Price Transparencybeta Hospital negotiated rates

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

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Hospital

ATHOL MEMORIAL HOSPITAL

Athol, MA · CCN 221303 · Rates published

20,274 distinct procedures filed
7 distinct payers
469,544 rate rows
2025-04-16 last MRF observed · ⚠ 18 mo old
Data quality

303,531 of 469,544 rate rows are consumer-grade (64.6%)

166,013 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 150,291
per-diem day rate — not a per-procedure price 14,514
exceeds 10× this hospital's gross charge — excluded from medians 832
template filing: same amount across many unrelated codes — excluded 162
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 103
percent-of-charges filed in the dollar field — excluded from medians 59
placeholder amount (≤ $0.02) — excluded from medians 52

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 18 months old.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://mrfs.hyvehealthcare.com/HeywoodHealthcare/042126583_athol-memorial-hospital_standardcharges.json
Discovered viaDiscovered by HANK (automated)
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-09-21
Content fingerprint bfc8df423808d6b2… · 55,868,503 bytes · first seen 2026-05-09

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
J3399
HCPCS 		Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 7 $2,146,250.00 $2,146,250.00 $2,146,250.00 nat. median
$2,455,111
0.9× median
5834
APR_DRG 		Neonate With Ecmo, Severe 1 $431,974.59 $492,348.91 $482,603.56 nat. median
$390,362
1.2× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 1 $394,123.72 $449,207.84 $440,316.41 nat. median
$286,698
1.5× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $381,093.41 $434,356.38 $425,758.91 nat. median
$99,483
outlier · 4.3×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $346,448.69 $394,869.59 $387,053.72 nat. median
$96,548
outlier · 4.0×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 1 $345,687.78 $394,002.31 $386,203.59 nat. median
$171,497
outlier · 2.3×
1614
APR_DRG 		Implantable Heart Assist Systems, Severe 1 $336,906.41 $383,993.63 $376,393.03 nat. median
$202,242
1.9× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 1 $314,953.81 $358,972.88 $351,867.50 nat. median
$77,096
outlier · 4.6×
24
APR_DRG 		Heart And/or Lung Transplant, Severe 1 $311,498.97 $355,035.16 $348,007.75 nat. median
$225,531
1.5× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft, Severe 1 $277,898.66 $316,738.78 $310,469.38 nat. median
$173,018
1.8× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 1 $273,938.19 $312,224.75 $306,044.72 nat. median
$168,439
1.8× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure, Major 1 $264,681.03 $301,673.78 $295,702.59 nat. median
$173,134
1.7× median
5833
APR_DRG 		Neonate With Ecmo, Major 1 $263,177.41 $299,960.00 $294,022.72 nat. median
$268,208
1.1× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant, Severe 1 $233,597.28 $266,245.66 $260,975.70 nat. median
$136,566
1.9× median
64
APR_DRG 		Pancreas Transplant, Severe 1 $231,677.55 $264,057.63 $258,830.98 nat. median
$92,994
outlier · 2.8×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 1 $227,267.80 $259,031.56 $253,904.39 nat. median
$135,630
1.9× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure, Major 1 $215,026.61 $245,079.48 $240,228.48 nat. median
$120,079
outlier · 2.0×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $211,110.88 $240,616.48 $235,853.81 nat. median
$124,731
1.9× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 1 $204,032.08 $232,548.31 $227,945.36 nat. median
$198,578
1.1× median
23
APR_DRG 		Heart And/or Lung Transplant, Major 1 $201,991.33 $230,222.34 $225,665.42 nat. median
$117,894
1.9× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 1 $181,926.97 $207,353.73 $203,249.45 nat. median
$115,963
1.8× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure, Major 1 $177,245.34 $202,017.78 $198,019.13 nat. median
$114,205
1.7× median
22
APR_DRG 		Heart And/or Lung Transplant, Moderate 1 $167,925.19 $191,395.02 $187,606.63 nat. median
$95,481
2.0× median
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 1 $167,368.17 $190,760.14 $186,984.31 nat. median
$100,752
1.9× median
3034
APR_DRG 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Severe 1 $159,425.66 $181,707.55 $178,110.91 nat. median
$75,821
outlier · 2.3×
1624
APR_DRG 		Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Severe 1 $156,491.34 $178,363.13 $174,832.69 nat. median
$77,606
outlier · 2.3×
63
APR_DRG 		Pancreas Transplant, Major 1 $153,757.63 $175,247.34 $171,778.56 nat. median
$69,792
outlier · 2.5×
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure, Major 1 $153,242.06 $174,659.70 $171,202.56 nat. median
$85,032
outlier · 2.0×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly, Severe 1 $150,287.86 $171,292.63 $167,902.13 nat. median
$106,926
1.6× median
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 1 $149,903.25 $170,854.27 $167,472.44 nat. median
$95,757
1.7× median
21
APR_DRG 		Heart And/or Lung Transplant, Minor 1 $147,763.03 $168,414.91 $165,081.38 nat. median
$77,825
outlier · 2.1×
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure, Severe 1 $147,738.16 $168,386.56 $165,053.59 nat. median
$91,350
1.8× median
13
APR_DRG 		Liver Transplant And/or Intestinal Transplant, Major 1 $145,178.52 $165,469.19 $162,193.95 nat. median
$69,772
outlier · 2.3×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 1 $144,621.50 $164,834.31 $161,571.66 nat. median
$187,567
0.9× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns, Severe 1 $144,273.36 $164,437.52 $161,182.70 nat. median
$91,950
1.8× median
4404
APR_DRG 		Kidney Transplant, Severe 1 $142,227.64 $162,105.88 $158,897.22 nat. median
$76,896
outlier · 2.1×
9104
APR_DRG 		Craniotomy For Multiple Significant Trauma, Severe 1 $139,863.61 $159,411.45 $156,256.13 nat. median
$56,989
outlier · 2.7×
6084
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Seve… 1 $136,211.48 $155,248.88 $152,175.94 nat. median
$62,234
outlier · 2.4×
1634
APR_DRG 		Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Severe 1 $134,963.16 $153,826.08 $150,781.31 nat. median
$69,586
outlier · 2.2×
1613
APR_DRG 		Implantable Heart Assist Systems, Major 1 $133,462.84 $152,116.09 $149,105.16 nat. median
$155,539
1.0× median
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure, Moderate 1 $126,080.66 $143,702.14 $140,857.77 nat. median
$85,835
1.6× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 1 $125,734.18 $143,307.23 $140,470.67 nat. median
$181,762
0.8× median
6114
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Severe 1 $125,638.03 $143,197.66 $140,363.25 nat. median
$85,322
1.6× median
3044
APR_DRG 		Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Severe 1 $125,346.26 $142,865.09 $140,037.28 nat. median
$54,427
outlier · 2.6×
1654
APR_DRG 		Coronary Bypass With Ami Or Complex Principal Diagnosis, Severe 1 $124,308.48 $141,682.27 $138,877.88 nat. median
$59,887
outlier · 2.3×
62
APR_DRG 		Pancreas Transplant, Moderate 1 $124,114.51 $141,461.20 $138,661.17 nat. median
$58,322
outlier · 2.4×
3124
APR_DRG 		Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses, Se… 1 $121,470.32 $138,447.44 $135,707.06 nat. median
$45,174
outlier · 3.0×
6124
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 1 $120,200.45 $137,000.09 $134,288.36 nat. median
$71,851
1.9× median
3033
APR_DRG 		Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Major 1 $119,320.16 $135,996.77 $133,304.91 nat. median
$49,592
outlier · 2.7×
12
APR_DRG 		Liver Transplant And/or Intestinal Transplant, Moderate 1 $119,205.77 $135,866.39 $133,177.09 nat. median
$51,907
outlier · 2.6×

Other procedures at this hospital

Browse this hospital's 20,274 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
             
1934 APR_DRG Acute And Subacute Endocarditis, Severe 6 1 — — $43,200.61 $49,238.48 $48,263.87 2025-04-16
6903 APR_DRG Acute Leukemia, Major 6 1 — — $45,717.15 $52,106.74 $51,075.36 2025-04-16
6904 APR_DRG Acute Leukemia, Severe 6 1 — — $102,922.86 $117,307.72 $114,985.78 2025-04-16
4013 APR_DRG Adrenal Procedures, Major 6 1 — — $48,087.80 $54,808.73 $53,723.86 2025-04-16
4014 APR_DRG Adrenal Procedures, Severe 6 1 — — $101,712.66 $115,928.38 $113,633.74 2025-04-16
3054 APR_DRG Amputation Of Lower Limb Except Toes, Severe 6 1 — — $72,749.24 $82,916.93 $81,275.70 2025-04-16
2264 APR_DRG Anal And Perineal Procedures, Severe 6 1 — — $44,356.10 $50,555.46 $49,554.79 2025-04-16
494 APR_DRG Bacterial And Tuberculous Infections Of Nervous System, Severe 6 1 — — $65,647.22 $74,822.31 $73,341.31 2025-04-16
564 APR_DRG Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or N… 6 1 — — $49,714.11 $56,662.33 $55,540.77 2025-04-16
3634 APR_DRG Breast Procedures Except Mastectomy, Severe 6 1 — — $67,616.69 $77,067.04 $75,541.60 2025-04-16
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns, Major 6 1 — — $53,895.08 $61,427.65 $60,211.77 2025-04-16
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns, Severe 6 1 — — $144,273.36 $164,437.52 $161,182.70 2025-04-16
1914 APR_DRG Cardiac Catheterization For Coronary Artery Disease, Severe 6 1 — — $41,144.94 $46,895.50 $45,967.27 2025-04-16
1924 APR_DRG Cardiac Catheterization For Other Non-coronary Conditions, Severe 6 1 — — $47,374.95 $53,996.24 $52,927.46 2025-04-16
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement, Severe 6 1 — — $65,846.16 $75,049.05 $73,563.56 2025-04-16
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Major 6 1 — — $103,912.56 $118,435.75 $116,091.48 2025-04-16
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Minor 6 1 — — $68,157.13 $77,683.01 $76,145.39 2025-04-16
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Moderate 6 1 — — $81,368.14 $92,740.44 $90,904.77 2025-04-16
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis, Severe 6 1 — — $156,491.34 $178,363.13 $174,832.69 2025-04-16
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Major 6 1 — — $87,225.15 $99,416.04 $97,448.24 2025-04-16
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Minor 6 1 — — $61,111.48 $69,652.64 $68,273.96 2025-04-16
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Moderate 6 1 — — $71,137.86 $81,080.33 $79,475.46 2025-04-16
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis, Severe 6 1 — — $134,963.16 $153,826.08 $150,781.31 2025-04-16
5404 APR_DRG Cesarean Section Without Sterilization, Severe 6 1 — — $42,282.19 $48,191.70 $47,237.81 2025-04-16
6954 APR_DRG Chemotherapy For Acute Leukemia, Severe 6 1 — — $85,088.24 $96,980.48 $95,060.88 2025-04-16
2634 APR_DRG Cholecystectomy, Severe 6 1 — — $54,914.63 $62,589.69 $61,350.81 2025-04-16
954 APR_DRG Cleft Lip And Palate Repair, Severe 6 1 — — $40,450.32 $46,103.80 $45,191.24 2025-04-16
6614 APR_DRG Coagulation And Platelet Disorders, Severe 6 1 — — $44,802.05 $51,063.74 $50,053.00 2025-04-16
3464 APR_DRG Connective Tissue Disorders, Severe 6 1 — — $46,360.38 $52,839.87 $51,793.98 2025-04-16
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Major 6 1 — — $88,733.75 $101,135.49 $99,133.65 2025-04-16
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Minor 6 1 — — $67,056.35 $76,428.39 $74,915.59 2025-04-16
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Moderate 6 1 — — $73,216.74 $83,449.77 $81,798.00 2025-04-16
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis, Severe 6 1 — — $124,308.48 $141,682.27 $138,877.88 2025-04-16
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Major 6 1 — — $75,643.76 $86,216.00 $84,509.47 2025-04-16
1661 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Minor 6 1 — — $56,297.23 $64,165.53 $62,895.46 2025-04-16
1662 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Moderate 6 1 — — $62,641.63 $71,396.65 $69,983.45 2025-04-16
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis, Severe 6 1 — — $110,142.57 $125,536.49 $123,051.67 2025-04-16
9103 APR_DRG Craniotomy For Multiple Significant Trauma, Major 6 1 — — $70,413.40 $80,254.62 $78,666.10 2025-04-16
9101 APR_DRG Craniotomy For Multiple Significant Trauma, Minor 6 1 — — $45,627.63 $52,004.71 $50,975.35 2025-04-16
9102 APR_DRG Craniotomy For Multiple Significant Trauma, Moderate 6 1 — — $53,354.64 $60,811.67 $59,607.99 2025-04-16
9104 APR_DRG Craniotomy For Multiple Significant Trauma, Severe 6 1 — — $139,863.61 $159,411.45 $156,256.13 2025-04-16
1314 APR_DRG Cystic Fibrosis - Pulmonary Disease, Severe 6 1 — — $40,811.72 $46,515.71 $45,595.00 2025-04-16
424 APR_DRG Degenerative Nervous System Disorders Except Multiple Sclerosis, Severe 6 1 — — $40,715.57 $46,406.12 $45,487.58 2025-04-16
5174 APR_DRG Dilation And Curettage For Non-obstetric Diagnoses, Severe 6 1 — — $50,291.02 $57,319.87 $56,185.31 2025-04-16
2824 APR_DRG Disorders Of Pancreas Except Malignancy, Severe 6 1 — — $43,593.51 $49,686.29 $48,702.82 2025-04-16
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Major 6 1 — — $78,380.78 $89,335.56 $87,567.29 2025-04-16
3041 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Minor 6 1 — — $46,821.25 $53,365.15 $52,308.86 2025-04-16
3042 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Moderate 6 1 — — $55,159.98 $62,869.33 $61,624.92 2025-04-16
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back, Severe 6 1 — — $125,346.26 $142,865.09 $140,037.28 2025-04-16
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Major 6 1 — — $119,320.16 $135,996.77 $133,304.91 2025-04-16
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Minor 6 1 — — $72,046.33 $82,115.78 $80,490.41 2025-04-16
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Moderate 6 1 — — $85,746.39 $97,730.61 $95,796.17 2025-04-16
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back, Severe 6 1 — — $159,425.66 $181,707.55 $178,110.91 2025-04-16
L7180 HCPCS Electronic Elbow, Microprocessor Sequential Control Of Elbow And Terminal Device 24 7 — — $49,701.46 $52,046.93 $50,874.19 2025-04-16
L7181 HCPCS Electronic Elbow, Microprocessor Simultaneous Control Of Elbow And Terminal Devi… 24 7 — — $51,938.39 $54,389.41 $53,163.90 2025-04-16
9113 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma, Majo… 6 1 — — $45,473.45 $51,828.99 $50,803.10 2025-04-16
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma, Seve… 6 1 — — $101,825.39 $116,056.87 $113,759.69 2025-04-16
9503 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis, Major 6 1 — — $51,933.90 $59,192.37 $58,020.74 2025-04-16
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 6 1 — — $94,920.65 $108,187.10 $106,045.69 2025-04-16
8413 APR_DRG Extensive Third Degree Burns With Skin Graft, Major 6 1 — — $103,324.04 $117,764.98 $115,433.98 2025-04-16
8411 APR_DRG Extensive Third Degree Burns With Skin Graft, Minor 6 1 — — $50,233.00 $57,253.74 $56,120.48 2025-04-16
8412 APR_DRG Extensive Third Degree Burns With Skin Graft, Moderate 6 1 — — $55,257.79 $62,980.81 $61,734.20 2025-04-16
8414 APR_DRG Extensive Third Degree Burns With Skin Graft, Severe 6 1 — — $277,898.66 $316,738.78 $310,469.38 2025-04-16
8434 APR_DRG Extensive Third Degree Burns Without Skin Graft, Severe 6 1 — — $45,078.90 $51,379.28 $50,362.30 2025-04-16
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures, Severe 6 1 — — $77,261.77 $88,060.15 $86,317.12 2025-04-16
5144 APR_DRG Female Reproductive System Reconstructive Procedures, Severe 6 1 — — $79,208.03 $90,278.42 $88,491.49 2025-04-16
3144 APR_DRG Foot And Toe Procedures, Severe 6 1 — — $52,444.50 $59,774.33 $58,591.18 2025-04-16
3164 APR_DRG Hand And Wrist Procedures, Severe 6 1 — — $52,819.17 $60,201.36 $59,009.76 2025-04-16
554 APR_DRG Head Trauma With Coma > 1 Hour Or Hemorrhage, Severe 6 1 — — $44,634.61 $50,872.90 $49,865.94 2025-04-16
23 APR_DRG Heart And/or Lung Transplant, Major 6 1 — — $201,991.33 $230,222.34 $225,665.42 2025-04-16
21 APR_DRG Heart And/or Lung Transplant, Minor 6 1 — — $147,763.03 $168,414.91 $165,081.38 2025-04-16
22 APR_DRG Heart And/or Lung Transplant, Moderate 6 1 — — $167,925.19 $191,395.02 $187,606.63 2025-04-16
24 APR_DRG Heart And/or Lung Transplant, Severe 6 1 — — $311,498.97 $355,035.16 $348,007.75 2025-04-16
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical, Severe 6 1 — — $65,713.53 $74,897.89 $73,415.39 2025-04-16
3084 APR_DRG Hip And Femur Fracture Repair, Severe 6 1 — — $56,378.46 $64,258.12 $62,986.22 2025-04-16
8904 APR_DRG HIV With Multiple Major HIV Related Conditions, Severe 6 1 — — $45,055.69 $51,352.83 $50,336.37 2025-04-16
1613 APR_DRG Implantable Heart Assist Systems, Major 6 1 — — $133,462.84 $152,116.09 $149,105.16 2025-04-16
1611 APR_DRG Implantable Heart Assist Systems, Minor 6 1 — — $64,816.66 $73,875.67 $72,413.41 2025-04-16
1612 APR_DRG Implantable Heart Assist Systems, Moderate 6 1 — — $85,413.17 $97,350.82 $95,423.90 2025-04-16
1614 APR_DRG Implantable Heart Assist Systems, Severe 6 1 — — $336,906.41 $383,993.63 $376,393.03 2025-04-16
7103 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure, Major 6 1 — — $40,718.88 $46,409.90 $45,491.28 2025-04-16
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure, Severe 6 1 — — $77,991.20 $88,891.53 $87,132.04 2025-04-16
2284 APR_DRG Inguinal, Femoral And Umbilical Hernia Procedures, Severe 6 1 — — $51,877.54 $59,128.12 $57,957.77 2025-04-16
J9029 HCPCS Injection, Nadofaragene Firadenovec-vncg, Per Therapeutic Dose 24 7 — — $61,200.00 $61,200.00 $61,200.00 2025-04-16
J3399 HCPCS Injection, Onasemnogene Abeparvovec-xioi, Per Treatment, Up To 5x10^15 Vector Ge… 24 7 — — $2,146,250.00 $2,146,250.00 $2,146,250.00 2025-04-16
0100T CPT Insertion Of Retinal Prosthesis Receiver Pulse Generator And Retinal Electrode A… 12 4 — — $2,890.00 $243,801.45 $120,052.85 2025-04-16
1763 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices, Maj… 6 1 — — $45,770.20 $52,167.21 $51,134.63 2025-04-16
1762 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices, Mod… 6 1 — — $41,067.02 $46,806.69 $45,880.22 2025-04-16
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices, Sev… 6 1 — — $69,365.67 $79,060.46 $77,495.57 2025-04-16
444 APR_DRG Intracranial Hemorrhage, Severe 6 1 — — $42,555.73 $48,503.47 $47,543.41 2025-04-16
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy, Severe 6 1 — — $73,414.02 $83,674.62 $82,018.40 2025-04-16
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy, Severe 6 1 — — $58,498.79 $66,674.79 $65,355.05 2025-04-16
4403 APR_DRG Kidney Transplant, Major 6 1 — — $95,066.54 $108,353.38 $106,208.67 2025-04-16
4401 APR_DRG Kidney Transplant, Minor 6 1 — — $71,086.46 $81,021.76 $79,418.05 2025-04-16
4402 APR_DRG Kidney Transplant, Moderate 6 1 — — $80,817.75 $92,113.13 $90,289.88 2025-04-16
4404 APR_DRG Kidney Transplant, Severe 6 1 — — $142,227.64 $162,105.88 $158,897.22 2025-04-16
3134 APR_DRG Knee And Lower Leg Procedures Except Foot, Severe 6 1 — — $69,330.85 $79,020.78 $77,456.67 2025-04-16
13 APR_DRG Liver Transplant And/or Intestinal Transplant, Major 6 1 — — $145,178.52 $165,469.19 $162,193.95 2025-04-16
11 APR_DRG Liver Transplant And/or Intestinal Transplant, Minor 6 1 — — $117,160.04 $133,534.73 $130,891.61 2025-04-16
12 APR_DRG Liver Transplant And/or Intestinal Transplant, Moderate 6 1 — — $119,205.77 $135,866.39 $133,177.09 2025-04-16
14 APR_DRG Liver Transplant And/or Intestinal Transplant, Severe 6 1 — — $233,597.28 $266,245.66 $260,975.70 2025-04-16
1813 APR_DRG Lower Extremity Arterial Procedures, Major 6 1 — — $51,605.66 $58,818.25 $57,654.02 2025-04-16
1814 APR_DRG Lower Extremity Arterial Procedures, Severe 6 1 — — $92,415.72 $105,332.07 $103,247.17 2025-04-16
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia, Severe 6 1 — — $51,648.76 $58,867.37 $57,702.18 2025-04-16
1693 APR_DRG Major Abdominal Vascular Procedures, Major 6 1 — — $58,459.00 $66,629.44 $65,310.60 2025-04-16
1694 APR_DRG Major Abdominal Vascular Procedures, Severe 6 1 — — $102,692.42 $117,045.08 $114,728.33 2025-04-16
2613 APR_DRG Major Biliary Tract Procedures, Major 6 1 — — $42,413.16 $48,340.97 $47,384.13 2025-04-16
2614 APR_DRG Major Biliary Tract Procedures, Severe 6 1 — — $75,390.11 $85,926.90 $84,226.10 2025-04-16
4413 APR_DRG Major Bladder Procedures, Major 6 1 — — $49,700.84 $56,647.21 $55,525.96 2025-04-16
4414 APR_DRG Major Bladder Procedures, Severe 6 1 — — $96,236.95 $109,687.36 $107,516.26 2025-04-16
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Major 6 1 — — $80,784.59 $92,075.34 $90,252.83 2025-04-16
1601 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Minor 6 1 — — $48,169.04 $54,901.31 $53,814.62 2025-04-16
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Moderate 6 1 — — $55,300.89 $63,029.94 $61,782.35 2025-04-16
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly, Severe 6 1 — — $150,287.86 $171,292.63 $167,902.13 2025-04-16
893 APR_DRG Major Cranial Or Facial Bone Procedures, Major 6 1 — — $53,755.82 $61,268.93 $60,056.19 2025-04-16
894 APR_DRG Major Cranial Or Facial Bone Procedures, Severe 6 1 — — $94,010.52 $107,149.77 $105,028.89 2025-04-16
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 6 1 — — $41,552.76 $47,360.32 $46,422.89 2025-04-16
4804 APR_DRG Major Male Pelvic Procedures, Severe 6 1 — — $76,414.63 $87,094.61 $85,370.70 2025-04-16
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Major 6 1 — — $52,953.45 $60,354.41 $59,159.78 2025-04-16
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 6 1 — — $99,681.86 $113,613.75 $111,364.92 2025-04-16
2603 APR_DRG Major Pancreas, Liver And Shunt Procedures, Major 6 1 — — $49,951.17 $56,932.52 $55,805.63 2025-04-16
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures, Severe 6 1 — — $95,147.77 $108,445.96 $106,299.43 2025-04-16
1203 APR_DRG Major Respiratory And Chest Procedures, Major 6 1 — — $52,237.28 $59,538.15 $58,359.67 2025-04-16
1204 APR_DRG Major Respiratory And Chest Procedures, Severe 6 1 — — $86,820.64 $98,955.00 $96,996.33 2025-04-16
3814 APR_DRG Major Skin Disorders, Severe 6 1 — — $44,984.40 $51,271.58 $50,256.73 2025-04-16
2203 APR_DRG Major Stomach, Esophageal And Duodenal Procedures, Major 6 1 — — $50,196.53 $57,212.17 $56,079.74 2025-04-16
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures, Severe 6 1 — — $93,854.69 $106,972.15 $104,854.79 2025-04-16
3624 APR_DRG Mastectomy Procedures, Severe 6 1 — — $55,673.90 $63,455.08 $62,199.07 2025-04-16
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 6 1 — — $69,881.24 $79,648.09 $78,071.57 2025-04-16
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies, S… 6 1 — — $48,596.75 $55,388.80 $54,292.46 2025-04-16
9304 APR_DRG Multiple Significant Trauma Without O.r. Procedure, Severe 6 1 — — $65,401.87 $74,542.66 $73,067.20 2025-04-16
9123 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma, Major 6 1 — — $57,961.66 $66,062.59 $64,754.97 2025-04-16
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma, Severe 6 1 — — $109,681.71 $125,011.21 $122,536.79 2025-04-16
8633 APR_DRG Neonatal Aftercare, Major 6 1 — — $49,314.58 $56,206.96 $55,094.42 2025-04-16
8634 APR_DRG Neonatal Aftercare, Severe 6 1 — — $95,038.36 $108,321.26 $106,177.19 2025-04-16
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Majo… 6 1 — — $105,446.03 $120,183.54 $117,804.67 2025-04-16
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Mode… 6 1 — — $62,963.24 $71,763.21 $70,342.76 2025-04-16
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition, Seve… 6 1 — — $181,926.97 $207,353.73 $203,249.45 2025-04-16
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $211,110.88 $240,616.48 $235,853.81 2025-04-16
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $149,903.25 $170,854.27 $167,472.44 2025-04-16
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $108,294.13 $123,429.70 $120,986.58 2025-04-16
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $46,300.70 $52,771.85 $51,727.30 2025-04-16
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Majo… 6 1 — — $96,432.57 $109,910.33 $107,734.80 2025-04-16
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Mode… 6 1 — — $64,937.68 $74,013.60 $72,548.61 2025-04-16
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition, Seve… 6 1 — — $136,211.48 $155,248.88 $152,175.94 2025-04-16
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $167,368.17 $190,760.14 $186,984.31 2025-04-16
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $116,316.22 $132,572.98 $129,948.89 2025-04-16
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $83,708.95 $95,408.41 $93,519.94 2025-04-16
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $45,990.69 $52,418.51 $51,380.96 2025-04-16
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Maj… 6 1 — — $77,905.00 $88,793.27 $87,035.74 2025-04-16
6132 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Mod… 6 1 — — $44,077.59 $50,238.03 $49,243.63 2025-04-16
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection, Sev… 6 1 — — $102,059.14 $116,323.29 $114,020.83 2025-04-16
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Major 6 1 — — $80,172.87 $91,378.11 $89,569.41 2025-04-16
6112 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Moderate 6 1 — — $46,421.72 $52,909.78 $51,862.50 2025-04-16
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly, Severe 6 1 — — $125,638.03 $143,197.66 $140,363.25 2025-04-16
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 6 1 — — $76,525.71 $87,221.21 $85,494.79 2025-04-16
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition… 6 1 — — $63,273.25 $72,116.55 $70,689.10 2025-04-16
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $120,200.45 $137,000.09 $134,288.36 2025-04-16
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $81,683.12 $93,099.44 $91,256.67 2025-04-16
6122 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $57,467.64 $65,499.52 $64,203.05 2025-04-16
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Major 6 1 — — $115,125.92 $131,216.33 $128,619.08 2025-04-16
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Moderate 6 1 — — $60,463.28 $68,913.84 $67,549.79 2025-04-16
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure, Severe 6 1 — — $204,032.08 $232,548.31 $227,945.36 2025-04-16
6233 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection, Maj… 6 1 — — $46,141.55 $52,590.45 $51,549.50 2025-04-16
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection, Sev… 6 1 — — $67,477.43 $76,908.32 $75,386.03 2025-04-16
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly, Major 6 1 — — $50,750.23 $57,843.26 $56,698.34 2025-04-16
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly, Severe 6 1 — — $98,368.88 $112,117.26 $109,898.06 2025-04-16
6253 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition, Major 6 1 — — $43,389.60 $49,453.88 $48,475.01 2025-04-16
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition, Severe 6 1 — — $64,868.06 $73,934.25 $72,470.82 2025-04-16
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $78,291.26 $89,233.53 $87,467.27 2025-04-16
6223 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 6 1 — — $51,973.69 $59,237.71 $58,065.19 2025-04-16
6264 APR_DRG Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Probl… 6 1 — — $41,622.38 $47,439.68 $46,500.67 2025-04-16
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Major 6 1 — — $215,026.61 $245,079.48 $240,228.48 2025-04-16
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Moderate 6 1 — — $126,080.66 $143,702.14 $140,857.77 2025-04-16
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure, Severe 6 1 — — $345,687.78 $394,002.31 $386,203.59 2025-04-16
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Major 6 1 — — $177,245.34 $202,017.78 $198,019.13 2025-04-16
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Moderate 6 1 — — $108,557.72 $123,730.13 $121,281.06 2025-04-16
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure, Severe 6 1 — — $273,938.19 $312,224.75 $306,044.72 2025-04-16
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Major 6 1 — — $264,681.03 $301,673.78 $295,702.59 2025-04-16
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Minor 6 1 — — $81,676.49 $93,091.89 $91,249.26 2025-04-16
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Moderate 6 1 — — $118,161.35 $134,676.00 $132,010.28 2025-04-16
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure, Severe 6 1 — — $394,123.72 $449,207.84 $440,316.41 2025-04-16
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 1 — — $381,093.41 $434,356.38 $425,758.91 2025-04-16
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 1 — — $346,448.69 $394,869.59 $387,053.72 2025-04-16
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 1 — — $314,953.81 $358,972.88 $351,867.50 2025-04-16
6364 APR_DRG Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection, Severe 6 1 — — $55,725.29 $63,513.65 $62,256.49 2025-04-16
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly, Severe 6 1 — — $50,324.18 $57,357.66 $56,222.35 2025-04-16
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Major 6 1 — — $67,986.38 $77,488.40 $75,954.62 2025-04-16
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Moderate 6 1 — — $42,603.80 $48,558.26 $47,597.12 2025-04-16
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure, Severe 6 1 — — $144,621.50 $164,834.31 $161,571.66 2025-04-16
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Major 6 1 — — $42,557.38 $48,505.35 $47,545.26 2025-04-16
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure, Severe 6 1 — — $125,734.18 $143,307.23 $140,470.67 2025-04-16
6394 APR_DRG Neonate Birth Weight > 2499 Grams With Other Significant Condition, Severe 6 1 — — $44,354.44 $50,553.57 $49,552.94 2025-04-16
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 6 1 — — $75,481.29 $86,030.82 $84,327.97 2025-04-16
5833 APR_DRG Neonate With Ecmo, Major 6 1 — — $263,177.41 $299,960.00 $294,022.72 2025-04-16
5831 APR_DRG Neonate With Ecmo, Minor 6 1 — — $67,845.47 $77,327.79 $75,797.19 2025-04-16
5832 APR_DRG Neonate With Ecmo, Moderate 6 1 — — $107,132.01 $122,105.16 $119,688.26 2025-04-16
5834 APR_DRG Neonate With Ecmo, Severe 6 1 — — $431,974.59 $492,348.91 $482,603.56 2025-04-16
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis, Severe 6 1 — — $59,017.68 $67,266.20 $65,934.76 2025-04-16
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis, Severe 6 1 — — $59,992.47 $68,377.23 $67,023.79 2025-04-16
464 APR_DRG Nonspecific Cva And Precerebral Occlusion Without Infarction, Severe 6 1 — — $42,898.89 $48,894.59 $47,926.79 2025-04-16
213 APR_DRG Open Craniotomy Except Trauma, Major 6 1 — — $61,051.80 $69,584.62 $68,207.29 2025-04-16
212 APR_DRG Open Craniotomy Except Trauma, Moderate 6 1 — — $41,113.44 $46,859.60 $45,932.08 2025-04-16
214 APR_DRG Open Craniotomy Except Trauma, Severe 6 1 — — $104,414.88 $119,008.27 $116,652.67 2025-04-16
203 APR_DRG Open Craniotomy For Trauma, Major 6 1 — — $51,749.88 $58,982.63 $57,815.15 2025-04-16
204 APR_DRG Open Craniotomy For Trauma, Severe 6 1 — — $102,956.01 $117,345.51 $115,022.82 2025-04-16
243 APR_DRG Open Extracranial Vascular Procedures, Major 6 1 — — $44,354.44 $50,553.57 $49,552.94 2025-04-16
244 APR_DRG Open Extracranial Vascular Procedures, Severe 6 1 — — $88,559.68 $100,937.09 $98,939.18 2025-04-16
734 APR_DRG Orbit And Eye Procedures, Severe 6 1 — — $51,134.84 $58,281.63 $57,128.02 2025-04-16
6813 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Major 6 1 — — $40,743.75 $46,438.24 $45,519.06 2025-04-16
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms, Severe 6 1 — — $91,263.55 $104,018.86 $101,959.96 2025-04-16
4454 APR_DRG Other Bladder Procedures, Severe 6 1 — — $46,658.78 $53,179.98 $52,127.35 2025-04-16
1673 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Major 6 1 — — $68,911.43 $78,542.74 $76,988.09 2025-04-16
1671 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Minor 6 1 — — $47,059.97 $53,637.24 $52,575.56 2025-04-16
1672 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Moderate 6 1 — — $52,926.92 $60,324.18 $59,130.14 2025-04-16
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures, Severe 6 1 — — $114,626.92 $130,647.59 $128,061.60 2025-04-16
6964 APR_DRG Other Chemotherapy, Severe 6 1 — — $44,510.27 $50,731.19 $49,727.03 2025-04-16
1804 APR_DRG Other Circulatory System Procedures, Severe 6 1 — — $59,853.21 $68,218.51 $66,868.22 2025-04-16
2294 APR_DRG Other Digestive System And Abdominal Procedures, Severe 6 1 — — $72,842.07 $83,022.74 $81,379.42 2025-04-16
984 APR_DRG Other Ear, Nose, Mouth And Throat Procedures, Severe 6 1 — — $55,337.36 $63,071.51 $61,823.10 2025-04-16
5184 APR_DRG Other Female Reproductive System And Related Procedures, Severe 6 1 — — $67,261.92 $76,662.68 $75,145.25 2025-04-16
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures, Severe 6 1 — — $74,869.56 $85,333.60 $83,644.54 2025-04-16
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures, Severe 6 1 — — $67,314.97 $76,723.15 $75,204.52 2025-04-16
913 APR_DRG Other Major Head And Neck Procedures, Major 6 1 — — $55,957.38 $63,778.18 $62,515.78 2025-04-16
914 APR_DRG Other Major Head And Neck Procedures, Severe 6 1 — — $86,477.48 $98,563.88 $96,612.94 2025-04-16
4844 APR_DRG Other Male Reproductive System And Related Procedures, Severe 6 1 — — $65,615.72 $74,786.41 $73,306.12 2025-04-16
3204 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures, Severe 6 1 — — $59,788.56 $68,144.82 $66,795.99 2025-04-16
264 APR_DRG Other Nervous System And Related Procedures, Severe 6 1 — — $71,751.24 $81,779.45 $80,160.74 2025-04-16
1823 APR_DRG Other Peripheral Vascular And Related Procedures, Major 6 1 — — $46,741.67 $53,274.45 $52,219.96 2025-04-16
1824 APR_DRG Other Peripheral Vascular And Related Procedures, Severe 6 1 — — $81,068.08 $92,398.44 $90,569.54 2025-04-16
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders, Severe 6 1 — — $74,533.03 $84,950.03 $83,268.56 2025-04-16
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs, Severe 6 1 — — $77,402.68 $88,220.76 $86,474.55 2025-04-16
1214 APR_DRG Other Respiratory And Chest Procedures, Severe 6 1 — — $72,155.75 $82,240.49 $80,612.65 2025-04-16
3093 APR_DRG Other Significant Hip And Femur Surgery, Major 6 1 — — $41,436.71 $47,228.05 $46,293.24 2025-04-16
3094 APR_DRG Other Significant Hip And Femur Surgery, Severe 6 1 — — $74,496.56 $84,908.46 $83,227.82 2025-04-16
3644 APR_DRG Other Skin, Subcutaneous Tissue And Related Procedures, Severe 6 1 — — $48,142.51 $54,871.08 $53,784.98 2025-04-16
2234 APR_DRG Other Small And Large Bowel Procedures, Severe 6 1 — — $76,464.37 $87,151.30 $85,426.26 2025-04-16
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures, Severe 6 1 — — $72,082.80 $82,157.35 $80,531.16 2025-04-16
63 APR_DRG Pancreas Transplant, Major 6 1 — — $153,757.63 $175,247.34 $171,778.56 2025-04-16
61 APR_DRG Pancreas Transplant, Minor 6 1 — — $93,231.36 $106,261.70 $104,158.40 2025-04-16
62 APR_DRG Pancreas Transplant, Moderate 6 1 — — $124,114.51 $141,461.20 $138,661.17 2025-04-16
64 APR_DRG Pancreas Transplant, Severe 6 1 — — $231,677.55 $264,057.63 $258,830.98 2025-04-16
8444 APR_DRG Partial Thickness Burns Without Skin Graft, Severe 6 1 — — $59,531.60 $67,851.95 $66,508.91 2025-04-16
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 6 1 — — $85,767.94 $97,755.17 $95,820.25 2025-04-16
5103 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 6 1 — — $42,043.47 $47,919.61 $46,971.11 2025-04-16
4834 APR_DRG Penis, Testes And Scrotal Procedures, Severe 6 1 — — $67,727.76 $77,193.63 $75,665.69 2025-04-16
1743 APR_DRG Percutaneous Cardiac Intervention With Ami, Major 6 1 — — $44,763.92 $51,020.28 $50,010.40 2025-04-16
1744 APR_DRG Percutaneous Cardiac Intervention With Ami, Severe 6 1 — — $68,332.86 $77,883.30 $76,341.71 2025-04-16
1753 APR_DRG Percutaneous Cardiac Intervention Without Ami, Major 6 1 — — $43,182.37 $49,217.70 $48,243.50 2025-04-16
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami, Severe 6 1 — — $77,311.50 $88,116.83 $86,372.68 2025-04-16
2243 APR_DRG Peritoneal Adhesiolysis, Major 6 1 — — $40,226.52 $45,848.72 $44,941.21 2025-04-16
2244 APR_DRG Peritoneal Adhesiolysis, Severe 6 1 — — $70,726.72 $80,611.74 $79,016.14 2025-04-16
1703 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock, Major 6 1 — — $49,616.30 $56,550.85 $55,431.50 2025-04-16
1702 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock, Moderate 6 1 — — $40,924.45 $46,644.20 $45,720.94 2025-04-16
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock, Severe 6 1 — — $72,649.77 $82,803.56 $81,164.58 2025-04-16
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock, Severe 6 1 — — $61,287.21 $69,852.93 $68,470.28 2025-04-16
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure, Severe 6 1 — — $75,043.63 $85,532.00 $83,839.01 2025-04-16
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 6 1 — — $70,030.45 $79,818.15 $78,238.26 2025-04-16
4034 APR_DRG Procedures For Obesity, Severe 6 1 — — $86,301.75 $98,363.59 $96,416.62 2025-04-16
6924 APR_DRG Radiotherapy, Severe 6 1 — — $54,397.39 $62,000.16 $60,772.96 2025-04-16
4444 APR_DRG Renal Dialysis Access Device Procedures, Severe 6 1 — — $62,311.73 $71,020.64 $69,614.88 2025-04-16
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Major 6 1 — — $59,750.43 $68,101.36 $66,753.39 2025-04-16
1301 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Minor 6 1 — — $45,851.43 $52,259.79 $51,225.38 2025-04-16
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Moderate 6 1 — — $47,250.62 $53,854.53 $52,788.55 2025-04-16
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours, Severe 6 1 — — $80,996.79 $92,317.19 $90,489.90 2025-04-16
3224 APR_DRG Shoulder And Elbow Joint Replacement, Severe 6 1 — — $63,417.48 $72,280.93 $70,850.23 2025-04-16
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement, Severe 6 1 — — $65,978.78 $75,200.21 $73,711.73 2025-04-16
Q2043 HCPCS Sipuleucel-t, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-gm… 24 7 — — $53,017.58 $53,426.66 $53,222.12 2025-04-16
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses, Severe 6 1 — — $70,938.92 $80,853.59 $79,253.21 2025-04-16
3123 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses, Ma… 6 1 — — $52,235.62 $59,536.26 $58,357.82 2025-04-16
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses, Se… 6 1 — — $121,470.32 $138,447.44 $135,707.06 2025-04-16
404 APR_DRG Spinal Disorders And Injuries, Severe 6 1 — — $50,150.11 $57,159.26 $56,027.88 2025-04-16
3213 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures, Maj… 6 1 — — $55,133.45 $62,839.10 $61,595.29 2025-04-16
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures, Sev… 6 1 — — $102,384.07 $116,693.63 $114,383.84 2025-04-16
233 APR_DRG Spinal Procedures, Major 6 1 — — $57,615.18 $65,667.68 $64,367.88 2025-04-16
234 APR_DRG Spinal Procedures, Severe 6 1 — — $104,487.82 $119,091.41 $116,734.16 2025-04-16
6504 APR_DRG Splenectomy, Severe 6 1 — — $76,737.90 $87,463.07 $85,731.86 2025-04-16
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures, Severe 6 1 — — $70,814.58 $80,711.88 $79,114.30 2025-04-16
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures, Severe 6 1 — — $74,740.26 $85,186.22 $83,500.08 2025-04-16
974 APR_DRG Tonsil And Adenoid Procedures, Severe 6 1 — — $53,941.50 $61,480.55 $60,263.63 2025-04-16
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Major 6 1 — — $153,242.06 $174,659.70 $171,202.56 2025-04-16
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Minor 6 1 — — $84,489.78 $96,298.37 $94,392.28 2025-04-16
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Moderate 6 1 — — $108,746.71 $123,945.53 $121,492.20 2025-04-16
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure, Severe 6 1 — — $227,267.80 $259,031.56 $253,904.39 2025-04-16
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Major 6 1 — — $106,376.05 $121,243.55 $118,843.70 2025-04-16
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Minor 6 1 — — $77,314.82 $88,120.61 $86,376.39 2025-04-16
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Moderate 6 1 — — $82,556.78 $94,095.21 $92,232.73 2025-04-16
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure, Severe 6 1 — — $147,738.16 $168,386.56 $165,053.59 2025-04-16
4824 APR_DRG Transurethral Prostatectomy, Severe 6 1 — — $47,326.87 $53,941.45 $52,873.75 2025-04-16
4464 APR_DRG Urethral And Transurethral Procedures, Severe 6 1 — — $44,614.71 $50,850.22 $49,843.72 2025-04-16
5194 APR_DRG Uterine And Adnexa Procedures For Leiomyoma, Severe 6 1 — — $68,725.76 $78,331.11 $76,780.66 2025-04-16
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma, Severe 6 1 — — $62,086.27 $70,763.66 $69,363.00 2025-04-16
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy, Severe 6 1 — — $64,518.26 $73,535.56 $72,080.03 2025-04-16
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy, Severe 6 1 — — $77,898.36 $88,785.72 $87,028.33 2025-04-16
5424 APR_DRG Vaginal Delivery With O.r. Procedure Except Sterilization And/or D&c, Severe 6 1 — — $58,402.64 $66,565.20 $65,247.63 2025-04-16
5414 APR_DRG Vaginal Delivery With Sterilization And/or D&c, Severe 6 1 — — $49,200.19 $56,076.58 $54,966.62 2025-04-16
224 APR_DRG Ventricular Shunt Procedures, Severe 6 1 — — $82,115.81 $93,592.60 $91,740.07 2025-04-16
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures, Severe 6 1 — — $59,516.68 $67,834.94 $66,492.24 2025-04-16
514 APR_DRG Viral Meningitis, Severe 6 1 — — $41,743.40 $47,577.61 $46,635.88 2025-04-16
A9543 HCPCS Yttrium Y-90 Ibritumomab Tiuxetan, Therapeutic, Per Treatment Dose, Up To 40 Mil… 24 7 — — $63,005.77 $103,434.56 $83,220.16 2025-04-16
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