Hospital

NORTON SCOTT HOSPITAL

Scottsburg, IN · CCN 151334 · Rates published

13,293 distinct procedures filed

23 distinct payers

162,258 rate rows

2025-03-27 last MRF observed · ⚠ 15 mo old

Data quality

161,626 of 162,258 rate rows are consumer-grade (99.6%)

632 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 — reason	Rows
placeholder amount (≤ $0.02) — excluded from medians	273
per-diem day rate — not a per-procedure price	161
no usable negotiated amount (only an out-of-band fallback) — excluded from medians	153
percent-of-charges filed in the dollar field — excluded from medians	38
exceeds 10× this hospital's gross charge — excluded from medians	7

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 15 months old. CMS requires hospitals to refresh these files at least annually, so newer rates may exist that we haven't ingested yet. The prices below are exactly as last filed.

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/12590/461113518-1013251594_norton-healthcareindiana%2C-inc_standardcharges.csv
Found on page	https://search.hospitalpriceindex.com/hpi2/machineReadable/NortonScottHospital/12590
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-05-19
Content fingerprint	60ed4e26b83f5c1c… · 77,413,328 bytes · first seen 2026-05-17

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
J1414 HCPCS	Inj, Beqvez, Per Tx Dose	3	$3,710,000.00	$4,452,000.00	$3,821,300.00	nat. median $3,710,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	9	$3,675,000.00	$4,452,000.00	$3,711,750.00	nat. median $3,710,000 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	9	$3,321,781.51	$3,986,137.81	$3,393,600.00	nat. median $3,325,455 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	3	$3,193,000.00	$3,831,600.00	$3,288,790.00	nat. median $3,286,000 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	3	$2,968,000.00	$3,561,600.00	$3,057,040.00	nat. median $3,006,423 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	3	$2,332,000.00	$2,798,400.00	$2,401,960.00	nat. median $2,448,600 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	9	$2,231,250.00	$2,884,150.50	$2,342,812.50	nat. median $2,469,189 0.9× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	3	$565,623.84	$678,748.61	$582,592.56	nat. median $754,974 0.8× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	9	$516,485.97	$619,783.16	$557,917.92	nat. median $674,188 0.8× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	9	$528,312.43	$633,974.92	$554,728.05	nat. median $625,184 0.9× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	9	$548,128.28	$661,582.01	$553,609.56	nat. median $675,122 0.8× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	9	$489,517.15	$587,420.58	$528,759.00	nat. median $634,511 0.8× median
Q2053 HCPCS	Brexucabtagene Car Pos T	9	$485,100.00	$585,661.81	$489,951.00	nat. median $620,080 0.8× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	2	$239,997.00	$279,608.16	$243,492.10	nat. median $370,174 0.7× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	2	$179,257.91	$208,844.17	$181,868.46	nat. median $265,286 0.7× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	2	$150,977.74	$175,896.40	$153,176.45	nat. median $206,368 0.7× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	2	$136,387.07	$158,897.56	$138,373.29	nat. median $202,986 0.7× median
5884 APR_DRG	Neonate Bwt <1500g W Major Procedure	6	$109,403.98	$114,874.18	$109,403.98	nat. median $246,434 outlier · 0.4×
24 APR_DRG	Heart &/or Lung Transplant	6	$98,727.72	$103,664.11	$98,727.72	nat. median $234,738 outlier · 0.4×
K1007 HCPCS	Bil Hkaf Pc S/d Micro Sensor	3	$93,216.70	$111,860.04	$96,013.20	nat. median $96,983 1.0× median
1614 APR_DRG	Cardiac Defibrillator & Heart Assist Implant	6	$95,450.99	$100,223.54	$95,450.99	nat. median $207,730 outlier · 0.5×
4 MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And…	2	$89,921.07	$104,762.41	$91,230.60	nat. median $133,176 0.7× median
14 MS_DRG	Allogeneic Bone Marrow Transplant	2	$83,377.36	$97,138.67	$84,591.59	nat. median $117,303 0.7× median
7 MS_DRG	Lung Transplant	2	$83,167.34	$96,893.99	$84,378.51	nat. median $122,708 0.7× median
Q0480 HCPCS	Driver Pneumatic Vad, Rep	9	$72,648.53	$119,999.94	$76,280.96	nat. median $111,989 0.7× median
14 APR_DRG	Liver Transplant &/or Intestinal Transplant	6	$71,979.64	$75,578.62	$71,979.64	nat. median $129,535 0.6× median
2 MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	2	$70,132.08	$81,707.28	$71,153.42	nat. median $108,660 0.7× median
212 MS_DRG	Concomitant Aortic And Mitral Valve Procedures	2	$69,326.37	$80,768.59	$70,335.98	nat. median $102,358 0.7× median
L8702 HCPCS	Ewhf S/d Uprt Micro Sensor	3	$67,452.66	$80,943.19	$69,476.24	nat. median $70,825 1.0× median
5 MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	2	$67,770.31	$78,955.70	$68,757.26	nat. median $100,136 0.7× median
215 MS_DRG	Other Heart Assist System Implant	2	$67,424.10	$78,552.35	$68,406.01	nat. median $99,019 0.7× median
426 MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	2	$66,707.49	$77,717.46	$67,678.96	nat. median $98,905 0.7× median
74 APR_DRG	Allogeneic Bone Marrow Transplant	6	$66,644.33	$69,976.55	$66,644.33	nat. median $187,294 outlier · 0.4×
Q2043 HCPCS	Sipuleucel-t Auto Cd54+	11	$55,536.50	$73,350.09	$65,732.65	nat. median $66,682 1.0× median
44 APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	$65,369.09	$68,637.54	$65,369.09	nat. median $105,658 0.6× median
J9029 HCPCS	Instill Adstiladrin, Tx Dose	11	$63,000.00	$83,738.55	$65,304.10	nat. median $69,774 0.9× median
94 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	$65,007.90	$68,258.30	$65,007.90	nat. median $164,834 outlier · 0.4×
5914 APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	$63,630.47	$66,811.99	$63,630.47	nat. median $164,279 outlier · 0.4×
216 MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	2	$61,417.52	$71,554.39	$62,311.95	nat. median $93,672 0.7× median
38240 CPT	Transplt Allo Hct/donor	3	$59,142.33	$70,970.80	$60,916.60	nat. median $15,912 outlier · 3.8×
6094 APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	$60,298.76	$63,313.70	$60,298.76	nat. median $162,982 outlier · 0.4×
850 MS_DRG	Acute Leukemia With Other Procedures	2	$58,622.99	$68,298.62	$59,476.72	nat. median $83,442 0.7× median
22 APR_DRG	Heart &/or Lung Transplant	6	$56,959.66	$59,807.64	$56,959.66	nat. median $78,029 0.7× median
23 APR_DRG	Heart &/or Lung Transplant	6	$56,959.66	$59,807.64	$56,959.66	nat. median $93,528 0.6× median
21 APR_DRG	Heart &/or Lung Transplant	6	$56,959.66	$59,807.64	$56,959.66	nat. median $65,130 0.9× median
5934 APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	$56,876.50	$59,720.33	$56,876.50	nat. median $151,838 outlier · 0.4×
231 MS_DRG	Coronary Bypass With Ptca With Mcc	2	$53,926.80	$62,827.34	$54,712.15	nat. median $79,312 0.7× median
456 MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	2	$53,896.25	$62,791.75	$54,681.15	nat. median $81,118 0.7× median
5832 APR_DRG	Neonate W Ecmo	6	$53,956.72	$56,654.56	$53,956.72	nat. median $156,126 outlier · 0.3×
5833 APR_DRG	Neonate W Ecmo	6	$53,956.72	$56,654.56	$53,956.72	nat. median $244,017 outlier · 0.2×

Other procedures at this hospital

Browse this hospital's 13,293 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J7330	HCPCS	Cultured Chondrocytes Implnt	2	2	—	—	$42,139.40	$42,139.40	$42,139.40	2025-03-27
J7310	HCPCS	Pharmacy	2	2	—	—	$23,744.00	$23,744.00	$23,744.00	2025-03-27
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	4	2	—	—	$239,997.00	$279,608.16	$243,492.10	2025-03-27
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	4	2	—	—	$179,257.91	$208,844.17	$181,868.46	2025-03-27
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	4	2	—	—	$150,977.74	$175,896.40	$153,176.45	2025-03-27
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	4	2	—	—	$136,387.07	$158,897.56	$138,373.29	2025-03-27
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	4	2	—	—	$89,921.07	$104,762.41	$91,230.60	2025-03-27
14	MS_DRG	Allogeneic Bone Marrow Transplant	4	2	—	—	$83,377.36	$97,138.67	$84,591.59	2025-03-27
7	MS_DRG	Lung Transplant	4	2	—	—	$83,167.34	$96,893.99	$84,378.51	2025-03-27
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	4	2	—	—	$70,132.08	$81,707.28	$71,153.42	2025-03-27
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	4	2	—	—	$69,326.37	$80,768.59	$70,335.98	2025-03-27
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	4	2	—	—	$67,770.31	$78,955.70	$68,757.26	2025-03-27
215	MS_DRG	Other Heart Assist System Implant	4	2	—	—	$67,424.10	$78,552.35	$68,406.01	2025-03-27
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	2	—	—	$66,707.49	$77,717.46	$67,678.96	2025-03-27
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	2	—	—	$61,417.52	$71,554.39	$62,311.95	2025-03-27
850	MS_DRG	Acute Leukemia With Other Procedures	4	2	—	—	$58,622.99	$68,298.62	$59,476.72	2025-03-27
231	MS_DRG	Coronary Bypass With Ptca With Mcc	4	2	—	—	$53,926.80	$62,827.34	$54,712.15	2025-03-27
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	2	—	—	$53,896.25	$62,791.75	$54,681.15	2025-03-27
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	4	2	—	—	$53,077.82	$61,838.23	$53,850.79	2025-03-27
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	4	2	—	—	$51,299.01	$59,765.83	$52,046.08	2025-03-27
10	MS_DRG	Pancreas Transplant	4	2	—	—	$50,739.59	$59,114.09	$51,478.51	2025-03-27
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	4	2	—	—	$50,447.47	$58,773.76	$51,182.15	2025-03-27
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	4	2	—	—	$49,741.68	$57,951.47	$50,466.07	2025-03-27
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	2	—	—	$49,240.17	$57,367.19	$49,957.26	2025-03-27
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	4	2	—	—	$47,500.83	$55,340.77	$48,192.59	2025-03-27
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	2	—	—	$45,177.88	$52,634.42	$45,835.81	2025-03-27
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	4	2	—	—	$44,972.95	$52,395.67	$45,627.89	2025-03-27
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	4	2	—	—	$44,272.88	$51,580.06	$44,917.63	2025-03-27
955	MS_DRG	Craniotomy For Multiple Significant Trauma	4	2	—	—	$43,454.43	$50,626.52	$44,087.26	2025-03-27
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	4	2	—	—	$42,667.18	$49,709.34	$43,288.55	2025-03-27
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	4	2	—	—	$42,503.62	$49,518.78	$43,122.60	2025-03-27
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	4	2	—	—	$42,431.70	$49,435.00	$43,049.64	2025-03-27
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	4	2	—	—	$41,162.03	$47,955.77	$41,761.48	2025-03-27
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	2	—	—	$41,096.49	$47,879.40	$41,694.98	2025-03-27
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	4	2	—	—	$40,246.86	$46,889.54	$40,832.98	2025-03-27
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	4	2	—	—	$39,420.14	$45,926.38	$39,994.22	2025-03-27
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	4	2	—	—	$39,369.23	$45,867.06	$39,942.57	2025-03-27
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	4	2	—	—	$39,189.76	$45,657.97	$39,760.49	2025-03-27
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	4	2	—	—	$39,055.47	$45,501.52	$39,624.24	2025-03-27
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	4	2	—	—	$38,874.72	$45,290.94	$39,440.86	2025-03-27
28	MS_DRG	Spinal Procedures With Mcc	4	2	—	—	$38,688.89	$45,074.44	$39,252.32	2025-03-27
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	4	2	—	—	$38,411.41	$44,751.16	$38,970.80	2025-03-27
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	4	2	—	—	$38,411.41	$44,751.16	$38,970.80	2025-03-27
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	4	2	—	—	$38,124.38	$44,416.75	$38,679.59	2025-03-27
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	4	2	—	—	$37,861.54	$44,110.54	$38,412.93	2025-03-27
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	4	2	—	—	$37,835.44	$44,080.13	$38,386.44	2025-03-27
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	4	2	—	—	$37,445.95	$43,626.35	$37,991.28	2025-03-27
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	4	2	—	—	$37,052.00	$43,167.38	$37,591.60	2025-03-27
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	2	—	—	$36,524.41	$42,552.71	$37,056.32	2025-03-27
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	4	2	—	—	$36,306.12	$42,298.39	$36,834.85	2025-03-27
653	MS_DRG	Major Bladder Procedures With Mcc	4	2	—	—	$35,475.58	$41,330.77	$35,992.21	2025-03-27
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	4	2	—	—	$35,177.10	$40,983.02	$35,689.38	2025-03-27
834	MS_DRG	Acute Leukemia With Mcc	4	2	—	—	$35,174.55	$40,980.06	$35,686.80	2025-03-27
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	4	2	—	—	$35,036.45	$40,819.16	$35,546.69	2025-03-27
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	4	2	—	—	$34,813.06	$40,558.91	$35,320.05	2025-03-27
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	4	2	—	—	$34,626.59	$40,341.66	$35,130.86	2025-03-27
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	4	2	—	—	$34,547.67	$40,249.72	$35,050.79	2025-03-27
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	4	2	—	—	$34,371.39	$40,044.34	$34,871.94	2025-03-27
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	4	2	—	—	$34,338.92	$40,006.51	$34,839.00	2025-03-27
576	MS_DRG	Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc	4	2	—	—	$34,334.47	$40,001.33	$34,834.49	2025-03-27
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	4	2	—	—	$33,857.15	$39,445.22	$34,350.21	2025-03-27
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	2	—	—	$33,706.96	$39,270.24	$34,197.83	2025-03-27
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	4	2	—	—	$32,773.96	$38,183.26	$33,251.25	2025-03-27
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	4	2	—	—	$32,666.41	$38,057.95	$33,142.14	2025-03-27
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	4	2	—	—	$32,421.38	$37,772.48	$32,893.54	2025-03-27
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	4	2	—	—	$32,322.10	$37,656.82	$32,792.81	2025-03-27
239	MS_DRG	Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc	4	2	—	—	$32,053.53	$37,343.92	$32,520.33	2025-03-27
837	MS_DRG	Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot…	4	2	—	—	$31,864.51	$37,123.70	$32,328.56	2025-03-27
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	4	2	—	—	$31,839.69	$37,094.78	$32,303.38	2025-03-27
853	MS_DRG	Infectious And Parasitic Diseases With O.r. Procedures With Mcc	4	2	—	—	$31,830.78	$37,084.40	$32,294.33	2025-03-27
228	MS_DRG	Other Cardiothoracic Procedures With Mcc	4	2	—	—	$31,712.40	$36,946.49	$32,174.23	2025-03-27
245	MS_DRG	Aicd Generator Procedures	4	2	—	—	$31,098.89	$36,231.72	$31,551.79	2025-03-27
471	MS_DRG	Cervical Spinal Fusion With Mcc	4	2	—	—	$30,911.14	$36,012.98	$31,361.31	2025-03-27
6	MS_DRG	Liver Transplant Without Mcc	4	2	—	—	$30,859.59	$35,952.92	$31,309.00	2025-03-27
826	MS_DRG	Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. …	4	2	—	—	$30,390.55	$35,406.47	$30,833.13	2025-03-27
799	MS_DRG	Splenic Procedures With Mcc	4	2	—	—	$30,258.80	$35,252.98	$30,699.47	2025-03-27
981	MS_DRG	Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	4	2	—	—	$30,257.54	$35,251.50	$30,698.19	2025-03-27
267	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc	4	2	—	—	$29,939.96	$34,881.50	$30,375.98	2025-03-27
823	MS_DRG	Lymphoma And Non-acute Leukemia With Other Procedures With Mcc	4	2	—	—	$29,779.59	$34,694.66	$30,213.27	2025-03-27
277	MS_DRG	Cardiac Defibrillator Implant Without Mcc	4	2	—	—	$29,607.75	$34,494.47	$30,038.93	2025-03-27
163	MS_DRG	Major Chest Procedures With Mcc	4	2	—	—	$29,332.18	$34,173.41	$29,759.35	2025-03-27
650	MS_DRG	Kidney Transplant With Hemodialysis With Mcc	4	2	—	—	$29,320.08	$34,159.32	$29,747.08	2025-03-27
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	4	2	—	—	$29,226.53	$34,050.32	$29,652.16	2025-03-27
329	MS_DRG	Major Small And Large Bowel Procedures With Mcc	4	2	—	—	$29,222.71	$34,045.87	$29,648.28	2025-03-27
856	MS_DRG	Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc	4	2	—	—	$28,711.02	$33,449.74	$29,129.15	2025-03-27
474	MS_DRG	Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc	4	2	—	—	$28,539.83	$33,250.28	$28,955.46	2025-03-27
25	MS_DRG	Craniotomy And Endovascular Intracranial Procedures With Mcc	4	2	—	—	$28,460.91	$33,158.34	$28,875.39	2025-03-27
901	MS_DRG	Wound Debridements For Injuries With Mcc	4	2	—	—	$28,194.88	$32,848.40	$28,605.49	2025-03-27
319	MS_DRG	Other Endovascular Cardiac Valve Procedures With Mcc	4	2	—	—	$27,954.95	$32,568.88	$28,362.06	2025-03-27
933	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft	4	2	—	—	$27,536.18	$32,080.99	$27,937.19	2025-03-27
458	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	4	2	—	—	$27,478.91	$32,014.26	$27,879.08	2025-03-27
356	MS_DRG	Other Digestive System O.r. Procedures With Mcc	4	2	—	—	$27,146.05	$31,626.47	$27,541.38	2025-03-27
323	MS_DRG	Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc	4	2	—	—	$27,106.60	$31,580.51	$27,501.36	2025-03-27
140	MS_DRG	Major Head And Neck Procedures With Mcc	4	2	—	—	$26,914.39	$31,356.58	$27,306.35	2025-03-27
31	MS_DRG	Ventricular Shunt Procedures With Mcc	4	2	—	—	$26,668.10	$31,069.63	$27,056.47	2025-03-27
673	MS_DRG	Other Kidney And Urinary Tract Procedures With Mcc	4	2	—	—	$26,666.20	$31,067.41	$27,054.54	2025-03-27
793	MS_DRG	Full Term Neonate With Major Problems	4	2	—	—	$26,542.73	$30,923.57	$26,929.28	2025-03-27
269	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc	4	2	—	—	$26,477.81	$30,847.93	$26,863.41	2025-03-27
236	MS_DRG	Coronary Bypass Without Cardiac Catheterization Without Mcc	4	2	—	—	$26,168.51	$30,487.58	$26,549.60	2025-03-27
958	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Cc	4	2	—	—	$26,153.87	$30,470.53	$26,534.75	2025-03-27
12	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc	4	2	—	—	$26,115.05	$30,425.30	$26,495.37	2025-03-27
448	MS_DRG	Multiple Level Spinal Fusion Except Cervical Without Mcc	4	2	—	—	$25,986.49	$30,275.52	$26,364.94	2025-03-27
423	MS_DRG	Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc	4	2	—	—	$25,884.02	$30,156.14	$26,260.97	2025-03-27
791	MS_DRG	Prematurity With Major Problems	4	2	—	—	$25,839.48	$30,104.24	$26,215.78	2025-03-27
907	MS_DRG	Other O.r. Procedures For Injuries With Mcc	4	2	—	—	$25,351.98	$29,536.28	$25,721.18	2025-03-27
739	MS_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc…	4	2	—	—	$25,334.16	$29,515.52	$25,703.10	2025-03-27
628	MS_DRG	Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc	4	2	—	—	$25,115.22	$29,260.45	$25,480.97	2025-03-27
736	MS_DRG	Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc	4	2	—	—	$25,057.94	$29,193.72	$25,422.86	2025-03-27
876	MS_DRG	O.r. Procedures With Principal Diagnosis Of Mental Illness	4	2	—	—	$25,007.67	$29,135.15	$25,371.86	2025-03-27
402	MS_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	4	2	—	—	$25,006.40	$29,133.67	$25,370.57	2025-03-27
273	MS_DRG	Percutaneous And Other Intracardiac Procedures With Mcc	4	2	—	—	$24,884.20	$28,991.30	$25,246.60	2025-03-27
34	MS_DRG	Carotid Artery Stent Procedures With Mcc	4	2	—	—	$24,747.37	$28,831.88	$25,107.76	2025-03-27
616	MS_DRG	Amputation Of Lower Limb For Endocrine, Nutritional And Metabolic Disorders With…	4	2	—	—	$24,597.17	$28,656.90	$24,955.38	2025-03-27
904	MS_DRG	Skin Grafts For Injuries With Cc/mcc	4	2	—	—	$24,571.72	$28,627.25	$24,929.56	2025-03-27
166	MS_DRG	Other Respiratory System O.r. Procedures With Mcc	4	2	—	—	$24,508.72	$28,553.84	$24,865.64	2025-03-27
956	MS_DRG	Limb Reattachment, Hip And Femur Procedures For Multiple Significant Trauma	4	2	—	—	$24,325.43	$28,340.30	$24,679.68	2025-03-27
24	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	4	2	—	—	$24,193.04	$28,186.07	$24,545.36	2025-03-27
40	MS_DRG	Peripheral, Cranial Nerve And Other Nervous System Procedures With Mcc	4	2	—	—	$24,004.67	$27,966.60	$24,354.25	2025-03-27
622	MS_DRG	Skin Grafts And Wound Debridement For Endocrine, Nutritional And Metabolic Disor…	4	2	—	—	$23,827.74	$27,760.48	$24,174.75	2025-03-27
94	MS_DRG	Bacterial And Tuberculous Infections Of Nervous System With Mcc	4	2	—	—	$23,219.32	$27,051.64	$23,557.47	2025-03-27
335	MS_DRG	Peritoneal Adhesiolysis With Mcc	4	2	—	—	$23,063.39	$26,869.97	$23,399.26	2025-03-27
97	MS_DRG	Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc	4	2	—	—	$22,814.55	$26,580.06	$23,146.80	2025-03-27
802	MS_DRG	Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc	4	2	—	—	$22,813.27	$26,578.57	$23,145.51	2025-03-27
518	MS_DRG	Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost…	4	2	—	—	$22,808.19	$26,572.64	$23,140.35	2025-03-27
265	MS_DRG	Aicd Lead Procedures	4	2	—	—	$22,700.63	$26,447.34	$23,031.22	2025-03-27
492	MS_DRG	Lower Extremity And Humerus Procedures Except Hip, Foot And Femur With Mcc	4	2	—	—	$22,599.44	$26,329.44	$22,928.56	2025-03-27
22	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage Without Cc/…	4	2	—	—	$22,468.34	$26,176.70	$22,795.55	2025-03-27
420	MS_DRG	Hepatobiliary Diagnostic Procedures With Mcc	4	2	—	—	$22,460.70	$26,167.80	$22,787.79	2025-03-27
495	MS_DRG	Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit…	4	2	—	—	$22,404.06	$26,101.81	$22,730.33	2025-03-27
414	MS_DRG	Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc	4	2	—	—	$22,297.77	$25,977.98	$22,622.50	2025-03-27
987	MS_DRG	Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc	4	2	—	—	$22,293.96	$25,973.54	$22,618.63	2025-03-27
408	MS_DRG	Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With…	4	2	—	—	$22,281.87	$25,959.46	$22,606.36	2025-03-27
264	MS_DRG	Other Circulatory System O.r. Procedures	4	2	—	—	$22,242.41	$25,913.48	$22,566.33	2025-03-27
651	MS_DRG	Kidney Transplant With Hemodialysis Without Mcc	4	2	—	—	$22,097.94	$25,745.17	$22,419.75	2025-03-27
332	MS_DRG	Rectal Resection With Mcc	4	2	—	—	$22,074.39	$25,717.74	$22,395.86	2025-03-27
574	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Cc	4	2	—	—	$22,050.21	$25,689.56	$22,371.33	2025-03-27
271	MS_DRG	Other Major Cardiovascular Procedures With Cc	4	2	—	—	$21,921.01	$25,539.04	$22,240.24	2025-03-27
477	MS_DRG	Biopsies Of Musculoskeletal System And Connective Tissue With Mcc	4	2	—	—	$21,885.37	$25,497.52	$22,204.09	2025-03-27
665	MS_DRG	Prostatectomy With Mcc	4	2	—	—	$21,851.01	$25,457.48	$22,169.22	2025-03-27
252	MS_DRG	Other Vascular Procedures With Mcc	4	2	—	—	$21,830.63	$25,433.75	$22,148.56	2025-03-27
467	MS_DRG	Revision Of Hip Or Knee Replacement With Cc	4	2	—	—	$21,796.91	$25,394.46	$22,114.34	2025-03-27
J1414	HCPCS	Inj, Beqvez, Per Tx Dose	5	3	—	—	$3,710,000.00	$4,452,000.00	$3,821,300.00	2025-03-27
J3394	HCPCS	Inj, Lovotibeglogene Autotem	5	3	—	—	$3,193,000.00	$3,831,600.00	$3,288,790.00	2025-03-27
J3393	HCPCS	Inj, Betibeglogene Autotemce	5	3	—	—	$2,968,000.00	$3,561,600.00	$3,057,040.00	2025-03-27
J3392	HCPCS	Inj, Exagamglogene Autotem	5	3	—	—	$2,332,000.00	$2,798,400.00	$2,401,960.00	2025-03-27
Q2042	HCPCS	Tisagenlecleucel Car-pos T	5	3	—	—	$565,623.84	$678,748.61	$582,592.56	2025-03-27
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	5	3	—	—	$93,216.70	$111,860.04	$96,013.20	2025-03-27
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	5	3	—	—	$67,452.66	$80,943.19	$69,476.24	2025-03-27
38240	CPT	Transplt Allo Hct/donor	5	3	—	—	$59,142.33	$70,970.80	$60,916.60	2025-03-27
33276	CPT	Insj Phrnc Nrv Stim Sys	5	3	—	—	$45,000.50	$54,000.60	$46,350.52	2025-03-27
0266T	CPT	Apc	5	3	—	—	$45,000.50	$54,000.60	$46,350.52	2025-03-27
L2006	HCPCS	Kaf Sng/dbl Swg/stn Mcpr Cus	5	3	—	—	$38,762.63	$46,515.16	$39,925.51	2025-03-27
0620T	CPT	Evasc Ven Artlz Tibl/prnl Vn	5	3	—	—	$35,000.50	$42,000.60	$36,050.52	2025-03-27
L8701	HCPCS	Ewh S/d Uprt Micro Sensor	5	3	—	—	$34,284.44	$41,141.33	$35,312.97	2025-03-27
0571T	CPT	Insj/rplcmt Icds Ss Eltrd	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
33231	CPT	Insrt Pulse Gen W/mult Leads	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
0915T	CPT	Insj Perm Ccm-d Sys Pg&eltrd	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
0408T	CPT	Insj/rplc Cardiac Modulj Sys	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
33264	CPT	Rmvl & Rplcmt Dfb Gen Mlt Ld	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
33270	CPT	Ins/rep Subq Defibrillator	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
33249	CPT	Insj/rplcmt Defib W/lead(s)	5	3	—	—	$32,061.58	$38,473.90	$33,023.43	2025-03-27
69930	CPT	Implant Cochlear Device	5	3	—	—	$31,807.82	$38,169.38	$32,762.05	2025-03-27
61886	CPT	Implant Neurostim Arrays	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
64582	CPT	Opn Mpltj Hpglsl Nstm Ary Pg	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
64568	CPT	Opn Impltj Crnl Nrv Nea&pg	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
63685	CPT	Ins/rplc Spi Npg/rcvr Pocket	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
0268T	CPT	Apc	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
0674T	CPT	Laps Insj Nw/rpcmt Prm Isdss	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
33287	CPT	Rmv&rplcmt Phrnc Nrv Stim Pg	5	3	—	—	$30,473.59	$36,568.31	$31,387.80	2025-03-27
33289	CPT	Tcat Impl Wrls P-art Prs Snr	5	3	—	—	$28,428.33	$34,114.00	$29,281.18	2025-03-27
C9760	HCPCS	Non-blind Interatrial Shunt	5	3	—	—	$27,500.50	$33,000.60	$28,325.52	2025-03-27
93654	CPT	Compre Ep Eval Tx Vt	5	3	—	—	$24,532.30	$29,438.76	$25,268.27	2025-03-27
93656	CPT	Compre Ep Eval Abltj Atr Fib	5	3	—	—	$24,532.30	$29,438.76	$25,268.27	2025-03-27
93653	CPT	Compre Ep Eval Tx Svt	5	3	—	—	$24,532.30	$29,438.76	$25,268.27	2025-03-27
L8614	HCPCS	Cochlear Device	5	3	—	—	$23,637.07	$28,364.48	$24,346.18	2025-03-27
0923T	CPT	Rmvl&rplcmt Perm Ccm-d Pg	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
0414T	CPT	Rmvl & Rpl Car Modulj Pls Gn	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
0614T	CPT	Rmvl&rplcmt Ss Impl Dfb Pg	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
0409T	CPT	Insj/rplc Car Modulj Pls Gn	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
0515T	CPT	Insj Wcs Lv Compl Sys	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
0916T	CPT	Insj Perm Ccm-d Sys Pg Only	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
33263	CPT	Rmvl & Rplcmt Dfb Gen 2 Lead	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
33262	CPT	Rmvl& Replc Pulse Gen 1 Lead	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
33230	CPT	Insrt Pulse Gen W/dual Leads	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
33240	CPT	Insrt Pulse Gen W/singl Lead	5	3	—	—	$22,446.19	$26,935.43	$23,119.58	2025-03-27
64590	CPT	Ins/rpl Prph Sac/gstr Npg/r	5	3	—	—	$21,444.39	$25,733.27	$22,087.72	2025-03-27
61885	CPT	Insrt/redo Neurostim 1 Array	5	3	—	—	$21,444.39	$25,733.27	$22,087.72	2025-03-27
5884	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$109,403.98	$114,874.18	$109,403.98	2025-03-27
24	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$98,727.72	$103,664.11	$98,727.72	2025-03-27
1614	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	6	6	—	—	$95,450.99	$100,223.54	$95,450.99	2025-03-27
14	APR_DRG	Liver Transplant &/or Intestinal Transplant	6	6	—	—	$71,979.64	$75,578.62	$71,979.64	2025-03-27
74	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$66,644.33	$69,976.55	$66,644.33	2025-03-27
44	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$65,369.09	$68,637.54	$65,369.09	2025-03-27
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$65,007.90	$68,258.30	$65,007.90	2025-03-27
5914	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$63,630.47	$66,811.99	$63,630.47	2025-03-27
6094	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$60,298.76	$63,313.70	$60,298.76	2025-03-27
22	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$56,959.66	$59,807.64	$56,959.66	2025-03-27
23	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$56,959.66	$59,807.64	$56,959.66	2025-03-27
21	APR_DRG	Heart &/or Lung Transplant	6	6	—	—	$56,959.66	$59,807.64	$56,959.66	2025-03-27
5934	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$56,876.50	$59,720.33	$56,876.50	2025-03-27
5832	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2025-03-27
5831	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2025-03-27
5833	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2025-03-27
5834	APR_DRG	Neonate W Ecmo	6	6	—	—	$53,956.72	$56,654.56	$53,956.72	2025-03-27
6314	APR_DRG	Neonate Birthwt >2499g W Other Major Procedure	6	6	—	—	$51,684.96	$54,269.21	$51,684.96	2025-03-27
6304	APR_DRG	Neonate Birthwt >2499g W Major Cardiovascular Procedure	6	6	—	—	$51,124.33	$53,680.55	$51,124.33	2025-03-27
5881	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$47,896.92	$50,291.77	$47,896.92	2025-03-27
5883	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$47,896.92	$50,291.77	$47,896.92	2025-03-27
5882	APR_DRG	Neonate Bwt <1500g W Major Procedure	6	6	—	—	$47,896.92	$50,291.77	$47,896.92	2025-03-27
64	APR_DRG	Pancreas Transplant	6	6	—	—	$46,244.64	$48,556.87	$46,244.64	2025-03-27
6114	APR_DRG	Neonate Birthwt 1500-1999g W Major Anomaly	6	6	—	—	$45,988.46	$48,287.88	$45,988.46	2025-03-27
5933	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$45,117.39	$47,373.26	$45,117.39	2025-03-27
54	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	6	6	—	—	$42,465.06	$44,588.31	$42,465.06	2025-03-27
6024	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$40,664.43	$42,697.65	$40,664.43	2025-03-27
73	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$40,223.96	$42,235.16	$40,223.96	2025-03-27
72	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$40,223.96	$42,235.16	$40,223.96	2025-03-27
71	APR_DRG	Allogeneic Bone Marrow Transplant	6	6	—	—	$40,223.96	$42,235.16	$40,223.96	2025-03-27
6074	APR_DRG	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$39,580.87	$41,559.91	$39,580.87	2025-03-27
6214	APR_DRG	Neonate Bwt 2000-2499g W Major Anomaly	6	6	—	—	$37,726.32	$39,612.64	$37,726.32	2025-03-27
6023	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$37,576.21	$39,455.02	$37,576.21	2025-03-27
92	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$37,515.60	$39,391.38	$37,515.60	2025-03-27
91	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$37,515.60	$39,391.38	$37,515.60	2025-03-27
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	6	6	—	—	$37,515.60	$39,391.38	$37,515.60	2025-03-27
4404	APR_DRG	Kidney Transplant	6	6	—	—	$36,521.91	$38,348.01	$36,521.91	2025-03-27
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	6	6	—	—	$34,847.77	$36,590.16	$34,847.77	2025-03-27
3034	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$34,706.12	$36,441.43	$34,706.12	2025-03-27
8634	APR_DRG	Neonatal Aftercare	6	6	—	—	$33,901.29	$35,596.35	$33,901.29	2025-03-27
1624	APR_DRG	Cardiac Valve Procedures W Ami Or Complex Pdx	6	6	—	—	$32,246.54	$33,858.87	$32,246.54	2025-03-27
42	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$32,097.13	$33,701.99	$32,097.13	2025-03-27
41	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$32,097.13	$33,701.99	$32,097.13	2025-03-27
43	APR_DRG	Tracheostomy W Mv 96+ Hours W Extensive Procedure	6	6	—	—	$32,097.13	$33,701.99	$32,097.13	2025-03-27
6092	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$31,722.21	$33,308.32	$31,722.21	2025-03-27
6093	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$31,722.21	$33,308.32	$31,722.21	2025-03-27
6091	APR_DRG	Neonate Bwt 1500-2499g W Major Procedure	6	6	—	—	$31,722.21	$33,308.32	$31,722.21	2025-03-27
61	APR_DRG	Pancreas Transplant	6	6	—	—	$31,710.58	$33,296.11	$31,710.58	2025-03-27
62	APR_DRG	Pancreas Transplant	6	6	—	—	$31,710.58	$33,296.11	$31,710.58	2025-03-27
63	APR_DRG	Pancreas Transplant	6	6	—	—	$31,710.58	$33,296.11	$31,710.58	2025-03-27
84	APR_DRG	Autologous Bone Marrow Transplant	6	6	—	—	$29,423.31	$30,894.48	$29,423.31	2025-03-27
104	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$29,365.88	$30,834.17	$29,365.88	2025-03-27
5913	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$29,104.41	$30,559.63	$29,104.41	2025-03-27
5911	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$29,104.41	$30,559.63	$29,104.41	2025-03-27
5912	APR_DRG	Neonate Birthwt 500-749g Without Major Procedure	6	6	—	—	$29,104.41	$30,559.63	$29,104.41	2025-03-27
1654	APR_DRG	Coronary Bypass W Ami Or Complex Pdx	6	6	—	—	$28,873.61	$30,317.29	$28,873.61	2025-03-27
6073	APR_DRG	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$28,682.97	$30,117.12	$28,682.97	2025-03-27
5932	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$28,427.85	$29,849.24	$28,427.85	2025-03-27
5931	APR_DRG	Neonate Birthwt 750-999g Without Major Procedure	6	6	—	—	$28,427.85	$29,849.24	$28,427.85	2025-03-27
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Pdx	6	6	—	—	$28,225.94	$29,637.24	$28,225.94	2025-03-27
3033	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$28,148.77	$29,556.21	$28,148.77	2025-03-27
3032	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$28,148.77	$29,556.21	$28,148.77	2025-03-27
3031	APR_DRG	Dorsal & Lumbar Fusion Proc For Curvature Of Back	6	6	—	—	$28,148.77	$29,556.21	$28,148.77	2025-03-27
102	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$27,256.56	$28,619.39	$27,256.56	2025-03-27
103	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$27,256.56	$28,619.39	$27,256.56	2025-03-27
101	APR_DRG	Head Trauma With Deep Coma	6	6	—	—	$27,256.56	$28,619.39	$27,256.56	2025-03-27
6022	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$26,658.23	$27,991.14	$26,658.23	2025-03-27
6021	APR_DRG	Neonate Bwt 1000-1249g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$26,658.23	$27,991.14	$26,658.23	2025-03-27
6072	APR_DRG	Neonate Bwt 1250-1499g W Resp Dist Synd/oth Maj Resp Or Maj Anom	6	6	—	—	$26,453.85	$27,776.54	$26,453.85	2025-03-27
53	APR_DRG	Tracheostomy W Mv 96+ Hours Without Extensive Procedure	6	6	—	—	$26,392.18	$27,711.79	$26,392.18	2025-03-27
6334	APR_DRG	Neonate Birthwt >2499g W Major Anomaly	6	6	—	—	$25,999.28	$27,299.24	$25,999.28	2025-03-27
8633	APR_DRG	Neonatal Aftercare	6	6	—	—	$25,544.02	$26,821.22	$25,544.02	2025-03-27
6124	APR_DRG	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	6	6	—	—	$25,088.04	$26,342.44	$25,088.04	2025-03-27
3124	APR_DRG	Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses	6	6	—	—	$24,703.60	$25,938.78	$24,703.60	2025-03-27
6083	APR_DRG	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	6	6	—	—	$24,357.22	$25,575.08	$24,357.22	2025-03-27
6084	APR_DRG	Neonate Bwt 1250-1499g W Or Without Other Significant Condition	6	6	—	—	$24,357.22	$25,575.08	$24,357.22	2025-03-27
1204	APR_DRG	Major Respiratory & Chest Procedures	6	6	—	—	$23,798.35	$24,988.27	$23,798.35	2025-03-27
6033	APR_DRG	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	6	6	—	—	$23,734.57	$24,921.30	$23,734.57	2025-03-27
6034	APR_DRG	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	6	6	—	—	$23,734.57	$24,921.30	$23,734.57	2025-03-27
9124	APR_DRG	Musculoskeletal & Other Procedures For Multiple Significant Trauma	6	6	—	—	$23,716.25	$24,902.06	$23,716.25	2025-03-27
6113	APR_DRG	Neonate Birthwt 1500-1999g W Major Anomaly	6	6	—	—	$23,478.04	$24,651.94	$23,478.04	2025-03-27
6032	APR_DRG	Neonate Birthwt 1000-1249g W Or Without Other Significant Condition	6	6	—	—	$23,398.40	$24,568.32	$23,398.40	2025-03-27
3044	APR_DRG	Dorsal & Lumbar Fusion Proc Except For Curvature Of Back	6	6	—	—	$23,302.21	$24,467.32	$23,302.21	2025-03-27
1623	APR_DRG	Cardiac Valve Procedures W Ami Or Complex Pdx	6	6	—	—	$23,173.24	$24,331.90	$23,173.24	2025-03-27
12	APR_DRG	Liver Transplant &/or Intestinal Transplant	6	6	—	—	$23,103.11	$24,258.27	$23,103.11	2025-03-27
11	APR_DRG	Liver Transplant &/or Intestinal Transplant	6	6	—	—	$23,103.11	$24,258.27	$23,103.11	2025-03-27
13	APR_DRG	Liver Transplant &/or Intestinal Transplant	6	6	—	—	$23,103.11	$24,258.27	$23,103.11	2025-03-27
2604	APR_DRG	Major Pancreas, Liver & Shunt Procedures	6	6	—	—	$23,026.65	$24,177.98	$23,026.65	2025-03-27
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	6	6	—	—	$23,009.74	$24,160.23	$23,009.74	2025-03-27
1664	APR_DRG	Coronary Bypass Without Ami Or Complex Pdx	6	6	—	—	$22,880.77	$24,024.81	$22,880.77	2025-03-27
1613	APR_DRG	Cardiac Defibrillator & Heart Assist Implant	6	6	—	—	$22,589.70	$23,719.19	$22,589.70	2025-03-27
1694	APR_DRG	Major Abdominal Vascular Procedures	6	6	—	—	$22,559.05	$23,687.00	$22,559.05	2025-03-27
894	APR_DRG	Major Cranial/facial Bone Procedures	6	6	—	—	$22,368.76	$23,487.20	$22,368.76	2025-03-27
6123	APR_DRG	Neonate Bwt 1500-1999g W Resp Dist Synd/oth Maj Resp Cond	6	6	—	—	$22,351.15	$23,468.71	$22,351.15	2025-03-27
6954	APR_DRG	Chemotherapy For Acute Leukemia	6	6	—	—	$22,266.22	$23,379.53	$22,266.22	2025-03-27
4414	APR_DRG	Major Bladder Procedures	6	6	—	—	$22,209.84	$23,320.33	$22,209.84	2025-03-27
J9600	HCPCS	Porfimer Sodium Injection	7	5	—	—	$3,968.52	$29,074.10	$24,955.27	2025-03-27
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	11	9	—	—	$3,675,000.00	$4,452,000.00	$3,711,750.00	2025-03-27
J1413	HCPCS	Inj Delandistrogene Mox Rokl	11	9	—	—	$3,321,781.51	$3,986,137.81	$3,393,600.00	2025-03-27
J3399	HCPCS	Inj Onase Abepar-xioi Treat	11	9	—	—	$2,231,250.00	$2,884,150.50	$2,342,812.50	2025-03-27
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	11	9	—	—	$516,485.97	$619,783.16	$557,917.92	2025-03-27
Q2055	HCPCS	Idecabtagene Vicleucel Car	11	9	—	—	$528,312.43	$633,974.92	$554,728.05	2025-03-27
Q2056	HCPCS	Ciltacabtagene Car-pos T	11	9	—	—	$548,128.28	$661,582.01	$553,609.56	2025-03-27
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	11	9	—	—	$489,517.15	$587,420.58	$528,759.00	2025-03-27
Q2053	HCPCS	Brexucabtagene Car Pos T	11	9	—	—	$485,100.00	$585,661.81	$489,951.00	2025-03-27
Q0480	HCPCS	Driver Pneumatic Vad, Rep	11	9	—	—	$72,648.53	$119,999.94	$76,280.96	2025-03-27
L7181	HCPCS	Electronic Elbo Simultaneous	11	9	—	—	$37,858.44	$58,044.91	$39,751.36	2025-03-27
L7180	HCPCS	Electronic Elbow Sequential	11	9	—	—	$25,912.94	$56,376.46	$27,208.59	2025-03-27
L6880	HCPCS	Elec Hand Ind Art Digits	11	9	—	—	$22,574.88	$34,612.01	$23,703.62	2025-03-27
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	13	11	—	—	$55,536.50	$73,350.09	$65,732.65	2025-03-27
J9029	HCPCS	Instill Adstiladrin, Tx Dose	13	11	—	—	$63,000.00	$83,738.55	$65,304.10	2025-03-27
J9226	HCPCS	Supprelin La Implant	13	11	—	—	$45,261.80	$59,779.73	$51,205.74	2025-03-27
J9266	HCPCS	Pegaspargase Injection	13	11	—	—	$26,815.15	$35,753.54	$27,882.65	2025-03-27

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