Hospital

SANFORD WORTHINGTON MEDICAL CENTER

Worthington, MN · CCN 240022 · Rates published

18,049 distinct procedures filed

14 distinct payers

250,259 rate rows

2026-03-04 last MRF observed

Data quality

245,798 of 250,259 rate rows are consumer-grade (98.2%)

4,461 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 — reason	Rows
template filing: same amount across many unrelated codes — excluded	3,692
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians	665
placeholder amount (≤ $0.02) — excluded from medians	68
exceeds 10× this hospital's gross charge — excluded from medians	20
percent-of-charges filed in the dollar field — excluded from medians	16

Data source & audit trail ↓ Download audit trail (JSON)

Source MRF file	https://sthpiprd.blob.core.windows.net/machine-readable-files/8370/460388596_sanford-worthington-medical-center_standardcharges.csv
Found on page	https://sanfordhealth.org/cms-hpt.txt
Discovered via	Discovered by HANK (automated)
Last fetch	not_modified · 2026-10-03
Content fingerprint	5a09390b70e0c2e8… · 145,196,514 bytes · first seen 2026-05-15

Top 50 most expensive offerings

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

Code	Description	Payers	Min $	Max $	Avg median	vs national
J3391 HCPCS	Inj, Atidarsagene Autotemcel	8	$4,279,750.00	$4,730,250.00	$4,640,150.00	nat. median $4,505,000 1.0× median
J1411 HCPCS	Inj, Hemgenix, Per Tx Dose	8	$3,501,003.33	$3,869,530.00	$3,795,824.67	nat. median $3,685,267 1.0× median
J1413 HCPCS	Inj Delandistrogene Mox Rokl	8	$3,150,639.46	$3,482,285.72	$3,415,956.47	nat. median $3,325,455 1.0× median
J3394 HCPCS	Inj, Lovotibeglogene Autotem	8	$3,086,023.43	$3,410,868.00	$3,345,899.09	nat. median $3,248,446 1.0× median
J3393 HCPCS	Inj, Betibeglogene Autotemce	8	$2,798,453.00	$3,093,027.00	$3,034,112.20	nat. median $2,968,000 1.0× median
J3399 HCPCS	Inj Onase Abepar-xioi Treat	8	$2,278,010.83	$2,577,866.14	$2,528,763.92	nat. median $2,455,111 1.0× median
J3392 HCPCS	Inj, Exagamglogene Autotem	8	$2,215,400.00	$2,448,600.00	$2,401,960.00	nat. median $2,332,000 1.0× median
C9076 HCPCS	Outpatient Services - Cpt/hcpcs	1	$347,221.77	$1,282,816.07	$815,018.92	nat. median $1,000,529 0.8× median
C9081 HCPCS	Outpatient Services - Cpt/hcpcs	1	$347,221.77	$1,282,816.07	$815,018.92	nat. median $422,856 1.9× median
Q2040 HCPCS	Outpatient Services - Cpt/hcpcs	1	$347,221.77	$1,282,816.07	$815,018.92	nat. median $6 outlier · 141989.4×
C9098 HCPCS	Outpatient Services - Cpt/hcpcs	1	$347,221.77	$1,282,816.07	$815,018.92	nat. median $2,313,353 outlier · 0.4×
C9073 HCPCS	Outpatient Services - Cpt/hcpcs	1	$347,221.77	$1,282,816.07	$815,018.92	nat. median $1,000,529 0.8× median
Q2057 HCPCS	Afamitresgene Autoleucel	8	$732,089.00	$809,151.00	$793,738.60	nat. median $813,967 1.0× median
Q2042 HCPCS	Tisagenlecleucel Car-pos T	8	$374,485.10	$1,383,540.83	$609,477.99	nat. median $621,313 1.0× median
5834 APR_DRG	Neonate With Ecmo	3	$370,559.36	$850,294.20	$587,297.87	nat. median $390,362 1.5× median
Q2056 HCPCS	Ciltacabtagene Car-pos T	8	$384,067.89	$1,418,944.62	$582,845.01	nat. median $599,737 1.0× median
Q2054 HCPCS	Lisocabtagene Mara Car Pos T	8	$365,857.47	$1,351,665.94	$579,414.33	nat. median $579,571 1.0× median
Q2055 HCPCS	Idecabtagene Vicleucel Car	8	$373,581.13	$1,380,201.11	$574,037.47	nat. median $574,037 1.0× median
Q2041 HCPCS	Axicabtagene Ciloleucel Car+	8	$347,221.77	$1,282,816.07	$549,227.08	nat. median $562,501 1.0× median
Q2053 HCPCS	Brexucabtagene Car Pos T	8	$347,297.62	$1,283,096.27	$503,983.75	nat. median $513,770 1.0× median
18 MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	8	$343,229.38	$503,242.62	$372,132.90	nat. median $168,055 outlier · 2.2×
5884 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$239,719.71	$550,066.46	$371,194.27	nat. median $286,698 1.3× median
5833 APR_DRG	Neonate With Ecmo	3	$216,626.83	$497,077.01	$354,595.29	nat. median $268,208 1.3× median
24 APR_DRG	Heart And/or Lung Transplant	3	$274,712.80	$630,362.42	$302,066.03	nat. median $225,531 1.3× median
Q2058 HCPCS	Obecbtge Autol Up To 400 Mil	8	$264,337.50	$292,162.50	$286,597.50	nat. median $286,598 1.0× median
J3403 HCPCS	Revakinagene, Per Implant	8	$244,625.00	$270,375.00	$265,225.00	nat. median $264,195 1.0× median
6094 APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	3	$192,560.94	$441,854.85	$261,025.57	nat. median $198,578 1.3× median
5914 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$225,110.86	$516,544.65	$255,404.15	nat. median $171,497 1.5× median
1614 APR_DRG	Implantable Heart Assist Systems	3	$178,071.79	$408,607.70	$251,161.77	nat. median $202,242 1.2× median
114 APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	3	$108,960.17	$332,617.61	$250,022.56	nat. median $135,803 1.8× median
5891 APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	3	$197,146.07	$565,781.88	$246,568.51	nat. median $99,483 outlier · 2.5×
94 APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	3	$117,662.35	$269,990.78	$241,718.99	nat. median $152,792 1.6× median
1 MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	8	$222,742.05	$375,880.61	$241,499.28	nat. median $186,516 1.3× median
5883 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$165,555.71	$379,888.01	$240,287.32	nat. median $173,134 1.4× median
8414 APR_DRG	Extensive Third Degree Burns With Skin Graft	3	$214,868.48	$542,993.96	$236,637.50	nat. median $173,018 1.4× median
5882 APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	3	$134,194.08	$307,924.87	$231,742.41	nat. median $152,383 1.5× median
5934 APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	3	$221,592.34	$508,470.97	$225,447.58	nat. median $168,439 1.3× median
6314 APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	3	$121,590.15	$279,003.62	$222,784.01	nat. median $181,762 1.2× median
5832 APR_DRG	Neonate With Ecmo	3	$139,843.01	$320,887.05	$222,516.58	nat. median $201,678 1.1× median
J3402 HCPCS	Inj. Remestemcel-l-rknd/ Td	8	$195,358.00	$215,922.00	$211,809.20	nat. median $207,733 1.0× median
1613 APR_DRG	Implantable Heart Assist Systems	3	$139,053.40	$319,075.18	$202,103.75	nat. median $155,539 1.3× median
5892 APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	3	$197,146.07	$452,626.39	$197,255.19	nat. median $96,548 outlier · 2.0×
5893 APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational…	3	$167,462.17	$384,262.63	$197,146.07	nat. median $77,096 outlier · 2.6×
5913 APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	3	$117,288.78	$269,133.58	$194,060.41	nat. median $120,079 1.6× median
6304 APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	3	$93,734.49	$215,085.36	$189,306.80	nat. median $187,567 1.0× median
5831 APR_DRG	Neonate With Ecmo	3	$114,417.01	$262,543.95	$187,748.40	nat. median $173,909 1.1× median
74 APR_DRG	Allogeneic Bone Marrow Transplant	3	$126,139.61	$289,442.91	$186,079.37	nat. median $149,836 1.2× median
44 APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	3	$122,621.09	$281,369.24	$184,660.59	nat. median $135,630 1.4× median
927 MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	8	$169,699.94	$268,379.96	$183,990.47	nat. median $131,925 1.4× median
3 MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	8	$168,704.03	$285,986.02	$182,910.69	nat. median $145,435 1.3× median

Other procedures at this hospital

Browse this hospital's 18,049 published procedures. Use the slice to choose what to show, then sort or filter any column.

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

J3391	HCPCS	Inj, Atidarsagene Autotemcel	8	8	—	—	$4,279,750.00	$4,730,250.00	$4,640,150.00	2026-03-04
J1411	HCPCS	Inj, Hemgenix, Per Tx Dose	10	8	—	—	$3,501,003.33	$3,869,530.00	$3,795,824.67	2026-03-04
J1413	HCPCS	Inj Delandistrogene Mox Rokl	10	8	—	—	$3,150,639.46	$3,482,285.72	$3,415,956.47	2026-03-04
J3394	HCPCS	Inj, Lovotibeglogene Autotem	8	8	—	—	$3,086,023.43	$3,410,868.00	$3,345,899.09	2026-03-04
J3393	HCPCS	Inj, Betibeglogene Autotemce	8	8	—	—	$2,798,453.00	$3,093,027.00	$3,034,112.20	2026-03-04
J3399	HCPCS	Inj Onase Abepar-xioi Treat	10	8	—	—	$2,278,010.83	$2,577,866.14	$2,528,763.92	2026-03-04
J3392	HCPCS	Inj, Exagamglogene Autotem	8	8	—	—	$2,215,400.00	$2,448,600.00	$2,401,960.00	2026-03-04
Q2056	HCPCS	Ciltacabtagene Car-pos T	10	8	—	—	$384,067.89	$1,418,944.62	$582,845.01	2026-03-04
Q2042	HCPCS	Tisagenlecleucel Car-pos T	10	8	—	—	$374,485.10	$1,383,540.83	$609,477.99	2026-03-04
Q2055	HCPCS	Idecabtagene Vicleucel Car	10	8	—	—	$373,581.13	$1,380,201.11	$574,037.47	2026-03-04
Q2054	HCPCS	Lisocabtagene Mara Car Pos T	10	8	—	—	$365,857.47	$1,351,665.94	$579,414.33	2026-03-04
Q2053	HCPCS	Brexucabtagene Car Pos T	10	8	—	—	$347,297.62	$1,283,096.27	$503,983.75	2026-03-04
C9098	HCPCS	Outpatient Services - Cpt/hcpcs	2	1	—	—	$347,221.77	$1,282,816.07	$815,018.92	2026-03-04
C9081	HCPCS	Outpatient Services - Cpt/hcpcs	2	1	—	—	$347,221.77	$1,282,816.07	$815,018.92	2026-03-04
C9073	HCPCS	Outpatient Services - Cpt/hcpcs	2	1	—	—	$347,221.77	$1,282,816.07	$815,018.92	2026-03-04
Q2040	HCPCS	Outpatient Services - Cpt/hcpcs	2	1	—	—	$347,221.77	$1,282,816.07	$815,018.92	2026-03-04
C9076	HCPCS	Outpatient Services - Cpt/hcpcs	2	1	—	—	$347,221.77	$1,282,816.07	$815,018.92	2026-03-04
Q2041	HCPCS	Axicabtagene Ciloleucel Car+	10	8	—	—	$347,221.77	$1,282,816.07	$549,227.08	2026-03-04
5834	APR_DRG	Neonate With Ecmo	5	3	—	—	$370,559.36	$850,294.20	$587,297.87	2026-03-04
Q2057	HCPCS	Afamitresgene Autoleucel	8	8	—	—	$732,089.00	$809,151.00	$793,738.60	2026-03-04
24	APR_DRG	Heart And/or Lung Transplant	5	3	—	—	$274,712.80	$630,362.42	$302,066.03	2026-03-04
5891	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	3	—	—	$197,146.07	$565,781.88	$246,568.51	2026-03-04
5884	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	5	3	—	—	$239,719.71	$550,066.46	$371,194.27	2026-03-04
8414	APR_DRG	Extensive Third Degree Burns With Skin Graft	5	3	—	—	$214,868.48	$542,993.96	$236,637.50	2026-03-04
5914	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	3	—	—	$225,110.86	$516,544.65	$255,404.15	2026-03-04
5934	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	3	—	—	$221,592.34	$508,470.97	$225,447.58	2026-03-04
18	MS_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	10	8	—	—	$343,229.38	$503,242.62	$372,132.90	2026-03-04
5833	APR_DRG	Neonate With Ecmo	5	3	—	—	$216,626.83	$497,077.01	$354,595.29	2026-03-04
5892	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	3	—	—	$197,146.07	$452,626.39	$197,255.19	2026-03-04
6094	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	3	—	—	$192,560.94	$441,854.85	$261,025.57	2026-03-04
1614	APR_DRG	Implantable Heart Assist Systems	5	3	—	—	$178,071.79	$408,607.70	$251,161.77	2026-03-04
5933	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	3	—	—	$161,055.77	$395,302.19	$172,273.23	2026-03-04
6024	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$164,664.48	$385,463.16	$167,985.37	2026-03-04
5893	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	3	—	—	$167,462.17	$384,262.63	$197,146.07	2026-03-04
5883	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	5	3	—	—	$165,555.71	$379,888.01	$240,287.32	2026-03-04
1	MS_DRG	Heart Transplant Or Implant Of Heart Assist System With Mcc	10	8	—	—	$222,742.05	$375,880.61	$241,499.28	2026-03-04
6074	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$122,569.33	$334,981.10	$145,985.21	2026-03-04
114	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	3	—	—	$108,960.17	$332,617.61	$250,022.56	2026-03-04
5832	APR_DRG	Neonate With Ecmo	5	3	—	—	$139,843.01	$320,887.05	$222,516.58	2026-03-04
1613	APR_DRG	Implantable Heart Assist Systems	5	3	—	—	$139,053.40	$319,075.18	$202,103.75	2026-03-04
5932	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	3	—	—	$125,223.24	$313,958.53	$136,823.55	2026-03-04
54	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	5	3	—	—	$131,358.04	$309,745.60	$134,987.55	2026-03-04
5882	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	5	3	—	—	$134,194.08	$307,924.87	$231,742.41	2026-03-04
6114	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	5	3	—	—	$103,288.52	$304,828.30	$132,844.59	2026-03-04
6023	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$114,781.61	$303,948.95	$132,461.36	2026-03-04
6034	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	5	3	—	—	$119,094.88	$300,925.47	$131,143.73	2026-03-04
23	APR_DRG	Heart And/or Lung Transplant	5	3	—	—	$131,044.30	$300,697.33	$163,346.66	2026-03-04
6214	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	5	3	—	—	$70,717.79	$295,297.16	$128,690.90	2026-03-04
Q2058	HCPCS	Obecbtge Autol Up To 400 Mil	8	8	—	—	$264,337.50	$292,162.50	$286,597.50	2026-03-04
74	APR_DRG	Allogeneic Bone Marrow Transplant	5	3	—	—	$126,139.61	$289,442.91	$186,079.37	2026-03-04
3	MS_DRG	Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mo…	10	8	—	—	$168,704.03	$285,986.02	$182,910.69	2026-03-04
5931	APR_DRG	Neonate Birth Weight 750-999 Grams Without Major Procedure	5	3	—	—	$62,076.22	$285,418.26	$124,385.66	2026-03-04
44	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	3	—	—	$122,621.09	$281,369.24	$184,660.59	2026-03-04
14	APR_DRG	Liver Transplant And/or Intestinal Transplant	5	3	—	—	$121,619.11	$279,070.07	$171,256.82	2026-03-04
6314	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	3	—	—	$121,590.15	$279,003.62	$222,784.01	2026-03-04
J3403	HCPCS	Revakinagene, Per Implant	8	8	—	—	$244,625.00	$270,375.00	$265,225.00	2026-03-04
94	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	5	3	—	—	$117,662.35	$269,990.78	$241,718.99	2026-03-04
5913	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	3	—	—	$117,288.78	$269,133.58	$194,060.41	2026-03-04
927	MS_DRG	Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft	10	8	—	—	$169,699.94	$268,379.96	$183,990.47	2026-03-04
5831	APR_DRG	Neonate With Ecmo	5	3	—	—	$114,417.01	$262,543.95	$187,748.40	2026-03-04
64	APR_DRG	Pancreas Transplant	5	3	—	—	$114,381.29	$262,462.00	$115,488.32	2026-03-04
113	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	3	—	—	$67,613.47	$259,607.87	$155,147.46	2026-03-04
1612	APR_DRG	Implantable Heart Assist Systems	5	3	—	—	$111,647.56	$256,189.12	$136,597.11	2026-03-04
1611	APR_DRG	Implantable Heart Assist Systems	5	3	—	—	$106,065.23	$243,379.77	$136,597.11	2026-03-04
6073	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$86,077.35	$234,411.24	$102,156.73	2026-03-04
13	APR_DRG	Liver Transplant And/or Intestinal Transplant	5	3	—	—	$94,576.07	$232,419.95	$101,288.93	2026-03-04
6113	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Major Anomaly	5	3	—	—	$44,901.56	$225,223.42	$98,152.67	2026-03-04
22	APR_DRG	Heart And/or Lung Transplant	5	3	—	—	$97,249.15	$223,150.18	$126,081.38	2026-03-04
112	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	3	—	—	$35,814.56	$219,378.29	$82,180.93	2026-03-04
43	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	3	—	—	$94,679.52	$217,253.85	$122,408.23	2026-03-04
J3402	HCPCS	Inj. Remestemcel-l-rknd/ Td	8	8	—	—	$195,358.00	$215,922.00	$211,809.20	2026-03-04
6304	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	3	—	—	$93,734.49	$215,085.36	$189,306.80	2026-03-04
5912	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	3	—	—	$90,176.40	$206,920.87	$157,574.87	2026-03-04
5881	APR_DRG	Neonate Birth Weight < 1500 Grams With Major Procedure	5	3	—	—	$88,331.71	$202,688.01	$154,134.79	2026-03-04
73	APR_DRG	Allogeneic Bone Marrow Transplant	5	3	—	—	$87,627.04	$201,071.06	$110,866.81	2026-03-04
53	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	5	3	—	—	$83,398.06	$191,367.14	$92,673.98	2026-03-04
21	APR_DRG	Heart And/or Lung Transplant	5	3	—	—	$83,369.10	$191,300.69	$96,650.00	2026-03-04
6124	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$75,693.72	$191,223.17	$83,335.31	2026-03-04
4	MS_DRG	Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And …	10	8	—	—	$110,094.93	$188,552.84	$119,366.08	2026-03-04
5911	APR_DRG	Neonate Birth Weight 500-749 Grams Without Major Procedure	5	3	—	—	$4,110.28	$188,111.09	$81,979.07	2026-03-04
1604	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	5	3	—	—	$81,427.88	$186,846.33	$132,789.71	2026-03-04
63	APR_DRG	Pancreas Transplant	5	3	—	—	$80,812.99	$185,435.37	$98,288.96	2026-03-04
1784	APR_DRG	External Heart Assist Systems	5	3	—	—	$80,114.11	$183,831.71	$82,248.47	2026-03-04
4404	APR_DRG	Kidney Transplant	5	3	—	—	$76,653.51	$175,890.94	$95,496.51	2026-03-04
6022	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$76,377.43	$175,257.45	$83,911.05	2026-03-04
14	MS_DRG	Allogeneic Bone Marrow Transplant	10	8	—	—	$95,521.74	$174,831.51	$103,565.68	2026-03-04
7	MS_DRG	Lung Transplant	10	8	—	—	$102,931.92	$174,391.13	$111,599.87	2026-03-04
8413	APR_DRG	Extensive Third Degree Burns With Skin Graft	5	3	—	—	$64,976.07	$174,090.14	$75,868.72	2026-03-04
84	APR_DRG	Autologous Bone Marrow Transplant	5	3	—	—	$74,871.56	$171,802.05	$80,856.54	2026-03-04
6093	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	3	—	—	$74,869.63	$171,797.62	$80,158.42	2026-03-04
62	APR_DRG	Pancreas Transplant	5	3	—	—	$70,154.14	$160,977.34	$83,114.13	2026-03-04
6303	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure	5	3	—	—	$69,465.88	$159,398.05	$102,812.73	2026-03-04
3034	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	5	3	—	—	$68,874.16	$158,040.25	$91,956.54	2026-03-04
72	APR_DRG	Allogeneic Bone Marrow Transplant	5	3	—	—	$68,543.06	$157,280.51	$82,518.05	2026-03-04
6334	APR_DRG	Neonate Birth Weight > 2499 Grams With Major Anomaly	5	3	—	—	$68,400.19	$156,952.69	$74,097.73	2026-03-04
1694	APR_DRG	Major Abdominal Vascular Procedures	5	3	—	—	$61,723.94	$155,399.97	$67,723.52	2026-03-04
6084	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	5	3	—	—	$60,021.62	$154,090.91	$67,153.03	2026-03-04
42	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	3	—	—	$65,496.57	$150,289.97	$76,337.06	2026-03-04
1624	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	3	—	—	$64,987.86	$149,122.66	$100,308.12	2026-03-04
E0766	HCPCS	Elec Stim Cancer Treatment	2	1	—	—	$149,026.20	$149,026.20	$149,026.20	2026-03-04
38240	CPT	Transplt Allo Hct/donor	12	8	—	—	$40,275.18	$148,797.26	$59,783.55	2026-03-04
8424	APR_DRG	Burns With Skin Graft Except Extensive Third Degree Burns	5	3	—	—	$64,416.40	$147,811.38	$114,905.13	2026-03-04
6033	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition	5	3	—	—	$48,742.26	$146,438.08	$63,817.91	2026-03-04
212	MS_DRG	Concomitant Aortic And Mitral Valve Procedures	10	8	—	—	$86,430.49	$145,368.42	$93,708.84	2026-03-04
8634	APR_DRG	Neonatal Aftercare	5	3	—	—	$63,159.58	$144,927.45	$98,546.72	2026-03-04
12	APR_DRG	Liver Transplant And/or Intestinal Transplant	5	3	—	—	$63,125.79	$144,849.93	$76,309.14	2026-03-04
1304	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours	5	3	—	—	$59,534.01	$143,210.83	$62,411.47	2026-03-04
2204	APR_DRG	Major Stomach, Esophageal And Duodenal Procedures	5	3	—	—	$56,688.93	$143,135.52	$62,378.65	2026-03-04
5894	APR_DRG	Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational …	5	3	—	—	$713.15	$142,732.39	$62,202.97	2026-03-04
93	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	5	3	—	—	$62,090.99	$142,475.45	$136,745.33	2026-03-04
4403	APR_DRG	Kidney Transplant	5	3	—	—	$62,051.41	$142,384.63	$63,570.18	2026-03-04
5	MS_DRG	Liver Transplant With Mcc Or Intestinal Transplant	10	8	—	—	$81,950.84	$142,105.57	$88,851.96	2026-03-04
6083	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	5	3	—	—	$60,021.62	$141,897.33	$61,839.05	2026-03-04
215	MS_DRG	Other Heart Assist System Implant	10	8	—	—	$79,141.11	$141,379.60	$85,805.62	2026-03-04
426	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	8	—	—	$87,599.68	$139,876.95	$94,976.50	2026-03-04
71	APR_DRG	Allogeneic Bone Marrow Transplant	5	3	—	—	$60,697.10	$139,276.99	$68,687.89	2026-03-04
234	APR_DRG	Spinal Procedures	5	3	—	—	$59,482.46	$138,262.52	$60,254.99	2026-03-04
6134	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	5	3	—	—	$60,143.02	$138,005.58	$65,924.43	2026-03-04
6072	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$58,629.69	$136,133.90	$59,327.34	2026-03-04
Q0480	HCPCS	Driver Pneumatic Vad, Rep	10	8	—	—	$94,999.95	$136,014.42	$133,423.67	2026-03-04
52	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	5	3	—	—	$58,797.39	$134,917.87	$62,060.11	2026-03-04
1674	APR_DRG	Other Cardiothoracic And Thoracic Vascular Procedures	5	3	—	—	$57,780.93	$132,585.47	$67,098.34	2026-03-04
9104	APR_DRG	Craniotomy For Multiple Significant Trauma	5	3	—	—	$57,574.35	$132,111.46	$70,773.64	2026-03-04
6123	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$52,374.60	$132,098.17	$57,568.56	2026-03-04
2224	APR_DRG	Other Stomach, Esophageal And Duodenal Procedures	5	3	—	—	$39,633.49	$131,686.18	$57,389.02	2026-03-04
6904	APR_DRG	Acute Leukemia	5	3	—	—	$55,982.23	$131,234.32	$57,192.09	2026-03-04
1634	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	5	3	—	—	$56,400.55	$129,418.02	$88,181.35	2026-03-04
216	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	8	—	—	$77,756.51	$128,784.59	$84,304.43	2026-03-04
9114	APR_DRG	Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma	5	3	—	—	$56,083.93	$128,691.50	$67,954.33	2026-03-04
11	APR_DRG	Liver Transplant And/or Intestinal Transplant	5	3	—	—	$56,047.25	$128,607.33	$62,703.45	2026-03-04
9504	APR_DRG	Extensive O.r. Procedure Unrelated To Principal Diagnosis	5	3	—	—	$55,567.66	$128,474.43	$55,989.33	2026-03-04
0266T	CPT	Outpatient Services	10	8	—	—	$34,773.42	$128,470.93	$45,488.40	2026-03-04
33276	CPT	Insj Phrnc Nrv Stim Sys	10	8	—	—	$34,773.42	$128,470.93	$45,488.40	2026-03-04
61	APR_DRG	Pancreas Transplant	5	3	—	—	$55,143.73	$126,534.09	$67,069.34	2026-03-04
1654	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	5	3	—	—	$54,983.49	$126,166.40	$79,057.55	2026-03-04
2	MS_DRG	Heart Transplant Or Implant Of Heart Assist System Without Mcc	10	8	—	—	$90,068.41	$125,493.71	$97,653.12	2026-03-04
914	APR_DRG	Other Major Head And Neck Procedures	5	3	—	—	$54,116.65	$124,177.33	$66,870.65	2026-03-04
1794	APR_DRG	Defibrillator Implants	5	3	—	—	$53,793.27	$123,435.31	$68,294.80	2026-03-04
8504	APR_DRG	Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal…	5	3	—	—	$53,709.29	$123,242.60	$58,567.40	2026-03-04
850	MS_DRG	Acute Leukemia With Other Procedures	10	8	—	—	$68,828.21	$122,924.80	$74,624.27	2026-03-04
4402	APR_DRG	Kidney Transplant	5	3	—	—	$53,218.92	$122,117.38	$54,870.62	2026-03-04
6224	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$44,207.75	$121,997.77	$53,166.79	2026-03-04
2614	APR_DRG	Major Biliary Tract Procedures	5	3	—	—	$51,659.30	$121,738.62	$53,053.85	2026-03-04
1783	APR_DRG	External Heart Assist Systems	5	3	—	—	$52,654.22	$120,821.61	$66,695.58	2026-03-04
4474	APR_DRG	Other Kidney, Urinary Tract And Related Procedures	5	3	—	—	$43,248.65	$120,332.09	$52,440.89	2026-03-04
7404	APR_DRG	Mental Illness Diagnosis With O.r. Procedure	5	3	—	—	$52,069.25	$119,479.32	$56,548.24	2026-03-04
3124	APR_DRG	Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses	5	3	—	—	$52,050.91	$119,437.23	$53,991.00	2026-03-04
6144	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition	5	3	—	—	$49,902.20	$118,941.07	$51,834.68	2026-03-04
1782	APR_DRG	External Heart Assist Systems	5	3	—	—	$51,734.29	$118,710.71	$53,765.45	2026-03-04
6814	APR_DRG	Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	5	3	—	—	$51,538.33	$118,261.07	$53,197.29	2026-03-04
6213	APR_DRG	Neonate Birth Weight 2000-2499 Grams With Major Anomaly	5	3	—	—	$30,648.24	$118,086.08	$51,462.07	2026-03-04
1204	APR_DRG	Major Respiratory And Chest Procedures	5	3	—	—	$51,267.08	$117,638.65	$55,874.83	2026-03-04
214	APR_DRG	Open Craniotomy Except Trauma	5	3	—	—	$51,257.43	$117,616.50	$61,648.76	2026-03-04
K1007	HCPCS	Bil Hkaf Pc S/d Micro Sensor	8	8	—	—	$106,267.04	$117,453.04	$115,215.84	2026-03-04
204	APR_DRG	Open Craniotomy For Trauma	5	3	—	—	$51,061.47	$117,166.86	$54,622.52	2026-03-04
6021	APR_DRG	Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$49,204.09	$115,640.72	$50,396.38	2026-03-04
1781	APR_DRG	External Heart Assist Systems	5	3	—	—	$49,328.67	$113,952.89	$49,660.82	2026-03-04
9124	APR_DRG	Musculoskeletal And Other Procedures For Multiple Significant Trauma	5	3	—	—	$49,503.48	$113,591.85	$64,874.04	2026-03-04
231	MS_DRG	Coronary Bypass With Ptca With Mcc	10	8	—	—	$67,003.29	$113,077.52	$72,645.67	2026-03-04
6804	APR_DRG	Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms	5	3	—	—	$49,278.57	$113,075.75	$65,810.59	2026-03-04
456	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	10	8	—	—	$66,792.66	$113,013.47	$72,417.30	2026-03-04
4414	APR_DRG	Major Bladder Procedures	5	3	—	—	$48,981.25	$112,393.53	$53,965.22	2026-03-04
51	APR_DRG	Tracheostomy With Mv >96 Hours Without Extensive Procedure	5	3	—	—	$31,265.80	$112,036.92	$48,825.84	2026-03-04
894	APR_DRG	Major Cranial Or Facial Bone Procedures	5	3	—	—	$48,515.01	$111,323.69	$56,924.14	2026-03-04
429	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion With Mcc	10	8	—	—	$71,610.91	$111,297.30	$77,641.30	2026-03-04
3614	APR_DRG	Skin Graft For Skin And Subcutaneous Tissue Diagnoses	5	3	—	—	$47,845.09	$109,786.48	$50,838.75	2026-03-04
20	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc	10	8	—	—	$62,543.49	$107,567.37	$67,810.31	2026-03-04
1814	APR_DRG	Lower Extremity Arterial Procedures	5	3	—	—	$46,856.63	$107,518.32	$48,387.83	2026-03-04
3174	APR_DRG	Tendon, Muscle And Other Soft Tissue Procedures	5	3	—	—	$33,684.50	$107,409.78	$46,809.33	2026-03-04
274	APR_DRG	Other Open Craniotomy	5	3	—	—	$46,804.50	$107,398.71	$48,429.72	2026-03-04
10	MS_DRG	Pancreas Transplant	10	8	—	—	$57,034.54	$106,394.35	$61,837.45	2026-03-04
1824	APR_DRG	Other Peripheral Vascular And Related Procedures	5	3	—	—	$39,036.34	$106,339.94	$46,343.09	2026-03-04
6514	APR_DRG	Other Procedures Of Blood And Blood-forming Organs	5	3	—	—	$46,293.86	$106,226.97	$47,842.23	2026-03-04
7104	APR_DRG	Infectious And Parasitic Diseases Including HIV With O.r. Procedure	5	3	—	—	$45,827.37	$105,801.69	$46,108.52	2026-03-04
19	MS_DRG	Simultaneous Pancreas And Kidney Transplant With Hemodialysis	10	8	—	—	$56,707.87	$105,781.81	$61,483.26	2026-03-04
2604	APR_DRG	Major Pancreas, Liver And Shunt Procedures	5	3	—	—	$46,054.46	$105,677.65	$58,320.37	2026-03-04
6122	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other…	5	3	—	—	$34,481.42	$105,615.63	$46,027.43	2026-03-04
233	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc	10	8	—	—	$60,766.26	$104,301.85	$65,883.41	2026-03-04
92	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	5	3	—	—	$45,287.05	$103,916.73	$75,039.64	2026-03-04
6082	APR_DRG	Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition	5	3	—	—	$36,206.29	$103,684.15	$45,185.69	2026-03-04
6614	APR_DRG	Coagulation And Platelet Disorders	5	3	—	—	$23,965.69	$103,542.39	$45,123.91	2026-03-04
219	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	8	—	—	$61,029.36	$103,250.27	$66,168.67	2026-03-04
7924	APR_DRG	Extensive O.r. Procedures For Other Complications Of Treatment	5	3	—	—	$44,472.34	$102,047.27	$48,120.40	2026-03-04
1664	APR_DRG	Coronary Bypass Without Ami Or Complex Principal Diagnosis	5	3	—	—	$44,410.56	$101,905.51	$68,361.39	2026-03-04
3094	APR_DRG	Other Significant Hip And Femur Surgery	5	3	—	—	$39,315.58	$101,431.50	$44,203.98	2026-03-04
6954	APR_DRG	Chemotherapy For Acute Leukemia	5	3	—	—	$44,177.92	$101,371.69	$48,465.16	2026-03-04
1303	APR_DRG	Respiratory System Diagnosis With Ventilator Support > 96 Hours	5	3	—	—	$43,958.80	$100,868.89	$44,521.36	2026-03-04
41	APR_DRG	Tracheostomy With Mv >96 Hours With Extensive Procedure	5	3	—	—	$43,736.78	$100,359.44	$54,084.44	2026-03-04
1764	APR_DRG	Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices	5	3	—	—	$42,139.18	$100,173.38	$43,655.69	2026-03-04
5104	APR_DRG	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	3	1	—	—	$43,612.25	$100,073.70	$90,120.55	2026-03-04
924	APR_DRG	Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures	5	3	—	—	$43,530.20	$99,885.43	$48,659.56	2026-03-04
957	MS_DRG	Other O.r. Procedures For Multiple Significant Trauma With Mcc	10	8	—	—	$60,565.17	$99,603.08	$65,665.39	2026-03-04
3044	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	5	3	—	—	$43,396.03	$99,577.54	$67,591.31	2026-03-04
209	MS_DRG	Complex Aortic Arch Procedures	8	8	—	—	$89,965.09	$99,435.09	$97,541.09	2026-03-04
1834	APR_DRG	Percutaneous Structural Cardiac Procedures	5	3	—	—	$43,201.04	$99,130.11	$72,983.97	2026-03-04
1214	APR_DRG	Other Respiratory And Chest Procedures	5	3	—	—	$43,173.04	$99,065.88	$47,240.78	2026-03-04
4401	APR_DRG	Kidney Transplant	5	3	—	—	$42,644.06	$97,852.06	$50,129.89	2026-03-04
6504	APR_DRG	Splenectomy	5	3	—	—	$42,095.77	$96,593.94	$43,526.82	2026-03-04
224	APR_DRG	Ventricular Shunt Procedures	5	3	—	—	$42,073.57	$96,542.99	$44,453.70	2026-03-04
83	APR_DRG	Autologous Bone Marrow Transplant	5	3	—	—	$42,061.02	$96,514.20	$53,035.12	2026-03-04
4044	APR_DRG	Thyroid, Parathyroid And Thyroglossal Procedures	5	3	—	—	$42,057.16	$96,505.34	$43,691.14	2026-03-04
3214	APR_DRG	Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures	5	3	—	—	$41,886.30	$96,113.28	$49,763.65	2026-03-04
4054	APR_DRG	Other Procedures For Endocrine, Nutritional And Metabolic Disorders	5	3	—	—	$41,663.31	$95,601.62	$45,615.79	2026-03-04
427	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	8	—	—	$57,375.53	$94,732.15	$62,207.15	2026-03-04
275	MS_DRG	Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc	10	8	—	—	$56,674.47	$94,302.44	$61,447.06	2026-03-04
1793	APR_DRG	Defibrillator Implants	5	3	—	—	$40,474.06	$92,872.74	$50,417.73	2026-03-04
870	MS_DRG	Septicemia Or Severe Sepsis With Mv >96 Hours	10	8	—	—	$54,936.98	$92,834.49	$59,563.25	2026-03-04
111	APR_DRG	Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies	5	3	—	—	$24,335.21	$92,677.20	$55,840.15	2026-03-04
4014	APR_DRG	Adrenal Procedures	5	3	—	—	$40,243.36	$92,343.35	$56,250.73	2026-03-04
8633	APR_DRG	Neonatal Aftercare	5	3	—	—	$40,013.62	$91,816.18	$45,619.01	2026-03-04
955	MS_DRG	Craniotomy For Multiple Significant Trauma	10	8	—	—	$53,500.72	$91,118.33	$58,006.05	2026-03-04
3033	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	5	3	—	—	$39,591.78	$90,848.23	$61,389.92	2026-03-04
2644	APR_DRG	Other Hepatobiliary, Pancreas And Abdominal Procedures	5	3	—	—	$39,260.68	$90,088.48	$44,624.47	2026-03-04
6133	APR_DRG	Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection	5	3	—	—	$39,219.17	$89,993.24	$48,613.38	2026-03-04
447	MS_DRG	Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall…	10	8	—	—	$53,107.28	$89,467.55	$57,579.47	2026-03-04
928	MS_DRG	Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc	10	8	—	—	$57,010.70	$89,124.58	$61,811.60	2026-03-04
1704	APR_DRG	Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock	5	3	—	—	$38,786.72	$89,000.92	$45,296.80	2026-03-04
268	MS_DRG	Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc	10	8	—	—	$54,667.55	$88,973.78	$59,271.13	2026-03-04
1623	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	3	—	—	$38,723.01	$88,854.73	$71,847.66	2026-03-04
7114	APR_DRG	Post-operative, Post-trauma, Other Device Infections With O.r. Procedure	5	3	—	—	$38,345.58	$87,988.66	$44,304.41	2026-03-04
8514	APR_DRG	Gender Related Procedures	2	2	—	—	$86,441.44	$86,441.44	$86,441.44	2026-03-04
207	MS_DRG	Respiratory System Diagnosis With Ventilator Support >96 Hours	10	8	—	—	$51,144.86	$86,311.46	$55,451.79	2026-03-04
217	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	8	—	—	$52,262.39	$86,174.00	$56,663.43	2026-03-04
91	APR_DRG	Extracorporeal Membrane Oxygenation (ecmo)	5	3	—	—	$37,166.95	$85,284.15	$60,713.29	2026-03-04
L8702	HCPCS	Ewhf S/d Uprt Micro Sensor	8	8	—	—	$76,896.03	$84,990.35	$83,371.49	2026-03-04
1653	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	5	3	—	—	$36,931.41	$84,743.69	$58,283.85	2026-03-04
969	MS_DRG	HIV With Extensive O.r. Procedures With Mcc	10	8	—	—	$48,653.87	$84,392.45	$52,751.04	2026-03-04
2304	APR_DRG	Major Small Bowel Procedures	5	3	—	—	$36,692.02	$84,194.37	$48,484.49	2026-03-04
5114	APR_DRG	Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy	5	3	—	—	$36,274.04	$83,235.27	$47,609.17	2026-03-04
2994	APR_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	2	—	—	$83,196.83	$83,196.83	$83,196.83	2026-03-04
304	APR_DRG	Percutaneous Intracranial And Extracranial Vascular Procedures	5	3	—	—	$36,173.65	$83,004.91	$46,529.78	2026-03-04
276	MS_DRG	Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator	10	8	—	—	$47,742.18	$82,658.93	$51,762.58	2026-03-04
317	MS_DRG	Concomitant Left Atrial Appendage Closure And Cardiac Ablation	10	8	—	—	$53,146.23	$82,552.17	$57,621.70	2026-03-04
573	MS_DRG	Skin Graft For Skin Ulcer Or Cellulitis With Mcc	10	8	—	—	$52,072.42	$82,175.84	$56,457.46	2026-03-04
232	MS_DRG	Coronary Bypass With Ptca Without Mcc	10	8	—	—	$48,187.29	$81,515.26	$52,245.16	2026-03-04
4804	APR_DRG	Major Male Pelvic Procedures	3	1	—	—	$35,438.09	$81,317.08	$73,229.43	2026-03-04
28	MS_DRG	Spinal Procedures With Mcc	10	8	—	—	$47,755.71	$81,125.59	$51,777.25	2026-03-04
16	MS_DRG	Autologous Bone Marrow Transplant With Cc/mcc	10	8	—	—	$47,130.96	$80,543.75	$51,099.89	2026-03-04
17	MS_DRG	Autologous Bone Marrow Transplant Without Cc/mcc	10	8	—	—	$43,177.49	$80,543.75	$46,813.49	2026-03-04
4424	APR_DRG	Kidney And Urinary Tract Procedures For Malignancy	5	3	—	—	$34,926.48	$80,143.13	$43,136.95	2026-03-04
266	MS_DRG	Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc	10	8	—	—	$48,710.29	$79,941.89	$52,812.21	2026-03-04
461	MS_DRG	Bilateral Or Multiple Major Joint Procedures Of Lower Extremity With Mcc	10	8	—	—	$43,898.40	$79,941.89	$47,595.11	2026-03-04
6313	APR_DRG	Neonate Birth Weight > 2499 Grams With Other Major Procedure	5	3	—	—	$34,836.71	$79,937.14	$61,612.24	2026-03-04
4034	APR_DRG	Procedures For Obesity	5	3	—	—	$34,714.12	$79,655.83	$45,264.58	2026-03-04
218	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza…	10	8	—	—	$52,262.39	$79,390.74	$56,663.43	2026-03-04
790	MS_DRG	Extreme Immaturity Or Respiratory Distress Syndrome, Neonate	10	8	—	—	$47,240.65	$79,336.03	$51,218.81	2026-03-04
294	APR_DRG	Other Percutaneous Intracranial Procedures	5	3	—	—	$34,337.65	$78,791.98	$44,486.99	2026-03-04
235	MS_DRG	Coronary Bypass Without Cardiac Catheterization With Mcc	10	8	—	—	$46,645.33	$78,519.31	$50,573.36	2026-03-04
6092	APR_DRG	Neonate Birth Weight 1500-2499 Grams With Major Procedure	5	3	—	—	$33,967.94	$77,943.64	$51,328.50	2026-03-04
820	MS_DRG	Lymphoma And Leukemia With Major O.r. Procedures With Mcc	10	8	—	—	$46,615.12	$77,693.26	$50,540.61	2026-03-04
3043	APR_DRG	Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back	5	3	—	—	$33,697.66	$77,323.44	$48,280.43	2026-03-04
1633	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	5	3	—	—	$33,527.76	$76,933.60	$60,278.31	2026-03-04
5124	APR_DRG	Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy	5	3	—	—	$33,432.20	$76,714.31	$47,376.11	2026-03-04
457	MS_DRG	Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex…	10	8	—	—	$47,396.44	$76,586.96	$51,387.72	2026-03-04
23	MS_DRG	Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi…	10	8	—	—	$45,546.08	$76,129.22	$49,381.54	2026-03-04
1603	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	5	3	—	—	$32,952.45	$75,613.46	$58,366.55	2026-03-04
653	MS_DRG	Major Bladder Procedures With Mcc	10	8	—	—	$41,302.49	$74,387.70	$44,780.60	2026-03-04
834	MS_DRG	Acute Leukemia With Mcc	10	8	—	—	$43,635.31	$73,756.48	$47,309.86	2026-03-04
428	MS_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit…	10	8	—	—	$44,685.28	$73,466.89	$48,448.25	2026-03-04
1754	APR_DRG	Percutaneous Cardiac Intervention Without Ami	5	3	—	—	$31,857.80	$73,101.65	$44,779.12	2026-03-04
430	MS_DRG	Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc	10	8	—	—	$45,838.58	$72,998.48	$49,698.67	2026-03-04
8	MS_DRG	Simultaneous Pancreas And Kidney Transplant	10	8	—	—	$44,546.98	$72,607.48	$48,298.31	2026-03-04
405	MS_DRG	Pancreas, Liver And Shunt Procedures With Mcc	10	8	—	—	$43,481.11	$72,442.00	$47,142.68	2026-03-04
463	MS_DRG	Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective …	10	8	—	—	$45,301.28	$72,072.34	$49,116.13	2026-03-04
11	MS_DRG	Tracheostomy For Face, Mouth And Neck Diagnoses Or Laryngectomy With Mcc	10	8	—	—	$43,350.77	$72,004.28	$47,001.36	2026-03-04
21	MS_DRG	Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc	10	8	—	—	$42,076.65	$71,268.97	$45,619.95	2026-03-04
234	MS_DRG	Coronary Bypass With Cardiac Catheterization Or Open Ablation Without Mcc	10	8	—	—	$43,419.12	$70,994.07	$47,075.47	2026-03-04
220	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	8	—	—	$42,386.63	$70,679.12	$45,956.04	2026-03-04
3032	APR_DRG	Dorsal And Lumbar Fusion Procedure For Curvature Of Back	5	3	—	—	$30,726.46	$70,505.67	$45,885.37	2026-03-04
1652	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	5	3	—	—	$30,529.54	$70,053.81	$47,894.86	2026-03-04
1833	APR_DRG	Percutaneous Structural Cardiac Procedures	5	3	—	—	$30,389.57	$69,732.63	$51,425.16	2026-03-04
450	MS_DRG	Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically …	10	8	—	—	$42,361.20	$68,722.75	$45,928.46	2026-03-04
270	MS_DRG	Other Major Cardiovascular Procedures With Mcc	10	8	—	—	$41,937.55	$68,497.22	$45,469.13	2026-03-04
466	MS_DRG	Revision Of Hip Or Knee Replacement With Mcc	10	8	—	—	$41,374.02	$67,983.43	$44,858.15	2026-03-04
1663	APR_DRG	Coronary Bypass Without Ami Or Complex Principal Diagnosis	5	3	—	—	$29,585.48	$67,887.54	$49,627.25	2026-03-04
326	MS_DRG	Stomach, Esophageal And Duodenal Procedures With Mcc	10	8	—	—	$39,641.29	$67,775.25	$42,979.50	2026-03-04
1622	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	3	—	—	$29,463.85	$67,608.45	$54,985.54	2026-03-04
278	MS_DRG	Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures …	10	8	—	—	$44,241.77	$66,763.70	$47,967.39	2026-03-04
J9029	HCPCS	Instill Adstiladrin, Tx Dose	10	8	—	—	$60,175.17	$66,509.40	$65,242.55	2026-03-04
A9543	HCPCS	Y90 Ibritumomab, Rx	10	8	—	—	$53,983.32	$65,476.58	$58,529.29	2026-03-04
2993	APR_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	2	—	—	$65,226.32	$65,226.32	$65,226.32	2026-03-04
3004	APR_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	2	—	—	$62,908.59	$62,908.59	$62,908.59	2026-03-04
Q2043	HCPCS	Sipuleucel-t Auto Cd54+	12	8	—	—	$52,508.71	$61,540.57	$56,930.49	2026-03-04
221	MS_DRG	Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter…	10	8	—	—	$40,060.98	$61,284.24	$43,434.53	2026-03-04
1632	APR_DRG	Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis	5	3	—	—	$26,493.62	$60,792.89	$45,814.48	2026-03-04
L7181	HCPCS	Electronic Elbo Simultaneous	10	8	—	—	$44,875.22	$60,495.24	$59,342.95	2026-03-04
1621	APR_DRG	Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis	5	3	—	—	$25,143.17	$57,694.11	$47,245.07	2026-03-04
1651	APR_DRG	Coronary Bypass With Ami Or Complex Principal Diagnosis	5	3	—	—	$25,070.77	$57,527.98	$43,725.51	2026-03-04
L7180	HCPCS	Electronic Elbow Sequential	10	8	—	—	$43,585.32	$54,891.80	$53,846.24	2026-03-04
5204	APR_DRG	Other GYN Procedures For Malignancy	2	2	—	—	$53,375.58	$53,375.58	$53,375.58	2026-03-04
4854	APR_DRG	Prostatectomy Procedures	2	2	—	—	$51,502.49	$51,502.49	$51,502.49	2026-03-04
1602	APR_DRG	Major Cardiothoracic Repair Of Heart Anomaly	5	3	—	—	$22,383.38	$51,361.42	$45,565.31	2026-03-04
82	APR_DRG	Autologous Bone Marrow Transplant	5	3	—	—	$22,076.41	$50,657.05	$42,922.14	2026-03-04
213	MS_DRG	Endovascular Abdominal Aorta With Iliac Branch Procedures	8	8	—	—	$45,360.10	$50,134.84	$49,179.89	2026-03-04
2992	APR_DRG	Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	2	—	—	$48,868.99	$48,868.99	$48,868.99	2026-03-04
90288	CPT	Botulism Ig IV	2	1	—	—	$48,705.00	$48,705.00	$48,705.00	2026-03-04
5103	APR_DRG	Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced…	3	1	—	—	$21,198.95	$48,643.62	$43,805.61	2026-03-04
J9226	HCPCS	Supprelin La Implant	10	8	—	—	$42,769.62	$47,271.68	$46,371.27	2026-03-04
4284	APR_DRG	Genetic Disorders	2	2	—	—	$45,273.17	$45,273.17	$45,273.17	2026-03-04
3003	APR_DRG	Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical	2	2	—	—	$42,976.92	$42,976.92	$42,976.92	2026-03-04

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