9,769.54 $134,576.78 $43,337.19 2026-03-01
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 2 $156,898.97 — $41,584.68 $45,014.34 $43,299.51 2026-07-31
8634 APR_DRG Neonatal Aftercare 6 6 — — $43,289.81 $64,934.71 $43,289.81 2026-03-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 62 32 — — $9,769.54 $121,423.15 $43,161.20 2026-03-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 6 — — $43,035.54 $64,553.31 $43,035.54 2026-03-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 56 31 — — $9,769.54 $130,364.45 $43,033.15 2026-03-01
1794 APR_DRG Defibrillator Implants 6 6 — — $42,971.97 $64,457.96 $42,971.97 2026-03-01
4403 APR_DRG Kidney Transplant 6 6 — — $42,908.40 $64,362.60 $42,908.40 2026-03-01
1824 APR_DRG Other Upper Vascular Procedures 6 6 — — $42,781.26 $64,171.89 $42,781.26 2026-03-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 6 6 — — $42,654.13 $63,981.19 $42,654.13 2026-03-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 62 32 — — $9,769.54 $116,384.19 $42,279.67 2026-03-01
72 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $42,272.72 $63,409.08 $42,272.72 2026-03-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 62 32 — — $9,769.54 $120,097.46 $42,127.79 2026-03-01
447 OTHER Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $40,438.76 $43,773.91 $42,106.34 2026-03-01
914 APR_DRG Other Major Head And Neck Procedures 6 6 — — $42,082.02 $63,123.03 $42,082.02 2026-03-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 49 28 — — $9,769.54 $130,667.85 $41,920.49 2026-03-01
01142 OTHER Supprelin La Implant 1 1 — — $41,889.78 $41,889.78 $41,889.78 2026-03-01
C0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 4 3 $43,749.14 — $40,967.43 $42,683.13 $41,846.21 2026-07-31
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 58 31 — — $9,769.54 $128,937.63 $41,584.15 2026-03-01
913 APR_DRG Other Major Head And Neck Procedures 6 6 — — $41,573.47 $62,360.21 $41,573.47 2026-03-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 62 32 — — $9,769.54 $119,396.00 $41,529.21 2026-03-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 6 — — $41,446.34 $62,169.51 $41,446.34 2026-03-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 58 31 — — $9,769.54 $125,303.51 $41,422.23 2026-03-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 6 — — $41,319.20 $61,978.80 $41,319.20 2026-03-01
010 OTHER Pancreas Transplant 2 2 $84,007.37 — $39,597.59 $42,863.37 $41,230.48 2026-07-31
11 APR_DRG Liver Transplant And/or Intestinal Transplant 6 6 — — $41,064.93 $61,597.40 $41,064.93 2026-03-01
B2102 HCPCS Burns; M=12-45 4 3 $40,079.86 — $40,158.00 $41,839.79 $41,019.40 2026-07-31
1834 APR_DRG Percutaneous Structural Cardiac Procedures 6 6 — — $41,001.36 $61,502.04 $41,001.36 2026-03-01
019 OTHER Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 $144,535.30 — $39,370.89 $42,617.98 $40,994.43 2026-07-31
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 $177,812.00 — $39,337.09 $42,581.39 $40,959.24 2026-07-31
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 6 6 — — $40,874.22 $61,311.33 $40,874.22 2026-03-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 56 31 — — $9,769.54 $123,217.13 $40,758.11 2026-03-01
D0404 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A > 63.5 4 3 $41,521.18 — $39,889.76 $41,560.32 $40,745.41 2026-07-31
B0405 HCPCS Traumatic Spinal Cord Injury; M < 16.05 & A < 63.5 4 3 $43,456.87 — $39,700.42 $41,363.05 $40,552.01 2026-07-31
C0106 HCPCS Stroke; M > 30.05 & M < 34.25 4 3 $41,795.08 — $39,687.79 $41,349.90 $40,539.12 2026-07-31
B0105 HCPCS Stroke; M > 34.25 & M < 38.85 4 3 $41,990.49 — $39,676.75 $41,338.39 $40,527.83 2026-07-31
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 6 — — $40,492.82 $60,739.23 $40,492.82 2026-03-01
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 47 25 — — $11,082.50 $125,466.20 $40,311.18 2026-03-01
G0299 HCPCS Direct Skilled Nursing Services Of A Registered Nurse (rn) In The Home Health Or… 4 1 — — $30,229.00 $40,306.00 $40,306.00 2026-03-01
G0300 HCPCS Direct Skilled Nursing Services Of A Licensed Practical Nurse (lpn) In The Home … 4 1 — — $30,229.00 $40,306.00 $40,306.00 2026-03-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 6 6 — — $40,238.54 $60,357.81 $40,238.54 2026-03-01
71 APR_DRG Allogeneic Bone Marrow Transplant 6 6 — — $40,174.98 $60,262.47 $40,174.98 2026-03-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 6 6 — — $40,174.98 $60,262.47 $40,174.98 2026-03-01
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