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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 MOOSE LAKE

Moose Lake, MN · CCN 241350 · Rates published

18,714 distinct procedures filed
42 distinct payers
466,064 rate rows
2026-01-01 last MRF observed
Data quality

440,088 of 466,064 rate rows are consumer-grade (94.4%)

25,976 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
template filing: same amount across many unrelated codes — excluded 7,020
below 25% of the Medicare reference for this code — likely a mislabeled per-diem or placeholder; excluded from medians 1,252
percent-of-billed methodology on a DRG bundle — not comparable to case rates; shown as context only 773
placeholder amount (≤ $0.02) — excluded from medians 359
percent-of-charges filed in the dollar field — excluded from medians 328
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 24
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.essentiahealth.org/standard-charges/2026/845099016_Essentia-Moose-Lake_standardcharges.csv
Found on page https://www.essentiahealth.org/patients-visitors/billing/price-estimates/
Discovered viaCMS hospital list
Last fetch not_modified · 2026-08-11
Content fingerprint 0c36da70a2e40ab8… · 400,475,304 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
HCPCS 		Inj- Hemgenix- Per Tx Dose 5 $3,672,900.00 $3,710,000.00 $3,710,000.00 nat. median
$3,710,000
1.0× median
C9172
HCPCS 		Inj Beqvez Per Tx Dose 1 $3,605,000.00 $3,605,000.00 $3,605,000.00 nat. median
$3,605,000
1.0× median
J1414
HCPCS 		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
HCPCS 		Inj Delandistrogene Mox Rokl 5 $3,321,781.51 $3,392,000.00 $3,392,000.00 nat. median
$3,324,572
1.0× median
J3394
HCPCS 		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
HCPCS 		Inj- Betibeglogene Autotemce 2 $2,968,000.00 $2,968,000.00 $2,968,000.00 nat. median
$2,997,086
1.0× median
J3392
HCPCS 		Inj- Exagamglogene Autotem 1 $2,332,000.00 $2,332,000.00 $2,332,000.00 nat. median
$2,405,851
1.0× median
J3399
HCPCS 		Inj Onase Abepar-xioi Treat 5 $2,278,010.83 $2,403,458.75 $2,278,010.83 nat. median
$2,460,273
0.9× median
5834
APR_DRG 		Neonate W Ecmo 5 $260,426.64 $1,112,292.30 $553,938.84 nat. median
$311,018
1.8× median
18
MS_DRG 		Chimeric Antigen Receptor (car) T-cell Immunotherapy 1 $551,042.76 $551,042.76 $551,042.76 nat. median
$370,165
1.5× median
Q2042
HCPCS 		Tisagenlecleucel Car-pos T 5 $334,050.97 $1,762,672.55 $547,408.35 nat. median
$691,418
0.8× median
Q2056
HCPCS 		Ciltacabtagene Car-pos T 5 $342,599.09 $1,807,778.04 $539,220.89 nat. median
$631,793
0.9× median
Q2055
HCPCS 		Idecabtagene Vicleucel Car 5 $333,244.61 $1,758,417.65 $527,450.01 nat. median
$610,161
0.9× median
Q2054
HCPCS 		Lisocabtagene Mara Car Pos T 5 $326,354.89 $1,722,062.99 $516,606.03 nat. median
$624,417
0.8× median
Q2041
HCPCS 		Axicabtagene Ciloleucel Car+ 5 $309,731.34 $1,634,346.18 $489,486.56 nat. median
$588,565
0.8× median
Q2053
HCPCS 		Brexucabtagene Car Pos T 5 $309,798.99 $1,634,703.17 $474,290.96 nat. median
$577,541
0.8× median
24
APR_DRG 		Heart Or Lung Transplant 5 $197,053.53 $824,593.73 $410,660.48 nat. median
$243,231
1.7× median
5891
APR_DRG 		Neonate Bwt 500g Or Ga 24 Weeks 5 $41,692.84 $740,114.22 $368,588.38 nat. median
$96,420
outlier · 3.8×
5884
APR_DRG 		Neonate Bwt 1500g W Major Procedure 5 $213,642.89 $719,556.46 $358,350.29 nat. median
$254,667
1.4× 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
$261,939
1.4× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 4 $183,603.51 $710,304.74 $353,742.79 nat. median
$165,646
outlier · 2.1×
5914
APR_DRG 		Neonate Birthwt 500749g Wo Major Procedure 5 $134,558.16 $675,705.69 $336,511.93 nat. median
$168,361
2.0× median
5934
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 5 $139,297.97 $665,144.31 $331,252.19 nat. median
$156,285
outlier · 2.1×
5833
APR_DRG 		Neonate W Ecmo 5 $206,269.84 $650,239.57 $323,829.40 nat. median
$250,089
1.3× median
5892
APR_DRG 		Neonate Bwt 500g Or Ga 24 Weeks 5 $34,670.89 $592,092.54 $294,871.28 nat. median
$89,188
outlier · 3.3×
6094
APR_DRG 		Neonate Bwt 15002499g W Major Procedure 4 $170,402.25 $578,001.99 $287,853.97 nat. median
$168,174
1.7× 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
$205,166
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
$199,832
1.4× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 5 $204,251.03 $534,510.52 $266,194.54 nat. median
$209,486
1.3× median
5933
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 5 $89,617.66 $517,105.24 $257,526.44 nat. median
$112,711
outlier · 2.3×
6024
APR_DRG 		Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 5 $99,887.27 $504,234.54 $251,116.63 nat. median
$123,690
outlier · 2.0×
5893
APR_DRG 		Neonate Bwt 500g Or Ga 24 Weeks 5 $27,561.16 $502,664.10 $250,334.53 nat. median
$71,350
outlier · 3.5×
5883
APR_DRG 		Neonate Bwt 1500g W Major Procedure 5 $137,630.26 $496,941.53 $247,484.60 nat. median
$180,995
1.4× median
6074
APR_DRG 		Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 5 $76,714.83 $438,197.62 $218,229.22 nat. median
$99,613
outlier · 2.2×
5832
APR_DRG 		Neonate W Ecmo 5 $152,113.04 $419,760.83 $209,047.41 nat. median
$169,230
1.2× median
1613
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 5 $156,501.76 $417,390.67 $207,867.04 nat. median
$127,938
1.6× median
5932
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 5 $71,009.49 $410,697.45 $204,533.71 nat. median
$89,063
outlier · 2.3×
54
APR_DRG 		Tracheostomy W Mv 96+ Hours Without Extensive Procedure 5 $84,351.20 $405,186.40 $201,789.12 nat. median
$88,000
outlier · 2.3×
5882
APR_DRG 		Neonate Bwt 1500g W Major Procedure 5 $134,733.70 $402,804.66 $200,602.97 nat. median
$147,847
1.4× median
6114
APR_DRG 		Neonate Birthwt 15001999g W Major Anomaly 4 $74,303.21 $398,753.95 $198,585.66 nat. median
$79,344
outlier · 2.5×
6023
APR_DRG 		Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 5 $78,733.64 $397,603.64 $198,012.79 nat. median
$92,000
outlier · 2.2×
6304
APR_DRG 		Neonate Birthwt 2499g W Major Cardiovascular Procedure 4 $140,121.07 $281,358.84 $197,648.44 nat. median
$160,171
1.2× median
6034
APR_DRG 		Neonate Birthwt 10001249g W Or Wo Other Significant Condition 5 $112,000.13 $393,648.56 $196,043.09 nat. median
$109,499
1.8× median
23
APR_DRG 		Heart Or Lung Transplant 5 $121,918.64 $393,350.11 $195,894.47 nat. median
$116,111
1.7× median
6214
APR_DRG 		Neonate Bwt 20002499g W Major Anomaly 4 $58,292.30 $386,286.01 $192,376.43 nat. median
$69,851
outlier · 2.8×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 5 $129,203.92 $378,627.92 $188,562.58 nat. median
$175,480
1.1× median
5931
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 5 $1,316.62 $373,363.16 $185,940.65 nat. median
$29,157
outlier · 6.4×
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 5 $127,975.08 $368,066.53 $183,302.85 nat. median
$127,600
1.4× median
14
APR_DRG 		Liver Transplant Or Intestinal Transplant 5 $125,956.26 $365,058.92 $181,805.01 nat. median
$137,901
1.3× median
6314
APR_DRG 		Neonate Birthwt 2499g W Other Major Procedure 4 $163,593.50 $364,972.00 $181,761.72 nat. median
$147,677
1.2× median

Other procedures at this hospital

Browse this hospital's 18,714 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
             
J1411 HCPCS Inj- Hemgenix- Per Tx Dose 6 5 — — $3,672,900.00 $3,710,000.00 $3,710,000.00 2026-01-01
C9172 HCPCS Inj Beqvez Per Tx Dose 1 1 — — $3,605,000.00 $3,605,000.00 $3,605,000.00 2026-01-01
J1414 HCPCS Inj- Beqvez- Per Tx Dose 1 1 — — $3,500,000.00 $3,500,000.00 $3,500,000.00 2026-01-01
J1413 HCPCS Inj Delandistrogene Mox Rokl 6 5 — — $3,321,781.51 $3,392,000.00 $3,392,000.00 2026-01-01
J3394 HCPCS Inj- Lovotibeglogene Autotem 2 2 — — $3,193,000.00 $3,286,000.00 $3,239,500.00 2026-01-01
J3393 HCPCS Inj- Betibeglogene Autotemce 2 2 — — $2,968,000.00 $2,968,000.00 $2,968,000.00 2026-01-01
J3392 HCPCS Inj- Exagamglogene Autotem 1 1 — — $2,332,000.00 $2,332,000.00 $2,332,000.00 2026-01-01
J3399 HCPCS Inj Onase Abepar-xioi Treat 6 5 — — $2,278,010.83 $2,403,458.75 $2,278,010.83 2026-01-01
5834 APR_DRG Neonate W Ecmo 6 5 — — $260,426.64 $1,112,292.30 $553,938.84 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
Q2042 HCPCS Tisagenlecleucel Car-pos T 6 5 — — $334,050.97 $1,762,672.55 $547,408.35 2026-01-01
Q2056 HCPCS Ciltacabtagene Car-pos T 6 5 — — $342,599.09 $1,807,778.04 $539,220.89 2026-01-01
Q2055 HCPCS Idecabtagene Vicleucel Car 6 5 — — $333,244.61 $1,758,417.65 $527,450.01 2026-01-01
Q2054 HCPCS Lisocabtagene Mara Car Pos T 6 5 — — $326,354.89 $1,722,062.99 $516,606.03 2026-01-01
Q2041 HCPCS Axicabtagene Ciloleucel Car+ 6 5 — — $309,731.34 $1,634,346.18 $489,486.56 2026-01-01
Q2053 HCPCS Brexucabtagene Car Pos T 6 5 — — $309,798.99 $1,634,703.17 $474,290.96 2026-01-01
24 APR_DRG Heart Or Lung Transplant 6 5 — — $197,053.53 $824,593.73 $410,660.48 2026-01-01
5891 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 6 5 — — $41,692.84 $740,114.22 $368,588.38 2026-01-01
5884 APR_DRG Neonate Bwt 1500g W Major Procedure 6 5 — — $213,642.89 $719,556.46 $358,350.29 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
8414 APR_DRG Extensive 3rd Degree Burns W Skin Graft 5 4 — — $183,603.51 $710,304.74 $353,742.79 2026-01-01
5914 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 6 5 — — $134,558.16 $675,705.69 $336,511.93 2026-01-01
5934 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 6 5 — — $139,297.97 $665,144.31 $331,252.19 2026-01-01
5833 APR_DRG Neonate W Ecmo 6 5 — — $206,269.84 $650,239.57 $323,829.40 2026-01-01
5892 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 6 5 — — $34,670.89 $592,092.54 $294,871.28 2026-01-01
6094 APR_DRG Neonate Bwt 15002499g W Major Procedure 5 4 — — $170,402.25 $578,001.99 $287,853.97 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
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
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 6 5 — — $204,251.03 $534,510.52 $266,194.54 2026-01-01
5933 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 6 5 — — $89,617.66 $517,105.24 $257,526.44 2026-01-01
6024 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $99,887.27 $504,234.54 $251,116.63 2026-01-01
5893 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 6 5 — — $27,561.16 $502,664.10 $250,334.53 2026-01-01
5883 APR_DRG Neonate Bwt 1500g W Major Procedure 6 5 — — $137,630.26 $496,941.53 $247,484.60 2026-01-01
6074 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $76,714.83 $438,197.62 $218,229.22 2026-01-01
5832 APR_DRG Neonate W Ecmo 6 5 — — $152,113.04 $419,760.83 $209,047.41 2026-01-01
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 6 5 — — $156,501.76 $417,390.67 $207,867.04 2026-01-01
5932 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 6 5 — — $71,009.49 $410,697.45 $204,533.71 2026-01-01
54 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 6 5 — — $84,351.20 $405,186.40 $201,789.12 2026-01-01
5882 APR_DRG Neonate Bwt 1500g W Major Procedure 6 5 — — $134,733.70 $402,804.66 $200,602.97 2026-01-01
6114 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 5 4 — — $74,303.21 $398,753.95 $198,585.66 2026-01-01
6023 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $78,733.64 $397,603.64 $198,012.79 2026-01-01
6304 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 5 4 — — $140,121.07 $281,358.84 $197,648.44 2026-01-01
6034 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 6 5 — — $112,000.13 $393,648.56 $196,043.09 2026-01-01
23 APR_DRG Heart Or Lung Transplant 6 5 — — $121,918.64 $393,350.11 $195,894.47 2026-01-01
6214 APR_DRG Neonate Bwt 20002499g W Major Anomaly 5 4 — — $58,292.30 $386,286.01 $192,376.43 2026-01-01
74 APR_DRG Allogeneic Bone Marrow Transplant 6 5 — — $129,203.92 $378,627.92 $188,562.58 2026-01-01
5931 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 6 5 — — $1,316.62 $373,363.16 $185,940.65 2026-01-01
44 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 6 5 — — $127,975.08 $368,066.53 $183,302.85 2026-01-01
14 APR_DRG Liver Transplant Or Intestinal Transplant 6 5 — — $125,956.26 $365,058.92 $181,805.01 2026-01-01
6314 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 5 4 — — $163,593.50 $364,972.00 $181,761.72 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
94 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 6 5 — — $125,341.84 $353,182.07 $175,890.16 2026-01-01
5913 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 6 5 — — $78,821.41 $352,060.74 $175,331.72 2026-01-01
114 APR_DRG Psychiatric 5 4 — — $162,881.51 $327,061.11 $171,276.15 2026-01-01
5831 APR_DRG Neonate W Ecmo 6 5 — — $131,398.28 $343,440.68 $171,038.79 2026-01-01
64 APR_DRG Pancreas Transplant 6 5 — — $111,297.94 $343,333.47 $170,985.40 2026-01-01
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 6 5 — — $125,605.17 $335,127.75 $166,898.82 2026-01-01
7 MS_DRG Lung Transplant 2 1 — — $165,253.62 $165,253.62 $165,253.62 2026-01-01
1611 APR_DRG Cardiac Defibrillator & Heart Assist Implant 6 5 — — $119,373.18 $318,371.51 $158,553.95 2026-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $153,356.82 $153,356.82 $153,356.82 2026-01-01
6073 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $59,686.59 $306,639.53 $152,711.25 2026-01-01
13 APR_DRG Liver Transplant Or Intestinal Transplant 6 5 — — $72,852.75 $304,034.68 $151,413.99 2026-01-01
E0766 HCPCS Elec Stim Cancer Treatment 4 3 — — $149,026.20 $149,026.20 $149,026.20 2026-01-01
6113 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 5 4 — — $48,396.39 $294,620.70 $146,725.68 2026-01-01
22 APR_DRG Heart Or Lung Transplant 6 5 — — $90,407.63 $291,908.64 $145,375.04 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
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
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 6 5 — — $87,598.85 $284,195.49 $141,533.77 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
212 MS_DRG Testes Procedures Age 0-17 2 1 — — $138,761.13 $138,761.13 $138,761.13 2026-01-01
5912 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 6 5 — — $41,956.16 $270,678.66 $134,802.17 2026-01-01
5881 APR_DRG Neonate Bwt 1500g W Major Procedure 6 5 — — $88,739.92 $265,141.53 $132,044.60 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
73 APR_DRG Allogeneic Bone Marrow Transplant 6 5 — — $76,188.18 $263,026.36 $130,991.21 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
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
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 6 5 — — $62,144.28 $250,332.41 $124,669.43 2026-01-01
21 APR_DRG Heart Or Lung Transplant 6 5 — — $77,504.80 $250,245.49 $124,626.14 2026-01-01
6124 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 5 4 — — $71,052.69 $250,144.07 $124,575.63 2026-01-01
5911 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 6 5 — — $1,141.07 $246,073.09 $122,548.22 2026-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 6 5 — — $86,457.78 $244,418.61 $121,724.27 2026-01-01
63 APR_DRG Pancreas Transplant 6 5 — — $78,206.99 $242,572.91 $120,805.07 2026-01-01
1784 APR_DRG External Heart Assist Systems 6 5 — — $68,815.13 $240,475.12 $119,760.34 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
4404 APR_DRG Kidney Transplant 6 5 — — $73,993.82 $230,087.58 $114,587.19 2026-01-01
6022 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $60,125.46 $229,258.89 $114,174.49 2026-01-01
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 5 4 — — $67,380.33 $227,731.91 $113,414.03 2026-01-01
84 APR_DRG Autologous Bone Marrow Transplant 6 5 — — $65,391.93 $224,738.79 $111,923.41 2026-01-01
6093 APR_DRG Neonate Bwt 15002499g W Major Procedure 6 5 — — $66,620.77 $224,733.00 $111,920.52 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
231 MS_DRG Coronary Bypass With Ptca With Mcc 2 1 — — $107,571.42 $107,571.42 $107,571.42 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
62 APR_DRG Pancreas Transplant 6 5 — — $67,937.39 $210,578.71 $104,871.47 2026-01-01
6303 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 5 4 — — $95,499.29 $208,512.79 $103,842.61 2026-01-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 6 5 — — $77,855.89 $206,736.63 $102,958.05 2026-01-01
72 APR_DRG Allogeneic Bone Marrow Transplant 6 5 — — $59,598.82 $205,742.78 $102,463.10 2026-01-01
6334 APR_DRG Neonate Birthwt 2499g W Major Anomaly 5 4 — — $52,981.81 $205,313.95 $102,249.54 2026-01-01
1694 APR_DRG Major Thoracic Abdominal Vascular Procedures 6 5 — — $53,454.61 $203,282.81 $101,237.99 2026-01-01
113 APR_DRG Pediatric 5 4 — — $84,306.53 $202,952.49 $101,073.49 2026-01-01
1624 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 6 5 — — $81,454.64 $195,071.29 $100,489.73 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
6084 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 6 5 — — $48,539.24 $201,570.38 $100,385.18 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
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 6 5 — — $60,213.24 $196,598.27 $97,908.99 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
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
8424 APR_DRG Full Thickness Burns W Skin Graft 5 4 — — $92,788.10 $193,355.97 $96,294.28 2026-01-01
6033 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 6 5 — — $54,507.90 $191,559.52 $95,399.62 2026-01-01
Q0480 HCPCS Driver Pneumatic Vad- Rep 6 5 — — $94,999.95 $99,999.95 $94,999.95 2026-01-01
8634 APR_DRG Neonatal Aftercare 5 4 — — $72,844.11 $189,583.43 $94,415.49 2026-01-01
12 APR_DRG Liver Transplant Or Intestinal Transplant 6 5 — — $61,090.98 $189,482.01 $94,364.99 2026-01-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 6 5 — — $43,448.33 $187,337.86 $93,297.17 2026-01-01
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 6 5 — — $47,310.40 $187,239.35 $93,248.10 2026-01-01
5894 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 6 5 — — $614.42 $186,712.00 $92,985.48 2026-01-01
93 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 6 5 — — $57,755.56 $186,375.89 $92,818.09 2026-01-01
J7330 HCPCS Autologous Cultured Chondrocytes Sheet 43 38 $197,466.00 $145,927.37 26% off $78,591.47 $178,706.73 $92,809.02 2026-01-01
4403 APR_DRG Kidney Transplant 6 5 — — $48,802.57 $186,257.10 $92,758.93 2026-01-01
6083 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 6 5 — — $46,257.11 $185,619.65 $92,441.47 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
10 MS_DRG Pancreas Transplant 2 1 — — $91,566.96 $91,566.96 $91,566.96 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
19 MS_DRG Simultaneous Pancreas And Kidney Transplant With Hemodialysis 2 1 — — $91,042.49 $91,042.49 $91,042.49 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
71 APR_DRG Allogeneic Bone Marrow Transplant 6 5 — — $53,015.74 $182,191.90 $90,734.40 2026-01-01
234 APR_DRG Spinal Procedures 6 5 — — $50,558.05 $180,864.85 $90,073.50 2026-01-01
6134 APR_DRG Neonate Birthwt 15001999g W Congenitalperinatal Infection 5 4 — — $69,711.08 $180,528.74 $89,906.12 2026-01-01
6072 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $46,169.33 $178,080.35 $88,686.78 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
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 6 5 — — $45,467.14 $176,489.62 $87,894.57 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
1674 APR_DRG Other Cardiothoracic Procedures 6 5 — — $62,319.82 $173,438.56 $86,375.09 2026-01-01
1634 APR_DRG Cardiac Valve Procedures Wo Cardiac Catheterization 6 5 — — $69,341.78 $169,295.13 $86,332.67 2026-01-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 5 4 — — $71,950.08 $172,818.49 $86,066.29 2026-01-01
6123 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 5 4 — — $49,969.62 $172,801.11 $86,057.63 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
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 6 5 — — $34,758.66 $172,262.17 $85,789.24 2026-01-01
6904 APR_DRG Acute Leukemia 5 4 — — $58,121.10 $171,671.08 $85,494.86 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
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
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
9114 APR_DRG Extensive AbdominalThoraic Procedures For Mult Si 5 4 — — $67,974.49 $168,344.75 $83,838.30 2026-01-01
11 APR_DRG Liver Transplant Or Intestinal Transplant 6 5 — — $54,244.58 $168,234.65 $83,783.47 2026-01-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 5 4 — — $59,257.94 $168,060.80 $83,696.89 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
61 APR_DRG Pancreas Transplant 6 5 — — $53,366.84 $165,522.59 $82,432.82 2026-01-01
1654 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 6 5 — — $63,373.12 $165,041.60 $82,193.28 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
914 APR_DRG Other Major Head & Neck Procedures 6 5 — — $52,840.19 $162,439.65 $80,897.47 2026-01-01
1794 APR_DRG Defibrillator Implants 6 5 — — $56,087.84 $161,468.98 $80,414.06 2026-01-01
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 5 4 — — $64,663.54 $161,216.90 $80,288.52 2026-01-01
4402 APR_DRG Kidney Transplant 6 5 — — $41,868.39 $159,744.97 $79,555.48 2026-01-01
6224 APR_DRG Neonate Bwt 20002499g W Resp Dist Syndoth Maj Resp Cond 5 4 — — $46,009.69 $159,588.51 $79,477.55 2026-01-01
2614 APR_DRG Major Biliary Tract Procedures 6 5 — — $43,272.78 $159,249.50 $79,308.72 2026-01-01
1783 APR_DRG External Heart Assist Systems 6 5 — — $50,909.15 $158,049.93 $78,711.32 2026-01-01
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 6 5 — — $36,865.25 $157,409.59 $78,392.42 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
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
7404 APR_DRG Mental Illness Diagnosis W Or Procedure 5 4 — — $62,000.47 $156,294.05 $77,836.86 2026-01-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 6 5 — — $53,103.51 $156,239.00 $77,809.45 2026-01-01
6144 APR_DRG Neonate Bwt 15001999g W Or Wo Other Significant Condition 5 4 — — $56,020.85 $155,589.96 $77,486.21 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
1782 APR_DRG External Heart Assist Systems 6 5 — — $47,485.95 $155,288.62 $77,336.14 2026-01-01
6814 APR_DRG Other Or Procedures For Lymphatichematopoieticother Neoplasms 5 4 — — $60,719.28 $154,700.42 $77,043.21 2026-01-01
6213 APR_DRG Neonate Bwt 20002499g W Major Anomaly 5 4 — — $34,217.19 $154,471.52 $76,929.22 2026-01-01
28 MS_DRG Spinal Procedures With Mcc 2 1 — — $76,670.11 $76,670.11 $76,670.11 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
1204 APR_DRG Major Respiratory & Chest Procedures 6 5 — — $45,818.24 $153,886.23 $76,637.73 2026-01-01
214 APR_DRG Craniotomy Except For Trauma 6 5 — — $49,943.63 $153,857.25 $76,623.30 2026-01-01
204 APR_DRG Craniotomy For Trauma 6 5 — — $46,081.56 $153,269.06 $76,330.37 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
790 MS_DRG Extreme Immaturity Or Respiratory Distress Syndrome- Neonate 2 1 — — $75,843.22 $75,843.22 $75,843.22 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
6021 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 6 5 — — $11,849.54 $151,272.68 $75,336.14 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
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
1781 APR_DRG External Heart Assist Systems 6 5 — — $42,307.26 $149,064.79 $74,236.58 2026-01-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 5 4 — — $66,043.20 $148,592.49 $74,001.37 2026-01-01
6804 APR_DRG Major Or Procedures For Lymphatichematopoieticother Neoplasms 5 4 — — $71,207.10 $147,917.38 $73,665.15 2026-01-01
430 MS_DRG Combined Anterior And Posterior Cervical Spinal Fusion Without Mcc 2 1 — — $73,592.23 $73,592.23 $73,592.23 2026-01-01
4414 APR_DRG Major Bladder Procedures 6 5 — — $49,855.86 $147,024.95 $73,220.71 2026-01-01
23 MS_DRG Craniotomy With Major Device Implant Or Acute Complex Cns Principal Diagnosis Wi… 2 1 — — $73,122.64 $73,122.64 $73,122.64 2026-01-01
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 6 5 — — $37,742.99 $146,558.45 $72,988.38 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
463 MS_DRG Wound Debridement And Skin Graft Except Hand For Musculoskeletal And Connective … 2 1 — — $72,729.61 $72,729.61 $72,729.61 2026-01-01
894 APR_DRG Major CranialFacial Bone Procedures 6 5 — — $46,959.30 $145,625.45 $72,523.74 2026-01-01
428 MS_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical Wit… 2 1 — — $71,740.66 $71,740.66 $71,740.66 2026-01-01
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 6 5 — — $44,940.49 $143,614.59 $71,522.30 2026-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 2 1 — — $71,518.62 $71,518.62 $71,518.62 2026-01-01
278 MS_DRG Ultrasound Accelerated And Other Thrombolysis Of Peripheral Vascular Structures … 2 1 — — $71,028.61 $71,028.61 $71,028.61 2026-01-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 6 5 — — $59,774.37 $130,260.01 $70,531.18 2026-01-01
461 MS_DRG Bilateral Or Multiple Major Joint Procs Of Lower Extremity W Mcc 2 1 — — $70,477.35 $70,477.35 $70,477.35 2026-01-01
834 MS_DRG Acute Leukemia Without Major O.r. Procedures With Mcc 2 1 — — $70,054.97 $70,054.97 $70,054.97 2026-01-01
1814 APR_DRG Lower Extremity Arterial Procedures 6 5 — — $44,238.30 $140,647.55 $70,044.66 2026-01-01
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 6 5 — — $29,579.97 $140,505.57 $69,973.96 2026-01-01
274 APR_DRG Other Open Craniotomy 6 5 — — $43,974.97 $140,491.08 $69,966.74 2026-01-01
405 MS_DRG Pancreas- Liver And Shunt Procedures With Mcc 2 1 — — $69,807.41 $69,807.41 $69,807.41 2026-01-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 6 5 — — $58,721.07 $129,674.72 $69,736.46 2026-01-01
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 2 1 — — $69,707.88 $69,707.88 $69,707.88 2026-01-01
1664 APR_DRG Coronary Bypass Wo Cardiac Cath Or Percutaneous Cardiac Procedure 6 5 — — $57,141.13 $133,305.28 $69,609.95 2026-01-01
11 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Mcc 2 1 — — $69,598.13 $69,598.13 $69,598.13 2026-01-01
17 MS_DRG Autologous Bone Marrow Transplant Without Cc/mcc 2 1 — — $69,319.95 $69,319.95 $69,319.95 2026-01-01
1824 APR_DRG Other Peripheral Vascular Procedures 6 5 — — $37,567.44 $139,106.08 $69,276.99 2026-01-01
6514 APR_DRG Other Procedures Of Blood & Blood-forming Organs 5 4 — — $52,556.61 $138,958.31 $69,203.39 2026-01-01
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 5 4 — — $48,877.54 $138,401.99 $68,926.34 2026-01-01
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 6 5 — — $49,241.44 $138,239.73 $68,845.53 2026-01-01
6122 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 5 4 — — $38,696.30 $138,158.60 $68,805.13 2026-01-01
220 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $68,050.26 $68,050.26 $68,050.26 2026-01-01
450 MS_DRG Single Level Spinal Fusion Except Cervical With Mcc Or Custom-made Anatomically … 2 1 — — $68,009.43 $68,009.43 $68,009.43 2026-01-01
92 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 6 5 — — $42,131.71 $135,936.21 $67,698.35 2026-01-01
21 MS_DRG Intracranial Vascular Procedures With Principal Diagnosis Hemorrhage With Cc 2 1 — — $67,552.59 $67,552.59 $67,552.59 2026-01-01
6082 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 6 5 — — $34,144.24 $135,631.98 $67,546.83 2026-01-01
6614 APR_DRG Coagulation & Platelet Disorders 5 4 — — $24,933.34 $135,446.54 $67,454.48 2026-01-01
270 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $67,329.28 $67,329.28 $67,329.28 2026-01-01
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 6 5 — — $58,984.40 $118,840.96 $67,172.49 2026-01-01
L8702 HCPCS Ewhf S/d Uprt Micro Sensor 2 2 — — $65,871.74 $67,452.66 $66,662.20 2026-01-01
7924 APR_DRG Extensive Or Procedures For Other Complications Of Treatment 5 4 — — $53,000.83 $133,490.72 $66,480.45 2026-01-01
466 MS_DRG Revision Of Hip Or Knee Replacement With Mcc 2 1 — — $66,424.55 $66,424.55 $66,424.55 2026-01-01
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $66,309.70 $66,309.70 $66,309.70 2026-01-01
3094 APR_DRG Other Significant Hip & Femur Surgery 6 5 — — $35,373.08 $132,685.22 $66,079.30 2026-01-01
6954 APR_DRG Chemotherapy For Acute Leukemia 5 4 — — $54,700.50 $132,606.99 $66,040.34 2026-01-01
1303 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 6 5 — — $33,529.82 $131,949.25 $65,712.78 2026-01-01
A9543 HCPCS Y90 Ibritumomab- Rx 6 5 — — $56,824.55 $65,476.58 $65,476.58 2026-01-01
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 6 5 — — $40,200.68 $131,282.83 $65,380.89 2026-01-01
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 6 5 — — $43,448.33 $131,039.44 $65,259.68 2026-01-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 6 5 — — $42,307.26 $130,909.05 $65,194.74 2026-01-01
924 APR_DRG Facial Bone Procedures Except Major Cranialfacial Bone Procedures 6 5 — — $41,780.61 $130,662.76 $65,072.09 2026-01-01
1214 APR_DRG Other Respiratory & Chest Procedures 6 5 — — $37,479.67 $129,590.69 $64,538.18 2026-01-01
1623 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 6 5 — — $55,824.52 $116,233.21 $64,500.65 2026-01-01
221 MS_DRG Cardiac Valve And Other Major Cardiothoracic Procedures Without Cardiac Catheter… 2 1 — — $64,316.48 $64,316.48 $64,316.48 2026-01-01
4401 APR_DRG Kidney Transplant 6 5 — — $37,391.89 $128,002.86 $63,747.41 2026-01-01
326 MS_DRG Stomach- Esophageal And Duodenal Procedures With Mcc 2 1 — — $63,642.72 $63,642.72 $63,642.72 2026-01-01
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $63,132.29 $63,132.29 $63,132.29 2026-01-01
853 MS_DRG Infectious And Parasitic Diseases With O.r. Procedures With Mcc 2 1 — — $63,019.99 $63,019.99 $63,019.99 2026-01-01
6504 APR_DRG Splenectomy 5 4 — — $47,695.94 $126,357.08 $62,927.79 2026-01-01
224 APR_DRG Ventricular Shunt Procedures 6 5 — — $38,094.09 $126,290.44 $62,894.60 2026-01-01
83 APR_DRG Autologous Bone Marrow Transplant 6 5 — — $41,166.19 $126,252.77 $62,875.84 2026-01-01
4044 APR_DRG Thyroid, Parathyroid & Thyroglossal Procedures 6 5 — — $40,815.10 $126,241.18 $62,870.07 2026-01-01
6313 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 5 4 — — $52,076.43 $104,567.88 $62,824.01 2026-01-01
239 MS_DRG Amputation For Circulatory System Disorders Except Upper Limb And Toe With Mcc 2 1 — — $62,804.34 $62,804.34 $62,804.34 2026-01-01
3214 APR_DRG Cervical Spinal Fusion & Other Back/neck Proc Exc Disc Excis/decomp 6 5 — — $39,235.16 $125,728.32 $62,614.66 2026-01-01
576 MS_DRG Skin Graft Except For Skin Ulcer Or Cellulitis With Mcc 2 1 — — $62,542.74 $62,542.74 $62,542.74 2026-01-01
J9226 HCPCS Histrelin Acetate (cpp) 50 Mg Kit 49 41 $132,981.50 $98,273.33 26% off $44,695.10 $120,348.26 $62,501.30 2026-01-01
4054 APR_DRG Other Procedures For Endocrine, Nutritional & Metabolic Disorders 6 5 — — $38,006.32 $125,059.00 $62,281.32 2026-01-01
6234 APR_DRG Neonate Bwt 20002499g W Congenitalperinatal Infection 5 4 — — $42,225.44 $124,775.04 $62,139.91 2026-01-01
J9029 HCPCS Instill Adstiladrin- Tx Dose 6 5 — — $61,800.00 $63,402.04 $61,800.00 2026-01-01
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $61,617.59 $61,617.59 $61,617.59 2026-01-01
3054 APR_DRG Amputation Of Lower Limb Except Toes 6 5 — — $33,705.37 $123,155.34 $61,333.27 2026-01-01
837 MS_DRG Chemotherapy With Acute Leukemia As Secondary Diagnosis Or With High Dose Chemot… 2 1 — — $61,306.23 $61,306.23 $61,306.23 2026-01-01
7504 APR_DRG Schizophrenia 5 4 — — $27,226.05 $122,616.41 $61,064.87 2026-01-01
4444 APR_DRG Renal Dialysis Access Device Procedure Only 6 5 — — $29,667.75 $122,283.19 $60,898.93 2026-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 3 2 — — $31,903.78 $60,751.14 $60,751.14 2026-01-01
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 5 4 — — $44,043.72 $121,813.80 $60,665.16 2026-01-01
6302 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 5 4 — — $58,269.78 $117,003.95 $60,590.60 2026-01-01
1793 APR_DRG Defibrillator Implants 6 5 — — $40,902.87 $121,489.28 $60,503.55 2026-01-01
4014 APR_DRG Pituitary & Adrenal Procedures 6 5 — — $41,517.29 $120,796.78 $60,158.67 2026-01-01
650 MS_DRG Neonate Birthwt 1500-1999g Without Signif O.r. Proc With Other Prob 3 2 — — $31,524.78 $59,993.16 $59,993.16 2026-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 3 2 — — $31,463.53 $59,870.65 $59,870.65 2026-01-01
8633 APR_DRG Neonatal Aftercare 5 4 — — $46,739.24 $120,107.17 $59,815.24 2026-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 3 2 — — $31,374.21 $59,692.00 $59,692.00 2026-01-01
6143 APR_DRG Neonate Bwt 15001999g W Or Wo Other Significant Condition 5 4 — — $42,976.25 $119,359.62 $59,442.94 2026-01-01
6 MS_DRG Liver Transplant Without Mcc 3 2 — — $31,113.89 $59,171.37 $59,171.37 2026-01-01
277 MS_DRG Other Major Cardiovascular Procedures With Mcc 3 2 — — $30,995.85 $58,935.29 $58,935.29 2026-01-01
2644 APR_DRG Other Hepatobiliary, Pancreas & Abdominal Procedures 6 5 — — $38,445.19 $117,847.12 $58,689.70 2026-01-01
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 5 4 — — $37,867.17 $117,826.84 $58,679.60 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 3 2 — — $30,855.49 $58,654.56 $58,654.56 2026-01-01
6133 APR_DRG Neonate Birthwt 15001999g W Congenitalperinatal Infection 5 4 — — $45,458.06 $117,722.53 $58,627.65 2026-01-01
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 5 4 — — $34,154.52 $117,684.86 $58,608.89 2026-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 3 2 — — $30,780.83 $58,505.26 $58,505.26 2026-01-01
245 MS_DRG Aicd Generator Procedures 3 2 — — $30,637.92 $58,219.42 $58,219.42 2026-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 3 2 — — $30,550.51 $58,044.60 $58,044.60 2026-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 3 2 — — $30,537.74 $58,019.07 $58,019.07 2026-01-01
7594 APR_DRG Eating Disorders 5 4 — — $52,652.18 $105,723.98 $58,017.04 2026-01-01
1704 APR_DRG Permanent Cardiac Pacemaker Implant W Ami, Heart Failure Or Shock 6 5 — — $37,742.99 $116,424.45 $57,981.18 2026-01-01
3134 APR_DRG Knee & Lower Leg Procedures Except Foot 6 5 — — $33,617.60 $116,302.75 $57,920.58 2026-01-01
799 MS_DRG Splenic Procedures With Mcc 3 2 — — $30,424.17 $57,791.93 $57,791.93 2026-01-01
3644 APR_DRG Other Skin, Subcutaneous Tissue & Related Procedures 6 5 — — $25,366.80 $115,815.97 $57,678.15 2026-01-01
8423 APR_DRG Full Thickness Burns W Skin Graft 5 4 — — $38,265.51 $115,723.25 $57,631.98 2026-01-01
2004 APR_DRG Cardiac Structural & Valvular Disorders 6 5 — — $12,288.42 $115,633.43 $57,587.24 2026-01-01
1653 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 6 5 — — $46,783.76 $110,855.45 $57,440.96 2026-01-01
7114 APR_DRG Postop Posttrauma Other Device Infections W Or Procedure 5 4 — — $46,107.04 $115,100.29 $57,321.73 2026-01-01
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $30,123.66 $57,190.91 $57,190.91 2026-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $30,115.37 $57,174.32 $57,174.32 2026-01-01
6032 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 6 5 — — $26,858.97 $114,459.94 $57,002.83 2026-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $30,003.07 $56,949.73 $56,949.73 2026-01-01
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 5 4 — — $40,606.33 $113,231.40 $56,391.00 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $29,555.81 $56,055.20 $56,055.20 2026-01-01
6903 APR_DRG Acute Leukemia 5 4 — — $33,381.34 $112,324.49 $55,939.34 2026-01-01
38240 CPT Transplt Allo Hct/donor 6 5 — — $35,926.56 $189,572.17 $55,913.53 2026-01-01
91 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 6 5 — — $34,583.11 $111,562.44 $55,559.83 2026-01-01
1804 APR_DRG Other Circulatory System Procedures 6 5 — — $31,774.33 $111,235.03 $55,396.77 2026-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $29,138.53 $55,220.65 $55,220.65 2026-01-01
264 APR_DRG Other Nervous System & Related Procedures 6 5 — — $38,357.41 $110,678.71 $55,119.71 2026-01-01
8154 APR_DRG Other Injury, Poisoning & Toxic Effect Diagnoses 5 4 — — $20,568.36 $110,400.55 $54,981.19 2026-01-01
6212 APR_DRG Neonate Bwt 20002499g W Major Anomaly 5 4 — — $14,388.45 $110,359.98 $54,960.98 2026-01-01
2304 APR_DRG Major Small Bowel Procedures 6 5 — — $42,395.04 $110,136.87 $54,849.87 2026-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $28,918.41 $54,780.41 $54,780.41 2026-01-01
2324 APR_DRG Gastric Fundoplication 6 5 — — $34,846.44 $109,566.07 $54,565.60 2026-01-01
1633 APR_DRG Cardiac Valve Procedures Wo Cardiac Catheterization 6 5 — — $46,169.33 $100,638.87 $54,469.52 2026-01-01
140 MS_DRG Simple Pneumonia And Pleurisy Age 0-17 3 2 — — $28,742.31 $54,428.21 $54,428.21 2026-01-01
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