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

WILCOX MEMORIAL HOSPITAL

Lihue, HI · CCN 120014 · Rates published

Your selected procedure

You selected 93306 (HCPCS)

ECHO TTHRC COMP SPEC/COLR FLW DPLR W/CON-TC

This hospital’s price: $1,321 across 14 payers · range $133-$2,624

Source: https://hph.pt.panaceainc.com/MRFDownload/hph/wilcox/990074365_Wilcox-Medical-Center_standardcharges.csv · observed 2026-02-12

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.

26,841 distinct procedures filed
26 distinct payers
800,431 rate rows
2026-02-12 last MRF observed
Data quality

751,490 of 800,431 rate rows are consumer-grade (93.9%)

48,941 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 31,068
per-diem day rate — not a per-procedure price 12,642
template filing: same amount across many unrelated codes — excluded 2,686
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 1,544
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 412
placeholder amount (≤ $0.02) — excluded from medians 339
percent-of-charges filed in the dollar field — excluded from medians 174
exceeds 10× this hospital's gross charge — excluded from medians 76
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://hph.pt.panaceainc.com/MRFDownload/hph/wilcox/990074365_Wilcox-Medical-Center_standardcharges.csv
Found on page https://www.hawaiipacifichealth.org/patients-visitors/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-19
Content fingerprint 6db826229832b059… · 200,083,896 bytes · first seen 2026-05-09

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
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 7 $3,378,750.00 $4,907,177.50 $4,688,302.50 nat. median
$4,505,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 6 $3,710,000.00 $4,158,910.00 $3,973,410.00 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 8 $2,763,950.00 $4,422,320.00 $3,946,920.60 nat. median
$3,703,693
1.1× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 8 $2,487,346.94 $3,979,755.11 $3,560,616.50 nat. median
$3,324,572
1.1× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 8 $2,436,334.29 $3,898,134.86 $3,492,911.21 nat. median
$3,286,000
1.1× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 8 $2,209,305.00 $3,534,888.00 $3,160,185.42 nat. median
$2,994,107
1.1× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 8 $1,841,332.96 $2,946,132.73 $2,626,215.81 nat. median
$2,466,282
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 8 $1,749,000.00 $2,798,400.00 $2,497,572.00 nat. median
$2,401,960
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 8 $577,965.00 $924,744.00 $770,620.00 nat. median
$809,217
1.0× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $443,794.65 $825,810.81 $619,385.63 nat. median
$738,272
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 9 $424,401.71 $804,924.78 $592,668.73 nat. median
$646,415
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 9 $421,903.64 $754,069.52 $580,091.79 nat. median
$640,950
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 9 $417,988.45 $771,336.15 $579,689.94 nat. median
$622,245
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 9 $399,922.63 $714,695.04 $570,924.91 nat. median
$608,101
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 9 $366,978.46 $712,555.20 $524,490.12 nat. median
$591,650
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 12 $439,315.39 $1,025,836.78 $479,034.85 nat. median
$359,358
1.3× median
583-4 Pediatric
OTHER 		Neonate W Ecmo 3 $417,541.55 $417,541.55 $417,541.55 nat. median
$417,542
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 12 $285,200.84 $665,726.80 $357,798.88 nat. median
$249,124
1.4× median
591-4 Pediatric
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 3 $351,938.95 $351,938.96 $351,938.95 nat. median
$351,939
1.0× median
588-4 Pediatric
OTHER 		Neonate Bwt <1500g W Major Procedure 3 $350,512.22 $350,512.23 $350,512.22 nat. median
$350,512
1.0× median
593-4 Pediatric
OTHER 		Neonate Birthwt 750-999g Without Major Procedure 3 $303,367.37 $303,367.37 $303,367.37 nat. median
$303,367
1.0× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $208,687.50 $333,900.00 $289,571.63 nat. median
$319,951
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 12 $170,392.36 $432,453.00 $288,720.93 nat. median
$198,433
1.5× median
609-4 Pediatric
OTHER 		Neonate Bwt 1500-2499g W Major Procedure 3 $277,598.31 $277,598.32 $277,598.31 nat. median
$277,598
1.0× median
591-3 Pediatric
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 3 $277,426.03 $277,426.04 $277,426.03 nat. median
$277,426
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 12 $216,081.14 $527,753.00 $272,228.08 nat. median
$190,557
1.4× median
J3403
HCPCS 		Revakinagene, Per Implant 4 $193,125.00 $309,000.00 $265,000.00 nat. median
$265,000
1.0× median
583-3 Pediatric
OTHER 		Neonate W Ecmo 3 $254,384.81 $254,384.82 $254,384.81 nat. median
$254,385
1.0× median
602-4 Pediatric
OTHER 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 $245,551.66 $245,551.66 $245,551.66 nat. median
$245,552
1.0× median
591-2 Pediatric
OTHER 		Neonate Birthwt 500-749g Without Major Procedure 3 $243,602.69 $243,602.70 $243,602.69 nat. median
$243,603
1.0× median
583-2 Pediatric
OTHER 		Neonate W Ecmo 3 $241,625.01 $241,625.02 $241,625.01 nat. median
$241,625
1.0× median
161-4 Pediatric
OTHER 		Implantable Heart Assist Systems 3 $239,475.16 $239,475.17 $239,475.16 nat. median
$239,475
1.0× median
589-1 Pediatric
OTHER 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 3 $229,916.86 $229,916.87 $229,916.86 nat. median
$229,917
1.0× median
630-4 Pediatric
OTHER 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 3 $227,418.74 $227,418.75 $227,418.74 nat. median
$227,419
1.0× median
588-3 Pediatric
OTHER 		Neonate Bwt <1500g W Major Procedure 3 $224,834.48 $224,834.48 $224,834.48 nat. median
$224,834
1.0× median
593-3 Pediatric
OTHER 		Neonate Birthwt 750-999g Without Major Procedure 3 $222,433.27 $222,433.27 $222,433.27 nat. median
$222,433
1.0× median
589-2 Pediatric
OTHER 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 3 $218,967.84 $218,967.85 $218,967.84 nat. median
$218,968
1.0× median
002-4 Pediatric
OTHER 		Heart &/or Lung Transplant 3 $217,578.69 $217,578.69 $217,578.69 nat. median
$217,579
1.0× median
007-4 Pediatric
OTHER 		Allogeneic Bone Marrow Transplant 3 $212,813.26 $212,813.26 $212,813.26 nat. median
$212,813
1.0× median
589-3 Pediatric
OTHER 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 3 $208,541.06 $208,541.06 $208,541.06 nat. median
$208,541
1.0× median
161-4 Adult
OTHER 		Implantable Heart Assist Systems 3 $208,239.27 $208,239.28 $208,239.27 nat. median
$208,239
1.0× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 7 $154,230.00 $246,768.00 $205,640.00 nat. median
$209,753
1.0× median
603-4 Pediatric
OTHER 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 3 $203,754.79 $203,754.79 $203,754.79 nat. median
$203,755
1.0× median
631-4 Pediatric
OTHER 		Neonate Birthwt >2499g W Other Major Procedure 3 $197,592.04 $197,592.04 $197,592.04 nat. median
$197,592
1.0× median
593-2 Pediatric
OTHER 		Neonate Birthwt 750-999g Without Major Procedure 3 $191,793.60 $191,793.60 $191,793.60 nat. median
$191,794
1.0× median
161-3 Pediatric
OTHER 		Implantable Heart Assist Systems 3 $191,301.58 $191,301.59 $191,301.58 nat. median
$191,302
1.0× median
607-4 Pediatric
OTHER 		Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 $191,160.10 $191,160.10 $191,160.10 nat. median
$191,160
1.0× median
002-4 Adult
OTHER 		Heart &/or Lung Transplant 3 $189,198.86 $189,198.86 $189,198.86 nat. median
$189,199
1.0× median

Other procedures at this hospital

Browse this hospital's 26,841 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
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 19 7 — — $3,378,750.00 $4,907,177.50 $4,688,302.50 2026-02-12
J1414 HCPCS Inj, Beqvez, Per Tx Dose 14 6 — — $3,710,000.00 $4,158,910.00 $3,973,410.00 2026-02-12
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 23 8 — — $2,763,950.00 $4,422,320.00 $3,946,920.60 2026-02-12
J1413 HCPCS Inj Delandistrogene Mox Rokl 23 8 — — $2,487,346.94 $3,979,755.11 $3,560,616.50 2026-02-12
J3394 HCPCS Inj, Lovotibeglogene Autotem 23 8 — — $2,436,334.29 $3,898,134.86 $3,492,911.21 2026-02-12
J3389 HCPCS Topi Adm Prad Zami Per Treat 4 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-02-12
J3387 HCPCS Inj Elivaldogene Autotemecel 4 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-02-12
J3393 HCPCS Inj, Betibeglogene Autotemce 23 8 — — $2,209,305.00 $3,534,888.00 $3,160,185.42 2026-02-12
J3399 HCPCS Inj Onase Abepar-xioi Treat 23 8 — — $1,841,332.96 $2,946,132.73 $2,626,215.81 2026-02-12
J3392 HCPCS Inj, Exagamglogene Autotem 23 8 — — $1,749,000.00 $2,798,400.00 $2,497,572.00 2026-02-12
Q2057 HCPCS Afamitresgene Autoleucel 30 8 — — $577,965.00 $924,744.00 $770,620.00 2026-02-12
Q2042 HCPCS Tisagenlecleucel Car-pos T 32 9 — — $443,794.65 $825,810.81 $619,385.63 2026-02-12
Q2056 HCPCS Ciltacabtagene Car-pos T 32 9 — — $424,401.71 $804,924.78 $592,668.73 2026-02-12
Q2054 HCPCS Lisocabtagene Mara Car Pos T 32 9 — — $421,903.64 $754,069.52 $580,091.79 2026-02-12
Q2055 HCPCS Idecabtagene Vicleucel Car 32 9 — — $417,988.45 $771,336.15 $579,689.94 2026-02-12
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 32 9 — — $399,922.63 $714,695.04 $570,924.91 2026-02-12
Q2053 HCPCS Brexucabtagene Car Pos T 32 9 — — $366,978.46 $712,555.20 $524,490.12 2026-02-12
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 26 12 — — $439,315.39 $1,025,836.78 $479,034.85 2026-02-12
583-4 Pediatric OTHER Neonate W Ecmo 12 3 — — $417,541.55 $417,541.55 $417,541.55 2026-02-12
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 27 12 — — $285,200.84 $665,726.80 $357,798.88 2026-02-12
591-4 Pediatric OTHER Neonate Birthwt 500-749g Without Major Procedure 12 3 — — $351,938.95 $351,938.96 $351,938.95 2026-02-12
588-4 Pediatric OTHER Neonate Bwt <1500g W Major Procedure 12 3 — — $350,512.22 $350,512.23 $350,512.22 2026-02-12
593-4 Pediatric OTHER Neonate Birthwt 750-999g Without Major Procedure 12 3 — — $303,367.37 $303,367.37 $303,367.37 2026-02-12
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 21 7 — — $208,687.50 $333,900.00 $289,571.63 2026-02-12
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 27 12 — — $170,392.36 $432,453.00 $288,720.93 2026-02-12
609-4 Pediatric OTHER Neonate Bwt 1500-2499g W Major Procedure 12 3 — — $277,598.31 $277,598.32 $277,598.31 2026-02-12
591-3 Pediatric OTHER Neonate Birthwt 500-749g Without Major Procedure 12 3 — — $277,426.03 $277,426.04 $277,426.03 2026-02-12
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 27 12 — — $216,081.14 $527,753.00 $272,228.08 2026-02-12
J3403 HCPCS Revakinagene, Per Implant 9 4 — — $193,125.00 $309,000.00 $265,000.00 2026-02-12
583-3 Pediatric OTHER Neonate W Ecmo 12 3 — — $254,384.81 $254,384.82 $254,384.81 2026-02-12
602-4 Pediatric OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $245,551.66 $245,551.66 $245,551.66 2026-02-12
591-2 Pediatric OTHER Neonate Birthwt 500-749g Without Major Procedure 12 3 — — $243,602.69 $243,602.70 $243,602.69 2026-02-12
583-2 Pediatric OTHER Neonate W Ecmo 12 3 — — $241,625.01 $241,625.02 $241,625.01 2026-02-12
161-4 Pediatric OTHER Implantable Heart Assist Systems 12 3 — — $239,475.16 $239,475.17 $239,475.16 2026-02-12
589-1 Pediatric OTHER Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 12 3 — — $229,916.86 $229,916.87 $229,916.86 2026-02-12
630-4 Pediatric OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 12 3 — — $227,418.74 $227,418.75 $227,418.74 2026-02-12
588-3 Pediatric OTHER Neonate Bwt <1500g W Major Procedure 12 3 — — $224,834.48 $224,834.48 $224,834.48 2026-02-12
593-3 Pediatric OTHER Neonate Birthwt 750-999g Without Major Procedure 12 3 — — $222,433.27 $222,433.27 $222,433.27 2026-02-12
589-2 Pediatric OTHER Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 12 3 — — $218,967.84 $218,967.85 $218,967.84 2026-02-12
002-4 Pediatric OTHER Heart &/or Lung Transplant 12 3 — — $217,578.69 $217,578.69 $217,578.69 2026-02-12
007-4 Pediatric OTHER Allogeneic Bone Marrow Transplant 12 3 — — $212,813.26 $212,813.26 $212,813.26 2026-02-12
589-3 Pediatric OTHER Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 12 3 — — $208,541.06 $208,541.06 $208,541.06 2026-02-12
161-4 Adult OTHER Implantable Heart Assist Systems 12 3 — — $208,239.27 $208,239.28 $208,239.27 2026-02-12
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 21 7 — — $154,230.00 $246,768.00 $205,640.00 2026-02-12
603-4 Pediatric OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 3 — — $203,754.79 $203,754.79 $203,754.79 2026-02-12
631-4 Pediatric OTHER Neonate Birthwt >2499g W Other Major Procedure 12 3 — — $197,592.04 $197,592.04 $197,592.04 2026-02-12
593-2 Pediatric OTHER Neonate Birthwt 750-999g Without Major Procedure 12 3 — — $191,793.60 $191,793.60 $191,793.60 2026-02-12
161-3 Pediatric OTHER Implantable Heart Assist Systems 12 3 — — $191,301.58 $191,301.59 $191,301.58 2026-02-12
607-4 Pediatric OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $191,160.10 $191,160.10 $191,160.10 2026-02-12
002-4 Adult OTHER Heart &/or Lung Transplant 12 3 — — $189,198.86 $189,198.86 $189,198.86 2026-02-12
007-4 Adult OTHER Allogeneic Bone Marrow Transplant 12 3 — — $185,055.00 $185,055.01 $185,055.00 2026-02-12
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 27 12 — — $141,114.63 $457,414.00 $179,481.83 2026-02-12
608-4 Pediatric OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 12 3 — — $178,472.08 $178,472.09 $178,472.08 2026-02-12
602-3 Pediatric OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $176,257.51 $176,257.52 $176,257.51 2026-02-12
001-4 Pediatric OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $168,690.09 $168,690.09 $168,690.09 2026-02-12
841-4 Pediatric OTHER Extensive 3rd Degree Burns W Skin Graft 12 3 — — $168,265.34 $168,265.35 $168,265.34 2026-02-12
14 MS_DRG Allogeneic Bone Marrow Transplant 27 12 — — $122,474.16 $285,493.39 $166,421.45 2026-02-12
161-3 Adult OTHER Implantable Heart Assist Systems 12 3 — — $166,349.20 $166,349.21 $166,349.20 2026-02-12
7 MS_DRG Lung Transplant 26 12 — — $131,952.48 $307,640.81 $166,002.27 2026-02-12
603-3 Pediatric OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 3 — — $158,445.84 $158,445.84 $158,445.84 2026-02-12
583-1 Pediatric OTHER Neonate W Ecmo 12 3 — — $153,017.09 $153,017.09 $153,017.09 2026-02-12
002-3 Pediatric OTHER Heart &/or Lung Transplant 12 3 — — $152,855.92 $152,855.92 $152,855.92 2026-02-12
006-4 Pediatric OTHER Pancreas Transplant 12 3 — — $152,242.10 $152,242.10 $152,242.10 2026-02-12
611-4 Pediatric OTHER Neonate Birthwt 1500-1999g W Major Anomaly 12 3 — — $151,450.38 $151,450.38 $151,450.38 2026-02-12
009-4 Pediatric OTHER Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $149,872.03 $149,872.04 $149,872.03 2026-02-12
588-2 Pediatric OTHER Neonate Bwt <1500g W Major Procedure 12 3 — — $147,573.98 $147,573.99 $147,573.98 2026-02-12
004-4 Pediatric OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $147,318.22 $147,318.23 $147,318.22 2026-02-12
001-4 Adult OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $146,687.03 $146,687.04 $146,687.04 2026-02-12
841-4 Adult OTHER Extensive 3rd Degree Burns W Skin Graft 12 3 — — $146,317.69 $146,317.69 $146,317.69 2026-02-12
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 27 12 — — $115,498.85 $305,297.00 $139,974.23 2026-02-12
007-3 Pediatric OTHER Allogeneic Bone Marrow Transplant 12 3 — — $138,968.40 $138,968.40 $138,968.40 2026-02-12
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 27 12 — — $110,845.60 $236,535.31 $138,376.30 2026-02-12
602-2 Pediatric OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $137,687.38 $137,687.39 $137,687.38 2026-02-12
161-2 Pediatric OTHER Implantable Heart Assist Systems 12 3 — — $136,490.48 $136,490.49 $136,490.48 2026-02-12
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 27 12 — — $105,115.70 $405,434.00 $135,270.62 2026-02-12
215 MS_DRG Other Heart Assist System Implant 27 12 — — $101,521.80 $232,397.07 $134,577.08 2026-02-12
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 12 — — $112,341.10 $261,816.10 $133,060.44 2026-02-12
002-3 Adult OTHER Heart &/or Lung Transplant 12 3 — — $132,918.19 $132,918.20 $132,918.19 2026-02-12
006-4 Adult OTHER Pancreas Transplant 12 3 — — $132,384.43 $132,384.44 $132,384.43 2026-02-12
630-3 Pediatric OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 12 3 — — $130,855.24 $130,855.24 $130,855.24 2026-02-12
009-4 Adult OTHER Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $130,323.51 $130,323.51 $130,323.51 2026-02-12
609-3 Pediatric OTHER Neonate Bwt 1500-2499g W Major Procedure 12 3 — — $128,791.42 $128,791.42 $128,791.42 2026-02-12
612-4 Pediatric OTHER Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 12 3 — — $128,590.42 $128,590.42 $128,590.42 2026-02-12
607-3 Pediatric OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $128,559.91 $128,559.91 $128,559.91 2026-02-12
004-4 Adult OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $128,102.80 $128,102.81 $128,102.80 2026-02-12
621-4 Pediatric OTHER Neonate Bwt 2000-2499g W Major Anomaly 12 3 — — $125,548.52 $125,548.53 $125,548.52 2026-02-12
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 12 — — $99,750.78 $218,623.00 $122,590.03 2026-02-12
007-3 Adult OTHER Allogeneic Bone Marrow Transplant 12 3 — — $120,842.09 $120,842.09 $120,842.09 2026-02-12
614-4 Pediatric OTHER Neonate Bwt 1500-1999g W Or Without Other Significant Condition 12 3 — — $120,841.22 $120,841.22 $120,841.22 2026-02-12
161-2 Adult OTHER Implantable Heart Assist Systems 12 3 — — $118,687.38 $118,687.38 $118,687.38 2026-02-12
209 MS_DRG #n/a 8 5 — — $115,366.68 $218,623.00 $117,114.70 2026-02-12
850 MS_DRG Acute Leukemia With Other Procedures 27 12 — — $88,330.63 $157,948.00 $117,011.23 2026-02-12
160-4 Pediatric OTHER Major Cardiothoracic Repair Of Heart Anomaly 12 3 — — $109,338.58 $109,338.59 $109,338.58 2026-02-12
002-2 Pediatric OTHER Heart &/or Lung Transplant 12 3 — — $109,333.26 $109,333.26 $109,333.26 2026-02-12
161-1 Pediatric OTHER Implantable Heart Assist Systems 12 3 — — $108,805.98 $108,805.99 $108,805.98 2026-02-12
231 MS_DRG Coronary Bypass With Ptca With Mcc 27 12 — — $85,996.38 $158,846.00 $107,637.02 2026-02-12
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 12 — — $85,726.96 $199,628.48 $107,577.32 2026-02-12
006-3 Pediatric OTHER Pancreas Transplant 12 3 — — $106,418.61 $106,418.61 $106,418.61 2026-02-12
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 27 12 — — $91,889.96 $214,029.17 $105,943.82 2026-02-12
608-3 Pediatric OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 12 3 — — $104,506.52 $104,506.53 $104,506.52 2026-02-12
004-3 Pediatric OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $103,055.25 $103,055.25 $103,055.25 2026-02-12
008-4 Pediatric OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 3 — — $102,760.99 $102,760.99 $102,760.99 2026-02-12
303-4 Pediatric OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 3 — — $102,578.57 $102,578.58 $102,578.57 2026-02-12
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 27 12 — — $80,291.90 $277,310.00 $102,393.56 2026-02-12
588-1 Pediatric OTHER Neonate Bwt <1500g W Major Procedure 12 3 — — $102,006.61 $102,006.61 $102,006.61 2026-02-12
001-3 Pediatric OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $101,899.51 $101,899.51 $101,899.51 2026-02-12
603-2 Pediatric OTHER Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 12 3 — — $101,647.68 $101,647.68 $101,647.68 2026-02-12
10 MS_DRG Pancreas Transplant 26 12 — — $73,245.42 $170,463.63 $101,274.49 2026-02-12
162-4 Pediatric OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 12 3 — — $101,026.04 $101,026.05 $101,026.04 2026-02-12
Q0480 HCPCS Driver Pneumatic Vad, Rep 9 2 — — $101,007.50 $101,007.50 $101,007.50 2026-02-12
613-4 Pediatric OTHER Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 12 3 — — $100,696.53 $100,696.53 $100,696.53 2026-02-12
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 26 12 — — $72,827.57 $169,487.27 $100,694.00 2026-02-12
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 27 12 — — $78,018.64 $143,957.00 $99,285.33 2026-02-12
607-2 Pediatric OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $98,867.80 $98,867.81 $98,867.80 2026-02-12
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 12 — — $78,355.16 $142,182.00 $98,283.13 2026-02-12
440-4 Pediatric OTHER Kidney Transplant 12 3 — — $97,807.81 $97,807.82 $97,807.81 2026-02-12
007-2 Pediatric OTHER Allogeneic Bone Marrow Transplant 12 3 — — $95,941.05 $95,941.06 $95,941.05 2026-02-12
160-4 Adult OTHER Major Cardiothoracic Repair Of Heart Anomaly 12 3 — — $95,077.03 $95,077.03 $95,077.03 2026-02-12
002-2 Adult OTHER Heart &/or Lung Transplant 12 3 — — $95,072.40 $95,072.40 $95,072.40 2026-02-12
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 27 12 — — $77,761.43 $172,708.00 $94,811.62 2026-02-12
161-1 Adult OTHER Implantable Heart Assist Systems 12 3 — — $94,613.90 $94,613.90 $94,613.90 2026-02-12
633-4 Pediatric OTHER Neonate Birthwt >2499g W Major Anomaly 12 3 — — $94,404.56 $94,404.57 $94,404.56 2026-02-12
005-4 Pediatric OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 3 — — $94,207.44 $94,207.45 $94,207.44 2026-02-12
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 9 2 — — $93,216.70 $93,216.70 $93,216.70 2026-02-12
006-3 Adult OTHER Pancreas Transplant 12 3 — — $92,537.92 $92,537.93 $92,537.92 2026-02-12
631-3 Pediatric OTHER Neonate Birthwt >2499g W Other Major Procedure 12 3 — — $92,337.15 $92,337.16 $92,337.15 2026-02-12
611-3 Pediatric OTHER Neonate Birthwt 1500-1999g W Major Anomaly 12 3 — — $91,084.50 $91,084.51 $91,084.50 2026-02-12
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 12 — — $73,681.57 $171,482.75 $90,219.79 2026-02-12
006-2 Pediatric OTHER Pancreas Transplant 12 3 — — $89,821.49 $89,821.50 $89,821.49 2026-02-12
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 27 12 — — $72,784.88 $180,935.00 $89,766.32 2026-02-12
863-4 Pediatric OTHER Neonatal Aftercare 12 3 — — $89,633.75 $89,633.76 $89,633.75 2026-02-12
004-3 Adult OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $89,613.26 $89,613.26 $89,613.26 2026-02-12
002-1 Pediatric OTHER Heart &/or Lung Transplant 12 3 — — $89,533.89 $89,533.89 $89,533.89 2026-02-12
008-4 Adult OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 3 — — $89,357.38 $89,357.38 $89,357.38 2026-02-12
303-4 Adult OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 3 — — $89,198.76 $89,198.76 $89,198.76 2026-02-12
612-3 Pediatric OTHER Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 12 3 — — $89,099.65 $89,099.65 $89,099.65 2026-02-12
001-3 Adult OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $88,608.27 $88,608.27 $88,608.27 2026-02-12
162-4 Adult OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 12 3 — — $87,848.73 $87,848.74 $87,848.73 2026-02-12
622-4 Pediatric OTHER Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 12 3 — — $86,917.38 $86,917.38 $86,917.38 2026-02-12
842-4 Pediatric OTHER Burns W Skin Graft Except Extensive 3rd Degree Burns 12 3 — — $86,834.94 $86,834.95 $86,834.94 2026-02-12
613-3 Pediatric OTHER Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 12 3 — — $86,768.43 $86,768.43 $86,768.43 2026-02-12
955 MS_DRG Craniotomy For Multiple Significant Trauma 27 12 — — $68,725.35 $254,220.00 $86,734.31 2026-02-12
007-1 Pediatric OTHER Allogeneic Bone Marrow Transplant 12 3 — — $86,287.70 $86,287.70 $86,287.70 2026-02-12
163-4 Pediatric OTHER Cardiac Valve Procedures Without Ami Or Complex Pdx 12 3 — — $85,643.25 $85,643.26 $85,643.25 2026-02-12
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 27 12 — — $68,222.10 $158,725.95 $85,164.32 2026-02-12
440-4 Adult OTHER Kidney Transplant 12 3 — — $85,050.27 $85,050.28 $85,050.27 2026-02-12
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 27 12 — — $70,217.81 $125,818.00 $84,693.07 2026-02-12
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 27 12 — — $46,145.40 $206,541.00 $84,664.84 2026-02-12
001-2 Pediatric OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $84,086.73 $84,086.74 $84,086.73 2026-02-12
178-4 Pediatric OTHER External Heart Assist Systems 12 3 — — $84,068.09 $84,068.10 $84,068.09 2026-02-12
001-1 Pediatric OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $83,514.19 $83,514.19 $83,514.19 2026-02-12
007-2 Adult OTHER Allogeneic Bone Marrow Transplant 12 3 — — $83,427.00 $83,427.01 $83,427.00 2026-02-12
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 27 12 — — $65,711.97 $258,321.64 $82,147.55 2026-02-12
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 12 — — $67,141.39 $218,623.00 $82,029.42 2026-02-12
005-4 Adult OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 3 — — $81,919.52 $81,919.52 $81,919.52 2026-02-12
841-3 Pediatric OTHER Extensive 3rd Degree Burns W Skin Graft 12 3 — — $81,496.97 $81,496.97 $81,496.97 2026-02-12
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 26 12 — — $73,214.92 $89,078.43 $81,286.28 2026-02-12
183-4 Pediatric OTHER Percutaneous Structural Cardiac Procedures 12 3 — — $79,465.10 $79,465.11 $79,465.10 2026-02-12
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 27 12 — — $61,359.64 $116,457.00 $78,682.39 2026-02-12
303-3 Pediatric OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 3 — — $78,550.36 $78,550.37 $78,550.36 2026-02-12
004-2 Pediatric OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $78,402.57 $78,402.57 $78,402.57 2026-02-12
165-4 Pediatric OTHER Coronary Bypass W Ami Or Complex Pdx 12 3 — — $78,332.00 $78,332.00 $78,332.00 2026-02-12
009-3 Pediatric OTHER Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $78,280.07 $78,280.08 $78,280.07 2026-02-12
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 27 12 — — $66,898.41 $82,465.47 $78,222.57 2026-02-12
609-2 Pediatric OTHER Neonate Bwt 1500-2499g W Major Procedure 12 3 — — $78,209.85 $78,209.85 $78,209.85 2026-02-12
006-2 Adult OTHER Pancreas Transplant 12 3 — — $78,105.64 $78,105.65 $78,105.64 2026-02-12
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 27 12 — — $56,443.07 $131,202.62 $77,949.48 2026-02-12
863-4 Adult OTHER Neonatal Aftercare 12 3 — — $77,942.39 $77,942.40 $77,942.39 2026-02-12
002-1 Adult OTHER Heart &/or Lung Transplant 12 3 — — $77,855.55 $77,855.56 $77,855.56 2026-02-12
232 MS_DRG Coronary Bypass With Ptca Without Mcc 27 12 — — $61,928.97 $181,616.92 $77,593.82 2026-02-12
630-2 Pediatric OTHER Neonate Birthwt >2499g W Major Cardiovascular Procedure 12 3 — — $77,508.15 $77,508.15 $77,508.15 2026-02-12
28 MS_DRG Spinal Procedures With Mcc 27 12 — — $61,376.93 $142,731.25 $77,222.91 2026-02-12
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 27 12 — — $62,525.75 $112,021.00 $76,970.58 2026-02-12
167-4 Pediatric OTHER Other Cardiothoracic & Thoracic Vascular Procedures 12 3 — — $76,899.31 $76,899.31 $76,899.31 2026-02-12
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 27 12 — — $60,577.83 $258,862.00 $76,669.10 2026-02-12
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 27 12 — — $55,520.96 $258,862.00 $76,669.10 2026-02-12
634-4 Pediatric OTHER Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 12 3 — — $76,433.17 $76,433.17 $76,433.17 2026-02-12
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 27 12 — — $62,597.94 $113,096.04 $76,096.23 2026-02-12
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 27 12 — — $67,141.39 $218,623.00 $75,569.09 2026-02-12
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 27 12 — — $60,718.13 $307,493.00 $75,511.93 2026-02-12
842-4 Adult OTHER Burns W Skin Graft Except Extensive 3rd Degree Burns 12 3 — — $75,508.64 $75,508.65 $75,508.64 2026-02-12
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 26 12 — — $57,139.53 $82,509.82 $75,292.25 2026-02-12
007-1 Adult OTHER Allogeneic Bone Marrow Transplant 12 3 — — $75,032.78 $75,032.78 $75,032.78 2026-02-12
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 27 12 — — $59,956.65 $109,895.00 $74,742.18 2026-02-12
614-3 Pediatric OTHER Neonate Bwt 1500-1999g W Or Without Other Significant Condition 12 3 — — $74,496.76 $74,496.77 $74,496.76 2026-02-12
163-4 Adult OTHER Cardiac Valve Procedures Without Ami Or Complex Pdx 12 3 — — $74,472.39 $74,472.40 $74,472.39 2026-02-12
38240 HCPCS Transplt Allo Hct/donor 31 8 — — $256.39 $84,128.78 $74,307.91 2026-02-12
304-4 Pediatric OTHER Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 12 3 — — $73,539.94 $73,539.94 $73,539.94 2026-02-12
001-2 Adult OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $73,118.90 $73,118.90 $73,118.90 2026-02-12
178-4 Adult OTHER External Heart Assist Systems 12 3 — — $73,102.69 $73,102.69 $73,102.69 2026-02-12
910-4 Pediatric OTHER Craniotomy For Multiple Significant Trauma 12 3 — — $73,067.26 $73,067.26 $73,067.26 2026-02-12
910-4 Adult OTHER Craniotomy For Multiple Significant Trauma 12 3 — — $73,067.26 $73,067.26 $73,067.26 2026-02-12
179-4 Pediatric OTHER Defibrillator Implants 12 3 — — $72,950.09 $72,950.09 $72,950.09 2026-02-12
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 27 12 — — $60,917.40 $155,208.00 $72,902.90 2026-02-12
607-1 Pediatric OTHER Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $72,660.86 $72,660.87 $72,660.86 2026-02-12
001-1 Adult OTHER Liver Transplant &/or Intestinal Transplant 12 3 — — $72,621.03 $72,621.04 $72,621.04 2026-02-12
608-2 Pediatric OTHER Neonate Bwt 1250-1499g W Or Without Other Significant Condition 12 3 — — $72,587.28 $72,587.29 $72,587.28 2026-02-12
005-3 Pediatric OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 3 — — $72,521.34 $72,521.35 $72,521.34 2026-02-12
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 27 12 — — $58,550.61 $136,127.17 $72,467.22 2026-02-12
162-3 Pediatric OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 12 3 — — $71,220.47 $71,220.48 $71,220.47 2026-02-12
841-3 Adult OTHER Extensive 3rd Degree Burns W Skin Graft 12 3 — — $70,866.93 $70,866.93 $70,866.93 2026-02-12
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 27 12 — — $53,179.46 $86,505.00 $70,860.93 2026-02-12
004-1 Pediatric OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $70,416.25 $70,416.25 $70,416.25 2026-02-12
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 27 12 — — $54,112.89 $277,310.00 $70,208.77 2026-02-12
166-4 Pediatric OTHER Coronary Bypass Without Ami Or Complex Pdx 12 3 — — $70,107.34 $70,107.34 $70,107.34 2026-02-12
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 27 12 — — $57,449.57 $133,554.43 $69,914.08 2026-02-12
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 27 12 — — $58,924.74 $137,001.38 $69,487.28 2026-02-12
091-4 Pediatric OTHER Other Major Head & Neck Procedures 12 3 — — $69,402.98 $69,402.98 $69,402.98 2026-02-12
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 27 12 — — $57,272.67 $787,846.00 $69,113.84 2026-02-12
183-4 Adult OTHER Percutaneous Structural Cardiac Procedures 12 3 — — $69,100.09 $69,100.09 $69,100.09 2026-02-12
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 27 12 — — $55,909.33 $129,955.45 $68,956.33 2026-02-12
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 27 12 — — $58,237.48 $135,395.50 $68,604.48 2026-02-12
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 27 12 — — $55,742.59 $129,565.85 $68,539.70 2026-02-12
303-3 Adult OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 3 — — $68,304.66 $68,304.67 $68,304.66 2026-02-12
004-2 Adult OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $68,176.15 $68,176.15 $68,176.15 2026-02-12
165-4 Adult OTHER Coronary Bypass W Ami Or Complex Pdx 12 3 — — $68,114.78 $68,114.79 $68,114.78 2026-02-12
009-3 Adult OTHER Extracorporeal Membrane Oxygenation (ecmo) 12 3 — — $68,069.63 $68,069.63 $68,069.63 2026-02-12
008-3 Pediatric OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 3 — — $67,991.59 $67,991.59 $67,991.59 2026-02-12
J9029 HCPCS Instill Adstiladrin, Tx Dose 37 10 — — $47,506.71 $78,935.54 $67,934.65 2026-02-12
653 MS_DRG Major Bladder Procedures With Mcc 27 12 — — $51,782.00 $74,350.06 $67,846.27 2026-02-12
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 27 12 — — $55,830.03 $139,412.58 $67,578.15 2026-02-12
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 9 2 — — $67,452.66 $67,452.66 $67,452.66 2026-02-12
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 12 — — $54,509.39 $142,182.00 $67,279.64 2026-02-12
834 MS_DRG Acute Leukemia With Mcc 27 12 — — $49,549.59 $157,948.00 $67,270.60 2026-02-12
169-4 Pediatric OTHER Major Abdominal Vascular Procedures 12 3 — — $66,937.04 $66,937.05 $66,937.04 2026-02-12
621-3 Pediatric OTHER Neonate Bwt 2000-2499g W Major Anomaly 12 3 — — $66,909.08 $66,909.09 $66,909.08 2026-02-12
167-4 Adult OTHER Other Cardiothoracic & Thoracic Vascular Procedures 12 3 — — $66,868.96 $66,868.97 $66,868.96 2026-02-12
680-4 Pediatric OTHER Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 12 3 — — $66,737.32 $66,737.32 $66,737.32 2026-02-12
440-3 Pediatric OTHER Kidney Transplant 12 3 — — $66,452.38 $66,452.38 $66,452.38 2026-02-12
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 27 12 — — $50,121.48 $71,958.68 $65,664.08 2026-02-12
612-2 Pediatric OTHER Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 12 3 — — $65,478.76 $65,478.77 $65,478.76 2026-02-12
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 26 12 — — $54,476.85 $126,608.27 $65,417.50 2026-02-12
260-4 Pediatric OTHER Major Pancreas, Liver & Shunt Procedures 12 3 — — $65,305.96 $65,305.96 $65,305.96 2026-02-12
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 27 12 — — $53,934.97 $125,818.00 $65,200.30 2026-02-12
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 27 12 — — $53,214.16 $123,657.82 $64,712.53 2026-02-12
178-3 Pediatric OTHER External Heart Assist Systems 12 3 — — $64,547.00 $64,547.01 $64,547.00 2026-02-12
441-4 Pediatric OTHER Major Bladder Procedures 12 3 — — $64,063.67 $64,063.68 $64,063.67 2026-02-12
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 27 12 — — $50,329.89 $91,354.00 $63,979.62 2026-02-12
304-4 Adult OTHER Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 12 3 — — $63,947.77 $63,947.78 $63,947.77 2026-02-12
089-4 Pediatric OTHER Major Cranial/facial Bone Procedures 12 3 — — $63,845.30 $63,845.31 $63,845.30 2026-02-12
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 27 12 — — $56,882.27 $85,672.48 $63,552.82 2026-02-12
179-4 Adult OTHER Defibrillator Implants 12 3 — — $63,434.86 $63,434.86 $63,434.86 2026-02-12
911-4 Pediatric OTHER Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 12 3 — — $63,303.39 $63,303.39 $63,303.39 2026-02-12
911-4 Adult OTHER Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 12 3 — — $63,303.39 $63,303.39 $63,303.39 2026-02-12
228 MS_DRG Other Cardiothoracic Procedures With Mcc 27 12 — — $50,591.18 $127,387.00 $63,298.78 2026-02-12
005-3 Adult OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 3 — — $63,062.04 $63,062.04 $63,062.04 2026-02-12
120-4 Pediatric OTHER Major Respiratory & Chest Procedures 12 3 — — $62,934.56 $62,934.57 $62,934.56 2026-02-12
160-3 Pediatric OTHER Major Cardiothoracic Repair Of Heart Anomaly 12 3 — — $62,806.74 $62,806.74 $62,806.74 2026-02-12
602-1 Pediatric OTHER Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 12 3 — — $62,034.87 $62,034.88 $62,034.87 2026-02-12
162-3 Adult OTHER Cardiac Valve Procedures W Ami Or Complex Pdx 12 3 — — $61,930.84 $61,930.85 $61,930.84 2026-02-12
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 27 12 — — $38,063.72 $143,172.00 $61,814.52 2026-02-12
471 MS_DRG Cervical Spinal Fusion With Mcc 27 12 — — $49,384.40 $114,709.05 $61,698.30 2026-02-12
6 MS_DRG Liver Transplant Without Mcc 27 12 — — $47,435.46 $405,434.00 $61,595.42 2026-02-12
006-1 Pediatric OTHER Pancreas Transplant 12 3 — — $61,572.44 $61,572.44 $61,572.44 2026-02-12
023-4 Pediatric OTHER Spinal Procedures 12 3 — — $61,346.08 $61,346.09 $61,346.08 2026-02-12
912-4 Adult OTHER Musculoskeletal & Other Procedures For Multiple Significant Trauma 12 3 — — $61,298.15 $61,298.16 $61,298.15 2026-02-12
912-4 Pediatric OTHER Musculoskeletal & Other Procedures For Multiple Significant Trauma 12 3 — — $61,298.15 $61,298.16 $61,298.15 2026-02-12
004-1 Adult OTHER Tracheostomy W Mv 96+ Hours W Extensive Procedure 12 3 — — $61,231.52 $61,231.52 $61,231.52 2026-02-12
623-4 Pediatric OTHER Neonate Bwt 2000-2499g W Congenital/perinatal Infection 12 3 — — $61,051.42 $61,051.42 $61,051.42 2026-02-12
092-4 Pediatric OTHER Facial Bone Procedures Except Major Cranial/facial Bone Procedures 12 3 — — $61,047.83 $61,047.83 $61,047.83 2026-02-12
166-4 Adult OTHER Coronary Bypass Without Ami Or Complex Pdx 12 3 — — $60,962.90 $60,962.91 $60,962.90 2026-02-12
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 27 12 — — $49,136.33 $66,782.48 $60,940.67 2026-02-12
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 27 12 — — $47,466.22 $174,159.00 $60,868.86 2026-02-12
A9543 HCPCS Y90 Ibritumomab, Rx 23 8 — — $42,618.41 $68,189.46 $60,859.09 2026-02-12
799 MS_DRG Splenic Procedures With Mcc 27 12 — — $46,336.45 $66,739.21 $60,396.33 2026-02-12
091-4 Adult OTHER Other Major Head & Neck Procedures 12 3 — — $60,350.41 $60,350.42 $60,350.41 2026-02-12
021-4 Pediatric OTHER Open Craniotomy Except Trauma 12 3 — — $60,323.49 $60,323.50 $60,323.49 2026-02-12
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 27 12 — — $48,694.09 $163,389.19 $59,759.95 2026-02-12
850-4 Pediatric OTHER Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 12 3 — — $59,508.62 $59,508.62 $59,508.62 2026-02-12
740-4 Adult OTHER Mental Illness Diagnosis W O.r. Procedure 12 3 — — $59,485.98 $59,485.99 $59,485.98 2026-02-12
740-4 Pediatric OTHER Mental Illness Diagnosis W O.r. Procedure 12 3 — — $59,485.98 $59,485.99 $59,485.98 2026-02-12
245 MS_DRG Aicd Generator Procedures 27 12 — — $46,677.03 $87,404.00 $59,475.33 2026-02-12
220-4 Pediatric OTHER Major Stomach, Esophageal & Duodenal Procedures 12 3 — — $59,331.53 $59,331.53 $59,331.53 2026-02-12
008-3 Adult OTHER Autologous Bone Marrow Transplant Or T-cell Immunotherapy 12 3 — — $59,123.12 $59,123.12 $59,123.12 2026-02-12
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 27 12 — — $47,247.38 $132,228.87 $59,089.28 2026-02-12
213 MS_DRG #n/a 8 5 — — $58,312.71 $108,580.00 $59,048.83 2026-02-12
163 MS_DRG Major Chest Procedures With Mcc 27 12 — — $45,857.60 $88,791.61 $58,546.89 2026-02-12
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 27 12 — — $48,090.19 $174,935.00 $58,522.76 2026-02-12
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 27 12 — — $47,992.59 $86,494.00 $58,403.34 2026-02-12
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 27 12 — — $51,534.64 $142,182.00 $58,336.04 2026-02-12
169-4 Adult OTHER Major Abdominal Vascular Procedures 12 3 — — $58,206.12 $58,206.13 $58,206.12 2026-02-12
303-2 Pediatric OTHER Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 3 — — $58,134.51 $58,134.52 $58,134.51 2026-02-12
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 27 12 — — $47,850.26 $83,033.00 $58,120.74 2026-02-12
680-4 Adult OTHER Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 12 3 — — $58,032.45 $58,032.45 $58,032.45 2026-02-12
681-4 Pediatric OTHER Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 12 3 — — $57,972.07 $57,972.07 $57,972.07 2026-02-12
165-3 Pediatric OTHER Coronary Bypass W Ami Or Complex Pdx 12 3 — — $57,845.58 $57,845.58 $57,845.58 2026-02-12
440-3 Adult OTHER Kidney Transplant 12 3 — — $57,784.68 $57,784.68 $57,784.68 2026-02-12
163-3 Pediatric OTHER Cardiac Valve Procedures Without Ami Or Complex Pdx 12 3 — — $57,504.71 $57,504.72 $57,504.71 2026-02-12
33276 HCPCS Insj Phrnc Nrv Stim Sys 19 6 — — $1,140.00 $64,012.31 $57,130.98 2026-02-12
0266T OTHER Implt/rpl Crtd Sns Dev Total 14 5 — — $57,130.98 $64,012.31 $57,130.98 2026-02-12
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 27 12 — — $43,937.13 $101,980.76 $56,965.47 2026-02-12
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 27 12 — — $46,904.76 $104,609.00 $56,952.36 2026-02-12
695-4 Pediatric OTHER Chemotherapy For Acute Leukemia 12 3 — — $56,925.51 $56,925.52 $56,925.51 2026-02-12
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 27 12 — — $46,517.42 $108,009.95 $56,807.96 2026-02-12
260-4 Adult OTHER Major Pancreas, Liver & Shunt Procedures 12 3 — — $56,787.79 $56,787.79 $56,787.79 2026-02-12
183-3 Pediatric OTHER Percutaneous Structural Cardiac Procedures 12 3 — — $56,756.41 $56,756.42 $56,756.41 2026-02-12
651-4 Pediatric OTHER Other Procedures Of Blood & Blood-forming Organs 12 3 — — $56,368.95 $56,368.95 $56,368.95 2026-02-12
005-2 Pediatric OTHER Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 3 — — $56,275.74 $56,275.75 $56,275.74 2026-02-12
178-3 Adult OTHER External Heart Assist Systems 12 3 — — $56,127.83 $56,127.83 $56,127.83 2026-02-12
613-2 Pediatric OTHER Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 12 3 — — $56,003.13 $56,003.14 $56,003.13 2026-02-12
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