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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 WHEATON MEDICAL CENTER

Wheaton, MN · CCN 241304 · Rates published

7,484 distinct procedures filed
15 distinct payers
96,729 rate rows
2026-03-04 last MRF observed
Data quality

96,565 of 96,729 rate rows are consumer-grade (99.8%)

164 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 110
per-diem day rate — not a per-procedure price 51
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
exceeds 10× this hospital's gross charge — excluded from medians 1
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8380/450409348_sanford-wheaton_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SanfordWheaton/8380
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-10-20
Content fingerprint 934c06d0d9ef32fa… · 52,385,871 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 $187,671.72 $187,671.72 $187,671.72 nat. median
$307,206
0.6× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $118,615.56 $118,615.56 $118,615.56 nat. median
$247,214
outlier · 0.5×
5833
APR_DRG 		Neonate With Ecmo 2 $113,311.34 $113,311.34 $113,311.34 nat. median
$244,017
outlier · 0.5×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $106,288.34 $106,288.34 $106,288.34 nat. median
$123,836
0.9× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $96,525.55 $96,525.55 $96,525.55 nat. median
$241,437
outlier · 0.4×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $83,411.02 $83,411.02 $83,411.02 nat. median
$165,000
0.5× median
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $82,957.99 $82,957.99 $82,957.99 nat. median
$67,735
1.2× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $81,614.69 $81,614.69 $81,614.69 nat. median
$162,342
0.5× median
1614
APR_DRG 		Implantable Heart Assist Systems 2 $80,259.04 $80,259.04 $80,259.04 nat. median
$202,993
outlier · 0.4×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $77,241.58 $77,241.58 $77,241.58 nat. median
$163,587
outlier · 0.5×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $76,784.09 $76,784.09 $76,784.09 nat. median
$175,204
outlier · 0.4×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $74,053.56 $74,053.56 $74,053.56 nat. median
$145,061
0.5× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $72,042.04 $72,042.04 $72,042.04 nat. median
$151,838
outlier · 0.5×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $71,190.89 $71,190.89 $71,190.89 nat. median
$133,164
0.5× median
5832
APR_DRG 		Neonate With Ecmo 2 $71,105.43 $71,105.43 $71,105.43 nat. median
$159,249
outlier · 0.4×
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $70,102.59 $70,102.59 $70,102.59 nat. median
$67,994
1.0× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $68,661.47 $68,661.47 $68,661.47 nat. median
$155,939
outlier · 0.4×
1613
APR_DRG 		Implantable Heart Assist Systems 2 $64,582.49 $64,582.49 $64,582.49 nat. median
$120,517
0.5× median
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $62,998.26 $62,998.26 $62,998.26 nat. median
$71,350
0.9× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $62,998.26 $62,998.26 $62,998.26 nat. median
$93,998
0.7× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $62,998.26 $62,998.26 $62,998.26 nat. median
$89,188
0.7× median
38240
CPT 		Transplt Allo Hct/donor 1 $62,099.45 $62,099.45 $62,099.45 nat. median
$12,842
outlier · 4.8×
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $62,012.23 $62,012.23 $62,012.23 nat. median
$101,406
0.6× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $60,493.21 $60,493.21 $60,493.21 nat. median
$154,011
outlier · 0.4×
5831
APR_DRG 		Neonate With Ecmo 2 $59,995.22 $59,995.22 $59,995.22 nat. median
$146,500
outlier · 0.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $59,461.88 $59,461.88 $59,461.88 nat. median
$170,082
outlier · 0.3×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $59,008.51 $59,008.51 $59,008.51 nat. median
$122,016
outlier · 0.5×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $58,743.27 $58,743.27 $58,743.27 nat. median
$65,720
0.9× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 2 $54,725.31 $54,725.31 $54,725.31 nat. median
$136,566
outlier · 0.4×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $52,618.73 $52,618.73 $52,618.73 nat. median
$118,620
outlier · 0.4×
23
APR_DRG 		Heart And/or Lung Transplant 2 $52,197.61 $52,197.61 $52,197.61 nat. median
$110,944
outlier · 0.5×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $51,465.56 $51,465.56 $51,465.56 nat. median
$108,695
outlier · 0.5×
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $50,353.23 $50,353.23 $50,353.23 nat. median
$82,129
0.6× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $49,253.95 $49,253.95 $49,253.95 nat. median
$120,208
outlier · 0.4×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $43,697.13 $43,697.13 $43,697.13 nat. median
$78,893
0.6× median
1612
APR_DRG 		Implantable Heart Assist Systems 2 $43,649.77 $43,649.77 $43,649.77 nat. median
$84,880
0.5× median
1611
APR_DRG 		Implantable Heart Assist Systems 2 $43,649.77 $43,649.77 $43,649.77 nat. median
$76,852
0.6× median
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 2 $42,433.11 $42,433.11 $42,433.11 nat. median
$98,624
outlier · 0.4×
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $41,975.61 $41,975.61 $41,975.61 nat. median
$81,521
0.5× median
22
APR_DRG 		Heart And/or Lung Transplant 2 $40,289.45 $40,289.45 $40,289.45 nat. median
$92,229
outlier · 0.4×
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $40,015.23 $40,015.23 $40,015.23 nat. median
$85,331
outlier · 0.5×
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 $39,167.17 $39,167.17 $39,167.17 nat. median
$96,883
outlier · 0.4×
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $39,115.69 $39,115.69 $39,115.69 nat. median
$74,757
0.5× median
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $38,056.91 $38,056.91 $38,056.91 nat. median
$107,681
outlier · 0.4×
64
APR_DRG 		Pancreas Transplant 2 $36,904.43 $36,904.43 $36,904.43 nat. median
$91,106
outlier · 0.4×
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 2 $36,718.07 $36,718.07 $36,718.07 nat. median
$82,180
outlier · 0.4×
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $36,678.60 $36,678.60 $36,678.60 nat. median
$88,008
outlier · 0.4×
73
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $35,427.62 $35,427.62 $35,427.62 nat. median
$89,273
outlier · 0.4×
33264
CPT 		Rmvl & Rplcmt Dfb Gen Mlt Ld 1 $33,664.66 $33,664.66 $33,664.66 nat. median
$31,574
1.1× median
33270
CPT 		Ins/rep Subq Defibrillator 1 $33,664.66 $33,664.66 $33,664.66 nat. median
$32,114
1.0× median

Other procedures at this hospital

Browse this hospital's 7,484 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 2 2 — — $187,671.72 $187,671.72 $187,671.72 2026-03-04
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $118,615.56 $118,615.56 $118,615.56 2026-03-04
5833 APR_DRG Neonate With Ecmo 2 2 — — $113,311.34 $113,311.34 $113,311.34 2026-03-04
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $106,288.34 $106,288.34 $106,288.34 2026-03-04
24 APR_DRG Heart And/or Lung Transplant 2 2 — — $96,525.55 $96,525.55 $96,525.55 2026-03-04
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $83,411.02 $83,411.02 $83,411.02 2026-03-04
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $82,957.99 $82,957.99 $82,957.99 2026-03-04
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $81,614.69 $81,614.69 $81,614.69 2026-03-04
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $80,259.04 $80,259.04 $80,259.04 2026-03-04
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $77,241.58 $77,241.58 $77,241.58 2026-03-04
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $76,784.09 $76,784.09 $76,784.09 2026-03-04
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $74,053.56 $74,053.56 $74,053.56 2026-03-04
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $72,042.04 $72,042.04 $72,042.04 2026-03-04
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $71,190.89 $71,190.89 $71,190.89 2026-03-04
5832 APR_DRG Neonate With Ecmo 2 2 — — $71,105.43 $71,105.43 $71,105.43 2026-03-04
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $70,102.59 $70,102.59 $70,102.59 2026-03-04
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $68,661.47 $68,661.47 $68,661.47 2026-03-04
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $64,582.49 $64,582.49 $64,582.49 2026-03-04
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $62,998.26 $62,998.26 $62,998.26 2026-03-04
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $62,998.26 $62,998.26 $62,998.26 2026-03-04
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $62,998.26 $62,998.26 $62,998.26 2026-03-04
38240 CPT Transplt Allo Hct/donor 1 1 — — $62,099.45 $62,099.45 $62,099.45 2026-03-04
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $62,012.23 $62,012.23 $62,012.23 2026-03-04
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $60,493.21 $60,493.21 $60,493.21 2026-03-04
5831 APR_DRG Neonate With Ecmo 2 2 — — $59,995.22 $59,995.22 $59,995.22 2026-03-04
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $59,461.88 $59,461.88 $59,461.88 2026-03-04
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $59,008.51 $59,008.51 $59,008.51 2026-03-04
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $58,743.27 $58,743.27 $58,743.27 2026-03-04
14 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $54,725.31 $54,725.31 $54,725.31 2026-03-04
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $52,618.73 $52,618.73 $52,618.73 2026-03-04
23 APR_DRG Heart And/or Lung Transplant 2 2 — — $52,197.61 $52,197.61 $52,197.61 2026-03-04
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $51,465.56 $51,465.56 $51,465.56 2026-03-04
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $50,353.23 $50,353.23 $50,353.23 2026-03-04
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $49,253.95 $49,253.95 $49,253.95 2026-03-04
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $43,697.13 $43,697.13 $43,697.13 2026-03-04
1612 APR_DRG Implantable Heart Assist Systems 2 2 — — $43,649.77 $43,649.77 $43,649.77 2026-03-04
1611 APR_DRG Implantable Heart Assist Systems 2 2 — — $43,649.77 $43,649.77 $43,649.77 2026-03-04
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $42,433.11 $42,433.11 $42,433.11 2026-03-04
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $41,975.61 $41,975.61 $41,975.61 2026-03-04
22 APR_DRG Heart And/or Lung Transplant 2 2 — — $40,289.45 $40,289.45 $40,289.45 2026-03-04
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $40,015.23 $40,015.23 $40,015.23 2026-03-04
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $39,167.17 $39,167.17 $39,167.17 2026-03-04
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $39,115.69 $39,115.69 $39,115.69 2026-03-04
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $38,056.91 $38,056.91 $38,056.91 2026-03-04
64 APR_DRG Pancreas Transplant 2 2 — — $36,904.43 $36,904.43 $36,904.43 2026-03-04
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $36,718.07 $36,718.07 $36,718.07 2026-03-04
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $36,678.60 $36,678.60 $36,678.60 2026-03-04
73 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $35,427.62 $35,427.62 $35,427.62 2026-03-04
33270 CPT Ins/rep Subq Defibrillator 1 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 1 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33249 CPT Insj/rplcmt Defib W/lead(s) 1 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33231 CPT Insrt Pulse Gen W/mult Leads 1 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
69930 CPT Implant Cochlear Device 1 1 — — $33,398.21 $33,398.21 $33,398.21 2026-03-04
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $33,005.97 $33,005.97 $33,005.97 2026-03-04
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $32,853.93 $32,853.93 $32,853.93 2026-03-04
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $32,053.57 $32,053.57 $32,053.57 2026-03-04
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 1 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
64582 CPT Opn Mpltj Hpglsl Nstm Ary Pg 1 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
61886 CPT Implant Neurostim Arrays 1 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
64568 CPT Opn Impltj Crnl Nrv Nea&pg 1 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
8634 APR_DRG Neonatal Aftercare 2 2 — — $31,490.72 $31,490.72 $31,490.72 2026-03-04
63 APR_DRG Pancreas Transplant 2 2 — — $31,408.35 $31,408.35 $31,408.35 2026-03-04
21 APR_DRG Heart And/or Lung Transplant 2 2 — — $30,884.62 $30,884.62 $30,884.62 2026-03-04
4404 APR_DRG Kidney Transplant 2 2 — — $30,516.02 $30,516.02 $30,516.02 2026-03-04
13 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $30,221.89 $30,221.89 $30,221.89 2026-03-04
33289 CPT Tcat Impl Wrls P-art Prs Snr 1 1 — — $29,849.75 $29,849.75 $29,849.75 2026-03-04
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $29,615.11 $29,615.11 $29,615.11 2026-03-04
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $29,614.08 $29,614.08 $29,614.08 2026-03-04
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $29,384.82 $29,384.82 $29,384.82 2026-03-04
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $28,875.53 $28,875.53 $28,875.53 2026-03-04
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $28,178.45 $28,178.45 $28,178.45 2026-03-04
8514 APR_DRG Gender Related Procedures 2 2 — — $27,622.46 $27,622.46 $27,622.46 2026-03-04
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $27,506.12 $27,506.12 $27,506.12 2026-03-04
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $26,813.87 $26,813.87 $26,813.87 2026-03-04
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $26,585.64 $26,585.64 $26,585.64 2026-03-04
62 APR_DRG Pancreas Transplant 2 2 — — $26,559.22 $26,559.22 $26,559.22 2026-03-04
72 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $26,368.74 $26,368.74 $26,368.74 2026-03-04
1784 APR_DRG External Heart Assist Devices 2 2 — — $26,282.59 $26,282.59 $26,282.59 2026-03-04
84 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $25,837.80 $25,837.80 $25,837.80 2026-03-04
93654 CPT Compre Ep Eval Tx Vt 1 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
93653 CPT Compre Ep Eval Tx Svt 1 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
93656 CPT Compre Ep Eval Abltj Atr Fib 1 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $25,614.72 $25,614.72 $25,614.72 2026-03-04
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $25,262.93 $25,262.93 $25,262.93 2026-03-04
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $24,393.60 $24,393.60 $24,393.60 2026-03-04
12 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $24,384.67 $24,384.67 $24,384.67 2026-03-04
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $24,188.02 $24,188.02 $24,188.02 2026-03-04
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $23,979.01 $23,979.01 $23,979.01 2026-03-04
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 2 2 — — $23,678.01 $23,678.01 $23,678.01 2026-03-04
33263 CPT Rmvl & Rplcmt Dfb Gen 2 Lead 1 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33262 CPT Rmvl& Replc Pulse Gen 1 Lead 1 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33240 CPT Insrt Pulse Gen W/singl Lead 1 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
33230 CPT Insrt Pulse Gen W/dual Leads 1 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
1834 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $23,322.11 $23,322.11 $23,322.11 2026-03-04
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $22,959.00 $22,959.00 $22,959.00 2026-03-04
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $22,615.80 $22,615.80 $22,615.80 2026-03-04
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $22,597.95 $22,597.95 $22,597.95 2026-03-04
64580 CPT Opn Impltj Nea Neuromuscular 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
61885 CPT Insrt/redo Neurostim 1 Array 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
63655 CPT Implant Neuroelectrodes 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
71 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $21,949.29 $21,949.29 $21,949.29 2026-03-04
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $21,844.96 $21,844.96 $21,844.96 2026-03-04
1794 APR_DRG Defibrillator Implants 2 2 — — $21,823.68 $21,823.68 $21,823.68 2026-03-04
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 2 2 — — $21,714.89 $21,714.89 $21,714.89 2026-03-04
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $21,598.88 $21,598.88 $21,598.88 2026-03-04
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 2 2 — — $21,441.35 $21,441.35 $21,441.35 2026-03-04
61 APR_DRG Pancreas Transplant 2 2 — — $21,432.09 $21,432.09 $21,432.09 2026-03-04
914 APR_DRG Other Major Head And Neck Procedures 2 2 — — $21,368.59 $21,368.59 $21,368.59 2026-03-04
1783 APR_DRG External Heart Assist Devices 2 2 — — $21,312.65 $21,312.65 $21,312.65 2026-03-04
54405 CPT Insert Multi-comp Penis Pros 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54411 CPT Remov/replc Penis Pros Comp 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54416 CPT Remv/repl Penis Contain Pros 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54401 CPT Insert Self-contd Prosthesis 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53445 CPT Insert Uro/ves Nck Sphincter 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53447 CPT Remove/replace Ur Sphincter 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
53444 CPT Insert Tandem Cuff 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54410 CPT Remove/replace Penis Prosth 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $21,066.23 $21,066.23 $21,066.23 2026-03-04
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $21,029.85 $21,029.85 $21,029.85 2026-03-04
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $20,843.15 $20,843.15 $20,843.15 2026-03-04
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $20,763.18 $20,763.18 $20,763.18 2026-03-04
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $20,730.58 $20,730.58 $20,730.58 2026-03-04
4403 APR_DRG Kidney Transplant 2 2 — — $20,313.93 $20,313.93 $20,313.93 2026-03-04
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $20,102.51 $20,102.51 $20,102.51 2026-03-04
11 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $20,036.96 $20,036.96 $20,036.96 2026-03-04
33221 CPT Insert Pulse Gen Mult Leads 1 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33274 CPT Tcat Insj/rpl Perm Ldls Pm 1 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33229 CPT Remv&replc Pm Gen Mult Leads 1 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $19,836.53 $19,836.53 $19,836.53 2026-03-04
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $19,831.38 $19,831.38 $19,831.38 2026-03-04
1694 APR_DRG Major Abdominal Vascular Procedures 2 2 — — $19,723.96 $19,723.96 $19,723.96 2026-03-04
214 APR_DRG Open Craniotomy Except Trauma 2 2 — — $19,699.93 $19,699.93 $19,699.93 2026-03-04
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $19,688.26 $19,688.26 $19,688.26 2026-03-04
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $19,617.22 $19,617.22 $19,617.22 2026-03-04
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $19,401.00 $19,401.00 $19,401.00 2026-03-04
C8003 HCPCS Imp Extar Knee Shck Absrb 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
20696 CPT App Mltpln Uni Xtrnl Fix 1st 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24363 CPT Replace Elbow Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24371 CPT Revise Reconst Elbow Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22856 CPT Tot Disc Arthrp 1ntrspc Crv 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22633 CPT Arthrd Cmbn 1ntrspc Lumbar 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22630 CPT Arthrd Pst Tq 1ntrspc Lum 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
27279 CPT Arthrd Si Jt Plmt Tartclr Dv 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
24361 CPT Reconstruct Elbow Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23472 CPT Reconstruct Shoulder Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
21243 CPT Reconstruction Of Jaw Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
25446 CPT Arthrp W/prostc Dst Rds&crps 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
27702 CPT Reconstruct Ankle Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
25442 CPT Arthrp W/prostc Dstl Ulna 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
28705 CPT Arthrodesis Pantalar 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $19,262.00 $19,262.00 $19,262.00 2026-03-04
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $19,179.98 $19,179.98 $19,179.98 2026-03-04
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $19,179.98 $19,179.98 $19,179.98 2026-03-04
J2350 HCPCS Ocrelizumab Soln For IV Infusion 300 Mg/10ml 41 15 $25,521.25 $20,417.00 20% off $60.94 $24,143.10 $19,089.90 2026-03-04
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $19,024.16 $19,024.16 $19,024.16 2026-03-04
234 APR_DRG Spinal Procedures 2 2 — — $19,007.69 $19,007.69 $19,007.69 2026-03-04
C9766 HCPCS Revasc Intra Lithotrip-ather 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9606 HCPCS Perc D-e Cor Revasc W Ami S 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9602 HCPCS Perc D-e Cor Stent Ather S 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9767 HCPCS Revasc Lithotrip-stent-ather 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9773 HCPCS Revasc Lithotr-stent Tib/per 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9774 HCPCS Revasc Lithotr-ather Tib/per 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93580 CPT Transcath Closure Of Asd 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93582 CPT Perq Transcath Closure Pda 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
92933 CPT Prq Trlml C Athrc St Angiop1 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
33902 CPT Perq P-art Revsc 1 Abnor Uni 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36906 CPT Thrmbc/nfs Dialysis Circuit 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36836 CPT Prq Av Fstl Crtj Uxtr 1 Acs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93590 CPT Perq Transcath Cls Mitral 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37242 CPT Vasc Embolize/occlude Artery 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37231 CPT Outpatient Services - Cpt/hcpcs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37227 CPT Outpatient Services - Cpt/hcpcs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37229 CPT Outpatient Services - Cpt/hcpcs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37225 CPT Outpatient Services - Cpt/hcpcs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9765 HCPCS Revasc Intra Lithotrip-stent 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37230 CPT Outpatient Services - Cpt/hcpcs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37184 CPT Prim Art M-thrmbc 1st Vsl 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9775 HCPCS Revasc Lith-sten-ath Tib/per 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93591 CPT Perq Transcath Cls Aortic 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93581 CPT Transcath Closure Of Vsd 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $18,735.18 $18,735.18 $18,735.18 2026-03-04
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 2 2 — — $18,715.28 $18,715.28 $18,715.28 2026-03-04
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $18,651.10 $18,651.10 $18,651.10 2026-03-04
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 2 2 — — $18,636.34 $18,636.34 $18,636.34 2026-03-04
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $18,624.67 $18,624.67 $18,624.67 2026-03-04
62362 CPT Implant Spine Infusion Pump 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62360 CPT Insert Spine Infusion Device 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62361 CPT Implant Spine Infusion Pump 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
C9758 HCPCS Blind Interatrial Shunt Ide 1 1 — — $18,375.53 $18,375.53 $18,375.53 2026-03-04
C8005 HCPCS Pef Bronch Ablt 3d Nav Ebus 1 1 — — $18,375.53 $18,375.53 $18,375.53 2026-03-04
19357 CPT Tiss Xpndr Plmt Brst Rcnstj 1 1 — — $18,268.26 $18,268.26 $18,268.26 2026-03-04
894 APR_DRG Major Cranial Or Facial Bone Procedures 2 2 — — $18,190.18 $18,190.18 $18,190.18 2026-03-04
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 2 2 — — $18,115.01 $18,115.01 $18,115.01 2026-03-04
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 2 2 — — $18,070.05 $18,070.05 $18,070.05 2026-03-04
4014 APR_DRG Adrenal Procedures 2 2 — — $17,974.99 $17,974.99 $17,974.99 2026-03-04
6904 APR_DRG Acute Leukemia 2 2 — — $17,889.19 $17,889.19 $17,889.19 2026-03-04
1204 APR_DRG Major Respiratory And Chest Procedures 2 2 — — $17,854.87 $17,854.87 $17,854.87 2026-03-04
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $17,756.71 $17,756.71 $17,756.71 2026-03-04
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $17,570.69 $17,570.69 $17,570.69 2026-03-04
4402 APR_DRG Kidney Transplant 2 2 — — $17,533.97 $17,533.97 $17,533.97 2026-03-04
204 APR_DRG Open Craniotomy For Trauma 2 2 — — $17,454.69 $17,454.69 $17,454.69 2026-03-04
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $17,282.74 $17,282.74 $17,282.74 2026-03-04
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $17,252.89 $17,252.89 $17,252.89 2026-03-04
4414 APR_DRG Major Bladder Procedures 2 2 — — $17,244.65 $17,244.65 $17,244.65 2026-03-04
66683 CPT Implantation Iris Prosthesis 1 1 — — $17,237.25 $17,237.25 $17,237.25 2026-03-04
1782 APR_DRG External Heart Assist Devices 2 2 — — $17,180.81 $17,180.81 $17,180.81 2026-03-04
5204 APR_DRG Other GYN Procedures For Malignancy 2 2 — — $17,056.23 $17,056.23 $17,056.23 2026-03-04
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $16,999.26 $16,999.26 $16,999.26 2026-03-04
83 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $16,947.43 $16,947.43 $16,947.43 2026-03-04
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $16,736.36 $16,736.36 $16,736.36 2026-03-04
2614 APR_DRG Major Biliary Tract Procedures 2 2 — — $16,507.79 $16,507.79 $16,507.79 2026-03-04
4854 APR_DRG Prostatectomy Procedures 2 2 — — $16,457.68 $16,457.68 $16,457.68 2026-03-04
1833 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $16,432.97 $16,432.97 $16,432.97 2026-03-04
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $16,402.08 $16,402.08 $16,402.08 2026-03-04
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 2 2 — — $16,245.58 $16,245.58 $16,245.58 2026-03-04
67027 CPT Implant Eye Drug System 1 1 — — $16,133.07 $16,133.07 $16,133.07 2026-03-04
1793 APR_DRG Defibrillator Implants 2 2 — — $16,111.04 $16,111.04 $16,111.04 2026-03-04
4401 APR_DRG Kidney Transplant 2 2 — — $16,019.07 $16,019.07 $16,019.07 2026-03-04
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $15,946.31 $15,946.31 $15,946.31 2026-03-04
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 2 2 — — $15,902.03 $15,902.03 $15,902.03 2026-03-04
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $15,858.45 $15,858.45 $15,858.45 2026-03-04
1781 APR_DRG External Heart Assist Devices 2 2 — — $15,763.03 $15,763.03 $15,763.03 2026-03-04
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $15,723.22 $15,723.22 $15,723.22 2026-03-04
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $15,616.14 $15,616.14 $15,616.14 2026-03-04
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $15,575.65 $15,575.65 $15,575.65 2026-03-04
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 2 2 — — $15,549.22 $15,549.22 $15,549.22 2026-03-04
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $15,534.46 $15,534.46 $15,534.46 2026-03-04
2304 APR_DRG Major Small Bowel Procedures 2 2 — — $15,493.28 $15,493.28 $15,493.28 2026-03-04
6954 APR_DRG Chemotherapy For Acute Leukemia 2 2 — — $15,487.10 $15,487.10 $15,487.10 2026-03-04
274 APR_DRG Other Open Craniotomy 2 2 — — $15,475.77 $15,475.77 $15,475.77 2026-03-04
1814 APR_DRG Lower Extremity Vascular Procedures 2 2 — — $15,462.39 $15,462.39 $15,462.39 2026-03-04
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $15,428.07 $15,428.07 $15,428.07 2026-03-04
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 2 2 — — $15,376.93 $15,376.93 $15,376.93 2026-03-04
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $15,304.86 $15,304.86 $15,304.86 2026-03-04
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 2 2 — — $15,288.04 $15,288.04 $15,288.04 2026-03-04
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 2 2 — — $15,213.56 $15,213.56 $15,213.56 2026-03-04
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 2 2 — — $15,139.09 $15,139.09 $15,139.09 2026-03-04
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $15,097.22 $15,097.22 $15,097.22 2026-03-04
1214 APR_DRG Other Respiratory And Chest Procedures 2 2 — — $15,095.85 $15,095.85 $15,095.85 2026-03-04
65770 CPT Keratoprosthesis 1 1 — — $15,003.78 $15,003.78 $15,003.78 2026-03-04
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 2 2 — — $14,868.64 $14,868.64 $14,868.64 2026-03-04
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $14,662.72 $14,662.72 $14,662.72 2026-03-04
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 2 2 — — $14,644.19 $14,644.19 $14,644.19 2026-03-04
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $14,640.07 $14,640.07 $14,640.07 2026-03-04
8633 APR_DRG Neonatal Aftercare 2 2 — — $14,577.61 $14,577.61 $14,577.61 2026-03-04
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 2 2 — — $14,576.58 $14,576.58 $14,576.58 2026-03-04
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $14,560.45 $14,560.45 $14,560.45 2026-03-04
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 2 2 — — $14,474.65 $14,474.65 $14,474.65 2026-03-04
4284 APR_DRG Genetic Disorders 2 2 — — $14,467.10 $14,467.10 $14,467.10 2026-03-04
4034 APR_DRG Procedures For Obesity 2 2 — — $14,464.35 $14,464.35 $14,464.35 2026-03-04
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $14,348.35 $14,348.35 $14,348.35 2026-03-04
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 2 2 — — $14,309.22 $14,309.22 $14,309.22 2026-03-04
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 2 2 — — $14,259.80 $14,259.80 $14,259.80 2026-03-04
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $14,226.85 $14,226.85 $14,226.85 2026-03-04
294 APR_DRG Other Percutaneous Intracranial Procedures 2 2 — — $14,215.87 $14,215.87 $14,215.87 2026-03-04
224 APR_DRG Ventricular Shunt Procedures 2 2 — — $14,205.23 $14,205.23 $14,205.23 2026-03-04
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 2 2 — — $14,157.52 $14,157.52 $14,157.52 2026-03-04
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $14,126.64 $14,126.64 $14,126.64 2026-03-04
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $13,972.54 $13,972.54 $13,972.54 2026-03-04
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 2 2 — — $13,961.55 $13,961.55 $13,961.55 2026-03-04
6504 APR_DRG Splenic Procedures 2 2 — — $13,909.04 $13,909.04 $13,909.04 2026-03-04
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 2 2 — — $13,820.15 $13,820.15 $13,820.15 2026-03-04
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 2 2 — — $13,784.46 $13,784.46 $13,784.46 2026-03-04
3003 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $13,733.32 $13,733.32 $13,733.32 2026-03-04
82 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $13,715.82 $13,715.82 $13,715.82 2026-03-04
54400 CPT Insert Semi-rigid Prosthesis 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
54417 CPT Remv/replc Penis Pros Compl 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
53451 CPT Tprnl Balo Cntnc Dev Bi 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
53440 CPT Male Sling Procedure 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 2 2 — — $13,578.88 $13,578.88 $13,578.88 2026-03-04
913 APR_DRG Other Major Head And Neck Procedures 2 2 — — $13,572.70 $13,572.70 $13,572.70 2026-03-04
2314 APR_DRG Major Large Bowel Procedures 2 2 — — $13,557.60 $13,557.60 $13,557.60 2026-03-04
25810 CPT Arthrd Wrst Iliac/oth Agrft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
C9757 HCPCS Spine Device Implant Surgery 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27758 CPT Treatment Of Tibia Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27759 CPT Treatment Of Tibia Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25391 CPT Lengthen Radius Or Ulna 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27709 CPT Osteotomy Tibia & Fibula 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25365 CPT Revise Radius & Ulna 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69730 CPT Rplc Oi Implt Sk Tc Esp>=100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69716 CPT Impl Oi Implt Sk Tc Esp<100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69714 CPT Impl Oi Implt Skull Perq Esp 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69719 CPT Rplcm Oi Implt Sk Tc Esp<100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69729 CPT Impl Oi Implt Sk Tc Esp>=100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23802 CPT Arthrd Glenohumeral Jt W/grf 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24802 CPT Arthrd Elbow Jt Autog Graft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24666 CPT Optx Radial Head/nck Fx Rplc 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23615 CPT Optx Prox Humrl Fx W/int Fix 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23680 CPT Optx Sho Dislc Neck Fx Fixj 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
22551 CPT Arthrd Ant Ntrbdy Cervical 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24587 CPT Optx Partclr Fx&/dslc Elbw W 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24586 CPT Optx Partclr Fx&/dislc Elbow 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
22554 CPT Arthrd Ant Ntrbd Min Dsc Crv 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
64628 CPT Trml Dstrj Ios Bvn 1st 2 L/s 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27446 CPT Revision Of Knee Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
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