|
0100T
|
HCPCS
|
Prosth Retina Receive&Gen
|
4
|
4
|
—
|
—
|
$5,061.76
|
$227,234.12
|
$116,359.06
|
2026-04-01
|
|
1
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System With Mcc
|
2
|
2
|
—
|
—
|
$192,328.03
|
$207,264.76
|
$199,796.40
|
2026-04-01
|
|
11
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
2
|
2
|
—
|
—
|
$133,386.48
|
$133,386.48
|
$133,386.48
|
2026-04-01
|
|
112
|
APR_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
2
|
—
|
—
|
$86,205.60
|
$86,205.60
|
$86,205.60
|
2026-04-01
|
|
113
|
APR_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
2
|
—
|
—
|
$162,745.20
|
$162,745.20
|
$162,745.20
|
2026-04-01
|
|
114
|
APR_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
2
|
—
|
—
|
$330,631.20
|
$330,631.20
|
$330,631.20
|
2026-04-01
|
|
12
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
2
|
2
|
—
|
—
|
$150,232.32
|
$150,232.32
|
$150,232.32
|
2026-04-01
|
|
1203
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
2
|
2
|
—
|
—
|
$64,648.80
|
$64,648.80
|
$64,648.80
|
2026-04-01
|
|
1204
|
APR_DRG
|
Major Respiratory And Chest Procedures
|
2
|
2
|
—
|
—
|
$112,769.28
|
$112,769.28
|
$112,769.28
|
2026-04-01
|
|
1214
|
APR_DRG
|
Other Respiratory And Chest Procedures
|
2
|
2
|
—
|
—
|
$92,203.92
|
$92,203.92
|
$92,203.92
|
2026-04-01
|
|
13
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
2
|
2
|
—
|
—
|
$179,249.76
|
$179,249.76
|
$179,249.76
|
2026-04-01
|
|
1301
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
2
|
2
|
—
|
—
|
$67,478.40
|
$67,478.40
|
$67,478.40
|
2026-04-01
|
|
1302
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
2
|
2
|
—
|
—
|
$67,493.52
|
$67,493.52
|
$67,493.52
|
2026-04-01
|
|
1303
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
2
|
2
|
—
|
—
|
$82,617.84
|
$82,617.84
|
$82,617.84
|
2026-04-01
|
|
1304
|
APR_DRG
|
Respiratory System Diagnosis With Ventilator Support > 96 Hours
|
2
|
2
|
—
|
—
|
$107,017.20
|
$107,017.20
|
$107,017.20
|
2026-04-01
|
|
14
|
APR_DRG
|
Liver Transplant And/Or Intestinal Transplant
|
2
|
2
|
—
|
—
|
$310,050.72
|
$310,050.72
|
$310,050.72
|
2026-04-01
|
|
14
|
MS_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
2
|
—
|
—
|
$82,478.85
|
$88,884.39
|
$85,681.62
|
2026-04-01
|
|
1602
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
2
|
2
|
—
|
—
|
$73,988.64
|
$73,988.64
|
$73,988.64
|
2026-04-01
|
|
1603
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
2
|
2
|
—
|
—
|
$114,160.32
|
$114,160.32
|
$114,160.32
|
2026-04-01
|
|
1604
|
APR_DRG
|
Major Cardiothoracic Repair Of Heart Anomaly
|
2
|
2
|
—
|
—
|
$212,667.12
|
$212,667.12
|
$212,667.12
|
2026-04-01
|
|
1611
|
APR_DRG
|
Implantable Heart Assist Systems
|
2
|
2
|
—
|
—
|
$293,690.88
|
$293,690.88
|
$293,690.88
|
2026-04-01
|
|
1612
|
APR_DRG
|
Implantable Heart Assist Systems
|
2
|
2
|
—
|
—
|
$309,150.00
|
$309,150.00
|
$309,150.00
|
2026-04-01
|
|
1613
|
APR_DRG
|
Implantable Heart Assist Systems
|
2
|
2
|
—
|
—
|
$385,035.12
|
$385,035.12
|
$385,035.12
|
2026-04-01
|
|
1614
|
APR_DRG
|
Implantable Heart Assist Systems
|
2
|
2
|
—
|
—
|
$502,588.80
|
$502,588.80
|
$502,588.80
|
2026-04-01
|
|
1621
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$92,847.60
|
$92,847.60
|
$92,847.60
|
2026-04-01
|
|
1622
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$108,801.36
|
$108,801.36
|
$108,801.36
|
2026-04-01
|
|
1623
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$137,280.96
|
$137,280.96
|
$137,280.96
|
2026-04-01
|
|
1624
|
APR_DRG
|
Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$200,435.04
|
$200,435.04
|
$200,435.04
|
2026-04-01
|
|
1631
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$81,207.36
|
$81,207.36
|
$81,207.36
|
2026-04-01
|
|
1632
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$89,860.32
|
$89,860.32
|
$89,860.32
|
2026-04-01
|
|
1633
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$113,544.72
|
$113,544.72
|
$113,544.72
|
2026-04-01
|
|
1634
|
APR_DRG
|
Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$170,557.92
|
$170,557.92
|
$170,557.92
|
2026-04-01
|
|
1651
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$78,678.00
|
$78,678.00
|
$78,678.00
|
2026-04-01
|
|
1652
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$95,808.96
|
$95,808.96
|
$95,808.96
|
2026-04-01
|
|
1653
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$115,194.96
|
$115,194.96
|
$115,194.96
|
2026-04-01
|
|
1654
|
APR_DRG
|
Coronary Bypass With Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$155,971.44
|
$155,971.44
|
$155,971.44
|
2026-04-01
|
|
1661
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$72,429.12
|
$72,429.12
|
$72,429.12
|
2026-04-01
|
|
1662
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$80,647.92
|
$80,647.92
|
$80,647.92
|
2026-04-01
|
|
1663
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$95,772.24
|
$95,772.24
|
$95,772.24
|
2026-04-01
|
|
1664
|
APR_DRG
|
Coronary Bypass Without Ami Or Complex Principal Diagnosis
|
2
|
2
|
—
|
—
|
$140,594.40
|
$140,594.40
|
$140,594.40
|
2026-04-01
|
|
1673
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
2
|
2
|
—
|
—
|
$95,556.24
|
$95,556.24
|
$95,556.24
|
2026-04-01
|
|
1674
|
APR_DRG
|
Other Cardiothoracic And Thoracic Vascular Procedures
|
2
|
2
|
—
|
—
|
$153,418.32
|
$153,418.32
|
$153,418.32
|
2026-04-01
|
|
1693
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
2
|
2
|
—
|
—
|
$80,887.68
|
$80,887.68
|
$80,887.68
|
2026-04-01
|
|
1694
|
APR_DRG
|
Major Abdominal Vascular Procedures
|
2
|
2
|
—
|
—
|
$131,591.52
|
$131,591.52
|
$131,591.52
|
2026-04-01
|
|
1703
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
2
|
2
|
—
|
—
|
$65,992.32
|
$65,992.32
|
$65,992.32
|
2026-04-01
|
|
1704
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock
|
2
|
2
|
—
|
—
|
$92,789.28
|
$92,789.28
|
$92,789.28
|
2026-04-01
|
|
1714
|
APR_DRG
|
Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock
|
2
|
2
|
—
|
—
|
$74,100.96
|
$74,100.96
|
$74,100.96
|
2026-04-01
|
|
1744
|
APR_DRG
|
Percutaneous Cardiac Intervention With Ami
|
2
|
2
|
—
|
—
|
$78,565.68
|
$78,565.68
|
$78,565.68
|
2026-04-01
|
|
1754
|
APR_DRG
|
Percutaneous Cardiac Intervention Without Ami
|
2
|
2
|
—
|
—
|
$86,812.56
|
$86,812.56
|
$86,812.56
|
2026-04-01
|
|
1763
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
2
|
2
|
—
|
—
|
$64,534.32
|
$64,534.32
|
$64,534.32
|
2026-04-01
|
|
1764
|
APR_DRG
|
Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices
|
2
|
2
|
—
|
—
|
$106,885.44
|
$106,885.44
|
$106,885.44
|
2026-04-01
|
|
1774
|
APR_DRG
|
Cardiac Pacemaker And Defibrillator Revision Except Device Replacement
|
2
|
2
|
—
|
—
|
$67,327.20
|
$67,327.20
|
$67,327.20
|
2026-04-01
|
|
1781
|
APR_DRG
|
External Heart Assist Systems
|
2
|
2
|
—
|
—
|
$104,153.04
|
$104,153.04
|
$104,153.04
|
2026-04-01
|
|
1782
|
APR_DRG
|
External Heart Assist Systems
|
2
|
2
|
—
|
—
|
$116,773.92
|
$116,773.92
|
$116,773.92
|
2026-04-01
|
|
1783
|
APR_DRG
|
External Heart Assist Systems
|
2
|
2
|
—
|
—
|
$125,336.16
|
$125,336.16
|
$125,336.16
|
2026-04-01
|
|
1784
|
APR_DRG
|
External Heart Assist Systems
|
2
|
2
|
—
|
—
|
$169,419.60
|
$169,419.60
|
$169,419.60
|
2026-04-01
|
|
1791
|
APR_DRG
|
Defibrillator Implants
|
2
|
2
|
—
|
—
|
$72,360.00
|
$72,360.00
|
$72,360.00
|
2026-04-01
|
|
1792
|
APR_DRG
|
Defibrillator Implants
|
2
|
2
|
—
|
—
|
$82,002.24
|
$82,002.24
|
$82,002.24
|
2026-04-01
|
|
1793
|
APR_DRG
|
Defibrillator Implants
|
2
|
2
|
—
|
—
|
$100,645.20
|
$100,645.20
|
$100,645.20
|
2026-04-01
|
|
1794
|
APR_DRG
|
Defibrillator Implants
|
2
|
2
|
—
|
—
|
$138,030.48
|
$138,030.48
|
$138,030.48
|
2026-04-01
|
|
18
|
MS_DRG
|
Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies
|
2
|
2
|
—
|
—
|
$296,363.56
|
$319,379.99
|
$307,871.78
|
2026-04-01
|
|
1804
|
APR_DRG
|
Other Circulatory System Procedures
|
2
|
2
|
—
|
—
|
$78,297.84
|
$78,297.84
|
$78,297.84
|
2026-04-01
|
|
1813
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
2
|
2
|
—
|
—
|
$69,785.28
|
$69,785.28
|
$69,785.28
|
2026-04-01
|
|
1814
|
APR_DRG
|
Lower Extremity Arterial Procedures
|
2
|
2
|
—
|
—
|
$108,801.36
|
$108,801.36
|
$108,801.36
|
2026-04-01
|
|
1824
|
APR_DRG
|
Other Peripheral Vascular Procedures
|
2
|
2
|
—
|
—
|
$92,437.20
|
$92,437.20
|
$92,437.20
|
2026-04-01
|
|
1831
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
2
|
—
|
—
|
$84,790.80
|
$84,790.80
|
$84,790.80
|
2026-04-01
|
|
1832
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
2
|
—
|
—
|
$87,220.80
|
$87,220.80
|
$87,220.80
|
2026-04-01
|
|
1833
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
2
|
—
|
—
|
$101,556.72
|
$101,556.72
|
$101,556.72
|
2026-04-01
|
|
1834
|
APR_DRG
|
Percutaneous Structural Cardiac Procedures
|
2
|
2
|
—
|
—
|
$144,573.12
|
$144,573.12
|
$144,573.12
|
2026-04-01
|
|
2
|
MS_DRG
|
Heart Transplant Or Implant Of Heart Assist System Without Mcc
|
2
|
2
|
—
|
—
|
$77,770.14
|
$83,809.99
|
$80,790.07
|
2026-04-01
|
|
203
|
APR_DRG
|
Open Craniotomy For Trauma
|
2
|
2
|
—
|
—
|
$72,468.00
|
$72,468.00
|
$72,468.00
|
2026-04-01
|
|
204
|
APR_DRG
|
Open Craniotomy For Trauma
|
2
|
2
|
—
|
—
|
$113,292.00
|
$113,292.00
|
$113,292.00
|
2026-04-01
|
|
209
|
MS_DRG
|
Complex Aortic Arch Procedures
|
2
|
2
|
—
|
—
|
$77,680.92
|
$83,713.84
|
$80,697.38
|
2026-04-01
|
|
21
|
APR_DRG
|
Heart And/Or Lung Transplant
|
2
|
2
|
—
|
—
|
$190,807.92
|
$190,807.92
|
$190,807.92
|
2026-04-01
|
|
212
|
MS_DRG
|
Concomitant Aortic And Mitral Valve Procedures
|
2
|
2
|
—
|
—
|
$74,628.95
|
$80,424.84
|
$77,526.89
|
2026-04-01
|
|
213
|
APR_DRG
|
Open Craniotomy Except Trauma
|
2
|
2
|
—
|
—
|
$78,708.24
|
$78,708.24
|
$78,708.24
|
2026-04-01
|
|
214
|
APR_DRG
|
Open Craniotomy Except Trauma
|
2
|
2
|
—
|
—
|
$122,800.32
|
$122,800.32
|
$122,800.32
|
2026-04-01
|
|
215
|
MS_DRG
|
Other Heart Assist System Implant
|
2
|
2
|
—
|
—
|
$68,334.89
|
$73,641.97
|
$70,988.43
|
2026-04-01
|
|
216
|
MS_DRG
|
Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…
|
2
|
2
|
—
|
—
|
$67,139.36
|
$72,353.59
|
$69,746.48
|
2026-04-01
|
|
22
|
APR_DRG
|
Heart And/Or Lung Transplant
|
2
|
2
|
—
|
—
|
$222,577.20
|
$222,577.20
|
$222,577.20
|
2026-04-01
|
|
2203
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
2
|
2
|
—
|
—
|
$65,124.00
|
$65,124.00
|
$65,124.00
|
2026-04-01
|
|
2204
|
APR_DRG
|
Major Stomach, Esophageal And Duodenal Procedures
|
2
|
2
|
—
|
—
|
$116,316.00
|
$116,316.00
|
$116,316.00
|
2026-04-01
|
|
2224
|
APR_DRG
|
Other Stomach, Esophageal And Duodenal Procedures
|
2
|
2
|
—
|
—
|
$85,440.96
|
$85,440.96
|
$85,440.96
|
2026-04-01
|
|
2234
|
APR_DRG
|
Other Small And Large Bowel Procedures
|
2
|
2
|
—
|
—
|
$82,118.88
|
$82,118.88
|
$82,118.88
|
2026-04-01
|
|
224
|
APR_DRG
|
Ventricular Shunt Procedures
|
2
|
2
|
—
|
—
|
$93,841.20
|
$93,841.20
|
$93,841.20
|
2026-04-01
|
|
2244
|
APR_DRG
|
Peritoneal Adhesiolysis
|
2
|
2
|
—
|
—
|
$79,751.52
|
$79,751.52
|
$79,751.52
|
2026-04-01
|
|
2274
|
APR_DRG
|
Hernia Procedures Except Inguinal, Femoral And Umbilical
|
2
|
2
|
—
|
—
|
$80,382.24
|
$80,382.24
|
$80,382.24
|
2026-04-01
|
|
2294
|
APR_DRG
|
Other Digestive System And Abdominal Procedures
|
2
|
2
|
—
|
—
|
$85,399.92
|
$85,399.92
|
$85,399.92
|
2026-04-01
|
|
23
|
APR_DRG
|
Heart And/Or Lung Transplant
|
2
|
2
|
—
|
—
|
$299,924.64
|
$299,924.64
|
$299,924.64
|
2026-04-01
|
|
2304
|
APR_DRG
|
Major Small Bowel Procedures
|
2
|
2
|
—
|
—
|
$104,252.40
|
$104,252.40
|
$104,252.40
|
2026-04-01
|
|
2314
|
APR_DRG
|
Major Large Bowel Procedures
|
2
|
2
|
—
|
—
|
$91,728.72
|
$91,728.72
|
$91,728.72
|
2026-04-01
|
|
2324
|
APR_DRG
|
Gastric Fundoplication
|
2
|
2
|
—
|
—
|
$85,644.00
|
$85,644.00
|
$85,644.00
|
2026-04-01
|
|
233
|
APR_DRG
|
Spinal Procedures
|
2
|
2
|
—
|
—
|
$76,507.20
|
$76,507.20
|
$76,507.20
|
2026-04-01
|
|
234
|
APR_DRG
|
Spinal Procedures
|
2
|
2
|
—
|
—
|
$124,506.72
|
$124,506.72
|
$124,506.72
|
2026-04-01
|
|
24
|
APR_DRG
|
Heart And/Or Lung Transplant
|
2
|
2
|
—
|
—
|
$485,012.88
|
$485,012.88
|
$485,012.88
|
2026-04-01
|
|
244
|
APR_DRG
|
Open Extracranial Vascular Procedures
|
2
|
2
|
—
|
—
|
$82,114.56
|
$82,114.56
|
$82,114.56
|
2026-04-01
|
|
2604
|
APR_DRG
|
Major Pancreas, Liver And Shunt Procedures
|
2
|
2
|
—
|
—
|
$121,238.64
|
$121,238.64
|
$121,238.64
|
2026-04-01
|
|
2614
|
APR_DRG
|
Major Biliary Tract Procedures
|
2
|
2
|
—
|
—
|
$106,565.76
|
$106,565.76
|
$106,565.76
|
2026-04-01
|
|
2634
|
APR_DRG
|
Cholecystectomy
|
2
|
2
|
—
|
—
|
$67,171.68
|
$67,171.68
|
$67,171.68
|
2026-04-01
|
|
264
|
APR_DRG
|
Other Nervous System And Related Procedures
|
2
|
2
|
—
|
—
|
$94,407.12
|
$94,407.12
|
$94,407.12
|
2026-04-01
|
|
2644
|
APR_DRG
|
Other Hepatobiliary, Pancreas And Abdominal Procedures
|
2
|
2
|
—
|
—
|
$94,657.68
|
$94,657.68
|
$94,657.68
|
2026-04-01
|
|
273
|
APR_DRG
|
Other Open Craniotomy
|
2
|
2
|
—
|
—
|
$65,648.88
|
$65,648.88
|
$65,648.88
|
2026-04-01
|
|
274
|
APR_DRG
|
Other Open Craniotomy
|
2
|
2
|
—
|
—
|
$108,241.92
|
$108,241.92
|
$108,241.92
|
2026-04-01
|
|
294
|
APR_DRG
|
Other Percutaneous Intracranial Procedures
|
2
|
2
|
—
|
—
|
$87,754.32
|
$87,754.32
|
$87,754.32
|
2026-04-01
|
|
3
|
MS_DRG
|
Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth…
|
2
|
2
|
—
|
—
|
$145,668.55
|
$156,981.58
|
$151,325.07
|
2026-04-01
|
|
303
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
2
|
2
|
—
|
—
|
$72,571.68
|
$72,571.68
|
$72,571.68
|
2026-04-01
|
|
3031
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
2
|
2
|
—
|
—
|
$87,765.12
|
$87,765.12
|
$87,765.12
|
2026-04-01
|
|
3032
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
2
|
2
|
—
|
—
|
$105,414.48
|
$105,414.48
|
$105,414.48
|
2026-04-01
|
|
3033
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
2
|
2
|
—
|
—
|
$145,089.36
|
$145,089.36
|
$145,089.36
|
2026-04-01
|
|
3034
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure For Curvature Of Back
|
2
|
2
|
—
|
—
|
$191,622.24
|
$191,622.24
|
$191,622.24
|
2026-04-01
|
|
304
|
APR_DRG
|
Percutaneous Intracranial And Extracranial Vascular Procedures
|
2
|
2
|
—
|
—
|
$95,813.28
|
$95,813.28
|
$95,813.28
|
2026-04-01
|
|
3042
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
2
|
2
|
—
|
—
|
$70,467.84
|
$70,467.84
|
$70,467.84
|
2026-04-01
|
|
3043
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
2
|
2
|
—
|
—
|
$99,396.72
|
$99,396.72
|
$99,396.72
|
2026-04-01
|
|
3044
|
APR_DRG
|
Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back
|
2
|
2
|
—
|
—
|
$147,078.72
|
$147,078.72
|
$147,078.72
|
2026-04-01
|
|
3054
|
APR_DRG
|
Amputation Of Lower Limb Except Toes
|
2
|
2
|
—
|
—
|
$83,039.04
|
$83,039.04
|
$83,039.04
|
2026-04-01
|
|
3084
|
APR_DRG
|
Hip And Femur Fracture Repair
|
2
|
2
|
—
|
—
|
$64,925.28
|
$64,925.28
|
$64,925.28
|
2026-04-01
|
|
3094
|
APR_DRG
|
Other Significant Hip And Femur Surgery
|
2
|
2
|
—
|
—
|
$87,058.80
|
$87,058.80
|
$87,058.80
|
2026-04-01
|
|
3104
|
APR_DRG
|
Intervertebral Disc Excision And Decompression
|
2
|
2
|
—
|
—
|
$76,014.72
|
$76,014.72
|
$76,014.72
|
2026-04-01
|
|
3123
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
2
|
2
|
—
|
—
|
$64,419.84
|
$64,419.84
|
$64,419.84
|
2026-04-01
|
|
3124
|
APR_DRG
|
Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses
|
2
|
2
|
—
|
—
|
$130,645.44
|
$130,645.44
|
$130,645.44
|
2026-04-01
|
|
3134
|
APR_DRG
|
Knee And Lower Leg Procedures Except Foot
|
2
|
2
|
—
|
—
|
$82,684.80
|
$82,684.80
|
$82,684.80
|
2026-04-01
|
|
3154
|
APR_DRG
|
Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement
|
2
|
2
|
—
|
—
|
$78,708.24
|
$78,708.24
|
$78,708.24
|
2026-04-01
|
|
3164
|
APR_DRG
|
Hand And Wrist Procedures
|
2
|
2
|
—
|
—
|
$65,024.64
|
$65,024.64
|
$65,024.64
|
2026-04-01
|
|
3174
|
APR_DRG
|
Tendon, Muscle And Other Soft Tissue Procedures
|
2
|
2
|
—
|
—
|
$72,865.44
|
$72,865.44
|
$72,865.44
|
2026-04-01
|
|
3204
|
APR_DRG
|
Other Musculoskeletal System And Connective Tissue Procedures
|
2
|
2
|
—
|
—
|
$76,831.20
|
$76,831.20
|
$76,831.20
|
2026-04-01
|
|
3214
|
APR_DRG
|
Decompression
|
2
|
2
|
—
|
—
|
$96,517.44
|
$96,517.44
|
$96,517.44
|
2026-04-01
|
|
3224
|
APR_DRG
|
Shoulder And Elbow Joint Replacement
|
2
|
2
|
—
|
—
|
$73,152.72
|
$73,152.72
|
$73,152.72
|
2026-04-01
|
|
3234
|
APR_DRG
|
Non-elective Or Complex Hip Joint Replacement
|
2
|
2
|
—
|
—
|
$73,753.20
|
$73,753.20
|
$73,753.20
|
2026-04-01
|
|
3244
|
APR_DRG
|
Elective Hip Joint Replacement
|
2
|
2
|
—
|
—
|
$73,822.32
|
$73,822.32
|
$73,822.32
|
2026-04-01
|
|
3253
|
APR_DRG
|
Non-elective Or Complex Knee Joint Replacement
|
2
|
2
|
—
|
—
|
$67,551.84
|
$67,551.84
|
$67,551.84
|
2026-04-01
|
|
3254
|
APR_DRG
|
Non-elective Or Complex Knee Joint Replacement
|
2
|
2
|
—
|
—
|
$94,035.60
|
$94,035.60
|
$94,035.60
|
2026-04-01
|
|
3614
|
APR_DRG
|
Skin Graft For Skin And Subcutaneous Tissue Diagnoses
|
2
|
2
|
—
|
—
|
$110,639.52
|
$110,639.52
|
$110,639.52
|
2026-04-01
|
|
3624
|
APR_DRG
|
Mastectomy Procedures
|
2
|
2
|
—
|
—
|
$81,257.04
|
$81,257.04
|
$81,257.04
|
2026-04-01
|
|
3634
|
APR_DRG
|
Breast Procedures Except Mastectomy
|
2
|
2
|
—
|
—
|
$65,668.32
|
$65,668.32
|
$65,668.32
|
2026-04-01
|
|
4
|
MS_DRG
|
Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec…
|
2
|
2
|
—
|
—
|
$95,062.16
|
$102,444.95
|
$98,753.55
|
2026-04-01
|
|
4014
|
APR_DRG
|
Adrenal Procedures
|
2
|
2
|
—
|
—
|
$102,101.04
|
$102,101.04
|
$102,101.04
|
2026-04-01
|
|
4034
|
APR_DRG
|
Procedures For Obesity
|
2
|
2
|
—
|
—
|
$80,833.68
|
$80,833.68
|
$80,833.68
|
2026-04-01
|
|
4044
|
APR_DRG
|
Thyroid, Parathyroid And Thyroglossal Procedures
|
2
|
2
|
—
|
—
|
$100,336.32
|
$100,336.32
|
$100,336.32
|
2026-04-01
|
|
4054
|
APR_DRG
|
Other Procedures For Endocrine, Nutritional And Metabolic Disorders
|
2
|
2
|
—
|
—
|
$93,631.68
|
$93,631.68
|
$93,631.68
|
2026-04-01
|
|
41
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
2
|
2
|
—
|
—
|
$98,949.60
|
$98,949.60
|
$98,949.60
|
2026-04-01
|
|
42
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
2
|
2
|
—
|
—
|
$148,176.00
|
$148,176.00
|
$148,176.00
|
2026-04-01
|
|
426
|
MS_DRG
|
Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…
|
2
|
2
|
—
|
—
|
$75,638.50
|
$81,512.80
|
$78,575.65
|
2026-04-01
|
|
43
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
2
|
2
|
—
|
—
|
$215,526.96
|
$215,526.96
|
$215,526.96
|
2026-04-01
|
|
434
|
APR_DRG
|
Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies
|
2
|
2
|
—
|
—
|
$64,614.24
|
$64,614.24
|
$64,614.24
|
2026-04-01
|
|
44
|
APR_DRG
|
Tracheostomy With Mv >96 Hours With Extensive Procedure
|
2
|
2
|
—
|
—
|
$314,947.44
|
$314,947.44
|
$314,947.44
|
2026-04-01
|
|
4401
|
APR_DRG
|
Kidney Transplant
|
2
|
2
|
—
|
—
|
$91,959.84
|
$91,959.84
|
$91,959.84
|
2026-04-01
|
|
4402
|
APR_DRG
|
Kidney Transplant
|
2
|
2
|
—
|
—
|
$102,986.64
|
$102,986.64
|
$102,986.64
|
2026-04-01
|
|
4403
|
APR_DRG
|
Kidney Transplant
|
2
|
2
|
—
|
—
|
$120,078.72
|
$120,078.72
|
$120,078.72
|
2026-04-01
|
|
4404
|
APR_DRG
|
Kidney Transplant
|
2
|
2
|
—
|
—
|
$182,170.08
|
$182,170.08
|
$182,170.08
|
2026-04-01
|
|
4414
|
APR_DRG
|
Major Bladder Procedures
|
2
|
2
|
—
|
—
|
$122,778.72
|
$122,778.72
|
$122,778.72
|
2026-04-01
|
|
4424
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Malignancy
|
2
|
2
|
—
|
—
|
$86,585.76
|
$86,585.76
|
$86,585.76
|
2026-04-01
|
|
4434
|
APR_DRG
|
Kidney And Urinary Tract Procedures For Non-malignancy
|
2
|
2
|
—
|
—
|
$70,362.00
|
$70,362.00
|
$70,362.00
|
2026-04-01
|
|
4444
|
APR_DRG
|
Renal Dialysis Access Device Procedures And Vessel Repair
|
2
|
2
|
—
|
—
|
$72,915.12
|
$72,915.12
|
$72,915.12
|
2026-04-01
|
|
4454
|
APR_DRG
|
Other Bladder Procedures
|
2
|
2
|
—
|
—
|
$67,325.04
|
$67,325.04
|
$67,325.04
|
2026-04-01
|
|
4474
|
APR_DRG
|
Other Kidney, Urinary Tract And Related Procedures
|
2
|
2
|
—
|
—
|
$90,674.64
|
$90,674.64
|
$90,674.64
|
2026-04-01
|
|
4804
|
APR_DRG
|
Major Male Pelvic Procedures
|
2
|
2
|
—
|
—
|
$77,533.20
|
$77,533.20
|
$77,533.20
|
2026-04-01
|
|
4834
|
APR_DRG
|
Penis, Testes And Scrotal Procedures
|
2
|
2
|
—
|
—
|
$70,750.80
|
$70,750.80
|
$70,750.80
|
2026-04-01
|
|
4844
|
APR_DRG
|
Other Male Reproductive System And Related Procedures
|
2
|
2
|
—
|
—
|
$78,639.12
|
$78,639.12
|
$78,639.12
|
2026-04-01
|
|
494
|
APR_DRG
|
Bacterial And Tuberculous Infections Of Nervous System
|
2
|
2
|
—
|
—
|
$72,623.52
|
$72,623.52
|
$72,623.52
|
2026-04-01
|
|
5
|
MS_DRG
|
Liver Transplant With Mcc Or Intestinal Transplant
|
2
|
2
|
—
|
—
|
$70,760.96
|
$76,256.46
|
$73,508.71
|
2026-04-01
|
|
504
|
APR_DRG
|
Non-bacterial Infections Of Nervous System Except Viral Meningitis
|
2
|
2
|
—
|
—
|
$76,798.80
|
$76,798.80
|
$76,798.80
|
2026-04-01
|
|
51
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
2
|
2
|
—
|
—
|
$92,903.76
|
$92,903.76
|
$92,903.76
|
2026-04-01
|
|
5104
|
APR_DRG
|
Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…
|
2
|
2
|
—
|
—
|
$104,213.52
|
$104,213.52
|
$104,213.52
|
2026-04-01
|
|
5114
|
APR_DRG
|
Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy
|
2
|
2
|
—
|
—
|
$94,076.64
|
$94,076.64
|
$94,076.64
|
2026-04-01
|
|
5124
|
APR_DRG
|
Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy
|
2
|
2
|
—
|
—
|
$83,538.00
|
$83,538.00
|
$83,538.00
|
2026-04-01
|
|
5144
|
APR_DRG
|
Female Reproductive System Reconstructive Procedures
|
2
|
2
|
—
|
—
|
$80,192.16
|
$80,192.16
|
$80,192.16
|
2026-04-01
|
|
5184
|
APR_DRG
|
Other Female Reproductive System And Related Procedures
|
2
|
2
|
—
|
—
|
$76,943.52
|
$76,943.52
|
$76,943.52
|
2026-04-01
|
|
5194
|
APR_DRG
|
Uterine And Adnexa Procedures For Leiomyoma
|
2
|
2
|
—
|
—
|
$75,189.60
|
$75,189.60
|
$75,189.60
|
2026-04-01
|
|
52
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
2
|
2
|
—
|
—
|
$111,877.20
|
$111,877.20
|
$111,877.20
|
2026-04-01
|
|
53
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
2
|
2
|
—
|
—
|
$152,841.60
|
$152,841.60
|
$152,841.60
|
2026-04-01
|
|
54
|
APR_DRG
|
Tracheostomy With Mv >96 Hours Without Extensive Procedure
|
2
|
2
|
—
|
—
|
$207,556.56
|
$207,556.56
|
$207,556.56
|
2026-04-01
|
|
5484
|
APR_DRG
|
Postpartum And Post Abortion Diagnosis With O.r. Procedure
|
2
|
2
|
—
|
—
|
$74,183.04
|
$74,183.04
|
$74,183.04
|
2026-04-01
|
|
5831
|
APR_DRG
|
Neonate With Ecmo
|
2
|
2
|
—
|
—
|
$323,436.24
|
$323,436.24
|
$323,436.24
|
2026-04-01
|
|
5832
|
APR_DRG
|
Neonate With Ecmo
|
2
|
2
|
—
|
—
|
$374,269.68
|
$374,269.68
|
$374,269.68
|
2026-04-01
|
|
5833
|
APR_DRG
|
Neonate With Ecmo
|
2
|
2
|
—
|
—
|
$507,550.32
|
$507,550.32
|
$507,550.32
|
2026-04-01
|
|
5834
|
APR_DRG
|
Neonate With Ecmo
|
2
|
2
|
—
|
—
|
$640,830.96
|
$640,830.96
|
$640,830.96
|
2026-04-01
|
|
5881
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$218,272.32
|
$218,272.32
|
$218,272.32
|
2026-04-01
|
|
5882
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$331,601.04
|
$331,601.04
|
$331,601.04
|
2026-04-01
|
|
5883
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$338,646.96
|
$338,646.96
|
$338,646.96
|
2026-04-01
|
|
5884
|
APR_DRG
|
Neonate Birth Weight < 1500 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$525,655.44
|
$525,655.44
|
$525,655.44
|
2026-04-01
|
|
5891
|
APR_DRG
|
Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini…
|
2
|
2
|
—
|
—
|
$102,701.52
|
$102,701.52
|
$102,701.52
|
2026-04-01
|
|
5892
|
APR_DRG
|
Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini…
|
2
|
2
|
—
|
—
|
$85,257.36
|
$85,257.36
|
$85,257.36
|
2026-04-01
|
|
5893
|
APR_DRG
|
Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini…
|
2
|
2
|
—
|
—
|
$67,815.36
|
$67,815.36
|
$67,815.36
|
2026-04-01
|
|
5912
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
2
|
2
|
—
|
—
|
$103,204.80
|
$103,204.80
|
$103,204.80
|
2026-04-01
|
|
5913
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
2
|
2
|
—
|
—
|
$193,948.56
|
$193,948.56
|
$193,948.56
|
2026-04-01
|
|
5914
|
APR_DRG
|
Neonate Birth Weight 500-749 Grams Without Major Procedure
|
2
|
2
|
—
|
—
|
$331,056.72
|
$331,056.72
|
$331,056.72
|
2026-04-01
|
|
5932
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
2
|
2
|
—
|
—
|
$174,735.36
|
$174,735.36
|
$174,735.36
|
2026-04-01
|
|
5933
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
2
|
2
|
—
|
—
|
$220,460.40
|
$220,460.40
|
$220,460.40
|
2026-04-01
|
|
5934
|
APR_DRG
|
Neonate Birth Weight 750-999 Grams Without Major Procedure
|
2
|
2
|
—
|
—
|
$342,826.56
|
$342,826.56
|
$342,826.56
|
2026-04-01
|
|
6022
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
2
|
2
|
—
|
—
|
$147,854.16
|
$147,854.16
|
$147,854.16
|
2026-04-01
|
|
6023
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
2
|
2
|
—
|
—
|
$193,771.44
|
$193,771.44
|
$193,771.44
|
2026-04-01
|
|
6024
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
2
|
2
|
—
|
—
|
$245,738.88
|
$245,738.88
|
$245,738.88
|
2026-04-01
|
|
6032
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
2
|
2
|
—
|
—
|
$66,165.12
|
$66,165.12
|
$66,165.12
|
2026-04-01
|
|
6033
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
2
|
2
|
—
|
—
|
$134,103.60
|
$134,103.60
|
$134,103.60
|
2026-04-01
|
|
6034
|
APR_DRG
|
Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition
|
2
|
2
|
—
|
—
|
$275,574.96
|
$275,574.96
|
$275,574.96
|
2026-04-01
|
|
6072
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
2
|
2
|
—
|
—
|
$113,700.24
|
$113,700.24
|
$113,700.24
|
2026-04-01
|
|
6073
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
2
|
2
|
—
|
—
|
$146,836.80
|
$146,836.80
|
$146,836.80
|
2026-04-01
|
|
6074
|
APR_DRG
|
Respiratory Condition Or Major Anomaly
|
2
|
2
|
—
|
—
|
$188,749.44
|
$188,749.44
|
$188,749.44
|
2026-04-01
|
|
6082
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
2
|
2
|
—
|
—
|
$84,021.84
|
$84,021.84
|
$84,021.84
|
2026-04-01
|
|
6083
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
2
|
2
|
—
|
—
|
$113,816.88
|
$113,816.88
|
$113,816.88
|
2026-04-01
|
|
6084
|
APR_DRG
|
Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition
|
2
|
2
|
—
|
—
|
$119,508.48
|
$119,508.48
|
$119,508.48
|
2026-04-01
|
|
6091
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$73,949.76
|
$73,949.76
|
$73,949.76
|
2026-04-01
|
|
6092
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$77,842.08
|
$77,842.08
|
$77,842.08
|
2026-04-01
|
|
6093
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$163,881.36
|
$163,881.36
|
$163,881.36
|
2026-04-01
|
|
6094
|
APR_DRG
|
Neonate Birth Weight 1500-2499 Grams With Major Procedure
|
2
|
2
|
—
|
—
|
$328,944.24
|
$328,944.24
|
$328,944.24
|
2026-04-01
|
|
61
|
APR_DRG
|
Pancreas Transplant
|
2
|
2
|
—
|
—
|
$131,375.52
|
$131,375.52
|
$131,375.52
|
2026-04-01
|
|
6113
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
2
|
2
|
—
|
—
|
$93,424.32
|
$93,424.32
|
$93,424.32
|
2026-04-01
|
|
6114
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Major Anomaly
|
2
|
2
|
—
|
—
|
$143,434.80
|
$143,434.80
|
$143,434.80
|
2026-04-01
|
|
6122
|
APR_DRG
|
Respiratory Condition
|
2
|
2
|
—
|
—
|
$74,699.28
|
$74,699.28
|
$74,699.28
|
2026-04-01
|
|
6123
|
APR_DRG
|
Respiratory Condition
|
2
|
2
|
—
|
—
|
$96,461.28
|
$96,461.28
|
$96,461.28
|
2026-04-01
|
|
6124
|
APR_DRG
|
Respiratory Condition
|
2
|
2
|
—
|
—
|
$137,160.00
|
$137,160.00
|
$137,160.00
|
2026-04-01
|
|
6133
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
2
|
2
|
—
|
—
|
$87,752.16
|
$87,752.16
|
$87,752.16
|
2026-04-01
|
|
6134
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection
|
2
|
2
|
—
|
—
|
$134,570.16
|
$134,570.16
|
$134,570.16
|
2026-04-01
|
|
6143
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
2
|
2
|
—
|
—
|
$82,961.28
|
$82,961.28
|
$82,961.28
|
2026-04-01
|
|
6144
|
APR_DRG
|
Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition
|
2
|
2
|
—
|
—
|
$108,142.56
|
$108,142.56
|
$108,142.56
|
2026-04-01
|
|
62
|
APR_DRG
|
Pancreas Transplant
|
2
|
2
|
—
|
—
|
$167,134.32
|
$167,134.32
|
$167,134.32
|
2026-04-01
|
|
6213
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
2
|
2
|
—
|
—
|
$66,052.80
|
$66,052.80
|
$66,052.80
|
2026-04-01
|
|
6214
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Major Anomaly
|
2
|
2
|
—
|
—
|
$112,527.36
|
$112,527.36
|
$112,527.36
|
2026-04-01
|
|
6224
|
APR_DRG
|
Respiratory Condition
|
2
|
2
|
—
|
—
|
$88,817.04
|
$88,817.04
|
$88,817.04
|
2026-04-01
|
|
6233
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
2
|
2
|
—
|
—
|
$67,217.04
|
$67,217.04
|
$67,217.04
|
2026-04-01
|
|
6234
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection
|
2
|
2
|
—
|
—
|
$81,511.92
|
$81,511.92
|
$81,511.92
|
2026-04-01
|
|
6254
|
APR_DRG
|
Neonate Birth Weight 2000-2499 Grams With Other Significant Condition
|
2
|
2
|
—
|
—
|
$75,092.40
|
$75,092.40
|
$75,092.40
|
2026-04-01
|
|
63
|
APR_DRG
|
Pancreas Transplant
|
2
|
2
|
—
|
—
|
$192,529.44
|
$192,529.44
|
$192,529.44
|
2026-04-01
|
|
6302
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
2
|
2
|
—
|
—
|
$116,964.00
|
$116,964.00
|
$116,964.00
|
2026-04-01
|
|
6303
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
2
|
2
|
—
|
—
|
$184,351.68
|
$184,351.68
|
$184,351.68
|
2026-04-01
|
|
6304
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure
|
2
|
2
|
—
|
—
|
$381,540.24
|
$381,540.24
|
$381,540.24
|
2026-04-01
|
|
6312
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
2
|
2
|
—
|
—
|
$74,377.44
|
$74,377.44
|
$74,377.44
|
2026-04-01
|
|
6313
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
2
|
2
|
—
|
—
|
$121,275.36
|
$121,275.36
|
$121,275.36
|
2026-04-01
|
|
6314
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Other Major Procedure
|
2
|
2
|
—
|
—
|
$315,800.64
|
$315,800.64
|
$315,800.64
|
2026-04-01
|
|
6334
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Major Anomaly
|
2
|
2
|
—
|
—
|
$102,276.00
|
$102,276.00
|
$102,276.00
|
2026-04-01
|
|
6344
|
APR_DRG
|
Respiratory Condition
|
2
|
2
|
—
|
—
|
$78,386.40
|
$78,386.40
|
$78,386.40
|
2026-04-01
|
|
6364
|
APR_DRG
|
Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection
|
2
|
2
|
—
|
—
|
$64,892.88
|
$64,892.88
|
$64,892.88
|
2026-04-01
|
|
64
|
APR_DRG
|
Pancreas Transplant
|
2
|
2
|
—
|
—
|
$273,810.24
|
$273,810.24
|
$273,810.24
|
2026-04-01
|
|
6504
|
APR_DRG
|
Splenectomy
|
2
|
2
|
—
|
—
|
$92,072.16
|
$92,072.16
|
$92,072.16
|
2026-04-01
|
|
6514
|
APR_DRG
|
Other Procedures Of Blood And Blood-forming Organs
|
2
|
2
|
—
|
—
|
$101,455.20
|
$101,455.20
|
$101,455.20
|
2026-04-01
|
|
6803
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
2
|
2
|
—
|
—
|
$71,750.88
|
$71,750.88
|
$71,750.88
|
2026-04-01
|
|
6804
|
APR_DRG
|
Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
2
|
2
|
—
|
—
|
$137,458.08
|
$137,458.08
|
$137,458.08
|
2026-04-01
|
|
6814
|
APR_DRG
|
Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms
|
2
|
2
|
—
|
—
|
$117,212.40
|
$117,212.40
|
$117,212.40
|
2026-04-01
|
|
6903
|
APR_DRG
|
Acute Leukemia
|
2
|
2
|
—
|
—
|
$64,439.28
|
$64,439.28
|
$64,439.28
|
2026-04-01
|
|
6904
|
APR_DRG
|
Acute Leukemia
|
2
|
2
|
—
|
—
|
$112,196.88
|
$112,196.88
|
$112,196.88
|
2026-04-01
|
|
6914
|
APR_DRG
|
Lymphoma, Myeloma And Non-acute Leukemia
|
2
|
2
|
—
|
—
|
$65,931.84
|
$65,931.84
|
$65,931.84
|
2026-04-01
|
|
6924
|
APR_DRG
|
Radiotherapy
|
2
|
2
|
—
|
—
|
$70,014.24
|
$70,014.24
|
$70,014.24
|
2026-04-01
|
|
6954
|
APR_DRG
|
Chemotherapy For Acute Leukemia
|
2
|
2
|
—
|
—
|
$105,593.76
|
$105,593.76
|
$105,593.76
|
2026-04-01
|
|
7
|
MS_DRG
|
Lung Transplant
|
2
|
2
|
—
|
—
|
$88,877.22
|
$95,779.68
|
$92,328.45
|
2026-04-01
|
|
71
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
2
|
—
|
—
|
$130,513.68
|
$130,513.68
|
$130,513.68
|
2026-04-01
|
|
7104
|
APR_DRG
|
Infectious And Parasitic Diseases Including HIV With O.r. Procedure
|
2
|
2
|
—
|
—
|
$94,353.12
|
$94,353.12
|
$94,353.12
|
2026-04-01
|
|
7114
|
APR_DRG
|
Post-operative, Post-trauma, Other Device Infections With O.r. Procedure
|
2
|
2
|
—
|
—
|
$89,004.96
|
$89,004.96
|
$89,004.96
|
2026-04-01
|
|
72
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
2
|
—
|
—
|
$146,575.44
|
$146,575.44
|
$146,575.44
|
2026-04-01
|
|
73
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
2
|
—
|
—
|
$187,386.48
|
$187,386.48
|
$187,386.48
|
2026-04-01
|
|
734
|
APR_DRG
|
Orbit And Eye Procedures
|
2
|
2
|
—
|
—
|
$73,085.76
|
$73,085.76
|
$73,085.76
|
2026-04-01
|
|
74
|
APR_DRG
|
Allogeneic Bone Marrow Transplant
|
2
|
2
|
—
|
—
|
$317,967.12
|
$317,967.12
|
$317,967.12
|
2026-04-01
|
|
7404
|
APR_DRG
|
Mental Illness Diagnosis With O.r. Procedure
|
2
|
2
|
—
|
—
|
$119,685.60
|
$119,685.60
|
$119,685.60
|
2026-04-01
|
|
7504
|
APR_DRG
|
Schizophrenia
|
2
|
2
|
—
|
—
|
$114,350.40
|
$114,350.40
|
$114,350.40
|
2026-04-01
|
|
7514
|
APR_DRG
|
Major Depressive Disorders And Other Or Unspecified Psychoses
|
2
|
2
|
—
|
—
|
$84,008.88
|
$84,008.88
|
$84,008.88
|
2026-04-01
|
|
7524
|
APR_DRG
|
Disorders Of Personality And Impulse Control
|
2
|
2
|
—
|
—
|
$170,765.28
|
$170,765.28
|
$170,765.28
|
2026-04-01
|
|
7534
|
APR_DRG
|
Bipolar Disorders
|
2
|
2
|
—
|
—
|
$82,730.16
|
$82,730.16
|
$82,730.16
|
2026-04-01
|
|
7544
|
APR_DRG
|
Depression Except Major Depressive Disorder
|
2
|
2
|
—
|
—
|
$66,489.12
|
$66,489.12
|
$66,489.12
|
2026-04-01
|
|
7574
|
APR_DRG
|
Organic Mental Health Disturbances
|
2
|
2
|
—
|
—
|
$97,886.88
|
$97,886.88
|
$97,886.88
|
2026-04-01
|
|
7594
|
APR_DRG
|
Eating Disorders
|
2
|
2
|
—
|
—
|
$243,673.92
|
$243,673.92
|
$243,673.92
|
2026-04-01
|
|
7604
|
APR_DRG
|
Other Mental Health Disorders
|
2
|
2
|
—
|
—
|
$68,327.28
|
$68,327.28
|
$68,327.28
|
2026-04-01
|
|
7724
|
APR_DRG
|
Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy
|
2
|
2
|
—
|
—
|
$83,717.28
|
$83,717.28
|
$83,717.28
|
2026-04-01
|
|
7734
|
APR_DRG
|
Opioid Abuse And Dependence
|
2
|
2
|
—
|
—
|
$76,701.60
|
$76,701.60
|
$76,701.60
|
2026-04-01
|
|
7744
|
APR_DRG
|
Cocaine Abuse And Dependence
|
2
|
2
|
—
|
—
|
$76,397.04
|
$76,397.04
|
$76,397.04
|
2026-04-01
|
|
7754
|
APR_DRG
|
Alcohol Abuse And Dependence
|
2
|
2
|
—
|
—
|
$89,305.20
|
$89,305.20
|
$89,305.20
|
2026-04-01
|
|
7924
|
APR_DRG
|
Extensive O.r. Procedures For Other Complications Of Treatment
|
2
|
2
|
—
|
—
|
$102,312.72
|
$102,312.72
|
$102,312.72
|
2026-04-01
|
|
7934
|
APR_DRG
|
Moderately Extensive O.r. Procedures For Other Complications Of Treatment
|
2
|
2
|
—
|
—
|
$80,561.52
|
$80,561.52
|
$80,561.52
|
2026-04-01
|
|
82
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
2
|
2
|
—
|
—
|
$84,741.12
|
$84,741.12
|
$84,741.12
|
2026-04-01
|
|
83
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
2
|
2
|
—
|
—
|
$101,282.40
|
$101,282.40
|
$101,282.40
|
2026-04-01
|
|
84
|
APR_DRG
|
Autologous Bone Marrow Transplant Or T-cell Immunotherapy
|
2
|
2
|
—
|
—
|
$160,846.56
|
$160,846.56
|
$160,846.56
|
2026-04-01
|
|
8413
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
2
|
2
|
—
|
—
|
$130,070.88
|
$130,070.88
|
$130,070.88
|
2026-04-01
|
|
8414
|
APR_DRG
|
Extensive Third Degree Burns With Skin Graft
|
2
|
2
|
—
|
—
|
$354,427.92
|
$354,427.92
|
$354,427.92
|
2026-04-01
|
|
8423
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
2
|
2
|
—
|
—
|
$73,867.68
|
$73,867.68
|
$73,867.68
|
2026-04-01
|
|
8424
|
APR_DRG
|
Burns With Skin Graft Except Extensive Third Degree Burns
|
2
|
2
|
—
|
—
|
$179,118.00
|
$179,118.00
|
$179,118.00
|
2026-04-01
|
|
8504
|
APR_DRG
|
Services
|
2
|
2
|
—
|
—
|
$124,826.40
|
$124,826.40
|
$124,826.40
|
2026-04-01
|
|
8633
|
APR_DRG
|
Neonatal Aftercare
|
2
|
2
|
—
|
—
|
$90,225.36
|
$90,225.36
|
$90,225.36
|
2026-04-01
|
|
8634
|
APR_DRG
|
Neonatal Aftercare
|
2
|
2
|
—
|
—
|
$140,618.16
|
$140,618.16
|
$140,618.16
|
2026-04-01
|
|
893
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
2
|
2
|
—
|
—
|
$80,233.20
|
$80,233.20
|
$80,233.20
|
2026-04-01
|
|
894
|
APR_DRG
|
Major Cranial Or Facial Bone Procedures
|
2
|
2
|
—
|
—
|
$115,529.76
|
$115,529.76
|
$115,529.76
|
2026-04-01
|
|
91
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
2
|
—
|
—
|
$85,065.12
|
$85,065.12
|
$85,065.12
|
2026-04-01
|
|
9101
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$64,260.00
|
$64,260.00
|
$64,260.00
|
2026-04-01
|
|
9102
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$73,509.12
|
$73,509.12
|
$73,509.12
|
2026-04-01
|
|
9103
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$82,758.24
|
$82,758.24
|
$82,758.24
|
2026-04-01
|
|
9104
|
APR_DRG
|
Craniotomy For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$138,892.32
|
$138,892.32
|
$138,892.32
|
2026-04-01
|
|
9114
|
APR_DRG
|
Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$131,217.84
|
$131,217.84
|
$131,217.84
|
2026-04-01
|
|
9123
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$71,802.72
|
$71,802.72
|
$71,802.72
|
2026-04-01
|
|
9124
|
APR_DRG
|
Musculoskeletal And Other Procedures For Multiple Significant Trauma
|
2
|
2
|
—
|
—
|
$127,489.68
|
$127,489.68
|
$127,489.68
|
2026-04-01
|
|
913
|
APR_DRG
|
Other Major Head And Neck Procedures
|
2
|
2
|
—
|
—
|
$82,950.48
|
$82,950.48
|
$82,950.48
|
2026-04-01
|
|
914
|
APR_DRG
|
Other Major Head And Neck Procedures
|
2
|
2
|
—
|
—
|
$129,960.72
|
$129,960.72
|
$129,960.72
|
2026-04-01
|
|
92
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
2
|
—
|
—
|
$103,651.92
|
$103,651.92
|
$103,651.92
|
2026-04-01
|
|
924
|
APR_DRG
|
Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures
|
2
|
2
|
—
|
—
|
$102,811.68
|
$102,811.68
|
$102,811.68
|
2026-04-01
|
|
927
|
MS_DRG
|
Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft
|
2
|
2
|
—
|
—
|
$146,528.48
|
$157,908.30
|
$152,218.39
|
2026-04-01
|
|
93
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
2
|
—
|
—
|
$142,112.88
|
$142,112.88
|
$142,112.88
|
2026-04-01
|
|
94
|
APR_DRG
|
Extracorporeal Membrane Oxygenation (Ecmo)
|
2
|
2
|
—
|
—
|
$308,342.16
|
$308,342.16
|
$308,342.16
|
2026-04-01
|
|
9504
|
APR_DRG
|
Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
2
|
2
|
—
|
—
|
$114,391.44
|
$114,391.44
|
$114,391.44
|
2026-04-01
|
|
9514
|
APR_DRG
|
Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis
|
2
|
2
|
—
|
—
|
$85,021.92
|
$85,021.92
|
$85,021.92
|
2026-04-01
|
|
9524
|
APR_DRG
|
Non-extensive O.r. Procedure Unrelated To Principal Diagnosis
|
2
|
2
|
—
|
—
|
$73,098.72
|
$73,098.72
|
$73,098.72
|
2026-04-01
|
|
984
|
APR_DRG
|
Other Ear, Nose, Mouth And Throat Procedures
|
2
|
2
|
—
|
—
|
$69,783.12
|
$69,783.12
|
$69,783.12
|
2026-04-01
|
|
A9543
|
HCPCS
|
Y90 Ibritumomab, Rx
|
4
|
4
|
—
|
—
|
$61,627.62
|
$89,185.07
|
$85,398.61
|
2026-04-01
|
|
J7330
|
HCPCS
|
Cultured Chondrocytes Implnt
|
3
|
3
|
—
|
—
|
$79,539.70
|
$83,977.18
|
$79,539.70
|
2026-04-01
|
|
J9029
|
HCPCS
|
Inj, Adstiladrin, Per Tx Dos
|
4
|
4
|
—
|
—
|
$64,274.79
|
$71,862.00
|
$65,003.68
|
2026-04-01
|