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

GRAND ITASCA CLINIC AND HOSPITAL

Grand Rapids, MN · CCN 240064 · Rates published

18,163 distinct procedures filed
15 distinct payers
1,121,165 rate rows
2026-01-28 last MRF observed
Data quality

711,292 of 1,121,165 rate rows are consumer-grade (63.4%)

409,873 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 405,196
exceeds 10× this hospital's gross charge — excluded from medians 1,860
template filing: same amount across many unrelated codes — excluded 1,856
percent-of-charges filed in the dollar field — excluded from medians 376
placeholder amount (≤ $0.02) — excluded from medians 373
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 212
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://requiredlearning.fairview.org/price_transparency/411865874_grand-itasca-clinic-and-hospital_standardcharges.csv
Found on page https://www.granditasca.org/hospital-price-transparency
Discovered viaCMS hospital list
Last fetch success · 2026-08-12
Content fingerprint 12dfaf7214a1bdb6… · 756,266,100 bytes · first seen 2026-05-11

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 10 $4,432,920.00 $4,698,895.20 $4,432,920.00 nat. median
$4,505,000
1.0× median
J1411
HCPCS 		Inj, Hemgenix, Per Tx Dose 10 $3,563,251.79 $4,097,739.56 $3,626,302.40 nat. median
$3,710,000
1.0× median
J1414
HCPCS 		Inj, Beqvez, Per Tx Dose 3 $3,563,251.79 $4,097,739.56 $3,563,251.79 nat. median
$3,710,000
1.0× median
J1413
HCPCS 		Inj Delandistrogene Mox Rokl 10 $3,257,830.21 $3,746,504.74 $3,263,399.19 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		Inj, Lovotibeglogene Autotem 10 $3,196,470.58 $3,388,258.81 $3,196,470.58 nat. median
$3,286,000
1.0× median
J3393
HCPCS 		Inj, Betibeglogene Autotemce 10 $2,898,608.16 $3,072,524.65 $2,898,608.16 nat. median
$2,997,086
1.0× median
J3392
HCPCS 		Inj, Exagamglogene Autotem 10 $2,294,688.00 $2,432,369.28 $2,294,688.00 nat. median
$2,405,851
1.0× median
J3399
HCPCS 		Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit (6.1-6.5 Kg; 35.8 Ml) 15 $733,125.00 $2,594,385.73 $1,627,750.00 nat. median
$2,460,273
0.7× median
Q2056
HCPCS 		Ciltacabtagene Autoleucel 100000000 Cells IV Susp 15 $389,016.10 $1,929,229.56 $1,384,664.31 nat. median
$631,793
outlier · 2.2×
Q2041
HCPCS 		Axicabtagene Ciloleucel 200000000 Cells IV Susp 15 $207,548.54 $1,908,853.72 $1,370,039.98 nat. median
$588,565
outlier · 2.3×
Q2042
HCPCS 		Tisagenlecleucel 250000000 Cells IV Susp 15 $207,548.54 $1,850,294.09 $1,328,010.02 nat. median
$691,418
1.9× median
Q2053
HCPCS 		Brexucabtagene Autoleucel 200000000 Cells IV Susp 15 $172,957.12 $1,815,666.13 $1,303,156.53 nat. median
$577,541
outlier · 2.3×
Q2054
HCPCS 		Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 15 $359,368.04 $1,782,197.34 $1,279,135.01 nat. median
$624,417
outlier · 2.0×
24
APR_DRG 		Heart And/or Lung Transplant 1 $370,481.89 $805,569.25 $791,325.39 nat. median
$243,231
outlier · 3.3×
Q2057
HCPCS 		Afamitresgene Autoleucel 10 $758,290.08 $1,487,765.14 $758,290.08 nat. median
$809,151
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 10 $548,400.85 $1,075,962.47 $548,400.85 nat. median
$610,161
0.9× median
5834
APR_DRG 		Neonate With Ecmo 4 $499,742.05 $1,086,630.23 $543,330.62 nat. median
$311,018
1.7× median
23
APR_DRG 		Heart And/or Lung Transplant 1 $176,728.36 $384,275.00 $377,480.35 nat. median
$116,111
outlier · 3.3×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $170,113.82 $369,892.46 $363,352.12 nat. median
$175,480
outlier · 2.1×
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $164,017.40 $356,636.52 $350,330.57 nat. median
$137,901
outlier · 2.5×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $323,289.68 $702,955.33 $343,405.32 nat. median
$254,667
1.3× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 10 $237,073.57 $664,640.15 $332,154.00 nat. median
$370,165
0.9× median
64
APR_DRG 		Pancreas Transplant 1 $154,256.37 $335,412.31 $329,481.64 nat. median
$92,994
outlier · 3.5×
5833
APR_DRG 		Neonate With Ecmo 4 $292,146.27 $635,237.67 $328,048.99 nat. median
$250,089
1.3× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 1 $146,945.36 $319,515.37 $313,865.79 nat. median
$119,243
outlier · 2.6×
13
APR_DRG 		Liver Transplant And/or Intestinal Transplant 1 $136,599.80 $297,020.19 $291,768.36 nat. median
$74,748
outlier · 3.9×
22
APR_DRG 		Heart And/or Lung Transplant 1 $131,151.69 $285,173.92 $280,131.55 nat. median
$94,014
outlier · 3.0×
Q2058
HCPCS 		Obecbtge Autol Up To 400 Mil 10 $273,798.00 $537,191.68 $273,798.00 nat. median
$302,242
0.9× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 4 $232,185.59 $660,116.26 $271,984.85 nat. median
$168,361
1.6× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 4 $195,334.98 $693,917.06 $260,681.63 nat. median
$165,646
1.6× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $179,223.70 $723,038.80 $259,038.19 nat. median
$96,420
outlier · 2.7×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 4 $204,952.35 $649,798.53 $255,515.00 nat. median
$156,285
1.6× median
J3403
HCPCS 		Revakinagene, Per Implant 10 $253,380.00 $268,582.80 $253,380.00 nat. median
$265,000
1.0× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 $237,295.98 $564,666.71 $252,681.59 nat. median
$168,174
1.5× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant 1 $118,175.17 $256,957.99 $252,414.53 nat. median
$89,814
outlier · 2.8×
21
APR_DRG 		Heart And/or Lung Transplant 1 $112,432.85 $244,471.99 $240,149.30 nat. median
$74,854
outlier · 3.2×
1614
APR_DRG 		Implantable Heart Assist Systems 4 $228,328.88 $522,178.64 $238,269.62 nat. median
$209,486
1.1× median
C9293
HCPCS 		Injection, Glucarpidase 1 $97,156.22 $237,990.24 $233,782.16 nat. median
$24,377
outlier · 9.6×
63
APR_DRG 		Pancreas Transplant 1 $108,985.63 $236,976.42 $232,786.27 nat. median
$75,474
outlier · 3.1×
Q2043
HCPCS 		Sipuleucel-t 50000000 Cells IV Susp 15 $23,248.04 $321,492.18 $230,744.31 nat. median
$65,655
outlier · 3.5×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $179,223.70 $578,432.17 $225,785.84 nat. median
$89,188
outlier · 2.5×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $218,443.02 $485,476.42 $224,712.52 nat. median
$180,995
1.2× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 4 $158,681.25 $345,033.69 $223,623.02 nat. median
$165,599
1.4× median
4404
APR_DRG 		Kidney Transplant 1 $103,376.10 $224,779.15 $220,804.67 nat. median
$80,513
outlier · 2.7×
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 10 $153,851.21 $431,719.75 $215,752.00 nat. median
$261,939
0.8× median
84
APR_DRG 		Autologous Bone Marrow Transplant 1 $100,972.94 $219,553.77 $215,671.68 nat. median
$79,228
outlier · 2.7×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 4 $180,976.19 $393,511.41 $214,393.33 nat. median
$147,847
1.5× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 $163,978.35 $356,551.61 $206,105.59 nat. median
$147,677
1.4× median
5832
APR_DRG 		Neonate With Ecmo 4 $188,594.43 $410,076.38 $205,858.18 nat. median
$169,230
1.2× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 4 $179,223.70 $491,066.96 $205,696.18 nat. median
$71,350
outlier · 2.9×

Other procedures at this hospital

Browse this hospital's 18,163 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
             
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 14 10 — — $153,851.21 $431,719.75 $215,752.00 2026-01-28
10 MS_DRG Pancreas Transplant 14 10 — — $39,394.59 $111,381.66 $55,663.00 2026-01-28
11 APR_DRG Liver Transplant And/or Intestinal Transplant 3 1 — — $75,586.18 $164,353.25 $161,447.20 2026-01-28
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 1 — — $32,818.84 $71,360.71 $70,098.93 2026-01-28
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 1 — — $48,300.07 $105,022.80 $103,165.82 2026-01-28
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 1 — — $91,184.57 $198,270.11 $194,764.35 2026-01-28
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 3 1 — — $146,945.36 $319,515.37 $313,865.79 2026-01-28
12 APR_DRG Liver Transplant And/or Intestinal Transplant 3 1 — — $85,132.41 $185,110.41 $181,837.34 2026-01-28
1204 APR_DRG Major Respiratory And Chest Procedures 6 4 — — $50,795.30 $150,335.87 $60,863.98 2026-01-28
1214 APR_DRG Other Respiratory And Chest Procedures 6 4 — — $42,946.16 $126,600.86 $51,343.00 2026-01-28
13 APR_DRG Liver Transplant And/or Intestinal Transplant 3 1 — — $136,599.80 $297,020.19 $291,768.36 2026-01-28
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 4 — — $40,473.96 $128,905.00 $50,593.10 2026-01-28
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 6 4 — — $54,121.83 $183,015.72 $70,100.70 2026-01-28
14 APR_DRG Liver Transplant And/or Intestinal Transplant 3 1 — — $164,017.40 $356,636.52 $350,330.57 2026-01-28
14 MS_DRG Allogeneic Bone Marrow Transplant 14 10 — — $65,978.27 $185,782.85 $92,845.00 2026-01-28
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 4 — — $44,440.17 $96,629.92 $53,997.02 2026-01-28
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 4 — — $109,814.89 $238,779.55 $122,848.59 2026-01-28
1611 APR_DRG Implantable Heart Assist Systems 6 4 — — $124,179.19 $311,026.25 $135,801.96 2026-01-28
1612 APR_DRG Implantable Heart Assist Systems 6 4 — — $124,179.19 $327,395.91 $139,566.17 2026-01-28
1613 APR_DRG Implantable Heart Assist Systems 6 4 — — $183,730.68 $407,760.91 $188,872.96 2026-01-28
1614 APR_DRG Implantable Heart Assist Systems 6 4 — — $228,328.88 $522,178.64 $238,269.62 2026-01-28
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 4 — — $39,735.40 $86,399.95 $50,869.12 2026-01-28
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 4 — — $52,222.45 $113,551.56 $66,468.88 2026-01-28
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 6 4 — — $87,643.62 $190,570.73 $92,798.69 2026-01-28
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 4 — — $45,216.06 $98,316.99 $55,765.65 2026-01-28
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 6 4 — — $76,062.65 $165,389.27 $81,579.78 2026-01-28
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 4 — — $49,806.27 $108,297.87 $53,920.51 2026-01-28
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 6 4 — — $71,870.50 $161,233.87 $74,279.55 2026-01-28
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 6 4 — — $59,892.76 $130,229.75 $63,243.60 2026-01-28
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 6 4 — — $60,998.49 $169,437.09 $70,537.99 2026-01-28
1694 APR_DRG Major Abdominal Vascular Procedures 6 4 — — $56,112.67 $198,592.79 $74,713.21 2026-01-28
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 6 4 — — $41,178.91 $113,738.38 $47,470.45 2026-01-28
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 6 4 — — $38,308.35 $128,016.19 $49,267.68 2026-01-28
1781 APR_DRG External Heart Assist Devices 6 4 — — $44,844.25 $145,625.66 $56,700.30 2026-01-28
1782 APR_DRG External Heart Assist Devices 6 4 — — $48,877.68 $151,705.90 $60,186.36 2026-01-28
1783 APR_DRG External Heart Assist Devices 6 4 — — $60,632.35 $154,403.51 $66,891.48 2026-01-28
1784 APR_DRG External Heart Assist Devices 6 4 — — $74,771.33 $234,927.04 $92,726.94 2026-01-28
1793 APR_DRG Defibrillator Implants 6 4 — — $45,834.30 $118,686.36 $51,018.10 2026-01-28
1794 APR_DRG Defibrillator Implants 6 4 — — $62,086.18 $157,743.68 $68,412.12 2026-01-28
18 MS_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 14 10 — — $237,073.57 $664,640.15 $332,154.00 2026-01-28
1814 APR_DRG Lower Extremity Arterial Procedures 6 4 — — $43,988.94 $137,402.62 $54,366.66 2026-01-28
1824 APR_DRG Other Peripheral Vascular And Related Procedures 6 4 — — $35,487.58 $135,896.72 $49,619.65 2026-01-28
1833 APR_DRG Percutaneous Structural Cardiac Procedures 6 4 — — $40,983.85 $89,114.55 $47,575.29 2026-01-28
1834 APR_DRG Percutaneous Structural Cardiac Procedures 6 4 — — $58,261.58 $126,682.94 $67,520.12 2026-01-28
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 14 10 — — $39,168.95 $110,749.35 $55,347.00 2026-01-28
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 14 10 — — $62,211.58 $175,241.58 $87,577.00 2026-01-28
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 14 10 — — $43,199.71 $122,030.99 $60,985.00 2026-01-28
204 APR_DRG Open Craniotomy For Trauma 6 4 — — $49,656.84 $149,732.94 $60,136.01 2026-01-28
207 MS_DRG Respiratory System Diagnosis With Ventilator Support &gt;96 Hours 14 10 — — $35,326.50 $99,995.97 $49,973.00 2026-01-28
20808 CPT Replantation Hand Complete 3 1 — — $22,041.60 $53,992.28 $53,037.60 2026-01-28
209 MS_DRG Complex Aortic Arch Procedures 14 10 — — $62,140.21 $175,041.48 $87,477.00 2026-01-28
21 APR_DRG Heart And/or Lung Transplant 3 1 — — $112,432.85 $244,471.99 $240,149.30 2026-01-28
212 MS_DRG Concomitant Aortic And Mitral Valve Procedures 14 10 — — $59,698.81 $168,208.06 $84,062.00 2026-01-28
214 APR_DRG Open Craniotomy Except Trauma 6 4 — — $56,044.33 $150,307.56 $63,574.62 2026-01-28
215 MS_DRG Other Heart Assist System Implant 14 10 — — $54,663.93 $154,117.02 $77,020.00 2026-01-28
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 10 — — $53,707.57 $151,439.68 $75,682.00 2026-01-28
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 10 — — $36,098.40 $102,155.05 $51,052.00 2026-01-28
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 14 10 — — $36,098.40 $102,155.05 $51,052.00 2026-01-28
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 14 10 — — $42,153.87 $119,103.52 $59,522.00 2026-01-28
22 APR_DRG Heart And/or Lung Transplant 3 1 — — $131,151.69 $285,173.92 $280,131.55 2026-01-28
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 6 4 — — $51,535.39 $182,919.48 $68,739.70 2026-01-28
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 6 4 — — $36,030.45 $168,287.85 $57,349.01 2026-01-28
224 APR_DRG Ventricular Shunt Procedures 6 4 — — $40,412.45 $123,376.74 $49,290.04 2026-01-28
23 APR_DRG Heart And/or Lung Transplant 3 1 — — $176,728.36 $384,275.00 $377,480.35 2026-01-28
2304 APR_DRG Major Small Bowel Procedures 6 4 — — $44,076.81 $107,595.87 $47,558.07 2026-01-28
231 MS_DRG Coronary Bypass With Ptca With Mcc 14 10 — — $46,280.15 $130,651.29 $65,293.00 2026-01-28
232 MS_DRG Coronary Bypass With Ptca Without Mcc 14 10 — — $33,283.67 $94,277.12 $47,115.00 2026-01-28
233 MS_DRG Coronary Bypass With Cardiac Catheterization Or Open Ablation With Mcc 14 10 — — $41,972.15 $118,595.27 $59,268.00 2026-01-28
234 APR_DRG Spinal Procedures 6 4 — — $54,074.96 $176,692.05 $68,622.31 2026-01-28
24 APR_DRG Heart And/or Lung Transplant 3 1 — — $370,481.89 $805,569.25 $791,325.39 2026-01-28
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 6 4 — — $53,018.52 $135,050.35 $58,499.92 2026-01-28
2614 APR_DRG Major Biliary Tract Procedures 6 4 — — $46,963.00 $155,575.40 $60,085.01 2026-01-28
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 6 4 — — $40,567.70 $115,128.23 $47,473.65 2026-01-28
26554 CPT Double Transfer Toe-hand 3 1 — — $21,066.24 $51,603.07 $50,690.64 2026-01-28
266 MS_DRG Endovascular Cardiac Valve Replacement And Supplement Procedures With Mcc 14 10 — — $33,644.92 $95,289.62 $47,621.00 2026-01-28
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 14 10 — — $37,759.67 $106,805.38 $53,376.00 2026-01-28
274 APR_DRG Other Open Craniotomy 6 4 — — $44,027.02 $137,249.76 $54,351.22 2026-01-28
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 14 10 — — $39,145.90 $110,685.32 $55,315.00 2026-01-28
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $59,296.66 $61,389.83 $59,296.66 2026-01-28
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $75,633.48 $78,303.34 $75,633.48 2026-01-28
3 MS_DRG Ecmo Or Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mo… 14 10 — — $116,526.35 $327,255.55 $163,546.00 2026-01-28
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 3 — — $57,189.62 $59,208.41 $57,189.62 2026-01-28
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 4 — — $53,394.08 $116,099.14 $56,794.05 2026-01-28
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 6 4 — — $83,596.85 $201,966.93 $89,716.28 2026-01-28
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 6 4 — — $58,524.55 $127,254.73 $62,531.18 2026-01-28
3094 APR_DRG Other Significant Hip And Femur Surgery 6 4 — — $35,741.44 $129,624.00 $48,308.64 2026-01-28
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 6 4 — — $49,082.72 $152,634.35 $60,505.99 2026-01-28
317 MS_DRG Concomitant Left Atrial Appendage Closure And Cardiac Ablation 14 10 — — $36,708.89 $103,863.91 $51,906.00 2026-01-28
3174 APR_DRG Tendon, Muscle And Other Soft Tissue Procedures 6 4 — — $30,622.27 $137,263.92 $47,415.51 2026-01-28
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 6 4 — — $45,239.68 $122,827.60 $51,662.57 2026-01-28
32445 CPT Removal Of Lung Extrapleural 3 1 — — $19,651.20 $48,136.84 $47,285.70 2026-01-28
32852 CPT Lung Transplant With Bypass 3 1 — — $19,902.72 $48,752.96 $47,890.92 2026-01-28
32853 CPT Lung Transplant Double 3 1 — — $25,635.84 $62,796.59 $61,686.24 2026-01-28
32854 CPT Lung Transplant With Bypass 3 1 — — $27,208.32 $66,648.48 $65,470.02 2026-01-28
33305 CPT Repair Of Heart Wound 3 1 — — $22,861.44 $56,000.53 $55,010.34 2026-01-28
33783 CPT Nikaidoh Proc W/ostia Implt 3 1 — — $19,518.72 $47,812.32 $46,966.92 2026-01-28
33877 CPT Thoracoabdominal Graft 3 1 — — $20,188.80 $49,453.73 $48,579.30 2026-01-28
33916 CPT Surgery Of Great Vessel 3 1 — — $23,648.64 $57,928.82 $56,904.54 2026-01-28
33935 CPT Transplantation Heart/lung 3 1 — — $27,628.80 $67,678.47 $66,481.80 2026-01-28
33945 CPT Transplantation Of Heart 3 1 — — $27,137.28 $66,474.46 $65,299.08 2026-01-28
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 6 4 — — $46,217.04 $140,301.21 $56,186.57 2026-01-28
38240 CPT Transplt Allo Hct/donor 16 10 — — $1,253.76 $116,770.20 $59,515.90 2026-01-28
39503 CPT Repair Of Diaphragm Hernia 3 1 — — $33,367.68 $81,736.22 $80,290.98 2026-01-28
4 MS_DRG Tracheostomy With Mv &gt;96 Hours Or Principal Diagnosis Except Face, Mouth And … 14 10 — — $76,044.19 $213,954.92 $106,924.00 2026-01-28
4014 APR_DRG Adrenal Procedures 6 4 — — $51,137.03 $118,009.83 $53,607.49 2026-01-28
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 6 4 — — $39,719.22 $123,328.62 $48,920.12 2026-01-28
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 6 4 — — $41,468.90 $122,173.72 $49,560.26 2026-01-28
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 4 — — $49,167.67 $128,253.96 $54,943.69 2026-01-28
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 4 — — $69,397.33 $192,062.49 $80,088.37 2026-01-28
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 10 — — $60,506.39 $170,469.19 $85,192.00 2026-01-28
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 14 10 — — $39,630.11 $112,039.99 $55,992.00 2026-01-28
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 14 10 — — $49,462.70 $139,559.75 $69,745.00 2026-01-28
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 4 — — $111,280.21 $277,638.72 $121,447.32 2026-01-28
43108 CPT Removal Of Esophagus 3 1 — — $24,944.64 $61,103.45 $60,023.04 2026-01-28
43112 CPT Esphg Tot W/thrcm 3 1 — — $19,516.80 $47,807.62 $46,962.30 2026-01-28
43113 CPT Removal Of Esophagus 3 1 — — $24,351.36 $59,650.18 $58,595.46 2026-01-28
43116 CPT Partial Removal Of Esophagus 3 1 — — $27,960.96 $68,492.12 $67,281.06 2026-01-28
43118 CPT Partial Removal Of Esophagus 3 1 — — $20,294.40 $49,712.40 $48,833.40 2026-01-28
43123 CPT Partial Removal Of Esophagus 3 1 — — $24,963.84 $61,150.49 $60,069.24 2026-01-28
43124 CPT Removal Of Esophagus 3 1 — — $21,210.24 $51,955.81 $51,037.14 2026-01-28
43287 CPT Esphg Dstl 2/3 W/laps Moblj 3 1 — — $19,994.88 $48,978.71 $48,112.68 2026-01-28
43288 CPT Esphg Thrsc Moblj 3 1 — — $20,822.40 $51,005.77 $50,103.90 2026-01-28
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 6 4 — — $165,368.69 $359,574.74 $170,836.23 2026-01-28
4401 APR_DRG Kidney Transplant 3 1 — — $57,510.43 $125,049.66 $122,838.57 2026-01-28
4402 APR_DRG Kidney Transplant 3 1 — — $71,771.85 $156,059.44 $153,300.04 2026-01-28
4403 APR_DRG Kidney Transplant 3 1 — — $83,683.49 $181,959.90 $178,742.53 2026-01-28
4404 APR_DRG Kidney Transplant 3 1 — — $103,376.10 $224,779.15 $220,804.67 2026-01-28
4414 APR_DRG Major Bladder Procedures 6 4 — — $49,059.29 $143,632.89 $58,423.97 2026-01-28
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 14 10 — — $36,681.98 $103,789.87 $51,869.00 2026-01-28
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 6 4 — — $39,316.95 $153,777.94 $55,713.71 2026-01-28
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature, Malignancy, Infection Or Ex… 14 10 — — $46,134.67 $130,245.09 $65,090.00 2026-01-28
46746 CPT Repair Of Cloacal Anomaly 3 1 — — $21,709.44 $53,178.63 $52,238.34 2026-01-28
46748 CPT Repair Of Cloacal Anomaly 3 1 — — $23,564.16 $57,721.88 $56,701.26 2026-01-28
47135 CPT Transplantation Of Liver 3 1 — — $30,009.60 $73,510.39 $72,210.60 2026-01-28
47140 CPT Partial Removal Donor Liver 3 1 — — $19,902.72 $48,752.96 $47,890.92 2026-01-28
47141 CPT Partial Removal Donor Liver 3 1 — — $23,825.28 $58,361.51 $57,329.58 2026-01-28
47142 CPT Partial Removal Donor Liver 3 1 — — $26,215.68 $64,216.95 $63,081.48 2026-01-28
4803 APR_DRG Major Male Pelvic Procedures 3 1 — — $22,512.35 $48,950.45 $48,084.92 2026-01-28
4804 APR_DRG Major Male Pelvic Procedures 3 1 — — $47,792.36 $103,918.86 $102,081.39 2026-01-28
4854 APR_DRG Prostatectomy Procedures 3 3 — — $46,820.45 $48,473.21 $46,820.45 2026-01-28
49605 CPT Repair Umbilical Lesion 3 1 — — $27,363.84 $67,029.44 $65,844.24 2026-01-28
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 14 10 — — $56,604.65 $159,547.73 $79,734.00 2026-01-28
51 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 4 — — $28,423.46 $143,177.15 $47,637.04 2026-01-28
5103 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 3 1 — — $28,589.23 $62,163.93 $61,064.76 2026-01-28
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Proced… 3 1 — — $58,816.16 $127,888.81 $125,627.51 2026-01-28
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 6 4 — — $43,281.06 $106,370.20 $46,864.31 2026-01-28
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 4 — — $56,418.28 $172,417.77 $68,852.46 2026-01-28
5204 APR_DRG Other GYN Procedures For Malignancy 3 3 — — $48,523.26 $50,236.13 $48,523.26 2026-01-28
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 4 — — $84,249.07 $244,556.91 $99,847.48 2026-01-28
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 6 4 — — $119,416.40 $395,838.20 $152,839.05 2026-01-28
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 14 10 — — $35,967.19 $101,788.87 $50,869.00 2026-01-28
5831 APR_DRG Neonate With Ecmo 6 4 — — $154,304.53 $335,517.04 $173,692.87 2026-01-28
5832 APR_DRG Neonate With Ecmo 6 4 — — $188,594.43 $410,076.38 $205,858.18 2026-01-28
5833 APR_DRG Neonate With Ecmo 6 4 — — $292,146.27 $635,237.67 $328,048.99 2026-01-28
5834 APR_DRG Neonate With Ecmo 6 4 — — $499,742.05 $1,086,630.23 $543,330.62 2026-01-28
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 4 — — $119,125.50 $259,024.36 $142,595.70 2026-01-28
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 4 — — $180,976.19 $393,511.41 $214,393.33 2026-01-28
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 4 — — $218,443.02 $485,476.42 $224,712.52 2026-01-28
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 6 4 — — $323,289.68 $702,955.33 $343,405.32 2026-01-28
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 4 — — $179,223.70 $723,038.80 $259,038.19 2026-01-28
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 4 — — $179,223.70 $578,432.17 $225,785.84 2026-01-28
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 6 4 — — $179,223.70 $491,066.96 $205,696.18 2026-01-28
5911 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 4 — — $3,736.61 $240,395.85 $57,213.37 2026-01-28
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 4 — — $121,613.27 $264,433.74 $145,778.25 2026-01-28
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 4 — — $158,177.44 $343,938.22 $179,532.35 2026-01-28
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 6 4 — — $232,185.59 $660,116.26 $271,984.85 2026-01-28
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 4 — — $56,432.93 $364,749.17 $113,086.71 2026-01-28
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 4 — — $113,839.31 $401,222.11 $151,190.09 2026-01-28
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 4 — — $146,414.34 $505,174.93 $191,956.54 2026-01-28
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 6 4 — — $204,952.35 $649,798.53 $255,515.00 2026-01-28
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $44,730.99 $147,782.61 $57,137.66 2026-01-28
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $76,282.77 $223,969.58 $90,989.67 2026-01-28
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $104,346.92 $388,430.39 $143,334.90 2026-01-28
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $149,694.98 $492,601.17 $190,763.43 2026-01-28
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 4 — — $44,311.14 $187,139.99 $65,970.57 2026-01-28
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 6 4 — — $108,268.07 $384,566.55 $144,476.18 2026-01-28
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $53,299.72 $173,971.80 $67,595.48 2026-01-28
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $78,252.14 $299,564.95 $109,392.29 2026-01-28
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $111,426.67 $428,087.81 $156,118.96 2026-01-28
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 4 — — $32,914.81 $132,502.77 $47,507.41 2026-01-28
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 4 — — $54,565.11 $181,337.15 $69,944.18 2026-01-28
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 6 4 — — $54,565.11 $196,919.88 $73,527.43 2026-01-28
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 4 — — $45,809.69 $99,607.77 $47,485.86 2026-01-28
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 4 — — $72,871.29 $219,548.11 $88,206.99 2026-01-28
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 6 4 — — $237,295.98 $564,666.71 $252,681.59 2026-01-28
61 APR_DRG Pancreas Transplant 3 1 — — $74,367.68 $161,703.76 $158,844.56 2026-01-28
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 4 — — $40,819.60 $287,823.41 $87,315.37 2026-01-28
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 6 4 — — $93,898.66 $389,554.16 $138,184.77 2026-01-28
6122 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $31,346.74 $134,971.09 $47,263.29 2026-01-28
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $47,613.27 $168,814.35 $63,465.93 2026-01-28
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $68,812.47 $244,372.92 $91,814.42 2026-01-28
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 4 — — $44,193.98 $115,006.51 $49,322.81 2026-01-28
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 6 4 — — $59,931.30 $176,363.70 $71,578.34 2026-01-28
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 6 4 — — $45,365.64 $152,000.29 $58,436.04 2026-01-28
61520 CPT Removal Of Brain Lesion 3 1 — — $21,185.28 $51,894.67 $50,977.08 2026-01-28
61576 CPT Skull Base/brainstem Surgery 3 1 — — $23,260.80 $56,978.78 $55,971.30 2026-01-28
61682 CPT Intracranial Vessel Surgery 3 1 — — $23,712.00 $58,084.03 $57,057.00 2026-01-28
61686 CPT Intracranial Vessel Surgery 3 1 — — $26,194.56 $64,165.21 $63,030.66 2026-01-28
61692 CPT Intracranial Vessel Surgery 3 1 — — $20,891.52 $51,175.08 $50,270.22 2026-01-28
61697 CPT Brain Aneurysm Repr Complx 3 1 — — $24,090.24 $59,010.55 $57,967.14 2026-01-28
61698 CPT Brain Aneurysm Repr Complx 3 1 — — $26,881.92 $65,848.94 $64,684.62 2026-01-28
61702 CPT Inner Skull Vessel Surgery 3 1 — — $22,711.68 $55,633.68 $54,649.98 2026-01-28
62 APR_DRG Pancreas Transplant 3 1 — — $94,610.95 $205,720.38 $202,082.89 2026-01-28
6213 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 6 4 — — $27,862.04 $150,907.66 $49,124.05 2026-01-28
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 6 4 — — $64,288.90 $377,373.87 $120,056.41 2026-01-28
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 6 4 — — $40,188.86 $155,906.59 $56,654.54 2026-01-28
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 6 4 — — $38,630.55 $121,896.32 $48,027.21 2026-01-28
63 APR_DRG Pancreas Transplant 3 1 — — $108,985.63 $236,976.42 $232,786.27 2026-01-28
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 4 — — $93,466.12 $203,702.13 $95,224.11 2026-01-28
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 6 4 — — $126,411.77 $274,867.51 $175,134.60 2026-01-28
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 4 — — $46,981.32 $102,155.35 $56,999.72 2026-01-28
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 6 4 — — $163,978.35 $356,551.61 $206,105.59 2026-01-28
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 6 4 — — $67,361.57 $200,577.09 $80,992.49 2026-01-28
64 APR_DRG Pancreas Transplant 3 1 — — $154,256.37 $335,412.31 $329,481.64 2026-01-28
6504 APR_DRG Splenectomy 6 4 — — $39,569.83 $123,441.86 $48,868.82 2026-01-28
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 6 4 — — $43,492.94 $135,752.35 $53,730.43 2026-01-28
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 4 — — $59,827.81 $144,504.72 $64,198.78 2026-01-28
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 6 4 — — $48,361.18 $151,131.27 $59,786.86 2026-01-28
6904 APR_DRG Acute Leukemia 6 4 — — $50,892.94 $167,710.40 $64,909.80 2026-01-28
6954 APR_DRG Chemotherapy For Acute Leukemia 6 4 — — $44,059.24 $129,547.56 $52,596.77 2026-01-28
7 MS_DRG Lung Transplant 14 10 — — $71,096.60 $200,108.00 $100,004.00 2026-01-28
71 APR_DRG Allogeneic Bone Marrow Transplant 3 1 — — $81,857.04 $177,988.49 $174,841.35 2026-01-28
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 6 4 — — $41,661.24 $135,208.87 $52,657.27 2026-01-28
72 APR_DRG Allogeneic Bone Marrow Transplant 3 1 — — $92,438.22 $200,996.02 $197,442.06 2026-01-28
73 APR_DRG Allogeneic Bone Marrow Transplant 3 1 — — $118,175.17 $256,957.99 $252,414.53 2026-01-28
74 APR_DRG Allogeneic Bone Marrow Transplant 3 1 — — $170,113.82 $369,892.46 $363,352.12 2026-01-28
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 6 4 — — $51,407.49 $152,688.13 $61,721.78 2026-01-28
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 6 4 — — $43,745.82 $130,410.91 $52,633.07 2026-01-28
81 APR_DRG Autologous Bone Marrow Transplant 3 1 — — $22,373.05 $48,647.56 $47,787.39 2026-01-28
82 APR_DRG Autologous Bone Marrow Transplant 3 1 — — $29,772.59 $64,736.98 $63,592.32 2026-01-28
83 APR_DRG Autologous Bone Marrow Transplant 3 1 — — $56,724.13 $123,339.94 $121,159.08 2026-01-28
84 APR_DRG Autologous Bone Marrow Transplant 3 1 — — $100,972.94 $219,553.77 $215,671.68 2026-01-28
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 6 4 — — $59,069.16 $222,477.83 $81,736.01 2026-01-28
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 6 4 — — $195,334.98 $693,917.06 $260,681.63 2026-01-28
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 6 4 — — $86,872.95 $188,894.99 $106,302.90 2026-01-28
850 MS_DRG Acute Leukemia With Other Procedures 14 10 — — $47,540.66 $134,181.06 $67,057.00 2026-01-28
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 6 4 — — $53,243.09 $157,497.41 $63,777.88 2026-01-28
8514 APR_DRG Gender Related Procedures 3 3 — — $78,583.13 $81,357.11 $78,583.13 2026-01-28
8633 APR_DRG Neonatal Aftercare 6 4 — — $41,471.83 $117,336.14 $48,449.39 2026-01-28
8634 APR_DRG Neonatal Aftercare 6 4 — — $85,177.98 $185,209.48 $91,169.15 2026-01-28
870 MS_DRG Septicemia Or Severe Sepsis With Mv &gt;96 Hours 14 10 — — $37,945.78 $107,325.64 $53,636.00 2026-01-28
894 APR_DRG Major Cranial Or Facial Bone Procedures 6 4 — — $51,749.22 $142,265.68 $59,502.03 2026-01-28
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 4 — — $50,123.91 $108,988.55 $56,168.07 2026-01-28
9104 APR_DRG Craniotomy For Multiple Significant Trauma 6 4 — — $64,339.67 $168,831.34 $72,128.26 2026-01-28
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 6 4 — — $61,776.67 $164,460.81 $69,796.52 2026-01-28
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 6 4 — — $58,976.40 $145,164.27 $63,909.71 2026-01-28
914 APR_DRG Other Major Head And Neck Procedures 6 4 — — $60,791.50 $158,691.95 $67,959.99 2026-01-28
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 4 — — $61,074.81 $132,799.98 $69,421.90 2026-01-28
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 6 4 — — $44,235.96 $127,648.20 $52,251.49 2026-01-28
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv &gt;96 Hours With Skin Graft 14 10 — — $117,214.25 $329,180.51 $164,508.00 2026-01-28
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 14 10 — — $39,378.12 $111,335.64 $55,640.00 2026-01-28
92921 CPT Fee Schedule 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
92925 CPT Fee Schedule 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
92929 CPT Fee Schedule 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
92934 CPT Fee Schedule 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
92938 CPT Fee Schedule 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
92944 CPT Fee Schedule 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
92998 CPT Pul Art Balloon Repr Percut 3 1 — — $20,776.46 $50,803.17 $49,904.88 2026-01-28
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 4 — — $83,736.86 $182,075.95 $126,508.07 2026-01-28
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 6 4 — — $158,681.25 $345,033.69 $223,623.02 2026-01-28
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 4 — — $50,516.05 $164,183.41 $63,903.67 2026-01-28
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 6 4 — — $38,405.01 $119,003.39 $47,245.23 2026-01-28
955 MS_DRG Craniotomy For Multiple Significant Trauma 14 10 — — $36,953.74 $104,550.25 $52,249.00 2026-01-28
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 14 10 — — $41,833.25 $118,207.07 $59,074.00 2026-01-28
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 14 10 — — $33,605.94 $95,179.57 $47,566.00 2026-01-28
A9543 HCPCS Y90 Ibritumomab, Rx 16 10 — — $26,936.92 $296,299.08 $55,688.06 2026-01-28
C9293 HCPCS Injection, Glucarpidase 3 1 — — $97,156.22 $237,990.24 $233,782.16 2026-01-28
J1411 HCPCS Inj, Hemgenix, Per Tx Dose 13 10 — — $3,563,251.79 $4,097,739.56 $3,626,302.40 2026-01-28
J1413 HCPCS Inj Delandistrogene Mox Rokl 13 10 — — $3,257,830.21 $3,746,504.74 $3,263,399.19 2026-01-28
J1414 HCPCS Inj, Beqvez, Per Tx Dose 3 3 — — $3,563,251.79 $4,097,739.56 $3,563,251.79 2026-01-28
J3391 HCPCS Inj, Atidarsagene Autotemcel 10 10 — — $4,432,920.00 $4,698,895.20 $4,432,920.00 2026-01-28
J3392 HCPCS Inj, Exagamglogene Autotem 10 10 — — $2,294,688.00 $2,432,369.28 $2,294,688.00 2026-01-28
J3393 HCPCS Inj, Betibeglogene Autotemce 10 10 — — $2,898,608.16 $3,072,524.65 $2,898,608.16 2026-01-28
J3394 HCPCS Inj, Lovotibeglogene Autotem 10 10 — — $3,196,470.58 $3,388,258.81 $3,196,470.58 2026-01-28
J3399 HCPCS Onasemnogene Abeparvovec-xioi 2x5.5ml & 3x8.3ml IV Kit (6.1-6.5 Kg; 35.8 Ml) 62 15 $2,125,000.00 $903,125.00 57% off $733,125.00 $2,594,385.73 $1,627,750.00 2026-01-28
J3402 HCPCS Inj. Remestemcel-l-rknd/ Td 10 10 — — $202,349.76 $214,490.75 $202,349.76 2026-01-28
J3403 HCPCS Revakinagene, Per Implant 10 10 — — $253,380.00 $268,582.80 $253,380.00 2026-01-28
J7330 HCPCS Cultured Chondrocytes Implnt 3 1 — — $21,243.96 $57,053.40 $56,044.60 2026-01-28
J9029 HCPCS Instill Adstiladrin, Tx Dose 13 10 — — $54,242.46 $66,068.54 $62,328.81 2026-01-28
J9226 HCPCS Histrelin Acetate (cpp) 50 Mg Sc Kit 62 15 $211,428.14 $89,856.96 57% off $18,251.70 $213,584.71 $153,295.97 2026-01-28
J9266 HCPCS Pegaspargase 750 Unit/ml Ij Soln 87 15 $76,671.55 $32,585.41 57% off $8,626.98 $93,703.86 $55,590.71 2026-01-28
K0879 HCPCS Pwc Gp4 Hd Sing Pow Opt S/b 3 1 — — $21,794.96 $53,388.10 $52,444.11 2026-01-28
K0880 HCPCS Pwc Gp4 Vhd Sing Pow Opt S/b 3 1 — — $34,106.69 $83,546.47 $82,069.22 2026-01-28
K0885 HCPCS Pwc Gp4 Std Mult Pow Opt Cap 3 1 — — $24,349.25 $59,645.01 $58,590.38 2026-01-28
K0886 HCPCS Pwc Gp4 Hd Mult Pow S/b 3 1 — — $22,488.46 $55,086.89 $54,112.86 2026-01-28
K0890 HCPCS Pwc Gp5 Ped Sing Pow Opt S/b 3 1 — — $37,826.00 $92,657.14 $91,018.80 2026-01-28
K0891 HCPCS Pwc Gp5 Ped Mult Pow Opt S/b 3 1 — — $49,111.37 $120,301.38 $118,174.24 2026-01-28
L7181 HCPCS Electronic Elbo Simultaneous 16 10 — — $19,570.31 $93,384.98 $47,596.83 2026-01-28
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 13 10 — — $65,388.11 $130,224.65 $66,373.42 2026-01-28
Q0480 HCPCS Driver Pneumatic Vad, Rep 16 10 — — $43,989.91 $209,909.63 $106,987.58 2026-01-28
Q2041 HCPCS Axicabtagene Ciloleucel 200000000 Cells IV Susp 59 15 $1,889,580.00 $803,071.50 57% off $207,548.54 $1,908,853.72 $1,370,039.98 2026-01-28
Q2042 HCPCS Tisagenlecleucel 250000000 Cells IV Susp 84 15 $1,831,611.65 $778,434.96 57% off $207,548.54 $1,850,294.09 $1,328,010.02 2026-01-28
Q2043 HCPCS Sipuleucel-t 50000000 Cells IV Susp 62 15 $318,246.07 $135,254.58 57% off $23,248.04 $321,492.18 $230,744.31 2026-01-28
Q2053 HCPCS Brexucabtagene Autoleucel 200000000 Cells IV Susp 84 15 $1,797,333.33 $763,866.67 57% off $172,957.12 $1,815,666.13 $1,303,156.53 2026-01-28
Q2054 HCPCS Lisocabtagene Maraleucel 70000000 Cells/ml IV Susp 59 15 $1,764,202.48 $749,786.06 57% off $359,368.04 $1,782,197.34 $1,279,135.01 2026-01-28
Q2055 HCPCS Idecabtagene Vicleucel Car 10 10 — — $548,400.85 $1,075,962.47 $548,400.85 2026-01-28
Q2056 HCPCS Ciltacabtagene Autoleucel 100000000 Cells IV Susp 59 15 $1,909,750.11 $811,643.80 57% off $389,016.10 $1,929,229.56 $1,384,664.31 2026-01-28
Q2057 HCPCS Afamitresgene Autoleucel 10 10 — — $758,290.08 $1,487,765.14 $758,290.08 2026-01-28
Q2058 HCPCS Obecbtge Autol Up To 400 Mil 10 10 — — $273,798.00 $537,191.68 $273,798.00 2026-01-28
S2068 HCPCS Breast Diep Or Siea Flap 3 1 — — $19,622.44 $48,066.39 $47,216.49 2026-01-28
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