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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 HEALTH METHODIST HOSPITAL

Peoria, IL · CCN 140209 · Rates published

19,222 distinct procedures filed
12 distinct payers
445,057 rate rows
2026-04-15 last MRF observed
Data quality

429,771 of 445,057 rate rows are consumer-grade (96.6%)

15,286 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 12,098
placeholder amount (≤ $0.02) — excluded from medians 2,981
percent-of-charges filed in the dollar field — excluded from medians 100
per-diem day rate — not a per-procedure price 89
exceeds 10× this hospital's gross charge — excluded from medians 18
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11406/370661223_methodist-medical-center-of-illinois_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/CarleHealthMethodistWestHospital/11406
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint b1b5b2ccde5348d4… · 536,330,424 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 6 $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 $4,274,909.33 $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 $3,869,551.20 $3,335,820.00 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,327,859.73 $3,860,317.28 $3,327,859.73 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,252,508.08 $3,772,909.37 $3,252,508.08 nat. median
$3,286,000
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 7 $3,180,000.00 $3,688,800.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,939,968.89 $3,410,363.91 $2,939,968.89 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $104,498.96 $3,003,218.22 $2,588,981.23 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $2,705,120.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 7 $770,620.00 $893,919.20 $770,620.00 nat. median
$824,563
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 8 $526,846.12 $681,673.51 $587,649.57 nat. median
$675,122
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 8 $489,521.37 $657,176.31 $566,531.30 nat. median
$754,974
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 8 $501,865.93 $652,153.44 $562,201.24 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 8 $512,460.88 $647,374.80 $558,081.73 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 8 $476,302.36 $617,343.00 $532,192.24 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 8 $476,406.40 $567,762.23 $489,450.20 nat. median
$620,080
0.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 9 $11,014.00 $580,376.83 $374,712.16 nat. median
$370,174
1.0× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 7 $278,250.00 $322,770.00 $278,250.00 nat. median
$324,450
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 7 $265,000.00 $307,400.00 $265,000.00 nat. median
$265,000
1.0× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 9 $11,014.00 $376,641.22 $243,381.10 nat. median
$265,286
0.9× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 7 $201,669.02 $233,936.06 $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 9 $11,014.00 $286,950.72 $185,565.26 nat. median
$206,368
0.9× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 9 $11,014.00 $285,266.69 $184,479.70 nat. median
$202,986
0.9× median
5833
APR_DRG 		Neonate W Ecmo 4 $168,776.11 $168,776.11 $168,776.11 nat. median
$244,017
0.7× 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
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 9 $11,014.00 $186,162.82 $120,595.85 nat. median
$133,176
0.9× 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
7
MS_DRG 		Lung Transplant 9 $11,014.00 $174,050.69 $112,788.20 nat. median
$122,708
0.9× 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 $128,646.04 $110,901.76 nat. median
$111,989
1.0× 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
14
MS_DRG 		Allogeneic Bone Marrow Transplant 9 $11,014.00 $161,520.58 $104,711.10 nat. median
$117,303
0.9× median
J7181
HCPCS 		Tretten 2,500 Unit Intravenous Solution 11 $17.10 $247,370.70 $101,532.75 nat. median
$22
outlier · 4685.4×
Q2043
HCPCS 		Provenge 50 Million Cell/250 Ml Intravenous Suspension 11 $54,404.11 $193,989.81 $100,111.04 nat. median
$66,682
1.5× 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
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 $11,014.00 $152,299.39 $98,766.98 nat. median
$108,660
0.9× median
209
MS_DRG 		Complex Aortic Arch Procedures 9 $11,014.00 $152,124.67 $98,654.35 nat. median
$98,017
1.0× 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×
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 9 $11,014.00 $148,124.93 $96,076.05 nat. median
$98,905
1.0× 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 $110,293.99 $95,081.03 nat. median
$96,983
1.0× median
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 9 $11,014.00 $146,147.90 $94,801.64 nat. median
$102,358
0.9× 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
J2326
HCPCS 		Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 11 $1,103.21 $223,486.29 $91,729.45 nat. median
$2,677
outlier · 34.3×

Other procedures at this hospital

Browse this hospital's 19,222 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
             
J7181 HCPCS Tretten 2,500 Unit Intravenous Solution 24 11 $369,210.00 $369,210.00 $17.10 $247,370.70 $101,532.75 2026-04-15
Q2043 HCPCS Provenge 50 Million Cell/250 Ml Intravenous Suspension 40 11 $289,537.03 $289,537.03 $54,404.11 $193,989.81 $100,111.04 2026-04-15
J2326 HCPCS Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 24 11 $333,561.63 $333,561.63 $1,103.21 $223,486.29 $91,729.45 2026-04-15
64654 CPT Opn Implt Bat Modulj Sys 41 11 $236,005.00 $236,005.00 $47,201.00 $165,203.50 $88,501.88 2026-04-15
J0225 HCPCS Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 24 11 $272,120.28 $272,120.28 $4,935.21 $182,320.59 $74,833.08 2026-04-15
J2351 HCPCS Ocrevus Zunovo 920 Mg-23,000 Unit/23 Ml Subcutaneous Solution 40 11 $193,199.36 $193,199.36 $47.05 $129,443.57 $72,449.76 2026-04-15
64656 CPT J/Rplcmt Bat Mod Sys Pg 41 11 $165,338.00 $165,338.00 $33,067.60 $115,736.60 $62,001.75 2026-04-15
J9999 HCPCS Gliadel Wafer 7.7 Mg Implant 33 11 $131,788.68 $131,788.68 $26,357.74 $88,298.42 $49,420.75 2026-04-15
J9226 HCPCS Supprelin La 50 Mg (65 Mcg/day) Implant Kit 40 11 $114,414.09 $114,414.09 $22,882.82 $76,657.44 $42,905.29 2026-04-15
J1823 HCPCS Uplizna 10 Mg/ml Intravenous Solution 24 11 $150,671.77 $150,671.77 $473.51 $100,950.09 $41,434.74 2026-04-15
0915T CPT Insj Perm Ccm-d Sys Pg&Eltrd 41 11 $105,273.00 $105,273.00 $21,054.60 $100,910.67 $39,477.38 2026-04-15
C2624 HCPCS System Sensor Cardiomems System Device Monitor / Pillo Cm Patient System 33 11 $101,587.50 $101,587.50 $20,317.50 $68,063.63 $38,095.32 2026-04-15
J9029 HCPCS Adstiladrin 3x10exp11 Vp/ml Intravesical Suspension 54 11 $34,713.00 $34,713.00 $6,942.60 $93,030.84 $37,044.40 2026-04-15
37290 CPT Sc Evsc Tpvt Athrc Cplx 1 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37288 CPT Sc Evsc Tpvt Athrc Sf 1st 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37284 CPT Sc Evasc Tpvt St Sf 1st 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37294 CPT C Evsc Tpvt St Athr Cpx 1 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37286 CPT Sc Evasc Tpvt St Cplx 1st 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37277 CPT C Evsc Fpvt St Athr Cpx 1 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37273 CPT Sc Evsc Fpvt Athrc Cplx 1 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37292 CPT C Evsc Tpvt St Athrc Sf 1 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37275 CPT C Evsc Fpvt St Athrc Sf 1 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
37271 CPT Sc Evsc Fpvt Athrc Sf 1st 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
92930 CPT Tcat Plmt Ntrac St 2+Les 41 11 $98,223.00 $98,223.00 $19,644.52 $68,756.10 $36,833.62 2026-04-15
J2350 HCPCS Ocrevus 30 Mg/ml Intravenous Solution 24 11 $131,276.50 $131,276.50 $58.76 $87,955.26 $36,101.04 2026-04-15
0408T CPT Insj/Rplc Car Modulj Sys Pls Gen Transvns Eltrd 26 11 $120,509.00 $120,509.00 $771.71 $100,910.67 $34,894.79 2026-04-15
33264 CPT Rmvl Pcd W/Rplc Mult Lead 24 11 $66,749.00 $66,749.00 $442.19 $100,910.67 $33,636.89 2026-04-15
0571T CPT Hc Insj/Rplcmt Icds W/Substernal Electrode 25 11 $100,989.00 $100,989.00 $543.72 $100,910.67 $33,636.89 2026-04-15
33249 CPT Ins/Rpos Dual Chmb Pcg Lds&Gen 27 11 $66,749.00 $66,749.00 $1,003.27 $100,910.67 $33,374.50 2026-04-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 9 — — $11,014.00 $580,376.83 $374,712.16 2026-04-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 16 9 — — $11,014.00 $376,641.22 $243,381.10 2026-04-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 16 9 — — $11,014.00 $286,950.72 $185,565.26 2026-04-15
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 16 9 — — $11,014.00 $285,266.69 $184,479.70 2026-04-15
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 16 9 — — $11,014.00 $186,162.82 $120,595.85 2026-04-15
7 MS_DRG Lung Transplant 16 9 — — $11,014.00 $174,050.69 $112,788.20 2026-04-15
14 MS_DRG Allogeneic Bone Marrow Transplant 16 9 — — $11,014.00 $161,520.58 $104,711.10 2026-04-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 16 9 — — $11,014.00 $152,299.39 $98,766.98 2026-04-15
209 MS_DRG Complex Aortic Arch Procedures 16 9 — — $11,014.00 $152,124.67 $98,654.35 2026-04-15
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 9 — — $11,014.00 $148,124.93 $96,076.05 2026-04-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 16 9 — — $11,014.00 $146,147.90 $94,801.64 2026-04-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 16 9 — — $11,014.00 $138,573.12 $89,918.81 2026-04-15
215 MS_DRG Other Heart Assist System Implant 16 9 — — $11,014.00 $133,822.08 $86,856.22 2026-04-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 9 — — $11,014.00 $131,480.83 $85,347.01 2026-04-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 16 9 — — $11,014.00 $121,089.02 $78,648.30 2026-04-15
850 MS_DRG Acute Leukemia With Other Procedures 16 9 — — $11,014.00 $116,383.68 $75,615.16 2026-04-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 16 9 — — $11,014.00 $113,297.86 $73,625.99 2026-04-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 9 — — $11,014.00 $112,941.70 $73,396.41 2026-04-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 16 9 — — $11,014.00 $105,756.67 $68,764.83 2026-04-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 9 — — $11,014.00 $103,196.35 $67,114.41 2026-04-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 16 9 — — $11,014.00 $102,751.49 $66,827.64 2026-04-15
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 16 9 — — $11,014.00 $102,411.46 $66,608.46 2026-04-15
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 9 — — $11,014.00 $97,017.98 $63,131.74 2026-04-15
10 MS_DRG Pancreas Transplant 16 9 — — $11,014.00 $96,441.41 $62,760.08 2026-04-15
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 16 9 — — $11,014.00 $96,401.09 $62,734.08 2026-04-15
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 16 9 — — $11,014.00 $95,889.02 $62,404.00 2026-04-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 16 9 — — $11,014.00 $95,832.58 $62,367.60 2026-04-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 16 9 — — $11,014.00 $92,894.59 $60,473.75 2026-04-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 16 9 — — $11,014.00 $92,438.98 $60,180.05 2026-04-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 16 9 — — $11,014.00 $90,465.98 $58,908.23 2026-04-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 16 9 — — $11,014.00 $89,866.56 $58,521.83 2026-04-15
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 16 9 — — $11,014.00 $89,800.70 $58,479.38 2026-04-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 9 — — $11,014.00 $88,372.03 $57,558.43 2026-04-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 16 9 — — $11,014.00 $88,372.03 $57,558.43 2026-04-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 16 9 — — $11,014.00 $88,050.82 $57,351.38 2026-04-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 16 9 — — $11,014.00 $86,482.37 $56,340.32 2026-04-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 16 9 — — $11,014.00 $82,365.70 $53,686.66 2026-04-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 16 9 — — $11,014.00 $82,270.27 $53,625.14 2026-04-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 16 9 — — $11,014.00 $81,481.34 $53,116.58 2026-04-15
28 MS_DRG Spinal Procedures With Mcc 16 9 — — $11,014.00 $80,751.55 $52,646.15 2026-04-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 16 9 — — $11,014.00 $80,728.70 $52,631.43 2026-04-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 9 — — $11,014.00 $80,144.06 $52,254.55 2026-04-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 16 9 — — $11,014.00 $79,695.17 $51,965.19 2026-04-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 16 9 — — $11,014.00 $78,873.98 $51,435.85 2026-04-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 16 9 — — $11,014.00 $78,822.91 $51,402.93 2026-04-15
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 16 9 — — $11,014.00 $77,509.82 $50,556.49 2026-04-15
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 9 — — $11,014.00 $77,015.23 $50,237.66 2026-04-15
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 16 9 — — $11,014.00 $76,700.74 $50,034.94 2026-04-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 16 9 — — $11,014.00 $76,601.28 $49,970.82 2026-04-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 16 9 — — $11,014.00 $75,559.68 $49,299.40 2026-04-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 16 9 — — $11,014.00 $75,325.82 $49,148.65 2026-04-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 16 9 — — $11,014.00 $74,809.73 $48,815.97 2026-04-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 16 9 — — $11,014.00 $74,229.12 $48,441.69 2026-04-15
834 MS_DRG Acute Leukemia With Mcc 16 9 — — $11,014.00 $73,784.26 $48,154.93 2026-04-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 16 9 — — $11,014.00 $73,523.52 $47,986.86 2026-04-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 16 9 — — $11,014.00 $73,418.69 $47,919.28 2026-04-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 16 9 — — $11,014.00 $73,303.10 $47,844.78 2026-04-15
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 16 9 — — $11,014.00 $73,010.11 $47,655.90 2026-04-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 9 — — $11,014.00 $71,672.83 $46,793.88 2026-04-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 16 9 — — $11,014.00 $71,629.82 $46,766.15 2026-04-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 16 9 — — $11,014.00 $71,148.67 $46,456.00 2026-04-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 16 9 — — $11,014.00 $70,913.47 $46,304.38 2026-04-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 16 9 — — $11,014.00 $69,960.58 $45,690.13 2026-04-15
653 MS_DRG Major Bladder Procedures With Mcc 16 9 — — $11,014.00 $69,839.62 $45,612.16 2026-04-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 16 9 — — $11,014.00 $67,740.29 $44,258.90 2026-04-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 16 9 — — $11,014.00 $67,030.66 $43,801.45 2026-04-15
228 MS_DRG Other Cardiothoracic Procedures With Mcc 16 9 — — $11,014.00 $66,493.06 $43,454.92 2026-04-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 16 9 — — $11,014.00 $66,374.78 $43,378.67 2026-04-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 16 9 — — $11,014.00 $66,147.65 $43,232.26 2026-04-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 16 9 — — $11,014.00 $65,872.13 $43,054.65 2026-04-15
471 MS_DRG Cervical Spinal Fusion With Mcc 16 9 — — $11,014.00 $64,897.73 $42,426.54 2026-04-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 16 9 — — $11,014.00 $64,569.79 $42,215.15 2026-04-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 16 9 — — $11,014.00 $63,985.15 $41,838.29 2026-04-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 16 9 — — $11,014.00 $63,186.82 $41,323.67 2026-04-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 16 9 — — $11,014.00 $63,057.79 $41,240.49 2026-04-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 16 9 — — $11,014.00 $62,869.63 $41,119.20 2026-04-15
C1822 HCPCS Hc Generator Neuro Rechg Bat Sys Hf 18 9 $104,740.00 $104,740.00 $73.34 $70,175.80 $40,848.60 2026-04-15
6 MS_DRG Liver Transplant Without Mcc 16 9 — — $11,014.00 $62,321.28 $40,765.73 2026-04-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 16 9 — — $11,014.00 $62,072.64 $40,605.44 2026-04-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 16 9 — — $11,014.00 $61,776.96 $40,414.84 2026-04-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 16 9 — — $11,014.00 $61,619.71 $40,313.48 2026-04-15
245 MS_DRG Aicd Generator Procedures 16 9 — — $11,014.00 $61,318.66 $40,119.42 2026-04-15
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 16 9 — — $11,014.00 $61,134.53 $40,000.73 2026-04-15
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 16 9 — — $11,014.00 $61,107.65 $39,983.40 2026-04-15
799 MS_DRG Splenic Procedures With Mcc 16 9 — — $11,014.00 $60,868.42 $39,829.18 2026-04-15
163 MS_DRG Major Chest Procedures With Mcc 16 9 — — $11,014.00 $60,235.39 $39,421.13 2026-04-15
31 MS_DRG Ventricular Shunt Procedures With Mcc 16 9 — — $11,014.00 $60,217.92 $39,409.87 2026-04-15
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 16 9 — — $11,014.00 $59,981.38 $39,257.39 2026-04-15
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 16 9 — — $11,014.00 $59,039.23 $38,650.06 2026-04-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 16 9 — — $11,014.00 $58,160.26 $38,083.46 2026-04-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 16 9 — — $11,014.00 $57,696.58 $37,784.57 2026-04-15
140 MS_DRG Major Head And Neck Procedures With Mcc 16 9 — — $11,014.00 $57,325.63 $37,545.46 2026-04-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 16 9 — — $11,014.00 $56,996.35 $37,333.19 2026-04-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 16 9 — — $11,014.00 $56,759.81 $37,180.72 2026-04-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 16 9 — — $11,014.00 $56,663.04 $37,118.33 2026-04-15
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 16 9 — — $11,014.00 $56,634.82 $37,100.15 2026-04-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 16 9 — — $11,014.00 $56,469.50 $36,993.57 2026-04-15
901 MS_DRG Wound Debridements For Injuries With Mcc 16 9 — — $11,014.00 $56,402.30 $36,950.26 2026-04-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 16 9 — — $11,014.00 $56,297.47 $36,882.68 2026-04-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 16 9 — — $11,014.00 $56,079.74 $36,742.33 2026-04-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 16 9 — — $11,014.00 $55,816.32 $36,572.52 2026-04-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 16 9 — — $11,014.00 $55,446.72 $36,334.28 2026-04-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 16 9 — — $11,014.00 $54,035.52 $35,424.60 2026-04-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 16 9 — — $11,014.00 $53,546.30 $35,109.24 2026-04-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 16 9 — — $11,014.00 $52,575.94 $34,483.73 2026-04-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 16 9 — — $11,014.00 $52,338.05 $34,330.39 2026-04-15
34 MS_DRG Carotid Artery Stent Procedures With Mcc 16 9 — — $11,014.00 $52,022.21 $34,126.79 2026-04-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 16 9 — — $11,014.00 $51,944.26 $34,076.54 2026-04-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 16 9 — — $11,014.00 $51,894.53 $34,044.48 2026-04-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 16 9 — — $11,014.00 $51,600.19 $33,854.76 2026-04-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 16 9 — — $11,014.00 $50,574.72 $33,193.71 2026-04-15
Q2056 HCPCS Ciltacabtagene Car-pos T 10 8 — — $526,846.12 $681,673.51 $587,649.57 2026-04-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 11 8 — — $489,521.37 $657,176.31 $566,531.30 2026-04-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 10 8 — — $501,865.93 $652,153.44 $562,201.24 2026-04-15
Q2055 HCPCS Idecabtagene Vicleucel Car 10 8 — — $512,460.88 $647,374.80 $558,081.73 2026-04-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 10 8 — — $476,302.36 $617,343.00 $532,192.24 2026-04-15
Q2053 HCPCS Brexucabtagene Car Pos T 10 8 — — $476,406.40 $567,762.23 $489,450.20 2026-04-15
Q0480 HCPCS Driver Pneumatic Vad, Rep 11 8 — — $50,709.24 $128,646.04 $110,901.76 2026-04-15
38240 CPT Transplt Allo Hct/donor 11 8 — — $210.32 $140,611.12 $67,406.01 2026-04-15
A9543 HCPCS Y90 Ibritumomab, Rx 11 8 — — $56,824.55 $73,587.03 $56,824.55 2026-04-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 14 8 — — $51,206.96 $79,880.64 $52,084.74 2026-04-15
L7181 HCPCS Electronic Elbo Simultaneous 11 8 — — $25,782.42 $57,232.29 $49,338.18 2026-04-15
L7180 HCPCS Electronic Elbow Sequential 11 8 — — $25,041.32 $55,587.19 $47,919.99 2026-04-15
0620T CPT Evasc Ven Artlz Tibl/prnl Vn 10 8 — — $3,895.33 $54,753.19 $47,201.02 2026-04-15
33276 CPT Insj Phrnc Nrv Stim Sys 10 8 — — $620.98 $54,753.19 $47,201.02 2026-04-15
64568 CPT Opn Impltj Crnl Nrv Nea&pg 11 8 — — $521.01 $72,451.00 $47,201.02 2026-04-15
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 11 8 — — $20,292.18 $45,863.95 $39,537.89 2026-04-15
793 MS_DRG Full Term Neonate With Major Problems 14 8 — — $36,277.38 $56,039.42 $36,716.35 2026-04-15
791 MS_DRG Prematurity With Major Problems 14 8 — — $35,346.54 $54,552.96 $35,758.15 2026-04-15
69930 CPT Implant Cochlear Device 11 8 — — $1,069.72 $75,622.52 $35,333.54 2026-04-15
L8701 HCPCS Ewh S/d Uprt Micro Sensor 10 8 — — $18,749.34 $40,565.35 $34,970.13 2026-04-15
33270 CPT Ins/rep Subq Defibrillator 11 8 — — $616.92 $76,226.72 $33,636.89 2026-04-15
33231 CPT Insrt Pulse Gen W/mult Leads 11 8 — — $437.51 $76,226.72 $33,636.89 2026-04-15
61891 CPT Rev/rplcmt Sk-mnt Crnl Nstm 11 8 — — $507.86 $50,983.88 $33,067.68 2026-04-15
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 11 8 — — $749.30 $72,451.00 $33,067.68 2026-04-15
33287 CPT Rmv&rplcmt Phrnc Nrv Stim Pg 11 8 — — $414.65 $72,451.00 $33,067.68 2026-04-15
61886 CPT Implant Neurostim Arrays 11 8 — — $776.01 $72,451.00 $33,067.68 2026-04-15
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 8 7 — — $3,685,266.67 $4,274,909.33 $3,685,266.67 2026-04-15
J3389 HCPCS Topi Adm Prad Zami Per Treat 8 7 — — $3,335,820.00 $3,869,551.20 $3,335,820.00 2026-04-15
J1413 HCPCS Inj Delandistrogene Mox Rokl 8 7 — — $3,327,859.73 $3,860,317.28 $3,327,859.73 2026-04-15
J3394 HCPCS Inj, Lovotibeglogene Autotem 8 7 — — $3,252,508.08 $3,772,909.37 $3,252,508.08 2026-04-15
J3387 HCPCS Inj Elivaldogene Autotemecel 8 7 — — $3,180,000.00 $3,688,800.00 $3,180,000.00 2026-04-15
J3393 HCPCS Inj, Betibeglogene Autotemce 8 7 — — $2,939,968.89 $3,410,363.91 $2,939,968.89 2026-04-15
J3399 HCPCS Inj Onase Abepar-xioi Treat 9 7 — — $104,498.96 $3,003,218.22 $2,588,981.23 2026-04-15
J3392 HCPCS Inj, Exagamglogene Autotem 8 7 — — $2,332,000.00 $2,705,120.00 $2,332,000.00 2026-04-15
Q2057 HCPCS Afamitresgene Autoleucel 8 7 — — $770,620.00 $893,919.20 $770,620.00 2026-04-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 8 7 — — $278,250.00 $322,770.00 $278,250.00 2026-04-15
J3403 HCPCS Revakinagene, Per Implant 8 7 — — $265,000.00 $307,400.00 $265,000.00 2026-04-15
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 8 7 — — $201,669.02 $233,936.06 $201,669.02 2026-04-15
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 8 7 — — $95,081.03 $110,293.99 $95,081.03 2026-04-15
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 8 7 — — $68,801.71 $79,809.98 $68,801.71 2026-04-15
0686T CPT Histotripsy Mal Hepatcel Tis 8 7 — — $36,712.02 $42,585.95 $36,712.02 2026-04-15
J3391 HCPCS Inj, Atidarsagene Autotemcel 7 6 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 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
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $152,009.25 $152,009.25 $152,009.25 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
24 APR_DRG Heart &/or Lung Transplant 4 4 — — $122,810.80 $122,810.80 $122,810.80 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
74 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $113,390.46 $113,390.46 $113,390.46 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
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $109,693.94 $109,693.94 $109,693.94 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
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 4 — — $97,254.14 $97,254.14 $97,254.14 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
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $95,146.70 $95,146.70 $95,146.70 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
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 4 4 — — $90,508.46 $90,508.46 $90,508.46 2026-04-15
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $90,214.49 $90,214.49 $90,214.49 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
14 APR_DRG Liver Transplant &/or Intestinal Transplant 4 4 — — $88,934.24 $88,934.24 $88,934.24 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
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $85,767.41 $85,767.41 $85,767.41 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
23 APR_DRG Heart &/or Lung Transplant 4 4 — — $84,640.00 $84,640.00 $84,640.00 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
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
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $81,138.94 $81,138.94 $81,138.94 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
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 4 4 — — $77,190.67 $77,190.67 $77,190.67 2026-04-15
64 APR_DRG Pancreas Transplant 4 4 — — $75,605.89 $75,605.89 $75,605.89 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
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
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
73 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $68,061.56 $68,061.56 $68,061.56 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
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $66,683.97 $66,683.97 $66,683.97 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
22 APR_DRG Heart &/or Lung Transplant 4 4 — — $66,012.76 $66,012.76 $66,012.76 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
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
84 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $58,674.84 $58,674.84 $58,674.84 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
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 4 4 — — $56,329.33 $56,329.33 $56,329.33 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
8634 APR_DRG Neonatal Aftercare 4 4 — — $55,723.80 $55,723.80 $55,723.80 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
4404 APR_DRG Kidney Transplant 4 4 — — $55,099.11 $55,099.11 $55,099.11 2026-04-15
72 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $54,673.40 $54,673.40 $54,673.40 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
63 APR_DRG Pancreas Transplant 4 4 — — $54,372.78 $54,372.78 $54,372.78 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
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 4 — — $53,471.33 $53,471.33 $53,471.33 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
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
21 APR_DRG Heart &/or Lung Transplant 4 4 — — $51,875.21 $51,875.21 $51,875.21 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
62 APR_DRG Pancreas Transplant 4 4 — — $51,218.47 $51,218.47 $51,218.47 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
6303 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 4 — — $50,634.44 $50,634.44 $50,634.44 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
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
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
13 APR_DRG Liver Transplant &/or Intestinal Transplant 4 4 — — $47,840.94 $47,840.94 $47,840.94 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
61 APR_DRG Pancreas Transplant 4 4 — — $46,096.66 $46,096.66 $46,096.66 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
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 4 4 — — $45,009.52 $45,009.52 $45,009.52 2026-04-15
71 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $43,724.57 $43,724.57 $43,724.57 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
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
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $42,981.04 $42,981.04 $42,981.04 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
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
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 4 4 — — $42,563.15 $42,563.15 $42,563.15 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
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
9104 APR_DRG Craniotomy For Multiple Significant Trauma 4 4 — — $41,474.45 $41,474.45 $41,474.45 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
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $41,362.64 $41,362.64 $41,362.64 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
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 4 4 — — $40,357.59 $40,357.59 $40,357.59 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
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
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 4 4 — — $39,048.02 $39,048.02 $39,048.02 2026-04-15
1694 APR_DRG Major Abdominal Vascular Procedures 4 4 — — $38,573.44 $38,573.44 $38,573.44 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
6514 APR_DRG Other Procedures Of Blood & Blood-forming Organs 4 4 — — $38,153.99 $38,153.99 $38,153.99 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
6904 APR_DRG Acute Leukemia 4 4 — — $38,105.51 $38,105.51 $38,105.51 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
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
6954 APR_DRG Chemotherapy For Acute Leukemia 4 4 — — $37,391.70 $37,391.70 $37,391.70 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
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
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
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 4 4 — — $36,799.85 $36,799.85 $36,799.85 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
4414 APR_DRG Major Bladder Procedures 4 4 — — $36,744.73 $36,744.73 $36,744.73 2026-04-15
83 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $36,604.00 $36,604.00 $36,604.00 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
894 APR_DRG Major Cranial/facial Bone Procedures 4 4 — — $36,451.54 $36,451.54 $36,451.54 2026-04-15
4403 APR_DRG Kidney Transplant 4 4 — — $36,249.04 $36,249.04 $36,249.04 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
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
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
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
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $35,012.57 $35,012.57 $35,012.57 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
1204 APR_DRG Major Respiratory & Chest Procedures 4 4 — — $34,341.76 $34,341.76 $34,341.76 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
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 4 4 — — $33,820.27 $33,820.27 $33,820.27 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
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 4 4 — — $33,240.15 $33,240.15 $33,240.15 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
234 APR_DRG Spinal Procedures 4 4 — — $33,077.53 $33,077.53 $33,077.53 2026-04-15
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $43,088.81 $55,541.88 $53,924.16 2026-04-15
90288 CPT Botulism Ig IV 3 3 — — $27.17 $50,166.15 $48,705.00 2026-04-15
E0766 HCPCS Elec Stim Cancer Treatment 2 2 — — $79,505.09 $81,890.24 $80,697.67 2026-04-15
C9150 HCPCS Inpatient Services 2 2 — — $49,920.00 $51,417.60 $50,668.80 2026-04-15
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