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

Your selected procedure

You selected 93458 (CPT)

L HRT ARTERY/VENTRICLE ANGIO

This hospital’s price: $6,860 across 8 payers · range $378-$12,702

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

364,342 of 922,034 rate rows are consumer-grade (39.5%)

557,692 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 249
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 success · 2026-09-21
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 $476,090.37 nat. median
$168,055
outlier · 2.8×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $274,621.50 $457,236.20 $365,928.85 nat. median
$186,516
2.0× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 11 $364,635.75 $364,635.75 $364,635.75 nat. median
$95,583
outlier · 3.8×
5834
APR_DRG 		Neonate With Ecmo, Severe 3 $359,163.54 $359,163.54 $359,163.54 nat. median
$390,362
0.9× median
5833
APR_DRG 		Neonate With Ecmo, Major 3 $288,533.35 $288,533.35 $288,533.35 nat. median
$268,208
1.1× 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
$286,698
1.0× median
L8702
HCPCS 		Ewhf S/d Uprt Micro Sensor 11 $263,854.56 $263,854.56 $263,854.56 nat. median
$68,802
outlier · 3.8×
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $235,389.26 $256,401.01 $245,895.14 nat. median
$131,925
1.9× median
Q0480
HCPCS 		Dme Pos 12 $43,199.96 $415,113.25 $229,156.61 nat. median
$108,243
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
$145,435
1.5× median
1614
APR_DRG 		Implantable Heart Assist Systems, Severe 3 $220,271.76 $220,271.76 $220,271.76 nat. median
$202,242
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
$173,018
1.1× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $131,457.04 $263,603.22 $197,530.13 nat. median
$65,418
outlier · 3.0×
5832
APR_DRG 		Neonate With Ecmo, Moderate 3 $195,774.10 $195,774.10 $195,774.10 nat. median
$201,678
1.0× 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
$171,497
1.1× median
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
$198,578
1.0× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $109,210.10 $266,313.14 $187,761.62 nat. median
$72,715
outlier · 2.6×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Major 3 $173,420.75 $173,420.75 $173,420.75 nat. median
$173,134
1.0× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo), Severe 3 $171,269.70 $171,269.70 $171,269.70 nat. median
$152,792
1.1× 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
$181,762
0.9× 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
$187,567
0.9× 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
$168,439
1.0× median
5831
APR_DRG 		Neonate With Ecmo, Minor 3 $154,685.38 $154,685.38 $154,685.38 nat. median
$173,909
0.9× median
7
MS_DRG 		Lung Transplant 2 $119,106.63 $189,289.50 $154,198.07 nat. median
$70,649
outlier · 2.2×
1613
APR_DRG 		Implantable Heart Assist Systems, Major 3 $153,568.89 $153,568.89 $153,568.89 nat. median
$155,539
1.0× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 $133,980.20 $184,878.23 $152,711.69 nat. median
$97,418
1.6× 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
$115,963
1.3× 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
$135,630
1.1× median
L2006
HCPCS 		Dme Pos 11 $149,712.38 $149,712.38 $149,712.38 nat. median
$38,763
outlier · 3.9×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $111,298.10 $181,535.05 $146,416.58 nat. median
$69,922
outlier · 2.1×
453
MS_DRG 		Combined Anterior And Posterior Spinal Fusion With Mcc 2 $89,323.38 $193,727.22 $141,525.30 nat. median
$2,106
outlier · 67.2×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 6 $30,058.57 $2,269,269.98 $137,204.04 nat. median
$621,313
outlier · 0.2×
Q2056
HCPCS 		Ciltacabtagene Car-pos T 6 $30,058.57 $2,170,107.40 $134,114.04 nat. median
$599,737
outlier · 0.2×
L8701
HCPCS 		Ewh S/d Uprt Micro Sensor 11 $134,110.45 $134,110.45 $134,110.45 nat. median
$34,970
outlier · 3.8×
J9029
HCPCS 		Instill Adstiladrin, Tx Dose 15 $18,978.98 $242,917.65 $130,948.32 nat. median
$66,211
2.0× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 6 $30,058.57 $2,137,314.28 $129,144.77 nat. median
$574,037
outlier · 0.2×
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 6 $30,058.57 $2,157,333.94 $126,590.26 nat. median
$579,571
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
$124,731
1.0× median
A9543
HCPCS 		Y90 Ibritumomab, Rx 15 $26,481.32 $217,922.15 $122,201.74 nat. median
$65,477
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
$2,736
outlier · 44.4×
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 6 $30,058.57 $2,044,937.71 $120,764.99 nat. median
$562,501
outlier · 0.2×
Q2053
HCPCS 		Brexucabtagene Car Pos T 6 $30,058.57 $1,876,483.17 $120,448.42 nat. median
$513,770
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
$99,483
1.2× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 1 $119,886.95 $119,886.95 $119,886.95 nat. median
$74,509
1.6× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 3 $115,724.32 $115,724.32 $115,724.32 nat. median
$96,548
1.2× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 15 $18,978.98 $211,969.36 $115,474.17 nat. median
$63,499
1.8× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure, Major 3 $115,439.52 $115,439.52 $115,439.52 nat. median
$120,079
1.0× median
L6700
HCPCS 		Upper Extremity Addition, External Powered Feature, Myoelectronic Control Module… 11 $113,171.58 $113,171.58 $113,171.58 nat. median
$30,100
outlier · 3.8×
L7181
HCPCS 		Dme Pos 11 $41,339.84 $184,676.34 $113,008.09 nat. median
$48,410
outlier · 2.3×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure, Major 3 $111,677.30 $111,677.30 $111,677.30 nat. median
$114,205
1.0× 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 3 3 — — $352,668.72 $614,092.60 $476,090.37 2026-08-19
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $274,621.50 $457,236.20 $365,928.85 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
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 16 11 — — $263,854.56 $263,854.56 $263,854.56 2026-08-19
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 2 — — $235,389.26 $256,401.01 $245,895.14 2026-08-19
Q0480 HCPCS Dme Pos 17 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… 3 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
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $131,457.04 $263,603.22 $197,530.13 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
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
14 MS_DRG Allogeneic Bone Marrow Transplant 2 2 — — $109,210.10 $266,313.14 $187,761.62 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
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
7 MS_DRG Lung Transplant 2 2 — — $119,106.63 $189,289.50 $154,198.07 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
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 3 3 — — $133,980.20 $184,878.23 $152,711.69 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
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $111,298.10 $181,535.05 $146,416.58 2026-08-19
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 2 — — $89,323.38 $193,727.22 $141,525.30 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
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
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
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
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
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 16 11 — — $41,339.84 $184,676.34 $113,008.09 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
215 MS_DRG Other Heart Assist System Implant 3 3 — — $100,528.32 $245,114.90 $109,775.93 2026-08-19
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $95,051.72 $122,981.55 $107,855.37 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
1612 APR_DRG Implantable Heart Assist Systems, Moderate 3 3 — — $107,559.50 $107,559.50 $107,559.50 2026-08-19
L7180 HCPCS Dme Pos 16 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
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
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $74,705.45 $132,648.98 $103,677.21 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
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
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
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 2 — — $59,365.49 $133,746.83 $96,556.16 2026-08-19
J9226 HCPCS Supprelin La Implant 20 15 — — $18,978.98 $172,654.19 $95,816.59 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 — — $81,892.45 $117,151.66 $92,939.65 2026-08-19
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $82,438.84 $140,221.55 $92,647.49 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
454 MS_DRG Combined Anterior And Posterior Spinal Fusion With Cc 2 2 — — $59,428.91 $124,458.03 $91,943.47 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
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $69,169.32 $112,619.69 $90,894.51 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
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 3 3 — — $86,753.52 $151,783.77 $90,772.30 2026-08-19
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $84,009.40 $95,478.89 $89,744.14 2026-08-19
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 2 2 — — $62,453.58 $110,303.27 $86,378.43 2026-08-19
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 2 — — $64,718.18 $106,768.31 $85,743.24 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
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $79,307.82 $104,744.54 $84,653.26 2026-08-19
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 3 3 — — $75,566.99 $106,798.07 $84,288.33 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
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
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
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 2 — — $58,747.87 $105,078.53 $81,913.20 2026-08-19
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $74,210.38 $89,232.34 $81,721.36 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
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 2 — — $79,079.02 $82,608.82 $80,843.92 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
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
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 3 3 — — $69,612.29 $110,118.09 $78,658.97 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
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $50,918.86 $102,831.56 $76,875.21 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
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 3 3 — — $66,258.81 $95,227.57 $76,202.60 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
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 3 — — $67,526.25 $107,937.26 $75,828.85 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
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
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
455 MS_DRG Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 2 2 — — $46,716.52 $99,943.07 $73,329.79 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
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $57,943.90 $85,988.37 $72,492.68 2026-08-19
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 3 3 — — $61,945.24 $100,741.66 $72,492.68 2026-08-19
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $57,278.47 $78,834.11 $72,229.19 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
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $49,347.98 $93,718.02 $71,533.00 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
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 3 3 — — $64,063.49 $123,545.35 $70,942.57 2026-08-19
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 3 3 — — $67,487.33 $96,454.40 $70,714.83 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
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
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
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
L5856 HCPCS Dme Pos 16 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
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 3 — — $64,403.03 $137,543.04 $67,565.61 2026-08-19
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 2 — — $54,552.36 $80,279.18 $67,415.77 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
227 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization Without Mcc 2 2 — — $48,986.97 $84,726.83 $66,856.90 2026-08-19
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 — — $57,154.55 $90,156.60 $66,840.17 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
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 3 — — $58,364.15 $113,560.47 $66,242.22 2026-08-19
28 MS_DRG Spinal Procedures With Mcc 3 3 — — $57,346.77 $77,774.28 $66,241.51 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
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $58,901.06 $108,013.32 $65,743.18 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
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
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 3 3 — — $58,444.43 $89,276.99 $64,701.32 2026-08-19
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 3 3 — — $51,883.82 $99,971.18 $64,659.42 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
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
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
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $55,921.27 $81,550.65 $63,176.56 2026-08-19
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 3 — — $51,142.29 $90,634.43 $62,836.99 2026-08-19
6 MS_DRG Liver Transplant Without Mcc 2 2 — — $46,924.34 $78,549.73 $62,737.03 2026-08-19
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 3 3 — — $60,891.08 $75,988.61 $62,593.11 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
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
834 MS_DRG Acute Leukemia With Mcc 3 3 — — $53,956.21 $110,891.88 $60,526.15 2026-08-19
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 3 3 — — $54,072.32 $79,328.48 $60,312.26 2026-08-19
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 2 2 — — $42,933.56 $77,539.50 $60,236.53 2026-08-19
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 3 3 — — $50,602.73 $74,968.46 $60,226.27 2026-08-19
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 3 3 — — $50,396.86 $64,423.08 $60,131.45 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
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
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $53,030.27 $78,759.71 $58,794.12 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
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 2 — — $42,639.07 $74,836.19 $58,737.63 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
J9266 HCPCS Pegaspargase Injection 20 15 — — $7,977.53 $109,006.27 $58,491.90 2026-08-19
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 — — $49,883.64 $72,994.30 $58,171.21 2026-08-19
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 3 — — $51,176.44 $74,414.57 $57,389.54 2026-08-19
653 MS_DRG Major Bladder Procedures With Mcc 3 3 — — $54,216.72 $95,602.89 $57,290.31 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
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
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 3 — — $46,166.22 $75,249.54 $55,568.21 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
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 3 — — $54,035.73 $68,745.07 $55,117.29 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
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 3 3 — — $49,944.13 $72,096.51 $54,986.09 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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 3 — — $48,085.42 $97,932.54 $54,545.09 2026-08-19
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 3 — — $47,819.06 $79,340.05 $54,448.07 2026-08-19
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 3 — — $45,371.03 $78,926.70 $54,261.74 2026-08-19
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $41,487.08 $66,908.14 $54,197.61 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
471 MS_DRG Cervical Spinal Fusion With Mcc 3 3 — — $49,146.01 $61,387.44 $53,236.42 2026-08-19
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 3 — — $52,514.13 $87,838.53 $52,967.41 2026-08-19
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 3 — — $50,351.97 $96,093.95 $52,487.82 2026-08-19
L5858 HCPCS Dme Pos 16 11 — — $19,175.09 $85,660.36 $52,417.72 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
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
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
409T OTHER Insj/rplc Car Modulj Pls Gn 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
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 3 3 — — $45,310.53 $74,553.46 $51,832.94 2026-08-19
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 3 — — $44,690.96 $66,884.99 $51,727.10 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
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
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 3 — — $50,169.52 $83,346.24 $51,572.75 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
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
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
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
799 MS_DRG Splenic Procedures With Mcc 3 3 — — $49,931.12 $69,836.31 $50,811.53 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
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 3 — — $45,109.54 $77,526.27 $50,676.41 2026-08-19
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 3 — — $42,212.68 $76,076.24 $50,547.42 2026-08-19
10 MS_DRG Pancreas Transplant 2 2 — — $40,460.33 $60,592.15 $50,526.24 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
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 2 — — $46,458.25 $54,176.96 $50,317.60 2026-08-19
245 MS_DRG Aicd Generator Procedures 3 3 — — $47,575.13 $67,890.26 $50,300.46 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
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 3 — — $43,054.71 $74,416.23 $50,149.42 2026-08-19
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 3 — — $44,301.66 $54,555.59 $50,127.37 2026-08-19
460 MS_DRG Spinal Fusion Except Cervical Without Mcc 2 2 — — $36,744.86 $62,642.37 $49,693.62 2026-08-19
L5973 HCPCS Dme Pos 16 11 — — $18,137.37 $81,024.58 $49,580.97 2026-08-19
163 MS_DRG Major Chest Procedures With Mcc 3 3 — — $47,259.98 $88,972.76 $49,411.85 2026-08-19
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 3 — — $40,208.60 $54,431.58 $49,397.51 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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 3 — — $42,019.50 $67,800.97 $49,203.47 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
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
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 3 — — $41,198.93 $51,972.98 $48,430.62 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
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
Q0483 HCPCS Dme Pos 17 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
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 3 — — $39,973.45 $73,126.58 $47,329.22 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
140 MS_DRG Major Head And Neck Procedures With Mcc 3 3 — — $40,553.02 $65,694.54 $47,024.93 2026-08-19
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 3 3 — — $46,002.92 $85,689.11 $46,961.42 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
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 — — $41,723.86 $68,662.40 $46,560.78 2026-08-19
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 3 3 — — $38,144.99 $54,879.65 $46,481.40 2026-08-19
515T OTHER Insj Wcs Lv Compl Sys 19 14 — — $5,519.28 $87,151.76 $46,335.52 2026-08-19
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 3 — — $34,090.96 $51,409.17 $46,322.64 2026-08-19
901 MS_DRG Wound Debridements For Injuries With Mcc 3 3 — — $42,917.14 $103,109.33 $46,267.52 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
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 3 — — $39,792.95 $60,653.33 $46,181.52 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 16 11 — — $16,795.04 $75,027.98 $45,911.51 2026-08-19
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 3 — — $38,363.55 $84,675.57 $45,786.83 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
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $45,494.82 $45,494.82 $45,494.82 2026-08-19
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 3 — — $39,154.84 $51,399.25 $45,483.64 2026-08-19
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Moderate 3 3 — — $45,406.63 $45,406.63 $45,406.63 2026-08-19
92 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Moderate 3 3 — — $45,380.29 $45,380.29 $45,380.29 2026-08-19
91 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo), Minor 3 3 — — $45,380.29 $45,380.29 $45,380.29 2026-08-19
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Major 3 3 — — $45,290.11 $45,290.11 $45,290.11 2026-08-19
54417 CPT Remv/replc Penis Pros Compl 19 14 — — $9,136.07 $81,206.28 $45,171.18 2026-08-19
54411 CPT Remov/replc Penis Pros Comp 19 14 — — $9,136.07 $81,206.28 $45,171.18 2026-08-19
816T OTHER Opn Insj/rplcmt Ins Ptn Subq 19 14 — — $13,736.49 $76,010.89 $44,873.69 2026-08-19
817T OTHER Opn Insj/rplcmt Ins Ptn Subf 19 14 — — $13,736.49 $76,010.89 $44,873.69 2026-08-19
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures, Severe 3 3 — — $44,865.36 $44,865.36 $44,865.36 2026-08-19
791 MS_DRG Prematurity With Major Problems 2 2 — — $40,121.76 $49,140.70 $44,631.23 2026-08-19
5484 APR_DRG Postpartum And Post Abortion Diagnosis With O.r. Procedure, Severe 3 3 — — $44,598.23 $44,598.23 $44,598.23 2026-08-19
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures, Severe 3 3 — — $44,382.23 $44,382.23 $44,382.23 2026-08-19
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 1 1 — — $44,326.01 $44,326.01 $44,326.01 2026-08-19
294 APR_DRG Other Percutaneous Intracranial Procedures, Severe 3 3 — — $44,301.06 $44,301.06 $44,301.06 2026-08-19
1793 APR_DRG Defibrillator Implants, Major 3 3 — — $44,166.45 $44,166.45 $44,166.45 2026-08-19
4804 APR_DRG Major Male Pelvic Procedures, Severe 3 3 — — $43,933.80 $43,933.80 $43,933.80 2026-08-19
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 3 — — $37,193.68 $74,596.45 $43,924.70 2026-08-19
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Moderate 3 3 — — $43,901.88 $43,901.88 $43,901.88 2026-08-19
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures, Severe 3 3 — — $43,757.21 $43,757.21 $43,757.21 2026-08-19
L5859 HCPCS Dme Pos 16 11 — — $15,863.68 $70,867.39 $43,365.54 2026-08-19
1824 APR_DRG Other Peripheral Vascular And Related Procedures, Severe 3 3 — — $43,233.36 $43,233.36 $43,233.36 2026-08-19
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Maj… 3 3 — — $43,231.96 $43,231.96 $43,231.96 2026-08-19
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 3 — — $38,528.44 $57,928.52 $43,128.70 2026-08-19
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