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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 JACKSON MEDICAL CENTER

Jackson, MN · CCN 241315 · Rates published

7,602 distinct procedures filed
15 distinct payers
95,295 rate rows
2026-03-04 last MRF observed
Data quality

94,978 of 95,295 rate rows are consumer-grade (99.7%)

317 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 257
per-diem day rate — not a per-procedure price 60
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8379/460388596_sanford-jackson-hospital_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SanfordJacksonHospital/8379
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint b51ad14153fcb138… · 53,742,513 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
5834
APR_DRG 		Neonate With Ecmo 2 $197,968.27 $197,968.27 $197,968.27 nat. median
$390,362
0.5× median
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $125,123.36 $125,123.36 $125,123.36 nat. median
$286,698
outlier · 0.4×
5833
APR_DRG 		Neonate With Ecmo 2 $119,528.13 $119,528.13 $119,528.13 nat. median
$268,208
outlier · 0.4×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $112,119.82 $112,119.82 $112,119.82 nat. median
$135,803
0.8× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $101,821.39 $101,821.39 $101,821.39 nat. median
$225,531
outlier · 0.5×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $87,987.34 $87,987.34 $87,987.34 nat. median
$198,578
outlier · 0.4×
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $87,509.46 $87,509.46 $87,509.46 nat. median
$68,335
1.3× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $86,092.46 $86,092.46 $86,092.46 nat. median
$171,497
0.5× median
1614
APR_DRG 		Implantable Heart Assist Systems 2 $84,662.42 $84,662.42 $84,662.42 nat. median
$202,242
outlier · 0.4×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $81,479.42 $81,479.42 $81,479.42 nat. median
$152,792
0.5× median
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $80,996.83 $80,996.83 $80,996.83 nat. median
$173,134
outlier · 0.5×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $78,116.48 $78,116.48 $78,116.48 nat. median
$152,383
0.5× median
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $75,994.60 $75,994.60 $75,994.60 nat. median
$168,439
outlier · 0.5×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $75,096.75 $75,096.75 $75,096.75 nat. median
$181,762
outlier · 0.4×
5832
APR_DRG 		Neonate With Ecmo 2 $75,006.61 $75,006.61 $75,006.61 nat. median
$201,678
outlier · 0.4×
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $73,948.74 $73,948.74 $73,948.74 nat. median
$63,564
1.2× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $72,428.56 $72,428.56 $72,428.56 nat. median
$173,018
outlier · 0.4×
1613
APR_DRG 		Implantable Heart Assist Systems 2 $68,125.79 $68,125.79 $68,125.79 nat. median
$155,539
outlier · 0.4×
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $66,454.64 $66,454.64 $66,454.64 nat. median
$77,096
0.9× median
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $66,454.64 $66,454.64 $66,454.64 nat. median
$96,548
0.7× median
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $66,454.64 $66,454.64 $66,454.64 nat. median
$99,483
0.7× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $65,414.51 $65,414.51 $65,414.51 nat. median
$120,079
0.5× median
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $63,812.15 $63,812.15 $63,812.15 nat. median
$187,567
outlier · 0.3×
5831
APR_DRG 		Neonate With Ecmo 2 $63,286.84 $63,286.84 $63,286.84 nat. median
$173,909
outlier · 0.4×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $62,724.24 $62,724.24 $62,724.24 nat. median
$149,836
outlier · 0.4×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $62,245.99 $62,245.99 $62,245.99 nat. median
$135,630
outlier · 0.5×
38240
CPT 		Transplt Allo Hct/donor 1 $62,099.45 $62,099.45 $62,099.45 nat. median
$28,331
outlier · 2.2×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $58,743.27 $58,743.27 $58,743.27 nat. median
$63,499
0.9× median
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 2 $57,727.80 $57,727.80 $57,727.80 nat. median
$136,566
outlier · 0.4×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $55,505.64 $55,505.64 $55,505.64 nat. median
$124,731
outlier · 0.4×
23
APR_DRG 		Heart And/or Lung Transplant 2 $55,061.42 $55,061.42 $55,061.42 nat. median
$117,894
outlier · 0.5×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $54,289.20 $54,289.20 $54,289.20 nat. median
$114,205
outlier · 0.5×
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $53,115.85 $53,115.85 $53,115.85 nat. median
$85,835
0.6× median
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $51,956.25 $51,956.25 $51,956.25 nat. median
$130,862
outlier · 0.4×
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $46,094.56 $46,094.56 $46,094.56 nat. median
$73,618
0.6× median
1612
APR_DRG 		Implantable Heart Assist Systems 2 $46,044.60 $46,044.60 $46,044.60 nat. median
$109,992
outlier · 0.4×
1611
APR_DRG 		Implantable Heart Assist Systems 2 $46,044.60 $46,044.60 $46,044.60 nat. median
$108,954
outlier · 0.4×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 2 $44,761.18 $44,761.18 $44,761.18 nat. median
$106,926
outlier · 0.4×
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $44,278.59 $44,278.59 $44,278.59 nat. median
$91,350
outlier · 0.5×
22
APR_DRG 		Heart And/or Lung Transplant 2 $42,499.92 $42,499.92 $42,499.92 nat. median
$95,481
outlier · 0.4×
5932
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $42,210.65 $42,210.65 $42,210.65 nat. median
$91,110
outlier · 0.5×
6074
APR_DRG 		Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 $41,316.07 $41,316.07 $41,316.07 nat. median
$100,752
outlier · 0.4×
43
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $41,261.76 $41,261.76 $41,261.76 nat. median
$85,032
outlier · 0.5×
6034
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 $40,144.89 $40,144.89 $40,144.89 nat. median
$115,963
outlier · 0.3×
64
APR_DRG 		Pancreas Transplant 2 $38,929.18 $38,929.18 $38,929.18 nat. median
$92,994
outlier · 0.4×
8424
APR_DRG 		Burns With Skin Graft Except Extensive Third Degree Burns 2 $38,732.59 $38,732.59 $38,732.59 nat. median
$91,950
outlier · 0.4×
6023
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $38,690.96 $38,690.96 $38,690.96 nat. median
$95,757
outlier · 0.4×
73
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $37,371.34 $37,371.34 $37,371.34 nat. median
$81,292
outlier · 0.5×
6114
APR_DRG 		Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 $34,816.83 $34,816.83 $34,816.83 nat. median
$85,322
outlier · 0.4×
6303
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $34,656.45 $34,656.45 $34,656.45 nat. median
$95,499
outlier · 0.4×

Other procedures at this hospital

Browse this hospital's 7,602 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 — — $197,968.27 $197,968.27 $197,968.27 2026-03-04
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $125,123.36 $125,123.36 $125,123.36 2026-03-04
5833 APR_DRG Neonate With Ecmo 2 2 — — $119,528.13 $119,528.13 $119,528.13 2026-03-04
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $112,119.82 $112,119.82 $112,119.82 2026-03-04
24 APR_DRG Heart And/or Lung Transplant 2 2 — — $101,821.39 $101,821.39 $101,821.39 2026-03-04
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $87,987.34 $87,987.34 $87,987.34 2026-03-04
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $87,509.46 $87,509.46 $87,509.46 2026-03-04
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $86,092.46 $86,092.46 $86,092.46 2026-03-04
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $84,662.42 $84,662.42 $84,662.42 2026-03-04
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $81,479.42 $81,479.42 $81,479.42 2026-03-04
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $80,996.83 $80,996.83 $80,996.83 2026-03-04
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $78,116.48 $78,116.48 $78,116.48 2026-03-04
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $75,994.60 $75,994.60 $75,994.60 2026-03-04
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $75,096.75 $75,096.75 $75,096.75 2026-03-04
5832 APR_DRG Neonate With Ecmo 2 2 — — $75,006.61 $75,006.61 $75,006.61 2026-03-04
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $73,948.74 $73,948.74 $73,948.74 2026-03-04
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $72,428.56 $72,428.56 $72,428.56 2026-03-04
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $68,125.79 $68,125.79 $68,125.79 2026-03-04
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $66,454.64 $66,454.64 $66,454.64 2026-03-04
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $66,454.64 $66,454.64 $66,454.64 2026-03-04
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $66,454.64 $66,454.64 $66,454.64 2026-03-04
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $65,414.51 $65,414.51 $65,414.51 2026-03-04
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $63,812.15 $63,812.15 $63,812.15 2026-03-04
5831 APR_DRG Neonate With Ecmo 2 2 — — $63,286.84 $63,286.84 $63,286.84 2026-03-04
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $62,724.24 $62,724.24 $62,724.24 2026-03-04
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $62,245.99 $62,245.99 $62,245.99 2026-03-04
38240 CPT Transplt Allo Hct/donor 1 1 — — $62,099.45 $62,099.45 $62,099.45 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 — — $57,727.80 $57,727.80 $57,727.80 2026-03-04
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $55,505.64 $55,505.64 $55,505.64 2026-03-04
23 APR_DRG Heart And/or Lung Transplant 2 2 — — $55,061.42 $55,061.42 $55,061.42 2026-03-04
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $54,289.20 $54,289.20 $54,289.20 2026-03-04
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $53,115.85 $53,115.85 $53,115.85 2026-03-04
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $51,956.25 $51,956.25 $51,956.25 2026-03-04
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $46,094.56 $46,094.56 $46,094.56 2026-03-04
1612 APR_DRG Implantable Heart Assist Systems 2 2 — — $46,044.60 $46,044.60 $46,044.60 2026-03-04
1611 APR_DRG Implantable Heart Assist Systems 2 2 — — $46,044.60 $46,044.60 $46,044.60 2026-03-04
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $44,761.18 $44,761.18 $44,761.18 2026-03-04
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $44,278.59 $44,278.59 $44,278.59 2026-03-04
22 APR_DRG Heart And/or Lung Transplant 2 2 — — $42,499.92 $42,499.92 $42,499.92 2026-03-04
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $42,210.65 $42,210.65 $42,210.65 2026-03-04
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $41,316.07 $41,316.07 $41,316.07 2026-03-04
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $41,261.76 $41,261.76 $41,261.76 2026-03-04
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $40,144.89 $40,144.89 $40,144.89 2026-03-04
64 APR_DRG Pancreas Transplant 2 2 — — $38,929.18 $38,929.18 $38,929.18 2026-03-04
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $38,732.59 $38,732.59 $38,732.59 2026-03-04
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $38,690.96 $38,690.96 $38,690.96 2026-03-04
73 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $37,371.34 $37,371.34 $37,371.34 2026-03-04
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $34,816.83 $34,816.83 $34,816.83 2026-03-04
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $34,656.45 $34,656.45 $34,656.45 2026-03-04
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $33,812.18 $33,812.18 $33,812.18 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
33270 CPT Ins/rep Subq Defibrillator 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
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 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
8634 APR_DRG Neonatal Aftercare 2 2 — — $33,218.45 $33,218.45 $33,218.45 2026-03-04
63 APR_DRG Pancreas Transplant 2 2 — — $33,131.56 $33,131.56 $33,131.56 2026-03-04
21 APR_DRG Heart And/or Lung Transplant 2 2 — — $32,579.10 $32,579.10 $32,579.10 2026-03-04
4404 APR_DRG Kidney Transplant 2 2 — — $32,190.27 $32,190.27 $32,190.27 2026-03-04
61886 CPT Implant Neurostim Arrays 1 1 — — $31,997.27 $31,997.27 $31,997.27 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
64568 CPT Opn Impltj Crnl Nrv Nea&pg 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
13 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $31,880.01 $31,880.01 $31,880.01 2026-03-04
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $31,239.93 $31,239.93 $31,239.93 2026-03-04
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $31,238.85 $31,238.85 $31,238.85 2026-03-04
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $30,997.01 $30,997.01 $30,997.01 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
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $29,724.46 $29,724.46 $29,724.46 2026-03-04
8514 APR_DRG Gender Related Procedures 2 2 — — $29,137.96 $29,137.96 $29,137.96 2026-03-04
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $29,015.23 $29,015.23 $29,015.23 2026-03-04
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $28,875.53 $28,875.53 $28,875.53 2026-03-04
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $28,285.01 $28,285.01 $28,285.01 2026-03-04
J3357 HCPCS Ustekinumab Soln Prefilled Syringe 90 Mg/ml 40 13 $45,011.86 $36,009.49 $10,897.37 $42,581.22 $28,082.42 2026-03-04
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $28,044.26 $28,044.26 $28,044.26 2026-03-04
62 APR_DRG Pancreas Transplant 2 2 — — $28,016.38 $28,016.38 $28,016.38 2026-03-04
72 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $27,815.45 $27,815.45 $27,815.45 2026-03-04
1784 APR_DRG External Heart Assist Devices 2 2 — — $27,724.58 $27,724.58 $27,724.58 2026-03-04
84 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $27,255.38 $27,255.38 $27,255.38 2026-03-04
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $27,020.06 $27,020.06 $27,020.06 2026-03-04
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $26,648.98 $26,648.98 $26,648.98 2026-03-04
93654 CPT Compre Ep Eval Tx Vt 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
93653 CPT Compre Ep Eval Tx Svt 1 1 — — $25,758.92 $25,758.92 $25,758.92 2026-03-04
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $25,731.94 $25,731.94 $25,731.94 2026-03-04
12 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $25,722.53 $25,722.53 $25,722.53 2026-03-04
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $25,515.08 $25,515.08 $25,515.08 2026-03-04
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $25,294.61 $25,294.61 $25,294.61 2026-03-04
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 2 2 — — $24,977.10 $24,977.10 $24,977.10 2026-03-04
1834 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $24,601.67 $24,601.67 $24,601.67 2026-03-04
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $24,218.64 $24,218.64 $24,218.64 2026-03-04
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $23,856.61 $23,856.61 $23,856.61 2026-03-04
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $23,837.78 $23,837.78 $23,837.78 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
33263 CPT Rmvl & Rplcmt Dfb Gen 2 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
33240 CPT Insrt Pulse Gen W/singl Lead 1 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
71 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $23,153.54 $23,153.54 $23,153.54 2026-03-04
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $23,043.48 $23,043.48 $23,043.48 2026-03-04
1794 APR_DRG Defibrillator Implants 2 2 — — $23,021.03 $23,021.03 $23,021.03 2026-03-04
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 2 2 — — $22,906.27 $22,906.27 $22,906.27 2026-03-04
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $22,783.90 $22,783.90 $22,783.90 2026-03-04
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 2 2 — — $22,617.72 $22,617.72 $22,617.72 2026-03-04
61 APR_DRG Pancreas Transplant 2 2 — — $22,607.95 $22,607.95 $22,607.95 2026-03-04
914 APR_DRG Other Major Head And Neck Procedures 2 2 — — $22,540.97 $22,540.97 $22,540.97 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
61885 CPT Insrt/redo Neurostim 1 Array 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
64580 CPT Opn Impltj Nea Neuromuscular 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
1783 APR_DRG External Heart Assist Devices 2 2 — — $22,481.96 $22,481.96 $22,481.96 2026-03-04
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $22,222.02 $22,222.02 $22,222.02 2026-03-04
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $22,183.65 $22,183.65 $22,183.65 2026-03-04
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $21,986.70 $21,986.70 $21,986.70 2026-03-04
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $21,902.35 $21,902.35 $21,902.35 2026-03-04
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $21,867.95 $21,867.95 $21,867.95 2026-03-04
4403 APR_DRG Kidney Transplant 2 2 — — $21,428.44 $21,428.44 $21,428.44 2026-03-04
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $21,205.43 $21,205.43 $21,205.43 2026-03-04
11 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $21,136.28 $21,136.28 $21,136.28 2026-03-04
54410 CPT Remove/replace Penis Prosth 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
53444 CPT Insert Tandem Cuff 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
53445 CPT Insert Uro/ves Nck Sphincter 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
54405 CPT Insert Multi-comp Penis Pros 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $20,924.85 $20,924.85 $20,924.85 2026-03-04
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $20,919.42 $20,919.42 $20,919.42 2026-03-04
1694 APR_DRG Major Abdominal Vascular Procedures 2 2 — — $20,806.11 $20,806.11 $20,806.11 2026-03-04
214 APR_DRG Open Craniotomy Except Trauma 2 2 — — $20,780.76 $20,780.76 $20,780.76 2026-03-04
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $20,768.45 $20,768.45 $20,768.45 2026-03-04
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $20,693.51 $20,693.51 $20,693.51 2026-03-04
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $20,465.43 $20,465.43 $20,465.43 2026-03-04
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $20,318.81 $20,318.81 $20,318.81 2026-03-04
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $20,232.28 $20,232.28 $20,232.28 2026-03-04
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $20,232.28 $20,232.28 $20,232.28 2026-03-04
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $20,067.92 $20,067.92 $20,067.92 2026-03-04
234 APR_DRG Spinal Procedures 2 2 — — $20,050.54 $20,050.54 $20,050.54 2026-03-04
33221 CPT Insert Pulse Gen Mult Leads 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
33274 CPT Tcat Insj/rpl Perm Ldls Pm 1 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $19,763.08 $19,763.08 $19,763.08 2026-03-04
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 2 2 — — $19,742.09 $19,742.09 $19,742.09 2026-03-04
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $19,674.39 $19,674.39 $19,674.39 2026-03-04
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 2 2 — — $19,658.82 $19,658.82 $19,658.82 2026-03-04
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $19,646.51 $19,646.51 $19,646.51 2026-03-04
23472 CPT Reconstruct Shoulder 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
C8003 HCPCS Imp Extar Knee Shck Absrb 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
22630 CPT Arthrd Pst Tq 1ntrspc Lum 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
25446 CPT Arthrp W/prostc Dst Rds&crps 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
20696 CPT App Mltpln Uni Xtrnl Fix 1st 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
21243 CPT Reconstruction Of Jaw 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
28705 CPT Arthrodesis Pantalar 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
27702 CPT Reconstruct Ankle Joint 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
894 APR_DRG Major Cranial Or Facial Bone Procedures 2 2 — — $19,188.17 $19,188.17 $19,188.17 2026-03-04
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 2 2 — — $19,108.89 $19,108.89 $19,108.89 2026-03-04
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 2 2 — — $19,061.46 $19,061.46 $19,061.46 2026-03-04
4014 APR_DRG Adrenal Procedures 2 2 — — $18,961.18 $18,961.18 $18,961.18 2026-03-04
6904 APR_DRG Acute Leukemia 2 2 — — $18,870.67 $18,870.67 $18,870.67 2026-03-04
C9766 HCPCS Revasc Intra Lithotrip-ather 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
C9607 HCPCS Perc D-e Cor Revasc Chro Sin 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
37242 CPT Vasc Embolize/occlude Artery 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
C9606 HCPCS Perc D-e Cor Revasc W Ami S 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
33902 CPT Perq P-art Revsc 1 Abnor Uni 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
C9767 HCPCS Revasc Lithotrip-stent-ather 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
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
92933 CPT Prq Trlml C Athrc St Angiop1 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
37230 CPT Outpatient Services - Cpt/hcpcs 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
37231 CPT Outpatient Services - Cpt/hcpcs 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
93582 CPT Perq Transcath Closure Pda 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
C9775 HCPCS Revasc Lith-sten-ath Tib/per 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
37227 CPT Outpatient Services - Cpt/hcpcs 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
1204 APR_DRG Major Respiratory And Chest Procedures 2 2 — — $18,834.47 $18,834.47 $18,834.47 2026-03-04
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $18,730.93 $18,730.93 $18,730.93 2026-03-04
62361 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
62362 CPT Implant Spine Infusion Pump 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $18,534.70 $18,534.70 $18,534.70 2026-03-04
4402 APR_DRG Kidney Transplant 2 2 — — $18,495.97 $18,495.97 $18,495.97 2026-03-04
204 APR_DRG Open Craniotomy For Trauma 2 2 — — $18,412.34 $18,412.34 $18,412.34 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
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $18,230.96 $18,230.96 $18,230.96 2026-03-04
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $18,199.46 $18,199.46 $18,199.46 2026-03-04
4414 APR_DRG Major Bladder Procedures 2 2 — — $18,190.77 $18,190.77 $18,190.77 2026-03-04
J1628 HCPCS Guselkumab IV Soln 200 Mg/20ml (10 Mg/ml) 40 13 $29,059.32 $23,247.46 $7,035.26 $27,490.12 $18,129.80 2026-03-04
1782 APR_DRG External Heart Assist Devices 2 2 — — $18,123.43 $18,123.43 $18,123.43 2026-03-04
5204 APR_DRG Other GYN Procedures For Malignancy 2 2 — — $17,992.01 $17,992.01 $17,992.01 2026-03-04
6814 APR_DRG Other O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $17,931.92 $17,931.92 $17,931.92 2026-03-04
83 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $17,877.25 $17,877.25 $17,877.25 2026-03-04
6123 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $17,654.60 $17,654.60 $17,654.60 2026-03-04
2614 APR_DRG Major Biliary Tract Procedures 2 2 — — $17,413.48 $17,413.48 $17,413.48 2026-03-04
4854 APR_DRG Prostatectomy Procedures 2 2 — — $17,360.63 $17,360.63 $17,360.63 2026-03-04
1833 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $17,334.56 $17,334.56 $17,334.56 2026-03-04
6092 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $17,301.98 $17,301.98 $17,301.98 2026-03-04
66683 CPT Implantation Iris Prosthesis 1 1 — — $17,237.25 $17,237.25 $17,237.25 2026-03-04
3614 APR_DRG Skin Graft For Skin And Subcutaneous Tissue Diagnoses 2 2 — — $17,136.89 $17,136.89 $17,136.89 2026-03-04
1793 APR_DRG Defibrillator Implants 2 2 — — $16,994.97 $16,994.97 $16,994.97 2026-03-04
4401 APR_DRG Kidney Transplant 2 2 — — $16,897.95 $16,897.95 $16,897.95 2026-03-04
6144 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $16,821.20 $16,821.20 $16,821.20 2026-03-04
3214 APR_DRG Spinal Fusion And Other Back And Neck Procedures Except For Disc Procedures 2 2 — — $16,774.49 $16,774.49 $16,774.49 2026-03-04
1663 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $16,728.51 $16,728.51 $16,728.51 2026-03-04
1781 APR_DRG External Heart Assist Devices 2 2 — — $16,627.87 $16,627.87 $16,627.87 2026-03-04
6021 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $16,585.87 $16,585.87 $16,585.87 2026-03-04
2992 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $16,472.92 $16,472.92 $16,472.92 2026-03-04
6033 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $16,430.20 $16,430.20 $16,430.20 2026-03-04
924 APR_DRG Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures 2 2 — — $16,402.32 $16,402.32 $16,402.32 2026-03-04
6133 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $16,386.75 $16,386.75 $16,386.75 2026-03-04
2304 APR_DRG Major Small Bowel Procedures 2 2 — — $16,343.31 $16,343.31 $16,343.31 2026-03-04
6954 APR_DRG Chemotherapy For Acute Leukemia 2 2 — — $16,336.79 $16,336.79 $16,336.79 2026-03-04
274 APR_DRG Other Open Craniotomy 2 2 — — $16,324.85 $16,324.85 $16,324.85 2026-03-04
1814 APR_DRG Lower Extremity Vascular Procedures 2 2 — — $16,310.73 $16,310.73 $16,310.73 2026-03-04
3043 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $16,274.52 $16,274.52 $16,274.52 2026-03-04
7924 APR_DRG Extensive O.r. Procedures For Other Complications Of Treatment 2 2 — — $16,220.58 $16,220.58 $16,220.58 2026-03-04
1652 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $16,144.55 $16,144.55 $16,144.55 2026-03-04
67027 CPT Implant Eye Drug System 1 1 — — $16,133.07 $16,133.07 $16,133.07 2026-03-04
6514 APR_DRG Other Procedures Of Blood And Blood-forming Organs 2 2 — — $16,126.81 $16,126.81 $16,126.81 2026-03-04
5114 APR_DRG Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy 2 2 — — $16,048.25 $16,048.25 $16,048.25 2026-03-04
5124 APR_DRG Uterine And Adnexa Procedures For Non-ovarian And Non-adnexal Malignancy 2 2 — — $15,969.69 $15,969.69 $15,969.69 2026-03-04
1621 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $15,925.52 $15,925.52 $15,925.52 2026-03-04
1214 APR_DRG Other Respiratory And Chest Procedures 2 2 — — $15,924.07 $15,924.07 $15,924.07 2026-03-04
304 APR_DRG Percutaneous Intracranial And Extracranial Vascular Procedures 2 2 — — $15,684.41 $15,684.41 $15,684.41 2026-03-04
3032 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $15,467.19 $15,467.19 $15,467.19 2026-03-04
7104 APR_DRG Infectious And Parasitic Diseases Including HIV With O.r. Procedure 2 2 — — $15,447.64 $15,447.64 $15,447.64 2026-03-04
1632 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $15,443.29 $15,443.29 $15,443.29 2026-03-04
8633 APR_DRG Neonatal Aftercare 2 2 — — $15,377.40 $15,377.40 $15,377.40 2026-03-04
4054 APR_DRG Other Procedures For Endocrine, Nutritional And Metabolic Disorders 2 2 — — $15,376.32 $15,376.32 $15,376.32 2026-03-04
1602 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $15,359.30 $15,359.30 $15,359.30 2026-03-04
1704 APR_DRG Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock 2 2 — — $15,268.79 $15,268.79 $15,268.79 2026-03-04
4284 APR_DRG Genetic Disorders 2 2 — — $15,260.83 $15,260.83 $15,260.83 2026-03-04
4034 APR_DRG Procedures For Obesity 2 2 — — $15,257.93 $15,257.93 $15,257.93 2026-03-04
6113 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $15,135.56 $15,135.56 $15,135.56 2026-03-04
1754 APR_DRG Percutaneous Cardiac Intervention Without Ami 2 2 — — $15,094.29 $15,094.29 $15,094.29 2026-03-04
2644 APR_DRG Other Hepatobiliary, Pancreas And Abdominal Procedures 2 2 — — $15,042.16 $15,042.16 $15,042.16 2026-03-04
1303 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $15,007.40 $15,007.40 $15,007.40 2026-03-04
65770 CPT Keratoprosthesis 1 1 — — $15,003.78 $15,003.78 $15,003.78 2026-03-04
294 APR_DRG Other Percutaneous Intracranial Procedures 2 2 — — $14,995.82 $14,995.82 $14,995.82 2026-03-04
224 APR_DRG Ventricular Shunt Procedures 2 2 — — $14,984.60 $14,984.60 $14,984.60 2026-03-04
7114 APR_DRG Post-operative, Post-trauma, Other Device Infections With O.r. Procedure 2 2 — — $14,934.27 $14,934.27 $14,934.27 2026-03-04
6224 APR_DRG Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $14,901.69 $14,901.69 $14,901.69 2026-03-04
1651 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $14,739.14 $14,739.14 $14,739.14 2026-03-04
4044 APR_DRG Thyroid, Parathyroid And Thyroglossal Procedures 2 2 — — $14,727.55 $14,727.55 $14,727.55 2026-03-04
6504 APR_DRG Splenic Procedures 2 2 — — $14,672.16 $14,672.16 $14,672.16 2026-03-04
4474 APR_DRG Other Kidney, Urinary Tract And Related Non-percutaneous Procedures 2 2 — — $14,578.39 $14,578.39 $14,578.39 2026-03-04
4424 APR_DRG Kidney And Urinary Tract Procedures For Malignancy 2 2 — — $14,540.74 $14,540.74 $14,540.74 2026-03-04
3003 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $14,486.80 $14,486.80 $14,486.80 2026-03-04
82 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $14,468.33 $14,468.33 $14,468.33 2026-03-04
6234 APR_DRG Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection 2 2 — — $14,323.88 $14,323.88 $14,323.88 2026-03-04
913 APR_DRG Other Major Head And Neck Procedures 2 2 — — $14,317.37 $14,317.37 $14,317.37 2026-03-04
2314 APR_DRG Major Large Bowel Procedures 2 2 — — $14,301.44 $14,301.44 $14,301.44 2026-03-04
9514 APR_DRG Moderately Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $14,240.25 $14,240.25 $14,240.25 2026-03-04
1764 APR_DRG Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices 2 2 — — $14,204.41 $14,204.41 $14,204.41 2026-03-04
1832 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $14,178.71 $14,178.71 $14,178.71 2026-03-04
213 APR_DRG Open Craniotomy Except Trauma 2 2 — — $14,159.16 $14,159.16 $14,159.16 2026-03-04
4484 APR_DRG Other Kidney, Urinary Tract And Related Percutaneous Procedures 2 2 — — $14,155.54 $14,155.54 $14,155.54 2026-03-04
6344 APR_DRG Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Ma… 2 2 — — $14,148.30 $14,148.30 $14,148.30 2026-03-04
1693 APR_DRG Major Abdominal Vascular Procedures 2 2 — — $14,141.06 $14,141.06 $14,141.06 2026-03-04
6032 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $14,135.63 $14,135.63 $14,135.63 2026-03-04
9103 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $14,127.30 $14,127.30 $14,127.30 2026-03-04
1673 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 2 2 — — $14,037.88 $14,037.88 $14,037.88 2026-03-04
2991 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $14,018.33 $14,018.33 $14,018.33 2026-03-04
3254 APR_DRG Non-elective Or Complex Knee Joint Replacement 2 2 — — $14,005.29 $14,005.29 $14,005.29 2026-03-04
1792 APR_DRG Defibrillator Implants 2 2 — — $13,970.54 $13,970.54 $13,970.54 2026-03-04
7524 APR_DRG Personality Disorders 2 2 — — $13,945.56 $13,945.56 $13,945.56 2026-03-04
6143 APR_DRG Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition 2 2 — — $13,942.66 $13,942.66 $13,942.66 2026-03-04
6091 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $13,926.73 $13,926.73 $13,926.73 2026-03-04
1662 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $13,840.93 $13,840.93 $13,840.93 2026-03-04
264 APR_DRG Other Nervous System And Related Procedures 2 2 — — $13,726.16 $13,726.16 $13,726.16 2026-03-04
3134 APR_DRG Knee And Lower Leg Procedures Except Foot 2 2 — — $13,703.72 $13,703.72 $13,703.72 2026-03-04
434 APR_DRG Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies 2 2 — — $13,682.36 $13,682.36 $13,682.36 2026-03-04
6302 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $13,651.22 $13,651.22 $13,651.22 2026-03-04
3031 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $13,646.88 $13,646.88 $13,646.88 2026-03-04
53451 CPT Tprnl Balo Cntnc Dev Bi 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
53440 CPT Male Sling Procedure 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
54400 CPT Insert Semi-rigid Prosthesis 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
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