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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 HOOPESTON REGIONAL HEALTH CENTER

Hoopeston, IL · CCN 141316 · Rates published

24,719 distinct procedures filed
18 distinct payers
362,983 rate rows
2026-07-17 last MRF observed
Data quality

332,214 of 362,983 rate rows are consumer-grade (91.5%)

30,769 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 15,185
exceeds 10× this hospital's gross charge — excluded from medians 7,594
per-diem day rate — not a per-procedure price 6,246
placeholder amount (≤ $0.02) — excluded from medians 1,544
percent-of-charges filed in the dollar field — excluded from medians 173
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 27
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11410/363637465_hoopeston-community-memorial-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/CarleHooperstonRegionalHealthCenter/11410
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-11
Content fingerprint 460a82e920d96d73… · 343,510,451 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 1 $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 1 $3,685,266.67 $3,685,266.67 $3,685,266.67 nat. median
$3,685,267
1.0× median
J3389
HCPCS 		Topi Adm Prad Zami Per Treat 1 $3,335,820.00 $3,335,820.00 $3,335,820.00 nat. median
$3,335,820
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 1 $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 1 $3,252,508.08 $3,252,508.08 $3,252,508.08 nat. median
$3,248,446
1.0× median
J3387
HCPCS 		Inj Elivaldogene Autotemecel 1 $3,180,000.00 $3,180,000.00 $3,180,000.00 nat. median
$3,180,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 1 $2,939,968.89 $2,939,968.89 $2,939,968.89 nat. median
$2,968,000
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 1 $2,588,981.23 $2,588,981.23 $2,588,981.23 nat. median
$2,455,111
1.1× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,332,000
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $770,620.00 $770,620.00 $770,620.00 nat. median
$813,967
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 2 $542,651.50 $587,649.57 $565,150.53 nat. median
$599,737
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 2 $529,111.93 $566,531.30 $547,821.61 nat. median
$621,313
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 2 $527,834.71 $558,081.73 $542,958.22 nat. median
$574,037
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 2 $516,921.91 $562,201.24 $539,561.57 nat. median
$579,571
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 2 $490,591.43 $532,192.24 $511,391.83 nat. median
$562,501
0.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 2 $489,450.20 $490,698.59 $490,074.40 nat. median
$513,770
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $326,165.13 $603,404.80 $464,784.97 nat. median
$168,055
outlier · 2.8×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 2 $211,668.05 $450,692.80 $331,180.42 nat. median
$186,516
1.8× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 1 $278,250.00 $278,250.00 $278,250.00 nat. median
$286,598
1.0× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 $161,263.03 $379,564.80 $270,413.91 nat. median
$131,925
outlier · 2.0×
J3403
HCPCS 		Revakinagene, Per Implant 1 $265,000.00 $265,000.00 $265,000.00 nat. median
$264,195
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo… 2 $160,316.61 $342,905.60 $251,611.10 nat. median
$145,435
1.7× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 1 $201,669.02 $201,669.02 $201,669.02 nat. median
$207,733
1.0× median
5834
APR_DRG 		Neonate W Ecmo 4 $185,653.60 $185,653.60 $185,653.60 nat. median
$390,362
outlier · 0.5×
5833
APR_DRG 		Neonate W Ecmo 4 $168,776.11 $168,776.11 $168,776.11 nat. median
$268,208
0.6× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And… 2 $104,621.37 $226,080.00 $165,350.68 nat. median
$97,418
1.7× median
7
MS_DRG 		Lung Transplant 2 $97,814.50 $209,100.80 $153,457.65 nat. median
$70,649
outlier · 2.2×
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $152,009.25 $152,009.25 $152,009.25 nat. median
$286,698
0.5× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 2 $90,772.72 $209,628.80 $150,200.76 nat. median
$72,715
outlier · 2.1×
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 $85,590.52 $176,315.20 $130,952.86 nat. median
$65,418
outlier · 2.0×
212
MS_DRG 		Concomitant Aortic And Mitral Valve Procedures 2 $82,133.45 $174,302.40 $128,217.92 nat. median
$74,509
1.7× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $125,613.29 $125,613.29 $125,613.29 nat. median
$171,497
0.7× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 $83,244.51 $167,606.40 $125,425.45 nat. median
$2,736
outlier · 45.8×
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 2 $77,876.51 $170,390.40 $124,133.45 nat. median
$69,922
1.8× median
24
APR_DRG 		Heart &/or Lung Transplant 4 $122,810.80 $122,810.80 $122,810.80 nat. median
$225,531
0.5× median
215
MS_DRG 		Other Heart Assist System Implant 2 $75,206.48 $169,516.80 $122,361.64 nat. median
$73,023
1.7× median
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 $73,890.72 $154,417.60 $114,154.16 nat. median
$69,822
1.6× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 4 $113,407.27 $113,407.27 $113,407.27 nat. median
$198,578
0.6× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 4 $113,390.46 $113,390.46 $113,390.46 nat. median
$149,836
0.8× 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
$99,483
1.1× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 4 $109,693.94 $109,693.94 $109,693.94 nat. median
$168,439
0.7× median
850
MS_DRG 		Acute Leukemia With Other Procedures 2 $65,406.29 $147,390.40 $106,398.35 nat. median
$2,633
outlier · 40.4×
429
MS_DRG 		Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 $68,050.65 $133,449.60 $100,750.12 nat. median
$2,596
outlier · 38.8×
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 2 $63,672.10 $135,582.40 $99,627.25 nat. median
$60,505
1.6× median
5832
APR_DRG 		Neonate W Ecmo 4 $99,495.67 $99,495.67 $99,495.67 nat. median
$201,678
outlier · 0.5×
456
MS_DRG 		Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 $63,471.94 $135,507.20 $99,489.57 nat. median
$59,651
1.7× median
5831
APR_DRG 		Neonate W Ecmo 4 $99,281.84 $99,281.84 $99,281.84 nat. median
$173,909
0.6× median
5913
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $97,254.14 $97,254.14 $97,254.14 nat. median
$120,079
0.8× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 4 $96,644.31 $96,644.31 $96,644.31 nat. median
$202,242
outlier · 0.5×
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $95,146.70 $95,146.70 $95,146.70 nat. median
$173,134
0.5× median

Other procedures at this hospital

Browse this hospital's 24,719 published procedures. Use the slice to choose what to show, then sort or filter any column.

Slice
Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
J3391 HCPCS Inj, Atidarsagene Autotemcel 1 1 — — $4,505,000.00 $4,505,000.00 $4,505,000.00 2026-04-15
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 1 1 — — $3,685,266.67 $3,685,266.67 $3,685,266.67 2026-04-15
J3389 HCPCS Topi Adm Prad Zami Per Treat 1 1 — — $3,335,820.00 $3,335,820.00 $3,335,820.00 2026-04-15
J1413 HCPCS Inj Delandistrogene Mox Rokl 1 1 — — $3,327,859.73 $3,327,859.73 $3,327,859.73 2026-04-15
J3394 HCPCS Inj, Lovotibeglogene Autotem 1 1 — — $3,252,508.08 $3,252,508.08 $3,252,508.08 2026-04-15
J3387 HCPCS Inj Elivaldogene Autotemecel 1 1 — — $3,180,000.00 $3,180,000.00 $3,180,000.00 2026-04-15
J3393 HCPCS Inj, Betibeglogene Autotemce 1 1 — — $2,939,968.89 $2,939,968.89 $2,939,968.89 2026-04-15
J3399 HCPCS Inj Onase Abepar-xioi Treat 1 1 — — $2,588,981.23 $2,588,981.23 $2,588,981.23 2026-04-15
J3392 HCPCS Inj, Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-04-15
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $770,620.00 $770,620.00 $770,620.00 2026-04-15
Q2056 HCPCS Ciltacabtagene Car-pos T 2 2 — — $542,651.50 $587,649.57 $565,150.53 2026-04-15
Q2042 HCPCS Tisagenlecleucel Car-pos T 2 2 — — $529,111.93 $566,531.30 $547,821.61 2026-04-15
Q2055 HCPCS Idecabtagene Vicleucel Car 2 2 — — $527,834.71 $558,081.73 $542,958.22 2026-04-15
Q2054 HCPCS Lisocabtagene Mara Car Pos T 2 2 — — $516,921.91 $562,201.24 $539,561.57 2026-04-15
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 2 2 — — $490,591.43 $532,192.24 $511,391.83 2026-04-15
Q2053 HCPCS Brexucabtagene Car Pos T 2 2 — — $489,450.20 $490,698.59 $490,074.40 2026-04-15
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $326,165.13 $603,404.80 $464,784.97 2026-04-15
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 2 — — $211,668.05 $450,692.80 $331,180.42 2026-04-15
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 1 1 — — $278,250.00 $278,250.00 $278,250.00 2026-04-15
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 2 2 — — $161,263.03 $379,564.80 $270,413.91 2026-04-15
J3403 HCPCS Revakinagene, Per Implant 1 1 — — $265,000.00 $265,000.00 $265,000.00 2026-04-15
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 2 2 — — $160,316.61 $342,905.60 $251,611.10 2026-04-15
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 1 1 — — $201,669.02 $201,669.02 $201,669.02 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
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 2 2 — — $104,621.37 $226,080.00 $165,350.68 2026-04-15
7 MS_DRG Lung Transplant 2 2 — — $97,814.50 $209,100.80 $153,457.65 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
14 MS_DRG Allogeneic Bone Marrow Transplant 2 2 — — $90,772.72 $209,628.80 $150,200.76 2026-04-15
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 2 — — $85,590.52 $176,315.20 $130,952.86 2026-04-15
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 2 2 — — $82,133.45 $174,302.40 $128,217.92 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
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $83,244.51 $167,606.40 $125,425.45 2026-04-15
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 2 — — $77,876.51 $170,390.40 $124,133.45 2026-04-15
24 APR_DRG Heart &/or Lung Transplant 4 4 — — $122,810.80 $122,810.80 $122,810.80 2026-04-15
215 MS_DRG Other Heart Assist System Implant 2 2 — — $75,206.48 $169,516.80 $122,361.64 2026-04-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $73,890.72 $154,417.60 $114,154.16 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
850 MS_DRG Acute Leukemia With Other Procedures 2 2 — — $65,406.29 $147,390.40 $106,398.35 2026-04-15
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 2 — — $68,050.65 $133,449.60 $100,750.12 2026-04-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 2 — — $63,672.10 $135,582.40 $99,627.25 2026-04-15
5832 APR_DRG Neonate W Ecmo 4 4 — — $99,495.67 $99,495.67 $99,495.67 2026-04-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $63,471.94 $135,507.20 $99,489.57 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
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $95,081.03 $95,081.03 $95,081.03 2026-04-15
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 2 — — $59,434.03 $128,977.60 $94,205.82 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
J7181 HCPCS Tretten 2,500 Unit Intravenous Solution 23 12 $369,210.00 $369,210.00 $17.61 $332,289.00 $92,302.50 2026-04-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 2 2 — — $57,745.15 $125,062.40 $91,403.77 2026-04-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $57,995.17 $123,800.00 $90,897.58 2026-04-15
10 MS_DRG Pancreas Transplant 2 2 — — $54,198.97 $127,568.00 $90,883.49 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
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 2 — — $53,888.54 $126,836.80 $90,362.67 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
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 2 — — $57,554.06 $119,427.20 $88,490.63 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
209 MS_DRG Complex Aortic Arch Procedures 1 1 — — $85,492.33 $85,492.33 $85,492.33 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
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $54,522.99 $113,643.20 $84,083.10 2026-04-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 2 — — $53,856.81 $113,072.00 $83,464.40 2026-04-15
J2326 HCPCS Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 23 12 $333,561.63 $333,561.63 $1,136.31 $300,205.47 $83,390.41 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
E0766 HCPCS Elec Stim Cancer Treatment 1 1 — — $81,890.24 $81,890.24 $81,890.24 2026-04-15
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 2 2 — — $52,205.69 $111,304.00 $81,754.85 2026-04-15
Q0480 HCPCS Driver Pneumatic Vad, Rep 2 2 — — $52,230.52 $110,901.76 $81,566.14 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
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 2 — — $54,176.31 $106,862.40 $80,519.35 2026-04-15
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $50,840.85 $109,252.80 $80,046.82 2026-04-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 2 — — $51,949.66 $106,681.60 $79,315.63 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
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 2 — — $50,466.97 $107,275.20 $78,871.08 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
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $49,664.07 $103,326.40 $76,495.24 2026-04-15
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 2 2 — — $48,602.10 $103,475.20 $76,038.65 2026-04-15
64 APR_DRG Pancreas Transplant 4 4 — — $75,605.89 $75,605.89 $75,605.89 2026-04-15
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 2 2 — — $50,503.99 $98,982.40 $74,743.19 2026-04-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 2 — — $49,483.55 $98,531.20 $74,007.38 2026-04-15
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 2 — — $46,234.95 $101,188.80 $73,711.88 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
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 2 — — $49,664.07 $95,188.80 $72,426.43 2026-04-15
Q2043 HCPCS Provenge 50 Million Cell/250 Ml Intravenous Suspension 23 12 $289,537.03 $289,537.03 $28,953.70 $260,583.33 $72,384.26 2026-04-15
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 2 — — $45,368.61 $99,110.40 $72,239.51 2026-04-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 2 — — $45,791.59 $97,739.20 $71,765.39 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
28 MS_DRG Spinal Procedures With Mcc 2 2 — — $45,381.45 $97,272.00 $71,326.73 2026-04-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 2 2 — — $46,288.58 $95,852.80 $71,070.69 2026-04-15
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 2 — — $44,787.77 $96,574.40 $70,681.08 2026-04-15
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 2 2 — — $44,892.00 $95,116.80 $70,004.40 2026-04-15
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 2 2 — — $41,715.91 $98,187.20 $69,951.55 2026-04-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 2 — — $44,326.28 $94,147.20 $69,236.74 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
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 2 — — $41,030.84 $96,574.40 $68,802.62 2026-04-15
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $68,801.71 $68,801.71 $68,801.71 2026-04-15
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 2 — — $44,297.58 $93,156.80 $68,727.19 2026-04-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $45,040.04 $91,830.40 $68,435.22 2026-04-15
73 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $68,061.56 $68,061.56 $68,061.56 2026-04-15
J0225 HCPCS Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 23 12 $272,120.28 $272,120.28 $5,009.56 $244,908.25 $68,030.07 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
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 2 — — $43,281.68 $91,281.60 $67,281.64 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
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 2 — — $43,559.64 $87,528.00 $65,543.82 2026-04-15
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 2 — — $42,463.67 $88,065.60 $65,264.64 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
834 MS_DRG Acute Leukemia With Mcc 2 2 — — $41,465.91 $88,436.80 $64,951.36 2026-04-15
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 2 — — $43,049.04 $86,416.00 $64,732.52 2026-04-15
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 2 2 — — $42,332.25 $87,057.60 $64,694.93 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
653 MS_DRG Major Bladder Procedures With Mcc 2 2 — — $39,249.07 $89,193.60 $64,221.34 2026-04-15
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 2 — — $39,984.74 $88,436.80 $64,210.77 2026-04-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 2 2 — — $41,319.37 $86,859.20 $64,089.29 2026-04-15
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 2 2 — — $41,195.50 $86,334.40 $63,764.95 2026-04-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 2 2 — — $41,260.47 $85,123.20 $63,191.83 2026-04-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $40,279.31 $84,747.20 $62,513.25 2026-04-15
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 2 — — $37,019.38 $86,324.80 $61,672.09 2026-04-15
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 2 — — $40,255.14 $82,401.60 $61,328.37 2026-04-15
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 2 — — $42,042.22 $80,052.80 $61,047.51 2026-04-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 2 — — $39,852.56 $82,128.00 $60,990.28 2026-04-15
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 2 — — $39,317.04 $81,513.60 $60,415.32 2026-04-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 2 2 — — $37,670.46 $81,264.00 $59,467.23 2026-04-15
A9543 HCPCS Y90 Ibritumomab, Rx 2 2 — — $56,824.55 $61,078.53 $58,951.54 2026-04-15
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 2 — — $37,174.22 $80,590.40 $58,882.31 2026-04-15
84 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $58,674.84 $58,674.84 $58,674.84 2026-04-15
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 2 — — $37,301.86 $80,020.80 $58,661.33 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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 2 — — $37,368.33 $79,732.80 $58,550.57 2026-04-15
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 2 — — $36,287.48 $80,115.20 $58,201.34 2026-04-15
471 MS_DRG Cervical Spinal Fusion With Mcc 2 2 — — $36,471.78 $77,716.80 $57,094.29 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
245 MS_DRG Aicd Generator Procedures 2 2 — — $34,460.38 $78,188.80 $56,324.59 2026-04-15
6 MS_DRG Liver Transplant Without Mcc 2 2 — — $35,023.85 $77,587.20 $56,305.52 2026-04-15
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 2 — — $35,332.01 $76,408.00 $55,870.01 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
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 2 — — $38,069.26 $73,481.60 $55,775.43 2026-04-15
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 2 — — $35,437.76 $76,062.40 $55,750.08 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
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 2 2 — — $35,958.93 $75,275.20 $55,617.07 2026-04-15
J7330 HCPCS Cultured Chondrocytes Implnt 1 1 — — $55,541.88 $55,541.88 $55,541.88 2026-04-15
799 MS_DRG Splenic Procedures With Mcc 2 2 — — $34,207.35 $76,076.80 $55,142.07 2026-04-15
4404 APR_DRG Kidney Transplant 4 4 — — $55,099.11 $55,099.11 $55,099.11 2026-04-15
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 2 — — $34,629.57 $74,872.00 $54,750.79 2026-04-15
72 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $54,673.40 $54,673.40 $54,673.40 2026-04-15
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 2 2 — — $34,884.11 $74,430.40 $54,657.25 2026-04-15
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 2 2 — — $35,510.28 $73,716.80 $54,613.54 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
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 2 — — $34,717.94 $73,470.40 $54,094.17 2026-04-15
163 MS_DRG Major Chest Procedures With Mcc 2 2 — — $33,851.60 $73,747.20 $53,799.40 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
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 2 — — $34,356.91 $72,185.60 $53,271.26 2026-04-15
J2351 HCPCS Ocrevus Zunovo 920 Mg-23,000 Unit/23 Ml Subcutaneous Solution 22 12 $193,199.36 $193,199.36 $47.05 $173,879.42 $53,129.82 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
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 2 — — $34,341.80 $71,556.80 $52,949.30 2026-04-15
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 2 2 — — $32,424.81 $71,755.20 $52,090.01 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
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 2 2 — — $33,708.85 $70,284.80 $51,996.82 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
C9150 HCPCS Inpatient Services 1 1 — — $51,417.60 $51,417.60 $51,417.60 2026-04-15
901 MS_DRG Wound Debridements For Injuries With Mcc 2 2 — — $31,697.45 $70,888.00 $51,292.73 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
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 2 2 — — $33,179.37 $68,251.20 $50,715.29 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
31 MS_DRG Ventricular Shunt Procedures With Mcc 2 2 — — $33,841.78 $67,049.60 $50,445.69 2026-04-15
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 2 2 — — $32,685.39 $68,150.40 $50,417.89 2026-04-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 2 2 — — $31,516.17 $69,088.00 $50,302.08 2026-04-15
90288 CPT Botulism Ig IV 1 1 — — $50,166.15 $50,166.15 $50,166.15 2026-04-15
140 MS_DRG Major Head And Neck Procedures With Mcc 2 2 — — $32,216.35 $67,667.20 $49,941.77 2026-04-15
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 2 2 — — $31,735.21 $67,033.60 $49,384.40 2026-04-15
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 2 2 — — $29,413.39 $69,230.40 $49,321.89 2026-04-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 2 2 — — $31,898.36 $66,571.20 $49,234.78 2026-04-15
793 MS_DRG Full Term Neonate With Major Problems 2 2 — — $31,493.51 $66,728.00 $49,110.76 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
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 2 2 — — $31,828.12 $65,756.80 $48,792.46 2026-04-15
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 2 2 — — $31,843.97 $65,659.20 $48,751.58 2026-04-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 2 2 — — $31,638.53 $65,793.60 $48,716.07 2026-04-15
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $32,031.29 $65,336.00 $48,683.65 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
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 2 2 — — $31,368.13 $65,078.40 $48,223.26 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
791 MS_DRG Prematurity With Major Problems 2 2 — — $30,658.14 $64,958.40 $47,808.27 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
64654 CPT 1st Opn Implt Bat Modulj Sys 1 1 — — $47,201.02 $47,201.02 $47,201.02 2026-04-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 2 2 — — $31,160.43 $62,564.80 $46,862.62 2026-04-15
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $30,367.35 $62,595.20 $46,481.27 2026-04-15
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 2 2 — — $28,998.72 $63,739.20 $46,368.96 2026-04-15
61 APR_DRG Pancreas Transplant 4 4 — — $46,096.66 $46,096.66 $46,096.66 2026-04-15
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 2 2 — — $29,192.08 $62,873.60 $46,032.84 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
34 MS_DRG Carotid Artery Stent Procedures With Mcc 2 2 — — $29,235.88 $62,219.20 $45,727.54 2026-04-15
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 2 2 — — $28,148.99 $63,131.20 $45,640.10 2026-04-15
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 2 2 — — $27,061.35 $63,694.40 $45,377.88 2026-04-15
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 2 — — $29,547.08 $60,827.20 $45,187.14 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
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 2 2 — — $26,998.65 $63,001.60 $45,000.12 2026-04-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 2 2 — — $28,231.32 $61,604.80 $44,918.06 2026-04-15
956 MS_DRG Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 2 2 — — $28,422.41 $61,158.40 $44,790.40 2026-04-15
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 2 2 — — $27,743.39 $61,777.60 $44,760.49 2026-04-15
40 MS_DRG Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc 2 2 — — $29,164.13 $60,353.60 $44,758.86 2026-04-15
616 MS_DRG Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With… 2 2 — — $26,340.77 $61,840.00 $44,090.38 2026-04-15
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 2 2 — — $30,092.41 $57,356.80 $43,724.61 2026-04-15
71 APR_DRG Allogeneic Bone Marrow Transplant 4 4 — — $43,724.57 $43,724.57 $43,724.57 2026-04-15
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 2 2 — — $26,883.08 $59,872.00 $43,377.54 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
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 1 1 — — $43,104.94 $43,104.94 $43,104.94 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
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 4 4 — — $42,981.04 $42,981.04 $42,981.04 2026-04-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 2 2 — — $28,228.30 $57,344.00 $42,786.15 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
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 2 2 — — $26,582.47 $58,379.20 $42,480.83 2026-04-15
335 MS_DRG Peritoneal Adhesiolysis With Mcc 2 2 — — $26,971.46 $57,974.40 $42,472.93 2026-04-15
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 2 2 — — $27,280.37 $57,353.60 $42,316.99 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
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc 2 2 — — $27,732.05 $56,819.20 $42,275.62 2026-04-15
265 MS_DRG Aicd Lead Procedures 2 2 — — $27,328.72 $57,075.20 $42,201.96 2026-04-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 2 2 — — $27,385.36 $56,329.60 $41,857.48 2026-04-15
651 MS_DRG Kidney Transplant With Hemodialysis Without Mcc 2 2 — — $27,990.37 $55,560.00 $41,775.18 2026-04-15
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 2 2 — — $26,908.77 $56,060.80 $41,484.79 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
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 2 2 — — $26,931.42 $56,020.80 $41,476.11 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
332 MS_DRG Rectal Resection With Mcc 2 2 — — $27,347.61 $55,499.20 $41,423.40 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
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 2 2 — — $25,734.25 $56,472.00 $41,103.12 2026-04-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 2 2 — — $26,861.19 $55,110.40 $40,985.79 2026-04-15
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 2 — — $25,895.14 $56,043.20 $40,969.17 2026-04-15
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 2 2 — — $26,219.92 $55,438.40 $40,829.16 2026-04-15
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 2 2 — — $26,636.86 $54,803.20 $40,720.03 2026-04-15
252 MS_DRG Other Vascular Procedures With Mcc 2 2 — — $26,347.57 $54,886.40 $40,616.99 2026-04-15
264 MS_DRG Other Circulatory System O.r. Procedures 2 2 — — $25,231.97 $55,921.60 $40,576.79 2026-04-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 2 2 — — $28,298.54 $52,830.40 $40,564.47 2026-04-15
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 2 2 — — $26,093.04 $55,024.00 $40,558.52 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
22 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 2 2 — — $23,999.31 $56,486.40 $40,242.86 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
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 2 2 — — $25,768.24 $53,707.20 $39,737.72 2026-04-15
J9999 HCPCS Gliadel Wafer 7.7 Mg Implant 21 12 $131,788.68 $131,788.68 $13,178.87 $118,609.81 $39,536.60 2026-04-15
260 MS_DRG Cardiac Pacemaker Revision Except Device Replacement With Mcc 2 2 — — $24,568.81 $54,499.20 $39,534.00 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
665 MS_DRG Prostatectomy With Mcc 2 2 — — $23,574.82 $54,937.60 $39,256.21 2026-04-15
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 2 — — $27,239.60 $51,270.40 $39,255.00 2026-04-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 2 2 — — $24,115.62 $54,272.00 $39,193.81 2026-04-15
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 2 2 — — $27,406.52 $50,784.00 $39,095.26 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
37 MS_DRG Extracranial Procedures With Mcc 2 2 — — $24,865.64 $53,134.40 $39,000.02 2026-04-15
J9028 HCPCS Anktiva 400 Mcg/0.4 Ml Intravesical Solution 29 12 $81,624.00 $81,624.00 $94.73 $73,461.60 $38,747.46 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
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 2 2 — — $24,460.80 $52,150.40 $38,305.60 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
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 2 2 — — $24,047.65 $52,128.00 $38,087.82 2026-04-15
L7181 HCPCS Electronic Elbo Simultaneous 2 2 — — $26,555.89 $49,338.18 $37,947.04 2026-04-15
485 MS_DRG Knee Procedures With Principal Diagnosis Of Infection With Mcc 2 2 — — $24,374.69 $51,508.80 $37,941.75 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
840 MS_DRG Lymphoma And Non-acute Leukemia With Mcc 2 2 — — $24,433.61 $51,024.00 $37,728.81 2026-04-15
J1823 HCPCS Uplizna 10 Mg/ml Intravenous Solution 23 12 $150,671.77 $150,671.77 $487.72 $135,604.59 $37,667.94 2026-04-15
929 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury Without Cc/mcc 2 2 — — $24,327.11 $50,886.40 $37,606.76 2026-04-15
469 MS_DRG Major Hip And Knee Joint Replacement Or Reattachment Of Lower Extremity With Mcc… 2 2 — — $22,910.14 $52,299.20 $37,604.67 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
324 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device Without Mcc 2 2 — — $23,799.90 $51,121.60 $37,460.75 2026-04-15
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 2 2 — — $24,862.63 $49,936.00 $37,399.32 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
500 MS_DRG Soft Tissue Procedures With Mcc 2 2 — — $23,904.14 $50,699.20 $37,301.67 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
451 MS_DRG Single Level Spinal Fusion Except Cervical Without Mcc 2 2 — — $24,399.62 $49,376.00 $36,887.81 2026-04-15
L7180 HCPCS Electronic Elbow Sequential 2 2 — — $25,792.56 $47,919.99 $36,856.28 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
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 2 2 — — $24,071.06 $49,478.40 $36,774.73 2026-04-15
652 MS_DRG Kidney Transplant 2 2 — — $24,392.82 $49,142.40 $36,767.61 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
229 MS_DRG Other Cardiothoracic Procedures Without Mcc 2 2 — — $23,788.58 $49,700.80 $36,744.69 2026-04-15
0686T CPT Histotripsy Mal Hepatcel Tis 1 1 — — $36,712.02 $36,712.02 $36,712.02 2026-04-15
829 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Other Proce… 2 2 — — $23,867.87 $49,340.80 $36,604.33 2026-04-15
83 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $36,604.00 $36,604.00 $36,604.00 2026-04-15
9381631 OTHER Xomedx Plus Trio, Ref 5 5 $48,000.00 $48,000.00 $33,600.00 $40,176.00 $38,400.00 2026-07-17
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