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

GRITMAN MEDICAL CENTER

Moscow, ID · CCN 131327 · Rates published

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You selected 93306 (CPT)

HC PRO TTE W/DOPPLER COMPLETE - TTE COMPLETE

This hospital’s price: $917 across 15 payers · range $75-$2,141

Source: https://mrfs.hyvehealthcare.com/GritmanMedicalCenter/820146328_gritman-medical-center_standardcharges.csv · observed 2026-08-19

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.

20,995 distinct procedures filed
15 distinct payers
922,034 rate rows
2026-08-19 last MRF observed
Data quality

364,332 of 922,034 rate rows are consumer-grade (39.5%)

557,702 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
professional (physician) fee — not the facility price 327,458
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 201,842
per-diem day rate — not a per-procedure price 10,996
placeholder amount (≤ $0.02) — excluded from medians 9,456
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 6,222
exceeds 10× this hospital's gross charge — excluded from medians 1,469
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 259
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://mrfs.hyvehealthcare.com/GritmanMedicalCenter/820146328_gritman-medical-center_standardcharges.csv
Found on page https://www.gritman.org/patients-visitors/billing-information/hospital-price-transparency/price-lists/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-23
Content fingerprint 45b694ec1f84eebd… · 158,777,315 bytes · first seen 2026-09-21

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
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 $352,668.72 $614,092.60 $545,091.48 nat. median
$359,454
1.5× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $274,621.50 $457,236.20 $457,236.20 nat. median
$249,036
1.8× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 11 $364,635.75 $364,635.75 $364,635.75 nat. median
$96,983
outlier · 3.8×
5834
APR_DRG 		Neonate With Ecmo, Severe 3 $359,163.54 $359,163.54 $359,163.54 nat. median
$307,206
1.2× median
5833
APR_DRG 		Neonate With Ecmo, Major 3 $288,533.35 $288,533.35 $288,533.35 nat. median
$244,017
1.2× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 3 $284,500.73 $284,500.73 $284,500.73 nat. median
$247,214
1.2× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $109,210.10 $266,313.14 $266,313.14 nat. median
$110,307
outlier · 2.4×
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 11 $263,854.56 $263,854.56 $263,854.56 nat. median
$70,178
outlier · 3.8×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $131,457.04 $263,603.22 $263,603.22 nat. median
$104,013
outlier · 2.5×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $235,389.26 $256,401.01 $256,401.01 nat. median
$198,418
1.3× median
Q0480
HCPCS 		Dme Pos 12 $43,199.96 $415,113.25 $229,156.61 nat. median
$111,503
outlier · 2.1×
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 3 $197,453.38 $234,007.83 $225,024.43 nat. median
$190,559
1.2× median
1614
APR_DRG 		Implantable Heart Assist Systems, Severe 3 $220,271.76 $220,271.76 $220,271.76 nat. median
$202,993
1.1× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft, Severe 3 $198,294.74 $198,294.74 $198,294.74 nat. median
$155,939
1.3× median
5832
APR_DRG 		Neonate With Ecmo, Moderate 3 $195,774.10 $195,774.10 $195,774.10 nat. median
$159,249
1.2× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 3 $194,241.95 $194,241.95 $194,241.95 nat. median
$162,342
1.2× median
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 2 $89,323.38 $193,727.22 $193,727.22 nat. median
$70,732
outlier · 2.7×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 3 $190,279.55 $190,279.55 $190,279.55 nat. median
$165,000
1.2× median
7
MS_DRG 		Lung Transplant 2 $119,106.63 $189,289.50 $189,289.50 nat. median
$117,974
1.6× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $111,298.10 $181,535.05 $181,535.05 nat. median
$95,038
1.9× median
215
MS_DRG 		Other Heart Assist System Implant 3 $100,528.32 $245,114.90 $177,445.41 nat. median
$93,901
1.9× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Major 3 $173,420.75 $173,420.75 $173,420.75 nat. median
$175,204
1.0× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo), Severe 3 $171,269.70 $171,269.70 $171,269.70 nat. median
$163,587
1.0× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 3 $169,645.21 $169,645.21 $169,645.21 nat. median
$133,164
1.3× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $133,980.20 $184,878.23 $168,794.96 nat. median
$126,695
1.3× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 3 $163,387.62 $163,387.62 $163,387.62 nat. median
$154,011
1.1× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 3 $161,261.71 $161,261.71 $161,261.71 nat. median
$151,838
1.1× median
5831
APR_DRG 		Neonate With Ecmo, Minor 3 $154,685.38 $154,685.38 $154,685.38 nat. median
$146,500
1.1× median
1613
APR_DRG 		Implantable Heart Assist Systems, Major 3 $153,568.89 $153,568.89 $153,568.89 nat. median
$120,517
1.3× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 3 $151,069.45 $151,069.45 $151,069.45 nat. median
$107,681
1.4× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 3 $150,374.31 $150,374.31 $150,374.31 nat. median
$122,016
1.2× median
L2006
HCPCS 		Dme Pos 11 $149,712.38 $149,712.38 $149,712.38 nat. median
$39,921
outlier · 3.8×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $30,058.57 $2,269,269.98 $137,204.04 nat. median
$739,258
outlier · 0.2×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $30,058.57 $2,170,107.40 $134,114.04 nat. median
$646,415
outlier · 0.2×
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 11 $134,110.45 $134,110.45 $134,110.45 nat. median
$35,670
outlier · 3.8×
16
MS_DRG 		Autologous Bone Marrow Transplant With Cc/mcc 2 $59,365.49 $133,746.83 $133,746.83 nat. median
$53,927
outlier · 2.5×
222
MS_DRG 		Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 $74,705.45 $132,648.98 $132,648.98 nat. median
$47,543
outlier · 2.8×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 15 $18,978.98 $242,917.65 $130,948.32 nat. median
$68,423
1.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 6 $30,058.57 $2,137,314.28 $129,144.77 nat. median
$622,450
outlier · 0.2×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 6 $30,058.57 $2,157,333.94 $126,590.26 nat. median
$640,950
outlier · 0.2×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 $124,792.10 $124,792.10 $124,792.10 nat. median
$118,620
1.1× median
454
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Cc 2 $59,428.91 $124,458.03 $124,458.03 nat. median
$49,540
outlier · 2.5×
A9543
HCPCS 		Y90 Ibritumomab, Rx 15 $26,481.32 $217,922.15 $122,201.74 nat. median
$63,528
1.9× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $121,508.73 $121,508.73 $121,508.73 nat. median
$93,276
1.3× median
20
MS_DRG 		Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 $86,753.52 $151,783.77 $121,278.04 nat. median
$74,370
1.6× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $30,058.57 $2,044,937.71 $120,764.99 nat. median
$608,239
outlier · 0.2×
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $30,058.57 $1,876,483.17 $120,448.42 nat. median
$591,721
outlier · 0.2×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $119,968.52 $119,968.52 $119,968.52 nat. median
$93,998
1.3× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $119,886.95 $119,886.95 $119,886.95 nat. median
$97,323
1.2× median
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 $82,438.84 $140,221.55 $116,434.52 nat. median
$77,632
1.5× median

Other procedures at this hospital

Browse this hospital's 20,995 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
             
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 3 — — $352,668.72 $614,092.60 $545,091.48 2026-08-19
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 3 2 — — $274,621.50 $457,236.20 $457,236.20 2026-08-19
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 16 11 — — $364,635.75 $364,635.75 $364,635.75 2026-08-19
5834 APR_DRG Neonate With Ecmo, Severe 3 3 — — $359,163.54 $359,163.54 $359,163.54 2026-08-19
5833 APR_DRG Neonate With Ecmo, Major 3 3 — — $288,533.35 $288,533.35 $288,533.35 2026-08-19
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 3 3 — — $284,500.73 $284,500.73 $284,500.73 2026-08-19
14 MS_DRG Allogeneic Bone Marrow Transplant 3 2 — — $109,210.10 $266,313.14 $266,313.14 2026-08-19
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 16 11 — — $263,854.56 $263,854.56 $263,854.56 2026-08-19
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 3 2 — — $131,457.04 $263,603.22 $263,603.22 2026-08-19
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 3 2 — — $235,389.26 $256,401.01 $256,401.01 2026-08-19
Q0480 HCPCS Dme Pos 26 12 — — $43,199.96 $415,113.25 $229,156.61 2026-08-19
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 4 3 — — $197,453.38 $234,007.83 $225,024.43 2026-08-19
1614 APR_DRG Implantable Heart Assist Systems, Severe 3 3 — — $220,271.76 $220,271.76 $220,271.76 2026-08-19
8414 APR_DRG Extensive Third Degree Burns With Skin Graft, Severe 3 3 — — $198,294.74 $198,294.74 $198,294.74 2026-08-19
5832 APR_DRG Neonate With Ecmo, Moderate 3 3 — — $195,774.10 $195,774.10 $195,774.10 2026-08-19
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 3 3 — — $194,241.95 $194,241.95 $194,241.95 2026-08-19
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 2 — — $89,323.38 $193,727.22 $193,727.22 2026-08-19
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 3 3 — — $190,279.55 $190,279.55 $190,279.55 2026-08-19
7 MS_DRG Lung Transplant 3 2 — — $119,106.63 $189,289.50 $189,289.50 2026-08-19
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 3 2 — — $111,298.10 $181,535.05 $181,535.05 2026-08-19
215 MS_DRG Other Heart Assist System Implant 4 3 — — $100,528.32 $245,114.90 $177,445.41 2026-08-19
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Major 3 3 — — $173,420.75 $173,420.75 $173,420.75 2026-08-19
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Severe 3 3 — — $171,269.70 $171,269.70 $171,269.70 2026-08-19
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 3 3 — — $169,645.21 $169,645.21 $169,645.21 2026-08-19
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 4 3 — — $133,980.20 $184,878.23 $168,794.96 2026-08-19
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 3 3 — — $163,387.62 $163,387.62 $163,387.62 2026-08-19
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 3 3 — — $161,261.71 $161,261.71 $161,261.71 2026-08-19
5831 APR_DRG Neonate With Ecmo, Minor 3 3 — — $154,685.38 $154,685.38 $154,685.38 2026-08-19
1613 APR_DRG Implantable Heart Assist Systems, Major 3 3 — — $153,568.89 $153,568.89 $153,568.89 2026-08-19
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 3 3 — — $151,069.45 $151,069.45 $151,069.45 2026-08-19
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 3 3 — — $150,374.31 $150,374.31 $150,374.31 2026-08-19
L2006 HCPCS Dme Pos 16 11 — — $149,712.38 $149,712.38 $149,712.38 2026-08-19
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 6 — — $30,058.57 $2,269,269.98 $137,204.04 2026-08-19
Q2056 HCPCS Ciltacabtagene Car-pos T 6 6 — — $30,058.57 $2,170,107.40 $134,114.04 2026-08-19
L8701 HCPCS Ewh S/d Uprt Micro Sensor 16 11 — — $134,110.45 $134,110.45 $134,110.45 2026-08-19
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 3 2 — — $59,365.49 $133,746.83 $133,746.83 2026-08-19
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 2 — — $74,705.45 $132,648.98 $132,648.98 2026-08-19
J9029 HCPCS Instill Adstiladrin, Tx Dose 20 15 — — $18,978.98 $242,917.65 $130,948.32 2026-08-19
Q2055 HCPCS Idecabtagene Vicleucel Car 6 6 — — $30,058.57 $2,137,314.28 $129,144.77 2026-08-19
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 6 — — $30,058.57 $2,157,333.94 $126,590.26 2026-08-19
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $124,792.10 $124,792.10 $124,792.10 2026-08-19
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 3 2 — — $59,428.91 $124,458.03 $124,458.03 2026-08-19
A9543 HCPCS Y90 Ibritumomab, Rx 20 15 — — $26,481.32 $217,922.15 $122,201.74 2026-08-19
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $121,508.73 $121,508.73 $121,508.73 2026-08-19
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 4 3 — — $86,753.52 $151,783.77 $121,278.04 2026-08-19
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 6 — — $30,058.57 $2,044,937.71 $120,764.99 2026-08-19
Q2053 HCPCS Brexucabtagene Car Pos T 6 6 — — $30,058.57 $1,876,483.17 $120,448.42 2026-08-19
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $119,968.52 $119,968.52 $119,968.52 2026-08-19
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 1 1 — — $119,886.95 $119,886.95 $119,886.95 2026-08-19
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 3 — — $82,438.84 $140,221.55 $116,434.52 2026-08-19
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $115,724.32 $115,724.32 $115,724.32 2026-08-19
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 20 15 — — $18,978.98 $211,969.36 $115,474.17 2026-08-19
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Major 3 3 — — $115,439.52 $115,439.52 $115,439.52 2026-08-19
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 3 — — $95,051.72 $122,981.55 $115,418.46 2026-08-19
L6700 HCPCS Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 16 11 — — $113,171.58 $113,171.58 $113,171.58 2026-08-19
L7181 HCPCS Dme Pos 25 11 — — $41,339.84 $184,676.34 $113,008.09 2026-08-19
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 2 — — $69,169.32 $112,619.69 $112,619.69 2026-08-19
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Major 3 3 — — $111,677.30 $111,677.30 $111,677.30 2026-08-19
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 3 2 — — $62,453.58 $110,303.27 $110,303.27 2026-08-19
1612 APR_DRG Implantable Heart Assist Systems, Moderate 3 3 — — $107,559.50 $107,559.50 $107,559.50 2026-08-19
1611 APR_DRG Implantable Heart Assist Systems, Minor 3 3 — — $107,559.50 $107,559.50 $107,559.50 2026-08-19
459 MS_DRG Spinal Fusion Except Cervical With Mcc 3 2 — — $64,718.18 $106,768.31 $106,768.31 2026-08-19
L7180 HCPCS Dme Pos 25 11 — — $38,505.25 $172,013.44 $105,259.35 2026-08-19
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $105,204.13 $105,204.13 $105,204.13 2026-08-19
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 3 2 — — $58,747.87 $105,078.53 $105,078.53 2026-08-19
231 MS_DRG Coronary Bypass With Ptca With Mcc 4 3 — — $81,892.45 $117,151.66 $105,045.65 2026-08-19
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Moderate 3 3 — — $104,432.34 $104,432.34 $104,432.34 2026-08-19
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Severe 3 3 — — $104,103.10 $104,103.10 $104,103.10 2026-08-19
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $104,035.05 $104,035.05 $104,035.05 2026-08-19
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 3 2 — — $50,918.86 $102,831.56 $102,831.56 2026-08-19
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Major 3 3 — — $102,824.28 $102,824.28 $102,824.28 2026-08-19
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 4 3 — — $64,403.03 $137,543.04 $102,554.33 2026-08-19
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 3 2 — — $46,716.52 $99,943.07 $99,943.07 2026-08-19
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 1 1 — — $99,330.84 $99,330.84 $99,330.84 2026-08-19
8634 APR_DRG Neonatal Aftercare, Severe 3 3 — — $99,178.59 $99,178.59 $99,178.59 2026-08-19
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Severe 3 3 — — $98,692.87 $98,692.87 $98,692.87 2026-08-19
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns, Severe 3 3 — — $98,610.68 $98,610.68 $98,610.68 2026-08-19
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 4 3 — — $64,063.49 $123,545.35 $97,243.96 2026-08-19
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Moderate 3 3 — — $96,740.76 $96,740.76 $96,740.76 2026-08-19
J9226 HCPCS Supprelin La Implant 20 15 — — $18,978.98 $172,654.19 $95,816.59 2026-08-19
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 4 3 — — $75,566.99 $106,798.07 $95,543.20 2026-08-19
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 3 2 — — $84,009.40 $95,478.89 $95,478.89 2026-08-19
850 MS_DRG Acute Leukemia With Other Procedures 1 1 — — $95,470.99 $95,470.99 $95,470.99 2026-08-19
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 3 — — $79,307.82 $104,744.54 $94,698.90 2026-08-19
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 4 3 — — $69,612.29 $110,118.09 $94,388.53 2026-08-19
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 3 2 — — $49,347.98 $93,718.02 $93,718.02 2026-08-19
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Seve… 3 3 — — $92,157.57 $92,157.57 $92,157.57 2026-08-19
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 4 3 — — $67,526.25 $107,937.26 $91,883.05 2026-08-19
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Severe 3 3 — — $91,397.39 $91,397.39 $91,397.39 2026-08-19
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Severe 3 3 — — $90,829.07 $90,829.07 $90,829.07 2026-08-19
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 4 3 — — $58,364.15 $113,560.47 $89,901.35 2026-08-19
955 MS_DRG Craniotomy For Multiple Significant Trauma 3 2 — — $74,210.38 $89,232.34 $89,232.34 2026-08-19
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 3 — — $58,901.06 $108,013.32 $86,878.25 2026-08-19
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 3 — — $61,945.24 $100,741.66 $86,617.17 2026-08-19
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 4 3 — — $66,258.81 $95,227.57 $85,715.09 2026-08-19
834 MS_DRG Acute Leukemia With Mcc 4 3 — — $53,956.21 $110,891.88 $85,709.01 2026-08-19
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $85,079.95 $85,079.95 $85,079.95 2026-08-19
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 3 2 — — $48,986.97 $84,726.83 $84,726.83 2026-08-19
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Severe 3 3 — — $83,848.99 $83,848.99 $83,848.99 2026-08-19
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Minor 3 3 — — $83,721.92 $83,721.92 $83,721.92 2026-08-19
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 3 3 — — $83,721.92 $83,721.92 $83,721.92 2026-08-19
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 4 3 — — $67,487.33 $96,454.40 $83,584.61 2026-08-19
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 3 2 — — $79,079.02 $82,608.82 $82,608.82 2026-08-19
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 4 3 — — $51,883.82 $99,971.18 $82,315.30 2026-08-19
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Major 3 3 — — $81,577.56 $81,577.56 $81,577.56 2026-08-19
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 3 2 — — $54,552.36 $80,279.18 $80,279.18 2026-08-19
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $79,585.07 $79,585.07 $79,585.07 2026-08-19
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 4 3 — — $57,943.90 $85,988.37 $79,240.52 2026-08-19
8413 APR_DRG Extensive Third Degree Burns With Skin Graft, Major 3 3 — — $78,770.87 $78,770.87 $78,770.87 2026-08-19
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $78,612.66 $78,612.66 $78,612.66 2026-08-19
6 MS_DRG Liver Transplant Without Mcc 3 2 — — $46,924.34 $78,549.73 $78,549.73 2026-08-19
232 MS_DRG Coronary Bypass With Ptca Without Mcc 4 3 — — $57,154.55 $90,156.60 $78,498.39 2026-08-19
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 2 — — $42,933.56 $77,539.50 $77,539.50 2026-08-19
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 4 3 — — $58,444.43 $89,276.99 $76,989.15 2026-08-19
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 4 3 — — $51,142.29 $90,634.43 $76,735.71 2026-08-19
653 MS_DRG Major Bladder Procedures With Mcc 4 3 — — $54,216.72 $95,602.89 $76,446.60 2026-08-19
1784 APR_DRG External Heart Assist Systems, Severe 3 3 — — $76,315.95 $76,315.95 $76,315.95 2026-08-19
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $76,252.76 $76,252.76 $76,252.76 2026-08-19
228 MS_DRG Other Cardiothoracic Procedures With Mcc 4 3 — — $48,085.42 $97,932.54 $76,238.82 2026-08-19
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Major 3 3 — — $76,094.35 $76,094.35 $76,094.35 2026-08-19
93 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Major 3 3 — — $75,802.60 $75,802.60 $75,802.60 2026-08-19
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Severe 3 3 — — $75,556.93 $75,556.93 $75,556.93 2026-08-19
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 4 3 — — $57,278.47 $78,834.11 $75,531.65 2026-08-19
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Minor 3 3 — — $75,295.72 $75,295.72 $75,295.72 2026-08-19
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 2 — — $42,639.07 $74,836.19 $74,836.19 2026-08-19
901 MS_DRG Wound Debridements For Injuries With Mcc 4 3 — — $42,917.14 $103,109.33 $74,688.43 2026-08-19
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 4 3 — — $50,351.97 $96,093.95 $74,290.88 2026-08-19
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 1 1 — — $73,718.66 $73,718.66 $73,718.66 2026-08-19
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 1 1 — — $73,664.64 $73,664.64 $73,664.64 2026-08-19
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Severe 3 3 — — $73,124.02 $73,124.02 $73,124.02 2026-08-19
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Majo… 3 3 — — $72,830.90 $72,830.90 $72,830.90 2026-08-19
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 3 — — $55,921.27 $81,550.65 $72,363.60 2026-08-19
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Moderate 3 3 — — $72,023.65 $72,023.65 $72,023.65 2026-08-19
28 MS_DRG Spinal Procedures With Mcc 4 3 — — $57,346.77 $77,774.28 $72,007.89 2026-08-19
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition, Severe 3 3 — — $71,020.50 $71,020.50 $71,020.50 2026-08-19
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 3 3 — — $70,437.53 $70,437.53 $70,437.53 2026-08-19
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 4 3 — — $52,514.13 $87,838.53 $70,402.97 2026-08-19
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Major 3 3 — — $70,186.85 $70,186.85 $70,186.85 2026-08-19
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 4 3 — — $54,072.32 $79,328.48 $69,820.37 2026-08-19
571T OTHER Insj/rplcmt Icds Ss Eltrd 19 14 — — $16,548.40 $122,983.58 $69,765.99 2026-08-19
915T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 19 14 — — $16,548.40 $122,983.58 $69,765.99 2026-08-19
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Severe 3 3 — — $69,731.85 $69,731.85 $69,731.85 2026-08-19
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Major 3 3 — — $69,372.48 $69,372.48 $69,372.48 2026-08-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 4 3 — — $60,891.08 $75,988.61 $69,290.86 2026-08-19
163 MS_DRG Major Chest Procedures With Mcc 4 3 — — $47,259.98 $88,972.76 $69,192.30 2026-08-19
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Sev… 3 3 — — $69,170.17 $69,170.17 $69,170.17 2026-08-19
9104 APR_DRG Craniotomy For Multiple Significant Trauma, Severe 3 3 — — $68,925.64 $68,925.64 $68,925.64 2026-08-19
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $68,827.16 $68,827.16 $68,827.16 2026-08-19
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 3 — — $53,030.27 $78,759.71 $68,776.92 2026-08-19
L5856 HCPCS Dme Pos 25 11 — — $24,767.79 $110,644.47 $67,706.13 2026-08-19
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma, Seve… 3 3 — — $67,661.24 $67,661.24 $67,661.24 2026-08-19
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 4 3 — — $50,602.73 $74,968.46 $67,597.37 2026-08-19
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 4 3 — — $50,169.52 $83,346.24 $67,459.49 2026-08-19
L6880 HCPCS Dme Pos 16 11 — — $24,650.85 $110,122.03 $67,386.44 2026-08-19
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 19 14 — — $13,736.49 $120,902.44 $67,319.46 2026-08-19
1834 APR_DRG Percutaneous Structural Cardiac Procedures, Severe 3 3 — — $67,264.40 $67,264.40 $67,264.40 2026-08-19
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $41,487.08 $66,908.14 $66,908.14 2026-08-19
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 4 3 — — $47,819.06 $79,340.05 $66,894.06 2026-08-19
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $66,737.75 $66,737.75 $66,737.75 2026-08-19
6904 APR_DRG Acute Leukemia, Severe 3 3 — — $66,715.41 $66,715.41 $66,715.41 2026-08-19
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 4 3 — — $45,371.03 $78,926.70 $66,594.22 2026-08-19
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 4 3 — — $46,002.92 $85,689.11 $66,325.26 2026-08-19
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 1 1 — — $66,222.77 $66,222.77 $66,222.77 2026-08-19
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 4 3 — — $51,176.44 $74,414.57 $65,902.06 2026-08-19
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 4 3 — — $49,883.64 $72,994.30 $65,582.76 2026-08-19
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Severe 3 3 — — $65,454.95 $65,454.95 $65,454.95 2026-08-19
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 4 3 — — $46,166.22 $75,249.54 $65,408.88 2026-08-19
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 4 3 — — $38,363.55 $84,675.57 $65,231.20 2026-08-19
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 4 3 — — $35,331.07 $91,133.75 $65,186.96 2026-08-19
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly, Severe 3 3 — — $65,041.80 $65,041.80 $65,041.80 2026-08-19
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses, Se… 3 3 — — $64,802.93 $64,802.93 $64,802.93 2026-08-19
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures, Severe 3 3 — — $64,801.15 $64,801.15 $64,801.15 2026-08-19
33289 CPT Tcat Impl Wrls P-art Prs Snr 19 14 — — $16,548.40 $112,383.22 $64,465.81 2026-08-19
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 4 3 — — $45,109.54 $77,526.27 $64,101.34 2026-08-19
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly, Severe 3 3 — — $63,990.23 $63,990.23 $63,990.23 2026-08-19
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs, Severe 3 3 — — $63,803.37 $63,803.37 $63,803.37 2026-08-19
2324 APR_DRG Gastric Fundoplication, Severe 3 3 — — $63,687.76 $63,687.76 $63,687.76 2026-08-19
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 1 1 — — $63,582.28 $63,582.28 $63,582.28 2026-08-19
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 4 3 — — $49,944.13 $72,096.51 $63,541.30 2026-08-19
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma, Severe 3 3 — — $63,459.61 $63,459.61 $63,459.61 2026-08-19
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 4 3 — — $30,218.40 $86,806.81 $63,405.51 2026-08-19
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 4 3 — — $42,212.68 $76,076.24 $63,311.83 2026-08-19
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 4 3 — — $45,310.53 $74,553.46 $63,193.20 2026-08-19
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 3 2 — — $36,744.86 $62,642.37 $62,642.37 2026-08-19
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 4 3 — — $43,054.71 $74,416.23 $62,282.82 2026-08-19
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 4 3 — — $50,396.86 $64,423.08 $62,277.26 2026-08-19
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 3 3 — — $62,271.90 $62,271.90 $62,271.90 2026-08-19
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 1 — — $61,982.55 $61,982.55 $61,982.55 2026-08-19
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 4 3 — — $54,035.73 $68,745.07 $61,931.18 2026-08-19
214 APR_DRG Open Craniotomy Except Trauma, Severe 3 3 — — $61,692.38 $61,692.38 $61,692.38 2026-08-19
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 1 1 — — $61,367.36 $61,367.36 $61,367.36 2026-08-19
6954 APR_DRG Chemotherapy For Acute Leukemia, Severe 3 3 — — $60,881.89 $60,881.89 $60,881.89 2026-08-19
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Minor 3 3 — — $60,670.09 $60,670.09 $60,670.09 2026-08-19
10 MS_DRG Pancreas Transplant 3 2 — — $40,460.33 $60,592.15 $60,592.15 2026-08-19
799 MS_DRG Splenic Procedures With Mcc 4 3 — — $49,931.12 $69,836.31 $60,323.92 2026-08-19
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 4 3 — — $35,030.84 $78,071.89 $60,298.88 2026-08-19
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 4 3 — — $39,973.45 $73,126.58 $60,227.90 2026-08-19
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Severe 3 3 — — $60,092.81 $60,092.81 $60,092.81 2026-08-19
960T OTHER Replacement Of Sub-scalp Implanted Electrode Array, Receiver, And Telemetry Unit… 19 14 — — $13,736.49 $106,312.83 $60,024.66 2026-08-19
956T OTHER Partial Craniectomy, Channel Creation, And Tunneling Of Electrode For Sub-scalp … 19 14 — — $13,736.49 $106,312.83 $60,024.66 2026-08-19
1794 APR_DRG Defibrillator Implants, Severe 3 3 — — $59,789.99 $59,789.99 $59,789.99 2026-08-19
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 4 3 — — $44,690.96 $66,884.99 $59,306.04 2026-08-19
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 4 3 — — $37,193.68 $74,596.45 $59,260.57 2026-08-19
245 MS_DRG Aicd Generator Procedures 4 3 — — $47,575.13 $67,890.26 $59,095.36 2026-08-19
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Major 3 3 — — $58,909.67 $58,909.67 $58,909.67 2026-08-19
914 APR_DRG Other Major Head And Neck Procedures, Severe 3 3 — — $58,829.62 $58,829.62 $58,829.62 2026-08-19
1694 APR_DRG Major Abdominal Vascular Procedures, Severe 3 3 — — $58,795.35 $58,795.35 $58,795.35 2026-08-19
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 1 1 — — $58,758.84 $58,758.84 $58,758.84 2026-08-19
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection, Sev… 3 3 — — $58,521.28 $58,521.28 $58,521.28 2026-08-19
894 APR_DRG Major Cranial Or Facial Bone Procedures, Severe 3 3 — — $58,515.47 $58,515.47 $58,515.47 2026-08-19
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 4 3 — — $42,019.50 $67,800.97 $58,502.22 2026-08-19
J9266 HCPCS Pegaspargase Injection 29 15 — — $7,977.53 $109,006.27 $58,491.90 2026-08-19
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 4 3 — — $41,723.86 $68,662.40 $57,611.59 2026-08-19
471 MS_DRG Cervical Spinal Fusion With Mcc 4 3 — — $49,146.01 $61,387.44 $57,311.93 2026-08-19
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Majo… 3 3 — — $56,755.35 $56,755.35 $56,755.35 2026-08-19
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Major 3 3 — — $56,536.00 $56,536.00 $56,536.00 2026-08-19
274 APR_DRG Other Open Craniotomy, Severe 3 3 — — $56,400.52 $56,400.52 $56,400.52 2026-08-19
140 MS_DRG Major Head And Neck Procedures With Mcc 4 3 — — $40,553.02 $65,694.54 $56,359.74 2026-08-19
335 MS_DRG Peritoneal Adhesiolysis With Mcc 4 3 — — $35,942.84 $73,063.75 $56,216.46 2026-08-19
C9760 HCPCS Non-blind Interatrial Shunt 19 14 — — $6,721.44 $105,464.42 $56,092.93 2026-08-19
234 APR_DRG Spinal Procedures, Severe 3 3 — — $55,839.84 $55,839.84 $55,839.84 2026-08-19
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 4 3 — — $35,767.21 $70,165.34 $55,686.74 2026-08-19
204 APR_DRG Open Craniotomy For Trauma, Severe 3 3 — — $55,180.33 $55,180.33 $55,180.33 2026-08-19
224 APR_DRG Ventricular Shunt Procedures, Severe 3 3 — — $55,126.96 $55,126.96 $55,126.96 2026-08-19
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures, Severe 3 3 — — $55,023.57 $55,023.57 $55,023.57 2026-08-19
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses, Severe 3 3 — — $54,691.76 $54,691.76 $54,691.76 2026-08-19
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 3 3 — — $54,574.54 $54,574.54 $54,574.54 2026-08-19
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Moderate 3 3 — — $54,565.68 $54,565.68 $54,565.68 2026-08-19
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $46,458.25 $54,176.96 $54,176.96 2026-08-19
4414 APR_DRG Major Bladder Procedures, Severe 3 3 — — $54,082.10 $54,082.10 $54,082.10 2026-08-19
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 3 3 — — $53,934.64 $53,934.64 $53,934.64 2026-08-19
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $53,553.48 $53,553.48 $53,553.48 2026-08-19
1783 APR_DRG External Heart Assist Systems, Major 3 3 — — $53,524.45 $53,524.45 $53,524.45 2026-08-19
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 4 3 — — $39,792.95 $60,653.33 $53,417.43 2026-08-19
L5858 HCPCS Dme Pos 25 11 — — $19,175.09 $85,660.36 $52,417.72 2026-08-19
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 4 3 — — $44,301.66 $54,555.59 $52,341.48 2026-08-19
1204 APR_DRG Major Respiratory And Chest Procedures, Severe 3 3 — — $52,254.23 $52,254.23 $52,254.23 2026-08-19
31 MS_DRG Ventricular Shunt Procedures With Mcc 4 3 — — $40,208.60 $54,431.58 $51,914.54 2026-08-19
409T OTHER Insj/rplc Car Modulj Pls Gn 19 14 — — $16,548.40 $87,151.76 $51,850.08 2026-08-19
916T OTHER Insertion Of Permanent Cardiac Contractility Modulation-defibrillation System Co… 19 14 — — $16,548.40 $87,151.76 $51,850.08 2026-08-19
923T OTHER Removal And Replacement Of Permanent Cardiac Contractility Modulation-defibrilla… 19 14 — — $16,548.40 $87,151.76 $51,850.08 2026-08-19
414T OTHER Rmvl & Rpl Car Modulj Pls Gn 19 14 — — $16,548.40 $87,151.76 $51,850.08 2026-08-19
614T OTHER Rmvl&rplcmt Ss Impl Dfb Pg 19 14 — — $16,548.40 $87,151.76 $51,850.08 2026-08-19
34 MS_DRG Carotid Artery Stent Procedures With Mcc 4 3 — — $39,022.15 $60,808.75 $51,741.61 2026-08-19
332 MS_DRG Rectal Resection With Mcc 4 3 — — $39,616.35 $63,555.04 $51,736.63 2026-08-19
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Moderate 3 3 — — $51,584.81 $51,584.81 $51,584.81 2026-08-19
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Minor 3 3 — — $51,584.81 $51,584.81 $51,584.81 2026-08-19
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 4 3 — — $30,315.00 $67,338.02 $51,501.40 2026-08-19
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 4 3 — — $31,819.53 $65,385.36 $51,474.32 2026-08-19
1814 APR_DRG Lower Extremity Arterial Procedures, Severe 3 3 — — $51,220.51 $51,220.51 $51,220.51 2026-08-19
8412 APR_DRG Extensive Third Degree Burns With Skin Graft, Moderate 3 3 — — $51,188.45 $51,188.45 $51,188.45 2026-08-19
8411 APR_DRG Extensive Third Degree Burns With Skin Graft, Minor 3 3 — — $51,188.45 $51,188.45 $51,188.45 2026-08-19
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 4 3 — — $34,600.27 $61,205.56 $51,031.00 2026-08-19
2614 APR_DRG Major Biliary Tract Procedures, Severe 3 3 — — $50,924.89 $50,924.89 $50,924.89 2026-08-19
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 1 1 — — $50,918.96 $50,918.96 $50,918.96 2026-08-19
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures, Severe 3 3 — — $50,758.85 $50,758.85 $50,758.85 2026-08-19
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 4 3 — — $38,144.99 $54,879.65 $50,680.53 2026-08-19
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 4 3 — — $38,528.44 $57,928.52 $50,528.61 2026-08-19
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 4 3 — — $32,206.88 $66,124.43 $50,423.83 2026-08-19
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices, Sev… 3 3 — — $50,414.48 $50,414.48 $50,414.48 2026-08-19
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $50,221.76 $50,221.76 $50,221.76 2026-08-19
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 4 3 — — $41,198.93 $51,972.98 $50,201.80 2026-08-19
570 MS_DRG Skin Debridement With Mcc 4 3 — — $28,462.14 $67,948.13 $50,186.88 2026-08-19
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 4 3 — — $39,408.86 $57,768.14 $49,691.85 2026-08-19
L5973 HCPCS Dme Pos 25 11 — — $18,137.37 $81,024.58 $49,580.97 2026-08-19
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Major 3 3 — — $49,383.44 $49,383.44 $49,383.44 2026-08-19
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures, Sev… 3 3 — — $49,264.79 $49,264.79 $49,264.79 2026-08-19
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Severe 3 3 — — $49,185.64 $49,185.64 $49,185.64 2026-08-19
791 MS_DRG Prematurity With Major Problems 3 2 — — $40,121.76 $49,140.70 $49,140.70 2026-08-19
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Moderate 3 3 — — $49,080.36 $49,080.36 $49,080.36 2026-08-19
8434 APR_DRG Extensive Third Degree Burns Without Skin Graft, Severe 3 3 — — $49,079.60 $49,079.60 $49,079.60 2026-08-19
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment, Severe 3 3 — — $49,063.27 $49,063.27 $49,063.27 2026-08-19
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders, Severe 3 3 — — $48,986.70 $48,986.70 $48,986.70 2026-08-19
L8614 HCPCS Dme Pos 16 12 — — $9,740.55 $88,199.32 $48,969.93 2026-08-19
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 4 3 — — $34,090.96 $51,409.17 $48,865.90 2026-08-19
652 MS_DRG Kidney Transplant 3 2 — — $30,101.32 $48,818.29 $48,818.29 2026-08-19
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 4 3 — — $35,562.31 $56,141.20 $48,614.58 2026-08-19
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 4 3 — — $39,154.84 $51,399.25 $48,441.44 2026-08-19
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Major 3 3 — — $48,343.02 $48,343.02 $48,343.02 2026-08-19
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 4 3 — — $35,803.31 $56,987.74 $48,149.24 2026-08-19
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Major 3 3 — — $48,121.12 $48,121.12 $48,121.12 2026-08-19
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 4 3 — — $36,730.23 $57,579.66 $48,014.12 2026-08-19
Q0483 HCPCS Dme Pos 26 12 — — $9,543.78 $86,417.58 $47,980.68 2026-08-19
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 1 1 — — $47,709.59 $47,709.59 $47,709.59 2026-08-19
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Major 3 3 — — $47,598.24 $47,598.24 $47,598.24 2026-08-19
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Mode… 3 3 — — $47,498.65 $47,498.65 $47,498.65 2026-08-19
2304 APR_DRG Major Small Bowel Procedures, Severe 3 3 — — $47,483.13 $47,483.13 $47,483.13 2026-08-19
264 APR_DRG Other Nervous System And Related Procedures, Severe 3 3 — — $47,128.97 $47,128.97 $47,128.97 2026-08-19
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 4 3 — — $37,717.63 $51,834.09 $47,081.18 2026-08-19
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 4 3 — — $34,488.07 $54,803.60 $47,040.63 2026-08-19
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 3 3 — — $46,949.29 $46,949.29 $46,949.29 2026-08-19
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 1 1 — — $46,754.82 $46,754.82 $46,754.82 2026-08-19
515T OTHER Insj Wcs Lv Compl Sys 19 14 — — $5,519.28 $87,151.76 $46,335.52 2026-08-19
1833 APR_DRG Percutaneous Structural Cardiac Procedures, Major 3 3 — — $46,258.96 $46,258.96 $46,258.96 2026-08-19
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure, Severe 3 3 — — $46,027.73 $46,027.73 $46,027.73 2026-08-19
L6975 HCPCS Dme Pos 25 11 — — $16,795.04 $75,027.98 $45,911.51 2026-08-19
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 4 3 — — $34,866.64 $52,439.23 $45,620.31 2026-08-19
1782 APR_DRG External Heart Assist Systems, Moderate 3 3 — — $45,597.33 $45,597.33 $45,597.33 2026-08-19
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure, Severe 3 3 — — $45,556.04 $45,556.04 $45,556.04 2026-08-19
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 4 3 — — $36,963.42 $48,509.10 $45,539.42 2026-08-19
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