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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 LUVERNE MEDICAL CENTER

Luverne, MN · CCN 241371 · Rates published

7,653 distinct procedures filed
15 distinct payers
129,183 rate rows
2026-03-04 last MRF observed
Data quality

128,937 of 129,183 rate rows are consumer-grade (99.8%)

246 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 184
per-diem day rate — not a per-procedure price 60
no usable negotiated amount (only an out-of-band fallback) — excluded from medians 2
Data source & audit trail ↓ Download audit trail (JSON)
Source MRF file https://sthpiprd.blob.core.windows.net/machine-readable-files/8367/460388596_sanford-luverne-medical-center_standardcharges.csv
Found on page https://search.hospitalpriceindex.com/hpi2/machineReadable/SanfordLuverneMedicalCenter/8367
Discovered viaDiscovered by HANK
Last fetch not_modified · 2026-09-21
Content fingerprint f801406d0d02c70a… · 83,391,005 bytes · first seen 2026-05-06

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 $135,783.56 $135,783.56 $135,783.56 nat. median
$390,362
outlier · 0.3×
5884
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $85,820.30 $85,820.30 $85,820.30 nat. median
$286,698
outlier · 0.3×
5833
APR_DRG 		Neonate With Ecmo 2 $81,982.61 $81,982.61 $81,982.61 nat. median
$268,208
outlier · 0.3×
114
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $76,901.36 $76,901.36 $76,901.36 nat. median
$135,803
0.6× median
24
APR_DRG 		Heart And/or Lung Transplant 2 $69,837.82 $69,837.82 $69,837.82 nat. median
$225,531
outlier · 0.3×
38240
CPT 		Transplt Allo Hct/donor 1 $62,099.45 $62,099.45 $62,099.45 nat. median
$28,331
outlier · 2.2×
6094
APR_DRG 		Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 $60,349.24 $60,349.24 $60,349.24 nat. median
$198,578
outlier · 0.3×
113
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $60,021.47 $60,021.47 $60,021.47 nat. median
$68,335
0.9× median
5914
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $59,049.57 $59,049.57 $59,049.57 nat. median
$171,497
outlier · 0.3×
Q2043
HCPCS 		Sipuleucel-t Auto Cd54+ 1 $58,743.27 $58,743.27 $58,743.27 nat. median
$63,499
0.9× median
1614
APR_DRG 		Implantable Heart Assist Systems 2 $58,068.73 $58,068.73 $58,068.73 nat. median
$202,242
outlier · 0.3×
94
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $55,885.55 $55,885.55 $55,885.55 nat. median
$152,792
outlier · 0.4×
5883
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $55,554.55 $55,554.55 $55,554.55 nat. median
$173,134
outlier · 0.3×
5882
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $53,578.96 $53,578.96 $53,578.96 nat. median
$152,383
outlier · 0.4×
5934
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $52,123.59 $52,123.59 $52,123.59 nat. median
$168,439
outlier · 0.3×
6314
APR_DRG 		Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 $51,507.77 $51,507.77 $51,507.77 nat. median
$181,762
outlier · 0.3×
5832
APR_DRG 		Neonate With Ecmo 2 $51,445.94 $51,445.94 $51,445.94 nat. median
$201,678
outlier · 0.3×
112
APR_DRG 		Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 $50,720.37 $50,720.37 $50,720.37 nat. median
$63,564
0.8× median
8414
APR_DRG 		Extensive Third Degree Burns With Skin Graft 2 $49,677.70 $49,677.70 $49,677.70 nat. median
$173,018
outlier · 0.3×
1613
APR_DRG 		Implantable Heart Assist Systems 2 $46,726.49 $46,726.49 $46,726.49 nat. median
$155,539
outlier · 0.3×
5892
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $45,580.27 $45,580.27 $45,580.27 nat. median
$96,548
outlier · 0.5×
5891
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $45,580.27 $45,580.27 $45,580.27 nat. median
$99,483
outlier · 0.5×
5893
APR_DRG 		Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational… 2 $45,580.27 $45,580.27 $45,580.27 nat. median
$77,096
0.6× median
5913
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $44,866.86 $44,866.86 $44,866.86 nat. median
$120,079
outlier · 0.4×
6304
APR_DRG 		Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 $43,767.83 $43,767.83 $43,767.83 nat. median
$187,567
outlier · 0.2×
5831
APR_DRG 		Neonate With Ecmo 2 $43,407.52 $43,407.52 $43,407.52 nat. median
$173,909
outlier · 0.2×
74
APR_DRG 		Allogeneic Bone Marrow Transplant 2 $43,021.64 $43,021.64 $43,021.64 nat. median
$149,836
outlier · 0.3×
44
APR_DRG 		Tracheostomy With Mv >96 Hours With Extensive Procedure 2 $42,693.62 $42,693.62 $42,693.62 nat. median
$135,630
outlier · 0.3×
14
APR_DRG 		Liver Transplant And/or Intestinal Transplant 2 $39,594.66 $39,594.66 $39,594.66 nat. median
$136,566
outlier · 0.3×
6024
APR_DRG 		Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 $38,070.51 $38,070.51 $38,070.51 nat. median
$124,731
outlier · 0.3×
23
APR_DRG 		Heart And/or Lung Transplant 2 $37,765.83 $37,765.83 $37,765.83 nat. median
$117,894
outlier · 0.3×
5933
APR_DRG 		Neonate Birth Weight 750-999 Grams Without Major Procedure 2 $37,236.17 $37,236.17 $37,236.17 nat. median
$114,205
outlier · 0.3×
5912
APR_DRG 		Neonate Birth Weight 500-749 Grams Without Major Procedure 2 $36,431.39 $36,431.39 $36,431.39 nat. median
$85,835
outlier · 0.4×
5881
APR_DRG 		Neonate Birth Weight < 1500 Grams With Major Procedure 2 $35,636.04 $35,636.04 $35,636.04 nat. median
$130,862
outlier · 0.3×
33270
CPT 		Ins/rep Subq Defibrillator 1 $33,664.66 $33,664.66 $33,664.66 nat. median
$32,475
1.0× median
33264
CPT 		Rmvl & Rplcmt Dfb Gen Mlt Ld 1 $33,664.66 $33,664.66 $33,664.66 nat. median
$32,779
1.0× median
33231
CPT 		Insrt Pulse Gen W/mult Leads 1 $33,664.66 $33,664.66 $33,664.66 nat. median
$31,377
1.1× median
33249
CPT 		Insj/rplcmt Defib W/lead(s) 1 $33,664.66 $33,664.66 $33,664.66 nat. median
$32,069
1.0× median
69930
CPT 		Implant Cochlear Device 1 $33,398.21 $33,398.21 $33,398.21 nat. median
$23,645
1.4× median
64568
CPT 		Opn Impltj Crnl Nrv Nea&pg 1 $31,997.27 $31,997.27 $31,997.27 nat. median
$27,905
1.1× median
61886
CPT 		Implant Neurostim Arrays 1 $31,997.27 $31,997.27 $31,997.27 nat. median
$23,007
1.4× median
64582
CPT 		Opn Mpltj Hpglsl Nstm Ary Pg 1 $31,997.27 $31,997.27 $31,997.27 nat. median
$29,815
1.1× median
63685
CPT 		Ins/rplc Spi Npg/rcvr Pocket 1 $31,997.27 $31,997.27 $31,997.27 nat. median
$21,812
1.5× median
93
APR_DRG 		Extracorporeal Membrane Oxygenation (ecmo) 2 $31,615.59 $31,615.59 $31,615.59 nat. median
$73,618
outlier · 0.4×
1612
APR_DRG 		Implantable Heart Assist Systems 2 $31,581.32 $31,581.32 $31,581.32 nat. median
$109,992
outlier · 0.3×
1611
APR_DRG 		Implantable Heart Assist Systems 2 $31,581.32 $31,581.32 $31,581.32 nat. median
$108,954
outlier · 0.3×
1604
APR_DRG 		Major Cardiothoracic Repair Of Heart Anomaly 2 $30,701.05 $30,701.05 $30,701.05 nat. median
$106,926
outlier · 0.3×
54
APR_DRG 		Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 $30,370.04 $30,370.04 $30,370.04 nat. median
$91,350
outlier · 0.3×
33289
CPT 		Tcat Impl Wrls P-art Prs Snr 1 $29,849.75 $29,849.75 $29,849.75 nat. median
$28,889
1.0× median
22
APR_DRG 		Heart And/or Lung Transplant 2 $29,150.08 $29,150.08 $29,150.08 nat. median
$95,481
outlier · 0.3×

Other procedures at this hospital

Browse this hospital's 7,653 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
             
5834 APR_DRG Neonate With Ecmo 2 2 — — $135,783.56 $135,783.56 $135,783.56 2026-03-04
5884 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $85,820.30 $85,820.30 $85,820.30 2026-03-04
5833 APR_DRG Neonate With Ecmo 2 2 — — $81,982.61 $81,982.61 $81,982.61 2026-03-04
114 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $76,901.36 $76,901.36 $76,901.36 2026-03-04
24 APR_DRG Heart And/or Lung Transplant 2 2 — — $69,837.82 $69,837.82 $69,837.82 2026-03-04
38240 CPT Transplt Allo Hct/donor 1 1 — — $62,099.45 $62,099.45 $62,099.45 2026-03-04
6094 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $60,349.24 $60,349.24 $60,349.24 2026-03-04
113 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $60,021.47 $60,021.47 $60,021.47 2026-03-04
5914 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $59,049.57 $59,049.57 $59,049.57 2026-03-04
Q2043 HCPCS Sipuleucel-t Auto Cd54+ 1 1 — — $58,743.27 $58,743.27 $58,743.27 2026-03-04
1614 APR_DRG Implantable Heart Assist Systems 2 2 — — $58,068.73 $58,068.73 $58,068.73 2026-03-04
94 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $55,885.55 $55,885.55 $55,885.55 2026-03-04
5883 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $55,554.55 $55,554.55 $55,554.55 2026-03-04
5882 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $53,578.96 $53,578.96 $53,578.96 2026-03-04
5934 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $52,123.59 $52,123.59 $52,123.59 2026-03-04
6314 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $51,507.77 $51,507.77 $51,507.77 2026-03-04
5832 APR_DRG Neonate With Ecmo 2 2 — — $51,445.94 $51,445.94 $51,445.94 2026-03-04
112 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $50,720.37 $50,720.37 $50,720.37 2026-03-04
8414 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $49,677.70 $49,677.70 $49,677.70 2026-03-04
1613 APR_DRG Implantable Heart Assist Systems 2 2 — — $46,726.49 $46,726.49 $46,726.49 2026-03-04
5892 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $45,580.27 $45,580.27 $45,580.27 2026-03-04
5893 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $45,580.27 $45,580.27 $45,580.27 2026-03-04
5891 APR_DRG Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational … 2 2 — — $45,580.27 $45,580.27 $45,580.27 2026-03-04
5913 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $44,866.86 $44,866.86 $44,866.86 2026-03-04
6304 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $43,767.83 $43,767.83 $43,767.83 2026-03-04
5831 APR_DRG Neonate With Ecmo 2 2 — — $43,407.52 $43,407.52 $43,407.52 2026-03-04
74 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $43,021.64 $43,021.64 $43,021.64 2026-03-04
44 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $42,693.62 $42,693.62 $42,693.62 2026-03-04
14 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $39,594.66 $39,594.66 $39,594.66 2026-03-04
6024 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $38,070.51 $38,070.51 $38,070.51 2026-03-04
23 APR_DRG Heart And/or Lung Transplant 2 2 — — $37,765.83 $37,765.83 $37,765.83 2026-03-04
5933 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $37,236.17 $37,236.17 $37,236.17 2026-03-04
5912 APR_DRG Neonate Birth Weight 500-749 Grams Without Major Procedure 2 2 — — $36,431.39 $36,431.39 $36,431.39 2026-03-04
5881 APR_DRG Neonate Birth Weight < 1500 Grams With Major Procedure 2 2 — — $35,636.04 $35,636.04 $35,636.04 2026-03-04
33270 CPT Ins/rep Subq Defibrillator 1 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33264 CPT Rmvl & Rplcmt Dfb Gen Mlt Ld 1 1 — — $33,664.66 $33,664.66 $33,664.66 2026-03-04
33231 CPT Insrt Pulse Gen W/mult Leads 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
69930 CPT Implant Cochlear Device 1 1 — — $33,398.21 $33,398.21 $33,398.21 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
61886 CPT Implant Neurostim Arrays 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
63685 CPT Ins/rplc Spi Npg/rcvr Pocket 1 1 — — $31,997.27 $31,997.27 $31,997.27 2026-03-04
93 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $31,615.59 $31,615.59 $31,615.59 2026-03-04
1611 APR_DRG Implantable Heart Assist Systems 2 2 — — $31,581.32 $31,581.32 $31,581.32 2026-03-04
1612 APR_DRG Implantable Heart Assist Systems 2 2 — — $31,581.32 $31,581.32 $31,581.32 2026-03-04
1604 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $30,701.05 $30,701.05 $30,701.05 2026-03-04
54 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $30,370.04 $30,370.04 $30,370.04 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
22 APR_DRG Heart And/or Lung Transplant 2 2 — — $29,150.08 $29,150.08 $29,150.08 2026-03-04
J2350 HCPCS Ocrelizumab Soln For IV Infusion 300 Mg/10ml 44 15 $39,310.80 $31,448.64 20% off $60.94 $37,188.02 $29,125.38 2026-03-04
5932 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $28,951.67 $28,951.67 $28,951.67 2026-03-04
C9760 HCPCS Non-blind Interatrial Shunt 1 1 — — $28,875.53 $28,875.53 $28,875.53 2026-03-04
6074 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $28,338.09 $28,338.09 $28,338.09 2026-03-04
43 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $28,300.84 $28,300.84 $28,300.84 2026-03-04
6034 APR_DRG Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition 2 2 — — $27,534.79 $27,534.79 $27,534.79 2026-03-04
64 APR_DRG Pancreas Transplant 2 2 — — $26,700.96 $26,700.96 $26,700.96 2026-03-04
8424 APR_DRG Burns With Skin Graft Except Extensive Third Degree Burns 2 2 — — $26,566.12 $26,566.12 $26,566.12 2026-03-04
6023 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $26,537.57 $26,537.57 $26,537.57 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
73 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $25,632.46 $25,632.46 $25,632.46 2026-03-04
6114 APR_DRG Neonate Birth Weight 1500-1999 Grams With Major Anomaly 2 2 — — $23,880.36 $23,880.36 $23,880.36 2026-03-04
6303 APR_DRG Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure 2 2 — — $23,770.35 $23,770.35 $23,770.35 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
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
33240 CPT Insrt Pulse Gen W/singl Lead 1 1 — — $23,568.50 $23,568.50 $23,568.50 2026-03-04
1624 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $23,191.29 $23,191.29 $23,191.29 2026-03-04
8634 APR_DRG Neonatal Aftercare 2 2 — — $22,784.05 $22,784.05 $22,784.05 2026-03-04
63 APR_DRG Pancreas Transplant 2 2 — — $22,724.46 $22,724.46 $22,724.46 2026-03-04
63655 CPT Implant Neuroelectrodes 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
61885 CPT Insrt/redo Neurostim 1 Array 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
64590 CPT Ins/rpl Prph Sac/gstr Npg/r 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
64580 CPT Opn Impltj Nea Neuromuscular 1 1 — — $22,516.61 $22,516.61 $22,516.61 2026-03-04
21 APR_DRG Heart And/or Lung Transplant 2 2 — — $22,345.53 $22,345.53 $22,345.53 2026-03-04
4404 APR_DRG Kidney Transplant 2 2 — — $22,078.84 $22,078.84 $22,078.84 2026-03-04
13 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $21,866.03 $21,866.03 $21,866.03 2026-03-04
111 APR_DRG Chimeric Antigen Receptor (car) T-cell And Other Immunotherapies 2 2 — — $21,427.02 $21,427.02 $21,427.02 2026-03-04
53 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $21,426.27 $21,426.27 $21,426.27 2026-03-04
3034 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $21,260.40 $21,260.40 $21,260.40 2026-03-04
53444 CPT Insert Tandem Cuff 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54410 CPT Remove/replace Penis Prosth 1 1 — — $21,134.99 $21,134.99 $21,134.99 2026-03-04
54405 CPT Insert Multi-comp Penis Pros 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
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
53447 CPT Remove/replace Ur Sphincter 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
1634 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $20,387.57 $20,387.57 $20,387.57 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
33221 CPT Insert Pulse Gen Mult Leads 1 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
33274 CPT Tcat Insj/rpl Perm Ldls Pm 1 1 — — $20,024.72 $20,024.72 $20,024.72 2026-03-04
8514 APR_DRG Gender Related Procedures 2 2 — — $19,985.30 $19,985.30 $19,985.30 2026-03-04
6073 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $19,901.13 $19,901.13 $19,901.13 2026-03-04
6022 APR_DRG Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $19,400.28 $19,400.28 $19,400.28 2026-03-04
C8003 HCPCS Imp Extar Knee Shck Absrb 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
22612 CPT Arthrd Pst Tq 1ntrspc Lumbar 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22630 CPT Arthrd Pst Tq 1ntrspc Lum 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23616 CPT Optx Prx Hmrl Fx Fix Rpr Rpl 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
22856 CPT Tot Disc Arthrp 1ntrspc Crv 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
23472 CPT Reconstruct Shoulder Joint 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
25446 CPT Arthrp W/prostc Dst Rds&crps 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
24363 CPT Replace Elbow Joint 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
24371 CPT Revise Reconst Elbow Joint 1 1 — — $19,309.55 $19,309.55 $19,309.55 2026-03-04
2994 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $19,235.15 $19,235.15 $19,235.15 2026-03-04
62 APR_DRG Pancreas Transplant 2 2 — — $19,216.03 $19,216.03 $19,216.03 2026-03-04
72 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $19,078.21 $19,078.21 $19,078.21 2026-03-04
1784 APR_DRG External Heart Assist Devices 2 2 — — $19,015.89 $19,015.89 $19,015.89 2026-03-04
C9766 HCPCS Revasc Intra Lithotrip-ather 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
C9606 HCPCS Perc D-e Cor Revasc W Ami S 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
93590 CPT Perq Transcath Cls Mitral 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
37229 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
92933 CPT Prq Trlml C Athrc St Angiop1 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
C9774 HCPCS Revasc Lithotr-ather Tib/per 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
93581 CPT Transcath Closure Of Vsd 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
37242 CPT Vasc Embolize/occlude Artery 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37231 CPT Outpatient Services - Cpt/hcpcs 1 1 — — $18,854.56 $18,854.56 $18,854.56 2026-03-04
37225 CPT Outpatient Services - Cpt/hcpcs 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
33902 CPT Perq P-art Revsc 1 Abnor Uni 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
36906 CPT Thrmbc/nfs Dialysis Circuit 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
C9765 HCPCS Revasc Intra Lithotrip-stent 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
36837 CPT Prq Av Fstl Crt Uxtr Sep Acs 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
84 APR_DRG Autologous Bone Marrow Transplant 2 2 — — $18,694.07 $18,694.07 $18,694.07 2026-03-04
62362 CPT Implant Spine Infusion Pump 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62361 CPT Implant Spine Infusion Pump 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
62360 CPT Insert Spine Infusion Device 1 1 — — $18,557.83 $18,557.83 $18,557.83 2026-03-04
6093 APR_DRG Neonate Birth Weight 1500-2499 Grams With Major Procedure 2 2 — — $18,532.67 $18,532.67 $18,532.67 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
1654 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $18,278.15 $18,278.15 $18,278.15 2026-03-04
19357 CPT Tiss Xpndr Plmt Brst Rcnstj 1 1 — — $18,268.26 $18,268.26 $18,268.26 2026-03-04
42 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $17,649.17 $17,649.17 $17,649.17 2026-03-04
12 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $17,642.71 $17,642.71 $17,642.71 2026-03-04
6124 APR_DRG Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $17,500.43 $17,500.43 $17,500.43 2026-03-04
92 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $17,349.20 $17,349.20 $17,349.20 2026-03-04
66683 CPT Implantation Iris Prosthesis 1 1 — — $17,237.25 $17,237.25 $17,237.25 2026-03-04
6334 APR_DRG Neonate Birth Weight > 2499 Grams With Major Anomaly 2 2 — — $17,131.43 $17,131.43 $17,131.43 2026-03-04
1834 APR_DRG Percutaneous Structural Cardiac Procedures 2 2 — — $16,873.93 $16,873.93 $16,873.93 2026-03-04
1623 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $16,611.21 $16,611.21 $16,611.21 2026-03-04
9104 APR_DRG Craniotomy For Multiple Significant Trauma 2 2 — — $16,362.90 $16,362.90 $16,362.90 2026-03-04
6214 APR_DRG Neonate Birth Weight 2000-2499 Grams With Major Anomaly 2 2 — — $16,349.99 $16,349.99 $16,349.99 2026-03-04
67027 CPT Implant Eye Drug System 1 1 — — $16,133.07 $16,133.07 $16,133.07 2026-03-04
71 APR_DRG Allogeneic Bone Marrow Transplant 2 2 — — $15,880.67 $15,880.67 $15,880.67 2026-03-04
1664 APR_DRG Coronary Bypass Without Ami Or Complex Principal Diagnosis 2 2 — — $15,805.19 $15,805.19 $15,805.19 2026-03-04
1794 APR_DRG Defibrillator Implants 2 2 — — $15,789.79 $15,789.79 $15,789.79 2026-03-04
9114 APR_DRG Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma 2 2 — — $15,711.08 $15,711.08 $15,711.08 2026-03-04
3044 APR_DRG Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back 2 2 — — $15,627.14 $15,627.14 $15,627.14 2026-03-04
1674 APR_DRG Other Cardiothoracic And Thoracic Circulatory Procedures 2 2 — — $15,513.17 $15,513.17 $15,513.17 2026-03-04
61 APR_DRG Pancreas Transplant 2 2 — — $15,506.46 $15,506.46 $15,506.46 2026-03-04
914 APR_DRG Other Major Head And Neck Procedures 2 2 — — $15,460.53 $15,460.53 $15,460.53 2026-03-04
1783 APR_DRG External Heart Assist Devices 2 2 — — $15,420.05 $15,420.05 $15,420.05 2026-03-04
6134 APR_DRG Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection 2 2 — — $15,241.76 $15,241.76 $15,241.76 2026-03-04
6804 APR_DRG Major O.r. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms 2 2 — — $15,215.44 $15,215.44 $15,215.44 2026-03-04
2993 APR_DRG Multiple Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $15,080.36 $15,080.36 $15,080.36 2026-03-04
8413 APR_DRG Extensive Third Degree Burns With Skin Graft 2 2 — — $15,022.50 $15,022.50 $15,022.50 2026-03-04
65770 CPT Keratoprosthesis 1 1 — — $15,003.78 $15,003.78 $15,003.78 2026-03-04
9124 APR_DRG Musculoskeletal And Other Procedures For Multiple Significant Trauma 2 2 — — $14,998.91 $14,998.91 $14,998.91 2026-03-04
J2427 HCPCS Paliperidone Palmitate ER Susp Pref Syr 819 Mg/2.63ml 41 15 $19,885.60 $15,908.48 $4,814.30 $18,811.78 $14,733.24 2026-03-04
4403 APR_DRG Kidney Transplant 2 2 — — $14,697.46 $14,697.46 $14,697.46 2026-03-04
3004 APR_DRG Single Level Combined Anterior And Posterior Spinal Fusion Except Cervical 2 2 — — $14,544.50 $14,544.50 $14,544.50 2026-03-04
11 APR_DRG Liver Transplant And/or Intestinal Transplant 2 2 — — $14,497.07 $14,497.07 $14,497.07 2026-03-04
5931 APR_DRG Neonate Birth Weight 750-999 Grams Without Major Procedure 2 2 — — $14,352.05 $14,352.05 $14,352.05 2026-03-04
52 APR_DRG Tracheostomy With Mv >96 Hours Without Extensive Procedure 2 2 — — $14,348.33 $14,348.33 $14,348.33 2026-03-04
1694 APR_DRG Major Abdominal Vascular Procedures 2 2 — — $14,270.61 $14,270.61 $14,270.61 2026-03-04
214 APR_DRG Open Craniotomy Except Trauma 2 2 — — $14,253.22 $14,253.22 $14,253.22 2026-03-04
6313 APR_DRG Neonate Birth Weight > 2499 Grams With Other Major Procedure 2 2 — — $14,244.78 $14,244.78 $14,244.78 2026-03-04
3033 APR_DRG Dorsal And Lumbar Fusion Procedure For Curvature Of Back 2 2 — — $14,193.38 $14,193.38 $14,193.38 2026-03-04
91 APR_DRG Extracorporeal Membrane Oxygenation (ecmo) 2 2 — — $14,036.94 $14,036.94 $14,036.94 2026-03-04
1633 APR_DRG Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis 2 2 — — $13,936.37 $13,936.37 $13,936.37 2026-03-04
6084 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $13,877.03 $13,877.03 $13,877.03 2026-03-04
6083 APR_DRG Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition 2 2 — — $13,877.03 $13,877.03 $13,877.03 2026-03-04
1304 APR_DRG Respiratory System Diagnosis With Ventilator Support > 96 Hours 2 2 — — $13,764.29 $13,764.29 $13,764.29 2026-03-04
234 APR_DRG Spinal Procedures 2 2 — — $13,752.37 $13,752.37 $13,752.37 2026-03-04
54417 CPT Remv/replc Penis Pros Compl 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
53440 CPT Male Sling Procedure 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
53451 CPT Tprnl Balo Cntnc Dev Bi 1 1 — — $13,642.04 $13,642.04 $13,642.04 2026-03-04
6072 APR_DRG Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other… 2 2 — — $13,555.21 $13,555.21 $13,555.21 2026-03-04
8504 APR_DRG Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Heal… 2 2 — — $13,540.81 $13,540.81 $13,540.81 2026-03-04
25810 CPT Arthrd Wrst Iliac/oth Agrft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
C9757 HCPCS Spine Device Implant Surgery 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25391 CPT Lengthen Radius Or Ulna 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27709 CPT Osteotomy Tibia & Fibula 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
20982 CPT Ablate Bone Tumor(s) Perq 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25365 CPT Revise Radius & Ulna 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69730 CPT Rplc Oi Implt Sk Tc Esp>=100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69729 CPT Impl Oi Implt Sk Tc Esp>=100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69714 CPT Impl Oi Implt Skull Perq Esp 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69716 CPT Impl Oi Implt Sk Tc Esp<100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27759 CPT Treatment Of Tibia Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
69719 CPT Rplcm Oi Implt Sk Tc Esp<100 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23680 CPT Optx Sho Dislc Neck Fx Fixj 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23802 CPT Arthrd Glenohumeral Jt W/grf 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24802 CPT Arthrd Elbow Jt Autog Graft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23615 CPT Optx Prox Humrl Fx W/int Fix 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24666 CPT Optx Radial Head/nck Fx Rplc 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
64628 CPT Trml Dstrj Ios Bvn 1st 2 L/s 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27758 CPT Treatment Of Tibia Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24579 CPT Optx Humrl Cndylr Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24586 CPT Optx Partclr Fx&/dislc Elbow 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23473 CPT Revis Reconst Shoulder Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27447 CPT Total Knee Arthroplasty 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
20692 CPT Appl Mltpln Uni Ext Fixj Sys 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23485 CPT Revision Of Collar Bone 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24587 CPT Optx Partclr Fx&/dslc Elbw W 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27440 CPT Revision Of Knee Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27438 CPT Revise Kneecap With Implant 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27441 CPT Revision Of Knee Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24545 CPT Optx Hum Fx Wo Ntrcndylr Xtn 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27442 CPT Revision Of Knee Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25491 CPT Prophylactic Tx Ulna 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23470 CPT Reconstruct Shoulder Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27443 CPT Revision Of Knee Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24546 CPT Optx Hum Fx W/ntrcndylr Xtn 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
22551 CPT Arthrd Ant Ntrbdy Cervical 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27446 CPT Revision Of Knee Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24575 CPT Optx Humeral Epcndylr Fx 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24498 CPT Proph Tx W/wo Mthylmthcrylt 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27415 CPT Osteochondral Knee Allograft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24515 CPT Optx Humrl Shft Fx Plate/scr 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24430 CPT Rpr Non/mal Humerus Wo Graft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27356 CPT Remove Femur Lesion/graft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24435 CPT Rpr Non/mal Hum With Agrft 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24516 CPT Tx Humrl Shaft Fx Imed Implt 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24410 CPT Mlt Osteot Rlgnm Imed Rd Hum 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27428 CPT Reconstruction Knee 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27130 CPT Total Hip Arthroplasty 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24370 CPT Revise Reconst Elbow Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24365 CPT Reconstruct Head Of Radius 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
23491 CPT Reinforce Shoulder Bones 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25444 CPT Arthrp W/prostc Lunate 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24366 CPT Reconstruct Head Of Radius 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24346 CPT Reconstruct Elbow Med Ligmnt 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
25441 CPT Arthrp W/prostc Dstl Rds 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
29889 CPT Arthrs Aid Pcl Rpr/agmntj 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28737 CPT Revision Of Foot Bones 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
29856 CPT Tibial Arthroscopy/surgery 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
29907 CPT Subtalar Arthro W/fusion 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28715 CPT Arthrodesis Triple 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28725 CPT Arthrodesis Subtalar 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28420 CPT Optx Calcaneal Fx W/bone Grf 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28320 CPT Repair Of Foot Bones 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
24362 CPT Reconstruct Elbow Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
29867 CPT Allgrft Implnt Knee W/scope 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28730 CPT Fusion Of Foot Bones 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
22554 CPT Arthrd Ant Ntrbd Min Dsc Crv 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27870 CPT Fusion Of Ankle Joint Open 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27871 CPT Fusion Of Tibiofibular Joint 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27827 CPT Treat Lower Leg Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27429 CPT Reconstruction Knee 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
27828 CPT Treat Lower Leg Fracture 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28297 CPT Cor Hlx Vlgs Jt Arthrd 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
28735 CPT Fusion Of Foot Bones 1 1 — — $13,510.16 $13,510.16 $13,510.16 2026-03-04
1603 APR_DRG Major Cardiothoracic Repair Of Heart Anomaly 2 2 — — $13,494.38 $13,494.38 $13,494.38 2026-03-04
2604 APR_DRG Major Pancreas, Liver And Shunt Procedures 2 2 — — $13,483.70 $13,483.70 $13,483.70 2026-03-04
1653 APR_DRG Coronary Bypass With Ami Or Complex Principal Diagnosis 2 2 — — $13,475.26 $13,475.26 $13,475.26 2026-03-04
894 APR_DRG Major Cranial Or Facial Bone Procedures 2 2 — — $13,160.89 $13,160.89 $13,160.89 2026-03-04
2204 APR_DRG Major Stomach, Esophageal And Duodenal Procedures 2 2 — — $13,106.51 $13,106.51 $13,106.51 2026-03-04
64575 CPT Opn Impltj Nea Perph Nerve 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
64553 CPT Implant Neuroelectrodes 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
64569 CPT Revise/repl Vagus N Eltrd 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
63664 CPT Revise Spine Eltrd Plate 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
64583 CPT Rev/rplct Hpglsl Nstm Ary Pg 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
61888 CPT Revise/remove Neuroreceiver 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
43647 CPT Lap Impl Electrode Antrum 1 1 — — $13,093.83 $13,093.83 $13,093.83 2026-03-04
7404 APR_DRG Mental Illness Diagnosis With O.r. Procedure 2 2 — — $13,073.98 $13,073.98 $13,073.98 2026-03-04
4014 APR_DRG Adrenal Procedures 2 2 — — $13,005.20 $13,005.20 $13,005.20 2026-03-04
6904 APR_DRG Acute Leukemia 2 2 — — $12,943.12 $12,943.12 $12,943.12 2026-03-04
1204 APR_DRG Major Respiratory And Chest Procedures 2 2 — — $12,918.29 $12,918.29 $12,918.29 2026-03-04
9504 APR_DRG Extensive O.r. Procedure Unrelated To Principal Diagnosis 2 2 — — $12,847.27 $12,847.27 $12,847.27 2026-03-04
J3380 HCPCS Vedolizumab For IV Solution 300 Mg 44 15 $17,323.20 $13,858.56 20% off $22.69 $16,387.75 $12,834.76 2026-03-04
1622 APR_DRG Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis 2 2 — — $12,712.68 $12,712.68 $12,712.68 2026-03-04
4402 APR_DRG Kidney Transplant 2 2 — — $12,686.11 $12,686.11 $12,686.11 2026-03-04
204 APR_DRG Open Craniotomy For Trauma 2 2 — — $12,628.75 $12,628.75 $12,628.75 2026-03-04
41 APR_DRG Tracheostomy With Mv >96 Hours With Extensive Procedure 2 2 — — $12,504.35 $12,504.35 $12,504.35 2026-03-04
3124 APR_DRG Skin Graft For Musculoskeletal And Connective Tissue Diagnoses 2 2 — — $12,482.74 $12,482.74 $12,482.74 2026-03-04
4414 APR_DRG Major Bladder Procedures 2 2 — — $12,476.79 $12,476.79 $12,476.79 2026-03-04
1782 APR_DRG External Heart Assist Devices 2 2 — — $12,430.60 $12,430.60 $12,430.60 2026-03-04
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