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

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Hospital

ALOMERE HEALTH

Alexandria, MN · CCN 240030 · Rates published

19,891 distinct procedures filed
27 distinct payers
163,422 rate rows
2026-04-01 last MRF observed
Data quality

128,312 of 163,422 rate rows are consumer-grade (78.5%)

35,110 rows are marked excluded from the consumer medians — these stay visible in the raw drill-down with the same reason shown here, so nothing is silently hidden.

Excluded — reasonRows
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 31,566
placeholder amount (≤ $0.02) — excluded from medians 3,384
template filing: same amount across many unrelated codes — excluded 160
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://alomerehealth.com/wp-content/uploads/2026/03/411410148_1558236091_alomere-health_standardcharges.csv
Found on page https://alomerehealth.com/patient-resources/billing-insurance/?o=08
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint 75c41e681a6eb0b4… · 35,974,445 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
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 4 $3,605,000.00 $4,837,990.80 $4,221,495.40 nat. median
$3,710,000
1.1× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 7 $3,672,900.00 $4,837,990.80 $3,869,530.00 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 7 $3,316,462.59 $4,331,738.14 $3,482,285.72 nat. median
$3,325,455
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 7 $3,248,445.72 $4,163,801.80 $3,410,868.00 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 7 $2,945,740.00 $3,870,392.59 $3,093,027.00 nat. median
$3,006,423
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 7 $2,388,614.23 $3,134,207.86 $2,577,866.14 nat. median
$2,469,189
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 7 $2,332,000.00 $3,041,022.82 $2,448,600.00 nat. median
$2,448,600
1.0× median
Q2040
HCPCS 		Tisagenlecleucel Car-pos T 2 $1,458,151.20 $1,458,151.20 $1,458,151.20 nat. median
$25,594
outlier · 57.0×
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 8 $278,143.77 $1,485,055.05 $1,002,977.25 nat. median
$754,974
1.3× median
Q2057
HCPCS 		Afamitresgene Autoleucel 4 $770,620.00 $1,934,024.75 $847,682.00 nat. median
$824,563
1.0× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 8 $527,123.43 $1,618,789.69 $622,455.84 nat. median
$675,122
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 8 $516,726.08 $1,511,570.00 $618,792.00 nat. median
$674,188
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 8 $526,587.59 $1,545,463.41 $613,049.72 nat. median
$625,184
1.0× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 8 $489,455.96 $1,432,569.60 $586,553.19 nat. median
$634,511
0.9× median
5834
APR_DRG 		Neonate With Ecmo 2 $261,766.19 $900,933.60 $581,349.90 nat. median
$309,665
1.9× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 8 $460,530.40 $1,432,569.60 $538,235.07 nat. median
$620,080
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $239,308.14 $823,638.64 $531,473.39 nat. median
$246,434
outlier · 2.2×
5891
APR_DRG 		Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 $235,475.61 $810,448.04 $522,961.83 nat. median
$93,260
outlier · 5.6×
5833
APR_DRG 		Neonate With Ecmo 2 $222,600.11 $766,133.79 $494,366.95 nat. median
$244,017
outlier · 2.0×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $215,898.29 $743,067.80 $479,483.05 nat. median
$164,279
outlier · 2.9×
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $175,950.20 $605,576.49 $390,763.34 nat. median
$160,267
outlier · 2.4×
24
APR_DRG 		Heart And/Or Lung Transplant 2 $174,538.00 $600,716.05 $387,627.03 nat. median
$234,738
1.7× median
5892
APR_DRG 		Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 $171,494.02 $590,239.43 $380,866.72 nat. median
$89,790
outlier · 4.2×
1614
APR_DRG 		Implantable Heart Assist Systems 2 $168,022.29 $578,290.62 $373,156.45 nat. median
$207,730
1.8× median
E0766
HCPCS 		Elec Stim Cancer Treatment 4 $160,634.60 $557,074.22 $358,854.41 nat. median
$16,785
outlier · 21.4×
6024
APR_DRG 		Respiratory Condition Or Major Anomaly 2 $151,175.49 $520,308.16 $335,741.82 nat. median
$118,620
outlier · 2.8×
5832
APR_DRG 		Neonate With Ecmo 2 $148,080.90 $509,657.35 $328,869.12 nat. median
$156,126
outlier · 2.1×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $147,332.35 $507,081.04 $327,206.69 nat. median
$151,838
outlier · 2.2×
1613
APR_DRG 		Implantable Heart Assist Systems 2 $147,245.01 $506,780.42 $327,012.71 nat. median
$119,796
outlier · 2.7×
18
MS_DRG 		Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 11 $155,587.63 $373,999.26 $325,216.75 nat. median
$370,174
0.9× median
5893
APR_DRG 		Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 $144,014.09 $495,660.42 $319,837.26 nat. median
$69,788
outlier · 4.6×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $138,755.49 $477,561.62 $308,158.55 nat. median
$162,982
1.9× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $133,570.35 $459,715.68 $296,643.02 nat. median
$187,294
1.6× median
5831
APR_DRG 		Neonate With Ecmo 2 $121,157.69 $416,994.42 $269,076.05 nat. median
$145,122
1.9× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $120,477.72 $414,654.10 $267,565.91 nat. median
$182,736
1.5× median
6074
APR_DRG 		Respiratory Condition Or Major Anomaly 2 $119,762.64 $412,192.98 $265,977.81 nat. median
$95,507
outlier · 2.8×
1612
APR_DRG 		Implantable Heart Assist Systems 2 $118,224.73 $406,899.88 $262,562.30 nat. median
$85,406
outlier · 3.1×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $117,273.74 $403,626.82 $260,450.28 nat. median
$145,336
1.8× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $115,431.35 $397,285.78 $256,358.57 nat. median
$105,658
outlier · 2.4×
6023
APR_DRG 		Respiratory Condition Or Major Anomaly 2 $114,202.82 $393,057.48 $253,630.15 nat. median
$86,492
outlier · 2.9×
23
APR_DRG 		Heart And/Or Lung Transplant 2 $113,839.57 $391,807.25 $252,823.41 nat. median
$93,528
outlier · 2.7×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $113,757.94 $391,526.30 $252,642.12 nat. median
$108,996
outlier · 2.3×
1611
APR_DRG 		Implantable Heart Assist Systems 2 $112,313.90 $386,556.30 $249,435.10 nat. median
$76,806
outlier · 3.2×
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $109,061.76 $375,363.25 $242,212.51 nat. median
$86,258
outlier · 2.8×
K1007
HCPCS 		Bil Hkaf Pc S/d Micro Sensor 5 $93,216.70 $335,098.03 $233,945.92 nat. median
$96,983
outlier · 2.4×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $104,354.16 $359,160.86 $231,757.51 nat. median
$109,499
outlier · 2.1×
14
APR_DRG 		Liver Transplant And/Or Intestinal Transplant 2 $102,509.32 $352,811.39 $227,660.36 nat. median
$129,535
1.8× median
J3402
HCPCS 		Inj. Remestemcel-l-rknd/ Td 4 $205,640.00 $516,094.64 $226,204.00 nat. median
$209,753
1.1× median
64
APR_DRG 		Pancreas Transplant 2 $101,684.04 $349,970.99 $225,827.52 nat. median
$91,748
outlier · 2.5×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $99,256.37 $341,615.53 $220,435.95 nat. median
$150,721
1.5× median

Other procedures at this hospital

Browse this hospital's 19,891 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
             
0266T HCPCS Implt/rpl Crtd Sns Dev Total 2 2 — — $23,652.26 $112,712.75 $68,182.51 2026-04-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 13 11 — — $89,928.70 $242,710.48 $211,052.59 2026-04-01
11 APR_DRG Liver Transplant And/Or Intestinal Transplant 2 2 — — $50,245.71 $172,933.15 $111,589.43 2026-04-01
111 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 2 2 — — $25,768.96 $88,690.30 $57,229.63 2026-04-01
112 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 2 2 — — $37,493.48 $129,043.14 $83,268.31 2026-04-01
113 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 2 2 — — $52,489.72 $180,656.47 $116,573.10 2026-04-01
114 APR_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 2 2 — — $97,686.62 $336,212.86 $216,949.74 2026-04-01
12 APR_DRG Liver Transplant And/Or Intestinal Transplant 2 2 — — $56,373.68 $194,024.07 $125,198.88 2026-04-01
1204 APR_DRG Major Respiratory And Chest Procedures 2 2 — — $50,355.10 $173,309.63 $111,832.36 2026-04-01
1214 APR_DRG Other Respiratory And Chest Procedures 2 2 — — $31,422.65 $108,148.89 $69,785.77 2026-04-01
13 APR_DRG Liver Transplant And/Or Intestinal Transplant 2 2 — — $82,538.54 $284,076.97 $183,307.76 2026-04-01
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $31,968.76 $110,028.45 $70,998.60 2026-04-01
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $41,298.25 $142,138.22 $91,718.24 2026-04-01
14 APR_DRG Liver Transplant And/Or Intestinal Transplant 2 2 — — $102,509.32 $352,811.39 $227,660.36 2026-04-01
14 MS_DRG Allogeneic Bone Marrow Transplant 13 11 — — $43,300.49 $104,085.10 $90,508.78 2026-04-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $86,224.95 $296,764.68 $191,494.82 2026-04-01
1611 APR_DRG Implantable Heart Assist Systems 2 2 — — $112,313.90 $386,556.30 $249,435.10 2026-04-01
1612 APR_DRG Implantable Heart Assist Systems 2 2 — — $118,224.73 $406,899.88 $262,562.30 2026-04-01
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $147,245.01 $506,780.42 $327,012.71 2026-04-01
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $168,022.29 $578,290.62 $373,156.45 2026-04-01
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $25,858.75 $88,999.34 $57,429.04 2026-04-01
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $34,728.67 $119,527.37 $77,128.02 2026-04-01
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $58,824.21 $202,458.19 $130,641.20 2026-04-01
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $27,958.28 $96,225.38 $62,091.83 2026-04-01
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $47,710.29 $164,206.85 $105,958.57 2026-04-01
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $25,153.47 $86,571.93 $55,862.70 2026-04-01
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $31,072.46 $106,943.62 $69,008.04 2026-04-01
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $47,730.69 $164,277.08 $106,003.88 2026-04-01
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $46,563.38 $160,259.50 $103,411.44 2026-04-01
1674 APR_DRG Other Cardiothoracic And Thoracic Vascular Procedures 2 2 — — $49,192.69 $169,308.90 $109,250.79 2026-04-01
1694 APR_DRG Major Abdominal Vascular Procedures 2 2 — — $46,483.39 $159,984.17 $103,233.78 2026-04-01
1703 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 2 2 — — $25,333.05 $87,190.02 $56,261.54 2026-04-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 2 2 — — $41,071.32 $141,357.18 $91,214.25 2026-04-01
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 2 2 — — $26,131.40 $89,937.71 $58,034.56 2026-04-01
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 2 2 — — $27,046.47 $93,087.16 $60,066.82 2026-04-01
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 2 2 — — $39,460.76 $135,814.04 $87,637.40 2026-04-01
1781 APR_DRG External Heart Assist Systems 2 2 — — $40,757.04 $140,275.53 $90,516.29 2026-04-01
1782 APR_DRG External Heart Assist Systems 2 2 — — $43,690.01 $150,370.06 $97,030.04 2026-04-01
1783 APR_DRG External Heart Assist Systems 2 2 — — $48,836.78 $168,083.96 $108,460.37 2026-04-01
1784 APR_DRG External Heart Assist Systems 2 2 — — $84,833.98 $291,977.29 $188,405.64 2026-04-01
1791 APR_DRG Defibrillator Implants 2 2 — — $25,595.90 $88,094.68 $56,845.29 2026-04-01
1792 APR_DRG Defibrillator Implants 2 2 — — $25,912.63 $89,184.77 $57,548.70 2026-04-01
1793 APR_DRG Defibrillator Implants 2 2 — — $31,972.02 $110,039.69 $71,005.85 2026-04-01
1794 APR_DRG Defibrillator Implants 2 2 — — $43,317.78 $149,088.93 $96,203.35 2026-04-01
18 MS_DRG Chimeric Antigen Receptor (Car) T-cell And Other Immunotherapies 13 11 — — $155,587.63 $373,999.26 $325,216.75 2026-04-01
1804 APR_DRG Other Circulatory System Procedures 2 2 — — $33,166.27 $114,149.98 $73,658.12 2026-04-01
1814 APR_DRG Lower Extremity Arterial Procedures 2 2 — — $46,106.26 $158,686.18 $102,396.22 2026-04-01
1824 APR_DRG Other Peripheral Vascular Procedures 2 2 — — $46,992.76 $161,737.30 $104,365.03 2026-04-01
1833 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $27,388.50 $94,264.34 $60,826.42 2026-04-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $42,167.61 $145,130.34 $93,648.98 2026-04-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 13 11 — — $36,363.75 $98,142.89 $85,341.64 2026-04-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 13 11 — — $25,250.98 $68,150.40 $59,261.22 2026-04-01
2004 APR_DRG Cardiac Structural And Valvular Disorders 2 2 — — $26,695.46 $91,879.08 $59,287.27 2026-04-01
203 APR_DRG Open Craniotomy For Trauma 2 2 — — $25,555.90 $87,957.02 $56,756.46 2026-04-01
204 APR_DRG Open Craniotomy For Trauma 2 2 — — $34,972.74 $120,367.41 $77,670.08 2026-04-01
209 MS_DRG Complex Aortic Arch Procedures 13 11 — — $36,322.03 $98,030.30 $85,243.74 2026-04-01
21 APR_DRG Heart And/Or Lung Transplant 2 2 — — $67,357.81 $231,828.70 $149,593.26 2026-04-01
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 13 11 — — $34,894.99 $94,178.82 $81,894.63 2026-04-01
214 APR_DRG Open Craniotomy Except Trauma 2 2 — — $47,554.37 $163,670.23 $105,612.30 2026-04-01
215 MS_DRG Other Heart Assist System Implant 13 11 — — $31,952.01 $86,235.97 $74,987.80 2026-04-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 13 11 — — $31,393.01 $84,727.25 $73,675.87 2026-04-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 13 11 — — $24,639.66 $66,500.52 $57,826.54 2026-04-01
22 APR_DRG Heart And/Or Lung Transplant 2 2 — — $81,933.66 $281,995.13 $181,964.40 2026-04-01
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 2 2 — — $53,286.43 $183,398.54 $118,342.49 2026-04-01
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 2 2 — — $36,461.67 $125,491.94 $80,976.80 2026-04-01
2234 APR_DRG Other Small And Large Bowel Procedures 2 2 — — $25,504.48 $87,780.02 $56,642.25 2026-04-01
224 APR_DRG Ventricular Shunt Procedures 2 2 — — $40,293.38 $138,679.73 $89,486.55 2026-04-01
2244 APR_DRG Peritoneal Adhesiolysis 2 2 — — $25,641.62 $88,252.01 $56,946.82 2026-04-01
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 2 2 — — $28,577.85 $98,357.79 $63,467.82 2026-04-01
2294 APR_DRG Other Digestive System And Abdominal Procedures 2 2 — — $26,732.19 $92,005.51 $59,368.85 2026-04-01
23 APR_DRG Heart And/Or Lung Transplant 2 2 — — $113,839.57 $391,807.25 $252,823.41 2026-04-01
2304 APR_DRG Major Small Bowel Procedures 2 2 — — $31,585.10 $108,707.98 $70,146.54 2026-04-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 13 11 — — $27,051.55 $73,010.00 $63,486.96 2026-04-01
2314 APR_DRG Major Large Bowel Procedures 2 2 — — $31,007.97 $106,721.67 $68,864.82 2026-04-01
2324 APR_DRG Gastric Fundoplication 2 2 — — $34,682.95 $119,370.04 $77,026.49 2026-04-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 13 11 — — $24,533.45 $66,213.84 $57,577.25 2026-04-01
234 APR_DRG Spinal Procedures 2 2 — — $51,179.56 $176,147.22 $113,663.39 2026-04-01
24 APR_DRG Heart And/Or Lung Transplant 2 2 — — $174,538.00 $600,716.05 $387,627.03 2026-04-01
244 APR_DRG Open Extracranial Vascular Procedures 2 2 — — $32,938.52 $113,366.13 $73,152.33 2026-04-01
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 2 2 — — $42,998.60 $147,990.41 $95,494.51 2026-04-01
2614 APR_DRG Major Biliary Tract Procedures 2 2 — — $33,707.48 $116,012.68 $74,860.08 2026-04-01
264 APR_DRG Other Nervous System And Related Procedures 2 2 — — $30,803.90 $106,019.29 $68,411.60 2026-04-01
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 2 2 — — $25,952.63 $89,322.43 $57,637.53 2026-04-01
274 APR_DRG Other Open Craniotomy 2 2 — — $38,788.13 $133,499.01 $86,143.57 2026-04-01
294 APR_DRG Other Percutaneous Intracranial Procedures 2 2 — — $33,276.47 $114,529.27 $73,902.87 2026-04-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth… 13 11 — — $68,111.67 $183,828.03 $159,850.46 2026-04-01
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $27,619.51 $95,059.43 $61,339.47 2026-04-01
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $37,580.00 $129,340.95 $83,460.48 2026-04-01
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $66,324.38 $228,271.88 $147,298.13 2026-04-01
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 2 2 — — $29,385.17 $101,136.38 $65,260.78 2026-04-01
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $28,459.48 $97,950.41 $63,204.95 2026-04-01
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $44,485.08 $153,106.51 $98,795.80 2026-04-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 2 2 — — $31,706.72 $109,126.60 $70,416.66 2026-04-01
3094 APR_DRG Other Significant Hip And Femur Surgery 2 2 — — $29,003.96 $99,824.34 $64,414.15 2026-04-01
3104 APR_DRG Intervertebral Disc Excision And Decompression 2 2 — — $29,952.50 $103,088.98 $66,520.74 2026-04-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $40,312.98 $138,747.16 $89,530.07 2026-04-01
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 2 2 — — $37,926.93 $130,534.99 $84,230.96 2026-04-01
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 2 2 — — $38,731.80 $133,305.16 $86,018.48 2026-04-01
3214 APR_DRG Decompression 2 2 — — $36,811.05 $126,694.40 $81,752.73 2026-04-01
3224 APR_DRG Shoulder And Elbow Joint Replacement 2 2 — — $28,557.44 $98,287.55 $63,422.49 2026-04-01
3234 APR_DRG Non-elective Or Complex Hip Joint Replacement 2 2 — — $26,165.68 $90,055.71 $58,110.70 2026-04-01
3244 APR_DRG Elective Hip Joint Replacement 2 2 — — $27,787.67 $95,638.19 $61,712.93 2026-04-01
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 2 2 — — $29,303.54 $100,855.43 $65,079.48 2026-04-01
3264 APR_DRG Elective Knee Joint Replacement 2 2 — — $30,114.94 $103,648.07 $66,881.51 2026-04-01
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 2 2 — — $36,803.70 $126,669.12 $81,736.41 2026-04-01
3624 APR_DRG Mastectomy Procedures 2 2 — — $26,788.52 $92,199.36 $59,493.94 2026-04-01
3634 APR_DRG Breast Procedures Except Mastectomy 2 2 — — $28,298.67 $97,396.94 $62,847.81 2026-04-01
38240 HCPCS Transplt Allo Hct/donor 8 8 — — $575.92 $165,987.72 $71,410.91 2026-04-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face, Mouth And Nec… 13 11 — — $44,449.14 $119,964.73 $104,317.16 2026-04-01
4014 APR_DRG Adrenal Procedures 2 2 — — $38,862.41 $133,754.68 $86,308.54 2026-04-01
4034 APR_DRG Procedures For Obesity 2 2 — — $36,758.81 $126,514.59 $81,636.70 2026-04-01
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 2 2 — — $33,847.06 $116,493.11 $75,170.08 2026-04-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 2 2 — — $34,859.28 $119,976.89 $77,418.08 2026-04-01
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $27,787.67 $95,638.19 $61,712.93 2026-04-01
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $41,613.34 $143,222.69 $92,418.01 2026-04-01
424 APR_DRG Degenerative Nervous System Disorders Except Multiple Sclerosis 2 2 — — $32,767.91 $112,778.95 $72,773.43 2026-04-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 13 11 — — $35,367.03 $95,452.83 $83,002.46 2026-04-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 13 11 — — $28,911.81 $78,030.69 $67,852.77 2026-04-01
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $60,153.96 $207,034.86 $133,594.41 2026-04-01
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 2 2 — — $32,092.83 $110,455.49 $71,274.16 2026-04-01
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $115,431.35 $397,285.78 $256,358.57 2026-04-01
4401 APR_DRG Kidney Transplant 2 2 — — $41,266.41 $142,028.65 $91,647.53 2026-04-01
4402 APR_DRG Kidney Transplant 2 2 — — $46,022.99 $158,399.61 $102,211.30 2026-04-01
4403 APR_DRG Kidney Transplant 2 2 — — $52,346.05 $180,162.00 $116,254.02 2026-04-01
4404 APR_DRG Kidney Transplant 2 2 — — $65,464.81 $225,313.47 $145,389.14 2026-04-01
4414 APR_DRG Major Bladder Procedures 2 2 — — $31,119.80 $107,106.57 $69,113.18 2026-04-01
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 2 2 — — $31,621.83 $108,834.41 $70,228.12 2026-04-01
4444 APR_DRG Renal Dialysis Access Device Procedures And Vessel Repair 2 2 — — $33,755.64 $116,178.44 $74,967.04 2026-04-01
4454 APR_DRG Other Bladder Procedures 2 2 — — $29,732.09 $102,330.42 $66,031.26 2026-04-01
4474 APR_DRG Other Kidney, Urinary Tract And Related Procedures 2 2 — — $42,202.71 $145,251.15 $93,726.93 2026-04-01
453 MS_DRG Combined Anterior And Posterior Spinal Fusion With Mcc 3 2 — — $59,191.36 $59,191.36 $59,191.36 2026-04-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 13 11 — — $26,966.51 $72,780.49 $63,287.38 2026-04-01
4804 APR_DRG Major Male Pelvic Procedures 2 2 — — $29,546.79 $101,692.66 $65,619.73 2026-04-01
4824 APR_DRG Transurethral Prostatectomy 2 2 — — $31,377.76 $107,994.37 $69,686.07 2026-04-01
4844 APR_DRG Other Male Reproductive System And Related Procedures 2 2 — — $29,915.76 $102,962.56 $66,439.16 2026-04-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 13 11 — — $33,086.39 $89,297.58 $77,650.07 2026-04-01
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $35,746.59 $123,030.81 $79,388.70 2026-04-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 2 2 — — $36,189.84 $124,556.37 $80,373.10 2026-04-01
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 2 2 — — $27,979.50 $96,298.42 $62,138.96 2026-04-01
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 2 2 — — $30,346.77 $104,445.97 $67,396.37 2026-04-01
5144 APR_DRG Female Reproductive System Reconstructive Procedures 2 2 — — $30,845.53 $106,162.58 $68,504.05 2026-04-01
5184 APR_DRG Other Female Reproductive System And Related Procedures 2 2 — — $32,878.93 $113,161.04 $73,019.98 2026-04-01
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $42,352.91 $145,768.10 $94,060.51 2026-04-01
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $74,277.59 $255,644.83 $164,961.21 2026-04-01
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $91,193.77 $313,866.10 $202,529.93 2026-04-01
5831 APR_DRG Neonate With Ecmo 2 2 — — $121,157.69 $416,994.42 $269,076.05 2026-04-01
5832 APR_DRG Neonate With Ecmo 2 2 — — $148,080.90 $509,657.35 $328,869.12 2026-04-01
5833 APR_DRG Neonate With Ecmo 2 2 — — $222,600.11 $766,133.79 $494,366.95 2026-04-01
5834 APR_DRG Neonate With Ecmo 2 2 — — $261,766.19 $900,933.60 $581,349.90 2026-04-01
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $77,999.91 $268,456.15 $173,228.03 2026-04-01
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $117,273.74 $403,626.82 $260,450.28 2026-04-01
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $120,477.72 $414,654.10 $267,565.91 2026-04-01
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $239,308.14 $823,638.64 $531,473.39 2026-04-01
5891 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $235,475.61 $810,448.04 $522,961.83 2026-04-01
5892 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $171,494.02 $590,239.43 $380,866.72 2026-04-01
5893 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $144,014.09 $495,660.42 $319,837.26 2026-04-01
5894 APR_DRG Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaini… 2 2 — — $43,204.31 $148,698.41 $95,951.36 2026-04-01
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $67,663.92 $232,882.26 $150,273.09 2026-04-01
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $74,430.23 $256,170.21 $165,300.22 2026-04-01
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $97,930.69 $337,052.91 $217,491.80 2026-04-01
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $215,898.29 $743,067.80 $479,483.05 2026-04-01
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $99,146.98 $341,239.06 $220,193.02 2026-04-01
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $109,061.76 $375,363.25 $242,212.51 2026-04-01
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $113,757.94 $391,526.30 $252,642.12 2026-04-01
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $147,332.35 $507,081.04 $327,206.69 2026-04-01
6021 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $53,365.61 $183,671.06 $118,518.33 2026-04-01
6022 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $80,876.56 $278,356.83 $179,616.70 2026-04-01
6023 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $114,202.82 $393,057.48 $253,630.15 2026-04-01
6024 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $151,175.49 $520,308.16 $335,741.82 2026-04-01
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $25,271.83 $86,979.31 $56,125.57 2026-04-01
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $50,389.38 $173,427.63 $111,908.51 2026-04-01
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $104,354.16 $359,160.86 $231,757.51 2026-04-01
6072 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $55,552.48 $191,197.71 $123,375.10 2026-04-01
6073 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $89,457.50 $307,890.30 $198,673.90 2026-04-01
6074 APR_DRG Respiratory Condition Or Major Anomaly 2 2 — — $119,762.64 $412,192.98 $265,977.81 2026-04-01
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $35,286.20 $121,446.26 $78,366.23 2026-04-01
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $49,069.43 $168,884.66 $108,977.05 2026-04-01
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $50,188.57 $172,736.49 $111,462.53 2026-04-01
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $34,421.74 $118,471.00 $76,446.37 2026-04-01
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $60,580.89 $208,504.23 $134,542.56 2026-04-01
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $138,755.49 $477,561.62 $308,158.55 2026-04-01
61 APR_DRG Pancreas Transplant 2 2 — — $54,856.18 $188,801.21 $121,828.70 2026-04-01
6112 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $34,896.01 $120,103.32 $77,499.67 2026-04-01
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $62,361.24 $214,631.75 $138,496.49 2026-04-01
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $84,402.15 $290,491.06 $187,446.60 2026-04-01
6122 APR_DRG Respiratory Condition 2 2 — — $38,996.28 $134,215.43 $86,605.85 2026-04-01
6123 APR_DRG Respiratory Condition 2 2 — — $59,109.10 $203,438.70 $131,273.90 2026-04-01
6124 APR_DRG Respiratory Condition 2 2 — — $72,331.53 $248,946.99 $160,639.26 2026-04-01
6132 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $25,801.61 $88,802.68 $57,302.14 2026-04-01
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $41,529.26 $142,933.31 $92,231.29 2026-04-01
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $48,217.21 $165,951.55 $107,084.38 2026-04-01
6142 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $27,836.65 $95,806.76 $61,821.70 2026-04-01
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $40,166.86 $138,244.26 $89,205.56 2026-04-01
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $51,798.32 $178,276.82 $115,037.57 2026-04-01
62 APR_DRG Pancreas Transplant 2 2 — — $66,035.40 $227,277.31 $146,656.35 2026-04-01
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $41,120.30 $141,525.75 $91,323.02 2026-04-01
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $81,763.06 $281,407.95 $181,585.51 2026-04-01
6222 APR_DRG Respiratory Condition 2 2 — — $27,316.66 $94,017.11 $60,666.88 2026-04-01
6223 APR_DRG Respiratory Condition 2 2 — — $32,438.13 $111,643.91 $72,041.02 2026-04-01
6224 APR_DRG Respiratory Condition 2 2 — — $34,846.21 $119,931.94 $77,389.08 2026-04-01
6233 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 2 2 — — $36,298.41 $124,930.04 $80,614.23 2026-04-01
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 2 2 — — $44,017.34 $151,496.67 $97,757.01 2026-04-01
6252 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 2 2 — — $25,751.00 $88,628.49 $57,189.75 2026-04-01
6253 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 2 2 — — $34,278.07 $117,976.52 $76,127.30 2026-04-01
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 2 2 — — $36,810.23 $126,691.59 $81,750.91 2026-04-01
6264 APR_DRG Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Probl… 2 2 — — $32,219.36 $110,890.96 $71,555.16 2026-04-01
63 APR_DRG Pancreas Transplant 2 2 — — $80,390.86 $276,685.18 $178,538.02 2026-04-01
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $35,220.90 $121,221.50 $78,221.20 2026-04-01
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $56,420.21 $194,184.21 $125,302.21 2026-04-01
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $99,256.37 $341,615.53 $220,435.95 2026-04-01
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $36,888.60 $126,961.30 $81,924.95 2026-04-01
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $92,241.90 $317,473.50 $204,857.70 2026-04-01
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 2 2 — — $72,429.48 $249,284.13 $160,856.80 2026-04-01
6344 APR_DRG Respiratory Condition 2 2 — — $29,581.08 $101,810.66 $65,695.87 2026-04-01
6364 APR_DRG Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection 2 2 — — $28,261.12 $97,267.70 $62,764.41 2026-04-01
6394 APR_DRG Neonate Birth Weight > 2499 Grams With Other Significant Condition 2 2 — — $29,871.68 $102,810.84 $66,341.26 2026-04-01
64 APR_DRG Pancreas Transplant 2 2 — — $101,684.04 $349,970.99 $225,827.52 2026-04-01
6504 APR_DRG Splenectomy 2 2 — — $32,211.20 $110,862.87 $71,537.04 2026-04-01
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 2 2 — — $40,143.19 $138,162.78 $89,152.99 2026-04-01
6604 APR_DRG Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagula… 2 2 — — $29,741.07 $102,361.32 $66,051.20 2026-04-01
6614 APR_DRG Coagulation And Platelet Disorders 2 2 — — $28,669.27 $98,672.45 $63,670.86 2026-04-01
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $52,181.98 $179,597.29 $115,889.64 2026-04-01
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $53,465.20 $184,013.82 $118,739.51 2026-04-01
6903 APR_DRG Acute Leukemia 2 2 — — $33,153.21 $114,105.03 $73,629.12 2026-04-01
6904 APR_DRG Acute Leukemia 2 2 — — $54,968.01 $189,186.11 $122,077.06 2026-04-01
6914 APR_DRG Lymphoma, Myeloma And Non-acute Leukemia 2 2 — — $37,727.75 $129,849.47 $83,788.61 2026-04-01
6924 APR_DRG Radiotherapy 2 2 — — $27,186.06 $93,567.59 $60,376.82 2026-04-01
6954 APR_DRG Chemotherapy For Acute Leukemia 2 2 — — $40,407.67 $139,073.06 $89,740.36 2026-04-01
7 MS_DRG Lung Transplant 13 11 — — $41,557.19 $112,159.59 $97,530.08 2026-04-01
71 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $52,392.58 $180,322.14 $116,357.36 2026-04-01
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 2 2 — — $36,082.91 $124,188.33 $80,135.62 2026-04-01
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 2 2 — — $31,587.54 $108,716.41 $70,151.98 2026-04-01
72 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $66,429.68 $228,634.30 $147,531.99 2026-04-01
73 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $84,335.22 $290,260.68 $187,297.95 2026-04-01
734 APR_DRG Orbit And Eye Procedures 2 2 — — $25,671.82 $88,355.97 $57,013.90 2026-04-01
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $133,570.35 $459,715.68 $296,643.02 2026-04-01
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 2 2 — — $40,489.30 $139,354.01 $89,921.65 2026-04-01
7504 APR_DRG Schizophrenia 2 2 — — $27,611.35 $95,031.34 $61,321.34 2026-04-01
7524 APR_DRG Disorders Of Personality And Impulse Control 2 2 — — $37,855.91 $130,290.56 $84,073.24 2026-04-01
7574 APR_DRG Organic Mental Health Disturbances 2 2 — — $26,982.80 $92,868.02 $59,925.41 2026-04-01
7594 APR_DRG Eating Disorders 2 2 — — $36,015.16 $123,955.14 $79,985.15 2026-04-01
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 2 2 — — $33,247.90 $114,430.94 $73,839.42 2026-04-01
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 2 2 — — $29,999.84 $103,251.93 $66,625.88 2026-04-01
83 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 2 2 — — $28,536.22 $98,214.50 $63,375.36 2026-04-01
84 APR_DRG Autologous Bone Marrow Transplant Or T-cell Immunotherapy 2 2 — — $50,443.26 $173,613.05 $112,028.15 2026-04-01
8412 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $26,100.38 $89,830.95 $57,965.66 2026-04-01
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $80,337.80 $276,502.56 $178,420.18 2026-04-01
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $175,950.20 $605,576.49 $390,763.34 2026-04-01
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $34,407.04 $118,420.42 $76,413.73 2026-04-01
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $59,378.48 $204,365.84 $131,872.16 2026-04-01
8444 APR_DRG Partial Thickness Burns Without Skin Graft 2 2 — — $30,732.06 $105,772.06 $68,252.06 2026-04-01
850 MS_DRG Acute Leukemia With Other Procedures 13 11 — — $27,788.34 $74,998.53 $65,216.11 2026-04-01
8504 APR_DRG Services 2 2 — — $46,244.21 $159,160.98 $102,702.60 2026-04-01
8514 APR_DRG Gender Related Procedures 2 2 — — $44,695.69 $153,831.36 $99,263.52 2026-04-01
8633 APR_DRG Neonatal Aftercare 2 2 — — $42,370.87 $145,829.91 $94,100.39 2026-04-01
8634 APR_DRG Neonatal Aftercare 2 2 — — $66,880.28 $230,185.14 $148,532.71 2026-04-01
894 APR_DRG Major Cranial Or Facial Bone Procedures 2 2 — — $42,899.83 $147,650.46 $95,275.14 2026-04-01
91 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 2 2 — — $29,123.95 $100,237.34 $64,680.65 2026-04-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $39,295.05 $135,243.71 $87,269.38 2026-04-01
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 2 2 — — $41,130.91 $141,562.28 $91,346.60 2026-04-01
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $44,162.65 $151,996.76 $98,079.71 2026-04-01
913 APR_DRG Other Major Head And Neck Procedures 2 2 — — $26,981.98 $92,865.21 $59,923.60 2026-04-01
914 APR_DRG Other Major Head And Neck Procedures 2 2 — — $38,142.43 $131,276.70 $84,709.57 2026-04-01
92 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 2 2 — — $30,656.96 $105,513.58 $68,085.27 2026-04-01
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 2 2 — — $35,042.13 $120,606.22 $77,824.17 2026-04-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 13 11 — — $68,513.75 $184,913.24 $160,794.12 2026-04-01
9287 OTHER Brentuximab Vedotin Inj 2 2 — — $59,065.10 $59,065.10 $59,065.10 2025-01-01
93 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 2 2 — — $52,509.31 $180,723.90 $116,616.60 2026-04-01
94 APR_DRG Extracorporeal Membrane Oxygenation (Ecmo) 2 2 — — $92,507.20 $318,386.59 $205,446.90 2026-04-01
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $49,909.40 $171,775.64 $110,842.52 2026-04-01
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $32,243.85 $110,975.25 $71,609.55 2026-04-01
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $35,879.65 $123,488.76 $79,684.20 2026-04-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 13 11 — — $24,452.26 $65,994.73 $57,386.72 2026-04-01
A9543 HCPCS Y90 Ibritumomab, Rx 7 7 — — $14,774.74 $161,017.57 $59,665.78 2026-04-01
E0194 HCPCS Air Fluidized Bed 3 3 — — $9,699.71 $134,035.96 $134,035.96 2026-04-01
E0766 HCPCS Elec Stim Cancer Treatment 4 4 — — $160,634.60 $557,074.22 $358,854.41 2026-04-01
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 7 7 — — $3,672,900.00 $4,837,990.80 $3,869,530.00 2026-04-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 7 7 — — $3,316,462.59 $4,331,738.14 $3,482,285.72 2026-04-01
J1414 HCPCS Inj, Beqvez, Per Tx Dose 4 4 — — $3,605,000.00 $4,837,990.80 $4,221,495.40 2026-04-01
J3392 HCPCS Inj, Exagamglogene Autotem 7 7 — — $2,332,000.00 $3,041,022.82 $2,448,600.00 2026-04-01
J3393 HCPCS Inj, Betibeglogene Autotemce 7 7 — — $2,945,740.00 $3,870,392.59 $3,093,027.00 2026-04-01
J3394 HCPCS Inj, Lovotibeglogene Autotem 7 7 — — $3,248,445.72 $4,163,801.80 $3,410,868.00 2026-04-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 7 7 — — $2,388,614.23 $3,134,207.86 $2,577,866.14 2026-04-01
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 4 4 — — $205,640.00 $516,094.64 $226,204.00 2026-04-01
J7330 HCPCS Cultured Chondrocytes Implnt 2 2 — — $101,732.21 $101,732.21 $101,732.21 2026-04-01
J9029 HCPCS Inj, Adstiladrin, Per Tx Dos 8 8 — — $63,342.28 $200,157.07 $69,676.51 2026-04-01
K0606 HCPCS Aed Garment W Elec Analysis 4 4 — — $36,944.60 $122,024.23 $79,484.42 2026-04-01
K1007 HCPCS Bil Hkaf Pc S/d Micro Sensor 5 5 — — $93,216.70 $335,098.03 $233,945.92 2026-04-01
L8614 HCPCS Cochlear Device 3 3 — — $59,321.94 $81,972.75 $81,972.75 2026-04-01
L8702 HCPCS Pow Ue Rom Dev Ewhf Uprt Cus 8 8 — — $67,452.66 $242,481.01 $75,681.89 2026-04-01
Q0480 HCPCS Driver Pneumatic Vad, Rep 8 8 — — $99,999.95 $377,061.16 $121,991.93 2026-04-01
Q2040 HCPCS Tisagenlecleucel Car-pos T 2 2 — — $1,458,151.20 $1,458,151.20 $1,458,151.20 2026-04-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 8 8 — — $489,455.96 $1,432,569.60 $586,553.19 2026-04-01
Q2042 HCPCS Tisagenlecleucel Car-pos T 8 8 — — $278,143.77 $1,485,055.05 $1,002,977.25 2026-04-01
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 8 8 — — $55,015.23 $173,809.88 $60,799.56 2026-04-01
Q2053 HCPCS Brexucabtagene Car Pos T 8 8 — — $460,530.40 $1,432,569.60 $538,235.07 2026-04-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 8 8 — — $516,726.08 $1,511,570.00 $618,792.00 2026-04-01
Q2055 HCPCS Idecabtagene Vicleucel Car 8 8 — — $526,587.59 $1,545,463.41 $613,049.72 2026-04-01
Q2056 HCPCS Ciltacabtagene Car-pos T 8 8 — — $527,123.43 $1,618,789.69 $622,455.84 2026-04-01
Q2057 HCPCS Afamitresgene Autoleucel 4 4 — — $770,620.00 $1,934,024.75 $847,682.00 2026-04-01
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