Price Transparency Hospital negotiated rates

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

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Hospital

WYANDOTTE HOSPITAL AND MEDICAL CENTER

Wyandotte, MI · CCN 230146 · Rates published

30,661 distinct procedures filed
49 distinct payers
1,393,765 rate rows
2025-06-28 last MRF observed · ⚠ 12 mo old
Data quality

623,165 of 1,393,765 rate rows are consumer-grade (44.7%)

770,600 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
professional (physician) fee — not the facility price 545,467
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 223,858
exceeds 10× this hospital's gross charge — excluded from medians 581
placeholder amount (≤ $0.02) — excluded from medians 349
percent-of-charges filed in the dollar field — excluded from medians 238
per-diem day rate — not a per-procedure price 107

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 12 months old.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://www.henryford.com/-/media/files/henry-ford/patients-visitors/price-transparency-2026/382791823_henry-ford-health_standardcharges.csv
Found on page https://www.henryford.com/visitors/billing/cost-of-care/hospital-standard-charges
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 77593eab737e074a… · 529,508,795 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
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 23 $1,988,560.00 $4,958,415.00 $3,672,900.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 22 $1,988,560.00 $4,866,750.00 $3,605,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 22 $1,780,474.89 $4,491,665.84 $3,325,454.76 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 22 $1,711,448.00 $4,436,100.00 $3,286,000.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 22 $1,590,848.00 $4,571,016.80 $2,968,000.00 nat. median
$3,004,655
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 23 $1,288,253.89 $4,637,171.50 $2,388,614.23 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 23 $1,249,952.00 $4,436,520.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
C9081
HCPCS 		Idecabtagene Car Pos T 1 $775,286.34 $775,286.34 $775,286.34 nat. median
$30,475
outlier · 25.4×
C9098
HCPCS 		Ciltacabtagene Car Pos T 1 $759,115.29 $759,115.29 $759,115.29 nat. median
$57,174
outlier · 13.3×
C9076
HCPCS 		Lisocabtagene Car Pos T 1 $758,283.64 $758,283.64 $758,283.64 nat. median
$30,475
outlier · 24.9×
Q2057
HCPCS 		Afamitresgene Autoleucel 1 $717,286.16 $717,286.16 $717,286.16 nat. median
$824,563
0.9× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 24 $303,174.38 $1,388,705.88 $529,192.86 nat. median
$753,246
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 24 $295,506.63 $1,383,275.30 $527,123.43 nat. median
$674,867
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 24 $283,175.46 $1,381,869.15 $526,587.59 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 24 $276,836.48 $1,368,546.09 $516,726.08 nat. median
$673,137
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 24 $262,381.19 $1,284,428.46 $489,455.96 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 24 $261,595.61 $1,208,522.13 $460,530.40 nat. median
$619,808
0.7× median
C9073
HCPCS 		Brexucabtagene Autoleucel Ca 1 $413,145.63 $413,145.63 $413,145.63 nat. median
$29,278
outlier · 14.1×
5834
APR_DRG 		6 $323,979.90 $336,939.09 $323,979.90 nat. median
$309,665
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $164,440.13 $556,640.93 $270,803.38 nat. median
$370,174
0.7× median
C9301
HCPCS 		Obecabtagene Car Pos T 1 $258,992.60 $258,992.60 $258,992.60 nat. median
$459,112
0.6× median
5884
APR_DRG 		6 $198,763.42 $206,713.95 $198,763.42 nat. median
$246,434
0.8× median
5833
APR_DRG 		6 $184,676.03 $192,063.07 $184,676.03 nat. median
$244,017
0.8× median
0114
APR_DRG 		6 $181,667.95 $188,934.67 $181,667.95 nat. median
$197,700
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 $161,979.23 $433,688.26 $170,504.45 nat. median
$206,474
0.8× median
6314
APR_DRG 		6 $168,164.44 $174,891.02 $168,164.44 nat. median
$122,924
1.4× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 23 $146,374.18 $487,521.50 $154,078.08 nat. median
$202,976
0.8× median
1614
APR_DRG 		6 $150,321.09 $156,333.94 $150,321.09 nat. median
$207,730
0.7× median
6094
APR_DRG 		6 $138,710.25 $144,258.67 $138,710.25 nat. median
$162,982
0.9× median
0113
APR_DRG 		6 $135,312.21 $140,724.70 $135,312.21 nat. median
$128,705
1.1× median
5883
APR_DRG 		6 $131,448.34 $136,706.27 $131,448.34 nat. median
$182,665
0.7× median
6304
APR_DRG 		6 $124,088.67 $129,052.21 $124,088.67 nat. median
$150,721
0.8× median
8414
APR_DRG 		6 $122,639.38 $127,544.96 $122,639.38 nat. median
$160,267
0.8× median
5914
APR_DRG 		6 $119,255.76 $124,025.99 $119,255.76 nat. median
$164,289
0.7× median
5934
APR_DRG 		6 $114,213.45 $118,781.98 $114,213.45 nat. median
$151,838
0.8× median
0094
APR_DRG 		6 $112,106.56 $116,590.82 $112,106.56 nat. median
$166,008
0.7× median
651
MS_DRG 		Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 $110,633.80 $110,633.80 $110,633.80 nat. median
$35,527
outlier · 3.1×
5882
APR_DRG 		6 $110,563.26 $114,985.79 $110,563.26 nat. median
$145,336
0.8× median
0112
APR_DRG 		6 $107,662.02 $111,968.50 $107,662.02 nat. median
$93,442
1.2× median
812000005-62-75666
CDM 		Hb Lung Acquisition Chg Cadaver Donor 13 $44,218.74 $185,306.40 $105,161.38 nat. median
$105,161
1.0× median
812000009-62-75667
CDM 		Hb Double Lung Acquisition Chrg Cadaver Donor 13 $44,218.74 $185,306.40 $105,161.38 nat. median
$105,161
1.0× median
5832
APR_DRG 		6 $102,582.84 $106,686.16 $102,582.84 nat. median
$156,126
0.7× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 23 $96,643.97 $235,208.45 $101,730.49 nat. median
$133,161
0.8× median
Q0480
HCPCS 		Driver Pneumatic Vad, Rep 15 $53,599.97 $317,917.16 $99,999.95 nat. median
$111,989
0.9× median
0044
APR_DRG 		6 $96,411.76 $100,268.24 $96,411.76 nat. median
$195,681
outlier · 0.5×
5881
APR_DRG 		6 $94,830.00 $98,623.20 $94,830.00 nat. median
$124,573
0.8× median
5893
APR_DRG 		6 $94,240.78 $98,010.41 $94,240.78 nat. median
$69,788
1.4× median
5892
APR_DRG 		6 $94,240.24 $98,009.85 $94,240.24 nat. median
$89,796
1.0× median
5913
APR_DRG 		6 $93,259.98 $96,990.38 $93,259.98 nat. median
$102,919
0.9× median
5891
APR_DRG 		6 $92,961.37 $96,679.82 $92,961.37 nat. median
$93,370
1.0× median

Other procedures at this hospital

Browse this hospital's 30,661 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
             
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 26 23 — — $1,988,560.00 $4,958,415.00 $3,672,900.00 2025-06-28
J1414 HCPCS Inj, Beqvez, Per Tx Dose 25 22 — — $1,988,560.00 $4,866,750.00 $3,605,000.00 2025-06-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 26 22 — — $1,780,474.89 $4,491,665.84 $3,325,454.76 2025-06-28
J3394 HCPCS Inj, Lovotibeglogene Autotem 26 22 — — $1,711,448.00 $4,436,100.00 $3,286,000.00 2025-06-28
J3393 HCPCS Inj, Betibeglogene Autotemce 27 22 — — $1,590,848.00 $4,571,016.80 $2,968,000.00 2025-06-28
J3399 HCPCS Inj Onase Abepar-xioi Treat 28 23 — — $1,288,253.89 $4,637,171.50 $2,388,614.23 2025-06-28
J3392 HCPCS Inj, Exagamglogene Autotem 27 23 — — $1,249,952.00 $4,436,520.00 $2,332,000.00 2025-06-28
C9081 HCPCS Idecabtagene Car Pos T 1 1 — — $775,286.34 $775,286.34 $775,286.34 2025-06-28
C9098 HCPCS Ciltacabtagene Car Pos T 1 1 — — $759,115.29 $759,115.29 $759,115.29 2025-06-28
C9076 HCPCS Lisocabtagene Car Pos T 1 1 — — $758,283.64 $758,283.64 $758,283.64 2025-06-28
Q2057 HCPCS Afamitresgene Autoleucel 1 1 — — $717,286.16 $717,286.16 $717,286.16 2025-06-28
Q2042 HCPCS Tisagenlecleucel Car-pos T 30 24 — — $303,174.38 $1,388,705.88 $529,192.86 2025-06-28
Q2056 HCPCS Ciltacabtagene Car-pos T 30 24 — — $295,506.63 $1,383,275.30 $527,123.43 2025-06-28
Q2055 HCPCS Idecabtagene Vicleucel Car 30 24 — — $283,175.46 $1,381,869.15 $526,587.59 2025-06-28
Q2054 HCPCS Lisocabtagene Mara Car Pos T 30 24 — — $276,836.48 $1,368,546.09 $516,726.08 2025-06-28
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 31 24 — — $262,381.19 $1,284,428.46 $489,455.96 2025-06-28
Q2053 HCPCS Brexucabtagene Car Pos T 30 24 — — $261,595.61 $1,208,522.13 $460,530.40 2025-06-28
C9073 HCPCS Brexucabtagene Autoleucel Ca 1 1 — — $413,145.63 $413,145.63 $413,145.63 2025-06-28
5834 APR_DRG — 6 6 — — $323,979.90 $336,939.09 $323,979.90 2025-06-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 29 23 — — $164,440.13 $556,640.93 $270,803.38 2025-06-28
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $258,992.60 $258,992.60 $258,992.60 2025-06-28
5884 APR_DRG — 6 6 — — $198,763.42 $206,713.95 $198,763.42 2025-06-28
5833 APR_DRG — 6 6 — — $184,676.03 $192,063.07 $184,676.03 2025-06-28
0114 APR_DRG — 6 6 — — $181,667.95 $188,934.67 $181,667.95 2025-06-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 23 — — $161,979.23 $433,688.26 $170,504.45 2025-06-28
6314 APR_DRG — 6 6 — — $168,164.44 $174,891.02 $168,164.44 2025-06-28
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 23 — — $146,374.18 $487,521.50 $154,078.08 2025-06-28
1614 APR_DRG — 6 6 — — $150,321.09 $156,333.94 $150,321.09 2025-06-28
6094 APR_DRG — 6 6 — — $138,710.25 $144,258.67 $138,710.25 2025-06-28
0113 APR_DRG — 6 6 — — $135,312.21 $140,724.70 $135,312.21 2025-06-28
5883 APR_DRG — 6 6 — — $131,448.34 $136,706.27 $131,448.34 2025-06-28
6304 APR_DRG — 6 6 — — $124,088.67 $129,052.21 $124,088.67 2025-06-28
8414 APR_DRG — 6 6 — — $122,639.38 $127,544.96 $122,639.38 2025-06-28
5914 APR_DRG — 6 6 — — $119,255.76 $124,025.99 $119,255.76 2025-06-28
5934 APR_DRG — 6 6 — — $114,213.45 $118,781.98 $114,213.45 2025-06-28
0094 APR_DRG — 6 6 — — $112,106.56 $116,590.82 $112,106.56 2025-06-28
651 MS_DRG Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $110,633.80 $110,633.80 $110,633.80 2025-06-28
5882 APR_DRG — 6 6 — — $110,563.26 $114,985.79 $110,563.26 2025-06-28
0112 APR_DRG — 6 6 — — $107,662.02 $111,968.50 $107,662.02 2025-06-28
812000009-62-75667 CDM Hb Double Lung Acquisition Chrg Cadaver Donor 19 13 $231,633.00 — $44,218.74 $185,306.40 $105,161.38 2025-06-28
812000005-62-75666 CDM Hb Lung Acquisition Chg Cadaver Donor 19 13 $231,633.00 — $44,218.74 $185,306.40 $105,161.38 2025-06-28
5832 APR_DRG — 6 6 — — $102,582.84 $106,686.16 $102,582.84 2025-06-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 29 23 — — $96,643.97 $235,208.45 $101,730.49 2025-06-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 18 15 — — $53,599.97 $317,917.16 $99,999.95 2025-06-28
0044 APR_DRG — 6 6 — — $96,411.76 $100,268.24 $96,411.76 2025-06-28
5881 APR_DRG — 6 6 — — $94,830.00 $98,623.20 $94,830.00 2025-06-28
5893 APR_DRG — 6 6 — — $94,240.78 $98,010.41 $94,240.78 2025-06-28
5892 APR_DRG — 6 6 — — $94,240.24 $98,009.85 $94,240.24 2025-06-28
5913 APR_DRG — 6 6 — — $93,259.98 $96,990.38 $93,259.98 2025-06-28
5891 APR_DRG — 6 6 — — $92,961.37 $96,679.82 $92,961.37 2025-06-28
5831 APR_DRG — 6 6 — — $92,126.95 $95,812.02 $92,126.95 2025-06-28
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 1 1 — — $91,128.87 $91,128.87 $91,128.87 2025-06-28
1613 APR_DRG — 6 6 — — $90,616.23 $94,240.88 $90,616.23 2025-06-28
90288 HCPCS Botulism Ig IV 2 2 — — $48,705.00 $129,068.25 $88,886.62 2025-06-28
8424 APR_DRG — 6 6 — — $86,362.93 $89,817.45 $86,362.93 2025-06-28
C9150 HCPCS Xe129 Xenon, Diagnostic 1 1 — — $84,890.31 $84,890.31 $84,890.31 2025-06-28
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 1 1 — — $84,202.72 $84,202.72 $84,202.72 2025-06-28
5933 APR_DRG — 6 6 — — $83,117.66 $86,442.37 $83,117.66 2025-06-28
30237890006 NDC Sipuleucel-t In Lactated Ringers 50 Million Cell/250 Ml IV Suspe 19 13 $187,857.50 — $0.38 $150,286.00 $82,093.73 2025-06-28
1604 APR_DRG — 6 6 — — $82,004.39 $85,284.57 $82,004.39 2025-06-28
0093 APR_DRG — 6 6 — — $80,773.59 $84,004.54 $80,773.59 2025-06-28
1612 APR_DRG — 6 6 — — $79,788.53 $82,980.07 $79,788.53 2025-06-28
5912 APR_DRG — 6 6 — — $79,602.09 $82,786.18 $79,602.09 2025-06-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 29 23 — — $74,603.33 $246,252.96 $78,529.82 2025-06-28
K0606 HCPCS Aed Garment W Elec Analysis 3 3 — — $2,902.60 $108,423.46 $77,907.96 2025-06-28
215 MS_DRG Other Heart Assist System Implant 29 23 — — $72,566.21 $194,501.09 $76,385.48 2025-06-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 22 — — $16,600.96 $150,004.22 $75,529.46 2025-06-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $66,138.79 $212,702.11 $69,619.78 2025-06-28
1611 APR_DRG — 6 6 — — $69,464.58 $72,243.16 $69,464.58 2025-06-28
6303 APR_DRG — 6 6 — — $68,860.93 $71,615.37 $68,860.93 2025-06-28
G0448 HCPCS Place Perm Pacing Cardiovert 2 2 — — $66,579.75 $67,340.62 $66,960.18 2025-06-28
850 MS_DRG Acute Leukemia With Other Procedures 23 22 — — $63,147.46 $167,901.98 $66,471.01 2025-06-28
0043 APR_DRG — 6 6 — — $65,774.86 $68,405.85 $65,774.86 2025-06-28
811000002-62-75662 CDM Hb Liver Acquisition Chg, Living Donor 19 13 $143,248.00 — $27,346.04 $114,598.40 $65,034.59 2025-06-28
812000004-62-75665 CDM Hb Liver Acquisition Charge, Cadaver Donor 19 13 $143,248.00 — $27,346.04 $114,598.40 $65,034.59 2025-06-28
812000003-62-75664 CDM Hb Kidney Acquisition Chg Cadaver Donor 19 13 $143,100.00 — $27,317.79 $114,480.00 $64,967.40 2025-06-28
811000001-62-75661 CDM Hb Kidney Acquisition Charge Living Donor 19 13 $143,100.00 — $27,317.79 $114,480.00 $64,967.40 2025-06-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 31 24 — — $33,983.49 $173,055.87 $63,354.77 2025-06-28
0054 APR_DRG — 6 6 — — $63,212.84 $65,741.35 $63,212.84 2025-06-28
6034 APR_DRG — 6 6 — — $62,224.57 $64,713.55 $62,224.57 2025-06-28
J7330 HCPCS Cultured Chondrocytes Implnt 6 6 — — $52,266.92 $154,331.76 $61,922.75 2025-06-28
812000010-62-75668 CDM Hb Double Kidney Acquistion Chg Cadaver Donor 19 13 $135,000.00 — $25,771.50 $108,000.00 $61,290.00 2025-06-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 29 23 — — $48,431.11 $161,134.27 $61,180.04 2025-06-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $57,985.22 $138,607.20 $61,146.35 2025-06-28
812000001-62-75663 CDM Hb Heart Acquisition Chrg, Cadaver Donor 19 13 $132,684.00 — $25,329.38 $106,147.20 $60,238.54 2025-06-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 23 22 — — $57,213.15 $147,469.25 $60,224.37 2025-06-28
75987015003 NDC Inebilizumab-cdon 10 Mg/ml Intravenous Solution 19 13 $137,145.29 — $0.38 $109,716.23 $59,932.49 2025-06-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 29 23 — — $55,309.51 $190,353.89 $58,220.54 2025-06-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 29 23 — — $53,642.90 $130,667.90 $56,466.21 2025-06-28
0053 APR_DRG — 6 6 — — $55,901.24 $58,137.29 $55,901.24 2025-06-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $53,105.52 $154,423.58 $55,900.55 2025-06-28
A9699 HCPCS Hb Lu Psma (pluvicto) Vipivotide Tetraxetan 200 Mci 21 15 $127,500.00 — $2.10 $127,500.00 $55,717.50 2025-06-28
6024 APR_DRG — 6 6 — — $55,401.23 $57,617.28 $55,401.23 2025-06-28
6134 APR_DRG — 6 6 — — $55,206.78 $57,415.05 $55,206.78 2025-06-28
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 32 24 — — $29,767.56 $167,027.66 $55,015.23 2025-06-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 29 23 — — $51,244.11 $165,286.66 $53,941.17 2025-06-28
5932 APR_DRG — 6 6 — — $53,678.44 $55,825.57 $53,678.44 2025-06-28
3034 APR_DRG — 6 6 — — $53,531.53 $55,672.79 $53,531.53 2025-06-28
0111 APR_DRG — 6 6 — — $53,246.80 $55,376.67 $53,246.80 2025-06-28
00310453530 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 19 13 $119,390.00 — $0.38 $95,512.00 $52,173.43 2025-06-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 22 — — $12,444.79 $100,284.48 $51,349.46 2025-06-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 29 23 — — $48,538.83 $148,099.10 $51,093.51 2025-06-28
8513 APR_DRG — 6 6 — — $50,590.76 $52,614.39 $50,590.76 2025-06-28
8514 APR_DRG — 6 6 — — $50,590.76 $52,614.39 $50,590.76 2025-06-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 29 23 — — $47,786.24 $139,094.50 $50,301.30 2025-06-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 29 23 — — $46,913.08 $195,771.17 $49,382.19 2025-06-28
1603 APR_DRG — 6 6 — — $49,020.75 $50,981.58 $49,020.75 2025-06-28
0092 APR_DRG — 6 6 — — $48,896.28 $50,852.13 $48,896.28 2025-06-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 23 22 — — $46,071.26 $107,630.21 $48,496.06 2025-06-28
L7181 HCPCS Electronic Elbo Simultaneous 18 15 — — $25,926.73 $141,435.54 $48,370.76 2025-06-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 29 23 — — $28,125.24 $113,851.01 $48,311.10 2025-06-28
K0743 HCPCS Portable Home Suction Pump 2 2 — — $40,366.20 $56,177.10 $48,271.65 2025-06-28
1624 APR_DRG — 6 6 — — $48,262.18 $50,192.67 $48,262.18 2025-06-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 29 23 — — $12,335.25 $119,055.74 $48,230.08 2025-06-28
8634 APR_DRG — 6 6 — — $48,132.37 $50,057.67 $48,132.37 2025-06-28
6093 APR_DRG — 6 6 — — $47,737.06 $49,646.55 $47,737.06 2025-06-28
624000014-62-74515 CDM Hb Pascal Clasp Tr Efs Ide G180266 19 13 $105,000.00 — $20,044.50 $84,000.00 $47,670.00 2025-06-28
L7180 HCPCS Electronic Elbow Sequential 19 16 — — $25,181.48 $137,370.10 $46,980.38 2025-06-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 29 23 — — $44,453.68 $142,985.09 $46,793.35 2025-06-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $42,935.88 $142,521.12 $46,726.67 2025-06-28
1634 APR_DRG — 6 6 — — $46,062.35 $47,904.84 $46,062.35 2025-06-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 29 23 — — $43,480.41 $145,947.74 $45,768.85 2025-06-28
00003232822 NDC Ipilimumab 200 Mg/40 Ml (5 Mg/ml) Intravenous Solution 19 13 $104,487.44 — $0.38 $83,589.95 $45,661.01 2025-06-28
8504 APR_DRG — 6 6 — — $45,488.62 $47,308.16 $45,488.62 2025-06-28
J9226 HCPCS Supprelin La Implant 33 25 — — $24,260.32 $123,542.07 $45,350.22 2025-06-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 29 23 — — $30,799.28 $145,981.44 $44,837.56 2025-06-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 23 22 — — $42,541.19 $90,424.51 $44,780.20 2025-06-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 29 23 — — $42,349.13 $134,040.10 $44,578.03 2025-06-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 29 23 — — $42,202.69 $114,947.42 $44,423.88 2025-06-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 29 23 — — $42,011.98 $142,116.77 $44,223.14 2025-06-28
0266T HCPCS Implt/rpl Crtd Sns Dev Total 28 22 — — $178.20 $101,408.36 $44,090.59 2025-06-28
28 MS_DRG Spinal Procedures With Mcc 29 23 — — $36,341.11 $100,795.10 $44,013.80 2025-06-28
6124 APR_DRG — 6 6 — — $43,603.96 $45,348.12 $43,603.96 2025-06-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 29 23 — — $34,339.05 $127,878.91 $43,377.88 2025-06-28
624000003-62-74514 CDM Hb Tendyne Mitral Valve (summit) Ide G140240 19 13 $95,400.00 — $18,211.86 $76,320.00 $43,311.60 2025-06-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $40,926.33 $114,626.02 $43,080.35 2025-06-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 29 23 — — $6,004.53 $157,720.61 $43,048.09 2025-06-28
L8701 HCPCS Ewh S/d Uprt Micro Sensor 1 1 — — $42,798.07 $42,798.07 $42,798.07 2025-06-28
6313 APR_DRG — 6 6 — — $42,712.91 $44,421.43 $42,712.91 2025-06-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 29 23 — — $40,482.95 $107,889.41 $42,613.63 2025-06-28
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 2 2 — — $35,485.23 $49,384.33 $42,434.78 2025-06-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 29 23 — — $40,061.36 $116,588.16 $42,169.85 2025-06-28
72187040101 NDC Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 19 13 $96,497.57 — $0.38 $77,198.06 $42,169.44 2025-06-28
0042 APR_DRG — 6 6 — — $42,044.63 $43,726.41 $42,044.63 2025-06-28
6074 APR_DRG — 6 6 — — $41,632.76 $43,298.07 $41,632.76 2025-06-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $39,496.73 $114,022.08 $41,575.51 2025-06-28
1674 APR_DRG — 6 6 — — $41,355.51 $43,009.73 $41,355.51 2025-06-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 29 23 — — $39,263.12 $116,772.19 $41,329.60 2025-06-28
0914 APR_DRG — 6 6 — — $40,607.63 $42,231.94 $40,607.63 2025-06-28
653 MS_DRG Major Bladder Procedures With Mcc 29 23 — — $29,864.88 $82,281.10 $40,394.00 2025-06-28
834 MS_DRG Acute Leukemia With Mcc 29 23 — — $38,052.15 $191,266.27 $40,054.89 2025-06-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 29 23 — — $38,052.15 $139,135.97 $40,054.89 2025-06-28
C1605 HCPCS Hb Pmkr Dual Leadless Lvl 69 19 13 $91,500.00 — $17,467.35 $73,200.00 $39,985.50 2025-06-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 23 22 — — $9,456.01 $84,377.38 $39,888.57 2025-06-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 23 22 — — $37,665.30 $103,656.67 $39,647.68 2025-06-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 29 23 — — $37,380.60 $97,671.74 $39,348.00 2025-06-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 29 23 — — $37,191.94 $112,705.34 $39,149.41 2025-06-28
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 29 23 — — $37,157.20 $107,249.18 $39,112.84 2025-06-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 29 23 — — $37,153.11 $118,088.93 $39,108.54 2025-06-28
0913 APR_DRG — 6 6 — — $39,031.21 $40,592.45 $39,031.21 2025-06-28
1602 APR_DRG — 6 6 — — $38,927.04 $40,484.12 $38,927.04 2025-06-28
8413 APR_DRG — 6 6 — — $38,838.36 $40,391.89 $38,838.36 2025-06-28
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 15 14 — — $20,776.77 $50,391.42 $38,762.63 2025-06-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 29 23 — — $36,641.62 $102,562.85 $38,570.13 2025-06-28
6804 APR_DRG — 6 6 — — $38,404.05 $39,940.22 $38,404.05 2025-06-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $36,481.57 $115,281.79 $38,401.65 2025-06-28
6023 APR_DRG — 6 6 — — $38,361.32 $39,895.77 $38,361.32 2025-06-28
58468020001 NDC Alemtuzumab 12 Mg/1.2 Ml Intravenous Solution 19 13 $87,524.49 — $0.38 $70,019.59 $38,248.20 2025-06-28
6254 APR_DRG — 6 6 — — $37,948.92 $39,466.87 $37,948.92 2025-06-28
1623 APR_DRG — 6 6 — — $37,823.91 $39,336.87 $37,823.91 2025-06-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 23 22 — — $35,483.09 $88,612.70 $37,350.62 2025-06-28
0204 APR_DRG — 6 6 — — $37,258.20 $38,748.52 $37,258.20 2025-06-28
3033 APR_DRG — 6 6 — — $37,246.44 $38,736.30 $37,246.44 2025-06-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 29 23 — — $2,985.51 $108,192.67 $37,228.03 2025-06-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 29 23 — — $35,105.09 $81,064.80 $36,952.73 2025-06-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 29 23 — — $34,998.84 $93,820.03 $36,840.88 2025-06-28
1764 APR_DRG — 6 6 — — $36,769.94 $38,240.73 $36,769.94 2025-06-28
9114 APR_DRG — 6 6 — — $36,706.37 $38,174.62 $36,706.37 2025-06-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 29 23 — — $32,351.71 $74,344.64 $36,539.06 2025-06-28
2994 APR_DRG — 6 6 — — $36,537.56 $37,999.06 $36,537.56 2025-06-28
79952011001 NDC Loncastuximab Tesirine-lpyl 10 Mg Intravenous Solution 19 13 $83,349.20 — $0.38 $66,679.36 $36,423.60 2025-06-28
1784 APR_DRG — 6 6 — — $36,393.33 $37,849.06 $36,393.33 2025-06-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 29 23 — — $34,509.82 $104,916.38 $36,326.13 2025-06-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 29 23 — — $26,677.45 $102,049.63 $36,298.17 2025-06-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 29 23 — — $34,469.64 $83,477.95 $36,283.83 2025-06-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 29 23 — — $34,347.04 $132,197.18 $36,154.78 2025-06-28
624000019-62-74517 CDM Hb Impella Ecp Pump Set Ide G200126 19 13 $79,500.00 — $15,176.55 $63,600.00 $36,093.00 2025-06-28
624000023-62-74520 CDM Hb Navitor Valve (abbott/envision Trial) Ide G230146 19 13 $79,500.00 — $15,176.55 $63,600.00 $36,093.00 2025-06-28
6033 APR_DRG — 6 6 — — $35,827.61 $37,260.71 $35,827.61 2025-06-28
6904 APR_DRG — 6 6 — — $35,499.08 $36,919.04 $35,499.08 2025-06-28
245 MS_DRG Aicd Generator Procedures 29 23 — — $33,689.79 $94,900.90 $35,462.94 2025-06-28
471 MS_DRG Cervical Spinal Fusion With Mcc 29 23 — — $33,488.87 $71,693.75 $35,251.44 2025-06-28
72694095401 NDC Pegaspargase 750 Unit/ml Injection Solution 19 13 $80,495.45 — $0.38 $64,396.36 $35,176.51 2025-06-28
0091 APR_DRG — 6 6 — — $35,111.78 $36,516.25 $35,111.78 2025-06-28
L5859 HCPCS Knee-shin Pro Flex/ext Cont 2 2 — — $18,450.95 $51,216.05 $34,833.50 2025-06-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 29 23 — — $32,931.74 $70,486.38 $34,664.99 2025-06-28
799 MS_DRG Splenic Procedures With Mcc 29 23 — — $32,790.76 $70,180.85 $34,516.59 2025-06-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 29 23 — — $32,784.62 $114,151.68 $34,510.13 2025-06-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 29 23 — — $3,308.42 $107,319.17 $34,157.40 2025-06-28
1664 APR_DRG — 6 6 — — $34,110.16 $35,474.56 $34,110.16 2025-06-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 29 23 — — $32,277.90 $98,871.84 $33,976.74 2025-06-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 29 23 — — $32,089.92 $116,743.68 $33,778.86 2025-06-28
163 MS_DRG Major Chest Procedures With Mcc 29 23 — — $31,799.09 $75,183.55 $33,472.73 2025-06-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $31,686.03 $102,472.13 $33,353.72 2025-06-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 29 23 — — $31,681.27 $74,260.80 $33,348.70 2025-06-28
1654 APR_DRG — 6 6 — — $33,318.47 $34,651.21 $33,318.47 2025-06-28
1834 APR_DRG — 6 6 — — $32,798.69 $34,110.64 $32,798.69 2025-06-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 29 23 — — $30,103.59 $84,260.74 $32,773.01 2025-06-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 29 23 — — $30,951.14 $83,013.98 $32,580.15 2025-06-28
6114 APR_DRG — 6 6 — — $32,526.25 $33,827.30 $32,526.25 2025-06-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 29 23 — — $30,866.69 $100,287.07 $32,491.25 2025-06-28
0924 APR_DRG — 6 6 — — $32,231.37 $33,520.63 $32,231.37 2025-06-28
901 MS_DRG Wound Debridements For Injuries With Mcc 29 23 — — $30,581.99 $73,192.90 $32,191.57 2025-06-28
1704 APR_DRG — 6 6 — — $32,018.23 $33,298.96 $32,018.23 2025-06-28
6954 APR_DRG — 6 6 — — $31,942.91 $33,220.62 $31,942.91 2025-06-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 29 23 — — $30,325.23 $78,058.08 $31,921.29 2025-06-28
C1824 HCPCS Hb Generator,cardiac Contractility Modulation(implantable) Lvl 5 38 13 $58,500.00 — $11,167.65 $63,600.00 $31,910.62 2025-06-28
9104 APR_DRG — 6 6 — — $31,876.67 $33,151.73 $31,876.67 2025-06-28
9124 APR_DRG — 6 6 — — $31,799.21 $33,071.17 $31,799.21 2025-06-28
5931 APR_DRG — 6 6 — — $31,621.32 $32,886.17 $31,621.32 2025-06-28
L5969 HCPCS Ak/ft Power Asst Incl Motors 2 2 — — $26,351.71 $36,673.32 $31,512.51 2025-06-28
1622 APR_DRG — 6 6 — — $31,490.97 $32,750.61 $31,490.97 2025-06-28
3124 APR_DRG — 6 6 — — $31,455.18 $32,713.39 $31,455.18 2025-06-28
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 29 23 — — $29,876.39 $63,865.04 $31,448.83 2025-06-28
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 27 23 — — $17,185.01 $72,250.57 $31,413.29 2025-06-28
33270 HCPCS Pr Insert/replace Perm Subq Implant Defibr W/subq Electrode 44 28 $60,599.00 — $311.79 $72,250.57 $31,413.29 2025-06-28
0571T HCPCS Hb Insert Implantable Cardioverter-def W Substrnal Electrode W I 41 26 $60,599.00 — $6,527.00 $72,250.57 $31,413.29 2025-06-28
25682002801 NDC Ravulizumab-cwvz 100 Mg/ml Intravenous Solution 19 13 $71,857.88 — $0.38 $57,486.30 $31,401.89 2025-06-28
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $29,815.77 $107,832.38 $31,385.02 2025-06-28
3614 APR_DRG — 6 6 — — $31,323.77 $32,576.72 $31,323.77 2025-06-28
1694 APR_DRG — 6 6 — — $31,298.13 $32,550.05 $31,298.13 2025-06-28
1633 APR_DRG — 6 6 — — $31,263.40 $32,513.94 $31,263.40 2025-06-28
69930 HCPCS Pr Implant Cochlear Device 32 25 — — $659.76 $107,952.31 $31,164.67 2025-06-28
C9755 HCPCS Rf Magnetic-guide Av Fistula 1 1 — — $31,162.99 $31,162.99 $31,162.99 2025-06-28
C9754 HCPCS Perc Av Fistula, Direct 1 1 — — $31,162.99 $31,162.99 $31,162.99 2025-06-28
33264 HCPCS Pr Remv Implant Defibr Pulse Gen W/replace Pulse Gen Multi Lead 44 28 $42,808.00 — $224.39 $72,250.57 $31,099.15 2025-06-28
33249 HCPCS Pr Insert Or Replace Implant Defibr Syst W/leads Sgl Or Dual 44 28 $41,752.00 — $507.24 $72,250.57 $31,099.15 2025-06-28
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 29 23 — — $26,595.70 $74,175.26 $31,010.07 2025-06-28
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 29 23 — — $29,416.66 $106,119.07 $30,964.90 2025-06-28
6022 APR_DRG — 6 6 — — $30,820.55 $32,053.37 $30,820.55 2025-06-28
140 MS_DRG Major Head And Neck Procedures With Mcc 29 23 — — $4,261.62 $86,863.10 $30,748.39 2025-06-28
6302 APR_DRG — 6 6 — — $30,642.13 $31,867.81 $30,642.13 2025-06-28
7404 APR_DRG — 6 6 — — $30,590.85 $31,814.48 $30,590.85 2025-06-28
6123 APR_DRG — 6 6 — — $30,509.11 $31,729.48 $30,509.11 2025-06-28
6092 APR_DRG — 6 6 — — $30,478.13 $31,697.25 $30,478.13 2025-06-28
E0764 HCPCS Functional Neuromuscularstim 3 3 — — $1,284.58 $42,413.15 $30,476.08 2025-06-28
31 MS_DRG Ventricular Shunt Procedures With Mcc 29 23 — — $20,218.39 $102,695.04 $30,471.65 2025-06-28
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 29 23 — — $24,278.91 $71,365.54 $30,464.48 2025-06-28
A9543 HCPCS Y90 Ibritumomab, Rx 32 24 — — $14,774.74 $165,001.00 $30,457.96 2025-06-28
793 MS_DRG Full Term Neonate With Major Problems 29 23 — — $5,208.49 $61,556.58 $30,327.55 2025-06-28
1794 APR_DRG — 6 6 — — $30,326.95 $31,540.03 $30,326.95 2025-06-28
33231 HCPCS Pr Insert Implant Defibr Pulse Gen W/exist Multi Leads 42 27 $38,674.00 — $222.64 $72,250.57 $30,313.83 2025-06-28
0894 APR_DRG — 6 6 — — $30,269.79 $31,480.58 $30,269.79 2025-06-28
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 29 23 — — $5,607.23 $76,987.58 $30,257.29 2025-06-28
E0469 HCPCS Lung Expans High Oscil Neb 3 3 — — $1,500.18 $42,092.94 $30,245.99 2025-06-28
4414 APR_DRG — 6 6 — — $30,197.67 $31,405.58 $30,197.67 2025-06-28
2614 APR_DRG — 6 6 — — $30,089.23 $31,292.80 $30,089.23 2025-06-28
1653 APR_DRG — 6 6 — — $29,956.22 $31,154.46 $29,956.22 2025-06-28
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 29 23 — — $28,413.42 $85,328.64 $29,908.86 2025-06-28
3044 APR_DRG — 6 6 — — $29,906.00 $31,102.24 $29,906.00 2025-06-28
K0871 HCPCS Pwc Gp 4 Vhd Seat/back 2 2 — — $24,997.21 $34,788.28 $29,892.74 2025-06-28
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 29 23 — — $28,397.75 $78,555.74 $29,892.37 2025-06-28
61886 HCPCS Pr Surg Incranial Infratentorial Cmplx 32 25 — — $519.44 $82,858.34 $29,857.41 2025-06-28
63685 HCPCS Pr Implant Spinal Neurostim/receiver 32 25 — — $190.59 $82,528.40 $29,857.41 2025-06-28
0268T HCPCS Implt/rpl Crtd Sns Dev Gen 28 22 — — $2,777.11 $68,672.04 $29,857.41 2025-06-28
64568 HCPCS Pr Open Implant Cranial Neuroelec Array+pulse Gen 31 24 — — $340.46 $84,213.28 $29,857.41 2025-06-28
64582 HCPCS Pr Open Implt Hypogloss Nstim Pulse Generator 32 24 — — $460.90 $68,672.04 $29,857.41 2025-06-28
0674T HCPCS Laps Insj Nw/rpcmt Prm Isdss 26 23 — — $16,333.84 $68,672.04 $29,857.41 2025-06-28
12 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Cc 29 23 — — $28,356.21 $107,145.50 $29,848.64 2025-06-28
0408T HCPCS Hb Ins/replace Perm Card Contractility Modulation Syst 41 26 $33,723.00 — $2.24 $72,250.57 $29,842.63 2025-06-28
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 23 22 — — $28,218.63 $67,951.87 $29,703.82 2025-06-28
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 2 2 — — $24,838.82 $34,567.86 $29,703.34 2025-06-28
K0879 HCPCS Pwc Gp4 Hd Sing Pow Opt S/b 2 2 — — $24,838.82 $34,567.86 $29,703.34 2025-06-28
0504 APR_DRG — 6 6 — — $29,643.17 $30,828.90 $29,643.17 2025-06-28
00008010001 NDC Inotuzumab Ozogamicin 0.9 Mg(0.25 Mg/ml Initial Concentration) I 19 13 $67,757.06 — $0.38 $54,205.65 $29,609.84 2025-06-28
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 29 23 — — $28,108.97 $84,517.34 $29,588.39 2025-06-28
791 MS_DRG Prematurity With Major Problems 29 23 — — $2,370.75 $59,924.12 $29,534.62 2025-06-28
6234 APR_DRG — 6 6 — — $29,501.08 $30,681.12 $29,501.08 2025-06-28
1783 APR_DRG — 6 6 — — $29,449.79 $30,627.79 $29,449.79 2025-06-28
0041 APR_DRG — 6 6 — — $29,424.69 $30,601.67 $29,424.69 2025-06-28
272005610-62-69130 CDM Hb Protek Duo Kit 19 13 $64,500.00 — $12,313.05 $51,600.00 $29,283.00 2025-06-28
6514 APR_DRG — 6 6 — — $29,201.39 $30,369.45 $29,201.39 2025-06-28
0912 APR_DRG — 6 6 — — $29,076.39 $30,239.44 $29,076.39 2025-06-28
1204 APR_DRG — 6 6 — — $29,040.06 $30,201.67 $29,040.06 2025-06-28
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 29 23 — — $25,187.15 $71,476.99 $28,988.32 2025-06-28
L5856 HCPCS Elec Knee-shin Swing/stance 19 16 — — $15,533.38 $84,737.70 $28,980.18 2025-06-28
739 MS_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy With Mc… 29 23 — — $27,519.83 $65,186.21 $28,968.24 2025-06-28
6814 APR_DRG — 6 6 — — $28,949.78 $30,107.77 $28,949.78 2025-06-28
0214 APR_DRG — 6 6 — — $28,938.57 $30,096.11 $28,938.57 2025-06-28
L6880 HCPCS Elec Hand Ind Art Digits 18 15 — — $780.58 $84,337.60 $28,843.34 2025-06-28
628 MS_DRG Other Endocrine, Nutritional And Metabolic O.r. Procedures With Mcc 29 23 — — $27,280.09 $58,238.53 $28,715.88 2025-06-28
6224 APR_DRG — 6 6 — — $28,689.09 $29,836.66 $28,689.09 2025-06-28
2993 APR_DRG — 6 6 — — $28,666.66 $29,813.32 $28,666.66 2025-06-28
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 29 23 — — $27,224.92 $77,899.97 $28,657.81 2025-06-28
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 29 23 — — $27,170.44 $58,000.90 $28,600.46 2025-06-28
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 23 22 — — $10,083.85 $64,597.82 $28,475.71 2025-06-28
273 MS_DRG Percutaneous And Other Intracardiac Procedures With Mcc 29 23 — — $27,038.99 $72,003.17 $28,462.09 2025-06-28
6073 APR_DRG — 6 6 — — $28,310.88 $29,443.32 $28,310.88 2025-06-28
34 MS_DRG Carotid Artery Stent Procedures With Mcc 29 23 — — $26,891.87 $69,203.81 $28,307.23 2025-06-28
7924 APR_DRG — 6 6 — — $28,232.35 $29,361.65 $28,232.35 2025-06-28
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