Price Transparencybeta Hospital negotiated rates

Hospital facility prices. What the hospital charges for the facility side of care — the surgeon’s and anesthesiologist’s fees are billed separately and are not included. How we scope prices →

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Hospital

JACKSONVILLE MEMORIAL HOSPITAL

Jacksonville, IL · CCN 141352 · Rates published

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You selected 93306 (CPT)

Echo Procedure with Modifier 52 -> Echo 2D w/Color

This hospital’s price: $2,054 across 26 payers · range $88-$4,479

Source: https://memorial.health/Resources/d997e3f0-da18-4ce6-9de5-f1465abf6e66/370661230_Jacksonville_Memorial_Hospital_standardcharges.csv?v=2 · observed 2026-07-15

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

6,195 distinct procedures filed
26 distinct payers
399,689 rate rows
2026-07-15 last MRF observed
Data quality

387,757 of 399,689 rate rows are consumer-grade (97.0%)

11,932 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
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 9,400
per-diem day rate — not a per-procedure price 1,125
below 25% of the Medicare reference for this DRG — likely a mislabeled per-diem; excluded from rankings 685
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 244
template filing: same amount across many unrelated codes — excluded 194
placeholder amount (≤ $0.02) — excluded from medians 155
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 100
exceeds 10× this hospital's gross charge — excluded from medians 29
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://memorial.health/Resources/d997e3f0-da18-4ce6-9de5-f1465abf6e66/370661230_Jacksonville_Memorial_Hospital_standardcharges.csv?v=2
Found on page https://memorial.health/financial/price-transparency/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-10-28
Content fingerprint f20076750e60394f… · 643,654,079 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
18
OTHER 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $1,174,290.18 $1,174,290.18 $1,174,290.18 nat. median
$380,401
outlier · 3.1×
681
OTHER 		Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip… 1 $739,710.07 $739,710.07 $739,710.07 nat. median
$1
166
OTHER 		Other Respiratory System O.r. Procedures With Mcc 1 $692,526.62 $692,526.62 $692,526.62 nat. median
$39,056
outlier · 17.7×
1
OTHER 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $545,448.31 $545,448.31 $545,448.31 nat. median
$225,321
outlier · 2.4×
955
OTHER 		Craniotomy For Multiple Significant Trauma 1 $317,663.87 $317,663.87 $317,663.87 nat. median
$61,896
outlier · 5.1×
266
OTHER 		Acute Leukemia Without Major O.r. Procedures Age 0-17 1 $317,163.74 $317,163.74 $317,163.74 nat. median
$60,180
outlier · 5.3×
7
OTHER 		Lung Transplant 1 $316,357.78 $316,357.78 $316,357.78 nat. median
$149,058
outlier · 2.1×
633
OTHER 		Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar… 1 $314,007.82 $314,007.82 $314,007.82 nat. median
$6,194
outlier · 50.7×
4
OTHER 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 $304,392.35 $304,392.35 $304,392.35 nat. median
$141,414
outlier · 2.2×
636
OTHER 		Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu… 1 $288,347.68 $288,347.68 $288,347.68 nat. median
$76
outlier · 3769.3×
835
OTHER 		Acute Leukemia Without Major O.r. Procedures Age >17 With Cc 1 $272,938.62 $272,938.62 $272,938.62 nat. median
$188
outlier · 1448.7×
423
OTHER 		Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 $272,604.02 $272,604.02 $272,604.02 nat. median
$39,009
outlier · 7.0×
215
OTHER 		Other Heart Assist System Implant 1 $272,168.32 $272,168.32 $272,168.32 nat. median
$75,018
outlier · 3.6×
622
OTHER 		Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 $262,577.69 $262,577.69 $262,577.69 nat. median
$35,346
outlier · 7.4×
634
OTHER 		Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc… 1 $260,731.47 $260,731.47 $260,731.47 nat. median
$190
outlier · 1370.3×
414
OTHER 		Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 $257,884.60 $257,884.60 $257,884.60 nat. median
$33,951
outlier · 7.6×
927
OTHER 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $257,597.33 $257,597.33 $257,597.33 nat. median
$2
outlier · 152424.5×
974
OTHER 		HIV With Major Related Condition With Mcc 1 $221,721.49 $221,721.49 $221,721.49 nat. median
$28,618
outlier · 7.7×
613
OTHER 		Neonate, Birth Weight <750 Grams, Died 1 $205,878.85 $205,878.85 $205,878.85 nat. median
$41,290
outlier · 5.0×
5834
APR_DRG 		Neonate With Ecmo 2 $184,106.49 $221,000.00 $202,553.24 nat. median
$307,206
0.7× median
3
OTHER 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 $197,347.26 $197,347.26 $197,347.26 nat. median
$204,908
1.0× median
5
OTHER 		Liver Transplant With Mcc Or Intestinal Transplant 1 $196,938.66 $196,938.66 $196,938.66 nat. median
$105,227
1.9× median
515
OTHER 		Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 $193,206.38 $193,206.38 $193,206.38 nat. median
$30,460
outlier · 6.3×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $151,017.25 $221,000.00 $186,008.62 nat. median
$247,214
0.8× median
969
OTHER 		HIV With Extensive O.r. Procedures With Mcc 1 $184,142.06 $184,142.06 $184,142.06 nat. median
$244
outlier · 753.9×
5833
APR_DRG 		Neonate With Ecmo 2 $145,815.85 $221,000.00 $183,407.92 nat. median
$244,017
0.8× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $139,341.07 $220,000.00 $179,670.54 nat. median
$241,437
0.7× median
52
OTHER 		Spinal Disorders And Injuries With Cc/mcc 1 $173,242.68 $173,242.68 $173,242.68 nat. median
$21,581
outlier · 8.0×
239
OTHER 		Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 $165,805.42 $165,805.42 $165,805.42 nat. median
$46,604
outlier · 3.6×
207
OTHER 		Respiratory System Diagnosis With Ventilator Support >96 Hours 1 $155,362.58 $155,362.58 $155,362.58 nat. median
$64,908
outlier · 2.4×
595
OTHER 		Major Skin Disorders With Mcc 1 $154,019.88 $154,019.88 $154,019.88 nat. median
$19,720
outlier · 7.8×
216
MS_DRG 		Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 $90,911.56 $211,601.96 $153,098.05 nat. median
$90,551
1.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 2 $144,390.42 $160,011.77 $152,201.10 nat. median
$202,993
0.7× median
632
OTHER 		Neonate, Birth Weight 750-999 Grams, Died 1 $148,380.86 $148,380.86 $148,380.86 nat. median
$4,380
outlier · 33.9×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $109,613.92 $187,068.20 $148,341.06 nat. median
$154,011
1.0× median
904
OTHER 		Skin Grafts For Injuries With Cc/mcc 1 $147,487.44 $147,487.44 $147,487.44 nat. median
$2,146
outlier · 68.7×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $91,349.78 $200,000.00 $145,674.89 nat. median
$170,082
0.9× median
956
OTHER 		Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 $142,956.30 $142,956.30 $142,956.30 nat. median
$39,193
outlier · 3.6×
411
OTHER 		Cholecystectomy With C.d.e. With Mcc 1 $141,405.16 $141,405.16 $141,405.16 nat. median
$27,439
outlier · 5.2×
853
OTHER 		Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 $139,433.60 $139,433.60 $139,433.60 nat. median
$16,884
outlier · 8.3×
5832
APR_DRG 		Neonate With Ecmo 2 $107,525.21 $170,396.20 $138,960.71 nat. median
$159,249
0.9× median
485
OTHER 		Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 $137,652.25 $137,652.25 $137,652.25 nat. median
$31,597
outlier · 4.4×
11
OTHER 		Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 $136,615.44 $136,615.44 $136,615.44 nat. median
$55,593
outlier · 2.5×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $94,503.59 $161,280.77 $127,892.18 nat. median
$165,000
0.8× median
231
MS_DRG 		Coronary Bypass With Ptca With Mcc 3 $78,339.07 $182,338.74 $125,546.50 nat. median
$77,028
1.6× median
288
OTHER 		Acute And Subacute Endocarditis With Mcc 1 $125,516.78 $125,516.78 $125,516.78 nat. median
$27,287
outlier · 4.6×
820
OTHER 		Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 $123,918.81 $123,918.81 $123,918.81 nat. median
$337
outlier · 367.7×
455
OTHER 		Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 1 $123,209.07 $123,209.07 $123,209.07 nat. median
$44,798
outlier · 2.8×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $90,727.61 $154,836.65 $122,782.13 nat. median
$133,164
0.9× median
862
OTHER 		Postoperative And Post-traumatic Infections With Mcc 1 $122,192.68 $122,192.68 $122,192.68 nat. median
$2,877
outlier · 42.5×

Other procedures at this hospital

Browse this hospital's 6,195 published procedures. Use the slice to choose what to show, then sort or filter any column.

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Sortable, filterable data table. Use the column headers to sort, the filter row to narrow results.
Code Type Description Rate rows Payers Gross Cash Min $ Max $ Avg median Last observed
             
18 OTHER Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 1 — — $1,174,290.18 $1,174,290.18 $1,174,290.18 2026-07-15
681 OTHER Neonate, Birth Weight >2499 Grams, With Significant O.r. Procedures, With Multip… 1 1 — — $739,710.07 $739,710.07 $739,710.07 2026-07-15
166 OTHER Other Respiratory System O.r. Procedures With Mcc 1 1 — — $692,526.62 $692,526.62 $692,526.62 2026-07-15
1 OTHER Heart Transplant Or Implant Of Heart Assist System With Mcc 1 1 — — $545,448.31 $545,448.31 $545,448.31 2026-07-15
955 OTHER Craniotomy For Multiple Significant Trauma 1 1 — — $317,663.87 $317,663.87 $317,663.87 2026-07-15
266 OTHER Acute Leukemia Without Major O.r. Procedures Age 0-17 1 1 — — $317,163.74 $317,163.74 $317,163.74 2026-07-15
7 OTHER Lung Transplant 1 1 — — $316,357.78 $316,357.78 $316,357.78 2026-07-15
633 OTHER Neonate, Birth Weight 1000-1499 Grams, With Significant O.r. Procedures, Dischar… 1 1 — — $314,007.82 $314,007.82 $314,007.82 2026-07-15
4 OTHER Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 1 1 — — $304,392.35 $304,392.35 $304,392.35 2026-07-15
636 OTHER Neonate, Birth Weight 1500-1999 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $288,347.68 $288,347.68 $288,347.68 2026-07-15
835 OTHER Acute Leukemia Without Major O.r. Procedures Age >17 With Cc 1 1 — — $272,938.62 $272,938.62 $272,938.62 2026-07-15
423 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 1 1 — — $272,604.02 $272,604.02 $272,604.02 2026-07-15
215 OTHER Other Heart Assist System Implant 1 1 — — $272,168.32 $272,168.32 $272,168.32 2026-07-15
622 OTHER Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $262,577.69 $262,577.69 $262,577.69 2026-07-15
634 OTHER Neonate, Birth Weight 1000-1499 Grams, Without Significant O.r. Procedures, Disc… 1 1 — — $260,731.47 $260,731.47 $260,731.47 2026-07-15
414 OTHER Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 1 1 — — $257,884.60 $257,884.60 $257,884.60 2026-07-15
927 OTHER Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 1 — — $257,597.33 $257,597.33 $257,597.33 2026-07-15
974 OTHER HIV With Major Related Condition With Mcc 1 1 — — $221,721.49 $221,721.49 $221,721.49 2026-07-15
613 OTHER Neonate, Birth Weight <750 Grams, Died 1 1 — — $205,878.85 $205,878.85 $205,878.85 2026-07-15
5834 APR_DRG Neonate With Ecmo 2 2 — — $184,106.49 $221,000.00 $202,553.24 2026-07-15
3 OTHER Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 1 1 — — $197,347.26 $197,347.26 $197,347.26 2026-07-15
5 OTHER Liver Transplant With Mcc Or Intestinal Transplant 1 1 — — $196,938.66 $196,938.66 $196,938.66 2026-07-15
515 OTHER Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 1 1 — — $193,206.38 $193,206.38 $193,206.38 2026-07-15
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $151,017.25 $221,000.00 $186,008.62 2026-07-15
969 OTHER HIV With Extensive O.r. Procedures With Mcc 1 1 — — $184,142.06 $184,142.06 $184,142.06 2026-07-15
5833 APR_DRG Neonate With Ecmo 2 2 — — $145,815.85 $221,000.00 $183,407.92 2026-07-15
24 APR_DRG Heart And/or Lung Transplant 2 2 — — $139,341.07 $220,000.00 $179,670.54 2026-07-15
52 OTHER Spinal Disorders And Injuries With Cc/mcc 1 1 — — $173,242.68 $173,242.68 $173,242.68 2026-07-15
239 OTHER Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 1 1 — — $165,805.42 $165,805.42 $165,805.42 2026-07-15
207 OTHER Respiratory System Diagnosis With Ventilator Support >96 Hours 1 1 — — $155,362.58 $155,362.58 $155,362.58 2026-07-15
595 OTHER Major Skin Disorders With Mcc 1 1 — — $154,019.88 $154,019.88 $154,019.88 2026-07-15
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 6 — — $90,911.56 $211,601.96 $153,098.05 2026-07-15
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $144,390.42 $160,011.77 $152,201.10 2026-07-15
632 OTHER Neonate, Birth Weight 750-999 Grams, Died 1 1 — — $148,380.86 $148,380.86 $148,380.86 2026-07-15
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $109,613.92 $187,068.20 $148,341.06 2026-07-15
904 OTHER Skin Grafts For Injuries With Cc/mcc 1 1 — — $147,487.44 $147,487.44 $147,487.44 2026-07-15
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $91,349.78 $200,000.00 $145,674.89 2026-07-15
956 OTHER Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma 1 1 — — $142,956.30 $142,956.30 $142,956.30 2026-07-15
411 OTHER Cholecystectomy With C.d.e. With Mcc 1 1 — — $141,405.16 $141,405.16 $141,405.16 2026-07-15
853 OTHER Infectious And Parasitic Diseases With O.r. Procedures With Mcc 1 1 — — $139,433.60 $139,433.60 $139,433.60 2026-07-15
5832 APR_DRG Neonate With Ecmo 2 2 — — $107,525.21 $170,396.20 $138,960.71 2026-07-15
485 OTHER Knee Procedures With Principal Diagnosis Of Infection With Mcc 1 1 — — $137,652.25 $137,652.25 $137,652.25 2026-07-15
11 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 1 1 — — $136,615.44 $136,615.44 $136,615.44 2026-07-15
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $94,503.59 $161,280.77 $127,892.18 2026-07-15
231 MS_DRG Coronary Bypass With Ptca With Mcc 3 3 — — $78,339.07 $182,338.74 $125,546.50 2026-07-15
288 OTHER Acute And Subacute Endocarditis With Mcc 1 1 — — $125,516.78 $125,516.78 $125,516.78 2026-07-15
820 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Mcc 1 1 — — $123,918.81 $123,918.81 $123,918.81 2026-07-15
455 OTHER Combined Anterior And Posterior Spinal Fusion Without Cc/mcc 1 1 — — $123,209.07 $123,209.07 $123,209.07 2026-07-15
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $90,727.61 $154,836.65 $122,782.13 2026-07-15
862 OTHER Postoperative And Post-traumatic Infections With Mcc 1 1 — — $122,192.68 $122,192.68 $122,192.68 2026-07-15
228 OTHER Other Cardiothoracic Procedures With Mcc 1 1 — — $121,986.18 $121,986.18 $121,986.18 2026-07-15
14 OTHER Allogeneic Bone Marrow Transplant 1 1 — — $120,867.16 $120,867.16 $120,867.16 2026-07-15
957 OTHER Other O.r. Procedures For Multiple Significant Trauma With Mcc 1 1 — — $119,890.32 $119,890.32 $119,890.32 2026-07-15
734 OTHER Pelvic Evisceration, Radical Hysterectomy And Radical Vulvectomy With Cc/mcc 1 1 — — $119,757.64 $119,757.64 $119,757.64 2026-07-15
216 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $116,920.09 $116,920.09 $116,920.09 2026-07-15
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $110,617.91 $122,585.46 $116,601.68 2026-07-15
5831 APR_DRG Neonate With Ecmo 2 2 — — $92,921.21 $139,015.17 $115,968.19 2026-07-15
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 6 6 — — $71,046.84 $165,365.68 $115,459.68 2026-07-15
405 OTHER Pancreas, Liver And Shunt Procedures With Mcc 1 1 — — $114,816.86 $114,816.86 $114,816.86 2026-07-15
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $97,291.06 $132,000.00 $114,645.53 2026-07-15
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 5 5 — — $78,092.80 $181,765.54 $114,481.13 2026-07-15
13 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy Without Cc/mcc 1 1 — — $114,040.14 $114,040.14 $114,040.14 2026-07-15
360 OTHER Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 1 1 — — $113,146.89 $113,146.89 $113,146.89 2026-07-15
23 APR_DRG Heart And/or Lung Transplant 2 2 — — $86,166.48 $140,000.00 $113,083.24 2026-07-15
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $95,266.86 $130,000.00 $112,633.43 2026-07-15
653 MS_DRG Major Bladder Procedures With Mcc 5 5 — — $48,290.14 $130,570.84 $112,398.13 2026-07-15
840 OTHER Lymphoma And Non-acute Leukemia With Mcc 1 1 — — $112,293.15 $112,293.15 $112,293.15 2026-07-15
233 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 1 1 — — $111,268.96 $111,268.96 $111,268.96 2026-07-15
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $98,491.99 $121,000.00 $109,745.99 2026-07-15
23 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $109,382.08 $109,382.08 $109,382.08 2026-07-15
98 OTHER Non-bacterial Infection Of Nervous System Except Viral Meningitis With Cc 1 1 — — $108,829.74 $108,829.74 $108,829.74 2026-07-15
78 OTHER Hypertensive Encephalopathy With Cc 1 1 — — $108,824.42 $108,824.42 $108,824.42 2026-07-15
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $95,110.28 $120,000.00 $107,555.14 2026-07-15
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $101,824.64 $112,840.88 $107,332.76 2026-07-15
28 OTHER Spinal Procedures With Mcc 1 1 — — $106,376.00 $106,376.00 $106,376.00 2026-07-15
438 OTHER Disorders Of Pancreas Except Malignancy With Mcc 1 1 — — $105,652.03 $105,652.03 $105,652.03 2026-07-15
217 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 1 1 — — $105,118.46 $105,118.46 $105,118.46 2026-07-15
673 OTHER Other Kidney And Urinary Tract Procedures With Mcc 1 1 — — $104,575.23 $104,575.23 $104,575.23 2026-07-15
14 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $89,075.44 $120,000.00 $104,537.72 2026-07-15
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 6 — — $71,354.44 $166,081.63 $103,828.81 2026-07-15
629 OTHER Other Endocrine, Nutritional And Metabolic O.r. Procedures With Cc 1 1 — — $103,424.77 $103,424.77 $103,424.77 2026-07-15
651 OTHER Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $103,222.33 $103,222.33 $103,222.33 2026-07-15
799 OTHER Splenic Procedures Age >17 With Mcc 1 1 — — $102,654.93 $102,654.93 $102,654.93 2026-07-15
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 3 3 — — $63,916.32 $148,768.98 $102,432.56 2026-07-15
219 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $102,212.79 $102,212.79 $102,212.79 2026-07-15
314 OTHER Other Circulatory System Diagnoses With Mcc 1 1 — — $101,372.94 $101,372.94 $101,372.94 2026-07-15
22 APR_DRG Heart And/or Lung Transplant 2 2 — — $63,944.88 $138,000.00 $100,972.44 2026-07-15
837 OTHER Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 1 1 — — $100,706.21 $100,706.21 $100,706.21 2026-07-15
277 MS_DRG Cellulitis Age >17 W Cc 5 5 — — $42,919.72 $123,909.18 $99,898.15 2026-07-15
454 OTHER Combined Anterior And Posterior Spinal Fusion With Cc 1 1 — — $99,893.39 $99,893.39 $99,893.39 2026-07-15
6 OTHER Liver Transplant Without Mcc 1 1 — — $96,807.86 $96,807.86 $96,807.86 2026-07-15
67 OTHER Nonspecific Cva And Precerebral Occlusion Without Infarction With Mcc 1 1 — — $96,547.30 $96,547.30 $96,547.30 2026-07-15
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $90,482.37 $100,271.50 $95,376.93 2026-07-15
J9266 HCPCS 72694-0954-01 - Pegaspargase 750 Iu/ml Inj 41 26 $187,706.05 $187,706.05 $998.60 $187,706.05 $94,866.64 2026-07-15
29 OTHER Spinal Procedures With Cc Or Spinal Neurostimulators 1 1 — — $94,714.62 $94,714.62 $94,714.62 2026-07-15
608 OTHER Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period 1 1 — — $94,450.17 $94,450.17 $94,450.17 2026-07-15
229 OTHER Other Cardiothoracic Procedures Without Mcc 1 1 — — $93,869.04 $93,869.04 $93,869.04 2026-07-15
250 OTHER Percutaneous Cardiovascular Procedures Without Intraluminal Device With Mcc 1 1 — — $93,775.72 $93,775.72 $93,775.72 2026-07-15
1612 APR_DRG Implantable Heart Assist Systems 2 2 — — $88,816.61 $98,425.53 $93,621.07 2026-07-15
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $88,584.57 $98,168.38 $93,376.48 2026-07-15
635 OTHER Neonate, Birth Weight 1000-1499 Grams, Died 1 1 — — $91,931.98 $91,931.98 $91,931.98 2026-07-15
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 3 3 — — $56,951.22 $132,557.29 $91,270.26 2026-07-15
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 6 — — $61,104.26 $142,223.74 $90,760.60 2026-07-15
870 OTHER Septicemia Or Severe Sepsis With Mv >96 Hours 1 1 — — $90,507.26 $90,507.26 $90,507.26 2026-07-15
232 MS_DRG Coronary Bypass With Ptca Without Mcc 3 3 — — $56,339.75 $131,134.04 $90,290.30 2026-07-15
73 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $53,834.86 $125,880.83 $89,857.85 2026-07-15
1611 APR_DRG Implantable Heart Assist Systems 2 2 — — $84,375.46 $93,503.89 $88,939.68 2026-07-15
21 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 1 1 — — $88,177.34 $88,177.34 $88,177.34 2026-07-15
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 6 6 — — $50,837.35 $118,326.92 $87,187.60 2026-07-15
515 MS_DRG Other Musculoskeletal System And Connective Tissue O.r. Procedures With Mcc 6 6 — — $29,615.86 $114,447.62 $85,913.51 2026-07-15
220 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $85,707.89 $85,707.89 $85,707.89 2026-07-15
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 6 6 — — $54,536.90 $126,937.82 $85,503.54 2026-07-15
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $70,599.25 $100,000.00 $85,299.62 2026-07-15
26 OTHER Craniotomy And Endovascular Intracranial Procedures Age >17 With Cc 1 1 — — $85,128.51 $85,128.51 $85,128.51 2026-07-15
453 OTHER Combined Anterior And Posterior Spinal Fusion With Mcc 1 1 — — $84,881.19 $84,881.19 $84,881.19 2026-07-15
20 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 1 1 — — $84,109.37 $84,109.37 $84,109.37 2026-07-15
265 OTHER Aicd Lead Procedures 1 1 — — $83,893.83 $83,893.83 $83,893.83 2026-07-15
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 6 6 — — $38,593.83 $117,736.71 $83,017.50 2026-07-15
64 APR_DRG Pancreas Transplant 2 2 — — $78,663.95 $85,000.00 $81,831.98 2026-07-15
799 MS_DRG Splenectomy With Mcc 6 6 — — $42,087.07 $100,491.26 $81,457.80 2026-07-15
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $63,336.68 $98,966.45 $81,151.57 2026-07-15
231 OTHER Coronary Bypass With Ptca With Mcc 1 1 — — $81,045.82 $81,045.82 $81,045.82 2026-07-15
803 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With Cc 1 1 — — $81,044.95 $81,044.95 $81,044.95 2026-07-15
275 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 1 1 — — $80,063.63 $80,063.63 $80,063.63 2026-07-15
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $79,171.04 $80,000.00 $79,585.52 2026-07-15
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 6 6 — — $46,347.90 $107,877.46 $79,384.62 2026-07-15
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 5 5 — — $66,262.80 $154,230.55 $79,279.49 2026-07-15
459 OTHER Spinal Fusion Except Cervical With Mcc 1 1 — — $79,197.34 $79,197.34 $79,197.34 2026-07-15
164 OTHER Major Chest Procedures With Cc 1 1 — — $78,767.86 $78,767.86 $78,767.86 2026-07-15
12 OTHER Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 1 1 — — $78,696.94 $78,696.94 $78,696.94 2026-07-15
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 3 — — $49,032.65 $114,126.37 $78,579.94 2026-07-15
654 OTHER Major Bladder Procedures With Cc 1 1 — — $78,051.10 $78,051.10 $78,051.10 2026-07-15
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $46,755.65 $109,327.69 $78,041.67 2026-07-15
318 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 1 1 — — $78,040.38 $78,040.38 $78,040.38 2026-07-15
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 6 6 — — $56,645.37 $142,223.74 $77,278.76 2026-07-15
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 2 2 — — $46,210.08 $108,051.98 $77,131.03 2026-07-15
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $37,368.53 $114,365.96 $75,867.24 2026-07-15
982 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Cc 1 1 — — $75,330.67 $75,330.67 $75,330.67 2026-07-15
58 OTHER Multiple Sclerosis And Cerebellar Ataxia With Mcc 1 1 — — $75,234.62 $75,234.62 $75,234.62 2026-07-15
163 OTHER Major Chest Procedures With Mcc 1 1 — — $74,554.96 $74,554.96 $74,554.96 2026-07-15
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 6 6 — — $60,658.44 $141,706.78 $74,297.29 2026-07-15
573 OTHER Skin Graft For Skin Ulcer Or Cellulitis With Mcc 1 1 — — $73,707.80 $73,707.80 $73,707.80 2026-07-15
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $54,226.49 $92,543.47 $73,384.98 2026-07-15
977 OTHER HIV With Or Without Other Related Condition 1 1 — — $73,342.71 $73,342.71 $73,342.71 2026-07-15
94 OTHER Bacterial And Tuberculous Infections Of Nervous System With Mcc 1 1 — — $73,188.13 $73,188.13 $73,188.13 2026-07-15
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 6 — — $49,557.71 $115,348.46 $72,593.96 2026-07-15
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $50,021.00 $94,988.04 $72,504.52 2026-07-15
329 OTHER Major Small And Large Bowel Procedures With Mcc 1 1 — — $71,781.72 $71,781.72 $71,781.72 2026-07-15
13 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $51,497.13 $92,000.00 $71,748.57 2026-07-15
27 OTHER Craniotomy And Endovascular Intracranial Procedures Age >17 Without Cc/mcc 1 1 — — $71,468.53 $71,468.53 $71,468.53 2026-07-15
234 OTHER Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 1 1 — — $71,406.20 $71,406.20 $71,406.20 2026-07-15
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $55,720.21 $87,065.36 $71,392.79 2026-07-15
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $55,669.27 $86,985.76 $71,327.51 2026-07-15
4404 APR_DRG Kidney Transplant 2 2 — — $52,336.24 $90,000.00 $71,168.12 2026-07-15
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 3 3 — — $44,242.11 $102,976.10 $70,902.59 2026-07-15
25 OTHER Craniotomy And Endovascular Intracranial Procedures Age >17 With Mcc 1 1 — — $70,818.10 $70,818.10 $70,818.10 2026-07-15
72 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $42,110.01 $98,464.88 $70,287.45 2026-07-15
63 APR_DRG Pancreas Transplant 2 2 — — $55,312.35 $85,000.00 $70,156.18 2026-07-15
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $61,097.81 $78,917.23 $70,007.52 2026-07-15
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 6 — — $55,415.09 $128,981.85 $69,958.69 2026-07-15
253 OTHER Other Vascular Procedures With Cc 1 1 — — $69,823.26 $69,823.26 $69,823.26 2026-07-15
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 6 6 — — $42,715.27 $99,422.29 $69,660.26 2026-07-15
503 OTHER Foot Procedures With Mcc 1 1 — — $69,192.86 $69,192.86 $69,192.86 2026-07-15
264 OTHER Other Circulatory System O.r. Procedures 1 1 — — $69,004.84 $69,004.84 $69,004.84 2026-07-15
826 OTHER Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 1 1 — — $68,694.77 $68,694.77 $68,694.77 2026-07-15
362 OTHER Cardiac Defibrillator Implant Without Mcc 1 1 — — $68,227.39 $68,227.39 $68,227.39 2026-07-15
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $52,962.93 $82,756.97 $67,859.95 2026-07-15
258 OTHER Cardiac Pacemaker Device Replacement With Mcc 1 1 — — $67,223.14 $67,223.14 $67,223.14 2026-07-15
659 MS_DRG Kidney And Ureter Procedures For Non-neoplasm With Mcc 6 6 — — $23,612.59 $117,082.12 $66,544.32 2026-07-15
62 APR_DRG Pancreas Transplant 2 2 — — $48,016.58 $85,000.00 $66,508.29 2026-07-15
457 OTHER Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 1 1 — — $66,367.43 $66,367.43 $66,367.43 2026-07-15
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 6 6 — — $50,764.88 $118,158.20 $66,313.84 2026-07-15
539 OTHER Osteomyelitis With Mcc 1 1 — — $66,214.69 $66,214.69 $66,214.69 2026-07-15
147 OTHER Ear, Nose, Mouth And Throat Malignancy With Cc 1 1 — — $66,133.09 $66,133.09 $66,133.09 2026-07-15
625 MS_DRG Thyroid, Parathyroid And Thyroglossal Procedures With Mcc 5 5 — — $28,065.79 $99,260.71 $65,324.76 2026-07-15
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $61,919.56 $68,618.53 $65,269.04 2026-07-15
12 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $43,160.78 $87,000.00 $65,080.39 2026-07-15
950 OTHER Aftercare Without Cc/mcc 1 1 — — $64,684.20 $64,684.20 $64,684.20 2026-07-15
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $50,200.36 $79,000.00 $64,600.18 2026-07-15
500 MS_DRG Soft Tissue Procedures With Mcc 6 6 — — $29,410.48 $71,839.04 $64,432.04 2026-07-15
656 MS_DRG Kidney And Ureter Procedures For Neoplasm With Mcc 6 6 — — $29,587.05 $90,602.73 $64,416.54 2026-07-15
652 OTHER Kidney Transplant 1 1 — — $64,230.90 $64,230.90 $64,230.90 2026-07-15
500 OTHER Soft Tissue Procedures With Mcc 1 1 — — $64,011.66 $64,011.66 $64,011.66 2026-07-15
7544 APR_DRG Depression Except Major Depressive Disorder 2 2 — — $8,779.67 $118,078.43 $63,429.05 2026-07-15
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 3 — — $39,246.20 $91,347.82 $62,896.11 2026-07-15
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $59,629.75 $66,080.99 $62,855.37 2026-07-15
739 OTHER Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 1 1 — — $62,700.77 $62,700.77 $62,700.77 2026-07-15
71 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $37,495.68 $87,675.29 $62,585.49 2026-07-15
J9347 HCPCS 00310-4535-30 - Tremelimumab Actl 20 mg/mL Sol 41 26 $122,671.40 $122,671.40 $652.61 $122,671.40 $61,998.13 2026-07-15
619 MS_DRG O.r. Procedures For Obesity With Mcc 6 6 — — $26,832.61 $64,596.49 $61,910.57 2026-07-15
409 OTHER Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 1 1 — — $61,851.80 $61,851.80 $61,851.80 2026-07-15
975 OTHER HIV With Major Related Condition With Cc 1 1 — — $61,785.05 $61,785.05 $61,785.05 2026-07-15
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 3 3 — — $38,338.27 $89,234.56 $61,441.07 2026-07-15
462 OTHER Bilateral Or Multiple Major Joint Procedures Of Lower Extremity Without Mcc 1 1 — — $61,433.75 $61,433.75 $61,433.75 2026-07-15
579 MS_DRG Other Skin, Subcutaneous Tissue And Breast Procedures With Mcc 6 6 — — $30,095.38 $74,189.88 $61,307.06 2026-07-15
377 OTHER Gastrointestinal Hemorrhage With Mcc 1 1 — — $61,223.15 $61,223.15 $61,223.15 2026-07-15
647 OTHER Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With… 1 1 — — $61,138.59 $61,138.59 $61,138.59 2026-07-15
333 OTHER Rectal Resection With Cc 1 1 — — $60,942.98 $60,942.98 $60,942.98 2026-07-15
597 OTHER Malignant Breast Disorders With Mcc 1 1 — — $60,851.37 $60,851.37 $60,851.37 2026-07-15
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $57,583.67 $63,813.55 $60,698.61 2026-07-15
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 6 6 — — $34,734.45 $80,846.45 $60,619.43 2026-07-15
277 OTHER Other Major Cardiovascular Procedures With Mcc 1 1 — — $60,573.85 $60,573.85 $60,573.85 2026-07-15
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $47,082.01 $73,567.78 $60,324.90 2026-07-15
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 6 6 — — $46,473.32 $109,019.53 $60,109.83 2026-07-15
236 OTHER Coronary Bypass Without Cardiac Catheterization Without Mcc 1 1 — — $59,817.23 $59,817.23 $59,817.23 2026-07-15
822 OTHER Lymphoma And Leukemia With Major O.r. Procedures Without Cc/mcc 1 1 — — $59,508.80 $59,508.80 $59,508.80 2026-07-15
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 6 6 — — $33,693.63 $78,423.89 $59,142.34 2026-07-15
157 OTHER Dental And Oral Diseases Age >17 With Mcc 1 1 — — $59,096.69 $59,096.69 $59,096.69 2026-07-15
905 OTHER Skin Grafts For Injuries Without Cc/mcc 1 1 — — $59,022.02 $59,022.02 $59,022.02 2026-07-15
289 OTHER Acute And Subacute Endocarditis With Cc 1 1 — — $58,838.20 $58,838.20 $58,838.20 2026-07-15
650 OTHER Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With… 1 1 — — $58,362.33 $58,362.33 $58,362.33 2026-07-15
235 OTHER Coronary Bypass Without Cardiac Catheterization With Mcc 1 1 — — $58,303.43 $58,303.43 $58,303.43 2026-07-15
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $55,051.64 $61,007.58 $58,029.61 2026-07-15
907 OTHER Other O.r. Procedures For Injuries With Mcc 1 1 — — $57,816.43 $57,816.43 $57,816.43 2026-07-15
4403 APR_DRG Kidney Transplant 2 2 — — $34,497.68 $80,665.15 $57,581.41 2026-07-15
35 OTHER Carotid Artery Stent Procedures With Cc 1 1 — — $57,476.88 $57,476.88 $57,476.88 2026-07-15
330 OTHER Major Small And Large Bowel Procedures With Cc 1 1 — — $57,312.06 $57,312.06 $57,312.06 2026-07-15
317 OTHER Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 1 1 — — $57,002.89 $57,002.89 $57,002.89 2026-07-15
J2507 HCPCS 75987-0080-10 - Pegloticase 8 mg/mL Inj 41 26 $111,842.24 $111,842.24 $595.00 $111,842.24 $56,525.07 2026-07-15
493 OTHER Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Age >17 With C… 1 1 — — $56,505.32 $56,505.32 $56,505.32 2026-07-15
5881 APR_DRG Female Reproductive System Reconstructive Procedures 2 2 — — $50,000.00 $62,708.10 $56,354.05 2026-07-15
474 OTHER Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 1 1 — — $55,999.29 $55,999.29 $55,999.29 2026-07-15
420 OTHER Hepatobiliary Diagnostic Procedures With Mcc 1 1 — — $55,819.47 $55,819.47 $55,819.47 2026-07-15
276 MS_DRG Non-maligant Breast Disorders 5 5 — — $35,538.36 $129,922.76 $55,819.34 2026-07-15
143 MS_DRG Other Ear, Nose, Mouth And Throat O.r. Procedures With Mcc 3 3 — — $34,817.15 $81,038.96 $55,798.11 2026-07-15
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $41,207.89 $70,325.79 $55,766.84 2026-07-15
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 3 — — $34,730.72 $80,837.80 $55,659.61 2026-07-15
623 OTHER Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor… 1 1 — — $55,334.57 $55,334.57 $55,334.57 2026-07-15
245 OTHER Aicd Generator Procedures 1 1 — — $55,310.02 $55,310.02 $55,310.02 2026-07-15
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $42,477.49 $67,314.48 $54,895.99 2026-07-15
279 OTHER Other Major Cardiovascular Procedures Without Cc/mcc 1 1 — — $54,776.71 $54,776.71 $54,776.71 2026-07-15
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $51,459.40 $57,026.70 $54,243.05 2026-07-15
213 OTHER Splenic Procedures Age 0-17 1 1 — — $54,194.27 $54,194.27 $54,194.27 2026-07-15
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $42,185.09 $65,916.12 $54,050.60 2026-07-15
411 MS_DRG Cholecystectomy With C.d.e. With Mcc 6 6 — — $30,697.57 $71,450.38 $54,018.47 2026-07-15
424 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 6 6 — — $20,332.15 $75,412.70 $54,018.19 2026-07-15
350 MS_DRG Inguinal And Femoral Hernia Procedures With Mcc 5 5 — — $23,157.23 $67,335.82 $53,899.80 2026-07-15
665 OTHER Prostatectomy With Mcc 1 1 — — $53,816.74 $53,816.74 $53,816.74 2026-07-15
505 OTHER Foot Procedures Without Cc/mcc 1 1 — — $53,774.75 $53,774.75 $53,774.75 2026-07-15
619 OTHER O.r. Procedures For Obesity With Mcc 1 1 — — $53,655.98 $53,655.98 $53,655.98 2026-07-15
472 OTHER Cervical Spinal Fusion With Cc 1 1 — — $53,615.76 $53,615.76 $53,615.76 2026-07-15
255 OTHER Upper Limb And Toe Amputation For Circulatory System Disorders With Mcc 1 1 — — $53,552.77 $53,552.77 $53,552.77 2026-07-15
802 OTHER Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 1 1 — — $53,359.91 $53,359.91 $53,359.91 2026-07-15
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $39,405.17 $67,249.26 $53,327.21 2026-07-15
C2616 HCPCS Nm Y-90 Microspheres- Nonstranded 64 24 $87,672.00 $87,672.00 $12,836.86 $89,975.00 $53,294.10 2026-07-15
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 3 — — $33,048.69 $76,922.77 $52,963.98 2026-07-15
24 OTHER Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 1 1 — — $52,811.91 $52,811.91 $52,811.91 2026-07-15
463 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $52,514.67 $52,514.67 $52,514.67 2026-07-15
21 APR_DRG Heart And/or Lung Transplant 2 2 — — $50,000.00 $54,817.71 $52,408.85 2026-07-15
481 OTHER Hip And Femur Procedures Except Major Joint Age >17 With Cc 1 1 — — $52,391.75 $52,391.75 $52,391.75 2026-07-15
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 6 6 — — $38,926.52 $90,603.74 $52,179.12 2026-07-15
821 OTHER Lymphoma And Leukemia With Major O.r. Procedures With Cc 1 1 — — $52,157.80 $52,157.80 $52,157.80 2026-07-15
435 OTHER Malignancy Of Hepatobiliary System Or Pancreas With Mcc 1 1 — — $51,946.06 $51,946.06 $51,946.06 2026-07-15
276 OTHER Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 1 1 — — $51,875.56 $51,875.56 $51,875.56 2026-07-15
494 OTHER Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Age >17 Withou… 1 1 — — $51,802.99 $51,802.99 $51,802.99 2026-07-15
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $49,000.19 $54,301.43 $51,650.81 2026-07-15
352 OTHER Inguinal And Femoral Hernia Procedures Age >17 Without Cc/mcc 1 1 — — $51,606.71 $51,606.71 $51,606.71 2026-07-15
162 OTHER Lower Extremity And Humerus Procedures Except Hip, Foot And Femur Age 0-17 1 1 — — $51,597.04 $51,597.04 $51,597.04 2026-07-15
657 OTHER Kidney And Ureter Procedures For Neoplasm With Cc 1 1 — — $51,443.56 $51,443.56 $51,443.56 2026-07-15
1784 APR_DRG External Heart Assist Systems 2 2 — — $48,673.07 $53,938.93 $51,306.00 2026-07-15
332 OTHER Rectal Resection With Mcc 1 1 — — $51,199.30 $51,199.30 $51,199.30 2026-07-15
252 MS_DRG Other Vascular Procedures With Mcc 6 6 — — $32,416.77 $75,451.93 $51,100.38 2026-07-15
J9043 HCPCS 00024-5824-11 - Cabazitaxel 60 Mg/1.5 Ml Vial 41 26 $100,794.61 $100,794.61 $536.23 $100,794.61 $50,941.60 2026-07-15
516 OTHER Other Musculoskeletal System And Connective Tissue O.r. Procedures With Cc 1 1 — — $50,914.18 $50,914.18 $50,914.18 2026-07-15
555 OTHER Signs And Symptoms Of Musculoskeletal System And Connective Tissue With Mcc 1 1 — — $50,914.05 $50,914.05 $50,914.05 2026-07-15
749 OTHER Other Female Reproductive System O.r. Procedures With Cc/mcc 1 1 — — $50,577.61 $50,577.61 $50,577.61 2026-07-15
273 OTHER Percutaneous And Other Intracardiac Procedures With Mcc 1 1 — — $50,368.72 $50,368.72 $50,368.72 2026-07-15
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $38,661.14 $62,000.00 $50,330.57 2026-07-15
221 OTHER Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 1 1 — — $50,148.64 $50,148.64 $50,148.64 2026-07-15
849 OTHER Radiotherapy 1 1 — — $50,123.08 $50,123.08 $50,123.08 2026-07-15
22 OTHER Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/… 1 1 — — $49,676.51 $49,676.51 $49,676.51 2026-07-15
871 OTHER Septicemia Or Severe Sepsis Without Mv >96 Hours Age >17 With Mcc 1 1 — — $49,595.41 $49,595.41 $49,595.41 2026-07-15
4402 APR_DRG Kidney Transplant 2 2 — — $29,587.55 $69,183.90 $49,385.72 2026-07-15
242 MS_DRG Permanent Cardiac Pacemaker Implant With Mcc 6 6 — — $29,670.69 $69,060.26 $49,376.86 2026-07-15
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $38,527.20 $60,200.51 $49,363.85 2026-07-15
347 MS_DRG Anal And Stomal Procedures With Mcc 6 6 — — $21,333.01 $51,376.57 $49,230.79 2026-07-15
981 OTHER Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 1 1 — — $49,224.72 $49,224.72 $49,224.72 2026-07-15
274 MS_DRG Percutaneous And Other Intracardiac Procedures Without Mcc 3 3 — — $30,589.77 $71,199.47 $49,023.29 2026-07-15
381 OTHER Complicated Peptic Ulcer With Cc 1 1 — — $48,863.84 $48,863.84 $48,863.84 2026-07-15
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 2 2 — — $29,097.82 $68,312.16 $48,704.99 2026-07-15
350 OTHER Inguinal And Femoral Hernia Procedures Age >17 With Mcc 1 1 — — $48,696.45 $48,696.45 $48,696.45 2026-07-15
545 OTHER Connective Tissue Disorders With Mcc 1 1 — — $48,687.93 $48,687.93 $48,687.93 2026-07-15
302 OTHER Atherosclerosis With Mcc 1 1 — — $48,668.99 $48,668.99 $48,668.99 2026-07-15
80 OTHER Nontraumatic Stupor And Coma With Mcc 1 1 — — $48,573.36 $48,573.36 $48,573.36 2026-07-15
747 OTHER Vagina, Cervix And Vulva Procedures Without Cc/mcc 1 1 — — $48,398.48 $48,398.48 $48,398.48 2026-07-15
471 MS_DRG Cervical Spinal Fusion With Mcc 6 6 — — $35,092.72 $104,444.78 $47,973.56 2026-07-15
16 OTHER Autologous Bone Marrow Transplant With Cc/mcc 1 1 — — $47,936.55 $47,936.55 $47,936.55 2026-07-15
424 OTHER Other Hepatobiliary Or Pancreas O.r. Procedures With Cc 1 1 — — $47,855.48 $47,855.48 $47,855.48 2026-07-15
4804 APR_DRG Major Male Pelvic Procedures 2 2 — — $22,274.80 $73,405.54 $47,840.17 2026-07-15
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 6 6 — — $38,775.98 $90,253.34 $47,529.51 2026-07-15
187 OTHER Pleural Effusion With Cc 1 1 — — $47,423.15 $47,423.15 $47,423.15 2026-07-15
464 OTHER Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 1 1 — — $47,415.14 $47,415.14 $47,415.14 2026-07-15
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $44,809.56 $49,657.43 $47,233.49 2026-07-15
582 OTHER Mastectomy For Malignancy With Cc/mcc 1 1 — — $47,232.81 $47,232.81 $47,232.81 2026-07-15
C2624 HCPCS Ccls-system Cardiomems Sensor 66 24 $82,500.00 $82,500.00 $9,883.30 $97,500.00 $46,980.00 2026-07-15
715 OTHER Other Male Reproductive System O.r. Procedures For Malignancy With Cc/mcc 1 1 — — $46,873.86 $46,873.86 $46,873.86 2026-07-15
471 OTHER Cervical Spinal Fusion With Mcc 1 1 — — $46,838.96 $46,838.96 $46,838.96 2026-07-15
834 OTHER Acute Leukemia Without Major O.r. Procedures Age >17 With Mcc 1 1 — — $46,820.85 $46,820.85 $46,820.85 2026-07-15
C1824 HCPCS Generator Optimizer Smart Mini 33 24 $78,000.00 $78,000.00 $11,420.70 $78,000.00 $46,800.00 2026-07-15
648 OTHER Neonate, Birth Weight 1500-1999 Grams, Without Significant O.r. Procedures, With… 1 1 — — $46,691.55 $46,691.55 $46,691.55 2026-07-15
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