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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

LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON

Burlington, MA · CCN 220171 · Rates published

15,296 distinct procedures filed
10 distinct payers
75,871 rate rows
2026-04-01 last MRF observed
Data quality

60,553 of 75,871 rate rows are consumer-grade (79.8%)

15,318 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
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 13,091
template filing: same amount across many unrelated codes — excluded 2,141
placeholder amount (≤ $0.02) — excluded from medians 53
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 33
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.lahey.org/042704686_lahey-hospital-medical-center-burlington_standardcharges.json
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-08-17
Content fingerprint 881faef13f6e9f9a… · 25,327,310 bytes · first seen 2026-05-13

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J3391
HCPCS 		Inj, Atidarsagene Autotemcel 2 $4,335,000.00 $4,505,000.00 $4,420,000.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 2 $3,570,000.00 $3,685,266.67 $3,627,633.33 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 1 $3,570,000.00 $3,570,000.00 $3,570,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 2 $3,264,000.00 $3,316,462.59 $3,290,231.29 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 2 $3,162,000.00 $3,248,445.72 $3,205,222.86 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 2 $2,856,000.00 $2,945,740.00 $2,900,870.00 nat. median
$2,997,086
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 3 $2,146,250.00 $4,557,709.01 $2,455,110.60 nat. median
$2,460,273
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 3 $2,244,000.00 $4,329,164.39 $2,332,000.00 nat. median
$2,405,851
1.0× median
Q2057
HCPCS 		Afamitresgene Autoleucel 2 $770,620.00 $770,620.00 $770,620.00 nat. median
$809,151
1.0× median
24
APR_DRG 		Heart And/Or Lung Transplant 2 $607,905.26 $799,756.73 $703,830.99 nat. median
$243,231
outlier · 2.9×
5834
APR_DRG 		Neonate With Ecmo 2 $588,716.24 $803,204.47 $695,960.35 nat. median
$311,018
outlier · 2.2×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $578,367.86 $658,845.82 $618,606.84 nat. median
$254,667
outlier · 2.4×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 3 $566,531.30 $1,120,613.94 $591,726.20 nat. median
$691,418
0.9× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 3 $565,868.94 $1,092,271.89 $587,649.57 nat. median
$631,793
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 3 $562,201.24 $1,023,262.00 $562,538.19 nat. median
$624,417
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 3 $557,317.93 $1,046,692.58 $558,081.73 nat. median
$610,161
0.9× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 3 $532,192.24 $969,831.38 $533,230.17 nat. median
$588,565
0.9× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $424,453.20 $578,367.86 $501,410.53 nat. median
$180,995
outlier · 2.8×
Q2053
HCPCS 		Brexucabtagene Car Pos T 3 $489,304.61 $966,927.65 $489,450.20 nat. median
$577,541
0.8× median
5833
APR_DRG 		Neonate With Ecmo 2 $334,457.81 $636,153.23 $485,305.52 nat. median
$250,089
1.9× median
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 5 $424,616.47 $722,003.03 $454,836.80 nat. median
$370,165
1.2× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $429,484.13 $444,232.74 $436,858.43 nat. median
$165,646
outlier · 2.6×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $414,939.75 $444,063.54 $429,501.65 nat. median
$168,361
outlier · 2.6×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $415,621.99 $442,459.14 $429,040.57 nat. median
$147,847
outlier · 2.9×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $399,630.83 $429,691.83 $414,661.33 nat. median
$156,285
outlier · 2.7×
114
APR_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 $414,406.41 $414,406.41 $414,406.41 nat. median
$119,243
outlier · 3.5×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $394,748.71 $414,212.53 $404,480.62 nat. median
$127,600
outlier · 3.2×
5832
APR_DRG 		Neonate With Ecmo 2 $328,202.94 $469,101.99 $398,652.46 nat. median
$169,230
outlier · 2.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $398,533.51 $398,533.51 $398,533.51 nat. median
$175,480
outlier · 2.3×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $365,899.46 $412,292.01 $389,095.73 nat. median
$168,174
outlier · 2.3×
14
APR_DRG 		Liver Transplant And/Or Intestinal Transplant 1 $388,611.26 $388,611.26 $388,611.26 nat. median
$137,901
outlier · 2.8×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (Ecmo) 1 $386,469.78 $386,469.78 $386,469.78 nat. median
$165,599
outlier · 2.3×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $280,300.14 $478,214.76 $379,257.45 nat. median
$160,171
outlier · 2.4×
5831
APR_DRG 		Neonate With Ecmo 2 $328,202.94 $405,388.39 $366,795.67 nat. median
$154,685
outlier · 2.4×
23
APR_DRG 		Heart And/Or Lung Transplant 2 $345,376.90 $375,919.43 $360,648.17 nat. median
$116,111
outlier · 3.1×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $273,578.08 $442,459.14 $358,018.61 nat. median
$120,928
outlier · 3.0×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $319,271.02 $345,400.04 $332,335.53 nat. median
$109,499
outlier · 3.0×
6024
APR_DRG 		Respiratory Condition Or Major Anomaly 2 $308,004.11 $346,587.07 $327,295.59 nat. median
$123,690
outlier · 2.6×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $240,967.13 $395,818.09 $318,392.61 nat. median
$147,677
outlier · 2.2×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 6 $158,656.00 $525,065.12 $295,170.78 nat. median
$261,939
1.1× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $276,320.57 $312,124.56 $294,222.57 nat. median
$112,711
outlier · 2.6×
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $260,147.16 $316,055.34 $288,101.25 nat. median
$88,000
outlier · 3.3×
22
APR_DRG 		Heart And/Or Lung Transplant 2 $278,973.73 $294,425.74 $286,699.73 nat. median
$94,014
outlier · 3.0×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 3 $267,750.00 $516,548.02 $278,250.00 nat. median
$302,242
0.9× median
J3403
HCPCS 		Revakinagene, Per Implant 2 $257,500.00 $265,000.00 $261,250.00 nat. median
$265,000
1.0× median
6074
APR_DRG 		Respiratory Condition Or Major Anomaly 2 $236,574.70 $282,961.15 $259,767.93 nat. median
$99,613
outlier · 2.6×
64
APR_DRG 		Pancreas Transplant 2 $175,083.59 $343,188.18 $259,135.89 nat. median
$92,994
outlier · 2.8×
21
APR_DRG 		Heart And/Or Lung Transplant 2 $239,154.76 $277,334.29 $258,244.52 nat. median
$74,854
outlier · 3.4×
904
APR_DRG 		Description Not Available 1 $257,400.77 $257,400.77 $257,400.77 nat. median
$117,387
outlier · 2.2×
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $243,091.17 $270,795.22 $256,943.20 nat. median
$108,751
outlier · 2.4×

Other procedures at this hospital

Browse this hospital's 15,296 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
             
0100T OTHER Prosth Retina Receive&Gen 2 2 — — $4,136.88 $336,752.94 $170,444.91 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 10 6 — — $158,656.00 $525,065.12 $295,170.78 2026-04-01
11 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $167,183.90 $167,183.90 $167,183.90 2026-04-01
112 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 1 — — $108,048.34 $108,048.34 $108,048.34 2026-04-01
113 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 1 — — $203,981.52 $203,981.52 $203,981.52 2026-04-01
114 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 1 1 — — $414,406.41 $414,406.41 $414,406.41 2026-04-01
12 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $188,298.13 $188,298.13 $188,298.13 2026-04-01
13 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $224,668.00 $224,668.00 $224,668.00 2026-04-01
14 APR_DRG Liver Transplant And/Or Intestinal Transplant 1 1 — — $388,611.26 $388,611.26 $388,611.26 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 8 5 — — $118,172.01 $200,935.56 $126,582.42 2026-04-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 2 2 — — $81,391.21 $133,968.03 $107,679.62 2026-04-01
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 2 2 — — $84,386.54 $145,189.03 $114,787.79 2026-04-01
1781 APR_DRG External Heart Assist Systems 1 1 — — $130,543.30 $130,543.30 $130,543.30 2026-04-01
1782 APR_DRG External Heart Assist Systems 1 1 — — $146,362.05 $146,362.05 $146,362.05 2026-04-01
1783 APR_DRG External Heart Assist Systems 1 1 — — $157,093.79 $157,093.79 $157,093.79 2026-04-01
1784 APR_DRG External Heart Assist Systems 1 1 — — $212,347.08 $212,347.08 $212,347.08 2026-04-01
1791 APR_DRG Defibrillator Implants 1 1 — — $90,694.55 $90,694.55 $90,694.55 2026-04-01
1792 APR_DRG Defibrillator Implants 1 1 — — $102,779.94 $102,779.94 $102,779.94 2026-04-01
1793 APR_DRG Defibrillator Implants 1 1 — — $126,146.64 $126,146.64 $126,146.64 2026-04-01
1794 APR_DRG Defibrillator Implants 1 1 — — $173,004.59 $173,004.59 $173,004.59 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 8 5 — — $424,616.47 $722,003.03 $454,836.80 2026-04-01
1804 APR_DRG Other Circulatory System Procedures 2 2 — — $98,136.92 $110,453.77 $104,295.35 2026-04-01
1813 APR_DRG Lower Extremity Arterial Procedures 2 2 — — $87,467.45 $93,749.68 $90,608.57 2026-04-01
1814 APR_DRG Lower Extremity Arterial Procedures 2 2 — — $136,369.41 $151,650.18 $144,009.79 2026-04-01
1824 APR_DRG Other Peripheral Vascular Procedures 2 2 — — $115,858.90 $143,754.24 $129,806.57 2026-04-01
1831 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $106,275.06 $106,275.06 $106,275.06 2026-04-01
1832 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $109,320.77 $109,320.77 $109,320.77 2026-04-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $127,289.12 $127,289.12 $127,289.12 2026-04-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 1 1 — — $181,205.00 $181,205.00 $181,205.00 2026-04-01
1924 APR_DRG Cardiac Catheterization For Other Non-coronary Conditions 2 2 — — $71,359.01 $94,368.52 $82,863.76 2026-04-01
1934 APR_DRG Acute And Subacute Endocarditis 2 2 — — $60,581.25 $102,319.46 $81,450.36 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 9 6 — — $111,425.59 $189,464.18 $119,355.85 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 8 5 — — $77,373.91 $131,563.90 $82,880.68 2026-04-01
203 APR_DRG Open Craniotomy For Trauma 2 2 — — $81,191.81 $90,829.92 $86,010.86 2026-04-01
204 APR_DRG Open Craniotomy For Trauma 2 2 — — $141,997.89 $153,334.80 $147,666.35 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 8 5 — — $111,297.76 $189,246.83 $119,218.92 2026-04-01
21 APR_DRG Heart And/Or Lung Transplant 2 2 — — $239,154.76 $277,334.29 $258,244.52 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 8 5 — — $106,925.03 $181,811.58 $114,534.97 2026-04-01
213 APR_DRG Open Craniotomy Except Trauma 2 2 — — $98,651.30 $99,287.15 $98,969.23 2026-04-01
214 APR_DRG Open Craniotomy Except Trauma 2 2 — — $153,915.42 $165,972.89 $159,944.16 2026-04-01
215 MS_DRG Other Heart Assist System Implant 10 6 — — $97,907.18 $207,938.00 $104,875.32 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 10 6 — — $96,194.27 $163,565.38 $103,040.50 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 18 8 — — $50,595.41 $128,378.80 $89,486.09 2026-04-01
22 APR_DRG Heart And/Or Lung Transplant 2 2 — — $278,973.73 $294,425.74 $286,699.73 2026-04-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 2 2 — — $145,788.11 $162,450.08 $154,119.09 2026-04-01
2214 APR_DRG Description Not Available 1 1 — — $151,462.24 $151,462.24 $151,462.24 2026-04-01
222 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 1 1 — — $130,507.00 $130,507.00 $130,507.00 2026-04-01
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 2 2 — — $107,089.96 $126,839.28 $116,964.62 2026-04-01
223 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization With Ami, Hf Or Shock… 2 2 — — $98,382.00 $125,411.00 $111,896.50 2026-04-01
2234 APR_DRG Other Small And Large Bowel Procedures 2 2 — — $102,926.13 $127,859.22 $115,392.68 2026-04-01
224 APR_DRG Ventricular Shunt Procedures 2 2 — — $117,618.65 $123,481.50 $120,550.07 2026-04-01
224 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 1 1 — — $116,099.00 $116,099.00 $116,099.00 2026-04-01
2244 APR_DRG Peritoneal Adhesiolysis 2 2 — — $99,958.93 $127,632.31 $113,795.62 2026-04-01
225 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization Without Ami, Hf Or Sh… 2 2 — — $92,184.00 $112,316.00 $102,250.00 2026-04-01
2254 APR_DRG Description Not Available 1 1 — — $93,105.62 $93,105.62 $93,105.62 2026-04-01
226 MS_DRG Cardiac Defibrillator Implant Without Cardiac Catheterization With Mcc 1 1 — — $98,784.00 $98,784.00 $98,784.00 2026-04-01
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 2 2 — — $100,749.46 $120,873.20 $110,811.33 2026-04-01
2284 APR_DRG Inguinal, Femoral And Umbilical Hernia Procedures 2 2 — — $71,794.89 $102,126.94 $86,960.92 2026-04-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 2 2 — — $107,038.52 $132,633.46 $119,835.99 2026-04-01
23 APR_DRG Heart And/Or Lung Transplant 2 2 — — $345,376.90 $375,919.43 $360,648.17 2026-04-01
2304 APR_DRG Major Small Bowel Procedures 1 1 — — $130,667.83 $130,667.83 $130,667.83 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 10 6 — — $82,891.21 $140,945.31 $88,790.65 2026-04-01
2314 APR_DRG Major Large Bowel Procedures 1 1 — — $114,970.91 $114,970.91 $114,970.91 2026-04-01
2324 APR_DRG Gastric Fundoplication 1 1 — — $107,344.45 $107,344.45 $107,344.45 2026-04-01
233 APR_DRG Spinal Procedures 2 2 — — $95,892.57 $98,473.49 $97,183.03 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 7 — — $58,970.59 $146,867.76 $80,525.54 2026-04-01
234 APR_DRG Spinal Procedures 2 2 — — $156,054.19 $185,241.73 $170,647.96 2026-04-01
24 APR_DRG Heart And/Or Lung Transplant 2 2 — — $607,905.26 $799,756.73 $703,830.99 2026-04-01
244 APR_DRG Open Extracranial Vascular Procedures 2 2 — — $102,920.72 $155,709.31 $129,315.01 2026-04-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 2 2 — — $151,958.04 $170,215.38 $161,086.71 2026-04-01
2614 APR_DRG Major Biliary Tract Procedures 2 2 — — $133,567.35 $140,742.55 $137,154.95 2026-04-01
2624 APR_DRG Description Not Available 1 1 — — $138,748.51 $138,748.51 $138,748.51 2026-04-01
2634 APR_DRG Cholecystectomy 2 2 — — $84,109.52 $84,191.62 $84,150.57 2026-04-01
264 APR_DRG Other Nervous System And Related Procedures 2 2 — — $118,327.96 $143,843.63 $131,085.80 2026-04-01
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 2 2 — — $118,642.01 $141,063.43 $129,852.72 2026-04-01
273 APR_DRG Other Open Craniotomy 1 1 — — $82,282.97 $82,282.97 $82,282.97 2026-04-01
274 APR_DRG Other Open Craniotomy 1 1 — — $135,668.22 $135,668.22 $135,668.22 2026-04-01
294 APR_DRG Other Percutaneous Intracranial Procedures 1 1 — — $109,989.48 $109,989.48 $109,989.48 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 9 5 — — $184,084.66 $354,878.76 $223,561.28 2026-04-01
3014 APR_DRG Hip Joint Replacement 1 1 — — $138,750.80 $138,750.80 $138,750.80 2026-04-01
3024 APR_DRG Knee Joint Replacement 1 1 — — $124,748.98 $124,748.98 $124,748.98 2026-04-01
303 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 1 1 — — $90,959.87 $90,959.87 $90,959.87 2026-04-01
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $101,301.82 $110,003.01 $105,652.42 2026-04-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $121,210.13 $132,124.36 $126,667.24 2026-04-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $160,164.96 $181,852.05 $171,008.51 2026-04-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $240,175.41 $249,701.94 $244,938.67 2026-04-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 1 1 — — $120,090.41 $120,090.41 $120,090.41 2026-04-01
3042 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $85,601.62 $88,322.96 $86,962.29 2026-04-01
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $122,108.59 $124,581.82 $123,345.21 2026-04-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $184,345.47 $210,456.02 $197,400.74 2026-04-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 2 2 — — $104,079.44 $144,437.26 $124,258.35 2026-04-01
3084 APR_DRG Hip And Femur Fracture Repair 2 2 — — $81,376.02 $132,220.90 $106,798.46 2026-04-01
3094 APR_DRG Other Significant Hip And Femur Surgery 2 2 — — $109,117.73 $131,677.69 $120,397.71 2026-04-01
3104 APR_DRG Intervertebral Disc Excision And Decompression 2 2 — — $95,275.30 $156,823.22 $126,049.26 2026-04-01
3123 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $80,742.52 $103,774.88 $92,258.70 2026-04-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $163,748.33 $206,332.72 $185,040.52 2026-04-01
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 2 2 — — $103,635.44 $148,322.20 $125,978.82 2026-04-01
3144 APR_DRG Foot And Toe Procedures 2 2 — — $75,238.57 $88,127.40 $81,682.99 2026-04-01
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 2 2 — — $98,651.30 $117,657.53 $108,154.42 2026-04-01
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 2 2 — — $91,328.06 $144,808.56 $118,068.31 2026-04-01
3204 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 2 2 — — $96,298.66 $114,682.51 $105,490.58 2026-04-01
3213 APR_DRG Decompression 2 2 — — $77,377.34 $84,863.59 $81,120.46 2026-04-01
3214 APR_DRG Decompression 2 2 — — $120,972.99 $161,911.46 $141,442.23 2026-04-01
3224 APR_DRG Shoulder And Elbow Joint Replacement 2 2 — — $78,349.73 $91,688.13 $85,018.93 2026-04-01
3234 APR_DRG Non-elective Or Complex Hip Joint Replacement 1 1 — — $92,440.76 $92,440.76 $92,440.76 2026-04-01
3244 APR_DRG Elective Hip Joint Replacement 1 1 — — $92,527.39 $92,527.39 $92,527.39 2026-04-01
3253 APR_DRG Non-elective Or Complex Knee Joint Replacement 1 1 — — $84,668.10 $84,668.10 $84,668.10 2026-04-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 1 1 — — $117,862.31 $117,862.31 $117,862.31 2026-04-01
3464 APR_DRG Connective Tissue Disorders 2 2 — — $67,436.14 $111,723.54 $89,579.84 2026-04-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 2 2 — — $138,673.32 $220,043.46 $179,358.39 2026-04-01
3624 APR_DRG Mastectomy Procedures 2 2 — — $66,552.80 $101,845.92 $84,199.36 2026-04-01
3644 APR_DRG Other Skin, Subcutaneous Tissue And Related Procedures 2 2 — — $78,281.58 $121,689.16 $99,985.37 2026-04-01
3814 APR_DRG Major Skin Disorders 2 2 — — $63,941.01 $135,292.18 $99,616.60 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 3 2 — — $75,383.68 $139,943.54 $83,675.13 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 10 5 — — $1,560.00 $249,336.92 $145,894.35 2026-04-01
4014 APR_DRG Adrenal Procedures 2 2 — — $127,971.36 $160,158.08 $144,064.72 2026-04-01
4034 APR_DRG Procedures For Obesity 2 2 — — $101,315.29 $150,737.96 $126,026.62 2026-04-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 2 2 — — $61,120.76 $125,759.50 $93,440.13 2026-04-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 2 2 — — $117,356.04 $192,255.25 $154,805.64 2026-04-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $124,021.41 $164,762.71 $144,392.06 2026-04-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $164,762.71 $185,720.78 $175,241.74 2026-04-01
4234 APR_DRG Inborn Errors Of Metabolism 2 2 — — $60,129.13 $124,645.84 $92,387.49 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 8 5 — — $108,371.46 $184,271.05 $116,084.35 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 8 5 — — $88,591.40 $150,637.72 $94,896.52 2026-04-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $230,818.15 $270,137.10 $250,477.62 2026-04-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 2 2 — — $80,986.17 $135,633.68 $108,309.92 2026-04-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $394,748.71 $414,212.53 $404,480.62 2026-04-01
4401 APR_DRG Kidney Transplant 1 1 — — $115,260.59 $115,260.59 $115,260.59 2026-04-01
4402 APR_DRG Kidney Transplant 1 1 — — $129,081.36 $129,081.36 $129,081.36 2026-04-01
4403 APR_DRG Kidney Transplant 1 1 — — $150,504.22 $150,504.22 $150,504.22 2026-04-01
4404 APR_DRG Kidney Transplant 1 1 — — $228,328.27 $228,328.27 $228,328.27 2026-04-01
4414 APR_DRG Major Bladder Procedures 2 2 — — $153,888.35 $155,014.84 $154,451.60 2026-04-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 2 2 — — $108,524.83 $146,135.63 $127,330.23 2026-04-01
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 2 2 — — $88,190.30 $116,153.98 $102,172.14 2026-04-01
4444 APR_DRG Renal Dialysis Access Device Procedures And Vessel Repair 2 2 — — $91,390.33 $141,780.83 $116,585.58 2026-04-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 2 2 — — $113,649.75 $174,893.35 $144,271.55 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 2 2 — — $84,652.75 $96,419.00 $90,535.88 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 8 5 — — $82,630.63 $140,502.24 $88,511.53 2026-04-01
459 MS_DRG Spinal Fusion Except Cervical With Mcc 2 2 — — $116,109.71 $119,404.91 $117,757.31 2026-04-01
4834 APR_DRG Penis, Testes And Scrotal Procedures 2 2 — — $88,677.61 $98,051.76 $93,364.68 2026-04-01
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System 2 2 — — $91,024.84 $136,775.10 $113,899.97 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 10 6 — — $101,383.15 $372,462.78 $108,598.67 2026-04-01
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 2 2 — — $96,258.05 $122,541.78 $109,399.92 2026-04-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $116,443.68 $130,554.61 $123,499.14 2026-04-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 2 2 — — $130,619.10 $146,901.16 $138,760.13 2026-04-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 2 2 — — $117,913.74 $142,709.09 $130,311.42 2026-04-01
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 2 2 — — $104,704.83 $171,977.93 $138,341.38 2026-04-01
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 2 2 — — $78,717.45 $110,052.67 $94,385.06 2026-04-01
5144 APR_DRG Female Reproductive System Reconstructive Procedures 2 2 — — $71,627.29 $100,511.22 $86,069.26 2026-04-01
5184 APR_DRG Other Female Reproductive System And Related Procedures 2 2 — — $96,439.44 $137,013.47 $116,726.46 2026-04-01
5194 APR_DRG Uterine And Adnexa Procedures For Leiomyoma 2 2 — — $94,241.11 $138,638.50 $116,439.80 2026-04-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $133,935.31 $140,224.60 $137,079.96 2026-04-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $191,568.55 $211,613.48 $201,591.02 2026-04-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $260,147.16 $316,055.34 $288,101.25 2026-04-01
5464 APR_DRG Description Not Available 1 1 — — $98,732.48 $98,732.48 $98,732.48 2026-04-01
5484 APR_DRG Postpartum And Post Abortion Diagnosis With O.r. Procedure 1 1 — — $92,979.51 $92,979.51 $92,979.51 2026-04-01
5831 APR_DRG Neonate With Ecmo 2 2 — — $328,202.94 $405,388.39 $366,795.67 2026-04-01
5832 APR_DRG Neonate With Ecmo 2 2 — — $328,202.94 $469,101.99 $398,652.46 2026-04-01
5833 APR_DRG Neonate With Ecmo 2 2 — — $334,457.81 $636,153.23 $485,305.52 2026-04-01
5834 APR_DRG Neonate With Ecmo 2 2 — — $588,716.24 $803,204.47 $695,960.35 2026-04-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $273,578.08 $442,459.14 $358,018.61 2026-04-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $415,621.99 $442,459.14 $429,040.57 2026-04-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $424,453.20 $578,367.86 $501,410.53 2026-04-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $578,367.86 $658,845.82 $618,606.84 2026-04-01
5891 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $128,723.99 $278,223.59 $203,473.79 2026-04-01
5892 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $106,859.84 $278,223.59 $192,541.72 2026-04-01
5893 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $84,998.39 $100,845.71 $92,922.05 2026-04-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $3,514.08 $203,745.05 $103,629.57 2026-04-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $129,354.79 $252,621.95 $190,988.37 2026-04-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $243,091.17 $270,795.22 $256,943.20 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $414,939.75 $444,063.54 $429,501.65 2026-04-01
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $4,055.54 $247,600.18 $125,827.86 2026-04-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $219,009.74 $255,376.93 $237,193.33 2026-04-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $276,320.57 $312,124.56 $294,222.57 2026-04-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $399,630.83 $429,691.83 $414,661.33 2026-04-01
6021 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $36,440.26 $148,812.68 $92,626.47 2026-04-01
6022 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $185,317.39 $217,373.28 $201,345.34 2026-04-01
6023 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $242,869.18 $255,835.33 $249,352.26 2026-04-01
6024 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $308,004.11 $346,587.07 $327,295.59 2026-04-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $82,930.01 $158,113.62 $120,521.82 2026-04-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $168,082.72 $205,787.22 $186,934.97 2026-04-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $319,271.02 $345,400.04 $332,335.53 2026-04-01
6071 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $58,986.65 $138,464.30 $98,725.48 2026-04-01
6072 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $142,509.56 $171,404.93 $156,957.24 2026-04-01
6073 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $184,042.25 $209,697.37 $196,869.81 2026-04-01
6074 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $236,574.70 $282,961.15 $259,767.93 2026-04-01
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $105,311.26 $130,323.12 $117,817.19 2026-04-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $142,655.76 $156,396.91 $149,526.34 2026-04-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $149,789.49 $164,620.61 $157,205.05 2026-04-01
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $81,771.68 $92,687.12 $87,229.40 2026-04-01
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $82,399.69 $97,565.68 $89,982.68 2026-04-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $166,928.65 $205,405.56 $186,167.10 2026-04-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $365,899.46 $412,292.01 $389,095.73 2026-04-01
61 APR_DRG Pancreas Transplant 2 2 — — $115,869.77 $164,663.40 $140,266.58 2026-04-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $117,096.14 $143,612.14 $130,354.14 2026-04-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $179,778.26 $188,258.00 $184,018.13 2026-04-01
6122 APR_DRG Respiratory Condition 2 2 — — $93,626.56 $104,288.29 $98,957.42 2026-04-01
6123 APR_DRG Respiratory Condition 2 2 — — $120,902.60 $145,381.56 $133,142.08 2026-04-01
6124 APR_DRG Respiratory Condition 2 2 — — $171,913.55 $194,214.91 $183,064.23 2026-04-01
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $109,986.77 $115,693.28 $112,840.02 2026-04-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $118,682.05 $168,667.50 $143,674.77 2026-04-01
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $103,981.98 $115,427.41 $109,704.70 2026-04-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $115,427.41 $135,543.68 $125,485.54 2026-04-01
62 APR_DRG Pancreas Transplant 2 2 — — $115,869.77 $209,482.75 $162,676.26 2026-04-01
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $82,789.23 $91,182.64 $86,985.93 2026-04-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $141,039.50 $155,674.93 $148,357.21 2026-04-01
6224 APR_DRG Respiratory Condition 2 2 — — $111,321.47 $118,473.48 $114,897.48 2026-04-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 2 2 — — $71,627.29 $102,165.38 $86,896.33 2026-04-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 2 2 — — $75,505.36 $94,119.28 $84,812.32 2026-04-01
63 APR_DRG Pancreas Transplant 2 2 — — $167,641.46 $241,312.48 $204,476.97 2026-04-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $82,207.16 $146,600.30 $114,403.73 2026-04-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $135,812.46 $231,062.64 $183,437.55 2026-04-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $280,300.14 $478,214.76 $379,257.45 2026-04-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $111,757.92 $152,004.07 $131,880.99 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $240,967.13 $395,818.09 $318,392.61 2026-04-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 2 2 — — $122,711.39 $128,190.66 $125,451.02 2026-04-01
6344 APR_DRG Respiratory Condition 2 2 — — $92,447.82 $98,247.92 $95,347.87 2026-04-01
64 APR_DRG Pancreas Transplant 2 2 — — $175,083.59 $343,188.18 $259,135.89 2026-04-01
64654 HCPCS 1st Opn Implt Bat Modulj Sys 3 3 — — $52,787.39 $133,201.48 $97,995.40 2026-04-01
6504 APR_DRG Splenectomy 2 2 — — $115,401.37 $130,712.76 $123,057.07 2026-04-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 2 2 — — $86,451.95 $127,161.88 $106,806.92 2026-04-01
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 2 2 — — $63,862.50 $114,095.76 $88,979.13 2026-04-01
6614 APR_DRG Coagulation And Platelet Disorders 2 2 — — $60,326.77 $104,655.01 $82,490.89 2026-04-01
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $88,670.60 $89,931.09 $89,300.85 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $172,287.16 $205,049.20 $188,668.18 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $146,911.63 $205,619.90 $176,265.77 2026-04-01
6903 APR_DRG Acute Leukemia 2 2 — — $80,766.88 $138,961.67 $109,864.28 2026-04-01
6904 APR_DRG Acute Leukemia 2 2 — — $140,625.28 $200,621.05 $170,623.16 2026-04-01
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 2 2 — — $82,637.63 $145,147.78 $113,892.71 2026-04-01
6954 APR_DRG Chemotherapy For Acute Leukemia 2 2 — — $132,349.07 $169,305.46 $150,827.27 2026-04-01
6964 APR_DRG Other Chemotherapy 2 2 — — $64,422.91 $100,719.65 $82,571.28 2026-04-01
7 MS_DRG Lung Transplant 8 5 — — $127,339.32 $216,523.33 $136,402.17 2026-04-01
71 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $163,583.19 $163,583.19 $163,583.19 2026-04-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 2 2 — — $118,260.28 $144,863.57 $131,561.92 2026-04-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 2 2 — — $111,557.00 $138,342.83 $124,949.91 2026-04-01
72 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $183,714.67 $183,714.67 $183,714.67 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $234,866.40 $234,866.40 $234,866.40 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant 1 1 — — $398,533.51 $398,533.51 $398,533.51 2026-04-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 2 2 — — $69,355.92 $150,011.49 $109,683.70 2026-04-01
7504 APR_DRG Schizophrenia 2 2 — — $66,580.31 $143,324.46 $104,952.38 2026-04-01
7524 APR_DRG Disorders Of Personality And Impulse Control 2 2 — — $21,732.74 $214,033.72 $117,883.23 2026-04-01
7594 APR_DRG Eating Disorders 2 2 — — $48,489.55 $305,415.93 $176,952.74 2026-04-01
766 MS_DRG Cesarean Section Without Cc/Mcc 1 1 — — $88,932.00 $88,932.00 $88,932.00 2026-04-01
7754 APR_DRG Alcohol Abuse And Dependence 2 2 — — $89,830.36 $111,933.32 $100,881.84 2026-04-01
7914 APR_DRG Description Not Available 1 1 — — $151,517.24 $151,517.24 $151,517.24 2026-04-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $128,236.68 $128,236.68 $128,236.68 2026-04-01
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 1 1 — — $100,974.17 $100,974.17 $100,974.17 2026-04-01
82 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $106,212.79 $106,212.79 $106,212.79 2026-04-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $126,945.30 $126,945.30 $126,945.30 2026-04-01
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 1 1 — — $201,601.80 $201,601.80 $201,601.80 2026-04-01
8411 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $41,927.96 $123,007.06 $82,467.51 2026-04-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $47,726.99 $162,317.15 $105,022.07 2026-04-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $163,028.19 $335,615.27 $249,321.73 2026-04-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $429,484.13 $444,232.74 $436,858.43 2026-04-01
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $92,584.25 $100,011.42 $96,297.83 2026-04-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $197,976.08 $224,502.85 $211,239.46 2026-04-01
8444 APR_DRG Partial Thickness Burns Without Skin Graft 2 2 — — $61,656.05 $116,426.72 $89,041.39 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 8 5 — — $85,148.86 $144,784.16 $91,208.98 2026-04-01
8504 APR_DRG Services 2 2 — — $156,454.87 $174,803.96 $165,629.41 2026-04-01
8633 APR_DRG Neonatal Aftercare 2 2 — — $95,152.38 $113,086.63 $104,119.51 2026-04-01
8634 APR_DRG Neonatal Aftercare 2 2 — — $121,453.08 $176,247.94 $148,850.51 2026-04-01
903 APR_DRG Description Not Available 1 1 — — $93,664.87 $93,664.87 $93,664.87 2026-04-01
904 APR_DRG Description Not Available 1 1 — — $257,400.77 $257,400.77 $257,400.77 2026-04-01
91 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $106,618.89 $106,618.89 $106,618.89 2026-04-01
9101 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $80,542.18 $86,165.45 $83,353.82 2026-04-01
9102 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $86,165.45 $92,134.83 $89,150.14 2026-04-01
9103 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $88,863.13 $103,727.49 $96,295.31 2026-04-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $164,622.90 $174,084.80 $169,353.85 2026-04-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 2 2 — — $148,757.68 $164,465.77 $156,611.72 2026-04-01
9123 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $89,996.07 $90,201.66 $90,098.87 2026-04-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $159,792.97 $173,655.67 $166,724.32 2026-04-01
92 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $129,915.21 $129,915.21 $129,915.21 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 8 5 — — $209,939.47 $356,973.74 $224,881.04 2026-04-01
93 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $178,121.39 $178,121.39 $178,121.39 2026-04-01
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 1 1 — — $386,469.78 $386,469.78 $386,469.78 2026-04-01
9503 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $78,584.80 $91,551.65 $85,068.23 2026-04-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $143,375.90 $185,979.76 $164,677.83 2026-04-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $106,564.74 $143,825.29 $125,195.02 2026-04-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $91,620.45 $135,952.27 $113,786.36 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 6 5 — — $56,824.55 $166,523.50 $87,326.45 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 2 2 — — $3,570,000.00 $3,685,266.67 $3,627,633.33 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 2 2 — — $3,264,000.00 $3,316,462.59 $3,290,231.29 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 1 1 — — $3,570,000.00 $3,570,000.00 $3,570,000.00 2026-04-01
J3391 HCPCS Inj, Atidarsagene Autotemcel 2 2 — — $4,335,000.00 $4,505,000.00 $4,420,000.00 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 3 3 — — $2,244,000.00 $4,329,164.39 $2,332,000.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 2 2 — — $2,856,000.00 $2,945,740.00 $2,900,870.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 2 2 — — $3,162,000.00 $3,248,445.72 $3,205,222.86 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 3 3 — — $2,146,250.00 $4,557,709.01 $2,455,110.60 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 2 2 — — $201,669.02 $205,640.00 $203,654.51 2026-04-01
J3403 HCPCS Revakinagene, Per Implant 2 2 — — $257,500.00 $265,000.00 $261,250.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 3 3 — — $31,905.54 $149,230.29 $85,266.56 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 1 1 — — $108,243.35 $108,243.35 $108,243.35 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 3 3 — — $532,192.24 $969,831.38 $533,230.17 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 3 3 — — $566,531.30 $1,120,613.94 $591,726.20 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 3 3 — — $489,304.61 $966,927.65 $489,450.20 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 3 3 — — $562,201.24 $1,023,262.00 $562,538.19 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 3 3 — — $557,317.93 $1,046,692.58 $558,081.73 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 3 3 — — $565,868.94 $1,092,271.89 $587,649.57 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 2 2 — — $770,620.00 $770,620.00 $770,620.00 2026-04-01
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 3 3 — — $267,750.00 $516,548.02 $278,250.00 2026-04-01
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