Price Transparency Hospital negotiated rates

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 FOSSTON

Fosston, MN · CCN 241357 · Rates published

15,404 distinct procedures filed
44 distinct payers
405,571 rate rows
2026-01-01 last MRF observed
Data quality

388,708 of 405,571 rate rows are consumer-grade (95.8%)

16,863 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 285
percent-of-charges filed in the dollar field — excluded from medians 275
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 83
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://www.essentiahealth.org/standard-charges/2026/410706143_Essentia-Fosston_standardcharges.csv
Found on page https://www.essentiahealth.org/patients-visitors/billing/price-estimates/
Discovered viaCMS hospital list
Last fetch Latest re-check couldn't be parsed — showing last good data · 2026-05-18
Content fingerprint 27f0e23b18c8d926… · 410,381,002 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 7 $260,426.64 $1,017,143.05 $458,794.18 nat. median
$309,665
1.5× median
8414
APR_DRG 		Extensive 3rd Degree Burns W Skin Graft 6 $183,603.51 $649,392.45 $369,895.55 nat. median
$160,267
outlier · 2.3×
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
24
APR_DRG 		Heart Or Lung Transplant 7 $197,053.53 $754,047.70 $340,125.35 nat. median
$234,738
1.4× median
6094
APR_DRG 		Neonate Bwt 15002499g W Major Procedure 6 $170,402.25 $528,575.25 $326,546.99 nat. median
$162,982
outlier · 2.0×
5891
APR_DRG 		Neonate Bwt 500g Or Ga 24 Weeks 7 $41,692.84 $676,682.30 $305,279.55 nat. median
$93,260
outlier · 3.3×
5884
APR_DRG 		Neonate Bwt 1500g W Major Procedure 7 $213,642.89 $657,968.88 $296,799.97 nat. median
$246,434
1.2× median
5914
APR_DRG 		Neonate Birthwt 500749g Wo Major Procedure 7 $134,558.16 $617,863.40 $278,712.57 nat. median
$164,279
1.7× median
5934
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 7 $139,297.97 $608,325.20 $274,356.24 nat. median
$151,838
1.8× 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
5833
APR_DRG 		Neonate W Ecmo 7 $206,269.84 $639,840.52 $268,208.39 nat. median
$244,017
1.1× median
1614
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 7 $204,251.03 $633,585.37 $260,354.96 nat. median
$207,730
1.3× median
6314
APR_DRG 		Neonate Birthwt 2499g W Other Major Procedure 6 $150,542.29 $341,056.20 $248,715.25 nat. median
$122,924
outlier · 2.0×
5892
APR_DRG 		Neonate Bwt 500g Or Ga 24 Weeks 7 $34,670.89 $541,292.85 $244,224.12 nat. median
$89,790
outlier · 2.7×
114
APR_DRG 		Psychiatric 6 $134,904.95 $416,807.07 $235,202.35 nat. median
$117,173
outlier · 2.0×
6304
APR_DRG 		Neonate Birthwt 2499g W Major Cardiovascular Procedure 6 $116,053.85 $480,986.47 $227,457.45 nat. median
$150,721
1.5× median
5933
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 7 $89,617.66 $472,935.75 $213,293.64 nat. median
$108,996
2.0× median
6024
APR_DRG 		Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 $99,887.27 $461,013.00 $207,984.78 nat. median
$118,620
1.8× median
5893
APR_DRG 		Neonate Bwt 500g Or Ga 24 Weeks 7 $27,561.16 $459,688.25 $207,337.01 nat. median
$69,788
outlier · 3.0×
5883
APR_DRG 		Neonate Bwt 1500g W Major Procedure 7 $137,630.26 $454,407.80 $204,976.59 nat. median
$182,736
1.1× median
1613
APR_DRG 		Cardiac Defibrillator & Heart Assist Implant 7 $156,501.76 $485,392.95 $199,458.89 nat. median
$119,796
1.7× median
5832
APR_DRG 		Neonate W Ecmo 7 $152,113.04 $471,821.17 $193,882.09 nat. median
$156,126
1.2× median
6074
APR_DRG 		Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 $76,714.83 $400,604.40 $180,746.12 nat. median
$95,507
1.9× 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
6114
APR_DRG 		Neonate Birthwt 15001999g W Major Anomaly 6 $74,303.21 $364,571.20 $173,650.43 nat. median
$72,694
outlier · 2.4×
5882
APR_DRG 		Neonate Bwt 1500g W Major Procedure 7 $134,733.70 $418,029.11 $171,778.55 nat. median
$145,336
1.2× median
5932
APR_DRG 		Neonate Birthwt 750999g Wo Major Procedure 7 $71,009.49 $375,434.15 $169,402.95 nat. median
$86,258
2.0× median
5831
APR_DRG 		Neonate W Ecmo 7 $131,398.28 $407,737.66 $167,548.96 nat. median
$145,122
1.2× median
54
APR_DRG 		Tracheostomy W Mv 96+ Hours Without Extensive Procedure 7 $84,351.20 $370,400.10 $167,129.78 nat. median
$68,217
outlier · 2.4×
6124
APR_DRG 		Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 6 $71,052.69 $233,880.17 $165,915.17 nat. median
$66,071
outlier · 2.5×
7
MS_DRG 		Lung Transplant 1 $165,253.62 $165,253.62 $165,253.62 nat. median
$122,708
1.3× median
74
APR_DRG 		Allogeneic Bone Marrow Transplant 7 $129,203.92 $400,842.50 $164,715.80 nat. median
$187,294
0.9× median
6023
APR_DRG 		Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 $78,733.64 $363,511.40 $164,002.07 nat. median
$86,492
1.9× median
44
APR_DRG 		Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 7 $127,975.08 $380,422.39 $163,151.52 nat. median
$105,658
1.5× median

Other procedures at this hospital

Browse this hospital's 15,404 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
             
5894 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 7 7 — — $614.42 $170,627.80 $77,014.27 2026-01-01
5911 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 7 7 — — $1,141.07 $224,942.55 $101,499.31 2026-01-01
5931 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 7 7 — — $1,316.62 $341,520.55 $154,003.44 2026-01-01
6021 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 7 — — $11,849.54 $196,391.64 $62,396.39 2026-01-01
6212 APR_DRG Neonate Bwt 20002499g W Major Anomaly 6 6 — — $14,388.45 $100,945.95 $56,977.56 2026-01-01
6333 APR_DRG Neonate Birthwt 2499g W Major Anomaly 6 6 — — $20,487.79 $116,218.68 $54,005.98 2026-01-01
6142 APR_DRG Neonate Bwt 15001999g W Or Wo Other Significant Condition 6 6 — — $23,611.87 $82,664.40 $55,082.38 2026-01-01
8634 APR_DRG Neonatal Aftercare 6 6 — — $24,349.37 $173,277.30 $78,198.66 2026-01-01
6614 APR_DRG Coagulation & Platelet Disorders 6 6 — — $24,933.34 $123,731.65 $79,070.37 2026-01-01
6223 APR_DRG Neonate Bwt 20002499g W Resp Dist Syndoth Maj Resp Cond 6 6 — — $26,795.26 $97,501.60 $69,113.14 2026-01-01
7504 APR_DRG Schizophrenia 6 6 — — $27,226.05 $112,073.85 $61,030.62 2026-01-01
5893 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 7 7 — — $27,561.16 $459,688.25 $207,337.01 2026-01-01
6112 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 6 6 — — $27,720.62 $91,672.70 $59,673.70 2026-01-01
6253 APR_DRG Neonate Bwt 20002499g W Other Significant Condition 6 6 — — $27,723.98 $88,758.25 $53,772.89 2026-01-01
673 MS_DRG Other Kidney And Urinary Tract Procedures With Mcc 3 2 — — $28,251.53 $53,615.36 $53,615.36 2026-01-01
958 MS_DRG Other O.r. Procedures For Multiple Significant Trauma With Cc 3 2 — — $28,330.01 $53,772.31 $53,772.31 2026-01-01
12 MS_DRG Tracheostomy For Facemouth & Neck Diagnoses W Cc 3 2 — — $28,343.41 $53,799.11 $53,799.11 2026-01-01
269 MS_DRG Aortic And Heart Assist Procedures Except Pulsation Balloon Without Mcc 3 2 — — $28,389.35 $53,890.99 $53,890.99 2026-01-01
448 MS_DRG Multiple Level Spinal Fusion Except Cervical Without Mcc 3 2 — — $28,501.65 $54,115.58 $54,115.58 2026-01-01
140 MS_DRG Simple Pneumonia And Pleurisy Age 0-17 3 2 — — $28,657.96 $54,428.21 $54,428.21 2026-01-01
474 MS_DRG Amputation For Musculoskeletal System And Connective Tissue Disorders With Mcc 3 2 — — $28,834.06 $54,780.41 $54,780.41 2026-01-01
323 MS_DRG Coronary Intravascular Lithotripsy With Intraluminal Device With Mcc 3 2 — — $29,054.18 $55,220.65 $55,220.65 2026-01-01
356 MS_DRG Other Digestive System O.r. Procedures With Mcc 3 2 — — $29,471.46 $56,055.20 $56,055.20 2026-01-01
3174 APR_DRG Tendon, Muscle & Other Soft Tissue Procedures 7 7 — — $29,579.97 $128,500.75 $57,955.21 2026-01-01
319 MS_DRG Other Endovascular Cardiac Valve Procedures With Mcc 3 2 — — $29,918.72 $56,949.73 $56,949.73 2026-01-01
31 MS_DRG Ventricular Shunt Procedures With Mcc 3 2 — — $30,031.01 $57,174.32 $57,174.32 2026-01-01
163 MS_DRG Major Chest Procedures With Mcc 3 2 — — $30,039.31 $57,190.91 $57,190.91 2026-01-01
8503 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 6 6 — — $30,436.29 $102,049.26 $55,754.00 2026-01-01
7944 APR_DRG Nonextensive Or Procedures For Other Complications Of Treatment 6 6 — — $31,118.84 $80,014.90 $53,603.13 2026-01-01
6903 APR_DRG Acute Leukemia 6 6 — — $33,381.34 $131,732.79 $74,565.89 2026-01-01
1303 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 7 7 — — $33,529.82 $137,653.44 $54,425.94 2026-01-01
6364 APR_DRG Neonate Birthwt 2499g W Congenitalperinatal Infection 6 6 — — $33,616.31 $90,612.90 $61,400.09 2026-01-01
6082 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 7 7 — — $34,144.24 $123,996.60 $55,944.97 2026-01-01
6914 APR_DRG Lymphoma, Myeloma & Non-acute Leukemia 6 6 — — $34,154.52 $107,569.70 $63,927.19 2026-01-01
6213 APR_DRG Neonate Bwt 20002499g W Major Anomaly 6 6 — — $34,217.19 $141,218.35 $81,774.24 2026-01-01
5892 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 7 7 — — $34,670.89 $541,292.85 $244,224.12 2026-01-01
2224 APR_DRG Other Stomach, Esophageal & Duodenal Procedures 7 7 — — $34,758.66 $157,645.25 $71,054.06 2026-01-01
6233 APR_DRG Neonate Bwt 20002499g W Congenitalperinatal Infection 6 6 — — $34,820.29 $94,057.25 $59,816.21 2026-01-01
3094 APR_DRG Other Significant Hip & Femur Surgery 7 7 — — $35,373.08 $121,347.10 $54,729.50 2026-01-01
6312 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 6 6 — — $35,902.31 $79,485.00 $57,402.25 2026-01-01
6924 APR_DRG Radiotherapy 6 6 — — $36,269.32 $88,263.40 $61,319.18 2026-01-01
1622 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 7 7 — — $36,479.56 $124,790.80 $56,362.13 2026-01-01
4474 APR_DRG Other Kidney, Urinary Tract & Related Procedures 7 7 — — $36,865.25 $143,867.85 $64,927.72 2026-01-01
1824 APR_DRG Other Peripheral Vascular Procedures 7 7 — — $37,567.44 $127,176.00 $57,377.96 2026-01-01
51 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 7 7 — — $37,742.99 $134,064.70 $60,451.88 2026-01-01
9524 APR_DRG Nonextensive Procedure Unrelated To Principal Diagnosis 6 6 — — $37,867.17 $107,834.65 $69,668.62 2026-01-01
3032 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 7 7 — — $38,042.82 $130,814.03 $54,607.63 2026-01-01
8423 APR_DRG Full Thickness Burns W Skin Graft 6 6 — — $38,265.51 $105,715.05 $70,796.90 2026-01-01
6122 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 6 6 — — $38,696.30 $142,575.05 $91,684.14 2026-01-01
6254 APR_DRG Neonate Bwt 20002499g W Other Significant Condition 6 6 — — $38,899.95 $95,382.00 $68,852.74 2026-01-01
41 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 7 7 — — $40,200.68 $124,739.51 $54,151.05 2026-01-01
6344 APR_DRG Neonate, Birthwt >2499g W Resp Dist Synd/oth Maj Resp Cond 6 6 — — $40,606.33 $107,726.84 $75,150.36 2026-01-01
7934 APR_DRG Moderately Extensive Or Procedures For Other Complications Of Treatment 6 6 — — $40,644.66 $108,023.43 $65,908.05 2026-01-01
7524 APR_DRG Disorders Of Personality & Impulse Control 6 6 — — $40,657.80 $98,942.87 $71,146.94 2026-01-01
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 7 7 — — $40,798.84 $143,917.51 $59,138.22 2026-01-01
1633 APR_DRG Cardiac Valve Procedures Wo Cardiac Catheterization 7 7 — — $41,511.15 $110,616.92 $58,819.32 2026-01-01
9104 APR_DRG Craniotomy For Multiple Significant Trauma 6 6 — — $41,513.68 $157,910.20 $71,616.80 2026-01-01
5891 APR_DRG Neonate Bwt 500g Or Ga 24 Weeks 7 7 — — $41,692.84 $676,682.30 $305,279.55 2026-01-01
924 APR_DRG Facial Bone Procedures Except Major Cranialfacial Bone Procedures 7 7 — — $41,780.61 $119,492.45 $53,895.29 2026-01-01
4402 APR_DRG Kidney Transplant 7 7 — — $41,868.39 $237,022.24 $65,891.01 2026-01-01
5912 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 7 7 — — $41,956.16 $247,463.30 $111,648.52 2026-01-01
92 APR_DRG Extracorporeal Membrane Oxygenation Ecmo 7 7 — — $42,131.71 $130,666.85 $56,070.46 2026-01-01
6234 APR_DRG Neonate Bwt 20002499g W Congenitalperinatal Infection 6 6 — — $42,225.44 $114,193.45 $77,112.57 2026-01-01
1781 APR_DRG External Heart Assist Systems 7 7 — — $42,307.26 $136,184.30 $61,485.69 2026-01-01
5104 APR_DRG Pelvic Evisceration, Radical Hysterectomy & Other Radical GYN Procs 7 7 — — $42,307.26 $131,375.99 $53,996.88 2026-01-01
2304 APR_DRG Major Small Bowel Procedures 7 7 — — $42,395.04 $138,913.39 $54,005.64 2026-01-01
6143 APR_DRG Neonate Bwt 15001999g W Or Wo Other Significant Condition 6 6 — — $42,976.25 $109,159.40 $78,055.11 2026-01-01
6313 APR_DRG Neonate Birthwt 2499g W Other Major Procedure 6 6 — — $43,131.77 $148,631.73 $79,235.48 2026-01-01
2614 APR_DRG Major Biliary Tract Procedures 7 7 — — $43,272.78 $145,722.50 $65,686.64 2026-01-01
1304 APR_DRG Respiratory System Diagnosis W Ventilator Support 96+ Hours 7 7 — — $43,448.33 $195,952.33 $77,272.42 2026-01-01
1764 APR_DRG Cardiac Pacemaker & Defibrillator Device Replacement 7 7 — — $43,448.33 $134,745.52 $55,369.63 2026-01-01
7594 APR_DRG Eating Disorders 6 6 — — $43,608.63 $141,185.76 $77,361.90 2026-01-01
274 APR_DRG Other Open Craniotomy 7 7 — — $43,974.97 $131,340.31 $57,949.24 2026-01-01
9514 APR_DRG Moderately Extensive Procedure Unrelated To Principal Diagnosis 6 6 — — $44,043.72 $156,084.39 $80,762.15 2026-01-01
1814 APR_DRG Lower Extremity Arterial Procedures 7 7 — — $44,238.30 $129,063.48 $58,013.78 2026-01-01
112 APR_DRG OB 6 6 — — $44,342.46 $108,674.59 $71,476.68 2026-01-01
3614 APR_DRG Skin Graft For Skin & Subcutaneous Tissue Diagnoses 7 7 — — $44,940.49 $139,477.58 $59,237.61 2026-01-01
J9226 CPT Histrelin Acetate (cpp) 50 Mg Kit 49 44 $132,981.50 $98,273.33 26% off $45,261.79 $120,348.26 $66,490.75 2026-01-01
6133 APR_DRG Neonate Birthwt 15001999g W Congenitalperinatal Infection 6 6 — — $45,458.06 $110,623.61 $78,063.73 2026-01-01
52 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 7 7 — — $45,467.14 $161,354.55 $72,797.78 2026-01-01
1653 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 7 7 — — $45,725.24 $101,475.85 $59,674.19 2026-01-01
1204 APR_DRG Major Respiratory & Chest Procedures 7 7 — — $45,818.24 $140,688.45 $63,474.42 2026-01-01
6224 APR_DRG Neonate Bwt 20002499g W Resp Dist Syndoth Maj Resp Cond 6 6 — — $46,009.69 $145,987.45 $83,875.43 2026-01-01
204 APR_DRG Craniotomy For Trauma 7 7 — — $46,081.56 $140,158.55 $63,219.85 2026-01-01
7114 APR_DRG Postop Posttrauma Other Device Infections W Or Procedure 6 6 — — $46,107.04 $105,185.15 $74,111.54 2026-01-01
6072 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 7 — — $46,169.33 $162,944.25 $73,453.92 2026-01-01
6083 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 7 7 — — $46,257.11 $169,832.95 $76,563.70 2026-01-01
894 APR_DRG Major CranialFacial Bone Procedures 7 7 — — $46,959.30 $139,388.38 $60,067.04 2026-01-01
2204 APR_DRG Major Stomach, Esophageal & Duodenal Procedures 7 7 — — $47,310.40 $171,157.70 $77,231.79 2026-01-01
1782 APR_DRG External Heart Assist Systems 7 7 — — $47,485.95 $147,208.99 $64,052.87 2026-01-01
6504 APR_DRG Splenectomy 6 6 — — $47,695.94 $115,518.20 $83,114.20 2026-01-01
1623 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 7 7 — — $47,943.44 $146,907.94 $71,115.35 2026-01-01
6302 APR_DRG Neonate Birthwt 2499g W Major Cardiovascular Procedure 6 6 — — $48,261.35 $147,449.83 $83,815.20 2026-01-01
6113 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 6 6 — — $48,396.39 $269,454.15 $133,111.03 2026-01-01
6084 APR_DRG Neonate Bwt 12501499g W Or Wo Other Significant Condition 7 7 — — $48,539.24 $184,405.20 $83,143.00 2026-01-01
4403 APR_DRG Kidney Transplant 7 7 — — $48,802.57 $276,359.44 $76,826.63 2026-01-01
7104 APR_DRG Infectious & Parasitic Diseases Including HIV W O.r. Procedure 6 6 — — $48,877.54 $126,646.10 $84,168.89 2026-01-01
3033 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 7 7 — — $49,019.08 $184,271.59 $75,160.32 2026-01-01
2604 APR_DRG Major Pancreas, Liver & Shunt Procedures 7 7 — — $49,241.44 $189,041.56 $62,804.98 2026-01-01
4414 APR_DRG Major Bladder Procedures 7 7 — — $49,855.86 $154,779.84 $63,602.79 2026-01-01
214 APR_DRG Craniotomy Except For Trauma 7 7 — — $49,943.63 $174,985.87 $63,613.98 2026-01-01
6123 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 6 6 — — $49,969.62 $164,480.34 $114,593.28 2026-01-01
234 APR_DRG Spinal Procedures 7 7 — — $50,558.05 $165,328.80 $74,602.46 2026-01-01
1783 APR_DRG External Heart Assist Systems 7 7 — — $50,909.15 $158,004.42 $65,191.85 2026-01-01
6514 APR_DRG Other Procedures Of Blood & Blood-forming Organs 6 6 — — $52,556.61 $127,899.42 $92,246.50 2026-01-01
38240 CPT Transplt Allo Hct/donor 2 2 — — $52,684.72 $59,142.33 $55,913.53 2026-01-01
914 APR_DRG Other Major Head & Neck Procedures 7 7 — — $52,840.19 $163,835.87 $67,323.26 2026-01-01
6334 APR_DRG Neonate Birthwt 2499g W Major Anomaly 6 6 — — $52,981.81 $211,738.50 $136,268.34 2026-01-01
7924 APR_DRG Extensive Or Procedures For Other Complications Of Treatment 6 6 — — $53,000.83 $157,170.40 $88,601.86 2026-01-01
71 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $53,015.74 $166,653.55 $75,149.84 2026-01-01
3124 APR_DRG Skin Graft, Except Hand, For Musculoskeletal & Connective Tissue Diagnoses 7 7 — — $53,103.51 $164,698.88 $67,677.97 2026-01-01
61 APR_DRG Pancreas Transplant 7 7 — — $53,366.84 $165,617.64 $68,274.14 2026-01-01
1694 APR_DRG Major Thoracic Abdominal Vascular Procedures 7 7 — — $53,454.61 $185,994.90 $83,849.33 2026-01-01
1834 APR_DRG Percutaneous Structural Cardiac Procedures 7 7 — — $53,487.74 $185,743.39 $74,892.89 2026-01-01
3044 APR_DRG Dorsal & Lumbar Fusion Proc Except For Curvature Of Back 7 7 — — $53,729.16 $188,626.78 $76,190.86 2026-01-01
11 APR_DRG Liver Transplant Or Intestinal Transplant 7 7 — — $54,244.58 $168,150.92 $69,392.80 2026-01-01
6033 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 7 7 — — $54,507.90 $175,131.95 $79,013.76 2026-01-01
6954 APR_DRG Chemotherapy For Acute Leukemia 6 6 — — $54,697.23 $133,742.02 $88,023.80 2026-01-01
1664 APR_DRG Coronary Bypass Wo Cardiac Cath Or Percutaneous Cardiac Procedure 7 7 — — $54,985.27 $141,941.73 $72,831.80 2026-01-01
Q2043 CPT Sipuleucel-t Auto Cd54+ 2 2 — — $55,015.23 $55,536.49 $55,275.86 2026-01-01
6144 APR_DRG Neonate Bwt 15001999g W Or Wo Other Significant Condition 6 6 — — $56,020.85 $142,278.15 $100,252.99 2026-01-01
1794 APR_DRG Defibrillator Implants 7 7 — — $56,087.84 $160,689.34 $71,503.62 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 7 7 — — $57,755.56 $179,153.74 $76,875.63 2026-01-01
799 MS_DRG Splenic Procedures With Mcc 2 1 — — $57,791.93 $57,791.93 $57,791.93 2026-01-01
25 MS_DRG Craniotomy And Endovascular Intracranial Procedures With Mcc 2 1 — — $58,019.07 $58,019.07 $58,019.07 2026-01-01
856 MS_DRG Postoperative Or Post-traumatic Infections With O.r. Procedures With Mcc 2 1 — — $58,044.60 $58,044.60 $58,044.60 2026-01-01
6904 APR_DRG Acute Leukemia 6 6 — — $58,121.10 $156,850.40 $107,857.82 2026-01-01
245 MS_DRG Aicd Generator Procedures 2 1 — — $58,219.42 $58,219.42 $58,219.42 2026-01-01
6214 APR_DRG Neonate Bwt 20002499g W Major Anomaly 6 6 — — $58,292.30 $353,178.35 $159,333.81 2026-01-01
823 MS_DRG Lymphoma And Non-acute Leukemia With Other Procedures With Mcc 2 1 — — $58,505.26 $58,505.26 $58,505.26 2026-01-01
329 MS_DRG Major Small And Large Bowel Procedures With Mcc 2 1 — — $58,654.56 $58,654.56 $58,654.56 2026-01-01
277 MS_DRG Other Major Cardiovascular Procedures With Mcc 2 1 — — $58,935.29 $58,935.29 $58,935.29 2026-01-01
6 MS_DRG Liver Transplant Without Mcc 2 1 — — $59,171.37 $59,171.37 $59,171.37 2026-01-01
9504 APR_DRG Extensive Procedure Unrelated To Principal Diagnosis 6 6 — — $59,257.94 $153,671.00 $69,351.54 2026-01-01
72 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $59,598.82 $188,114.50 $84,864.02 2026-01-01
6073 APR_DRG Neonate Bwt 12501499g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 7 — — $59,686.59 $280,317.10 $126,481.53 2026-01-01
826 MS_DRG Myeloproliferative Disorders Or Poorly Differentiated Neoplasms With Major O.r. … 2 1 — — $59,692.00 $59,692.00 $59,692.00 2026-01-01
981 MS_DRG Extensive O.r. Procedures Unrelated To Principal Diagnosis With Mcc 2 1 — — $59,870.65 $59,870.65 $59,870.65 2026-01-01
650 MS_DRG Neonate Birthwt 1500-1999g Without Signif O.r. Proc With Other Prob 2 1 — — $59,993.16 $59,993.16 $59,993.16 2026-01-01
6022 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 7 — — $60,125.46 $218,212.19 $94,563.85 2026-01-01
42 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 7 7 — — $60,213.24 $179,901.05 $81,092.12 2026-01-01
6814 APR_DRG Other Or Procedures For Lymphatichematopoieticother Neoplasms 6 6 — — $60,719.28 $141,483.30 $99,274.54 2026-01-01
267 MS_DRG Endovascular Cardiac Valve Replacement Without Mcc 2 1 — — $60,751.14 $60,751.14 $60,751.14 2026-01-01
6804 APR_DRG Major Or Procedures For Lymphatichematopoieticother Neoplasms 6 6 — — $61,012.41 $163,748.90 $103,298.28 2026-01-01
12 APR_DRG Liver Transplant Or Intestinal Transplant 7 7 — — $61,090.98 $189,389.44 $78,156.83 2026-01-01
9124 APR_DRG Musculoskeletal & Other Procedures For Multiple Significant Trauma 6 6 — — $61,290.88 $232,644.75 $100,981.27 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
471 MS_DRG Cervical Spinal Fusion With Mcc 2 1 — — $61,617.59 $61,617.59 $61,617.59 2026-01-01
7404 APR_DRG Mental Illness Diagnosis W Or Procedure 6 6 — — $62,000.47 $150,881.80 $103,637.82 2026-01-01
53 APR_DRG Tracheostomy W Mv 96+ Hours Without Extensive Procedure 7 7 — — $62,144.28 $239,470.78 $103,256.18 2026-01-01
1674 APR_DRG Other Cardiothoracic Procedures 7 7 — — $62,319.82 $195,000.12 $79,474.95 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
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
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
228 MS_DRG Other Cardiothoracic Procedures With Mcc 2 1 — — $63,132.29 $63,132.29 $63,132.29 2026-01-01
J9029 CPT Instill Adstiladrin- Tx Dose 2 2 — — $63,354.77 $63,402.04 $63,378.40 2026-01-01
1654 APR_DRG Coronary Bypass W Cardiac Cath Or Percutaneous Cardiac Procedure 7 7 — — $63,373.12 $151,021.50 $80,797.54 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
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
8504 APR_DRG Procedure W Diag Of Rehab, Aftercare Or Oth Contact W Health Service 6 6 — — $64,663.54 $157,359.95 $106,905.18 2026-01-01
84 APR_DRG Autologous Bone Marrow Transplant 7 7 — — $65,391.93 $205,601.20 $92,699.42 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
653 MS_DRG Major Bladder Procedures With Mcc 2 1 — — $66,309.70 $66,309.70 $66,309.70 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
6093 APR_DRG Neonate Bwt 15002499g W Major Procedure 7 7 — — $66,620.77 $206,596.12 $92,697.03 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
8413 APR_DRG Extensive 3rd Degree Burns W Skin Graft 6 6 — — $67,380.33 $208,250.70 $128,952.95 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
62 APR_DRG Pancreas Transplant 7 7 — — $67,937.39 $210,697.09 $86,858.72 2026-01-01
9114 APR_DRG Extensive AbdominalThoraic Procedures For Mult Si 6 6 — — $67,974.49 $159,460.61 $111,687.09 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
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
1784 APR_DRG External Heart Assist Systems 7 7 — — $68,815.13 $219,908.50 $99,190.28 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
1634 APR_DRG Cardiac Valve Procedures Wo Cardiac Catheterization 7 7 — — $69,341.78 $188,504.13 $88,353.74 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
234 MS_DRG Coronary Bypass With Cardiac Catheterization Without Mcc 2 1 — — $69,707.88 $69,707.88 $69,707.88 2026-01-01
6134 APR_DRG Neonate Birthwt 15001999g W Congenitalperinatal Infection 6 6 — — $69,711.08 $169,645.02 $119,763.84 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
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
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
5932 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 7 7 — — $71,009.49 $375,434.15 $169,402.95 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
6124 APR_DRG Neonate Bwt 15001999g W Resp Dist Syndoth Maj Resp Cond 6 6 — — $71,052.69 $233,880.17 $165,915.17 2026-01-01
8 MS_DRG Simultaneous Pancreas/kidney Transplant 2 1 — — $71,518.62 $71,518.62 $71,518.62 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
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
213 MS_DRG Splenic Procedures Age 0-17 2 1 — — $72,824.04 $72,824.04 $72,824.04 2026-01-01
13 APR_DRG Liver Transplant Or Intestinal Transplant 7 7 — — $72,852.75 $277,932.55 $125,407.09 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
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
4404 APR_DRG Kidney Transplant 7 7 — — $73,993.82 $419,255.61 $94,905.67 2026-01-01
6114 APR_DRG Neonate Birthwt 15001999g W Major Anomaly 6 6 — — $74,303.21 $364,571.20 $173,650.43 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
16 MS_DRG Autologous Bone Marrow Transplant With Cc/mcc 2 1 — — $75,667.12 $75,667.12 $75,667.12 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
73 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $76,188.18 $240,574.60 $108,492.13 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 7 7 — — $76,714.83 $400,604.40 $180,746.12 2026-01-01
J7330 CPT Autologous Cultured Chondrocytes Sheet 47 42 $197,466.00 $145,927.37 26% off $76,814.27 $178,706.73 $98,733.00 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 7 7 — — $77,504.80 $240,541.18 $103,220.32 2026-01-01
3034 APR_DRG Dorsal & Lumbar Fusion Proc For Curvature Of Back 7 7 — — $77,855.89 $241,569.21 $99,265.64 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
63 APR_DRG Pancreas Transplant 7 7 — — $78,206.99 $242,710.97 $100,055.57 2026-01-01
6023 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 7 — — $78,733.64 $363,511.40 $164,002.07 2026-01-01
5913 APR_DRG Neonate Birthwt 500749g Wo Major Procedure 7 7 — — $78,821.41 $321,914.25 $145,216.70 2026-01-01
8424 APR_DRG Full Thickness Burns W Skin Graft 6 6 — — $79,754.75 $225,803.11 $134,754.88 2026-01-01
1624 APR_DRG Cardiac Valve Procedures W Cardiac Catheterization 7 7 — — $80,462.28 $206,598.35 $103,830.92 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 6 6 — — $83,713.09 $205,162.23 $134,885.77 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 7 7 — — $84,351.20 $370,400.10 $167,129.78 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 6 6 — — $86,006.58 $232,401.68 $143,131.64 2026-01-01
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 7 7 — — $86,457.78 $268,097.29 $110,167.48 2026-01-01
43 APR_DRG Tracheostomy W Mv 96+ Hours W Extensive Procedure Or Ecmo 7 7 — — $87,598.85 $259,915.95 $117,223.90 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 7 7 — — $88,739.92 $275,164.16 $113,071.12 2026-01-01
5933 APR_DRG Neonate Birthwt 750999g Wo Major Procedure 7 7 — — $89,617.66 $472,935.75 $213,293.64 2026-01-01
22 APR_DRG Heart Or Lung Transplant 7 7 — — $90,407.63 $280,589.75 $120,405.39 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
6024 APR_DRG Neonate Bwt 10001249g W Resp Dist Syndoth Maj Resp Or Maj Anom 7 7 — — $99,887.27 $461,013.00 $207,984.78 2026-01-01
Q0480 CPT Driver Pneumatic Vad- Rep 2 2 — — $99,999.95 $99,999.95 $99,999.95 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
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
64 APR_DRG Pancreas Transplant 7 7 — — $111,297.94 $345,177.24 $141,841.31 2026-01-01
6034 APR_DRG Neonate Birthwt 10001249g W Or Wo Other Significant Condition 7 7 — — $112,000.13 $360,067.05 $162,370.69 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 6 6 — — $116,053.85 $480,986.47 $227,457.45 2026-01-01
1611 APR_DRG Cardiac Defibrillator & Heart Assist Implant 7 7 — — $119,373.18 $370,240.21 $152,140.03 2026-01-01
23 APR_DRG Heart Or Lung Transplant 7 7 — — $121,918.64 $378,096.50 $162,247.59 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 7 7 — — $125,341.84 $340,893.41 $159,729.80 2026-01-01
1612 APR_DRG Cardiac Defibrillator & Heart Assist Implant 7 7 — — $125,605.17 $389,725.95 $160,148.29 2026-01-01
14 APR_DRG Liver Transplant Or Intestinal Transplant 7 7 — — $125,956.26 $390,863.25 $160,614.89 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 7 7 — — $127,975.08 $380,422.39 $163,151.52 2026-01-01
74 APR_DRG Allogeneic Bone Marrow Transplant 7 7 — — $129,203.92 $400,842.50 $164,715.80 2026-01-01
5831 APR_DRG Neonate W Ecmo 7 7 — — $131,398.28 $407,737.66 $167,548.96 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 7 7 — — $134,558.16 $617,863.40 $278,712.57 2026-01-01
5882 APR_DRG Neonate Bwt 1500g W Major Procedure 7 7 — — $134,733.70 $418,029.11 $171,778.55 2026-01-01
114 APR_DRG Psychiatric 6 6 — — $134,904.95 $416,807.07 $235,202.35 2026-01-01
5883 APR_DRG Neonate Bwt 1500g W Major Procedure 7 7 — — $137,630.26 $454,407.80 $204,976.59 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 7 7 — — $139,297.97 $608,325.20 $274,356.24 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 6 6 — — $150,542.29 $341,056.20 $248,715.25 2026-01-01
5832 APR_DRG Neonate W Ecmo 7 7 — — $152,113.04 $471,821.17 $193,882.09 2026-01-01
14 MS_DRG Allogeneic Bone Marrow Transplant 2 1 — — $153,356.82 $153,356.82 $153,356.82 2026-01-01
1613 APR_DRG Cardiac Defibrillator & Heart Assist Implant 7 7 — — $156,501.76 $485,392.95 $199,458.89 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 6 6 — — $170,402.25 $528,575.25 $326,546.99 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 6 6 — — $183,603.51 $649,392.45 $369,895.55 2026-01-01
24 APR_DRG Heart Or Lung Transplant 7 7 — — $197,053.53 $754,047.70 $340,125.35 2026-01-01
1614 APR_DRG Cardiac Defibrillator & Heart Assist Implant 7 7 — — $204,251.03 $633,585.37 $260,354.96 2026-01-01
5833 APR_DRG Neonate W Ecmo 7 7 — — $206,269.84 $639,840.52 $268,208.39 2026-01-01
5884 APR_DRG Neonate Bwt 1500g W Major Procedure 7 7 — — $213,642.89 $657,968.88 $296,799.97 2026-01-01
5834 APR_DRG Neonate W Ecmo 7 7 — — $260,426.64 $1,017,143.05 $458,794.18 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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