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

SANFORD WESTBROOK MEDICAL CENTER

Westbrook, MN · CCN 241302 · Rates published

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You selected 27447 (CPT)

TOTAL KNEE ARTHROPLASTY

This hospital’s price: $13,510 across 1 payer

Source: https://sthpiprd.blob.core.windows.net/machine-readable-files/8377/460388596_sanford-westbrook-hospital_standardcharges.csv · observed 2026-03-04

This is the facility’s filed rate for this code. The comparison board’s estimate also adds the surgeon and anesthesia fees, so it is usually higher.

7,623 distinct procedures filed
16 distinct payers
228,374 rate rows
2026-03-04 last MRF observed
Data quality

227,550 of 228,374 rate rows are consumer-grade (99.6%)

824 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
percent-of-charges filed in the dollar field — excluded from medians 720
per-diem day rate — not a per-procedure price 78
exceeds 10× this hospital's gross charge — excluded from medians 18
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 8
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8377/460388596_sanford-westbrook-hospital_standardcharges.csv
Found on page https://sanfordhealth.org/cms-hpt.txt
Discovered viaDiscovered by HANK (automated)
Last fetch not_modified · 2026-08-03
Content fingerprint 7b1d971d944a8a5b… · 57,895,150 bytes · first seen 2026-05-14

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
5834
APR_DRG 		Neonate With Ecmo 2 $255,556.88 $255,556.88 $255,556.88 nat. median
$311,018
0.8× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $161,521.53 $161,521.53 $161,521.53 nat. median
$254,667
0.6× median
5833
APR_DRG 		Neonate With Ecmo 2 $154,298.64 $154,298.64 $154,298.64 nat. median
$250,089
0.6× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $144,735.27 $144,735.27 $144,735.27 nat. median
$119,243
1.2× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $131,441.06 $131,441.06 $131,441.06 nat. median
$243,231
0.5× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $113,582.70 $113,582.70 $113,582.70 nat. median
$168,174
0.7× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $112,965.80 $112,965.80 $112,965.80 nat. median
$67,603
1.7× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $111,136.60 $111,136.60 $111,136.60 nat. median
$168,361
0.7× median
1614
APR_DRG 		Implantable Heart Assist Systems 2 $109,290.57 $109,290.57 $109,290.57 nat. median
$209,486
0.5× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $105,181.63 $105,181.63 $105,181.63 nat. median
$165,599
0.6× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $104,558.66 $104,558.66 $104,558.66 nat. median
$180,995
0.6× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $100,840.43 $100,840.43 $100,840.43 nat. median
$147,847
0.7× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $98,101.29 $98,101.29 $98,101.29 nat. median
$156,285
0.6× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $96,942.27 $96,942.27 $96,942.27 nat. median
$147,677
0.7× median
5832
APR_DRG 		Neonate With Ecmo 2 $96,825.90 $96,825.90 $96,825.90 nat. median
$169,230
0.6× median
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $95,460.30 $95,460.30 $95,460.30 nat. median
$63,564
1.5× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $93,497.90 $93,497.90 $93,497.90 nat. median
$165,646
0.6× median
1613
APR_DRG 		Implantable Heart Assist Systems 2 $87,943.45 $87,943.45 $87,943.45 nat. median
$127,938
0.7× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $85,786.17 $85,786.17 $85,786.17 nat. median
$96,420
0.9× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $85,786.17 $85,786.17 $85,786.17 nat. median
$89,188
1.0× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $85,786.17 $85,786.17 $85,786.17 nat. median
$71,350
1.2× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $84,443.48 $84,443.48 $84,443.48 nat. median
$108,751
0.8× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $82,374.99 $82,374.99 $82,374.99 nat. median
$160,171
0.5× median
5831
APR_DRG 		Neonate With Ecmo 2 $81,696.86 $81,696.86 $81,696.86 nat. median
$154,685
0.5× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $80,970.60 $80,970.60 $80,970.60 nat. median
$175,480
outlier · 0.5×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $80,353.23 $80,353.23 $80,353.23 nat. median
$127,600
0.6× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 2 $74,520.72 $74,520.72 $74,520.72 nat. median
$137,901
0.5× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $71,652.13 $71,652.13 $71,652.13 nat. median
$123,690
0.6× median
23
APR_DRG 		Heart And/or Lung Transplant 2 $71,078.69 $71,078.69 $71,078.69 nat. median
$116,111
0.6× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $70,081.83 $70,081.83 $70,081.83 nat. median
$112,711
0.6× median
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $68,567.15 $68,567.15 $68,567.15 nat. median
$84,000
0.8× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $67,070.23 $67,070.23 $67,070.23 nat. median
$120,928
0.6× median
38240
CPT 		Transplt Allo Hct/donor 1 $62,099.45 $62,099.45 $62,099.45 nat. median
$13,835
outlier · 4.5×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $59,503.38 $59,503.38 $59,503.38 nat. median
$80,413
0.7× median
1612
APR_DRG 		Implantable Heart Assist Systems 2 $59,438.89 $59,438.89 $59,438.89 nat. median
$93,192
0.6× median
1611
APR_DRG 		Implantable Heart Assist Systems 2 $59,438.89 $59,438.89 $59,438.89 nat. median
$82,164
0.7× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $58,743.27 $58,743.27 $58,743.27 nat. median
$65,655
0.9× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 2 $57,782.13 $57,782.13 $57,782.13 nat. median
$101,315
0.6× median
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $57,159.16 $57,159.16 $57,159.16 nat. median
$88,000
0.6× median
22
APR_DRG 		Heart And/or Lung Transplant 2 $54,863.07 $54,863.07 $54,863.07 nat. median
$94,014
0.6× median
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $54,489.66 $54,489.66 $54,489.66 nat. median
$89,063
0.6× median
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 $53,334.84 $53,334.84 $53,334.84 nat. median
$99,613
0.5× median
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $53,264.73 $53,264.73 $53,264.73 nat. median
$78,024
0.7× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $51,822.96 $51,822.96 $51,822.96 nat. median
$109,499
outlier · 0.5×
64
APR_DRG 		Pancreas Transplant 2 $50,253.60 $50,253.60 $50,253.60 nat. median
$92,994
0.5× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 2 $49,999.83 $49,999.83 $49,999.83 nat. median
$83,517
0.6× median
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $49,946.09 $49,946.09 $49,946.09 nat. median
$92,000
0.5× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $48,242.60 $48,242.60 $48,242.60 nat. median
$89,814
0.5× median
6114
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 $44,944.98 $44,944.98 $44,944.98 nat. median
$79,344
0.6× median
6303
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $44,737.95 $44,737.95 $44,737.95 nat. median
$80,447
0.6× median

Other procedures at this hospital

Browse this hospital's 7,623 published procedures. Use the slice to choose what to show, then sort or filter any column.

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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
             
5834 APR_DRG Neonate With Ecmo 4 2 — — $255,556.88 $255,556.88 $255,556.88 2026-03-04
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $161,521.53 $161,521.53 $161,521.53 2026-03-04
5833 APR_DRG Neonate With Ecmo 4 2 — — $154,298.64 $154,298.64 $154,298.64 2026-03-04
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $144,735.27 $144,735.27 $144,735.27 2026-03-04
24 APR_DRG Heart And/or Lung Transplant 4 2 — — $131,441.06 $131,441.06 $131,441.06 2026-03-04
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $113,582.70 $113,582.70 $113,582.70 2026-03-04
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $112,965.80 $112,965.80 $112,965.80 2026-03-04
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 2 — — $111,136.60 $111,136.60 $111,136.60 2026-03-04
1614 APR_DRG Implantable Heart Assist Systems 4 2 — — $109,290.57 $109,290.57 $109,290.57 2026-03-04
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $105,181.63 $105,181.63 $105,181.63 2026-03-04
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $104,558.66 $104,558.66 $104,558.66 2026-03-04
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $100,840.43 $100,840.43 $100,840.43 2026-03-04
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $98,101.29 $98,101.29 $98,101.29 2026-03-04
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 2 — — $96,942.27 $96,942.27 $96,942.27 2026-03-04
5832 APR_DRG Neonate With Ecmo 4 2 — — $96,825.90 $96,825.90 $96,825.90 2026-03-04
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $95,460.30 $95,460.30 $95,460.30 2026-03-04
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 4 2 — — $93,497.90 $93,497.90 $93,497.90 2026-03-04
1613 APR_DRG Implantable Heart Assist Systems 4 2 — — $87,943.45 $87,943.45 $87,943.45 2026-03-04
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 2 — — $85,786.17 $85,786.17 $85,786.17 2026-03-04
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 2 — — $85,786.17 $85,786.17 $85,786.17 2026-03-04
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 2 — — $85,786.17 $85,786.17 $85,786.17 2026-03-04
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 2 — — $84,443.48 $84,443.48 $84,443.48 2026-03-04
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 2 — — $82,374.99 $82,374.99 $82,374.99 2026-03-04
5831 APR_DRG Neonate With Ecmo 4 2 — — $81,696.86 $81,696.86 $81,696.86 2026-03-04
74 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $80,970.60 $80,970.60 $80,970.60 2026-03-04
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $80,353.23 $80,353.23 $80,353.23 2026-03-04
14 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $74,520.72 $74,520.72 $74,520.72 2026-03-04
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $71,652.13 $71,652.13 $71,652.13 2026-03-04
23 APR_DRG Heart And/or Lung Transplant 4 2 — — $71,078.69 $71,078.69 $71,078.69 2026-03-04
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $70,081.83 $70,081.83 $70,081.83 2026-03-04
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 2 — — $68,567.15 $68,567.15 $68,567.15 2026-03-04
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $67,070.23 $67,070.23 $67,070.23 2026-03-04
38240 CPT Transplt Allo Hct/donor 2 1 — — $62,099.45 $62,099.45 $62,099.45 2026-03-04
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $59,503.38 $59,503.38 $59,503.38 2026-03-04
1612 APR_DRG Implantable Heart Assist Systems 4 2 — — $59,438.89 $59,438.89 $59,438.89 2026-03-04
1611 APR_DRG Implantable Heart Assist Systems 4 2 — — $59,438.89 $59,438.89 $59,438.89 2026-03-04
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $58,743.27 $58,743.27 $58,743.27 2026-03-04
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 2 — — $57,782.13 $57,782.13 $57,782.13 2026-03-04
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 2 — — $57,159.16 $57,159.16 $57,159.16 2026-03-04
22 APR_DRG Heart And/or Lung Transplant 4 2 — — $54,863.07 $54,863.07 $54,863.07 2026-03-04
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $54,489.66 $54,489.66 $54,489.66 2026-03-04
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $53,334.84 $53,334.84 $53,334.84 2026-03-04
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $53,264.73 $53,264.73 $53,264.73 2026-03-04
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 2 — — $51,822.96 $51,822.96 $51,822.96 2026-03-04
64 APR_DRG Pancreas Transplant 4 2 — — $50,253.60 $50,253.60 $50,253.60 2026-03-04
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 2 — — $49,999.83 $49,999.83 $49,999.83 2026-03-04
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $49,946.09 $49,946.09 $49,946.09 2026-03-04
73 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $48,242.60 $48,242.60 $48,242.60 2026-03-04
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 2 — — $44,944.98 $44,944.98 $44,944.98 2026-03-04
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 2 — — $44,737.95 $44,737.95 $44,737.95 2026-03-04
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $43,648.09 $43,648.09 $43,648.09 2026-03-04
8634 APR_DRG Neonatal Aftercare 4 2 — — $42,881.64 $42,881.64 $42,881.64 2026-03-04
63 APR_DRG Pancreas Transplant 4 2 — — $42,769.47 $42,769.47 $42,769.47 2026-03-04
21 APR_DRG Heart And/or Lung Transplant 4 2 — — $42,056.30 $42,056.30 $42,056.30 2026-03-04
4404 APR_DRG Kidney Transplant 4 2 — — $41,554.36 $41,554.36 $41,554.36 2026-03-04
13 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $41,153.84 $41,153.84 $41,153.84 2026-03-04
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $40,327.57 $40,327.57 $40,327.57 2026-03-04
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 2 — — $40,326.17 $40,326.17 $40,326.17 2026-03-04
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $40,013.98 $40,013.98 $40,013.98 2026-03-04
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $38,371.25 $38,371.25 $38,371.25 2026-03-04
8514 APR_DRG Gender Related Procedures 4 2 — — $37,614.14 $37,614.14 $37,614.14 2026-03-04
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $37,455.71 $37,455.71 $37,455.71 2026-03-04
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $36,513.07 $36,513.07 $36,513.07 2026-03-04
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $36,202.28 $36,202.28 $36,202.28 2026-03-04
62 APR_DRG Pancreas Transplant 4 2 — — $36,166.29 $36,166.29 $36,166.29 2026-03-04
72 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $35,906.91 $35,906.91 $35,906.91 2026-03-04
1784 APR_DRG External Heart Assist Devices 4 2 — — $35,789.61 $35,789.61 $35,789.61 2026-03-04
84 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $35,183.92 $35,183.92 $35,183.92 2026-03-04
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $34,880.15 $34,880.15 $34,880.15 2026-03-04
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $34,401.11 $34,401.11 $34,401.11 2026-03-04
33231 CPT Insrt Pulse Gen W/mult Leads 2 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33270 CPT Ins/rep Subq Defibrillator 2 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33249 CPT Insj/rplcmt Defib W/lead(s) 2 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 2 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
69930 CPT Implant Cochlear Device 2 1 — — $33,398.21 $33,398.21 $33,398.21 2026-03-04
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $33,217.32 $33,217.32 $33,217.32 2026-03-04
12 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $33,205.17 $33,205.17 $33,205.17 2026-03-04
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $32,937.38 $32,937.38 $32,937.38 2026-03-04
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $32,652.76 $32,652.76 $32,652.76 2026-03-04
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 4 2 — — $32,242.90 $32,242.90 $32,242.90 2026-03-04
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 2 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
61886 CPT Implant Neurostim Arrays 2 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
64568 CPT Opn Impltj Crnl Nrv Nea&pg 2 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 2 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
1834 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $31,758.25 $31,758.25 $31,758.25 2026-03-04
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $31,263.80 $31,263.80 $31,263.80 2026-03-04
9104 APR_DRG Craniotomy For Multiple Significant Trauma 4 2 — — $30,796.45 $30,796.45 $30,796.45 2026-03-04
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 4 2 — — $30,772.15 $30,772.15 $30,772.15 2026-03-04
71 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $29,888.86 $29,888.86 $29,888.86 2026-03-04
33289 CPT Tcat Impl Wrls P-art Prs Snr 2 1 — — $29,849.75 $29,849.75 $29,849.75 2026-03-04
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $29,746.78 $29,746.78 $29,746.78 2026-03-04
1794 APR_DRG Defibrillator Implants 4 2 — — $29,717.81 $29,717.81 $29,717.81 2026-03-04
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 4 2 — — $29,569.66 $29,569.66 $29,569.66 2026-03-04
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 2 — — $29,411.69 $29,411.69 $29,411.69 2026-03-04
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 4 2 — — $29,197.18 $29,197.18 $29,197.18 2026-03-04
61 APR_DRG Pancreas Transplant 4 2 — — $29,184.56 $29,184.56 $29,184.56 2026-03-04
914 APR_DRG Other Major Head And Neck Procedures 4 2 — — $29,098.10 $29,098.10 $29,098.10 2026-03-04
1783 APR_DRG External Heart Assist Devices 4 2 — — $29,021.92 $29,021.92 $29,021.92 2026-03-04
C9760 HCPCS Non-blind Interatrial Shunt 2 1 — — $28,875.53 $28,875.53 $28,875.53 2026-03-04
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 2 — — $28,686.37 $28,686.37 $28,686.37 2026-03-04
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 2 — — $28,636.83 $28,636.83 $28,636.83 2026-03-04
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $28,382.59 $28,382.59 $28,382.59 2026-03-04
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 4 2 — — $28,273.70 $28,273.70 $28,273.70 2026-03-04
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 4 2 — — $28,229.30 $28,229.30 $28,229.30 2026-03-04
4403 APR_DRG Kidney Transplant 4 2 — — $27,661.94 $27,661.94 $27,661.94 2026-03-04
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $27,374.05 $27,374.05 $27,374.05 2026-03-04
11 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $27,284.79 $27,284.79 $27,284.79 2026-03-04
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $27,011.85 $27,011.85 $27,011.85 2026-03-04
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 2 — — $27,004.84 $27,004.84 $27,004.84 2026-03-04
1694 APR_DRG Major Abdominal Vascular Procedures 4 2 — — $26,858.56 $26,858.56 $26,858.56 2026-03-04
214 APR_DRG Open Craniotomy Except Trauma 4 2 — — $26,825.85 $26,825.85 $26,825.85 2026-03-04
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 2 — — $26,809.96 $26,809.96 $26,809.96 2026-03-04
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $26,713.22 $26,713.22 $26,713.22 2026-03-04
J2350 HCPCS Ocrelizumab Soln For IV Infusion 300 Mg/10ml 90 16 $35,668.80 $28,535.04 20% off $60.94 $33,742.68 $26,680.26 2026-03-04
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $26,418.79 $26,418.79 $26,418.79 2026-03-04
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $26,229.51 $26,229.51 $26,229.51 2026-03-04
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 2 — — $26,117.82 $26,117.82 $26,117.82 2026-03-04
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 2 — — $26,117.82 $26,117.82 $26,117.82 2026-03-04
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 2 — — $25,905.64 $25,905.64 $25,905.64 2026-03-04
234 APR_DRG Spinal Procedures 4 2 — — $25,883.21 $25,883.21 $25,883.21 2026-03-04
93654 CPT Compre Ep Eval Tx Vt 2 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
93656 CPT Compre Ep Eval Abltj Atr Fib 2 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
93653 CPT Compre Ep Eval Tx Svt 2 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $25,512.13 $25,512.13 $25,512.13 2026-03-04
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 2 — — $25,485.02 $25,485.02 $25,485.02 2026-03-04
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 2 — — $25,397.63 $25,397.63 $25,397.63 2026-03-04
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 4 2 — — $25,377.53 $25,377.53 $25,377.53 2026-03-04
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $25,361.64 $25,361.64 $25,361.64 2026-03-04
894 APR_DRG Major Cranial Or Facial Bone Procedures 4 2 — — $24,769.98 $24,769.98 $24,769.98 2026-03-04
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 4 2 — — $24,667.63 $24,667.63 $24,667.63 2026-03-04
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 4 2 — — $24,606.41 $24,606.41 $24,606.41 2026-03-04
4014 APR_DRG Adrenal Procedures 4 2 — — $24,476.95 $24,476.95 $24,476.95 2026-03-04
6904 APR_DRG Acute Leukemia 4 2 — — $24,360.11 $24,360.11 $24,360.11 2026-03-04
1204 APR_DRG Major Respiratory And Chest Procedures 4 2 — — $24,313.38 $24,313.38 $24,313.38 2026-03-04
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 2 — — $24,179.72 $24,179.72 $24,179.72 2026-03-04
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $23,926.41 $23,926.41 $23,926.41 2026-03-04
4402 APR_DRG Kidney Transplant 4 2 — — $23,876.41 $23,876.41 $23,876.41 2026-03-04
204 APR_DRG Open Craniotomy For Trauma 4 2 — — $23,768.45 $23,768.45 $23,768.45 2026-03-04
33240 CPT Insrt Pulse Gen W/singl Lead 2 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 2 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 2 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33230 CPT Insrt Pulse Gen W/dual Leads 2 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $23,534.31 $23,534.31 $23,534.31 2026-03-04
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 4 2 — — $23,493.65 $23,493.65 $23,493.65 2026-03-04
4414 APR_DRG Major Bladder Procedures 4 2 — — $23,482.43 $23,482.43 $23,482.43 2026-03-04
1782 APR_DRG External Heart Assist Devices 4 2 — — $23,395.51 $23,395.51 $23,395.51 2026-03-04
5204 APR_DRG Other GYN Procedures For Malignancy 4 2 — — $23,225.86 $23,225.86 $23,225.86 2026-03-04
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 2 — — $23,148.28 $23,148.28 $23,148.28 2026-03-04
83 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $23,077.71 $23,077.71 $23,077.71 2026-03-04
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $22,790.29 $22,790.29 $22,790.29 2026-03-04
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 2 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
61885 CPT Insrt/redo Neurostim 1 Array 2 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
63655 CPT Implant Neuroelectrodes 2 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
64580 CPT Opn Impltj Nea Neuromuscular 2 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
2614 APR_DRG Major Biliary Tract Procedures 4 2 — — $22,479.03 $22,479.03 $22,479.03 2026-03-04
4854 APR_DRG Prostatectomy Procedures 4 2 — — $22,410.80 $22,410.80 $22,410.80 2026-03-04
1833 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $22,377.15 $22,377.15 $22,377.15 2026-03-04
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $22,335.09 $22,335.09 $22,335.09 2026-03-04
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 4 2 — — $22,121.98 $22,121.98 $22,121.98 2026-03-04
1793 APR_DRG Defibrillator Implants 4 2 — — $21,938.78 $21,938.78 $21,938.78 2026-03-04
4401 APR_DRG Kidney Transplant 4 2 — — $21,813.53 $21,813.53 $21,813.53 2026-03-04
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 2 — — $21,714.45 $21,714.45 $21,714.45 2026-03-04
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 4 2 — — $21,654.16 $21,654.16 $21,654.16 2026-03-04
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $21,594.81 $21,594.81 $21,594.81 2026-03-04
1781 APR_DRG External Heart Assist Devices 4 2 — — $21,464.89 $21,464.89 $21,464.89 2026-03-04
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $21,410.67 $21,410.67 $21,410.67 2026-03-04
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $21,264.86 $21,264.86 $21,264.86 2026-03-04
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 2 — — $21,209.71 $21,209.71 $21,209.71 2026-03-04
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 4 2 — — $21,173.73 $21,173.73 $21,173.73 2026-03-04
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 2 — — $21,153.63 $21,153.63 $21,153.63 2026-03-04
54405 CPT Insert Multi-comp Penis Pros 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54401 CPT Insert Self-contd Prosthesis 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54410 CPT Remove/replace Penis Prosth 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53447 CPT Remove/replace Ur Sphincter 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53444 CPT Insert Tandem Cuff 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54411 CPT Remov/replc Penis Pros Comp 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53445 CPT Insert Uro/ves Nck Sphincter 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54416 CPT Remv/repl Penis Contain Pros 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
2304 APR_DRG Major Small Bowel Procedures 4 2 — — $21,097.55 $21,097.55 $21,097.55 2026-03-04
6954 APR_DRG Chemotherapy For Acute Leukemia 4 2 — — $21,089.14 $21,089.14 $21,089.14 2026-03-04
274 APR_DRG Other Open Craniotomy 4 2 — — $21,073.71 $21,073.71 $21,073.71 2026-03-04
1814 APR_DRG Lower Extremity Vascular Procedures 4 2 — — $21,055.49 $21,055.49 $21,055.49 2026-03-04
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 2 — — $21,008.75 $21,008.75 $21,008.75 2026-03-04
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 4 2 — — $20,939.12 $20,939.12 $20,939.12 2026-03-04
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $20,840.97 $20,840.97 $20,840.97 2026-03-04
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 4 2 — — $20,818.07 $20,818.07 $20,818.07 2026-03-04
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 4 2 — — $20,716.66 $20,716.66 $20,716.66 2026-03-04
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 4 2 — — $20,615.24 $20,615.24 $20,615.24 2026-03-04
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $20,558.23 $20,558.23 $20,558.23 2026-03-04
1214 APR_DRG Other Respiratory And Chest Procedures 4 2 — — $20,556.36 $20,556.36 $20,556.36 2026-03-04
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 2 — — $20,246.97 $20,246.97 $20,246.97 2026-03-04
33274 CPT Tcat Insj/rpl Perm Ldls Pm 2 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33229 CPT Remv&replc Pm Gen Mult Leads 2 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33221 CPT Insert Pulse Gen Mult Leads 2 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $19,966.56 $19,966.56 $19,966.56 2026-03-04
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 4 2 — — $19,941.33 $19,941.33 $19,941.33 2026-03-04
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $19,935.72 $19,935.72 $19,935.72 2026-03-04
8633 APR_DRG Neonatal Aftercare 4 2 — — $19,850.66 $19,850.66 $19,850.66 2026-03-04
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 4 2 — — $19,849.26 $19,849.26 $19,849.26 2026-03-04
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 2 — — $19,827.29 $19,827.29 $19,827.29 2026-03-04
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 4 2 — — $19,710.46 $19,710.46 $19,710.46 2026-03-04
4284 APR_DRG Genetic Disorders 4 2 — — $19,700.18 $19,700.18 $19,700.18 2026-03-04
4034 APR_DRG Procedures For Obesity 4 2 — — $19,696.44 $19,696.44 $19,696.44 2026-03-04
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 2 — — $19,538.47 $19,538.47 $19,538.47 2026-03-04
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 4 2 — — $19,485.19 $19,485.19 $19,485.19 2026-03-04
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 4 2 — — $19,417.90 $19,417.90 $19,417.90 2026-03-04
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 2 — — $19,373.03 $19,373.03 $19,373.03 2026-03-04
294 APR_DRG Other Percutaneous Intracranial Procedures 4 2 — — $19,358.08 $19,358.08 $19,358.08 2026-03-04
224 APR_DRG Ventricular Shunt Procedures 4 2 — — $19,343.59 $19,343.59 $19,343.59 2026-03-04
C8003 HCPCS Imp Extar Knee Shck Absrb 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
21243 CPT Reconstruction Of Jaw Joint 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22630 CPT Arthrd Pst Tq 1ntrspc Lum 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22856 CPT Tot Disc Arthrp 1ntrspc Crv 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23472 CPT Reconstruct Shoulder Joint 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
27279 CPT Arthrd Si Jt Plmt Tartclr Dv 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
27702 CPT Reconstruct Ankle Joint 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24371 CPT Revise Reconst Elbow Joint 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24363 CPT Replace Elbow Joint 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
25446 CPT Arthrp W/prostc Dst Rds&crps 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
28705 CPT Arthrodesis Pantalar 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24361 CPT Reconstruct Elbow Joint 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
25442 CPT Arthrp W/prostc Dstl Ulna 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
20696 CPT App Mltpln Uni Xtrnl Fix 1st 2 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 4 2 — — $19,278.63 $19,278.63 $19,278.63 2026-03-04
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $19,236.56 $19,236.56 $19,236.56 2026-03-04
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $19,026.72 $19,026.72 $19,026.72 2026-03-04
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 4 2 — — $19,011.77 $19,011.77 $19,011.77 2026-03-04
6504 APR_DRG Splenic Procedures 4 2 — — $18,940.27 $18,940.27 $18,940.27 2026-03-04
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9765 HCPCS Revasc Intra Lithotrip-stent 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9602 HCPCS Perc D-e Cor Stent Ather S 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9606 HCPCS Perc D-e Cor Revasc W Ami S 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9766 HCPCS Revasc Intra Lithotrip-ather 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9767 HCPCS Revasc Lithotrip-stent-ather 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93580 CPT Transcath Closure Of Asd 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93581 CPT Transcath Closure Of Vsd 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93582 CPT Perq Transcath Closure Pda 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
92933 CPT Prq Trlml C Athrc St Angiop1 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93591 CPT Perq Transcath Cls Aortic 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93590 CPT Perq Transcath Cls Mitral 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9774 HCPCS Revasc Lithotr-ather Tib/per 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9775 HCPCS Revasc Lith-sten-ath Tib/per 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37242 CPT Vasc Embolize/occlude Artery 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37231 CPT Outpatient Services - Cpt/hcpcs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37230 CPT Outpatient Services - Cpt/hcpcs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37229 CPT Outpatient Services - Cpt/hcpcs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37225 CPT Outpatient Services - Cpt/hcpcs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36906 CPT Thrmbc/nfs Dialysis Circuit 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37184 CPT Prim Art M-thrmbc 1st Vsl 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
33902 CPT Perq P-art Revsc 1 Abnor Uni 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37227 CPT Outpatient Services - Cpt/hcpcs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9773 HCPCS Revasc Lithotr-stent Tib/per 2 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 4 2 — — $18,819.22 $18,819.22 $18,819.22 2026-03-04
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 4 2 — — $18,770.62 $18,770.62 $18,770.62 2026-03-04
3003 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $18,700.98 $18,700.98 $18,700.98 2026-03-04
82 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $18,677.15 $18,677.15 $18,677.15 2026-03-04
62361 CPT Implant Spine Infusion Pump 2 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62360 CPT Insert Spine Infusion Device 2 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62362 CPT Implant Spine Infusion Pump 2 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 4 2 — — $18,490.68 $18,490.68 $18,490.68 2026-03-04
913 APR_DRG Other Major Head And Neck Procedures 4 2 — — $18,482.26 $18,482.26 $18,482.26 2026-03-04
2314 APR_DRG Major Large Bowel Procedures 4 2 — — $18,461.70 $18,461.70 $18,461.70 2026-03-04
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 2 — — $18,382.72 $18,382.72 $18,382.72 2026-03-04
C9758 HCPCS Blind Interatrial Shunt Ide 2 1 — — $18,375.53 $18,375.53 $18,375.53 2026-03-04
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 2 1 — — $18,375.53 $18,375.53 $18,375.53 2026-03-04
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 4 2 — — $18,336.45 $18,336.45 $18,336.45 2026-03-04
1832 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $18,303.27 $18,303.27 $18,303.27 2026-03-04
213 APR_DRG Open Craniotomy Except Trauma 4 2 — — $18,278.03 $18,278.03 $18,278.03 2026-03-04
4484 APR_DRG Other Kidney, Urinary Tract And Related Percutaneous Procedures 4 2 — — $18,273.36 $18,273.36 $18,273.36 2026-03-04
19357 CPT Tiss Xpndr Plmt Brst Rcnstj 2 1 — — $18,268.26 $18,268.26 $18,268.26 2026-03-04
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 4 2 — — $18,264.01 $18,264.01 $18,264.01 2026-03-04
1693 APR_DRG Major Abdominal Vascular Procedures 4 2 — — $18,254.66 $18,254.66 $18,254.66 2026-03-04
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 2 — — $18,247.65 $18,247.65 $18,247.65 2026-03-04
9103 APR_DRG Craniotomy For Multiple Significant Trauma 4 2 — — $18,236.90 $18,236.90 $18,236.90 2026-03-04
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 4 2 — — $18,121.47 $18,121.47 $18,121.47 2026-03-04
2991 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $18,096.23 $18,096.23 $18,096.23 2026-03-04
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 4 2 — — $18,079.41 $18,079.41 $18,079.41 2026-03-04
1792 APR_DRG Defibrillator Implants 4 2 — — $18,034.54 $18,034.54 $18,034.54 2026-03-04
7524 APR_DRG Personality Disorders 4 2 — — $18,002.30 $18,002.30 $18,002.30 2026-03-04
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 2 — — $17,998.56 $17,998.56 $17,998.56 2026-03-04
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $17,977.99 $17,977.99 $17,977.99 2026-03-04
1662 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $17,867.23 $17,867.23 $17,867.23 2026-03-04
264 APR_DRG Other Nervous System And Related Procedures 4 2 — — $17,719.08 $17,719.08 $17,719.08 2026-03-04
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 4 2 — — $17,690.11 $17,690.11 $17,690.11 2026-03-04
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 4 2 — — $17,662.53 $17,662.53 $17,662.53 2026-03-04
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 2 — — $17,622.34 $17,622.34 $17,622.34 2026-03-04
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $17,616.73 $17,616.73 $17,616.73 2026-03-04
1744 APR_DRG Percutaneous Cardiac Intervention With Ami 4 2 — — $17,583.08 $17,583.08 $17,583.08 2026-03-04
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 4 2 — — $17,564.39 $17,564.39 $17,564.39 2026-03-04
2294 APR_DRG Other Digestive System And Abdominal Procedures 4 2 — — $17,484.94 $17,484.94 $17,484.94 2026-03-04
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 2 — — $17,438.67 $17,438.67 $17,438.67 2026-03-04
2244 APR_DRG Peritoneal Adhesiolysis 4 2 — — $17,317.63 $17,317.63 $17,317.63 2026-03-04
893 APR_DRG Major Cranial Or Facial Bone Procedures 4 2 — — $17,275.57 $17,275.57 $17,275.57 2026-03-04
1831 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $17,271.36 $17,271.36 $17,271.36 2026-03-04
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $17,258.74 $17,258.74 $17,258.74 2026-03-04
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