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

MEMORIAL HEALTH MEADOWS HOSPITAL

Vidalia, GA · CCN 110128 · Rates published

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You selected 93306 (CPT)

ECHO2D COMP W CF DOP

This hospital’s price: $1,588 across 14 payers · range $531-$3,761

Source: https://core.secure.ehc.com/src/util/json-detail-price-list/85-2556972_memorial-health-meadows-hospital_standardcharges.json · observed 2024-10-01

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

24,779 distinct procedures filed
29 distinct payers
345,276 rate rows
2026-07-31 last MRF observed
Data quality

294,253 of 345,276 rate rows are consumer-grade (85.2%)

51,023 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 36,947
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,941
per-diem day rate — not a per-procedure price 4,507
template filing: same amount across many unrelated codes — excluded 2,397
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 74
placeholder amount (≤ $0.02) — excluded from medians 69
percent-of-charges filed in the dollar field — excluded from medians 66
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 13
exceeds 10× this hospital's gross charge — excluded from medians 9
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://core.secure.ehc.com/src/util/json-detail-price-list/85-2556972_memorial-health-meadows-hospital_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 · 2026-10-03
Content fingerprint 1d12d47d42cbbbac… · 220,734,953 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
$2,994,107
1.6× median
9138
OTHER 		Inj, Hemgenix, Per Tx Dos 12 $2,387,385.00 $3,856,545.00 $3,709,629.00 nat. median
$3,758,972
1.0× median
773
OTHER 		Inj, Beqvez, Per Tx Dose 12 $2,343,250.00 $3,785,250.00 $3,641,050.00 nat. median
$3,672,053
1.0× median
J1411
HCPCS 		Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 4 $465,980.20 $4,111,590.00 $3,563,378.00 nat. median
$3,705,478
1.0× median
714
OTHER 		Inj Delandistrogene Mox R 13 $5,320.60 $3,491,727.75 $3,358,709.55 nat. median
$3,325,455
1.0× median
748
OTHER 		Inj, Lovotibeglogene Auto 13 $8,776.31 $3,450,300.00 $3,318,860.00 nat. median
$3,252,508
1.0× median
746
OTHER 		Inj, Betibeglogene Autote 13 $7,795.11 $3,116,400.00 $2,997,680.00 nat. median
$2,939,969
1.0× median
J1413
HCPCS 		Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 3 $426,039.04 $3,651,763.20 $2,864,128.00 nat. median
$3,324,572
0.9× median
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 5 $309,150.46 $3,884,946.48 $2,648,347.96 nat. median
$2,467,386
1.1× median
9141
OTHER 		Inj Onase Abepar-xioi Tre 12 $1,552,599.10 $2,508,044.70 $2,412,500.14 nat. median
$2,588,981
0.9× median
Q2042
HCPCS 		Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 $73,428.36 $1,292,595.50 $657,793.40 nat. median
$739,258
0.9× median
Q2054
HCPCS 		Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 8 $66,087.96 $1,198,462.58 $599,371.74 nat. median
$640,950
0.9× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 7 $67,592.00 $1,282,791.58 $595,823.34 nat. median
$646,415
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 $595,395.54 nat. median
$608,239
1.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 $67,028.42 $1,225,870.24 $574,529.28 nat. median
$622,450
0.9× median
9194
OTHER 		Tisagenlecleucel Car-pos 12 $343,975.39 $555,652.55 $534,484.83 nat. median
$577,163
0.9× median
9498
OTHER 		Ciltacabtagene Car-pos T 12 $342,630.21 $553,479.57 $532,394.63 nat. median
$587,650
0.9× median
9422
OTHER 		Idecabtagene Vicleucel Ca 12 $342,281.94 $552,916.98 $531,853.48 nat. median
$563,449
0.9× median
Q2053
HCPCS 		Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 $59,837.13 $1,136,715.72 $527,975.14 nat. median
$591,721
0.9× median
9413
OTHER 		Lisocabtagene Car Pos T 12 $335,871.96 $542,562.41 $521,893.36 nat. median
$562,201
0.9× median
9035
OTHER 		Axicabtagene Ciloleucel C 12 $318,146.40 $513,928.80 $494,350.56 nat. median
$533,230
0.9× median
9391
OTHER 		Brexucabtagene Car Pos T 12 $299,344.76 $483,556.92 $465,135.70 nat. median
$492,768
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 $9,933.00 $1,390,867.30 $252,336.47 nat. median
$359,454
0.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 4 $164,800.80 $210,121.02 $206,001.00 nat. median
$202,993
1.0× median
5834
APR_DRG 		Neonate With Ecmo 4 $157,397.60 $200,681.94 $196,747.00 nat. median
$307,206
0.6× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 18 $11,919.00 $1,083,843.07 $189,092.80 nat. median
$249,036
0.8× median
001
OTHER 		$11,234.00 1 $180,346.21 $180,346.21 $180,346.21 nat. median
$214,523
0.8× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $141,880.80 $180,898.02 $177,351.00 nat. median
$163,587
1.1× median
A9543
HCPCS 		Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 3 $108,036.36 $165,601.38 $162,221.76 nat. median
$63,528
outlier · 2.6×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 18 $11,919.00 $912,853.34 $159,646.42 nat. median
$198,418
0.8× median
5833
APR_DRG 		Neonate With Ecmo 4 $124,640.00 $158,916.00 $155,800.00 nat. median
$244,017
0.6× median
1613
APR_DRG 		Implantable Heart Assist Systems 4 $120,684.80 $153,873.12 $150,856.00 nat. median
$120,517
1.3× median
018
OTHER 		$8,819.00 1 $148,812.20 $148,812.20 $148,812.20 nat. median
$297,123
0.5× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 4 $118,757.60 $151,415.94 $148,447.00 nat. median
$122,016
1.2× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 $118,656.80 $151,287.42 $148,321.00 nat. median
$154,011
1.0× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $116,324.00 $148,313.10 $145,405.00 nat. median
$247,214
0.6× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 18 $11,919.00 $778,723.61 $144,454.13 nat. median
$190,559
0.8× median
1907
OTHER 		New Technology - Level 52 12 $89,365.44 $144,359.57 $138,860.15 nat. median
$155,833
0.9× median
1908
OTHER 		New Technology - Level 52 12 $89,365.44 $144,359.57 $138,860.15 nat. median
$155,563
0.9× median
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 $126,562.11 $126,562.11 $126,562.11 nat. median
$47,543
outlier · 2.7×
1906
OTHER 		New Technology - Level 51 12 $80,575.43 $130,160.31 $125,201.82 nat. median
$140,341
0.9× median
1905
OTHER 		New Technology - Level 51 12 $80,575.43 $130,160.31 $125,201.82 nat. median
$140,341
0.9× median
003
OTHER 		$11,234.00 1 $120,795.89 $120,795.89 $120,795.89 nat. median
$165,355
0.7× median
J7330
HCPCS 		$134,810.16 1 $120,116.70 $120,116.70 $120,116.70 nat. median
$75,000
1.6× median
24
APR_DRG 		Heart And/or Lung Transplant 4 $93,556.00 $119,283.90 $116,945.00 nat. median
$241,437
outlier · 0.5×
5832
APR_DRG 		Neonate With Ecmo 4 $91,933.60 $117,215.34 $114,917.00 nat. median
$159,249
0.7× median
224
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 $113,119.68 $113,119.68 $113,119.68 nat. median
$39,452
outlier · 2.9×
1903
OTHER 		New Technology - Level 50 12 $71,785.42 $115,961.06 $111,543.49 nat. median
$120,722
0.9× median
1904
OTHER 		New Technology - Level 50 12 $71,785.42 $115,961.06 $111,543.49 nat. median
$120,722
0.9× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 4 $87,065.60 $111,008.64 $108,832.00 nat. median
$155,939
0.7× median

Other procedures at this hospital

Browse this hospital's 24,779 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3393 HCPCS Injection, Betibeglogene Autotemcel, Per Treatment 1 1 — — $4,897,200.00 $4,897,200.00 $4,897,200.00 2024-10-01
9138 OTHER Inj, Hemgenix, Per Tx Dos 15 12 — — $2,387,385.00 $3,856,545.00 $3,709,629.00 2024-10-01
773 OTHER Inj, Beqvez, Per Tx Dose 15 12 — — $2,343,250.00 $3,785,250.00 $3,641,050.00 2024-10-01
J1411 HCPCS Injection, Etranacogene Dezaparvovec-drlb, Per Therapeutic Dose 4 4 — — $465,980.20 $4,111,590.00 $3,563,378.00 2026-07-31
714 OTHER Inj Delandistrogene Mox R 16 13 $19,440.00 — $5,320.60 $3,491,727.75 $3,358,709.55 2026-07-31
748 OTHER Inj, Lovotibeglogene Auto 16 13 $19,670.46 — $8,776.31 $3,450,300.00 $3,318,860.00 2026-07-31
746 OTHER Inj, Betibeglogene Autote 16 13 $21,276.05 — $7,795.11 $3,116,400.00 $2,997,680.00 2026-07-31
J1413 HCPCS Injection, Delandistrogene Moxeparvovec-rokl, Per Therapeutic Dose 3 3 — — $426,039.04 $3,651,763.20 $2,864,128.00 2024-10-01
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10°15 Vector Ge… 5 5 — — $309,150.46 $3,884,946.48 $2,648,347.96 2026-07-31
9141 OTHER Inj Onase Abepar-xioi Tre 15 12 — — $1,552,599.10 $2,508,044.70 $2,412,500.14 2024-10-01
Q2042 HCPCS Tisagenlecleucel, Up To 600 Million Car-positive Viable T Cells, Including Leuka… 8 8 $1,011,785.25 — $73,428.36 $1,292,595.50 $657,793.40 2026-07-31
Q2054 HCPCS Lisocabtagene Maraleucel, Up To 110 Million Autologous Anti-cd19 Car-positive Vi… 8 8 $1,024,847.73 — $66,087.96 $1,198,462.58 $599,371.74 2026-07-31
Q2056 HCPCS Ciltacabtagene Autoleucel, Up To 100 Million Autologous B-cell Maturation Antige… 7 7 $1,059,735.00 — $67,592.00 $1,282,791.58 $595,823.34 2026-07-31
Q2041 HCPCS Axicabtagene Ciloleucel, Up To 200 Million Autologous Anti-cd19 Car Positive Via… 8 8 $970,645.45 — $68,614.69 $1,136,715.72 $595,395.54 2026-07-31
Q2055 HCPCS Idecabtagene Vicleucel, Up To 510 Million Autologous B-cell Maturation Antigen (… 7 7 $1,047,827.50 — $67,028.42 $1,225,870.24 $574,529.28 2026-07-31
9194 OTHER Tisagenlecleucel Car-pos 15 12 $794,249.05 — $343,975.39 $555,652.55 $534,484.83 2026-07-31
9498 OTHER Ciltacabtagene Car-pos T 15 12 $838,162.50 — $342,630.21 $553,479.57 $532,394.63 2026-07-31
9422 OTHER Idecabtagene Vicleucel Ca 15 12 $778,172.50 — $342,281.94 $552,916.98 $531,853.48 2026-07-31
Q2053 HCPCS Brexucabtagene Autoleucel, Up To 200 Million Autologous Anti-cd19 Car Positive V… 7 7 $964,817.66 — $59,837.13 $1,136,715.72 $527,975.14 2026-07-31
9413 OTHER Lisocabtagene Car Pos T 15 12 $761,106.50 — $335,871.96 $542,562.41 $521,893.36 2026-07-31
9035 OTHER Axicabtagene Ciloleucel C 15 12 $740,048.35 — $318,146.40 $513,928.80 $494,350.56 2026-07-31
9391 OTHER Brexucabtagene Car Pos T 15 12 $740,145.00 — $299,344.76 $483,556.92 $465,135.70 2026-07-31
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 22 18 — — $9,933.00 $1,390,867.30 $252,336.47 2024-10-01
1614 APR_DRG Implantable Heart Assist Systems 4 4 — — $164,800.80 $210,121.02 $206,001.00 2024-10-01
5834 APR_DRG Neonate With Ecmo 4 4 — — $157,397.60 $200,681.94 $196,747.00 2024-10-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 23 18 — — $11,919.00 $1,083,843.07 $189,092.80 2024-10-01
001 OTHER $11,234.00 1 1 $376,743.70 — $180,346.21 $180,346.21 $180,346.21 2026-07-31
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $141,880.80 $180,898.02 $177,351.00 2024-10-01
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 3 3 $140,899.18 — $108,036.36 $165,601.38 $162,221.76 2026-07-31
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 18 — — $11,919.00 $912,853.34 $159,646.42 2024-10-01
5833 APR_DRG Neonate With Ecmo 4 4 — — $124,640.00 $158,916.00 $155,800.00 2024-10-01
1613 APR_DRG Implantable Heart Assist Systems 4 4 — — $120,684.80 $153,873.12 $150,856.00 2024-10-01
018 OTHER $8,819.00 1 1 $401,057.06 — $148,812.20 $148,812.20 $148,812.20 2026-07-31
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $118,757.60 $151,415.94 $148,447.00 2024-10-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $118,656.80 $151,287.42 $148,321.00 2024-10-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $116,324.00 $148,313.10 $145,405.00 2024-10-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 23 18 — — $11,919.00 $778,723.61 $144,454.13 2024-10-01
1907 OTHER New Technology - Level 52 15 12 $239,606.50 — $89,365.44 $144,359.57 $138,860.15 2026-07-31
1908 OTHER New Technology - Level 52 15 12 $239,606.50 — $89,365.44 $144,359.57 $138,860.15 2026-07-31
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $126,562.11 $126,562.11 $126,562.11 2024-10-01
1906 OTHER New Technology - Level 51 15 12 $216,038.72 — $80,575.43 $130,160.31 $125,201.82 2026-07-31
1905 OTHER New Technology - Level 51 15 12 $216,038.72 — $80,575.43 $130,160.31 $125,201.82 2026-07-31
003 OTHER $11,234.00 1 1 $226,352.61 — $120,795.89 $120,795.89 $120,795.89 2026-07-31
J7330 HCPCS $134,810.16 1 1 $134,810.16 — $120,116.70 $120,116.70 $120,116.70 2026-07-31
24 APR_DRG Heart And/or Lung Transplant 4 4 — — $93,556.00 $119,283.90 $116,945.00 2024-10-01
5832 APR_DRG Neonate With Ecmo 4 4 — — $91,933.60 $117,215.34 $114,917.00 2024-10-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $113,119.68 $113,119.68 $113,119.68 2024-10-01
1904 OTHER New Technology - Level 50 15 12 $192,470.95 — $71,785.42 $115,961.06 $111,543.49 2026-07-31
1903 OTHER New Technology - Level 50 15 12 $192,470.95 — $71,785.42 $115,961.06 $111,543.49 2026-07-31
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 4 4 — — $87,065.60 $111,008.64 $108,832.00 2024-10-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $85,240.00 $108,681.00 $106,550.00 2024-10-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $83,160.80 $106,030.02 $103,951.00 2024-10-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 1 — — $103,606.87 $103,606.87 $103,606.87 2024-10-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $82,349.60 $104,995.74 $102,937.00 2024-10-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $81,436.80 $103,831.92 $101,796.00 2024-10-01
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $81,183.20 $103,508.58 $101,479.00 2024-10-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $80,777.60 $102,991.44 $100,972.00 2024-10-01
5831 APR_DRG Neonate With Ecmo 4 4 — — $79,459.20 $101,310.48 $99,324.00 2024-10-01
1902 OTHER New Technology - Level 49 15 12 $168,903.17 — $62,995.40 $101,761.80 $97,885.16 2026-07-31
1901 OTHER New Technology - Level 49 15 12 $168,903.17 — $62,995.40 $101,761.80 $97,885.16 2026-07-31
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 23 18 — — $11,919.00 $528,395.82 $96,072.10 2024-10-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $95,122.15 $95,122.15 $95,122.15 2024-10-01
1612 APR_DRG Implantable Heart Assist Systems 4 4 — — $75,909.60 $96,784.74 $94,887.00 2024-10-01
74 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $74,946.40 $95,556.66 $93,683.00 2024-10-01
1611 APR_DRG Implantable Heart Assist Systems 4 4 — — $72,106.40 $91,935.66 $90,133.00 2024-10-01
14 MS_DRG Allogeneic Bone Marrow Transplant 23 18 — — $9,933.00 $504,122.63 $89,258.55 2024-10-01
7 MS_DRG Lung Transplant 23 18 — — $11,919.00 $502,852.79 $89,039.86 2024-10-01
J9029 HCPCS Intravesical Instillation, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 6 6 — — $8,454.12 $156,303.14 $88,618.88 2024-10-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $70,585.60 $89,996.64 $88,232.00 2024-10-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 5 5 — — $82,554.24 $352,276.70 $87,080.98 2024-10-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $87,002.91 $87,002.91 $87,002.91 2024-10-01
1599 OTHER New Technology - Level 48 15 12 $149,263.36 — $55,670.39 $89,929.09 $86,503.22 2026-07-31
1585 OTHER New Technology - Level 48 15 12 $149,263.36 — $55,670.39 $89,929.09 $86,503.22 2026-07-31
004 OTHER $11,234.00 1 1 $154,909.61 — $84,934.52 $84,934.52 $84,934.52 2026-07-31
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $67,695.20 $86,311.38 $84,619.00 2024-10-01
64 APR_DRG Pancreas Transplant 4 4 — — $67,238.40 $85,728.96 $84,048.00 2024-10-01
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 1 1 — — $81,439.03 $81,439.03 $81,439.03 2024-10-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 4 — — $64,297.60 $81,979.44 $80,372.00 2024-10-01
933396 CDM Set Vntrc 17.4x13.8in 18 13 $209,625.00 $209,625.00 $26,622.38 $188,662.50 $79,657.50 2024-10-01
014 OTHER $8,819.00 1 1 $166,403.05 — $78,918.78 $78,918.78 $78,918.78 2026-07-31
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 4 — — $62,674.40 $79,909.86 $78,343.00 2024-10-01
1598 OTHER New Technology - Level 47 15 12 $133,551.51 — $49,810.38 $80,462.92 $77,397.66 2026-07-31
1584 OTHER New Technology - Level 47 15 12 $133,551.51 — $49,810.38 $80,462.92 $77,397.66 2026-07-31
13 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $61,812.80 $78,811.32 $77,266.00 2024-10-01
12 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $61,812.80 $78,811.32 $77,266.00 2024-10-01
14 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $61,812.80 $78,811.32 $77,266.00 2024-10-01
651 OTHER $11,234.00 1 1 $54,154.07 — $76,855.36 $76,855.36 $76,855.36 2026-07-31
A9699 HCPCS $101,856.21 1 1 $101,856.21 — $76,785.37 $76,785.37 $76,785.37 2026-07-31
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $60,950.40 $77,711.76 $76,188.00 2024-10-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 23 18 — — $11,919.00 $424,038.06 $75,467.10 2024-10-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 23 19 — — $11,919.00 $419,166.49 $74,628.17 2024-10-01
215 MS_DRG Other Heart Assist System Implant 27 20 — — $11,919.00 $396,467.14 $74,071.91 2024-10-01
338 MS_DRG Appendectomy With Complicated Principal Diagnosis With Mcc 2 2 — — $44,152.92 $102,222.12 $73,187.52 2024-10-01
23 APR_DRG Heart And/or Lung Transplant 4 4 — — $58,516.80 $74,608.92 $73,146.00 2024-10-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 23 18 — — $11,919.00 $409,758.13 $73,007.94 2024-10-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $58,313.60 $74,349.84 $72,892.00 2024-10-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 17 — — $11,919.00 $251,217.00 $71,196.36 2024-10-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $56,539.20 $72,087.48 $70,674.00 2024-10-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $56,133.60 $71,570.34 $70,167.00 2024-10-01
1583 OTHER New Technology - Level 46 15 12 $117,839.66 — $43,950.37 $70,996.75 $68,292.11 2026-07-31
1597 OTHER New Technology - Level 46 15 12 $117,839.66 — $43,950.37 $70,996.75 $68,292.11 2026-07-31
007 OTHER $11,234.00 1 1 $139,243.85 — $68,092.54 $68,092.54 $68,092.54 2026-07-31
002 OTHER $11,234.00 1 1 $374,964.00 — $67,969.02 $67,969.02 $67,969.02 2026-07-31
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 26 19 — — $42,309.38 $371,347.39 $67,695.01 2024-10-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 4 — — $53,598.40 $68,337.96 $66,998.00 2024-10-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 4 — — $53,293.60 $67,949.34 $66,617.00 2024-10-01
812898 CDM Ins/repos Dual Icd+lead 17 10 $174,834.25 $174,834.25 $22,203.95 $157,350.83 $66,437.01 2024-10-01
817685 CDM Rem/repl Aicd Mult Ld 17 10 $174,834.25 $174,834.25 $22,203.95 $157,350.83 $66,437.01 2024-10-01
823254 CDM Ins Perm Subq Defib 17 10 $174,834.25 $174,834.25 $22,203.95 $157,350.83 $66,437.01 2024-10-01
817682 CDM Insrt Aicd Only Mult Ld 17 10 $174,834.25 $174,834.25 $22,203.95 $157,350.83 $66,437.01 2024-10-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 4 4 — — $52,989.60 $67,561.74 $66,237.00 2024-10-01
1643 OTHER Y90 Ibritumomab, Rx 15 12 $104,639.20 — $42,559.78 $68,750.41 $66,131.35 2026-07-31
247 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent Without Mcc 2 2 — — $31,655.38 $100,200.00 $65,927.69 2024-10-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 5 5 — — $61,787.52 $255,237.84 $65,175.61 2024-10-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 4 — — $52,127.20 $66,462.18 $65,159.00 2024-10-01
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 4 4 — — $51,721.60 $65,945.04 $64,652.00 2024-10-01
717 OTHER Instill Adstiladrin, Tx D 16 13 $25,327.63 — $12,750.63 $66,522.51 $63,988.32 2026-07-31
230 MS_DRG Other Cardiothoracic Procedures Without Cc/mcc 1 1 — — $63,910.98 $63,910.98 $63,910.98 2024-10-01
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 7 7 $123,527.05 — $7,390.73 $135,125.34 $63,349.14 2026-07-31
955 OTHER $11,234.00 1 1 $81,491.96 — $62,904.47 $62,904.47 $62,904.47 2026-07-31
850 MS_DRG Acute Leukemia With Other Procedures 20 16 — — $11,919.00 $354,450.82 $62,861.03 2024-10-01
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $49,947.20 $63,682.68 $62,434.00 2024-10-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $48,527.20 $61,872.18 $60,659.00 2024-10-01
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 5 5 — — $56,979.84 $234,377.83 $60,104.88 2024-10-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $48,071.20 $61,290.78 $60,089.00 2024-10-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 26 19 — — $37,339.06 $326,056.43 $59,742.49 2024-10-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 4 — — $47,614.40 $60,708.36 $59,518.00 2024-10-01
341 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Mcc 2 2 — — $31,976.29 $86,926.32 $59,451.31 2024-10-01
1596 OTHER New Technology - Level 45 15 12 $102,127.81 — $38,090.36 $61,530.58 $59,186.56 2026-07-31
1582 OTHER New Technology - Level 45 15 12 $102,127.81 — $38,090.36 $61,530.58 $59,186.56 2026-07-31
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 26 19 — — $37,318.78 $139,744.55 $58,561.78 2024-10-01
020 OTHER $11,234.00 1 1 $156,021.00 — $57,974.96 $57,974.96 $57,974.96 2026-07-31
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 23 17 — — $11,919.00 $200,021.00 $57,709.59 2024-10-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 27 20 — — $11,919.00 $357,990.98 $56,952.68 2024-10-01
J9600 HCPCS Injection, Porfimer Sodium, 75 Mg 4 4 $51,502.66 — $38,803.31 $57,735.72 $56,852.01 2026-07-31
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $45,180.80 $57,605.52 $56,476.00 2024-10-01
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $44,977.60 $57,346.44 $56,222.00 2024-10-01
21 APR_DRG Heart And/or Lung Transplant 4 4 — — $44,724.00 $57,023.10 $55,905.00 2024-10-01
22 APR_DRG Heart And/or Lung Transplant 4 4 — — $44,724.00 $57,023.10 $55,905.00 2024-10-01
005 OTHER $11,234.00 1 1 $193,389.50 — $55,870.52 $55,870.52 $55,870.52 2026-07-31
453 OTHER $11,234.00 1 1 $164,071.96 — $55,743.00 $55,743.00 $55,743.00 2026-07-31
9273 OTHER Sipuleucel-t Auto Cd54+ 15 12 $93,634.68 — $35,759.90 $57,765.99 $55,565.38 2026-07-31
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 4 — — $44,268.00 $56,441.70 $55,335.00 2024-10-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 26 19 — — $34,562.09 $298,023.75 $55,299.34 2024-10-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 22 18 — — $11,919.00 $305,019.42 $54,970.79 2024-10-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 26 19 — — $34,229.32 $297,719.76 $54,766.91 2024-10-01
10 MS_DRG Pancreas Transplant 23 18 — — $11,919.00 $306,785.65 $54,733.03 2024-10-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $43,659.20 $55,665.48 $54,574.00 2024-10-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 4 — — $43,557.60 $55,535.94 $54,447.00 2024-10-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 4 4 — — $42,594.40 $54,307.86 $53,243.00 2024-10-01
214 APR_DRG Open Craniotomy Except Trauma 4 4 — — $42,442.40 $54,114.06 $53,053.00 2024-10-01
J9226 HCPCS Histrelin Implant (supprelin La), 50 Mg 7 7 $102,368.20 — $5,879.08 $112,740.18 $52,365.14 2026-07-31
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 24 19 — — $11,919.00 $285,156.04 $51,902.63 2024-10-01
215 OTHER $11,234.00 1 1 $262,239.00 — $51,843.19 $51,843.19 $51,843.19 2026-07-31
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $41,377.60 $52,756.44 $51,722.00 2024-10-01
73 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $41,174.40 $52,497.36 $51,468.00 2024-10-01
984 MS_DRG Prostatic O.r. Procedure Unrelated To Principal Diagnosis W Mcc 1 1 — — $50,281.35 $50,281.35 $50,281.35 2024-10-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 25 19 — — $31,397.88 $271,918.92 $50,236.61 2024-10-01
216 OTHER $11,234.00 1 1 $177,812.00 — $50,183.85 $50,183.85 $50,183.85 2026-07-31
84 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $40,109.60 $51,139.74 $50,137.00 2024-10-01
83 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $40,109.60 $51,139.74 $50,137.00 2024-10-01
1581 OTHER New Technology - Level 44 15 12 $86,415.96 — $32,230.35 $52,064.41 $50,081.00 2026-07-31
1595 OTHER New Technology - Level 44 15 12 $86,415.96 — $32,230.35 $52,064.41 $50,081.00 2026-07-31
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 4 — — $39,957.60 $50,945.94 $49,947.00 2024-10-01
217 OTHER $11,234.00 1 1 $177,812.00 — $49,904.80 $49,904.80 $49,904.80 2026-07-31
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 17 — — $11,919.00 $170,334.00 $49,483.89 2024-10-01
C9760 HCPCS Non-randomized, Non-blinded Procedure For Nyha Class Ii, Iii, IV Heart Failure; … 4 4 $64,802.62 — $19,000.00 $69,553.54 $49,462.04 2026-07-31
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 4 — — $39,146.40 $49,911.66 $48,933.00 2024-10-01
246 MS_DRG Percutaneous Cardiovascular Procedures With Drug-eluting Stent With Mcc Or 4+ Ar… 1 1 — — $48,275.69 $48,275.69 $48,275.69 2024-10-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 27 20 — — $9,700.00 $261,313.83 $48,065.69 2024-10-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 4 4 — — $38,385.60 $48,941.64 $47,982.00 2024-10-01
1784 APR_DRG External Heart Assist Devices 4 4 — — $38,233.60 $48,747.84 $47,792.00 2024-10-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 24 19 — — $11,919.00 $259,201.28 $47,689.39 2024-10-01
5244 OTHER Level 4 Blood Product Exc 15 12 $64,460.98 — $30,510.82 $49,286.72 $47,409.13 2026-07-31
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 23 18 — — $11,919.00 $256,988.68 $46,699.36 2024-10-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 26 19 — — $29,711.68 $256,553.86 $46,624.49 2024-10-01
817683 CDM Rem/repl Aicd Sing Ld 17 10 $122,665.81 $122,665.81 $15,578.56 $110,399.23 $46,613.01 2024-10-01
816307 CDM Aicd Insertion 17 10 $122,665.81 $122,665.81 $15,578.56 $110,399.23 $46,613.01 2024-10-01
815599 CDM Pmaker Repl Gen Dual 17 10 $122,665.81 $122,665.81 $15,578.56 $110,399.23 $46,613.01 2024-10-01
817681 CDM Insrt Aicd Only Dual Ld 17 10 $122,665.81 $122,665.81 $15,578.56 $110,399.23 $46,613.01 2024-10-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 22 16 — — $24,540.00 $160,789.00 $46,410.17 2024-10-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 4 — — $37,067.20 $47,260.68 $46,334.00 2024-10-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 20 — — $11,919.00 $248,480.75 $46,121.15 2024-10-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 4 — — $36,712.00 $46,807.80 $45,890.00 2024-10-01
1142 OTHER Supprelin La Implant 15 12 $66,970.62 — $29,477.64 $47,617.72 $45,803.71 2026-07-31
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 4 — — $36,509.60 $46,549.74 $45,637.00 2024-10-01
248 MS_DRG Percutaneous Cardiovascular Procedures With Non-drug-eluting Stent With Mcc Or 4… 1 1 — — $45,604.43 $45,604.43 $45,604.43 2024-10-01
021 OTHER $11,234.00 1 1 $156,021.00 — $45,490.88 $45,490.88 $45,490.88 2026-07-31
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 24 19 — — $9,700.00 $252,655.83 $45,302.46 2024-10-01
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 5 5 — — $42,906.24 $184,242.24 $45,259.23 2024-10-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 4 4 — — $36,204.80 $46,161.12 $45,256.00 2024-10-01
231 OTHER $11,234.00 1 1 $144,523.00 — $45,048.79 $45,048.79 $45,048.79 2026-07-31
4404 APR_DRG Kidney Transplant 4 4 — — $35,799.20 $45,643.98 $44,749.00 2024-10-01
339 MS_DRG Appendectomy With Complicated Principal Diagnosis With Cc 2 2 — — $26,286.14 $62,660.83 $44,473.49 2024-10-01
019 OTHER $11,234.00 1 1 $82,459.56 — $44,373.15 $44,373.15 $44,373.15 2026-07-31
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 24 19 — — $11,919.00 $278,887.65 $44,349.55 2024-10-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 26 20 — — $11,919.00 $238,345.12 $44,341.46 2024-10-01
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $35,343.20 $45,062.58 $44,179.00 2024-10-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 4 — — $35,241.60 $44,933.04 $44,052.00 2024-10-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 4 — — $35,241.60 $44,933.04 $44,052.00 2024-10-01
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 4 4 — — $35,241.60 $44,933.04 $44,052.00 2024-10-01
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 27 20 — — $11,919.00 $246,856.90 $43,954.30 2024-10-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $35,140.00 $44,803.50 $43,925.00 2024-10-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $35,140.00 $44,803.50 $43,925.00 2024-10-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 4 — — $35,140.00 $44,803.50 $43,925.00 2024-10-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 27 20 — — $11,919.00 $235,047.38 $43,762.42 2024-10-01
63 APR_DRG Pancreas Transplant 4 4 — — $34,988.00 $44,609.70 $43,735.00 2024-10-01
956 OTHER $7,865.96 1 1 $53,276.31 — $43,668.01 $43,668.01 $43,668.01 2026-07-31
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $34,886.40 $44,480.16 $43,608.00 2024-10-01
28 MS_DRG Spinal Procedures With Mcc 27 20 — — $11,919.00 $226,166.20 $43,565.12 2024-10-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 4 — — $34,734.40 $44,286.36 $43,418.00 2024-10-01
C9782 HCPCS Blinded Procedure For New York Heart Association (nyha) Class Ii Or Iii Heart Fa… 3 3 $21,170.00 — $21,170.00 $44,261.70 $43,358.40 2026-07-31
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 24 19 — — $11,919.00 $225,896.84 $43,248.86 2024-10-01
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 20 16 — — $11,919.00 $238,037.28 $43,222.80 2024-10-01
8634 APR_DRG Neonatal Aftercare 4 4 — — $34,532.00 $44,028.30 $43,165.00 2024-10-01
957 OTHER $11,234.00 1 1 $94,024.44 — $43,151.90 $43,151.90 $43,151.90 2026-07-31
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 27 20 — — $11,919.00 $253,994.94 $42,965.81 2024-10-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $34,328.80 $43,769.22 $42,911.00 2024-10-01
1794 APR_DRG Defibrillator Implants 4 4 — — $34,278.40 $43,704.96 $42,848.00 2024-10-01
4403 APR_DRG Kidney Transplant 4 4 — — $34,227.20 $43,639.68 $42,784.00 2024-10-01
A9604 HCPCS Samarium Sm-153 Lexidronam, Therapeutic, Per Treatment Dose, Up To 150 Millicuri… 3 3 $40,671.39 — $28,478.75 $43,653.12 $42,762.24 2026-07-31
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 20 — — $11,919.00 $228,921.37 $42,686.76 2024-10-01
1824 APR_DRG Other Peripheral Vascular And Related Procedures 4 4 — — $34,126.40 $43,511.16 $42,658.00 2024-10-01
C2616 HCPCS Brachytherapy Source, Non-stranded, Yttrium-90, Per Source 3 3 $41,857.52 — $11,974.00 $43,443.40 $42,556.80 2026-07-31
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 4 — — $34,024.80 $43,381.62 $42,531.00 2024-10-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 23 18 — — $9,933.00 $232,246.04 $42,438.42 2024-10-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 23 18 — — $9,933.00 $232,246.04 $42,438.42 2024-10-01
834 OTHER $8,819.00 1 1 $80,368.05 — $42,370.74 $42,370.74 $42,370.74 2026-07-31
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 27 20 — — $11,919.00 $230,495.20 $42,245.56 2024-10-01
72 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $33,720.80 $42,994.02 $42,151.00 2024-10-01
914 APR_DRG Other Major Head And Neck Procedures 4 4 — — $33,568.00 $42,799.20 $41,960.00 2024-10-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 19 15 — — $26,661.91 $77,701.06 $41,838.70 2024-10-01
913 APR_DRG Other Major Head And Neck Procedures 4 4 — — $33,162.40 $42,282.06 $41,453.00 2024-10-01
423 OTHER $11,234.00 1 1 $61,219.81 — $41,403.04 $41,403.04 $41,403.04 2026-07-31
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 4 — — $33,061.60 $42,153.54 $41,327.00 2024-10-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 20 — — $11,919.00 $120,000.00 $41,267.20 2024-10-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $32,960.00 $42,024.00 $41,200.00 2024-10-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 20 — — $11,919.00 $220,544.27 $41,035.45 2024-10-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 24 19 — — $11,919.00 $224,026.71 $41,022.95 2024-10-01
1580 OTHER New Technology - Level 43 15 12 $70,704.11 — $26,370.34 $42,598.24 $40,975.45 2026-07-31
1594 OTHER New Technology - Level 43 15 12 $70,704.11 — $26,370.34 $42,598.24 $40,975.45 2026-07-31
11 APR_DRG Liver Transplant And/or Intestinal Transplant 4 4 — — $32,756.80 $41,764.92 $40,946.00 2024-10-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 4 4 — — $32,706.40 $41,700.66 $40,883.00 2024-10-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 4 4 — — $32,604.80 $41,571.12 $40,756.00 2024-10-01
G0173 HCPCS Linear Accelerator Based Stereotactic Radiosurgery, Complete Course Of Therapy I… 5 3 $37,503.00 — $2,844.00 $40,688.00 $40,688.00 2026-07-31
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 4 — — $32,300.80 $41,183.52 $40,376.00 2024-10-01
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 4 4 — — $32,097.60 $40,924.44 $40,122.00 2024-10-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 4 4 — — $32,047.20 $40,860.18 $40,059.00 2024-10-01
71 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $32,047.20 $40,860.18 $40,059.00 2024-10-01
G0300 HCPCS Direct Skilled Nursing Services Of A Licensed Practical Nurse (lpn) In The Home … 3 1 — — $40,025.00 $40,025.00 $40,025.00 2024-10-01
G0299 HCPCS Direct Skilled Nursing Services Of A Registered Nurse (rn) In The Home Health Or… 3 1 — — $40,025.00 $40,025.00 $40,025.00 2024-10-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 4 4 — — $31,945.60 $40,730.64 $39,932.00 2024-10-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 4 4 — — $31,895.20 $40,666.38 $39,869.00 2024-10-01
893 APR_DRG Major Cranial Or Facial Bone Procedures 4 4 — — $31,895.20 $40,666.38 $39,869.00 2024-10-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 27 20 — — $11,919.00 $261,248.42 $39,836.83 2024-10-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 4 — — $31,540.00 $40,213.50 $39,425.00 2024-10-01
653 MS_DRG Major Bladder Procedures With Mcc 24 19 — — $11,919.00 $213,821.82 $39,381.53 2024-10-01
0888T CPT Histotripsy (ie, Non-thermal Ablation Via Acoustic Energy Delivery) Of Malignant… 1 1 — — $39,376.13 $39,376.13 $39,376.13 2024-10-01
6903 APR_DRG Acute Leukemia 4 4 — — $31,336.80 $39,954.42 $39,171.00 2024-10-01
6904 APR_DRG Acute Leukemia 4 4 — — $31,336.80 $39,954.42 $39,171.00 2024-10-01
C1820 HCPCS Generator Ipg Nrstm 20 6 $98,718.00 $98,718.00 $11,983.08 $92,772.90 $39,170.78 2024-10-01
834 MS_DRG Acute Leukemia With Mcc 24 19 — — $9,700.00 $212,675.11 $39,068.08 2024-10-01
1783 APR_DRG External Heart Assist Devices 4 4 — — $31,236.00 $39,825.90 $39,045.00 2024-10-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 4 — — $31,184.80 $39,760.62 $38,981.00 2024-10-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 17 — — $11,919.00 $131,997.00 $38,924.28 2024-10-01
61 APR_DRG Pancreas Transplant 4 4 — — $31,084.00 $39,632.10 $38,855.00 2024-10-01
62 APR_DRG Pancreas Transplant 4 4 — — $31,084.00 $39,632.10 $38,855.00 2024-10-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 4 — — $31,032.80 $39,566.82 $38,791.00 2024-10-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 23 17 — — $11,919.00 $131,191.00 $38,691.69 2024-10-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective 24 19 — — $11,919.00 $201,696.77 $38,606.62 2024-10-01
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 23 18 — — $11,919.00 $209,361.98 $38,497.52 2024-10-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 27 20 — — $11,919.00 $199,568.82 $38,435.50 2024-10-01
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 24 19 — — $11,919.00 $213,252.31 $38,415.35 2024-10-01
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 4 — — $30,677.60 $39,113.94 $38,347.00 2024-10-01
818440 CDM Prc D-e Cor Revsc Ami Sl 17 10 $100,900.45 $100,900.45 $12,814.36 $90,810.40 $38,342.17 2024-10-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 20 — — $11,919.00 $203,801.62 $38,276.05 2024-10-01
232 OTHER $11,234.00 1 1 $144,523.00 — $38,240.39 $38,240.39 $38,240.39 2026-07-31
219 OTHER $11,234.00 1 1 $129,906.00 — $38,236.88 $38,236.88 $38,236.88 2026-07-31
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 24 19 — — $11,919.00 $198,756.90 $38,198.00 2024-10-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 24 19 — — $11,919.00 $217,373.52 $38,193.36 2024-10-01
969 OTHER $11,234.00 1 1 $83,700.54 — $38,150.87 $38,150.87 $38,150.87 2026-07-31
466 OTHER $11,234.00 1 1 $72,335.55 — $38,088.86 $38,088.86 $38,088.86 2026-07-31
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 4 — — $30,373.60 $38,726.34 $37,967.00 2024-10-01
461 OTHER $11,234.00 1 1 $74,559.03 — $37,850.31 $37,850.31 $37,850.31 2026-07-31
342 MS_DRG Appendectomy Without Complicated Principal Diagnosis With Cc 2 2 — — $19,722.40 $55,919.14 $37,820.77 2024-10-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 4 — — $30,221.60 $38,532.54 $37,777.00 2024-10-01
233 OTHER $11,234.00 1 1 $112,954.00 — $37,662.27 $37,662.27 $37,662.27 2026-07-31
817680 CDM Rem/repl Pacer Mult Ld 17 10 $99,086.34 $99,086.34 $12,583.97 $89,177.71 $37,652.81 2024-10-01
817677 CDM Insrt Pacer Gen Only 17 10 $99,086.34 $99,086.34 $12,583.97 $89,177.71 $37,652.81 2024-10-01
870 OTHER $8,819.00 1 1 $84,375.68 — $37,530.24 $37,530.24 $37,530.24 2026-07-31
133 MS_DRG Other Ear, Nose, Mouth & Throat O.r. Procedures W Cc/mcc 4 2 — — $27,593.53 $37,482.00 $37,482.00 2024-10-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 27 20 — — $11,919.00 $201,831.45 $36,911.21 2024-10-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 4 4 — — $29,410.40 $37,498.26 $36,763.00 2024-10-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 4 — — $29,359.20 $37,432.98 $36,699.00 2024-10-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 27 20 — — $11,919.00 $197,510.14 $36,456.51 2024-10-01
006 OTHER $11,234.00 1 1 $88,115.32 — $36,453.52 $36,453.52 $36,453.52 2026-07-31
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically 23 17 — — $11,919.00 $123,508.00 $36,209.98 2024-10-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 4 4 — — $28,953.60 $36,915.84 $36,192.00 2024-10-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 27 20 — — $11,919.00 $191,741.99 $36,158.52 2024-10-01
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 24 19 — — $11,919.00 $196,971.42 $36,098.00 2024-10-01
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