Price Transparency 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

CARLE BROMENN MEDICAL CENTER

Normal, IL · CCN 140127 · Rates published

19,292 distinct procedures filed
13 distinct payers
438,292 rate rows
2026-04-15 last MRF observed
Data quality

419,456 of 438,292 rate rows are consumer-grade (95.7%)

18,836 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 15,727
placeholder amount (≤ $0.02) — excluded from medians 2,950
percent-of-charges filed in the dollar field — excluded from medians 101
per-diem day rate — not a per-procedure price 54
exceeds 10× this hospital's gross charge — excluded from medians 4
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11475/850682363_carle-bromenn-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/CarleBroMennMedicalCenter/11475
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint ae0aea66459d90fe… · 473,869,492 bytes · first seen 2026-05-08

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 $4,505,000.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 7 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,327,859.73 $3,327,859.73 $3,327,859.73 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,252,508.08 $3,252,508.08 $3,252,508.08 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 7 $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 7 $2,939,968.89 $2,939,968.89 $2,939,968.89 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $104,498.96 $2,588,981.23 $2,588,981.23 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $770,620.00 $770,620.00 $770,620.00 nat. median
$824,563
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 8 $526,846.12 $587,649.57 $587,649.57 nat. median
$675,122
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 8 $489,521.37 $566,531.30 $566,531.30 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 8 $501,865.93 $562,201.24 $562,201.24 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 8 $512,460.88 $558,081.73 $558,081.73 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 8 $476,302.36 $532,192.24 $532,192.24 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 8 $476,406.40 $490,698.59 $489,450.20 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $341,308.78 $870,565.25 $341,308.78 nat. median
$370,174
0.9× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $278,250.00 $278,250.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 7 $265,000.00 $265,000.00 $265,000.00 nat. median
$265,000
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $221,726.73 $564,961.82 $221,726.73 nat. median
$265,286
0.8× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 7 $201,669.02 $201,669.02 $201,669.02 nat. median
$209,753
1.0× median
5834
APR_DRG 		Neonate W Ecmo 4 $185,653.60 $185,653.60 $185,653.60 nat. median
$309,665
0.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 10 $169,083.14 $430,426.08 $169,083.14 nat. median
$206,368
0.8× median
5833
APR_DRG 		Neonate W Ecmo 4 $168,776.11 $168,776.11 $168,776.11 nat. median
$244,017
0.7× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 10 $168,094.71 $427,900.03 $168,094.71 nat. median
$202,986
0.8× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $152,009.25 $152,009.25 $152,009.25 nat. median
$246,434
0.6× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $125,613.29 $125,613.29 $125,613.29 nat. median
$164,279
0.8× median
24
APR_DRG 		Heart &/or Lung Transplant 4 $122,810.80 $122,810.80 $122,810.80 nat. median
$234,738
0.5× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 4 $113,407.27 $113,407.27 $113,407.27 nat. median
$162,982
0.7× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 4 $113,390.46 $113,390.46 $113,390.46 nat. median
$187,294
0.6× median
5891
APR_DRG 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 $112,507.37 $112,507.37 $112,507.37 nat. median
$93,260
1.2× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 8 $50,709.24 $110,901.76 $110,901.76 nat. median
$111,989
1.0× median
Q2043
HCPCS 		Provenge 50 Million Cell/250 Ml Intravenous Suspension 13 $28,953.70 $217,152.77 $110,168.84 nat. median
$66,682
1.7× median
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 10 $109,925.95 $279,244.22 $109,925.95 nat. median
$133,176
0.8× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 4 $109,693.94 $109,693.94 $109,693.94 nat. median
$151,838
0.7× median
7
MS_DRG 		Lung Transplant 10 $102,816.78 $261,076.03 $102,816.78 nat. median
$122,708
0.8× median
5832
APR_DRG 		Neonate W Ecmo 4 $99,495.67 $99,495.67 $99,495.67 nat. median
$156,126
0.6× median
5831
APR_DRG 		Neonate W Ecmo 4 $99,281.84 $99,281.84 $99,281.84 nat. median
$145,122
0.7× median
5913
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $97,254.14 $97,254.14 $97,254.14 nat. median
$102,636
0.9× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 4 $96,644.31 $96,644.31 $96,644.31 nat. median
$207,730
outlier · 0.5×
14
MS_DRG 		Allogeneic Bone Marrow Transplant 10 $95,462.25 $242,280.86 $95,462.25 nat. median
$117,303
0.8× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $95,146.70 $95,146.70 $95,146.70 nat. median
$182,736
0.5× median
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 7 $95,081.03 $95,081.03 $95,081.03 nat. median
$96,983
1.0× median
6024
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 $93,533.39 $93,533.39 $93,533.39 nat. median
$118,620
0.8× median
5912
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $90,508.46 $90,508.46 $90,508.46 nat. median
$81,294
1.1× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $90,214.49 $90,214.49 $90,214.49 nat. median
$164,834
0.5× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 10 $90,049.90 $228,449.09 $90,049.90 nat. median
$108,660
0.8× median
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 $90,048.35 $90,048.35 $90,048.35 nat. median
$150,721
0.6× median
209
MS_DRG 		Complex Aortic Arch Procedures 10 $89,947.37 $228,187.01 $89,947.37 nat. median
$98,017
0.9× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 4 $88,934.24 $88,934.24 $88,934.24 nat. median
$129,535
0.7× median

Other procedures at this hospital

Browse this hospital's 19,292 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
             
64654 CPT 1st Opn Implt Bat Modulj Sys 8 7 — — $47,201.02 $47,201.02 $47,201.02 2026-04-15
6904 APR_DRG Acute Leukemia 4 4 — — $38,105.51 $38,105.51 $38,105.51 2026-04-15
834 MS_DRG Acute Leukemia With Mcc 15 10 — — $43,965.65 $110,676.38 $43,965.65 2026-04-15
850 MS_DRG Acute Leukemia With Other Procedures 15 10 — — $68,969.26 $174,575.52 $68,969.26 2026-04-15
J9029 HCPCS Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension 48 13 $34,713.00 $34,713.00 $3,471.30 $104,139.00 $34,440.93 2026-04-15
Q2057 HCPCS Afamitresgene Autoleucel 8 7 — — $770,620.00 $770,620.00 $770,620.00 2026-04-15
245 MS_DRG Aicd Generator Procedures 15 10 — — $36,649.01 $91,977.98 $36,649.01 2026-04-15
74 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $113,390.46 $113,390.46 $113,390.46 2026-04-15
14 MS_DRG Allogeneic Bone Marrow Transplant 15 10 — — $95,462.25 $242,280.86 $95,462.25 2026-04-15
73 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $68,061.56 $68,061.56 $68,061.56 2026-04-15
72 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $54,673.40 $54,673.40 $54,673.40 2026-04-15
71 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $43,724.57 $43,724.57 $43,724.57 2026-04-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 15 10 — — $39,483.38 $99,221.47 $39,483.38 2026-04-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 15 10 — — $34,523.03 $86,544.86 $34,523.03 2026-04-15
J9028 HCPCS Anktiva 400 Mcg/0.4 Ml Intravesical Solution 31 12 $81,624.00 $81,624.00 $94.73 $61,218.00 $31,057.93 2026-04-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 15 10 — — $54,915.01 $138,658.46 $54,915.01 2026-04-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 15 10 — — $33,973.20 $85,139.71 $33,973.20 2026-04-15
84 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $58,674.84 $58,674.84 $58,674.84 2026-04-15
83 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $36,604.00 $36,604.00 $36,604.00 2026-04-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 15 10 — — $47,435.05 $119,542.75 $47,435.05 2026-04-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 15 10 — — $43,511.27 $109,515.17 $43,511.27 2026-04-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 10 8 — — $476,302.36 $532,192.24 $532,192.24 2026-04-15
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 8 7 — — $95,081.03 $95,081.03 $95,081.03 2026-04-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 15 10 — — $44,226.76 $111,343.68 $44,226.76 2026-04-15
90288 CPT Botulism Ig IV 3 3 — — $27.17 $50,166.15 $48,705.00 2026-04-15
Q2053 HCPCS Brexucabtagene Car Pos T 10 8 — — $476,406.40 $490,698.59 $489,450.20 2026-04-15
8424 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 4 4 — — $54,603.82 $54,603.82 $54,603.82 2026-04-15
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 4 4 — — $96,644.31 $96,644.31 $96,644.31 2026-04-15
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 4 4 — — $42,284.43 $42,284.43 $42,284.43 2026-04-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 15 10 — — $56,906.87 $143,748.86 $56,906.87 2026-04-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 15 10 — — $48,041.68 $121,093.06 $48,041.68 2026-04-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 15 10 — — $37,091.56 $93,108.96 $37,091.56 2026-04-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 10 — — $77,830.52 $197,221.25 $77,830.52 2026-04-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 10 — — $52,527.91 $132,558.05 $52,527.91 2026-04-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 15 10 — — $52,527.91 $132,558.05 $52,527.91 2026-04-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 10 — — $61,229.01 $154,794.53 $61,229.01 2026-04-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 10 — — $42,726.37 $107,509.25 $42,726.37 2026-04-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 15 10 — — $40,418.16 $101,610.43 $40,418.16 2026-04-15
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 4 4 — — $58,580.24 $58,580.24 $58,580.24 2026-04-15
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 4 4 — — $37,037.92 $37,037.92 $37,037.92 2026-04-15
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 4 4 — — $48,110.67 $48,110.67 $48,110.67 2026-04-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 15 10 — — $31,192.48 $78,033.31 $31,192.48 2026-04-15
471 MS_DRG Cervical Spinal Fusion With Mcc 15 10 — — $38,749.74 $97,346.59 $38,749.74 2026-04-15
6954 APR_DRG Chemotherapy For Acute Leukemia 4 4 — — $37,391.70 $37,391.70 $37,391.70 2026-04-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 15 10 — — $38,557.23 $96,854.69 $38,557.23 2026-04-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 15 10 — — $341,308.78 $870,565.25 $341,308.78 2026-04-15
Q2056 HCPCS Ciltacabtagene Car-pos T 10 8 — — $526,846.12 $587,649.57 $587,649.57 2026-04-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 15 10 — — $71,731.06 $181,633.54 $71,731.06 2026-04-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 15 10 — — $46,152.38 $116,264.74 $46,152.38 2026-04-15
209 MS_DRG Complex Aortic Arch Procedures 15 10 — — $89,947.37 $228,187.01 $89,947.37 2026-04-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 15 10 — — $86,439.29 $219,221.86 $86,439.29 2026-04-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 15 10 — — $53,405.15 $134,799.84 $53,405.15 2026-04-15
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 4 4 — — $42,563.15 $42,563.15 $42,563.15 2026-04-15
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 4 4 — — $38,114.90 $38,114.90 $38,114.90 2026-04-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 15 10 — — $60,967.89 $154,127.23 $60,967.89 2026-04-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 15 10 — — $43,751.09 $110,128.03 $43,751.09 2026-04-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 15 10 — — $67,158.07 $169,946.78 $67,158.07 2026-04-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 15 10 — — $48,483.45 $122,222.02 $48,483.45 2026-04-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 15 10 — — $46,953.07 $118,310.98 $46,953.07 2026-04-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 15 10 — — $33,701.84 $84,446.21 $33,701.84 2026-04-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 15 10 — — $34,795.19 $87,240.38 $34,795.19 2026-04-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 15 10 — — $36,525.16 $91,661.47 $36,525.16 2026-04-15
214 APR_DRG Craniotomy Except For Trauma 4 4 — — $31,480.24 $31,480.24 $31,480.24 2026-04-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 15 10 — — $53,756.96 $135,698.98 $53,756.96 2026-04-15
9104 APR_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $41,474.45 $41,474.45 $41,474.45 2026-04-15
204 APR_DRG Craniotomy For Trauma 4 4 — — $32,620.15 $32,620.15 $32,620.15 2026-04-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 15 10 — — $45,862.08 $115,522.85 $45,862.08 2026-04-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 15 10 — — $31,517.49 $78,863.90 $31,517.49 2026-04-15
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $43,088.81 $55,541.88 $53,924.16 2026-04-15
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 4 4 — — $42,686.29 $42,686.29 $42,686.29 2026-04-15
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 4 4 — — $53,104.65 $53,104.65 $53,104.65 2026-04-15
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 4 4 — — $41,480.31 $41,480.31 $41,480.31 2026-04-15
Q0480 HCPCS Driver Pneumatic Vad, Rep 10 8 — — $50,709.24 $110,901.76 $110,901.76 2026-04-15
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 15 10 — — $168,094.71 $427,900.03 $168,094.71 2026-04-15
E0766 HCPCS Elec Stim Cancer Treatment 2 2 — — $79,505.09 $81,890.24 $80,697.67 2026-04-15
L7181 HCPCS Electronic Elbo Simultaneous 10 8 — — $25,782.42 $49,338.18 $49,338.18 2026-04-15
L7180 HCPCS Electronic Elbow Sequential 10 8 — — $25,041.32 $47,919.99 $47,919.99 2026-04-15
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 15 10 — — $45,677.49 $115,051.10 $45,677.49 2026-04-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 15 10 — — $49,002.51 $123,548.54 $49,002.51 2026-04-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 15 10 — — $38,214.12 $95,977.73 $38,214.12 2026-04-15
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 10 8 — — $3,895.33 $47,201.02 $47,201.02 2026-04-15
L8701 HCPCS Ewh S/d Uprt Micro Sensor 10 8 — — $18,749.34 $34,970.13 $34,970.13 2026-04-15
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 8 7 — — $68,801.71 $68,801.71 $68,801.71 2026-04-15
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 4 4 — — $87,524.19 $87,524.19 $87,524.19 2026-04-15
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 4 4 — — $40,357.59 $40,357.59 $40,357.59 2026-04-15
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 4 4 — — $36,501.58 $36,501.58 $36,501.58 2026-04-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 15 10 — — $169,083.14 $430,426.08 $169,083.14 2026-04-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 15 10 — — $31,377.87 $78,507.07 $31,377.87 2026-04-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 15 10 — — $37,669.80 $94,586.69 $37,669.80 2026-04-15
7924 APR_DRG Extensive Or Procedures For Other Complications Of Treatment 4 4 — — $31,388.76 $31,388.76 $31,388.76 2026-04-15
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 4 4 — — $31,157.34 $31,157.34 $31,157.34 2026-04-15
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $90,214.49 $90,214.49 $90,214.49 2026-04-15
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $41,362.64 $41,362.64 $41,362.64 2026-04-15
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $35,012.57 $35,012.57 $35,012.57 2026-04-15
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $31,511.90 $31,511.90 $31,511.90 2026-04-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 15 10 — — $47,543.90 $119,820.96 $47,543.90 2026-04-15
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 4 4 — — $35,083.72 $35,083.72 $35,083.72 2026-04-15
793 MS_DRG Full Term Neonate With Major Problems 15 10 — — $33,550.37 $84,059.14 $33,550.37 2026-04-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 15 10 — — $57,240.55 $144,601.63 $57,240.55 2026-04-15
J9999 HCPCS Gliadel Wafer 7.7 Mg Implant 29 13 $131,788.68 $131,788.68 $13,178.87 $98,841.51 $50,145.60 2026-04-15
104 APR_DRG Head Trauma With Deep Coma 4 4 — — $42,756.66 $42,756.66 $42,756.66 2026-04-15
24 APR_DRG Heart &/or Lung Transplant 4 4 — — $122,810.80 $122,810.80 $122,810.80 2026-04-15
23 APR_DRG Heart &/or Lung Transplant 4 4 — — $84,640.00 $84,640.00 $84,640.00 2026-04-15
22 APR_DRG Heart &/or Lung Transplant 4 4 — — $66,012.76 $66,012.76 $66,012.76 2026-04-15
21 APR_DRG Heart &/or Lung Transplant 4 4 — — $51,875.21 $51,875.21 $51,875.21 2026-04-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 15 10 — — $221,726.73 $564,961.82 $221,726.73 2026-04-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 15 10 — — $90,049.90 $228,449.09 $90,049.90 2026-04-15
0686T CPT Histotripsy Mal Hepatcel Tis 8 7 — — $36,712.02 $36,712.02 $36,712.02 2026-04-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 15 10 — — $48,946.51 $123,405.41 $48,946.51 2026-04-15
Q2055 HCPCS Idecabtagene Vicleucel Car 10 8 — — $512,460.88 $558,081.73 $558,081.73 2026-04-15
69930 CPT Implant Cochlear Device 10 8 — — $1,069.72 $35,333.54 $35,333.54 2026-04-15
61886 CPT Implant Neurostim Arrays 10 8 — — $776.01 $33,067.68 $33,067.68 2026-04-15
63685 CPT Implant Spinal Neurostim/Receiver 22 13 $91,421.00 $91,421.00 $82.00 $68,565.75 $33,067.68 2026-04-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 15 10 — — $39,616.68 $99,562.18 $39,616.68 2026-04-15
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 7 — — $3,327,859.73 $3,327,859.73 $3,327,859.73 2026-04-15
J3387 HCPCS Inj Elivaldogene Autotemecel 8 7 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-04-15
J3399 HCPCS Inj Onase Abepar-xioi Treat 9 7 — — $104,498.96 $2,588,981.23 $2,588,981.23 2026-04-15
J3391 HCPCS Inj, Atidarsagene Autotemcel 8 7 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-15
J3393 HCPCS Inj, Betibeglogene Autotemce 8 7 — — $2,939,968.89 $2,939,968.89 $2,939,968.89 2026-04-15
J3392 HCPCS Inj, Exagamglogene Autotem 8 7 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-15
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 7 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-15
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 7 — — $3,252,508.08 $3,252,508.08 $3,252,508.08 2026-04-15
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 8 7 — — $201,669.02 $201,669.02 $201,669.02 2026-04-15
33249 CPT Ins/Rpos Dual Chmb Pcg Lds&Gen 22 13 $57,686.00 $57,686.00 $1,003.27 $43,264.50 $33,636.89 2026-04-15
0915T CPT Insj Perm Ccm-d Sys Pg&Eltrd 38 13 $100,994.00 $100,994.00 $10,099.40 $75,745.50 $38,428.21 2026-04-15
33276 CPT Insj Phrnc Nrv Stim Sys 10 8 — — $620.98 $47,201.02 $47,201.02 2026-04-15
0408T CPT Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd 23 13 $103,785.00 $103,785.00 $771.71 $77,838.75 $33,636.89 2026-04-15
0571T CPT Insj/rplcmt Icds Ss Eltrd 10 8 — — $543.72 $33,636.89 $33,636.89 2026-04-15
33231 CPT Insrt Icd Genrtr W/Exst Mult Leads 22 13 $96,185.00 $96,185.00 $437.51 $72,138.75 $33,636.89 2026-04-15
61885 CPT Insrt/redo Neurostim 1 Array 10 8 — — $465.84 $33,067.68 $33,067.68 2026-04-15
33270 CPT Insrtn Subq Implnt Defib Systm 22 13 $60,155.00 $60,155.00 $616.92 $45,116.25 $33,636.89 2026-04-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 15 10 — — $42,418.72 $106,723.01 $42,418.72 2026-04-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 15 10 — — $62,731.78 $158,635.01 $62,731.78 2026-04-15
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 10 8 — — $20,292.18 $39,537.89 $39,537.89 2026-04-15
4404 APR_DRG Kidney Transplant 4 4 — — $55,099.11 $55,099.11 $55,099.11 2026-04-15
4403 APR_DRG Kidney Transplant 4 4 — — $36,249.04 $36,249.04 $36,249.04 2026-04-15
4402 APR_DRG Kidney Transplant 4 4 — — $32,355.89 $32,355.89 $32,355.89 2026-04-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 15 10 — — $37,745.53 $94,780.22 $37,745.53 2026-04-15
0674T CPT Laps Insj Nw/rpcmt Prm Isdss 8 7 — — $33,067.68 $33,067.68 $33,067.68 2026-04-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 10 8 — — $501,865.93 $562,201.24 $562,201.24 2026-04-15
14 APR_DRG Liver Transplant &/or Intestinal Transplant 4 4 — — $88,934.24 $88,934.24 $88,934.24 2026-04-15
13 APR_DRG Liver Transplant &/or Intestinal Transplant 4 4 — — $47,840.94 $47,840.94 $47,840.94 2026-04-15
12 APR_DRG Liver Transplant &/or Intestinal Transplant 4 4 — — $45,825.36 $45,825.36 $45,825.36 2026-04-15
11 APR_DRG Liver Transplant &/or Intestinal Transplant 4 4 — — $43,278.92 $43,278.92 $43,278.92 2026-04-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 15 10 — — $81,993.32 $207,859.68 $81,993.32 2026-04-15
6 MS_DRG Liver Transplant Without Mcc 15 10 — — $37,237.49 $93,481.92 $37,237.49 2026-04-15
7 MS_DRG Lung Transplant 15 10 — — $102,816.78 $261,076.03 $102,816.78 2026-04-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 15 10 — — $46,923.09 $118,234.37 $46,923.09 2026-04-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 15 10 — — $36,825.71 $92,429.57 $36,825.71 2026-04-15
1694 APR_DRG Major Abdominal Vascular Procedures 4 4 — — $38,573.44 $38,573.44 $38,573.44 2026-04-15
2614 APR_DRG Major Biliary Tract Procedures 4 4 — — $32,509.91 $32,509.91 $32,509.91 2026-04-15
4414 APR_DRG Major Bladder Procedures 4 4 — — $36,744.73 $36,744.73 $36,744.73 2026-04-15
653 MS_DRG Major Bladder Procedures With Mcc 15 10 — — $41,650.37 $104,759.42 $41,650.37 2026-04-15
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $66,683.97 $66,683.97 $66,683.97 2026-04-15
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $34,012.21 $34,012.21 $34,012.21 2026-04-15
163 MS_DRG Major Chest Procedures With Mcc 15 10 — — $36,013.19 $90,353.09 $36,013.19 2026-04-15
894 APR_DRG Major Cranial/facial Bone Procedures 4 4 — — $36,451.54 $36,451.54 $36,451.54 2026-04-15
140 MS_DRG Major Head And Neck Procedures With Mcc 15 10 — — $34,305.32 $85,988.45 $34,305.32 2026-04-15
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 4 4 — — $39,788.42 $39,788.42 $39,788.42 2026-04-15
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 4 4 — — $39,048.02 $39,048.02 $39,048.02 2026-04-15
1204 APR_DRG Major Respiratory & Chest Procedures 4 4 — — $34,341.76 $34,341.76 $34,341.76 2026-04-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 15 10 — — $36,917.99 $92,665.44 $36,917.99 2026-04-15
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 4 4 — — $33,820.27 $33,820.27 $33,820.27 2026-04-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 10 — — $87,599.72 $222,187.39 $87,599.72 2026-04-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 10 — — $57,602.63 $145,526.98 $57,602.63 2026-04-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 15 10 — — $45,007.73 $113,339.52 $45,007.73 2026-04-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 15 10 — — $53,366.48 $134,701.06 $53,366.48 2026-04-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 15 10 — — $34,112.05 $85,494.53 $34,112.05 2026-04-15
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 4 4 — — $34,369.51 $34,369.51 $34,369.51 2026-04-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 15 10 — — $37,559.35 $94,304.45 $37,559.35 2026-04-15
8634 APR_DRG Neonatal Aftercare 4 4 — — $55,723.80 $55,723.80 $55,723.80 2026-04-15
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 4 4 — — $81,364.89 $81,364.89 $81,364.89 2026-04-15
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 4 4 — — $52,027.28 $52,027.28 $52,027.28 2026-04-15
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 4 4 — — $36,131.77 $36,131.77 $36,131.77 2026-04-15
6134 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 4 4 — — $54,300.07 $54,300.07 $54,300.07 2026-04-15
6133 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 4 4 — — $31,462.64 $31,462.64 $31,462.64 2026-04-15
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 4 4 — — $66,180.85 $66,180.85 $66,180.85 2026-04-15
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 4 4 — — $36,799.85 $36,799.85 $36,799.85 2026-04-15
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 4 — — $125,613.29 $125,613.29 $125,613.29 2026-04-15
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 4 — — $97,254.14 $97,254.14 $97,254.14 2026-04-15
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 4 — — $90,508.46 $90,508.46 $90,508.46 2026-04-15
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 4 — — $65,236.79 $65,236.79 $65,236.79 2026-04-15
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $109,693.94 $109,693.94 $109,693.94 2026-04-15
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $81,138.94 $81,138.94 $81,138.94 2026-04-15
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $67,495.51 $67,495.51 $67,495.51 2026-04-15
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $42,981.04 $42,981.04 $42,981.04 2026-04-15
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 4 4 — — $51,014.80 $51,014.80 $51,014.80 2026-04-15
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 4 — — $90,048.35 $90,048.35 $90,048.35 2026-04-15
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 4 — — $50,634.44 $50,634.44 $50,634.44 2026-04-15
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 4 4 — — $84,713.10 $84,713.10 $84,713.10 2026-04-15
6313 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 4 4 — — $38,410.82 $38,410.82 $38,410.82 2026-04-15
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $93,533.39 $93,533.39 $93,533.39 2026-04-15
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $64,513.59 $64,513.59 $64,513.59 2026-04-15
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $49,010.56 $49,010.56 $49,010.56 2026-04-15
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $41,372.42 $41,372.42 $41,372.42 2026-04-15
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 4 4 — — $69,154.96 $69,154.96 $69,154.96 2026-04-15
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 4 4 — — $39,414.31 $39,414.31 $39,414.31 2026-04-15
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $73,367.88 $73,367.88 $73,367.88 2026-04-15
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $47,361.67 $47,361.67 $47,361.67 2026-04-15
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $36,061.79 $36,061.79 $36,061.79 2026-04-15
6144 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 4 4 — — $51,582.02 $51,582.02 $51,582.02 2026-04-15
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 4 4 — — $48,243.58 $48,243.58 $48,243.58 2026-04-15
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 4 4 — — $33,203.01 $33,203.01 $33,203.01 2026-04-15
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 4 — — $113,407.27 $113,407.27 $113,407.27 2026-04-15
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 4 — — $53,471.33 $53,471.33 $53,471.33 2026-04-15
6092 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 4 — — $31,206.59 $31,206.59 $31,206.59 2026-04-15
6234 APR_DRG Neonate Bwt 2000-2499g W Congenital/perinatal Infection 4 4 — — $33,526.30 $33,526.30 $33,526.30 2026-04-15
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 4 4 — — $56,329.33 $56,329.33 $56,329.33 2026-04-15
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 4 4 — — $36,974.59 $36,974.59 $36,974.59 2026-04-15
5891 APR_DRG Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 4 — — $112,507.37 $112,507.37 $112,507.37 2026-04-15
5892 APR_DRG Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 4 — — $78,918.13 $78,918.13 $78,918.13 2026-04-15
5893 APR_DRG Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 4 — — $71,744.01 $71,744.01 $71,744.01 2026-04-15
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $152,009.25 $152,009.25 $152,009.25 2026-04-15
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $95,146.70 $95,146.70 $95,146.70 2026-04-15
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $85,767.41 $85,767.41 $85,767.41 2026-04-15
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $77,190.67 $77,190.67 $77,190.67 2026-04-15
5834 APR_DRG Neonate W Ecmo 4 4 — — $185,653.60 $185,653.60 $185,653.60 2026-04-15
5833 APR_DRG Neonate W Ecmo 4 4 — — $168,776.11 $168,776.11 $168,776.11 2026-04-15
5832 APR_DRG Neonate W Ecmo 4 4 — — $99,495.67 $99,495.67 $99,495.67 2026-04-15
5831 APR_DRG Neonate W Ecmo 4 4 — — $99,281.84 $99,281.84 $99,281.84 2026-04-15
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 4 4 — — $32,770.66 $32,770.66 $32,770.66 2026-04-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 15 10 — — $31,146.72 $77,916.38 $31,146.72 2026-04-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 7 — — $278,250.00 $278,250.00 $278,250.00 2026-04-15
J2351 HCPCS Ocrevus Zunovo 920 Mg-23,000 Unit/23 Ml Subcutaneous Solution 31 12 $193,199.36 $193,199.36 $47.05 $144,899.52 $73,512.36 2026-04-15
0908T CPT Opn Imp Int Nstm Sys Vgs Nrv 8 7 — — $33,067.68 $33,067.68 $33,067.68 2026-04-15
64568 CPT Opn Impltj Crnl Nrv Nea&pg 10 8 — — $521.01 $47,201.02 $47,201.02 2026-04-15
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 10 8 — — $749.30 $33,067.68 $33,067.68 2026-04-15
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 4 4 — — $45,009.52 $45,009.52 $45,009.52 2026-04-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 15 10 — — $39,686.10 $99,739.58 $39,686.10 2026-04-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 15 10 — — $35,311.12 $88,558.85 $35,311.12 2026-04-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 15 10 — — $35,864.10 $89,972.06 $35,864.10 2026-04-15
215 MS_DRG Other Heart Assist System Implant 15 10 — — $79,204.70 $200,733.12 $79,204.70 2026-04-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 15 10 — — $33,419.43 $83,724.48 $33,419.43 2026-04-15
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 4 4 — — $33,240.15 $33,240.15 $33,240.15 2026-04-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 15 10 — — $33,802.81 $84,704.26 $33,802.81 2026-04-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 15 10 — — $42,280.65 $106,370.21 $42,280.65 2026-04-15
914 APR_DRG Other Major Head & Neck Procedures 4 4 — — $37,343.22 $37,343.22 $37,343.22 2026-04-15
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 4 4 — — $36,758.41 $36,758.41 $36,758.41 2026-04-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 15 10 — — $33,899.85 $84,952.22 $33,899.85 2026-04-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 15 10 — — $60,768.30 $153,617.18 $60,768.30 2026-04-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 15 10 — — $32,087.04 $80,319.46 $32,087.04 2026-04-15
6514 APR_DRG Other Procedures Of Blood & Blood-forming Organs 4 4 — — $38,153.99 $38,153.99 $38,153.99 2026-04-15
C9150 HCPCS Outpatient Services 2 2 — — $49,920.00 $51,417.60 $50,668.80 2026-04-15
64 APR_DRG Pancreas Transplant 4 4 — — $75,605.89 $75,605.89 $75,605.89 2026-04-15
10 MS_DRG Pancreas Transplant 15 10 — — $57,264.21 $144,662.11 $57,264.21 2026-04-15
63 APR_DRG Pancreas Transplant 4 4 — — $54,372.78 $54,372.78 $54,372.78 2026-04-15
62 APR_DRG Pancreas Transplant 4 4 — — $51,218.47 $51,218.47 $51,218.47 2026-04-15
61 APR_DRG Pancreas Transplant 4 4 — — $46,096.66 $46,096.66 $46,096.66 2026-04-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 15 10 — — $43,812.63 $110,285.28 $43,812.63 2026-04-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 15 10 — — $33,202.49 $83,170.08 $33,202.49 2026-04-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 15 10 — — $31,117.53 $77,841.79 $31,117.53 2026-04-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 15 10 — — $36,540.95 $91,701.79 $36,540.95 2026-04-15
791 MS_DRG Prematurity With Major Problems 15 10 — — $32,677.92 $81,829.44 $32,677.92 2026-04-15
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 4 4 — — $37,890.12 $37,890.12 $37,890.12 2026-04-15
Q2043 HCPCS Provenge 50 Million Cell/250 Ml Intravenous Suspension 38 13 $289,537.03 $289,537.03 $28,953.70 $217,152.77 $110,168.84 2026-04-15
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 4 4 — — $32,224.93 $32,224.93 $32,224.93 2026-04-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 15 10 — — $51,418.78 $129,723.55 $51,418.78 2026-04-15
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 10 8 — — $507.86 $33,067.68 $33,067.68 2026-04-15
J3403 HCPCS Revakinagene, Per Implant 8 7 — — $265,000.00 $265,000.00 $265,000.00 2026-04-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 15 10 — — $41,721.36 $104,940.86 $41,721.36 2026-04-15
64656 CPT Revj/rplcmt Bat Mod Sys Pg 8 7 — — $33,067.68 $33,067.68 $33,067.68 2026-04-15
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 10 8 — — $414.65 $33,067.68 $33,067.68 2026-04-15
33264 CPT Rmvl Pcd W/Rplc Mult Lead 22 13 $96,185.00 $96,185.00 $442.19 $72,138.75 $33,636.89 2026-04-15
0909T CPT Rplcmt Int Nstim Sys Vgs Nrv 8 7 — — $33,067.68 $33,067.68 $33,067.68 2026-04-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 15 10 — — $55,182.42 $139,341.89 $55,182.42 2026-04-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 15 10 — — $44,870.47 $112,988.74 $44,870.47 2026-04-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 15 10 — — $56,940.00 $143,833.54 $56,940.00 2026-04-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 15 10 — — $32,374.20 $81,053.28 $32,374.20 2026-04-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 15 10 — — $42,701.11 $107,444.74 $42,701.11 2026-04-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 15 10 — — $39,321.67 $98,808.19 $39,321.67 2026-04-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 15 10 — — $52,339.37 $132,076.22 $52,339.37 2026-04-15
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 4 4 — — $35,951.95 $35,951.95 $35,951.95 2026-04-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 10 — — $66,949.00 $169,412.54 $66,949.00 2026-04-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 10 — — $47,698.52 $120,216.10 $47,698.52 2026-04-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 15 10 — — $33,574.03 $84,119.62 $33,574.03 2026-04-15
234 APR_DRG Spinal Procedures 4 4 — — $33,077.53 $33,077.53 $33,077.53 2026-04-15
28 MS_DRG Spinal Procedures With Mcc 15 10 — — $48,055.10 $121,127.33 $48,055.10 2026-04-15
J2326 HCPCS Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 21 13 $333,561.63 $333,561.63 $1,103.21 $250,171.22 $33,356.16 2026-04-15
799 MS_DRG Splenic Procedures With Mcc 15 10 — — $36,384.74 $91,302.62 $36,384.74 2026-04-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 15 10 — — $40,001.65 $100,545.98 $40,001.65 2026-04-15
J9226 HCPCS Supprelin La 50 Mg (65 Mcg/day) Implant Kit 37 13 $114,414.09 $114,414.09 $11,441.41 $85,810.57 $43,534.56 2026-04-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 8 — — $489,521.37 $566,531.30 $566,531.30 2026-04-15
J3389 HCPCS Topi Adm Prad Zami Per Treat 8 7 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 15 10 — — $33,916.39 $84,994.56 $33,916.39 2026-04-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 15 10 — — $43,683.26 $109,954.66 $43,683.26 2026-04-15
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 4 4 — — $82,957.10 $82,957.10 $82,957.10 2026-04-15
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 4 4 — — $55,803.94 $55,803.94 $55,803.94 2026-04-15
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 4 4 — — $43,025.61 $43,025.61 $43,025.61 2026-04-15
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 4 4 — — $37,557.84 $37,557.84 $37,557.84 2026-04-15
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 4 4 — — $55,669.46 $55,669.46 $55,669.46 2026-04-15
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 4 4 — — $41,179.69 $41,179.69 $41,179.69 2026-04-15
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 15 10 — — $109,925.95 $279,244.22 $109,925.95 2026-04-15
38240 CPT Transplt Allo Hct/donor 10 8 — — $210.32 $67,406.01 $67,406.01 2026-04-15
J7181 HCPCS Tretten 2,500 Unit Intravenous Solution 21 13 $369,210.00 $369,210.00 $17.10 $276,907.50 $36,921.00 2026-04-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 15 10 — — $44,567.56 $112,214.59 $44,567.56 2026-04-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 15 10 — — $36,002.94 $90,326.88 $36,002.94 2026-04-15
C2624 HCPCS Wireless Pressure Sensor 30 13 $90,846.00 $90,846.00 $9,084.60 $68,134.50 $34,566.90 2026-04-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 15 10 — — $45,619.11 $114,901.92 $45,619.11 2026-04-15
901 MS_DRG Wound Debridements For Injuries With Mcc 15 10 — — $33,763.37 $84,603.46 $33,763.37 2026-04-15
A9543 HCPCS Y90 Ibritumomab, Rx 11 8 — — $56,824.55 $73,587.03 $56,824.55 2026-04-15
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