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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

SANFORD TRACY MEDICAL CENTER

Tracy, MN · CCN 241303 · Rates published

7,677 distinct procedures filed
16 distinct payers
230,280 rate rows
2026-03-04 last MRF observed
Data quality

229,312 of 230,280 rate rows are consumer-grade (99.6%)

968 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 864
per-diem day rate — not a per-procedure price 64
exceeds 10× this hospital's gross charge — excluded from medians 32
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/8378/460388596_sanford-tracy-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SanfordTracyHospital/8378
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-03
Content fingerprint a714a189a9b21439… · 62,530,814 bytes · first seen 2026-05-08

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 $334,575.88 $334,575.88 $334,575.88 nat. median
$390,362
0.9× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $211,464.50 $211,464.50 $211,464.50 nat. median
$286,698
0.7× median
5833
APR_DRG 		Neonate With Ecmo 2 $202,008.28 $202,008.28 $202,008.28 nat. median
$268,208
0.8× median
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $189,487.88 $189,487.88 $189,487.88 nat. median
$135,803
1.4× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $172,083.05 $172,083.05 $172,083.05 nat. median
$225,531
0.8× median
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $148,702.84 $148,702.84 $148,702.84 nat. median
$198,578
0.7× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $147,895.19 $147,895.19 $147,895.19 nat. median
$68,335
outlier · 2.2×
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $145,500.39 $145,500.39 $145,500.39 nat. median
$171,497
0.8× median
1614
APR_DRG 		Implantable Heart Assist Systems 2 $143,083.56 $143,083.56 $143,083.56 nat. median
$202,242
0.7× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $137,704.13 $137,704.13 $137,704.13 nat. median
$152,792
0.9× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $136,888.53 $136,888.53 $136,888.53 nat. median
$173,134
0.8× median
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $132,020.61 $132,020.61 $132,020.61 nat. median
$152,383
0.9× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $128,434.53 $128,434.53 $128,434.53 nat. median
$168,439
0.8× median
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $126,917.12 $126,917.12 $126,917.12 nat. median
$181,762
0.7× median
5832
APR_DRG 		Neonate With Ecmo 2 $126,764.77 $126,764.77 $126,764.77 nat. median
$201,678
0.6× median
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $124,976.93 $124,976.93 $124,976.93 nat. median
$63,564
2.0× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $122,407.75 $122,407.75 $122,407.75 nat. median
$173,018
0.7× median
1613
APR_DRG 		Implantable Heart Assist Systems 2 $115,135.85 $115,135.85 $115,135.85 nat. median
$155,539
0.7× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $112,311.53 $112,311.53 $112,311.53 nat. median
$99,483
1.1× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $112,311.53 $112,311.53 $112,311.53 nat. median
$96,548
1.2× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $112,311.53 $112,311.53 $112,311.53 nat. median
$77,096
1.5× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $110,553.67 $110,553.67 $110,553.67 nat. median
$120,079
0.9× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $107,845.60 $107,845.60 $107,845.60 nat. median
$187,567
0.6× median
5831
APR_DRG 		Neonate With Ecmo 2 $106,957.80 $106,957.80 $106,957.80 nat. median
$173,909
0.6× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $106,006.97 $106,006.97 $106,006.97 nat. median
$149,836
0.7× median
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $105,198.71 $105,198.71 $105,198.71 nat. median
$135,630
0.8× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 2 $97,562.76 $97,562.76 $97,562.76 nat. median
$136,566
0.7× median
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $93,807.19 $93,807.19 $93,807.19 nat. median
$124,731
0.8× median
23
APR_DRG 		Heart And/or Lung Transplant 2 $93,056.45 $93,056.45 $93,056.45 nat. median
$117,894
0.8× median
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $91,751.36 $91,751.36 $91,751.36 nat. median
$114,205
0.8× median
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $89,768.34 $89,768.34 $89,768.34 nat. median
$85,835
1.0× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $87,808.56 $87,808.56 $87,808.56 nat. median
$130,862
0.7× median
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $77,902.02 $77,902.02 $77,902.02 nat. median
$73,618
1.1× median
1612
APR_DRG 		Implantable Heart Assist Systems 2 $77,817.58 $77,817.58 $77,817.58 nat. median
$109,992
0.7× median
1611
APR_DRG 		Implantable Heart Assist Systems 2 $77,817.58 $77,817.58 $77,817.58 nat. median
$108,954
0.7× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 2 $75,648.55 $75,648.55 $75,648.55 nat. median
$106,926
0.7× median
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $74,832.95 $74,832.95 $74,832.95 nat. median
$91,350
0.8× median
22
APR_DRG 		Heart And/or Lung Transplant 2 $71,826.91 $71,826.91 $71,826.91 nat. median
$95,481
0.8× median
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $71,338.03 $71,338.03 $71,338.03 nat. median
$91,110
0.8× median
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 $69,826.14 $69,826.14 $69,826.14 nat. median
$100,752
0.7× median
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $69,734.36 $69,734.36 $69,734.36 nat. median
$85,032
0.8× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $67,846.79 $67,846.79 $67,846.79 nat. median
$115,963
0.6× median
64
APR_DRG 		Pancreas Transplant 2 $65,792.18 $65,792.18 $65,792.18 nat. median
$92,994
0.7× median
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 2 $65,459.94 $65,459.94 $65,459.94 nat. median
$91,950
0.7× median
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $65,389.58 $65,389.58 $65,389.58 nat. median
$95,757
0.7× median
73
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $63,159.36 $63,159.36 $63,159.36 nat. median
$81,292
0.8× median
38240
CPT 		Transplt Allo Hct/donor 1 $62,099.45 $62,099.45 $62,099.45 nat. median
$28,331
outlier · 2.2×
6114
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 $58,842.11 $58,842.11 $58,842.11 nat. median
$85,322
0.7× median
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $58,743.27 $58,743.27 $58,743.27 nat. median
$63,499
0.9× median
6303
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $58,571.06 $58,571.06 $58,571.06 nat. median
$95,499
0.6× median

Other procedures at this hospital

Browse this hospital's 7,677 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
             
11 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $35,721.33 $35,721.33 $35,721.33 2026-03-04
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $52,796.99 $52,796.99 $52,796.99 2026-03-04
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $124,976.93 $124,976.93 $124,976.93 2026-03-04
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $147,895.19 $147,895.19 $147,895.19 2026-03-04
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 4 2 — — $189,487.88 $189,487.88 $189,487.88 2026-03-04
12 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $43,472.31 $43,472.31 $43,472.31 2026-03-04
1203 APR_DRG Major Respiratory And Chest Procedures 4 2 — — $19,587.32 $19,587.32 $19,587.32 2026-03-04
1204 APR_DRG Major Respiratory And Chest Procedures 4 2 — — $31,831.15 $31,831.15 $31,831.15 2026-03-04
1214 APR_DRG Other Respiratory And Chest Procedures 4 2 — — $26,912.45 $26,912.45 $26,912.45 2026-03-04
13 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $53,878.75 $53,878.75 $53,878.75 2026-03-04
1302 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 2 — — $20,696.00 $20,696.00 $20,696.00 2026-03-04
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 2 — — $25,363.23 $25,363.23 $25,363.23 2026-03-04
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 4 2 — — $33,915.75 $33,915.75 $33,915.75 2026-03-04
14 APR_DRG Liver Transplant And/or Intestinal Transplant 4 2 — — $97,562.76 $97,562.76 $97,562.76 2026-03-04
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 2 — — $25,957.96 $25,957.96 $25,957.96 2026-03-04
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 2 — — $33,250.66 $33,250.66 $33,250.66 2026-03-04
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 4 2 — — $75,648.55 $75,648.55 $75,648.55 2026-03-04
1611 APR_DRG Implantable Heart Assist Systems 4 2 — — $77,817.58 $77,817.58 $77,817.58 2026-03-04
1612 APR_DRG Implantable Heart Assist Systems 4 2 — — $77,817.58 $77,817.58 $77,817.58 2026-03-04
1613 APR_DRG Implantable Heart Assist Systems 4 2 — — $115,135.85 $115,135.85 $115,135.85 2026-03-04
1614 APR_DRG Implantable Heart Assist Systems 4 2 — — $143,083.56 $143,083.56 $143,083.56 2026-03-04
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $26,914.90 $26,914.90 $26,914.90 2026-03-04
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $31,324.54 $31,324.54 $31,324.54 2026-03-04
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $40,930.67 $40,930.67 $40,930.67 2026-03-04
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 4 2 — — $57,144.22 $57,144.22 $57,144.22 2026-03-04
1631 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $22,595.20 $22,595.20 $22,595.20 2026-03-04
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $26,099.91 $26,099.91 $26,099.91 2026-03-04
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $34,339.76 $34,339.76 $34,339.76 2026-03-04
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 4 2 — — $50,235.76 $50,235.76 $50,235.76 2026-03-04
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $24,909.85 $24,909.85 $24,909.85 2026-03-04
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $27,285.07 $27,285.07 $27,285.07 2026-03-04
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $33,203.55 $33,203.55 $33,203.55 2026-03-04
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 4 2 — — $45,038.05 $45,038.05 $45,038.05 2026-03-04
1661 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $21,061.28 $21,061.28 $21,061.28 2026-03-04
1662 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $23,391.84 $23,391.84 $23,391.84 2026-03-04
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $28,271.99 $28,271.99 $28,271.99 2026-03-04
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 4 2 — — $38,944.58 $38,944.58 $38,944.58 2026-03-04
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 4 2 — — $23,724.69 $23,724.69 $23,724.69 2026-03-04
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 4 2 — — $38,225.04 $38,225.04 $38,225.04 2026-03-04
1692 APR_DRG Major Abdominal Vascular Procedures 4 2 — — $19,452.71 $19,452.71 $19,452.71 2026-03-04
1693 APR_DRG Major Abdominal Vascular Procedures 4 2 — — $23,899.06 $23,899.06 $23,899.06 2026-03-04
1694 APR_DRG Major Abdominal Vascular Procedures 4 2 — — $35,163.32 $35,163.32 $35,163.32 2026-03-04
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 4 2 — — $25,804.99 $25,804.99 $25,804.99 2026-03-04
1714 APR_DRG Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock 4 2 — — $22,426.33 $22,426.33 $22,426.33 2026-03-04
1744 APR_DRG Percutaneous Cardiac Intervention With Ami 4 2 — — $23,019.83 $23,019.83 $23,019.83 2026-03-04
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 4 2 — — $25,510.08 $25,510.08 $25,510.08 2026-03-04
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 4 2 — — $24,006.14 $24,006.14 $24,006.14 2026-03-04
1774 APR_DRG Cardiac Pacemaker And Defibrillator Revision Except Device Replacement 4 2 — — $20,093.32 $20,093.32 $20,093.32 2026-03-04
1781 APR_DRG External Heart Assist Devices 4 2 — — $28,101.90 $28,101.90 $28,101.90 2026-03-04
1782 APR_DRG External Heart Assist Devices 4 2 — — $30,629.47 $30,629.47 $30,629.47 2026-03-04
1783 APR_DRG External Heart Assist Devices 4 2 — — $37,995.60 $37,995.60 $37,995.60 2026-03-04
1784 APR_DRG External Heart Assist Devices 4 2 — — $46,855.87 $46,855.87 $46,855.87 2026-03-04
1791 APR_DRG Defibrillator Implants 4 2 — — $19,885.29 $19,885.29 $19,885.29 2026-03-04
1792 APR_DRG Defibrillator Implants 4 2 — — $23,610.88 $23,610.88 $23,610.88 2026-03-04
1793 APR_DRG Defibrillator Implants 4 2 — — $28,722.32 $28,722.32 $28,722.32 2026-03-04
1794 APR_DRG Defibrillator Implants 4 2 — — $38,906.65 $38,906.65 $38,906.65 2026-03-04
1804 APR_DRG Other Circulatory System Procedures 4 2 — — $22,208.51 $22,208.51 $22,208.51 2026-03-04
1814 APR_DRG Lower Extremity Vascular Procedures 4 2 — — $27,565.91 $27,565.91 $27,565.91 2026-03-04
1824 APR_DRG Other Peripheral Vascular And Related Procedures 4 2 — — $22,238.49 $22,238.49 $22,238.49 2026-03-04
1831 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $22,611.72 $22,611.72 $22,611.72 2026-03-04
1832 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $23,962.70 $23,962.70 $23,962.70 2026-03-04
1833 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $29,296.24 $29,296.24 $29,296.24 2026-03-04
1834 APR_DRG Percutaneous Structural Cardiac Procedures 4 2 — — $41,578.01 $41,578.01 $41,578.01 2026-03-04
203 APR_DRG Open Craniotomy For Trauma 4 2 — — $20,595.66 $20,595.66 $20,595.66 2026-03-04
204 APR_DRG Open Craniotomy For Trauma 4 2 — — $31,117.73 $31,117.73 $31,117.73 2026-03-04
21 APR_DRG Heart And/or Lung Transplant 4 2 — — $55,060.24 $55,060.24 $55,060.24 2026-03-04
213 APR_DRG Open Craniotomy Except Trauma 4 2 — — $23,929.66 $23,929.66 $23,929.66 2026-03-04
214 APR_DRG Open Craniotomy Except Trauma 4 2 — — $35,120.49 $35,120.49 $35,120.49 2026-03-04
22 APR_DRG Heart And/or Lung Transplant 4 2 — — $71,826.91 $71,826.91 $71,826.91 2026-03-04
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 4 2 — — $32,294.94 $32,294.94 $32,294.94 2026-03-04
2224 APR_DRG Other Stomach, Esophageal And Duodenal Procedures 4 2 — — $22,578.68 $22,578.68 $22,578.68 2026-03-04
2234 APR_DRG Other Small And Large Bowel Procedures 4 2 — — $21,805.30 $21,805.30 $21,805.30 2026-03-04
224 APR_DRG Ventricular Shunt Procedures 4 2 — — $25,324.69 $25,324.69 $25,324.69 2026-03-04
2244 APR_DRG Peritoneal Adhesiolysis 4 2 — — $22,672.29 $22,672.29 $22,672.29 2026-03-04
2274 APR_DRG Hernia Procedures Except Inguinal, Femoral And Umbilical 4 2 — — $22,437.95 $22,437.95 $22,437.95 2026-03-04
2294 APR_DRG Other Digestive System And Abdominal Procedures 4 2 — — $22,891.34 $22,891.34 $22,891.34 2026-03-04
23 APR_DRG Heart And/or Lung Transplant 4 2 — — $93,056.45 $93,056.45 $93,056.45 2026-03-04
2304 APR_DRG Major Small Bowel Procedures 4 2 — — $27,620.98 $27,620.98 $27,620.98 2026-03-04
2314 APR_DRG Major Large Bowel Procedures 4 2 — — $24,170.12 $24,170.12 $24,170.12 2026-03-04
2324 APR_DRG Gastric Fundoplication 4 2 — — $19,663.80 $19,663.80 $19,663.80 2026-03-04
233 APR_DRG Spinal Procedures 4 2 — — $22,049.43 $22,049.43 $22,049.43 2026-03-04
234 APR_DRG Spinal Procedures 4 2 — — $33,886.38 $33,886.38 $33,886.38 2026-03-04
24 APR_DRG Heart And/or Lung Transplant 4 2 — — $172,083.05 $172,083.05 $172,083.05 2026-03-04
244 APR_DRG Open Extracranial Vascular Procedures 4 2 — — $21,226.48 $21,226.48 $21,226.48 2026-03-04
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 4 2 — — $33,224.35 $33,224.35 $33,224.35 2026-03-04
2614 APR_DRG Major Biliary Tract Procedures 4 2 — — $29,429.62 $29,429.62 $29,429.62 2026-03-04
264 APR_DRG Other Nervous System And Related Procedures 4 2 — — $23,197.88 $23,197.88 $23,197.88 2026-03-04
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 4 2 — — $25,421.97 $25,421.97 $25,421.97 2026-03-04
273 APR_DRG Other Open Craniotomy 4 2 — — $19,489.42 $19,489.42 $19,489.42 2026-03-04
274 APR_DRG Other Open Craniotomy 4 2 — — $27,589.77 $27,589.77 $27,589.77 2026-03-04
294 APR_DRG Other Percutaneous Intracranial Procedures 4 2 — — $25,343.65 $25,343.65 $25,343.65 2026-03-04
2991 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $23,691.65 $23,691.65 $23,691.65 2026-03-04
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $27,840.02 $27,840.02 $27,840.02 2026-03-04
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $37,158.58 $37,158.58 $37,158.58 2026-03-04
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $47,396.14 $47,396.14 $47,396.14 2026-03-04
3003 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $24,483.39 $24,483.39 $24,483.39 2026-03-04
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 4 2 — — $35,838.19 $35,838.19 $35,838.19 2026-03-04
303 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 2 — — $19,402.54 $19,402.54 $19,402.54 2026-03-04
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $23,063.88 $23,063.88 $23,063.88 2026-03-04
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $26,140.29 $26,140.29 $26,140.29 2026-03-04
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $34,973.03 $34,973.03 $34,973.03 2026-03-04
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 4 2 — — $52,386.43 $52,386.43 $52,386.43 2026-03-04
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 4 2 — — $26,507.40 $26,507.40 $26,507.40 2026-03-04
3042 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 2 — — $19,921.39 $19,921.39 $19,921.39 2026-03-04
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 2 — — $27,504.73 $27,504.73 $27,504.73 2026-03-04
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 4 2 — — $38,505.88 $38,505.88 $38,505.88 2026-03-04
3054 APR_DRG Amputation Of Lower Limb Except Toes 4 2 — — $22,087.36 $22,087.36 $22,087.36 2026-03-04
3094 APR_DRG Other Significant Hip And Femur Surgery 4 2 — — $22,397.57 $22,397.57 $22,397.57 2026-03-04
3104 APR_DRG Vertebral And Intervertebral Spinal Procedures Including Disc Procedures 4 2 — — $20,034.59 $20,034.59 $20,034.59 2026-03-04
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 4 2 — — $30,757.96 $30,757.96 $30,757.96 2026-03-04
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 4 2 — — $23,159.94 $23,159.94 $23,159.94 2026-03-04
3154 APR_DRG Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement 4 2 — — $21,741.05 $21,741.05 $21,741.05 2026-03-04
3204 APR_DRG Other Musculoskeletal System And Connective Tissue Procedures 4 2 — — $20,766.98 $20,766.98 $20,766.98 2026-03-04
3213 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 4 2 — — $20,343.57 $20,343.57 $20,343.57 2026-03-04
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 4 2 — — $28,349.70 $28,349.70 $28,349.70 2026-03-04
3224 APR_DRG Shoulder And Elbow Joint Replacement 4 2 — — $21,194.05 $21,194.05 $21,194.05 2026-03-04
3234 APR_DRG Non-elective Or Complex Hip Joint Replacement 4 2 — — $21,600.32 $21,600.32 $21,600.32 2026-03-04
3244 APR_DRG Elective Hip Joint Replacement 4 2 — — $20,738.22 $20,738.22 $20,738.22 2026-03-04
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 4 2 — — $23,669.62 $23,669.62 $23,669.62 2026-03-04
33221 CPT Insert Pulse Gen Mult Leads 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
33230 CPT Insrt Pulse Gen W/dual Leads 2 1 — — $23,568.50 $23,568.50 $23,568.50 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
33240 CPT Insrt Pulse Gen W/singl Lead 2 1 — — $23,568.50 $23,568.50 $23,568.50 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
33262 CPT Rmvl& Replc Pulse Gen 1 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
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 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
33274 CPT Tcat Insj/rpl Perm Ldls Pm 2 1 — — $20,024.72 $20,024.72 $20,024.72 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
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 4 2 — — $28,962.17 $28,962.17 $28,962.17 2026-03-04
38240 CPT Transplt Allo Hct/donor 2 1 — — $62,099.45 $62,099.45 $62,099.45 2026-03-04
4014 APR_DRG Adrenal Procedures 4 2 — — $32,045.30 $32,045.30 $32,045.30 2026-03-04
4034 APR_DRG Procedures For Obesity 4 2 — — $25,786.64 $25,786.64 $25,786.64 2026-03-04
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 4 2 — — $24,890.27 $24,890.27 $24,890.27 2026-03-04
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 4 2 — — $25,986.71 $25,986.71 $25,986.71 2026-03-04
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $30,811.19 $30,811.19 $30,811.19 2026-03-04
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $43,488.22 $43,488.22 $43,488.22 2026-03-04
4284 APR_DRG Genetic Disorders 4 2 — — $25,791.53 $25,791.53 $25,791.53 2026-03-04
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $69,734.36 $69,734.36 $69,734.36 2026-03-04
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 4 2 — — $23,123.84 $23,123.84 $23,123.84 2026-03-04
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 4 2 — — $105,198.71 $105,198.71 $105,198.71 2026-03-04
4401 APR_DRG Kidney Transplant 4 2 — — $28,558.34 $28,558.34 $28,558.34 2026-03-04
4402 APR_DRG Kidney Transplant 4 2 — — $31,259.07 $31,259.07 $31,259.07 2026-03-04
4403 APR_DRG Kidney Transplant 4 2 — — $36,215.10 $36,215.10 $36,215.10 2026-03-04
4404 APR_DRG Kidney Transplant 4 2 — — $54,403.11 $54,403.11 $54,403.11 2026-03-04
4413 APR_DRG Major Bladder Procedures 4 2 — — $19,691.34 $19,691.34 $19,691.34 2026-03-04
4414 APR_DRG Major Bladder Procedures 4 2 — — $30,743.28 $30,743.28 $30,743.28 2026-03-04
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 4 2 — — $24,574.55 $24,574.55 $24,574.55 2026-03-04
4434 APR_DRG Kidney And Urinary Tract Procedures For Non-malignancy 4 2 — — $20,026.02 $20,026.02 $20,026.02 2026-03-04
4444 APR_DRG Renal Dialysis Access Device Procedures 4 2 — — $21,933.17 $21,933.17 $21,933.17 2026-03-04
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 4 2 — — $24,638.19 $24,638.19 $24,638.19 2026-03-04
4484 APR_DRG Other Kidney, Urinary Tract And Related Percutaneous Procedures 4 2 — — $23,923.54 $23,923.54 $23,923.54 2026-03-04
4834 APR_DRG Penis, Testes And Scrotal Procedures 4 2 — — $19,401.93 $19,401.93 $19,401.93 2026-03-04
4844 APR_DRG Other Male Reproductive System And Related Procedures 4 2 — — $21,685.98 $21,685.98 $21,685.98 2026-03-04
4854 APR_DRG Prostatectomy Procedures 4 2 — — $29,340.29 $29,340.29 $29,340.29 2026-03-04
504 APR_DRG Non-bacterial Infections Of Nervous System Except Viral Meningitis 4 2 — — $20,079.86 $20,079.86 $20,079.86 2026-03-04
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 4 2 — — $27,122.32 $27,122.32 $27,122.32 2026-03-04
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 4 2 — — $26,989.54 $26,989.54 $26,989.54 2026-03-04
5134 APR_DRG Uterine And Adnexa Procedures For Non-malignancy Except Leiomyoma 4 2 — — $21,660.29 $21,660.29 $21,660.29 2026-03-04
5144 APR_DRG Female Reproductive System Reconstructive Procedures 4 2 — — $19,959.33 $19,959.33 $19,959.33 2026-03-04
5184 APR_DRG Other Female Reproductive System And Related Procedures 4 2 — — $21,826.71 $21,826.71 $21,826.71 2026-03-04
5194 APR_DRG Uterine And Adnexa Procedures For Leiomyoma 4 2 — — $22,165.07 $22,165.07 $22,165.07 2026-03-04
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 2 — — $35,354.83 $35,354.83 $35,354.83 2026-03-04
5204 APR_DRG Other GYN Procedures For Malignancy 4 2 — — $30,407.37 $30,407.37 $30,407.37 2026-03-04
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 2 — — $52,795.15 $52,795.15 $52,795.15 2026-03-04
53444 CPT Insert Tandem Cuff 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
53447 CPT Remove/replace Ur Sphincter 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 4 2 — — $74,832.95 $74,832.95 $74,832.95 2026-03-04
54401 CPT Insert Self-contd Prosthesis 2 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54405 CPT Insert Multi-comp Penis Pros 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
54411 CPT Remov/replc Penis Pros Comp 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
5831 APR_DRG Neonate With Ecmo 4 2 — — $106,957.80 $106,957.80 $106,957.80 2026-03-04
5832 APR_DRG Neonate With Ecmo 4 2 — — $126,764.77 $126,764.77 $126,764.77 2026-03-04
5833 APR_DRG Neonate With Ecmo 4 2 — — $202,008.28 $202,008.28 $202,008.28 2026-03-04
5834 APR_DRG Neonate With Ecmo 4 2 — — $334,575.88 $334,575.88 $334,575.88 2026-03-04
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $87,808.56 $87,808.56 $87,808.56 2026-03-04
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $132,020.61 $132,020.61 $132,020.61 2026-03-04
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $136,888.53 $136,888.53 $136,888.53 2026-03-04
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 4 2 — — $211,464.50 $211,464.50 $211,464.50 2026-03-04
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 2 — — $112,311.53 $112,311.53 $112,311.53 2026-03-04
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 2 — — $112,311.53 $112,311.53 $112,311.53 2026-03-04
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 4 2 — — $112,311.53 $112,311.53 $112,311.53 2026-03-04
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 2 — — $89,768.34 $89,768.34 $89,768.34 2026-03-04
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 2 — — $110,553.67 $110,553.67 $110,553.67 2026-03-04
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 4 2 — — $145,500.39 $145,500.39 $145,500.39 2026-03-04
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $35,364.01 $35,364.01 $35,364.01 2026-03-04
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $71,338.03 $71,338.03 $71,338.03 2026-03-04
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $91,751.36 $91,751.36 $91,751.36 2026-03-04
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 4 2 — — $128,434.53 $128,434.53 $128,434.53 2026-03-04
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $28,030.92 $28,030.92 $28,030.92 2026-03-04
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $47,803.02 $47,803.02 $47,803.02 2026-03-04
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $65,389.58 $65,389.58 $65,389.58 2026-03-04
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $93,807.19 $93,807.19 $93,807.19 2026-03-04
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 2 — — $23,889.89 $23,889.89 $23,889.89 2026-03-04
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 2 — — $27,767.82 $27,767.82 $27,767.82 2026-03-04
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 4 2 — — $67,846.79 $67,846.79 $67,846.79 2026-03-04
6071 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $20,877.11 $20,877.11 $20,877.11 2026-03-04
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $33,400.56 $33,400.56 $33,400.56 2026-03-04
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $49,037.14 $49,037.14 $49,037.14 2026-03-04
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $69,826.14 $69,826.14 $69,826.14 2026-03-04
6082 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 2 — — $20,626.25 $20,626.25 $20,626.25 2026-03-04
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 2 — — $34,193.53 $34,193.53 $34,193.53 2026-03-04
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 4 2 — — $34,193.53 $34,193.53 $34,193.53 2026-03-04
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $23,536.85 $23,536.85 $23,536.85 2026-03-04
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $29,241.17 $29,241.17 $29,241.17 2026-03-04
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $45,665.20 $45,665.20 $45,665.20 2026-03-04
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 4 2 — — $148,702.84 $148,702.84 $148,702.84 2026-03-04
61 APR_DRG Pancreas Transplant 4 2 — — $38,208.52 $38,208.52 $38,208.52 2026-03-04
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 2 — — $25,579.83 $25,579.83 $25,579.83 2026-03-04
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 4 2 — — $58,842.11 $58,842.11 $58,842.11 2026-03-04
6122 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $19,643.61 $19,643.61 $19,643.61 2026-03-04
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $29,837.12 $29,837.12 $29,837.12 2026-03-04
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $43,121.72 $43,121.72 $43,121.72 2026-03-04
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 2 — — $27,694.40 $27,694.40 $27,694.40 2026-03-04
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 4 2 — — $37,556.28 $37,556.28 $37,556.28 2026-03-04
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 2 — — $23,563.77 $23,563.77 $23,563.77 2026-03-04
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 4 2 — — $28,428.63 $28,428.63 $28,428.63 2026-03-04
61885 CPT Insrt/redo Neurostim 1 Array 2 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
61886 CPT Implant Neurostim Arrays 2 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
62 APR_DRG Pancreas Transplant 4 2 — — $47,349.03 $47,349.03 $47,349.03 2026-03-04
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 4 2 — — $40,286.99 $40,286.99 $40,286.99 2026-03-04
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 4 2 — — $25,184.57 $25,184.57 $25,184.57 2026-03-04
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 4 2 — — $24,208.05 $24,208.05 $24,208.05 2026-03-04
6254 APR_DRG Neonate Birth Weight 2000-2499 Grams With Other Significant Condition 4 2 — — $22,995.35 $22,995.35 $22,995.35 2026-03-04
63 APR_DRG Pancreas Transplant 4 2 — — $55,993.93 $55,993.93 $55,993.93 2026-03-04
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 2 — — $23,071.22 $23,071.22 $23,071.22 2026-03-04
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 2 — — $58,571.06 $58,571.06 $58,571.06 2026-03-04
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 4 2 — — $107,845.60 $107,845.60 $107,845.60 2026-03-04
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 2 — — $35,099.69 $35,099.69 $35,099.69 2026-03-04
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 4 2 — — $126,917.12 $126,917.12 $126,917.12 2026-03-04
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 4 2 — — $42,212.50 $42,212.50 $42,212.50 2026-03-04
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 4 2 — — $23,911.30 $23,911.30 $23,911.30 2026-03-04
63655 CPT Implant Neuroelectrodes 2 1 — — $22,516.61 $22,516.61 $22,516.61 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
64 APR_DRG Pancreas Transplant 4 2 — — $65,792.18 $65,792.18 $65,792.18 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
64580 CPT Opn Impltj Nea Neuromuscular 2 1 — — $22,516.61 $22,516.61 $22,516.61 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
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 2 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
6504 APR_DRG Splenic Procedures 4 2 — — $24,796.66 $24,796.66 $24,796.66 2026-03-04
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 4 2 — — $27,255.09 $27,255.09 $27,255.09 2026-03-04
6803 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 2 — — $19,903.04 $19,903.04 $19,903.04 2026-03-04
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 2 — — $37,491.43 $37,491.43 $37,491.43 2026-03-04
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 4 2 — — $30,305.80 $30,305.80 $30,305.80 2026-03-04
6904 APR_DRG Acute Leukemia 4 2 — — $31,892.34 $31,892.34 $31,892.34 2026-03-04
6954 APR_DRG Chemotherapy For Acute Leukemia 4 2 — — $27,609.97 $27,609.97 $27,609.97 2026-03-04
69930 CPT Implant Cochlear Device 2 1 — — $33,398.21 $33,398.21 $33,398.21 2026-03-04
71 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $39,130.59 $39,130.59 $39,130.59 2026-03-04
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 4 2 — — $26,107.25 $26,107.25 $26,107.25 2026-03-04
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 4 2 — — $25,239.64 $25,239.64 $25,239.64 2026-03-04
72 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $47,009.45 $47,009.45 $47,009.45 2026-03-04
73 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $63,159.36 $63,159.36 $63,159.36 2026-03-04
734 APR_DRG Orbit And Eye Procedures 4 2 — — $19,696.23 $19,696.23 $19,696.23 2026-03-04
74 APR_DRG Allogeneic Bone Marrow Transplant 4 2 — — $106,006.97 $106,006.97 $106,006.97 2026-03-04
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 4 2 — — $32,214.79 $32,214.79 $32,214.79 2026-03-04
7524 APR_DRG Personality Disorders 4 2 — — $23,568.66 $23,568.66 $23,568.66 2026-03-04
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 4 2 — — $27,413.56 $27,413.56 $27,413.56 2026-03-04
7934 APR_DRG Moderately Extensive O.r. Procedures For Other Complications Of Treatment 4 2 — — $20,875.28 $20,875.28 $20,875.28 2026-03-04
81 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $20,640.32 $20,640.32 $20,640.32 2026-03-04
82 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $24,452.18 $24,452.18 $24,452.18 2026-03-04
83 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $30,213.41 $30,213.41 $30,213.41 2026-03-04
84 APR_DRG Autologous Bone Marrow Transplant 4 2 — — $46,062.91 $46,062.91 $46,062.91 2026-03-04
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 4 2 — — $37,016.02 $37,016.02 $37,016.02 2026-03-04
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 4 2 — — $122,407.75 $122,407.75 $122,407.75 2026-03-04
8423 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 2 — — $22,830.76 $22,830.76 $22,830.76 2026-03-04
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 4 2 — — $65,459.94 $65,459.94 $65,459.94 2026-03-04
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 4 2 — — $33,365.08 $33,365.08 $33,365.08 2026-03-04
8514 APR_DRG Gender Related Procedures 4 2 — — $49,244.55 $49,244.55 $49,244.55 2026-03-04
8633 APR_DRG Neonatal Aftercare 4 2 — — $25,988.55 $25,988.55 $25,988.55 2026-03-04
8634 APR_DRG Neonatal Aftercare 4 2 — — $56,140.77 $56,140.77 $56,140.77 2026-03-04
893 APR_DRG Major Cranial Or Facial Bone Procedures 4 2 — — $22,617.23 $22,617.23 $22,617.23 2026-03-04
894 APR_DRG Major Cranial Or Facial Bone Procedures 4 2 — — $32,428.94 $32,428.94 $32,428.94 2026-03-04
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $34,587.56 $34,587.56 $34,587.56 2026-03-04
9103 APR_DRG Craniotomy For Multiple Significant Trauma 4 2 — — $23,875.81 $23,875.81 $23,875.81 2026-03-04
9104 APR_DRG Craniotomy For Multiple Significant Trauma 4 2 — — $40,318.81 $40,318.81 $40,318.81 2026-03-04
9113 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 4 2 — — $20,688.05 $20,688.05 $20,688.05 2026-03-04
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 4 2 — — $38,712.69 $38,712.69 $38,712.69 2026-03-04
9123 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 4 2 — — $21,942.35 $21,942.35 $21,942.35 2026-03-04
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 4 2 — — $36,957.89 $36,957.89 $36,957.89 2026-03-04
913 APR_DRG Other Major Head And Neck Procedures 4 2 — — $24,197.04 $24,197.04 $24,197.04 2026-03-04
914 APR_DRG Other Major Head And Neck Procedures 4 2 — — $38,095.33 $38,095.33 $38,095.33 2026-03-04
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $42,749.10 $42,749.10 $42,749.10 2026-03-04
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 4 2 — — $27,720.71 $27,720.71 $27,720.71 2026-03-04
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $77,902.02 $77,902.02 $77,902.02 2026-03-04
93653 CPT Compre Ep Eval Tx Svt 2 1 — — $25,758.92 $25,758.92 $25,758.92 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
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 4 2 — — $137,704.13 $137,704.13 $137,704.13 2026-03-04
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 2 — — $31,656.16 $31,656.16 $31,656.16 2026-03-04
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 4 2 — — $24,066.71 $24,066.71 $24,066.71 2026-03-04
9524 APR_DRG Non-extensive O.r. Procedure Unrelated To Principal Diagnosis 4 2 — — $21,422.27 $21,422.27 $21,422.27 2026-03-04
984 APR_DRG Other Ear, Nose, Mouth, Throat, Craniofacial, And Neck Procedures 4 2 — — $21,654.78 $21,654.78 $21,654.78 2026-03-04
C9760 HCPCS Non-blind Interatrial Shunt 2 1 — — $28,875.53 $28,875.53 $28,875.53 2026-03-04
J2350 HCPCS Ocrelizumab Soln For IV Infusion 300 Mg/10ml 90 16 $39,310.80 $31,448.64 20% off $60.94 $37,188.02 $29,404.48 2026-03-04
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 2 1 — — $58,743.27 $58,743.27 $58,743.27 2026-03-04
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