Price Transparency Hospital negotiated rates

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

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Hospital

MEMORIAL HOSPITAL AND HEALTH CARE CENTER

Jasper, IN · CCN 150115 · Rates published

20,314 distinct procedures filed
22 distinct payers
534,138 rate rows
2026-02-13 last MRF observed
Data quality

270,457 of 534,138 rate rows are consumer-grade (50.6%)

263,681 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
professional (physician) fee — not the facility price 254,526
placeholder amount (≤ $0.02) — excluded from medians 7,670
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 1,374
percent-of-charges filed in the dollar field — excluded from medians 74
per-diem day rate — not a per-procedure price 34
template filing: same amount across many unrelated codes — excluded 2
exceeds 10× this hospital's gross charge — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/12036/350985964_little-company-of-mary-hospital-of-indiana-inc_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/deaconessmemorialhospitalandhealthcenter/12036
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-05-15
Content fingerprint e9dd89d8522a1be0… · 265,379,454 bytes · first seen 2026-05-06

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 5 $3,829,250.00 $4,505,000.00 $4,505,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 8 $3,132,476.67 $4,790,846.67 $3,685,266.67 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 3 $3,675,000.00 $3,675,000.00 $3,675,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 8 $2,818,993.20 $4,311,401.36 $3,338,231.29 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 6 $2,761,178.86 $4,222,979.43 $3,248,445.72 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,503,879.00 $4,713,184.00 $2,945,740.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 9 $2,086,844.01 $3,928,176.97 $2,455,110.61 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $1,982,200.00 $3,731,200.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 11 $655,027.00 $2,311,860.00 $770,620.00 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 9 $502,967.27 $1,775,178.60 $665,691.97 nat. median
$754,974
0.9× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 16 $308,689.11 $1,089,490.98 $602,893.71 nat. median
$370,174
1.6× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 11 $480,988.60 $1,697,606.84 $583,075.96 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 11 $478,157.46 $1,687,614.56 $562,538.19 nat. median
$674,188
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 11 $473,720.24 $1,671,953.80 $557,317.93 nat. median
$625,184
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 11 $453,245.65 $1,599,690.51 $533,230.17 nat. median
$634,511
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 11 $415,908.92 $1,467,913.82 $489,304.61 nat. median
$620,080
0.8× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 16 $200,612.55 $708,044.28 $391,522.69 nat. median
$265,286
1.5× median
5884
APR_DRG 		Neonate Bwt <1500g W Major Procedure 3 $389,138.18 $389,138.18 $389,138.18 nat. median
$246,434
1.6× median
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 11 $236,512.50 $834,750.00 $361,725.00 nat. median
$324,450
1.1× median
24
APR_DRG 		Heart &/or Lung Transplant 3 $347,823.88 $347,823.88 $347,823.88 nat. median
$234,738
1.5× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 3 $335,581.31 $335,581.31 $335,581.31 nat. median
$207,730
1.6× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 15 $153,034.03 $540,120.09 $288,064.05 nat. median
$206,368
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 15 $152,140.68 $536,967.12 $286,382.46 nat. median
$202,986
1.4× median
J3403
HCPCS 		Revakinagene, Per Implant 11 $218,875.00 $772,500.00 $262,500.00 nat. median
$265,000
1.0× median
14
APR_DRG 		Liver Transplant &/or Intestinal Transplant 3 $253,450.94 $253,450.94 $253,450.94 nat. median
$129,535
2.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 3 $235,802.91 $235,802.91 $235,802.91 nat. median
$187,294
1.3× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 $231,442.75 $231,442.75 $231,442.75 nat. median
$105,658
outlier · 2.2×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 3 $228,301.66 $228,301.66 $228,301.66 nat. median
$164,834
1.4× median
5914
APR_DRG 		Neonate Birthwt 500-749g Without Major Procedure 3 $225,770.39 $225,770.39 $225,770.39 nat. median
$164,279
1.4× median
6094
APR_DRG 		Neonate Bwt 1500-2499g W Major Procedure 3 $214,457.72 $214,457.72 $214,457.72 nat. median
$162,982
1.3× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 11 $174,794.00 $616,920.00 $205,640.00 nat. median
$209,753
1.0× median
5934
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 3 $202,944.19 $202,944.19 $202,944.19 nat. median
$151,838
1.3× median
23
APR_DRG 		Heart &/or Lung Transplant 3 $200,848.75 $200,848.75 $200,848.75 nat. median
$93,528
outlier · 2.1×
22
APR_DRG 		Heart &/or Lung Transplant 3 $200,365.00 $200,365.00 $200,365.00 nat. median
$78,029
outlier · 2.6×
21
APR_DRG 		Heart &/or Lung Transplant 3 $200,197.30 $200,197.30 $200,197.30 nat. median
$65,130
outlier · 3.1×
5832
APR_DRG 		Neonate W Ecmo 3 $191,228.56 $191,228.56 $191,228.56 nat. median
$156,126
1.2× median
5833
APR_DRG 		Neonate W Ecmo 3 $191,228.56 $191,228.56 $191,228.56 nat. median
$244,017
0.8× median
5834
APR_DRG 		Neonate W Ecmo 3 $191,228.56 $191,228.56 $191,228.56 nat. median
$309,665
0.6× median
5831
APR_DRG 		Neonate W Ecmo 3 $189,687.01 $189,687.01 $189,687.01 nat. median
$145,122
1.3× median
4
MS_DRG 		Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And… 15 $99,568.61 $351,418.62 $187,423.26 nat. median
$133,176
1.4× median
6314
APR_DRG 		Neonate Birthwt >2499g W Other Major Procedure 3 $182,838.79 $182,838.79 $182,838.79 nat. median
$122,924
1.5× median
7
MS_DRG 		Lung Transplant 16 $93,143.44 $328,741.56 $181,339.68 nat. median
$122,708
1.5× median
6304
APR_DRG 		Neonate Birthwt >2499g W Major Cardiovascular Procedure 3 $180,341.24 $180,341.24 $180,341.24 nat. median
$150,721
1.2× median
5883
APR_DRG 		Neonate Bwt <1500g W Major Procedure 3 $171,934.93 $171,934.93 $171,934.93 nat. median
$182,736
0.9× median
5882
APR_DRG 		Neonate Bwt <1500g W Major Procedure 3 $171,212.53 $171,212.53 $171,212.53 nat. median
$145,336
1.2× median
5881
APR_DRG 		Neonate Bwt <1500g W Major Procedure 3 $171,212.53 $171,212.53 $171,212.53 nat. median
$124,573
1.4× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 16 $86,496.52 $305,281.83 $168,339.97 nat. median
$117,303
1.4× median
6114
APR_DRG 		Neonate Birthwt 1500-1999g W Major Anomaly 3 $163,952.41 $163,952.41 $163,952.41 nat. median
$72,694
outlier · 2.3×
64
APR_DRG 		Pancreas Transplant 3 $162,404.48 $162,404.48 $162,404.48 nat. median
$91,748
1.8× median
5933
APR_DRG 		Neonate Birthwt 750-999g Without Major Procedure 3 $161,361.62 $161,361.62 $161,361.62 nat. median
$108,996
1.5× median

Other procedures at this hospital

Browse this hospital's 20,314 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 5 5 — — $3,829,250.00 $4,505,000.00 $4,505,000.00 2026-02-13
J1414 HCPCS Inj, Beqvez, Per Tx Dose 3 3 — — $3,675,000.00 $3,675,000.00 $3,675,000.00 2026-02-13
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 10 8 — — $3,132,476.67 $4,790,846.67 $3,685,266.67 2026-02-13
J1413 HCPCS Inj Delandistrogene Mox Rokl 10 8 — — $2,818,993.20 $4,311,401.36 $3,338,231.29 2026-02-13
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 6 — — $2,761,178.86 $4,222,979.43 $3,248,445.72 2026-02-13
J3393 HCPCS Inj, Betibeglogene Autotemce 8 7 — — $2,503,879.00 $4,713,184.00 $2,945,740.00 2026-02-13
J3399 HCPCS Inj Onase Abepar-xioi Treat 11 9 — — $2,086,844.01 $3,928,176.97 $2,455,110.61 2026-02-13
J3392 HCPCS Inj, Exagamglogene Autotem 8 7 — — $1,982,200.00 $3,731,200.00 $2,332,000.00 2026-02-13
Q2057 HCPCS Afamitresgene Autoleucel 13 11 — — $655,027.00 $2,311,860.00 $770,620.00 2026-02-13
Q2042 HCPCS Tisagenlecleucel Car-pos T 10 9 — — $502,967.27 $1,775,178.60 $665,691.97 2026-02-13
Q2056 HCPCS Ciltacabtagene Car-pos T 13 11 — — $480,988.60 $1,697,606.84 $583,075.96 2026-02-13
Q2054 HCPCS Lisocabtagene Mara Car Pos T 13 11 — — $478,157.46 $1,687,614.56 $562,538.19 2026-02-13
Q2055 HCPCS Idecabtagene Vicleucel Car 13 11 — — $473,720.24 $1,671,953.80 $557,317.93 2026-02-13
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 13 11 — — $453,245.65 $1,599,690.51 $533,230.17 2026-02-13
Q2053 HCPCS Brexucabtagene Car Pos T 13 11 — — $415,908.92 $1,467,913.82 $489,304.61 2026-02-13
5884 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $389,138.18 $389,138.18 $389,138.18 2026-02-13
24 APR_DRG Heart &/or Lung Transplant 3 3 — — $347,823.88 $347,823.88 $347,823.88 2026-02-13
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 3 3 — — $335,581.31 $335,581.31 $335,581.31 2026-02-13
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 18 16 — — $308,689.11 $1,089,490.98 $602,893.71 2026-02-13
14 APR_DRG Liver Transplant &/or Intestinal Transplant 3 3 — — $253,450.94 $253,450.94 $253,450.94 2026-02-13
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 13 11 — — $236,512.50 $834,750.00 $361,725.00 2026-02-13
74 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $235,802.91 $235,802.91 $235,802.91 2026-02-13
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $231,442.75 $231,442.75 $231,442.75 2026-02-13
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $228,301.66 $228,301.66 $228,301.66 2026-02-13
5914 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $225,770.39 $225,770.39 $225,770.39 2026-02-13
J3403 HCPCS Revakinagene, Per Implant 13 11 — — $218,875.00 $772,500.00 $262,500.00 2026-02-13
6094 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $214,457.72 $214,457.72 $214,457.72 2026-02-13
5934 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $202,944.19 $202,944.19 $202,944.19 2026-02-13
23 APR_DRG Heart &/or Lung Transplant 3 3 — — $200,848.75 $200,848.75 $200,848.75 2026-02-13
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 18 16 — — $200,612.55 $708,044.28 $391,522.69 2026-02-13
22 APR_DRG Heart &/or Lung Transplant 3 3 — — $200,365.00 $200,365.00 $200,365.00 2026-02-13
21 APR_DRG Heart &/or Lung Transplant 3 3 — — $200,197.30 $200,197.30 $200,197.30 2026-02-13
5833 APR_DRG Neonate W Ecmo 3 3 — — $191,228.56 $191,228.56 $191,228.56 2026-02-13
5834 APR_DRG Neonate W Ecmo 3 3 — — $191,228.56 $191,228.56 $191,228.56 2026-02-13
5832 APR_DRG Neonate W Ecmo 3 3 — — $191,228.56 $191,228.56 $191,228.56 2026-02-13
5831 APR_DRG Neonate W Ecmo 3 3 — — $189,687.01 $189,687.01 $189,687.01 2026-02-13
6314 APR_DRG Neonate Birthwt >2499g W Other Major Procedure 3 3 — — $182,838.79 $182,838.79 $182,838.79 2026-02-13
6304 APR_DRG Neonate Birthwt >2499g W Major Cardiovascular Procedure 3 3 — — $180,341.24 $180,341.24 $180,341.24 2026-02-13
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 13 11 — — $174,794.00 $616,920.00 $205,640.00 2026-02-13
5883 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $171,934.93 $171,934.93 $171,934.93 2026-02-13
5881 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $171,212.53 $171,212.53 $171,212.53 2026-02-13
5882 APR_DRG Neonate Bwt <1500g W Major Procedure 3 3 — — $171,212.53 $171,212.53 $171,212.53 2026-02-13
6114 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 3 3 — — $163,952.41 $163,952.41 $163,952.41 2026-02-13
64 APR_DRG Pancreas Transplant 3 3 — — $162,404.48 $162,404.48 $162,404.48 2026-02-13
5933 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $161,361.62 $161,361.62 $161,361.62 2026-02-13
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 17 15 — — $153,034.03 $540,120.09 $288,064.05 2026-02-13
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 17 15 — — $152,140.68 $536,967.12 $286,382.46 2026-02-13
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 3 3 — — $150,698.17 $150,698.17 $150,698.17 2026-02-13
6024 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $145,995.55 $145,995.55 $145,995.55 2026-02-13
72 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $142,486.66 $142,486.66 $142,486.66 2026-02-13
71 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $142,486.66 $142,486.66 $142,486.66 2026-02-13
73 APR_DRG Allogeneic Bone Marrow Transplant 3 3 — — $142,486.66 $142,486.66 $142,486.66 2026-02-13
6074 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $142,087.01 $142,087.01 $142,087.01 2026-02-13
6023 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $135,186.80 $135,186.80 $135,186.80 2026-02-13
6214 APR_DRG Neonate Bwt 2000-2499g W Major Anomaly 3 3 — — $134,235.14 $134,235.14 $134,235.14 2026-02-13
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $132,078.62 $132,078.62 $132,078.62 2026-02-13
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $132,078.62 $132,078.62 $132,078.62 2026-02-13
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 3 3 — — $132,078.62 $132,078.62 $132,078.62 2026-02-13
4404 APR_DRG Kidney Transplant 3 3 — — $128,478.12 $128,478.12 $128,478.12 2026-02-13
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $122,896.01 $122,896.01 $122,896.01 2026-02-13
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 3 3 — — $122,155.11 $122,155.11 $122,155.11 2026-02-13
8634 APR_DRG Neonatal Aftercare 3 3 — — $120,447.63 $120,447.63 $120,447.63 2026-02-13
1624 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 3 3 — — $113,894.89 $113,894.89 $113,894.89 2026-02-13
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $113,713.82 $113,713.82 $113,713.82 2026-02-13
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $113,262.32 $113,262.32 $113,262.32 2026-02-13
E0766 HCPCS Elec Stim Cancer Treatment 1 1 — — $113,141.86 $113,141.86 $113,141.86 2026-02-13
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure 3 3 — — $113,049.47 $113,049.47 $113,049.47 2026-02-13
6091 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $112,943.37 $112,943.37 $112,943.37 2026-02-13
6093 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $112,943.37 $112,943.37 $112,943.37 2026-02-13
6092 APR_DRG Neonate Bwt 1500-2499g W Major Procedure 3 3 — — $112,943.37 $112,943.37 $112,943.37 2026-02-13
63 APR_DRG Pancreas Transplant 3 3 — — $111,535.28 $111,535.28 $111,535.28 2026-02-13
62 APR_DRG Pancreas Transplant 3 3 — — $111,438.53 $111,438.53 $111,438.53 2026-02-13
61 APR_DRG Pancreas Transplant 3 3 — — $111,406.28 $111,406.28 $111,406.28 2026-02-13
5912 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $104,929.20 $104,929.20 $104,929.20 2026-02-13
5913 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $104,929.20 $104,929.20 $104,929.20 2026-02-13
84 APR_DRG Autologous Bone Marrow Transplant 3 3 — — $104,413.49 $104,413.49 $104,413.49 2026-02-13
104 APR_DRG Head Trauma With Deep Coma 3 3 — — $104,064.11 $104,064.11 $104,064.11 2026-02-13
C9150 HCPCS Chemotherapy Drugs 2 2 — — $104,000.00 $218,400.00 $161,200.00 2026-02-13
5911 APR_DRG Neonate Birthwt 500-749g Without Major Procedure 3 3 — — $103,735.95 $103,735.95 $103,735.95 2026-02-13
6073 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $103,060.70 $103,060.70 $103,060.70 2026-02-13
1654 APR_DRG Coronary Bypass W Ami Or Complex Pdx 3 3 — — $102,012.23 $102,012.23 $102,012.23 2026-02-13
5932 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $101,883.99 $101,883.99 $101,883.99 2026-02-13
5931 APR_DRG Neonate Birthwt 750-999g Without Major Procedure 3 3 — — $99,884.49 $99,884.49 $99,884.49 2026-02-13
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 3 3 — — $99,693.80 $99,693.80 $99,693.80 2026-02-13
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 17 15 — — $99,568.61 $351,418.62 $187,423.26 2026-02-13
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 3 3 — — $98,946.40 $98,946.40 $98,946.40 2026-02-13
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 3 3 — — $98,836.75 $98,836.75 $98,836.75 2026-02-13
3031 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 3 3 — — $98,772.25 $98,772.25 $98,772.25 2026-02-13
102 APR_DRG Head Trauma With Deep Coma 3 3 — — $96,681.51 $96,681.51 $96,681.51 2026-02-13
101 APR_DRG Head Trauma With Deep Coma 3 3 — — $96,681.51 $96,681.51 $96,681.51 2026-02-13
103 APR_DRG Head Trauma With Deep Coma 3 3 — — $96,681.51 $96,681.51 $96,681.51 2026-02-13
6022 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $96,251.44 $96,251.44 $96,251.44 2026-02-13
6072 APR_DRG Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $95,258.77 $95,258.77 $95,258.77 2026-02-13
6021 APR_DRG Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom 3 3 — — $95,180.74 $95,180.74 $95,180.74 2026-02-13
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 10 9 — — $95,081.03 $335,580.12 $125,842.54 2026-02-13
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 3 3 — — $93,875.49 $93,875.49 $93,875.49 2026-02-13
7 MS_DRG Lung Transplant 18 16 — — $93,143.44 $328,741.56 $181,339.68 2026-02-13
6334 APR_DRG Neonate Birthwt >2499g W Major Anomaly 3 3 — — $92,371.35 $92,371.35 $92,371.35 2026-02-13
8633 APR_DRG Neonatal Aftercare 3 3 — — $91,197.16 $91,197.16 $91,197.16 2026-02-13
6124 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 3 3 — — $90,007.60 $90,007.60 $90,007.60 2026-02-13
6084 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 3 3 — — $88,346.26 $88,346.26 $88,346.26 2026-02-13
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 3 3 — — $87,926.76 $87,926.76 $87,926.76 2026-02-13
6083 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 3 3 — — $87,849.61 $87,849.61 $87,849.61 2026-02-13
6034 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 3 3 — — $87,586.00 $87,586.00 $87,586.00 2026-02-13
14 MS_DRG Allogeneic Bone Marrow Transplant 18 16 — — $86,496.52 $305,281.83 $168,339.97 2026-02-13
6033 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 3 3 — — $85,805.80 $85,805.80 $85,805.80 2026-02-13
6032 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 3 3 — — $84,467.97 $84,467.97 $84,467.97 2026-02-13
1204 APR_DRG Major Respiratory & Chest Procedures 3 3 — — $84,377.83 $84,377.83 $84,377.83 2026-02-13
6113 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 3 3 — — $84,159.75 $84,159.75 $84,159.75 2026-02-13
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 3 3 — — $83,664.76 $83,664.76 $83,664.76 2026-02-13
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 3 3 — — $82,254.32 $82,254.32 $82,254.32 2026-02-13
1623 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 3 3 — — $81,860.98 $81,860.98 $81,860.98 2026-02-13
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 3 3 — — $81,657.52 $81,657.52 $81,657.52 2026-02-13
13 APR_DRG Liver Transplant &/or Intestinal Transplant 3 3 — — $81,615.55 $81,615.55 $81,615.55 2026-02-13
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 18 16 — — $81,604.91 $288,017.34 $158,773.20 2026-02-13
209 MS_DRG Complex Aortic Arch Procedures 17 15 — — $81,512.25 $287,690.28 $153,434.82 2026-02-13
12 APR_DRG Liver Transplant &/or Intestinal Transplant 3 3 — — $81,331.75 $81,331.75 $81,331.75 2026-02-13
11 APR_DRG Liver Transplant &/or Intestinal Transplant 3 3 — — $81,312.40 $81,312.40 $81,312.40 2026-02-13
9104 APR_DRG Craniotomy For Multiple Significant Trauma 3 3 — — $81,088.77 $81,088.77 $81,088.77 2026-02-13
1664 APR_DRG Coronary Bypass Without Ami Or Complex Pdx 3 3 — — $80,850.23 $80,850.23 $80,850.23 2026-02-13
6123 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 3 3 — — $80,273.66 $80,273.66 $80,273.66 2026-02-13
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 3 3 — — $79,670.26 $79,670.26 $79,670.26 2026-02-13
1694 APR_DRG Major Abdominal Vascular Procedures 3 3 — — $79,530.72 $79,530.72 $79,530.72 2026-02-13
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 15 — — $79,390.48 $280,201.71 $149,440.91 2026-02-13
6954 APR_DRG Chemotherapy For Acute Leukemia 3 3 — — $79,163.73 $79,163.73 $79,163.73 2026-02-13
894 APR_DRG Major Cranial/facial Bone Procedures 3 3 — — $79,013.08 $79,013.08 $79,013.08 2026-02-13
4414 APR_DRG Major Bladder Procedures 3 3 — — $78,766.45 $78,766.45 $78,766.45 2026-02-13
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 17 15 — — $78,341.72 $276,500.19 $147,466.77 2026-02-13
6904 APR_DRG Acute Leukemia 3 3 — — $76,802.25 $76,802.25 $76,802.25 2026-02-13
4403 APR_DRG Kidney Transplant 3 3 — — $75,658.81 $75,658.81 $75,658.81 2026-02-13
1814 APR_DRG Lower Extremity Arterial Procedures 3 3 — — $75,492.65 $75,492.65 $75,492.65 2026-02-13
2304 APR_DRG Major Small Bowel Procedures 3 3 — — $75,262.63 $75,262.63 $75,262.63 2026-02-13
214 APR_DRG Craniotomy Except For Trauma 3 3 — — $74,838.03 $74,838.03 $74,838.03 2026-02-13
1324 APR_DRG Bpd & Oth Chronic Respiratory Diseases Arising In Perinatal Period 3 3 — — $74,341.73 $74,341.73 $74,341.73 2026-02-13
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 18 16 — — $74,323.49 $262,318.20 $144,532.52 2026-02-13
6903 APR_DRG Acute Leukemia 3 3 — — $74,232.03 $74,232.03 $74,232.03 2026-02-13
1674 APR_DRG Other Cardiothoracic & Thoracic Vascular Procedures 3 3 — — $73,979.36 $73,979.36 $73,979.36 2026-02-13
6031 APR_DRG Neonate Birthwt 1000-1249g W Or Without Other Significant Condition 3 3 — — $73,494.34 $73,494.34 $73,494.34 2026-02-13
9114 APR_DRG Extensive Abdominal/thoracic Procedures For Mult Significant Trauma 3 3 — — $72,900.50 $72,900.50 $72,900.50 2026-02-13
Q0480 HCPCS Driver Pneumatic Vad, Rep 13 11 — — $72,648.53 $388,612.62 $129,537.54 2026-02-13
6224 APR_DRG Neonate Bwt 2000-2499g W Resp Dist Synd/oth Maj Resp Cond 3 3 — — $72,526.95 $72,526.95 $72,526.95 2026-02-13
6112 APR_DRG Neonate Birthwt 1500-1999g W Major Anomaly 3 3 — — $72,122.16 $72,122.16 $72,122.16 2026-02-13
3043 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 3 3 — — $71,945.22 $71,945.22 $71,945.22 2026-02-13
215 MS_DRG Other Heart Assist System Implant 17 15 — — $71,803.19 $253,423.02 $135,158.94 2026-02-13
1214 APR_DRG Other Respiratory & Chest Procedures 3 3 — — $70,983.15 $70,983.15 $70,983.15 2026-02-13
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 15 — — $70,561.22 $249,039.60 $132,821.12 2026-02-13
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 3 3 — — $70,247.03 $70,247.03 $70,247.03 2026-02-13
83 APR_DRG Autologous Bone Marrow Transplant 3 3 — — $69,848.26 $69,848.26 $69,848.26 2026-02-13
82 APR_DRG Autologous Bone Marrow Transplant 3 3 — — $69,745.06 $69,745.06 $69,745.06 2026-02-13
6814 APR_DRG Other O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 3 3 — — $69,646.51 $69,646.51 $69,646.51 2026-02-13
81 APR_DRG Autologous Bone Marrow Transplant 3 3 — — $69,628.96 $69,628.96 $69,628.96 2026-02-13
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 3 3 — — $69,102.33 $69,102.33 $69,102.33 2026-02-13
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 10 9 — — $68,801.71 $242,829.57 $91,061.09 2026-02-13
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 3 3 — — $67,714.76 $67,714.76 $67,714.76 2026-02-13
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 3 3 — — $67,447.89 $67,447.89 $67,447.89 2026-02-13
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 3 3 — — $67,161.21 $67,161.21 $67,161.21 2026-02-13
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 3 3 — — $66,929.40 $66,929.40 $66,929.40 2026-02-13
1763 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 3 3 — — $66,768.15 $66,768.15 $66,768.15 2026-02-13
5894 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 3 3 — — $66,187.61 $66,187.61 $66,187.61 2026-02-13
5891 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 3 3 — — $66,187.61 $66,187.61 $66,187.61 2026-02-13
5892 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 3 3 — — $66,187.61 $66,187.61 $66,187.61 2026-02-13
5893 APR_DRG Neonate Bwt <500g Or Ga <24 Weeks 3 3 — — $66,187.61 $66,187.61 $66,187.61 2026-02-13
6804 APR_DRG Major O.r. Procedures For Lymphatic/hematopoietic/other Neoplasms 3 3 — — $66,105.30 $66,105.30 $66,105.30 2026-02-13
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 3 3 — — $65,889.68 $65,889.68 $65,889.68 2026-02-13
234 APR_DRG Spinal Procedures 3 3 — — $65,807.40 $65,807.40 $65,807.40 2026-02-13
4402 APR_DRG Kidney Transplant 3 3 — — $65,530.30 $65,530.30 $65,530.30 2026-02-13
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 3 3 — — $65,374.54 $65,374.54 $65,374.54 2026-02-13
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 17 15 — — $65,048.61 $229,583.34 $122,444.45 2026-02-13
1754 APR_DRG Percutaneous Coronary Intervention Without Ami 3 3 — — $64,568.55 $64,568.55 $64,568.55 2026-02-13
4401 APR_DRG Kidney Transplant 3 3 — — $63,958.87 $63,958.87 $63,958.87 2026-02-13
924 APR_DRG Facial Bone Procedures Except Major Cranial/facial Bone Procedures 3 3 — — $63,334.64 $63,334.64 $63,334.64 2026-02-13
6082 APR_DRG Neonate Bwt 1250-1499g W Or Without Other Significant Condition 3 3 — — $63,219.93 $63,219.93 $63,219.93 2026-02-13
J7330 HCPCS Cultured Chondrocytes Implnt 3 2 — — $63,189.12 $235,918.20 $121,330.00 2026-02-13
914 APR_DRG Other Major Head & Neck Procedures 3 3 — — $63,072.51 $63,072.51 $63,072.51 2026-02-13
850 MS_DRG Acute Leukemia With Other Procedures 17 15 — — $62,552.55 $220,773.72 $117,745.98 2026-02-13
6144 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 3 3 — — $62,156.27 $62,156.27 $62,156.27 2026-02-13
6143 APR_DRG Neonate Bwt 1500-1999g W Or Without Other Significant Condition 3 3 — — $61,633.82 $61,633.82 $61,633.82 2026-02-13
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 3 3 — — $61,631.76 $61,631.76 $61,631.76 2026-02-13
4034 APR_DRG Procedures For Obesity 3 3 — — $61,577.27 $61,577.27 $61,577.27 2026-02-13
7924 APR_DRG Extensive Or Procedures For Other Complications Of Treatment 3 3 — — $61,518.92 $61,518.92 $61,518.92 2026-02-13
204 APR_DRG Craniotomy For Trauma 3 3 — — $61,515.24 $61,515.24 $61,515.24 2026-02-13
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 3 3 — — $61,502.76 $61,502.76 $61,502.76 2026-02-13
6122 APR_DRG Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond 3 3 — — $61,042.03 $61,042.03 $61,042.03 2026-02-13
231 MS_DRG Coronary Bypass With Ptca With Mcc 17 15 — — $60,915.61 $214,996.26 $114,664.67 2026-02-13
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 15 — — $60,726.66 $214,329.39 $114,309.01 2026-02-13
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 3 3 — — $60,705.47 $60,705.47 $60,705.47 2026-02-13
7114 APR_DRG Post-op, Post-trauma, Other Device Infections W O.r. Procedure 3 3 — — $60,183.13 $60,183.13 $60,183.13 2026-02-13
1653 APR_DRG Coronary Bypass W Ami Or Complex Pdx 3 3 — — $60,067.05 $60,067.05 $60,067.05 2026-02-13
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 3 3 — — $59,454.30 $59,454.30 $59,454.30 2026-02-13
893 APR_DRG Major Cranial/facial Bone Procedures 3 3 — — $59,085.66 $59,085.66 $59,085.66 2026-02-13
244 APR_DRG Extracranial Vascular Procedures 3 3 — — $58,683.67 $58,683.67 $58,683.67 2026-02-13
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Pdx 3 3 — — $57,640.95 $57,640.95 $57,640.95 2026-02-13
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 17 15 — — $56,915.21 $200,877.21 $107,134.51 2026-02-13
213 APR_DRG Craniotomy Except For Trauma 3 3 — — $56,248.43 $56,248.43 $56,248.43 2026-02-13
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Xcis/decomp 3 3 — — $55,747.89 $55,747.89 $55,747.89 2026-02-13
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 15 — — $55,557.00 $196,083.54 $104,577.89 2026-02-13
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 17 15 — — $55,321.03 $195,250.68 $104,133.70 2026-02-13
1611 APR_DRG Cardiac Defibrillator & Heart Assist Implant 3 3 — — $55,181.11 $55,181.11 $55,181.11 2026-02-13
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 17 15 — — $55,140.65 $194,614.05 $103,794.16 2026-02-13
2444 APR_DRG Diverticulitis & Diverticulosis 3 3 — — $54,423.80 $54,423.80 $54,423.80 2026-02-13
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 3 3 — — $54,309.01 $54,309.01 $54,309.01 2026-02-13
3042 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 3 3 — — $54,008.14 $54,008.14 $54,008.14 2026-02-13
J9029 HCPCS Instill Adstiladrin, Tx Dose 15 11 — — $53,840.94 $252,000.00 $63,945.00 2026-02-13
1622 APR_DRG Cardiac Valve Procedures W Ami Or Complex Pdx 3 3 — — $53,660.97 $53,660.97 $53,660.97 2026-02-13
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 15 — — $52,279.56 $184,516.08 $98,408.58 2026-02-13
10 MS_DRG Pancreas Transplant 18 16 — — $51,973.69 $183,436.56 $100,821.84 2026-02-13
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 17 15 — — $51,952.30 $183,361.05 $97,792.56 2026-02-13
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 18 16 — — $51,680.67 $182,402.37 $100,248.76 2026-02-13
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 17 15 — — $51,650.72 $182,296.65 $97,224.88 2026-02-13
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 17 15 — — $50,092.18 $176,795.94 $94,291.17 2026-02-13
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 17 15 — — $49,850.50 $175,942.95 $93,836.24 2026-02-13
955 MS_DRG Craniotomy For Multiple Significant Trauma 17 15 — — $48,803.87 $172,248.96 $91,866.11 2026-02-13
90288 CPT Botulism Ig IV 2 1 — — $48,705.00 $170,467.50 $109,586.25 2026-02-13
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 17 15 — — $48,485.90 $171,126.69 $91,267.57 2026-02-13
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 17 15 — — $48,450.97 $171,003.42 $91,201.82 2026-02-13
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 15 — — $47,693.09 $168,328.56 $89,775.23 2026-02-13
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 17 15 — — $47,693.09 $168,328.56 $89,775.23 2026-02-13
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 17 15 — — $47,522.69 $167,727.15 $89,454.48 2026-02-13
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 15 11 — — $46,981.48 $194,294.73 $65,732.65 2026-02-13
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 17 15 — — $46,690.66 $164,790.57 $87,888.30 2026-02-13
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 17 15 — — $44,506.88 $157,083.12 $83,777.66 2026-02-13
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 17 15 — — $44,456.26 $156,904.44 $83,682.37 2026-02-13
232 MS_DRG Coronary Bypass With Ptca Without Mcc 17 15 — — $44,037.76 $155,427.39 $82,894.61 2026-02-13
28 MS_DRG Spinal Procedures With Mcc 17 15 — — $43,650.63 $154,061.04 $82,165.89 2026-02-13
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 17 15 — — $43,638.49 $154,018.20 $82,143.04 2026-02-13
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 15 — — $43,328.35 $152,923.59 $81,559.25 2026-02-13
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 17 15 — — $43,188.63 $152,430.45 $81,296.24 2026-02-13
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 18 16 — — $43,090.22 $152,083.14 $83,447.99 2026-02-13
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 17 15 — — $42,654.62 $150,545.70 $80,291.04 2026-02-13
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 17 15 — — $42,627.53 $150,450.12 $80,240.06 2026-02-13
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 17 15 — — $41,930.98 $147,991.68 $78,928.90 2026-02-13
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 17 15 — — $41,668.59 $147,065.61 $78,434.99 2026-02-13
213 MS_DRG Endovascular Abdominal Aorta With Iliac Branch Procedures 17 15 — — $41,501.77 $146,476.83 $78,120.98 2026-02-13
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 17 15 — — $41,449.00 $146,290.59 $78,021.65 2026-02-13
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 17 15 — — $40,896.48 $144,340.50 $76,981.60 2026-02-13
8 MS_DRG Simultaneous Pancreas And Kidney Transplant 18 16 — — $40,772.40 $143,902.59 $78,914.90 2026-02-13
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 17 15 — — $40,498.63 $142,936.35 $76,232.72 2026-02-13
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 17 15 — — $40,190.63 $141,849.27 $75,652.94 2026-02-13
0266T CPT Outpatient Services 11 10 — — $40,070.38 $141,424.87 $56,569.95 2026-02-13
834 MS_DRG Acute Leukemia With Mcc 17 15 — — $39,954.64 $141,016.38 $75,208.74 2026-02-13
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 17 15 — — $39,816.34 $140,528.25 $74,948.40 2026-02-13
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 17 15 — — $39,760.72 $140,331.96 $74,843.71 2026-02-13
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 17 15 — — $39,699.41 $140,115.57 $74,728.30 2026-02-13
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 18 16 — — $39,543.98 $139,566.99 $76,512.40 2026-02-13
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 15 — — $38,834.59 $137,063.25 $73,100.40 2026-02-13
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 17 15 — — $38,811.78 $136,982.76 $73,057.47 2026-02-13
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 17 15 — — $38,556.54 $136,081.89 $72,577.01 2026-02-13
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 17 15 — — $38,431.76 $135,641.52 $72,342.14 2026-02-13
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 17 15 — — $37,926.29 $133,857.48 $71,390.66 2026-02-13
653 MS_DRG Major Bladder Procedures With Mcc 17 15 — — $37,862.12 $133,631.01 $71,269.87 2026-02-13
L7181 HCPCS Electronic Elbo Simultaneous 13 11 — — $37,858.44 $172,843.53 $57,614.51 2026-02-13
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 17 15 — — $36,748.48 $129,700.53 $69,173.62 2026-02-13
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 17 15 — — $36,372.03 $128,371.86 $68,464.99 2026-02-13
228 MS_DRG Other Cardiothoracic Procedures With Mcc 17 15 — — $36,086.84 $127,365.33 $67,928.18 2026-02-13
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 17 15 — — $36,024.11 $127,143.90 $67,810.08 2026-02-13
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 17 15 — — $35,903.62 $126,718.65 $67,583.28 2026-02-13
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 17 15 — — $35,757.47 $126,202.83 $67,308.18 2026-02-13
471 MS_DRG Cervical Spinal Fusion With Mcc 17 15 — — $35,240.56 $124,378.44 $66,335.17 2026-02-13
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 17 15 — — $35,066.61 $123,764.49 $66,007.73 2026-02-13
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 17 15 — — $34,756.47 $122,669.91 $65,423.95 2026-02-13
650 MS_DRG Kidney Transplant With Hemodialysis With Mcc 18 16 — — $34,332.97 $121,175.19 $66,320.96 2026-02-13
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 17 15 — — $34,264.52 $120,933.60 $64,497.92 2026-02-13
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 17 15 — — $34,164.72 $120,581.37 $64,310.06 2026-02-13
6 MS_DRG Liver Transplant Without Mcc 18 16 — — $33,873.83 $119,554.71 $65,422.99 2026-02-13
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 17 15 — — $33,741.94 $119,089.20 $63,514.24 2026-02-13
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 17 15 — — $33,585.07 $118,535.55 $63,218.96 2026-02-13
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 17 15 — — $33,501.65 $118,241.13 $63,061.94 2026-02-13
245 MS_DRG Aicd Generator Procedures 17 15 — — $33,341.96 $117,677.52 $62,761.34 2026-02-13
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 17 15 — — $33,244.28 $117,332.76 $62,577.47 2026-02-13
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 17 15 — — $33,230.03 $117,282.45 $62,550.64 2026-02-13
799 MS_DRG Splenic Procedures With Mcc 17 15 — — $33,103.12 $116,834.55 $62,311.76 2026-02-13
163 MS_DRG Major Chest Procedures With Mcc 17 15 — — $32,767.31 $115,649.34 $61,679.65 2026-02-13
31 MS_DRG Ventricular Shunt Procedures With Mcc 17 15 — — $32,758.05 $115,616.64 $61,662.21 2026-02-13
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 17 15 — — $32,632.57 $115,173.78 $61,426.02 2026-02-13
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 17 15 — — $32,132.79 $113,409.84 $60,485.25 2026-02-13
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 17 15 — — $31,666.51 $111,764.16 $59,607.55 2026-02-13
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 17 15 — — $31,420.54 $110,896.02 $59,144.54 2026-02-13
140 MS_DRG Major Head And Neck Procedures With Mcc 17 15 — — $31,223.76 $110,201.52 $58,774.14 2026-02-13
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 17 15 — — $31,049.09 $109,585.02 $58,445.34 2026-02-13
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 17 15 — — $30,923.59 $109,142.07 $58,209.10 2026-02-13
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 17 15 — — $30,872.27 $108,960.96 $58,112.51 2026-02-13
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 17 15 — — $30,857.30 $108,908.13 $58,084.34 2026-02-13
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 17 15 — — $30,769.62 $108,598.65 $57,919.28 2026-02-13
901 MS_DRG Wound Debridements For Injuries With Mcc 17 15 — — $30,733.97 $108,472.83 $57,852.18 2026-02-13
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 17 15 — — $30,678.35 $108,276.54 $57,747.49 2026-02-13
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 17 15 — — $30,562.86 $107,868.90 $57,530.08 2026-02-13
793 MS_DRG Full Term Neonate With Major Problems 17 15 — — $30,541.47 $107,793.42 $57,489.82 2026-02-13
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 17 15 — — $30,423.12 $107,375.73 $57,267.06 2026-02-13
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 17 15 — — $30,227.05 $106,683.72 $56,897.98 2026-02-13
791 MS_DRG Prematurity With Major Problems 17 15 — — $29,752.93 $105,010.35 $56,005.52 2026-02-13
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 17 15 — — $29,478.44 $104,041.56 $55,488.83 2026-02-13
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 17 15 — — $29,218.92 $103,125.60 $55,000.32 2026-02-13
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 17 15 — — $28,704.18 $101,308.86 $54,031.39 2026-02-13
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours Without Skin Graft 17 15 — — $28,577.98 $100,863.45 $53,793.84 2026-02-13
A9543 HCPCS Pr Y90 Ibritumomab, Rx 15 11 — — $12,505.30 $259,435.51 $56,824.55 2026-02-13
J2507 HCPCS Pegloticase 8 Mg/ml IV Soln 48 22 $90,102.00 $27,030.60 70% off $3,111.71 $76,586.70 $56,394.84 2026-02-13
38240 CPT Transplt Allo Hct/donor 12 10 — — $475.34 $185,868.97 $68,151.96 2026-02-13
J9043 HCPCS Cabazitaxel 60 Mg/1.5ml IV Soln 48 22 $211,136.50 $63,340.95 70% off $193.19 $179,466.03 $132,150.34 2026-02-13
J9359 HCPCS Loncastuximab Tesirine-lpyl 10 Mg IV Solr 48 22 $113,289.50 $33,986.85 70% off $184.37 $96,296.08 $70,907.90 2026-02-13
J9228 HCPCS Ipilimumab 200 Mg/40ml IV Soln 61 22 $125,551.00 $37,665.30 70% off $155.96 $106,718.35 $60,942.46 2026-02-13
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