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

CARLE RICHLAND MEMORIAL HOSPITAL

Olney, IL · CCN 141355 · Rates published

Your selected procedure

You selected 807 (MS_DRG)

VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC

This hospital’s price: $7,333 across 1 payer

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/11476/371363001_richland-memorial-hospital-inc_standardcharges.csv · observed 2026-04-15

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.

4,124 distinct procedures filed
13 distinct payers
302,838 rate rows
2026-04-15 last MRF observed
Data quality

301,159 of 302,838 rate rows are consumer-grade (99.4%)

1,679 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
per-diem day rate — not a per-procedure price 1,105
template filing: same amount across many unrelated codes — excluded 333
percent-of-charges filed in the dollar field — excluded from medians 96
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 91
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 30
placeholder amount (≤ $0.02) — excluded from medians 22
exceeds 10× this hospital's gross charge — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/11476/371363001_richland-memorial-hospital-inc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/CarleRichlandMemorialHospital/11476
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-03
Content fingerprint ad0f9548e5427a0d… · 287,770,079 bytes · first seen 2026-05-13

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
J7181
HCPCS 		Tretten 2,500 Unit Intravenous Solution 12 $77,534.10 $321,212.70 $215,987.85 nat. median
$20
outlier · 10541.1×
J2326
HCPCS 		Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 12 $70,047.94 $290,198.62 $195,133.55 nat. median
$2,353
outlier · 82.9×
5834
APR_DRG 		Neonate W Ecmo 4 $185,653.60 $185,653.60 $185,653.60 nat. median
$311,018
0.6× median
Q2043
HCPCS 		Provenge 50 Million Cell/250 Ml Intravenous Suspension 12 $60,802.78 $251,897.22 $169,379.17 nat. median
$65,655
outlier · 2.6×
5833
APR_DRG 		Neonate W Ecmo 4 $168,776.11 $168,776.11 $168,776.11 nat. median
$250,089
0.7× median
J0225
HCPCS 		Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 12 $57,145.26 $236,744.64 $159,190.36 nat. median
$8,133
outlier · 19.6×
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $152,009.25 $152,009.25 $152,009.25 nat. median
$254,667
0.6× median
64654
CPT 		Opn Implt Bat Modulj Sys 12 $49,561.05 $205,324.35 $138,062.92 nat. median
$44,598
outlier · 3.1×
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $125,613.29 $125,613.29 $125,613.29 nat. median
$168,361
0.7× median
24
APR_DRG 		Heart &/or Lung Transplant 4 $122,810.80 $122,810.80 $122,810.80 nat. median
$243,231
0.5× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 4 $113,407.27 $113,407.27 $113,407.27 nat. median
$168,174
0.7× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 4 $113,390.46 $113,390.46 $113,390.46 nat. median
$175,480
0.6× median
J2351
HCPCS 		Ocrevus Zunovo 920 Mg-23,000 Unit/23 Ml Subcutaneous Solution 12 $40,571.87 $168,083.44 $113,021.62 nat. median
$76
outlier · 1488.6×
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
$96,420
1.2× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 4 $109,693.94 $109,693.94 $109,693.94 nat. median
$156,285
0.7× median
5832
APR_DRG 		Neonate W Ecmo 4 $99,495.67 $99,495.67 $99,495.67 nat. median
$169,230
0.6× median
5831
APR_DRG 		Neonate W Ecmo 4 $99,281.84 $99,281.84 $99,281.84 nat. median
$154,685
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
$108,751
0.9× median
64656
CPT 		J/Rplcmt Bat Mod Sys Pg 12 $34,720.98 $143,844.06 $96,722.73 nat. median
$32,123
outlier · 3.0×
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 4 $96,644.31 $96,644.31 $96,644.31 nat. median
$209,486
outlier · 0.5×
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $95,146.70 $95,146.70 $95,146.70 nat. median
$180,995
0.5× 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
$123,690
0.8× median
5912
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $90,508.46 $90,508.46 $90,508.46 nat. median
$84,000
1.1× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $90,214.49 $90,214.49 $90,214.49 nat. median
$165,599
0.5× median
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 $90,048.35 $90,048.35 $90,048.35 nat. median
$160,171
0.6× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 4 $88,934.24 $88,934.24 $88,934.24 nat. median
$137,901
0.6× median
J1823
HCPCS 		Uplizna 10 Mg/ml Intravenous Solution 12 $31,641.07 $131,084.44 $88,142.99 nat. median
$818
outlier · 107.8×
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 4 $87,524.19 $87,524.19 $87,524.19 nat. median
$165,646
0.5× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $85,767.41 $85,767.41 $85,767.41 nat. median
$147,847
0.6× median
6314
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure 4 $84,713.10 $84,713.10 $84,713.10 nat. median
$147,677
0.6× median
23
APR_DRG 		Heart &/or Lung Transplant 4 $84,640.00 $84,640.00 $84,640.00 nat. median
$116,111
0.7× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure 4 $82,957.10 $82,957.10 $82,957.10 nat. median
$127,600
0.7× median
6034
APR_DRG 		Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 4 $81,364.89 $81,364.89 $81,364.89 nat. median
$109,499
0.7× median
5933
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 4 $81,138.94 $81,138.94 $81,138.94 nat. median
$112,711
0.7× median
5892
APR_DRG 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 $78,918.13 $78,918.13 $78,918.13 nat. median
$89,188
0.9× median
5881
APR_DRG 		Neonate Bwt <1500g W Major Procedure 4 $77,190.67 $77,190.67 $77,190.67 nat. median
$120,928
0.6× median
J9999
HCPCS 		Gliadel Wafer 7.7 Mg Implant 12 $27,675.62 $114,656.15 $77,096.38 nat. median
$2,547
outlier · 30.3×
J2350
HCPCS 		Ocrevus 30 Mg/ml Intravenous Solution 12 $27,568.07 $114,210.56 $76,796.76 nat. median
$331
outlier · 232.2×
64
APR_DRG 		Pancreas Transplant 4 $75,605.89 $75,605.89 $75,605.89 nat. median
$92,994
0.8× median
6074
APR_DRG 		Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 $73,367.88 $73,367.88 $73,367.88 nat. median
$99,613
0.7× median
5893
APR_DRG 		Neonate Bwt < 500g, Or Bwt 500-999g & Gestational Age <24 Wks, Or Bwt 500-749g W… 4 $71,744.01 $71,744.01 $71,744.01 nat. median
$71,350
1.0× median
6084
APR_DRG 		Neonate Bwt 1250-1499g W Or Without Other Significant Condition 4 $69,154.96 $69,154.96 $69,154.96 nat. median
$64,930
1.1× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant 4 $68,061.56 $68,061.56 $68,061.56 nat. median
$89,814
0.8× median
5932
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 4 $67,495.51 $67,495.51 $67,495.51 nat. median
$89,063
0.8× median
J9226
HCPCS 		Supprelin La 50 Mg (65 Mcg/day) Implant Kit 12 $24,026.96 $99,540.26 $66,932.24 nat. median
$55,200
1.2× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 4 $66,683.97 $66,683.97 $66,683.97 nat. median
$101,315
0.7× median
6114
APR_DRG 		Neonate Birthwt 1500-1999g W Major Anomaly 4 $66,180.85 $66,180.85 $66,180.85 nat. median
$79,344
0.8× median
22
APR_DRG 		Heart &/or Lung Transplant 4 $66,012.76 $66,012.76 $66,012.76 nat. median
$94,014
0.7× median
5911
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 4 $65,236.79 $65,236.79 $65,236.79 nat. median
$37,247
1.8× median
6023
APR_DRG 		Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 $64,513.59 $64,513.59 $64,513.59 nat. median
$92,000
0.7× median

Other procedures at this hospital

Browse this hospital's 4,124 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 37 12 $369,210.00 $369,210.00 $77,534.10 $321,212.70 $215,987.85 2026-04-15
J2326 HCPCS Spinraza (pf) 12 Mg/5 Ml Intrathecal Solution 37 12 $333,561.63 $333,561.63 $70,047.94 $290,198.62 $195,133.55 2026-04-15
5834 APR_DRG Neonate W Ecmo 4 4 — — $185,653.60 $185,653.60 $185,653.60 2026-04-15
Q2043 HCPCS Provenge 50 Million Cell/250 Ml Intravenous Suspension 37 12 $289,537.03 $289,537.03 $60,802.78 $251,897.22 $169,379.17 2026-04-15
5833 APR_DRG Neonate W Ecmo 4 4 — — $168,776.11 $168,776.11 $168,776.11 2026-04-15
J0225 HCPCS Amvuttra 25 Mg/0.5 Ml Subcutaneous Syringe 37 12 $272,120.28 $272,120.28 $57,145.26 $236,744.64 $159,190.36 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
64654 CPT Opn Implt Bat Modulj Sys 39 12 $236,005.00 $236,005.00 $49,561.05 $205,324.35 $138,062.92 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
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
J2351 HCPCS Ocrevus Zunovo 920 Mg-23,000 Unit/23 Ml Subcutaneous Solution 37 12 $193,199.36 $193,199.36 $40,571.87 $168,083.44 $113,021.62 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
64656 CPT J/Rplcmt Bat Mod Sys Pg 39 12 $165,338.00 $165,338.00 $34,720.98 $143,844.06 $96,722.73 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
J1823 HCPCS Uplizna 10 Mg/ml Intravenous Solution 37 12 $150,671.77 $150,671.77 $31,641.07 $131,084.44 $88,142.99 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
J9999 HCPCS Gliadel Wafer 7.7 Mg Implant 37 12 $131,788.68 $131,788.68 $27,675.62 $114,656.15 $77,096.38 2026-04-15
J2350 HCPCS Ocrevus 30 Mg/ml Intravenous Solution 37 12 $131,276.50 $131,276.50 $27,568.07 $114,210.56 $76,796.76 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
J9226 HCPCS Supprelin La 50 Mg (65 Mcg/day) Implant Kit 37 12 $114,414.09 $114,414.09 $24,026.96 $99,540.26 $66,932.24 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
0915T CPT Insj Perm Ccm-d Sys Pg&Eltrd 39 12 $105,273.00 $105,273.00 $22,107.33 $91,587.51 $61,584.71 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
C9293 HCPCS Voraxaze 1,000 Unit Intravenous Solution 37 12 $98,571.24 $98,571.24 $20,699.96 $85,756.98 $57,664.18 2026-04-15
37277 CPT C Evsc Fpvt St Athr Cpx 1 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37288 CPT Sc Evsc Tpvt Athrc Sf 1st 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37275 CPT C Evsc Fpvt St Athrc Sf 1 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37273 CPT Sc Evsc Fpvt Athrc Cplx 1 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
92930 CPT Tcat Plmt Ntrac St 2+Les 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37271 CPT Sc Evsc Fpvt Athrc Sf 1st 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37294 CPT C Evsc Tpvt St Athr Cpx 1 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37290 CPT Sc Evsc Tpvt Athrc Cplx 1 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37292 CPT C Evsc Tpvt St Athrc Sf 1 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37286 CPT Sc Evasc Tpvt St Cplx 1st 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
37284 CPT Sc Evasc Tpvt St Sf 1st 39 12 $98,223.00 $98,223.00 $20,626.83 $85,454.01 $57,460.46 2026-04-15
J9347 HCPCS Imjudo 20 Mg/ml Intravenous Solution 58 12 $269,802.57 $269,802.57 $4,721.55 $234,728.24 $56,658.54 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
J9028 HCPCS Anktiva 400 Mcg/0.4 Ml Intravesical Solution 37 12 $81,624.00 $81,624.00 $17,141.04 $71,012.88 $47,750.04 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
J9269 HCPCS Elzonris 1,000 Mcg/ml Intravenous Solution 37 12 $76,965.16 $76,965.16 $16,162.68 $66,959.69 $45,024.62 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
0923T CPT Rmvl&Rplcmt Perm Ccm-d Pg 39 12 $73,700.00 $73,700.00 $15,477.00 $64,119.00 $43,114.50 2026-04-15
0916T CPT Insj Perm Ccm-d Sys Pg Only 39 12 $73,700.00 $73,700.00 $15,477.00 $64,119.00 $43,114.50 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
J2507 HCPCS Krystexxa 8 Mg/ml Intravenous Solution 37 12 $72,477.21 $72,477.21 $15,220.21 $63,055.17 $42,399.17 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
J9334 HCPCS Vyvgart Hytrulo 1,008 Mg-11,200 Unit/5.6 Ml Subcutaneous Solution 60 12 $68,922.99 $68,922.99 $14,473.83 $61,138.73 $40,319.95 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
J0202 HCPCS Lemtrada 12 Mg/1.2 Ml Intravenous Solution 37 12 $67,816.87 $67,816.87 $14,241.54 $59,000.68 $39,672.87 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
J9345 HCPCS Zynyz 500 Mg/20 Ml Intravenous Solution 37 12 $66,768.72 $66,768.72 $14,021.43 $58,088.79 $39,059.71 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
J9359 HCPCS Zynlonta 10 Mg Intravenous Solution 37 12 $66,187.87 $66,187.87 $13,899.45 $57,583.45 $38,719.90 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
J1246 HCPCS Unituxin 3.5 Mg/ml Intravenous Solution 37 12 $65,310.78 $65,310.78 $13,715.26 $56,820.38 $38,206.81 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
J0222 HCPCS Onpattro 2 Mg/ml Intravenous Solution 37 12 $62,232.60 $62,232.60 $13,068.85 $54,142.36 $36,406.07 2026-04-15
4403 APR_DRG Kidney Transplant 4 4 — — $36,249.04 $36,249.04 $36,249.04 2026-04-15
37282 CPT C Evsc Tpvt Angio Cplx 1 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37280 CPT Sc Evsc Tpvt Angio Sf 1st 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37269 CPT Sc Evasc Fpvt St Cplx 1st 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37260 CPT Sc Evasc Ivt St Cplx 1st 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37258 CPT Sc Evasc Ivt Stent Sf 1st 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
92945 CPT Trl Rvs Ch Occ Ant&Rtrgr 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37298 CPT Sc Evsc Imvt Angio Cplx 1 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37267 CPT Sc Evsc Fpvt Stent Sf 1st 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 2026-04-15
37296 CPT Sc Evasc Imvt Angio Sf 1 39 12 $61,855.00 $61,855.00 $12,989.55 $53,813.85 $36,185.18 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
J2267 HCPCS Omvoh 300 Mg/15 Ml (20 Mg/ml) Intravenous Solution 37 12 $61,012.83 $61,012.83 $12,812.69 $53,081.16 $35,692.50 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
47384 CPT Tj Ire Liver 1+ Tum Perq 39 12 $56,956.00 $56,956.00 $11,960.76 $49,551.72 $33,319.26 2026-04-15
55877 CPT Tj Ire Prst8 1+ Tum Perq 39 12 $56,956.00 $56,956.00 $11,960.76 $49,551.72 $33,319.26 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
J2323 HCPCS Tysabri 300 Mg/15 Ml Intravenous Solution 37 12 $56,471.79 $56,471.79 $11,859.08 $49,130.46 $33,036.00 2026-04-15
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 4 4 — — $32,770.66 $32,770.66 $32,770.66 2026-04-15
204 APR_DRG Craniotomy For Trauma 4 4 — — $32,620.15 $32,620.15 $32,620.15 2026-04-15
J9229 HCPCS Besponsa 0.9 Mg(0.25 Mg/ml Initial Concentration) Intravenous Solution 37 12 $55,618.93 $55,618.93 $11,679.98 $48,388.47 $32,537.08 2026-04-15
2614 APR_DRG Major Biliary Tract Procedures 4 4 — — $32,509.91 $32,509.91 $32,509.91 2026-04-15
J2329 HCPCS Briumvi 25 Mg/ml Intravenous Solution 37 12 $55,374.46 $55,374.46 $11,628.64 $48,175.78 $32,394.06 2026-04-15
4402 APR_DRG Kidney Transplant 4 4 — — $32,355.89 $32,355.89 $32,355.89 2026-04-15
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 4 4 — — $32,224.93 $32,224.93 $32,224.93 2026-04-15
J9316 HCPCS Phesgo 1,200 Mg-600 Mg-30,000 Unit/15 Ml Subcutaneous Solution 58 12 $65,129.40 $65,129.40 $9,117.75 $56,662.58 $31,913.40 2026-04-15
J9272 HCPCS Jemperli 50 Mg/ml Intravenous Solution 37 12 $54,482.72 $54,482.72 $11,441.37 $47,399.97 $31,872.40 2026-04-15
J2327 HCPCS Skyrizi 150 Mg/ml Subcutaneous Syringe 58 12 $54,351.59 $54,351.59 $11,413.83 $60,299.80 $31,795.68 2026-04-15
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 4 — — $31,511.90 $31,511.90 $31,511.90 2026-04-15
214 APR_DRG Craniotomy Except For Trauma 4 4 — — $31,480.24 $31,480.24 $31,480.24 2026-04-15
6133 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 4 4 — — $31,462.64 $31,462.64 $31,462.64 2026-04-15
7924 APR_DRG Extensive Or Procedures For Other Complications Of Treatment 4 4 — — $31,388.76 $31,388.76 $31,388.76 2026-04-15
6092 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 4 — — $31,206.59 $31,206.59 $31,206.59 2026-04-15
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 4 4 — — $31,157.34 $31,157.34 $31,157.34 2026-04-15
4234 APR_DRG Inborn Errors Of Metabolism 4 4 — — $30,937.64 $30,937.64 $30,937.64 2026-04-15
2304 APR_DRG Major Small Bowel Procedures 4 4 — — $30,907.15 $30,907.15 $30,907.15 2026-04-15
82 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $30,851.25 $30,851.25 $30,851.25 2026-04-15
1814 APR_DRG Lower Extremity Arterial Procedures 4 4 — — $30,835.61 $30,835.61 $30,835.61 2026-04-15
J3316 HCPCS Triptodur 22.5 Mg IM Suspension 37 12 $52,363.85 $52,363.85 $10,996.41 $45,556.55 $30,632.85 2026-04-15
7404 APR_DRG Mental Illness Diagnosis W O.r. Procedure 4 4 — — $30,339.15 $30,339.15 $30,339.15 2026-04-15
2324 APR_DRG Gastric Fundoplication 4 4 — — $30,158.54 $30,158.54 $30,158.54 2026-04-15
6302 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 4 4 — — $30,146.42 $30,146.42 $30,146.42 2026-04-15
C1767 HCPCS Generator, Neurostimulator(Imp) 37 12 $51,507.00 $51,507.00 $10,816.47 $44,811.09 $30,131.60 2026-04-15
J9024 HCPCS Tecentriq Hybreza 1,875 Mg-30,000 Unit/15 Ml Subcutaneous Solution 37 12 $51,456.77 $51,456.77 $10,805.92 $44,767.39 $30,102.21 2026-04-15
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 4 4 — — $30,035.40 $30,035.40 $30,035.40 2026-04-15
4034 APR_DRG Procedures For Obesity 4 4 — — $30,024.46 $30,024.46 $30,024.46 2026-04-15
4401 APR_DRG Kidney Transplant 4 4 — — $30,006.47 $30,006.47 $30,006.47 2026-04-15
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 4 4 — — $29,959.56 $29,959.56 $29,959.56 2026-04-15
6213 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 4 4 — — $29,943.15 $29,943.15 $29,943.15 2026-04-15
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 4 4 — — $29,937.67 $29,937.67 $29,937.67 2026-04-15
J0638 HCPCS Ilaris (pf) 150 Mg/ml Subcutaneous Solution 37 12 $51,121.00 $51,121.00 $10,735.41 $44,475.27 $29,905.78 2026-04-15
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 4 4 — — $29,764.89 $29,764.89 $29,764.89 2026-04-15
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 4 4 — — $29,534.25 $29,534.25 $29,534.25 2026-04-15
J9119 HCPCS Libtayo 50 Mg/ml Intravenous Solution 37 12 $50,325.85 $50,325.85 $10,568.43 $43,783.49 $29,440.62 2026-04-15
1622 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 4 4 — — $29,176.95 $29,176.95 $29,176.95 2026-04-15
6143 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 4 4 — — $29,101.11 $29,101.11 $29,101.11 2026-04-15
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 4 4 — — $29,088.99 $29,088.99 $29,088.99 2026-04-15
1824 APR_DRG Other Peripheral Vascular Procedures 4 4 — — $29,040.13 $29,040.13 $29,040.13 2026-04-15
J2502 HCPCS Signifor Lar 40 Mg IM Suspension 37 12 $49,610.29 $49,610.29 $10,418.16 $43,160.95 $29,022.02 2026-04-15
6254 APR_DRG Neonate Bwt 2000-2499g W Other Significant Condition 4 4 — — $29,010.42 $29,010.42 $29,010.42 2026-04-15
6091 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 4 4 — — $29,008.46 $29,008.46 $29,008.46 2026-04-15
224 APR_DRG Ventricular Shunt Procedures 4 4 — — $28,952.95 $28,952.95 $28,952.95 2026-04-15
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 4 4 — — $28,943.18 $28,943.18 $28,943.18 2026-04-15
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 4 4 — — $28,809.48 $28,809.48 $28,809.48 2026-04-15
37293 CPT C Evsc Tpvt St Athr Sf Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37291 CPT Sc Evsc Tpvt Athr Cplx Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37289 CPT Sc Evsc Tpvt Athrc Sf Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37287 CPT Sc Evasc Tpvt St Cplx Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37285 CPT Sc Evasc Tpvt St Sf Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37278 CPT C Evsc Fpvt St Ath Cpx Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37276 CPT C Evsc Fpvt St Athr Sf Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37274 CPT C Evsc Fpvt Athrc Cplx Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37272 CPT Sc Evsc Fpvt Athrc Sf Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
37295 CPT C Evsc Tpvt St Ath Cpx Ea 39 12 $49,111.00 $49,111.00 $10,313.31 $42,726.57 $28,729.94 2026-04-15
4444 APR_DRG Renal Dialysis Access Device And Vessel Repair 4 4 — — $28,727.00 $28,727.00 $28,727.00 2026-04-15
J9274 HCPCS Kimmtrak 100 Mcg/0.5 Ml Intravenous Solution 37 12 $49,042.80 $49,042.80 $10,298.99 $42,667.24 $28,690.04 2026-04-15
1754 APR_DRG Percutaneous Coronary Intervention Without Ami 4 4 — — $28,608.55 $28,608.55 $28,608.55 2026-04-15
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 4 4 — — $28,452.97 $28,452.97 $28,452.97 2026-04-15
6071 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 4 4 — — $28,409.97 $28,409.97 $28,409.97 2026-04-15
1653 APR_DRG Coronary Bypass W Ami Or Complex Pdx 4 4 — — $28,300.12 $28,300.12 $28,300.12 2026-04-15
244 APR_DRG Extracranial Vascular Procedures 4 4 — — $28,193.01 $28,193.01 $28,193.01 2026-04-15
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 4 4 — — $27,965.49 $27,965.49 $27,965.49 2026-04-15
4044 APR_DRG Thyroid, Parathyroid & Thyroglossal Procedures 4 4 — — $27,537.83 $27,537.83 $27,537.83 2026-04-15
J9144 HCPCS Darzalex Faspro 1,800 Mg-30,000 Unit/15 Ml Subcutaneous Solution 37 12 $46,939.07 $46,939.07 $9,857.20 $40,836.99 $27,459.35 2026-04-15
4014 APR_DRG Adrenal Procedures 4 4 — — $27,334.55 $27,334.55 $27,334.55 2026-04-15
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 4 4 — — $27,265.75 $27,265.75 $27,265.75 2026-04-15
1214 APR_DRG Other Respiratory & Chest Procedures 4 4 — — $26,971.00 $26,971.00 $26,971.00 2026-04-15
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 4 4 — — $26,943.63 $26,943.63 $26,943.63 2026-04-15
8633 APR_DRG Neonatal Aftercare 4 4 — — $26,739.96 $26,739.96 $26,739.96 2026-04-15
6504 APR_DRG Splenectomy 4 4 — — $26,714.95 $26,714.95 $26,714.95 2026-04-15
3043 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 4 4 — — $26,631.68 $26,631.68 $26,631.68 2026-04-15
2314 APR_DRG Major Large Bowel Procedures 4 4 — — $26,407.29 $26,407.29 $26,407.29 2026-04-15
5114 APR_DRG Uterine & Adnexa Procedures For Ovarian & Adnexal Malignancy 4 4 — — $26,302.92 $26,302.92 $26,302.92 2026-04-15
8412 APR_DRG Extensive 3rd Degree Burns W Skin Graft 4 4 — — $26,225.91 $26,225.91 $26,225.91 2026-04-15
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 4 4 — — $26,223.56 $26,223.56 $26,223.56 2026-04-15
5144 APR_DRG Female Reproductive System Reconstructive Procedures 4 4 — — $25,994.09 $25,994.09 $25,994.09 2026-04-15
264 APR_DRG Other Nervous System & Related Procedures 4 4 — — $25,916.30 $25,916.30 $25,916.30 2026-04-15
8411 APR_DRG Extensive 3rd Degree Burns W Skin Graft 4 4 — — $25,781.04 $25,781.04 $25,781.04 2026-04-15
3031 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 4 4 — — $25,735.70 $25,735.70 $25,735.70 2026-04-15
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 4 4 — — $25,692.30 $25,692.30 $25,692.30 2026-04-15
734 APR_DRG Orbit And Eye Procedures 4 4 — — $25,487.07 $25,487.07 $25,487.07 2026-04-15
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 4 4 — — $25,378.79 $25,378.79 $25,378.79 2026-04-15
504 APR_DRG Non-bacterial Infections Of Nervous System Exc Viral Meningitis 4 4 — — $25,378.79 $25,378.79 $25,378.79 2026-04-15
6364 APR_DRG Neonate Birthwt >2499g W Congenital/perinatal Infection 4 4 — — $25,356.90 $25,356.90 $25,356.90 2026-04-15
J3263 HCPCS Loqtorzi 240 Mg/6 Ml (40 Mg/ml) Intravenous Solution 37 12 $43,322.19 $43,322.19 $9,097.66 $37,690.31 $25,343.49 2026-04-15
6924 APR_DRG Radiotherapy 4 4 — — $25,292.79 $25,292.79 $25,292.79 2026-04-15
4844 APR_DRG Other Male Reproductive System & Related Procedures 4 4 — — $25,196.62 $25,196.62 $25,196.62 2026-04-15
J9022 HCPCS Tecentriq 1,200 Mg/20 Ml (60 Mg/ml) Intravenous Solution 58 12 $51,456.79 $51,456.79 $7,059.88 $44,767.41 $25,191.88 2026-04-15
81 APR_DRG Autologous Bone Marrow Transplant 4 4 — — $25,131.73 $25,131.73 $25,131.73 2026-04-15
J3241 HCPCS Tepezza 500 Mg Intravenous Solution 37 12 $42,685.46 $42,685.46 $8,963.95 $37,136.35 $24,970.99 2026-04-15
4804 APR_DRG Major Male Pelvic Procedures 4 4 — — $24,914.77 $24,914.77 $24,914.77 2026-04-15
J9600 HCPCS Photofrin 75 Mg Intravenous Solution 37 12 $42,417.01 $42,417.01 $8,907.57 $36,902.80 $24,813.95 2026-04-15
1621 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 4 4 — — $24,725.17 $24,725.17 $24,725.17 2026-04-15
6122 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 4 4 — — $24,615.72 $24,615.72 $24,615.72 2026-04-15
1611 APR_DRG Cardiac Defibrillator & Heart Assist Implant 4 4 — — $24,599.69 $24,599.69 $24,599.69 2026-04-15
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 4 — — $24,366.31 $24,366.31 $24,366.31 2026-04-15
J1299 HCPCS Soliris 300 Mg/30 Ml Intravenous Solution 37 12 $41,486.28 $41,486.28 $8,712.12 $36,093.06 $24,269.47 2026-04-15
4434 APR_DRG Kidney & Urinary Tract Procedures For Nonmalignancy 4 4 — — $24,185.71 $24,185.71 $24,185.71 2026-04-15
6132 APR_DRG Neonate Birthwt 1500-1999g W Congenital/perinatal Infection 4 4 — — $24,105.57 $24,105.57 $24,105.57 2026-04-15
6031 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 4 4 — — $24,039.89 $24,039.89 $24,039.89 2026-04-15
5184 APR_DRG Other Female Reproductive System & Related Procedures 4 4 — — $24,021.52 $24,021.52 $24,021.52 2026-04-15
J3245 HCPCS Ilumya 100 Mg/ml Subcutaneous Syringe 37 12 $40,952.09 $40,952.09 $8,599.94 $35,628.32 $23,956.97 2026-04-15
3094 APR_DRG Other Significant Hip & Femur Surgery 4 4 — — $23,912.84 $23,912.84 $23,912.84 2026-04-15
4424 APR_DRG Kidney & Urinary Tract Procedures For Malignancy 4 4 — — $23,860.07 $23,860.07 $23,860.07 2026-04-15
1673 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 4 4 — — $23,826.06 $23,826.06 $23,826.06 2026-04-15
1663 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 4 4 — — $23,598.55 $23,598.55 $23,598.55 2026-04-15
6394 APR_DRG Neonate Birthwt >2499g W Other Significant Condition 4 4 — — $23,588.77 $23,588.77 $23,588.77 2026-04-15
494 APR_DRG Bacterial & Tuberculous Infections Of Nervous System 4 4 — — $23,585.65 $23,585.65 $23,585.65 2026-04-15
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 4 4 — — $23,524.27 $23,524.27 $23,524.27 2026-04-15
J9228 HCPCS Yervoy 50 Mg/10 Ml (5 Mg/ml) Intravenous Solution 58 12 $40,203.05 $40,203.05 $8,442.64 $139,906.37 $23,518.78 2026-04-15
J9332 HCPCS Vyvgart 20 Mg/ml Intravenous Solution 37 12 $40,158.31 $40,158.31 $8,433.25 $34,937.73 $23,492.61 2026-04-15
1652 APR_DRG Coronary Bypass W Ami Or Complex Pdx 4 4 — — $23,426.15 $23,426.15 $23,426.15 2026-04-15
J9301 HCPCS Gazyva 1,000 Mg/40 Ml Intravenous Solution 37 12 $39,961.33 $39,961.33 $8,391.88 $34,766.36 $23,377.38 2026-04-15
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 4 4 — — $23,343.28 $23,343.28 $23,343.28 2026-04-15
5124 APR_DRG Uterine & Adnexa Procedures For Non-ovarian & Non-adnexal Malig 4 4 — — $23,269.00 $23,269.00 $23,269.00 2026-04-15
2234 APR_DRG Other Small & Large Bowel Procedures 4 4 — — $23,263.92 $23,263.92 $23,263.92 2026-04-15
2244 APR_DRG Peritoneal Adhesiolysis 4 4 — — $23,232.65 $23,232.65 $23,232.65 2026-04-15
1303 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 4 4 — — $23,111.07 $23,111.07 $23,111.07 2026-04-15
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 4 4 — — $23,082.54 $23,082.54 $23,082.54 2026-04-15
8423 APR_DRG Burns With Skin Graft Except Extensive 3rd Degree Burns 4 4 — — $23,039.14 $23,039.14 $23,039.14 2026-04-15
7934 APR_DRG Moderately Extensive Or Procedures For Other Complications Of Treatment 4 4 — — $22,953.92 $22,953.92 $22,953.92 2026-04-15
1804 APR_DRG Other Circulatory System Procedures 4 4 — — $22,824.14 $22,824.14 $22,824.14 2026-04-15
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral & Umbilical 4 4 — — $22,795.99 $22,795.99 $22,795.99 2026-04-15
2294 APR_DRG Other Digestive System & Abdominal Procedures 4 4 — — $22,773.32 $22,773.32 $22,773.32 2026-04-15
62330 CPT Hc Dcmprn Perq Prtl Rmvl Liga Flavm Bi 1ntrspc Lmbr 39 12 $38,879.00 $38,879.00 $8,164.59 $33,824.73 $22,744.22 2026-04-15
3204 APR_DRG Other Musculoskeletal System & Connective Tissue Procedures 4 4 — — $22,712.73 $22,712.73 $22,712.73 2026-04-15
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 4 4 — — $22,691.62 $22,691.62 $22,691.62 2026-04-15
1704 APR_DRG Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock 4 4 — — $22,633.37 $22,633.37 $22,633.37 2026-04-15
3054 APR_DRG Amputation Of Lower Limb Except Toes 4 4 — — $22,509.45 $22,509.45 $22,509.45 2026-04-15
984 APR_DRG Other Ear, Nose, Mouth & Throat Procedures 4 4 — — $22,331.97 $22,331.97 $22,331.97 2026-04-15
1693 APR_DRG Major Abdominal Vascular Procedures 4 4 — — $22,134.17 $22,134.17 $22,134.17 2026-04-15
6112 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 4 4 — — $22,063.02 $22,063.02 $22,063.02 2026-04-15
1744 APR_DRG Percutaneous Coronary Intervention W Ami 4 4 — — $22,029.01 $22,029.01 $22,029.01 2026-04-15
8444 APR_DRG Partial Thickness Burns Without Skin Graft 4 4 — — $21,824.17 $21,824.17 $21,824.17 2026-04-15
6312 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 4 4 — — $21,703.38 $21,703.38 $21,703.38 2026-04-15
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