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

HENRY FORD HEALTH WEST BLOOMFIELD HOSPITAL

W Bloomfield, MI · CCN 230302 · Rates published

37,762 distinct procedures filed
46 distinct payers
1,703,165 rate rows
2025-06-28 last MRF observed · ⚠ 13 mo old
Data quality

757,564 of 1,703,165 rate rows are consumer-grade (44.5%)

945,601 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 533,963
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 407,826
template filing: same amount across many unrelated codes — excluded 1,972
percent-of-charges filed in the dollar field — excluded from medians 705
exceeds 10× this hospital's gross charge — excluded from medians 660
placeholder amount (≤ $0.02) — excluded from medians 420
per-diem day rate — not a per-procedure price 55

⚠ Possibly outdated The most recent machine-readable file we have for this hospital is 13 months old.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-2026/381357020-1407867559_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 2d24df7dfe4644b4… · 823,411,512 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 24 $1,968,674.40 $4,958,415.00 $3,672,900.00 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 23 $1,932,280.00 $4,866,750.00 $3,605,000.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 23 $1,780,474.89 $4,489,363.93 $3,325,454.76 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 23 $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 23 $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 24 $1,280,297.23 $4,674,653.35 $2,388,614.23 nat. median
$2,468,984
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 24 $1,249,952.00 $4,472,380.00 $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 25 $283,647.37 $1,388,705.88 $529,192.86 nat. median
$753,246
0.7× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 25 $282,538.16 $1,383,275.30 $527,123.43 nat. median
$674,867
0.8× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 25 $282,250.95 $1,381,869.15 $526,587.59 nat. median
$625,184
0.8× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 25 $276,836.48 $1,368,546.09 $516,726.08 nat. median
$673,137
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 25 $262,348.39 $1,284,428.46 $489,455.96 nat. median
$634,303
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 25 $246,844.29 $1,208,522.13 $460,530.40 nat. median
$619,808
0.7× median
583-4.1
APR_DRG 		Neonate With Ecmo 3 $430,062.93 $430,062.93 $430,062.93 —
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 		7 $300,422.89 $334,333.30 $321,474.32 nat. median
$309,665
1.0× median
583-3.1
APR_DRG 		Neonate With Ecmo 3 $278,563.65 $278,563.65 $278,563.65 —
631-4.1
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 $267,434.94 $267,434.94 $267,434.94 —
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 23 $164,440.13 $641,645.57 $266,543.42 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
588-4.1
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $204,154.13 $204,154.13 $204,154.13 —
630-4.1
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 $201,698.04 $201,698.04 $201,698.04 —
5884
APR_DRG 		7 $196,443.18 $205,253.90 $197,359.52 nat. median
$246,434
0.8× median
5833
APR_DRG 		7 $183,396.07 $194,887.45 $183,396.07 nat. median
$244,017
0.8× median
0114
APR_DRG 		7 $149,730.02 $187,631.04 $180,414.46 nat. median
$197,700
0.9× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 23 $159,356.16 $467,637.08 $167,743.33 nat. median
$206,474
0.8× median
6314
APR_DRG 		7 $160,186.81 $173,710.95 $167,029.76 nat. median
$122,924
1.4× median
591-4.1
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $162,971.17 $162,971.17 $162,971.17 —
588-2.1
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $155,919.39 $155,919.39 $155,919.39 —
583-2.1
APR_DRG 		Neonate With Ecmo 3 $154,438.37 $154,438.37 $154,438.37 —
812000009-36-66326
CDM 		Hb Double Lung Acquisition Chrg Cadaver Donor 14 $80,044.80 $216,894.73 $153,952.83 nat. median
$153,953
1.0× median
812000005-36-66324
CDM 		Hb Lung Acquisition Chg Cadaver Donor 14 $80,044.80 $216,894.73 $153,952.83 nat. median
$153,953
1.0× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 23 $143,984.31 $525,684.36 $151,562.43 nat. median
$202,976
0.7× median
603-4.1
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 $150,041.75 $150,041.75 $150,041.75 —
1614
APR_DRG 		7 $149,343.40 $161,768.16 $149,343.40 nat. median
$207,730
0.7× median
609-4.1
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 $148,954.60 $148,954.60 $148,954.60 —
6094
APR_DRG 		7 $129,536.95 $143,348.11 $137,834.72 nat. median
$162,982
0.8× median
588-3.1
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $136,464.42 $136,464.42 $136,464.42 —
0113
APR_DRG 		7 $87,672.99 $139,845.23 $134,466.57 nat. median
$128,705
1.0× median
588-1.1
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 3 $133,641.68 $133,641.68 $133,641.68 —
5883
APR_DRG 		7 $127,020.02 $135,862.17 $130,636.69 nat. median
$182,665
0.7× median
591-3.1
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 3 $125,298.35 $125,298.35 $125,298.35 —
6304
APR_DRG 		7 $123,341.77 $147,220.57 $123,341.77 nat. median
$150,721
0.8× median
593-4.1
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 3 $122,397.69 $122,397.69 $122,397.69 —
8414
APR_DRG 		7 $121,905.24 $140,669.93 $121,905.24 nat. median
$160,267
0.8× median
5914
APR_DRG 		7 $114,365.46 $123,293.45 $118,551.39 nat. median
$164,289
0.7× median

Other procedures at this hospital

Browse this hospital's 37,762 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 27 24 — — $1,968,674.40 $4,958,415.00 $3,672,900.00 2025-06-28
J1414 HCPCS Inj, Beqvez, Per Tx Dose 26 23 — — $1,932,280.00 $4,866,750.00 $3,605,000.00 2025-06-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 27 23 — — $1,780,474.89 $4,489,363.93 $3,325,454.76 2025-06-28
J3394 HCPCS Inj, Lovotibeglogene Autotem 27 23 — — $1,711,448.00 $4,436,100.00 $3,286,000.00 2025-06-28
J3393 HCPCS Inj, Betibeglogene Autotemce 28 23 — — $1,590,848.00 $4,571,016.80 $2,968,000.00 2025-06-28
J3399 HCPCS Inj Onase Abepar-xioi Treat 29 24 — — $1,280,297.23 $4,674,653.35 $2,388,614.23 2025-06-28
J3392 HCPCS Inj, Exagamglogene Autotem 29 24 — — $1,249,952.00 $4,472,380.00 $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 31 25 — — $283,647.37 $1,388,705.88 $529,192.86 2025-06-28
Q2056 HCPCS Ciltacabtagene Car-pos T 31 25 — — $282,538.16 $1,383,275.30 $527,123.43 2025-06-28
Q2055 HCPCS Idecabtagene Vicleucel Car 31 25 — — $282,250.95 $1,381,869.15 $526,587.59 2025-06-28
Q2054 HCPCS Lisocabtagene Mara Car Pos T 31 25 — — $276,836.48 $1,368,546.09 $516,726.08 2025-06-28
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 32 25 — — $262,348.39 $1,284,428.46 $489,455.96 2025-06-28
Q2053 HCPCS Brexucabtagene Car Pos T 31 25 — — $246,844.29 $1,208,522.13 $460,530.40 2025-06-28
583-4.1 APR_DRG Neonate With Ecmo 3 3 — — $430,062.93 $430,062.93 $430,062.93 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 — 7 7 — — $300,422.89 $334,333.30 $321,474.32 2025-06-28
583-3.1 APR_DRG Neonate With Ecmo 3 3 — — $278,563.65 $278,563.65 $278,563.65 2025-06-28
631-4.1 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $267,434.94 $267,434.94 $267,434.94 2025-06-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 29 23 — — $164,440.13 $641,645.57 $266,543.42 2025-06-28
C9301 HCPCS Obecabtagene Car Pos T 1 1 — — $258,992.60 $258,992.60 $258,992.60 2025-06-28
588-4.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $204,154.13 $204,154.13 $204,154.13 2025-06-28
630-4.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $201,698.04 $201,698.04 $201,698.04 2025-06-28
5884 APR_DRG — 7 7 — — $196,443.18 $205,253.90 $197,359.52 2025-06-28
5833 APR_DRG — 7 7 — — $183,396.07 $194,887.45 $183,396.07 2025-06-28
0114 APR_DRG — 7 7 — — $149,730.02 $187,631.04 $180,414.46 2025-06-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 29 23 — — $159,356.16 $467,637.08 $167,743.33 2025-06-28
6314 APR_DRG — 7 7 — — $160,186.81 $173,710.95 $167,029.76 2025-06-28
591-4.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $162,971.17 $162,971.17 $162,971.17 2025-06-28
588-2.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $155,919.39 $155,919.39 $155,919.39 2025-06-28
583-2.1 APR_DRG Neonate With Ecmo 3 3 — — $154,438.37 $154,438.37 $154,438.37 2025-06-28
812000009-36-66326 CDM Hb Double Lung Acquisition Chrg Cadaver Donor 16 14 $266,816.00 — $80,044.80 $216,894.73 $153,952.83 2025-06-28
812000005-36-66324 CDM Hb Lung Acquisition Chg Cadaver Donor 16 14 $266,816.00 — $80,044.80 $216,894.73 $153,952.83 2025-06-28
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 29 23 — — $143,984.31 $525,684.36 $151,562.43 2025-06-28
603-4.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $150,041.75 $150,041.75 $150,041.75 2025-06-28
1614 APR_DRG — 7 7 — — $149,343.40 $161,768.16 $149,343.40 2025-06-28
609-4.1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $148,954.60 $148,954.60 $148,954.60 2025-06-28
6094 APR_DRG — 7 7 — — $129,536.95 $143,348.11 $137,834.72 2025-06-28
588-3.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $136,464.42 $136,464.42 $136,464.42 2025-06-28
0113 APR_DRG — 7 7 — — $87,672.99 $139,845.23 $134,466.57 2025-06-28
588-1.1 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 3 3 — — $133,641.68 $133,641.68 $133,641.68 2025-06-28
5883 APR_DRG — 7 7 — — $127,020.02 $135,862.17 $130,636.69 2025-06-28
591-3.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $125,298.35 $125,298.35 $125,298.35 2025-06-28
6304 APR_DRG — 7 7 — — $123,341.77 $147,220.57 $123,341.77 2025-06-28
593-4.1 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $122,397.69 $122,397.69 $122,397.69 2025-06-28
8414 APR_DRG — 7 7 — — $121,905.24 $140,669.93 $121,905.24 2025-06-28
5914 APR_DRG — 7 7 — — $114,365.46 $123,293.45 $118,551.39 2025-06-28
5934 APR_DRG — 7 7 — — $113,553.43 $118,095.58 $113,553.43 2025-06-28
360000073-36-63203 CDM Hb Ivad Pump 16 14 $197,168.00 — $59,150.40 $160,277.87 $112,720.95 2025-06-28
583-1.1 APR_DRG Neonate With Ecmo 3 3 — — $112,257.39 $112,257.39 $112,257.39 2025-06-28
651 MS_DRG Neonate, Birth Weight 2000-2499 Grams, With Significant O.r. Procedures, With Mu… 1 1 — — $112,242.24 $112,242.24 $112,242.24 2025-06-28
0094 APR_DRG — 7 7 — — $97,525.09 $115,923.70 $111,465.09 2025-06-28
5882 APR_DRG — 7 7 — — $109,453.29 $114,332.78 $109,935.36 2025-06-28
589-1.1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $109,780.49 $109,780.49 $109,780.49 2025-06-28
589-2.1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $108,015.01 $108,015.01 $108,015.01 2025-06-28
0112 APR_DRG — 7 7 — — $75,397.89 $111,342.04 $107,059.65 2025-06-28
589-3.1 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 3 3 — — $105,713.16 $105,713.16 $105,713.16 2025-06-28
5832 APR_DRG — 7 7 — — $102,025.16 $108,423.25 $102,025.16 2025-06-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 20 16 — — $53,599.97 $317,917.16 $99,999.95 2025-06-28
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 29 23 — — $94,997.26 $253,620.41 $99,997.12 2025-06-28
630-3.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $98,240.29 $98,240.29 $98,240.29 2025-06-28
811000002-36-66319 CDM Hb Liver Acquisition Chg, Living Donor 16 14 $169,951.00 — $50,985.30 $138,153.17 $98,061.73 2025-06-28
812000004-36-66323 CDM Hb Liver Acquisition Charge, Cadaver Donor 16 14 $169,951.00 — $50,985.30 $138,153.17 $98,061.73 2025-06-28
0044 APR_DRG — 7 7 — — $95,908.38 $99,744.72 $95,908.38 2025-06-28
591-2.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $94,477.71 $94,477.71 $94,477.71 2025-06-28
5881 APR_DRG — 7 7 — — $93,935.96 $98,114.15 $94,340.53 2025-06-28
5893 APR_DRG — 7 7 — — $74,479.93 $97,506.75 $93,756.49 2025-06-28
5892 APR_DRG — 7 7 — — $76,083.16 $97,506.20 $93,755.96 2025-06-28
5913 APR_DRG — 7 7 — — $88,123.43 $96,495.70 $92,784.33 2025-06-28
5891 APR_DRG — 7 7 — — $77,313.34 $96,187.87 $92,488.34 2025-06-28
5831 APR_DRG — 7 7 — — $79,039.86 $95,327.71 $91,661.26 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
593-3.1 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $90,325.52 $90,325.52 $90,325.52 2025-06-28
1613 APR_DRG — 7 7 — — $84,507.08 $93,770.39 $90,163.83 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 — 7 7 — — $85,947.95 $90,779.12 $85,947.95 2025-06-28
812000003-36-66322 CDM Hb Kidney Acquisition Chg Cadaver Donor 16 14 $148,400.00 — $44,520.00 $120,634.36 $85,626.80 2025-06-28
811000001-36-66318 CDM Hb Kidney Acquisition Charge Living Donor 16 14 $148,400.00 — $44,520.00 $120,634.36 $85,626.80 2025-06-28
602-4.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $85,324.22 $85,324.22 $85,324.22 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 — 7 7 — — $79,828.13 $86,040.49 $82,731.24 2025-06-28
812000001-36-66320 CDM Hb Heart Acquisition Chrg, Cadaver Donor 16 14 $141,482.00 — $42,444.60 $115,010.72 $81,635.11 2025-06-28
1604 APR_DRG — 7 7 — — $81,627.76 $89,847.82 $81,627.76 2025-06-28
812000010-36-66327 CDM Hb Double Kidney Acquistion Chg Cadaver Donor 16 14 $140,000.00 — $42,000.00 $113,806.00 $80,780.00 2025-06-28
0093 APR_DRG — 7 7 — — $45,443.44 $83,624.11 $80,407.79 2025-06-28
1612 APR_DRG — 7 7 — — $79,431.40 $82,608.66 $79,431.40 2025-06-28
593-2.1 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 3 3 — — $79,294.48 $79,294.48 $79,294.48 2025-06-28
5912 APR_DRG — 7 7 — — $66,654.28 $82,416.47 $79,246.60 2025-06-28
K0606 HCPCS Aed Garment W Elec Analysis 3 3 — — $2,902.60 $108,423.46 $78,580.77 2025-06-28
819000003-36-66331 CDM Hb Matched Unrelated Donor Procurement 16 14 $134,395.00 — $40,318.50 $109,249.70 $77,545.92 2025-06-28
609-3.1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $77,237.06 $77,237.06 $77,237.06 2025-06-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 29 23 — — $73,286.00 $265,529.47 $77,143.16 2025-06-28
613-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $76,506.43 $76,506.43 $76,506.43 2025-06-28
603-3.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 3 3 — — $76,117.36 $76,117.36 $76,117.36 2025-06-28
215 MS_DRG Other Heart Assist System Implant 29 23 — — $71,279.31 $209,726.50 $75,030.85 2025-06-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 22 — — $16,842.31 $178,228.45 $74,187.63 2025-06-28
1611 APR_DRG — 7 7 — — $67,405.73 $71,966.21 $69,198.28 2025-06-28
611-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $68,610.34 $68,610.34 $68,610.34 2025-06-28
6303 APR_DRG — 7 7 — — $68,599.94 $71,343.95 $68,599.94 2025-06-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $64,947.95 $229,352.29 $68,366.26 2025-06-28
G0448 HCPCS Place Perm Pacing Cardiovert 2 2 — — $66,579.75 $67,950.82 $67,265.29 2025-06-28
624000016-36-64900 CDM Hb Edwards Tricuspid Valve Ide G190289 16 14 $114,000.00 — $34,200.00 $92,670.60 $65,778.00 2025-06-28
00310453530 NDC Tremelimumab-actl 20 Mg/ml Intravenous Solution 15 13 $119,390.00 — $2.10 $102,914.18 $65,580.93 2025-06-28
0043 APR_DRG — 7 7 — — $60,257.89 $68,162.67 $65,541.02 2025-06-28
607-4.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $65,501.53 $65,501.53 $65,501.53 2025-06-28
850 MS_DRG Acute Leukemia With Other Procedures 24 22 — — $62,001.32 $181,045.24 $65,264.55 2025-06-28
633-4.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 3 3 — — $64,785.31 $64,785.31 $64,785.31 2025-06-28
602-3.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $64,456.02 $64,456.02 $64,456.02 2025-06-28
812000006-36-66325 CDM Hb Pancreas Acquisition Chrg Cadaver Donor 16 14 $111,035.00 — $33,310.50 $90,260.35 $64,067.20 2025-06-28
602-2.1 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $63,807.04 $63,807.04 $63,807.04 2025-06-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 32 25 — — $33,958.16 $173,055.87 $63,354.77 2025-06-28
0054 APR_DRG — 7 7 — — $58,720.83 $65,521.61 $63,001.54 2025-06-28
6034 APR_DRG — 7 7 — — $62,021.97 $105,359.27 $62,021.97 2025-06-28
J7330 HCPCS Cultured Chondrocytes Implnt 6 6 — — $52,266.92 $154,331.76 $61,922.75 2025-06-28
612-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $61,639.68 $61,639.68 $61,639.68 2025-06-28
278000001-SUP-53193 CDM Device Ventricular Assist Impella 5.5 Smartassist Catheter 16 14 $105,000.00 — $31,500.00 $85,354.50 $60,585.00 2025-06-28
624000014-36-64899 CDM Hb Pascal Clasp Tr Efs Ide G180266 16 14 $105,000.00 — $31,500.00 $85,354.50 $60,585.00 2025-06-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 29 23 — — $49,135.22 $173,747.75 $60,052.65 2025-06-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $57,018.48 $149,457.28 $60,019.45 2025-06-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 24 22 — — $56,155.70 $159,013.04 $59,111.26 2025-06-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 29 23 — — $54,280.50 $205,254.66 $57,137.37 2025-06-28
630-2.1 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 3 3 — — $55,830.89 $55,830.89 $55,830.89 2025-06-28
0053 APR_DRG — 7 7 — — $50,272.36 $57,984.45 $55,754.27 2025-06-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 29 23 — — $52,638.79 $140,896.50 $55,409.25 2025-06-28
6024 APR_DRG — 7 7 — — $55,258.66 $57,469.01 $55,258.66 2025-06-28
6134 APR_DRG — 7 7 — — $54,135.28 $57,268.57 $55,065.92 2025-06-28
624000003-36-64895 CDM Hb Tendyne Mitral Valve (summit) Ide G140240 16 14 $95,400.00 — $28,620.00 $77,550.66 $55,045.80 2025-06-28
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 33 25 — — $29,488.16 $167,027.66 $55,015.23 2025-06-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $52,109.45 $166,511.76 $54,852.05 2025-06-28
812000002-36-66321 CDM Hb Intestine Acquisition Chg Cadaver Donor 16 14 $94,976.00 — $28,492.80 $77,205.99 $54,801.15 2025-06-28
581-4.1 APR_DRG Neonate, Transferred < 5 Days Old, Born Here 3 3 — — $53,975.75 $53,975.75 $53,975.75 2025-06-28
5932 APR_DRG — 7 7 — — $52,633.45 $55,693.07 $53,551.02 2025-06-28
3034 APR_DRG — 7 7 — — $53,405.41 $63,059.28 $53,405.41 2025-06-28
0111 APR_DRG — 7 7 — — $34,838.29 $55,248.12 $53,123.19 2025-06-28
625-4.1 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 3 3 — — $53,121.30 $53,121.30 $53,121.30 2025-06-28
72187040101 NDC Tagraxofusp-erzs 1 000 Mcg/ml Intravenous Solution 15 13 $96,497.57 — $2.10 $83,180.91 $53,006.12 2025-06-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 29 23 — — $50,275.85 $178,225.18 $52,921.95 2025-06-28
591-1.1 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 3 3 — — $52,566.78 $52,566.78 $52,566.78 2025-06-28
624000012-36-64897 CDM Hb Mitraclip (pascal/clasp) Ide G170166 16 14 $90,000.00 — $27,000.00 $73,161.00 $51,930.00 2025-06-28
631-3.1 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 3 3 — — $51,586.37 $51,586.37 $51,586.37 2025-06-28
819000004-36-66332 CDM Hb Unrelated Donor Allogeneic Procurement 16 14 $88,771.00 — $26,631.30 $72,161.95 $51,220.87 2025-06-28
819000002-36-66330 CDM Hb Allogeneic Bone Mrr Acq Chg,complex 16 14 $87,649.00 — $26,294.70 $71,249.87 $50,573.47 2025-06-28
8514 APR_DRG — 7 7 — — $50,490.51 $58,591.14 $50,490.51 2025-06-28
8513 APR_DRG — 7 7 — — $17,655.82 $52,510.14 $50,490.51 2025-06-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 22 — — $12,625.72 $120,845.33 $50,368.97 2025-06-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 29 23 — — $47,611.01 $159,692.20 $50,116.85 2025-06-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 29 23 — — $46,869.65 $149,982.72 $49,336.47 2025-06-28
624000013-36-64898 CDM Hb Acurate Valve Ide G190051 (boston Scientific) 16 14 $85,500.00 — $25,650.00 $69,502.95 $49,333.50 2025-06-28
1603 APR_DRG — 7 7 — — $47,164.63 $50,891.69 $48,934.31 2025-06-28
C1605 HCPCS Hb Pmkr Dual Leadless Lvl 69 16 14 $91,500.00 — $27,450.00 $78,873.00 $48,920.47 2025-06-28
0092 APR_DRG — 7 7 — — $33,180.09 $50,763.38 $48,810.94 2025-06-28
K0743 HCPCS Portable Home Suction Pump 2 2 — — $40,714.80 $56,177.10 $48,445.95 2025-06-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 29 23 — — $46,009.55 $211,096.00 $48,431.10 2025-06-28
L7181 HCPCS Electronic Elbo Simultaneous 20 16 — — $25,926.73 $141,435.54 $48,370.76 2025-06-28
1624 APR_DRG — 7 7 — — $48,182.42 $53,852.95 $48,182.42 2025-06-28
274000170-36-52434 CDM Hb Go Gear Heart Mate Ii Support Kit- Pocket Controller With Eq 16 14 $89,955.00 — $26,986.50 $77,541.21 $48,094.44 2025-06-28
8634 APR_DRG — 7 7 — — $48,053.76 $49,975.91 $48,053.76 2025-06-28
613-3.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 3 3 — — $47,803.51 $47,803.51 $47,803.51 2025-06-28
6093 APR_DRG — 7 7 — — $47,661.93 $49,568.41 $47,661.93 2025-06-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 24 22 — — $45,180.30 $116,055.43 $47,558.21 2025-06-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 29 23 — — $28,534.14 $122,763.19 $47,376.01 2025-06-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 29 23 — — $12,514.58 $128,375.35 $47,296.21 2025-06-28
L7180 HCPCS Electronic Elbow Sequential 21 17 — — $25,181.48 $137,370.10 $46,980.38 2025-06-28
1634 APR_DRG — 7 7 — — $46,001.94 $48,984.54 $46,001.94 2025-06-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 29 23 — — $43,586.89 $154,177.86 $45,880.94 2025-06-28
624000019-36-64902 CDM Hb Impella Ecp Pump Set Ide G200126 16 14 $79,500.00 — $23,850.00 $64,625.55 $45,871.50 2025-06-28
624000023-36-64905 CDM Hb Navitor Valve (abbott/envision Trial) Ide G230146 16 14 $79,500.00 — $23,850.00 $64,625.55 $45,871.50 2025-06-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $43,524.50 $153,677.58 $45,815.26 2025-06-28
607-3.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $45,662.84 $45,662.84 $45,662.84 2025-06-28
8504 APR_DRG — 7 7 — — $45,433.26 $58,729.37 $45,433.26 2025-06-28
J9226 HCPCS Supprelin La Implant 34 26 — — $24,260.32 $123,542.07 $45,350.22 2025-06-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 29 23 — — $42,628.17 $157,372.43 $44,871.76 2025-06-28
0266T HCPCS Implt/rpl Crtd Sns Dev Total 29 23 — — $178.20 $101,408.36 $44,090.59 2025-06-28
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 29 23 — — $31,247.05 $157,408.77 $43,954.38 2025-06-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 24 22 — — $41,702.99 $105,255.40 $43,897.88 2025-06-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 29 23 — — $41,513.79 $144,532.66 $43,698.73 2025-06-28
6124 APR_DRG — 7 7 — — $43,565.18 $47,185.44 $43,565.18 2025-06-28
461 MS_DRG Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc 29 23 — — $41,369.55 $123,945.43 $43,546.89 2025-06-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 29 23 — — $41,181.69 $153,241.57 $43,349.15 2025-06-28
28 MS_DRG Spinal Procedures With Mcc 29 23 — — $36,869.45 $108,685.28 $43,142.93 2025-06-28
623-4.1 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 3 3 — — $43,028.50 $43,028.50 $43,028.50 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 — 7 7 — — $41,871.39 $44,389.26 $42,681.98 2025-06-28
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 2 2 — — $35,791.68 $49,384.33 $42,588.01 2025-06-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 29 23 — — $34,838.29 $137,889.19 $42,516.51 2025-06-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 29 23 — — $40,112.26 $123,598.86 $42,223.43 2025-06-28
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome, Neonate 29 23 — — $6,091.83 $170,066.87 $42,191.65 2025-06-28
0042 APR_DRG — 7 7 — — $37,376.57 $43,700.36 $42,019.57 2025-06-28
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 29 23 — — $39,675.50 $116,334.92 $41,763.68 2025-06-28
6074 APR_DRG — 7 7 — — $41,407.60 $43,275.79 $41,611.33 2025-06-28
1674 APR_DRG — 7 7 — — $41,336.52 $50,224.33 $41,336.52 2025-06-28
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 29 23 — — $39,260.20 $125,714.60 $41,326.53 2025-06-28
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 29 23 — — $38,704.03 $122,947.65 $40,741.08 2025-06-28
0914 APR_DRG — 7 7 — — $39,298.42 $42,219.03 $40,595.22 2025-06-28
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 29 23 — — $38,473.91 $125,913.04 $40,498.85 2025-06-28
278000001-SUP-53654 CDM Implant: Graft Xenograft; Cryoartery Aortoiliac 8-15mm X 4-5mm X 16 14 $70,185.00 — $21,055.50 $57,053.39 $40,496.75 2025-06-28
614-4.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 3 3 — — $40,376.01 $40,376.01 $40,376.01 2025-06-28
608-4.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 3 3 — — $40,282.61 $40,282.61 $40,282.61 2025-06-28
653 MS_DRG Major Bladder Procedures With Mcc 29 23 — — $30,299.07 $94,846.24 $39,577.23 2025-06-28
834 MS_DRG Acute Leukemia With Mcc 29 23 — — $37,281.03 $206,238.47 $39,243.19 2025-06-28
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 29 23 — — $37,281.03 $150,027.44 $39,243.19 2025-06-28
A9543 HCPCS Hb Y90 Ibritumomab Therapeutic Up To 40mci 42 30 $87,500.00 — $2.10 $130,696.47 $39,197.87 2025-06-28
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 24 22 — — $9,593.49 $93,646.75 $39,079.34 2025-06-28
0913 APR_DRG — 7 7 — — $39,032.66 $40,593.98 $39,032.66 2025-06-28
1602 APR_DRG — 7 7 — — $31,479.72 $40,486.59 $38,929.41 2025-06-28
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 24 22 — — $36,899.95 $111,770.85 $38,842.05 2025-06-28
8413 APR_DRG — 7 7 — — $38,841.51 $44,077.71 $38,841.51 2025-06-28
L2006 HCPCS Kaf Sng/dbl Swg/stn Mcpr Cus 17 15 — — $20,776.77 $52,329.55 $38,762.63 2025-06-28
405 MS_DRG Pancreas, Liver And Shunt Procedures With Mcc 29 23 — — $36,619.51 $105,317.42 $38,546.85 2025-06-28
6804 APR_DRG — 7 7 — — $38,411.03 $44,920.95 $38,411.03 2025-06-28
6023 APR_DRG — 7 7 — — $38,368.67 $39,903.42 $38,368.67 2025-06-28
C1822 HCPCS Kit Pulse Generator Vercise Genus R16 32 14 $66,000.00 — $19,800.00 $66,589.50 $38,353.50 2025-06-28
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 29 23 — — $36,433.67 $121,527.84 $38,351.23 2025-06-28
11 MS_DRG Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc 29 23 — — $36,399.46 $115,644.58 $38,315.22 2025-06-28
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 29 23 — — $36,395.43 $127,332.85 $38,310.98 2025-06-28
6254 APR_DRG — 7 7 — — $37,844.62 $39,478.30 $37,959.90 2025-06-28
1623 APR_DRG — 7 7 — — $37,032.87 $39,349.44 $37,835.99 2025-06-28
234 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc 29 23 — — $35,891.58 $110,591.40 $37,780.61 2025-06-28
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $35,733.92 $124,305.97 $37,614.65 2025-06-28
607-2.1 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $37,423.04 $37,423.04 $37,423.04 2025-06-28
C1824 HCPCS Hb Generator,cardiac Contractility Modulation(implantable) Lvl 5 32 14 $58,500.00 — $17,550.00 $68,529.00 $37,286.25 2025-06-28
0204 APR_DRG — 7 7 — — $37,275.25 $41,474.32 $37,275.25 2025-06-28
3033 APR_DRG — 7 7 — — $37,263.60 $43,196.03 $37,263.60 2025-06-28
272005610-36-52128 CDM Hb Protek Duo Kit 16 14 $64,500.00 — $19,350.00 $52,432.05 $37,216.50 2025-06-28
621-4.1 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 3 3 — — $37,179.14 $37,179.14 $37,179.14 2025-06-28
1764 APR_DRG — 7 7 — — $36,791.29 $44,456.10 $36,791.29 2025-06-28
9114 APR_DRG — 7 7 — — $36,728.28 $38,225.15 $36,728.28 2025-06-28
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 24 22 — — $34,750.36 $95,549.25 $36,579.33 2025-06-28
2994 APR_DRG — 6 6 — — $36,560.96 $38,023.40 $36,560.96 2025-06-28
609-2.1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $36,528.56 $36,528.56 $36,528.56 2025-06-28
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 29 23 — — $3,028.91 $116,661.92 $36,458.56 2025-06-28
1784 APR_DRG — 7 7 — — $36,417.99 $39,075.87 $36,417.99 2025-06-28
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 29 23 — — $34,378.01 $87,410.50 $36,187.38 2025-06-28
326 MS_DRG Stomach, Esophageal And Duodenal Procedures With Mcc 29 23 — — $34,273.35 $101,164.20 $36,077.21 2025-06-28
C2624 HCPCS Hb Implantable Pulmonary Pressure Sensor W/del Cath Lvl 61 48 14 $67,500.00 — $17,550.00 $63,357.00 $35,925.00 2025-06-28
6033 APR_DRG — 7 7 — — $35,857.25 $47,538.22 $35,857.25 2025-06-28
609-1.1 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 3 3 — — $35,788.85 $35,788.85 $35,788.85 2025-06-28
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 29 23 — — $32,822.06 $85,697.81 $35,779.89 2025-06-28
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 29 23 — — $33,791.63 $113,129.17 $35,570.14 2025-06-28
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 29 23 — — $27,065.30 $110,038.01 $35,542.60 2025-06-28
6904 APR_DRG — 7 7 — — $35,531.61 $41,947.71 $35,531.61 2025-06-28
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 29 23 — — $33,752.05 $90,012.55 $35,528.47 2025-06-28
228 MS_DRG Other Cardiothoracic Procedures With Mcc 29 23 — — $33,631.28 $142,545.49 $35,401.35 2025-06-28
0091 APR_DRG — 7 7 — — $30,860.63 $36,553.64 $35,147.72 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
245 MS_DRG Aicd Generator Procedures 29 23 — — $32,983.86 $102,329.67 $34,719.85 2025-06-28
471 MS_DRG Cervical Spinal Fusion With Mcc 29 23 — — $32,785.94 $82,642.10 $34,511.52 2025-06-28
1664 APR_DRG — 7 7 — — $34,154.91 $37,121.99 $34,154.91 2025-06-28
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 29 23 — — $32,237.14 $81,250.35 $33,933.83 2025-06-28
611-3.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 3 3 — — $33,853.12 $33,853.12 $33,853.12 2025-06-28
799 MS_DRG Splenic Procedures With Mcc 29 23 — — $32,098.26 $80,898.16 $33,787.64 2025-06-28
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 29 23 — — $32,092.23 $123,087.40 $33,781.29 2025-06-28
819000001-36-66329 CDM Hb Allogeneic Bone Marrow Acq Chg, Simple 16 14 $58,433.00 — $17,529.90 $47,500.19 $33,715.84 2025-06-28
267 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures Without Mcc 29 23 — — $3,356.52 $115,720.04 $33,433.83 2025-06-28
1654 APR_DRG — 7 7 — — $33,370.19 $36,907.45 $33,370.19 2025-06-28
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 29 23 — — $31,593.07 $106,611.46 $33,255.86 2025-06-28
277 MS_DRG Cardiac Defibrillator Implant Without Mcc 29 23 — — $31,407.89 $125,882.30 $33,060.94 2025-06-28
622-4.1 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $33,005.08 $33,005.08 $33,005.08 2025-06-28
1834 APR_DRG — 7 7 — — $32,854.99 $34,169.19 $32,854.99 2025-06-28
163 MS_DRG Major Chest Procedures With Mcc 29 23 — — $31,121.42 $81,068.87 $32,759.39 2025-06-28
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 29 23 — — $31,010.04 $110,493.58 $32,642.15 2025-06-28
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 29 23 — — $31,005.35 $80,073.89 $32,637.21 2025-06-28
6114 APR_DRG — 7 7 — — $31,632.89 $33,888.34 $32,584.94 2025-06-28
0620T HCPCS Hb Endovas Ven Artlz Tibial/peroneal Vein 39 28 $32,740.00 — $4,698.00 $78,873.42 $32,578.15 2025-06-28
50242015001 NDC Ocrelizumab 30 Mg/ml Intravenous Solution 15 13 $59,193.14 — $2.10 $51,024.49 $32,514.79 2025-06-28
5104 APR_DRG — 3 3 — — $32,323.50 $32,323.50 $32,323.50 2025-06-28
0924 APR_DRG — 7 7 — — $32,292.66 $36,287.29 $32,292.66 2025-06-28
1704 APR_DRG — 7 7 — — $30,747.48 $33,364.65 $32,081.39 2025-06-28
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 29 23 — — $30,466.61 $90,856.61 $32,070.12 2025-06-28
6954 APR_DRG — 7 7 — — $32,006.73 $36,405.23 $32,006.73 2025-06-28
C1882 HCPCS Hb Icd Other Than Sgl Or Dual Lvl 52 240 14 $58,500.00 — $9,450.00 $73,701.00 $32,001.75 2025-06-28
9104 APR_DRG — 7 7 — — $25,351.77 $33,218.72 $31,941.07 2025-06-28
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 29 23 — — $30,286.13 $89,512.26 $31,880.14 2025-06-28
9124 APR_DRG — 7 7 — — $31,864.29 $33,353.00 $31,864.29 2025-06-28
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 29 23 — — $30,202.94 $108,137.48 $31,792.57 2025-06-28
5931 APR_DRG — 7 7 — — $9,466.19 $32,955.49 $31,687.97 2025-06-28
L5969 HCPCS Ak/ft Power Asst Incl Motors 2 2 — — $26,579.28 $36,673.32 $31,626.30 2025-06-28
1622 APR_DRG — 7 7 — — $30,416.59 $32,821.13 $31,558.77 2025-06-28
3124 APR_DRG — 7 7 — — $31,523.29 $40,028.52 $31,523.29 2025-06-28
901 MS_DRG Wound Debridements For Injuries With Mcc 29 23 — — $29,922.50 $78,922.39 $31,497.37 2025-06-28
0915T HCPCS Insj Perm Ccm-d Sys Pg&eltrd 29 24 — — $16,837.53 $72,250.57 $31,413.29 2025-06-28
33264 HCPCS Pr Remv Implant Defibr Pulse Gen W/replace Pulse Gen Multi Lead 42 30 $42,808.00 — $224.39 $72,250.57 $31,413.29 2025-06-28
33249 HCPCS Pr Insert Or Replace Implant Defibr Syst W/leads Sgl Or Dual 42 30 $41,752.00 — $507.24 $72,250.57 $31,413.29 2025-06-28
33270 HCPCS Pr Insert/replace Perm Subq Implant Defibr W/subq Electrode 42 30 $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 39 28 $60,599.00 — $6,527.00 $72,250.57 $31,413.29 2025-06-28
3614 APR_DRG — 7 7 — — $31,393.04 $39,699.76 $31,393.04 2025-06-28
1694 APR_DRG — 7 7 — — $31,367.62 $33,707.91 $31,367.62 2025-06-28
1633 APR_DRG — 7 7 — — $29,714.24 $32,586.54 $31,333.20 2025-06-28
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 29 23 — — $29,669.57 $84,168.41 $31,231.13 2025-06-28
33231 HCPCS Pr Insert Implant Defibr Pulse Gen W/exist Multi Leads 40 29 $38,674.00 — $222.64 $72,250.57 $31,176.25 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
0408T HCPCS Hb Ins/replace Perm Card Contractility Modulation Syst 38 28 $33,723.00 — $3,688.00 $72,250.57 $31,099.15 2025-06-28
612-3.1 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 3 3 — — $30,934.85 $30,934.85 $30,934.85 2025-06-28
6022 APR_DRG — 7 7 — — $30,894.25 $32,130.02 $30,894.25 2025-06-28
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