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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

ESSENTIA HEALTH SANDSTONE

Sandstone, MN · CCN 241309 · Rates published

16,528 distinct procedures filed
48 distinct payers
441,593 rate rows
2026-01-01 last MRF observed
Data quality

424,652 of 441,593 rate rows are consumer-grade (96.2%)

16,941 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
per-diem day rate — not a per-procedure price 16,220
placeholder amount (≤ $0.02) — excluded from medians 355
percent-of-charges filed in the dollar field — excluded from medians 321
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 45
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.essentiahealth.org/standard-charges/2026/411884597_Essentia-Sandstone_standardcharges.csv
Found on page https://www.essentiahealth.org/patients-visitors/billing/price-estimates/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-05-17
Content fingerprint e2a304f9a1149c4e… · 431,622,204 bytes · first seen 2026-05-09

Top 50 most expensive offerings

Outliers are flagged where this hospital's filed rate is ≥2× or ≤0.5× the national median for the same code.

Code Description Payers Min $ Max $ Avg median vs national
J1411
CPT 		Inj- Hemgenix- Per Tx Dose 2 $3,672,900.00 $3,710,000.00 $3,691,450.00 nat. median
$3,710,000
1.0× median
C9172
CPT 		Inj Beqvez Per Tx Dose 1 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,570,000
1.0× median
J1414
CPT 		Inj- Beqvez- Per Tx Dose 1 $3,500,000.00 $3,500,000.00 $3,500,000.00 nat. median
$3,710,000
0.9× median
J1413
CPT 		Inj Delandistrogene Mox Rokl 2 $3,321,781.51 $3,325,454.76 $3,323,618.13 nat. median
$3,325,455
1.0× median
J3394
CPT 		Inj- Lovotibeglogene Autotem 2 $3,193,000.00 $3,286,000.00 $3,239,500.00 nat. median
$3,286,000
1.0× median
J3393
CPT 		Inj- Betibeglogene Autotemce 2 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$3,006,423
1.0× median
J3399
CPT 		Inj Onase Abepar-xioi Treat 2 $2,388,614.23 $2,403,458.75 $2,396,036.49 nat. median
$2,469,189
1.0× median
J3392
CPT 		Inj- Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,448,600
1.0× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 1 $551,042.76 $551,042.76 $551,042.76 nat. median
$370,174
1.5× median
Q2042
CPT 		Tisagenlecleucel Car-pos T 2 $529,192.86 $565,623.84 $547,408.35 nat. median
$754,974
0.7× median
Q2056
CPT 		Ciltacabtagene Car-pos T 2 $527,123.43 $551,318.34 $539,220.89 nat. median
$675,122
0.8× median
Q2055
CPT 		Idecabtagene Vicleucel Car 2 $526,587.59 $528,312.43 $527,450.01 nat. median
$625,184
0.8× median
Q2054
CPT 		Lisocabtagene Mara Car Pos T 2 $516,485.97 $516,726.08 $516,606.03 nat. median
$674,188
0.8× median
Q2041
CPT 		Axicabtagene Ciloleucel Car+ 2 $489,455.96 $489,517.15 $489,486.56 nat. median
$634,511
0.8× median
Q2053
CPT 		Brexucabtagene Car Pos T 2 $460,530.40 $488,051.51 $474,290.96 nat. median
$620,080
0.8× median
5834
APR_DRG 		Neonate W Ecmo 11 $260,426.64 $1,017,143.05 $390,361.97 nat. median
$309,665
1.3× median
1
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System With Mcc 1 $357,604.58 $357,604.58 $357,604.58 nat. median
$265,286
1.3× median
927
MS_DRG 		Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 1 $272,447.33 $272,447.33 $272,447.33 nat. median
$206,368
1.3× median
3
MS_DRG 		Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 1 $270,848.41 $270,848.41 $270,848.41 nat. median
$202,986
1.3× median
5884
APR_DRG 		Neonate Bwt 1500g W Major Procedure 11 $213,642.89 $657,968.88 $254,666.60 nat. median
$246,434
1.0× median
5833
APR_DRG 		Neonate W Ecmo 11 $206,269.84 $594,547.80 $252,888.58 nat. median
$244,017
1.0× median
24
APR_DRG 		Heart Or Lung Transplant 11 $197,053.53 $754,047.70 $225,530.55 nat. median
$234,738
1.0× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 11 $193,278.30 $488,832.75 $198,764.66 nat. median
$207,730
1.0× median
114
APR_DRG 		Psychiatric 9 $134,904.95 $198,309.46 $198,309.46 nat. median
$117,173
1.7× median
5832
APR_DRG 		Neonate W Ecmo 11 $152,113.04 $383,912.55 $194,172.15 nat. median
$156,126
1.2× median
6304
APR_DRG 		Neonate Birthwt 2499g W Major Cardiovascular Procedure 10 $116,053.85 $257,266.45 $185,770.26 nat. median
$150,721
1.2× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 10 $183,225.66 $649,392.45 $183,225.66 nat. median
$160,267
1.1× median
4
MS_DRG 		Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 1 $176,753.56 $176,753.56 $176,753.56 nat. median
$133,176
1.3× median
6094
APR_DRG 		Neonate Bwt 15002499g W Major Procedure 10 $167,444.50 $528,575.25 $167,444.50 nat. median
$162,982
1.0× median
5883
APR_DRG 		Neonate Bwt 1500g W Major Procedure 11 $137,630.26 $454,407.80 $165,628.52 nat. median
$182,736
0.9× median
7
MS_DRG 		Lung Transplant 1 $165,253.62 $165,253.62 $165,253.62 nat. median
$122,708
1.3× median
6314
APR_DRG 		Neonate Birthwt 2499g W Other Major Procedure 10 $150,542.29 $333,837.00 $164,388.59 nat. median
$122,924
1.3× median
5914
APR_DRG 		Neonate Birthwt 500749g Wo Major Procedure 11 $134,558.16 $617,863.40 $161,780.72 nat. median
$164,279
1.0× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 11 $129,203.92 $346,289.65 $153,561.93 nat. median
$187,294
0.8× median
14
MS_DRG 		Allogeneic Bone Marrow Transplant 1 $153,356.82 $153,356.82 $153,356.82 nat. median
$117,303
1.3× median
94
APR_DRG 		Extracorporeal Membrane Oxygenation Ecmo 11 $125,341.84 $322,974.05 $152,792.37 nat. median
$164,834
0.9× median
5934
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 11 $139,297.97 $608,325.20 $150,011.84 nat. median
$151,838
1.0× median
5882
APR_DRG 		Neonate Bwt 1500g W Major Procedure 11 $134,733.70 $368,328.19 $145,335.69 nat. median
$145,336
1.0× median
2
MS_DRG 		Heart Transplant Or Implant Of Heart Assist System Without Mcc 1 $144,601.70 $144,601.70 $144,601.70 nat. median
$108,660
1.3× median
209
MS_DRG 		Kidney And Urinary Tract Signs And Symptoms Age 0-17 1 $144,435.81 $144,435.81 $144,435.81 nat. median
$98,017
1.5× median
1613
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 11 $130,777.34 $381,792.95 $143,639.55 nat. median
$119,796
1.2× median
5831
APR_DRG 		Neonate W Ecmo 11 $131,398.28 $313,965.75 $141,137.35 nat. median
$145,122
1.0× median
426
MS_DRG 		Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 1 $140,638.23 $140,638.23 $140,638.23 nat. median
$98,905
1.4× median
212
MS_DRG 		Testes Procedures Age 0-17 1 $138,761.13 $138,761.13 $138,761.13 nat. median
$102,358
1.4× median
6034
APR_DRG 		Neonate Birthwt 10001249g W Or Wo Other Significant Condition 11 $112,000.13 $360,067.05 $138,755.74 nat. median
$109,499
1.3× median
14
APR_DRG 		Liver Transplant Or Intestinal Transplant 11 $125,956.26 $333,837.00 $136,566.14 nat. median
$129,535
1.1× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 11 $127,975.08 $336,486.50 $135,629.87 nat. median
$105,658
1.3× median
5
MS_DRG 		Liver Transplant With Mcc Or Intestinal Transplant 1 $131,569.20 $131,569.20 $131,569.20 nat. median
$100,136
1.3× median
215
MS_DRG 		Other Heart Assist System Implant 1 $127,058.29 $127,058.29 $127,058.29 nat. median
$99,019
1.3× median
23
APR_DRG 		Heart Or Lung Transplant 11 $121,918.64 $359,802.10 $126,634.07 nat. median
$93,528
1.4× median

Other procedures at this hospital

Browse this hospital's 16,528 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
             
5911 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 12 11 — — $1,141.07 $224,942.55 $54,737.65 2026-01-01
264 MS_DRG Other Circulatory System O.r. Procedures 3 2 — — $23,173.33 $42,628.39 $42,628.39 2026-01-01
420 MS_DRG Hepatobiliary Diagnostic Procedures With Mcc 3 2 — — $23,597.62 $43,476.98 $43,476.98 2026-01-01
29 MS_DRG Spinal Procedures With Cc Or Spinal Neurostimulators 3 2 — — $23,626.33 $43,534.40 $43,534.40 2026-01-01
987 MS_DRG Non-extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $23,733.53 $43,748.78 $43,748.78 2026-01-01
477 MS_DRG Biopsies Of Musculoskeletal System And Connective Tissue With Mcc 3 2 — — $23,900.69 $44,083.11 $44,083.11 2026-01-01
574 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Cc 3 2 — — $24,007.88 $44,297.49 $44,297.49 2026-01-01
616 MS_DRG Amputation Of Lower Limb For Endocrine- Nutritional And Metabolic Disorders With… 3 2 — — $24,109.97 $44,501.67 $44,501.67 2026-01-01
252 MS_DRG Other Vascular Procedures With Mcc 3 2 — — $24,115.71 $44,513.15 $44,513.15 2026-01-01
94 MS_DRG Bacterial And Tuberculous Infections Of Nervous System With Mcc 3 2 — — $24,314.14 $44,910.01 $44,910.01 2026-01-01
467 MS_DRG Revision Of Hip Or Knee Replacement With Cc 3 2 — — $24,360.08 $45,001.88 $45,001.88 2026-01-01
271 MS_DRG Other Major Cardiovascular Procedures With Cc 3 2 — — $24,549.58 $45,380.88 $45,380.88 2026-01-01
622 MS_DRG Skin Grafts And Wound Debridement For Endocrine- Nutritional And Metabolic Disor… 3 2 — — $24,568.08 $45,417.88 $45,417.88 2026-01-01
414 MS_DRG Cholecystectomy Except By Laparoscope Without C.d.e. With Mcc 3 2 — — $24,589.77 $45,461.27 $45,461.27 2026-01-01
408 MS_DRG Biliary Tract Procedures Except Only Cholecystectomy With Or Without C.d.e. With… 3 2 — — $24,608.91 $45,499.55 $45,499.55 2026-01-01
335 MS_DRG Peritoneal Adhesiolysis With Mcc 3 2 — — $24,642.72 $45,567.18 $45,567.18 2026-01-01
736 MS_DRG Uterine And Adnexa Procedures For Ovarian Or Adnexal Malignancy With Mcc 3 2 — — $24,665.69 $45,613.12 $45,613.12 2026-01-01
739 MS_DRG Uterineadnexa Proc For Non-ovarian/adnexal Malig W Mcc 3 2 — — $24,718.65 $45,719.04 $45,719.04 2026-01-01
279 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $24,869.23 $46,020.19 $46,020.19 2026-01-01
97 MS_DRG Non-bacterial Infection Of Nervous System Except Viral Meningitis With Mcc 3 2 — — $24,903.69 $46,089.10 $46,089.10 2026-01-01
265 MS_DRG Aicd Lead Procedures 3 2 — — $24,944.51 $46,170.76 $46,170.76 2026-01-01
332 MS_DRG Rectal Resection With Mcc 3 2 — — $24,960.47 $46,202.67 $46,202.67 2026-01-01
495 MS_DRG Local Excision And Removal Of Internal Fixation Devices Except Hip And Femur Wit… 3 2 — — $24,992.37 $46,266.47 $46,266.47 2026-01-01
939 MS_DRG O.r. Procedures With Diagnoses Of Other Contact With Health Services With Mcc 3 2 — — $25,010.24 $46,302.20 $46,302.20 2026-01-01
492 MS_DRG Lower Extremity And Humerus Procedures Except Hip- Foot And Femur With Mcc 3 2 — — $25,285.23 $46,852.19 $46,852.19 2026-01-01
904 MS_DRG Skin Grafts For Injuries With Cc/mcc 3 2 — — $25,294.80 $46,871.33 $46,871.33 2026-01-01
651 MS_DRG Neonate Birthwt 2000-2499g With Signif O.r. Proc With Mult Major Prob 3 2 — — $25,503.44 $47,288.60 $47,288.60 2026-01-01
628 MS_DRG Other Endocrine- Nutritional And Metabolic O.r. Procedures With Mcc 3 2 — — $25,637.42 $47,556.58 $47,556.58 2026-01-01
518 MS_DRG Back And Neck Procedures Except Spinal Fusion With Mcc Or Disc Device Or Neurost… 3 2 — — $25,704.42 $47,690.56 $47,690.56 2026-01-01
166 MS_DRG Other Respiratory System O.r. Procedures With Mcc 3 2 — — $25,706.97 $47,695.67 $47,695.67 2026-01-01
143 MS_DRG Stomach Esophageal And Duodenal Proc Age 0-17 3 2 — — $25,763.76 $47,809.24 $47,809.24 2026-01-01
956 MS_DRG Limb Reattachment- Hip And Femur Procedures For Multiple Significant Trauma 3 2 — — $25,868.39 $48,018.51 $48,018.51 2026-01-01
907 MS_DRG Other O.r. Procedures For Injuries With Mcc 3 2 — — $26,355.22 $48,992.16 $48,992.16 2026-01-01
40 MS_DRG Peripheral- Cranial Nerve And Other Nervous System Procedures With Mcc 3 2 — — $26,494.94 $49,271.61 $49,271.61 2026-01-01
876 MS_DRG O.r. Procedures With Principal Diagnosis Of Mental Illness 3 2 — — $26,518.55 $49,318.83 $49,318.83 2026-01-01
34 MS_DRG Carotid Artery Stent Procedures With Mcc 3 2 — — $26,555.56 $49,392.84 $49,392.84 2026-01-01
933 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours Without Skin Graft 3 2 — — $26,705.49 $49,692.72 $49,692.72 2026-01-01
24 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $26,818.42 $49,918.58 $49,918.58 2026-01-01
802 MS_DRG Other O.r. Procedures Of The Blood And Blood Forming Organs With Mcc 3 2 — — $27,279.08 $50,839.90 $50,839.90 2026-01-01
402 MS_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 3 2 — — $27,511.33 $51,304.39 $51,304.39 2026-01-01
5893 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 12 11 — — $27,561.16 $459,688.25 $94,491.23 2026-01-01
791 MS_DRG Prematurity With Major Problems 3 2 — — $27,756.97 $51,795.68 $51,795.68 2026-01-01
273 MS_DRG Percutaneous Intracardiac Procedures W Mcc 3 2 — — $28,181.27 $52,644.27 $52,644.27 2026-01-01
423 MS_DRG Other Hepatobiliary Or Pancreas O.r. Procedures With Mcc 3 2 — — $28,356.73 $52,995.19 $52,995.19 2026-01-01
793 MS_DRG Full Term Neonate With Major Problems 3 2 — — $28,462.64 $53,207.01 $53,207.01 2026-01-01
458 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 3 2 — — $28,481.78 $53,245.30 $53,245.30 2026-01-01
236 MS_DRG Coronary Bypass Without Cardiac Catheterization Without Mcc 3 2 — — $28,585.15 $53,452.02 $53,452.02 2026-01-01
901 MS_DRG Wound Debridements For Injuries With Mcc 3 2 — — $28,634.91 $53,551.55 $53,551.55 2026-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $28,666.81 $53,615.36 $53,615.36 2026-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $28,745.29 $53,772.31 $53,772.31 2026-01-01
12 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Cc 3 2 — — $28,758.69 $53,799.11 $53,799.11 2026-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $28,804.63 $53,890.99 $53,890.99 2026-01-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $28,916.92 $54,115.58 $54,115.58 2026-01-01
140 MS_DRG Simple Pneumonia And Pleurisy Age 0-17 3 2 — — $29,073.24 $54,428.21 $54,428.21 2026-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $29,249.34 $54,780.41 $54,780.41 2026-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $29,469.46 $55,220.65 $55,220.65 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $29,886.74 $56,055.20 $56,055.20 2026-01-01
111 APR_DRG Medical/Surgical/Gyn 9 9 — — $30,096.13 $45,282.65 $45,282.65 2026-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $30,334.00 $56,949.73 $56,949.73 2026-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $30,446.29 $57,174.32 $57,174.32 2026-01-01
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $30,454.59 $57,190.91 $57,190.91 2026-01-01
799 MS_DRG Splenic Procedures With Mcc 3 2 — — $30,755.10 $57,791.93 $57,791.93 2026-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $30,868.67 $58,019.07 $58,019.07 2026-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 2 — — $30,881.44 $58,044.60 $58,044.60 2026-01-01
245 MS_DRG Aicd Generator Procedures 3 2 — — $30,968.85 $58,219.42 $58,219.42 2026-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 2 — — $31,111.76 $58,505.26 $58,505.26 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $31,186.42 $58,654.56 $58,654.56 2026-01-01
277 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $31,326.78 $58,935.29 $58,935.29 2026-01-01
6 MS_DRG Liver Transplant Without Mcc 3 2 — — $31,444.82 $59,171.37 $59,171.37 2026-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $31,705.13 $59,692.00 $59,692.00 2026-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $31,794.46 $59,870.65 $59,870.65 2026-01-01
650 MS_DRG Neonate Birthwt 1500-1999g Without Signif O.r. Proc With Other Prob 3 2 — — $31,855.72 $59,993.16 $59,993.16 2026-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 3 2 — — $32,234.71 $60,751.14 $60,751.14 2026-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 3 2 — — $32,512.25 $61,306.23 $61,306.23 2026-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 3 2 — — $32,667.93 $61,617.59 $61,617.59 2026-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 3 2 — — $33,130.50 $62,542.74 $62,542.74 2026-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 3 2 — — $33,261.31 $62,804.34 $62,804.34 2026-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 3 2 — — $33,369.13 $63,019.99 $63,019.99 2026-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 3 2 — — $33,425.28 $63,132.29 $63,132.29 2026-01-01
326 MS_DRG Stomach- Esophageal And Duodenal Procedures With Mcc 3 2 — — $33,680.50 $63,642.72 $63,642.72 2026-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $34,017.38 $64,316.48 $64,316.48 2026-01-01
5892 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 12 11 — — $34,670.89 $541,292.85 $96,548.35 2026-01-01
2324 APR_DRG Gastric Fundoplication 12 11 — — $34,846.44 $100,151.10 $47,044.30 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 3 2 — — $35,013.99 $66,309.70 $66,309.70 2026-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 3 2 — — $35,071.41 $66,424.55 $66,424.55 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $35,523.78 $67,329.28 $67,329.28 2026-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 3 2 — — $35,635.43 $67,552.59 $67,552.59 2026-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 3 2 — — $35,863.85 $68,009.43 $68,009.43 2026-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 3 2 — — $35,884.26 $68,050.26 $68,050.26 2026-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 3 2 — — $36,519.11 $69,319.95 $69,319.95 2026-01-01
11 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Mcc 3 2 — — $36,658.20 $69,598.13 $69,598.13 2026-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 3 2 — — $36,713.07 $69,707.88 $69,707.88 2026-01-01
405 MS_DRG Pancreas- Liver And Shunt Procedures With Mcc 3 2 — — $36,762.84 $69,807.41 $69,807.41 2026-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 3 2 — — $36,886.62 $70,054.97 $70,054.97 2026-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 3 2 — — $37,097.81 $70,477.35 $70,477.35 2026-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 3 2 — — $37,373.44 $71,028.61 $71,028.61 2026-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 3 2 — — $37,618.44 $71,518.62 $71,518.62 2026-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 3 2 — — $37,729.46 $71,740.66 $71,740.66 2026-01-01
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 3 2 — — $38,223.94 $72,729.61 $72,729.61 2026-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 3 2 — — $38,420.46 $73,122.64 $73,122.64 2026-01-01
250 EAPG Cochlear Device Implantation 2 1 — — $38,557.16 $50,252.62 $44,404.89 2026-01-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 3 2 — — $38,655.25 $73,592.23 $73,592.23 2026-01-01
6254 APR_DRG Neonate Bwt 20002499g W Other Significant Condition 11 10 — — $38,899.95 $95,382.00 $48,706.96 2026-01-01
1653 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 12 11 — — $40,078.82 $101,475.85 $42,902.03 2026-01-01
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 11 — — $40,200.68 $120,022.35 $46,572.44 2026-01-01
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 11 — — $40,350.47 $161,354.55 $42,908.81 2026-01-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 12 11 — — $40,798.84 $90,347.95 $45,671.15 2026-01-01
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 12 11 — — $41,373.08 $119,757.40 $42,410.71 2026-01-01
2614 APR_DRG Major Biliary Tract Procedures 12 11 — — $41,681.20 $145,722.50 $42,476.99 2026-01-01
5891 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 12 11 — — $41,692.84 $676,682.30 $99,482.94 2026-01-01
924 APR_DRG Facial Bone Procedures Except Major Cranialfacial Bone Procedures 12 11 — — $41,780.61 $119,492.45 $43,572.35 2026-01-01
61 APR_DRG Pancreas Transplant 12 11 — — $41,792.09 $151,286.45 $47,579.46 2026-01-01
5912 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 12 11 — — $41,956.16 $247,463.30 $91,058.73 2026-01-01
894 APR_DRG Major CranialFacial Bone Procedures 12 11 — — $42,074.91 $133,269.85 $44,517.11 2026-01-01
4414 APR_DRG Major Bladder Procedures 12 11 — — $42,484.25 $134,329.65 $46,170.06 2026-01-01
6113 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 11 10 — — $42,747.72 $269,454.15 $42,747.72 2026-01-01
6083 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 12 11 — — $42,947.92 $169,832.95 $44,602.51 2026-01-01
6313 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 11 10 — — $43,131.77 $95,646.95 $49,361.90 2026-01-01
1782 APR_DRG External Heart Assist Systems 12 11 — — $43,513.55 $142,013.20 $45,499.75 2026-01-01
4403 APR_DRG Kidney Transplant 12 11 — — $43,599.14 $170,362.85 $46,200.85 2026-01-01
7594 APR_DRG Eating Disorders 11 10 — — $43,608.63 $96,706.75 $49,869.48 2026-01-01
6072 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 12 11 — — $43,647.52 $162,944.25 $44,908.43 2026-01-01
359 MS_DRG Percutaneous Coronary Atherectomy With Intraluminal Device With Mcc 2 1 — — $43,878.94 $43,878.94 $43,878.94 2026-01-01
274 APR_DRG Other Open Craniotomy 12 11 — — $43,974.97 $128,500.75 $47,365.81 2026-01-01
3060 EAPG Ventricular Assist Device Procedures 2 1 — — $44,046.93 $57,407.60 $50,727.26 2026-01-01
112 APR_DRG OB 9 9 — — $44,342.46 $99,304.32 $99,304.32 2026-01-01
11 APR_DRG Liver Transplant Or Intestinal Transplant 12 11 — — $44,623.24 $153,935.95 $49,433.91 2026-01-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 11 10 — — $44,684.27 $153,671.00 $44,684.27 2026-01-01
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 12 11 — — $44,940.49 $131,415.20 $51,523.96 2026-01-01
0266T CPT Implt/rpl Crtd Sns Dev Total 2 2 — — $45,000.50 $45,535.10 $45,267.80 2026-01-01
33276 CPT Insj Phrnc Nrv Stim Sys 2 2 — — $45,000.50 $45,535.10 $45,267.80 2026-01-01
J9226 CPT Histrelin Acetate (cpp) 50 Mg Kit 50 44 $132,981.50 $98,273.33 26% off $45,261.79 $132,981.50 $62,501.30 2026-01-01
1783 APR_DRG External Heart Assist Systems 12 11 — — $45,265.53 $144,397.75 $48,087.34 2026-01-01
204 APR_DRG Craniotomy For Trauma 12 11 — — $45,271.48 $140,158.55 $45,676.52 2026-01-01
1204 APR_DRG Major Respiratory & Chest Procedures 12 11 — — $45,818.24 $140,688.45 $48,475.50 2026-01-01
L7180 CPT Electronic Elbow Sequential 2 2 — — $45,879.28 $46,980.38 $46,429.83 2026-01-01
1694 APR_DRG Major Thoracic Abdominal Vascular Procedures 12 11 — — $46,217.43 $185,994.90 $49,836.02 2026-01-01
234 APR_DRG Spinal Procedures 12 11 — — $46,393.07 $165,328.80 $48,475.56 2026-01-01
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 12 11 — — $46,521.08 $171,157.70 $46,915.74 2026-01-01
6954 APR_DRG Chemotherapy For Acute Leukemia 11 10 — — $46,812.83 $121,347.10 $46,812.83 2026-01-01
L7181 CPT Electronic Elbo Simultaneous 2 2 — — $47,237.07 $48,370.76 $47,803.92 2026-01-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 11 10 — — $47,544.43 $135,919.35 $47,544.43 2026-01-01
1623 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 12 11 — — $47,943.44 $106,244.95 $49,179.56 2026-01-01
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 12 11 — — $48,086.25 $126,381.15 $48,663.85 2026-01-01
6302 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 11 10 — — $48,261.35 $107,039.80 $50,761.84 2026-01-01
6084 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 12 11 — — $48,539.24 $184,405.20 $53,938.32 2026-01-01
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 11 — — $49,019.08 $108,629.50 $55,192.39 2026-01-01
6144 APR_DRG Neonate Bwt 15001999g W Or Wo Other Significant Condition 11 10 — — $49,786.13 $142,278.15 $49,786.13 2026-01-01
1794 APR_DRG Defibrillator Implants 12 11 — — $49,802.50 $147,577.15 $52,945.17 2026-01-01
214 APR_DRG Craniotomy Except For Trauma 12 11 — — $49,943.63 $140,688.45 $50,531.13 2026-01-01
9114 APR_DRG Extensive AbdominalThoraic Procedures For Mult Si 11 10 — — $50,840.74 $153,935.95 $50,840.74 2026-01-01
12 APR_DRG Liver Transplant Or Intestinal Transplant 12 11 — — $51,321.52 $173,277.30 $56,206.25 2026-01-01
914 APR_DRG Other Major Head & Neck Procedures 12 11 — — $51,369.90 $148,636.95 $52,105.04 2026-01-01
1664 APR_DRG Coronary Bypass Wo Cardiac Cath Or Percutaneous Cardiac Procedure 12 11 — — $52,443.86 $121,877.00 $53,714.57 2026-01-01
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 11 — — $52,481.07 $179,901.05 $56,347.15 2026-01-01
38240 CPT Transplt Allo Hct/donor 2 2 — — $52,684.72 $59,142.33 $55,913.53 2026-01-01
6904 APR_DRG Acute Leukemia 11 10 — — $52,824.92 $156,850.40 $52,824.92 2026-01-01
6334 APR_DRG Neonate Birthwt 2499g W Major Anomaly 11 10 — — $52,981.81 $187,849.55 $57,982.60 2026-01-01
71 APR_DRG Allogeneic Bone Marrow Transplant 12 11 — — $53,015.74 $166,653.55 $57,173.59 2026-01-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 12 11 — — $53,103.51 $142,808.05 $53,178.44 2026-01-01
7404 APR_DRG Mental Illness Diagnosis W Or Procedure 11 10 — — $53,107.73 $142,808.05 $53,107.73 2026-01-01
6814 APR_DRG Other Or Procedures For Lymphatichematopoieticother Neoplasms 11 10 — — $53,325.80 $141,483.30 $53,325.80 2026-01-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 12 11 — — $53,487.74 $118,697.60 $53,554.29 2026-01-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 12 11 — — $53,729.16 $119,227.50 $56,785.09 2026-01-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 11 10 — — $54,210.72 $157,910.20 $54,210.72 2026-01-01
6033 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 12 11 — — $54,507.90 $175,131.95 $61,290.06 2026-01-01
Q2043 CPT Sipuleucel-t Auto Cd54+ 2 2 — — $55,015.23 $55,536.49 $55,275.86 2026-01-01
62 APR_DRG Pancreas Transplant 12 11 — — $55,882.31 $192,618.65 $61,909.85 2026-01-01
A9543 CPT Y90 Ibritumomab- Rx 2 2 — — $56,824.55 $65,476.58 $61,150.57 2026-01-01
93 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 12 11 — — $57,755.56 $170,362.85 $65,848.62 2026-01-01
6214 APR_DRG Neonate Bwt 20002499g W Major Anomaly 11 10 — — $58,292.30 $353,178.35 $58,572.79 2026-01-01
6804 APR_DRG Major Or Procedures For Lymphatichematopoieticother Neoplasms 11 10 — — $58,522.92 $135,389.45 $58,522.92 2026-01-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 11 10 — — $58,636.05 $208,250.70 $58,636.05 2026-01-01
6073 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 12 11 — — $59,097.49 $280,317.10 $59,392.04 2026-01-01
72 APR_DRG Allogeneic Bone Marrow Transplant 12 11 — — $59,598.82 $188,114.50 $60,182.61 2026-01-01
1654 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 12 11 — — $59,887.14 $151,021.50 $61,630.13 2026-01-01
6022 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 12 11 — — $60,125.46 $209,575.45 $63,190.14 2026-01-01
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 11 10 — — $60,423.01 $147,312.20 $60,423.01 2026-01-01
6124 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 11 10 — — $60,980.45 $228,651.85 $60,980.45 2026-01-01
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 11 — — $61,110.70 $228,916.80 $61,627.49 2026-01-01
1784 APR_DRG External Heart Assist Systems 12 11 — — $61,452.31 $219,908.50 $65,133.72 2026-01-01
1674 APR_DRG Other Cardiothoracic Procedures 12 11 — — $62,319.82 $158,705.05 $64,561.80 2026-01-01
6093 APR_DRG Neonate Bwt 15002499g W Major Procedure 12 11 — — $62,520.31 $205,601.20 $64,570.54 2026-01-01
J9029 CPT Instill Adstiladrin- Tx Dose 2 2 — — $63,354.77 $63,402.04 $63,378.40 2026-01-01
13 APR_DRG Liver Transplant Or Intestinal Transplant 12 11 — — $63,886.02 $277,932.55 $68,369.38 2026-01-01
1634 APR_DRG Cardiac Valve Procedures Wo Cardiac Catheterization 12 11 — — $64,125.67 $154,730.80 $66,733.73 2026-01-01
84 APR_DRG Autologous Bone Marrow Transplant 12 11 — — $65,391.93 $205,601.20 $76,111.88 2026-01-01
L8702 CPT Ewhf S/d Uprt Micro Sensor 2 2 — — $65,871.74 $67,452.66 $66,662.20 2026-01-01
6114 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 11 10 — — $69,191.81 $364,571.20 $69,191.81 2026-01-01
6134 APR_DRG Neonate Birthwt 15001999g W Congenitalperinatal Infection 11 10 — — $69,517.04 $165,063.85 $69,517.04 2026-01-01
63 APR_DRG Pancreas Transplant 12 11 — — $69,792.42 $221,763.15 $73,999.71 2026-01-01
5932 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 12 11 — — $71,009.49 $375,434.15 $85,212.62 2026-01-01
8634 APR_DRG Neonatal Aftercare 11 10 — — $71,101.56 $173,277.30 $71,101.56 2026-01-01
4404 APR_DRG Kidney Transplant 12 11 — — $71,941.82 $210,370.30 $72,967.82 2026-01-01
213 MS_DRG Splenic Procedures Age 0-17 2 1 — — $72,824.04 $72,824.04 $72,824.04 2026-01-01
820 MS_DRG Lymphoma And Leukemia With Major O.r. Procedures With Mcc 2 1 — — $74,838.95 $74,838.95 $74,838.95 2026-01-01
235 MS_DRG Coronary Bypass Without Cardiac Catheterization With Mcc 2 1 — — $74,887.44 $74,887.44 $74,887.44 2026-01-01
73 APR_DRG Allogeneic Bone Marrow Transplant 12 11 — — $75,051.32 $240,574.60 $75,619.75 2026-01-01
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $75,667.12 $75,667.12 $75,667.12 2026-01-01
J7330 CPT Autologous Cultured Chondrocytes Sheet 48 42 $197,466.00 $145,927.37 26% off $75,807.20 $197,466.00 $92,809.02 2026-01-01
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome- Neonate 2 1 — — $75,843.22 $75,843.22 $75,843.22 2026-01-01
457 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 2 1 — — $76,093.33 $76,093.33 $76,093.33 2026-01-01
276 MS_DRG Cardiac Defibrillator Implant With Mcc Or Carotid Sinus Neurostimulator 2 1 — — $76,648.42 $76,648.42 $76,648.42 2026-01-01
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $76,670.11 $76,670.11 $76,670.11 2026-01-01
6074 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 12 11 — — $76,714.83 $400,604.40 $85,371.14 2026-01-01
1624 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 12 11 — — $76,982.66 $178,311.35 $78,722.47 2026-01-01
232 MS_DRG Coronary Bypass With Ptca Without Mcc 2 1 — — $77,363.02 $77,363.02 $77,363.02 2026-01-01
21 APR_DRG Heart Or Lung Transplant 12 11 — — $77,504.80 $228,916.80 $84,752.67 2026-01-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 12 11 — — $77,855.89 $189,174.30 $80,990.46 2026-01-01
969 MS_DRG HIV With Extensive O.r. Procedures With Mcc 2 1 — — $78,112.07 $78,112.07 $78,112.07 2026-01-01
266 MS_DRG Endovascular Cardiac Valve Replacement W Mcc 2 1 — — $78,202.67 $78,202.67 $78,202.67 2026-01-01
6023 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 12 11 — — $78,733.64 $363,511.40 $79,016.70 2026-01-01
5913 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 12 11 — — $78,821.41 $321,914.25 $120,079.43 2026-01-01
8424 APR_DRG Full Thickness Burns W Skin Graft 11 10 — — $79,754.75 $176,721.65 $93,836.29 2026-01-01
207 MS_DRG Respiratory System Diagnosis With Ventilator Support >96 Hours 2 1 — — $82,111.28 $82,111.28 $82,111.28 2026-01-01
573 MS_DRG Skin Graft For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $83,600.45 $83,600.45 $83,600.45 2026-01-01
113 APR_DRG Pediatric 9 9 — — $83,713.09 $115,654.09 $115,654.09 2026-01-01
218 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $83,905.43 $83,905.43 $83,905.43 2026-01-01
217 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $83,905.43 $83,905.43 $83,905.43 2026-01-01
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 12 11 — — $84,351.20 $370,400.10 $88,467.98 2026-01-01
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 11 — — $85,048.88 $259,915.95 $86,323.87 2026-01-01
447 MS_DRG Multiple Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomicall… 2 1 — — $85,261.89 $85,261.89 $85,261.89 2026-01-01
317 MS_DRG Endovascular Cardiac Valve Replacement With Mcc 2 1 — — $85,324.42 $85,324.42 $85,324.42 2026-01-01
955 MS_DRG Craniotomy For Multiple Significant Trauma 2 1 — — $85,893.55 $85,893.55 $85,893.55 2026-01-01
6303 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 11 10 — — $86,006.58 $190,764.00 $88,705.40 2026-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 12 11 — — $86,457.78 $223,617.80 $112,764.90 2026-01-01
268 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon With Mcc 2 1 — — $87,766.82 $87,766.82 $87,766.82 2026-01-01
870 MS_DRG Septicemia Or Severe Sepsis With Mv >96 Hours 2 1 — — $88,199.41 $88,199.41 $88,199.41 2026-01-01
5881 APR_DRG Neonate Bwt 1500g W Major Procedure 12 11 — — $88,739.92 $242,447.80 $124,573.23 2026-01-01
5933 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 12 11 — — $89,617.66 $472,935.75 $104,038.52 2026-01-01
22 APR_DRG Heart Or Lung Transplant 12 11 — — $90,407.63 $266,804.65 $92,158.00 2026-01-01
275 MS_DRG Cardiac Defibrillator Implant With Cardiac Catheterization And Mcc 2 1 — — $90,988.90 $90,988.90 $90,988.90 2026-01-01
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $91,042.49 $91,042.49 $91,042.49 2026-01-01
928 MS_DRG Full Thickness Burn With Skin Graft Or Inhalation Injury With Cc/mcc 2 1 — — $91,528.67 $91,528.67 $91,528.67 2026-01-01
10 MS_DRG Pancreas Transplant 2 1 — — $91,566.96 $91,566.96 $91,566.96 2026-01-01
427 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $92,114.39 $92,114.39 $92,114.39 2026-01-01
957 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Mcc 2 1 — — $97,235.26 $97,235.26 $97,235.26 2026-01-01
233 MS_DRG Coronary Bypass With Cardiac Catheterization With Mcc 2 1 — — $97,558.10 $97,558.10 $97,558.10 2026-01-01
219 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $97,980.48 $97,980.48 $97,980.48 2026-01-01
64 APR_DRG Pancreas Transplant 12 11 — — $98,241.53 $313,965.75 $104,769.74 2026-01-01
6024 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 12 11 — — $99,887.27 $461,013.00 $111,395.47 2026-01-01
Q0480 CPT Driver Pneumatic Vad- Rep 2 2 — — $99,999.95 $99,999.95 $99,999.95 2026-01-01
1611 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 11 — — $100,018.06 $291,180.05 $109,695.62 2026-01-01
20 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Mcc 2 1 — — $100,411.40 $100,411.40 $100,411.40 2026-01-01
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 11 — — $104,977.03 $306,547.15 $115,291.10 2026-01-01
456 MS_DRG Spinal Fusion Except Cervical With Spinal Curvature- Malignancy- Infection Or Ex… 2 1 — — $107,233.27 $107,233.27 $107,233.27 2026-01-01
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $107,571.42 $107,571.42 $107,571.42 2026-01-01
850 MS_DRG Acute Leukemia With Other Procedures 2 1 — — $110,501.28 $110,501.28 $110,501.28 2026-01-01
6034 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 12 11 — — $112,000.13 $360,067.05 $138,755.74 2026-01-01
429 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion With Mcc 2 1 — — $114,968.80 $114,968.80 $114,968.80 2026-01-01
6304 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 11 10 — — $116,053.85 $257,266.45 $185,770.26 2026-01-01
23 APR_DRG Heart Or Lung Transplant 12 11 — — $121,918.64 $359,802.10 $126,634.07 2026-01-01
216 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures With Cardiac Catheteriza… 2 1 — — $124,835.38 $124,835.38 $124,835.38 2026-01-01
94 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 12 11 — — $125,341.84 $322,974.05 $152,792.37 2026-01-01
14 APR_DRG Liver Transplant Or Intestinal Transplant 12 11 — — $125,956.26 $333,837.00 $136,566.14 2026-01-01
215 MS_DRG Other Heart Assist System Implant 2 1 — — $127,058.29 $127,058.29 $127,058.29 2026-01-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 12 11 — — $127,975.08 $336,486.50 $135,629.87 2026-01-01
74 APR_DRG Allogeneic Bone Marrow Transplant 12 11 — — $129,203.92 $346,289.65 $153,561.93 2026-01-01
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 11 — — $130,777.34 $381,792.95 $143,639.55 2026-01-01
5831 APR_DRG Neonate W Ecmo 12 11 — — $131,398.28 $313,965.75 $141,137.35 2026-01-01
5 MS_DRG Liver Transplant With Mcc Or Intestinal Transplant 2 1 — — $131,569.20 $131,569.20 $131,569.20 2026-01-01
5914 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 12 11 — — $134,558.16 $617,863.40 $161,780.72 2026-01-01
5882 APR_DRG Neonate Bwt 1500g W Major Procedure 12 11 — — $134,733.70 $368,328.19 $145,335.69 2026-01-01
114 APR_DRG Psychiatric 9 9 — — $134,904.95 $198,309.46 $198,309.46 2026-01-01
5883 APR_DRG Neonate Bwt 1500g W Major Procedure 12 11 — — $137,630.26 $454,407.80 $165,628.52 2026-01-01
212 MS_DRG Testes Procedures Age 0-17 2 1 — — $138,761.13 $138,761.13 $138,761.13 2026-01-01
5934 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 12 11 — — $139,297.97 $608,325.20 $150,011.84 2026-01-01
426 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $140,638.23 $140,638.23 $140,638.23 2026-01-01
209 MS_DRG Kidney And Urinary Tract Signs And Symptoms Age 0-17 2 1 — — $144,435.81 $144,435.81 $144,435.81 2026-01-01
2 MS_DRG Heart Transplant Or Implant Of Heart Assist System Without Mcc 2 1 — — $144,601.70 $144,601.70 $144,601.70 2026-01-01
6314 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 11 10 — — $150,542.29 $333,837.00 $164,388.59 2026-01-01
5832 APR_DRG Neonate W Ecmo 12 11 — — $152,113.04 $383,912.55 $194,172.15 2026-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $153,356.82 $153,356.82 $153,356.82 2026-01-01
7 MS_DRG Lung Transplant 2 1 — — $165,253.62 $165,253.62 $165,253.62 2026-01-01
6094 APR_DRG Neonate Bwt 15002499g W Major Procedure 11 10 — — $167,444.50 $528,575.25 $167,444.50 2026-01-01
4 MS_DRG Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth And Nec… 2 1 — — $176,753.56 $176,753.56 $176,753.56 2026-01-01
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 11 10 — — $183,225.66 $649,392.45 $183,225.66 2026-01-01
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 12 11 — — $193,278.30 $488,832.75 $198,764.66 2026-01-01
24 APR_DRG Heart Or Lung Transplant 12 11 — — $197,053.53 $754,047.70 $225,530.55 2026-01-01
5833 APR_DRG Neonate W Ecmo 12 11 — — $206,269.84 $594,547.80 $252,888.58 2026-01-01
5884 APR_DRG Neonate Bwt 1500g W Major Procedure 12 11 — — $213,642.89 $657,968.88 $254,666.60 2026-01-01
5834 APR_DRG Neonate W Ecmo 12 11 — — $260,426.64 $1,017,143.05 $390,361.97 2026-01-01
3 MS_DRG Ecmo Or Tracheostomy With Mv >96 Hours Or Principal Diagnosis Except Face- Mouth… 2 1 — — $270,848.41 $270,848.41 $270,848.41 2026-01-01
927 MS_DRG Extensive Burns Or Full Thickness Burns With Mv >96 Hours With Skin Graft 2 1 — — $272,447.33 $272,447.33 $272,447.33 2026-01-01
1 MS_DRG Heart Transplant Or Implant Of Heart Assist System With Mcc 2 1 — — $357,604.58 $357,604.58 $357,604.58 2026-01-01
Q2053 CPT Brexucabtagene Car Pos T 2 2 — — $460,530.40 $488,051.51 $474,290.96 2026-01-01
Q2041 CPT Axicabtagene Ciloleucel Car+ 2 2 — — $489,455.96 $489,517.15 $489,486.56 2026-01-01
Q2054 CPT Lisocabtagene Mara Car Pos T 2 2 — — $516,485.97 $516,726.08 $516,606.03 2026-01-01
Q2055 CPT Idecabtagene Vicleucel Car 2 2 — — $526,587.59 $528,312.43 $527,450.01 2026-01-01
Q2056 CPT Ciltacabtagene Car-pos T 2 2 — — $527,123.43 $551,318.34 $539,220.89 2026-01-01
Q2042 CPT Tisagenlecleucel Car-pos T 2 2 — — $529,192.86 $565,623.84 $547,408.35 2026-01-01
18 MS_DRG Chimeric Antigen Receptor (car) T-cell Immunotherapy 2 1 — — $551,042.76 $551,042.76 $551,042.76 2026-01-01
J3392 CPT Inj- Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-01-01
J3399 CPT Inj Onase Abepar-xioi Treat 2 2 — — $2,388,614.23 $2,403,458.75 $2,396,036.49 2026-01-01
J3393 CPT Inj- Betibeglogene Autotemce 2 2 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2026-01-01
J3394 CPT Inj- Lovotibeglogene Autotem 2 2 — — $3,193,000.00 $3,286,000.00 $3,239,500.00 2026-01-01
J1413 CPT Inj Delandistrogene Mox Rokl 2 2 — — $3,321,781.51 $3,325,454.76 $3,323,618.13 2026-01-01
J1414 CPT Inj- Beqvez- Per Tx Dose 1 1 — — $3,500,000.00 $3,500,000.00 $3,500,000.00 2026-01-01
C9172 CPT Inj Beqvez Per Tx Dose 1 1 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2026-01-01
J1411 CPT Inj- Hemgenix- Per Tx Dose 2 2 — — $3,672,900.00 $3,710,000.00 $3,691,450.00 2026-01-01
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